Hospital

Pawnee Valley Community Hospital

Pawnee Valley Community Hospital in Larned, KS publishes cash prices for 212 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 below the Kansas median for 190 of 211 procedures and above it for 19. By typical cash price it ranks #5 of 55 Kansas hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

923 Carroll Ave,Larned,KS,67550 Collected Sep 27, 2026 Source price file (620) 285-3161

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 171345 · CMS hospital register

Scans and imaging

ProcedureCash price List priceInsurers payvs KansasOff list
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE $912.00 $2,280.00 $550.09 at median 60%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C- $684.00 $1,710.00 $480.41 28% below 60%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE $908.00 $2,270.00 $552.52 19% below 60%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE $996.00 $2,490.00 $688.43 72% below 60%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY OF MIDDLE SPINE; 2 VIEWS $148.00 $370.00 $133.80 33% below 60%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS $160.00 $400.00 $133.80 28% below 60%

Lab tests

ProcedureCash price List priceInsurers payvs KansasOff list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER ENZYME (SGPT); LEVEL $32.00 $80.00 $11.36 14% below 60%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT) $36.00 $90.00 $11.36 4% below 60%
AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER ENZYME (SGOT); LEVEL $28.00 $70.00 $11.11 25% below 60%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT) $32.00 $80.00 $11.11 14% below 60%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL $164.00 $410.00 $137.99 21% below 60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA $16.00 $40.00 $15.51 48% below 60%
Allergy blood test, specific IgE, per allergen CPT 86003 MEASUREMENT OF ANTIBODY (IGE) TO ALLERGIC SUBSTANCE; CRUDE ALLERGEN EXTRACT; EACH $368.00 $920.00 $15.51 1092% above 60%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 MEASUREMENT OF ANTIBODY FOR RHEUMATOID ARTHRITIS ASSESSMENT $52.00 $130.00 $27.79 52% below 60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 SCREENING TEST FOR AUTOIMMUNE DISORDER $68.00 $170.00 $44.30 3% below 60%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (HEART AND BLOOD VESSEL PROTEIN) LEVEL $86.40 $216.00 $72.84 33% below 60%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE $96.00 $240.00 $72.84 25% below 60%
Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) $56.00 $140.00 $19.65 31% below 60%
Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA $45.60 $114.00 $38.41 39% below 60%
Blood culture for bacteria CPT 87040 BACTERIAL BLOOD CULTURE $91.20 $228.00 $38.41 21% above 60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE $5.60 $14.00 $12.05 69% below 60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE $11.20 $28.00 $12.05 39% below 60%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT $6.00 $15.00 $8.64 81% below 60%
Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE (SUGAR) LEVEL $28.00 $70.00 $8.64 14% below 60%
Blood lead test CPT 83655 LEAD LEVEL $36.00 $90.00 $24.36 31% below 60%
Blood lead test CPT 83655 ASSAY OF LEAD $40.00 $100.00 $24.36 23% below 60%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (REPRODUCTIVE HORMONE) ANALYSIS $64.00 $160.00 $34.32 12% above 60%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD GROUP TYPING (ABO) $32.00 $80.00 $210.75 63% below 60%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO $120.00 $300.00 $210.75 37% above 60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION $34.40 $86.00 $26.14 28% below 60%
C. difficile toxin gene test (stool PCR) CPT 87493 DETECTION TEST BY NUCLEIC ACID FOR CLOSTRIDIUM DIFFICILE; AMPLIFIED PROBE TECHNIQUE $100.00 $250.00 $75.32 8% below 60%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 19-9 $84.00 $210.00 $54.51 2% below 60%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 125 $88.00 $220.00 $54.77 4% below 60%
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 $56.00 $140.00 $51.31–$114.18 59% below 60%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB $64.00 $160.00 $51.31–$114.18 53% below 60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DETECTION TEST BY NUCLEIC ACID FOR CHLAMYDIA TRACHOMATIS; AMPLIFIED PROBE TECHNIQUE $76.00 $190.00 $75.32 33% below 60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE $84.00 $210.00 $75.32 26% below 60%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) $62.40 $156.00 $43.18 28% below 60%
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 $44.00 $110.00 $13.36 8% above 60%
Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST $40.00 $100.00 $13.90 14% below 60%
Comprehensive metabolic panel (blood test) CPT 80053 BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS $72.00 $180.00 $22.68 31% below 60%
D-dimer blood test (blood clot marker) CPT 85379 COAGULATION FUNCTION MEASUREMENT; D-DIMER; QUANTITATIVE $72.00 $180.00 $73.62 38% below 60%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE (DHEA-S) HORMONE LEVEL $72.00 $180.00 $80.41 44% below 60%
Estradiol blood test CPT 82670 MEASUREMENT OF TOTAL ESTRADIOL (HORMONE) $104.00 $260.00 $125.19 38% below 60%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLICLE STIMULATING (REPRODUCTIVE HORMONE) LEVEL $84.00 $210.00 $71.29 27% below 60%
Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN (PROTEIN) LEVEL $92.00 $230.00 $24.56 58% below 60%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL $100.00 $250.00 $24.56 54% below 60%
Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL $72.00 $180.00 $53.23 19% below 60%
Folate (folic acid) blood test CPT 82746 FOLIC ACID LEVEL; SERUM $68.00 $170.00 $61.81 31% below 60%
Free T3 thyroid hormone test CPT 84481 THYROID HORMONE; T3 MEASUREMENT; FREE $88.00 $220.00 $84.25 31% below 60%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (THYROID CHEMICAL); FREE $53.60 $134.00 $30.77 12% below 60%
Free testosterone test CPT 84402 TESTOSTERONE (HORMONE) LEVEL; FREE $80.00 $200.00 $108.65 44% below 60%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 BLOOD GLUCOSE (SUGAR) LEVEL AFTER RECEIVING DOSE OF GLUCOSE $28.00 $70.00 $20.08 42% below 60%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST $32.00 $80.00 $20.08 33% below 60%
Glucose tolerance test, 3 samples CPT 82951 BLOOD GLUCOSE (SUGAR) TOLERANCE TEST; 3 SPECIMENS $60.00 $150.00 $48.72 35% below 60%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT) $68.00 $170.00 $48.72 26% below 60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 DETECTION TEST BY NUCLEIC ACID FOR NEISSERIA GONORRHOEAE (GONORRHOEAE BACTERIA); AMPLIFIED PROBE TECHNIQUE $76.00 $190.00 $75.32 25% below 60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB $84.00 $210.00 $75.32 18% below 60%
H. pylori stool antigen test CPT 87338 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HELICOBACTER PYLORI (GI TRACT BACTERIA) IN STOOL $56.00 $140.00 $31.18 51% below 60%
H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG IA $64.00 $160.00 $31.18 44% below 60%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ $180.00 $450.00 $182.59 47% below 60%
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 $68.00 $170.00 $60.02 26% below 60%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1&-2 AB AG IA $76.00 $190.00 $60.02 18% below 60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C $14.00 $35.00 $35.94 80% below 60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL $41.60 $104.00 $35.94 40% below 60%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY MEASUREMENT $56.00 $140.00 $46.36 23% below 60%
Hepatitis B surface antigen (HBsAg) test CPT 87340 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HEPATITIS B SURFACE ANTIGEN $52.00 $130.00 $24.62 12% below 60%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA $56.00 $140.00 $24.62 5% below 60%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY MEASUREMENT $72.00 $180.00 $45.09 5% below 60%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ $76.00 $190.00 $91.91 75% below 60%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST $52.00 $130.00 $63.53 45% below 60%
Herpes blood test, HSV-2 antibody CPT 86696 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 2 $52.00 $130.00 $67.05 41% below 60%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST $60.00 $150.00 $67.05 31% below 60%
High-sensitivity CRP (hs-CRP) test CPT 86141 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION; HIGH SENSITIVITY $48.00 $120.00 $61.27 47% below 60%
Homocysteine blood test CPT 83090 HOMOCYSTEINE (AMINO ACID) LEVEL $76.00 $190.00 $176.58 67% below 60%
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE $100.00 $250.00 $176.58 57% below 60%
Insulin blood test CPT 83525 INSULIN MEASUREMENT; TOTAL $44.00 $110.00 $50.72 45% below 60%
Iron blood test (serum iron) CPT 83540 IRON LEVEL $23.20 $58.00 $25.62 46% below 60%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY $33.60 $84.00 $41.23 47% below 60%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST $40.00 $100.00 $41.23 37% below 60%
Kidney function blood test panel CPT 80069 KIDNEY FUNCTION BLOOD TEST PANEL $72.00 $180.00 $20.32 1% above 60%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING (REPRODUCTIVE HORMONE) LEVEL $68.00 $170.00 $69.56 39% below 60%
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE $36.00 $90.00 $27.78 42% below 60%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (FAT ENZYME) LEVEL $72.00 $180.00 $27.78 15% above 60%
Liver function blood test panel CPT 80076 LIVER FUNCTION BLOOD TEST PANEL $92.00 $230.00 $31.88 1% below 60%
Lyme disease antibody test CPT 86618 ANALYSIS FOR ANTIBODY BORRELIA BURGDORFERI (LYME DISEASE BACTERIA) $56.00 $140.00 $76.68 54% below 60%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY $64.00 $160.00 $76.68 48% below 60%
Magnesium blood test CPT 83735 MAGNESIUM LEVEL $34.40 $86.00 $25.85 36% below 60%
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM $40.00 $100.00 $25.85 26% below 60%
Measles (rubeola) antibody test CPT 86765 ANALYSIS FOR ANTIBODY TO RUBEOLA (MEASLES VIRUS) $36.00 $90.00 $68.27 62% below 60%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY $40.00 $100.00 $68.27 57% below 60%
Mono test (heterophile antibody, Monospot) CPT 86308 SCREENING TEST FOR MONONUCLEOSIS (MONO) $52.00 $130.00 $19.50 13% above 60%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN $60.00 $150.00 $19.50 30% above 60%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; FREE $48.00 $120.00 $52.90 48% below 60%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL $60.80 $152.00 $67.95 41% below 60%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL $68.00 $170.00 $67.95 34% below 60%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH C/V AUTO FLUID REDO $68.00 $170.00 $33.50 26% below 60%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER $56.00 $140.00 $64.77 44% below 60%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) LEVEL $108.00 $270.00 $155.01 46% below 60%
Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD $28.80 $72.00 $22.53 35% below 60%
Progesterone blood test CPT 84144 PROGESTERONE (REPRODUCTIVE HORMONE) LEVEL $72.00 $180.00 $71.72 35% below 60%
Prolactin blood test CPT 84146 PROLACTIN (MILK PRODUCING HORMONE) LEVEL $80.00 $200.00 $79.41 38% below 60%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME $8.40 $21.00 $16.08 73% below 60%
Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME $23.20 $58.00 $16.08 25% below 60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 TESTING FOR PRESENCE OF DRUG; READ BY DIRECT OBSERVATION $54.40 $136.00 $28.15 2% below 60%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC $52.00 $130.00 $54.84 24% below 60%
Rapid flu test (influenza antigen) CPT 87804 DETECTION TEST BY IMMUNOASSAY WITH DIRECT VISUAL OBSERVATION FOR INFLUENZA VIRUS $104.00 $260.00 $54.84 53% above 60%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC $20.00 $50.00 $54.84 71% below 60%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 DETECTION TEST BY IMMUNOASSAY WITH DIRECT VISUAL OBSERVATION FOR STREPTOCOCCUS; GROUP A (STREP) $52.00 $130.00 $54.84 25% below 60%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR LEVEL $44.00 $110.00 $25.74 8% below 60%
Rubella antibody test (immunity check) CPT 86762 ANALYSIS FOR ANTIBODY TO RUBELLA (GERMAN MEASLES VIRUS) $48.00 $120.00 $30.90 17% below 60%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RED BLOOD CELL SEDIMENTATION RATE; TO DETECT INFLAMMATION; AUTOMATED $32.00 $80.00 $12.82 1% below 60%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED $36.00 $90.00 $12.82 12% above 60%
Stool ova and parasites exam CPT 87177 SMEAR FOR PARASITES $44.00 $110.00 $31.41 28% below 60%
Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL ANALYSIS FOR BLOOD TO SCREEN FOR COLON TUMORS $24.00 $60.00 $12.41 11% below 60%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL $12.00 $30.00 $34.14 77% below 60%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 STOOL ANALYSIS FOR BLOOD; BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY $32.00 $80.00 $34.14 37% below 60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS DETECTION TEST $32.00 $80.00 $16.26 11% below 60%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST; GAMMA INTERFERON $116.00 $290.00 $133.00 39% below 60%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE $128.00 $320.00 $133.00 32% below 60%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (HORMONE) LEVEL; TOTAL $92.00 $230.00 $104.86 36% below 60%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT $60.00 $150.00 $50.96 23% below 60%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH) $53.60 $134.00 $43.97 40% below 60%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE $56.00 $140.00 $43.97 38% below 60%
Trichomonas test (NAAT) CPT 87661 DETECTION TEST BY NUCLEIC ACID FOR TRICHOMONAS VAGINALIS (GENITAL PARASITE); AMPLIFIED PROBE TECHNIQUE $64.00 $160.00 $95.50 54% below 60%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF $72.00 $180.00 $95.50 48% below 60%
Uric acid blood test CPT 84550 URIC ACID LEVEL; BLOOD $32.80 $82.00 $14.72 12% below 60%
Urinalysis with microscope exam, automated CPT 81001 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED $32.00 $80.00 $9.72 7% below 60%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W/SCOPE $6.00 $15.00 $15.54 70% below 60%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE $6.00 $15.00 $9.20 73% below 60%
Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST $20.00 $50.00 $9.20 12% below 60%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE $6.00 $15.00 $10.36 66% below 60%
Urine culture for bacteria, with colony count CPT 87086 BACTERIAL COLONY COUNT; URINE $64.00 $160.00 $30.38 20% above 60%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST $28.00 $70.00 $27.14 39% below 60%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) LEVEL $48.00 $120.00 $57.41 46% below 60%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 $52.00 $130.00 $57.41 41% below 60%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 LEVEL $108.00 $270.00 $218.43 56% below 60%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY $124.00 $310.00 $218.43 49% below 60%
Zinc blood test CPT 84630 ZINC LEVEL $40.00 $100.00 $28.85 31% below 60%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN; CHORIONIC (REPRODUCTIVE HORMONE) LEVEL $88.00 $220.00 $60.36 8% below 60%

Surgery and procedures

ProcedureCash price List priceInsurers payvs KansasOff list
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE $396.00 $990.00 $293.63 9% above 60%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE $142.80 $357.00 $38.38 65% below 60%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE $114.80 $287.00 $38.38 65% below 60%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT $688.00 $1,720.00 $481.93 23% above 60%
Catheter ablation for atrial fibrillation CPT 93656 COMPRE EP EVAL ABLTJ ATR FIB $13,700.00 $34,250.00 $30,665.38 49% below 60%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONL BLOCK $696.00 $1,740.00 $3,014.00–$5,822.85 — 60%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DST RDL FX/EPHYS SEP WO $170.40 $426.00 $38.38 59% below 60%
Colonoscopy with polyp removal CPT 45385 REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $900.00 $2,250.00 $1,473.85 26% below 60%
Colonoscopy with tissue sample CPT 45380 BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $450.00 $1,125.00 $1,473.85 70% below 60%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $450.00 $1,125.00 $1,321.08 57% below 60%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE LEEP $158.80 $397.00 $38.38 79% below 60%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE $62.00 $155.00 $38.38 83% below 60%
Coronary stent placement, one artery CPT 92928 PRQ TCAT PLMT NTRAC ST 1 LES $7,448.00 $18,620.00 $7,807.30 38% below 60%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY $135.20 $338.00 $38.38 87% below 60%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION $36.80 $92.00 $38.38 66% below 60%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING $113.20 $283.00 $38.38 75% below 60%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI $84.00 $210.00 $586.49 2% above 60%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI $28.00 $70.00 $38.38 66% below 60%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING $39.20 $98.00 $38.38 83% below 60%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE $944.00 $2,360.00 $1,141.80 22% below 60%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC EXAM OF LOWER PORTION OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $900.00 $2,250.00 $1,139.64 6% above 60%
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S) $140.00 $350.00 $38.38 88% below 60%
Incision and drainage of a simple or single skin abscess CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS $364.00 $910.00 $248.38 80% above 60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT $220.00 $550.00 $368.99 at median 60%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DLVR IMPLANT $75.20 $188.00 $38.38 53% below 60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/< $131.20 $328.00 $38.38 61% below 60%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE $944.00 $2,360.00 $1,141.80 21% below 60%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC $992.00 $2,480.00 $1,141.80 17% below 60%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC $860.00 $2,150.00 $588.83 8% above 60%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM< $69.20 $173.00 $38.38 63% below 60%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/< $68.80 $172.00 $38.38 63% below 60%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE $59.20 $148.00 $38.38 57% below 60%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV $396.00 $990.00 $319.16 6% above 60%
Pacemaker implant (dual chamber) CPT 33208 INSRT HEART PM ATRIAL & VENT $5,668.00 $14,170.00 $17,859.83 74% below 60%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING $592.00 $1,480.00 $1,171.95 10% below 60%
Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL $48.00 $120.00 $38.38 79% below 60%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK $900.00 $2,250.00 $1,139.64 8% below 60%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK $900.00 $2,250.00 $1,139.64 12% below 60%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST $45.60 $114.00 $38.38 79% below 60%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT $36.00 $90.00 $38.38 79% below 60%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST $42.80 $107.00 $38.38 77% below 60%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT $37.60 $94.00 $38.38 76% below 60%
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 $216.00 $540.00 $382.79 10% below 60%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION $70.40 $176.00 $38.38 86% below 60%
Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15 $49.20 $123.00 $38.38 63% below 60%
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 $232.00 $580.00 $457.53 12% below 60%
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 $256.00 $640.00 $457.53 3% below 60%
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 $228.00 $570.00 $475.71 13% below 60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/< $268.00 $670.00 $475.71 2% above 60%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES $55.60 $139.00 $38.38 79% below 60%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING $500.00 $1,250.00 $862.54 43% below 60%
Upper endoscopy (EGD) with biopsy CPT 43239 BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $450.00 $1,125.00 $1,171.95 66% below 60%
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 $474.00 $1,185.00 $2,371.24 69% below 60%
Upper endoscopy (EGD), diagnostic CPT 43235 DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $450.00 $1,125.00 $1,171.95 64% below 60%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S) $210.00 $525.00 $38.38 79% below 60%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14 $61.20 $153.00 $38.38 63% below 60%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS $456.00 $1,140.00 $451.17 41% above 60%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs KansasOff list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD PRODUCTS $280.00 $700.00 $515.69 51% below 60%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT $308.00 $770.00 $515.69 47% below 60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT $18.40 $46.00 $254.03 84% below 60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION $84.00 $210.00 $3,014.00–$5,822.85 — 60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT $336.00 $840.00 $3,014.00–$5,822.85 — 60%
Chemotherapy IV infusion, first hour CPT 96413 ADMINISTRATION OF CHEMOTHERAPY INTO VEIN; 1 HOUR OR LESS $364.00 $910.00 $358.20 8% below 60%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR $404.00 $1,010.00 $358.20 2% above 60%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR $1,332.00 $3,330.00 $1,021.79 101% above 60%
EEG (brain wave test), awake and drowsy, routine CPT 95816 MEASUREMENT OF BRAIN WAVE ACTIVITY (EEG); AWAKE AND DROWSY $404.00 $1,010.00 $311.41 53% below 60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING $160.00 $400.00 $164.48 13% below 60%
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 $132.00 $330.00 $170.31 6% below 60%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY $232.00 $580.00 $265.31 20% above 60%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY $416.00 $1,040.00 $407.79 52% above 60%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY $628.00 $1,570.00 $695.24 60% above 60%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY $956.00 $2,390.00 $1,080.54 49% above 60%
Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE OR DRUG-INDUCED HEART STRESS TEST WITH ELECTROCARDIOGRAM (ECG) $676.00 $1,690.00 $356.37 18% above 60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION INTO A VEIN FOR HYDRATION; 31-60 MINUTES $204.00 $510.00 $255.28 16% below 60%
IV infusion of a medicine, first hour CPT 96365 INFUSION INTO A VEIN FOR THERAPY; PREVENTION; OR DIAGNOSIS; 1 HOUR OR LESS $236.00 $590.00 $255.28 11% below 60%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM $22.00 $55.00 $83.90 67% below 60%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE $76.00 $190.00 $83.90 14% above 60%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION $65.20 $163.00 $38.38 67% below 60%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION $56.00 $140.00 $50.50 28% below 60%
New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30 MIN $55.60 $139.00 $38.38 63% below 60%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES $120.00 $300.00 $101.00 21% below 60%
New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45 MIN $55.60 $139.00 $38.38 72% below 60%
New patient office visit, about 60 minutes CPT 99205 OFFICE O/P NEW HI 60 MIN $55.60 $139.00 $38.38 80% below 60%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN $55.60 $139.00 $38.38 52% below 60%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 15-29 MINUTES $108.00 $270.00 $67.67 7% below 60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN $28.00 $70.00 $14.70 6% below 60%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN $68.00 $170.00 $117.24 59% below 60%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN $176.00 $440.00 $120.60 16% below 60%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN $68.00 $170.00 $138.69 58% below 60%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN $144.00 $360.00 $120.60 22% below 60%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS $60.00 $150.00 $58.08 21% below 60%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES $48.00 $120.00 $56.91 39% below 60%
Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL W/MED SRVCS $54.00 $135.00 $38.38 76% below 60%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60 MIN $74.00 $185.00 $38.38 63% below 60%
Psychotherapy session, 30 minutes CPT 90832 PSYTX W PT 30 MINUTES $20.40 $51.00 $38.38 90% below 60%
Psychotherapy session, 45 minutes CPT 90834 PSYTX W PT 45 MINUTES $38.80 $97.00 $38.38 78% below 60%
Psychotherapy session, 60 minutes CPT 90837 PSYTX W PT 60 MINUTES $36.00 $90.00 $38.38 84% below 60%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN $8.00 $20.00 $37.24 71% below 60%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE O/P EST HI 40 MIN $55.60 $139.00 $38.38 73% below 60%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20 MIN $76.00 $190.00 $38.38 44% below 60%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES $112.00 $280.00 $133.49 17% below 60%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES $55.60 $139.00 $38.38 68% below 60%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30 MIN $132.00 $330.00 $188.57 24% below 60%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 10-19 MINUTES $92.00 $230.00 $85.38 12% below 60%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN $228.00 $570.00 $116.15 3% below 60%
Speech therapy session, individual CPT 92507 TX SP LANG VOICE COMM INDIV $120.00 $300.00 $77.77 12% below 60%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES $52.00 $130.00 $56.91 34% below 60%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 DRAWING OF BLOOD FOR A MEDICAL PROBLEM $112.00 $280.00 $69.01 5% below 60%

Vaccines

ProcedureCash price List priceInsurers payvs KansasOff list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VACCINE LIVE SUBQ $80.00 $200.00 $248.76 64% below 60%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM $15.20 $38.00 $28.00 52% below 60%
Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM $40.00 $100.00 $115.94 68% below 60%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM $40.00 $100.00 $95.25 66% below 60%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM $65.20 $163.00 $104.59 24% below 60%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC $34.00 $85.00 $131.54 71% below 60%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II $149.60 $374.00 $131.54 26% above 60%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWYCRM VACC IM $84.00 $210.00 $237.94 67% below 60%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB-4C VACCINE IM $80.00 $200.00 $338.44 74% below 60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE IM $186.00 $465.00 $373.39 51% below 60%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM $52.00 $130.00 $167.20 69% below 60%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23 $194.00 $485.00 $167.20 16% above 60%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACC PREF BIVALENT IM $216.00 $540.00 $421.26 41% below 60%
Rabies vaccine, one dose CPT 90675 RabAvert $565.60 $1,414.00 $591.06 2% below 60%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM $17.60 $44.00 $57.20 71% below 60%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TDVAX $70.80 $177.00 $57.20 15% above 60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM $22.00 $55.00 $67.14 69% below 60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix $78.20 $195.49 $67.14 10% above 60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN $18.00 $45.00 $8.08 53% below 60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE $36.00 $90.00 $8.08 5% below 60%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD $9.60 $24.00 $8.08 60% below 60%

Source file: https://apim.services.craneware.com/api-pricing-transparency/api/public/e445c0003c86bbd0f4d86176579fd38a/charges/mrf