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Acute Care Hospital

Susan B Allen Memorial Hospital

El Dorado, Kansas · Butler County · Emergency services listed

Summary

Susan B Allen Memorial Hospital is an acute care hospital in El Dorado, Kansas. Medicare data lists emergency services. Its official website lists 46 services, specialties and programs. Medicare lists 159 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-07-22.

What is an acute care hospital?

A general hospital for short-term care: emergencies, surgery, illness and injury. Most patients stay a few days. More about hospital types

Compare

Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-10-30). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

YesEmergency services
Not ratedNot rated by CMSMedicare rating
YesBirthing-friendly (CMS)
46Services listed

Quick answers

Does Susan B Allen Memorial Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Susan B Allen Memorial Hospital. In a medical emergency, call 911.
Where is Susan B Allen Memorial Hospital?
720 W Central St, El Dorado, KS 67042, in Butler County, Kansas.
What is the phone number of Susan B Allen Memorial Hospital?
(316) 321-3300, as listed by Medicare (CMS).
What is the Medicare star rating of Susan B Allen Memorial Hospital?
CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas[4][7][18]

Conditions treated[8][12][14][15][18]

Treatments[4][7][18]

Procedures[4][7][8][9][18]

Programs and centers[11][14][16][17][18]

  • Emergency Department
  • Chest pain center
  • Cancer center
  • Mammography self-referral program
  • Free bone density screenings
  • Childbirth education classes
  • Clinical trials

Emergency care (hospital website)[4][16]

Emergency roomYes
Open 24/7Yes

Visiting and practical information

Patient portalMy Health Portal

Doctors and clinicians (159)

159 doctors and other clinicians list Susan B Allen Memorial Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (159)

And 135 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Clinics and urgent care

Pharmacies

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Susan B Allen Memorial Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Summary star rating (all survey topics)Not reported to Medicare
Overall rating of the hospitalNot reported to Medicare
Would recommend the hospitalNot reported to Medicare
Nurses communicated wellNot reported to Medicare
Doctors communicated wellNot reported to Medicare
Staff explained medicinesNot reported to Medicare
Information about recovery at homeNot reported to Medicare
Room and bathroom kept cleanNot reported to Medicare
Quiet at nightNot reported to Medicare
Rated the hospital 9 or 10 out of 1078%National average: 72%
Would definitely recommend the hospital78%National average: 71%
Nurses “always” communicated well85%National average: 80%
Doctors “always” communicated well87%National average: 80%
Staff “always” explained medicines before giving them72%National average: 62%
Were given information about recovery at home88%National average: 86%
Room and bathroom “always” clean69%National average: 74%
Area around the room “always” quiet at night75%National average: 60%
Completed surveys95Response rate: 21%

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)Not reported to Medicare
Surgical site infections after colon surgeryNot reported to Medicare
Surgical site infections after abdominal hysterectomyNot reported to Medicare
MRSA bloodstream infectionsNot reported to Medicare
Clostridioides difficile (C. diff) intestinal infectionsNot reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patientsNot reported to Medicare
Deaths within 30 days: heart failure patientsToo few cases to report
Deaths within 30 days: pneumonia patients14.5%
Deaths within 30 days: COPD patientsToo few cases to report
Deaths within 30 days: stroke patientsToo few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)Not reported to Medicare
Serious complications (patient safety indicator PSI-90)0.96No different from the national rate
Complications after hip or knee replacementToo few cases to report

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)Not reported to Medicare
Readmitted within 30 days: heart attackToo few cases to report
Readmitted within 30 days: heart failureToo few cases to report
Readmitted within 30 days: pneumonia16.5%
Readmitted within 30 days: COPDToo few cases to report
Readmitted within 30 days: coronary bypass surgeryNot reported to Medicare
Readmitted within 30 days: hip or knee replacementToo few cases to report

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; data from July 2023 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)91 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)81%National average: 65%

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 65 common services exactly as Susan B Allen Memorial Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean
Hospital charge
The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price
The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates
The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees
A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

$ 5 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW LOW 30 MIN $194 $126.10 $350 – $757
New patient office visit (about 30–44 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT, 30-44 MINUTES $122 $79.30 $350 – $757
New patient office visit (about 30–44 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT, 30-44 MINUTES $155 $100.75 $350 – $757
New patient office visit (about 30–44 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW MOD 45 MIN $235 $152.75 $350 – $757
New patient office visit (about 45–59 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT, 45-59 MINUTES $122 $79.30 $350 – $757
New patient office visit (about 45–59 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT, 45-59 MINUTES $188 $122.20 $350 – $757
New patient office visit (about 45–59 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW HI 60 MIN $312 $202.80 $350 – $757
New patient office visit (about 60–74 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST LOW 20 MIN $155 $100.75 $350 – $757
Established patient office visit (about 20–29 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT, 20-29 MINUTES $115 $74.75 $350 – $757
Established patient office visit (about 20–29 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT, 20-29 MINUTES $155 $100.75 $350 – $757
Established patient office visit (about 20–29 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST MOD 30 MIN $201 $130.65 $350 – $757
Established patient office visit (about 30–39 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT, 30-39 MINUTES $122 $79.30 $350 – $757
Established patient office visit (about 30–39 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT LOW MDM $181 $117.65 $350 – $757
Emergency room visit (moderate): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY $553 $359.45 $350 – $757
Emergency room visit (moderate): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY $553 $359.45 $350 – $757
Emergency room visit (moderate): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT MOD MDM $240 $156 $350 – $757
Emergency room visit (moderately high): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY $829 $538.85 $350 – $757
Emergency room visit (moderately high): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY $829 $538.85 $350 – $757
Emergency room visit (moderately high): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EMERGENCY DEPT VISIT HI MDM $299 $194.35 $350 – $757
Emergency room visit (high): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY $1,174 $763.10 $350 – $757
Emergency room visit (high): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY $1,174 $763.10 $350 – $757
Emergency room visit (high): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST, BASIC GROUP OF BLOOD CHEMICALS (CALCIUM, TOTAL) $32 $20.80 $350 – $757
Basic metabolic panel (blood test): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST, COMPREHENSIVE GROUP OF BLOOD CHEMICALS $40 $26 $350 – $757
Comprehensive metabolic panel (blood test): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST, COMPREHENSIVE GROUP OF BLOOD CHEMICALS $40 $26 $350 – $757
Comprehensive metabolic panel (blood test): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST, LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) $81 $52.65 $350 – $757
Cholesterol panel (lipid panel): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GA In the file: BLOOD TEST, LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) $81 $52.65 $350 – $757
Cholesterol panel (lipid panel): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KIDNEY FUNCTION BLOOD TEST PANEL $33 $21.45 $350 – $757
Kidney function panel: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION BLOOD TEST PANEL $27 $17.55 $350 – $757
Liver function panel: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE, AUTOMATED $25 $16.25 $350 – $757
Urine test (automated, with microscope): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O SCOPE $16 $10.40 $350 – $757
Urine test (automated, without microscope): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AUTOMATED URINALYSIS TEST $27 $17.55 $350 – $757
Urine test (automated, without microscope): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: AUTOMATED URINALYSIS TEST $27 $17.55 $350 – $757
Urine test (automated, without microscope): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT, TOTAL $122 $79.30 $350 – $757
PSA (prostate specific antigen) blood test: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY OF PSA TOTAL $272 $176.80 $350 – $757
PSA (prostate specific antigen) blood test: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GZ In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT, TOTAL $122 $79.30 $350 – $757
PSA (prostate specific antigen) blood test: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY THYROID STIM HORMONE $12 $7.80 $350 – $757
Thyroid stimulating hormone (TSH) test: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST, THYROID STIMULATING HORMONE (TSH) $63 $40.95 $350 – $757
Thyroid stimulating hormone (TSH) test: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GA In the file: BLOOD TEST, THYROID STIMULATING HORMONE (TSH) $63 $40.95 $350 – $757
Thyroid stimulating hormone (TSH) test: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS, WHITE BLOOD CELL, PLATELETS), AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT $27 $17.55 $350 – $757
Complete blood count (CBC) with differential: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC W/AUTO DIFF WBC $7.50 $4.88 $350 – $757
Complete blood count (CBC) with differential: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS, WHITE BLOOD CELL, PLATELETS), AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT $27 $17.55 $350 – $757
Complete blood count (CBC) with differential: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS, WHITE BLOOD CELL, PLATELETS), AUTOMATED TEST $23 $14.95 $350 – $757
Complete blood count (CBC), automated: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC AUTOMATED $8 $5.20 $350 – $757
Complete blood count (CBC), automated: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST, CLOTTING TIME $16 $10.40 $350 – $757
Blood clotting time test (prothrombin time, PT): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME $35 $22.75 $350 – $757
Blood clotting time test (prothrombin time, PT): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GA In the file: BLOOD TEST, CLOTTING TIME $16 $10.40 $350 – $757
Blood clotting time test (prothrombin time, PT): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST, PLASMA OR WHOLE BLOOD $42 $27.30 $350 – $757
Blood clotting test (partial thromboplastin time, PTT): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL $7 $4.55 $350 – $757
Blood clotting test (partial thromboplastin time, PTT): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GA In the file: COAGULATION ASSESSMENT BLOOD TEST, PLASMA OR WHOLE BLOOD $42 $27.30 $350 – $757
Blood clotting test (partial thromboplastin time, PTT): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST $1,140 $741 $350 – $919
CT scan of the head or brain, without contrast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $919
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST $1,140 $741 $350 – $919
CT scan of the head or brain, without contrast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $919
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST $2,946 $1,914.90 $350 – $757
MRI of the brain, before and after contrast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST $2,946 $1,914.90 $350 – $757
MRI of the brain, before and after contrast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM CHEST 2 VIEWS $249 $161.85 $350 – $757
Chest X-ray, 2 views: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF CHEST, 2 VIEWS $227 $147.55 $350 – $757
Chest X-ray, 2 views: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO_TC In the file: X-RAY OF CHEST, 2 VIEWS $167 $108.55 $350 – $757
Chest X-ray, 2 views: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF LOWER AND SACRAL SPINE, MINIMUM OF 4 VIEWS $400 $260 $350 – $757
X-ray of the lower spine, at least 4 views: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY OF LOWER AND SACRAL SPINE, MINIMUM OF 4 VIEWS $400 $260 $350 – $757
X-ray of the lower spine, at least 4 views: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST $1,929 $1,253.85 $350 – $757
MRI of the lower back (lumbar spine), without contrast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST $1,929 $1,253.85 $350 – $757
MRI of the lower back (lumbar spine), without contrast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF PELVIS WITH CONTRAST $1,140 $741 $350 – $919
CT scan of the pelvis, with contrast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $919
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE $1,929 $1,253.85 $350 – $1,731
MRI of a leg joint (such as the knee), without contrast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $1,731
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST $1,929 $1,253.85 $350 – $1,731
MRI of a leg joint (such as the knee), without contrast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $1,731
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_TC In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST $1,929 $1,253.85 $350 – $1,731
MRI of a leg joint (such as the knee), without contrast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $1,731
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST $1,140 $741 $350 – $919
CT scan of the abdomen and pelvis, with contrast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $919
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST $1,140 $741 $350 – $919
CT scan of the abdomen and pelvis, with contrast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $919
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN $631 $410.15 $350 – $757
Ultrasound of the abdomen, complete: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN $631 $410.15 $350 – $757
Ultrasound of the abdomen, complete: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE), SINGLE OR FIRST FETUS $669 $434.85 $350 – $757
Pregnancy ultrasound (after the first trimester): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE), SINGLE OR FIRST FETUS $669 $434.85 $350 – $757
Pregnancy ultrasound (after the first trimester): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF UTERUS, OVARIES, TUBES, CERVIX AND PELVIC AREA THROUGH VAGINA $498 $323.70 $350 – $757
Transvaginal ultrasound: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF UTERUS, OVARIES, TUBES, CERVIX AND PELVIC AREA THROUGH VAGINA $498 $323.70 $350 – $757
Transvaginal ultrasound: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD UNI $238 $154.70 $162 – $350
Diagnostic mammogram, one breast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $162
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST $209 $135.85 $162 – $350
Diagnostic mammogram, one breast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $162
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_TC In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST $209 $135.85 $162 – $350
Diagnostic mammogram, one breast: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $162
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS $209 $135.85 $162 – $350
Diagnostic mammogram, both breasts: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $162
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD BI $237 $154.05 $162 – $350
Diagnostic mammogram, both breasts: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $162
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS $209 $135.85 $162 – $350
Diagnostic mammogram, both breasts: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $162
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY $209 $135.85 $350 – $757
Screening mammogram, both breasts: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: SCREENING MAMMOGRAPHY $209 $135.85 $350 – $757
Screening mammogram, both breasts: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: SCREENING MAMMOGRAPHY $209 $135.85 $350 – $757
Screening mammogram, both breasts: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOM 6/> YRS 4/> PARAM $3,105 $2,018.25 $350 – $757
Sleep study (overnight, in a sleep lab): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISES $122 $79.30 $350 – $757
Physical therapy: therapeutic exercise (each 15 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH, ENDURANCE, RANGE OF MOTION, AND FLEXIBILITY, EACH 15 MINUTES $122 $79.30 $350 – $757
Physical therapy: therapeutic exercise (each 15 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH, ENDURANCE, RANGE OF MOTION, AND FLEXIBILITY, EACH 15 MINUTES $488 $317.20 $350 – $757
Physical therapy: therapeutic exercise (each 15 minutes): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL LOW COMPLEX 20 MIN $258 $167.70 $350 – $757
Physical therapy evaluation (low complexity): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY, TYPICALLY 20 MINUTES $258 $167.70 $350 – $757
Physical therapy evaluation (low complexity): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL MOD COMPLEX 30 MIN $315 $204.75 $350 – $757
Physical therapy evaluation (moderate complexity): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY, TYPICALLY 30 MINUTES $315 $204.75 $350 – $757
Physical therapy evaluation (moderate complexity): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEX 45 MIN $371 $241.15 $350 – $757
Physical therapy evaluation (high complexity): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY, TYPICALLY 45 MINUTES $371 $241.15 $350 – $757
Physical therapy evaluation (high complexity): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST, DUCT, OR NIPPLE $5,245 $3,409.25 $350 – $757
Removal of breast growth (open surgery): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST, DUCT, OR NIPPLE $5,245 $3,409.25 $350 – $757
Removal of breast growth (open surgery): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS $11,048 $7,181.20 $350 – $757
Total hip replacement: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF KNEE JOINT, BOTH SIDES OF KNEE $12,706 $8,258.90 $350 – $757
Total knee replacement: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPLACEMENT OF KNEE JOINT, BOTH SIDES OF KNEE $11,048 $7,181.20 $350 – $757
Total knee replacement: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE $6,903 $4,486.95 $350 – $757
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE $6,903 $4,486.95 $350 – $757
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS) $4,416 $2,870.40 $350 – $757
Removal of tonsils and adenoids (under age 12): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD DIAGNOSTIC BRUSH WASH $2,134 $1,387.10 $350 – $757
Upper GI endoscopy (diagnostic): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF ESOPHAGUS, STOMACH, AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $1,920.50 $1,248.33 $350 – $757
Upper GI endoscopy (diagnostic): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF ESOPHAGUS, STOMACH, AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $1,646 $1,069.90 $350 – $757
Upper GI endoscopy with biopsy: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: BIOPSY OF ESOPHAGUS, STOMACH, AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $1,371.50 $891.48 $350 – $757
Upper GI endoscopy with biopsy: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $1,646 $1,069.90 $350 – $757
Colonoscopy (diagnostic): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33 In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $2,743 $1,782.95 $350 – $757
Colonoscopy (diagnostic): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $2,743 $1,782.95 $350 – $757
Colonoscopy (diagnostic): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $3,292 $2,139.80 $350 – $757
Colonoscopy with biopsy: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33 In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $3,841 $2,496.65 $350 – $757
Colonoscopy with biopsy: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $3,292 $2,139.80 $350 – $757
Colonoscopy with biopsy: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $3,841 $2,496.65 $350 – $757
Colonoscopy with removal of polyps (snare): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33 In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $2,743 $1,782.95 $350 – $757
Colonoscopy with removal of polyps (snare): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 53 In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $2,195 $1,426.75 $350 – $757
Colonoscopy with removal of polyps (snare): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK $3,292 $2,139.80 $350 – $757
Screening colonoscopy (not high risk): rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE $6,074 $3,948.10 $350 – $757
Gallbladder removal by laparoscope: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) $8,561 $5,564.65 $350 – $757
Groin (inguinal) hernia repair, age 5 or older: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) $8,561 $5,564.65 $350 – $757
Groin (inguinal) hernia repair, age 5 or older: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE $2,497 $1,623.05 $350 – $757
Prostate biopsy: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE $5,245 $3,409.25 $350 – $757
Hysteroscopy with biopsy of the uterus lining: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE $1,233 $801.45 $350 – $757
Spinal injection, lower back (epidural), with imaging guidance: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC $1,270 $825.50 $350 – $757
Spinal injection, lower back (epidural), with imaging guidance: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1 $923 $599.95 $350 – $757
Nerve root injection, lower back, with imaging guidance: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE $5,245 $3,409.25 $350 – $757
Carpal tunnel release: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE $5,245 $3,409.25 $350 – $757
Carpal tunnel release: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER $1,722 $1,119.30 $350 – $757
Laser treatment of clouding after cataract surgery: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER $1,722 $1,119.30 $350 – $757
Laser treatment of clouding after cataract surgery: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER $1,722 $1,119.30 $350 – $757
Laser treatment of clouding after cataract surgery: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74_LT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS $3,065 $1,992.25 $350 – $757
Cataract removal with lens implant: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS $3,065 $1,992.25 $350 – $757
Cataract removal with lens implant: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS $3,065 $1,992.25 $350 – $757
Cataract removal with lens implant: rates for 10 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Aetna — Commercial: 81.1% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC WITH CARD CATH WITH COMORBITY Not listed in the file Not listed in the file $350 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $102,832.47
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 10 insurance plans
  • Aetna — Commercial: $102,832.47
  • ProviDrs Care — Commercial: $757 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • United Healthcare — Commercial: $350 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT COMORBITY Not listed in the file Not listed in the file $350 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $757
Spinal fusion (not neck), without major complications: rates for 9 insurance plans
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT COMORBITY Not listed in the file Not listed in the file $350 – $20,090
Hip or knee replacement (major joint of the leg), without major complications: rates for 10 insurance plans
  • Aetna — Commercial: $20,090
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT COMPLICATION/COMORBITY Not listed in the file Not listed in the file $350 – $25,224.65
Neck (cervical) spinal fusion, without complications: rates for 10 insurance plans
  • Aetna — Commercial: $25,224.65
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE & ADNEXA PROC FOR NON-MALIGNANCY WITHOUT COMPLICATION/COMORBITY Not listed in the file Not listed in the file $350 – $12,772.15
Uterus and ovary surgery (not for cancer), without complications: rates for 10 insurance plans
  • Aetna — Commercial: $12,772.15
  • ProviDrs Care — Commercial: $757
  • United Healthcare — Commercial: $350
  • Blue Cross Blue Shield — Commercial: 95% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- CAP Trad — Commercial: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross Blue Shield- Value Blue — Commercial: 47.5% (a percentage in the contract, not a dollar amount)
  • Cigna — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • First Health — Commercial: 90% (a percentage in the contract, not a dollar amount)
  • Health Partners of KS — Commercial: 80% (a percentage in the contract, not a dollar amount)
  • Multiplan — Commercial: 90% (a percentage in the contract, not a dollar amount)

Source: Susan B Allen Memorial Hospital’s standard charges file (apim.services.craneware.com, CSV, CMS template 2.0.0; it can be a very large file), last updated by the hospital on May 27, 2025; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital typeAcute Care Hospital
Address720 W Central St, El Dorado, KS 67042
CountyButler County
StateKansas
Phone(316) 321‑3300
Emergency servicesYes
OwnershipVoluntary non-profit - Private
Medicare overall ratingNot rated by CMS
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number170017
Name in Medicare recordsSUSAN B ALLEN MEMORIAL HOSPITAL
Profile levelMedicare data + hospital website
Official websitesbamh.org
CorrectionsReport an error or suggest an update →

Sources

  1. Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
  2. Medicare Care Compare — official Medicare profile of this hospital
  3. U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

  1. Services — sbamh.org
  2. Susan B. Allen Memorial Hospital [Services & Departments - Diagnostic Imaging/Radiology - Overview] — sbamh.org
  3. Susan B. Allen Memorial Hospital [Services & Departments - Diagnostic Imaging/Radiology - Cardiac Calcium CT Screening] — sbamh.org
  4. Susan B. Allen Memorial Hospital [Services & Departments - Diagnostic Imaging/Radiology - CT Scan] — sbamh.org
  5. Susan B. Allen Memorial Hospital [Services & Departments - Diagnostic Imaging/Radiology - Mammography] — sbamh.org
  6. Susan B. Allen Memorial Hospital [Services & Departments - Diagnostic Imaging/Radiology - Nuclear Med] — sbamh.org
  7. Susan B. Allen Memorial Hospital [Services & Departments - Diagnostic Imaging/Radiology - Bone Densitometry] — sbamh.org
  8. Susan B. Allen Memorial Hospital [Services & Departments - Diagnostic Imaging/Radiology - Stereotactic Breast Biopsy] — sbamh.org
  9. Susan B. Allen Memorial Hospital [Services & Departments - Emergency Department] — sbamh.org
  10. Susan B. Allen Memorial Hospital [Services & Departments - Birth Center] — sbamh.org
  11. Susan B. Allen Memorial Hospital [Services & Departments - Cancer Center] — sbamh.org