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 |
|---|---|---|---|---|
| Induced ab 1+vag supp d&c CPT 59856 | not published | not published | not published | 0 |
| Induced ab 1+ vag sup w/dlv fetus CPT 59855 | not published | not published | not published | 0 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | not published | not published | $70.20 – $196.56 | 16 |
| Infect ag drug suscept pheno predict CPT 87900 | not published | not published | $118.25 – $463.59 | 18 |
| Infect ag eia chlamydia trachomatis CPT 87320 | not published | not published | $10.88 – $48.53 | 18 |
| Infect ag eia influenza a or b ea CPT 87400 | not published | not published | $10.88 – $48.53 | 18 |
| Infect ag genotype na cytomegalovirus CPT 87910 | not published | not published | $233.56 – $808.39 | 17 |
| Infect ag genotype na dna hepatitis b CPT 87912 | not published | not published | $233.56 – $808.39 | 17 |
| Infect ag genotype na hiv-1 other region CPT 87906 | not published | not published | $116.78 – $404.21 | 17 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | not published | not published | $233.56 – $1,041.19 | 18 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | not published | not published | $32.77 – $102.90 | 17 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $10.88 – $110.81 | 18 |
| Infect ag ia optc obs influenza CPT 87804 | not published | not published | $9.89 – $51.97 | 18 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | not published | not published | $10.88 – $48.53 | 18 |
| Infect ag if hep delta agent CPT 87380 | not published | not published | $14.89 – $66.42 | 18 |
| Infect ag if influenza a CPT 87276 | not published | not published | $10.88 – $50.46 | 18 |
| Infect ag if influenza b CPT 87275 | not published | not published | $10.88 – $48.53 | 18 |
| Infect ag if legionella pneumophila CPT 87278 | not published | not published | $10.88 – $48.98 | 18 |
| Infect ag if nos ea CPT 87299 | not published | not published | $10.88 – $50.55 | 18 |
| Infect ag if pneumocystis carinii CPT 87281 | not published | not published | $10.88 – $48.53 | 18 |
| Infect ag if varicella zoster CPT 87290 | not published | not published | $10.88 – $48.53 | 18 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $31.72 – $167.90 | 18 |
| Infect ag na hep b amp CPT 87516 | not published | not published | $31.84 – $141.96 | 18 |
| Infect ag na herpes simplex quant CPT 87530 | not published | not published | $38.86 – $173.24 | 18 |
| Infect ag na hpv high-risk types CPT 87624 | not published | not published | $35.09 – $110.18 | 17 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | not published | not published | $77.19 – $300.81 | 17 |
| Infect ag na influenza revr/amp ea type CPT 87501 | not published | not published | $46.56 – $161.11 | 17 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | not published | not published | $51.31 – $143.67 | 16 |
| Infect ag na resp virus 12-25 targets CPT 87633 | not published | not published | $378.12 – $1,308.69 | 17 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | not published | not published | $443.31 – $1,976.20 | 18 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | not published | not published | $23.65 – $92.71 | 18 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $41.38 – $115.86 | 16 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | not published | not published | $10.88 – $48.53 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | not published | not published | $10.88 – $48.53 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | not published | not published | $10.88 – $48.53 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | not published | not published | $10.88 – $48.53 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | not published | not published | $10.88 – $58.17 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | not published | not published | $9.37 – $41.77 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | not published | not published | $9.37 – $41.77 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | not published | not published | $21.85 – $75.61 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | not published | not published | $9.89 – $48.53 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | not published | not published | $10.88 – $48.53 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | not published | not published | $10.88 – $48.53 | 18 |
| Infectious agent nucleic acid amplified probe CPT 87798 | not published | not published | $31.84 – $141.96 | 18 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | not published | not published | $31.84 – $141.96 | 18 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | not published | not published | $31.84 – $117.03 | 17 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | not published | not published | $416.78 – $1,308.69 | 17 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | not published | not published | $31.84 – $141.96 | 18 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | not published | not published | $31.84 – $141.96 | 18 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | not published | not published | $31.84 – $141.96 | 18 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | not published | not published | $31.84 – $141.96 | 18 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | not published | not published | $34.38 – $143.67 | 18 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | not published | not published | $142.63 – $399.36 | 16 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | not published | not published | $142.63 – $399.36 | 16 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | not published | not published | $31.84 – $141.96 | 18 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | not published | not published | $35.09 – $110.18 | 17 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | not published | not published | $76.77 – $214.96 | 16 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | not published | not published | $416.78 – $1,308.69 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | not published | not published | $128.29 – $402.83 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | not published | not published | $262.99 – $825.79 | 17 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | not published | not published | $38.86 – $173.24 | 18 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | not published | not published | $38.86 – $173.24 | 18 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | not published | not published | $38.86 – $173.24 | 18 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | not published | not published | $77.19 – $344.14 | 18 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | not published | not published | $116.38 – $447.86 | 17 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $18.84 – $91.75 | 17 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $74.38 – $78.13 | 2 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $46.92 – $46.92 | 1 |
| Infratemporal approach/skull CPT 61591 | not published | not published | not published | 0 |
| Infuse radioactive materials CPT 77750 | not published | not published | $243.21 – $680.99 | 18 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $490.71 – $1,373.99 | 16 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | not published | not published | $188.10 – $526.68 | 16 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | not published | 0 |
| Initiation & management bipap/cpap initial day CPT 94660 | not published | not published | $188.10 – $526.68 | 16 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $273.00 – $764.40 | 16 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | not published | not published | $640.46 – $1,793.29 | 16 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $273.00 – $764.40 | 16 |
| Injection during cath supravalvular aortography CPT 93567 | not published | not published | $10,792.00 – $16,108.00 | 4 |
| Injection epidural blood patch or clot CPT 62273 | not published | not published | $640.46 – $1,793.29 | 16 |
| Injection eye drug CPT 67028 | not published | not published | $306.75 – $858.90 | 16 |
| Injection for bladder x-ray CPT 51600 | not published | not published | not published | 0 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | not published | not published | not published | 0 |
| Injection for spleen x-ray CPT 38200 | not published | not published | not published | 0 |
| Injection into brain canal CPT 61026 | not published | not published | $640.46 – $1,793.29 | 16 |
| Injection into brain canal CPT 61055 | not published | not published | $273.00 – $764.40 | 16 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $843.17 – $2,360.88 | 16 |
| Injection into spinal artery CPT 62294 | not published | not published | $823.36 – $2,305.41 | 16 |
| Injection into vocal cord CPT 31513 | not published | not published | $359.12 – $1,005.54 | 16 |
| Injection jugular CPT 36299 | not published | not published | not published | 0 |
| Injection of sinus tract CPT 20500 | not published | not published | not published | 0 |
| Injection px peyronie ds CPT 54200 | not published | not published | $224.93 – $629.80 | 16 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | not published | not published | $371.62 – $1,040.54 | 16 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | not published | not published | $640.46 – $1,793.29 | 16 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | not published | not published | $640.46 – $1,793.29 | 16 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | not published | not published | $823.36 – $2,305.41 | 16 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | not published | not published | $823.36 – $2,305.41 | 16 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | not published | not published | $823.36 – $2,305.41 | 16 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | not published | not published | $640.46 – $1,793.29 | 16 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | not published | not published | $640.46 – $1,793.29 | 16 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | not published | not published | $273.00 – $764.40 | 16 |
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.