Does University of KS Hlth System Great Bend Campus have an emergency room?

Yes. Medicare (CMS) data lists emergency services at University of KS Hlth System Great Bend Campus. In a medical emergency, call 911.

Where is University of KS Hlth System Great Bend Campus?

514 Cleveland Street, Great Bend, KS 67530, in Barton County, Kansas.

What is the phone number of University of KS Hlth System Great Bend Campus?

(620) 792-8830, as listed by Medicare (CMS).

What is the Medicare star rating of University of KS Hlth System Great Bend Campus?

4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

University of KS Hlth System Great Bend Campus

Quick answers

Does University of KS Hlth System Great Bend Campus have an emergency room?: Yes. Medicare (CMS) data lists emergency services at University of KS Hlth System Great Bend Campus. In a medical emergency, call 911.
Where is University of KS Hlth System Great Bend Campus?: 514 Cleveland Street, Great Bend, KS 67530, in Barton County, Kansas.
What is the phone number of University of KS Hlth System Great Bend Campus?: (620) 792-8830, as listed by Medicare (CMS).
What is the Medicare star rating of University of KS Hlth System Great Bend Campus?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][7]

Treatments^[5]

Trauma care
Burn care
Pediatric emergency care
Stroke care
Cardiac care

Procedures^[5]

Ultrasound

Programs and centers^[4]

Labor and delivery
Swing bed

Emergency care (hospital website)^[4][5][6]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level IV

Visiting and practical information

Parking	Free parking is available close to the buildings^[4]

Recognition^[5][6]

Level IV Trauma Center

Doctors and clinicians (265)

265 doctors and other clinicians list University of KS Hlth System Great Bend Campus 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

And 241 more: the button below opens the full list.

Other emergency rooms nearby

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

Ellinwood District Hospital11 mi · Ellinwood, KS · Critical Access Hospital
Clara Barton Hospital11 mi · Hoisington, KS · Critical Access Hospital
Pawnee Valley Community Hospital21 mi · Larned, KS · Critical Access Hospital
Stafford County Hospital30 mi · Stafford, KS · Critical Access Hospital
Rush County Memorial Hospital31 mi · La Crosse, KS · Rural Emergency Hospital

Other hospitals nearby

Larned State Hospital21 mi · Larned, KS · Psychiatric Hospital

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

Azria Health Great Bend1.2 mi · Great Bend, KS · 2 of 5 stars
Medicalodges Great Bend1.4 mi · Great Bend, KS · 2 of 5 stars
Diversicare of Larned21 mi · Larned, KS · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Golden Belt Hospice0.4 mi · Great Bend, KS

All hospice providers in the state →

Home health agencies

Golden Belt Home Health0.4 mi · Great Bend, KS · 2 of 5 stars

All home health agencies in the state →

Dialysis facilities

Renal Care Group - Great Bend0.4 mi · Great Bend, KS · 4 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Pain, Spine & Rehab, Asc P A0.4 mi · Great Bend, KS

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

Heart of Kansas Behavioral Health Services1.8 mi · Great Bend, KS · Community health center
Great Bend Dental Clinic1.8 mi · Great Bend, KS · Community health center
Great Bend Clinic1.8 mi · Great Bend, KS · Community health center

Clinics and urgent care

Clara Barton Medical Clinic - Great Bend0.4 mi · Great Bend, KS · Rural health clinic
St. Rose Medical Pavilion0.4 mi · Great Bend, KS · Rural health clinic
The University of Kansas Health System Great Bend Campus0.4 mi · Great Bend, KS · Rural health clinic

Pharmacies

Medical Park Pharmacy of Great Bend PA0.4 mi · Great Bend, KS · Community/retail pharmacy
Walgreen Co0.4 mi · Great Bend, KS · Pharmacy
Walmart Inc.0.4 mi · Great Bend, KS · Community/retail pharmacy

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 University of KS Hlth System Great Bend Campus 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)	3 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	2 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	5 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	64%National average: 72%
Would definitely recommend the hospital	64%National average: 71%
Nurses “always” communicated well	80%National average: 80%
Doctors “always” communicated well	77%National average: 80%
Staff “always” explained medicines before giving them	60%National average: 62%
Were given information about recovery at home	92%National average: 86%
Room and bathroom “always” clean	71%National average: 74%
Area around the room “always” quiet at night	56%National average: 60%
Completed surveys	177Response rate: 23%

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 surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not 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 patients	Too few cases to report
Deaths within 30 days: heart failure patients	9.6%
Deaths within 30 days: pneumonia patients	10.8%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.92No different from the national rate
Complications after hip or knee replacement	Too 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 attack	Too few cases to report
Readmitted within 30 days: heart failure	22.2%
Readmitted within 30 days: pneumonia	18.1%
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Too 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)	107 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	87%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.

ER wait times in Kansas Best hospitals in Kansas

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 68 common services exactly as University of KS Hlth System Great Bend Campus 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 →

$ 6 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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · modifier NULL In the file: Office/Outpatient New Low Mdm 30 Minutes	$242	Not listed in the file	$47.50 – $418.91
New patient office visit (about 30–44 minutes): 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $196.70 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $242 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $242 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $242 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $63.53 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $242 AETNA [503200004] — AETNA FED: $123.42 AETNA [503200004] — AETNA/COVENTRY: $123.42 AETNA [503200004] — NON-CONTRACTED: $242 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $92.89
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient (hospital stay) · modifier NULL In the file: Office/Outpatient New Low Mdm 30 Minutes	$204	Not listed in the file	$47.50 – $418.91
New patient office visit (about 30–44 minutes): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $123.50 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $204 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $204 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $190 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $63.53 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $204 AETNA [503200004] — AETNA FED: $104.04 AETNA [503200004] — AETNA/COVENTRY: $96.90 AETNA [503200004] — NON-CONTRACTED: $190 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $92.89
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · modifier NULL In the file: Office/Outpatient New Low Mdm 30 Minutes	$242	Not listed in the file	$47.50 – $418.91
New patient office visit (about 30–44 minutes): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $157.30 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $389 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $389 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $242 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $84.70 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $242 AETNA [503200004] — AETNA FED: $198.39 AETNA [503200004] — AETNA/COVENTRY: $145.20 AETNA [503200004] — NON-CONTRACTED: $242 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $92.89
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient · modifier NULL In the file: Office/Outpatient New Moderate Mdm 45 Minutes	$365	Not listed in the file	$74.50 – $511
New patient office visit (about 45–59 minutes): 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $297.83 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $365 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $365 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $365 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $90.20 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $365 AETNA [503200004] — AETNA FED: $186.15 AETNA [503200004] — AETNA/COVENTRY: $186.15 AETNA [503200004] — NON-CONTRACTED: $365 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $246.16
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · modifier NULL In the file: Office/Outpatient New Moderate Mdm 45 Minutes	$365	Not listed in the file	$74.50 – $511
New patient office visit (about 45–59 minutes): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $237.25 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $365 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $365 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $511 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $120.26 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $365 AETNA [503200004] — AETNA FED: $260.61 AETNA [503200004] — AETNA/COVENTRY: $260.61 AETNA [503200004] — NON-CONTRACTED: $365 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $165.46
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient (hospital stay) · modifier NULL In the file: Office/Outpatient New Moderate Mdm 45 Minutes	$308	Not listed in the file	$74.50 – $511
New patient office visit (about 45–59 minutes): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $199.46 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $298 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $308 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $298 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $90.20 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $308 AETNA [503200004] — AETNA FED: $184.80 AETNA [503200004] — AETNA/COVENTRY: $186.15 AETNA [503200004] — NON-CONTRACTED: $298 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $110.81
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · modifier NULL In the file: Office/Outpatient New High Mdm 60 Minutes	$434	Not listed in the file	$90 – $639
New patient office visit (about 60–74 minutes): 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $396.88 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $434 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $434 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $434 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $115.04 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $434 AETNA [503200004] — AETNA FED: $221.34 AETNA [503200004] — AETNA/COVENTRY: $221.34 AETNA [503200004] — NON-CONTRACTED: $434 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $187.42
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · modifier NULL In the file: Office/Outpatient New High Mdm 60 Minutes	$434	Not listed in the file	$90 – $639
New patient office visit (about 60–74 minutes): 10 of 247 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $396.88 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $434 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $434 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $434 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $115.04 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $434 AETNA [503200004] — AETNA FED: $221.34 AETNA [503200004] — AETNA/COVENTRY: $260.40 AETNA [503200004] — NON-CONTRACTED: $639 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $246.16
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient (hospital stay) · modifier NULL In the file: Office/Outpatient New High Mdm 60 Minutes	$375	Not listed in the file	$90 – $639
New patient office visit (about 60–74 minutes): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $272.43 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $375 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $375 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $375 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $153.38 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $360 AETNA [503200004] — AETNA FED: $191.25 AETNA [503200004] — AETNA/COVENTRY: $191.25 AETNA [503200004] — NON-CONTRACTED: $375 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $128.65
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · modifier NULL In the file: Office/Outpatient Established Low Mdm 20 Min	$196	Not listed in the file	$34.40 – $418.91
Established patient office visit (about 20–29 minutes): 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $160.24 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $196 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $196 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $196 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $34.40 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $196 AETNA [503200004] — AETNA FED: $99.96 AETNA [503200004] — AETNA/COVENTRY: $99.96 AETNA [503200004] — NON-CONTRACTED: $196 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $246.16
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · modifier NULL In the file: Office/Outpatient Established Low Mdm 20 Min	$196	Not listed in the file	$34.40 – $418.91
Established patient office visit (about 20–29 minutes): 10 of 247 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $160.24 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $196 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $339 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $196 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $45.86 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $339 AETNA [503200004] — AETNA FED: $117.60 AETNA [503200004] — AETNA/COVENTRY: $99.96 AETNA [503200004] — NON-CONTRACTED: $196 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $246.16
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · modifier NULL In the file: Office/Outpatient Established Low Mdm 20 Min	$154	Not listed in the file	$34.40 – $418.91
Established patient office visit (about 20–29 minutes): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $100.10 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $154 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $154 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $154 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $34.40 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $153 AETNA [503200004] — AETNA FED: $78.03 AETNA [503200004] — AETNA/COVENTRY: $78.54 AETNA [503200004] — NON-CONTRACTED: $153 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $75.67
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · modifier NULL In the file: PR Occ Hlth Physical 30 Min	$279	$97.65	$54.08 – $437
Established patient office visit (about 30–39 minutes): 10 of 194 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $181.35 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $279 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $279 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $279 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $279 AETNA [503200004] — AETNA FED: $142.29 AETNA [503200004] — AETNA/COVENTRY: $142.29 AETNA [503200004] — NON-CONTRACTED: $279 AGENCY [50311255] — NON-CONTRACTED: $279 AHA-HEALTHCARE PREFERRED [503200050] — COVENTRY FH LEASED NTWK: $167.40
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · modifier NULL In the file: PR Occ Hlth Physical 30 Min	$224	$78.40	$54.08 – $437
Established patient office visit (about 30–39 minutes): 10 of 194 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $145.60 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $224 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $224 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $224 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $224 AETNA [503200004] — AETNA FED: $114.24 AETNA [503200004] — AETNA/COVENTRY: $114.24 AETNA [503200004] — NON-CONTRACTED: $224 AGENCY [50311255] — NON-CONTRACTED: $224 AHA-HEALTHCARE PREFERRED [503200050] — COVENTRY FH LEASED NTWK: $134.40
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · modifier NULL In the file: PR Occ Hlth Physical 30 Min	$279	$97.65	$54.08 – $437
Established patient office visit (about 30–39 minutes): 10 of 194 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $181.35 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $279 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $279 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $279 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $279 AETNA [503200004] — AETNA FED: $142.29 AETNA [503200004] — AETNA/COVENTRY: $142.29 AETNA [503200004] — NON-CONTRACTED: $279 AGENCY [50311255] — NON-CONTRACTED: $279 AHA-HEALTHCARE PREFERRED [503200050] — COVENTRY FH LEASED NTWK: $167.40
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient · modifier NULL In the file: Office/OP Consltj New/Est Pt Low Mdm 30 Minutes	$211	Not listed in the file	$43.50 – $406
Office consultation with a specialist (moderate): 10 of 199 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $137.15 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $211 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $211 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $211 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $211 AETNA [503200004] — AETNA FED: $107.61 AETNA [503200004] — AETNA/COVENTRY: $107.61 AETNA [503200004] — NON-CONTRACTED: $211 AGENCY [50311255] — NON-CONTRACTED: $211 AHA-HEALTHCARE PREFERRED [503200050] — COVENTRY FH LEASED NTWK: $126.60
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · modifier NULL In the file: Office/OP Consltj New/Est Pt Low Mdm 30 Minutes	$211	Not listed in the file	$43.50 – $406
Office consultation with a specialist (moderate): 10 of 195 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $137.15 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $406 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $211 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $211 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $406 AETNA [503200004] — AETNA FED: $207.06 AETNA [503200004] — AETNA/COVENTRY: $207.06 AETNA [503200004] — NON-CONTRACTED: $211 AGENCY [50311255] — NON-CONTRACTED: $406 AHA-HEALTHCARE PREFERRED [503200050] — COVENTRY FH LEASED NTWK: $126.60
Office consultation with a specialist (moderate) CPT 99243 · Inpatient (hospital stay) · modifier NULL In the file: Office/OP Consltj New/Est Pt Low Mdm 30 Minutes	$174	Not listed in the file	$43.50 – $406
Office consultation with a specialist (moderate): 10 of 195 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $113.10 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $221 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $174 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $221 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $221 AETNA [503200004] — AETNA FED: $112.71 AETNA [503200004] — AETNA/COVENTRY: $112.71 AETNA [503200004] — NON-CONTRACTED: $221 AGENCY [50311255] — NON-CONTRACTED: $221 AHA-HEALTHCARE PREFERRED [503200050] — COVENTRY FH LEASED NTWK: $104.40
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · modifier NULL In the file: Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes	$313	Not listed in the file	$66.25 – $544
Office consultation with a specialist (moderate to high): 10 of 199 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $203.45 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $313 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $544 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $313 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $313 AETNA [503200004] — AETNA FED: $187.80 AETNA [503200004] — AETNA/COVENTRY: $187.80 AETNA [503200004] — NON-CONTRACTED: $313 AGENCY [50311255] — NON-CONTRACTED: $544 AHA-HEALTHCARE PREFERRED [503200050] — COVENTRY FH LEASED NTWK: $187.80
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient · modifier NULL In the file: Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes	$313	Not listed in the file	$66.25 – $544
Office consultation with a specialist (moderate to high): 10 of 199 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $203.45 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $313 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $313 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $313 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $313 AETNA [503200004] — AETNA FED: $159.63 AETNA [503200004] — AETNA/COVENTRY: $159.63 AETNA [503200004] — NON-CONTRACTED: $313 AGENCY [50311255] — NON-CONTRACTED: $313 AHA-HEALTHCARE PREFERRED [503200050] — COVENTRY FH LEASED NTWK: $187.80
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient (hospital stay) · modifier NULL In the file: Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes	$265	Not listed in the file	$66.25 – $544
Office consultation with a specialist (moderate to high): 10 of 195 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $172.25 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $331 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $265 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $265 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $265 AETNA [503200004] — AETNA FED: $159 AETNA [503200004] — AETNA/COVENTRY: $159 AETNA [503200004] — NON-CONTRACTED: $265 AGENCY [50311255] — NON-CONTRACTED: $265 AHA-HEALTHCARE PREFERRED [503200050] — COVENTRY FH LEASED NTWK: $159
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · modifier NULL In the file: Initial Preventive Medicine New Pt Age 18-39yrs	$298	Not listed in the file	$24.53 – $331
Preventive checkup, new patient, age 18–39: 10 of 214 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $193.70 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $331 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $331 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $331 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $24.53 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $331 AETNA [503200004] — AETNA FED: $151.98 AETNA [503200004] — AETNA/COVENTRY: $198.60 AETNA [503200004] — NON-CONTRACTED: $298 AGENCY [50311255] — MEDICAID KS: $24.53
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · modifier NULL In the file: Initial Preventive Medicine New Pt Age 18-39yrs	$331	Not listed in the file	$24.53 – $331
Preventive checkup, new patient, age 18–39: 10 of 214 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $215.15 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $331 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $331 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $331 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $24.53 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $331 AETNA [503200004] — AETNA FED: $168.81 AETNA [503200004] — AETNA/COVENTRY: $168.81 AETNA [503200004] — NON-CONTRACTED: $331 AGENCY [50311255] — MEDICAID KS: $24.53
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient (hospital stay) · modifier NULL In the file: Initial Preventive Medicine New Pt Age 18-39yrs	$248	Not listed in the file	$24.53 – $331
Preventive checkup, new patient, age 18–39: 10 of 210 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $161.20 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $238 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $248 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $238 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $24.53 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $238 AETNA [503200004] — AETNA FED: $121.38 AETNA [503200004] — AETNA/COVENTRY: $126.48 AETNA [503200004] — NON-CONTRACTED: $248 AGENCY [50311255] — MEDICAID KS: $24.53
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · modifier NULL In the file: Initial Preventive Medicine New Patient 40-64yrs	$305	Not listed in the file	$24.53 – $382
Preventive checkup, new patient, age 40–64: 10 of 214 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $226.85 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $305 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $305 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $349 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $24.53 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $305 AETNA [503200004] — AETNA FED: $177.99 AETNA [503200004] — AETNA/COVENTRY: $177.99 AETNA [503200004] — NON-CONTRACTED: $349 AGENCY [50311255] — MEDICAID KS: $24.53
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · modifier NULL In the file: Initial Preventive Medicine New Patient 40-64yrs	$305	Not listed in the file	$24.53 – $382
Preventive checkup, new patient, age 40–64: 10 of 214 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $198.25 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $382 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $305 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $305 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $24.53 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $305 AETNA [503200004] — AETNA FED: $155.55 AETNA [503200004] — AETNA/COVENTRY: $194.82 AETNA [503200004] — NON-CONTRACTED: $382 AGENCY [50311255] — MEDICAID KS: $24.53
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient (hospital stay) · modifier NULL In the file: Initial Preventive Medicine New Patient 40-64yrs	$300	Not listed in the file	$24.53 – $382
Preventive checkup, new patient, age 40–64: 10 of 210 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $195 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $300 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $300 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $290 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $24.53 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $300 AETNA [503200004] — AETNA FED: $147.90 AETNA [503200004] — AETNA/COVENTRY: $153 AETNA [503200004] — NON-CONTRACTED: $300 AGENCY [50311255] — MEDICAID KS: $24.53
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · modifier NULL In the file: HC 99283 ER Level 3	$629	$125.80	$30.36 – $891
Emergency room visit (moderate): 10 of 38 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $637.15 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $806.61 AETNA [503200004] — Aetna: $377.40 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $414.51 Allied National [503999937] — Allied National: $377.40 ALLWELL [503200078] — Wellcare Medicare Adv: $262.51 ALT BNSF RAILWAY CO [503301503] — Kansas Workers Comp: $440.30 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $314.50 ALT MERITAIN HEALTH [503999911] — Aetna: $377.40 ALT WPPA [5032000964] — WPPA: $264.18
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) · modifier NULL In the file: Emergency Department Visit Low Mdm	$279	Not listed in the file	$30.36 – $891
Emergency room visit (moderate): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $117.47 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $279 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $235 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $279 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $30.36 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $279 AETNA [503200004] — AETNA FED: $119.85 AETNA [503200004] — AETNA/COVENTRY: $119.85 AETNA [503200004] — NON-CONTRACTED: $279 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $55.47
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · modifier NULL In the file: Emergency Department Visit Low Mdm	$235	Not listed in the file	$30.36 – $891
Emergency room visit (moderate): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $117.47 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $235 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $235 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $235 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $30.36 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $235 AETNA [503200004] — AETNA FED: $119.85 AETNA [503200004] — AETNA/COVENTRY: $119.85 AETNA [503200004] — NON-CONTRACTED: $235 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $55.47
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · modifier NULL In the file: HC 99284 ER Level 4	$1,025	$205	$73.86 – $1,351
Emergency room visit (moderately high): 10 of 38 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $973.92 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $1,232.95 AETNA [503200004] — Aetna: $615 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $675.48 Allied National [503999937] — Allied National: $615 ALLWELL [503200078] — Wellcare Medicare Adv: $401.26 ALT BNSF RAILWAY CO [503301503] — Kansas Workers Comp: $717.50 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $512.50 ALT MERITAIN HEALTH [503999911] — Aetna: $615 ALT WPPA [5032000964] — WPPA: $430.50
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) · modifier NULL In the file: Emergency Department Visit Moderate Mdm	$386	Not listed in the file	$73.86 – $1,351
Emergency room visit (moderately high): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $199.80 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $386 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $443 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $386 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $73.86 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $443 AETNA [503200004] — AETNA FED: $225.93 AETNA [503200004] — AETNA/COVENTRY: $225.93 AETNA [503200004] — NON-CONTRACTED: $386 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $94.35
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · modifier NULL In the file: Emergency Department Visit Moderate Mdm	$386	Not listed in the file	$73.86 – $1,351
Emergency room visit (moderately high): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $199.80 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $386 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $386 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $386 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $73.86 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $386 AETNA [503200004] — AETNA FED: $196.86 AETNA [503200004] — AETNA/COVENTRY: $196.86 AETNA [503200004] — NON-CONTRACTED: $386 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $94.35
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · modifier NULL In the file: HC 99285 ER Level 5	$1,474	$294.80	$73.86 – $2,587
Emergency room visit (high): 10 of 41 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $1,390.02 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $1,759.71 AETNA [503200004] — Aetna: $884.40 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $884.40 Allied National [503999937] — Allied National: $884.40 ALLWELL [503200078] — Wellcare Medicare Adv: $572.69 ALT BNSF RAILWAY CO [503301503] — Kansas Workers Comp: $1,031.80 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $737 ALT MERITAIN HEALTH [503999911] — Aetna: $884.40 ALT WPPA [5032000964] — WPPA: $619.08
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) · modifier NULL In the file: Emergency Department Visit High Mdm	$569	Not listed in the file	$73.86 – $2,587
Emergency room visit (high): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $290.36 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $569 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $569 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $852 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $73.86 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $569 AETNA [503200004] — AETNA FED: $434.52 AETNA [503200004] — AETNA/COVENTRY: $290.19 AETNA [503200004] — NON-CONTRACTED: $852 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $137.11
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · modifier NULL In the file: Emergency Department Visit High Mdm	$569	Not listed in the file	$73.86 – $2,587
Emergency room visit (high): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $290.36 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $569 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $569 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $569 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $73.86 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $569 AETNA [503200004] — AETNA FED: $290.19 AETNA [503200004] — AETNA/COVENTRY: $290.19 AETNA [503200004] — NON-CONTRACTED: $569 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $137.11

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · modifier NULL In the file: HC Basic Metabolic Panel	$305	$61	$7.10 – $274.50
Basic metabolic panel (blood test): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $64.80 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $183 Allied National [503999937] — Allied National: $64.80 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $152.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $86.40 ALT MERITAIN HEALTH [503999911] — Aetna: $183 ALT WPPA [5032000964] — WPPA: $128.10 CIGNA [503200903] — HealthPartners of Kansas: $64.80 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $213.50 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $64.80
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · modifier NULL In the file: HC Comprehensive Metabolic Panel	$148	$29.60	$8.86 – $436.50
Comprehensive metabolic panel (blood test): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $88.80 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $291 Allied National [503999937] — Allied National: $88.80 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $242.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $388 ALT MERITAIN HEALTH [503999911] — Aetna: $88.80 ALT WPPA [5032000964] — WPPA: $203.70 CIGNA [503200903] — HealthPartners of Kansas: $88.80 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $339.50 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $88.80
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · modifier NULL In the file: HC Comprehensive Metabolic Panel (Ch12ct)	$48	$9.60	$8.86 – $436.50
Comprehensive metabolic panel (blood test): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $28.80 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $28.80 Allied National [503999937] — Allied National: $28.80 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $24 ALT CIGNA [503200906] — Cigna Behavioral Health: $38.40 ALT MERITAIN HEALTH [503999911] — Aetna: $28.80 ALT WPPA [5032000964] — WPPA: $20.16 CIGNA [503200903] — HealthPartners of Kansas: $28.80 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $33.60 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $28.80
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · modifier NULL In the file: HC Comp Metabolic Panel Isol	$48	$9.60	$8.86 – $436.50
Comprehensive metabolic panel (blood test): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $28.80 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $28.80 Allied National [503999937] — Allied National: $28.80 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $24 ALT CIGNA [503200906] — Cigna Behavioral Health: $38.40 ALT MERITAIN HEALTH [503999911] — Aetna: $28.80 ALT WPPA [5032000964] — WPPA: $20.16 CIGNA [503200903] — HealthPartners of Kansas: $28.80 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $33.60 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $28.80
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · modifier NULL In the file: HC Lipid-5:Chol/Trg/Hdl/Ldl+Vldl	$139	$27.80	$11.23 – $319.50
Cholesterol panel (lipid panel): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $213 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $213 Allied National [503999937] — Allied National: $83.40 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $69.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $111.20 ALT MERITAIN HEALTH [503999911] — Aetna: $83.40 ALT WPPA [5032000964] — WPPA: $58.38 CIGNA [503200903] — HealthPartners of Kansas: $83.40 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $97.30 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $213
Kidney function panel CPT 80069 · Inpatient or outpatient · modifier NULL In the file: HC Renal Function Panel	$138	$27.60	$7.28 – $124.20
Kidney function panel: 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $82.80 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $82.80 Allied National [503999937] — Allied National: $82.80 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $69 ALT CIGNA [503200906] — Cigna Behavioral Health: $110.40 ALT MERITAIN HEALTH [503999911] — Aetna: $82.80 ALT WPPA [5032000964] — WPPA: $57.96 CIGNA [503200903] — HealthPartners of Kansas: $82.80 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $96.60 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $82.80
Liver function panel CPT 80076 · Inpatient or outpatient · modifier NULL In the file: HC Hepatic Function Panel	$127	$25.40	$6.85 – $124.20
Liver function panel: 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $76.20 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $82.80 Allied National [503999937] — Allied National: $82.80 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $63.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $101.60 ALT MERITAIN HEALTH [503999911] — Aetna: $82.80 ALT WPPA [5032000964] — WPPA: $53.34 CIGNA [503200903] — HealthPartners of Kansas: $82.80 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $88.90 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $76.20
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · modifier NULL In the file: HC Urinalysis Uar	$66	$13.20	$2.66 – $59.40
Urine test (automated, with microscope): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $39.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $39.60 Allied National [503999937] — Allied National: $39.60 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $33 ALT CIGNA [503200906] — Cigna Behavioral Health: $52.80 ALT MERITAIN HEALTH [503999911] — Aetna: $39.60 ALT WPPA [5032000964] — WPPA: $27.72 CIGNA [503200903] — HealthPartners of Kansas: $39.60 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $46.20 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $39.60
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · modifier NULL In the file: HC Urinalysis, Auto W Micro	$66	$13.20	$2.66 – $59.40
Urine test (automated, with microscope): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $39.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $39.60 Allied National [503999937] — Allied National: $39.60 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $33 ALT CIGNA [503200906] — Cigna Behavioral Health: $52.80 ALT MERITAIN HEALTH [503999911] — Aetna: $39.60 ALT WPPA [5032000964] — WPPA: $27.72 CIGNA [503200903] — HealthPartners of Kansas: $39.60 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $46.20 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $39.60
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · modifier NULL In the file: HC Ketones-Urine (Acetone)	$20	$4	$2.09 – $36.90
Urine test (manual, without microscope): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $12 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $12 Allied National [503999937] — Allied National: $12 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $10 ALT CIGNA [503200906] — Cigna Behavioral Health: $16 ALT MERITAIN HEALTH [503999911] — Aetna: $12 ALT WPPA [5032000964] — WPPA: $8.40 CIGNA [503200903] — HealthPartners of Kansas: $12 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $14 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $12
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · modifier NULL In the file: HC Specific Gravity-Urine	$41	$8.20	$2.09 – $36.90
Urine test (manual, without microscope): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $24.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $24.60 Allied National [503999937] — Allied National: $24.60 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $20.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $32.80 ALT MERITAIN HEALTH [503999911] — Aetna: $24.60 ALT WPPA [5032000964] — WPPA: $17.22 CIGNA [503200903] — HealthPartners of Kansas: $24.60 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $28.70 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $24.60
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · modifier NULL In the file: Hp 81002 Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp	$10	$2	$2.09 – $36.90
Urine test (manual, without microscope): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $6 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $6 Allied National [503999937] — Allied National: $6 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $5 ALT CIGNA [503200906] — Cigna Behavioral Health: $8 ALT MERITAIN HEALTH [503999911] — Aetna: $6 ALT WPPA [5032000964] — WPPA: $4.20 CIGNA [503200903] — HealthPartners of Kansas: $6 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $7 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $6
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · modifier NULL In the file: HC Urinalysis Dipstick POC	$14	$2.80	$1.88 – $69.30
Urine test (automated, without microscope): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $8.40 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $8.40 Allied National [503999937] — Allied National: $8.40 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $7 ALT CIGNA [503200906] — Cigna Behavioral Health: $11.20 ALT MERITAIN HEALTH [503999911] — Aetna: $8.40 ALT WPPA [5032000964] — WPPA: $5.88 CIGNA [503200903] — HealthPartners of Kansas: $8.40 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $9.80 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $8.40
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · modifier NULL In the file: HC Urinalysis Dipstick	$77	$15.40	$1.88 – $69.30
Urine test (automated, without microscope): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $46.20 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $24.60 Allied National [503999937] — Allied National: $46.20 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $38.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $32.80 ALT MERITAIN HEALTH [503999911] — Aetna: $46.20 ALT WPPA [5032000964] — WPPA: $32.34 CIGNA [503200903] — HealthPartners of Kansas: $46.20 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $28.70 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $24.60
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · modifier NULL In the file: HC Urine Macroscopic W/ Reflex to Culture	$41	$8.20	$1.88 – $69.30
Urine test (automated, without microscope): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $24.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $24.60 Allied National [503999937] — Allied National: $24.60 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $20.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $32.80 ALT MERITAIN HEALTH [503999911] — Aetna: $24.60 ALT WPPA [5032000964] — WPPA: $17.22 CIGNA [503200903] — HealthPartners of Kansas: $24.60 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $28.70 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $24.60
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · modifier NULL In the file: HC Prostatic Specif Ag(Psa);Tot	$172	$34.40	$15.42 – $154.80
PSA (prostate specific antigen) blood test: 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $103.20 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $103.20 Allied National [503999937] — Allied National: $103.20 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $86 ALT CIGNA [503200906] — Cigna Behavioral Health: $137.60 ALT MERITAIN HEALTH [503999911] — Aetna: $103.20 ALT WPPA [5032000964] — WPPA: $72.24 CIGNA [503200903] — HealthPartners of Kansas: $103.20 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $120.40 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $103.20
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · modifier NULL In the file: HC Tsh W-Free T4 Reflex During Pregnancy	$77	$15.40	$14.08 – $205.20
Thyroid stimulating hormone (TSH) test: 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $46.20 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $46.20 Allied National [503999937] — Allied National: $46.20 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $38.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $61.60 ALT MERITAIN HEALTH [503999911] — Aetna: $46.20 ALT WPPA [5032000964] — WPPA: $32.34 CIGNA [503200903] — HealthPartners of Kansas: $46.20 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $53.90 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $46.20
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · modifier NULL In the file: HC Tsh(Thyroid Stimulating Horm) for Rei Clinic	$77	$15.40	$14.08 – $205.20
Thyroid stimulating hormone (TSH) test: 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $46.20 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $46.20 Allied National [503999937] — Allied National: $46.20 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $38.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $61.60 ALT MERITAIN HEALTH [503999911] — Aetna: $46.20 ALT WPPA [5032000964] — WPPA: $32.34 CIGNA [503200903] — HealthPartners of Kansas: $46.20 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $53.90 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $46.20
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · modifier NULL In the file: HC Tsh(Thyroid Stimulating Horm)	$228	$45.60	$14.08 – $205.20
Thyroid stimulating hormone (TSH) test: 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $136.80 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $136.80 Allied National [503999937] — Allied National: $136.80 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $114 ALT CIGNA [503200906] — Cigna Behavioral Health: $182.40 ALT MERITAIN HEALTH [503999911] — Aetna: $89.40 ALT WPPA [5032000964] — WPPA: $62.58 CIGNA [503200903] — HealthPartners of Kansas: $136.80 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $159.60 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $89.40
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier NULL In the file: HC Cbc With Diff Bm (Bmhpd)	$285	$57	$6.52 – $256.50
Complete blood count (CBC) with differential: 10 of 24 insurance plan rates AETNA [503200004] — Aetna: $171 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $171 Allied National [503999937] — Allied National: $171 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $142.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $228 ALT MERITAIN HEALTH [503999911] — Aetna: $171 ALT WPPA [5032000964] — WPPA: $119.70 CIGNA [503200903] — HealthPartners of Kansas: $171 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $199.50 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $171
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier NULL In the file: HC Cbc W Automated Diff (Hpdct)	$36	$7.20	$6.52 – $256.50
Complete blood count (CBC) with differential: 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $21.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $21.60 Allied National [503999937] — Allied National: $21.60 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $18 ALT CIGNA [503200906] — Cigna Behavioral Health: $28.80 ALT MERITAIN HEALTH [503999911] — Aetna: $21.60 ALT WPPA [5032000964] — WPPA: $15.12 CIGNA [503200903] — HealthPartners of Kansas: $21.60 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $25.20 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $21.60
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier NULL In the file: HC Cbc W/ Automated Diff	$94	$18.80	$6.52 – $256.50
Complete blood count (CBC) with differential: 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $103.20 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $103.20 Allied National [503999937] — Allied National: $56.40 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $47 ALT CIGNA [503200906] — Cigna Behavioral Health: $75.20 ALT MERITAIN HEALTH [503999911] — Aetna: $103.20 ALT WPPA [5032000964] — WPPA: $39.48 CIGNA [503200903] — HealthPartners of Kansas: $56.40 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $65.80 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $56.40
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · modifier NULL In the file: HC Cbc,Automated	$90	$18	$5.42 – $153.90
Complete blood count (CBC), automated: 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $102.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $54 Allied National [503999937] — Allied National: $54 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $45 ALT CIGNA [503200906] — Cigna Behavioral Health: $72 ALT MERITAIN HEALTH [503999911] — Aetna: $54 ALT WPPA [5032000964] — WPPA: $71.82 CIGNA [503200903] — HealthPartners of Kansas: $54 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $63 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $102.60
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · modifier NULL In the file: HC Cbc Automated (Hpct)	$30	$6	$5.42 – $153.90
Complete blood count (CBC), automated: 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $18 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $18 Allied National [503999937] — Allied National: $18 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $15 ALT CIGNA [503200906] — Cigna Behavioral Health: $24 ALT MERITAIN HEALTH [503999911] — Aetna: $18 ALT WPPA [5032000964] — WPPA: $12.60 CIGNA [503200903] — HealthPartners of Kansas: $18 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $21 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $18
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · modifier NULL In the file: HC Cbc, Automated	$90	$18	$5.42 – $153.90
Complete blood count (CBC), automated: 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $54 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $54 Allied National [503999937] — Allied National: $54 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $45 ALT CIGNA [503200906] — Cigna Behavioral Health: $72 ALT MERITAIN HEALTH [503999911] — Aetna: $54 ALT WPPA [5032000964] — WPPA: $37.80 CIGNA [503200903] — HealthPartners of Kansas: $54 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $63 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $54
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · modifier NULL In the file: Prothrombin Time	$16	$5.60	$2.57 – $149.40
Blood clotting time test (prothrombin time, PT): 10 of 247 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $7.72 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $16 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $16 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $16 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $3.22 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $16 AETNA [503200004] — AETNA FED: $8.16 AETNA [503200004] — AETNA/COVENTRY: $8.16 AETNA [503200004] — NON-CONTRACTED: $16 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $3.65
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · modifier NULL In the file: HC Pt(Inr)	$56	$11.20	$2.57 – $149.40
Blood clotting time test (prothrombin time, PT): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $99.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $99.60 Allied National [503999937] — Allied National: $33.60 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $28 ALT CIGNA [503200906] — Cigna Behavioral Health: $44.80 ALT MERITAIN HEALTH [503999911] — Aetna: $99.60 ALT WPPA [5032000964] — WPPA: $69.72 CIGNA [503200903] — HealthPartners of Kansas: $33.60 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $39.20 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $99.60
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · modifier NULL In the file: Hp Prothrombin Time	$56	$11.20	$2.57 – $149.40
Blood clotting time test (prothrombin time, PT): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $33.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $33.60 Allied National [503999937] — Allied National: $33.60 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $28 ALT CIGNA [503200906] — Cigna Behavioral Health: $44.80 ALT MERITAIN HEALTH [503999911] — Aetna: $33.60 ALT WPPA [5032000964] — WPPA: $23.52 CIGNA [503200903] — HealthPartners of Kansas: $33.60 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $39.20 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $33.60
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · modifier NULL In the file: HC Thromboplastin Time, Partial (Ptt)	$182	$36.40	$5.03 – $166.50
Blood clotting test (partial thromboplastin time, PTT): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $109.20 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $109.20 Allied National [503999937] — Allied National: $109.20 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $91 ALT CIGNA [503200906] — Cigna Behavioral Health: $145.60 ALT MERITAIN HEALTH [503999911] — Aetna: $109.20 ALT WPPA [5032000964] — WPPA: $76.44 CIGNA [503200903] — HealthPartners of Kansas: $109.20 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $127.40 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $109.20
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · modifier NULL In the file: HC Ptt(Aptt)	$72	$14.40	$5.03 – $166.50
Blood clotting test (partial thromboplastin time, PTT): 10 of 17 insurance plan rates AETNA [503200004] — Aetna: $111 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $111 Allied National [503999937] — Allied National: $43.20 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $36 ALT CIGNA [503200906] — Cigna Behavioral Health: $57.60 ALT MERITAIN HEALTH [503999911] — Aetna: $111 ALT WPPA [5032000964] — WPPA: $77.70 CIGNA [503200903] — HealthPartners of Kansas: $43.20 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $50.40 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $43.20

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · modifier TC In the file: CT Head/Brain W/O Contrast Material\|TECHNICAL COMPONENT	$357	$124.95	$24.87 – $1,400.40
CT scan of the head or brain, without contrast: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $176.72 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $357 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $357 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $357 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $40.87 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $357 AETNA [503200004] — AETNA FED: $182.07 AETNA [503200004] — AETNA/COVENTRY: $182.07 AETNA [503200004] — NON-CONTRACTED: $357 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $51.48
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · modifier TC In the file: CT Head/Brain W/O Contrast Material\|TECHNICAL COMPONENT	$357	$124.95	$24.87 – $1,400.40
CT scan of the head or brain, without contrast: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $109.01 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $357 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $357 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $357 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $40.87 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $357 AETNA [503200004] — AETNA FED: $182.07 AETNA [503200004] — AETNA/COVENTRY: $182.07 AETNA [503200004] — NON-CONTRACTED: $357 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $51.48
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · modifier NULL In the file: HC CT Head WO Contrast	$1,556	$311.20	$24.87 – $1,400.40
CT scan of the head or brain, without contrast: 10 of 32 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $244.02 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $308.92 AETNA [503200004] — Aetna: $933.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $933.60 Allied National [503999937] — Allied National: $933.60 ALLWELL [503200078] — Wellcare Medicare Adv: $100.54 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $778 ALT CIGNA [503200906] — Cigna Behavioral Health: $1,244.80 ALT MERITAIN HEALTH [503999911] — Aetna: $933.60 ALT WPPA [5032000964] — WPPA: $653.52
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · modifier TC In the file: MRI Brain Brain Stem W/O W/Contrast Material\|TECHNICAL COMPONENT	$757	$264.95	$67.03 – $3,154.50
MRI of the brain, before and after contrast: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $343.85 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $757 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $757 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $757 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $154.49 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $757 AETNA [503200004] — AETNA FED: $386.07 AETNA [503200004] — AETNA/COVENTRY: $386.07 AETNA [503200004] — NON-CONTRACTED: $757 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $162.38
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · modifier TC In the file: MRI Brain Brain Stem W/O W/Contrast Material\|TECHNICAL COMPONENT	$757	$264.95	$67.03 – $3,154.50
MRI of the brain, before and after contrast: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $343.85 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $757 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $757 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $757 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $154.49 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $757 AETNA [503200004] — AETNA FED: $386.07 AETNA [503200004] — AETNA/COVENTRY: $386.07 AETNA [503200004] — NON-CONTRACTED: $757 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $162.38
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · modifier NULL In the file: HC MRI Head WO/W Contrast	$3,505	$701	$67.03 – $3,154.50
MRI of the brain, before and after contrast: 10 of 32 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $814.30 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $1,030.87 AETNA [503200004] — Aetna: $2,103 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $2,103 Allied National [503999937] — Allied National: $2,103 ALLWELL [503200078] — Wellcare Medicare Adv: $335.49 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $1,752.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $2,804 ALT MERITAIN HEALTH [503999911] — Aetna: $2,103 ALT WPPA [5032000964] — WPPA: $1,472.10
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · modifier NULL In the file: Radiologic Exam Chest 2 Views	$259	$90.65	$6.43 – $318.60
Chest X-ray, 2 views: 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $54.54 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $81 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $81 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $259 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $20.06 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $81 AETNA [503200004] — AETNA FED: $41.31 AETNA [503200004] — AETNA/COVENTRY: $132.09 AETNA [503200004] — NON-CONTRACTED: $81 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $25.76
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier NULL In the file: Radiologic Exam Chest 2 Views	$81	$28.35	$6.43 – $318.60
Chest X-ray, 2 views: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $54.54 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $81 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $81 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $81 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $20.06 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $81 AETNA [503200004] — AETNA FED: $41.31 AETNA [503200004] — AETNA/COVENTRY: $41.31 AETNA [503200004] — NON-CONTRACTED: $81 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $25.76
Chest X-ray, 2 views CPT 71046 · Inpatient (hospital stay) · modifier NULL In the file: Radiologic Exam Chest 2 Views	$259	$90.65	$6.43 – $318.60
Chest X-ray, 2 views: 10 of 242 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $54.54 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $259 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $259 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $259 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $26.74 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $259 AETNA [503200004] — AETNA FED: $155.40 AETNA [503200004] — AETNA/COVENTRY: $155.40 AETNA [503200004] — NON-CONTRACTED: $259 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $30.30
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · modifier NULL In the file: Radex Spine Lumbosacral Minimum 4 Views	$384	$134.40	$7.68 – $487.80
X-ray of the lower spine, at least 4 views: 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $87.68 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $384 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $142 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $142 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $30.53 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $384 AETNA [503200004] — AETNA FED: $72.42 AETNA [503200004] — AETNA/COVENTRY: $72.42 AETNA [503200004] — NON-CONTRACTED: $384 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $41.40
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · modifier TC In the file: Radex Spine Lumbosacral Minimum 4 Views\|TECHNICAL COMPONENT	$286	$100.10	$7.68 – $487.80
X-ray of the lower spine, at least 4 views: 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $87.68 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $93 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $93 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $93 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $22.84 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $93 AETNA [503200004] — AETNA FED: $47.43 AETNA [503200004] — AETNA/COVENTRY: $47.43 AETNA [503200004] — NON-CONTRACTED: $286 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $31.20
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · modifier TC In the file: Radex Spine Lumbosacral Minimum 4 Views\|TECHNICAL COMPONENT	$93	$32.55	$7.68 – $487.80
X-ray of the lower spine, at least 4 views: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $66.06 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $93 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $93 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $93 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $22.84 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $93 AETNA [503200004] — AETNA FED: $47.43 AETNA [503200004] — AETNA/COVENTRY: $47.43 AETNA [503200004] — NON-CONTRACTED: $93 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $31.20
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · modifier TC In the file: MRI Spinal Canal Lumbar W/O Contrast Material\|TECHNICAL COMPONENT	$669	$234.15	$43.42 – $2,223.90
MRI of the lower back (lumbar spine), without contrast: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $317.88 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $669 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $669 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $669 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $88.77 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $669 AETNA [503200004] — AETNA FED: $341.19 AETNA [503200004] — AETNA/COVENTRY: $341.19 AETNA [503200004] — NON-CONTRACTED: $669 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $94.48
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · modifier TC In the file: MRI Spinal Canal Lumbar W/O Contrast Material\|TECHNICAL COMPONENT	$669	$234.15	$43.42 – $2,223.90
MRI of the lower back (lumbar spine), without contrast: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $200.07 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $669 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $669 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $669 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $88.77 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $669 AETNA [503200004] — AETNA FED: $341.19 AETNA [503200004] — AETNA/COVENTRY: $341.19 AETNA [503200004] — NON-CONTRACTED: $669 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $94.48
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · modifier NULL In the file: HC MRI L-Spine WO Contrast	$2,471	$494.20	$43.42 – $2,223.90
MRI of the lower back (lumbar spine), without contrast: 10 of 32 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $556.92 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $705.04 AETNA [503200004] — Aetna: $1,482.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $1,482.60 Allied National [503999937] — Allied National: $1,482.60 ALLWELL [503200078] — Wellcare Medicare Adv: $229.45 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $1,235.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $1,976.80 ALT MERITAIN HEALTH [503999911] — Aetna: $1,482.60 ALT WPPA [5032000964] — WPPA: $1,037.82
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · modifier TC In the file: CT Pelvis W/Contrast Material\|TECHNICAL COMPONENT	$552	$193.20	$33.94 – $1,361.70
CT scan of the pelvis, with contrast: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $279.97 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $552 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $552 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $552 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $104.06 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $552 AETNA [503200004] — AETNA FED: $281.52 AETNA [503200004] — AETNA/COVENTRY: $281.52 AETNA [503200004] — NON-CONTRACTED: $552 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $132.21
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · modifier TC In the file: CT Pelvis W/Contrast Material\|TECHNICAL COMPONENT	$552	$193.20	$33.94 – $1,361.70
CT scan of the pelvis, with contrast: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $279.97 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $552 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $552 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $552 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $104.06 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $552 AETNA [503200004] — AETNA FED: $281.52 AETNA [503200004] — AETNA/COVENTRY: $281.52 AETNA [503200004] — NON-CONTRACTED: $552 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $132.21
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · modifier NULL In the file: HC CT Pelvis W Contrast	$1,513	$302.60	$33.94 – $1,361.70
CT scan of the pelvis, with contrast: 10 of 32 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $409.40 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $518.28 AETNA [503200004] — Aetna: $907.80 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $907.80 Allied National [503999937] — Allied National: $907.80 ALLWELL [503200078] — Wellcare Medicare Adv: $168.67 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $756.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $1,210.40 ALT MERITAIN HEALTH [503999911] — Aetna: $907.80 ALT WPPA [5032000964] — WPPA: $635.46
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier TC In the file: MRI Any Jt Lower Extrem W/O Contrast Matrl\|TECHNICAL COMPONENT	$695	$243.25	$39.72 – $4,858.20
MRI of a leg joint (such as the knee), without contrast: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $338.08 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $695 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $695 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $695 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $100.99 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $695 AETNA [503200004] — AETNA FED: $354.45 AETNA [503200004] — AETNA/COVENTRY: $354.45 AETNA [503200004] — NON-CONTRACTED: $695 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $108.60
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier TC In the file: MRI Any Jt Lower Extrem W/O Contrast Matrl\|TECHNICAL COMPONENT	$695	$243.25	$39.72 – $4,858.20
MRI of a leg joint (such as the knee), without contrast: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $229.97 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $695 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $695 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $695 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $100.99 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $695 AETNA [503200004] — AETNA FED: $354.45 AETNA [503200004] — AETNA/COVENTRY: $354.45 AETNA [503200004] — NON-CONTRACTED: $695 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $108.60
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier NULL In the file: HC MRI Lower Ext Jnt WO Cont Bl	$5,398	$1,079.60	$39.72 – $4,858.20
MRI of a leg joint (such as the knee), without contrast: 10 of 32 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $556.92 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $705.04 AETNA [503200004] — Aetna: $3,238.80 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $3,238.80 Allied National [503999937] — Allied National: $3,238.80 ALLWELL [503200078] — Wellcare Medicare Adv: $229.45 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $2,699 ALT CIGNA [503200906] — Cigna Behavioral Health: $4,318.40 ALT MERITAIN HEALTH [503999911] — Aetna: $3,238.80 ALT WPPA [5032000964] — WPPA: $2,267.16
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · modifier TC In the file: CT Abdomen & Pelvis W/Contrast Material\|TECHNICAL COMPONENT	$537	$187.95	$53.33 – $2,271.60
CT scan of the abdomen and pelvis, with contrast: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $496.24 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $537 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $537 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $537 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $135.81 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $537 AETNA [503200004] — AETNA FED: $273.87 AETNA [503200004] — AETNA/COVENTRY: $273.87 AETNA [503200004] — NON-CONTRACTED: $537 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $166.34
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · modifier TC In the file: CT Abdomen & Pelvis W/Contrast Material\|TECHNICAL COMPONENT	$537	$187.95	$53.33 – $2,271.60
CT scan of the abdomen and pelvis, with contrast: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $352.24 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $537 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $537 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $537 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $135.81 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $537 AETNA [503200004] — AETNA FED: $273.87 AETNA [503200004] — AETNA/COVENTRY: $273.87 AETNA [503200004] — NON-CONTRACTED: $537 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $166.34
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · modifier NULL In the file: HC CT Enterography	$2,524	$504.80	$53.33 – $2,271.60
CT scan of the abdomen and pelvis, with contrast: 10 of 32 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $814.30 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $1,030.87 AETNA [503200004] — Aetna: $1,514.40 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $1,514.40 Allied National [503999937] — Allied National: $1,514.40 ALLWELL [503200078] — Wellcare Medicare Adv: $335.49 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $1,262 ALT CIGNA [503200906] — Cigna Behavioral Health: $2,019.20 ALT MERITAIN HEALTH [503999911] — Aetna: $1,514.40 ALT WPPA [5032000964] — WPPA: $1,060.08
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · modifier NULL In the file: US Abdominal Real Time W/Image Documentation	$320	$112	$23.61 – $847.80
Ultrasound of the abdomen, complete: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $189 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $320 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $320 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $320 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $69.96 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $320 AETNA [503200004] — AETNA FED: $163.20 AETNA [503200004] — AETNA/COVENTRY: $163.20 AETNA [503200004] — NON-CONTRACTED: $320 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $89.25
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier NULL In the file: US Abdominal Real Time W/Image Documentation	$320	$112	$23.61 – $847.80
Ultrasound of the abdomen, complete: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $189 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $320 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $320 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $320 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $69.96 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $320 AETNA [503200004] — AETNA FED: $163.20 AETNA [503200004] — AETNA/COVENTRY: $163.20 AETNA [503200004] — NON-CONTRACTED: $320 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $89.25
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier TC In the file: US Abdominal Real Time W/Image Documentation\|TECHNICAL COMPONENT	$211	$73.85	$23.61 – $847.80
Ultrasound of the abdomen, complete: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $189 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $211 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $211 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $211 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $46.35 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $211 AETNA [503200004] — AETNA FED: $107.61 AETNA [503200004] — AETNA/COVENTRY: $107.61 AETNA [503200004] — NON-CONTRACTED: $211 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $58.80
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · modifier NULL In the file: HC OB =>14 Wks Transab; 1st Gest	$474	$94.80	$29.27 – $426.60
Pregnancy ultrasound (after the first trimester): 10 of 34 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $244.02 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $308.92 AETNA [503200004] — Aetna: $284.40 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $284.40 Allied National [503999937] — Allied National: $284.40 ALLWELL [503200078] — Wellcare Medicare Adv: $100.54 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $237 ALT CIGNA [503200906] — Cigna Behavioral Health: $379.20 ALT MERITAIN HEALTH [503999911] — Aetna: $284.40 ALT WPPA [5032000964] — WPPA: $199.08
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · modifier 26 In the file: US Preg Uterus After 1st Trimest 1/1st Gestation\|PROFESSIONAL COMPONENT	$128	Not listed in the file	$29.27 – $426.60
Pregnancy ultrasound (after the first trimester): 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $80.48 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $235 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $128 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $128 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $29.27 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $128 AETNA [503200004] — AETNA FED: $119.85 AETNA [503200004] — AETNA/COVENTRY: $65.28 AETNA [503200004] — NON-CONTRACTED: $128 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $38
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · modifier 26 In the file: US Preg Uterus After 1st Trimest 1/1st Gestation\|PROFESSIONAL COMPONENT	$128	Not listed in the file	$29.27 – $426.60
Pregnancy ultrasound (after the first trimester): 10 of 104 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $80.48 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $29.27 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $128 AETNA [503200004] — AETNA FED: $65.28 AETNA [503200004] — AETNA/COVENTRY: $65.28 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $38 AGENCY [50311255] — MEDICAID KS: $29.27 AHA-HEALTHCARE PREFERRED [503200050] — COVENTRY FH LEASED NTWK: $76.80 ALLEGIANCE BENEFIT PLAN MGMT INC [50311259] — MEDICAID KS: $29.27 Allied National [503999937] — ALLIED NATIONAL: $76.80
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · modifier NULL In the file: HC Ultrasound Transvaginal	$730	$146	$20.43 – $657
Transvaginal ultrasound: 10 of 34 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $244.02 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $308.92 AETNA [503200004] — Aetna: $438 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $438 Allied National [503999937] — Allied National: $438 ALLWELL [503200078] — Wellcare Medicare Adv: $100.54 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $365 ALT CIGNA [503200906] — Cigna Behavioral Health: $584 ALT MERITAIN HEALTH [503999911] — Aetna: $438 ALT WPPA [5032000964] — WPPA: $306.60
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · modifier 26 In the file: US Transvaginal\|PROFESSIONAL COMPONENT	$92	Not listed in the file	$20.43 – $657
Transvaginal ultrasound: 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $55.62 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $92 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $116 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $116 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $20.43 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $116 AETNA [503200004] — AETNA FED: $59.16 AETNA [503200004] — AETNA/COVENTRY: $59.16 AETNA [503200004] — NON-CONTRACTED: $116 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $26.27
Transvaginal ultrasound CPT 76830 · Inpatient (hospital stay) · modifier 26 In the file: US Transvaginal\|PROFESSIONAL COMPONENT	$92	Not listed in the file	$20.43 – $657
Transvaginal ultrasound: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $55.62 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $92 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $92 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $92 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $27.24 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $92 AETNA [503200004] — AETNA FED: $55.20 AETNA [503200004] — AETNA/COVENTRY: $55.20 AETNA [503200004] — NON-CONTRACTED: $92 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $30.90
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier TC In the file: Diagnostic Mammography Computer-Aided Detcj Uni\|TECHNICAL COMPONENT	$207	$72.45	$23.61 – $233.31
Diagnostic mammogram, one breast: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $139.99 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $207 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $207 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $207 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $51.25 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $207 AETNA [503200004] — AETNA FED: $105.57 AETNA [503200004] — AETNA/COVENTRY: $105.57 AETNA [503200004] — NON-CONTRACTED: $207 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $66.10
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier TC In the file: Diagnostic Mammography Computer-Aided Detcj Uni\|TECHNICAL COMPONENT	$207	$72.45	$23.61 – $233.31
Diagnostic mammogram, one breast: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $139.99 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $207 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $207 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $207 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $51.25 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $207 AETNA [503200004] — AETNA FED: $105.57 AETNA [503200004] — AETNA/COVENTRY: $105.57 AETNA [503200004] — NON-CONTRACTED: $207 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $66.10
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier NULL In the file: HC Digital Mammo Dx Lt	$225	$45	$23.61 – $233.31
Diagnostic mammogram, one breast: 10 of 22 insurance plan rates AETNA [503200004] — Aetna: $135 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $135 Allied National [503999937] — Allied National: $135 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $112.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $180 ALT MERITAIN HEALTH [503999911] — Aetna: $135 ALT WPPA [5032000964] — WPPA: $94.50 CENTURION [5032000966] — Centurion: $90 CIGNA [503200903] — HealthPartners of Kansas: $135 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $157.50
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · modifier TC In the file: Diagnostic Mammography Computer-Aided Detcj Bi\|TECHNICAL COMPONENT	$266	$93.10	$29.09 – $405
Diagnostic mammogram, both breasts: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $179.42 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $266 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $266 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $266 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $65.36 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $266 AETNA [503200004] — AETNA FED: $135.66 AETNA [503200004] — AETNA/COVENTRY: $135.66 AETNA [503200004] — NON-CONTRACTED: $266 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $84.73
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · modifier TC In the file: Diagnostic Mammography Computer-Aided Detcj Bi\|TECHNICAL COMPONENT	$266	$93.10	$29.09 – $405
Diagnostic mammogram, both breasts: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $179.42 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $266 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $266 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $266 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $65.36 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $266 AETNA [503200004] — AETNA FED: $135.66 AETNA [503200004] — AETNA/COVENTRY: $135.66 AETNA [503200004] — NON-CONTRACTED: $266 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $84.73
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · modifier NULL In the file: HC Digital Mammo Dx Bil	$450	$90	$29.09 – $405
Diagnostic mammogram, both breasts: 10 of 21 insurance plan rates AETNA [503200004] — Aetna: $270 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $270 Allied National [503999937] — Allied National: $270 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $225 ALT CIGNA [503200906] — Cigna Behavioral Health: $360 ALT MERITAIN HEALTH [503999911] — Aetna: $270 ALT WPPA [5032000964] — WPPA: $189 CIGNA [503200903] — HealthPartners of Kansas: $270 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $315 FIRST HEALTH [5032000110] — Aetna/Coventry First Health: $270
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier TC In the file: Screening Mammography Bi 2-View Breast Inc Cad\|TECHNICAL COMPONENT	$219	$76.65	$22.34 – $279
Screening mammogram, both breasts: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $148.14 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $219 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $219 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $219 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $54.19 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $219 AETNA [503200004] — AETNA FED: $111.69 AETNA [503200004] — AETNA/COVENTRY: $111.69 AETNA [503200004] — NON-CONTRACTED: $219 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $69.96
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · modifier TC In the file: Screening Mammography Bi 2-View Breast Inc Cad\|TECHNICAL COMPONENT	$219	$76.65	$22.34 – $279
Screening mammogram, both breasts: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $208.51 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $219 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $219 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $219 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $54.19 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $219 AETNA [503200004] — AETNA FED: $111.69 AETNA [503200004] — AETNA/COVENTRY: $111.69 AETNA [503200004] — NON-CONTRACTED: $219 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $69.96
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · modifier NULL In the file: HC Mammo Screen Uni 52	$186	$37.20	$22.34 – $279
Screening mammogram, both breasts: 10 of 24 insurance plan rates AETNA [503200004] — Aetna: $111.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $111.60 Allied National [503999937] — Allied National: $111.60 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $93 ALT CIGNA [503200906] — Cigna Behavioral Health: $148.80 ALT MERITAIN HEALTH [503999911] — Aetna: $111.60 ALT WPPA [5032000964] — WPPA: $78.12 CENTURION [5032000966] — Centurion: $74.40 CIGNA [503200903] — HealthPartners of Kansas: $111.60 CORRECT CARE SOLUTIONS [50311253] — Wellpath: $130.20

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient · modifier NULL In the file: Ecg Routine Ecg W/Least 12 Lds W/I&R	$144	Not listed in the file	$12.04 – $175
Electrocardiogram (ECG/EKG) with reading: 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $25.51 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $144 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $175 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $175 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $18.12 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $144 AETNA [503200004] — AETNA FED: $73.44 AETNA [503200004] — AETNA/COVENTRY: $73.44 AETNA [503200004] — NON-CONTRACTED: $144 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $12.04
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient (hospital stay) · modifier NULL In the file: Ecg Routine Ecg W/Least 12 Lds W/I&R	$175	Not listed in the file	$12.04 – $175
Electrocardiogram (ECG/EKG) with reading: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $25.51 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $175 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $175 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $175 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $18.12 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $175 AETNA [503200004] — AETNA FED: $89.25 AETNA [503200004] — AETNA/COVENTRY: $89.25 AETNA [503200004] — NON-CONTRACTED: $175 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $12.04
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · modifier NULL In the file: Ecg Routine Ecg W/Least 12 Lds W/I&R	$144	Not listed in the file	$12.04 – $175
Electrocardiogram (ECG/EKG) with reading: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $25.51 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $144 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $144 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $144 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $18.12 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $144 AETNA [503200004] — AETNA FED: $73.44 AETNA [503200004] — AETNA/COVENTRY: $73.44 AETNA [503200004] — NON-CONTRACTED: $144 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $12.04

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier NULL In the file: HC 97110 Therap Exercise-Pt Ea 15 Min	$113	$22.60	$20.75 – $150
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 37 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $68.33 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $81.99 AETNA [503200004] — Aetna: $67.80 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $67.80 Allied National [503999937] — Allied National: $67.80 ALLWELL [503200078] — Wellcare Medicare Adv: $28.15 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $56.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $90.40 ALT MERITAIN HEALTH [503999911] — Aetna: $67.80 ALT WPPA [5032000964] — WPPA: $47.46
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier NULL In the file: HC 97110 Ther Exercise I-Ot Ea 15 Min	$113	$22.60	$20.75 – $150
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 37 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $68.33 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $81.99 AETNA [503200004] — Aetna: $67.80 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $67.80 Allied National [503999937] — Allied National: $67.80 ALLWELL [503200078] — Wellcare Medicare Adv: $28.15 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $56.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $90.40 ALT MERITAIN HEALTH [503999911] — Aetna: $67.80 ALT WPPA [5032000964] — WPPA: $47.46
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier NULL In the file: Therapeutic Px 1/> Areas Each 15 Min Exercises	$129	Not listed in the file	$20.75 – $150
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 198 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $83.85 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $83 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $83 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $129 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $129 AETNA [503200004] — AETNA FED: $42.33 AETNA [503200004] — AETNA/COVENTRY: $42.33 AETNA [503200004] — NON-CONTRACTED: $83 AGENCY [50311255] — NON-CONTRACTED: $129 AHA-HEALTHCARE PREFERRED [503200050] — COVENTRY FH LEASED NTWK: $77.40
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier NULL In the file: HC 97161 Pt Eval, Low Complexity	$168	$33.60	$55.85 – $281
Physical therapy evaluation (low complexity): 10 of 37 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $232.53 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $279.03 AETNA [503200004] — Aetna: $100.80 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $100.80 Allied National [503999937] — Allied National: $100.80 ALLWELL [503200078] — Wellcare Medicare Adv: $95.80 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $84 ALT CIGNA [503200906] — Cigna Behavioral Health: $134.40 ALT MERITAIN HEALTH [503999911] — Aetna: $100.80 ALT WPPA [5032000964] — WPPA: $70.56
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier NULL In the file: Physical Therapy Evaluation Low Complex 20 Mins	$250	Not listed in the file	$55.85 – $281
Physical therapy evaluation (low complexity): 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $168.44 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $250 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $281 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $250 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $57.70 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $250 AETNA [503200004] — AETNA FED: $143.31 AETNA [503200004] — AETNA/COVENTRY: $127.50 AETNA [503200004] — NON-CONTRACTED: $281 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $79.54
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier NULL In the file: Physical Therapy Evaluation Low Complex 20 Mins	$250	Not listed in the file	$55.85 – $281
Physical therapy evaluation (low complexity): 10 of 58 insurance plan rates ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $76.93 AETNA [503200004] — AETNA FED: $150 AETNA [503200004] — AETNA/COVENTRY: $150 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $93.58 AGENCY [50311255] — MEDICAID KS: $76.93 ALLEGIANCE BENEFIT PLAN MGMT INC [50311259] — MEDICAID KS: $76.93 ALLWELL [503200078] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $93.58 ALT MEDICARE [503100009] — MEDICARE KS: $93.58 ALT MEDICARE RAILROAD [503100012] — MEDICARE KS: $93.58 ALT MEDICARE-NORIDIAN [503100011] — MEDICARE KS: $93.58
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier NULL In the file: HC 97162 Pt Eval, Moderate Complexity	$201	$40.20	$55.85 – $281
Physical therapy evaluation (moderate complexity): 10 of 37 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $232.53 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $279.03 AETNA [503200004] — Aetna: $120.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $120.60 Allied National [503999937] — Allied National: $120.60 ALLWELL [503200078] — Wellcare Medicare Adv: $95.80 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $100.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $160.80 ALT MERITAIN HEALTH [503999911] — Aetna: $120.60 ALT WPPA [5032000964] — WPPA: $84.42
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier NULL In the file: Physical Therapy Evaluation Mod Complex 30 Mins	$250	Not listed in the file	$55.85 – $281
Physical therapy evaluation (moderate complexity): 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $168.44 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $250 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $250 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $250 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $57.70 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $250 AETNA [503200004] — AETNA FED: $127.50 AETNA [503200004] — AETNA/COVENTRY: $127.50 AETNA [503200004] — NON-CONTRACTED: $250 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $79.54
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier NULL In the file: Physical Therapy Evaluation Mod Complex 30 Mins	$250	Not listed in the file	$55.85 – $281
Physical therapy evaluation (moderate complexity): 10 of 58 insurance plan rates ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $76.93 AETNA [503200004] — AETNA FED: $150 AETNA [503200004] — AETNA/COVENTRY: $150 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $93.58 AGENCY [50311255] — MEDICAID KS: $76.93 ALLEGIANCE BENEFIT PLAN MGMT INC [50311259] — MEDICAID KS: $76.93 ALLWELL [503200078] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $93.58 ALT MEDICARE [503100009] — MEDICARE KS: $93.58 ALT MEDICARE RAILROAD [503100012] — MEDICARE KS: $93.58 ALT MEDICARE-NORIDIAN [503100011] — MEDICARE KS: $93.58
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · modifier NULL In the file: HC 97163 Pt Eval, High Complexity	$184	$36.80	$55.85 – $281
Physical therapy evaluation (high complexity): 10 of 37 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $232.53 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $279.03 AETNA [503200004] — Aetna: $110.40 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $110.40 Allied National [503999937] — Allied National: $110.40 ALLWELL [503200078] — Wellcare Medicare Adv: $95.80 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $92 ALT CIGNA [503200906] — Cigna Behavioral Health: $147.20 ALT MERITAIN HEALTH [503999911] — Aetna: $110.40 ALT WPPA [5032000964] — WPPA: $77.28
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · modifier NULL In the file: Physical Therapy Evaluation High Complex 45 Mins	$250	Not listed in the file	$55.85 – $281
Physical therapy evaluation (high complexity): 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $168.44 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $281 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $281 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $250 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $57.70 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $281 AETNA [503200004] — AETNA FED: $127.50 AETNA [503200004] — AETNA/COVENTRY: $127.50 AETNA [503200004] — NON-CONTRACTED: $250 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $79.54
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient (hospital stay) · modifier NULL In the file: Physical Therapy Evaluation High Complex 45 Mins	$281	Not listed in the file	$55.85 – $281
Physical therapy evaluation (high complexity): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $168.44 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $281 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $281 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $281 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $57.70 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $281 AETNA [503200004] — AETNA FED: $143.31 AETNA [503200004] — AETNA/COVENTRY: $143.31 AETNA [503200004] — NON-CONTRACTED: $281 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $79.54

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · modifier NULL In the file: Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion	$7,731	Not listed in the file	$133.45 – $3,865.50
Removal of breast growth (open surgery): 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $331.02 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $3,865.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $3,865.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $502 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $133.45 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $3,865.50 AETNA [503200004] — AETNA FED: $1,971.41 AETNA [503200004] — AETNA/COVENTRY: $1,971.41 AETNA [503200004] — NON-CONTRACTED: $3,865.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $219.84
Removal of breast growth (open surgery) CPT 19120 · Inpatient (hospital stay) · modifier NULL In the file: Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion	$1,004	Not listed in the file	$133.45 – $3,865.50
Removal of breast growth (open surgery): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $331.02 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $896 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $502 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $896 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $133.45 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $502 AETNA [503200004] — AETNA FED: $256.02 AETNA [503200004] — AETNA/COVENTRY: $456.96 AETNA [503200004] — NON-CONTRACTED: $502 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $156.32
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · modifier NULL In the file: Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion	$7,731	Not listed in the file	$133.45 – $3,865.50
Removal of breast growth (open surgery): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $465.55 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $3,865.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $3,865.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $3,865.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $133.45 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $3,865.50 AETNA [503200004] — AETNA FED: $1,971.41 AETNA [503200004] — AETNA/COVENTRY: $1,971.41 AETNA [503200004] — NON-CONTRACTED: $3,865.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $219.84
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · modifier NULL In the file: Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft	$3,090	$8,592.42	$417.32 – $37,936.48
Total hip replacement: 10 of 274 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $951.72 6 DEGREES HEALTH [503999050] — 6 Degrees: $29,966.55 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $1,636 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $1,636 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $1,636 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $417.32 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $37,936.48 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $1,636 AETNA [503200004] — AETNA FED: $834.36 AETNA [503200004] — AETNA/COVENTRY: $834.36
Total hip replacement CPT 27130 · Inpatient or outpatient · modifier NULL In the file: Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft	$3,090	Not listed in the file	$417.32 – $37,936.48
Total hip replacement: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $951.72 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $1,545 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $1,545 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $1,545 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $417.32 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $1,545 AETNA [503200004] — AETNA FED: $787.95 AETNA [503200004] — AETNA/COVENTRY: $787.95 AETNA [503200004] — NON-CONTRACTED: $1,545 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $449.42
Total hip replacement CPT 27130 · Inpatient (hospital stay) · modifier NULL In the file: Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft	$3,272	Not listed in the file	$417.32 – $37,936.48
Total hip replacement: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $951.72 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $1,636 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $1,636 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $1,636 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $556.42 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $1,636 AETNA [503200004] — AETNA FED: $834.36 AETNA [503200004] — AETNA/COVENTRY: $927 AETNA [503200004] — NON-CONTRACTED: $1,636 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $449.42
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier NULL In the file: Arthrp Kne Condyle&Platu Medial&Lat Compartments	$38,472.11	$7,694.42	$433.69 – $37,936.48
Total knee replacement: 10 of 274 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $29,966.55 6 DEGREES HEALTH [503999050] — 6 DEGREES: $950.33 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $1,629.08 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $1,629.08 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $1,629.08 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $433.69 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $37,936.48 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $1,629.08 AETNA [503200004] — AETNA FED: $786.93 AETNA [503200004] — AETNA/COVENTRY: $786.93
Total knee replacement CPT 27447 · Inpatient or outpatient · modifier NULL In the file: Arthrp Kne Condyle&Platu Medial&Lat Compartments	$3,086	Not listed in the file	$433.69 – $37,936.48
Total knee replacement: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $950.33 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $1,543 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $1,543 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $1,543 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $433.69 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $1,543 AETNA [503200004] — AETNA FED: $786.93 AETNA [503200004] — AETNA/COVENTRY: $786.93 AETNA [503200004] — NON-CONTRACTED: $1,543 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $448.77
Total knee replacement CPT 27447 · Inpatient (hospital stay) · modifier NULL In the file: Arthrp Kne Condyle&Platu Medial&Lat Compartments	$3,269	Not listed in the file	$433.69 – $37,936.48
Total knee replacement: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $950.33 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $1,634.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $1,634.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $1,634.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $578.25 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $1,634.50 AETNA [503200004] — AETNA FED: $925.80 AETNA [503200004] — AETNA/COVENTRY: $925.80 AETNA [503200004] — NON-CONTRACTED: $1,634.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $448.77
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier NULL In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls	$534	$5,870.83	$69.78 – $21,441.08
Shoulder arthroscopy: shaving of shoulder bone: 10 of 271 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $16,936.61 6 DEGREES HEALTH [503999050] — 6 DEGREES: $243.20 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $931.99 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $931.99 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $931.99 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $406.68 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $21,441.08 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $931.99 AETNA [503200004] — AETNA FED: $272.34 AETNA [503200004] — AETNA/COVENTRY: $272.34
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient (hospital stay) · modifier NULL In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls	$970	Not listed in the file	$69.78 – $21,441.08
Shoulder arthroscopy: shaving of shoulder bone: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $243.20 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $970 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $970 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $970 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $534 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $970 AETNA [503200004] — AETNA FED: $320.40 AETNA [503200004] — AETNA/COVENTRY: $320.40 AETNA [503200004] — NON-CONTRACTED: $970 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $114.84
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · modifier NULL In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls	$534	Not listed in the file	$69.78 – $21,441.08
Shoulder arthroscopy: shaving of shoulder bone: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $243.20 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $534 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $534 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $534 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $406.68 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $534 AETNA [503200004] — AETNA FED: $272.34 AETNA [503200004] — AETNA/COVENTRY: $272.34 AETNA [503200004] — NON-CONTRACTED: $534 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $114.84
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier NULL In the file: Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg	$6,988.26	$1,397.65	$3.56 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $9,668.30
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 271 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $422.79 6 DEGREES HEALTH [503999050] — 6 Degrees: $7,637.12 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $696 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $696 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $696 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $185.38 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $9,668.30 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $696 AETNA [503200004] — AETNA FED: $354.96 AETNA [503200004] — AETNA/COVENTRY: $354.96
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · modifier NULL In the file: Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg	$1,319	Not listed in the file	$3.56 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $9,668.30
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $422.79 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $659.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $659.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $659.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $185.38 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $659.50 AETNA [503200004] — AETNA FED: $336.35 AETNA [503200004] — AETNA/COVENTRY: $336.35 AETNA [503200004] — NON-CONTRACTED: $659.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $199.65
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient (hospital stay) · modifier NULL In the file: Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg	$1,392	Not listed in the file	$3.56 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $9,668.30
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $422.79 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $696 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $696 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $696 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $247.18 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $696 AETNA [503200004] — AETNA FED: $354.96 AETNA [503200004] — AETNA/COVENTRY: $395.70 AETNA [503200004] — NON-CONTRACTED: $696 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $199.65
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier NULL In the file: Esophagogastroduodenoscopy Transoral Diagnostic	$2,725.50	$545.10	$43.89 – $2,680.01
Upper GI endoscopy (diagnostic): 10 of 274 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $265.78 6 DEGREES HEALTH [503999050] — 6 Degrees: $2,116.98 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $156.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $156.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $156.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $93.75 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $2,680.01 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $156.50 AETNA [503200004] — AETNA FED: $79.82 AETNA [503200004] — AETNA/COVENTRY: $79.82
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient (hospital stay) · modifier NULL In the file: Esophagogastroduodenoscopy Transoral Diagnostic	$313	Not listed in the file	$43.89 – $2,680.01
Upper GI endoscopy (diagnostic): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $92.95 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $156.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $199.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $156.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $93.75 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $199.50 AETNA [503200004] — AETNA FED: $119.70 AETNA [503200004] — AETNA/COVENTRY: $119.70 AETNA [503200004] — NON-CONTRACTED: $199.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $51.64
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · modifier NULL In the file: Esophagogastroduodenoscopy Transoral Diagnostic	$399	Not listed in the file	$43.89 – $2,680.01
Upper GI endoscopy (diagnostic): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $92.95 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $199.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $199.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $199.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $93.75 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $199.50 AETNA [503200004] — AETNA FED: $101.75 AETNA [503200004] — AETNA/COVENTRY: $101.75 AETNA [503200004] — NON-CONTRACTED: $199.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $125.51
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier NULL In the file: Egd Transoral Biopsy Single/Multiple	$903	$790.87	$49.12 – $2,680.01
Upper GI endoscopy with biopsy: 10 of 272 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $344.25 6 DEGREES HEALTH [503999050] — 6 Degrees: $2,116.98 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $451.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $451.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $451.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $106.80 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $2,680.01 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $177 AETNA [503200004] — AETNA FED: $90.27 AETNA [503200004] — AETNA/COVENTRY: $90.27
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · modifier NULL In the file: Egd Transoral Biopsy Single/Multiple	$903	Not listed in the file	$49.12 – $2,680.01
Upper GI endoscopy with biopsy: 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $104.02 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $451.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $451.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $451.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $106.80 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $451.50 AETNA [503200004] — AETNA FED: $230.27 AETNA [503200004] — AETNA/COVENTRY: $230.27 AETNA [503200004] — NON-CONTRACTED: $451.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $162.57
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) · modifier NULL In the file: Egd Transoral Biopsy Single/Multiple	$615	Not listed in the file	$49.12 – $2,680.01
Upper GI endoscopy with biopsy: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $104.02 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $177 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $177 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $177 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $106.80 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $307.50 AETNA [503200004] — AETNA FED: $90.27 AETNA [503200004] — AETNA/COVENTRY: $184.50 AETNA [503200004] — NON-CONTRACTED: $307.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $57.79
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier NULL In the file: Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$1,088	$758.18	$65.27 – $2,747.89
Colonoscopy (diagnostic): 10 of 274 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $2,170.60 6 DEGREES HEALTH [503999050] — 6 DEGREES: $311.87 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $254.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $544 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $254.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $115.24 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $2,747.89 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $254.50 AETNA [503200004] — AETNA FED: $277.44 AETNA [503200004] — AETNA/COVENTRY: $129.80
Colonoscopy (diagnostic) CPT 45378 · Inpatient (hospital stay) · modifier NULL In the file: Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$509	Not listed in the file	$65.27 – $2,747.89
Colonoscopy (diagnostic): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $138.22 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $378 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $254.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $254.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $153.65 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $378 AETNA [503200004] — AETNA FED: $226.80 AETNA [503200004] — AETNA/COVENTRY: $226.80 AETNA [503200004] — NON-CONTRACTED: $378 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $65.27
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · modifier NULL In the file: Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$1,088	Not listed in the file	$65.27 – $2,747.89
Colonoscopy (diagnostic): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $311.87 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $544 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $544 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $544 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $115.24 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $544 AETNA [503200004] — AETNA FED: $277.44 AETNA [503200004] — AETNA/COVENTRY: $277.44 AETNA [503200004] — NON-CONTRACTED: $544 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $147.27
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier NULL In the file: Colonoscopy W/Biopsy Single/Multiple	$1,393	$1,333.98	$70.61 – $3,535.91
Colonoscopy with biopsy: 10 of 271 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $395.74 6 DEGREES HEALTH [503999050] — 6 Degrees: $2,793.06 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $696.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $256 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $696.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $146.65 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $3,535.91 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $256 AETNA [503200004] — AETNA FED: $130.56 AETNA [503200004] — AETNA/COVENTRY: $130.56
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · modifier NULL In the file: Colonoscopy W/Biopsy Single/Multiple	$1,393	Not listed in the file	$70.61 – $3,535.91
Colonoscopy with biopsy: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $149.54 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $696.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $696.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $696.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $146.65 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $696.50 AETNA [503200004] — AETNA FED: $355.22 AETNA [503200004] — AETNA/COVENTRY: $355.22 AETNA [503200004] — NON-CONTRACTED: $696.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $186.88
Colonoscopy with biopsy CPT 45380 · Inpatient (hospital stay) · modifier NULL In the file: Colonoscopy W/Biopsy Single/Multiple	$886	Not listed in the file	$70.61 – $3,535.91
Colonoscopy with biopsy: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $149.54 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $256 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $256 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $256 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $195.53 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $443 AETNA [503200004] — AETNA FED: $130.56 AETNA [503200004] — AETNA/COVENTRY: $130.56 AETNA [503200004] — NON-CONTRACTED: $256 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $83.08
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier NULL In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$5,563.26	$1,112.65	$89.03 – $3,535.91
Colonoscopy with removal of polyps (snare): 10 of 271 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $2,793.06 6 DEGREES HEALTH [503999050] — 6 DEGREES: $413.82 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $324.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $324.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $324.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $157.83 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $3,535.91 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $324.50 AETNA [503200004] — AETNA FED: $165.50 AETNA [503200004] — AETNA/COVENTRY: $165.50
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient (hospital stay) · modifier NULL In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$649	Not listed in the file	$89.03 – $3,535.91
Colonoscopy with removal of polyps (snare): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $188.54 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $546 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $324.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $324.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $157.83 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $546 AETNA [503200004] — AETNA FED: $165.50 AETNA [503200004] — AETNA/COVENTRY: $327.60 AETNA [503200004] — NON-CONTRACTED: $324.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $89.04
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · modifier NULL In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$1,092	Not listed in the file	$89.03 – $3,535.91
Colonoscopy with removal of polyps (snare): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $188.54 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $546 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $546 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $546 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $157.83 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $546 AETNA [503200004] — AETNA FED: $278.46 AETNA [503200004] — AETNA/COVENTRY: $278.46 AETNA [503200004] — NON-CONTRACTED: $546 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $195.42
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · modifier NULL In the file: Colon ca scrn not hi rsk ind	$820	Not listed in the file	$65.34 – $410
Screening colonoscopy (not high risk): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $312.02 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $410 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $410 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $410 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $74.95 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $410 AETNA [503200004] — AETNA FED: $209.10 AETNA [503200004] — AETNA/COVENTRY: $209.10 AETNA [503200004] — NON-CONTRACTED: $410 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $147.35
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · modifier NULL In the file: Colon ca scrn not hi rsk ind	$820	Not listed in the file	$65.34 – $410
Screening colonoscopy (not high risk): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $312.02 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $410 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $254.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $254.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $74.95 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $254.50 AETNA [503200004] — AETNA FED: $209.10 AETNA [503200004] — AETNA/COVENTRY: $129.80 AETNA [503200004] — NON-CONTRACTED: $410 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $147.35
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient (hospital stay) · modifier NULL In the file: Colon ca scrn not hi rsk ind	$445	Not listed in the file	$65.34 – $410
Screening colonoscopy (not high risk): 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $138.38 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $222.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $254.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $222.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $74.95 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $254.50 AETNA [503200004] — AETNA FED: $133.50 AETNA [503200004] — AETNA/COVENTRY: $133.50 AETNA [503200004] — NON-CONTRACTED: $254.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $76.88
Gallbladder removal by laparoscope CPT 47562 · Inpatient (hospital stay) · modifier NULL In the file: Laparoscopy Surg Cholecystectomy	$1,335	Not listed in the file	$218.69 – $833.50
Gallbladder removal by laparoscope: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $511.36 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $667.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $667.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $833.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $291.59 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $833.50 AETNA [503200004] — AETNA FED: $425.09 AETNA [503200004] — AETNA/COVENTRY: $400.50 AETNA [503200004] — NON-CONTRACTED: $667.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $284.09
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient · modifier NULL In the file: Laparoscopy Surg Cholecystectomy	$1,335	Not listed in the file	$218.69 – $833.50
Gallbladder removal by laparoscope: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $511.36 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $667.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $667.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $667.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $218.69 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $667.50 AETNA [503200004] — AETNA FED: $340.43 AETNA [503200004] — AETNA/COVENTRY: $340.43 AETNA [503200004] — NON-CONTRACTED: $667.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $241.48
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier NULL In the file: Laparoscopy Surg Cholecystectomy	Not listed in the file	Not listed in the file	$218.69 – $833.50
Gallbladder removal by laparoscope: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $511.36 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $833.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $833.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $833.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $218.69 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $833.50 AETNA [503200004] — AETNA FED: $425.09 AETNA [503200004] — AETNA/COVENTRY: $425.09 AETNA [503200004] — NON-CONTRACTED: $833.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $241.48
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier NULL In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible	$19,522.73	$3,904.55	$154.05 – $10,579.57
Groin (inguinal) hernia repair, age 5 or older: 10 of 274 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $410.92 6 DEGREES HEALTH [503999050] — 6 Degrees: $8,356.95 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $662.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $662.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $662.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $154.05 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $10,579.57 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $662.50 AETNA [503200004] — AETNA FED: $337.88 AETNA [503200004] — AETNA/COVENTRY: $337.88
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient (hospital stay) · modifier NULL In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible	$1,325	Not listed in the file	$154.05 – $10,579.57
Groin (inguinal) hernia repair, age 5 or older: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $410.92 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $662.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $662.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $662.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $154.05 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $662.50 AETNA [503200004] — AETNA FED: $337.88 AETNA [503200004] — AETNA/COVENTRY: $337.88 AETNA [503200004] — NON-CONTRACTED: $662.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $194.05
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · modifier NULL In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible	$1,254	Not listed in the file	$154.05 – $10,579.57
Groin (inguinal) hernia repair, age 5 or older: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $410.92 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $627 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $627 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $627 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $154.05 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $627 AETNA [503200004] — AETNA FED: $319.77 AETNA [503200004] — AETNA/COVENTRY: $319.77 AETNA [503200004] — NON-CONTRACTED: $627 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $194.05
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier NULL In the file: Hp 58558 Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$12,688.84	$2,537.77	$79.99 – $9,565.25
Hysteroscopy with biopsy of the uterus lining: 10 of 28 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $7,555.72 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $9,565.25 ALLWELL [503200078] — Wellcare Medicare Adv: $3,112.96 ALT BCBS KS [503201524] — BCBS Kansas: $3,974.41 ALT BNSF RAILWAY CO [503301503] — Kansas Workers Comp: $4,545.54 AMBETTER [503200087] — Ambetter Exchange (Sunflower): $4,382.32 BCBS KANSAS [503301501] — BCBS Kansas: $3,974.41 BCBS MEDICARE [50311204] — Healthy Blue KS Medicare Adv: $3,112.96 CENTURION [5032000966] — Centurion: $3,928.97 FORT HAYS STATE STUDENT ATHLETES [5032000960] — Occunet: $6,346.81
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient · modifier NULL In the file: Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$476	Not listed in the file	$79.99 – $9,565.25
Hysteroscopy with biopsy of the uterus lining: 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $169.40 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $238 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $3,146.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $3,146.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $287.05 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $238 AETNA [503200004] — AETNA FED: $1,604.72 AETNA [503200004] — AETNA/COVENTRY: $1,604.72 AETNA [503200004] — NON-CONTRACTED: $3,146.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $489.74
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier NULL In the file: Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$6,293	Not listed in the file	$79.99 – $9,565.25
Hysteroscopy with biopsy of the uterus lining: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $1,037.10 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $3,146.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $3,146.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $3,146.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $287.05 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $3,146.50 AETNA [503200004] — AETNA FED: $1,604.72 AETNA [503200004] — AETNA/COVENTRY: $1,604.72 AETNA [503200004] — NON-CONTRACTED: $3,146.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $489.74
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · modifier NULL In the file: HC 62323 Inject Lumb/Sac Incl Needle Plcmt W Guidance	$1,451	$290.20	$18 – $7,500
Spinal injection, lower back (epidural), with imaging guidance: 10 of 46 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $1,647.58 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $2,085.78 AETNA [503200004] — Aetna: $870.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $870.60 Allied National [503999937] — Allied National: $870.60 ALLWELL [503200078] — Wellcare Medicare Adv: $678.81 ALT BNSF RAILWAY CO [503301503] — Kansas Workers Comp: $1,086.76 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $725.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $1,160.80 ALT MERITAIN HEALTH [503999911] — Aetna: $870.60
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · modifier NULL In the file: HC Lp Therapeutic Infusion W/Fluoro	$1,451	$290.20	$18 – $7,500
Spinal injection, lower back (epidural), with imaging guidance: 10 of 40 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $1,647.58 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $2,085.78 AETNA [503200004] — Aetna: $870.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $870.60 Allied National [503999937] — Allied National: $870.60 ALLWELL [503200078] — Wellcare Medicare Adv: $678.81 ALT BNSF RAILWAY CO [503301503] — Kansas Workers Comp: $1,086.76 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $725.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $1,160.80 ALT MERITAIN HEALTH [503999911] — Aetna: $870.60
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · modifier NULL In the file: Esi Lumbar/Sacral/Caudal	$1,451	$290.20	$18 – $7,500
Spinal injection, lower back (epidural), with imaging guidance: 10 of 40 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $1,647.58 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $2,085.78 AETNA [503200004] — Aetna: $870.60 AHA-HEALTHCARE PREFERRED [503200050] — Aetna/Coventry First Health: $870.60 Allied National [503999937] — Allied National: $870.60 ALLWELL [503200078] — Wellcare Medicare Adv: $678.81 ALT BNSF RAILWAY CO [503301503] — Kansas Workers Comp: $1,086.76 Alt Carelon Behavioral Health [503200905] — CARELON BEHAVIORAL HEALTH: $725.50 ALT CIGNA [503200906] — Cigna Behavioral Health: $1,160.80 ALT MERITAIN HEALTH [503999911] — Aetna: $870.60
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · modifier NULL In the file: Hp 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level	$1,738.38	$347.68	$12 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $7,500
Nerve root injection, lower back, with imaging guidance: 10 of 31 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $2,064.43 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $2,613.49 ALLWELL [503200078] — Wellcare Medicare Adv: $850.55 ALT BCBS KS [503201524] — BCBS Kansas: $1,112.86 ALT BNSF RAILWAY CO [503301503] — Kansas Workers Comp: $1,344.36 AMBETTER [503200087] — Ambetter Exchange (Sunflower): $1,197.37 BCBS KANSAS [503301501] — BCBS Kansas: $1,112.86 BCBS KS MEDICAID [503999940] — Medicaid KS Healthy Blue KS: $295.27 BCBS MEDICARE [50311204] — Healthy Blue KS Medicare Adv: $850.55 CENTENE MEDICAID KS [503201515] — Medicaid KS Sunflower Health Plan: $295.27
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier NULL In the file: Hp 64721 Neuroplasty &/Transpos Median Nrv Carpal Tunne	$4,676.72	$935.34	$126.29 – $5,770.02
Carpal tunnel release: 10 of 31 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $4,557.82 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $5,770.02 ALLWELL [503200078] — Wellcare Medicare Adv: $1,877.82 ALT BCBS KS [503201524] — BCBS Kansas: $1,624.08 ALT BNSF RAILWAY CO [503301503] — Kansas Workers Comp: $3,221 AMBETTER [503200087] — Ambetter Exchange (Sunflower): $2,643.54 BCBS KANSAS [503301501] — BCBS Kansas: $1,624.08 BCBS KS MEDICAID [503999940] — Medicaid KS Healthy Blue KS: $625.47 BCBS MEDICARE [50311204] — Healthy Blue KS Medicare Adv: $1,877.82 CENTENE MEDICAID KS [503201515] — Medicaid KS Sunflower Health Plan: $625.47
Carpal tunnel release CPT 64721 · Inpatient or outpatient · modifier NULL In the file: Neuroplasty &/Transpos Median Nrv Carpal Tunne	$1,086	Not listed in the file	$126.29 – $5,770.02
Carpal tunnel release: 10 of 248 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $394.77 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $2,377.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $2,377.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $543 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $126.29 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $543 AETNA [503200004] — AETNA FED: $1,212.53 AETNA [503200004] — AETNA/COVENTRY: $1,212.53 AETNA [503200004] — NON-CONTRACTED: $543 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $186.42
Carpal tunnel release CPT 64721 · Inpatient (hospital stay) · modifier NULL In the file: Neuroplasty &/Transpos Median Nrv Carpal Tunne	$1,067	Not listed in the file	$126.29 – $5,770.02
Carpal tunnel release: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $346.40 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $562.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $533.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $562.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $126.29 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $562.50 AETNA [503200004] — AETNA FED: $286.88 AETNA [503200004] — AETNA/COVENTRY: $286.88 AETNA [503200004] — NON-CONTRACTED: $533.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $163.58
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · modifier NULL In the file: Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp	$8,344.65	$1,668.93	$754.92 – $6,819.29
Cataract removal with lens implant: 10 of 31 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $5,386.65 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $6,819.29 ALLWELL [503200078] — Wellcare Medicare Adv: $2,219.30 ALT BCBS KS [503201524] — BCBS Kansas: $2,860.91 ALT BNSF RAILWAY CO [503301503] — Kansas Workers Comp: $3,842.18 AMBETTER [503200087] — Ambetter Exchange (Sunflower): $3,124.26 BCBS KANSAS [503301501] — BCBS Kansas: $2,860.91 BCBS KS MEDICAID [503999940] — Medicaid KS Healthy Blue KS: $754.92 BCBS MEDICARE [50311204] — Healthy Blue KS Medicare Adv: $2,219.30 CENTENE MEDICAID KS [503201515] — Medicaid KS Sunflower Health Plan: $754.92

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Inpatient (hospital stay) · modifier NULL In the file: OB Care Antepartum Vag Dlvr & Postpartum	$5,757	Not listed in the file	$656.64 – $3,016.50
Vaginal delivery, with care before and after: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $1,781.59 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $3,016.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $2,878.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $3,016.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $875.52 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $2,878.50 AETNA [503200004] — AETNA FED: $1,538.42 AETNA [503200004] — AETNA/COVENTRY: $1,538.42 AETNA [503200004] — NON-CONTRACTED: $3,016.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $989.77
Vaginal delivery, with care before and after CPT 59400 · Inpatient or outpatient · modifier NULL In the file: OB Care Antepartum Vag Dlvr & Postpartum	$5,757	Not listed in the file	$656.64 – $3,016.50
Vaginal delivery, with care before and after: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $1,781.59 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $2,878.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $2,878.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $2,878.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $656.64 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $2,878.50 AETNA [503200004] — AETNA FED: $1,468.04 AETNA [503200004] — AETNA/COVENTRY: $1,468.04 AETNA [503200004] — NON-CONTRACTED: $2,878.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $841.31
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · modifier NULL In the file: OB Care Antepartum Vag Dlvr & Postpartum	Not listed in the file	Not listed in the file	$656.64 – $3,016.50
Vaginal delivery, with care before and after: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $1,781.59 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $2,878.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $2,878.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $3,016.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $656.64 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $2,878.50 AETNA [503200004] — AETNA FED: $1,468.04 AETNA [503200004] — AETNA/COVENTRY: $1,468.04 AETNA [503200004] — NON-CONTRACTED: $2,878.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $841.31
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient (hospital stay) · modifier NULL In the file: OB Antepartum Care Cesarean Dlvr & Postpartum	$6,364	Not listed in the file	$721.86 – $3,316.50
Cesarean delivery (C-section), with care before and after: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $1,974.73 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $3,182 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $3,182 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $3,182 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $721.86 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $3,182 AETNA [503200004] — AETNA FED: $1,691.42 AETNA [503200004] — AETNA/COVENTRY: $1,691.42 AETNA [503200004] — NON-CONTRACTED: $3,182 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $932.51
Cesarean delivery (C-section), with care before and after CPT 59510 · Inpatient or outpatient · modifier NULL In the file: OB Antepartum Care Cesarean Dlvr & Postpartum	$6,364	Not listed in the file	$721.86 – $3,316.50
Cesarean delivery (C-section), with care before and after: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $1,974.73 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $3,182 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $3,182 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $3,182 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $721.86 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $3,182 AETNA [503200004] — AETNA FED: $1,622.82 AETNA [503200004] — AETNA/COVENTRY: $1,622.82 AETNA [503200004] — NON-CONTRACTED: $3,182 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $932.51
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · modifier NULL In the file: OB Antepartum Care Cesarean Dlvr & Postpartum	Not listed in the file	Not listed in the file	$721.86 – $3,316.50
Cesarean delivery (C-section), with care before and after: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $1,974.73 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $3,316.50 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $3,316.50 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $3,316.50 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $721.86 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $3,182 AETNA [503200004] — AETNA FED: $1,691.42 AETNA [503200004] — AETNA/COVENTRY: $1,691.42 AETNA [503200004] — NON-CONTRACTED: $3,316.50 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $932.51
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient (hospital stay) · modifier NULL In the file: Routine OB Care Vag Dlvry & Postpartum Care Vb	$6,276	Not listed in the file	$683.07 – $3,138
Vaginal delivery after a previous C-section, with care before and after: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $1,858.40 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $3,138 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $2,998 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $3,138 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $683.07 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $3,138 AETNA [503200004] — AETNA FED: $1,600.38 AETNA [503200004] — AETNA/COVENTRY: $1,600.38 AETNA [503200004] — NON-CONTRACTED: $2,998 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $1,032.45
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Inpatient or outpatient · modifier NULL In the file: Routine OB Care Vag Dlvry & Postpartum Care Vb	$5,996	Not listed in the file	$683.07 – $3,138
Vaginal delivery after a previous C-section, with care before and after: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $1,858.40 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $2,998 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $2,998 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $2,998 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $683.07 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $2,998 AETNA [503200004] — AETNA FED: $1,528.98 AETNA [503200004] — AETNA/COVENTRY: $1,528.98 AETNA [503200004] — NON-CONTRACTED: $2,998 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $877.58
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · modifier NULL In the file: Routine OB Care Vag Dlvry & Postpartum Care Vb	Not listed in the file	Not listed in the file	$683.07 – $3,138
Vaginal delivery after a previous C-section, with care before and after: 10 of 243 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 DEGREES: $1,858.40 6 DEGREES HEALTH [503999050] — NON-CONTRACTED: $3,138 A-G ADMINISTRATORS [503301512] — NON-CONTRACTED: $3,138 ACCARENT HEALTH [503999034] — NON-CONTRACTED: $3,138 ADVANCED CORRECTIONAL HEALTH [503999922] — MEDICAID KS: $683.07 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — NON-CONTRACTED: $3,138 AETNA [503200004] — AETNA FED: $1,600.38 AETNA [503200004] — AETNA/COVENTRY: $1,600.38 AETNA [503200004] — NON-CONTRACTED: $3,138 AETNA MEDICARE [50311203] — UKHS RPB NON-CONTRACTED MEDICARE ADVANTAGE PLAN_GBC: $877.58

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · modifier NULL In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	$41,349.16	$8,269.83	$0.66 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $159,060.87
Hip or knee replacement (major joint of the leg), without major complications: 10 of 25 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $36,243.15 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $43,491.78 ALLWELL [503200078] — Wellcare Medicare Adv: $14,932.18 ALT BCBS KS [503201524] — BCBS Kansas: $22,152.04 ALT BNSF RAILWAY CO [503301503] — Kansas Workers Comp: $14,148.06 AMBETTER [503200087] — Ambetter Exchange (Sunflower): $21,021.03 BCBS KANSAS [503301501] — BCBS Kansas: $22,152.04 BCBS MEDICARE [50311204] — Healthy Blue KS Medicare Adv: $14,932.18 CENTENE MEDICAID KS [503201515] — Medicaid KS Sunflower Health Plan: $10,524.77 CENTURION [5032000966] — Centurion: $18,846.44
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · modifier NULL In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	$27,478.12	$5,495.62	$0.66 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $159,060.87
Uterus and ovary surgery (not for cancer), without complications: 10 of 25 insurance plan rates 6 DEGREES HEALTH [503999050] — 6 Degrees: $24,596.93 ADVANCED MEDICAL PRICING SOLUTIONS [503301513] — AMPS: $29,516.31 ALLWELL [503200078] — Wellcare Medicare Adv: $10,133.93 ALT BCBS KS [503201524] — BCBS Kansas: $10,492.93 ALT BNSF RAILWAY CO [503301503] — Kansas Workers Comp: $8,662.44 AMBETTER [503200087] — Ambetter Exchange (Sunflower): $14,266.22 BCBS KANSAS [503301501] — BCBS Kansas: $10,492.93 BCBS MEDICARE [50311204] — Healthy Blue KS Medicare Adv: $10,133.93 CENTENE MEDICAID KS [503201515] — Medicaid KS Sunflower Health Plan: $4,203.49 CENTURION [5032000966] — Centurion: $12,790.40

Source: University of KS Hlth System Great Bend Campus’s standard charges file (ukhspricetransparency.blob.core.windows.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 8, 2026; 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 type	Acute Care Hospital
Address	514 Cleveland Street, Great Bend, KS 67530
County	Barton County
State	Kansas
Phone	(620) 792‑8830
Emergency services	Yes
Ownership	Government - Hospital District or Authority
Medicare overall rating	4 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	170191
Name in Medicare records	UNIVERSITY OF KS HLTH SYSTEM GREAT BEND CAMPUS
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(620) 792‑8833^[4]
Name on the hospital’s website	Great Bend Campus
Official website	kansashealthsystem.com
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Great Bend Campus - The University of Kansas Health System — kansashealthsystem.com
Emergency Services | The University of Kansas Health System — kansashealthsystem.com
Great Bend Campus Emergency Department | The University of Kansas Health System — kansashealthsystem.com
Great Bend Campus, Hospital | The University of Kansas Health System — kansashealthsystem.com