Ascension Via Christi Hospital St. Teresa, Inc.
14800 St Teresa St, Wichita, KS · Ascension · · NPI 1023334950
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 |
|---|---|---|---|---|
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | not published | not published | $369.49 – $1,034.57 | 16 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | not published | not published | $369.49 – $1,034.57 | 16 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | not published | not published | $369.49 – $1,034.57 | 16 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | not published | not published | $369.49 – $1,034.57 | 16 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | not published | not published | $183.76 – $514.53 | 16 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | not published | not published | $183.76 – $514.53 | 16 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | not published | not published | $183.76 – $514.53 | 16 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | not published | not published | $183.76 – $514.53 | 16 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $183.76 – $514.53 | 16 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $144.70 – $405.16 | 16 |
| Ghs somatosensory testing lower extremit CPT 95926 | not published | not published | $287.99 – $806.37 | 16 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | not published | not published | $490.71 – $1,373.99 | 16 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $44.97 – $125.92 | 16 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $273.00 – $764.40 | 16 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $119.21 – $333.79 | 16 |
| Ghs sp train/fitting sp device - kx CPT 92609 | not published | not published | $95.52 – $267.46 | 16 |
| Ghs st - eval for alt comm CPT 92567 | not published | not published | $36.30 – $101.64 | 16 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | $119.21 – $333.79 | 16 |
| Ghs st - re-eval for alt comm CPT 92597 | not published | not published | $67.83 – $189.92 | 16 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | not published | not published | $42.67 – $119.48 | 16 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | not published | not published | $194.85 – $545.58 | 16 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | not published | not published | $566.11 – $1,585.11 | 16 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $369.49 – $1,034.57 | 16 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $6.62 – $29.53 | 18 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | not published | not published | $221.85 – $621.18 | 16 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $221.85 – $621.18 | 16 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $22.06 – $98.31 | 18 |
| Ghs urine, porphyrins quant CPT 84120 | not published | not published | $13.35 – $59.47 | 18 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $490.71 – $1,373.99 | 16 |
| Ghs windowing of cast CPT 29730 | not published | not published | $145.93 – $408.60 | 16 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $13.36 – $59.56 | 18 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $143.28 – $625.94 | 17 |
| Gi inhouse confirmation CPT 87045 | not published | not published | $8.56 – $38.14 | 18 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | not published | 0 |
| Gi protein loss CPT 78282 | not published | not published | $56.34 – $1,040.54 | 17 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $867.07 – $2,427.80 | 16 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $843.17 – $2,360.88 | 16 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $867.07 – $2,427.80 | 16 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $867.07 – $2,427.80 | 16 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $101.12 – $317.52 | 17 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $61.52 – $193.17 | 17 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $35.00 – $109.90 | 17 |
| Glucagon plasma - sendout CPT 82943 | not published | not published | $12.96 – $57.78 | 18 |
| Glucose 1 hr post dose CPT 82950 | not published | not published | $4.31 – $19.20 | 18 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $5.49 – $24.49 | 18 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | not published | not published | $1.49 – $10.30 | 18 |
| Glucose blood quantitative CPT 82947 | not published | not published | $1.08 – $15.87 | 18 |
| Glucose body fluid CPT 82945 | not published | not published | $3.56 – $15.87 | 18 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $54.93 – $153.80 | 16 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | not published | not published | $11.68 – $52.08 | 18 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | not published | not published | $3.56 – $15.84 | 18 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | not published | not published | $16.86 – $75.18 | 18 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | not published | not published | $16.80 – $74.90 | 18 |
| Gonioscopy CPT 92020 | not published | not published | $119.21 – $333.79 | 16 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | not published | 0 |
| Great toe with reduction 28495 CPT 28495 | not published | not published | $221.85 – $621.18 | 16 |
| Growth hormone antibody CPT 86277 | not published | not published | $14.28 – $63.65 | 18 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $75.60 – $237.38 | 17 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | not published | 0 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | not published | 0 |
| G-tube reposition CPT 43761 | not published | not published | $224.93 – $629.80 | 16 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $237.18 – $241.89 | 2 |
| Guided cath fluid drainage 10030 CPT 10030 | not published | not published | $650.69 – $1,821.93 | 16 |
| Guid loc target vol rad tx CPT 77387 | not published | not published | not published | 0 |
| Gum graft CPT 41870 | not published | not published | not published | 0 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $566.11 – $1,585.11 | 16 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $369.49 – $1,034.57 | 16 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $369.49 – $1,034.57 | 16 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $4.69 – $7.00 | 3 |
| Hand X-ray CPT 73130 | not published | not published | $58.81 – $228.00 | 18 |
| Haptoglobin quantitative CPT 83010 | not published | not published | $11.41 – $50.88 | 18 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | not published | 0 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | not published | 0 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $404.31 – $1,132.07 | 16 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | not published | 0 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $119.21 – $333.79 | 16 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $119.21 – $333.79 | 16 |
| Hba1/hba2 full gene sequence CPT 81259 | not published | not published | $600.00 – $1,884.00 | 17 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | not published | not published | $202.40 – $635.54 | 17 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $375.25 – $1,178.29 | 17 |
| Hbb full gene sequence CPT 81364 | not published | not published | $324.58 – $1,019.18 | 17 |
| Hbb gene com variants CPT 81361 | not published | not published | $174.81 – $548.90 | 17 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $202.40 – $635.54 | 17 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $375.25 – $1,178.29 | 17 |
| Hc ea ha check monaural CPT 92594 | not published | not published | not published | 0 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | not published | not published | $164.64 – $584.96 | 18 |
| Hcg free betachain test CPT 84704 | not published | not published | $15.29 – $60.88 | 18 |
| Hcg qualitative CPT 84703 | not published | not published | $6.82 – $30.39 | 18 |
| Hcg quantitative CPT 84702 | not published | not published | $13.66 – $60.88 | 18 |
| Hc hearing aid chck binaurl CPT 92593 | not published | not published | not published | 0 |
| Hc hearing aid chck monarl CPT 92592 | not published | not published | not published | 0 |
| Hc hearing aid exam both ears CPT 92591 | not published | not published | not published | 0 |
| Hc hearing aid exam one ear CPT 92590 | not published | not published | not published | 0 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $566.11 – $1,585.11 | 16 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $566.11 – $1,585.11 | 16 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $422.89 – $1,393.84 | 18 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | $371.62 – $1,040.54 | 16 |
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $371.62 – $1,040.54 | 18 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $497.80 – $1,393.84 | 18 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $261.64 – $261.64 | 1 |
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.