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 |
|---|---|---|---|---|
| Leishmania antibody CPT 86717 | not published | not published | $11.11 – $49.56 | 18 |
| Lengthening of palate CPT 42227 | not published | not published | not published | 0 |
| Lengthening or shortening - tibia and fibula 27715 CPT 27715 | not published | not published | not published | 0 |
| Leukacyte transfusion CPT 86950 | not published | not published | $5.63 – $443.74 | 16 |
| Leukocyte phagocytosis CPT 86344 | not published | not published | $7.17 – $32.62 | 18 |
| Levetiracetam therapeutic drug level CPT 80177 | not published | not published | $13.25 – $41.61 | 17 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | not published | not published | $10,792.00 – $16,108.00 | 3 |
| Lidocaine therapeutic drug level CPT 80176 | not published | not published | $13.33 – $59.42 | 18 |
| Ligate leg veins open CPT 37761 | not published | not published | not published | 0 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | not published | 0 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | not published | 0 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | not published | 0 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | not published | 0 |
| Ligation/major artery/extremity 37618 CPT 37618 | not published | not published | not published | 0 |
| Ligation major artery neck CPT 37615 | not published | not published | not published | 0 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | not published | 0 |
| Ligation of neck artery CPT 37606 | not published | not published | not published | 0 |
| Limb exercise test CPT 95875 | not published | not published | $144.70 – $405.16 | 16 |
| Limited visual field xm CPT 92081 | not published | not published | $54.93 – $153.80 | 16 |
| Lipase CPT 83690 | not published | not published | $6.25 – $27.87 | 18 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $22.52 – $106.32 | 18 |
| Lipoprotein blood quant CPT 83704 | not published | not published | $28.62 – $107.36 | 18 |
| Lipoprotein direct measurement hdl CPT 83718 | not published | not published | $7.43 – $33.13 | 18 |
| Lipoprotein direct measurement ldl CPT 83721 | not published | not published | $8.65 – $38.59 | 18 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $34.19 – $107.36 | 17 |
| Lip surgery procedure CPT 40799 | not published | not published | $214.76 – $601.33 | 16 |
| Listeria monocytogenes CPT 86723 | not published | not published | $11.97 – $53.32 | 18 |
| Lithium therapeutic drug level CPT 80178 | not published | not published | $6.00 – $26.73 | 18 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | not published | 0 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $176.19 – $493.33 | 16 |
| Liver elastography 91200 CPT 91200 | not published | not published | $144.70 – $405.16 | 16 |
| Liver Function Test CPT 80076 | not published | not published | $7.59 – $33.05 | 18 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | not published | 0 |
| Liver imaging CPT 78201 | not published | not published | $401.17 – $1,393.84 | 18 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $462.35 – $1,393.84 | 18 |
| Liver/spleen imag static only CPT 78215 | not published | not published | $371.62 – $1,040.54 | 18 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $293.16 – $1,040.54 | 18 |
| Loudness balance test CPT 92562 | not published | not published | $287.99 – $806.37 | 16 |
| Low back disk surgery CPT 63030 | not published | not published | $7,024.00 – $7,024.00 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | not published | not published | $164.64 – $642.22 | 18 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | not published | not published | $330.28 – $924.78 | 18 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | not published | not published | $98.35 – $404.96 | 18 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | not published | not published | $330.28 – $1,446.96 | 19 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | not published | not published | $330.28 – $1,155.99 | 19 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | not published | not published | $223.55 – $939.84 | 19 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | not published | not published | $72.98 – $275.38 | 18 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $183.76 – $514.53 | 16 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $19.95 – $88.89 | 18 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $209.36 – $309.91 | 2 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | not published | 0 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $54.93 – $153.80 | 16 |
| Lung Function Test (Spirometry) CPT 94010 | not published | not published | $144.70 – $405.16 | 16 |
| Lung perfusion imaging CPT 78580 | not published | not published | $371.62 – $1,040.54 | 18 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | not published | 0 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $22.65 – $63.42 | 16 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | not published | 0 |
| Lymphatics/lymph node imaging CPT 78195 | not published | not published | $497.80 – $1,393.84 | 18 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $36.56 – $228.36 | 18 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $44.48 – $198.28 | 18 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $30.55 – $595.06 | 18 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $144.80 – $1,600.98 | 17 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $200.79 – $200.79 | 1 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $139.54 – $139.54 | 1 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $191.04 – $191.04 | 1 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $470.96 – $1,318.69 | 16 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $20.19 – $30.28 | 2 |
| Macroscopic exam arthropod CPT 87168 | not published | not published | $3.87 – $17.26 | 18 |
| Macroscopic exam parasite CPT 87169 | not published | not published | $3.87 – $17.26 | 18 |
| Magnesium CPT 83735 | not published | not published | $6.08 – $27.09 | 18 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $223.55 – $942.77 | 18 |
| Malaria antibody CPT 86750 | not published | not published | $11.97 – $53.32 | 18 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | not published | 0 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | not published | not published | $119.21 – $333.79 | 16 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | not published | not published | $119.21 – $333.79 | 16 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $221.85 – $621.18 | 16 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $3.37 – $15.92 | 18 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | not published | 0 |
| Mastoids complete CPT 70130 | not published | not published | $98.35 – $275.38 | 18 |
| M.avium-intra dna amp prob CPT 87561 | not published | not published | $31.84 – $141.96 | 18 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $18.20 – $85.69 | 18 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | not published | not published | $13.12 – $58.47 | 18 |
| Mayo aathr protein s free CPT 85306 | not published | not published | $13.90 – $61.96 | 18 |
| Mayo activated protein c resistance assay CPT 85307 | not published | not published | $13.90 – $61.96 | 18 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | not published | not published | $38.57 – $121.11 | 17 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | not published | not published | $16.18 – $16.18 | 1 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | not published | not published | $16.18 – $16.18 | 1 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | not published | not published | $13.42 – $59.80 | 18 |
| Mayo alpha 1 antitrypsin CPT 82103 | not published | not published | $12.19 – $54.32 | 18 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | not published | not published | $13.68 – $47.35 | 18 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | not published | not published | $26.09 – $26.09 | 1 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | not published | not published | $23.72 – $23.72 | 1 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | not published | not published | $109.35 – $381.92 | 17 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | not published | not published | $91.66 – $287.81 | 17 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | not published | not published | $137.00 – $430.18 | 17 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | not published | not published | $215.61 – $3,642.40 | 2 |
| Mayo androstenedione CPT 82157 | not published | not published | $26.56 – $110.61 | 18 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | not published | not published | $13.25 – $59.03 | 18 |
| Mayo antithrombin iii antigen CPT 85301 | not published | not published | $9.81 – $43.74 | 18 |
| Mayo aspergillus fumigatus antibody CPT 86606 | not published | not published | $13.66 – $60.88 | 18 |
| Mayo avwpr vw factor activity CPT 85397 | not published | not published | $20.82 – $96.90 | 18 |
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.