Hospital Warner Robins, GA

Perry Hospital

Listed in its price file as “Houston Hospitals INC”.

Perry Hospital in Perry, GA publishes cash prices for 340 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Georgia median for 186 of 340 procedures and below it for 148. By typical cash price it ranks #68 of 96 Georgia hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

1120 Morningside Dr, Perry, GA 31069 Collected Oct 30, 2026 Source price file Check a bill from this hospital

The price file shows no self-pay discount

For 2690 of the 2690 prices listed here, the cash price in Perry Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Abdominal CT scan without and with contrast CPT 74170 Ct Abdomen Wwo 74170	$1,275.00	$1,275.00	—	32% below	—
Abdominal CT scan without and with contrast inpatient CPT 74170 Ct Abdomen Wwo 74170	$1,275.00	$1,275.00	—	—	—
Abdominal X-ray, 2 views CPT 74019 Abdomen Decubitus 74019	$572.00	$572.00	—	113% above	—
Abdominal X-ray, 2 views CPT 74019 Abdomen Flat Upright 74019	$572.00	$572.00	—	113% above	—
Abdominal X-ray, 2 views CPT 74019 Abdomen Ap And Lat 74019	$572.00	$572.00	—	113% above	—
Abdominal X-ray, 2 views CPT 74019 Abdomen Decubitus Hcc 74019	$572.00	$572.00	—	113% above	—
Abdominal X-ray, 2 views CPT 74019 Abdomen Flat Upright Hcc 74019	$572.00	$572.00	—	113% above	—
Abdominal X-ray, 2 views inpatient CPT 74019 Abdomen Flat Upright 74019	$572.00	$572.00	—	—	—
Abdominal X-ray, 2 views inpatient CPT 74019 Abdomen Flat Upright Hcc 74019	$572.00	$572.00	—	—	—
Abdominal X-ray, 2 views inpatient CPT 74019 Abdomen Decubitus Hcc 74019	$572.00	$572.00	—	—	—
Abdominal X-ray, 2 views inpatient CPT 74019 Abdomen Decubitus 74019	$572.00	$572.00	—	—	—
Abdominal X-ray, 2 views inpatient CPT 74019 Abdomen Ap And Lat 74019	$572.00	$572.00	—	—	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Rad Rt M3V Hcc 73610	$440.00	$440.00	—	62% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Rad Lt M3V Hcc 73610	$440.00	$440.00	—	62% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Minimum 3 Views Rt 73610	$440.00	$440.00	—	62% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Minimum 3 Views Lt 73610	$440.00	$440.00	—	62% above	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle Rad Rt M3V Hcc 73610	$440.00	$440.00	—	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle Minimum 3 Views Rt 73610	$440.00	$440.00	—	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle Rad Lt M3V Hcc 73610	$440.00	$440.00	—	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle Minimum 3 Views Lt 73610	$440.00	$440.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Us Abi Ltd Bilat 93922	$635.00	$635.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Abi 2 Levels	$635.00	$635.00	—	95% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Abi Ankle Brachial Prt 93922	$635.00	$635.00	—	95% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Abi Tbi Woc 93922	$635.00	$635.00	—	95% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 Us Abi Ltd Bilat 93922	$635.00	$635.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Abi Ankle Brachial Prt 93922	$635.00	$635.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Abi 2 Levels	$635.00	$635.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Abi Tbi Woc 93922	$635.00	$635.00	—	—	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Extremity Upper L Wo 73200	$1,275.00	$1,275.00	—	20% above	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Extremity Upper R Wo 73200	$1,275.00	$1,275.00	—	20% above	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Extremity Upper R Wo 73200	$1,275.00	$1,275.00	—	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Extremity Upper L Wo 73200	$1,275.00	$1,275.00	—	—	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 Gastrografin Esophogram 74220	$938.00	$938.00	—	173% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 Barium Swallow Esophogm 74220	$938.00	$938.00	—	173% above	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Gastrografin Esophogram 74220	$938.00	$938.00	—	—	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Barium Swallow Esophogm 74220	$938.00	$938.00	—	—	—
Bone scan, whole body (nuclear medicine) CPT 78306 Nm Bone Scan Total Bdy 78306	$1,577.00	$1,577.00	—	24% above	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Nm Bone Scan Total Bdy 78306	$1,577.00	$1,577.00	—	—	—
Breast ultrasound, complete, one breast CPT 76641 Us Breast Complete Uni 76641	$606.00	$606.00	—	44% above	—
Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Complete Lt 76641	$606.00	$606.00	—	44% above	—
Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Complete Rt 76641	$606.00	$606.00	—	44% above	—
Breast ultrasound, complete, one breast inpatient CPT 76641 Us Breast Complete Uni 76641	$606.00	$606.00	—	—	—
Breast ultrasound, complete, one breast inpatient one side CPT 76641 Us Breast Complete Lt 76641	$606.00	$606.00	—	—	—
Breast ultrasound, complete, one breast inpatient one side CPT 76641 Us Breast Complete Rt 76641	$606.00	$606.00	—	—	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Limited Lt 76642	$475.00	$475.00	—	36% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Limited Rt 76642	$475.00	$475.00	—	36% above	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 Us Breast Limited Lt 76642	$475.00	$475.00	—	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 Us Breast Limited Rt 76642	$475.00	$475.00	—	—	—
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Ct Abdomen Pelvis Angio 74174	$3,150.00	$3,150.00	—	39% above	—
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 Ct Abdomen Pelvis Angio 74174	$3,150.00	$3,150.00	—	—	—
CT angiography (CTA) of the head CPT 70496 Ct Head Angiography 70496	$2,859.00	$2,859.00	—	81% above	—
CT angiography (CTA) of the head inpatient CPT 70496 Ct Head Angiography 70496	$2,859.00	$2,859.00	—	—	—
CT angiography (CTA) of the neck CPT 70498 Ct Neck Angiography 70498	$2,859.00	$2,859.00	—	70% above	—
CT angiography (CTA) of the neck inpatient CPT 70498 Ct Neck Angiography 70498	$2,859.00	$2,859.00	—	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Ct Chest Angio 71275	$3,150.00	$3,150.00	—	113% above	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 Ct Chest Angio 71275	$3,150.00	$3,150.00	—	—	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Coronary Cta Arteries 75574	$1,275.00	$1,275.00	—	63% above	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 Coronary Cta Arteries 75574	$1,275.00	$1,275.00	—	—	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Ct Calcium Scoring 75571	$224.00	$224.00	—	124% above	—
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 Ct Calcium Scoring 75571	$224.00	$224.00	—	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Ab Pel W Rectal Cntrst Only	$1,418.00	$1,418.00	—	32% below	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Abdomen Pelvis Wo 74176	$1,418.00	$1,418.00	—	32% below	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Ct Ab Pel W Rectal Cntrst Only	$1,418.00	$1,418.00	—	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Ct Abdomen Pelvis Wo 74176	$1,418.00	$1,418.00	—	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Ct Abdomen Pelvis W 74177	$2,272.00	$2,272.00	—	6% below	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Ct Ab Pel W Iv W Rectal Cntrst	$2,272.00	$2,272.00	—	6% below	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Ct Abdomen Pelvis W 74177	$2,272.00	$2,272.00	—	—	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Ct Ab Pel W Iv W Rectal Cntrst	$2,272.00	$2,272.00	—	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abdomen Wwo Pelvis W 74178	$2,272.00	$2,272.00	—	22% below	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abdomen W Pelvis Wwo 74178	$2,272.00	$2,272.00	—	22% below	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Ab Pel Wwo Iv And Rectal	$2,272.00	$2,272.00	—	22% below	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abdomen Pelvis Wwo 74178	$2,272.00	$2,272.00	—	22% below	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Ct Ab Pel Wwo Iv And Rectal	$2,272.00	$2,272.00	—	—	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Ct Abdomen Wwo Pelvis W 74178	$2,272.00	$2,272.00	—	—	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Ct Abdomen Pelvis Wwo 74178	$2,272.00	$2,272.00	—	—	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Ct Abdomen W Pelvis Wwo 74178	$2,272.00	$2,272.00	—	—	—
CT scan of the abdomen with contrast CPT 74160 Ct Abdomen W 74160	$1,275.00	$1,275.00	—	24% below	—
CT scan of the abdomen with contrast inpatient CPT 74160 Ct Abdomen W 74160	$1,275.00	$1,275.00	—	—	—
CT scan of the abdomen without contrast CPT 74150 Ct Abdomen Wo 74150	$1,275.00	$1,275.00	—	1% above	—
CT scan of the abdomen without contrast inpatient CPT 74150 Ct Abdomen Wo 74150	$1,275.00	$1,275.00	—	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Face Sinus Wo 70486	$1,157.00	$1,157.00	—	12% above	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Ct Face Sinus Wo 70486	$1,157.00	$1,157.00	—	—	—
CT scan of the head or brain, no contrast dye CPT 70450 Ct Head Wo 70450	$1,157.00	$1,157.00	—	2% below	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 Ct Head Wo 70450	$1,157.00	$1,157.00	—	—	—
CT scan of the head with contrast CPT 70460 Ct Head W 70460	$1,157.00	$1,157.00	—	19% below	—
CT scan of the head with contrast inpatient CPT 70460 Ct Head W 70460	$1,157.00	$1,157.00	—	—	—
CT scan of the head without and with contrast CPT 70470 Ct Head Wwo 70470	$1,157.00	$1,157.00	—	37% below	—
CT scan of the head without and with contrast inpatient CPT 70470 Ct Head Wwo 70470	$1,157.00	$1,157.00	—	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct Spine Lumbar Wo 72131	$1,275.00	$1,275.00	—	1% below	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 Ct Spine Lumbar Wo 72131	$1,275.00	$1,275.00	—	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct Spine Cervical Wo 72125	$1,157.00	$1,157.00	—	4% below	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 Ct Spine Cervical Wo 72125	$1,157.00	$1,157.00	—	—	—
CT scan of the pelvis, with contrast dye CPT 72193 Ct Pelvis W 72193	$1,275.00	$1,275.00	—	20% below	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 Ct Pelvis W 72193	$1,275.00	$1,275.00	—	—	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Doppler Carotid Duplex Bl93880	$1,288.00	$1,288.00	—	148% above	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Doppler Carotid Duplex Bl93880	$1,288.00	$1,288.00	—	—	—
Chest CT scan without and with contrast CPT 71270 Ct Chest Wwo 71270	$1,275.00	$1,275.00	—	25% below	—
Chest CT scan without and with contrast inpatient CPT 71270 Ct Chest Wwo 71270	$1,275.00	$1,275.00	—	—	—
Chest X-ray, 2 views CPT 71046 Chest Pa Lat Hcc 71046	$317.00	$317.00	—	41% above	—
Chest X-ray, 2 views CPT 71046 Chest Lateral Decubitus 71046	$317.00	$317.00	—	41% above	—
Chest X-ray, 2 views CPT 71046 Chest Lat Decubitus Hcc 71046	$317.00	$317.00	—	41% above	—
Chest X-ray, 2 views CPT 71046 Chest Pa Lat 71046	$317.00	$317.00	—	41% above	—
Chest X-ray, 2 views inpatient CPT 71046 Chest Lateral Decubitus 71046	$317.00	$317.00	—	—	—
Chest X-ray, 2 views inpatient CPT 71046 Chest Pa Lat 71046	$317.00	$317.00	—	—	—
Chest X-ray, 2 views inpatient CPT 71046 Chest Pa Lat Hcc 71046	$317.00	$317.00	—	—	—
Chest X-ray, 2 views inpatient CPT 71046 Chest Lat Decubitus Hcc 71046	$317.00	$317.00	—	—	—
Chest X-ray, single view CPT 71045 Chest 1 View Hcc 71045	$317.00	$317.00	—	88% above	—
Chest X-ray, single view CPT 71045 Chest Lordotic View Hcc 71045	$317.00	$317.00	—	88% above	—
Chest X-ray, single view CPT 71045 Chest Lordotic View 71045	$317.00	$317.00	—	88% above	—
Chest X-ray, single view CPT 71045 Chest 1 View Ir 71045	$317.00	$317.00	—	88% above	—
Chest X-ray, single view CPT 71045 Chest 1 View Rad 71045	$317.00	$317.00	—	88% above	—
Chest X-ray, single view inpatient CPT 71045 Chest 1 View Hcc 71045	$317.00	$317.00	—	—	—
Chest X-ray, single view inpatient CPT 71045 Chest 1 View Rad 71045	$317.00	$317.00	—	—	—
Chest X-ray, single view inpatient CPT 71045 Chest Lordotic View 71045	$317.00	$317.00	—	—	—
Chest X-ray, single view inpatient CPT 71045 Chest Lordotic View Hcc 71045	$317.00	$317.00	—	—	—
Chest X-ray, single view inpatient CPT 71045 Chest 1 View Ir 71045	$317.00	$317.00	—	—	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Lt 73000	$440.00	$440.00	—	82% above	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Rt Hcc 73000	$440.00	$440.00	—	82% above	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Lt Hcc 73000	$440.00	$440.00	—	82% above	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Rt 73000	$440.00	$440.00	—	82% above	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Rt Hcc 73000	$440.00	$440.00	—	—	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Lt 73000	$440.00	$440.00	—	—	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Rt 73000	$440.00	$440.00	—	—	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Lt Hcc 73000	$440.00	$440.00	—	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Abdomen Aorta Us 76770	$606.00	$606.00	—	21% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Abdomen Aorta Us 76770	$606.00	$606.00	—	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Bone Mineral Density Std 77080	$542.00	$542.00	—	41% above	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Bone Mineral Density Std 77080	$542.00	$542.00	—	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Bone Density Forearm 77081	$440.00	$440.00	—	137% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Bone Density Forearm 77081	$440.00	$440.00	—	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest Veran 71250	$1,275.00	$1,275.00	—	27% above	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest Wo 71250	$1,275.00	$1,275.00	—	27% above	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Ct Chest Wo 71250	$1,275.00	$1,275.00	—	—	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Ct Chest Veran 71250	$1,275.00	$1,275.00	—	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Chest W 71260	$1,275.00	$1,275.00	—	17% below	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Ct Chest W 71260	$1,275.00	$1,275.00	—	—	—
Diagnostic mammogram, both breasts CPT 77066 Mammo Digital Bil Diag 77066	$499.00	$499.00	—	55% above	—
Diagnostic mammogram, both breasts inpatient CPT 77066 Mammo Digital Bil Diag 77066	$499.00	$499.00	—	—	—
Diagnostic mammogram, one breast one side CPT 77065 Mammo Digital Diag R 77065	$391.00	$391.00	—	60% above	—
Diagnostic mammogram, one breast one side CPT 77065 Mammo Digital Diag L 77065	$391.00	$391.00	—	60% above	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 Mammo Digital Diag L 77065	$391.00	$391.00	—	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 Mammo Digital Diag R 77065	$391.00	$391.00	—	—	—
Duplex ultrasound of the leg arteries, both legs CPT 93925 Doppler Artery B Low Ext 93925	$1,288.00	$1,288.00	—	120% above	—
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 Doppler Artery B Low Ext 93925	$1,288.00	$1,288.00	—	—	—
Duplex ultrasound of the leg veins, both legs CPT 93970 Doppler Venous B Up Ext 93970	$1,288.00	$1,288.00	—	34% above	—
Duplex ultrasound of the leg veins, both legs CPT 93970 Venous Insufficiency Bl 93970	$1,288.00	$1,288.00	—	34% above	—
Duplex ultrasound of the leg veins, both legs CPT 93970 Doppler Venous B Lower E 93970	$1,288.00	$1,288.00	—	34% above	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Doppler Venous B Up Ext 93970	$1,288.00	$1,288.00	—	—	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Doppler Venous B Lower E 93970	$1,288.00	$1,288.00	—	—	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Venous Insufficiency Bl 93970	$1,288.00	$1,288.00	—	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo W Doppler Colorflow 93306	$2,407.00	$2,407.00	—	55% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Wdop Color F Peds 93306	$2,407.00	$2,407.00	—	55% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo W Doppler Colorflow 93306	$2,407.00	$2,407.00	—	—	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo Wdop Color F Peds 93306	$2,407.00	$2,407.00	—	—	—
Elbow X-ray, 2 views one side CPT 73070 Elbow 2 Views Lt 73070	$440.00	$440.00	—	128% above	—
Elbow X-ray, 2 views one side CPT 73070 Elbow 2 Views Rt 73070	$440.00	$440.00	—	128% above	—
Elbow X-ray, 2 views one side CPT 73070 Elbow Rt 2 Views Hcc 73070	$440.00	$440.00	—	128% above	—
Elbow X-ray, 2 views one side CPT 73070 Elbow Lt 2 Views Hcc 73070	$440.00	$440.00	—	128% above	—
Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow Lt 2 Views Hcc 73070	$440.00	$440.00	—	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow 2 Views Rt 73070	$440.00	$440.00	—	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow Rt 2 Views Hcc 73070	$440.00	$440.00	—	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow 2 Views Lt 73070	$440.00	$440.00	—	—	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Rt Hcc 73080	$440.00	$440.00	—	68% above	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Minimum 3 Views Lt 73080	$440.00	$440.00	—	68% above	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Lt Hcc 73080	$440.00	$440.00	—	68% above	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Minimum 3 Views Rt 73080	$440.00	$440.00	—	68% above	—
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Rt Hcc 73080	$440.00	$440.00	—	—	—
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Minimum 3 Views Lt 73080	$440.00	$440.00	—	—	—
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Minimum 3 Views Rt 73080	$440.00	$440.00	—	—	—
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Lt Hcc 73080	$440.00	$440.00	—	—	—
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Orbit Internal Au Wo 70480	$1,157.00	$1,157.00	—	7% above	—
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Ct Orbit Internal Au Wo 70480	$1,157.00	$1,157.00	—	—	—
Facial bones X-ray, complete, 3 or more views CPT 70150 Facial Bones Min 3 Views 70150	$566.00	$566.00	—	85% above	—
Facial bones X-ray, complete, 3 or more views CPT 70150 Face Facial Bones Hcc 70150	$566.00	$566.00	—	85% above	—
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Face Facial Bones Hcc 70150	$566.00	$566.00	—	—	—
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Facial Bones Min 3 Views 70150	$566.00	$566.00	—	—	—
Forearm X-ray (radius and ulna), 2 views CPT 73090 Forearm L 73090	$440.00	$440.00	—	102% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Rt Hcc 73090	$440.00	$440.00	—	102% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm R 73090	$440.00	$440.00	—	102% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Lt Hcc 73090	$440.00	$440.00	—	102% above	—
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 Forearm L 73090	$440.00	$440.00	—	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Lt Hcc 73090	$440.00	$440.00	—	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Rt Hcc 73090	$440.00	$440.00	—	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm R 73090	$440.00	$440.00	—	—	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Nm Hepatobiliary Scan 78226	$1,577.00	$1,577.00	—	23% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Nm Hepatobiliary Scan 78226	$1,577.00	$1,577.00	—	—	—
Hand X-ray, 2 views one side CPT 73120 Hand 2 Views Lt 73120	$566.00	$566.00	—	164% above	—
Hand X-ray, 2 views one side CPT 73120 Hand Lt 2 Views Hcc 73120	$566.00	$566.00	—	164% above	—
Hand X-ray, 2 views one side CPT 73120 Hand Rt 2 Views Hcc 73120	$566.00	$566.00	—	164% above	—
Hand X-ray, 2 views one side CPT 73120 Hand 2 Views Rt 73120	$566.00	$566.00	—	164% above	—
Hand X-ray, 2 views inpatient one side CPT 73120 Hand 2 Views Rt 73120	$566.00	$566.00	—	—	—
Hand X-ray, 2 views inpatient one side CPT 73120 Hand 2 Views Lt 73120	$566.00	$566.00	—	—	—
Hand X-ray, 2 views inpatient one side CPT 73120 Hand Rt 2 Views Hcc 73120	$566.00	$566.00	—	—	—
Hand X-ray, 2 views inpatient one side CPT 73120 Hand Lt 2 Views Hcc 73120	$566.00	$566.00	—	—	—
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Heel Os Calcis L 73650	$440.00	$440.00	—	115% above	—
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Heel Os Calcis R 73650	$440.00	$440.00	—	115% above	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Heel Os Calcis Rt Hcc 73650	$440.00	$440.00	—	115% above	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Heel Os Calcis Lt Hcc 73650	$440.00	$440.00	—	115% above	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 Heel Os Calcis L 73650	$440.00	$440.00	—	—	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 Heel Os Calcis R 73650	$440.00	$440.00	—	—	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Heel Os Calcis Rt Hcc 73650	$440.00	$440.00	—	—	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Heel Os Calcis Lt Hcc 73650	$440.00	$440.00	—	—	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study Ambulat Home 95806	$1,461.00	$1,461.00	—	164% above	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Sleep Study Ambulat Home 95806	$1,461.00	$1,461.00	—	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep Stdwcpap Gt6H Gt6A 95811	$7,540.00	$7,540.00	—	203% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Sleep Stdwcpap Gt6H Gt6A 95811	$7,540.00	$7,540.00	—	—	—
Knee X-ray, 3 views one side CPT 73562 Knee 3 Views Rt Hcc 73562	$440.00	$440.00	—	84% above	—
Knee X-ray, 3 views one side CPT 73562 Knee 3 Views Rt 73562	$440.00	$440.00	—	84% above	—
Knee X-ray, 3 views one side CPT 73562 Knee 3 Views Lt Hcc 73562	$440.00	$440.00	—	84% above	—
Knee X-ray, 3 views one side CPT 73562 Knee 3 Views Lt 73562	$440.00	$440.00	—	84% above	—
Knee X-ray, 3 views inpatient one side CPT 73562 Knee 3 Views Rt 73562	$440.00	$440.00	—	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 Knee 3 Views Rt Hcc 73562	$440.00	$440.00	—	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 Knee 3 Views Lt Hcc 73562	$440.00	$440.00	—	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 Knee 3 Views Lt 73562	$440.00	$440.00	—	—	—
Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Rt 4 Ormore V Hcc 73564	$566.00	$566.00	—	107% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 Knee 4 Or More Views Rt 73564	$566.00	$566.00	—	107% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Lt 4 Ormore V Hcc 73564	$566.00	$566.00	—	107% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 Knee 4 Or More Views Lt 73564	$566.00	$566.00	—	107% above	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee Rt 4 Ormore V Hcc 73564	$566.00	$566.00	—	—	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee 4 Or More Views Rt 73564	$566.00	$566.00	—	—	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee 4 Or More Views Lt 73564	$566.00	$566.00	—	—	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee Lt 4 Ormore V Hcc 73564	$566.00	$566.00	—	—	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Extremity Lower L Wo 73700	$1,275.00	$1,275.00	—	24% above	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Extremity Lower R Wo 73700	$1,275.00	$1,275.00	—	24% above	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Extremity Lower R Wo 73700	$1,275.00	$1,275.00	—	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Extremity Lower L Wo 73700	$1,275.00	$1,275.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Liver Ultrasound Ltd 76705	$606.00	$606.00	—	24% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Gallbladder Us Ltd 76705	$606.00	$606.00	—	24% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdomen Appendix Ltd 76705	$606.00	$606.00	—	24% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Ir Abdominal Us Limited 76705	$606.00	$606.00	—	24% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Abdomen Limited Us 76705	$606.00	$606.00	—	24% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Soft Tissue Low Back 76705	$606.00	$606.00	—	24% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Spleen Ultrasound Ltd 76705	$606.00	$606.00	—	24% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Pediatric Pyloric Stenos 76705	$606.00	$606.00	—	24% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Pancreas Ultrasound Ltd 76705	$606.00	$606.00	—	24% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Soft Tissue Abdomen 76705	$606.00	$606.00	—	24% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 Abdomen Rt Upper Quad Ltd76705	$606.00	$606.00	—	24% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Ir Abdominal Us Limited 76705	$606.00	$606.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Abdomen Limited Us 76705	$606.00	$606.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Gallbladder Us Ltd 76705	$606.00	$606.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Us Soft Tissue Abdomen 76705	$606.00	$606.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Pediatric Pyloric Stenos 76705	$606.00	$606.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Spleen Ultrasound Ltd 76705	$606.00	$606.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Pancreas Ultrasound Ltd 76705	$606.00	$606.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Us Soft Tissue Low Back 76705	$606.00	$606.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Liver Ultrasound Ltd 76705	$606.00	$606.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Us Abdomen Appendix Ltd 76705	$606.00	$606.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 Abdomen Rt Upper Quad Ltd76705	$606.00	$606.00	—	—	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Soft Tissue Groin Us Ltd 76882	$606.00	$606.00	—	41% above	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Extremity Ultrasound Ltd 76882	$606.00	$606.00	—	41% above	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Soft Tissue Axilla Us Ltd76882	$606.00	$606.00	—	41% above	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Us Breast Axillia Lt 76882	$606.00	$606.00	—	41% above	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Us Breast Axillia Rt 76882	$606.00	$606.00	—	41% above	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Extremity L Podiatry Std 76882	$606.00	$606.00	—	41% above	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Extremity R Podiatry Std 76882	$606.00	$606.00	—	41% above	—
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Soft Tissue Axilla Us Ltd76882	$606.00	$606.00	—	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Extremity Ultrasound Ltd 76882	$606.00	$606.00	—	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Soft Tissue Groin Us Ltd 76882	$606.00	$606.00	—	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 Extremity L Podiatry Std 76882	$606.00	$606.00	—	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 Extremity R Podiatry Std 76882	$606.00	$606.00	—	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 Us Breast Axillia Lt 76882	$606.00	$606.00	—	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 Us Breast Axillia Rt 76882	$606.00	$606.00	—	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Lung Cancer Screening	$600.00	$600.00	—	139% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Ct Lung Cancer Screening	$600.00	$600.00	—	—	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tibia Fibula 2 Views Rt 73590	$440.00	$440.00	—	84% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tibia Fibula 2 Views Lt 73590	$440.00	$440.00	—	84% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tibia Fibula Rt Hcc 73590	$440.00	$440.00	—	84% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tibia Fibula Lt Hcc 73590	$440.00	$440.00	—	84% above	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Tibia Fibula Lt Hcc 73590	$440.00	$440.00	—	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Tibia Fibula 2 Views Lt 73590	$440.00	$440.00	—	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Tibia Fibula 2 Views Rt 73590	$440.00	$440.00	—	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Tibia Fibula Rt Hcc 73590	$440.00	$440.00	—	—	—
MR angiography (MRA) of the head without contrast CPT 70544 Mra Head Wo 70544	$1,500.00	$1,500.00	—	3% below	—
MR angiography (MRA) of the head without contrast CPT 70544 Mrv Head Wo 70544	$1,500.00	$1,500.00	—	3% below	—
MR angiography (MRA) of the head without contrast CPT 70544 Openmri Mra Head Wo 70544	$1,948.00	$1,948.00	—	27% above	—
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Mra Head Wo 70544	$1,500.00	$1,500.00	—	—	—
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Mrv Head Wo 70544	$1,500.00	$1,500.00	—	—	—
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Openmri Mra Head Wo 70544	$1,948.00	$1,948.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Openmri Ext Jt Low Wo L 73721	$1,288.00	$1,288.00	—	15% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Extrem Jt Low Wo R 73721	$1,500.00	$1,500.00	—	1% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Extrem Jt Low Wo L 73721	$1,500.00	$1,500.00	—	1% below	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Openmri Ext Jt Low Wo L 73721	$1,288.00	$1,288.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Extrem Jt Low Wo L 73721	$1,500.00	$1,500.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Extrem Jt Low Wo R 73721	$1,500.00	$1,500.00	—	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Extrem Jt Low Wwo L 73723	$3,806.00	$3,806.00	—	52% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Extrem Jt Low Wwo R 73723	$3,806.00	$3,806.00	—	52% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Extrem Jt Low Wwo R 73723	$3,806.00	$3,806.00	—	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Extrem Jt Low Wwo L 73723	$3,806.00	$3,806.00	—	—	—
MRI of the abdomen without contrast CPT 74181 Mri Abdomen Mrcp 74181	$1,500.00	$1,500.00	—	18% below	—
MRI of the abdomen without contrast CPT 74181 Mri Abdomen Wo 74181	$1,500.00	$1,500.00	—	18% below	—
MRI of the abdomen without contrast inpatient CPT 74181 Mri Abdomen Mrcp 74181	$1,500.00	$1,500.00	—	—	—
MRI of the abdomen without contrast inpatient CPT 74181 Mri Abdomen Wo 74181	$1,500.00	$1,500.00	—	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 Mri Abdomen Wwo 74183	$2,122.00	$2,122.00	—	at median	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 Mri Abdomen Wwo 74183	$2,122.00	$2,122.00	—	—	—
MRI of the brain, no contrast dye CPT 70551 Mri Pituitary Wo 70551	$1,500.00	$1,500.00	—	at median	—
MRI of the brain, no contrast dye CPT 70551 Mri Head Wo 70551	$1,500.00	$1,500.00	—	at median	—
MRI of the brain, no contrast dye CPT 70551 Openmri Mri Head Wo 70551	$1,948.00	$1,948.00	—	30% above	—
MRI of the brain, no contrast dye inpatient CPT 70551 Mri Head Wo 70551	$1,500.00	$1,500.00	—	—	—
MRI of the brain, no contrast dye inpatient CPT 70551 Mri Pituitary Wo 70551	$1,500.00	$1,500.00	—	—	—
MRI of the brain, no contrast dye inpatient CPT 70551 Openmri Mri Head Wo 70551	$1,948.00	$1,948.00	—	—	—
MRI of the brain, with and without contrast dye CPT 70553 Mri Head Wwo 70553	$2,122.00	$2,122.00	—	11% below	—
MRI of the brain, with and without contrast dye CPT 70553 Mri Pituitary Wwo 70553	$2,122.00	$2,122.00	—	11% below	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 Mri Pituitary Wwo 70553	$2,122.00	$2,122.00	—	—	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 Mri Head Wwo 70553	$2,122.00	$2,122.00	—	—	—
MRI of the lower back, no contrast dye CPT 72148 Mri Spine Lumbar Wo 72148	$1,500.00	$1,500.00	—	12% below	—
MRI of the lower back, no contrast dye inpatient CPT 72148 Mri Spine Lumbar Wo 72148	$1,500.00	$1,500.00	—	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 Mri Spine Lumbar Wwo 72158	$2,122.00	$2,122.00	—	10% below	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 Mri Spine Lumbar Wwo 72158	$2,122.00	$2,122.00	—	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mri Spine Thoracic Wo 72146	$1,500.00	$1,500.00	—	15% below	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 Mri Spine Thoracic Wo 72146	$1,500.00	$1,500.00	—	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 Mri Spine Cervical Wwo 72156	$2,122.00	$2,122.00	—	11% below	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 Mri Spine Cervical Wwo 72156	$2,122.00	$2,122.00	—	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 Mri Spine Cervical Wo 72141	$1,500.00	$1,500.00	—	15% below	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 Mri Spine Cervical Wo 72141	$1,500.00	$1,500.00	—	—	—
MRI of the pelvis without and with contrast CPT 72197 Mri Pelvis Wwo 72197	$2,122.00	$2,122.00	—	at median	—
MRI of the pelvis without and with contrast inpatient CPT 72197 Mri Pelvis Wwo 72197	$2,122.00	$2,122.00	—	—	—
MRI of the pelvis, no contrast dye CPT 72195 Mri Pelvis Wo 72195	$1,500.00	$1,500.00	—	12% below	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 Mri Pelvis Wo 72195	$1,500.00	$1,500.00	—	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Extrem Jt Up Wo L 73221	$1,500.00	$1,500.00	—	3% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Extrem Jt Up Wo R 73221	$1,500.00	$1,500.00	—	3% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Chest Sternclv J Wo L73221	$1,500.00	$1,500.00	—	3% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Chest Sternclv J Wo R73221	$1,500.00	$1,500.00	—	3% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Chest Sternclv J Wo R73221	$1,500.00	$1,500.00	—	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Extrem Jt Up Wo R 73221	$1,500.00	$1,500.00	—	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Extrem Jt Up Wo L 73221	$1,500.00	$1,500.00	—	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Chest Sternclv J Wo L73221	$1,500.00	$1,500.00	—	—	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Spine Cervical Wobliques 72050	$566.00	$566.00	—	34% above	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Spine Cervical Woblq Hcc 72050	$566.00	$566.00	—	34% above	—
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Spine Cervical Wobliques 72050	$566.00	$566.00	—	—	—
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Spine Cervical Woblq Hcc 72050	$566.00	$566.00	—	—	—
Neck soft tissue CT scan with contrast CPT 70491 Ct Neck W 70491	$1,157.00	$1,157.00	—	24% below	—
Neck soft tissue CT scan with contrast inpatient CPT 70491 Ct Neck W 70491	$1,157.00	$1,157.00	—	—	—
Neck soft tissue CT scan without contrast CPT 70490 Ct Neck Wo 70490	$1,157.00	$1,157.00	—	17% above	—
Neck soft tissue CT scan without contrast inpatient CPT 70490 Ct Neck Wo 70490	$1,157.00	$1,157.00	—	—	—
Neck soft tissue X-ray CPT 70360 Neck Soft Tissue Hcc 70360	$445.00	$445.00	—	120% above	—
Neck soft tissue X-ray CPT 70360 Neck Soft Tissue 70360	$445.00	$445.00	—	120% above	—
Neck soft tissue X-ray inpatient CPT 70360 Neck Soft Tissue Hcc 70360	$445.00	$445.00	—	—	—
Neck soft tissue X-ray inpatient CPT 70360 Neck Soft Tissue 70360	$445.00	$445.00	—	—	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Cardiac Rest Stress Sest 78452	$5,387.00	$5,387.00	—	87% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Cardiac Rest Stress Thal 78452	$5,387.00	$5,387.00	—	87% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nm Rest And Stress Spect 78452	$5,387.00	$5,387.00	—	87% above	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Cardiac Rest Stress Sest 78452	$5,387.00	$5,387.00	—	—	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Cardiac Rest Stress Thal 78452	$5,387.00	$5,387.00	—	—	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Nm Rest And Stress Spect 78452	$5,387.00	$5,387.00	—	—	—
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Tumor Skull Mi Thigh 78815	$7,795.00	$7,795.00	—	121% above	—
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Pet Tumor Skull Mi Thigh 78815	$7,795.00	$7,795.00	—	—	—
Pelvic CT scan without contrast CPT 72192 Ct Pelvis Wo 72192	$1,275.00	$1,275.00	—	at median	—
Pelvic CT scan without contrast inpatient CPT 72192 Ct Pelvis Wo 72192	$1,275.00	$1,275.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Pelvic Mass Limited Us 76857	$606.00	$606.00	—	82% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us Soft Tissue Buttock 76857	$606.00	$606.00	—	82% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Bladder Urine Retent Vol 76857	$606.00	$606.00	—	82% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Bladder Urine Retent Vol 76857	$606.00	$606.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Pelvic Mass Limited Us 76857	$606.00	$606.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Us Soft Tissue Buttock 76857	$606.00	$606.00	—	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Pelvic Mass Ultrasound 76856	$606.00	$606.00	—	26% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Male Pelvis Ultrasound 76856	$606.00	$606.00	—	26% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Male Pelvis Ultrasound 76856	$606.00	$606.00	—	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Pelvic Mass Ultrasound 76856	$606.00	$606.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Us Preg 2Nd3Rd Tri Snggs 76805	$606.00	$606.00	—	12% above	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Us Preg 2Nd3Rd Tri Snggs 76805	$606.00	$606.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Pregnancy 1St Tri Sng Gs 76801	$606.00	$606.00	—	26% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Pregnancy 1St Tri Sng Gs 76801	$606.00	$606.00	—	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Pregnancy Limited Us 76815	$606.00	$606.00	—	112% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Pregnancy Limited Us 76815	$606.00	$606.00	—	—	—
Rib X-ray, one side, 2 views one side CPT 71100 Ribs 2 Views Rt 71100	$440.00	$440.00	—	92% above	—
Rib X-ray, one side, 2 views one side CPT 71100 Ribs 2 Views Lt 71100	$440.00	$440.00	—	92% above	—
Rib X-ray, one side, 2 views one side CPT 71100 Ribs Lt Hcc 71100	$440.00	$440.00	—	92% above	—
Rib X-ray, one side, 2 views one side CPT 71100 Ribs Rt Hcc 71100	$440.00	$440.00	—	92% above	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs Rt Hcc 71100	$440.00	$440.00	—	—	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs 2 Views Lt 71100	$440.00	$440.00	—	—	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs 2 Views Rt 71100	$440.00	$440.00	—	—	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs Lt Hcc 71100	$440.00	$440.00	—	—	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs With Pa Chest Lt 71101	$566.00	$566.00	—	89% above	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs With Pa Chest Rt 71101	$566.00	$566.00	—	89% above	—
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Ribs With Pa Chest Lt 71101	$566.00	$566.00	—	—	—
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Ribs With Pa Chest Rt 71101	$566.00	$566.00	—	—	—
Screening mammogram, both breasts CPT 77067 Mammo Digital Bil Screen 77067	$419.00	$419.00	—	86% above	—
Screening mammogram, both breasts CPT 77067 Mammo Digital Uni Scn 7706752	$419.00	$419.00	—	86% above	—
Screening mammogram, both breasts inpatient CPT 77067 Mammo Digital Uni Scn 7706752	$419.00	$419.00	—	—	—
Screening mammogram, both breasts inpatient CPT 77067 Mammo Digital Bil Screen 77067	$419.00	$419.00	—	—	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Shoulder Minimum 2View Rt73030	$440.00	$440.00	—	102% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Lt M2V Hcc 73030	$440.00	$440.00	—	102% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Minimum 2View Lt73030	$440.00	$440.00	—	102% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Rt M2V Hcc 73030	$440.00	$440.00	—	102% above	—
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Shoulder Minimum 2View Rt73030	$440.00	$440.00	—	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Lt M2V Hcc 73030	$440.00	$440.00	—	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Rt M2V Hcc 73030	$440.00	$440.00	—	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Minimum 2View Lt73030	$440.00	$440.00	—	—	—
Sinus X-ray, complete, 3 or more views CPT 70220 Sinus Series M3V 70220	$440.00	$440.00	—	31% above	—
Sinus X-ray, complete, 3 or more views CPT 70220 Sinus Series M3V Hcc 70220	$440.00	$440.00	—	31% above	—
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Sinus Series M3V Hcc 70220	$440.00	$440.00	—	—	—
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Sinus Series M3V 70220	$440.00	$440.00	—	—	—
Skull X-ray, fewer than 4 views CPT 70250 Head Skull Ap Lat 70250	$566.00	$566.00	—	166% above	—
Skull X-ray, fewer than 4 views CPT 70250 Head Skull Ap Lat Hcc 70250	$566.00	$566.00	—	166% above	—
Skull X-ray, fewer than 4 views inpatient CPT 70250 Head Skull Ap Lat 70250	$566.00	$566.00	—	—	—
Skull X-ray, fewer than 4 views inpatient CPT 70250 Head Skull Ap Lat Hcc 70250	$566.00	$566.00	—	—	—
Sleep study in a lab (polysomnography) CPT 95810 Sleep Std Psg4 Gt6H Gt6A 95810	$6,290.00	$6,290.00	—	189% above	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 Sleep Std Psg4 Gt6H Gt6A 95810	$6,290.00	$6,290.00	—	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 Barium Swallow Modified 74230	$938.00	$938.00	—	188% above	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Barium Swallow Modified 74230	$938.00	$938.00	—	—	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Rt Hcc 73552	$440.00	$440.00	—	95% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Left Hcc 73552	$440.00	$440.00	—	95% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Minimum 2 Views Lt 73552	$440.00	$440.00	—	95% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Minimum 2 Views Rt 73552	$440.00	$440.00	—	95% above	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur Minimum 2 Views Rt 73552	$440.00	$440.00	—	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur Minimum 2 Views Lt 73552	$440.00	$440.00	—	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur Rt Hcc 73552	$440.00	$440.00	—	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur Left Hcc 73552	$440.00	$440.00	—	—	—
Thoracic spine (mid back) CT scan without contrast CPT 72128 Ct Spine Thoracic Wo 72128	$1,275.00	$1,275.00	—	1% below	—
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 Ct Spine Thoracic Wo 72128	$1,275.00	$1,275.00	—	—	—
Toe X-ray, 2 or more views one side CPT 73660 Toes Minimum 2 Views Rt 73660	$440.00	$440.00	—	142% above	—
Toe X-ray, 2 or more views one side CPT 73660 Toes Rt Hcc 73660	$440.00	$440.00	—	142% above	—
Toe X-ray, 2 or more views one side CPT 73660 Toes Lt Hcc 73660	$440.00	$440.00	—	142% above	—
Toe X-ray, 2 or more views one side CPT 73660 Toes Minimum 2 Views Lt 73660	$440.00	$440.00	—	142% above	—
Toe X-ray, 2 or more views inpatient one side CPT 73660 Toes Lt Hcc 73660	$440.00	$440.00	—	—	—
Toe X-ray, 2 or more views inpatient one side CPT 73660 Toes Rt Hcc 73660	$440.00	$440.00	—	—	—
Toe X-ray, 2 or more views inpatient one side CPT 73660 Toes Minimum 2 Views Rt 73660	$440.00	$440.00	—	—	—
Toe X-ray, 2 or more views inpatient one side CPT 73660 Toes Minimum 2 Views Lt 73660	$440.00	$440.00	—	—	—
Transvaginal pelvic ultrasound CPT 76830 Transvaginal Non Ob Us 76830	$606.00	$606.00	—	24% above	—
Transvaginal pelvic ultrasound inpatient CPT 76830 Transvaginal Non Ob Us 76830	$606.00	$606.00	—	—	—
Transvaginal ultrasound during pregnancy CPT 76817 Pregnancy Transvaginal 76817	$606.00	$606.00	—	57% above	—
Transvaginal ultrasound during pregnancy CPT 76817 Us Preg Cerv Length Tv 76817	$606.00	$606.00	—	57% above	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Us Preg Cerv Length Tv 76817	$606.00	$606.00	—	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Pregnancy Transvaginal 76817	$606.00	$606.00	—	—	—
Ultrasound of the abdomen, complete CPT 76700 Ir Abdominal Ultrasound 76700	$600.00	$600.00	—	18% below	—
Ultrasound of the abdomen, complete CPT 76700 Abdomen Ultrasound 76700	$606.00	$606.00	—	17% below	—
Ultrasound of the abdomen, complete inpatient CPT 76700 Ir Abdominal Ultrasound 76700	$600.00	$600.00	—	—	—
Ultrasound of the abdomen, complete inpatient CPT 76700 Abdomen Ultrasound 76700	$606.00	$606.00	—	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Soft Tissue Neck Head 76536	$606.00	$606.00	—	at median	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Thyroid Ultrasound 76536	$606.00	$606.00	—	at median	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Soft Tissue Neck Head 76536	$606.00	$606.00	—	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Thyroid Ultrasound 76536	$606.00	$606.00	—	—	—
Upper arm X-ray (humerus), 2 views CPT 73060 Humerus R 73060	$440.00	$440.00	—	87% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Lt Hcc 73060	$440.00	$440.00	—	87% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus L 73060	$440.00	$440.00	—	87% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Rt Hcc 73060	$440.00	$440.00	—	87% above	—
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 Humerus R 73060	$440.00	$440.00	—	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Rt Hcc 73060	$440.00	$440.00	—	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Lt Hcc 73060	$440.00	$440.00	—	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus L 73060	$440.00	$440.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Doppler Venous U Low Ext 93971	$610.00	$610.00	—	2% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Doppler Venous U Up Ext 93971	$610.00	$610.00	—	2% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Doppler Venous Rt Up Ext 93971	$610.00	$610.00	—	2% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Insufficiency Lt 93971	$610.00	$610.00	—	2% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Doppler Venous Lt Up Ext 93971	$610.00	$610.00	—	2% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Doppler Venous Lt Lo Ext 93971	$610.00	$610.00	—	2% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Doppler Venous Rt Lo Ext 93971	$610.00	$610.00	—	2% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Insufficiency Rt 93971	$610.00	$610.00	—	2% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Doppler Venous U Low Ext 93971	$610.00	$610.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Doppler Venous U Up Ext 93971	$610.00	$610.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Insufficiency Lt 93971	$610.00	$610.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Doppler Venous Rt Up Ext 93971	$610.00	$610.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Doppler Venous Lt Up Ext 93971	$610.00	$610.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Doppler Venous Lt Lo Ext 93971	$610.00	$610.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Doppler Venous Rt Lo Ext 93971	$610.00	$610.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Insufficiency Rt 93971	$610.00	$610.00	—	—	—
Wrist X-ray, 2 views one side CPT 73100 Wrist 2 Views Rt 73100	$440.00	$440.00	—	132% above	—
Wrist X-ray, 2 views one side CPT 73100 Wrist 2 Views Lt 73100	$440.00	$440.00	—	132% above	—
Wrist X-ray, 2 views one side CPT 73100 Wrist Lt 2 Views Hcc 73100	$440.00	$440.00	—	132% above	—
Wrist X-ray, 2 views one side CPT 73100 Wrist Rt 2 Views Hcc 73100	$440.00	$440.00	—	132% above	—
Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist Rt 2 Views Hcc 73100	$440.00	$440.00	—	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist Lt 2 Views Hcc 73100	$440.00	$440.00	—	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist 2 Views Rt 73100	$440.00	$440.00	—	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist 2 Views Lt 73100	$440.00	$440.00	—	—	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Minimum 3 Views Rt 73110	$440.00	$440.00	—	87% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Rt Hcc 73110	$440.00	$440.00	—	87% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Lt Hcc 73110	$440.00	$440.00	—	87% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Minimum 3 Views Lt 73110	$440.00	$440.00	—	87% above	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Lt Hcc 73110	$440.00	$440.00	—	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Minimum 3 Views Lt 73110	$440.00	$440.00	—	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Minimum 3 Views Rt 73110	$440.00	$440.00	—	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Rt Hcc 73110	$440.00	$440.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Left Hcc 73502	$440.00	$440.00	—	133% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip 2 To 3 Views Rt 73502	$440.00	$440.00	—	133% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip 2 To 3 Views Lt 73502	$440.00	$440.00	—	133% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Rt Hcc 73502	$440.00	$440.00	—	133% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip 2 To 3 Views Lt 73502	$440.00	$440.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Rt Hcc 73502	$440.00	$440.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Left Hcc 73502	$440.00	$440.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip 2 To 3 Views Rt 73502	$440.00	$440.00	—	—	—
X-ray of the abdomen, 1 view CPT 74018 Abdomen Upright Kub 74018	$445.00	$445.00	—	107% above	—
X-ray of the abdomen, 1 view CPT 74018 Abdomen 1View Kub Hcc 74018	$445.00	$445.00	—	107% above	—
X-ray of the abdomen, 1 view CPT 74018 Abdomen Sitz Marker Stdy 74018	$445.00	$445.00	—	107% above	—
X-ray of the abdomen, 1 view CPT 74018 Abdomen Upright Kub Hcc 74018	$445.00	$445.00	—	107% above	—
X-ray of the abdomen, 1 view CPT 74018 Abdomen Kub Wgastrograff 74018	$445.00	$445.00	—	107% above	—
X-ray of the abdomen, 1 view CPT 74018 Abdomen 1View Kub 74018	$445.00	$445.00	—	107% above	—
X-ray of the abdomen, 1 view CPT 74018 Abdomen 1 View Kub Ir 74018	$445.00	$445.00	—	107% above	—
X-ray of the abdomen, 1 view CPT 74018 Abdomen Sitz Marker Hcc 74018	$445.00	$445.00	—	107% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen 1View Kub 74018	$445.00	$445.00	—	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen Sitz Marker Hcc 74018	$445.00	$445.00	—	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen Upright Kub Hcc 74018	$445.00	$445.00	—	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen 1View Kub Hcc 74018	$445.00	$445.00	—	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen Upright Kub 74018	$445.00	$445.00	—	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen Sitz Marker Stdy 74018	$445.00	$445.00	—	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen Kub Wgastrograff 74018	$445.00	$445.00	—	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen 1 View Kub Ir 74018	$445.00	$445.00	—	—	—
X-ray of the ankle, 2 views one side CPT 73600 Ankle Lt 2 Views Hcc 73600	$440.00	$440.00	—	108% above	—
X-ray of the ankle, 2 views one side CPT 73600 Ankle 2 Views Rt 73600	$440.00	$440.00	—	108% above	—
X-ray of the ankle, 2 views one side CPT 73600 Ankle Rt 2 Views Hcc 73600	$440.00	$440.00	—	108% above	—
X-ray of the ankle, 2 views one side CPT 73600 Ankle 2 Views Lt 73600	$440.00	$440.00	—	108% above	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle 2 Views Rt 73600	$440.00	$440.00	—	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle Lt 2 Views Hcc 73600	$440.00	$440.00	—	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle 2 Views Lt 73600	$440.00	$440.00	—	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle Rt 2 Views Hcc 73600	$440.00	$440.00	—	—	—
X-ray of the finger(s), 2 or more views CPT 73140 Finger L 73140	$440.00	$440.00	—	123% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger Rt Hcc 73140	$440.00	$440.00	—	123% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger R 73140	$440.00	$440.00	—	123% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger Lt Hcc 73140	$440.00	$440.00	—	123% above	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 Finger L 73140	$440.00	$440.00	—	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger Lt Hcc 73140	$440.00	$440.00	—	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger R 73140	$440.00	$440.00	—	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger Rt Hcc 73140	$440.00	$440.00	—	—	—
X-ray of the foot, 2 views CPT 73620 Foot R Ap Lat Wweight Hcc73620	$440.00	$440.00	—	137% above	—
X-ray of the foot, 2 views one side CPT 73620 Foot L Ap Lat Wweight Hcc73620	$440.00	$440.00	—	137% above	—
X-ray of the foot, 2 views one side CPT 73620 Foot Lt 2 Views Hcc 73620	$440.00	$440.00	—	137% above	—
X-ray of the foot, 2 views one side CPT 73620 Foot Rt 2 Views Hcc 73620	$440.00	$440.00	—	137% above	—
X-ray of the foot, 2 views one side CPT 73620 Foot Ap Lat Weight Lt 73620	$440.00	$440.00	—	137% above	—
X-ray of the foot, 2 views one side CPT 73620 Foot Ap Lat Weight Rt 73620	$440.00	$440.00	—	137% above	—
X-ray of the foot, 2 views one side CPT 73620 Foot 2 Views Lt 73620	$440.00	$440.00	—	137% above	—
X-ray of the foot, 2 views one side CPT 73620 Foot 2 Views Rt 73620	$440.00	$440.00	—	137% above	—
X-ray of the foot, 2 views inpatient CPT 73620 Foot R Ap Lat Wweight Hcc73620	$440.00	$440.00	—	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 Foot Rt 2 Views Hcc 73620	$440.00	$440.00	—	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 Foot L Ap Lat Wweight Hcc73620	$440.00	$440.00	—	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 Foot 2 Views Rt 73620	$440.00	$440.00	—	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 Foot 2 Views Lt 73620	$440.00	$440.00	—	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 Foot Ap Lat Weight Rt 73620	$440.00	$440.00	—	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 Foot Ap Lat Weight Lt 73620	$440.00	$440.00	—	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 Foot Lt 2 Views Hcc 73620	$440.00	$440.00	—	—	—
X-ray of the foot, complete, 3 or more views CPT 73630 Foot Minimum 3 Views Bl 73630	$440.00	$440.00	—	70% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Minimum 3 Views Lt 73630	$440.00	$440.00	—	70% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Lt Hcc 73630	$440.00	$440.00	—	70% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Minimum 3 Views Rt 73630	$440.00	$440.00	—	70% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Rt Hcc 73630	$440.00	$440.00	—	70% above	—
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Foot Minimum 3 Views Bl 73630	$440.00	$440.00	—	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot Minimum 3 Views Rt 73630	$440.00	$440.00	—	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot Minimum 3 Views Lt 73630	$440.00	$440.00	—	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot Lt Hcc 73630	$440.00	$440.00	—	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot Rt Hcc 73630	$440.00	$440.00	—	—	—
X-ray of the hand, 3 or more views one side CPT 73130 Hand Rt Hcc 73130	$440.00	$440.00	—	107% above	—
X-ray of the hand, 3 or more views one side CPT 73130 Hand Minimum 3 Views Lt 73130	$440.00	$440.00	—	107% above	—
X-ray of the hand, 3 or more views one side CPT 73130 Hand Minimum 3 Views Rt 73130	$440.00	$440.00	—	107% above	—
X-ray of the hand, 3 or more views one side CPT 73130 Hand Lt Hcc 73130	$440.00	$440.00	—	107% above	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Lt Hcc 73130	$440.00	$440.00	—	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Minimum 3 Views Lt 73130	$440.00	$440.00	—	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Minimum 3 Views Rt 73130	$440.00	$440.00	—	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Rt Hcc 73130	$440.00	$440.00	—	—	—
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Rt Ap Lat Hcc 73560	$440.00	$440.00	—	123% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 1 Or 2 Views Lt 73560	$440.00	$440.00	—	123% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 1 Or 2 Views Rt 73560	$440.00	$440.00	—	123% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Ap Lat Weight Rt 73560	$440.00	$440.00	—	123% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Ap Lat Weight Lt 73560	$440.00	$440.00	—	123% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee L Ap Lat Wweight Hcc73560	$440.00	$440.00	—	123% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Lt Ap Lat Hcc 73560	$440.00	$440.00	—	123% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee R Ap Lat Wweight Hcc73560	$440.00	$440.00	—	123% above	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Rt Ap Lat Hcc 73560	$440.00	$440.00	—	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee 1 Or 2 Views Rt 73560	$440.00	$440.00	—	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee R Ap Lat Wweight Hcc73560	$440.00	$440.00	—	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Lt Ap Lat Hcc 73560	$440.00	$440.00	—	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Ap Lat Weight Rt 73560	$440.00	$440.00	—	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee 1 Or 2 Views Lt 73560	$440.00	$440.00	—	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee L Ap Lat Wweight Hcc73560	$440.00	$440.00	—	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Ap Lat Weight Lt 73560	$440.00	$440.00	—	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Spine Lumbar Ap Lat Hcc 72100	$566.00	$566.00	—	66% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Spine Lumbar Ap Lat 72100	$566.00	$566.00	—	66% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Spine Lumbar Ap Lat 72100	$566.00	$566.00	—	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Spine Lumbar Ap Lat Hcc 72100	$566.00	$566.00	—	—	—
X-ray of the lower back, 4 or more views CPT 72110 Spine Lumbar Woblique Hcc72110	$566.00	$566.00	—	22% above	—
X-ray of the lower back, 4 or more views CPT 72110 Spine Lumbar Wobliques 72110	$566.00	$566.00	—	22% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 Spine Lumbar Woblique Hcc72110	$566.00	$566.00	—	—	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 Spine Lumbar Wobliques 72110	$566.00	$566.00	—	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Spinethoracic Flexextend 72070	$566.00	$566.00	—	112% above	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Spinethoracic Flx Ext Hcc72070	$566.00	$566.00	—	112% above	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Spinethoracic Flx Ext Hcc72070	$566.00	$566.00	—	—	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Spinethoracic Flexextend 72070	$566.00	$566.00	—	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 Nasal Bones Min 3 Views 70160	$440.00	$440.00	—	87% above	—
X-ray of the nasal bones, 3 or more views CPT 70160 Face Nasal Bones Hcc 70160	$440.00	$440.00	—	87% above	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Face Nasal Bones Hcc 70160	$440.00	$440.00	—	—	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Nasal Bones Min 3 Views 70160	$440.00	$440.00	—	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Spine Cervical Ap Lat Hcc72040	$440.00	$440.00	—	54% above	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Spine Cervical Ap Lat 72040	$440.00	$440.00	—	54% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Spine Cervical Ap Lat Hcc72040	$440.00	$440.00	—	—	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Spine Cervical Ap Lat 72040	$440.00	$440.00	—	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis Hcc 72170	$566.00	$566.00	—	174% above	—
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis 1 Or 2 Views 72170	$566.00	$566.00	—	174% above	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvis 1 Or 2 Views 72170	$566.00	$566.00	—	—	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvis Hcc 72170	$566.00	$566.00	—	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Spine Sacrum Coccyx Hcc 72220	$440.00	$440.00	—	68% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Spine Sacrum Coccyx 72220	$440.00	$440.00	—	68% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Spine Sacrum Coccyx Hcc 72220	$440.00	$440.00	—	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Spine Sacrum Coccyx 72220	$440.00	$440.00	—	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
ACTH blood test CPT 82024 Acth Plasma 82024	$178.00	$178.00	—	3% above	—
ACTH blood test inpatient CPT 82024 Acth Plasma 82024	$178.00	$178.00	—	—	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase Alt	$26.00	$26.00	—	19% below	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase 84460	$26.00	$26.00	—	19% below	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanineaminotransferasalt84460	$26.00	$26.00	—	19% below	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanineaminotransferasalt84460	$26.00	$26.00	—	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase 84460	$26.00	$26.00	—	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase Alt	$26.00	$26.00	—	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Asparateaminotransferase 84450	$25.00	$25.00	—	20% below	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Asparate Aminotransferase Ast	$25.00	$25.00	—	20% below	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Asparate Aminotranfer 84450	$25.00	$25.00	—	20% below	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransfer 84450	$25.00	$25.00	—	20% below	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Asparate Aminotranfer 84450	$25.00	$25.00	—	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Asparate Aminotransferase Ast	$25.00	$25.00	—	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransfer 84450	$25.00	$25.00	—	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Asparateaminotransferase 84450	$25.00	$25.00	—	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel Acute Inhouse	$219.00	$219.00	—	21% below	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel Acute Inhouse	$219.00	$219.00	—	—	—
Albumin blood test CPT 82040 Albumin 82040	$23.00	$23.00	—	36% below	—
Albumin blood test CPT 82040 Albumin Serum 82040	$24.00	$24.00	—	33% below	—
Albumin blood test CPT 82040 Albumin Serum Plasma 82040	$24.00	$24.00	—	33% below	—
Albumin blood test CPT 82040 Albumin Serum	$24.00	$24.00	—	33% below	—
Albumin blood test inpatient CPT 82040 Albumin 82040	$23.00	$23.00	—	—	—
Albumin blood test inpatient CPT 82040 Albumin Serum 82040	$24.00	$24.00	—	—	—
Albumin blood test inpatient CPT 82040 Albumin Serum	$24.00	$24.00	—	—	—
Albumin blood test inpatient CPT 82040 Albumin Serum Plasma 82040	$24.00	$24.00	—	—	—
Aldosterone blood test CPT 82088 Aldosterone 82088	$187.00	$187.00	—	14% above	—
Aldosterone blood test CPT 82088 Aldosterone 24H Ur 82088	$187.00	$187.00	—	14% above	—
Aldosterone blood test CPT 82088 Aldosterone 24 Hour Ur 82088	$187.00	$187.00	—	14% above	—
Aldosterone blood test CPT 82088 Aldosterone Lc Ms Ms 82088	$187.00	$187.00	—	14% above	—
Aldosterone blood test inpatient CPT 82088 Aldosterone 24H Ur 82088	$187.00	$187.00	—	—	—
Aldosterone blood test inpatient CPT 82088 Aldosterone 24 Hour Ur 82088	$187.00	$187.00	—	—	—
Aldosterone blood test inpatient CPT 82088 Aldosterone Lc Ms Ms 82088	$187.00	$187.00	—	—	—
Aldosterone blood test inpatient CPT 82088 Aldosterone 82088	$187.00	$187.00	—	—	—
Alkaline phosphatase (ALP) blood test CPT 84075 Akaline Phosphate 84075	$25.00	$25.00	—	43% below	—
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase 84075	$25.00	$25.00	—	43% below	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase 84075	$25.00	$25.00	—	—	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Akaline Phosphate 84075	$25.00	$25.00	—	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 Tree Nut Allergy 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mango Fruit F91 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Casein Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Lysozyme Rk208 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Beta Lactoglobulin Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Bahia Grass Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Alpha Lactalbumin Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut Total Wreflex To Panel	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Apple Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cultivated Wheat Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Onion Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Garlic Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Johnson Grass Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Yeast F45 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pork F26 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Plum F255 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Lobster F80 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Sunflower Seed K84 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Scallop F338 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Rabbit F213 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Honey Bee Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 White Faced Hornet Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Yellow Jacket Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Paper Wasp Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Strawberry F44 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Red Top Grass Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Salmon F41 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Oyster F290 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Tuna F40 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 June Grass Kentucky Blue 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Blue Mussel F37 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mushroon Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Yellow Hornet Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cockroach I6 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Fire Ant Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mosquito Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Squid F258 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Turkey Meat F284 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Barley Pollen Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Coconut F36 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Timothy Grass Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Potato Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Honey F247 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Orange Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Perennial Rye Grass F5 Ige	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Carrot Ige 860	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Clam F207 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pork F26 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Meadow Fescue G4 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Tomato Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Avacado Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Shrimp F24 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Bermuda Grass Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Crab F23 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Latex K82 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Almond F20 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cedar Rt212 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Egg White Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Brazil Nut F18 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Banana Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Hazelnut F17 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Formaldehyde Formalinige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cows Milk Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Codfish Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Wheat Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Rye Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Egg Yolk F75 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mandarin F302 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Nutmeg F282 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Gluten F79 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Chicken Meat Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cheddar Cheese Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cashew Nut Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cheese Mold Type F82 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Brewer Yeast Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Celery F85 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cacao Chocolate Igg 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Parsley F86 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Barley Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Oat F7 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Maize Corn Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Swiss Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Rice F9 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Lettuce F215 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Sesame Seed F10 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Buckwheat Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 White Bean 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pear Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Soybean Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Venison Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Peach Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pea Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Annatto Seed 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Pnl Seafood Grp 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Finch Feathers Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Panel Nutmix Grp 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Aller Spec Ige Cantaloup 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Pnl 14 Pedsgrp 8600359	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mozarella Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Pnl 14 Peds Grp 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allerge Spec Ige Lactase 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Yellow Jacket I3 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Rast Aspen 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Yellow Hornet I5 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Shellfish Panel 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Whitefaced Hornet I2 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Crab F23 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Paper Wasp I4 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Coriander Cilantro Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Honey Bee I1 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Flaxseed F333 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Penicilloyl V Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Romano Cheese Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Penicilloyl G Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Food Allergy Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Tea F222 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Stemphylium Botryosum Ige86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Carmine Red Dye Extract 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Rhizopus Nigricans Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pork Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Phoma Betae M13 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Lamb Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Helminthosporium Halodes 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Beef Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Fusarium Moniliforme Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Respiratory Allergen 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Epicoccum Purpurascens 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cocklebur W13 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Curvularia Lunata Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Rough Pigweed Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Botrytis Cinerea M7 Ige86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Sheep Sorrel Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Aureobasidiumpullulansige86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Nettle Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Aspen Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Maple Box Elder Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pepper Cayenne 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Birch T3 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Bean Pinto Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Hazel Nut Tree Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Bean Navy Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mountain Cedar Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Wall Eyed Pike 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Oak Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allspice F339 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Elm Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Chick Pea Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Sycamore Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Crayfish Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Rast Psyllium Seed Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Malt F90 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Common Ragweed Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pecan Nut F201 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Rast Tilapia Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cocoa Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Goose Feathers Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Parrot Parakeet Feathers 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Willow T12 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Black Olive Rf342 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cottonwood T14 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Amoxicillin C6 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 White Ash T15 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Macadamia Nut 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 White Pine Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Parmesan Cheese Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Hickory Pecan Tree Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Venom Bumble Bee Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Turkey Feathers Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Catfish F369 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Canary Bird Feathers Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Yellow Squash Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Deer Epithelium Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Zucchini Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Sweet Potato Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cranberry Rf341 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Black Pepper F280 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pinto Bean Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Apricot Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cows Milk Ige W Rflx To Panel	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Basil F269 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Trichophyton Mentagrophyte Ige	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Blueberry Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cockroach American Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 White Mulberry Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Giant Ragweed Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Kiwi Fruit F84 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Flounder Ige 23893 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Melon F87 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mugwort W6 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Lamb F88 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Whitefish Ige Allergen 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cat Dander Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Specific Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Horse Dander Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mustard F89 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 English Plantain Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Coffee F221 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Hickory White Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cow Dander Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus Niger Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Dog Dander Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Duck Feathers Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Walnut F256 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Guinea Pig Epithelia 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Black Bean 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cashew Nut F202Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Grape Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Green Bean Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Penicillium Notatum Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cladosporium Herbarum Ige86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus Fumigatus Ige86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pine Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dog Fennel Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Chestnut Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Curry F281 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Chaetomium Globosum Ige	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cherry F242 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Sweet Gum Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Chili Pepper F279 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Privet T210 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pigeon Feathers Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Penicillium Glabrum Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Asparagus F261 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Acremonium Kiliense Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Raspberry Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Whey F236 Ige	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Blackberry F211 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Vanilla F234 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Broccoli F260 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Watermelon Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cabbage F216 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Dog Fennel W46 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cauliflower F291 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Trout Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Thyme F273 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cinnamon Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Papaya F293 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Lambs Quarters Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Dill F277 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Sugar Cane Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Spinach Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cucumber F244 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cayenne Pepper Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ginger F270 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Red Kidney Bean Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Chicken Feathers Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pumpkin F225 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Hamster Epithelia Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Egg Yolk White Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Goldenrod W12 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Goat Milk Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Grapefruit Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Green Pepper F263 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pistachio F203 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pine Nut Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pineapple 210 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Rabbit Epithelia Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Paprika F218 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mouse Urine Proteins 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mucor Racemosus Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Candida Albicans Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Alternaria Alternata Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Lemon F208 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Lime F306 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Oregano F283 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Passion Fruit F294 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Lentils Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Guava F292 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 House Dust Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mackerel F206 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Galactose Alpha 1 3 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Dermatophagoides Farinae 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Halibut F303 Ige 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Dermatophagoides Pterony 86003	$24.00	$24.00	—	15% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Tree Nut Allergy Panel 86003	$25.00	$25.00	—	11% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Chestnut Sweet F299 Ige 86003	$25.00	$25.00	—	11% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ovalbumin F232 Ige 86003	$83.00	$83.00	—	194% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pineapple 210 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sugar Cane Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dog Fennel Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Whitefish Ige Allergen 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Flounder Ige 23893 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rast Tilapia Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rast Psyllium Seed Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cacao Chocolate Igg 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cashew Nut Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tree Nut Allergy 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lysozyme Rk208 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peanut Total Wreflex To Panel	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pork F26 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oyster F290 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mushroon Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Honey F247 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Clam F207 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Avacado Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Latex K82 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Banana Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pear Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peach Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy Pnl Seafood Grp 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy Panel Nutmix Grp 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy Pnl 14 Pedsgrp 8600359	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy Pnl 14 Peds Grp 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Yellow Jacket I3 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Yellow Hornet I5 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Whitefaced Hornet I2 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Paper Wasp I4 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Honey Bee I1 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicilloyl V Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicilloyl G Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tea F222 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Stemphylium Botryosum Ige86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rhizopus Nigricans Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Phoma Betae M13 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Helminthosporium Halodes 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Fusarium Moniliforme Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Epicoccum Purpurascens 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Curvularia Lunata Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Botrytis Cinerea M7 Ige86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aureobasidiumpullulansige86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspen Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pepper Cayenne 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bean Pinto Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bean Navy Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Wall Eyed Pike 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allspice F339 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chick Pea Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Crayfish Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Black Olive Rf342 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Amoxicillin C6 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Macadamia Nut 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Parmesan Cheese Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Venom Bumble Bee Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Catfish F369 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Yellow Squash Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Zucchini Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cranberry Rf341 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pinto Bean Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cows Milk Ige W Rflx To Panel	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Trichophyton Mentagrophyte Ige	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cockroach American Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Specific Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy Specific Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hickory White Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus Niger Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Walnut F256 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Black Bean 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pine Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chestnut Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chaetomium Globosum Ige	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sweet Gum Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Privet T210 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicillium Glabrum Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Acremonium Kiliense Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Whey F236 Ige	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Vanilla F234 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Watermelon Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dog Fennel W46 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Trout Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Thyme F273 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Spinach Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cayenne Pepper Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Red Kidney Bean Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pumpkin F225 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Goldenrod W12 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Paprika F218 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oregano F283 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lentils Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Galactose Alpha 1 3 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Halibut F303 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Guava F292 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Green Pepper F263 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Grapefruit Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Goat Milk Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg Yolk White Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dill F277 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Curry F281 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Coffee F221 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mustard F89 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lamb F88 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Melon F87 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Kiwi Fruit F84 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cocoa Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pecan Nut F201 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Malt F90 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lettuce F215 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Parsley F86 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Celery F85 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cheese Mold Type F82 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cheddar Cheese Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chicken Meat Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg Yolk F75 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lobster F80 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Gluten F79 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Casein Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Beta Lactoglobulin Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alpha Lactalbumin Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Apple Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Onion Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Garlic Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Yeast F45 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Strawberry F44 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Salmon F41 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tuna F40 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Blue Mussel F37 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Coconut F36 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Potato Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Orange Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Carrot Ige 860	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pork F26 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tomato Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Shrimp F24 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Crab F23 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Almond F20 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Brazil Nut F18 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hazelnut F17 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Bean 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Soybean Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peanut Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pea Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Buckwheat Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sesame Seed F10 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rice F9 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Maize Corn Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oat F7 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Barley Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rye Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Wheat Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Codfish Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cows Milk Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg White Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Barley Pollen Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Turkey Meat F284 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Squid F258 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mosquito Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Fire Ant Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cockroach I6 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Yellow Hornet Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Paper Wasp Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Yellow Jacket Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Faced Hornet Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Honey Bee Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rabbit F213 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Scallop F338 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Plum F255 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pistachio F203 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pine Nut Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Passion Fruit F294 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dermatophagoides Farinae 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dermatophagoides Pterony 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Papaya F293 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Nutmeg F282 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mandarin F302 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mackerel F206 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 House Dust Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lime F306 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lemon F208 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alternaria Alternata Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Candida Albicans Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mucor Racemosus Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus Fumigatus Ige86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cladosporium Herbarum Ige86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicillium Notatum Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Green Bean Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Grape Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Duck Feathers Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Parrot Parakeet Feathers 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Goose Feathers Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mouse Urine Proteins 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rabbit Epithelia Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hamster Epithelia Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chicken Feathers Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ginger F270 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cucumber F244 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cinnamon Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cauliflower F291 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cabbage F216 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Broccoli F260 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Blackberry F211 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Raspberry Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Asparagus F261 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pigeon Feathers Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chili Pepper F279 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cherry F242 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cashew Nut F202Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Guinea Pig Epithelia 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dog Dander Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cow Dander Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Horse Dander Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cat Dander Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Mulberry Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Blueberry Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Basil F269 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Apricot Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Black Pepper F280 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sweet Potato Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Deer Epithelium Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Canary Bird Feathers Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Turkey Feathers Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hickory Pecan Tree Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Pine Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Ash T15 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cottonwood T14 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Willow T12 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sycamore Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Elm Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oak Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mountain Cedar Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hazel Nut Tree Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Birch T3 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Maple Box Elder Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Nettle Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sheep Sorrel Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rough Pigweed Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cocklebur W13 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Respiratory Allergen 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Beef Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lamb Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pork Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Carmine Red Dye Extract 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Food Allergy Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Romano Cheese Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Flaxseed F333 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Coriander Cilantro Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Crab F23 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Shellfish Panel 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Rast Aspen 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allerge Spec Ige Lactase 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mozarella Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aller Spec Ige Cantaloup 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Finch Feathers Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Annatto Seed 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Venison Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Formaldehyde Formalinige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cedar Rt212 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bermuda Grass Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Meadow Fescue G4 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Perennial Rye Grass F5 Ige	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Timothy Grass Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 June Grass Kentucky Blue 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Red Top Grass Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Johnson Grass Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cultivated Wheat Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bahia Grass Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mango Fruit F91 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sunflower Seed K84 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Brewer Yeast Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Swiss Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Common Ragweed Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Giant Ragweed Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mugwort W6 Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 English Plantain Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lambs Quarters Ige 86003	$24.00	$24.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tree Nut Allergy Panel 86003	$25.00	$25.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chestnut Sweet F299 Ige 86003	$25.00	$25.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ovalbumin F232 Ige 86003	$83.00	$83.00	—	—	—
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Tumor 82105	$77.00	$77.00	—	12% below	—
Alpha-fetoprotein (AFP) blood test CPT 82105 Maternal Serum Afp 82105	$77.00	$77.00	—	12% below	—
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Serum 82105	$77.00	$77.00	—	12% below	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Maternal Serum Afp 82105	$77.00	$77.00	—	—	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein Serum 82105	$77.00	$77.00	—	—	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein Tumor 82105	$77.00	$77.00	—	—	—
Ammonia blood test CPT 82140 Ammonia 82140	$67.00	$67.00	—	24% below	—
Ammonia blood test CPT 82140 Ammonia Plasma 82140	$67.00	$67.00	—	24% below	—
Ammonia blood test CPT 82140 Ammonia Plasma 82140	$67.00	$67.00	—	24% below	—
Ammonia blood test inpatient CPT 82140 Ammonia Plasma 82140	$67.00	$67.00	—	—	—
Ammonia blood test inpatient CPT 82140 Ammonia Plasma 82140	$67.00	$67.00	—	—	—
Ammonia blood test inpatient CPT 82140 Ammonia 82140	$67.00	$67.00	—	—	—
Amylase blood test CPT 82150 Amylase Urine 82150	$32.00	$32.00	—	58% below	—
Amylase blood test CPT 82150 Assay Of Amylase 82150	$32.00	$32.00	—	58% below	—
Amylase blood test CPT 82150 Amylase Body Fluid 82150	$32.00	$32.00	—	58% below	—
Amylase blood test CPT 82150 Amylase Peritoneal Fluid 82150	$32.00	$32.00	—	58% below	—
Amylase blood test CPT 82150 Amylase 82150	$32.00	$32.00	—	58% below	—
Amylase blood test CPT 82150 Amylase Urine 24Hr 82150	$32.00	$32.00	—	58% below	—
Amylase blood test CPT 82150 Amylase Pancreatic Cyst 82150	$32.00	$32.00	—	58% below	—
Amylase blood test CPT 82150 Amylase 82150	$32.00	$32.00	—	58% below	—
Amylase blood test inpatient CPT 82150 Amylase Body Fluid 82150	$32.00	$32.00	—	—	—
Amylase blood test inpatient CPT 82150 Assay Of Amylase 82150	$32.00	$32.00	—	—	—
Amylase blood test inpatient CPT 82150 Amylase 82150	$32.00	$32.00	—	—	—
Amylase blood test inpatient CPT 82150 Amylase Pancreatic Cyst 82150	$32.00	$32.00	—	—	—
Amylase blood test inpatient CPT 82150 Amylase Peritoneal Fluid 82150	$32.00	$32.00	—	—	—
Amylase blood test inpatient CPT 82150 Amylase 82150	$32.00	$32.00	—	—	—
Amylase blood test inpatient CPT 82150 Amylase Urine 24Hr 82150	$32.00	$32.00	—	—	—
Amylase blood test inpatient CPT 82150 Amylase Urine 82150	$32.00	$32.00	—	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrul Pep Ccp Ab 86200	$60.00	$60.00	—	36% below	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citru Peptide Igg 86200	$60.00	$60.00	—	36% below	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Ccp Ab Igg 86200	$60.00	$60.00	—	36% below	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrull Pep Ab 86200	$60.00	$60.00	—	36% below	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citru Peptide Ab	$60.00	$60.00	—	36% below	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrul Pep Ccp Ab 86200	$60.00	$60.00	—	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citru Peptide Ab	$60.00	$60.00	—	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Ccp Ab Igg 86200	$60.00	$60.00	—	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrull Pep Ab 86200	$60.00	$60.00	—	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citru Peptide Igg 86200	$60.00	$60.00	—	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Centromere B Antibody 86038	$56.00	$56.00	—	39% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies 86038	$56.00	$56.00	—	39% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Ifa Screen Wreflx 86038	$56.00	$56.00	—	39% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen Ifa 86038	$56.00	$56.00	—	39% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Reflex 86038	$56.00	$56.00	—	39% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen Ifa Reflex 86038	$56.00	$56.00	—	39% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinulcear Abs Ana 86038	$56.00	$56.00	—	39% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen Ifa 86038	$56.00	$56.00	—	39% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Ifa Lupus Panel 1 86038	$56.00	$56.00	—	39% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Multi W Reflex 86038	$56.00	$56.00	—	39% below	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Centromere B Antibody 86038	$56.00	$56.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinulcear Abs Ana 86038	$56.00	$56.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Ana Screen Ifa Reflex 86038	$56.00	$56.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Ana Screen Ifa 86038	$56.00	$56.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Ana Ifa Lupus Panel 1 86038	$56.00	$56.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Ana Ifa Screen Wreflx 86038	$56.00	$56.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Ana Screen Ifa 86038	$56.00	$56.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies 86038	$56.00	$56.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Ana Reflex 86038	$56.00	$56.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Ana Multi W Reflex 86038	$56.00	$56.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Ed Poc B N Peptide 83880	$157.04	$157.04	—	30% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Nt Probnp 83880	$181.00	$181.00	—	50% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptd 83880	$181.00	$181.00	—	50% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Ed Poc B N Peptide 83880	$157.04	$157.04	—	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B Type Natriuretic Peptd 83880	$181.00	$181.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Nt Probnp 83880	$181.00	$181.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Csf 87070	$40.00	$40.00	—	48% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Surgical 87070	$40.00	$40.00	—	48% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Body Fluid 87070	$40.00	$40.00	—	48% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Wound 87070	$40.00	$40.00	—	48% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Bronchial 87070	$40.00	$40.00	—	48% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Aerobic 87070	$40.00	$40.00	—	48% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Nasopharyngeal 87070	$40.00	$40.00	—	48% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Sputum 87070	$40.00	$40.00	—	48% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Genital 87070	$40.00	$40.00	—	48% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Ear Eye 87070	$40.00	$40.00	—	48% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Surgical 87070	$40.00	$40.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Bronchial 87070	$40.00	$40.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Aerobic 87070	$40.00	$40.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Ear Eye 87070	$40.00	$40.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Nasopharyngeal 87070	$40.00	$40.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Sputum 87070	$40.00	$40.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Genital 87070	$40.00	$40.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Body Fluid 87070	$40.00	$40.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Wound 87070	$40.00	$40.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Csf 87070	$40.00	$40.00	—	—	—
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel 80048	$43.00	$43.00	—	64% below	—
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel 80048	$43.00	$43.00	—	—	—
Bilirubin blood test, total CPT 82247 Body Fluid Total Bili 82247	$23.00	$23.00	—	46% below	—
Bilirubin blood test, total CPT 82247 Bilirubin Total 82247	$25.00	$25.00	—	41% below	—
Bilirubin blood test, total CPT 82247 Bilirubin Total 82247	$25.00	$25.00	—	41% below	—
Bilirubin blood test, total CPT 82247 Bilirubin Body Fluid 82247	$25.00	$25.00	—	41% below	—
Bilirubin blood test, total CPT 82247 Bilirubin Fract Total 82247	$25.00	$25.00	—	41% below	—
Bilirubin blood test, total inpatient CPT 82247 Body Fluid Total Bili 82247	$23.00	$23.00	—	—	—
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Fract Total 82247	$25.00	$25.00	—	—	—
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total 82247	$25.00	$25.00	—	—	—
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total 82247	$25.00	$25.00	—	—	—
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Body Fluid 82247	$25.00	$25.00	—	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level Iv Surgical Path 88305	$214.00	$214.00	—	155% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Gross Micro Level 4 88305	$214.00	$214.00	—	155% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surg Path Gross Micro 88305	$214.00	$214.00	—	155% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Path Level Iv 88305	$214.00	$214.00	—	155% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surg Path Gross Micro 88305	$214.00	$214.00	—	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surgical Path Level Iv 88305	$214.00	$214.00	—	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Level Iv Surgical Path 88305	$214.00	$214.00	—	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Gross Micro Level 4 88305	$214.00	$214.00	—	—	—
Blood culture for bacteria CPT 87040 Culture Blood 87040	$47.00	$47.00	—	69% below	—
Blood culture for bacteria inpatient CPT 87040 Culture Blood 87040	$47.00	$47.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture P Surg 36415	$14.00	$14.00	—	5% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture 36415	$14.00	$14.00	—	5% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture Hmc Opsurg 36415	$14.00	$14.00	—	5% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture Iv Therapy 36415	$14.00	$14.00	—	5% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Ethanol Collect Charge 36415	$14.00	$14.00	—	5% above	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture Iv Therapy 36415	$14.00	$14.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Ethanol Collect Charge 36415	$14.00	$14.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture Hmc Opsurg 36415	$14.00	$14.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture P Surg 36415	$14.00	$14.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture 36415	$14.00	$14.00	—	—	—
Blood glucose (sugar) test CPT 82947 Ed Poc Glucose 82947	$15.72	$15.72	—	57% below	—
Blood glucose (sugar) test CPT 82947 Glucose Quantative Serum 82947	$20.00	$20.00	—	45% below	—
Blood glucose (sugar) test CPT 82947 Glucose Quan Serum 82947	$20.00	$20.00	—	45% below	—
Blood glucose (sugar) test inpatient CPT 82947 Ed Poc Glucose 82947	$15.72	$15.72	—	—	—
Blood glucose (sugar) test inpatient CPT 82947 Glucose Quantative Serum 82947	$20.00	$20.00	—	—	—
Blood glucose (sugar) test inpatient CPT 82947 Glucose Quan Serum 82947	$20.00	$20.00	—	—	—
Blood lead test CPT 83655 Lead Random Urine 83655	$60.00	$60.00	—	12% below	—
Blood lead test CPT 83655 Lead 83655	$60.00	$60.00	—	12% below	—
Blood lead test CPT 83655 Lead Capillary 83655	$60.00	$60.00	—	12% below	—
Blood lead test CPT 83655 Lead 24 Hour Urine 83655	$60.00	$60.00	—	12% below	—
Blood lead test CPT 83655 Lead Whole Blood 83655	$60.00	$60.00	—	12% below	—
Blood lead test inpatient CPT 83655 Lead Whole Blood 83655	$60.00	$60.00	—	—	—
Blood lead test inpatient CPT 83655 Lead Random Urine 83655	$60.00	$60.00	—	—	—
Blood lead test inpatient CPT 83655 Lead 24 Hour Urine 83655	$60.00	$60.00	—	—	—
Blood lead test inpatient CPT 83655 Lead Capillary 83655	$60.00	$60.00	—	—	—
Blood lead test inpatient CPT 83655 Lead 83655	$60.00	$60.00	—	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Serum 84703	$38.00	$38.00	—	61% below	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Serum 84703	$38.00	$38.00	—	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Typing Abo 86900	$423.00	$423.00	—	664% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Arc Blood Typing Abo 86900	$423.00	$423.00	—	664% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Arc Blood Typing Abo 86900	$423.00	$423.00	—	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood Typing Abo 86900	$423.00	$423.00	—	—	—
Blood urea nitrogen (BUN) test CPT 84520 Ed Poc Bloodureanitrogen 84520	$15.80	$15.80	—	51% below	—
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen Body Fluid	$20.00	$20.00	—	38% below	—
Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Quant 84520	$20.00	$20.00	—	38% below	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 Ed Poc Bloodureanitrogen 84520	$15.80	$15.80	—	—	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen Body Fluid	$20.00	$20.00	—	—	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Quant 84520	$20.00	$20.00	—	—	—
C-peptide blood test CPT 84681 C Peptide 84681	$96.00	$96.00	—	7% below	—
C-peptide blood test inpatient CPT 84681 C Peptide 84681	$96.00	$96.00	—	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein 86140	$24.00	$24.00	—	73% below	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein 86140	$26.00	$26.00	—	70% below	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein 86140	$24.00	$24.00	—	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein 86140	$26.00	$26.00	—	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium Difficile 87493	$171.00	$171.00	—	94% above	—
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium Diff Tox B 87493	$175.00	$175.00	—	98% above	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium Difficile 87493	$171.00	$171.00	—	—	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium Diff Tox B 87493	$175.00	$175.00	—	—	—
CA 19-9 blood test (tumor marker) CPT 86301 Ca 19 9 86301	$96.00	$96.00	—	at median	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Ca 19 9 86301	$96.00	$96.00	—	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Ag 125 Ovarian Ag 86304	$96.00	$96.00	—	32% below	—
CA-125 blood test (ovarian cancer marker) CPT 86304 Immonoassay Ca 125 86304	$96.00	$96.00	—	32% below	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Immonoassay Ca 125 86304	$96.00	$96.00	—	—	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Ag 125 Ovarian Ag 86304	$96.00	$96.00	—	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars Coronavirus W Cov2 Rna	$345.00	$345.00	—	300% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Sars Coronavirus W Cov2 Rna	$345.00	$345.00	—	—	—
Calcium blood test, total CPT 82310 Calcium Total 82310	$25.00	$25.00	—	16% below	—
Calcium blood test, total CPT 82310 Calcium Total 82310	$25.00	$25.00	—	16% below	—
Calcium blood test, total inpatient CPT 82310 Calcium Total 82310	$25.00	$25.00	—	—	—
Calcium blood test, total inpatient CPT 82310 Calcium Total 82310	$25.00	$25.00	—	—	—
Carcinoembryonic antigen (CEA) test CPT 82378 Cea Pleural Fluid 82378	$87.00	$87.00	—	12% below	—
Carcinoembryonic antigen (CEA) test CPT 82378 Cea Peritoneal Fluid 82378	$87.00	$87.00	—	12% below	—
Carcinoembryonic antigen (CEA) test CPT 82378 Cea Pancreatic Cyst Fld 82378	$87.00	$87.00	—	12% below	—
Carcinoembryonic antigen (CEA) test CPT 82378 Cea 82378	$87.00	$87.00	—	12% below	—
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Cea Peritoneal Fluid 82378	$87.00	$87.00	—	—	—
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Cea Pleural Fluid 82378	$87.00	$87.00	—	—	—
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Cea Pancreatic Cyst Fld 82378	$87.00	$87.00	—	—	—
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Cea 82378	$87.00	$87.00	—	—	—
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virusab 86787	$60.00	$60.00	—	18% below	—
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus Ab Igm	$60.00	$60.00	—	18% below	—
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Igm 86787	$60.00	$60.00	—	18% below	—
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Igg 86787	$60.00	$60.00	—	18% below	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Igm 86787	$60.00	$60.00	—	—	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus Ab Igm	$60.00	$60.00	—	—	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virusab 86787	$60.00	$60.00	—	—	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Igg 86787	$60.00	$60.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis 87491	$161.00	$161.00	—	101% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Amp Probe 87491	$161.00	$161.00	—	101% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis Apt	$161.00	$161.00	—	101% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis	$161.00	$161.00	—	101% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomaitis 87491	$161.00	$161.00	—	101% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatisrna 87491	$161.00	$161.00	—	101% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlmyd Trach Dna Amp Pro 87491	$161.00	$161.00	—	101% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis 87491	$161.00	$161.00	—	101% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Amp Probe 87491	$161.00	$161.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlmyd Trach Dna Amp Pro 87491	$161.00	$161.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis 87491	$161.00	$161.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis 87491	$161.00	$161.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis Apt	$161.00	$161.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis	$161.00	$161.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomaitis 87491	$161.00	$161.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatisrna 87491	$161.00	$161.00	—	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Pan W Refl Dir Ldl 80061	$62.00	$62.00	—	18% below	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel 80061	$67.00	$67.00	—	12% below	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Pan W Refl Dir Ldl 80061	$62.00	$62.00	—	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel 80061	$67.00	$67.00	—	—	—
Complete blood count (CBC) with differential CPT 85025 Cbc Wauto Differential 85025	$36.00	$36.00	—	42% below	—
Complete blood count (CBC) with differential CPT 85025 Cbc Wauto Differential 85025	$36.00	$36.00	—	42% below	—
Complete blood count (CBC) with differential inpatient CPT 85025 Cbc Wauto Differential 85025	$36.00	$36.00	—	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 Cbc Wauto Differential 85025	$36.00	$36.00	—	—	—
Complete blood count (CBC), no differential CPT 85027 Cbc 85027	$30.00	$30.00	—	47% below	—
Complete blood count (CBC), no differential inpatient CPT 85027 Cbc 85027	$30.00	$30.00	—	—	—
Comprehensive metabolic panel (blood test) CPT 80053 Comprenhesive Metabolic 80053	$53.00	$53.00	—	63% below	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprenhesive Metabolic 80053	$53.00	$53.00	—	—	—
Cortisol blood test, total CPT 82533 Cortisol Total Lc Ms 82533	$75.00	$75.00	—	27% below	—
Cortisol blood test, total CPT 82533 Cortisol Total 82533	$75.00	$75.00	—	27% below	—
Cortisol blood test, total CPT 82533 Cortisol 82533	$75.00	$75.00	—	27% below	—
Cortisol blood test, total CPT 82533 Dexamethasone Supp Test 82533	$75.00	$75.00	—	27% below	—
Cortisol blood test, total inpatient CPT 82533 Cortisol 82533	$75.00	$75.00	—	—	—
Cortisol blood test, total inpatient CPT 82533 Cortisol Total Lc Ms 82533	$75.00	$75.00	—	—	—
Cortisol blood test, total inpatient CPT 82533 Cortisol Total 82533	$75.00	$75.00	—	—	—
Cortisol blood test, total inpatient CPT 82533 Dexamethasone Supp Test 82533	$75.00	$75.00	—	—	—
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase Total 82550	$32.00	$32.00	—	38% below	—
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase Total 82550	$32.00	$32.00	—	—	—
Creatinine blood test CPT 82565 Ed Poc Creatinine 82565	$20.48	$20.48	—	1% below	—
Creatinine blood test CPT 82565 Creatinine 82565	$25.00	$25.00	—	21% above	—
Creatinine blood test CPT 82565 Creatinine Blood 82565	$25.00	$25.00	—	21% above	—
Creatinine blood test inpatient CPT 82565 Ed Poc Creatinine 82565	$20.48	$20.48	—	—	—
Creatinine blood test inpatient CPT 82565 Creatinine Blood 82565	$25.00	$25.00	—	—	—
Creatinine blood test inpatient CPT 82565 Creatinine 82565	$25.00	$25.00	—	—	—
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Ab Igg 86644	$67.00	$67.00	—	31% below	—
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Igg Avidity	$67.00	$67.00	—	31% below	—
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Ab Igg 86644	$67.00	$67.00	—	31% below	—
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Ab 86644	$67.00	$67.00	—	31% below	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Igg Avidity	$67.00	$67.00	—	—	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Ab 86644	$67.00	$67.00	—	—	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Ab Igg 86644	$67.00	$67.00	—	—	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Ab Igg 86644	$67.00	$67.00	—	—	—
D-dimer blood test (blood clot marker) CPT 85379 D Dimer Quantitative 85379	$47.00	$47.00	—	51% below	—
D-dimer blood test (blood clot marker) CPT 85379 D Dimer Quant 85379	$47.00	$47.00	—	51% below	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer Quantitative 85379	$47.00	$47.00	—	—	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer Quant 85379	$47.00	$47.00	—	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandroster Sulf 82627	$102.00	$102.00	—	4% above	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandroster Sulf 82627	$102.00	$102.00	—	—	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitoring Panel 1 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor Panel 5 Scr Ur	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Mntr Panel 1 Scr Ur 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor Alcohol Ur 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Expnd Drugs Abuse Screen 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Tox Monitor Alcohol Meta	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Tox Mntr Alcochol Ethyl U	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Diphenoxylate Screen Ur 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Diuretics Screen Urine 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Amphetamines Scrn Urine 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Gamma Hydroxybutyric Acid Ur	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Panel 9 Meco 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Comprehensive Drug Scren 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Scrn 10 Panel 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Tox Monitor 9 Scr Ur	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Mntr Oxycodone Screen Ur	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Mntr Alcoh Metabolite Ur	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Panel 9 Serum 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Mntr Amphetamines Ur	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs Of Abuse Scrn Ser 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drg Mtr Fentanyl Wconf Ur80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Panel 9 Meconium	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drg Mtr Opiates Wconf Ur 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Opiates Screen Ur 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Fentanyl Screen Urine 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Panel 8 Serum	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor Opioid Panel Ur	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor Fentanyl 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor Pnl 6 Ur W Confir	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Tox Monitor 9 Urine	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Urine 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor Pnl 7 Ur W Confir	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor Panel 8 Ur 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Alcohol Ethyl Urine 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 Benzodiazepine Ur Screen 80307	$249.00	$249.00	—	94% above	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Tox Mntr Alcochol Ethyl U	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitor Alcohol Ur 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Abuse Panel 9 Serum 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs Of Abuse Scrn Ser 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Abuse Panel 9 Meconium	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Opiates Screen Ur 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Abuse Panel 8 Serum	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitor Fentanyl 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Gamma Hydroxybutyric Acid Ur	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitor Opioid Panel Ur	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Fentanyl Screen Urine 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Mntr Oxycodone Screen Ur	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Mntr Alcoh Metabolite Ur	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Mntr Amphetamines Ur	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drg Mtr Fentanyl Wconf Ur80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drg Mtr Opiates Wconf Ur 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Mntr Panel 1 Scr Ur 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitor Panel 5 Scr Ur	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Urine 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitoring Panel 1 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitor Pnl 6 Ur W Confir	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitor Pnl 7 Ur W Confir	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Panel 9 Meco 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitor Panel 8 Ur 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Alcohol Ethyl Urine 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Benzodiazepine Ur Screen 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Expnd Drugs Abuse Screen 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Tox Monitor Alcohol Meta	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Amphetamines Scrn Urine 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Diphenoxylate Screen Ur 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Diuretics Screen Urine 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Comprehensive Drug Scren 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Abuse Scrn 10 Panel 80307	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Tox Monitor 9 Scr Ur	$249.00	$249.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Tox Monitor 9 Urine	$249.00	$249.00	—	—	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Ed Poc Electrolye Panel 80051	$28.04	$28.04	—	69% below	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Anion Gap Panel 80051	$32.00	$32.00	—	64% below	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolytes Panel 80051	$34.00	$34.00	—	62% below	—
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Ed Poc Electrolye Panel 80051	$28.04	$28.04	—	—	—
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Anion Gap Panel 80051	$32.00	$32.00	—	—	—
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolytes Panel 80051	$34.00	$34.00	—	—	—
Epstein-Barr virus (EBV) antibody test CPT 86665 Epsteinbarr Virusvca Igg 86665	$83.00	$83.00	—	16% above	—
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Vca Igg 86665	$84.00	$84.00	—	17% above	—
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Vir Vca Igm 86665	$84.00	$84.00	—	17% above	—
Epstein-Barr virus (EBV) antibody test CPT 86665 Epsteinbarr Virus Anti B 86665	$84.00	$84.00	—	17% above	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epsteinbarr Virusvca Igg 86665	$83.00	$83.00	—	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epsteinbarr Virus Anti B 86665	$84.00	$84.00	—	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Vca Igg 86665	$84.00	$84.00	—	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Vir Vca Igm 86665	$84.00	$84.00	—	—	—
Estradiol blood test CPT 82670 Estradiol Ultrasen Lc Ms	$129.00	$129.00	—	8% above	—
Estradiol blood test CPT 82670 Estradiol 82670	$129.00	$129.00	—	8% above	—
Estradiol blood test CPT 82670 Estradiol Total 82670	$129.00	$129.00	—	8% above	—
Estradiol blood test inpatient CPT 82670 Estradiol Total 82670	$129.00	$129.00	—	—	—
Estradiol blood test inpatient CPT 82670 Estradiol Ultrasen Lc Ms	$129.00	$129.00	—	—	—
Estradiol blood test inpatient CPT 82670 Estradiol 82670	$129.00	$129.00	—	—	—
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stim Horm Peds 83001	$92.00	$92.00	—	27% below	—
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulate Horm 83001	$92.00	$92.00	—	27% below	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stim Horm Peds 83001	$92.00	$92.00	—	—	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulate Horm 83001	$92.00	$92.00	—	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Stool 83993	$91.00	$91.00	—	59% below	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Stool 83993	$91.00	$91.00	—	—	—
Ferritin blood test (iron stores) CPT 82728 Ferratin 82728	$63.00	$63.00	—	16% below	—
Ferritin blood test (iron stores) CPT 82728 Ferritin 82728	$63.00	$63.00	—	16% below	—
Ferritin blood test (iron stores) inpatient CPT 82728 Ferratin 82728	$63.00	$63.00	—	—	—
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin 82728	$63.00	$63.00	—	—	—
Fibrinogen blood test CPT 85384 Fibrinogen Activity 85384	$45.00	$45.00	—	50% below	—
Fibrinogen blood test inpatient CPT 85384 Fibrinogen Activity 85384	$45.00	$45.00	—	—	—
Folate (folic acid) blood test CPT 82746 Micronutrient Folate 82746	$68.00	$68.00	—	21% below	—
Folate (folic acid) blood test CPT 82746 Folate Serum 82746	$68.00	$68.00	—	21% below	—
Folate (folic acid) blood test inpatient CPT 82746 Micronutrient Folate 82746	$68.00	$68.00	—	—	—
Folate (folic acid) blood test inpatient CPT 82746 Folate Serum 82746	$68.00	$68.00	—	—	—
Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3 Free 84481	$78.00	$78.00	—	19% below	—
Free T3 thyroid hormone test CPT 84481 T3 Free Triiodothyronine 84481	$78.00	$78.00	—	19% below	—
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine T3 Free 84481	$78.00	$78.00	—	—	—
Free T3 thyroid hormone test inpatient CPT 84481 T3 Free Triiodothyronine 84481	$78.00	$78.00	—	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Free Thyroxine 84439	$41.00	$41.00	—	46% below	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Direct Dialysis 84439	$41.00	$41.00	—	46% below	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 Free Thyroxine 84439	$41.00	$41.00	—	—	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 Direct Dialysis 84439	$41.00	$41.00	—	—	—
Free testosterone test CPT 84402 Testosterone Free 84402	$117.00	$117.00	—	27% below	—
Free testosterone test inpatient CPT 84402 Testosterone Free 84402	$117.00	$117.00	—	—	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Trnsfr 82977	$36.00	$36.00	—	23% below	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gammaglutamyltransferase 82977	$36.00	$36.00	—	23% below	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transfer 82977	$36.00	$36.00	—	23% below	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Trnsfr 82977	$36.00	$36.00	—	—	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gammaglutamyltransferase 82977	$36.00	$36.00	—	—	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transfer 82977	$36.00	$36.00	—	—	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel 80050	$171.00	$171.00	—	32% below	—
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel 80050	$171.00	$171.00	—	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 1 Hour Post Prandial 82950	$24.00	$24.00	—	46% below	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2H Post Prandial 82950	$24.00	$24.00	—	46% below	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 1 Hour Post Prandial 82950	$24.00	$24.00	—	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2H Post Prandial 82950	$24.00	$24.00	—	—	—
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 3 Spec 82951	$64.00	$64.00	—	14% below	—
Glucose tolerance test, 3 samples CPT 82951 Diabetic Screen 82951	$64.00	$64.00	—	14% below	—
Glucose tolerance test, 3 samples inpatient CPT 82951 Diabetic Screen 82951	$64.00	$64.00	—	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 3 Spec 82951	$64.00	$64.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrh Rnatma 87591	$161.00	$161.00	—	97% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae 87591	$161.00	$161.00	—	97% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N Gonorrh Dna Amp Probe 87591	$161.00	$161.00	—	97% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrh Rna Tma Uro	$161.00	$161.00	—	97% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae 87591	$161.00	$161.00	—	97% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae Apt	$161.00	$161.00	—	97% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrh Rna 87591	$161.00	$161.00	—	97% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrh Amp Pb 87591	$161.00	$161.00	—	97% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae	$161.00	$161.00	—	97% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeaerna 87591	$161.00	$161.00	—	97% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhoeae Apt	$161.00	$161.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhoeae	$161.00	$161.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrh Rna Tma Uro	$161.00	$161.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrh Rna 87591	$161.00	$161.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N Gonorrh Dna Amp Probe 87591	$161.00	$161.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhoeae 87591	$161.00	$161.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhoeaerna 87591	$161.00	$161.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhoeae 87591	$161.00	$161.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrh Rnatma 87591	$161.00	$161.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrh Amp Pb 87591	$161.00	$161.00	—	—	—
H. pylori stool antigen test CPT 87338 Helicobacter Pylori Ag 87338	$71.00	$71.00	—	44% below	—
H. pylori stool antigen test inpatient CPT 87338 Helicobacter Pylori Ag 87338	$71.00	$71.00	—	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv 1 Rna Quant Pcr 87536	$391.00	$391.00	—	14% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv 1 Rna Quant Wrlfx 87536	$391.00	$391.00	—	14% above	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv 1 Rna Quant Pcr 87536	$391.00	$391.00	—	—	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv 1 Rna Quant Wrlfx 87536	$391.00	$391.00	—	—	—
HIV-1 and HIV-2 antibody test CPT 86703 Hiv 1 2 Antibodies Diag 86703	$63.00	$63.00	—	43% below	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Hiv 1 2 Antibodies Diag 86703	$63.00	$63.00	—	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv 1 And 2 Ab Ag 87389	$111.00	$111.00	—	3% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv 1Ag Whiv 1And2 Ab Ag 87389	$111.00	$111.00	—	3% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv 1 Ag Hiv 1 2 Ab Ag 87389	$111.00	$111.00	—	3% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv 1 2 Ag Ab 4Th Gen 87389	$120.00	$120.00	—	11% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv 1Ag Whiv 1And2 Ab Ag 87389	$111.00	$111.00	—	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv 1 Ag Hiv 1 2 Ab Ag 87389	$111.00	$111.00	—	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv 1 And 2 Ab Ag 87389	$111.00	$111.00	—	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv 1 2 Ag Ab 4Th Gen 87389	$120.00	$120.00	—	—	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 Human Papillomavirus 87624	$161.00	$161.00	—	37% above	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv High Risk Types 87624	$161.00	$161.00	—	37% above	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv High Risk Types	$161.00	$161.00	—	37% above	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Hpv High Risk Types	$161.00	$161.00	—	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Hpv High Risk Types 87624	$161.00	$161.00	—	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Human Papillomavirus 87624	$161.00	$161.00	—	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C 82172	$45.00	$45.00	—	16% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C 83036	$48.00	$48.00	—	11% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C 82172	$45.00	$45.00	—	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C 83036	$48.00	$48.00	—	—	—
Hemoglobin blood test CPT 85018 Ed Poc Hemoglobin 85018	$9.48	$9.48	—	59% below	—
Hemoglobin blood test CPT 85018 Hemoglobin 85018	$12.00	$12.00	—	48% below	—
Hemoglobin blood test inpatient CPT 85018 Ed Poc Hemoglobin 85018	$9.48	$9.48	—	—	—
Hemoglobin blood test inpatient CPT 85018 Hemoglobin 85018	$12.00	$12.00	—	—	—
Hepatitis B core antibody test (total) CPT 86704 Hepatits B Core 86704	$55.00	$55.00	—	39% below	—
Hepatitis B core antibody test (total) CPT 86704 Hep B Core Ab Total W Rflx To	$55.00	$55.00	—	39% below	—
Hepatitis B core antibody test (total) CPT 86704 Hep B Core Ab Total 86704	$55.00	$55.00	—	39% below	—
Hepatitis B core antibody test (total) CPT 86704 Hepatits B Core Ab 86704	$55.00	$55.00	—	39% below	—
Hepatitis B core antibody test (total) CPT 86704 Hepatits B Core Ab Total 86704	$55.00	$55.00	—	39% below	—
Hepatitis B core antibody test (total) CPT 86704 Hepatits B Core Ab 86704	$55.00	$55.00	—	39% below	—
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatits B Core Ab Total 86704	$55.00	$55.00	—	—	—
Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Ab Total W Rflx To	$55.00	$55.00	—	—	—
Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Ab Total 86704	$55.00	$55.00	—	—	—
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatits B Core Ab 86704	$55.00	$55.00	—	—	—
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatits B Core 86704	$55.00	$55.00	—	—	—
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatits B Core Ab 86704	$55.00	$55.00	—	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab 86706	$52.00	$52.00	—	33% below	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab 86706	$52.00	$52.00	—	33% below	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab 86706	$52.00	$52.00	—	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab 86706	$52.00	$52.00	—	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surf Ant Qual87340	$48.00	$48.00	—	26% below	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Surface Ag 87340	$48.00	$48.00	—	26% below	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Surantg Wrefl Conf 87340	$48.00	$48.00	—	26% below	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag 87340	$48.00	$48.00	—	26% below	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep B Surface Ag 87340	$48.00	$48.00	—	—	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep B Surantg Wrefl Conf 87340	$48.00	$48.00	—	—	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surf Ant Qual87340	$48.00	$48.00	—	—	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Ag 87340	$48.00	$48.00	—	—	—
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Ab 86803	$71.00	$71.00	—	41% below	—
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody 86803	$71.00	$71.00	—	41% below	—
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Ab Wref Quan86803	$71.00	$71.00	—	41% below	—
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Ab Wref 86803	$71.00	$71.00	—	41% below	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Ab 86803	$71.00	$71.00	—	—	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Ab Wref Quan86803	$71.00	$71.00	—	—	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Ab Wref 86803	$71.00	$71.00	—	—	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody 86803	$71.00	$71.00	—	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Viral Rna Qnt87522	$197.00	$197.00	—	29% below	—
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Viral Rna 87522	$197.00	$197.00	—	29% below	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Viral Rna Qnt87522	$197.00	$197.00	—	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Viral Rna 87522	$197.00	$197.00	—	—	—
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Virus 1 Igg	$61.00	$61.00	—	9% below	—
Herpes blood test, HSV-1 antibody CPT 86695 Hsv Igm Type 1 Ab 86695	$61.00	$61.00	—	9% below	—
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Virus1Igg 86695	$61.00	$61.00	—	9% below	—
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Virus Type 1 86695	$61.00	$61.00	—	9% below	—
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Virus Type 1 86695	$61.00	$61.00	—	9% below	—
Herpes blood test, HSV-1 antibody CPT 86695 Hsv 1 Igg Type Specif Ab 86695	$61.00	$61.00	—	9% below	—
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simples Type 1 86695	$61.00	$61.00	—	9% below	—
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type1 Ab 86695	$61.00	$61.00	—	9% below	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Hsv Igm Type 1 Ab 86695	$61.00	$61.00	—	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Virus Type 1 86695	$61.00	$61.00	—	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Type1 Ab 86695	$61.00	$61.00	—	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Virus 1 Igg	$61.00	$61.00	—	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Hsv 1 Igg Type Specif Ab 86695	$61.00	$61.00	—	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simples Type 1 86695	$61.00	$61.00	—	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Virus1Igg 86695	$61.00	$61.00	—	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Virus Type 1 86695	$61.00	$61.00	—	—	—
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Virus Type 2 86696	$89.00	$89.00	—	43% above	—
Herpes blood test, HSV-2 antibody CPT 86696 Hsv 2 Igg Type Specif Ab 86696	$89.00	$89.00	—	43% above	—
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type2 Ab 86696	$89.00	$89.00	—	43% above	—
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Virus Type 2 86696	$89.00	$89.00	—	43% above	—
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2 86696	$89.00	$89.00	—	43% above	—
Herpes blood test, HSV-2 antibody CPT 86696 Hsv Igm Type 2 Ab 86696	$89.00	$89.00	—	43% above	—
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Virus2Igg 86696	$89.00	$89.00	—	43% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Virus2Igg 86696	$89.00	$89.00	—	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Hsv Igm Type 2 Ab 86696	$89.00	$89.00	—	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Type2 Ab 86696	$89.00	$89.00	—	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Type 2 86696	$89.00	$89.00	—	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Virus Type 2 86696	$89.00	$89.00	—	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Virus Type 2 86696	$89.00	$89.00	—	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Hsv 2 Igg Type Specif Ab 86696	$89.00	$89.00	—	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C React P High Sensitive 86141	$60.00	$60.00	—	33% below	—
High-sensitivity CRP (hs-CRP) test CPT 86141 Hs Crp 86141	$60.00	$60.00	—	33% below	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Hs Crp 86141	$60.00	$60.00	—	—	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C React P High Sensitive 86141	$60.00	$60.00	—	—	—
Homocysteine blood test CPT 83090 Homocysteine 83090	$83.00	$83.00	—	39% below	—
Homocysteine blood test inpatient CPT 83090 Homocysteine 83090	$83.00	$83.00	—	—	—
Insulin blood test CPT 83525 Insulin 83525	$53.00	$53.00	—	28% below	—
Insulin blood test CPT 83525 Insulin Total 83036	$53.00	$53.00	—	28% below	—
Insulin blood test CPT 83525 Insulin Level 83525	$53.00	$53.00	—	28% below	—
Insulin blood test CPT 83525 Insulin Intact Lc Mc Ms 83525	$53.00	$53.00	—	28% below	—
Insulin blood test inpatient CPT 83525 Insulin Total 83036	$53.00	$53.00	—	—	—
Insulin blood test inpatient CPT 83525 Insulin Intact Lc Mc Ms 83525	$53.00	$53.00	—	—	—
Insulin blood test inpatient CPT 83525 Insulin Level 83525	$53.00	$53.00	—	—	—
Insulin blood test inpatient CPT 83525 Insulin 83525	$53.00	$53.00	—	—	—
Iron blood test (serum iron) CPT 83540 Iron 83540	$30.00	$30.00	—	41% below	—
Iron blood test (serum iron) CPT 83540 Iron Liver 83540	$30.00	$30.00	—	41% below	—
Iron blood test (serum iron) inpatient CPT 83540 Iron Liver 83540	$30.00	$30.00	—	—	—
Iron blood test (serum iron) inpatient CPT 83540 Iron 83540	$30.00	$30.00	—	—	—
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity 83550	$40.00	$40.00	—	30% below	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity 83550	$40.00	$40.00	—	—	—
Kidney function blood test panel CPT 80069 Renal Function Panel 80069	$44.00	$44.00	—	49% below	—
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel 80069	$44.00	$44.00	—	—	—
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone Peds 83002	$92.00	$92.00	—	30% above	—
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone 83002	$92.00	$92.00	—	30% above	—
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone 83002	$92.00	$92.00	—	—	—
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone Peds 83002	$92.00	$92.00	—	—	—
Lactate (lactic acid) blood test CPT 83605 Poc Lactic Acid 83605	$53.00	$53.00	—	46% below	—
Lactate (lactic acid) blood test CPT 83605 Lactic Acid 83605	$53.00	$53.00	—	46% below	—
Lactate (lactic acid) blood test CPT 83605 D Lactate Plasma 83605	$53.00	$53.00	—	46% below	—
Lactate (lactic acid) blood test CPT 83605 Lactate Lactic Acid 83605	$53.00	$53.00	—	46% below	—
Lactate (lactic acid) blood test inpatient CPT 83605 Poc Lactic Acid 83605	$53.00	$53.00	—	—	—
Lactate (lactic acid) blood test inpatient CPT 83605 Lactate Lactic Acid 83605	$53.00	$53.00	—	—	—
Lactate (lactic acid) blood test inpatient CPT 83605 D Lactate Plasma 83605	$53.00	$53.00	—	—	—
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid 83605	$53.00	$53.00	—	—	—
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh Body Fluid 83615	$28.00	$28.00	—	44% below	—
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Ld	$28.00	$28.00	—	44% below	—
Lactate dehydrogenase (LDH) blood test CPT 83615 Ld Synovial Fluid 83615	$28.00	$28.00	—	44% below	—
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Csf83615	$28.00	$28.00	—	44% below	—
Lactate dehydrogenase (LDH) blood test CPT 83615 Ld Pleural Fluid 83615	$28.00	$28.00	—	44% below	—
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase 83615	$28.00	$28.00	—	44% below	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Csf83615	$28.00	$28.00	—	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Ld Pleural Fluid 83615	$28.00	$28.00	—	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Ld Synovial Fluid 83615	$28.00	$28.00	—	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Ld	$28.00	$28.00	—	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Ldh Body Fluid 83615	$28.00	$28.00	—	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase 83615	$28.00	$28.00	—	—	—
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Peritoneal Fluid 83690	$32.00	$32.00	—	67% below	—
Lipase blood test (pancreas enzyme) CPT 83690 Lipase 83690	$32.00	$32.00	—	67% below	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase 83690	$32.00	$32.00	—	—	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Peritoneal Fluid 83690	$32.00	$32.00	—	—	—
Liver function blood test panel CPT 80076 Hepatic Function Panel 80076	$38.00	$38.00	—	64% below	—
Liver function blood test panel CPT 80076 Hepatic Function Panel 80076	$38.00	$38.00	—	64% below	—
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel 80076	$38.00	$38.00	—	—	—
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel 80076	$38.00	$38.00	—	—	—
Lyme disease antibody test CPT 86618 Lyme Ab Rfx Blot Igg Igm 86618	$78.00	$78.00	—	25% below	—
Lyme disease antibody test CPT 86618 Lyme Disease Abwrflx Immu86618	$85.00	$85.00	—	18% below	—
Lyme disease antibody test CPT 86618 Lyme Dese Abwrflx Toblot 86618	$85.00	$85.00	—	18% below	—
Lyme disease antibody test CPT 86618 Lyme Igg Igm Antibody 86618	$85.00	$85.00	—	18% below	—
Lyme disease antibody test inpatient CPT 86618 Lyme Ab Rfx Blot Igg Igm 86618	$78.00	$78.00	—	—	—
Lyme disease antibody test inpatient CPT 86618 Lyme Igg Igm Antibody 86618	$85.00	$85.00	—	—	—
Lyme disease antibody test inpatient CPT 86618 Lyme Dese Abwrflx Toblot 86618	$85.00	$85.00	—	—	—
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Abwrflx Immu86618	$85.00	$85.00	—	—	—
Magnesium blood test CPT 83735 Micronutri Magnesium Rbc 83735	$31.00	$31.00	—	31% below	—
Magnesium blood test CPT 83735 Magnesium Ur 83735	$31.00	$31.00	—	31% below	—
Magnesium blood test CPT 83735 Magnesium Serum 83735	$31.00	$31.00	—	31% below	—
Magnesium blood test CPT 83735 Magesnium Urine 24Hr 83735	$31.00	$31.00	—	31% below	—
Magnesium blood test CPT 83735 Magnesium Urine 83735	$31.00	$31.00	—	31% below	—
Magnesium blood test CPT 83735 Magnesium Rbc 83735	$31.00	$31.00	—	31% below	—
Magnesium blood test inpatient CPT 83735 Magesnium Urine 24Hr 83735	$31.00	$31.00	—	—	—
Magnesium blood test inpatient CPT 83735 Magnesium Serum 83735	$31.00	$31.00	—	—	—
Magnesium blood test inpatient CPT 83735 Micronutri Magnesium Rbc 83735	$31.00	$31.00	—	—	—
Magnesium blood test inpatient CPT 83735 Magnesium Rbc 83735	$31.00	$31.00	—	—	—
Magnesium blood test inpatient CPT 83735 Magnesium Ur 83735	$31.00	$31.00	—	—	—
Magnesium blood test inpatient CPT 83735 Magnesium Urine 83735	$31.00	$31.00	—	—	—
Measles (rubeola) antibody test CPT 86765 Measles Antibody Igm 86765	$60.00	$60.00	—	25% below	—
Measles (rubeola) antibody test CPT 86765 Measles Igg 86765	$60.00	$60.00	—	25% below	—
Measles (rubeola) antibody test CPT 86765 Measles Ab Igg 86765	$60.00	$60.00	—	25% below	—
Measles (rubeola) antibody test CPT 86765 Rubeola Ab 86765	$60.00	$60.00	—	25% below	—
Measles (rubeola) antibody test inpatient CPT 86765 Measles Igg 86765	$60.00	$60.00	—	—	—
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Ab 86765	$60.00	$60.00	—	—	—
Measles (rubeola) antibody test inpatient CPT 86765 Measles Antibody Igm 86765	$60.00	$60.00	—	—	—
Measles (rubeola) antibody test inpatient CPT 86765 Measles Ab Igg 86765	$60.00	$60.00	—	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis 86308	$25.00	$25.00	—	55% below	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis 86308	$25.00	$25.00	—	—	—
Mumps immunity blood test CPT 86735 Mumps Ab 86735	$60.00	$60.00	—	9% above	—
Mumps immunity blood test CPT 86735 Mumps Igg 86735	$60.00	$60.00	—	9% above	—
Mumps immunity blood test CPT 86735 Mumps Virus Antibod Igg 86735	$60.00	$60.00	—	9% above	—
Mumps immunity blood test CPT 86735 Mumps Virus Ab Igg 86735	$64.00	$64.00	—	16% above	—
Mumps immunity blood test CPT 86735 Mumps Virus Ab Igm 86735	$64.00	$64.00	—	16% above	—
Mumps immunity blood test inpatient CPT 86735 Mumps Virus Antibod Igg 86735	$60.00	$60.00	—	—	—
Mumps immunity blood test inpatient CPT 86735 Mumps Ab 86735	$60.00	$60.00	—	—	—
Mumps immunity blood test inpatient CPT 86735 Mumps Igg 86735	$60.00	$60.00	—	—	—
Mumps immunity blood test inpatient CPT 86735 Mumps Virus Ab Igg 86735	$64.00	$64.00	—	—	—
Mumps immunity blood test inpatient CPT 86735 Mumps Virus Ab Igm 86735	$64.00	$64.00	—	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Prostatic Spec Ag Free 84154	$85.00	$85.00	—	3% above	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Prostatic Spec Ag Free 84154	$85.00	$85.00	—	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Post Prostatectomy	$85.00	$85.00	—	16% below	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Total W Reflex Free 84153	$85.00	$85.00	—	16% below	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Total 84153	$85.00	$85.00	—	16% below	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Total Diag 84153	$85.00	$85.00	—	16% below	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Total Diag 84153	$85.00	$85.00	—	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Post Prostatectomy	$85.00	$85.00	—	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Total W Reflex Free 84153	$85.00	$85.00	—	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Total 84153	$85.00	$85.00	—	—	—
Pap test (liquid-based, automated screening with review) CPT 88175 Thin Prep Imaging Syspap 88175	$136.00	$136.00	—	191% above	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Thin Prep Imaging Syspap 88175	$136.00	$136.00	—	—	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Thin Prep Reflex Hpvmrna 88142	$93.00	$93.00	—	82% above	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Thin Prep Reflex Hpvmrna 88142	$93.00	$93.00	—	—	—
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone 83970	$190.00	$190.00	—	24% above	—
Parathyroid hormone (PTH) blood test CPT 83970 Intraoperative Pth 83970	$190.00	$190.00	—	24% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone 83970	$190.00	$190.00	—	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Intraoperative Pth 83970	$190.00	$190.00	—	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Von Willebrand Scrn Ptt 85730	$28.00	$28.00	—	43% below	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt 85730	$28.00	$28.00	—	43% below	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin Time 85730	$28.00	$28.00	—	43% below	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Mixing Study 85730	$28.00	$28.00	—	43% below	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt La Wreflex To Hexagnl85730	$28.00	$28.00	—	43% below	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Mixing Study 85730	$28.00	$28.00	—	43% below	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Activated 85730	$28.00	$28.00	—	43% below	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt La Screen 85730	$28.00	$28.00	—	43% below	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Mixing Study 85730	$28.00	$28.00	—	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt Activated 85730	$28.00	$28.00	—	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Von Willebrand Scrn Ptt 85730	$28.00	$28.00	—	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt Mixing Study 85730	$28.00	$28.00	—	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt La Screen 85730	$28.00	$28.00	—	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin Time 85730	$28.00	$28.00	—	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt La Wreflex To Hexagnl85730	$28.00	$28.00	—	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt 85730	$28.00	$28.00	—	—	—
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Blood 84100	$22.00	$22.00	—	37% below	—
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Blood 84100	$22.00	$22.00	—	—	—
Potassium blood test CPT 84132 Potassium Serum 84132	$23.00	$23.00	—	32% below	—
Potassium blood test CPT 84132 Potassium Rbc	$23.00	$23.00	—	32% below	—
Potassium blood test inpatient CPT 84132 Potassium Serum 84132	$23.00	$23.00	—	—	—
Potassium blood test inpatient CPT 84132 Potassium Rbc	$23.00	$23.00	—	—	—
Progesterone blood test CPT 84144 Progesterone 84144	$96.00	$96.00	—	at median	—
Progesterone blood test CPT 84144 Progesterone Lc Ms 84144	$96.00	$96.00	—	at median	—
Progesterone blood test inpatient CPT 84144 Progesterone Lc Ms 84144	$96.00	$96.00	—	—	—
Progesterone blood test inpatient CPT 84144 Progesterone 84144	$96.00	$96.00	—	—	—
Prolactin blood test CPT 84146 Prolactin Total 84146	$89.00	$89.00	—	25% below	—
Prolactin blood test CPT 84146 Prolactin Total And Mono 84146	$90.00	$90.00	—	24% below	—
Prolactin blood test CPT 84146 Prolactin 84146	$90.00	$90.00	—	24% below	—
Prolactin blood test inpatient CPT 84146 Prolactin Total 84146	$89.00	$89.00	—	—	—
Prolactin blood test inpatient CPT 84146 Prolactin Total And Mono 84146	$90.00	$90.00	—	—	—
Prolactin blood test inpatient CPT 84146 Prolactin 84146	$90.00	$90.00	—	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time 85610	$20.00	$20.00	—	49% below	—
Prothrombin time (PT/INR) clotting test CPT 85610 Pt Mixing Study 85610	$20.00	$20.00	—	49% below	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time 85610	$20.00	$20.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Pt Mixing Study 85610	$20.00	$20.00	—	—	—
Rapid flu test (influenza antigen) CPT 87804 Influenza A 87804	$76.00	$76.00	—	4% above	—
Rapid flu test (influenza antigen) CPT 87804 Influenza A	$76.00	$76.00	—	4% above	—
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A 87804	$76.00	$76.00	—	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A	$76.00	$76.00	—	—	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A Screen 87880	$76.00	$76.00	—	5% above	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A Screen 87880	$76.00	$76.00	—	—	—
Renin blood test CPT 84244 Renin Activity Plasma 84244	$101.00	$101.00	—	3% below	—
Renin blood test CPT 84244 Plasma Renin Activity 84244	$101.00	$101.00	—	3% below	—
Renin blood test inpatient CPT 84244 Renin Activity Plasma 84244	$101.00	$101.00	—	—	—
Renin blood test inpatient CPT 84244 Plasma Renin Activity 84244	$101.00	$101.00	—	—	—
Rh blood typing CPT 86901 Arc Blood Typing Rh D 86901	$132.00	$132.00	—	183% above	—
Rh blood typing CPT 86901 Blood Typing Rh D 86901	$136.00	$136.00	—	191% above	—
Rh blood typing CPT 86901 Blood Typing Rh D 86901	$136.00	$136.00	—	191% above	—
Rh blood typing inpatient CPT 86901 Arc Blood Typing Rh D 86901	$132.00	$132.00	—	—	—
Rh blood typing inpatient CPT 86901 Blood Typing Rh D 86901	$136.00	$136.00	—	—	—
Rh blood typing inpatient CPT 86901 Blood Typing Rh D 86901	$136.00	$136.00	—	—	—
Rheumatoid factor (RF) test CPT 86431 Islet Cell Antibody 86431	$26.00	$26.00	—	65% below	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quant 86431	$26.00	$26.00	—	65% below	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Qnt 86431	$26.00	$26.00	—	65% below	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor 86431	$26.00	$26.00	—	65% below	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Qnt 86431	$26.00	$26.00	—	65% below	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quant 86431	$26.00	$26.00	—	65% below	—
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Qnt 86431	$26.00	$26.00	—	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor 86431	$26.00	$26.00	—	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quant 86431	$26.00	$26.00	—	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Qnt 86431	$26.00	$26.00	—	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quant 86431	$26.00	$26.00	—	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 Islet Cell Antibody 86431	$26.00	$26.00	—	—	—
Rubella antibody test (immunity check) CPT 86762 Rubella Ab 86762	$67.00	$67.00	—	3% below	—
Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies Igg 86762	$67.00	$67.00	—	3% below	—
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody Igm 86762	$67.00	$67.00	—	3% below	—
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody 86762	$67.00	$67.00	—	3% below	—
Rubella antibody test (immunity check) CPT 86762 Rubella Igg 86762	$67.00	$67.00	—	3% below	—
Rubella antibody test (immunity check) CPT 86762 Rubella Immune Status 86762	$67.00	$67.00	—	3% below	—
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Igg 86762	$67.00	$67.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Ab 86762	$67.00	$67.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody Igm 86762	$67.00	$67.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody 86762	$67.00	$67.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Immune Status 86762	$67.00	$67.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies Igg 86762	$67.00	$67.00	—	—	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate Auto 85652	$13.00	$13.00	—	61% below	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate Auto 85652	$13.00	$13.00	—	—	—
Sodium blood test CPT 84295 Sodium Serum 84295	$24.00	$24.00	—	26% below	—
Sodium blood test CPT 84295 Sodium 84295	$24.00	$24.00	—	26% below	—
Sodium blood test inpatient CPT 84295 Sodium Serum 84295	$24.00	$24.00	—	—	—
Sodium blood test inpatient CPT 84295 Sodium 84295	$24.00	$24.00	—	—	—
Stool ova and parasites exam CPT 87177 Ova Parasite Smear 87177	$41.00	$41.00	—	50% below	—
Stool ova and parasites exam CPT 87177 Ova And Parasite Smear 87177	$41.00	$41.00	—	50% below	—
Stool ova and parasites exam CPT 87177 Ova And Parasites Dirsmr 87177	$41.00	$41.00	—	50% below	—
Stool ova and parasites exam inpatient CPT 87177 Ova Parasite Smear 87177	$41.00	$41.00	—	—	—
Stool ova and parasites exam inpatient CPT 87177 Ova And Parasite Smear 87177	$41.00	$41.00	—	—	—
Stool ova and parasites exam inpatient CPT 87177 Ova And Parasites Dirsmr 87177	$41.00	$41.00	—	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Feces 3 Spc 82270	$21.00	$21.00	—	44% below	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Feces 3 Spc 82270	$21.00	$21.00	—	—	—
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum Igg 86780	$61.00	$61.00	—	9% below	—
Syphilis antibody test (Treponema pallidum) CPT 86780 Fta Abs 86780	$66.00	$66.00	—	1% below	—
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum?Antib 86780	$66.00	$66.00	—	1% below	—
Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Anby Cascade Ref86780	$66.00	$66.00	—	1% below	—
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum 86780	$66.00	$66.00	—	1% below	—
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum Ab 86780	$66.00	$66.00	—	1% below	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema Pallidum Igg 86780	$61.00	$61.00	—	—	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema Pallidum 86780	$66.00	$66.00	—	—	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema Pallidum?Antib 86780	$66.00	$66.00	—	—	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Syphilis Anby Cascade Ref86780	$66.00	$66.00	—	—	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema Pallidum Ab 86780	$66.00	$66.00	—	—	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Fta Abs 86780	$66.00	$66.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Vdrl Serum 86592	$20.00	$20.00	—	53% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr Syphillis Ab Qual 86592	$20.00	$20.00	—	53% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr W Reflex To Titer 86592	$20.00	$20.00	—	53% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr Refl Ttr Treponema Pall Ab	$20.00	$20.00	—	53% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr Syphilis Test Non Treponem	$20.00	$20.00	—	53% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Vdrl Csf 86592	$20.00	$20.00	—	53% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin 86592	$20.00	$20.00	—	53% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rpr Syphilis Test Non Treponem	$20.00	$20.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin 86592	$20.00	$20.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Vdrl Csf 86592	$20.00	$20.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rpr Refl Ttr Treponema Pall Ab	$20.00	$20.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Vdrl Serum 86592	$20.00	$20.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rpr Syphillis Ab Qual 86592	$20.00	$20.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rpr W Reflex To Titer 86592	$20.00	$20.00	—	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quaniferon Tb Gold Plus 86480	$285.00	$285.00	—	72% above	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon Tb Gold 86480	$285.00	$285.00	—	72% above	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quaniferon Tb Gold Plus 86480	$285.00	$285.00	—	—	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon Tb Gold 86480	$285.00	$285.00	—	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone 84403	$119.00	$119.00	—	9% below	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total	$119.00	$119.00	—	9% below	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total Ms 84403	$119.00	$119.00	—	9% below	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total Males 84403	$119.00	$119.00	—	9% below	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total 84403	$119.00	$119.00	—	9% below	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total Ms 84403	$119.00	$119.00	—	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone 84403	$119.00	$119.00	—	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total 84403	$119.00	$119.00	—	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total	$119.00	$119.00	—	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total Males 84403	$119.00	$119.00	—	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Ab 86376	$67.00	$67.00	—	27% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Liverkidney Microsom Igg 86376	$67.00	$67.00	—	27% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver Kidney Microsome 86376	$67.00	$67.00	—	27% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Ab 86376	$67.00	$67.00	—	27% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase 86376	$67.00	$67.00	—	27% below	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liverkidney Microsom Igg 86376	$67.00	$67.00	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver Kidney Microsome 86376	$67.00	$67.00	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase 86376	$67.00	$67.00	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Ab 86376	$67.00	$67.00	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Ab 86376	$67.00	$67.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh Wreflex Free T4 84443	$77.00	$77.00	—	13% below	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulate Hormon 84443	$84.00	$84.00	—	5% below	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulat Hormone 84443	$84.00	$84.00	—	5% below	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Cascading Reflex 84443	$84.00	$84.00	—	5% below	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Tsh Wreflex Free T4 84443	$77.00	$77.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulate Hormon 84443	$84.00	$84.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulat Hormone 84443	$84.00	$84.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Cascading Reflex 84443	$84.00	$84.00	—	—	—
Total IgE blood test CPT 82785 Gammaglobulin Ige 82785	$76.00	$76.00	—	1% above	—
Total IgE blood test CPT 82785 Gammaglobulin Ige 82785	$76.00	$76.00	—	1% above	—
Total IgE blood test CPT 82785 Ige 82785	$76.00	$76.00	—	1% above	—
Total IgE blood test CPT 82785 Ige 82785	$76.00	$76.00	—	1% above	—
Total IgE blood test CPT 82785 Immunoglobulin E 82785	$76.00	$76.00	—	1% above	—
Total IgE blood test inpatient CPT 82785 Gammaglobulin Ige 82785	$76.00	$76.00	—	—	—
Total IgE blood test inpatient CPT 82785 Gammaglobulin Ige 82785	$76.00	$76.00	—	—	—
Total IgE blood test inpatient CPT 82785 Ige 82785	$76.00	$76.00	—	—	—
Total IgE blood test inpatient CPT 82785 Ige 82785	$76.00	$76.00	—	—	—
Total IgE blood test inpatient CPT 82785 Immunoglobulin E 82785	$76.00	$76.00	—	—	—
Total cholesterol blood test CPT 82465 Cholesterol Serum 82465	$22.00	$22.00	—	24% below	—
Total cholesterol blood test inpatient CPT 82465 Cholesterol Serum 82465	$22.00	$22.00	—	—	—
Total thyroxine (T4) blood test CPT 84436 T4 Thyroxine 84436	$32.00	$32.00	—	37% below	—
Total thyroxine (T4) blood test CPT 84436 T4 Total Thyroxine 84436	$32.00	$32.00	—	37% below	—
Total thyroxine (T4) blood test CPT 84436 T4 Thyroxine Total 84436	$32.00	$32.00	—	37% below	—
Total thyroxine (T4) blood test inpatient CPT 84436 T4 Total Thyroxine 84436	$32.00	$32.00	—	—	—
Total thyroxine (T4) blood test inpatient CPT 84436 T4 Thyroxine 84436	$32.00	$32.00	—	—	—
Total thyroxine (T4) blood test inpatient CPT 84436 T4 Thyroxine Total 84436	$32.00	$32.00	—	—	—
Total triiodothyronine (T3) blood test CPT 84480 T3 Total 84480	$66.00	$66.00	—	21% below	—
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 Total 84480	$66.00	$66.00	—	—	—
Transferrin blood test CPT 84466 Transferrin 84466	$59.00	$59.00	—	33% below	—
Transferrin blood test CPT 84466 Transferrin 84466	$59.00	$59.00	—	33% below	—
Transferrin blood test inpatient CPT 84466 Transferrin 84466	$59.00	$59.00	—	—	—
Transferrin blood test inpatient CPT 84466 Transferrin 84466	$59.00	$59.00	—	—	—
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalisrna	$161.00	$161.00	—	77% above	—
Trichomonas test (NAAT) CPT 87661 Trichomonas Amplif 87661	$161.00	$161.00	—	77% above	—
Trichomonas test (NAAT) CPT 87661 Trachomatis Vaginalis 87661	$161.00	$161.00	—	77% above	—
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalisrna 87661	$161.00	$161.00	—	77% above	—
Trichomonas test (NAAT) CPT 87661 Trichomonasvaginalis Rna 87661	$161.00	$161.00	—	77% above	—
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalismale87661	$161.00	$161.00	—	77% above	—
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Amplif 87661	$161.00	$161.00	—	—	—
Trichomonas test (NAAT) inpatient CPT 87661 Trachomatis Vaginalis 87661	$161.00	$161.00	—	—	—
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalisrna	$161.00	$161.00	—	—	—
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalismale87661	$161.00	$161.00	—	—	—
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonasvaginalis Rna 87661	$161.00	$161.00	—	—	—
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalisrna 87661	$161.00	$161.00	—	—	—
Triglycerides blood test CPT 84478 Triglycerides	$29.00	$29.00	—	27% below	—
Triglycerides blood test CPT 84478 Triglycerides 84478	$29.00	$29.00	—	27% below	—
Triglycerides blood test CPT 84478 Trigyceride 84478	$29.00	$29.00	—	27% below	—
Triglycerides blood test CPT 84478 Triglycerides Pleural Fluid	$29.00	$29.00	—	27% below	—
Triglycerides blood test inpatient CPT 84478 Triglycerides Pleural Fluid	$29.00	$29.00	—	—	—
Triglycerides blood test inpatient CPT 84478 Trigyceride 84478	$29.00	$29.00	—	—	—
Triglycerides blood test inpatient CPT 84478 Triglycerides 84478	$29.00	$29.00	—	—	—
Triglycerides blood test inpatient CPT 84478 Triglycerides	$29.00	$29.00	—	—	—
Troponin test, quantitative CPT 84484 Ed Poc Troponin Quant 84484	$49.88	$49.88	—	60% below	—
Troponin test, quantitative CPT 84484 Troponin T 84484	$58.00	$58.00	—	54% below	—
Troponin test, quantitative CPT 84484 Toponin I High Sensitiv 84484	$58.00	$58.00	—	54% below	—
Troponin test, quantitative CPT 84484 Troponin 1 Quantitative 84484	$58.00	$58.00	—	54% below	—
Troponin test, quantitative inpatient CPT 84484 Ed Poc Troponin Quant 84484	$49.88	$49.88	—	—	—
Troponin test, quantitative inpatient CPT 84484 Toponin I High Sensitiv 84484	$58.00	$58.00	—	—	—
Troponin test, quantitative inpatient CPT 84484 Troponin T 84484	$58.00	$58.00	—	—	—
Troponin test, quantitative inpatient CPT 84484 Troponin 1 Quantitative 84484	$58.00	$58.00	—	—	—
Uric acid blood test CPT 84550 Uric Acid Blood 84550	$23.00	$23.00	—	55% below	—
Uric acid blood test inpatient CPT 84550 Uric Acid Blood 84550	$23.00	$23.00	—	—	—
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Wmicroscopy 81001	$15.00	$15.00	—	76% below	—
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Wmicroscopy 81001	$15.00	$15.00	—	—	—
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Womicroscopy 81003	$12.00	$12.00	—	67% below	—
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Womicroscopy 81003	$12.00	$12.00	—	—	—
Urinalysis without microscope exam, manual CPT 81002 Reducing Substances 81002	$16.00	$16.00	—	56% below	—
Urinalysis without microscope exam, manual inpatient CPT 81002 Reducing Substances 81002	$16.00	$16.00	—	—	—
Urine culture for bacteria, with colony count CPT 87086 Culture Urine 87086	$37.00	$37.00	—	57% below	—
Urine culture for bacteria, with colony count inpatient CPT 87086 Culture Urine 87086	$37.00	$37.00	—	—	—
Urine microalbumin (albumin) test CPT 82043 Albumin Random Ur Wout Creat	$29.00	$29.00	—	48% below	—
Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine Qnt 82043	$29.00	$29.00	—	48% below	—
Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine 82043	$29.00	$29.00	—	48% below	—
Urine microalbumin (albumin) test CPT 82043 Albumin Urine Quant 82043	$29.00	$29.00	—	48% below	—
Urine microalbumin (albumin) test CPT 82043 Albumin 24 Hr Ur Wo Creatinine	$29.00	$29.00	—	48% below	—
Urine microalbumin (albumin) test CPT 82043 Albumin Random Ur Wo Creat	$29.00	$29.00	—	48% below	—
Urine microalbumin (albumin) test CPT 82043 Albumin Urine Quantitate 82043	$29.00	$29.00	—	48% below	—
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine Qnt 82043	$29.00	$29.00	—	—	—
Urine microalbumin (albumin) test inpatient CPT 82043 Albumin Urine Quantitate 82043	$29.00	$29.00	—	—	—
Urine microalbumin (albumin) test inpatient CPT 82043 Albumin Random Ur Wo Creat	$29.00	$29.00	—	—	—
Urine microalbumin (albumin) test inpatient CPT 82043 Albumin 24 Hr Ur Wo Creatinine	$29.00	$29.00	—	—	—
Urine microalbumin (albumin) test inpatient CPT 82043 Albumin Urine Quant 82043	$29.00	$29.00	—	—	—
Urine microalbumin (albumin) test inpatient CPT 82043 Albumin Random Ur Wout Creat	$29.00	$29.00	—	—	—
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine 82043	$29.00	$29.00	—	—	—
Urine pregnancy test, read by color change CPT 81025 Poc Pregnancy Urine 81025	$40.00	$40.00	—	49% below	—
Urine pregnancy test, read by color change CPT 81025 Pregnancy Urine 81025	$40.00	$40.00	—	49% below	—
Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy Urine 81025	$40.00	$40.00	—	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 Poc Pregnancy Urine 81025	$40.00	$40.00	—	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 Micronutrient Vitaminb12 82607	$69.00	$69.00	—	15% below	—
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 82607	$69.00	$69.00	—	15% below	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Micronutrient Vitaminb12 82607	$69.00	$69.00	—	—	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 82607	$69.00	$69.00	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Cardioiq Vitd 25 Hydroxy 82306	$136.00	$136.00	—	46% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Oh 82306	$136.00	$136.00	—	46% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Questassure Dtm25Hydroxy 82306	$136.00	$136.00	—	46% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Questassure Dtm25Hydroxy 82306	$136.00	$136.00	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Oh 82306	$136.00	$136.00	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Cardioiq Vitd 25 Hydroxy 82306	$136.00	$136.00	—	—	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D 1 25 Dihydroxy 82652	$177.00	$177.00	—	32% above	—
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D 1 25 Dihydroxy 82652	$177.00	$177.00	—	—	—
Zinc blood test CPT 84630 Zinc Serum 84630	$53.00	$53.00	—	19% below	—
Zinc blood test CPT 84630 Zinc	$53.00	$53.00	—	19% below	—
Zinc blood test CPT 84630 Zinc Rbc 84630	$53.00	$53.00	—	19% below	—
Zinc blood test inpatient CPT 84630 Zinc	$53.00	$53.00	—	—	—
Zinc blood test inpatient CPT 84630 Zinc Rbc 84630	$53.00	$53.00	—	—	—
Zinc blood test inpatient CPT 84630 Zinc Serum 84630	$53.00	$53.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin Chorionic 84702	$69.00	$69.00	—	42% below	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Quantitative 84702	$69.00	$69.00	—	42% below	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Total Quantitative 84702	$69.00	$69.00	—	42% below	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Alternate Method 84702	$69.00	$69.00	—	42% below	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg Quantitative 84702	$69.00	$69.00	—	42% below	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg Quantitative 84702	$69.00	$69.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg Total Quantitative 84702	$69.00	$69.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta Hcg Quantitative 84702	$69.00	$69.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Gonadotropin Chorionic 84702	$69.00	$69.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg Alternate Method 84702	$69.00	$69.00	—	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Tr Cl Distal Fib No Red 27786	$858.00	$858.00	—	55% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Tr Cl Distal Fib No Red 27786	$858.00	$858.00	—	—	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Treat Metatarsal Fx 28470	$858.00	$858.00	—	6% above	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Treat Metatarsal Fx 28470	$858.00	$858.00	—	—	—
Cardiac catheterization with coronary angiogram CPT 93458 Abort Cath 93458	$8,750.00	$8,750.00	—	8% below	—
Cardiac catheterization with coronary angiogram CPT 93458 Card L Cath Nvgm 93458	$17,500.00	$17,500.00	—	84% above	—
Cardiac catheterization with coronary angiogram CPT 93458 Lt Heart Art Vent Angio 93458	$17,500.00	$17,500.00	—	84% above	—
Cardiac catheterization with coronary angiogram inpatient CPT 93458 Abort Cath 93458	$8,750.00	$8,750.00	—	—	—
Cardiac catheterization with coronary angiogram inpatient CPT 93458 Card L Cath Nvgm 93458	$17,500.00	$17,500.00	—	—	—
Cardiac catheterization with coronary angiogram inpatient CPT 93458 Lt Heart Art Vent Angio 93458	$17,500.00	$17,500.00	—	—	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Hhi 92960	$1,772.00	$1,772.00	—	20% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Icu 92960	$2,363.00	$2,363.00	—	59% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Ed 92960	$2,363.00	$2,363.00	—	59% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Ph Icu 92960	$2,363.00	$2,363.00	—	59% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Cardiology 92960	$2,363.00	$2,363.00	—	59% above	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Hhi 92960	$1,772.00	$1,772.00	—	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Icu 92960	$2,363.00	$2,363.00	—	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Cardiology 92960	$2,363.00	$2,363.00	—	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Ed 92960	$2,363.00	$2,363.00	—	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Ph Icu 92960	$2,363.00	$2,363.00	—	—	—
Catheter ablation for atrial fibrillation CPT 93656 Ep Ablat Afib Arrhythm 93656	$64,184.00	$64,184.00	—	331% above	—
Catheter ablation for atrial fibrillation inpatient CPT 93656 Ep Ablat Afib Arrhythm 93656	$64,184.00	$64,184.00	—	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Treat Distal Radial Fx 25600	$858.00	$858.00	—	64% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Treat Distal Radial Fx 25600	$858.00	$858.00	—	—	—
Coronary stent placement, one artery CPT 92928 Cardnon Rx Elut Stent Int92928	$29,016.00	$29,016.00	—	152% above	—
Coronary stent placement, one artery inpatient CPT 92928 Cardnon Rx Elut Stent Int92928	$29,016.00	$29,016.00	—	—	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystoscopy At Bedside 52000	$2,279.00	$2,279.00	—	41% above	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Cystoscopy At Bedside 52000	$2,279.00	$2,279.00	—	—	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 Impact Cerumen Irrig Lavage	$170.00	$170.00	—	66% above	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 Tech Ent Impacted Cerumen69209	$199.00	$199.00	—	94% above	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 Ent Impact Cerumen Irrig 69209	$231.00	$231.00	—	125% above	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Impact Cerumen Irrig Lavage	$170.00	$170.00	—	—	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Tech Ent Impacted Cerumen69209	$199.00	$199.00	—	—	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Ent Impact Cerumen Irrig 69209	$231.00	$231.00	—	—	—
Earwax removal with instruments, one ear CPT 69210 Tech Ent Impact Cerumen 69210	$141.00	$141.00	—	61% below	—
Earwax removal with instruments, one ear CPT 69210 Remove Impacted Cerumen	$170.00	$170.00	—	53% below	—
Earwax removal with instruments, one ear CPT 69210 Remove Impacted Cerumen 69210	$231.00	$231.00	—	36% below	—
Earwax removal with instruments, one ear inpatient CPT 69210 Tech Ent Impact Cerumen 69210	$141.00	$141.00	—	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 Remove Impacted Cerumen	$170.00	$170.00	—	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 Remove Impacted Cerumen 69210	$231.00	$231.00	—	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 Tech Incise Drain S Ms 10060	$488.00	$488.00	—	19% below	—
Incision and drainage of a simple or single skin abscess CPT 10060 I D Abscess Sngl Simp 10060	$491.00	$491.00	—	18% below	—
Incision and drainage of a simple or single skin abscess CPT 10060 I D Abscess Simple 10060	$725.00	$725.00	—	21% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 Incise Drain Abscess 10060	$725.00	$725.00	—	21% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 Incise Drain Abscess S S 10060	$726.00	$726.00	—	21% above	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Tech Incise Drain S Ms 10060	$488.00	$488.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I D Abscess Sngl Simp 10060	$491.00	$491.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I D Abscess Simple 10060	$725.00	$725.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incise Drain Abscess 10060	$725.00	$725.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incise Drain Abscess S S 10060	$726.00	$726.00	—	—	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inject Tendon Lig Gangli 20550	$1,092.00	$1,092.00	—	7% below	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inject Tendon Lig Gangli 20550	$1,092.00	$1,092.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drain Inj Jntbursa Wous H2M	$1,041.00	$1,041.00	—	15% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 M Joint Asp Inject Wo Us 20610	$1,092.00	$1,092.00	—	21% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Major Joint Asp Inj Wous 20610	$1,092.00	$1,092.00	—	21% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis M Jt Burs 20610	$1,092.00	$1,092.00	—	21% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Drain Inj Jntbursa Wous H2M	$1,041.00	$1,041.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis M Jt Burs 20610	$1,092.00	$1,092.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 M Joint Asp Inject Wo Us 20610	$1,092.00	$1,092.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Major Joint Asp Inj Wous 20610	$1,092.00	$1,092.00	—	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis I Jt Burs 20605	$1,092.00	$1,092.00	—	45% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis I Jt Burs 20605	$1,092.00	$1,092.00	—	—	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis S Jt Burs 20600	$1,092.00	$1,092.00	—	120% above	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis S Jt Burs 20600	$1,092.00	$1,092.00	—	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Sut C Scalp Trunk Lt2.6 12031	$1,499.00	$1,499.00	—	259% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Sut C Scalp Trunk Lt2.6 12031	$1,499.00	$1,499.00	—	—	—
Left heart catheterization, diagnostic CPT 93452 Lt Heart Cath Wvgram S I 93452	$17,500.00	$17,500.00	—	170% above	—
Left heart catheterization, diagnostic inpatient CPT 93452 Lt Heart Cath Wvgram S I 93452	$17,500.00	$17,500.00	—	—	—
Nail removal (partial or complete), one nail CPT 11730 Avulsion Of Nail Plate 1	$416.00	$416.00	—	34% below	—
Nail removal (partial or complete), one nail CPT 11730 Tech Nail Remove Initial 11730	$482.00	$482.00	—	24% below	—
Nail removal (partial or complete), one nail CPT 11730 Avulsion Of Nail Plate S 11730	$726.00	$726.00	—	15% above	—
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Of Nail Plate 1	$416.00	$416.00	—	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 Tech Nail Remove Initial 11730	$482.00	$482.00	—	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Of Nail Plate S 11730	$726.00	$726.00	—	—	—
Paracentesis with imaging guidance CPT 49083 Abd Paracentesis Wimg Ed 49083	$3,341.00	$3,341.00	—	113% above	—
Paracentesis with imaging guidance inpatient CPT 49083 Abd Paracentesis Wimg Ed 49083	$3,341.00	$3,341.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Of Nail Part Complt	$952.00	$952.00	—	2% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Of Nail Matrix 11750	$1,499.00	$1,499.00	—	61% above	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Of Nail Part Complt	$952.00	$952.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Of Nail Matrix 11750	$1,499.00	$1,499.00	—	—	—
Removal of a foreign object under the skin, simple CPT 10120 Tech Foreign Body Skin S 10120	$1,181.00	$1,181.00	—	6% above	—
Removal of a foreign object under the skin, simple CPT 10120 Incise Fbr Subq Tissue S 10120	$1,499.00	$1,499.00	—	34% above	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 Tech Foreign Body Skin S 10120	$1,181.00	$1,181.00	—	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incise Fbr Subq Tissue S 10120	$1,499.00	$1,499.00	—	—	—
Short arm cast (elbow to hand) CPT 29075 Cast Elbow Finger 29075	$977.00	$977.00	—	10% above	—
Short arm cast (elbow to hand) inpatient CPT 29075 Cast Elbow Finger 29075	$977.00	$977.00	—	—	—
Short arm splint (forearm and hand) CPT 29125 Tech App Splint Arm Immb 29125	$332.00	$332.00	—	14% below	—
Short arm splint (forearm and hand) CPT 29125 Apply Splint Arm Short S 29125	$466.00	$466.00	—	21% above	—
Short arm splint (forearm and hand) inpatient CPT 29125 Tech App Splint Arm Immb 29125	$332.00	$332.00	—	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 Apply Splint Arm Short S 29125	$466.00	$466.00	—	—	—
Short leg cast (below the knee) CPT 29405 Cast Short Leg 29405	$977.00	$977.00	—	208% above	—
Short leg cast (below the knee) inpatient CPT 29405 Cast Short Leg 29405	$977.00	$977.00	—	—	—
Short leg splint (calf to foot) CPT 29515 Tech App Splint Leg Shor 29515	$437.00	$437.00	—	14% above	—
Short leg splint (calf to foot) CPT 29515 Apply Splint Leg Short 29515	$586.00	$586.00	—	52% above	—
Short leg splint (calf to foot) inpatient CPT 29515 Tech App Splint Leg Shor 29515	$437.00	$437.00	—	—	—
Short leg splint (calf to foot) inpatient CPT 29515 Apply Splint Leg Short 29515	$586.00	$586.00	—	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Tech Lac S Lest 2.6Cm Oth12001	$528.00	$528.00	—	84% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Sut S Sclp Nec Ext Lt2.6 12001	$726.00	$726.00	—	152% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Tech Lac S Lest 2.6Cm Oth12001	$528.00	$528.00	—	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Sut S Sclp Nec Ext Lt2.6 12001	$726.00	$726.00	—	—	—
Skin biopsy, punch, one lesion CPT 11104 Punch Bx Skin Addt Les 11105	$800.00	$800.00	—	40% above	—
Skin biopsy, punch, one lesion CPT 11104 Punch Bx Skin Singl Lesion	$843.00	$843.00	—	48% above	—
Skin biopsy, punch, one lesion CPT 11104 Punch Bx Skin 1St Les 11104	$1,601.00	$1,601.00	—	180% above	—
Skin biopsy, punch, one lesion CPT 11104 Punch Bx Skin 1St Les Ed 11104	$1,601.00	$1,601.00	—	180% above	—
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bx Skin Addt Les 11105	$800.00	$800.00	—	—	—
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bx Skin Singl Lesion	$843.00	$843.00	—	—	—
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bx Skin 1St Les Ed 11104	$1,601.00	$1,601.00	—	—	—
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bx Skin 1St Les 11104	$1,601.00	$1,601.00	—	—	—
Skin tag removal, up to 15 tags CPT 11200 Remove Skin Tag 1 To 15 11200	$726.00	$726.00	—	129% above	—
Skin tag removal, up to 15 tags inpatient CPT 11200 Remove Skin Tag 1 To 15 11200	$726.00	$726.00	—	—	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Ed 62270	$2,589.00	$2,589.00	—	104% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Ivt 62270	$2,589.00	$2,589.00	—	104% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Nursery 62270	$2,589.00	$2,589.00	—	104% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture H2P 62270	$2,589.00	$2,589.00	—	104% above	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture Ivt 62270	$2,589.00	$2,589.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture Nursery 62270	$2,589.00	$2,589.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture Ed 62270	$2,589.00	$2,589.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture H2P 62270	$2,589.00	$2,589.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Tech Lac S 2.6To7.5Cm Oth12002	$486.00	$486.00	—	22% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Sut S Sclp Neck 2.6To7.5 12002	$726.00	$726.00	—	82% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Tech Lac S 2.6To7.5Cm Oth12002	$486.00	$486.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Sut S Sclp Neck 2.6To7.5 12002	$726.00	$726.00	—	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Sut S Face Ear Nos Lt2.6 12011	$726.00	$726.00	—	105% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair one side CPT 12011 Tech Lac S Lt 2.5Cm Face 12011	$487.00	$487.00	—	37% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Sut S Face Ear Nos Lt2.6 12011	$726.00	$726.00	—	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient one side CPT 12011 Tech Lac S Lt 2.5Cm Face 12011	$487.00	$487.00	—	—	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangntl Bx Skin Single Lesion	$535.00	$535.00	—	4% below	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangntl Bx Skin Single Lesion	$535.00	$535.00	—	—	—
Thoracentesis with imaging guidance CPT 32555 Thoracentesis Us Bedside 32555	$2,506.00	$2,506.00	—	78% above	—
Thoracentesis with imaging guidance CPT 32555 Thoracentesis Wimage Ivt 32555	$2,506.00	$2,506.00	—	78% above	—
Thoracentesis with imaging guidance CPT 32555 Thorcentesis Wimage Ed 32555	$2,506.00	$2,506.00	—	78% above	—
Thoracentesis with imaging guidance CPT 32555 Thoracentesis Wimage Us 32555	$2,506.00	$2,506.00	—	78% above	—
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis Wimage Ivt 32555	$2,506.00	$2,506.00	—	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis Us Bedside 32555	$2,506.00	$2,506.00	—	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 Thorcentesis Wimage Ed 32555	$2,506.00	$2,506.00	—	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis Wimage Us 32555	$2,506.00	$2,506.00	—	—	—
Trigger point injections, 1 or 2 muscles CPT 20552 Inj Trigger Point 1To2 20552	$1,092.00	$1,092.00	—	10% below	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj Trigger Point 1To2 20552	$1,092.00	$1,092.00	—	—	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Up Gi Endo Wesop Dilate 43248	$4,513.00	$4,513.00	—	144% above	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 Up Gi Endo Wesop Dilate 43248	$4,513.00	$4,513.00	—	—	—
Upper endoscopy (EGD), diagnostic CPT 43235 Upper Gi Endoscopy Sim 43235	$5,700.00	$5,700.00	—	270% above	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Upper Gi Endoscopy Sim 43235	$5,700.00	$5,700.00	—	—	—
Wart removal, up to 14 warts CPT 17110 Destruction Wart Lt15 17110	$726.00	$726.00	—	35% below	—
Wart removal, up to 14 warts inpatient CPT 17110 Destruction Wart Lt15 17110	$726.00	$726.00	—	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Subq 1St 20Sq Cm	$952.00	$952.00	—	13% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Subq 1St 20Sq Cm 11042	$1,499.00	$1,499.00	—	37% above	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Skn Sq Tissue 11042	$1,499.00	$1,499.00	—	37% above	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Subq 1St 20Sq Cm	$952.00	$952.00	—	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Skn Sq Tissue 11042	$1,499.00	$1,499.00	—	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Subq 1St 20Sq Cm 11042	$1,499.00	$1,499.00	—	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U H5 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U Nursery 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U H4M 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U H2Wc 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U Ed 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U H2N 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U H2M 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U Cl 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U H4W 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U Dialy 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U P Meds 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U H2P 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U H2W 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U H3M 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U Ivt 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U P Icu 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U Ir 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U Surg 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 1U H4N 36430	$1,638.00	$1,638.00	—	112% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U H2W 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U P Icu 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U H3M 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U H4N 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U H2P 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U H2Wc	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U H2N 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U Surg 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U Ed 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U P Meds 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U H4W 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U Nursery 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U H5 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U Cl 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U H4M 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U Ivt 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U Dialy 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 2U H2M 36430	$1,748.00	$1,748.00	—	126% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U Ivt 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U H4M 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U H5 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U H2M 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U H2P 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U P Meds 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U H2N 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U H3M 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U P Icu 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U H4N 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U H4W 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U Nursery 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U H2W 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U Surg 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U Ed 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 3U Cl 36430	$1,859.00	$1,859.00	—	140% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U Ed 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U H4W 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U H2P 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U H2W 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U Ivt 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U H5 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U Cl 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U Nursery 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U H2N 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U P Icu 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U H2M 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U H3M 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U H4M 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U H4N 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U Surg 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 4U P Meds 36430	$1,969.00	$1,969.00	—	154% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 5U Ed 36430	$2,079.00	$2,079.00	—	169% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 5U H5 36430	$2,079.00	$2,079.00	—	169% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 5U P Meds 36430	$2,079.00	$2,079.00	—	169% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 5U H4W 36430	$2,079.00	$2,079.00	—	169% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 5U Surg 36430	$2,079.00	$2,079.00	—	169% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 6U H2N 36430	$2,189.00	$2,189.00	—	183% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 6U Surg 36430	$2,189.00	$2,189.00	—	183% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 6U H4W 36430	$2,189.00	$2,189.00	—	183% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 6U Ed 36430	$2,189.00	$2,189.00	—	183% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 6U Ivt 36430	$2,189.00	$2,189.00	—	183% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 5U Ivt 36430	$2,189.00	$2,189.00	—	183% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 7U H4W 36430	$2,300.00	$2,300.00	—	197% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 7U H2W 36430	$2,300.00	$2,300.00	—	197% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 7U Ed 36430	$2,300.00	$2,300.00	—	197% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 7U H4M	$2,300.00	$2,300.00	—	197% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 8U H4W 36430	$2,410.00	$2,410.00	—	211% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 8U Surg 36430	$2,410.00	$2,410.00	—	211% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 9U H4W 36430	$2,520.00	$2,520.00	—	226% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 11U H4W 36430	$2,741.00	$2,741.00	—	254% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 12U H4W 36430	$2,851.00	$2,851.00	—	268% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 14U H4W 36430	$3,071.00	$3,071.00	—	297% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 15U H4W 36430	$3,182.00	$3,182.00	—	311% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 16U H4W 36430	$3,292.00	$3,292.00	—	325% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 20U H4W 36430	$3,733.00	$3,733.00	—	382% above	—
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Bld 26U H4W 36430	$4,394.00	$4,394.00	—	468% above	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U H2N 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U Dialy 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U Ed 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U H4M 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U H5 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U Ivt 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U Surg 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U H2W 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U Ir 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U H2M 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U Nursery 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U H2Wc 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U Cl 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U H2P 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U P Meds 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U H4W 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U H4N 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U P Icu 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 1U H3M 36430	$1,638.00	$1,638.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U H4W 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U Ed 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U H4M 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U H2W 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U H5 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U Nursery 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U Surg 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U Ivt 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U P Icu 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U H2M 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U H3M 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U H2P 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U H2Wc	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U H2N 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U P Meds 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U Cl 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U H4N 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 2U Dialy 36430	$1,748.00	$1,748.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U H4W 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U H4M 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U Ed 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U H4N 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U H2M 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U H2W 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U Cl 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U P Meds 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U H5 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U Ivt 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U P Icu 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U H2P 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U H3M 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U Surg 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U Nursery 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 3U H2N 36430	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U P Icu 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U H2W 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U H4M 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U H2M 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U Surg 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U H2P 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U H2N 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U H4W 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U Ed 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U P Meds 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U H4N 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U Cl 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U H3M 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U Ivt 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U Nursery 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 4U H5 36430	$1,969.00	$1,969.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 5U H4W 36430	$2,079.00	$2,079.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 5U P Meds 36430	$2,079.00	$2,079.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 5U H5 36430	$2,079.00	$2,079.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 5U Ed 36430	$2,079.00	$2,079.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 5U Surg 36430	$2,079.00	$2,079.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 6U H2N 36430	$2,189.00	$2,189.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 6U Ed 36430	$2,189.00	$2,189.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 6U H4W 36430	$2,189.00	$2,189.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 5U Ivt 36430	$2,189.00	$2,189.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 6U Surg 36430	$2,189.00	$2,189.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 6U Ivt 36430	$2,189.00	$2,189.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 7U H2W 36430	$2,300.00	$2,300.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 7U Ed 36430	$2,300.00	$2,300.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 7U H4M	$2,300.00	$2,300.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 7U H4W 36430	$2,300.00	$2,300.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 8U Surg 36430	$2,410.00	$2,410.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 8U H4W 36430	$2,410.00	$2,410.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 9U H4W 36430	$2,520.00	$2,520.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 11U H4W 36430	$2,741.00	$2,741.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 12U H4W 36430	$2,851.00	$2,851.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 14U H4W 36430	$3,071.00	$3,071.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 15U H4W 36430	$3,182.00	$3,182.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 16U H4W 36430	$3,292.00	$3,292.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 20U H4W 36430	$3,733.00	$3,733.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Bld 26U H4W 36430	$4,394.00	$4,394.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Treatmt Adult 94640	$581.00	$581.00	—	208% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Metered Dose Inhaler Tmt 94640	$581.00	$581.00	—	208% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Treatment Peds 94640	$581.00	$581.00	—	208% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Vent Treatment 94640	$581.00	$581.00	—	208% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Sputum Induct Init Day 94640	$581.00	$581.00	—	208% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aero Neb Tx Initial Ms 94640	$581.00	$581.00	—	208% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Metered Dose Inhaler Tmt 94640	$581.00	$581.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aero Neb Tx Initial Ms 94640	$581.00	$581.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Treatmt Adult 94640	$581.00	$581.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Sputum Induct Init Day 94640	$581.00	$581.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Treatment Peds 94640	$581.00	$581.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Vent Treatment 94640	$581.00	$581.00	—	—	—
Chemotherapy IV infusion, first hour CPT 96413 Chemo Inf Initial 1St Hr 96413	$1,364.00	$1,364.00	—	204% above	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Inf Initial 1St Hr 96413	$1,364.00	$1,364.00	—	—	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg Awake Drowsy 95816	$1,233.00	$1,233.00	—	107% above	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Eeg Awake Drowsy 95816	$1,233.00	$1,233.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg Technical Ms 93005	$298.00	$298.00	—	57% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg Tech Hmc Opsurg 93005	$298.00	$298.00	—	57% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg Technical Hpdc 93005	$298.00	$298.00	—	57% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg Technical 93005	$298.00	$298.00	—	57% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg Technical Ed 93005	$298.00	$298.00	—	57% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg Technical Ms 93005	$298.00	$298.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg Technical Ed 93005	$298.00	$298.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg Tech Hmc Opsurg 93005	$298.00	$298.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg Technical 93005	$298.00	$298.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg Technical Hpdc 93005	$298.00	$298.00	—	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Ed Level 1 99281	$1,700.00	$1,700.00	—	635% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Ed Level 1 99281	$1,700.00	$1,700.00	—	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Ed Level 2 99282	$1,900.00	$1,900.00	—	430% above	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Ed Level 2 99282	$1,900.00	$1,900.00	—	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Ed Level 3 99283	$2,100.00	$2,100.00	—	233% above	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Ed Level 3 99283	$2,100.00	$2,100.00	—	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Ed Level 4 99284	$2,300.00	$2,300.00	—	187% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Ed Level 4 99284	$2,300.00	$2,300.00	—	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Ed Level 5 99285	$3,650.00	$3,650.00	—	231% above	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Ed Level 5 99285	$3,650.00	$3,650.00	—	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiac Stress Test 93017	$1,021.00	$1,021.00	—	22% above	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiac Stress Test 93017	$1,021.00	$1,021.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr H5 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr H2M 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr H4N 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr H4M 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr P Icu 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr Nurser 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr H3M 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr Edinpt 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr H2N 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr H2W 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr P Meds 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr Cl 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr H2P 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr Hwomen 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr Ms 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr Hisu 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr H4W 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr P Surg 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydrate Iv Inf 1Sthr Ivt 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Inf Hydrate 1Sthr H Ed 96360	$678.00	$678.00	—	134% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr H4M 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr H2W 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr Nurser 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr Hwomen 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr H4W 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr H Ed 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr Edinpt 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr Cl 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr H4N 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr Hisu 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr P Icu 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr H3M 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydrate Iv Inf 1Sthr Ivt 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr H2N 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr P Meds 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr H2P 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr H2M 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr Ms 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr H5 96360	$678.00	$678.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Inf Hydrate 1Sthr P Surg 96360	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr H4M 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr H4W 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr H5 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr H2M 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr H2W 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr H4N 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr H2P 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr P Meds 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr Ir 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr H2N 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr H3M 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr Surg 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr Hisru 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr Nursery 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr Ed 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr Cl 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr Ed Inpt 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr P Icu 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr H Women 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse Initial 1Sthr Ivt 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour CPT 96365 Infuse 1St Hr Hcard 96365	$678.00	$678.00	—	132% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr Hcard 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr H4N 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr P Icu 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr H3M 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr H2N 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr P Meds 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr H2P 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr H2M 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr H5 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr H4M 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr H Women 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr Nursery 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr H2W 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr Surg 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr Ed 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr Ed Inpt 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse Initial 1Sthr Ivt 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr Hisru 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr Ir 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr Cl 96365	$678.00	$678.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 Infuse 1St Hr H4W 96365	$678.00	$678.00	—	—	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx Nursery 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx H5 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx Ivt 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx H4M 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx Ed 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx Hwomen 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx Ed Inpt 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx H4W 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx Irru 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx H4N 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx P Icu 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx H3M 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx H2N 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx Cl 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx Hisru 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx P Meds 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx H2P 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx Medstop 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx Pacu 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx O Surg 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx H2W 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug CPT 96374 Ivp Sngl Init Rx H2M 96374	$678.00	$678.00	—	225% above	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx Medstop 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx H4M 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx H5 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx H2M 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx H2P 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx P Meds 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx H2N 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx H3M 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx P Icu 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx H4N 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx H4W 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx Hwomen 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx Nursery 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx H2W 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx O Surg 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx Pacu 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx Ed 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx Ed Inpt 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx Cl 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx Irru 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx Hisru 96374	$678.00	$678.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 Ivp Sngl Init Rx Ivt 96374	$678.00	$678.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq H4N 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq P Icu 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq Ed 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq Medstop 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq H3M 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq Ivt 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq H5 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq H4M 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq H2M 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq Cl 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq H4W 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq H Women 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq Nursery 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq H2W 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq Surg 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq Pain Clinic 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq H2N 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq Ph Wound Ctr	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq P Meds 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq Ed Inpt 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq H2P 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im Sq Hmc H1W 96372	$221.00	$221.00	—	122% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq Ivt 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq Pain Clinic 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq Ed 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq Ed Inpt 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq Ph Wound Ctr	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq Cl 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq Medstop 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq Hmc H1W 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq Surg 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq H2W 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq Nursery 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq H Women 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq H4W 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq H4N 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq H4M 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq P Icu 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq H3M 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq H2N 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq P Meds 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq H2P 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq H2M 96372	$221.00	$221.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject Im Sq H5 96372	$221.00	$221.00	—	—	—
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nerve Conduct Std 7 To8 95910	$3,398.00	$3,398.00	—	136% above	—
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Nerve Conduct Std 7 To8 95910	$3,398.00	$3,398.00	—	—	—
Spirometry (breathing test) CPT 94010 Spirometry 94010	$596.00	$596.00	—	143% above	—
Spirometry (breathing test) CPT 94010 Spirometry Bedside 94010	$596.00	$596.00	—	143% above	—
Spirometry (breathing test) inpatient CPT 94010 Spirometry Bedside 94010	$596.00	$596.00	—	—	—
Spirometry (breathing test) inpatient CPT 94010 Spirometry 94010	$596.00	$596.00	—	—	—
Spirometry before and after a bronchodilator CPT 94060 Spirometry W Bronch 94060	$1,272.00	$1,272.00	—	205% above	—
Spirometry before and after a bronchodilator inpatient CPT 94060 Spirometry W Bronch 94060	$1,272.00	$1,272.00	—	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy 99195	$453.00	$453.00	—	153% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy 99195	$453.00	$453.00	—	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 influenza virus vaccine 2024-2025 45 mcg (15 mcg x 3)/0.5 mL syringe 0.5 mL Syringe	$307.58	$307.58	—	43% above	—
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 influenza virus vaccine 2024-2025 45 mcg (15 mcg x 3)/0.5 mL syringe 0.5 mL Syringe	$307.58	$307.58	—	—	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 diph,pertus(acel),tet ped (PF) 25-58-10 Lf-mcg-Lf/0.5mL syringe 0.5 mL Syringe	$122.71	$122.71	—	115% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 diph,pertus(acel),tet ped (PF) 25-58-10 Lf-mcg-Lf/0.5mL syringe 0.5 mL Syringe	$122.71	$122.71	—	—	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTaP-hepatitis B recombinant-IPV 10 mcg-25Lf-25 mcg-10Lf/0.5 mL syringe 0.5 mL Syringe	$432.57	$432.57	—	58% above	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTaP-hepatitis B recombinant-IPV 10 mcg-25Lf-25 mcg-10Lf/0.5 mL syringe 0.5 mL Syringe	$432.57	$432.57	—	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Flu Vaccine Tri G6Mo 0.5Ml Syr	$42.95	$42.95	—	3% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza virus vaccine 2024-2025 45 mcg (15 mcg x 3)/0.5 mL syringe 0.5 mL Syringe	$82.36	$82.36	—	97% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Flu Vaccine Tri G6Mo 0.5Ml Syr	$42.95	$42.95	—	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza virus vaccine 2024-2025 45 mcg (15 mcg x 3)/0.5 mL syringe 0.5 mL Syringe	$82.36	$82.36	—	—	—
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 hepatitis A and B vaccine (PF) 720 ELISA unit- 20 mcg/mL syringe 1 mL Syringe	$555.17	$555.17	—	11% above	—
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 hepatitis A and B vaccine (PF) 720 ELISA unit- 20 mcg/mL syringe 1 mL Syringe	$555.17	$555.17	—	—	—
Hepatitis A vaccine, adult dose CPT 90632 hepatitis A 1,440 ELISA unit/mL syringe 1 mL Syringe	$334.25	$334.25	—	109% above	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 hepatitis A 1,440 ELISA unit/mL syringe 1 mL Syringe	$334.25	$334.25	—	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Engerix B 20Mcg Ml Vial Adult	$257.20	$257.20	—	82% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Engerix B 20Mcg Ml Vial Adult	$257.20	$257.20	—	—	—
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 hepatitis B 20 mcg/0.5 mL syringe 0.5 mL Syringe	$1,308.30	$1,308.30	—	126% above	—
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 hepatitis B 20 mcg/0.5 mL syringe 0.5 mL Syringe	$1,308.30	$1,308.30	—	—	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Engerix B Ped 10Mcg 0.5M	$104.93	$104.93	—	54% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B 10 mcg/0.5 mL syringe 0.5 mL Syringe	$122.33	$122.33	—	80% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Engerix B Ped 10Mcg 0.5M	$104.93	$104.93	—	—	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 hepatitis B 10 mcg/0.5 mL syringe 0.5 mL Syringe	$122.33	$122.33	—	—	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 haemophilus b conjugate 10 mcg/0.5 mL recon soln 1 each Vial	$55.78	$55.78	—	31% below	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 haemophilus b conjugate 7.5 mcg/0.5 mL solution 0.5 mL Vial	$131.66	$131.66	—	64% above	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 haemophilus b conjugate 10 mcg/0.5 mL recon soln 1 each Vial	$55.78	$55.78	—	—	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 haemophilus b conjugate 7.5 mcg/0.5 mL solution 0.5 mL Vial	$131.66	$131.66	—	—	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles Mumps Rubella Vaccine	$341.58	$341.58	—	90% above	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 measles, mumps and rubella 1,000-12,500 TCID50/0.5 mL recon soln 1 each Vial	$409.98	$409.98	—	128% above	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Measles Mumps Rubella Vaccine	$341.58	$341.58	—	—	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles, mumps and rubella 1,000-12,500 TCID50/0.5 mL recon soln 1 each Vial	$409.98	$409.98	—	—	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734 mening vac A,C,Y,W135 dip (PF) 10-5 mcg/0.5 mL solution 0.5 mL Vial	$699.83	$699.83	—	109% above	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 mening vac A,C,Y,W135 dip (PF) 10-5 mcg/0.5 mL solution 0.5 mL Vial	$699.83	$699.83	—	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20 Pneumo Vacc 0.5Ml	$941.23	$941.23	—	68% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal conjugate 0.5 mL syringe 0.5 mL Syringe	$1,099.53	$1,099.53	—	97% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Prevnar 20 Pneumo Vacc 0.5Ml	$941.23	$941.23	—	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal conjugate 0.5 mL syringe 0.5 mL Syringe	$1,099.53	$1,099.53	—	—	—
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 pneumococcal conjugate 0.5 mL syringe 0.5 mL Syringe	$1,268.30	$1,268.30	—	at median	—
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 pneumococcal conjugate 0.5 mL syringe 0.5 mL Syringe	$1,268.30	$1,268.30	—	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 pneumococcal polysaccharide 25 mcg/0.5 mL solution 0.5 mL Syringe	$491.74	$491.74	—	62% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 pneumococcal polysaccharide 25 mcg/0.5 mL solution 0.5 mL Syringe	$491.74	$491.74	—	—	—
Polio vaccine, inactivated (IPV) CPT 90713 poliovirus 40-8-32 unit/0.5 mL suspension 5 mL Vial	$187.35	$187.35	—	2% above	—
Polio vaccine, inactivated (IPV) inpatient CPT 90713 poliovirus 40-8-32 unit/0.5 mL suspension 5 mL Vial	$187.35	$187.35	—	—	—
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 nirsevimab-alip 100 mg/mL syringe 1 mL Syringe	$1,188.00	$1,188.00	—	18% below	—
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 nirsevimab-alip 100 mg/mL syringe 1 mL Syringe	$1,188.00	$1,188.00	—	—	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 nirsevimab-alip 50 mg/0.5 mL syringe 0.5 mL Syringe	$1,334.72	$1,334.72	—	9% above	—
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 nirsevimab-alip 50 mg/0.5 mL syringe 0.5 mL Syringe	$1,334.72	$1,334.72	—	—	—
Rabies vaccine, one dose CPT 90675 rabies, human diploid vaccine (PF) 2.5 unit recon soln 1 each Vial	$1,021.04	$1,021.04	—	30% above	—
Rabies vaccine, one dose CPT 90675 rabies vaccine (from purified chicken embryo cells) 2.5 unit suspension for reconstitution 1 each KIT	$1,043.06	$1,043.06	—	33% above	—
Rabies vaccine, one dose CPT 90675 Rabies Vaccine 1Ml 90675	$1,534.77	$1,534.77	—	95% above	—
Rabies vaccine, one dose CPT 90675 rabies vaccine (from purified chicken embryo cells) 2.5 unit suspension for reconstitution 1 each Vial	$1,591.98	$1,591.98	—	102% above	—
Rabies vaccine, one dose inpatient CPT 90675 rabies, human diploid vaccine (PF) 2.5 unit recon soln 1 each Vial	$1,021.04	$1,021.04	—	—	—
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine (from purified chicken embryo cells) 2.5 unit suspension for reconstitution 1 each KIT	$1,043.06	$1,043.06	—	—	—
Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine 1Ml 90675	$1,534.77	$1,534.77	—	—	—
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine (from purified chicken embryo cells) 2.5 unit suspension for reconstitution 1 each Vial	$1,591.98	$1,591.98	—	—	—
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 zoster vaccine-recombinant adjuvanted 50 mcg/0.5 mL suspension for reconstitution 1 each KIT	$680.44	$680.44	—	at median	—
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 varicella-zoster gE vac 50 mcg suspension for reconstitution 1 each Vial	$770.30	$770.30	—	13% above	—
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 zoster vaccine-recombinant adjuvanted 50 mcg/0.5 mL suspension for reconstitution 1 each KIT	$680.44	$680.44	—	—	—
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 varicella-zoster gE vac 50 mcg suspension for reconstitution 1 each Vial	$770.30	$770.30	—	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Diphtheria Tetanus 0.5Ml 90714	$103.77	$103.77	—	25% below	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus and diphther. tox (PF) 5 Lf unit- 2 Lf unit/0.5mL suspension 0.5 mL Syringe	$176.38	$176.38	—	27% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus and diphther. tox (PF) 5 Lf unit- 2 Lf unit/0.5mL suspension 0.5 mL Vial	$176.40	$176.40	—	27% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Diphtheria Tetanus 0.5Ml 90714	$103.77	$103.77	—	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus and diphther. tox (PF) 5 Lf unit- 2 Lf unit/0.5mL suspension 0.5 mL Syringe	$176.38	$176.38	—	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus and diphther. tox (PF) 5 Lf unit- 2 Lf unit/0.5mL suspension 0.5 mL Vial	$176.40	$176.40	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Adacel Vaccine Dpt 90715	$174.34	$174.34	—	78% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 diphth,pertus(acell),tetanus 2.5-8-5 Lf-mcg-Lf/0.5mL suspension 0.5 mL Syringe	$191.95	$191.95	—	96% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 diphth,pertus(acell),tetanus 2.5-8-5 Lf-mcg-Lf/0.5mL suspension 0.5 mL Vial	$203.18	$203.18	—	108% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Adacel Vaccine Dpt 90715	$174.34	$174.34	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 diphth,pertus(acell),tetanus 2.5-8-5 Lf-mcg-Lf/0.5mL suspension 0.5 mL Syringe	$191.95	$191.95	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 diphth,pertus(acell),tetanus 2.5-8-5 Lf-mcg-Lf/0.5mL suspension 0.5 mL Vial	$203.18	$203.18	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunize Adm 1St Ed 90471	$221.00	$221.00	—	357% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunize Adm 1St Wc 90471	$221.00	$221.00	—	357% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Admin In 2N 90471	$221.00	$221.00	—	357% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunize Adm 1St Ms 90471	$221.00	$221.00	—	357% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunize Adm 1St P Surg 90471	$221.00	$221.00	—	357% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunize Adm 1St Ivt 90471	$221.00	$221.00	—	357% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization Admin In 2N 90471	$221.00	$221.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunize Adm 1St P Surg 90471	$221.00	$221.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunize Adm 1St Wc 90471	$221.00	$221.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunize Adm 1St Ed 90471	$221.00	$221.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunize Adm 1St Ms 90471	$221.00	$221.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunize Adm 1St Ivt 90471	$221.00	$221.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunize Adm Addt P Surg 90472	$112.00	$112.00	—	188% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunize Adm Addt Ivt 90472	$112.00	$112.00	—	188% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunize Adm Addt Ed 90472	$112.00	$112.00	—	188% above	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunize Adm Addt Ivt 90472	$112.00	$112.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunize Adm Addt P Surg 90472	$112.00	$112.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunize Adm Addt Ed 90472	$112.00	$112.00	—	—	—

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

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

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

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

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

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

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

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

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

Source file: https://www.emoryhealthcare.org/-/media/project/eh/emory/ui/pricing-transparency/csv/2026/711045290_1891808499_houston-hospitals-inc_standardcharges.csv