Hospital Columbus, OH

Pickerington Methodist Hospital

Pickerington Methodist Hospital in Pickerington, OH publishes cash prices for 402 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Ohio median for 243 of 396 procedures and above it for 132. By typical cash price it ranks #55 of 139 Ohio hospitals and #13 of 20 hospitals in the Columbus, OH area, cheapest first. Select a procedure to compare it with other hospitals nearby.

1010 Refugee Rd, Pickerington, OH 43147 Collected Sep 23, 2026 Source price file Check a bill from this hospital (614) 544-2136

Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 360152 · CMS hospital register NPI 1972535052

Financial assistance

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

Pickerington Methodist 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.

State law

This state limits hospital bills for lower-income patients

Ohio's Hospital Care Assurance Program (HCAP): Ohio residents who are not on Medicaid and whose income is at or below 100% of the federal poverty level get basic, medically necessary hospital services free at hospitals in the program; physician bills are not included. Ask the hospital's billing office for an HCAP application. Other states' laws.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Abdominal CT scan without and with contrast CPT 74170 Hc Ct Abdomen W Wo Contrast	$1,266.20	$1,948.00	—	5% below	35%
Abdominal CT scan without and with contrast inpatient CPT 74170 Hc Ct Abdomen W Wo Contrast	$1,266.20	$1,948.00	—	—	35%
Abdominal X-ray, 2 views CPT 74019 Hc Xr Abdomen 2 Views	$252.20	$388.00	—	25% below	35%
Abdominal X-ray, 2 views inpatient CPT 74019 Hc Xr Abdomen 2 Views	$252.20	$388.00	—	—	35%
Ankle X-ray, complete, 3 or more views CPT 73610 Hc Xr Ankle Complete 3 + Vw	$241.15	$371.00	—	25% below	35%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Hc Xr Ankle Complete 3 + Vw	$241.15	$371.00	—	—	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Hc Noninvsve Physiolgc Studies Ext Art Ltd Bilat	$560.95	$863.00	—	—	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 Hc Noninvsve Physiolgc Studies Ext Art Ltd Bilat	$560.95	$863.00	—	—	35%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 Hc Ct Upper Extremity Wo Contrast	$846.95	$1,303.00	—	10% below	35%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 Hc Ct Upper Extremity Wo Contrast	$846.95	$1,303.00	—	—	35%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Hc Xr Esophagus Single Contrast Study	$353.60	$544.00	—	20% below	35%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Hc Xr Esophagus Single Contrast Study	$353.60	$544.00	—	—	35%
Bone scan, whole body (nuclear medicine) CPT 78306 Hc Bone Imaging Whole Body	$1,504.10	$2,314.00	—	2% below	35%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Hc Bone Imaging Whole Body	$1,504.10	$2,314.00	—	—	35%
Breast ultrasound, complete, one breast both sides CPT 76641 Hc Us Screening Breast Bilat	$292.50	$450.00	—	—	35%
Breast ultrasound, complete, one breast CPT 76641 Hc Us Breast Complete	$610.35	$939.00	—	28% above	35%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 Hc Us Screening Breast Bilat	$292.50	$450.00	—	—	35%
Breast ultrasound, complete, one breast inpatient CPT 76641 Hc Us Breast Complete	$610.35	$939.00	—	—	35%
Breast ultrasound, limited (one breast or one area) CPT 76642 Hc Us Breast Limited	$464.75	$715.00	—	13% above	35%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 Hc Us Breast Limited	$464.75	$715.00	—	—	35%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Hc Cta Abdomen Pelvis W Wo Contrast	$2,152.80	$3,312.00	—	1% above	35%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 Hc Cta Abdomen Pelvis W Wo Contrast	$2,152.80	$3,312.00	—	—	35%
CT angiography (CTA) of the head CPT 70496 Hc Cta Head W Wo Contrast	$1,301.95	$2,003.00	—	3% below	35%
CT angiography (CTA) of the head inpatient CPT 70496 Hc Cta Head W Wo Contrast	$1,301.95	$2,003.00	—	—	35%
CT angiography (CTA) of the neck CPT 70498 Hc Cta Neck W Wo Contrast	$1,300.65	$2,001.00	—	at median	35%
CT angiography (CTA) of the neck inpatient CPT 70498 Hc Cta Neck W Wo Contrast	$1,300.65	$2,001.00	—	—	35%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Hc Cta Chest W Wo Contrast	$1,416.35	$2,179.00	—	at median	35%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 Hc Cta Chest W Wo Contrast	$1,416.35	$2,179.00	—	—	35%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Hc Cta Heart W Dye Cor Ateries And Bypass Grafts	$1,220.70	$1,878.00	—	24% below	35%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 Hc Cta Heart W Dye Cor Ateries And Bypass Grafts	$1,220.70	$1,878.00	—	—	35%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Hc Ct Coronary Calcium Scan Diagnostic	$380.25	$585.00	—	36% above	35%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 Hc Ct Coronary Calcium Scan Diagnostic	$380.25	$585.00	—	—	35%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Hc Ct Abdomen Pelvis Wo Contrast	$1,571.05	$2,417.00	—	1% below	35%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Hc Ct Abdomen Pelvis Wo Contrast	$1,571.05	$2,417.00	—	—	35%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Hc Ct Abdomen Pelvis W Contrast	$1,931.80	$2,972.00	—	3% below	35%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Hc Ct Abdomen Pelvis W Contrast	$1,931.80	$2,972.00	—	—	35%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Hc Ct Abdomen Pelvis W Wo Contrast	$2,051.40	$3,156.00	—	12% below	35%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Hc Ct Abdomen Pelvis W Wo Contrast	$2,051.40	$3,156.00	—	—	35%
CT scan of the abdomen with contrast CPT 74160 Hc Ct Abdomen W Contrast	$1,167.40	$1,796.00	—	at median	35%
CT scan of the abdomen with contrast inpatient CPT 74160 Hc Ct Abdomen W Contrast	$1,167.40	$1,796.00	—	—	35%
CT scan of the abdomen without contrast CPT 74150 Hc Ct Abdomen Wo Contrast	$1,068.60	$1,644.00	—	2% above	35%
CT scan of the abdomen without contrast inpatient CPT 74150 Hc Ct Abdomen Wo Contrast	$1,068.60	$1,644.00	—	—	35%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Ct Maxillofacial Wo Contrast	$875.55	$1,347.00	—	at median	35%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Hc Ct Maxillofacial Wo Contrast	$875.55	$1,347.00	—	—	35%
CT scan of the head or brain, no contrast dye CPT 70450 Hc Ct Brain Wo Contrast	$835.25	$1,285.00	—	at median	35%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 Hc Ct Brain Wo Contrast	$835.25	$1,285.00	—	—	35%
CT scan of the head with contrast CPT 70460 Hc Ct Brain W Contrast	$950.95	$1,463.00	—	5% below	35%
CT scan of the head with contrast inpatient CPT 70460 Hc Ct Brain W Contrast	$950.95	$1,463.00	—	—	35%
CT scan of the head without and with contrast CPT 70470 Hc Ct Brain W Wo Contrast	$1,077.70	$1,658.00	—	10% below	35%
CT scan of the head without and with contrast inpatient CPT 70470 Hc Ct Brain W Wo Contrast	$1,077.70	$1,658.00	—	—	35%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Hc Ct Lumbar Spine Wo Contrast	$867.75	$1,335.00	—	21% below	35%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 Hc Ct Lumbar Spine Wo Contrast	$867.75	$1,335.00	—	—	35%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Hc Ct Cervical Spine Wo Contrast	$1,073.15	$1,651.00	—	at median	35%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 Hc Ct Cervical Spine Wo Contrast	$1,073.15	$1,651.00	—	—	35%
CT scan of the pelvis, with contrast dye CPT 72193 Hc Ct Pelvis W Contrast	$1,101.10	$1,694.00	—	10% below	35%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 Hc Ct Pelvis W Contrast	$1,101.10	$1,694.00	—	—	35%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Hc Duplex Scan Extracranial Arteries Bilat	$804.70	$1,238.00	—	—	35%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Hc Duplex Scan Extracranial Arteries Bilat	$804.70	$1,238.00	—	—	35%
Chest CT scan without and with contrast CPT 71270 Hc Ct Chest Diagnostic W Wo Contrast	$1,633.45	$2,513.00	—	8% above	35%
Chest CT scan without and with contrast inpatient CPT 71270 Hc Ct Chest Diagnostic W Wo Contrast	$1,633.45	$2,513.00	—	—	35%
Chest X-ray, 2 views CPT 71046 Hc Xr Chest 2 Views	$199.55	$307.00	—	24% below	35%
Chest X-ray, 2 views inpatient CPT 71046 Hc Xr Chest 2 Views	$199.55	$307.00	—	—	35%
Chest X-ray, single view CPT 71045 Hc Xr Chest 1 View	$170.95	$263.00	—	24% below	35%
Chest X-ray, single view inpatient CPT 71045 Hc Xr Chest 1 View	$170.95	$263.00	—	—	35%
Collarbone (clavicle) X-ray, complete CPT 73000 Hc Xr Clavicle Complete	$193.05	$297.00	—	29% below	35%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 Hc Xr Clavicle Complete	$193.05	$297.00	—	—	35%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Hc Us Retroperitioneal Complete	$438.75	$675.00	—	38% below	35%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Hc Us Retroperitioneal Complete	$438.75	$675.00	—	—	35%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Hc Bone Density Dexa Axial	$291.20	$448.00	—	36% below	35%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Hc Bone Density Dexa Axial	$291.20	$448.00	—	—	35%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Hc Bone Density Dexa Appendicular	$203.45	$313.00	—	21% below	35%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Hc Bone Density Dexa Appendicular	$203.45	$313.00	—	—	35%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Hc Us Pregnant Uterus W Detail Fetal Anatomy Sgl Fetus	$446.55	$687.00	—	47% below	35%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 Hc Us Pregnant Uterus W Detail Fetal Anatomy Sgl Fetus	$446.55	$687.00	—	—	35%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Hc Ct Chest Diagnostic Wo Contrast	$996.45	$1,533.00	—	6% above	35%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Hc Ct Chest Diagnostic Wo Contrast	$996.45	$1,533.00	—	—	35%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Hc Ct Chest Diagnostic W Contrast	$1,368.90	$2,106.00	—	13% above	35%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Hc Ct Chest Diagnostic W Contrast	$1,368.90	$2,106.00	—	—	35%
Diagnostic mammogram, both breasts both sides CPT 77066 Hc Mammogram Diag Bilat Digital W Cad	$540.80	$832.00	—	—	35%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Hc Mammogram Diag Bilat Digital W Cad	$540.80	$832.00	—	—	35%
Diagnostic mammogram, one breast one side CPT 77065 Hc Mammogram Diag Unilat Digital W Cad	$482.30	$742.00	—	34% above	35%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Hc Mammogram Diag Unilat Digital W Cad	$482.30	$742.00	—	—	35%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Hc Duplex Scan Lower Extrem Arteries Complt Bilat	$1,006.85	$1,549.00	—	—	35%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Hc Duplex Scan Lower Extrem Arteries Complt Bilat	$1,006.85	$1,549.00	—	—	35%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Hc Duplex Scan Extremity Veins Complete Bilat	$931.45	$1,433.00	—	—	35%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Hc Duplex Scan Extremity Veins Complete Bilat	$931.45	$1,433.00	—	—	35%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Hc Echo Complete W Doppler	$1,565.20	$2,408.00	—	7% below	35%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Hc Echo Complete W Doppler	$1,565.20	$2,408.00	—	—	35%
Elbow X-ray, 2 views CPT 73070 Hc Xr Elbow 2 Vw	$204.75	$315.00	—	22% below	35%
Elbow X-ray, 2 views inpatient CPT 73070 Hc Xr Elbow 2 Vw	$204.75	$315.00	—	—	35%
Elbow X-ray, complete, 3 or more views CPT 73080 Hc Xr Elbow Complete 3 + Vw	$240.50	$370.00	—	24% below	35%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 Hc Xr Elbow Complete 3 + Vw	$240.50	$370.00	—	—	35%
Eye socket (orbit) CT scan without contrast CPT 70480 Hc Ct Orbit Sella Post Fossa Ear Wo Contrast	$861.90	$1,326.00	—	at median	35%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Hc Ct Orbit Sella Post Fossa Ear Wo Contrast	$861.90	$1,326.00	—	—	35%
Facial bones X-ray, complete, 3 or more views CPT 70150 Hc Xr Facial Bones Complete 3 + Vw	$252.20	$388.00	—	33% below	35%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Hc Xr Facial Bones Complete 3 + Vw	$252.20	$388.00	—	—	35%
Forearm X-ray (radius and ulna), 2 views CPT 73090 Hc Xr Forearm 2 Vw	$215.80	$332.00	—	21% below	35%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 Hc Xr Forearm 2 Vw	$215.80	$332.00	—	—	35%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hc Hepatobiliary System Imaging	$2,078.05	$3,197.00	—	31% above	35%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hc Hepatobiliary System Imaging	$2,078.05	$3,197.00	—	—	35%
Hand X-ray, 2 views CPT 73120 Hc Xr Hand 2 Vw	$159.90	$246.00	—	40% below	35%
Hand X-ray, 2 views inpatient CPT 73120 Hc Xr Hand 2 Vw	$159.90	$246.00	—	—	35%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Hc Xr Calcaneus 2 + Vw	$208.00	$320.00	—	23% below	35%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 Hc Xr Calcaneus 2 + Vw	$208.00	$320.00	—	—	35%
Knee X-ray, 3 views CPT 73562 Hc Xr Knee 3 Vw	$245.05	$377.00	—	31% below	35%
Knee X-ray, 3 views inpatient CPT 73562 Hc Xr Knee 3 Vw	$245.05	$377.00	—	—	35%
Knee X-ray, complete, 4 or more views CPT 73564 Hc Xr Knee Complete 4 + Vw	$263.90	$406.00	—	33% below	35%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 Hc Xr Knee Complete 4 + Vw	$263.90	$406.00	—	—	35%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 Hc Ct Lower Extrem Wo Contrast	$872.30	$1,342.00	—	8% below	35%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 Hc Ct Lower Extrem Wo Contrast	$872.30	$1,342.00	—	—	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Hc Us Abdomen Limited	$354.90	$546.00	—	36% below	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Hc Us Abdomen Limited	$354.90	$546.00	—	—	35%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Hc Us Extremity Limited Joint Or Non Vasc Structure	$278.85	$429.00	—	42% below	35%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Hc Us Extremity Limited Joint Or Non Vasc Structure	$278.85	$429.00	—	—	35%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Hc Ct Chest Low Dose Lung Cancer Screening Wo Contrast	$345.80	$532.00	—	17% above	35%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Hc Ct Chest Low Dose Lung Cancer Screening Wo Contrast	$345.80	$532.00	—	—	35%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Hc Xr Tibia Fibula 2 Vw	$199.55	$307.00	—	27% below	35%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 Hc Xr Tibia Fibula 2 Vw	$199.55	$307.00	—	—	35%
MR angiography (MRA) of the head without contrast CPT 70544 Hc Mra Brain Wo Contrast	$928.20	$1,428.00	—	36% below	35%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Hc Mra Brain Wo Contrast	$928.20	$1,428.00	—	—	35%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 Hc Mri Breast Abbreviated Bilat W & Wo Cont	$345.80	$532.00	—	—	35%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 Hc Mri Breast Bilat W Contrast	$1,638.65	$2,521.00	—	—	35%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 Hc Mri Breast Bilat W And Wo Contrast	$2,187.25	$3,365.00	—	—	35%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 Hc Mri Breast Abbreviated Bilat W & Wo Cont	$345.80	$532.00	—	—	35%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 Hc Mri Breast Bilat W Contrast	$1,638.65	$2,521.00	—	—	35%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 Hc Mri Breast Bilat W And Wo Contrast	$2,187.25	$3,365.00	—	—	35%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Hc Mri Low Extremity Joint Wo Contrast	$1,223.95	$1,883.00	—	30% below	35%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Hc Mri Low Extremity Joint Wo Contrast	$1,223.95	$1,883.00	—	—	35%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Hc Mri Low Extremity Joint W Wo Contrast	$1,688.05	$2,597.00	—	29% below	35%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Hc Mri Low Extremity Joint W Wo Contrast	$1,688.05	$2,597.00	—	—	35%
MRI of the abdomen without contrast CPT 74181 Hc Mri Abdomen Wo Contrast	$1,285.05	$1,977.00	—	30% below	35%
MRI of the abdomen without contrast inpatient CPT 74181 Hc Mri Abdomen Wo Contrast	$1,285.05	$1,977.00	—	—	35%
MRI of the abdomen, without and then with contrast dye CPT 74183 Hc Mri Abdomen W Wo Contrast	$2,029.30	$3,122.00	—	11% below	35%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 Hc Mri Abdomen W Wo Contrast	$2,029.30	$3,122.00	—	—	35%
MRI of the brain, no contrast dye CPT 70551 Hc Mri Brain Stem Wo Contrast	$1,274.65	$1,961.00	—	21% below	35%
MRI of the brain, no contrast dye inpatient CPT 70551 Hc Mri Brain Stem Wo Contrast	$1,274.65	$1,961.00	—	—	35%
MRI of the brain, with and without contrast dye CPT 70553 Hc Mri Brain Stem W Wo Contrast	$2,004.60	$3,084.00	—	8% below	35%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Hc Mri Brain Stem W Wo Contrast	$2,004.60	$3,084.00	—	—	35%
MRI of the lower back, no contrast dye CPT 72148 Hc Mri Lumbar Spine Wo Contrast	$1,309.10	$2,014.00	—	21% below	35%
MRI of the lower back, no contrast dye inpatient CPT 72148 Hc Mri Lumbar Spine Wo Contrast	$1,309.10	$2,014.00	—	—	35%
MRI of the lower back, without and then with contrast dye CPT 72158 Hc Mri Lumbar Spine W Wo Contrast	$1,842.75	$2,835.00	—	21% below	35%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 Hc Mri Lumbar Spine W Wo Contrast	$1,842.75	$2,835.00	—	—	35%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Hc Mri Thoracic Spine Wo Contrast	$1,286.35	$1,979.00	—	23% below	35%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 Hc Mri Thoracic Spine Wo Contrast	$1,286.35	$1,979.00	—	—	35%
MRI of the neck (cervical spine) without and with contrast CPT 72156 Hc Mri Cervical Spine W Wo Contrast	$1,864.20	$2,868.00	—	18% below	35%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 Hc Mri Cervical Spine W Wo Contrast	$1,864.20	$2,868.00	—	—	35%
MRI of the neck (cervical spine), no contrast dye CPT 72141 Hc Mri Cervical Spine Wo Contrast	$1,291.55	$1,987.00	—	22% below	35%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 Hc Mri Cervical Spine Wo Contrast	$1,291.55	$1,987.00	—	—	35%
MRI of the pelvis without and with contrast CPT 72197 Hc Mri Pelvis W Wo Contrast	$1,891.50	$2,910.00	—	3% below	35%
MRI of the pelvis without and with contrast inpatient CPT 72197 Hc Mri Pelvis W Wo Contrast	$1,891.50	$2,910.00	—	—	35%
MRI of the pelvis, no contrast dye CPT 72195 Hc Mri Pelvis Wo Contrast	$1,323.40	$2,036.00	—	13% below	35%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Hc Mri Pelvis Wo Contrast	$1,323.40	$2,036.00	—	—	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 Hc Mri Upper Ext Joint Wo Contrast	$1,264.25	$1,945.00	—	16% below	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 Hc Mri Upper Ext Joint Wo Contrast	$1,264.25	$1,945.00	—	—	35%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Hc Xr Cervical Spine 4 To 5 Vw	$299.65	$461.00	—	33% below	35%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Hc Xr Cervical Spine 4 To 5 Vw	$299.65	$461.00	—	—	35%
Neck soft tissue CT scan with contrast CPT 70491 Hc Ct Soft Tissue Neck W Contrast	$1,181.70	$1,818.00	—	at median	35%
Neck soft tissue CT scan with contrast inpatient CPT 70491 Hc Ct Soft Tissue Neck W Contrast	$1,181.70	$1,818.00	—	—	35%
Neck soft tissue CT scan without contrast CPT 70490 Hc Ct Soft Tissue Neck Wo Contrast	$995.15	$1,531.00	—	8% above	35%
Neck soft tissue CT scan without contrast inpatient CPT 70490 Hc Ct Soft Tissue Neck Wo Contrast	$995.15	$1,531.00	—	—	35%
Neck soft tissue X-ray CPT 70360 Hc Xr Neck Soft Tissue	$202.80	$312.00	—	22% below	35%
Neck soft tissue X-ray inpatient CPT 70360 Hc Xr Neck Soft Tissue	$202.80	$312.00	—	—	35%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Hc Myocard Perfusion Imaging Spect Multiple	$3,253.25	$5,005.00	—	19% below	35%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Hc Myocard Perfusion Imaging Spect Multiple	$3,253.25	$5,005.00	—	—	35%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Hc Pet Imaging W Ct Skull Base To Mid Thigh	$4,977.05	$7,657.00	—	3% above	35%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Hc Pet Imaging W Ct Skull Base To Mid Thigh	$4,977.05	$7,657.00	—	—	35%
Pelvic CT scan without contrast CPT 72192 Hc Ct Pelvis Wo Contrast	$1,019.85	$1,569.00	—	1% above	35%
Pelvic CT scan without contrast inpatient CPT 72192 Hc Ct Pelvis Wo Contrast	$1,019.85	$1,569.00	—	—	35%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Hc Us Pelvis Non Ob Limited Follow Up	$183.30	$282.00	—	58% below	35%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Hc Us Pelvis Non Ob Limited Follow Up	$183.30	$282.00	—	—	35%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Hc Us Pelvis Non Ob Complete	$225.55	$347.00	—	55% below	35%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Hc Us Pelvis Non Ob Complete	$225.55	$347.00	—	—	35%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Hc Us Pregnant Uterus After 1St Trimester Sgl Fetus	$332.80	$512.00	—	45% below	35%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Hc Us Pregnant Uterus After 1St Trimester Sgl Fetus	$332.80	$512.00	—	—	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Hc Us Pregnant Uterus 1St Trimester Sgl Fetus	$300.95	$463.00	—	45% below	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Hc Us Pregnant Uterus 1St Trimester Sgl Fetus	$300.95	$463.00	—	—	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Hc Us Pregnant Uterus Limited 1 Or More Fetuses	$137.15	$211.00	—	71% below	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Hc Us Pregnant Uterus Limited 1 Or More Fetuses	$137.15	$211.00	—	—	35%
Rib X-ray, one side, 2 views one side CPT 71100 Hc Xr Ribs Unilateral 2 Vw	$209.30	$322.00	—	31% below	35%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Hc Xr Ribs Unilateral 2 Vw	$209.30	$322.00	—	—	35%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Hc Xr Ribs Unilateral W Cxr 3 + Vw	$328.25	$505.00	—	14% below	35%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Hc Xr Ribs Unilateral W Cxr 3 + Vw	$328.25	$505.00	—	—	35%
Screening mammogram, both breasts CPT 77067 Hc Mammogram Screening Digital W Cad	$160.55	$247.00	—	16% below	35%
Screening mammogram, both breasts inpatient CPT 77067 Hc Mammogram Screening Digital W Cad	$160.55	$247.00	—	—	35%
Shoulder X-ray, complete, 2 or more views CPT 73030 Hc Xr Shoulder Complete 2 + Vw	$287.95	$443.00	—	15% below	35%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Hc Xr Shoulder Complete 2 + Vw	$287.95	$443.00	—	—	35%
Sinus X-ray, complete, 3 or more views CPT 70220 Hc Xr Sinuses Paranasal Complete 3 + Vw	$258.70	$398.00	—	28% below	35%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Hc Xr Sinuses Paranasal Complete 3 + Vw	$258.70	$398.00	—	—	35%
Skull X-ray, fewer than 4 views CPT 70250 Hc Xr Skull Less Than 4 Vw	$233.35	$359.00	—	19% below	35%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Hc Xr Skull Less Than 4 Vw	$233.35	$359.00	—	—	35%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Hc Xr Swallowing Function Contrast Study	$300.95	$463.00	—	40% below	35%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Hc Xr Swallowing Function Contrast Study	$300.95	$463.00	—	—	35%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Hc Xr Femur 2+ Views	$152.75	$235.00	—	44% below	35%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 Hc Xr Femur 2+ Views	$152.75	$235.00	—	—	35%
Thoracic spine (mid back) CT scan without contrast CPT 72128 Hc Ct Thoracic Spine Wo Contrast	$835.25	$1,285.00	—	8% below	35%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 Hc Ct Thoracic Spine Wo Contrast	$835.25	$1,285.00	—	—	35%
Toe X-ray, 2 or more views CPT 73660 Hc Xr Toes 2 + Vw	$219.05	$337.00	—	12% below	35%
Toe X-ray, 2 or more views inpatient CPT 73660 Hc Xr Toes 2 + Vw	$219.05	$337.00	—	—	35%
Transvaginal pelvic ultrasound CPT 76830 Hc Us Transvaginal	$427.70	$658.00	—	24% below	35%
Transvaginal pelvic ultrasound inpatient CPT 76830 Hc Us Transvaginal	$427.70	$658.00	—	—	35%
Transvaginal ultrasound during pregnancy CPT 76817 Hc Us Pregnant Uterus Transvaginal	$284.70	$438.00	—	43% below	35%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Hc Us Pregnant Uterus Transvaginal	$284.70	$438.00	—	—	35%
Ultrasound of the abdomen, complete CPT 76700 Hc Us Abdomen Complete	$403.00	$620.00	—	36% below	35%
Ultrasound of the abdomen, complete inpatient CPT 76700 Hc Us Abdomen Complete	$403.00	$620.00	—	—	35%
Ultrasound of the scrotum and testicles CPT 76870 Hc Us Scrotum	$399.75	$615.00	—	26% below	35%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Hc Us Scrotum	$399.75	$615.00	—	—	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Hc Us Soft Tissue Head And Neck	$478.40	$736.00	—	17% below	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Hc Us Soft Tissue Head And Neck	$478.40	$736.00	—	—	35%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Hc Xr Upper Gi Single Contrast Study	$534.95	$823.00	—	10% below	35%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Hc Xr Upper Gi Single Contrast Study	$534.95	$823.00	—	—	35%
Upper arm X-ray (humerus), 2 views CPT 73060 Hc Xr Humerus 2 + Vw	$217.75	$335.00	—	21% below	35%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 Hc Xr Humerus 2 + Vw	$217.75	$335.00	—	—	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Hc Duplex Scan Extremity Veins Limited Unilat	$735.80	$1,132.00	—	at median	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Hc Duplex Scan Extremity Veins Limited Unilat	$735.80	$1,132.00	—	—	35%
Wrist X-ray, 2 views CPT 73100 Hc Xr Wrist 2 Vw	$147.55	$227.00	—	43% below	35%
Wrist X-ray, 2 views inpatient CPT 73100 Hc Xr Wrist 2 Vw	$147.55	$227.00	—	—	35%
Wrist X-ray, complete, 3 or more views CPT 73110 Hc Xr Wrist Complete 3 + Vw	$182.00	$280.00	—	46% below	35%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Hc Xr Wrist Complete 3 + Vw	$182.00	$280.00	—	—	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hc Xr Hip Unilateral W Pelvis 2-3 Views	$235.30	$362.00	—	24% below	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hc Xr Hip Unilateral W Pelvis 2-3 Views	$235.30	$362.00	—	—	35%
X-ray of the abdomen, 1 view CPT 74018 Hc Xr Abdomen 1 View	$163.15	$251.00	—	36% below	35%
X-ray of the abdomen, 1 view inpatient CPT 74018 Hc Xr Abdomen 1 View	$163.15	$251.00	—	—	35%
X-ray of the ankle, 2 views CPT 73600 Hc Xr Ankle 2 Vw	$218.40	$336.00	—	12% below	35%
X-ray of the ankle, 2 views inpatient CPT 73600 Hc Xr Ankle 2 Vw	$218.40	$336.00	—	—	35%
X-ray of the finger(s), 2 or more views CPT 73140 Hc Xr Fingers 2 + Vw	$165.10	$254.00	—	36% below	35%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 Hc Xr Fingers 2 + Vw	$165.10	$254.00	—	—	35%
X-ray of the foot, 2 views CPT 73620 Hc Xr Foot 2 Vw	$184.60	$284.00	—	20% below	35%
X-ray of the foot, 2 views inpatient CPT 73620 Hc Xr Foot 2 Vw	$184.60	$284.00	—	—	35%
X-ray of the foot, complete, 3 or more views CPT 73630 Hc Xr Foot Complete 3 + Vw	$245.05	$377.00	—	20% below	35%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Hc Xr Foot Complete 3 + Vw	$245.05	$377.00	—	—	35%
X-ray of the hand, 3 or more views CPT 73130 Hc Xr Hand Complete 3 + Vw	$208.00	$320.00	—	36% below	35%
X-ray of the hand, 3 or more views inpatient CPT 73130 Hc Xr Hand Complete 3 + Vw	$208.00	$320.00	—	—	35%
X-ray of the knee, 1 or 2 views CPT 73560 Hc Xr Knee 1 Or 2 Vw	$204.10	$314.00	—	25% below	35%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 Hc Xr Knee 1 Or 2 Vw	$204.10	$314.00	—	—	35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Hc Xr Lumbosacral Spine 2 Or 3 Vw	$206.70	$318.00	—	36% below	35%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Hc Xr Lumbosacral Spine 2 Or 3 Vw	$206.70	$318.00	—	—	35%
X-ray of the lower back, 4 or more views CPT 72110 Hc Xr Lumbosacral Spine 4 + Vw	$286.65	$441.00	—	39% below	35%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Hc Xr Lumbosacral Spine 4 + Vw	$286.65	$441.00	—	—	35%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Hc Xr Thoracic Spine 2 Vw	$216.45	$333.00	—	28% below	35%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Hc Xr Thoracic Spine 2 Vw	$216.45	$333.00	—	—	35%
X-ray of the nasal bones, 3 or more views CPT 70160 Hc Xr Nasal Bones Complete 3 + Vw	$154.70	$238.00	—	47% below	35%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Hc Xr Nasal Bones Complete 3 + Vw	$154.70	$238.00	—	—	35%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Hc Xr Cervical Spine 2 To 3 Views	$235.95	$363.00	—	29% below	35%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Hc Xr Cervical Spine 2 To 3 Views	$235.95	$363.00	—	—	35%
X-ray of the pelvis, 1 or 2 views CPT 72170 Hc Xr Pelvis 1 Or 2 Vw	$234.65	$361.00	—	7% below	35%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Hc Xr Pelvis 1 Or 2 Vw	$234.65	$361.00	—	—	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Hc Xr Sacrum/Coccyx 2 + Vw	$223.60	$344.00	—	25% below	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Hc Xr Sacrum/Coccyx 2 + Vw	$223.60	$344.00	—	—	35%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
ACTH blood test CPT 82024 Hc Acth	$76.05	$117.00	—	42% below	35%
ACTH blood test inpatient CPT 82024 Hc Acth	$76.05	$117.00	—	—	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Hc Alt Sgpt	$6.50	$10.00	—	77% below	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Hc Fsed Alt Sgpt	$6.50	$10.00	—	77% below	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Hc Alt Sgpt	$6.50	$10.00	—	—	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Hc Fsed Alt Sgpt	$6.50	$10.00	—	—	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 Hc Ast Sgot	$6.50	$10.00	—	74% below	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 Hc Fsed Ast Sgot	$6.50	$10.00	—	74% below	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Hc Fsed Ast Sgot	$6.50	$10.00	—	—	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Hc Ast Sgot	$6.50	$10.00	—	—	35%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hc Hepatitis Panel Acute	$284.70	$438.00	—	31% above	35%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hc Hepatitis Panel Acute	$284.70	$438.00	—	—	35%
Albumin blood test CPT 82040 Hc Albumin So	$6.50	$10.00	—	71% below	35%
Albumin blood test CPT 82040 Hc Fsed Albumin	$6.50	$10.00	—	71% below	35%
Albumin blood test CPT 82040 Hc Albumin	$6.50	$10.00	—	71% below	35%
Albumin blood test CPT 82040 Hc Albumin Specials	$6.50	$10.00	—	71% below	35%
Albumin blood test inpatient CPT 82040 Hc Fsed Albumin	$6.50	$10.00	—	—	35%
Albumin blood test inpatient CPT 82040 Hc Albumin Specials	$6.50	$10.00	—	—	35%
Albumin blood test inpatient CPT 82040 Hc Albumin So	$6.50	$10.00	—	—	35%
Albumin blood test inpatient CPT 82040 Hc Albumin	$6.50	$10.00	—	—	35%
Aldosterone blood test CPT 82088 Hc Aldosterone So	$37.05	$57.00	—	74% below	35%
Aldosterone blood test CPT 82088 Hc Aldosterone	$59.15	$91.00	—	58% below	35%
Aldosterone blood test inpatient CPT 82088 Hc Aldosterone So	$37.05	$57.00	—	—	35%
Aldosterone blood test inpatient CPT 82088 Hc Aldosterone	$59.15	$91.00	—	—	35%
Alkaline phosphatase (ALP) blood test CPT 84075 Hc Alkaline Phosphatase Alk Phos	$6.50	$10.00	—	73% below	35%
Alkaline phosphatase (ALP) blood test CPT 84075 Hc Alkaline Phosphatase So	$6.50	$10.00	—	73% below	35%
Alkaline phosphatase (ALP) blood test CPT 84075 Hc Fsed Alkaline Phosphatase Alk Phos	$6.50	$10.00	—	73% below	35%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Hc Alkaline Phosphatase So	$6.50	$10.00	—	—	35%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Hc Fsed Alkaline Phosphatase Alk Phos	$6.50	$10.00	—	—	35%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Hc Alkaline Phosphatase Alk Phos	$6.50	$10.00	—	—	35%
Allergy blood test, specific IgE, per allergen CPT 86003 Hc Allergen Specific Ige, Qt/Semi-Qt, Crude Allergen Extract, Each So	$35.75	$55.00	—	53% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 Hc Allergen Specific Ige, Qt/Semi-Qt, Crude Extract Special, Each So	$138.45	$213.00	—	492% above	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hc Allergen Specific Ige, Qt/Semi-Qt, Crude Allergen Extract, Each So	$35.75	$55.00	—	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hc Allergen Specific Ige, Qt/Semi-Qt, Crude Extract Special, Each So	$138.45	$213.00	—	—	35%
Alpha-fetoprotein (AFP) blood test CPT 82105 Hc Alpha Fetoprotein Serum	$46.15	$71.00	—	24% below	35%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Hc Alpha Fetoprotein Serum	$46.15	$71.00	—	—	35%
Ammonia blood test CPT 82140 Hc Ammonia	$38.35	$59.00	—	30% below	35%
Ammonia blood test CPT 82140 Hc Ammonia So	$227.50	$350.00	—	316% above	35%
Ammonia blood test inpatient CPT 82140 Hc Ammonia	$38.35	$59.00	—	—	35%
Ammonia blood test inpatient CPT 82140 Hc Ammonia So	$227.50	$350.00	—	—	35%
Amylase blood test CPT 82150 Hc Amylase	$53.95	$83.00	—	13% above	35%
Amylase blood test CPT 82150 Hc Fsed Amylase	$53.95	$83.00	—	13% above	35%
Amylase blood test CPT 82150 Hc Amylase So	$76.70	$118.00	—	60% above	35%
Amylase blood test inpatient CPT 82150 Hc Fsed Amylase	$53.95	$83.00	—	—	35%
Amylase blood test inpatient CPT 82150 Hc Amylase	$53.95	$83.00	—	—	35%
Amylase blood test inpatient CPT 82150 Hc Amylase So	$76.70	$118.00	—	—	35%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Hc Ccp Antibody	$105.30	$162.00	—	82% above	35%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Hc Ccp Antibody	$105.30	$162.00	—	—	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Hc Antinuclear Abs (Ana) So	$65.65	$101.00	—	19% above	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Hc Antinuclear Abs (Ana)	$122.85	$189.00	—	122% above	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Hc Antinuclear Abs (Ana) So	$65.65	$101.00	—	—	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Hc Antinuclear Abs (Ana)	$122.85	$189.00	—	—	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Hc Fsed Brain Natriuretic Peptide Bnp	$174.85	$269.00	—	17% above	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Hc Brain Natriuretic Peptide Bnp	$174.85	$269.00	—	17% above	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Hc Fsed Brain Natriuretic Peptide Bnp	$174.85	$269.00	—	—	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Hc Brain Natriuretic Peptide Bnp	$174.85	$269.00	—	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Donor Culture Bacterial Aerobic (Excp Urn Bld Stool), Cell Product	$56.55	$87.00	—	14% below	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Culture Aerobic	$193.05	$297.00	—	192% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Donor Culture Bacterial Aerobic (Excp Urn Bld Stool), Cell Product	$56.55	$87.00	—	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Culture Aerobic	$193.05	$297.00	—	—	35%
Basic metabolic panel (blood test) CPT 80048 Hc Basic Metabolic Panel Calcium Total	$36.40	$56.00	—	45% below	35%
Basic metabolic panel (blood test) CPT 80048 Hc Fsed Basic Metabolic Panel Calcium Total	$36.40	$56.00	—	45% below	35%
Basic metabolic panel (blood test) inpatient CPT 80048 Hc Fsed Basic Metabolic Panel Calcium Total	$36.40	$56.00	—	—	35%
Basic metabolic panel (blood test) inpatient CPT 80048 Hc Basic Metabolic Panel Calcium Total	$36.40	$56.00	—	—	35%
Bilirubin blood test, total CPT 82247 Hc Fsed Bilirubin Total	$6.50	$10.00	—	73% below	35%
Bilirubin blood test, total CPT 82247 Hc Bilirubin Total	$6.50	$10.00	—	73% below	35%
Bilirubin blood test, total inpatient CPT 82247 Hc Fsed Bilirubin Total	$6.50	$10.00	—	—	35%
Bilirubin blood test, total inpatient CPT 82247 Hc Bilirubin Total	$6.50	$10.00	—	—	35%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Hc Prostate Biopsy, Any Method	$459.55	$707.00	—	126% above	35%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Hc Gross And Micro Level Iv	$459.55	$707.00	—	126% above	35%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Hc Gross And Micro Level Iv So	$531.05	$817.00	—	161% above	35%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Hc Gross And Micro Level Iv	$459.55	$707.00	—	—	35%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Hc Prostate Biopsy, Any Method	$459.55	$707.00	—	—	35%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Hc Gross And Micro Level Iv So	$531.05	$817.00	—	—	35%
Blood culture for bacteria CPT 87040 Hc Bacterial Culture, Cell Product	$93.60	$144.00	—	at median	35%
Blood culture for bacteria CPT 87040 Hc Culture Blood Aerob Anaerob Pltlt	$93.60	$144.00	—	at median	35%
Blood culture for bacteria CPT 87040 Hc Culture Blood	$157.95	$243.00	—	69% above	35%
Blood culture for bacteria inpatient CPT 87040 Hc Bacterial Culture, Cell Product	$93.60	$144.00	—	—	35%
Blood culture for bacteria inpatient CPT 87040 Hc Culture Blood Aerob Anaerob Pltlt	$93.60	$144.00	—	—	35%
Blood culture for bacteria inpatient CPT 87040 Hc Culture Blood	$157.95	$243.00	—	—	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Hc Venipuncture Amb	$13.00	$20.00	—	18% below	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Hc Venipuncture	$13.00	$20.00	—	18% below	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Hc Pat Venipuncture	$13.00	$20.00	—	18% below	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Hc Venipuncture Amb	$13.00	$20.00	—	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Hc Venipuncture	$13.00	$20.00	—	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Hc Pat Venipuncture	$13.00	$20.00	—	—	35%
Blood glucose (sugar) test CPT 82947 Hc Glucose Quantitative Blood	$5.85	$9.00	—	75% below	35%
Blood glucose (sugar) test CPT 82947 Hc Glucose Quantitative Pulmonary	$5.85	$9.00	—	75% below	35%
Blood glucose (sugar) test CPT 82947 Hc Glucose Quantitative Amb	$5.85	$9.00	—	75% below	35%
Blood glucose (sugar) test CPT 82947 Hc Glucose Quant Blood	$5.85	$9.00	—	75% below	35%
Blood glucose (sugar) test CPT 82947 Hc Fsed Glucose Quantitative Blood	$5.85	$9.00	—	75% below	35%
Blood glucose (sugar) test CPT 82947 Hc Mstu Glucose Quant Blood	$5.85	$9.00	—	75% below	35%
Blood glucose (sugar) test CPT 82947 Hc Glucose Quantitative Cath Lab	$5.85	$9.00	—	75% below	35%
Blood glucose (sugar) test CPT 82947 Hc Glucose Quantitative Perfusion	$5.85	$9.00	—	75% below	35%
Blood glucose (sugar) test inpatient CPT 82947 Hc Glucose Quantitative Pulmonary	$5.85	$9.00	—	—	35%
Blood glucose (sugar) test inpatient CPT 82947 Hc Glucose Quantitative Perfusion	$5.85	$9.00	—	—	35%
Blood glucose (sugar) test inpatient CPT 82947 Hc Glucose Quantitative Cath Lab	$5.85	$9.00	—	—	35%
Blood glucose (sugar) test inpatient CPT 82947 Hc Mstu Glucose Quant Blood	$5.85	$9.00	—	—	35%
Blood glucose (sugar) test inpatient CPT 82947 Hc Fsed Glucose Quantitative Blood	$5.85	$9.00	—	—	35%
Blood glucose (sugar) test inpatient CPT 82947 Hc Glucose Quant Blood	$5.85	$9.00	—	—	35%
Blood glucose (sugar) test inpatient CPT 82947 Hc Glucose Quantitative Amb	$5.85	$9.00	—	—	35%
Blood glucose (sugar) test inpatient CPT 82947 Hc Glucose Quantitative Blood	$5.85	$9.00	—	—	35%
Blood lead test CPT 83655 Hc Lead So	$8.45	$13.00	—	83% below	35%
Blood lead test inpatient CPT 83655 Hc Lead So	$8.45	$13.00	—	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hc Fsed Hcg Qualitative	$20.80	$32.00	—	62% below	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hc Hcg Qualitative	$20.80	$32.00	—	62% below	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Hc Fsed Hcg Qualitative	$20.80	$32.00	—	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Hc Hcg Qualitative	$20.80	$32.00	—	—	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Hc Donor Blood Typing Abo	$13.65	$21.00	—	77% below	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Hc Recipient Blood Typing Abo	$79.95	$123.00	—	35% above	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Hc Blood Typing Abo	$86.45	$133.00	—	46% above	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Hc Donor Blood Typing Abo	$13.65	$21.00	—	—	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Hc Recipient Blood Typing Abo	$79.95	$123.00	—	—	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Hc Blood Typing Abo	$86.45	$133.00	—	—	35%
Blood urea nitrogen (BUN) test CPT 84520 Hc Bun Amb	$5.85	$9.00	—	75% below	35%
Blood urea nitrogen (BUN) test CPT 84520 Hc Mstu Bun	$5.85	$9.00	—	75% below	35%
Blood urea nitrogen (BUN) test CPT 84520 Hc Fsed Bun	$5.85	$9.00	—	75% below	35%
Blood urea nitrogen (BUN) test CPT 84520 Hc Bun	$5.85	$9.00	—	75% below	35%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Hc Fsed Bun	$5.85	$9.00	—	—	35%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Hc Bun Amb	$5.85	$9.00	—	—	35%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Hc Bun	$5.85	$9.00	—	—	35%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Hc Mstu Bun	$5.85	$9.00	—	—	35%
C-peptide blood test CPT 84681 Hc C Peptide	$31.85	$49.00	—	60% below	35%
C-peptide blood test inpatient CPT 84681 Hc C Peptide	$31.85	$49.00	—	—	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Hc C Reactive Protein Crp So	$19.50	$30.00	—	61% below	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Hc C Reactive Protein Crp	$24.70	$38.00	—	51% below	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 Hc C Reactive Protein Crp So	$19.50	$30.00	—	—	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 Hc C Reactive Protein Crp	$24.70	$38.00	—	—	35%
C. difficile toxin gene test (stool PCR) CPT 87493 Hc C Diff Amplified Probe So	$115.05	$177.00	—	12% below	35%
C. difficile toxin gene test (stool PCR) CPT 87493 Hc C Difficile Toxin Gene Pcr	$148.85	$229.00	—	14% above	35%
C. difficile toxin gene test (stool PCR) CPT 87493 Hc C Difficile Toxin Pcr	$148.85	$229.00	—	14% above	35%
C. difficile toxin gene test (stool PCR) CPT 87493 Hc C Difficille Toxin Pcr, Fecal So	$1,120.60	$1,724.00	—	759% above	35%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Hc C Diff Amplified Probe So	$115.05	$177.00	—	—	35%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Hc C Difficile Toxin Pcr	$148.85	$229.00	—	—	35%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Hc C Difficile Toxin Gene Pcr	$148.85	$229.00	—	—	35%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Hc C Difficille Toxin Pcr, Fecal So	$1,120.60	$1,724.00	—	—	35%
CA 19-9 blood test (tumor marker) CPT 86301 Hc Ca 19 9	$25.35	$39.00	—	65% below	35%
CA 19-9 blood test (tumor marker) CPT 86301 Hc Ca 19 9 Pancreatic Cyst Fluid So	$27.95	$43.00	—	62% below	35%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Hc Ca 19 9	$25.35	$39.00	—	—	35%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Hc Ca 19 9 Pancreatic Cyst Fluid So	$27.95	$43.00	—	—	35%
CA-125 blood test (ovarian cancer marker) CPT 86304 Hc Ca 125 So	$25.35	$39.00	—	73% below	35%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Hc Ca 125 So	$25.35	$39.00	—	—	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Hc Sars-Cov-2 Covid-19 Amp Prb High Troughput Method Mb	$168.35	$259.00	—	19% above	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Hc Sars-Cov-2 Covid-19 Amp Prb High Troughput Method St	$168.35	$259.00	—	19% above	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Hc Sars-Cov-2 Covid-19 Amp Prb High Troughput Method So	$168.35	$259.00	—	19% above	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Hc Sars-Cov-2 Covid-19 Amp Prb High Troughput Method St	$168.35	$259.00	—	—	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Hc Sars-Cov-2 Covid-19 Amp Prb High Troughput Method So	$168.35	$259.00	—	—	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Hc Sars-Cov-2 Covid-19 Amp Prb High Troughput Method Mb	$168.35	$259.00	—	—	35%
Calcium blood test, total CPT 82310 Hc Calcium Total	$5.85	$9.00	—	81% below	35%
Calcium blood test, total CPT 82310 Hc Fsed Calcium Total	$5.85	$9.00	—	81% below	35%
Calcium blood test, total CPT 82310 Hc Calcium Total So	$50.05	$77.00	—	58% above	35%
Calcium blood test, total inpatient CPT 82310 Hc Calcium Total	$5.85	$9.00	—	—	35%
Calcium blood test, total inpatient CPT 82310 Hc Fsed Calcium Total	$5.85	$9.00	—	—	35%
Calcium blood test, total inpatient CPT 82310 Hc Calcium Total So	$50.05	$77.00	—	—	35%
Carcinoembryonic antigen (CEA) test CPT 82378 Hc Cea	$96.85	$149.00	—	11% above	35%
Carcinoembryonic antigen (CEA) test CPT 82378 Hc Cea So	$269.10	$414.00	—	209% above	35%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Hc Cea	$96.85	$149.00	—	—	35%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Hc Cea So	$269.10	$414.00	—	—	35%
Chickenpox (varicella) immunity blood test CPT 86787 Hc Varicella Zoster Igm Antibody So	$35.10	$54.00	—	39% below	35%
Chickenpox (varicella) immunity blood test CPT 86787 Hc Varicella Zoster Igg Antibody	$126.10	$194.00	—	118% above	35%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Hc Varicella Zoster Igm Antibody So	$35.10	$54.00	—	—	35%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Hc Varicella Zoster Igg Antibody	$126.10	$194.00	—	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Hc Rna Probe Amplified Chlamydia	$59.15	$91.00	—	36% below	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Hc Chlamydia Trachomatis Amplified Rna So	$59.15	$91.00	—	36% below	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Hc Rna Probe Amplified Chlamydia	$59.15	$91.00	—	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Hc Chlamydia Trachomatis Amplified Rna So	$59.15	$91.00	—	—	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Hc Lipid Panel	$39.65	$61.00	—	25% below	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Hc Lipid Panel So	$39.65	$61.00	—	25% below	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Hc Lipid Panel	$39.65	$61.00	—	—	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Hc Lipid Panel So	$39.65	$61.00	—	—	35%
Complete blood count (CBC) with differential CPT 85025 Hc Cbc With Diff	$20.15	$31.00	—	45% below	35%
Complete blood count (CBC) with differential CPT 85025 Hc Cbc With Diff Amb	$20.15	$31.00	—	45% below	35%
Complete blood count (CBC) with differential CPT 85025 Hc Fsed Cbc With Diff	$20.15	$31.00	—	45% below	35%
Complete blood count (CBC) with differential inpatient CPT 85025 Hc Cbc With Diff Amb	$20.15	$31.00	—	—	35%
Complete blood count (CBC) with differential inpatient CPT 85025 Hc Cbc With Diff	$20.15	$31.00	—	—	35%
Complete blood count (CBC) with differential inpatient CPT 85025 Hc Fsed Cbc With Diff	$20.15	$31.00	—	—	35%
Complete blood count (CBC), no differential CPT 85027 Hc Cbc Without Diff	$18.20	$28.00	—	46% below	35%
Complete blood count (CBC), no differential CPT 85027 Hc Fsed Cbc Without Diff	$18.20	$28.00	—	46% below	35%
Complete blood count (CBC), no differential inpatient CPT 85027 Hc Fsed Cbc Without Diff	$18.20	$28.00	—	—	35%
Complete blood count (CBC), no differential inpatient CPT 85027 Hc Cbc Without Diff	$18.20	$28.00	—	—	35%
Comprehensive metabolic panel (blood test) CPT 80053 Hc Comprehensive Metabolic Panel	$48.10	$74.00	—	24% below	35%
Comprehensive metabolic panel (blood test) CPT 80053 Hc Fsed Comprehensive Metabolic Panel	$48.10	$74.00	—	24% below	35%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Hc Fsed Comprehensive Metabolic Panel	$48.10	$74.00	—	—	35%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Hc Comprehensive Metabolic Panel	$48.10	$74.00	—	—	35%
Cortisol blood test, total CPT 82533 Hc Cortisol Total	$46.80	$72.00	—	35% below	35%
Cortisol blood test, total CPT 82533 Hc Cortisol Total So	$87.75	$135.00	—	21% above	35%
Cortisol blood test, total inpatient CPT 82533 Hc Cortisol Total	$46.80	$72.00	—	—	35%
Cortisol blood test, total inpatient CPT 82533 Hc Cortisol Total So	$87.75	$135.00	—	—	35%
Creatine kinase (CK) blood test, total CPT 82550 Hc Cpk	$42.25	$65.00	—	19% above	35%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Hc Cpk	$42.25	$65.00	—	—	35%
Creatinine blood test CPT 82565 Hc Mstu Creatinine	$5.85	$9.00	—	76% below	35%
Creatinine blood test CPT 82565 Hc Creatinine	$5.85	$9.00	—	76% below	35%
Creatinine blood test CPT 82565 Hc Fsed Creatinine	$5.85	$9.00	—	76% below	35%
Creatinine blood test CPT 82565 Hc Creatinine Amb	$5.85	$9.00	—	76% below	35%
Creatinine blood test inpatient CPT 82565 Hc Creatinine Amb	$5.85	$9.00	—	—	35%
Creatinine blood test inpatient CPT 82565 Hc Fsed Creatinine	$5.85	$9.00	—	—	35%
Creatinine blood test inpatient CPT 82565 Hc Creatinine	$5.85	$9.00	—	—	35%
Creatinine blood test inpatient CPT 82565 Hc Mstu Creatinine	$5.85	$9.00	—	—	35%
Cytomegalovirus (CMV) antibody test CPT 86644 Hc Recipient Cytomegalovirus Antibody-Pk-Cmv So	$22.75	$35.00	—	67% below	35%
Cytomegalovirus (CMV) antibody test CPT 86644 Hc Donor Cytomegalovirus Antibody-Pk-Cmv So	$22.75	$35.00	—	67% below	35%
Cytomegalovirus (CMV) antibody test CPT 86644 Hc Cmv Antibody	$122.85	$189.00	—	79% above	35%
Cytomegalovirus (CMV) antibody test CPT 86644 Hc Cmv Antibody So	$264.55	$407.00	—	285% above	35%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Hc Donor Cytomegalovirus Antibody-Pk-Cmv So	$22.75	$35.00	—	—	35%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Hc Recipient Cytomegalovirus Antibody-Pk-Cmv So	$22.75	$35.00	—	—	35%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Hc Cmv Antibody	$122.85	$189.00	—	—	35%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Hc Cmv Antibody So	$264.55	$407.00	—	—	35%
D-dimer blood test (blood clot marker) CPT 85379 Hc Fsed D Dimer	$120.25	$185.00	—	73% above	35%
D-dimer blood test (blood clot marker) CPT 85379 Hc D Dimer	$120.25	$185.00	—	73% above	35%
D-dimer blood test (blood clot marker) CPT 85379 Hc D Dimer So	$347.10	$534.00	—	399% above	35%
D-dimer blood test (blood clot marker) inpatient CPT 85379 Hc Fsed D Dimer	$120.25	$185.00	—	—	35%
D-dimer blood test (blood clot marker) inpatient CPT 85379 Hc D Dimer	$120.25	$185.00	—	—	35%
D-dimer blood test (blood clot marker) inpatient CPT 85379 Hc D Dimer So	$347.10	$534.00	—	—	35%
DHEA sulfate (DHEA-S) blood test CPT 82627 Hc Dhea Sulfate Dhea S	$57.20	$88.00	—	42% below	35%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Hc Dhea Sulfate Dhea S	$57.20	$88.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Test Prsmv Chem Anlyzr	$79.95	$123.00	—	16% below	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Test Prsmv Chem Anlyzer So	$83.20	$128.00	—	13% below	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Test Prsmv Chem Anlyzer Special So	$565.50	$870.00	—	492% above	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Test Prsmv Chem Anlyzr	$79.95	$123.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Test Prsmv Chem Anlyzer So	$83.20	$128.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Test Prsmv Chem Anlyzer Special So	$565.50	$870.00	—	—	35%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Hc Electrolyte Panel	$29.90	$46.00	—	37% below	35%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Hc Fsed Electrolyte Panel	$29.90	$46.00	—	37% below	35%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Hc Fsed Electrolyte Panel	$29.90	$46.00	—	—	35%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Hc Electrolyte Panel	$29.90	$46.00	—	—	35%
Epstein-Barr virus (EBV) antibody test CPT 86665 Hc Ebv Viral Capsid Vca	$65.00	$100.00	—	at median	35%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Hc Ebv Viral Capsid Vca	$65.00	$100.00	—	—	35%
Estradiol blood test CPT 82670 Hc Estradiol; Total	$34.45	$53.00	—	69% below	35%
Estradiol blood test CPT 82670 Hc Estradiol; Total So	$44.20	$68.00	—	61% below	35%
Estradiol blood test inpatient CPT 82670 Hc Estradiol; Total	$34.45	$53.00	—	—	35%
Estradiol blood test inpatient CPT 82670 Hc Estradiol; Total So	$44.20	$68.00	—	—	35%
FSH (follicle-stimulating hormone) test CPT 83001 Hc Fsh	$25.35	$39.00	—	70% below	35%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Hc Fsh	$25.35	$39.00	—	—	35%
Fecal calprotectin (stool inflammation test) CPT 83993 Hc Calprotectin Fecal So	$214.50	$330.00	—	44% above	35%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Hc Calprotectin Fecal So	$214.50	$330.00	—	—	35%
Ferritin blood test (iron stores) CPT 82728 Hc Ferritin	$40.30	$62.00	—	47% below	35%
Ferritin blood test (iron stores) CPT 82728 Hc Ferritin So	$159.90	$246.00	—	110% above	35%
Ferritin blood test (iron stores) inpatient CPT 82728 Hc Ferritin	$40.30	$62.00	—	—	35%
Ferritin blood test (iron stores) inpatient CPT 82728 Hc Ferritin So	$159.90	$246.00	—	—	35%
Fibrinogen blood test CPT 85384 Hc Fibrinogen	$40.30	$62.00	—	10% below	35%
Fibrinogen blood test CPT 85384 Hc Fibrinogen So	$331.50	$510.00	—	637% above	35%
Fibrinogen blood test inpatient CPT 85384 Hc Fibrinogen	$40.30	$62.00	—	—	35%
Fibrinogen blood test inpatient CPT 85384 Hc Fibrinogen So	$331.50	$510.00	—	—	35%
Folate (folic acid) blood test CPT 82746 Hc Folic Acid Serum	$40.30	$62.00	—	40% below	35%
Folate (folic acid) blood test inpatient CPT 82746 Hc Folic Acid Serum	$40.30	$62.00	—	—	35%
Free T3 thyroid hormone test CPT 84481 Hc T3 Free	$38.35	$59.00	—	50% below	35%
Free T3 thyroid hormone test inpatient CPT 84481 Hc T3 Free	$38.35	$59.00	—	—	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Hc T4 Free	$24.05	$37.00	—	43% below	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Hc T4 Free By Dialysis So	$57.20	$88.00	—	35% above	35%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Hc T4 Free	$24.05	$37.00	—	—	35%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Hc T4 Free By Dialysis So	$57.20	$88.00	—	—	35%
Free testosterone test CPT 84402 Hc Testosterone Free So	$85.80	$132.00	—	12% below	35%
Free testosterone test CPT 84402 Hc Testosterone Free	$130.00	$200.00	—	34% above	35%
Free testosterone test inpatient CPT 84402 Hc Testosterone Free So	$85.80	$132.00	—	—	35%
Free testosterone test inpatient CPT 84402 Hc Testosterone Free	$130.00	$200.00	—	—	35%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Hc Glutramyltransferase Gamma Ggt	$33.15	$51.00	—	22% below	35%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Hc Fsed Glutramyltransferase Gamma Ggt	$33.15	$51.00	—	22% below	35%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Hc Fsed Glutramyltransferase Gamma Ggt	$33.15	$51.00	—	—	35%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Hc Glutramyltransferase Gamma Ggt	$33.15	$51.00	—	—	35%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 Hc General Health Panel	$142.35	$219.00	—	36% below	35%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 Hc General Health Panel	$142.35	$219.00	—	—	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Hc Glucose Post Glucose Dose	$13.65	$21.00	—	64% below	35%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Hc Glucose Post Glucose Dose	$13.65	$21.00	—	—	35%
Glucose tolerance test, 3 samples CPT 82951 Hc Glucose Tolerance 1St 3 Specimen	$29.90	$46.00	—	56% below	35%
Glucose tolerance test, 3 samples inpatient CPT 82951 Hc Glucose Tolerance 1St 3 Specimen	$29.90	$46.00	—	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Hc Rna Probe Amplified Gonorrhoeae	$59.15	$91.00	—	36% below	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Hc Neisseria Gonnorrhoeae Amplified Rna So	$59.15	$91.00	—	36% below	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Hc Neisseria Gonnorrhoeae Amplified Rna So	$59.15	$91.00	—	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Hc Rna Probe Amplified Gonorrhoeae	$59.15	$91.00	—	—	35%
H. pylori antibody blood test CPT 86677 Hc Helicobacter Iga Igm So	$57.20	$88.00	—	24% below	35%
H. pylori antibody blood test CPT 86677 Hc Helicobacter Pylori Igg	$107.25	$165.00	—	42% above	35%
H. pylori antibody blood test inpatient CPT 86677 Hc Helicobacter Iga Igm So	$57.20	$88.00	—	—	35%
H. pylori antibody blood test inpatient CPT 86677 Hc Helicobacter Pylori Igg	$107.25	$165.00	—	—	35%
H. pylori stool antigen test CPT 87338 Hc H Pylori Antigen Stool So	$110.50	$170.00	—	58% above	35%
H. pylori stool antigen test inpatient CPT 87338 Hc H Pylori Antigen Stool So	$110.50	$170.00	—	—	35%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hc Hiv-1 Quant And Reverse Transcription So	$165.75	$255.00	—	54% below	35%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hc Hiv 1 Virus Quantitation	$725.40	$1,116.00	—	103% above	35%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hc Hiv-1 Quant And Reverse Transcription So	$165.75	$255.00	—	—	35%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hc Hiv 1 Virus Quantitation	$725.40	$1,116.00	—	—	35%
HIV-1 and HIV-2 antibody test CPT 86703 Hc Recipient Hiv Antibody (Hiv-1/2/O) So	$24.70	$38.00	—	60% below	35%
HIV-1 and HIV-2 antibody test CPT 86703 Hc Hiv 1 And 2 Single Result Rapid	$24.70	$38.00	—	60% below	35%
HIV-1 and HIV-2 antibody test CPT 86703 Hc Donor Hiv Antibody (Hiv-1/2/O) So	$24.70	$38.00	—	60% below	35%
HIV-1 and HIV-2 antibody test CPT 86703 Hc Hiv 1 And 2 Single Result	$24.70	$38.00	—	60% below	35%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Hc Recipient Hiv Antibody (Hiv-1/2/O) So	$24.70	$38.00	—	—	35%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Hc Hiv 1 And 2 Single Result Rapid	$24.70	$38.00	—	—	35%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Hc Donor Hiv Antibody (Hiv-1/2/O) So	$24.70	$38.00	—	—	35%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Hc Hiv 1 And 2 Single Result	$24.70	$38.00	—	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hc Donor Hiv Antibody (Hiv-1/2/O)-Abbott So	$22.75	$35.00	—	69% below	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hc Recipient Hiv Antibody (Hiv-1/2/O)-Abbott So	$22.75	$35.00	—	69% below	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hc Hiv-1/-2 Ags And Abs Single Result So	$44.85	$69.00	—	39% below	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hc Hiv-1/-2 Ags And Abs Single Result	$58.50	$90.00	—	21% below	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hc Recipient Hiv Antibody (Hiv-1/2/O)-Abbott So	$22.75	$35.00	—	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hc Donor Hiv Antibody (Hiv-1/2/O)-Abbott So	$22.75	$35.00	—	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hc Hiv-1/-2 Ags And Abs Single Result So	$44.85	$69.00	—	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hc Hiv-1/-2 Ags And Abs Single Result	$58.50	$90.00	—	—	35%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hc Hpv Probe High Risk Types So	$112.45	$173.00	—	5% below	35%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Hc Hpv Probe High Risk Types So	$112.45	$173.00	—	—	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hc Hemoglobin A1C	$66.30	$102.00	—	45% above	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hc Hemoglobin A1C	$66.30	$102.00	—	—	35%
Hemoglobin blood test CPT 85018 Hc Hemoglobin Wb Perfusion	$6.50	$10.00	—	60% below	35%
Hemoglobin blood test CPT 85018 Hc Hemoglobin	$6.50	$10.00	—	60% below	35%
Hemoglobin blood test CPT 85018 Hc Hemoglobin Wb Cath Lab	$6.50	$10.00	—	60% below	35%
Hemoglobin blood test CPT 85018 Hc Hemoglobin Wb Pulm	$6.50	$10.00	—	60% below	35%
Hemoglobin blood test inpatient CPT 85018 Hc Hemoglobin	$6.50	$10.00	—	—	35%
Hemoglobin blood test inpatient CPT 85018 Hc Hemoglobin Wb Pulm	$6.50	$10.00	—	—	35%
Hemoglobin blood test inpatient CPT 85018 Hc Hemoglobin Wb Perfusion	$6.50	$10.00	—	—	35%
Hemoglobin blood test inpatient CPT 85018 Hc Hemoglobin Wb Cath Lab	$6.50	$10.00	—	—	35%
Hepatitis B core antibody test (total) CPT 86704 Hc Recipient Hepatitis B Core Antibody (Hbc)-Abbott So	$29.25	$45.00	—	46% below	35%
Hepatitis B core antibody test (total) CPT 86704 Hc Donor Hepatitis B Core Antibody (Hbc)-Abbott So	$29.25	$45.00	—	46% below	35%
Hepatitis B core antibody test (total) CPT 86704 Hc Hepatitis B Core Total Antibody	$57.20	$88.00	—	6% above	35%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hc Donor Hepatitis B Core Antibody (Hbc)-Abbott So	$29.25	$45.00	—	—	35%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hc Recipient Hepatitis B Core Antibody (Hbc)-Abbott So	$29.25	$45.00	—	—	35%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hc Hepatitis B Core Total Antibody	$57.20	$88.00	—	—	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hc Hepatitis B Surface Antibody	$46.80	$72.00	—	3% below	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hc Hepatitis B Surface Antibody	$46.80	$72.00	—	—	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hc Recipient Hepatitis B Surface Antigen (Hbsag)-Abbott So	$20.15	$31.00	—	57% below	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hc Donor Hepatitis B Surface Antigen (Hbsag)-Abbott So	$20.15	$31.00	—	57% below	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hc Hepatitis B Surface Antigen	$20.15	$31.00	—	57% below	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hc Hepatitis B Surface Antigen	$20.15	$31.00	—	—	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hc Recipient Hepatitis B Surface Antigen (Hbsag)-Abbott So	$20.15	$31.00	—	—	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hc Donor Hepatitis B Surface Antigen (Hbsag)-Abbott So	$20.15	$31.00	—	—	35%
Hepatitis C antibody blood test (screening) CPT 86803 Hc Hepatitis C Antibody Screen	$23.40	$36.00	—	63% below	35%
Hepatitis C antibody blood test (screening) CPT 86803 Hc Recipient Hepatitis C Virus Antibody (Hcv)-Abbott So	$23.40	$36.00	—	63% below	35%
Hepatitis C antibody blood test (screening) CPT 86803 Hc Donor Hepatitis C Virus Antibody (Hcv)-Abbott So	$23.40	$36.00	—	63% below	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hc Donor Hepatitis C Virus Antibody (Hcv)-Abbott So	$23.40	$36.00	—	—	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hc Recipient Hepatitis C Virus Antibody (Hcv)-Abbott So	$23.40	$36.00	—	—	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hc Hepatitis C Antibody Screen	$23.40	$36.00	—	—	35%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hc Hepatitis C Quant And Reverse Transcription So	$175.50	$270.00	—	9% below	35%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hc Hcv Virus Quantitation	$819.65	$1,261.00	—	326% above	35%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hc Hepatitis C Quant And Reverse Transcription So	$175.50	$270.00	—	—	35%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hc Hcv Virus Quantitation	$819.65	$1,261.00	—	—	35%
Herpes blood test, HSV-1 antibody CPT 86695 Hc Herpes 1 Igg	$66.30	$102.00	—	12% above	35%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Hc Herpes 1 Igg	$66.30	$102.00	—	—	35%
Herpes blood test, HSV-2 antibody CPT 86696 Hc Herpes Simplex Type 2 Igg	$66.30	$102.00	—	at median	35%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Hc Herpes Simplex Type 2 Igg	$66.30	$102.00	—	—	35%
High-sensitivity CRP (hs-CRP) test CPT 86141 Hc C Reactive Protein Cardiac Risk	$24.70	$38.00	—	63% below	35%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Hc C Reactive Protein Cardiac Risk	$24.70	$38.00	—	—	35%
Homocysteine blood test CPT 83090 Hc Homocysteine So	$54.60	$84.00	—	32% below	35%
Homocysteine blood test CPT 83090 Hc Homocysteine	$219.05	$337.00	—	172% above	35%
Homocysteine blood test inpatient CPT 83090 Hc Homocysteine So	$54.60	$84.00	—	—	35%
Homocysteine blood test inpatient CPT 83090 Hc Homocysteine	$219.05	$337.00	—	—	35%
Insulin blood test CPT 83525 Hc Insulin	$46.15	$71.00	—	10% below	35%
Insulin blood test CPT 83525 Hc Insulin Total So	$46.80	$72.00	—	9% below	35%
Insulin blood test inpatient CPT 83525 Hc Insulin	$46.15	$71.00	—	—	35%
Insulin blood test inpatient CPT 83525 Hc Insulin Total So	$46.80	$72.00	—	—	35%
Iron blood test (serum iron) CPT 83540 Hc Iron	$33.15	$51.00	—	13% below	35%
Iron blood test (serum iron) CPT 83540 Hc Iron Liver Tissue Or Urine So	$89.05	$137.00	—	134% above	35%
Iron blood test (serum iron) inpatient CPT 83540 Hc Iron	$33.15	$51.00	—	—	35%
Iron blood test (serum iron) inpatient CPT 83540 Hc Iron Liver Tissue Or Urine So	$89.05	$137.00	—	—	35%
Iron-binding capacity (TIBC) test CPT 83550 Hc Iron Binding Capacity	$32.50	$50.00	—	17% below	35%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Hc Iron Binding Capacity	$32.50	$50.00	—	—	35%
Kidney function blood test panel CPT 80069 Hc Fsed Renal Function Panel	$42.90	$66.00	—	40% below	35%
Kidney function blood test panel CPT 80069 Hc Renal Function Panel	$42.90	$66.00	—	40% below	35%
Kidney function blood test panel inpatient CPT 80069 Hc Fsed Renal Function Panel	$42.90	$66.00	—	—	35%
Kidney function blood test panel inpatient CPT 80069 Hc Renal Function Panel	$42.90	$66.00	—	—	35%
LH (luteinizing hormone) test CPT 83002 Hc Luteinizing Hormone Lh	$34.45	$53.00	—	64% below	35%
LH (luteinizing hormone) test CPT 83002 Hc Luteinizing Hormone Lh So	$214.50	$330.00	—	124% above	35%
LH (luteinizing hormone) test inpatient CPT 83002 Hc Luteinizing Hormone Lh	$34.45	$53.00	—	—	35%
LH (luteinizing hormone) test inpatient CPT 83002 Hc Luteinizing Hormone Lh So	$214.50	$330.00	—	—	35%
Lactate (lactic acid) blood test CPT 83605 Hc Lactic Acid Lactate Cath Lab	$51.35	$79.00	—	1% below	35%
Lactate (lactic acid) blood test CPT 83605 Hc Lactic Acid Lactate	$51.35	$79.00	—	1% below	35%
Lactate (lactic acid) blood test CPT 83605 Hc Lactic Acid Lactate Pulmonary	$51.35	$79.00	—	1% below	35%
Lactate (lactic acid) blood test CPT 83605 Hc Fsed Lactic Acid Lactate	$51.35	$79.00	—	1% below	35%
Lactate (lactic acid) blood test CPT 83605 Hc Mstu Lactic Acid (Lactate)	$51.35	$79.00	—	1% below	35%
Lactate (lactic acid) blood test CPT 83605 Hc Lactic Acid Lactate Perfusion	$51.35	$79.00	—	1% below	35%
Lactate (lactic acid) blood test CPT 83605 Hc D Lactate So	$118.30	$182.00	—	128% above	35%
Lactate (lactic acid) blood test inpatient CPT 83605 Hc Lactic Acid Lactate Perfusion	$51.35	$79.00	—	—	35%
Lactate (lactic acid) blood test inpatient CPT 83605 Hc Lactic Acid Lactate Pulmonary	$51.35	$79.00	—	—	35%
Lactate (lactic acid) blood test inpatient CPT 83605 Hc Fsed Lactic Acid Lactate	$51.35	$79.00	—	—	35%
Lactate (lactic acid) blood test inpatient CPT 83605 Hc Lactic Acid Lactate	$51.35	$79.00	—	—	35%
Lactate (lactic acid) blood test inpatient CPT 83605 Hc Lactic Acid Lactate Cath Lab	$51.35	$79.00	—	—	35%
Lactate (lactic acid) blood test inpatient CPT 83605 Hc Mstu Lactic Acid (Lactate)	$51.35	$79.00	—	—	35%
Lactate (lactic acid) blood test inpatient CPT 83605 Hc D Lactate So	$118.30	$182.00	—	—	35%
Lactate dehydrogenase (LDH) blood test CPT 83615 Hc Ldh	$16.25	$25.00	—	40% below	35%
Lactate dehydrogenase (LDH) blood test CPT 83615 Hc Ldh So	$16.25	$25.00	—	40% below	35%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Hc Ldh So	$16.25	$25.00	—	—	35%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Hc Ldh	$16.25	$25.00	—	—	35%
Lipase blood test (pancreas enzyme) CPT 83690 Hc Lipase	$48.10	$74.00	—	17% below	35%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Hc Lipase	$48.10	$74.00	—	—	35%
Liver function blood test panel CPT 80076 Hc Fsed Hepatic Function Panel	$18.20	$28.00	—	70% below	35%
Liver function blood test panel CPT 80076 Hc Hepatic Function Panel	$18.20	$28.00	—	70% below	35%
Liver function blood test panel inpatient CPT 80076 Hc Fsed Hepatic Function Panel	$18.20	$28.00	—	—	35%
Liver function blood test panel inpatient CPT 80076 Hc Hepatic Function Panel	$18.20	$28.00	—	—	35%
Lyme disease antibody test CPT 86618 Hc Lyme Disease Antibody So	$44.20	$68.00	—	42% below	35%
Lyme disease antibody test CPT 86618 Hc Lyme Disease Antibody	$123.50	$190.00	—	61% above	35%
Lyme disease antibody test inpatient CPT 86618 Hc Lyme Disease Antibody So	$44.20	$68.00	—	—	35%
Lyme disease antibody test inpatient CPT 86618 Hc Lyme Disease Antibody	$123.50	$190.00	—	—	35%
Magnesium blood test CPT 83735 Hc Magnesium	$35.75	$55.00	—	6% above	35%
Magnesium blood test CPT 83735 Hc Fsed Magnesium	$35.75	$55.00	—	6% above	35%
Magnesium blood test CPT 83735 Hc Magnesium So	$48.75	$75.00	—	44% above	35%
Magnesium blood test inpatient CPT 83735 Hc Magnesium	$35.75	$55.00	—	—	35%
Magnesium blood test inpatient CPT 83735 Hc Fsed Magnesium	$35.75	$55.00	—	—	35%
Magnesium blood test inpatient CPT 83735 Hc Magnesium So	$48.75	$75.00	—	—	35%
Measles (rubeola) antibody test CPT 86765 Hc Rubeola Antibody So	$35.10	$54.00	—	39% below	35%
Measles (rubeola) antibody test CPT 86765 Hc Rubeola Antibody Igg	$127.40	$196.00	—	123% above	35%
Measles (rubeola) antibody test inpatient CPT 86765 Hc Rubeola Antibody So	$35.10	$54.00	—	—	35%
Measles (rubeola) antibody test inpatient CPT 86765 Hc Rubeola Antibody Igg	$127.40	$196.00	—	—	35%
Mono test (heterophile antibody, Monospot) CPT 86308 Hc Heterophile Antibodies Screen	$117.65	$181.00	—	121% above	35%
Mono test (heterophile antibody, Monospot) CPT 86308 Hc Fsed Heterophile Antibodies Screen	$117.65	$181.00	—	121% above	35%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Hc Heterophile Antibodies Screen	$117.65	$181.00	—	—	35%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Hc Fsed Heterophile Antibodies Screen	$117.65	$181.00	—	—	35%
Mumps immunity blood test CPT 86735 Hc Mumps Antibodies So	$36.40	$56.00	—	38% below	35%
Mumps immunity blood test CPT 86735 Hc Mumps Antibody	$129.35	$199.00	—	121% above	35%
Mumps immunity blood test inpatient CPT 86735 Hc Mumps Antibodies So	$36.40	$56.00	—	—	35%
Mumps immunity blood test inpatient CPT 86735 Hc Mumps Antibody	$129.35	$199.00	—	—	35%
Obstetric blood test panel CPT 80055 Hc Obstetric Panel	$196.30	$302.00	—	8% below	35%
Obstetric blood test panel inpatient CPT 80055 Hc Obstetric Panel	$196.30	$302.00	—	—	35%
PSA (prostate-specific antigen) blood test, free CPT 84154 Hc Psa Free	$54.60	$84.00	—	34% below	35%
PSA (prostate-specific antigen) blood test, free CPT 84154 Hc Psa Free So	$81.90	$126.00	—	1% below	35%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Hc Psa Free	$54.60	$84.00	—	—	35%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Hc Psa Free So	$81.90	$126.00	—	—	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Psa Total So	$29.25	$45.00	—	63% below	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Psa Total	$54.60	$84.00	—	31% below	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Hc Psa Total So	$29.25	$45.00	—	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Hc Psa Total	$54.60	$84.00	—	—	35%
Pap test (liquid-based, automated screening with review) CPT 88175 Hc Cyto Pap Smear Automated	$50.70	$78.00	—	48% below	35%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Hc Cyto Pap Smear Automated	$50.70	$78.00	—	—	35%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Hc Cytopath Pap Smear Thin	$44.85	$69.00	—	51% below	35%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Hc Cytopath Pap Smear Thin	$44.85	$69.00	—	—	35%
Parathyroid hormone (PTH) blood test CPT 83970 Hc Pth Intact	$71.50	$110.00	—	50% below	35%
Parathyroid hormone (PTH) blood test CPT 83970 Hc Pth Fnab Needle Wash So	$126.75	$195.00	—	10% below	35%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Hc Pth Intact	$71.50	$110.00	—	—	35%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Hc Pth Fnab Needle Wash So	$126.75	$195.00	—	—	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Aptt	$38.35	$59.00	—	2% above	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Aptt So	$204.75	$315.00	—	445% above	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Aptt	$38.35	$59.00	—	—	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Aptt So	$204.75	$315.00	—	—	35%
Phosphorus (phosphate) blood test CPT 84100 Hc Phosphorus	$35.75	$55.00	—	at median	35%
Phosphorus (phosphate) blood test CPT 84100 Hc Fsed Phosphorus	$35.75	$55.00	—	at median	35%
Phosphorus (phosphate) blood test CPT 84100 Hc Phosphorus So	$195.00	$300.00	—	445% above	35%
Phosphorus (phosphate) blood test inpatient CPT 84100 Hc Phosphorus	$35.75	$55.00	—	—	35%
Phosphorus (phosphate) blood test inpatient CPT 84100 Hc Fsed Phosphorus	$35.75	$55.00	—	—	35%
Phosphorus (phosphate) blood test inpatient CPT 84100 Hc Phosphorus So	$195.00	$300.00	—	—	35%
Potassium blood test CPT 84132 Hc Mstu Potassium Serum Plasma Or Wb	$5.85	$9.00	—	75% below	35%
Potassium blood test CPT 84132 Hc Potassium Whole Blood Pulmonary	$5.85	$9.00	—	75% below	35%
Potassium blood test CPT 84132 Hc Potassium Whole Blood Perfusion	$5.85	$9.00	—	75% below	35%
Potassium blood test CPT 84132 Hc Potassium Whole Blood Cath Lab	$5.85	$9.00	—	75% below	35%
Potassium blood test CPT 84132 Hc Potassium Amb	$5.85	$9.00	—	75% below	35%
Potassium blood test CPT 84132 Hc Fsed Potassium Serum Plasma Or Whole Blood	$5.85	$9.00	—	75% below	35%
Potassium blood test CPT 84132 Hc Potassium Serum Plasma Or Whole Blood	$5.85	$9.00	—	75% below	35%
Potassium blood test inpatient CPT 84132 Hc Potassium Whole Blood Pulmonary	$5.85	$9.00	—	—	35%
Potassium blood test inpatient CPT 84132 Hc Mstu Potassium Serum Plasma Or Wb	$5.85	$9.00	—	—	35%
Potassium blood test inpatient CPT 84132 Hc Potassium Whole Blood Perfusion	$5.85	$9.00	—	—	35%
Potassium blood test inpatient CPT 84132 Hc Potassium Whole Blood Cath Lab	$5.85	$9.00	—	—	35%
Potassium blood test inpatient CPT 84132 Hc Fsed Potassium Serum Plasma Or Whole Blood	$5.85	$9.00	—	—	35%
Potassium blood test inpatient CPT 84132 Hc Potassium Amb	$5.85	$9.00	—	—	35%
Potassium blood test inpatient CPT 84132 Hc Potassium Serum Plasma Or Whole Blood	$5.85	$9.00	—	—	35%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Hc Fetal Chrmoml Aneuploidy Genomic Seq Analys So	$3,747.25	$5,765.00	—	157% above	35%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Hc Fetal Chrmoml Aneuploidy Genomic Seq Analys So	$3,747.25	$5,765.00	—	—	35%
Progesterone blood test CPT 84144 Hc Progesterone	$25.35	$39.00	—	69% below	35%
Progesterone blood test inpatient CPT 84144 Hc Progesterone	$25.35	$39.00	—	—	35%
Prolactin blood test CPT 84146 Hc Prolactin	$26.65	$41.00	—	69% below	35%
Prolactin blood test CPT 84146 Hc Macroprolactin So	$126.10	$194.00	—	45% above	35%
Prolactin blood test inpatient CPT 84146 Hc Prolactin	$26.65	$41.00	—	—	35%
Prolactin blood test inpatient CPT 84146 Hc Macroprolactin So	$126.10	$194.00	—	—	35%
Prothrombin time (PT/INR) clotting test CPT 85610 Hc Pt Inr Amb	$23.40	$36.00	—	3% below	35%
Prothrombin time (PT/INR) clotting test CPT 85610 Hc Mstu Inr	$23.40	$36.00	—	3% below	35%
Prothrombin time (PT/INR) clotting test CPT 85610 Hc Fsed Pt/Inr	$23.40	$36.00	—	3% below	35%
Prothrombin time (PT/INR) clotting test CPT 85610 Hc Pt/Inr	$23.40	$36.00	—	3% below	35%
Prothrombin time (PT/INR) clotting test CPT 85610 Hc Pt/Inr So	$146.90	$226.00	—	511% above	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Pt/Inr	$23.40	$36.00	—	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Pt Inr Amb	$23.40	$36.00	—	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Mstu Inr	$23.40	$36.00	—	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Fsed Pt/Inr	$23.40	$36.00	—	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Pt/Inr So	$146.90	$226.00	—	—	35%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Hc Fsed Drug Test Prsmv Dir Opt Obs	$77.35	$119.00	—	34% above	35%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Hc Drug Test Prsmv Dir Opt Obs	$77.35	$119.00	—	34% above	35%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Hc Drug Test Prsmv Dir Opt Obs	$77.35	$119.00	—	—	35%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Hc Fsed Drug Test Prsmv Dir Opt Obs	$77.35	$119.00	—	—	35%
Rapid flu test (influenza antigen) CPT 87804 Hc Influenza Antigen Immunoassay W Dir Optical Obs	$65.65	$101.00	—	at median	35%
Rapid flu test (influenza antigen) CPT 87804 Hc Fsed Influenza Antigen Immunoassay W Dir Optical Obs	$130.65	$201.00	—	99% above	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 Hc Influenza Antigen Immunoassay W Dir Optical Obs	$65.65	$101.00	—	—	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 Hc Fsed Influenza Antigen Immunoassay W Dir Optical Obs	$130.65	$201.00	—	—	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Hc Fsed Rapid Strep Antigen Grp A Throat	$57.20	$88.00	—	at median	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Hc Rapid Strep Antigen Grp A Throat	$57.20	$88.00	—	at median	35%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Hc Rapid Strep Antigen Grp A Throat	$57.20	$88.00	—	—	35%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Hc Fsed Rapid Strep Antigen Grp A Throat	$57.20	$88.00	—	—	35%
Renin blood test CPT 84244 Hc Renin Activity Plasma So	$30.55	$47.00	—	64% below	35%
Renin blood test inpatient CPT 84244 Hc Renin Activity Plasma So	$30.55	$47.00	—	—	35%
Rh blood typing CPT 86901 Hc Donor Blood Typing Rh D	$6.50	$10.00	—	83% below	35%
Rh blood typing CPT 86901 Hc Recipient Blood Typing Rh D	$26.00	$40.00	—	30% below	35%
Rh blood typing CPT 86901 Hc Blood Typing Rh D	$26.00	$40.00	—	30% below	35%
Rh blood typing inpatient CPT 86901 Hc Donor Blood Typing Rh D	$6.50	$10.00	—	—	35%
Rh blood typing inpatient CPT 86901 Hc Blood Typing Rh D	$26.00	$40.00	—	—	35%
Rh blood typing inpatient CPT 86901 Hc Recipient Blood Typing Rh D	$26.00	$40.00	—	—	35%
Rheumatoid factor (RF) test CPT 86431 Hc Rheumatoid Factor Rf Body Fluid So	$26.00	$40.00	—	22% below	35%
Rheumatoid factor (RF) test CPT 86431 Hc Rheumatoid Factor Rf Quantitative	$37.70	$58.00	—	14% above	35%
Rheumatoid factor (RF) test inpatient CPT 86431 Hc Rheumatoid Factor Rf Body Fluid So	$26.00	$40.00	—	—	35%
Rheumatoid factor (RF) test inpatient CPT 86431 Hc Rheumatoid Factor Rf Quantitative	$37.70	$58.00	—	—	35%
Rubella antibody test (immunity check) CPT 86762 Hc Rubella Antibody So	$18.20	$28.00	—	63% below	35%
Rubella antibody test (immunity check) CPT 86762 Hc Rubella Antibody	$23.40	$36.00	—	52% below	35%
Rubella antibody test (immunity check) inpatient CPT 86762 Hc Rubella Antibody So	$18.20	$28.00	—	—	35%
Rubella antibody test (immunity check) inpatient CPT 86762 Hc Rubella Antibody	$23.40	$36.00	—	—	35%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Hc Sed Rate Esr Automated	$48.10	$74.00	—	27% above	35%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Hc Sed Rate Esr Automated	$48.10	$74.00	—	—	35%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Hc Semen Analysis Complete	$135.85	$209.00	—	2% above	35%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Hc Semen Analysis Complete	$135.85	$209.00	—	—	35%
Sodium blood test CPT 84295 Hc Fsed Sodium	$5.85	$9.00	—	78% below	35%
Sodium blood test CPT 84295 Hc Sodium Wb Cath Lab	$5.85	$9.00	—	78% below	35%
Sodium blood test CPT 84295 Hc Sodium Amb	$5.85	$9.00	—	78% below	35%
Sodium blood test CPT 84295 Hc Sodium Wb Perfusion	$5.85	$9.00	—	78% below	35%
Sodium blood test CPT 84295 Hc Mstu Sodium	$5.85	$9.00	—	78% below	35%
Sodium blood test CPT 84295 Hc Sodium Wb Pulm	$5.85	$9.00	—	78% below	35%
Sodium blood test CPT 84295 Hc Sodium	$5.85	$9.00	—	78% below	35%
Sodium blood test inpatient CPT 84295 Hc Fsed Sodium	$5.85	$9.00	—	—	35%
Sodium blood test inpatient CPT 84295 Hc Sodium Wb Cath Lab	$5.85	$9.00	—	—	35%
Sodium blood test inpatient CPT 84295 Hc Sodium Wb Perfusion	$5.85	$9.00	—	—	35%
Sodium blood test inpatient CPT 84295 Hc Mstu Sodium	$5.85	$9.00	—	—	35%
Sodium blood test inpatient CPT 84295 Hc Sodium Amb	$5.85	$9.00	—	—	35%
Sodium blood test inpatient CPT 84295 Hc Sodium Wb Pulm	$5.85	$9.00	—	—	35%
Sodium blood test inpatient CPT 84295 Hc Sodium	$5.85	$9.00	—	—	35%
Stool ova and parasites exam CPT 87177 Hc Ova And Parasites Smears So	$34.45	$53.00	—	13% below	35%
Stool ova and parasites exam CPT 87177 Hc Ova & Parasite O And P Stool	$300.30	$462.00	—	657% above	35%
Stool ova and parasites exam inpatient CPT 87177 Hc Ova And Parasites Smears So	$34.45	$53.00	—	—	35%
Stool ova and parasites exam inpatient CPT 87177 Hc Ova & Parasite O And P Stool	$300.30	$462.00	—	—	35%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Hc Fsed Occult Blood Stool	$46.80	$72.00	—	62% above	35%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Hc Occult Blood Stool	$46.80	$72.00	—	62% above	35%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Hc Occult Blood Stool	$46.80	$72.00	—	—	35%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Hc Fsed Occult Blood Stool	$46.80	$72.00	—	—	35%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Hc Occult Blood Fecal Ia	$57.85	$89.00	—	8% above	35%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Hc Occult Blood Fecal Ia	$57.85	$89.00	—	—	35%
Syphilis antibody test (Treponema pallidum) CPT 86780 Hc Treponema Pallidum Antibody	$22.75	$35.00	—	61% below	35%
Syphilis antibody test (Treponema pallidum) CPT 86780 Hc Treponema Pallidum Antibody So	$66.95	$103.00	—	16% above	35%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Hc Treponema Pallidum Antibody	$22.75	$35.00	—	—	35%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Hc Treponema Pallidum Antibody So	$66.95	$103.00	—	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Hc Rpr Vdrl So	$7.80	$12.00	—	67% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Hc Rpr Qualitative	$7.80	$12.00	—	67% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Hc Donor Syphilis-Pk-Tp So	$20.80	$32.00	—	13% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Hc Recipient Syphilis-Pk-Tp So	$20.80	$32.00	—	13% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Hc Rpr Vdrl So	$7.80	$12.00	—	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Hc Rpr Qualitative	$7.80	$12.00	—	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Hc Donor Syphilis-Pk-Tp So	$20.80	$32.00	—	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Hc Recipient Syphilis-Pk-Tp So	$20.80	$32.00	—	—	35%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Hc M Tuberculosis By Quantiferon So	$68.90	$106.00	—	41% below	35%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Hc M Tuberculosis By Quantiferon	$137.80	$212.00	—	18% above	35%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Hc M Tuberculosis By Quantiferon So	$68.90	$106.00	—	—	35%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Hc M Tuberculosis By Quantiferon	$137.80	$212.00	—	—	35%
Testosterone blood test, total (not free testosterone) CPT 84403 Hc Testosterone Total So	$33.80	$52.00	—	63% below	35%
Testosterone blood test, total (not free testosterone) CPT 84403 Hc Testosterone Total	$70.85	$109.00	—	23% below	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Hc Testosterone Total So	$33.80	$52.00	—	—	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Hc Testosterone Total	$70.85	$109.00	—	—	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 Hc Microsomal Liver Or Kidney Antibody Each So	$38.35	$59.00	—	41% below	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 Hc Thyroid Peroxidase Antibody Tpo	$49.40	$76.00	—	24% below	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Hc Microsomal Liver Or Kidney Antibody Each So	$38.35	$59.00	—	—	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Hc Thyroid Peroxidase Antibody Tpo	$49.40	$76.00	—	—	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc Tsh	$46.15	$71.00	—	39% below	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Hc Tsh	$46.15	$71.00	—	—	35%
Total IgE blood test CPT 82785 Hc Ige Immunoglobulins So	$26.65	$41.00	—	57% below	35%
Total IgE blood test inpatient CPT 82785 Hc Ige Immunoglobulins So	$26.65	$41.00	—	—	35%
Total cholesterol blood test CPT 82465 Hc Cholesterol Total	$33.15	$51.00	—	9% below	35%
Total cholesterol blood test inpatient CPT 82465 Hc Cholesterol Total	$33.15	$51.00	—	—	35%
Total thyroxine (T4) blood test CPT 84436 Hc T4 Total	$38.35	$59.00	—	8% below	35%
Total thyroxine (T4) blood test CPT 84436 Hc T4 Total So	$146.25	$225.00	—	249% above	35%
Total thyroxine (T4) blood test inpatient CPT 84436 Hc T4 Total	$38.35	$59.00	—	—	35%
Total thyroxine (T4) blood test inpatient CPT 84436 Hc T4 Total So	$146.25	$225.00	—	—	35%
Total triiodothyronine (T3) blood test CPT 84480 Hc T3 Total	$34.45	$53.00	—	43% below	35%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Hc T3 Total	$34.45	$53.00	—	—	35%
Transferrin blood test CPT 84466 Hc Transferrin	$80.60	$124.00	—	9% above	35%
Transferrin blood test inpatient CPT 84466 Hc Transferrin	$80.60	$124.00	—	—	35%
Trichomonas test (NAAT) CPT 87661 Hc Trichomonas Vaginalis Amplified Probe	$62.40	$96.00	—	28% below	35%
Trichomonas test (NAAT) CPT 87661 Hc Trichomonas Vaginalis Amplif So	$97.50	$150.00	—	13% above	35%
Trichomonas test (NAAT) inpatient CPT 87661 Hc Trichomonas Vaginalis Amplified Probe	$62.40	$96.00	—	—	35%
Trichomonas test (NAAT) inpatient CPT 87661 Hc Trichomonas Vaginalis Amplif So	$97.50	$150.00	—	—	35%
Triglycerides blood test CPT 84478 Hc Triglycerides	$34.45	$53.00	—	at median	35%
Triglycerides blood test CPT 84478 Hc Triglycerides So	$55.90	$86.00	—	62% above	35%
Triglycerides blood test inpatient CPT 84478 Hc Triglycerides	$34.45	$53.00	—	—	35%
Triglycerides blood test inpatient CPT 84478 Hc Triglycerides So	$55.90	$86.00	—	—	35%
Troponin test, quantitative CPT 84484 Hc Troponin Quantitative So	$25.35	$39.00	—	70% below	35%
Troponin test, quantitative CPT 84484 Hc Fsed Troponin Quantitative	$59.80	$92.00	—	29% below	35%
Troponin test, quantitative CPT 84484 Hc Troponin Quantitative	$59.80	$92.00	—	29% below	35%
Troponin test, quantitative inpatient CPT 84484 Hc Troponin Quantitative So	$25.35	$39.00	—	—	35%
Troponin test, quantitative inpatient CPT 84484 Hc Fsed Troponin Quantitative	$59.80	$92.00	—	—	35%
Troponin test, quantitative inpatient CPT 84484 Hc Troponin Quantitative	$59.80	$92.00	—	—	35%
Uric acid blood test CPT 84550 Hc Uric Acid Blood	$11.05	$17.00	—	69% below	35%
Uric acid blood test inpatient CPT 84550 Hc Uric Acid Blood	$11.05	$17.00	—	—	35%
Urinalysis with microscope exam, automated CPT 81001 Hc Urinalysis Automated	$7.80	$12.00	—	71% below	35%
Urinalysis with microscope exam, automated inpatient CPT 81001 Hc Urinalysis Automated	$7.80	$12.00	—	—	35%
Urinalysis without microscope exam, automated CPT 81003 Hc Urine Analysis Dipstick Auto Amb	$32.50	$50.00	—	39% above	35%
Urinalysis without microscope exam, automated CPT 81003 Hc Fsed Urine Analysis Dipstick Automated	$40.30	$62.00	—	72% above	35%
Urinalysis without microscope exam, automated CPT 81003 Hc Urine Analysis Dipstick Automated	$40.30	$62.00	—	72% above	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urine Analysis Dipstick Auto Amb	$32.50	$50.00	—	—	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Fsed Urine Analysis Dipstick Automated	$40.30	$62.00	—	—	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urine Analysis Dipstick Automated	$40.30	$62.00	—	—	35%
Urinalysis without microscope exam, manual CPT 81002 Hc Urinalysis Nonauto Wo Micro	$74.75	$115.00	—	361% above	35%
Urinalysis without microscope exam, manual inpatient CPT 81002 Hc Urinalysis Nonauto Wo Micro	$74.75	$115.00	—	—	35%
Urine culture for bacteria, with colony count CPT 87086 Hc Culture Urine Aerobic Colony Count	$135.85	$209.00	—	139% above	35%
Urine culture for bacteria, with colony count inpatient CPT 87086 Hc Culture Urine Aerobic Colony Count	$135.85	$209.00	—	—	35%
Urine microalbumin (albumin) test CPT 82043 Hc Microalbumin Urine Quantitative	$55.90	$86.00	—	10% above	35%
Urine microalbumin (albumin) test inpatient CPT 82043 Hc Microalbumin Urine Quantitative	$55.90	$86.00	—	—	35%
Urine pregnancy test, read by color change CPT 81025 Hc Urine Pregnancy Visual Amb	$45.50	$70.00	—	6% below	35%
Urine pregnancy test, read by color change CPT 81025 Hc Urine Pregnancy Visual	$83.20	$128.00	—	71% above	35%
Urine pregnancy test, read by color change inpatient CPT 81025 Hc Urine Pregnancy Visual Amb	$45.50	$70.00	—	—	35%
Urine pregnancy test, read by color change inpatient CPT 81025 Hc Urine Pregnancy Visual	$83.20	$128.00	—	—	35%
Vitamin B12 (cobalamin) blood test CPT 82607 Hc Vitamin B 12	$40.30	$62.00	—	46% below	35%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Hc Vitamin B 12	$40.30	$62.00	—	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Hc 25-Hydroxyvitamin D2 And D3 So	$16.25	$25.00	—	83% below	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Hc Vitamin D Total 25-Oh	$87.10	$134.00	—	8% below	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Hc 25-Hydroxyvitamin D2 And D3 So	$16.25	$25.00	—	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Hc Vitamin D Total 25-Oh	$87.10	$134.00	—	—	35%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Hc Vitamin D (1 25 Dihydroxy)	$86.45	$133.00	—	44% below	35%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Hc Vitamin D (1 25 Dihydroxy)	$86.45	$133.00	—	—	35%
Zinc blood test CPT 84630 Hc Zinc So	$18.85	$29.00	—	63% below	35%
Zinc blood test inpatient CPT 84630 Hc Zinc So	$18.85	$29.00	—	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hc Hcg Quantitative	$30.55	$47.00	—	55% below	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hc Hcg Quantitative So	$40.95	$63.00	—	39% below	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hc Hcg Quantitative Special So	$384.15	$591.00	—	468% above	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hc Hcg Quantitative	$30.55	$47.00	—	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hc Hcg Quantitative So	$40.95	$63.00	—	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hc Hcg Quantitative Special So	$384.15	$591.00	—	—	35%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Botox injections for chronic migraine CPT 64615 Hc Botox Inj Chronic Migraine	$1,292.20	$1,988.00	—	133% above	35%
Botox injections for chronic migraine inpatient CPT 64615 Hc Botox Inj Chronic Migraine	$1,292.20	$1,988.00	—	—	35%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Hc Bx Breast W Device Stereotactic 1St Les5	$3,849.95	$5,923.00	—	4% below	35%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 Hc Bx Breast W Device Stereotactic 1St Les5	$3,849.95	$5,923.00	—	—	35%
Cardiac catheterization with coronary angiogram CPT 93458 Hc Coronary Angiography W Lhc	$9,351.55	$14,387.00	—	22% below	35%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 Hc Coronary Angiography W Lhc	$9,351.55	$14,387.00	—	—	35%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Hc Cardioversion Elective External	$5,136.30	$7,902.00	—	149% above	35%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Hc Cardioversion Elective External	$5,136.30	$7,902.00	—	—	35%
Carpal tunnel release, open surgery CPT 64721 Hc Neuroplasty Carpal Tunnel Median Nerve	$4,184.70	$6,438.00	—	49% below	35%
Carpal tunnel release, open surgery inpatient CPT 64721 Hc Neuroplasty Carpal Tunnel Median Nerve	$4,184.70	$6,438.00	—	—	35%
Catheter ablation for atrial fibrillation CPT 93656 Hc Ep Eval W Ablation A Fib Including 3D Mapping	$41,078.70	$63,198.00	—	21% above	35%
Catheter ablation for atrial fibrillation inpatient CPT 93656 Hc Ep Eval W Ablation A Fib Including 3D Mapping	$41,078.70	$63,198.00	—	—	35%
Cervical biopsy CPT 57500 Hc Biopsy Cervix	$3,771.95	$5,803.00	—	116% above	35%
Cervical biopsy inpatient CPT 57500 Hc Biopsy Cervix	$3,771.95	$5,803.00	—	—	35%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Hc Circumcision	$1,614.60	$2,484.00	—	9% below	35%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Hc Circumcision	$1,614.60	$2,484.00	—	—	35%
Colonoscopy with endoscopic ultrasound CPT 45391 Hc Colonoscopy W Endoscope Us	$2,962.70	$4,558.00	—	5% below	35%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Hc Colonoscopy W Endoscope Us	$2,962.70	$4,558.00	—	—	35%
Colonoscopy with polyp removal CPT 45385 Hc Colonoscopy W Polypectomy	$3,320.85	$5,109.00	—	1% below	35%
Colonoscopy with polyp removal inpatient CPT 45385 Hc Colonoscopy W Polypectomy	$3,320.85	$5,109.00	—	—	35%
Colonoscopy with tissue sample CPT 45380 Hc Colonoscopy W Biopsy	$3,198.65	$4,921.00	—	4% below	35%
Colonoscopy with tissue sample inpatient CPT 45380 Hc Colonoscopy W Biopsy	$3,198.65	$4,921.00	—	—	35%
Colonoscopy, diagnostic CPT 45378 Hc Colonoscopy	$2,875.60	$4,424.00	—	5% above	35%
Colonoscopy, diagnostic inpatient CPT 45378 Hc Colonoscopy	$2,875.60	$4,424.00	—	—	35%
Coronary stent placement, one artery CPT 92928 Hc Stent Sgl Maj Cor Art Or Branch	$10,559.25	$16,245.00	—	18% below	35%
Coronary stent placement, one artery inpatient CPT 92928 Hc Stent Sgl Maj Cor Art Or Branch	$10,559.25	$16,245.00	—	—	35%
Cystoscopy with ureteral stent placement CPT 52332 Hc Cystoscopy W Ins Ureteral Stent	$4,999.15	$7,691.00	—	50% below	35%
Cystoscopy with ureteral stent placement inpatient CPT 52332 Hc Cystoscopy W Ins Ureteral Stent	$4,999.15	$7,691.00	—	—	35%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Hc Cystourethroscopy	$2,629.25	$4,045.00	—	32% above	35%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Hc Cystourethroscopy	$2,629.25	$4,045.00	—	—	35%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Hc Removal Impacted Cerumen By Irrig Unilat	$584.35	$899.00	—	278% above	35%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Hc Removal Impacted Cerumen By Irrig Unilat	$584.35	$899.00	—	—	35%
Earwax removal with instruments, one ear CPT 69210 Hc Removal Impacted Cerumen	$630.50	$970.00	—	308% above	35%
Earwax removal with instruments, one ear inpatient CPT 69210 Hc Removal Impacted Cerumen	$630.50	$970.00	—	—	35%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Hc Endometrial Sampling Biopsy	$664.30	$1,022.00	—	73% above	35%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Hc Endometrial Sampling Biopsy	$664.30	$1,022.00	—	—	35%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Hc Injection Dx Or Ther Epidur Or Subarach Cer Or Thor W Img	$5,265.00	$8,100.00	—	136% above	35%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Hc Injection Dx Or Ther Epidur Or Subarach Cer Or Thor W Img	$5,265.00	$8,100.00	—	—	35%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Hc Injection Anes Facet Joint Lum Or Sacr W Img Sgl	$3,700.45	$5,693.00	—	69% above	35%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Hc Injection Anes Facet Joint Lum Or Sacr W Img Sgl	$3,700.45	$5,693.00	—	—	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Hc Sigmoidoscopy	$2,563.60	$3,944.00	—	at median	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Hc Sigmoidoscopy	$2,563.60	$3,944.00	—	—	35%
Hemorrhoid banding (rubber band ligation) CPT 46221 Hc Hemorrhoidectomy Simple Ligature	$4,278.95	$6,583.00	—	124% above	35%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 Hc Hemorrhoidectomy Simple Ligature	$4,278.95	$6,583.00	—	—	35%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Hc Catheterization For Hysterosalpingogram	$367.25	$565.00	—	4% below	35%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Hc Catheterization For Hysterosalpingogram	$367.25	$565.00	—	—	35%
IUD insertion (the device itself billed separately) CPT 58300 Hc Insertion Intrauterine Device	$2,288.00	$3,520.00	—	354% above	35%
IUD insertion (the device itself billed separately) inpatient CPT 58300 Hc Insertion Intrauterine Device	$2,288.00	$3,520.00	—	—	35%
Incision and drainage of a simple or single skin abscess CPT 10060 Hc I And D Abscess Simple	$605.15	$931.00	—	56% above	35%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Hc I And D Abscess Simple	$605.15	$931.00	—	—	35%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Hc Inj Single Tendon Sheath Or Ligament	$910.00	$1,400.00	—	168% above	35%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Hc Inj Single Tendon Sheath Or Ligament	$910.00	$1,400.00	—	—	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Hc Asp Or Inj Joint Large	$2,020.85	$3,109.00	—	190% above	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Hc Asp Or Inj Joint Large	$2,020.85	$3,109.00	—	—	35%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Hc Insertion Contraceptive Capsule	$759.20	$1,168.00	—	101% above	35%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Hc Insertion Contraceptive Capsule	$759.20	$1,168.00	—	—	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Hc Asp Or Inj Joint Intermediate	$1,853.15	$2,851.00	—	200% above	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Hc Asp Or Inj Joint Intermediate	$1,853.15	$2,851.00	—	—	35%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Hc Asp Or Inj Joint Small	$1,685.45	$2,593.00	—	242% above	35%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Hc Asp Or Inj Joint Small	$1,685.45	$2,593.00	—	—	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Hc Lac Repair Intermediate	$874.25	$1,345.00	—	64% above	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Hc Lac Repair Intermediate	$874.25	$1,345.00	—	—	35%
Left heart catheterization, diagnostic one side CPT 93452 Hc Left Heart Cath	$5,912.40	$9,096.00	—	36% below	35%
Left heart catheterization, diagnostic inpatient one side CPT 93452 Hc Left Heart Cath	$5,912.40	$9,096.00	—	—	35%
Lower-back epidural injection, with imaging guidance CPT 62323 Hc Injection Dx Or Ther Epidur Or Subarach Lum Or Sacr W Img	$4,732.65	$7,281.00	—	132% above	35%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Hc Injection Dx Or Ther Epidur Or Subarach Lum Or Sacr W Img	$4,732.65	$7,281.00	—	—	35%
Lower-back epidural injection, without imaging guidance CPT 62322 Hc Injection Dx Or Ther Epidur Or Subarach Lum Or Sacr Wo Img	$4,290.65	$6,601.00	—	164% above	35%
Lower-back epidural injection, without imaging guidance CPT 62322 Hc Pain Procedure Lumbar Or Sacral Wo Fluoro 1St 30 Min	$4,290.65	$6,601.00	—	164% above	35%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Hc Injection Dx Or Ther Epidur Or Subarach Lum Or Sacr Wo Img	$4,290.65	$6,601.00	—	—	35%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Hc Pain Procedure Lumbar Or Sacral Wo Fluoro 1St 30 Min	$4,290.65	$6,601.00	—	—	35%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Hc Injection Anes/Steroid Trnsfrmnl Epi Lumb/Sacr W Img Sgl	$2,177.50	$3,350.00	—	5% above	35%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Hc Injection Anes/Steroid Trnsfrmnl Epi Lumb/Sacr W Img Sgl	$2,177.50	$3,350.00	—	—	35%
Nail removal (partial or complete), one nail CPT 11730 Hc Avulsion Nail Plate Single	$583.70	$898.00	—	83% above	35%
Nail removal (partial or complete), one nail inpatient CPT 11730 Hc Avulsion Nail Plate Single	$583.70	$898.00	—	—	35%
Occipital nerve block (injection for headaches) CPT 64405 Hc Injection Anes/Steroid Greater Occipital Nerve	$1,095.90	$1,686.00	—	39% above	35%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Hc Injection Anes/Steroid Greater Occipital Nerve	$1,095.90	$1,686.00	—	—	35%
Pacemaker implant (dual chamber) CPT 33208 Hc Insert Pacer Atrial And Ventricular W Lead	$17,323.80	$26,652.00	—	11% above	35%
Pacemaker implant (dual chamber) inpatient CPT 33208 Hc Insert Pacer Atrial And Ventricular W Lead	$17,323.80	$26,652.00	—	—	35%
Paracentesis with imaging guidance CPT 49083 Hc Abdominal Paracentesis W Img	$3,368.95	$5,183.00	—	94% above	35%
Paracentesis with imaging guidance inpatient CPT 49083 Hc Abdominal Paracentesis W Img	$3,368.95	$5,183.00	—	—	35%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Hc Excision Nail And Matrix	$881.40	$1,356.00	—	13% above	35%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Hc Excision Nail And Matrix	$881.40	$1,356.00	—	—	35%
Prostate biopsy CPT 55700 Hc Biopsy Prostate Needle	$1,394.90	$2,146.00	—	31% below	35%
Prostate biopsy inpatient CPT 55700 Hc Biopsy Prostate Needle	$1,394.90	$2,146.00	—	—	35%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Hc Dest Neurolytic Facet Joint Lumb Or Sacr W Img Sgl	$4,115.15	$6,331.00	—	23% above	35%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Hc Dest Neurolytic Facet Joint Lumb Or Sacr W Img Sgl	$4,115.15	$6,331.00	—	—	35%
Removal of a foreign object under the skin, simple CPT 10120 Hc I And D Fb Subq Simple	$919.10	$1,414.00	—	37% above	35%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Hc I And D Fb Subq Simple	$919.10	$1,414.00	—	—	35%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Hc Screen Col Cancer Colonoscopy Not Hr	$2,442.70	$3,758.00	—	6% below	35%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 Hc Screen Col Cancer Colonoscopy Not Hr	$2,442.70	$3,758.00	—	—	35%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Hc Screen Can Colonoscopy High Risk	$2,442.70	$3,758.00	—	6% below	35%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 Hc Screen Can Colonoscopy High Risk	$2,442.70	$3,758.00	—	—	35%
Short arm cast (elbow to hand) CPT 29075 Hc Application Cast Short Arm	$276.25	$425.00	—	8% below	35%
Short arm cast (elbow to hand) inpatient CPT 29075 Hc Application Cast Short Arm	$276.25	$425.00	—	—	35%
Short leg cast (below the knee) CPT 29405 Hc Application Short Leg Cast	$847.60	$1,304.00	—	123% above	35%
Short leg cast (below the knee) inpatient CPT 29405 Hc Application Short Leg Cast	$847.60	$1,304.00	—	—	35%
Skin biopsy, punch, one lesion CPT 11104 Hc Punch Biopsy Skin Single Lesion	$474.50	$730.00	—	7% above	35%
Skin biopsy, punch, one lesion inpatient CPT 11104 Hc Punch Biopsy Skin Single Lesion	$474.50	$730.00	—	—	35%
Skin tag removal, up to 15 tags CPT 11200 Hc Skin Tag Removal 1-15 Lesions	$768.30	$1,182.00	—	163% above	35%
Skin tag removal, up to 15 tags inpatient CPT 11200 Hc Skin Tag Removal 1-15 Lesions	$768.30	$1,182.00	—	—	35%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Hc Spinal Puncture Lumbar Diagnostic Wo Img	$1,263.60	$1,944.00	—	18% above	35%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Hc Spinal Puncture Lumbar Diagnostic Wo Img	$1,263.60	$1,944.00	—	—	35%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Hc Tangential Biopsy Skin Single Les	$439.40	$676.00	—	46% above	35%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Hc Tangential Biopsy Skin Single Les	$439.40	$676.00	—	—	35%
Thoracentesis with imaging guidance CPT 32555 Hc Thoracentesis W Imaging	$3,657.55	$5,627.00	—	110% above	35%
Thoracentesis with imaging guidance inpatient CPT 32555 Hc Thoracentesis W Imaging	$3,657.55	$5,627.00	—	—	35%
Trigger point injections, 1 or 2 muscles CPT 20552 Hc Inj Trigger Point 1 Or 2 Muscles	$1,095.90	$1,686.00	—	57% above	35%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Hc Inj Trigger Point 1 Or 2 Muscles	$1,095.90	$1,686.00	—	—	35%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Hc Bx Breast W Device Us Guidance 1St Les	$3,849.95	$5,923.00	—	16% above	35%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Hc Bx Breast W Device Us Guidance 1St Les	$3,849.95	$5,923.00	—	—	35%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Hc Egd W Esoph Balloon Dilation	$3,313.70	$5,098.00	—	5% below	35%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 Hc Egd W Esoph Balloon Dilation	$3,313.70	$5,098.00	—	—	35%
Upper endoscopy (EGD) with biopsy CPT 43239 Hc Egd W Biopsy	$2,738.45	$4,213.00	—	2% below	35%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Hc Egd W Biopsy	$2,738.45	$4,213.00	—	—	35%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Hc Egd W Injections	$1,314.95	$2,023.00	—	53% below	35%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 Hc Egd W Injections	$1,314.95	$2,023.00	—	—	35%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Hc Egd W/Tumor/Polyp Remove Snare	$3,121.30	$4,802.00	—	4% below	35%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 Hc Egd W/Tumor/Polyp Remove Snare	$3,121.30	$4,802.00	—	—	35%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Hc Egd W Esoph Dilation Over Guide	$3,325.40	$5,116.00	—	19% above	35%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 Hc Egd W Esoph Dilation Over Guide	$3,325.40	$5,116.00	—	—	35%
Upper endoscopy (EGD), diagnostic CPT 43235 Hc Egd	$2,598.70	$3,998.00	—	at median	35%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Hc Egd	$2,598.70	$3,998.00	—	—	35%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 Hc Egd W Drainage Pseudocyst	$4,568.20	$7,028.00	—	at median	35%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 Hc Egd W Drainage Pseudocyst	$4,568.20	$7,028.00	—	—	35%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Hc Vasectomy Without Anesthesia	$9,300.20	$14,308.00	—	171% above	35%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 Hc Vasectomy Without Anesthesia	$9,300.20	$14,308.00	—	—	35%
Vein ablation, radiofrequency, first vein CPT 36475 Hc Endovenous Ablation Ext Rf 1St Vein	$6,113.90	$9,406.00	—	6% below	35%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 Hc Endovenous Ablation Ext Rf 1St Vein	$6,113.90	$9,406.00	—	—	35%
Wart removal, up to 14 warts CPT 17110 Hc Destruction Flat Warts <15	$651.30	$1,002.00	—	108% above	35%
Wart removal, up to 14 warts inpatient CPT 17110 Hc Destruction Flat Warts <15	$651.30	$1,002.00	—	—	35%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Hc Debr Subq Tissue <=20 Sq Cm	$906.75	$1,395.00	—	16% above	35%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Hc Debr Subq Tissue <=20 Sq Cm	$906.75	$1,395.00	—	—	35%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Hc Transfuse Blood Products Level I	$1,385.15	$2,131.00	—	25% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 Hc Transfuse Blood Products Level Ii	$1,800.50	$2,770.00	—	62% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 Hc Transfuse Blood Products Level Iii	$2,215.85	$3,409.00	—	99% above	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Hc Transfuse Blood Products Level I	$1,385.15	$2,131.00	—	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Hc Transfuse Blood Products Level Ii	$1,800.50	$2,770.00	—	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Hc Transfuse Blood Products Level Iii	$2,215.85	$3,409.00	—	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hc Inhalation Treatment For Aao Or Sputum Induction	$245.05	$377.00	—	40% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hc Inhalation Treatment For Aao Or Sputum Induction	$245.05	$377.00	—	—	35%
Chemotherapy IV infusion, first hour CPT 96413 Hc Chemo Infusion Initial Up To 1 Hr	$1,050.40	$1,616.00	—	37% above	35%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Hc Chemo Infusion Initial Up To 1 Hr	$1,050.40	$1,616.00	—	—	35%
Critical care, first 30 to 74 minutes CPT 99291 Hc Critical Care First 30 To 74 Min	$3,766.10	$5,794.00	—	28% above	35%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Hc Critical Care First 30 To 74 Min	$3,766.10	$5,794.00	—	—	35%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Hc Eeg Awake And Drowsy	$1,062.10	$1,634.00	—	11% above	35%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Hc Eeg Awake And Drowsy	$1,062.10	$1,634.00	—	—	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Hc Ekg	$99.45	$153.00	—	46% below	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Hc Ekg	$99.45	$153.00	—	—	35%
Electroconvulsive therapy (ECT), one session CPT 90870 Hc Ect Single Seizure	$3,064.10	$4,714.00	—	126% above	35%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 Hc Ect Single Seizure	$3,064.10	$4,714.00	—	—	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Hc Er Level I	$437.45	$673.00	—	40% above	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Hc Er Level I	$437.45	$673.00	—	—	35%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Hc Er Level Ii	$717.60	$1,104.00	—	41% above	35%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Hc Er Level Ii	$717.60	$1,104.00	—	—	35%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Hc Er Level Iii	$1,136.20	$1,748.00	—	35% above	35%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Hc Er Level Iii	$1,136.20	$1,748.00	—	—	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Hc Er Level Iv	$1,879.15	$2,891.00	—	41% above	35%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Hc Er Level Iv	$1,879.15	$2,891.00	—	—	35%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Hc Er Level V	$2,693.60	$4,144.00	—	55% above	35%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Hc Er Level V	$2,693.60	$4,144.00	—	—	35%
Exercise stress test, tracing only, the hospital charge CPT 93017 Hc Stress Test Tracing Only	$759.20	$1,168.00	—	15% below	35%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Hc Stress Test Tracing Only	$759.20	$1,168.00	—	—	35%
Family therapy with the patient, 50 minutes CPT 90847 Hc Family Psychotherapy W Pt 50 Min	$364.00	$560.00	—	23% above	35%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Hc Family Psychotherapy W Pt 50 Min	$364.00	$560.00	—	—	35%
Family therapy without the patient, 50 minutes CPT 90846 Hc Family Psychotherapy Wo Pt 50 Min	$364.00	$560.00	—	18% above	35%
Family therapy without the patient, 50 minutes inpatient CPT 90846 Hc Family Psychotherapy Wo Pt 50 Min	$364.00	$560.00	—	—	35%
Group psychotherapy session CPT 90853 Hc Group Psychotherapy Less Than 30 Minutes	$159.25	$245.00	—	7% below	35%
Group psychotherapy session CPT 90853 Hc Mcd Group Psychotherapy <30 Min	$159.25	$245.00	—	7% below	35%
Group psychotherapy session CPT 90853 Hc Pnes Group Psychotherapy	$182.00	$280.00	—	6% above	35%
Group psychotherapy session CPT 90853 Hc Iop Group Psych Therapy	$544.70	$838.00	—	219% above	35%
Group psychotherapy session CPT 90853 Hc Aftercare Group Therapy	$544.70	$838.00	—	219% above	35%
Group psychotherapy session inpatient CPT 90853 Hc Group Psychotherapy Less Than 30 Minutes	$159.25	$245.00	—	—	35%
Group psychotherapy session inpatient CPT 90853 Hc Mcd Group Psychotherapy <30 Min	$159.25	$245.00	—	—	35%
Group psychotherapy session inpatient CPT 90853 Hc Pnes Group Psychotherapy	$182.00	$280.00	—	—	35%
Group psychotherapy session inpatient CPT 90853 Hc Aftercare Group Therapy	$544.70	$838.00	—	—	35%
Group psychotherapy session inpatient CPT 90853 Hc Iop Group Psych Therapy	$544.70	$838.00	—	—	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hc Hydration Therapy Initial 31 Min To 1 Hr	$417.95	$643.00	—	at median	35%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hc Hydration Therapy Initial 31 Min To 1 Hr	$417.95	$643.00	—	—	35%
IV infusion of a medicine, first hour CPT 96365 Hc Infusion Therapy Initial Up To 1 Hr	$432.90	$666.00	—	at median	35%
IV infusion of a medicine, first hour inpatient CPT 96365 Hc Infusion Therapy Initial Up To 1 Hr	$432.90	$666.00	—	—	35%
IV push of a medicine, first drug CPT 96374 Hc Ivp Single Or Initial Drug	$226.85	$349.00	—	12% below	35%
IV push of a medicine, first drug inpatient CPT 96374 Hc Ivp Single Or Initial Drug	$226.85	$349.00	—	—	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Hc Injection Im/Subcutaneous	$182.65	$281.00	—	29% above	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Hc Injection Im/Subcutaneous	$182.65	$281.00	—	—	35%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Hc Psych Diagnostic Eval	$326.30	$502.00	—	4% above	35%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Hc Psych Diagnostic Eval	$326.30	$502.00	—	—	35%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Hc Nerve Conduction Studies 7-8	$1,154.40	$1,776.00	—	16% below	35%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Hc Nerve Conduction Studies 7-8	$1,154.40	$1,776.00	—	—	35%
Neuromuscular re-education, 15 minutes CPT 97112 Hc Pt Neuromuscular Reeducation 15 Min	$107.25	$165.00	—	2% below	35%
Neuromuscular re-education, 15 minutes CPT 97112 Hc Ot Neuromuscular Reeducation 15 Min	$107.25	$165.00	—	2% below	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Hc Ot Neuromuscular Reeducation 15 Min	$107.25	$165.00	—	—	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Hc Pt Neuromuscular Reeducation 15 Min	$107.25	$165.00	—	—	35%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Hc Medical Nutrition Assess Indiv Initial Ea 15 Min	$42.25	$65.00	—	35% below	35%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Hc Medical Nutrition Assess Indiv Initial Ea 15 Min	$42.25	$65.00	—	—	35%
Occupational therapy evaluation, low complexity CPT 97165 Hc Ot Eval Low Complexity	$261.30	$402.00	—	at median	35%
Occupational therapy evaluation, low complexity inpatient CPT 97165 Hc Ot Eval Low Complexity	$261.30	$402.00	—	—	35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Hc Pt Eval High Complexity	$326.95	$503.00	—	9% above	35%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Hc Pt Eval High Complexity	$326.95	$503.00	—	—	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Hc Pt Eval Low Complexity	$278.20	$428.00	—	7% above	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Hc Pt Eval Low Complexity	$278.20	$428.00	—	—	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Hc Pt Eval Moderate Complexity	$302.25	$465.00	—	9% above	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Hc Pt Eval Moderate Complexity	$302.25	$465.00	—	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Hc Pt Manual Therapy 15 Min	$128.70	$198.00	—	16% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Hc Ot Manual Therapy 15 Min	$128.70	$198.00	—	16% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Hc Ot Manual Therapy 15 Min	$128.70	$198.00	—	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Hc Pt Manual Therapy 15 Min	$128.70	$198.00	—	—	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Pt Exercise Therapeutic 15 Min	$125.45	$193.00	—	6% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Ot Exercise Therapeutic 15 Min	$125.45	$193.00	—	6% above	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Hc Pt Exercise Therapeutic 15 Min	$125.45	$193.00	—	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Hc Ot Exercise Therapeutic 15 Min	$125.45	$193.00	—	—	35%
Preventive checkup, new patient aged 18–39 CPT 99385 Hc Visit Preventive New 18-39 Yrs	$102.70	$158.00	—	14% below	35%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Hc Visit Preventive New 18-39 Yrs	$102.70	$158.00	—	—	35%
Preventive checkup, new patient aged 40–64 CPT 99386 Hc Visit Preventive New 40-64 Yrs	$102.70	$158.00	—	29% below	35%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Hc Visit Preventive New 40-64 Yrs	$102.70	$158.00	—	—	35%
Preventive checkup, new patient aged 65 or older CPT 99387 Hc Visit Preventive New >65 Yrs	$102.70	$158.00	—	34% below	35%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Hc Visit Preventive New >65 Yrs	$102.70	$158.00	—	—	35%
Preventive checkup, returning patient aged 18–39 CPT 99395 Hc Visit Preventive Estab 18-39 Yrs	$102.70	$158.00	—	18% below	35%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Hc Visit Preventive Estab 18-39 Yrs	$102.70	$158.00	—	—	35%
Preventive checkup, returning patient aged 40–64 CPT 99396 Hc Visit Preventive Estab 40-64 Yrs	$102.70	$158.00	—	18% below	35%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Hc Visit Preventive Estab 40-64 Yrs	$102.70	$158.00	—	—	35%
Preventive checkup, returning patient aged 65 or older CPT 99397 Hc Visit Preventive Estab >65 Yrs	$102.70	$158.00	—	20% below	35%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Hc Visit Preventive Estab >65 Yrs	$102.70	$158.00	—	—	35%
Psychiatric evaluation with medical services CPT 90792 Hc Psych Diag Eval W Med Srvcs	$446.55	$687.00	—	26% above	35%
Psychiatric evaluation with medical services inpatient CPT 90792 Hc Psych Diag Eval W Med Srvcs	$446.55	$687.00	—	—	35%
Psychotherapy session, 30 minutes CPT 90832 Hc Psychotherapy W Pt 30 Min	$181.35	$279.00	—	4% below	35%
Psychotherapy session, 30 minutes inpatient CPT 90832 Hc Psychotherapy W Pt 30 Min	$181.35	$279.00	—	—	35%
Psychotherapy session, 45 minutes CPT 90834 Hc Psychotherapy W Pt 45 Min	$326.30	$502.00	—	22% above	35%
Psychotherapy session, 45 minutes inpatient CPT 90834 Hc Psychotherapy W Pt 45 Min	$326.30	$502.00	—	—	35%
Psychotherapy session, 60 minutes CPT 90837 Hc Psychotherapy W Pt 60 Min	$364.00	$560.00	—	16% above	35%
Psychotherapy session, 60 minutes inpatient CPT 90837 Hc Psychotherapy W Pt 60 Min	$364.00	$560.00	—	—	35%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Hc Smoke Tobacco Counseling 3-10 Min	$22.75	$35.00	—	48% below	35%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Hc Smoke Tobacco Counseling 3-10 Min	$22.75	$35.00	—	—	35%
Speech and language evaluation CPT 92523 Hc St Speech And Comprehension Eval	$226.85	$349.00	—	33% below	35%
Speech and language evaluation inpatient CPT 92523 Hc St Speech And Comprehension Eval	$226.85	$349.00	—	—	35%
Speech therapy session, individual CPT 92507 Hc St Ped Treat Basic	$218.40	$336.00	—	at median	35%
Speech therapy session, individual CPT 92507 Hc St Treat Basic	$218.40	$336.00	—	at median	35%
Speech therapy session, individual CPT 92507 Hc St Treat Complex	$270.40	$416.00	—	24% above	35%
Speech therapy session, individual CPT 92507 Hc St Ped Treat Complex	$270.40	$416.00	—	24% above	35%
Speech therapy session, individual inpatient CPT 92507 Hc St Ped Treat Basic	$218.40	$336.00	—	—	35%
Speech therapy session, individual inpatient CPT 92507 Hc St Treat Basic	$218.40	$336.00	—	—	35%
Speech therapy session, individual inpatient CPT 92507 Hc St Ped Treat Complex	$270.40	$416.00	—	—	35%
Speech therapy session, individual inpatient CPT 92507 Hc St Treat Complex	$270.40	$416.00	—	—	35%
Spirometry (breathing test) CPT 94010 Hc Spirometry Pft Simple	$439.40	$676.00	—	42% above	35%
Spirometry (breathing test) inpatient CPT 94010 Hc Spirometry Pft Simple	$439.40	$676.00	—	—	35%
Spirometry before and after a bronchodilator CPT 94060 Hc Spirometry Pft Pre Post Bronchodilation	$887.90	$1,366.00	—	55% above	35%
Spirometry before and after a bronchodilator inpatient CPT 94060 Hc Spirometry Pft Pre Post Bronchodilation	$887.90	$1,366.00	—	—	35%
TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 Hc Therap Tms Treatment Intial	$577.85	$889.00	—	29% above	35%
TMS (transcranial magnetic stimulation), first session with mapping inpatient CPT 90867 Hc Therap Tms Treatment Intial	$577.85	$889.00	—	—	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 Hc Ot Functional Activity 15 Min	$123.50	$190.00	—	1% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 Hc St Functional Activity	$123.50	$190.00	—	1% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 Hc Pt Functional Activity 15 Min	$123.50	$190.00	—	1% above	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Hc St Functional Activity	$123.50	$190.00	—	—	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Hc Pt Functional Activity 15 Min	$123.50	$190.00	—	—	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Hc Ot Functional Activity 15 Min	$123.50	$190.00	—	—	35%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Hc Phlebotomy Therapeutic	$307.45	$473.00	—	30% above	35%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Hc Phlebotomy Therapeutic	$307.45	$473.00	—	—	35%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Noncdm Charge Record Pharmacy	$559.32	$860.50	—	50% above	35%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$563.48	$866.90	—	51% above	35%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Noncdm Charge Record Pharmacy	$559.32	$860.50	—	—	35%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$563.48	$866.90	—	—	35%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP	$93.63	$144.05	—	44% above	35%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH,PERTUS(ACEL),TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP	$93.63	$144.05	—	—	35%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Noncdm Charge Record Pharmacy	$72.03	$110.81	—	57% above	35%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$89.80	$138.15	—	96% above	35%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Noncdm Charge Record Pharmacy	$72.03	$110.81	—	—	35%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$89.80	$138.15	—	—	35%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Hc Hpv Vaccine 9 Valent	$494.83	$761.28	—	5% below	35%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Hc Grant Funded Hpv Vaccine 9 Valent	$494.83	$761.28	—	5% below	35%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Hc Grant Funded Hpv Vaccine 9 Valent	$494.83	$761.28	—	—	35%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Hc Hpv Vaccine 9 Valent	$494.83	$761.28	—	—	35%
Hepatitis A vaccine, adult dose CPT 90632 Noncdm Charge Record Pharmacy	$244.26	$375.78	—	26% above	35%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Noncdm Charge Record Pharmacy	$244.26	$375.78	—	—	35%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Noncdm Charge Record Pharmacy	$101.38	$155.97	—	13% above	35%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE	$108.84	$167.45	—	21% above	35%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION	$111.74	$171.90	—	25% above	35%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Noncdm Charge Record Pharmacy	$101.38	$155.97	—	—	35%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE	$108.84	$167.45	—	—	35%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION	$111.74	$171.90	—	—	35%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Noncdm Charge Record Pharmacy	$105.73	$162.66	—	32% below	35%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Noncdm Charge Record Pharmacy	$105.73	$162.66	—	—	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP	$87.72	$134.95	—	46% above	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECMB(PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$87.72	$134.95	—	46% above	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE	$109.69	$168.75	—	83% above	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECMB(PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$87.72	$134.95	—	—	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP	$87.72	$134.95	—	—	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE	$109.69	$168.75	—	—	35%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN	$59.28	$91.20	—	94% above	35%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Noncdm Charge Record Pharmacy	$60.68	$93.35	—	99% above	35%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN	$59.28	$91.20	—	—	35%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Noncdm Charge Record Pharmacy	$60.68	$93.35	—	—	35%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Noncdm Charge Record Pharmacy	$210.48	$323.81	—	104% above	35%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$303.88	$467.50	—	194% above	35%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Noncdm Charge Record Pharmacy	$210.48	$323.81	—	—	35%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$303.88	$467.50	—	—	35%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$294.94	$453.75	—	41% above	35%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Noncdm Charge Record Pharmacy	$302.16	$464.86	—	45% above	35%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$294.94	$453.75	—	—	35%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Noncdm Charge Record Pharmacy	$302.16	$464.86	—	—	35%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION	$399.75	$615.00	—	at median	35%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 Noncdm Charge Record Pharmacy	$408.94	$629.14	—	2% above	35%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION	$399.75	$615.00	—	—	35%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 Noncdm Charge Record Pharmacy	$408.94	$629.14	—	—	35%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Noncdm Charge Record Pharmacy	$695.25	$1,069.62	—	26% above	35%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$700.73	$1,078.05	—	27% above	35%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Noncdm Charge Record Pharmacy	$695.25	$1,069.62	—	—	35%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$700.73	$1,078.05	—	—	35%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$737.88	$1,135.20	—	12% above	35%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Noncdm Charge Record Pharmacy	$812.27	$1,249.64	—	23% above	35%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$737.88	$1,135.20	—	—	35%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Noncdm Charge Record Pharmacy	$812.27	$1,249.64	—	—	35%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE	$363.74	$559.60	—	32% above	35%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Noncdm Charge Record Pharmacy	$394.41	$606.78	—	43% above	35%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE	$363.74	$559.60	—	—	35%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Noncdm Charge Record Pharmacy	$394.41	$606.78	—	—	35%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Noncdm Charge Record Pharmacy	$1,449.07	$2,229.34	—	7% above	35%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Noncdm Charge Record Pharmacy	$1,449.07	$2,229.34	—	—	35%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RESP SYNCYTIAL VIRUS VAC, PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION	$844.45	$1,299.15	—	17% above	35%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RESP SYNCYTIAL VIRUS VAC, PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION	$844.45	$1,299.15	—	—	35%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$875.16	$1,346.40	—	8% below	35%
Rabies vaccine, one dose CPT 90675 Noncdm Charge Record Pharmacy	$951.40	$1,463.69	—	at median	35%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$1,036.49	$1,594.60	—	9% above	35%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$875.16	$1,346.40	—	—	35%
Rabies vaccine, one dose inpatient CPT 90675 Noncdm Charge Record Pharmacy	$951.40	$1,463.69	—	—	35%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$1,036.49	$1,594.60	—	—	35%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Noncdm Charge Record Pharmacy	$552.09	$849.37	—	9% above	35%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Noncdm Charge Record Pharmacy	$552.09	$849.37	—	—	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Noncdm Charge Record Pharmacy	$135.46	$208.40	—	51% above	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP	$144.53	$222.35	—	61% above	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$144.53	$222.35	—	61% above	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Noncdm Charge Record Pharmacy	$135.46	$208.40	—	—	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP	$144.53	$222.35	—	—	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$144.53	$222.35	—	—	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE	$144.56	$222.40	—	31% above	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$144.56	$222.40	—	31% above	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Noncdm Charge Record Pharmacy	$148.06	$227.79	—	34% above	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$144.56	$222.40	—	—	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE	$144.56	$222.40	—	—	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Noncdm Charge Record Pharmacy	$148.06	$227.79	—	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Hc Admin Immun One Vaccine	$47.45	$73.00	—	17% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Hc Admin Immun One Vaccine	$47.45	$73.00	—	—	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Hc Admin Immun Ea Addl Vaccine	$32.50	$50.00	—	7% below	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Hc Admin Immun Ea Addl Vaccine	$32.50	$50.00	—	—	35%

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.ohiohealth.com/siteassets/patients-and-visitors/preparing-for-your-visit/out-of-pocket-estimates/314394942_pickerington-methodist-hospital_standardcharges.json