Hospital Fond du Lac, WI

ThedaCare Regional Medical Center-Fond Du Lac

Listed in its price file as “ThedaCare Regional Medical Center-Appleton Inc”.

ThedaCare Regional Medical Center-Fond Du Lac in Fond Du Lac, WI publishes cash prices for 527 common procedures listed here, from its own machine-readable price file updated Aug 8, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Wisconsin median for 341 of 522 procedures and above it for 82. By typical cash price it ranks #24 of 103 Wisconsin hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

755 W Johnson St, Fond Du Lac, WI 54935-2089 Collected Sep 23, 2026 Source price file Check a bill from this hospital

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT Abdomen W/ W/O Contr	$1,766.41	$3,154.30	$410.06–$3,272.30	26% below	44%
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W/ W/O CONTR	$1,801.74	$3,217.40	$410.06–$3,272.30	24% below	44%
Abdominal X-ray, 2 views CPT 74019 RADIOLOGIC EXAM ABDOMEN 2 VIEWS	$163.74	$292.40	$11.51–$271.93	32% below	44%
Abdominal X-ray, 2 views CPT 74019 HC Radiologic Exam Abdomen 2 Views	$242.59	$433.20	$56.32–$506.76	1% above	44%
Abdominal X-ray, 2 views CPT 74019 HC RADIOLOGIC EXAM ABDOMEN 2 VIEWS	$266.84	$476.50	$56.32–$506.76	11% above	44%
Ankle X-ray, complete, 3 or more views CPT 73610 HC Ankle X-Ray 3+ Vw	$154.95	$276.70	$35.97–$362.79	34% below	44%
Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE X-RAY 3+ VW	$163.24	$291.50	$8.66–$271.10	31% below	44%
Ankle X-ray, complete, 3 or more views CPT 73610 HC ANKLE X-RAY 3+ VW	$201.43	$359.70	$35.97–$362.79	14% below	44%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC US Abi 1-2 Levels(Limited)	$254.58	$454.60	$136.38–$430.78	34% below	44%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC US ABI 1-2 LEVELS(LIMITED)	$285.15	$509.20	$136.38–$430.78	26% below	44%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O CONTRAST	$735.50	$1,313.40	$117.56–$1,221.46	49% below	44%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT Upper Extremity W/O Contrast	$1,469.89	$2,624.80	$341.22–$3,832.72	2% above	44%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY W/O CONTRAST	$1,499.29	$2,677.30	$341.22–$3,832.72	4% above	44%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Esophagram X-Ray	$399.78	$713.90	$92.81–$730.33	25% below	44%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC ESOPHAGRAM X-RAY	$439.77	$785.30	$92.81–$730.33	17% below	44%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM Bone Scan (Whole Body)	$995.96	$1,778.50	$231.21–$2,150.25	33% below	44%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE SCAN (WHOLE BODY)	$1,294.78	$2,312.10	$231.21–$2,150.25	13% below	44%
Breast ultrasound, complete, one breast CPT 76641 HC Ultrasound Breast Complete	$250.43	$447.20	$58.14–$767.81	53% below	44%
Breast ultrasound, complete, one breast CPT 76641 HC ULTRASOUND BREAST COMPLETE	$257.94	$460.60	$58.14–$767.81	51% below	44%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC Ultrasound Breast Limited	$200.37	$357.80	$46.51–$698.34	49% below	44%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC ULTRASOUND BREAST LIMITED	$206.36	$368.50	$46.51–$698.34	47% below	44%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT Angio Abd&Pelv W/O&W/Dye	$2,215.02	$3,955.40	$514.20–$4,195.32	27% below	44%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT ANGIO ABD&PELV W/O&W/DYE	$2,259.32	$4,034.50	$514.20–$4,195.32	26% below	44%
CT angiography (CTA) of the head CPT 70496 HC CT Angio Head W/Contrast Only	$2,074.58	$3,704.60	$481.60–$3,514.19	at median	44%
CT angiography (CTA) of the head CPT 70496 HC CT Angiography Head W & W/O Contrast	$2,074.58	$3,704.60	$481.60–$3,514.19	at median	44%
CT angiography (CTA) of the head CPT 70496 HC CT ANGIO HEAD W/CONTRAST ONLY	$2,116.07	$3,778.70	$481.60–$3,514.19	2% above	44%
CT angiography (CTA) of the head CPT 70496 HC CT ANGIOGRAPHY HEAD W & W/O CONTRAST	$2,116.07	$3,778.70	$481.60–$3,514.19	2% above	44%
CT angiography (CTA) of the neck CPT 70498 HC CT Angiography Neck W & W/O Contrast	$1,642.31	$2,932.70	$381.25–$3,198.74	19% below	44%
CT angiography (CTA) of the neck CPT 70498 HC CT ANGIOGRAPHY NECK W & W/O CONTRAST	$1,675.18	$2,991.40	$381.25–$3,198.74	17% below	44%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT Angiography Chest	$1,765.01	$3,151.80	$409.73–$3,377.95	13% below	44%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST	$1,800.29	$3,214.80	$409.73–$3,377.95	11% below	44%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CT Angio Hrt W/3d Image	$1,377.82	$2,460.40	$319.85–$2,333.93	21% below	44%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CT ANGIO HRT W/3D IMAGE	$1,405.38	$2,509.60	$319.85–$2,333.93	20% below	44%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT Hrt W/O Dye W/Ca Test	$28.00	$50.00	$6.50–$46.50	56% below	44%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HRT W/O DYE W/CA TEST	$28.00	$50.00	$6.50–$46.50	56% below	44%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS W/O CONTRAST	$1,904.00	$3,400.00	$442.00–$3,906.00	24% below	44%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abd & Pelvis W/O Contrast	$2,028.15	$3,621.70	$442.00–$3,906.00	19% below	44%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN&PELVIS W/CONTRAST	$1,531.43	$2,734.70	$97.27–$2,543.27	52% below	44%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN&PELVIS W/CONTRAST	$2,072.00	$3,700.00	$481.00–$4,510.13	35% below	44%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abdomen&Pelvis W/Contrast	$2,300.20	$4,107.50	$481.00–$4,510.13	28% below	44%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD&PELV 1+ SECTION/REGNS	$2,240.00	$4,000.00	$520.00–$4,836.00	39% below	44%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abd&Pelv 1+ Section/Regns	$2,591.23	$4,627.20	$520.00–$4,836.00	30% below	44%
CT scan of the abdomen with contrast CPT 74160 HC CT Scan of Abdomen W Contrast (74160)	$1,469.10	$2,623.40	$341.04–$2,974.98	10% below	44%
CT scan of the abdomen with contrast CPT 74160 HC CT SCAN OF ABDOMEN W CONTRAST (74160)	$1,498.50	$2,675.90	$341.04–$2,974.98	9% below	44%
CT scan of the abdomen without contrast CPT 74150 HC CT Scan of Abdomen WO Contrast (74150)	$1,042.38	$1,861.40	$241.98–$2,249.86	17% below	44%
CT scan of the abdomen without contrast CPT 74150 HC CT SCAN OF ABDOMEN WO CONTRAST (74150)	$1,063.22	$1,898.60	$241.98–$2,249.86	16% below	44%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Scan of Face, Jaw WO Contrast	$989.91	$1,767.70	$229.80–$2,331.70	29% below	44%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SCAN OF FACE, JAW WO CONTRAST	$1,009.74	$1,803.10	$229.80–$2,331.70	27% below	44%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head W/O Contrast (70450)	$936.77	$1,672.80	$217.46–$2,395.96	27% below	44%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD W/O CONTRAST (70450)	$955.53	$1,706.30	$217.46–$2,395.96	26% below	44%
CT scan of the head with contrast CPT 70460 HC CT Head W/ Contrast (70460)	$1,042.38	$1,861.40	$241.98–$2,635.25	32% below	44%
CT scan of the head with contrast CPT 70460 HC CT HEAD W/ CONTRAST (70460)	$1,063.22	$1,898.60	$241.98–$2,635.25	31% below	44%
CT scan of the head without and with contrast CPT 70470 HC CT Head W and W/O Contrast	$1,346.46	$2,404.40	$312.57–$2,898.44	27% below	44%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD W AND W/O CONTRAST	$1,373.40	$2,452.50	$312.57–$2,898.44	25% below	44%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT L-Spine WO Contrast (72131)	$1,088.02	$1,942.90	$252.58–$2,570.06	29% below	44%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT L-SPINE WO CONTRAST (72131)	$1,109.81	$1,981.80	$252.58–$2,570.06	28% below	44%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT Cervical Sp W/O Contrast	$1,088.02	$1,942.90	$252.58–$2,757.45	29% below	44%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SP W/O CONTRAST	$1,109.81	$1,981.80	$252.58–$2,757.45	28% below	44%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT Scan of Pelvis Contrast	$1,002.18	$1,789.60	$232.65–$2,867.28	39% below	44%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT SCAN OF PELVIS CONTRAST	$1,022.22	$1,825.40	$232.65–$2,867.28	38% below	44%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HC US Carotid Duplex	$627.54	$1,120.60	$336.18–$1,218.23	36% below	44%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HC US CAROTID/TEMPORAL ART. DUPLEX	$702.86	$1,255.10	$336.18–$1,218.23	29% below	44%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID/TEMPORAL DUPLEX	$710.08	$1,268.00	$75.12–$933.25	28% below	44%
Chest CT scan without and with contrast CPT 71270 HC CT Chest W/ & W/O Contrast	$1,563.18	$2,791.40	$362.88–$3,277.41	32% below	44%
Chest CT scan without and with contrast CPT 71270 HC CT CHEST W/ & W/O CONTRAST	$1,594.43	$2,847.20	$362.88–$3,277.41	31% below	44%
Chest X-ray, 2 views CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS	$148.90	$265.90	$10.79–$247.29	31% below	44%
Chest X-ray, 2 views CPT 71046 HC Radiologic Exam Chest 2 Views	$151.14	$269.90	$35.09–$390.60	30% below	44%
Chest X-ray, 2 views CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS	$235.20	$420.00	$35.09–$390.60	10% above	44%
Chest X-ray, single view CPT 71045 RADIOLOGIC EXAM CHEST SINGLE VIEW	$114.58	$204.60	$9.01–$190.28	29% below	44%
Chest X-ray, single view CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW	$207.20	$370.00	$48.10–$354.52	28% above	44%
Chest X-ray, single view CPT 71045 HC Radiologic Exam Chest Single View	$213.47	$381.20	$48.10–$354.52	32% above	44%
Collarbone (clavicle) X-ray, complete CPT 73000 HC X-Ray Clavicle	$116.42	$207.90	$27.03–$212.69	44% below	44%
Collarbone (clavicle) X-ray, complete CPT 73000 HC X-RAY CLAVICLE	$128.07	$228.70	$27.03–$212.69	38% below	44%
Collarbone (clavicle) X-ray, complete CPT 73000 X-RAY CLAVICLE	$142.58	$254.60	$8.28–$236.78	31% below	44%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US Retoperitoneal Abd	$387.35	$691.70	$89.92–$778.78	29% below	44%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETOPERITONEAL ABD	$399.00	$712.50	$89.92–$778.78	27% below	44%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETOPERITONEAL ABD	$526.06	$939.40	$82.89–$873.64	4% below	44%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY, AXIAL	$182.62	$326.10	$31.81–$303.27	54% below	44%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA Bone Density, Axial	$212.41	$379.30	$49.31–$413.94	47% below	44%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY, AXIAL	$233.52	$417.00	$49.31–$413.94	41% below	44%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DXA Bone Density/Peripheral	$146.05	$260.80	$33.90–$266.82	48% below	44%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DXA BONE DENSITY/PERIPHERAL	$160.66	$286.90	$33.90–$266.82	43% below	44%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC OB US, Detailed, Sngl Fetus	$819.34	$1,463.10	$190.20–$1,401.51	19% above	44%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC OB US, DETAILED, SNGL FETUS	$843.92	$1,507.00	$190.20–$1,401.51	23% above	44%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Chest W/O Contrast (71250)	$1,094.30	$1,954.10	$254.03–$2,544.11	24% below	44%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST W/O CONTRAST (71250)	$1,116.19	$1,993.20	$254.03–$2,544.11	22% below	44%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC Cat Scan of Chest Contrast (71260)	$1,340.30	$2,393.40	$311.14–$2,962.61	18% below	44%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CAT SCAN OF CHEST CONTRAST (71260)	$1,367.13	$2,441.30	$311.14–$2,962.61	17% below	44%
Diagnostic mammogram, both breasts both sides CPT 77066 HC Diagnostic Mammography Computer-Aided Detcj Bi	$308.00	$550.00	$71.50–$614.73	—	44%
Diagnostic mammogram, both breasts both sides CPT 77066 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$314.16	$561.00	$71.50–$614.73	—	44%
Diagnostic mammogram, one breast CPT 77065 HC Diagnostic Mammography Computer-Aided Detcj Uni	$308.00	$550.00	$71.50–$521.73	at median	44%
Diagnostic mammogram, one breast CPT 77065 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$314.16	$561.00	$71.50–$521.73	2% above	44%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC Duplex Lo Extrem Art Bilat	$934.36	$1,668.50	$500.55–$1,375.36	—	44%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT	$1,046.47	$1,868.70	$500.55–$1,375.36	—	44%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Reflux Vascular or Guidance Bilat	$901.26	$1,609.40	$482.82–$1,343.64	—	44%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Duplex Extrem Venous,Bilat	$901.26	$1,609.40	$482.82–$1,343.64	—	44%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT	$1,009.40	$1,802.50	$482.82–$1,343.64	—	44%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC REFLUX VASCULAR OR GUIDANCE BILAT	$1,009.40	$1,802.50	$482.82–$1,343.64	—	44%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TRANSTHORACIC W CONTRAST HC	$1,344.00	$2,400.00	$720.00–$2,209.32	23% below	44%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO W SPECTRAL DOPPLER AND COLOR FLOW HC	$1,344.00	$2,400.00	$720.00–$2,209.32	23% below	44%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Transthoracic W Contrast HC	$1,581.38	$2,823.90	$720.00–$2,209.32	10% below	44%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo W Spectral Doppler and Color Flow HC	$1,581.38	$2,823.90	$720.00–$2,209.32	10% below	44%
Elbow X-ray, 2 views CPT 73070 X-RAY ELBOW 2 VW	$129.25	$230.80	$8.28–$214.64	32% below	44%
Elbow X-ray, 2 views CPT 73070 HC X-Ray Elbow 2 Vw	$138.77	$247.80	$32.21–$299.55	27% below	44%
Elbow X-ray, 2 views CPT 73070 HC X-RAY ELBOW 2 VW	$180.38	$322.10	$32.21–$299.55	6% below	44%
Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW X-RAY MIN 3 VIEWS	$144.09	$257.30	$8.66–$239.29	39% below	44%
Elbow X-ray, complete, 3 or more views CPT 73080 HC Elbow X-Ray Min 3 Views	$170.07	$303.70	$39.48–$394.88	28% below	44%
Elbow X-ray, complete, 3 or more views CPT 73080 HC ELBOW X-RAY MIN 3 VIEWS	$221.09	$394.80	$39.48–$394.88	6% below	44%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Orbit/Ear/Fossa W/O Dye	$1,042.38	$1,861.40	$241.98–$2,249.86	28% below	44%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT/EAR/FOSSA W/O DYE	$1,063.22	$1,898.60	$241.98–$2,249.86	26% below	44%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC Facial Bones Xray 3 View	$192.70	$344.10	$44.73–$387.35	36% below	44%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC FACIAL BONES XRAY 3 VIEW	$211.96	$378.50	$44.73–$387.35	29% below	44%
Forearm X-ray (radius and ulna), 2 views CPT 73090 X-RAY FOREARM	$129.25	$230.80	$7.94–$214.64	34% below	44%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC X-Ray Forearm	$142.30	$254.10	$33.03–$422.50	28% below	44%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC X-RAY FOREARM	$156.52	$279.50	$33.03–$422.50	21% below	44%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC Hepatobiliary System Imaging	$763.50	$1,363.40	$177.24–$1,648.15	48% below	44%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC HEPATOBILIARY SYSTEM IMAGING	$809.31	$1,445.20	$177.24–$1,648.15	45% below	44%
Hand X-ray, 2 views CPT 73120 X-RAY HAND 2 VW	$138.10	$246.60	$8.28–$229.34	27% below	44%
Hand X-ray, 2 views CPT 73120 HC X-Ray Hand 2 Vw	$188.78	$337.10	$43.82–$322.90	at median	44%
Hand X-ray, 2 views CPT 73120 HC X-RAY HAND 2 VW	$191.07	$341.20	$43.82–$322.90	1% above	44%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-RAY HEEL	$126.28	$225.50	$21.39–$209.72	36% below	44%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC X-Ray Heel	$201.04	$359.00	$46.67–$367.26	1% above	44%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC X-RAY HEEL	$221.14	$394.90	$46.67–$367.26	11% above	44%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 PULM DIAG-POLYSOMNOGRAPHY	$342.50	$611.60	$367.00–$603.00	44% below	44%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC Pulm Diag-Polysomnography	$703.53	$1,256.30	$367.00–$603.00	15% above	44%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC PULM DIAG-POLYSOMNOGRAPHY	$787.98	$1,407.10	$367.00–$603.00	28% above	44%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC Polysomnography W/Cpap	$2,957.14	$5,280.60	$1,836.00–$2,787.00	19% below	44%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAPHY W/CPAP	$3,312.01	$5,914.30	$1,836.00–$2,787.00	10% below	44%
Knee X-ray, 3 views CPT 73562 HC X-Ray Knee 3+ Vw	$170.07	$303.70	$39.48–$512.15	33% below	44%
Knee X-ray, 3 views CPT 73562 X-RAY KNEE 3+ VW	$179.59	$320.70	$9.35–$298.25	29% below	44%
Knee X-ray, 3 views CPT 73562 HC X-RAY KNEE 3+ VW	$221.09	$394.80	$39.48–$512.15	13% below	44%
Knee X-ray, complete, 4 or more views CPT 73564 HC Knee X-Ray 4+ Views/Complete	$188.78	$337.10	$43.82–$544.05	32% below	44%
Knee X-ray, complete, 4 or more views CPT 73564 KNEE X-RAY 4+ VIEWS/COMPLETE	$206.47	$368.70	$11.48–$342.89	25% below	44%
Knee X-ray, complete, 4 or more views CPT 73564 HC KNEE X-RAY 4+ VIEWS/COMPLETE	$245.39	$438.20	$43.82–$544.05	11% below	44%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT Scan Lower Ext WO Contrast	$1,165.08	$2,080.50	$270.47–$2,526.53	20% below	44%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT SCAN LOWER EXT WO CONTRAST	$1,188.38	$2,122.10	$270.47–$2,526.53	18% below	44%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$425.21	$759.30	$31.49–$706.15	4% below	44%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Abdomen Limited	$492.18	$878.90	$114.26–$858.30	11% above	44%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED	$506.97	$905.30	$114.26–$858.30	14% above	44%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LTD EXTREMITY NON VASCULAR	$202.83	$362.20	$19.55–$336.85	29% below	44%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US Lmtd Joint/Oth Nonvasc Xtr Strux R-T W/Img	$205.02	$366.10	$47.59–$519.87	28% below	44%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG	$211.18	$377.10	$47.59–$519.87	26% below	44%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US Extremety Limited- Right	$205.02	$366.10	$47.59–$519.87	28% below	44%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US Extremity Limited- Left	$205.02	$366.10	$47.59–$519.87	28% below	44%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US EXTREMETY LIMITED- RIGHT	$211.18	$377.10	$47.59–$519.87	26% below	44%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US EXTREMITY LIMITED- LEFT	$211.18	$377.10	$47.59–$519.87	26% below	44%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC PR Ldct for Lung Ca Screen	$356.16	$636.00	$82.68–$604.50	20% below	44%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC PR LDCT FOR LUNG CA SCREEN	$364.00	$650.00	$82.68–$604.50	18% below	44%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-RAY LOWER LEG	$139.55	$249.20	$7.94–$231.76	34% below	44%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC X-Ray Lower Leg	$222.21	$396.80	$51.58–$423.62	4% above	44%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC X-RAY LOWER LEG	$244.44	$436.50	$51.58–$423.62	15% above	44%
MR angiography (MRA) of the head without contrast CPT 70544 HC MR Angiography Head W/O Dye	$1,431.02	$2,555.40	$332.20–$3,815.98	35% below	44%
MR angiography (MRA) of the head without contrast CPT 70544 HC MR ANGIOGRAPHY HEAD W/O DYE	$1,860.32	$3,322.00	$332.20–$3,815.98	16% below	44%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL	$1,201.87	$2,146.20	$279.01–$1,995.97	—	44%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MAGNETIC RESONANCE IMAGING, BREAST, W/WO CONTRAST BILATERAL	$1,201.87	$2,146.20	$279.01–$1,995.97	—	44%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI, JOINT OF LEG	$1,015.17	$1,812.80	$163.18–$1,685.90	54% below	44%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI, Joint of Leg	$1,889.50	$3,374.10	$438.63–$3,738.32	15% below	44%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI, JOINT OF LEG	$2,251.03	$4,019.70	$438.63–$3,738.32	2% above	44%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Lwr Extre Joint W/O&W Dye	$3,069.70	$5,481.60	$712.61–$5,862.53	10% below	44%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LWR EXTRE JOINT W/O&W DYE	$3,530.13	$6,303.80	$712.61–$5,862.53	3% above	44%
MRI of the abdomen without contrast CPT 74181 HC MRI, Abdomen	$1,854.83	$3,312.20	$430.59–$4,004.49	16% below	44%
MRI of the abdomen without contrast CPT 74181 HC MRI, ABDOMEN	$2,411.30	$4,305.90	$430.59–$4,004.49	9% above	44%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI Abdomen W/O&W Dye	$2,410.18	$4,303.90	$559.51–$5,131.93	29% below	44%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W/O&W DYE	$3,090.19	$5,518.20	$559.51–$5,131.93	10% below	44%
MRI of the brain, no contrast dye CPT 70551 HC MRI Brain	$1,531.94	$2,735.60	$355.63–$3,814.95	31% below	44%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN	$1,685.04	$3,009.00	$355.63–$3,814.95	24% below	44%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain WO and W Contrast	$1,818.15	$3,246.70	$422.07–$5,074.64	47% below	44%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN WO AND W CONTRAST	$2,363.59	$4,220.70	$422.07–$5,074.64	31% below	44%
MRI of the lower back, no contrast dye CPT 72148 HC MRI Lumbar Spine WO Contrast	$1,472.30	$2,629.10	$341.78–$4,101.39	33% below	44%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE WO CONTRAST	$1,913.97	$3,417.80	$341.78–$4,101.39	13% below	44%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI, Lumbar Spine Combo	$2,306.08	$4,118.00	$535.34–$4,971.13	32% below	44%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI, LUMBAR SPINE COMBO	$2,993.37	$5,345.30	$535.34–$4,971.13	12% below	44%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC Limited Combo-MRI Thoracic Spine W/O Contrast	$1,702.85	$3,040.80	$395.30–$4,606.94	23% below	44%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC LIMITED COMBO-MRI THORACIC SPINE W/O CONTRAST	$1,984.14	$3,543.10	$395.30–$4,606.94	10% below	44%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI, Cerv Spine Combo	$2,058.50	$3,675.90	$477.87–$4,543.24	40% below	44%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI, CERV SPINE COMBO	$2,676.07	$4,778.70	$477.87–$4,543.24	22% below	44%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI Cervical Spine WO Contrast	$1,700.89	$3,037.30	$394.85–$3,892.05	23% below	44%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE WO CONTRAST	$2,044.73	$3,651.30	$394.85–$3,892.05	7% below	44%
MRI of the pelvis without and with contrast CPT 72197 HC MRI Pelvis W and WO Contrast	$1,639.29	$2,927.30	$380.55–$4,668.60	52% below	44%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W AND WO CONTRAST	$2,016.00	$3,600.00	$380.55–$4,668.60	41% below	44%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI Pelvis W/O Contrast	$1,201.14	$2,144.90	$278.84–$3,815.98	46% below	44%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS W/O CONTRAST	$1,381.30	$2,466.60	$278.84–$3,815.98	37% below	44%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI, JOINT UPPER EXTREM	$1,016.79	$1,815.70	$163.18–$1,688.60	54% below	44%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI, Joint Upper Extrem	$1,901.93	$3,396.30	$441.52–$3,802.58	14% below	44%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI, JOINT UPPER EXTREM	$2,221.30	$3,966.60	$441.52–$3,802.58	1% above	44%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SP XRAY 4/5 VIEW	$236.38	$422.10	$41.25–$392.55	26% below	44%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC Cervical Sp Xray 4/5 View	$340.82	$608.60	$79.12–$622.64	6% above	44%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC CERVICAL SP XRAY 4/5 VIEW	$374.92	$669.50	$79.12–$622.64	17% above	44%
Neck soft tissue CT scan with contrast CPT 70491 HC CT Neck Tissue Contrast	$1,383.93	$2,471.30	$321.27–$2,344.25	16% below	44%
Neck soft tissue CT scan with contrast CPT 70491 HC CT NECK TISSUE CONTRAST	$1,411.59	$2,520.70	$321.27–$2,344.25	14% below	44%
Neck soft tissue CT scan without contrast CPT 70490 HC CT Scan of Neck Tissue	$1,042.38	$1,861.40	$241.98–$2,120.40	27% below	44%
Neck soft tissue CT scan without contrast CPT 70490 HC CT SCAN OF NECK TISSUE	$1,063.22	$1,898.60	$241.98–$2,120.40	25% below	44%
Neck soft tissue X-ray CPT 70360 HC Neck Soft Tissue Xray	$150.36	$268.50	$34.91–$300.86	28% below	44%
Neck soft tissue X-ray CPT 70360 HC NECK SOFT TISSUE XRAY	$165.42	$295.40	$34.91–$300.86	21% below	44%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Heart Spect Multi Image HC	$1,714.61	$3,061.80	$398.03–$4,494.69	45% below	44%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HEART SPECT MULTI IMAGE HC	$2,228.97	$3,980.30	$398.03–$4,494.69	28% below	44%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Tumor Imag Pet W/CT; Skull Mid Thi	$3,672.70	$6,558.40	$852.59–$6,880.23	13% below	44%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC TUMOR IMAG PET W/CT; SKULL MID THI	$3,893.06	$6,951.90	$852.59–$6,880.23	8% below	44%
Pelvic CT scan without contrast CPT 72192 HC CT Scan of Pelvis WO Contrast (72192)	$690.54	$1,233.10	$160.30–$2,730.57	46% below	44%
Pelvic CT scan without contrast CPT 72192 HC CT SCAN OF PELVIS WO CONTRAST (72192)	$704.37	$1,257.80	$160.30–$2,730.57	45% below	44%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US Pelvic Limited	$215.71	$385.20	$50.08–$414.41	46% below	44%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIC LIMITED	$222.21	$396.80	$50.08–$414.41	45% below	44%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED	$235.48	$420.50	$28.09–$391.07	41% below	44%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US Pelvic	$429.41	$766.80	$99.68–$943.02	18% below	44%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC	$442.29	$789.80	$99.68–$943.02	16% below	44%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC	$511.17	$912.80	$81.77–$848.90	2% below	44%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB >14 Weeks, Single Fetus	$488.15	$871.70	$113.32–$1,174.78	15% below	44%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB >14 WEEKS, SINGLE FETUS	$502.82	$897.90	$113.32–$1,174.78	12% below	44%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC OB US < 14 Wks, Single Fetus	$389.98	$696.40	$90.53–$902.75	24% below	44%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC OB US < 14 WKS, SINGLE FETUS	$401.69	$717.30	$90.53–$902.75	22% below	44%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US <14 WKS, SINGLE(76801)	$571.54	$1,020.60	$79.53–$949.16	11% above	44%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US Preg W Image Ltd & Amniotic Fluid 1 or More Fetuses	$319.14	$569.90	$74.09–$686.25	13% below	44%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US PREG W IMAGE LTD & AMNIOTIC FLUID 1 OR MORE FETUSES	$328.72	$587.00	$74.09–$686.25	11% below	44%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LTD 1 OR MORE FETUSES (76815)	$393.62	$702.90	$34.96–$653.70	7% above	44%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS XRAY, UNILAT 2 VIEW	$163.63	$292.20	$11.14–$271.75	27% below	44%
Rib X-ray, one side, 2 views one side CPT 71100 HC Ribs Xray, Unilat 2 View	$204.06	$364.40	$47.37–$372.74	9% below	44%
Rib X-ray, one side, 2 views one side CPT 71100 HC RIBS XRAY, UNILAT 2 VIEW	$224.45	$400.80	$47.37–$372.74	at median	44%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC X-Ray Ribs Unilateral, 3+ Vw	$248.70	$444.10	$57.73–$528.43	10% below	44%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC X-RAY RIBS UNILATERAL, 3+ VW	$318.19	$568.20	$57.73–$528.43	15% above	44%
Screening mammogram, both breasts both sides CPT 77067 HC Screening Mammography Bi 2-View Breast Inc Cad	$307.16	$548.50	$71.31–$534.75	—	44%
Screening mammogram, both breasts both sides CPT 77067 HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$322.00	$575.00	$71.31–$534.75	—	44%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY SHOULDER 2+ VW	$152.99	$273.20	$9.35–$254.08	35% below	44%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC X-Ray Shoulder 2+ Vw	$153.50	$274.10	$35.63–$480.16	35% below	44%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC X-RAY SHOULDER 2+ VW	$199.53	$356.30	$35.63–$480.16	15% below	44%
Sinus X-ray, complete, 3 or more views CPT 70220 HC Sinus Xray Routine	$173.82	$310.40	$40.35–$422.50	34% below	44%
Sinus X-ray, complete, 3 or more views CPT 70220 HC SINUS XRAY ROUTINE	$191.18	$341.40	$40.35–$422.50	28% below	44%
Skull X-ray, fewer than 4 views CPT 70250 HC X-Ray Skull <4 Vw	$110.38	$197.10	$25.62–$220.88	55% below	44%
Skull X-ray, fewer than 4 views CPT 70250 HC X-RAY SKULL <4 VW	$121.41	$216.80	$25.62–$220.88	50% below	44%
Sleep study in a lab (polysomnography) CPT 95810 HC Sleep Study-Psg	$2,457.67	$4,388.70	$1,836.00–$2,787.00	28% below	44%
Sleep study in a lab (polysomnography) CPT 95810 HC SLEEP STUDY-PSG	$2,752.57	$4,915.30	$1,836.00–$2,787.00	19% below	44%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC Echo Stress W Phy With Contrast	$1,263.98	$2,257.10	$677.13–$1,661.23	38% below	44%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC ECHO STRESS W PHY WITH CONTRAST	$1,263.98	$2,257.10	$677.13–$1,661.23	38% below	44%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Stress Echo W Supervision	$1,263.98	$2,257.10	$677.13–$1,661.23	38% below	44%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO W SUPERVISION	$1,263.98	$2,257.10	$677.13–$1,661.23	38% below	44%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC Video Fluoro Esophagus	$349.16	$623.50	$81.06–$753.86	24% below	44%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC VIDEO FLUORO ESOPHAGUS	$453.94	$810.60	$81.06–$753.86	1% below	44%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 XRAY FEMUR MINIMUM 2 VIEWS	$157.47	$281.20	$9.01–$261.52	36% below	44%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC Xray Femur Minimum 2 Views	$273.56	$488.50	$63.51–$467.98	11% above	44%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC XRAY FEMUR MINIMUM 2 VIEWS	$274.74	$490.60	$63.51–$467.98	12% above	44%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT Thoracic Sp W/O Contrast	$1,022.62	$1,826.10	$237.39–$2,654.96	34% below	44%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC SP W/O CONTRAST	$1,043.06	$1,862.60	$237.39–$2,654.96	32% below	44%
Toe X-ray, 2 or more views CPT 73660 X-RAY TOE(S)	$129.02	$230.40	$23.43–$214.27	36% below	44%
Toe X-ray, 2 or more views CPT 73660 HC X-Ray Toe(S)	$153.50	$274.10	$35.63–$331.36	24% below	44%
Toe X-ray, 2 or more views CPT 73660 HC X-RAY TOE(S)	$199.53	$356.30	$35.63–$331.36	1% below	44%
Transvaginal pelvic ultrasound CPT 76830 HC US Transvaginal	$341.94	$610.60	$79.38–$921.26	27% below	44%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL	$352.18	$628.90	$79.38–$921.26	25% below	44%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$580.27	$1,036.20	$97.44–$963.67	24% above	44%
Transvaginal ultrasound during pregnancy CPT 76817 HC Transvaginal US, Obstetric	$371.28	$663.00	$86.19–$687.46	5% below	44%
Transvaginal ultrasound during pregnancy CPT 76817 HC TRANSVAGINAL US, OBSTETRIC	$382.42	$682.90	$86.19–$687.46	2% below	44%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL (76817)	$449.06	$801.90	$63.88–$745.77	15% above	44%
Ultrasound of the abdomen, complete CPT 76700 HC US Abdomen Complete	$552.22	$986.10	$128.19–$1,051.83	19% below	44%
Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN COMPLETE	$568.79	$1,015.70	$128.19–$1,051.83	16% below	44%
Ultrasound of the scrotum and testicles CPT 76870 HC US Scrotum/Testicular	$376.60	$672.50	$87.43–$787.43	24% below	44%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM/TESTICULAR	$387.91	$692.70	$87.43–$787.43	21% below	44%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US Thyroid	$397.99	$710.70	$92.39–$787.43	22% below	44%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US THYROID	$409.92	$732.00	$92.39–$787.43	20% below	44%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$537.43	$959.70	$94.45–$892.52	5% above	44%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC Upper GI W Kub	$420.90	$751.60	$97.71–$797.01	39% below	44%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC UPPER GI W KUB	$463.01	$826.80	$97.71–$797.01	32% below	44%
Upper arm X-ray (humerus), 2 views CPT 73060 X-RAY HUMERUS	$142.58	$254.60	$8.28–$236.78	32% below	44%
Upper arm X-ray (humerus), 2 views CPT 73060 HC X-Ray Humerus	$207.09	$369.80	$48.07–$402.32	1% below	44%
Upper arm X-ray (humerus), 2 views CPT 73060 HC X-RAY HUMERUS	$227.81	$406.80	$48.07–$402.32	9% above	44%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC Duplex Extrem Venous,Uni or Ltd	$538.27	$961.20	$288.36–$792.30	25% below	44%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD	$602.84	$1,076.50	$288.36–$792.30	16% below	44%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Duplex Extrem Venous, Right	$538.27	$961.20	$288.36–$792.30	25% below	44%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Duplex Extrem Venous, Left	$538.27	$961.20	$288.36–$792.30	25% below	44%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUPLEX EXTREM VENOUS, LEFT	$602.84	$1,076.50	$288.36–$792.30	16% below	44%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUPLEX EXTREM VENOUS, RIGHT	$602.84	$1,076.50	$288.36–$792.30	16% below	44%
Wrist X-ray, 2 views CPT 73100 HC X-Ray Wrist 2 Vw	$115.86	$206.90	$26.90–$394.88	46% below	44%
Wrist X-ray, 2 views CPT 73100 HC X-RAY WRIST 2 VW	$137.14	$244.90	$26.90–$394.88	36% below	44%
Wrist X-ray, 2 views CPT 73100 X-RAY WRIST 2 VW	$149.91	$267.70	$8.28–$248.96	31% below	44%
Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY WRIST 3+ VW	$180.99	$323.20	$8.66–$300.58	29% below	44%
Wrist X-ray, complete, 3 or more views CPT 73110 HC X-Ray Wrist 3+ Vw	$183.68	$328.00	$42.64–$513.27	28% below	44%
Wrist X-ray, complete, 3 or more views CPT 73110 HC X-RAY WRIST 3+ VW	$238.78	$426.40	$42.64–$513.27	6% below	44%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XRAY HIP UNILATERAL WITH PELVIS 2-3 VIEWS	$207.93	$371.30	$11.14–$345.31	29% below	44%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Xray Hip Unilateral With Pelvis 2-3 Views	$315.90	$564.10	$73.33–$552.79	8% above	44%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC XRAY HIP UNILATERAL WITH PELVIS 2-3 VIEWS	$332.86	$594.40	$73.33–$552.79	14% above	44%
X-ray of the abdomen, 1 view CPT 74018 RADIOLOGIC EXAM ABDOMEN 1 VIEW	$132.33	$236.30	$9.01–$219.76	37% below	44%
X-ray of the abdomen, 1 view CPT 74018 HC Radiologic Exam Abdomen 1 View	$220.64	$394.00	$51.22–$453.47	5% above	44%
X-ray of the abdomen, 1 view CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW	$242.70	$433.40	$51.22–$453.47	15% above	44%
X-ray of the ankle, 2 views CPT 73600 HC Ankle Xray 2 View	$138.77	$247.80	$32.21–$253.52	30% below	44%
X-ray of the ankle, 2 views CPT 73600 ANKLE XRAY 2 VIEW	$143.98	$257.10	$8.28–$239.10	28% below	44%
X-ray of the ankle, 2 views CPT 73600 HC ANKLE XRAY 2 VIEW	$152.66	$272.60	$32.21–$253.52	23% below	44%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S)	$167.38	$298.90	$6.85–$277.98	32% below	44%
X-ray of the finger(s), 2 or more views CPT 73140 HC X-Ray Exam of Finger(S)	$178.42	$318.60	$41.42–$385.21	27% below	44%
X-ray of the finger(s), 2 or more views CPT 73140 HC X-RAY EXAM OF FINGER(S)	$231.95	$414.20	$41.42–$385.21	5% below	44%
X-ray of the foot, 2 views CPT 73620 X-RAY FOOT 2 VW	$124.77	$222.80	$7.61–$207.20	34% below	44%
X-ray of the foot, 2 views CPT 73620 HC X-Ray Foot 2 Vw	$203.28	$363.00	$47.19–$438.87	7% above	44%
X-ray of the foot, 2 views CPT 73620 HC X-RAY FOOT 2 VW	$264.26	$471.90	$47.19–$438.87	39% above	44%
X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY FOOT 3+ VW	$151.48	$270.50	$8.31–$251.57	37% below	44%
X-ray of the foot, complete, 3 or more views CPT 73630 HC X-Ray Foot 3+ Vw	$236.49	$422.30	$54.90–$481.18	2% below	44%
X-ray of the foot, complete, 3 or more views CPT 73630 HC X-RAY FOOT 3+ VW	$289.74	$517.40	$54.90–$481.18	20% above	44%
X-ray of the hand, 3 or more views CPT 73130 X-RAY HAND 3+ VW	$163.24	$291.50	$8.66–$271.10	30% below	44%
X-ray of the hand, 3 or more views CPT 73130 HC X-Ray Hand 3+ Vw	$233.52	$417.00	$54.21–$504.15	at median	44%
X-ray of the hand, 3 or more views CPT 73130 HC X-RAY HAND 3+ VW	$303.58	$542.10	$54.21–$504.15	29% above	44%
X-ray of the knee, 1 or 2 views CPT 73560 XRAY KNEE 1 OR 2 VW	$151.37	$270.30	$8.28–$251.38	29% below	44%
X-ray of the knee, 1 or 2 views CPT 73560 HC Xray Knee 1 or 2 Vw	$153.50	$274.10	$35.63–$450.31	28% below	44%
X-ray of the knee, 1 or 2 views CPT 73560 HC XRAY KNEE 1 OR 2 VW	$199.53	$356.30	$35.63–$450.31	6% below	44%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY LUMBAR SPINE 2 VW	$176.96	$316.00	$29.94–$293.88	39% below	44%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC X-Ray Lumbar Spine 2 Vw	$188.78	$337.10	$43.82–$393.30	35% below	44%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC X-RAY LUMBAR SPINE 2 VW	$236.82	$422.90	$43.82–$393.30	19% below	44%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY LUMBAR SPINE 4 VW	$227.47	$406.20	$13.38–$377.77	39% below	44%
X-ray of the lower back, 4 or more views CPT 72110 HC X-Ray Lumbar Spine 4 Vw	$236.49	$422.30	$54.90–$576.04	37% below	44%
X-ray of the lower back, 4 or more views CPT 72110 HC X-RAY LUMBAR SPINE 4 VW	$307.44	$549.00	$54.90–$576.04	18% below	44%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY DORSAL SPINE 2 VW	$145.77	$260.30	$23.78–$242.08	39% below	44%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC X-Ray Dorsal Spine 2 Vw	$184.63	$329.70	$42.86–$398.60	22% below	44%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC X-RAY DORSAL SPINE 2 VW	$240.02	$428.60	$42.86–$398.60	1% above	44%
X-ray of the nasal bones, 3 or more views CPT 70160 HC Nasal Bones Xray	$163.97	$292.80	$38.06–$329.59	32% below	44%
X-ray of the nasal bones, 3 or more views CPT 70160 HC NASAL BONES XRAY	$180.38	$322.10	$38.06–$329.59	26% below	44%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY CERV SPINE 3 VIEWS OR LESS	$175.45	$313.30	$11.14–$291.37	27% below	44%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC X-Ray Cerv Spine 3 Views or Less	$245.62	$438.60	$57.02–$448.73	2% above	44%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC X-RAY CERV SPINE 3 VIEWS OR LESS	$270.20	$482.50	$57.02–$448.73	12% above	44%
X-ray of the pelvis, 1 or 2 views CPT 72170 XRAY PELVIS 1 OR 2 VIEWS	$123.42	$220.40	$19.99–$204.97	44% below	44%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC Xray Pelvis 1 or 2 Views	$218.40	$390.00	$50.70–$423.62	1% below	44%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC XRAY PELVIS 1 OR 2 VIEWS	$240.24	$429.00	$50.70–$423.62	8% above	44%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM/COCCYX X-RAY	$144.09	$257.30	$24.80–$239.29	33% below	44%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Sacrum/Coccyx X-Ray	$231.22	$412.90	$53.68–$422.41	7% above	44%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC SACRUM/COCCYX X-RAY	$254.35	$454.20	$53.68–$422.41	18% above	44%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE	$157.42	$281.10	—	28% below	44%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE; ALANINE AMINO (ALT) (SGPT)	$21.62	$38.60	—	38% below	44%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT)	$21.62	$38.60	—	38% below	44%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT)	$21.06	$37.60	—	56% below	44%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$194.15	$346.70	—	36% below	44%
Albumin blood test CPT 82040 ALBUMIN	$20.16	$36.00	—	46% below	44%
Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN	$20.16	$36.00	—	46% below	44%
Aldosterone blood test CPT 82088 ALDOSTERONE ASSAY	$166.15	$296.70	—	15% below	44%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE, ALKALINE	$21.06	$37.60	—	57% below	44%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$21.06	$37.60	—	57% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE ANTIBODY, MULTI-ALLERGEN	$13.22	$23.60	—	47% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE ANTIBODY, SINGLE ALLERGEN	$13.22	$23.60	—	47% below	44%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN, TUMOR MARKER	$71.96	$128.50	—	14% below	44%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP SINGLE MARKER SCRN, MATERNAL	$71.96	$128.50	—	14% below	44%
Ammonia blood test CPT 82140 AMMONIUM, URINE	$59.42	$106.10	—	34% below	44%
Ammonia blood test CPT 82140 AMMONIA	$59.42	$106.10	—	34% below	44%
Amylase blood test CPT 82150 AMYLASE	$26.43	$47.20	—	57% below	44%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 C CITRULLINE PEP AB	$52.81	$94.30	—	36% below	44%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$52.81	$94.30	—	36% below	44%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES (ANA)	$42.45	$75.80	—	38% below	44%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BRAIN NATRIURETIC PEPTIDE	$138.38	$247.10	—	3% below	44%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PRO BNP	$138.38	$247.10	—	3% below	44%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$138.38	$247.10	—	3% below	44%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHR SPECIMN AEROBIC	$43.79	$78.20	—	17% below	44%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIA, AEROBIC	$43.79	$78.20	—	17% below	44%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$34.50	$61.60	—	61% below	44%
Bilirubin blood test, total CPT 82247 BILIRUBIN, TOTAL	$20.44	$36.50	—	56% below	44%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 MISC LEVEL IV	$39.65	$70.80	—	82% below	44%
Blood culture for bacteria CPT 87040 CULTURE, BLOOD	$52.81	$94.30	—	38% below	44%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture	$7.28	$13.00	—	50% below	44%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DRAWING BLOOD FOR SPEC(NON-MOB	$7.45	$13.30	—	49% below	44%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 LINE DRAW	$8.40	$15.00	—	43% below	44%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$8.40	$15.00	—	43% below	44%
Blood glucose (sugar) test CPT 82947 GLUCOSE; QUANTITATIVE, BLOOD	$13.22	$23.60	—	46% below	44%
Blood glucose (sugar) test CPT 82947 Glucose, Blood	$13.22	$23.60	—	46% below	44%
Blood glucose (sugar) test CPT 82947 GLUCOSE, BLOOD	$13.22	$23.60	—	46% below	44%
Blood lead test CPT 83655 LEAD	$49.34	$88.10	—	10% below	44%
Blood lead test CPT 83655 LEAD, BLOOD	$49.34	$88.10	—	10% below	44%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST, SERUM, QUAL	$38.42	$68.60	—	38% below	44%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING; ABO, COMMUNITY BLD CTR	$13.83	$24.70	—	67% below	44%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/RH	$13.83	$24.70	—	67% below	44%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING, ABO	$13.83	$24.70	—	67% below	44%
Blood urea nitrogen (BUN) test CPT 84520 BLOOD URIEA NITROGEN	$16.07	$28.70	—	38% below	44%
Blood urea nitrogen (BUN) test CPT 84520 BLOOD UREA NITROGEN, BLOOD	$16.07	$28.70	—	38% below	44%
C-peptide blood test CPT 84681 C-PEPTIDE ASSAY	$40.99	$73.20	—	53% below	44%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN	$25.20	$45.00	—	54% below	44%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$25.20	$45.00	—	54% below	44%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE TOXINS,PCR, STOOL	$143.02	$255.40	—	5% below	44%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$143.02	$255.40	—	5% below	44%
CA 19-9 blood test (tumor marker) CPT 86301 CARBOHYDRATE ANTIGEN 19-9	$84.84	$151.50	—	25% below	44%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY-TUMOR CA 19-9	$84.84	$151.50	—	25% below	44%
CA-125 blood test (ovarian cancer marker) CPT 86304 TUMOR ANTIGEN, QUANTITATIVE; CA125	$97.78	$174.60	—	19% below	44%
CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125	$97.78	$174.60	—	19% below	44%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 INFECTIOUS AGENT DETEC BY NUCLEIC ACID (SARS-COV-2), AMPLIFIED PROBE	$168.00	$300.00	—	24% above	44%
Calcium blood test, total CPT 82310 CALCIUM, TOTAL	$21.00	$37.50	—	60% below	44%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYOGENIC AG	$84.00	$150.00	—	38% below	44%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER VIRUS AB, IGG	$25.82	$46.10	—	65% below	44%
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY; VARICELLA-ZOSTER	$25.82	$46.10	—	65% below	44%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER VIRUS AB, IGM	$25.82	$46.10	—	65% below	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE	$143.02	$255.40	—	at median	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMATIS, DNA OR RNA	$143.02	$255.40	—	at median	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMATIS,AMP,RNA	$143.02	$255.40	—	at median	44%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$54.60	$97.50	—	39% below	44%
Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CT W/DIFF	$31.81	$56.80	—	56% below	44%
Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CT W/MANUAL DIFF	$26.38	$47.10	—	50% below	44%
Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CT NO DIFF	$26.38	$47.10	—	50% below	44%
Comprehensive metabolic panel (blood test) CPT 80053 PANEL, COMPREHENSIVE METABOLIC	$43.06	$76.90	—	62% below	44%
Cortisol blood test, total CPT 82533 CORTISOL, TOTAL	$66.47	$118.70	—	45% below	44%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE (CK), (CPK); TOTAL	$26.54	$47.40	—	58% below	44%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE ASSAY	$26.54	$47.40	—	58% below	44%
Creatinine blood test CPT 82565 CREATININE, SERUM	$20.89	$37.30	—	34% below	44%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS (CMV)	$58.63	$104.70	—	17% below	44%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER, QUANTITATIVE	$40.82	$72.90	—	49% below	44%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER REFLEX	$40.82	$72.90	—	49% below	44%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$90.61	$161.80	—	36% below	44%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST(S), PRESUMPTIVE W/CONFIRM, BY CHEM INSTRUMENT, PER DAY	$185.98	$332.10	—	60% above	44%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST(S), PRESUMPTIVE, BY CHEM INSTRUMENT, PER DAY	$185.98	$332.10	—	60% above	44%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST(S), PRESUMPTIVE W/CONFIRM, COC, BY CHEM INSTRUMENT, PER DAY	$185.98	$332.10	—	60% above	44%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES	$28.62	$51.10	—	41% below	44%
Epstein-Barr virus (EBV) antibody test CPT 86665 ANTIBODY, EPSTEIN BARR VIRUS, VIRAL CAPSID	$76.78	$137.10	—	7% below	44%
Estradiol blood test CPT 82670 ESTRADIOL	$113.90	$203.40	—	11% below	44%
Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL	$113.90	$203.40	—	11% below	44%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE	$75.77	$135.30	—	35% below	44%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL	$83.38	$148.90	—	56% below	44%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$55.55	$99.20	—	39% below	44%
Fibrinogen blood test CPT 85384 FIBRINOGEN; ACTIVITY, TEG	$37.80	$67.50	—	44% below	44%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$37.80	$67.50	—	44% below	44%
Folate (folic acid) blood test CPT 82746 FOLIC ACID (FOLATE), SERUM	$59.92	$107.00	—	39% below	44%
Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3)	$48.16	$86.00	—	51% below	44%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$48.16	$86.00	—	51% below	44%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, FREE	$36.74	$65.60	—	55% below	44%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$36.74	$65.60	—	55% below	44%
Free testosterone test CPT 84402 TESTOSTERONE,FREE	$103.77	$185.30	—	12% below	44%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT(GGT)	$29.34	$52.40	—	45% below	44%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE, GAMMA (GGT)	$29.34	$52.40	—	45% below	44%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$131.94	$235.60	—	52% below	44%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 ORAL GLUCOSE TOLERANCE	$16.18	$28.90	—	67% below	44%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE, 1 HR GESTATIONAL SCRN	$16.18	$28.90	—	67% below	44%
Glucose tolerance test, 3 samples CPT 82951 LAB-GLUC TOLER/GTT 3 SPC	$44.41	$79.30	—	51% below	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECH	$143.02	$255.40	—	at median	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECHNIQUE	$143.02	$255.40	—	at median	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, AMPLIFIED PROBE	$143.02	$255.40	—	at median	44%
H. pylori stool antigen test CPT 87338 H.PYLORI ANTIGEN,FECES	$61.21	$109.30	—	53% below	44%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA, QUANT, BLOOD	$346.86	$619.40	—	10% below	44%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT/REFLEX TO GENOTYPE, BLOOD	$346.86	$619.40	—	10% below	44%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 AND 2	$55.89	$99.80	—	28% below	44%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$98.17	$175.30	—	4% below	44%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HUMAN PAPILLOMA VIRUS	$143.02	$255.40	—	at median	44%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HUMAN PAPILLOMA VIRUS HIGH RISK	$143.02	$255.40	—	at median	44%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HUMAN PAPILLOMA VIRUS HIGH RISK FOR MEDICARE 30-65	$143.02	$255.40	—	at median	44%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HBA1C AND EST AV GLU,BLOOD	$40.82	$72.90	—	41% below	44%
Hemoglobin blood test CPT 85018 HEMOGLOBIN, BLOOD COUNT	$8.40	$15.00	—	52% below	44%
Hemoglobin blood test CPT 85018 HEMOGLOBIN BY HEMOCUE METHOD (POCT)	$8.62	$15.40	—	51% below	44%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY	$49.11	$87.70	—	39% below	44%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY	$43.79	$78.20	—	41% below	44%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$42.11	$75.20	—	35% below	44%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$58.18	$103.90	—	27% below	44%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA,QUANT,BDNA	$174.72	$312.00	—	26% below	44%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA, QUANT,RT-PCR	$174.72	$312.00	—	26% below	44%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX,TYPE 1	$53.76	$96.00	—	21% below	44%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX,TYPE 2	$78.90	$140.90	—	3% below	44%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN, HIGH SENS	$55.22	$98.60	—	31% below	44%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN; HIGH SENSITIVITY	$55.22	$98.60	—	31% below	44%
High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVITY CRP,BLOOD	$55.22	$98.60	—	31% below	44%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$74.37	$132.80	—	37% below	44%
Insulin blood test CPT 83525 INSULIN; TOTAL	$46.59	$83.20	—	31% below	44%
Insulin blood test CPT 83525 INSULIN, SERUM	$46.59	$83.20	—	31% below	44%
Iron blood test (serum iron) CPT 83540 IRON	$26.38	$47.10	—	51% below	44%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$38.42	$68.60	—	38% below	44%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$44.41	$79.30	—	57% below	44%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING HORMONE (LH)	$75.49	$134.80	—	23% below	44%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE (LH)	$75.49	$134.80	—	23% below	44%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID ASSAY	$46.82	$83.60	—	33% below	44%
Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID	$46.82	$83.60	—	33% below	44%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME	$28.22	$50.40	—	44% below	44%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$35.39	$63.20	—	48% below	44%
Liver function blood test panel CPT 80076 LIVER PANEL	$33.60	$60.00	—	67% below	44%
Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI ANTIBODY (LYME DISEASE)	$69.44	$124.00	—	17% below	44%
Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI IGG ANTIBODY (LYME DISEASE)	$69.44	$124.00	—	17% below	44%
Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI IGM ANTIBODY (LYME DISEASE)	$69.44	$124.00	—	17% below	44%
Magnesium blood test CPT 83735 ASSAY MAGNESIUM	$34.22	$61.10	—	35% below	44%
Magnesium blood test CPT 83735 MAGNESIUM	$34.22	$61.10	—	35% below	44%
Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) ANTIBODIES, I	$54.60	$97.50	—	34% below	44%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSPOT	$16.80	$30.00	—	70% below	44%
Mumps immunity blood test CPT 86735 ANTIBODY; MUMPS	$53.20	$95.00	—	38% below	44%
PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATE SPECIFIC ANTIGEN, FREE	$74.98	$133.90	—	19% below	44%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN	$74.98	$133.90	—	21% below	44%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN, TOTAL	$74.98	$133.90	—	21% below	44%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPC AG, SYMPTOMATIC	$74.98	$133.90	—	21% below	44%
Pap test (liquid-based, automated screening with review) CPT 88175 IMAGED THINPREP PAP SMEAR, DIAGNOSTIC	$105.28	$188.00	—	at median	44%
Pap test (liquid-based, automated screening with review) CPT 88175 IMAGED THINPREP PAP SMEAR, SCREEN	$105.28	$188.00	—	at median	44%
Pap test (liquid-based, automated screening with review) CPT 88175 IMAGED THINPREP PAP SMEAR	$105.28	$188.00	—	at median	44%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THINPREP PAP	$80.92	$144.50	—	10% below	44%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE (PTH)INTACT	$168.28	$300.50	—	21% below	44%
Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE	$168.28	$300.50	—	21% below	44%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME	$24.47	$43.70	—	53% below	44%
Phosphorus (phosphate) blood test CPT 84100 ASSAY PHOSPHORUS	$19.32	$34.50	—	54% below	44%
Potassium blood test CPT 84132 POTASSIUM, SERUM	$18.76	$33.50	—	32% below	44%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQUENCE	$2,333.24	$4,166.50	—	93% above	44%
Progesterone blood test CPT 84144 PROGESTERONE	$75.82	$135.40	—	37% below	44%
Prolactin blood test CPT 84146 PROLACTIN ASSAY	$78.96	$141.00	—	35% below	44%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$12.26	$21.90	—	64% below	44%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST, PRESUMPTIVE, QUAL-DIRECT OPTICAL OBS, PER DAY	$43.51	$77.70	—	24% below	44%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A OR B DIFFERENTIATED	$52.81	$94.30	—	at median	44%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID GROUP A STREP THROAT SCREEN	$40.82	$72.90	—	10% below	44%
Renin blood test CPT 84244 RENIN ACTIVITY, PLASMA	$89.66	$160.10	—	39% below	44%
Rh blood typing CPT 86901 BLOOD TYPING; RH(D), COMMUNITY BLD CTR	$13.83	$24.70	—	65% below	44%
Rh blood typing CPT 86901 BLOOD TYPING, RH (D)	$13.83	$24.70	—	65% below	44%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR,SERUM	$23.13	$41.30	—	60% below	44%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE	$23.13	$41.30	—	60% below	44%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR, BLOOD	$23.13	$41.30	—	60% below	44%
Rheumatoid factor (RF) test CPT 86431 RA TITER	$23.13	$41.30	—	60% below	44%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY; RUBELLA	$58.63	$104.70	—	29% below	44%
Rubella antibody test (immunity check) CPT 86762 RUBELLA	$58.63	$104.70	—	29% below	44%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR,AUTO (SED-RATE)	$12.60	$22.50	—	70% below	44%
Sodium blood test CPT 84295 SODIUM, SERUM	$19.60	$35.00	—	21% below	44%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES	$37.80	$67.50	—	42% below	44%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD X 3, STOOL	$10.19	$18.20	—	52% below	44%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL OCCULT BLOOD	$53.98	$96.40	—	11% below	44%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS CONFIRMATION	$34.78	$62.10	—	37% below	44%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS ANTIBODY	$34.78	$62.10	—	37% below	44%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, SPINAL FLUID	$21.62	$38.60	—	45% below	44%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SEROLOGY	$21.62	$38.60	—	45% below	44%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST, VDRL, SERUM	$21.62	$38.60	—	45% below	44%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD, BLOOD	$252.62	$451.10	—	at median	44%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL	$102.76	$183.50	—	11% below	44%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES, EACH	$59.30	$105.90	—	15% below	44%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB	$59.30	$105.90	—	15% below	44%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER/KIDNEY MICROSOME TYPE I A	$59.30	$105.90	—	15% below	44%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE AB, SERUM	$59.30	$105.90	—	15% below	44%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH)	$68.49	$122.30	—	24% below	44%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$68.49	$122.30	—	24% below	44%
Total IgE blood test CPT 82785 ALLERGY,FOOD PANEL,PEDIATRIC	$69.61	$124.30	—	32% below	44%
Total IgE blood test CPT 82785 ALLERGY,FOOD PANEL,ADULT	$69.61	$124.30	—	32% below	44%
Total IgE blood test CPT 82785 ALLERGY,ENVIRO PANEL,ADULT	$69.61	$124.30	—	32% below	44%
Total IgE blood test CPT 82785 IGE IMMUNOGLOBULIN, SERUM	$69.61	$124.30	—	32% below	44%
Total cholesterol blood test CPT 82465 CHOLESTEROL, SERUM	$17.75	$31.70	—	62% below	44%
Total thyroxine (T4) blood test CPT 84436 ASSAY OF TOTAL THYROXINE	$29.40	$52.50	—	43% below	44%
Total thyroxine (T4) blood test CPT 84436 T4	$29.40	$52.50	—	43% below	44%
Total triiodothyronine (T3) blood test CPT 84480 T3, TOTAL ONLY	$59.98	$107.10	—	44% below	44%
Transferrin blood test CPT 84466 TRANSFERRIN	$52.08	$93.00	—	45% below	44%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$143.02	$255.40	—	5% above	44%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS, AMP PROBE TECHNIQUE	$143.02	$255.40	—	5% above	44%
Triglycerides blood test CPT 84478 TRYGLYCERIDES	$24.02	$42.90	—	55% below	44%
Troponin test, quantitative CPT 84484 TROPONIN	$50.40	$90.00	—	40% below	44%
Uric acid blood test CPT 84550 URIC ACID ASSAY	$18.42	$32.90	—	64% below	44%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS,AUTO,W/MICRO	$10.19	$18.20	—	72% below	44%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS,NONAUTO,W/MICRO	$10.19	$18.20	—	18% below	44%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, DIP ONLY, AUTO	$7.00	$12.50	—	72% below	44%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS, DIP ONLY, NONAUTO	$8.01	$14.30	—	42% below	44%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE, COLONY COUNT	$38.42	$68.60	—	49% below	44%
Urine microalbumin (albumin) test CPT 82043 URINE, MICROALBUMIN, QUANTITATIVE	$24.02	$42.90	—	63% below	44%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST, URINE, QUAL	$21.62	$38.60	—	56% below	44%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$61.43	$109.70	—	40% below	44%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY D2/D3	$120.68	$215.50	—	22% below	44%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$120.68	$215.50	—	22% below	44%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D,1,25-DIHYDROXY, SERUM	$156.91	$280.20	—	2% below	44%
Zinc blood test CPT 84630 ZINC ASSAY	$42.22	$75.40	—	47% below	44%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN, CHORIONIC (HCG) TOTAL	$58.80	$105.00	—	50% below	44%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL ADENOIDS,PRIMARY,<12 Y/O	$1,393.78	$2,488.90	$746.67–$1,831.83	at median	44%
Adenoid removal (adenoidectomy), child under 12 CPT 42830 HC Removal Adenoids,Primary,<12 Y/O	$4,797.58	$8,567.10	$2,570.13–$6,997.67	244% above	44%
Adenoid removal (adenoidectomy), child under 12 CPT 42830 HC REMOVAL ADENOIDS,PRIMARY,<12 Y/O	$4,941.50	$8,824.10	$2,570.13–$6,997.67	255% above	44%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 HC Neck Spine Fuse&Remove Addl	$6,937.95	$12,389.20	$3,716.76–$18,563.39	at median	44%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 HC NECK SPINE FUSE&REMOVE ADDL	$9,019.36	$16,106.00	$3,716.76–$18,563.39	30% above	44%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 HC Appendectomy,Rupt Appendx+Abscess	$4,862.31	$8,682.70	$2,604.81–$6,582.20	at median	44%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 HC APPENDECTOMY,RUPT APPENDX+ABSCESS	$5,008.19	$8,943.20	$2,604.81–$6,582.20	3% above	44%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY,RUPT APPENDX+ABSCESS	$5,454.06	$9,739.40	$2,921.82–$7,168.20	12% above	44%
Appendectomy, open surgery CPT 44950 HC Appendectomy	$2,439.70	$4,356.60	$1,306.98–$6,699.37	at median	44%
Appendectomy, open surgery CPT 44950 HC APPENDECTOMY	$3,171.84	$5,664.00	$1,306.98–$6,699.37	30% above	44%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 HC Knee Scope,Aid Ant Cruciate Repair	$11,779.38	$21,034.60	$6,310.38–$15,945.88	at median	44%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 HC KNEE SCOPE,AID ANT CRUCIATE REPAIR	$12,132.74	$21,665.60	$6,310.38–$15,945.88	3% above	44%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 ARTHROSCOP ROTATOR CUFF REPR	$5,268.87	$9,408.70	$2,822.61–$6,924.80	at median	44%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 HC Arthroscop Rotator Cuff Repr	$10,984.62	$19,615.40	$5,884.62–$14,720.00	108% above	44%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 HC ARTHROSCOP ROTATOR CUFF REPR	$11,200.00	$20,000.00	$5,884.62–$14,720.00	113% above	44%
Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC Maxillary Sinus Endo W/Balloon Dil	$4,424.84	$7,901.50	$2,370.45–$5,990.01	131% above	44%
Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC MAXILLARY SINUS ENDO W/BALLOON DIL	$4,557.62	$8,138.60	$2,370.45–$5,990.01	138% above	44%
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$732.98	$1,308.90	$305.76–$963.35	at median	44%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE	$1,814.96	$3,241.00	$306.33–$2,385.38	29% below	44%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC Bx Breast W Device 1st Lesion Stereotactic Guide	$2,152.98	$3,844.60	$1,153.38–$2,956.81	15% below	44%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE	$2,217.54	$3,959.90	$1,153.38–$2,956.81	13% below	44%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC Cltx Dstl Fibular Fx Lat Malls W/O Manj	$418.54	$747.40	$224.22–$723.12	24% below	44%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$456.18	$814.60	$224.22–$723.12	17% below	44%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT	$4,489.69	$8,017.30	$1,388.85–$5,900.73	at median	44%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HC Corrj Hallux Valgus W/Sesmdc W/Dist Metar Osteot	$5,300.85	$9,465.80	$2,839.74–$7,175.85	18% above	44%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HC CORRJ HALLUX VALGUS W/SESMDC W/DIST METAR OSTEOT	$5,459.89	$9,749.80	$2,839.74–$7,175.85	22% above	44%
Bunion correction with removal of part of the big toe joint CPT 28292 CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE	$3,517.58	$6,281.40	$1,308.09–$4,623.11	38% below	44%
Bunion correction with removal of part of the big toe joint CPT 28292 HC Corrj Hallux Valgus W/Sesmdc W/Rescj Prox Phal	$5,300.85	$9,465.80	$2,839.74–$7,175.85	6% below	44%
Bunion correction with removal of part of the big toe joint CPT 28292 HC CORRJ HALLUX VALGUS W/SESMDC W/RESCJ PROX PHAL	$5,459.89	$9,749.80	$2,839.74–$7,175.85	3% below	44%
Cardiac catheterization with coronary angiogram CPT 93458 HC L HRT ARTERY/VENTRICLE ANGIO (93458)	$7,248.64	$12,944.00	$9,180.00–$13,345.00	26% below	44%
Cardiac catheterization with coronary angiogram CPT 93458 HC L Hrt Artery/Ventricle Angio (93458)	$7,629.94	$13,624.90	$9,180.00–$13,345.00	22% below	44%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HEART ELECTROCARDIOVERSION (92960)	$766.19	$1,368.20	$283.17–$1,007.00	22% below	44%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION	$1,177.51	$2,102.70	$630.81–$1,547.59	20% above	44%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC-ELECTIVE CARDIOVERSION	$1,177.51	$2,102.70	$630.81–$1,547.59	20% above	44%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC-Elective Cardioversion	$1,177.51	$2,102.70	$630.81–$1,547.59	20% above	44%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion(92960)	$1,177.51	$2,102.70	$630.81–$1,547.59	20% above	44%
Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY MEDIAN NERVE CARPL	$2,228.86	$3,980.10	$1,172.07–$2,929.35	at median	44%
Carpal tunnel release, open surgery CPT 64721 HC Neuroplasty Median Nerve Carpl	$3,185.28	$5,688.00	$1,706.40–$4,311.93	43% above	44%
Carpal tunnel release, open surgery CPT 64721 HC NEUROPLASTY MEDIAN NERVE CARPL	$3,280.82	$5,858.60	$1,706.40–$4,311.93	47% above	44%
Cataract surgery with lens implant CPT 66984 HC Remv Cataract Extracap,Insert	$4,048.18	$7,228.90	$3,799.00	at median	44%
Cataract surgery with lens implant CPT 66984 HC REMV CATARACT EXTRACAP,INSERT	$4,169.65	$7,445.80	$3,799.00	3% above	44%
Catheter ablation for atrial fibrillation CPT 93656 COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$5,355.78	$9,563.90	$24,720.00–$27,869.00	70% below	44%
Catheter ablation for atrial fibrillation CPT 93656 TX ATRIAL FIB PULM VEIN ISOL	$23,306.25	$41,618.30	$24,720.00–$27,869.00	32% above	44%
Catheter ablation for atrial fibrillation CPT 93656 HC Ep/Transseptal/a Fib Abl W Vein Isolation (93656)	$23,306.25	$41,618.30	$24,720.00–$27,869.00	32% above	44%
Cervical biopsy CPT 57500 BIOPSY/EXCIS CERVICAL LESN	$592.65	$1,058.30	$149.94–$778.91	at median	44%
Cervical biopsy CPT 57500 HC Biopsy/Excis Cervical Lesn	$844.09	$1,507.30	$452.19–$1,666.01	42% above	44%
Cervical biopsy CPT 57500 HC BIOPSY/EXCIS CERVICAL LESN	$1,097.32	$1,959.50	$452.19–$1,666.01	85% above	44%
Cesarean delivery, including prenatal and postpartum care CPT 59510 FULL ROUT OBSTE CARE,CESAREAN DELIV	$5,437.94	$9,710.60	$2,913.18–$7,147.00	at median	44%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC Circumcision,Othr	$929.04	$1,659.00	$497.70–$5,955.56	at median	44%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC CIRCUMCISION,OTHR	$956.93	$1,708.80	$497.70–$5,955.56	3% above	44%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC Circumcision	$136.64	$244.00	$73.20–$187.68	33% below	44%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC Circumcision,Clamp,Newborn	$136.64	$244.00	$73.20–$187.68	33% below	44%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION	$142.80	$255.00	$73.20–$187.68	30% below	44%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION,CLAMP,NEWBORN	$142.80	$255.00	$73.20–$187.68	30% below	44%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION,CLAMP,NEWBORN	$766.86	$1,369.40	$261.42–$1,007.88	276% above	44%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION,OTHR,NEWBORN	$742.28	$1,325.50	$397.65–$1,498.72	at median	44%
Circumcision, surgical, older than a newborn CPT 54160 HC Circumcision,Othr,Newborn	$2,835.22	$5,062.90	$1,518.87–$3,838.09	282% above	44%
Circumcision, surgical, older than a newborn CPT 54160 HC CIRCUMCISION,OTHR,NEWBORN	$2,920.29	$5,214.80	$1,518.87–$3,838.09	293% above	44%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC Closed Rx Dist Rad/Ulna Fx	$1,250.37	$2,232.80	$669.84–$1,692.65	103% above	44%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLOSED RX DIST RAD/ULNA FX	$1,287.89	$2,299.80	$669.84–$1,692.65	109% above	44%
Colonoscopy with endoscopic ultrasound CPT 45391 HC Colonoscopy W/Endoscope US	$2,369.02	$4,230.40	$1,269.12–$4,093.19	5% below	44%
Colonoscopy with endoscopic ultrasound CPT 45391 HC COLONOSCOPY W/ENDOSCOPE US	$2,440.09	$4,357.30	$1,269.12–$4,093.19	2% below	44%
Colonoscopy with polyp removal CPT 45385 HC Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$1,928.58	$3,443.90	$1,033.17–$2,610.74	21% below	44%
Colonoscopy with polyp removal CPT 45385 HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$1,986.43	$3,547.20	$1,033.17–$2,610.74	19% below	44%
Colonoscopy with tissue sample CPT 45380 HC Colonoscopy W/Biopsy Single/Multiple	$1,928.58	$3,443.90	$1,033.17–$3,574.75	6% below	44%
Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$1,986.43	$3,547.20	$1,033.17–$3,574.75	3% below	44%
Colonoscopy, diagnostic CPT 45378 HC Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$1,741.38	$3,109.60	$932.88–$2,357.33	at median	44%
Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$1,793.62	$3,202.90	$932.88–$2,357.33	3% above	44%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$2,233.11	$3,987.70	$630.21–$2,934.95	28% above	44%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPY,LOOP ELECTRD CERVIX EXCIS	$1,209.66	$2,160.10	$317.82–$1,589.83	41% above	44%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC Colposcopy,Loop Electrd Cervix Excis	$3,547.15	$6,334.20	$1,900.26–$5,285.80	312% above	44%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC COLPOSCOPY,LOOP ELECTRD CERVIX EXCIS	$3,653.55	$6,524.20	$1,900.26–$5,285.80	325% above	44%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC Colposcopy,Bx Cervix/Endocerv Curr	$522.42	$932.90	$279.87–$707.22	15% above	44%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC COLPOSCOPY,BX CERVIX/ENDOCERV CURR	$538.10	$960.90	$279.87–$707.22	19% above	44%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY,BX CERVIX/ENDOCERV CURR	$640.30	$1,143.40	$265.47–$841.54	41% above	44%
Complex cataract surgery with lens implant CPT 66982 HC Cataract Surgery Complex	$4,048.18	$7,228.90	$3,799.00	at median	44%
Complex cataract surgery with lens implant CPT 66982 HC CATARACT SURGERY COMPLEX	$4,169.65	$7,445.80	$3,799.00	3% above	44%
Coronary stent placement, one artery CPT 92928 PERQ TCAT PLMT NTRAC ST 1 LES 1+C SEGMENTS	$2,675.51	$4,777.70	$24,463.00	66% below	44%
Coronary stent placement, one artery CPT 92928 HC Stent, Bare Metal Cor Major Artery or Branch (92928)	$6,898.30	$12,318.40	$24,463.00	12% below	44%
Coronary stent placement, one artery CPT 92928 HC STENT, BARE METAL COR MAJOR ARTERY OR BRANCH (92928)	$6,898.30	$12,318.40	$24,463.00	12% below	44%
Cystoscopy with ureteral stent placement CPT 52332 HC Cystoscopy,Insert Ureteral Stent	$5,391.85	$9,628.30	$2,888.49–$8,832.00	24% above	44%
Cystoscopy with ureteral stent placement CPT 52332 HC CYSTOSCOPY,INSERT URETERAL STENT	$6,720.00	$12,000.00	$2,888.49–$8,832.00	54% above	44%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC Cystourethroscopy	$1,388.86	$2,480.10	$744.03–$1,880.11	40% above	44%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY	$1,430.52	$2,554.50	$744.03–$1,880.11	44% above	44%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION/CURETTAGE,DIAGNOSTIC	$1,133.83	$2,024.70	$471.03–$1,490.18	at median	44%
D&C (dilation and curettage), not related to pregnancy CPT 58120 HC Dilation/Curettage,Diagnostic	$3,547.15	$6,334.20	$1,900.26–$5,285.80	213% above	44%
D&C (dilation and curettage), not related to pregnancy CPT 58120 HC DILATION/CURETTAGE,DIAGNOSTIC	$3,653.55	$6,524.20	$1,900.26–$5,285.80	222% above	44%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESION 1ST	$240.24	$429.00	$104.25–$315.74	33% above	44%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING,GEN ANESTH	$610.62	$1,090.40	$327.12–$802.53	at median	44%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 HC Create Eardrum Opening,Gen Anesth	$2,433.70	$4,345.90	$1,303.77–$3,626.64	299% above	44%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 HC CREATE EARDRUM OPENING,GEN ANESTH	$2,506.73	$4,476.30	$1,303.77–$3,626.64	311% above	44%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING,LOCAL ANESTH	$781.20	$1,395.00	$271.08–$1,026.72	49% above	44%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC Create Eardrum Opening,Local Anesth	$839.83	$1,499.70	$449.91–$1,136.90	61% above	44%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC CREATE EARDRUM OPENING,LOCAL ANESTH	$865.03	$1,544.70	$449.91–$1,136.90	66% above	44%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC Removal Impacted Cerumen Irrigation/Lvg Unilat	$139.16	$248.50	$74.55–$188.42	50% above	44%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$143.36	$256.00	$74.55–$188.42	55% above	44%
Earwax removal with instruments, one ear CPT 69210 HC Remove Impacted Ear Wax	$173.26	$309.40	$92.82–$234.56	107% above	44%
Earwax removal with instruments, one ear CPT 69210 HC REMOVE IMPACTED EAR WAX	$178.47	$318.70	$92.82–$234.56	113% above	44%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$387.24	$691.50	$125.76–$508.94	43% above	44%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC Biopsy of Uterus Lining	$389.20	$695.00	$208.50–$526.90	43% above	44%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC BIOPSY OF UTERUS LINING	$400.90	$715.90	$208.50–$526.90	48% above	44%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 HC Nasal/Sinus Ndsc W/Total Ethoidectomy	$5,667.09	$10,119.80	$3,035.94–$7,671.62	at median	44%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 HC NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY	$5,837.10	$10,423.40	$3,035.94–$7,671.62	3% above	44%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 HC Nasal/Sinus Ndsc W/Rmvl Tiss From Frontal Sinus	$4,424.84	$7,901.50	$2,370.45–$5,990.01	at median	44%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 HC NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS	$4,557.62	$8,138.60	$2,370.45–$5,990.01	3% above	44%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 HC Nasal Scopy,Open Maxill Sinus	$2,896.04	$5,171.50	$1,551.45–$3,920.45	21% above	44%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 HC NASAL SCOPY,OPEN MAXILL SINUS	$2,982.95	$5,326.70	$1,551.45–$3,920.45	25% above	44%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 HC Nasal Scopy,Rmv Tiss Maxill Sinus	$4,073.27	$7,273.70	$2,182.11–$5,514.04	at median	44%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 HC NASAL SCOPY,RMV TISS MAXILL SINUS	$4,195.46	$7,491.90	$2,182.11–$5,514.04	3% above	44%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn	$1,147.44	$2,049.00	$614.70–$1,552.67	13% below	44%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn(62321)	$1,147.44	$2,049.00	$614.70–$2,083.10	13% below	44%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN(62321)	$1,181.38	$2,109.60	$614.70–$2,083.10	11% below	44%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN	$1,181.38	$2,109.60	$614.70–$1,552.67	11% below	44%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN(62321)	$1,336.27	$2,386.20	$285.90–$1,756.24	1% above	44%
Eye injection into the vitreous (intravitreal injection) CPT 67028 HC INTRAVITREAL NJX PHARMACOLOGIC AGT SPX	$752.25	$1,343.30	$391.26–$1,261.95	86% above	44%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT FACET LUMBAR/SACRAL 1 LEVEL (64493)	$894.15	$1,596.70	$241.14–$1,175.17	45% below	44%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC Inj Paravert Facet Lumbar/Sacral 1 Level (64493)	$1,482.82	$2,647.90	$794.37–$2,007.29	8% below	44%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ PARAVERT FACET LUMBAR/SACRAL 1 LEVEL (64493)	$1,527.29	$2,727.30	$794.37–$2,007.29	6% below	44%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 HC Init Rpr Sliding Hernia of Abd 3-10 Cm	$6,402.09	$11,432.30	$3,429.69–$12,763.20	at median	44%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 HC INIT RPR SLIDING HERNIA OF ABD 3-10 CM	$6,594.17	$11,775.30	$3,429.69–$12,763.20	3% above	44%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 HC Init Rpr Sliding Hernia of Abd > 10 Cm	$6,402.09	$11,432.30	$3,429.69–$12,763.20	at median	44%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 HC INIT RPR SLIDING HERNIA OF ABD > 10 CM	$6,594.17	$11,775.30	$3,429.69–$12,763.20	3% above	44%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$2,114.00	$3,775.00	$1,132.50–$2,778.40	at median	44%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 HC Init Rpr Ss Hernia 1st < 3cm Red	$6,402.09	$11,432.30	$3,429.69–$12,763.20	203% above	44%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 HC INIT RPR SS HERNIA 1ST < 3CM RED	$6,594.17	$11,775.30	$3,429.69–$12,763.20	212% above	44%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD	$1,232.56	$2,201.00	$192.75–$1,619.94	44% above	44%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC Sigmoidoscopy Flx Dx W/Collj Spec Br/Wa if Pfrmd	$1,479.86	$2,642.60	$792.78–$2,013.03	73% above	44%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD	$1,524.26	$2,721.90	$792.78–$2,013.03	78% above	44%
Gallbladder removal, laparoscopic CPT 47562 HC Cholecystectomy Laparoscopic	$8,873.59	$15,845.70	$4,753.71–$19,643.99	4% below	44%
Gallbladder removal, laparoscopic CPT 47562 HC CHOLECYSTECTOMY LAPAROSCOPIC	$9,139.82	$16,321.10	$4,753.71–$19,643.99	1% below	44%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC CHOLE WITH CHOLANGIOGRAPHY	$8,429.68	$15,053.00	$4,515.90–$11,662.44	10% below	44%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC Chole With Cholangiography	$8,873.59	$15,845.70	$4,515.90–$11,662.44	5% below	44%
Gallbladder removal, open surgery through a larger incision CPT 47600 HC REMOVAL OF GALLBLADDER	$2,808.06	$5,014.40	$1,504.32–$4,710.55	at median	44%
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE,ONE	$2,716.39	$4,850.70	$1,041.75–$3,570.12	at median	44%
Hammertoe correction surgery CPT 28285 HC Repair of Hammertoe,One	$3,062.98	$5,469.60	$1,640.88–$4,146.40	13% above	44%
Hammertoe correction surgery CPT 28285 HC REPAIR OF HAMMERTOE,ONE	$3,154.87	$5,633.70	$1,640.88–$4,146.40	16% above	44%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC Ligation of Hemorrhoid(S)	$1,391.77	$2,485.30	$745.59–$2,013.03	8% above	44%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC LIGATION OF HEMORRHOID(S)	$1,472.46	$2,629.40	$745.59–$2,013.03	15% above	44%
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S)	$1,867.49	$3,334.80	$671.70–$2,454.41	46% above	44%
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY,INT/EXT,SIMPLE	$3,398.64	$6,069.00	$1,224.96–$4,466.78	at median	44%
Hemorrhoidectomy (internal and external), one area CPT 46255 HC Hemorrhoidectomy,Int/Ext,Simple	$4,284.39	$7,650.70	$2,295.21–$5,799.83	26% above	44%
Hemorrhoidectomy (internal and external), one area CPT 46255 HC HEMORRHOIDECTOMY,INT/EXT,SIMPLE	$4,412.91	$7,880.20	$2,295.21–$5,799.83	30% above	44%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 CONVERT HIP REVSN TO TOTAL HIP	$8,157.97	$14,567.80	$4,370.34–$10,721.90	at median	44%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 HC TOTAL HIP ARTHROPLASTY	$22,036.00	$39,350.00	$11,805.00–$41,475.29	170% above	44%
Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABDOM HYSTERECTOMY	$3,793.55	$6,774.20	$2,032.26–$4,985.81	at median	44%
Hysterectomy through an abdominal incision (total) CPT 58150 HC Total Abdominal Hysterect W/WO Rmvl Tube Ovary	$9,910.15	$17,696.70	$5,309.01–$17,122.67	161% above	44%
Hysterectomy through an abdominal incision (total) CPT 58150 HC TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY	$10,207.46	$18,227.60	$5,309.01–$17,122.67	169% above	44%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC Cath/Inject Hysterosalpingogram	$231.22	$412.90	$123.87–$313.02	31% below	44%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC CATH/INJECT HYSTEROSALPINGOGRAM	$238.17	$425.30	$123.87–$313.02	29% below	44%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH/INJECT HYSTEROSALPINGOGRAM	$952.73	$1,701.30	$115.08–$1,252.16	183% above	44%
Hysteroscopy with endometrial ablation CPT 58563 HC Hysteroscopy Endometrial	$8,143.46	$14,541.90	$4,362.57–$12,134.43	at median	44%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ENDOMETRIAL	$8,294.94	$14,812.40	$3,213.96–$10,901.93	2% above	44%
Hysteroscopy with endometrial ablation CPT 58563 HC HYSTEROSCOPY ENDOMETRIAL	$8,387.79	$14,978.20	$4,362.57–$12,134.43	3% above	44%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC HYSTEROSCOPY BIOPSY	$4,705.68	$8,403.00	$2,520.90–$6,509.99	30% above	44%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC Hysteroscopy Biopsy	$4,953.26	$8,845.10	$2,520.90–$6,509.99	37% above	44%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY	$5,202.23	$9,289.70	$460.20–$6,837.22	44% above	44%
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE	$427.22	$762.90	$102.87–$561.49	40% above	44%
IUD insertion (the device itself billed separately) CPT 58300 HC Insert Intrauterine Device	$1,482.38	$2,647.10	$794.13–$2,209.40	387% above	44%
IUD insertion (the device itself billed separately) CPT 58300 HC INSERT INTRAUTERINE DEVICE	$1,526.84	$2,726.50	$794.13–$2,209.40	402% above	44%
Incision and drainage of a simple or single skin abscess CPT 10060 HC Drain Skin Abscess Simple	$435.79	$778.20	$233.46–$753.15	49% above	44%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D SIMPLE	$448.90	$801.60	$233.46–$589.98	54% above	44%
Incision and drainage of a simple or single skin abscess CPT 10060 HC DRAIN SKIN ABSCESS SIMPLE	$448.90	$801.60	$233.46–$753.15	54% above	44%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC Repair Ing Hernia,5+Y/O,Reducibl	$5,579.56	$9,963.50	$2,989.05–$8,654.11	12% below	44%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC REPAIR ING HERNIA,5+Y/O,REDUCIBL	$5,746.94	$10,262.40	$2,989.05–$8,654.11	9% below	44%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON/LIGAMENT (20550)	$290.75	$519.20	$103.62–$382.13	15% below	44%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC Inj Tendon/Ligament	$535.25	$955.80	$286.74–$724.59	57% above	44%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ TENDON/LIGAMENT	$551.32	$984.50	$286.74–$724.59	62% above	44%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US (20610)	$322.90	$576.60	$119.04–$424.38	26% below	44%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US	$532.62	$951.10	$285.33–$720.84	23% above	44%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US (20610)	$532.62	$951.10	$285.33–$720.84	23% above	44%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US (20610)	$548.46	$979.40	$285.33–$720.84	27% above	44%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$548.46	$979.40	$285.33–$720.84	27% above	44%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC Insert Drug Implant Device	$206.58	$368.90	$110.67–$279.68	22% below	44%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERT DRUG IMPLANT DEVICE	$212.80	$380.00	$110.67–$279.68	19% below	44%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$352.30	$629.10	$114.84–$463.02	33% above	44%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$276.47	$493.70	$97.77–$363.36	14% below	44%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US (20605)	$535.25	$955.80	$286.74–$724.59	67% above	44%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US	$535.25	$955.80	$286.74–$724.59	67% above	44%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$551.32	$984.50	$286.74–$724.59	72% above	44%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US (20605)	$551.32	$984.50	$286.74–$724.59	72% above	44%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$266.62	$476.10	$94.35–$350.41	28% below	44%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US	$451.81	$806.80	$242.04–$651.80	22% above	44%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$476.78	$851.40	$242.04–$651.80	28% above	44%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 KNEE SCOPE,MED OR LAT MENIS REPAIR	$3,418.13	$6,103.80	$1,831.14–$4,492.40	51% below	44%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 HC Knee Scope,Med or Lat Menis Repair	$4,273.92	$7,632.00	$2,289.60–$5,785.70	39% below	44%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 HC KNEE SCOPE,MED OR LAT MENIS REPAIR	$4,402.16	$7,861.00	$2,289.60–$5,785.70	37% below	44%
Knee arthroscopy with meniscus trim CPT 29881 HC Meniscectomy Medial or Lateral	$4,966.42	$8,868.60	$2,660.58–$6,723.14	at median	44%
Knee arthroscopy with meniscus trim CPT 29881 HC MENISCECTOMY MEDIAL OR LATERAL	$5,115.43	$9,134.70	$2,660.58–$6,723.14	3% above	44%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 HC Meniscectomy Medial and Lateral	$5,498.58	$9,818.90	$2,945.67–$7,443.54	at median	44%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 HC MENISCECTOMY MEDIAL AND LATERAL	$5,663.56	$10,113.50	$2,945.67–$7,443.54	3% above	44%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 KNEE SCOPE,SHAVE ARTICULAR CART	$3,084.87	$5,508.70	$1,652.61–$4,054.40	at median	44%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 HC Knee Scope,Shave Articular Cart	$4,273.92	$7,632.00	$2,289.60–$5,785.70	39% above	44%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 HC KNEE SCOPE,SHAVE ARTICULAR CART	$4,402.16	$7,861.00	$2,289.60–$5,785.70	43% above	44%
Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 HC Lap Gastr Rstrc;Gastr Byps&Rouxeny	$7,401.46	$13,216.90	$3,965.07–$10,019.46	at median	44%
Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 HC LAP GASTR RSTRC;GASTR BYPS&ROUXENY	$7,623.50	$13,613.40	$3,965.07–$10,019.46	3% above	44%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY	$3,771.32	$6,734.50	$2,020.35–$4,956.59	16% below	44%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 HC Laparoscopy Appendectomy	$8,873.59	$15,845.70	$4,753.71–$12,012.33	96% above	44%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 HC LAPAROSCOPY APPENDECTOMY	$9,139.82	$16,321.10	$4,753.71–$12,012.33	102% above	44%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 HC Laparoscopy Esophagogastric	$15,619.86	$27,892.60	$8,367.78–$21,144.84	470% above	44%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 HC LAPAROSCOPY ESOPHAGOGASTRIC	$16,088.46	$28,729.40	$8,367.78–$21,144.84	487% above	44%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 HC Tlh, Uterus 250 G or Less	$5,080.60	$9,072.50	$2,721.75–$8,680.38	at median	44%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 HC TLH, UTERUS 250 G OR LESS	$6,604.64	$11,794.00	$2,721.75–$8,680.38	30% above	44%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 TLH W/T/O 250 G OR LESS	$3,403.23	$6,077.20	$1,823.16–$4,472.82	at median	44%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 HC TLH W/T/O 250 G OR LESS	$12,394.48	$22,133.00	$6,639.90–$17,147.11	264% above	44%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 HC Tlh W/T/O 250 G or Less	$13,046.71	$23,297.70	$6,639.90–$17,147.11	283% above	44%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 INGUINAL HERNIA REPAIR	$2,722.61	$4,861.80	$1,458.54–$3,578.28	at median	44%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 HC Inguinal Hernia Repair	$8,873.59	$15,845.70	$4,753.71–$12,012.33	226% above	44%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 HC INGUINAL HERNIA REPAIR	$9,139.82	$16,321.10	$4,753.71–$12,012.33	236% above	44%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 HC Inguinal Hernia Repair	$7,273.95	$12,989.20	$3,896.76–$9,846.87	at median	44%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 HC INGUINAL HERNIA REPAIR	$7,492.18	$13,378.90	$3,896.76–$9,846.87	3% above	44%
Laparoscopic removal of an adjustable gastric band and its port CPT 43774 HC Lap Remov Adj Gast Band/Port	$5,384.79	$9,615.70	$2,884.71–$7,289.49	at median	44%
Laparoscopic removal of an adjustable gastric band and its port CPT 43774 HC LAP REMOV ADJ GAST BAND/PORT	$5,546.35	$9,904.20	$2,884.71–$7,289.49	3% above	44%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY, REMOVAL OF ADNEXAL STRUCTURES	$2,440.42	$4,357.90	$1,307.37–$3,207.41	at median	44%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 HC Laparoscopy, Removal of Adnexal Structures	$7,315.73	$13,063.80	$3,919.14–$10,900.45	200% above	44%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 HC LAPAROSCOPY, REMOVAL OF ADNEXAL STRUCTURES	$7,535.19	$13,455.70	$3,919.14–$10,900.45	209% above	44%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 HC Lap Sleeve Gastrectomy	$8,532.10	$15,235.90	$4,570.77–$11,550.05	at median	44%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 HC LAP SLEEVE GASTRECTOMY	$8,788.08	$15,693.00	$4,570.77–$11,550.05	3% above	44%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC Layr Clos Wnd Trunk,Arm,Leg <2.5cm	$776.38	$1,386.40	$415.92–$1,051.01	47% above	44%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC LAYR CLOS WND TRUNK,ARM,LEG <2.5CM	$799.68	$1,428.00	$415.92–$1,051.01	52% above	44%
Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HRT CATH INCLUDES LVG (93452)	$4,158.56	$7,426.00	$9,180.00–$13,345.00	39% below	44%
Left heart catheterization, diagnostic one side CPT 93452 HC Left Hrt Cath Includes Lvg (93452)	$4,158.56	$7,426.00	$9,180.00–$13,345.00	39% below	44%
Lower-back epidural injection, with imaging guidance CPT 62323 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62323)	$1,147.44	$2,049.00	$614.70–$1,665.79	at median	44%
Lower-back epidural injection, with imaging guidance CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN (62323)	$1,181.88	$2,110.50	$614.70–$1,665.79	3% above	44%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN (62323)	$1,317.23	$2,352.20	$264.75–$1,731.22	15% above	44%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$700.34	$1,250.60	$214.17–$920.44	15% below	44%
Lower-back epidural injection, without imaging guidance CPT 62322 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn	$923.94	$1,649.90	$494.97–$1,578.65	12% above	44%
Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$1,201.14	$2,144.90	$494.97–$1,578.65	46% above	44%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 HC Lumbar Nerve Block Bilateral (64483.02)	$1,507.74	$2,692.40	$807.72–$2,041.08	—	44%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 HC LUMBAR NERVE BLOCK BILATERAL (64483.02)	$1,552.99	$2,773.20	$807.72–$2,041.08	—	44%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORAMINAL INJECTION LUMBAR OR SACRAL 1 LEVEL (64483)	$1,253.34	$2,238.10	$297.24–$1,647.24	17% above	44%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Transforaminal Injection Lumbar or Sacral 1 Level (64483)	$1,507.74	$2,692.40	$807.72–$2,041.08	41% above	44%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC TRANSFORAMINAL INJECTION LUMBAR OR SACRAL 1 LEVEL (64483)	$1,552.99	$2,773.20	$807.72–$2,041.08	45% above	44%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 EXCIS LUMBAR DISK,ONE LEVEL	$4,376.79	$7,815.70	$2,344.71–$5,752.36	72% below	44%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 HC Excis Lumbar Disk,One Level	$12,752.32	$22,772.00	$6,831.60–$17,263.03	19% below	44%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 HC EXCIS LUMBAR DISK,ONE LEVEL	$13,134.91	$23,455.20	$6,831.60–$17,263.03	16% below	44%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 HC Lumbar Spine Fusion Combined	$4,425.18	$7,902.10	$2,370.63–$7,560.93	at median	44%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 HC LUMBAR SPINE FUSION COMBINED	$5,752.88	$10,273.00	$2,370.63–$7,560.93	30% above	44%
Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR	$7,334.99	$13,098.20	$3,929.46–$9,640.28	at median	44%
Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 HC Arthrodesis Posterior Interbody Lumbar	$31,550.06	$56,339.40	$16,901.82–$54,511.77	330% above	44%
Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 HC ARTHRODESIS POSTERIOR INTERBODY LUMBAR	$32,496.58	$58,029.60	$16,901.82–$54,511.77	343% above	44%
Lumbar laminectomy (spinal decompression), one level CPT 63047 LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR	$5,278.00	$9,425.00	$2,827.50–$6,936.80	57% below	44%
Lumbar laminectomy (spinal decompression), one level CPT 63047 HC Laminec/Facetect/Foramin,Lumbar	$8,838.09	$15,782.30	$4,734.69–$11,964.27	27% below	44%
Lumbar laminectomy (spinal decompression), one level CPT 63047 HC LAMINEC/FACETECT/FORAMIN,LUMBAR	$9,103.25	$16,255.80	$4,734.69–$11,964.27	25% below	44%
Lumbar spinal fusion (posterior), one level CPT 22612 ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR	$7,572.66	$13,522.60	$4,056.78–$9,952.63	at median	44%
Lumbar spinal fusion (posterior), one level CPT 22612 HC Lumbar Spine Fusn,Post Tech	$11,870.94	$21,198.10	$6,359.43–$20,510.26	57% above	44%
Lumbar spinal fusion (posterior), one level CPT 22612 HC LUMBAR SPINE FUSN,POST TECH	$12,227.04	$21,834.00	$6,359.43–$20,510.26	61% above	44%
Lumpectomy (partial mastectomy) CPT 19301 HC Partial Mastectomy	$3,164.50	$5,650.90	$1,695.27–$5,343.21	at median	44%
Lumpectomy (partial mastectomy) CPT 19301 HC PARTIAL MASTECTOMY	$3,259.42	$5,820.40	$1,695.27–$5,343.21	3% above	44%
Mastectomy (total removal of the breast) CPT 19303 HC Mast, Simple, Complete	$4,076.24	$7,279.00	$2,183.70–$7,428.45	43% below	44%
Mastectomy (total removal of the breast) CPT 19303 HC MAST, SIMPLE, COMPLETE	$4,198.54	$7,497.40	$2,183.70–$7,428.45	42% below	44%
Miscarriage treatment with D&C, first trimester CPT 59820 SURG RX MISSED ABORTN,1ST TRI	$1,163.12	$2,077.00	$541.98–$1,528.67	at median	44%
Miscarriage treatment with D&C, first trimester CPT 59820 HC Surg Rx Missed Abortn,1st Tri	$4,059.61	$7,249.30	$2,174.79–$5,495.56	249% above	44%
Miscarriage treatment with D&C, first trimester CPT 59820 HC SURG RX MISSED ABORTN,1ST TRI	$4,181.41	$7,466.80	$2,174.79–$5,495.56	259% above	44%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC SKIN BENIG <5MM TRUNK,ARM,LEG	$458.02	$817.90	$159.21–$601.97	31% above	44%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC Exc Skin Benig <5mm Trunk,Arm,Leg	$874.16	$1,561.00	$468.30–$1,553.55	151% above	44%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC SKIN BENIG <5MM TRUNK,ARM,LEG	$1,136.35	$2,029.20	$468.30–$1,553.55	226% above	44%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC SKIN BENIG <5MM FACE,FACIAL	$514.98	$919.60	$202.59–$676.83	at median	44%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC Exc Skin Benig <5mm Face,Facial	$874.16	$1,561.00	$468.30–$1,493.56	70% above	44%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXC SKIN BENIG <5MM FACE,FACIAL	$1,136.35	$2,029.20	$468.30–$1,493.56	121% above	44%
Nail removal (partial or complete), one nail CPT 11730 HC Removal of Nail Plate	$449.57	$802.80	$240.84–$608.60	91% above	44%
Nail removal (partial or complete), one nail CPT 11730 HC REMOVAL OF NAIL PLATE	$463.06	$826.90	$240.84–$608.60	97% above	44%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION AA&/STRD GREATER OCCIPITAL NERVE	$365.79	$653.20	$134.67–$480.76	21% below	44%
Occipital nerve block (injection for headaches) CPT 64405 INJECT NERV BLCK, GREAT OCCIPTL (TECH)	$365.79	$653.20	$134.67–$480.76	21% below	44%
Occipital nerve block (injection for headaches) CPT 64405 HC Injection, Anesthetic Agent; Trigeminal Ner(64405)	$772.80	$1,380.00	$414.00–$1,381.25	67% above	44%
Occipital nerve block (injection for headaches) CPT 64405 HC Inject Nerv Blck,Great Occiptl (64405)	$772.80	$1,380.00	$414.00–$1,046.15	67% above	44%
Occipital nerve block (injection for headaches) CPT 64405 HC Injection, Anesthetic Agent; Trigeminal Ner	$772.80	$1,380.00	$414.00–$1,381.25	67% above	44%
Occipital nerve block (injection for headaches) CPT 64405 HC INJECT NERV BLCK,GREAT OCCIPTL (64405)	$795.98	$1,421.40	$414.00–$1,046.15	72% above	44%
Occipital nerve block (injection for headaches) CPT 64405 HC INJECTION, ANESTHETIC AGENT; TRIGEMINAL NER	$795.98	$1,421.40	$414.00–$1,381.25	72% above	44%
Occipital nerve block (injection for headaches) CPT 64405 HC INJECTION, ANESTHETIC AGENT; TRIGEMINAL NER(64405)	$795.98	$1,421.40	$414.00–$1,381.25	72% above	44%
Open Roux-en-Y gastric bypass through an abdominal incision CPT 43846 Gastric Rstcv W/Byp W/Short Limb 150 Cm/<	$13,689.82	$24,446.10	$7,333.83–$18,532.11	at median	44%
Open Roux-en-Y gastric bypass through an abdominal incision CPT 43846 GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<	$14,100.52	$25,179.50	$7,333.83–$18,532.11	3% above	44%
Pacemaker implant (dual chamber) CPT 33208 INSER HART PACER XVENOUS ATR/VENTR (33208)	$2,943.75	$5,256.70	$33,475.00	54% below	44%
Pacemaker implant (dual chamber) CPT 33208 HC INSER HART PACER XVENOUS ATR/VENTR (33208)	$11,200.00	$20,000.00	$33,475.00	77% above	44%
Pacemaker implant (dual chamber) CPT 33208 HC Inser Hart Pacer Xvenous Atr/Ventr (33208)	$11,644.86	$20,794.40	$33,475.00	84% above	44%
Paracentesis with imaging guidance CPT 49083 HC Abd Paracentesis W/Imaging (49083)	$1,470.34	$2,625.60	$787.68–$2,116.74	14% above	44%
Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W/IMAGING (49083)	$1,514.63	$2,704.70	$787.68–$2,116.74	18% above	44%
Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W/IMAGING	$1,514.63	$2,704.70	$787.68–$1,990.66	18% above	44%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING (49083)	$1,955.63	$3,492.20	$367.68–$2,570.26	52% above	44%
Partial knee replacement (one compartment) CPT 27446 ARTHROPLASTY KNEE,MED OR LAT COMPARTMT	$5,626.38	$10,047.10	$3,014.13–$7,394.67	at median	44%
Partial knee replacement (one compartment) CPT 27446 HC Arthroplasty Knee,Med or Lat Compartmt	$10,969.78	$19,588.90	$5,876.67–$18,953.40	95% above	44%
Partial knee replacement (one compartment) CPT 27446 HC ARTHROPLASTY KNEE,MED OR LAT COMPARTMT	$11,298.90	$20,176.60	$5,876.67–$18,953.40	101% above	44%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Removal of Nail Bed	$776.38	$1,386.40	$415.92–$1,051.01	138% above	44%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL OF NAIL BED	$799.68	$1,428.00	$415.92–$1,051.01	145% above	44%
Prostate biopsy CPT 55700 HC Biopsy of Prostate,Needle/Punch	$2,702.22	$4,825.40	$1,447.62–$4,105.04	77% above	44%
Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPS SURG PRST8ECT RPBIC RAD W/NERVE SPARING	$6,062.39	$10,825.70	$3,247.71–$7,967.72	at median	44%
Prostate removal (prostatectomy), laparoscopic CPT 55866 HC Laparo Radical Prostatectomy	$8,723.46	$15,577.60	$4,673.28–$11,809.05	44% above	44%
Prostate removal (prostatectomy), laparoscopic CPT 55866 HC LAPARO RADICAL PROSTATECTOMY	$8,985.14	$16,044.90	$4,673.28–$11,809.05	48% above	44%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DESTROY LUMB/SAC FACET JNT (64635)	$2,190.16	$3,911.00	$1,173.30–$3,030.11	12% below	44%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT (64635)	$2,252.99	$4,023.20	$515.40–$2,961.08	9% below	44%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC Destroy Lumb/Sac Facet Jnt (64635)	$2,305.52	$4,117.00	$1,173.30–$3,030.11	7% below	44%
Removal of a breast lump, open surgery CPT 19120 HC Excise Breast Lesion	$4,935.78	$8,813.90	$2,644.17–$6,681.63	147% above	44%
Removal of a breast lump, open surgery CPT 19120 HC EXCISE BREAST LESION	$5,083.85	$9,078.30	$2,644.17–$6,681.63	154% above	44%
Removal of a foreign object under the skin, simple CPT 10120 HC Remove Foreign Body Simple	$664.22	$1,186.10	$355.83–$899.17	97% above	44%
Removal of a foreign object under the skin, simple CPT 10120 HC REMOVE FOREIGN BODY SIMPLE	$684.15	$1,221.70	$355.83–$899.17	103% above	44%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 THYROID LOBECTOMY,UNILAT	$2,634.86	$4,705.10	$1,411.53–$3,462.95	at median	44%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 HC Thyroid Lobectomy,Unilat	$6,082.61	$10,861.80	$3,258.54–$8,234.15	131% above	44%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 HC THYROID LOBECTOMY,UNILAT	$6,265.11	$11,187.70	$3,258.54–$8,234.15	138% above	44%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC Colorec Canc Scrn,Scopy Not Hi Risk	$1,741.38	$3,109.60	$932.88–$2,357.33	9% below	44%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC COLOREC CANC SCRN,SCOPY NOT HI RISK	$1,793.62	$3,202.90	$932.88–$2,357.33	7% below	44%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC Colorec Canc Scrn,Colonoscpy Hi Risk	$1,741.38	$3,109.60	$932.88–$2,517.12	8% below	44%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC COLOREC CANC SCRN,COLONOSCPY HI RISK	$1,915.20	$3,420.00	$932.88–$2,517.12	1% above	44%
Septoplasty to straighten the nasal septum CPT 30520 HC Repair of Nasal Septum	$3,593.07	$6,416.20	$1,924.86–$4,864.00	at median	44%
Septoplasty to straighten the nasal septum CPT 30520 HC REPAIR OF NASAL SEPTUM	$3,700.87	$6,608.70	$1,924.86–$4,864.00	3% above	44%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 HC Fragmenting of Kidney Stone	$4,469.81	$7,981.80	$10,098.00–$14,679.00	52% below	44%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 HC FRAGMENTING OF KIDNEY STONE	$4,603.93	$8,221.30	$10,098.00–$14,679.00	51% below	44%
Short arm cast (elbow to hand) CPT 29075 HC Apply Forearm Cast	$489.89	$874.80	$262.44–$663.14	94% above	44%
Short arm cast (elbow to hand) CPT 29075 HC APPLY FOREARM CAST	$504.56	$901.00	$262.44–$663.14	100% above	44%
Short arm splint (forearm and hand) CPT 29125 HC Apply Forearm Splint,Static	$173.82	$310.40	$93.12–$235.30	1% below	44%
Short arm splint (forearm and hand) CPT 29125 HC APPLY FOREARM SPLINT,STATIC	$179.03	$319.70	$93.12–$235.30	2% above	44%
Short arm splint (forearm and hand) CPT 29125 HC Apply Splint, Short Arm	$250.32	$447.00	$134.10–$345.48	42% above	44%
Short arm splint (forearm and hand) CPT 29125 HC APPLY SPLINT, SHORT ARM	$262.86	$469.40	$134.10–$345.48	50% above	44%
Short leg cast (below the knee) CPT 29405 HC Apply Short Leg Cast	$378.84	$676.50	$202.95–$586.37	61% above	44%
Short leg cast (below the knee) CPT 29405 HC APPLY SHORT LEG CAST	$428.96	$766.00	$202.95–$586.37	83% above	44%
Short leg splint (calf to foot) CPT 29515 HC Application Lower Leg Splint	$231.17	$412.80	$123.84–$405.39	11% above	44%
Short leg splint (calf to foot) CPT 29515 HC Apply Lower Leg Splint	$231.17	$412.80	$123.84–$334.95	11% above	44%
Short leg splint (calf to foot) CPT 29515 HC Apply Splint, Short Leg	$231.17	$412.80	$123.84–$405.39	11% above	44%
Short leg splint (calf to foot) CPT 29515 HC APPLICATION LOWER LEG SPLINT	$254.86	$455.10	$123.84–$405.39	23% above	44%
Short leg splint (calf to foot) CPT 29515 HC APPLY LOWER LEG SPLINT	$254.86	$455.10	$123.84–$334.95	23% above	44%
Short leg splint (calf to foot) CPT 29515 HC APPLY SPLINT, SHORT LEG	$254.86	$455.10	$123.84–$405.39	23% above	44%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 SHOULDER ARTHROSCOPY/SURGERY	$3,368.74	$6,015.60	$1,804.68–$4,427.48	at median	44%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 HC Shoulder Arthroscopy/Surgery	$4,504.81	$8,044.30	$2,413.29–$8,258.51	34% above	44%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 HC SHOULDER ARTHROSCOPY/SURGERY	$4,639.94	$8,285.60	$2,413.29–$8,258.51	38% above	44%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HC Shldr Arthroscop,Part Acromioplas	$2,186.35	$3,904.20	$1,171.26–$2,959.68	at median	44%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HC SHLDR ARTHROSCOP,PART ACROMIOPLAS	$2,251.93	$4,021.30	$1,171.26–$2,959.68	3% above	44%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC REPR SUPERF WND BODY <2.5CM-SIMPLE CLOSURE	$325.36	$581.00	$174.30–$449.84	at median	44%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC Repr Superf Wnd Body <2.5cm-Simple Closure	$342.27	$611.20	$174.30–$449.84	5% above	44%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION (11104)	$450.80	$805.00	$87.87–$592.48	88% above	44%
Skin biopsy, punch, one lesion CPT 11104 HC Punch Bx of Skin; Single Lesion	$525.11	$937.70	$281.31–$707.66	119% above	44%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BX OF SKIN; SINGLE LESION	$538.44	$961.50	$281.31–$707.66	124% above	44%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC SKIN MALIG <5MM TRUNK,ARM,LEG	$705.38	$1,259.60	$230.04–$927.07	92% above	44%
Skin tag removal, up to 15 tags CPT 11200 HC Removal of Skin Tags Up to Including 15	$141.57	$252.80	$75.84–$211.16	at median	44%
Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL OF SKIN TAGS UP TO INCLUDING 15	$145.82	$260.40	$75.84–$211.16	3% above	44%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS UP TO INCLUDING 15	$325.92	$582.00	$145.02–$428.35	130% above	44%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Spinal Puncture,Lumbar,Diagnostic	$989.80	$1,767.50	$530.25–$1,649.01	64% above	44%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Spinal Puncture, Lumbar, Diagnostic	$989.80	$1,767.50	$530.25–$1,649.01	64% above	44%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC	$1,118.49	$1,997.30	$530.25–$1,649.01	85% above	44%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC	$1,118.49	$1,997.30	$530.25–$1,649.01	85% above	44%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC Repr Sup Npterf Wnd Body 2.6-7.5	$201.94	$360.60	$108.18–$273.35	at median	44%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC REPR SUP NPTERF WND BODY 2.6-7.5	$207.98	$371.40	$108.18–$273.35	3% above	44%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<	$427.84	$764.00	$229.20–$748.36	38% above	44%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC REPR SUPERF WND FACE <2.5CM	$427.84	$764.00	$229.20–$591.52	38% above	44%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC RPR F/E/E/N/L/M 2.5 CM/<	$427.84	$764.00	$229.20–$591.52	38% above	44%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Repr Superf Wnd Face <2.5cm	$450.07	$803.70	$229.20–$591.52	45% above	44%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Simple Repair F/E/E/N/L/M 2.5cm/<	$450.07	$803.70	$229.20–$748.36	45% above	44%
TURP (transurethral resection of the prostate) CPT 52601 HC Transurethral Elec-Surg Prostatectom	$5,196.97	$9,280.30	$2,784.09–$7,035.20	at median	44%
TURP (transurethral resection of the prostate) CPT 52601 HC TRANSURETHRAL ELEC-SURG PROSTATECTOM	$5,352.87	$9,558.70	$2,784.09–$7,035.20	3% above	44%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION (11102)	$364.56	$651.00	$71.25–$479.14	52% above	44%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC Tangential Bx of Skin, Single Lesion (11102)	$532.78	$951.40	$285.42–$721.21	122% above	44%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BX OF SKIN, SINGLE LESION	$548.74	$979.90	$285.42–$721.21	129% above	44%
Thoracentesis with imaging guidance CPT 32555 HC Aspirate Pleura W/ Imaging (32555)	$1,369.14	$2,444.90	$733.47–$1,853.47	14% above	44%
Thoracentesis with imaging guidance CPT 32555 HC Aspirate Pleura W/ Imaging	$1,375.98	$2,457.10	$737.13–$1,853.47	15% above	44%
Thoracentesis with imaging guidance CPT 32555 HC ASPIRATE PLEURA W/ IMAGING (32555)	$1,410.25	$2,518.30	$733.47–$1,853.47	18% above	44%
Thoracentesis with imaging guidance CPT 32555 HC ASPIRATE PLEURA W/ IMAGING	$1,410.25	$2,518.30	$733.47–$1,853.47	18% above	44%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING (32555)	$1,574.38	$2,811.40	$284.40–$2,069.19	31% above	44%
Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS/ADENOIDS,12+ Y/O	$1,989.51	$3,552.70	$1,065.81–$2,614.79	at median	44%
Tonsil and adenoid removal, age 12 or older CPT 42821 HC Remove Tonsils/Adenoids,12+ Y/O	$4,797.58	$8,567.10	$2,570.13–$6,494.54	141% above	44%
Tonsil and adenoid removal, age 12 or older CPT 42821 HC REMOVE TONSILS/ADENOIDS,12+ Y/O	$4,941.50	$8,824.10	$2,570.13–$6,494.54	148% above	44%
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS/ADENOIDS,<12 Y/O	$1,902.26	$3,396.90	$1,019.07–$2,500.12	at median	44%
Tonsil and adenoid removal, child under 12 CPT 42820 HC Remove Tonsils/Adenoids,<12 Y/O	$6,232.80	$11,130.00	$3,339.00–$8,437.43	228% above	44%
Tonsil and adenoid removal, child under 12 CPT 42820 HC REMOVE TONSILS/ADENOIDS,<12 Y/O	$6,419.78	$11,463.90	$3,339.00–$8,437.43	237% above	44%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS,12+ Y/O	$1,674.12	$2,989.50	$896.85–$2,200.27	at median	44%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 HC Removal of Tonsils,12+ Y/O	$4,797.58	$8,567.10	$2,570.13–$6,494.54	187% above	44%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 HC REMOVAL OF TONSILS,12+ Y/O	$4,941.50	$8,824.10	$2,570.13–$6,494.54	195% above	44%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS,<12 Y/O	$1,761.14	$3,144.90	$943.47–$2,314.65	at median	44%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 HC Removal of Tonsils,<12 Y/O	$7,666.34	$13,689.90	$4,106.97–$10,378.04	335% above	44%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 HC REMOVAL OF TONSILS,<12 Y/O	$7,896.34	$14,100.60	$4,106.97–$10,378.04	348% above	44%
Total hip replacement CPT 27130 HC Total Hip Replacement	$3,621.58	$6,467.10	$1,940.13–$6,187.70	at median	44%
Total hip replacement CPT 27130 HC TOTAL HIP REPLACEMENT	$4,707.92	$8,407.00	$1,940.13–$6,187.70	30% above	44%
Total hip replacement CPT 27130 TOTAL HIP REPLACEMENT	$6,281.30	$11,216.60	$3,364.98–$8,255.42	73% above	44%
Total knee replacement CPT 27447 TOTAL KNEE REPLACEMENT	$6,275.53	$11,206.30	$3,361.89–$8,247.84	at median	44%
Total knee replacement CPT 27447 HC Total Knee Replacement	$8,384.94	$14,973.10	$4,491.93–$12,311.00	34% above	44%
Total knee replacement CPT 27447 HC TOTAL KNEE REPLACEMENT	$8,636.49	$15,422.30	$4,491.93–$12,311.00	38% above	44%
Total shoulder replacement CPT 23472 HC Reconstr Total Shoulder Implant	$6,045.20	$10,795.00	$3,238.50–$10,329.02	at median	44%
Total shoulder replacement CPT 23472 HC RECONSTR TOTAL SHOULDER IMPLANT	$7,859.04	$14,034.00	$3,238.50–$10,329.02	30% above	44%
Total thyroid removal (thyroidectomy) CPT 60240 THYROIDECTOMY	$3,392.98	$6,058.90	$1,817.67–$4,459.35	at median	44%
Total thyroid removal (thyroidectomy) CPT 60240 HC Thyroidectomy	$4,749.02	$8,480.40	$2,544.12–$6,428.81	40% above	44%
Total thyroid removal (thyroidectomy) CPT 60240 HC THYROIDECTOMY	$4,891.49	$8,734.80	$2,544.12–$6,428.81	44% above	44%
Trigger finger release surgery CPT 26055 HC Incise Finger Tendon Sheath	$2,566.70	$4,583.40	$1,375.02–$3,474.58	70% above	44%
Trigger finger release surgery CPT 26055 HC INCISE FINGER TENDON SHEATH	$2,643.70	$4,720.90	$1,375.02–$3,474.58	76% above	44%
Trigger point injections, 1 or 2 muscles CPT 20552 1-2 TRIGGER POINTS INJECT (20552)	$266.62	$476.10	$98.91–$350.41	25% below	44%
Trigger point injections, 1 or 2 muscles CPT 20552 HC Trigger Point Inject Sing/Multi 1-2 Muscles	$534.41	$954.30	$286.29–$723.41	51% above	44%
Trigger point injections, 1 or 2 muscles CPT 20552 HC Inject Trigger Point, 1 or 2 (20552)	$534.41	$954.30	$286.29–$723.41	51% above	44%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJECT TRIGGER POINT, 1 OR 2 (20552)	$550.42	$982.90	$286.29–$723.41	55% above	44%
Trigger point injections, 1 or 2 muscles CPT 20552 HC TRIGGER POINT INJECT SING/MULTI 1-2 MUSCLES	$550.42	$982.90	$286.29–$723.41	55% above	44%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY FULGURATION	$1,400.95	$2,501.70	$750.51–$1,841.25	at median	44%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 HC Laparoscopy Fulguration	$8,092.11	$14,450.20	$4,335.06–$12,056.56	478% above	44%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 HC LAPAROSCOPY FULGURATION	$8,334.87	$14,883.70	$4,335.06–$12,056.56	495% above	44%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE	$1,816.19	$3,243.20	$288.33–$2,387.00	10% below	44%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC Bx Breast W Device 1st Lesion Ultrasound Guide	$2,670.42	$4,768.60	$1,430.58–$3,615.01	32% above	44%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE	$2,750.55	$4,911.70	$1,430.58–$3,615.01	36% above	44%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC Up GI Endoscopy,Ball Dil,30mm	$2,848.38	$5,086.40	$1,525.92–$3,855.90	7% above	44%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC UP GI ENDOSCOPY,BALL DIL,30MM	$2,933.84	$5,239.00	$1,525.92–$3,855.90	10% above	44%
Upper endoscopy (EGD) with biopsy CPT 43239 HC Upper GI Endoscopy,Biopsy	$1,467.98	$2,621.40	$786.42–$2,162.15	7% below	44%
Upper endoscopy (EGD) with biopsy CPT 43239 HC UPPER GI ENDOSCOPY,BIOPSY	$1,514.24	$2,704.00	$786.42–$2,162.15	4% below	44%
Upper endoscopy (EGD) with injection into the lining CPT 43236 HC Uppr GI Scope W/Submuc Inj	$1,418.98	$2,533.90	$760.17–$2,070.15	7% below	44%
Upper endoscopy (EGD) with injection into the lining CPT 43236 HC UPPR GI SCOPE W/SUBMUC INJ	$1,514.24	$2,704.00	$760.17–$2,070.15	1% below	44%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC Up GI Endoscopy,Remv Tumor,Snare	$2,848.38	$5,086.40	$1,525.92–$3,855.90	29% above	44%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC UP GI ENDOSCOPY,REMV TUMOR,SNARE	$2,933.84	$5,239.00	$1,525.92–$3,855.90	33% above	44%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 UP GI ENDOSCOPY,REMV TUMOR,SNARE	$3,283.34	$5,863.10	$670.71–$4,315.24	48% above	44%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC UP GI ENDOSCOPY,DILATN W GUIDE	$1,400.00	$2,500.00	$750.00–$3,778.62	24% below	44%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC Up GI Endoscopy,Dilatn W Guide	$1,470.34	$2,625.60	$750.00–$3,778.62	21% below	44%
Upper endoscopy (EGD), diagnostic CPT 43235 HC Upper GI Endoscopy,Diagnosis	$1,467.98	$2,621.40	$786.42–$2,637.38	at median	44%
Upper endoscopy (EGD), diagnostic CPT 43235 HC UPPER GI ENDOSCOPY,DIAGNOSIS	$1,514.24	$2,704.00	$786.42–$2,637.38	3% above	44%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 HC Egd W/Transmural Drain Cyst	$6,930.45	$12,375.80	$3,712.74–$9,381.87	95% above	44%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 HC EGD W/TRANSMURAL DRAIN CYST	$7,138.38	$12,747.10	$3,712.74–$9,381.87	101% above	44%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 HC Cystouretero W/Lithotripsy	$2,907.46	$5,191.90	$1,557.57–$6,891.24	at median	44%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 HC CYSTOURETERO W/LITHOTRIPSY	$2,994.71	$5,347.70	$1,557.57–$6,891.24	3% above	44%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT	$2,086.11	$3,725.20	$1,117.56–$2,741.75	at median	44%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 HC Cysto/Uretero W/Lithotripsy &Indwell Stent Insrt	$7,801.19	$13,930.70	$4,179.21–$10,560.57	274% above	44%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 HC CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT	$8,035.22	$14,348.60	$4,179.21–$10,560.57	285% above	44%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 ROUT OB CARE,VAG DELIV,PREV C-SEC	$5,143.88	$9,185.50	$2,755.65–$6,760.53	at median	44%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S)	$1,739.64	$3,106.50	$630.36–$2,286.38	11% above	44%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 HC Removal of Sperm Duct(S)	$3,489.70	$6,231.60	$1,869.48–$5,356.17	122% above	44%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 HC REMOVAL OF SPERM DUCT(S)	$3,594.42	$6,418.60	$1,869.48–$5,356.17	129% above	44%
Vein ablation, radiofrequency, first vein CPT 36475 HC Endovenus Ablat Tx Vein Ext Rf;1 Vn	$4,009.15	$7,159.20	$2,147.76–$5,427.26	3% above	44%
Vein ablation, radiofrequency, first vein CPT 36475 HC ENDOVENUS ABLAT TX VEIN EXT RF;1 VN	$4,129.44	$7,374.00	$2,147.76–$5,427.26	6% above	44%
Wart removal, up to 14 warts CPT 17110 HC Destruc Benign Lesion 1-14	$190.46	$340.10	$102.03–$257.82	3% below	44%
Wart removal, up to 14 warts CPT 17110 HC DESTRUC BENIGN LESION 1-14	$196.17	$350.30	$102.03–$257.82	at median	44%
Wart removal, up to 14 warts CPT 17110 DESTRUC BENIGN LESION 1-14	$407.96	$728.50	$127.92–$536.18	107% above	44%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debride of Skin and Subcut	$783.61	$1,399.30	$419.79–$1,030.11	47% above	44%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debride of Skin & Subcut	$783.61	$1,399.30	$419.79–$1,030.11	47% above	44%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE OF SKIN AND SUBCUT	$783.78	$1,399.60	$419.79–$1,030.11	47% above	44%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE OF SKIN & SUBCUT	$783.78	$1,399.60	$419.79–$1,030.11	47% above	44%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<	$783.78	$1,399.60	$419.79–$1,030.11	47% above	44%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC Treat Fx Rad Extra-Articul	$9,096.92	$16,244.50	$4,873.35–$12,314.60	at median	44%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC TREAT FX RAD EXTRA-ARTICUL	$9,369.81	$16,731.80	$4,873.35–$12,314.60	3% above	44%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION	$565.66	$1,010.10	$303.03–$743.43	3% below	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$35.78	$63.90	$19.17–$47.03	59% below	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MED AEROSOL SUBSEQUENT	$150.25	$268.30	$80.49–$197.47	74% above	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Mdi Tx Each Med Initial	$150.25	$268.30	$80.49–$197.47	74% above	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Mdi Tx Each Med Subsequent	$150.25	$268.30	$80.49–$197.47	74% above	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Med Aerosol Initial	$150.25	$268.30	$80.49–$197.47	74% above	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Med Aerosol Subsequent	$150.25	$268.30	$80.49–$197.47	74% above	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Airway Inhalation Treatment	$150.25	$268.30	$80.49–$197.47	74% above	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI TX EACH MED INITIAL	$150.25	$268.30	$80.49–$197.47	74% above	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI TX EACH MED SUBSEQUENT	$150.25	$268.30	$80.49–$197.47	74% above	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MED AEROSOL INITIAL	$150.25	$268.30	$80.49–$197.47	74% above	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TREATMENT	$150.25	$268.30	$80.49–$197.47	74% above	44%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO, IV INFUSION, 1HR	$499.80	$892.50	$267.75–$656.88	11% below	44%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO, IV INFUSION, 1 HR	$499.80	$892.50	$267.75–$656.88	11% below	44%
Chemotherapy IV infusion, first hour CPT 96413 HC Chemo, IV Infusion, 1hr	$582.12	$1,039.50	$311.85–$765.44	4% above	44%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO, IV INFUSION, 1HR	$582.40	$1,040.00	$311.85–$765.44	4% above	44%
Critical care, first 30 to 74 minutes CPT 99291 HC Critical Care 1st Hour	$1,785.95	$3,189.20	$2,232.44–$5,701.00	at median	44%
Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE 1ST HOUR	$1,876.00	$3,350.00	$2,232.44–$5,701.00	5% above	44%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Rapid Eeg Awake,Drowsy W Stimulatn	$551.99	$985.70	$295.71–$812.54	18% below	44%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Eeg Awake,Drowsy W Stimulatn	$551.99	$985.70	$295.71–$812.54	18% below	44%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE,DROWSY W STIMULATN	$618.24	$1,104.00	$295.71–$812.54	8% below	44%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC RAPID EEG AWAKE,DROWSY W STIMULATN	$618.24	$1,104.00	$295.71–$812.54	8% below	44%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM, COMPLETE	$53.03	$94.70	$28.41–$69.70	21% below	44%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC Ekg-Electrocardiogram, Global	$162.57	$290.30	$87.09–$226.47	141% above	44%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC EKG-ELECTROCARDIOGRAM, GLOBAL	$172.31	$307.70	$87.09–$226.47	155% above	44%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG-ELECTROCARDIOGRAM,TRACING	$22.85	$40.80	$12.24–$30.03	85% below	44%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC Ekg-Electrocardiogram,Tracing	$148.57	$265.30	$79.59–$206.96	1% above	44%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG-ELECTROCARDIOGRAM,TRACING	$157.47	$281.20	$79.59–$206.96	7% above	44%
Electroconvulsive therapy (ECT), one session CPT 90870 ELECTROCONVULSIVE THERAPY,1 SEIZ	$364.90	$651.60	$123.00–$479.58	50% below	44%
Electroconvulsive therapy (ECT), one session CPT 90870 HC Electroconvulsive Therapy,1 Seiz	$928.42	$1,657.90	$497.37–$1,293.45	27% above	44%
Electroconvulsive therapy (ECT), one session CPT 90870 HC ELECTROCONVULSIVE THERAPY,1 SEIZ	$984.14	$1,757.40	$497.37–$1,293.45	35% above	44%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPT VISIT,LEVEL I	$49.28	$88.00	$180.00–$503.00	74% below	44%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC Emergency Dept Visit,Level I	$147.28	$263.00	$180.00–$503.00	21% below	44%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMERGENCY DEPT VISIT,LEVEL I	$154.00	$275.00	$180.00–$503.00	18% below	44%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT,LEVEL II	$135.35	$241.70	$361.00	58% below	44%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC Emergency Dept Visit,Level II	$337.68	$603.00	$361.00	5% above	44%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY DEPT VISIT,LEVEL II	$364.00	$650.00	$361.00	13% above	44%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT,LEVEL III	$231.90	$414.10	$826.00–$1,457.00	61% below	44%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC Emergency Dept Visit,Level III	$608.72	$1,087.00	$826.00–$1,457.00	3% above	44%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY DEPT VISIT,LEVEL III	$672.00	$1,200.00	$826.00–$1,457.00	13% above	44%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT,LEVEL IV	$392.45	$700.80	$1,836.00–$2,669.00	57% below	44%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC Emergency Dept Visit,Level IV	$917.28	$1,638.00	$1,836.00–$2,669.00	at median	44%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY DEPT VISIT,LEVEL IV	$963.20	$1,720.00	$1,836.00–$2,669.00	5% above	44%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC Emergency Dept Visit,Level V	$1,446.48	$2,583.00	$2,009.00	1% below	44%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMERGENCY DEPT VISIT,LEVEL V	$1,447.60	$2,585.00	$2,009.00	1% below	44%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Tracing for NM and Echo	$511.28	$913.00	$273.90–$946.86	35% below	44%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TRACING FOR NM AND ECHO	$511.28	$913.00	$273.90–$946.86	35% below	44%
Family therapy with the patient, 50 minutes CPT 90847 HC Family Mtg W Pt Present	$148.85	$265.80	$79.74–$254.29	22% below	44%
Family therapy with the patient, 50 minutes CPT 90847 HC Family Visit Lvl 2	$148.85	$265.80	$79.74–$254.29	22% below	44%
Family therapy with the patient, 50 minutes CPT 90847 HC Iop Family Mtg W Pt Present	$148.85	$265.80	$79.74–$254.29	22% below	44%
Family therapy with the patient, 50 minutes CPT 90847 HC IOP FAMILY MTG W PT PRESENT	$193.48	$345.50	$79.74–$254.29	2% above	44%
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY VISIT LVL 2	$193.48	$345.50	$79.74–$254.29	2% above	44%
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY MTG W PT PRESENT	$193.48	$345.50	$79.74–$254.29	2% above	44%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY VISIT LEVEL 1	$209.38	$373.90	$111.78–$275.19	10% above	44%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$220.98	$394.60	$117.60–$290.43	16% above	44%
Family therapy without the patient, 50 minutes CPT 90846 HC Family Mtg W/O Pt Present	$168.62	$301.10	$90.33–$230.37	8% below	44%
Family therapy without the patient, 50 minutes CPT 90846 HC Iop Family Psychotherapy W/O Pat 50 Min	$168.62	$301.10	$90.33–$230.37	8% below	44%
Family therapy without the patient, 50 minutes CPT 90846 HC IOP FAMILY PSYCHOTHERAPY W/O PAT 50 MIN	$175.28	$313.00	$90.33–$230.37	4% below	44%
Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY MTG W/O PT PRESENT	$175.28	$313.00	$90.33–$230.37	4% below	44%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY-NO PT	$200.70	$358.40	$107.16–$263.78	10% above	44%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$212.58	$379.60	$113.13–$279.39	16% above	44%
Group psychotherapy session CPT 90853 HC Group Therapy Level 2 Hr	$136.19	$243.20	$72.96–$186.21	80% above	44%
Group psychotherapy session CPT 90853 HC Group Psychotherapy	$136.19	$243.20	$72.96–$186.21	80% above	44%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY	$141.62	$252.90	$66.48–$186.13	88% above	44%
Group psychotherapy session CPT 90853 GROUP THERAPY W/MOD (1 HR)	$141.62	$252.90	$66.48–$186.13	88% above	44%
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY	$141.68	$253.00	$72.96–$186.21	88% above	44%
Group psychotherapy session CPT 90853 HC IOP GROUP PSYCHOTHERAPY	$141.68	$253.00	$72.96–$186.21	88% above	44%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION, INIT	$121.18	$216.40	$80.31–$1,047.03	58% below	44%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION, INIT (31 MIN TO 1 HR)	$121.18	$216.40	$80.31–$1,047.03	58% below	44%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Therapy Hydration 31 Min-1hr	$347.87	$621.20	$80.31–$1,047.03	22% above	44%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV THERAPY HYDRATION 31 MIN-1HR	$367.30	$655.90	$80.31–$1,047.03	29% above	44%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF, INIT (16-60 MIN)	$236.04	$421.50	$80.31–$1,047.03	26% below	44%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF, INIT	$236.04	$421.50	$80.31–$1,047.03	26% below	44%
IV infusion of a medicine, first hour CPT 96365 HC IV Therapy Prophylaxis 1st Hr	$368.03	$657.20	$80.31–$1,047.03	16% above	44%
IV infusion of a medicine, first hour CPT 96365 HC IV THERAPY PROPHYLAXIS 1ST HR	$390.10	$696.60	$80.31–$1,047.03	23% above	44%
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ, IV PUSH	$137.87	$246.20	$80.31–$1,047.03	16% below	44%
IV push of a medicine, first drug CPT 96374 HC IV Push	$141.57	$252.80	$80.31–$1,047.03	14% below	44%
IV push of a medicine, first drug CPT 96374 HC IV PUSH	$168.22	$300.40	$80.31–$1,047.03	2% above	44%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ, SUBCUTANEOUS/INTRAMUSCULAR	$52.58	$93.90	$80.31–$1,047.03	35% below	44%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC	$52.58	$93.90	$80.31–$1,047.03	35% below	44%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM INJECTION (752)	$52.58	$93.90	$80.31–$1,047.03	35% below	44%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION - SUB Q/IM	$110.88	$198.00	$80.31–$1,047.03	38% above	44%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Injection - Sub Q/Im	$110.99	$198.20	$80.31–$1,047.03	38% above	44%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCHIATRIC DIAG EVAL	$260.68	$465.50	$139.65–$360.64	19% above	44%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC Psychiatric Diag Eval	$274.40	$490.00	$139.65–$360.64	25% above	44%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$366.58	$654.60	$170.04–$481.79	67% above	44%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV CNDJ TEST 7-8 STUDIES	$656.10	$1,171.60	$208.41–$862.30	32% below	44%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC Nerve Conduction Studies; 7-8 Studies	$1,162.45	$2,075.80	$622.74–$1,711.13	21% above	44%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC NERVE CONDUCTION STUDIES; 7-8 STUDIES	$1,301.94	$2,324.90	$622.74–$1,711.13	35% above	44%
Neuromuscular re-education, 15 minutes CPT 97112 LAT NEUROMUSCULAR/15 MIN(747)	$133.11	$237.70	$70.02–$80.31	39% above	44%
New patient office visit, about 30 minutes CPT 99203 HC New Pt Level 3	$168.62	$301.10	$90.33–$221.61	15% below	44%
New patient office visit, about 30 minutes CPT 99203 HC NEW PT LEVEL 3	$168.62	$301.10	$90.33–$221.61	15% below	44%
New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$228.48	$408.00	$89.76–$379.44	16% above	44%
New patient office visit, about 45 minutes CPT 99204 HC NEW PT LEVEL 4	$175.56	$313.50	$94.05–$230.74	22% below	44%
New patient office visit, about 45 minutes CPT 99204 HC New Pt Level 4	$175.56	$313.50	$94.05–$230.74	22% below	44%
New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$340.82	$608.60	$145.50–$566.00	52% above	44%
New patient office visit, about 60 minutes CPT 99205 HC New Pt Level 5	$304.53	$543.80	$163.14–$400.24	at median	44%
New patient office visit, about 60 minutes CPT 99205 HC NEW PT LEVEL 5	$304.53	$543.80	$163.14–$400.24	at median	44%
New patient office visit, about 60 minutes CPT 99205 OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$449.74	$803.10	$197.55–$746.88	48% above	44%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES	$148.51	$265.20	$52.50–$246.64	14% above	44%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC New Pt Level 2	$153.50	$274.10	$82.23–$201.74	17% above	44%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC NEW PT LEVEL 2	$153.50	$274.10	$82.23–$201.74	17% above	44%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC Nutrition Ther Init/15 Min	$38.92	$69.50	$70.02–$80.31	35% below	44%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC NUTRITION THER INIT/15 MIN	$50.62	$90.40	$70.02–$80.31	16% below	44%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION THER INIT/15 MIN	$138.43	$247.20	$70.02–$80.31	131% above	44%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTRITION INDIV INT	$138.43	$247.20	$70.02–$80.31	131% above	44%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY TECHNIQUES	$106.74	$190.60	$70.02–$80.31	10% above	44%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL TREATMENT/15 MIN(747)	$106.74	$190.60	$70.02–$80.31	10% above	44%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 LAT THERAPUTIC EXERCISE	$115.98	$207.10	$70.02–$80.31	20% above	44%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 LAT THERAPUTIC EXERCISE W/MOD 15 MIN(747)	$115.98	$207.10	$70.02–$80.31	20% above	44%
Preventive checkup, new patient aged 18–39 CPT 99385 PREVENTIVE VISIT,NEW,18-39	$251.44	$449.00	$101.07–$330.46	80% above	44%
Preventive checkup, new patient aged 40–64 CPT 99386 PREVENTIVE VISIT,NEW,40-64	$290.98	$519.60	$122.58–$382.43	93% above	44%
Preventive checkup, new patient aged 65 or older CPT 99387 PREVENTIVE VISIT,NEW,65 & OVER	$315.28	$563.00	$131.67–$414.37	77% above	44%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREVENTIVE VISIT,EST,18-39	$226.07	$403.70	$92.10–$297.12	46% above	44%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREVENTIVE VISIT,EST,40-64	$241.36	$431.00	$100.32–$317.22	43% above	44%
Preventive checkup, returning patient aged 65 or older CPT 99397 PREVENTIVE VISIT,EST,65 & OVER	$259.73	$463.80	$105.48–$341.36	74% above	44%
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES	$408.35	$729.20	$192.06–$536.69	48% above	44%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR	$250.49	$447.30	$121.56–$329.21	at median	44%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS; FIRST 60 MINUTES	$295.46	$527.60	$141.12–$388.31	at median	44%
Psychotherapy session, 30 minutes CPT 90832 HC Php Individual Psychotherapy Lvl 1	$109.09	$194.80	$58.44–$149.19	3% above	44%
Psychotherapy session, 30 minutes CPT 90832 HC Psych Therapy 30 Min W/Pt &/or Family	$109.09	$194.80	$58.44–$149.19	3% above	44%
Psychotherapy session, 30 minutes CPT 90832 HC Individual Psychotherapy Lvl 1	$109.09	$194.80	$58.44–$149.19	3% above	44%
Psychotherapy session, 30 minutes CPT 90832 HC PHP INDIVIDUAL PSYCHOTHERAPY LVL 1	$113.51	$202.70	$58.44–$149.19	7% above	44%
Psychotherapy session, 30 minutes CPT 90832 HC IOP INDIVIDUAL PSYCHOTHERAPY LVL 1	$113.51	$202.70	$58.44–$149.19	7% above	44%
Psychotherapy session, 30 minutes CPT 90832 HC INDIVIDUAL PSYCHOTHERAPY LVL 1	$113.51	$202.70	$58.44–$149.19	7% above	44%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES	$158.70	$283.40	$75.03–$208.58	49% above	44%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES	$209.61	$374.30	$99.33–$275.48	48% above	44%
Psychotherapy session, 45 minutes CPT 90834 HC Php Individual Psychotherapy Lvl 2	$215.21	$384.30	$115.29–$341.06	52% above	44%
Psychotherapy session, 45 minutes CPT 90834 HC Individual Psychotherapy Lvl 2	$215.21	$384.30	$115.29–$341.06	52% above	44%
Psychotherapy session, 45 minutes CPT 90834 HC Psych Therapy 45 Min W/Pt &/or Family	$215.21	$384.30	$115.29–$341.06	52% above	44%
Psychotherapy session, 45 minutes CPT 90834 HC PHP INDIVIDUAL PSYCHOTHERAPY LVL 2	$259.50	$463.40	$115.29–$341.06	83% above	44%
Psychotherapy session, 45 minutes CPT 90834 HC INDIVIDUAL PSYCHOTHERAPY LVL 2	$259.50	$463.40	$115.29–$341.06	83% above	44%
Psychotherapy session, 45 minutes CPT 90834 HC IOP INDIVIDUAL PSYCHOTHERAPY LVL 2	$259.50	$463.40	$115.29–$341.06	83% above	44%
Psychotherapy session, 60 minutes CPT 90837 HC Php Psych Therapy 60 Min W/Pt &/or Family	$214.93	$383.80	$115.14–$341.06	1% above	44%
Psychotherapy session, 60 minutes CPT 90837 HC Psych Therapy 60 Min W/Pt &/or Family	$214.93	$383.80	$115.14–$341.06	1% above	44%
Psychotherapy session, 60 minutes CPT 90837 HC PSYCH THERAPY 60 MIN W/PT &/OR FAMILY	$259.50	$463.40	$115.14–$341.06	22% above	44%
Psychotherapy session, 60 minutes CPT 90837 HC PHP PSYCH THERAPY 60 MIN W/PT &/OR FAMILY	$259.50	$463.40	$115.14–$341.06	22% above	44%
Psychotherapy session, 60 minutes CPT 90837 HC IOP PSYCH THERAPY 60 MIN W/PT &/OR FAMILY	$259.50	$463.40	$115.14–$341.06	22% above	44%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES	$308.78	$551.40	$146.13–$405.83	45% above	44%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$29.18	$52.10	$12.63–$38.35	1% above	44%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN	$326.31	$582.70	$139.32–$541.91	11% above	44%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Est Pt Level 5	$328.16	$586.00	$175.80–$431.30	11% above	44%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC EST PT LEVEL 5	$328.16	$586.00	$175.80–$431.30	11% above	44%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$164.36	$293.50	$64.08–$272.96	at median	44%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC EST PT LEVEL 3	$175.56	$313.50	$94.05–$230.74	7% above	44%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Est Pt Level 3	$175.56	$313.50	$94.05–$230.74	7% above	44%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Est Pt Level 4	$182.45	$325.80	$97.74–$239.79	2% below	44%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC EST PT LEVEL 4	$182.45	$325.80	$97.74–$239.79	2% below	44%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 FLIGHT PHYSICAL	$232.74	$415.60	$94.80–$305.88	25% above	44%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$232.74	$415.60	$94.80–$386.51	25% above	44%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WIAA PHYSICAL	$16.80	$30.00	$9.00–$22.08	83% below	44%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN	$102.76	$183.50	$34.38–$170.66	6% above	44%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Est Pt Level 2	$153.50	$274.10	$82.23–$201.74	59% above	44%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC EST PT LEVEL 2	$153.50	$274.10	$82.23–$201.74	59% above	44%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULTATION,LEVEL III	$250.43	$447.20	$104.49–$329.14	25% above	44%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULTATION,LEVEL IV	$350.56	$626.00	$158.46–$460.74	9% above	44%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$99.12	$177.00	$53.10–$130.27	65% below	44%
Spirometry (breathing test) CPT 94010 HC Spirometry Study	$228.14	$407.40	$122.22–$341.95	18% below	44%
Spirometry (breathing test) CPT 94010 HC SPIROMETRY STUDY	$260.18	$464.60	$122.22–$341.95	7% below	44%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY, PRE & POST	$143.08	$255.50	$76.65–$188.05	71% below	44%
Spirometry before and after a bronchodilator CPT 94060 HC Bronchodilator Study	$493.92	$882.00	$264.60–$687.57	2% above	44%
Spirometry before and after a bronchodilator CPT 94060 HC BRONCHODILATOR STUDY	$515.31	$920.20	$264.60–$687.57	6% above	44%
TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 TCRANIAL MAGN STIM TX PLAN	$1,474.59	$2,633.20	$789.96–$1,938.04	267% above	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC Ot Treat-Indv Psych 15min	$75.43	$134.70	$70.02–$80.31	16% below	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT TREAT-INDV PSYCH 15MIN	$86.91	$155.20	$70.02–$80.31	3% below	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES	$145.54	$259.90	$70.02–$80.31	62% above	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPUTIC ACTIVITIES/15 MIN(747)	$145.54	$259.90	$70.02–$80.31	62% above	44%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC Phlebotomy Therapeutic	$109.76	$196.00	$58.80–$236.92	45% below	44%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THERAPEUTIC	$142.69	$254.80	$58.80–$236.92	29% below	44%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$356.38	$636.40	$190.92–$468.39	78% above	44%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 mRNA Vac 12y+ Moderna 50 mcg/0.5 mL Susy 0.5 mL Syringe	$139.64	$249.36	$1.62–$58,699.64	16% below	44%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 mRNA Vac Moderna 50 mcg/0.5 mL Susp 0.5 mL Vial	$139.64	$249.36	$1.62–$58,699.64	16% below	44%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$305.42	$545.40	—	83% above	44%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE	$168.06	$300.10	—	3% above	44%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus vaccine live 1,350 PFU/0.5 mL Susr 1 each Vial	$221.18	$394.97	$1.62–$58,699.64	35% above	44%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VACC 4-6 YR IM	$84.17	$150.30	—	at median	44%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP IMMUNIZATION	$39.09	$69.80	—	5% below	44%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$113.90	$203.40	—	18% below	44%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE	$116.59	$208.20	—	at median	44%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 RIV3 VACCINE PRESERVATIVE FREE FOR IM USE	$72.69	$129.80	—	3% below	44%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACCINE,PF,MA 19YRS +	$31.92	$57.00	—	at median	44%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACCINE,MA 3-18YRS,FREE SUPPLY	$31.92	$57.00	—	at median	44%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$31.92	$57.00	—	at median	44%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza virus trivalent vacc iiv3 split PF 0.5 mL Susy 0.5 mL Syringe	$38.12	$68.07	$1.62–$58,699.64	19% above	44%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE	$318.64	$569.00	—	at median	44%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPA/HEPB VACCINE ADULT IM	$142.86	$255.10	—	25% below	44%
Hepatitis A vaccine, adult dose CPT 90632 hepatitis A vaccine 50 Units/mL Susp 1 mL Syringe	$54.07	$96.56	$1.62–$58,699.64	59% below	44%
Hepatitis A vaccine, adult dose CPT 90632 hepatitis A vaccine 1,440 EL U/mL Susp 1 mL Vial	$88.91	$158.77	$1.62–$58,699.64	33% below	44%
Hepatitis A vaccine, adult dose CPT 90632 hepatitis A vaccine 1,440 EL U/mL Susp 1 mL Syringe	$96.67	$172.63	$1.62–$58,699.64	27% below	44%
Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM	$104.61	$186.80	—	21% below	44%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A(PED 2 DOSE)	$51.91	$92.70	—	at median	44%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 hepatitis A vaccine 25 Units/0.5 mL Susp 0.5 mL Syringe	$52.42	$93.60	$1.62–$58,699.64	1% above	44%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 hepatitis A Vaccine 720 EL U/0.5 mL Susy 0.5 mL Syringe	$55.45	$99.02	$1.62–$58,699.64	7% above	44%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B vaccine recombinant 10 mcg/mL Susp 1 mL Vial	$47.20	$84.29	$1.62–$58,699.64	59% below	44%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B vaccine recombinant 20 mcg/mL Susy 1 mL Syringe	$71.86	$128.32	$1.62–$58,699.64	38% below	44%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE, OVER 20YR	$105.11	$187.70	—	9% below	44%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEP B VACC ADULT 2 DOSE IM	$211.51	$377.70	—	1% below	44%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B vaccine recombinant 5 mcg/0.5 mL Susp 0.5 mL Vial	$36.55	$65.26	$1.62–$58,699.64	35% below	44%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B vaccine recombinant 10 mcg/0.5 mL Susy 0.5 mL Syringe	$43.37	$77.45	$1.62–$58,699.64	23% below	44%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACCINE, THRU 19YR	$50.51	$90.20	—	10% below	44%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIB VACCINE, PRP-OMP, IM	$43.79	$78.20	—	13% below	44%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB VACCINE, PRP-T, IM	$41.78	$74.60	—	at median	44%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH-DOSE	$82.17	$146.74	$1.62–$58,699.64	4% above	44%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC PRSV FREE INC ANTIG HIGH DOSE	$153.61	$274.30	—	94% above	44%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 JAPANESE ENCEPHALITIS VIRUS VACCINE, INACTIVATED, INTRAMUSCULAR USE	$279.16	$498.50	—	at median	44%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VIRUS IMMUNIZATION	$92.12	$164.50	—	40% below	44%
MMR vaccine (measles, mumps and rubella), live CPT 90707 measles, mumps & rubella vac Solr 1 each Vial	$118.88	$212.28	$1.62–$58,699.64	22% below	44%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 COMBINED VACCINE,MMR+VARICELLA	$518.17	$925.30	—	104% above	44%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MCV4 MENACWY-D CONJ VACC GRPS ACYW-135 IM USE	$490.50	$875.90	—	114% above	44%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MCV4 MENACWY-TT CONJ VACC GRPS ACYW IM USE	$216.16	$386.00	—	6% above	44%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL RECOMBINANT 2 DOSE IM	$231.62	$413.60	—	at median	44%
Meningococcal B vaccine (Trumenba) CPT 90621 MENINGOCOCCAL FULLY RECOMBINANT 3 DOSE IM	$190.40	$340.00	—	1% below	44%
Nasal spray flu vaccine, live (FluMist) CPT 90660 FLU VACCINE, NASAL	$38.81	$69.30	—	at median	44%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL 13	$322.84	$576.50	—	10% above	44%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PNEUMOCOCCAL CONJUGATE VACCINE, 15 VALENT (PCV15), INTRAMUSCULAR USE	$336.73	$601.30	—	15% above	44%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-val conj vacc 0.5 mL Susy 0.5 mL Syringe	$281.67	$502.99	$1.62–$58,699.64	4% below	44%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL CONJUGATE VACCINE, 20 VALENT (PCV20), INTRAMUSCULAR USE	$364.50	$650.90	—	25% above	44%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL(PNEUMOVAX) IMMUNI	$168.22	$300.40	—	19% above	44%
Polio vaccine, inactivated (IPV) CPT 90713 POLIO IMMUNIZATION, INJECTABLE	$43.79	$78.20	—	27% below	44%
Polio vaccine, inactivated (IPV) CPT 90713 poliovirus vaccine inactivated Susp 5 mL Vial	$474.22	$846.82	$1.62–$58,699.64	693% above	44%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 nirsevimab-alip 100 mg/mL Sosy 1 mL Syringe	$564.66	$1,008.33	$1.62–$58,699.64	45% below	44%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE	$1,131.82	$2,021.10	$606.33–$1,487.53	11% above	44%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 nirsevimab-alip 50 mg/0.5 mL Sosy 0.5 mL Syringe	$537.91	$960.56	$1.62–$58,699.64	47% below	44%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE	$565.94	$1,010.60	$303.18–$743.80	45% below	44%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$293.55	$524.20	—	47% below	44%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RESPIRATORY SYNCYTIAL VIRUS VACCINE, PREF, RECOMBINANT,	$281.79	$503.20	—	48% below	44%
Rabies vaccine, one dose CPT 90675 rabies virus vaccine Susr 1 each Vial	$435.98	$778.53	$1.62–$58,699.64	25% below	44%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, IM	$467.94	$835.60	—	19% below	44%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VACC 2 DOSE ORAL (ROTARIX)	$178.98	$319.60	—	18% above	44%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACC 3 DOSE ORAL (ROTATEQ)	$116.59	$208.20	—	at median	44%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX	$197.90	$353.40	—	at median	44%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS DIPHTHERIA PRESERVATIVE FREE	$41.44	$74.00	—	at median	44%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphtheria (age 7 yrs-adult) adult Susp 0.5 mL Syringe	$66.63	$118.99	$1.62–$58,699.64	61% above	44%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus toxoid-diphtheria-acellular pertussis Tdap adult Susy 0.5 mL Syringe	$58.07	$103.69	$1.62–$58,699.64	29% below	44%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP IMMUNIZATION (BOOSTRIX)	$70.95	$126.70	—	13% below	44%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP IMMUNIZATION (ADACEL)	$70.95	$126.70	—	13% below	44%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACC IND 7 YEARS/OLDER IM USE	$70.95	$126.70	—	13% below	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION, 1 VACCINE	$55.61	$99.30	—	44% above	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION, 1ST OR ONLY INJ	$55.61	$99.30	—	44% above	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 FLU OR PNEUMO ADMINISTATION FEE	$55.61	$99.30	—	44% above	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION, 1ST OR ONLY INJ SELF PAY	$55.61	$99.30	—	44% above	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Immunization Administration	$56.00	$100.00	—	45% above	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMINISTRATION	$61.60	$110.00	—	59% above	44%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Immunization Administration, Each Additional Vaccine	$38.58	$68.90	—	19% above	44%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADMINISTRATION, EACH ADDITIONAL VACCINE	$39.20	$70.00	—	21% above	44%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION, ADDITIONAL INJ	$39.82	$71.10	—	23% above	44%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION, EACH ADDITIONAL VACCINE	$39.82	$71.10	—	23% above	44%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION, ADDITIONAL INJ SELF PAY	$39.82	$71.10	—	23% above	44%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION SUBSEQUENT FLU/PNEUMONIA	$39.82	$71.10	—	23% above	44%

Dental

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Routine teeth cleaning (prophylaxis), adult or teen CDT D1110 HC Dental Prophylaxis Adult	$267.68	$478.00	$143.40–$362.33	at median	44%
Routine teeth cleaning (prophylaxis), adult or teen CDT D1110 HC DENTAL PROPHYLAXIS ADULT	$275.69	$492.30	$143.40–$362.33	3% above	44%
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 HC Extrac Erupted Tooth/Exposed Root	$1,207.86	$2,156.90	$647.07–$2,063.74	at median	44%
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 HC EXTRAC ERUPTED TOOTH/EXPOSED ROOT	$1,570.24	$2,804.00	$647.07–$2,063.74	30% above	44%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://hospitalpricetransparencyfiles.com/thedacare-regional-medical-center-appleton-inc/391509362_ThedaCare-Regional-Medical-Center-Appleton-Inc-dba-Fond-du-Lac_standardcharges.csv