Regional Medical Center
Regional Medical Center in Manchester, IA publishes cash prices for 258 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Iowa median for 137 of 256 procedures and below it for 117. By typical cash price it ranks #43 of 78 Iowa hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
709 W Main St,Manchester,IA,52057 Collected Sep 27, 2026 Source price file (563) 927-3232
Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 4 of 5 CCN 161343 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS | $412.80 | $516.00 | $870.00 | 29% above | 20% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST | $346.40 | $433.00 | $870.00 | 5% below | 20% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 SINGLE CONTRAST X-RAY OF ESOPHAGUS | $360.80 | $451.00 | $870.00 | 1% below | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST | $2,328.00 | $2,910.00 | $870.00 | 10% above | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT SCAN OF BLOOD VESSELS OF CHEST WITH CONTRAST | $2,421.60 | $3,027.00 | $870.00 | 14% above | 20% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST | $2,387.20 | $2,984.00 | $870.00 | 15% below | 20% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT SCAN OF ABDOMEN AND PELVIS WITHOUT CONTRAST | $2,483.20 | $3,104.00 | $870.00 | 12% below | 20% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST | $3,156.00 | $3,945.00 | $870.00 | 2% below | 20% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST | $3,282.40 | $4,103.00 | $870.00 | 2% above | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR | $3,589.60 | $4,487.00 | $870.00 | at median | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT SCAN OF ABDOMEN AND PELVIS BEFORE AND AFTER CONTRAST | $3,733.60 | $4,667.00 | $870.00 | 4% above | 20% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST | $1,558.40 | $1,948.00 | $870.00 | 8% below | 20% |
| CT scan of the abdomen with contrast CPT 74160 CT SCAN OF ABDOMEN WITH CONTRAST | $1,762.40 | $2,203.00 | $870.00 | 4% above | 20% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST | $1,412.80 | $1,766.00 | $870.00 | 4% above | 20% |
| CT scan of the abdomen without contrast CPT 74150 CT SCAN OF ABDOMEN WITHOUT CONTRAST | $1,469.60 | $1,837.00 | $870.00 | 8% above | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE | $1,059.20 | $1,324.00 | $870.00 | 18% below | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN OF FACE WITHOUT CONTRAST | $1,101.60 | $1,377.00 | $870.00 | 15% below | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE | $1,219.20 | $1,524.00 | $870.00 | 11% below | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN HEAD OR BRAIN WITHOUT CONTRAST | $1,268.00 | $1,585.00 | $870.00 | 7% below | 20% |
| CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE | $1,548.80 | $1,936.00 | $870.00 | 1% above | 20% |
| CT scan of the head with contrast CPT 70460 CT SCAN HEAD OR BRAIN WITH CONTRAST | $1,676.00 | $2,095.00 | $870.00 | 10% above | 20% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE | $1,708.80 | $2,136.00 | $870.00 | 5% below | 20% |
| CT scan of the head without and with contrast CPT 70470 CT SCAN OF HEAD OR BRAIN BEFORE AND AFTER CONTRAST | $1,777.60 | $2,222.00 | $870.00 | 2% below | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE | $1,412.80 | $1,766.00 | $870.00 | 7% below | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN OF LOWER SPINE WITHOUT CONTRAST | $1,469.60 | $1,837.00 | $870.00 | 3% below | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE | $1,705.60 | $2,132.00 | $870.00 | 13% above | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN OF UPPER SPINE WITHOUT CONTRAST | $1,774.40 | $2,218.00 | $870.00 | 18% above | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE | $1,792.80 | $2,241.00 | $870.00 | 3% above | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN OF PELVIS WITH CONTRAST | $1,864.80 | $2,331.00 | $870.00 | 7% above | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY | $739.20 | $924.00 | $870.00 | — | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 ULTRASOUND OF BOTH SIDES OF HEAD AND NECK BLOOD FLOW | $768.80 | $961.00 | $870.00 | 13% below | 20% |
| Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS | $215.20 | $269.00 | $870.00 | 4% above | 20% |
| Chest X-ray, 2 views CPT 71046 X-RAY OF CHEST; 2 VIEWS | $224.00 | $280.00 | $870.00 | 9% above | 20% |
| Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW | $204.00 | $255.00 | $870.00 | 22% above | 20% |
| Chest X-ray, single view CPT 71045 X-RAY OF CHEST; 1 VIEW | $212.80 | $266.00 | $870.00 | 27% above | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP | $590.40 | $738.00 | $870.00 | 4% below | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 COMPLETE ULTRASOUND SCAN BEHIND ABDOMINAL CAVITY | $614.40 | $768.00 | $870.00 | at median | 20% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL | $399.20 | $499.00 | $870.00 | 2% above | 20% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY MEASUREMENT OF HIP; PELVIS; SPINE | $415.20 | $519.00 | $870.00 | 6% above | 20% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS | $588.00 | $735.00 | $870.00 | 9% below | 20% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN OF CHEST WITHOUT CONTRAST | $964.00 | $1,205.00 | $870.00 | 31% below | 20% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C- | $1,224.00 | $1,530.00 | $870.00 | 13% below | 20% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX C+ | $1,360.00 | $1,700.00 | $870.00 | 25% below | 20% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN OF CHEST WITH CONTRAST | $1,933.60 | $2,417.00 | $870.00 | 7% above | 20% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI | $504.80 | $631.00 | $870.00 | — | 20% |
| Diagnostic mammogram, both breasts CPT 77066 DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS | $470.40 | $588.00 | $870.00 | 39% above | 20% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 LOWER EXTREMITY STUDY | $670.40 | $838.00 | $870.00 | 8% below | 20% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 ULTRASOUND OF LEG ARTERIES OR ARTERY GRAFTS | $697.60 | $872.00 | $870.00 | 4% below | 20% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY | $804.80 | $1,006.00 | $870.00 | 10% below | 20% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 ULTRASOUND STUDY OF ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS | $837.60 | $1,047.00 | $870.00 | 6% below | 20% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE | $576.80 | $721.00 | $870.00 | 62% below | 20% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ULTRASOUND OF HEART WITH COLOR-DEPICTED BLOOD FLOW; RATE; DIRECTION AND VALVE FUNCTION | $600.00 | $750.00 | $870.00 | 61% below | 20% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY INCLUDING HEART RATE; BREATHING; AIRFLOW; AND EFFORT | $692.80 | $866.00 | $870.00 | 24% above | 20% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY IN SLEEP LAB WITH CONTINUOUS AIRWAY PRESSURE (6 YEARS OR OLDER) | $2,856.00 | $3,570.00 | $870.00 | 9% below | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN | $440.80 | $551.00 | $870.00 | 11% below | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIMITED ULTRASOUND SCAN OF ABDOMEN | $459.20 | $574.00 | $870.00 | 7% below | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CANCER SCR C- | $477.60 | $597.00 | $870.00 | 5% above | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LOW DOSE CT SCAN OF CHEST FOR LUNG CANCER SCREENING | $496.80 | $621.00 | $870.00 | 9% above | 20% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST | $2,785.60 | $3,482.00 | $870.00 | 34% above | 20% |
| MRI of the abdomen without contrast CPT 74181 MRI SCAN OF ABDOMEN WITHOUT CONTRAST | $2,897.60 | $3,622.00 | $870.00 | 40% above | 20% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/O CNTR FLWD CNTR | $4,112.80 | $5,141.00 | $870.00 | 20% above | 20% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST | $4,277.60 | $5,347.00 | $870.00 | 25% above | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE | $2,785.60 | $3,482.00 | $870.00 | 22% above | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI SCAN OF BRAIN WITHOUT CONTRAST | $2,897.60 | $3,622.00 | $870.00 | 27% above | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE | $4,112.80 | $5,141.00 | $870.00 | 14% above | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST | $4,277.60 | $5,347.00 | $870.00 | 19% above | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE | $2,785.60 | $3,482.00 | $870.00 | 16% above | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST | $2,897.60 | $3,622.00 | $870.00 | 20% above | 20% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE | $4,112.80 | $5,141.00 | $870.00 | 16% above | 20% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SCAN OF LOWER SPINAL CANAL BEFORE AND AFTER CONTRAST | $4,277.60 | $5,347.00 | $870.00 | 21% above | 20% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI CHEST SPINE W/O DYE | $2,785.60 | $3,482.00 | $870.00 | 18% above | 20% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SCAN OF MIDDLE SPINAL CANAL WITHOUT CONTRAST | $2,897.60 | $3,622.00 | $870.00 | 23% above | 20% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI NECK SPINE W/O & W/DYE | $4,112.80 | $5,141.00 | $870.00 | 21% above | 20% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SCAN OF UPPER SPINAL CANAL BEFORE AND AFTER CONTRAST | $4,277.60 | $5,347.00 | $870.00 | 26% above | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE | $2,785.60 | $3,482.00 | $870.00 | 22% above | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SCAN OF UPPER SPINAL CANAL WITHOUT CONTRAST | $2,897.60 | $3,622.00 | $870.00 | 27% above | 20% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE | $4,112.80 | $5,141.00 | $870.00 | 27% above | 20% |
| MRI of the pelvis without and with contrast CPT 72197 MRI SCAN OF PELVIS BEFORE AND AFTER CONTRAST | $4,277.60 | $5,347.00 | $870.00 | 32% above | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE | $2,785.60 | $3,482.00 | $870.00 | 35% above | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI SCAN OF PELVIS WITHOUT CONTRAST | $2,897.60 | $3,622.00 | $870.00 | 40% above | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED | $336.80 | $421.00 | $870.00 | 5% below | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 LIMITED ULTRASOUND SCAN OF PELVIS | $350.40 | $438.00 | $870.00 | 1% below | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE | $492.80 | $616.00 | $870.00 | 9% below | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 COMPLETE ULTRASOUND SCAN OF PELVIS | $512.80 | $641.00 | $870.00 | 5% below | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >= 14 WKS SNGL FETUS | $625.60 | $782.00 | $870.00 | 14% above | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS | $651.20 | $814.00 | $870.00 | 18% above | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS | $590.40 | $738.00 | $870.00 | 28% above | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND SCAN OF PREGNANT UTERUS (LESS THAN 14 WEEKS); SINGLE OR FIRST FETUS | $614.40 | $768.00 | $870.00 | 34% above | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S) | $308.00 | $385.00 | $870.00 | 10% below | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 LIMITED ULTRASOUND OF PREGNANT UTERUS | $320.80 | $401.00 | $870.00 | 6% below | 20% |
| Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD | $439.20 | $549.00 | $870.00 | — | 20% |
| Screening mammogram, both breasts CPT 77067 SCREENING MAMMOGRAPHY | $456.80 | $571.00 | $870.00 | 49% above | 20% |
| Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER) | $2,596.00 | $3,245.00 | $870.00 | 10% below | 20% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+ | $380.80 | $476.00 | $870.00 | 6% below | 20% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 IMAGING FOR EVALUATION OF SWALLOWING FUNCTION | $396.80 | $496.00 | $870.00 | 2% below | 20% |
| Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB | $492.80 | $616.00 | $870.00 | 6% below | 20% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA | $512.80 | $641.00 | $870.00 | 2% below | 20% |
| Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC | $590.40 | $738.00 | $870.00 | 30% above | 20% |
| Transvaginal ultrasound during pregnancy CPT 76817 VAGINAL ULTRASOUND OF PREGNANT UTERUS | $614.40 | $768.00 | $870.00 | 35% above | 20% |
| Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE | $691.20 | $864.00 | $870.00 | at median | 20% |
| Ultrasound of the abdomen, complete CPT 76700 COMPLETE ULTRASOUND SCAN OF ABDOMEN | $719.20 | $899.00 | $870.00 | 4% above | 20% |
| Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM | $521.60 | $652.00 | $870.00 | 4% below | 20% |
| Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND SCAN OF SCROTUM | $543.20 | $679.00 | $870.00 | at median | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK | $440.80 | $551.00 | $870.00 | 5% below | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SCAN OF HEAD AND NECK SOFT TISSUE | $459.20 | $574.00 | $870.00 | 1% below | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST | $380.80 | $476.00 | $870.00 | 11% below | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 SINGLE CONTRAST X-RAY OF UPPER DIGESTIVE TRACT | $396.80 | $496.00 | $870.00 | 7% below | 20% |
| X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW | $190.40 | $238.00 | $870.00 | 6% above | 20% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY OF ABDOMEN; 1 VIEW | $198.40 | $248.00 | $870.00 | 11% above | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS | $303.20 | $379.00 | $870.00 | 6% above | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY OF LOWER AND SACRAL SPINE; 2-3 VIEWS | $316.00 | $395.00 | $870.00 | 10% above | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS | $380.00 | $475.00 | $870.00 | 8% above | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS | $395.20 | $494.00 | $870.00 | 12% above | 20% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS | $267.20 | $334.00 | $870.00 | 5% above | 20% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY OF MIDDLE SPINE; 2 VIEWS | $278.40 | $348.00 | $870.00 | 10% above | 20% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES | $240.00 | $300.00 | $870.00 | 17% above | 20% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY OF NOSE BONES; MINIMUM OF 3 VIEWS | $249.60 | $312.00 | $870.00 | 22% above | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW | $303.20 | $379.00 | $870.00 | 21% above | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY OF UPPER SPINE; 2-3 VIEWS | $316.00 | $395.00 | $870.00 | 26% above | 20% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS | $181.60 | $227.00 | $870.00 | 8% below | 20% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY OF PELVIS; 1-2 VIEWS | $189.60 | $237.00 | $870.00 | 4% below | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE | $204.00 | $255.00 | $870.00 | 8% below | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY OF SACRUM AND TAILBONE; MINIMUM OF 2 VIEWS | $212.80 | $266.00 | $870.00 | 4% below | 20% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT) | $33.60 | $42.00 | $870.00 | 20% below | 20% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER ENZYME (SGPT); LEVEL | $35.20 | $44.00 | $870.00 | 17% below | 20% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT) | $32.80 | $41.00 | $870.00 | 17% below | 20% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER ENZYME (SGOT); LEVEL | $34.40 | $43.00 | $870.00 | 13% below | 20% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $140.80 | $176.00 | $870.00 | 39% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA | $46.40 | $58.00 | $870.00 | 19% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MEASUREMENT OF ANTIBODY (IGE) TO ALLERGIC SUBSTANCE; CRUDE ALLERGEN EXTRACT; EACH | $48.80 | $61.00 | $870.00 | 25% above | 20% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY | $90.40 | $113.00 | $870.00 | 30% above | 20% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 MEASUREMENT OF ANTIBODY FOR RHEUMATOID ARTHRITIS ASSESSMENT | $94.40 | $118.00 | $870.00 | 36% above | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES | $80.80 | $101.00 | $870.00 | 11% above | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 SCREENING TEST FOR AUTOIMMUNE DISORDER | $84.80 | $106.00 | $870.00 | 16% above | 20% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE | $168.00 | $210.00 | $870.00 | 7% above | 20% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (HEART AND BLOOD VESSEL PROTEIN) LEVEL | $208.00 | $260.00 | $870.00 | 33% above | 20% |
| Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL TOTAL CA | $67.20 | $84.00 | $870.00 | 19% below | 20% |
| Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) | $92.00 | $115.00 | $870.00 | 11% above | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST | $78.40 | $98.00 | $870.00 | 56% below | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY EXAMINATION OF TISSUE USING A MICROSCOPE; INTERMEDIATE COMPLEXITY | $179.20 | $224.00 | $870.00 | 1% above | 20% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA | $72.00 | $90.00 | $870.00 | 17% below | 20% |
| Blood culture for bacteria CPT 87040 BACTERIAL BLOOD CULTURE | $75.20 | $94.00 | $870.00 | 13% below | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE | $24.00 | $30.00 | $870.00 | 21% above | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE | $30.40 | $38.00 | $870.00 | 54% above | 20% |
| Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT | $24.80 | $31.00 | $870.00 | 26% below | 20% |
| Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE (SUGAR) LEVEL | $26.40 | $33.00 | $870.00 | 21% below | 20% |
| Blood lead test CPT 83655 ASSAY OF LEAD | $80.80 | $101.00 | $870.00 | 54% above | 20% |
| Blood lead test CPT 83655 LEAD LEVEL | $84.80 | $106.00 | $870.00 | 62% above | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY | $32.00 | $40.00 | $870.00 | 48% below | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (REPRODUCTIVE HORMONE) ANALYSIS | $33.60 | $42.00 | $870.00 | 46% below | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO | $32.00 | $40.00 | $870.00 | 44% below | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD GROUP TYPING (ABO) | $33.60 | $42.00 | $870.00 | 41% below | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $42.40 | $53.00 | $870.00 | 26% below | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION | $44.80 | $56.00 | $870.00 | 22% below | 20% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9 | $84.00 | $105.00 | $870.00 | 12% below | 20% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 19-9 | $88.00 | $110.00 | $870.00 | 8% below | 20% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125 | $92.00 | $115.00 | $870.00 | 20% below | 20% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 125 | $96.00 | $120.00 | $870.00 | 16% below | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB | $212.80 | $266.00 | $870.00 | 86% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 AMPLIFED DNA OR RNA PROBE DETECTION OF SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (COVID-19) ANTIGEN | $221.60 | $277.00 | $870.00 | 93% above | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE | $79.20 | $99.00 | $870.00 | 20% below | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DETECTION TEST BY NUCLEIC ACID FOR CHLAMYDIA TRACHOMATIS; AMPLIFIED PROBE TECHNIQUE | $82.40 | $103.00 | $870.00 | 17% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $84.00 | $105.00 | $870.00 | 1% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) | $88.00 | $110.00 | $870.00 | 3% above | 20% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC | $85.60 | $107.00 | $870.00 | 39% above | 20% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT | $89.60 | $112.00 | $870.00 | 45% above | 20% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED | $41.60 | $52.00 | $870.00 | 7% below | 20% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST | $44.00 | $55.00 | $870.00 | 2% below | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL | $120.00 | $150.00 | $870.00 | 1% above | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS | $124.80 | $156.00 | $870.00 | 5% above | 20% |
| D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT | $57.60 | $72.00 | $870.00 | 32% below | 20% |
| D-dimer blood test (blood clot marker) CPT 85379 COAGULATION FUNCTION MEASUREMENT; D-DIMER; QUANTITATIVE | $60.00 | $75.00 | $870.00 | 29% below | 20% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE | $79.20 | $99.00 | $870.00 | 29% below | 20% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE (DHEA-S) HORMONE LEVEL | $82.40 | $103.00 | $870.00 | 26% below | 20% |
| Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL | $84.00 | $105.00 | $870.00 | 35% below | 20% |
| Estradiol blood test CPT 82670 MEASUREMENT OF TOTAL ESTRADIOL (HORMONE) | $88.00 | $110.00 | $870.00 | 32% below | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH) | $67.20 | $84.00 | $870.00 | 34% below | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLICLE STIMULATING (REPRODUCTIVE HORMONE) LEVEL | $70.40 | $88.00 | $870.00 | 30% below | 20% |
| Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL | $166.40 | $208.00 | $870.00 | 4% above | 20% |
| Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN (PROTEIN) LEVEL | $173.60 | $217.00 | $870.00 | 8% above | 20% |
| Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN | $92.00 | $115.00 | $870.00 | 4% above | 20% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL | $96.00 | $120.00 | $870.00 | 8% above | 20% |
| Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM | $92.80 | $116.00 | $870.00 | 5% above | 20% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID LEVEL; SERUM | $102.40 | $128.00 | $870.00 | 16% above | 20% |
| Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3) | $109.60 | $137.00 | $870.00 | 2% above | 20% |
| Free T3 thyroid hormone test CPT 84481 THYROID HORMONE; T3 MEASUREMENT; FREE | $114.40 | $143.00 | $870.00 | 7% above | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE | $64.00 | $80.00 | $870.00 | 1% below | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (THYROID CHEMICAL); FREE | $67.20 | $84.00 | $870.00 | 4% above | 20% |
| Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE | $131.20 | $164.00 | $870.00 | 24% above | 20% |
| Free testosterone test CPT 84402 TESTOSTERONE (HORMONE) LEVEL; FREE | $136.80 | $171.00 | $870.00 | 29% above | 20% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $220.00 | $275.00 | $870.00 | 16% above | 20% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST | $35.20 | $44.00 | $870.00 | 2% below | 20% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 BLOOD GLUCOSE (SUGAR) LEVEL AFTER RECEIVING DOSE OF GLUCOSE | $36.80 | $46.00 | $870.00 | 2% above | 20% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT) | $67.20 | $84.00 | $870.00 | 20% below | 20% |
| Glucose tolerance test, 3 samples CPT 82951 BLOOD GLUCOSE (SUGAR) TOLERANCE TEST; 3 SPECIMENS | $70.40 | $88.00 | $870.00 | 17% below | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB | $79.20 | $99.00 | $870.00 | 13% below | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 DETECTION TEST BY NUCLEIC ACID FOR NEISSERIA GONORRHOEAE (GONORRHOEAE BACTERIA); AMPLIFIED PROBE TECHNIQUE | $82.40 | $103.00 | $870.00 | 9% below | 20% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY | $98.40 | $123.00 | $870.00 | 23% above | 20% |
| H. pylori antibody blood test CPT 86677 ANALYSIS FOR ANTIBODY TO HELICOBACTER PYLORI (GASTROINTESTINAL BACTERIA) | $102.40 | $128.00 | $870.00 | 28% above | 20% |
| H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG IA | $112.00 | $140.00 | $870.00 | at median | 20% |
| H. pylori stool antigen test CPT 87338 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HELICOBACTER PYLORI (GI TRACT BACTERIA) IN STOOL | $116.80 | $146.00 | $870.00 | 4% above | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ | $519.20 | $649.00 | $870.00 | 92% above | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 DETECTION TEST BY NUCLEIC ACID FOR HIV-1 VIRUS; QUANTIFICATION | $540.00 | $675.00 | $870.00 | 100% above | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1&-2 AB AG IA | $109.60 | $137.00 | $870.00 | 46% above | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HIV-1 ANTIGEN AND HIV-1 AND HIV-2 ANTIBODIES | $114.40 | $143.00 | $870.00 | 53% above | 20% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOLED RSLT | $94.40 | $118.00 | $870.00 | at median | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C | $61.60 | $77.00 | $870.00 | 1% above | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL | $64.80 | $81.00 | $870.00 | 7% above | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY | $72.00 | $90.00 | $870.00 | 6% above | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY MEASUREMENT | $75.20 | $94.00 | $870.00 | 11% above | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA | $58.40 | $73.00 | $870.00 | 11% below | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HEPATITIS B SURFACE ANTIGEN | $60.80 | $76.00 | $870.00 | 7% below | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST | $88.00 | $110.00 | $870.00 | 13% above | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY MEASUREMENT | $92.00 | $115.00 | $870.00 | 18% above | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ | $208.00 | $260.00 | $870.00 | 19% below | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 DETECTION TEST BY NUCLEIC ACID FOR HEPATITIS C VIRUS; QUANTIFICATION | $260.00 | $325.00 | $870.00 | 1% above | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST | $64.80 | $81.00 | $870.00 | 4% below | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 1 | $68.00 | $85.00 | $870.00 | 1% above | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST | $64.80 | $81.00 | $870.00 | 12% above | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 2 | $68.00 | $85.00 | $870.00 | 18% above | 20% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS | $98.40 | $123.00 | $870.00 | 26% above | 20% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION; HIGH SENSITIVITY | $102.40 | $128.00 | $870.00 | 32% above | 20% |
| Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE | $109.60 | $137.00 | $870.00 | 16% above | 20% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE (AMINO ACID) LEVEL | $114.40 | $143.00 | $870.00 | 21% above | 20% |
| Insulin blood test CPT 83525 ASSAY OF INSULIN | $79.20 | $99.00 | $870.00 | 3% above | 20% |
| Insulin blood test CPT 83525 INSULIN MEASUREMENT; TOTAL | $82.40 | $103.00 | $870.00 | 7% above | 20% |
| Iron blood test (serum iron) CPT 83540 ASSAY OF IRON | $45.60 | $57.00 | $870.00 | 12% above | 20% |
| Iron blood test (serum iron) CPT 83540 IRON LEVEL | $48.00 | $60.00 | $870.00 | 18% above | 20% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST | $51.20 | $64.00 | $870.00 | 5% above | 20% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $53.60 | $67.00 | $870.00 | 10% above | 20% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $96.00 | $120.00 | $870.00 | 10% above | 20% |
| Kidney function blood test panel CPT 80069 KIDNEY FUNCTION BLOOD TEST PANEL | $100.00 | $125.00 | $870.00 | 14% above | 20% |
| LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH) | $67.20 | $84.00 | $870.00 | 27% below | 20% |
| LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING (REPRODUCTIVE HORMONE) LEVEL | $70.40 | $88.00 | $870.00 | 24% below | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE | $65.60 | $82.00 | $870.00 | 1% above | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (FAT ENZYME) LEVEL | $68.80 | $86.00 | $870.00 | 6% above | 20% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $80.00 | $100.00 | $870.00 | 5% below | 20% |
| Liver function blood test panel CPT 80076 LIVER FUNCTION BLOOD TEST PANEL | $83.20 | $104.00 | $870.00 | 1% below | 20% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY | $45.60 | $57.00 | $870.00 | 48% below | 20% |
| Lyme disease antibody test CPT 86618 ANALYSIS FOR ANTIBODY BORRELIA BURGDORFERI (LYME DISEASE BACTERIA) | $48.00 | $60.00 | $870.00 | 46% below | 20% |
| Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM | $42.40 | $53.00 | $870.00 | 12% below | 20% |
| Magnesium blood test CPT 83735 MAGNESIUM LEVEL | $44.80 | $56.00 | $870.00 | 8% below | 20% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY | $80.80 | $101.00 | $870.00 | 48% above | 20% |
| Measles (rubeola) antibody test CPT 86765 ANALYSIS FOR ANTIBODY TO RUBEOLA (MEASLES VIRUS) | $84.80 | $106.00 | $870.00 | 55% above | 20% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN | $31.20 | $39.00 | $870.00 | 36% below | 20% |
| Mono test (heterophile antibody, Monospot) CPT 86308 SCREENING TEST FOR MONONUCLEOSIS (MONO) | $34.40 | $43.00 | $870.00 | 29% below | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE | $49.60 | $62.00 | $870.00 | 49% below | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; FREE | $52.00 | $65.00 | $870.00 | 47% below | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL | $115.20 | $144.00 | $870.00 | 20% above | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL | $120.00 | $150.00 | $870.00 | 25% above | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE | $136.80 | $171.00 | $870.00 | 23% below | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) LEVEL | $142.40 | $178.00 | $870.00 | 20% below | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL | $37.60 | $47.00 | $870.00 | 17% below | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD | $39.20 | $49.00 | $870.00 | 13% below | 20% |
| Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE | $88.00 | $110.00 | $870.00 | 10% below | 20% |
| Progesterone blood test CPT 84144 PROGESTERONE (REPRODUCTIVE HORMONE) LEVEL | $92.00 | $115.00 | $870.00 | 6% below | 20% |
| Prolactin blood test CPT 84146 ASSAY OF PROLACTIN | $67.20 | $84.00 | $870.00 | 33% below | 20% |
| Prolactin blood test CPT 84146 PROLACTIN (MILK PRODUCING HORMONE) LEVEL | $70.40 | $88.00 | $870.00 | 30% below | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $28.00 | $35.00 | $870.00 | 15% below | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME | $29.60 | $37.00 | $870.00 | 10% below | 20% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC | $20.00 | $25.00 | $870.00 | 57% below | 20% |
| Rapid flu test (influenza antigen) CPT 87804 DETECTION TEST BY IMMUNOASSAY WITH DIRECT VISUAL OBSERVATION FOR INFLUENZA VIRUS | $20.80 | $26.00 | $870.00 | 55% below | 20% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC | $30.40 | $38.00 | $870.00 | 39% below | 20% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $38.40 | $48.00 | $870.00 | 21% below | 20% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR LEVEL | $40.00 | $50.00 | $870.00 | 18% below | 20% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY | $95.20 | $119.00 | $870.00 | 62% above | 20% |
| Rubella antibody test (immunity check) CPT 86762 ANALYSIS FOR ANTIBODY TO RUBELLA (GERMAN MEASLES VIRUS) | $99.20 | $124.00 | $870.00 | 69% above | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED | $24.00 | $30.00 | $870.00 | 29% below | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RED BLOOD CELL SEDIMENTATION RATE; TO DETECT INFLAMMATION; AUTOMATED | $25.60 | $32.00 | $870.00 | 24% below | 20% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS | $38.40 | $48.00 | $870.00 | 21% below | 20% |
| Stool ova and parasites exam CPT 87177 SMEAR FOR PARASITES | $40.00 | $50.00 | $870.00 | 18% below | 20% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL ANALYSIS FOR BLOOD TO SCREEN FOR COLON TUMORS | $25.60 | $32.00 | $870.00 | 23% below | 20% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES | $40.80 | $51.00 | $870.00 | 23% above | 20% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL | $33.60 | $42.00 | $870.00 | 42% below | 20% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 STOOL ANALYSIS FOR BLOOD; BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY | $44.00 | $55.00 | $870.00 | 24% below | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL | $32.00 | $40.00 | $870.00 | 34% below | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS DETECTION TEST | $33.60 | $42.00 | $870.00 | 31% below | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE | $164.80 | $206.00 | $870.00 | 5% above | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST; GAMMA INTERFERON | $172.00 | $215.00 | $870.00 | 9% above | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE | $97.60 | $122.00 | $870.00 | 5% below | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (HORMONE) LEVEL; TOTAL | $101.60 | $127.00 | $870.00 | 2% below | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH | $41.60 | $52.00 | $870.00 | 45% below | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT | $44.00 | $55.00 | $870.00 | 42% below | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE | $104.00 | $130.00 | $870.00 | 7% above | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH) | $108.80 | $136.00 | $870.00 | 12% above | 20% |
| Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID | $28.80 | $36.00 | $870.00 | 20% below | 20% |
| Uric acid blood test CPT 84550 URIC ACID LEVEL; BLOOD | $30.40 | $38.00 | $870.00 | 16% below | 20% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE | $37.60 | $47.00 | $870.00 | 10% below | 20% |
| Urinalysis with microscope exam, automated CPT 81001 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED | $39.20 | $49.00 | $870.00 | 6% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE | $20.80 | $26.00 | $870.00 | 19% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST | $22.40 | $28.00 | $870.00 | 13% below | 20% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE | $17.60 | $22.00 | $870.00 | 24% below | 20% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS; MANUAL TEST | $24.00 | $30.00 | $870.00 | 3% above | 20% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT | $57.60 | $72.00 | $870.00 | 2% below | 20% |
| Urine culture for bacteria, with colony count CPT 87086 BACTERIAL COLONY COUNT; URINE | $60.00 | $75.00 | $870.00 | 3% above | 20% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST | $26.40 | $33.00 | $870.00 | 37% below | 20% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 | $100.80 | $126.00 | $870.00 | 21% above | 20% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) LEVEL | $105.60 | $132.00 | $870.00 | 26% above | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $147.20 | $184.00 | $870.00 | 17% above | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 LEVEL | $153.60 | $192.00 | $870.00 | 22% above | 20% |
| Zinc blood test CPT 84630 ASSAY OF ZINC | $49.60 | $62.00 | $870.00 | 6% below | 20% |
| Zinc blood test CPT 84630 ZINC LEVEL | $52.00 | $65.00 | $870.00 | 1% below | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST | $94.40 | $118.00 | $870.00 | 7% above | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN; CHORIONIC (REPRODUCTIVE HORMONE) LEVEL | $98.40 | $123.00 | $870.00 | 11% above | 20% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 PRIMARY REMOVAL OF ADENOIDS (YOUNGER THAN 12 YEARS) | $2,362.00 | $2,952.50 | $870.00 | 54% above | 20% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 REPAIR OF ANTERIOR CRUCIATE LIGAMENT OF KNEE USING AN ENDOSCOPE | $11,408.80 | $14,261.00 | $870.00 | 301% above | 20% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE | $2,854.50 | $3,568.13 | $870.00 | 8% below | 20% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LESION STRTCTC | $3,819.20 | $4,774.00 | $870.00 | 31% above | 20% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL SHOCK TO HEART TO REGULATE HEART BEAT | $2,115.20 | $2,644.00 | $870.00 | 154% above | 20% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT | $2,363.20 | $2,954.00 | $870.00 | 184% above | 20% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONL BLOCK | $444.80 | $556.00 | $870.00–$3,546.11 | — | 20% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 REMOVAL OF FORESKIN USING CLAMP OR DEVICE | $463.20 | $579.00 | $870.00–$3,546.11 | — | 20% |
| Colonoscopy with polyp removal CPT 45385 REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE | $1,515.20 | $1,894.00 | $870.00 | 5% above | 20% |
| Colonoscopy with tissue sample CPT 45380 BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $3,030.40 | $3,788.00 | $870.00 | 117% above | 20% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $5,882.40 | $7,353.00 | $870.00 | 404% above | 20% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BIOPSY AND SCRAPING OF CERVIX USING AN ENDOSCOPE | $1,355.20 | $1,694.00 | $870.00 | 295% above | 20% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY | $1,776.80 | $2,221.00 | $870.00 | 106% above | 20% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 DIAGNOSTIC EXAM OF BLADDER AND URETHRA USING AN ENDOSCOPE | $1,848.00 | $2,310.00 | $870.00 | 115% above | 20% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND SCRAPING OF UTERUS | $3,030.40 | $3,788.00 | $870.00 | 253% above | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION | $472.80 | $591.00 | $870.00 | 219% above | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE | $1,280.80 | $1,601.00 | $870.00 | 4% above | 20% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); 3 CM TO 10 CM; REDUCIBLE | $16,467.20 | $20,584.00 | $870.00 | 568% above | 20% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); LESS THAN 3 CM; REDUCIBLE | $15,753.60 | $19,692.00 | $870.00 | 629% above | 20% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC EXAM OF LOWER PORTION OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $5,525.60 | $6,907.00 | $870.00 | 617% above | 20% |
| Gallbladder removal, laparoscopic CPT 47562 REMOVAL OF GALLBLADDER USING AN ENDOSCOPE | $15,998.40 | $19,998.00 | $870.00 | 684% above | 20% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 REMOVAL OF GALLBLADDER WITH X-RAY STUDY OF BILE DUCTS USING AN ENDOSCOPE | $11,230.40 | $14,038.00 | $870.00 | 442% above | 20% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 REMOVAL OF GALLBLADDER | $14,616.80 | $18,271.00 | $870.00 | 582% above | 20% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 REMOVAL OF EXTERNAL HEMORRHOIDS BY RUBBER BANDING | $2,941.20 | $3,676.50 | $870.00 | 352% above | 20% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVAL OF SINGLE EXTERNAL AND INTERNAL HEMORRHOID GROUP | $3,565.60 | $4,457.00 | $870.00 | 208% above | 20% |
| Hysterectomy through an abdominal incision (total) CPT 58150 REMOVAL OF UTERUS AND CERVIX THROUGH ABDOMEN | $11,765.60 | $14,707.00 | $870.00 | 339% above | 20% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY | $287.20 | $359.00 | $870.00 | 14% below | 20% |
| Hysteroscopy with endometrial ablation CPT 58563 EXAM OF UTERUS WITH DESTRUCTION OF LINING OF UTERUS USING AN ENDOSCOPE | $4,545.60 | $5,682.00 | $870.00 | 17% above | 20% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE | $4,545.60 | $5,682.00 | $870.00 | 28% above | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE | $896.80 | $1,121.00 | $870.00 | 261% above | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS | $4,545.60 | $5,682.00 | $870.00 | 1730% above | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION INTO TENDON OR LIGAMENT | $636.00 | $795.00 | $870.00 | 157% above | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT | $508.00 | $635.00 | $870.00 | 44% above | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US | $656.80 | $821.00 | $870.00 | 86% above | 20% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DLVR IMPLANT | $316.00 | $395.00 | $870.00 | 15% above | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT | $613.60 | $767.00 | $870.00 | 100% above | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US | $677.60 | $847.00 | $870.00 | 120% above | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US | $379.20 | $474.00 | $870.00 | 37% above | 20% |
| Knee arthroscopy with meniscus trim CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE | $7,843.20 | $9,804.00 | $870.00 | 225% above | 20% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 REMOVAL OF APPENDIX USING AN ENDOSCOPE | $10,695.20 | $13,369.00 | $870.00 | 519% above | 20% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 REMOVAL OF UTERUS; TUBES; AND/OR OVARIES THROUGH ABDOMEN USING AN ENDOSCOPE; 250.0 G OR LESS | $13,760.80 | $17,201.00 | $870.00 | 413% above | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS | $2,272.80 | $2,841.00 | $870.00 | 539% above | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE | $1,280.80 | $1,601.00 | $870.00 | 8% above | 20% |
| Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE | $2,819.20 | $3,524.00 | $870.00 | 150% above | 20% |
| Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT OF MISCARRIAGE DURING FIRST TRIMESTER | $3,387.20 | $4,234.00 | $870.00 | 201% above | 20% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $1,151.20 | $1,439.00 | $870.00 | 2% above | 20% |
| Paracentesis with imaging guidance CPT 49083 DRAINAGE OF FLUID FROM ABDOMINAL CAVITY USING IMAGING GUIDANCE | $2,497.60 | $3,122.00 | $870.00 | 120% above | 20% |
| Prostate biopsy CPT 55700 BIOPSY OF PROSTATE | $2,454.40 | $3,068.00 | $870.00 | 18% above | 20% |
| Prostate biopsy CPT 55700 BIOPSY OF PROSTATE GLAND | $2,552.80 | $3,191.00 | $870.00 | 22% above | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL | $291.20 | $364.00 | $870.00 | 6% below | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE | $932.80 | $1,166.00 | $870.00 | 202% above | 20% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK | $6,060.80 | $7,576.00 | $870.00 | 486% above | 20% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK | $5,932.00 | $7,415.00 | $870.00 | 442% above | 20% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT | $413.60 | $517.00 | $870.00 | 132% above | 20% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST | $417.60 | $522.00 | $870.00 | 73% above | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/< | $564.00 | $705.00 | $870.00 | 146% above | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS | $587.20 | $734.00 | $870.00 | 156% above | 20% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION | $756.00 | $945.00 | $870.00 | 190% above | 20% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH | $1,432.80 | $1,791.00 | $870.00 | 450% above | 20% |
| Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15 | $328.80 | $411.00 | $870.00 | 91% above | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR | $2,005.60 | $2,507.00 | $870.00 | 312% above | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 REMOVAL OF CEREBROSPINAL FLUID WITH LOWER BACK SPINAL TAP FOR DIAGNOSTIC TEST | $2,169.60 | $2,712.00 | $870.00 | 346% above | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM | $542.40 | $678.00 | $870.00 | 121% above | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM | $587.20 | $734.00 | $870.00 | 139% above | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SURFACE WOUND OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 2.5 CM OR LESS | $587.20 | $734.00 | $870.00 | 134% above | 20% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY OF RELATED SKIN GROWTH; FIRST GROWTH | $832.00 | $1,040.00 | $870.00 | 296% above | 20% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING | $1,568.80 | $1,961.00 | $870.00 | 68% above | 20% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE | $2,400.80 | $3,001.00 | $870.00 | 157% above | 20% |
| Tonsil and adenoid removal, child under 12 CPT 42820 REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS) | $4,367.20 | $5,459.00 | $870.00 | 27% above | 20% |
| Total hip replacement CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS | $22,416.00 | $28,020.00 | $870.00 | 301% above | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL | $588.80 | $736.00 | $870.00 | 95% above | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES | $613.60 | $767.00 | $870.00 | 104% above | 20% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 BALLOON DILATION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE; LESS THAN 3.0 CM | $1,515.20 | $1,894.00 | $870.00 | 30% below | 20% |
| Upper endoscopy (EGD) with biopsy CPT 43239 BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE | $5,525.60 | $6,907.00 | $870.00 | 299% above | 20% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 REMOVAL OF POLYPS OR GROWTHS OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE | $1,960.80 | $2,451.00 | $870.00 | 66% above | 20% |
| Upper endoscopy (EGD), diagnostic CPT 43235 DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE | $3,298.00 | $4,122.50 | $870.00 | 203% above | 20% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S) | $494.40 | $618.00 | $870.00 | 43% below | 20% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT | $514.40 | $643.00 | $870.00 | 41% below | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/< | $506.40 | $633.00 | $870.00 | 19% above | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS | $527.20 | $659.00 | $870.00 | 24% above | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT | $720.00 | $900.00 | $870.00 | 26% above | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD PRODUCTS | $748.80 | $936.00 | $870.00 | 31% above | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT | $109.60 | $137.00 | $870.00–$3,546.11 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION | $228.80 | $286.00 | $870.00–$3,546.11 | — | 20% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR | $470.40 | $588.00 | $870.00 | 13% below | 20% |
| Chemotherapy IV infusion, first hour CPT 96413 ADMINISTRATION OF CHEMOTHERAPY INTO VEIN; 1 HOUR OR LESS | $489.60 | $612.00 | $870.00 | 10% below | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR | $1,539.20 | $1,924.00 | $870.00 | 75% above | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE; FIRST 30-74 MINUTES | $1,600.80 | $2,001.00 | $870.00 | 82% above | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING | $19.20 | $24.00 | $870.00 | 88% below | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING | $324.80 | $406.00 | $870.00 | 104% above | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP | $28.00 | $35.00 | $870.00 | 60% below | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD SEVERITY | $29.60 | $37.00 | $870.00 | 58% below | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM | $315.20 | $394.00 | $870.00 | 101% above | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY | $328.00 | $410.00 | $870.00 | 109% above | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM | $537.60 | $672.00 | $870.00 | 81% above | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY | $559.20 | $699.00 | $870.00 | 88% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM | $973.60 | $1,217.00 | $870.00 | 73% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY | $1,012.80 | $1,266.00 | $870.00 | 80% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM | $1,206.40 | $1,508.00 | $870.00 | 40% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY | $2,494.40 | $3,118.00 | $870.00 | 189% above | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT | $359.20 | $449.00 | $870.00 | 27% above | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION INTO A VEIN FOR HYDRATION; 31-60 MINUTES | $373.60 | $467.00 | $870.00 | 32% above | 20% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION INTO A VEIN FOR THERAPY; PREVENTION; OR DIAGNOSIS; 1 HOUR OR LESS | $343.20 | $429.00 | $870.00 | 9% above | 20% |
| IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT | $409.60 | $512.00 | $870.00 | 30% above | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM | $56.00 | $70.00 | $870.00 | 38% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE | $58.40 | $73.00 | $870.00 | 35% below | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES | $35.20 | $44.00 | $870.00 | 70% below | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES | $35.20 | $44.00 | $870.00 | 79% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 10-19 MINUTES | $36.80 | $46.00 | $870.00 | 53% below | 20% |
| Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST | $33.60 | $42.00 | $870.00 | 83% below | 20% |
| Spirometry (breathing test) CPT 94010 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME | $346.40 | $433.00 | $870.00 | 73% above | 20% |
| Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING | $786.40 | $983.00 | $870.00 | 99% above | 20% |
| Spirometry before and after a bronchodilator CPT 94060 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME CHANGES BEFORE AND AFTER MEDICATION ADMINISTRATION | $818.40 | $1,023.00 | $870.00 | 107% above | 20% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY | $247.20 | $309.00 | $870.00 | 26% above | 20% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 DRAWING OF BLOOD FOR A MEDICAL PROBLEM | $257.60 | $322.00 | $870.00 | 31% above | 20% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM | $116.80 | $146.00 | $145.92–$870.00 | 56% below | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VACCINE LIVE SUBQ | $132.00 | $165.00 | $174.32–$870.00 | 17% below | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluarix 2024-2025 Formula | $20.00 | $25.00 | $22.35–$870.00 | 8% below | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone 2025-2026 Formula PFS | $20.80 | $26.00 | $22.35–$870.00 | 4% below | 20% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9VHPV VACCINE 2/3 DOSE IM | $219.20 | $274.00 | $287.54–$870.00 | 27% below | 20% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/HEP B VACC ADULT IM | $125.60 | $157.00 | $126.20–$870.00 | 1% above | 20% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM | $87.20 | $109.00 | $70.54–$870.00 | 32% below | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM | $76.00 | $95.00 | $70.38–$870.00 | 32% below | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose 2024-2025 Formula | $60.00 | $75.00 | $73.40–$870.00 | 25% below | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM | $60.00 | $75.00 | $73.40–$870.00 | 25% below | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose 2025-2026 Formula | $67.20 | $84.00 | $73.40–$870.00 | 16% below | 20% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC | $81.60 | $102.00 | $92.49–$870.00 | 22% below | 20% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II | $133.19 | $166.49 | $870.00–$3,546.11 | — | 20% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWYCRM VACC IM | $124.80 | $156.00 | $157.35–$870.00 | 46% below | 20% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB-4C VACCINE IM | $174.40 | $218.00 | $223.75–$870.00 | 29% below | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE IM | $241.60 | $302.00 | $298.04–$870.00 | 52% below | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL CONJUGATE VACCINE; 20 VALENT (PCV20); FOR INTRAMUSCULAR USE | $254.40 | $318.00 | $298.04–$870.00 | 49% below | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM | $110.40 | $138.00 | $133.47–$870.00 | 50% below | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumovax 23 | $112.40 | $140.50 | $870.00–$3,546.11 | — | 20% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM | $318.40 | $398.00 | $322.77–$870.00 | 54% below | 20% |
| Rabies vaccine, one dose CPT 90675 Imovax Rabies | $520.80 | $651.00 | $322.77–$870.00 | 25% below | 20% |
| Rabies vaccine, one dose inpatient CPT 90675 Imovax Rabies | $449.00 | $561.25 | $870.00–$3,546.11 | — | 20% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VACC RECOMBINANT IM | $197.60 | $247.00 | $197.90–$870.00 | 17% below | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM | $51.20 | $64.00 | $18.83–$870.00 | 14% below | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tenivac | $81.37 | $101.71 | $870.00–$3,546.11 | — | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIPHTHERIA AND TETANUS VACCINE (7 YEARS OR OLDER) | $476.80 | $596.00 | $870.00–$3,546.11 | — | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM | $56.80 | $71.00 | $39.09–$870.00 | 32% below | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix | $65.01 | $81.26 | $39.09–$870.00 | 23% below | 20% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE IM | $96.80 | $121.00 | $91.90–$870.00 | 19% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN | $24.00 | $30.00 | $870.00 | 31% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE | $26.40 | $33.00 | $870.00 | 25% below | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD | $19.20 | $24.00 | $870.00 | 33% below | 20% |
Source file: https://apim.services.craneware.com/api-pricing-transparency/api/public/acdb3a51286ee4c85247c4fa1712961d/charges/mrf