CHI St. Vincent North
2215 Wildwood Avenue, Sherwood, AR · CommonSpirit Health · · NPI 1629011002
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Intro cath dialysis circuit w/pta CPT 36902 | $1,840.41 | $7,240.00 | not published | 0 |
| Intro cath dialysis circuit w/stent plcmnt CPT 36903 | $3,740.05 | $14,713.00 | not published | 0 |
| Intro catheter aorta CPT 36200 | $212.26 | $835.00 | not published | 0 |
| Intro cath svc/ivc CPT 36010 | $184.05 | $724.00 | not published | 0 |
| Intro long gi tube CPT 44500 | $314.45 | $1,237.00 | $497.81 – $497.81 | 1 |
| Intro long gi tube w/mult fluo CPT 74340 | $78.04 | $307.00 | $107.45 – $295.30 | 6 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $2,627.42 | $10,336.00 | $674.19 – $674.19 | 3 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $2,627.42 | $10,336.00 | $674.19 – $674.19 | 3 |
| Intubation endotracheal emergency procedure CPT 31500 | $448.16 | $1,763.00 | $211.37 – $951.31 | 2 |
| Ionm in operatng room 15 min CPT 95940 | $61.78 | $243.00 | $235.00 – $235.00 | 1 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $2.94 | $11.55 | $0.15 – $0.62 | 4 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $18.10 | $71.19 | $0.10 – $0.42 | 4 |
| Iron CPT 83540 | $30.25 | $119.00 | $4.88 – $21.00 | 9 |
| Iron binding capacity CPT 83550 | $27.71 | $109.00 | $6.59 – $28.33 | 9 |
| Irradiation of blood product each unit reference CPT 86945 | $63.30 | $249.00 | $0.64 – $136.95 | 8 |
| Irrigation sphenoid sinus CPT 31002 | not published | not published | $1,092.62 – $1,092.62 | 1 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | not published | not published | $502.01 – $502.01 | 1 |
| Ivc venogram s&i CPT 75825 | $1,469.79 | $5,782.00 | $279.41 – $6,438.74 | 5 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $79.57 | $313.00 | $64.04 – $962.66 | 8 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $45.00 | $177.00 | $19.64 – $962.66 | 8 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $69.91 | $275.00 | $40.23 – $430.00 | 3 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $190.15 | $748.00 | $196.08 – $492.57 | 6 |
| IV inj ra drug dx study CPT 78808 | $299.71 | $1,179.00 | $52.96 – $848.52 | 7 |
| IV njx tst vasc flo flap/grf CPT 15860 | not published | not published | $384.00 – $384.00 | 1 |
| Ivp w/nephrotomography CPT 74415 | $325.38 | $1,280.00 | $145.28 – $704.00 | 8 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $204.89 | $806.00 | $124.85 – $601.15 | 8 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $30.76 | $121.00 | $6.16 – $22.72 | 9 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $8.45 | $33.23 | $0.57 – $22.11 | 7 |
| Kidney imag w/bld flow multi CPT 78709 | $581.11 | $2,286.00 | $385.65 – $1,101.15 | 7 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $220.14 | $866.00 | $99.88 – $377.57 | 7 |
| Kit case 4.2mm spinejack HCPCS C1062 | $3,811.48 | $14,994.00 | $3,748.50 – $7,497.00 | 4 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $3,225.80 | $12,690.00 | not published | 0 |
| Kit lead specify 5-6-5 HCPCS C1778 | $18,479.58 | $72,697.00 | $36.52 – $73.04 | 4 |
| Knee MRI (with and without contrast) CPT 73723 | $1,272.78 | $5,007.00 | $366.59 – $2,827.78 | 9 |
| Knee MRI (with contrast) CPT 73722 | $1,148.48 | $4,518.00 | $584.00 – $2,827.78 | 9 |
| Knee MRI (without contrast) CPT 73721 | $1,034.85 | $4,071.00 | $223.73 – $2,827.78 | 9 |
| Knee X-ray CPT 73564 | $137.27 | $540.00 | $47.47 – $297.00 | 8 |
| Kras gene variants exon 2 CPT 81275 | $477.65 | $1,879.00 | $141.98 – $531.38 | 9 |
| Lactate dehydrogenase (ldh) CPT 83615 | $26.95 | $106.00 | $4.56 – $19.59 | 9 |
| Lactic acid CPT 83605 | $49.83 | $196.00 | $5.50 – $34.62 | 9 |
| Lactoferrin fecal qualitative CPT 83630 | $19.07 | $75.00 | $14.86 – $37.82 | 9 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $15,145.66 | $59,581.64 | $29.31 – $29,790.82 | 8 |
| Laps abltj uterine fibroids CPT 58674 | not published | not published | $824.01 – $824.01 | 3 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $445.87 | $1,754.00 | not published | 0 |
| Laryngoscopy telescopic CPT 31579 | not published | not published | $866.93 – $866.93 | 1 |
| Laryngoscopy w/fb removal CPT 31530 | $445.62 | $1,753.00 | not published | 0 |
| Lavage cannulation maxillary sinus CPT 31000 | not published | not published | $354.36 – $354.36 | 1 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $6,855.76 | $26,969.93 | $185.22 – $370.44 | 4 |
| Lead capillary CPT 83655 | $40.68 | $160.00 | $8.25 – $39.23 | 9 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $2,012.80 | $7,918.16 | $23.16 – $46.31 | 4 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $4,804.38 | $18,900.00 | $542.74 – $1,085.48 | 4 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $383.85 | $1,510.00 | $95.34 – $830.50 | 8 |
| Lens, intraocular (new tech) HCPCS C1780 | $730.30 | $2,872.92 | $826.78 – $826.78 | 1 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $3,818.36 | $15,021.07 | $180.79 – $7,510.54 | 8 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $3,204.24 | $12,605.18 | $397.04 – $6,302.59 | 8 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $48.41 | $190.44 | $0.06 – $95.22 | 7 |
| Levetiracetam therapeutic drug level CPT 80177 | $6.11 | $24.00 | $9.99 – $41.06 | 9 |
| Liberta rc ipg HCPCS C1820 | $20,750.60 | $81,630.98 | $977.64 – $1,955.27 | 4 |
| Lidocaine therapeutic drug level CPT 80176 | $46.02 | $181.00 | $11.08 – $47.62 | 9 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $2,704.14 – $2,704.14 | 1 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $2,704.14 – $2,704.14 | 1 |
| Ligation/major artery/extremity 37618 CPT 37618 | $489.85 | $1,927.00 | $115.77 – $115.77 | 3 |
| Ligation major artery neck CPT 37615 | not published | not published | $3,119.67 – $3,119.67 | 1 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $116.76 | $459.29 | $3.96 – $229.65 | 7 |
| Lipase CPT 83690 | $28.73 | $113.00 | $5.20 – $22.34 | 9 |
| Lipoprotein blood high res frac & quant CPT 83701 | $80.84 | $318.00 | $24.34 – $79.88 | 9 |
| Lipoprotein direct measurement hdl CPT 83718 | $27.20 | $107.00 | $6.17 – $26.54 | 9 |
| Lipoprotein direct measurement ldl CPT 83721 | $33.31 | $131.00 | $7.92 – $30.92 | 9 |
| Lip surgery procedure CPT 40799 | $217.35 | $855.00 | $115.77 – $115.77 | 3 |
| Lithium therapeutic drug level CPT 80178 | $21.87 | $86.00 | $4.99 – $21.41 | 9 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $662.70 | $2,607.00 | $5,825.00 – $5,825.00 | 1 |
| Liver Function Test CPT 80076 | $34.32 | $135.00 | $6.16 – $26.49 | 9 |
| Liver imag w/vasclr flow CPT 78202 | $435.70 | $1,714.00 | $90.80 – $1,221.35 | 7 |
| Liver/spleen imag static only CPT 78215 | $293.35 | $1,154.00 | $68.10 – $848.52 | 7 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $287.76 | $1,132.00 | $129.39 – $848.52 | 7 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $0.25 | $0.97 | $0.12 – $0.97 | 4 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $842.68 | $3,315.00 | $174.94 – $2,117.84 | 9 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $756.25 | $2,975.00 | $366.59 – $2,117.84 | 9 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $720.41 | $2,834.00 | $107.60 – $2,117.84 | 9 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $1,386.92 | $5,456.00 | $366.59 – $2,827.78 | 9 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,164.24 | $4,580.00 | $366.59 – $2,827.78 | 9 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,012.48 | $3,983.00 | $223.73 – $2,827.78 | 9 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $118.72 | $467.00 | $45.59 – $256.85 | 8 |
| L/s ratio fetal lung CPT 83661 | $72.71 | $286.00 | $16.58 – $71.26 | 9 |
| Lumbar diskogram s&i CPT 72295 | $935.72 | $3,681.00 | $160.61 – $3,947.38 | 5 |
| Lung function test (mbc/mvv) CPT 94200 | $68.38 | $269.00 | $36.32 – $180.00 | 6 |
| Lung Function Test (Spirometry) CPT 94010 | $98.13 | $386.00 | $54.48 – $180.00 | 6 |
| Lung perfusion imaging CPT 78580 | $415.88 | $1,636.00 | $143.01 – $848.52 | 7 |
| Lymphatics/lymph node imaging CPT 78195 | $458.84 | $1,805.00 | $74.91 – $1,101.15 | 7 |
| Lymph vessel x-ray trunk CPT 75807 | $816.50 | $3,212.00 | $412.28 – $6,438.74 | 5 |
| Magnesium CPT 83735 | $31.27 | $123.00 | $5.06 – $21.72 | 9 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $4.23 | $16.62 | $0.53 – $8.31 | 7 |
| Magnetic image bone marrow CPT 77084 | $918.18 | $3,612.00 | $223.73 – $2,827.78 | 9 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $45.51 | $179.00 | $62.65 – $258.00 | 4 |
| Map tachycard site(s) CPT 93609 | $3,928.16 | $15,453.00 | $231.54 – $5,825.00 | 5 |
| Mastoids complete CPT 70130 | $106.77 | $420.00 | $61.93 – $245.18 | 8 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $47.79 | $188.00 | $10.90 – $46.88 | 9 |
| Mayo aathr protein s free CPT 85306 | $72.20 | $284.00 | $11.55 – $49.69 | 9 |
| Mayo activated protein c resistance assay CPT 85307 | $56.18 | $221.00 | $11.55 – $49.69 | 9 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $36.36 | $143.00 | $15.08 – $78.65 | 6 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.