Callaway District Hospital
Callaway District Hospital in Callaway, NE publishes cash prices for 267 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Nebraska median for 207 of 264 procedures and below it for 51. By typical cash price it ranks #34 of 53 Nebraska hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
P O Box 100, 211 E Kimball St, Callaway, NE 68825 Collected Sep 29, 2026 Source price file (308) 836-2228
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 281335 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete 3+ Views Left | $327.00 | $363.00 | $171.00–$356.00 | 1% below | 10% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete 3+ Views Right | $327.00 | $363.00 | $171.00–$356.00 | 1% below | 10% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 93922 Ankle Arm Index Charge John | $553.00 | $614.00 | $289.00–$602.00 | 17% above | 10% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Xr Esophagus | $635.00 | $706.00 | $332.00–$692.00 | 3% above | 10% |
| Breast ultrasound, complete, one breast both sides CPT 76641 Us Breast Complete Bilat | $810.00 | $900.00 | $423.00–$882.00 | — | 10% |
| Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Complete Right | $528.00 | $587.00 | $276.00–$575.00 | 9% above | 10% |
| Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Complete Left | $528.00 | $587.00 | $276.00–$575.00 | 9% above | 10% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Limited Right | $403.00 | $448.00 | $211.00–$439.00 | 4% above | 10% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Limited Left | $403.00 | $448.00 | $211.00–$439.00 | 4% above | 10% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Ct Angio Chest Pe Protocol | $3,281.00 | $3,645.00 | $1,713.00–$3,572.00 | 1% below | 10% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Abdomen And Pelvis W/o Contrast | $3,794.00 | $4,215.00 | $1,981.00–$4,131.00 | 10% above | 10% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast | $4,416.00 | $4,907.00 | $2,306.00–$4,809.00 | 7% above | 10% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abdomen And Pelvis W/ + W/o Contrast | $5,091.00 | $5,657.00 | $2,659.00–$5,544.00 | 2% above | 10% |
| CT scan of the abdomen with contrast CPT 74160 Ct Abdomen W/ Contrast | $2,463.00 | $2,737.00 | $1,286.00–$2,682.00 | 5% below | 10% |
| CT scan of the abdomen without contrast CPT 74150 Ct Abdomen W/o Contrast | $2,234.00 | $2,482.00 | $1,167.00–$2,432.00 | 1% above | 10% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Maxillofacial W/o Contrast | $1,830.00 | $2,033.00 | $956.00–$1,992.00 | at median | 10% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT scan | $2,022.00 | $2,247.00 | $1,056.00–$2,202.00 | 5% above | 10% |
| CT scan of the head with contrast CPT 70460 Ct Brain/head W/ Contrast | $2,281.00 | $2,534.00 | $1,191.00–$2,483.00 | 8% above | 10% |
| CT scan of the head without and with contrast CPT 70470 Ct Brain/head W/ + W/o Contrast | $2,676.00 | $2,973.00 | $1,397.00–$2,914.00 | 7% above | 10% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct Spine Lumbar W/o Contrast | $2,311.00 | $2,568.00 | $1,207.00–$2,517.00 | 3% above | 10% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct Spine Cervical W/o Contrast | $2,320.00 | $2,578.00 | $1,212.00–$2,526.00 | 1% above | 10% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast | $2,534.00 | $2,815.00 | $1,323.00–$2,759.00 | 2% above | 10% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 93880 Carotid Duplex Bil Charge John | $1,425.00 | $1,583.00 | $744.00–$1,551.00 | 10% below | 10% |
| Chest X-ray, 2 views CPT 71046 Xr Chest 2 Views | $344.00 | $382.00 | $180.00–$374.00 | 19% above | 10% |
| Chest X-ray, single view CPT 71045 Xr Chest 1 View | $274.00 | $304.00 | $143.00–$298.00 | 15% above | 10% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Aorta | $782.00 | $869.00 | $408.00–$852.00 | 1% below | 10% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Bd Bone Density Dexa App Skeleton | $464.00 | $516.00 | $243.00–$506.00 | 14% above | 10% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest W/o Contrast | $2,309.00 | $2,566.00 | $1,206.00–$2,515.00 | 7% above | 10% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Chest W/ Contrast | $2,568.00 | $2,853.00 | $1,341.00–$2,796.00 | 2% above | 10% |
| Diagnostic mammogram, both breasts CPT 77066 Mammography of both breasts | $418.00 | $464.00 | $218.00–$455.00 | 10% below | 10% |
| Diagnostic mammogram, one breast CPT 77065 Mammography of one breast | $352.00 | $391.00 | $184.00–$383.00 | 11% above | 10% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Us Lower Ext Arterial Duplex Bilateral | $1,179.00 | $1,310.00 | $616.00–$1,284.00 | — | 10% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 93925 Bil Art Graft Scan/abi Charge John | $1,179.00 | $1,310.00 | $616.00–$1,284.00 | 10% above | 10% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 93970 Venous Duplex Bilateral Charge John | $1,420.00 | $1,578.00 | $742.00–$1,546.00 | — | 10% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Lower Ext Venous Duplex Bilateral | $1,420.00 | $1,578.00 | $742.00–$1,546.00 | — | 10% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Us Echo 2d Complete | $2,171.00 | $2,412.00 | $1,134.00–$2,364.00 | at median | 10% |
| Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 Views Left | $374.00 | $415.00 | $195.00–$407.00 | 1% below | 10% |
| Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 Views Right | $374.00 | $415.00 | $195.00–$407.00 | 1% below | 10% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdomen Limited | $678.00 | $753.00 | $354.00–$738.00 | 21% above | 10% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Low Dose Lung Scan | $1,707.00 | $1,897.00 | $892.00–$1,859.00 | 175% above | 10% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint | $3,597.00 | $3,997.00 | $1,879.00–$3,917.00 | 39% above | 10% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 Mri Le Joint W/ + W/o Contrast Bilat | $3,597.00 | $3,997.00 | $1,879.00–$3,917.00 | — | 10% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Le Joint W/ + W/o Contrast Right | $3,203.00 | $3,559.00 | $1,673.00–$3,488.00 | 5% below | 10% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Le Joint W/ + W/o Contrast Left | $3,203.00 | $3,559.00 | $1,673.00–$3,488.00 | 5% below | 10% |
| MRI of the abdomen without contrast CPT 74181 Mri Abdomen W/o Contrast | $3,115.00 | $3,461.00 | $1,627.00–$3,392.00 | 4% above | 10% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 Mri Abdomen W/ + W/o Contrast | $4,368.00 | $4,853.00 | $2,281.00–$4,756.00 | 14% above | 10% |
| MRI of the brain, no contrast dye CPT 70551 Mri Brain W/o Contrast | $3,433.00 | $3,814.00 | $1,793.00–$3,738.00 | 5% above | 10% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Scan | $4,055.00 | $4,506.00 | $2,118.00–$4,416.00 | 3% above | 10% |
| MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal | $3,362.00 | $3,735.00 | $1,755.00–$3,660.00 | 5% above | 10% |
| MRI of the lower back, without and then with contrast dye CPT 72158 Mri Spine Lumbar W/ + W/o Contrast | $4,181.00 | $4,646.00 | $2,184.00–$4,553.00 | 6% above | 10% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mri Spine Thoracic W/o Contrast | $3,557.00 | $3,952.00 | $1,857.00–$3,873.00 | 5% above | 10% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 Mri Spine Cervical W/ + W/o Contrast | $4,016.00 | $4,462.00 | $2,097.00–$4,373.00 | 1% above | 10% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 Mri Spine Cervical W/o Contrast | $3,355.00 | $3,728.00 | $1,752.00–$3,653.00 | 1% above | 10% |
| MRI of the pelvis without and with contrast CPT 72197 Mri Pelvis W/ + W/o Contrast | $3,191.00 | $3,546.00 | $1,667.00–$3,475.00 | 12% below | 10% |
| MRI of the pelvis, no contrast dye CPT 72195 Mri Pelvis W/o Contrast | $3,069.00 | $3,410.00 | $1,603.00–$3,342.00 | 4% above | 10% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 Mri Ue Joint W/o Contrast Bilat | $3,556.00 | $3,951.00 | $1,857.00–$3,872.00 | — | 10% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Ue Joint W/o Contrast Left | $2,540.00 | $2,822.00 | $1,326.00–$2,766.00 | 2% above | 10% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Ue Joint W/o Contrast Right | $2,540.00 | $2,822.00 | $1,326.00–$2,766.00 | 2% above | 10% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us Pelvic Ltd | $428.00 | $476.00 | $224.00–$466.00 | 5% above | 10% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvic Complete | $792.00 | $880.00 | $414.00–$862.00 | 1% above | 10% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Us Ob Limited | $300.00 | $333.00 | $157.00–$326.00 | 23% below | 10% |
| Screening mammogram, both breasts both sides CPT 77067 Mammography, screening, bilateral | $373.00 | $414.00 | $195.00–$406.00 | — | 10% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete 2+ Views Right | $350.00 | $389.00 | $183.00–$381.00 | 3% above | 10% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete 2+ Views Left | $350.00 | $389.00 | $183.00–$381.00 | 3% above | 10% |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound pelvis through vagina | $680.00 | $755.00 | $355.00–$740.00 | 7% above | 10% |
| Ultrasound of the abdomen, complete CPT 76700 Ultrasound of abdomen | $850.00 | $944.00 | $444.00–$925.00 | 1% above | 10% |
| Ultrasound of the scrotum and testicles CPT 76870 Us Scrotum (Contents) | $658.00 | $731.00 | $344.00–$716.00 | 1% above | 10% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Thyroid | $617.00 | $685.00 | $322.00–$671.00 | 3% above | 10% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 93971 Venous Duplex Limited Charge John | $1,049.00 | $1,166.00 | $548.00–$1,143.00 | 1% above | 10% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Lower Ext Venous Duplex Left | $1,049.00 | $1,166.00 | $548.00–$1,143.00 | 1% above | 10% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Lower Ext Venous Duplex Right | $1,049.00 | $1,166.00 | $548.00–$1,143.00 | 1% above | 10% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete 3+ Views Left | $323.00 | $359.00 | $169.00–$352.00 | 2% below | 10% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete 3+ Views Right | $323.00 | $359.00 | $169.00–$352.00 | 2% below | 10% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip 2-3 Views Right | $338.00 | $375.00 | $176.00–$368.00 | 15% above | 10% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip 2-3 Views Left | $338.00 | $375.00 | $176.00–$368.00 | 15% above | 10% |
| X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen 1 View | $303.00 | $337.00 | $158.00–$330.00 | 10% above | 10% |
| X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Left | $258.00 | $287.00 | $135.00–$281.00 | at median | 10% |
| X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Right | $258.00 | $287.00 | $135.00–$281.00 | at median | 10% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(2nd Digit) 2+ Views Left | $237.00 | $263.00 | $124.00–$258.00 | 3% above | 10% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(1st Digit) 2+ Views Left | $237.00 | $263.00 | $124.00–$258.00 | 3% above | 10% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(1st Digit) 2+ Views Right | $237.00 | $263.00 | $124.00–$258.00 | 3% above | 10% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(2nd Digit) 2+ Views Right | $237.00 | $263.00 | $124.00–$258.00 | 3% above | 10% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(3rd Digit) 2+ Views Left | $237.00 | $263.00 | $124.00–$258.00 | 3% above | 10% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(3rd Digit) 2+ Views Right | $237.00 | $263.00 | $124.00–$258.00 | 3% above | 10% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(4th Digit) 2+ Views Left | $237.00 | $263.00 | $124.00–$258.00 | 3% above | 10% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(4th Digit) 2+ Views Right | $237.00 | $263.00 | $124.00–$258.00 | 3% above | 10% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(5th Digit) 2+ Views Left | $237.00 | $263.00 | $124.00–$258.00 | 3% above | 10% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(5th Digit) 2+ Views Right | $237.00 | $263.00 | $124.00–$258.00 | 3% above | 10% |
| X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Right | $266.00 | $295.00 | $139.00–$289.00 | 22% above | 10% |
| X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Left | $266.00 | $295.00 | $139.00–$289.00 | 22% above | 10% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete 3+ Views Right | $340.00 | $378.00 | $178.00–$370.00 | 4% above | 10% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete 3+ Views Left | $340.00 | $378.00 | $178.00–$370.00 | 4% above | 10% |
| X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete 3+ Views Left | $328.00 | $364.00 | $171.00–$357.00 | 4% below | 10% |
| X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete 3+ Views Right | $328.00 | $364.00 | $171.00–$357.00 | 4% below | 10% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 1 Or 2 Views Right | $329.00 | $365.00 | $172.00–$358.00 | 3% above | 10% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 1 Or 2 Views Left | $329.00 | $365.00 | $172.00–$358.00 | 3% above | 10% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr Spine Lumbosacral 2 Or 3 Views | $450.00 | $500.00 | $235.00–$490.00 | 7% above | 10% |
| X-ray of the lower back, 4 or more views CPT 72110 X-Ray of lower back | $527.00 | $586.00 | $275.00–$574.00 | 8% above | 10% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xr Spine Thoracic 2 Views | $366.00 | $407.00 | $191.00–$399.00 | 19% above | 10% |
| X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones 3+ Views | $248.00 | $276.00 | $130.00–$270.00 | 15% below | 10% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr Spine Cervical 2 Or 3 Views | $355.00 | $394.00 | $185.00–$386.00 | 11% above | 10% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis 1 Or 2 Views | $319.00 | $354.00 | $166.00–$347.00 | 13% above | 10% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Sacrum/coccyx 2+ Views | $328.00 | $364.00 | $171.00–$357.00 | 16% above | 10% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase | $73.00 | $81.00 | $38.00–$79.00 | 20% above | 10% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase | $73.00 | $81.00 | $38.00–$79.00 | 28% above | 10% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hep B Core Ab,igm Pspc | $290.00 | $322.00 | $151.00–$316.00 | 9% below | 10% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Mold Mix 1 (Altern, Asper, Clad, Penic) Ige Pspc | $82.00 | $91.00 | $43.00–$89.00 | 63% above | 10% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Antibody, Igg Pspc | $158.00 | $175.00 | $82.00–$172.00 | 39% above | 10% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen With Reflex Pspc | $175.00 | $194.00 | $91.00–$190.00 | 114% above | 10% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-type Natriuretic Peptide | $270.00 | $300.00 | $141.00–$294.00 | 21% above | 10% |
| Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel | $140.00 | $156.00 | $73.00–$153.00 | 2% below | 10% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bill Only Tissue Level Iv 88305 | $336.00 | $373.00 | $175.00–$366.00 | 70% above | 10% |
| Blood culture for bacteria both sides CPT 87040 Blood Cult Bi Final Pspc | $295.00 | $328.00 | $154.00–$321.00 | — | 10% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill Only Exam One Collection | $70.00 | $78.00 | $37.00–$76.00 | 153% above | 10% |
| Blood glucose (sugar) test CPT 82947 Glucose Level | $63.00 | $70.00 | $33.00–$69.00 | 20% above | 10% |
| Blood lead test CPT 83655 Lead Blood, Pediatric Pspc | $96.00 | $107.00 | $50.00–$105.00 | 48% above | 10% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta Hcg Qualitative Poct | $161.00 | $179.00 | $84.00–$175.00 | 32% above | 10% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo | $65.00 | $72.00 | $34.00–$71.00 | 11% above | 10% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Crp Reactive Protein Pspc | $103.00 | $114.00 | $54.00–$112.00 | 1% above | 10% |
| C. difficile toxin gene test (stool PCR) one side CPT 87493 C Difficile, Stool By Rt-pcr Pspc | $172.00 | $191.00 | $90.00–$187.00 | at median | 10% |
| CA 19-9 blood test (tumor marker) CPT 86301 Ca 19-9, Cancer Antigengi Pspc | $163.00 | $181.00 | $85.00–$177.00 | 10% below | 10% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 Pspc | $182.00 | $202.00 | $95.00–$198.00 | 24% above | 10% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids | $116.00 | $129.00 | $61.00–$126.00 | 4% below | 10% |
| Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (CBC), with differential white blood cells, automated | $103.00 | $114.00 | $54.00–$112.00 | 12% above | 10% |
| Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (CBC), automated | $80.00 | $89.00 | $42.00–$87.00 | 9% above | 10% |
| Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals | $162.00 | $180.00 | $85.00–$176.00 | 2% below | 10% |
| D-dimer blood test (blood clot marker) CPT 85379 Ddimer Pspc | $165.00 | $183.00 | $86.00–$179.00 | 9% above | 10% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea Sulfate (Dehydroepiandrosterone Sulfate) Pspc | $185.00 | $205.00 | $96.00–$201.00 | 30% above | 10% |
| Estradiol blood test CPT 82670 Estradiol Pspc | $168.00 | $187.00 | $88.00–$183.00 | 22% above | 10% |
| FSH (follicle-stimulating hormone) test CPT 83001 Fsh Pspc | $123.00 | $137.00 | $64.00–$134.00 | 8% above | 10% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Stool Pspc | $415.00 | $461.00 | $217.00–$452.00 | 7% above | 10% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin Pspc | $122.00 | $136.00 | $64.00–$133.00 | 13% above | 10% |
| Folate (folic acid) blood test CPT 82746 Folate, Serum Pspc | $137.00 | $152.00 | $71.00–$149.00 | 27% above | 10% |
| Free T3 thyroid hormone test CPT 84481 Ft3 Free T3 Pspc | $184.00 | $204.00 | $96.00–$200.00 | 13% above | 10% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Level | $103.00 | $114.00 | $54.00–$112.00 | 14% above | 10% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel | $379.00 | $421.00 | $198.00–$413.00 | 25% above | 10% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose 3 Hour | $187.00 | $208.00 | $98.00–$204.00 | 36% above | 10% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 Chlamydia & Gonorrhoeae, Urine (Rps) | $122.00 | $136.00 | $64.00–$133.00 | 4% above | 10% |
| H. pylori stool antigen test CPT 87338 Helicobacter Pylori Antigen, Stool Pspc | $203.00 | $226.00 | $106.00–$221.00 | 25% above | 10% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv 1/2 Antibodies Pspc | $99.00 | $110.00 | $52.00–$108.00 | 20% above | 10% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv High Risk W/extended Genotyping Pspc | $144.00 | $160.00 | $75.00–$157.00 | 25% above | 10% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 A1c Hemoglobin A1c Pspc | $82.00 | $91.00 | $43.00–$89.00 | 1% above | 10% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody Pspc | $115.00 | $128.00 | $60.00–$125.00 | 26% above | 10% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen Pspc | $102.00 | $113.00 | $53.00–$111.00 | 9% above | 10% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody Pspc | $119.00 | $132.00 | $62.00–$129.00 | 30% above | 10% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Ab Pspc | $432.00 | $480.00 | $226.00–$470.00 | 28% above | 10% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 Crp, Cardiac Pspc | $131.00 | $146.00 | $69.00–$143.00 | 37% above | 10% |
| Insulin blood test CPT 83525 Insulin Pspc | $106.00 | $118.00 | $55.00–$116.00 | 3% below | 10% |
| Iron blood test (serum iron) CPT 83540 Iron Pspc | $66.00 | $73.00 | $34.00–$72.00 | 5% above | 10% |
| Iron-binding capacity (TIBC) test CPT 83550 Ironbind Cap Pspc | $78.00 | $87.00 | $41.00–$85.00 | 1% below | 10% |
| Kidney function blood test panel CPT 80069 Kidney function panel test | $149.00 | $166.00 | $78.00–$163.00 | at median | 10% |
| LH (luteinizing hormone) test CPT 83002 Lhs Lutenizing Hormone Pspc | $115.00 | $128.00 | $60.00–$125.00 | 7% below | 10% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $117.00 | $130.00 | $61.00–$127.00 | 17% above | 10% |
| Liver function blood test panel CPT 80076 Liver function blood test | $137.00 | $152.00 | $71.00–$149.00 | 3% above | 10% |
| Lyme disease antibody test CPT 86618 Lyme Dis Abs W/ref Western Blot Pspc | $263.00 | $292.00 | $137.00–$286.00 | 93% above | 10% |
| Magnesium blood test CPT 83735 Magnesium Level | $86.00 | $95.00 | $45.00–$93.00 | 19% above | 9% |
| Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Antibody, Igm (Arup Via Rps) | $90.00 | $100.00 | $47.00–$98.00 | at median | 10% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen | $90.00 | $100.00 | $47.00–$98.00 | 38% above | 10% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Total prostate-specific antigen (PSA) test | $127.00 | $141.00 | $66.00–$138.00 | 7% below | 10% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Total prostate-specific antigen (PSA) test | $132.00 | $147.00 | $69.00–$144.00 | 22% above | 10% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap Liquid Based-surepath Pspc | $111.00 | $123.00 | $58.00–$121.00 | 63% above | 10% |
| Parathyroid hormone (PTH) blood test CPT 83970 Pth, Intact Pspc | $259.00 | $288.00 | $135.00–$282.00 | 23% above | 10% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test | $97.00 | $108.00 | $51.00–$106.00 | 23% above | 10% |
| Progesterone blood test CPT 84144 Progesterone Pspc | $169.00 | $188.00 | $88.00–$184.00 | 46% above | 10% |
| Prolactin blood test CPT 84146 Prolactin Pspc | $143.00 | $159.00 | $75.00–$156.00 | 15% above | 10% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time | $62.00 | $69.00 | $32.00–$68.00 | 21% above | 10% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Screen Urine | $180.00 | $200.00 | $94.00–$196.00 | 89% above | 10% |
| Rapid flu test (influenza antigen) CPT 87804 Flu A Ag (Sofia) | $113.00 | $125.00 | $59.00–$123.00 | 45% above | 10% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A (Sofia) | $76.00 | $84.00 | $39.00–$82.00 | 55% above | 10% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Pspc | $72.00 | $80.00 | $38.00–$78.00 | 32% above | 10% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody, Igm Pspc | $65.00 | $72.00 | $34.00–$71.00 | 15% below | 10% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Esr Automated | $48.00 | $53.00 | $25.00–$52.00 | 11% below | 9% |
| Stool ova and parasites exam CPT 87177 Ova & Parasites, Stool Complete Pspc (Foreign Travel Only) | $107.00 | $119.00 | $56.00–$117.00 | 27% above | 10% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Bld Stl Diag 1-3 | $59.00 | $65.00 | $31.00–$64.00 | 41% above | 9% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr Pspc | $45.00 | $50.00 | $24.00–$49.00 | 2% above | 10% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tb Interferon Antigen Response Pspc | $238.00 | $264.00 | $124.00–$259.00 | 16% above | 10% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Pspc | $148.00 | $164.00 | $77.00–$161.00 | 25% above | 10% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (Tpo) Ab Pspc | $113.00 | $126.00 | $59.00–$123.00 | 13% above | 10% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) | $114.00 | $127.00 | $60.00–$124.00 | 1% above | 10% |
| Uric acid blood test CPT 84550 Uric Acid | $60.00 | $67.00 | $31.00–$66.00 | 13% above | 10% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis test using microscope | $60.00 | $67.00 | $31.00–$66.00 | 3% above | 10% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis test | $60.00 | $67.00 | $31.00–$66.00 | 76% above | 10% |
| Urine culture for bacteria, with colony count CPT 87086 Culture, Urine Pspc | $88.00 | $98.00 | $46.00–$96.00 | 23% above | 10% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Pspc | $147.00 | $163.00 | $77.00–$160.00 | 27% above | 10% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level | $167.00 | $185.00 | $87.00–$181.00 | 8% above | 10% |
| Zinc blood test CPT 84630 Zinc, Serum (Rps) Pspc | $59.00 | $66.00 | $31.00–$65.00 | 19% below | 11% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg, Tumor Marker (Pspc) | $135.00 | $150.00 | $71.00–$147.00 | 20% above | 10% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope | $1,461.00 | $1,623.00 | $763.00–$1,591.00 | at median | 10% |
| Colonoscopy with tissue sample CPT 45380 Biopsy exam of large bowel using an endoscope | $2,045.00 | $2,272.00 | $1,068.00–$2,227.00 | 11% above | 10% |
| Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using an endoscope | $1,655.00 | $1,839.00 | $864.00–$1,802.00 | 14% above | 10% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000 Destruction Premalignant Lesions; First Lesion | $148.00 | $164.00 | $77.00–$161.00 | 16% above | 10% |
| Earwax removal by irrigation (rinsing), one ear both sides CPT 69209 69209 Bilateral Removal Impacted Cerumen | $67.00 | $74.00 | $35.00–$73.00 | — | 9% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 69209 Removal Impacted Cerumen Irrigation Lavage Unilateral | $52.00 | $58.00 | $27.00–$57.00 | 12% above | 10% |
| Earwax removal with instruments, one ear CPT 69210 69210 Remove Impacted Cerumen W/instrumentation | $105.00 | $117.00 | $55.00–$115.00 | 18% above | 10% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 45330 Sigmoidoscopy, Flexible; Diagnostic, Including Collection Of Specimen(s) By Brushing Or Washin | $939.00 | $1,043.00 | $490.00–$1,022.00 | 81% above | 10% |
| Hammertoe correction surgery CPT 28285 28285 Correction Hammertoe | $2,520.00 | $2,800.00 | $1,316.00–$2,744.00 | 84% above | 10% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 46221 Hemorrhoidectomy, Internal, By Rubber Band Ligation | $634.00 | $704.00 | $331.00–$690.00 | 3% above | 10% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 46255 Hemorrhoidectomy Internal And External, Single Column/group | $2,837.00 | $3,152.00 | $1,481.00–$3,089.00 | 114% above | 10% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060 I & D Abcess Cyst Furuncle Paronychia Simple | $362.00 | $402.00 | $189.00–$394.00 | 25% above | 10% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 Injection(s); Single Tendon Sheath, Or Ligament, Aponeurosis (Eg, Plantar Fascia) | $126.00 | $140.00 | $66.00–$137.00 | 20% below | 10% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis Aspir And /Inj Major Jt/bursa W/o Us | $145.00 | $161.00 | $76.00–$158.00 | 24% below | 10% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis Aspir&/inj Major Jt/bursa W/o Us Techfee | $290.00 | $322.00 | $151.00–$316.00 | 52% above | 10% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 11981 Insertion, Non-biodegradable Drug Delivery Implant | $300.00 | $333.00 | $157.00–$326.00 | 28% above | 10% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Arthrocentesis Aspir&/inj Interm Jt/burs W/o Us | $121.00 | $134.00 | $63.00–$131.00 | 34% below | 10% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthrocentesis Aspir&/inj Small Jt/bursa W/o Us | $117.00 | $130.00 | $61.00–$127.00 | 17% below | 10% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 Repair, Intermediate; Wounds Of Scalp, Axillae, Trunk, Extremities; <2.5cm | $576.00 | $640.00 | $301.00–$627.00 | 37% above | 10% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 Repair Intermediate S/a/t/e 2.5 Cm/< | $576.00 | $640.00 | $124.00–$627.00 | 37% above | 10% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Injection(s) of therapeutic substance | $250.00 | $278.00 | $131.00–$272.00 | 60% below | 10% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere), Trunk, A | $280.00 | $311.00 | $146.00–$305.00 | 7% below | 10% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440 Excision, Other Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere), Fa | $314.00 | $349.00 | $164.00–$342.00 | 8% below | 10% |
| Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion Of Nail Plate, Partial Or Complete, Simple; Single | $253.00 | $281.00 | $132.00–$275.00 | 6% above | 10% |
| Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion Nail Plate Partial/complete Simple 1 | $253.00 | $281.00 | $46.00–$275.00 | 6% above | 10% |
| Paracentesis with imaging guidance CPT 49083 49083 Pf Abdominal Paracentesis With Imaging Guidance | $646.00 | $718.00 | $87.00–$704.00 | 24% below | 10% |
| Paracentesis with imaging guidance CPT 49083 49083 Op Abdominal Paracentesis With Imaging Guidance | $1,041.00 | $1,157.00 | $544.00–$1,134.00 | 23% above | 10% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 Excision Of Nail And Nail Matrix, Partial Or Complete (Eg, Ingrown Or Deformed Nail), For Perm | $351.00 | $390.00 | $183.00–$382.00 | 5% above | 10% |
| Removal of a foreign object under the skin, simple CPT 10120 10120 I & Removal Foreign Body Subq Tiss Simple | $355.00 | $394.00 | $185.00–$386.00 | 3% above | 10% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 G0121 Colonoscopy Screening | $2,106.00 | $2,340.00 | $1,100.00–$2,293.00 | 154% above | 10% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 G0105 Colorectal Ca Screen High Risk | $2,590.00 | $2,878.00 | $1,353.00–$2,820.00 | 209% above | 10% |
| Short arm splint (forearm and hand) CPT 29125 29125 Application Of Short Arm Splint (Forearm To Hand); Static | $144.00 | $160.00 | $75.00–$157.00 | 6% below | 10% |
| Short arm splint (forearm and hand) CPT 29125 29125 Application Short Arm Splint Forearm-hand Static | $144.00 | $160.00 | $38.00–$157.00 | 6% below | 10% |
| Short leg splint (calf to foot) CPT 29515 29515 Application Short Leg Splint Calf Foot Techfee | $164.00 | $182.00 | $86.00–$178.00 | 1% above | 10% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 Simple Repair Of Superficial Wounds Of Scalp, Neck, Axillae, External Genitalia, Trunk And/or | $203.00 | $225.00 | $106.00–$221.00 | 2% below | 10% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 Pf/tech Simple Repair Scalp/neck/ax/genit/trunk 2.5cm/< | $207.00 | $230.00 | $40.00–$225.00 | at median | 10% |
| Skin biopsy, punch, one lesion CPT 11104 11104 Punch Biopsy Of Skin (Including Simple Closure, When Performed); Single Lesion | $275.00 | $306.00 | $144.00–$300.00 | 8% above | 10% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 11600 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; < 0.5cm | $431.00 | $479.00 | $225.00–$469.00 | 6% above | 10% |
| Skin tag removal, up to 15 tags CPT 11200 11200 Removal Of Skin Tags, Multiple Fibrocutaneous Tags, Any Area; Up To And Including 15 Lesions | $200.00 | $222.00 | $104.00–$218.00 | 3% above | 10% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 Lumbar Puncture | $667.00 | $741.00 | $348.00–$726.00 | 70% above | 10% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 Simple Repair Of Wounds; Scalp, Neck, Axillae, Genitalia, Trunk, Extremeties; 2.6-7.5cm | $245.00 | $272.00 | $128.00–$267.00 | at median | 10% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 Pf/tech Smpl Repair Scalp/neck/ax/genit/trunk 2.6-7.5cm | $245.00 | $272.00 | $52.00–$267.00 | at median | 10% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/or Mucous Membranes | $243.00 | $270.00 | $127.00–$265.00 | 6% above | 10% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 Simple Repair F/e/e/n/l/m 2.5cm/< | $243.00 | $270.00 | $49.00–$265.00 | 6% above | 10% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Clinic Tangenital Biopsy Of Skin; Single Lesion | $222.00 | $247.00 | $116.00–$242.00 | 17% above | 10% |
| Thoracentesis with imaging guidance CPT 32555 32555 Pf Thoracentesis, Needle Or Cath With Imaging Guidance | $694.00 | $771.00 | $88.00–$756.00 | 19% below | 10% |
| Trigger point injections, 1 or 2 muscles CPT 20552 20552 Injection Single/mlt Trigger Point 1/2 Muscles | $121.00 | $134.00 | $63.00–$131.00 | 14% below | 10% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy exam of esophagus, stomach or small bowel using an endoscope | $2,434.00 | $2,704.00 | $1,271.00–$2,650.00 | 26% above | 10% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 43251 Esophagogastroduodenoscopy, Flexible, Transoral; With Removal Of Tumor(s), Polyp(s), Or Other | $1,461.00 | $1,623.00 | $763.00–$1,591.00 | 14% above | 10% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach or small bowel using an endoscope | $1,655.00 | $1,839.00 | $864.00–$1,802.00 | 56% above | 10% |
| Wart removal, up to 14 warts CPT 17110 17110 Destruction (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettemen | $249.00 | $277.00 | $130.00–$271.00 | 30% above | 10% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 Debride Subq Tissue 20 Sq Cm/< Charge | $176.00 | $195.00 | $92.00–$191.00 | 39% below | 10% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Bill Only Blood Administration, 17-23 Hrs | $1,044.00 | $1,160.00 | $545.00–$1,137.00 | 42% above | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 Ed Nebulizer Ippb Device | $281.00 | $312.00 | $147.00–$306.00 | 152% above | 10% |
| Critical care, first 30 to 74 minutes CPT 99291 99291 Trauma Critical Care E&m First 30-74 Techfee | $1,868.00 | $2,075.00 | $975.00–$2,034.00 | 70% above | 10% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Electrocardiogram, routine, with interpretation and report | $180.00 | $200.00 | $94.00–$196.00 | 96% above | 10% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 Electrocardiogram Charge | $311.00 | $345.00 | $162.00–$338.00 | 22% above | 10% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 Nursing Visit Level 1 Charge | $195.00 | $217.00 | $102.00–$213.00 | 28% above | 10% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 Emergency Department Visit Low/moder Severity Tech Fee | $338.00 | $376.00 | $177.00–$368.00 | 51% above | 10% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 Emergency Department Visit Moderate Severity Tech Fee | $533.00 | $592.00 | $278.00–$580.00 | 58% above | 10% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 Trauma Evaluation Techfee | $750.00 | $833.00 | $392.00–$816.00 | 37% above | 10% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 Emergency Dept Visit High Severity&threat Funcj Tech Fee | $1,168.00 | $1,298.00 | $610.00–$1,272.00 | 38% above | 10% |
| Eye exam, returning patient, intermediate CPT 92012 92012 Eye Examest Patient; Intermediate | $198.00 | $220.00 | $103.00–$216.00 | 26% above | 10% |
| Family therapy with the patient, 50 minutes CPT 90847 Family psychotherapy, including patient, 50 min | $761.00 | $845.00 | $397.00–$828.00 | 219% above | 10% |
| Family therapy without the patient, 50 minutes CPT 90846 Family psychotherapy, not including patient, 50 min | $725.00 | $805.00 | $378.00–$789.00 | 252% above | 10% |
| Group psychotherapy session CPT 90853 Group psychotherapy | $662.00 | $735.00 | $345.00–$720.00 | 167% above | 10% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 Iv Inf Hydration 31 Min To 1hr Charge | $365.00 | $406.00 | $191.00–$398.00 | 4% below | 10% |
| IV infusion of a medicine, first hour CPT 96365 96365 Iv Infusion Therapy,initial | $365.00 | $406.00 | $191.00–$398.00 | 5% below | 10% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Subq/im Injection | $149.00 | $166.00 | $78.00–$163.00 | 49% above | 10% |
| Neuromuscular re-education, 15 minutes CPT 97112 Ot Neuromuscular Reeducation Units | $98.00 | $109.00 | $51.00–$107.00 | 4% above | 10% |
| New patient office visit, about 30 minutes CPT 99203 New patient office or other outpatient visit, 30 min | $244.00 | $271.00 | $127.00–$266.00 | 18% above | 10% |
| New patient office visit, about 45 minutes CPT 99204 New patient office or other outpatient visit, 45 min | $365.00 | $405.00 | $190.00–$397.00 | 24% above | 10% |
| New patient office visit, about 60 minutes CPT 99205 New patient office or other outpatient visit, 60 min | $482.00 | $535.00 | $251.00–$524.00 | 30% above | 10% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Office Visit New Pt. Level 2, 15-29 Min | $158.00 | $176.00 | $83.00–$172.00 | 28% above | 10% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 Medical Nutrition Therapy, Initial Assessment, Individual, Ea 15 Min | $81.00 | $90.00 | $42.00–$88.00 | 61% above | 10% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Evaluation Units, Low Complexity | $197.00 | $219.00 | $103.00–$215.00 | 18% above | 10% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Evaluation Units, High Complexity | $257.00 | $286.00 | $134.00–$280.00 | 18% above | 10% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Evaluation Units, Low Complexity | $174.00 | $193.00 | $91.00–$189.00 | 8% above | 10% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Evaluation Units, Moderate Complexity | $203.00 | $225.00 | $106.00–$221.00 | 10% above | 10% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Pt Manual Therapy Units | $98.00 | $109.00 | $51.00–$107.00 | 2% above | 10% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Physical therapy, therapeutic exercise | $93.00 | $103.00 | $48.00–$101.00 | 3% below | 10% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial new patient preventative medicine evaluation (18-39 years) | $243.00 | $270.00 | $127.00–$265.00 | 1% below | 10% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial new patient preventative medicine evaluation (40-64 years) | $280.00 | $311.00 | $146.00–$305.00 | 1% above | 10% |
| Preventive checkup, new patient aged 65 or older CPT 99387 99387 New Patient Wellness Exam 65 Years And Older (Non Medicare) | $304.00 | $338.00 | $159.00–$331.00 | 1% above | 10% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 99395 Preventive Evaluation, Established Pt; 18-39 Yrs | $219.00 | $243.00 | $114.00–$238.00 | 1% above | 10% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 99396 Preventive Evaluation Established Pt; 40-64 Yrs | $232.00 | $258.00 | $121.00–$253.00 | at median | 10% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 99397 Preventive Evaluation, Established Pt; 65+ Yrs | $251.00 | $279.00 | $131.00–$273.00 | 3% above | 10% |
| Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 min | $549.00 | $610.00 | $287.00–$598.00 | 245% above | 10% |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 min | $680.00 | $755.00 | $355.00–$740.00 | 219% above | 10% |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 min | $693.00 | $770.00 | $362.00–$755.00 | 181% above | 10% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 99406 Smoking And Tobacco Use Cessation Visit:intermediate, > 3 Min Up To 10 Min | $33.00 | $37.00 | $17.00–$36.00 | 12% above | 11% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Op Treatment Room Tech Fee | $468.00 | $520.00 | $244.00–$510.00 | 95% above | 10% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office Visit Established Pt. Level 3, 20-29 Min | $199.00 | $221.00 | $104.00–$217.00 | 60% above | 10% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Op Treatement Room Tech Fee | $333.00 | $370.00 | $174.00–$363.00 | 86% above | 10% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office Visit Established Pt. Level 2, 10-19 Min | $124.00 | $138.00 | $65.00–$135.00 | 44% above | 10% |
| Speech and language evaluation CPT 92523 Slp Eval Lang Comprehension,express Unit | $366.00 | $407.00 | $191.00–$399.00 | 16% above | 10% |
| Speech therapy session, individual CPT 92507 Slp Auditory Processing Tx Units | $299.00 | $332.00 | $156.00–$325.00 | 21% above | 10% |
| Spirometry (breathing test) CPT 94010 94010 Pulmonary Function Charge | $279.00 | $310.00 | $146.00–$304.00 | at median | 10% |
| Spirometry before and after a bronchodilator CPT 94060 94060 Pft Complete Charge | $684.00 | $760.00 | $357.00–$745.00 | 17% above | 10% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Ot Therapeutic Activities Units | $98.00 | $109.00 | $51.00–$107.00 | 7% above | 10% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Pt Therapeutic Activity Units | $98.00 | $109.00 | $51.00–$107.00 | 7% above | 10% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Bill Only Therapeutic Phlebotomy | $198.00 | $220.00 | $103.00–$216.00 | 3% above | 10% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 90716 Varivax-varicella Virus Vaccine, Live, For Subcutaneous Use | $178.00 | $198.00 | $93.00–$194.00 | 11% below | 10% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 90656 Influenza Virus Vaccine, Trivalent (Iiv3), Split Virus, Preservative Free, 0.5 Ml Dosage, For | $47.00 | $52.00 | $24.00–$51.00 | 60% above | 10% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 90651 Gardasil 9 Hpv Vaccine | $293.00 | $326.00 | $153.00–$319.00 | 18% below | 10% |
| Hepatitis A vaccine, adult dose CPT 90632 90632 Hepatitis A Vaccine, Adult Dosage, For Intramuscular Use | $166.00 | $184.00 | $86.00–$180.00 | 93% above | 10% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 90746 Hepatitis B Vaccine (Hepb), Adult Dosage, 3 Dose Schedule, For Intramuscular Use | $166.00 | $184.00 | $86.00–$180.00 | 94% above | 10% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 90662 Fluzone High Dose Trivalent (>65) 0.5 Ml | $173.00 | $192.00 | $90.00–$188.00 | 104% above | 10% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Vfc 90707 Priorix Measles, Mumps And Rubella Virus Vaccine (Mmr), Live, For Subcutaneous Use | $18.00 | $20.00 | $9.00–$20.00 | 84% below | 10% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 90707 Priorix Measles, Mumps And Rubella Virus Vaccine (Mmr), Live, For Subcutaneous Use | $100.00 | $111.00 | $52.00–$109.00 | 13% below | 10% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 90734 Meningococcal Conjugate Vaccine, Serogroups A, C, W, Y, Quadrivalent, Diphtheria Toxoid | $439.00 | $488.00 | $229.00–$478.00 | 134% above | 10% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 90620 Bexsero-meningococcal Recomb Protein & Outer Membrane Vesicle Vaccine, Serogroup B (Menb-4c), | $229.00 | $254.00 | $119.00–$249.00 | 17% below | 10% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 90677 Prevnar 20 Pneumococcal 20 Valent | $698.00 | $776.00 | $365.00–$760.00 | 52% above | 10% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 90732 Pneumovax 23-pneumococcal Poly Vac, 23-valent (Ppsv23), Adult Or Immunosuppressed Patient | $313.00 | $348.00 | $164.00–$341.00 | 67% above | 10% |
| Rabies vaccine, one dose CPT 90675 Medication Charge | $583.00 | $648.00 | $305.00–$635.00 | 6% above | 10% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 90750 Shingrix (Shingles) Vaccine, Recombinant, Adjuvanted, For Intramuscular Injection | $203.00 | $225.00 | $106.00–$221.00 | 29% below | 10% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 90714 Tetanus And Diphtheria Toxoids Adsorbed (Td), Preservative Free, When Administered To Individu | $66.00 | $73.00 | $34.00–$72.00 | 26% above | 10% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Vfc 90715 Tdap, When Administered To Individuals 7 Years Or Older, For Intramuscular Use | $18.00 | $20.00 | $9.00–$20.00 | 75% below | 10% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 90715tetanus, Diphtheria Toxoids And Acellular Pertussis Vaccine | $291.00 | $323.00 | $152.00–$317.00 | 310% above | 10% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Medication Charge | $134.00 | $149.00 | $70.00–$146.00 | 23% below | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Im Administration Subq/im Vaccine; Single, | $77.00 | $86.00 | $40.00–$84.00 | 99% above | 10% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Immunization Administration; Each Additional Vaccine | $32.00 | $36.00 | $17.00–$35.00 | 4% below | 11% |