SelfPayRates
Hospital

Sedgwick County Health Center

Sedgwick County Health Center publishes cash prices for 377 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Click a procedure to compare it with other hospitals nearby.

Collected Sep 27, 2026 Source price file

The price file shows no self-pay discount

For 605 of the 605 prices listed here, the cash price in Sedgwick County Health Center's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

Scans and imaging

ProcedureCash price List priceInsurers payOff list
Abdominal CT scan without and with contrast CPT 74170 Ct Abdomen W/ + W/o Contrast $3,811.00 $3,811.00 $1,143.00–$4,954.00 —
Abdominal X-ray, 2 views CPT 74019 Xr Abdomen 2 Views $393.00 $393.00 $118.00–$511.00 —
Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete 3+ Views Left $263.00 $263.00 $79.00–$342.00 —
Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete 3+ Views Right $263.00 $263.00 $79.00–$342.00 —
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Us Abi Limited Bilateral $260.00 $260.00 $78.00–$338.00 —
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Upper Extremity W/o Contrast Right $2,304.00 $2,304.00 $691.00–$2,995.00 —
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Upper Extremity W/o Contrast Left $2,304.00 $2,304.00 $691.00–$2,995.00 —
Bone scan, whole body (nuclear medicine) CPT 78306 Nm Bone Imaging Whole Body $1,838.00 $1,838.00 $551.00–$2,389.00 —
Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Complete Right $732.00 $732.00 $220.00–$952.00 —
Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Complete Left $732.00 $732.00 $220.00–$952.00 —
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Limited Right $732.00 $732.00 $220.00–$952.00 —
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Limited Left $732.00 $732.00 $220.00–$952.00 —
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Ct Angio Abdomen And Pelvis $8,469.00 $8,469.00 $2,541.00–$11,010.00 —
CT angiography (CTA) of the head CPT 70496 Ct Angio Brain/head $7,049.00 $7,049.00 $2,115.00–$9,164.00 —
CT angiography (CTA) of the neck CPT 70498 70498 Ct Angio Neck $7,049.00 $7,049.00 $2,115.00–$9,164.00 —
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Ct Angio Chest $7,049.00 $7,049.00 $2,115.00–$9,164.00 —
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Ct Heart Calcium Scoring $174.00 $174.00 $52.00–$226.00 —
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Abdomen And Pelvis W/o Contrast $4,604.00 $4,604.00 $1,381.00–$5,985.00 —
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast $5,419.00 $5,419.00 $1,626.00–$7,045.00 —
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abdomen And Pelvis W/ + W/o Contrast $7,151.00 $7,151.00 $2,145.00–$9,296.00 —
CT scan of the abdomen with contrast CPT 74160 Ct Abdomen W/ Contrast $2,994.00 $2,994.00 $898.00–$3,892.00 —
CT scan of the abdomen without contrast CPT 74150 Ct Abdomen W/o Contrast $2,304.00 $2,304.00 $691.00–$2,995.00 —
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Sinus W/o Contrast $2,304.00 $2,304.00 $691.00–$2,995.00 —
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Maxillofacial W/o Contrast $2,304.00 $2,304.00 $691.00–$2,995.00 —
CT scan of the head or brain, no contrast dye CPT 70450 CT scan $2,304.00 $2,304.00 $691.00–$2,995.00 —
CT scan of the head with contrast CPT 70460 Ct Brain/head W/ Contrast $5,419.00 $5,419.00 $1,626.00–$7,045.00 —
CT scan of the head without and with contrast CPT 70470 Ct Brain/head W/ + W/o Contrast $7,366.00 $7,366.00 $2,210.00–$9,576.00 —
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct Spine Lumbar W/o Contrast $2,304.00 $2,304.00 $691.00–$2,995.00 —
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct Spine Cervical W/o Contrast $2,304.00 $2,304.00 $691.00–$2,995.00 —
CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast $2,994.00 $2,994.00 $898.00–$3,892.00 —
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Us Carotid Duplex Bilateral $921.00 $921.00 $276.00–$1,197.00 —
Chest CT scan without and with contrast CPT 71270 Ct Chest W/ + W/o Contrast $4,235.00 $4,235.00 $1,271.00–$5,506.00 —
Chest X-ray, 2 views CPT 71046 Xr Chest 2 Views $293.00 $293.00 $88.00–$381.00 —
Chest X-ray, single view CPT 71045 Xr Chest 1 View Portable $235.00 $235.00 $71.00–$306.00 —
Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle Right $263.00 $263.00 $79.00–$342.00 —
Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle Left $263.00 $263.00 $79.00–$342.00 —
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Retroperitoneal Complete $732.00 $732.00 $220.00–$952.00 —
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Aorta $732.00 $732.00 $220.00–$952.00 —
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Us Ob Greater Than 14 Weeks $732.00 $732.00 $220.00–$952.00 —
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Low Dose Lung Scan $2,092.00 $2,092.00 $628.00–$2,720.00 —
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest High Resolution $2,304.00 $2,304.00 $691.00–$2,995.00 —
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest W/o Contrast $2,304.00 $2,304.00 $691.00–$2,995.00 —
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Chest W/ Contrast $2,994.00 $2,994.00 $898.00–$3,892.00 —
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Us Lower Ext Arterial Duplex Bilateral $921.00 $921.00 $276.00–$1,197.00 —
Duplex ultrasound of the leg arteries, both legs CPT 93925 Us Vascular Screening Special $206.00 $206.00 $62.00–$268.00 —
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Upper Ext Venous Duplex Bilateral $921.00 $921.00 $276.00–$1,197.00 —
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Lower Ext Venous Duplex Bilateral $921.00 $921.00 $276.00–$1,197.00 —
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Venous Insufficiency Bilateral $1,014.00 $1,014.00 $304.00–$1,318.00 —
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Us Echocardiogram Complete Eo $1,486.00 $1,486.00 $446.00–$1,932.00 —
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Us Echo Bubble Study Eo $1,939.00 $1,939.00 $582.00–$2,521.00 —
Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 2 Views Right $235.00 $235.00 $71.00–$306.00 —
Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 2 Views Left $235.00 $235.00 $71.00–$306.00 —
Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow Complete 3+ Views Left $293.00 $293.00 $88.00–$381.00 —
Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow Complete 3+ Views Right $293.00 $293.00 $88.00–$381.00 —
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Orbits Sella W/o Contrast $2,304.00 $2,304.00 $691.00–$2,995.00 —
Facial bones X-ray, complete, 3 or more views CPT 70150 Xr Facial Bones 3+ Views $437.00 $437.00 $131.00–$568.00 —
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm 2 Views Right $235.00 $235.00 $71.00–$306.00 —
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm 2 Views Left $235.00 $235.00 $71.00–$306.00 —
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Nm Hepatobiliary Imaging $2,532.00 $2,532.00 $760.00–$3,292.00 —
Hand X-ray, 2 views one side CPT 73120 Xr Hand 2 Views Left $205.00 $205.00 $62.00–$267.00 —
Hand X-ray, 2 views one side CPT 73120 Xr Hand 2 Views Right $205.00 $205.00 $62.00–$267.00 —
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Calcaneus Right $263.00 $263.00 $79.00–$342.00 —
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Calcaneus Left $263.00 $263.00 $79.00–$342.00 —
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep Study With Therapycpap $3,747.00 $3,747.00 $1,124.00–$4,871.00 —
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Diagnostic Split Sleep Study $3,747.00 $3,747.00 $1,124.00–$4,871.00 —
Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 Views Left $321.00 $321.00 $96.00–$417.00 —
Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 Views Right $321.00 $321.00 $96.00–$417.00 —
Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee Complete 4+ Views Left $366.00 $366.00 $110.00–$476.00 —
Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee Complete 4+ Views Right $366.00 $366.00 $110.00–$476.00 —
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Lower Extremity W/o Contrast Left $2,304.00 $2,304.00 $691.00–$2,995.00 —
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Lower Extremity W/o Contrast Right $2,304.00 $2,304.00 $691.00–$2,995.00 —
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us F.a.s.t Abdominal $216.00 $216.00 $65.00–$281.00 —
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdomen Limited 76705 $732.00 $732.00 $220.00–$952.00 —
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Us Extremity Nonvascular Limited Right $732.00 $732.00 $220.00–$952.00 —
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Us Extremity Nonvascular Limited Left $732.00 $732.00 $220.00–$952.00 —
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Low Dose Lung Screening $2,092.00 $2,092.00 $628.00–$2,720.00 —
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia/fibula Right $293.00 $293.00 $88.00–$381.00 —
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia/fibula Left $293.00 $293.00 $88.00–$381.00 —
MR angiography (MRA) of the head without contrast CPT 70544 Mra Brain/head W/o Contrast $3,428.00 $3,428.00 $1,028.00–$4,456.00 —
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint $3,328.00 $3,328.00 $998.00–$4,326.00 —
MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 Mri Hip W/ + W/o Contrast Bilat $5,400.00 $5,400.00 $1,620.00–$7,020.00 —
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 $5,400.00 $5,400.00 $1,620.00–$7,020.00 —
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Knee W/ + W/o Contrast Left $5,400.00 $5,400.00 $1,620.00–$7,020.00 —
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Knee W/ + W/o Contrast Right $5,400.00 $5,400.00 $1,620.00–$7,020.00 —
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 $5,400.00 $5,400.00 $1,620.00–$7,020.00 —
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Hip W/ + W/o Contrast Left $5,400.00 $5,400.00 $1,620.00–$7,020.00 —
MRI of the abdomen without contrast CPT 74181 Mri Abdomen W/o Contrast $3,328.00 $3,328.00 $998.00–$4,326.00 —
MRI of the abdomen, without and then with contrast dye CPT 74183 Mri Abdomen W/ + W/o Contrast $5,400.00 $5,400.00 $1,620.00–$7,020.00 —
MRI of the brain, no contrast dye CPT 70551 Mri Brain W/o Contrast $3,328.00 $3,328.00 $998.00–$4,326.00 —
MRI of the brain, with and without contrast dye CPT 70553 MRI Scan $5,400.00 $5,400.00 $1,620.00–$7,020.00 —
MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal $3,328.00 $3,328.00 $998.00–$4,326.00 —
MRI of the lower back, without and then with contrast dye CPT 72158 Mri Spine Lumbar W/ + W/o Contrast $5,400.00 $5,400.00 $1,620.00–$7,020.00 —
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mri Spine Thoracic W/o Contrast $3,328.00 $3,328.00 $998.00–$4,326.00 —
MRI of the neck (cervical spine) without and with contrast CPT 72156 Mri Spine Cervical W/ + W/o Contrast $5,400.00 $5,400.00 $1,620.00–$7,020.00 —
MRI of the neck (cervical spine), no contrast dye CPT 72141 Mri Spine Cervical W/o Contrast $3,328.00 $3,328.00 $998.00–$4,326.00 —
MRI of the pelvis without and with contrast CPT 72197 Mri Pelvis W/ + W/o Contrast $5,400.00 $5,400.00 $1,620.00–$7,020.00 —
MRI of the pelvis, no contrast dye CPT 72195 Mri Pelvis W/o Contrast $3,328.00 $3,328.00 $998.00–$4,326.00 —
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Shoulder W/o Contrast Right $3,328.00 $3,328.00 $998.00–$4,326.00 —
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Wrist W/o Contrast Right $3,328.00 $3,328.00 $998.00–$4,326.00 —
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Elbow W/o Contrast Left $3,328.00 $3,328.00 $998.00–$4,326.00 —
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Elbow W/o Contrast Right $3,328.00 $3,328.00 $998.00–$4,326.00 —
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Scapula W/o Contrast Left $3,328.00 $3,328.00 $998.00–$4,326.00 —
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Shoulder W/o Contrast Left $3,328.00 $3,328.00 $998.00–$4,326.00 —
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Wrist W/o Contrast Left $3,328.00 $3,328.00 $998.00–$4,326.00 —
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Xr Spine Cervical 4 Or 5 Views $509.00 $509.00 $153.00–$662.00 —
Neck soft tissue CT scan with contrast CPT 70491 Ct Neck Soft Tissue W/ Contrast $2,994.00 $2,994.00 $898.00–$3,892.00 —
Neck soft tissue CT scan without contrast CPT 70490 Ct Neck Soft Tissue W/o Contrast $2,304.00 $2,304.00 $691.00–$2,995.00 —
Neck soft tissue X-ray CPT 70360 Xr Neck Soft Tissue $366.00 $366.00 $110.00–$476.00 —
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nm Myocardial Spect Multiple Studies $5,669.00 $5,669.00 $1,701.00–$7,370.00 —
Pelvic CT scan without contrast CPT 72192 Ct Pelvis W/o Contrast $2,304.00 $2,304.00 $691.00–$2,995.00 —
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us Pelvic Ltd $732.00 $732.00 $220.00–$952.00 —
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvic Complete $732.00 $732.00 $220.00–$952.00 —
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Us Ob < 14 Weeks $732.00 $732.00 $220.00–$952.00 —
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Us Ob Limited $732.00 $732.00 $220.00–$952.00 —
Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs 2 Views Right $366.00 $366.00 $110.00–$476.00 —
Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs 2 Views Left $366.00 $366.00 $110.00–$476.00 —
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Xr Ribs W/ Pa Chest Left $494.00 $494.00 $148.00–$642.00 —
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Xr Ribs W/ Pa Chest Right $494.00 $494.00 $148.00–$642.00 —
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete 2+ Views Right $235.00 $235.00 $71.00–$306.00 —
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete 2+ Views Left $235.00 $235.00 $71.00–$306.00 —
Sinus X-ray, complete, 3 or more views CPT 70220 Xr Sinuses Paranasal Complete $437.00 $437.00 $131.00–$568.00 —
Skull X-ray, fewer than 4 views CPT 70250 Xr Skull < 4 Views $366.00 $366.00 $110.00–$476.00 —
Sleep study in a lab (polysomnography) CPT 95810 Sleep study $3,747.00 $3,747.00 $1,124.00–$4,871.00 —
Swallow study (modified barium swallow, video X-ray) CPT 74230 Xr Modified Barium Swallow $361.00 $361.00 $108.00–$469.00 —
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Xr Femur 2 Views Right $293.00 $293.00 $88.00–$381.00 —
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Xr Femur 2 Views Left $293.00 $293.00 $88.00–$381.00 —
Thoracic spine (mid back) CT scan without contrast CPT 72128 Ct Spine Thoracic W/o Contrast $2,304.00 $2,304.00 $691.00–$2,995.00 —
Toe X-ray, 2 or more views one side CPT 73660 Xr Toe(2nd Digit) 2+ Views Right $205.00 $205.00 $62.00–$267.00 —
Toe X-ray, 2 or more views one side CPT 73660 Xr Toe(1st Digit) 2+ Views Left $205.00 $205.00 $62.00–$267.00 —
Toe X-ray, 2 or more views one side CPT 73660 Xr Toe(1st Digit) 2+ Views Right $205.00 $205.00 $62.00–$267.00 —
Toe X-ray, 2 or more views one side CPT 73660 Xr Toe(2nd Digit) 2+ Views Left $205.00 $205.00 $62.00–$267.00 —
Toe X-ray, 2 or more views one side CPT 73660 Xr Toe(3rd Digit) 2+ Views Left $205.00 $205.00 $62.00–$267.00 —
Toe X-ray, 2 or more views one side CPT 73660 Xr Toe(3rd Digit) 2+ Views Right $205.00 $205.00 $62.00–$267.00 —
Toe X-ray, 2 or more views one side CPT 73660 Xr Toe(4th Digit) 2+ Views Left $205.00 $205.00 $62.00–$267.00 —
Toe X-ray, 2 or more views one side CPT 73660 Xr Toe(4th Digit) 2+ Views Right $205.00 $205.00 $62.00–$267.00 —
Toe X-ray, 2 or more views one side CPT 73660 Xr Toe(5th Digit) 2+ Views Left $205.00 $205.00 $62.00–$267.00 —
Toe X-ray, 2 or more views one side CPT 73660 Xr Toe(5th Digit) 2+ Views Right $205.00 $205.00 $62.00–$267.00 —
Transvaginal pelvic ultrasound CPT 76830 Ultrasound pelvis through vagina $732.00 $732.00 $220.00–$952.00 —
Transvaginal ultrasound during pregnancy CPT 76817 Sdgw Us Ob Transvaginal $732.00 $732.00 $220.00–$952.00 —
Transvaginal ultrasound during pregnancy CPT 76817 Us Ob Transvaginal $732.00 $732.00 $220.00–$952.00 —
Transvaginal ultrasound during pregnancy CPT 76817 Ob Transvaginal Us $732.00 $732.00 $220.00–$952.00 —
Ultrasound of the abdomen, complete CPT 76700 Ultrasound of abdomen $732.00 $732.00 $220.00–$952.00 —
Ultrasound of the scrotum and testicles CPT 76870 Us Scrotum (Contents) $732.00 $732.00 $220.00–$952.00 —
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Head/neck Soft Tissue $732.00 $732.00 $220.00–$952.00 —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Xr Small Bowel Follow Through $362.00 $362.00 $109.00–$471.00 —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Xr Upper Gi W/ Small Bowel $747.00 $747.00 $224.00–$971.00 —
Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus Left $293.00 $293.00 $88.00–$381.00 —
Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus Right $293.00 $293.00 $88.00–$381.00 —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Upper Ext Venous Duplex Right $813.00 $813.00 $244.00–$1,057.00 —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Lower Ext Venous Duplex Right $813.00 $813.00 $244.00–$1,057.00 —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Lower Ext Venous Duplex Left $813.00 $813.00 $244.00–$1,057.00 —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Upper Ext Venous Duplex Left $813.00 $813.00 $244.00–$1,057.00 —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Venous Insufficiancy Follow Up Right $813.00 $813.00 $244.00–$1,057.00 —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Venous Insufficiancy Follow Up Left $813.00 $813.00 $244.00–$1,057.00 —
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 2 Views Right $205.00 $205.00 $62.00–$267.00 —
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 2 Views Left $205.00 $205.00 $62.00–$267.00 —
Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete 3+ Views Right $263.00 $263.00 $79.00–$342.00 —
Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete 3+ Views Left $263.00 $263.00 $79.00–$342.00 —
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip 2-3 Views W/ap Pelvis Left $410.00 $410.00 $123.00–$533.00 —
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip 2-3 Views W/ap Pelvis Right $410.00 $410.00 $123.00–$533.00 —
X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen 1 View $235.00 $235.00 $71.00–$306.00 —
X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen Kub 1 View $235.00 $235.00 $71.00–$306.00 —
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Right $205.00 $205.00 $62.00–$267.00 —
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Left $205.00 $205.00 $62.00–$267.00 —
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(3rd Digit) 2+ Views Left $205.00 $205.00 $62.00–$267.00 —
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(5th Digit) 2+ Views Right $205.00 $205.00 $62.00–$267.00 —
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(5th Digit) 2+ Views Left $205.00 $205.00 $62.00–$267.00 —
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(4th Digit) 2+ Views Right $205.00 $205.00 $62.00–$267.00 —
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(4th Digit) 2+ Views Left $205.00 $205.00 $62.00–$267.00 —
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(3rd Digit) 2+ Views Right $205.00 $205.00 $62.00–$267.00 —
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(2nd Digit) 2+ Views Left $205.00 $205.00 $62.00–$267.00 —
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(1st Digit) 2+ Views Right $205.00 $205.00 $62.00–$267.00 —
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(2nd Digit) 2+ Views Right $205.00 $205.00 $62.00–$267.00 —
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(1st Digit) 2+ Views Left $205.00 $205.00 $62.00–$267.00 —
X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Left $205.00 $205.00 $62.00–$267.00 —
X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Right $205.00 $205.00 $62.00–$267.00 —
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete 3+ Views Right $263.00 $263.00 $79.00–$342.00 —
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete 3+ Views Left $263.00 $263.00 $79.00–$342.00 —
X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete 3+ Views Right $263.00 $263.00 $79.00–$342.00 —
X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete 3+ Views Left $263.00 $263.00 $79.00–$342.00 —
X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 1 Or 2 Views Left $263.00 $263.00 $79.00–$342.00 —
X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 1 Or 2 Views Right $263.00 $263.00 $79.00–$342.00 —
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr Spine Lumbosacral 2 Or 3 Views $410.00 $410.00 $123.00–$533.00 —
X-ray of the lower back, 4 or more views CPT 72110 X-Ray of lower back $524.00 $524.00 $157.00–$681.00 —
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xr Spine Thoracic 2 Views $410.00 $410.00 $123.00–$533.00 —
X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones 3+ Views $293.00 $293.00 $88.00–$381.00 —
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr Spine Cervical 2 Or 3 Views $366.00 $366.00 $110.00–$476.00 —
X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis 1 Or 2 Views $263.00 $263.00 $79.00–$342.00 —
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Sacrum/coccyx 2+ Views $366.00 $366.00 $110.00–$476.00 —

Lab tests

ProcedureCash price List priceInsurers payOff list
ACTH blood test CPT 82024 Acth (Adrenocorticotropic) Hormone Level Pspc $245.00 $245.00 $74.00–$319.00 —
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase $105.00 $105.00 $32.00–$137.00 —
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase $105.00 $105.00 $32.00–$137.00 —
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel, Acute Pspc $229.00 $229.00 $69.00–$298.00 —
Albumin blood test CPT 82040 Albumin Level $105.00 $105.00 $32.00–$137.00 —
Aldosterone blood test CPT 82088 Aldosterone, Serum Pspc $245.00 $245.00 $74.00–$319.00 —
Alkaline phosphatase (ALP) blood test CPT 84075 Alk Phos Iso Total Pspc $167.00 $167.00 $50.00–$217.00 —
Allergy blood test, specific IgE, per allergen CPT 86003 Alternaria Alternaria Ige Pspc $64.00 $64.00 $19.00–$83.00 —
Allergy blood test, specific IgE, per allergen CPT 86003 Mold Mix 1 (Altern, Asper, Clad, Penic) Ige Pspc $125.00 $125.00 $38.00–$163.00 —
Allergy blood test, specific IgE, per allergen CPT 86003 Food Allergy Profile Pspc $306.00 $306.00 $92.00–$398.00 —
Allergy blood test, specific IgE, per allergen CPT 86003 Food Allergy Panel Inc $412.00 $412.00 $124.00–$536.00 —
Allergy blood test, specific IgE, per allergen CPT 86003 Food Allergy Prof Iii (Ibt 401481p) Pspc $665.00 $665.00 $200.00–$865.00 —
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein, Tumor Marker Pspc $73.00 $73.00 $22.00–$95.00 —
Ammonia blood test CPT 82140 Ammonia (Nh3) Pspc $152.00 $152.00 $46.00–$198.00 —
Amylase blood test CPT 82150 Amylase Level $105.00 $105.00 $32.00–$137.00 —
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Antibody, Igg Pspc $123.00 $123.00 $37.00–$160.00 —
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen With Reflex Pspc $126.00 $126.00 $38.00–$164.00 —
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 N-terminal Pro B-type Natriuretic Peptide $200.00 $200.00 $60.00–$260.00 —
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Nt Probnp Pspc $200.00 $200.00 $60.00–$260.00 —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerob/anaerob Cult Final Pspc $66.00 $66.00 $20.00–$86.00 —
Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel $177.00 $177.00 $53.00–$230.00 —
Bilirubin blood test, total CPT 82247 Bilirubin Total $105.00 $105.00 $32.00–$137.00 —
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Tissue Pathology Pspc $279.00 $279.00 $84.00–$363.00 —
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Tissue Source 4 Pspc $359.00 $359.00 $108.00–$467.00 —
Blood culture for bacteria both sides CPT 87040 Blood Culture, Bi Pspc $148.00 $148.00 $44.00–$192.00 —
Blood culture for bacteria CPT 87040 Blood Culture Pspc $148.00 $148.00 $44.00–$192.00 —
Blood culture for bacteria CPT 87040 Blood Culture 1 Gl $148.00 $148.00 $44.00–$192.00 —
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture $25.00 $25.00 $8.00–$33.00 —
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection: Venous Draw $25.00 $25.00 $8.00–$33.00 —
Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415drawing Fee-venous $107.00 $107.00 $32.00–$139.00 —
Blood glucose (sugar) test CPT 82947 Glucose Poct $105.00 $105.00 $32.00–$137.00 —
Blood glucose (sugar) test CPT 82947 Glucose Level $105.00 $105.00 $32.00–$137.00 —
Blood glucose (sugar) test CPT 82947 Glucose Fasting $105.00 $105.00 $32.00–$137.00 —
Blood lead test CPT 83655 Lead, Capillary (Rps) Pspc $161.00 $161.00 $48.00–$209.00 —
Blood lead test CPT 83655 Heavy Metal Lead Pspc $161.00 $161.00 $48.00–$209.00 —
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Urine Pregnancy Test Clinic Poc (Re) $87.00 $87.00 $26.00–$113.00 —
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta Hcg Qualitative $97.00 $97.00 $29.00–$126.00 —
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Serum Creatinine (Provided Value) Pspc $97.00 $97.00 $29.00–$126.00 —
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo/rh $143.00 $143.00 $43.00–$186.00 —
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen $102.00 $102.00 $31.00–$133.00 —
Blood urea nitrogen (BUN) test CPT 84520 Bun Lc $105.00 $105.00 $32.00–$137.00 —
C-peptide blood test CPT 84681 C Peptide Pspc $166.00 $166.00 $50.00–$216.00 —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Crp, Cardiac Pspc $129.00 $129.00 $39.00–$168.00 —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive Protein $129.00 $129.00 $39.00–$168.00 —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Crp Reactive Protein Pspc $129.00 $129.00 $39.00–$168.00 —
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium Difficile Toxin $160.00 $160.00 $48.00–$208.00 —
C. difficile toxin gene test (stool PCR) CPT 87493 C Diff Toxin, Dna Detection, Confirmatory Testing Pspc $160.00 $160.00 $48.00–$208.00 —
CA 19-9 blood test (tumor marker) CPT 86301 Ca 19-9, Cancer Antigengi Pspc $200.00 $200.00 $60.00–$260.00 —
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 Pspc $169.00 $169.00 $51.00–$220.00 —
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Coronavirus Pcr Pspc $128.00 $128.00 $38.00–$166.00 —
Calcium blood test, total CPT 82310 Calcium Level Total $105.00 $105.00 $32.00–$137.00 —
Carcinoembryonic antigen (CEA) test CPT 82378 Ceas Carcinoembryonic Ag Pspc $175.00 $175.00 $53.00–$228.00 —
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-zoster Virus Antibody, Igm Pspc $148.00 $148.00 $44.00–$192.00 —
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Ab Screen Pspc $148.00 $148.00 $44.00–$192.00 —
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-zoster Virus Antibody, Igg Pspc $148.00 $148.00 $44.00–$192.00 —
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Dna Assay Pspc $59.00 $59.00 $18.00–$77.00 —
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Amp Probe Pspc $60.00 $60.00 $18.00–$78.00 —
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia/gonorrhea (Binx Io) $60.00 $60.00 $18.00–$78.00 —
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia & Gonorrhea Amplified Probe Trin $97.00 $97.00 $29.00–$126.00 —
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Reference Lab Pspc $106.00 $106.00 $32.00–$138.00 —
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids $227.00 $227.00 $68.00–$295.00 —
Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (CBC), with differential white blood cells, automated $87.00 $87.00 $26.00–$113.00 —
Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (CBC), automated $108.00 $108.00 $32.00–$140.00 —
Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals $228.00 $228.00 $68.00–$296.00 —
Cortisol blood test, total CPT 82533 Cortisol, Pm Pspc $103.00 $103.00 $31.00–$134.00 —
Cortisol blood test, total CPT 82533 Cortisol Pspc $103.00 $103.00 $31.00–$134.00 —
Cortisol blood test, total CPT 82533 Cortisol, Am Pspc $103.00 $103.00 $31.00–$134.00 —
Cortisol blood test, total CPT 82533 Cortisol, Saliva Pspc $103.00 $103.00 $31.00–$134.00 —
Creatinine blood test CPT 82565 Creatinine $102.00 $102.00 $31.00–$133.00 —
Creatinine blood test CPT 82565 Creat Lc $105.00 $105.00 $32.00–$137.00 —
D-dimer blood test (blood clot marker) CPT 85379 D-dimer $216.00 $216.00 $65.00–$281.00 —
D-dimer blood test (blood clot marker) CPT 85379 Ddimer Pspc $216.00 $216.00 $65.00–$281.00 —
DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea Sulfate Pspc $132.00 $132.00 $40.00–$172.00 —
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs Of Abuse 9 Panel, Serum Or Plasma Pspc $267.00 $267.00 $80.00–$347.00 —
Drug screen by lab instrument (any number of drug classes) CPT 80307 .Benzodiazepines Conf Lc $404.00 $404.00 $121.00–$525.00 —
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel $127.00 $127.00 $38.00–$165.00 —
Epstein-Barr virus (EBV) antibody test CPT 86665 Ebv Vca Igg Pspc $148.00 $148.00 $44.00–$192.00 —
Epstein-Barr virus (EBV) antibody test CPT 86665 Ebv Vca Igm Pspc $148.00 $148.00 $44.00–$192.00 —
Estradiol blood test CPT 82670 Free Estradiol By Ed/lc-ms/ms Pspc $157.00 $157.00 $47.00–$204.00 —
Estradiol blood test CPT 82670 Estradiol Pspc $157.00 $157.00 $47.00–$204.00 —
FSH (follicle-stimulating hormone) test CPT 83001 Fsh Pspc $135.00 $135.00 $41.00–$176.00 —
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Stool Pspc $576.00 $576.00 $173.00–$749.00 —
Ferritin blood test (iron stores) CPT 82728 Ferritin Pspc $149.00 $149.00 $45.00–$194.00 —
Ferritin blood test (iron stores) CPT 82728 Ferritin $149.00 $149.00 $45.00–$194.00 —
Ferritin blood test (iron stores) CPT 82728 Ferritin Level $149.00 $149.00 $45.00–$194.00 —
Fibrinogen blood test CPT 85384 Fibrinogen Pspc $132.00 $132.00 $40.00–$172.00 —
Folate (folic acid) blood test CPT 82746 Folate Level $109.00 $109.00 $33.00–$142.00 —
Folate (folic acid) blood test CPT 82746 Folate, Serum Pspc $109.00 $109.00 $33.00–$142.00 —
Free T3 thyroid hormone test CPT 84481 Free T3 $71.00 $71.00 $21.00–$92.00 —
Free T3 thyroid hormone test CPT 84481 Ft3 Free T3 Pspc $184.00 $184.00 $55.00–$239.00 —
Free T4 (free thyroxine) thyroid blood test CPT 84439 Ft4 Free Thyroxine Pspc $103.00 $103.00 $31.00–$134.00 —
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Level $103.00 $103.00 $31.00–$134.00 —
Free testosterone test CPT 84402 Testosterone, Free Pspc $156.00 $156.00 $47.00–$203.00 —
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase $102.00 $102.00 $31.00–$133.00 —
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Gt Pspc $102.00 $102.00 $31.00–$133.00 —
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1 Hour $133.00 $133.00 $40.00–$173.00 —
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Gtt 1 Hour Ob 50 Grams $133.00 $133.00 $40.00–$173.00 —
Glucose tolerance test, 3 samples CPT 82951 Glucose 3 Hour $340.00 $340.00 $102.00–$442.00 —
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 Chlamydia/gonorrhea (Binx Io) $60.00 $60.00 $18.00–$78.00 —
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N Gonorrhea Dna Pspc $60.00 $60.00 $18.00–$78.00 —
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gc Amplified Probe Pspc $60.00 $60.00 $18.00–$78.00 —
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Test Name Pspc $106.00 $106.00 $32.00–$138.00 —
H. pylori stool antigen test CPT 87338 Helicobacter Pylori Antigen, Stool Pspc $188.00 $188.00 $56.00–$244.00 —
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Poca1c $37.00 $37.00 $11.00–$48.00 —
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c Clinic Poc (Re) $37.00 $37.00 $11.00–$48.00 —
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 A1c Hemoglobin A1c Pspc $129.00 $129.00 $39.00–$168.00 —
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c $129.00 $129.00 $39.00–$168.00 —
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hgb A1c $129.00 $129.00 $39.00–$168.00 —
Hemoglobin blood test CPT 85018 Hemoglobin $38.00 $38.00 $11.00–$49.00 —
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Antibody, Total Pspc $98.00 $98.00 $29.00–$127.00 —
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody Pspc $109.00 $109.00 $33.00–$142.00 —
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen Pspc $198.00 $198.00 $59.00–$257.00 —
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody Pspc $228.00 $228.00 $68.00–$296.00 —
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus Rna Detection & Quantitation Pspc $558.00 $558.00 $167.00–$725.00 —
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis Panel, Acute With Reflex To Hepatitis C Rna Quantitation Pspc $558.00 $558.00 $167.00–$725.00 —
Herpes blood test, HSV-1 antibody CPT 86695 Hsv-1/hsv-2 Subtype Pcr Plab $76.00 $76.00 $23.00–$99.00 —
Herpes blood test, HSV-2 antibody CPT 86696 Hsv-2 Type Spec Ab, Igg W/rfx Lc $76.00 $76.00 $23.00–$99.00 —
Homocysteine blood test CPT 83090 Homocysteine, Blood Pspc $355.00 $355.00 $107.00–$462.00 —
Insulin blood test CPT 83525 Insulin Pspc $129.00 $129.00 $39.00–$168.00 —
Iron blood test (serum iron) CPT 83540 Iron Panel W/ Ferritin $135.00 $135.00 $41.00–$176.00 —
Iron blood test (serum iron) CPT 83540 Iron Pspc $135.00 $135.00 $41.00–$176.00 —
Iron blood test (serum iron) CPT 83540 Iron Level $135.00 $135.00 $41.00–$176.00 —
Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity $125.00 $125.00 $38.00–$163.00 —
Iron-binding capacity (TIBC) test CPT 83550 Iron Level And Tibc $125.00 $125.00 $38.00–$163.00 —
Kidney function blood test panel CPT 80069 Kidney function panel test $116.00 $116.00 $35.00–$151.00 —
LH (luteinizing hormone) test CPT 83002 Lhs Lutenizing Hormone Pspc $135.00 $135.00 $41.00–$176.00 —
Lactate (lactic acid) blood test CPT 83605 Lactic Acid Level $65.00 $65.00 $20.00–$85.00 —
Lactate dehydrogenase (LDH) blood test CPT 83615 Ld (Ldh), Serum Pspc $57.00 $57.00 $17.00–$74.00 —
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase $121.00 $121.00 $36.00–$157.00 —
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level $142.00 $142.00 $43.00–$185.00 —
Liver function blood test panel CPT 80076 Liver function blood test $171.00 $171.00 $51.00–$222.00 —
Lyme disease antibody test CPT 86618 Borrelia Burgdorferi Antibodies, Total Lyme Pspc $183.00 $183.00 $55.00–$238.00 —
Lyme disease antibody test CPT 86618 Lyme Dis Abs W/ref Western Blot Pspc $183.00 $183.00 $55.00–$238.00 —
Magnesium blood test CPT 83735 Magnesium Level $109.00 $109.00 $33.00–$142.00 —
Magnesium blood test CPT 83735 Magnesium, Urine, 24 Hour Pspc $149.00 $149.00 $45.00–$194.00 —
Magnesium blood test CPT 83735 Magnesium Pspc $149.00 $149.00 $45.00–$194.00 —
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Antibody, Igm (Arup Via Rps) $79.00 $79.00 $24.00–$103.00 —
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Antibody, Igg Quant (Rps) Pspc $79.00 $79.00 $24.00–$103.00 —
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Igg Pspc $83.00 $83.00 $25.00–$108.00 —
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen $101.00 $101.00 $30.00–$131.00 —
Mumps immunity blood test CPT 86735 Mumps Antibody Igg Pspc $98.00 $98.00 $29.00–$127.00 —
Mumps immunity blood test CPT 86735 Mumps Ab Igg Pspc $98.00 $98.00 $29.00–$127.00 —
PSA (prostate-specific antigen) blood test, free CPT 84154 Total prostate-specific antigen (PSA) test $297.00 $297.00 $89.00–$386.00 —
PSA (prostate-specific antigen) blood test, total CPT 84153 Total prostate-specific antigen (PSA) test $297.00 $297.00 $89.00–$386.00 —
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap Smear With Reflex To Hpv If Ascus [I] Pspc $157.00 $157.00 $47.00–$204.00 —
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap Liquid Based-surepath Pspc $157.00 $157.00 $47.00–$204.00 —
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 88142 Cytopath Pap Collect/screen $190.00 $190.00 $57.00–$247.00 —
Parathyroid hormone (PTH) blood test CPT 83970 Pth, Intact Pspc $248.00 $248.00 $74.00–$322.00 —
Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test $97.00 $97.00 $29.00–$126.00 —
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level $105.00 $105.00 $32.00–$137.00 —
Potassium blood test CPT 84132 Potassium Level $105.00 $105.00 $32.00–$137.00 —
Progesterone blood test CPT 84144 Progesterone Pspc $148.00 $148.00 $44.00–$192.00 —
Prolactin blood test CPT 84146 Prolactin Pspc $166.00 $166.00 $50.00–$216.00 —
Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time $104.00 $104.00 $31.00–$135.00 —
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Urine Drug Screen Clinic Poc (Re) $32.00 $32.00 $10.00–$42.00 —
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep Clinic Poc (Re) $50.00 $50.00 $15.00–$65.00 —
Renin blood test CPT 84244 Renin Activity Pspc $130.00 $130.00 $39.00–$169.00 —
Rh blood typing CPT 86901 Rh Typing Addon $141.00 $141.00 $42.00–$183.00 —
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Pspc $80.00 $80.00 $24.00–$104.00 —
Rubella antibody test (immunity check) CPT 86762 Rubella Igg Eia Pspc $93.00 $93.00 $28.00–$121.00 —
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody, Igg Pspc $197.00 $197.00 $59.00–$256.00 —
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody, Igm Pspc $197.00 $197.00 $59.00–$256.00 —
Sodium blood test CPT 84295 Sodium Level $105.00 $105.00 $32.00–$137.00 —
Stool ova and parasites exam CPT 87177 Ova And Parasitepspc[i] $127.00 $127.00 $38.00–$165.00 —
Stool ova and parasites exam CPT 87177 Ova & Parasites, Stool Complete Pspc (Foreign Travel Only) $127.00 $127.00 $38.00–$165.00 —
Stool test for hidden blood (guaiac FOBT) CPT 82270 Immunological Fecal Occult Blood $88.00 $88.00 $26.00–$114.00 —
Stool test for hidden blood (guaiac FOBT) CPT 82270 Stool For Occult Blood Clinic Poc (Re) $88.00 $88.00 $26.00–$114.00 —
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood, Fecal $47.00 $47.00 $14.00–$61.00 —
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum Fta Pspc $54.00 $54.00 $16.00–$70.00 —
Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Antibody Total Pspc $54.00 $54.00 $16.00–$70.00 —
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr Pspc $95.00 $95.00 $29.00–$124.00 —
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tb Interferon Antigen Response Pspc $311.00 $311.00 $93.00–$404.00 —
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Pspc $156.00 $156.00 $47.00–$203.00 —
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (Tpo) Ab Pspc $129.00 $129.00 $39.00–$168.00 —
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Ab Pspc $129.00 $129.00 $39.00–$168.00 —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) $211.00 $211.00 $63.00–$274.00 —
Total IgE blood test CPT 82785 Ige Total Tc $49.00 $49.00 $15.00–$64.00 —
Total cholesterol blood test CPT 82465 Lipoprotein $105.00 $105.00 $32.00–$137.00 —
Total thyroxine (T4) blood test CPT 84436 T4 Pspc $105.00 $105.00 $32.00–$137.00 —
Total triiodothyronine (T3) blood test CPT 84480 T3 Total T3 Pspc $156.00 $156.00 $47.00–$203.00 —
Transferrin blood test CPT 84466 Transferrin Pspc $111.00 $111.00 $33.00–$144.00 —
Transferrin blood test CPT 84466 Soluble Transferrin Receptor Pspc $111.00 $111.00 $33.00–$144.00 —
Trichomonas test (NAAT) CPT 87661 Test Result Pspc $106.00 $106.00 $32.00–$138.00 —
Triglycerides blood test CPT 84478 Triglycerides $105.00 $105.00 $32.00–$137.00 —
Troponin test, quantitative CPT 84484 Hs Troponin-i $215.00 $215.00 $65.00–$280.00 —
Uric acid blood test CPT 84550 Uric Acid $105.00 $105.00 $32.00–$137.00 —
Urinalysis without microscope exam, manual CPT 81002 Urinalysis test $59.00 $59.00 $18.00–$77.00 —
Urine culture for bacteria, with colony count CPT 87086 Urine Culture Pspc $121.00 $121.00 $36.00–$157.00 —
Urine microalbumin (albumin) test CPT 82043 Urine Microalbumin $201.00 $201.00 $60.00–$261.00 —
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test Poct $76.00 $76.00 $23.00–$99.00 —
Urine pregnancy test, read by color change CPT 81025 Beta Hcg Qualitative Urine $76.00 $76.00 $23.00–$99.00 —
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level $143.00 $143.00 $43.00–$186.00 —
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Pspc $143.00 $143.00 $43.00–$186.00 —
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25-hydroxy Pspc $96.00 $96.00 $29.00–$125.00 —
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level $273.00 $273.00 $82.00–$355.00 —
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D, 1, 25-dihydroxy (Calcitriol) Pspc $306.00 $306.00 $92.00–$398.00 —
Zinc blood test CPT 84630 Zinc, Serum (Rps) Pspc $129.00 $129.00 $39.00–$168.00 —
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg Quantitative $129.00 $129.00 $39.00–$168.00 —
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg, Tumor Marker (Pspc) $181.00 $181.00 $54.00–$235.00 —
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg, Quantitative Pspc $181.00 $181.00 $54.00–$235.00 —

Surgery and procedures

ProcedureCash price List priceInsurers payOff list
Botox injections for chronic migraine both sides CPT 64615 64615 Bilateral Chemodenervation Of Muscle Innervated By Trigeminal, Cervial Spinal $584.00 $584.00 $175.00–$759.00 —
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28470metatarsal W/o Manipulation $476.00 $476.00 $143.00–$619.00 —
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 External Electrical Cardioversion $1,282.00 $1,282.00 $385.00–$1,667.00 —
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 54161 Circumcision, Surgical Excision Other Than Clamp Or Device; Older Than 28 Days Of Age $276.00 $276.00 $83.00–$359.00 —
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 54150 Circumcision, Using Clamp Or Other Device With Regional Dorsal Penile Or Ring Block $193.00 $193.00 $58.00–$251.00 —
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600-distal Radial W/o Manipulation $791.00 $791.00 $237.00–$1,028.00 —
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600 Closed Treatment Of Distal Radial Fracture; Without Manipulation $1,012.00 $1,012.00 $304.00–$1,316.00 —
Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope $3,800.00 $3,800.00 $1,140.00–$4,940.00 —
Colonoscopy with tissue sample CPT 45380 Biopsy exam of large bowel using an endoscope $3,800.00 $3,800.00 $1,140.00–$4,940.00 —
Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using an endoscope $3,800.00 $3,800.00 $1,140.00–$4,940.00 —
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000 Destruction Premalignant Lesion; 1st Lesion $221.00 $221.00 $66.00–$287.00 —
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000 Destruction Premalignant Lesions; First Lesion $221.00 $221.00 $66.00–$287.00 —
Earwax removal with instruments, one ear CPT 69210 Ear Irrigation Poc $243.00 $243.00 $73.00–$316.00 —
Earwax removal with instruments, one ear one side CPT 69210 69210 Removal Impacted Cerumen Requiring Instrumentation, Unilateral $243.00 $243.00 $73.00–$316.00 —
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 58100 Endometrial Biopsy $384.00 $384.00 $115.00–$499.00 —
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 62321 Interlaminarcervical Or Thoracic $1,323.00 $1,323.00 $397.00–$1,720.00 —
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 62321 Esi Cervical Or Thoracic With Fluoroscopy $1,363.00 $1,363.00 $409.00–$1,772.00 —
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 64493 Bilateral Injection(s), Diagnostic Or Therapeutic Agent, Paravertebral Facet (Zygapophyseal) $1,796.00 $1,796.00 $539.00–$2,335.00 —
Gallbladder removal, laparoscopic CPT 47562 Removal of gallbladder using an endoscope $1,508.00 $1,508.00 $452.00–$1,960.00 —
IUD insertion (the device itself billed separately) CPT 58300 58300 Insertion Of Intrauterine Device (Iud) $339.00 $339.00 $102.00–$441.00 —
Incision and drainage of a simple or single skin abscess CPT 10060 10060-i&d Abscess/cyst/hematoma Simple $194.00 $194.00 $58.00–$252.00 —
Incision and drainage of a simple or single skin abscess CPT 10060 10060 Incision And Drainage Of Abscess; Simple Or Single $327.00 $327.00 $98.00–$425.00 —
Incision and drainage of a simple or single skin abscess CPT 10060 10060 I&d Abscess Smpl Or Sngl $390.00 $390.00 $117.00–$507.00 —
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Repair of groin hernia patient age 5 years or older $861.00 $861.00 $258.00–$1,119.00 —
Injection into a tendon sheath or ligament (for example trigger finger) both sides CPT 20550 20550 Bilat Injection(s); Single Tendon Sheath, Or Ligament, Aponeurosis $437.00 $437.00 $131.00–$568.00 —
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 Injection(s); Single Tendon Sheath, Or Ligament, Aponeurosis (Eg, Plantar Fascia) $359.00 $359.00 $108.00–$467.00 —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-major Joint Aspirate/inject W/o Us $149.00 $149.00 $45.00–$194.00 —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610: Large Jointamb Inj Med Admin Charge $366.00 $366.00 $110.00–$476.00 —
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 $366.00 $366.00 $110.00–$476.00 —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-arthrocentesis, Aspiration And/or Injection, Major Joint/bursa; W/o Ultrasound Guidance $567.00 $567.00 $170.00–$737.00 —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis, Aspiration And/or Injection, Major Joint/bursa; W/o Ultrasound Guidance $567.00 $567.00 $170.00–$737.00 —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Joints Large Joint/bursa/shd/kn $584.00 $584.00 $175.00–$759.00 —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis Aspir&/inj Major Jt/bursa W/o Us Techfee $584.00 $584.00 $175.00–$759.00 —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthro Aspir Inj Major Joints W/o Guid Charge $584.00 $584.00 $175.00–$759.00 —
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 11981 Insertion, Non-biodegradable Drug Delivery Implant $198.00 $198.00 $59.00–$257.00 —
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605-intermediate Aspiration/inj W/o Us $116.00 $116.00 $35.00–$151.00 —
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Arthrocentesis, Aspiration And/or Injection, Intermediate Joint Or Bursa (Eg, Temporomandibula $308.00 $308.00 $92.00–$400.00 —
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605: Medium Jointamb Inj Med Admin Charge $308.00 $308.00 $92.00–$400.00 —
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Drain/inj. Joint/bursa W/o Us $584.00 $584.00 $175.00–$759.00 —
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600: Small Jointamb Inj Med Admin Charge $269.00 $269.00 $81.00–$350.00 —
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthrocentesis, Aspiration And/or Injection, Small Joint Or Bursa; Without Ultrasound Guidance $269.00 $269.00 $81.00–$350.00 —
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthrocentesis Aspiration / Injection Small Joint/bursa $1,363.00 $1,363.00 $409.00–$1,772.00 —
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031-scalp/trunk/extremity Less Than/equal To 2.5 Cm $271.00 $271.00 $81.00–$352.00 —
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 Repair Intermediate S/a/t/e 2.5 Cm/< $656.00 $656.00 $197.00–$853.00 —
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 Repair, Intermediate; Wounds Of Scalp, Axillae, Trunk, Extremities; <2.5cm $656.00 $656.00 $197.00–$853.00 —
Lower-back epidural injection, with imaging guidance CPT 62323 Injection(s) of therapeutic substance $1,363.00 $1,363.00 $409.00–$1,772.00 —
Lower-back epidural injection, without imaging guidance CPT 62322 Injection(s) of therapeutic substance $428.00 $428.00 $128.00–$556.00 —
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection(s) of anesthetic into lower spine using imaging guidance $3,488.00 $3,488.00 $1,046.00–$4,534.00 —
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400-excision Lesion Benign Trunk/extremity <= 0.5 Cm $176.00 $176.00 $53.00–$229.00 —
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 $423.00 $423.00 $127.00–$550.00 —
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440-excise Lesion Benign Face Less Than/equal To 0.5 Cm $244.00 $244.00 $73.00–$317.00 —
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440 Excision, Other Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere), Fa $486.00 $486.00 $146.00–$632.00 —
Nail removal (partial or complete), one nail CPT 11730 11730-avulsion Nail Plate Single $191.00 $191.00 $57.00–$248.00 —
Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion Of Nail Plate, Partial Or Complete, Simple; Single $274.00 $274.00 $82.00–$356.00 —
Occipital nerve block (injection for headaches) both sides CPT 64405 64405 Bilat Injection, Anesthetic Agent; Greater Occipital Nerve $584.00 $584.00 $175.00–$759.00 —
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750-excision Nail & Matrix $475.00 $475.00 $143.00–$618.00 —
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 (Removal Of Nail Bed) $541.00 $541.00 $162.00–$703.00 —
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 Excision Of Nail And Nail Matrix, Partial Or Complete (Eg, Ingrown Or Deformed Nail), For Perm $541.00 $541.00 $162.00–$703.00 —
Removal of a foreign object under the skin, simple CPT 10120 10120 Incision And Removal Of Foreign Body, Subcutaneous Tissues; Simple $400.00 $400.00 $120.00–$520.00 —
Removal of a foreign object under the skin, simple CPT 10120 10120-subcutaneous Tissue Simple $784.00 $784.00 $235.00–$1,019.00 —
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 G0121 Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For High Risk $520.00 $520.00 $156.00–$676.00 —
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 G0105 Colorectal Cancer Screening; Colonoscopy On Individual At High Risk $520.00 $520.00 $156.00–$676.00 —
Short arm cast (elbow to hand) CPT 29075 29075 Application Of Forearm Cast $534.00 $534.00 $160.00–$694.00 —
Short arm splint (forearm and hand) CPT 29125 29125 Application Of Short Arm Splint (Forearm To Hand); Static $232.00 $232.00 $70.00–$302.00 —
Short arm splint (forearm and hand) CPT 29125 29125 Application Short Arm Splint Forearm-hand Static $232.00 $232.00 $70.00–$302.00 —
Short arm splint (forearm and hand) CPT 29125 29125-splint Application Short Arm $317.00 $317.00 $95.00–$412.00 —
Short leg splint (calf to foot) CPT 29515 29515-short Leg $150.00 $150.00 $45.00–$195.00 —
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 $215.00 $215.00 $65.00–$280.00 —
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 Pf/tech Simple Repair Scalp/neck/ax/genit/trunk 2.5cm/< $540.00 $540.00 $162.00–$702.00 —
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 $540.00 $540.00 $162.00–$702.00 —
Skin biopsy, punch, one lesion CPT 11104 11104 Punch Biopsy Of Skin (Including Simple Closure, When Performed); Single Lesion $310.00 $310.00 $93.00–$403.00 —
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 11600excise Trunk/arms/legs; < 0.5 $314.00 $314.00 $94.00–$408.00 —
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 11600 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; < 0.5cm $541.00 $541.00 $162.00–$703.00 —
Skin tag removal, up to 15 tags CPT 11200 11200-removal Skin Tag Up To 15 $147.00 $147.00 $44.00–$191.00 —
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 $259.00 $259.00 $78.00–$337.00 —
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 Spinal Puncture, Lumbar, Diagnostic $1,238.00 $1,238.00 $371.00–$1,609.00 —
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270-lumbar Puncture Diagnostic $1,238.00 $1,238.00 $371.00–$1,609.00 —
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 $260.00 $260.00 $78.00–$338.00 —
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 Pf/tech Smpl Repair Scalp/neck/ax/genit/trunk 2.6-7.5cm $582.00 $582.00 $175.00–$757.00 —
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 $582.00 $582.00 $175.00–$757.00 —
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 $238.00 $238.00 $71.00–$309.00 —
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 Simple Repair F/e/e/n/l/m 2.5cm/< $561.00 $561.00 $168.00–$729.00 —
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 $561.00 $561.00 $168.00–$729.00 —
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Tangential Biopsy Of Skin (Shave,curette); Single Lesion $284.00 $284.00 $85.00–$369.00 —
Thoracentesis with imaging guidance CPT 32555 32555 Thoracentesis, Needle Or Catheter, Aspiration Of The Pleural Space W/ Imaging Guidance $400.00 $400.00 $120.00–$520.00 —
Thoracentesis with imaging guidance CPT 32555 32555-thoracentesis W/ Imaging Guidance $1,090.00 $1,090.00 $327.00–$1,417.00 —
Thoracentesis with imaging guidance CPT 32555 32555 Thoracentesis, Needle Or Catheter, Aspiration Of The Pleural Space; W/ Imaging Guidance $1,242.00 $1,242.00 $373.00–$1,615.00 —
Trigger point injections, 1 or 2 muscles CPT 20552 20552-inject Trigger Point 1-2 Muscles $324.00 $324.00 $97.00–$421.00 —
Trigger point injections, 1 or 2 muscles CPT 20552 20552 Injection(s); Single Or Multiple Trigger Point(s), 1 Or 2 Muscle(s) $359.00 $359.00 $108.00–$467.00 —
Trigger point injections, 1 or 2 muscles CPT 20552 20552 Joints Trp. Inj. One-two Muscles $584.00 $584.00 $175.00–$759.00 —
Trigger point injections, 1 or 2 muscles CPT 20552 20552 Trigger Point Injection; 1-2 Muscles Charge $584.00 $584.00 $175.00–$759.00 —
Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy exam of esophagus, stomach or small bowel using an endoscope $3,800.00 $3,800.00 $1,140.00–$4,940.00 —
Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach or small bowel using an endoscope $3,800.00 $3,800.00 $1,140.00–$4,940.00 —
Wart removal, up to 14 warts CPT 17110 17110 Destruction (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettemen $313.00 $313.00 $94.00–$407.00 —
Wart removal, up to 14 warts CPT 17110 17110destruction Benign; Up To 14 $314.00 $314.00 $94.00–$408.00 —
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042-sq Tissue Less Than/equal To 1st 20 Sq Cm $264.00 $264.00 $79.00–$343.00 —
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 Debridement, Subcutaneous Tissue; First 20 Sq Cm Or Less $456.00 $456.00 $137.00–$593.00 —
Wrist fracture surgery (plate and screws), distal radius CPT 25607 25607 Open Tx Distal Radial Extra-articular Fx Or Epiphyseal Separation, With Internal Fixation $1,032.00 $1,032.00 $310.00–$1,342.00 —

Doctor visits and therapy

ProcedureCash price List priceInsurers payOff list
Blood transfusion (giving blood or blood components) CPT 36430 36430 Blood Transfusion Admin Charge $176.00 $176.00 $53.00–$229.00 —
Blood transfusion (giving blood or blood components) CPT 36430 36430transfusion, Blood $176.00 $176.00 $53.00–$229.00 —
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 Pressurized Or Nonpressurized Inhalation Treatment For Acute Airway Obstruction For Therapeuti $92.00 $92.00 $28.00–$120.00 —
Critical care, first 30 to 74 minutes CPT 99291 99291 Critical Care, Evaluation And Management Of The Critically Ill Or Critically Injured Patient; $942.00 $942.00 $283.00–$1,225.00 —
Critical care, first 30 to 74 minutes CPT 99291 99291critical Care, 30-74 $3,717.00 $3,717.00 $1,115.00–$4,832.00 —
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Cv Ekg Eo $297.00 $297.00 $89.00–$386.00 —
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281level 1 $308.00 $308.00 $92.00–$400.00 —
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 Emergency Department Visit, Level 2 $161.00 $161.00 $48.00–$209.00 —
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282level 2 $461.00 $461.00 $138.00–$599.00 —
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 Emergency Department Visit, Level 3 $310.00 $310.00 $93.00–$403.00 —
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283level 3 $714.00 $714.00 $214.00–$928.00 —
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284level 4 $1,757.00 $1,757.00 $527.00–$2,284.00 —
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285level 5 $3,101.00 $3,101.00 $930.00–$4,031.00 —
Exercise stress test, tracing only, the hospital charge CPT 93017 93017 Cardiovascular Stress Test; Tracing Only, Without Interpretation And Report $79.00 $79.00 $24.00–$103.00 —
Exercise stress test, tracing only, the hospital charge CPT 93017 Cv Stress Test Eo $261.00 $261.00 $78.00–$339.00 —
Family therapy with the patient, 50 minutes CPT 90847 Family psychotherapy, including patient, 50 min $144.00 $144.00 $43.00–$187.00 —
Family therapy without the patient, 50 minutes CPT 90846 Family psychotherapy, not including patient, 50 min $140.00 $140.00 $42.00–$182.00 —
Group psychotherapy session CPT 90853 Group psychotherapy $38.00 $38.00 $11.00–$49.00 —
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf/h Iv Inf Initial 3160 Min $328.00 $328.00 $98.00–$426.00 —
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 Iv Inf Hydration 31 Min To 1hr Charge $328.00 $328.00 $98.00–$426.00 —
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 Hydration, First Hour $328.00 $328.00 $98.00–$426.00 —
IV infusion of a medicine, first hour CPT 96365 96365 Iv Infusion 1st Hour Charge $328.00 $328.00 $98.00–$426.00 —
IV infusion of a medicine, first hour CPT 96365 96365 Iv Tx, First Hour $328.00 $328.00 $98.00–$426.00 —
IV infusion of a medicine, first hour CPT 96365 Inf/nc Iv Infusion Ther Initial $328.00 $328.00 $98.00–$426.00 —
IV push of a medicine, first drug CPT 96374 96374 Initial Iv Push 15 Minutes Or Less $71.00 $71.00 $21.00–$92.00 —
IV push of a medicine, first drug CPT 96374 96374 Therapeutic, Prophylactic, Or Diagnostic Injection $71.00 $71.00 $21.00–$92.00 —
IV push of a medicine, first drug CPT 96374 96374 Iv Injection, Single/initial $71.00 $71.00 $21.00–$92.00 —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection-intramuscular/subqamb Inj Med Admin Charge $36.00 $36.00 $11.00–$47.00 —
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 $36.00 $36.00 $11.00–$47.00 —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Subq/im Injection $71.00 $71.00 $21.00–$92.00 —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Im Therapeutic $71.00 $71.00 $21.00–$92.00 —
Mental health diagnostic evaluation (intake), without medical services CPT 90791 90791 Psychiatric Diagnostic Evaluation $412.00 $412.00 $124.00–$536.00 —
Neuromuscular re-education, 15 minutes CPT 97112 97112 Neuromuscular Reeducation $122.00 $122.00 $37.00–$159.00 —
Neuromuscular re-education, 15 minutes CPT 97112 97112 Neuromuscular Reeducation Ot $158.00 $158.00 $47.00–$205.00 —
New patient office visit, about 30 minutes CPT 99203 New patient office or other outpatient visit, 30 min $391.00 $391.00 $117.00–$508.00 —
New patient office visit, about 45 minutes CPT 99204 New patient office or other outpatient visit, 45 min $558.00 $558.00 $167.00–$725.00 —
New patient office visit, about 60 minutes CPT 99205 New patient office or other outpatient visit, 60 min $706.00 $706.00 $212.00–$918.00 —
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Office/outpatient Visitnew Patient, Level 2 (20 Min) $249.00 $249.00 $75.00–$324.00 —
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Office Visit New Pt. Level 2 $266.00 $266.00 $80.00–$346.00 —
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 Dietary Consult Initial 15 Mins $69.00 $69.00 $21.00–$90.00 —
Occupational therapy evaluation, low complexity CPT 97165 97165 Ot Eval Low Complex $212.00 $212.00 $64.00–$276.00 —
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 97163 Pt Eval High Complex $399.00 $399.00 $120.00–$519.00 —
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 97161 Pt Eval Low Complexity $212.00 $212.00 $64.00–$276.00 —
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 97162 Pt Eval Moderate Complexi $306.00 $306.00 $92.00–$398.00 —
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 Manual Therapy Tech (15) $151.00 $151.00 $45.00–$196.00 —
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 Manual Therapy (15) $158.00 $158.00 $47.00–$205.00 —
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Physical therapy, therapeutic exercise $158.00 $158.00 $47.00–$205.00 —
Preventive checkup, new patient aged 18–39 CPT 99385 Initial new patient preventative medicine evaluation (18-39 years) $615.00 $615.00 $185.00–$800.00 —
Preventive checkup, new patient aged 40–64 CPT 99386 Initial new patient preventative medicine evaluation (40-64 years) $676.00 $676.00 $203.00–$879.00 —
Preventive checkup, new patient aged 65 or older CPT 99387 99387 Preventive Evaluation, New Pt; 65+ Yrs $726.00 $726.00 $218.00–$944.00 —
Preventive checkup, new patient aged 65 or older CPT 99387 99387 Preventive Eval Initial New Pt. > 65 Year Age $726.00 $726.00 $218.00–$944.00 —
Preventive checkup, returning patient aged 18–39 CPT 99395 99395 Preventive Evaluation, Established Pt; 18-39 Yrs $544.00 $544.00 $163.00–$707.00 —
Preventive checkup, returning patient aged 18–39 CPT 99395 99395 Preventive Eval Est Pt. 18-39 Year Age $544.00 $544.00 $163.00–$707.00 —
Preventive checkup, returning patient aged 40–64 CPT 99396 99396 Preventive Eval Est Pt. 40-64 Year Age $567.00 $567.00 $170.00–$737.00 —
Preventive checkup, returning patient aged 65 or older CPT 99397 99397 Preventive Eval Est Pt. >65 Year Age $605.00 $605.00 $182.00–$787.00 —
Preventive checkup, returning patient aged 65 or older CPT 99397 99397 Preventive Evaluation, Established Pt; 65+ Yrs $605.00 $605.00 $182.00–$787.00 —
Psychiatric evaluation with medical services CPT 90792 90792 Psychiatric Diagnostic Evaluation With Medical Services $202.00 $202.00 $61.00–$263.00 —
Psychotherapy for crisis, first 60 minutes CPT 90839 90839 Psychotherapy For Crisis; First 60 Minutes $180.00 $180.00 $54.00–$234.00 —
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 min $412.00 $412.00 $124.00–$536.00 —
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 min $424.00 $424.00 $127.00–$551.00 —
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 min $530.00 $530.00 $159.00–$689.00 —
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Office/outpatient Visitestablished Patient, Level 5 (40 Min) $462.00 $462.00 $139.00–$601.00 —
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Office Visit Established Pt. Level 5 $464.00 $464.00 $139.00–$603.00 —
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Outpatient Visit Level 5 $495.00 $495.00 $149.00–$644.00 —
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office/outpatient Visitestablished Patient, Level 3 (15 Min) $203.00 $203.00 $61.00–$264.00 —
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office Visit Established Pt. Level 3 $205.00 $205.00 $62.00–$267.00 —
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Outpatient Visit Level 3 $218.00 $218.00 $65.00–$283.00 —
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Office Visit Established Pt. Level 4 $321.00 $321.00 $96.00–$417.00 —
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Office/outpatient Visitestablished Patient, Level 4 (25 Min) $321.00 $321.00 $96.00–$417.00 —
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Outpatient Visit Level 4 $345.00 $345.00 $104.00–$449.00 —
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office/outpatient Visitestablished Patient, Level 2 (10 Min) $143.00 $143.00 $43.00–$186.00 —
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office Visit Established Pt. Level 2 $144.00 $144.00 $43.00–$187.00 —
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Outpatient Visit Level 2 $155.00 $155.00 $47.00–$202.00 —
Specialist consultation, low complexity or 30+ minutes CPT 99243 Patient office consultation, 40 min $502.00 $502.00 $151.00–$653.00 —
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Patient office consultation, 60 min $712.00 $712.00 $214.00–$926.00 —
Speech and language evaluation CPT 92523 92523 Speech Evalw/lang Comp Charge $331.00 $331.00 $99.00–$430.00 —
Speech therapy session, individual CPT 92507 92507 Speech Ther Ind Treatment $331.00 $331.00 $99.00–$430.00 —
Spirometry (breathing test) CPT 94010 94010 Spirometry Poc (Pre Only) $141.00 $141.00 $42.00–$183.00 —
Spirometry before and after a bronchodilator CPT 94060 94060 Spirometry (Pre & Post Bronchodilator) $250.00 $250.00 $75.00–$325.00 —
Therapeutic activities (functional training), 15 minutes CPT 97530 97530 Therapeutic Activities $158.00 $158.00 $47.00–$205.00 —
Therapeutic activities (functional training), 15 minutes CPT 97530 97530 Theraputic Activities(15) $165.00 $165.00 $50.00–$215.00 —
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 99195 Phlebotomy Only (Therapeutic) $161.00 $161.00 $48.00–$209.00 —
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomybedside Procedure Type $161.00 $161.00 $48.00–$209.00 —
Treadmill or drug stress test with ECG, supervision and report CPT 93015 93015 Cardiovascular Stress Test Using Maximal Or Submaximal Treadmill Or Bicycle Exercise $79.00 $79.00 $24.00–$103.00 —

Vaccines

ProcedureCash price List priceInsurers payOff list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 91322 Moderna (12y+)amb Sars-cov-2 (Covid-19) Mrna (Cvx 312) $221.00 $221.00 $66.00–$287.00 —
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 No Chargepfizer Vaccine Admin Charge $342.00 $342.00 $103.00–$445.00 —
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella Vaccineamb Varicella Charge $321.00 $321.00 $96.00–$417.00 —
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 0.5 Ml Diphtheria/pertussis/poliovirus/tetanus Vaccine (Kinramb Diphtheria/pertussis/polio/tetanus Charge $148.00 $148.00 $44.00–$192.00 —
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 90700 Infanrix-dtap, Under 7 Years, Im $170.00 $170.00 $51.00–$221.00 —
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Chdp Dtap Under 7amb Diphtheria/pertussis/tetanus Charge $175.00 $175.00 $53.00–$228.00 —
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 0.5 Ml Diphtheria/pertussis/tetanus Vaccine (Daptacel)amb Diphtheria/pertussis/tetanus Charge $175.00 $175.00 $53.00–$228.00 —
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 0.5 Ml Diphtheria/hepatitis B/pertussis/poliovirus/tetanus Vamb Dipht/hepb/pertussis/polio/tetanusvac Charge $191.00 $191.00 $57.00–$248.00 —
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 90698 Dtaphibipv (Pentacel), For Intramuscular Use $216.00 $216.00 $65.00–$281.00 —
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 90697 Dtap-ipv-hib-hepb Vacc Imamb Med Charge (Dtap-hib-hepb-ibv) $191.00 $191.00 $57.00–$248.00 —
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 90656 Fluarix No Prsv 3 Vl 6-35 Mamb Influenza Vacc Charge $71.00 $71.00 $21.00–$92.00 —
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Hpv9 (Gardasil 9) 90651amb Human Papillomavirus Charge $511.00 $511.00 $153.00–$664.00 —
Hepatitis A vaccine, adult dose CPT 90632 Vaccine Hepa Adult (Havrix)amb Hepatitis A Vaccine Charge $187.00 $187.00 $56.00–$243.00 —
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Chdp Hepatitis A (0-19 Yrs)amb Hepatitis A Pediatric Charge $166.00 $166.00 $50.00–$216.00 —
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 20mcg/ml Hepatitis B Vaccineamb Hepatitis B Vaccine Charge $166.00 $166.00 $50.00–$216.00 —
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Vaccine Hepb (Engerix-b)amb Hepatitis B Pediatric/adolescent Charge $166.00 $166.00 $50.00–$216.00 —
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 0.5 Ml Hib Vaccineamb Haemophilus B Conjugate Charge $205.00 $205.00 $62.00–$267.00 —
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 90662 Prsv Free Inc Antigamb Influenza Vacc Charge $135.00 $135.00 $41.00–$176.00 —
MMR vaccine (measles, mumps and rubella), live CPT 90707 Vaccine Measles-mumps-rubellaamb Measles-mumps-rubella Vaccine Charge $169.00 $169.00 $51.00–$220.00 —
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 Medication Charge $492.00 $492.00 $148.00–$640.00 —
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 48mg/6ml (Synvisc-1)amb Hylan G-f 20 Charge $492.00 $492.00 $148.00–$640.00 —
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 90710 Proquad-measles, Mumps, Rubella, And Varicella Vaccine (Mmrv), Live, Subq $492.00 $492.00 $148.00–$640.00 —
Meningococcal ACWY (MenACWY) vaccine CPT 90734 90734 Vaccine For Meningococcus Admin Into Muscle Menactra Charge $358.00 $358.00 $107.00–$465.00 —
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Vaccine Pneumococcal 13-valent Conjugate (Prevnar)amb Pneumococcal 13-valent Conjugate Vac Charge $420.00 $420.00 $126.00–$546.00 —
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Vaccine Pneumococcal 20-valent Conjugateamb Pneumococcal 20-valent Vaccine Charge $447.00 $447.00 $134.00–$581.00 —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Vaccine Pneumococcal 23-valent Conjugateamb Pneumococcal 23-valent Vaccine Charge $374.00 $374.00 $112.00–$486.00 —
Polio vaccine, inactivated (IPV) CPT 90713 0.5ml Poliovirus Vaccine (Ipol)amb Poliovirus Vaccine Charge $175.00 $175.00 $53.00–$228.00 —
Rabies vaccine, one dose CPT 90675 1 Ml Rabiesamb Rabies Vaccine Charge $686.00 $686.00 $206.00–$892.00 —
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 1 Ml Oral Vaccine Rotavirus (Rotarix)amb Rotavirus Oral Vaccine Charge $165.00 $165.00 $50.00–$215.00 —
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap 90715 Age Over 7amb Tdap Charge $167.00 $167.00 $50.00–$217.00 —
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Vaccine Typhim Viamb Typhoid Vaccine Charge $102.00 $102.00 $31.00–$133.00 —
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Cmmcl Admin Immunization 1 Vaccine Sngl/comb Charge $22.00 $22.00 $7.00–$29.00 —
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 First Vaccine 90471admin Immunization Charge $22.00 $22.00 $7.00–$29.00 —
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Manual Charge Subsq Vaccine Amb Admin Charge 19 And < $15.00 $15.00 $5.00–$20.00 —

Source file: https://secure.claraprice.net/price-transparency/KWNF-1755280847857/machine-readable/840816593_sedgwick-county-health-center_standardcharges.json