Robert Packer Hospital
Robert Packer Hospital in Sayre, PA publishes cash prices for 52 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
1 Guthrie Square, Sayre, PA 18840 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 CT Abd/Pelv W/ Contrast | $3,533.20 | $4,416.50 | 20% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd/Pelv W/ Contrast | $3,533.20 | $4,416.50 | 20% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd/Pelv W/ Contrast | $3,533.20 | $4,416.50 | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head W/O Contrast | $1,989.49 | $2,486.86 | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head W/O Contrast | $1,989.49 | $2,486.86 | 20% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head W/O Contrast | $1,989.49 | $2,486.86 | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W/Contrast | $4,249.58 | $5,311.97 | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W/Contrast | $4,249.58 | $5,311.97 | 20% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W/Contrast | $4,249.58 | $5,311.97 | 20% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Mammo Diagnostic W/ Cad Bilat | $368.00 | $460.00 | 20% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Mammo Diagnostic W/ Cad Bilat | $368.00 | $460.00 | 20% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Dx Mammo Incl Cad Bi | $1,100.55 | $1,375.69 | 20% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Dx Mammo Incl Cad Bi | $1,100.55 | $1,375.69 | 20% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Mammo Diagnostic W/ Cad Bilat | $368.00 | $460.00 | 20% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Dx Mammo Incl Cad Bi | $1,100.55 | $1,375.69 | 20% |
| Diagnostic mammogram, one breast CPT 77065 Dx Mammo Incl Cad Un | $724.05 | $905.06 | 20% |
| Diagnostic mammogram, one breast CPT 77065 Dx Mammo Incl Cad Un | $724.05 | $905.06 | 20% |
| Diagnostic mammogram, one breast inpatient CPT 77065 Dx Mammo Incl Cad Un | $724.05 | $905.06 | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Lower Extrem Jt W/O Contrast | $4,430.61 | $5,538.26 | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Lower Extrem Jt W/O Contrast | $4,430.61 | $5,538.26 | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Lower Extrem Jt W/O Contrast | $4,430.61 | $5,538.26 | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Lower Extrem Jt W/O & W/Contrast | $8,462.46 | $10,578.08 | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Lower Extrem Jt W/O & W/Contrast | $8,462.46 | $10,578.08 | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Lower Extrem Jt W/O & W/Contrast | $8,462.46 | $10,578.08 | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain Inc Brain Stem WO/Contrast | $3,563.52 | $4,454.40 | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain Inc Brain Stem WO/Contrast | $3,563.52 | $4,454.40 | 20% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain Inc Brain Stem WO/Contrast | $3,563.52 | $4,454.40 | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain Inc Brain Stem W/WO Contrast | $5,841.84 | $7,302.30 | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain Inc Brain Stem W/WO Contrast | $5,841.84 | $7,302.30 | 20% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain Inc Brain Stem W/WO Contrast | $5,841.84 | $7,302.30 | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L-Spine WO Contrast | $4,221.84 | $5,277.30 | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L-Spine WO Contrast | $4,221.84 | $5,277.30 | 20% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-Spine WO Contrast | $4,221.84 | $5,277.30 | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Eval>=14wks Sng Gest | $288.12 | $360.15 | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Eval>=14wks Sng Gest | $288.12 | $360.15 | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound Pregnant Uterus/B-Scan W/Image Doc | $1,516.94 | $1,896.18 | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound Pregnant Uterus/B-Scan W/Image Doc | $1,516.94 | $1,896.18 | 20% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Eval>=14wks Sng Gest | $288.12 | $360.15 | 20% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ultrasound Pregnant Uterus/B-Scan W/Image Doc | $1,516.94 | $1,896.18 | 20% |
| Screening mammogram, both breasts both sides CPT 77067 Scr Mammo Bi Incl Cad | $798.72 | $998.40 | 20% |
| Screening mammogram, both breasts both sides CPT 77067 Scr Mammo Bi Incl Cad | $798.72 | $998.40 | 20% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 Scr Mammo Bi Incl Cad | $798.72 | $998.40 | 20% |
| Sleep study in a lab (polysomnography) CPT 95810 Nocturnal Polysomnogram 4 or More Parameters | $6,365.30 | $7,956.62 | 20% |
| Sleep study in a lab (polysomnography) CPT 95810 Nocturnal Polysomnogram 4 or More Parameters | $6,365.30 | $7,956.62 | 20% |
| Sleep study in a lab (polysomnography) CPT 95810 Nocturnal Polysomnogram Less Than 6hrs | $6,365.30 | $7,956.62 | 20% |
| Sleep study in a lab (polysomnography) CPT 95810 Nocturnal Polysomnogram Less Than 6hrs | $6,365.30 | $7,956.62 | 20% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Nocturnal Polysomnogram 4 or More Parameters | $6,365.30 | $7,956.62 | 20% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Nocturnal Polysomnogram Less Than 6hrs | $6,365.30 | $7,956.62 | 20% |
| Transvaginal pelvic ultrasound CPT 76830 Transvaginal US Non-OB | $380.44 | $475.55 | 20% |
| Transvaginal pelvic ultrasound CPT 76830 Transvaginal US Non-OB | $380.44 | $475.55 | 20% |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound Transvaginal | $1,391.60 | $1,739.50 | 20% |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound Transvaginal | $1,391.60 | $1,739.50 | 20% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Transvaginal US Non-OB | $380.44 | $475.55 | 20% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Ultrasound Transvaginal | $1,391.60 | $1,739.50 | 20% |
| Ultrasound of the abdomen, complete CPT 76700 Ultrasound Abdominal/B-Scan W/Image Doc | $1,653.75 | $2,067.19 | 20% |
| Ultrasound of the abdomen, complete CPT 76700 Ultrasound Abdominal/B-Scan W/Image Doc | $1,653.75 | $2,067.19 | 20% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Ultrasound Abdominal/B-Scan W/Image Doc | $1,653.75 | $2,067.19 | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 L Spine, Min of 4 Views | $860.83 | $1,076.04 | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 L Spine, Min of 4 Views | $860.83 | $1,076.04 | 20% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 L Spine, Min of 4 Views | $860.83 | $1,076.04 | 20% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $255.36 | $319.20 | 20% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $255.36 | $319.20 | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $255.36 | $319.20 | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $186.96 | $233.70 | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $186.96 | $233.70 | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Profile | $186.96 | $233.70 | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Profile | $186.96 | $233.70 | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Profile | $186.96 | $233.70 | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $186.96 | $233.70 | 20% |
| Complete blood count (CBC) with differential CPT 85025 Cbc/Auto Diff | $160.17 | $200.21 | 20% |
| Complete blood count (CBC) with differential CPT 85025 Cbc/Auto Diff | $160.17 | $200.21 | 20% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Cbc/Auto Diff | $160.17 | $200.21 | 20% |
| Complete blood count (CBC), no differential CPT 85027 Cbc/No Diff | $112.48 | $140.60 | 20% |
| Complete blood count (CBC), no differential CPT 85027 Cbc/No Diff | $112.48 | $140.60 | 20% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Cbc/No Diff | $112.48 | $140.60 | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic | $300.96 | $376.20 | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic | $300.96 | $376.20 | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic | $300.96 | $376.20 | 20% |
| Kidney function blood test panel CPT 80069 Renal Panel | $128.44 | $160.55 | 20% |
| Kidney function blood test panel CPT 80069 Renal Panel | $128.44 | $160.55 | 20% |
| Kidney function blood test panel inpatient CPT 80069 Renal Panel | $128.44 | $160.55 | 20% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $154.28 | $192.85 | 20% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $154.28 | $192.85 | 20% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $154.28 | $192.85 | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Psa; Free | $47.50 | $59.38 | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Psa; Free | $47.50 | $59.38 | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Psa Total and Free - Quest | $206.17 | $257.71 | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Psa Total and Free - Quest | $206.17 | $257.71 | 20% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Psa; Free | $47.50 | $59.38 | 20% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Psa Total and Free - Quest | $206.17 | $257.71 | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Psa: Total | $47.48 | $59.35 | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Psa: Total | $47.48 | $59.35 | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen (Psa), Total | $135.66 | $169.58 | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen (Psa), Total | $135.66 | $169.58 | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa: Total | $47.48 | $59.35 | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen (Psa), Total | $135.66 | $169.58 | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 P T T | $95.76 | $119.70 | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 P T T | $95.76 | $119.70 | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 P T T | $95.76 | $119.70 | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $71.44 | $89.30 | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $71.44 | $89.30 | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $71.44 | $89.30 | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $336.68 | $420.85 | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $336.68 | $420.85 | 20% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $336.68 | $420.85 | 20% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Auto W Micro | $31.92 | $39.90 | 20% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Auto W Micro | $31.92 | $39.90 | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Auto W Micro | $31.92 | $39.90 | 20% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis W/O Micro | $19.32 | $24.15 | 20% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis W/O Micro | $19.32 | $24.15 | 20% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick On | $27.84 | $34.80 | 20% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick On | $27.84 | $34.80 | 20% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Auto W/O Micro | $27.84 | $34.80 | 20% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Auto W/O Micro | $27.84 | $34.80 | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis W/O Micro | $19.32 | $24.15 | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Dipstick On | $27.84 | $34.80 | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Auto W/O Micro | $27.84 | $34.80 | 20% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick Non-Auto W/O Micro | $20.00 | $25.00 | 20% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick Non-Auto W/O Micro | $20.00 | $25.00 | 20% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Dipstick Non-Auto W/O Micro | $20.00 | $25.00 | 20% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 HC Fac Remv Cataract Extracap,Insert Lens | $1,825.15 | $2,281.44 | 20% |
| Cataract surgery with lens implant CPT 66984 HC Fac Remv Cataract Extracap,Insert Lens | $1,825.15 | $2,281.44 | 20% |
| Cataract surgery with lens implant inpatient CPT 66984 HC Fac Remv Cataract Extracap,Insert Lens | $1,825.15 | $2,281.44 | 20% |
| Colonoscopy with polyp removal CPT 45385 Colonoscopy Flex W Rem Lesion by Snare | $5,406.96 | $6,758.70 | 20% |
| Colonoscopy with polyp removal CPT 45385 Colonoscopy Flex W Rem Lesion by Snare | $5,406.96 | $6,758.70 | 20% |
| Colonoscopy with polyp removal inpatient CPT 45385 Colonoscopy Flex W Rem Lesion by Snare | $5,406.96 | $6,758.70 | 20% |
| Colonoscopy with tissue sample CPT 45380 HC Fac Colonoscopy W/Biopsy Single/Multiple | $1,083.10 | $1,353.87 | 20% |
| Colonoscopy with tissue sample CPT 45380 HC Fac Colonoscopy W/Biopsy Single/Multiple | $1,083.10 | $1,353.87 | 20% |
| Colonoscopy with tissue sample CPT 45380 Colonoscopy Flex W Bx; Sgl/Multi | $4,271.50 | $5,339.37 | 20% |
| Colonoscopy with tissue sample CPT 45380 Colonoscopy Flex W Bx; Sgl/Multi | $4,271.50 | $5,339.37 | 20% |
| Colonoscopy with tissue sample inpatient CPT 45380 HC Fac Colonoscopy W/Biopsy Single/Multiple | $1,083.10 | $1,353.87 | 20% |
| Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy Flex W Bx; Sgl/Multi | $4,271.50 | $5,339.37 | 20% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy Flex ; Dx | $4,206.24 | $5,257.80 | 20% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy Flex ; Dx | $4,206.24 | $5,257.80 | 20% |
| Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy Flex ; Dx | $4,206.24 | $5,257.80 | 20% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HC Fac Discission,2nd Cataract,Laser | $404.07 | $505.09 | 20% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HC Fac Discission,2nd Cataract,Laser | $644.86 | $806.07 | 20% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 HC Fac Discission,2nd Cataract,Laser | $404.07 | $505.09 | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Njx Interlaminar Lmbr/Sac W/Imaging | $3,721.54 | $4,651.92 | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Njx Interlaminar Lmbr/Sac W/Imaging | $3,721.54 | $4,651.92 | 20% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Njx Interlaminar Lmbr/Sac W/Imaging | $3,721.54 | $4,651.92 | 20% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Njx Interlaminar Lmbr/Sac | $2,605.07 | $3,256.34 | 20% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Njx Interlaminar Lmbr/Sac | $2,605.07 | $3,256.34 | 20% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Njx Interlaminar Lmbr/Sac (727) | $2,605.07 | $3,256.34 | 20% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Njx Interlaminar Lmbr/Sac (727) | $2,605.07 | $3,256.34 | 20% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Njx Interlaminar Lmbr/Sac (727) | $2,605.07 | $3,256.34 | 20% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Njx Interlaminar Lmbr/Sac | $2,605.07 | $3,256.34 | 20% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Single Inject , Anesth Agent, Lumbar or Sacral W/Imaging | $2,490.40 | $3,113.00 | 20% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Single Inject , Anesth Agent, Lumbar or Sacral W/Imaging | $2,490.40 | $3,113.00 | 20% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Foramen Epidural L/S | $3,504.98 | $4,381.22 | 20% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inject Transforaminal Epidural Lumbar | $3,504.98 | $4,381.22 | 20% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Foramen Epidural L/S | $3,504.98 | $4,381.22 | 20% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inject Transforaminal Epidural Lumbar | $3,504.98 | $4,381.22 | 20% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Single Inject , Anesth Agent, Lumbar or Sacral W/Imaging | $2,490.40 | $3,113.00 | 20% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inj Foramen Epidural L/S | $3,504.98 | $4,381.22 | 20% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inject Transforaminal Epidural Lumbar | $3,504.98 | $4,381.22 | 20% |
| Prostate biopsy CPT 55700 Prostate Needle Biopsy Any Approach | $377.50 | $471.87 | 20% |
| Prostate biopsy CPT 55700 Needle Biopsy, Prostrate,Sngle/Multiple | $4,575.20 | $5,719.00 | 20% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Egd Biopsy Single/Multiple | $4,969.12 | $6,211.40 | 20% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Egd Biopsy Single/Multiple | $4,969.12 | $6,211.40 | 20% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Ugi W Bx. Sgl/Multiple | $4,969.12 | $6,211.40 | 20% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Ugi W Bx. Sgl/Multiple | $4,969.12 | $6,211.40 | 20% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Ugi W Bx. Sgl/Multiple | $4,969.12 | $6,211.40 | 20% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Egd Biopsy Single/Multiple | $4,969.12 | $6,211.40 | 20% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Upper GI Diagnostic | $4,875.94 | $6,094.92 | 20% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Egd Diagnostic Brush Wash | $4,875.94 | $6,094.92 | 20% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Upper GI Diagnostic | $4,875.94 | $6,094.92 | 20% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Egd Diagnostic Brush Wash | $4,875.94 | $6,094.92 | 20% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Egd Diagnostic Brush Wash | $4,875.94 | $6,094.92 | 20% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Upper GI Diagnostic | $4,875.94 | $6,094.92 | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Group psychotherapy session CPT 90853 HC Fac Group Psychotherapy | $27.11 | $33.89 | 20% |
| Group psychotherapy session CPT 90853 HC Fac Group Psychotherapy | $38.63 | $48.29 | 20% |
| Group psychotherapy session CPT 90853 Group Psychotherapy | $58.40 | $73.00 | 20% |
| Group psychotherapy session CPT 90853 Group Psychotherapy | $58.40 | $73.00 | 20% |
| Group psychotherapy session inpatient CPT 90853 HC Fac Group Psychotherapy | $27.11 | $33.89 | 20% |
| Group psychotherapy session inpatient CPT 90853 Group Psychotherapy | $58.40 | $73.00 | 20% |
| New patient office visit, about 30 minutes CPT 99203 Office/Outpatient New Low Mdm 30 Minutes | $586.66 | $733.32 | 20% |
| New patient office visit, about 30 minutes CPT 99203 Office/Outpatient New Low Mdm 30 Minutes | $586.66 | $733.32 | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office/Outpatient New Low Mdm 30 Minutes | $586.66 | $733.32 | 20% |
| New patient office visit, about 45 minutes CPT 99204 Office/Outpatient New Moderate Mdm 45 Minutes | $737.22 | $921.52 | 20% |
| New patient office visit, about 45 minutes CPT 99204 Office/Outpatient New Moderate Mdm 45 Minutes | $737.22 | $921.52 | 20% |
| New patient office visit, about 45 minutes CPT 99204 Office/Outpatient Visit New Lvl 4 | $743.82 | $929.78 | 20% |
| New patient office visit, about 45 minutes CPT 99204 Office/Outpatient Visit New Lvl 4 | $743.82 | $929.78 | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office/Outpatient New Moderate Mdm 45 Minutes | $737.22 | $921.52 | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office/Outpatient Visit New Lvl 4 | $743.82 | $929.78 | 20% |
| New patient office visit, about 60 minutes CPT 99205 Office/Outpatient New Hi Mdm 60 Minutes | $1,007.18 | $1,258.98 | 20% |
| New patient office visit, about 60 minutes CPT 99205 Office/Outpatient New Hi Mdm 60 Minutes | $1,007.18 | $1,258.98 | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Office/Outpatient New Hi Mdm 60 Minutes | $1,007.18 | $1,258.98 | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Pt Therapeutic Px-Exercises Ea 15mn | $197.40 | $246.75 | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Pt Therapeutic Px-Exercises Ea 15mn | $197.40 | $246.75 | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ot Therapeutic Px-Exercises Ea 15 Min | $197.40 | $246.75 | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ot Therapeutic Px-Exercises Ea 15 Min | $197.40 | $246.75 | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Pt Therapeutic Px-Exercises Ea 15mn | $197.40 | $246.75 | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ot Therapeutic Px-Exercises Ea 15 Min | $197.40 | $246.75 | 20% |
| Preventive checkup, new patient aged 18–39 CPT 99385 New Prevent 18-39 Yr | $202.27 | $252.84 | 20% |
| Preventive checkup, new patient aged 18–39 CPT 99385 New Prevent 18-39 Yr | $202.27 | $252.84 | 20% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 New Prevent 18-39 Yr | $202.27 | $252.84 | 20% |
| Preventive checkup, new patient aged 40–64 CPT 99386 New Prevent 40-64yr Age | $233.44 | $291.80 | 20% |
| Preventive checkup, new patient aged 40–64 CPT 99386 New Prevent 40-64yr Age | $233.44 | $291.80 | 20% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 New Prevent 40-64yr Age | $233.44 | $291.80 | 20% |
| Psychotherapy session, 30 minutes CPT 90832 HC Fac Psychotherapy W/Patient 30 Minutes | $23.87 | $29.84 | 20% |
| Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 Min | $23.87 | $29.84 | 20% |
| Psychotherapy session, 30 minutes CPT 90832 HC Fac Psychotherapy W/Patient 30 Minutes | $89.74 | $112.18 | 20% |
| Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 Min | $89.74 | $112.18 | 20% |
| Psychotherapy session, 30 minutes CPT 90832 Psytx Pt&/Family 30 Minutes | $167.80 | $209.75 | 20% |
| Psychotherapy session, 30 minutes CPT 90832 Psytx Pt&/Family 30 Minutes | $167.80 | $209.75 | 20% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy, 30 Min | $23.87 | $29.84 | 20% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC Fac Psychotherapy W/Patient 30 Minutes | $23.87 | $29.84 | 20% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Psytx Pt&/Family 30 Minutes | $167.80 | $209.75 | 20% |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 Mi | $73.64 | $92.05 | 20% |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 Mi | $119.97 | $149.96 | 20% |
| Psychotherapy session, 45 minutes CPT 90834 Psytx Pt&/Family 45 Minutes | $330.60 | $413.25 | 20% |
| Psychotherapy session, 45 minutes CPT 90834 Psytx Pt&/Family 45 Minutes | $330.60 | $413.25 | 20% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy, 45 Mi | $73.64 | $92.05 | 20% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Psytx Pt&/Family 45 Minutes | $330.60 | $413.25 | 20% |
| Psychotherapy session, 60 minutes CPT 90837 HC Fac Psychotherapy Patient &/ Family 60 Minutes | $63.96 | $79.95 | 20% |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 Min | $63.96 | $79.95 | 20% |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 Min | $179.91 | $224.89 | 20% |
| Psychotherapy session, 60 minutes CPT 90837 HC Fac Psychotherapy Patient &/ Family 60 Minutes | $179.91 | $224.89 | 20% |
| Psychotherapy session, 60 minutes CPT 90837 Psytx Pt&/Family 60 Minutes | $380.20 | $475.25 | 20% |
| Psychotherapy session, 60 minutes CPT 90837 Psytx Pt&/Family 60 Minutes | $380.20 | $475.25 | 20% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy, 60 Min | $63.96 | $79.95 | 20% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC Fac Psychotherapy Patient &/ Family 60 Minutes | $63.96 | $79.95 | 20% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Psytx Pt&/Family 60 Minutes | $380.20 | $475.25 | 20% |