LEE'S SUMMIT MEDICAL CENTER
2100 SE Blue Parkway, Lee's Summit, MO · Hcamidwest · · NPI 1225085871
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 |
|---|---|---|---|---|
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | not published | not published | $22.67 – $182.03 | 9 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $98.66 – $116.21 | 8 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $1.11 – $1.17 | 7 |
| Dexamethasone 4 mg tablet HCPCS J8540 | not published | not published | $0.02 – $0.06 | 2 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | not published | not published | $0.09 – $0.11 | 8 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $204.54 – $215.50 | 8 |
| Dexamethasone panel CPT 80420 | not published | not published | $81.35 – $289.09 | 21 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $0.72 – $0.76 | 7 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $1,600.80 | $1,600.80 | $58.01 – $85.01 | 8 |
| Dextran 40 infusion HCPCS J7100 | $179.90 | $179.90 | $45.75 – $70.70 | 7 |
| Dextran 75 infusion HCPCS J7110 | not published | not published | $14.52 – $15.25 | 7 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $89.90 | $89.90 | $1.25 – $1.36 | 8 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | not published | not published | $5.25 – $5.51 | 7 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | not published | not published | $1.75 – $1.91 | 8 |
| Dextrose 5 % IV bolus HCPCS J7070 | $128.56 | $128.56 | $2.94 – $3.82 | 8 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $951.75 | $951.75 | $11.27 – $48.83 | 21 |
| Diabetes (HbA1c) Test CPT 83036 | $406.81 | $406.81 | $4.92 – $21.20 | 21 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $269.08 – $290.83 | 9 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $45.33 – $49.00 | 9 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $45.33 – $49.00 | 9 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $45.33 – $49.00 | 9 |
| Diab manage trn ind/group HCPCS G0109 | not published | not published | $11.11 – $16.67 | 15 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $89.72 – $96.97 | 9 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $45.33 – $49.00 | 9 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $549.83 – $2,620.75 | 10 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $1,869.18 – $8,886.97 | 10 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $168.05 – $218.40 | 10 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $234.00 – $1,853.93 | 10 |
| Diagnostic anoscopy spx 46600 CPT 46600 | not published | not published | $168.05 – $218.40 | 10 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $15.67 – $157.60 | 10 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | not published | not published | $15.67 – $201.34 | 10 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $234.00 – $311.00 | 10 |
| Diagnostic laryngoscopy 31575 CPT 31575 | not published | not published | $115.37 – $311.00 | 11 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $1,503.61 | $1,503.61 | $59.88 – $199.44 | 20 |
| Diagnostic Mammogram (one breast) CPT 77065 | not published | not published | $48.20 – $155.91 | 20 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $71.77 – $100.81 | 9 |
| Dialysis one evaluation CPT 90945 | not published | not published | $143.48 – $150.65 | 7 |
| Dialysis repeated eval CPT 90947 | not published | not published | $77.66 – $81.54 | 7 |
| Diathermy eg microwave CPT 97024 | not published | not published | $6.86 – $13.07 | 19 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $90.50 | $90.50 | $0.08 – $0.12 | 2 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $313.11 | $313.11 | $5.79 – $11.04 | 2 |
| Dicyclomine injection HCPCS J0500 | $146.68 | $146.68 | $11.33 – $13.50 | 8 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.23 – $0.24 | 7 |
| Diffusing capacity CPT 94729 | $966.59 | $966.59 | $42.11 – $44.22 | 7 |
| Digital analysis of eeg CPT 95957 | not published | not published | $4.36 – $4.58 | 7 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $90.50 | $90.50 | $4.88 – $9.95 | 8 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $11,780.02 | $11,780.02 | $4,968.58 – $8,525.53 | 2 |
| Digoxin total therapeutic drug level CPT 80162 | $708.07 | $708.07 | $6.73 – $29.55 | 21 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $143.85 | $143.85 | $57.08 – $90.04 | 8 |
| Dilate esophagus CPT 43453 | not published | not published | $616.42 – $2,826.03 | 10 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $293.65 – $1,472.01 | 10 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $1,115.40 – $1,171.17 | 7 |
| Dilate tear duct opening CPT 68801 | not published | not published | $156.16 – $653.38 | 10 |
| Dilate urethra stricture CPT 53600 | not published | not published | $228.80 – $454.43 | 10 |
| Dilate urethra stricture CPT 53601 | not published | not published | $168.05 – $327.60 | 10 |
| Dilate urethra stricture CPT 53605 | not published | not published | $1,129.34 – $3,357.23 | 10 |
| Dilate urethra stricture CPT 53621 | not published | not published | $312.00 – $454.43 | 10 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $208.00 – $269.89 | 10 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $382.28 – $1,853.93 | 10 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $1,012.78 – $4,499.77 | 10 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $382.28 – $1,853.93 | 10 |
| Dilation of salivary duct CPT 42660 | not published | not published | $735.74 – $910.48 | 3 |
| Dilation of urethra CPT 53661 | not published | not published | $168.05 – $218.40 | 10 |
| Dilation of urethra CPT 53665 | not published | not published | $659.82 – $3,357.23 | 10 |
| Dilation of vagina CPT 57400 | not published | not published | $1,012.78 – $4,499.77 | 10 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $494.04 – $2,253.44 | 10 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $343.20 – $1,119.81 | 10 |
| Dilat xst trc ndurlgc px CPT 50436 | not published | not published | $1,130.84 – $1,187.38 | 7 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | $1,902.46 – $1,997.58 | 7 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | not published | not published | $0.05 – $0.05 | 1 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $0.92 – $8.77 | 8 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $714.72 – $779.20 | 8 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $2.34 – $2.34 | 1 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $90.50 | $90.50 | $0.66 – $0.74 | 8 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $26.15 – $27.46 | 7 |
| Dipyridamole injection HCPCS J1245 | not published | not published | $3.84 – $8.75 | 8 |
| Direct advanced life support CPT 99288 | not published | not published | $39.14 – $41.10 | 7 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $12.99 – $13.64 | 7 |
| Disaccharidases CPT 82657 | $152.70 | $152.70 | $11.24 – $39.83 | 21 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $2,509.31 – $3,105.27 | 3 |
| Disarticulation shoulder CPT 23920 | not published | not published | $312.00 – $327.60 | 7 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $68.02 – $2,141.97 | 15 |
| Disconnect insert locking wr HCPCS L6616 | not published | not published | $78.62 – $84.97 | 9 |
| Disconnect locking wrist uni HCPCS L6615 | not published | not published | $231.10 – $249.77 | 9 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $109.28 – $114.74 | 7 |
| Dis site tele svcs rhc/fqhc HCPCS G2025 | not published | not published | $78.29 – $78.29 | 1 |
| Dissolve clot heart vessel CPT 92975 | not published | not published | $1,045.17 – $1,045.17 | 1 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $1,279.64 – $8,444.05 | 10 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $6,941.58 – $8,590.21 | 3 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $452.40 – $475.02 | 7 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $9.10 – $43.05 | 10 |
| Dmd dup/delet analysis CPT 81161 | $3,809.37 | $3,809.37 | $141.45 – $497.87 | 15 |
| Dmpk gene charac alleles CPT 81239 | not published | not published | $139.34 – $417.74 | 18 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $69.46 – $208.24 | 18 |
| Dna antibody native/double stranded CPT 86225 | $326.24 | $326.24 | $6.97 – $30.20 | 21 |
| Dna gardnerella CPT 87510 | not published | not published | $10.16 – $44.32 | 21 |
| Dna probe chlamydia CPT 87490 | not published | not published | $11.54 – $44.32 | 21 |
| Dna probe gc CPT 87590 | not published | not published | $13.63 – $48.18 | 21 |
| Dna trichomonas CPT 87660 | not published | not published | $10.16 – $44.32 | 21 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $179.90 | $179.90 | $8.02 – $8.56 | 8 |
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.