Hospital

Ste. Genevieve County Memorial Hospital

Ste. Genevieve County Memorial Hospital in Ste. Genevieve, MO publishes cash prices for 385 common procedures listed here, from its own machine-readable price file updated May 19, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Missouri median for 301 of 380 procedures and above it for 76. By typical cash price it ranks #12 of 68 Missouri hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

800 Ste Genevieve Dr, Ste. Genevieve, MO 63670 Collected Sep 29, 2026 Source price file (573) 883-2751

Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 4 of 5 CCN 261330 · CMS hospital register NPI 1073587655

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ABI-ANKLE/BRACHIAL INDCES	$427.75	$855.50	$68.41–$727.18	37% above	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Timed Barium Swallow	$314.25	$628.50	$54.70–$534.23	26% below	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Xray, esophagus w/contrast	$314.50	$629.00	$54.70–$534.65	26% below	50%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE SCAN	$747.25	$1,494.50	$182.55–$1,270.33	47% below	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CHEST - ANGIOGRAPHY	$1,588.00	$3,176.00	$248.73–$4,612.34	19% below	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 OCC MED HEART SCORE	$29.00	$58.00	$14.50–$770.00	66% below	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART SCORE	$37.50	$75.00	$18.75–$770.00	56% below	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELV W/O CONTRAST	$2,529.75	$5,059.50	$82.19–$4,300.58	15% above	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELV WITH CONTRAST	$2,645.25	$5,290.50	$178.80–$4,496.93	4% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELV W & W/O CONTRAST	$2,991.00	$5,982.00	$207.14–$5,084.70	7% below	50%
CT scan of the abdomen with contrast CPT 74160 CT ABD W/CONTRAST	$1,454.75	$2,909.50	$202.04–$3,704.86	13% below	50%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN WITH CONTRAST	$1,454.75	$2,909.50	$202.04–$3,704.86	13% below	50%
CT scan of the abdomen without contrast CPT 74150 CT ABD W/OUT CONTRAST	$1,258.75	$2,517.50	$130.54–$2,570.37	14% above	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE	$1,195.00	$2,390.00	$133.10–$2,644.50	8% above	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONTRAST	$1,195.00	$2,390.00	$133.10–$2,116.52	4% below	50%
CT scan of the head with contrast CPT 70460 CT HEAD WITH CONTRAST	$1,266.50	$2,533.00	$199.10–$2,741.69	14% below	50%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/O & W CONTRAST	$1,371.00	$2,742.00	$199.10–$3,376.14	25% below	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE /WO	$1,199.00	$2,398.00	$150.73–$2,644.50	16% below	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE /WO	$1,460.00	$2,920.00	$150.73–$2,644.50	10% below	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST	$1,381.00	$2,762.00	$224.10–$3,237.08	16% below	50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DOPPLER CAROTID BILATERAL	$860.00	$1,720.00	$151.12–$1,462.00	—	50%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS	$67.00	$134.00	$17.46–$235.00	73% below	50%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEW	$220.25	$440.50	$17.46–$392.05	10% below	50%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW	$58.50	$117.00	$12.90–$235.00	71% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Renal and Bladder Eval US	$516.50	$1,033.00	$56.47–$878.05	10% below	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY SPINE/HIP	$319.00	$638.00	$52.47–$542.30	at median	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITY WRIST	$196.00	$392.00	$17.05–$333.20	2% above	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB AFTER 1ST TRI/DETAIL FET AN	$407.50	$815.00	$80.40–$707.76	39% below	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/OUT CONT	$1,194.75	$2,389.50	$149.60–$2,644.50	6% below	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST	$1,279.50	$2,559.00	$215.60–$3,408.44	22% below	50%
Diagnostic mammogram, both breasts both sides CPT 77066 2D MAM BILAT, DIAGNOSTIC	$340.00	$680.00	$93.61–$605.20	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 2D Bilat Diag Mammo w/Implant	$509.75	$1,019.50	$93.61–$907.36	—	50%
Diagnostic mammogram, one breast CPT 77065 Post stereo clip placemt mammo	$692.75	$1,385.50	$73.42–$1,233.10	196% above	50%
Diagnostic mammogram, one breast one side CPT 77065 2D MAM, DIAG UNILATERAL	$280.75	$561.50	$73.42–$499.74	20% above	50%
Diagnostic mammogram, one breast one side CPT 77065 2D Unilat Diag Mammo w/Implant	$420.75	$841.50	$73.42–$748.94	80% above	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Low Ext Arterial Duplex Bilat	$1,173.25	$2,346.50	$156.21–$1,994.53	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS REFLUX STUDY BILATERAL	$1,255.50	$2,511.00	$118.25–$2,234.79	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 LOW EXT VENOUS BILATERAL	$1,255.50	$2,511.00	$118.25–$2,234.79	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 UP EXT VENOUS BILATERAL	$1,255.50	$2,511.00	$118.25–$2,234.79	—	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo w/bubble test	$1,258.75	$2,517.50	$118.51–$2,139.88	19% below	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO 2D/M MODE	$1,651.50	$3,303.00	$118.51–$2,807.55	6% above	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILLARY SCAN	$877.00	$1,754.00	$207.10–$1,490.90	35% below	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT&RESP EFFT	$92.00	$184.00	$46.00–$451.80	85% below	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 2 NIGHT SLEEP STUDY, UNATTENDE	$848.50	$1,697.00	$52.93–$1,827.00	36% above	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 3 NIGHT SLEEP STUDY, UNATTENDE	$1,272.25	$2,544.50	$52.93–$2,162.83	105% above	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY W/CPAP	$372.50	$745.00	$186.25–$663.05	86% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 SINGLE ORGAN OR LIMITED AREA	$376.00	$752.00	$45.58–$639.20	24% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ABDOMEN RUQ OR LIMITED US	$432.25	$864.50	$45.58–$734.83	13% below	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 EMP WELL LUNG CA SCREENING	$1,072.50	$2,145.00	$113.73–$1,909.05	146% above	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST, LOW DOSE	$1,160.25	$2,320.50	$113.73–$1,972.43	166% above	50%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST BILAT W&W/OUT	$1,551.25	$3,102.50	$192.73–$2,637.13	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW EXT W/JT-W&W/O CONT	$1,708.50	$3,417.00	$468.14–$5,265.34	24% below	50%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O	$1,420.25	$2,840.50	$236.35–$3,381.88	14% below	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO	$1,953.50	$3,907.00	$476.07–$5,265.34	22% below	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI MRCP W/W OUT CONTRAST	$1,994.00	$3,988.00	$476.07–$5,265.34	21% below	50%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O	$1,507.50	$3,015.00	$245.12–$3,385.18	4% below	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W & W/O	$2,146.50	$4,293.00	$479.21–$5,265.34	14% below	50%
MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O	$1,657.00	$3,314.00	$255.06–$3,381.88	11% below	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE W & W/O	$2,146.50	$4,293.00	$477.61–$5,265.34	13% below	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE W/O	$1,522.50	$3,045.00	$255.06–$3,381.88	15% below	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE W & W/O	$1,926.25	$3,852.50	$477.61–$5,265.34	23% below	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O	$1,632.00	$3,264.00	$235.56–$3,381.88	17% below	50%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO	$1,994.00	$3,988.00	$475.87–$5,265.34	20% below	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS /WO	$1,486.50	$2,973.00	$245.86–$3,385.18	20% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL SPECT MULTI STUDIES	$1,870.25	$3,740.50	$282.77–$3,179.43	51% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 LEXISCAN NUC STRESS TEST	$1,870.25	$3,740.50	$282.77–$3,179.43	51% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 DOBUTAMINE NUCLEAR STRESS TEST	$1,870.25	$3,740.50	$282.77–$3,179.43	51% below	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT STANDARD BODY	$3,516.25	$7,032.50	$1,261.56–$5,977.63	18% below	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 BLADDER EVAL	$294.25	$588.50	$38.22–$500.23	23% below	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIC (TRANABD) ULT	$514.50	$1,029.00	$55.96–$874.65	19% below	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB AFTER 1ST TRIMESTER	$407.50	$815.00	$67.11–$692.75	23% below	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HI-RISK OB AFTER 1ST TRIMESTER	$480.00	$960.00	$67.11–$816.00	10% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB 1ST TRIMESTER	$314.25	$628.50	$53.93–$534.23	38% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HI-RISK OB 1ST TRIMESTER	$405.00	$810.00	$53.93–$688.50	21% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB ULTRASOUND, LIMITED	$155.25	$310.50	$38.48–$386.00	57% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HI-RISK OB US, LIMITED	$245.50	$491.00	$38.48–$417.35	32% below	50%
Screening mammogram, both breasts both sides CPT 77067 2D MAM BILAT, SCREEN	$301.00	$602.00	$77.35–$535.78	—	50%
Screening mammogram, both breasts both sides CPT 77067 2D Bilat Screen w/Implant	$451.50	$903.00	$77.35–$803.67	—	50%
Screening mammogram, both breasts one side CPT 77067 UNILAT SCRN MAMMOGRAM	$272.75	$545.50	$77.35–$485.50	74% above	50%
Screening mammogram, both breasts one side CPT 77067 2D Unilat Screen w/Implant	$408.25	$816.50	$77.35–$726.69	160% above	50%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY	$2,148.25	$4,296.50	$366.81–$3,652.03	4% below	50%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE	$241.50	$483.00	$114.92–$451.80	86% below	50%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO-TREADMILL	$2,222.25	$4,444.50	$114.92–$3,777.83	24% above	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 ESOPHAGUS BA SWALLOW(SPEECH)	$305.25	$610.50	$79.52–$518.93	32% below	50%
Transvaginal pelvic ultrasound CPT 76830 ESSURE TVU	$305.00	$610.00	$66.60–$518.50	41% below	50%
Transvaginal pelvic ultrasound CPT 76830 PELVIC (TRANSVAG) ULT	$428.25	$856.50	$66.60–$728.03	17% below	50%
Transvaginal ultrasound during pregnancy CPT 76817 OB TRANSVAG EA ADD GESTATION	$376.00	$752.00	$43.55–$639.20	13% below	50%
Transvaginal ultrasound during pregnancy CPT 76817 OB TRANSVAG	$376.00	$752.00	$43.55–$639.20	13% below	50%
Transvaginal ultrasound during pregnancy CPT 76817 HI-RISK OB TRANSVAG	$465.75	$931.50	$43.55–$791.78	8% above	50%
Ultrasound of the abdomen, complete CPT 76700 ABD COM ULTRASOUND	$497.00	$994.00	$60.52–$844.90	37% below	50%
Ultrasound of the scrotum and testicles CPT 76870 SCROTUM ULTRASOUND	$398.25	$796.50	$72.69–$677.03	31% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 SOFT TISSUE NECK US	$406.75	$813.50	$64.83–$691.48	28% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W/BARIUM	$415.50	$831.00	$66.86–$706.35	27% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI w/Gastrografin	$416.00	$832.00	$66.86–$707.20	27% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 LOW EXT VENOUS SINGLE	$701.75	$1,403.50	$77.63–$1,249.12	29% above	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UP EXT VENOUS UNILATERAL	$664.25	$1,328.50	$77.63–$1,182.37	23% above	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS REFLUX STUDY UNILATERAL	$701.75	$1,403.50	$77.63–$1,249.12	29% above	50%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN, 1 view	$155.50	$311.00	$16.19–$276.79	25% below	50%
X-ray of the finger(s), 2 or more views CPT 73140 FINGERS 2 VIEW	$137.50	$275.00	$23.28–$235.00	32% below	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 L SPINE 2-3 VIEW	$122.50	$245.00	$22.01–$235.00	58% below	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 L SPINE 2 3 VIEW	$268.25	$536.50	$22.01–$456.03	7% below	50%
X-ray of the lower back, 4 or more views CPT 72110 L SPINE W OBLS	$325.50	$651.00	$29.36–$553.35	23% below	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 T SPINE 2 VIEW	$172.75	$345.50	$17.46–$293.68	33% below	50%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONE	$181.50	$363.00	$22.52–$308.55	27% below	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C-SPINE 2 3 VIEWS	$251.50	$503.00	$21.77–$427.55	16% below	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS	$151.25	$302.50	$14.67–$257.13	32% below	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM-COCCYX	$185.00	$370.00	$18.22–$314.50	30% below	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINOTRANSFERASE	$36.75	$73.50	$4.77–$62.48	24% below	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT	$38.25	$76.50	$4.66–$65.03	18% below	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL	$262.25	$524.50	$42.87–$445.83	12% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN-Aspergillus fumagatis	$14.50	$29.00	$4.70–$55.00	32% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROF VIII EACH	$14.50	$29.00	$4.70–$55.00	32% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 IMCAP EACH ALLERGEN	$14.50	$29.00	$4.70–$55.00	32% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 IMCAP-EACH ALLERGEN	$30.25	$60.50	$4.70–$55.00	42% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN IgE	$30.25	$60.50	$4.70–$55.00	42% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 BANANA IgE	$35.00	$70.00	$4.70–$59.50	65% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG YOLK IgE	$35.00	$70.00	$4.70–$59.50	65% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Penicilloyl V	$38.75	$77.50	$4.70–$65.88	82% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Penicilloyl G	$38.75	$77.50	$4.70–$65.88	82% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND IgE	$39.75	$79.50	$4.70–$67.58	87% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT IgE	$39.75	$79.50	$4.70–$67.58	87% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT IgE	$39.75	$79.50	$4.70–$67.58	87% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RICE	$44.75	$89.50	$4.70–$76.08	111% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HAZELNUT	$44.75	$89.50	$4.70–$76.08	111% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 PAPER WASP IgE	$50.00	$100.00	$4.70–$85.00	135% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ECHINOCOCCUS IgE	$53.25	$106.50	$4.70–$90.53	151% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 GLOVE LATEX EXTRACT	$57.00	$114.00	$4.70–$96.90	168% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 AMMONIATED LATEX EXTRACT	$57.00	$114.00	$4.70–$96.90	168% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 BUFFERED LATEX	$57.00	$114.00	$4.70–$96.90	168% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 OAT IgE	$67.00	$134.00	$4.70–$113.90	215% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT (F13) IgE	$67.00	$134.00	$4.70–$113.90	215% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERTEN IgE HOP (FRUIT CONE)	$72.00	$144.00	$4.70–$122.40	239% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RASPBERRY IgE	$74.25	$148.50	$4.70–$126.23	249% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 CANTALOUPE IgE	$85.50	$171.00	$4.70–$145.35	302% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 RED MULBERRY IgE	$98.25	$196.50	$4.70–$167.03	362% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MELONS	$98.25	$196.50	$4.70–$167.03	362% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALPHA GAL IgE	$99.75	$199.50	$4.70–$169.58	369% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Cephalosporin IgE	$102.75	$205.50	$4.70–$174.68	384% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Amoxicillin IgE	$274.00	$548.00	$4.70–$465.80	1189% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Ampicillin IgE	$604.00	$1,208.00	$4.70–$1,026.80	2742% above	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINE PEPTIDE	$161.50	$323.00	$11.66–$274.55	101% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB (ANA)	$88.75	$177.50	$10.88–$150.88	30% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CENTROMERE AB SCREEN	$88.75	$177.50	$10.88–$150.88	30% above	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE B TYPE	$168.00	$336.00	$35.33–$285.60	35% above	50%
Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL BASIC	$87.75	$175.50	$7.61–$149.18	26% below	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LVL IV PATH GROSS & MICRO TC	$102.75	$205.50	$29.66–$283.48	50% below	50%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$103.50	$207.00	$9.29–$175.95	7% below	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 OC-VENIPUNCTURE	$8.75	$17.50	$4.38–$55.00	46% below	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$14.50	$29.00	$7.25–$451.80	11% below	50%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$4.50	$9.00	$2.25–$55.00	86% below	50%
Blood glucose (sugar) test CPT 82947 Glucose; quantitative, blood	$27.50	$55.00	$3.54–$55.00	11% below	50%
Blood glucose (sugar) test CPT 82947 GLUCOSE 2HR PP	$38.75	$77.50	$3.54–$65.88	25% above	50%
Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING	$38.75	$77.50	$3.54–$65.88	25% above	50%
Blood glucose (sugar) test CPT 82947 GLUCOSE SERUM	$38.75	$77.50	$3.54–$65.88	25% above	50%
Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE CHK PROCEDURE	$46.25	$92.50	$3.54–$78.63	49% above	50%
Blood lead test CPT 83655 LEAD ASSAY	$12.50	$25.00	$6.25–$88.35	77% below	50%
Blood lead test CPT 83655 LEAD	$43.50	$87.00	$10.90–$88.35	20% below	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$12.50	$25.00	$6.25–$54.85	77% below	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE URINE	$53.75	$107.50	$6.77–$91.38	1% above	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE SERUM	$57.50	$115.00	$6.77–$97.75	8% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ARC ABO	$61.50	$123.00	$2.69–$104.55	at median	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO GROUP	$61.50	$123.00	$2.69–$104.55	at median	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$79.00	$158.00	$4.66–$134.30	33% above	50%
C. difficile toxin gene test (stool PCR) CPT 87493 C.DIFFICILE TOXIN GENE(S)	$170.75	$341.50	$33.54–$303.94	21% above	50%
CA 19-9 blood test (tumor marker) CPT 86301 CARBOHYDRATE AB (CA) 19-9	$124.25	$248.50	$18.73–$211.23	13% above	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN (CA) 125	$138.25	$276.50	$18.73–$235.03	27% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 RESP + COVID TEST	$37.50	$75.00	$18.75–$184.17	61% below	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID BioFire w/Mini Resp	$112.75	$225.50	$44.33–$200.70	17% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID SARS CoV2 RNA, RL	$151.25	$302.50	$44.33–$269.23	56% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID SARS CoV2 RNA	$151.25	$302.50	$44.33–$269.23	56% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS	$35.25	$70.50	$17.63–$256.25	61% below	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 OC-LIPID PROFILE	$12.50	$25.00	$6.25–$97.85	88% below	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HEALTH FAIR LIPID PANEL	$23.00	$46.00	$11.50–$97.85	77% below	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$69.75	$139.50	$12.05–$118.58	32% below	50%
Complete blood count (CBC) with differential CPT 85025 OC-CBC	$11.50	$23.00	$5.75–$56.75	77% below	50%
Complete blood count (CBC) with differential CPT 85025 Direct Pay CBC w/PLT Auto diff	$16.50	$33.00	$6.99–$56.75	68% below	50%
Complete blood count (CBC) with differential CPT 85025 CBC w/PLT w/AUTO DIFF	$54.00	$108.00	$6.99–$91.80	6% above	50%
Complete blood count (CBC), no differential CPT 85027 CBC w/PLT	$54.00	$108.00	$5.82–$91.80	1% above	50%
Comprehensive metabolic panel (blood test) CPT 80053 OC-CMP	$15.25	$30.50	$7.63–$77.20	88% below	50%
Comprehensive metabolic panel (blood test) CPT 80053 METABOLIC PANEL COMPREHENSIVE	$93.00	$186.00	$9.50–$158.10	26% below	50%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER QUANT	$145.75	$291.50	$9.16–$247.78	16% above	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$132.50	$265.00	$20.01–$225.25	1% below	50%
Estradiol blood test CPT 82670 ESTRADIOL (E2)	$153.75	$307.50	$25.15–$261.38	7% above	50%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE	$102.75	$205.50	$16.72–$174.68	1% above	50%
Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN	$227.50	$455.00	$17.67–$386.75	22% above	50%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$104.75	$209.50	$12.27–$178.08	21% above	50%
Folate (folic acid) blood test CPT 82746 FOLIC ACID	$88.75	$177.50	$13.23–$150.88	10% above	50%
Free T3 thyroid hormone test CPT 84481 T3 FREE, SERUM	$70.00	$140.00	$15.25–$123.70	28% below	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, FREE	$69.50	$139.00	$8.12–$118.15	6% below	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE BY DIRECT DIALYSIS	$86.50	$173.00	$8.12–$147.05	17% above	50%
Free testosterone test CPT 84402 TESTOSTERONE FREE, SERUM	$132.50	$265.00	$22.92–$225.25	6% above	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$324.25	$648.50	$55.00–$577.17	14% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1 HR	$38.75	$77.50	$4.28–$65.88	9% below	50%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE (PREG)	$112.75	$225.50	$11.58–$191.68	24% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE	$35.25	$70.50	$17.63–$256.25	56% below	50%
H. pylori antibody blood test CPT 86677 H. pylori AB IgG QUANT	$123.25	$246.50	$15.17–$209.53	59% above	50%
H. pylori antibody blood test CPT 86677 H. pylori AB IgA	$123.25	$246.50	$15.17–$209.53	59% above	50%
H. pylori antibody blood test CPT 86677 H. PYLORI AB WESTERN BLOT EACH	$123.25	$246.50	$15.17–$209.53	59% above	50%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI AB IgM	$123.25	$246.50	$15.17–$209.53	59% above	50%
H. pylori antibody blood test CPT 86677 H. pylorii IgG Qual	$123.25	$246.50	$15.17–$209.53	59% above	50%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI AG	$76.75	$153.50	$12.94–$130.48	36% below	50%
H. pylori stool antigen test CPT 87338 H.PYLORI AG	$170.75	$341.50	$12.94–$290.28	42% above	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA QN PCR V1.5	$273.75	$547.50	$55.00–$621.20	22% below	50%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1/2 SCREEN/RESCREEN	$93.25	$186.50	$12.34–$158.53	15% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 AB w/p 24 AG	$90.50	$181.00	$21.67–$161.09	4% above	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HUMAN PAPILLOMAVIRUS EACH	$52.00	$104.00	$26.00–$201.18	54% below	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN (Hgb) A1C	$59.50	$119.00	$8.74–$101.15	3% below	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB QNT	$8.25	$16.50	$4.13–$78.40	88% below	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB	$68.75	$137.50	$9.67–$116.88	3% above	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG	$67.00	$134.00	$9.30–$113.90	6% above	50%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB	$30.75	$61.50	$12.84–$104.20	62% below	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPTIMAX TM HCV RNA	$170.75	$341.50	$38.56–$312.70	39% below	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRUS AB RNA	$170.75	$341.50	$38.56–$312.70	39% below	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QNT REAL TIME PCR	$170.75	$341.50	$38.56–$312.70	39% below	50%
Herpes blood test, HSV-1 antibody CPT 86695 HSV I IgG AB	$83.75	$167.50	$11.87–$142.38	31% above	50%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IgM AB	$83.75	$167.50	$11.87–$142.38	31% above	50%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IgG INHIBITION ELISA	$112.75	$225.50	$17.42–$191.68	86% above	50%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IgM AB	$112.75	$225.50	$17.42–$191.68	86% above	50%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IgG, HERPESELECT AB	$112.75	$225.50	$17.42–$191.68	86% above	50%
Herpes blood test, HSV-2 antibody CPT 86696 HSV II IgG AB	$112.75	$225.50	$17.42–$191.68	86% above	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO CRP	$110.50	$221.00	$11.66–$187.85	53% above	50%
Homocysteine blood test CPT 83090 CARDIO IQ HOMOCYSTEINE	$47.00	$94.00	$16.13–$123.15	57% below	50%
Homocysteine blood test CPT 83090 HYMOCYSTEINE	$114.75	$229.50	$16.13–$195.08	5% above	50%
Homocysteine blood test CPT 83090 HOMOCYSTEINE SERUM	$130.00	$260.00	$16.13–$221.00	19% above	50%
Homocysteine blood test CPT 83090 HOMOCYSTEINE URINE	$188.25	$376.50	$16.13–$320.03	72% above	50%
Insulin blood test CPT 83525 INSULIN	$69.75	$139.50	$10.29–$118.58	17% above	50%
Iron blood test (serum iron) CPT 83540 IRON SERUM	$51.50	$103.00	$5.82–$87.55	12% above	50%
Iron blood test (serum iron) CPT 83540 FE TIBC	$51.50	$103.00	$5.82–$87.55	12% above	50%
Iron-binding capacity (TIBC) test CPT 83550 FE TOTAL BINDING CAPACITY	$57.25	$114.50	$7.87–$97.33	15% below	50%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$110.50	$221.00	$7.81–$187.85	2% above	50%
LH (luteinizing hormone) test CPT 83002 LUTEININZING HORMONE (LH)	$102.75	$205.50	$16.67–$174.68	1% above	50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE RANDOM URINE	$93.00	$186.00	$6.20–$158.10	44% above	50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE SERUM	$93.00	$186.00	$6.20–$158.10	44% above	50%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$63.50	$127.00	$7.35–$107.95	49% below	50%
Lyme disease antibody test CPT 86618 LYME DISEASE EIA	$83.75	$167.50	$15.33–$142.38	10% below	50%
Magnesium blood test CPT 83735 MAGNESIUM SERUM	$49.50	$99.00	$6.03–$84.15	3% above	50%
Magnesium blood test CPT 83735 MAGNESIUM URINE	$49.50	$99.00	$6.03–$84.15	3% above	50%
Magnesium blood test CPT 83735 RBC MAGNESIUM	$49.50	$99.00	$6.03–$84.15	3% above	50%
Measles (rubeola) antibody test CPT 86765 MEASLES IGG	$8.00	$16.00	$4.00–$94.05	86% below	50%
Measles (rubeola) antibody test CPT 86765 MEASLES AB IgM	$98.50	$197.00	$11.59–$167.45	67% above	50%
Measles (rubeola) antibody test CPT 86765 MEASLES IgG AB (RUBEOLA)	$98.50	$197.00	$11.59–$167.45	67% above	50%
Mono test (heterophile antibody, Monospot) CPT 86308 MONONUCLEOSIS SCREEN	$55.50	$111.00	$4.66–$94.35	34% above	50%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$295.25	$590.50	$43.03–$525.55	at median	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$138.25	$276.50	$16.55–$235.03	74% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$94.25	$188.50	$16.55–$160.23	20% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA FREE TOTAL	$94.25	$188.50	$16.55–$160.23	20% above	50%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH C/V AUTO THIN LAYER	$98.75	$197.50	$23.95–$167.88	33% above	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SMHW-CYTOPATH C/V AUTO THIN	$12.50	$25.00	$6.25–$110.25	83% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V AUTO W/ RESCREEN	$79.25	$158.50	$18.23–$134.73	8% above	50%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$219.00	$438.00	$37.15–$372.30	28% above	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$55.50	$111.00	$5.41–$94.35	at median	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT (LAC) SCREEN	$55.50	$111.00	$5.41–$94.35	at median	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT ACTIVATED	$55.50	$111.00	$5.41–$94.35	at median	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT APC-RESISTANCE	$55.50	$111.00	$5.41–$94.35	at median	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 STACLOT-LA PTT I	$55.50	$111.00	$5.41–$94.35	at median	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 STACLOT-LA PTT II	$55.50	$111.00	$5.41–$94.35	at median	50%
Progesterone blood test CPT 84144 PROGESTERONE	$74.50	$149.00	$18.77–$152.30	32% below	50%
Prolactin blood test CPT 84146 PROLACTIN	$86.00	$172.00	$17.44–$146.20	22% below	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$37.00	$74.00	$3.86–$62.90	28% above	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREENING COLLECTION	$11.03	$22.05	$5.51–$59.20	84% below	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 10 PANEL DRUG SCREEN	$13.53	$27.05	$6.76–$59.20	80% below	50%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA TESTING	$17.50	$35.00	$8.75–$87.60	70% below	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP	$34.00	$68.00	$14.88–$87.60	17% below	50%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR	$55.00	$110.00	$5.10–$93.50	12% above	50%
Rheumatoid factor (RF) test CPT 86431 RA FACTOR QUANTITATIVE	$55.00	$110.00	$5.10–$93.50	12% above	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB, IgG Immune Status	$102.75	$205.50	$12.95–$174.68	100% above	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IgM AB	$102.75	$205.50	$12.95–$174.68	100% above	50%
Stool ova and parasites exam CPT 87177 OVA & PARASITES STOOL	$69.00	$138.00	$8.01–$117.30	20% above	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL	$5.00	$10.00	$2.50–$55.00	77% below	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLOOD OCCULT	$9.00	$18.00	$3.94–$55.00	58% below	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL 3 SPECIMENS	$33.75	$67.50	$3.94–$57.38	57% above	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL/EMESIS GUIAC PROCEDURE	$35.00	$70.00	$3.94–$59.50	63% above	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL GLOBIN	$55.00	$110.00	$14.33–$116.10	8% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL SERUM	$40.50	$81.00	$4.09–$68.85	37% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF	$40.50	$81.00	$4.09–$68.85	37% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR (RAPID PLASMA REAGIN)	$40.50	$81.00	$4.09–$68.85	37% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANIFERON GOLD	$43.00	$86.00	$21.50–$452.45	77% below	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$150.75	$301.50	$55.00–$452.45	21% below	50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL, SERUM	$132.50	$265.00	$23.23–$225.25	11% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB	$89.50	$179.00	$13.10–$152.15	17% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOMAL IgG	$89.50	$179.00	$13.10–$152.15	17% above	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 NEO TSH	$27.00	$54.00	$13.50–$122.65	40% below	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH, ULTRASENSITIVE	$86.00	$172.00	$15.12–$146.20	92% above	50%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS	$42.00	$84.00	$21.00–$207.72	70% below	50%
Trichomonas test (NAAT) CPT 87661 SURESWAB TRICHOMONAS RNA	$137.00	$274.00	$31.58–$243.86	1% below	50%
Uric acid blood test CPT 84550 URIC ACID, SERUM	$47.50	$95.00	$4.07–$80.75	13% above	50%
Urinalysis with microscope exam, automated CPT 81001 OC-UA W/MICRO	$10.00	$20.00	$2.85–$55.00	71% below	50%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS	$40.00	$80.00	$2.85–$68.00	14% above	50%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS WITH MICROSCOPY	$12.00	$24.00	$3.62–$451.80	56% below	50%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, MACRO ONLY	$28.50	$57.00	$2.03–$55.00	27% above	50%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$6.50	$13.00	$3.13–$55.00	52% below	50%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NON-AUTO MACRO	$27.00	$54.00	$3.13–$55.00	100% above	50%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE	$67.00	$134.00	$7.26–$113.90	at median	50%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST	$21.50	$43.00	$8.26–$55.00	56% below	50%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$99.50	$199.00	$13.57–$169.15	29% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D,25 HYDROXY	$153.75	$307.50	$26.64–$261.38	6% above	50%
Zinc blood test CPT 84630 ZINC	$91.50	$183.00	$10.25–$155.55	50% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA hCG	$40.25	$80.50	$13.55–$68.43	53% below	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE	$108.00	$216.00	$13.55–$183.60	27% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT TUMOR MARKER	$108.00	$216.00	$13.55–$183.60	27% above	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY	$1,140.50	$2,281.00	$451.80–$2,030.09	20% below	50%
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$990.50	$1,981.00	$451.80–$1,763.09	11% below	50%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 KNEE ARTHRO/SURGERY	$1,038.50	$2,077.00	$451.80–$1,848.53	94% below	50%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 D&S ARTHRO SHOULDER	$1,111.00	$2,222.00	$451.80–$1,977.58	88% below	50%
Balloon dilation of the maxillary sinus opening, one side CPT 31295 NSL/SINS NDSC SURG MAX SINS	$976.50	$1,953.00	$451.80–$1,738.17	84% below	50%
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$140.00	$280.00	$70.00–$451.80	47% below	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LESION STRTCTC	$671.00	$1,342.00	$335.50–$1,194.38	74% below	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Stereo guided breast biopsy	$1,620.00	$3,240.00	$235.00–$2,883.60	36% below	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 FX DISTAL FIBULA W/O MANIP	$216.50	$433.00	$108.25–$385.37	57% below	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE	$371.50	$743.00	$185.75–$661.27	26% below	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 FX DISTAL FIBULA W/0 MANIP	$431.00	$862.00	$317.98–$775.80	14% below	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 FX METATARSAL, EACH W/O MANIP	$173.25	$346.50	$224.62–$311.85	54% below	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CL TX METATARSAL FX W/O MANIP	$300.00	$600.00	$150.00–$534.00	20% below	50%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECTION HALLUX VALGUS	$1,078.50	$2,157.00	$451.80–$1,919.73	55% below	50%
Bunion correction with removal of part of the big toe joint CPT 28292 CORRECTION HALLUX VALGUS	$750.00	$1,500.00	$375.00–$1,335.00	36% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$155.00	$310.00	$77.50–$451.80	80% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION PHYS FEE	$478.00	$956.00	$125.27–$860.40	38% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$602.50	$1,205.00	$301.25–$1,356.00	22% below	50%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$442.00	$884.00	$221.00–$786.76	87% below	50%
Cervical biopsy CPT 57500 CERVICAL BIOPSY ONLY	$210.00	$420.00	$105.00–$451.80	66% below	50%
Cesarean delivery, including prenatal and postpartum care CPT 59510 OB & ANTEPARTUM C-SECTION & PP	$2,515.00	$5,030.00	$451.80–$4,476.70	28% below	50%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUM 28 DAYS OR OLDER	$213.50	$427.00	$106.75–$451.80	92% below	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION NEWBORN	$105.00	$210.00	$52.50–$451.80	71% below	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 FX, RADIAL DISTAL W/O MANIP	$216.50	$433.00	$108.25–$385.37	63% below	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FRACTURE RADIUS/ULNA	$336.00	$672.00	$168.00–$598.08	42% below	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 FX, RADIAL DISTAL W/0 MANIP	$431.00	$862.00	$345.80–$775.80	26% below	50%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/LESION REMOVAL	$867.00	$1,734.00	$433.50–$1,543.26	49% below	50%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY WITH BIOPSY	$769.50	$1,539.00	$384.75–$1,369.71	57% below	50%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY	$647.50	$1,295.00	$323.75–$1,152.55	49% below	50%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE LEEP	$796.00	$1,592.00	$398.00–$1,416.88	64% below	50%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY WITH BIOPSY AND EEC	$292.00	$584.00	$146.00–$519.76	17% below	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$274.50	$549.00	$137.25–$488.61	73% below	50%
D&C (dilation and curettage), not related to pregnancy CPT 58120 D&C NONOBSTETRICAL	$632.50	$1,265.00	$316.25–$1,125.85	82% below	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT BENGN/LESION/WART 1ST	$110.00	$220.00	$55.00–$451.80	5% below	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUC PREMALIG LESIONS, 1ST	$207.25	$414.50	$53.11–$373.05	79% above	50%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMIES W/TUBE GEN ANES	$166.50	$333.00	$83.25–$451.80	95% below	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING	$202.50	$405.00	$101.25–$451.80	51% below	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$13.00	$26.00	$6.50–$451.80	82% below	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMPAC CERUMEN W/IRIG/LAV U	$106.25	$212.50	$14.50–$191.25	49% above	50%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED WAX INSTRMT	$53.00	$106.00	$26.50–$451.80	42% below	50%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACT CERUMEN EAR	$80.00	$160.00	$38.51–$144.00	13% below	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BIOPSY	$197.50	$395.00	$98.75–$451.80	23% below	50%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 NSL/SINS NDSC W/TOT ETHMDCT	$428.00	$856.00	$214.00–$761.84	95% below	50%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NSL/SINS NDSC FRNT TISS RMVL	$412.00	$824.00	$206.00–$733.36	95% below	50%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 NASAL ENDO W/ MAX ANTROSTOMY	$210.50	$421.00	$105.25–$451.80	93% below	50%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 ENDOSCOPY MAXILLARY SINUS	$339.50	$679.00	$169.75–$604.31	96% below	50%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR AA HRN 1ST 3-10CM RDC	$549.50	$1,099.00	$274.75–$978.11	75% below	50%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 REPAIR AA HRN 1ST > 10 RDC	$739.00	$1,478.00	$369.50–$1,315.42	79% below	50%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR AA HRN 1ST <3CM RDC	$327.00	$654.00	$163.50–$582.06	73% below	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY	$169.00	$338.00	$84.50–$451.80	84% below	50%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$878.50	$1,757.00	$439.25–$4,765.00	85% below	50%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH	$690.30	$1,380.60	$345.15–$4,765.00	89% below	50%
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY	$1,120.00	$2,240.00	$451.80–$1,993.60	39% below	50%
Hammertoe correction surgery CPT 28285 CORRECTION HAMMERTOE	$635.50	$1,271.00	$317.75–$1,131.19	73% below	50%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDAL BANDING	$345.00	$690.00	$172.50–$614.10	69% below	50%
Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVE INT/EXT HEM 1 GROUP	$599.00	$1,198.00	$299.50–$1,066.22	85% below	50%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 TOTAL HIP ARTHROPLASTY	$3,154.50	$6,309.00	$451.80–$5,615.01	6% above	50%
Hysterectomy through an abdominal incision (total) CPT 58150 HYST ABDOMINAL TAH	$2,055.00	$4,110.00	$451.80–$3,657.90	77% below	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HYSTEROSALPINGOGRAPHY	$195.00	$390.00	$97.50–$451.80	24% below	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH & INTRO NS/CONT MAT	$206.25	$412.50	$103.13–$367.13	19% below	50%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ENDO ABLATION	$1,536.50	$3,073.00	$451.80–$2,734.97	74% below	50%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY W/BX OR POLYP	$409.50	$819.00	$204.75–$728.91	89% below	50%
IUD insertion (the device itself billed separately) CPT 58300 IUD INSERT	$201.50	$403.00	$100.75–$451.80	52% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D SIMPLE SQ CYST ABSCESS	$116.50	$233.00	$58.25–$207.37	48% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D SIMPLE SQ/CYST/ABCESS	$184.75	$369.50	$100.08–$332.55	18% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMP/SINGLE	$188.00	$376.00	$94.00–$451.80	16% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABSCESS (SIMPLE)	$291.50	$583.00	$145.75–$518.87	30% above	50%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PRP I/HERN INIT REDUC >5 YR	$636.00	$1,272.00	$318.00–$1,132.08	90% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$81.50	$163.00	$40.75–$451.80	64% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SINGLE TENDON/LIGAMENT	$166.50	$333.00	$45.62–$299.70	26% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Single Tendon/Ligament	$233.00	$466.00	$116.50–$414.74	4% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION OR INJECTION JOINT	$75.50	$151.00	$37.75–$451.80	71% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 MAJOR JOINT ARTHROCE/INJ BURSA	$116.50	$233.00	$58.25–$207.37	55% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS/INJ MAJ JT	$184.75	$369.50	$52.81–$332.55	29% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$244.25	$488.50	$122.13–$434.77	6% below	50%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DLVR IMPLANT	$159.50	$319.00	$79.75–$451.80	4% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INTERMED JNT ARTHRO/INJ BURSA	$79.25	$158.50	$39.63–$141.07	68% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTERM JOINT	$83.00	$166.00	$41.50–$451.80	66% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INTER(TMJ/AC/WRIST/ELB/AN	$125.50	$251.00	$43.39–$225.90	49% below	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$76.00	$152.00	$38.00–$451.80	68% below	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 SM JOINT ARTHROCENT/INJ BURSA	$110.00	$220.00	$41.82–$198.00	53% below	50%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 KNEE ARTHRO/SURGERY	$744.50	$1,489.00	$372.25–$1,325.21	93% below	50%
Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTH W/MENISC W/ SHAVING	$1,102.00	$2,204.00	$451.80–$1,961.56	83% below	50%
Knee arthroscopy with removal of both torn meniscus parts both sides CPT 29880 KNEE ARTHRO W/MENISCCTMY BILAT	$2,492.00	$4,984.00	$451.80–$4,435.76	—	50%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHRO W/MENISCECTOMY	$1,246.00	$2,492.00	$451.80–$2,217.88	82% below	50%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 KNEE ARTHRO/SURGERY	$649.50	$1,299.00	$324.75–$1,156.11	86% below	50%
Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 Lapgastric bypass/rouv-en-y	$1,656.50	$3,313.00	$451.80–$2,948.57	93% below	50%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY,SURG,APPENDECTOMY	$654.00	$1,308.00	$327.00–$1,164.12	92% below	50%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 Laparpscopy esophagogastric	$1,027.00	$2,054.00	$451.80–$1,828.06	88% below	50%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 TLH UTERUS 250 G OR LESS	$843.00	$1,686.00	$421.50–$1,500.54	94% below	50%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 TLH W/T/O 250 G OR LESS	$971.50	$1,943.00	$451.80–$1,729.27	94% below	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP ING HERNIA REPAIR INIT	$410.50	$821.00	$205.25–$730.69	93% below	50%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 Lap ing hernia repair	$525.00	$1,050.00	$262.50–$934.50	94% below	50%
Laparoscopic removal of fallopian tubes and/or ovaries both sides CPT 58661 LAPSCOPY REMOVE ADNEXA BILAT	$1,400.00	$2,800.00	$451.80–$2,492.00	—	50%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY/REM ADNEXAL STRCTR	$700.00	$1,400.00	$350.00–$1,246.00	93% below	50%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 Lap Sleeve Gastrectomy	$1,060.00	$2,120.00	$451.80–$1,886.80	95% below	50%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 IRIDOCAPSULOTOMY BY LASER	$818.75	$1,637.50	$409.38–$1,457.38	12% above	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$140.00	$280.00	$70.00–$451.80	63% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC, INTERMEDIATE 0-2.5 CM	$270.00	$540.00	$135.00–$480.60	29% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMED REPAIR:0-2.5cm	$370.25	$740.50	$152.95–$666.45	3% below	50%
Lower-back epidural injection, without imaging guidance CPT 62322 Inj, Dx OR Therap Sub Lmbr/SAC	$490.00	$980.00	$97.63–$882.00	54% below	50%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LAMINOTOMY ONE INTERSPACE	$1,754.00	$3,508.00	$451.80–$3,122.12	84% below	50%
Lumpectomy (partial mastectomy) both sides CPT 19301 MASTECTOMY, PARTIAL BILAT	$1,415.00	$2,830.00	$451.80–$2,518.70	—	50%
Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY,PARTIAL	$707.50	$1,415.00	$353.75–$1,259.35	44% below	50%
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY, SIMPLE, COMPLETE	$1,040.00	$2,080.00	$451.80–$1,851.20	26% below	50%
Miscarriage treatment with D&C, first trimester CPT 59820 D&C MISSED ABORT SURGICAL	$414.00	$828.00	$207.00–$736.92	90% below	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$190.00	$380.00	$95.00–$451.80	23% below	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/<	$219.00	$438.00	$109.50–$451.80	38% below	50%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL	$124.75	$249.50	$62.38–$222.06	35% below	50%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$133.50	$267.00	$66.75–$451.80	30% below	50%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE, PART	$198.75	$397.50	$56.86–$357.75	4% above	50%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV	$81.50	$163.00	$40.75–$451.80	78% below	50%
Partial knee replacement (one compartment) CPT 27446 ARTHROPLASTY UNICOMPART KNEE	$1,225.50	$2,451.00	$451.80–$2,181.39	83% below	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL EX PARTIAL/COMPLETE	$105.00	$210.00	$52.50–$186.90	77% below	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL EXCISION PART/COMPLE	$166.50	$333.00	$103.31–$299.70	63% below	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$245.00	$490.00	$122.50–$451.80	46% below	50%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$599.00	$1,198.00	$299.50–$1,066.22	44% below	50%
Removal of a foreign object under the skin, simple CPT 10120 SQ RFB, SIMPLE	$98.50	$197.00	$49.25–$175.33	66% below	50%
Removal of a foreign object under the skin, simple CPT 10120 SQ, SIMPLE	$155.25	$310.50	$102.35–$279.45	47% below	50%
Removal of a foreign object under the skin, simple CPT 10120 INCISION&REM FB SUBQ TISS SIMP	$186.50	$373.00	$93.25–$451.80	36% below	50%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 PARTIAL REMOVAL OF THYROID	$753.00	$1,506.00	$376.50–$1,340.34	93% below	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 MEDICARE COLONOSCOPY SCREENING	$647.50	$1,295.00	$323.75–$1,152.55	20% below	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLAN CX SCREEN,HIGH RISK	$599.00	$1,198.00	$299.50–$1,066.22	22% below	50%
Septoplasty to straighten the nasal septum CPT 30520 SEPTOPLASTY	$623.50	$1,247.00	$311.75–$1,109.83	91% below	50%
Shock-wave lithotripsy to break up kidney stones (from outside the body) both sides CPT 50590 FRAGMENTING KIDNEY STONE BILAT	$815.00	$1,630.00	$407.50–$1,450.70	—	50%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY	$725.00	$1,450.00	$362.50–$1,290.50	89% below	50%
Short arm cast (elbow to hand) CPT 29075 Application Short Arm Cast	$88.50	$177.00	$44.25–$157.53	64% below	50%
Short arm splint (forearm and hand) CPT 29125 Apply Forearm Splint	$60.00	$120.00	$30.00–$106.80	59% below	50%
Short leg cast (below the knee) CPT 29405 Application Of Short Leg Cast	$105.00	$210.00	$52.50–$186.90	59% below	50%
Short leg splint (calf to foot) CPT 29515 Application Lower Leg Splint	$75.50	$151.00	$37.75–$134.39	54% below	50%
Short leg splint (calf to foot) CPT 29515 SPLINT APP SHORT LEG	$87.75	$175.50	$56.04–$157.95	47% below	50%
Short leg splint (calf to foot) CPT 29515 Splint App Short Leg	$287.75	$575.50	$143.88–$512.20	74% above	50%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 SHO ARTHRS SRG DSTL CLAVICLC	$695.00	$1,390.00	$103.00–$1,237.10	92% below	50%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHO ARTHRS SRG DECOMPRESSION	$188.50	$377.00	$94.25–$451.80	99% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LACERATIN SIMPLE, 0-2.5CM	$242.25	$484.50	$121.13–$431.21	8% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$258.50	$517.00	$129.25–$460.13	15% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR:0-2.5 cm	$308.75	$617.50	$47.07–$555.75	37% above	50%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$124.50	$249.00	$62.25–$451.80	53% below	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM/<	$200.00	$400.00	$100.00–$451.80	42% below	50%
Skin tag removal, up to 15 tags CPT 11200 Removal of skin tags, up to 15	$131.50	$263.00	$65.75–$451.80	8% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR SPINE PUNCTURE	$332.75	$665.50	$72.50–$598.95	36% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR SPINAL PUNCTURE	$456.75	$913.50	$228.38–$813.02	12% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$456.75	$913.50	$72.50–$822.15	12% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LACERATION, SIMPLE 2.6-7.5 CM	$242.25	$484.50	$121.13–$431.21	11% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$275.50	$551.00	$137.75–$490.39	1% above	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR:2.6-7.5cm	$370.25	$740.50	$62.80–$666.45	36% above	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC, SIMPLE FACE 0-2.5 CM	$242.25	$484.50	$121.13–$431.21	5% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR:0-2.5cm	$294.00	$588.00	$59.16–$529.20	15% above	50%
TURP (transurethral resection of the prostate) CPT 52601 PROSTATECTOMY (TURP)	$481.50	$963.00	$240.75–$857.07	94% below	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$94.00	$188.00	$47.00–$451.80	52% below	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY (SKIN, SUBCUTANEOUS)	$385.00	$770.00	$192.50–$685.30	97% above	50%
Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS AND ADENOIDS	$319.00	$638.00	$159.50–$567.82	92% below	50%
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS AND ADENOIDS	$307.50	$615.00	$153.75–$547.35	92% below	50%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY 12 AND OVER	$265.00	$530.00	$132.50–$471.70	92% below	50%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 TONSILLECTOMY UNDER 12 Y/O	$252.50	$505.00	$126.25–$451.80	89% below	50%
Total hip replacement CPT 27130 TOTAL HIP REPLACEMENT	$1,436.00	$2,872.00	$451.80–$2,556.08	59% below	50%
Total knee replacement CPT 27447 TOTAL KNEE REPLACEMENT	$1,436.00	$2,872.00	$451.80–$2,556.08	68% below	50%
Total shoulder replacement CPT 23472 TOTAL SHLDR REPLACEMENT	$1,541.00	$3,082.00	$451.80–$2,742.98	84% below	50%
Total thyroid removal (thyroidectomy) CPT 60240 THROIDECTOMY, TOTAL/COMPLETE	$983.00	$1,966.00	$451.80–$1,749.74	93% below	50%
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH	$569.50	$1,139.00	$284.75–$1,013.71	64% below	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$49.00	$98.00	$24.50–$451.80	76% below	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ, 1 0R 2 MUSCLE TRIGGER PT	$166.50	$333.00	$44.35–$299.70	19% below	50%
Trigger point injections, 1 or 2 muscles CPT 20552 Inj, 1 0R 2 Muscle Trigger Pt	$380.25	$760.50	$190.13–$676.85	86% above	50%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY/TUBAL/FULG	$1,396.50	$2,793.00	$451.80–$2,485.77	10% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG	$658.00	$1,316.00	$329.00–$1,171.24	62% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Breast bx w/clip using US	$2,288.00	$4,576.00	$386.00	31% above	50%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH EGD DILATION <30 MM	$444.00	$888.00	$222.00–$790.32	82% below	50%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD WITH BIOPSY	$259.00	$518.00	$129.50–$461.02	85% below	50%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE	$450.00	$900.00	$225.00–$801.00	78% below	50%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD	$172.00	$344.00	$86.00–$451.80	83% below	50%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTO WITH LITHOTRIPSY	$429.50	$859.00	$214.75–$764.51	92% below	50%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 VBAC DELIVERY	$1,979.00	$3,958.00	$451.80–$3,522.62	22% below	50%
Vaginal delivery, including prenatal and postpartum care CPT 59400 OBSTETRICAL CARE	$2,266.00	$4,532.00	$451.80–$4,033.48	7% below	50%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S)	$326.50	$653.00	$163.25–$581.17	74% below	50%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14	$153.00	$306.00	$76.50–$451.80	5% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$123.50	$247.00	$61.75–$451.80	68% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SUBQ TISSUE 1ST 20 CM	$990.50	$1,981.00	$495.25–$1,763.09	158% above	50%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 TREAT FX RAD EXTRA-ARTICUL	$769.50	$1,539.00	$384.75–$1,369.71	85% below	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion admin	$769.75	$1,539.50	$384.88–$1,370.16	27% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Tx Acute Episode	$38.50	$77.00	$8.35–$451.80	72% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM SPEC INDUCTION	$42.00	$84.00	$8.35–$141.00	70% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB TX, SUB	$97.25	$194.50	$8.35–$165.33	30% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB TX, INITIAL	$133.25	$266.50	$8.35–$226.53	5% below	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$538.50	$1,077.00	$182.00–$958.53	25% above	50%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$306.00	$612.00	$153.00–$544.68	78% below	50%
Critical care, first 30 to 74 minutes CPT 99291 ER CRITICAL CARE EVAL	$454.50	$909.00	$192.17–$818.10	67% below	50%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care Initial 30-74min	$893.75	$1,787.50	$446.88–$3,662.00	34% below	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 ROUTINE EEG	$546.00	$1,092.00	$245.12–$928.20	21% below	50%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Electrocardiogram complete	$13.00	$26.00	$6.50–$451.80	78% below	50%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 OCC MED EKG	$42.25	$84.50	$21.13–$256.00	30% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG FACILITY	$92.75	$185.50	$10.36–$256.00	51% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$31.00	$62.00	$15.50–$451.80	79% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER PHYS FEE: MINOR	$79.00	$158.00	$18.40–$142.20	46% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 E.R. CATEGORY #1	$199.25	$398.50	$99.63–$476.00	37% above	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM	$42.00	$84.00	$21.00–$451.80	85% below	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER PHYS: LIMITED	$146.25	$292.50	$35.88–$263.25	48% below	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 E.R. CATEGORY #2	$292.00	$584.00	$146.00–$637.00	4% above	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$93.50	$187.00	$46.75–$451.80	81% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER PHYSCIAN:INTERMEDIATE	$180.25	$360.50	$53.69–$324.45	63% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 E.R. CATEGORY #3	$419.25	$838.50	$209.63–$864.00	14% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$224.50	$449.00	$112.25–$451.80	70% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER PHYSCIAN:EXTENDED	$298.00	$596.00	$101.89–$536.40	60% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 E.R. CATEGORY #4	$664.00	$1,328.00	$332.00–$1,368.00	10% below	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM	$172.50	$345.00	$86.25–$451.80	85% below	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER PHYS. COMPREHENSIVE	$367.00	$734.00	$150.14–$660.60	68% below	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 E.R. CATEGORY #5	$902.75	$1,805.50	$451.38–$3,662.00	21% below	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$403.50	$807.00	$51.91–$685.95	48% below	50%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY CONJOIN W PT	$82.50	$165.00	$41.25–$451.80	54% below	50%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PT 50 MIN	$66.00	$132.00	$33.00–$451.80	71% below	50%
Group psychotherapy session CPT 90853 GROUP THERAPY	$103.00	$206.00	$51.50–$451.80	51% below	50%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 ECG MONIT/REPRT UP TO 48 HRS	$67.50	$135.00	$33.75–$451.80	31% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$47.50	$95.00	$23.75–$451.80	81% below	50%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$61.15	$122.30	$30.58–$451.80	79% below	50%
IV infusion of a medicine, first hour CPT 96365 INFUSION, TPD, INITIAL	$527.50	$1,055.00	$117.00–$938.95	83% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$13.00	$26.00	$6.50–$451.80	86% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM/SQ (MUE=5)	$202.75	$405.50	$101.38–$360.90	118% above	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$107.50	$215.00	$53.75–$451.80	46% below	50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV CNDJ TEST 7-8 STUDIES	$198.50	$397.00	$55.96–$451.80	56% below	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO-MUSCULAR RE-EDUCATION	$55.75	$111.50	$27.88–$200.00	38% below	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATION	$57.50	$115.00	$28.75–$192.00	36% below	50%
Neuromuscular re-education, 15 minutes CPT 97112 Neuro-Muscular Re-Ed 30 min	$111.50	$223.00	$55.75–$200.00	24% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Re-Edu 30 min	$115.00	$230.00	$57.50–$204.70	28% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 Neuro-Muscular Re-Ed 45 min	$166.50	$333.00	$83.25–$296.37	85% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Re-Edu 45 min	$172.25	$344.50	$86.13–$306.61	91% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 Neuro-Muscular Re-Ed 60 min	$222.25	$444.50	$102.00–$395.61	147% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Re-Edu 60 min	$229.50	$459.00	$114.75–$408.51	155% above	50%
New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30-44 MIN	$101.50	$203.00	$50.75–$451.80	23% below	50%
New patient office visit, about 30 minutes CPT 99203 NP 3-INTERMEDIATE OP	$240.25	$480.50	$120.13–$427.65	81% above	50%
New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45-59 MIN	$156.00	$312.00	$78.00–$451.80	12% below	50%
New patient office visit, about 45 minutes CPT 99204 NP 4-EXTENDED OP	$327.00	$654.00	$163.50–$582.06	85% above	50%
New patient office visit, about 60 minutes CPT 99205 OFFICE O/P NEW HI 60-74 MIN	$198.00	$396.00	$99.00–$451.80	23% below	50%
New patient office visit, about 60 minutes CPT 99205 NP 5-COMPREHENSIVE OP	$413.75	$827.50	$206.88–$736.48	60% above	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15-29 MIN	$71.00	$142.00	$35.50–$451.80	17% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT 2-LIMITED OP	$161.50	$323.00	$80.75–$287.47	90% above	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN	$34.50	$69.00	$17.25–$451.80	14% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT OP INITIAL, EA 15 MIN	$42.25	$84.50	$21.13–$80.00	6% above	50%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL, Low Complex 30 min	$87.75	$175.50	$43.88–$200.00	36% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL, High Complex 45 min	$135.75	$271.50	$67.88–$230.78	19% below	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL, Low Complexity 20 min	$60.75	$121.50	$30.38–$192.00	51% below	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL, Moderate Comp 30 min	$90.50	$181.00	$45.25–$192.00	41% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MYOFASCIAL TRIGGER POINT	$38.00	$76.00	$19.00–$451.80	53% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY - 15 MINUTES	$64.00	$128.00	$32.00–$192.00	22% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY	$64.00	$128.00	$32.00–$200.00	22% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy - 30 Minutes	$128.00	$256.00	$64.00–$227.84	57% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy - 45 Minutes	$192.00	$384.00	$96.00–$341.76	135% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy - 60 Minutes	$255.50	$511.00	$127.75–$454.79	213% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE	$52.50	$105.00	$26.25–$192.00	32% below	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise 30 min	$104.75	$209.50	$52.38–$192.00	37% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise 45 min	$157.25	$314.50	$78.63–$279.91	105% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise 60 min	$209.25	$418.50	$104.63–$372.47	173% above	50%
Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW AGE 18-39	$151.50	$303.00	$75.75–$451.80	8% above	50%
Preventive checkup, new patient aged 40–64 CPT 99386 PREV VISIT NEW AGE 40-64	$165.00	$330.00	$82.50–$451.80	at median	50%
Preventive checkup, new patient aged 65 or older CPT 99387 INIT PM E/M NEW PAT 65+ YRS	$186.50	$373.00	$93.25–$451.80	13% above	50%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREV VISIT EST AGE 18-39	$126.00	$252.00	$63.00–$451.80	1% above	50%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREV VISIT EST AGE 40-64	$137.50	$275.00	$68.75–$451.80	7% above	50%
Preventive checkup, returning patient aged 65 or older CPT 99397 PER PM REEVAL EST PAT 65+ YR	$156.50	$313.00	$78.25–$451.80	9% above	50%
Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL W/MED SRVCS	$170.00	$340.00	$85.00–$451.80	at median	50%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$85.50	$171.00	$42.75–$451.80	50% below	50%
Psychotherapy session, 30 minutes CPT 90832 PSYTX W PT 30 MINUTES	$67.50	$135.00	$33.75–$451.80	47% below	50%
Psychotherapy session, 45 minutes CPT 90834 PSYTX W PT 45 MINUTES	$89.00	$178.00	$44.50–$451.80	46% below	50%
Psychotherapy session, 60 minutes CPT 90837 PSYTX W PT 60 MINUTES	$107.50	$215.00	$53.75–$451.80	45% below	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Cessation Counseling	$14.00	$28.00	$7.00–$451.80	37% below	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking cessation 3-10 min	$47.50	$95.00	$23.75–$80.75	115% above	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE O/P EST HI 40-54 MIN	$138.50	$277.00	$69.25–$451.80	23% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20-29 MIN	$70.50	$141.00	$35.25–$451.80	33% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST OP VISIT 20-29 MINUTES	$317.25	$634.50	$158.63–$564.71	203% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30-39 MIN	$102.50	$205.00	$51.25–$451.80	27% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10-19 MIN	$42.00	$84.00	$21.00–$451.80	39% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST OP VISIT 10-19 MINUTES	$276.50	$553.00	$138.25–$492.17	303% above	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFF/OP CNSLTJ NEW/EST LOW 30	$139.00	$278.00	$69.50–$451.80	22% below	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 Anesthesia Consult 30-39 min	$156.00	$312.00	$78.00–$277.68	13% below	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFF/OP CNSLTJ NEW/EST MOD 40	$206.50	$413.00	$103.25–$451.80	16% below	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Anesthesia Consult 40-54 min	$248.75	$497.50	$124.38–$442.78	2% above	50%
Speech and language evaluation CPT 92523 SPEECH,LANG,AURAL REHAB EVAL	$136.00	$272.00	$68.00–$242.08	47% below	50%
Speech therapy session, individual CPT 92507 SPEECH/HEAR THPY	$255.00	$510.00	$102.00–$453.90	59% above	50%
Spirometry (breathing test) CPT 94010 PULMONARY FUNCTION TEST	$26.50	$53.00	$13.25–$451.80	88% below	50%
Spirometry (breathing test) CPT 94010 SPIROMETRY-VC,FVC,MVV	$129.25	$258.50	$15.75–$562.00	39% below	50%
Spirometry (breathing test) CPT 94010 PULM FUNC SPIROMETRY	$289.50	$579.00	$15.75–$562.00	36% above	50%
Spirometry before and after a bronchodilator CPT 94060 NIOSH-Spirometry	$55.75	$111.50	$27.14–$562.00	87% below	50%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY P & P	$255.50	$511.00	$27.14–$562.00	39% below	50%
Spirometry before and after a bronchodilator CPT 94060 PUL FUNC SP B&A BRON	$413.25	$826.50	$27.14–$702.53	1% below	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES	$51.50	$103.00	$25.75–$451.80	36% below	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities 30 min	$124.00	$248.00	$62.00–$220.72	55% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities 45 min	$185.25	$370.50	$92.63–$329.75	131% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities 60 min	$247.00	$494.00	$123.50–$439.66	208% above	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$234.50	$469.00	$117.00–$417.41	35% above	50%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 CARDIOVASCULAR STRESS TEST	$75.50	$151.00	$37.75–$451.80	44% below	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Covid Vaccine-Comirnaty	$104.50	$209.00	$52.25–$186.01	61% below	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE	$96.50	$193.00	$48.25–$171.77	41% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM	$20.00	$40.00	$10.00–$35.60	57% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU RX	$21.00	$42.00	$10.50–$37.38	55% below	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9	$157.50	$315.00	$78.75–$280.35	52% below	50%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A AND B VACCINE	$50.50	$101.00	$25.25–$85.85	43% below	50%
Hepatitis A vaccine, adult dose CPT 90632 HEP A ADULT VACCINE	$25.00	$50.00	$12.50–$42.50	67% below	50%
Hepatitis A vaccine, adult dose CPT 90632 HEP A VACCINE	$32.03	$64.05	$16.01–$57.00	58% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hep B Virus Vac/PF 1ml Vial	$239.50	$478.99	$119.75–$426.30	206% above	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 High Dose Flu Vac	$38.50	$77.00	$19.25–$68.53	61% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU HIGH DOSE	$39.00	$78.00	$19.50–$69.42	60% below	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC	$47.50	$95.00	$23.75–$451.80	70% below	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJUGATE	$100.00	$200.00	$50.00–$451.80	22% below	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB-4C VACC 2 DOSE IM	$142.00	$284.00	$71.00–$252.76	54% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR PNEUMOCOCCAL-20	$180.25	$360.50	$90.13–$320.85	64% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20	$210.00	$420.00	$105.00–$373.80	58% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMONIA RX	$59.00	$118.00	$29.50–$105.02	67% below	50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV Vac, Pref A&B/PF 0.5ml	$730.64	$1,461.27	$365.32–$1,300.53	38% above	50%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 PREFUSION F (RSV) VACCINE	$300.00	$600.00	$150.00–$534.00	34% below	50%
Rabies vaccine, one dose CPT 90675 Imovax Rabies Vacc .5 IU/Dose	$1,181.55	$2,363.10	$590.78–$2,103.16	36% above	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$30.00	$60.00	$15.00–$451.80	58% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP IMMUNIZ OVER 7 YEARS OLD	$42.50	$85.00	$21.25–$451.80	57% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX 0.5 ML VIAL	$161.38	$322.76	$80.69–$287.26	64% above	50%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE, VI CAPSULAR	$20.50	$41.00	$10.25–$36.49	82% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADMIN, SINGLE/MULTI TOXOID	$14.00	$28.00	$7.00–$24.92	74% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADM	$49.25	$98.50	$24.63–$87.67	10% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION INJ ADM	$49.25	$98.50	$24.63–$87.67	10% below	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD	$9.00	$18.00	$4.50–$16.02	80% below	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATIO ADM EA ADD VACCINE	$51.25	$102.50	$25.63–$91.23	11% above	50%

Source file: https://genevievecountymemorialhospital.pg.quadax.revenuemasters.com/cdm-files/430915730_ste-genevieve-county-memorial-hospital_standardcharges.csv