Hospital Detroit-Warren-Dearborn, MI

Henry Ford Rochester Hospital

Listed in its price file as “Henry Ford Health”.

Henry Ford Rochester Hospital in Rochester, MI publishes cash prices for 329 common procedures listed here, from its own machine-readable price file updated Jan 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Michigan median for 303 of 323 procedures and above it for 19. By typical cash price it ranks #8 of 97 Michigan hospitals and #2 of 31 hospitals in the Detroit, MI area, cheapest first. Select a procedure to compare it with other hospitals nearby.

1101 W. University Dr Rochester MI 48307 Collected Sep 23, 2026 Source price file Check a bill from this hospital (248) 652-5000

Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 230254 · CMS hospital register NPI 1437176203

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Henry Ford Rochester Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN LIMITED W/W/O CONTRAST	$1,220.59	$2,597.00	$286.70–$560.44	22% below	53%
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/W/O CONTRAST	$1,220.59	$2,597.00	$286.70–$310.14	22% below	53%
Abdominal X-ray, 2 views CPT 74019 XRAY ABDOMEN 2 VIEWS	$101.99	$217.00	$17.18–$42.96	51% below	53%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 BILATERAL ANKLE COMP MIN 3 VIEWS	$266.02	$566.00	$21.05–$77.96	—	53%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE RT MIN 3 VIEWS	$134.42	$286.00	$21.05–$77.96	37% below	53%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE LT MIN 3 VIEWS	$134.42	$286.00	$21.05–$77.96	37% below	53%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ARTERIAL SINGLE LEVEL	$210.56	$448.00	$113.79–$213.10	32% below	53%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREM W/O CONTRAST RIGH	$796.18	$1,694.00	$149.15–$326.55	21% below	53%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O CONTRAST B	$1,538.78	$3,274.00	$149.15–$326.55	52% above	53%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREM W/O CONTRAST LEFT	$796.18	$1,694.00	$149.15–$326.55	21% below	53%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS BARIUM SWALLOW	$224.66	$478.00	$57.46–$120.19	21% below	53%
Barium swallow (esophagus X-ray with contrast) CPT 74220 DX ESOPHAGRAM/BARIUM SWALLOW	$224.66	$478.00	$57.46–$120.19	21% below	53%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN WHOLE BODY	$940.47	$2,001.00	$177.38–$435.60	at median	53%
Breast ultrasound, complete, one breast both sides CPT 76641 U/S BREAST BILATERAL COMPLETE	$152.28	$324.00	$55.95–$188.03	—	53%
Breast ultrasound, complete, one breast both sides CPT 76641 ABUS BREAST COMPLETE BILAT	$152.28	$324.00	$55.95–$188.03	—	53%
Breast ultrasound, complete, one breast one side CPT 76641 U/S BREAST UNILATERAL COMPLETE-LT	$129.72	$276.00	$55.95–$188.03	57% below	53%
Breast ultrasound, complete, one breast one side CPT 76641 ABUS BREAST COMPLETE LT	$129.72	$276.00	$55.95–$188.03	57% below	53%
Breast ultrasound, complete, one breast one side CPT 76641 ABUS BREAST COMPLETE RT	$129.72	$276.00	$55.95–$188.03	57% below	53%
Breast ultrasound, complete, one breast one side CPT 76641 U/S BREAST UNILATERAL COMPLETE RT	$129.72	$276.00	$55.95–$188.03	57% below	53%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 U/S BREAST BILATERAL LIMITED	$176.72	$376.00	$42.89–$145.84	—	53%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 U/S BREAST UNILATERAL LIMITED LT	$154.16	$328.00	$42.89–$145.84	42% below	53%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 U/S BREAST UNILATERAL LIMITED RT	$154.16	$328.00	$42.89–$145.84	42% below	53%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT VENOGRAPHY ABDOMEN & PELVIS	$327.59	$697.00	$373.12–$540.33	87% below	53%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABDOMEN/PELVIS W/O&W DYE	$1,220.59	$2,597.00	$373.12–$540.33	51% below	53%
CT angiography (CTA) of the head CPT 70496 CT VENOGRAPHY HEAD	$382.11	$813.00	$310.14–$389.24	75% below	53%
CT angiography (CTA) of the head CPT 70496 CT HEAD ANGIOGRAPHY-STROKE	$666.93	$1,419.00	$310.14–$389.24	57% below	53%
CT angiography (CTA) of the head CPT 70496 CT HEAD ANGIOGRAPHY	$666.93	$1,419.00	$310.14–$389.24	57% below	53%
CT angiography (CTA) of the neck CPT 70498 CT NECK ANGIOGRAPHY	$666.93	$1,419.00	$310.14–$401.46	56% below	53%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT VENOGRAPHY CHEST	$382.11	$813.00	$288.36–$310.14	77% below	53%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CHEST TOMO ANGIOGRAPHY	$1,220.59	$2,597.00	$288.36–$310.14	27% below	53%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT CARDIAC CTA W/O CALCIUM SCORIN	$433.81	$923.00	$286.42–$309.52	67% below	53%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CARDIAC CTA CALCIUM SCORE ONLY	$41.83	$89.00	$71.35	72% below	53%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT SCREENIN HEART CAL SCORE ONLY	$41.83	$89.00	$71.35	72% below	53%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT LIMITED ABD & PELVIS W/O CONTR	$770.80	$1,640.00	$116.93–$292.60	57% below	53%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN & PELVIS W/O CONTRAST	$770.80	$1,640.00	$116.93–$199.28	57% below	53%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST	$1,135.05	$2,415.00	$221.12–$433.06	60% below	53%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS LIMITED W/CON	$1,135.05	$2,415.00	$221.12–$622.82	60% below	53%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN & PELVIS W/ & W/O CONT	$1,220.59	$2,597.00	$292.25–$489.38	53% below	53%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT LIMITED ABD PELVIS W&W/O CONTR	$1,220.59	$2,597.00	$292.25–$703.52	53% below	53%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$1,135.05	$2,415.00	$208.06–$310.10	23% below	53%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN LIMITED W/CONTRAST	$1,135.05	$2,415.00	$208.06–$494.39	23% below	53%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$770.33	$1,639.00	$142.49–$159.30	17% below	53%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN LIMITED W/O CONTRAST	$770.33	$1,639.00	$142.49–$232.07	17% below	53%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CONT	$774.56	$1,648.00	$159.72–$171.42	26% below	53%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD OR BRAIN W/O CONTRAST	$816.86	$1,738.00	$117.19–$129.03	12% below	53%
CT scan of the head with contrast CPT 70460 CT HEAD OR BRAIN W/ CONTRAST	$1,183.93	$2,519.00	$152.21–$187.16	5% below	53%
CT scan of the head without and with contrast CPT 70470 CT HEAD OR BRAIN W/ & W/O CONTRA	$1,316.47	$2,801.00	$159.99–$225.31	16% below	53%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONT	$877.96	$1,868.00	$152.21–$161.73	19% below	53%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O CONT	$877.96	$1,868.00	$153.32–$162.94	21% below	53%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST	$1,135.05	$2,415.00	$180.00–$310.10	15% below	53%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS LIMITED W/CONTRAST	$1,135.05	$2,415.00	$180.00–$497.15	15% below	53%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX SCAN CAROTID BILATERAL	$445.56	$948.00	$252.68–$460.39	—	53%
Chest CT scan without and with contrast CPT 71270 CT SCAN CHEST W & W/0 CONTRAST	$1,220.59	$2,597.00	$237.78–$273.75	30% below	53%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/ OR W/OUT CONTRAST	$1,220.59	$2,597.00	$237.78–$273.75	30% below	53%
Chest X-ray, 2 views CPT 71046 XRAY CHEST 2 VIEWS	$109.04	$232.00	$15.51–$38.38	39% below	53%
Chest X-ray, single view CPT 71045 XRAY CHEST SINGLE VIEW	$68.62	$146.00	$8.55–$28.08	57% below	53%
Collarbone (clavicle) X-ray, complete both sides CPT 73000 BILATERAL CLAVICLE COMPLETE	$260.38	$554.00	$17.72–$67.87	—	53%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE LEFT COMPLETE	$130.66	$278.00	$17.72–$67.87	27% below	53%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE RIGHT COMPLETE	$130.66	$278.00	$17.72–$67.87	27% below	53%
Complete ultrasound of the back of the abdomen, such as both kidneys both sides CPT 76770 US RENAL BILATERAL & RAS	$326.18	$694.00	$81.91–$129.36	—	53%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US AORTA/RETROPERITONEAL ORGANS	$326.18	$694.00	$81.91–$129.36	47% below	53%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROP RENAL/AORTA	$326.18	$694.00	$81.91–$129.36	47% below	53%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 PF DX EXEC PHYSICAL DEXA	$104.34	$222.00	$47.53–$73.65	66% below	53%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DX DXA BONE DEN-HIP/PEL/SPINE 1 O	$239.23	$509.00	$47.53–$73.65	23% below	53%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DX DXA BONE DEN-RADIUS/WRIST/HEEL	$103.87	$221.00	$14.94–$36.09	21% below	53%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PELVIS OB >18 WKS FETAL ASSES	$340.28	$724.00	$81.34–$141.42	52% below	53%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PELVIS OB >18 WKS FETAL ASSESS	$340.28	$724.00	$81.34–$141.42	52% below	53%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$816.86	$1,738.00	$151.94–$161.13	18% below	53%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST LOW DOSE SCREENING	$816.86	$1,738.00	$151.94–$161.13	18% below	53%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN CHEST W/O CONTRAST	$816.86	$1,738.00	$151.94–$161.13	18% below	53%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN CHEST W/ CONTRAST	$1,151.50	$2,450.00	$189.71–$221.07	12% below	53%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/ CONTRAST	$1,151.50	$2,450.00	$189.71–$221.07	12% below	53%
Diagnostic mammogram, both breasts both sides CPT 77066 MA DX MAMMO INC CAD BILATERAL	$204.45	$435.00	$94.53–$191.72	—	53%
Diagnostic mammogram, one breast one side CPT 77065 MA DX MAMMO INC CAD UNILAT LT	$146.64	$312.00	$73.93–$240.32	53% below	53%
Diagnostic mammogram, one breast one side CPT 77065 MA DX MAMMO INC CAD UNILAT RT	$146.64	$312.00	$73.93–$240.32	53% below	53%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX SCAN LOWER EXTREMITY BILAT	$399.97	$851.00	$339.27–$613.20	—	53%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX ARTERIAL LOWER EXT BILAT	$426.76	$908.00	$339.27–$613.20	—	53%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS DUPLEX BILATERAL	$483.63	$1,029.00	$254.82–$466.44	—	53%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 COMPLETE ECHO	$1,009.56	$2,148.00	$253.06–$389.03	29% below	53%
Elbow X-ray, 2 views both sides CPT 73070 BILATERAL ELBOW AP & LAT	$161.21	$343.00	$17.72–$58.71	—	53%
Elbow X-ray, 2 views one side CPT 73070 ELBOW RT AP & LAT	$93.06	$198.00	$17.72–$58.71	31% below	53%
Elbow X-ray, 2 views one side CPT 73070 ELBOW LT AP & LAT	$93.06	$198.00	$17.72–$58.71	31% below	53%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 BILATERAL ELBOW MIN 3 VIEWS	$260.38	$554.00	$21.61–$67.87	—	53%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW RT MIN 3 VIEWS	$130.66	$278.00	$21.61–$67.87	31% below	53%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW LEFT MIN 3 VIEWS	$130.66	$278.00	$21.61–$67.87	31% below	53%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA P FOSSA W/O CONT	$819.21	$1,743.00	$193.22–$196.39	18% below	53%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL COMPLETE MINIMUM 3 VIEWS	$222.78	$474.00	$25.50–$57.84	14% below	53%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 BILATERAL FOREARM AP & LAT	$260.38	$554.00	$16.88–$59.62	—	53%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM RT AP & LAT	$99.64	$212.00	$16.88–$59.62	44% below	53%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM LT AP & LAT	$99.64	$212.00	$16.88–$59.62	44% below	53%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY SYSTEM IMAGING	$734.61	$1,563.00	$240.17–$492.29	21% below	53%
Hand X-ray, 2 views both sides CPT 73120 BILATERAL HAND 2 VIEWS	$161.68	$344.00	$16.88–$65.12	—	53%
Hand X-ray, 2 views one side CPT 73120 HAND LT 2 VIEWS	$81.31	$173.00	$16.88–$65.12	44% below	53%
Hand X-ray, 2 views one side CPT 73120 HAND RT 2 VIEWS	$81.31	$173.00	$16.88–$65.12	44% below	53%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 DX CALCANEUS MINIMUM 2 VIEWS RIGH	$81.78	$174.00	$17.44–$57.78	47% below	53%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 DX CALCANEUS MIN 2 VIEWS BILATERA	$150.87	$321.00	$17.44–$57.78	2% below	53%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 DX CALCANEUS MINIMUM 2 VIEWS LEFT	$81.78	$174.00	$17.44–$57.78	47% below	53%
Knee X-ray, 3 views both sides CPT 73562 DX KNEE 3 VIEWS BILATERAL	$320.07	$681.00	$23.28–$88.06	—	53%
Knee X-ray, 3 views one side CPT 73562 DX KNEE 3 VIEWS LEFT	$159.80	$340.00	$23.28–$88.06	20% below	53%
Knee X-ray, 3 views one side CPT 73562 DX KNEE 3 VIEWS RIGHT	$159.80	$340.00	$23.28–$88.06	20% below	53%
Knee X-ray, complete, 4 or more views CPT 73564 DX KNEE COMPL/OBL/SPEC VIEW 13564	$115.62	$246.00	$26.89–$99.97	46% below	53%
Knee X-ray, complete, 4 or more views CPT 73564 DX KNEE COMPL/OBL/SPEC VIEW 73564	$115.62	$246.00	$26.89–$99.97	46% below	53%
Knee X-ray, complete, 4 or more views CPT 73564 DX KNEE COMPL/OBL/SPEC VIEW 03564	$184.71	$393.00	$26.89–$99.97	14% below	53%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREM W/O CONTRAST RIGH	$816.86	$1,738.00	$149.71–$236.65	26% below	53%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O CONTRAST B	$1,633.25	$3,475.00	$149.71–$161.73	48% above	53%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREM W/O CONTRAST LEFT	$816.86	$1,738.00	$149.71–$236.65	26% below	53%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$184.24	$392.00	$66.62–$104.75	61% below	53%
Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 US LIMITED JOINT/NONVASC BILAT	$129.25	$275.00	$9.10–$55.55	—	53%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US LIMITED JOINT/NONVASC UNILAT	$64.39	$137.00	$9.10–$55.55	82% below	53%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US AXILLA RT	$116.09	$247.00	$9.10–$85.30	68% below	53%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US AXILLA LT	$116.09	$247.00	$9.10–$85.30	68% below	53%
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 BILATERAL TIBIA FIBULA AP & LAT	$260.38	$554.00	$16.34–$66.05	—	53%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA FIBULA RT AP & LAT	$130.66	$278.00	$16.34–$66.05	29% below	53%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA FIBULA LT AP & LAT	$130.66	$278.00	$16.34–$66.05	29% below	53%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST	$233.59	$497.00	$374.78–$391.81	85% below	53%
MR angiography (MRA) of the head without contrast CPT 70544 MRV BRAIN W/O CONTRAST	$233.59	$497.00	$374.78–$391.81	85% below	53%
MR angiography (MRA) of the head without contrast CPT 70544 MRA BRAIN W/O CONTRAST	$233.59	$497.00	$374.78–$391.81	85% below	53%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER JOINT W/O CONTRAST	$233.59	$497.00	$325.61–$342.30	85% below	53%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LEFT HIP W/O CONTRAST	$233.59	$497.00	$325.61–$398.09	85% below	53%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI RIGHT HIP W/O CONTRAST	$233.59	$497.00	$325.61–$398.09	85% below	53%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LEFT KNEE W/O CONTRAST	$233.59	$497.00	$325.61–$398.09	85% below	53%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI RIGHT KNEE W/O CONTRAST	$233.59	$497.00	$325.61–$398.09	85% below	53%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LEFT ANKLE W/O CONTRAST	$233.59	$497.00	$325.61–$398.09	85% below	53%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI RIGHT ANKLE W/O CONTRAST	$233.59	$497.00	$325.61–$398.09	85% below	53%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LOWER EXTREM W/AND W/O	$360.49	$767.00	$432.58–$729.57	85% below	53%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LEFT KNEE W/WO CONTRAST	$360.49	$767.00	$432.58–$759.13	85% below	53%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI RIGHT HIP W/WO CONTRAST	$360.49	$767.00	$432.58–$759.13	85% below	53%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI RIGHT KNEE W/WO CONTRAST	$360.49	$767.00	$432.58–$759.13	85% below	53%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LEFT ANKLE W/WO CONTRAST	$360.49	$767.00	$432.58–$759.13	85% below	53%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LEFT HIP W/WO CONTRAST	$360.49	$767.00	$432.58–$759.13	85% below	53%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI RIGHT ANKLE W/WO CONTRAST	$360.49	$767.00	$432.58–$759.13	85% below	53%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST	$277.30	$590.00	$292.53–$321.54	84% below	53%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WITH OR W/O CONTRAST	$420.18	$894.00	$462.86–$597.27	87% below	53%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WITHOUT CONTRAST	$233.59	$497.00	$314.20–$337.54	86% below	53%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WITH AND W/O CONTRAST	$360.49	$767.00	$443.69–$529.27	87% below	53%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O CONTRAST	$233.59	$497.00	$293.37–$303.81	87% below	53%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE WITH AND W/O	$360.49	$767.00	$433.69–$535.18	87% below	53%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE W/O CONTRAST	$233.59	$497.00	$293.64–$303.07	86% below	53%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE WITH AND W/O	$360.49	$767.00	$434.52–$536.67	87% below	53%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE W/O CONTRAST	$360.49	$767.00	$290.86–$303.07	79% below	53%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WITH AND W/O CONTRAST	$418.77	$891.00	$461.48–$595.80	85% below	53%
MRI of the pelvis without and with contrast CPT 72197 MRI PROSTATE W / WO	$418.77	$891.00	$461.48–$595.80	85% below	53%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST	$321.95	$685.00	$335.04–$407.34	81% below	53%
MRI of the pelvis, no contrast dye CPT 72195 MRI PROSTATE W/O	$321.95	$685.00	$335.04–$407.34	81% below	53%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER JOINT W/O CONTRAST	$233.59	$497.00	$317.26–$343.04	87% below	53%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI LEFT SHOULDER W/O CONTRAST	$233.59	$497.00	$317.26–$399.00	87% below	53%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI RIGHT SHOULDER W/O CONTRAST	$233.59	$497.00	$317.26–$399.00	87% below	53%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI LEFT WRIST W/O CONTRAST	$233.59	$497.00	$317.26–$399.00	87% below	53%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI RIGHT WRIST W/O CONTRAST	$233.59	$497.00	$317.26–$399.00	87% below	53%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI LEFT ELBOW W/O CONTRAST	$233.59	$497.00	$317.26–$399.00	87% below	53%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI RIGHT ELBOW W/O CONTRAST	$233.59	$497.00	$317.26–$399.00	87% below	53%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SPINE CERVICAL MIN 4 VIEWS 72050	$193.17	$411.00	$31.89–$65.85	34% below	53%
Neck soft tissue CT scan with contrast CPT 70491 CT NECK W/CONTRAST	$1,135.05	$2,415.00	$186.11–$237.42	14% below	53%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK W/O CONTRAST	$816.86	$1,738.00	$148.88–$177.48	20% below	53%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE EXAM	$129.72	$276.00	$16.05–$37.80	27% below	53%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM CARDIAC PERFUSION SPECT MULTI	$1,057.03	$2,249.00	$349.30–$670.27	64% below	53%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 NM PET/CT SKULL BASE TO MID 28815	$2,466.09	$5,247.00	$747.11–$2,567.11	55% below	53%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 NM PET W/ CT SKULL BASE TO MID-T	$2,466.09	$5,247.00	$747.11–$2,043.39	55% below	53%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 NM PET/CT SKULL BASE TO MID 18815	$2,466.09	$5,247.00	$747.11–$2,567.11	55% below	53%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$770.80	$1,640.00	$143.04–$161.13	23% below	53%
Pelvic CT scan without contrast CPT 72192 CT PELVIS LIMITED W/O CONTRAST	$770.80	$1,640.00	$143.04–$234.82	23% below	53%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NON-OBSTETRIC LIMITED	$209.15	$445.00	$40.66–$67.18	38% below	53%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NON OBSTETRIC LIMITED	$209.15	$445.00	$40.66–$67.18	38% below	53%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS TRANSABDOMINAL	$442.74	$942.00	$77.19–$128.21	22% below	53%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NON-OBSTETRIC COMPLETE	$442.74	$942.00	$77.19–$128.21	22% below	53%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PELVIS OBSTETRIC COMP 14-18 WK	$340.28	$724.00	$85.24–$154.53	39% below	53%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PELVIS OBSTETRIC COMP(14-18 WK	$340.28	$724.00	$85.24–$154.53	39% below	53%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PELVIS T OB < 14 WKS	$350.15	$745.00	$68.29–$123.63	32% below	53%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PELVIS OB < 14 WKS	$350.15	$745.00	$68.29–$123.63	32% below	53%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US LIMITED 1 OR MORE FETUSES	$204.92	$436.00	$50.79–$88.16	36% below	53%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US FETAL LIMITED	$204.92	$436.00	$50.79–$88.16	36% below	53%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PELVIC OBSTETRIC LIMITED	$204.92	$436.00	$50.79–$88.16	36% below	53%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 FETAL ULTRASOUND	$204.92	$436.00	$50.79–$88.16	36% below	53%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS LT 2 VIEWS	$134.42	$286.00	$18.55–$72.47	32% below	53%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS RT 2 VIEWS	$134.42	$286.00	$18.55–$72.47	32% below	53%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNILATERAL MIN 3 VIEWS W/PA	$155.10	$330.00	$22.45–$48.67	34% below	53%
Screening mammogram, both breasts both sides CPT 77067 MA SCREEN MAMMO INC CAD BILATERAL	$186.12	$396.00	$78.10–$158.53	—	53%
Screening mammogram, both breasts CPT 77067 MAMMOGRAM SCREEN BIL-2 VIEWS	$186.12	$396.00	$78.10–$158.53	35% below	53%
Screening mammogram, both breasts one side CPT 77067 MA SCREEN MAMMO INC CAD UNI RT	$130.66	$278.00	$78.10–$254.08	54% below	53%
Screening mammogram, both breasts one side CPT 77067 MA SCREEN MAMMO INC CAD UNI LT	$130.66	$278.00	$78.10–$254.08	54% below	53%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 BILATERAL SHOULDER COMP MIN 2 VIE	$266.02	$566.00	$18.00–$71.54	—	53%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LEFT COMPLETE	$134.42	$286.00	$18.00–$71.54	37% below	53%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RIGHT COMPLETE	$134.42	$286.00	$18.00–$71.54	37% below	53%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES COMPLETE MIN 3 VIEWS	$159.80	$340.00	$23.00–$45.24	32% below	53%
Skull X-ray, fewer than 4 views CPT 70250 SKULL LIMITED LESS THAN 4 VIEWS	$118.44	$252.00	$21.33–$44.67	44% below	53%
Skull X-ray, fewer than 4 views CPT 70250 SKULL LESS THAN 4 VIEWS	$118.44	$252.00	$21.33–$44.67	44% below	53%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO DOBUT W/CONT ECG	$1,170.30	$2,490.00	$293.07–$456.38	1% below	53%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO EXER. W/CONT ECG	$1,170.30	$2,490.00	$293.07–$456.38	1% below	53%
Swallow study (modified barium swallow, video X-ray) CPT 74230 ORAL PHARYNGEAL MOTILITY STUDY	$291.40	$620.00	$55.79–$180.28	23% below	53%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY FEMUR 2/> VIEWS	$149.93	$319.00	$17.91–$44.10	30% below	53%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY FEMUR 2/> VIEWS LT	$149.93	$319.00	$17.91–$74.30	30% below	53%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY FEMUR 2/> VIEWS-LT	$149.93	$319.00	$17.91–$74.30	30% below	53%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY FEMUR 2/> VIEWS-RT	$149.93	$319.00	$17.91–$74.30	30% below	53%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T-SPINE W/O CONTRAST	$783.02	$1,666.00	$152.76–$162.33	26% below	53%
Toe X-ray, 2 or more views both sides CPT 73660 DX TOES BILAT MIN 2 VIEWS	$159.80	$340.00	$19.94–$63.29	—	53%
Toe X-ray, 2 or more views one side CPT 73660 DX TOES LT MIN 2 VIEWS	$79.90	$170.00	$19.94–$63.29	37% below	53%
Toe X-ray, 2 or more views one side CPT 73660 DX TOES RT MIN 2 VIEWS	$79.90	$170.00	$19.94–$63.29	37% below	53%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$355.79	$757.00	$78.03–$152.24	33% below	53%
Transvaginal ultrasound during pregnancy CPT 76817 US PELVIS OB TRANSVAGINAL	$134.89	$287.00	$56.07–$100.17	69% below	53%
Transvaginal ultrasound during pregnancy CPT 76817 US PELVIS TRANSVAGINAL OB	$134.89	$287.00	$56.07–$100.17	69% below	53%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$405.14	$862.00	$85.24–$139.08	39% below	53%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM/TESTICLE	$282.00	$600.00	$78.29–$124.20	46% below	53%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISS HEAD/NECK/THY/PARATH	$188.94	$402.00	$78.57–$149.38	60% below	53%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 DX UGI TRACT W/WO KUB SNGL CONT	$267.43	$569.00	$67.74–$145.38	33% below	53%
Upper arm X-ray (humerus), 2 views both sides CPT 73060 BILATERAL HUMERUS MIN 2 VIEWS	$231.24	$492.00	$17.72–$40.09	—	53%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS LT MIN 2 VIEWS	$116.09	$247.00	$17.72–$66.96	37% below	53%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS RT MIN 2 VIEWS	$116.09	$247.00	$17.72–$66.96	37% below	53%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 PF LMTD/UNILATERAL VENOUS STUDY	$190.35	$405.00	$145.99–$296.55	64% below	53%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX LIMITED RIGHT	$352.50	$750.00	$145.99–$296.55	34% below	53%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX LIMITED LEFT	$352.50	$750.00	$145.99–$296.55	34% below	53%
Wrist X-ray, 2 views both sides CPT 73100 BILATERAL WRIST AP & LAT	$180.95	$385.00	$19.39–$71.54	—	53%
Wrist X-ray, 2 views one side CPT 73100 WRIST RT AP & LAT	$90.71	$193.00	$19.39–$71.54	35% below	53%
Wrist X-ray, 2 views one side CPT 73100 WRIST LT AP & LAT	$90.71	$193.00	$19.39–$71.54	35% below	53%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 BILATERAL WRIST MIN 3 VIEWS	$193.64	$412.00	$24.39–$90.81	—	53%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST LT MIN 3 VIEWS	$121.73	$259.00	$24.39–$90.81	38% below	53%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST RT MIN 3 VIEWS	$121.73	$259.00	$24.39–$90.81	38% below	53%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY HIP UNILATERAL 2/3 VIEWS LT	$122.67	$261.00	$23.49–$101.82	41% below	53%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY HIP UNILATERAL W/3 VIEWS-RT	$122.67	$261.00	$23.49–$101.82	41% below	53%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY HIP UNILATERAL 2/3 VIEWS RT	$122.67	$261.00	$23.49–$101.82	41% below	53%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY HIP UNILATERAL 2/3 VIEWS-LT	$122.67	$261.00	$23.49–$101.82	41% below	53%
X-ray of the abdomen, 1 view CPT 74018 XRAY ABDOMEN SINGLE VIEW	$68.62	$146.00	$14.40–$34.95	57% below	53%
X-ray of the ankle, 2 views both sides CPT 73600 BILATERAL ANKLES AP & LAT VIEWS	$137.71	$293.00	$17.72–$67.87	—	53%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE RT 2 VIEWS	$90.24	$192.00	$17.72–$67.87	49% below	53%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE LT 2 VIEWS	$90.24	$192.00	$17.72–$67.87	49% below	53%
X-ray of the finger(s), 2 or more views both sides CPT 73140 DX FINGERS BILATERAL MIN 2 VIEWS	$159.33	$339.00	$22.17–$87.14	—	53%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS RT MIN 2 VIEWS	$79.90	$170.00	$22.17–$87.14	40% below	53%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS LT MIN 2 VIEWS	$79.90	$170.00	$22.17–$87.14	40% below	53%
X-ray of the foot, 2 views both sides CPT 73620 BILATERAL FOOT AP & LAT	$162.15	$345.00	$16.88–$58.71	—	53%
X-ray of the foot, 2 views one side CPT 73620 FOOT LT 2 VIEWS	$101.99	$217.00	$16.88–$58.71	36% below	53%
X-ray of the foot, 2 views one side CPT 73620 FOOT RT 2 VIEWS	$101.99	$217.00	$16.88–$58.71	36% below	53%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 BILATERAL FOOT COMPLETE MIN 3 VIE	$193.64	$412.00	$19.94–$72.47	—	53%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT LT COMPLETE STUDY MIN 3 VIEW	$121.73	$259.00	$19.94–$72.47	32% below	53%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT RT COMPLETE STUDY-MIN 3 VIEW	$121.73	$259.00	$19.94–$72.47	32% below	53%
X-ray of the hand, 3 or more views both sides CPT 73130 DX HAND MIN 3 VIEW BILATERAL	$154.16	$328.00	$20.22–$79.81	—	53%
X-ray of the hand, 3 or more views one side CPT 73130 HAND LT 3 VIEWS	$95.88	$204.00	$20.22–$79.81	48% below	53%
X-ray of the hand, 3 or more views one side CPT 73130 HAND RT 3 VIEWS	$95.88	$204.00	$20.22–$79.81	48% below	53%
X-ray of the knee, 1 or 2 views both sides CPT 73560 BILATERAL KNEE AP & LAT VIEWS	$180.95	$385.00	$18.55–$72.47	—	53%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LT 1 OR 2 VIEWS	$90.71	$193.00	$18.55–$72.47	42% below	53%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE RT 2 VIEWS	$90.71	$193.00	$18.55–$72.47	42% below	53%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 DX SPINE 2OR3 VIEWS LUMBARSACRAL	$124.55	$265.00	$21.61–$48.10	42% below	53%
X-ray of the lower back, 4 or more views CPT 72110 DX SPINE MIN 4 VIEW LUMBARSACRAL	$200.22	$426.00	$29.39–$63.55	35% below	53%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 DX SPINE 2 VIEW THORACIC AP/LAT	$134.42	$286.00	$19.39–$37.80	27% below	53%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MINIMUM 3 VIEWS	$130.66	$278.00	$21.05–$49.24	25% below	53%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 DX SPINE 2 OR 3 VIEW CERVICAL AP/	$149.93	$319.00	$23.84–$47.53	35% below	53%
X-ray of the pelvis, 1 or 2 views CPT 72170 DX PELVIS 1 OR 2 VIEW	$92.59	$197.00	$14.94–$32.09	44% below	53%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM/COCCYX MINIMUM 2 VIEWS	$109.04	$232.00	$17.44–$39.52	37% below	53%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
ACTH blood test CPT 82024 ACTH -SJH	$40.42	$86.00	$45.86–$49.89	57% below	53%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT	$5.64	$12.00	$6.30–$6.74	76% below	53%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT	$5.64	$12.00	$6.15–$6.68	74% below	53%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL	$41.36	$88.00	$56.56–$59.98	76% below	53%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 RL HEPATITIS PANEL	$89.30	$190.00	$56.56–$59.98	47% below	53%
Albumin blood test CPT 82040 RL ASSAY OF SERUM ALBUMIN	$3.29	$7.00	$5.88–$6.39	84% below	53%
Albumin blood test CPT 82040 ALBUMIN (SERUM)	$7.99	$17.00	$5.88–$6.39	60% below	53%
Albumin blood test CPT 82040 ALBUMIN SERUM/PLASMA/WB -SJH	$7.99	$17.00	$5.88–$6.39	60% below	53%
Alkaline phosphatase (ALP) blood test CPT 84075 RL ALKP TOTAL (PHOSPHATASE)	$6.37	$13.56	$6.15–$6.68	70% below	53%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$12.22	$26.00	$6.15–$6.68	42% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 CASEIN ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 CARROT ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 CABBAGE ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK, BOILED ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 BLACK PEPPER ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 BETA LACTOGLOBULIN ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 BELL GREEN PEPPER ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 BEEF ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 BARLEY ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 BANANA ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 BAKER'S YEAST ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 APPLE ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND ALLERGEN -SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 HAZEL NUT ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 LETTUCE ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 MACKEREL CHUB ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 OAT ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 ONION ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 OVALBUMIN ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 OVOMUCOID ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 ORANGE ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 OYSTER ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 PARSLEY ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 PEA ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 PEACH ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 PEAR ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 PORK ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 POTATO ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 RICE ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 RYE ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 CRAB ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG YOLK ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 GRAPE ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 COD ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 COCONUT ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 CLAM ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 CHOCOLATE ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 CELERY ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 CORN ALLERGEN --SJH	$5.64	$12.00	$6.20–$6.74	11% below	53%
Allergy blood test, specific IgE, per allergen CPT 86003 RL ALLERGEN, FOOD NECTARINE	$10.12	$21.53	$6.20–$6.74	59% above	53%
Allergy blood test, specific IgE, per allergen CPT 86003 RL ALLERGEN SPECIFIC IGE, EACH	$40.47	$86.10	$6.20–$6.74	535% above	53%
Allergy blood test, specific IgE, per allergen CPT 86003 RL IN VITRO PEANUT ALLERGEN IGE	$45.83	$97.50	$6.20–$6.74	619% above	53%
Allergy blood test, specific IgE, per allergen CPT 86003 RL REGION 7 RESPIRAT PANEL IGE	$52.76	$112.25	$6.20–$6.74	728% above	53%
Alpha-fetoprotein (AFP) blood test CPT 82105 RL ALPHA-FETOPROTEIN SERUM	$11.75	$25.00	$19.91–$21.66	77% below	53%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEN SERUM -SJH	$29.61	$63.00	$19.91–$21.66	42% below	53%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN MATERNAL	$29.61	$63.00	$19.91–$21.66	42% below	53%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN TUMOR MARKER	$29.61	$63.00	$19.91–$21.66	42% below	53%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN SERUM -SJH	$29.61	$63.00	$19.91–$21.66	42% below	53%
Ammonia blood test CPT 82140 AMMONIA	$41.36	$88.00	$17.30–$18.82	36% below	53%
Amylase blood test CPT 82150 AMYLASE 2 HR URINE	$10.81	$23.00	$7.70–$8.37	46% below	53%
Amylase blood test CPT 82150 AMYLASE 24 HOUR URINE	$10.81	$23.00	$7.70–$8.37	46% below	53%
Amylase blood test CPT 82150 AMYLASE -SJH	$10.81	$23.00	$7.70–$8.37	46% below	53%
Amylase blood test CPT 82150 AMYLASE QUANT. DUODENAL	$10.81	$23.00	$7.70–$8.37	46% below	53%
Amylase blood test CPT 82150 AMYLASE SERUM	$10.81	$23.00	$7.70–$8.37	46% below	53%
Amylase blood test CPT 82150 AMYLASE ISOENZYMES	$10.81	$23.00	$7.70–$8.37	46% below	53%
Amylase blood test CPT 82150 RL ASSAY OF AMYLASE	$16.03	$34.10	$7.70–$8.37	20% below	53%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY -SJH -SJH	$13.63	$29.00	$15.38–$16.72	76% below	53%
Antinuclear antibody (ANA) blood test, screen CPT 86038 SJP ANA SCREEN	$12.69	$27.00	$14.36–$15.61	77% below	53%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY (ANA)	$12.69	$27.00	$14.36–$15.61	77% below	53%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY	$12.69	$27.00	$14.36–$15.61	77% below	53%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BRAIN NATURETIC PEPTIDE	$83.19	$177.00	$43.84–$46.63	8% above	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 EAR CULTURE	$19.74	$42.00	$10.24–$11.13	63% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 EYE CULTURE	$19.74	$42.00	$10.24–$11.13	63% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SPINAL FLUID CULTURE	$19.74	$42.00	$10.24–$11.13	63% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 THROAT CULTURE	$19.74	$42.00	$10.24–$11.13	63% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SPUTUM CULTURE	$19.74	$42.00	$10.24–$11.13	63% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 N-P CULTURE	$19.74	$42.00	$10.24–$11.13	63% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CERVIX CULTURE	$23.97	$51.00	$10.24–$11.13	55% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 WOUND CULTURE DEEP	$23.97	$51.00	$10.24–$11.13	55% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 WOUND CULTURE SURFACE	$23.97	$51.00	$10.24–$11.13	55% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BRONCHIAL WASHING	$23.97	$51.00	$10.24–$11.13	55% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 MISC CULTURE	$23.97	$51.00	$10.24–$11.13	55% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SJP-CSF CULTURE W/STAIN	$23.97	$51.00	$10.24–$11.13	55% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BODY FLUID CULTURE	$23.97	$51.00	$10.24–$11.13	55% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 RL AEROBIC CULTURE	$25.35	$53.94	$10.24–$11.13	52% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 MOUTH CULTURE	$26.32	$56.00	$10.24–$11.13	50% below	53%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 TISSUE CULTURE	$59.69	$127.00	$10.24–$11.13	13% above	53%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$12.69	$27.00	$10.05–$10.92	75% below	53%
Bilirubin blood test, total CPT 82247 BILIRUBIN - CORD	$8.93	$19.00	$5.96–$6.47	61% below	53%
Bilirubin blood test, total CPT 82247 BILIRUBIN BODY FLUID	$8.93	$19.00	$5.96–$6.47	61% below	53%
Bilirubin blood test, total CPT 82247 NB BILIRUBIN TOTAL	$8.93	$19.00	$5.96–$6.47	61% below	53%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL -SJH	$8.93	$19.00	$5.96–$6.47	61% below	53%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL/NEWBORN	$8.93	$19.00	$5.96–$6.47	61% below	53%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATHOLOGY LEVEL IV	$46.53	$99.00	$48.99	57% below	53%
Blood culture for bacteria CPT 87040 BLOOD CULTURE	$28.67	$61.00	$7.51–$12.25	54% below	53%
Blood culture for bacteria CPT 87040 BLOOD CULTURE-PEDS URGENT CARE CE	$49.82	$106.00	$7.51–$12.25	21% below	53%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENPUNCTURE	$7.99	$17.00	$2.74	38% below	53%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 NEWBORN SCREEN COLLECTION MBU	$7.99	$17.00	$2.74	38% below	53%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DRAWING FEE	$7.99	$17.00	$2.74	38% below	53%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 NEWBORN SCREEN COLLECTION SPNU	$7.99	$17.00	$2.74	38% below	53%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE NEWBORN COLLECTION	$7.99	$17.00	$2.74	38% below	53%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DRAW BLOOD BANK SPECIMEN ONLY	$7.99	$17.00	$2.74	38% below	53%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$7.05	$15.00	$4.66–$4.85	71% below	53%
Blood glucose (sugar) test CPT 82947 SJP-GLUCOSE,FASTING QUANT BLOOD	$7.05	$15.00	$4.66–$4.85	71% below	53%
Blood glucose (sugar) test CPT 82947 SJP-G6PD, QUANTITATIVE	$7.05	$15.00	$4.66–$4.85	71% below	53%
Blood glucose (sugar) test CPT 82947 FASTING GLUCOSE TOLERANC	$7.05	$15.00	$4.66–$4.85	71% below	53%
Blood lead test CPT 83655 RL ASSAY OF LEAD	$8.46	$18.00	$14.38–$15.64	11% above	53%
Blood lead test CPT 83655 DMC LEAD	$15.04	$32.00	$14.38–$15.64	97% above	53%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 BETA HUMAN CHORIONIC GONADOTROPIN	$12.69	$27.00	$8.93–$9.70	66% below	53%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 RL ABO VERSITI	$11.52	$24.50	$3.55–$4.23	45% below	53%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO	$28.67	$61.00	$3.55–$4.23	36% above	53%
Blood urea nitrogen (BUN) test CPT 84520 BLOOD UREA NITROGEN (BUN)	$10.81	$23.00	$4.69–$4.86	39% below	53%
C-peptide blood test CPT 84681 C-PEPTIDE -SJH	$21.62	$46.00	$24.71–$26.87	69% below	53%
C-peptide blood test CPT 84681 C-PEPTIDE	$21.62	$46.00	$24.71–$26.87	69% below	53%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$5.64	$12.00	$6.15–$6.68	83% below	53%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN -SJH	$5.64	$12.00	$6.15–$6.68	83% below	53%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$45.12	$96.00	$44.26–$45.33	61% below	53%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$21.62	$46.00	$24.71–$26.88	77% below	53%
CA 19-9 blood test (tumor marker) CPT 86301 SJP CANCER ANTIGEN 19-9	$21.62	$46.00	$24.71–$26.88	77% below	53%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 -SJH	$21.62	$46.00	$24.71–$26.88	77% below	53%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$57.34	$122.00	$24.71–$26.88	43% below	53%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 RL COVID19 SARACOV2BY PCR	$44.65	$95.00	$22.85–$95.00	58% below	53%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 SARA-COV-2BY PCR SJH	$61.10	$130.00	$22.85–$130.00	42% below	53%
Calcium blood test, total CPT 82310 RL ASSAY OF CALCIUM	$3.76	$8.00	$6.06–$6.13	81% below	53%
Calcium blood test, total CPT 82310 RL CALCIUM PARATHYROID HORMONE	$4.94	$10.50	$6.06–$6.13	75% below	53%
Calcium blood test, total CPT 82310 ASSY OF CALCIUM -SJH	$6.58	$14.00	$6.06–$6.13	67% below	53%
Calcium blood test, total CPT 82310 CALCIUM	$6.58	$14.00	$6.06–$6.13	67% below	53%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA-SJH	$31.96	$68.00	$22.51–$24.50	61% below	53%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA -SJH	$31.96	$68.00	$22.51–$24.50	61% below	53%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA)	$31.96	$68.00	$22.51–$24.50	61% below	53%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGM ACUTE TITER	$8.93	$19.00	$15.30–$16.65	78% below	53%
Chickenpox (varicella) immunity blood test CPT 86787 VZV IGG SJH	$13.63	$29.00	$15.30–$16.65	66% below	53%
Chickenpox (varicella) immunity blood test CPT 86787 VZV IGG -SJH	$13.63	$29.00	$15.30–$16.65	66% below	53%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA AMPLIFICATION	$23.97	$51.00	$41.67–$45.33	68% below	53%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA SEND OUT SJH	$32.90	$70.00	$41.67–$45.33	56% below	53%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 SJH CHLAMYDIA TRACHOMATIS BY PCR	$36.66	$78.00	$41.67–$45.33	50% below	53%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 SJH- TRACH-AMPLIFIED DNA ASSAY	$36.66	$78.00	$41.67–$45.33	50% below	53%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 RL LIPID PANEL	$9.40	$20.00	$15.90–$16.50	82% below	53%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 SJP-LIPID PROFILE	$19.74	$42.00	$15.90–$16.50	61% below	53%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL -SJH	$19.74	$42.00	$15.90–$16.50	61% below	53%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE 00656	$19.74	$42.00	$15.90–$16.50	61% below	53%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 OCCUMED LIPID PROFILE	$48.88	$104.00	$15.90–$16.50	4% below	53%
Complete blood count (CBC) with differential CPT 85025 CBC	$11.28	$24.00	$9.22–$10.03	72% below	53%
Complete blood count (CBC) with differential CPT 85025 SJP-COMPLETE CBC WAUTO DIFF WBC	$11.28	$24.00	$9.22–$10.03	72% below	53%
Complete blood count (CBC) with differential CPT 85025 CBC PEDS	$11.28	$24.00	$9.22–$10.03	72% below	53%
Complete blood count (CBC), no differential CPT 85027 PBC	$7.05	$15.00	$6.00–$7.69	76% below	53%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PAN 00561	$19.74	$42.00	$12.54–$13.45	74% below	53%
Comprehensive metabolic panel (blood test) CPT 80053 SJP-COMPREHENSIVE METABOLIC PANEL	$19.74	$42.00	$12.54–$13.45	74% below	53%
Cortisol blood test, total CPT 82533 RL TOTAL CORTISOL	$11.63	$24.75	$19.36–$21.06	66% below	53%
Cortisol blood test, total CPT 82533 CORTISOL MORNING	$31.49	$67.00	$19.36–$21.06	7% below	53%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL -SJH	$31.49	$67.00	$19.36–$21.06	7% below	53%
Cortisol blood test, total CPT 82533 CORTISOL	$31.49	$67.00	$19.36–$21.06	7% below	53%
Cortisol blood test, total CPT 82533 CORTISOL EVENING	$31.49	$67.00	$19.36–$21.06	7% below	53%
Cortisol blood test, total CPT 82533 CORTISOL 24 HOUR URINE	$31.49	$67.00	$19.36–$21.06	7% below	53%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE	$6.11	$13.00	$7.72–$8.42	80% below	53%
Creatinine blood test CPT 82565 POC CREATININE	$5.17	$11.00	$6.08–$6.20	78% below	53%
Creatinine blood test CPT 82565 CREATININE/CREATINITE LEVEL SERUM	$8.93	$19.00	$6.08–$6.20	63% below	53%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB IGG	$15.04	$32.00	$17.09–$17.78	65% below	53%
Cytomegalovirus (CMV) antibody test CPT 86644 SJP-CYTOMEGALOVIRUS IGG	$15.04	$32.00	$17.09–$17.78	65% below	53%
Cytomegalovirus (CMV) antibody test CPT 86644 RL CMV IGG TORCH IGG	$15.60	$33.20	$17.09–$17.78	64% below	53%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER QUANTITATIVE	$48.88	$104.00	$11.69–$12.09	14% above	53%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE SULFATE	$30.55	$65.00	$26.40–$28.71	53% below	53%
Drug screen by lab instrument (any number of drug classes) CPT 80307 RL PMGNT PAN QTY NO REFLEX	$20.40	$43.40	$43.40	65% below	53%
Drug screen by lab instrument (any number of drug classes) CPT 80307 RL MEDOCIUM DRUG SCREEN	$25.38	$54.00	$54.00	56% below	53%
Drug screen by lab instrument (any number of drug classes) CPT 80307 RL DRUG SCREEN TARGETED	$36.43	$77.50	$73.79–$77.50	37% below	53%
Drug screen by lab instrument (any number of drug classes) CPT 80307 RL DRUG TEST PRSMV CHEM ANLYZR	$43.71	$93.00	$73.79–$93.00	25% below	53%
Drug screen by lab instrument (any number of drug classes) CPT 80307 RL DRUG PANEL PAIN MGT W INTERP	$45.90	$97.65	$73.79–$97.65	21% below	53%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL ETHANOL -SJH	$60.63	$129.00	$73.79–$129.00	4% above	53%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN URINE	$60.63	$129.00	$73.79–$129.00	4% above	53%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DMC MECONIUM DRUG SCREEN	$70.50	$150.00	$73.79–$150.00	21% above	53%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$13.63	$29.00	$5.93–$8.32	57% below	53%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 PERFUSION ELECTROLYTE PANEL	$59.22	$126.00	$5.93–$8.32	85% above	53%
Epstein-Barr virus (EBV) antibody test CPT 86665 SJH EPSTEIN BARR VIRAL CAPSID VC	$18.80	$40.00	$17.17–$21.54	71% below	53%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR VIRAL CAPSID VCA-SJH	$18.80	$40.00	$17.17–$21.54	71% below	53%
Epstein-Barr virus (EBV) antibody test CPT 86665 EB VIRUS PANEL-EBV ANTI VCA IGG,I	$18.80	$40.00	$17.17–$21.54	71% below	53%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV ANTIBODY TO VCA IGM	$18.80	$40.00	$17.17–$21.54	71% below	53%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV PANEL -SJH	$18.80	$40.00	$17.17–$21.54	71% below	53%
Estradiol blood test CPT 82670 RL ASSAY OF TOTAL ESTRADIOL	$19.74	$42.00	$33.17–$36.09	75% below	53%
Estradiol blood test CPT 82670 ESTRADIOL -SJH	$29.14	$62.00	$33.17–$36.09	63% below	53%
Estradiol blood test CPT 82670 ESTRADIOL	$29.14	$62.00	$33.17–$36.09	63% below	53%
FSH (follicle-stimulating hormone) test CPT 83001 FSH SJH	$33.84	$72.00	$22.06–$24.00	58% below	53%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$33.84	$72.00	$22.06–$24.00	58% below	53%
Fecal calprotectin (stool inflammation test) CPT 83993 RL CALPROTECTIN, FECAL	$66.06	$140.56	$20.55–$23.31	4% above	53%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$32.43	$69.00	$16.19–$17.60	46% below	53%
Fibrinogen blood test CPT 85384 FIBRINOGEN QUANT.	$20.68	$44.00	$10.97–$11.54	29% below	53%
Folate (folic acid) blood test CPT 82746 125 I FOLATE	$28.20	$60.00	$17.46–$18.98	62% below	53%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$16.92	$36.00	$20.11–$21.88	75% below	53%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$13.63	$29.00	$10.71–$11.64	55% below	53%
Free testosterone test CPT 84402 RL ASSAY OF FREE TESTOSTERONE	$17.86	$38.00	$30.25–$32.89	51% below	53%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$21.62	$46.00	$30.25–$32.89	41% below	53%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 SJP GAMMA GLUTAMYL TRANSFERASE	$6.11	$13.00	$8.55–$9.30	80% below	53%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GLUTAMYL TRANSPEPTIDASE (GG	$6.11	$13.00	$8.55–$9.30	80% below	53%
Glucose tolerance test, 3 samples CPT 82951 GLUCOS 2 HOUR BLOOD	$24.91	$53.00	$15.29–$16.63	56% below	53%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 1 HR	$24.91	$53.00	$15.29–$16.63	56% below	53%
Glucose tolerance test, 3 samples CPT 82951 GLUCOS 3 HOUR BLOOD	$24.91	$53.00	$15.29–$16.63	56% below	53%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHEA DNA AMPLIFICATION	$23.97	$51.00	$41.67–$45.33	75% below	53%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 SJH- N GONO-AMPLIFIED DNA ASSAY	$36.66	$78.00	$41.67–$45.33	62% below	53%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 SJH NEISSERIA GONORRHOEAE BY PCR	$36.66	$78.00	$41.67–$45.33	62% below	53%
H. pylori antibody blood test CPT 86677 H PYLORI IGG SERUM SCREEN	$13.63	$29.00	$17.17–$20.01	77% below	53%
H. pylori stool antigen test CPT 87338 RL HELICO PYLORIA AG, FECAL EIA	$20.56	$43.75	$17.07–$18.58	68% below	53%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 SP IMMUNO RNA PCR QT -SJH	$88.83	$189.00	$101.06–$109.89	51% below	53%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 AND 2	$12.22	$26.00	$16.27–$17.17	74% below	53%
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1 P4 AG	$20.21	$43.00	$16.27–$17.17	57% below	53%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$12.69	$27.00	$23.77	74% below	53%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 RL HIV-1/O/2 4TH GEN	$22.56	$48.00	$23.77–$28.60	54% below	53%
HPV test for high-risk types, one combined (pooled) result CPT 87624 SJP HPV RAPID TEST	$36.66	$78.00	$41.67–$42.67	50% below	53%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH-RISK TYPES	$36.66	$78.00	$41.67–$42.67	50% below	53%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 SJP-GLYCOSYLATED HEMOGLOBIN TEST	$10.34	$22.00	$11.53–$12.54	73% below	53%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOHEMOGLOBIN	$10.34	$22.00	$11.53–$12.54	73% below	53%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$14.57	$31.00	$2.81–$3.06	9% below	53%
Hemoglobin blood test CPT 85018 HEMOGLOBIN OR	$19.74	$42.00	$2.81–$3.06	23% above	53%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB -SJH	$12.69	$27.00	$14.31–$15.57	71% below	53%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY IGG+IGM	$12.69	$27.00	$14.31–$15.57	71% below	53%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY	$7.99	$17.00	$12.75–$13.87	81% below	53%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 RL HBS AB-LC	$19.74	$42.00	$12.75–$13.87	53% below	53%
Hepatitis B surface antigen (HBsAg) test CPT 87340 RL HBSAG-LC	$19.74	$42.00	$12.26–$13.34	57% below	53%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBS-ANTIGEN	$22.09	$47.00	$12.26–$13.34	52% below	53%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBS AG DIALYSIS	$22.09	$47.00	$12.26–$13.34	52% below	53%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB-TOTAL	$8.93	$19.00	$16.90–$16.95	81% below	53%
Hepatitis C antibody blood test (screening) CPT 86803 SJP-HEPATITIS C TOTAL AB	$15.04	$32.00	$16.90–$16.95	69% below	53%
Hepatitis C antibody blood test (screening) CPT 86803 ANTI HCV	$17.86	$38.00	$16.90–$16.95	63% below	53%
Hepatitis C antibody blood test (screening) CPT 86803 RL HCV-LC	$27.26	$58.00	$16.90–$16.95	43% below	53%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV BY QUANTITATIVE NAAT	$27.73	$59.01	$50.88–$55.32	79% below	53%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QT BY PCR SJH	$44.65	$95.00	$50.88–$55.32	66% below	53%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QT BY PCR -SJH	$44.65	$95.00	$50.88–$55.32	66% below	53%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA PCR QUANTITATIVE	$47.94	$102.00	$50.88–$55.32	64% below	53%
Herpes blood test, HSV-1 antibody CPT 86695 SJP-HSV-1 SPECIFIC IGG	$13.63	$29.00	$15.66–$17.03	67% below	53%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 SPECIFIC - IGG	$13.63	$29.00	$15.66–$17.03	67% below	53%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGG ELISA -SJH	$13.63	$29.00	$15.66–$17.03	67% below	53%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGG ELISA-SJH	$20.21	$43.00	$22.98–$25.00	61% below	53%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGG ELISA -SJH	$20.21	$43.00	$22.98–$25.00	61% below	53%
Herpes blood test, HSV-2 antibody CPT 86696 HSV-2 SPECIFIC IGG	$20.21	$43.00	$22.98–$25.00	61% below	53%
Herpes blood test, HSV-2 antibody CPT 86696 SJP-HSV-2 SPECIFIC IGG	$20.21	$43.00	$22.98–$25.00	61% below	53%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HIGH SENSITIV	$13.16	$28.00	$15.38–$16.72	77% below	53%
Homocysteine blood test CPT 83090 HOMOCYSTINE	$23.50	$50.00	$21.27–$21.79	69% below	53%
Insulin blood test CPT 83525 INSULIN	$20.21	$43.00	$13.57–$14.76	45% below	53%
Insulin blood test CPT 83525 INSULIN TOLERANCE	$306.30	$651.70	$13.57–$14.76	737% above	53%
Iron blood test (serum iron) CPT 83540 IRON -SJH	$6.58	$14.00	$7.69–$8.37	78% below	53%
Iron blood test (serum iron) CPT 83540 RL IRON	$25.95	$55.22	$7.69–$8.37	11% below	53%
Iron-binding capacity (TIBC) test CPT 83550 IRON STUDY	$18.33	$39.00	$10.38–$11.14	54% below	53%
Kidney function blood test panel CPT 80069 RENAL PANEL	$11.75	$25.00	$10.31–$11.21	81% below	53%
LH (luteinizing hormone) test CPT 83002 LH	$37.60	$80.00	$21.99–$23.92	51% below	53%
LH (luteinizing hormone) test CPT 83002 LH SJH	$37.60	$80.00	$21.99–$23.92	51% below	53%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$31.49	$67.00	$7.51–$13.74	30% below	53%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID -SJH	$31.49	$67.00	$7.51–$13.74	30% below	53%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID (CSF)	$31.49	$67.00	$7.51–$13.74	30% below	53%
Lactate dehydrogenase (LDH) blood test CPT 83615 RL LD TOTAL	$3.64	$7.75	$7.17–$7.61	85% below	53%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH BODY FLUID AURP	$3.64	$7.75	$7.17–$7.61	85% below	53%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE CEREBROSPIN	$8.93	$19.00	$7.17–$7.61	63% below	53%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTIC DEHYDROGENASE (LDH)	$8.93	$19.00	$7.17–$7.61	63% below	53%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH BODY FLUID	$8.93	$19.00	$7.17–$7.61	63% below	53%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH -SJH	$8.93	$19.00	$7.17–$7.61	63% below	53%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$43.24	$92.00	$8.19–$8.89	43% above	53%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$15.04	$32.00	$5.93–$9.70	68% below	53%
Lyme disease antibody test CPT 86618 LYME DISEASE AB -IGG -SJH	$17.86	$38.00	$17.17–$20.23	31% below	53%
Lyme disease antibody test CPT 86618 LYME ANTIBODY SCREEN	$17.86	$38.00	$17.17–$20.23	31% below	53%
Magnesium blood test CPT 83735 RL MAGNESIUM RBCS	$6.34	$13.48	$7.96–$8.65	68% below	53%
Magnesium blood test CPT 83735 MAGNESIUM	$6.58	$14.00	$7.96–$8.65	67% below	53%
Magnesium blood test CPT 83735 MAGNESIUM LEVEL 24 HOUR URINE	$6.58	$14.00	$7.96–$8.65	67% below	53%
Magnesium blood test CPT 83735 MAGNESIUM-SERUM -SJH	$6.58	$14.00	$7.96–$8.65	67% below	53%
Magnesium blood test CPT 83735 MAGNESIUM LEVEL URINE	$6.58	$14.00	$7.96–$8.65	67% below	53%
Magnesium blood test CPT 83735 RL /SSAT24/MAGNESIUM	$7.42	$15.79	$7.96–$8.65	63% below	53%
Measles (rubeola) antibody test CPT 86765 MEASLES -SJH	$13.63	$29.00	$15.30–$16.65	45% below	53%
Measles (rubeola) antibody test CPT 86765 MEASLES IG G (RUBEOLA)	$49.82	$106.00	$15.30–$16.65	102% above	53%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSPOT	$12.69	$27.00	$6.15–$6.68	69% below	53%
Mumps immunity blood test CPT 86735 MUMPS -SJH	$13.63	$29.00	$15.50–$16.86	46% below	53%
Mumps immunity blood test CPT 86735 MUMPS SJH	$13.63	$29.00	$15.50–$16.86	46% below	53%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$39.01	$83.00	$53.66–$56.77	78% below	53%
PSA (prostate-specific antigen) blood test, free CPT 84154 RL ASSAY OF PSA FREE	$13.16	$28.00	$21.84–$23.77	77% below	53%
PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE -SJH	$19.27	$41.00	$21.84–$23.77	66% below	53%
PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATE SPECIFIC ANTIGEN FREE	$19.27	$41.00	$21.84–$23.77	66% below	53%
PSA (prostate-specific antigen) blood test, total CPT 84153 RL ASSAY OF PSA TOTAL	$13.16	$28.00	$21.84–$23.77	74% below	53%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA	$19.27	$41.00	$21.84–$23.77	62% below	53%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL & FREE PSA -SJH	$19.27	$41.00	$21.84–$23.77	62% below	53%
Pap test (liquid-based, automated screening with review) CPT 88175 GYN CYTOLOGY LIQUID PREP NOT IMAG	$43.71	$93.00	$31.60–$34.04	41% below	53%
Pap test (liquid-based, automated screening with review) CPT 88175 GYN CYTOLOGY LIQUID PREP IMAGED	$43.71	$93.00	$31.60–$34.04	41% below	53%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR WITH HPV	$21.15	$45.00	$24.06–$26.17	73% below	53%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 GYN CYTOLOGY TPP W/O PATH INTERP	$33.84	$72.00	$24.06–$26.17	56% below	53%
Parathyroid hormone (PTH) blood test CPT 83970 RL ASSAY OF PARATHORMONE	$29.14	$62.00	$49.02–$53.30	78% below	53%
Parathyroid hormone (PTH) blood test CPT 83970 PTH C-TERMINAL	$43.24	$92.00	$49.02–$53.30	68% below	53%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE INTACT 05340	$43.24	$92.00	$49.02–$53.30	68% below	53%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$43.24	$92.00	$49.02–$53.30	68% below	53%
Parathyroid hormone (PTH) blood test CPT 83970 PTH -SJH	$43.24	$92.00	$49.02–$53.30	68% below	53%
Partial thromboplastin time (PTT) clotting test CPT 85730 RL PTTD HEPARIN REFLEX BILL	$7.65	$16.28	$7.14–$7.75	75% below	53%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT	$12.69	$27.00	$7.14–$7.75	59% below	53%
Partial thromboplastin time (PTT) clotting test CPT 85730 SJP THROMBOPLASTIN TIME PARTIAL	$12.69	$27.00	$7.14–$7.75	59% below	53%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHOROUS	$6.58	$14.00	$5.31–$5.63	69% below	53%
Potassium blood test CPT 84132 POTASSIUM	$8.46	$18.00	$5.65–$5.94	64% below	53%
Potassium blood test CPT 84132 RL POTASSIUM RBC	$38.07	$81.00	$5.65–$5.94	64% above	53%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHRMOML ANEUPLOIDY	$356.75	$759.05	$759.05	19% above	53%
Progesterone blood test CPT 84144 PROGESTRONE	$25.85	$55.00	$24.77–$26.95	59% below	53%
Progesterone blood test CPT 84144 PROGESTRONE SJH	$25.85	$55.00	$24.77–$26.95	59% below	53%
Prolactin blood test CPT 84146 PROLACTIN SJH	$16.45	$35.00	$23.01–$25.03	78% below	53%
Prolactin blood test CPT 84146 PROLACTIN	$16.45	$35.00	$23.01–$25.03	78% below	53%
Prothrombin time (PT/INR) clotting test CPT 85610 RL INHIBITOR ASSAY PT REFLEX 1	$4.66	$9.92	$5.07–$5.10	76% below	53%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$8.46	$18.00	$5.07–$5.10	56% below	53%
Prothrombin time (PT/INR) clotting test CPT 85610 SJP PROTHROMBIN TIME	$8.46	$18.00	$5.07–$5.10	56% below	53%
Prothrombin time (PT/INR) clotting test CPT 85610 RL LUPUS ANTICOAG REFLX PANE	$11.40	$24.25	$5.07–$5.10	41% below	53%
Prothrombin time (PT/INR) clotting test CPT 85610 RL LUPUS ANTICOAG REFLEX PANE	$11.40	$24.25	$5.07–$5.10	41% below	53%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS	$6.11	$13.00	$13.00	84% below	53%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC	$7.99	$17.00	$15.49	83% below	53%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP SCREEN THROAT	$19.74	$42.00	$15.49–$19.63	63% below	53%
Rh blood typing CPT 86901 RH TYPE-ARC	$5.64	$12.00	$3.55–$4.23	73% below	53%
Rh blood typing CPT 86901 RL RH VERSITI	$11.52	$24.50	$3.55–$4.23	44% below	53%
Rh blood typing CPT 86901 RH	$30.55	$65.00	$3.55–$4.23	47% above	53%
Rubella antibody test (immunity check) CPT 86762 RL RUBELLA ANTIBODY	$10.34	$22.00	$17.09–$17.78	80% below	53%
Rubella antibody test (immunity check) CPT 86762 SJP RUBELLA IGG ANTIBODY SCREEN	$15.04	$32.00	$17.09–$17.78	71% below	53%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG AB	$15.04	$32.00	$17.09–$17.78	71% below	53%
Rubella antibody test (immunity check) CPT 86762 SJP-RUBELLA IGG AB (QUANT)	$15.04	$32.00	$17.09–$17.78	71% below	53%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG -SJH	$15.04	$32.00	$17.09–$17.78	71% below	53%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG-SJH	$15.04	$32.00	$17.09–$17.78	71% below	53%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS COMPLETE	$31.49	$67.00	$14.61–$15.57	66% below	53%
Sodium blood test CPT 84295 SODIUM	$8.46	$18.00	$5.71–$6.00	59% below	53%
Stool ova and parasites exam CPT 87177 SJP-OVA AND PARASITES SMEARS	$9.40	$20.00	$10.57–$11.48	78% below	53%
Stool ova and parasites exam CPT 87177 RL OVA AND PARASITE	$10.34	$22.00	$10.57–$11.48	76% below	53%
Stool ova and parasites exam CPT 87177 RL OVA & PARASITE BODY FLUID SM	$18.37	$39.08	$10.57–$11.48	58% below	53%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES	$35.72	$76.00	$10.57–$11.48	18% below	53%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES	$9.87	$21.00	$3.36–$5.20	44% below	53%
Syphilis antibody test (Treponema pallidum) CPT 86780 FLUORESCENT TREPONEMAL ANTIBODIES	$13.63	$29.00	$15.04–$15.72	71% below	53%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM -SJH	$13.63	$29.00	$15.04–$15.72	71% below	53%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL (CSF)	$2.82	$6.00	$5.08–$5.52	84% below	53%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RL SYPHILIS TEST NON-TREP QUAL	$2.82	$6.00	$5.08–$5.52	84% below	53%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RL RAPID PLASMA REAGIN	$2.91	$6.20	$5.08–$5.52	83% below	53%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS G SEROLOGY (RPR)	$3.76	$8.00	$5.08–$5.52	78% below	53%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 ROUTINE RPR (VDRL)	$10.81	$23.00	$5.08–$5.52	37% below	53%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF	$14.57	$31.00	$5.08–$5.52	15% below	53%
Testosterone blood test, total (not free testosterone) CPT 84403 RL ASSAY OF TOTAL TESTOSTERONE	$18.33	$39.00	$30.65–$33.35	49% below	53%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$35.25	$75.00	$30.65–$33.35	1% below	53%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL -SJH	$35.25	$75.00	$30.65–$33.35	1% below	53%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL SJH	$35.25	$75.00	$30.65–$33.35	1% below	53%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL MALE-SJH	$95.88	$204.00	$30.65–$33.35	169% above	53%
Thyroid peroxidase (TPO) antibody test CPT 86376 RL MICROSOMAL ANTIBODY EACH	$10.34	$22.00	$17.27–$18.79	78% below	53%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB (TPO) -SJH	$15.04	$32.00	$17.27–$18.79	67% below	53%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB TPO -SJH	$15.04	$32.00	$17.27–$18.79	67% below	53%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID ABS -SJH	$15.04	$32.00	$17.27–$18.79	67% below	53%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID ANTI-MICROSOMAL ANTIBODY	$15.04	$32.00	$17.27–$18.79	67% below	53%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI MICROSOMAL ANTIBODY	$15.04	$32.00	$17.27–$18.79	67% below	53%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI THYROID ANTIBODY	$15.04	$32.00	$17.27–$18.79	67% below	53%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 3RD GENERATION 00950	$22.09	$47.00	$19.95–$21.70	66% below	53%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 SJP-TSH	$22.09	$47.00	$19.95–$21.70	66% below	53%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH-3RD GENERATION	$22.09	$47.00	$19.95–$21.70	66% below	53%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH BY RIA	$22.09	$47.00	$19.95–$21.70	66% below	53%
Total IgE blood test CPT 82785 GAMMAGLOBULIN IGE -SJH	$17.39	$37.00	$19.55–$21.26	61% below	53%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL	$4.23	$9.00	$5.16–$5.62	79% below	53%
Total thyroxine (T4) blood test CPT 84436 T4	$82.25	$175.00	$8.16–$8.88	148% above	53%
Total triiodothyronine (T3) blood test CPT 84480 T3 00954	$43.71	$93.00	$16.84–$18.31	5% below	53%
Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3 SJH	$57.34	$122.00	$16.84–$18.31	24% above	53%
Transferrin blood test CPT 84466 TRANSFERRIN	$26.79	$57.00	$15.06–$15.15	53% below	53%
Trichomonas test (NAAT) CPT 87661 RL TRICHOMONAS VAGINALIS BY TMA	$30.60	$65.10	$41.67–$43.65	58% below	53%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS BY PCR -SJH	$91.18	$194.00	$41.67–$43.65	24% above	53%
Triglycerides blood test CPT 84478 TRIGLYCERIDE BODY FLUID	$19.27	$41.00	$6.81–$7.43	3% above	53%
Triglycerides blood test CPT 84478 TRIGLYCERIDES -SJH	$19.27	$41.00	$6.81–$7.43	3% above	53%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$19.27	$41.00	$6.81–$7.43	3% above	53%
Triglycerides blood test CPT 84478 RL TRIGLYCERIDES VAP CHOLESTERL	$25.85	$55.00	$6.81–$7.43	39% above	53%
Troponin test, quantitative CPT 84484 TROPONIN	$33.37	$71.00	$12.71–$14.81	21% below	53%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$14.10	$30.00	$5.36–$5.84	36% below	53%
Urinalysis with microscope exam, automated CPT 81001 COMPLETE UA	$8.93	$19.00	$3.76–$4.08	55% below	53%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO WITH REFLEX	$8.93	$19.00	$3.76–$4.08	55% below	53%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W/SCOPE	$3.76	$8.00	$4.08–$4.78	75% below	53%
Urinalysis without microscope exam, automated CPT 81003 ACETONE - URINE	$5.64	$12.00	$2.67–$2.90	57% below	53%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O REFLEX	$5.64	$12.00	$2.67–$2.90	57% below	53%
Urinalysis without microscope exam, automated CPT 81003 SUGAR ONLY (REDUCING SUBSTANCE)	$5.64	$12.00	$2.67–$2.90	57% below	53%
Urinalysis without microscope exam, automated CPT 81003 POST-TRANS UA HGB	$5.64	$12.00	$2.67–$2.90	57% below	53%
Urinalysis without microscope exam, automated CPT 81003 ROUTINE URINALYSIS	$7.05	$15.00	$2.67–$2.90	46% below	53%
Urinalysis without microscope exam, automated CPT 81003 UA & C&S IF INDICATED	$8.93	$19.00	$2.67–$2.90	31% below	53%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$2.82	$6.00	$3.30–$4.14	82% below	53%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN EXCRETION RATE 24H URINE	$5.64	$12.00	$6.86–$7.27	78% below	53%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN LEVEL 24 HOUR URINE	$10.34	$22.00	$6.86–$7.27	60% below	53%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN	$11.28	$24.00	$6.86–$7.27	57% below	53%
Urine pregnancy test, read by color change CPT 81025 PREG TEST QUALITATIVE URINE	$9.40	$20.00	$8.17–$10.22	62% below	53%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST QUALITATIVE URINE	$9.40	$20.00	$8.17–$10.22	62% below	53%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TST	$9.40	$20.00	$8.17–$10.22	62% below	53%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$9.40	$20.00	$8.17–$10.22	62% below	53%
Vitamin B12 (cobalamin) blood test CPT 82607 B12	$15.51	$33.00	$17.91–$19.47	74% below	53%
Vitamin B12 (cobalamin) blood test CPT 82607 SJP-VITAMIN B-12	$15.51	$33.00	$17.91–$19.47	74% below	53%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY (EIA)	$31.02	$66.00	$35.15–$38.24	65% below	53%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 SJP-VITAMIN D,25 HYDROXY	$31.02	$66.00	$35.15–$38.24	65% below	53%
Zinc blood test CPT 84630 RL ZINC LEVEL	$5.95	$12.65	$12.04	75% below	53%
Zinc blood test CPT 84630 RL ZINC, RBC	$33.84	$72.00	$12.04–$13.53	42% above	53%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 RL CHORIONIC GONADOTROPIN TEST	$10.81	$23.00	$7.22–$17.88	78% below	53%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 RL MATERNAL SCREEN #2 HCG	$11.87	$25.25	$7.22–$17.88	75% below	53%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 SJP-BHCG, QUANTITATIVE	$18.80	$40.00	$7.22–$17.88	61% below	53%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA SUB UNIT HCG	$18.80	$40.00	$7.22–$17.88	61% below	53%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 QUANT BHCG TUMOR MARKER	$18.80	$40.00	$7.22–$17.88	61% below	53%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion both sides CPT 19081 MA STEREO BREAST BIOPSY BILAT	$1,500.24	$3,192.00	$1,191.73–$1,278.68	—	53%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MA STEREO BREAST BIOPSY RT	$749.65	$1,595.00	$1,191.73–$1,278.68	67% below	53%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MA STEREO BREAST BIOPSY LT	$749.65	$1,595.00	$1,191.73–$1,278.68	67% below	53%
Cardiac catheterization with coronary angiogram one side CPT 93458 CORS LT HRT CTH INTERV SAM PRA XU	$4,982.47	$10,601.00	$2,077.04–$6,996.66	50% below	53%
Cardiac catheterization with coronary angiogram one side CPT 93458 CORS & LT HEART CATH	$4,982.47	$10,601.00	$2,077.04–$2,228.58	50% below	53%
Cardiac catheterization with coronary angiogram one side CPT 93458 CORS LT HRT CTH INTERV SEP PRA XP	$4,982.47	$10,601.00	$2,077.04–$6,996.66	50% below	53%
Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL CARDIOVERSION	$531.57	$1,131.00	$983.14–$1,054.87	46% below	53%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$666.93	$1,419.00	$983.14–$1,054.87	32% below	53%
Catheter ablation for atrial fibrillation CPT 93656 A-FIB ABLATION	$19,345.67	$41,161.00	$638.94–$685.56	46% below	53%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY ENDO	$967.73	$2,059.00	$1,231.34–$1,321.18	17% below	53%
Coronary stent placement, one artery CPT 92928 BMS INITIAL LM	$10,607.43	$22,569.00	$15,808.82–$16,962.25	18% below	53%
Coronary stent placement, one artery CPT 92928 BMS INITIAL LD	$10,607.43	$22,569.00	$15,808.82–$16,962.25	18% below	53%
Coronary stent placement, one artery CPT 92928 BMS INITIAL LC	$10,607.43	$22,569.00	$15,808.82–$16,962.25	18% below	53%
Coronary stent placement, one artery CPT 92928 BMS INITIAL RC	$10,607.43	$22,569.00	$15,808.82–$16,962.25	18% below	53%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT	$3,627.93	$7,719.00	$4,380.84–$4,700.47	17% below	53%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ INTERLAMINAR CRV/THRC W/IG	$825.32	$1,756.00	$999.99–$1,072.95	15% below	53%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJECT FOR HYSTEROSALPINGOGRAM	$231.24	$492.00	$485.97	53% below	53%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ATHEROCENTESIS INJECT ASP W/O US	$327.12	$696.00	$478.27–$513.17	24% below	53%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DX JOINT INJECTION	$327.12	$696.00	$478.27–$513.17	24% below	53%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ MED JNT W/O US*20605	$337.93	$719.00	$478.27–$513.17	4% above	53%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HRT CATH W/VENTRICULOGRAPHY	$5,711.44	$12,152.00	$1,839.08–$1,973.26	18% below	53%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ INTERLAMINAR LMBR/SAC W/IG	$825.32	$1,756.00	$926.83–$994.45	20% below	53%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFOR LUMB/SACRAL SNG*64483	$934.83	$1,989.00	$1,308.32–$1,403.77	13% below	53%
Pacemaker implant (dual chamber) CPT 33208 INS NEW RPL PM W TRV ELT ATRIAVEN	$18,620.46	$39,618.00	$21,521.50–$23,091.74	14% above	53%
Pacemaker implant (dual chamber) CPT 33208 INSERT/ REPLACE PERM PACER DUAL	$18,620.46	$39,618.00	$21,521.50–$23,091.74	14% above	53%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLOREC CNCR SCRN, NO HI RISK	$827.67	$1,761.00	$1,231.34–$1,321.18	20% below	53%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 SCREENING COLONOSCOPY HIGH RISK M	$827.67	$1,761.00	$1,231.34–$1,321.18	20% below	53%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$197.87	$421.00	$130.67–$140.20	4% above	53%
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT-ED	$311.61	$663.00	$144.16–$154.68	91% above	53%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE SUTURE REPAIR 2.5CM<	$221.84	$472.00	$219.23–$235.23	5% above	53%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC REPR SIMP EXT 2.5CM ORLESS	$221.84	$472.00	$219.23–$235.23	5% above	53%
Skin biopsy, punch, one lesion CPT 11104 PF PUNCH BX SKIN SINGLE LESION	$166.38	$354.00	$257.39–$276.16	55% below	53%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$236.88	$504.00	$257.39–$276.16	36% below	53%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE SUTURE REPAIR 2.6-7.5	$235.47	$501.00	$264.33–$283.62	5% below	53%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC REPR SIMP EXTREM 2.6 - 7.5 CM	$235.47	$501.00	$264.33–$283.62	5% below	53%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 PF TANGNTL BX SKIN SINGLE LES	$166.38	$354.00	$132.77–$142.46	42% below	53%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$236.88	$504.00	$132.77–$142.46	17% below	53%
Thoracentesis with imaging guidance both sides CPT 32555 CT PUNCTURE THORACENTESIS BILAT	$841.77	$1,791.00	$833.79–$894.63	—	53%
Thoracentesis with imaging guidance both sides CPT 32555 PUNCTURE THORACENTESIS BILATERAL	$841.77	$1,791.00	$833.79–$894.63	—	53%
Thoracentesis with imaging guidance one side CPT 32555 US PUNCTURE THORACENTESIS RIGHT	$425.35	$905.00	$833.79–$894.63	62% below	53%
Thoracentesis with imaging guidance one side CPT 32555 CT PUNCTURE THORACENTESIS RIGHT	$425.35	$905.00	$833.79–$894.63	62% below	53%
Thoracentesis with imaging guidance one side CPT 32555 CT PUNCTURE THORACENTESIS LEFT	$425.35	$905.00	$833.79–$894.63	62% below	53%
Thoracentesis with imaging guidance one side CPT 32555 PUNCTURE THORACENTESIS LEFT	$425.35	$905.00	$833.79–$894.63	62% below	53%
Ultrasound-guided breast needle biopsy with marker clip, first lesion both sides CPT 19083 US BREAST BIOPSY BILAT	$1,500.24	$3,192.00	$1,042.82–$1,118.90	—	53%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US BREAST BIOPSY LT	$749.65	$1,595.00	$1,042.82–$1,118.90	60% below	53%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US BREAST BX RT	$749.65	$1,595.00	$1,042.82–$1,118.90	60% below	53%
Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS ABLATION RF	$2,686.52	$5,716.00	$4,300.31–$4,614.07	28% below	53%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SUB-Q TISSUE	$820.15	$1,745.00	$503.99–$540.76	47% above	53%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFSN BLOOD/ BLOOD COMP ENDO	$591.26	$1,258.00	$116.17–$124.65	21% below	53%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFSN BLOOD/ BLOOD COMP ER	$591.26	$1,258.00	$116.17–$124.65	21% below	53%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$591.26	$1,258.00	$116.17–$124.65	21% below	53%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUS	$591.26	$1,258.00	$116.17–$124.65	21% below	53%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANFUS	$591.26	$1,258.00	$116.17–$124.65	21% below	53%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT 1	$77.55	$165.00	$21.55–$23.12	55% below	53%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 METERED DOSE INHALER	$77.55	$165.00	$21.55–$23.12	55% below	53%
Critical care, first 30 to 74 minutes CPT 99291 ER CRITICAL CARE 6 CC (30-74)	$2,595.34	$5,522.00	$1,465.35–$1,572.26	29% above	53%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ADLT 12 LEAD	$80.37	$171.00	$10.09–$14.27	38% below	53%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG PEDIATRICS 12 LEAD	$80.37	$171.00	$10.09–$14.27	38% below	53%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ADULT 12 LEAD	$80.37	$171.00	$10.09–$14.27	38% below	53%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 PF OB-ED ER VISIT -LEVEL I	$83.19	$177.00	$109.83–$117.84	56% below	53%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 PF OB-ED ER VISIT LEVEL I	$83.19	$177.00	$109.83–$117.84	56% below	53%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 OB-ED ER VISIT -LEVEL I	$236.88	$504.00	$109.83–$117.84	26% above	53%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY ROOM - LEVEL 1	$236.88	$504.00	$109.83–$117.84	26% above	53%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 PF OB-ED ER VISIT LEVEL II	$166.85	$355.00	$210.26–$225.60	52% below	53%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 PF OB-ED ER VISIT -LEVEL II	$166.85	$355.00	$210.26–$225.60	52% below	53%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY ROOM - LEVEL 2	$474.23	$1,009.00	$210.26–$225.60	36% above	53%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 OB-ED ER VISIT -LEVEL II	$474.23	$1,009.00	$210.26–$225.60	36% above	53%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PF OB-ED ER VISIT -LEVEL III	$289.99	$617.00	$352.98–$378.73	54% below	53%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PF OB-ED ER VISIT LEVEL III	$289.99	$617.00	$352.98–$378.73	54% below	53%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY ROOM - LEVEL 3	$823.44	$1,752.00	$352.98–$378.73	29% above	53%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 OB-ED ER VISIT -LEVEL III	$823.44	$1,752.00	$352.98–$378.73	29% above	53%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 PF OB-ED ER VISIT LEVEL IV	$372.24	$792.00	$605.60–$649.79	65% below	53%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 PF OB-ED ER VISIT -LEVEL IV	$372.24	$792.00	$605.60–$649.79	65% below	53%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 OB-ED ER VISIT -LEVEL IV	$1,057.50	$2,250.00	$605.60–$649.79	at median	53%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY ROOM - LEVEL 4	$1,057.50	$2,250.00	$605.60–$649.79	at median	53%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 PF OB-ED ER VISIT LEVEL V	$672.10	$1,430.00	$873.88–$937.64	60% below	53%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 PF OB-ED ER VISIT -LEVEL V	$672.10	$1,430.00	$873.88–$937.64	60% below	53%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY ROOM - LEVEL 5	$1,906.79	$4,057.00	$873.88–$937.64	13% above	53%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 OB-ED ER VISIT -LEVEL V	$1,906.79	$4,057.00	$873.88–$937.64	13% above	53%
Exercise stress test, tracing only, the hospital charge CPT 93017 PERSANTINE NUCLEAR STRESS TEST	$746.36	$1,588.00	$65.11–$111.59	2% above	53%
Exercise stress test, tracing only, the hospital charge CPT 93017 NON-IMAGING STRESS TEST	$746.36	$1,588.00	$65.11–$111.59	2% above	53%
Exercise stress test, tracing only, the hospital charge CPT 93017 DOBUTAMINE NUCLEAR STRESS TEST	$746.36	$1,588.00	$65.11–$111.59	2% above	53%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS COMPONENT OF STRESS ECHO	$746.36	$1,588.00	$65.11–$111.59	2% above	53%
Exercise stress test, tracing only, the hospital charge CPT 93017 NUCLEAR IMAGING STRESS TEST	$746.36	$1,588.00	$65.11–$111.59	2% above	53%
Family therapy with the patient, 50 minutes CPT 90847 PF FAMILY PSYCHOTHRPY W/PATIENT6W	$114.21	$243.00	$28.07–$80.00	13% below	53%
Family therapy without the patient, 50 minutes CPT 90846 PF FAMILY PSYCHOTHRPY W/O PATIENT	$81.78	$174.00	$32.79–$80.00	45% below	53%
Family therapy without the patient, 50 minutes inpatient CPT 90846 PF FAMILY PSYCHOTHRPY W/O PATIENT	$81.78	$174.00	$32.79–$80.00	—	53%
Group psychotherapy session CPT 90853 PF GROUP PSYCHOTHERAPY	$31.49	$67.00	$14.04–$33.00	46% below	53%
Group psychotherapy session inpatient CPT 90853 PF GROUP PSYCHOTHERAPY	$31.49	$67.00	$14.04–$33.00	—	53%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION 31MIN-1HR	$199.75	$425.00	$90.87–$117.76	23% below	53%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION INFUSION,31 MIN- 1ST HO	$199.75	$425.00	$90.87–$117.76	23% below	53%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION INFUSION, 31-60 MIN	$199.75	$425.00	$90.87–$117.76	23% below	53%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV THERAPY HYDRATION >30 MIN UP	$199.75	$425.00	$90.87–$117.76	23% below	53%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV THERAPY HYDRATION >30 MIN	$199.75	$425.00	$90.87–$117.76	23% below	53%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION INFUSION, 31 MIN-60 MIN	$199.75	$425.00	$90.87–$117.76	23% below	53%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY UP TO 1 HR ENDO	$199.75	$425.00	$176.13–$228.25	33% below	53%
IV infusion of a medicine, first hour CPT 96365 IVPB/IV INFUSION UP TO 1 HR	$199.75	$425.00	$176.13–$228.25	33% below	53%
IV infusion of a medicine, first hour CPT 96365 IV INITIAL UP TO 1 HR EKG	$199.75	$425.00	$176.13–$228.25	33% below	53%
IV infusion of a medicine, first hour CPT 96365 IV INF TX/PROPH/DX INITIAL UT 1HR	$199.75	$425.00	$176.13–$228.25	33% below	53%
IV infusion of a medicine, first hour CPT 96365 IVPB/IV INFUSION UP TO 1 HOUR	$199.75	$425.00	$176.13–$228.25	33% below	53%
IV infusion of a medicine, first hour CPT 96365 IV INITIAL UP TO 1 HR CARDCTH	$199.75	$425.00	$176.13–$228.25	33% below	53%
IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL (FIRST IVP)	$111.86	$238.00	$103.06–$133.56	39% below	53%
IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL (FIRST IVP)-59	$111.86	$238.00	$103.06–$133.56	39% below	53%
IV push of a medicine, first drug CPT 96374 IV PUSH 1ST INJ	$111.86	$238.00	$103.06–$133.56	39% below	53%
IV push of a medicine, first drug CPT 96374 TX/PROPH/DX INJ IV PUSH SNGL DRUG	$111.86	$238.00	$103.06–$133.56	39% below	53%
IV push of a medicine, first drug CPT 96374 IV PUSH 1ST INJECTION	$111.86	$238.00	$103.06–$133.56	39% below	53%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION ADMINISTRATION	$83.19	$177.00	$27.00–$34.99	9% below	53%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 TX/PROPHY/DX INJ SUBQ/IM	$83.19	$177.00	$27.00–$34.99	9% below	53%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$83.19	$177.00	$27.00–$34.99	9% below	53%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PF DIAGNOSTIC REVIEW	$161.68	$344.00	$129.00	28% below	53%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PF DIAGNOSTIC REVIEW	$98.23	$209.00	$129.00	—	53%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PF PSYCH DIAGNOSTIC EVALUATION	$108.57	$231.00	$129.00	—	53%
Neuromuscular re-education, 15 minutes CPT 97112 PTA NEUROMUSCULA REEDUCATION EA	$46.53	$99.00	$27.18–$56.67	51% below	53%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR REEDUCATION EA	$46.53	$99.00	$27.18–$56.67	51% below	53%
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSCULAR REEDUCAT EA OTA	$46.53	$99.00	$27.18–$56.67	51% below	53%
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSCULAR REEDUCATION EA	$46.53	$99.00	$27.18–$56.67	51% below	53%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDU 15 MIN PTA	$46.53	$99.00	$27.18–$56.67	51% below	53%
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSCULAR RE-ED EACH	$46.53	$99.00	$27.18–$56.67	51% below	53%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDU 15 MIN	$46.53	$99.00	$27.18–$56.67	51% below	53%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR RE-ED EACH	$46.53	$99.00	$27.18–$56.67	51% below	53%
New patient office visit, about 30 minutes CPT 99203 PF NEW VISIT 3	$88.83	$189.00	$100.85–$108.20	21% below	53%
New patient office visit, about 30 minutes CPT 99203 E & M NEW PT INTERMED	$124.08	$264.00	$100.85–$108.20	11% above	53%
New patient office visit, about 30 minutes CPT 99203 E&M NEW PT INTERMEDIATE (MODIFIER	$124.08	$264.00	$100.85–$108.20	11% above	53%
New patient office visit, about 30 minutes CPT 99203 CHF NEW PATIENT 30-44MIN VIRTUAL	$124.08	$264.00	$100.85–$108.20	11% above	53%
New patient office visit, about 30 minutes CPT 99203 OFFICE OUTPATIENT NEW 30 MINUTES	$124.08	$264.00	$100.85–$108.20	11% above	53%
New patient office visit, about 30 minutes CPT 99203 PF OP CONSULT 40 MIN	$130.66	$278.00	$100.85–$108.20	17% above	53%
New patient office visit, about 30 minutes CPT 99203 PF OP CONSUL 40 MIN	$130.66	$278.00	$100.85–$108.20	17% above	53%
New patient office visit, about 30 minutes CPT 99203 LEVEL 3 NEW DETAILED	$142.88	$304.00	$100.85–$108.20	28% above	53%
New patient office visit, about 45 minutes CPT 99204 E&M NEW PT EXTENDED (MODIFIER)	$159.33	$339.00	$134.90–$165.35	35% above	53%
New patient office visit, about 45 minutes CPT 99204 E & M NEW PT EXTENDED	$159.33	$339.00	$134.90–$165.35	35% above	53%
New patient office visit, about 45 minutes CPT 99204 OFFICE OUTPATIENT NEW 45 MINUTES	$159.33	$339.00	$134.90–$165.35	35% above	53%
New patient office visit, about 45 minutes CPT 99204 CHF NEW PATIENT 45-59MIN VIRTUAL	$159.33	$339.00	$134.90–$165.35	35% above	53%
New patient office visit, about 45 minutes CPT 99204 PF OP CONSULT 60 MIN	$164.97	$351.00	$134.90–$165.35	40% above	53%
New patient office visit, about 45 minutes CPT 99204 PF OP CONSUL 60 MIN	$164.97	$351.00	$134.90–$165.35	40% above	53%
New patient office visit, about 45 minutes CPT 99204 LEVEL 4 NEW COMPREHENSIVE	$183.30	$390.00	$134.90–$165.35	55% above	53%
New patient office visit, about 60 minutes CPT 99205 PF E&M NEW PT LEVEL 5 CHF	$164.97	$351.00	$163.50–$204.87	21% above	53%
New patient office visit, about 60 minutes CPT 99205 E&M NEW PT COMPLEX (MODIFIER)	$173.43	$369.00	$163.50–$204.87	27% above	53%
New patient office visit, about 60 minutes CPT 99205 OFFICE OUTPATIENT NEW 60 MINUTES	$173.43	$369.00	$163.50–$204.87	27% above	53%
New patient office visit, about 60 minutes CPT 99205 E & M NEW PT COMPLEX	$173.43	$369.00	$163.50–$204.87	27% above	53%
New patient office visit, about 60 minutes CPT 99205 CHF NEW PATIENT 60-74MIN VIRTUAL	$173.43	$369.00	$163.50–$204.87	27% above	53%
New patient office visit, about 60 minutes CPT 99205 LEVEL 5 NEW COMPLEX	$199.28	$424.00	$163.50–$204.87	46% above	53%
New patient office visit, about 60 minutes CPT 99205 PF OP CONSULT 80 MIN	$221.37	$471.00	$163.50–$204.87	62% above	53%
New patient office visit, about 60 minutes CPT 99205 PF OP CONSUL 80 MIN	$221.37	$471.00	$163.50–$204.87	62% above	53%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PF NEW VISIT LEVEL 2 6W	$54.99	$117.00	$73.74–$81.87	33% below	53%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PF OP CONSUL 30 MIN	$79.43	$169.00	$73.74–$81.87	4% below	53%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PF OP CONSULT 30 MIN	$79.43	$169.00	$73.74–$81.87	4% below	53%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 LEVEL 1 NEW FOCUSED	$81.31	$173.00	$73.74–$81.87	2% below	53%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 CHF NEW PATIENT 15-29MIN VIRTUAL	$93.06	$198.00	$73.74–$81.87	13% above	53%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 E&M NEW PT LIMITED (MODIFIER)	$93.06	$198.00	$73.74–$81.87	13% above	53%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 E & M NEW PT LIMITED	$93.06	$198.00	$73.74–$81.87	13% above	53%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE OUTPATIENT NEW 20 MINUTES	$93.06	$198.00	$73.74–$81.87	13% above	53%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 LEVEL 2 NEW EXPANDED	$107.16	$228.00	$73.74–$81.87	30% above	53%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 20 MIN	$65.33	$139.00	$78.27–$108.38	68% below	53%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 20 MIN	$65.33	$139.00	$78.27–$108.38	68% below	53%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX 20 MIN	$65.33	$139.00	$78.27–$108.38	—	53%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$68.62	$146.00	$80.62–$140.49	71% below	53%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$68.62	$146.00	$80.62–$140.49	65% below	53%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$68.62	$146.00	$80.62–$140.49	69% below	53%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY EACH 15 MINUTES	$46.53	$99.00	$22.12–$45.45	52% below	53%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY EACH 15 MINUTES	$46.53	$99.00	$22.12–$45.45	52% below	53%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY EACH 15 MINUTE	$46.53	$99.00	$22.12–$45.45	52% below	53%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY EACH 15 MINUTE	$46.53	$99.00	$22.12–$45.45	52% below	53%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAP EA 15 MINUTE PTA	$46.53	$99.00	$22.12–$45.45	52% below	53%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY EA 15 MINS OTA	$46.53	$99.00	$22.12–$45.45	52% below	53%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EACH 15 MINS OTA	$46.53	$99.00	$22.12–$45.45	52% below	53%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EACH 15 MINUTES	$46.53	$99.00	$22.12–$45.45	52% below	53%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PTA MANUAL THERAPY EACH 15 MIN	$46.53	$99.00	$22.12–$45.45	52% below	53%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 NEUROMUSCULAR REEDU 15 MIN OTA	$46.53	$99.00	$24.01–$49.38	50% below	53%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE EACH 15 MIN	$46.53	$99.00	$24.01–$49.38	50% below	53%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE EA 15MIN OTA	$46.53	$99.00	$24.01–$49.38	50% below	53%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 ADL TRAINING EACH 15 MINUTES OTA	$46.53	$99.00	$24.01–$49.38	50% below	53%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCIS EA 15 MIN PTA	$46.53	$99.00	$24.01–$49.38	50% below	53%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISE EA 15 OTA	$46.53	$99.00	$24.01–$49.38	50% below	53%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUTIC EXCERISE ECH 15MIN	$46.53	$99.00	$24.01–$49.38	50% below	53%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OTA THERAPEUTIC ACTIV EA 15MIN	$46.53	$99.00	$24.01–$49.38	50% below	53%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUTIC EXERCISE EA 15 PTA	$46.53	$99.00	$24.01–$49.38	50% below	53%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUTIC EXERCISE EACH 15	$46.53	$99.00	$24.01–$49.38	50% below	53%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISE EACH 15	$46.53	$99.00	$24.01–$49.38	50% below	53%
Psychiatric evaluation with medical services inpatient CPT 90792 PF PSYCH DIAG EVAL W MED SRVCS	$112.33	$239.00	$129.00	—	53%
Psychotherapy for crisis, first 60 minutes CPT 90839 PF PSYTX CRISIS INITIAL 60 MINUTE	$102.93	$219.00	$80.00	1% above	53%
Psychotherapy session, 30 minutes CPT 90832 PF PSYCHOTHERAPY 30 MINUTES	$40.89	$87.00	$45.00	79% below	53%
Psychotherapy session, 30 minutes inpatient CPT 90832 PF PSYTX PT & FAMILY 30 MINUTES	$46.06	$98.00	$45.00	—	53%
Psychotherapy session, 45 minutes CPT 90834 PF PSYCHOTHERAPY 45 MINUTES	$61.57	$131.00	$80.00	71% below	53%
Psychotherapy session, 45 minutes CPT 90834 PF PSYTX PT & FAMILY 45 MINUTES	$68.15	$145.00	$80.00	68% below	53%
Psychotherapy session, 45 minutes inpatient CPT 90834 PF PSYCHOTHERAPY 45 MINUTES	$61.57	$131.00	$80.00	—	53%
Psychotherapy session, 60 minutes inpatient CPT 90837 PF PSYCHOTHERAPY 60 MINUTES	$92.12	$196.00	$80.00	—	53%
Psychotherapy session, 60 minutes inpatient CPT 90837 PF PSYTX PT & FAMILY 60 MINUTES	$102.93	$219.00	$80.00	—	53%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 PF SMOKING CESSATION 3-10 MINS	$12.69	$27.00	$12.30–$13.19	69% below	53%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF EST OUTPATIENT VISIT 40 MIN	$104.34	$222.00	$61.00–$222.00	37% below	53%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF EST OUTPATIENT VISIT 40 MINUTE	$104.34	$222.00	$61.00–$222.00	37% below	53%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF EST OUTPATIENT VISIT 40 MIN	$104.34	$222.00	$61.00–$222.00	37% below	53%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF EST OUTPATIENT VISIT 40 MINUTE	$104.34	$222.00	$61.00–$222.00	37% below	53%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 E&M EST PT COMPLEX (MODIFIER)	$217.61	$463.00	$61.00–$463.00	32% above	53%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 E & M EST PT COMPLEX	$217.61	$463.00	$61.00–$463.00	32% above	53%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 E & M EST PT COMPLEX	$217.61	$463.00	$61.00–$463.00	32% above	53%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OP ESTAB VISIT 40-54 MIN	$217.61	$463.00	$61.00–$463.00	32% above	53%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CHF EST. PATIENT 40-45MIN VIRTUAL	$217.61	$463.00	$61.00–$463.00	32% above	53%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 E&M EST PT COMPLEX (MODIFIER)	$217.61	$463.00	$61.00–$463.00	32% above	53%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CHF EST. PATIENT 40-45MIN VIRTUAL	$217.61	$463.00	$61.00–$463.00	32% above	53%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OP ESTAB VISIT 40-54 MIN	$217.61	$463.00	$61.00–$463.00	32% above	53%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 LEVEL 5 EST COMPLEX	$250.04	$532.00	$61.00–$532.00	52% above	53%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 LEVEL 5 EST COMPLEX	$250.04	$532.00	$61.00–$532.00	52% above	53%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PF EST OUTPATIENT VISIT 40 MINUTE	$104.34	$222.00	$61.00–$222.00	—	53%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PF EST OUTPATIENT VISIT 40 MIN	$104.34	$222.00	$61.00–$222.00	—	53%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PF EST OUTPATIENT VISIT 40 MIN	$104.34	$222.00	$61.00–$222.00	—	53%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 CHF EST. PATIENT 40-45MIN VIRTUAL	$217.61	$463.00	$61.00–$463.00	—	53%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 LEVEL 5 EST COMPLEX	$217.61	$463.00	$61.00–$463.00	—	53%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OP ESTAB VISIT 40-54 MIN	$217.61	$463.00	$61.00–$463.00	—	53%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E&M EST PT COMPLEX (MODIFIER)	$217.61	$463.00	$61.00–$463.00	—	53%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E & M EST PT COMPLEX	$217.61	$463.00	$61.00–$463.00	—	53%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OP ESTAB VISIT 40-54 MIN	$217.61	$463.00	$61.00–$463.00	—	53%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 LEVEL 5 EST COMPLEX	$250.04	$532.00	$61.00–$532.00	—	53%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PF EST OUTPATIENT VISIT 15 MINUTE	$43.24	$92.00	$34.00–$81.37	55% below	53%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PF EST OUTPATIENT VISIT 15 MIN	$43.24	$92.00	$34.00–$81.37	55% below	53%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST OUTPATIENT VISIT 15 MINUTE	$43.24	$92.00	$34.00–$81.37	55% below	53%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OP ESTAB VISIT 20-29 MIN	$119.85	$255.00	$34.00–$81.37	25% above	53%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 E&M EST PT INERMEDIATE (MODIFIER)	$119.85	$255.00	$34.00–$81.37	25% above	53%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 E & M EST PT INTERMED	$119.85	$255.00	$34.00–$81.37	25% above	53%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CHF EST. PATIENT 20-29MIN VIRTUAL	$119.85	$255.00	$34.00–$81.37	25% above	53%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 LEVEL 3 EST DETAILED	$137.71	$293.00	$34.00–$81.37	44% above	53%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CHF EST. PATIENT 20-29MIN VIRTUAL	$119.85	$255.00	$34.00–$81.37	—	53%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OP ESTAB VISIT 20-29 MIN	$119.85	$255.00	$34.00–$81.37	—	53%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 E&M EST PT INERMEDIATE (MODIFIER)	$119.85	$255.00	$34.00–$81.37	—	53%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 LEVEL 3 EST DETAILED	$137.71	$293.00	$34.00–$81.37	—	53%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PF EST OUTPATIENT VISIT 25 MIN	$71.91	$153.00	$38.00–$111.30	39% below	53%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST OUTPATIENT VISIT 25 MINUTE	$71.91	$153.00	$38.00–$111.30	39% below	53%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PF EST OUTPATIENT VISIT 25 MINUTE	$71.91	$153.00	$38.00–$111.30	39% below	53%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E&M EST PT EXTENDED (MODIFIER)	$156.98	$334.00	$38.00–$111.30	33% above	53%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E & M EST PT EXTENDED	$156.98	$334.00	$38.00–$111.30	33% above	53%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OP ESTAB VISIT 30-39 MIN	$156.98	$334.00	$38.00–$111.30	33% above	53%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CHF EST. PATIENT 30-39MIN VIRTUAL	$156.98	$334.00	$38.00–$111.30	33% above	53%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 LEVEL 4 EST COMPREHENSIVE	$180.48	$384.00	$38.00–$111.30	53% above	53%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 E&M EST PT EXTENDED (MODIFIER)	$156.98	$334.00	$38.00–$111.30	—	53%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CHF EST. PATIENT 30-39MIN VIRTUAL	$156.98	$334.00	$38.00–$111.30	—	53%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 E & M EST PT EXTENDED	$156.98	$334.00	$38.00–$111.30	—	53%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 LEVEL 4 EST COMPREHENSIVE	$180.48	$384.00	$38.00–$111.30	—	53%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PF EST OUTPATIENT VISIT 10 MIN	$39.01	$83.00	$28.00–$60.40	47% below	53%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PF EST OUTPATIENT VISIT 10 MINUTE	$39.01	$83.00	$28.00–$60.40	47% below	53%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CHF EST. PATIENT 10-19MIM VIRTUAL	$96.35	$205.00	$28.00–$60.40	31% above	53%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 E&M EST PT LIMITED (MODIFIER)	$96.35	$205.00	$28.00–$60.40	31% above	53%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE OUTPATIENT VISIT 10-19 MIN	$96.35	$205.00	$28.00–$60.40	31% above	53%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 E & M EST PT LIMITED	$96.35	$205.00	$28.00–$60.40	31% above	53%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 LEVEL 2 EST EXPANDED	$110.92	$236.00	$28.00–$60.40	50% above	53%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 LEVL 2 EST EXPANDED	$110.92	$236.00	$28.00–$60.40	50% above	53%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PF EST OUTPATIENT VISIT 10 MIN	$39.01	$83.00	$28.00–$60.40	—	53%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE OUTPATIENT VISIT 10-19 MIN	$96.35	$205.00	$28.00–$60.40	—	53%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 E & M EST PT LIMITED	$96.35	$205.00	$28.00–$60.40	—	53%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 LEVEL 2 EST EXPANDED	$96.35	$205.00	$28.00–$60.40	—	53%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 E&M EST PT LIMITED (MODIFIER)	$96.35	$205.00	$28.00–$60.40	—	53%
Speech and language evaluation CPT 92523 SPEECH EVAL SOUND LANG COMP 30	$156.51	$333.00	$231.74	58% below	53%
Speech and language evaluation CPT 92523 SPEECH EVAL SOUND LANG COMP 15	$212.44	$452.00	$231.74–$412.69	44% below	53%
Speech and language evaluation CPT 92523 SPEECH EVAL SOUND LANG COMP 15	$212.44	$452.00	$231.74–$412.69	44% below	53%
Speech and language evaluation CPT 92523 SPEECH EVAL SOUND LANG COMP 45	$213.38	$454.00	$231.74–$412.69	43% below	53%
Speech and language evaluation CPT 92523 SPEECH EVAL SOUND LANG COMP 45	$213.38	$454.00	$231.74–$412.69	43% below	53%
Speech and language evaluation CPT 92523 SPEECH EVL SOUND LANG COM 45MINS	$213.38	$454.00	$231.74–$412.69	43% below	53%
Speech and language evaluation CPT 92523 SPEECH EVAL SOUND LANG COM 45MINS	$213.38	$454.00	$231.74–$412.69	43% below	53%
Speech and language evaluation CPT 92523 SPEECH EVAL SOUND LANG COM 45MIN	$213.38	$454.00	$231.74–$412.69	43% below	53%
Speech and language evaluation CPT 92523 SPEECH EVAL SOUND LANG COM 45MIN	$213.38	$454.00	$231.74–$412.69	43% below	53%
Speech and language evaluation CPT 92523 SPEECH EVAL SOUND LANG COM 45MINS	$213.38	$454.00	$231.74–$412.69	43% below	53%
Speech and language evaluation CPT 92523 SPEECH EVL SOUND LANG COM 45MINS	$213.38	$454.00	$231.74–$412.69	43% below	53%
Speech and language evaluation CPT 92523 SPEECH EVAL SOUND LANG COMP 60	$319.13	$679.00	$231.74–$572.53	15% below	53%
Speech and language evaluation inpatient CPT 92523 SPEECH EVAL SOUND LANG COMP 15	$212.44	$452.00	$231.74–$412.69	—	53%
Speech and language evaluation inpatient CPT 92523 SPEECH EVL SOUND LANG COM 45MINS	$213.38	$454.00	$231.74–$412.69	—	53%
Speech and language evaluation inpatient CPT 92523 SPEECH EVAL SOUND LANG COM 45MIN	$213.38	$454.00	$231.74–$412.69	—	53%
Speech and language evaluation inpatient CPT 92523 SPEECH EVAL SOUND LANG COMP 45	$213.38	$454.00	$231.74–$412.69	—	53%
Speech and language evaluation inpatient CPT 92523 SPEECH EVAL SOUND LANG COM 45MINS	$213.38	$454.00	$231.74–$412.69	—	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAGE TREATMENT (15)	$39.95	$85.00	$27.18–$77.09	81% below	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAG TREATMENT (15)	$39.95	$85.00	$27.18–$77.09	81% below	53%
Speech therapy session, individual CPT 92507 SPEECH TREATMENT (15)	$39.95	$85.00	$27.18–$77.09	81% below	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAGE TREATMENT(15)	$39.95	$85.00	$27.18–$77.09	81% below	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAGE TREATMENT (30)	$77.55	$165.00	$27.18–$139.41	64% below	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAG TREATMENT (30)	$77.55	$165.00	$27.18–$139.41	64% below	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAG TREATMENT (30)	$77.55	$165.00	$27.18–$139.41	64% below	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAGE TREATMENT (30)	$77.55	$165.00	$27.18–$139.41	64% below	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAGE TREATMENT(30)	$77.55	$165.00	$27.18–$139.41	64% below	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAGE TREATMENT(30)	$77.55	$165.00	$27.18–$139.41	64% below	53%
Speech therapy session, individual CPT 92507 SPEECH TREATMENT (30)	$77.55	$165.00	$27.18–$139.41	64% below	53%
Speech therapy session, individual CPT 92507 SPEECH TREATMENT (30)	$77.55	$165.00	$27.18–$139.41	64% below	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAGE TREATMENT(45)	$117.03	$249.00	$27.18–$191.69	45% below	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAGE TREATMENT (45)	$117.03	$249.00	$27.18–$191.69	45% below	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAG TREATMENT (45)	$117.03	$249.00	$27.18–$191.69	45% below	53%
Speech therapy session, individual CPT 92507 SPEECH TREATMENT (45)	$117.03	$249.00	$27.18–$191.69	45% below	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAGE TREATMENT(60)	$156.51	$333.00	$27.18–$191.69	27% below	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAG TREATMENT (60)	$156.51	$333.00	$27.18–$191.69	27% below	53%
Speech therapy session, individual CPT 92507 SPEECH TREATMENT (60)	$156.51	$333.00	$27.18–$191.69	27% below	53%
Speech therapy session, individual CPT 92507 SPEECH-LANGUAGE TREATMENT (60)	$156.51	$333.00	$27.18–$191.69	27% below	53%
Speech therapy session, individual inpatient CPT 92507 SPEECH-LANGUAG TREATMENT (30)	$77.55	$165.00	$27.18–$139.41	—	53%
Speech therapy session, individual inpatient CPT 92507 SPEECH TREATMENT (30)	$77.55	$165.00	$27.18–$139.41	—	53%
Speech therapy session, individual inpatient CPT 92507 SPEECH-LANGUAGE TREATMENT(30)	$77.55	$165.00	$27.18–$139.41	—	53%
Speech therapy session, individual inpatient CPT 92507 SPEECH-LANGUAGE TREATMENT (30)	$77.55	$165.00	$27.18–$139.41	—	53%
Spirometry (breathing test) CPT 94010 PEAK FLOW TEST	$50.29	$107.00	$54.34–$58.30	76% below	53%
Spirometry before and after a bronchodilator CPT 94060 PF BRONCHODILAT RESPSE SPIROMETRY	$104.34	$222.00	$81.51–$87.46	74% below	53%
Spirometry before and after a bronchodilator CPT 94060 VENTILATORY SCREENING/STUDIES B/A	$139.59	$297.00	$81.51–$87.46	66% below	53%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTIVITY EA 15 MIN	$46.53	$99.00	$27.18–$61.72	42% below	53%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTIC ACTI EA 15 MIN PTA	$46.53	$99.00	$27.18–$61.72	42% below	53%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTI EA 15 MIN OTA	$46.53	$99.00	$27.18–$61.72	42% below	53%
Therapeutic activities (functional training), 15 minutes CPT 97530 PTA THERAPEUTIC ACTIVITY EA 15MIN	$46.53	$99.00	$27.18–$61.72	42% below	53%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTIC ACTIVITY EA 15 MIN	$46.53	$99.00	$27.18–$61.72	42% below	53%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX VACCINE	$31.83	$67.71	$67.31	18% below	53%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL 0.5ML VACCINE	$72.03	$153.25	$109.51	at median	53%

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.henryford.com/-/media/files/henry-ford/patients-visitors/price-transparency-2026/legacy-ascension/381359247_henry-ford-rochester-hospital_standardcharges.csv