Midwest Surgical Hospital
Midwest Surgical Hospital in Omaha, NE publishes cash prices for 234 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 144 of 233 procedures and above it for 88. By typical cash price it ranks #4 of 52 Nebraska hospitals and #3 of 14 hospitals in the Omaha, NE area, cheapest first. Click a procedure to compare it with other hospitals nearby.
7915 Farnam Dr,Omaha,NE,68114 Collected Sep 27, 2026 Source price file (402) 399-1900
Acute care hospital No emergency department CCN 280131 · CMS hospital register NPI 1013122571
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT ABD WO CNTRST FLWD CNTRST | $350.00 | $1,598.00 | $181.25–$1,097.00 | 89% below | 78% |
| Abdominal X-ray, 2 views CPT 74019 X-RAY OF ABDOMEN; 2 VIEWS | $150.00 | $276.00 | $108.03–$220.38 | 58% below | 46% |
| Abdominal X-ray, 2 views CPT 74019 RADEX ABDOMEN 2 VIEWS | $150.00 | $290.00 | $108.03–$220.38 | 58% below | 48% |
| Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE | $125.00 | $569.00 | $89.93–$183.46 | 62% below | 78% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREMITY W/O DYE | $350.00 | $922.00 | $108.03–$1,097.00 | 83% below | 62% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREMITY W/O DYE | $350.00 | $922.00 | $108.03–$1,097.00 | 83% below | 62% |
| CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD | $350.00 | $1,968.00 | $181.25–$1,097.00 | 88% below | 82% |
| CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK | $400.00 | $1,968.00 | $181.25–$1,097.00 | 86% below | 80% |
| CT angiography (CTA) of the neck CPT 70498 CT SCAN OF BLOOD VESSELS OF NECK WITH CONTRAST | $400.00 | $1,874.00 | $181.25–$1,097.00 | 86% below | 79% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST | $400.00 | $1,593.00 | $181.25–$1,097.00 | 88% below | 75% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST | $500.00 | $599.00 | $246.55–$1,097.00 | 87% below | 17% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT SCAN OF ABDOMEN AND PELVIS WITHOUT CONTRAST | $500.00 | $570.00 | $246.55–$1,097.00 | 87% below | 12% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST | $550.00 | $1,136.00 | $360.49–$1,097.00 | 87% below | 52% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST | $550.00 | $1,081.00 | $360.49–$1,097.00 | 87% below | 49% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR | $550.00 | $1,495.00 | $360.49–$1,097.00 | 89% below | 63% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT SCAN OF ABDOMEN AND PELVIS BEFORE AND AFTER CONTRAST | $550.00 | $1,423.00 | $360.49–$1,097.00 | 89% below | 61% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST | $350.00 | $1,272.00 | $181.25–$1,097.00 | 87% below | 72% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST | $350.00 | $1,053.00 | $108.03–$1,097.00 | 84% below | 67% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN OF FACE WITHOUT CONTRAST | $350.00 | $836.00 | $108.03–$1,097.00 | 81% below | 58% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE | $350.00 | $878.00 | $108.03–$1,097.00 | 81% below | 60% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE | $350.00 | $927.00 | $108.03–$1,097.00 | 82% below | 62% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN HEAD OR BRAIN WITHOUT CONTRAST | $350.00 | $836.00 | $108.03–$1,097.00 | 82% below | 58% |
| CT scan of the head with contrast CPT 70460 CT SCAN HEAD OR BRAIN WITH CONTRAST | $350.00 | $1,002.00 | $181.25–$1,097.00 | 83% below | 65% |
| CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE | $350.00 | $1,053.00 | $181.25–$1,097.00 | 83% below | 67% |
| CT scan of the head without and with contrast CPT 70470 CT SCAN OF HEAD OR BRAIN BEFORE AND AFTER CONTRAST | $350.00 | $1,248.00 | $181.25–$1,097.00 | 86% below | 72% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE | $350.00 | $1,311.00 | $181.25–$1,097.00 | 86% below | 73% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE | $350.00 | $1,098.00 | $108.03–$1,097.00 | 85% below | 68% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN OF LOWER SPINE WITHOUT CONTRAST | $350.00 | $1,045.00 | $108.03–$1,097.00 | 85% below | 67% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE | $350.00 | $1,098.00 | $108.03–$1,097.00 | 85% below | 68% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN OF UPPER SPINE WITHOUT CONTRAST | $350.00 | $1,045.00 | $108.03–$1,097.00 | 85% below | 67% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE | $350.00 | $1,272.00 | $181.25–$1,097.00 | 86% below | 72% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN OF PELVIS WITH CONTRAST | $350.00 | $1,211.00 | $181.25–$1,097.00 | 86% below | 71% |
| Chest CT scan without and with contrast CPT 71270 CT THORAX DX C-/C+ | $350.00 | $1,636.00 | $181.25–$1,097.00 | 87% below | 79% |
| Chest X-ray, 2 views CPT 71046 X-RAY OF CHEST; 2 VIEWS | $305.25 | $407.00 | $89.93–$183.46 | 1% above | 25% |
| Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS | $321.00 | $428.00 | $89.93–$183.46 | 6% above | 25% |
| Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW | $321.00 | $428.00 | $89.93–$183.46 | 30% above | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C- | $350.00 | $1,098.00 | $108.03–$1,097.00 | 84% below | 68% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN OF CHEST WITHOUT CONTRAST | $350.00 | $1,045.00 | $108.03–$1,097.00 | 84% below | 67% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN OF CHEST WITH CONTRAST | $350.00 | $1,517.00 | $181.25–$1,097.00 | 86% below | 77% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX C+ | $350.00 | $1,593.00 | $181.25–$1,097.00 | 86% below | 78% |
| Elbow X-ray, 2 views one side CPT 73070 X-RAY EXAM OF ELBOW | $125.00 | $185.00 | $89.93–$183.46 | 53% below | 32% |
| Elbow X-ray, 2 views one side CPT 73070 X-RAY EXAM OF ELBOW | $125.00 | $185.00 | $89.93–$183.46 | 53% below | 32% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY EXAM OF ELBOW | $125.00 | $185.00 | $89.93–$183.46 | 62% below | 32% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY EXAM OF ELBOW | $125.00 | $185.00 | $89.93–$183.46 | 62% below | 32% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE | $350.00 | $1,043.00 | $108.03–$1,097.00 | 84% below | 66% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY EXAM OF FOREARM | $125.00 | $185.00 | $89.93–$183.46 | 54% below | 32% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY EXAM OF FOREARM | $125.00 | $185.00 | $89.93–$183.46 | 54% below | 32% |
| Hand X-ray, 2 views one side CPT 73120 X-RAY EXAM OF HAND | $150.00 | $290.00 | $108.03–$220.38 | 43% below | 48% |
| Hand X-ray, 2 views one side CPT 73120 X-RAY EXAM OF HAND | $150.00 | $290.00 | $108.03–$220.38 | 43% below | 48% |
| Knee X-ray, 3 views one side CPT 73562 X-RAY EXAM OF KNEE 3 | $125.00 | $290.00 | $89.93–$183.46 | 66% below | 57% |
| Knee X-ray, 3 views one side CPT 73562 X-RAY EXAM OF KNEE 3 | $125.00 | $290.00 | $89.93–$183.46 | 66% below | 57% |
| Knee X-ray, complete, 4 or more views CPT 73564 X-RAY EXAM KNEE 4 OR MORE | $138.75 | $185.00 | $108.03–$220.38 | 64% below | 25% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST | $350.00 | $1,575.00 | $108.03–$1,097.00 | 84% below | 78% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREMITY W/O DYE | $350.00 | $1,654.00 | $108.03–$1,097.00 | 84% below | 79% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST | $350.00 | $1,575.00 | $108.03–$1,097.00 | 84% below | 78% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREMITY W/O DYE | $350.00 | $1,654.00 | $108.03–$1,097.00 | 84% below | 79% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-RAY EXAM OF LOWER LEG | $125.00 | $569.00 | $89.93–$183.46 | 59% below | 78% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRI SCAN OF BLOOD VESSELS OF HEAD WITHOUT CONTRAST | $500.00 | $1,885.00 | $246.55–$1,831.00 | 84% below | 73% |
| MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE | $500.00 | $1,980.00 | $246.55–$1,831.00 | 84% below | 75% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JNT OF LWR EXTRE W/O DYE | $500.00 | $1,980.00 | $246.55–$1,831.00 | 80% below | 75% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST | $500.00 | $1,885.00 | $246.55–$1,831.00 | 80% below | 73% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JNT OF LWR EXTRE W/O DYE | $500.00 | $1,980.00 | $246.55–$1,831.00 | 80% below | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE | $600.00 | $1,980.00 | $360.49–$1,831.00 | 82% below | 70% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE | $600.00 | $1,980.00 | $360.49–$1,831.00 | 82% below | 70% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST | $600.00 | $1,884.00 | $360.49–$1,831.00 | 82% below | 68% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE | $500.00 | $1,823.00 | $246.55–$1,831.00 | 85% below | 73% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST | $600.00 | $3,641.00 | $360.49–$1,831.00 | 85% below | 84% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE | $600.00 | $3,824.00 | $360.49–$1,831.00 | 85% below | 84% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE | $500.00 | $1,880.00 | $246.55–$1,831.00 | 84% below | 73% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST | $500.00 | $1,790.00 | $246.55–$1,831.00 | 84% below | 72% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE | $600.00 | $3,756.00 | $360.49–$1,831.00 | 85% below | 84% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SCAN OF LOWER SPINAL CANAL BEFORE AND AFTER CONTRAST | $600.00 | $3,577.00 | $360.49–$1,831.00 | 85% below | 83% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SCAN OF MIDDLE SPINAL CANAL WITHOUT CONTRAST | $500.00 | $2,073.00 | $246.55–$1,831.00 | 85% below | 76% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI CHEST SPINE W/O DYE | $500.00 | $2,177.00 | $246.55–$1,831.00 | 85% below | 77% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SCAN OF UPPER SPINAL CANAL BEFORE AND AFTER CONTRAST | $600.00 | $3,577.00 | $360.49–$1,831.00 | 85% below | 83% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI NECK SPINE W/O & W/DYE | $600.00 | $3,756.00 | $360.49–$1,831.00 | 85% below | 84% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SCAN OF UPPER SPINAL CANAL WITHOUT CONTRAST | $500.00 | $1,790.00 | $246.55–$1,831.00 | 85% below | 72% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE | $500.00 | $1,880.00 | $246.55–$1,831.00 | 85% below | 73% |
| MRI of the pelvis without and with contrast CPT 72197 MRI SCAN OF PELVIS BEFORE AND AFTER CONTRAST | $600.00 | $3,577.00 | $360.49–$1,831.00 | 83% below | 83% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE | $600.00 | $3,756.00 | $360.49–$1,831.00 | 83% below | 84% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI SCAN OF PELVIS WITHOUT CONTRAST | $500.00 | $1,885.00 | $246.55–$1,831.00 | 83% below | 73% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE | $500.00 | $1,980.00 | $246.55–$1,831.00 | 83% below | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI JOINT UPR EXTREM W/O DYE | $500.00 | $1,980.00 | $246.55–$1,831.00 | 80% below | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST | $500.00 | $1,885.00 | $246.55–$1,831.00 | 80% below | 73% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST | $500.00 | $1,885.00 | $246.55–$1,831.00 | 80% below | 73% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI JOINT UPR EXTREM W/O DYE | $500.00 | $1,980.00 | $246.55–$1,831.00 | 80% below | 75% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY OF UPPER SPINE; 4-5 VIEWS | $150.00 | $276.00 | $108.03–$220.38 | 67% below | 46% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS | $150.00 | $290.00 | $108.03–$220.38 | 67% below | 48% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/DYE | $350.00 | $1,053.00 | $181.25–$1,097.00 | 85% below | 67% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SCAN OF SOFT TISSUE OF NECK WITH CONTRAST | $350.00 | $1,002.00 | $181.25–$1,097.00 | 85% below | 65% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O DYE | $350.00 | $894.00 | $108.03–$1,097.00 | 82% below | 61% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SCAN OF SOFT TISSUE OF NECK WITHOUT CONTRAST | $350.00 | $851.00 | $108.03–$1,097.00 | 82% below | 59% |
| Neck soft tissue X-ray CPT 70360 X-RAY EXAM OF NECK | $217.50 | $290.00 | $89.93–$183.46 | 25% below | 25% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O DYE | $350.00 | $1,098.00 | $108.03–$1,097.00 | 84% below | 68% |
| Pelvic CT scan without contrast CPT 72192 CT SCAN OF PELVIS WITHOUT CONTRAST | $350.00 | $1,045.00 | $108.03–$1,097.00 | 84% below | 67% |
| Rib X-ray, one side, 2 views one side CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS | $125.00 | $185.00 | $89.93–$183.46 | 57% below | 32% |
| Rib X-ray, one side, 2 views one side CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS | $125.00 | $185.00 | $89.93–$183.46 | 57% below | 32% |
| Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY EXAM OF SINUSES | $125.00 | $290.00 | $89.93–$183.46 | 61% below | 57% |
| Skull X-ray, fewer than 4 views CPT 70250 X-RAY EXAM OF SKULL | $150.00 | $290.00 | $108.03–$220.38 | 46% below | 48% |
| Skull X-ray, fewer than 4 views CPT 70250 X-RAY OF SKULL; 1-3 VIEWS | $150.00 | $276.00 | $108.03–$220.38 | 46% below | 46% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY EXAM OF FEMUR 2/> | $125.00 | $428.00 | $89.93–$183.46 | 60% below | 71% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY EXAM OF FEMUR 2/> | $125.00 | $428.00 | $89.93–$183.46 | 60% below | 71% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SCAN OF MIDDLE SPINE WITHOUT CONTRAST | $350.00 | $1,045.00 | $108.03–$1,097.00 | 85% below | 67% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT CHEST SPINE W/O DYE | $350.00 | $1,098.00 | $108.03–$1,097.00 | 85% below | 68% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 X-RAY EXAM OF HUMERUS | $125.00 | $185.00 | $89.93–$183.46 | 59% below | 32% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 X-RAY EXAM OF HUMERUS | $125.00 | $185.00 | $89.93–$183.46 | 59% below | 32% |
| Wrist X-ray, 2 views one side CPT 73100 X-RAY EXAM OF WRIST | $125.00 | $185.00 | $89.93–$183.46 | 47% below | 32% |
| Wrist X-ray, 2 views one side CPT 73100 X-RAY EXAM OF WRIST | $125.00 | $185.00 | $89.93–$183.46 | 47% below | 32% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY EXAM OF WRIST | $125.00 | $185.00 | $89.93–$183.46 | 62% below | 32% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY EXAM OF WRIST | $125.00 | $185.00 | $89.93–$183.46 | 62% below | 32% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY OF HIP; 2-3 VIEWS | $417.75 | $557.00 | $89.93–$183.46 | 29% above | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS | $438.75 | $585.00 | $89.93–$183.46 | 36% above | 25% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY OF ABDOMEN; 1 VIEW | $125.00 | $213.00 | $89.93–$183.46 | 55% below | 41% |
| X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW | $125.00 | $224.00 | $89.93–$183.46 | 55% below | 44% |
| X-ray of the ankle, 2 views one side CPT 73600 X-RAY EXAM OF ANKLE | $125.00 | $290.00 | $89.93–$183.46 | 52% below | 57% |
| X-ray of the ankle, 2 views one side CPT 73600 X-RAY EXAM OF ANKLE | $125.00 | $290.00 | $89.93–$183.46 | 52% below | 57% |
| X-ray of the foot, 2 views one side CPT 73620 X-RAY EXAM OF FOOT | $125.00 | $185.00 | $89.93–$183.46 | 48% below | 32% |
| X-ray of the foot, 2 views one side CPT 73620 X-RAY EXAM OF FOOT | $125.00 | $185.00 | $89.93–$183.46 | 48% below | 32% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY EXAM OF FOOT | $125.00 | $209.00 | $89.93–$183.46 | 63% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY EXAM OF FOOT | $125.00 | $209.00 | $89.93–$183.46 | 63% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 X-RAY EXAM OF HAND | $125.00 | $185.00 | $89.93–$183.46 | 63% below | 32% |
| X-ray of the hand, 3 or more views one side CPT 73130 X-RAY EXAM OF HAND | $125.00 | $185.00 | $89.93–$183.46 | 63% below | 32% |
| X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2 | $125.00 | $569.00 | $89.93–$183.46 | 62% below | 78% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS | $150.00 | $290.00 | $108.03–$220.38 | 65% below | 48% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY OF LOWER AND SACRAL SPINE; 2-3 VIEWS | $150.00 | $276.00 | $108.03–$220.38 | 65% below | 46% |
| X-ray of the lower back, 4 or more views CPT 72110 X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS | $150.00 | $276.00 | $108.03–$220.38 | 70% below | 46% |
| X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS | $150.00 | $290.00 | $108.03–$220.38 | 70% below | 48% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS | $150.00 | $290.00 | $108.03–$220.38 | 55% below | 48% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY OF MIDDLE SPINE; 2 VIEWS | $150.00 | $276.00 | $108.03–$220.38 | 55% below | 46% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW | $125.00 | $290.00 | $89.93–$183.46 | 63% below | 57% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY OF UPPER SPINE; 2-3 VIEWS | $125.00 | $276.00 | $89.93–$183.46 | 63% below | 55% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS | $150.00 | $428.00 | $108.03–$220.38 | 49% below | 65% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY OF PELVIS; 1-2 VIEWS | $150.00 | $814.00 | $108.03–$220.38 | 49% below | 82% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY OF SACRUM AND TAILBONE; MINIMUM OF 2 VIEWS | $125.00 | $176.00 | $89.93–$183.46 | 60% below | 29% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE | $125.00 | $185.00 | $89.93–$183.46 | 60% below | 32% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT) | $24.00 | $32.00 | $5.30–$10.81 | 61% below | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT) | $24.00 | $32.00 | $5.18–$10.57 | 58% below | 25% |
| Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN | $26.25 | $35.00 | $4.95–$10.10 | 43% below | 25% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY ALKALINE PHOSPHATASE | $23.25 | $31.00 | $5.18–$10.57 | 56% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA | $28.50 | $38.00 | $5.22–$10.65 | 43% below | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM | $87.75 | $117.00 | $16.77–$34.21 | 7% below | 25% |
| Ammonia blood test CPT 82140 ASSAY OF AMMONIA | $54.75 | $73.00 | $14.57–$29.72 | 57% below | 25% |
| Amylase blood test CPT 82150 ASSAY OF AMYLASE | $38.25 | $51.00 | $6.48–$13.22 | 55% below | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE | $126.00 | $168.00 | $39.26–$80.09 | 43% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL CULTURE; ANY OTHER SOURCE EXCEPT URINE; BLOOD OR STOOL; AEROBIC | $53.25 | $71.00 | $8.62–$17.58 | 31% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHR SPECIMN AEROBIC | $56.25 | $75.00 | $8.62–$17.58 | 27% below | 25% |
| Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) | $43.50 | $58.00 | $8.46–$17.26 | 70% below | 25% |
| Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL TOTAL CA | $45.75 | $61.00 | $8.46–$17.26 | 68% below | 25% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL | $15.75 | $21.00 | $5.02–$10.24 | 74% below | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY EXAMINATION OF TISSUE USING A MICROSCOPE; INTERMEDIATE COMPLEXITY | $810.75 | $1,081.00 | $43.76–$109.83 | 310% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST | $852.00 | $1,136.00 | $43.76–$109.83 | 331% above | 25% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA | $54.75 | $73.00 | $10.32–$21.05 | 70% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE | $24.75 | $33.00 | $9.34–$19.05 | 11% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE | $26.25 | $35.00 | $9.34–$19.05 | 5% below | 25% |
| Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT | $14.25 | $19.00 | $3.93–$8.02 | 73% below | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY | $87.75 | $117.00 | $7.52–$15.34 | 28% below | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO | $27.75 | $37.00 | $3.97–$280.46 | 53% below | 25% |
| Blood urea nitrogen (BUN) test CPT 84520 ASSAY OF UREA NITROGEN | $15.75 | $21.00 | $3.95–$8.06 | 68% below | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $24.75 | $33.00 | $5.18–$10.57 | 76% below | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB | $120.75 | $161.00 | $51.31–$104.67 | 8% below | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 AMPLIFED DNA OR RNA PROBE DETECTION OF SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (COVID-19) ANTIGEN | $229.50 | $306.00 | $51.31–$104.67 | 74% above | 25% |
| Calcium blood test, total CPT 82310 ASSAY OF CALCIUM | $30.75 | $41.00 | $5.16–$10.53 | 47% below | 25% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT | $51.75 | $69.00 | $7.77–$15.85 | 44% below | 25% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC | $53.25 | $71.00 | $7.77–$15.85 | 42% below | 25% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST | $48.75 | $65.00 | $6.47–$13.20 | 34% below | 25% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED | $54.75 | $73.00 | $6.47–$13.20 | 26% below | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS | $43.50 | $58.00 | $10.56–$21.54 | 74% below | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL | $45.75 | $61.00 | $10.56–$21.54 | 72% below | 25% |
| Cortisol blood test, total CPT 82533 TOTAL CORTISOL | $42.75 | $57.00 | $16.30–$33.25 | 65% below | 25% |
| Creatine kinase (CK) blood test, total CPT 82550 ASSAY OF CK (CPK) | $47.25 | $63.00 | $6.51–$13.28 | 52% below | 25% |
| Creatinine blood test CPT 82565 ASSAY OF CREATININE | $24.75 | $33.00 | $5.12–$10.44 | 55% below | 25% |
| Creatinine blood test CPT 82565 BLOOD CREATININE LEVEL | $46.50 | $62.00 | $5.12–$10.44 | 15% below | 25% |
| D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT | $55.50 | $74.00 | $10.18–$20.77 | 63% below | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR | $81.00 | $108.00 | $62.14–$126.77 | 42% below | 25% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $24.00 | $32.00 | $7.01–$14.30 | 77% below | 25% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY | $22.50 | $30.00 | $9.72–$19.83 | 79% below | 25% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN (FACTOR 1) ACTIVITY MEASUREMENT | $52.50 | $70.00 | $9.72–$19.83 | 52% below | 25% |
| Free T3 thyroid hormone test CPT 84481 THYROID HORMONE; T3 MEASUREMENT; FREE | $151.50 | $202.00 | $16.94–$34.56 | 7% below | 25% |
| Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3) | $159.75 | $213.00 | $16.94–$34.56 | 2% below | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE | $44.25 | $59.00 | $9.02–$18.40 | 51% below | 25% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $44.25 | $59.00 | $52.46–$59.00 | 86% below | 25% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY | $30.00 | $40.00 | $13.71–$27.97 | 59% below | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1&-2 AB AG IA | $97.50 | $130.00 | $24.08–$49.12 | 18% above | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C | $59.25 | $79.00 | $9.71–$19.81 | 27% below | 25% |
| Hemoglobin blood test CPT 85018 BLOOD COUNT; HEMOGLOBIN | $20.25 | $27.00 | $2.37–$4.83 | 40% below | 25% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN | $21.75 | $29.00 | $2.37–$4.83 | 36% below | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY | $55.50 | $74.00 | $10.74–$21.91 | 39% below | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA | $60.75 | $81.00 | $10.33–$21.07 | 35% below | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST | $63.00 | $84.00 | $14.27–$29.11 | 31% below | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ | $340.50 | $454.00 | $42.84–$87.39 | 1% above | 25% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION; HIGH SENSITIVITY | $12.00 | $16.00 | $12.95–$26.42 | 87% below | 25% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS | $12.75 | $17.00 | $12.95–$26.42 | 87% below | 25% |
| Insulin blood test CPT 83525 ASSAY OF INSULIN | $45.00 | $60.00 | $11.43–$23.32 | 59% below | 25% |
| Iron blood test (serum iron) CPT 83540 IRON LEVEL | $27.75 | $37.00 | $6.47–$13.20 | 56% below | 25% |
| Iron blood test (serum iron) CPT 83540 ASSAY OF IRON | $29.25 | $39.00 | $6.47–$13.20 | 54% below | 25% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $27.00 | $36.00 | $8.74–$17.83 | 66% below | 25% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST | $28.50 | $38.00 | $8.74–$17.83 | 64% below | 25% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $26.25 | $35.00 | $8.68–$17.71 | 82% below | 25% |
| Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID | $42.75 | $57.00 | $11.57–$23.60 | 66% below | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE | $85.50 | $114.00 | $6.89–$14.06 | 14% below | 25% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $53.25 | $71.00 | $8.17–$16.67 | 60% below | 25% |
| Magnesium blood test CPT 83735 MAGNESIUM LEVEL | $97.50 | $130.00 | $6.70–$13.67 | 34% above | 25% |
| Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM | $102.75 | $137.00 | $6.70–$13.67 | 42% above | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN | $20.25 | $27.00 | $5.18–$10.57 | 69% below | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD | $39.75 | $53.00 | $6.01–$12.26 | 50% below | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL | $42.00 | $56.00 | $6.01–$12.26 | 47% below | 25% |
| Phosphorus (phosphate) blood test CPT 84100 ASSAY OF PHOSPHORUS | $23.25 | $31.00 | $4.74–$9.67 | 56% below | 25% |
| Potassium blood test CPT 84132 BLOOD POTASSIUM LEVEL | $23.25 | $31.00 | $4.76–$9.71 | 51% below | 25% |
| Potassium blood test CPT 84132 ASSAY OF SERUM POTASSIUM | $24.75 | $33.00 | $4.76–$9.71 | 48% below | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME | $24.00 | $32.00 | $4.29–$8.75 | 53% below | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $24.75 | $33.00 | $4.29–$8.75 | 52% below | 25% |
| Rh blood typing CPT 86901 BLOOD TYPING SEROLOGIC RH(D) | $35.25 | $47.00 | $3.97–$78.74 | 32% below | 25% |
| Sodium blood test CPT 84295 ASSAY OF SERUM SODIUM | $43.50 | $58.00 | $4.81–$9.81 | 18% below | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH) | $99.00 | $132.00 | $16.80–$34.27 | 12% below | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE | $104.25 | $139.00 | $16.80–$34.27 | 8% below | 25% |
| Total IgE blood test CPT 82785 ASSAY OF IGE | $28.50 | $38.00 | $16.46–$33.58 | 72% below | 25% |
| Total thyroxine (T4) blood test CPT 84436 THYROXINE (THYROID CHEMICAL); TOTAL | $28.50 | $38.00 | $6.87–$14.01 | 50% below | 25% |
| Total thyroxine (T4) blood test CPT 84436 ASSAY OF TOTAL THYROXINE | $30.00 | $40.00 | $6.87–$14.01 | 48% below | 25% |
| Total triiodothyronine (T3) blood test CPT 84480 ASSAY TRIIODOTHYRONINE (T3) | $76.50 | $102.00 | $14.18–$28.93 | 14% below | 25% |
| Troponin test, quantitative CPT 84484 ASSAY OF TROPONIN QUANT | $159.75 | $213.00 | $12.47–$25.44 | 16% below | 25% |
| Troponin test, quantitative CPT 84484 TROPONIN (PROTEIN) ANALYSIS; QUANTITATIVE | $292.50 | $390.00 | $12.47–$25.44 | 54% above | 25% |
| Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID | $24.00 | $32.00 | $4.52–$9.22 | 55% below | 25% |
| Urinalysis with microscope exam, automated CPT 81001 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED | $23.25 | $31.00 | $3.17–$6.47 | 60% below | 25% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE | $24.75 | $33.00 | $3.17–$6.47 | 57% below | 25% |
| Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST | $23.25 | $31.00 | $2.25–$4.59 | 32% below | 25% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE | $24.75 | $33.00 | $2.25–$4.59 | 27% below | 25% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT | $54.75 | $73.00 | $8.07–$16.46 | 24% below | 25% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST | $45.75 | $61.00 | $8.61–$17.56 | 29% below | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $65.25 | $87.00 | $29.60–$60.38 | 58% below | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST | $87.75 | $117.00 | $15.05–$30.70 | 22% below | 25% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL OF ADENOIDS | $3,268.50 | $4,358.00 | $3,425.88–$6,988.80 | 461% above | 25% |
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 PRIMARY REMOVAL OF ADENOIDS (YOUNGER THAN 12 YEARS) | $6,218.25 | $8,291.00 | $3,425.88–$6,988.80 | 967% above | 25% |
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 FUSION OF UPPER SPINE BONE WITH REMOVAL OF DISC AND RELEASE OF SPINAL CORD OR NERVE; 1 DISC | $27,025.50 | $36,034.00 | $9,696.14–$27,063.23 | 395% above | 25% |
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 ARTHRD ANT NTRBDY CERVICAL | $28,377.00 | $37,836.00 | $9,696.14–$27,063.23 | 420% above | 25% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 KNEE ARTHROSCOPY/SURGERY | $18,518.25 | $24,691.00 | $6,059.29–$15,295.70 | 394% above | 25% |
| Arthroscopic ACL reconstruction or repair of the knee one side CPT 29888 REPAIR OF ANTERIOR CRUCIATE LIGAMENT OF KNEE USING AN ENDOSCOPE | $17,636.25 | $23,515.00 | $6,059.29–$15,295.70 | 371% above | 25% |
| Arthroscopic ACL reconstruction or repair of the knee one side CPT 29888 REPAIR OF ANTERIOR CRUCIATE LIGAMENT OF KNEE USING AN ENDOSCOPE | $17,636.25 | $23,515.00 | $6,059.29–$15,295.70 | 371% above | 25% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE | $10,346.25 | $13,795.00 | $7,497.89–$15,295.70 | 209% above | 25% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 SHO ARTHRS SRG RT8TR CUF RPR | $10,863.75 | $14,485.00 | $7,497.89–$15,295.70 | 225% above | 25% |
| Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE | $10,346.25 | $13,795.00 | $7,497.89–$15,295.70 | 209% above | 25% |
| Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE | $10,346.25 | $13,795.00 | $7,497.89–$15,295.70 | 209% above | 25% |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 NSL/SINS NDSC SURG MAX SINS | $12,198.75 | $16,265.00 | $5,533.00–$14,876.74 | — | 25% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE | $1,410.00 | $1,880.00 | $254.88–$3,588.88 | 238% above | 25% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE | $1,410.00 | $1,880.00 | $254.88–$3,588.88 | 269% above | 25% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 COR HLX VLGS DSTL MTAR OSTEO | $6,596.25 | $8,795.00 | $3,380.98–$6,897.20 | 179% above | 25% |
| Bunion correction with removal of part of the big toe joint CPT 28292 COR HLX VLGS RSC PRX PHLX BS | $7,359.00 | $9,812.00 | $3,380.98–$6,897.20 | 287% above | 25% |
| Bunion correction with removal of part of the big toe joint one side CPT 28292 CORRECTION OF BUNION | $6,282.00 | $8,376.00 | $3,380.98–$6,897.20 | 231% above | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT | $1,238.25 | $1,651.00 | $682.96–$1,927.00 | 13% below | 25% |
| Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY | $4,389.00 | $5,852.00 | $2,017.76–$5,076.00 | 145% above | 25% |
| Carpal tunnel release, open surgery one side CPT 64721 RELEASE AND/OR RELOCATION OF HAND NERVE | $4,179.75 | $5,573.00 | $2,017.76–$5,076.00 | 133% above | 25% |
| Carpal tunnel release, open surgery one side CPT 64721 RELEASE AND/OR RELOCATION OF HAND NERVE | $4,179.75 | $5,573.00 | $2,017.76–$5,076.00 | 133% above | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DST RDL FX/EPHYS SEP WO | $1,376.25 | $1,835.00 | $254.88–$3,588.88 | 194% above | 25% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING | $7,758.00 | $10,344.00 | $1,603.27–$6,059.29 | 1222% above | 25% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear one side CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA | $4,925.25 | $6,567.00 | $1,603.27–$6,059.29 | 740% above | 25% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear one side CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA | $4,925.25 | $6,567.00 | $1,603.27–$6,059.29 | 740% above | 25% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING | $1,744.50 | $2,326.00 | $557.30–$6,059.29 | 321% above | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI | $421.50 | $562.00 | $60.96–$3,588.88 | 642% above | 25% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI | $1,597.50 | $2,130.00 | $60.96–$3,588.88 | 1779% above | 25% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 NSL/SINS NDSC W/TOT ETHMDCT | $6,119.25 | $8,159.00 | $5,533.00–$14,876.74 | 304% above | 25% |
| Endoscopic sinus surgery: full ethmoid sinus opening one side CPT 31255 REMOVAL OF NASAL SINUS USING AN ENDOSCOPE | $5,827.50 | $7,770.00 | $5,533.00–$14,876.74 | 285% above | 25% |
| Endoscopic sinus surgery: full ethmoid sinus opening one side CPT 31255 REMOVAL OF NASAL SINUS USING AN ENDOSCOPE | $5,827.50 | $7,770.00 | $5,533.00–$14,876.74 | 285% above | 25% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NSL/SINS NDSC FRNT TISS RMVL | $6,119.25 | $8,159.00 | $5,533.00–$14,876.74 | 195% above | 25% |
| Endoscopic sinus surgery: opening the frontal sinus one side CPT 31276 EXPLORATION OF NASAL SINUS USING AN ENDOSCOPE | $5,827.50 | $7,770.00 | $5,533.00–$14,876.74 | 181% above | 25% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 EXPLORATION MAXILLARY SINUS | $6,119.25 | $8,159.00 | $3,852.52–$7,859.14 | 444% above | 25% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus one side CPT 31256 INCISION OF NASAL SINUS USING AN ENDOSCOPE | $5,827.50 | $7,770.00 | $3,852.52–$7,859.14 | 418% above | 25% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus one side CPT 31256 INCISION OF NASAL SINUS USING AN ENDOSCOPE | $5,827.50 | $7,770.00 | $3,852.52–$7,859.14 | 418% above | 25% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 ENDOSCOPY MAXILLARY SINUS | $6,119.25 | $8,159.00 | $4,315.00–$14,876.74 | 304% above | 25% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue one side CPT 31267 REMOVAL OF NASAL SINUS TISSUE USING AN ENDOSCOPE | $5,827.50 | $7,770.00 | $4,315.00–$14,876.74 | 285% above | 25% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue one side CPT 31267 REMOVAL OF NASAL SINUS TISSUE USING AN ENDOSCOPE | $5,827.50 | $7,770.00 | $4,315.00–$14,876.74 | 285% above | 25% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE | $1,485.75 | $1,981.00 | $729.39–$4,137.00 | 35% above | 25% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC | $1,560.75 | $2,081.00 | $729.39–$4,137.00 | 42% above | 25% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV | $1,560.75 | $2,081.00 | $913.93–$4,137.00 | 5% above | 25% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL | $1,485.75 | $1,981.00 | $913.93–$4,137.00 | at median | 25% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL | $1,485.75 | $1,981.00 | $913.93–$4,137.00 | at median | 25% |
| Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE | $5,170.50 | $6,894.00 | $3,380.98–$6,897.20 | 256% above | 25% |
| Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 TOTAL HIP ARTHROPLASTY | $31,218.00 | $41,624.00 | $9,696.14–$27,063.23 | 468% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE | $2,643.00 | $3,524.00 | $207.32–$3,588.88 | 811% above | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT | $1,560.75 | $2,081.00 | $317.18–$3,588.88 | 684% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US | $1,560.75 | $2,081.00 | $317.18–$3,588.88 | 717% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT | $1,485.75 | $1,981.00 | $317.18–$3,588.88 | 677% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT | $1,485.75 | $1,981.00 | $317.18–$3,588.88 | 677% above | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DLVR IMPLANT | $471.00 | $628.00 | $137.48–$3,588.88 | 100% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT | $1,485.75 | $1,981.00 | $317.18–$3,588.88 | 606% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US | $1,560.75 | $2,081.00 | $317.18–$3,588.88 | 641% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US | $1,560.75 | $2,081.00 | $317.18–$3,588.88 | 758% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT | $1,485.75 | $1,981.00 | $317.18–$3,588.88 | 716% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT | $1,485.75 | $1,981.00 | $317.18–$3,588.88 | 716% above | 25% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 KNEE ARTHROSCOPY/SURGERY | $6,495.00 | $8,660.00 | $3,380.98–$6,897.20 | 197% above | 25% |
| Knee arthroscopy with meniscus repair (one side of the knee) one side CPT 29882 REPAIR OF INSIDE OR OUTSIDE KNEE JOINT CARTILAGE USING AN ENDOSCOPE | $6,185.25 | $8,247.00 | $3,380.98–$6,897.20 | 183% above | 25% |
| Knee arthroscopy with meniscus repair (one side of the knee) one side CPT 29882 REPAIR OF INSIDE OR OUTSIDE KNEE JOINT CARTILAGE USING AN ENDOSCOPE | $6,185.25 | $8,247.00 | $3,380.98–$6,897.20 | 183% above | 25% |
| Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY/SURGERY | $3,250.50 | $4,334.00 | $3,380.98–$6,897.20 | 14% below | 25% |
| Knee arthroscopy with meniscus trim one side CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE | $6,185.25 | $8,247.00 | $3,380.98–$6,897.20 | 63% above | 25% |
| Knee arthroscopy with meniscus trim one side CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE | $6,185.25 | $8,247.00 | $3,380.98–$6,897.20 | 63% above | 25% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 REMOVAL OF BOTH KNEE CARTILAGES USING AN ENDOSCOPE | $6,185.25 | $8,247.00 | $3,380.98–$6,897.20 | 155% above | 25% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY/SURGERY | $6,495.00 | $8,660.00 | $3,380.98–$6,897.20 | 167% above | 25% |
| Knee arthroscopy with removal of both torn meniscus parts one side CPT 29880 REMOVAL OF BOTH KNEE CARTILAGES USING AN ENDOSCOPE | $6,185.25 | $8,247.00 | $3,380.98–$6,897.20 | 155% above | 25% |
| Knee arthroscopy with removal of both torn meniscus parts one side CPT 29880 REMOVAL OF BOTH KNEE CARTILAGES USING AN ENDOSCOPE | $6,185.25 | $8,247.00 | $3,380.98–$6,897.20 | 155% above | 25% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 KNEE ARTHROSCOPY/SURGERY | $6,495.00 | $8,660.00 | $3,380.98–$6,897.20 | 238% above | 25% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) one side CPT 29877 REMOVAL OR SHAVING OF KNEE JOINT CARTILAGE USING AN ENDOSCOPE | $6,185.25 | $8,247.00 | $3,380.98–$6,897.20 | 222% above | 25% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) one side CPT 29877 REMOVAL OR SHAVING OF KNEE JOINT CARTILAGE USING AN ENDOSCOPE | $6,185.25 | $8,247.00 | $3,380.98–$6,897.20 | 222% above | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/< | $1,410.00 | $1,880.00 | $420.05–$3,588.88 | 224% above | 25% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE | $1,485.75 | $1,981.00 | $729.39–$4,137.00 | 10% above | 25% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC | $1,560.75 | $2,081.00 | $729.39–$4,137.00 | 15% above | 25% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC | $1,560.75 | $2,081.00 | $913.93–$4,137.00 | 110% above | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1 | $1,560.75 | $2,081.00 | $913.93–$4,137.00 | 6% above | 25% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL | $1,485.75 | $1,981.00 | $913.93–$4,137.00 | 1% above | 25% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL | $1,485.75 | $1,981.00 | $913.93–$4,137.00 | 1% above | 25% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LOW BACK DISK SURGERY | $11,678.25 | $15,571.00 | $7,497.89–$15,295.70 | 189% above | 25% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC | $22,236.00 | $29,648.00 | $7,497.89–$15,295.70 | 449% above | 25% |
| Lumbar discectomy or laminotomy to free a nerve root, one level one side CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC | $22,236.00 | $29,648.00 | $7,497.89–$15,295.70 | 449% above | 25% |
| Lumbar discectomy or laminotomy to free a nerve root, one level one side CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC | $22,236.00 | $29,648.00 | $7,497.89–$15,295.70 | 449% above | 25% |
| Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 ARTHRD CMBN 1NTRSPC LUMBAR | $14,161.50 | $18,882.00 | $9,696.14–$57,197.01 | 144% above | 25% |
| Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 FUSION OF SPINE IN LOWER BACK WITH PARTIAL REMOVAL OF SPINE BONE AND DISC | $26,967.75 | $35,957.00 | $9,696.14–$57,197.01 | 364% above | 25% |
| Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 FUSION OF LOWER SPINE BONE AND PARTIAL REMOVAL OF SPINE BONE OR DISC THROUGH BACK; 1 DISC | $26,967.75 | $35,957.00 | $9,696.14–$57,197.01 | 554% above | 25% |
| Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 ARTHRD PST TQ 1NTRSPC LUM | $28,316.25 | $37,755.00 | $9,696.14–$57,197.01 | 587% above | 25% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD AND/OR NERVES; 1 SEGMENT | $22,236.00 | $29,648.00 | $7,497.89–$15,295.70 | 446% above | 25% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 LAM FACETEC & FORAMOT LUMBAR | $23,348.25 | $31,131.00 | $7,497.89–$15,295.70 | 473% above | 25% |
| Lumbar spinal fusion (posterior), one level CPT 22612 ARTHRD PST TQ 1NTRSPC LUMBAR | $22,724.25 | $30,299.00 | $9,696.14–$36,960.31 | 297% above | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM< | $2,010.75 | $2,681.00 | $731.72–$3,588.88 | 570% above | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/< | $2,010.75 | $2,681.00 | $731.72–$4,518.60 | 481% above | 25% |
| Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE | $1,049.25 | $1,399.00 | $207.32–$3,588.88 | 331% above | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV | $2,445.75 | $3,261.00 | $317.18–$4,137.00 | 491% above | 25% |
| Partial knee replacement (one compartment) CPT 27446 REVISION OF KNEE JOINT | $19,755.00 | $26,340.00 | $7,510.39–$27,063.23 | 417% above | 25% |
| Partial knee replacement (one compartment) one side CPT 27446 REPLACEMENT OF KNEE JOINT ON SIDE OF KNEE | $18,813.75 | $25,085.00 | $7,510.39–$27,063.23 | 392% above | 25% |
| Partial knee replacement (one compartment) one side CPT 27446 REPLACEMENT OF KNEE JOINT ON SIDE OF KNEE | $18,813.75 | $25,085.00 | $7,510.39–$27,063.23 | 392% above | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED | $2,212.50 | $2,950.00 | $420.05–$3,588.88 | 547% above | 25% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT | $4,878.00 | $6,504.00 | $2,017.76–$5,076.00 | 120% above | 25% |
| Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT | $4,645.50 | $6,194.00 | $2,017.76–$5,076.00 | 110% above | 25% |
| Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT | $4,645.50 | $6,194.00 | $2,017.76–$5,076.00 | 110% above | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL | $2,643.00 | $3,524.00 | $420.05–$4,137.00 | 670% above | 25% |
| Removal of one lobe of the thyroid (lobectomy) CPT 60220 PARTIAL REMOVAL OF THYROID | $11,778.00 | $15,704.00 | $4,518.60–$12,795.00 | 357% above | 25% |
| Septoplasty to straighten the nasal septum CPT 30520 REPAIR OF NASAL SEPTUM | $2,655.75 | $3,541.00 | $3,425.88–$6,988.80 | 4% above | 25% |
| Septoplasty to straighten the nasal septum CPT 30520 RESHAPING OF NASAL CARTILAGE | $5,055.00 | $6,740.00 | $3,425.88–$6,988.80 | 99% above | 25% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST | $399.75 | $533.00 | $289.01–$1,301.00 | 100% above | 25% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT | $393.75 | $525.00 | $167.91–$1,301.00 | 140% above | 25% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 SHO ARTHRS SRG DSTL CLAVICLC | $6,255.75 | $8,341.00 | $3,380.98–$12,795.00 | 142% above | 25% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) one side CPT 29824 PARTIAL REMOVAL OF COLLAR BONE AT SHOULDER USING AN ENDOSCOPE | $2,982.00 | $3,976.00 | $3,380.98–$12,795.00 | 16% above | 25% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) one side CPT 29824 PARTIAL REMOVAL OF COLLAR BONE AT SHOULDER USING AN ENDOSCOPE | $2,982.00 | $3,976.00 | $3,380.98–$12,795.00 | 16% above | 25% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE | $5,174.25 | $6,899.00 | $133.24–$6,059.29 | 22% above | 25% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHO ARTHRS SRG DECOMPRESSION | $10,863.75 | $14,485.00 | $133.24–$6,059.29 | 157% above | 25% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE | $10,346.25 | $13,795.00 | $133.24–$6,059.29 | 145% above | 25% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE | $10,346.25 | $13,795.00 | $133.24–$6,059.29 | 145% above | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/< | $1,410.00 | $1,880.00 | $207.32–$3,588.88 | 578% above | 25% |
| Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15 | $1,579.50 | $2,106.00 | $207.32–$4,137.00 | 712% above | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR | $1,560.75 | $2,081.00 | $729.39–$3,588.88 | 287% above | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM | $1,410.00 | $1,880.00 | $207.32–$1,301.00 | 476% above | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/< | $1,049.25 | $1,399.00 | $207.32–$1,301.00 | 347% above | 25% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVAL OF TONSILS AND ADENOID GLANDS (12 YEARS OR OLDER) | $6,218.25 | $8,291.00 | $3,425.88–$7,510.39 | 849% above | 25% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS AND ADENOIDS | $6,529.50 | $8,706.00 | $3,425.88–$7,510.39 | 897% above | 25% |
| Tonsil and adenoid removal, child under 12 CPT 42820 REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS) | $6,218.25 | $8,291.00 | $4,315.00–$12,478.68 | 37% above | 25% |
| Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS AND ADENOIDS | $6,529.50 | $8,706.00 | $4,315.00–$12,478.68 | 44% above | 25% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS (12 YEARS OR OLDER) | $6,218.25 | $8,291.00 | $3,425.88–$6,988.80 | 203% above | 25% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS | $6,529.50 | $8,706.00 | $3,425.88–$6,988.80 | 218% above | 25% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS | $6,529.50 | $8,706.00 | $4,315.00–$12,478.68 | 1085% above | 25% |
| Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY | $31,218.00 | $41,624.00 | $9,696.14–$27,063.23 | 550% above | 25% |
| Total hip replacement one side CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS | $29,730.75 | $39,641.00 | $9,696.14–$27,063.23 | 519% above | 25% |
| Total hip replacement one side CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS | $29,730.75 | $39,641.00 | $9,696.14–$27,063.23 | 519% above | 25% |
| Total knee replacement CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE | $30,509.25 | $40,679.00 | $9,696.14–$27,063.23 | 501% above | 25% |
| Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY | $32,034.75 | $42,713.00 | $9,696.14–$27,063.23 | 531% above | 25% |
| Total knee replacement one side CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE | $30,509.25 | $40,679.00 | $9,696.14–$27,063.23 | 501% above | 25% |
| Total knee replacement one side CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE | $30,509.25 | $40,679.00 | $9,696.14–$27,063.23 | 501% above | 25% |
| Total shoulder replacement CPT 23472 RECONSTRUCT SHOULDER JOINT | $32,373.00 | $43,164.00 | $7,510.39–$36,960.31 | 484% above | 25% |
| Total shoulder replacement one side CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER | $30,831.00 | $41,108.00 | $7,510.39–$36,960.31 | 456% above | 25% |
| Total shoulder replacement one side CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER | $30,831.00 | $41,108.00 | $7,510.39–$36,960.31 | 456% above | 25% |
| Total thyroid removal (thyroidectomy) CPT 60240 REMOVAL OF THYROID | $11,778.00 | $15,704.00 | $6,246.88–$12,795.00 | 301% above | 25% |
| Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH | $3,567.00 | $4,756.00 | $1,661.55–$4,518.60 | 147% above | 25% |
| Trigger finger release surgery one side CPT 26055 INCISION OF TENDON COVERING OF FINGER | $3,396.75 | $4,529.00 | $1,661.55–$4,518.60 | 135% above | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL | $1,560.75 | $2,081.00 | $317.18–$3,588.88 | 832% above | 25% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14 | $1,143.75 | $1,525.00 | $207.32–$3,588.88 | 505% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/< | $1,579.50 | $2,106.00 | $420.05–$4,518.60 | 375% above | 25% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 OPTX DST RD XARTC FX/EPI SEP | $13,678.50 | $18,238.00 | $7,497.89–$15,295.70 | 576% above | 25% |
| Wrist fracture surgery (plate and screws), distal radius one side CPT 25607 TREATMENT OF BROKEN FOREARM BONE ON THUMB SIDE OF WRIST; ABOVE WRIST; WITH PLACEMENT OF STABILIZING DEVICE | $13,026.75 | $17,369.00 | $7,497.89–$15,295.70 | 544% above | 25% |
| Wrist fracture surgery (plate and screws), distal radius one side CPT 25607 TREATMENT OF BROKEN FOREARM BONE ON THUMB SIDE OF WRIST; ABOVE WRIST; WITH PLACEMENT OF STABILIZING DEVICE | $13,026.75 | $17,369.00 | $7,497.89–$15,295.70 | 544% above | 25% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT | $1,302.00 | $1,736.00 | $455.87–$3,588.88 | 77% above | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR | $1,614.75 | $2,153.00 | $853.54–$1,741.22 | 21% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING | $137.25 | $183.00 | $60.96–$124.36 | 46% below | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING | $144.75 | $193.00 | $60.96–$124.36 | 43% below | 25% |
| IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH | $1,560.75 | $2,081.00 | $36.56–$448.37 | 547% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM | $1,560.75 | $2,081.00 | $13.51–$151.76 | 1461% above | 25% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30 MIN | $282.75 | $377.00 | $67.18–$137.05 | 37% above | 25% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45 MIN | $358.50 | $478.00 | $110.22–$224.85 | 21% above | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN | $222.75 | $297.00 | $39.04–$79.64 | 80% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN | $222.75 | $297.00 | $29.38–$59.94 | 158% above | 25% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Fluad 2025-2026 Formula | $70.67 | $94.22 | $62.67–$63.30 | 7% below | 25% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 IIV ADJUVANT VACCINE IM | $82.50 | $110.00 | $62.67–$63.30 | 8% above | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Afluria 2025-2026 Formula PFS | $16.91 | $22.54 | $19.77–$19.97 | 43% below | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Afluria 2024-2025 Formula PFS | $33.14 | $44.19 | $19.77–$19.97 | 13% above | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluad 2024-2025 Formula | $139.94 | $186.58 | $19.77–$19.97 | 375% above | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM | $154.50 | $206.00 | $19.77–$19.97 | 425% above | 25% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PCV13 VACCINE IM | $56.25 | $75.00 | $75.00 | 83% below | 25% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM | $56.25 | $75.00 | $75.00 | 70% below | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM | $56.25 | $75.00 | $36.16–$36.52 | 21% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE | $53.25 | $71.00 | $15.71–$151.76 | 38% above | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN | $56.25 | $75.00 | $15.71–$151.76 | 45% above | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD | $56.25 | $75.00 | $11.87–$11.99 | 69% above | 25% |
Source file: https://apim.services.craneware.com/api-pricing-transparency/api/public/14677e342f2d86ddd5320d28b4b4eb86/charges/mrf