▸ Hospital · KS · CCN 170200

Ascension Via Christi St. Teresa

14800 W ST TERESA, WICHITA, KS, 67235

38 bedsAcute Care Hospitals1

Compliance grade

92/100

Procedures tracked

151

of 209 target codes

Payers

with negotiated rates

Rates published

13,182

last crawl 2026-05-23

▸ Compare with other hospitals All KS hospitals JSON Full cost report on HCRIS.io →

Source MRF: https://healthcare.ascension.org/-/media/project/ascension/healthcare/price-transparency-files/ks-csv/271965272_ascension-via-christi-hospital-wichita-st-teresa-inc_standardcharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	16	—	—	$1,582.8	$8,209.87	$25,665
Psychiatric diagnostic evaluation	CPT	90791	13	—	—	$148.59	$150.08	$416.05
Psychiatric eval with medical services	CPT	90792	12	—	—	$148.59	$150.08	$416.05
Psychotherapy 30 minutes	CPT	90832	13	—	—	$148.59	$150.08	$416.05
Psychotherapy 45 minutes	CPT	90834	13	—	—	$148.59	$150.08	$416.05
Psychotherapy 60 minutes	CPT	90837	13	—	—	$148.59	$150.08	$416.05
Crisis psychotherapy 60 minutes	CPT	90839	13	—	—	$148.59	$150.08	$416.05
emergency
ED visit level 1	CPT	99281	15	—	—	$81.43	$83.06	$1,573
ED visit level 2	CPT	99282	15	—	—	$146.45	$149.38	$1,573
ED visit level 3	CPT	99283	15	—	—	$256.07	$261.19	$2,112
ED visit level 4	CPT	99284	15	—	—	$393.81	$401.69	$2,608
ED visit level 5	CPT	99285	15	—	—	$567.01	$578.35	$3,197
Critical care, first hour	CPT	99291	14	—	—	$779.26	$787.05	$3,171
imaging
CT head without contrast	CPT	70450	14	—	—	$98.35	$99.33	$591.78
CT head with contrast	CPT	70460	13	—	—	$164.64	$166.29	$460.99
CT head with and without contrast	CPT	70470	13	—	—	$164.64	$166.29	$493.25
CT neck with contrast	CPT	70491	13	—	—	$164.64	$166.29	$515.3
MRI brain without contrast	CPT	70551	15	—	—	$223.55	$225.79	$943.39
MRI brain with contrast	CPT	70552	15	—	—	$330.28	$333.58	$1,155.99
MRI brain with and without contrast	CPT	70553	15	—	—	$330.28	$333.58	$1,446.68
Chest X-ray single view	CPT	71045	13	—	—	$52.84	$82.24	$228
Chest X-ray 2 views	CPT	71046	13	—	—	$70.25	$82.24	$228
Chest X-ray 3 views	CPT	71047	13	—	—	$81.43	$82.24	$228
CT chest without contrast	CPT	71250	14	—	—	$98.35	$99.33	$658.05
CT chest with contrast	CPT	71260	14	—	—	$164.64	$166.29	$944.5
CT chest with and without contrast	CPT	71270	13	—	—	$164.64	$166.29	$631.18
MRI chest without contrast	CPT	71550	15	—	—	$223.55	$225.79	$947.14
MRI chest with contrast	CPT	71551	15	—	—	$730.66	$737.97	$2,045.85
MRI chest with and without contrast	CPT	71552	15	—	—	$330.28	$333.58	$1,465.71
Lumbosacral spine X-ray	CPT	72100	14	—	—	$72.98	$98.84	$275.38
CT cervical spine without contrast	CPT	72125	14	—	—	$98.35	$99.33	$1,198.91
CT thoracic spine without contrast	CPT	72128	13	—	—	$98.35	$99.33	$407.74
CT lumbar spine without contrast	CPT	72131	13	—	—	$98.35	$99.33	$404.96
MRI cervical spine without contrast	CPT	72141	15	—	—	$223.55	$225.79	$940.56
MRI thoracic spine without contrast	CPT	72146	15	—	—	$223.55	$225.79	$939.84
MRI lumbar spine without contrast	CPT	72148	15	—	—	$223.55	$225.79	$939.84
MRI lumbar spine with and without contrast	CPT	72149	15	—	—	$330.28	$333.58	$1,155.99
MRI cervical spine with and without contrast	CPT	72156	15	—	—	$330.28	$333.58	$1,446.96
MRI lumbar spine with contrast	CPT	72158	15	—	—	$330.28	$333.58	$1,446.96
CT pelvis without contrast	CPT	72192	13	—	—	$98.35	$99.33	$351.16
CT pelvis with contrast	CPT	72193	13	—	—	$164.64	$166.29	$695.98
Shoulder X-ray	CPT	73030	14	—	—	$54.13	$81.84	$228
Humerus X-ray	CPT	73060	14	—	—	$54.13	$81.84	$228
Hand X-ray 3 views	CPT	73130	14	—	—	$58.81	$82.24	$228
MRI upper extremity joint without contrast	CPT	73221	15	—	—	$223.55	$225.79	$947.14
MRI upper extremity joint with and without contrast	CPT	73223	15	—	—	$330.28	$333.58	$1,459.38
Hip X-ray 2 views	CPT	73510	1	—	—	$68.02	$68.02	$68.02
Knee X-ray 1-2 views	CPT	73560	14	—	—	$51.89	$81.84	$228
Ankle X-ray 3 views	CPT	73610	14	—	—	$58.81	$82.24	$228
MRI lower extremity joint without contrast	CPT	73721	15	—	—	$223.55	$225.79	$947.14
MRI lower extremity joint with and without contrast	CPT	73723	15	—	—	$330.28	$333.58	$1,458.38
CT abdomen without contrast	CPT	74150	13	—	—	$98.35	$99.33	$345.66
CT abdomen with contrast	CPT	74160	14	—	—	$164.64	$166.29	$962.96
CT abdomen with and without contrast	CPT	74170	14	—	—	$164.64	$166.29	$1,158.88
CT abdomen and pelvis without contrast	CPT	74176	13	—	—	$223.55	$225.79	$625.94
CT abdomen and pelvis with contrast	CPT	74177	13	—	—	$330.28	$333.58	$924.78
CT abdomen and pelvis with and without contrast	CPT	74178	13	—	—	$330.28	$333.58	$1,034.75
MRI abdomen without contrast	CPT	74181	15	—	—	$223.55	$225.79	$944.58
MRI abdomen with and without contrast	CPT	74183	15	—	—	$330.28	$333.58	$1,458.29
Abdominal ultrasound complete	CPT	76700	14	—	—	$98.35	$99.33	$275.38
Abdominal ultrasound limited	CPT	76705	14	—	—	$98.35	$99.33	$275.38
Retroperitoneal ultrasound complete	CPT	76770	14	—	—	$98.35	$99.33	$275.38
Obstetric ultrasound first trimester	CPT	76801	14	—	—	$98.35	$99.33	$275.38
Obstetric ultrasound after first trimester	CPT	76805	14	—	—	$98.35	$99.33	$293.98
Obstetric ultrasound with fetal anatomy	CPT	76811	14	—	—	$223.55	$225.79	$625.94
Transvaginal ultrasound	CPT	76830	14	—	—	$98.35	$99.33	$288.19
Pelvic ultrasound complete	CPT	76856	14	—	—	$98.35	$99.33	$275.38
Scrotal ultrasound	CPT	76870	14	—	—	$98.35	$99.33	$275.38
Diagnostic mammography unilateral	CPT	77065	13	—	—	$76.84	$77.61	$303.26
Diagnostic mammography bilateral	CPT	77066	13	—	—	$97.94	$98.92	$386.75
Screening mammography bilateral	CPT	77067	13	—	—	$81.06	$81.87	$320.67
EKG tracing only	CPT	93005	12	—	—	$54.93	$55.48	$153.8
Transthoracic echocardiogram complete	CPT	93306	12	—	—	$507.08	$512.15	$1,419.82
Transthoracic echocardiogram	CPT	93307	12	—	—	$223.55	$225.79	$625.94
Stress echocardiogram	CPT	93350	12	—	—	$507.08	$512.15	$1,419.82
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	15	—	—	$9,004.87	$10,731	$25,665
COPD w MCC	MS-DRG	190	15	—	—	$6,382.99	$7,978.74	$25,665
COPD w CC	MS-DRG	191	15	—	—	$4,857.69	$6,072.11	$25,665
COPD w/o CC/MCC	MS-DRG	192	15	—	—	$3,699.45	$4,624.31	$25,665
Simple pneumonia & pleurisy w CC	MS-DRG	194	15	—	—	$4,643.9	$5,804.88	$25,665
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	15	—	—	$3,621.66	$4,527.07	$25,665
AMI discharged alive w MCC	MS-DRG	280	15	—	—	$9,243.43	$10,731	$25,882
AMI discharged alive w CC	MS-DRG	281	15	—	—	$5,296.2	$6,620.25	$25,665
AMI discharged alive w/o CC/MCC	MS-DRG	282	15	—	—	$4,166.78	$5,208.47	$25,665
Heart failure & shock w MCC	MS-DRG	291	15	—	—	$7,397.74	$9,247.17	$25,665
Heart failure & shock w CC	MS-DRG	292	15	—	—	$4,892.26	$6,115.33	$25,665
Heart failure & shock w/o CC/MCC	MS-DRG	293	15	—	—	$3,261.51	$4,076.89	$25,665
Cardiac arrhythmia w MCC	MS-DRG	308	15	—	—	$6,937.91	$8,672.39	$25,665
Cardiac arrhythmia w CC	MS-DRG	309	15	—	—	$4,239.38	$5,299.23	$25,665
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	15	—	—	$3,262.08	$4,077.6	$25,665
GI hemorrhage w CC	MS-DRG	378	15	—	—	$5,651.17	$7,063.96	$25,665
GI hemorrhage w/o CC/MCC	MS-DRG	379	15	—	—	$3,632.6	$4,540.75	$25,665
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	15	—	—	$4,492.35	$5,615.44	$25,665
Fractures of femur w/o MCC	MS-DRG	533	15	—	—	$9,033.68	$10,731	$25,665
Kidney/UTI w MCC	MS-DRG	689	15	—	—	$6,686.09	$8,357.61	$25,665
Kidney/UTI w/o MCC	MS-DRG	690	15	—	—	$4,664.65	$5,830.81	$25,665
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	15	—	—	$10,731	$11,417	$31,342
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	15	—	—	$5,896.64	$7,370.8	$25,665
lab
Basic metabolic panel (BMP)	CPT	80048	14	—	—	$8.46	$8.54	$34.24
General health panel	CPT	80050	1	—	—	$35.77	$35.77	$35.77
Electrolyte panel	CPT	80051	14	—	—	$4.34	$7.08	$28.36
Comprehensive metabolic panel	CPT	80053	14	—	—	$10.56	$10.67	$42.77
Lipid panel	CPT	80061	14	—	—	$12.16	$13.52	$54.21
Renal function panel	CPT	80069	14	—	—	$8.68	$8.77	$35.12
Hepatic function panel	CPT	80076	14	—	—	$7.59	$8.25	$33.05
Urinalysis non-automated	CPT	81002	14	—	—	$2.11	$3.51	$10.93
Urinalysis automated	CPT	81003	14	—	—	$1.85	$2.27	$9.09
Glucose quantitative	CPT	82947	14	—	—	$1.08	$3.97	$15.87
Hemoglobin A1c	CPT	83036	14	—	—	$8	$9.81	$39.25
Thyroid stimulating hormone (TSH)	CPT	84443	14	—	—	$15.25	$16.97	$67.95
Complete blood count with automated differential	CPT	85025	14	—	—	$6.41	$7.85	$24.4
Complete blood count without differential	CPT	85027	14	—	—	$5.33	$6.53	$26.18
Urine culture bacterial	CPT	87086	14	—	—	$7.33	$8.15	$32.66
Urine culture identification	CPT	87088	14	—	—	$6.93	$8.17	$32.74
Tissue exam by pathologist level IV	CPT	88305	14	—	—	$49.41	$49.9	$161.71
maternity
Fetal non-stress test	CPT	59025	12	—	—	$186.05	$187.91	$520.94
office
Office visit, new patient, 15-29 min	CPT	99202	1	—	—	$71.02	$71.02	$71.02
Office visit, new patient, 30-44 minutes	CPT	99203	1	—	—	$102.58	$102.58	$102.58
Office visit, established patient, 5 min	CPT	99211	1	—	—	$19.06	$19.06	$19.06
Office visit, established patient, 10-19 min	CPT	99212	1	—	—	$41.26	$41.26	$41.26
Office visit, established patient, 20-29 minutes	CPT	99213	1	—	—	$69.62	$69.62	$69.62
preventive
Upper GI endoscopy diagnostic	CPT	43235	12	—	—	$867.07	$875.74	$2,427.8
Upper GI endoscopy with biopsy	CPT	43239	12	—	—	$867.07	$875.74	$2,427.8
Sigmoidoscopy diagnostic	CPT	45330	12	—	—	$843.17	$851.6	$2,360.88
Sigmoidoscopy with biopsy	CPT	45331	12	—	—	$843.17	$851.6	$2,360.88
Colonoscopy diagnostic	CPT	45378	12	—	—	$843.17	$851.6	$2,360.88
surgery
Major small/large bowel procedures w MCC	MS-DRG	329	15	—	—	$10,731	$26,487	$74,163
Major small/large bowel procedures w CC	MS-DRG	330	15	—	—	$10,731	$14,090	$38,678
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	15	—	—	$9,697.51	$10,731	$27,153
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	15	—	—	$9,747.64	$10,731	$27,293
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	15	—	—	$7,870.26	$9,837.83	$25,665
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	15	—	—	$10,731	$19,829	$54,972
Major joint replacement w MCC	MS-DRG	469	15	—	—	$10,731	$17,828	$48,940
Major joint replacement w/o MCC	MS-DRG	470	15	—	—	$10,731	$11,337	$31,122
Laparoscopic cholecystectomy	CPT	47562	1	—	—	$7,024	$7,024	$7,024
Lap cholecystectomy with cholangiography	CPT	47563	1	—	—	$7,024	$7,024	$7,024
Hip & femur procedures except major joint w MCC	MS-DRG	480	15	—	—	$10,731	$17,117	$46,989
Hip & femur procedures except major joint w CC	MS-DRG	481	15	—	—	$10,731	$12,311	$33,794
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	15	—	—	$9,398.44	$10,731	$26,316
OR procedure for obesity w MCC	MS-DRG	619	17	—	—	$10,731	$16,971	$46,587
OR procedure for obesity w CC	MS-DRG	620	17	—	—	$9,221.54	$11,973	$32,413
OR procedure for obesity w/o CC/MCC	MS-DRG	621	17	—	—	$8,691.97	$11,517	$32,413
Intravitreal injection	CPT	67028	12	—	—	$306.75	$309.82	$858.9
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	15	—	—	$7,149.38	$8,936.73	$25,665
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	15	—	—	$10,731	$12,044	$33,062
PCI single major coronary artery	CPT	92920	3	—	—	$7,726	$14,405	$20,700
PCI with drug-eluting stent	CPT	92928	3	—	—	$7,726	$14,405	$20,700
PCI bypass graft	CPT	92937	3	—	—	$7,726	$14,405	$20,700
Left heart catheterization	CPT	93452	3	—	—	$6,498	$10,792	$16,108
Coronary angiography with cath	CPT	93455	3	—	—	$6,498	$10,792	$16,108
Coronary angiography with bypass cath	CPT	93458	3	—	—	$6,498	$10,792	$16,108

Payer mix (top 20)

Payer	Codes covered	Median rate
smarthealth	140	$462.39
Ambetter	136	$279.89
Blue Cross Blue Shield	136	$167.93
corizon	136	$205.8
via christi research	136	$164.64
Humana	136	$223.55
Medicare	136	$167.93
Medicare Advantage	136	$165.47
saint lukes health systems	136	$164.64
UnitedHealthcare	136	$336.89
va	136	$164.64
vc hope	136	$164.64
Aetna	130	$12,420
First Health	64	$365.95
healthchoice of ok	40	$12,694
medica	40	$10,731
Cigna	35	$810
early detection works	5	$69.62
providrs care	3	$18,734
Multiplan	1	$3,879