Summit Surgical
Summit Surgical in Hutchinson, KS publishes cash prices for 222 common procedures listed here, from its own machine-readable price file updated Aug 19, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Kansas median for 140 of 217 procedures and below it for 76. By typical cash price it ranks #66 of 85 Kansas hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
1818 E. 23rd Avenue, Hutchinson, KS, 67502 Collected Sep 27, 2026 Source price file Check a bill from this hospital (620) 663-4800
Acute care hospital For-profit hospital No emergency department CCN 170198 · CMS hospital register NPI 1932117975
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Summit Surgical in Hutchinson, KS:
- Jun 9, 2026 Warning notice
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Kansas | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VIEWS LT | $320.00 | $400.00 | $48.74–$400.00 | 39% above | 20% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VIEWS RT | $320.00 | $400.00 | $48.74–$400.00 | 39% above | 20% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEWS RT | $320.00 | $400.00 | $48.74–$400.00 | — | 20% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEWS LT | $320.00 | $400.00 | $48.74–$400.00 | — | 20% |
| Breast ultrasound, complete, one breast CPT 76641 US BREAST COMPLETE | $640.00 | $800.00 | — | 106% above | 20% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST COMPLETE | $640.00 | $800.00 | — | — | 20% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED | $520.00 | $650.00 | — | 76% above | 20% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST LIMITED | $520.00 | $650.00 | — | — | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 **CT SCAN CEREBRAL WO CONTRAST | $696.80 | $871.00 | — | 32% below | 20% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 **CT SCAN CEREBRAL WO CONTRAST | $696.80 | $871.00 | — | — | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 **CT SCAN CERVICAL SPINE WO CONTRAST | $793.60 | $992.00 | — | 18% below | 20% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 **CT SCAN CERVICAL SPINE WO CONTRAST | $793.60 | $992.00 | — | — | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID BILAT | $960.00 | $1,200.00 | — | — | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID BILAT | $960.00 | $1,200.00 | — | — | 20% |
| Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEW | $320.00 | $400.00 | $120.42 | 45% above | 20% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEW | $320.00 | $400.00 | $120.42 | — | 20% |
| Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW | $320.00 | $400.00 | $98.72–$400.00 | 67% above | 20% |
| Chest X-ray, single view inpatient CPT 71045 XR CHEST 1 VIEW | $320.00 | $400.00 | $98.72–$400.00 | — | 20% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE 2 VIEWS RT | $320.00 | $400.00 | $48.74–$400.00 | 60% above | 20% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE 2 VIEWS LT | $320.00 | $400.00 | $48.74–$400.00 | 60% above | 20% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE 2 VIEWS RT | $320.00 | $400.00 | $48.74–$400.00 | — | 20% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE 2 VIEWS LT | $320.00 | $400.00 | $48.74–$400.00 | — | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL | $640.00 | $800.00 | $119.28 | 60% above | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 **US RETROPERITONEAL | $640.00 | $800.00 | $119.28 | 60% above | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 **US RETROPERITONEAL | $640.00 | $800.00 | $119.28 | — | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL | $640.00 | $800.00 | $119.28 | — | 20% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS DOPPLER BILAT | $1,600.00 | $2,000.00 | — | — | 20% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS DOPPLER BILAT | $1,600.00 | $2,000.00 | — | — | 20% |
| Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS LT | $320.00 | $400.00 | $48.74–$90.55 | 63% above | 20% |
| Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS RT | $320.00 | $400.00 | $48.74–$90.55 | 63% above | 20% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEWS LT | $320.00 | $400.00 | $48.74–$90.55 | — | 20% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEWS RT | $320.00 | $400.00 | $48.74–$90.55 | — | 20% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3 VIEWS RT | $320.00 | $400.00 | $48.74–$400.00 | 34% above | 20% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3 VIEWS LT | $320.00 | $400.00 | $48.74–$400.00 | 34% above | 20% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 3 VIEWS RT | $320.00 | $400.00 | $48.74–$400.00 | — | 20% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 3 VIEWS LT | $320.00 | $400.00 | $48.74–$400.00 | — | 20% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES MORE THAN 3 VIEWS | $440.00 | $550.00 | — | 44% above | 20% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES MORE THAN 3 VIEWS | $440.00 | $550.00 | — | — | 20% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS RT | $320.00 | $400.00 | $85.19–$320.00 | 54% above | 20% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS LT | $320.00 | $400.00 | $85.19–$320.00 | 54% above | 20% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS LT | $320.00 | $400.00 | $85.19–$320.00 | — | 20% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS RT | $320.00 | $400.00 | $85.19–$320.00 | — | 20% |
| Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS LT | $320.00 | $400.00 | — | 68% above | 20% |
| Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS RT | $320.00 | $400.00 | — | 68% above | 20% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS LT | $320.00 | $400.00 | — | — | 20% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS RT | $320.00 | $400.00 | — | — | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS LT | $320.00 | $400.00 | — | 64% above | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS RT | $320.00 | $400.00 | — | 64% above | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEUS LT | $320.00 | $400.00 | — | — | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEUS RT | $320.00 | $400.00 | — | — | 20% |
| Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEWS LT | $320.00 | $400.00 | $16.29–$400.00 | 33% above | 20% |
| Knee X-ray, 3 views one side CPT 73562 XR STRESS VIEW ANY JOINT RT | $320.00 | $400.00 | $16.29–$400.00 | 33% above | 20% |
| Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEWS RT | $320.00 | $400.00 | $16.29–$400.00 | 33% above | 20% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEWS LT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR STRESS VIEW ANY JOINT RT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEWS RT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4 OR MORE LT | $440.00 | $550.00 | $19.67–$550.00 | 33% above | 20% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4 OR MORE RT | $440.00 | $550.00 | $19.67–$550.00 | 33% above | 20% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE 4 OR MORE LT | $440.00 | $550.00 | $19.67–$550.00 | — | 20% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE 4 OR MORE RT | $440.00 | $550.00 | $19.67–$550.00 | — | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED | $520.00 | $650.00 | $125.50 | 64% above | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED | $520.00 | $650.00 | $125.50 | — | 20% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT VASCULAR LIMITED RT | $640.00 | $800.00 | — | 112% above | 20% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT VASCULAR LIMITED LT | $640.00 | $800.00 | — | 112% above | 20% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT VASCULAR LIMITED RT | $640.00 | $800.00 | — | — | 20% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT VASCULAR LIMITED LT | $640.00 | $800.00 | — | — | 20% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIB FIB LT | $320.00 | $400.00 | $16.29–$400.00 | 43% above | 20% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIB FIB RT | $320.00 | $400.00 | $16.29–$400.00 | 43% above | 20% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIB FIB RT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIB FIB LT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| MR angiography (MRA) of the head without contrast CPT 70544 **MRA HEAD WITHOUT CONTRAST | $1,600.00 | $2,000.00 | — | 15% above | 20% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 **MRA HEAD WITHOUT CONTRAST | $1,600.00 | $2,000.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE RT | $1,600.00 | $2,000.00 | $72.33–$2,000.00 | 26% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE RT | $1,600.00 | $2,000.00 | $72.33–$2,000.00 | 26% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE LT | $1,600.00 | $2,000.00 | $72.33–$2,000.00 | 26% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE LT | $1,600.00 | $2,000.00 | $72.33–$2,000.00 | 26% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP RT | $1,600.00 | $2,000.00 | $72.33–$2,000.00 | 26% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP LT | $1,600.00 | $2,000.00 | $72.33–$2,000.00 | 26% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE RT | $1,600.00 | $2,000.00 | $72.33–$2,000.00 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE RT | $1,600.00 | $2,000.00 | $72.33–$2,000.00 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP RT | $1,600.00 | $2,000.00 | $72.33–$2,000.00 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE LT | $1,600.00 | $2,000.00 | $72.33–$2,000.00 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP LT | $1,600.00 | $2,000.00 | $72.33–$2,000.00 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE LT | $1,600.00 | $2,000.00 | $72.33–$2,000.00 | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOWER EXT JOINT W/WO RT | $4,000.00 | $5,000.00 | $4,500.00 | 143% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOWER EXT JOINT W/WO LT | $4,000.00 | $5,000.00 | $4,500.00 | 143% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LOWER EXT JOINT W/WO RT | $4,000.00 | $5,000.00 | $4,500.00 | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LOWER EXT JOINT W/WO LT | $4,000.00 | $5,000.00 | $4,500.00 | — | 20% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO | $1,600.00 | $2,000.00 | — | 28% above | 20% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO | $1,600.00 | $2,000.00 | — | — | 20% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO | $4,000.00 | $5,000.00 | — | 141% above | 20% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO | $4,000.00 | $5,000.00 | — | — | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST | $1,600.00 | $2,000.00 | — | 28% above | 20% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST | $1,600.00 | $2,000.00 | — | — | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO | $4,000.00 | $5,000.00 | — | 130% above | 20% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO | $4,000.00 | $5,000.00 | — | — | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WO | $1,600.00 | $2,000.00 | $44.72–$2,000.00 | 29% above | 20% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE WO | $1,600.00 | $2,000.00 | $44.72–$2,000.00 | — | 20% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/WO | $4,000.00 | $5,000.00 | $5,000.00 | 131% above | 20% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/WO | $4,000.00 | $5,000.00 | $5,000.00 | — | 20% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE WO | $1,600.00 | $2,000.00 | $131.00–$2,000.00 | 34% above | 20% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE WO | $1,600.00 | $2,000.00 | $131.00–$2,000.00 | — | 20% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE W/WO | $4,000.00 | $5,000.00 | — | 137% above | 20% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SPINE W/WO | $4,000.00 | $5,000.00 | — | — | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE WO | $1,600.00 | $2,000.00 | $131.00–$2,000.00 | 37% above | 20% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE WO | $1,600.00 | $2,000.00 | $131.00–$2,000.00 | — | 20% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO | $4,000.00 | $5,000.00 | $515.80 | 142% above | 20% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO | $4,000.00 | $5,000.00 | $515.80 | — | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO | $1,600.00 | $2,000.00 | $44.72–$2,000.00 | 34% above | 20% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO | $1,600.00 | $2,000.00 | $44.72–$2,000.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST LT | $1,600.00 | $2,000.00 | $99.94–$2,000.00 | 29% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER RT | $1,600.00 | $2,000.00 | $99.94–$2,000.00 | 29% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW LT | $1,600.00 | $2,000.00 | $99.94–$2,000.00 | 29% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW RT | $1,600.00 | $2,000.00 | $99.94–$2,000.00 | 29% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER LT | $1,600.00 | $2,000.00 | $99.94–$2,000.00 | 29% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST RT | $1,600.00 | $2,000.00 | $99.94–$2,000.00 | 29% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER LT | $1,600.00 | $2,000.00 | $99.94–$2,000.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW RT | $1,600.00 | $2,000.00 | $99.94–$2,000.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER RT | $1,600.00 | $2,000.00 | $99.94–$2,000.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST LT | $1,600.00 | $2,000.00 | $99.94–$2,000.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW LT | $1,600.00 | $2,000.00 | $99.94–$2,000.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST RT | $1,600.00 | $2,000.00 | $99.94–$2,000.00 | — | 20% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR CERVICAL SPINE 4 OR MORE VIEWS | $440.00 | $550.00 | $19.67–$550.00 | 18% above | 20% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR CERVICAL SPINE 4 OR MORE VIEWS | $440.00 | $550.00 | $19.67–$550.00 | — | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LIMITED | $640.00 | $800.00 | — | 116% above | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LIMITED | $640.00 | $800.00 | — | — | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC TRANSABDOMINAL | $640.00 | $800.00 | $19.67–$800.00 | 80% above | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC TRANSABDOMINAL | $640.00 | $800.00 | $19.67–$800.00 | — | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB SECOND OR THRID TRIMESTER | $640.00 | $800.00 | $59.96–$720.00 | 73% above | 20% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB SECOND OR THRID TRIMESTER | $640.00 | $800.00 | $59.96–$720.00 | — | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB FIRST TRI EA ADDITIONAL GESTATION | $160.00 | $200.00 | $55.38–$149.63 | 48% below | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB FIRST TRIMESTER | $520.00 | $650.00 | $55.38–$149.63 | 68% above | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB FIRST TRI EA ADDITIONAL GESTATION | $160.00 | $200.00 | $55.38–$149.63 | — | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB FIRST TRIMESTER | $520.00 | $650.00 | $55.38–$149.63 | — | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED | $520.00 | $650.00 | $104.03–$149.63 | 105% above | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED | $520.00 | $650.00 | $104.03–$149.63 | — | 20% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS RT | $440.00 | $550.00 | $106.86 | 92% above | 20% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS LT | $440.00 | $550.00 | $106.86 | 92% above | 20% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS RT | $440.00 | $550.00 | $106.86 | — | 20% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS LT | $440.00 | $550.00 | $106.86 | — | 20% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W PA CHEST RT | $440.00 | $550.00 | — | 48% above | 20% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W PA CHEST LT | $440.00 | $550.00 | — | 48% above | 20% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W PA CHEST LT | $440.00 | $550.00 | — | — | 20% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W PA CHEST RT | $440.00 | $550.00 | — | — | 20% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 OR MORE VIEWS LT | $320.00 | $400.00 | $16.29–$400.00 | 42% above | 20% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 OR MORE VIEWS RT | $320.00 | $400.00 | $16.29–$400.00 | 42% above | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2 OR MORE VIEWS LT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2 OR MORE VIEWS RT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUS 3 OR MORE VIEWS | $440.00 | $550.00 | — | 47% above | 20% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUS 3 OR MORE VIEWS | $440.00 | $550.00 | — | — | 20% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL LESS THAN 4 VIEWS | $440.00 | $550.00 | — | 84% above | 20% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL LESS THAN 4 VIEWS | $440.00 | $550.00 | — | — | 20% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR 2 VIEWS LT | $320.00 | $400.00 | $16.29–$400.00 | 31% above | 20% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR 2 VIEWS RT | $320.00 | $400.00 | $16.29–$400.00 | 31% above | 20% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR 2 VIEWS RT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR 2 VIEWS LT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| Toe X-ray, 2 or more views one side CPT 73660 XR TOES RT | $320.00 | $400.00 | $86.10–$400.00 | 77% above | 20% |
| Toe X-ray, 2 or more views one side CPT 73660 XR TOES LT | $320.00 | $400.00 | $86.10–$400.00 | 77% above | 20% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOES LT | $320.00 | $400.00 | $86.10–$400.00 | — | 20% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOES RT | $320.00 | $400.00 | $86.10–$400.00 | — | 20% |
| Transvaginal pelvic ultrasound CPT 76830 US PELVIC TRANSVAGINAL NON OB | $640.00 | $800.00 | $59.96–$800.00 | 112% above | 20% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US PELVIC TRANSVAGINAL NON OB | $640.00 | $800.00 | $59.96–$800.00 | — | 20% |
| Transvaginal ultrasound during pregnancy CPT 76817 US PELVIC TRANSVAGINAL OB | $640.00 | $800.00 | $59.96–$800.00 | 83% above | 20% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PELVIC TRANSVAGINAL OB | $640.00 | $800.00 | $59.96–$800.00 | — | 20% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE | $960.00 | $1,200.00 | — | 123% above | 20% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE | $960.00 | $1,200.00 | — | — | 20% |
| Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR SCROTAL | $640.00 | $800.00 | $99.05 | 88% above | 20% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICULAR SCROTAL | $640.00 | $800.00 | $99.05 | — | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD NECK | $640.00 | $800.00 | $468.12 | 4% above | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD NECK | $640.00 | $800.00 | $468.12 | — | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 **X-RAY EXAM UPPER GI TRACT | $440.00 | $550.00 | — | 19% below | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 **X-RAY EXAM UPPER GI TRACT | $440.00 | $550.00 | — | — | 20% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS RT | $320.00 | $400.00 | $16.29–$400.00 | 40% above | 20% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS LT | $320.00 | $400.00 | $16.29–$400.00 | 40% above | 20% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS LT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS RT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DOPPLER UNILAT LT | $960.00 | $1,200.00 | — | 44% above | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DOPPLER UNILAT RT | $960.00 | $1,200.00 | — | 44% above | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS DOPPLER UNILAT RT | $960.00 | $1,200.00 | — | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS DOPPLER UNILAT LT | $960.00 | $1,200.00 | — | — | 20% |
| Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS LT | $320.00 | $400.00 | $48.74–$400.00 | 74% above | 20% |
| Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS RT | $320.00 | $400.00 | $48.74–$400.00 | 74% above | 20% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS LT | $320.00 | $400.00 | $48.74–$400.00 | — | 20% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS RT | $320.00 | $400.00 | $48.74–$400.00 | — | 20% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 VIEWS LT | $320.00 | $400.00 | $16.29–$400.00 | 38% above | 20% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 VIEWS RT | $320.00 | $400.00 | $16.29–$400.00 | 38% above | 20% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3 VIEWS LT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3 VIEWS RT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP 2 OR 3 VIEWS RT | $320.00 | $400.00 | $16.29–$400.00 | 26% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP 2 OR 3 VIEWS LT | $320.00 | $400.00 | $16.29–$400.00 | 26% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP 2 OR 3 VIEWS RT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP 2 OR 3 VIEWS LT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN KUB | $320.00 | $400.00 | — | 54% above | 20% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN KUB | $320.00 | $400.00 | — | — | 20% |
| X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS RT | $320.00 | $400.00 | — | 68% above | 20% |
| X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LT | $320.00 | $400.00 | — | 68% above | 20% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS RT | $320.00 | $400.00 | — | — | 20% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS LT | $320.00 | $400.00 | — | — | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGERS 2 OR MORE LT | $320.00 | $400.00 | $16.29–$400.00 | 83% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGERS 2 OR MORE RT | $320.00 | $400.00 | $16.29–$400.00 | 83% above | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGERS 2 OR MORE LT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGERS 2 OR MORE RT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS RT | $320.00 | $400.00 | $75.69 | 68% above | 20% |
| X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS LT | $320.00 | $400.00 | $75.69 | 68% above | 20% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS LT | $320.00 | $400.00 | $75.69 | — | 20% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS RT | $320.00 | $400.00 | $75.69 | — | 20% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 VIEWS RT | $320.00 | $400.00 | $47.97–$400.00 | 41% above | 20% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 VIEWS LT | $320.00 | $400.00 | $47.97–$400.00 | 41% above | 20% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3 VIEWS RT | $320.00 | $400.00 | $47.97–$400.00 | — | 20% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3 VIEWS LT | $320.00 | $400.00 | $47.97–$400.00 | — | 20% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 VIEWS LT | $320.00 | $400.00 | $16.29–$400.00 | 45% above | 20% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 VIEWS RT | $320.00 | $400.00 | $16.29–$400.00 | 45% above | 20% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3 VIEWS RT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3 VIEWS LT | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 OR 2 VIEWS RT | $320.00 | $400.00 | $79.64–$400.00 | 68% above | 20% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 OR 2 VIEWS LT | $320.00 | $400.00 | $79.64–$400.00 | 68% above | 20% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1 OR 2 VIEWS RT | $320.00 | $400.00 | $79.64–$400.00 | — | 20% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1 OR 2 VIEWS LT | $320.00 | $400.00 | $79.64–$400.00 | — | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR SPINE 2 VIEWS | $320.00 | $400.00 | $19.67–$400.00 | 18% above | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR SPINE 2 VIEWS | $320.00 | $400.00 | $19.67–$400.00 | — | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 XR LUMBAR SPINE 4 VIEWS | $440.00 | $550.00 | $19.67–$550.00 | 13% above | 20% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LUMBAR SPINE 4 VIEWS | $440.00 | $550.00 | $19.67–$550.00 | — | 20% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR THORACIC SPINE 2 VIEWS | $320.00 | $400.00 | $77.82–$400.00 | 43% above | 20% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR THORACIC SPINE 2 VIEWS | $320.00 | $400.00 | $77.82–$400.00 | — | 20% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES | $320.00 | $400.00 | — | 33% above | 20% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES | $320.00 | $400.00 | — | — | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR CERVICAL SPINE 2 OR 3 VIEWS | $320.00 | $400.00 | $16.29–$400.00 | 30% above | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR CERVICAL SPINE 2 OR 3 VIEWS | $320.00 | $400.00 | $16.29–$400.00 | — | 20% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 VIEW | $320.00 | $400.00 | $19.67–$400.00 | 60% above | 20% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 VIEW | $320.00 | $400.00 | $19.67–$400.00 | — | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM COCCYX | $320.00 | $400.00 | — | 42% above | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM COCCYX | $320.00 | $400.00 | — | — | 20% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Kansas | Off list |
|---|---|---|---|---|---|
| Ammonia blood test CPT 82140 AMMONIA LEVEL (RL) | $56.00 | $70.00 | — | 34% below | 20% |
| Ammonia blood test inpatient CPT 82140 AMMONIA LEVEL (RL) | $56.00 | $70.00 | — | — | 20% |
| Amylase blood test CPT 82150 AMYLASE LEVEL (RL) | $105.60 | $132.00 | — | 93% above | 20% |
| Amylase blood test inpatient CPT 82150 AMYLASE LEVEL (RL) | $105.60 | $132.00 | — | — | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES ANA (RL) | $139.20 | $174.00 | — | 105% above | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES ANA (RL) | $139.20 | $174.00 | — | — | 20% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE REF Lab (RL) | $228.00 | $285.00 | — | 76% above | 20% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE REF Lab (RL) | $228.00 | $285.00 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND REF LAB (RL) | $54.40 | $68.00 | $14.98–$193.50 | 3% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, AERO/ANAEROBIC W/SN 0004446 (RL | $154.80 | $193.50 | $14.98–$193.50 | 177% above | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND REF LAB (RL) | $54.40 | $68.00 | $14.98–$193.50 | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, AERO/ANAEROBIC W/SN 0004446 (RL | $154.80 | $193.50 | $14.98–$193.50 | — | 20% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL WITH H/H ISTAT | $85.60 | $107.00 | $8.46–$107.00 | 22% above | 20% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL (RL) | $85.60 | $107.00 | $8.46–$107.00 | 22% above | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL WITH H/H ISTAT | $85.60 | $107.00 | $8.46–$107.00 | — | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL (RL) | $85.60 | $107.00 | $8.46–$107.00 | — | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY LEVEL 4 | $140.00 | $175.00 | $50.14–$393.75 | 36% below | 20% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATHOLOGY LEVEL 4 | $140.00 | $175.00 | $50.14–$393.75 | — | 20% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE (RL) | $140.00 | $175.00 | — | 79% above | 20% |
| Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE (RL) | $140.00 | $175.00 | — | — | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $12.80 | $16.00 | $6.07–$16.00 | 29% below | 20% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE | $12.80 | $16.00 | $6.07–$16.00 | — | 20% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE LVL RL | $13.44 | $16.80 | — | 48% below | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE LVL RL | $13.44 | $16.80 | — | — | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 SERUM HCG (REF LAB) (RL) | $20.98 | $26.23 | $3.18–$31.00 | 64% below | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG URINE (REF LAB) (RL) | $24.80 | $31.00 | $3.18–$31.00 | 57% below | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 INTERNAL HCG URINE | $24.80 | $31.00 | $3.18–$31.00 | 57% below | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN, CHORIONIC (HCG) SERUM (RL) | $110.40 | $138.00 | $3.18–$31.00 | 90% above | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 SERUM HCG (REF LAB) (RL) | $20.98 | $26.23 | $3.18–$31.00 | — | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 INTERNAL HCG URINE | $24.80 | $31.00 | $3.18–$31.00 | — | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG URINE (REF LAB) (RL) | $24.80 | $31.00 | $3.18–$31.00 | — | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADOTROPIN, CHORIONIC (HCG) SERUM (RL) | $110.40 | $138.00 | $3.18–$31.00 | — | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB BLOOD TYPE ABO/RH (RL) | $83.20 | $104.00 | — | 13% below | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB BLOOD TYPE ABO/RH (RL) | $83.20 | $104.00 | — | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE (RL) | $75.60 | $94.50 | — | 14% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL (RL) | $136.80 | $171.00 | — | 55% above | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE (RL) | $75.60 | $94.50 | — | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL (RL) | $136.80 | $171.00 | — | — | 20% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO DIFF (RL) | $99.20 | $124.00 | — | 144% above | 20% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/O DIFF | $99.20 | $124.00 | — | 144% above | 20% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO DIFF (RL) | $99.20 | $124.00 | — | — | 20% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/O DIFF | $99.20 | $124.00 | — | — | 20% |
| Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT CBC AUTOMATED (RL) | $53.60 | $67.00 | — | 25% above | 20% |
| Complete blood count (CBC), no differential inpatient CPT 85027 BLOOD COUNT CBC AUTOMATED (RL) | $53.60 | $67.00 | — | — | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL (RL) | $164.80 | $206.00 | — | 66% above | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL (RL) | $164.80 | $206.00 | — | — | 20% |
| Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE RL | $62.40 | $78.00 | — | 36% above | 20% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE RL | $62.40 | $78.00 | — | — | 20% |
| Creatinine blood test CPT 82565 CREATININE (REF LAB) RL | $17.13 | $21.41 | $5.12–$22.37 | 49% below | 20% |
| Creatinine blood test CPT 82565 CREATININE ISTAT | $77.60 | $97.00 | $5.12–$22.37 | 133% above | 20% |
| Creatinine blood test inpatient CPT 82565 CREATININE (REF LAB) RL | $17.13 | $21.41 | $5.12–$22.37 | — | 20% |
| Creatinine blood test inpatient CPT 82565 CREATININE ISTAT | $77.60 | $97.00 | $5.12–$22.37 | — | 20% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE FIBRIN DEGRADATION | $118.40 | $148.00 | — | 4% above | 20% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE FIBRIN DEGRADATION | $118.40 | $148.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL LEVEL (RL) | $248.60 | $310.75 | — | 70% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE DRUG SCREEN (RL) | $248.80 | $311.00 | — | 70% above | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ALCOHOL LEVEL (RL) | $248.60 | $310.75 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE DRUG SCREEN (RL) | $248.80 | $311.00 | — | — | 20% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $120.00 | $150.00 | — | 116% above | 20% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL | $120.00 | $150.00 | — | — | 20% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN LEVEL (RL) | $106.40 | $133.00 | — | 85% above | 20% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN LEVEL (RL) | $106.40 | $133.00 | — | — | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE (RL) | $42.40 | $53.00 | — | 32% below | 20% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE (RL) | $42.40 | $53.00 | — | — | 20% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/ 2 AB-RS (RL) | $60.00 | $75.00 | — | 28% below | 20% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/ 2 AB-RS (RL) | $60.00 | $75.00 | — | — | 20% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN RL | $16.00 | $20.00 | $2.01–$104.00 | 25% below | 20% |
| Hemoglobin blood test CPT 85018 HGB/HCT ISTAT | $48.80 | $61.00 | $2.01–$104.00 | 128% above | 20% |
| Hemoglobin blood test CPT 85018 **INR | $48.80 | $61.00 | $2.01–$104.00 | 128% above | 20% |
| Hemoglobin blood test CPT 85018 GROUP A STREPTOCOCCUS (RL) | $48.80 | $61.00 | $2.01–$104.00 | 128% above | 20% |
| Hemoglobin blood test CPT 85018 RPR (SYPHILIS) (RL) | $48.80 | $61.00 | $2.01–$104.00 | 128% above | 20% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN ISTAT | $83.20 | $104.00 | $2.01–$104.00 | 288% above | 20% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN RL | $16.00 | $20.00 | $2.01–$104.00 | — | 20% |
| Hemoglobin blood test inpatient CPT 85018 RPR (SYPHILIS) (RL) | $48.80 | $61.00 | $2.01–$104.00 | — | 20% |
| Hemoglobin blood test inpatient CPT 85018 GROUP A STREPTOCOCCUS (RL) | $48.80 | $61.00 | $2.01–$104.00 | — | 20% |
| Hemoglobin blood test inpatient CPT 85018 HGB/HCT ISTAT | $48.80 | $61.00 | $2.01–$104.00 | — | 20% |
| Hemoglobin blood test inpatient CPT 85018 **INR | $48.80 | $61.00 | $2.01–$104.00 | — | 20% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN ISTAT | $83.20 | $104.00 | $2.01–$104.00 | — | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 ..TEST HEP B CONFIRM (RL) | $44.00 | $55.00 | — | 26% below | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 ..TEST HEP B SURF AG W REFLEX (RL) | $44.00 | $55.00 | — | 26% below | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP A (RL) | $44.00 | $55.00 | — | 26% below | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 ..TEST UNDEFINED MISC | $44.00 | $55.00 | — | 26% below | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURF AG W/CONF (RL) | $55.20 | $69.00 | — | 7% below | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 ..TEST HEP B CONFIRM (RL) | $44.00 | $55.00 | — | — | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP A (RL) | $44.00 | $55.00 | — | — | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 ..TEST HEP B SURF AG W REFLEX (RL) | $44.00 | $55.00 | — | — | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 ..TEST UNDEFINED MISC | $44.00 | $55.00 | — | — | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURF AG W/CONF (RL) | $55.20 | $69.00 | — | — | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB W/RFX PCR (RL) | $81.60 | $102.00 | — | 8% above | 20% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB W/RFX PCR (RL) | $81.60 | $102.00 | — | — | 20% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 ..CRP C-REACTIVE PROTEIN: HIGH SENSI(RL) | $96.80 | $121.00 | — | 10% above | 20% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 ..CRP C-REACTIVE PROTEIN: HIGH SENSI(RL) | $96.80 | $121.00 | — | — | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE LEVEL (RL) | $97.60 | $122.00 | — | 57% above | 20% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE LEVEL (RL) | $97.60 | $122.00 | — | — | 20% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL (RL) | $126.40 | $158.00 | — | 65% above | 20% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL (RL) | $126.40 | $158.00 | — | — | 20% |
| Magnesium blood test CPT 83735 MAGNESIUM (RL) | $46.40 | $58.00 | — | 10% below | 20% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM (RL) | $46.40 | $58.00 | — | — | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 **AMYLASE | $47.20 | $59.00 | — | 4% above | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT (RL) | $71.20 | $89.00 | — | 57% above | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 **AMYLASE | $47.20 | $59.00 | — | — | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT (RL) | $71.20 | $89.00 | — | — | 20% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS (PHOSPHATE) (RL) | $74.00 | $92.50 | — | 110% above | 20% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS (PHOSPHATE) (RL) | $74.00 | $92.50 | — | — | 20% |
| Potassium blood test CPT 84132 POTASSIUM ISTAT | $62.40 | $78.00 | $4.20–$17.99 | 95% above | 20% |
| Potassium blood test CPT 84132 POTASSIUM RL | $62.40 | $78.00 | $4.20–$17.99 | 95% above | 20% |
| Potassium blood test inpatient CPT 84132 POTASSIUM RL | $62.40 | $78.00 | $4.20–$17.99 | — | 20% |
| Potassium blood test inpatient CPT 84132 POTASSIUM ISTAT | $62.40 | $78.00 | $4.20–$17.99 | — | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR (REF LAB) (RL) | $12.00 | $15.00 | — | 62% below | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 **PT/INR | $163.20 | $204.00 | — | 418% above | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR (REF LAB) (RL) | $12.00 | $15.00 | — | — | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 **PT/INR | $163.20 | $204.00 | — | — | 20% |
| Rh blood typing CPT 86901 BB BLOOD TYPE RH (RL) | $75.60 | $94.50 | — | 19% above | 20% |
| Rh blood typing inpatient CPT 86901 BB BLOOD TYPE RH (RL) | $75.60 | $94.50 | — | — | 20% |
| Sodium blood test CPT 84295 SODIUM ISTAT | $13.44 | $16.80 | $1.63–$4.20 | 54% below | 20% |
| Sodium blood test CPT 84295 SODIUM RL | $19.20 | $24.00 | $1.63–$4.20 | 35% below | 20% |
| Sodium blood test inpatient CPT 84295 SODIUM ISTAT | $13.44 | $16.80 | $1.63–$4.20 | — | 20% |
| Sodium blood test inpatient CPT 84295 SODIUM RL | $19.20 | $24.00 | $1.63–$4.20 | — | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (RL) | $85.60 | $107.00 | — | at median | 20% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (RL) | $85.60 | $107.00 | — | — | 20% |
| Troponin test, quantitative CPT 84484 TROPONIN I (RL) | $143.20 | $179.00 | — | 25% above | 20% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN I (RL) | $143.20 | $179.00 | — | — | 20% |
| Uric acid blood test CPT 84550 ..TEST PATHOLOGY SINGLE SPECIMEN (RL) | $66.00 | $82.50 | — | 83% above | 20% |
| Uric acid blood test CPT 84550 ..TEST PATHOLOGY MULTI SPECIMEN (RL) | $66.00 | $82.50 | — | 83% above | 20% |
| Uric acid blood test CPT 84550 ..TEST CMP (RL) | $66.00 | $82.50 | — | 83% above | 20% |
| Uric acid blood test CPT 84550 URIC ACID BLOOD (RL) | $66.00 | $82.50 | — | 83% above | 20% |
| Uric acid blood test CPT 84550 ..CULTURE FLUID REF LAB (RL) | $66.00 | $82.50 | — | 83% above | 20% |
| Uric acid blood test CPT 84550 ..CULTURE TISSUE REF LAB(RL) | $66.00 | $82.50 | — | 83% above | 20% |
| Uric acid blood test CPT 84550 ..GRAM STAIN REF LAB (RL) | $66.00 | $82.50 | — | 83% above | 20% |
| Uric acid blood test CPT 84550 ..CULTURE ANAEROBIC REF LAB (RL) | $66.00 | $82.50 | — | 83% above | 20% |
| Uric acid blood test CPT 84550 ..CULTURE WOUND REF LAB (RL) | $66.00 | $82.50 | — | 83% above | 20% |
| Uric acid blood test CPT 84550 ..CULTURE URINE REF LAB (RL) | $66.00 | $82.50 | — | 83% above | 20% |
| Uric acid blood test inpatient CPT 84550 ..TEST CMP (RL) | $66.00 | $82.50 | — | — | 20% |
| Uric acid blood test inpatient CPT 84550 ..CULTURE WOUND REF LAB (RL) | $66.00 | $82.50 | — | — | 20% |
| Uric acid blood test inpatient CPT 84550 ..CULTURE TISSUE REF LAB(RL) | $66.00 | $82.50 | — | — | 20% |
| Uric acid blood test inpatient CPT 84550 ..CULTURE URINE REF LAB (RL) | $66.00 | $82.50 | — | — | 20% |
| Uric acid blood test inpatient CPT 84550 ..CULTURE FLUID REF LAB (RL) | $66.00 | $82.50 | — | — | 20% |
| Uric acid blood test inpatient CPT 84550 ..GRAM STAIN REF LAB (RL) | $66.00 | $82.50 | — | — | 20% |
| Uric acid blood test inpatient CPT 84550 ..CULTURE ANAEROBIC REF LAB (RL) | $66.00 | $82.50 | — | — | 20% |
| Uric acid blood test inpatient CPT 84550 ..TEST PATHOLOGY MULTI SPECIMEN (RL) | $66.00 | $82.50 | — | — | 20% |
| Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD (RL) | $66.00 | $82.50 | — | — | 20% |
| Uric acid blood test inpatient CPT 84550 ..TEST PATHOLOGY SINGLE SPECIMEN (RL) | $66.00 | $82.50 | — | — | 20% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS MICROSCOPIC (RL) | $13.00 | $16.25 | — | 60% below | 20% |
| Urinalysis with microscope exam, automated CPT 81001 UA WITH MICROSCOPIC (RL) | $14.64 | $18.30 | — | 55% below | 20% |
| Urinalysis with microscope exam, automated CPT 81001 UA WITH CULTURE-LAB (RL) | $14.64 | $18.30 | — | 55% below | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS MICROSCOPIC (RL) | $13.00 | $16.25 | — | — | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA WITH CULTURE-LAB (RL) | $14.64 | $18.30 | — | — | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA WITH MICROSCOPIC (RL) | $14.64 | $18.30 | — | — | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS (RL) | $9.00 | $11.25 | — | 59% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 UA ROUTINE-LAB (RL) | $68.00 | $85.00 | — | 209% above | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS (RL) | $9.00 | $11.25 | — | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA ROUTINE-LAB (RL) | $68.00 | $85.00 | — | — | 20% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE REF LAB (RL) | $54.40 | $68.00 | — | 2% above | 20% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE BACTE QUANATIVE COLONY COUNT (RL | $121.60 | $152.00 | — | 129% above | 20% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE REF LAB (RL) | $54.40 | $68.00 | — | — | 20% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE BACTE QUANATIVE COLONY COUNT (RL | $121.60 | $152.00 | — | — | 20% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Kansas | Off list |
|---|---|---|---|---|---|
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 Neck spine fuse&remov bel c2 | $8,944.00 | $11,180.00 | $1,201.81–$11,807.18 | 26% below | 20% |
| Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 Neck spine fuse&remov bel c2 | $8,944.00 | $11,180.00 | $1,201.81–$11,807.18 | — | 20% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 KNEE ARTHROSCOPY/SURGERY | $11,040.00 | $13,800.00 | $4,718.06–$11,292.00 | 12% above | 20% |
| Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 KNEE ARTHROSCOPY/SURGERY | $11,040.00 | $13,800.00 | $4,718.06–$11,292.00 | — | 20% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 ARTHROSCOP ROTATOR CUFF REPR | $5,593.92 | $6,992.40 | $1,541.60–$9,249.32 | 25% below | 20% |
| Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 ARTHROSCOP ROTATOR CUFF REPR | $5,593.92 | $6,992.40 | $1,541.60–$9,249.32 | — | 20% |
| Botox injections for chronic migraine CPT 64615 INJECTION BOTOX FOR MIGRAINE | $260.00 | $325.00 | $118.49–$232.22 | 26% below | 20% |
| Botox injections for chronic migraine inpatient CPT 64615 INJECTION BOTOX FOR MIGRAINE | $260.00 | $325.00 | $118.49–$232.22 | — | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE | $207.24 | $259.05 | — | 69% below | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TREATMENT OF ANKLE FRACTURE | $207.24 | $259.05 | — | — | 20% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE | $207.24 | $259.05 | — | 58% below | 20% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TREAT METATARSAL FRACTURE | $207.24 | $259.05 | — | — | 20% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECTION OF BUNION | $3,471.08 | $4,338.85 | — | 6% below | 20% |
| Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CORRECTION OF BUNION | $3,471.08 | $4,338.85 | — | — | 20% |
| Bunion correction with removal of part of the big toe joint CPT 28292 CORRECTION OF BUNION | $3,471.08 | $4,338.85 | — | 11% below | 20% |
| Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CORRECTION OF BUNION | $3,471.08 | $4,338.85 | — | — | 20% |
| Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY | $5,520.00 | $6,900.00 | $368.10–$6,900.00 | 202% above | 20% |
| Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL SURGERY | $5,520.00 | $6,900.00 | $368.10–$6,900.00 | — | 20% |
| Cervical biopsy CPT 57500 BIOPSY OF CERVIX | $356.10 | $445.13 | — | 48% below | 20% |
| Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX | $356.10 | $445.13 | — | — | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FRACTURE RADIUS/ULNA | $207.24 | $259.05 | — | 66% below | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TREAT FRACTURE RADIUS/ULNA | $207.24 | $259.05 | — | — | 20% |
| Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY W/ENDOSCOPE US | $800.00 | $1,000.00 | — | — | 20% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLONOSCOPY W/ENDOSCOPE US | $800.00 | $1,000.00 | — | — | 20% |
| Colonoscopy with polyp removal CPT 45385 LESION REMOVAL COLONOSCOPY | $1,836.00 | $2,295.00 | $774.73–$2,295.00 | 5% above | 20% |
| Colonoscopy with polyp removal inpatient CPT 45385 LESION REMOVAL COLONOSCOPY | $1,836.00 | $2,295.00 | $774.73–$2,295.00 | — | 20% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY | $3,672.00 | $4,590.00 | $735.79–$4,590.00 | 133% above | 20% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY AND BIOPSY | $3,672.00 | $4,590.00 | $735.79–$4,590.00 | — | 20% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY | $3,672.00 | $4,590.00 | $779.14–$4,131.00 | 192% above | 20% |
| Colonoscopy, diagnostic inpatient CPT 45378 DIAGNOSTIC COLONOSCOPY | $3,672.00 | $4,590.00 | $779.14–$4,131.00 | — | 20% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE LEEP | $1,825.46 | $2,281.83 | — | 132% above | 20% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 BX OF CERVIX W/SCOPE LEEP | $1,825.46 | $2,281.83 | — | — | 20% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE | $356.10 | $445.13 | — | 11% below | 20% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 BX/CURETT OF CERVIX W/SCOPE | $356.10 | $445.13 | — | — | 20% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE | $2,182.10 | $2,727.63 | — | 66% above | 20% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION AND CURETTAGE | $2,182.10 | $2,727.63 | — | — | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION | $58.52 | $73.15 | — | 50% below | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT PREMALG LESION | $58.52 | $73.15 | — | — | 20% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING | $158.58 | $198.23 | — | 34% below | 20% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY OF UTERUS LINING | $158.58 | $198.23 | — | — | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INTERLAMINAR EPIDURALS CERVICAL/THORACIC | $3,672.00 | $4,590.00 | $128.10–$4,590.00 | 206% above | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CERVICAL/THORACIC INTRALAMINAL INJECTION | $3,672.00 | $4,590.00 | $128.10–$4,590.00 | 206% above | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CERVICAL/THORACIC INTRALAMINAL INJECTION | $3,672.00 | $4,590.00 | $128.10–$4,590.00 | — | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INTERLAMINAR EPIDURALS CERVICAL/THORACIC | $3,672.00 | $4,590.00 | $128.10–$4,590.00 | — | 20% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 MEDIAL BRANCH BLOCK IMAG GUID LUM SACRAL | $1,836.00 | $2,295.00 | $143.67–$2,295.00 | 81% above | 20% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 NBLOCK MED BRANCH BLOCK L/S W/IMAGE SING | $1,836.00 | $2,295.00 | $143.67–$2,295.00 | 81% above | 20% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 MEDIAL BRANCH BLOCK IMAG GUID LUM SACRAL | $1,836.00 | $2,295.00 | $143.67–$2,295.00 | — | 20% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 NBLOCK MED BRANCH BLOCK L/S W/IMAGE SING | $1,836.00 | $2,295.00 | $143.67–$2,295.00 | — | 20% |
| Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE | $2,511.12 | $3,138.90 | — | 7% below | 20% |
| Hammertoe correction surgery inpatient CPT 28285 REPAIR OF HAMMERTOE | $2,511.12 | $3,138.90 | — | — | 20% |
| Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 TOTAL HIP ARTHROPLASTY | $14,513.00 | $18,141.25 | — | — | 20% |
| Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 TOTAL HIP ARTHROPLASTY | $14,513.00 | $18,141.25 | — | — | 20% |
| Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL HYSTERECTOMY | $5,600.00 | $7,000.00 | — | 104% above | 20% |
| Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL HYSTERECTOMY | $5,600.00 | $7,000.00 | — | — | 20% |
| Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ABLATION | $8,352.00 | $10,440.00 | $949.00 | 93% above | 20% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY ABLATION | $8,352.00 | $10,440.00 | $949.00 | — | 20% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY | $8,352.00 | $10,440.00 | $1,131.14–$10,440.00 | 174% above | 20% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY BIOPSY | $8,352.00 | $10,440.00 | $1,131.14–$10,440.00 | — | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS | $176.92 | $221.15 | — | 32% below | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF SKIN ABSCESS | $176.92 | $221.15 | — | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT | $2,760.00 | $3,450.00 | $121.23–$2,217.85 | 1385% above | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT | $2,760.00 | $3,450.00 | $121.23–$2,217.85 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 JOINT INJECTION OR ASPIRATION | $3,672.00 | $4,590.00 | $81.90–$4,590.00 | 973% above | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION/ARTHROCENTESIS INJECTION ANES | $3,672.00 | $4,590.00 | $81.90–$4,590.00 | 973% above | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 JOINT INJECTION OR ASPIRATION | $3,672.00 | $4,590.00 | $81.90–$4,590.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATION/ARTHROCENTESIS INJECTION ANES | $3,672.00 | $4,590.00 | $81.90–$4,590.00 | — | 20% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG IMPLANT DEVICE | $75.02 | $93.78 | — | 58% below | 20% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT DRUG IMPLANT DEVICE | $75.02 | $93.78 | — | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJECT JOINT/BURSA W/O ULTRASOUND | $124.80 | $156.00 | — | 54% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJECT JOINT/BURSA W/O ULTRASOUND | $124.80 | $156.00 | — | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJECT JOINT/BURSA | $1,836.00 | $2,295.00 | $2,295.00 | 677% above | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJECT JOINT/BURSA | $1,836.00 | $2,295.00 | $2,295.00 | — | 20% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 KNEE ARTHROSCOPY/SURGERY | $4,268.00 | $5,335.00 | $1,328.42 | 3% below | 20% |
| Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 KNEE ARTHROSCOPY/SURGERY | $4,268.00 | $5,335.00 | $1,328.42 | — | 20% |
| Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY/SURGERY | $3,518.98 | $4,398.73 | $1,330.36–$6,250.50 | 16% below | 20% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 KNEE ARTHROSCOPY/SURGERY | $3,518.98 | $4,398.73 | $1,330.36–$6,250.50 | — | 20% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY/SURGERY | $5,520.00 | $6,900.00 | $600.14–$6,900.00 | 34% above | 20% |
| Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 KNEE ARTHROSCOPY/SURGERY | $5,520.00 | $6,900.00 | $600.14–$6,900.00 | — | 20% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 KNEE ARTHROSCOPY/SURGERY | $5,520.00 | $6,900.00 | $2,186.40–$2,616.94 | 26% above | 20% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 KNEE ARTHROSCOPY/SURGERY | $5,520.00 | $6,900.00 | $2,186.40–$2,616.94 | — | 20% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY REMOVE ADNEXA | $7,200.00 | $9,000.00 | $674.10–$7,344.00 | 26% above | 20% |
| Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAPAROSCOPY REMOVE ADNEXA | $7,200.00 | $9,000.00 | $674.10–$7,344.00 | — | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE OF WOUND(S) | $182.48 | $228.10 | — | 54% below | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE OF WOUND(S) | $182.48 | $228.10 | — | — | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 LUMBAR/SACRAL INTRALAMINAR INJ W/IMAGE | $3,672.00 | $4,590.00 | $128.10–$4,590.00 | 206% above | 20% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 LUMBAR/SACRAL INTRALAMINAR INJ W/IMAGE | $3,672.00 | $4,590.00 | $128.10–$4,590.00 | — | 20% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ FORAMEN EPIDURAL L/S SINGLE LEVEL | $3,672.00 | $4,590.00 | $151.54–$4,590.00 | 259% above | 20% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ FORAMEN EPIDURAL L/S SINGLE LEVEL | $3,672.00 | $4,590.00 | $151.54–$4,590.00 | — | 20% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LOW BACK DISK SURGERY | $12,528.00 | $15,660.00 | $2,317.55–$15,660.00 | 30% above | 20% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 Low back disk surgery | $12,528.00 | $15,660.00 | $2,317.55–$15,660.00 | 30% above | 20% |
| Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 Low back disk surgery | $12,528.00 | $15,660.00 | $2,317.55–$15,660.00 | — | 20% |
| Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 LOW BACK DISK SURGERY | $12,528.00 | $15,660.00 | $2,317.55–$15,660.00 | — | 20% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 REMOVAL OF SPINAL LAMINA | $16,560.00 | $20,700.00 | $1,328.11–$15,660.00 | 67% above | 20% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 Remove spine lamina 1 lmbr | $16,560.00 | $20,700.00 | $1,328.11–$15,660.00 | 67% above | 20% |
| Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 REMOVAL OF SPINAL LAMINA | $16,560.00 | $20,700.00 | $1,328.11–$15,660.00 | — | 20% |
| Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 Remove spine lamina 1 lmbr | $16,560.00 | $20,700.00 | $1,328.11–$15,660.00 | — | 20% |
| Lumbar spinal fusion (posterior), one level CPT 22612 LUMBAR SPINE FUSION | $5,427.48 | $6,784.35 | $4,651.79 | 51% below | 20% |
| Lumbar spinal fusion (posterior), one level CPT 22612 POSTEROLATERAL LUMBAR FUSION- 1 LEVEL | $8,135.20 | $10,169.00 | $4,651.79 | 26% below | 20% |
| Lumbar spinal fusion (posterior), one level inpatient CPT 22612 LUMBAR SPINE FUSION | $5,427.48 | $6,784.35 | $4,651.79 | — | 20% |
| Lumbar spinal fusion (posterior), one level inpatient CPT 22612 POSTEROLATERAL LUMBAR FUSION- 1 LEVEL | $8,135.20 | $10,169.00 | $4,651.79 | — | 20% |
| Lumpectomy (partial mastectomy) CPT 19301 PARTICAL MASTECTOMY | $2,370.06 | $2,962.58 | — | 22% below | 20% |
| Lumpectomy (partial mastectomy) inpatient CPT 19301 PARTICAL MASTECTOMY | $2,370.06 | $2,962.58 | — | — | 20% |
| Mastectomy (total removal of the breast) CPT 19303 MAST SIMPLE COMPLETE | $3,444.24 | $4,305.30 | — | 7% below | 20% |
| Mastectomy (total removal of the breast) inpatient CPT 19303 MAST SIMPLE COMPLETE | $3,444.24 | $4,305.30 | — | — | 20% |
| Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE | $2,276.78 | $2,845.98 | — | at median | 20% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 CARE OF MISCARRIAGE | $2,276.78 | $2,845.98 | — | — | 20% |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 MOHS 1 STAGE H/N/HF/G | $458.46 | $573.08 | — | — | 20% |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 MOHS 1 STAGE H/N/HF/G | $458.46 | $573.08 | — | — | 20% |
| 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 | $503.04 | $628.80 | $562.00 | 140% above | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC TR-EXT B9+MARG 0.5 < CM | $503.04 | $628.80 | $562.00 | — | 20% |
| 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 | $503.04 | $628.80 | — | 131% above | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC FACE-MM B9+MARG 0.5 < CM | $503.04 | $628.80 | — | — | 20% |
| Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE | $134.22 | $167.78 | — | 18% below | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE | $134.22 | $167.78 | — | — | 20% |
| Occipital nerve block (injection for headaches) CPT 64405 NBLOCK INJ OCCIPITAL | $3,672.00 | $4,590.00 | $189.38–$4,590.00 | 820% above | 20% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 NBLOCK INJ OCCIPITAL | $3,672.00 | $4,590.00 | $189.38–$4,590.00 | — | 20% |
| Partial knee replacement (one compartment) CPT 27446 REVISION OF KNEE JOINT | $25,285.66 | $31,607.08 | — | 43% above | 20% |
| Partial knee replacement (one compartment) inpatient CPT 27446 REVISION OF KNEE JOINT | $25,285.66 | $31,607.08 | — | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED | $503.04 | $628.80 | — | 19% above | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED | $503.04 | $628.80 | — | — | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 INJECTIONPARVERTEBRAL W/IM L/S, SING LEV | $2,760.00 | $3,450.00 | $361.20–$3,450.00 | 40% above | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCTION BY NEUROLYTIC AGENT | $2,760.00 | $3,450.00 | $361.20–$3,450.00 | 40% above | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTRUCTION BY NEUROLYTIC AGENT | $2,760.00 | $3,450.00 | $361.20–$3,450.00 | — | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 INJECTIONPARVERTEBRAL W/IM L/S, SING LEV | $2,760.00 | $3,450.00 | $361.20–$3,450.00 | — | 20% |
| Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION | $2,370.06 | $2,962.58 | — | 1% below | 20% |
| Removal of a breast lump, open surgery inpatient CPT 19120 REMOVAL OF BREAST LESION | $2,370.06 | $2,962.58 | — | — | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY | $176.92 | $221.15 | — | 52% below | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY | $176.92 | $221.15 | — | — | 20% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 SHOULDER ARTHROSCOPY/SURGERY | $3,518.98 | $4,398.73 | $416.19–$3,955.50 | 22% below | 20% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 SHOULDER ARTHROSCOPY/SURGERY | $3,518.98 | $4,398.73 | $416.19–$3,955.50 | — | 20% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHOULDER ARTHROSCOPY/SURGERY | $5,593.92 | $6,992.40 | $770.21–$3,955.50 | 21% above | 20% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 SHOULDER ARTHROSCOPY/SURGERY | $5,593.92 | $6,992.40 | $770.21–$3,955.50 | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SUPERFICIAL WOUND(S) | $182.48 | $228.10 | — | 30% below | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPAIR SUPERFICIAL WOUND(S) | $182.48 | $228.10 | — | — | 20% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC TR-EXT MLG+MARG 0.5 < CM | $503.04 | $628.80 | — | 93% above | 20% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC TR-EXT MLG+MARG 0.5 < CM | $503.04 | $628.80 | — | — | 20% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS | $134.22 | $167.78 | — | 9% below | 20% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS | $134.22 | $167.78 | — | — | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SUPERFICIAL WOUND(S) | $182.48 | $228.10 | — | 44% below | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPAIR SUPERFICIAL WOUND(S) | $182.48 | $228.10 | — | — | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR SUPERFICIAL WOUND(S) | $182.48 | $228.10 | — | 40% below | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPAIR SUPERFICIAL WOUND(S) | $182.48 | $228.10 | — | — | 20% |
| Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY | $14,513.00 | $18,141.25 | $1,669.79–$12,420.00 | 9% above | 20% |
| Total hip replacement inpatient CPT 27130 TOTAL HIP ARTHROPLASTY | $14,513.00 | $18,141.25 | $1,669.79–$12,420.00 | — | 20% |
| Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY | $14,513.00 | $18,141.25 | $6,147.64–$16,659.29 | 20% above | 20% |
| Total knee replacement inpatient CPT 27447 TOTAL KNEE ARTHROPLASTY | $14,513.00 | $18,141.25 | $6,147.64–$16,659.29 | — | 20% |
| Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH | $3,672.00 | $4,590.00 | $296.03–$4,590.00 | 143% above | 20% |
| Trigger finger release surgery inpatient CPT 26055 INCISE FINGER TENDON SHEATH | $3,672.00 | $4,590.00 | $296.03–$4,590.00 | — | 20% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY TUBAL CAUTERY | $5,353.72 | $6,692.15 | — | 1% below | 20% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 LAPAROSCOPY TUBAL CAUTERY | $5,353.72 | $6,692.15 | — | — | 20% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ESOPHAGOGASTRODUODENOSCOPY FLEXIBLE TRAN | $1,680.00 | $2,100.00 | — | 28% above | 20% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ESOPHAGOGASTRODUODENOSCOPY FLEXIBLE TRAN | $1,680.00 | $2,100.00 | — | — | 20% |
| Upper endoscopy (EGD), diagnostic CPT 43235 DX EXAM OF ESOPHAGUS STOMASH AND OR UPP | $1,680.00 | $2,100.00 | — | 31% above | 20% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 DX EXAM OF ESOPHAGUS STOMASH AND OR UPP | $1,680.00 | $2,100.00 | — | — | 20% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14 | $103.66 | $129.58 | — | 43% below | 20% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT B9 LESION 1-14 | $103.66 | $129.58 | — | — | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN/TISSUE | $328.84 | $411.05 | — | 7% below | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN/TISSUE | $328.84 | $411.05 | — | — | 20% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 TREAT FX RAD EXTRA-ARTICUL | $7,034.06 | $8,792.58 | — | 1% above | 20% |
| Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 TREAT FX RAD EXTRA-ARTICUL | $7,034.06 | $8,792.58 | — | — | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Kansas | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD INFUSION ROOM | $300.00 | $375.00 | — | 48% below | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD INFUSION ROOM | $300.00 | $375.00 | — | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT HANDHELD NEBULIZER TX | $23.46 | $29.32 | — | 82% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT HANDHELD NEBULIZER TX | $23.46 | $29.32 | — | — | 20% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG 12 LEAD ROUTINE WITH REPORT | $46.58 | $58.23 | — | 46% below | 20% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG 12 LEAD ROUTINE WITH REPORT | $46.58 | $58.23 | — | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD | $46.58 | $58.23 | — | 71% below | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD | $46.58 | $58.23 | — | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY ROOM LEVEL 3 | $164.80 | $206.00 | — | 68% below | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY ROOM LEVEL 3 | $164.80 | $206.00 | — | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY ROOM LEVEL 4 | $424.80 | $531.00 | — | 50% below | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY ROOM LEVEL 4 | $424.80 | $531.00 | — | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY ROOM LEVEL 5 | $535.20 | $669.00 | — | 59% below | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY ROOM LEVEL 5 | $535.20 | $669.00 | — | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION INITIAL 31-60 MINU | $222.40 | $278.00 | — | 10% below | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL HOUR | $222.40 | $278.00 | — | 10% below | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION THER/PROH/DIAG INITIAL HOUR | $222.40 | $278.00 | — | 10% below | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL HOUR | $222.40 | $278.00 | — | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION THER/PROH/DIAG INITIAL HOUR | $222.40 | $278.00 | — | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INITIAL 31-60 MINU | $222.40 | $278.00 | — | — | 20% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPEUTIC, PROPHYLACTIC | $589.93 | $737.41 | $35.24–$737.41 | 117% above | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPEUTIC, PROPHYLACTIC | $589.93 | $737.41 | $35.24–$737.41 | — | 20% |
| IV push of a medicine, first drug CPT 96374 THERAPEAUTIC PROPHYLACTIC OR DX INJECTIO | $300.00 | $375.00 | — | 38% above | 20% |
| IV push of a medicine, first drug inpatient CPT 96374 THERAPEAUTIC PROPHYLACTIC OR DX INJECTIO | $300.00 | $375.00 | — | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC INJECTION | $64.00 | $80.00 | $4.95–$80.00 | 5% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC INJECTION | $64.00 | $80.00 | $4.95–$80.00 | — | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 1500 97112 THERAPEUTIC PROCEDURE 1 | $48.00 | $60.00 | $6.08–$48.00 | 38% below | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 1500 PTA 97112 THERAPEUTIC PROCEDURES | $48.00 | $60.00 | $6.08–$48.00 | 38% below | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 PTA 97112 THERAPEUTIC PROCEDURE 1 OR MOR | $48.00 | $60.00 | $6.08–$48.00 | 38% below | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT 97112 THERAPEUTIC PROCEDURE 1 OR MORE | $48.00 | $60.00 | $6.08–$48.00 | 38% below | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT 97112 THERAPEUTIC PROCEDURE 1 OR MORE | $52.80 | $66.00 | $6.08–$48.00 | 32% below | 20% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PTA 97112 THERAPEUTIC PROCEDURE 1 OR MOR | $48.00 | $60.00 | $6.08–$48.00 | — | 20% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 1500 97112 THERAPEUTIC PROCEDURE 1 | $48.00 | $60.00 | $6.08–$48.00 | — | 20% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT 97112 THERAPEUTIC PROCEDURE 1 OR MORE | $48.00 | $60.00 | $6.08–$48.00 | — | 20% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 1500 PTA 97112 THERAPEUTIC PROCEDURES | $48.00 | $60.00 | $6.08–$48.00 | — | 20% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT 97112 THERAPEUTIC PROCEDURE 1 OR MORE | $52.80 | $66.00 | $6.08–$48.00 | — | 20% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE OP VISIT NEW PT 99203 | $254.40 | $318.00 | $18.58–$139.00 | 69% above | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE OP VISIT NEW PT 99203 | $254.40 | $318.00 | $18.58–$139.00 | — | 20% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE OP VISIT NEW PT 99204 | $380.80 | $476.00 | $28.13–$140.64 | 107% above | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE OP VISIT NEW PT 99204 | $380.80 | $476.00 | $28.13–$140.64 | — | 20% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE OP VISIT NEW PT 99205 | $504.00 | $630.00 | — | 80% above | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE OP VISIT NEW PT 99205 | $504.00 | $630.00 | — | — | 20% |
| Occupational therapy evaluation, low complexity CPT 97165 OT 97165 EVAL LOW COMPLEXITY | $136.40 | $170.50 | $41.26–$95.69 | 18% below | 20% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT 97165 EVAL LOW COMPLEXITY | $136.40 | $170.50 | $41.26–$95.69 | — | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT 97163 EVAL HIGH COMPLEXITY | $136.40 | $170.50 | $18.65–$130.40 | 35% below | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 1500 PT 97163 EVAL HIGH COMPLEXITY | $136.40 | $170.50 | $18.65–$130.40 | 35% below | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT 97163 EVAL HIGH COMPLEXITY | $136.40 | $170.50 | $18.65–$130.40 | — | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 1500 PT 97163 EVAL HIGH COMPLEXITY | $136.40 | $170.50 | $18.65–$130.40 | — | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT 97161 EVAL LOW COMPLEXITY | $136.40 | $170.50 | $18.60–$136.40 | 18% below | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 1500 PT 97161 EVAL LOW COMPLEXITY | $136.40 | $170.50 | $18.60–$136.40 | 18% below | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT 97161 EVAL LOW COMPLEXITY | $136.40 | $170.50 | $18.60–$136.40 | — | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 1500 PT 97161 EVAL LOW COMPLEXITY | $136.40 | $170.50 | $18.60–$136.40 | — | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT 97162 EVAL MODERATE COMPLEXITY | $136.40 | $170.50 | $18.60–$130.21 | 28% below | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 1500 PT 97162 EVAL MODERATE COMPLEXITY | $136.40 | $170.50 | $18.60–$130.21 | 28% below | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 1500 PT 97162 EVAL MODERATE COMPLEXITY | $136.40 | $170.50 | $18.60–$130.21 | — | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT 97162 EVAL MODERATE COMPLEXITY | $136.40 | $170.50 | $18.60–$130.21 | — | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT 97140 MANUAL THERAPY TECHNIQUES | $56.00 | $70.00 | $3.99–$61.60 | 26% below | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PTA 97140 MANUAL THERAPY TECHNIQUE | $61.60 | $77.00 | $3.99–$61.60 | 19% below | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 1500 PTA 97140 MANUAL THERAPY TECHNIQUES | $61.60 | $77.00 | $3.99–$61.60 | 19% below | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 1500 PT 97140 MANUAL THERAPY TECHNIQUES | $61.60 | $77.00 | $3.99–$61.60 | 19% below | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT 97140 MANUAL THERAPY TECHNIQUES | $61.60 | $77.00 | $3.99–$61.60 | 19% below | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT 97140 MANUAL THERAPY TECHNIQUES | $56.00 | $70.00 | $3.99–$61.60 | — | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT 97140 MANUAL THERAPY TECHNIQUES | $61.60 | $77.00 | $3.99–$61.60 | — | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 1500 PT 97140 MANUAL THERAPY TECHNIQUES | $61.60 | $77.00 | $3.99–$61.60 | — | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PTA 97140 MANUAL THERAPY TECHNIQUE | $61.60 | $77.00 | $3.99–$61.60 | — | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 1500 PTA 97140 MANUAL THERAPY TECHNIQUES | $61.60 | $77.00 | $3.99–$61.60 | — | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT 97110 THERAPEUTIC EXERCISES | $58.48 | $73.10 | $8.41–$73.10 | 25% below | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 1500 PT 97110 THERAPEUTIC EXERCISES | $58.48 | $73.10 | $8.41–$73.10 | 25% below | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT 97110 OCCUPATIONAL THER EXERCISES | $58.48 | $73.10 | $8.41–$73.10 | 25% below | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PTA 97110 THERAPEUTIC EXERCISES | $58.48 | $73.10 | $8.41–$73.10 | 25% below | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 1500 PTA 97110 THERAPEUTIC EXERCISES | $58.48 | $73.10 | $8.41–$73.10 | 25% below | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 1500 PT 97110 THERAPEUTIC EXERCISES | $58.48 | $73.10 | $8.41–$73.10 | — | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PTA 97110 THERAPEUTIC EXERCISES | $58.48 | $73.10 | $8.41–$73.10 | — | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT 97110 THERAPEUTIC EXERCISES | $58.48 | $73.10 | $8.41–$73.10 | — | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT 97110 OCCUPATIONAL THER EXERCISES | $58.48 | $73.10 | $8.41–$73.10 | — | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 1500 PTA 97110 THERAPEUTIC EXERCISES | $58.48 | $73.10 | $8.41–$73.10 | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE OP VISIT EST. PT 99215 | $412.80 | $516.00 | — | 87% above | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE OP VISIT EST. PT 99215 | $412.80 | $516.00 | — | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE OP VISIT LOW LEVEL 99213 | $207.20 | $259.00 | $15.13–$121.00 | 53% above | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE OP VISIT LOW LEVEL 99213 | $207.20 | $259.00 | $15.13–$121.00 | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE OP VISIT MOD LEVEL 99214 | $293.60 | $367.00 | $22.54–$115.58 | 78% above | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE OP VISIT MOD LEVEL 99214 | $293.60 | $367.00 | $22.54–$115.58 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE OP VISIT EST/OTHER 99212 | $128.00 | $160.00 | $9.38–$74.00 | 23% above | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE OP VISIT EST/OTHER 99212 | $128.00 | $160.00 | $9.38–$74.00 | — | 20% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULTATION PT MODERATE 99243 | $192.00 | $240.00 | — | 1% below | 20% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE CONSULTATION PT MODERATE 99243 | $192.00 | $240.00 | — | — | 20% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULTATION PT MOD/HIGH 99244 | $288.00 | $360.00 | — | 8% above | 20% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE CONSULTATION PT MOD/HIGH 99244 | $288.00 | $360.00 | — | — | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT 97530 THERAPEUTIC ACTIVITIES 15 MIN | $58.48 | $73.10 | $6.52–$49.71 | 26% below | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PTA 97530 THERAPEUTIC ACTIVITIES 15 MIN | $58.48 | $73.10 | $6.52–$49.71 | 26% below | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT 97530 THERAPEUTIC ACTIVITIES 15 MIN | $58.48 | $73.10 | $6.52–$49.71 | 26% below | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 1500 PTA 97530 THERAP ACTIVITIES 15 MIN | $58.48 | $73.10 | $6.52–$49.71 | 26% below | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 1500 97530 THERAPEUTIC ACTIVITIES 15 MIN | $58.48 | $73.10 | $6.52–$49.71 | 26% below | 20% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 1500 PTA 97530 THERAP ACTIVITIES 15 MIN | $58.48 | $73.10 | $6.52–$49.71 | — | 20% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 1500 97530 THERAPEUTIC ACTIVITIES 15 MIN | $58.48 | $73.10 | $6.52–$49.71 | — | 20% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT 97530 THERAPEUTIC ACTIVITIES 15 MIN | $58.48 | $73.10 | $6.52–$49.71 | — | 20% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PTA 97530 THERAPEUTIC ACTIVITIES 15 MIN | $58.48 | $73.10 | $6.52–$49.71 | — | 20% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT 97530 THERAPEUTIC ACTIVITIES 15 MIN | $58.48 | $73.10 | $6.52–$49.71 | — | 20% |
Vaccines
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://summitks.com/wp-content/uploads/203283620_summit-surgical-llc_standardcharges_9.1.26.csv