Rock County Hospital
Rock County Hospital in Bassett, NE publishes cash prices for 265 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 Nebraska median for 242 of 261 procedures and below it for 17. By typical cash price it ranks #36 of 44 Nebraska hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
102 East South Street, Bassett, NE 68714 Collected Sep 27, 2026 Source price file (402) 684-3366
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 281333 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 Xr Ankle Complete 3+ Views Bilateral | $694.00 | $730.00 | $74.00–$708.00 | — | 5% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete 3+ Views Left | $347.00 | $365.00 | $74.00–$354.00 | 6% above | 5% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete 3+ Views Right | $347.00 | $365.00 | $74.00–$354.00 | 6% above | 5% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Us Abi Limited Bilateral | $586.00 | $617.00 | $158.00–$598.00 | — | 5% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Us Segmental Pressures Le 1-2 Lvls Bilat | $1,064.00 | $1,120.00 | $158.00–$1,086.00 | — | 5% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 Us Abi Limited Left | $586.00 | $617.00 | $158.00–$598.00 | 28% above | 5% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 Us Abi Limited Right | $586.00 | $617.00 | $158.00–$598.00 | 28% above | 5% |
| Bone scan, whole body (nuclear medicine) CPT 78306 Nm Bone Imaging Whole Body | $1,987.00 | $2,092.00 | $684.00–$2,029.00 | 18% above | 5% |
| Breast ultrasound, complete, one breast both sides CPT 76641 Us Breast Complete Bilat | $1,216.00 | $1,280.00 | $239.00–$1,242.00 | — | 5% |
| Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Complete Right | $608.00 | $640.00 | $230.00–$621.00 | 28% above | 5% |
| Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Complete Left | $608.00 | $640.00 | $230.00–$621.00 | 28% above | 5% |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 Us Breast Limited Bilat | $882.00 | $928.00 | $196.00–$900.00 | — | 5% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Limited Right | $441.00 | $464.00 | $167.00–$450.00 | 14% above | 5% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Limited Left | $441.00 | $464.00 | $167.00–$450.00 | 14% above | 5% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Ct Angio Chest | $3,570.00 | $3,758.00 | $648.00–$3,645.00 | 13% above | 5% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Abdomen And Pelvis W/o Contrast | $4,147.00 | $4,365.00 | $449.00–$4,234.00 | 21% above | 5% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Abd And Pelvis Wo | $4,147.00 | $4,365.00 | $449.00–$4,234.00 | 21% above | 5% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast | $4,877.00 | $5,134.00 | $711.00–$4,980.00 | 21% above | 5% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abd And Pelvis W/wo | $5,662.00 | $5,960.00 | $802.00–$5,781.00 | 16% above | 5% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abdomen And Pelvis W/ + W/o Contrast | $5,662.00 | $5,960.00 | $802.00–$5,781.00 | 16% above | 5% |
| CT scan of the abdomen with contrast CPT 74160 Ct Abdomen W | $2,826.00 | $2,975.00 | $531.00–$2,886.00 | 10% above | 5% |
| CT scan of the abdomen with contrast CPT 74160 Ct Abdomen W/ Contrast | $2,826.00 | $2,975.00 | $531.00–$2,886.00 | 10% above | 5% |
| CT scan of the abdomen without contrast CPT 74150 Ct Abdomen Wo | $2,484.00 | $2,615.00 | $335.00–$2,537.00 | 13% above | 5% |
| CT scan of the abdomen without contrast CPT 74150 Ct Abdomen W/o Contrast | $2,484.00 | $2,615.00 | $335.00–$2,537.00 | 13% above | 5% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Maxillofacial W/o Contrast | $2,038.00 | $2,145.00 | $310.00–$2,081.00 | 14% above | 5% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT scan | $2,164.00 | $2,278.00 | $258.00–$2,210.00 | 16% above | 5% |
| CT scan of the head with contrast CPT 70460 Ct Head W/ Contrast | $2,481.00 | $2,612.00 | $365.00–$2,534.00 | 21% above | 5% |
| CT scan of the head without and with contrast CPT 70470 Ct Brain/head W/ + W/o Contrast | $2,846.00 | $2,996.00 | $427.00–$2,906.00 | 14% above | 5% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct Spine Cervical W/o Contrast | $2,576.00 | $2,712.00 | $367.00–$2,631.00 | 16% above | 5% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast | $2,786.00 | $2,933.00 | $520.00–$2,845.00 | 17% above | 5% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Us Carotid Duplex Bilateral | $1,520.00 | $1,600.00 | $371.00–$1,552.00 | — | 5% |
| Chest X-ray, single view CPT 71045 Xr Chest 1 View | $295.00 | $311.00 | $55.00–$302.00 | 30% above | 5% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Aorta Complete | $997.00 | $1,049.00 | $252.00–$1,018.00 | 27% above | 5% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Bd Bone Density Dexa Axial Skeleton | $542.00 | $570.00 | $89.00–$553.00 | 38% above | 5% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Bd Bone Density Dexa App Skeleton | $302.00 | $318.00 | $74.00–$308.00 | 30% above | 5% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Thorax Wo | $2,487.00 | $2,618.00 | $354.00–$2,539.00 | 16% above | 5% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Thorax W | $2,774.00 | $2,920.00 | $438.00–$2,832.00 | 13% above | 5% |
| Diagnostic mammogram, both breasts CPT 77066 Mammography of both breasts | $464.00 | $488.00 | $175.00–$473.00 | 6% above | 5% |
| Diagnostic mammogram, one breast CPT 77065 Mammography of one breast | $380.00 | $400.00 | $144.00–$388.00 | 22% above | 5% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Us Lower Ext Arterial Duplex Bilateral | $1,282.00 | $1,349.00 | $471.00–$1,309.00 | — | 5% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Lower Ext Venous Duplex Bilateral | $1,525.00 | $1,605.00 | $359.00–$1,557.00 | — | 5% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Transthoracic Tte | $2,255.00 | $2,374.00 | $385.00–$2,303.00 | 7% above | 5% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Us Echo 2d Comp W/ Color Flow Doppler | $2,375.00 | $2,500.00 | $385.00–$2,425.00 | 13% above | 5% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Nm Hepatobiliary Imaging | $1,873.00 | $1,972.00 | $708.00–$1,913.00 | 29% above | 5% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 95811 Polysom 6/> Yrs Cpap 4/> Parm Charge | $4,035.00 | $4,247.00 | $1,188.00–$4,120.00 | 7% above | 5% |
| Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 Views Left | $393.00 | $414.00 | $82.00–$402.00 | 7% above | 5% |
| Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 Views Right | $393.00 | $414.00 | $82.00–$402.00 | 7% above | 5% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdomen Limited | $731.00 | $769.00 | $203.00–$746.00 | 31% above | 5% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 Us Ruq Right Upper Quadrant | $637.00 | $671.00 | $203.00–$651.00 | 14% above | 5% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Low Dose Lung Scan | $1,231.00 | $1,296.00 | $306.00–$1,257.00 | 99% above | 5% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint | $5,607.00 | $5,902.00 | $519.00–$5,725.00 | 121% above | 5% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 Mri Ankle W/ + W/o Contrast Bilat | $7,490.00 | $7,884.00 | $1,022.00–$7,647.00 | — | 5% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Ankle W/ + W/o Contrast Left | $3,745.00 | $3,942.00 | $1,022.00–$3,824.00 | 11% above | 5% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Ankle W/ + W/o Contrast Right | $3,745.00 | $3,942.00 | $1,022.00–$3,824.00 | 11% above | 5% |
| MRI of the abdomen without contrast CPT 74181 Mri Abdomen And Pelvis W/o Contrast | $3,475.00 | $3,658.00 | $544.00–$3,548.00 | 18% above | 5% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 Mri Abdomen And Pelvis W/ + W/o Contrast | $4,415.00 | $4,647.00 | $889.00–$4,508.00 | 20% above | 5% |
| MRI of the brain, no contrast dye CPT 70551 Mri Brain W/o Contrast | $3,727.00 | $3,923.00 | $505.00–$3,805.00 | 21% above | 5% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Scan | $4,315.00 | $4,542.00 | $827.00–$4,406.00 | 10% above | 5% |
| MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal | $3,547.00 | $3,734.00 | $493.00–$3,622.00 | 13% above | 5% |
| MRI of the lower back, without and then with contrast dye CPT 72158 Mri Spine Lumbar W/ + W/o Contrast | $4,464.00 | $4,699.00 | $831.00–$4,558.00 | 15% above | 5% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mri Spine Thoracic W/o Contrast | $3,733.00 | $3,929.00 | $493.00–$3,811.00 | 16% above | 5% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 Mri Spine Cervical W/ + W/o Contrast | $4,624.00 | $4,867.00 | $832.00–$4,721.00 | 19% above | 5% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 Mri Spine Cervical W/o Contrast | $3,632.00 | $3,823.00 | $492.00–$3,708.00 | 18% above | 5% |
| MRI of the pelvis without and with contrast CPT 72197 Mri Pelvis W/ + W/o Contrast | $4,329.00 | $4,557.00 | $888.00–$4,420.00 | 23% above | 5% |
| MRI of the pelvis, no contrast dye CPT 72195 Mri Pelvis W/o Contrast | $3,253.00 | $3,424.00 | $602.00–$3,321.00 | 22% above | 5% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 Mri Elbow W/o Contrast Bilat | $5,508.00 | $5,798.00 | $519.00–$5,624.00 | — | 5% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Elbow W/o Contrast Left | $2,754.00 | $2,899.00 | $519.00–$2,812.00 | 14% above | 5% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Elbow W/o Contrast Right | $2,754.00 | $2,899.00 | $519.00–$2,812.00 | 14% above | 5% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nm Myocardial Spect Multiple Studies | $4,612.00 | $4,855.00 | $1,069.00–$4,709.00 | 15% above | 5% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us Bladder Scan | $493.00 | $519.00 | $110.00–$503.00 | 38% above | 5% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvic Complete | $860.00 | $905.00 | $244.00–$878.00 | 11% above | 5% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Abdomial ultrasound of pregnant uterus | $791.00 | $833.00 | $299.00–$808.00 | 14% above | 5% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Us Ob < 14 Weeks Single | $725.00 | $763.00 | $274.00–$740.00 | 18% above | 5% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Us Ob Limited | $479.00 | $504.00 | $181.00–$489.00 | 22% above | 5% |
| Screening mammogram, both breasts both sides CPT 77067 Mammography, screening, bilateral | $396.00 | $417.00 | $150.00–$404.00 | — | 5% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 Xr Shoulder Complete 2+ Views Bilat | $735.00 | $774.00 | $67.00–$751.00 | — | 5% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete 2+ Views Left | $368.00 | $387.00 | $67.00–$375.00 | 10% above | 5% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete 2+ Views Right | $368.00 | $387.00 | $67.00–$375.00 | 10% above | 5% |
| Sleep study in a lab (polysomnography) CPT 95810 Sleep study | $3,705.00 | $3,900.00 | $1,133.00–$3,783.00 | 4% above | 5% |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound pelvis through vagina | $695.00 | $732.00 | $263.00–$710.00 | 15% above | 5% |
| Transvaginal ultrasound during pregnancy CPT 76817 Us Ob Transvaginal | $571.00 | $601.00 | $216.00–$583.00 | 14% above | 5% |
| Ultrasound of the abdomen, complete CPT 76700 Ultrasound of abdomen | $938.00 | $987.00 | $272.00–$957.00 | 14% above | 5% |
| Ultrasound of the scrotum and testicles CPT 76870 Us Scrotum (Contents) | $716.00 | $754.00 | $235.00–$731.00 | 11% above | 5% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Head/neck Soft Tissue | $665.00 | $700.00 | $251.00–$679.00 | 13% above | 5% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Lower Ext Venous Duplex Left | $1,134.00 | $1,194.00 | $223.00–$1,158.00 | 11% above | 5% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Lower Ext Venous Duplex Right | $1,134.00 | $1,194.00 | $223.00–$1,158.00 | 11% above | 5% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 Xr Wrist Complete 3+ Views Bilateral | $665.00 | $700.00 | $81.00–$679.00 | — | 5% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete 3+ Views Left | $333.00 | $350.00 | $81.00–$340.00 | 1% above | 5% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete 3+ Views Right | $333.00 | $350.00 | $81.00–$340.00 | 1% above | 5% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip 2-3 Views Right | $362.00 | $381.00 | $95.00–$370.00 | 27% above | 5% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip 2-3 Views Left | $362.00 | $381.00 | $95.00–$370.00 | 27% above | 5% |
| X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen 1 View | $322.00 | $339.00 | $63.00–$329.00 | 23% above | 5% |
| X-ray of the abdomen, 1 view one side CPT 74018 Xr Abdomen Decubitus Right | $322.00 | $339.00 | $63.00–$329.00 | 23% above | 5% |
| X-ray of the abdomen, 1 view one side CPT 74018 Xr Abdomen Decubitus Left | $322.00 | $339.00 | $63.00–$329.00 | 23% above | 5% |
| X-ray of the ankle, 2 views both sides CPT 73600 Xr Ankle 2 Views Bilateral | $564.00 | $594.00 | $68.00–$576.00 | — | 5% |
| X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Right | $282.00 | $297.00 | $68.00–$288.00 | 25% above | 5% |
| X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Left | $282.00 | $297.00 | $68.00–$288.00 | 25% above | 5% |
| X-ray of the finger(s), 2 or more views both sides CPT 73140 Xr Finger(s) 2+ Views Bilat | $504.00 | $530.00 | $74.00–$514.00 | — | 5% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(s) 2+ Views Left | $252.00 | $265.00 | $74.00–$257.00 | 12% above | 5% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(s) 2+ Views Right | $252.00 | $265.00 | $74.00–$257.00 | 12% above | 5% |
| X-ray of the foot, 2 views both sides CPT 73620 Xr Foot 2 Views Bilateral | $515.00 | $542.00 | $60.00–$526.00 | — | 5% |
| X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Right | $276.00 | $290.00 | $60.00–$281.00 | 28% above | 5% |
| X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Left | $276.00 | $290.00 | $60.00–$281.00 | 28% above | 5% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 Xr Foot Complete 3+ Views Bilateral | $728.00 | $766.00 | $69.00–$743.00 | — | 5% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete 3+ Views Right | $364.00 | $383.00 | $69.00–$372.00 | 17% above | 5% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete 3+ Views Left | $364.00 | $383.00 | $69.00–$372.00 | 17% above | 5% |
| X-ray of the hand, 3 or more views both sides CPT 73130 Xr Hand Complete 3+ Views Bilateral | $701.00 | $738.00 | $74.00–$716.00 | — | 5% |
| X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete 3+ Views Right | $351.00 | $369.00 | $74.00–$358.00 | 3% above | 5% |
| X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete 3+ Views Left | $351.00 | $369.00 | $74.00–$358.00 | 3% above | 5% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 Xr Knee 1 Or 2 Views Bilateral | $686.00 | $722.00 | $71.00–$700.00 | — | 5% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 1 Or 2 Views Left | $343.00 | $361.00 | $71.00–$350.00 | 8% above | 5% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 1 Or 2 Views Right | $343.00 | $361.00 | $71.00–$350.00 | 8% above | 5% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr Spine Lumbosacral 2 Or 3 Views | $455.00 | $479.00 | $81.00–$465.00 | 20% above | 5% |
| X-ray of the lower back, 4 or more views CPT 72110 X-Ray of lower back | $523.00 | $551.00 | $113.00–$534.00 | 12% above | 5% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xr Spine Thoracic 2 Views | $387.00 | $407.00 | $76.00–$395.00 | 26% above | 5% |
| X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones 3+ Views | $352.00 | $371.00 | $76.00–$360.00 | 21% above | 5% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr Spine Cervical 2 Or 3 Views | $366.00 | $385.00 | $81.00–$373.00 | 20% above | 5% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis 1 Or 2 Views | $341.00 | $359.00 | $73.00–$348.00 | 28% above | 5% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Sacrum/coccyx 2+ Views | $332.00 | $349.00 | $68.00–$339.00 | 24% above | 5% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase | $58.00 | $61.00 | $11.00–$59.00 | 5% below | 5% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase | $64.00 | $67.00 | $11.00–$65.00 | 13% above | 4% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel 2 Plab | $321.00 | $338.00 | $97.00–$328.00 | 2% above | 5% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Profile Acute Plab | $321.00 | $338.00 | $97.00–$328.00 | 2% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Food Type | $190.00 | $200.00 | $11.00–$419.00 | 313% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Food: Tomato Plab | $414.00 | $436.00 | $11.00–$423.00 | 800% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Immunocap X 1 Plab | $414.00 | $436.00 | $11.00–$423.00 | 800% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Food: Soybean Plab | $414.00 | $436.00 | $11.00–$423.00 | 800% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Milk (Cow) Ige Plab | $414.00 | $436.00 | $11.00–$423.00 | 800% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Food: Potato Plab | $414.00 | $436.00 | $11.00–$423.00 | 800% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Seafood Panel, Allergy Plab | $2,071.00 | $2,180.00 | $11.00–$2,115.00 | 4402% above | 5% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Ccp (Cyclic Citrullinated Peptide) Igg Plab | $160.00 | $168.00 | $26.00–$163.00 | 65% above | 5% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana, Igg Screen W/ Reflex To Ctd Plab | $115.00 | $121.00 | $25.00–$117.00 | 70% above | 5% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 N-terminal Pro B-type Natriuretic Peptide | $302.00 | $318.00 | $72.00–$308.00 | 54% above | 5% |
| Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel | $147.00 | $155.00 | $17.00–$150.00 | 9% above | 5% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Tissue Exam By Pathologist. | $413.00 | $435.00 | $121.00–$422.00 | 116% above | 5% |
| Blood culture for bacteria CPT 87040 Blood Culture #1 Plab | $323.00 | $340.00 | $21.00–$330.00 | 79% above | 5% |
| Blood culture for bacteria CPT 87040 Culture Blood [Rock] | $323.00 | $340.00 | $21.00–$330.00 | 79% above | 5% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection Venous Draw-36415 | $36.00 | $38.00 | $4.00–$37.00 | 36% above | 5% |
| Blood glucose (sugar) test CPT 82947 Glucose Fasting [Rock] | $64.00 | $67.00 | $8.00–$65.00 | 36% above | 4% |
| Blood lead test CPT 83655 Lead Assay [Rock] | $83.00 | $87.00 | $25.00–$84.00 | 28% above | 5% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta Hcg Qualitative | $124.00 | $130.00 | $15.00–$126.00 | 13% above | 5% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Typing [Rock] | $79.00 | $83.00 | $6.00–$81.00 | 47% above | 5% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Type And Screen Rock | $79.00 | $83.00 | $6.00–$81.00 | 47% above | 5% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Type (Abo Rh) Rock | $79.00 | $83.00 | $6.00–$81.00 | 47% above | 5% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive Protein | $114.00 | $120.00 | $11.00–$116.00 | 26% above | 5% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C. Difficile Toxigenic Dna Detect Plab | $223.00 | $235.00 | $71.00–$228.00 | 50% above | 5% |
| CA 19-9 blood test (tumor marker) CPT 86301 Ca19-9 Plab | $232.00 | $244.00 | $42.00–$237.00 | 54% above | 5% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Ca-125 Plab | $201.00 | $212.00 | $42.00–$206.00 | 55% above | 5% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars-cov-2 (Covid-19) Rna (Id Now) | $192.00 | $202.00 | $68.00–$196.00 | 55% above | 5% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious Agent Detection By Nucleic Ac [Rock] | $209.00 | $220.00 | $68.00–$213.00 | 69% above | 5% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia [Rock] | $145.00 | $153.00 | $55.00–$148.00 | 32% above | 5% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids | $130.00 | $137.00 | $27.00–$133.00 | 14% above | 5% |
| Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (CBC), with differential white blood cells, automated | $109.00 | $115.00 | $16.00–$112.00 | 21% above | 5% |
| Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (CBC), automated | $86.00 | $90.00 | $13.00–$87.00 | 22% above | 4% |
| Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals | $179.00 | $188.00 | $22.00–$182.00 | 16% above | 5% |
| D-dimer blood test (blood clot marker) CPT 85379 D-dimer | $169.00 | $178.00 | $21.00–$173.00 | 26% above | 5% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea-s Plab | $187.00 | $197.00 | $45.00–$191.00 | 32% above | 5% |
| Estradiol blood test CPT 82670 Estradiol, Adult Plab | $177.00 | $186.00 | $57.00–$180.00 | 37% above | 5% |
| FSH (follicle-stimulating hormone) test CPT 83001 Fsh Plab | $137.00 | $144.00 | $38.00–$140.00 | 22% above | 5% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal Plab | $455.00 | $479.00 | $40.00–$465.00 | 28% above | 5% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin Rock | $130.00 | $137.00 | $28.00–$133.00 | 25% above | 5% |
| Folate (folic acid) blood test CPT 82746 Folate Plab | $143.00 | $150.00 | $30.00–$146.00 | 36% above | 5% |
| Free T3 thyroid hormone test CPT 84481 T3, Free Plab | $182.00 | $192.00 | $35.00–$186.00 | 17% above | 5% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Level | $98.00 | $103.00 | $18.00–$100.00 | 15% above | 5% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 2 Hour Post Glucose Dose [Rock] | $68.00 | $72.00 | $10.00–$70.00 | 24% above | 6% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance (Gtt) [Rock] | $166.00 | $175.00 | $26.00–$170.00 | 28% above | 5% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonorrhoeae [Rock] | $144.00 | $152.00 | $55.00–$147.00 | 32% above | 5% |
| H. pylori stool antigen test CPT 87338 Helicobacter Pylori Antigen, Fecal Plab | $207.00 | $218.00 | $29.00–$211.00 | 30% above | 5% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 Viral Load Pcr Plab | $433.00 | $456.00 | $164.00–$442.00 | 17% below | 5% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv Ag/ab Combo Plab | $110.00 | $116.00 | $42.00–$113.00 | 49% above | 5% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv High Risk Screen Plab | $167.00 | $176.00 | $63.00–$171.00 | 54% above | 5% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c | $86.00 | $90.00 | $20.00–$87.00 | 21% above | 4% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Antibody [Rock] | $134.00 | $141.00 | $22.00–$137.00 | 48% above | 5% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag [Rock] | $114.00 | $120.00 | $21.00–$116.00 | 23% above | 5% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody Igg Plab | $115.00 | $121.00 | $29.00–$117.00 | 26% above | 5% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus (Hcv), Quant Naat Plab | $485.00 | $510.00 | $87.00–$495.00 | 45% above | 5% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hep C Vir | $485.00 | $510.00 | $87.00–$495.00 | 45% above | 5% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex 1 & 2 Ab, Igg Plab | $260.00 | $274.00 | $27.00–$266.00 | 160% above | 5% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2 Test [Rock] | $146.00 | $154.00 | $39.00–$149.00 | 38% above | 5% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 Crp, Highly Sensitive Plab | $144.00 | $152.00 | $26.00–$147.00 | 77% above | 5% |
| Homocysteine blood test CPT 83090 Homocystine Total Plasma [Rock] | $222.00 | $234.00 | $34.00–$227.00 | 57% above | 5% |
| Insulin blood test CPT 83525 Insulin, Fasting Plab | $130.00 | $137.00 | $23.00–$133.00 | 20% above | 5% |
| Iron blood test (serum iron) CPT 83540 Iron [Rock] | $75.00 | $79.00 | $13.00–$77.00 | 19% above | 5% |
| Iron blood test (serum iron) CPT 83540 Iron Panel W/ Ferritin | $75.00 | $79.00 | $13.00–$77.00 | 19% above | 5% |
| Iron blood test (serum iron) CPT 83540 Iron Level And Tibc | $75.00 | $79.00 | $13.00–$77.00 | 19% above | 5% |
| Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Test Rock | $90.00 | $95.00 | $18.00–$92.00 | 31% above | 5% |
| Kidney function blood test panel CPT 80069 Kidney function panel test | $181.00 | $190.00 | $18.00–$184.00 | 34% above | 5% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone Plab | $135.00 | $142.00 | $38.00–$138.00 | 9% above | 5% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $131.00 | $138.00 | $14.00–$134.00 | 37% above | 5% |
| Liver function blood test panel CPT 80076 Liver function blood test | $147.00 | $155.00 | $17.00–$150.00 | 13% above | 5% |
| Lyme disease antibody test CPT 86618 Lyme Disease Total Antibody With Reflex To Immunoblot Plab | $207.00 | $218.00 | $35.00–$211.00 | 61% above | 5% |
| Magnesium blood test CPT 83735 Magnesium, Rbc Plab | $97.00 | $102.00 | $14.00–$99.00 | 42% above | 5% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibody [Rock] | $129.00 | $136.00 | $26.00–$132.00 | 55% above | 5% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen | $86.00 | $91.00 | $11.00–$88.00 | 33% above | 5% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Total prostate-specific antigen (PSA) test | $138.00 | $145.00 | $37.00–$141.00 | 8% above | 5% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Total prostate-specific antigen (PSA) test | $141.00 | $148.00 | $37.00–$144.00 | 36% above | 5% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap, Thinprep W/reflex To Hpv (Acog) Plab | $122.00 | $128.00 | $41.00–$124.00 | 123% above | 5% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathormone [Rock] | $296.00 | $312.00 | $84.00–$303.00 | 40% above | 5% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test | $106.00 | $112.00 | $12.00–$109.00 | 38% above | 5% |
| Progesterone blood test CPT 84144 Progesterone Plab | $153.00 | $161.00 | $43.00–$156.00 | 40% above | 5% |
| Prolactin blood test CPT 84146 Prolactin Plab | $188.00 | $198.00 | $39.00–$192.00 | 68% above | 5% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time | $67.00 | $71.00 | $8.00–$69.00 | 33% above | 6% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Screen Urine | $188.00 | $198.00 | $23.00–$192.00 | 98% above | 5% |
| Rapid flu test (influenza antigen) CPT 87804 Influenza A/b [Rock] | $146.00 | $154.00 | $30.00–$149.00 | 97% above | 5% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Plab | $77.00 | $81.00 | $12.00–$79.00 | 42% above | 5% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody [Rock] | $105.00 | $111.00 | $29.00–$108.00 | 42% above | 5% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Esr (Erythrocyte Sedimentation Rate) | $55.00 | $58.00 | $6.00–$56.00 | 17% above | 5% |
| Stool ova and parasites exam CPT 87177 O & P Smears [Rock] | $106.00 | $112.00 | $18.00–$109.00 | 42% above | 5% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood, Fecal | $59.00 | $62.00 | $22.00–$60.00 | 42% above | 5% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr (Monitor) With Reflex To Titer Plab | $58.00 | $61.00 | $9.00–$59.00 | 38% above | 5% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tb Gold Plus Plab | $236.00 | $248.00 | $89.00–$241.00 | 17% above | 5% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total [Rock] | $137.00 | $144.00 | $52.00–$140.00 | 28% above | 5% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Antibodies Plab | $128.00 | $135.00 | $30.00–$131.00 | 53% above | 5% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Antibodies [Rock] | $128.00 | $135.00 | $30.00–$131.00 | 53% above | 5% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) | $120.00 | $126.00 | $34.00–$122.00 | 14% above | 5% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas [Rock] | $116.00 | $122.00 | $44.00–$118.00 | 24% above | 5% |
| Uric acid blood test CPT 84550 Uric Acid | $67.00 | $71.00 | $9.00–$69.00 | 28% above | 6% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis test using microscope | $63.00 | $66.00 | $6.00–$64.00 | 26% above | 5% |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis test using microscope | $43.00 | $45.00 | $7.00–$44.00 | 23% above | 4% |
| Urine culture for bacteria, with colony count CPT 87086 Culture Urine Colony Cnt87086 | $96.00 | $101.00 | $16.00–$98.00 | 34% above | 5% |
| Urine pregnancy test, read by color change CPT 81025 Beta Hcg Qualitative Urine | $91.00 | $96.00 | $16.00–$93.00 | 43% above | 5% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Plab | $140.00 | $147.00 | $31.00–$143.00 | 24% above | 5% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vit D 3, | $169.00 | $178.00 | $60.00–$173.00 | 21% above | 5% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-hydroxy Plab | $174.00 | $183.00 | $60.00–$178.00 | 25% above | 5% |
| Zinc blood test CPT 84630 Zinc, Serum Plab | $105.00 | $110.00 | $23.00–$107.00 | 59% above | 5% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta-hcg Quantitative [Rock] | $148.00 | $156.00 | $31.00–$151.00 | 67% above | 5% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Cardioversion, elective (restoring heart rhythm) CPT 92960 92960cardioversion; Elective | $1,608.00 | $1,693.00 | $210.00–$1,642.00 | 12% above | 5% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 Cardioversion Elective Arrhthmia Externa Charge | $1,608.00 | $1,693.00 | $210.00–$1,642.00 | 12% above | 5% |
| Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope | $2,234.00 | $2,352.00 | $584.00–$2,281.00 | 101% above | 5% |
| Colonoscopy with tissue sample CPT 45380 Biopsy exam of large bowel using an endoscope | $2,103.00 | $2,214.00 | $460.00–$2,148.00 | 62% above | 5% |
| Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using an endoscope | $2,031.00 | $2,138.00 | $423.00–$2,074.00 | 65% above | 5% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000 Destruction Premalignant Lesion; 1st Lesion | $119.00 | $125.00 | $45.00–$121.00 | 7% below | 5% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000 Destruction Premalignant Lesions; First Lesion | $151.00 | $159.00 | $57.00–$154.00 | 18% above | 5% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 69209-cerumen Irrigation/lavage | $985.00 | $1,037.00 | $31.00–$1,006.00 | 2013% above | 5% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 69209 Removal Impacted Cerumen Irrigation/lvg Unilat | $41.00 | $43.00 | $15.00–$996.00 | 12% below | 5% |
| Earwax removal with instruments, one ear one side CPT 69210 69210 Removal Impacted Cerumen Require Instrumentation, Unilat | $117.00 | $123.00 | $44.00–$119.00 | 36% above | 5% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 Hemorrhoid Banding | $1,203.00 | $1,266.00 | $428.00–$1,228.00 | 100% above | 5% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 46221 Hemorrhoidectomy, Internal, Rubber Band Ligation | $1,203.00 | $1,266.00 | $428.00–$1,228.00 | 100% above | 5% |
| IUD insertion (the device itself billed separately) CPT 58300 58300 Insertion Of Intrauterine Device (Iud) | $238.00 | $250.00 | $90.00–$243.00 | 18% above | 5% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060-i&d Abscess/cyst/hematoma Simple | $337.00 | $355.00 | $127.00–$344.00 | 30% above | 5% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060 Incision And Drainage Of Abscess; Simple Or Single | $337.00 | $355.00 | $127.00–$344.00 | 30% above | 5% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 Injection Tendon Sheath Charge | $238.00 | $251.00 | $89.00–$243.00 | 39% above | 5% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 20610 Bilat Arthrocentesis, Aspiration And/or Injection, Major Joint Or Bursa Rock_ne | $572.00 | $602.00 | $103.00–$584.00 | — | 5% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis, Aspiration And/or Injection, Major Joint Or Bursa; Without Ultrasound Guidance | $238.00 | $250.00 | $90.00–$243.00 | 25% above | 5% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-major Joint Aspirate/inject W/o Us | $286.00 | $301.00 | $103.00–$292.00 | 50% above | 5% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis Major Joint Wo Ultrasound | $286.00 | $301.00 | $103.00–$292.00 | 50% above | 5% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 20610 Rt Arthrocentesis, Aspiration And/or Injection, Major Joint Or Bursa Rock_ne | $286.00 | $301.00 | $103.00–$292.00 | 50% above | 5% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 20610 Lt Arthrocentesis, Aspiration And/or Injection, Major Joint Or Bursa Rock_ne | $286.00 | $301.00 | $103.00–$292.00 | 50% above | 5% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 11981 Insertion, Non-biodegradable Drug Delivery Implant | $334.00 | $352.00 | $126.00–$341.00 | 46% above | 5% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 20605 Bilat Arthrocentesis, Aspiration And/or Injection, Intermediate Joint Or Bursa Rock_ne | $215.00 | $226.00 | $81.00–$219.00 | — | 5% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Arthrocentesis, Aspiration And/or Injection, Intermediate Joint Or Bursa (Eg, Temporomandibula | $139.00 | $146.00 | $52.00–$217.00 | 25% below | 5% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Arthrocentesis Intermediate Joint Wo Ultrasound | $215.00 | $226.00 | $81.00–$219.00 | 16% above | 5% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 20605 Lt Arthrocentesis, Aspiration And/or Injection, Intermediate Joint Or Bursa Rock_ne | $215.00 | $226.00 | $81.00–$219.00 | 16% above | 5% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 20605 Rt Arthrocentesis, Aspiration And/or Injection, Intermediate Joint Or Bursa Rock_ne | $215.00 | $226.00 | $81.00–$219.00 | 16% above | 5% |
| Joint injection or drainage, small joint (fingers, toes) both sides CPT 20600 20600 Bilat Arthrocentesis, Aspiration And/or Injection, Small Joint Or Bursa Rock_ne | $201.00 | $212.00 | $76.00–$206.00 | — | 5% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthrocentesis, Aspiration And/or Injection, Small Joint Or Bursa (Eg, Fingers, Toes); Without | $133.00 | $140.00 | $50.00–$204.00 | 7% below | 5% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthrocentesis Small Joint Wo Ultrasound | $201.00 | $212.00 | $76.00–$206.00 | 40% above | 5% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 20600 Lt Arthrocentesis, Aspiration And/or Injection, Small Joint Or Bursa Rock_ne | $201.00 | $212.00 | $76.00–$206.00 | 40% above | 5% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 20600 Rt Arthrocentesis, Aspiration And/or Injection, Small Joint Or Bursa Rock_ne | $201.00 | $212.00 | $76.00–$206.00 | 40% above | 5% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Injection(s) of therapeutic substance | $957.00 | $1,007.00 | $196.00–$977.00 | 52% above | 5% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere), Trunk, A | $233.00 | $245.00 | $88.00–$238.00 | 23% below | 5% |
| Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion Of Nail Plate, Partial Or Complete, Simple; Single | $214.00 | $225.00 | $81.00–$291.00 | 9% below | 5% |
| Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion Nail Plate Part/comp Simple 1 | $288.00 | $303.00 | $109.00–$294.00 | 23% above | 5% |
| Nail removal (partial or complete), one nail CPT 11730 11730-avulsion Nail Plate Single | $348.00 | $366.00 | $127.00–$355.00 | 48% above | 5% |
| Paracentesis with imaging guidance CPT 49083 49083 Abdominal Paracentesis W/imaging | $1,123.00 | $1,182.00 | $248.00–$1,147.00 | 36% above | 5% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 Excision Nail And Nail Matrix, Partial Or Complete Permanent Removal | $610.00 | $642.00 | $231.00–$623.00 | 84% above | 5% |
| Removal of a foreign object under the skin, simple CPT 10120 10120 Incision And Removal Of Foreign Body, Subq | $353.00 | $372.00 | $134.00–$561.00 | 8% above | 5% |
| Removal of a foreign object under the skin, simple CPT 10120 10120 Incision/remove Foreign Body Sub Q Simple | $555.00 | $584.00 | $210.00–$566.00 | 70% above | 5% |
| Removal of a foreign object under the skin, simple CPT 10120 10120-subcutaneous Tissue Simple | $555.00 | $584.00 | $210.00–$566.00 | 70% above | 5% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 G0105colonoscopy, Medicare Screening High Risk Patient | $1,762.00 | $1,855.00 | $288.00–$1,799.00 | 115% above | 5% |
| Short arm cast (elbow to hand) CPT 29075 29075-cast Application Elbow To Finger (Short Arm) | $273.00 | $287.00 | $31.00–$278.00 | 38% above | 5% |
| Short arm cast (elbow to hand) CPT 29075 29075 Application Of Forearm Cast | $567.00 | $597.00 | $137.00–$579.00 | 187% above | 5% |
| Short arm splint (forearm and hand) CPT 29125 29125 Application Of Short Arm Splint (Forearm To Hand); Static | $170.00 | $179.00 | $64.00–$174.00 | 10% above | 5% |
| Short arm splint (forearm and hand) CPT 29125 29125-short Arm | $187.00 | $197.00 | $21.00–$191.00 | 21% above | 5% |
| Short arm splint (forearm and hand) CPT 29125 29125 Splint Short Arm (Forearm To Hand) Static | $217.00 | $228.00 | $82.00–$221.00 | 40% above | 5% |
| Short leg cast (below the knee) CPT 29405 29405-app Of Short Leg Cast (Below Knee To Toes) | $270.00 | $284.00 | $102.00–$275.00 | 45% above | 5% |
| Short leg splint (calf to foot) CPT 29515 29515-short Leg | $219.00 | $230.00 | $83.00–$223.00 | 38% above | 5% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001-scalp/neck/trunk/genital/extremity <= 2.5 Cm | $306.00 | $322.00 | $23.00–$312.00 | 47% above | 5% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 Simple Repair Of Superficial Wounds Of Scalp, Neck, Axillae, External Genitalia, Trunk And/or | $306.00 | $322.00 | $100.00–$312.00 | 47% above | 5% |
| Skin biopsy, punch, one lesion CPT 11104 11104 Punch Biopsy Skin Single Lesion | $217.00 | $228.00 | $82.00–$221.00 | 15% below | 5% |
| Skin biopsy, punch, one lesion CPT 11104 11104 Punch Biopsy Of Skin ; Single Lesion | $261.00 | $275.00 | $99.00–$267.00 | 3% above | 5% |
| Skin tag removal, up to 15 tags CPT 11200 11200 Removal Of Skin Tags, Multiple Fibrocutaneous Tags, Any Area; Up To And Including 15 Lesions | $190.00 | $200.00 | $72.00–$275.00 | 1% above | 5% |
| Skin tag removal, up to 15 tags CPT 11200 11200 Removal Skin Tages Up To 15 Lesions | $272.00 | $286.00 | $103.00–$277.00 | 44% above | 5% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 Simple Repair Of Wounds; Scalp, Neck, Axillae, Genitalia, Trunk, Extremeties; 2.6-7.5cm | $314.00 | $330.00 | $119.00–$320.00 | 29% above | 5% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002-scalp/neck/trunk/genital/extremity 2.6-7.5 Cm | $329.00 | $346.00 | $124.00–$336.00 | 35% above | 5% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/or Mucous Membranes | $323.00 | $340.00 | $122.00–$330.00 | 42% above | 5% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011-face/ear/eyelid/nose/lip Less Than/equal To 2.5 Cm | $336.00 | $354.00 | $28.00–$343.00 | 47% above | 5% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Tangential Biopsy Of Skin (Shave,curette); Single Lesion | $237.00 | $249.00 | $89.00–$282.00 | 25% above | 5% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Tangential Biopsy Skin; Single Lesion | $279.00 | $294.00 | $89.00–$285.00 | 47% above | 5% |
| Thoracentesis with imaging guidance CPT 32555 32555 Thoracentesis, Needle Or Catheter, Aspiration Of The Pleural Space Techfee | $1,526.00 | $1,606.00 | $258.00–$1,558.00 | 85% above | 5% |
| Trigger point injections, 1 or 2 muscles CPT 20552 20552 Joints Trp. Inj. One-two Muscles | $282.00 | $297.00 | $86.00–$288.00 | 119% above | 5% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Esophagogastroduodenoscopy Balloon Dilatation | $1,742.00 | $1,834.00 | $352.00–$1,779.00 | at median | 5% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy exam of esophagus, stomach or small bowel using an endoscope | $2,023.00 | $2,129.00 | $317.00–$2,065.00 | 33% above | 5% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach or small bowel using an endoscope | $1,987.00 | $2,092.00 | $280.00–$2,029.00 | 172% above | 5% |
| Wart removal, up to 14 warts CPT 17110 17110 Destruction Benign Lesions Up To 14 | $189.00 | $199.00 | $71.00–$193.00 | 8% above | 5% |
| Wart removal, up to 14 warts CPT 17110 17110 Destruction (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettemen | $219.00 | $230.00 | $83.00–$223.00 | 25% above | 5% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 Debride Skin Tissue First 20cm2 Charge | $428.00 | $450.00 | $139.00–$437.00 | 42% above | 5% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042-sq Tissue Less Than/equal To 1st 20 Sq Cm | $428.00 | $450.00 | $139.00–$437.00 | 42% above | 5% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion | $945.00 | $995.00 | $76.00–$965.00 | 32% above | 5% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Admin Fee [Rock] | $945.00 | $995.00 | $76.00–$965.00 | 32% above | 5% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Rt Aerosol Initial Charge | $288.00 | $303.00 | $33.00–$294.00 | 172% above | 5% |
| Chemotherapy IV infusion, first hour CPT 96413 96413 Chemo Iv Infusion Initial, Up To 1hr Charge | $321.00 | $338.00 | $121.00–$328.00 | 44% below | 5% |
| Critical care, first 30 to 74 minutes CPT 99291 99291 Critical Care, First 30-74 Min | $747.00 | $786.00 | $107.00–$762.00 | 15% above | 5% |
| Critical care, first 30 to 74 minutes CPT 99291 99291critical Care, 30-74 | $1,557.00 | $1,639.00 | $412.00–$1,590.00 | 139% above | 5% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Rt Electrocardiogram (Ekg) Charge | $306.00 | $322.00 | $15.00–$312.00 | 29% above | 5% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 Emergency Department Visit, Level 1 | $172.00 | $181.00 | $6.00–$176.00 | 13% above | 5% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281level 1 | $198.00 | $208.00 | $39.00–$1,000.00 | 30% above | 5% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 Emergency Department Visit, Level 2 | $202.00 | $213.00 | $21.00–$207.00 | 5% above | 5% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282level 2 | $331.00 | $348.00 | $77.00–$1,000.00 | 72% above | 5% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 Emergency Department Visit, Level 3 | $379.00 | $399.00 | $37.00–$387.00 | 38% above | 5% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283level 3 | $525.00 | $553.00 | $115.00–$1,000.00 | 91% above | 5% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 Emergency Department Visit, Level 4 | $733.00 | $772.00 | $63.00–$749.00 | 56% above | 5% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284level 4 | $843.00 | $887.00 | $218.00–$1,000.00 | 79% above | 5% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 Emergency Department Visit, Level 5 | $1,017.00 | $1,071.00 | $91.00–$1,039.00 | 55% above | 5% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285level 5 | $1,287.00 | $1,355.00 | $321.00–$1,314.00 | 96% above | 5% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 Intravenous Infusion, Hydration, Initial 31 Minutes To 1 Hour | $409.00 | $430.00 | $70.00–$417.00 | 8% above | 5% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 Hydration, First Hour | $409.00 | $430.00 | $70.00–$417.00 | 8% above | 5% |
| IV infusion of a medicine, first hour CPT 96365 96365 Intravenous Infusion Initial Up To 1 Hour | $429.00 | $452.00 | $131.00–$438.00 | 12% above | 5% |
| IV infusion of a medicine, first hour CPT 96365 96365 Iv Tx, First Hour | $429.00 | $452.00 | $131.00–$438.00 | 12% above | 5% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Therapeutic, Prophylactic, Or Diagnostic Injection (Specify Substance Or Drug); Subcutaneous O | $57.00 | $60.00 | $22.00–$186.00 | 37% below | 5% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Subq/im Injection | $184.00 | $194.00 | $31.00–$188.00 | 102% above | 5% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Injection Therapeutic, Prophylactic Or Diagnostic; Subq/im | $184.00 | $194.00 | $31.00–$188.00 | 102% above | 5% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-injection/sq/im | $184.00 | $194.00 | $31.00–$188.00 | 102% above | 5% |
| Neuromuscular re-education, 15 minutes CPT 97112 Ot Neuromuscular Reeducation Units | $98.00 | $103.00 | $37.00–$100.00 | 7% above | 5% |
| Neuromuscular re-education, 15 minutes CPT 97112 Pt Neuromuscular Reeducation Units | $98.00 | $103.00 | $37.00–$100.00 | 7% above | 5% |
| New patient office visit, about 30 minutes CPT 99203 New patient office or other outpatient visit, 30 min | $252.00 | $265.00 | $95.00–$257.00 | 22% above | 5% |
| New patient office visit, about 45 minutes CPT 99204 New patient office or other outpatient visit, 45 min | $390.00 | $410.00 | $147.00–$398.00 | 29% above | 5% |
| New patient office visit, about 60 minutes CPT 99205 New patient office or other outpatient visit, 60 min | $570.00 | $600.00 | $210.00–$582.00 | 54% above | 5% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Specialty Clinic New 15-29 Min | $115.00 | $121.00 | $43.00–$117.00 | 7% below | 5% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Medical Nutrition Individual 15 Min Charge | $137.00 | $144.00 | $52.00–$140.00 | 185% above | 5% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Evaluation Units, Low Complexity | $172.00 | $181.00 | $65.00–$176.00 | 5% above | 5% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Evaluation Units, High Complexity | $255.00 | $268.00 | $90.00–$260.00 | 23% above | 5% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Evaluation Units, Low Complexity | $158.00 | $166.00 | $60.00–$161.00 | at median | 5% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Evaluation Units, Moderate Complexity | $194.00 | $204.00 | $73.00–$198.00 | 10% above | 5% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Ot Manual Therapy Units | $96.00 | $101.00 | $36.00–$98.00 | at median | 5% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Pt Manual Therapy Units | $96.00 | $101.00 | $36.00–$98.00 | at median | 5% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Physical therapy, therapeutic exercise | $176.00 | $185.00 | $50.00–$179.00 | 85% above | 5% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial new patient preventative medicine evaluation (18-39 years) | $285.00 | $300.00 | $108.00–$291.00 | 16% above | 5% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial new patient preventative medicine evaluation (40-64 years) | $314.00 | $330.00 | $119.00–$320.00 | 13% above | 5% |
| Preventive checkup, new patient aged 65 or older CPT 99387 99387 Preventive Eval Initial New Pt. > 65 Year Age | $356.00 | $375.00 | $135.00–$364.00 | 30% above | 5% |
| Psychiatric evaluation with medical services CPT 90792 90792 Psychiatric Diagnostic Evaluation | $276.00 | $290.00 | $104.00–$281.00 | 19% above | 5% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Mh Treatment Rm Visit Level 5 | $300.00 | $316.00 | $113.00–$307.00 | 27% above | 5% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Specialty Clinic Est. 40-54 Min | $300.00 | $316.00 | $113.00–$307.00 | 27% above | 5% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Treatment Rm Visit Level 5 | $300.00 | $316.00 | $113.00–$307.00 | 27% above | 5% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Specialty Clinic Est. 20-29 Min | $142.00 | $149.00 | $54.00–$145.00 | 20% above | 5% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Treatment Rm Visit Level 3 | $142.00 | $149.00 | $54.00–$145.00 | 20% above | 5% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Mh Treatment Rm Visit Level 3 | $142.00 | $149.00 | $54.00–$145.00 | 20% above | 5% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Specialty Clinic Est. 30-39 Min | $213.00 | $224.00 | $80.00–$217.00 | 22% above | 5% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Treatment Rm Visit Level 4 | $213.00 | $224.00 | $80.00–$217.00 | 22% above | 5% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Mh Treatment Rm Visit Level 4 | $213.00 | $224.00 | $80.00–$217.00 | 22% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Specialty Clinic Est. 10-19 Min | $92.00 | $97.00 | $35.00–$94.00 | 10% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Treatment Rm Visit Level 2 | $92.00 | $97.00 | $35.00–$94.00 | 10% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Mh Treatment Rm Visit Level 2 | $92.00 | $97.00 | $35.00–$94.00 | 10% above | 5% |
| Speech and language evaluation CPT 92523 Slp Eval Lang Comprehension,express Unit | $323.00 | $340.00 | $90.00–$374.00 | 5% above | 5% |
| Speech therapy session, individual CPT 92507 Slp Auditory Processing Tx Units | $272.00 | $286.00 | $90.00–$277.00 | 12% above | 5% |
| Spirometry (breathing test) CPT 94010 Rt Incentive Spirometry Initial Charge | $334.00 | $352.00 | $65.00–$341.00 | 24% above | 5% |
| Spirometry (breathing test) CPT 94010 Pft Screen Spirometry | $337.00 | $355.00 | $65.00–$344.00 | 25% above | 5% |
| Spirometry (breathing test) CPT 94010 94010 Spirometry | $357.00 | $376.00 | $65.00–$365.00 | 32% above | 5% |
| Spirometry before and after a bronchodilator CPT 94060 Pft Pre & Post Screen Spirometry | $705.00 | $742.00 | $110.00–$720.00 | 25% above | 5% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Pt Therapeutic Activity Units | $100.00 | $105.00 | $38.00–$102.00 | 16% above | 5% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Ot Therapeutic Activities Units | $101.00 | $106.00 | $38.00–$103.00 | 17% above | 5% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Pulmonary Rehab Indiv 15 Min | $164.00 | $173.00 | $62.00–$168.00 | 90% above | 5% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy | $181.00 | $190.00 | $68.00–$184.00 | 6% below | 5% |
| Treadmill or drug stress test with ECG, supervision and report CPT 93015 93015 Cardiovascular Stress Test | $921.00 | $969.00 | $134.00–$940.00 | 253% above | 5% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 91322 Moderna (12y+)amb Sars-cov-2 (Covid-19) Mrna (Cvx 312) | $246.00 | $259.00 | $93.00–$294.00 | 29% above | 5% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 91322 Moderna Vaccine Single Dose Pre-filled Syringe 12y+ | $246.00 | $259.00 | $93.00–$294.00 | 29% above | 5% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella Vaccineamb Varicella Charge | $297.00 | $313.00 | $112.00–$304.00 | 49% above | 5% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 90656 No Prsv 3+>amb Influenza Vacc Charge | $45.00 | $47.00 | $17.00–$46.00 | 67% above | 4% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Hpv9 (Gardasil 9) 90651amb Human Papillomavirus Charge | $475.00 | $500.00 | $180.00–$485.00 | 28% above | 5% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 20mcg/ml Hepatitis B Vaccineamb Hepatitis B Vaccine Charge | $98.00 | $103.00 | $37.00–$100.00 | 8% above | 5% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 90662 Prsv Free Inc Antigamb Influenza Vacc Charge | $128.00 | $135.00 | $48.00–$131.00 | 56% above | 5% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Vaccine Measles-mumps-rubellaamb Measles-mumps-rubella Vaccine Charge | $158.00 | $166.00 | $60.00–$161.00 | 41% above | 5% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menactraamb Meningococcal Conjugate Charge | $238.00 | $250.00 | $90.00–$243.00 | 30% above | 5% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Vaccine Bexseroamb Meningococcal Group B Charge | $321.00 | $338.00 | $121.00–$328.00 | 16% above | 5% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Vaccine Pneumococcal 20-valent Conjugateamb Pneumococcal 20-valent Vaccine Charge | $460.00 | $484.00 | $174.00–$469.00 | 6% above | 5% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 90678 Abrysvo (Rsv Vac) Charge | $488.00 | $514.00 | $185.00–$499.00 | 29% above | 5% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Vaccine Zosteramb Zoster Vaccine Charge | $337.00 | $355.00 | $127.00–$344.00 | 18% above | 5% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus Diptheria Toxoids Vaccine (Tenivac)amb Tetanus Diptheria Toxoids Charge | $35.00 | $37.00 | $13.00–$36.00 | 33% below | 5% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Vfc Boostrix Tdap For Ages7+ | $19.00 | $20.00 | $7.00–$19.00 | 73% below | 5% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap 90715 Age Over 7amb Tdap Charge | $128.00 | $135.00 | $48.00–$131.00 | 82% above | 5% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Immunization Administration < 19 Yrsamb Immun Admin Charge | $57.00 | $60.00 | $22.00–$65.00 | 61% above | 5% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471-adult Vaccine Administration | $65.00 | $68.00 | $22.00–$66.00 | 84% above | 4% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Adult Each Additional 90472admin Immunization Charge | $33.00 | $35.00 | $13.00–$48.00 | 1% below | 6% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Adult Immunization Admin, Ea Add Vaccine Charge | $48.00 | $50.00 | $18.00–$49.00 | 43% above | 4% |