Capital Health System Inc
Capital Health System Inc in Trenton, NJ publishes cash prices for 45 common procedures listed here, from its own machine-readable price file updated Jun 24, 2026. Click a procedure to compare it with other hospitals nearby.
750 Brunswick Ave, Trenton, NJ 08638-4514 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 IR CT ABDN/PELVIS WI CONT | $44,856.00 | $44,856.00 | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W/ CON | $44,856.00 | $44,856.00 | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ENTEROGRAPHY | $44,856.00 | $44,856.00 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ENTEROGRAPHY | $44,856.00 | $44,856.00 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 IR CT ABDN/PELVIS WI CONT | $44,856.00 | $44,856.00 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W/ CON | $44,856.00 | $44,856.00 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT PORT HEAD W/O CON | $3,078.00 | $3,078.00 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT DE BRAIN | $3,078.00 | $3,078.00 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD TRAUMATIC INJ W/O | $18,988.00 | $18,988.00 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD(STROKE PROTOCOL) | $18,988.00 | $18,988.00 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CON | $18,988.00 | $18,988.00 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT PORT HEAD W/O CON | $3,078.00 | $3,078.00 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT DE BRAIN | $3,078.00 | $3,078.00 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CON | $18,988.00 | $18,988.00 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD TRAUMATIC INJ W/O | $18,988.00 | $18,988.00 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD(STROKE PROTOCOL) | $18,988.00 | $18,988.00 | — |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/ CON | $44,856.00 | $44,856.00 | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/ CON | $44,856.00 | $44,856.00 | — |
| Diagnostic mammogram, both breasts CPT 77066 MG MAMMO DIG DIAGNOS BILA | $13,663.00 | $13,663.00 | — |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MG MAMMO DIG DIAGNOS BILA | $13,663.00 | $13,663.00 | — |
| Diagnostic mammogram, one breast one side CPT 77065 MG MAMMO DIG DIAG RT | $4,566.00 | $4,566.00 | — |
| Diagnostic mammogram, one breast one side CPT 77065 MG MAMMO DIG DIAG LT | $4,566.00 | $4,566.00 | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG MAMMO DIG DIAG LT | $4,566.00 | $4,566.00 | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG MAMMO DIG DIAG RT | $4,566.00 | $4,566.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP W/O CON LT | $15,487.00 | $15,487.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP W/O CON RT | $15,487.00 | $15,487.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE W/O CON LT | $15,487.00 | $15,487.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE W/O CON RT | $15,487.00 | $15,487.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JNT LOW EXT WO CON LT | $17,036.00 | $17,036.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JNT LOW EXT WO CON RT | $17,036.00 | $17,036.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE W/O CON LT | $18,997.00 | $18,997.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE W/O RT | $18,997.00 | $18,997.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP W/O CON LT | $15,487.00 | $15,487.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP W/O CON RT | $15,487.00 | $15,487.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE W/O CON RT | $15,487.00 | $15,487.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE W/O CON LT | $15,487.00 | $15,487.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI JNT LOW EXT WO CON RT | $17,036.00 | $17,036.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI JNT LOW EXT WO CON LT | $17,036.00 | $17,036.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE W/O RT | $18,997.00 | $18,997.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE W/O CON LT | $18,997.00 | $18,997.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP WO/W CON LT | $19,307.00 | $19,307.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE WO/W CON LT | $19,307.00 | $19,307.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE WO/W CON RT | $19,307.00 | $19,307.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE WO/W CON LT | $19,307.00 | $19,307.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE WO/W CON RT | $19,307.00 | $19,307.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP WO/W CON RT | $19,307.00 | $19,307.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP WO/W CON LT | $19,307.00 | $19,307.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE WO/W CON LT | $19,307.00 | $19,307.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP WO/W CON RT | $19,307.00 | $19,307.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE WO/W CON RT | $19,307.00 | $19,307.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE WO/W CON LT | $19,307.00 | $19,307.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE WO/W CON RT | $19,307.00 | $19,307.00 | — |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CINE | $10,725.00 | $10,725.00 | — |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN IAC W/O CON | $10,725.00 | $10,725.00 | — |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN PITUIT W/O CON | $10,725.00 | $10,725.00 | — |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CON | $11,798.00 | $11,798.00 | — |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STROKE PROTOCOL | $11,798.00 | $11,798.00 | — |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN TRAUMATIC W/O | $11,798.00 | $11,798.00 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CINE | $10,725.00 | $10,725.00 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN PITUIT W/O CON | $10,725.00 | $10,725.00 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN IAC W/O CON | $10,725.00 | $10,725.00 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CON | $11,798.00 | $11,798.00 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN STROKE PROTOCOL | $11,798.00 | $11,798.00 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN TRAUMATIC W/O | $11,798.00 | $11,798.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN PITUIT WO/W CON | $25,214.00 | $25,214.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN IAC WO/W CON | $25,214.00 | $25,214.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W&WO PLUS STRYK | $27,735.00 | $27,735.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/W CON | $27,735.00 | $27,735.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/W CINE | $27,735.00 | $27,735.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN TRAUMATIC W&W/O | $27,735.00 | $27,735.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN IAC WO/W CON | $25,214.00 | $25,214.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN PITUIT WO/W CON | $25,214.00 | $25,214.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO/W CON | $27,735.00 | $27,735.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO/W CINE | $27,735.00 | $27,735.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W&WO PLUS STRYK | $27,735.00 | $27,735.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN TRAUMATIC W&W/O | $27,735.00 | $27,735.00 | — |
| MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE | $32,281.00 | $32,281.00 | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-SPINE | $32,281.00 | $32,281.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US TRNSAB SNG FETUS >14WK | $4,549.00 | $4,549.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US MF COMP ANAT SING | $4,549.00 | $4,549.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US 1ST TRIMESTER >14WKS | $4,549.00 | $4,549.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US TRNSAB SNG FETUS >14WK | $4,549.00 | $4,549.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US 1ST TRIMESTER >14WKS | $4,549.00 | $4,549.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US MF COMP ANAT SING | $4,549.00 | $4,549.00 | — |
| Screening mammogram, both breasts both sides CPT 77067 MG MAMMO DIG SCREEN BILAT | $11,598.00 | $11,598.00 | — |
| Screening mammogram, both breasts one side CPT 77067 MG MAMMO DIG SCREEN RT | $5,799.00 | $5,799.00 | — |
| Screening mammogram, both breasts one side CPT 77067 MG MAMMO DIG SCREEN LT | $5,799.00 | $5,799.00 | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG MAMMO DIG SCREEN BILAT | $11,598.00 | $11,598.00 | — |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG MAMMO DIG SCREEN RT | $5,799.00 | $5,799.00 | — |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG MAMMO DIG SCREEN LT | $5,799.00 | $5,799.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 < 6HRS PSG ADULT | $33,788.00 | $33,788.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY | $56,305.00 | $56,305.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 < 6HRS PSG ADULT | $33,788.00 | $33,788.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY | $56,305.00 | $56,305.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAG ONLY (NON OB) | $21,997.00 | $21,997.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON OB | $21,997.00 | $21,997.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL (NON OB) | $21,997.00 | $21,997.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL (NON OB) | $21,997.00 | $21,997.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAG ONLY (NON OB) | $21,997.00 | $21,997.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON OB | $21,997.00 | $21,997.00 | — |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE | $11,128.00 | $11,128.00 | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE | $11,128.00 | $11,128.00 | — |
| X-ray of the lower back, 4 or more views CPT 72110 CHC LUMBAR SPINE XRAY | $837.00 | $837.00 | — |
| X-ray of the lower back, 4 or more views CPT 72110 XR LUMBOSACRAL ROUTINE | $21,797.00 | $21,797.00 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 CHC LUMBAR SPINE XRAY | $837.00 | $837.00 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LUMBOSACRAL ROUTINE | $21,797.00 | $21,797.00 | — |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $755.00 | $755.00 | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $755.00 | $755.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HYPERSENSITIVITY PNEU QUA | $200.00 | $200.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIAC IQ LIPID | $316.00 | $316.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $4,098.00 | $4,098.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HYPERSENSITIVITY PNEU QUA | $200.00 | $200.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARDIAC IQ LIPID | $316.00 | $316.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $4,098.00 | $4,098.00 | — |
| Complete blood count (CBC) with differential CPT 85025 LIVER FIBROSIS RISK P2 | $48.00 | $48.00 | — |
| Complete blood count (CBC) with differential CPT 85025 OB PANEL W/4TH HIV | $70.00 | $70.00 | — |
| Complete blood count (CBC) with differential CPT 85025 CBC W/DIFF (SED) | $1,485.00 | $1,485.00 | — |
| Complete blood count (CBC) with differential CPT 85025 CBC WITH DIFFERENTIAL | $1,634.00 | $1,634.00 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 LIVER FIBROSIS RISK P2 | $48.00 | $48.00 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 OB PANEL W/4TH HIV | $70.00 | $70.00 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/DIFF (SED) | $1,485.00 | $1,485.00 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH DIFFERENTIAL | $1,634.00 | $1,634.00 | — |
| Complete blood count (CBC), no differential CPT 85027 POC CBC | $41.00 | $41.00 | — |
| Complete blood count (CBC), no differential CPT 85027 CBC | $466.00 | $466.00 | — |
| Complete blood count (CBC), no differential CPT 85027 CBC ANGIOJET | $466.00 | $466.00 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 POC CBC | $41.00 | $41.00 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC | $466.00 | $466.00 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC ANGIOJET | $466.00 | $466.00 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOL PAN | $1,434.00 | $1,434.00 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 CMP, SERUM | $1,434.00 | $1,434.00 | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOL PAN | $1,434.00 | $1,434.00 | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP, SERUM | $1,434.00 | $1,434.00 | — |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $642.00 | $642.00 | — |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $642.00 | $642.00 | — |
| Liver function blood test panel CPT 80076 LIVER FIBROSIS RISK | $48.00 | $48.00 | — |
| Liver function blood test panel CPT 80076 HEPATIC FUNC (BABY) | $914.00 | $914.00 | — |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $914.00 | $914.00 | — |
| Liver function blood test panel CPT 80076 HEPATIC,SERUM | $914.00 | $914.00 | — |
| Liver function blood test panel CPT 80076 HEPATIC,BABY,SERUM | $914.00 | $914.00 | — |
| Liver function blood test panel inpatient CPT 80076 LIVER FIBROSIS RISK | $48.00 | $48.00 | — |
| Liver function blood test panel inpatient CPT 80076 HEPATIC,SERUM | $914.00 | $914.00 | — |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNC (BABY) | $914.00 | $914.00 | — |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $914.00 | $914.00 | — |
| Liver function blood test panel inpatient CPT 80076 HEPATIC,BABY,SERUM | $914.00 | $914.00 | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA TOTAL/FREE PART 1 | $414.00 | $414.00 | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA TOTAL/FREE PART 1 | $414.00 | $414.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL/FREE | $1,128.00 | $1,128.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA/PROSTATIC SPECIFIC AG | $3,326.00 | $3,326.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL/FREE | $1,128.00 | $1,128.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA/PROSTATIC SPECIFIC AG | $3,326.00 | $3,326.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAG/CARDIO P5 | $101.00 | $101.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 ANTIPHOSPHOLIP SYNDROM P4 | $228.00 | $228.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 VENOUS THROM PROFILE | $397.00 | $397.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT ANGIOJET | $936.00 | $936.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT*THROMBOPLASTIN TIME P | $936.00 | $936.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOSI VENOUS RISK P11 | $1,060.00 | $1,060.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 FACTOR INHIBITOR PANEL | $2,574.00 | $2,574.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS ANTICOAG/CARDIO P5 | $101.00 | $101.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ANTIPHOSPHOLIP SYNDROM P4 | $228.00 | $228.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 VENOUS THROM PROFILE | $397.00 | $397.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT ANGIOJET | $936.00 | $936.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT*THROMBOPLASTIN TIME P | $936.00 | $936.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOSI VENOUS RISK P11 | $1,060.00 | $1,060.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 FACTOR INHIBITOR PANEL | $2,574.00 | $2,574.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 LUPUS ANTICOAG/CARDIO P2 | $101.00 | $101.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 SM POC PT/INR | $121.00 | $121.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 POC PT/INR | $121.00 | $121.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT* PROTHROMBIN TIME/INR | $800.00 | $800.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT ANGIOJET | $800.00 | $800.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 THROMBOSIS VENOUS RISK P8 | $1,060.00 | $1,060.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LUPUS ANTICOAG/CARDIO P2 | $101.00 | $101.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POC PT/INR | $121.00 | $121.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 SM POC PT/INR | $121.00 | $121.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT* PROTHROMBIN TIME/INR | $800.00 | $800.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT ANGIOJET | $800.00 | $800.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 THROMBOSIS VENOUS RISK P8 | $1,060.00 | $1,060.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID CASCADE REFLEX | $208.00 | $208.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH WITH REFLEX | $252.00 | $252.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM.HORMONE | $3,083.00 | $3,083.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID CASCADE REFLEX | $208.00 | $208.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH WITH REFLEX | $252.00 | $252.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM.HORMONE | $3,083.00 | $3,083.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICRO | $94.00 | $94.00 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICRO | $94.00 | $94.00 | — |
| Urinalysis with microscope exam, manual CPT 81000 COMPONENTS OF URINALYSIS | $337.00 | $337.00 | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 COMPONENTS OF URINALYSIS | $337.00 | $337.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS ROUTINE | $37.00 | $37.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS REFLEX TO CULT | $37.00 | $37.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS | $41.00 | $41.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 KIDNEY STONE/URINE SAT | $50.00 | $50.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 HEMOGLOBIN, FREE,URINE | $216.00 | $216.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY, URINE | $252.00 | $252.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 ACETONE, URINE | $264.00 | $264.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 URINE KETONES | $264.00 | $264.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 PH, URINE, SEMI-QUANT | $279.00 | $279.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 HEMOGLOBIN, QUAL URINE | $520.00 | $520.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS ROUTINE | $37.00 | $37.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS REFLEX TO CULT | $37.00 | $37.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS | $41.00 | $41.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 KIDNEY STONE/URINE SAT | $50.00 | $50.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HEMOGLOBIN, FREE,URINE | $216.00 | $216.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY, URINE | $252.00 | $252.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE KETONES | $264.00 | $264.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 ACETONE, URINE | $264.00 | $264.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 PH, URINE, SEMI-QUANT | $279.00 | $279.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HEMOGLOBIN, QUAL URINE | $520.00 | $520.00 | — |
| Urinalysis without microscope exam, manual CPT 81002 POC URINALYSIS | $604.00 | $604.00 | — |
| Urinalysis without microscope exam, manual CPT 81002 POC UA DIPSTICK | $604.00 | $604.00 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 POC UA DIPSTICK | $604.00 | $604.00 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 POC URINALYSIS | $604.00 | $604.00 | — |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY | $31,686.00 | $31,686.00 | — |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY | $31,686.00 | $31,686.00 | — |
| Left heart catheterization, diagnostic CPT 93452 CATH LAB KIT G | $119,803.00 | $119,803.00 | — |
| Left heart catheterization, diagnostic one side CPT 93452 LEFT HEART CATH | $111,486.00 | $111,486.00 | — |
| Left heart catheterization, diagnostic inpatient CPT 93452 CATH LAB KIT G | $119,803.00 | $119,803.00 | — |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HEART CATH | $111,486.00 | $111,486.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 EPIDURAL INJ/ANESTHESIA | $7,160.00 | $7,160.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 EPIDURAL INJ LUMB/SAC | $7,876.00 | $7,876.00 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 EPIDURAL INJ/ANESTHESIA | $7,160.00 | $7,160.00 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 EPIDURAL INJ LUMB/SAC | $7,876.00 | $7,876.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 IR INJ LUMBAR TRANSF BIL | $14,433.00 | $14,433.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 IR INJ LUMBAR TRANSF RT | $7,216.00 | $7,216.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 IR INJ LUMBAR TRANSF LT | $7,216.00 | $7,216.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 IR INJ LUMBAR TRANSF BIL | $14,433.00 | $14,433.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 IR INJ LUMBAR TRANSF LT | $7,216.00 | $7,216.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 IR INJ LUMBAR TRANSF RT | $7,216.00 | $7,216.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GI ENDO | $25,106.00 | $25,106.00 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPER GI ENDO | $25,106.00 | $25,106.00 | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 OP PSYCHO FAM W/PT 50 MIN | $788.00 | $788.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 OP PSYCHO FAM W/PT 50 MIN | $788.00 | $788.00 | — |
| New patient office visit, about 30 minutes CPT 99203 COT PHYS EXAM VISIT | $376.00 | $376.00 | — |
| New patient office visit, about 30 minutes CPT 99203 PHYS EXAM VISIT | $376.00 | $376.00 | — |
| New patient office visit, about 30 minutes CPT 99203 DOT PHYS VISIT W/DIP | $376.00 | $376.00 | — |
| New patient office visit, about 30 minutes CPT 99203 COT DOT PHYS VISIT | $376.00 | $376.00 | — |
| New patient office visit, about 30 minutes CPT 99203 INITIAL VISIT | $678.00 | $678.00 | — |
| New patient office visit, about 30 minutes CPT 99203 NEW PT SELF LOW COMPLEXIT | $864.00 | $864.00 | — |
| New patient office visit, about 30 minutes CPT 99203 NEW VST LEV 3 W/PROC/RES | $1,195.00 | $1,195.00 | — |
| New patient office visit, about 30 minutes CPT 99203 NEW VST LEVL THREE W/PROC | $1,671.00 | $1,671.00 | — |
| New patient office visit, about 30 minutes CPT 99203 NEW VST LEVL THREE/W PROC | $1,671.00 | $1,671.00 | — |
| New patient office visit, about 30 minutes CPT 99203 NEW DET/LOW COMPLEX NURSE | $1,862.00 | $1,862.00 | — |
| New patient office visit, about 30 minutes CPT 99203 NEW VISIT LEVEL 3/RESID | $2,566.00 | $2,566.00 | — |
| New patient office visit, about 30 minutes CPT 99203 NEW VISIT LEVEL THREE | $2,717.00 | $2,717.00 | — |
| New patient office visit, about 30 minutes CPT 99203 NEW PT INTERMEDIATE-HBO | $5,667.00 | $5,667.00 | — |
| New patient office visit, about 30 minutes CPT 99203 VISIT NEW PT INTERMEDIATE | $5,667.00 | $5,667.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 COT DOT PHYS VISIT | $376.00 | $376.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 DOT PHYS VISIT W/DIP | $376.00 | $376.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 COT PHYS EXAM VISIT | $376.00 | $376.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 PHYS EXAM VISIT | $376.00 | $376.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 INITIAL VISIT | $678.00 | $678.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PT SELF LOW COMPLEXIT | $864.00 | $864.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW VST LEV 3 W/PROC/RES | $1,195.00 | $1,195.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW VST LEVL THREE/W PROC | $1,671.00 | $1,671.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW VST LEVL THREE W/PROC | $1,671.00 | $1,671.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW DET/LOW COMPLEX NURSE | $1,862.00 | $1,862.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW VISIT LEVEL 3/RESID | $2,566.00 | $2,566.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW VISIT LEVEL THREE | $2,717.00 | $2,717.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 VISIT NEW PT INTERMEDIATE | $5,667.00 | $5,667.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PT INTERMEDIATE-HBO | $5,667.00 | $5,667.00 | — |
| New patient office visit, about 45 minutes CPT 99204 NEW COMPRE/MOD COMPLEX | $1,153.00 | $1,153.00 | — |
| New patient office visit, about 45 minutes CPT 99204 NEW VST LEV 4 W/PROC/RES | $2,310.00 | $2,310.00 | — |
| New patient office visit, about 45 minutes CPT 99204 NEW VST LEVL FOUR W/PROC | $2,433.00 | $2,433.00 | — |
| New patient office visit, about 45 minutes CPT 99204 NEW VST LEVL FOUR/ W PROC | $2,433.00 | $2,433.00 | — |
| New patient office visit, about 45 minutes CPT 99204 NEW VISIT LEVEL 4/RESID | $3,000.00 | $3,000.00 | — |
| New patient office visit, about 45 minutes CPT 99204 NEW PT SELF MODER COMPLEX | $3,136.00 | $3,136.00 | — |
| New patient office visit, about 45 minutes CPT 99204 NEW VISIT LEVEL FOUR | $3,168.00 | $3,168.00 | — |
| New patient office visit, about 45 minutes CPT 99204 VISIT NEW PT EXTENDED | $3,777.00 | $3,777.00 | — |
| New patient office visit, about 45 minutes CPT 99204 NEW PT EXTENDED-HBO | $3,777.00 | $3,777.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW COMPRE/MOD COMPLEX | $1,153.00 | $1,153.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW VST LEV 4 W/PROC/RES | $2,310.00 | $2,310.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW VST LEVL FOUR W/PROC | $2,433.00 | $2,433.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW VST LEVL FOUR/ W PROC | $2,433.00 | $2,433.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW VISIT LEVEL 4/RESID | $3,000.00 | $3,000.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT SELF MODER COMPLEX | $3,136.00 | $3,136.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW VISIT LEVEL FOUR | $3,168.00 | $3,168.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 VISIT NEW PT EXTENDED | $3,777.00 | $3,777.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT EXTENDED-HBO | $3,777.00 | $3,777.00 | — |
| New patient office visit, about 60 minutes CPT 99205 NEW COMPRE/HIGH COMPLEX | $956.00 | $956.00 | — |
| New patient office visit, about 60 minutes CPT 99205 VISIT NEW PATIENT COMPLEX | $1,965.00 | $1,965.00 | — |
| New patient office visit, about 60 minutes CPT 99205 NEW PT COMPLEX-HBO | $1,965.00 | $1,965.00 | — |
| New patient office visit, about 60 minutes CPT 99205 NEW VISIT LEVEL 5/RESID | $2,006.00 | $2,006.00 | — |
| New patient office visit, about 60 minutes CPT 99205 NEW VST LEV 5 W/PROC/RES | $2,145.00 | $2,145.00 | — |
| New patient office visit, about 60 minutes CPT 99205 NEW VST LEVL FIVE W/PROC | $2,266.00 | $2,266.00 | — |
| New patient office visit, about 60 minutes CPT 99205 NEW VST LEVL FIVE/ W PROC | $2,266.00 | $2,266.00 | — |
| New patient office visit, about 60 minutes CPT 99205 NEW VISIT LEVEL FIVE | $2,811.00 | $2,811.00 | — |
| New patient office visit, about 60 minutes CPT 99205 NEW PT SELF HIGH COMPLEX | $3,543.00 | $3,543.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW COMPRE/HIGH COMPLEX | $956.00 | $956.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 VISIT NEW PATIENT COMPLEX | $1,965.00 | $1,965.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT COMPLEX-HBO | $1,965.00 | $1,965.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW VISIT LEVEL 5/RESID | $2,006.00 | $2,006.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW VST LEV 5 W/PROC/RES | $2,145.00 | $2,145.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW VST LEVL FIVE/ W PROC | $2,266.00 | $2,266.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW VST LEVL FIVE W/PROC | $2,266.00 | $2,266.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW VISIT LEVEL FIVE | $2,811.00 | $2,811.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT SELF HIGH COMPLEX | $3,543.00 | $3,543.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EX/PROC 15 | $1,043.00 | $1,043.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 BC THERAPEUTIC EXER 15M | $1,043.00 | $1,043.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EX/PROC | $1,043.00 | $1,043.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXER/PROC 15M | $1,043.00 | $1,043.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 BC THERAPEUTIC EXER 15M | $1,043.00 | $1,043.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EX/PROC | $1,043.00 | $1,043.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EX/PROC 15 | $1,043.00 | $1,043.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXER/PROC 15M | $1,043.00 | $1,043.00 | — |
| Psychotherapy session, 30 minutes CPT 90832 OP PSYCHOTHY W/ PT 30 MIN | $788.00 | $788.00 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 OP PSYCHOTHY W/ PT 30 MIN | $788.00 | $788.00 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULT INTERMEDIATE-HBO | $4,093.00 | $4,093.00 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CONSULT INTERMEDIATE-HBO | $4,093.00 | $4,093.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT EXTENDED-HBO | $7,075.00 | $7,075.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULT EXTENDED-HBO | $7,075.00 | $7,075.00 | — |