Ascension Via Christi Rehabilitation Hospital
KS
Prices last published by the hospital: —
What these numbers mean.
Cash price is what the hospital lists for patients paying out of pocket.
Negotiated median is the middle of what insurance companies actually agreed to pay.
Gross charge is the sticker price — almost nobody pays it.
What you will actually pay is usually different from both numbers:
with insurance, your deductible, copay, or coinsurance decides what you owe —
the negotiated rate is what the insurer pays, not your bill.
A single line item may not be the whole cost: physician, anesthesia, pathology,
and facility fees can be billed separately.
Prices vary by hospital and change over time; always confirm with the hospital before you go.
Can't afford a bill from Ascension Via Christi Rehabilitation Hospital?
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Financial assistance: see income limits & how to applyPrices at this hospital (472 procedures)
| Procedure | Cash price | Where it sits | Insurance pays (typical) | Gross charge |
|---|---|---|---|---|
| Abdominal ultrasound | —Insurance typically pays $100Sticker price — | — | $100 | — |
| Ablation for supraventricular tachycardia | —Insurance typically pays $17,838Sticker price — | — | $17,838 | — |
| Achilles tendon repair, primary | —Insurance typically pays $2,485Sticker price — | — | $2,485 | — |
| ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION | —Insurance typically pays $9,176Sticker price — | — | $9,176 | — |
| Amino acid analysis, quantitative, each specimen | —Insurance typically pays $23Sticker price — | — | $23 | — |
| Analysis for antibody to Herpes simplex virus | —Insurance typically pays $15Sticker price — | — | $15 | — |
| Ankle-brachial index (ABI), complete | —Insurance typically pays $147Sticker price — | — | $147 | — |
| Ankle-brachial index (ABI), limited | —Insurance typically pays $121Sticker price — | — | $121 | — |
| Ankle fracture repair, open | —Insurance typically pays $2,855Sticker price — | — | $2,855 | — |
| Appendix removal, laparoscopic | —Insurance typically pays $2,122Sticker price — | — | $2,122 | — |
| Application of long leg cast | —Insurance typically pays $248Sticker price — | — | $248 | — |
| Application of short arm cast | —Insurance typically pays $248Sticker price — | — | $248 | — |
| Application of short leg cast | —Insurance typically pays $248Sticker price — | — | $248 | — |
| Application of short leg splint | —Insurance typically pays $147Sticker price — | — | $147 | — |
| Arterial line placement | —Insurance typically pays $197Sticker price — | — | $197 | — |
| Arterial puncture for blood draw | —Insurance typically pays $120Sticker price — | — | $120 | — |
| Arteriovenous fistula creation for dialysis | —Insurance typically pays $2,639Sticker price — | — | $2,639 | — |
| Arthroscopic ACL reconstruction | —Insurance typically pays $3,677Sticker price — | — | $3,677 | — |
| Arthroscopic rotator cuff repair | —Insurance typically pays $4,016Sticker price — | — | $4,016 | — |
| Aspiration of fluid from chest cavity | —Insurance typically pays $578Sticker price — | — | $578 | — |
| Aspiration or injection of ganglion cyst | —Insurance typically pays $276Sticker price — | — | $276 | — |
| Basic metabolic blood panel | —Insurance typically pays $9Sticker price — | — | $9 | — |
| Benign skin growth removal | —Insurance typically pays $657Sticker price — | — | $657 | — |
| Biceps tenodesis (tendon repair) | —Insurance typically pays $2,716Sticker price — | — | $2,716 | — |
| Bladder catheter placement | —Insurance typically pays $120Sticker price — | — | $120 | — |
| Blood count (CBC) | —Insurance typically pays $7Sticker price — | — | $7 | — |
| Blood count with differential | —Insurance typically pays $8Sticker price — | — | $8 | — |
| Blood draw | —Insurance typically pays $9Sticker price — | — | $9 | — |
| Blood sugar test | —Insurance typically pays $4Sticker price — | — | $4 | — |
| Bone biopsy, deep | —Insurance typically pays $446Sticker price — | — | $446 | — |
| Bone biopsy, superficial | —Insurance typically pays $297Sticker price — | — | $297 | — |
| Bowel adhesion removal, laparoscopic | —Insurance typically pays $3,305Sticker price — | — | $3,305 | — |
| Breast biopsy, open | —Insurance typically pays $866Sticker price — | — | $866 | — |
| Breast biopsy with stereotactic guidance | —Insurance typically pays $421Sticker price — | — | $421 | — |
| Bunionectomy | —Insurance typically pays $2,030Sticker price — | — | $2,030 | — |
| BUN kidney test | —Insurance typically pays $4Sticker price — | — | $4 | — |
| Capillary blood draw (finger stick) | —Insurance typically pays $3Sticker price — | — | $3 | — |
| Cardiac stress test | —Insurance typically pays $332Sticker price — | — | $332 | — |
| Carotid endarterectomy | —Insurance typically pays $4,164Sticker price — | — | $4,164 | — |
| Carpal tunnel release | —Insurance typically pays $1,617Sticker price — | — | $1,617 | — |
| Cataract surgery, complex | —Insurance typically pays $3,711Sticker price — | — | $3,711 | — |
| Cataract surgery with lens implant | —Insurance typically pays $2,667Sticker price — | — | $2,667 | — |
| Cervical spinal fusion, anterior | —Insurance typically pays $7,197Sticker price — | — | $7,197 | — |
| Cesarean delivery only | —Insurance typically pays $2,809Sticker price — | — | $2,809 | — |
| Cesarean delivery with routine obstetric care | —Insurance typically pays $6,253Sticker price — | — | $6,253 | — |
| Chemotherapy infusion, additional hour | —Insurance typically pays $66Sticker price — | — | $66 | — |
| Chemotherapy infusion, first hour | —Insurance typically pays $310Sticker price — | — | $310 | — |
| Chemotherapy injection under skin or into muscle | —Insurance typically pays $66Sticker price — | — | $66 | — |
| Chiropractic adjustment | —Insurance typically pays $24Sticker price — | — | $24 | — |
| Cholesterol panel | —Insurance typically pays $14Sticker price — | — | $14 | — |
| Closed treatment of broken middle or upper end of outside lower leg bone | —Insurance typically pays $224Sticker price — | — | $224 | — |
| Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation | —Insurance typically pays $2,098Sticker price — | — | $2,098 | — |
| Clotting factor VII (proconvertin, stable factor) | —Insurance typically pays $18Sticker price — | — | $18 | — |
| Cold knife conization of cervix | —Insurance typically pays $1,008Sticker price — | — | $1,008 | — |
| Colectomy with colostomy | —Insurance typically pays $6,000Sticker price — | — | $6,000 | — |
| Colonoscopy | —Insurance typically pays $852Sticker price — | — | $852 | — |
| Colonoscopy with ablation of lesion | —Insurance typically pays $1,263Sticker price — | — | $1,263 | — |
| Colonoscopy with biopsy | —Insurance typically pays $983Sticker price — | — | $983 | — |
| Colonoscopy with polyp removal | —Insurance typically pays $1,168Sticker price — | — | $1,168 | — |
| Colonoscopy with submucosal injection | —Insurance typically pays $1,025Sticker price — | — | $1,025 | — |
| Coronary angiography | —Insurance typically pays $9,315Sticker price — | — | $9,315 | — |
| Coronary angioplasty (balloon), single vessel | —Insurance typically pays $12,668Sticker price — | — | $12,668 | — |
| Creatinine test | —Insurance typically pays $5Sticker price — | — | $5 | — |
| Critical care, additional 30 minutes | —Insurance typically pays $2,088Sticker price — | — | $2,088 | — |
| Critical care, first hour | —Insurance typically pays $795Sticker price — | — | $795 | — |
| C-section delivery | —Insurance typically pays $9,729Sticker price — | — | $9,729 | — |
| CT abdomen and pelvis with contrast | —Insurance typically pays $337Sticker price — | — | $337 | — |
| CT head without contrast | —Insurance typically pays $100Sticker price — | — | $100 | — |
| Debridement of skin, muscle or fascia | —Insurance typically pays $572Sticker price — | — | $572 | — |
| Defibrillator interrogation in office | —Insurance typically pays $35Sticker price — | — | $35 | — |
| DEPRESSIVE NEUROSES | —Insurance typically pays $8,802Sticker price — | — | $8,802 | — |
| Detailed obstetric ultrasound | —Insurance typically pays $228Sticker price — | — | $228 | — |
| Detection test by immunoassay technique for rotavirus | —Insurance typically pays $12Sticker price — | — | $12 | — |
| Diagnostic exam of bladder and urethra using an endoscope | —Insurance typically pays $623Sticker price — | — | $623 | — |
| Diagnostic exam of lower portion of large bowel using a flexible endoscope | —Insurance typically pays $852Sticker price — | — | $852 | — |
| Dilation and curettage (D&C), diagnostic | —Insurance typically pays $807Sticker price — | — | $807 | — |
| DISORDERS OF PERSONALITY AND IMPULSE CONTROL | —Insurance typically pays $11,576Sticker price — | — | $11,576 | — |
| Distal radius fracture repair, open | —Insurance typically pays $2,644Sticker price — | — | $2,644 | — |
| Doctor office visit (established patient) | —Insurance typically pays $108Sticker price — | — | $108 | — |
| Doctor visit, established patient | —Insurance typically pays $227Sticker price — | — | $227 | — |
| Doctor visit, established patient, complex | —Insurance typically pays $320Sticker price — | — | $320 | — |
| Doctor visit, established patient, quick | —Insurance typically pays $58Sticker price — | — | $58 | — |
| Doctor visit, new patient | —Insurance typically pays $374Sticker price — | — | $374 | — |
| Doctor visit, new patient | —Insurance typically pays $162Sticker price — | — | $162 | — |
| Doctor visit, new patient, complex | —Insurance typically pays $483Sticker price — | — | $483 | — |
| Doctor visit, new patient, quick | —Insurance typically pays $108Sticker price — | — | $108 | — |
| Duplex ultrasound of aorta and iliac arteries | —Insurance typically pays $227Sticker price — | — | $227 | — |
| Duplex ultrasound of dialysis access | —Insurance typically pays $100Sticker price — | — | $100 | — |
| Duplex ultrasound of lower extremity arteries, bilateral | —Insurance typically pays $227Sticker price — | — | $227 | — |
| Ear wax removal | —Insurance typically pays $55Sticker price — | — | $55 | — |
| ECG reading | —Insurance typically pays $33Sticker price — | — | $33 | — |
| EEG, awake and asleep | —Insurance typically pays $291Sticker price — | — | $291 | — |
| EEG, awake and drowsy | —Insurance typically pays $291Sticker price — | — | $291 | — |
| EKG | —Insurance typically pays $71Sticker price — | — | $71 | — |
| Electrophysiology study, comprehensive | —Insurance typically pays $2,405Sticker price — | — | $2,405 | — |
| Emergency room visit, high complexity | —Insurance typically pays $578Sticker price — | — | $578 | — |
| Emergency room visit (high severity) | —Insurance typically pays $402Sticker price — | — | $402 | — |
| Emergency room visit, low complexity | —Insurance typically pays $149Sticker price — | — | $149 | — |
| Emergency room visit, minor | —Insurance typically pays $83Sticker price — | — | $83 | — |
| Emergency room visit, moderate | —Insurance typically pays $261Sticker price — | — | $261 | — |
| Endoscopic lumbar decompression | —Insurance typically pays $3,409Sticker price — | — | $3,409 | — |
| Epidural injection, cervical or thoracic | —Insurance typically pays $647Sticker price — | — | $647 | — |
| Epidural steroid shot, lower back | —Insurance typically pays $647Sticker price — | — | $647 | — |
| Esophagus stretching | —Insurance typically pays $660Sticker price — | — | $660 | — |
| ESRD dialysis management, adult | —Insurance typically pays $839Sticker price — | — | $839 | — |
| Excision of breast lesion with radiologic marker | —Insurance typically pays $964Sticker price — | — | $964 | — |
| Extended doctor visit | —Insurance typically pays $94Sticker price — | — | $94 | — |
| Eye exam | —Insurance typically pays $120Sticker price — | — | $120 | — |
| Eye exam, established patient | —Insurance typically pays $120Sticker price — | — | $120 | — |
| Eye exam, new patient | —Insurance typically pays $120Sticker price — | — | $120 | — |
| Eye exam, new patient, comprehensive | —Insurance typically pays $120Sticker price — | — | $120 | — |
| Eye injection | —Insurance typically pays $310Sticker price — | — | $310 | — |
| Eyelid bump removal | —Insurance typically pays $120Sticker price — | — | $120 | — |
| Facet joint injection, cervical or thoracic | —Insurance typically pays $832Sticker price — | — | $832 | — |
| Facet joint injection, lumbar or sacral | —Insurance typically pays $832Sticker price — | — | $832 | — |
| Femoral/popliteal artery stent placement | —Insurance typically pays $2,195Sticker price — | — | $2,195 | — |
| Femoral-popliteal bypass graft | —Insurance typically pays $5,569Sticker price — | — | $5,569 | — |
| Femur shaft fracture repair with plate or screws | —Insurance typically pays $4,971Sticker price — | — | $4,971 | — |
| Ferritin test | —Insurance typically pays $14Sticker price — | — | $14 | — |
| Fetal non-stress test | —Insurance typically pays $188Sticker price — | — | $188 | — |
| Flu shot | —Insurance typically pays $52Sticker price — | — | $52 | — |
| Flu shot | —Insurance typically pays $108Sticker price — | — | $108 | — |
| Gallbladder removal (laparoscopic) | —Insurance typically pays $7,024Sticker price — | — | $7,024 | — |
| Gastric bypass (Roux-en-Y), open | —Insurance typically pays $5,855Sticker price — | — | $5,855 | — |
| Glaucoma laser treatment | —Insurance typically pays $512Sticker price — | — | $512 | — |
| Glaucoma laser treatment | —Insurance typically pays $512Sticker price — | — | $512 | — |
| Hammertoe correction | —Insurance typically pays $1,226Sticker price — | — | $1,226 | — |
| HCHG ACTH PLASMA LC | —Insurance typically pays $39Sticker price — | — | $39 | — |
| HCHG AFB CONCENTRATION | —Insurance typically pays $7Sticker price — | — | $7 | — |
| HCHG ALDOLASE LC | —Insurance typically pays $10Sticker price — | — | $10 | — |
| HCHG ALK PHOSPHATASE | —Insurance typically pays $5Sticker price — | — | $5 | — |
| HCHG ALPHA-1-ANTITRYPSIN SERUM LC | —Insurance typically pays $14Sticker price — | — | $14 | — |
| HCHG AMINO ACIDEMIAS (PKU) | —Insurance typically pays $25Sticker price — | — | $25 | — |
| HCHG AMPA RECEPTOR ABY TITER SPINAL FLUID | —Insurance typically pays $12Sticker price — | — | $12 | — |
| HCHG ANA | —Insurance typically pays $12Sticker price — | — | $12 | — |
| HCHG ANAEROBIC CULTURE | —Insurance typically pays $10Sticker price — | — | $10 | — |
| HCHG ANTI-DNASE B STREP ANTIBODIES LC | —Insurance typically pays $14Sticker price — | — | $14 | — |
| HCHG ANTISTREPTOLYSIN O AB LC | —Insurance typically pays $7Sticker price — | — | $7 | — |
| HCHG ANTITHROMBIN III | —Insurance typically pays $12Sticker price — | — | $12 | — |
| HCHG ARC-ABY ID EACH SELECTED REAGENT CELL | —Insurance typically pays $158Sticker price — | — | $158 | — |
| HCHG ARTHROCENT/ASPIR/INJ SMALL JOINT/BURSA WO US | —Insurance typically pays $276Sticker price — | — | $276 | — |
| HCHG BLOOD/BLOOD PRODUCT ADMIN PER UNIT | —Insurance typically pays $408Sticker price — | — | $408 | — |
| HCHG CA15.3 | —Insurance typically pays $21Sticker price — | — | $21 | — |
| HCHG CARBAMAZEPINE | —Insurance typically pays $15Sticker price — | — | $15 | — |
| HCHG CATECHOLAMINESURFREE24 HR LC | —Insurance typically pays $26Sticker price — | — | $26 | — |
| HCHG CF SCREEN | —Insurance typically pays $12Sticker price — | — | $12 | — |
| HCHG CHROMIUM BLOOD | —Insurance typically pays $21Sticker price — | — | $21 | — |
| HCHG CHROMOGRANIN A | —Insurance typically pays $21Sticker price — | — | $21 | — |
| HCHG CMV IGM ABY | —Insurance typically pays $17Sticker price — | — | $17 | — |
| HCHG CMV QUANT DNA PCR (PLASMA) LC | —Insurance typically pays $44Sticker price — | — | $44 | — |
| HCHG COMPREHENSIVE METABOLIC PANE | —Insurance typically pays $11Sticker price — | — | $11 | — |
| HCHG COVID 19 NAA LC | —Insurance typically pays $52Sticker price — | — | $52 | — |
| HCHG C-PEPTIDE SERUM | —Insurance typically pays $21Sticker price — | — | $21 | — |
| HCHG CREATININE URINE | —Insurance typically pays $5Sticker price — | — | $5 | — |
| HCHG CROSSMATCH IS | —Insurance typically pays $160Sticker price — | — | $160 | — |
| HCHG CRYOGLOBULIN QUAL WITH REFLEX | —Insurance typically pays $7Sticker price — | — | $7 | — |
| HCHG CRYPTOCOCCAL AG LATEX SCREEN W/REFL TITER QUE | —Insurance typically pays $12Sticker price — | — | $12 | — |
| HCHG CT CHEST TUBE PLACEMENT AND PLEURAL DRAINAGE | —Insurance typically pays $687Sticker price — | — | $687 | — |
| HCHG CT SOFT TISSUE NECK W CONTRAST | —Insurance typically pays $168Sticker price — | — | $168 | — |
| HCHG CT THORACENTESIS PLEURAL ASPIRATION | —Insurance typically pays $578Sticker price — | — | $578 | — |
| HCHG DEBRIDE SQ TISSUE FIRST 20 SQ CM | —Insurance typically pays $373Sticker price — | — | $373 | — |
| HCHG DHEA SERUM LC | —Insurance typically pays $26Sticker price — | — | $26 | — |
| HCHG DIPTHERIA TOXOID IGG ABY | —Insurance typically pays $15Sticker price — | — | $15 | — |
| HCHG DIRECT ANTIGLOBULIN TEST | —Insurance typically pays $55Sticker price — | — | $55 | — |
| HCHG EBV NA | —Insurance typically pays $16Sticker price — | — | $16 | — |
| HCHG EBV VCA IGG | —Insurance typically pays $18Sticker price — | — | $18 | — |
| HCHG ECHO 2D F-U OR LTD STUDY W BUBBLE | —Insurance typically pays $226Sticker price — | — | $226 | — |
| HCHG FACTOR 2 GENE MUTATION | —Insurance typically pays $67Sticker price — | — | $67 | — |
| HCHG FACTOR 8 ASSAY | —Insurance typically pays $18Sticker price — | — | $18 | — |
| HCHG FACTOR IX ACTIVITY LC | —Insurance typically pays $19Sticker price — | — | $19 | — |
| HCHG FLUORO < 1 HOUR | —Insurance typically pays $226Sticker price — | — | $226 | — |
| HCHG FOLIC ACID | —Insurance typically pays $15Sticker price — | — | $15 | — |
| HCHG FSH-SERUM | —Insurance typically pays $19Sticker price — | — | $19 | — |
| HCHG GENERAL LAB 8007400 | —Insurance typically pays $49Sticker price — | — | $49 | — |
| HCHG GENERAL LAB 8663103 LC | —Insurance typically pays $12Sticker price — | — | $12 | — |
| HCHG GENERAL LAB 8670600 | —Insurance typically pays $11Sticker price — | — | $11 | — |
| HCHG GENERAL LAB 8680300 | —Insurance typically pays $15Sticker price — | — | $15 | — |
| HCHG GENERAL LAB 8738900 | —Insurance typically pays $25Sticker price — | — | $25 | — |
| HCHG GENERAL LAB 8748602 LC | —Insurance typically pays $36Sticker price — | — | $36 | — |
| HCHG GENERAL LAB 8749100 | —Insurance typically pays $36Sticker price — | — | $36 | — |
| HCHG GENERAL LAB 87522 LCC | —Insurance typically pays $44Sticker price — | — | $44 | — |
| HCHG GENTAMICIN KINETICS | —Insurance typically pays $17Sticker price — | — | $17 | — |
| HCHG GRAM STAIN | —Insurance typically pays $4Sticker price — | — | $4 | — |
| HCHG HEMOGLOBINOPATHIES | —Insurance typically pays $13Sticker price — | — | $13 | — |
| HCHG H HEMACHROMATOSIS | —Insurance typically pays $67Sticker price — | — | $67 | — |
| HCHG H. PYLORI ANTIGEN STOOL | —Insurance typically pays $15Sticker price — | — | $15 | — |
| HCHG ICU MD RETROPERITONEAL LIMITED | —Insurance typically pays $100Sticker price — | — | $100 | — |
| HCHG I D ABSCESS/CARB/CYST SINGLE SIMPLE | —Insurance typically pays $186Sticker price — | — | $186 | — |
| HCHG I D HEMATOMA/SEROMA FLUID COLL | —Insurance typically pays $397Sticker price — | — | $397 | — |
| HCHG IHC STAIN ADDL | —Insurance typically pays $97Sticker price — | — | $97 | — |
| HCHG IHC STAIN FIRST | —Insurance typically pays $160Sticker price — | — | $160 | — |
| HCHG INJ EPIDURAL BLOOD/CLOT PATCH TX | —Insurance typically pays $647Sticker price — | — | $647 | — |
| HCHG INSERT PICC WO SUBQ PORT/PUMP WO GUIDANCE >5 | —Insurance typically pays $368Sticker price — | — | $368 | — |
| HCHG INTRINSIC FACTOR ABS SERUM LC | —Insurance typically pays $15Sticker price — | — | $15 | — |
| HCHG INTUBATION ENDOTRACHEAL EMERGENCY | —Insurance typically pays $217Sticker price — | — | $217 | — |
| HCHG IR INJ CHOLANGIOGRAPHY PERC W GUIDE EXISTING | —Insurance typically pays $384Sticker price — | — | $384 | — |
| HCHG IRON | —Insurance typically pays $7Sticker price — | — | $7 | — |
| HCHG JAK2 MUTATION DETECTION | —Insurance typically pays $93Sticker price — | — | $93 | — |
| HCHG LEAD FILTER PAPER | —Insurance typically pays $12Sticker price — | — | $12 | — |
| HCHG LUTEINIZING HORMONE | —Insurance typically pays $19Sticker price — | — | $19 | — |
| HCHG MEAS POST VOID RES US NON-IMAGING | —Insurance typically pays $55Sticker price — | — | $55 | — |
| HCHG N METHYLHISTAMINE URINE | —Insurance typically pays $25Sticker price — | — | $25 | — |
| HCHG OCCULT BLOOD IFOBT | —Insurance typically pays $16Sticker price — | — | $16 | — |
| HCHG OT APPLICATION LONG ARM CAST | —Insurance typically pays $248Sticker price — | — | $248 | — |
| HCHG OT EVAL HIGH COMPLEXITY | —Insurance typically pays $97Sticker price — | — | $97 | — |
| HCHG OT EVAL LOW COMPLEXITY | —Insurance typically pays $97Sticker price — | — | $97 | — |
| HCHG OT EVAL MOD COMPLEXITY | —Insurance typically pays $97Sticker price — | — | $97 | — |
| HCHG OT RE-EVALUATION | —Insurance typically pays $67Sticker price — | — | $67 | — |
| HCHG OT THER INTERVENT COGNITIVE FUNCT 1 1 EA ADDL | —Insurance typically pays $20Sticker price — | — | $20 | — |
| HCHG OT THER INTERVENT COGNITIVE FUNCT 1 1 INIT 15 | —Insurance typically pays $21Sticker price — | — | $21 | — |
| HCHG PARACENTESIS ABD WO IMAGING | —Insurance typically pays $876Sticker price — | — | $876 | — |
| HCHG PFT C0 MEMBRANE DIFFUSE CAPACITY | —Insurance typically pays $129Sticker price — | — | $129 | — |
| HCHG PHENOBARBITAL | —Insurance typically pays $16Sticker price — | — | $16 | — |
| HCHG PLCMT NEPHROSTOMY CATHETER WWO NEPHRO/URETERO | —Insurance typically pays $886Sticker price — | — | $886 | — |
| HCHG POTASSIUM | —Insurance typically pays $5Sticker price — | — | $5 | — |
| HCHG PROCALCITONIN | —Insurance typically pays $28Sticker price — | — | $28 | — |
| HCHG PROTEIN TOTAL | —Insurance typically pays $4Sticker price — | — | $4 | — |
| HCHG PROTHOMBIN TIME | —Insurance typically pays $4Sticker price — | — | $4 | — |
| HCHG PT APPLICATION LONG ARM SPLINT | —Insurance typically pays $147Sticker price — | — | $147 | — |
| HCHG PT E-STIM-ATTENDED 15MIN | —Insurance typically pays $14Sticker price — | — | $14 | — |
| HCHG PT EVAL HIGH COMPLEXITY | —Insurance typically pays $94Sticker price — | — | $94 | — |
| HCHG PT EVAL LOW COMPLEXITY | —Insurance typically pays $94Sticker price — | — | $94 | — |
| HCHG PT EVAL MOD COMPLEXITY | —Insurance typically pays $94Sticker price — | — | $94 | — |
| HCHG PT FLUIDOTHERAPY | —Insurance typically pays $15Sticker price — | — | $15 | — |
| HCHG PT GAIT TRAINING 15MIN | —Insurance typically pays $28Sticker price — | — | $28 | — |
| HCHG PT GROUP THERAPY | —Insurance typically pays $17Sticker price — | — | $17 | — |
| HCHG PT IONTOPHORESIS 15MIN | —Insurance typically pays $18Sticker price — | — | $18 | — |
| HCHG PT MANUAL THERAPY 15MIN | —Insurance typically pays $26Sticker price — | — | $26 | — |
| HCHG PT MASSAGE 15 MIN | —Insurance typically pays $28Sticker price — | — | $28 | — |
| HCHG PT MECHANICAL TRACTION | —Insurance typically pays $14Sticker price — | — | $14 | — |
| HCHG PT NEUROMUSCULAR RE-ED 15MIN | —Insurance typically pays $31Sticker price — | — | $31 | — |
| HCHG PT ORTHO/PROSTHETIC TRAIN UPR/LWR EXT TRUNK S | —Insurance typically pays $47Sticker price — | — | $47 | — |
| HCHG PT ORTHOTIC FIT/TRAIN UPR/LWR EXT TRUNK INITI | —Insurance typically pays $43Sticker price — | — | $43 | — |
| HCHG PT PHONOPHORESIS 15MIN | —Insurance typically pays $13Sticker price — | — | $13 | — |
| HCHG PT PROSTHETIC TRAIN UPR/LWR EXT INITIAL ENC E | —Insurance typically pays $38Sticker price — | — | $38 | — |
| HCHG PT RE-EVALUATION | —Insurance typically pays $65Sticker price — | — | $65 | — |
| HCHG PT SELFCARE/HOME MNGMNT 15MIN | —Insurance typically pays $31Sticker price — | — | $31 | — |
| HCHG PT STRAPPING ANKLE | —Insurance typically pays $147Sticker price — | — | $147 | — |
| HCHG PT THERAPEUTIC ACTIVITY 15MIN | —Insurance typically pays $33Sticker price — | — | $33 | — |
| HCHG PT THERAPEUTIC EXERCISE 15MIN | —Insurance typically pays $28Sticker price — | — | $28 | — |
| HCHG RAD CT ANGIO CHEST | —Insurance typically pays $168Sticker price — | — | $168 | — |
| HCHG RAD CT ANGIO HEART CORONARY ARTERIES | —Insurance typically pays $337Sticker price — | — | $337 | — |
| HCHG RAD CT ANGIO LOWER EXTREMITY | —Insurance typically pays $168Sticker price — | — | $168 | — |
| HCHG RAD CT ANGIO NECK W CONTRAST | —Insurance typically pays $168Sticker price — | — | $168 | — |
| HCHG RAD CT GUIDED NEEDLE PLACEMENT | —Insurance typically pays $307Sticker price — | — | $307 | — |
| HCHG RAD CT HEAD BRAIN WWO | —Insurance typically pays $168Sticker price — | — | $168 | — |
| HCHG RAD CT LIMITED OR LOCALIZED FOLLOW UP | —Insurance typically pays $83Sticker price — | — | $83 | — |
| HCHG RAD CT LOWER EXTREMITY WO | —Insurance typically pays $100Sticker price — | — | $100 | — |
| HCHG RAD ECHO STRESS TRANSTHORACIC 2D EXERCISE OR | —Insurance typically pays $512Sticker price — | — | $512 | — |
| HCHG RAD MRI ANGIO HEAD BRAIN WWO | —Insurance typically pays $337Sticker price — | — | $337 | — |
| HCHG RAD MRI ANGIO HEAD WO | —Insurance typically pays $228Sticker price — | — | $228 | — |
| HCHG RAD MRI ANGIO NECK WO | —Insurance typically pays $228Sticker price — | — | $228 | — |
| HCHG RAD MRI ANGIO NECK WWO | —Insurance typically pays $337Sticker price — | — | $337 | — |
| HCHG RAD MRI JOINT LOWER EXTREMITY WO | —Insurance typically pays $228Sticker price — | — | $228 | — |
| HCHG RAD MRI SPINE CERVICAL WO | —Insurance typically pays $228Sticker price — | — | $228 | — |
| HCHG RAD MRI SPINE THORACIC WO | —Insurance typically pays $228Sticker price — | — | $228 | — |
| HCHG RAD NM BONE SCAN WHOLE BODY | —Insurance typically pays $379Sticker price — | — | $379 | — |
| HCHG RAD NM LUNG PERFUSION SCAN | —Insurance typically pays $379Sticker price — | — | $379 | — |
| HCHG RAD NM LUNG VENTILATION AND PERFUSION QUANTIT | —Insurance typically pays $508Sticker price — | — | $508 | — |
| HCHG RAD NM RADIOPHARM ORAL THERAPY | —Insurance typically pays $209Sticker price — | — | $209 | — |
| HCHG RAD US ARTERIAL UPPER EXTREMITY BILATERAL COM | —Insurance typically pays $227Sticker price — | — | $227 | — |
| HCHG RAD XRAY ABDOMEN ACUTE W CHEST 1 VIEW | —Insurance typically pays $99Sticker price — | — | $99 | — |
| HCHG RAD XRAY CHEST FRONTAL 1 VIEW | —Insurance typically pays $82Sticker price — | — | $82 | — |
| HCHG RAD XRAY FEMUR 1 VIEW UNILATERAL | —Insurance typically pays $82Sticker price — | — | $82 | — |
| HCHG RAD XRAY FOOT 2 VIEWS | —Insurance typically pays $82Sticker price — | — | $82 | — |
| HCHG RAD XRAY KNEE 3 VIEWS | —Insurance typically pays $82Sticker price — | — | $82 | — |
| HCHG RAD XRAY KNEES STANDING BILATERAL | —Insurance typically pays $82Sticker price — | — | $82 | — |
| HCHG RAD XRAY MANDIBLE MINIMUM OF FOUR VIEWS | —Insurance typically pays $99Sticker price — | — | $99 | — |
| HCHG RAD XRAY RIBS 3 VIEWS BILATERAL | —Insurance typically pays $99Sticker price — | — | $99 | — |
| HCHG REPLACE CATH ONLY CVAD W SQ PORT/PUMP | —Insurance typically pays $835Sticker price — | — | $835 | — |
| HCHG REPOSITIONING PREV PLC CV CATH FLUOR GUID | —Insurance typically pays $246Sticker price — | — | $246 | — |
| HCHG RESPIRATORY DISEASE MULTIPLEX PCR PANEL | —Insurance typically pays $425Sticker price — | — | $425 | — |
| HCHG REVERSE T3 SERUM LC | —Insurance typically pays $16Sticker price — | — | $16 | — |
| HCHG RN APPL MULTLAY COMPRS LWR LEG UNILATERAL | —Insurance typically pays $147Sticker price — | — | $147 | — |
| HCHG SCHISTOSOMA IGG ABY | —Insurance typically pays $13Sticker price — | — | $13 | — |
| HCHG SELENIUM SERUM/PLASMA LC | —Insurance typically pays $26Sticker price — | — | $26 | — |
| HCHG SLP EVAL ORAL/PHAR SWALLOWING | —Insurance typically pays $80Sticker price — | — | $80 | — |
| HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP | —Insurance typically pays $216Sticker price — | — | $216 | — |
| HCHG SLP INDIV TX COMMUNICATION | —Insurance typically pays $72Sticker price — | — | $72 | — |
| HCHG SODIUM URINE | —Insurance typically pays $5Sticker price — | — | $5 | — |
| HCHG SP STAIN 1 ORG | —Insurance typically pays $50Sticker price — | — | $50 | — |
| HCHG STONE ANALYSIS LC | —Insurance typically pays $13Sticker price — | — | $13 | — |
| HCHG STOOL CULTURE AEROBIC BACTERIA LC | —Insurance typically pays $10Sticker price — | — | $10 | — |
| HCHG T3 FREE | —Insurance typically pays $17Sticker price — | — | $17 | — |
| HCHG T4 FREE | —Insurance typically pays $9Sticker price — | — | $9 | — |
| HCHG TACROLIMUS AHL | —Insurance typically pays $14Sticker price — | — | $14 | — |
| HCHG TESTOSTERONE FREE EQUILIBRIUM ULTRAFILTRATION | —Insurance typically pays $26Sticker price — | — | $26 | — |
| HCHG THER APHERESIS PLASMA PHERESIS | —Insurance typically pays $353Sticker price — | — | $353 | — |
| HCHG THY PEROXIDASE ABY | —Insurance typically pays $15Sticker price — | — | $15 | — |
| HCHG THYROGLOBULIN ABY LC | —Insurance typically pays $16Sticker price — | — | $16 | — |
| HCHG THYROGLOBULIN TUMOR MARKER FNA ASP BX NEEDLE | —Insurance typically pays $16Sticker price — | — | $16 | — |
| HCHG TISSUE LEVEL 2 | —Insurance typically pays $37Sticker price — | — | $37 | — |
| HCHG TOTAL T CELLS | —Insurance typically pays $38Sticker price — | — | $38 | — |
| HCHG URIC ACID URINE | —Insurance typically pays $5Sticker price — | — | $5 | — |
| HCHG US ABDOMEN LIMITED | —Insurance typically pays $100Sticker price — | — | $100 | — |
| HCHG VALPROIC ACID | —Insurance typically pays $14Sticker price — | — | $14 | — |
| HCHG VANILLYLMANDELIC ACID 24-HR U LC | —Insurance typically pays $16Sticker price — | — | $16 | — |
| HCHG VEDOLIZUMAB QUANT LC | —Insurance typically pays $39Sticker price — | — | $39 | — |
| HCHG VENOUS MECH THROMBECTOMY | —Insurance typically pays $1,664Sticker price — | — | $1,664 | — |
| HCHG VITAMIN A SERUM LC | —Insurance typically pays $12Sticker price — | — | $12 | — |
| HCHG VITAMIN B6 PLASMA LC | —Insurance typically pays $29Sticker price — | — | $29 | — |
| Heart catheterization | —Insurance typically pays $9,315Sticker price — | — | $9,315 | — |
| Heart catheterization with bypass graft angiography | —Insurance typically pays $9,315Sticker price — | — | $9,315 | — |
| Heart stent placement | —Insurance typically pays $12,668Sticker price — | — | $12,668 | — |
| Heart ultrasound | —Insurance typically pays $512Sticker price — | — | $512 | — |
| Hemodialysis with repeated evaluation | —Insurance typically pays $325Sticker price — | — | $325 | — |
| Hemodialysis with single evaluation | —Insurance typically pays $654Sticker price — | — | $654 | — |
| Hemorrhoid banding | —Insurance typically pays $852Sticker price — | — | $852 | — |
| Hemorrhoid removal | —Insurance typically pays $1,634Sticker price — | — | $1,634 | — |
| Hernia repair (inguinal) | —Insurance typically pays $1,834Sticker price — | — | $1,834 | — |
| Hernia repair, laparoscopic | —Insurance typically pays $1,501Sticker price — | — | $1,501 | — |
| Hernia repair, open | —Insurance typically pays $2,627Sticker price — | — | $2,627 | — |
| Hip fracture repair with pins or screws | —Insurance typically pays $4,438Sticker price — | — | $4,438 | — |
| Hip fracture repair with plate and screws | —Insurance typically pays $4,566Sticker price — | — | $4,566 | — |
| Hip replacement (total) | —Insurance typically pays $5,390Sticker price — | — | $5,390 | — |
| Hormonal chemotherapy injection | —Insurance typically pays $66Sticker price — | — | $66 | — |
| Hospital admission visit | —Insurance typically pays $579Sticker price — | — | $579 | — |
| Hospital admission visit | —Insurance typically pays $392Sticker price — | — | $392 | — |
| Hospital discharge visit | —Insurance typically pays $206Sticker price — | — | $206 | — |
| Hospital discharge visit, extended | —Insurance typically pays $302Sticker price — | — | $302 | — |
| Hospital follow-up visit | —Insurance typically pays $209Sticker price — | — | $209 | — |
| Hospital follow-up visit, complex | —Insurance typically pays $301Sticker price — | — | $301 | — |
| Hysterectomy (laparoscopic) | —Insurance typically pays $3,806Sticker price — | — | $3,806 | — |
| Hysteroscopy with biopsy | —Insurance typically pays $1,002Sticker price — | — | $1,002 | — |
| Hysteroscopy with endometrial ablation | —Insurance typically pays $1,289Sticker price — | — | $1,289 | — |
| Iliac artery stent placement | —Insurance typically pays $2,164Sticker price — | — | $2,164 | — |
| Inguinal hernia repair, incarcerated, open | —Insurance typically pays $2,259Sticker price — | — | $2,259 | — |
| Insertion of tube in bypass graft for diagnosis with review by radiologist | —Insurance typically pays $9,315Sticker price — | — | $9,315 | — |
| Insertion of tube in right heart chambers for measurement | —Insurance typically pays $9,315Sticker price — | — | $9,315 | — |
| Iron test | —Insurance typically pays $9Sticker price — | — | $9 | — |
| Irrigation of implanted venous access (port flush) | —Insurance typically pays $55Sticker price — | — | $55 | — |
| IV hydration infusion, additional hour | —Insurance typically pays $43Sticker price — | — | $43 | — |
| IV hydration infusion, first hour | —Insurance typically pays $197Sticker price — | — | $197 | — |
| IV infusion, additional drug or sequence | —Insurance typically pays $66Sticker price — | — | $66 | — |
| IV infusion, additional hour | —Insurance typically pays $43Sticker price — | — | $43 | — |
| IV infusion, first hour | —Insurance typically pays $197Sticker price — | — | $197 | — |
| IV placement (needle into vein) | —Insurance typically pays $37Sticker price — | — | $37 | — |
| IV push injection | —Insurance typically pays $197Sticker price — | — | $197 | — |
| Joint injection, large joint | —Insurance typically pays $276Sticker price — | — | $276 | — |
| Joint injection, medium joint | —Insurance typically pays $276Sticker price — | — | $276 | — |
| Joint injection with ultrasound | —Insurance typically pays $276Sticker price — | — | $276 | — |
| Kidney function panel | —Insurance typically pays $9Sticker price — | — | $9 | — |
| Knee arthroscopy | —Insurance typically pays $2,367Sticker price — | — | $2,367 | — |
| Knee arthroscopy, meniscectomy medial and lateral | —Insurance typically pays $2,536Sticker price — | — | $2,536 | — |
| Knee arthroscopy with debridement | —Insurance typically pays $2,274Sticker price — | — | $2,274 | — |
| Knee arthroscopy with meniscus repair | —Insurance typically pays $2,561Sticker price — | — | $2,561 | — |
| Knee replacement (total) | —Insurance typically pays $5,764Sticker price — | — | $5,764 | — |
| Kyphoplasty (vertebral augmentation) | —Insurance typically pays $2,182Sticker price — | — | $2,182 | — |
| Laparoscopic colectomy with anastomosis | —Insurance typically pays $6,628Sticker price — | — | $6,628 | — |
| Laparoscopic gastric bypass | —Insurance typically pays $6,240Sticker price — | — | $6,240 | — |
| Laparoscopic incisional hernia repair | —Insurance typically pays $3,139Sticker price — | — | $3,139 | — |
| Laparoscopic inguinal hernia repair, incarcerated | —Insurance typically pays $1,846Sticker price — | — | $1,846 | — |
| Laparoscopic partial colectomy | —Insurance typically pays $5,561Sticker price — | — | $5,561 | — |
| Laparoscopic removal of ovary | —Insurance typically pays $2,404Sticker price — | — | $2,404 | — |
| Laparoscopic sleeve gastrectomy | —Insurance typically pays $18,266Sticker price — | — | $18,266 | — |
| Laparoscopic ventral hernia repair | —Insurance typically pays $2,728Sticker price — | — | $2,728 | — |
| Laser treatment after cataract surgery | —Insurance typically pays $512Sticker price — | — | $512 | — |
| LDH test | —Insurance typically pays $6Sticker price — | — | $6 | — |
| LEEP conization of cervix | —Insurance typically pays $899Sticker price — | — | $899 | — |
| Left heart catheterization with coronary angiography | —Insurance typically pays $9,315Sticker price — | — | $9,315 | — |
| Leg vein ultrasound | —Insurance typically pays $227Sticker price — | — | $227 | — |
| Liver biopsy | —Insurance typically pays $385Sticker price — | — | $385 | — |
| Liver function panel | —Insurance typically pays $8Sticker price — | — | $8 | — |
| Lumbar laminectomy with discectomy | —Insurance typically pays $7,024Sticker price — | — | $7,024 | — |
| Lumbar laminectomy with facetectomy | —Insurance typically pays $7,024Sticker price — | — | $7,024 | — |
| Lumbar spinal fusion, posterior | —Insurance typically pays $5,875Sticker price — | — | $5,875 | — |
| Lumpectomy (partial mastectomy) | —Insurance typically pays $2,124Sticker price — | — | $2,124 | — |
| Lysis of bowel adhesions, open | —Insurance typically pays $3,926Sticker price — | — | $3,926 | — |
| Manipulation of knee under anesthesia | —Insurance typically pays $538Sticker price — | — | $538 | — |
| Mastectomy, modified radical | —Insurance typically pays $3,922Sticker price — | — | $3,922 | — |
| Mastectomy, simple | —Insurance typically pays $3,292Sticker price — | — | $3,292 | — |
| Mohs skin cancer surgery | —Insurance typically pays $572Sticker price — | — | $572 | — |
| Molecular pathology procedure level 6 genetic analysis | —Insurance typically pays $307Sticker price — | — | $307 | — |
| Molecular pathology procedure level 7 genetic analysis | —Insurance typically pays $286Sticker price — | — | $286 | — |
| Molecular pathology procedure level 9 genetic analysis | —Insurance typically pays $4,648Sticker price — | — | $4,648 | — |
| MRI brain with and without contrast | —Insurance typically pays $337Sticker price — | — | $337 | — |
| MRI brain without contrast | —Insurance typically pays $228Sticker price — | — | $228 | — |
| MRI lower back with and without contrast | —Insurance typically pays $337Sticker price — | — | $337 | — |
| MRI lower back without contrast | —Insurance typically pays $228Sticker price — | — | $228 | — |
| Nail avulsion, additional nail | —Insurance typically pays $102Sticker price — | — | $102 | — |
| Nail avulsion (ingrown nail removal) | —Insurance typically pays $186Sticker price — | — | $186 | — |
| Nail bed removal | —Insurance typically pays $373Sticker price — | — | $373 | — |
| Nail trimming, 6 or more nails | —Insurance typically pays $55Sticker price — | — | $55 | — |
| Nebulizer treatment | —Insurance typically pays $190Sticker price — | — | $190 | — |
| Neck artery ultrasound | —Insurance typically pays $227Sticker price — | — | $227 | — |
| Needle EMG, one extremity | —Insurance typically pays $120Sticker price — | — | $120 | — |
| Needle EMG, two extremities | —Insurance typically pays $120Sticker price — | — | $120 | — |
| Nerve conduction study, 1-2 nerves | —Insurance typically pays $146Sticker price — | — | $146 | — |
| Nerve conduction study, 3-4 nerves | —Insurance typically pays $291Sticker price — | — | $291 | — |
| Nerve conduction study, 5-6 nerves | —Insurance typically pays $291Sticker price — | — | $291 | — |
| Nuclear heart stress test | —Insurance typically pays $1,256Sticker price — | — | $1,256 | — |
| Nursing home visit | —Insurance typically pays $191Sticker price — | — | $191 | — |
| Nursing home visit, complex | —Insurance typically pays $252Sticker price — | — | $252 | — |
| Obstetric ultrasound | —Insurance typically pays $100Sticker price — | — | $100 | — |
| Occipital nerve block | —Insurance typically pays $276Sticker price — | — | $276 | — |
| Occlusion of growths or obstructed vessels with review by radiologist | —Insurance typically pays $2,407Sticker price — | — | $2,407 | — |
| Osteotomy of foot bone | —Insurance typically pays $1,540Sticker price — | — | $1,540 | — |
| OTHER CARDIOTHORACIC PROCEDURES WITH MCC | —Insurance typically pays $21,783Sticker price — | — | $21,783 | — |
| OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC | —Insurance typically pays $14,274Sticker price — | — | $14,274 | — |
| OTHER HEART ASSIST SYSTEM IMPLANT | —Insurance typically pays $20,160Sticker price — | — | $20,160 | — |
| Pacemaker insertion, single chamber | —Insurance typically pays $1,813Sticker price — | — | $1,813 | — |
| Pacemaker interrogation in office | —Insurance typically pays $35Sticker price — | — | $35 | — |
| Panniculectomy (excess abdominal skin removal) | —Insurance typically pays $3,911Sticker price — | — | $3,911 | — |
| Parathyroidectomy | —Insurance typically pays $3,696Sticker price — | — | $3,696 | — |
| Partial colectomy | —Insurance typically pays $4,819Sticker price — | — | $4,819 | — |
| Partial excision of foot bone | —Insurance typically pays $1,914Sticker price — | — | $1,914 | — |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC | —Insurance typically pays $21,783Sticker price — | — | $21,783 | — |
| Peripheral nerve block | —Insurance typically pays $647Sticker price — | — | $647 | — |
| Peritoneal dialysis with single evaluation | —Insurance typically pays $398Sticker price — | — | $398 | — |
| Posterior spinal instrumentation | —Insurance typically pays $2,895Sticker price — | — | $2,895 | — |
| Precancerous skin spot removal | —Insurance typically pays $186Sticker price — | — | $186 | — |
| Precancerous skin spots removal, 15+ | —Insurance typically pays $373Sticker price — | — | $373 | — |
| Precancerous skin spots removal, 2-14 | —Insurance typically pays $15Sticker price — | — | $15 | — |
| Radiofrequency ablation, lumbar/sacral facet nerve | —Insurance typically pays $1,029Sticker price — | — | $1,029 | — |
| Radiofrequency ablation of facet joint nerve | —Insurance typically pays $1,050Sticker price — | — | $1,050 | — |
| Removal of abdominal cavity tube | —Insurance typically pays $1,391Sticker price — | — | $1,391 | — |
| Retina scan (OCT) | —Insurance typically pays $55Sticker price — | — | $55 | — |
| Rhythm ECG interpretation | —Insurance typically pays $48Sticker price — | — | $48 | — |
| Sacroiliac joint injection | —Insurance typically pays $275Sticker price — | — | $275 | — |
| Salpingo-oophorectomy (tube and ovary removal) | —Insurance typically pays $2,674Sticker price — | — | $2,674 | — |
| Screening mammogram (3D) | —Insurance typically pays $83Sticker price — | — | $83 | — |
| Shot in muscle or under skin | —Insurance typically pays $66Sticker price — | — | $66 | — |
| Shoulder arthroscopy with distal clavicle excision | —Insurance typically pays $2,476Sticker price — | — | $2,476 | — |
| Shoulder arthroscopy with subacromial decompression | —Insurance typically pays $2,464Sticker price — | — | $2,464 | — |
| Sigmoidoscopy | —Insurance typically pays $852Sticker price — | — | $852 | — |
| Sigmoidoscopy with biopsy | —Insurance typically pays $398Sticker price — | — | $398 | — |
| Simple drainage of abscess of finger | —Insurance typically pays $186Sticker price — | — | $186 | — |
| Skin biopsy, shave | —Insurance typically pays $186Sticker price — | — | $186 | — |
| Skin cancer removal | —Insurance typically pays $373Sticker price — | — | $373 | — |
| Skin substitute graft | —Insurance typically pays $393Sticker price — | — | $393 | — |
| Sleep study (polysomnography) | —Insurance typically pays $960Sticker price — | — | $960 | — |
| Sleep study with CPAP initiation | —Insurance typically pays $960Sticker price — | — | $960 | — |
| Small bowel resection | —Insurance typically pays $4,386Sticker price — | — | $4,386 | — |
| Spinal nerve injection, lower back | —Insurance typically pays $832Sticker price — | — | $832 | — |
| Spirometry before and after bronchodilator | —Insurance typically pays $291Sticker price — | — | $291 | — |
| Spirometry (lung function test) | —Insurance typically pays $146Sticker price — | — | $146 | — |
| Stool blood test | —Insurance typically pays $4Sticker price — | — | $4 | — |
| Tdap vaccine | —Insurance typically pays $64Sticker price — | — | $64 | — |
| Tendon insertion injection | —Insurance typically pays $276Sticker price — | — | $276 | — |
| Tendon sheath injection | —Insurance typically pays $276Sticker price — | — | $276 | — |
| Therapy session, 60 minutes | —Insurance typically pays $151Sticker price — | — | $151 | — |
| Thyroid biopsy, open | —Insurance typically pays $657Sticker price — | — | $657 | — |
| Thyroid (TSH) test | —Insurance typically pays $17Sticker price — | — | $17 | — |
| Tilt table test | —Insurance typically pays $496Sticker price — | — | $496 | — |
| Tissue lab exam (pathology) | —Insurance typically pays $50Sticker price — | — | $50 | — |
| Tonsillectomy | —Insurance typically pays $931Sticker price — | — | $931 | — |
| Total abdominal hysterectomy | —Insurance typically pays $3,703Sticker price — | — | $3,703 | — |
| Total shoulder replacement (arthroplasty) | —Insurance typically pays $5,604Sticker price — | — | $5,604 | — |
| Total thyroidectomy | —Insurance typically pays $3,550Sticker price — | — | $3,550 | — |
| Total thyroidectomy with neck dissection | —Insurance typically pays $4,822Sticker price — | — | $4,822 | — |
| Transforaminal epidural, additional level | —Insurance typically pays $281Sticker price — | — | $281 | — |
| Trigger finger release | —Insurance typically pays $1,076Sticker price — | — | $1,076 | — |
| Trigger point injection | —Insurance typically pays $276Sticker price — | — | $276 | — |
| Trigger point injections, multiple | —Insurance typically pays $276Sticker price — | — | $276 | — |
| Unattended home sleep study | —Insurance typically pays $148Sticker price — | — | $148 | — |
| Upper endoscopy | —Insurance typically pays $876Sticker price — | — | $876 | — |
| Upper endoscopy (EGD) | —Insurance typically pays $876Sticker price — | — | $876 | — |
| Upper endoscopy with ablation | —Insurance typically pays $975Sticker price — | — | $975 | — |
| Upper endoscopy with control of bleeding | —Insurance typically pays $1,075Sticker price — | — | $1,075 | — |
| Upper endoscopy with fine needle biopsy | —Insurance typically pays $1,612Sticker price — | — | $1,612 | — |
| Upper endoscopy with guide wire placement | —Insurance typically pays $876Sticker price — | — | $876 | — |
| Upper endoscopy with limited ultrasound | —Insurance typically pays $895Sticker price — | — | $895 | — |
| Upper endoscopy with submucosal injection | —Insurance typically pays $876Sticker price — | — | $876 | — |
| Upper endoscopy with ultrasound | —Insurance typically pays $1,155Sticker price — | — | $1,155 | — |
| Urinalysis | —Insurance typically pays $3Sticker price — | — | $3 | — |
| Vaginal delivery only | —Insurance typically pays $2,366Sticker price — | — | $2,366 | — |
| VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC | —Insurance typically pays $5,558Sticker price — | — | $5,558 | — |
| Vaginal delivery with routine obstetric care | —Insurance typically pays $5,523Sticker price — | — | $5,523 | — |
| Vertebroplasty | —Insurance typically pays $1,854Sticker price — | — | $1,854 | — |
| Visual field test | —Insurance typically pays $120Sticker price — | — | $120 | — |
| Voice box scope | —Insurance typically pays $181Sticker price — | — | $181 | — |
| Wound repair, layered stitches | —Insurance typically pays $373Sticker price — | — | $373 | — |
Source: this hospital's own published price file. Original file · Methodology