Pawnee County Memorial Hospital
Pawnee County Memorial Hospital in Pawnee City, NE publishes cash prices for 282 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Nebraska median for 198 of 278 procedures and above it for 75. By typical cash price it ranks #18 of 45 Nebraska hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
600 I Street, Pawnee City, NE 68420 Collected Sep 28, 2026 Source price file (402) 852-2231
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 281302 · 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 CPT 73610 Xr Ankle Comp Min 3 Vw | $277.00 | $346.00 | $239.00–$332.00 | 16% below | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Vas Ankle Brachial Index/abi | $454.00 | $568.00 | $392.00–$545.00 | 2% below | 20% |
| Bone scan, whole body (nuclear medicine) CPT 78306 Nm Bone Survey/scan | $1,385.00 | $1,731.00 | $1,194.00–$1,662.00 | 19% below | 20% |
| Breast ultrasound, complete, one breast both sides CPT 76641 Us Breast Complete Bilat | $498.00 | $622.00 | $429.00–$597.00 | — | 20% |
| Breast ultrasound, complete, one breast CPT 76641 Us Breast Complete Unila | $433.00 | $541.00 | $373.00–$519.00 | 11% below | 20% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 Us Breast Limited | $329.00 | $411.00 | $284.00–$395.00 | 15% below | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Cta Chest | $2,726.00 | $3,407.00 | $2,351.00–$3,271.00 | 15% below | 20% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Combo Abd/pelv W/o Con | $3,202.00 | $4,002.00 | $2,761.00–$3,842.00 | 7% below | 20% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast | $3,807.00 | $4,759.00 | $3,284.00–$4,569.00 | 7% below | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abd/pelv Combo W W/out | $4,326.00 | $5,408.00 | $3,732.00–$5,192.00 | 13% below | 20% |
| CT scan of the abdomen with contrast CPT 74160 Ct Abd W Cont | $2,163.00 | $2,704.00 | $1,866.00–$2,596.00 | 17% below | 20% |
| CT scan of the abdomen without contrast CPT 74150 Ct Abd W/o Cont | $1,817.00 | $2,271.00 | $1,567.00–$2,180.00 | 18% below | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Max Fac Sinus W/o Cont | $1,514.00 | $1,893.00 | $1,306.00–$1,817.00 | 16% below | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Sinus W/o | $1,514.00 | $1,893.00 | $1,306.00–$1,817.00 | 16% below | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT scan | $1,644.00 | $2,055.00 | $1,418.00–$1,973.00 | 14% below | 20% |
| CT scan of the head with contrast CPT 70460 Ct Head W Cont | $1,769.00 | $2,211.00 | $1,526.00–$2,123.00 | 14% below | 20% |
| CT scan of the head without and with contrast CPT 70470 Ct Head W W/o Con | $2,163.00 | $2,704.00 | $1,866.00–$2,596.00 | 13% below | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct Lumbar Spine W/o Cont | $1,990.00 | $2,488.00 | $1,717.00–$2,388.00 | 8% below | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct C Spine W/o Con | $1,990.00 | $2,488.00 | $1,717.00–$2,388.00 | 11% below | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast | $2,120.00 | $2,650.00 | $1,828.00–$2,544.00 | 12% below | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Vas Carotid Dup Bilat | $1,120.00 | $1,400.00 | $966.00–$1,344.00 | — | 20% |
| Chest X-ray, 2 views CPT 71046 Xr Chest Two Views | $282.00 | $352.00 | $243.00–$338.00 | at median | 20% |
| Chest X-ray, single view CPT 71045 Xr Chest Single View | $234.00 | $292.00 | $201.00–$280.00 | 2% above | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Renal | $606.00 | $757.00 | $522.00–$727.00 | 23% below | 20% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dexa Scan | $380.00 | $475.00 | $328.00–$456.00 | 3% below | 20% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest W/o Con | $1,904.00 | $2,380.00 | $1,642.00–$2,285.00 | 12% below | 20% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Chest W Cont | $2,077.00 | $2,596.00 | $1,791.00–$2,492.00 | 17% below | 20% |
| Diagnostic mammogram, both breasts CPT 77066 Mammography of both breasts | $437.00 | $546.00 | $377.00–$524.00 | 3% below | 20% |
| Diagnostic mammogram, one breast CPT 77065 Mammography of one breast | $346.00 | $433.00 | $299.00–$416.00 | 10% above | 20% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Vas Bilat Art Dup Lower | $952.00 | $1,190.00 | $821.00–$1,142.00 | — | 20% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Vas Venous Bilateral | $1,125.00 | $1,406.00 | $970.00–$1,350.00 | — | 20% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo 2d Mmode Doppler | $1,638.00 | $2,048.00 | $1,413.00–$1,966.00 | 23% below | 20% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Nm Nm Hida Scan | $1,260.00 | $1,575.00 | $1,087.00–$1,512.00 | 13% below | 20% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Nm Gall Bladder Ejection Fx | $1,260.00 | $1,575.00 | $1,087.00–$1,512.00 | 13% below | 20% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomn W Cpap | $2,912.00 | $3,640.00 | $2,512.00–$3,494.00 | 23% below | 20% |
| Knee X-ray, 3 views CPT 73562 Xr Knee Ap Lat 3 Views | $298.00 | $373.00 | $257.00–$358.00 | 20% below | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdomen Limited | $562.00 | $703.00 | $485.00–$675.00 | 1% above | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Chest Low Dose Screen | $606.00 | $757.00 | $522.00–$727.00 | 3% below | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint | $2,206.00 | $2,758.00 | $1,903.00–$2,648.00 | 14% below | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Mri Low Extrm Joint W&w/o | $2,985.00 | $3,731.00 | $2,574.00–$3,582.00 | 12% below | 20% |
| MRI of the abdomen without contrast CPT 74181 Mri Abdomen W/o Contrast | $2,800.00 | $3,500.00 | $2,415.00–$3,360.00 | 5% below | 20% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 Mri Abdomen W W/o | $3,600.00 | $4,500.00 | $3,105.00–$4,320.00 | 3% below | 20% |
| MRI of the brain, no contrast dye CPT 70551 Mri Brain W/o Contrast | $2,950.00 | $3,688.00 | $2,545.00–$3,540.00 | 7% below | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Scan | $3,374.00 | $4,218.00 | $2,910.00–$4,049.00 | 14% below | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal | $2,655.00 | $3,319.00 | $2,290.00–$3,186.00 | 16% below | 20% |
| MRI of the lower back, without and then with contrast dye CPT 72158 Mri Lumbar Spine W & W/o | $3,461.00 | $4,326.00 | $2,985.00–$4,153.00 | 12% below | 20% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mri Thoracic Spine W/o | $2,655.00 | $3,319.00 | $2,290.00–$3,186.00 | 18% below | 20% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 Mri Cervical Spine W& W/o | $3,461.00 | $4,326.00 | $2,985.00–$4,153.00 | 11% below | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 Mri Cervical Spine W/o | $2,655.00 | $3,319.00 | $2,290.00–$3,186.00 | 17% below | 20% |
| MRI of the pelvis without and with contrast CPT 72197 Mri Pelvis W/&w/o | $2,790.00 | $3,488.00 | $2,407.00–$3,348.00 | 23% below | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 Mri Pelvis W/o | $2,279.00 | $2,849.00 | $1,966.00–$2,735.00 | 19% below | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 Mri Up Extrm Joint W/o | $1,783.00 | $2,229.00 | $1,538.00–$2,140.00 | 27% below | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nm Spect Cardiac Scan | $3,374.00 | $4,218.00 | $2,910.00–$4,049.00 | 18% below | 20% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 Nm Pet Skull Base To Mid Thi | $4,992.00 | $6,240.00 | $4,306.00–$5,990.00 | 7% below | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us Pelvis Non Ob Limited | $331.00 | $414.00 | $286.00–$397.00 | 7% below | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvis Non Ob Complet | $606.00 | $757.00 | $522.00–$727.00 | 23% below | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Abdomial ultrasound of pregnant uterus | $606.00 | $758.00 | $523.00–$728.00 | 13% below | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Us Ob Complete | $519.00 | $649.00 | $448.00–$623.00 | 15% below | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Us Fetal Growth | $336.00 | $420.00 | $290.00–$403.00 | 14% below | 20% |
| Screening mammogram, both breasts both sides CPT 77067 Mammography, screening, bilateral | $362.00 | $453.00 | $313.00–$435.00 | — | 20% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 Xr Shoulder Comp Min 2vw/3vw | $295.00 | $369.00 | $255.00–$354.00 | 12% below | 20% |
| Sleep study in a lab (polysomnography) CPT 95810 Sleep study | $2,639.00 | $3,299.00 | $2,276.00–$3,167.00 | 26% below | 20% |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound pelvis through vagina | $519.00 | $649.00 | $448.00–$623.00 | 16% below | 20% |
| Transvaginal ultrasound during pregnancy CPT 76817 Us Ob Transvaginal | $467.00 | $584.00 | $403.00–$561.00 | 8% below | 20% |
| Ultrasound of the abdomen, complete CPT 76700 Ultrasound of abdomen | $710.00 | $887.00 | $612.00–$852.00 | 14% below | 20% |
| Ultrasound of the scrotum and testicles CPT 76870 Us Genetalia | $588.00 | $735.00 | $507.00–$706.00 | 10% below | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Thyroid Neck Head | $519.00 | $649.00 | $448.00–$623.00 | 12% below | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Vas Venous Unilateral | $909.00 | $1,136.00 | $784.00–$1,091.00 | 12% below | 20% |
| Wrist X-ray, complete, 3 or more views CPT 73110 Xr Wrist Min 3 View | $259.00 | $324.00 | $224.00–$311.00 | 22% below | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Xr Hip Complete Min 2 V Uni | $294.00 | $368.00 | $254.00–$353.00 | 2% above | 20% |
| X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen Ap | $259.00 | $324.00 | $224.00–$311.00 | 2% below | 20% |
| X-ray of the ankle, 2 views CPT 73600 Xr Ankle 2 Views | $186.00 | $233.00 | $161.00–$224.00 | 26% below | 20% |
| X-ray of the foot, 2 views CPT 73620 Xr Foot 2 Views | $216.00 | $270.00 | $186.00–$259.00 | at median | 20% |
| X-ray of the foot, complete, 3 or more views CPT 73630 Xr Foot 3 Views | $277.00 | $346.00 | $239.00–$332.00 | 12% below | 20% |
| X-ray of the hand, 3 or more views CPT 73130 Xr Hand Min 3 Vw | $275.00 | $344.00 | $237.00–$330.00 | 20% below | 20% |
| X-ray of the knee, 1 or 2 views CPT 73560 Xr Knee 1-2 Vw | $259.00 | $324.00 | $224.00–$311.00 | 19% below | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr Lumbo-sacral Ap/lat | $363.00 | $454.00 | $313.00–$436.00 | 8% below | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 X-Ray of lower back | $433.00 | $541.00 | $373.00–$519.00 | 9% below | 20% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xr Thoracic Ap/lat | $303.00 | $379.00 | $262.00–$364.00 | 1% below | 20% |
| X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones Comp. | $290.00 | $362.00 | $250.00–$348.00 | at median | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr Spine Cervical 2 Or 3 V | $294.00 | $368.00 | $254.00–$353.00 | 8% below | 20% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis-ap | $259.00 | $324.00 | $224.00–$311.00 | 4% below | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Saccro-coccyx Ap/lat | $259.00 | $324.00 | $224.00–$311.00 | 4% below | 20% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Sgpt/alt | $46.00 | $58.00 | $40.00–$56.00 | 24% below | 21% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Transaminase Sgot | $56.00 | $70.00 | $48.00–$67.00 | 2% below | 20% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hep Profile #3 | $256.00 | $320.00 | $221.00–$307.00 | 19% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Immunocap Hornet | $46.00 | $58.00 | $40.00–$56.00 | 2% below | 21% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Ccp Igg | $117.00 | $146.00 | $101.00–$140.00 | 12% above | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana | $88.00 | $110.00 | $76.00–$106.00 | 10% above | 20% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Bnp | $229.00 | $286.00 | $197.00–$275.00 | 17% above | 20% |
| Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel | $120.00 | $150.00 | $103.00–$144.00 | 12% below | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Path Gr-micro Lvl 4 Tech | $199.00 | $249.00 | $172.00–$239.00 | 4% above | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Path Gr-micro Level 4 | $199.00 | $249.00 | $172.00–$239.00 | 4% above | 20% |
| Blood culture for bacteria CPT 87040 Blood Culture | $212.00 | $265.00 | $183.00–$254.00 | 18% above | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture | $28.00 | $35.00 | $24.00–$34.00 | 9% above | 20% |
| Blood glucose (sugar) test CPT 82947 Glucose Blood | $40.00 | $50.00 | $35.00–$48.00 | 17% below | 20% |
| Blood lead test CPT 83655 Lead Level | $66.00 | $83.00 | $57.00–$80.00 | 2% above | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hcg Qualitative | $103.00 | $129.00 | $89.00–$124.00 | 6% below | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Type Abo | $53.00 | $66.00 | $46.00–$63.00 | 1% below | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive Protein | $90.00 | $113.00 | $78.00–$108.00 | 1% below | 20% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C Difficile Dna Fecal | $122.00 | $152.00 | $105.00–$146.00 | 21% below | 20% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium Diff Toxin | $122.00 | $152.00 | $105.00–$146.00 | 21% below | 20% |
| CA 19-9 blood test (tumor marker) CPT 86301 Ca 19-9 | $142.00 | $178.00 | $123.00–$171.00 | 9% below | 20% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Ca 125 | $152.00 | $190.00 | $131.00–$182.00 | 17% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars Cov 2 Rna By Pcr | $151.00 | $189.00 | $130.00–$181.00 | 19% above | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Probe | $110.00 | $138.00 | $95.00–$132.00 | at median | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids | $92.00 | $115.00 | $79.00–$110.00 | 21% below | 20% |
| Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (CBC), with differential white blood cells, automated | $86.00 | $108.00 | $75.00–$104.00 | 7% below | 20% |
| Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (CBC), automated | $69.00 | $86.00 | $59.00–$83.00 | 3% below | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals | $142.00 | $177.00 | $122.00–$170.00 | 9% below | 20% |
| D-dimer blood test (blood clot marker) CPT 85379 D-dimer | $119.00 | $149.00 | $103.00–$143.00 | 11% below | 20% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea-s | $158.00 | $197.00 | $136.00–$189.00 | 11% above | 20% |
| Estradiol blood test CPT 82670 Estradiol | $121.00 | $151.00 | $104.00–$145.00 | 12% below | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 Fsh G Pituitary | $112.00 | $140.00 | $97.00–$134.00 | at median | 20% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Fecal By Immunoassay | $334.00 | $418.00 | $288.00–$401.00 | 7% below | 20% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin Assay | $112.00 | $140.00 | $97.00–$134.00 | 7% above | 20% |
| Folate (folic acid) blood test CPT 82746 Folic Acid Serum | $111.00 | $139.00 | $96.00–$133.00 | 5% above | 20% |
| Free T3 thyroid hormone test CPT 84481 T 3 Free | $158.00 | $198.00 | $137.00–$190.00 | 2% above | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T-4 Free | $90.00 | $113.00 | $78.00–$108.00 | 3% above | 20% |
| Free testosterone test CPT 84402 Testosterone Free | $139.00 | $174.00 | $120.00–$167.00 | 26% above | 20% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 Gen Hlth Panl-cmp Cbc Tsh | $296.00 | $370.00 | $255.00–$355.00 | 1% above | 20% |
| Glucose tolerance test, 3 samples CPT 82951 Gtt 3 Spec | $130.00 | $162.00 | $112.00–$156.00 | 1% below | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gc Dna Probe | $109.00 | $136.00 | $94.00–$131.00 | 1% below | 20% |
| H. pylori antibody blood test CPT 86677 H-pylori | $113.00 | $141.00 | $97.00–$135.00 | 48% above | 20% |
| H. pylori stool antigen test CPT 87338 H Pylori Fecal | $161.00 | $201.00 | $139.00–$193.00 | at median | 20% |
| HIV-1 and HIV-2 antibody test CPT 86703 Hiv 1/2 | $85.00 | $106.00 | $73.00–$102.00 | 19% above | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv 1/2 Ag/ab Combo | $84.00 | $105.00 | $72.00–$101.00 | 14% above | 20% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv Hi Risk Screen | $101.00 | $126.00 | $87.00–$121.00 | 8% below | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c | $56.00 | $70.00 | $48.00–$67.00 | 23% below | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Antibody | $110.00 | $138.00 | $95.00–$132.00 | 21% above | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surf Antigen | $95.00 | $119.00 | $82.00–$114.00 | 2% above | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hep C Antibody | $82.00 | $103.00 | $71.00–$99.00 | 10% below | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hcv Quantitative | $333.00 | $416.00 | $287.00–$399.00 | 1% below | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex | $72.00 | $90.00 | $62.00–$86.00 | 30% below | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex T-2 | $77.00 | $96.00 | $66.00–$92.00 | 28% below | 20% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 Hs-crp-pl | $90.00 | $113.00 | $78.00–$108.00 | 8% above | 20% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 Hs-crp | $90.00 | $113.00 | $78.00–$108.00 | 8% above | 20% |
| Homocysteine blood test CPT 83090 Homocystine Assay | $112.00 | $140.00 | $97.00–$134.00 | 22% below | 20% |
| Insulin blood test CPT 83525 Insulin Fasting | $98.00 | $123.00 | $85.00–$118.00 | 10% below | 20% |
| Iron blood test (serum iron) CPT 83540 Iron Tot Serum | $51.00 | $64.00 | $44.00–$61.00 | 19% below | 20% |
| Iron-binding capacity (TIBC) test CPT 83550 Iron Tot-ibc | $59.00 | $74.00 | $51.00–$71.00 | 17% below | 20% |
| Kidney function blood test panel CPT 80069 Kidney function panel test | $132.00 | $165.00 | $114.00–$158.00 | 4% below | 20% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone | $104.00 | $130.00 | $90.00–$125.00 | 16% below | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase | $100.00 | $125.00 | $86.00–$120.00 | 4% above | 20% |
| Liver function blood test panel CPT 80076 Liver function blood test | $112.00 | $140.00 | $97.00–$134.00 | 15% below | 20% |
| Lyme disease antibody test CPT 86618 Lyme Disease Antibody | $126.00 | $157.00 | $108.00–$151.00 | 3% below | 20% |
| Lyme disease antibody test CPT 86618 Hiv | $126.00 | $157.00 | $108.00–$151.00 | 3% below | 20% |
| Magnesium blood test CPT 83735 Magnesium | $74.00 | $92.00 | $63.00–$88.00 | 8% above | 20% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibody Igg | $85.00 | $106.00 | $73.00–$102.00 | 1% above | 20% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Monospot | $66.00 | $82.00 | $57.00–$79.00 | 2% above | 20% |
| Obstetric blood test panel CPT 80055 Obstetric blood test panel | $196.00 | $245.00 | $169.00–$235.00 | 1% below | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Total prostate-specific antigen (PSA) test | $112.00 | $140.00 | $97.00–$134.00 | 12% below | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Total prostate-specific antigen (PSA) test | $104.00 | $130.00 | $90.00–$125.00 | 1% below | 20% |
| Pap test (liquid-based, automated screening with review) CPT 88175 Pap Thinprep W Image Reflex To Hpv | $86.00 | $108.00 | $75.00–$104.00 | 4% above | 20% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Thin Prep / Surepath | $77.00 | $96.00 | $66.00–$92.00 | 35% above | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyr Hormne | $198.00 | $248.00 | $171.00–$238.00 | 6% below | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test | $79.00 | $99.00 | $68.00–$95.00 | 2% above | 20% |
| Progesterone blood test CPT 84144 Progesterone | $106.00 | $133.00 | $92.00–$128.00 | 5% below | 20% |
| Prolactin blood test CPT 84146 Prolactin Serum | $129.00 | $161.00 | $111.00–$155.00 | 8% above | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time | $51.00 | $64.00 | $44.00–$61.00 | 1% above | 20% |
| Rapid flu test (influenza antigen) CPT 87804 Influenza A/b Ea Rapid | $74.00 | $92.00 | $63.00–$88.00 | 5% above | 20% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor | $55.00 | $69.00 | $48.00–$66.00 | 1% above | 20% |
| Rheumatoid factor (RF) test CPT 86431 Ra Latex Fix | $77.00 | $96.00 | $66.00–$92.00 | 41% above | 20% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Igg | $74.00 | $92.00 | $63.00–$88.00 | 2% below | 20% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Igm | $74.00 | $92.00 | $63.00–$88.00 | 2% below | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Esr Wintrobe | $47.00 | $59.00 | $41.00–$57.00 | at median | 20% |
| Stool ova and parasites exam CPT 87177 Ova-para Conc | $98.00 | $123.00 | $85.00–$118.00 | 29% above | 20% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Hemoccult Cards | $30.00 | $37.00 | $26.00–$36.00 | 8% above | 19% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood Scr Fecal/stool | $41.00 | $51.00 | $35.00–$49.00 | 1% below | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr | $42.00 | $52.00 | $36.00–$50.00 | 1% below | 19% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferontb Gold | $210.00 | $263.00 | $181.00–$252.00 | 4% above | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total Level | $118.00 | $147.00 | $101.00–$141.00 | 2% above | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Antibody Ea | $100.00 | $125.00 | $86.00–$120.00 | 11% above | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) | $95.00 | $119.00 | $82.00–$114.00 | 12% below | 20% |
| Trichomonas test (NAAT) CPT 87661 Trichomonos Probe | $63.00 | $79.00 | $55.00–$76.00 | 33% below | 20% |
| Uric acid blood test CPT 84550 Uric Acid | $49.00 | $61.00 | $42.00–$59.00 | 7% below | 20% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis test using microscope | $51.00 | $64.00 | $44.00–$61.00 | at median | 20% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis test | $35.00 | $44.00 | $30.00–$42.00 | 11% above | 20% |
| Urine culture for bacteria, with colony count CPT 87086 Culture Urine | $78.00 | $98.00 | $68.00–$94.00 | 9% above | 20% |
| Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy (Surevue) | $70.00 | $88.00 | $61.00–$84.00 | 10% above | 20% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B 12 | $112.00 | $140.00 | $97.00–$134.00 | 1% below | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-oh | $155.00 | $194.00 | $134.00–$186.00 | 5% above | 20% |
| Zinc blood test CPT 84630 Zinc Serum | $85.00 | $106.00 | $73.00–$102.00 | 24% above | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Sub Unit Hcg | $115.00 | $144.00 | $99.00–$138.00 | 30% above | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Quantitative | $115.00 | $144.00 | $99.00–$138.00 | 30% above | 20% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 C Tx Fx Fibula Distal | $550.00 | $688.00 | $475.00–$660.00 | 32% above | 20% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 C Tx Fx Metatarsal Each | $382.00 | $478.00 | $330.00–$459.00 | 4% above | 20% |
| Carpal tunnel release, open surgery CPT 64721 Carpal Tunnel Release | $1,830.00 | $2,288.00 | $1,579.00–$2,196.00 | 23% above | 20% |
| Cervical biopsy CPT 57500 Biop One Or Mor Cervix Ut | $267.00 | $334.00 | $230.00–$321.00 | 27% below | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 C Tx Fx Rad Dist-colles | $596.00 | $745.00 | $514.00–$715.00 | 24% above | 20% |
| Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope | $1,904.00 | $2,380.00 | $1,642.00–$2,285.00 | 64% above | 20% |
| Colonoscopy with tissue sample CPT 45380 Biopsy exam of large bowel using an endoscope | $1,730.00 | $2,163.00 | $1,492.00–$2,076.00 | 21% above | 20% |
| Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using an endoscope | $1,860.00 | $2,325.00 | $1,604.00–$2,232.00 | 47% above | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Dest B L 1 | $114.00 | $142.00 | $98.00–$136.00 | 11% below | 20% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Remove Cerumen Impact W/ Irrigation | $26.00 | $32.00 | $22.00–$31.00 | 44% below | 19% |
| Earwax removal with instruments, one ear CPT 69210 Remove Cerumen Impact W/ Instrument | $82.00 | $102.00 | $70.00–$98.00 | 8% below | 20% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Sigmoidoscopy | $1,601.00 | $2,001.00 | $1,381.00–$1,921.00 | 261% above | 20% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 Hemorrhoid Banding | $491.00 | $614.00 | $424.00–$589.00 | 19% below | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&d Simp Furuncle/cyst | $219.00 | $274.00 | $189.00–$263.00 | 15% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Tendon Sh Lig | $99.00 | $124.00 | $86.00–$119.00 | 47% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injtrigpt.tnd | $106.00 | $132.00 | $91.00–$127.00 | 43% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Inj/asp Maj Jt Bursa | $107.00 | $134.00 | $92.00–$129.00 | 44% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Lrgjoint/bur | $183.00 | $229.00 | $158.00–$220.00 | 4% below | 20% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insert Drug Implant Devic | $178.00 | $223.00 | $154.00–$214.00 | 24% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Inj/asp Int Jt Bursa | $90.00 | $113.00 | $78.00–$108.00 | 49% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Inj/asp Sm Jt Bursa | $139.00 | $174.00 | $120.00–$167.00 | 2% below | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Rep L Scaxtkarlg 0-2.5 | $458.00 | $572.00 | $395.00–$549.00 | 9% above | 20% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Injection(s) of therapeutic substance | $627.00 | $784.00 | $252.00–$753.00 | at median | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc B L Tr Ar Lg .5<cm | $218.00 | $272.00 | $188.00–$261.00 | 27% below | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Exc B L Fcereynslpm .5< Cm | $250.00 | $312.00 | $215.00–$300.00 | 26% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Avuls Nail Plate 1 | $201.00 | $251.00 | $173.00–$241.00 | 10% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Exc Nail Mat Perm Part/co | $278.00 | $348.00 | $240.00–$334.00 | 17% below | 20% |
| Removal of a breast lump, open surgery CPT 19120 Removal of one or more breast growth, open procedure | $874.00 | $1,093.00 | $754.00–$1,049.00 | 27% below | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 Ex Fb Granuloma Dr Chg | $265.00 | $331.00 | $95.00–$318.00 | 20% below | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 Rem Fb Sq Simp | $265.00 | $331.00 | $228.00–$318.00 | 20% below | 20% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colonoscopy Medicare Screening | $1,601.00 | $2,001.00 | $1,381.00–$1,921.00 | 103% above | 20% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colonoscopy Medicare Hi-risk Screening | $1,730.00 | $2,163.00 | $1,492.00–$2,076.00 | 110% above | 20% |
| Short arm cast (elbow to hand) CPT 29075 App Short Arm Cas | $150.00 | $187.00 | $129.00–$180.00 | 24% below | 20% |
| Short arm splint (forearm and hand) CPT 29125 App Short Arm Splint | $110.00 | $137.00 | $95.00–$132.00 | 28% below | 20% |
| Short leg cast (below the knee) CPT 29405 App Short Leg Cast | $138.00 | $172.00 | $119.00–$165.00 | 26% below | 20% |
| Short leg splint (calf to foot) CPT 29515 App Short Leg Splint | $123.00 | $154.00 | $106.00–$148.00 | 24% below | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rep S Scnkaxtkexg 0-2.5 | $155.00 | $194.00 | $134.00–$186.00 | 25% below | 20% |
| Skin biopsy, punch, one lesion CPT 11104 Biop Skin Sq Mm 1-punch B | $219.00 | $274.00 | $189.00–$263.00 | 14% below | 20% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Exc M L Tr Ar Lg .5<cm | $342.00 | $428.00 | $295.00–$411.00 | 16% below | 20% |
| Skin tag removal, up to 15 tags CPT 11200 Dest Skintag 1-15 | $154.00 | $193.00 | $133.00–$185.00 | 19% below | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Tap | $226.00 | $283.00 | $195.00–$272.00 | 41% below | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Rep S Scnkaxtkexg 2.6-7.5 | $190.00 | $238.00 | $164.00–$228.00 | 21% below | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Rep S Fcereynslpm 0-2.5 | $190.00 | $237.00 | $164.00–$228.00 | 16% below | 20% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangential Biopsy Of Skin Single | $190.00 | $237.00 | $164.00–$228.00 | at median | 20% |
| Thoracentesis with imaging guidance CPT 32555 Thoracentesis W/ Imaging | $941.00 | $1,176.00 | $811.00–$1,129.00 | 16% above | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Inj Tp 1-2 Muscle Grps | $97.00 | $121.00 | $83.00–$116.00 | 24% below | 20% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Egd Balloon Dilation Eso <30 Mm | $1,730.00 | $2,163.00 | $1,492.00–$2,076.00 | 1% below | 20% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy exam of esophagus, stomach or small bowel using an endoscope | $1,558.00 | $1,947.00 | $1,343.00–$1,869.00 | 1% above | 20% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach or small bowel using an endoscope | $1,730.00 | $2,163.00 | $1,492.00–$2,076.00 | 129% above | 20% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Vasectomy | $1,664.00 | $2,080.00 | $1,435.00–$1,997.00 | 71% above | 20% |
| Wart removal, up to 14 warts CPT 17110 Dest Fl Warts Up 14 | $194.00 | $242.00 | $167.00–$232.00 | 7% above | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Subcu 1st 20 Sq | $224.00 | $280.00 | $193.00–$269.00 | 25% below | 20% |
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 Administration | $735.00 | $919.00 | $634.00–$882.00 | 4% above | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Non Or Pressurized Inhalation Tx | $200.00 | $250.00 | $173.00–$240.00 | 82% above | 20% |
| Chemotherapy IV infusion, first hour CPT 96413 Chemo Iv Infusion 1 Hr | $520.00 | $650.00 | $448.00–$624.00 | 7% below | 20% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 St Comp Audio Thrs Evl/sp Rc | $150.00 | $188.00 | $130.00–$180.00 | 55% above | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ecg-routine | $229.00 | $286.00 | $197.00–$275.00 | 2% below | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Er Serv Fee Lvl 1 | $173.00 | $216.00 | $149.00–$207.00 | 13% above | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Er Expand/low Lvl 2 | $72.00 | $90.00 | $38.00–$86.00 | 61% below | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Er Serv Fee Lvl 2 | $294.00 | $368.00 | $254.00–$353.00 | 60% above | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Er Expand/mod Lvl 3 | $124.00 | $155.00 | $64.00–$149.00 | 50% below | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Er Serv Fee Lvl 3 | $458.00 | $573.00 | $395.00–$550.00 | 83% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Er Detailed Lvl 4 | $210.00 | $263.00 | $109.00–$252.00 | 54% below | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Er Serv Fee Lvl 4 | $692.00 | $865.00 | $597.00–$830.00 | 50% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Er Comp Lvl 5 | $306.00 | $382.00 | $159.00–$367.00 | 53% below | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Er Serv Fee Lvl 5 | $1,168.00 | $1,460.00 | $1,007.00–$1,402.00 | 78% above | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Inf Hyd Initial 31-1hr | $320.00 | $400.00 | $276.00–$384.00 | 16% below | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration Iv Inf Initial | $320.00 | $400.00 | $276.00–$384.00 | 16% below | 20% |
| IV infusion of a medicine, first hour CPT 96365 Iv Inf Thr/pro/dig 1 Hr | $320.00 | $400.00 | $276.00–$384.00 | 17% below | 20% |
| IV infusion of a medicine, first hour CPT 96365 Iv Inf Thr/prop/dg Up 1hr-er | $320.00 | $400.00 | $276.00–$384.00 | 17% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj Admin Subcu/im-rhc | $25.00 | $31.00 | $21.00–$30.00 | 72% below | 19% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj Sq Or Im Ther/prop/dg-er | $120.00 | $150.00 | $103.00–$144.00 | 33% above | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj Sq Or Im Ther/pro/dig | $120.00 | $150.00 | $103.00–$144.00 | 33% above | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 Pt Neuromuscular Education | $86.00 | $108.00 | $75.00–$104.00 | 7% below | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 Ot Neuromuscular Re-educatio | $86.00 | $108.00 | $75.00–$104.00 | 7% below | 20% |
| New patient office visit, about 30 minutes CPT 99203 New patient office or other outpatient visit, 30 min | $188.00 | $235.00 | $162.00–$226.00 | 9% below | 20% |
| New patient office visit, about 45 minutes CPT 99204 New patient office or other outpatient visit, 45 min | $287.00 | $359.00 | $248.00–$345.00 | 6% below | 20% |
| New patient office visit, about 60 minutes CPT 99205 New patient office or other outpatient visit, 60 min | $363.00 | $454.00 | $313.00–$436.00 | 2% below | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Pt Bc/bs Comp Eval | $64.00 | $80.00 | $55.00–$77.00 | 47% below | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Clinic Visit New Pt Expan | $83.00 | $104.00 | $72.00–$100.00 | 32% below | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Ov New Straight Forward | $132.00 | $165.00 | $114.00–$158.00 | 8% above | 20% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 O/p Diet Consult/fu | $96.00 | $120.00 | $83.00–$115.00 | 98% above | 20% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Ot Eval Low Cmplx | $151.00 | $189.00 | $130.00–$181.00 | 9% below | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Pt Eval High Cmplx | $242.00 | $303.00 | $209.00–$291.00 | 14% above | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Pt Eval Low Cmplx | $138.00 | $173.00 | $119.00–$166.00 | 13% below | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Pt Eval Mod Cmplx | $173.00 | $216.00 | $149.00–$207.00 | 3% below | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Ot Manual Therapy | $86.00 | $108.00 | $75.00–$104.00 | 11% below | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Pt Manual Therapy | $86.00 | $108.00 | $75.00–$104.00 | 11% below | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Physical therapy, therapeutic exercise | $82.00 | $103.00 | $71.00–$99.00 | 14% below | 20% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial new patient preventative medicine evaluation (18-39 years) | $210.00 | $262.00 | $181.00–$252.00 | 15% below | 20% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial new patient preventative medicine evaluation (40-64 years) | $242.00 | $302.00 | $208.00–$290.00 | 14% below | 20% |
| Preventive checkup, new patient aged 65 or older CPT 99387 Prev Med Np Initial 65> | $262.00 | $328.00 | $226.00–$315.00 | 9% below | 20% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 Prev Med Estab 18-39 (Mcaid 18-21) | $189.00 | $236.00 | $163.00–$227.00 | 14% below | 20% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 Prev Med Estab 40-64 | $201.00 | $251.00 | $173.00–$241.00 | 14% below | 20% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 Prev Med Estab >65 | $216.00 | $270.00 | $186.00–$259.00 | 11% below | 20% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Cessation 3-10mm'care | $26.00 | $32.00 | $22.00–$31.00 | 11% below | 19% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Clinic Visit Estab Comp | $250.00 | $312.00 | $215.00–$300.00 | 4% above | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Ov Est Comprehensive | $292.00 | $365.00 | $252.00–$350.00 | 22% above | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 School Sports Physicalselfpay Only | $40.00 | $50.00 | $35.00–$48.00 | 67% below | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Outpt Clinic Est Pt Visit | $121.00 | $151.00 | $104.00–$145.00 | 1% above | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Out Pt Clinic Cons Detail | $121.00 | $151.00 | $104.00–$145.00 | 1% above | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Telehealth Ov Est Expanded | $148.00 | $185.00 | $128.00–$178.00 | 23% above | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Ov Est Expanded | $148.00 | $185.00 | $128.00–$178.00 | 23% above | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Out Pt Clinic Cons Compre | $183.00 | $229.00 | $158.00–$220.00 | 3% above | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Clinic Visit Est Pat | $183.00 | $229.00 | $158.00–$220.00 | 3% above | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Telehealth Ov Est Detailed | $208.00 | $260.00 | $179.00–$250.00 | 17% above | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Ov Est Detailed | $208.00 | $260.00 | $179.00–$250.00 | 17% above | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Op Est Stfwd | $79.00 | $99.00 | $68.00–$95.00 | 6% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Outpt Clinic Consult Expa | $79.00 | $99.00 | $68.00–$95.00 | 6% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Out Pt Clinic Striaght | $79.00 | $99.00 | $68.00–$95.00 | 6% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Ov Est Straight Forward | $96.00 | $120.00 | $83.00–$115.00 | 14% above | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Telehealth Ov Est Strt Fowrd | $96.00 | $120.00 | $83.00–$115.00 | 14% above | 20% |
| Speech and language evaluation CPT 92523 St Speech Sound Lang Compr | $308.00 | $385.00 | $266.00–$370.00 | 1% below | 20% |
| Speech therapy session, individual CPT 92507 St Speech Therapy | $242.00 | $303.00 | $209.00–$291.00 | 1% below | 20% |
| Spirometry (breathing test) CPT 94010 Spirometry | $259.00 | $324.00 | $224.00–$311.00 | 5% below | 20% |
| Spirometry (breathing test) CPT 94010 Spirometry W/o Broncho Di | $259.00 | $324.00 | $224.00–$311.00 | 5% below | 20% |
| Spirometry before and after a bronchodilator CPT 94060 Pulm Function Stg #1/dila | $562.00 | $703.00 | $485.00–$675.00 | at median | 20% |
| Spirometry before and after a bronchodilator CPT 94060 Spirometry Pre-post | $562.00 | $703.00 | $485.00–$675.00 | at median | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Ot Theraputic Activities | $82.00 | $103.00 | $71.00–$99.00 | 6% below | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Pt Theraputic Activities | $82.00 | $103.00 | $71.00–$99.00 | 6% below | 20% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy | $129.00 | $161.00 | $111.00–$155.00 | 33% below | 20% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phelbotomy | $174.00 | $217.00 | $150.00–$208.00 | 9% below | 20% |
| Treadmill or drug stress test with ECG, supervision and report CPT 93015 Cv Strs Tst Trdml W/s&i | $123.00 | $154.00 | $106.00–$148.00 | 56% below | 20% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Covid19 Vaccine Mrna Spikevax 0.5ml Inj | $176.00 | $220.00 | $152.00–$211.00 | 8% below | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella Vaccine | $227.00 | $284.00 | $196.00–$273.00 | 14% above | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Vfc Influenza Vaccine | $16.00 | $20.00 | $14.00–$19.00 | 38% below | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza Vac Fluzone Trivalent Pf 0.5ml | $24.00 | $30.00 | $21.00–$29.00 | 8% below | 20% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Hpv-9 Vaccine | $346.00 | $432.00 | $298.00–$415.00 | 6% below | 20% |
| Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Adult | $73.00 | $91.00 | $63.00–$87.00 | 15% below | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hep B Vac Adult 20mcg/ml | $80.00 | $100.00 | $69.00–$96.00 | 6% below | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza Vac Hd Pf(do Not Use) | $78.00 | $98.00 | $68.00–$94.00 | 5% below | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal 20 | $304.00 | $380.00 | $262.00–$365.00 | 30% below | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal 23 Vac | $136.00 | $170.00 | $117.00–$163.00 | 27% below | 20% |
| Rabies vaccine, one dose CPT 90675 Rabies Vacc 2.5u Syr | $471.00 | $589.00 | $406.00–$565.00 | 7% below | 20% |
| Rabies vaccine, one dose CPT 90675 Rabies Vaccine Imovax 2.5u | $493.00 | $616.00 | $425.00–$591.00 | 3% below | 20% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Shingrixvaricella Zoster Vaccine | $226.00 | $282.00 | $195.00–$271.00 | 21% below | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanusdiphthtoxoid Adult | $50.00 | $63.00 | $43.00–$60.00 | 4% below | 21% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Vfc Adacel | $16.00 | $20.00 | $14.00–$19.00 | 77% below | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immuniz Admin 1st >18 | $64.00 | $80.00 | $55.00–$77.00 | 87% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immuniz Admin 2nd Ea >18 | $25.00 | $31.00 | $21.00–$30.00 | 25% below | 19% |
Source file: https://secure.claraprice.net/price-transparency/VVKZ-1769396935421/machine-readable