The University of Chicago Medical Center
The University of Chicago Medical Center in Chicago, IL publishes cash prices for 59 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Click a procedure to compare it with other hospitals nearby.
5841 South Maryland, Chicago, IL 60637,5700 S Maryland Ave, Chicago, IL 60637,5721 S Maryland Ave, Chicago, IL 60637 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 Hc Computed Tomography, Abdomen And Pelvis; With Contrast Material(S) | $5,839.00 | $5,839.00 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Hc Computed Tomography, Abdomen And Pelvis; With Contrast Material(S) | $5,839.00 | $5,839.00 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 Hc Ct, Head Or Brain; Without Contrast Material | $2,610.00 | $2,610.00 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 Hc Ct, Head Or Brain; Without Contrast Material | $2,610.00 | $2,610.00 | — |
| CT scan of the pelvis, with contrast dye CPT 72193 Hc Computed Tomography, Pelvis; With Contrast Material(S) | $2,903.00 | $2,903.00 | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 Hc Computed Tomography, Pelvis; With Contrast Material(S) | $2,903.00 | $2,903.00 | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 Hc Diagnostic Mammography, Producing Direct 2D Digital Image, Bilateral, All Views | $719.00 | $719.00 | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 Hc Diagnostic Mammography Including Computer-Aided Detection; Bilateral | $719.00 | $719.00 | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Hc Diagnostic Mammography, Producing Direct 2D Digital Image, Bilateral, All Views | $719.00 | $719.00 | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Hc Diagnostic Mammography Including Computer-Aided Detection; Bilateral | $719.00 | $719.00 | — |
| Diagnostic mammogram, one breast one side CPT 77065 Hc Diagnostic Mammography, Producing Direct 2D Digital Image, Unilateral, All Views | $538.00 | $538.00 | — |
| Diagnostic mammogram, one breast one side CPT 77065 Hc Diagnostic Mammography Including Computer-Aided Detection; Unilateral | $538.00 | $538.00 | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Hc Diagnostic Mammography, Producing Direct 2D Digital Image, Unilateral, All Views | $538.00 | $538.00 | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Hc Diagnostic Mammography Including Computer-Aided Detection; Unilateral | $538.00 | $538.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Hc Magnetic Resonance Imaging, Any Joint Of Lower Extremity; Without Contrast Material | $4,638.00 | $4,638.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Hc Magnetic Resonance Imaging, Any Joint Of Lower Extremity; Without Contrast Material | $4,638.00 | $4,638.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Hc Mri, Any Joint Of Lower Extremity;Wo Contrast Mat(S),Followed By Contrast Mat(S)&Further Seq | $7,177.00 | $7,177.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Hc Mri, Any Joint Of Lower Extremity;Wo Contrast Mat(S),Followed By Contrast Mat(S)&Further Seq | $7,177.00 | $7,177.00 | — |
| MRI of the brain, no contrast dye CPT 70551 Hc Mri, Brain; Without Contrast Material | $4,097.00 | $4,097.00 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 Hc Mri, Brain; Without Contrast Material | $4,097.00 | $4,097.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 Hc Mri Pituitary, Without Contrast Material, Follow By Contrast Material | $7,132.00 | $7,132.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 Hc Mri, Brain Without Contrast Material, Followed By Contrast Material | $7,132.00 | $7,132.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 Hc Mri Pituitary, Without Contrast Material, Follow By Contrast Material | $7,132.00 | $7,132.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 Hc Mri, Brain Without Contrast Material, Followed By Contrast Material | $7,132.00 | $7,132.00 | — |
| MRI of the lower back, no contrast dye CPT 72148 Hc Magnetic Resonance Imaging, Spinal Canal And Contents, Lumbar; Without Contrast Material | $5,558.00 | $5,558.00 | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 Hc Magnetic Resonance Imaging, Spinal Canal And Contents, Lumbar; Without Contrast Material | $5,558.00 | $5,558.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Chg Us Preg Uterus After 1St Trimest 1/1St Gestation-Pbb | $628.00 | $628.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Hc U/S,Preg Utrs,Rl Time W Image Doc,Ftl&Matrnl Eval,After 1St Tri,Transabd Appr,Single Or 1St Gest- | $1,423.00 | $1,423.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Hc U/S,Preg Utrs,Rl Time W Image Doc,Ftl&Matrnl Eval,After 1St Tri,Transabd Appr,Single Or 1St Gest | $1,423.00 | $1,423.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Chg Us Preg Uterus After 1St Trimest 1/1St Gestation-Pbb | $628.00 | $628.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Hc U/S,Preg Utrs,Rl Time W Image Doc,Ftl&Matrnl Eval,After 1St Tri,Transabd Appr,Single Or 1St Gest- | $1,423.00 | $1,423.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Hc U/S,Preg Utrs,Rl Time W Image Doc,Ftl&Matrnl Eval,After 1St Tri,Transabd Appr,Single Or 1St Gest | $1,423.00 | $1,423.00 | — |
| Screening mammogram, both breasts both sides CPT 77067 Hc Screening Mammography, Bilateral Include Cad | $614.00 | $614.00 | — |
| Screening mammogram, both breasts both sides CPT 77067 Hc Screening Mammography, Producing Direct Digital Image, Bilateral, All Views | $616.00 | $616.00 | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 Hc Screening Mammography, Bilateral Include Cad | $614.00 | $614.00 | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 Hc Screening Mammography, Producing Direct Digital Image, Bilateral, All Views | $616.00 | $616.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 Hc Research Polysom; Sleep Stage W/ 4 Or More Parameters, Tech Attend | $388.00 | $388.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 Hc Research Polysomnography Tech Only | $400.00 | $400.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 Hc Research Polysomnography Tech & Scoring | $450.00 | $450.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 Hc Research Polysomnography With Physician Interpretation | $600.00 | $600.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 Hc Polysomnography; Sleep Staging W/ 4 Or More Add Parameters Of Sleep, Attended By A Technologist | $7,842.00 | $7,842.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Hc Research Polysom; Sleep Stage W/ 4 Or More Parameters, Tech Attend | $388.00 | $388.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Hc Research Polysomnography Tech Only | $400.00 | $400.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Hc Research Polysomnography Tech & Scoring | $450.00 | $450.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Hc Research Polysomnography With Physician Interpretation | $600.00 | $600.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Hc Polysomnography; Sleep Staging W/ 4 Or More Add Parameters Of Sleep, Attended By A Technologist | $7,842.00 | $7,842.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 Chg Us Transvaginal-Pbb | $673.00 | $673.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 Hc Ultrasound, Transvaginal-Pbb | $1,063.00 | $1,063.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 Hc Ultrasound, Transvaginal | $1,063.00 | $1,063.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Chg Us Transvaginal-Pbb | $673.00 | $673.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Hc Ultrasound, Transvaginal | $1,063.00 | $1,063.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Hc Ultrasound, Transvaginal-Pbb | $1,063.00 | $1,063.00 | — |
| Ultrasound of the abdomen, complete CPT 76700 Chg Us Abdominal Real Time W/Image Documentation-Pbb | $399.00 | $399.00 | — |
| Ultrasound of the abdomen, complete CPT 76700 Hc Ultrasound, Abdominal, Real Time With Image Documentation, Complete | $2,716.00 | $2,716.00 | — |
| Ultrasound of the abdomen, complete CPT 76700 Hc Ultrasound, Abdominal, Real Time With Image Documentation, Complete-Pbb | $2,716.00 | $2,716.00 | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Chg Us Abdominal Real Time W/Image Documentation-Pbb | $399.00 | $399.00 | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Hc Ultrasound, Abdominal, Real Time With Image Documentation, Complete | $2,716.00 | $2,716.00 | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Hc Ultrasound, Abdominal, Real Time With Image Documentation, Complete-Pbb | $2,716.00 | $2,716.00 | — |
| X-ray of the lower back, 4 or more views CPT 72110 Hc Radiologic Examination, Spine, Lumbosacral; Minimum Of 4 Views | $721.00 | $721.00 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Hc Radiologic Examination, Spine, Lumbosacral; Minimum Of 4 Views | $721.00 | $721.00 | — |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Hc Basic Metabolic Panel-Laf | $81.00 | $81.00 | — |
| Basic metabolic panel (blood test) CPT 80048 Hc Basic Metabolic Panel | $379.00 | $379.00 | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 Hc Basic Metabolic Panel-Laf | $81.00 | $81.00 | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 Hc Basic Metabolic Panel | $379.00 | $379.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Hc Lipid Panel-Laf | $128.00 | $128.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Hc Lipid Panel | $465.00 | $465.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Hc Lipid Panel-Laf | $128.00 | $128.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Hc Lipid Panel | $465.00 | $465.00 | — |
| Complete blood count (CBC) with differential CPT 85025 Hc Complete Blood Count Platelet, Differential-Laf | $75.00 | $75.00 | — |
| Complete blood count (CBC) with differential CPT 85025 Hc Complete Blood Count Platelet, Differential | $281.00 | $281.00 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 Hc Complete Blood Count Platelet, Differential-Laf | $75.00 | $75.00 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 Hc Complete Blood Count Platelet, Differential | $281.00 | $281.00 | — |
| Complete blood count (CBC), no differential CPT 85027 Hc Blood Count; Complete (Cbc), Automated-Laf | $61.00 | $61.00 | — |
| Complete blood count (CBC), no differential CPT 85027 Hc Blood Count; Complete (Cbc), Automated | $230.00 | $230.00 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 Hc Blood Count; Complete (Cbc), Automated-Laf | $61.00 | $61.00 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 Hc Blood Count; Complete (Cbc), Automated | $230.00 | $230.00 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Hc Comprehensive Metabolic Panel-Laf | $101.00 | $101.00 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Hc Comprehensive Metabolic Panel | $496.00 | $496.00 | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Hc Comprehensive Metabolic Panel-Laf | $101.00 | $101.00 | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Hc Comprehensive Metabolic Panel | $496.00 | $496.00 | — |
| Kidney function blood test panel CPT 80069 Hc Renal Function Panel | $432.00 | $432.00 | — |
| Kidney function blood test panel inpatient CPT 80069 Hc Renal Function Panel | $432.00 | $432.00 | — |
| Liver function blood test panel CPT 80076 Hc Hepatic Function Panel | $330.00 | $330.00 | — |
| Liver function blood test panel inpatient CPT 80076 Hc Hepatic Function Panel | $330.00 | $330.00 | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Hc Prostate Specific Antigen (Psa); Free | $356.00 | $356.00 | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Hc Prostate Specific Antigen (Psa); Free | $356.00 | $356.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Prostate Specific Antigen (Psa); Total-Laf | $175.00 | $175.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Prostate Specific Antigen (Psa); Total | $433.00 | $433.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Hc Prostate Specific Antigen (Psa); Total-Laf | $175.00 | $175.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Hc Prostate Specific Antigen (Psa); Total | $433.00 | $433.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Partial Thromboplastin Time (Ptt) Hepcheck | $216.00 | $216.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Partial Thromboplastin Time (Ptt) | $216.00 | $216.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Partial Thromboplastin Time (Ptt) Hepcheck | $216.00 | $216.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Partial Thromboplastin Time (Ptt) | $216.00 | $216.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Prothrombin Time-Laf | $36.00 | $36.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Protime Padua-Laf | $36.00 | $36.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Hepcheck Pt-Laf | $36.00 | $36.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Hepcheck Pt | $180.00 | $180.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Protime Padua | $180.00 | $180.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Prothrombin Time | $180.00 | $180.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Protime Padua-Laf | $36.00 | $36.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Hepcheck Pt-Laf | $36.00 | $36.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Prothrombin Time-Laf | $36.00 | $36.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Hepcheck Pt | $180.00 | $180.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Prothrombin Time | $180.00 | $180.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Protime Padua | $180.00 | $180.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc T4 Newborn Screen | $37.00 | $37.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc Thyroid Stimulating Hormone (Tsh)-Laf | $161.00 | $161.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc Thyroid Stimulating Hormone (Tsh) | $512.00 | $512.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Hc T4 Newborn Screen | $37.00 | $37.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Hc Thyroid Stimulating Hormone (Tsh)-Laf | $161.00 | $161.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Hc Thyroid Stimulating Hormone (Tsh) | $512.00 | $512.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 Hc Ua,By Dip Stck/Tblt Rgnt For Blrbn,Gluc,Hgb,Ket,Lukcytes,Nit,Ph, Prot,Spec Grav,Urobil;Aut,W/Micr | $140.00 | $140.00 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Hc Ua,By Dip Stck/Tblt Rgnt For Blrbn,Gluc,Hgb,Ket,Lukcytes,Nit,Ph, Prot,Spec Grav,Urobil;Aut,W/Micr | $140.00 | $140.00 | — |
| Urinalysis with microscope exam, manual CPT 81000 Hc Urinalysis, By Dip Stick Or Tablet Reagent ; Non-Automated, With Microscopy | $105.00 | $105.00 | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Hc Urinalysis, By Dip Stick Or Tablet Reagent ; Non-Automated, With Microscopy | $105.00 | $105.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Specific Gravity Only-Laf | $22.00 | $22.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Ph Only-Laf | $22.00 | $22.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Auto, Without Microscopy-Laf | $22.00 | $22.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Protein/Qual/Ur | $92.00 | $92.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Ph Only | $112.00 | $112.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Specific Gravity Only | $112.00 | $112.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Auto, Without Microscopy | $112.00 | $112.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Specific Gravity Only-Laf | $22.00 | $22.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Auto, Without Microscopy-Laf | $22.00 | $22.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Ph Only-Laf | $22.00 | $22.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Protein/Qual/Ur | $92.00 | $92.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Auto, Without Microscopy | $112.00 | $112.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Specific Gravity Only | $112.00 | $112.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Ph Only | $112.00 | $112.00 | — |
| Urinalysis without microscope exam, manual CPT 81002 Hc Urinalysis, By Dip Stick Or Tab Reagent; Non-Auto, W/Out Microscopy | $116.00 | $116.00 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Hc Urinalysis, By Dip Stick Or Tab Reagent; Non-Auto, W/Out Microscopy | $116.00 | $116.00 | — |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy with endoscopic ultrasound CPT 45391 Pr Colsc Flx W/Ndsc Us Xm Rctm Et Al Lmtd&Adj Strux-Pbb | $2,138.00 | $2,138.00 | — |
| Colonoscopy with endoscopic ultrasound CPT 45391 Pr Colsc Flx W/Ndsc Us Xm Rctm Et Al Lmtd&Adj Strux-Gast | $2,138.00 | $2,138.00 | — |
| Colonoscopy with endoscopic ultrasound CPT 45391 Hc Clnscpy,Flex;W/Endoscpc U/S Exm Lmtd To The Rctm,Sigm,Desc,Trans,Or Asc Colon&Cecum,& Adj Strctrs | $8,015.00 | $8,015.00 | — |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Pr Colsc Flx W/Ndsc Us Xm Rctm Et Al Lmtd&Adj Strux-Pbb | $2,138.00 | $2,138.00 | — |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Pr Colsc Flx W/Ndsc Us Xm Rctm Et Al Lmtd&Adj Strux-Gast | $2,138.00 | $2,138.00 | — |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Hc Clnscpy,Flex;W/Endoscpc U/S Exm Lmtd To The Rctm,Sigm,Desc,Trans,Or Asc Colon&Cecum,& Adj Strctrs | $8,015.00 | $8,015.00 | — |
| Colonoscopy with polyp removal CPT 45385 Pr Colsc Flx W/Rmvl Of Tumor Polyp Lesion Snare Tq-Gast | $3,949.00 | $3,949.00 | — |
| Colonoscopy with polyp removal CPT 45385 Pr Colsc Flx W/Rmvl Of Tumor Polyp Lesion Snare Tq-Pbb | $3,949.00 | $3,949.00 | — |
| Colonoscopy with polyp removal CPT 45385 Hc Colonoscopy, Flexible; With Removal Of Tumor, Polyp, Or Other Lesion By Snare Technique-Pbb | $5,037.00 | $5,037.00 | — |
| Colonoscopy with polyp removal CPT 45385 Hc Colonoscopy, Flexible; With Removal Of Tumor, Polyp, Or Other Lesion By Snare Technique | $8,724.00 | $8,724.00 | — |
| Colonoscopy with polyp removal inpatient CPT 45385 Pr Colsc Flx W/Rmvl Of Tumor Polyp Lesion Snare Tq-Gast | $3,949.00 | $3,949.00 | — |
| Colonoscopy with polyp removal inpatient CPT 45385 Pr Colsc Flx W/Rmvl Of Tumor Polyp Lesion Snare Tq-Pbb | $3,949.00 | $3,949.00 | — |
| Colonoscopy with polyp removal inpatient CPT 45385 Hc Colonoscopy, Flexible; With Removal Of Tumor, Polyp, Or Other Lesion By Snare Technique-Pbb | $5,037.00 | $5,037.00 | — |
| Colonoscopy with polyp removal inpatient CPT 45385 Hc Colonoscopy, Flexible; With Removal Of Tumor, Polyp, Or Other Lesion By Snare Technique | $8,724.00 | $8,724.00 | — |
| Colonoscopy with tissue sample CPT 45380 Pr Colonoscopy W/Biopsy Single/Multiple-Gast | $289.00 | $289.00 | — |
| Colonoscopy with tissue sample CPT 45380 Hc Research Colonoscopy Complete-Pbb | $2,767.00 | $2,767.00 | — |
| Colonoscopy with tissue sample CPT 45380 Pr Colonoscopy W/Biopsy Single/Multiple-Pbb | $3,064.00 | $3,064.00 | — |
| Colonoscopy with tissue sample CPT 45380 Hc Colonoscopy, Flexible; With Biopsy, Single Or Multiple-Pbb | $4,703.00 | $4,703.00 | — |
| Colonoscopy with tissue sample CPT 45380 Hc Research Colonoscopy Complete | $5,566.00 | $5,566.00 | — |
| Colonoscopy with tissue sample CPT 45380 Hc Colonoscopy, Flexible; With Biopsy, Single Or Multiple | $7,767.00 | $7,767.00 | — |
| Colonoscopy with tissue sample inpatient CPT 45380 Pr Colonoscopy W/Biopsy Single/Multiple-Gast | $289.00 | $289.00 | — |
| Colonoscopy with tissue sample inpatient CPT 45380 Hc Research Colonoscopy Complete-Pbb | $2,767.00 | $2,767.00 | — |
| Colonoscopy with tissue sample inpatient CPT 45380 Pr Colonoscopy W/Biopsy Single/Multiple-Pbb | $3,064.00 | $3,064.00 | — |
| Colonoscopy with tissue sample inpatient CPT 45380 Hc Colonoscopy, Flexible; With Biopsy, Single Or Multiple-Pbb | $4,703.00 | $4,703.00 | — |
| Colonoscopy with tissue sample inpatient CPT 45380 Hc Research Colonoscopy Complete | $5,566.00 | $5,566.00 | — |
| Colonoscopy with tissue sample inpatient CPT 45380 Hc Colonoscopy, Flexible; With Biopsy, Single Or Multiple | $7,767.00 | $7,767.00 | — |
| Colonoscopy, diagnostic CPT 45378 Pr Colonoscopy Flx Dx W/Collj Spec When Pfrmd-Gast | $2,790.00 | $2,790.00 | — |
| Colonoscopy, diagnostic CPT 45378 Pr Colonoscopy Flx Dx W/Collj Spec When Pfrmd-Pbb | $2,790.00 | $2,790.00 | — |
| Colonoscopy, diagnostic CPT 45378 Hc Colonoscopy, Flex; Diag, Incl Collection Of Specimen By Brushing Or Washing, When Perf-Pbb | $4,970.00 | $4,970.00 | — |
| Colonoscopy, diagnostic CPT 45378 Hc Colonoscopy, Flex; Diag, Incl Collection Of Specimen By Brushing Or Washing, When Perf | $7,534.00 | $7,534.00 | — |
| Colonoscopy, diagnostic inpatient CPT 45378 Pr Colonoscopy Flx Dx W/Collj Spec When Pfrmd-Pbb | $2,790.00 | $2,790.00 | — |
| Colonoscopy, diagnostic inpatient CPT 45378 Pr Colonoscopy Flx Dx W/Collj Spec When Pfrmd-Gast | $2,790.00 | $2,790.00 | — |
| Colonoscopy, diagnostic inpatient CPT 45378 Hc Colonoscopy, Flex; Diag, Incl Collection Of Specimen By Brushing Or Washing, When Perf-Pbb | $4,970.00 | $4,970.00 | — |
| Colonoscopy, diagnostic inpatient CPT 45378 Hc Colonoscopy, Flex; Diag, Incl Collection Of Specimen By Brushing Or Washing, When Perf | $7,534.00 | $7,534.00 | — |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Hc Discission Of Secondary Membranous Cataract; Laser Surgery | $5,356.00 | $5,356.00 | — |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Hc Discission Of Secondary Membranous Cataract; Laser Surgery | $5,356.00 | $5,356.00 | — |
| Left heart catheterization, diagnostic CPT 93452 Hc L Hrt Cath Incl Intrprcdrl Inj(S) Ventriculography,Imgng Supervision & Intrprtn, When Perf | $15,764.00 | $15,764.00 | — |
| Left heart catheterization, diagnostic inpatient CPT 93452 Hc L Hrt Cath Incl Intrprcdrl Inj(S) Ventriculography,Imgng Supervision & Intrprtn, When Perf | $15,764.00 | $15,764.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 Hc Injections Interlaminar Lumbar/Sacral With Imaging Guidance | $8,188.00 | $8,188.00 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Hc Injections Interlaminar Lumbar/Sacral With Imaging Guidance | $8,188.00 | $8,188.00 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 Hc Injections Interlaminar Lumbar/Sacral | $7,762.00 | $7,762.00 | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Hc Injections Interlaminar Lumbar/Sacral | $7,762.00 | $7,762.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Pr Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level-Pbb | $1,211.00 | $1,211.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Hc Inj, Anes Agent A/O Steroid, Transforaminal Epidural,W/Image Guid; Lumbar Or Sacral, Single Level | $5,519.00 | $5,519.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Pr Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level-Pbb | $1,211.00 | $1,211.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Hc Inj, Anes Agent A/O Steroid, Transforaminal Epidural,W/Image Guid; Lumbar Or Sacral, Single Level | $5,519.00 | $5,519.00 | — |
| Prostate biopsy CPT 55700 Pr Prostate Needle Biopsy Any Approach-Pbb | $1,908.00 | $1,908.00 | — |
| Prostate biopsy CPT 55700 Hc Biopsy, Prostate; Needle Or Punch, Single Or Multiple, Any Approach | $6,194.00 | $6,194.00 | — |
| Prostate biopsy CPT 55700 Hc Biopsy, Prostate; Needle Or Punch, Single Or Multiple, Any Approach-Pbb | $6,194.00 | $6,194.00 | — |
| Prostate biopsy inpatient CPT 55700 Pr Prostate Needle Biopsy Any Approach-Pbb | $1,908.00 | $1,908.00 | — |
| Prostate biopsy inpatient CPT 55700 Hc Biopsy, Prostate; Needle Or Punch, Single Or Multiple, Any Approach-Pbb | $6,194.00 | $6,194.00 | — |
| Prostate biopsy inpatient CPT 55700 Hc Biopsy, Prostate; Needle Or Punch, Single Or Multiple, Any Approach | $6,194.00 | $6,194.00 | — |
| Removal of a breast lump, open surgery CPT 19120 Pr Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion-Pbb | $4,446.00 | $4,446.00 | — |
| Removal of a breast lump, open surgery CPT 19120 Hc Removal Of Breast Lesion 1+-Pbb | $11,340.00 | $11,340.00 | — |
| Removal of a breast lump, open surgery inpatient CPT 19120 Pr Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion-Pbb | $4,446.00 | $4,446.00 | — |
| Removal of a breast lump, open surgery inpatient CPT 19120 Hc Removal Of Breast Lesion 1+-Pbb | $11,340.00 | $11,340.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 Pr Egd Transoral Biopsy Single/Multiple-Pbb | $2,569.00 | $2,569.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 Pr Egd Transoral Biopsy Single/Multiple-Gast | $2,569.00 | $2,569.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 Hc Esophagogastroduodenoscopy, Flexible, Transoral; With Biopsy, Single Or Multiple-Pbb | $4,634.00 | $4,634.00 | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Pr Egd Transoral Biopsy Single/Multiple-Gast | $2,569.00 | $2,569.00 | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Pr Egd Transoral Biopsy Single/Multiple-Pbb | $2,569.00 | $2,569.00 | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Hc Esophagogastroduodenoscopy, Flexible, Transoral; With Biopsy, Single Or Multiple-Pbb | $4,634.00 | $4,634.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 Pr Esophagogastroduodenoscopy Transoral Diagnostic-Pbb | $2,216.00 | $2,216.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 Pr Esophagogastroduodenoscopy Transoral Diagnostic-Gast | $2,216.00 | $2,216.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 Hc Egd, Flex; Transoral, Diag, Incl Collection Of Specimen By Brushing Or Washing, When Perf-Pbb | $4,004.00 | $4,004.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 Hc Egd, Flex; Transoral, Diag, Incl Collection Of Specimen By Brushing Or Washing, When Perf | $6,039.00 | $6,039.00 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Pr Esophagogastroduodenoscopy Transoral Diagnostic-Gast | $2,216.00 | $2,216.00 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Pr Esophagogastroduodenoscopy Transoral Diagnostic-Pbb | $2,216.00 | $2,216.00 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Hc Egd, Flex; Transoral, Diag, Incl Collection Of Specimen By Brushing Or Washing, When Perf-Pbb | $4,004.00 | $4,004.00 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Hc Egd, Flex; Transoral, Diag, Incl Collection Of Specimen By Brushing Or Washing, When Perf | $6,039.00 | $6,039.00 | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 Hc Family Psychotherapy W/Patient Present 50 Mins Cash Technical-Csm,Pbb | $25.00 | $25.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 Profee Family Psychotherapy W/Patient Present 50 Mins Cash-Csm,Pbb | $100.00 | $100.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 Pr Family Psychotherapy W/Patient Present 50 Mins-Pbb | $283.00 | $283.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 Hc Family Psychotherapy (Conjoint Psychotherapy) (With Patient Present) | $541.00 | $541.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 Hc Family Psychotherapy (Conjoint Psychotherapy) (With Patient Present)-Pbb | $541.00 | $541.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Hc Family Psychotherapy W/Patient Present 50 Mins Cash Technical-Csm,Pbb | $25.00 | $25.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Profee Family Psychotherapy W/Patient Present 50 Mins Cash-Csm,Pbb | $100.00 | $100.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Pr Family Psychotherapy W/Patient Present 50 Mins-Pbb | $283.00 | $283.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Hc Family Psychotherapy (Conjoint Psychotherapy) (With Patient Present)-Pbb | $541.00 | $541.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Hc Family Psychotherapy (Conjoint Psychotherapy) (With Patient Present) | $541.00 | $541.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 Hc Family Psychotherapy W/O Patient Present 50 Mins Cash-Csm,Pbb | $25.00 | $25.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 Profee Family Psychotherapy (Without Patient Present), 50 Min Cash-Csm,Pbb | $100.00 | $100.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 Pr Family Psychotherapy W/O Patient Present 50 Mins-Pbb | $230.00 | $230.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 Hc Family Psychotherapy (Without Patient Present)-Pbb | $435.00 | $435.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 Hc Family Psychotherapy (Without Patient Present) | $435.00 | $435.00 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Hc Family Psychotherapy W/O Patient Present 50 Mins Cash-Csm,Pbb | $25.00 | $25.00 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Profee Family Psychotherapy (Without Patient Present), 50 Min Cash-Csm,Pbb | $100.00 | $100.00 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Pr Family Psychotherapy W/O Patient Present 50 Mins-Pbb | $230.00 | $230.00 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Hc Family Psychotherapy (Without Patient Present) | $435.00 | $435.00 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Hc Family Psychotherapy (Without Patient Present)-Pbb | $435.00 | $435.00 | — |
| Group psychotherapy session CPT 90853 Pr Group Psychotherapy-Pbb | $94.00 | $94.00 | — |
| Group psychotherapy session CPT 90853 Hc Group Psychotherapy-Pbb | $341.00 | $341.00 | — |
| Group psychotherapy session CPT 90853 Hc Group Psychotherapy | $435.00 | $435.00 | — |
| Group psychotherapy session inpatient CPT 90853 Pr Group Psychotherapy-Pbb | $94.00 | $94.00 | — |
| Group psychotherapy session inpatient CPT 90853 Hc Group Psychotherapy-Pbb | $341.00 | $341.00 | — |
| Group psychotherapy session inpatient CPT 90853 Hc Group Psychotherapy | $435.00 | $435.00 | — |
| New patient office visit, about 30 minutes CPT 99203 Pr Cosmetic Conslt Rfnd Cncl Cash | $52.00 | $52.00 | — |
| New patient office visit, about 30 minutes CPT 99203 Hc Cosmetic Conslt Rfnd Cncl Cash | $52.00 | $52.00 | — |
| New patient office visit, about 30 minutes CPT 99203 Pr Office/Outpatient New Low Mdm 30 Minutes | $243.00 | $243.00 | — |
| New patient office visit, about 30 minutes CPT 99203 Pr Office/Outpatient New Low Mdm 30 Minutes-Pbb | $425.00 | $425.00 | — |
| New patient office visit, about 30 minutes CPT 99203 New Patient Initial Prenatal Visit 99203 & 0500F For Medicaid | $425.00 | $425.00 | — |
| New patient office visit, about 30 minutes CPT 99203 New Patient Initial Prenatal Visit 99203 & 0500F For Medicaid-Pbb | $425.00 | $425.00 | — |
| New patient office visit, about 30 minutes CPT 99203 Hc Evaluation And Management New Patient Level 3-Pbb | $479.00 | $479.00 | — |
| New patient office visit, about 30 minutes CPT 99203 Hc Evaluation And Management New Patient Level 3 | $479.00 | $479.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 Pr Cosmetic Conslt Rfnd Cncl Cash | $52.00 | $52.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 Hc Cosmetic Conslt Rfnd Cncl Cash | $52.00 | $52.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 Pr Office/Outpatient New Low Mdm 30 Minutes | $243.00 | $243.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 New Patient Initial Prenatal Visit 99203 & 0500F For Medicaid-Pbb | $425.00 | $425.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 New Patient Initial Prenatal Visit 99203 & 0500F For Medicaid | $425.00 | $425.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 Pr Office/Outpatient New Low Mdm 30 Minutes-Pbb | $425.00 | $425.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 Hc Evaluation And Management New Patient Level 3-Pbb | $479.00 | $479.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 Hc Evaluation And Management New Patient Level 3 | $479.00 | $479.00 | — |
| New patient office visit, about 45 minutes CPT 99204 Pr Office/Outpatient New Moderate Mdm 45 Minutes | $360.00 | $360.00 | — |
| New patient office visit, about 45 minutes CPT 99204 Hc Evaluation And Management New Patient Level 4 | $598.00 | $598.00 | — |
| New patient office visit, about 45 minutes CPT 99204 Hc Evaluation And Management New Patient Level 4-Pbb | $598.00 | $598.00 | — |
| New patient office visit, about 45 minutes CPT 99204 New Patient Initial Prenatal Visit 99204 & 0500F For Medicaid-Pbb | $606.00 | $606.00 | — |
| New patient office visit, about 45 minutes CPT 99204 New Patient Initial Prenatal Visit 99204 & 0500F For Medicaid | $606.00 | $606.00 | — |
| New patient office visit, about 45 minutes CPT 99204 Pr Office/Outpatient New Moderate Mdm 45 Minutes-Pbb | $606.00 | $606.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 Pr Office/Outpatient New Moderate Mdm 45 Minutes | $360.00 | $360.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 Hc Evaluation And Management New Patient Level 4 | $598.00 | $598.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 Hc Evaluation And Management New Patient Level 4-Pbb | $598.00 | $598.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 Pr Office/Outpatient New Moderate Mdm 45 Minutes-Pbb | $606.00 | $606.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 New Patient Initial Prenatal Visit 99204 & 0500F For Medicaid | $606.00 | $606.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 New Patient Initial Prenatal Visit 99204 & 0500F For Medicaid-Pbb | $606.00 | $606.00 | — |
| New patient office visit, about 60 minutes CPT 99205 Pr Office/Outpatient New High Mdm 60 Minutes | $472.00 | $472.00 | — |
| New patient office visit, about 60 minutes CPT 99205 Hc Evaluation And Management New Patient Level 5 | $759.00 | $759.00 | — |
| New patient office visit, about 60 minutes CPT 99205 Hc Evaluation And Management New Patient Level 5-Pbb | $759.00 | $759.00 | — |
| New patient office visit, about 60 minutes CPT 99205 New Patient Initial Prenatal Visit 99205 & 0500F For Medicaid | $820.00 | $820.00 | — |
| New patient office visit, about 60 minutes CPT 99205 New Patient Initial Prenatal Visit 99205 & 0500F For Medicaid-Pbb | $820.00 | $820.00 | — |
| New patient office visit, about 60 minutes CPT 99205 Pr Office/Outpatient New High Mdm 60 Minutes-Pbb | $820.00 | $820.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 Pr Office/Outpatient New High Mdm 60 Minutes | $472.00 | $472.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 Hc Evaluation And Management New Patient Level 5 | $759.00 | $759.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 Hc Evaluation And Management New Patient Level 5-Pbb | $759.00 | $759.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 New Patient Initial Prenatal Visit 99205 & 0500F For Medicaid-Pbb | $820.00 | $820.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 New Patient Initial Prenatal Visit 99205 & 0500F For Medicaid | $820.00 | $820.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 Pr Office/Outpatient New High Mdm 60 Minutes-Pbb | $820.00 | $820.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Research High Intensity Walking Protocol | $100.00 | $100.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Therapuetic Exercise Ea 15M | $223.00 | $223.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Hc Research High Intensity Walking Protocol | $100.00 | $100.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Hc Therapuetic Exercise Ea 15M | $223.00 | $223.00 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 Hc Ocmc-Pre-Employment Exam, Intermediate | $249.00 | $249.00 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 Hc Preventive Medicine Evaluation New Patient; 18-39 Years-Pbb | $264.00 | $264.00 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 Hc Ocmc-Pre-Employment Exam, Intermediate-Pbb | $294.00 | $294.00 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 Pr Initial Preventive Medicine New Pt Age 18-39Yrs-Pbb | $661.00 | $661.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Hc Ocmc-Pre-Employment Exam, Intermediate | $249.00 | $249.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Hc Preventive Medicine Evaluation New Patient; 18-39 Years-Pbb | $264.00 | $264.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Hc Ocmc-Pre-Employment Exam, Intermediate-Pbb | $294.00 | $294.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Pr Initial Preventive Medicine New Pt Age 18-39Yrs-Pbb | $661.00 | $661.00 | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 Hc Preventive Medicine Evaluation New Patient; 40-64 Years-Pbb | $315.00 | $315.00 | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 Pr Initial Preventive Medicine New Patient 40-64Yrs-Pbb | $722.00 | $722.00 | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Hc Preventive Medicine Evaluation New Patient; 40-64 Years-Pbb | $315.00 | $315.00 | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Pr Initial Preventive Medicine New Patient 40-64Yrs-Pbb | $722.00 | $722.00 | — |
| Psychotherapy session, 30 minutes CPT 90832 Pr Psychotherapy W/Patient 30 Minutes-Pbb | $170.00 | $170.00 | — |
| Psychotherapy session, 30 minutes CPT 90832 Hc Psychotherapy, 30 Minutes With Patient And/Or Family Member-Pbb | $215.00 | $215.00 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Pr Psychotherapy W/Patient 30 Minutes-Pbb | $170.00 | $170.00 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Hc Psychotherapy, 30 Minutes With Patient And/Or Family Member-Pbb | $215.00 | $215.00 | — |
| Psychotherapy session, 45 minutes CPT 90834 Pr Psychotherapy W/Patient 45 Minutes-Pbb,Telmd | $225.00 | $225.00 | — |
| Psychotherapy session, 45 minutes CPT 90834 Pr Psychotherapy W/Patient 45 Minutes-Pbb | $225.00 | $225.00 | — |
| Psychotherapy session, 45 minutes CPT 90834 Hc Psychotherapy, 45 Minutes With Patient And/Or Family Member-Pbb | $273.00 | $273.00 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Pr Psychotherapy W/Patient 45 Minutes-Pbb | $225.00 | $225.00 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Pr Psychotherapy W/Patient 45 Minutes-Pbb,Telmd | $225.00 | $225.00 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Hc Psychotherapy, 45 Minutes With Patient And/Or Family Member-Pbb | $273.00 | $273.00 | — |
| Psychotherapy session, 60 minutes CPT 90837 Pr Psychotherapy W/Patient 60 Minutes-Pbb | $307.00 | $307.00 | — |
| Psychotherapy session, 60 minutes CPT 90837 Hc Psychotherapy, 60 Minutes With Patient And/Or Family Member-Pbb | $400.00 | $400.00 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Pr Psychotherapy W/Patient 60 Minutes-Pbb | $307.00 | $307.00 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Hc Psychotherapy, 60 Minutes With Patient And/Or Family Member-Pbb | $400.00 | $400.00 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Pr Attending Cosmetic Consult Cash-Csm,Pbb | $75.00 | $75.00 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Hc Attending Cosmetic Consult Cash-Csm,Pbb | $100.00 | $100.00 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Pr Office/Op Consltj New/Est Pt Low Mdm 30 Minutes | $318.00 | $318.00 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Pr Office Consultation New Patient 30 Min | $630.00 | $630.00 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Pr Office Consultation Established Patient 30 Min | $630.00 | $630.00 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Pr Office Consultation Established Patient 30 Min-Pbb | $630.00 | $630.00 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Pr Office/Op Consltj New/Est Pt Low Mdm 30 Minutes-Pbb | $630.00 | $630.00 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Pr Attending Cosmetic Consult Cash-Csm,Pbb | $75.00 | $75.00 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Hc Attending Cosmetic Consult Cash-Csm,Pbb | $100.00 | $100.00 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Pr Office/Op Consltj New/Est Pt Low Mdm 30 Minutes | $318.00 | $318.00 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Pr Office Consultation New Patient 30 Min | $630.00 | $630.00 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Pr Office Consultation Established Patient 30 Min-Pbb | $630.00 | $630.00 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Pr Office/Op Consltj New/Est Pt Low Mdm 30 Minutes-Pbb | $630.00 | $630.00 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Pr Office Consultation Established Patient 30 Min | $630.00 | $630.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Pr Office/Op Consltj New/Est Pt Mod Mdm 40 Minutes | $463.00 | $463.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Pr Office/Op Consltj New/Est Pt Mod Mdm 40 Minutes-Pbb | $823.00 | $823.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Pr Office Consultation Established Patient 40 Min-Pbb | $823.00 | $823.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Pr Office Consultation Established Patient 40 Min | $823.00 | $823.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Pr Office Consultation New Patient 40 Min | $823.00 | $823.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Pr Office/Op Consltj New/Est Pt Mod Mdm 40 Minutes | $463.00 | $463.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Pr Office Consultation New Patient 40 Min | $823.00 | $823.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Pr Office Consultation Established Patient 40 Min | $823.00 | $823.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Pr Office Consultation Established Patient 40 Min-Pbb | $823.00 | $823.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Pr Office/Op Consltj New/Est Pt Mod Mdm 40 Minutes-Pbb | $823.00 | $823.00 | — |