Hospital

Sedan City Hospital

Sedan City Hospital in Sedan, KS publishes cash prices for 190 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Kansas median for 119 of 187 procedures and above it for 66. By typical cash price it ranks #28 of 81 Kansas hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

300 W North Street, Sedan, KS 67361 Collected Sep 29, 2026 Source price file (620) 725-3115

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 171318 · CMS hospital register NPI 1033114277

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Sedan City Hospital in Sedan, KS:

  • Sep 2, 2025 Corrective action plan requested
  • Mar 9, 2026 Case closed
  • May 11, 2026 Met requirements

Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems. Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

ProcedureCash price List priceInsurers payvs KansasOff list
Abdominal X-ray, 2 views CPT 74019 ABD FLAT AND UPRIGHT $273.19 $364.25 $149.60–$364.25 6% above 25%
Abdominal X-ray, 2 views inpatient CPT 74019 ABD FLAT AND UPRIGHT $273.19 $364.25 $149.60–$364.25 — 25%
Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE - 3 VIEW (MIN) $187.31 $249.75 $139.38–$249.75 19% below 25%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE - 3 VIEW (MIN) $187.31 $249.75 $139.38–$249.75 — 25%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O CONTRAS $1,253.25 $1,671.00 $1,671.00 20% above 25%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY W/O CONTRAS $1,253.25 $1,671.00 $1,671.00 — 25%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABDOMEN/PELVIS WITH $1,594.48 $2,125.97 $2,125.97 35% below 25%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN/PELVIS WITH $1,594.48 $2,125.97 $2,125.97 — 25%
CT angiography (CTA) of the head CPT 70496 CTA HEAD $2,437.50 $3,250.00 $3,250.00 34% above 25%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD $2,437.50 $3,250.00 $3,250.00 — 25%
CT angiography (CTA) of the neck CPT 70498 CTA NECK $2,418.75 $3,225.00 $3,225.00 35% above 25%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK $2,418.75 $3,225.00 $3,225.00 — 25%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST (DISECTION) $1,939.50 $2,586.00 $1,143.85–$2,586.00 9% above 25%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST (PE) $1,939.50 $2,586.00 $1,143.85–$2,586.00 9% above 25%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST (DISECTION) $1,939.50 $2,586.00 $1,143.85–$2,586.00 — 25%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST (PE) $1,939.50 $2,586.00 $1,143.85–$2,586.00 — 25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT PELVIS & ABDOMEN WO CONTRAS $1,052.44 $1,403.25 $480.41–$1,403.25 22% below 25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT PELVIS & ABDOMEN WO CONTRAS $1,052.44 $1,403.25 $480.41–$1,403.25 — 25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT PELVIS & ABDOMEN W/CONTRAST $1,072.88 $1,430.50 $480.41–$1,430.50 29% below 25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT PELVIS & ABDOMEN W/CONTRAST $1,072.88 $1,430.50 $480.41–$1,430.50 — 25%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT PELVIS & ABDOMEN W/WO CONTR $1,251.00 $1,668.00 $480.41–$1,668.00 35% below 25%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT PELVIS & ABDOMEN W/WO CONTR $1,251.00 $1,668.00 $480.41–$1,668.00 — 25%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST $1,072.88 $1,430.50 $1,430.50 22% below 25%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST $1,072.88 $1,430.50 $1,430.50 — 25%
CT scan of the abdomen without contrast CPT 74150 CT RENAL STONE PROTOCOL $1,052.44 $1,403.25 $1,403.25 9% below 25%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST $1,052.44 $1,403.25 $480.41–$1,403.25 9% below 25%
CT scan of the abdomen without contrast inpatient CPT 74150 CT RENAL STONE PROTOCOL $1,052.44 $1,403.25 $1,403.25 — 25%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST $1,052.44 $1,403.25 $480.41–$1,403.25 — 25%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACE WO CONTRAST $795.56 $1,060.75 $1,060.75 21% below 25%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLO FACIAL SINUSES WO C $795.56 $1,060.75 $1,060.75 21% below 25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACE WO CONTRAST $795.56 $1,060.75 $1,060.75 — 25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLO FACIAL SINUSES WO C $795.56 $1,060.75 $1,060.75 — 25%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONTRAST $1,037.25 $1,383.00 $480.41–$1,383.00 5% below 25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O CONTRAST $1,037.25 $1,383.00 $480.41–$1,383.00 — 25%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONTRAST $932.06 $1,242.75 $1,242.75 18% below 25%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST $932.06 $1,242.75 $1,242.75 — 25%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O CONTRAST $912.94 $1,217.25 $480.41–$1,217.25 14% below 25%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O CONTRAST $912.94 $1,217.25 $480.41–$1,217.25 — 25%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US, BILATERAL CAROTID DOPPLER $359.77 $479.69 $479.69 — 25%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US, BILATERAL CAROTID DOPPLER $359.77 $479.69 $479.69 — 25%
Chest X-ray, 2 views CPT 71046 CHEST PA AND LAT $172.88 $230.50 $150.77–$230.50 25% below 25%
Chest X-ray, 2 views inpatient CPT 71046 CHEST PA AND LAT $172.88 $230.50 $150.77–$230.50 — 25%
Chest X-ray, single view CPT 71045 CHEST PORTABLE $108.75 $145.00 $123.58–$145.00 44% below 25%
Chest X-ray, single view CPT 71045 CHEST SINGLE VIEW $131.25 $175.00 $175.00 33% below 25%
Chest X-ray, single view inpatient CPT 71045 CHEST PORTABLE $108.75 $145.00 $123.58–$145.00 — 25%
Chest X-ray, single view inpatient CPT 71045 CHEST SINGLE VIEW $131.25 $175.00 $175.00 — 25%
Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE $179.81 $239.75 $114.29–$239.75 10% below 25%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE $179.81 $239.75 $114.29–$239.75 — 25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US, RENAL/AORTA $262.10 $349.46 $151.50–$349.46 36% below 25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US, RENAL/AORTA $262.10 $349.46 $151.50–$349.46 — 25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST/THORAX/WO CONTRAST $1,052.44 $1,403.25 $480.41–$1,403.25 at median 25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST/THORAX/WO CONTRAST $1,052.44 $1,403.25 $480.41–$1,403.25 — 25%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST/THORAX W/CONTRAST $1,226.06 $1,634.75 $480.41–$1,634.75 5% above 25%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST/THORAX W/CONTRAST $1,226.06 $1,634.75 $480.41–$1,634.75 — 25%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US, ARTERIAL DOPPLER, BILAT $359.77 $479.69 $479.69 — 25%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US, ARTERIAL DOPPLER, BILAT $359.77 $479.69 $479.69 — 25%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US, VENOUS DOPPLER, BILAT $359.77 $479.69 $480.76–$479.69 — 25%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US, VENOUS DOPPLER, BILAT $359.77 $479.69 $480.76–$479.69 — 25%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US, ECHOCARDIOGRAM COMPLETE $286.51 $382.01 $1,532.17–$382.01 85% below 25%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US, ECHOCARDIOGRAM COMPLETE $286.51 $382.01 $1,532.17–$382.01 — 25%
Elbow X-ray, 2 views CPT 73070 ELBOW 2 VIEW $146.25 $195.00 $195.00 26% below 25%
Elbow X-ray, 2 views inpatient CPT 73070 ELBOW 2 VIEW $146.25 $195.00 $195.00 — 25%
Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW 3 VIEW MINIMUM $162.19 $216.25 $151.46–$216.25 33% below 25%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 ELBOW 3 VIEW MINIMUM $162.19 $216.25 $151.46–$216.25 — 25%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA MID/INNER EAR W $780.19 $1,040.25 $1,040.25 28% below 25%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT SELLA MID/INNER EAR W $780.19 $1,040.25 $1,040.25 — 25%
Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM $160.88 $214.50 $124.51–$214.50 25% below 25%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 FOREARM $160.88 $214.50 $124.51–$214.50 — 25%
Knee X-ray, 3 views one side CPT 73562 KNEE - 3 VIEW (LEFT) $223.50 $298.00 $298.00 10% below 25%
Knee X-ray, 3 views one side CPT 73562 KNEE - 3 VIEW (RIGHT) $223.50 $298.00 $149.60–$298.00 10% below 25%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE - 3 VIEW (LEFT) $223.50 $298.00 $298.00 — 25%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE - 3 VIEW (RIGHT) $223.50 $298.00 $149.60–$298.00 — 25%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE 4 VIEW MIN (RIGHT) $214.13 $285.50 $216.50–$285.50 36% below 25%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE 4 VIEW MIN (RIGHT) $214.13 $285.50 $216.50–$285.50 — 25%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O CONTRAS $1,253.25 $1,671.00 $1,671.00 14% above 25%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY W/O CONTRAS $1,253.25 $1,671.00 $1,671.00 — 25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US, ABDOMEN LIMITED $262.10 $349.46 $132.93–$349.46 25% below 25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US, ABDOMEN LIMITED $262.10 $349.46 $132.93–$349.46 — 25%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US, EXTREMITY, NON VASCULAR $139.18 $185.57 $185.57 56% below 25%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US, EXTREMITY, NON VASCULAR $139.18 $185.57 $185.57 — 25%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 ANNUAL CT LUNG CANCER SCREEN $482.81 $643.75 $480.41–$643.75 26% below 25%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK/ W/CONTRAS $1,013.25 $1,351.00 $480.41–$1,351.00 14% below 25%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK/ W/CONTRAS $1,013.25 $1,351.00 $480.41–$1,351.00 — 25%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O CONTR $801.00 $1,068.00 $480.41–$1,068.00 20% below 25%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O CONTR $801.00 $1,068.00 $480.41–$1,068.00 — 25%
Pelvic CT scan without contrast CPT 72192 CT PELVIS BONY $1,052.44 $1,403.25 $1,403.25 4% below 25%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST $1,052.44 $1,403.25 $1,403.25 4% below 25%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS BONY $1,052.44 $1,403.25 $1,403.25 — 25%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST $1,052.44 $1,403.25 $1,403.25 — 25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US, BLADDER/PELVIC LIMITED $262.10 $349.46 $349.46 19% below 25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US, BLADDER/PELVIC LIMITED $262.10 $349.46 $349.46 — 25%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US, PELVIC COMPLETE $262.10 $349.46 $349.46 31% below 25%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US, PELVIC COMPLETE $262.10 $349.46 $349.46 — 25%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILATERAL $126.75 $169.00 $169.00 46% below 25%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILATERAL $126.75 $169.00 $169.00 — 25%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNILATERAL WITH CHEST $225.00 $300.00 $199.78–$300.00 27% below 25%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS UNILATERAL WITH CHEST $225.00 $300.00 $199.78–$300.00 — 25%
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER 2 VIEW MINIMUM $180.19 $240.25 $140.31–$240.25 21% below 25%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER 2 VIEW MINIMUM $180.19 $240.25 $140.31–$240.25 — 25%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES 3 VIEW MINIMUM $130.31 $173.75 $173.75 58% below 25%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES 3 VIEW MINIMUM $130.31 $173.75 $173.75 — 25%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 FEMUR, MINIMUM 2 VIEW $148.88 $198.50 $198.50 39% below 25%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 TIBIA FIBULA $158.81 $211.75 $110.06–$211.75 35% below 25%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 FEMUR, MINIMUM 2 VIEW $148.88 $198.50 $198.50 — 25%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 TIBIA FIBULA $158.81 $211.75 $110.06–$211.75 — 25%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE W/O CONTRAST $932.06 $1,242.75 $1,242.75 9% below 25%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE W/O CONTRAST $932.06 $1,242.75 $1,242.75 — 25%
Toe X-ray, 2 or more views CPT 73660 TOES $148.88 $198.50 $198.50 18% below 25%
Toe X-ray, 2 or more views inpatient CPT 73660 TOES $148.88 $198.50 $198.50 — 25%
Transvaginal pelvic ultrasound CPT 76830 US, PELVIC TRANSVAGINAL ONLY $262.10 $349.46 $349.46 19% below 25%
Transvaginal pelvic ultrasound inpatient CPT 76830 US, PELVIC TRANSVAGINAL ONLY $262.10 $349.46 $349.46 — 25%
Ultrasound of the abdomen, complete CPT 76700 US, ABDOMEN COMPLETE $262.10 $349.46 $349.46 43% below 25%
Ultrasound of the abdomen, complete inpatient CPT 76700 US, ABDOMEN COMPLETE $262.10 $349.46 $349.46 — 25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US, THYROID $262.10 $349.46 $480.76–$349.46 58% below 25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US, THYROID $262.10 $349.46 $480.76–$349.46 — 25%
Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS $180.94 $241.25 $241.25 22% below 25%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HUMERUS $180.94 $241.25 $241.25 — 25%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US, VENOUS DOPPLER LOWER EXT $230.92 $307.89 $480.76–$307.89 66% below 25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US, VENOUS DOPPLER LOWER EXT $230.92 $307.89 $480.76–$307.89 — 25%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST 3 VIEW $165.00 $220.00 $132.93–$220.00 31% below 25%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST 3 VIEW $165.00 $220.00 $132.93–$220.00 — 25%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP, UNILATERAL W/PELVIS $111.00 $148.00 $148.00 58% below 25%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP, UNILATERAL; 2-3 VIEWS $178.69 $238.25 $238.25 33% below 25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP, UNILATERAL W/PELVIS $111.00 $148.00 $148.00 — 25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP, UNILATERAL; 2-3 VIEWS $178.69 $238.25 $238.25 — 25%
X-ray of the abdomen, 1 view CPT 74018 ABD AP PORTABLE $182.06 $242.75 $134.73–$242.75 13% below 25%
X-ray of the abdomen, 1 view CPT 74018 KUB 1 VIEW ABDOMEN $197.25 $263.00 $263.00 6% below 25%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABD AP PORTABLE $182.06 $242.75 $134.73–$242.75 — 25%
X-ray of the abdomen, 1 view inpatient CPT 74018 KUB 1 VIEW ABDOMEN $197.25 $263.00 $263.00 — 25%
X-ray of the finger(s), 2 or more views CPT 73140 FINGERS $178.31 $237.75 $110.06–$237.75 at median 25%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGERS $178.31 $237.75 $110.06–$237.75 — 25%
X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3 VIEW $187.31 $249.75 $134.73–$249.75 19% below 25%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT 3 VIEW $187.31 $249.75 $134.73–$249.75 — 25%
X-ray of the hand, 3 or more views CPT 73130 HAND 3 VIEW $195.00 $260.00 $136.59–$260.00 15% below 25%
X-ray of the hand, 3 or more views inpatient CPT 73130 HAND 3 VIEW $195.00 $260.00 $136.59–$260.00 — 25%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE AP AND LAT $148.88 $198.50 $110.06–$198.50 25% below 25%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE AP AND LAT $148.88 $198.50 $110.06–$198.50 — 25%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE (min 2 views) $220.50 $294.00 $174.69–$294.00 20% below 25%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE (min 2 views) $220.50 $294.00 $174.69–$294.00 — 25%
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE WITH OBLIQUES $336.94 $449.25 $449.25 15% below 25%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE WITH OBLIQUES $336.94 $449.25 $449.25 — 25%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE AP AND LAT $150.00 $200.00 $133.80–$200.00 35% below 25%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE AP AND LAT $150.00 $200.00 $133.80–$200.00 — 25%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C SPINE 2-3 VIEWS $220.50 $294.00 $159.82–$294.00 15% below 25%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C SPINE 2-3 VIEWS $220.50 $294.00 $159.82–$294.00 — 25%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 - 2 views $166.50 $222.00 $222.00 21% below 25%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 - 2 views $166.50 $222.00 $222.00 — 25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM WITH COCCYX $57.00 $76.00 $76.00 76% below 25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 COCCYX $169.88 $226.50 $226.50 29% below 25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM WITH COCCYX $57.00 $76.00 $76.00 — 25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 COCCYX $169.88 $226.50 $226.50 — 25%

Lab tests

ProcedureCash price List priceInsurers payvs KansasOff list
ACTH blood test CPT 82024 ACTH $147.15 $196.20 $118.38–$196.20 19% below 25%
ACTH blood test inpatient CPT 82024 ACTH $147.15 $196.20 $118.38–$196.20 — 25%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT / SGPT $49.50 $66.00 $11.36–$66.00 34% above 25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT / SGPT $49.50 $66.00 $11.36–$66.00 — 25%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST / SGOT $61.88 $82.50 $11.11–$82.50 67% above 25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST / SGOT $61.88 $82.50 $11.11–$82.50 — 25%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PROFILE $123.94 $165.25 $137.99–$165.25 42% below 25%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PROFILE $123.94 $165.25 $137.99–$165.25 — 25%
Albumin blood test CPT 82040 ALBUMIN $46.13 $61.50 $10.63–$61.50 42% above 25%
Albumin blood test inpatient CPT 82040 ALBUMIN $46.13 $61.50 $10.63–$61.50 — 25%
Aldosterone blood test CPT 82088 ALDOSTERONE, SERUM $147.15 $196.20 $196.20 22% below 25%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE, SERUM $147.15 $196.20 $196.20 — 25%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOS $44.63 $59.50 $11.11–$59.50 21% above 25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOS $44.63 $59.50 $11.11–$59.50 — 25%
Ammonia blood test CPT 82140 AMMONIA $117.00 $156.00 $49.38–$156.00 35% above 25%
Ammonia blood test inpatient CPT 82140 AMMONIA $117.00 $156.00 $49.38–$156.00 — 25%
Amylase blood test CPT 82150 AMYLASE $52.13 $69.50 $25.05–$69.50 7% below 25%
Amylase blood test inpatient CPT 82150 AMYLASE $52.13 $69.50 $25.05–$69.50 — 25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP AB $85.28 $113.70 $27.79–$113.70 11% below 25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP AB $85.28 $113.70 $27.79–$113.70 — 25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN $95.25 $127.00 $44.30–$127.00 36% above 25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN $95.25 $127.00 $44.30–$127.00 — 25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, ROUTINE AEROBIC $79.50 $106.00 $106.00 34% above 25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SPUTUM CULTURE $79.50 $106.00 $106.00 34% above 25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, ROUTINE AEROBIC $79.50 $106.00 $106.00 — 25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SPUTUM CULTURE $79.50 $106.00 $106.00 — 25%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PROFILE $66.75 $89.00 $19.65–$89.00 18% below 25%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PROFILE $66.75 $89.00 $19.65–$89.00 — 25%
Bilirubin blood test, total CPT 82247 BILIRUBIN, TOTAL $99.19 $132.25 $21.30–$132.25 172% above 25%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN, TOTAL $99.19 $132.25 $21.30–$132.25 — 25%
Blood culture for bacteria CPT 87040 CULTURE, BLOOD X1 $88.50 $118.00 $38.41–$118.00 1% above 25%
Blood culture for bacteria CPT 87040 CULTURE, BLOOD X 2 $177.00 $236.00 $76.82–$236.00 101% above 25%
Blood culture for bacteria inpatient CPT 87040 CULTURE, BLOOD X1 $88.50 $118.00 $38.41–$118.00 — 25%
Blood culture for bacteria inpatient CPT 87040 CULTURE, BLOOD X 2 $177.00 $236.00 $76.82–$236.00 — 25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE $11.63 $15.50 $12.05–$15.50 35% below 25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE $11.63 $15.50 $12.05–$15.50 — 25%
Blood lead test CPT 83655 LEAD $95.25 $127.00 $127.00 80% above 25%
Blood lead test inpatient CPT 83655 LEAD $95.25 $127.00 $127.00 — 25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE $59.25 $79.00 $34.32–$79.00 at median 25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUALITATIVE $59.25 $79.00 $34.32–$79.00 — 25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO $23.25 $31.00 $31.00 78% below 25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO $23.25 $31.00 $31.00 — 25%
Blood urea nitrogen (BUN) test CPT 84520 BUN $31.50 $42.00 $42.00 1% above 25%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN $31.50 $42.00 $42.00 — 25%
C-peptide blood test CPT 84681 C-PEPTIDE, SERUM $162.75 $217.00 $217.00 55% above 25%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE, SERUM $162.75 $217.00 $217.00 — 25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN $40.01 $53.35 $26.14–$53.35 17% below 25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN $40.01 $53.35 $26.14–$53.35 — 25%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 $81.56 $108.75 $108.75 15% below 25%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 $81.56 $108.75 $108.75 — 25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 (NASAL) $96.00 $128.00 $128.00 30% below 25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 (NASAL) $96.00 $128.00 $128.00 — 25%
Calcium blood test, total CPT 82310 CALCIUM, TOTAL $59.44 $79.25 $79.25 76% above 25%
Calcium blood test, total inpatient CPT 82310 CALCIUM, TOTAL $59.44 $79.25 $79.25 — 25%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA $104.06 $138.75 $138.75 6% below 25%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA $104.06 $138.75 $138.75 — 25%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGM $56.63 $75.50 $75.50 39% below 25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGM $56.63 $75.50 $75.50 — 25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE $116.25 $155.00 $43.18–$155.00 26% above 25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE $116.25 $155.00 $43.18–$155.00 — 25%
Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO DIFF $61.50 $82.00 $13.36–$82.00 45% above 25%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO DIFF $61.50 $82.00 $13.36–$82.00 — 25%
Complete blood count (CBC), no differential CPT 85027 CBC $56.25 $75.00 $13.90–$75.00 24% above 25%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC $56.25 $75.00 $13.90–$75.00 — 25%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC $60.00 $80.00 $22.68–$80.00 43% below 25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC $60.00 $80.00 $22.68–$80.00 — 25%
Cortisol blood test, total CPT 82533 CORTISOL $129.00 $172.00 $60.54–$172.00 31% above 25%
Cortisol blood test, total inpatient CPT 82533 CORTISOL $129.00 $172.00 $60.54–$172.00 — 25%
Creatine kinase (CK) blood test, total CPT 82550 CPK/CK $51.75 $69.00 $23.11–$69.00 11% above 25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK/CK $51.75 $69.00 $23.11–$69.00 — 25%
Creatinine blood test CPT 82565 CREATININE $40.50 $54.00 $11.00–$54.00 11% above 25%
Creatinine blood test inpatient CPT 82565 CREATININE $40.50 $54.00 $11.00–$54.00 — 25%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS ANTIBODY $159.38 $212.50 $212.50 46% above 25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS ANTIBODY $159.38 $212.50 $212.50 — 25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN QUALITATIVE $57.79 $77.05 $150.08–$77.05 64% below 25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN URINE, CLINICAL $239.03 $318.70 $318.70 47% above 25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ACETAMINOPHEN QUALITATIVE $57.79 $77.05 $150.08–$77.05 — 25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN URINE, CLINICAL $239.03 $318.70 $318.70 — 25%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL $55.50 $74.00 $74.00 8% below 25%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL $55.50 $74.00 $74.00 — 25%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR VCA AB G/M $63.75 $85.00 $85.00 38% below 25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR VCA AB G/M $63.75 $85.00 $85.00 — 25%
FSH (follicle-stimulating hormone) test CPT 83001 FSH $147.00 $196.00 $71.29–$196.00 27% above 25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH $147.00 $196.00 $71.29–$196.00 — 25%
Ferritin blood test (iron stores) CPT 82728 FERRITIN $108.00 $144.00 $53.23–$144.00 22% above 25%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN $108.00 $144.00 $53.23–$144.00 — 25%
Folate (folic acid) blood test CPT 82746 FOLATE $51.30 $68.40 $61.81–$68.40 48% below 25%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE $51.30 $68.40 $61.81–$68.40 — 25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T 4 FREE $69.34 $92.45 $30.77–$92.45 4% above 25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T 4 FREE $69.34 $92.45 $30.77–$92.45 — 25%
Free testosterone test CPT 84402 TESTOSTERONE, FREE AND TOTAL $313.50 $418.00 $108.65–$418.00 120% above 25%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE AND TOTAL $313.50 $418.00 $108.65–$418.00 — 25%
H. pylori stool antigen test CPT 87338 H PYLORI ANTIGEN DETECT STOOL $228.75 $305.00 $31.18–$305.00 105% above 25%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI ANTIGEN DETECT STOOL $228.75 $305.00 $31.18–$305.00 — 25%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 & 2 ANTIBODIES $51.23 $68.30 $68.30 38% below 25%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 & 2 ANTIBODIES $51.23 $68.30 $68.30 — 25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C $68.25 $91.00 $35.94–$91.00 5% above 25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C $68.25 $91.00 $35.94–$91.00 — 25%
Hemoglobin blood test CPT 85018 HEMOGLOBIN $34.31 $45.75 $45.75 60% above 25%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN $34.31 $45.75 $45.75 — 25%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY $65.21 $86.95 $86.95 4% below 25%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY $65.21 $86.95 $86.95 — 25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY $84.75 $113.00 $113.00 9% above 25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY $84.75 $113.00 $113.00 — 25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN $81.75 $109.00 $109.00 32% above 25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN $81.75 $109.00 $109.00 — 25%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY $84.75 $113.00 $113.00 7% above 25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY $84.75 $113.00 $113.00 — 25%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HR $45.00 $60.00 $60.00 50% below 25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HR $45.00 $60.00 $60.00 — 25%
Homocysteine blood test CPT 83090 HOMOCYSTINE $85.50 $114.00 $176.58–$114.00 62% below 25%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE $85.50 $114.00 $176.58–$114.00 — 25%
Insulin blood test CPT 83525 INSULIN, FASTING $87.53 $116.70 $50.72–$116.70 8% above 25%
Insulin blood test inpatient CPT 83525 INSULIN, FASTING $87.53 $116.70 $50.72–$116.70 — 25%
Iron blood test (serum iron) CPT 83540 IRON $44.25 $59.00 $25.62–$59.00 at median 25%
Iron blood test (serum iron) inpatient CPT 83540 IRON $44.25 $59.00 $25.62–$59.00 — 25%
Iron-binding capacity (TIBC) test CPT 83550 TIBC $69.00 $92.00 $41.23–$92.00 7% above 25%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC $69.00 $92.00 $41.23–$92.00 — 25%
Kidney function blood test panel CPT 80069 RENAL PANEL $157.50 $210.00 $210.00 114% above 25%
Kidney function blood test panel inpatient CPT 80069 RENAL PANEL $157.50 $210.00 $210.00 — 25%
LH (luteinizing hormone) test CPT 83002 LH $61.05 $81.40 $69.56–$81.40 46% below 25%
LH (luteinizing hormone) test inpatient CPT 83002 LH $61.05 $81.40 $69.56–$81.40 — 25%
Lactate (lactic acid) blood test CPT 83605 LACTATE $71.63 $95.50 $47.35–$95.50 10% below 25%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE $71.63 $95.50 $47.35–$95.50 — 25%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH $22.05 $29.40 $22.78–$29.40 46% below 25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH $22.05 $29.40 $22.78–$29.40 — 25%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE $65.63 $87.50 $27.78–$87.50 4% above 25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE $65.63 $87.50 $27.78–$87.50 — 25%
Liver function blood test panel CPT 80076 LIVER PANEL $64.50 $86.00 $31.88–$86.00 22% below 25%
Liver function blood test panel inpatient CPT 80076 LIVER PANEL $64.50 $86.00 $31.88–$86.00 — 25%
Lyme disease antibody test CPT 86618 LYMES TITER IGM/IGG $134.25 $179.00 $76.68–$179.00 10% above 25%
Lyme disease antibody test inpatient CPT 86618 LYMES TITER IGM/IGG $134.25 $179.00 $76.68–$179.00 — 25%
Magnesium blood test CPT 83735 MAGNESIUM, SERUM $89.44 $119.25 $25.85–$119.25 72% above 25%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, SERUM $89.44 $119.25 $25.85–$119.25 — 25%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SPOT $40.50 $54.00 $19.50–$54.00 10% below 25%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SPOT $40.50 $54.00 $19.50–$54.00 — 25%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC $145.50 $194.00 $194.00 36% above 25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC $145.50 $194.00 $194.00 — 25%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE $136.84 $182.45 $182.45 32% below 25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE $136.84 $182.45 $182.45 — 25%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT $56.06 $74.75 $22.53–$74.75 19% above 25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT $56.06 $74.75 $22.53–$74.75 — 25%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS LEVEL $44.63 $59.50 $59.50 16% above 25%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS LEVEL $44.63 $59.50 $59.50 — 25%
Potassium blood test CPT 84132 POTASSIUM, SERUM $41.06 $54.75 $54.75 24% above 25%
Potassium blood test inpatient CPT 84132 POTASSIUM, SERUM $41.06 $54.75 $54.75 — 25%
Prolactin blood test CPT 84146 PROLACTIN $82.16 $109.55 $79.04–$109.55 35% below 25%
Prolactin blood test inpatient CPT 84146 PROLACTIN $82.16 $109.55 $79.04–$109.55 — 25%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME $51.75 $69.00 $16.08–$69.00 57% above 25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME $51.75 $69.00 $16.08–$69.00 — 25%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A & B $85.28 $113.70 $113.70 25% above 25%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A & B $85.28 $113.70 $113.70 — 25%
Renin blood test CPT 84244 RENIN $174.00 $232.00 $232.00 35% above 25%
Renin blood test inpatient CPT 84244 RENIN $174.00 $232.00 $232.00 — 25%
Rh blood typing CPT 86901 BLOOD TYPING RH $49.31 $65.75 $65.75 23% below 25%
Rh blood typing inpatient CPT 86901 BLOOD TYPING RH $49.31 $65.75 $65.75 — 25%
Rheumatoid factor (RF) test CPT 86431 RA FACTOR QUANTITATIVE $44.25 $59.00 $25.74–$59.00 10% below 25%
Rheumatoid factor (RF) test inpatient CPT 86431 RA FACTOR QUANTITATIVE $44.25 $59.00 $25.74–$59.00 — 25%
Stool ova and parasites exam CPT 87177 OVA & PARASITE $69.00 $92.00 $31.41–$92.00 13% above 25%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITE $69.00 $92.00 $31.41–$92.00 — 25%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD $15.94 $21.25 $34.14–$21.25 69% below 25%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD $15.94 $21.25 $34.14–$21.25 — 25%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM ANTIBODY $71.25 $95.00 $95.00 1% below 25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM ANTIBODY $71.25 $95.00 $95.00 — 25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR (VDRL) $33.75 $45.00 $45.00 10% below 25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR (VDRL) $33.75 $45.00 $45.00 — 25%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL $97.91 $130.55 $104.86–$130.55 29% below 25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL $97.91 $130.55 $104.86–$130.55 — 25%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOMAL ANTI $168.98 $225.30 $50.96–$225.30 114% above 25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER-KIDNEY MICROSOMAL ANTI $168.98 $225.30 $50.96–$225.30 — 25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH $132.75 $177.00 $43.97–$177.00 48% above 25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH $132.75 $177.00 $43.97–$177.00 — 25%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL $112.50 $150.00 $47.20–$150.00 41% above 25%
Total triiodothyronine (T3) blood test CPT 84480 F-T3 (FREE T3) $210.15 $280.20 $280.20 163% above 25%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL $112.50 $150.00 $47.20–$150.00 — 25%
Total triiodothyronine (T3) blood test inpatient CPT 84480 F-T3 (FREE T3) $210.15 $280.20 $280.20 — 25%
Transferrin blood test CPT 84466 TRANSFERRIN $52.61 $70.15 $70.15 50% below 25%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN $52.61 $70.15 $70.15 — 25%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS URINE $86.81 $115.75 $115.75 34% below 25%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS URINE $86.81 $115.75 $115.75 — 25%
Uric acid blood test CPT 84550 URIC ACID- SERUM $35.25 $47.00 $14.72–$47.00 6% below 25%
Uric acid blood test inpatient CPT 84550 URIC ACID- SERUM $35.25 $47.00 $14.72–$47.00 — 25%
Urinalysis with microscope exam, manual CPT 81000 UA DIP & MICRO $45.75 $61.00 $15.54–$61.00 72% above 25%
Urinalysis with microscope exam, manual inpatient CPT 81000 UA DIP & MICRO $45.75 $61.00 $15.54–$61.00 — 25%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE $63.75 $85.00 $30.38–$85.00 15% above 25%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE $63.75 $85.00 $30.38–$85.00 — 25%
Urine microalbumin (albumin) test CPT 82043 MICRO ALBUMIN $52.84 $70.45 $24.82–$70.45 15% above 25%
Urine microalbumin (albumin) test inpatient CPT 82043 MICRO ALBUMIN $52.84 $70.45 $24.82–$70.45 — 25%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 $119.25 $159.00 $57.41–$159.00 30% above 25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 $119.25 $159.00 $57.41–$159.00 — 25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25-HYDROXY $144.75 $193.00 $218.43–$193.00 41% below 25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25-HYDROXY $144.75 $193.00 $218.43–$193.00 — 25%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D, 1,25 $146.48 $195.30 $88.45–$195.30 3% below 25%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D, 1,25 $146.48 $195.30 $88.45–$195.30 — 25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE $118.50 $158.00 $158.00 20% above 25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTITATIVE $118.50 $158.00 $158.00 — 25%

Surgery and procedures

ProcedureCash price List priceInsurers payvs KansasOff list
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE 10060 $172.50 $230.00 $248.38–$230.00 29% below 25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE 10060 $172.50 $230.00 $248.38–$230.00 — 25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LACERATION REPAIR 2.6CM TO 7.5 $295.50 $394.00 $394.00 21% below 25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LACERATION REPAIR 2.6CM TO 7.5 $295.50 $394.00 $394.00 — 25%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL - SIMPLE 1 $171.75 $229.00 $229.00 40% below 25%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL - SIMPLE 1 $171.75 $229.00 $229.00 — 25%
Short arm cast (elbow to hand) CPT 29075 ELBOW - FINGER SHORT ARM CAST $115.50 $154.00 $74.63–$154.00 50% below 25%
Short arm cast (elbow to hand) inpatient CPT 29075 ELBOW - FINGER SHORT ARM CAST $115.50 $154.00 $74.63–$154.00 — 25%
Short arm splint (forearm and hand) CPT 29125 SPLINT APPLICATION - ARM 2912 $80.25 $107.00 $47.55–$107.00 55% below 25%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT APPLICATION - ARM 2912 $80.25 $107.00 $47.55–$107.00 — 25%
Short leg splint (calf to foot) CPT 29515 SPLINT APPLICATION - LEG 2951 $95.25 $127.00 $127.00 44% below 25%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT APPLICATION - LEG 2951 $95.25 $127.00 $127.00 — 25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PA SIMPLE REPAIR 12001 $198.00 $264.00 $64.34–$264.00 17% below 25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 PA SIMPLE REPAIR 12001 $198.00 $264.00 $64.34–$264.00 — 25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR 2.6CM TO 7.5CM 12002 $219.75 $293.00 $83.06–$293.00 21% below 25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPAIR 2.6CM TO 7.5CM 12002 $219.75 $293.00 $83.06–$293.00 — 25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR 2.5CM FACE 12011 $204.75 $273.00 $273.00 26% below 25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPAIR 2.5CM FACE 12011 $204.75 $273.00 $273.00 — 25%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT 1 OR 2 MUSCLE GR $119.58 $159.44 $159.44 43% below 25%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT 1 OR 2 MUSCLE GR $119.58 $159.44 $159.44 — 25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN SQ 11042/PHYSICIA $78.54 $104.72 $94.24–$104.72 76% below 25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN, INTO SQ 11042 $559.50 $746.00 $451.17–$746.00 74% above 25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN SQ 11042/PHYSICIA $78.54 $104.72 $94.24–$104.72 — 25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN, INTO SQ 11042 $559.50 $746.00 $451.17–$746.00 — 25%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs KansasOff list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION $546.94 $729.25 $729.25 9% below 25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION $546.94 $729.25 $729.25 — 25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG $85.50 $114.00 $164.68–$114.00 48% below 25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG $85.50 $114.00 $164.68–$114.00 — 25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY ROOM LEVEL 1 99281 $136.10 $181.47 $181.47 24% below 25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY ROOM LEVEL 11 99282 $253.78 $338.37 $47.65–$338.37 12% below 25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY ROOM LEVEL 111 99283 $446.38 $595.17 $96.36–$595.17 3% below 25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY ROOM LEVEL IV 99284 $751.05 $1,001.40 $162.21–$1,001.40 3% below 25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY ROOM LEVEL V 99285 $1,108.55 $1,478.07 $1,478.07 12% below 25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRAT IV INFUS, INIT 31-60 MI $243.54 $324.72 $62.13–$324.72 7% below 25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRAT IV INFUS, INIT 31-60 MI $243.54 $324.72 $62.13–$324.72 — 25%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION 1ST HR (OP) 96365 $390.58 $520.77 $520.77 42% above 25%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION 1ST HR (ER)96365 $390.58 $520.77 $89.51–$520.77 42% above 25%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION 1ST HR (OP) 96365 $390.58 $520.77 $520.77 — 25%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION 1ST HR (ER)96365 $390.58 $520.77 $89.51–$520.77 — 25%
IV push of a medicine, first drug CPT 96374 IV PUSH (ER) 96374 $243.54 $324.72 $61.58–$324.72 3% above 25%
IV push of a medicine, first drug CPT 96374 IV PUSH (OP) 96374 $243.54 $324.72 $324.72 3% above 25%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH (ER) 96374 $243.54 $324.72 $61.58–$324.72 — 25%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH (OP) 96374 $243.54 $324.72 $324.72 — 25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ SC/IM ERM ROOM 96372 $120.47 $160.62 $25.25–$160.62 77% above 25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ SC/IM OUTPATIENT 96372 $120.47 $160.62 $160.62 77% above 25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SC/IM ERM ROOM 96372 $120.47 $160.62 $25.25–$160.62 — 25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SC/IM OUTPATIENT 96372 $120.47 $160.62 $160.62 — 25%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT LEV 3 99203/PHYSI $117.76 $157.01 $157.01 22% below 25%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT LEV 2 99202/PHYSI $76.76 $102.34 $102.34 32% below 25%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MYOFASCIAL REL $55.50 $74.00 $74.00 27% below 25%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MYOFASCIAL REL $55.50 $74.00 $74.00 — 25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTAB PT LEVEL 3 99213/PHYSIC $76.11 $101.48 $101.48 44% below 25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTAB PATIENT VISIT LEVEL 3 9 $225.75 $301.00 $133.49–$301.00 67% above 25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTAB PATIENT LEVEL 4 99214 $328.50 $438.00 $188.57–$438.00 90% above 25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTAB PT LEVEL 2 99212/PHYSIC $39.74 $52.98 $52.98 62% below 25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTAB PATIENT VISIT LEVEL 2 9 $196.50 $262.00 $262.00 89% above 25%

Vaccines

ProcedureCash price List priceInsurers payvs KansasOff list
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS TOX WITH DIPTH $70.46 $93.95 $57.29–$93.95 4% above 25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS TOX WITH DIPTH $70.46 $93.95 $57.29–$93.95 — 25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN. 90471 $120.47 $160.62 $8.08–$160.62 209% above 25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN. 90471 $120.47 $160.62 $8.08–$160.62 — 25%

Source file: https://sedancityhospital.org/standardcharges.csv