Belton Regional Medical Center
MO 64012
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 Belton Regional Medical Center?
This hospital has a financial assistance program that may reduce or erase it.
Financial assistance: see income limits & how to applyPrices at this hospital (465 procedures)
| Procedure | Cash price | Where it sits | Insurance pays (typical) | Gross charge |
|---|---|---|---|---|
| Abdominal ultrasound | —Insurance typically pays $114Sticker price — | — | $114 | — |
| Ablation for supraventricular tachycardia | —Insurance typically pays $15,460Sticker price — | — | $15,460 | — |
| Achilles tendon repair, primary | —Insurance typically pays $4,345Sticker price — | — | $4,345 | — |
| Amino acid analysis, quantitative, each specimen | —Insurance typically pays $23Sticker price — | — | $23 | — |
| Analysis for antibody to Herpes simplex virus | —Insurance typically pays $14Sticker price — | — | $14 | — |
| Ankle-brachial index (ABI), complete | —Insurance typically pays $124Sticker price — | — | $124 | — |
| Ankle-brachial index (ABI), limited | —Insurance typically pays $93Sticker price — | — | $93 | — |
| Ankle fracture repair, open | —Insurance typically pays $4,345Sticker price — | — | $4,345 | — |
| Appendix removal, laparoscopic | —Insurance typically pays $5,486Sticker price — | — | $5,486 | — |
| Application of long leg cast | —Insurance typically pays $561Sticker price — | — | $561 | — |
| Application of short arm cast | —Insurance typically pays $561Sticker price — | — | $561 | — |
| Application of short leg cast | —Insurance typically pays $561Sticker price — | — | $561 | — |
| Application of short leg splint | —Insurance typically pays $313Sticker price — | — | $313 | — |
| Arterial line placement | —Insurance typically pays $2,479Sticker price — | — | $2,479 | — |
| Arterial puncture for blood draw | —Insurance typically pays $877Sticker price — | — | $877 | — |
| Arteriovenous fistula creation for dialysis | —Insurance typically pays $3,495Sticker price — | — | $3,495 | — |
| Arthroscopic ACL reconstruction | —Insurance typically pays $6,399Sticker price — | — | $6,399 | — |
| Arthroscopic rotator cuff repair | —Insurance typically pays $5,558Sticker price — | — | $5,558 | — |
| Aspiration of fluid from chest cavity | —Insurance typically pays $1,932Sticker price — | — | $1,932 | — |
| Aspiration or injection of ganglion cyst | —Insurance typically pays $1,321Sticker price — | — | $1,321 | — |
| Basic metabolic blood panel | —Insurance typically pays $8Sticker price — | — | $8 | — |
| Benign skin growth removal | —Insurance typically pays $1,859Sticker price — | — | $1,859 | — |
| Biceps tenodesis (tendon repair) | —Insurance typically pays $5,363Sticker price — | — | $5,363 | — |
| Bladder catheter placement | —Insurance typically pays $1,156Sticker price — | — | $1,156 | — |
| Blood count (CBC) | —Insurance typically pays $6Sticker price — | — | $6 | — |
| Blood count with differential | —Insurance typically pays $8Sticker price — | — | $8 | — |
| Blood draw | —Insurance typically pays $3Sticker price — | — | $3 | — |
| Blood sugar test | —Insurance typically pays $4Sticker price — | — | $4 | — |
| Bone biopsy, deep | —Insurance typically pays $2,357Sticker price — | — | $2,357 | — |
| Bone biopsy, superficial | —Insurance typically pays $1,932Sticker price — | — | $1,932 | — |
| Bowel adhesion removal, laparoscopic | —Insurance typically pays $4,669Sticker price — | — | $4,669 | — |
| Breast biopsy, open | —Insurance typically pays $4,006Sticker price — | — | $4,006 | — |
| Breast biopsy with stereotactic guidance | —Insurance typically pays $2,219Sticker price — | — | $2,219 | — |
| Bunionectomy | —Insurance typically pays $4,038Sticker price — | — | $4,038 | — |
| BUN kidney test | —Insurance typically pays $4Sticker price — | — | $4 | — |
| Capillary blood draw (finger stick) | —Insurance typically pays $1,995Sticker price — | — | $1,995 | — |
| Cardiac stress test | —Insurance typically pays $130Sticker price — | — | $130 | — |
| Carotid endarterectomy | —Insurance typically pays $2,550Sticker price — | — | $2,550 | — |
| Carpal tunnel release | —Insurance typically pays $2,624Sticker price — | — | $2,624 | — |
| Cataract surgery, complex | —Insurance typically pays $3,159Sticker price — | — | $3,159 | — |
| Cataract surgery with lens implant | —Insurance typically pays $3,159Sticker price — | — | $3,159 | — |
| Cervical spinal fusion, anterior | —Insurance typically pays $10,265Sticker price — | — | $10,265 | — |
| Cesarean delivery only | —Insurance typically pays $2,272Sticker price — | — | $2,272 | — |
| Cesarean delivery with routine obstetric care | —Insurance typically pays $2,964Sticker price — | — | $2,964 | — |
| Chemotherapy infusion, additional hour | —Insurance typically pays $55Sticker price — | — | $55 | — |
| Chemotherapy infusion, first hour | —Insurance typically pays $283Sticker price — | — | $283 | — |
| Chemotherapy injection under skin or into muscle | —Insurance typically pays $55Sticker price — | — | $55 | — |
| Chiropractic adjustment | —Insurance typically pays $24Sticker price — | — | $24 | — |
| Cholesterol panel | —Insurance typically pays $13Sticker price — | — | $13 | — |
| Closed treatment of broken middle or upper end of outside lower leg bone | —Insurance typically pays $1,441Sticker price — | — | $1,441 | — |
| Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation | —Insurance typically pays $2,609Sticker price — | — | $2,609 | — |
| Clotting factor VII (proconvertin, stable factor) | —Insurance typically pays $18Sticker price — | — | $18 | — |
| Cold knife conization of cervix | —Insurance typically pays $2,550Sticker price — | — | $2,550 | — |
| Colectomy with colostomy | —Insurance typically pays $2,550Sticker price — | — | $2,550 | — |
| Colonoscopy | —Insurance typically pays $1,666Sticker price — | — | $1,666 | — |
| Colonoscopy with ablation of lesion | —Insurance typically pays $1,933Sticker price — | — | $1,933 | — |
| Colonoscopy with biopsy | —Insurance typically pays $1,666Sticker price — | — | $1,666 | — |
| Colonoscopy with polyp removal | —Insurance typically pays $1,995Sticker price — | — | $1,995 | — |
| Colonoscopy with submucosal injection | —Insurance typically pays $1,995Sticker price — | — | $1,995 | — |
| Coronary angiography | —Insurance typically pays $4,610Sticker price — | — | $4,610 | — |
| Coronary angioplasty (balloon), single vessel | —Insurance typically pays $7,514Sticker price — | — | $7,514 | — |
| Creatinine test | —Insurance typically pays $5Sticker price — | — | $5 | — |
| Critical care, additional 30 minutes | —Insurance typically pays $1,224Sticker price — | — | $1,224 | — |
| Critical care, first hour | —Insurance typically pays $687Sticker price — | — | $687 | — |
| CT abdomen and pelvis with contrast | —Insurance typically pays $414Sticker price — | — | $414 | — |
| CT head without contrast | —Insurance typically pays $167Sticker price — | — | $167 | — |
| Debridement of skin, muscle or fascia | —Insurance typically pays $1,629Sticker price — | — | $1,629 | — |
| Defibrillator interrogation in office | —Insurance typically pays $33Sticker price — | — | $33 | — |
| Detailed obstetric ultrasound | —Insurance typically pays $166Sticker price — | — | $166 | — |
| 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 $1,932Sticker price — | — | $1,932 | — |
| Diagnostic exam of lower portion of large bowel using a flexible endoscope | —Insurance typically pays $1,368Sticker price — | — | $1,368 | — |
| Dialysis circuit angiogram | —Insurance typically pays $1,614Sticker price — | — | $1,614 | — |
| Dilation and curettage (D&C), diagnostic | —Insurance typically pays $2,550Sticker price — | — | $2,550 | — |
| Distal radius fracture repair, open | —Insurance typically pays $5,295Sticker price — | — | $5,295 | — |
| Doctor office visit (established patient) | —Insurance typically pays $135Sticker price — | — | $135 | — |
| Doctor visit, established patient | —Insurance typically pays $177Sticker price — | — | $177 | — |
| Doctor visit, established patient, complex | —Insurance typically pays $224Sticker price — | — | $224 | — |
| Doctor visit, established patient, quick | —Insurance typically pays $135Sticker price — | — | $135 | — |
| Doctor visit, new patient | —Insurance typically pays $224Sticker price — | — | $224 | — |
| Doctor visit, new patient | —Insurance typically pays $177Sticker price — | — | $177 | — |
| Doctor visit, new patient, complex | —Insurance typically pays $318Sticker price — | — | $318 | — |
| Doctor visit, new patient, quick | —Insurance typically pays $135Sticker price — | — | $135 | — |
| Duplex ultrasound of aorta and iliac arteries | —Insurance typically pays $204Sticker price — | — | $204 | — |
| Duplex ultrasound of dialysis access | —Insurance typically pays $97Sticker price — | — | $97 | — |
| Duplex ultrasound of lower extremity arteries, bilateral | —Insurance typically pays $204Sticker price — | — | $204 | — |
| Ear wax removal | —Insurance typically pays $313Sticker price — | — | $313 | — |
| ECG reading | —Insurance typically pays $14Sticker price — | — | $14 | — |
| EEG, awake and asleep | —Insurance typically pays $235Sticker price — | — | $235 | — |
| EEG, awake and drowsy | —Insurance typically pays $235Sticker price — | — | $235 | — |
| EKG | —Insurance typically pays $31Sticker price — | — | $31 | — |
| Electrophysiology study, comprehensive | —Insurance typically pays $6,915Sticker price — | — | $6,915 | — |
| Emergency room visit, high complexity | —Insurance typically pays $3,194Sticker price — | — | $3,194 | — |
| Emergency room visit (high severity) | —Insurance typically pays $2,134Sticker price — | — | $2,134 | — |
| Emergency room visit, low complexity | —Insurance typically pays $468Sticker price — | — | $468 | — |
| Emergency room visit, minor | —Insurance typically pays $210Sticker price — | — | $210 | — |
| Emergency room visit, moderate | —Insurance typically pays $948Sticker price — | — | $948 | — |
| Endoscopic lumbar decompression | —Insurance typically pays $5,556Sticker price — | — | $5,556 | — |
| Epidural injection, cervical or thoracic | —Insurance typically pays $2,040Sticker price — | — | $2,040 | — |
| Epidural steroid shot, lower back | —Insurance typically pays $2,040Sticker price — | — | $2,040 | — |
| Esophagus stretching | —Insurance typically pays $1,995Sticker price — | — | $1,995 | — |
| ESRD dialysis management, adult | —Insurance typically pays $235Sticker price — | — | $235 | — |
| Excision of breast lesion with radiologic marker | —Insurance typically pays $4,006Sticker price — | — | $4,006 | — |
| Extended doctor visit | —Insurance typically pays $25Sticker price — | — | $25 | — |
| Eye exam | —Insurance typically pays $108Sticker price — | — | $108 | — |
| Eye exam, established patient | —Insurance typically pays $108Sticker price — | — | $108 | — |
| Eye exam, new patient | —Insurance typically pays $108Sticker price — | — | $108 | — |
| Eye exam, new patient, comprehensive | —Insurance typically pays $108Sticker price — | — | $108 | — |
| Eye injection | —Insurance typically pays $1,321Sticker price — | — | $1,321 | — |
| Eyelid bump removal | —Insurance typically pays $313Sticker price — | — | $313 | — |
| Facet joint injection, cervical or thoracic | —Insurance typically pays $1,964Sticker price — | — | $1,964 | — |
| Facet joint injection, lumbar or sacral | —Insurance typically pays $1,964Sticker price — | — | $1,964 | — |
| Femoral/popliteal artery stent placement | —Insurance typically pays $7,950Sticker price — | — | $7,950 | — |
| Femoral-popliteal bypass graft | —Insurance typically pays $2,550Sticker price — | — | $2,550 | — |
| Femur shaft fracture repair with plate or screws | —Insurance typically pays $2,948Sticker price — | — | $2,948 | — |
| Ferritin test | —Insurance typically pays $14Sticker price — | — | $14 | — |
| Fetal non-stress test | —Insurance typically pays $1,156Sticker price — | — | $1,156 | — |
| Flu shot | —Insurance typically pays $22Sticker price — | — | $22 | — |
| Flu shot | —Insurance typically pays $35Sticker price — | — | $35 | — |
| Gallbladder removal (laparoscopic) | —Insurance typically pays $4,950Sticker price — | — | $4,950 | — |
| Gastric bypass (Roux-en-Y), open | —Insurance typically pays $3,640Sticker price — | — | $3,640 | — |
| Glaucoma laser treatment | —Insurance typically pays $1,859Sticker price — | — | $1,859 | — |
| Glaucoma laser treatment | —Insurance typically pays $1,859Sticker price — | — | $1,859 | — |
| Hammertoe correction | —Insurance typically pays $3,762Sticker price — | — | $3,762 | — |
| 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 $13Sticker price — | — | $13 | — |
| HCHG AMINO ACIDEMIAS (PKU) | —Insurance typically pays $24Sticker price — | — | $24 | — |
| 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 $9Sticker price — | — | $9 | — |
| HCHG ANTI-DNASE B STREP ANTIBODIES LC | —Insurance typically pays $13Sticker price — | — | $13 | — |
| 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 $6Sticker price — | — | $6 | — |
| HCHG ARTHROCENT/ASPIR/INJ SMALL JOINT/BURSA WO US | —Insurance typically pays $1,071Sticker price — | — | $1,071 | — |
| HCHG BLOOD/BLOOD PRODUCT ADMIN PER UNIT | —Insurance typically pays $1,201Sticker price — | — | $1,201 | — |
| HCHG CA15.3 | —Insurance typically pays $21Sticker price — | — | $21 | — |
| HCHG CARBAMAZEPINE | —Insurance typically pays $15Sticker price — | — | $15 | — |
| HCHG CATECHOLAMINESURFREE24 HR LC | —Insurance typically pays $25Sticker price — | — | $25 | — |
| HCHG CF SCREEN | —Insurance typically pays $12Sticker price — | — | $12 | — |
| HCHG CHROMIUM BLOOD | —Insurance typically pays $20Sticker price — | — | $20 | — |
| 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 $43Sticker price — | — | $43 | — |
| HCHG COMPREHENSIVE METABOLIC PANE | —Insurance typically pays $11Sticker price — | — | $11 | — |
| HCHG COVID 19 NAA LC | —Insurance typically pays $51Sticker price — | — | $51 | — |
| 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 $61Sticker price — | — | $61 | — |
| HCHG CRYOGLOBULIN QUAL WITH REFLEX | —Insurance typically pays $6Sticker price — | — | $6 | — |
| 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 $1,932Sticker price — | — | $1,932 | — |
| HCHG CT SOFT TISSUE NECK W CONTRAST | —Insurance typically pays $329Sticker price — | — | $329 | — |
| HCHG CT THORACENTESIS PLEURAL ASPIRATION | —Insurance typically pays $1,932Sticker price — | — | $1,932 | — |
| HCHG DEBRIDE SQ TISSUE FIRST 20 SQ CM | —Insurance typically pays $1,629Sticker price — | — | $1,629 | — |
| HCHG DHEA SERUM LC | —Insurance typically pays $25Sticker price — | — | $25 | — |
| HCHG DIPTHERIA TOXOID IGG ABY | —Insurance typically pays $15Sticker price — | — | $15 | — |
| HCHG DIRECT ANTIGLOBULIN TEST | —Insurance typically pays $6Sticker price — | — | $6 | — |
| HCHG EBV NA | —Insurance typically pays $15Sticker price — | — | $15 | — |
| HCHG EBV VCA IGG | —Insurance typically pays $18Sticker price — | — | $18 | — |
| HCHG ECHO 2D F-U OR LTD STUDY W BUBBLE | —Insurance typically pays $204Sticker price — | — | $204 | — |
| HCHG FACTOR 2 GENE MUTATION | —Insurance typically pays $65Sticker price — | — | $65 | — |
| 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 $115Sticker price — | — | $115 | — |
| 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 $48Sticker price — | — | $48 | — |
| 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 $14Sticker price — | — | $14 | — |
| HCHG GENERAL LAB 8738900 | —Insurance typically pays $24Sticker price — | — | $24 | — |
| HCHG GENERAL LAB 8748602 LC | —Insurance typically pays $35Sticker price — | — | $35 | — |
| HCHG GENERAL LAB 8749100 | —Insurance typically pays $35Sticker price — | — | $35 | — |
| HCHG GENERAL LAB 87522 LCC | —Insurance typically pays $43Sticker price — | — | $43 | — |
| HCHG GENTAMICIN KINETICS | —Insurance typically pays $16Sticker price — | — | $16 | — |
| HCHG GRAM STAIN | —Insurance typically pays $4Sticker price — | — | $4 | — |
| HCHG HEMOGLOBINOPATHIES | —Insurance typically pays $13Sticker price — | — | $13 | — |
| HCHG H HEMACHROMATOSIS | —Insurance typically pays $65Sticker price — | — | $65 | — |
| HCHG H. PYLORI ANTIGEN STOOL | —Insurance typically pays $14Sticker price — | — | $14 | — |
| HCHG ICU MD RETROPERITONEAL LIMITED | —Insurance typically pays $97Sticker price — | — | $97 | — |
| HCHG I D ABSCESS/CARB/CYST SINGLE SIMPLE | —Insurance typically pays $718Sticker price — | — | $718 | — |
| HCHG I D HEMATOMA/SEROMA FLUID COLL | —Insurance typically pays $1,712Sticker price — | — | $1,712 | — |
| HCHG IHC STAIN ADDL | —Insurance typically pays $69Sticker price — | — | $69 | — |
| HCHG IHC STAIN FIRST | —Insurance typically pays $98Sticker price — | — | $98 | — |
| HCHG INJ EPIDURAL BLOOD/CLOT PATCH TX | —Insurance typically pays $1,932Sticker price — | — | $1,932 | — |
| HCHG INSERT PICC WO SUBQ PORT/PUMP WO GUIDANCE >5 | —Insurance typically pays $2,550Sticker price — | — | $2,550 | — |
| HCHG INTRINSIC FACTOR ABS SERUM LC | —Insurance typically pays $15Sticker price — | — | $15 | — |
| HCHG INTUBATION ENDOTRACHEAL EMERGENCY | —Insurance typically pays $1,201Sticker price — | — | $1,201 | — |
| HCHG IR INJ CHOLANGIOGRAPHY PERC W GUIDE EXISTING | —Insurance typically pays $2,687Sticker price — | — | $2,687 | — |
| HCHG IRON | —Insurance typically pays $6Sticker price — | — | $6 | — |
| HCHG JAK2 MUTATION DETECTION | —Insurance typically pays $92Sticker price — | — | $92 | — |
| 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 $313Sticker price — | — | $313 | — |
| HCHG N METHYLHISTAMINE URINE | —Insurance typically pays $24Sticker price — | — | $24 | — |
| HCHG OCCULT BLOOD IFOBT | —Insurance typically pays $16Sticker price — | — | $16 | — |
| HCHG OT APPLICATION LONG ARM CAST | —Insurance typically pays $561Sticker price — | — | $561 | — |
| HCHG OT EVAL HIGH COMPLEXITY | —Insurance typically pays $96Sticker price — | — | $96 | — |
| HCHG OT EVAL LOW COMPLEXITY | —Insurance typically pays $96Sticker price — | — | $96 | — |
| HCHG OT EVAL MOD COMPLEXITY | —Insurance typically pays $96Sticker price — | — | $96 | — |
| HCHG OT RE-EVALUATION | —Insurance typically pays $65Sticker price — | — | $65 | — |
| HCHG OT THER INTERVENT COGNITIVE FUNCT 1 1 EA ADDL | —Insurance typically pays $22Sticker price — | — | $22 | — |
| HCHG OT THER INTERVENT COGNITIVE FUNCT 1 1 INIT 15 | —Insurance typically pays $22Sticker price — | — | $22 | — |
| HCHG PARACENTESIS ABD WO IMAGING | —Insurance typically pays $2,122Sticker price — | — | $2,122 | — |
| HCHG PFT C0 MEMBRANE DIFFUSE CAPACITY | —Insurance typically pays $53Sticker price — | — | $53 | — |
| HCHG PHENOBARBITAL | —Insurance typically pays $15Sticker price — | — | $15 | — |
| HCHG PLCMT NEPHROSTOMY CATHETER WWO NEPHRO/URETERO | —Insurance typically pays $2,656Sticker price — | — | $2,656 | — |
| HCHG POTASSIUM | —Insurance typically pays $5Sticker price — | — | $5 | — |
| HCHG PROCALCITONIN | —Insurance typically pays $27Sticker price — | — | $27 | — |
| HCHG PROTEIN TOTAL | —Insurance typically pays $4Sticker price — | — | $4 | — |
| HCHG PROTHOMBIN TIME | —Insurance typically pays $4Sticker price — | — | $4 | — |
| HCHG PSA-SCREEN | —Insurance typically pays $19Sticker price — | — | $19 | — |
| HCHG PT APPLICATION LONG ARM SPLINT | —Insurance typically pays $313Sticker price — | — | $313 | — |
| HCHG PT E-STIM-ATTENDED 15MIN | —Insurance typically pays $14Sticker price — | — | $14 | — |
| HCHG PT EVAL HIGH COMPLEXITY | —Insurance typically pays $95Sticker price — | — | $95 | — |
| HCHG PT EVAL LOW COMPLEXITY | —Insurance typically pays $95Sticker price — | — | $95 | — |
| HCHG PT EVAL MOD COMPLEXITY | —Insurance typically pays $95Sticker price — | — | $95 | — |
| HCHG PT FLUIDOTHERAPY | —Insurance typically pays $16Sticker price — | — | $16 | — |
| 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 $32Sticker price — | — | $32 | — |
| HCHG PT ORTHO/PROSTHETIC TRAIN UPR/LWR EXT TRUNK S | —Insurance typically pays $50Sticker price — | — | $50 | — |
| HCHG PT ORTHOTIC FIT/TRAIN UPR/LWR EXT TRUNK INITI | —Insurance typically pays $45Sticker price — | — | $45 | — |
| HCHG PT PHONOPHORESIS 15MIN | —Insurance typically pays $13Sticker price — | — | $13 | — |
| HCHG PT PROSTHETIC TRAIN UPR/LWR EXT INITIAL ENC E | —Insurance typically pays $39Sticker price — | — | $39 | — |
| 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 $313Sticker price — | — | $313 | — |
| HCHG PT THERAPEUTIC ACTIVITY 15MIN | —Insurance typically pays $35Sticker price — | — | $35 | — |
| HCHG PT THERAPEUTIC EXERCISE 15MIN | —Insurance typically pays $28Sticker price — | — | $28 | — |
| HCHG RAD CT ANGIO CHEST | —Insurance typically pays $386Sticker price — | — | $386 | — |
| HCHG RAD CT ANGIO HEART CORONARY ARTERIES | —Insurance typically pays $402Sticker price — | — | $402 | — |
| HCHG RAD CT ANGIO LOWER EXTREMITY | —Insurance typically pays $386Sticker price — | — | $386 | — |
| HCHG RAD CT ANGIO NECK W CONTRAST | —Insurance typically pays $386Sticker price — | — | $386 | — |
| HCHG RAD CT GUIDED NEEDLE PLACEMENT | —Insurance typically pays $156Sticker price — | — | $156 | — |
| HCHG RAD CT HEAD BRAIN WWO | —Insurance typically pays $299Sticker price — | — | $299 | — |
| HCHG RAD CT LIMITED OR LOCALIZED FOLLOW UP | —Insurance typically pays $105Sticker price — | — | $105 | — |
| HCHG RAD CT LOWER EXTREMITY WO | —Insurance typically pays $198Sticker price — | — | $198 | — |
| HCHG RAD ECHO STRESS TRANSTHORACIC 2D EXERCISE OR | —Insurance typically pays $164Sticker price — | — | $164 | — |
| HCHG RAD MRI ANGIO HEAD BRAIN WWO | —Insurance typically pays $652Sticker price — | — | $652 | — |
| HCHG RAD MRI ANGIO HEAD WO | —Insurance typically pays $390Sticker price — | — | $390 | — |
| HCHG RAD MRI ANGIO NECK WO | —Insurance typically pays $390Sticker price — | — | $390 | — |
| HCHG RAD MRI ANGIO NECK WWO | —Insurance typically pays $652Sticker price — | — | $652 | — |
| HCHG RAD MRI JOINT LOWER EXTREMITY WO | —Insurance typically pays $475Sticker price — | — | $475 | — |
| HCHG RAD MRI SPINE CERVICAL WO | —Insurance typically pays $475Sticker price — | — | $475 | — |
| HCHG RAD MRI SPINE THORACIC WO | —Insurance typically pays $522Sticker price — | — | $522 | — |
| HCHG RAD NM BONE SCAN WHOLE BODY | —Insurance typically pays $334Sticker price — | — | $334 | — |
| HCHG RAD NM LUNG PERFUSION SCAN | —Insurance typically pays $314Sticker price — | — | $314 | — |
| HCHG RAD NM LUNG VENTILATION AND PERFUSION QUANTIT | —Insurance typically pays $418Sticker price — | — | $418 | — |
| HCHG RAD NM RADIOPHARM ORAL THERAPY | —Insurance typically pays $171Sticker price — | — | $171 | — |
| HCHG RAD US ARTERIAL UPPER EXTREMITY BILATERAL COM | —Insurance typically pays $204Sticker price — | — | $204 | — |
| HCHG RAD XRAY ABDOMEN ACUTE W CHEST 1 VIEW | —Insurance typically pays $62Sticker price — | — | $62 | — |
| HCHG RAD XRAY CHEST FRONTAL 1 VIEW | —Insurance typically pays $51Sticker price — | — | $51 | — |
| HCHG RAD XRAY FEMUR 1 VIEW UNILATERAL | —Insurance typically pays $55Sticker price — | — | $55 | — |
| HCHG RAD XRAY FOOT 2 VIEWS | —Insurance typically pays $37Sticker price — | — | $37 | — |
| HCHG RAD XRAY KNEE 3 VIEWS | —Insurance typically pays $52Sticker price — | — | $52 | — |
| HCHG RAD XRAY KNEES STANDING BILATERAL | —Insurance typically pays $52Sticker price — | — | $52 | — |
| HCHG RAD XRAY MANDIBLE MINIMUM OF FOUR VIEWS | —Insurance typically pays $71Sticker price — | — | $71 | — |
| HCHG RAD XRAY RIBS 3 VIEWS BILATERAL | —Insurance typically pays $54Sticker price — | — | $54 | — |
| HCHG REPLACE CATH ONLY CVAD W SQ PORT/PUMP | —Insurance typically pays $2,596Sticker price — | — | $2,596 | — |
| HCHG REPOSITIONING PREV PLC CV CATH FLUOR GUID | —Insurance typically pays $2,085Sticker price — | — | $2,085 | — |
| HCHG RESPIRATORY DISEASE MULTIPLEX PCR PANEL | —Insurance typically pays $417Sticker price — | — | $417 | — |
| HCHG REVERSE T3 SERUM LC | —Insurance typically pays $16Sticker price — | — | $16 | — |
| HCHG RN APPL MULTLAY COMPRS LWR LEG UNILATERAL | —Insurance typically pays $780Sticker price — | — | $780 | — |
| 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 $81Sticker price — | — | $81 | — |
| HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP | —Insurance typically pays $217Sticker price — | — | $217 | — |
| HCHG SLP INDIV TX COMMUNICATION | —Insurance typically pays $73Sticker price — | — | $73 | — |
| 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 $9Sticker price — | — | $9 | — |
| 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 $25Sticker price — | — | $25 | — |
| HCHG THER APHERESIS PLASMA PHERESIS | —Insurance typically pays $1,995Sticker price — | — | $1,995 | — |
| 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 $23Sticker price — | — | $23 | — |
| 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 $5,240Sticker price — | — | $5,240 | — |
| HCHG VITAMIN A SERUM LC | —Insurance typically pays $12Sticker price — | — | $12 | — |
| HCHG VITAMIN B6 PLASMA LC | —Insurance typically pays $28Sticker price — | — | $28 | — |
| Heart catheterization | —Insurance typically pays $5,128Sticker price — | — | $5,128 | — |
| Heart catheterization with bypass graft angiography | —Insurance typically pays $5,128Sticker price — | — | $5,128 | — |
| Heart stent placement | —Insurance typically pays $9,017Sticker price — | — | $9,017 | — |
| Heart ultrasound | —Insurance typically pays $429Sticker price — | — | $429 | — |
| Hemodialysis with repeated evaluation | —Insurance typically pays $130Sticker price — | — | $130 | — |
| Hemodialysis with single evaluation | —Insurance typically pays $581Sticker price — | — | $581 | — |
| Hemorrhoid banding | —Insurance typically pays $1,859Sticker price — | — | $1,859 | — |
| Hemorrhoid removal | —Insurance typically pays $3,015Sticker price — | — | $3,015 | — |
| Hernia repair (inguinal) | —Insurance typically pays $4,472Sticker price — | — | $4,472 | — |
| Hernia repair, laparoscopic | —Insurance typically pays $4,950Sticker price — | — | $4,950 | — |
| Hernia repair, open | —Insurance typically pays $4,116Sticker price — | — | $4,116 | — |
| Hip fracture repair with pins or screws | —Insurance typically pays $2,948Sticker price — | — | $2,948 | — |
| Hip fracture repair with plate and screws | —Insurance typically pays $4,532Sticker price — | — | $4,532 | — |
| Hip replacement (total) | —Insurance typically pays $16,216Sticker price — | — | $16,216 | — |
| Hormonal chemotherapy injection | —Insurance typically pays $55Sticker price — | — | $55 | — |
| Hospital admission visit | —Insurance typically pays $93Sticker price — | — | $93 | — |
| Hospital admission visit | —Insurance typically pays $130Sticker price — | — | $130 | — |
| Hospital discharge visit | —Insurance typically pays $58Sticker price — | — | $58 | — |
| Hospital discharge visit, extended | —Insurance typically pays $80Sticker price — | — | $80 | — |
| Hospital follow-up visit | —Insurance typically pays $46Sticker price — | — | $46 | — |
| Hospital follow-up visit, complex | —Insurance typically pays $65Sticker price — | — | $65 | — |
| Hysterectomy (laparoscopic) | —Insurance typically pays $7,903Sticker price — | — | $7,903 | — |
| Hysteroscopy with biopsy | —Insurance typically pays $4,298Sticker price — | — | $4,298 | — |
| Hysteroscopy with endometrial ablation | —Insurance typically pays $4,857Sticker price — | — | $4,857 | — |
| Iliac artery stent placement | —Insurance typically pays $7,013Sticker price — | — | $7,013 | — |
| Inguinal hernia repair, incarcerated, open | —Insurance typically pays $4,950Sticker price — | — | $4,950 | — |
| Insertion of tube in bypass graft for diagnosis with review by radiologist | —Insurance typically pays $4,610Sticker price — | — | $4,610 | — |
| Insertion of tube in right heart chambers for measurement | —Insurance typically pays $4,144Sticker price — | — | $4,144 | — |
| Iron test | —Insurance typically pays $9Sticker price — | — | $9 | — |
| Irrigation of implanted venous access (port flush) | —Insurance typically pays $50Sticker price — | — | $50 | — |
| IV hydration infusion, additional hour | —Insurance typically pays $36Sticker price — | — | $36 | — |
| IV hydration infusion, first hour | —Insurance typically pays $182Sticker price — | — | $182 | — |
| IV infusion, additional drug or sequence | —Insurance typically pays $55Sticker price — | — | $55 | — |
| IV infusion, additional hour | —Insurance typically pays $36Sticker price — | — | $36 | — |
| IV infusion, first hour | —Insurance typically pays $182Sticker price — | — | $182 | — |
| IV placement (needle into vein) | —Insurance typically pays $1,890Sticker price — | — | $1,890 | — |
| IV push injection | —Insurance typically pays $72Sticker price — | — | $72 | — |
| Joint injection, large joint | —Insurance typically pays $1,071Sticker price — | — | $1,071 | — |
| Joint injection, medium joint | —Insurance typically pays $1,071Sticker price — | — | $1,071 | — |
| Joint injection with ultrasound | —Insurance typically pays $1,441Sticker price — | — | $1,441 | — |
| Kidney function panel | —Insurance typically pays $9Sticker price — | — | $9 | — |
| Knee arthroscopy | —Insurance typically pays $4,950Sticker price — | — | $4,950 | — |
| Knee arthroscopy, meniscectomy medial and lateral | —Insurance typically pays $4,950Sticker price — | — | $4,950 | — |
| Knee arthroscopy with debridement | —Insurance typically pays $4,950Sticker price — | — | $4,950 | — |
| Knee arthroscopy with meniscus repair | —Insurance typically pays $4,298Sticker price — | — | $4,298 | — |
| Knee replacement (total) | —Insurance typically pays $14,000Sticker price — | — | $14,000 | — |
| Kyphoplasty (vertebral augmentation) | —Insurance typically pays $5,375Sticker price — | — | $5,375 | — |
| Laparoscopic colectomy with anastomosis | —Insurance typically pays $7,154Sticker price — | — | $7,154 | — |
| Laparoscopic gastric bypass | —Insurance typically pays $7,708Sticker price — | — | $7,708 | — |
| Laparoscopic incisional hernia repair | —Insurance typically pays $7,520Sticker price — | — | $7,520 | — |
| Laparoscopic inguinal hernia repair, incarcerated | —Insurance typically pays $4,116Sticker price — | — | $4,116 | — |
| Laparoscopic partial colectomy | —Insurance typically pays $7,154Sticker price — | — | $7,154 | — |
| Laparoscopic removal of ovary | —Insurance typically pays $6,022Sticker price — | — | $6,022 | — |
| Laparoscopic sleeve gastrectomy | —Insurance typically pays $3,901Sticker price — | — | $3,901 | — |
| Laparoscopic ventral hernia repair | —Insurance typically pays $4,950Sticker price — | — | $4,950 | — |
| Laser treatment after cataract surgery | —Insurance typically pays $1,995Sticker price — | — | $1,995 | — |
| LDH test | —Insurance typically pays $6Sticker price — | — | $6 | — |
| LEEP conization of cervix | —Insurance typically pays $2,550Sticker price — | — | $2,550 | — |
| Left heart catheterization with coronary angiography | —Insurance typically pays $5,128Sticker price — | — | $5,128 | — |
| Leg vein ultrasound | —Insurance typically pays $204Sticker price — | — | $204 | — |
| Liver biopsy | —Insurance typically pays $2,085Sticker price — | — | $2,085 | — |
| Liver function panel | —Insurance typically pays $8Sticker price — | — | $8 | — |
| Lumbar laminectomy with discectomy | —Insurance typically pays $6,050Sticker price — | — | $6,050 | — |
| Lumbar laminectomy with facetectomy | —Insurance typically pays $5,234Sticker price — | — | $5,234 | — |
| Lumbar spinal fusion, posterior | —Insurance typically pays $8,092Sticker price — | — | $8,092 | — |
| Lumpectomy (partial mastectomy) | —Insurance typically pays $3,231Sticker price — | — | $3,231 | — |
| Lysis of bowel adhesions, open | —Insurance typically pays $2,272Sticker price — | — | $2,272 | — |
| Manipulation of knee under anesthesia | —Insurance typically pays $2,085Sticker price — | — | $2,085 | — |
| Mastectomy, modified radical | —Insurance typically pays $4,950Sticker price — | — | $4,950 | — |
| Mastectomy, simple | —Insurance typically pays $4,910Sticker price — | — | $4,910 | — |
| Mohs skin cancer surgery | —Insurance typically pays $1,201Sticker price — | — | $1,201 | — |
| Molecular pathology procedure level 6 genetic analysis | —Insurance typically pays $301Sticker price — | — | $301 | — |
| Molecular pathology procedure level 7 genetic analysis | —Insurance typically pays $283Sticker price — | — | $283 | — |
| Molecular pathology procedure level 9 genetic analysis | —Insurance typically pays $2,000Sticker price — | — | $2,000 | — |
| MRI brain with and without contrast | —Insurance typically pays $830Sticker price — | — | $830 | — |
| MRI brain without contrast | —Insurance typically pays $390Sticker price — | — | $390 | — |
| MRI lower back with and without contrast | —Insurance typically pays $652Sticker price — | — | $652 | — |
| MRI lower back without contrast | —Insurance typically pays $522Sticker price — | — | $522 | — |
| Nail avulsion, additional nail | —Insurance typically pays $1,156Sticker price — | — | $1,156 | — |
| Nail avulsion (ingrown nail removal) | —Insurance typically pays $719Sticker price — | — | $719 | — |
| Nail bed removal | —Insurance typically pays $1,321Sticker price — | — | $1,321 | — |
| Nail trimming, 6 or more nails | —Insurance typically pays $1,156Sticker price — | — | $1,156 | — |
| Nebulizer treatment | —Insurance typically pays $52Sticker price — | — | $52 | — |
| Neck artery ultrasound | —Insurance typically pays $204Sticker price — | — | $204 | — |
| Needle EMG, one extremity | —Insurance typically pays $100Sticker price — | — | $100 | — |
| Needle EMG, two extremities | —Insurance typically pays $100Sticker price — | — | $100 | — |
| Nerve conduction study, 1-2 nerves | —Insurance typically pays $37Sticker price — | — | $37 | — |
| Nerve conduction study, 3-4 nerves | —Insurance typically pays $235Sticker price — | — | $235 | — |
| Nerve conduction study, 5-6 nerves | —Insurance typically pays $235Sticker price — | — | $235 | — |
| Nuclear heart stress test | —Insurance typically pays $954Sticker price — | — | $954 | — |
| Obstetric ultrasound | —Insurance typically pays $122Sticker price — | — | $122 | — |
| Occipital nerve block | —Insurance typically pays $1,031Sticker price — | — | $1,031 | — |
| Occlusion of growths or obstructed vessels with review by radiologist | —Insurance typically pays $6,807Sticker price — | — | $6,807 | — |
| Osteotomy of foot bone | —Insurance typically pays $4,951Sticker price — | — | $4,951 | — |
| Pacemaker insertion, single chamber | —Insurance typically pays $9,121Sticker price — | — | $9,121 | — |
| Pacemaker interrogation in office | —Insurance typically pays $33Sticker price — | — | $33 | — |
| Panniculectomy (excess abdominal skin removal) | —Insurance typically pays $4,522Sticker price — | — | $4,522 | — |
| Parathyroidectomy | —Insurance typically pays $4,513Sticker price — | — | $4,513 | — |
| Partial colectomy | —Insurance typically pays $2,550Sticker price — | — | $2,550 | — |
| Partial excision of foot bone | —Insurance typically pays $2,811Sticker price — | — | $2,811 | — |
| Peripheral nerve block | —Insurance typically pays $1,482Sticker price — | — | $1,482 | — |
| Peritoneal dialysis with single evaluation | —Insurance typically pays $224Sticker price — | — | $224 | — |
| Posterior spinal instrumentation | —Insurance typically pays $4,950Sticker price — | — | $4,950 | — |
| Precancerous skin spot removal | —Insurance typically pays $313Sticker price — | — | $313 | — |
| Precancerous skin spots removal, 15+ | —Insurance typically pays $1,201Sticker price — | — | $1,201 | — |
| Precancerous skin spots removal, 2-14 | —Insurance typically pays $1,156Sticker price — | — | $1,156 | — |
| Radiofrequency ablation, lumbar/sacral facet nerve | —Insurance typically pays $2,168Sticker price — | — | $2,168 | — |
| Radiofrequency ablation of facet joint nerve | —Insurance typically pays $2,168Sticker price — | — | $2,168 | — |
| Removal of abdominal cavity tube | —Insurance typically pays $2,550Sticker price — | — | $2,550 | — |
| Retina scan (OCT) | —Insurance typically pays $49Sticker price — | — | $49 | — |
| Rhythm ECG interpretation | —Insurance typically pays $9Sticker price — | — | $9 | — |
| Sacroiliac joint injection | —Insurance typically pays $1,321Sticker price — | — | $1,321 | — |
| Salpingo-oophorectomy (tube and ovary removal) | —Insurance typically pays $2,550Sticker price — | — | $2,550 | — |
| Screening colonoscopy | —Insurance typically pays $2,089Sticker price — | — | $2,089 | — |
| Screening mammogram (3D) | —Insurance typically pays $85Sticker price — | — | $85 | — |
| Shot in muscle or under skin | —Insurance typically pays $49Sticker price — | — | $49 | — |
| Shoulder arthroscopy with distal clavicle excision | —Insurance typically pays $4,741Sticker price — | — | $4,741 | — |
| Shoulder arthroscopy with subacromial decompression | —Insurance typically pays $4,345Sticker price — | — | $4,345 | — |
| Sigmoidoscopy | —Insurance typically pays $1,932Sticker price — | — | $1,932 | — |
| Sigmoidoscopy with biopsy | —Insurance typically pays $1,666Sticker price — | — | $1,666 | — |
| Simple drainage of abscess of finger | —Insurance typically pays $718Sticker price — | — | $718 | — |
| Skin biopsy | —Insurance typically pays $896Sticker price — | — | $896 | — |
| Skin biopsy, shave | —Insurance typically pays $2,040Sticker price — | — | $2,040 | — |
| Skin cancer removal | —Insurance typically pays $1,321Sticker price — | — | $1,321 | — |
| Skin substitute graft | —Insurance typically pays $2,122Sticker price — | — | $2,122 | — |
| Sleep study (polysomnography) | —Insurance typically pays $1,280Sticker price — | — | $1,280 | — |
| Sleep study with CPAP initiation | —Insurance typically pays $1,280Sticker price — | — | $1,280 | — |
| Small bowel resection | —Insurance typically pays $2,550Sticker price — | — | $2,550 | — |
| Spinal nerve injection, lower back | —Insurance typically pays $1,932Sticker price — | — | $1,932 | — |
| Spirometry before and after bronchodilator | —Insurance typically pays $181Sticker price — | — | $181 | — |
| Spirometry (lung function test) | —Insurance typically pays $108Sticker price — | — | $108 | — |
| Stool blood test | —Insurance typically pays $4Sticker price — | — | $4 | — |
| Tdap vaccine | —Insurance typically pays $54Sticker price — | — | $54 | — |
| Tendon insertion injection | —Insurance typically pays $1,031Sticker price — | — | $1,031 | — |
| Tendon sheath injection | —Insurance typically pays $1,071Sticker price — | — | $1,071 | — |
| Therapy session, 60 minutes | —Insurance typically pays $106Sticker price — | — | $106 | — |
| Thyroid biopsy, open | —Insurance typically pays $1,786Sticker price — | — | $1,786 | — |
| Thyroid (TSH) test | —Insurance typically pays $17Sticker price — | — | $17 | — |
| Tilt table test | —Insurance typically pays $959Sticker price — | — | $959 | — |
| Tissue lab exam (pathology) | —Insurance typically pays $46Sticker price — | — | $46 | — |
| Tonsillectomy | —Insurance typically pays $3,440Sticker price — | — | $3,440 | — |
| Total abdominal hysterectomy | —Insurance typically pays $5,981Sticker price — | — | $5,981 | — |
| Total shoulder replacement (arthroplasty) | —Insurance typically pays $16,216Sticker price — | — | $16,216 | — |
| Total thyroidectomy | —Insurance typically pays $4,490Sticker price — | — | $4,490 | — |
| Total thyroidectomy with neck dissection | —Insurance typically pays $4,513Sticker price — | — | $4,513 | — |
| Transforaminal epidural, additional level | —Insurance typically pays $1,598Sticker price — | — | $1,598 | — |
| Trigger finger release | —Insurance typically pays $2,357Sticker price — | — | $2,357 | — |
| Trigger point injection | —Insurance typically pays $1,071Sticker price — | — | $1,071 | — |
| Trigger point injections, multiple | —Insurance typically pays $1,201Sticker price — | — | $1,201 | — |
| Unattended home sleep study | —Insurance typically pays $588Sticker price — | — | $588 | — |
| Upper endoscopy | —Insurance typically pays $1,666Sticker price — | — | $1,666 | — |
| Upper endoscopy (EGD) | —Insurance typically pays $1,666Sticker price — | — | $1,666 | — |
| Upper endoscopy with ablation | —Insurance typically pays $2,795Sticker price — | — | $2,795 | — |
| Upper endoscopy with control of bleeding | —Insurance typically pays $1,995Sticker price — | — | $1,995 | — |
| Upper endoscopy with fine needle biopsy | —Insurance typically pays $1,995Sticker price — | — | $1,995 | — |
| Upper endoscopy with guide wire placement | —Insurance typically pays $1,995Sticker price — | — | $1,995 | — |
| Upper endoscopy with limited ultrasound | —Insurance typically pays $1,995Sticker price — | — | $1,995 | — |
| Upper endoscopy with submucosal injection | —Insurance typically pays $1,666Sticker price — | — | $1,666 | — |
| Upper endoscopy with ultrasound | —Insurance typically pays $1,998Sticker price — | — | $1,998 | — |
| Urinalysis | —Insurance typically pays $3Sticker price — | — | $3 | — |
| Vaginal delivery only | —Insurance typically pays $2,408Sticker price — | — | $2,408 | — |
| Vaginal delivery with routine obstetric care | —Insurance typically pays $2,964Sticker price — | — | $2,964 | — |
| Vertebroplasty | —Insurance typically pays $4,384Sticker price — | — | $4,384 | — |
| Visual field test | —Insurance typically pays $100Sticker price — | — | $100 | — |
| Voice box scope | —Insurance typically pays $313Sticker price — | — | $313 | — |
| Wound repair, layered stitches | —Insurance typically pays $719Sticker price — | — | $719 | — |
Source: this hospital's own published price file. Original file · Methodology