Kansas Test/Procedure Costs

The following test / procedure costs apply to:

  • St. Catherine Hospital
  • Bob Wilson Memorial Grant County Hospital
Location Service Description Test/Procedure Billing Code Self-Pay Rate Payment Method
KANSAS INPATIENT VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES DRG 775 $4,757 PER CASE
KANSAS INPATIENT MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC DRG 470 $27,267 PER CASE
KANSAS INPATIENT CESAREAN SECTION W/O CC/MCC DRG 766 $6,711 PER CASE
KANSAS INPATIENT CESAREAN SECTION W CC/MCC DRG 765 $8,247 PER CASE
KANSAS INPATIENT SPINAL FUSION EXCEPT CERVICAL W/O MCC DRG 460 N/A PER CASE
KANSAS INPATIENT SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC DRG 871 $19,799 PER CASE
KANSAS INPATIENT VAGINAL DELIVERY W COMPLICATING DIAGNOSES DRG 774 $6,045 PER CASE
KANSAS INPATIENT PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC DRG 247 $28,209 PER CASE
KANSAS INPATIENT ESOPHAGITIS GASTROENT  MISC DIGEST DISORDERS W/O MCC DRG 392 $4,815 PER CASE
KANSAS INPATIENT SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC DRG 872 $9,529 PER CASE
KANSAS INPATIENT CERVICAL SPINAL FUSION W/O CC/MCC DRG 473 N/A PER CASE
KANSAS INPATIENT O.R. PROCEDURES FOR OBESITY W/O CC/MCC DRG 621 N/A PER CASE
KANSAS INPATIENT MAJOR SMALL  LARGE BOWEL PROCEDURES W CC DRG 330 $34,733 PER CASE
KANSAS INPATIENT MAJOR SMALL  LARGE BOWEL PROCEDURES W/O CC/MCC DEG 331 $20,934 PER CASE
KANSAS INPATIENT LOWER EXTREM  HUMER PROC EXCEPT HIPFOOTFEMUR W/O CC/MCC DEG 494 $22,214 PER CASE
KANSAS INPATIENT CELLULITIS W/O MCC DRG 603 $4,630 PER CASE
KANSAS INPATIENT UTERINE  ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC DRG 743 $8,899 PER CASE
KANSAS INPATIENT VAGINAL DELIVERY W STERILIZATION /OR DC DRG 767 $4,891 PER CASE
KANSAS INPATIENT MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES DRG 483 N/A PER CASE
KANSAS INPATIENT DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC DRG 439 $14,423 PER CASE
KANSAS INPATIENT PULMONARY EDEMA  RESPIRATORY FAILURE DRG 189 $13,452 PER CASE
KANSAS INPATIENT MAJOR MALE PELVIC PROCEDURES W/O CC/MCC DRG 708 N/A PER CASE
KANSAS INPATIENT NEUROSES EXCEPT DEPRESSIVE DRG 882 $5,571 PER CASE
KANSAS INPATIENT INFECTIOUS  PARASITIC DISEASES W O.R. PROCEDURE W MCC DRG 853 $52,322 PER CASE
KANSAS INPATIENT DIABETES W CC DRG 638 $7,898 PER CASE
KANSAS INPATIENT G.I. OBSTRUCTION W/O CC/MCC DRG 390 $5,652 PER CASE
KANSAS INPATIENT NORMAL NEWBORN DRG 795 $1,255 PER CASE
KANSAS INPATIENT ALCOHOL/DRGU ABUSE/DEPEND W/O REHAB W/O MCC DRG 897 $12,871 PER CASE
KANSAS INPATIENT REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC DRG 468 N/A PER CASE
KANSAS INPATIENT SHOULDER, ELBOW, OR FOREARM PROC, EXC MAJOR JOINT W/O CC/MCC DRG 512 N/A PER CASE
KANSAS INPATIENT NEONATE W OTHER SIGNIFICANT PROBLEMS DRG 794 $1,957 PER CASE
KANSAS INPATIENT PSYCHOSES DRG 885 $4,506 PER CASE
KANSAS INPATIENT FULL TERM NEONATE W MAJOR PROBLEMS DRG 793 $4,793 PER CASE
KANSAS INPATIENT PREMATURITY W/O MAJOR PROBLEMS DRG 792 $2,804 PER CASE
KANSAS INPATIENT POISONING  TOXIC EFFECTS OF DRUGS W MCC DRG 917 $6,788 PER CASE
KANSAS INPATIENT EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE DRG 790 $14,349 PER CASE
KANSAS INPATIENT PREMATURITY W MAJOR PROBLEMS DRG 791 $9,897 PER CASE
KANSAS INPATIENT POISONING  TOXIC EFFECTS OF DRUGS W/O MCC DRG 918 $4,917 PER CASE
KANSAS INPATIENT INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS DRG 065 $11,753 PER CASE
KANSAS INPATIENT PERC CARDIOVASC PROC W DRUG-ELUTING STENT W MCC OR 4+ VESSELS/STENTS DRG 246 $37,722 PER CASE
KANSAS INPATIENT MISC DISORDERS OF NUTRITIONMETABOLISMFLUIDS/ELECTROLYTES W/O MCC DRG 641 $8,107 PER CASE
KANSAS INPATIENT OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS DRG 781 $6,227 PER CASE
KANSAS INPATIENT LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC DRG 419 $10,669 PER CASE
KANSAS INPATIENT PULMONARY EMBOLISM W/O MCC DRG 176 $7,470 PER CASE
KANSAS INPATIENT BRONCHITIS  ASTHMA W/O CC/MCC DRG 203 $4,680 PER CASE
KANSAS INPATIENT BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC DRG 462 $33,714 PER CASE
KANSAS INPATIENT SIMPLE PNEUMONIA  PLEURISY W MCC DRG 193 $13,967 PER CASE
KANSAS INPATIENT SIMPLE PNEUMONIA  PLEURISY W CC DRG 194 $7,592 PER CASE
KANSAS INPATIENT G.I. HEMORRHAGE W CC DRG 378 N/A PER CASE
KANSAS INPATIENT HIP  FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC DRG 482 $17,239 PER CASE
KANSAS INPATIENT RENAL FAILURE W CC DRG 683 $9,695 PER CASE
KANSAS INPATIENT CERVICAL SPINAL FUSION W CC DRG 472 N/A PER CASE
KANSAS INPATIENT CIRCULATORY DISORDERS EXCEPT AMI W CARD CATH W/O MCC DRG 287 $10,104 PER CASE
KANSAS INPATIENT DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC DRG 440 $3,882 PER CASE
KANSAS INPATIENT PULMONARY EMBOLISM W MCC DRG 175 N/A PER CASE
KANSAS INPATIENT BRONCHITIS  ASTHMA W CC/MCC DRG 202 $5,692 PER CASE
KANSAS INPATIENT MAJOR SMALL  LARGE BOWEL PROCEDURES W MCC DRG 329 $37,761 PER CASE
KANSAS INPATIENT KIDNEY  URINARY TRACT INFECTIONS W/O MCC DRG 690 $5,750 PER CASE
KANSAS INPATIENT DEPRESSIVE NEUROSES DRG 881 $2,835 PER CASE
KANSAS INPATIENT INFECTIOUS  PARASITIC DISEASES W O.R. PROCEDURE W CC DRG 854 N/A PER CASE
KANSAS INPATIENT LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC DRG 418 $11,137 PER CASE
KANSAS INPATIENT INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC DRG 064 N/A PER CASE
KANSAS INPATIENT MEDICAL BACK PROBLEMS W/O MCC DRG 552 $7,781 PER CASE
KANSAS INPATIENT COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC DRG 454 N/A PER CASE
KANSAS INPATIENT G.I. OBSTRUCTION W CC DRG 389 $8,168 PER CASE
KANSAS INPATIENT COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC DRG 455 N/A PER CASE
KANSAS INPATIENT DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC DRG 057 $10,763 PER CASE
KANSAS INPATIENT LOWER EXTREM  HUMER PROC EXCEPT HIPFOOTFEMUR W CC DRG 493 $15,220 PER CASE
KANSAS INPATIENT SIMPLE PNEUMONIA  PLEURISY W/O CC/MCC DRG 195 $6,075 PER CASE
KANSAS OUTPATIENT CARDIAC DIAGNOSTIC - ELECTROCARDIOGRAM TRACING CPT 93005 $440 PER PROCEDURE
KANSAS OUTPATIENT CARDIAC DIAGNOSTIC - CARDIOVASCULAR STRESS TEST CPT 93017 $763 PER PROCEDURE
KANSAS OUTPATIENT CARDIAC DIAGNOSTIC - ECHOCARDIOGRAM, TTE W/DOPPLER COMPLETE CPT 93306 N/A PER PROCEDURE
KANSAS OUTPATIENT SURGERY - COLONOSCOPY AND BIOPSY CPT 45380 $2,117 PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - DIAGNOSTIC COLONOSCOPY CPT 45378 $1,493 PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - EGD BIOPSY SINGLE/MULTIPLE CPT 43239 $1,424 PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - LAPAROSCOPIC CHOLECYSTECTOMY CPT 47562 $5,429 PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - COLONOSCOPY W/LESION REMOVAL CPT 45385 $1,918 PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - HYSTEROSCOPY BIOPSY CPT 58558 N/A PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - LAP ING HERNIA REPAIR INIT CPT 49650 $5,889 PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - LOW BACK DISK SURGERY CPT 63030 N/A PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - PRP I/HERN INIT REDUC >5 YR CPT 49505 $3,478 PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - KNEE ARTHROSCOPY/SURGERY CPT 29881 $4,523 PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - LAPARO CHOLECYSTECTOMY/GRAPH CPT 47563 $5,325 PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - CARE OF MISCARRIAGE CPT 59820 $3,002 PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - TLH W/T/O 250 G OR LESS CPT 58571 N/A PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - CYSTO/URETERO W/LITHOTRIPSY CPT 52356 $5,738 PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - EGD DIAGNOSTIC BRUSH WASH CPT 43235 $1,326 PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT SURGERY - INSERT TUNNELED CV CATH CPT 36561 $2,836 PER CASE, SINGLE PROCEDURE
KANSAS OUTPATIENT IMAGING - COMPUTED TOMOGRAPHY SCAN - CALCIUM SCORING CPT 75571 $99 PER SCAN
KANSAS OUTPATIENT IMAGING - COMPUTED TOMOGRAPHY SCAN - LUNG SCREENING CPT G0297 $453 PER SCAN
KANSAS OUTPATIENT IMAGING - COMPUTED TOMOGRAPHY SCAN - ALL OTHER CPT 70010-76499 $833 PER SCAN
KANSAS OUTPATIENT IMAGING - MAGNETIC RESONANCE IMAGING - MRI CPT 70010-76499 $806 PER SCAN
KANSAS OUTPATIENT IMAGING - DIAGNOSTIC X-RAY CPT 70010-76499 $633 PER SCAN
KANSAS OUTPATIENT IMAGING - MAMMOGRAPHY CPT 77053-77067 $151 PER SCAN
KANSAS OUTPATIENT IMAGING - POSITRON EMMISSION TOMOGRAHY - PET CPT 78491-78815 N/A PER SCAN
KANSAS OUTPATIENT IMAGING - ULTRASOUND CPT 76506-76999 $510 PER SCAN
KANSAS OUTPATIENT LAB - ASSAY THYROID STIM HORMONE CPT 84443 $54 PER PROCEDURE
KANSAS OUTPATIENT LAB - COMPREHEN METABOLIC PANEL CPT 80053 $90 PER PROCEDURE
KANSAS OUTPATIENT LAB - URINALYSIS AUTO W/O SCOPE CPT 81003 $29 PER PROCEDURE
KANSAS OUTPATIENT LAB - COMPLETE CBC W/AUTO DIFF WBC CPT 85025 $21 PER PROCEDURE
KANSAS OUTPATIENT LAB - METABOLIC PANEL TOTAL CA CPT 80048 $35 PER PROCEDURE
KANSAS OUTPATIENT LAB - VENIPUNCTURE CPT 36415 $3 PER PROCEDURE
KANSAS OUTPATIENT ANCILLARY - SLEEP STUDY FACILITY CPT 95805-95811 N/A PER VISIT
KANSAS OUTPATIENT ANCILLARY - PHYSICAL THERAPY REV 420-429 $494 PER VISIT
KANSAS OUTPATIENT ANCILLARY - OCCUPATIONAL THERAPY REV 430-439 $252 PER VISIT
KANSAS OUTPATIENT ANCILLARY - SPEECH THERAPY REV 440-449 N/A PER VISIT

Select another location

The pricing information provided on this website is intended to give self-pay patients, who have scheduled services, an estimate of the prices and expected payment amounts for commonly provided health care services at Centura Health hospitals. The pricing only covers the specific service listed and provided through the hospital, and does not include complicating factors or professional fees for services such as those provided by a physician, surgeon, pathologist, anesthesiologist, radiologist, nurse practitioner or other independent practitioners. Please contact those offices directly for price information associated with their care and service. The pricing does not include fees associated with implants, high-cost drugs, or second procedures. The pricing is for patients who have pre-scheduled the service and not applicable to patients who receive services in the emergency department.

This pricing does not apply to patients who have health insurance coverage through Medicare, Medicaid, other government insurance programs, or an insurance company. If a patient has health insurance, the patient’s health insurance policy (including deductibles, co-pay, co-insurance and out-of-pocket maximums) will apply and the amount the patient owes for health care services will depend on the patient’s insurance coverage.

The pricing information provided is region specific, and is not transferrable across regions.

The pricing information is not a guarantee of insurance coverage or availability of services.

There are certain chronic conditions or long-term care that Centura Health may not be able to provide customized pricing  for without additional clinical information from your physician.

Centura Health reserves the right to update or change any price at any time.

If you do not see the procedure or service you are looking for, or wish to receive a customized quote on a specific procedure, please request a custom estimate.

Select Another Location