Mosaic Medical Center Maryville
Mosaic Medical Center Maryville in Maryville, MO publishes cash prices for 284 common procedures listed here, from its own machine-readable price file updated Sep 26, 2025. Compared with other hospitals in the state, its outpatient cash prices are above the Missouri median for 195 of 279 procedures and below it for 64. By typical cash price it ranks #45 of 60 Missouri hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
2016 S. Main Street, Maryville, MO 64468 Collected Sep 27, 2026 Source price file (660) 562-2600
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 261340 · 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 3 actions for a hospital named Mosaic Medical Center Maryville in Maryville, MO:
- Feb 26, 2026 Corrective action plan requested
- May 20, 2026 Corrective action plan requested
- Jul 22, 2026 Case closed
Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.
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 Missouri | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS | $340.00 | $400.00 | $85.41–$496.00 | 13% above | 15% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS | $340.00 | $400.00 | $160.00–$360.00 | — | 15% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC VASC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL | $467.50 | $550.00 | $125.04–$682.00 | 37% above | 15% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC VASC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL | $467.50 | $550.00 | $220.00–$495.00 | — | 15% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC ESOPHAGRAM - FL ESOPHAGUS BARIUM SWALLOW | $680.00 | $800.00 | $172.69–$992.00 | 56% above | 15% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC ESOPHAGRAM - FL ESOPHAGUS BARIUM SWALLOW | $680.00 | $800.00 | $320.00–$720.00 | — | 15% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC BONE IMAGING, WHOLE BODY - NM BONE WHOLE BODY | $1,870.00 | $2,200.00 | $389.79–$2,728.00 | 25% above | 15% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC BONE IMAGING, WHOLE BODY - NM BONE WHOLE BODY | $1,870.00 | $2,200.00 | $880.00–$1,980.00 | — | 15% |
| Breast ultrasound, complete, one breast CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST COMPLETE | $765.00 | $900.00 | $103.15–$1,116.00 | 98% above | 15% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST COMPLETE | $765.00 | $900.00 | $360.00–$810.00 | — | 15% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST LIMITED | $510.00 | $600.00 | $85.41–$744.00 | 57% above | 15% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST LIMITED | $510.00 | $600.00 | $240.00–$540.00 | — | 15% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIO, CHEST, COMBO, INCL IMAGE - CT CHEST ANGIO W AND WO IV CONT | $2,975.00 | $3,500.00 | $172.69–$4,340.00 | 53% above | 15% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIO, CHEST, COMBO, INCL IMAGE - CT CHEST ANGIO W AND WO IV CONT | $2,975.00 | $3,500.00 | $1,400.00–$3,150.00 | — | 15% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HRT W/O DYE W/CA TEST - CT HEART CALCIUM SCORING WO CONTRAST | $42.50 | $50.00 | $34.55–$85.41 | 50% below | 15% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HRT W/O DYE W/CA TEST - CT HEART CALCIUM SCORING WO CONTRAST | $42.50 | $50.00 | $20.00–$45.00 | — | 15% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS W/O CONTRAST - CT ABDOMEN PELVIS WO CONTRAST | $2,125.00 | $2,500.00 | $234.48–$3,100.00 | at median | 15% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS W/O CONTRAST - CT ABDOMEN PELVIS WO CONTRAST | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST | $3,230.00 | $3,800.00 | $346.43–$4,712.00 | 36% above | 15% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST | $3,230.00 | $3,800.00 | $1,520.00–$3,420.00 | — | 15% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD & PELV 1/> REGNS - CT ABDOMEN PELVIS W WO CONTRAST | $3,825.00 | $4,500.00 | $346.43–$5,580.00 | 31% above | 15% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD & PELV 1/> REGNS - CT ABDOMEN PELVIS W WO CONTRAST | $3,825.00 | $4,500.00 | $1,800.00–$4,050.00 | — | 15% |
| CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W/DYE - CT ABDOMEN W CONTRAST | $2,550.00 | $3,000.00 | $172.69–$3,720.00 | 63% above | 15% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W/DYE - CT ABDOMEN W CONTRAST | $2,550.00 | $3,000.00 | $1,200.00–$2,700.00 | — | 15% |
| CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O DYE - CT ABDOMEN WO CONTRAST | $1,870.00 | $2,200.00 | $103.15–$2,728.00 | 74% above | 15% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN W/O DYE - CT ABDOMEN WO CONTRAST | $1,870.00 | $2,200.00 | $880.00–$1,980.00 | — | 15% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST | $1,955.00 | $2,300.00 | $103.15–$2,852.00 | 81% above | 15% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST | $1,955.00 | $2,300.00 | $920.00–$2,070.00 | — | 15% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST | $2,125.00 | $2,500.00 | $103.15–$3,100.00 | 69% above | 15% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| CT scan of the head with contrast CPT 70460 HC CT SCAN HEAD CONTRAST - CT HEAD W CONTRAST | $2,550.00 | $3,000.00 | $172.69–$3,720.00 | 77% above | 15% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT SCAN HEAD CONTRAST - CT HEAD W CONTRAST | $2,550.00 | $3,000.00 | $1,200.00–$2,700.00 | — | 15% |
| CT scan of the head without and with contrast CPT 70470 HC CT SCAN HEAD COMBO - CT HEAD W WO CONTRAST | $2,720.00 | $3,200.00 | $172.69–$3,968.00 | 52% above | 15% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT SCAN HEAD COMBO - CT HEAD W WO CONTRAST | $2,720.00 | $3,200.00 | $1,280.00–$2,880.00 | — | 15% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT SCAN,LUMBAR SPINE,W/O CONTRAST - CT LUMBAR SPINE WO CONTRAST | $2,125.00 | $2,500.00 | $103.15–$3,100.00 | 54% above | 15% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT SCAN,LUMBAR SPINE,W/O CONTRAST - CT LUMBAR SPINE WO CONTRAST | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT SCAN,CERVICAL SPINE,W/O CONTRAST - CT CERVICAL SPINE WO CONTRAST | $2,125.00 | $2,500.00 | $103.15–$3,100.00 | 31% above | 15% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT SCAN,CERVICAL SPINE,W/O CONTRAST - CT CERVICAL SPINE WO CONTRAST | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST | $2,720.00 | $3,200.00 | $172.69–$3,968.00 | 66% above | 15% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST | $2,720.00 | $3,200.00 | $1,280.00–$2,880.00 | — | 15% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL,BILAT - CAROTID DUPLEX | $680.00 | $800.00 | $234.48–$992.00 | — | 15% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL,BILAT - CAROTID DUPLEX | $680.00 | $800.00 | $320.00–$720.00 | — | 15% |
| Chest X-ray, 2 views CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS | $382.50 | $450.00 | $85.41–$558.00 | 52% above | 15% |
| Chest X-ray, 2 views inpatient CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS | $382.50 | $450.00 | $180.00–$405.00 | — | 15% |
| Chest X-ray, single view CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST 1 VIEW | $361.25 | $425.00 | $85.41–$527.00 | 72% above | 15% |
| Chest X-ray, single view inpatient CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST 1 VIEW | $361.25 | $425.00 | $170.00–$382.50 | — | 15% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY AXIAL - DEXA BONE DENSITY | $425.00 | $500.00 | $103.15–$620.00 | 24% above | 15% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DXA BONE DENSITY AXIAL - DEXA BONE DENSITY | $425.00 | $500.00 | $200.00–$450.00 | — | 15% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DXA BONE DENSITY/PERIPHERAL - DEXA BONE DENSITY EXTREMITY | $276.25 | $325.00 | $85.41–$403.00 | 51% above | 15% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC DXA BONE DENSITY/PERIPHERAL - DEXA BONE DENSITY EXTREMITY | $276.25 | $325.00 | $130.00–$292.50 | — | 15% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT SCAN,THORAX,W/O CONTRAST - CT CHEST WO CONTRAST | $2,125.00 | $2,500.00 | $103.15–$3,100.00 | 65% above | 15% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT SCAN,THORAX,W/O CONTRAST - CT CHEST WO CONTRAST | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CAT SCAN OF CHEST CONTRAST - CT CHEST W CONTRAST | $2,720.00 | $3,200.00 | $172.69–$3,968.00 | 65% above | 15% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CAT SCAN OF CHEST CONTRAST - CT CHEST W CONTRAST | $2,720.00 | $3,200.00 | $1,280.00–$2,880.00 | — | 15% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI - MAMMO BREAST DIAGNOSTIC BILATERAL | $297.50 | $350.00 | $93.16–$434.00 | — | 15% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI - MAMMO BREAST DIAGNOSTIC BILATERAL | $297.50 | $350.00 | $140.00–$315.00 | — | 15% |
| Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC | $233.75 | $275.00 | $73.15–$341.00 | at median | 15% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC | $233.75 | $275.00 | $110.00–$247.50 | — | 15% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC VASC DUPLEX LO EXTREM ART BILAT | $935.00 | $1,100.00 | $234.48–$1,364.00 | — | 15% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC VASC DUPLEX LO EXTREM ART BILAT | $935.00 | $1,100.00 | $440.00–$990.00 | — | 15% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC VASC DUPLEX EXTREM VENOUS,BILAT | $850.00 | $1,000.00 | $234.48–$1,240.00 | — | 15% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC VASC DUPLEX EXTREM VENOUS,BILAT | $850.00 | $1,000.00 | $400.00–$900.00 | — | 15% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE W OR WO FOL WCON,DOPPLER, COMP | $2,125.00 | $2,500.00 | $531.88–$3,100.00 | 26% above | 15% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE COMP W/WOM-MODE COMPL SPEC&COLR D | $2,125.00 | $2,500.00 | $531.88–$3,100.00 | 26% above | 15% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE COMP W/WOM-MODE COMPL SPEC&COLR D | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE W OR WO FOL WCON,DOPPLER, COMP | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP SCREENING - HOME | $488.75 | $575.00 | $151.77–$713.00 | 26% below | 15% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP SCREENING - HOME | $488.75 | $575.00 | $230.00–$517.50 | — | 15% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOM 6/>YRS CPAP 4/> PARM | $4,058.75 | $4,775.00 | $986.92–$5,921.00 | 53% above | 15% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOM 6/>YRS CPAP 4/> PARM | $4,058.75 | $4,775.00 | $1,910.00–$4,297.50 | — | 15% |
| Knee X-ray, 3 views CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS | $467.50 | $550.00 | $85.41–$682.00 | 73% above | 15% |
| Knee X-ray, 3 views inpatient CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS | $467.50 | $550.00 | $220.00–$495.00 | — | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED | $680.00 | $800.00 | $103.15–$992.00 | 32% above | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED SPLEEN | $935.00 | $1,100.00 | $103.15–$1,364.00 | 81% above | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED | $680.00 | $800.00 | $320.00–$720.00 | — | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED SPLEEN | $935.00 | $1,100.00 | $440.00–$990.00 | — | 15% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C- | $255.00 | $300.00 | $103.15–$372.00 | 41% below | 15% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C- | $255.00 | $300.00 | $120.00–$270.00 | — | 15% |
| MRI of both breasts, without and then with contrast dye CPT 77049 HC MR BREAST BIL W+W/O CONTRAST | $2,465.00 | $2,900.00 | $855.49–$3,596.00 | 38% above | 15% |
| MRI of both breasts, without and then with contrast dye inpatient CPT 77049 HC MR BREAST BIL W+W/O CONTRAST | $2,465.00 | $2,900.00 | $1,160.00–$2,610.00 | — | 15% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI JNT OF LWR EXTRE W/O CONTRAST | $2,125.00 | $2,500.00 | $234.48–$3,100.00 | 14% above | 15% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI JNT OF LWR EXTRE W/O CONTRAST | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI JOINT LOWER EXTREM W/O & W/CONTRAST | $3,400.00 | $4,000.00 | $346.43–$4,960.00 | 52% above | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI JOINT LOWER EXTREM W/O & W/CONTRAST | $3,400.00 | $4,000.00 | $1,600.00–$3,600.00 | — | 15% |
| MRI of the abdomen without contrast CPT 74181 HC MRI, ABDOMEN (MRI) - MRI ABDOMEN WO CONTRAST | $2,125.00 | $2,500.00 | $234.48–$3,100.00 | 28% above | 15% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI, ABDOMEN (MRI) - MRI ABDOMEN WO CONTRAST | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN W WO CONTRAST | $3,315.00 | $3,900.00 | $346.43–$4,836.00 | 37% above | 15% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN W WO CONTRAST | $3,315.00 | $3,900.00 | $1,560.00–$3,510.00 | — | 15% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $2,295.00 | $2,700.00 | $234.48–$3,348.00 | 42% above | 15% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $2,295.00 | $2,700.00 | $1,080.00–$2,430.00 | — | 15% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN/BRAIN STEM W/O & W/CONTRAST | $3,825.00 | $4,500.00 | $346.43–$5,580.00 | 50% above | 15% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN/BRAIN STEM W/O & W/CONTRAST | $3,825.00 | $4,500.00 | $1,800.00–$4,050.00 | — | 15% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI, LUMBAR SPINE - MRI LUMBAR SPINE WO CONTRAST | $2,125.00 | $2,500.00 | $234.48–$3,100.00 | 14% above | 15% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI, LUMBAR SPINE - MRI LUMBAR SPINE WO CONTRAST | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI, LUMBAR SPINE COMBO - MRI LUMBAR SPINE W WO CONTRAST | $3,485.00 | $4,100.00 | $346.43–$5,084.00 | 40% above | 15% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI, LUMBAR SPINE COMBO - MRI LUMBAR SPINE W WO CONTRAST | $3,485.00 | $4,100.00 | $1,640.00–$3,690.00 | — | 15% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI, DORSAL SPINE - MRI THORACIC SPINE WO CONTRAST | $2,125.00 | $2,500.00 | $234.48–$3,100.00 | 21% above | 15% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI, DORSAL SPINE - MRI THORACIC SPINE WO CONTRAST | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI, CERV SPINE COMBO - MRI CERVICAL SPINE W WO CONTRAST | $3,485.00 | $4,100.00 | $346.43–$5,084.00 | 40% above | 15% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI, CERV SPINE COMBO - MRI CERVICAL SPINE W WO CONTRAST | $3,485.00 | $4,100.00 | $1,640.00–$3,690.00 | — | 15% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI, CERV SPINE - MRI CERVICAL SPINE WO CONTRAST | $2,125.00 | $2,500.00 | $234.48–$3,100.00 | 7% above | 15% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI, CERV SPINE - MRI CERVICAL SPINE WO CONTRAST | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI, PELVIS, COMBO - MRI PELVIS W WO CONTRAST | $3,400.00 | $4,000.00 | $346.43–$4,960.00 | 33% above | 15% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI, PELVIS, COMBO - MRI PELVIS W WO CONTRAST | $3,400.00 | $4,000.00 | $1,600.00–$3,600.00 | — | 15% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI, PELVIS, W/O CONTRAST - MRI PELVIS WO CONTRAST | $2,550.00 | $3,000.00 | $234.48–$3,720.00 | 36% above | 15% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI, PELVIS, W/O CONTRAST - MRI PELVIS WO CONTRAST | $2,550.00 | $3,000.00 | $1,200.00–$2,700.00 | — | 15% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI, JOINT UPPER EXTREM W/O CONTRAST | $2,380.00 | $2,800.00 | $234.48–$3,472.00 | 28% above | 15% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI, JOINT UPPER EXTREM W/O CONTRAST | $2,380.00 | $2,800.00 | $1,120.00–$2,520.00 | — | 15% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST EXERCISE W MYOCARD PERF | $4,590.00 | $5,400.00 | $1,266.38–$6,696.00 | 12% above | 15% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST REGADENOSON W MYOCARD PERF | $4,590.00 | $5,400.00 | $1,266.38–$6,696.00 | 12% above | 15% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST DOBUTAMINE W MYOCARD PERF | $4,590.00 | $5,400.00 | $1,266.38–$6,696.00 | 12% above | 15% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - NM HEART PERFUSION SPECT STRESS & REST | $4,590.00 | $5,400.00 | $1,266.38–$6,696.00 | 12% above | 15% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST DOBUTAMINE W MYOCARD PERF | $4,590.00 | $5,400.00 | $2,160.00–$4,860.00 | — | 15% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST REGADENOSON W MYOCARD PERF | $4,590.00 | $5,400.00 | $2,160.00–$4,860.00 | — | 15% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST EXERCISE W MYOCARD PERF | $4,590.00 | $5,400.00 | $2,160.00–$4,860.00 | — | 15% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - NM HEART PERFUSION SPECT STRESS & REST | $4,590.00 | $5,400.00 | $2,160.00–$4,860.00 | — | 15% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGE W/CT SKULL-THIGH - PT/CT BONE SKULL BASE TO MID THIGH | $6,630.00 | $7,800.00 | $1,414.90–$9,672.00 | 44% above | 15% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGE W/CT SKULL-THIGH - PT/CT BONE SKULL BASE TO MID THIGH | $6,630.00 | $7,800.00 | $3,120.00–$7,020.00 | — | 15% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED | $595.00 | $700.00 | $103.15–$868.00 | 43% above | 15% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED | $595.00 | $700.00 | $280.00–$630.00 | — | 15% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC ECHO,PELVIC (NONOBSTETRIC) - US PELVIS | $1,020.00 | $1,200.00 | $103.15–$1,488.00 | 57% above | 15% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC ECHO,PELVIC (NONOBSTETRIC) - US PELVIS | $1,020.00 | $1,200.00 | $480.00–$1,080.00 | — | 15% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST | $510.00 | $600.00 | $103.15–$744.00 | 11% below | 15% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST | $510.00 | $600.00 | $240.00–$540.00 | — | 15% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC OB US < 14 WKS SINGLE FETUS - US OB < 14 WEEKS SINGLE OR FIRST GEST | $595.00 | $700.00 | $103.15–$868.00 | 14% above | 15% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC OB US < 14 WKS SINGLE FETUS - US OB < 14 WEEKS SINGLE OR FIRST GEST | $595.00 | $700.00 | $280.00–$630.00 | — | 15% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC OB US LIMITED FETUS(S) - US OB LIMITED 1+ FETUSES | $637.50 | $750.00 | $103.15–$930.00 | 71% above | 15% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC OB US LIMITED FETUS(S) - US OB LIMITED 1+ FETUSES | $637.50 | $750.00 | $300.00–$675.00 | — | 15% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING BILATERAL | $212.50 | $250.00 | $77.00–$310.00 | — | 15% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING BILATERAL | $212.50 | $250.00 | $100.00–$225.00 | — | 15% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS | $425.00 | $500.00 | $85.41–$620.00 | 56% above | 15% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS | $425.00 | $500.00 | $200.00–$450.00 | — | 15% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOM 6/> YRS 4/> PARAM | $4,058.75 | $4,775.00 | $986.92–$5,921.00 | 50% above | 15% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOM 6/> YRS 4/> PARAM | $4,058.75 | $4,775.00 | $1,910.00–$4,297.50 | — | 15% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC CINE/VID X-RAY THROAT/ESOPH - FL ESOPH BARIUM SWLW W/ VIDEO & SPEECH | $722.50 | $850.00 | $172.69–$1,054.00 | 57% above | 15% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC CINE/VID X-RAY THROAT/ESOPH - FL ESOPH BARIUM SWLW W/ VIDEO & SPEECH | $722.50 | $850.00 | $340.00–$765.00 | — | 15% |
| Transvaginal pelvic ultrasound CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL - US PELVIS TRANSVAGINAL | $637.50 | $750.00 | $103.15–$930.00 | 9% above | 15% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL - US PELVIS TRANSVAGINAL | $637.50 | $750.00 | $300.00–$675.00 | — | 15% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC TRANSVAGINAL US OBSTETRIC - US OB TRANSVAGINAL | $807.50 | $950.00 | $103.15–$1,178.00 | 70% above | 15% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC TRANSVAGINAL US OBSTETRIC - US OB TRANSVAGINAL | $807.50 | $950.00 | $380.00–$855.00 | — | 15% |
| Ultrasound of the abdomen, complete CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN COMPLETE | $850.00 | $1,000.00 | $103.15–$1,240.00 | 5% above | 15% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN COMPLETE | $850.00 | $1,000.00 | $400.00–$900.00 | — | 15% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME IMAGE DOCUMENTATION | $680.00 | $800.00 | $103.15–$992.00 | 20% above | 15% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME IMAGE DOCUMENTATION | $680.00 | $800.00 | $320.00–$720.00 | — | 15% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC X-RAY UPPER GI DELAY W/O KUB - FL UPPER GI WITHOUT KUB | $1,020.00 | $1,200.00 | $172.69–$1,488.00 | 78% above | 15% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC X-RAY UPPER GI DELAY W/O KUB - FL UPPER GI WITHOUT KUB | $1,020.00 | $1,200.00 | $480.00–$1,080.00 | — | 15% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC VASC DUPLEX EXTREM VENOUS,UNI OR LTD | $807.50 | $950.00 | $103.15–$1,178.00 | 37% above | 15% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC VASC DUPLEX EXTREM VENOUS,UNI OR LTD | $807.50 | $950.00 | $380.00–$855.00 | — | 15% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS | $340.00 | $400.00 | $85.41–$496.00 | 30% above | 15% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS | $340.00 | $400.00 | $160.00–$360.00 | — | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW | $340.00 | $400.00 | $85.41–$496.00 | 43% above | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW | $340.00 | $400.00 | $160.00–$360.00 | — | 15% |
| X-ray of the abdomen, 1 view CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR ABDOMEN 1 VIEW | $340.00 | $400.00 | $85.41–$496.00 | 56% above | 15% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR ABDOMEN 1 VIEW | $340.00 | $400.00 | $160.00–$360.00 | — | 15% |
| X-ray of the ankle, 2 views CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS | $382.50 | $450.00 | $85.41–$558.00 | 102% above | 15% |
| X-ray of the ankle, 2 views inpatient CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS | $382.50 | $450.00 | $180.00–$405.00 | — | 15% |
| X-ray of the finger(s), 2 or more views CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS | $382.50 | $450.00 | $85.41–$558.00 | 86% above | 15% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS | $382.50 | $450.00 | $180.00–$405.00 | — | 15% |
| X-ray of the foot, 2 views CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS | $382.50 | $450.00 | $85.41–$558.00 | 93% above | 15% |
| X-ray of the foot, 2 views inpatient CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS | $382.50 | $450.00 | $180.00–$405.00 | — | 15% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS | $340.00 | $400.00 | $85.41–$496.00 | 24% above | 15% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS | $340.00 | $400.00 | $160.00–$360.00 | — | 15% |
| X-ray of the hand, 3 or more views CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS | $340.00 | $400.00 | $85.41–$496.00 | 35% above | 15% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS | $340.00 | $400.00 | $160.00–$360.00 | — | 15% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS | $382.50 | $450.00 | $85.41–$558.00 | 67% above | 15% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS | $382.50 | $450.00 | $180.00–$405.00 | — | 15% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC X-RAY LUMBAR SPINE 2/3 VW - XR LUMBAR SPINE 2-3 VIEWS | $425.00 | $500.00 | $103.15–$620.00 | 44% above | 15% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC X-RAY LUMBAR SPINE 2/3 VW - XR LUMBAR SPINE 2-3 VIEWS | $425.00 | $500.00 | $200.00–$450.00 | — | 15% |
| X-ray of the lower back, 4 or more views CPT 72110 HC RADEX SPINE LUMBOSARCRAL MINIMUM 4 VIEWS | $531.25 | $625.00 | $103.15–$775.00 | 24% above | 15% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC RADEX SPINE LUMBOSARCRAL MINIMUM 4 VIEWS | $531.25 | $625.00 | $250.00–$562.50 | — | 15% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC X-RAY THORACIC SPINE 2 VW - XR THORACIC SPINE 2 VIEWS | $425.00 | $500.00 | $103.15–$620.00 | 62% above | 15% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC X-RAY THORACIC SPINE 2 VW - XR THORACIC SPINE 2 VIEWS | $425.00 | $500.00 | $200.00–$450.00 | — | 15% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC X-RAY NASAL BONES | $425.00 | $500.00 | $85.41–$620.00 | 70% above | 15% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC X-RAY NASAL BONES | $425.00 | $500.00 | $200.00–$450.00 | — | 15% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 2-3 VIEWS | $510.00 | $600.00 | $85.41–$744.00 | 70% above | 15% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 2-3 VIEWS | $510.00 | $600.00 | $240.00–$540.00 | — | 15% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC X-RAY PELVIS 1/2 VW - XR PELVIS 1-2 VIEWS | $361.25 | $425.00 | $103.15–$527.00 | 60% above | 15% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC X-RAY PELVIS 1/2 VW - XR PELVIS 1-2 VIEWS | $361.25 | $425.00 | $170.00–$382.50 | — | 15% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC X-RAY SACRUM/COCCYX 2+ VW - XR SACRUM COCCYX 2+ VIEWS | $425.00 | $500.00 | $85.41–$620.00 | 62% above | 15% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC X-RAY SACRUM/COCCYX 2+ VW - XR SACRUM COCCYX 2+ VIEWS | $425.00 | $500.00 | $200.00–$450.00 | — | 15% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE ALANINE AMINO (ALT) (SGPT) - ALT (SGPT) | $76.50 | $90.00 | $5.04–$111.60 | 58% above | 15% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE ALANINE AMINO (ALT) (SGPT) - ALT (SGPT) | $76.50 | $90.00 | $36.00–$81.00 | — | 15% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO (AST) (SGOT) - AST (SGOT) | $51.00 | $60.00 | $4.92–$74.40 | 10% above | 15% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO (AST) (SGOT) - AST (SGOT) | $51.00 | $60.00 | $24.00–$54.00 | — | 15% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS PANEL,ACUTE - BUNDLED CHARGE | $221.00 | $260.00 | $45.25–$322.40 | 6% below | 15% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS PANEL,ACUTE - BUNDLED CHARGE | $221.00 | $260.00 | $104.00–$234.00 | — | 15% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH | $17.00 | $20.00 | $4.96–$24.80 | 23% below | 15% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH | $17.00 | $20.00 | $8.00–$18.00 | — | 15% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CIRULLINATED PEPTIDE ANTIBODY - CYCLIC CITRUL PEPTIDE ANTIBDY | $51.00 | $60.00 | $12.30–$74.40 | 36% below | 15% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CIRULLINATED PEPTIDE ANTIBODY - CYCLIC CITRUL PEPTIDE ANTIBDY | $51.00 | $60.00 | $24.00–$54.00 | — | 15% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES TITER - ANA TITER | $51.00 | $60.00 | $11.49–$74.40 | 25% below | 15% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES TITER - ANA TITER | $51.00 | $60.00 | $24.00–$54.00 | — | 15% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE - B-TYPE NATRIURETIC PEPTIDE (BNP) | $102.00 | $120.00 | $37.30–$148.80 | 17% below | 15% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE - B-TYPE NATRIURETIC PEPTIDE (BNP) | $102.00 | $120.00 | $48.00–$108.00 | — | 15% |
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL - BUNDLED CHARGE | $136.00 | $160.00 | $8.04–$198.40 | 10% above | 15% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL - BUNDLED CHARGE | $136.00 | $160.00 | $64.00–$144.00 | — | 15% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURG PATH,LEVEL IV - LAB SURG PATH,LEVEL IV | $204.00 | $240.00 | $51.83–$297.60 | at median | 15% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SURG PATH,LEVEL IV - LAB SURG PATH,LEVEL IV | $204.00 | $240.00 | $96.00–$216.00 | — | 15% |
| Blood culture for bacteria CPT 87040 HC BLOOD CULTURE | $85.00 | $100.00 | $9.80–$124.00 | 24% below | 15% |
| Blood culture for bacteria inpatient CPT 87040 HC BLOOD CULTURE | $85.00 | $100.00 | $40.00–$90.00 | — | 15% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC CHG COLLECTION VENOUS BLOOD,VENIPUNCTURE - DRAW CHARGE | $17.00 | $20.00 | $8.39–$24.80 | 1% above | 15% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC CHG COLLECTION VENOUS BLOOD,VENIPUNCTURE - DRAW CHARGE | $17.00 | $20.00 | $8.00–$18.00 | — | 15% |
| Blood glucose (sugar) test CPT 82947 HC ASSAY GLUCOSE BLOOD QUANT | $34.00 | $40.00 | $3.73–$49.60 | 4% above | 15% |
| Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY GLUCOSE BLOOD QUANT | $34.00 | $40.00 | $16.00–$36.00 | — | 15% |
| Blood lead test CPT 83655 HC ASSAY OF LEAD - LEAD BLOOD | $51.00 | $60.00 | $11.50–$74.40 | 7% below | 15% |
| Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD - LEAD BLOOD | $51.00 | $60.00 | $24.00–$54.00 | — | 15% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO - BLOOD TYPE AND SCREEN | $119.00 | $140.00 | $96.74–$173.60 | 65% above | 15% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO - BLOOD TYPE AND SCREEN | $119.00 | $140.00 | $56.00–$126.00 | — | 15% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN - C-REACTIVE PROTEIN | $59.50 | $70.00 | $4.92–$86.80 | at median | 15% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN - C-REACTIVE PROTEIN | $59.50 | $70.00 | $28.00–$63.00 | — | 15% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC C DIFF EPI PCR | $102.00 | $120.00 | $35.41–$148.80 | 27% below | 15% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C DIFF EPI PCR | $102.00 | $120.00 | $48.00–$108.00 | — | 15% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 19-9 - CANCER ANTIGEN 19-9 | $59.50 | $70.00 | $19.77–$86.80 | 46% below | 15% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 19-9 - CANCER ANTIGEN 19-9 | $59.50 | $70.00 | $28.00–$63.00 | — | 15% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 125 - CA 125 | $51.00 | $60.00 | $19.77–$74.40 | 53% below | 15% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 125 - CA 125 | $51.00 | $60.00 | $24.00–$54.00 | — | 15% |
| COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ - SARS-COV-2 RT PCR | $204.00 | $240.00 | $48.74–$297.60 | 104% above | 15% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ - SARS-COV-2 RT PCR | $204.00 | $240.00 | $96.00–$216.00 | — | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHYLMD TRACH, DNA, AMP PROBE | $170.00 | $200.00 | $33.34–$248.00 | 89% above | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHYLMD TRACH, DNA, AMP PROBE | $170.00 | $200.00 | $80.00–$180.00 | — | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL - BUNDLED CHARGE | $102.00 | $120.00 | $12.72–$148.80 | 1% below | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL - BUNDLED CHARGE | $102.00 | $120.00 | $48.00–$108.00 | — | 15% |
| Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC & AUTO DIFF WBC - ADDITIONAL CHARGE | $85.00 | $100.00 | $7.38–$124.00 | 60% above | 15% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE CBC & AUTO DIFF WBC - ADDITIONAL CHARGE | $85.00 | $100.00 | $40.00–$90.00 | — | 15% |
| Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC - CBC | $68.00 | $80.00 | $6.15–$99.20 | 39% above | 15% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC - CBC | $68.00 | $80.00 | $32.00–$72.00 | — | 15% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC METABOLIC PANEL,COMPREHENSIVE - BUNDLED CHARGE | $191.25 | $225.00 | $10.03–$279.00 | 52% above | 15% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC METABOLIC PANEL,COMPREHENSIVE - BUNDLED CHARGE | $191.25 | $225.00 | $90.00–$202.50 | — | 15% |
| D-dimer blood test (blood clot marker) CPT 85379 HC FIBRIN DEGRADPRODUCTS,D-DIMER, QUANT - D-DIMER,QUANTITATIVE | $195.50 | $230.00 | $9.67–$285.20 | 56% above | 15% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC FIBRIN DEGRADPRODUCTS,D-DIMER, QUANT - D-DIMER,QUANTITATIVE | $195.50 | $230.00 | $92.00–$207.00 | — | 15% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE - DHEA-SULFATE | $110.50 | $130.00 | $21.12–$161.20 | 19% below | 15% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE - DHEA-SULFATE | $110.50 | $130.00 | $52.00–$117.00 | — | 15% |
| Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL - ESTRADIOL | $136.00 | $160.00 | $26.54–$198.40 | 5% below | 15% |
| Estradiol blood test inpatient CPT 82670 HC ASSAY OF ESTRADIOL - ESTRADIOL | $136.00 | $160.00 | $64.00–$144.00 | — | 15% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN (FSH) - FSH | $102.00 | $120.00 | $17.65–$148.80 | at median | 15% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN (FSH) - FSH | $102.00 | $120.00 | $48.00–$108.00 | — | 15% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC CALPROTECTIN, STOOL | $272.00 | $320.00 | $18.65–$396.80 | 46% above | 15% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC CALPROTECTIN, STOOL | $272.00 | $320.00 | $128.00–$288.00 | — | 15% |
| Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN - FERRITIN | $136.00 | $160.00 | $12.95–$198.40 | 62% above | 15% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN - FERRITIN | $136.00 | $160.00 | $64.00–$144.00 | — | 15% |
| Folate (folic acid) blood test CPT 82746 HC BLOOD FOLIC ACID SERUM - FOLATE | $59.50 | $70.00 | $13.97–$86.80 | 22% below | 15% |
| Folate (folic acid) blood test inpatient CPT 82746 HC BLOOD FOLIC ACID SERUM - FOLATE | $59.50 | $70.00 | $28.00–$63.00 | — | 15% |
| Free T3 thyroid hormone test CPT 84481 HC TRIIODOTHYRONINE FREE ASSAY (FT-3) - T3 FREE | $76.50 | $90.00 | $16.09–$111.60 | 23% below | 15% |
| Free T3 thyroid hormone test inpatient CPT 84481 HC TRIIODOTHYRONINE FREE ASSAY (FT-3) - T3 FREE | $76.50 | $90.00 | $36.00–$81.00 | — | 15% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE - T4 FREE | $42.50 | $50.00 | $8.57–$62.00 | 43% below | 15% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE - T4 FREE | $42.50 | $50.00 | $20.00–$45.00 | — | 15% |
| Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE | $136.00 | $160.00 | $24.20–$198.40 | 8% above | 15% |
| Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE | $136.00 | $160.00 | $64.00–$144.00 | — | 15% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC GENERAL HEALTH PANEL - BUNDLED CHARGE | $340.00 | $400.00 | $51.39–$496.00 | 23% above | 15% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC GENERAL HEALTH PANEL - BUNDLED CHARGE | $340.00 | $400.00 | $160.00–$360.00 | — | 15% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE | $42.50 | $50.00 | $4.51–$62.00 | at median | 15% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUCOSE DOSE | $42.50 | $50.00 | $20.00–$45.00 | — | 15% |
| Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) | $106.25 | $125.00 | $12.23–$155.00 | 17% above | 15% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) | $106.25 | $125.00 | $50.00–$112.50 | — | 15% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.GONORRHOEAE, DNA, AMP PROB - GC DNA PCR | $144.50 | $170.00 | $33.34–$210.80 | 78% above | 15% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N.GONORRHOEAE, DNA, AMP PROB - GC DNA PCR | $144.50 | $170.00 | $68.00–$153.00 | — | 15% |
| H. pylori stool antigen test CPT 87338 HC IAAD IA HPYLORI STOOL - H PYLORI ANTIGEN STOOL | $144.50 | $170.00 | $13.66–$210.80 | 21% above | 15% |
| H. pylori stool antigen test inpatient CPT 87338 HC IAAD IA HPYLORI STOOL - H PYLORI ANTIGEN STOOL | $144.50 | $170.00 | $68.00–$153.00 | — | 15% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRPJ - HIV RNA, QUANTITATIVE, PCR | $340.00 | $400.00 | $80.85–$496.00 | 3% below | 15% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRPJ - HIV RNA, QUANTITATIVE, PCR | $340.00 | $400.00 | $160.00–$360.00 | — | 15% |
| HIV-1 and HIV-2 antibody test CPT 86703 HC HIV-1/HIV-2, SINGLE ASSAY - RAPID HIV 1 AND 2 SCREEN | $68.00 | $80.00 | $13.02–$99.20 | 41% below | 15% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV-1/HIV-2, SINGLE ASSAY - RAPID HIV 1 AND 2 SCREEN | $68.00 | $80.00 | $32.00–$72.00 | — | 15% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE | $110.50 | $130.00 | $22.88–$161.20 | 36% above | 15% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE | $110.50 | $130.00 | $52.00–$117.00 | — | 15% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES, POOLED RESULT | $153.00 | $180.00 | $33.34–$223.20 | 38% above | 15% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES, POOLED RESULT | $153.00 | $180.00 | $72.00–$162.00 | — | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - HEMOGLOBIN A1C | $68.00 | $80.00 | $9.22–$99.20 | 11% above | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - HEMOGLOBIN A1C | $68.00 | $80.00 | $32.00–$72.00 | — | 15% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY | $51.00 | $60.00 | $10.20–$74.40 | 26% below | 15% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY | $51.00 | $60.00 | $24.00–$54.00 | — | 15% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN - HEPATITIS B SURFACE ANTIGEN | $51.00 | $60.00 | $9.81–$74.40 | 21% below | 15% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN - HEPATITIS B SURFACE ANTIGEN | $51.00 | $60.00 | $24.00–$54.00 | — | 15% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C AB TEST - HEPATITIS C ANTIBODY | $68.00 | $80.00 | $13.56–$99.20 | 20% below | 15% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C AB TEST - HEPATITIS C ANTIBODY | $68.00 | $80.00 | $32.00–$72.00 | — | 15% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION | $297.50 | $350.00 | $40.70–$434.00 | at median | 15% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION | $297.50 | $350.00 | $140.00–$315.00 | — | 15% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TEST, TYPE 1 | $68.00 | $80.00 | $12.53–$99.20 | 3% above | 15% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TEST, TYPE 1 | $68.00 | $80.00 | $32.00–$72.00 | — | 15% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TEST, TYPE 2 | $93.50 | $110.00 | $18.38–$136.40 | 54% above | 15% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TEST, TYPE 2 | $93.50 | $110.00 | $44.00–$99.00 | — | 15% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN,HIGH SENSITIVITY - HIGH SENSITIVITY CRP | $93.50 | $110.00 | $12.30–$136.40 | 32% above | 15% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN,HIGH SENSITIVITY - HIGH SENSITIVITY CRP | $93.50 | $110.00 | $44.00–$99.00 | — | 15% |
| Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE | $59.50 | $70.00 | $17.02–$86.80 | 46% below | 15% |
| Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE | $59.50 | $70.00 | $28.00–$63.00 | — | 15% |
| Insulin blood test CPT 83525 HC ASSAY OF INSULIN,TOTAL - INSULIN, TOTAL | $59.50 | $70.00 | $10.86–$86.80 | at median | 15% |
| Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN,TOTAL - INSULIN, TOTAL | $59.50 | $70.00 | $28.00–$63.00 | — | 15% |
| Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON - IRON | $59.50 | $70.00 | $6.15–$86.80 | 29% above | 15% |
| Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON - IRON | $59.50 | $70.00 | $28.00–$63.00 | — | 15% |
| Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING TEST - IRON + TRANSFERRIN + TIBC | $68.00 | $80.00 | $8.30–$99.20 | 1% above | 15% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING TEST - IRON + TRANSFERRIN + TIBC | $68.00 | $80.00 | $32.00–$72.00 | — | 15% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL - BUNDLED CHARGE | $102.00 | $120.00 | $8.25–$148.80 | 4% below | 15% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL - BUNDLED CHARGE | $102.00 | $120.00 | $48.00–$108.00 | — | 15% |
| LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN (LH) - LUTEINIZING HORMONE | $102.00 | $120.00 | $17.59–$148.80 | at median | 15% |
| LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN (LH) - LUTEINIZING HORMONE | $102.00 | $120.00 | $48.00–$108.00 | — | 15% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE - LIPASE | $93.50 | $110.00 | $6.55–$136.40 | 48% above | 15% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE - LIPASE | $93.50 | $110.00 | $44.00–$99.00 | — | 15% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL - BUNDLED CHARGE | $153.00 | $180.00 | $7.76–$223.20 | 15% above | 15% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL - BUNDLED CHARGE | $153.00 | $180.00 | $72.00–$162.00 | — | 15% |
| Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES | $85.00 | $100.00 | $16.18–$124.00 | 7% below | 15% |
| Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES | $85.00 | $100.00 | $40.00–$90.00 | — | 15% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM | $76.50 | $90.00 | $6.37–$111.60 | 63% above | 15% |
| Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM | $76.50 | $90.00 | $36.00–$81.00 | — | 15% |
| Measles (rubeola) antibody test CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY IGG | $51.00 | $60.00 | $12.24–$74.40 | 14% below | 15% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY IGG | $51.00 | $60.00 | $24.00–$54.00 | — | 15% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES,SCREEN - MONONUCLEOSIS SCREEN | $93.50 | $110.00 | $4.92–$136.40 | 128% above | 15% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES,SCREEN - MONONUCLEOSIS SCREEN | $93.50 | $110.00 | $44.00–$99.00 | — | 15% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA, FREE SENDOUT ADD-ON | $76.50 | $90.00 | $17.47–$111.60 | at median | 15% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA, FREE SENDOUT ADD-ON | $76.50 | $90.00 | $36.00–$81.00 | — | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA | $76.50 | $90.00 | $17.47–$111.60 | 1% below | 15% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA | $76.50 | $90.00 | $36.00–$81.00 | — | 15% |
| Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTOPATH C/V AUTO FLUID REDO - LAB CYTOPAT,CER/VAG,THIN LAYER,INTER | $85.00 | $100.00 | $25.28–$124.00 | 15% above | 15% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTOPATH C/V AUTO FLUID REDO - LAB CYTOPAT,CER/VAG,THIN LAYER,INTER | $85.00 | $100.00 | $40.00–$90.00 | — | 15% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE - PTH INTACT | $204.00 | $240.00 | $39.22–$297.60 | 19% above | 15% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC ASSAY OF PARATHORMONE - PTH INTACT | $204.00 | $240.00 | $96.00–$216.00 | — | 15% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLAS TIME PARTIAL - APTT | $85.00 | $100.00 | $5.71–$124.00 | 62% above | 15% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLAS TIME PARTIAL - APTT | $85.00 | $100.00 | $40.00–$90.00 | — | 15% |
| Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE - PROGESTERONE | $110.50 | $130.00 | $19.82–$161.20 | at median | 15% |
| Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE - PROGESTERONE | $110.50 | $130.00 | $52.00–$117.00 | — | 15% |
| Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN - PROLACTIN | $102.00 | $120.00 | $18.41–$148.80 | 17% below | 15% |
| Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN - PROLACTIN | $102.00 | $120.00 | $48.00–$108.00 | — | 15% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $51.00 | $60.00 | $4.08–$74.40 | 82% above | 15% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $51.00 | $60.00 | $24.00–$54.00 | — | 15% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRSMV DIR OPT OBS - RAPID DRUG SCREEN, URINE | $68.00 | $80.00 | $11.97–$99.20 | at median | 15% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TEST PRSMV DIR OPT OBS - RAPID DRUG SCREEN, URINE | $68.00 | $80.00 | $32.00–$72.00 | — | 15% |
| Rapid flu test (influenza antigen) CPT 87804 HC DETECT AGENT,IMMUN,DIR OBS,INFLUENZA - RAPID FLU | $51.00 | $60.00 | $15.72–$74.40 | 15% below | 15% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 HC DETECT AGENT,IMMUN,DIR OBS,INFLUENZA - RAPID FLU | $51.00 | $60.00 | $24.00–$54.00 | — | 15% |
| Rubella antibody test (immunity check) CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGM | $42.50 | $50.00 | $13.67–$62.00 | 19% below | 15% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGM | $42.50 | $50.00 | $20.00–$45.00 | — | 15% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC RBC SED RATE, AUTO - SEDIMENTATION RATE, AUTOMATED | $42.50 | $50.00 | $2.57–$62.00 | 24% above | 15% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC RBC SED RATE, AUTO - SEDIMENTATION RATE, AUTOMATED | $42.50 | $50.00 | $20.00–$45.00 | — | 15% |
| Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS - OVA AND PARASITE EXAMINATION | $42.50 | $50.00 | $8.46–$62.00 | 26% below | 15% |
| Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES SMEARS - OVA AND PARASITE EXAMINATION | $42.50 | $50.00 | $20.00–$45.00 | — | 15% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD FECES - POCT OCCULT BLOOD STOOL | $15.30 | $18.00 | $4.16–$22.32 | 29% below | 15% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC OCCULT BLOOD FECES - POCT OCCULT BLOOD STOOL | $15.30 | $18.00 | $7.20–$16.20 | — | 15% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 | $51.00 | $60.00 | $15.12–$74.40 | at median | 15% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 | $51.00 | $60.00 | $24.00–$54.00 | — | 15% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB TEST, CELL MEDIATED ANTIGEN RESPONSE,GAMMA INTERFRON - TB TEST | $229.50 | $270.00 | $58.88–$334.80 | 21% above | 15% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB TEST, CELL MEDIATED ANTIGEN RESPONSE,GAMMA INTERFRON - TB TEST | $229.50 | $270.00 | $108.00–$243.00 | — | 15% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE | $119.00 | $140.00 | $24.52–$173.60 | at median | 15% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE | $119.00 | $140.00 | $56.00–$126.00 | — | 15% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY | $76.50 | $90.00 | $13.82–$111.60 | at median | 15% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY | $76.50 | $90.00 | $36.00–$81.00 | — | 15% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE | $119.00 | $140.00 | $15.96–$173.60 | 160% above | 15% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE | $119.00 | $140.00 | $56.00–$126.00 | — | 15% |
| Trichomonas test (NAAT) CPT 87661 HC T VAGINALIS RNA | $187.00 | $220.00 | $33.34–$272.80 | 36% above | 15% |
| Trichomonas test (NAAT) inpatient CPT 87661 HC T VAGINALIS RNA | $187.00 | $220.00 | $88.00–$198.00 | — | 15% |
| Uric acid blood test CPT 84550 HC ASSAY OF URIC ACID, BLOOD - URIC ACID | $68.00 | $80.00 | $4.29–$99.20 | 61% above | 15% |
| Uric acid blood test inpatient CPT 84550 HC ASSAY OF URIC ACID, BLOOD - URIC ACID | $68.00 | $80.00 | $32.00–$72.00 | — | 15% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS, AUTO, W/SCOPE - URINALYSIS MICROSCOPIC | $68.00 | $80.00 | $3.01–$99.20 | 82% above | 15% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS, AUTO, W/SCOPE - URINALYSIS MICROSCOPIC | $68.00 | $80.00 | $32.00–$72.00 | — | 15% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY | $42.50 | $50.00 | $2.14–$62.00 | 112% above | 15% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY | $42.50 | $50.00 | $20.00–$45.00 | — | 15% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS NONAUTO W/O SCOPE | $11.05 | $13.00 | $3.31–$16.12 | 15% below | 15% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS NONAUTO W/O SCOPE | $11.05 | $13.00 | $5.20–$11.70 | — | 15% |
| Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST - PREGNANCY URINE | $119.00 | $140.00 | $8.18–$173.60 | 139% above | 15% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST - PREGNANCY URINE | $119.00 | $140.00 | $56.00–$126.00 | — | 15% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12 - VITAMIN B12 | $59.50 | $70.00 | $14.33–$86.80 | 23% below | 15% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B-12 - VITAMIN B12 | $59.50 | $70.00 | $28.00–$63.00 | — | 15% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC ASSAY OF VIT D,CALCIFEDIOL W FRACTIONS, IF PERFORMED - VITAMIN D 25 | $153.00 | $180.00 | $28.12–$223.20 | 13% above | 15% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC ASSAY OF VIT D,CALCIFEDIOL W FRACTIONS, IF PERFORMED - VITAMIN D 25 | $153.00 | $180.00 | $72.00–$162.00 | — | 15% |
| Zinc blood test CPT 84630 HC ASSAY OF ZINC - ZINC | $59.50 | $70.00 | $10.82–$86.80 | 3% below | 15% |
| Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC - ZINC | $59.50 | $70.00 | $28.00–$63.00 | — | 15% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC CHORIONIC GONADOTROPIN, QUANT - HCG QUANTITATIVE BLOOD | $68.00 | $80.00 | $14.30–$99.20 | 20% below | 15% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC CHORIONIC GONADOTROPIN, QUANT - HCG QUANTITATIVE BLOOD | $68.00 | $80.00 | $32.00–$72.00 | — | 15% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL | $1,445.00 | $1,700.00 | $634.78–$2,108.00 | 76% above | 15% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL | $1,445.00 | $1,700.00 | $680.00–$1,530.00 | — | 15% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 HC CAESAREAN SECTION | $5,100.00 | $6,000.00 | $4,146.00–$7,440.00 | 14% above | 15% |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 HC CAESAREAN SECTION | $5,100.00 | $6,000.00 | $2,400.00–$5,400.00 | — | 15% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC NEWBORN CIRCUMCISION | $255.00 | $300.00 | $207.30–$1,987.15 | 30% below | 15% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC NEWBORN CIRCUMCISION | $255.00 | $300.00 | $120.00–$270.00 | — | 15% |
| Colonoscopy with endoscopic ultrasound CPT 45391 HC COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX - COLONOSCOPY | $3,145.00 | $3,700.00 | $1,143.76–$4,588.00 | 13% above | 15% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 HC COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX - COLONOSCOPY | $3,145.00 | $3,700.00 | $1,480.00–$3,330.00 | — | 15% |
| Colonoscopy with polyp removal CPT 45385 HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ - COLONOSCOPY | $1,700.00 | $2,000.00 | $1,143.76–$2,480.00 | at median | 15% |
| Colonoscopy with polyp removal inpatient CPT 45385 HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ - COLONOSCOPY | $1,700.00 | $2,000.00 | $800.00–$1,800.00 | — | 15% |
| Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE - COLONOSCOPY | $1,785.00 | $2,100.00 | $1,143.76–$2,604.00 | 2% below | 15% |
| Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE - COLONOSCOPY | $1,785.00 | $2,100.00 | $840.00–$1,890.00 | — | 15% |
| Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD - COLONOSCOPY | $1,700.00 | $2,000.00 | $884.40–$2,480.00 | 30% above | 15% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD - COLONOSCOPY | $1,700.00 | $2,000.00 | $800.00–$1,800.00 | — | 15% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUC BENIGN/PREMAL,FIRST LESION | $212.50 | $250.00 | $172.75–$310.00 | 82% above | 15% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUC BENIGN/PREMAL,FIRST LESION | $212.50 | $250.00 | $100.00–$225.00 | — | 15% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $110.50 | $130.00 | $57.62–$161.20 | 49% above | 15% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $110.50 | $130.00 | $52.00–$117.00 | — | 15% |
| Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $148.75 | $175.00 | $57.62–$217.00 | 59% above | 15% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $148.75 | $175.00 | $70.00–$157.50 | — | 15% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN | $1,530.00 | $1,800.00 | $671.78–$2,232.00 | 15% above | 15% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN | $1,530.00 | $1,800.00 | $720.00–$1,620.00 | — | 15% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1ST LEVEL | $2,125.00 | $2,500.00 | $863.62–$3,100.00 | 104% above | 15% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1ST LEVEL | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD - ENDOSCOPY SIGMOID | $1,275.00 | $1,500.00 | $884.40–$1,860.00 | 12% above | 15% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD - ENDOSCOPY SIGMOID | $1,275.00 | $1,500.00 | $600.00–$1,350.00 | — | 15% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS | $1,105.00 | $1,300.00 | $884.40–$1,612.00 | 19% below | 15% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS | $1,105.00 | $1,300.00 | $520.00–$1,170.00 | — | 15% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC CATH/INJECT HYSTEROSALPINGOGRAM | $1,530.00 | $1,800.00 | $1,243.80–$2,232.00 | 433% above | 15% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC CATH/INJECT HYSTEROSALPINGOGRAM | $1,530.00 | $1,800.00 | $720.00–$1,620.00 | — | 15% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC DRAIN SKIN ABSCESS SIMPLE | $510.00 | $600.00 | $192.75–$744.00 | 122% above | 15% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC DRAIN SKIN ABSCESS SIMPLE | $510.00 | $600.00 | $240.00–$540.00 | — | 15% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $1,190.00 | $1,400.00 | $286.35–$1,736.00 | 451% above | 15% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $1,190.00 | $1,400.00 | $560.00–$1,260.00 | — | 15% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US | $637.50 | $750.00 | $286.35–$930.00 | 205% above | 15% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US | $637.50 | $750.00 | $300.00–$675.00 | — | 15% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM | $935.00 | $1,100.00 | $387.56–$1,364.00 | 146% above | 15% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM | $935.00 | $1,100.00 | $440.00–$990.00 | — | 15% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,487.50 | $1,750.00 | $671.78–$2,170.00 | 26% above | 15% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,487.50 | $1,750.00 | $700.00–$1,575.00 | — | 15% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL | $1,955.00 | $2,300.00 | $863.62–$2,852.00 | 31% above | 15% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL | $1,955.00 | $2,300.00 | $920.00–$2,070.00 | — | 15% |
| Nail removal (partial or complete), one nail CPT 11730 HC REMOVAL OF NAIL PLATE | $276.25 | $325.00 | $192.75–$403.00 | 49% above | 15% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC REMOVAL OF NAIL PLATE | $276.25 | $325.00 | $130.00–$292.50 | — | 15% |
| Occipital nerve block (injection for headaches) CPT 64405 HC INJECT NERV BLCK,GREAT OCCIPTL | $595.00 | $700.00 | $286.35–$868.00 | 66% above | 15% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJECT NERV BLCK,GREAT OCCIPTL | $595.00 | $700.00 | $280.00–$630.00 | — | 15% |
| Paracentesis with imaging guidance CPT 49083 HC ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE | $1,700.00 | $2,000.00 | $909.48–$2,480.00 | 97% above | 15% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE | $1,700.00 | $2,000.00 | $800.00–$1,800.00 | — | 15% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL OF NAIL BED | $850.00 | $1,000.00 | $387.56–$1,240.00 | 89% above | 15% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC REMOVAL OF NAIL BED | $850.00 | $1,000.00 | $400.00–$900.00 | — | 15% |
| Removal of a foreign object under the skin, simple CPT 10120 HC REMOVE FOREIGN BODY SIMPLE | $595.00 | $700.00 | $387.56–$868.00 | 95% above | 15% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMOVE FOREIGN BODY SIMPLE | $595.00 | $700.00 | $280.00–$630.00 | — | 15% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC COLON CA SCRN NOT HI RSK IND | $2,550.00 | $3,000.00 | $884.40–$3,720.00 | 194% above | 15% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC COLON CA SCRN NOT HI RSK IND | $2,550.00 | $3,000.00 | $1,200.00–$2,700.00 | — | 15% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC COLORECTAL SCRN; HI RISK IND | $2,125.00 | $2,500.00 | $884.40–$3,100.00 | 164% above | 15% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC COLORECTAL SCRN; HI RISK IND | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| Short arm cast (elbow to hand) CPT 29075 HC APPLY FOREARM CAST | $263.50 | $310.00 | $214.21–$384.40 | 1% below | 15% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLY FOREARM CAST | $263.50 | $310.00 | $124.00–$279.00 | — | 15% |
| Short arm splint (forearm and hand) CPT 29125 HC APPLY FOREARM SPLINT,STATIC | $127.50 | $150.00 | $103.65–$186.00 | 15% below | 15% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY FOREARM SPLINT,STATIC | $127.50 | $150.00 | $60.00–$135.00 | — | 15% |
| Short leg cast (below the knee) CPT 29405 HC APPLY SHORT LEG CAST | $391.00 | $460.00 | $257.63–$570.40 | 38% above | 15% |
| Short leg cast (below the knee) inpatient CPT 29405 HC APPLY SHORT LEG CAST | $391.00 | $460.00 | $184.00–$414.00 | — | 15% |
| Short leg splint (calf to foot) CPT 29515 HC APPLY LOWER LEG SPLINT | $127.50 | $150.00 | $103.65–$186.00 | 23% below | 15% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC APPLY LOWER LEG SPLINT | $127.50 | $150.00 | $60.00–$135.00 | — | 15% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK2.5CM/< | $255.00 | $300.00 | $192.75–$372.00 | 15% above | 15% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK2.5CM/< | $255.00 | $300.00 | $120.00–$270.00 | — | 15% |
| Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY SKIN; SINGLE LESION -CLINIC | $297.50 | $350.00 | $241.85–$434.00 | 14% above | 15% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BIOPSY SKIN; SINGLE LESION -CLINIC | $297.50 | $350.00 | $140.00–$315.00 | — | 15% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC | $1,530.00 | $1,800.00 | $671.78–$2,232.00 | 167% above | 15% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC | $1,530.00 | $1,800.00 | $720.00–$1,620.00 | — | 15% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC RESUP NPTERF WND BODY 2.6-7.5 CM | $255.00 | $300.00 | $192.75–$372.00 | 12% below | 15% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC RESUP NPTERF WND BODY 2.6-7.5 CM | $255.00 | $300.00 | $120.00–$270.00 | — | 15% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< | $255.00 | $300.00 | $192.75–$372.00 | 4% below | 15% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< | $255.00 | $300.00 | $120.00–$270.00 | — | 15% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BIOPSY SKIN; SINGLE LESION -CLINIC | $552.50 | $650.00 | $192.75–$806.00 | 179% above | 15% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGENTIAL BIOPSY SKIN; SINGLE LESION -CLINIC | $552.50 | $650.00 | $260.00–$585.00 | — | 15% |
| Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING | $1,190.00 | $1,400.00 | $599.74–$1,736.00 | 33% above | 15% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING | $1,190.00 | $1,400.00 | $560.00–$1,260.00 | — | 15% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC INJECT TRIGGER POINT, 1 OR 2 | $1,105.00 | $1,300.00 | $286.35–$1,612.00 | 440% above | 15% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJECT TRIGGER POINT, 1 OR 2 | $1,105.00 | $1,300.00 | $520.00–$1,170.00 | — | 15% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE | $3,570.00 | $4,200.00 | $1,571.71–$5,208.00 | 78% above | 15% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE | $3,570.00 | $4,200.00 | $1,680.00–$3,780.00 | — | 15% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM - EGD | $2,465.00 | $2,900.00 | $1,840.17–$3,596.00 | at median | 15% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM - EGD | $2,465.00 | $2,900.00 | $1,160.00–$2,610.00 | — | 15% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD TRANSORAL BIOPSY SINGLE/MULTIPLE - EGD | $2,125.00 | $2,500.00 | $909.48–$3,100.00 | 25% above | 15% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD TRANSORAL BIOPSY SINGLE/MULTIPLE - EGD | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 HC ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION - EGD | $1,700.00 | $2,000.00 | $909.48–$2,480.00 | 17% below | 15% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HC ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION - EGD | $1,700.00 | $2,000.00 | $800.00–$1,800.00 | — | 15% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH - EGD | $2,125.00 | $2,500.00 | $1,727.50–$3,100.00 | 4% above | 15% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH - EGD | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS - EGD | $1,360.00 | $1,600.00 | $909.48–$1,984.00 | at median | 15% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HC EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS - EGD | $1,360.00 | $1,600.00 | $640.00–$1,440.00 | — | 15% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $2,125.00 | $2,500.00 | $909.48–$3,100.00 | 58% above | 15% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 HC EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST - ENDO US (UPPER) | $12,750.00 | $15,000.00 | $5,774.51–$18,600.00 | 10% above | 15% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 HC EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST - ENDO US (UPPER) | $12,750.00 | $15,000.00 | $6,000.00–$13,500.00 | — | 15% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM | $850.00 | $1,000.00 | $387.56–$1,240.00 | 114% above | 15% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM | $850.00 | $1,000.00 | $400.00–$900.00 | — | 15% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION SERVICE | $850.00 | $1,000.00 | $424.09–$1,240.00 | 30% above | 15% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION SERVICE | $850.00 | $1,000.00 | $400.00–$900.00 | — | 15% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT INHALATION TREATMENT | $212.50 | $250.00 | $172.75–$310.00 | 39% above | 15% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT INHALATION TREATMENT | $212.50 | $250.00 | $100.00–$225.00 | — | 15% |
| Chemotherapy IV infusion, first hour CPT 96413 HC CHEMOTHER, IV INFUSION, 1 HR | $807.50 | $950.00 | $321.76–$1,178.00 | 86% above | 15% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMOTHER, IV INFUSION, 1 HR | $807.50 | $950.00 | $380.00–$855.00 | — | 15% |
| Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE, E/M 30-74 MINUTES | $2,975.00 | $3,500.00 | $817.37–$4,340.00 | 118% above | 15% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE, E/M 30-74 MINUTES | $2,975.00 | $3,500.00 | $1,400.00–$3,150.00 | — | 15% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ELECTROCARDIOGRAM, TRACING | $178.50 | $210.00 | $57.62–$260.40 | 7% below | 15% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ELECTROCARDIOGRAM, TRACING | $178.50 | $210.00 | $84.00–$189.00 | — | 15% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMERGENCY DEPARTMENT LEVEL 1 VISIT LIMITED/MINOR PROB | $276.25 | $325.00 | $11.49–$403.00 | 97% above | 15% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC EMERGENCY DEPARTMENT LEVEL 1 VISIT LIMITED/MINOR PROB | $276.25 | $325.00 | $130.00–$292.50 | — | 15% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY DEPARTMENT LEVEL 2 VISIT LOW/MODER SEVERITY | $510.00 | $600.00 | $153.62–$744.00 | 108% above | 15% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC EMERGENCY DEPARTMENT LEVEL 2 VISIT LOW/MODER SEVERITY | $510.00 | $600.00 | $240.00–$540.00 | — | 15% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY | $1,190.00 | $1,400.00 | $268.60–$1,736.00 | 165% above | 15% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY | $1,190.00 | $1,400.00 | $560.00–$1,260.00 | — | 15% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY | $1,530.00 | $1,800.00 | $413.07–$2,232.00 | 118% above | 15% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY | $1,530.00 | $1,800.00 | $720.00–$1,620.00 | — | 15% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC | $2,125.00 | $2,500.00 | $594.74–$3,100.00 | 100% above | 15% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC | $2,125.00 | $2,500.00 | $1,000.00–$2,250.00 | — | 15% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - STRESS TEST ONLY, EXERCISE | $935.00 | $1,100.00 | $302.07–$1,364.00 | 14% above | 15% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - STRESS TEST ONLY, EXERCISE | $935.00 | $1,100.00 | $440.00–$990.00 | — | 15% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV INFUSION, HYDRATION, 31-60 MIN | $255.00 | $300.00 | $204.38–$372.00 | 3% above | 15% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV INFUSION, HYDRATION, 31-60 MIN | $255.00 | $300.00 | $120.00–$270.00 | — | 15% |
| IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR | $340.00 | $400.00 | $204.38–$496.00 | 12% above | 15% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR | $340.00 | $400.00 | $160.00–$360.00 | — | 15% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT | $127.50 | $150.00 | $69.04–$186.00 | 31% above | 15% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT | $127.50 | $150.00 | $60.00–$135.00 | — | 15% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC PT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $114.75 | $135.00 | $25.96–$167.40 | 29% above | 15% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC OT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $114.75 | $135.00 | $25.96–$167.40 | 29% above | 15% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $114.75 | $135.00 | $54.00–$121.50 | — | 15% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC OT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $114.75 | $135.00 | $54.00–$121.50 | — | 15% |
| New patient office visit, about 30 minutes CPT 99203 HC OFFICE/OUTPATIENT NEW LEVEL THREE | $106.25 | $125.00 | $86.38–$155.00 | 21% below | 15% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE/OUTPATIENT NEW LEVEL THREE | $106.25 | $125.00 | $50.00–$112.50 | — | 15% |
| New patient office visit, about 45 minutes CPT 99204 HC OFFICE/OUTPATIENT NEW LEVEL FOUR | $170.00 | $200.00 | $138.20–$248.00 | 4% below | 15% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE/OUTPATIENT NEW LEVEL FOUR | $170.00 | $200.00 | $80.00–$180.00 | — | 15% |
| New patient office visit, about 60 minutes CPT 99205 HC OFFICE/OUTPATIENT NEW LEVEL FIVE | $340.00 | $400.00 | $276.40–$496.00 | 31% above | 15% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE/OUTPATIENT NEW LEVEL FIVE | $340.00 | $400.00 | $160.00–$360.00 | — | 15% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC OFFICE/OUTPATIENT NEW LEVEL TWO | $63.75 | $75.00 | $51.83–$93.00 | 29% below | 15% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC OFFICE/OUTPATIENT NEW LEVEL TWO | $63.75 | $75.00 | $30.00–$67.50 | — | 15% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MED NUTR THER, 1ST, INDIV, EA 15 MIN | $78.20 | $92.00 | $15.19–$114.08 | 76% above | 15% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MED NUTR THER, 1ST, INDIV, EA 15 MIN | $78.20 | $92.00 | $36.80–$82.80 | — | 15% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS | $208.25 | $245.00 | $71.16–$303.80 | 50% above | 15% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS | $208.25 | $245.00 | $98.00–$220.50 | — | 15% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS | $212.50 | $250.00 | $73.33–$310.00 | 24% above | 15% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS | $212.50 | $250.00 | $100.00–$225.00 | — | 15% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS | $212.50 | $250.00 | $73.33–$310.00 | 67% above | 15% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS | $212.50 | $250.00 | $100.00–$225.00 | — | 15% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS | $212.50 | $250.00 | $73.33–$310.00 | 36% above | 15% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS | $212.50 | $250.00 | $100.00–$225.00 | — | 15% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC OT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $106.25 | $125.00 | $23.28–$155.00 | 29% above | 15% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $106.25 | $125.00 | $23.28–$155.00 | 29% above | 15% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC OT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $106.25 | $125.00 | $50.00–$112.50 | — | 15% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $106.25 | $125.00 | $50.00–$112.50 | — | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISES | $144.50 | $170.00 | $24.88–$210.80 | 86% above | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISES | $144.50 | $170.00 | $24.88–$210.80 | 86% above | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC SLP THERAPEUTIC EXERCISES | $144.50 | $170.00 | $24.88–$210.80 | 86% above | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISES | $144.50 | $170.00 | $68.00–$153.00 | — | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISES | $144.50 | $170.00 | $68.00–$153.00 | — | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC SLP THERAPEUTIC EXERCISES | $144.50 | $170.00 | $68.00–$153.00 | — | 15% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OFFICE/OUTPATIENT ESTABLISHED LEVEL FIVE | $318.75 | $375.00 | $259.13–$465.00 | 70% above | 15% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OFFICE/OUTPATIENT ESTABLISHED LEVEL FIVE | $318.75 | $375.00 | $150.00–$337.50 | — | 15% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OFFICE/OUTPATIENT ESTABLISHED LEVEL THREE | $212.50 | $250.00 | $172.75–$310.00 | 97% above | 15% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OFFICE/OUTPATIENT ESTABLISHED LEVEL THREE | $212.50 | $250.00 | $100.00–$225.00 | — | 15% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE/OUTPATIENT ESTABLISHED LEVEL FOUR | $255.00 | $300.00 | $207.30–$372.00 | 79% above | 15% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OFFICE/OUTPATIENT ESTABLISHED LEVEL FOUR | $255.00 | $300.00 | $120.00–$270.00 | — | 15% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OFFICE/OUTPATIENT ESTABLISHED LEVEL TWO | $140.25 | $165.00 | $114.02–$204.60 | 101% above | 15% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OFFICE/OUTPATIENT ESTABLISHED LEVEL TWO | $140.25 | $165.00 | $66.00–$148.50 | — | 15% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE CONSULTATION NEW/ESTAB PATIENT LEVEL THREE | $212.50 | $250.00 | $172.75–$310.00 | 16% above | 15% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 HC OFFICE CONSULTATION NEW/ESTAB PATIENT LEVEL THREE | $212.50 | $250.00 | $100.00–$225.00 | — | 15% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OFFICE CONSULTATION NEW/ESTAB PATIENT LEVEL FOUR | $318.75 | $375.00 | $259.13–$465.00 | 30% above | 15% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 HC OFFICE CONSULTATION NEW/ESTAB PATIENT LEVEL FOUR | $318.75 | $375.00 | $150.00–$337.50 | — | 15% |
| Speech and language evaluation CPT 92523 HC SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $403.75 | $475.00 | $175.08–$589.00 | 49% above | 15% |
| Speech and language evaluation inpatient CPT 92523 HC SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $403.75 | $475.00 | $190.00–$427.50 | — | 15% |
| Speech therapy session, individual CPT 92507 HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL | $276.25 | $325.00 | $70.50–$403.00 | 74% above | 15% |
| Speech therapy session, individual inpatient CPT 92507 HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL | $276.25 | $325.00 | $130.00–$292.50 | — | 15% |
| Spirometry (breathing test) CPT 94010 HC BREATHING CAPACITY TEST - OFFICE SPIROMETRY | $212.50 | $250.00 | $151.77–$310.00 | 6% below | 15% |
| Spirometry (breathing test) inpatient CPT 94010 HC BREATHING CAPACITY TEST - OFFICE SPIROMETRY | $212.50 | $250.00 | $100.00–$225.00 | — | 15% |
| Spirometry before and after a bronchodilator CPT 94060 HC BRINCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMIN | $552.50 | $650.00 | $302.07–$806.00 | 25% above | 15% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC BRINCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMIN | $552.50 | $650.00 | $260.00–$585.00 | — | 15% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $85.00 | $100.00 | $30.83–$124.00 | 3% above | 15% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $85.00 | $100.00 | $30.83–$124.00 | 3% above | 15% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC OT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $85.00 | $100.00 | $40.00–$90.00 | — | 15% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $85.00 | $100.00 | $40.00–$90.00 | — | 15% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY | $235.45 | $277.00 | $125.04–$343.48 | 25% above | 15% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY | $235.45 | $277.00 | $110.80–$249.30 | — | 15% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID VAC 2023-24 (12 YRS AND UP) (RAXTOZIN)(PF) 30 MCG/0.3 ML IM SUSP | $272.85 | $321.00 | $131.10–$398.04 | at median | 15% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID VACC 2024-2025 (12 YRS UP) (PFIZER)(PF) 30 MCG/0.3 ML IM SYRINGE | $273.70 | $321.99 | $131.10–$399.27 | at median | 15% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID VAC 2023-24 (12 YRS AND UP) (RAXTOZIN)(PF) 30 MCG/0.3 ML IM SUSP | $272.85 | $321.00 | $128.40–$288.90 | — | 15% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID VACC 2024-2025 (12 YRS UP) (PFIZER)(PF) 30 MCG/0.3 ML IM SYRINGE | $273.70 | $321.99 | $128.80–$289.79 | — | 15% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP | $112.20 | $132.00 | $91.21–$176.43 | 38% below | 15% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP | $112.20 | $132.00 | $52.80–$118.80 | — | 15% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE | $46.84 | $55.10 | $12.91–$68.32 | 21% below | 15% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE | $46.84 | $55.10 | $22.04–$49.59 | — | 15% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE | $328.95 | $387.00 | $267.42–$479.88 | at median | 15% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE | $328.95 | $387.00 | $154.80–$348.30 | — | 15% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A AND B VIRUS VACCINE(PF)720 ELISA UNIT-20 MCG/ML IM SYRINGE | $167.45 | $197.00 | $136.13–$244.28 | 52% above | 15% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS A AND B VIRUS VACCINE(PF)720 ELISA UNIT-20 MCG/ML IM SYRINGE | $167.45 | $197.00 | $78.80–$177.30 | — | 15% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $88.40 | $104.00 | $71.86–$128.96 | 7% above | 15% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $88.40 | $104.00 | $41.60–$93.60 | — | 15% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP | $78.20 | $92.00 | $63.57–$114.08 | at median | 15% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $95.57 | $112.43 | $67.55–$139.41 | 22% above | 15% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP | $78.20 | $92.00 | $36.80–$82.80 | — | 15% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $95.57 | $112.43 | $44.97–$101.19 | — | 15% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE QS2020-21(65YR UP)(PF)240 MCG/0.7 ML INTRAMUSCULAR SYRINGE | $73.10 | $86.00 | $59.43–$106.64 | 28% below | 15% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE TS2024-25(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $104.40 | $122.82 | $65.21–$152.30 | 3% above | 15% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACCINE QS2020-21(65YR UP)(PF)240 MCG/0.7 ML INTRAMUSCULAR SYRINGE | $73.10 | $86.00 | $34.40–$77.40 | — | 15% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACCINE TS2024-25(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $104.40 | $122.82 | $49.13–$110.54 | — | 15% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACC LIVE(PF)10EXP3.4-4.2-3.3CCID50/0.5ML SUBCUT | $189.21 | $222.60 | $153.82–$276.02 | 14% above | 15% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACC LIVE(PF)10EXP3.4-4.2-3.3CCID50/0.5ML SUBCUT | $66.30 | $78.00 | $31.20–$70.20 | — | 15% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) | $127.50 | $150.00 | $103.65–$186.00 | 1% below | 15% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION | $138.77 | $163.25 | $112.81–$202.43 | 8% above | 15% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) | $127.50 | $150.00 | $60.00–$135.00 | — | 15% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION | $138.77 | $163.25 | $65.30–$146.93 | — | 15% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE | $308.37 | $362.78 | $213.90–$449.85 | at median | 15% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE | $307.70 | $362.00 | $144.80–$325.80 | — | 15% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HC PCV20 VACCINE FOR INTRAMUSCULAR USE | $488.75 | $575.00 | $257.09–$713.00 | 9% below | 15% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE | $501.88 | $590.44 | $257.09–$732.15 | 6% below | 15% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 HC PCV20 VACCINE FOR INTRAMUSCULAR USE | $488.75 | $575.00 | $230.00–$517.50 | — | 15% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE | $501.88 | $590.44 | $236.18–$531.40 | — | 15% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE | $101.38 | $119.26 | $82.41–$147.88 | 45% below | 15% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE | $100.30 | $118.00 | $47.20–$106.20 | — | 15% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP | $1,562.70 | $1,838.47 | $350.14–$2,279.70 | 79% above | 15% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION | $1,830.48 | $2,153.50 | $350.14–$2,670.34 | 110% above | 15% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP | $1,565.65 | $1,841.93 | $736.77–$1,657.74 | — | 15% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION | $1,762.86 | $2,073.95 | $829.58–$1,866.56 | — | 15% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT | $271.15 | $319.00 | $185.76–$395.56 | 13% above | 15% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GLYCOP E VACCINE (VIAL 2 OF 2) 50 MCG IM SUSPENSION | $271.15 | $319.00 | $185.76–$395.56 | 13% above | 15% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT | $271.15 | $319.00 | $127.60–$287.10 | — | 15% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GLYCOP E VACCINE (VIAL 2 OF 2) 50 MCG IM SUSPENSION | $271.15 | $319.00 | $127.60–$287.10 | — | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION | $40.80 | $48.00 | $33.17–$59.52 | 43% below | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE | $88.46 | $104.07 | $71.91–$129.05 | 24% above | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP | $233.99 | $275.28 | $190.22–$341.35 | 228% above | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION | $40.80 | $48.00 | $19.20–$43.20 | — | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE | $88.46 | $104.07 | $41.63–$93.66 | — | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP | $233.99 | $275.28 | $110.11–$247.75 | — | 15% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP | $45.90 | $54.00 | $37.31–$66.96 | 55% below | 15% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE | $141.41 | $166.36 | $114.95–$206.29 | 40% above | 15% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE | $244.31 | $287.42 | $198.61–$356.40 | 141% above | 15% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM SUSP | $45.90 | $54.00 | $21.60–$48.60 | — | 15% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE | $130.99 | $154.10 | $61.64–$138.69 | — | 15% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE | $244.31 | $287.42 | $114.97–$258.68 | — | 15% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $75.65 | $89.00 | $61.50–$110.36 | 36% below | 15% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $75.65 | $89.00 | $35.60–$80.10 | — | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID | $77.35 | $91.00 | $62.88–$112.84 | 31% above | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID | $77.35 | $91.00 | $36.40–$81.90 | — | 15% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZ,ADMIN,EACH ADDL | $77.35 | $91.00 | $62.88–$112.84 | 63% above | 15% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZ,ADMIN,EACH ADDL | $77.35 | $91.00 | $36.40–$81.90 | — | 15% |