Monroe County Hospital
Monroe County Hospital in Albia, IA publishes cash prices for 186 common procedures listed here, from its own machine-readable price file updated Sep 9, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Iowa median for 110 of 186 procedures and below it for 74. By typical cash price it ranks #51 of 78 Iowa hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
6580 165th St Albia IA 52531 Collected Sep 27, 2026 Source price file (641) 932-2134
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 161342 · CMS hospital register
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Monroe County Hospital in Albia, IA:
- Jul 11, 2025 Met requirements
Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.
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 Iowa | Off list |
|---|---|---|---|---|---|
| Breast ultrasound, complete, one breast CPT 76641 Complete ultrasound scan of 1 breast | $635.40 | $1,059.00 | $139.56–$1,027.23 | 74% above | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT scan of blood vessels of chest with contrast | $1,786.20 | $2,977.00 | $79.53–$3,125.85 | 16% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT scan of abdomen and pelvis without contrast | $2,595.60 | $4,326.00 | $413.62–$4,196.22 | 8% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast | $3,213.60 | $5,356.00 | $413.62–$5,195.32 | at median | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT scan of abdomen and pelvis before and after contrast | $3,318.60 | $5,531.00 | $413.62–$5,365.07 | 8% below | 40% |
| CT scan of the abdomen with contrast CPT 74160 CT scan of abdomen with contrast | $1,786.20 | $2,977.00 | $413.62–$2,887.69 | 6% above | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT scan of abdomen without contrast | $1,168.20 | $1,947.00 | $150.58–$1,888.59 | 14% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT scan of face without contrast | $1,168.20 | $1,947.00 | $150.58–$1,888.59 | 10% below | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT scan head or brain without contrast | $1,099.20 | $1,832.00 | $413.62–$1,777.04 | 20% below | 40% |
| CT scan of the head with contrast CPT 70460 CT scan head or brain with contrast | $1,786.20 | $2,977.00 | $413.62–$2,887.69 | 17% above | 40% |
| CT scan of the head without and with contrast CPT 70470 CT scan of head or brain before and after contrast | $2,026.80 | $3,378.00 | $413.62–$3,276.66 | 12% above | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT scan of lower spine without contrast | $1,168.20 | $1,947.00 | $150.58–$1,888.59 | 23% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT scan of upper spine without contrast | $1,373.40 | $2,289.00 | $150.58–$2,220.33 | 9% below | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast | $1,786.20 | $2,977.00 | $413.62–$2,887.69 | 3% above | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Ultrasound of both sides of head and neck blood flow | $1,461.00 | $2,435.00 | $216.57–$2,361.95 | 66% above | 40% |
| Chest X-ray, 2 views CPT 71046 X-ray of chest, 2 views | $155.40 | $259.00 | $72.55–$251.23 | 25% below | 40% |
| Chest X-ray, single view CPT 71045 X-ray of chest, 1 view | $155.40 | $259.00 | $72.55–$251.23 | 7% below | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Complete ultrasound scan behind abdominal cavity | $955.20 | $1,592.00 | $216.57–$1,544.24 | 55% above | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA bone density measurement of hip, pelvis, spine | $228.00 | $380.00 | $102.62–$368.60 | 42% below | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, single or first fetus | $643.80 | $1,073.00 | $130.90–$1,040.81 | at median | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT scan of chest without contrast | $1,168.20 | $1,947.00 | $150.58–$1,888.59 | 17% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT scan of chest with contrast | $1,786.20 | $2,977.00 | $413.62–$2,887.69 | 1% below | 40% |
| Diagnostic mammogram, both breasts CPT 77066 Diagnostic mammography of both breasts | $369.60 | $616.00 | $63.50–$597.52 | 9% above | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 Ultrasound study of arm or leg veins with compression and maneuvers | $633.60 | $1,056.00 | $216.57–$1,024.32 | 29% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | $2,528.40 | $4,214.00 | $600.28–$4,087.58 | 66% above | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep study including heart rate, breathing, airflow, and effort | $480.60 | $801.00 | $188.14–$776.97 | 14% below | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep study in sleep lab with continuous airway pressure (6 years or older) | $2,957.40 | $4,929.00 | $118.69–$5,175.45 | 6% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Limited ultrasound scan of abdomen | $808.80 | $1,348.00 | $139.56–$1,307.56 | 64% above | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Low dose CT scan of chest for lung cancer screening | $432.60 | $721.00 | $150.58–$699.37 | 5% below | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI scan of abdomen without contrast | $2,163.00 | $3,605.00 | $324.82–$3,496.85 | 4% above | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI scan of abdomen before and after contrast | $2,762.40 | $4,604.00 | $556.38–$4,465.88 | 19% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI scan of brain without contrast | $2,163.00 | $3,605.00 | $324.82–$3,496.85 | 6% below | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI scan of brain before and after contrast | $2,762.40 | $4,604.00 | $556.38–$4,465.88 | 23% below | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal without contrast | $2,163.00 | $3,605.00 | $324.82–$3,496.85 | 10% below | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI scan of lower spinal canal before and after contrast | $2,762.40 | $4,604.00 | $556.38–$4,465.88 | 22% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI scan of middle spinal canal without contrast | $2,163.00 | $3,605.00 | $324.82–$3,496.85 | 8% below | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI scan of upper spinal canal before and after contrast | $2,762.40 | $4,604.00 | $556.38–$4,465.88 | 19% below | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI scan of upper spinal canal without contrast | $2,163.00 | $3,605.00 | $324.82–$3,496.85 | 5% below | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI scan of pelvis before and after contrast | $2,762.40 | $4,604.00 | $556.38–$4,465.88 | 15% below | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI scan of pelvis without contrast | $2,163.00 | $3,605.00 | $324.82–$3,496.85 | 5% above | 40% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 Nuclear medicine study from skull base to mid-thigh with CT scan | $2,701.20 | $4,502.00 | $1,706.33–$4,366.94 | 36% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Limited ultrasound scan of pelvis | $596.40 | $994.00 | $139.56–$964.18 | 69% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Complete ultrasound scan of pelvis | $370.20 | $617.00 | $216.57–$598.49 | 32% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus | $682.20 | $1,137.00 | $130.90–$1,102.89 | 24% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus | $329.40 | $549.00 | $130.90–$532.53 | 28% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Limited ultrasound of pregnant uterus | $471.00 | $785.00 | $130.90–$761.45 | 38% above | 40% |
| Screening mammogram, both breasts CPT 77067 Screening mammography | $352.80 | $588.00 | $63.50–$570.36 | 15% above | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 Sleep study in sleep lab (6 years or older) | $3,109.20 | $5,182.00 | $114.44–$5,441.10 | 8% above | 40% |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina | $523.20 | $872.00 | $139.56–$845.84 | at median | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 Vaginal ultrasound of pregnant uterus | $523.20 | $872.00 | $130.90–$845.84 | 15% above | 40% |
| Ultrasound of the abdomen, complete CPT 76700 Complete ultrasound scan of abdomen | $555.00 | $925.00 | $216.57–$897.25 | 20% below | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 Ultrasound scan of scrotum | $474.00 | $790.00 | $139.56–$766.30 | 13% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Ultrasound scan of head and neck soft tissue | $414.60 | $691.00 | $139.56–$670.27 | 11% below | 40% |
| X-ray of the abdomen, 1 view CPT 74018 X-ray of abdomen, 1 view | $114.00 | $190.00 | $72.55–$184.30 | 36% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-ray of lower and sacral spine, 2-3 views | $143.40 | $239.00 | $72.55–$231.83 | 50% below | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 X-ray of lower and sacral spine, minimum of 4 views | $249.00 | $415.00 | $72.55–$402.55 | 29% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-ray of middle spine, 2 views | $139.20 | $232.00 | $72.55–$225.04 | 45% below | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-ray of nose bones, minimum of 3 views | $114.00 | $190.00 | $72.55–$184.30 | 44% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-ray of upper spine, 2-3 views | $129.60 | $216.00 | $72.55–$209.52 | 48% below | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-ray of pelvis, 1-2 views | $114.00 | $190.00 | $72.55–$184.30 | 42% below | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Liver enzyme (SGPT), level | $99.60 | $166.00 | $6.33–$161.02 | 136% above | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Liver enzyme (SGOT), level | $99.60 | $166.00 | $6.33–$161.02 | 153% above | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel | $305.40 | $509.00 | $10.47–$493.73 | 33% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Measurement of antibody (IgE) to allergic substance, crude allergen extract, each | $119.40 | $199.00 | $10.39–$193.03 | 206% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Measurement of antibody for rheumatoid arthritis assessment | $99.60 | $166.00 | $12.81–$161.02 | 43% above | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Screening test for autoimmune disorder | $84.60 | $141.00 | $12.81–$136.77 | 16% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Natriuretic peptide (heart and blood vessel protein) level | $178.80 | $298.00 | $34.36–$289.06 | 14% above | 40% |
| Basic metabolic panel (blood test) CPT 80048 Blood test, basic group of blood chemicals (Calcium, total) | $88.20 | $147.00 | $10.47–$142.59 | 6% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Pathology examination of tissue using a microscope, intermediate complexity | $160.80 | $268.00 | $47.09–$259.96 | 10% below | 40% |
| Blood culture for bacteria CPT 87040 Bacterial blood culture | $114.00 | $190.00 | $9.22–$184.30 | 32% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Insertion of needle into vein for collection of blood sample | $31.20 | $52.00 | $2.97–$50.44 | 58% above | 40% |
| Blood glucose (sugar) test CPT 82947 Blood glucose (sugar) level | $99.60 | $166.00 | $6.33–$161.02 | 197% above | 40% |
| Blood lead test CPT 83655 Lead level | $49.20 | $82.00 | $9.93–$79.54 | 6% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Gonadotropin (reproductive hormone) analysis | $97.80 | $163.00 | $6.33–$158.11 | 59% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood group typing (ABO) | $75.00 | $125.00 | $3.74–$121.25 | 31% above | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Measurement C-reactive protein for detection of infection or inflammation | $61.20 | $102.00 | $5.28–$98.94 | 6% above | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Detection test by nucleic acid for clostridium difficile, amplified probe technique | $66.60 | $111.00 | $33.74–$107.67 | 38% below | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 Immunologic analysis for detection of tumor antigen, quantitative; CA 19-9 | $220.80 | $368.00 | $12.81–$356.96 | 130% above | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Immunologic analysis for detection of tumor antigen, quantitative; CA 125 | $136.80 | $228.00 | $12.81–$221.16 | 20% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen | $114.60 | $191.00 | $33.74–$185.27 | at median | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique | $128.40 | $214.00 | $33.74–$207.58 | 29% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids (cholesterol and triglycerides) | $144.00 | $240.00 | $10.47–$232.80 | 69% above | 40% |
| Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $118.20 | $197.00 | $7.11–$191.09 | 91% above | 40% |
| Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (red cells, white blood cell, platelets), automated test | $88.20 | $147.00 | $7.11–$142.59 | 97% above | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals | $114.00 | $190.00 | $10.47–$184.30 | 4% below | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 Coagulation function measurement, D-dimer; quantitative | $30.00 | $50.00 | $4.69–$48.50 | 65% below | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone (DHEA-S) hormone level | $145.80 | $243.00 | $15.54–$235.71 | 30% above | 40% |
| Estradiol blood test CPT 82670 Measurement of total estradiol (hormone) | $147.60 | $246.00 | $15.54–$238.62 | 14% above | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin, follicle stimulating (reproductive hormone) level | $198.00 | $330.00 | $15.54–$320.10 | 96% above | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Stool calprotectin (protein) level | $213.00 | $355.00 | $13.67–$344.35 | 33% above | 40% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin (blood protein) level | $144.00 | $240.00 | $13.67–$232.80 | 62% above | 40% |
| Folate (folic acid) blood test CPT 82746 Folic acid level, serum | $156.60 | $261.00 | $13.67–$253.17 | 77% above | 40% |
| Free T3 thyroid hormone test CPT 84481 Thyroid hormone, T3 measurement, free | $130.20 | $217.00 | $15.54–$210.49 | 22% above | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine (thyroid chemical), free | $88.80 | $148.00 | $13.35–$143.56 | 37% above | 40% |
| Free testosterone test CPT 84402 Testosterone (hormone) level, free | $135.00 | $225.00 | $15.54–$218.25 | 27% above | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Blood glucose (sugar) level after receiving dose of glucose | $46.20 | $77.00 | $3.66–$74.69 | 28% above | 40% |
| Glucose tolerance test, 3 samples CPT 82951 Blood glucose (sugar) tolerance test, 3 specimens | $114.00 | $190.00 | $13.67–$184.30 | 35% above | 40% |
| H. pylori antibody blood test CPT 86677 Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria) | $153.60 | $256.00 | $12.81–$248.32 | 92% above | 40% |
| H. pylori stool antigen test CPT 87338 Detection test by immunoassay technique for Helicobacter pylori (GI tract bacteria) in stool | $141.60 | $236.00 | $9.22–$228.92 | 26% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Detection test by nucleic acid for HIV-1 virus, quantification | $139.20 | $232.00 | $33.74–$225.04 | 48% below | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Detection test by immunoassay technique for HIV-1 antigen and HIV-1 and HIV-2 antibodies | $105.00 | $175.00 | $9.22–$169.75 | 40% above | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C level | $107.40 | $179.00 | $6.33–$173.63 | 77% above | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B surface antibody measurement | $128.40 | $214.00 | $12.81–$207.58 | 89% above | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Detection test by immunoassay technique for hepatitis B surface antigen | $110.40 | $184.00 | $9.22–$178.48 | 68% above | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C antibody measurement | $153.00 | $255.00 | $12.81–$247.35 | 96% above | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Detection test by nucleic acid for Hepatitis C virus, quantification | $279.60 | $466.00 | $33.74–$452.02 | 8% above | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 Analysis for antibody to Herpes simplex virus, type 1 | $107.40 | $179.00 | $12.81–$173.63 | 60% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 Analysis for antibody to Herpes simplex virus, type 2 | $107.40 | $179.00 | $12.81–$173.63 | 86% above | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 Measurement C-reactive protein for detection of infection or inflammation, high sensitivity | $91.20 | $152.00 | $12.81–$147.44 | 17% above | 40% |
| Homocysteine blood test CPT 83090 Homocysteine (amino acid) level | $160.20 | $267.00 | $15.54–$258.99 | 69% above | 40% |
| Insulin blood test CPT 83525 Insulin measurement, total | $103.20 | $172.00 | $15.54–$166.84 | 34% above | 40% |
| Iron blood test (serum iron) CPT 83540 Iron level | $73.80 | $123.00 | $6.33–$119.31 | 81% above | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity | $73.80 | $123.00 | $6.33–$119.31 | 51% above | 40% |
| Kidney function blood test panel CPT 80069 Kidney function blood test panel | $100.20 | $167.00 | $10.47–$161.99 | 14% above | 40% |
| LH (luteinizing hormone) test CPT 83002 Gonadotropin, luteinizing (reproductive hormone) level | $129.00 | $215.00 | $15.54–$208.55 | 39% above | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase (fat enzyme) level | $77.40 | $129.00 | $6.33–$125.13 | 20% above | 40% |
| Liver function blood test panel CPT 80076 Liver function blood test panel | $88.80 | $148.00 | $10.47–$143.56 | 5% above | 40% |
| Lyme disease antibody test CPT 86618 Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria) | $102.60 | $171.00 | $12.81–$165.87 | 16% above | 40% |
| Magnesium blood test CPT 83735 Magnesium level | $75.60 | $126.00 | $6.33–$122.22 | 56% above | 40% |
| Measles (rubeola) antibody test CPT 86765 Analysis for antibody to Rubeola (measles virus) | $99.60 | $166.00 | $12.81–$161.02 | 82% above | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Screening test for mononucleosis (mono) | $61.20 | $102.00 | $5.28–$98.94 | 26% above | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (prostate specific antigen) measurement, free | $97.80 | $163.00 | $13.67–$158.11 | at median | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (prostate specific antigen) measurement, total | $198.00 | $330.00 | $13.67–$320.10 | 106% above | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (parathyroid hormone) level | $285.00 | $475.00 | $37.02–$460.75 | 61% above | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test, plasma or whole blood | $61.20 | $102.00 | $4.69–$98.94 | 36% above | 40% |
| Progesterone blood test CPT 84144 Progesterone (reproductive hormone) level | $220.80 | $368.00 | $15.54–$356.96 | 127% above | 40% |
| Prolactin blood test CPT 84146 Prolactin (milk producing hormone) level | $204.60 | $341.00 | $15.54–$330.77 | 104% above | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time | $39.60 | $66.00 | $2.83–$64.02 | 21% above | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Testing for presence of drug, read by direct observation | $153.60 | $256.00 | $14.45–$248.32 | 113% above | 40% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor level | $77.40 | $129.00 | $7.31–$125.13 | 59% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 Analysis for antibody to Rubella (German measles virus) | $100.80 | $168.00 | $12.81–$162.96 | 71% above | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Stool analysis for blood, by fecal hemoglobin determination by immunoassay | $50.40 | $84.00 | $13.37–$81.48 | 12% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis detection test | $48.60 | $81.00 | $3.46–$78.57 | at median | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tuberculosis test, gamma interferon | $93.60 | $156.00 | $42.56–$151.32 | 40% below | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone (hormone) level, total | $110.40 | $184.00 | $15.54–$178.48 | 7% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal antibodies (autoantibody) measurement | $114.00 | $190.00 | $12.81–$184.30 | 51% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) | $116.40 | $194.00 | $15.54–$188.18 | 20% above | 40% |
| Uric acid blood test CPT 84550 Uric acid level, blood | $61.20 | $102.00 | $4.61–$98.94 | 70% above | 40% |
| Urinalysis with microscope exam, automated CPT 81001 Manual urinalysis test with examination using microscope, automated | $73.80 | $123.00 | $3.51–$119.31 | 77% above | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Automated urinalysis test | $38.40 | $64.00 | $1.44–$62.08 | 49% above | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Bacterial colony count, urine | $88.80 | $148.00 | $9.22–$143.56 | 52% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test | $66.60 | $111.00 | $3.51–$107.67 | 59% above | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (vitamin B-12) level | $130.20 | $217.00 | $15.54–$210.49 | 56% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D-3 level | $155.40 | $259.00 | $34.36–$251.23 | 24% above | 40% |
| Zinc blood test CPT 84630 Zinc level | $45.60 | $76.00 | $8.66–$73.72 | 13% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin, chorionic (reproductive hormone) level | $62.40 | $104.00 | $15.54–$100.88 | 30% below | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Repair of anterior cruciate ligament of knee using an endoscope | $2,434.80 | $4,058.00 | $806.03–$4,260.90 | 14% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Injection of substance into middle or upper spine canal using imaging guidance | $1,579.80 | $2,633.00 | $89.69–$2,764.65 | 29% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Injection of lower or sacral spine facet joint using imaging guidance, single level | $1,436.40 | $2,394.00 | $76.35–$2,513.70 | 12% above | 40% |
| Hysteroscopy with endometrial ablation CPT 58563 Exam of uterus with destruction of lining of uterus using an endoscope | $707.40 | $1,179.00 | $197.53–$1,237.95 | 82% below | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspiration and/or injection of fluid from large joint | $1,293.00 | $2,155.00 | $36.31–$2,262.75 | 265% above | 40% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 Removal of ovaries and/or tubes using an endoscope | $1,446.60 | $2,411.00 | $530.94–$2,531.55 | 23% below | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Injection of substance into lower spine canal using imaging guidance | $1,436.40 | $2,394.00 | $83.66–$2,513.70 | 21% above | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | $1,436.40 | $2,394.00 | $93.39–$2,513.70 | 10% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 Injection of anesthetic agent and/or steroid into upper neck and back of head nerve | $718.80 | $1,198.00 | $41.15–$1,257.90 | 78% above | 40% |
| Paracentesis with imaging guidance CPT 49083 Drainage of fluid from abdominal cavity using imaging guidance | $654.00 | $1,090.00 | $457.80–$1,057.30 | 42% below | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint | $1,436.40 | $2,394.00 | $162.49–$2,513.70 | 34% below | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test | $718.80 | $1,198.00 | $52.15–$1,257.90 | 48% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less | $256.20 | $427.00 | $196.42–$433.65 | 2% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Injection of trigger points, 1-2 muscles | $109.80 | $183.00 | $33.31–$192.15 | 64% below | 40% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Removal of sperm duct | $649.80 | $1,083.00 | $201.64–$1,137.15 | 25% below | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion of blood or blood products | $602.40 | $1,004.00 | $421.68–$973.88 | 5% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation treatment for airway obstruction or sputum production | $85.80 | $143.00 | $60.06–$138.71 | 25% below | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 Administration of chemotherapy into vein, 1 hour or less | $327.00 | $545.00 | $228.90–$528.65 | 40% below | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 Critical care, first 30-74 minutes | $699.60 | $1,166.00 | $489.72–$1,131.02 | 21% below | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical care, first 30-74 minutes | $699.60 | $1,166.00 | $489.72–$1,131.02 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing | $124.80 | $208.00 | $34.13–$201.76 | 22% below | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency department visit for problem that may not require health care professional | $114.60 | $191.00 | $80.22–$185.27 | 62% above | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency department visit for problem that may not require health care professional | $114.60 | $191.00 | $80.22–$185.27 | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency department visit with straightforward medical decision making | $160.20 | $267.00 | $112.14–$258.99 | 2% above | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency department visit with straightforward medical decision making | $160.20 | $267.00 | $112.14–$258.99 | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency department visit with low level of medical decision making | $300.00 | $500.00 | $210.00–$485.00 | 1% above | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency department visit with low level of medical decision making | $300.00 | $500.00 | $210.00–$485.00 | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency department visit with moderate level of medical decision making | $376.80 | $628.00 | $263.76–$609.16 | 33% below | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency department visit with moderate level of medical decision making | $376.80 | $628.00 | $263.76–$609.16 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency department visit with high level of medical decision making | $517.20 | $862.00 | $362.04–$836.14 | 40% below | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency department visit with high level of medical decision making | $517.20 | $862.00 | $362.04–$836.14 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infusion into a vein for hydration, 31-60 minutes | $134.40 | $224.00 | $94.08–$406.79 | 52% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | $162.00 | $270.00 | $113.40–$406.79 | 49% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection of drug or substance under skin or into muscle | $69.00 | $115.00 | $48.30–$111.55 | 23% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection of drug or substance under skin or into muscle | $69.00 | $115.00 | $48.30–$111.55 | 23% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection of drug or substance under skin or into muscle | $69.00 | $115.00 | $48.30–$111.55 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Therapy procedure for nutrition management, each 15 minutes | $40.20 | $67.00 | $28.14–$310.75 | 6% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Therapy procedure using manual technique, each 15 minutes | $103.20 | $172.00 | $72.24–$215.57 | 7% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking and tobacco use intermediate counseling, 3-10 minutes | $31.20 | $52.00 | $10.12–$54.60 | 15% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | $386.40 | $644.00 | $270.48–$624.68 | 64% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $150.00 | $250.00 | $80.35–$262.50 | 9% below | 40% |
| Speech therapy session, individual CPT 92507 Treatment of speech, language, voice, communication, and/or hearing processing disorder | $308.40 | $514.00 | $215.88–$498.58 | 41% above | 40% |
| Spirometry (breathing test) CPT 94010 Test to measure expiratory airflow and volume | $144.00 | $240.00 | $71.07–$232.80 | 28% below | 40% |
| Spirometry before and after a bronchodilator CPT 94060 Test to measure expiratory airflow and volume changes before and after medication administration | $172.20 | $287.00 | $120.54–$278.39 | 57% below | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapy procedure using functional activities | $69.00 | $115.00 | $48.30–$215.57 | 32% below | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Drawing of blood for a medical problem | $101.40 | $169.00 | $70.98–$163.93 | 48% below | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Rabies vaccine, one dose CPT 90675 Rabies vaccine for injection into muscle | $613.93 | $1,023.21 | $322.77–$961.82 | 12% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration of vaccine | $49.80 | $83.00 | $34.86–$80.51 | 42% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration of vaccine | $61.80 | $103.00 | $43.26–$99.91 | 77% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Administration of vaccine | $61.80 | $103.00 | $43.26–$99.91 | — | 40% |
Source file: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbMCHALBIAIA&type=CDMWithoutLabel&fileType=CSV