Madison Medical Center
Madison Medical Center in Fredericktown, MO publishes cash prices for 227 common procedures listed here, from its own machine-readable price file updated Jan 5, 2025. Compared with other hospitals in the state, its outpatient cash prices are above the Missouri median for 176 of 225 procedures and below it for 47. By typical cash price it ranks #47 of 60 Missouri hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
611 W Main St, Fredericktown, MO 63645 Collected Sep 27, 2026 Source price file (573) 781-3341
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 261302 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE XRAY RT | $359.00 | $424.00 | $122.96–$315.46 | 20% above | 15% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ANKLE BRACHIAL INDICES (ABI) | $339.00 | $401.00 | $116.29–$298.34 | 1% below | 15% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS XRAY | $393.00 | $465.00 | $134.85–$346.86 | 10% below | 15% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN FULL BODY | $860.00 | $1,015.00 | $294.35–$755.16 | 42% below | 15% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILATERAL | $431.00 | $510.00 | $147.90–$379.44 | 13% above | 15% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST | $3,278.00 | $3,868.00 | $346.86–$2,877.79 | 69% above | 15% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD PELVIS WO CONTRAST | $3,742.00 | $4,415.00 | $447.05–$3,284.76 | 76% above | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PEL W CONT | $4,382.00 | $5,170.00 | $715.12–$3,846.48 | 85% above | 15% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD PELVIS WWO CONT | $4,720.00 | $5,569.00 | $715.12–$4,143.34 | 61% above | 15% |
| CT scan of the abdomen with contrast CPT 74160 CT ABD W CONT | $2,159.00 | $2,548.00 | $346.86–$1,895.71 | 38% above | 15% |
| CT scan of the abdomen without contrast CPT 74150 CT ABD WO CONT | $1,956.00 | $2,308.00 | $211.68–$1,717.15 | 81% above | 15% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLA FACIAL SINUSES WO | $1,682.00 | $1,985.00 | $211.68–$1,476.84 | 56% above | 15% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST | $1,864.00 | $2,199.00 | $211.68–$1,636.06 | 48% above | 15% |
| CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST | $2,039.00 | $2,406.00 | $346.86–$1,790.06 | 42% above | 15% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD WWO CONTRAST | $2,263.00 | $2,670.00 | $346.86–$1,986.48 | 27% above | 15% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONTRAST | $1,971.00 | $2,524.00 | $211.68–$1,877.86 | 43% above | 22% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C SPINE WO CONTRAST | $1,788.00 | $2,109.00 | $211.68–$1,569.10 | 10% above | 15% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST | $2,226.00 | $2,627.00 | $346.86–$1,954.49 | 36% above | 15% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DOPPLER | $832.00 | $982.00 | $284.78–$730.61 | at median | 15% |
| Chest X-ray, 2 views CPT 71046 CHEST XRAY | $344.00 | $406.00 | $117.74–$302.06 | 37% above | 15% |
| Chest X-ray, single view CPT 71045 PORTABLE CHEST | $288.00 | $314.00 | $91.06–$233.62 | 37% above | 8% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL | $615.00 | $726.00 | $210.54–$540.14 | 9% above | 15% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY, DEXA, AXIAL SKELETON | $408.00 | $481.00 | $139.49–$357.86 | 19% above | 15% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST | $1,788.00 | $2,109.00 | $211.68–$1,569.10 | 39% above | 15% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONT | $1,991.00 | $2,349.00 | $346.86–$1,747.66 | 21% above | 15% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMOGRAM BILATERAL | $386.00 | $455.00 | $131.95–$338.52 | — | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAM UNILATERAL RIGHT | $241.00 | $285.00 | $82.65–$212.04 | 4% above | 15% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 US ARTERIAL DOPPLER LOWER EXT | $615.00 | $726.00 | $210.54–$540.14 | 12% below | 15% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS BILATERAL LOWER EXT | $1,502.00 | $469.00 | $136.01–$447.05 | — | -220% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO MMODE & COLOR DOPPLER | $2,741.00 | $3,233.00 | $937.57–$2,405.35 | 81% above | 15% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HIDA SCAN WO CCK | $1,373.00 | $1,621.00 | $470.09–$1,206.02 | at median | 15% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY; SLEEP STUDY W/CPAP TECH | $4,959.00 | $5,850.00 | $1,696.50–$4,352.40 | 89% above | 15% |
| Knee X-ray, 3 views one side CPT 73562 KNEE RT 3 VIEW | $405.00 | $478.00 | $138.62–$355.63 | 50% above | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GB,CBD,CHD,/RUQ | $831.00 | $981.00 | $211.68–$729.86 | 65% above | 15% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR RT LOWER JOINTW/O | $3,366.00 | $3,971.00 | $447.05–$2,954.42 | 81% above | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR RT LOWER JOINT W/WO | $3,826.00 | $4,443.00 | $715.12–$3,305.59 | 71% above | 14% |
| MRI of the abdomen without contrast CPT 74181 MR ABDOMEN WO CONTRAST | $2,648.00 | $3,124.00 | $447.05–$2,324.26 | 59% above | 15% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABDOMEN W WO CONTRAST | $3,101.00 | $3,659.00 | $715.12–$2,722.30 | 28% above | 15% |
| MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO CONTRAST | $2,558.00 | $3,018.00 | $447.05–$2,245.39 | 58% above | 15% |
| MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN W WO CONTRAST | $3,239.00 | $3,821.00 | $715.12–$2,842.82 | 27% above | 15% |
| MRI of the lower back, no contrast dye CPT 72148 MR LUMBAR WO | $2,694.00 | $3,179.00 | $447.05–$2,365.18 | 45% above | 15% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MR LUMBAR WWO CONTRAST | $3,202.00 | $3,777.00 | $715.12–$2,810.09 | 28% above | 15% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR THORACIC WO | $2,477.00 | $2,923.00 | $447.05–$2,174.71 | 41% above | 15% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MR CERVICAL WWO CONTRAST | $3,297.00 | $3,890.00 | $715.12–$2,894.16 | 32% above | 15% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MR CERVICAL WO | $2,743.00 | $3,237.00 | $447.05–$2,408.33 | 38% above | 15% |
| MRI of the pelvis without and with contrast CPT 72197 MR PELVIS W W/O CONTRAST | $2,571.00 | $3,034.00 | $715.12–$2,257.30 | at median | 15% |
| MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS WO CONTRAST | $2,270.00 | $2,679.00 | $447.05–$1,993.18 | 21% above | 15% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR RT UPPER JOINT W/O | $3,366.00 | $3,971.00 | $447.05–$2,954.42 | 81% above | 15% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARDIAL PERFUSION | $2,472.00 | $2,917.00 | $845.93–$2,536.92 | 40% below | 15% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC (NON0B) | $718.00 | $848.00 | $211.68–$630.91 | 11% above | 15% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB > 14 WEEKS | $754.00 | $890.00 | $211.68–$662.16 | 33% above | 15% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB < 14 WEEKS | $754.00 | $890.00 | $211.68–$662.16 | 47% above | 15% |
| Screening mammogram, both breasts CPT 77067 MAMMOGRAM SCREENING | $254.00 | $301.00 | $87.29–$223.94 | 54% above | 16% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER XRAY LT | $344.00 | $406.00 | $117.74–$302.06 | 26% above | 15% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY; SLEEP STAGING W/TECHNOL | $4,195.00 | $4,949.00 | $1,435.21–$3,682.06 | 66% above | 15% |
| Transvaginal pelvic ultrasound CPT 76830 US PELVIC TRANS VAGINAL | $506.00 | $597.00 | $173.13–$444.17 | 13% below | 15% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE | $886.00 | $1,045.00 | $211.68–$777.48 | 13% above | 15% |
| Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR | $462.00 | $545.00 | $158.05–$405.48 | 20% below | 15% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID | $598.00 | $706.00 | $204.74–$525.26 | 6% above | 15% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI | $567.00 | $669.00 | $194.01–$497.74 | at median | 15% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS UNILATERAL LT | $542.00 | $640.00 | $185.60–$476.16 | 3% below | 15% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST XRAY LT | $333.00 | $394.00 | $114.26–$293.14 | 27% above | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP XRAY, RT | $339.00 | $401.00 | $116.29–$298.34 | 42% above | 15% |
| X-ray of the abdomen, 1 view CPT 74018 KUB | $326.00 | $385.00 | $111.65–$286.44 | 49% above | 15% |
| X-ray of the ankle, 2 views one side CPT 73600 2 VIEW ANKLE RT | $309.00 | $365.00 | $105.85–$271.56 | 63% above | 15% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS XRAY LT | $332.00 | $392.00 | $113.68–$291.65 | 62% above | 15% |
| X-ray of the foot, 2 views one side CPT 73620 2 VIEW FOOT RT | $308.00 | $364.00 | $105.56–$270.82 | 55% above | 15% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT XRAY RT | $355.00 | $419.00 | $121.51–$311.74 | 29% above | 15% |
| X-ray of the hand, 3 or more views one side CPT 73130 HAND XRAY RT | $344.00 | $406.00 | $117.74–$302.06 | 37% above | 15% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE XRAY LT | $332.00 | $392.00 | $113.68–$291.65 | 45% above | 15% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 L SPINE XRAY | $469.00 | $553.00 | $160.37–$411.43 | 59% above | 15% |
| X-ray of the lower back, 4 or more views CPT 72110 L SPINE OBLS XRAY | $462.00 | $545.00 | $158.05–$405.48 | 8% above | 15% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES XRAY | $371.00 | $438.00 | $127.02–$325.87 | 49% above | 15% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C SPINE XRAY | $410.00 | $485.00 | $140.65–$360.84 | 37% above | 15% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS XRAY | $344.00 | $406.00 | $117.74–$302.06 | 52% above | 15% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM | $427.00 | $406.00 | $117.74–$302.06 | 62% above | -5% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT / SGPT | $90.00 | $108.00 | $11.92–$80.35 | 86% above | 17% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST / SGOT | $90.00 | $108.00 | $11.65–$80.35 | 94% above | 17% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS DIAGNOSTIC (ACUTE) | $215.00 | $255.00 | $73.95–$189.72 | 9% below | 16% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN (SINGLE ALLGERGEN) LAB USE ONLY | $13.00 | $176.00 | $11.74–$130.94 | 41% below | 93% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTI | $83.00 | $98.00 | $28.42–$72.91 | 3% above | 15% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN, IFA PATTERN IF POS | $39.00 | $47.00 | $13.63–$34.97 | 43% below | 17% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PROBNP | $269.00 | $318.00 | $88.33–$236.59 | 120% above | 15% |
| Basic metabolic panel (blood test) CPT 80048 BMP BASIC METABOLIC PROFILE | $222.00 | $262.00 | $19.04–$194.93 | 79% above | 15% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH COMP 88305 | $129.00 | $152.00 | $1.00–$113.09 | 37% below | 15% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD LABCORP 1ST SET | $160.00 | $189.00 | $23.22–$140.62 | 44% above | 15% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $26.00 | $54.00 | $15.66–$40.18 | 55% above | 52% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE | $88.00 | $103.00 | $8.84–$76.63 | 170% above | 15% |
| Blood lead test CPT 83655 LEAD, OTHER SOURCE | $95.00 | $103.00 | $27.25–$76.63 | 74% above | 8% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM | $69.00 | $81.00 | $16.92–$60.26 | 29% above | 15% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPE ABO | $90.00 | $51.00 | $6.73–$37.94 | 25% above | -76% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP | $90.00 | $108.00 | $11.65–$80.35 | 51% above | 17% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 199 | $134.00 | $159.00 | $46.11–$118.30 | 22% above | 16% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 | $141.00 | $166.00 | $46.82–$123.50 | 29% above | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA PROBE | $117.00 | $139.00 | $40.31–$103.42 | 30% above | 16% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROF | $171.00 | $203.00 | $30.13–$151.03 | 66% above | 16% |
| Complete blood count (CBC) with differential CPT 85025 .CBC AUTO DIFF CHG ONLY | $122.00 | $144.00 | $17.48–$107.14 | 129% above | 15% |
| Complete blood count (CBC), no differential CPT 85027 .CBC CHG ONLY (NO AUTO DIFF) | $116.00 | $135.00 | $14.56–$100.44 | 136% above | 14% |
| Comprehensive metabolic panel (blood test) CPT 80053 CMP COMPREHENSIVE MET PROFILE | $281.00 | $332.00 | $23.76–$247.01 | 123% above | 15% |
| D-dimer blood test (blood clot marker) CPT 85379 DDIMER | $132.00 | $157.00 | $22.91–$116.81 | 5% above | 16% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE | $130.00 | $155.00 | $44.95–$115.32 | 5% below | 16% |
| Estradiol blood test CPT 82670 ESTRADIOL | $109.00 | $129.00 | $37.41–$95.98 | 24% below | 16% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $112.00 | $133.00 | $38.57–$98.95 | 10% above | 16% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL | $390.00 | $461.00 | $44.17–$342.98 | 110% above | 15% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $172.00 | $204.00 | $30.67–$151.78 | 105% above | 16% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID | $239.00 | $283.00 | $33.07–$210.55 | 214% above | 16% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE | $185.00 | $219.00 | $38.12–$162.94 | 86% above | 16% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE (FT4) | $200.00 | $502.00 | $20.29–$373.49 | 170% above | 60% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE&TOTAL MALE | $188.00 | $222.00 | $57.31–$165.17 | 50% above | 15% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $306.00 | $306.00 | $1.00–$227.66 | 11% above | — |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 2 HR | $174.00 | $206.00 | $28.96–$153.26 | 91% above | 16% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE NAA | $117.00 | $139.00 | $40.31–$103.42 | 44% above | 16% |
| H. pylori antibody blood test CPT 86677 H PYLORI, IGG | $49.00 | $58.00 | $16.82–$43.15 | 35% below | 16% |
| H. pylori stool antigen test CPT 87338 H PYLORI STOOL | $217.00 | $257.00 | $32.36–$191.21 | 81% above | 16% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV1 PCR/HIV VIRAL LOAD | $536.00 | $583.00 | $169.07–$433.75 | 54% above | 8% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV SCREEN | $130.00 | $130.00 | $30.85–$96.72 | 14% above | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4TH GENERATION ANTIGEN/ANTIBODY | $133.00 | $155.00 | $44.95–$115.32 | 64% above | 14% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C | $112.00 | $126.00 | $21.85–$93.74 | 82% above | 11% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB | $49.00 | $58.00 | $16.82–$43.15 | 29% below | 16% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURF AG | $130.00 | $155.00 | $23.24–$115.32 | 101% above | 16% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV AB (LC140659) | $30.00 | $36.00 | $10.44–$32.11 | 65% below | 17% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RTPCR QUANT (LC550080) | $252.00 | $381.00 | $96.39–$283.46 | 15% below | 34% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV I | $46.00 | $24.00 | $6.96–$29.68 | 30% below | -92% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV II | $46.00 | $63.00 | $18.27–$46.87 | 24% below | 27% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY | $164.00 | $194.00 | $29.14–$144.34 | 132% above | 15% |
| Homocysteine blood test CPT 83090 HOMOCYSTINE NON CARDIAC | $155.00 | $183.00 | $40.32–$136.15 | 42% above | 15% |
| Insulin blood test CPT 83525 INSULIN | $89.00 | $74.00 | $21.46–$55.06 | 50% above | -20% |
| Iron blood test (serum iron) CPT 83540 IRON | $83.00 | $98.00 | $14.56–$72.91 | 80% above | 15% |
| Iron-binding capacity (TIBC) test CPT 83550 TIBC TOTAL IRON BINDING CAPACITY | $137.00 | $38.00 | $11.02–$28.27 | 103% above | -261% |
| Kidney function blood test panel CPT 80069 RENAL PANEL | $226.00 | $267.00 | $19.53–$198.65 | 112% above | 15% |
| LH (luteinizing hormone) test CPT 83002 LUTENIZING HORMONE | $124.00 | $146.00 | $41.67–$108.62 | 22% above | 15% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $143.00 | $170.00 | $15.50–$126.48 | 127% above | 16% |
| Liver function blood test panel CPT 80076 LIVER PROFILE | $212.00 | $251.00 | $18.38–$186.74 | 59% above | 16% |
| Lyme disease antibody test CPT 86618 LYME DISEASE AB | $62.00 | $74.00 | $21.46–$55.06 | 32% below | 16% |
| Magnesium blood test CPT 83735 MAGNESIUM | $93.00 | $111.00 | $15.08–$82.58 | 98% above | 16% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM | $66.00 | $55.00 | $15.95–$40.92 | 12% above | -20% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREEN | $73.00 | $87.00 | $11.65–$64.73 | 78% above | 16% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 .PSA FREE | $121.00 | $143.00 | $41.38–$106.39 | 58% above | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREEN | $220.00 | $260.00 | $41.38–$193.44 | 186% above | 15% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT LABCORP | $164.00 | $194.00 | $56.26–$144.34 | 4% below | 15% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT | $92.00 | $110.00 | $13.52–$81.84 | 75% above | 16% |
| Progesterone blood test CPT 84144 PROGESTERONE | $115.00 | $136.00 | $39.44–$101.18 | 4% above | 15% |
| Prolactin blood test CPT 84146 PROLACTIN | $136.00 | $161.00 | $43.60–$119.78 | 11% above | 16% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME / INR | $93.00 | $18.00 | $5.22–$13.39 | 232% above | -417% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR | $58.00 | $69.00 | $12.76–$51.34 | 30% above | 16% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG | $47.00 | $55.00 | $15.95–$40.92 | 11% below | 15% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE (ESR) | $73.00 | $87.00 | $6.08–$64.73 | 112% above | 16% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS **33000 | $101.00 | $101.00 | $18.46–$75.14 | 14% below | — |
| Stool ova and parasites exam CPT 87177 .OVA AND PARASITES STOOL SMEAR | $24.00 | $29.00 | $8.41–$21.58 | 58% below | 17% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD | $54.00 | $65.00 | $9.86–$48.36 | 152% above | 17% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD #1 STOOL | $54.00 | $65.00 | $18.85–$48.36 | 6% above | 17% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR | $54.00 | $65.00 | $9.61–$48.36 | 83% above | 17% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON GOLD | $196.00 | $231.00 | $66.99–$171.86 | 3% above | 15% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 TPO THYROID PEROXIDASE | $121.00 | $162.00 | $32.74–$120.53 | 58% above | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $195.00 | $30.00 | $8.70–$37.80 | 326% above | -550% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS BY NAA | $251.00 | $297.00 | $78.95–$220.97 | 82% above | 15% |
| Uric acid blood test CPT 84550 URIC ACID | $90.00 | $17.00 | $4.93–$12.65 | 113% above | -429% |
| Urinalysis with microscope exam, automated CPT 81001 .UA COMP CHG ONLY | $77.00 | $77.00 | $7.13–$57.29 | 106% above | — |
| Urinalysis without microscope exam, automated CPT 81003 .UA DIP CHG ONLY | $59.00 | $70.00 | $5.06–$52.08 | 194% above | 16% |
| Urinalysis without microscope exam, manual CPT 81002 URINE DIP | $46.00 | $54.00 | $7.83–$40.18 | 254% above | 15% |
| Urine culture for bacteria, with colony count CPT 87086 URINE COL CT ONLY/GR **33000 | $58.00 | $69.00 | $18.16–$51.34 | 10% below | 16% |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE | $69.00 | $19.00 | $5.51–$19.37 | 38% above | -263% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $172.00 | $204.00 | $33.93–$151.78 | 123% above | 16% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D | $185.00 | $219.00 | $63.51–$162.94 | 36% above | 16% |
| Zinc blood test CPT 84630 ZINC SERUM | $90.00 | $108.00 | $25.63–$80.35 | 47% above | 17% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TOTAL QUANTITATIVE | $141.00 | $74.00 | $21.46–$55.06 | 66% above | -91% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX METATARSAL FX W/O MANIP EACH | $722.00 | $722.00 | $209.38–$537.17 | 84% above | — |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION, ELECTIVE ARRHY | $952.00 | $1,124.00 | $325.96–$836.26 | 16% above | 15% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TX DISTAL RADIAL FX | $1,015.00 | $1,574.00 | $456.46–$1,171.06 | 72% above | 36% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY WITH REM POLYP BY SNARE | $2,040.00 | $2,040.00 | $591.60–$2,672.00 | 20% above | — |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY, FLEXIBLE, WITH BIOPSY(S) | $1,680.00 | $1,680.00 | $487.20–$2,672.00 | 6% below | — |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY DIAG BRUSHING & WASHING | $1,450.00 | $1,450.00 | $420.50–$2,672.00 | 15% above | — |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTO FLEX TUBE | $992.00 | $701.00 | $203.29–$521.54 | 7% below | -42% |
| Earwax removal with instruments, one ear CPT 69210 CERUMEN | $194.00 | $229.00 | $66.41–$170.38 | 112% above | 15% |
| Gallbladder removal, laparoscopic CPT 47562 CHOLECYSTECOMY **7/31/02 | $2,969.00 | $2,969.00 | $861.01–$9,830.43 | 51% below | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 I & D SIMPLE | $331.00 | $391.00 | $113.39–$290.90 | 47% above | 15% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SINGLE TENDON SHEATH,LIGAMENT | $180.00 | $180.00 | $52.20–$507.35 | 9% below | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECTION MAJOR JOINT | $255.00 | $425.00 | $123.25–$316.20 | 19% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJECTION WRIST ELBOW ANKLE | $195.00 | $323.00 | $93.67–$240.31 | 2% below | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJECTION SMALL JOINT FINGERS TOES | $180.00 | $180.00 | $52.20–$507.35 | 10% below | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE UP TO 2.5CM | $538.00 | $636.00 | $184.44–$473.18 | 42% above | 15% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL COMPLETE SINGLE | $284.00 | $335.00 | $97.15–$249.24 | 73% above | 15% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCIS.OF NAIL % MATRIX | $730.00 | $863.00 | $250.27–$642.07 | 84% above | 15% |
| Removal of a foreign object under the skin, simple CPT 10120 FRGN BODY RMVLSQ TISSUE,SIMPL | $331.00 | $391.00 | $113.39–$290.90 | 9% above | 15% |
| Short arm cast (elbow to hand) CPT 29075 CAST SHRT ARM ELBOW TO FINGER | $424.00 | $500.00 | $145.00–$372.00 | 76% above | 15% |
| Short arm splint (forearm and hand) CPT 29125 SPLINT SHRT FOREARM TO HAND | $241.00 | $285.00 | $82.65–$212.04 | 63% above | 15% |
| Short leg cast (below the knee) CPT 29405 SHRT LEG CAST TOES TO KNEE | $490.00 | $579.00 | $167.91–$430.78 | 75% above | 15% |
| Short leg splint (calf to foot) CPT 29515 SHRT SPLINT CALF TO FOOT | $331.00 | $391.00 | $113.39–$290.90 | 100% above | 15% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIRWOUNDS SIMPLE 0 TO 2.5C | $417.00 | $493.00 | $142.97–$366.79 | 88% above | 15% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP | $621.00 | $733.00 | $212.57–$545.35 | 23% above | 15% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR WOUNDSSIMPLE,2.67.5CM | $458.00 | $541.00 | $156.89–$402.50 | 59% above | 15% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR WOUNDS2.5CM,FACE,EARS | $466.00 | $550.00 | $159.50–$409.20 | 75% above | 15% |
| Total hip replacement one side CPT 27130 HIP NAILING PROSTH RT | $785.00 | $927.00 | $268.83–$689.69 | 73% below | 15% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TO TRIGGER POINT, MUSCLES | $319.00 | $376.00 | $109.04–$279.74 | 56% above | 15% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBUMIST | $121.00 | $223.00 | $64.67–$165.91 | 24% below | 46% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN UP TO 1 HR | $787.00 | $929.00 | $269.41–$691.18 | 82% above | 15% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMOTHERAPY ADMIN UP TO 1 HR | $963.00 | $963.00 | $279.27–$712.62 | 122% above | — |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE, INIT.1ST HR. | $1,016.00 | $813.00 | $235.77–$604.87 | 25% below | -25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM | $368.00 | $76.00 | $22.04–$56.54 | 93% above | -384% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 TREADMILL EKG, TRACING ONLY | $1,367.00 | $1,612.00 | $467.48–$1,199.33 | 67% above | 15% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ONLY NONCHEMO SQ OR IM INJECTION | $91.00 | $109.00 | $31.61–$81.10 | 6% below | 17% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT EXERCISE 15 MIN.BALANCE COORD REEDUC | $104.00 | $123.00 | $35.67–$153.00 | 17% above | 15% |
| New patient office visit, about 60 minutes CPT 99205 ER CODE BLUE | $693.00 | $818.00 | $237.22–$608.59 | 168% above | 15% |
| Occupational therapy evaluation, low complexity CPT 97165 OT LOW EVALUATION | $195.00 | $195.00 | $56.55–$153.00 | 40% above | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT HIGH EVALUATION | $172.00 | $172.00 | $49.88–$153.00 | at median | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW | $172.00 | $172.00 | $49.88–$153.00 | 35% above | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MOD COMPLEXITY | $172.00 | $172.00 | $49.88–$153.00 | 10% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY MYOFACIAL MOBIL MANIP | $108.00 | $128.00 | $37.12–$153.00 | 33% above | 16% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT EXERCISE 15 MIN ROM STRENGTH ENDUR | $108.00 | $105.00 | $30.45–$153.00 | 39% above | -3% |
| Speech and language evaluation CPT 92523 ST EVAL COMPREHENSION | $199.00 | $402.00 | $94.00–$153.00 | 27% below | 50% |
| Speech therapy session, individual CPT 92507 ST SP THER SESS 1 HR | $140.00 | $165.00 | $47.85–$153.00 | 12% below | 15% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY | $284.00 | $392.00 | $113.68–$291.65 | 32% above | 28% |
| Spirometry before and after a bronchodilator CPT 94060 BRONCHODILATION RESPONSIVENESS | $466.00 | $550.00 | $159.50–$409.20 | 3% above | 15% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPUTIC ACT15 MIN | $91.00 | $75.00 | $21.75–$153.00 | 10% above | -21% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPUTIC | $276.00 | $394.00 | $114.26–$293.14 | 47% above | 30% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 CL | $100.00 | $100.00 | $29.00–$74.00 | 96% above | — |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 CL-FLUAD HI DOSE | $100.00 | $100.00 | $29.00–$74.00 | 96% above | — |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 CL- FLUAD HI DOSE | $100.00 | $100.00 | $29.00–$74.00 | 96% above | — |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA HIGH-DOSE VACC 65+ PFS | $313.00 | $313.00 | $90.77–$231.62 | 514% above | — |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 CL- FISCHER VARICELLA VARIVAX VACCINE | $95.00 | $95.00 | $27.55–$70.30 | 48% below | — |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 CL- VARIVAX DAVIS | $100.00 | $100.00 | $29.00–$74.00 | 45% below | — |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 CL- DEFRAN VARICELLA VACCINE | $100.00 | $100.00 | $29.00–$74.00 | 45% below | — |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 CL | $100.00 | $100.00 | $29.00–$74.00 | 45% below | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CL- FLUCELVAX 60 MO | $90.00 | $90.00 | $26.10–$66.60 | 51% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CL-FLUCELVAX 6 MO | $90.00 | $90.00 | $26.10–$66.60 | 51% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CL- FLUCELVAX 6 MO | $90.00 | $90.00 | $26.10–$66.60 | 51% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CL | $90.00 | $90.00 | $26.10–$66.60 | 51% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VAC (FLUZONE) I-D PFS 3YRS+ | $143.00 | $143.00 | $41.47–$105.82 | 140% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUEN VACC PED 6M-35M PFS 0.25ML | $179.00 | $179.00 | $51.91–$132.46 | 200% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUEN VACC 6M | $193.00 | $193.00 | $55.97–$142.82 | 223% above | — |
| Hepatitis A vaccine, adult dose CPT 90632 CL- DEFRAN HEPATITIS A VACCINE | $25.00 | $25.00 | $7.25–$18.50 | 70% below | — |
| Hepatitis A vaccine, adult dose CPT 90632 CL- FISCHER HEP A ADULT VACCINE | $25.00 | $25.00 | $7.25–$18.50 | 70% below | — |
| Hepatitis A vaccine, adult dose CPT 90632 CL | $25.00 | $25.00 | $7.25–$18.50 | 70% below | — |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS-A VACCINE 1ML INJ (HAVRIX) | $386.00 | $386.00 | $111.94–$285.64 | 367% above | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CL- HIGH DOSE VACCINE 65+ | $90.00 | $90.00 | $26.10–$66.60 | 11% below | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CL | $90.00 | $90.00 | $26.10–$66.60 | 11% below | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CL- HIGHDOSE 65+ | $90.00 | $90.00 | $26.10–$66.60 | 11% below | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CL- HIGHDOSE FLU 65+ | $90.00 | $90.00 | $26.10–$66.60 | 11% below | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 CL- DEFRAN MMR LIVE SUBCUTANEOUS USE | $55.00 | $55.00 | $15.95–$40.70 | 67% below | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 CL- FISCHER MMR VACCINE | $55.00 | $55.00 | $15.95–$40.70 | 67% below | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 CL- BUFORD MMR VACCINE | $55.00 | $55.00 | $15.95–$40.70 | 67% below | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 CL- DEFRAN MENECTRA | $130.00 | $130.00 | $37.70–$96.20 | 1% above | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 CL- FISCHER MENACTRA VACCINE | $130.00 | $130.00 | $37.70–$96.20 | 1% above | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 CL | $130.00 | $130.00 | $37.70–$96.20 | 1% above | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 CL- MENACTRA DAVIS | $130.00 | $130.00 | $37.70–$96.20 | 1% above | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 CL- PREVNAR 20 VACCINE DAVIS | $918.00 | $918.00 | $266.22–$679.32 | 72% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL- ALLEN PNEUMO 23 VACCINE | $250.00 | $250.00 | $72.50–$185.00 | 34% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL- DEFRAN PNEUMO 23 VACCINE | $250.00 | $250.00 | $72.50–$185.00 | 34% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL- FISCHER PNEUMO 23 VACCINE | $250.00 | $250.00 | $72.50–$185.00 | 34% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL- MCGRAW PNEUMOVAX 23 VACCINE DAVIS | $250.00 | $250.00 | $72.50–$185.00 | 34% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL- MENZ PNEUMO 23 VACCINE | $250.00 | $250.00 | $72.50–$185.00 | 34% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL- BUFORD PNEUMO 23 VACCINE | $250.00 | $250.00 | $72.50–$185.00 | 34% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL | $250.00 | $250.00 | $72.50–$185.00 | 34% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL- BENZ PNEUMO 23 VACCINE | $250.00 | $250.00 | $72.50–$185.00 | 34% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL- PNEUMOCOCCAL VAC | $250.00 | $250.00 | $72.50–$185.00 | 34% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL- PNEUMOVAX 23 VACCINE DAVIS | $250.00 | $250.00 | $72.50–$185.00 | 34% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 ZOSTER VACCINE LIVE 0.65ML INJ W/DILUENT | $420.00 | $420.00 | $121.80–$310.80 | 126% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMONIA VACCINE 23 POLYVALENT | $463.00 | $463.00 | $134.27–$342.62 | 149% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMO VACC 20 CONJUGATE PFS INJ 0.5ML | $983.00 | $983.00 | $285.07–$727.42 | 429% above | — |
| Rabies vaccine, one dose CPT 90675 CL- ALLEN RABAVERT VACCINE FOR IM USE | $350.00 | $350.00 | $101.50–$259.00 | 60% below | — |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE (RABAVERT) INJ | $1,225.00 | $1,225.00 | $355.25–$906.50 | 41% above | — |
| Rabies vaccine, one dose CPT 90675 IMOVAX RABIES VAC 1ML IM INJ (EGG FREE) | $2,178.00 | $2,178.00 | $631.62–$1,611.72 | 150% above | — |
| Rabies vaccine, one dose CPT 90675 RABAVERT INJ (VACCINE FOR RABIES) | $2,178.00 | $2,178.00 | $631.62–$1,611.72 | 150% above | — |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 CL | $225.00 | $225.00 | $65.25–$166.50 | 6% below | — |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 CL- ZOOSTER SHINGLES VACCINE OLIVERO | $600.00 | $600.00 | $174.00–$444.00 | 150% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 CL- TETNUS INJECTION DAVIS | $33.00 | $33.00 | $9.57–$24.42 | 54% below | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 CL- BUFORD TD 7 & > IMMUNIZATION | $33.00 | $33.00 | $9.57–$24.42 | 54% below | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 CL- DEFRAN TD IMMUNIZATION | $33.00 | $33.00 | $9.57–$24.42 | 54% below | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 CL- MENZ TD 7 AND > IMMUNIZATION | $33.00 | $33.00 | $9.57–$24.42 | 54% below | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 CL- BENZ TD AGE 7 & > IMMUNIZATION | $33.00 | $33.00 | $9.57–$24.42 | 54% below | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 CL- ALLEN TD AGES 7 AND > | $50.00 | $50.00 | $14.50–$37.00 | 30% below | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 CL | $70.00 | $70.00 | $20.30–$51.80 | 2% below | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS & DIPTH TOX 7Y+ INJ 0.5ML | $177.00 | $177.00 | $51.33–$130.98 | 148% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS & DIPTH TOX 7Y+ INJ 0.5ML EMP | $177.00 | $177.00 | $51.33–$130.98 | 148% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS, DIPTHERIA, PERTUSSIS VACCINE | $211.00 | $211.00 | $61.19–$156.14 | 196% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 CL- TDAP DAVIS | $50.00 | $50.00 | $14.50–$37.00 | 51% below | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 CL | $50.00 | $50.00 | $14.50–$37.00 | 51% below | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 CL- DEFRAN TDAP >7 YEARS OF AGE | $50.00 | $50.00 | $14.50–$37.00 | 51% below | — |
Source file: https://madisonmedicalcenter.net/431445493_Madison%20Medical%20Center_standardcharges.json