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Susan B Allen Memorial Hospital
El Dorado, KS · CMS ID: 170017
This hospital has pricing data for 33 procedures ranging from $15 to $1,768.
Procedures (33)
Chest X-Ray 1 View
71045Cash Price
(No Insurance)
$117
Gross Charge
$195
Medicare Rate
$24
Insurance Negotiated Rates
Blue Cross Blue Shield$16
Chest X-Ray 2 Views
71046Cash Price
(No Insurance)
$149
Gross Charge
$249
Medicare Rate
$31
Insurance Negotiated Rates
Blue Cross Blue Shield$71
Cash Price
(No Insurance)
$135
Gross Charge
$225
Medicare Rate
$450
Insurance Negotiated Rates
Blue Cross Blue Shield$0
Cash Price
(No Insurance)
$88
Gross Charge
$147
Insurance Negotiated Rates
Blue Cross Blue Shield$3
Cash Price
(No Insurance)
$24
Gross Charge
$40
Insurance Negotiated Rates
Aetna$11
Cash Price
(No Insurance)
$684
Gross Charge
$1,140
Medicare Rate
$280
Insurance Negotiated Rates
Blue Cross Blue Shield$215
Cash Price
(No Insurance)
$684
Gross Charge
$1,140
Medicare Rate
$172
Insurance Negotiated Rates
Aetna$213
CT Chest Low Dose
71271Cash Price
(No Insurance)
$337
Gross Charge
$561
Medicare Rate
$128
Insurance Negotiated Rates
Aetna$95
Cash Price
(No Insurance)
$684
Gross Charge
$1,140
Medicare Rate
$156
Insurance Negotiated Rates
Aetna$159
ER Visit Level 3
99283Cash Price
(No Insurance)
$97
Gross Charge
$161
Medicare Rate
$69
Insurance Negotiated Rates
Aetna$37
ER Visit Level 4
99284Cash Price
(No Insurance)
$183
Gross Charge
$305
Medicare Rate
$117
Insurance Negotiated Rates
Sunflower/Centene Kancare Chip - All Plans$47
ER Visit Level 5
99285Cash Price
(No Insurance)
$235
Gross Charge
$392
Medicare Rate
$170
Insurance Negotiated Rates
Aetna$45
Cash Price
(No Insurance)
$494
Gross Charge
$823
Medicare Rate
$48
Insurance Negotiated Rates
Blue Cross Blue Shield$1
Knee X-Ray
73560Cash Price
(No Insurance)
$106
Gross Charge
$177
Medicare Rate
$32
Insurance Negotiated Rates
Blue Cross Blue Shield$51
Mammogram Diagnostic
77066Cash Price
(No Insurance)
$142
Gross Charge
$237
Medicare Rate
$146
Insurance Negotiated Rates
Blue Cross Blue Shield$58
Mammogram Screening
77067Cash Price
(No Insurance)
$125
Gross Charge
$209
Medicare Rate
$118
Insurance Negotiated Rates
Blue Cross Blue Shield$58
MRI Brain
70551Cash Price
(No Insurance)
$1,157
Gross Charge
$1,929
Medicare Rate
$183
Insurance Negotiated Rates
Aetna$213
Cash Price
(No Insurance)
$1,768
Gross Charge
$2,946
Medicare Rate
$296
Insurance Negotiated Rates
Blue Cross Blue Shield$247
MRI Cervical Spine
72141Cash Price
(No Insurance)
$1,157
Gross Charge
$1,929
Medicare Rate
$179
Insurance Negotiated Rates
Aetna$213
MRI Knee
73721Cash Price
(No Insurance)
$1,157
Gross Charge
$1,929
Medicare Rate
$191
Insurance Negotiated Rates
Aetna$213
MRI Lumbar Spine
72148Cash Price
(No Insurance)
$1,157
Gross Charge
$1,929
Medicare Rate
$180
Insurance Negotiated Rates
Aetna$213
MRI Shoulder
73221Cash Price
(No Insurance)
$1,157
Gross Charge
$1,929
Medicare Rate
$191
Insurance Negotiated Rates
Aetna$213
Office Visit Level 3
99213Cash Price
(No Insurance)
$73
Gross Charge
$122
Medicare Rate
$91
Insurance Negotiated Rates
Blue Cross Blue Shield$18
Office Visit Level 4
99214Cash Price
(No Insurance)
$73
Gross Charge
$122
Medicare Rate
$130
Insurance Negotiated Rates
Blue Cross Blue Shield$18
Shoulder X-Ray
73030Cash Price
(No Insurance)
$70
Gross Charge
$117
Medicare Rate
$33
Insurance Negotiated Rates
Blue Cross Blue Shield$1
TSH (Thyroid)
84443Cash Price
(No Insurance)
$49
Gross Charge
$81
Insurance Negotiated Rates
Blue Cross Blue Shield$5
Ultrasound Abdomen
76700Cash Price
(No Insurance)
$379
Gross Charge
$631
Medicare Rate
$107
Insurance Negotiated Rates
Blue Cross Blue Shield$71
Ultrasound Pelvis
76856Cash Price
(No Insurance)
$301
Gross Charge
$502
Medicare Rate
$98
Insurance Negotiated Rates
Blue Cross Blue Shield$58
Cash Price
(No Insurance)
$299
Gross Charge
$498
Medicare Rate
$109
Insurance Negotiated Rates
Blue Cross Blue Shield$58
Cash Price
(No Insurance)
$1,280
Gross Charge
$2,134
Medicare Rate
$301
Insurance Negotiated Rates
Blue Cross Blue Shield$486
Urinalysis
81001Cash Price
(No Insurance)
$15
Gross Charge
$25
Insurance Negotiated Rates
Blue Cross Blue Shield$1