Northern Light Mayo Hospital
Listed in its price file as “Mayo Regional Hospital”.
Northern Light Mayo Hospital in Dover Foxcroft, ME publishes cash prices for 312 common procedures listed here, from its own machine-readable price file updated Mar 30, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Maine median for 297 of 309 procedures and above it for 9. By typical cash price it ranks #6 of 28 Maine hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
897 W Main St., Dover Foxcroft, ME 04426 Collected Sep 23, 2026 Source price file Check a bill from this hospital (207) 564-4251
Critical access hospital (rural, 25 beds or fewer) Government-owned hospital Emergency department CMS star rating 2 of 5 CCN 201309 · CMS hospital register NPI 1558319103
Financial assistance
Public hospital: ask for its charity care or sliding-scale discount
Northern Light Mayo Hospital is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Contrast | $596.64 | $1,808.00 | $759.36–$1,808.00 | 57% below | 67% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/ + w/o Contrast | $596.64 | $1,808.00 | $1,175.20–$1,808.00 | — | 67% |
| Abdominal X-ray, 2 views CPT 74019 XR Abdomen 2 Views | $161.04 | $488.00 | $204.96–$488.00 | 34% below | 67% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen 2 Views | $161.04 | $488.00 | $317.20–$488.00 | — | 67% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Right | $140.58 | $426.00 | $178.92–$426.00 | 34% below | 67% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Left | $140.58 | $426.00 | $178.92–$426.00 | 34% below | 67% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Left | $140.58 | $426.00 | $276.90–$426.00 | — | 67% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Right | $140.58 | $426.00 | $276.90–$426.00 | — | 67% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ART VASC LIMITED CHARGE | $76.56 | $232.00 | $97.44–$232.00 | 48% below | 67% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ART VASC LIMITED CHARGE | $76.56 | $232.00 | $150.80–$232.00 | — | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Right | $421.74 | $1,278.00 | $536.76–$1,278.00 | 63% below | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm w/o Contrast Right | $421.74 | $1,278.00 | $536.76–$1,278.00 | 63% below | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm w/o Contrast Left | $421.74 | $1,278.00 | $536.76–$1,278.00 | 63% below | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Right | $421.74 | $1,278.00 | $536.76–$1,278.00 | 63% below | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Left | $421.74 | $1,278.00 | $536.76–$1,278.00 | 63% below | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Left | $421.74 | $1,278.00 | $536.76–$1,278.00 | 63% below | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Right | $421.74 | $1,278.00 | $536.76–$1,278.00 | 63% below | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Left | $421.74 | $1,278.00 | $536.76–$1,278.00 | 63% below | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus w/o Contrast Right | $421.74 | $1,278.00 | $536.76–$1,278.00 | 63% below | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Right | $421.74 | $1,278.00 | $536.76–$1,278.00 | 63% below | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus w/o Contrast Left | $421.74 | $1,278.00 | $536.76–$1,278.00 | 63% below | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Left | $421.74 | $1,278.00 | $536.76–$1,278.00 | 63% below | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder w/o Contrast Right | $421.74 | $1,278.00 | $830.70–$1,278.00 | — | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist w/o Contrast Right | $421.74 | $1,278.00 | $830.70–$1,278.00 | — | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm w/o Contrast Left | $421.74 | $1,278.00 | $830.70–$1,278.00 | — | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm w/o Contrast Right | $421.74 | $1,278.00 | $830.70–$1,278.00 | — | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand w/o Contrast Left | $421.74 | $1,278.00 | $830.70–$1,278.00 | — | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand w/o Contrast Right | $421.74 | $1,278.00 | $830.70–$1,278.00 | — | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus w/o Contrast Left | $421.74 | $1,278.00 | $830.70–$1,278.00 | — | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus w/o Contrast Right | $421.74 | $1,278.00 | $830.70–$1,278.00 | — | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow w/o Contrast Left | $421.74 | $1,278.00 | $830.70–$1,278.00 | — | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow w/o Contrast Right | $421.74 | $1,278.00 | $830.70–$1,278.00 | — | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder w/o Contrast Left | $421.74 | $1,278.00 | $830.70–$1,278.00 | — | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist w/o Contrast Left | $421.74 | $1,278.00 | $830.70–$1,278.00 | — | 67% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Barium Swallow | $270.93 | $821.00 | $344.82–$821.00 | 23% below | 67% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Barium Swallow | $270.93 | $821.00 | $533.65–$821.00 | — | 67% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Imaging Whole Body | $593.01 | $1,797.00 | $754.74–$1,797.00 | 50% below | 67% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Imaging Whole Body | $593.01 | $1,797.00 | $1,168.05–$1,797.00 | — | 67% |
| Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Bilateral. | $162.03 | $491.00 | $206.22–$491.00 | — | 67% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Right Axillary Only. | $162.03 | $491.00 | $206.22–$491.00 | 20% below | 67% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Left. | $162.03 | $491.00 | $206.22–$491.00 | 20% below | 67% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Right. | $162.03 | $491.00 | $206.22–$491.00 | 20% below | 67% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Left Axillary Only. | $162.03 | $491.00 | $206.22–$491.00 | 20% below | 67% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast Bilateral. | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Right Axillary Only. | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Left. | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Left Axillary Only. | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Right. | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIOGRAPHY ABDOMEN/PELVIS W/ + W/O C | $1,487.64 | $4,508.00 | $1,893.36–$4,508.00 | 3% below | 67% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIOGRAPHY ABDOMEN/PELVIS | $1,487.64 | $4,508.00 | $1,893.36–$4,508.00 | 3% below | 67% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIOGRAPHY ABDOMEN/PELVIS W/ + W/O C | $1,487.64 | $4,508.00 | $2,930.20–$4,508.00 | — | 67% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIOGRAPHY ABDOMEN/PELVIS | $1,487.64 | $4,508.00 | $2,930.20–$4,508.00 | — | 67% |
| CT angiography (CTA) of the head CPT 70496 CT Angiography Head | $735.57 | $2,229.00 | $936.18–$2,229.00 | 53% below | 67% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT Angiography Head | $735.57 | $2,229.00 | $1,448.85–$2,229.00 | — | 67% |
| CT angiography (CTA) of the neck CPT 70498 CT Angiography Neck | $915.75 | $2,775.00 | $1,165.50–$2,775.00 | 42% below | 67% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT Angiography Neck | $915.75 | $2,775.00 | $1,803.75–$2,775.00 | — | 67% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST AORTA | $1,209.78 | $3,666.00 | $1,539.72–$3,666.00 | 34% below | 67% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography Chest PE | $1,218.36 | $3,692.00 | $1,550.64–$3,692.00 | 34% below | 67% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST AORTA | $1,209.78 | $3,666.00 | $2,382.90–$3,666.00 | — | 67% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angiography Chest PE | $1,218.36 | $3,692.00 | $2,399.80–$3,692.00 | — | 67% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen/Pelvis w/o Contrast | $1,191.63 | $3,611.00 | $1,516.62–$3,611.00 | 14% below | 67% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen/Pelvis w/o Contrast | $1,191.63 | $3,611.00 | $2,347.15–$3,611.00 | — | 67% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen/Pelvis w/ Contrast | $1,494.90 | $4,530.00 | $1,902.60–$4,530.00 | 25% below | 67% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen/Pelvis w/ Contrast | $1,494.90 | $4,530.00 | $2,944.50–$4,530.00 | — | 67% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen/Pelvis w + w/o Contrast | $1,688.61 | $5,117.00 | $2,149.14–$5,117.00 | 23% below | 67% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen/Pelvis w + w/o Contrast | $1,688.61 | $5,117.00 | $3,326.05–$5,117.00 | — | 67% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast | $528.66 | $1,602.00 | $672.84–$1,602.00 | 53% below | 67% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast | $528.66 | $1,602.00 | $1,041.30–$1,602.00 | — | 67% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast | $427.68 | $1,296.00 | $544.32–$1,296.00 | 49% below | 67% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast | $427.68 | $1,296.00 | $842.40–$1,296.00 | — | 67% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus | $447.15 | $1,355.00 | $569.10–$1,355.00 | 49% below | 67% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast | $447.15 | $1,355.00 | $569.10–$1,355.00 | 49% below | 67% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus | $447.15 | $1,355.00 | $880.75–$1,355.00 | — | 67% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast | $447.15 | $1,355.00 | $880.75–$1,355.00 | — | 67% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Stroke Study | $565.62 | $1,714.00 | $719.88–$1,714.00 | 42% below | 67% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain w/o Contrast | $565.62 | $1,714.00 | $719.88–$1,714.00 | 42% below | 67% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Stroke Study | $565.62 | $1,714.00 | $1,114.10–$1,714.00 | — | 67% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain w/o Contrast | $565.62 | $1,714.00 | $1,114.10–$1,714.00 | — | 67% |
| CT scan of the head with contrast CPT 70460 CT Head or Brain w/ Contrast | $586.41 | $1,777.00 | $746.34–$1,777.00 | 45% below | 67% |
| CT scan of the head with contrast inpatient CPT 70460 CT Head or Brain w/ Contrast | $586.41 | $1,777.00 | $1,155.05–$1,777.00 | — | 67% |
| CT scan of the head without and with contrast CPT 70470 CT Head or Brain w/ + w/o Contrast | $700.59 | $2,123.00 | $891.66–$2,123.00 | 52% below | 67% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Head or Brain w/ + w/o Contrast | $700.59 | $2,123.00 | $1,379.95–$2,123.00 | — | 67% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast | $460.02 | $1,394.00 | $585.48–$1,394.00 | 53% below | 67% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast | $460.02 | $1,394.00 | $906.10–$1,394.00 | — | 67% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast | $493.02 | $1,494.00 | $627.48–$1,494.00 | 50% below | 67% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast | $493.02 | $1,494.00 | $971.10–$1,494.00 | — | 67% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast | $590.04 | $1,788.00 | $750.96–$1,788.00 | 41% below | 67% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast | $590.04 | $1,788.00 | $1,162.20–$1,788.00 | — | 67% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Doppler Bilateral | $361.02 | $1,094.00 | $459.48–$1,094.00 | — | 67% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Doppler Bilateral | $361.02 | $1,094.00 | $711.10–$1,094.00 | — | 67% |
| Chest CT scan without and with contrast CPT 71270 CT Thorax w/ + w/o Contrast | $1,093.95 | $3,315.00 | $1,392.30–$3,315.00 | 36% below | 67% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Thorax w/ + w/o Contrast | $1,093.95 | $3,315.00 | $2,154.75–$3,315.00 | — | 67% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views | $154.11 | $467.00 | $196.14–$467.00 | 27% below | 67% |
| Chest X-ray, 2 views CPT 71046 XR Chest Special Views | $154.11 | $467.00 | $196.14–$467.00 | 27% below | 67% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest Special Views | $154.11 | $467.00 | $303.55–$467.00 | — | 67% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views | $154.11 | $467.00 | $303.55–$467.00 | — | 67% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View Portable | $133.98 | $406.00 | $170.52–$406.00 | 33% below | 67% |
| Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW | $133.98 | $406.00 | $170.52–$406.00 | 33% below | 67% |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Portable | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right | $133.98 | $406.00 | $170.52–$406.00 | 39% below | 67% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left | $133.98 | $406.00 | $170.52–$406.00 | 39% below | 67% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 76770 ULTRASOUND OF RETROPERITONEMUM BEDSIDE | $254.10 | $770.00 | $323.40–$770.00 | 44% below | 67% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete | $254.10 | $770.00 | $323.40–$770.00 | 44% below | 67% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete | $254.10 | $770.00 | $500.50–$770.00 | — | 67% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 76770 ULTRASOUND OF RETROPERITONEMUM BEDSIDE | $254.10 | $770.00 | $500.50–$770.00 | — | 67% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton | $162.03 | $491.00 | $206.22–$491.00 | 35% below | 67% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT-THORAX LIMITED FUP LUNG SCREEN W/O CONTRAST (3- | $442.86 | $1,342.00 | $563.64–$1,342.00 | 53% below | 67% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o Contrast | $590.37 | $1,789.00 | $751.38–$1,789.00 | 37% below | 67% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT-THORAX LIMITED FUP LUNG SCREEN W/O CONTRAST (3- | $442.86 | $1,342.00 | $872.30–$1,342.00 | — | 67% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o Contrast | $590.37 | $1,789.00 | $1,162.85–$1,789.00 | — | 67% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/ Contrast | $892.65 | $2,705.00 | $1,136.10–$2,705.00 | 31% below | 67% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/ Contrast | $892.65 | $2,705.00 | $1,758.25–$2,705.00 | — | 67% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MA Mammo Diagnostic 3D Bilateral. | $175.23 | $531.00 | $223.02–$531.00 | — | 67% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MA Mammogram Diagnostic Bilateral. | $175.23 | $531.00 | $223.02–$531.00 | — | 67% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA Mammogram Diagnostic Bilateral. | $175.23 | $531.00 | $345.15–$531.00 | — | 67% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA Mammo Diagnostic 3D Bilateral. | $175.23 | $531.00 | $345.15–$531.00 | — | 67% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Mammo Diagnostic 3D Left. | $103.29 | $313.00 | $131.46–$313.00 | 34% below | 67% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Mammo Diagnostic 3D Right. | $103.29 | $313.00 | $131.46–$313.00 | 34% below | 67% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Mammogram Diagnostic Right. | $103.29 | $313.00 | $131.46–$313.00 | 34% below | 67% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Mammogram Diagnostic Left. | $103.29 | $313.00 | $131.46–$313.00 | 34% below | 67% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Mammo Diagnostic 3D Left. | $103.29 | $313.00 | $203.45–$313.00 | — | 67% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Mammo Diagnostic 3D Right. | $103.29 | $313.00 | $203.45–$313.00 | — | 67% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Mammogram Diagnostic Right. | $103.29 | $313.00 | $203.45–$313.00 | — | 67% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Mammogram Diagnostic Left. | $103.29 | $313.00 | $203.45–$313.00 | — | 67% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UE Venous Doppler Bilateral | $361.02 | $1,094.00 | $459.48–$1,094.00 | — | 67% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Doppler Bilateral | $361.02 | $1,094.00 | $459.48–$1,094.00 | — | 67% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US UE Venous Doppler Bilateral | $361.02 | $1,094.00 | $711.10–$1,094.00 | — | 67% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US LE Venous Doppler Bilateral | $361.02 | $1,094.00 | $711.10–$1,094.00 | — | 67% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echo 2D Complete | $812.46 | $2,462.00 | $1,034.04–$2,462.00 | 25% below | 67% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 93306 ECHO COMPLETE W/SPECT & DOPPLER CHARGE | $812.46 | $2,462.00 | $1,034.04–$2,462.00 | 25% below | 67% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echo 2D Complete EO | $812.46 | $2,462.00 | $1,034.04–$2,462.00 | 25% below | 67% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echo 2D Complete EO | $812.46 | $2,462.00 | $1,600.30–$2,462.00 | — | 67% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 93306 ECHO COMPLETE W/SPECT & DOPPLER CHARGE | $812.46 | $2,462.00 | $1,600.30–$2,462.00 | — | 67% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echo 2D Complete | $812.46 | $2,462.00 | $1,600.30–$2,462.00 | — | 67% |
| Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Left | $88.77 | $269.00 | $112.98–$269.00 | 59% below | 67% |
| Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Right | $88.77 | $269.00 | $112.98–$269.00 | 59% below | 67% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Left | $88.77 | $269.00 | $174.85–$269.00 | — | 67% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Right | $88.77 | $269.00 | $174.85–$269.00 | — | 67% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Min 3 Views Left | $133.65 | $405.00 | $170.10–$405.00 | 39% below | 67% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Min 3 Views Right | $133.65 | $405.00 | $170.10–$405.00 | 39% below | 67% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Min 3 Views Left | $133.65 | $405.00 | $263.25–$405.00 | — | 67% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Min 3 Views Right | $133.65 | $405.00 | $263.25–$405.00 | — | 67% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC w/o Contrast | $458.70 | $1,390.00 | $583.80–$1,390.00 | 53% below | 67% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit Sella etc. w/o Contrast | $458.70 | $1,390.00 | $583.80–$1,390.00 | 53% below | 67% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC w/o Contrast | $458.70 | $1,390.00 | $903.50–$1,390.00 | — | 67% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbit Sella etc. w/o Contrast | $458.70 | $1,390.00 | $903.50–$1,390.00 | — | 67% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones Minimum 3 Views | $138.60 | $420.00 | $176.40–$420.00 | 39% below | 67% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones Minimum 3 Views | $138.60 | $420.00 | $273.00–$420.00 | — | 67% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Right | $133.98 | $406.00 | $170.52–$406.00 | 37% below | 67% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Left | $133.98 | $406.00 | $170.52–$406.00 | 37% below | 67% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Right | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Left | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HIDA Scan w/o CCK | $607.53 | $1,841.00 | $773.22–$1,841.00 | 39% below | 67% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HIDA Scan w/o CCK | $607.53 | $1,841.00 | $1,196.65–$1,841.00 | — | 67% |
| Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Left | $150.81 | $457.00 | $191.94–$457.00 | 29% below | 67% |
| Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Right | $150.81 | $457.00 | $191.94–$457.00 | 29% below | 67% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Right | $150.81 | $457.00 | $297.05–$457.00 | — | 67% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Left | $150.81 | $457.00 | $297.05–$457.00 | — | 67% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneous Min 2 Views Right | $97.35 | $295.00 | $123.90–$295.00 | 53% below | 67% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneous Min 2 Views Left | $97.35 | $295.00 | $123.90–$295.00 | 53% below | 67% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneous Min 2 Views Left | $97.35 | $295.00 | $191.75–$295.00 | — | 67% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneous Min 2 Views Right | $97.35 | $295.00 | $191.75–$295.00 | — | 67% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 G0399 HOME SLEEP STUDY CHARGE | $230.34 | $698.00 | $293.16–$698.00 | 17% below | 67% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 G0399 HOME SLEEP STUDY CHARGE | $230.34 | $698.00 | $453.70–$698.00 | — | 67% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 95811 SLEEP STUDY W/ CPAP/BIPAP TITRATION CHARGE | $1,539.45 | $4,665.00 | $1,959.30–$4,665.00 | 12% below | 67% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 95811 SLEEP STUDY W/ CPAP/BIPAP TITRATION CHARGE | $1,539.45 | $4,665.00 | $3,032.25–$4,665.00 | — | 67% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right | $133.98 | $406.00 | $170.52–$406.00 | 41% below | 67% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left | $133.98 | $406.00 | $170.52–$406.00 | 41% below | 67% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Right | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Left | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete Right | $162.03 | $491.00 | $206.22–$491.00 | 36% below | 67% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete Left | $162.03 | $491.00 | $206.22–$491.00 | 36% below | 67% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete Left | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete Right | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Ankle w/o Contrast Bilateral | $439.23 | $1,331.00 | $559.02–$1,331.00 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia/Fibula w/o Contrast Right | $439.23 | $1,331.00 | $559.02–$1,331.00 | 58% below | 67% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Right | $439.23 | $1,331.00 | $559.02–$1,331.00 | 58% below | 67% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Right | $439.23 | $1,331.00 | $559.02–$1,331.00 | 58% below | 67% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur w/o Contrast Right | $439.23 | $1,331.00 | $559.02–$1,331.00 | 58% below | 67% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur w/o Contrast Left | $439.23 | $1,331.00 | $559.02–$1,331.00 | 58% below | 67% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Left | $439.23 | $1,331.00 | $559.02–$1,331.00 | 58% below | 67% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Left | $439.23 | $1,331.00 | $559.02–$1,331.00 | 58% below | 67% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip w/o Contrast Right | $439.23 | $1,331.00 | $559.02–$1,331.00 | 58% below | 67% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Left | $439.23 | $1,331.00 | $559.02–$1,331.00 | 58% below | 67% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip w/o Contrast Left | $439.23 | $1,331.00 | $559.02–$1,331.00 | 58% below | 67% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Right | $439.23 | $1,331.00 | $559.02–$1,331.00 | 58% below | 67% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia/Fibula w/o Contrast Left | $439.23 | $1,331.00 | $559.02–$1,331.00 | 58% below | 67% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Ankle w/o Contrast Bilateral | $439.23 | $1,331.00 | $865.15–$1,331.00 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/o Contrast Left | $439.23 | $1,331.00 | $865.15–$1,331.00 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee w/o Contrast Left | $439.23 | $1,331.00 | $865.15–$1,331.00 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip w/o Contrast Right | $439.23 | $1,331.00 | $865.15–$1,331.00 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip w/o Contrast Left | $439.23 | $1,331.00 | $865.15–$1,331.00 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia/Fibula w/o Contrast Left | $439.23 | $1,331.00 | $865.15–$1,331.00 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia/Fibula w/o Contrast Right | $439.23 | $1,331.00 | $865.15–$1,331.00 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot w/o Contrast Right | $439.23 | $1,331.00 | $865.15–$1,331.00 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur w/o Contrast Right | $439.23 | $1,331.00 | $865.15–$1,331.00 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee w/o Contrast Right | $439.23 | $1,331.00 | $865.15–$1,331.00 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot w/o Contrast Left | $439.23 | $1,331.00 | $865.15–$1,331.00 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/o Contrast Right | $439.23 | $1,331.00 | $865.15–$1,331.00 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur w/o Contrast Left | $439.23 | $1,331.00 | $865.15–$1,331.00 | — | 67% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited | $220.77 | $669.00 | $280.98–$669.00 | 9% below | 67% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 76705 LIMITED ABDOMINAL ULTRASOUND | $220.77 | $669.00 | $280.98–$669.00 | 9% below | 67% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited | $220.77 | $669.00 | $434.85–$669.00 | — | 67% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 76705 LIMITED ABDOMINAL ULTRASOUND | $220.77 | $669.00 | $434.85–$669.00 | — | 67% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Upper Extremity Non-Vascular Limited Right | $162.03 | $491.00 | $206.22–$491.00 | 3% below | 67% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Nonvascular Ltd Rt | $162.03 | $491.00 | $206.22–$491.00 | 3% below | 67% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Nonvascular Ltd Lt | $162.03 | $491.00 | $206.22–$491.00 | 3% below | 67% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Upper Extremity Non-Vascular Limited Left | $162.03 | $491.00 | $206.22–$491.00 | 3% below | 67% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Lower Exremity Non-Vascular Limited Right | $162.03 | $491.00 | $206.22–$491.00 | 3% below | 67% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Lower Extremity Non-Vascular Limited Left | $162.03 | $491.00 | $206.22–$491.00 | 3% below | 67% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Lower Extremity Non-Vascular Limited Left | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Lower Exremity Non-Vascular Limited Right | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Upper Extremity Non-Vascular Limited Left | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Upper Extremity Non-Vascular Limited Right | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Nonvascular Ltd Lt | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Nonvascular Ltd Rt | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Low Dose Lung Screening | $162.03 | $491.00 | $206.22–$491.00 | 28% below | 67% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Low Dose Lung Screening | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula 2 Views Left | $133.98 | $406.00 | $170.52–$406.00 | 37% below | 67% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula 2 Views Right | $133.98 | $406.00 | $170.52–$406.00 | 37% below | 67% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula 2 Views Left | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula 2 Views Right | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Head w/o Contrast | $637.89 | $1,933.00 | $811.86–$1,933.00 | 64% below | 67% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Head w/ + w/o Contrast | $637.89 | $1,933.00 | $811.86–$1,933.00 | 64% below | 67% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Head w/ + w/o Contrast | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Head w/o Contrast | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right | $637.89 | $1,933.00 | $811.86–$1,933.00 | 57% below | 67% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left | $637.89 | $1,933.00 | $811.86–$1,933.00 | 57% below | 67% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left | $637.89 | $1,933.00 | $811.86–$1,933.00 | 57% below | 67% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right | $637.89 | $1,933.00 | $811.86–$1,933.00 | 57% below | 67% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right | $637.89 | $1,933.00 | $811.86–$1,933.00 | 57% below | 67% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left | $637.89 | $1,933.00 | $811.86–$1,933.00 | 57% below | 67% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Right | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Left | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Right | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Left | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Right | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Left | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $1,081.41 | $3,277.00 | $1,376.34–$3,277.00 | 58% below | 67% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $1,081.41 | $3,277.00 | $1,376.34–$3,277.00 | 58% below | 67% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $1,081.41 | $3,277.00 | $1,376.34–$3,277.00 | 58% below | 67% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $1,081.41 | $3,277.00 | $1,376.34–$3,277.00 | 58% below | 67% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $1,081.41 | $3,277.00 | $1,376.34–$3,277.00 | 58% below | 67% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $1,081.41 | $3,277.00 | $1,376.34–$3,277.00 | 58% below | 67% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $1,081.41 | $3,277.00 | $2,130.05–$3,277.00 | — | 67% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $1,081.41 | $3,277.00 | $2,130.05–$3,277.00 | — | 67% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $1,081.41 | $3,277.00 | $2,130.05–$3,277.00 | — | 67% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $1,081.41 | $3,277.00 | $2,130.05–$3,277.00 | — | 67% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $1,081.41 | $3,277.00 | $2,130.05–$3,277.00 | — | 67% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $1,081.41 | $3,277.00 | $2,130.05–$3,277.00 | — | 67% |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast | $637.89 | $1,933.00 | $811.86–$1,933.00 | 63% below | 67% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast | $810.81 | $2,457.00 | $1,031.94–$2,457.00 | 63% below | 67% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast | $810.81 | $2,457.00 | $1,597.05–$2,457.00 | — | 67% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast | $637.89 | $1,933.00 | $811.86–$1,933.00 | 56% below | 67% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast | $810.48 | $2,456.00 | $1,031.52–$2,456.00 | 63% below | 67% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast | $810.48 | $2,456.00 | $1,596.40–$2,456.00 | — | 67% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast | $610.17 | $1,849.00 | $776.58–$1,849.00 | 57% below | 67% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast | $610.17 | $1,849.00 | $1,201.85–$1,849.00 | — | 67% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $810.81 | $2,457.00 | $1,031.94–$2,457.00 | 65% below | 67% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $810.81 | $2,457.00 | $1,597.05–$2,457.00 | — | 67% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast | $637.89 | $1,933.00 | $811.86–$1,933.00 | 55% below | 67% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $810.81 | $2,457.00 | $1,031.94–$2,457.00 | 60% below | 67% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $810.81 | $2,457.00 | $1,597.05–$2,457.00 | — | 67% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast | $617.76 | $1,872.00 | $786.24–$1,872.00 | 56% below | 67% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast | $617.76 | $1,872.00 | $1,216.80–$1,872.00 | — | 67% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast | $969.21 | $2,937.00 | $1,233.54–$2,937.00 | 58% below | 67% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast | $969.21 | $2,937.00 | $1,909.05–$2,937.00 | — | 67% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast | $637.89 | $1,933.00 | $811.86–$1,933.00 | 59% below | 67% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Right | $637.89 | $1,933.00 | $811.86–$1,933.00 | 57% below | 67% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Right | $637.89 | $1,933.00 | $811.86–$1,933.00 | 57% below | 67% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Left | $637.89 | $1,933.00 | $811.86–$1,933.00 | 57% below | 67% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Left | $637.89 | $1,933.00 | $811.86–$1,933.00 | 57% below | 67% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Right | $637.89 | $1,933.00 | $811.86–$1,933.00 | 57% below | 67% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Left | $637.89 | $1,933.00 | $811.86–$1,933.00 | 57% below | 67% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Left | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Right | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Left | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Right | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Right | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Left | $637.89 | $1,933.00 | $1,256.45–$1,933.00 | — | 67% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical Minimum 4 Views | $162.03 | $491.00 | $206.22–$491.00 | 45% below | 67% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical Minimum 4 Views | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tissue Neck w/ Contrast | $568.92 | $1,724.00 | $724.08–$1,724.00 | 56% below | 67% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Soft Tissue Neck w/ Contrast | $568.92 | $1,724.00 | $1,120.60–$1,724.00 | — | 67% |
| Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck w/o Contrast | $401.94 | $1,218.00 | $511.56–$1,218.00 | 60% below | 67% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tissue Neck w/o Contrast | $401.94 | $1,218.00 | $791.70–$1,218.00 | — | 67% |
| Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue | $131.67 | $399.00 | $167.58–$399.00 | 37% below | 67% |
| Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue | $131.67 | $399.00 | $259.35–$399.00 | — | 67% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perf Multi Rest/Stress | $1,685.64 | $5,108.00 | $2,145.36–$5,108.00 | 18% below | 67% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perf Multi Rest/Stress | $1,685.64 | $5,108.00 | $3,320.20–$5,108.00 | — | 67% |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast | $450.78 | $1,366.00 | $573.72–$1,366.00 | 52% below | 67% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast | $450.78 | $1,366.00 | $887.90–$1,366.00 | — | 67% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Limited | $136.95 | $415.00 | $174.30–$415.00 | 22% below | 67% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic Limited | $136.95 | $415.00 | $269.75–$415.00 | — | 67% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Complete | $226.38 | $686.00 | $288.12–$686.00 | 43% below | 67% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Complete | $226.38 | $686.00 | $445.90–$686.00 | — | 67% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Complete | $240.57 | $729.00 | $306.18–$729.00 | 45% below | 67% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 MAYO OB Complete | $240.57 | $729.00 | $306.18–$729.00 | 45% below | 67% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 MAYO OB Complete | $240.57 | $729.00 | $473.85–$729.00 | — | 67% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Complete | $240.57 | $729.00 | $473.85–$729.00 | — | 67% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnancy < 14 weeks | $170.61 | $517.00 | $217.14–$517.00 | 45% below | 67% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 MAYO US Pregnancy < 14 weeks | $170.61 | $517.00 | $217.14–$517.00 | 45% below | 67% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 MAYO US Pregnancy < 14 weeks | $170.61 | $517.00 | $336.05–$517.00 | — | 67% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Pregnancy < 14 weeks | $170.61 | $517.00 | $336.05–$517.00 | — | 67% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 MAYO US Pregnancy Limited | $162.03 | $491.00 | $206.22–$491.00 | 16% below | 67% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 76815 ULTRASOUND PREGNANT UTERUS LIMITED | $162.03 | $491.00 | $206.22–$491.00 | 16% below | 67% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 BEDSIDE ULTRASOUND CHARGE | $162.03 | $491.00 | $206.22–$491.00 | 16% below | 67% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited | $162.03 | $491.00 | $206.22–$491.00 | 16% below | 67% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 MAYO US Pregnancy Limited | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 76815 ULTRASOUND PREGNANT UTERUS LIMITED | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 BEDSIDE ULTRASOUND CHARGE | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 3 Views Right | $133.98 | $406.00 | $170.52–$406.00 | 42% below | 67% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 3 Views Left | $133.98 | $406.00 | $170.52–$406.00 | 42% below | 67% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 3 Views Right | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 3 Views Left | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs Min 3 Views Left w/ PA Chest | $162.03 | $491.00 | $206.22–$491.00 | 51% below | 67% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs Min 3 Views Right w/ PA Chest | $162.03 | $491.00 | $206.22–$491.00 | 51% below | 67% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs Min 3 Views Left w/ PA Chest | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs Min 3 Views Right w/ PA Chest | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Screening mammogram, both breasts both sides CPT 77067 MA Mammo Screening 3D Bilateral. | $119.13 | $361.00 | $151.62–$361.00 | — | 67% |
| Screening mammogram, both breasts both sides CPT 77067 MA Mammogram Routine Screening Bilat. | $119.13 | $361.00 | $151.62–$361.00 | — | 67% |
| Screening mammogram, both breasts one side CPT 77067 MA Mammogram Routine Screening Left. | $119.13 | $361.00 | $151.62–$361.00 | 30% below | 67% |
| Screening mammogram, both breasts one side CPT 77067 MA Mammo Screening 3D Right. | $119.13 | $361.00 | $151.62–$361.00 | 30% below | 67% |
| Screening mammogram, both breasts one side CPT 77067 MA Mammo Screening 3D Left. | $119.13 | $361.00 | $151.62–$361.00 | 30% below | 67% |
| Screening mammogram, both breasts one side CPT 77067 MA Mammogram Routine Screening Right. | $119.13 | $361.00 | $151.62–$361.00 | 30% below | 67% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MA Mammogram Routine Screening Bilat. | $119.13 | $361.00 | $234.65–$361.00 | — | 67% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MA Mammo Screening 3D Bilateral. | $119.13 | $361.00 | $234.65–$361.00 | — | 67% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MA Mammogram Routine Screening Right. | $119.13 | $361.00 | $234.65–$361.00 | — | 67% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MA Mammo Screening 3D Right. | $119.13 | $361.00 | $234.65–$361.00 | — | 67% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MA Mammogram Routine Screening Left. | $119.13 | $361.00 | $234.65–$361.00 | — | 67% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MA Mammo Screening 3D Left. | $119.13 | $361.00 | $234.65–$361.00 | — | 67% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Left | $138.27 | $419.00 | $175.98–$419.00 | 40% below | 67% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Right | $138.27 | $419.00 | $175.98–$419.00 | 40% below | 67% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Right | $138.27 | $419.00 | $272.35–$419.00 | — | 67% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Left | $138.27 | $419.00 | $272.35–$419.00 | — | 67% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete | $120.45 | $365.00 | $153.30–$365.00 | 47% below | 67% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete | $120.45 | $365.00 | $237.25–$365.00 | — | 67% |
| Skull X-ray, fewer than 4 views CPT 70250 XR Skull < 4 Views | $103.95 | $315.00 | $132.30–$315.00 | 52% below | 67% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull < 4 Views | $103.95 | $315.00 | $204.75–$315.00 | — | 67% |
| Sleep study in a lab (polysomnography) CPT 95810 Sleep Study Diagnostic | $1,539.45 | $4,665.00 | $1,959.30–$4,665.00 | 6% below | 67% |
| Sleep study in a lab (polysomnography) CPT 95810 95810 SLEEP STUDY (DIAGNOSTIC) CHARGE | $1,539.45 | $4,665.00 | $1,959.30–$4,665.00 | 6% below | 67% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Sleep Study Diagnostic | $1,539.45 | $4,665.00 | $3,032.25–$4,665.00 | — | 67% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 95810 SLEEP STUDY (DIAGNOSTIC) CHARGE | $1,539.45 | $4,665.00 | $3,032.25–$4,665.00 | — | 67% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Fluoro Modified Esophagram | $239.25 | $725.00 | $304.50–$725.00 | 46% below | 67% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Fluoro Modified Esophagram | $239.25 | $725.00 | $471.25–$725.00 | — | 67% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Left | $133.98 | $406.00 | $170.52–$406.00 | 37% below | 67% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Right | $133.98 | $406.00 | $170.52–$406.00 | 37% below | 67% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Left | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Right | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic w/o Contrast | $450.45 | $1,365.00 | $573.30–$1,365.00 | 58% below | 67% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic w/o Contrast | $450.45 | $1,365.00 | $887.25–$1,365.00 | — | 67% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB | $187.77 | $569.00 | $238.98–$569.00 | 50% below | 67% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB | $187.77 | $569.00 | $369.85–$569.00 | — | 67% |
| Transvaginal ultrasound during pregnancy CPT 76817 US Pregnancy Transvaginal | $162.03 | $491.00 | $206.22–$491.00 | 48% below | 67% |
| Transvaginal ultrasound during pregnancy CPT 76817 MAYO US Pregnancy Transvaginal | $162.03 | $491.00 | $206.22–$491.00 | 48% below | 67% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 MAYO US Pregnancy Transvaginal | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Pregnancy Transvaginal | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $264.99 | $803.00 | $337.26–$803.00 | 44% below | 67% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $264.99 | $803.00 | $521.95–$803.00 | — | 67% |
| Ultrasound of the scrotum and testicles CPT 76870 76870 ULTRASOUND SCROTUM (CONTENTS) BEDSIDE | $223.08 | $676.00 | $283.92–$676.00 | 52% below | 67% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents) | $223.08 | $676.00 | $283.92–$676.00 | 52% below | 67% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents) | $223.08 | $676.00 | $439.40–$676.00 | — | 67% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 76870 ULTRASOUND SCROTUM (CONTENTS) BEDSIDE | $223.08 | $676.00 | $439.40–$676.00 | — | 67% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid | $196.68 | $596.00 | $250.32–$596.00 | 51% below | 67% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue | $196.68 | $596.00 | $250.32–$596.00 | 51% below | 67% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid | $196.68 | $596.00 | $387.40–$596.00 | — | 67% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue | $196.68 | $596.00 | $387.40–$596.00 | — | 67% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Fluoro UGI w/ Small Bowel | $270.93 | $821.00 | $344.82–$821.00 | 38% below | 67% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Fluoro Upper GI Single | $270.93 | $821.00 | $344.82–$821.00 | 38% below | 67% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI | $270.93 | $821.00 | $344.82–$821.00 | 38% below | 67% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI | $270.93 | $821.00 | $533.65–$821.00 | — | 67% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Fluoro UGI w/ Small Bowel | $270.93 | $821.00 | $533.65–$821.00 | — | 67% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Fluoro Upper GI Single | $270.93 | $821.00 | $533.65–$821.00 | — | 67% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Min 2 Views Left | $133.98 | $406.00 | $170.52–$406.00 | 35% below | 67% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Minimum 2 Views Right | $133.98 | $406.00 | $170.52–$406.00 | 35% below | 67% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Minimum 2 Views Right | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Min 2 Views Left | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Left DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY | $244.20 | $740.00 | $310.80–$740.00 | 51% below | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Right DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY | $244.20 | $740.00 | $310.80–$740.00 | 51% below | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Extremity Venous Doppler Right | $244.20 | $740.00 | $310.80–$740.00 | 51% below | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Extremity Venous Doppler Left | $244.20 | $740.00 | $310.80–$740.00 | 51% below | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Extremity Venous Doppler Right | $244.20 | $740.00 | $310.80–$740.00 | 51% below | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Extremity Venous Doppler Left | $244.20 | $740.00 | $310.80–$740.00 | 51% below | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Left DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY | $244.20 | $740.00 | $481.00–$740.00 | — | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Extremity Venous Doppler Right | $244.20 | $740.00 | $481.00–$740.00 | — | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Right DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY | $244.20 | $740.00 | $481.00–$740.00 | — | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Extremity Venous Doppler Left | $244.20 | $740.00 | $481.00–$740.00 | — | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Extremity Venous Doppler Left | $244.20 | $740.00 | $481.00–$740.00 | — | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Extremity Venous Doppler Right | $244.20 | $740.00 | $481.00–$740.00 | — | 67% |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Left | $130.35 | $395.00 | $165.90–$395.00 | 43% below | 67% |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Right | $130.35 | $395.00 | $165.90–$395.00 | 43% below | 67% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Right | $130.35 | $395.00 | $256.75–$395.00 | — | 67% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Left | $130.35 | $395.00 | $256.75–$395.00 | — | 67% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Left | $133.98 | $406.00 | $170.52–$406.00 | 39% below | 67% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Right | $133.98 | $406.00 | $170.52–$406.00 | 39% below | 67% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Right | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Left | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Rt w/ Pelvis | $133.98 | $406.00 | $170.52–$406.00 | 34% below | 67% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip w/Pelvis 2-3 Views Right | $133.98 | $406.00 | $170.52–$406.00 | 34% below | 67% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip w/Pelvis 2-3 Views Left | $133.98 | $406.00 | $170.52–$406.00 | 34% below | 67% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Lt w/ Pelvis | $133.98 | $406.00 | $170.52–$406.00 | 34% below | 67% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip w/Pelvis 2-3 Views Right | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip w/Pelvis 2-3 Views Left | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Rt w/ Pelvis | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Lt w/ Pelvis | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen Single View (KUB) | $133.65 | $405.00 | $170.10–$405.00 | 37% below | 67% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen Single View (KUB) | $133.65 | $405.00 | $263.25–$405.00 | — | 67% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left | $133.98 | $406.00 | $170.52–$406.00 | 35% below | 67% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right | $133.98 | $406.00 | $170.52–$406.00 | 35% below | 67% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right | $133.98 | $406.00 | $170.52–$406.00 | 34% below | 67% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left | $133.98 | $406.00 | $170.52–$406.00 | 34% below | 67% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Left | $140.58 | $426.00 | $178.92–$426.00 | 34% below | 67% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Right | $140.58 | $426.00 | $178.92–$426.00 | 34% below | 67% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Right | $140.58 | $426.00 | $276.90–$426.00 | — | 67% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Left | $140.58 | $426.00 | $276.90–$426.00 | — | 67% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Min 3 Views Right | $158.40 | $480.00 | $201.60–$480.00 | 28% below | 67% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Min 3 Views Left | $158.40 | $480.00 | $201.60–$480.00 | 28% below | 67% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Min 3 Views Right | $158.40 | $480.00 | $312.00–$480.00 | — | 67% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Min 3 Views Left | $158.40 | $480.00 | $312.00–$480.00 | — | 67% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 2 Views Right | $129.69 | $393.00 | $165.06–$393.00 | 41% below | 67% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 2 Views Left | $129.69 | $393.00 | $165.06–$393.00 | 41% below | 67% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 2 Views Left | $129.69 | $393.00 | $255.45–$393.00 | — | 67% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 2 Views Right | $129.69 | $393.00 | $255.45–$393.00 | — | 67% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 3 Views | $162.03 | $491.00 | $206.22–$491.00 | 34% below | 67% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 3 Views | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 Views | $186.78 | $566.00 | $237.72–$566.00 | 42% below | 67% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 Views | $186.78 | $566.00 | $367.90–$566.00 | — | 67% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic Minimum 2 Views | $162.03 | $491.00 | $206.22–$491.00 | 29% below | 67% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic Minimum 2 Views | $162.03 | $491.00 | $319.15–$491.00 | — | 67% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Minimum 3 Views | $133.98 | $406.00 | $170.52–$406.00 | 41% below | 67% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Minimum 3 Views | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views | $133.98 | $406.00 | $170.52–$406.00 | 37% below | 67% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views | $95.04 | $288.00 | $120.96–$288.00 | 55% below | 67% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views | $95.04 | $288.00 | $187.20–$288.00 | — | 67% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum and Coccyx | $133.98 | $406.00 | $170.52–$406.00 | 41% below | 67% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum and Coccyx | $133.98 | $406.00 | $263.90–$406.00 | — | 67% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH) QST | $107.58 | $326.00 | $136.92–$326.00 | 33% below | 67% |
| ACTH blood test CPT 82024 Adrenocorticotropic Hormone ALI | $107.58 | $326.00 | $136.92–$326.00 | 33% below | 67% |
| ACTH blood test inpatient CPT 82024 Adrenocorticotropic Hormone ALI | $107.58 | $326.00 | $211.90–$326.00 | — | 67% |
| ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH) QST | $107.58 | $326.00 | $211.90–$326.00 | — | 67% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 84460 Alanine Aminotransferase | $23.43 | $71.00 | $29.82–$71.00 | 31% below | 67% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase | $23.43 | $71.00 | $29.82–$71.00 | 31% below | 67% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase | $23.43 | $71.00 | $46.15–$71.00 | — | 67% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 84460 Alanine Aminotransferase | $23.43 | $71.00 | $46.15–$71.00 | — | 67% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase | $20.13 | $61.00 | $25.62–$61.00 | 35% below | 67% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 84450 Aspartate Aminotransferase | $20.13 | $61.00 | $25.62–$61.00 | 35% below | 67% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase | $20.13 | $61.00 | $39.65–$61.00 | — | 67% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 84450 Aspartate Aminotransferase | $20.13 | $61.00 | $39.65–$61.00 | — | 67% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL (REFL) QST | $99.33 | $301.00 | $126.42–$301.00 | 38% below | 67% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel (Acute) ALI | $99.33 | $301.00 | $126.42–$301.00 | 38% below | 67% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL (REFL) QST | $99.33 | $301.00 | $195.65–$301.00 | — | 67% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel (Acute) ALI | $99.33 | $301.00 | $195.65–$301.00 | — | 67% |
| Albumin blood test CPT 82040 Albumin Level | $21.45 | $65.00 | $27.30–$65.00 | 6% below | 67% |
| Albumin blood test inpatient CPT 82040 Albumin Level | $21.45 | $65.00 | $42.25–$65.00 | — | 67% |
| Aldosterone blood test CPT 82088 ALDOSTERONE QST | $136.95 | $415.00 | $174.30–$415.00 | 12% below | 67% |
| Aldosterone blood test CPT 82088 Aldosterone ALI | $136.95 | $415.00 | $174.30–$415.00 | 12% below | 67% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone ALI | $136.95 | $415.00 | $269.75–$415.00 | — | 67% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE QST | $136.95 | $415.00 | $269.75–$415.00 | — | 67% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase | $16.83 | $51.00 | $21.42–$51.00 | 39% below | 67% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase | $16.83 | $51.00 | $33.15–$51.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Shrimp Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Macadamia Nut Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Lambs Quarters Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Hormodendrum Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Oyster Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Oak IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Shell Fish Profile ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Yellow Jacket Venom Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Paper Wasp Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Walnut IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Tuna Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Timothy Grass IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Scallop Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Pistachio Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Lobster Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Latex IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Box Elder/Maple Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Nut Mix Allergen Profile ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, Ped Allergy, March Profile IgE ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, Mold Profile ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Mixed Nuts Allergen Panel ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Food Panel 9 Allergens ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergy, Food Comprehensive Profile 1 ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergy, Food,Profile 13 ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Fish Allergen Profile ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Animal Epi/Dander/Feather Mix Profile ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, Inhalants, Profile 18 IgE ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Profile A (ie.NE Rast) IgE ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Yellow-Faced Hornet Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 White-Faced Hornet Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Giant Ragweed Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 June Grass IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 House Dust Greer IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Honey Bee Venom Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Hazelnut (Filbert) IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 English Plantain Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Elm Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Crab Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cow Hair/Dander Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Coconut Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Clam Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cashew IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Brazil Nut Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Birch Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PANEL (REGION 1) RESPIRATORY QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAT EPITHELIUM/DANDER (E1) IGG QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OYSTER (F290) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLAM (F207) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus Fumigat IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Alternaria Tenuis IgE ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Almond Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, Seafood Profile ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Northeast Allergen Panel ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Yolk IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Wheat IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Tomato IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Soybean IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Peanut IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Milk IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Egg White IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D. Pteronyssinus Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Dog Dander IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D farinea IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Corn IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Codfish Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cockroach IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Chocolate IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cat Epi. & Dander IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MACADAMIA NUT (RF345) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TREE NUT ALLERGY PANEL QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LAMB'S QUARTERS(GOOSE FOOT)(W10)IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCOA (F93) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG YOLK (F75) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT (F201) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT (F4) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT (F17) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND (F20) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PAPER WASP (I4) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JUNE GRASS (KENTUCKY BLUE) (G8) IGE | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LATEX IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LAMBDA, SERUM NLL | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT (F4) IGG QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergy,Common Adult Food ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, SEAFOOD PANEL 19 QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT (F256) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCONUT (F36) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT (F18) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED (F10) QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MAIZE/CORE (F8) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE (F1) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH (I6) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW JACKET (I3) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COW DANDER (E4) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BIRCH (T3) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MAPLE (BOX ELDER) (T1) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ENGLISH PLANTAIN (W9) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS (G6) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORCHARD GRASS (G3) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOP IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS (G6) IGE, QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CRAB (F23) IGE, QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN (F14) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO (F203) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT (F202) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TOMATO (F20) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW HORNET (I5) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE FACED HORNET (I2) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BEE VENOM ALLERGEN PANEL ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER (F80) IGE | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TUNA (F40) IGE | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP (F24) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH (F3) IGE | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COW'S MILK (F2) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MANUAL DIFFERENTIAL 46 | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER (E5) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAK (T7) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GIANT RAGWEED (TALL) (W3) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JUNE GRASS(KENTUCKY BLUE) (G8) IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHELLFISH ALLERGY PANEL, QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PROFILE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBARUM IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA ALTERNATA IGE QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL - MOLD QST | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 O & P SCREEN | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT, TOTAL WITH REFLEX TO PEANUT COMPONENT PANE | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 31702157 ALLERGEN FOR PEANUT | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 86003 ALLERGEN SPECIFIC IGE | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergy,Common Adult Food | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Sesame Seed Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Pecan IgE Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Orchard Grass Allergen ALI | $8.25 | $25.00 | $10.50–$25.00 | 64% below | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Milk IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT (F4) IGG QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMBDA, SERUM NLL | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JUNE GRASS (KENTUCKY BLUE) (G8) IGE | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPER WASP (I4) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND (F20) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT (F17) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT (F4) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN NUT (F201) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG YOLK (F75) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCOA (F93) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMB'S QUARTERS(GOOSE FOOT)(W10)IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TREE NUT ALLERGY PANEL QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MACADAMIA NUT (RF345) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT EPITHELIUM/DANDER (E1) IGG QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PANEL (REGION 1) RESPIRATORY QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OYSTER (F290) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLAM (F207) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, SEAFOOD PANEL 19 QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT (F256) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCONUT (F36) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TOMATO (F20) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT (F18) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SEED (F10) QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAIZE/CORE (F8) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE (F1) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH (I6) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW JACKET (I3) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COW DANDER (E4) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BIRCH (T3) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAPLE (BOX ELDER) (T1) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ENGLISH PLANTAIN (W9) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS (G6) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORCHARD GRASS (G3) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SCALLOP IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS (G6) IGE, QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAB (F23) IGE, QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN (F14) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO (F203) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT (F202) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW HORNET (I5) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE FACED HORNET (I2) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEE VENOM ALLERGEN PANEL ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER (F80) IGE | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA (F40) IGE | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP (F24) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH (F3) IGE | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COW'S MILK (F2) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MANUAL DIFFERENTIAL 46 | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER (E5) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAK (T7) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GIANT RAGWEED (TALL) (W3) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JUNE GRASS(KENTUCKY BLUE) (G8) IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHELLFISH ALLERGY PANEL, QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD ALLERGY PROFILE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM HERBARUM IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA ALTERNATA IGE QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL - MOLD QST | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O & P SCREEN | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT, TOTAL WITH REFLEX TO PEANUT COMPONENT PANE | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 31702157 ALLERGEN FOR PEANUT | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 ALLERGEN SPECIFIC IGE | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy,Common Adult Food | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sesame Seed Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pecan IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Orchard Grass Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Shrimp Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Macadamia Nut Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lambs Quarters Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hormodendrum Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oyster Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oak IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Shell Fish Profile ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Yellow Jacket Venom Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Paper Wasp Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Walnut IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tuna Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Timothy Grass IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Scallop Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pistachio Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lobster Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Latex IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Box Elder/Maple Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Nut Mix Allergen Profile ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens, Ped Allergy, March Profile IgE ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens, Mold Profile ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mixed Nuts Allergen Panel ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Food Panel 9 Allergens ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy, Food Comprehensive Profile 1 ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy, Food,Profile 13 ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Fish Allergen Profile ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Animal Epi/Dander/Feather Mix Profile ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens, Inhalants, Profile 18 IgE ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy Profile A (ie.NE Rast) IgE ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Yellow-Faced Hornet Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White-Faced Hornet Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Giant Ragweed Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 June Grass IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 House Dust Greer IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Honey Bee Venom Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hazelnut (Filbert) IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 English Plantain Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Elm Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Crab Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cow Hair/Dander Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Coconut Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Clam Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cashew IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Brazil Nut Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Birch Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus Fumigat IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Alternaria Tenuis IgE ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Almond Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens, Seafood Profile ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Northeast Allergen Panel ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Yolk IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Wheat IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tomato IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Soybean IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peanut IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg White IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D. Pteronyssinus Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dog Dander IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D farinea IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Corn IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Codfish Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cockroach IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chocolate IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cat Epi. & Dander IgE Allergen ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy,Common Adult Food ALI | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Tumor Marker ALI | $54.45 | $165.00 | $69.30–$165.00 | 18% below | 67% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Maternal Screen, Alpha Fetoprotein ALI | $54.45 | $165.00 | $69.30–$165.00 | 18% below | 67% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 MATERNAL SERUM AFP QST | $54.45 | $165.00 | $69.30–$165.00 | 18% below | 67% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN TUMOR MARKER QST | $54.45 | $165.00 | $69.30–$165.00 | 18% below | 67% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 MATERNAL SERUM AFP QST | $54.45 | $165.00 | $107.25–$165.00 | — | 67% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN TUMOR MARKER QST | $54.45 | $165.00 | $107.25–$165.00 | — | 67% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Maternal Screen, Alpha Fetoprotein ALI | $54.45 | $165.00 | $107.25–$165.00 | — | 67% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein Tumor Marker ALI | $54.45 | $165.00 | $107.25–$165.00 | — | 67% |
| Ammonia blood test CPT 82140 Ammonia Level | $43.23 | $131.00 | $55.02–$131.00 | 53% below | 67% |
| Ammonia blood test inpatient CPT 82140 Ammonia Level | $43.23 | $131.00 | $85.15–$131.00 | — | 67% |
| Amylase blood test CPT 82150 Amylase Level Urine | $32.01 | $97.00 | $40.74–$97.00 | 23% below | 67% |
| Amylase blood test CPT 82150 Amylase Level | $32.01 | $97.00 | $40.74–$97.00 | 23% below | 67% |
| Amylase blood test inpatient CPT 82150 Amylase Level Urine | $32.01 | $97.00 | $63.05–$97.00 | — | 67% |
| Amylase blood test inpatient CPT 82150 Amylase Level | $32.01 | $97.00 | $63.05–$97.00 | — | 67% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab IgG ALI | $57.42 | $174.00 | $73.08–$174.00 | 20% below | 67% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE AB, IGG, QST | $57.42 | $174.00 | $73.08–$174.00 | 20% below | 67% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE AB, IGG, QST | $57.42 | $174.00 | $113.10–$174.00 | — | 67% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Ab IgG ALI | $57.42 | $174.00 | $113.10–$174.00 | — | 67% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Anti-Nuclear Ab ALI | $39.27 | $119.00 | $49.98–$119.00 | 29% below | 67% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Centromere, IgG ALI | $39.27 | $119.00 | $49.98–$119.00 | 29% below | 67% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN,IFA, WITH RFLX TO TITER AND PATTERN QST | $39.27 | $119.00 | $49.98–$119.00 | 29% below | 67% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN,IFA, WITH RFLX TO TITER AND PATTERN QST | $39.27 | $119.00 | $77.35–$119.00 | — | 67% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Centromere, IgG ALI | $39.27 | $119.00 | $77.35–$119.00 | — | 67% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Anti-Nuclear Ab ALI | $39.27 | $119.00 | $77.35–$119.00 | — | 67% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT Pro-BNP | $67.32 | $204.00 | $85.68–$204.00 | 57% below | 67% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT Pro-BNP | $67.32 | $204.00 | $132.60–$204.00 | — | 67% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Sputum ALI | $34.32 | $104.00 | $43.68–$104.00 | 36% below | 67% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Aerobic ALI | $34.32 | $104.00 | $43.68–$104.00 | 36% below | 67% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Respiratory Virus Culture ALI | $34.32 | $104.00 | $43.68–$104.00 | 36% below | 67% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Respiratory Upper ALI | $34.32 | $104.00 | $43.68–$104.00 | 36% below | 67% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, SPUTUM/LOWER RESPIRATORY MB QST | $38.61 | $117.00 | $49.14–$117.00 | 29% below | 67% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, AEROBIC BACTERIA WITH GRAM STAIN MB QST | $38.61 | $117.00 | $49.14–$117.00 | 29% below | 67% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, THROAT MB QST | $38.61 | $117.00 | $49.14–$117.00 | 29% below | 67% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Sputum ALI | $34.32 | $104.00 | $67.60–$104.00 | — | 67% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Respiratory Upper ALI | $34.32 | $104.00 | $67.60–$104.00 | — | 67% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Respiratory Virus Culture ALI | $34.32 | $104.00 | $67.60–$104.00 | — | 67% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Aerobic ALI | $34.32 | $104.00 | $67.60–$104.00 | — | 67% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, SPUTUM/LOWER RESPIRATORY MB QST | $38.61 | $117.00 | $76.05–$117.00 | — | 67% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, THROAT MB QST | $38.61 | $117.00 | $76.05–$117.00 | — | 67% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, AEROBIC BACTERIA WITH GRAM STAIN MB QST | $38.61 | $117.00 | $76.05–$117.00 | — | 67% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel ALI | $63.03 | $191.00 | $80.22–$191.00 | 19% below | 67% |
| Basic metabolic panel (blood test) CPT 80048 i-STAT BMP 2 | $63.03 | $191.00 | $80.22–$191.00 | 19% below | 67% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel Standard | $63.03 | $191.00 | $80.22–$191.00 | 19% below | 67% |
| Basic metabolic panel (blood test) inpatient CPT 80048 i-STAT BMP 2 | $63.03 | $191.00 | $124.15–$191.00 | — | 67% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel ALI | $63.03 | $191.00 | $124.15–$191.00 | — | 67% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel Standard | $63.03 | $191.00 | $124.15–$191.00 | — | 67% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL | $21.45 | $65.00 | $27.30–$65.00 | 31% below | 67% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total | $21.45 | $65.00 | $27.30–$65.00 | 31% below | 67% |
| Bilirubin blood test, total CPT 82247 Bilirubin Indirect | $21.45 | $65.00 | $27.30–$65.00 | 31% below | 67% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL | $21.45 | $65.00 | $42.25–$65.00 | — | 67% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total | $21.45 | $65.00 | $42.25–$65.00 | — | 67% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Indirect | $21.45 | $65.00 | $42.25–$65.00 | — | 67% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bill Only - Prostate Needle Biopsy | $101.31 | $307.00 | $128.94–$307.00 | 27% below | 67% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bill Level IV Surgical Pathology | $101.31 | $307.00 | $128.94–$307.00 | 27% below | 67% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Bill Level IV Surgical Pathology | $101.31 | $307.00 | $199.55–$307.00 | — | 67% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Bill Only - Prostate Needle Biopsy | $101.31 | $307.00 | $199.55–$307.00 | — | 67% |
| Blood culture for bacteria CPT 87040 CULTURE, BLOOD MB QST | $50.49 | $153.00 | $64.26–$153.00 | 41% below | 67% |
| Blood culture for bacteria CPT 87040 Culture Blood ALI | $70.95 | $215.00 | $90.30–$215.00 | 17% below | 67% |
| Blood culture for bacteria CPT 87040 Blood Culture MAYO | $70.95 | $215.00 | $90.30–$215.00 | 17% below | 67% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE, BLOOD MB QST | $50.49 | $153.00 | $99.45–$153.00 | — | 67% |
| Blood culture for bacteria inpatient CPT 87040 Culture Blood ALI | $70.95 | $215.00 | $139.75–$215.00 | — | 67% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture MAYO | $70.95 | $215.00 | $139.75–$215.00 | — | 67% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill Venipuncture Progenity [i] | $7.92 | $24.00 | $10.08–$24.00 | 44% below | 67% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 VENIPUNCTURE | $7.92 | $24.00 | $10.08–$24.00 | 44% below | 67% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw | $7.92 | $24.00 | $10.08–$24.00 | 44% below | 67% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 BILL VENIPUNCTURE OP/INLAB | $7.92 | $24.00 | $10.08–$24.00 | 44% below | 67% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw | $7.92 | $24.00 | $15.60–$24.00 | — | 67% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Bill Venipuncture Progenity [i] | $7.92 | $24.00 | $15.60–$24.00 | — | 67% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 36415 VENIPUNCTURE | $7.92 | $24.00 | $15.60–$24.00 | — | 67% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BILL VENIPUNCTURE OP/INLAB | $7.92 | $24.00 | $15.60–$24.00 | — | 67% |
| Blood glucose (sugar) test CPT 82947 Glucose Level | $9.90 | $30.00 | $12.60–$30.00 | 57% below | 67% |
| Blood glucose (sugar) test CPT 82947 Gluc 1 Hr OB | $9.90 | $30.00 | $12.60–$30.00 | 57% below | 67% |
| Blood glucose (sugar) test CPT 82947 GTT 2 Hr PP | $9.90 | $30.00 | $12.60–$30.00 | 57% below | 67% |
| Blood glucose (sugar) test CPT 82947 GTT-1 Hour | $9.90 | $30.00 | $12.60–$30.00 | 57% below | 67% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE FINGERSTICK POC | $9.90 | $30.00 | $12.60–$30.00 | 57% below | 67% |
| Blood glucose (sugar) test inpatient CPT 82947 GTT-1 Hour | $9.90 | $30.00 | $19.50–$30.00 | — | 67% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FINGERSTICK POC | $9.90 | $30.00 | $19.50–$30.00 | — | 67% |
| Blood glucose (sugar) test inpatient CPT 82947 Gluc 1 Hr OB | $9.90 | $30.00 | $19.50–$30.00 | — | 67% |
| Blood glucose (sugar) test inpatient CPT 82947 GTT 2 Hr PP | $9.90 | $30.00 | $19.50–$30.00 | — | 67% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Level | $9.90 | $30.00 | $19.50–$30.00 | — | 67% |
| Blood lead test CPT 83655 LEAD LEVEL (83655) POC | $28.05 | $85.00 | $35.70–$85.00 | 38% below | 67% |
| Blood lead test CPT 83655 Lead Level - <6 Years ALI | $29.70 | $90.00 | $37.80–$90.00 | 34% below | 67% |
| Blood lead test CPT 83655 Lead Whole Blood ALI | $29.70 | $90.00 | $37.80–$90.00 | 34% below | 67% |
| Blood lead test CPT 83655 83655 Lead, 24 Hr Urine | $29.70 | $90.00 | $37.80–$90.00 | 34% below | 67% |
| Blood lead test CPT 83655 LEAD LEVEL QST | $29.70 | $90.00 | $37.80–$90.00 | 34% below | 67% |
| Blood lead test inpatient CPT 83655 LEAD LEVEL (83655) POC | $28.05 | $85.00 | $55.25–$85.00 | — | 67% |
| Blood lead test inpatient CPT 83655 Lead Level - <6 Years ALI | $29.70 | $90.00 | $58.50–$90.00 | — | 67% |
| Blood lead test inpatient CPT 83655 LEAD LEVEL QST | $29.70 | $90.00 | $58.50–$90.00 | — | 67% |
| Blood lead test inpatient CPT 83655 83655 Lead, 24 Hr Urine | $29.70 | $90.00 | $58.50–$90.00 | — | 67% |
| Blood lead test inpatient CPT 83655 Lead Whole Blood ALI | $29.70 | $90.00 | $58.50–$90.00 | — | 67% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Serum Pregnancy Test Qualitative Standard | $30.69 | $93.00 | $39.06–$93.00 | 29% below | 67% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Serum Pregnancy Test Qualitative Standard | $30.69 | $93.00 | $60.45–$93.00 | — | 67% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABORh | $39.93 | $121.00 | $50.82–$121.00 | 19% below | 67% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh Typing | $39.93 | $121.00 | $50.82–$121.00 | 19% below | 67% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO/Rh | $39.93 | $121.00 | $50.82–$121.00 | 19% below | 67% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord Blood ABO Rh | $39.93 | $121.00 | $50.82–$121.00 | 19% below | 67% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABO/Rh | $39.93 | $121.00 | $78.65–$121.00 | — | 67% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord Blood ABO Rh | $39.93 | $121.00 | $78.65–$121.00 | — | 67% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABORh | $39.93 | $121.00 | $78.65–$121.00 | — | 67% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/Rh Typing | $39.93 | $121.00 | $78.65–$121.00 | — | 67% |
| Blood urea nitrogen (BUN) test CPT 84520 84520 Blood Urea Nitrogen | $10.89 | $33.00 | $13.86–$33.00 | 57% below | 67% |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen, Body Fluid | $10.89 | $33.00 | $13.86–$33.00 | 57% below | 67% |
| Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen | $10.89 | $33.00 | $13.86–$33.00 | 57% below | 67% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 84520 Blood Urea Nitrogen | $10.89 | $33.00 | $21.45–$33.00 | — | 67% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen | $10.89 | $33.00 | $21.45–$33.00 | — | 67% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen, Body Fluid | $10.89 | $33.00 | $21.45–$33.00 | — | 67% |
| C-peptide blood test CPT 84681 C-PEPTIDE QST | $50.16 | $152.00 | $63.84–$152.00 | 29% below | 67% |
| C-peptide blood test CPT 84681 C-Peptide ALI | $50.16 | $152.00 | $63.84–$152.00 | 29% below | 67% |
| C-peptide blood test inpatient CPT 84681 C-PEPTIDE QST | $50.16 | $152.00 | $98.80–$152.00 | — | 67% |
| C-peptide blood test inpatient CPT 84681 C-Peptide ALI | $50.16 | $152.00 | $98.80–$152.00 | — | 67% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein ALI | $14.19 | $43.00 | $18.06–$43.00 | 62% below | 67% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN QST | $14.19 | $43.00 | $18.06–$43.00 | 62% below | 67% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein | $14.19 | $43.00 | $18.06–$43.00 | 62% below | 67% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein | $14.19 | $43.00 | $27.95–$43.00 | — | 67% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN QST | $14.19 | $43.00 | $27.95–$43.00 | — | 67% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein ALI | $14.19 | $43.00 | $27.95–$43.00 | — | 67% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile Testing by PCR ALI | $58.41 | $177.00 | $74.34–$177.00 | 43% below | 67% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile Testing by PCR ALI | $58.41 | $177.00 | $115.05–$177.00 | — | 67% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 QST | $42.90 | $130.00 | $54.60–$130.00 | 34% below | 67% |
| CA 19-9 blood test (tumor marker) CPT 86301 Cancer Ag GI (CA19-9) ALI | $42.90 | $130.00 | $54.60–$130.00 | 34% below | 67% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 QST | $42.90 | $130.00 | $84.50–$130.00 | — | 67% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 Cancer Ag GI (CA19-9) ALI | $42.90 | $130.00 | $84.50–$130.00 | — | 67% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Ag 125 ALI | $49.17 | $149.00 | $62.58–$149.00 | 43% below | 67% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 QST | $49.17 | $149.00 | $62.58–$149.00 | 43% below | 67% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 QST | $49.17 | $149.00 | $96.85–$149.00 | — | 67% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Ag 125 ALI | $49.17 | $149.00 | $96.85–$149.00 | — | 67% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 ME STATE LAB ALI | $44.55 | $135.00 | $56.70–$135.00 | 49% below | 67% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 RNA (COVID-19), QUALITATIVE NAAT QST | $44.55 | $135.00 | $56.70–$135.00 | 49% below | 67% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 RNA (COVID-19), QUALITATIVE NAAT QST | $44.55 | $135.00 | $87.75–$135.00 | — | 67% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 ME STATE LAB ALI | $44.55 | $135.00 | $87.75–$135.00 | — | 67% |
| Calcium blood test, total CPT 82310 Calcium Urine | $10.56 | $32.00 | $13.44–$32.00 | 63% below | 67% |
| Calcium blood test, total CPT 82310 Calcium Level Total | $10.56 | $32.00 | $13.44–$32.00 | 63% below | 67% |
| Calcium blood test, total CPT 82310 CALCIUM, RANDOM URINE (W/O CREATININE) QST | $10.56 | $32.00 | $13.44–$32.00 | 63% below | 67% |
| Calcium blood test, total CPT 82310 PTH, INTACT W/ CALCIUM QST | $10.56 | $32.00 | $13.44–$32.00 | 63% below | 67% |
| Calcium blood test, total inpatient CPT 82310 PTH, INTACT W/ CALCIUM QST | $10.56 | $32.00 | $20.80–$32.00 | — | 67% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM, RANDOM URINE (W/O CREATININE) QST | $10.56 | $32.00 | $20.80–$32.00 | — | 67% |
| Calcium blood test, total inpatient CPT 82310 Calcium Urine | $10.56 | $32.00 | $20.80–$32.00 | — | 67% |
| Calcium blood test, total inpatient CPT 82310 Calcium Level Total | $10.56 | $32.00 | $20.80–$32.00 | — | 67% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN QST | $50.49 | $153.00 | $64.26–$153.00 | 43% below | 67% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Ag ALI | $50.49 | $153.00 | $64.26–$153.00 | 43% below | 67% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN QST | $50.49 | $153.00 | $99.45–$153.00 | — | 67% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Ag ALI | $50.49 | $153.00 | $99.45–$153.00 | — | 67% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella IgG (Immune Status) ALI | $37.62 | $114.00 | $47.88–$114.00 | 23% below | 67% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Virus Ab, IgM ALI | $37.62 | $114.00 | $47.88–$114.00 | 23% below | 67% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGM AB QST | $37.62 | $114.00 | $47.88–$114.00 | 23% below | 67% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG AB QST | $37.62 | $114.00 | $47.88–$114.00 | 23% below | 67% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella IgG (Immune Status) ALI | $37.62 | $114.00 | $74.10–$114.00 | — | 67% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Virus Ab, IgM ALI | $37.62 | $114.00 | $74.10–$114.00 | — | 67% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGG AB QST | $37.62 | $114.00 | $74.10–$114.00 | — | 67% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGM AB QST | $37.62 | $114.00 | $74.10–$114.00 | — | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/ N GONORRHOEAE AND T. VAGINALIS RNA TMA | $36.30 | $110.00 | $46.20–$110.00 | 50% below | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/N. GONORRHOEAE RNA, TMA QST | $37.29 | $113.00 | $47.46–$113.00 | 48% below | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Bill Infectious Agent, Chlamydia | $39.27 | $119.00 | $49.98–$119.00 | 46% below | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 BILL CHLAMYDIA | $39.27 | $119.00 | $49.98–$119.00 | 46% below | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlam/ Trach Molecular Amplification ALI | $39.27 | $119.00 | $49.98–$119.00 | 46% below | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 STD Panel - Chlam trach/ N. gonorr. Molecular ALI | $39.27 | $119.00 | $49.98–$119.00 | 46% below | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA CULTURE QST | $39.27 | $119.00 | $49.98–$119.00 | 46% below | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS RNA, TMA QST | $39.27 | $119.00 | $49.98–$119.00 | 46% below | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA/ N GONORRHOEAE AND T. VAGINALIS RNA TMA | $36.30 | $110.00 | $71.50–$110.00 | — | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA/N. GONORRHOEAE RNA, TMA QST | $37.29 | $113.00 | $73.45–$113.00 | — | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS RNA, TMA QST | $39.27 | $119.00 | $77.35–$119.00 | — | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 BILL CHLAMYDIA | $39.27 | $119.00 | $77.35–$119.00 | — | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 STD Panel - Chlam trach/ N. gonorr. Molecular ALI | $39.27 | $119.00 | $77.35–$119.00 | — | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA CULTURE QST | $39.27 | $119.00 | $77.35–$119.00 | — | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlam/ Trach Molecular Amplification ALI | $39.27 | $119.00 | $77.35–$119.00 | — | 67% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Bill Infectious Agent, Chlamydia | $39.27 | $119.00 | $77.35–$119.00 | — | 67% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL WITH REFLEX TO DIRECT LDL QST | $44.55 | $135.00 | $56.70–$135.00 | 40% below | 67% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL W/ TRIGLYCERIDES/HDL-C QST | $44.55 | $135.00 | $56.70–$135.00 | 40% below | 67% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HDL 2 Profile ALI | $44.55 | $135.00 | $56.70–$135.00 | 40% below | 67% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel with Direct LDL if indicated | $44.55 | $135.00 | $56.70–$135.00 | 40% below | 67% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel Standard | $44.55 | $135.00 | $56.70–$135.00 | 40% below | 67% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL W/ TRIGLYCERIDES/HDL-C QST | $44.55 | $135.00 | $87.75–$135.00 | — | 67% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel Standard | $44.55 | $135.00 | $87.75–$135.00 | — | 67% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel with Direct LDL if indicated | $44.55 | $135.00 | $87.75–$135.00 | — | 67% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HDL 2 Profile ALI | $44.55 | $135.00 | $87.75–$135.00 | — | 67% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL WITH REFLEX TO DIRECT LDL QST | $44.55 | $135.00 | $87.75–$135.00 | — | 67% |
| Complete blood count (CBC) with differential CPT 85025 CBC w/Diff Standard | $40.26 | $122.00 | $51.24–$122.00 | 14% below | 67% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/Diff Standard | $40.26 | $122.00 | $79.30–$122.00 | — | 67% |
| Complete blood count (CBC), no differential CPT 85027 Hemogram Standard | $23.10 | $70.00 | $29.40–$70.00 | 25% below | 67% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Hemogram Standard | $23.10 | $70.00 | $45.50–$70.00 | — | 67% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel Standard | $93.72 | $284.00 | $119.28–$284.00 | 11% below | 67% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel ALI | $93.72 | $284.00 | $119.28–$284.00 | 11% below | 67% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel ALI | $93.72 | $284.00 | $184.60–$284.00 | — | 67% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel Standard | $93.72 | $284.00 | $184.60–$284.00 | — | 67% |
| Cortisol blood test, total CPT 82533 CORTISOL, TOTAL QST | $47.19 | $143.00 | $60.06–$143.00 | 33% below | 67% |
| Cortisol blood test, total CPT 82533 Cortisol Baseline | $47.19 | $143.00 | $60.06–$143.00 | 33% below | 67% |
| Cortisol blood test, total CPT 82533 Cortisol ALI | $47.19 | $143.00 | $60.06–$143.00 | 33% below | 67% |
| Cortisol blood test, total CPT 82533 .Cortisol Baseline ALI | $47.19 | $143.00 | $60.06–$143.00 | 33% below | 67% |
| Cortisol blood test, total CPT 82533 .Cortisol 30 min ALI | $47.19 | $143.00 | $60.06–$143.00 | 33% below | 67% |
| Cortisol blood test, total CPT 82533 .Cortisol 60 min ALI | $47.19 | $143.00 | $60.06–$143.00 | 33% below | 67% |
| Cortisol blood test, total CPT 82533 ACTH STIMULATION, 3 SPECIMENS QST | $47.19 | $143.00 | $60.06–$143.00 | 33% below | 67% |
| Cortisol blood test, total inpatient CPT 82533 .Cortisol Baseline ALI | $47.19 | $143.00 | $92.95–$143.00 | — | 67% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol Baseline | $47.19 | $143.00 | $92.95–$143.00 | — | 67% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol ALI | $47.19 | $143.00 | $92.95–$143.00 | — | 67% |
| Cortisol blood test, total inpatient CPT 82533 ACTH STIMULATION, 3 SPECIMENS QST | $47.19 | $143.00 | $92.95–$143.00 | — | 67% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL, TOTAL QST | $47.19 | $143.00 | $92.95–$143.00 | — | 67% |
| Cortisol blood test, total inpatient CPT 82533 .Cortisol 60 min ALI | $47.19 | $143.00 | $92.95–$143.00 | — | 67% |
| Cortisol blood test, total inpatient CPT 82533 .Cortisol 30 min ALI | $47.19 | $143.00 | $92.95–$143.00 | — | 67% |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase | $22.44 | $68.00 | $28.56–$68.00 | 51% below | 67% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase | $22.44 | $68.00 | $44.20–$68.00 | — | 67% |
| Creatinine blood test CPT 82565 Creatinine | $12.21 | $37.00 | $15.54–$37.00 | 58% below | 67% |
| Creatinine blood test inpatient CPT 82565 Creatinine | $12.21 | $37.00 | $24.05–$37.00 | — | 67% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS AB (IGG, IGM) QST | $33.99 | $103.00 | $43.26–$103.00 | 46% below | 67% |
| Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Abs IgG/IgM ALI | $33.99 | $103.00 | $43.26–$103.00 | 46% below | 67% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Abs IgG/IgM ALI | $33.99 | $103.00 | $66.95–$103.00 | — | 67% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS AB (IGG, IGM) QST | $33.99 | $103.00 | $66.95–$103.00 | — | 67% |
| D-dimer blood test (blood clot marker) CPT 85379 D-Dimer | $30.69 | $93.00 | $39.06–$93.00 | 57% below | 67% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer | $30.69 | $93.00 | $60.45–$93.00 | — | 67% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA Sulfate ALI | $81.51 | $247.00 | $103.74–$247.00 | 10% below | 67% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE QST | $81.51 | $247.00 | $103.74–$247.00 | 10% below | 67% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE QST | $81.51 | $247.00 | $160.55–$247.00 | — | 67% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA Sulfate ALI | $81.51 | $247.00 | $160.55–$247.00 | — | 67% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONITOR,ANTIDEPRESSANT,W/CONF,U QST | $70.29 | $213.00 | $89.46–$213.00 | 28% below | 67% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Panel, Meconium Scn w/rflx to confirm ALI | $84.81 | $257.00 | $107.94–$257.00 | 13% below | 67% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONITOR, METHADONE METAB, W/CONF, URINE QST | $84.81 | $257.00 | $107.94–$257.00 | 13% below | 67% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONITOR, BUP, SCREEN, URINE QST | $84.81 | $257.00 | $107.94–$257.00 | 13% below | 67% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONITORING, PANEL 6 WITH CONFIRMATION, URINE | $84.81 | $257.00 | $107.94–$257.00 | 13% below | 67% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN PANEL 9, MECONIUM QST | $84.81 | $257.00 | $107.94–$257.00 | 13% below | 67% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 FENTANYL, DRUG MONITORING, WITH CONFIRMATION, URIN | $84.81 | $257.00 | $107.94–$257.00 | 13% below | 67% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONITOR,ANTIDEPRESSANT,W/CONF,U QST | $70.29 | $213.00 | $138.45–$213.00 | — | 67% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONITOR, METHADONE METAB, W/CONF, URINE QST | $84.81 | $257.00 | $167.05–$257.00 | — | 67% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Panel, Meconium Scn w/rflx to confirm ALI | $84.81 | $257.00 | $167.05–$257.00 | — | 67% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN PANEL 9, MECONIUM QST | $84.81 | $257.00 | $167.05–$257.00 | — | 67% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FENTANYL, DRUG MONITORING, WITH CONFIRMATION, URIN | $84.81 | $257.00 | $167.05–$257.00 | — | 67% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONITORING, PANEL 6 WITH CONFIRMATION, URINE | $84.81 | $257.00 | $167.05–$257.00 | — | 67% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONITOR, BUP, SCREEN, URINE QST | $84.81 | $257.00 | $167.05–$257.00 | — | 67% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel Standard | $32.67 | $99.00 | $41.58–$99.00 | 35% below | 67% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel Standard | $32.67 | $99.00 | $64.35–$99.00 | — | 67% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR VIRUS IGM, CAPSID AG | $40.26 | $122.00 | $51.24–$122.00 | 34% below | 67% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR VIRUS VCA AB (IGM) QST | $40.26 | $122.00 | $51.24–$122.00 | 34% below | 67% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR VIRUS IGG,CAPSID AG | $40.26 | $122.00 | $51.24–$122.00 | 34% below | 67% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Viral Capsid IgG ALI | $40.26 | $122.00 | $51.24–$122.00 | 34% below | 67% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR VIRUS VCA AB (IGG) QST | $40.26 | $122.00 | $51.24–$122.00 | 34% below | 67% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Viral Capsid IgM ALI | $40.26 | $122.00 | $51.24–$122.00 | 34% below | 67% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR VIRUS IGG,CAPSID AG | $40.26 | $122.00 | $79.30–$122.00 | — | 67% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR VIRUS VCA AB (IGG) QST | $40.26 | $122.00 | $79.30–$122.00 | — | 67% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR VIRUS VCA AB (IGM) QST | $40.26 | $122.00 | $79.30–$122.00 | — | 67% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR VIRUS IGM, CAPSID AG | $40.26 | $122.00 | $79.30–$122.00 | — | 67% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Viral Capsid IgM ALI | $40.26 | $122.00 | $79.30–$122.00 | — | 67% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Viral Capsid IgG ALI | $40.26 | $122.00 | $79.30–$122.00 | — | 67% |
| Estradiol blood test CPT 82670 ESTRADIOL QST | $92.07 | $279.00 | $117.18–$279.00 | 10% below | 67% |
| Estradiol blood test CPT 82670 Estradiol Level ALI | $92.07 | $279.00 | $117.18–$279.00 | 10% below | 67% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL QST | $92.07 | $279.00 | $181.35–$279.00 | — | 67% |
| Estradiol blood test inpatient CPT 82670 Estradiol Level ALI | $92.07 | $279.00 | $181.35–$279.00 | — | 67% |
| FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE QST | $55.77 | $169.00 | $70.98–$169.00 | 30% below | 67% |
| FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone ALI | $55.77 | $169.00 | $70.98–$169.00 | 30% below | 67% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE QST | $55.77 | $169.00 | $109.85–$169.00 | — | 67% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone ALI | $55.77 | $169.00 | $109.85–$169.00 | — | 67% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN QST | $92.07 | $279.00 | $117.18–$279.00 | 40% below | 67% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal ALI | $92.07 | $279.00 | $117.18–$279.00 | 40% below | 67% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN QST | $92.07 | $279.00 | $181.35–$279.00 | — | 67% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal ALI | $92.07 | $279.00 | $181.35–$279.00 | — | 67% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin ALI | $45.54 | $138.00 | $57.96–$138.00 | 39% below | 67% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN QST | $45.54 | $138.00 | $57.96–$138.00 | 39% below | 67% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin ALI | $45.54 | $138.00 | $89.70–$138.00 | — | 67% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN QST | $45.54 | $138.00 | $89.70–$138.00 | — | 67% |
| Fibrinogen blood test CPT 85384 Fibrinogen | $33.33 | $101.00 | $42.42–$101.00 | 45% below | 67% |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen | $33.33 | $101.00 | $65.65–$101.00 | — | 67% |
| Folate (folic acid) blood test CPT 82746 FOLATE QST | $30.36 | $92.00 | $38.64–$92.00 | 60% below | 67% |
| Folate (folic acid) blood test CPT 82746 Folate Level ALI | $30.36 | $92.00 | $38.64–$92.00 | 60% below | 67% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Level ALI | $30.36 | $92.00 | $59.80–$92.00 | — | 67% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE QST | $30.36 | $92.00 | $59.80–$92.00 | — | 67% |
| Free T3 thyroid hormone test CPT 84481 Free T3 (Triiodothyronine) ALI | $59.40 | $180.00 | $75.60–$180.00 | 31% below | 67% |
| Free T3 thyroid hormone test CPT 84481 FREE T3 QST | $59.40 | $180.00 | $75.60–$180.00 | 31% below | 67% |
| Free T3 thyroid hormone test inpatient CPT 84481 Free T3 (Triiodothyronine) ALI | $59.40 | $180.00 | $117.00–$180.00 | — | 67% |
| Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 QST | $59.40 | $180.00 | $117.00–$180.00 | — | 67% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 | $51.48 | $156.00 | $65.52–$156.00 | 14% below | 67% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 | $51.48 | $156.00 | $101.40–$156.00 | — | 67% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT QST | $31.68 | $96.00 | $40.32–$96.00 | 29% below | 67% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase ALI | $31.68 | $96.00 | $40.32–$96.00 | 29% below | 67% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 82977 Gamma Glutamyl Transferase ALI | $31.68 | $96.00 | $40.32–$96.00 | 29% below | 67% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT QST | $31.68 | $96.00 | $62.40–$96.00 | — | 67% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase ALI | $31.68 | $96.00 | $62.40–$96.00 | — | 67% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 82977 Gamma Glutamyl Transferase ALI | $31.68 | $96.00 | $62.40–$96.00 | — | 67% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 3-Hour | $48.18 | $146.00 | $61.32–$146.00 | 25% below | 67% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 2 Hour | $48.18 | $146.00 | $61.32–$146.00 | 25% below | 67% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL TEST (3 SPECIMENS) | $48.18 | $146.00 | $61.32–$146.00 | 25% below | 67% |
| Glucose tolerance test, 3 samples CPT 82951 .GTT-3 Hr | $48.18 | $146.00 | $61.32–$146.00 | 25% below | 67% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT-3 Hr | $48.18 | $146.00 | $94.90–$146.00 | — | 67% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3-Hour | $48.18 | $146.00 | $94.90–$146.00 | — | 67% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 2 Hour | $48.18 | $146.00 | $94.90–$146.00 | — | 67% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL TEST (3 SPECIMENS) | $48.18 | $146.00 | $94.90–$146.00 | — | 67% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Bill Infectious Agent Neisseria | $40.59 | $123.00 | $51.66–$123.00 | 38% below | 67% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INFECTIOUS AGENT, NEISSERIA | $40.59 | $123.00 | $51.66–$123.00 | 38% below | 67% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC CHG | $40.59 | $123.00 | $51.66–$123.00 | 38% below | 67% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC CHG | $40.59 | $123.00 | $79.95–$123.00 | — | 67% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INFECTIOUS AGENT, NEISSERIA | $40.59 | $123.00 | $79.95–$123.00 | — | 67% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Bill Infectious Agent Neisseria | $40.59 | $123.00 | $79.95–$123.00 | — | 67% |
| H. pylori stool antigen test CPT 87338 H. Pylori Antigen, Stool | $42.24 | $128.00 | $53.76–$128.00 | 63% below | 67% |
| H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI AG, EIA, STOOL MB QST | $42.24 | $128.00 | $53.76–$128.00 | 63% below | 67% |
| H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI AG, EIA, STOOL MB QST | $42.24 | $128.00 | $83.20–$128.00 | — | 67% |
| H. pylori stool antigen test inpatient CPT 87338 H. Pylori Antigen, Stool | $42.24 | $128.00 | $83.20–$128.00 | — | 67% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA Quant by PCR ALI | $151.14 | $458.00 | $192.36–$458.00 | 34% below | 67% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 .HIV 1 RNA, QL TMA QST | $151.14 | $458.00 | $192.36–$458.00 | 34% below | 67% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA, QUANT PCR QST | $151.14 | $458.00 | $192.36–$458.00 | 34% below | 67% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 RNA, QUANT PCR QST | $151.14 | $458.00 | $297.70–$458.00 | — | 67% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 .HIV 1 RNA, QL TMA QST | $151.14 | $458.00 | $297.70–$458.00 | — | 67% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA Quant by PCR ALI | $151.14 | $458.00 | $297.70–$458.00 | — | 67% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/2 COMBO AG/AB EIA REFLEXIVE PANEL ALI | $23.43 | $71.00 | $29.82–$71.00 | 49% below | 67% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV Ag/Ab Panel 5th Generation ALI | $23.43 | $71.00 | $29.82–$71.00 | 49% below | 67% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/2 COMBO AG/AB EIA REFLEXIVE PANEL ALI | $23.43 | $71.00 | $46.15–$71.00 | — | 67% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV Ag/Ab Panel 5th Generation ALI | $23.43 | $71.00 | $46.15–$71.00 | — | 67% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 Antibody & Antigen MAYO | $31.35 | $95.00 | $39.90–$95.00 | 34% below | 67% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV QST | $31.35 | $95.00 | $39.90–$95.00 | 34% below | 67% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 Antibody & Antigen | $31.35 | $95.00 | $39.90–$95.00 | 34% below | 67% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 Antibody & Antigen | $31.35 | $95.00 | $61.75–$95.00 | — | 67% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 Antibody & Antigen MAYO | $31.35 | $95.00 | $61.75–$95.00 | — | 67% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV QST | $31.35 | $95.00 | $61.75–$95.00 | — | 67% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c with eAvg Glucose | $37.62 | $114.00 | $47.88–$114.00 | 28% below | 67% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c Standard | $37.62 | $114.00 | $47.88–$114.00 | 28% below | 67% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c Standard | $37.62 | $114.00 | $74.10–$114.00 | — | 67% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c with eAvg Glucose | $37.62 | $114.00 | $74.10–$114.00 | — | 67% |
| Hemoglobin blood test CPT 85018 Hemoglobin | $8.25 | $25.00 | $10.50–$25.00 | 46% below | 67% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN POC | $8.25 | $25.00 | $10.50–$25.00 | 46% below | 67% |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN POC | $8.25 | $25.00 | $16.25–$25.00 | — | 67% |
| Hepatitis B core antibody test (total) CPT 86704 Hepatitis Panel Prior History ALI | $34.32 | $104.00 | $43.68–$104.00 | 44% below | 67% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY TOTAL WITH REFLEX TO IGM | $34.32 | $104.00 | $43.68–$104.00 | 44% below | 67% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS PANEL, GENERAL QST | $34.32 | $104.00 | $43.68–$104.00 | 44% below | 67% |
| Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core - IgG & IgM ALI | $34.32 | $104.00 | $43.68–$104.00 | 44% below | 67% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core - IgG & IgM ALI | $34.32 | $104.00 | $67.60–$104.00 | — | 67% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis Panel Prior History ALI | $34.32 | $104.00 | $67.60–$104.00 | — | 67% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY TOTAL WITH REFLEX TO IGM | $34.32 | $104.00 | $67.60–$104.00 | — | 67% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS PANEL, GENERAL QST | $34.32 | $104.00 | $67.60–$104.00 | — | 67% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab ALI | $34.32 | $104.00 | $43.68–$104.00 | 32% below | 67% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY QST | $34.32 | $104.00 | $43.68–$104.00 | 32% below | 67% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY QST | $34.32 | $104.00 | $67.60–$104.00 | — | 67% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab ALI | $34.32 | $104.00 | $67.60–$104.00 | — | 67% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG QST | $32.67 | $99.00 | $41.58–$99.00 | 33% below | 67% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag ALI | $32.67 | $99.00 | $41.58–$99.00 | 33% below | 67% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Ag ALI | $32.67 | $99.00 | $64.35–$99.00 | — | 67% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG QST | $32.67 | $99.00 | $64.35–$99.00 | — | 67% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus Ab ALI | $46.86 | $142.00 | $59.64–$142.00 | 36% below | 67% |
| Hepatitis C antibody blood test (screening) one side CPT 86803 HEPATITIS C AB W/REFLEX TO HCV, RNA QNT, RT-PCR QS | $46.86 | $142.00 | $59.64–$142.00 | 36% below | 67% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Virus Ab ALI | $46.86 | $142.00 | $92.30–$142.00 | — | 67% |
| Hepatitis C antibody blood test (screening) inpatient one side CPT 86803 HEPATITIS C AB W/REFLEX TO HCV, RNA QNT, RT-PCR QS | $46.86 | $142.00 | $92.30–$142.00 | — | 67% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus (HCV) Quantitation ALI | $119.79 | $363.00 | $152.46–$363.00 | 30% below | 67% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA PCR QST | $119.79 | $363.00 | $152.46–$363.00 | 30% below | 67% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus (HCV) Quant. Rflx ALI | $119.79 | $363.00 | $152.46–$363.00 | 30% below | 67% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus (HCV) Quantitation ALI | $119.79 | $363.00 | $235.95–$363.00 | — | 67% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus (HCV) Quant. Rflx ALI | $119.79 | $363.00 | $235.95–$363.00 | — | 67% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA PCR QST | $119.79 | $363.00 | $235.95–$363.00 | — | 67% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 & 2 IgG ALI | $33.99 | $103.00 | $43.26–$103.00 | 36% below | 67% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV I/II Combined AB Screen IGM ALI | $33.99 | $103.00 | $43.26–$103.00 | 36% below | 67% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 & 2 IgG ALI | $33.99 | $103.00 | $66.95–$103.00 | — | 67% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV I/II Combined AB Screen IGM ALI | $33.99 | $103.00 | $66.95–$103.00 | — | 67% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 1 & 2 IgG ALI | $45.54 | $138.00 | $57.96–$138.00 | 36% below | 67% |
| Herpes blood test, HSV-2 antibody CPT 86696 86696 HSV II COMBINED AB SCREEN | $45.54 | $138.00 | $57.96–$138.00 | 36% below | 67% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 1 & 2 IgG ALI | $45.54 | $138.00 | $89.70–$138.00 | — | 67% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 HSV II COMBINED AB SCREEN | $45.54 | $138.00 | $89.70–$138.00 | — | 67% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP-High Sensitivity ALI | $31.35 | $95.00 | $39.90–$95.00 | 39% below | 67% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO C-REACTIVE PROTEIN QST | $31.35 | $95.00 | $39.90–$95.00 | 39% below | 67% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP-High Sensitivity ALI | $31.35 | $95.00 | $61.75–$95.00 | — | 67% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CARDIO C-REACTIVE PROTEIN QST | $31.35 | $95.00 | $61.75–$95.00 | — | 67% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE QST | $50.82 | $154.00 | $64.68–$154.00 | 30% below | 67% |
| Homocysteine blood test CPT 83090 Homocysteine Total ALI | $50.82 | $154.00 | $64.68–$154.00 | 30% below | 67% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE QST | $50.82 | $154.00 | $100.10–$154.00 | — | 67% |
| Homocysteine blood test inpatient CPT 83090 Homocysteine Total ALI | $50.82 | $154.00 | $100.10–$154.00 | — | 67% |
| Insulin blood test CPT 83525 INSULIN QST | $33.66 | $102.00 | $42.84–$102.00 | 48% below | 67% |
| Insulin blood test CPT 83525 Insulin Level, Fasting ALI | $33.66 | $102.00 | $42.84–$102.00 | 48% below | 67% |
| Insulin blood test CPT 83525 Insulin Level, Random ALI | $33.66 | $102.00 | $42.84–$102.00 | 48% below | 67% |
| Insulin blood test inpatient CPT 83525 Insulin Level, Random ALI | $33.66 | $102.00 | $66.30–$102.00 | — | 67% |
| Insulin blood test inpatient CPT 83525 Insulin Level, Fasting ALI | $33.66 | $102.00 | $66.30–$102.00 | — | 67% |
| Insulin blood test inpatient CPT 83525 INSULIN QST | $33.66 | $102.00 | $66.30–$102.00 | — | 67% |
| Iron blood test (serum iron) CPT 83540 IRON BINDING CAPACITY & IRON TOTAL QST | $25.74 | $78.00 | $32.76–$78.00 | 31% below | 67% |
| Iron blood test (serum iron) CPT 83540 IRON LEVEL QST | $25.74 | $78.00 | $32.76–$78.00 | 31% below | 67% |
| Iron blood test (serum iron) CPT 83540 Iron ALI | $25.74 | $78.00 | $32.76–$78.00 | 31% below | 67% |
| Iron blood test (serum iron) CPT 83540 IRON | $25.74 | $78.00 | $32.76–$78.00 | 31% below | 67% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron ALI | $25.74 | $78.00 | $50.70–$78.00 | — | 67% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON | $25.74 | $78.00 | $50.70–$78.00 | — | 67% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON BINDING CAPACITY & IRON TOTAL QST | $25.74 | $78.00 | $50.70–$78.00 | — | 67% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON LEVEL QST | $25.74 | $78.00 | $50.70–$78.00 | — | 67% |
| Iron-binding capacity (TIBC) test CPT 83550 TOTAL BINDING CAPACITY | $23.43 | $71.00 | $29.82–$71.00 | 42% below | 67% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL BINDING CAPACITY | $23.43 | $71.00 | $46.15–$71.00 | — | 67% |
| Kidney function blood test panel CPT 80069 Renal Function Panel Standard | $33.66 | $102.00 | $42.84–$102.00 | 50% below | 67% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel Standard | $33.66 | $102.00 | $66.30–$102.00 | — | 67% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone ALI | $70.29 | $213.00 | $89.46–$213.00 | 17% below | 67% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE QST | $70.29 | $213.00 | $89.46–$213.00 | 17% below | 67% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE QST | $70.29 | $213.00 | $138.45–$213.00 | — | 67% |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone ALI | $70.29 | $213.00 | $138.45–$213.00 | — | 67% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid - Sepsis | $29.37 | $89.00 | $37.38–$89.00 | 50% below | 67% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid 2 | $29.37 | $89.00 | $37.38–$89.00 | 50% below | 67% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid | $29.37 | $89.00 | $37.38–$89.00 | 50% below | 67% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid | $29.37 | $89.00 | $57.85–$89.00 | — | 67% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid 2 | $29.37 | $89.00 | $57.85–$89.00 | — | 67% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid - Sepsis | $29.37 | $89.00 | $57.85–$89.00 | — | 67% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LD ISOENZYME QST | $15.18 | $46.00 | $19.32–$46.00 | 58% below | 67% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase | $15.18 | $46.00 | $19.32–$46.00 | 58% below | 67% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH, Body Fluid | $15.18 | $46.00 | $19.32–$46.00 | 58% below | 67% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Isoenzymes ALI | $15.18 | $46.00 | $19.32–$46.00 | 58% below | 67% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase | $15.18 | $46.00 | $29.90–$46.00 | — | 67% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH, Body Fluid | $15.18 | $46.00 | $29.90–$46.00 | — | 67% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Isoenzymes ALI | $15.18 | $46.00 | $29.90–$46.00 | — | 67% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD ISOENZYME QST | $15.18 | $46.00 | $29.90–$46.00 | — | 67% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $30.69 | $93.00 | $39.06–$93.00 | 33% below | 67% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level | $30.69 | $93.00 | $60.45–$93.00 | — | 67% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel Standard | $48.18 | $146.00 | $61.32–$146.00 | 42% below | 67% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel Standard | $48.18 | $146.00 | $94.90–$146.00 | — | 67% |
| Lyme disease antibody test CPT 86618 CSF Lyme Ab by ELISA ALI | $53.46 | $162.00 | $68.04–$162.00 | 31% below | 67% |
| Lyme disease antibody test CPT 86618 Lyme Ab ALI | $53.46 | $162.00 | $68.04–$162.00 | 31% below | 67% |
| Lyme disease antibody test CPT 86618 LYME DISEASE AB, TOTAL W/REFL WB (IGG, IGM) QST | $53.46 | $162.00 | $68.04–$162.00 | 31% below | 67% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Ab ALI | $53.46 | $162.00 | $105.30–$162.00 | — | 67% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB, TOTAL W/REFL WB (IGG, IGM) QST | $53.46 | $162.00 | $105.30–$162.00 | — | 67% |
| Lyme disease antibody test inpatient CPT 86618 CSF Lyme Ab by ELISA ALI | $53.46 | $162.00 | $105.30–$162.00 | — | 67% |
| Magnesium blood test CPT 83735 Magnesium Level | $33.66 | $102.00 | $42.84–$102.00 | 16% below | 67% |
| Magnesium blood test CPT 83735 Magnesium Level ALI | $33.66 | $102.00 | $42.84–$102.00 | 16% below | 67% |
| Magnesium blood test CPT 83735 Magnesium Level Ur Timed Collection ALI | $33.66 | $102.00 | $42.84–$102.00 | 16% below | 67% |
| Magnesium blood test inpatient CPT 83735 Magnesium Level | $33.66 | $102.00 | $66.30–$102.00 | — | 67% |
| Magnesium blood test inpatient CPT 83735 Magnesium Level ALI | $33.66 | $102.00 | $66.30–$102.00 | — | 67% |
| Magnesium blood test inpatient CPT 83735 Magnesium Level Ur Timed Collection ALI | $33.66 | $102.00 | $66.30–$102.00 | — | 67% |
| Measles (rubeola) antibody test CPT 86765 MEASLES IGG AB QST | $28.38 | $86.00 | $36.12–$86.00 | 19% below | 67% |
| Measles (rubeola) antibody test CPT 86765 Rubeola IgG (Immune Status) ALI | $28.38 | $86.00 | $36.12–$86.00 | 19% below | 67% |
| Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) IGM ALI | $28.38 | $86.00 | $36.12–$86.00 | 19% below | 67% |
| Measles (rubeola) antibody test CPT 86765 MEASLES ANTIBODY (IGM) | $28.38 | $86.00 | $36.12–$86.00 | 19% below | 67% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES ANTIBODY (IGM) | $28.38 | $86.00 | $55.90–$86.00 | — | 67% |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola IgG (Immune Status) ALI | $28.38 | $86.00 | $55.90–$86.00 | — | 67% |
| Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) IGM ALI | $28.38 | $86.00 | $55.90–$86.00 | — | 67% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES IGG AB QST | $28.38 | $86.00 | $55.90–$86.00 | — | 67% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Rapid Mono Screen Standard | $22.44 | $68.00 | $28.56–$68.00 | 38% below | 67% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Rapid Mono Screen Standard | $22.44 | $68.00 | $44.20–$68.00 | — | 67% |
| Mumps immunity blood test CPT 86735 Mumps IgG (Immune Status) ALI | $35.97 | $109.00 | $45.78–$109.00 | 3% below | 67% |
| Mumps immunity blood test CPT 86735 MUMPS VIRUS ANTIBODY (IGM) QST | $35.97 | $109.00 | $45.78–$109.00 | 3% below | 67% |
| Mumps immunity blood test CPT 86735 MUMPS IGG AB QST | $35.97 | $109.00 | $45.78–$109.00 | 3% below | 67% |
| Mumps immunity blood test CPT 86735 Mumps Virus Ab IGM ALI | $35.97 | $109.00 | $45.78–$109.00 | 3% below | 67% |
| Mumps immunity blood test inpatient CPT 86735 Mumps IgG (Immune Status) ALI | $35.97 | $109.00 | $70.85–$109.00 | — | 67% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS ANTIBODY (IGM) QST | $35.97 | $109.00 | $70.85–$109.00 | — | 67% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS IGG AB QST | $35.97 | $109.00 | $70.85–$109.00 | — | 67% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Virus Ab IGM ALI | $35.97 | $109.00 | $70.85–$109.00 | — | 67% |
| Obstetric blood test panel CPT 80055 Prenatal Panel Standard | $160.71 | $487.00 | $204.54–$487.00 | 13% above | 67% |
| Obstetric blood test panel CPT 80055 MAYO PRENATAL PANEL | $160.71 | $487.00 | $204.54–$487.00 | 13% above | 67% |
| Obstetric blood test panel CPT 80055 Prenatal Panel MAYO | $160.71 | $487.00 | $204.54–$487.00 | 13% above | 67% |
| Obstetric blood test panel inpatient CPT 80055 MAYO PRENATAL PANEL | $160.71 | $487.00 | $316.55–$487.00 | — | 67% |
| Obstetric blood test panel inpatient CPT 80055 Prenatal Panel MAYO | $160.71 | $487.00 | $316.55–$487.00 | — | 67% |
| Obstetric blood test panel inpatient CPT 80055 Prenatal Panel Standard | $160.71 | $487.00 | $316.55–$487.00 | — | 67% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (FREE AND TOTAL) QST | $53.79 | $163.00 | $68.46–$163.00 | 42% below | 67% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Free ALI | $53.79 | $163.00 | $68.46–$163.00 | 42% below | 67% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Free ALI | $53.79 | $163.00 | $105.95–$163.00 | — | 67% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA (FREE AND TOTAL) QST | $53.79 | $163.00 | $105.95–$163.00 | — | 67% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Diagnostic | $48.51 | $147.00 | $61.74–$147.00 | 32% below | 67% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Diagnostic | $48.51 | $147.00 | $95.55–$147.00 | — | 67% |
| Pap test (liquid-based, automated screening with review) CPT 88175 SurePath Pap w/ HPV age 30+ DC | $26.07 | $79.00 | $33.18–$79.00 | 59% below | 67% |
| Pap test (liquid-based, automated screening with review) CPT 88175 THIN PREP PAP TEST DC | $26.07 | $79.00 | $33.18–$79.00 | 59% below | 67% |
| Pap test (liquid-based, automated screening with review) CPT 88175 SurePath Pap only- age <=20 DC | $26.07 | $79.00 | $33.18–$79.00 | 59% below | 67% |
| Pap test (liquid-based, automated screening with review) CPT 88175 SurePath Pap w/ rflx HPV ASCUS or LGSIL DC | $26.07 | $79.00 | $33.18–$79.00 | 59% below | 67% |
| Pap test (liquid-based, automated screening with review) CPT 88175 SurePath Pap w/ rflx HPV age 21-29 DC | $26.07 | $79.00 | $33.18–$79.00 | 59% below | 67% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SurePath Pap only- age <=20 DC | $26.07 | $79.00 | $51.35–$79.00 | — | 67% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THIN PREP PAP TEST DC | $26.07 | $79.00 | $51.35–$79.00 | — | 67% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SurePath Pap w/ HPV age 30+ DC | $26.07 | $79.00 | $51.35–$79.00 | — | 67% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SurePath Pap w/ rflx HPV ASCUS or LGSIL DC | $26.07 | $79.00 | $51.35–$79.00 | — | 67% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SurePath Pap w/ rflx HPV age 21-29 DC | $26.07 | $79.00 | $51.35–$79.00 | — | 67% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact w/Calcium ALI | $50.49 | $153.00 | $64.26–$153.00 | 49% below | 67% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact W/O Calcium ALI | $50.49 | $153.00 | $64.26–$153.00 | 49% below | 67% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH, INTACT W/O CALCIUM QST | $50.49 | $153.00 | $64.26–$153.00 | 49% below | 67% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact w/Calcium ALI | $50.49 | $153.00 | $99.45–$153.00 | — | 67% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact W/O Calcium ALI | $50.49 | $153.00 | $99.45–$153.00 | — | 67% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, INTACT W/O CALCIUM QST | $50.49 | $153.00 | $99.45–$153.00 | — | 67% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 zzLupus Anticoagulant Panel Reflex ALI | $23.10 | $70.00 | $29.40–$70.00 | 47% below | 67% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT Non-Heparin | $23.10 | $70.00 | $29.40–$70.00 | 47% below | 67% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $23.10 | $70.00 | $29.40–$70.00 | 47% below | 67% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT ALI | $23.10 | $70.00 | $29.40–$70.00 | 47% below | 67% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Silica Clotting Time ALI | $23.10 | $70.00 | $29.40–$70.00 | 47% below | 67% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Prothrombin Time/ PTT | $23.10 | $70.00 | $29.40–$70.00 | 47% below | 67% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-LA W/REFLEX TO HEXAGONAL PHASE CONFIRMATION QS | $23.10 | $70.00 | $29.40–$70.00 | 47% below | 67% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Silica Clotting Time ALI | $23.10 | $70.00 | $45.50–$70.00 | — | 67% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 zzLupus Anticoagulant Panel Reflex ALI | $23.10 | $70.00 | $45.50–$70.00 | — | 67% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Prothrombin Time/ PTT | $23.10 | $70.00 | $45.50–$70.00 | — | 67% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-LA W/REFLEX TO HEXAGONAL PHASE CONFIRMATION QS | $23.10 | $70.00 | $45.50–$70.00 | — | 67% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT Non-Heparin | $23.10 | $70.00 | $45.50–$70.00 | — | 67% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time | $23.10 | $70.00 | $45.50–$70.00 | — | 67% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT ALI | $23.10 | $70.00 | $45.50–$70.00 | — | 67% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus ALI | $13.53 | $41.00 | $17.22–$41.00 | 51% below | 67% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level | $13.53 | $41.00 | $17.22–$41.00 | 51% below | 67% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level | $13.53 | $41.00 | $26.65–$41.00 | — | 67% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus ALI | $13.53 | $41.00 | $26.65–$41.00 | — | 67% |
| Potassium blood test CPT 84132 Potassium Level | $13.20 | $40.00 | $16.80–$40.00 | 46% below | 67% |
| Potassium blood test inpatient CPT 84132 Potassium Level | $13.20 | $40.00 | $26.00–$40.00 | — | 67% |
| Progesterone blood test CPT 84144 PROGESTERONE AEL | $60.72 | $184.00 | $77.28–$184.00 | 32% below | 67% |
| Progesterone blood test CPT 84144 Progesterone Level ALI | $60.72 | $184.00 | $77.28–$184.00 | 32% below | 67% |
| Progesterone blood test CPT 84144 PROGESTERONE LEVEL QST | $60.72 | $184.00 | $77.28–$184.00 | 32% below | 67% |
| Progesterone blood test inpatient CPT 84144 Progesterone Level ALI | $60.72 | $184.00 | $119.60–$184.00 | — | 67% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE AEL | $60.72 | $184.00 | $119.60–$184.00 | — | 67% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE LEVEL QST | $60.72 | $184.00 | $119.60–$184.00 | — | 67% |
| Prolactin blood test CPT 84146 PROLACTIN LEVEL QST | $57.75 | $175.00 | $73.50–$175.00 | 23% below | 67% |
| Prolactin blood test CPT 84146 Prolactin Level ALI | $57.75 | $175.00 | $73.50–$175.00 | 23% below | 67% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN LEVEL QST | $57.75 | $175.00 | $113.75–$175.00 | — | 67% |
| Prolactin blood test inpatient CPT 84146 Prolactin Level ALI | $57.75 | $175.00 | $113.75–$175.00 | — | 67% |
| Prothrombin time (PT/INR) clotting test CPT 85610 INR | $15.51 | $47.00 | $19.74–$47.00 | 47% below | 67% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN/INR POC | $15.51 | $47.00 | $19.74–$47.00 | 47% below | 67% |
| Prothrombin time (PT/INR) clotting test CPT 85610 INR ALI | $15.51 | $47.00 | $19.74–$47.00 | 47% below | 67% |
| Prothrombin time (PT/INR) clotting test CPT 85610 INR POC Confirm | $15.51 | $47.00 | $19.74–$47.00 | 47% below | 67% |
| Prothrombin time (PT/INR) clotting test CPT 85610 INR POC (Lab) | $15.51 | $47.00 | $19.74–$47.00 | 47% below | 67% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR POC (Lab) | $15.51 | $47.00 | $30.55–$47.00 | — | 67% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN/INR POC | $15.51 | $47.00 | $30.55–$47.00 | — | 67% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR | $15.51 | $47.00 | $30.55–$47.00 | — | 67% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR POC Confirm | $15.51 | $47.00 | $30.55–$47.00 | — | 67% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR ALI | $15.51 | $47.00 | $30.55–$47.00 | — | 67% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE DRUG TOX POC | $18.81 | $57.00 | $23.94–$57.00 | 27% below | 67% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE DRUG TOX POC | $18.81 | $57.00 | $37.05–$57.00 | — | 67% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP POC | $15.84 | $48.00 | $20.16–$48.00 | 60% below | 67% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP POC | $15.84 | $48.00 | $31.20–$48.00 | — | 67% |
| Renin blood test CPT 84244 PLASMA RENIN ACTIVITY (PRA) QST | $52.14 | $158.00 | $66.36–$158.00 | 29% below | 67% |
| Renin blood test CPT 84244 Renin Activity ALI | $52.14 | $158.00 | $66.36–$158.00 | 29% below | 67% |
| Renin blood test inpatient CPT 84244 Renin Activity ALI | $52.14 | $158.00 | $102.70–$158.00 | — | 67% |
| Renin blood test inpatient CPT 84244 PLASMA RENIN ACTIVITY (PRA) QST | $52.14 | $158.00 | $102.70–$158.00 | — | 67% |
| Rh blood typing CPT 86901 Du Test | $29.04 | $88.00 | $36.96–$88.00 | 20% below | 67% |
| Rh blood typing CPT 86901 Newborn Rh | $29.04 | $88.00 | $36.96–$88.00 | 20% below | 67% |
| Rh blood typing CPT 86901 Rh Typing | $29.04 | $88.00 | $36.96–$88.00 | 20% below | 67% |
| Rh blood typing CPT 86901 Cord Blood Rh | $29.04 | $88.00 | $36.96–$88.00 | 20% below | 67% |
| Rh blood typing inpatient CPT 86901 Cord Blood Rh | $29.04 | $88.00 | $57.20–$88.00 | — | 67% |
| Rh blood typing inpatient CPT 86901 Newborn Rh | $29.04 | $88.00 | $57.20–$88.00 | — | 67% |
| Rh blood typing inpatient CPT 86901 Du Test | $29.04 | $88.00 | $57.20–$88.00 | — | 67% |
| Rh blood typing inpatient CPT 86901 Rh Typing | $29.04 | $88.00 | $57.20–$88.00 | — | 67% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor 3 | $23.76 | $72.00 | $30.24–$72.00 | 29% below | 67% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QST | $23.76 | $72.00 | $30.24–$72.00 | 29% below | 67% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor 3 | $23.76 | $72.00 | $46.80–$72.00 | — | 67% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QST | $23.76 | $72.00 | $46.80–$72.00 | — | 67% |
| Rubella antibody test (immunity check) CPT 86762 Rubella ALI | $29.37 | $89.00 | $37.38–$89.00 | 41% below | 67% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IMMUNE STATUS QST | $29.37 | $89.00 | $37.38–$89.00 | 41% below | 67% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IMMUNE STATUS QST | $29.37 | $89.00 | $57.85–$89.00 | — | 67% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella ALI | $29.37 | $89.00 | $57.85–$89.00 | — | 67% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Analysis Fertility | $22.77 | $69.00 | $28.98–$69.00 | 72% below | 67% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Semen Analysis Fertility | $22.77 | $69.00 | $44.85–$69.00 | — | 67% |
| Sodium blood test CPT 84295 Sodium Level | $12.54 | $38.00 | $15.96–$38.00 | 47% below | 67% |
| Sodium blood test inpatient CPT 84295 Sodium Level | $12.54 | $38.00 | $24.70–$38.00 | — | 67% |
| Stool ova and parasites exam CPT 87177 Ova + Parasites Stool ALI | $20.79 | $63.00 | $26.46–$63.00 | 43% below | 67% |
| Stool ova and parasites exam CPT 87177 Ova and Para Travel History ALI | $20.79 | $63.00 | $26.46–$63.00 | 43% below | 67% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES, CONC AND PERM SMEAR MB QST | $27.39 | $83.00 | $34.86–$83.00 | 25% below | 67% |
| Stool ova and parasites exam inpatient CPT 87177 Ova + Parasites Stool ALI | $20.79 | $63.00 | $40.95–$63.00 | — | 67% |
| Stool ova and parasites exam inpatient CPT 87177 Ova and Para Travel History ALI | $20.79 | $63.00 | $40.95–$63.00 | — | 67% |
| Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES, CONC AND PERM SMEAR MB QST | $27.39 | $83.00 | $53.95–$83.00 | — | 67% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-ABS QST | $34.32 | $104.00 | $43.68–$104.00 | 36% below | 67% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Fluorescent Treponemal Ab-Absorption ALI | $34.32 | $104.00 | $43.68–$104.00 | 36% below | 67% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Fluorescent Treponemal Ab-Absorption ALI | $34.32 | $104.00 | $67.60–$104.00 | — | 67% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA-ABS QST | $34.32 | $104.00 | $67.60–$104.00 | — | 67% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR W/REFLEX TITER QST | $20.13 | $61.00 | $25.62–$61.00 | 36% below | 67% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR ALI | $20.13 | $61.00 | $25.62–$61.00 | 36% below | 67% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR W/REFLEX TITER QST | $20.13 | $61.00 | $39.65–$61.00 | — | 67% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR ALI | $20.13 | $61.00 | $39.65–$61.00 | — | 67% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD PLUS QST | $68.64 | $208.00 | $87.36–$208.00 | 42% below | 67% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon Gold TB ALI | $68.64 | $208.00 | $87.36–$208.00 | 42% below | 67% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD PLUS QST | $68.64 | $208.00 | $135.20–$208.00 | — | 67% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon Gold TB ALI | $68.64 | $208.00 | $135.20–$208.00 | — | 67% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE LEVEL TOTAL, M QST | $73.59 | $223.00 | $93.66–$223.00 | 19% below | 67% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Free Panel (Male Only) ALI | $73.59 | $223.00 | $93.66–$223.00 | 19% below | 67% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total ALI | $73.59 | $223.00 | $93.66–$223.00 | 19% below | 67% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Women/ Child ALI | $73.59 | $223.00 | $93.66–$223.00 | 19% below | 67% |
| Testosterone blood test, total (not free testosterone) CPT 84403 .TESTOSTERONE, BIOAVAILABLE | $73.59 | $223.00 | $93.66–$223.00 | 19% below | 67% |
| Testosterone blood test, total (not free testosterone) CPT 84403 84403 TESTOSTERONE FREE PANEL | $73.59 | $223.00 | $93.66–$223.00 | 19% below | 67% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, FREE AND TOTAL QST | $73.59 | $223.00 | $93.66–$223.00 | 19% below | 67% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL, MS, QST | $73.59 | $223.00 | $93.66–$223.00 | 19% below | 67% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, FREE, BIOAVAILABLE AND TOTAL, MALES | $73.59 | $223.00 | $93.66–$223.00 | 19% below | 67% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 84403 TESTOSTERONE FREE PANEL | $73.59 | $223.00 | $144.95–$223.00 | — | 67% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 .TESTOSTERONE, BIOAVAILABLE | $73.59 | $223.00 | $144.95–$223.00 | — | 67% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Women/ Child ALI | $73.59 | $223.00 | $144.95–$223.00 | — | 67% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE LEVEL TOTAL, M QST | $73.59 | $223.00 | $144.95–$223.00 | — | 67% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL, MS, QST | $73.59 | $223.00 | $144.95–$223.00 | — | 67% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, FREE AND TOTAL QST | $73.59 | $223.00 | $144.95–$223.00 | — | 67% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, FREE, BIOAVAILABLE AND TOTAL, MALES | $73.59 | $223.00 | $144.95–$223.00 | — | 67% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Free Panel (Male Only) ALI | $73.59 | $223.00 | $144.95–$223.00 | — | 67% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total ALI | $73.59 | $223.00 | $144.95–$223.00 | — | 67% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Abs ALI | $57.09 | $173.00 | $72.66–$173.00 | 33% below | 67% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsome Abs, IgG ALI | $57.09 | $173.00 | $72.66–$173.00 | 33% below | 67% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB QST | $57.09 | $173.00 | $72.66–$173.00 | 33% below | 67% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOMAL ANTIBODY (IGG) QST | $57.09 | $173.00 | $72.66–$173.00 | 33% below | 67% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Ab ALI | $57.09 | $173.00 | $72.66–$173.00 | 33% below | 67% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Abs ALI | $57.09 | $173.00 | $112.45–$173.00 | — | 67% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOMAL ANTIBODY (IGG) QST | $57.09 | $173.00 | $112.45–$173.00 | — | 67% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB QST | $57.09 | $173.00 | $112.45–$173.00 | — | 67% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsome Abs, IgG ALI | $57.09 | $173.00 | $112.45–$173.00 | — | 67% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Ab ALI | $57.09 | $173.00 | $112.45–$173.00 | — | 67% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $52.80 | $160.00 | $67.20–$160.00 | 32% below | 67% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/ Reflex to Free T4 | $52.80 | $160.00 | $67.20–$160.00 | 32% below | 67% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $52.80 | $160.00 | $104.00–$160.00 | — | 67% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/ Reflex to Free T4 | $52.80 | $160.00 | $104.00–$160.00 | — | 67% |
| Total IgE blood test CPT 82785 Immunoglobulin E ALI | $56.76 | $172.00 | $72.24–$172.00 | 11% below | 67% |
| Total IgE blood test CPT 82785 IMMUNOGLOBULIN E QST | $56.76 | $172.00 | $72.24–$172.00 | 11% below | 67% |
| Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E QST | $56.76 | $172.00 | $111.80–$172.00 | — | 67% |
| Total IgE blood test inpatient CPT 82785 Immunoglobulin E ALI | $56.76 | $172.00 | $111.80–$172.00 | — | 67% |
| Total cholesterol blood test CPT 82465 Cholesterol Total | $22.77 | $69.00 | $28.98–$69.00 | 7% below | 67% |
| Total cholesterol blood test CPT 82465 82465 | $22.77 | $69.00 | $28.98–$69.00 | 7% below | 67% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL, TOTAL QST | $22.77 | $69.00 | $28.98–$69.00 | 7% below | 67% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL, TOTAL QST | $22.77 | $69.00 | $44.85–$69.00 | — | 67% |
| Total cholesterol blood test inpatient CPT 82465 82465 | $22.77 | $69.00 | $44.85–$69.00 | — | 67% |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol Total | $22.77 | $69.00 | $44.85–$69.00 | — | 67% |
| Total thyroxine (T4) blood test CPT 84436 T4 TOTAL QST | $33.00 | $100.00 | $42.00–$100.00 | 32% below | 67% |
| Total thyroxine (T4) blood test CPT 84436 Total Thyroxine (T4) ALI | $33.00 | $100.00 | $42.00–$100.00 | 32% below | 67% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4 TOTAL QST | $33.00 | $100.00 | $65.00–$100.00 | — | 67% |
| Total thyroxine (T4) blood test inpatient CPT 84436 Total Thyroxine (T4) ALI | $33.00 | $100.00 | $65.00–$100.00 | — | 67% |
| Total triiodothyronine (T3) blood test CPT 84480 Total Triiodothyronine ALI | $44.55 | $135.00 | $56.70–$135.00 | 47% below | 67% |
| Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3 QST | $44.55 | $135.00 | $56.70–$135.00 | 47% below | 67% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 Total Triiodothyronine ALI | $44.55 | $135.00 | $87.75–$135.00 | — | 67% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3 QST | $44.55 | $135.00 | $87.75–$135.00 | — | 67% |
| Transferrin blood test CPT 84466 TRANSFERRIN QST | $23.76 | $72.00 | $30.24–$72.00 | 59% below | 67% |
| Transferrin blood test CPT 84466 Transferrin ALI | $23.76 | $72.00 | $30.24–$72.00 | 59% below | 67% |
| Transferrin blood test inpatient CPT 84466 TRANSFERRIN QST | $23.76 | $72.00 | $46.80–$72.00 | — | 67% |
| Transferrin blood test inpatient CPT 84466 Transferrin ALI | $23.76 | $72.00 | $46.80–$72.00 | — | 67% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS RNA, FEMALE, QST | $36.30 | $110.00 | $46.20–$110.00 | 59% below | 67% |
| Trichomonas test (NAAT) CPT 87661 TRICH CHG | $36.30 | $110.00 | $46.20–$110.00 | 59% below | 67% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS RNA, FEMALE, QST | $36.30 | $110.00 | $71.50–$110.00 | — | 67% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICH CHG | $36.30 | $110.00 | $71.50–$110.00 | — | 67% |
| Triglycerides blood test CPT 84478 Triglycerides | $29.70 | $90.00 | $37.80–$90.00 | 33% below | 67% |
| Triglycerides blood test CPT 84478 Triglyceride, Body Fluid | $29.70 | $90.00 | $37.80–$90.00 | 33% below | 67% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides | $29.70 | $90.00 | $58.50–$90.00 | — | 67% |
| Triglycerides blood test inpatient CPT 84478 Triglyceride, Body Fluid | $29.70 | $90.00 | $58.50–$90.00 | — | 67% |
| Troponin test, quantitative CPT 84484 Troponin T High Sensitivity 2nd Draw | $74.25 | $225.00 | $94.50–$225.00 | 7% below | 67% |
| Troponin test, quantitative CPT 84484 TROPONIN I HIGH SENSITIVITY 2ND DRAW | $74.25 | $225.00 | $94.50–$225.00 | 7% below | 67% |
| Troponin test, quantitative CPT 84484 TROPONIN I HIGH SENSITIVITY RANDOM | $74.25 | $225.00 | $94.50–$225.00 | 7% below | 67% |
| Troponin test, quantitative CPT 84484 Troponin T High Sensitivity 3rd Draw | $74.25 | $225.00 | $94.50–$225.00 | 7% below | 67% |
| Troponin test, quantitative CPT 84484 Troponin T High Sensitivity Random | $74.25 | $225.00 | $94.50–$225.00 | 7% below | 67% |
| Troponin test, quantitative CPT 84484 Troponin | $74.25 | $225.00 | $94.50–$225.00 | 7% below | 67% |
| Troponin test, quantitative CPT 84484 TROPONIN I HIGH SENSITIVITY | $74.25 | $225.00 | $94.50–$225.00 | 7% below | 67% |
| Troponin test, quantitative CPT 84484 TROPONIN I HIGH SENSITIVITY 3RD DRAW | $74.25 | $225.00 | $94.50–$225.00 | 7% below | 67% |
| Troponin test, quantitative CPT 84484 Troponin T High Sensitivity | $74.25 | $225.00 | $94.50–$225.00 | 7% below | 67% |
| Troponin test, quantitative inpatient CPT 84484 Troponin T High Sensitivity 2nd Draw | $74.25 | $225.00 | $146.25–$225.00 | — | 67% |
| Troponin test, quantitative inpatient CPT 84484 Troponin T High Sensitivity 3rd Draw | $74.25 | $225.00 | $146.25–$225.00 | — | 67% |
| Troponin test, quantitative inpatient CPT 84484 Troponin T High Sensitivity Random | $74.25 | $225.00 | $146.25–$225.00 | — | 67% |
| Troponin test, quantitative inpatient CPT 84484 Troponin | $74.25 | $225.00 | $146.25–$225.00 | — | 67% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN I HIGH SENSITIVITY | $74.25 | $225.00 | $146.25–$225.00 | — | 67% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN I HIGH SENSITIVITY 3RD DRAW | $74.25 | $225.00 | $146.25–$225.00 | — | 67% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN I HIGH SENSITIVITY RANDOM | $74.25 | $225.00 | $146.25–$225.00 | — | 67% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN I HIGH SENSITIVITY 2ND DRAW | $74.25 | $225.00 | $146.25–$225.00 | — | 67% |
| Troponin test, quantitative inpatient CPT 84484 Troponin T High Sensitivity | $74.25 | $225.00 | $146.25–$225.00 | — | 67% |
| Uric acid blood test CPT 84550 Uric Acid | $13.20 | $40.00 | $16.80–$40.00 | 57% below | 67% |
| Uric acid blood test CPT 84550 UREA NITROGEN, 24-HOUR URINE WITHOUT CREATININE QS | $13.20 | $40.00 | $16.80–$40.00 | 57% below | 67% |
| Uric acid blood test inpatient CPT 84550 Uric Acid | $13.20 | $40.00 | $26.00–$40.00 | — | 67% |
| Uric acid blood test inpatient CPT 84550 UREA NITROGEN, 24-HOUR URINE WITHOUT CREATININE QS | $13.20 | $40.00 | $26.00–$40.00 | — | 67% |
| Urinalysis with microscope exam, manual CPT 81000 URINE DIPSTICK AND MICROSCOPY POC | $8.91 | $27.00 | $11.34–$27.00 | 64% below | 67% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 URINE DIPSTICK AND MICROSCOPY POC | $8.91 | $27.00 | $17.55–$27.00 | — | 67% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick Only Standard | $12.21 | $37.00 | $15.54–$37.00 | 43% below | 67% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis with Culture, if indicated Standard | $12.21 | $37.00 | $15.54–$37.00 | 43% below | 67% |
| Urinalysis without microscope exam, automated CPT 81003 URINE DIPSTICK - AUTOMATED POC | $12.21 | $37.00 | $15.54–$37.00 | 43% below | 67% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE DIPSTICK - AUTOMATED POC | $12.21 | $37.00 | $24.05–$37.00 | — | 67% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis with Culture, if indicated Standard | $12.21 | $37.00 | $24.05–$37.00 | — | 67% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Dipstick Only Standard | $12.21 | $37.00 | $24.05–$37.00 | — | 67% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis | $8.91 | $27.00 | $11.34–$27.00 | 44% below | 67% |
| Urinalysis without microscope exam, manual CPT 81002 Reducing Substance Ur ALI | $8.91 | $27.00 | $11.34–$27.00 | 44% below | 67% |
| Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTICK POC | $8.91 | $27.00 | $11.34–$27.00 | 44% below | 67% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Reducing Substance Ur ALI | $8.91 | $27.00 | $17.55–$27.00 | — | 67% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis | $8.91 | $27.00 | $17.55–$27.00 | — | 67% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTICK POC | $8.91 | $27.00 | $17.55–$27.00 | — | 67% |
| Urine culture for bacteria, with colony count CPT 87086 Culture Urine ALI | $30.69 | $93.00 | $39.06–$93.00 | 52% below | 67% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE | $30.69 | $93.00 | $39.06–$93.00 | 52% below | 67% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE, URINE, ROUTINE MB QST | $32.01 | $97.00 | $40.74–$97.00 | 50% below | 67% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Culture Urine ALI | $30.69 | $93.00 | $60.45–$93.00 | — | 67% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE | $30.69 | $93.00 | $60.45–$93.00 | — | 67% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE, URINE, ROUTINE MB QST | $32.01 | $97.00 | $63.05–$97.00 | — | 67% |
| Urine microalbumin (albumin) test CPT 82043 Microalb/Creat Ratio | $43.56 | $132.00 | $55.44–$132.00 | 15% below | 67% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Level 24 Hour Urine | $43.56 | $132.00 | $55.44–$132.00 | 15% below | 67% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Level 24 Hour Urine | $43.56 | $132.00 | $85.80–$132.00 | — | 67% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalb/Creat Ratio | $43.56 | $132.00 | $85.80–$132.00 | — | 67% |
| Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test Qualitative Standard | $20.46 | $62.00 | $26.04–$62.00 | 27% below | 67% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST POC | $26.40 | $80.00 | $33.60–$80.00 | 6% below | 67% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test Qualitative Standard | $20.46 | $62.00 | $40.30–$62.00 | — | 67% |
| Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST POC | $26.40 | $80.00 | $52.00–$80.00 | — | 67% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level ALI | $39.60 | $120.00 | $50.40–$120.00 | 54% below | 67% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 LEVEL QST | $39.60 | $120.00 | $50.40–$120.00 | 54% below | 67% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 LEVEL QST | $39.60 | $120.00 | $78.00–$120.00 | — | 67% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level ALI | $39.60 | $120.00 | $78.00–$120.00 | — | 67% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY TOTAL IA QST | $59.40 | $180.00 | $75.60–$180.00 | 48% below | 67% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 Hydroxyvitamin D2/ D3 by TMS ALI | $59.40 | $180.00 | $75.60–$180.00 | 48% below | 67% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level ALI | $59.40 | $180.00 | $75.60–$180.00 | 48% below | 67% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25-HYDROXY, TOT, D2 , D3 QST | $59.40 | $180.00 | $75.60–$180.00 | 48% below | 67% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy Level ALI | $59.40 | $180.00 | $117.00–$180.00 | — | 67% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25-HYDROXY, TOT, D2 , D3 QST | $59.40 | $180.00 | $117.00–$180.00 | — | 67% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25 Hydroxyvitamin D2/ D3 by TMS ALI | $59.40 | $180.00 | $117.00–$180.00 | — | 67% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY TOTAL IA QST | $59.40 | $180.00 | $117.00–$180.00 | — | 67% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D, 1,25 DIHYDROXY QST | $88.11 | $267.00 | $112.14–$267.00 | 33% below | 67% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D 1-25 Dihydroxy Level ALI | $88.11 | $267.00 | $112.14–$267.00 | 33% below | 67% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D 1-25 Dihydroxy Level ALI | $88.11 | $267.00 | $173.55–$267.00 | — | 67% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D, 1,25 DIHYDROXY QST | $88.11 | $267.00 | $173.55–$267.00 | — | 67% |
| Zinc blood test CPT 84630 ZINC LEVEL QST | $32.01 | $97.00 | $40.74–$97.00 | 24% below | 67% |
| Zinc blood test CPT 84630 Zinc Level ALI | $32.01 | $97.00 | $40.74–$97.00 | 24% below | 67% |
| Zinc blood test inpatient CPT 84630 ZINC LEVEL QST | $32.01 | $97.00 | $63.05–$97.00 | — | 67% |
| Zinc blood test inpatient CPT 84630 Zinc Level ALI | $32.01 | $97.00 | $63.05–$97.00 | — | 67% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG Quantitative | $50.49 | $153.00 | $64.26–$153.00 | 38% below | 67% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta-HCG (Tumor Marker) ALI | $50.49 | $153.00 | $64.26–$153.00 | 38% below | 67% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 .HUMAN CHORIONIC GONADOTROPHIN | $50.49 | $153.00 | $64.26–$153.00 | 38% below | 67% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HUMAN CHORIONIC GONADOTROPIN (HCG) SERUM QST | $50.49 | $153.00 | $64.26–$153.00 | 38% below | 67% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG Quantitative | $50.49 | $153.00 | $99.45–$153.00 | — | 67% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta-HCG (Tumor Marker) ALI | $50.49 | $153.00 | $99.45–$153.00 | — | 67% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 .HUMAN CHORIONIC GONADOTROPHIN | $50.49 | $153.00 | $99.45–$153.00 | — | 67% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HUMAN CHORIONIC GONADOTROPIN (HCG) SERUM QST | $50.49 | $153.00 | $99.45–$153.00 | — | 67% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ TechFee | $248.82 | $754.00 | $316.68–$754.00 | 10% below | 67% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ TechFee | $248.82 | $754.00 | $490.10–$754.00 | — | 67% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28470 CLOSED TX METATARSAL FRACTURE W/O MANIPULATION TechFee | $215.16 | $652.00 | $273.84–$652.00 | 11% below | 67% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 28470 CLOSED TX METATARSAL FRACTURE W/O MANIPULATION TechFee | $215.16 | $652.00 | $423.80–$652.00 | — | 67% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL ED TechFee | $365.97 | $1,109.00 | $465.78–$1,109.00 | 25% below | 67% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL ED TechFee | $365.97 | $1,109.00 | $720.85–$1,109.00 | — | 67% |
| Circumcision, surgical, older than a newborn CPT 54160 54160 Circumcision surgical excision other than clamp | $135.30 | $410.00 | $172.20–$410.00 | 16% below | 67% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 54160 Circumcision surgical excision other than clamp | $135.30 | $410.00 | $266.50–$410.00 | — | 67% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT TechFee | $33.00 | $100.00 | $42.00–$100.00 | 34% below | 67% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT TechFee | $33.00 | $100.00 | $65.00–$100.00 | — | 67% |
| Earwax removal with instruments, one ear one side CPT 69210 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT TechFee | $36.30 | $110.00 | $46.20–$110.00 | 37% below | 67% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT TechFee | $36.30 | $110.00 | $71.50–$110.00 | — | 67% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 MAYO Hysterosalp Inj | $89.10 | $270.00 | $113.40–$270.00 | 74% below | 67% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 MAYO Hysterosalp Inj | $89.10 | $270.00 | $175.50–$270.00 | — | 67% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Incision and drainage of abscess (eg, carbuncle, suppurative | $103.29 | $313.00 | $131.46–$313.00 | 35% below | 67% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision and drainage of abscess (eg, carbuncle, suppurative | $103.29 | $313.00 | $203.45–$313.00 | — | 67% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Hip Inj or Aspiration Left | $59.40 | $180.00 | $75.60–$180.00 | 78% below | 67% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Hip Inj or Aspiration Right | $59.40 | $180.00 | $75.60–$180.00 | 78% below | 67% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Hip Inj or Aspiration Right | $59.40 | $180.00 | $117.00–$180.00 | — | 67% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Hip Inj or Aspiration Left | $59.40 | $180.00 | $117.00–$180.00 | — | 67% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US TechFee | $47.85 | $145.00 | $60.90–$145.00 | 74% below | 67% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US TechFee | $47.85 | $145.00 | $94.25–$145.00 | — | 67% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US TechFee | $43.23 | $131.00 | $55.02–$131.00 | 78% below | 67% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US TechFee | $43.23 | $131.00 | $85.15–$131.00 | — | 67% |
| Nail removal (partial or complete), one nail CPT 11730 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 TechFee | $55.44 | $168.00 | $70.56–$168.00 | 57% below | 67% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 TechFee | $55.44 | $168.00 | $109.20–$168.00 | — | 67% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Injection(s), anesthetic agent(s) and/or steroid; femoral ne | $189.09 | $573.00 | $240.66–$573.00 | 42% below | 67% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Injection(s), anesthetic agent(s) and/or steroid; femoral ne | $189.09 | $573.00 | $372.45–$573.00 | — | 67% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE TechFee | $93.72 | $284.00 | $119.28–$284.00 | 59% below | 67% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE TechFee | $93.72 | $284.00 | $184.60–$284.00 | — | 67% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Lithotripsy | $2,412.96 | $7,312.00 | $3,071.04–$7,312.00 | 7% below | 67% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 Lithotripsy | $2,412.96 | $7,312.00 | $4,752.80–$7,312.00 | — | 67% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST ELBOW FINGER SHORT ARM | $62.04 | $188.00 | $78.96–$188.00 | 65% below | 67% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST ELBOW FINGER SHORT ARM | $62.04 | $188.00 | $122.20–$188.00 | — | 67% |
| Short arm splint (forearm and hand) CPT 29125 OT Short Arm Splint Units | $83.49 | $253.00 | $106.26–$253.00 | 28% below | 67% |
| Short arm splint (forearm and hand) CPT 29125 29125 APPLICATION OF SHORT ARM SPLINT | $83.49 | $253.00 | $106.26–$253.00 | 28% below | 67% |
| Short arm splint (forearm and hand) CPT 29125 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC TechFee | $83.49 | $253.00 | $106.26–$253.00 | 28% below | 67% |
| Short arm splint (forearm and hand) inpatient CPT 29125 29125 APPLICATION OF SHORT ARM SPLINT | $83.49 | $253.00 | $164.45–$253.00 | — | 67% |
| Short arm splint (forearm and hand) inpatient CPT 29125 OT Short Arm Splint Units | $83.49 | $253.00 | $164.45–$253.00 | — | 67% |
| Short arm splint (forearm and hand) inpatient CPT 29125 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC TechFee | $83.49 | $253.00 | $164.45–$253.00 | — | 67% |
| Short leg cast (below the knee) CPT 29405 29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE TechFee | $67.98 | $206.00 | $86.52–$206.00 | 58% below | 67% |
| Short leg cast (below the knee) inpatient CPT 29405 29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE TechFee | $67.98 | $206.00 | $133.90–$206.00 | — | 67% |
| Short leg splint (calf to foot) CPT 29515 29515 APPLICATION SHORT LEG SPLINT CALF FOOT TechFee | $83.49 | $253.00 | $106.26–$253.00 | 34% below | 67% |
| Short leg splint (calf to foot) inpatient CPT 29515 29515 APPLICATION SHORT LEG SPLINT CALF FOOT TechFee | $83.49 | $253.00 | $164.45–$253.00 | — | 67% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee | $122.43 | $371.00 | $155.82–$371.00 | 18% below | 67% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 SIM SPRFCL S,N,A,G,T | $210.54 | $638.00 | $267.96–$638.00 | 42% above | 67% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee | $122.43 | $371.00 | $241.15–$371.00 | — | 67% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 SIM SPRFCL S,N,A,G,T | $210.54 | $638.00 | $414.70–$638.00 | — | 67% |
| Skin tag removal, up to 15 tags CPT 11200 11200 REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW | $51.48 | $156.00 | $65.52–$156.00 | 61% below | 67% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 11200 REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW | $51.48 | $156.00 | $101.40–$156.00 | — | 67% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee | $144.87 | $439.00 | $184.38–$439.00 | 22% below | 67% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee | $144.87 | $439.00 | $285.35–$439.00 | — | 67% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee | $148.50 | $450.00 | $189.00–$450.00 | 10% below | 67% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee | $148.50 | $450.00 | $292.50–$450.00 | — | 67% |
| Trigger point injections, 1 or 2 muscles CPT 20552 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES TechFee | $45.21 | $137.00 | $57.54–$137.00 | 76% below | 67% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES TechFee | $45.21 | $137.00 | $89.05–$137.00 | — | 67% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION TRANSFUSION | $340.89 | $1,033.00 | $433.86–$1,033.00 | 31% below | 67% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION | $340.89 | $1,033.00 | $433.86–$1,033.00 | 31% below | 67% |
| Blood transfusion (giving blood or blood components) CPT 36430 36430 BLOOD TRANSFUSION CHARGE | $340.89 | $1,033.00 | $433.86–$1,033.00 | 31% below | 67% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION | $340.89 | $1,033.00 | $671.45–$1,033.00 | — | 67% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION TRANSFUSION | $340.89 | $1,033.00 | $671.45–$1,033.00 | — | 67% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 36430 BLOOD TRANSFUSION CHARGE | $340.89 | $1,033.00 | $671.45–$1,033.00 | — | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT TechFee | $221.10 | $670.00 | $281.40–$670.00 | 21% above | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 AEROSOL/VAPOR INHAL TRMT CHARGE | $221.10 | $670.00 | $281.40–$670.00 | 21% above | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT | $234.96 | $712.00 | $299.04–$712.00 | 28% above | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 NEBULIZER CHARGE | $234.96 | $712.00 | $299.04–$712.00 | 28% above | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT TechFee | $221.10 | $670.00 | $435.50–$670.00 | — | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 AEROSOL/VAPOR INHAL TRMT CHARGE | $221.10 | $670.00 | $435.50–$670.00 | — | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TREATMENT | $234.96 | $712.00 | $462.80–$712.00 | — | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 NEBULIZER CHARGE | $234.96 | $712.00 | $462.80–$712.00 | — | 67% |
| Chemotherapy IV infusion, first hour CPT 96413 96413 - Chemo Admin, IV Push, Single/First Drug, First Hour | $269.61 | $817.00 | $343.14–$817.00 | 31% below | 67% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 96413 - Chemo Admin, IV Push, Single/First Drug, First Hour | $269.61 | $817.00 | $531.05–$817.00 | — | 67% |
| Critical care, first 30 to 74 minutes CPT 99291 99291- ED CRITICAL CARE-1ST HOUR | $617.76 | $1,872.00 | $786.24–$1,872.00 | 40% below | 67% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 99291- ED CRITICAL CARE-1ST HOUR | $617.76 | $1,872.00 | $1,216.80–$1,872.00 | — | 67% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG 12 LEAD, INTERP/REPORT ONLY CHARGE | $30.36 | $92.00 | $38.64–$92.00 | 78% below | 67% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG POC | $48.18 | $146.00 | $61.32–$146.00 | 65% below | 67% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG 12 LEAD, INTERP/REPORT ONLY CHARGE | $30.36 | $92.00 | $59.80–$92.00 | — | 67% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG POC | $48.18 | $146.00 | $94.90–$146.00 | — | 67% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 Electrocardiogram, routine ECG w/ at least 12 leads; tracing only, w/o interpretation & report | $90.42 | $274.00 | $115.08–$274.00 | 20% below | 67% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG (Resp) | $100.98 | $306.00 | $128.52–$306.00 | 10% below | 67% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 93005 Electrocardiogram, routine ECG w/ at least 12 leads; tracing only, w/o interpretation & report | $90.42 | $274.00 | $178.10–$274.00 | — | 67% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG (Resp) | $100.98 | $306.00 | $198.90–$306.00 | — | 67% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281- ED VISIT LEVEL 1 ED FACILITY CHARGE TICKET | $71.28 | $216.00 | $90.72–$216.00 | 31% below | 67% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281- ED VISIT LEVEL 1 ED FACILITY CHARGE TICKET | $71.28 | $216.00 | $140.40–$216.00 | — | 67% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282- ED VISIT LEVEL 2 | $137.94 | $418.00 | $175.56–$418.00 | 34% below | 67% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282- ED VISIT LEVEL 2 | $137.94 | $418.00 | $271.70–$418.00 | — | 67% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283- ED VISIT LEVEL 3 INTERMEDIATE | $247.17 | $749.00 | $314.58–$749.00 | 26% below | 67% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283- ED VISIT LEVEL 3 INTERMEDIATE | $247.17 | $749.00 | $486.85–$749.00 | — | 67% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284- ED VISIT LEVEL 4 MODERATE | $403.26 | $1,222.00 | $513.24–$1,222.00 | 34% below | 67% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284- ED VISIT LEVEL 4 MODERATE | $403.26 | $1,222.00 | $794.30–$1,222.00 | — | 67% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285- ED VISIT LEVEL 5 HIGH DECISION MAKING | $669.57 | $2,029.00 | $852.18–$2,029.00 | 32% below | 67% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285- ED VISIT LEVEL 5 HIGH DECISION MAKING | $669.57 | $2,029.00 | $1,318.85–$2,029.00 | — | 67% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour- Hosp | $113.85 | $345.00 | $144.90–$345.00 | 46% below | 67% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 HYDRATION (1ST HR) CHARGE | $113.85 | $345.00 | $144.90–$345.00 | 46% below | 67% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour- Hosp | $113.85 | $345.00 | $224.25–$345.00 | — | 67% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 HYDRATION (1ST HR) CHARGE | $113.85 | $345.00 | $224.25–$345.00 | — | 67% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion Therapy, PROPHYLAXIS /DX 1ST TO 1 HR | $316.14 | $958.00 | $402.36–$958.00 | 3% below | 67% |
| IV infusion of a medicine, first hour CPT 96365 96365 IV INFUSION, UP TO 1 HOUR (INITIAL 16-60 MIN | $316.14 | $958.00 | $402.36–$958.00 | 3% below | 67% |
| IV infusion of a medicine, first hour CPT 96365 96365 COVID INFUSION ADMINISTRATION fee | $316.14 | $958.00 | $402.36–$958.00 | 3% below | 67% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion Therapy, PROPHYLAXIS /DX 1ST TO 1 HR | $316.14 | $958.00 | $622.70–$958.00 | — | 67% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 COVID INFUSION ADMINISTRATION fee | $316.14 | $958.00 | $622.70–$958.00 | — | 67% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV INFUSION, UP TO 1 HOUR (INITIAL 16-60 MIN | $316.14 | $958.00 | $622.70–$958.00 | — | 67% |
| IV push of a medicine, first drug CPT 96374 MAYO Echo Inj for Definity (Non-Stress) | $316.14 | $958.00 | $402.36–$958.00 | 60% above | 67% |
| IV push of a medicine, first drug CPT 96374 96374 - IV Push, Single or Initial- Hosp | $316.14 | $958.00 | $402.36–$958.00 | 60% above | 67% |
| IV push of a medicine, first drug CPT 96374 96374 IV INJECTION | $316.14 | $958.00 | $402.36–$958.00 | 60% above | 67% |
| IV push of a medicine, first drug CPT 96374 96374 ECHO INJ FOR DEFINITY (NON-STRESS) CHARGE | $316.14 | $958.00 | $402.36–$958.00 | 60% above | 67% |
| IV push of a medicine, first drug inpatient CPT 96374 96374 ECHO INJ FOR DEFINITY (NON-STRESS) CHARGE | $316.14 | $958.00 | $622.70–$958.00 | — | 67% |
| IV push of a medicine, first drug inpatient CPT 96374 MAYO Echo Inj for Definity (Non-Stress) | $316.14 | $958.00 | $622.70–$958.00 | — | 67% |
| IV push of a medicine, first drug inpatient CPT 96374 96374 IV INJECTION | $316.14 | $958.00 | $622.70–$958.00 | — | 67% |
| IV push of a medicine, first drug inpatient CPT 96374 96374 - IV Push, Single or Initial- Hosp | $316.14 | $958.00 | $622.70–$958.00 | — | 67% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 SUBQ/IM INJECTION CHARGE | $103.95 | $315.00 | $132.30–$315.00 | 50% above | 67% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 INJECTION, SUBQ/IM CHARGE | $103.95 | $315.00 | $132.30–$315.00 | 50% above | 67% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Injection Admin, SQ or IM- Hosp | $103.95 | $315.00 | $132.30–$315.00 | 50% above | 67% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJ | $103.95 | $315.00 | $132.30–$315.00 | 50% above | 67% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 Injection Admin, SQ or IM- Hosp | $103.95 | $315.00 | $204.75–$315.00 | — | 67% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 SUBQ/IM INJECTION CHARGE | $103.95 | $315.00 | $204.75–$315.00 | — | 67% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJ | $103.95 | $315.00 | $204.75–$315.00 | — | 67% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 INJECTION, SUBQ/IM CHARGE | $103.95 | $315.00 | $204.75–$315.00 | — | 67% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric diagnostic evaluation with medical services | $284.79 | $863.00 | $362.46–$863.00 | 32% above | 67% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 90791 Psychiatric diagnostic evaluation | $284.79 | $863.00 | $362.46–$863.00 | 32% above | 67% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psychiatric diagnostic evaluation with medical services | $284.79 | $863.00 | $560.95–$863.00 | — | 67% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 90791 Psychiatric diagnostic evaluation | $284.79 | $863.00 | $560.95–$863.00 | — | 67% |
| Neuromuscular re-education, 15 minutes CPT 97112 97112 PTA NEUROMUSCULAR REEDUCATION (TIMED PER 15 | $50.82 | $154.00 | $64.68–$154.00 | 49% below | 67% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 97112 PTA NEUROMUSCULAR REEDUCATION (TIMED PER 15 | $50.82 | $154.00 | $100.10–$154.00 | — | 67% |
| New patient office visit, about 45 minutes CPT 99204 99204 OV NEW PT 4 Facility | $209.22 | $634.00 | $266.28–$634.00 | at median | 67% |
| New patient office visit, about 45 minutes CPT 99204 99204 Office/OP New Visit Level 4 99204 | $209.22 | $634.00 | $266.28–$634.00 | at median | 67% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 Office/OP New Visit Level 4 99204 | $209.22 | $634.00 | $412.10–$634.00 | — | 67% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 OV NEW PT 4 Facility | $209.22 | $634.00 | $412.10–$634.00 | — | 67% |
| New patient office visit, about 60 minutes CPT 99205 99205 OV NEW PT 5 Facility | $312.51 | $947.00 | $397.74–$947.00 | 6% below | 67% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205 OV NEW PT 5 Facility | $312.51 | $947.00 | $615.55–$947.00 | — | 67% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 RESPIRATOR CLEARANCE | $52.47 | $159.00 | $66.78–$159.00 | 41% below | 67% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 DRIVER PHYS EXAM | $52.47 | $159.00 | $66.78–$159.00 | 41% below | 67% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 OV NEW PT 2 Facility | $105.93 | $321.00 | $134.82–$321.00 | 20% above | 67% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 DRIVER PHYS EXAM | $52.47 | $159.00 | $103.35–$159.00 | — | 67% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 RESPIRATOR CLEARANCE | $52.47 | $159.00 | $103.35–$159.00 | — | 67% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 OV NEW PT 2 Facility | $105.93 | $321.00 | $208.65–$321.00 | — | 67% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 NUTRITION CONS INITIAL INDIV EA 15 MINS CHARGE | $30.03 | $91.00 | $38.22–$91.00 | 34% below | 67% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 - TELEHEALTH NUTRITION CONS INITIAL INDIV EA | $30.03 | $91.00 | $38.22–$91.00 | 34% below | 67% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 97802 NUTRITION CONS INITIAL INDIV EA 15 MINS CHARGE | $30.03 | $91.00 | $59.15–$91.00 | — | 67% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 97802 - TELEHEALTH NUTRITION CONS INITIAL INDIV EA | $30.03 | $91.00 | $59.15–$91.00 | — | 67% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 PTA THERAPEUTIC EXERCISES (TIMED PER 15 MINS | $43.56 | $132.00 | $55.44–$132.00 | 36% below | 67% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 PTA THERAPEUTIC EXERCISES (TIMED PER 15 MINS | $43.56 | $132.00 | $85.80–$132.00 | — | 67% |
| Psychiatric evaluation with medical services CPT 90792 P90792 Psychiatric diagnostic evaluation with medical services | $214.17 | $649.00 | $272.58–$649.00 | 5% below | 67% |
| Psychiatric evaluation with medical services inpatient CPT 90792 P90792 Psychiatric diagnostic evaluation with medical services | $214.17 | $649.00 | $421.85–$649.00 | — | 67% |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 minutes with patient and/or family member | $174.24 | $528.00 | $221.76–$528.00 | at median | 67% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy, 45 minutes with patient and/or family member | $174.24 | $528.00 | $343.20–$528.00 | — | 67% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OB TREATMENT ROOM LEVEL 5 CHARGE | $113.19 | $343.00 | $144.06–$343.00 | 22% below | 67% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 OV EST PT 5 FACILITY | $231.33 | $701.00 | $294.42–$701.00 | 59% above | 67% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OB TREATMENT ROOM LEVEL 5 CHARGE | $113.19 | $343.00 | $222.95–$343.00 | — | 67% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 OV EST PT 5 FACILITY | $231.33 | $701.00 | $455.65–$701.00 | — | 67% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OB TREATMENT ROOM LEVEL 3 CHARGE | $56.76 | $172.00 | $72.24–$172.00 | 22% below | 67% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 TELEHEALTH EST PT. LEVEL 3 | $116.82 | $354.00 | $148.68–$354.00 | 60% above | 67% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OB TREATMENT ROOM LEVEL 3 CHARGE | $56.76 | $172.00 | $111.80–$172.00 | — | 67% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 TELEHEALTH EST PT. LEVEL 3 | $116.82 | $354.00 | $230.10–$354.00 | — | 67% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OB TREATMENT ROOM LEVEL 4 CHARGE | $74.58 | $226.00 | $94.92–$226.00 | 29% below | 67% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 OV EST PT 4 FACILITY | $159.06 | $482.00 | $202.44–$482.00 | 51% above | 67% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OB TREATMENT ROOM LEVEL 4 CHARGE | $74.58 | $226.00 | $146.90–$226.00 | — | 67% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 OV EST PT 4 FACILITY | $159.06 | $482.00 | $313.30–$482.00 | — | 67% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OB TREATMENT ROOM LEVEL 2 CHARGE | $43.89 | $133.00 | $55.86–$133.00 | 22% below | 67% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 OV EST PT 2 FACILITY | $79.20 | $240.00 | $100.80–$240.00 | 41% above | 67% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 TELEHEALTH EST PT. LEVEL 2 | $79.20 | $240.00 | $100.80–$240.00 | 41% above | 67% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office/OP Established Visit Level 2 | $79.20 | $240.00 | $100.80–$240.00 | 41% above | 67% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OB TREATMENT ROOM LEVEL 2 CHARGE | $43.89 | $133.00 | $86.45–$133.00 | — | 67% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Office/OP Established Visit Level 2 | $79.20 | $240.00 | $156.00–$240.00 | — | 67% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 OV EST PT 2 FACILITY | $79.20 | $240.00 | $156.00–$240.00 | — | 67% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 TELEHEALTH EST PT. LEVEL 2 | $79.20 | $240.00 | $156.00–$240.00 | — | 67% |
| Speech and language evaluation CPT 92523 92523 SPEECH SOUND LANG COMPREHEND (UNTIMED) | $197.67 | $599.00 | $251.58–$599.00 | 39% below | 67% |
| Speech and language evaluation inpatient CPT 92523 92523 SPEECH SOUND LANG COMPREHEND (UNTIMED) | $197.67 | $599.00 | $389.35–$599.00 | — | 67% |
| Spirometry (breathing test) CPT 94010 94010 PFT - SPIROMETRY SIMPLE CHARGE | $116.49 | $353.00 | $148.26–$353.00 | 17% below | 67% |
| Spirometry (breathing test) CPT 94010 PEAK FLOW CHARGE | $116.49 | $353.00 | $148.26–$353.00 | 17% below | 67% |
| Spirometry (breathing test) inpatient CPT 94010 PEAK FLOW CHARGE | $116.49 | $353.00 | $229.45–$353.00 | — | 67% |
| Spirometry (breathing test) inpatient CPT 94010 94010 PFT - SPIROMETRY SIMPLE CHARGE | $116.49 | $353.00 | $229.45–$353.00 | — | 67% |
| Spirometry before and after a bronchodilator CPT 94060 94060 PFT - SPIROMETRY W/MEDS CHARGE | $257.73 | $781.00 | $328.02–$781.00 | 20% below | 67% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 94060 PFT - SPIROMETRY W/MEDS CHARGE | $257.73 | $781.00 | $507.65–$781.00 | — | 67% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 99195 PHELBOTOMY CHARGE | $100.98 | $306.00 | $128.52–$306.00 | 35% below | 67% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 99195 PHELBOTOMY CHARGE | $100.98 | $306.00 | $198.90–$306.00 | — | 67% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 90698 DIPHTHERIA, TETANUS TOXOIDS VACCINE CHARGE | $233.65 | $708.02 | $297.37–$708.02 | 244% above | 67% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 90698 DIPHTHERIA, TETANUS TOXOIDS VACCINE CHARGE | $233.65 | $708.02 | $460.21–$708.02 | — | 67% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 90651 HPV - GARDASIL 9 | $148.50 | $450.00 | $189.00–$450.00 | at median | 67% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 90651 HPV - GARDASIL 9 | $148.50 | $450.00 | $292.50–$450.00 | — | 67% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 LOGISTIC FLU | $41.58 | $126.00 | $52.92–$126.00 | 68% below | 67% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS B VAC #2 | $41.58 | $126.00 | $52.92–$126.00 | 68% below | 67% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS B VAC #3 | $41.58 | $126.00 | $52.92–$126.00 | 68% below | 67% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS B VAC #1 | $41.58 | $126.00 | $52.92–$126.00 | 68% below | 67% |
| Hepatitis A vaccine, adult dose CPT 90632 hepatitis A adult vaccine 50 units/mL (NF-Med) [MAYO] | $118.74 | $359.82 | $151.12–$359.82 | 21% above | 67% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 hepatitis A adult vaccine 50 units/mL (NF-Med) [MAYO] | $118.74 | $359.82 | $233.88–$359.82 | — | 67% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella virus vaccine Inj [MAYO] | $138.73 | $420.39 | $176.56–$420.39 | 7% above | 67% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles/mumps/rubella virus vaccine Inj [MAYO] | $138.73 | $420.39 | $273.25–$420.39 | — | 67% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphth toxoids (Td) adult/adol 5 units-2 units/0.5 mL preservative-free Sus [MAYO] | $63.85 | $193.48 | $81.26–$193.48 | 56% above | 67% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus-diphth toxoids (Td) adult/adol 5 units-2 units/0.5 mL preservative-free Sus [MAYO] | $63.85 | $193.48 | $125.76–$193.48 | — | 67% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 IMMUNIZATION ADMINISTRATION; 1 VACCINE | $7.12 | $21.58 | $9.06–$21.58 | 60% below | 67% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 IM/SQ VACCINE INIT INFLUENZA CHARGE | $23.10 | $70.00 | $29.40–$70.00 | 31% above | 67% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 IM/SQ VACCINE INIT PNEUMOCOCCAL CHARGE | $23.10 | $70.00 | $29.40–$70.00 | 31% above | 67% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 IM/SQ VACCINE INIT OTHER CHARGE | $23.10 | $70.00 | $29.40–$70.00 | 31% above | 67% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 IMMUNIZATION ADMINISTRATION; 1 VACCINE | $7.12 | $21.58 | $14.03–$21.58 | — | 67% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 IM/SQ VACCINE INIT PNEUMOCOCCAL CHARGE | $23.10 | $70.00 | $45.50–$70.00 | — | 67% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 IM/SQ VACCINE INIT INFLUENZA CHARGE | $23.10 | $70.00 | $45.50–$70.00 | — | 67% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 IM/SQ VACCINE INIT OTHER CHARGE | $23.10 | $70.00 | $45.50–$70.00 | — | 67% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 EACH ADDITIONAL VACCINE | $7.12 | $21.58 | $9.06–$21.58 | 60% below | 67% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 IM/SQ VACCINE ADDTL INFLUENZA CHARGE | $13.20 | $40.00 | $16.80–$40.00 | 25% below | 67% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 IM/SQ VACCINE ADDTL OTHER CHARGE | $13.20 | $40.00 | $16.80–$40.00 | 25% below | 67% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 IM/SQ VACCINE ADDTL PNEUMOCOCCAL CHARGE | $13.20 | $40.00 | $16.80–$40.00 | 25% below | 67% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 EACH ADDITIONAL VACCINE | $7.12 | $21.58 | $14.03–$21.58 | — | 67% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 IM/SQ VACCINE ADDTL OTHER CHARGE | $13.20 | $40.00 | $26.00–$40.00 | — | 67% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 IM/SQ VACCINE ADDTL INFLUENZA CHARGE | $13.20 | $40.00 | $26.00–$40.00 | — | 67% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 IM/SQ VACCINE ADDTL PNEUMOCOCCAL CHARGE | $13.20 | $40.00 | $26.00–$40.00 | — | 67% |
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://northernlighthealth.org/NLH/media/Price-Transparency/843689003_Mayo-hospital_standardcharges.csv