Hospital Spearfish, SD

Monument Health Lead-Deadwood Hospital

Listed in its price file as “Monument Health Network Inc”.

Monument Health Lead-Deadwood Hospital in Deadwood, SD publishes cash prices for 263 common procedures listed here, from its own machine-readable price file updated Sep 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the South Dakota median for 66 of 263 procedures and below it for 52. By typical cash price it ranks #12 of 20 South Dakota hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

61 Charles St Deadwood SD 57732 Collected Sep 27, 2026 Source price file (605) 717-6000

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 431320 · CMS hospital register

Scans and imaging

ProcedureCash price List priceInsurers payvs South DakotaOff list
Ankle X-ray, complete, 3 or more views CPT 73610 X-ray of ankle, minimum of 3 views $280.00 $350.00 $47.10–$350.00 3% below 20%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Ultrasound study of arm and leg arteries $512.80 $641.00 $185.89–$641.00 at median 20%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Single contrast X-ray of esophagus $875.20 $1,094.00 $116.94–$1,094.00 4% above 20%
Bone scan, whole body (nuclear medicine) CPT 78306 Nuclear medicine study of bone and/or joint whole body $2,284.80 $2,856.00 $387.64–$2,856.00 10% above 20%
Breast ultrasound, complete, one breast CPT 76641 Complete ultrasound scan of 1 breast $563.20 $704.00 $113.69–$704.00 at median 20%
Breast ultrasound, limited (one breast or one area) CPT 76642 Limited ultrasound scan of 1 breast $562.40 $703.00 $87.17–$703.00 at median 20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT scan of blood vessels of chest with contrast $2,736.00 $3,420.00 $991.80–$3,420.00 at median 20%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT scan of blood vessels and grafts of heart with contrast $3,602.40 $4,503.00 $1,305.87–$4,503.00 at median 20%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT scan of heart with evaluation of blood vessel calcium $261.60 $327.00 $94.83–$327.00 at median 20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT scan of abdomen and pelvis without contrast $3,567.20 $4,459.00 $1,293.11–$4,459.00 6% below 20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast $4,688.80 $5,861.00 $1,699.69–$5,861.00 at median 20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT scan of abdomen and pelvis before and after contrast $4,544.00 $5,680.00 $1,647.20–$5,680.00 9% below 20%
CT scan of the abdomen with contrast CPT 74160 CT scan of abdomen with contrast $3,043.20 $3,804.00 $1,103.16–$3,804.00 at median 20%
CT scan of the abdomen without contrast CPT 74150 CT scan of abdomen without contrast $1,937.60 $2,422.00 $702.38–$2,422.00 2% below 20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT scan of face without contrast $1,789.60 $2,237.00 $648.73–$2,237.00 8% below 20%
CT scan of the head or brain, no contrast dye CPT 70450 CT scan head or brain without contrast $1,854.40 $2,318.00 $672.22–$2,318.00 6% below 20%
CT scan of the head with contrast CPT 70460 CT scan head or brain with contrast $2,232.80 $2,791.00 $809.39–$2,791.00 3% below 20%
CT scan of the head without and with contrast CPT 70470 CT scan of head or brain before and after contrast $2,804.00 $3,505.00 $1,016.45–$3,505.00 at median 20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT scan of lower spine without contrast $1,947.20 $2,434.00 $705.86–$2,434.00 18% below 20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT scan of upper spine without contrast $1,991.20 $2,489.00 $721.81–$2,489.00 12% below 20%
CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast $2,208.80 $2,761.00 $800.69–$2,761.00 1% below 20%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Ultrasound of both sides of head and neck blood flow $1,251.20 $1,564.00 $453.56–$1,564.00 at median 20%
Chest X-ray, 2 views CPT 71046 X-ray of chest, 2 views $374.40 $468.00 $37.90–$468.00 at median 20%
Chest X-ray, single view CPT 71045 X-ray of chest, 1 view $349.60 $437.00 $28.15–$437.00 14% above 20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Complete ultrasound scan behind abdominal cavity $880.80 $1,101.00 $122.36–$1,101.00 2% below 20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA bone density measurement of hip, pelvis, spine $588.00 $735.00 $47.10–$735.00 7% above 20%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA bone density measurement of forearm, finger, hand, or foot $180.80 $226.00 $35.19–$226.00 at median 20%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, single or first fetus $583.20 $729.00 $130.48–$729.00 at median 20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT scan of chest without contrast $1,991.20 $2,489.00 $721.81–$2,489.00 4% below 20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT scan of chest with contrast $2,668.80 $3,336.00 $967.44–$3,336.00 at median 20%
Diagnostic mammogram, both breasts CPT 77066 Diagnostic mammography of both breasts $580.80 $726.00 $183.53–$726.00 at median 20%
Diagnostic mammogram, one breast CPT 77065 Diagnostic mammography of 1 breast $424.80 $531.00 $144.01–$531.00 at median 20%
Duplex ultrasound of the leg arteries, both legs CPT 93925 Ultrasound of leg arteries or artery grafts $1,251.20 $1,564.00 $453.56–$1,564.00 at median 20%
Duplex ultrasound of the leg veins, both legs CPT 93970 Ultrasound study of arm or leg veins with compression and maneuvers $1,251.20 $1,564.00 $453.56–$1,564.00 at median 20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Ultrasound of heart with color-depicted blood flow, rate, direction and valve function $2,399.20 $2,999.00 $869.71–$2,999.00 at median 20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Nuclear medicine study of liver and bile duct system $2,430.40 $3,038.00 $441.78–$3,038.00 21% above 20%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep study including heart rate, breathing, airflow, and effort $838.40 $1,048.00 $303.92–$1,048.00 at median 20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep study in sleep lab with continuous airway pressure (6 years or older) $4,762.40 $5,953.00 $1,726.37–$5,953.00 1% above 20%
Knee X-ray, 3 views CPT 73562 X-ray of knee, 3 views $304.00 $380.00 $51.97–$380.00 10% below 20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Limited ultrasound scan of abdomen $880.80 $1,101.00 $99.08–$1,101.00 3% above 20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Low dose CT scan of chest for lung cancer screening $177.60 $222.00 $64.38–$222.00 80% below 20%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint without contrast $3,169.60 $3,962.00 $1,148.98–$3,962.00 at median 20%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI scan of leg joint before and after contrast $4,168.00 $5,210.00 $1,510.90–$5,210.00 at median 20%
MRI of the abdomen without contrast CPT 74181 MRI scan of abdomen without contrast $3,580.80 $4,476.00 $1,298.04–$4,476.00 9% above 20%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI scan of abdomen before and after contrast $4,354.40 $5,443.00 $1,578.47–$5,443.00 at median 20%
MRI of the brain, no contrast dye CPT 70551 MRI scan of brain without contrast $3,210.40 $4,013.00 $1,163.77–$4,013.00 2% above 20%
MRI of the brain, with and without contrast dye CPT 70553 MRI scan of brain before and after contrast $4,320.00 $5,400.00 $1,566.00–$5,400.00 at median 20%
MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal without contrast $3,269.60 $4,087.00 $1,185.23–$4,087.00 at median 20%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI scan of lower spinal canal before and after contrast $4,410.40 $5,513.00 $1,598.77–$5,513.00 at median 20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI scan of middle spinal canal without contrast $3,269.60 $4,087.00 $1,185.23–$4,087.00 at median 20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI scan of upper spinal canal before and after contrast $4,293.60 $5,367.00 $1,556.43–$5,367.00 at median 20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI scan of upper spinal canal without contrast $3,269.60 $4,087.00 $1,185.23–$4,087.00 at median 20%
MRI of the pelvis without and with contrast CPT 72197 MRI scan of pelvis before and after contrast $4,309.60 $5,387.00 $1,562.23–$5,387.00 at median 20%
MRI of the pelvis, no contrast dye CPT 72195 MRI scan of pelvis without contrast $3,821.60 $4,777.00 $1,385.33–$4,777.00 6% above 20%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI scan of arm joint without contrast $3,590.40 $4,488.00 $1,301.52–$4,488.00 10% above 20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nuclear medicine studies of heart muscle at rest and with stress and SPECT $3,480.80 $4,351.00 $597.16–$4,351.00 19% below 20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Limited ultrasound scan of pelvis $405.60 $507.00 $36.27–$507.00 17% below 20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Complete ultrasound scan of pelvis $1,029.60 $1,287.00 $103.95–$1,287.00 3% above 20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus $488.80 $611.00 $127.23–$611.00 38% below 20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus $496.00 $620.00 $105.03–$620.00 31% below 20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Limited ultrasound of pregnant uterus $408.80 $511.00 $74.17–$511.00 24% below 20%
Screening mammogram, both breasts CPT 77067 Screening mammography $484.80 $606.00 $152.13–$606.00 at median 20%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-ray of shoulder, minimum of 2 views $342.40 $428.00 $41.69–$428.00 at median 20%
Sleep study in a lab (polysomnography) CPT 95810 Sleep study in sleep lab (6 years or older) $4,656.80 $5,821.00 $1,688.09–$5,821.00 7% above 20%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Ultrasound of heart with continuous electrocardiogram (ECG) during rest, exercise and/or drug induced stress with review and report $2,314.40 $2,893.00 $838.97–$2,893.00 at median 20%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Imaging for evaluation of swallowing function $783.20 $979.00 $168.38–$979.00 8% above 20%
Transvaginal pelvic ultrasound CPT 76830 Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina $580.80 $726.00 $120.19–$726.00 16% below 20%
Transvaginal ultrasound during pregnancy CPT 76817 Vaginal ultrasound of pregnant uterus $512.00 $640.00 $83.38–$640.00 17% below 20%
Ultrasound of the abdomen, complete CPT 76700 Complete ultrasound scan of abdomen $1,153.60 $1,442.00 $129.94–$1,442.00 2% above 20%
Ultrasound of the scrotum and testicles CPT 76870 Ultrasound scan of scrotum $984.80 $1,231.00 $116.94–$1,231.00 8% above 20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Ultrasound scan of head and neck soft tissue $821.60 $1,027.00 $139.68–$1,027.00 at median 20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Single contrast X-ray of upper digestive tract $983.20 $1,229.00 $142.93–$1,229.00 at median 20%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Ultrasound study of one arm or leg veins with compression and maneuvers $973.60 $1,217.00 $352.93–$1,217.00 at median 20%
Wrist X-ray, complete, 3 or more views CPT 73110 X-ray of wrist, minimum of 3 views $298.40 $373.00 $53.60–$373.00 at median 20%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-ray of hip, 2-3 views $256.00 $320.00 $59.55–$320.00 17% below 20%
X-ray of the abdomen, 1 view CPT 74018 X-ray of abdomen, 1 view $326.40 $408.00 $34.65–$408.00 at median 20%
X-ray of the ankle, 2 views CPT 73600 X-ray of ankle, 2 views $286.40 $358.00 $40.06–$358.00 at median 20%
X-ray of the finger(s), 2 or more views CPT 73140 X-ray of finger, minimum of 2 views $219.20 $274.00 $51.43–$274.00 7% below 20%
X-ray of the foot, 2 views CPT 73620 X-ray of foot, 2 views $281.60 $352.00 $34.11–$352.00 at median 20%
X-ray of the foot, complete, 3 or more views CPT 73630 X-ray of foot, minimum of 3 views $289.60 $362.00 $42.77–$362.00 6% below 20%
X-ray of the hand, 3 or more views CPT 73130 X-ray of hand, minimum of 3 views $300.00 $375.00 $47.10–$375.00 at median 20%
X-ray of the knee, 1 or 2 views CPT 73560 X-ray of knee, 1-2 views $270.40 $338.00 $42.77–$338.00 5% below 20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-ray of lower and sacral spine, 2-3 views $388.80 $486.00 $48.18–$486.00 9% below 20%
X-ray of the lower back, 4 or more views CPT 72110 X-ray of lower and sacral spine, minimum of 4 views $582.40 $728.00 $63.89–$728.00 at median 20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-ray of middle spine, 2 views $351.20 $439.00 $37.90–$439.00 3% below 20%
X-ray of the nasal bones, 3 or more views CPT 70160 X-ray of nose bones, minimum of 3 views $252.00 $315.00 $49.27–$315.00 20% below 20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-ray of upper spine, 2-3 views $354.40 $443.00 $47.64–$443.00 4% below 20%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-ray of pelvis, 1-2 views $316.80 $396.00 $31.94–$396.00 at median 20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-ray of sacrum and tailbone, minimum of 2 views $276.00 $345.00 $39.52–$345.00 9% below 20%

Surgery and procedures

ProcedureCash price List priceInsurers payvs South DakotaOff list
Balloon dilation of the maxillary sinus opening, one side CPT 31295 Dilation of nasal sinus using an endoscope $7,839.20 $9,799.00 $2,841.71–$9,799.00 at median 20%
Botox injections for chronic migraine CPT 64615 Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face $686.40 $858.00 $248.82–$858.00 at median 20%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Biopsy of breast and placement of locating device using X-ray with needle, first growth $2,172.00 $2,715.00 $787.35–$2,715.00 at median 20%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Closed treatment of broken outside lower leg bone at ankle $654.40 $818.00 $237.22–$818.00 5% above 20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed treatment of broken bone in forefoot or midfoot $573.60 $717.00 $207.93–$717.00 9% above 20%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Correction of bunion with alignment correction of midfoot bone toward toe area $4,262.40 $5,328.00 $1,545.12–$5,328.00 at median 20%
Bunion correction with removal of part of the big toe joint CPT 28292 Correction of bunion $4,262.40 $5,328.00 $1,545.12–$5,328.00 at median 20%
Cardiac catheterization with coronary angiogram one side CPT 93458 Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist $9,688.80 $12,111.00 $3,512.19–$12,111.00 at median 20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 External shock to heart to regulate heart beat $1,465.60 $1,832.00 $531.28–$1,832.00 at median 20%
Carpal tunnel release, open surgery CPT 64721 Release and/or relocation of hand nerve $4,684.80 $5,856.00 $1,698.24–$5,856.00 at median 20%
Catheter ablation for atrial fibrillation CPT 93656 Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction of upper chambers of heart) by pulmonary vein isolation $43,484.00 $54,355.00 $15,762.95–$54,355.00 at median 20%
Cervical biopsy CPT 57500 Biopsy of cervix or removal of growth $1,712.80 $2,141.00 $620.89–$2,141.00 10% above 20%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Removal of foreskin (older than 28 days) $1,764.00 $2,205.00 $639.45–$2,205.00 at median 20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Removal of foreskin using clamp or device $1,764.00 $2,205.00 $639.45–$2,205.00 at median 20%
Circumcision, surgical, older than a newborn CPT 54160 Removal of foreskin (28 days or younger) $686.40 $858.00 $248.82–$858.00 at median 20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed treatment of broken forearm (radius) bone at the wrist area on the thumb side of the wrist without manipulation $603.20 $754.00 $218.66–$754.00 1% above 20%
Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare $2,934.40 $3,668.00 $1,063.72–$3,668.00 1% above 20%
Colonoscopy with tissue sample CPT 45380 Biopsy of large bowel using a flexible endoscope $1,766.40 $2,208.00 $640.32–$2,208.00 at median 20%
Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using a flexible endoscope $2,144.00 $2,680.00 $777.20–$2,680.00 at median 20%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 Biopsy of cervix using an endoscope with loop electrode $6,132.00 $7,665.00 $2,222.85–$7,665.00 at median 20%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Biopsy and scraping of cervix using an endoscope $746.40 $933.00 $270.57–$933.00 at median 20%
Coronary stent placement, one artery CPT 92928 Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch $25,981.60 $32,477.00 $9,418.33–$32,477.00 at median 20%
Cystoscopy with ureteral stent placement CPT 52332 Insertion of stent in ureter using an endoscope $4,346.40 $5,433.00 $1,575.57–$5,433.00 at median 20%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Diagnostic exam of bladder and urethra using an endoscope $1,589.60 $1,987.00 $576.23–$1,987.00 at median 20%
D&C (dilation and curettage), not related to pregnancy CPT 58120 Dilation and scraping of uterus $7,586.40 $9,483.00 $2,750.07–$9,483.00 31% above 20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruction of precancer skin growth, 1 growth $456.00 $570.00 $165.30–$570.00 27% above 20%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Incision of eardrum with placement of eardrum tube under general anesthesia $3,700.80 $4,626.00 $1,341.54–$4,626.00 at median 20%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Incision of eardrum with insertion of eardrum tube under local or topical anesthesia $741.60 $927.00 $268.83–$927.00 at median 20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Removal of impacted ear wax by washing $167.20 $209.00 $60.61–$209.00 at median 20%
Earwax removal with instruments, one ear CPT 69210 Removal of impacted ear wax $250.40 $313.00 $90.77–$313.00 34% above 20%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Biopsy of lining of uterus $451.20 $564.00 $163.56–$564.00 3% above 20%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 Incision of nasal sinus using an endoscope $8,818.40 $11,023.00 $3,196.67–$11,023.00 at median 20%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Injection of substance into middle or upper spine canal using imaging guidance $1,913.60 $2,392.00 $693.68–$2,392.00 at median 20%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Injection of lower or sacral spine facet joint using imaging guidance, single level $1,984.00 $2,480.00 $719.20–$2,480.00 at median 20%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Diagnostic exam of lower portion of large bowel using a flexible endoscope $1,144.80 $1,431.00 $414.99–$1,431.00 at median 20%
Hammertoe correction surgery CPT 28285 Correction of toe joint deformity $4,262.40 $5,328.00 $1,545.12–$5,328.00 at median 20%
Hemorrhoid banding (rubber band ligation) CPT 46221 Removal of external hemorrhoids by rubber banding $1,183.20 $1,479.00 $428.91–$1,479.00 at median 20%
Hemorrhoidectomy (internal and external), one area CPT 46255 Removal of single external and internal hemorrhoid group $6,248.00 $7,810.00 $2,264.90–$7,810.00 at median 20%
Hysterectomy through an abdominal incision (total) CPT 58150 Removal of uterus and cervix through abdomen $4,720.00 $5,900.00 $1,711.00–$5,900.00 at median 20%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Insertion of tube and introduction of contrast for X-ray of uterus and fallopian tubes $458.40 $573.00 $166.17–$573.00 at median 20%
Hysteroscopy with endometrial ablation CPT 58563 Exam of uterus with destruction of lining of uterus using an endoscope $6,700.00 $8,375.00 $2,428.75–$8,375.00 at median 20%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Biopsy of lining of uterus and/or removal of polyp using an endoscope $3,663.20 $4,579.00 $1,327.91–$4,579.00 at median 20%
IUD insertion (the device itself billed separately) CPT 58300 Insertion of IUD for pregnancy prevention $379.20 $474.00 $137.46–$474.00 at median 20%
Incision and drainage of a simple or single skin abscess CPT 10060 Simple or single drainage of skin abscess $583.20 $729.00 $211.41–$729.00 28% above 20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection into tendon or ligament $844.80 $1,056.00 $306.24–$1,056.00 69% above 20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspiration and/or injection of fluid from large joint $688.00 $860.00 $249.40–$860.00 at median 20%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insertion of drug delivery implant into tissue $308.00 $385.00 $111.65–$385.00 at median 20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Aspiration and/or injection of fluid from medium joint $756.00 $945.00 $274.05–$945.00 56% above 20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Aspiration and/or injection of fluid from small joint $722.40 $903.00 $261.87–$903.00 51% above 20%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Removal of appendix using an endoscope $12,716.00 $15,895.00 $4,609.55–$15,895.00 at median 20%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 Strengthening of muscle between esophagus and stomach by wrapping part of stomach around esophagus using an endoscope $22,698.40 $28,373.00 $8,228.17–$28,373.00 at median 20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less $918.40 $1,148.00 $332.92–$1,148.00 33% above 20%
Lower-back epidural injection, with imaging guidance CPT 62323 Injection of substance into lower spine canal using imaging guidance $1,729.60 $2,162.00 $626.98–$2,162.00 at median 20%
Lower-back epidural injection, without imaging guidance CPT 62322 Injection of substance into lower spine canal $1,620.00 $2,025.00 $587.25–$2,025.00 10% above 20%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level $1,885.60 $2,357.00 $683.53–$2,357.00 at median 20%
Miscarriage treatment with D&C, first trimester CPT 59820 Treatment of miscarriage during first trimester $3,663.20 $4,579.00 $1,327.91–$4,579.00 at median 20%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks $1,239.20 $1,549.00 $449.21–$1,549.00 at median 20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Removal of noncancer skin growth of body, arms, or legs, 0.5 cm or less $1,546.40 $1,933.00 $560.57–$1,933.00 90% above 20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less $923.20 $1,154.00 $334.66–$1,154.00 at median 20%
Nail removal (partial or complete), one nail CPT 11730 Simple separation of fingernail or toenail from nail bed, first nail $473.60 $592.00 $171.68–$592.00 44% above 20%
Occipital nerve block (injection for headaches) CPT 64405 Injection of anesthetic agent and/or steroid into upper neck and back of head nerve $787.20 $984.00 $285.36–$984.00 at median 20%
Pacemaker implant (dual chamber) CPT 33208 Insertion of pacemaker and upper and lower heart chamber electrode $28,425.60 $35,532.00 $10,304.28–$35,532.00 at median 20%
Paracentesis with imaging guidance CPT 49083 Drainage of fluid from abdominal cavity using imaging guidance $2,312.80 $2,891.00 $838.39–$2,891.00 17% above 20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Permanent removal fingernail or toenail $908.80 $1,136.00 $329.44–$1,136.00 6% above 20%
Prostate biopsy CPT 55700 Biopsy of prostate gland $4,941.60 $6,177.00 $1,791.33–$6,177.00 at median 20%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint $4,508.80 $5,636.00 $1,634.44–$5,636.00 at median 20%
Removal of a breast lump, open surgery CPT 19120 Removal of growth and tissue of breast, duct, or nipple $4,396.80 $5,496.00 $1,593.84–$5,496.00 at median 20%
Removal of a foreign object under the skin, simple CPT 10120 Removal of foreign body from tissue, accessed beneath the skin, simple $872.00 $1,090.00 $316.10–$1,090.00 38% above 20%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK $1,212.80 $1,516.00 $155.69–$195.75 at median 20%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK $949.60 $1,187.00 $155.57–$195.75 at median 20%
Septoplasty to straighten the nasal septum CPT 30520 Reshaping of nasal cartilage $7,584.00 $9,480.00 $2,749.20–$9,480.00 at median 20%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Shock wave crushing of kidney stones $12,732.80 $15,916.00 $4,615.64–$15,916.00 at median 20%
Short arm cast (elbow to hand) CPT 29075 Application of elbow to finger cast $608.80 $761.00 $220.69–$761.00 98% above 20%
Short arm splint (forearm and hand) CPT 29125 Application of nonmoveable forearm to hand splint $312.00 $390.00 $113.10–$390.00 3% above 20%
Short leg cast (below the knee) CPT 29405 Application of short leg cast $667.20 $834.00 $241.86–$834.00 117% above 20%
Short leg splint (calf to foot) CPT 29515 Application of short leg splint from calf to foot $380.00 $475.00 $137.75–$475.00 36% above 20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less $473.60 $592.00 $171.68–$592.00 3% above 20%
Skin biopsy, punch, one lesion CPT 11104 Punch biopsy, first skin growth $466.40 $583.00 $169.07–$583.00 at median 20%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Removal of cancer skin growth of body, arms, or legs, 0.5 cm or less $923.20 $1,154.00 $334.66–$1,154.00 at median 20%
Skin tag removal, up to 15 tags CPT 11200 Removal of skin tag, 1-15 skin tags $433.60 $542.00 $157.18–$542.00 7% above 20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test $1,696.80 $2,121.00 $615.09–$2,121.00 67% above 20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm $521.60 $652.00 $189.08–$652.00 2% above 20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less $473.60 $592.00 $171.68–$592.00 at median 20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Biopsy of related skin growth, first growth $466.40 $583.00 $169.07–$583.00 38% above 20%
Thoracentesis with imaging guidance CPT 32555 Aspiration of fluid from chest cavity using imaging guidance $1,989.60 $2,487.00 $721.23–$2,487.00 3% above 20%
Trigger finger release surgery CPT 26055 Incision of tendon covering of finger $3,943.20 $4,929.00 $1,429.41–$4,929.00 1% above 20%
Trigger point injections, 1 or 2 muscles CPT 20552 Injection of trigger points, 1-2 muscles $721.60 $902.00 $261.58–$902.00 20% above 20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Biopsy of breast and placement of locating device using ultrasound, first growth $3,779.20 $4,724.00 $1,369.96–$4,724.00 at median 20%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm $2,534.40 $3,168.00 $918.72–$3,168.00 at median 20%
Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope $1,400.80 $1,751.00 $507.79–$1,751.00 at median 20%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Injection of esophagus, stomach, and/or upper small bowel using a flexible endoscope $1,165.60 $1,457.00 $117.60–$222.33 at median 20%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare $1,432.80 $1,791.00 $164.37–$313.19 at median 20%
Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope $1,198.40 $1,498.00 $434.42–$1,498.00 at median 20%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Removal of sperm duct $2,732.80 $3,416.00 $990.64–$3,416.00 at median 20%
Vein ablation, radiofrequency, first vein CPT 36475 Destruction of first incompetent vein of arm or leg using radiofrequency and imaging guidance $5,213.60 $6,517.00 $1,889.93–$6,517.00 at median 20%
Wart removal, up to 14 warts CPT 17110 Destruction of skin growth, 1-14 growths $470.40 $588.00 $170.52–$588.00 8% above 20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Removal of skin and tissue, 20.0 sq cm or less $1,073.60 $1,342.00 $389.18–$1,342.00 19% above 20%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs South DakotaOff list
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion of blood or blood products $966.40 $1,208.00 $350.32–$1,208.00 at median 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation treatment for airway obstruction or sputum production $260.00 $325.00 $94.25–$325.00 19% above 20%
Chemotherapy IV infusion, first hour CPT 96413 Administration of chemotherapy into vein, 1 hour or less $753.60 $942.00 $273.18–$942.00 at median 20%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 New patient complete exam of visual system $321.60 $402.00 $116.58–$402.00 at median 20%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Comprehensive hearing and speech recognition test $335.20 $419.00 $121.51–$419.00 at median 20%
Critical care, first 30 to 74 minutes CPT 99291 Critical care, first 30-74 minutes $920.00 $1,150.00 $188.87–$343.66 7% below 20%
Critical care, first 30 to 74 minutes CPT 99291 Critical care, first 30-74 minutes $2,462.40 $3,078.00 $892.62–$3,078.00 150% above 20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical care, first 30-74 minutes $2,462.40 $3,078.00 $892.62–$3,078.00 — 20%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Measurement of brain wave activity (EEG), awake and drowsy $1,009.60 $1,262.00 $365.98–$1,262.00 at median 20%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Routine electrocardiogram (ECG) using at least 12 leads with interpretation and report $40.80 $51.00 $14.79–$51.00 50% below 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing $241.60 $302.00 $87.58–$302.00 at median 20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency department visit for problem that may not require health care professional $60.00 $75.00 $10.36–$18.06 61% below 20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency department visit for problem that may not require health care professional $274.40 $343.00 $99.47–$343.00 76% above 20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency department visit for problem that may not require health care professional $274.40 $343.00 $99.47–$343.00 — 20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency department visit with straightforward medical decision making $176.00 $220.00 $37.98–$67.15 30% below 20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency department visit with straightforward medical decision making $437.60 $547.00 $158.63–$547.00 73% above 20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency department visit with straightforward medical decision making $437.60 $547.00 $158.63–$547.00 — 20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency department visit with low level of medical decision making $266.40 $333.00 $65.04–$113.42 25% below 20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency department visit with low level of medical decision making $701.60 $877.00 $254.33–$877.00 99% above 20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency department visit with low level of medical decision making $701.60 $877.00 $254.33–$877.00 — 20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency department visit with moderate level of medical decision making $397.60 $497.00 $110.48–$192.43 35% below 20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency department visit with moderate level of medical decision making $1,138.40 $1,423.00 $412.67–$1,423.00 87% above 20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency department visit with moderate level of medical decision making $1,138.40 $1,423.00 $412.67–$1,423.00 — 20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency department visit with high level of medical decision making $595.20 $744.00 $160.70–$278.76 30% below 20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency department visit with high level of medical decision making $1,622.40 $2,028.00 $588.12–$2,028.00 91% above 20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency department visit with high level of medical decision making $1,622.40 $2,028.00 $588.12–$2,028.00 — 20%
Exercise stress test, tracing only, the hospital charge CPT 93017 Exercise or drug-induced heart stress test with electrocardiogram (ECG) $1,412.80 $1,766.00 $512.14–$1,766.00 20% above 20%
Family therapy with the patient, 50 minutes CPT 90847 Family psychotherapy with patient, 50 minutes $307.20 $384.00 $111.36–$384.00 at median 20%
Family therapy without the patient, 50 minutes CPT 90846 Family psychotherapy without patient, 50 minutes $307.20 $384.00 $111.36–$384.00 at median 20%
Group psychotherapy session CPT 90853 Group psychotherapy $188.80 $236.00 $68.44–$236.00 at median 20%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 Electrocardiogram (ECG) 2-day continuous with review and report by health care professional $224.80 $281.00 $69.81–$120.20 at median 20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infusion into a vein for hydration, 31-60 minutes $432.00 $540.00 $156.60–$540.00 at median 20%
IV infusion of a medicine, first hour CPT 96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less $444.00 $555.00 $160.95–$555.00 at median 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection of drug or substance under skin or into muscle $100.00 $125.00 $36.25–$125.00 8% above 20%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric diagnostic evaluation $307.20 $384.00 $111.36–$384.00 at median 20%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nerve conduction, 7-8 studies $568.80 $711.00 $206.19–$711.00 at median 20%
Neuromuscular re-education, 15 minutes CPT 97112 Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes $22.40 $28.00 $8.12–$121.50 81% below 20%
New patient office visit, about 30 minutes CPT 99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more $288.80 $361.00 $133.17 30% above 20%
New patient office visit, about 45 minutes CPT 99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more $430.40 $538.00 $217.26 28% above 20%
New patient office visit, about 60 minutes CPT 99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more $569.60 $712.00 $295.13 51% above 20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more $188.80 $236.00 $39.53–$76.74 8% above 20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Therapy procedure for nutrition management, each 15 minutes $68.00 $85.00 $24.65–$85.00 22% above 20%
Occupational therapy evaluation, low complexity CPT 97165 Evaluation for occupational therapy, typically 30 minutes $262.40 $328.00 $95.12–$328.00 at median 20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Evaluation for physical therapy, typically 45 minutes $262.40 $328.00 $95.12–$328.00 12% below 20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Evaluation for physical therapy, typically 20 minutes $206.40 $258.00 $74.82–$258.00 8% below 20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Evaluation for physical therapy, typically 30 minutes $262.40 $328.00 $95.12–$328.00 at median 20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Therapy procedure using manual technique, each 15 minutes $98.40 $123.00 $35.67–$123.00 11% below 20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes $19.20 $24.00 $6.96–$121.50 84% below 20%
Preventive checkup, new patient aged 40–64 CPT 99386 Initial new patient preventive medicine evaluation (40-64 years) $263.20 $329.00 $186.78 at median 20%
Preventive checkup, new patient aged 65 or older CPT 99387 Initial new patient preventive medicine evaluation (65 years or older) $271.20 $339.00 $200.33 at median 20%
Preventive checkup, returning patient aged 18–39 CPT 99395 Established patient periodic preventive medicine examination (18-39 years) $1,088.00 $1,360.00 $394.40–$1,360.00 51% above 20%
Preventive checkup, returning patient aged 40–64 CPT 99396 Established patient periodic preventive medicine examination (40-64 years) $223.20 $279.00 $152.93 at median 20%
Preventive checkup, returning patient aged 65 or older CPT 99397 Established patient periodic preventive medicine examination (65 year old or older) $235.20 $294.00 $160.83 at median 20%
Psychiatric evaluation with medical services CPT 90792 Psychiatric diagnostic evaluation with medical services $307.20 $384.00 $111.36–$384.00 at median 20%
Psychotherapy for crisis, first 60 minutes CPT 90839 Psychotherapy for crisis, first hour $388.00 $485.00 $140.65–$485.00 at median 20%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 minutes $304.00 $380.00 $110.20–$380.00 at median 20%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 minutes $332.00 $415.00 $120.35–$415.00 at median 20%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 1 hour $368.00 $460.00 $133.40–$460.00 at median 20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking and tobacco use intermediate counseling, 3-10 minutes $69.60 $87.00 $25.23–$87.00 30% above 20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more $468.80 $586.00 $235.31 45% above 20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more $236.00 $295.00 $107.78 57% above 20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more $333.60 $417.00 $159.13 46% above 20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more $148.00 $185.00 $58.12 18% above 20%
Speech and language evaluation CPT 92523 Evaluation of speech sound production with evaluation of language comprehension and expression $423.20 $529.00 $121.50–$529.00 at median 20%
Speech therapy session, individual CPT 92507 Treatment of speech, language, voice, communication, and/or hearing processing disorder $200.80 $251.00 $72.79–$251.00 28% below 20%
Spirometry (breathing test) CPT 94010 Test to measure expiratory airflow and volume $318.40 $398.00 $115.42–$398.00 at median 20%
Spirometry before and after a bronchodilator CPT 94060 Test to measure expiratory airflow and volume changes before and after medication administration $579.20 $724.00 $209.96–$724.00 at median 20%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapy procedure using functional activities $91.20 $114.00 $33.06–$121.50 24% below 20%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 Exercise or drug-induced heart stress test with electrocardiogram (ECG) with supervision and review by physician $200.80 $251.00 $72.59–$124.15 at median 20%

Vaccines

ProcedureCash price List priceInsurers payvs South DakotaOff list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Influenza vaccine, inactivated $136.00 $170.00 $49.30–$170.00 101% above 20%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use $206.40 $258.00 $74.82–$258.00 at median 20%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella vaccine $198.40 $248.00 $71.92–$248.00 7% below 20%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza vaccine, trivalent, split virus, preservative-free, 0.5 mL dosage $16.80 $21.00 $6.09–$21.00 39% below 20%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent $304.80 $381.00 $110.49–$381.00 at median 20%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Hepatitis A and hepatitis B vaccine $146.40 $183.00 $53.07–$183.00 at median 20%
Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A vaccine adult dosage $96.00 $120.00 $34.80–$120.00 22% below 20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B vaccine, adult dosage (3 dose schedule) $82.40 $103.00 $29.87–$103.00 8% below 20%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles, mumps, and rubella vaccine $105.60 $132.00 $38.28–$132.00 at median 20%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine $180.00 $225.00 $65.25–$225.00 at median 20%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B $239.20 $299.00 $86.71–$299.00 at median 20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use $316.80 $396.00 $114.84–$396.00 at median 20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal vaccine, 23-valent $141.60 $177.00 $51.33–$177.00 at median 20%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Respiratory syncytial virus antibody, 0.5 mL dosage for injection into muscle $768.80 $961.00 $278.69–$961.00 at median 20%
Rabies vaccine, one dose CPT 90675 Rabies vaccine for injection into muscle $506.40 $633.00 $183.57–$633.00 1% below 20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Diphtheria and tetanus vaccine (7 years or older) $40.80 $51.00 $14.79–$51.00 45% below 20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older) $41.60 $52.00 $15.08–$52.00 51% below 20%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Typhoid vaccine for injection into muscle $136.00 $170.00 $49.30–$170.00 at median 20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration of vaccine $72.80 $91.00 $26.39–$91.00 12% above 20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Administration of vaccine, each additional vaccine $72.80 $91.00 $26.39–$91.00 at median 20%

Source file: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbRHLHDEADWOODSD&type=CDMWithoutLabel&fileType=CSV