Penn Highlands Tyrone
Penn Highlands Tyrone in Tyrone, PA publishes cash prices for 425 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Pennsylvania median for 353 of 423 procedures and below it for 64. By typical cash price it ranks #94 of 108 Pennsylvania hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
187 Hospital Drive, Tyrone, PA 16686 Collected Sep 23, 2026 Source price file Check a bill from this hospital (814) 684-1255
Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 391307 · CMS hospital register NPI 1659472447
The price file shows no self-pay discount
For 2394 of the 2394 prices listed here, the cash price in Penn Highlands Tyrone's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Penn Highlands Tyrone is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Contrast | $2,155.00 | $2,155.00 | — | 14% above | — |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/ + w/o Contrast | $2,155.00 | $2,155.00 | — | — | — |
| Abdominal X-ray, 2 views CPT 74019 XR Abdomen AP Decub and/or Erect | $1,287.00 | $1,287.00 | — | 294% above | — |
| Abdominal X-ray, 2 views CPT 74019 XR Abdomen AP Obliques Cone Views | $1,287.00 | $1,287.00 | — | 294% above | — |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen AP Decub and/or Erect | $1,287.00 | $1,287.00 | — | — | — |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen AP Obliques Cone Views | $1,287.00 | $1,287.00 | — | — | — |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Min 3 Views Right | $1,066.00 | $1,066.00 | — | 194% above | — |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 zzXR Ankle Complete Right | $1,066.00 | $1,066.00 | — | 194% above | — |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Min 3 Views Left | $1,066.00 | $1,066.00 | — | 194% above | — |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 zzXR Ankle Complete Left | $1,066.00 | $1,066.00 | — | 194% above | — |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 zzXR Ankle Complete Left | $1,066.00 | $1,066.00 | — | — | — |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 zzXR Ankle Complete Right | $1,066.00 | $1,066.00 | — | — | — |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Min 3 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Min 3 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 LIMITED BILAT PHYSIOLOGIC STUDY | $1,561.00 | $1,561.00 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US ABI Bilateral | $1,561.00 | $1,561.00 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Arterial Brachial Index | $1,561.00 | $1,561.00 | — | 249% above | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Physio Ext Art Multi B/L US | $1,561.00 | $1,561.00 | — | 249% above | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Physio Ext Art Sing B/L | $1,561.00 | $1,561.00 | — | 249% above | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 LIMITED BILAT PHYSIOLOGIC STUDY | $1,561.00 | $1,561.00 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US ABI Bilateral | $1,561.00 | $1,561.00 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Physio Ext Art Sing B/L | $1,561.00 | $1,561.00 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Arterial Brachial Index | $1,561.00 | $1,561.00 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Physio Ext Art Multi B/L US | $1,561.00 | $1,561.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus w/o Contrast Right | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Right | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm w/o Contrast Left | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity w/o Contrast Right | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm w/o Contrast Right | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Left | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Right | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus w/o Contrast Left | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Left | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Right | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity w/o Contrast Left | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Left | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Right | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Zimmer Shoulder Left | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Zimmer Shoulder Right | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Left | $1,287.00 | $1,287.00 | — | 9% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm w/o Contrast Right | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist w/o Contrast Right | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Zimmer Shoulder Left | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Zimmer Shoulder Right | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow w/o Contrast Left | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand w/o Contrast Right | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow w/o Contrast Right | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus w/o Contrast Left | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm w/o Contrast Left | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand w/o Contrast Left | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus w/o Contrast Right | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder w/o Contrast Left | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity w/o Contrast Right | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder w/o Contrast Right | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity w/o Contrast Left | $1,287.00 | $1,287.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist w/o Contrast Left | $1,287.00 | $1,287.00 | — | — | — |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus | $2,155.00 | $2,155.00 | — | 368% above | — |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Gastrografin Swallow | $2,155.00 | $2,155.00 | — | 368% above | — |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophagus | $2,155.00 | $2,155.00 | — | — | — |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Gastrografin Swallow | $2,155.00 | $2,155.00 | — | — | — |
| Bone scan, whole body (nuclear medicine) CPT 78306 Injection | $4,865.00 | $4,865.00 | — | 296% above | — |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Injection | $4,865.00 | $4,865.00 | — | — | — |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Screening Complete Left | $1,287.00 | $1,287.00 | — | 135% above | — |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Screening Complete Right | $1,287.00 | $1,287.00 | — | 135% above | — |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast incl. Axilla Complete Left | $1,287.00 | $1,287.00 | — | 135% above | — |
| Breast ultrasound, complete, one breast one side CPT 76641 Breast US Incl. Axilla Complete LT | $1,287.00 | $1,287.00 | — | 135% above | — |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast incl. Axilla Complete Right | $1,287.00 | $1,287.00 | — | 135% above | — |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Screening Complete Left | $1,287.00 | $1,287.00 | — | — | — |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast incl. Axilla Complete Right | $1,287.00 | $1,287.00 | — | — | — |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast incl. Axilla Complete Left | $1,287.00 | $1,287.00 | — | — | — |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Screening Complete Right | $1,287.00 | $1,287.00 | — | — | — |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 Breast US Incl. Axilla Complete LT | $1,287.00 | $1,287.00 | — | — | — |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast incl. Axilla Limited Right | $1,066.00 | $1,066.00 | — | 131% above | — |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast incl.Axilla Limited Left | $1,066.00 | $1,066.00 | — | 131% above | — |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast incl. Axilla Limited Right | $1,066.00 | $1,066.00 | — | — | — |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast incl.Axilla Limited Left | $1,066.00 | $1,066.00 | — | — | — |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abdomen + Pelvis | $4,324.00 | $4,324.00 | — | 45% above | — |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abd/Pel wo+w Bleeding Protocol | $4,324.00 | $4,324.00 | — | 45% above | — |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abd/Pel wo+w Bleeding Protocol | $4,324.00 | $4,324.00 | — | — | — |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abdomen + Pelvis | $4,324.00 | $4,324.00 | — | — | — |
| CT angiography (CTA) of the head CPT 70496 CT Angio Head | $2,155.00 | $2,155.00 | — | 26% above | — |
| CT angiography (CTA) of the head CPT 70496 T Angio Head wo+w Contrast | $2,155.00 | $2,155.00 | — | 26% above | — |
| CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Head | $2,155.00 | $2,155.00 | — | — | — |
| CT angiography (CTA) of the head inpatient CPT 70496 T Angio Head wo+w Contrast | $2,155.00 | $2,155.00 | — | — | — |
| CT angiography (CTA) of the neck CPT 70498 zzCT Angiography Carotids w/ + w/o cont | $2,155.00 | $2,155.00 | — | 29% above | — |
| CT angiography (CTA) of the neck CPT 70498 CT Angiography Neck w/ + w/o Contrast | $2,155.00 | $2,155.00 | — | 29% above | — |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT Angiography Neck w/ + w/o Contrast | $2,155.00 | $2,155.00 | — | — | — |
| CT angiography (CTA) of the neck inpatient CPT 70498 zzCT Angiography Carotids w/ + w/o cont | $2,155.00 | $2,155.00 | — | — | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography Chest w/ + w/o Contrast | $2,155.00 | $2,155.00 | — | 12% above | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography Chest w/ contrast | $2,155.00 | $2,155.00 | — | 12% above | — |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angiography Chest w/ contrast | $2,155.00 | $2,155.00 | — | — | — |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angiography Chest w/ + w/o Contrast | $2,155.00 | $2,155.00 | — | — | — |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angiography Heart Coronary Art w Cont | $4,324.00 | $4,324.00 | — | 119% above | — |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angiography Heart Coronary Art w Cont | $4,324.00 | $4,324.00 | — | — | — |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart w/o Contrast Calcium Scoring | $225.00 | $225.00 | — | 27% above | — |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart CA Screening | $225.00 | $225.00 | — | 27% above | — |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Heart w/o Contrast Calcium Scoring | $225.00 | $225.00 | — | — | — |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Heart CA Screening | $225.00 | $225.00 | — | — | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 zzCT Abdomen w/o Pelvis w/o contrast | $2,926.00 | $2,926.00 | — | 41% above | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen + Pelvis w/o Contrast | $2,926.00 | $2,926.00 | — | 41% above | — |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 zzCT Abdomen w/o Pelvis w/o contrast | $2,926.00 | $2,926.00 | — | — | — |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen + Pelvis w/o Contrast | $2,926.00 | $2,926.00 | — | — | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 zzCT Abdomen w/ Pelvis w/ contrast | $4,324.00 | $4,324.00 | — | 45% above | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen + Pelvis w/ Contrast | $4,324.00 | $4,324.00 | — | 45% above | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen + Pelvis w/ Contrast | $4,324.00 | $4,324.00 | — | — | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 zzCT Abdomen w/ Pelvis w/ contrast | $4,324.00 | $4,324.00 | — | — | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 zzCT Abdomen w/ + w/o Pelvis w/ + w/o cont | $4,324.00 | $4,324.00 | — | 45% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen + Pelvis w/ + w/o Contrast | $4,324.00 | $4,324.00 | — | 45% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 zzCT Abdomen w/ + w/o Pelvis w/ contrast | $4,324.00 | $4,324.00 | — | 45% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen + Pelvis w/ + w/o Contrast | $4,324.00 | $4,324.00 | — | — | — |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 zzCT Abdomen w/ + w/o Pelvis w/ + w/o cont | $4,324.00 | $4,324.00 | — | — | — |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 zzCT Abdomen w/ + w/o Pelvis w/ contrast | $4,324.00 | $4,324.00 | — | — | — |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast | $2,155.00 | $2,155.00 | — | 30% above | — |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast | $2,155.00 | $2,155.00 | — | — | — |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast | $1,287.00 | $1,287.00 | — | 14% above | — |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast | $1,287.00 | $1,287.00 | — | — | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial ICAT SP | $1,287.00 | $1,287.00 | — | 14% above | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast | $1,457.00 | $1,457.00 | — | 29% above | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast | $1,457.00 | $1,457.00 | — | 29% above | — |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial ICAT SP | $1,287.00 | $1,287.00 | — | — | — |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast | $1,457.00 | $1,457.00 | — | — | — |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast | $1,457.00 | $1,457.00 | — | — | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain wo Contrast w Stealth Protocol | $1,287.00 | $1,287.00 | — | 19% above | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain w/o Contrast | $1,287.00 | $1,287.00 | — | 19% above | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain w/o Contrast | $1,287.00 | $1,287.00 | — | — | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain wo Contrast w Stealth Protocol | $1,287.00 | $1,287.00 | — | — | — |
| CT scan of the head with contrast CPT 70460 CT Head or Brain w/ Contrast | $2,155.00 | $2,155.00 | — | 59% above | — |
| CT scan of the head with contrast CPT 70460 CT Brain w/contrast w/ stealth | $2,155.00 | $2,155.00 | — | 59% above | — |
| CT scan of the head with contrast inpatient CPT 70460 CT Brain w/contrast w/ stealth | $2,155.00 | $2,155.00 | — | — | — |
| CT scan of the head with contrast inpatient CPT 70460 CT Head or Brain w/ Contrast | $2,155.00 | $2,155.00 | — | — | — |
| CT scan of the head without and with contrast CPT 70470 CT Brain wo/w contrast w/ stealth | $2,155.00 | $2,155.00 | — | 29% above | — |
| CT scan of the head without and with contrast CPT 70470 CT Head or Brain w/ + w/o Contrast | $2,155.00 | $2,155.00 | — | 29% above | — |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Brain wo/w contrast w/ stealth | $2,155.00 | $2,155.00 | — | — | — |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Head or Brain w/ + w/o Contrast | $2,155.00 | $2,155.00 | — | — | — |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast | $1,652.00 | $1,652.00 | — | 44% above | — |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast | $1,652.00 | $1,652.00 | — | — | — |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast | $1,621.00 | $1,621.00 | — | 37% above | — |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast | $1,621.00 | $1,621.00 | — | — | — |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Cystogram | $2,155.00 | $2,155.00 | — | 27% above | — |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast | $2,155.00 | $2,155.00 | — | 27% above | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Cystogram | $2,155.00 | $2,155.00 | — | — | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast | $2,155.00 | $2,155.00 | — | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral | $2,926.00 | $2,926.00 | — | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral | $2,926.00 | $2,926.00 | — | — | — |
| Chest CT scan without and with contrast CPT 71270 CT Brachial Plexus w/ + w/o Contrast | $2,155.00 | $2,155.00 | — | 34% above | — |
| Chest CT scan without and with contrast CPT 71270 CT Thorax w/ + w/o Contrast | $2,155.00 | $2,155.00 | — | 34% above | — |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Brachial Plexus w/ + w/o Contrast | $2,155.00 | $2,155.00 | — | — | — |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Thorax w/ + w/o Contrast | $2,155.00 | $2,155.00 | — | — | — |
| Chest X-ray, 2 views CPT 71046 XR Chest PA and Lateral | $1,066.00 | $1,066.00 | — | 231% above | — |
| Chest X-ray, 2 views CPT 71046 XR Chest PA Inspir + Expir | $1,066.00 | $1,066.00 | — | 231% above | — |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest PA Inspir + Expir | $1,066.00 | $1,066.00 | — | — | — |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest PA and Lateral | $1,066.00 | $1,066.00 | — | — | — |
| Chest X-ray, single view CPT 71045 OCCHLTH CHEST XRAY | $105.00 | $105.00 | — | 44% below | — |
| Chest X-ray, single view CPT 71045 XR Chest Special Views | $1,066.00 | $1,066.00 | — | 466% above | — |
| Chest X-ray, single view CPT 71045 XR Chest 1 view | $1,066.00 | $1,066.00 | — | 466% above | — |
| Chest X-ray, single view CPT 71045 XR Chest/Abdomen NICU Only | $1,066.00 | $1,066.00 | — | 466% above | — |
| Chest X-ray, single view CPT 71045 XR Chest 1 View Frontal | $1,066.00 | $1,066.00 | — | 466% above | — |
| Chest X-ray, single view one side CPT 71045 XR Chest Decubitus Right | $1,066.00 | $1,066.00 | — | 466% above | — |
| Chest X-ray, single view one side CPT 71045 XR Chest Decubitus Left | $1,066.00 | $1,066.00 | — | 466% above | — |
| Chest X-ray, single view inpatient CPT 71045 OCCHLTH CHEST XRAY | $105.00 | $105.00 | — | — | — |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Frontal | $1,066.00 | $1,066.00 | — | — | — |
| Chest X-ray, single view inpatient CPT 71045 XR Chest/Abdomen NICU Only | $1,066.00 | $1,066.00 | — | — | — |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 view | $1,066.00 | $1,066.00 | — | — | — |
| Chest X-ray, single view inpatient CPT 71045 XR Chest Special Views | $1,066.00 | $1,066.00 | — | — | — |
| Chest X-ray, single view inpatient one side CPT 71045 XR Chest Decubitus Right | $1,066.00 | $1,066.00 | — | — | — |
| Chest X-ray, single view inpatient one side CPT 71045 XR Chest Decubitus Left | $1,066.00 | $1,066.00 | — | — | — |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right | $1,066.00 | $1,066.00 | — | 272% above | — |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left | $1,066.00 | $1,066.00 | — | 272% above | — |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right | $1,066.00 | $1,066.00 | — | — | — |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left | $1,066.00 | $1,066.00 | — | — | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renals + Bladder w/ PVR | $1,287.00 | $1,287.00 | — | 77% above | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renals + Bladder w/o PVR | $1,287.00 | $1,287.00 | — | 77% above | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete | $1,287.00 | $1,287.00 | — | 77% above | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renals + Bladder w/ PVR | $1,287.00 | $1,287.00 | — | — | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete | $1,287.00 | $1,287.00 | — | — | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renals + Bladder w/o PVR | $1,287.00 | $1,287.00 | — | — | — |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD DEXA BMD Axial Skeleton | $338.00 | $338.00 | — | 24% above | — |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD DEXA BMD Axial Skeleton | $338.00 | $338.00 | — | — | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD DEXA Peripheral Forearm | $1,066.00 | $1,066.00 | — | 489% above | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BD DEXA Peripheral Forearm | $1,066.00 | $1,066.00 | — | — | — |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Pelvic OB Detailed Fetal/Mat 1st | $2,926.00 | $2,926.00 | — | 133% above | — |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Pelvic OB Detailed Fetal/Mat 1st | $2,926.00 | $2,926.00 | — | — | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Brachial Plexus w/o Contrast | $1,332.00 | $1,332.00 | — | 21% above | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax BLVR Protocol wo Contrast | $1,332.00 | $1,332.00 | — | 21% above | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o Contrast | $1,332.00 | $1,332.00 | — | 21% above | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o Contrast | $1,332.00 | $1,332.00 | — | — | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax BLVR Protocol wo Contrast | $1,332.00 | $1,332.00 | — | — | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Brachial Plexus w/o Contrast | $1,332.00 | $1,332.00 | — | — | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 zzCT Chest w/o Abdomen w/o contrast | $2,155.00 | $2,155.00 | — | 51% above | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Brachial Plexus w/ Contrast | $2,155.00 | $2,155.00 | — | 51% above | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/ Contrast | $2,155.00 | $2,155.00 | — | 51% above | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/ Contrast | $2,155.00 | $2,155.00 | — | — | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Brachial Plexus w/ Contrast | $2,155.00 | $2,155.00 | — | — | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 zzCT Chest w/o Abdomen w/o contrast | $2,155.00 | $2,155.00 | — | — | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 MA Mammogram Digital Diagnostic Bilat | $1,180.00 | $1,180.00 | — | — | — |
| Diagnostic mammogram, both breasts CPT 77066 MA Diag Digital Mammo+Tomo B/L | $1,180.00 | $1,180.00 | — | 264% above | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA Mammogram Digital Diagnostic Bilat | $1,180.00 | $1,180.00 | — | — | — |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MA Diag Digital Mammo+Tomo B/L | $1,180.00 | $1,180.00 | — | — | — |
| Diagnostic mammogram, one breast one side CPT 77065 MA Diag Digital Mammo+Tomo RT | $927.00 | $927.00 | — | 193% above | — |
| Diagnostic mammogram, one breast one side CPT 77065 MA Diag Digital Mammo+Tomo LT | $927.00 | $927.00 | — | 193% above | — |
| Diagnostic mammogram, one breast one side CPT 77065 MA Mammogram Digital Diagnostic Right | $927.00 | $927.00 | — | 193% above | — |
| Diagnostic mammogram, one breast one side CPT 77065 MA Mammogram Digital Diagnostic Left | $927.00 | $927.00 | — | 193% above | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Diag Digital Mammo+Tomo LT | $927.00 | $927.00 | — | — | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Mammogram Digital Diagnostic Left | $927.00 | $927.00 | — | — | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Mammogram Digital Diagnostic Right | $927.00 | $927.00 | — | — | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Diag Digital Mammo+Tomo RT | $927.00 | $927.00 | — | — | — |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Duplex Bilateral | $2,926.00 | $2,926.00 | — | — | — |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LE Arterial Duplex Bilateral | $2,926.00 | $2,926.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Duplex Bilateral | $2,926.00 | $2,926.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UE Venous Duplex Bilateral | $2,926.00 | $2,926.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs CPT 93970 CP LE Venous Mapping Veins B/L | $2,926.00 | $2,926.00 | — | 236% above | — |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US LE Venous Doppler Reflux Study B/L | $2,926.00 | $2,926.00 | — | 236% above | — |
| Duplex ultrasound of the leg veins, both legs CPT 93970 CP LE Venous Doppler Reflux Study B/L | $2,926.00 | $2,926.00 | — | 236% above | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US LE Venous Duplex Bilateral | $2,926.00 | $2,926.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US UE Venous Duplex Bilateral | $2,926.00 | $2,926.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 CP LE Venous Mapping Veins B/L | $2,926.00 | $2,926.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 CP LE Venous Doppler Reflux Study B/L | $2,926.00 | $2,926.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US LE Venous Doppler Reflux Study B/L | $2,926.00 | $2,926.00 | — | — | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO 2D COMPL COLOR PULSE WAVE | $6,638.00 | $6,638.00 | — | 254% above | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CP Echo Thransthoracic 2D Complete | $6,638.00 | $6,638.00 | — | 254% above | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CP Echo Bubble Study Adult | $6,638.00 | $6,638.00 | — | 254% above | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO 2D COMPL COLOR PULSE WAVE | $6,638.00 | $6,638.00 | — | — | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CP Echo Bubble Study Adult | $6,638.00 | $6,638.00 | — | — | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CP Echo Thransthoracic 2D Complete | $6,638.00 | $6,638.00 | — | — | — |
| Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Left | $1,066.00 | $1,066.00 | — | 249% above | — |
| Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Right | $1,066.00 | $1,066.00 | — | 249% above | — |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Min 3 Left | $1,066.00 | $1,066.00 | — | 208% above | — |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Min 3 Right | $1,066.00 | $1,066.00 | — | 208% above | — |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Min 3 Left | $1,066.00 | $1,066.00 | — | — | — |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Min 3 Right | $1,066.00 | $1,066.00 | — | — | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 zzCT Orbit Sella etc. w/o Contrast | $1,287.00 | $1,287.00 | — | 18% above | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbits,Sella, or IACs w/o Contrast | $1,287.00 | $1,287.00 | — | 18% above | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 zzCT Outer/Middle/Inner ear w/o contrast | $1,287.00 | $1,287.00 | — | 18% above | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 zzCT Orbits w/o contrast | $1,287.00 | $1,287.00 | — | 18% above | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC w/o Contrast | $1,287.00 | $1,287.00 | — | 18% above | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbits,Sella, or IACs w/o Contrast | $1,287.00 | $1,287.00 | — | — | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 zzCT Orbits w/o contrast | $1,287.00 | $1,287.00 | — | — | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 zzCT Orbit Sella etc. w/o Contrast | $1,287.00 | $1,287.00 | — | — | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 zzCT Outer/Middle/Inner ear w/o contrast | $1,287.00 | $1,287.00 | — | — | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC w/o Contrast | $1,287.00 | $1,287.00 | — | — | — |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR Zygomatic Arches | $1,287.00 | $1,287.00 | — | 213% above | — |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones Minimum 3 Views | $1,287.00 | $1,287.00 | — | 213% above | — |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Zygomatic Arches | $1,287.00 | $1,287.00 | — | — | — |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones Minimum 3 Views | $1,287.00 | $1,287.00 | — | — | — |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Right | $1,066.00 | $1,066.00 | — | 281% above | — |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Left | $1,066.00 | $1,066.00 | — | 281% above | — |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Injection | $4,865.00 | $4,865.00 | — | 296% above | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Injection | $4,865.00 | $4,865.00 | — | — | — |
| Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Right | $1,287.00 | $1,287.00 | — | 360% above | — |
| Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Left | $1,287.00 | $1,287.00 | — | 360% above | — |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Right | $1,287.00 | $1,287.00 | — | — | — |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Left | $1,287.00 | $1,287.00 | — | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Left | $1,066.00 | $1,066.00 | — | 303% above | — |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Right | $1,066.00 | $1,066.00 | — | 303% above | — |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus Right | $1,066.00 | $1,066.00 | — | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus Left | $1,066.00 | $1,066.00 | — | — | — |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Unattended Sleep Study | $874.00 | $874.00 | — | 44% above | — |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Unattended Sleep Study | $874.00 | $874.00 | — | — | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnography With Titration | $2,900.00 | $2,900.00 | — | 8% below | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysomnography With Titration | $2,900.00 | $2,900.00 | — | — | — |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right | $1,066.00 | $1,066.00 | — | 167% above | — |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left | $1,066.00 | $1,066.00 | — | 167% above | — |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Min 4 views Left | $1,287.00 | $1,287.00 | — | 195% above | — |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee min 4 views Right | $1,287.00 | $1,287.00 | — | 195% above | — |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee min 4 views Right | $1,287.00 | $1,287.00 | — | — | — |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Min 4 views Left | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Right | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Left | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip w/o Contrast Right | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip w/o Contrast Left | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip RT MAKO Protocol | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip LT MAKO Protocol | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Left | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Left | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur w/o Contrast Right | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur w/o Contrast Left | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Right | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity w/o Contrast Left | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Right | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Zimmer Whole Leg Left | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity w/o Contrast Right | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia/Fibula w/o Contrast Left | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Zimmer 3 Region Right | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Zimmer 3 Region Left | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia/Fibula w/o Contrast Right | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Zimmer Whole Leg Right | $1,287.00 | $1,287.00 | — | 22% above | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip RT MAKO Protocol | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip w/o Contrast Right | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Zimmer 3 Region Right | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/o Contrast Left | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia/Fibula w/o Contrast Left | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot w/o Contrast Left | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee w/o Contrast Right | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee w/o Contrast Left | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity w/o Contrast Left | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/o Contrast Right | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip w/o Contrast Left | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur w/o Contrast Left | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Zimmer Whole Leg Left | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur w/o Contrast Right | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot w/o Contrast Right | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity w/o Contrast Right | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Zimmer 3 Region Left | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Zimmer Whole Leg Right | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia/Fibula w/o Contrast Right | $1,287.00 | $1,287.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip LT MAKO Protocol | $1,287.00 | $1,287.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited | $1,287.00 | $1,287.00 | — | 112% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder | $1,287.00 | $1,287.00 | — | 112% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Right Lower Quadrant | $1,287.00 | $1,287.00 | — | 112% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Left Lower Quadrant | $1,287.00 | $1,287.00 | — | 112% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Left Upper Quadrant | $1,287.00 | $1,287.00 | — | 112% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Right Upper Quadrant | $1,287.00 | $1,287.00 | — | 112% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder | $1,287.00 | $1,287.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited | $1,287.00 | $1,287.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Left Upper Quadrant | $1,287.00 | $1,287.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Right Lower Quadrant | $1,287.00 | $1,287.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Right Upper Quadrant | $1,287.00 | $1,287.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Left Lower Quadrant | $1,287.00 | $1,287.00 | — | — | — |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US UE Non-Vascular Specific Area Right | $1,287.00 | $1,287.00 | — | 226% above | — |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US LE Non-Vascular Specific Area Right | $1,287.00 | $1,287.00 | — | 226% above | — |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US UE Non-Vascular Specific Area Left | $1,287.00 | $1,287.00 | — | 226% above | — |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US LE Non-Vascular Specific Area Left | $1,287.00 | $1,287.00 | — | 226% above | — |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Axilla Left BCS Only | $1,287.00 | $1,287.00 | — | 226% above | — |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Axilla Right BCS Only | $1,287.00 | $1,287.00 | — | 226% above | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US UE Non-Vascular Specific Area Right | $1,287.00 | $1,287.00 | — | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Axilla Left BCS Only | $1,287.00 | $1,287.00 | — | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US UE Non-Vascular Specific Area Left | $1,287.00 | $1,287.00 | — | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US LE Non-Vascular Specific Area Left | $1,287.00 | $1,287.00 | — | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US LE Non-Vascular Specific Area Right | $1,287.00 | $1,287.00 | — | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Axilla Right BCS Only | $1,287.00 | $1,287.00 | — | — | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Screening Low Dose INS | $1,332.00 | $1,332.00 | — | 236% above | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Screening Low Dose INS | $1,332.00 | $1,332.00 | — | — | — |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Left | $1,066.00 | $1,066.00 | — | 219% above | — |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula 1 View Left | $1,066.00 | $1,066.00 | — | 219% above | — |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Right | $1,066.00 | $1,066.00 | — | 219% above | — |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula 1 View Right | $1,066.00 | $1,066.00 | — | 219% above | — |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Right | $1,066.00 | $1,066.00 | — | — | — |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Left | $1,066.00 | $1,066.00 | — | — | — |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula 1 View Right | $1,066.00 | $1,066.00 | — | — | — |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula 1 View Left | $1,066.00 | $1,066.00 | — | — | — |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Head w/o Contrast | $2,926.00 | $2,926.00 | — | 63% above | — |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Head MRV | $2,926.00 | $2,926.00 | — | 63% above | — |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Head MRV | $2,926.00 | $2,926.00 | — | — | — |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Head w/o Contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of both breasts, without and then with contrast dye CPT 77049 MRI Breast Pre-surgical planning w + w/o | $3,240.00 | $3,240.00 | — | 67% above | — |
| MRI of both breasts, without and then with contrast dye CPT 77049 MRI Breast wo+w Contrast w CAD B/L | $3,240.00 | $3,240.00 | — | 67% above | — |
| MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI Breast wo+w Contrast w CAD B/L | $3,240.00 | $3,240.00 | — | — | — |
| MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI Breast Pre-surgical planning w + w/o | $3,240.00 | $3,240.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left | $2,926.00 | $2,926.00 | — | 44% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right | $2,926.00 | $2,926.00 | — | 44% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LE Joint w/o Contrast Right | $2,926.00 | $2,926.00 | — | 44% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LE Joint w/o Contrast Left | $2,926.00 | $2,926.00 | — | 44% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right | $2,926.00 | $2,926.00 | — | 44% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right | $2,926.00 | $2,926.00 | — | 44% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Zimmer Knee w/o Contrast Left | $2,926.00 | $2,926.00 | — | 44% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left | $2,926.00 | $2,926.00 | — | 44% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Zimmer Knee w/o Contrast Right | $2,926.00 | $2,926.00 | — | 44% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left | $2,926.00 | $2,926.00 | — | 44% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Toe w/o Contrast Right | $2,926.00 | $2,926.00 | — | 44% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Toe w/o Contrast Left | $2,926.00 | $2,926.00 | — | 44% above | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LE Joint w/o Contrast Left | $2,926.00 | $2,926.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Zimmer Knee w/o Contrast Left | $2,926.00 | $2,926.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Zimmer Knee w/o Contrast Right | $2,926.00 | $2,926.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Left | $2,926.00 | $2,926.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LE Joint w/o Contrast Right | $2,926.00 | $2,926.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Right | $2,926.00 | $2,926.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Toe w/o Contrast Left | $2,926.00 | $2,926.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Right | $2,926.00 | $2,926.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Right | $2,926.00 | $2,926.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Toe w/o Contrast Right | $2,926.00 | $2,926.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Left | $2,926.00 | $2,926.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Left | $2,926.00 | $2,926.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Toe w/o + w/Contrast Right | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Arthrogram Right | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Arthrogram Right | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Arthrogram Left | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Arthrogram Right | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Arthrogram Left | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Arthrogram Left | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LE Joint w/ + w/o Contrast Left | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LE Joint w/ + w/o Contrast Right | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Toe w/o + w/Contrast Left | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Arthrogram Right | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Arthrogram Right | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Arthrogram Left | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Arthrogram Right | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Toe w/o + w/Contrast Right | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Arthrogram Left | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LE Joint w/ + w/o Contrast Left | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Toe w/o + w/Contrast Left | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LE Joint w/ + w/o Contrast Right | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Arthrogram Left | $4,324.00 | $4,324.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $4,324.00 | $4,324.00 | — | — | — |
| MRI of the abdomen without contrast CPT 74181 MRI Adrenals wo Contrast | $2,926.00 | $2,926.00 | — | 48% above | — |
| MRI of the abdomen without contrast CPT 74181 MRI Liver wo Contrast | $2,926.00 | $2,926.00 | — | 48% above | — |
| MRI of the abdomen without contrast CPT 74181 MRI MRCP | $2,926.00 | $2,926.00 | — | 48% above | — |
| MRI of the abdomen without contrast CPT 74181 MRI Pancreas wo Contrast | $2,926.00 | $2,926.00 | — | 48% above | — |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast | $2,926.00 | $2,926.00 | — | 48% above | — |
| MRI of the abdomen without contrast CPT 74181 MRI Kidneys wo Contrast | $2,926.00 | $2,926.00 | — | 48% above | — |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Pancreas wo Contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Adrenals wo Contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Kidneys wo Contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Liver wo Contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Kidneys wo + w Contrast | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Liver wo + w Contrast | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Adrenals wo + w Contrast | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Pancreas wo + w Contrast | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Adrenals wo + w Contrast | $4,324.00 | $4,324.00 | — | — | — |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast | $4,324.00 | $4,324.00 | — | — | — |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Kidneys wo + w Contrast | $4,324.00 | $4,324.00 | — | — | — |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Pancreas wo + w Contrast | $4,324.00 | $4,324.00 | — | — | — |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Liver wo + w Contrast | $4,324.00 | $4,324.00 | — | — | — |
| MRI of the brain, no contrast dye CPT 70551 MRI IAC's w/o contrast | $2,926.00 | $2,926.00 | — | 61% above | — |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast | $2,926.00 | $2,926.00 | — | 61% above | — |
| MRI of the brain, no contrast dye CPT 70551 MRI Pitiutary wo Contrast | $2,926.00 | $2,926.00 | — | 61% above | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Pitiutary wo Contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI IAC's w/o contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast | $4,324.00 | $4,324.00 | — | 49% above | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI IAC's w/ + w/o contrast | $4,324.00 | $4,324.00 | — | 49% above | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Pituitary wo + w Contrast | $4,324.00 | $4,324.00 | — | 49% above | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IAC's w/ + w/o contrast | $4,324.00 | $4,324.00 | — | — | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast | $4,324.00 | $4,324.00 | — | — | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Pituitary wo + w Contrast | $4,324.00 | $4,324.00 | — | — | — |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast | $2,926.00 | $2,926.00 | — | 63% above | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $4,324.00 | $4,324.00 | — | 32% above | — |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $4,324.00 | $4,324.00 | — | — | — |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast | $2,926.00 | $2,926.00 | — | 41% above | — |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $4,324.00 | $4,324.00 | — | 48% above | — |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $4,324.00 | $4,324.00 | — | — | — |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast | $2,926.00 | $2,926.00 | — | 67% above | — |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o contrast | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of the pelvis without and with contrast CPT 72197 MRI Prostate wo + w Contrast | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis Rectal Staging wo+w Contrast | $4,324.00 | $4,324.00 | — | 23% above | — |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis Rectal Staging wo+w Contrast | $4,324.00 | $4,324.00 | — | — | — |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o contrast | $4,324.00 | $4,324.00 | — | — | — |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Prostate wo + w Contrast | $4,324.00 | $4,324.00 | — | — | — |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Prostate wo Contrast | $2,926.00 | $2,926.00 | — | 49% above | — |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast | $2,926.00 | $2,926.00 | — | 49% above | — |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis Rectal Staging wo Contrast | $2,926.00 | $2,926.00 | — | 49% above | — |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Prostate wo Contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis Rectal Staging wo Contrast | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UE Joint w/o Contrast Left | $2,926.00 | $2,926.00 | — | 38% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Finger w/o Contrast Left | $2,926.00 | $2,926.00 | — | 38% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Right | $2,926.00 | $2,926.00 | — | 38% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Right | $2,926.00 | $2,926.00 | — | 38% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Left | $2,926.00 | $2,926.00 | — | 38% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Left | $2,926.00 | $2,926.00 | — | 38% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Right | $2,926.00 | $2,926.00 | — | 38% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Left | $2,926.00 | $2,926.00 | — | 38% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UE Joint w/o Contrast Right | $2,926.00 | $2,926.00 | — | 38% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Finger w/o Contrast Right | $2,926.00 | $2,926.00 | — | 38% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Left | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Finger w/o Contrast Left | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UE Joint w/o Contrast Right | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UE Joint w/o Contrast Left | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Right | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Left | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Finger w/o Contrast Right | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Left | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Right | $2,926.00 | $2,926.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Right | $2,926.00 | $2,926.00 | — | — | — |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical Minimum 4 Views | $1,287.00 | $1,287.00 | — | 192% above | — |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical Minimum 4 Views | $1,287.00 | $1,287.00 | — | — | — |
| Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tissue Neck w/ Contrast | $2,155.00 | $2,155.00 | — | 59% above | — |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Soft Tissue Neck w/ Contrast | $2,155.00 | $2,155.00 | — | — | — |
| Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck w/o Contrast | $1,287.00 | $1,287.00 | — | 19% above | — |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tissue Neck w/o Contrast | $1,287.00 | $1,287.00 | — | — | — |
| Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue | $1,066.00 | $1,066.00 | — | 281% above | — |
| Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue | $1,066.00 | $1,066.00 | — | — | — |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Injection 1 | $15,805.00 | $15,805.00 | — | 303% above | — |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Injection 1 | $15,805.00 | $15,805.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET Injection | $17,658.00 | $17,658.00 | — | 144% above | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET Injection | $17,658.00 | $17,658.00 | — | — | — |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis MAKO Protocol | $1,287.00 | $1,287.00 | — | 18% above | — |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast | $1,287.00 | $1,287.00 | — | 18% above | — |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast | $1,287.00 | $1,287.00 | — | — | — |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis MAKO Protocol | $1,287.00 | $1,287.00 | — | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non-OB Limited | $1,287.00 | $1,287.00 | — | 188% above | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Bladder Capacity PVR | $1,287.00 | $1,287.00 | — | 188% above | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic GYN Limited | $1,287.00 | $1,287.00 | — | 188% above | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Bladder w/o PVR | $1,287.00 | $1,287.00 | — | 188% above | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Bladder w/o PVR | $1,287.00 | $1,287.00 | — | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic GYN Limited | $1,287.00 | $1,287.00 | — | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non-OB Limited | $1,287.00 | $1,287.00 | — | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Bladder Capacity PVR | $1,287.00 | $1,287.00 | — | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic GYN Complete | $1,287.00 | $1,287.00 | — | 121% above | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non-OB Complete | $1,287.00 | $1,287.00 | — | 121% above | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Non-OB Complete | $1,287.00 | $1,287.00 | — | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic GYN Complete | $1,287.00 | $1,287.00 | — | — | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Pelvic OB > 14 Weeks Complete | $1,287.00 | $1,287.00 | — | 110% above | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Pelvic OB > 14 Weeks Complete | $1,287.00 | $1,287.00 | — | — | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pelvic OB < 14 Weeks Complete | $1,287.00 | $1,287.00 | — | 129% above | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 zzUS Pregnancy 1st Trimester | $1,287.00 | $1,287.00 | — | 129% above | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 zzUS Pregnancy 1st Trimester | $1,287.00 | $1,287.00 | — | — | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Pelvic OB < 14 Weeks Complete | $1,287.00 | $1,287.00 | — | — | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pelvic OB Limited | $1,287.00 | $1,287.00 | — | 141% above | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pelvic OB Limited | $1,287.00 | $1,287.00 | — | — | — |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 Views Left | $1,066.00 | $1,066.00 | — | 217% above | — |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 Views Right | $1,066.00 | $1,066.00 | — | 217% above | — |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w/ PA Chest Left | $1,287.00 | $1,287.00 | — | 213% above | — |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w/ PA Chest Right | $1,287.00 | $1,287.00 | — | 213% above | — |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w/ PA Chest Left | $1,287.00 | $1,287.00 | — | — | — |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w/ PA Chest Right | $1,287.00 | $1,287.00 | — | — | — |
| Screening mammogram, both breasts CPT 77067 MA Screen Digital Mammo+Tomo | $976.00 | $976.00 | — | 279% above | — |
| Screening mammogram, both breasts CPT 77067 MA Mammogram Digital Screening | $976.00 | $976.00 | — | 279% above | — |
| Screening mammogram, both breasts inpatient CPT 77067 MA Screen Digital Mammo+Tomo | $976.00 | $976.00 | — | — | — |
| Screening mammogram, both breasts inpatient CPT 77067 MA Mammogram Digital Screening | $976.00 | $976.00 | — | — | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Intern/Extern Rotation Right | $1,066.00 | $1,066.00 | — | 215% above | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Right | $1,066.00 | $1,066.00 | — | 215% above | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Min 2 Views Left | $1,066.00 | $1,066.00 | — | 215% above | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Left | $1,066.00 | $1,066.00 | — | 215% above | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Min 2 Views Right | $1,066.00 | $1,066.00 | — | 215% above | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Intern/Extern Rotation Left | $1,066.00 | $1,066.00 | — | 215% above | — |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Intern/Extern Rotation Right | $1,066.00 | $1,066.00 | — | — | — |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Min 2 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Intern/Extern Rotation Left | $1,066.00 | $1,066.00 | — | — | — |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Right | $1,066.00 | $1,066.00 | — | — | — |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Min 2 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Left | $1,066.00 | $1,066.00 | — | — | — |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete | $1,066.00 | $1,066.00 | — | 151% above | — |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete | $1,066.00 | $1,066.00 | — | — | — |
| Skull X-ray, fewer than 4 views CPT 70250 XR Skull < 4 Views | $1,287.00 | $1,287.00 | — | 261% above | — |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull < 4 Views | $1,287.00 | $1,287.00 | — | — | — |
| Sleep study in a lab (polysomnography) CPT 95810 Polysomnography | $3,145.00 | $3,145.00 | — | 9% below | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysomnography | $3,145.00 | $3,145.00 | — | — | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR MBS For Speech Therapist | $2,155.00 | $2,155.00 | — | 265% above | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Barium Swallow w/ contrast video | $2,155.00 | $2,155.00 | — | 265% above | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function w/ Video | $2,155.00 | $2,155.00 | — | 265% above | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 MBS For Speech Therapist | $2,155.00 | $2,155.00 | — | 265% above | — |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Barium Swallow w/ contrast video | $2,155.00 | $2,155.00 | — | — | — |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR MBS For Speech Therapist | $2,155.00 | $2,155.00 | — | — | — |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MBS For Speech Therapist | $2,155.00 | $2,155.00 | — | — | — |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function w/ Video | $2,155.00 | $2,155.00 | — | — | — |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur min 2 Views Right | $1,066.00 | $1,066.00 | — | 168% above | — |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur min 2 Views Left | $1,066.00 | $1,066.00 | — | 168% above | — |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur min 2 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur min 2 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic w/o Contrast | $1,287.00 | $1,287.00 | — | 10% above | — |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic w/o Contrast | $1,287.00 | $1,287.00 | — | — | — |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes Left | $1,066.00 | $1,066.00 | — | 281% above | — |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes Right | $1,066.00 | $1,066.00 | — | 281% above | — |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toe(s) Min 2 Views Right | $1,066.00 | $1,066.00 | — | 281% above | — |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toe(s) Min 2 Views Left | $1,066.00 | $1,066.00 | — | 281% above | — |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toe(s) Min 2 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toe(s) Min 2 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes Left | $1,066.00 | $1,066.00 | — | — | — |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes Right | $1,066.00 | $1,066.00 | — | — | — |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB | $1,287.00 | $1,287.00 | — | 130% above | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB | $1,287.00 | $1,287.00 | — | — | — |
| Transvaginal ultrasound during pregnancy CPT 76817 US Pelvic OB Transvaginal | $1,287.00 | $1,287.00 | — | 133% above | — |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Pelvic OB Transvaginal | $1,287.00 | $1,287.00 | — | — | — |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $1,287.00 | $1,287.00 | — | 64% above | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $1,287.00 | $1,287.00 | — | — | — |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents) | $1,287.00 | $1,287.00 | — | 109% above | — |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents) | $1,287.00 | $1,287.00 | — | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 zzUS Parotid | $1,287.00 | $1,287.00 | — | 125% above | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid | $1,287.00 | $1,287.00 | — | 125% above | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 zzUS Parathyroid | $1,287.00 | $1,287.00 | — | 125% above | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue | $1,287.00 | $1,287.00 | — | 125% above | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 zzUS Parotid | $1,287.00 | $1,287.00 | — | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 zzUS Parathyroid | $1,287.00 | $1,287.00 | — | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue | $1,287.00 | $1,287.00 | — | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid | $1,287.00 | $1,287.00 | — | — | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI w/wo Scout+Delay, Gastrograph | $2,155.00 | $2,155.00 | — | 243% above | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI w/wo Scout+Delay,Single Cont | $2,155.00 | $2,155.00 | — | 243% above | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 zzXR Upper GI w/o contrast KUB | $2,155.00 | $2,155.00 | — | 243% above | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UGI w/wo Scout+Delay, Gastrograph | $2,155.00 | $2,155.00 | — | — | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 zzXR Upper GI w/o contrast KUB | $2,155.00 | $2,155.00 | — | — | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UGI w/wo Scout+Delay,Single Cont | $2,155.00 | $2,155.00 | — | — | — |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus 1 view Right | $1,066.00 | $1,066.00 | — | 285% above | — |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Left | $1,066.00 | $1,066.00 | — | 285% above | — |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus 1 view Left | $1,066.00 | $1,066.00 | — | 285% above | — |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Min 2 Views Left | $1,066.00 | $1,066.00 | — | 285% above | — |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Right | $1,066.00 | $1,066.00 | — | 285% above | — |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Min 2 Views Right | $1,066.00 | $1,066.00 | — | 285% above | — |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Min 2 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus 1 view Left | $1,066.00 | $1,066.00 | — | — | — |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Min 2 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Right | $1,066.00 | $1,066.00 | — | — | — |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Left | $1,066.00 | $1,066.00 | — | — | — |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus 1 view Right | $1,066.00 | $1,066.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY VEIN STUDY | $1,287.00 | $1,287.00 | — | 101% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX DOPPLER VEIN UNI 1 ARM AND 1 LEG | $1,287.00 | $1,287.00 | — | 101% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX DOPPLER VEIN UNI 1 ARM OR 1 LEG | $1,287.00 | $1,287.00 | — | 101% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Doppler Reflux Study Right | $1,287.00 | $1,287.00 | — | 101% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Right | $1,287.00 | $1,287.00 | — | 101% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Left | $1,287.00 | $1,287.00 | — | 101% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CP LE Venous Doppler Reflux Study Left | $1,287.00 | $1,287.00 | — | 101% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CP LE Venous Mapping Veins Left | $1,287.00 | $1,287.00 | — | 101% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CP LE Venous Mapping Veins Right | $1,287.00 | $1,287.00 | — | 101% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Right | $1,287.00 | $1,287.00 | — | 101% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Left | $1,287.00 | $1,287.00 | — | 101% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 S LE Venous Doppler Reflux Study Left | $1,287.00 | $1,287.00 | — | 101% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX DOPPLER VEIN UNI 1 ARM OR 1 LEG | $1,287.00 | $1,287.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX DOPPLER VEIN UNI 1 ARM AND 1 LEG | $1,287.00 | $1,287.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 EXTREMITY VEIN STUDY | $1,287.00 | $1,287.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 S LE Venous Doppler Reflux Study Left | $1,287.00 | $1,287.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Doppler Reflux Study Right | $1,287.00 | $1,287.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Right | $1,287.00 | $1,287.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Left | $1,287.00 | $1,287.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Right | $1,287.00 | $1,287.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Left | $1,287.00 | $1,287.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CP LE Venous Mapping Veins Left | $1,287.00 | $1,287.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CP LE Venous Mapping Veins Right | $1,287.00 | $1,287.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CP LE Venous Doppler Reflux Study Left | $1,287.00 | $1,287.00 | — | — | — |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Left | $1,066.00 | $1,066.00 | — | 289% above | — |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Right | $1,066.00 | $1,066.00 | — | 289% above | — |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete w/ Navicular Left | $1,066.00 | $1,066.00 | — | 231% above | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete w/ Navicular Right | $1,066.00 | $1,066.00 | — | 231% above | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Left | $1,066.00 | $1,066.00 | — | 231% above | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Right | $1,066.00 | $1,066.00 | — | 231% above | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Min 3 Right | $1,066.00 | $1,066.00 | — | 231% above | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Min 3 Left | $1,066.00 | $1,066.00 | — | 231% above | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Min 3 Left | $1,066.00 | $1,066.00 | — | — | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Min 3 Right | $1,066.00 | $1,066.00 | — | — | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete w/ Navicular Right | $1,066.00 | $1,066.00 | — | — | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Right | $1,066.00 | $1,066.00 | — | — | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete w/ Navicular Left | $1,066.00 | $1,066.00 | — | — | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Left | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2 V wo AP Pelvis Left | $1,066.00 | $1,066.00 | — | 201% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2 V wo AP Pelvis Right | $1,066.00 | $1,066.00 | — | 201% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2 V w AP Pelvis Left | $1,066.00 | $1,066.00 | — | 201% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 1 V w AP Pelvis Right | $1,066.00 | $1,066.00 | — | 201% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2 V w AP Pelvis Right | $1,066.00 | $1,066.00 | — | 201% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 1 V w AP Pelvis Left | $1,066.00 | $1,066.00 | — | 201% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2 V wo AP Pelvis Right | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 1 V w AP Pelvis Left | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2 V w AP Pelvis Right | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 1 V w AP Pelvis Right | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2 V wo AP Pelvis Left | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2 V w AP Pelvis Left | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen AP | $1,066.00 | $1,066.00 | — | 281% above | — |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen AP | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left | $1,066.00 | $1,066.00 | — | 215% above | — |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right | $1,066.00 | $1,066.00 | — | 215% above | — |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) Left Min 2 Views | $1,066.00 | $1,066.00 | — | 341% above | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 zzXR Finger LT | $1,066.00 | $1,066.00 | — | 341% above | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 zzXR Finger 3rd Digit Right | $1,066.00 | $1,066.00 | — | 341% above | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) Right Min 2 Views | $1,066.00 | $1,066.00 | — | 341% above | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 zzXR Finger RT | $1,066.00 | $1,066.00 | — | 341% above | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 zzXR Finger RT | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 zzXR Finger 3rd Digit Right | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 zzXR Finger LT | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) Left Min 2 Views | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) Right Min 2 Views | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left | $1,066.00 | $1,066.00 | — | 228% above | — |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right | $1,066.00 | $1,066.00 | — | 228% above | — |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Min 3 Views Right | $1,066.00 | $1,066.00 | — | 192% above | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 zzXR Foot Complete Right | $1,066.00 | $1,066.00 | — | 192% above | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Left | $1,066.00 | $1,066.00 | — | 192% above | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Min 3 Views Left | $1,066.00 | $1,066.00 | — | 192% above | — |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Left | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 zzXR Foot Complete Right | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Min 3 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Min 3 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Left | $1,066.00 | $1,066.00 | — | 258% above | — |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Right | $1,066.00 | $1,066.00 | — | 258% above | — |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Min 3 Views Left | $1,066.00 | $1,066.00 | — | 258% above | — |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Min 3 Views Right | $1,066.00 | $1,066.00 | — | 258% above | — |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Right | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Left | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Min 3 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Min 3 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Zimmer Knee 1 or 2 views Right | $1,066.00 | $1,066.00 | — | 278% above | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Zimmer Knee 1 or 2 Views Left | $1,066.00 | $1,066.00 | — | 278% above | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Left | $1,066.00 | $1,066.00 | — | 278% above | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Right | $1,066.00 | $1,066.00 | — | 278% above | — |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Right | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Zimmer Knee 1 or 2 views Right | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Zimmer Knee 1 or 2 Views Left | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views | $1,287.00 | $1,287.00 | — | 253% above | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views | $1,287.00 | $1,287.00 | — | — | — |
| X-ray of the lower back, 4 or more views CPT 72110 OCCHLTH LS XRAY 4 VIEW | $213.00 | $213.00 | — | 53% below | — |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 Views | $1,287.00 | $1,287.00 | — | 184% above | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 OCCHLTH LS XRAY 4 VIEW | $213.00 | $213.00 | — | — | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 Views | $1,287.00 | $1,287.00 | — | — | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views | $1,287.00 | $1,287.00 | — | 252% above | — |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views | $1,287.00 | $1,287.00 | — | — | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Minimum 3 Views | $1,066.00 | $1,066.00 | — | 293% above | — |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Minimum 3 Views | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views | $1,066.00 | $1,066.00 | — | 221% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical Flexion + Extension | $1,066.00 | $1,066.00 | — | 221% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical Flexion + Extension | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views | $1,287.00 | $1,287.00 | — | 340% above | — |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views | $1,287.00 | $1,287.00 | — | — | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx Minimum 2 Views | $1,066.00 | $1,066.00 | — | 218% above | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum | $1,066.00 | $1,066.00 | — | 218% above | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx Minimum 2 Views | $1,066.00 | $1,066.00 | — | — | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum | $1,066.00 | $1,066.00 | — | — | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 Adrenocorticotropic Hormone-Quest | $454.00 | $454.00 | — | 104% above | — |
| ACTH blood test inpatient CPT 82024 Adrenocorticotropic Hormone-Quest | $454.00 | $454.00 | — | — | — |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT S/O | $62.00 | $62.00 | — | 70% above | — |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase | $62.00 | $62.00 | — | 70% above | — |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase | $62.00 | $62.00 | — | — | — |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT S/O | $62.00 | $62.00 | — | — | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase | $61.00 | $61.00 | — | 69% above | — |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase | $61.00 | $61.00 | — | — | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 AcuteHep | $560.00 | $560.00 | — | 81% above | — |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 AcuteHep | $560.00 | $560.00 | — | — | — |
| Albumin blood test CPT 82040 Albumin S/O Chrg Only | $58.00 | $58.00 | — | 81% above | — |
| Albumin blood test CPT 82040 Albumin Level | $58.00 | $58.00 | — | 81% above | — |
| Albumin blood test inpatient CPT 82040 Albumin Level | $58.00 | $58.00 | — | — | — |
| Albumin blood test inpatient CPT 82040 Albumin S/O Chrg Only | $58.00 | $58.00 | — | — | — |
| Aldosterone blood test CPT 82088 Aldosterone-Quest | $479.00 | $479.00 | — | 130% above | — |
| Aldosterone blood test CPT 82088 Aldosterone 24 Hour Urine-Quest | $479.00 | $479.00 | — | 130% above | — |
| Aldosterone blood test inpatient CPT 82088 Aldosterone 24 Hour Urine-Quest | $479.00 | $479.00 | — | — | — |
| Aldosterone blood test inpatient CPT 82088 Aldosterone-Quest | $479.00 | $479.00 | — | — | — |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase Bone-Quest | $61.00 | $61.00 | — | 68% above | — |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase | $61.00 | $61.00 | — | 68% above | — |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase Bone-Quest | $61.00 | $61.00 | — | — | — |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Oak-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile II | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 FOOD I | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Bermuda Grass-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Corn/Maize-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Dermatophag farinae-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Alternaria alternata-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Common Ragweed-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cinnamon-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cladosporium herbarum (Hormodendrum)-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Coconut-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Dermatophag pteronyssin-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Dog Dander-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Egg Mix(White & Yolk) IgE-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Brazilnut-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Carrot-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Banana-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Apple-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cat Dander-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Egg Yolk-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Egg White-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, White Bean-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rast Single Allergen - Chrg Only | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 zzAllergen Profile II-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Gluten IgE-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Helminthosporium halodes-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Hickory, White-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, House Dust-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, White Ash-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, English Plantain-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Lamb's Quarters-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Strawberry-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Soybean IgE-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Elm Tree-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Maple Tree (Box Elder)-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Paper Wasp-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Peanut IgE-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Potato-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pea-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pistachio-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Latex IgE-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Wheat-Quest | $61.00 | $61.00 | — | 89% above | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cladosporium herbarum (Hormodendrum)-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Dog Dander-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cat Dander-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Maple Tree (Box Elder)-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Egg Yolk-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Lamb's Quarters-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Coconut-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cinnamon-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Common Ragweed-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pistachio-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Egg White-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Oak-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, White Bean-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Wheat-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rast Single Allergen - Chrg Only | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Paper Wasp-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 zzAllergen Profile II-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, English Plantain-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Gluten IgE-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Peanut IgE-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Helminthosporium halodes-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Alternaria alternata-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pea-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Dermatophag farinae-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Corn/Maize-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Strawberry-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Hickory, White-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Potato-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, House Dust-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Bermuda Grass-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, White Ash-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD I | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profile II | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Egg Mix(White & Yolk) IgE-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Dermatophag pteronyssin-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Brazilnut-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Soybean IgE-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Carrot-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Latex IgE-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Banana-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Elm Tree-Quest | $61.00 | $61.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Apple-Quest | $61.00 | $61.00 | — | — | — |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpafetoprotein, Maternal | $197.00 | $197.00 | — | 79% above | — |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha-Fetoprotein Tumor Marker-Quest | $197.00 | $197.00 | — | 79% above | — |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha-Fetoprotein Maternal-Quest | $197.00 | $197.00 | — | 79% above | — |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha-Fetoprotein Tumor Marker-Quest | $197.00 | $197.00 | — | — | — |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpafetoprotein, Maternal | $197.00 | $197.00 | — | — | — |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha-Fetoprotein Maternal-Quest | $197.00 | $197.00 | — | — | — |
| Ammonia blood test CPT 82140 Ammonia Level | $171.00 | $171.00 | — | 88% above | — |
| Ammonia blood test CPT 82140 Ammonia 24HR Urine S/O Chrg Only | $171.00 | $171.00 | — | 88% above | — |
| Ammonia blood test inpatient CPT 82140 Ammonia 24HR Urine S/O Chrg Only | $171.00 | $171.00 | — | — | — |
| Ammonia blood test inpatient CPT 82140 Ammonia Level | $171.00 | $171.00 | — | — | — |
| Amylase blood test CPT 82150 Amylase PD Fluid | $76.00 | $76.00 | — | 74% above | — |
| Amylase blood test CPT 82150 Amylase Pleural Fluid | $76.00 | $76.00 | — | 74% above | — |
| Amylase blood test CPT 82150 Amylase Pericardial Fluid | $76.00 | $76.00 | — | 74% above | — |
| Amylase blood test CPT 82150 Amylase Isoenzymes S/O | $76.00 | $76.00 | — | 74% above | — |
| Amylase blood test CPT 82150 Amylase Level | $76.00 | $76.00 | — | 74% above | — |
| Amylase blood test CPT 82150 Amylase Peritoneal Fluid | $76.00 | $76.00 | — | 74% above | — |
| Amylase blood test CPT 82150 Amylase Synovial Fluid | $76.00 | $76.00 | — | 74% above | — |
| Amylase blood test CPT 82150 Amylase S/O | $76.00 | $76.00 | — | 74% above | — |
| Amylase blood test CPT 82150 Amylase Other Body Fluid | $76.00 | $76.00 | — | 74% above | — |
| Amylase blood test CPT 82150 Amylase Level 24 Hour Urine | $76.00 | $76.00 | — | 74% above | — |
| Amylase blood test CPT 82150 Amylase Isoenzymes Serum-Quest | $76.00 | $76.00 | — | 74% above | — |
| Amylase blood test inpatient CPT 82150 Amylase Isoenzymes S/O | $76.00 | $76.00 | — | — | — |
| Amylase blood test inpatient CPT 82150 Amylase Level 24 Hour Urine | $76.00 | $76.00 | — | — | — |
| Amylase blood test inpatient CPT 82150 Amylase Other Body Fluid | $76.00 | $76.00 | — | — | — |
| Amylase blood test inpatient CPT 82150 Amylase Pleural Fluid | $76.00 | $76.00 | — | — | — |
| Amylase blood test inpatient CPT 82150 Amylase S/O | $76.00 | $76.00 | — | — | — |
| Amylase blood test inpatient CPT 82150 Amylase PD Fluid | $76.00 | $76.00 | — | — | — |
| Amylase blood test inpatient CPT 82150 Amylase Peritoneal Fluid | $76.00 | $76.00 | — | — | — |
| Amylase blood test inpatient CPT 82150 Amylase Isoenzymes Serum-Quest | $76.00 | $76.00 | — | — | — |
| Amylase blood test inpatient CPT 82150 Amylase Pericardial Fluid | $76.00 | $76.00 | — | — | — |
| Amylase blood test inpatient CPT 82150 Amylase Synovial Fluid | $76.00 | $76.00 | — | — | — |
| Amylase blood test inpatient CPT 82150 Amylase Level | $76.00 | $76.00 | — | — | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Transfusion Service Tagging, PLT IRL | $152.00 | $152.00 | — | 78% above | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrulline Peptide IgG-Quest | $152.00 | $152.00 | — | 78% above | — |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrulline Peptide IgG-Quest | $152.00 | $152.00 | — | — | — |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Transfusion Service Tagging, PLT IRL | $152.00 | $152.00 | — | — | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody Screen w/Rfx-Quest | $142.00 | $142.00 | — | 91% above | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody | $142.00 | $142.00 | — | 91% above | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibody Screen w/Rfx-Quest | $142.00 | $142.00 | — | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibody | $142.00 | $142.00 | — | — | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 iSTAT B-Type Natriuretic Peptide | $461.00 | $461.00 | — | 131% above | — |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 iSTAT B-Type Natriuretic Peptide | $461.00 | $461.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 RHC CULTURE OTHR SPECIMN AEROBIC | $23.00 | $23.00 | — | 56% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture | $84.00 | $84.00 | — | 61% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture | $84.00 | $84.00 | — | 61% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Tissue Culture | $84.00 | $84.00 | — | 61% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Miscellaneous Culture | $84.00 | $84.00 | — | 61% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasal Culture | $84.00 | $84.00 | — | 61% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Vaginal/Cervical Culture | $84.00 | $84.00 | — | 61% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Respiratory Culture | $84.00 | $84.00 | — | 61% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture | $84.00 | $84.00 | — | 61% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture | $84.00 | $84.00 | — | 61% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Eye Culture | $84.00 | $84.00 | — | 61% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Ear Culture | $84.00 | $84.00 | — | 61% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Wound Culture | $84.00 | $84.00 | — | 61% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cerebrospinal Fluid Culture | $84.00 | $84.00 | — | 61% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Catheter Culture | $84.00 | $84.00 | — | 61% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 RHC CULTURE OTHR SPECIMN AEROBIC | $23.00 | $23.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Wound Culture | $84.00 | $84.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture | $84.00 | $84.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Eye Culture | $84.00 | $84.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Ear Culture | $84.00 | $84.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Cerebrospinal Fluid Culture | $84.00 | $84.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Catheter Culture | $84.00 | $84.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture | $84.00 | $84.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nasal Culture | $84.00 | $84.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Miscellaneous Culture | $84.00 | $84.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Tissue Culture | $84.00 | $84.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture | $84.00 | $84.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Respiratory Culture | $84.00 | $84.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture | $84.00 | $84.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Vaginal/Cervical Culture | $84.00 | $84.00 | — | — | — |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $99.00 | $99.00 | — | 35% above | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $99.00 | $99.00 | — | — | — |
| Bilirubin blood test, total CPT 82247 Bilirubin Other Body Fluid | $59.00 | $59.00 | — | 84% above | — |
| Bilirubin blood test, total CPT 82247 Bilirubin Total S/O | $59.00 | $59.00 | — | 84% above | — |
| Bilirubin blood test, total CPT 82247 Bilirubin PD Fluid | $59.00 | $59.00 | — | 84% above | — |
| Bilirubin blood test, total CPT 82247 Bilirubin Pericardial Fluid | $59.00 | $59.00 | — | 84% above | — |
| Bilirubin blood test, total CPT 82247 Bilirubin Peritoneal Fluid | $59.00 | $59.00 | — | 84% above | — |
| Bilirubin blood test, total CPT 82247 Bilirubin Pleural Fluid | $59.00 | $59.00 | — | 84% above | — |
| Bilirubin blood test, total CPT 82247 Bilirubin Synovial Fluid | $59.00 | $59.00 | — | 84% above | — |
| Bilirubin blood test, total CPT 82247 Bilirubin Total | $59.00 | $59.00 | — | 84% above | — |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin PD Fluid | $59.00 | $59.00 | — | — | — |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Other Body Fluid | $59.00 | $59.00 | — | — | — |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Peritoneal Fluid | $59.00 | $59.00 | — | — | — |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total | $59.00 | $59.00 | — | — | — |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Pleural Fluid | $59.00 | $59.00 | — | — | — |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Pericardial Fluid | $59.00 | $59.00 | — | — | — |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Synovial Fluid | $59.00 | $59.00 | — | — | — |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total S/O | $59.00 | $59.00 | — | — | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexity | $647.00 | $647.00 | — | 265% above | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 TC ONLY AP Bill Surgical Pathology Level IV Complexity | $647.00 | $647.00 | — | 265% above | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexity | $647.00 | $647.00 | — | — | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 TC ONLY AP Bill Surgical Pathology Level IV Complexity | $647.00 | $647.00 | — | — | — |
| Blood culture for bacteria CPT 87040 Blood Culture | $121.00 | $121.00 | — | 43% above | — |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture | $121.00 | $121.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 OCCHLTH BLOOD DRAW | $15.00 | $15.00 | — | at median | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 EBO Blood Draw | $15.50 | $15.50 | — | 3% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNTURE SPECIMEN COLLECTION | $26.00 | $26.00 | — | 73% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 RHC VENIPUNTURE SPECIMEN COLLECTION | $26.00 | $26.00 | — | 73% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 SCOLL | $26.00 | $26.00 | — | 73% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw | $26.00 | $26.00 | — | 73% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Drawn - Sendout | $26.00 | $26.00 | — | 73% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection Fee | $26.00 | $26.00 | — | 73% above | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 OCCHLTH BLOOD DRAW | $15.00 | $15.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 EBO Blood Draw | $15.50 | $15.50 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood Drawn - Sendout | $26.00 | $26.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw | $26.00 | $26.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 RHC VENIPUNTURE SPECIMEN COLLECTION | $26.00 | $26.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collection Fee | $26.00 | $26.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNTURE SPECIMEN COLLECTION | $26.00 | $26.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 SCOLL | $26.00 | $26.00 | — | — | — |
| Blood glucose (sugar) test CPT 82947 Glucose Arterial | $46.00 | $46.00 | — | 78% above | — |
| Blood glucose (sugar) test CPT 82947 Glucose | $46.00 | $46.00 | — | 78% above | — |
| Blood glucose (sugar) test CPT 82947 Glucose Level | $46.00 | $46.00 | — | 78% above | — |
| Blood glucose (sugar) test CPT 82947 GLUCOSE ARTERIAL RESP | $46.00 | $46.00 | — | 78% above | — |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE ARTERIAL RESP | $46.00 | $46.00 | — | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose | $46.00 | $46.00 | — | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Arterial | $46.00 | $46.00 | — | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Level | $46.00 | $46.00 | — | — | — |
| Blood lead test CPT 83655 RHC ASSAY OF LEAD | $78.00 | $78.00 | — | at median | — |
| Blood lead test CPT 83655 Lead Level, Capillary-Quest | $142.00 | $142.00 | — | 82% above | — |
| Blood lead test CPT 83655 Lead Level-Quest | $142.00 | $142.00 | — | 82% above | — |
| Blood lead test CPT 83655 Lead | $142.00 | $142.00 | — | 82% above | — |
| Blood lead test inpatient CPT 83655 RHC ASSAY OF LEAD | $78.00 | $78.00 | — | — | — |
| Blood lead test inpatient CPT 83655 Lead Level, Capillary-Quest | $142.00 | $142.00 | — | — | — |
| Blood lead test inpatient CPT 83655 Lead | $142.00 | $142.00 | — | — | — |
| Blood lead test inpatient CPT 83655 Lead Level-Quest | $142.00 | $142.00 | — | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 RHC PREGNANCY TEST SERUM | $91.00 | $91.00 | — | 82% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM | $98.00 | $98.00 | — | 96% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Positive | $98.00 | $98.00 | — | 96% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Negative | $98.00 | $98.00 | — | 96% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Preg Qual | $98.00 | $98.00 | — | 96% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 RHC PREGNANCY TEST SERUM | $91.00 | $91.00 | — | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Preg Qual | $98.00 | $98.00 | — | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Negative | $98.00 | $98.00 | — | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST SERUM | $98.00 | $98.00 | — | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Positive | $98.00 | $98.00 | — | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO Only | $297.00 | $297.00 | — | 123% above | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO Only | $297.00 | $297.00 | — | — | — |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Pericardial Fluid | $46.00 | $46.00 | — | 70% above | — |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Other Body Fluid | $46.00 | $46.00 | — | 70% above | — |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Synovial Fluid | $46.00 | $46.00 | — | 70% above | — |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen PD Fluid | $46.00 | $46.00 | — | 70% above | — |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Peritoneal Fluid | $46.00 | $46.00 | — | 70% above | — |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Blood | $46.00 | $46.00 | — | 70% above | — |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Pleural Fluid | $46.00 | $46.00 | — | 70% above | — |
| Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen | $46.00 | $46.00 | — | 70% above | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Blood | $46.00 | $46.00 | — | — | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen PD Fluid | $46.00 | $46.00 | — | — | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen | $46.00 | $46.00 | — | — | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Pericardial Fluid | $46.00 | $46.00 | — | — | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Other Body Fluid | $46.00 | $46.00 | — | — | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Synovial Fluid | $46.00 | $46.00 | — | — | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Pleural Fluid | $46.00 | $46.00 | — | — | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Peritoneal Fluid | $46.00 | $46.00 | — | — | — |
| C-peptide blood test CPT 84681 C-Peptide-Quest | $245.00 | $245.00 | — | 126% above | — |
| C-peptide blood test inpatient CPT 84681 C-Peptide-Quest | $245.00 | $245.00 | — | — | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein | $61.00 | $61.00 | — | 71% above | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein | $61.00 | $61.00 | — | — | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 CDiff Toxin DNA Probe | $438.00 | $438.00 | — | 111% above | — |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CDiff Toxin DNA Probe | $438.00 | $438.00 | — | — | — |
| CA 19-9 blood test (tumor marker) CPT 86301 Cancer Antigen 19-9-Quest | $245.00 | $245.00 | — | 84% above | — |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $245.00 | $245.00 | — | 84% above | — |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 | $245.00 | $245.00 | — | — | — |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 Cancer Antigen 19-9-Quest | $245.00 | $245.00 | — | — | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 | $245.00 | $245.00 | — | 87% above | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 | $245.00 | $245.00 | — | 87% above | — |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 | $245.00 | $245.00 | — | — | — |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen 125 | $245.00 | $245.00 | — | — | — |
| Calcium blood test, total CPT 82310 Calcium Level Total | $61.00 | $61.00 | — | 82% above | — |
| Calcium blood test, total CPT 82310 Calcium Serum | $61.00 | $61.00 | — | 82% above | — |
| Calcium blood test, total CPT 82310 Calcium Level Urine | $61.00 | $61.00 | — | 82% above | — |
| Calcium blood test, total inpatient CPT 82310 Calcium Serum | $61.00 | $61.00 | — | — | — |
| Calcium blood test, total inpatient CPT 82310 Calcium Level Total | $61.00 | $61.00 | — | — | — |
| Calcium blood test, total inpatient CPT 82310 Calcium Level Urine | $61.00 | $61.00 | — | — | — |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen | $223.00 | $223.00 | — | 88% above | — |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA Pericardial Fluid-Quest | $223.00 | $223.00 | — | 88% above | — |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA Pleural Fluid-Quest | $223.00 | $223.00 | — | 88% above | — |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA Peritoneal Fluid-Quest | $223.00 | $223.00 | — | 88% above | — |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA Pericardial Fluid-Quest | $223.00 | $223.00 | — | — | — |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen | $223.00 | $223.00 | — | — | — |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA Pleural Fluid-Quest | $223.00 | $223.00 | — | — | — |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA Peritoneal Fluid-Quest | $223.00 | $223.00 | — | — | — |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster AB IGG | $151.00 | $151.00 | — | 78% above | — |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Antibody IgG-Quest | $151.00 | $151.00 | — | 78% above | — |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Antibody IgM-Quest | $151.00 | $151.00 | — | 78% above | — |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster AB IGM | $151.00 | $151.00 | — | 78% above | — |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster AB IGM | $151.00 | $151.00 | — | — | — |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster AB IGG | $151.00 | $151.00 | — | — | — |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Antibody IgG-Quest | $151.00 | $151.00 | — | — | — |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Antibody IgM-Quest | $151.00 | $151.00 | — | — | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C Trachomatis Amp Probe Chrg Only | $412.00 | $412.00 | — | 110% above | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C.trachomatis Amp Probe Chrg Only | $412.00 | $412.00 | — | 110% above | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C Trachomatis Amp Probe Chrg Only | $412.00 | $412.00 | — | — | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C.trachomatis Amp Probe Chrg Only | $412.00 | $412.00 | — | — | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel w/Rfx LDL Direct-Quest | $157.00 | $157.00 | — | 76% above | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $157.00 | $157.00 | — | 76% above | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $157.00 | $157.00 | — | — | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel w/Rfx LDL Direct-Quest | $157.00 | $157.00 | — | — | — |
| Complete blood count (CBC) with differential CPT 85025 CBC w/ Auto Diff | $91.00 | $91.00 | — | 78% above | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Auto Diff | $91.00 | $91.00 | — | — | — |
| Complete blood count (CBC), no differential CPT 85027 Hemogram | $76.00 | $76.00 | — | 76% above | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 Hemogram | $76.00 | $76.00 | — | — | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $124.00 | $124.00 | — | 40% above | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $124.00 | $124.00 | — | — | — |
| Cortisol blood test, total CPT 82533 .Cortisol 60 Minutes | $192.00 | $192.00 | — | 86% above | — |
| Cortisol blood test, total CPT 82533 .Cortisol Post Dexamethasone | $192.00 | $192.00 | — | 86% above | — |
| Cortisol blood test, total CPT 82533 Cortisol | $192.00 | $192.00 | — | 86% above | — |
| Cortisol blood test, total CPT 82533 Cortisol, Total | $192.00 | $192.00 | — | 86% above | — |
| Cortisol blood test, total CPT 82533 .Cortisol Baseline | $192.00 | $192.00 | — | 86% above | — |
| Cortisol blood test, total inpatient CPT 82533 .Cortisol Baseline | $192.00 | $192.00 | — | — | — |
| Cortisol blood test, total inpatient CPT 82533 .Cortisol 60 Minutes | $192.00 | $192.00 | — | — | — |
| Cortisol blood test, total inpatient CPT 82533 .Cortisol Post Dexamethasone | $192.00 | $192.00 | — | — | — |
| Cortisol blood test, total inpatient CPT 82533 Cortisol | $192.00 | $192.00 | — | — | — |
| Cortisol blood test, total inpatient CPT 82533 Cortisol, Total | $192.00 | $192.00 | — | — | — |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase | $76.00 | $76.00 | — | 69% above | — |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase | $76.00 | $76.00 | — | — | — |
| Creatinine blood test CPT 82565 Creatinine Serum | $60.00 | $60.00 | — | 78% above | — |
| Creatinine blood test CPT 82565 Creatinine | $60.00 | $60.00 | — | 78% above | — |
| Creatinine blood test inpatient CPT 82565 Creatinine | $60.00 | $60.00 | — | — | — |
| Creatinine blood test inpatient CPT 82565 Creatinine Serum | $60.00 | $60.00 | — | — | — |
| Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus IgG Antibody-Quest | $169.00 | $169.00 | — | 95% above | — |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV Profile (IGG/IGM) | $169.00 | $169.00 | — | 95% above | — |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV Antibody Testing | $169.00 | $169.00 | — | 95% above | — |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV Profile (IGG/IGM) | $169.00 | $169.00 | — | — | — |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV Antibody Testing | $169.00 | $169.00 | — | — | — |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus IgG Antibody-Quest | $169.00 | $169.00 | — | — | — |
| D-dimer blood test (blood clot marker) CPT 85379 D-Dimer | $120.00 | $120.00 | — | 75% above | — |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer | $120.00 | $120.00 | — | — | — |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate-Quest | $261.00 | $261.00 | — | 94% above | — |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone Sulfate-Quest | $261.00 | $261.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen QL Chrom Ea Proc | $730.00 | $730.00 | — | 301% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Heroin Metabolite Urine-Quest | $730.00 | $730.00 | — | 301% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen, Comp., Blood/Urine | $730.00 | $730.00 | — | 301% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Gamma Hydroxybutyric Acid-Quest | $730.00 | $730.00 | — | 301% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine 10 Drug Screen | $730.00 | $730.00 | — | 301% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Oxycodone Screen and Confirmation Urine-Quest | $730.00 | $730.00 | — | 301% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Ethanol Level Urine-Quest | $730.00 | $730.00 | — | 301% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen, Ea Class Chrg Only | $730.00 | $730.00 | — | 301% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Panel (Serum)-Quest | $730.00 | $730.00 | — | 301% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen, Comp., Blood | $730.00 | $730.00 | — | 301% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Urine In House | $730.00 | $730.00 | — | 301% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Cord Stat Xylazine | $730.00 | $730.00 | — | 301% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Diuretics Screen Urine-ACL | $730.00 | $730.00 | — | 301% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Buprenorphine Urine Scr/Conf-Quest | $730.00 | $730.00 | — | 301% above | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Urine 10 Drug Screen | $730.00 | $730.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen QL Chrom Ea Proc | $730.00 | $730.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cord Stat Xylazine | $730.00 | $730.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Urine In House | $730.00 | $730.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen, Comp., Blood | $730.00 | $730.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen, Comp., Blood/Urine | $730.00 | $730.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Heroin Metabolite Urine-Quest | $730.00 | $730.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Buprenorphine Urine Scr/Conf-Quest | $730.00 | $730.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Diuretics Screen Urine-ACL | $730.00 | $730.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Abuse Panel (Serum)-Quest | $730.00 | $730.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen, Ea Class Chrg Only | $730.00 | $730.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Ethanol Level Urine-Quest | $730.00 | $730.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Oxycodone Screen and Confirmation Urine-Quest | $730.00 | $730.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Gamma Hydroxybutyric Acid-Quest | $730.00 | $730.00 | — | — | — |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolytes Serum | $93.00 | $93.00 | — | 76% above | — |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel | $93.00 | $93.00 | — | 76% above | — |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel | $93.00 | $93.00 | — | — | — |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolytes Serum | $93.00 | $93.00 | — | — | — |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Virus Capsid IgM-Quest | $213.00 | $213.00 | — | 86% above | — |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Virus Capsid IgG-Quest | $213.00 | $213.00 | — | 86% above | — |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EB Virus Viral Capsid & IGG Capsi | $213.00 | $213.00 | — | 86% above | — |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Virus Capsid IgG-Quest | $213.00 | $213.00 | — | — | — |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Virus Capsid IgM-Quest | $213.00 | $213.00 | — | — | — |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EB Virus Viral Capsid & IGG Capsi | $213.00 | $213.00 | — | — | — |
| Estradiol blood test CPT 82670 Estradiol Level | $328.00 | $328.00 | — | 97% above | — |
| Estradiol blood test inpatient CPT 82670 Estradiol Level | $328.00 | $328.00 | — | — | — |
| FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone | $218.00 | $218.00 | — | 83% above | — |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone | $218.00 | $218.00 | — | — | — |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin,Stool-Quest | $231.00 | $231.00 | — | 79% above | — |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin,Stool-Quest | $231.00 | $231.00 | — | — | — |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $160.00 | $160.00 | — | 85% above | — |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin | $160.00 | $160.00 | — | — | — |
| Fibrinogen blood test CPT 85384 Fibrinogen Activity | $114.00 | $114.00 | — | 72% above | — |
| Fibrinogen blood test CPT 85384 Fibrinogen Level | $114.00 | $114.00 | — | 72% above | — |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen Level | $114.00 | $114.00 | — | — | — |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen Activity | $114.00 | $114.00 | — | — | — |
| Folate (folic acid) blood test CPT 82746 Folate Level | $97.00 | $97.00 | — | 12% above | — |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Level | $97.00 | $97.00 | — | — | — |
| Free T3 thyroid hormone test CPT 84481 T3 Free | $199.00 | $199.00 | — | 86% above | — |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 Free | $199.00 | $199.00 | — | — | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free | $143.00 | $143.00 | — | 138% above | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Free Direct Dialysis-Quest | $143.00 | $143.00 | — | 138% above | — |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 Free Direct Dialysis-Quest | $143.00 | $143.00 | — | — | — |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine Free | $143.00 | $143.00 | — | — | — |
| Free testosterone test CPT 84402 Testosterone Free-Quest | $299.00 | $299.00 | — | 87% above | — |
| Free testosterone test CPT 84402 Testosterone Free | $299.00 | $299.00 | — | 87% above | — |
| Free testosterone test inpatient CPT 84402 Testosterone Free-Quest | $299.00 | $299.00 | — | — | — |
| Free testosterone test inpatient CPT 84402 Testosterone Free | $299.00 | $299.00 | — | — | — |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT S/O | $85.00 | $85.00 | — | 79% above | — |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase | $85.00 | $85.00 | — | 79% above | — |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT S/O | $85.00 | $85.00 | — | — | — |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase | $85.00 | $85.00 | — | — | — |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $318.00 | $318.00 | — | 68% above | — |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 Complete Blood Count w/ Differential | $318.00 | $318.00 | — | 68% above | — |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 Complete Blood Count w/ Differential | $318.00 | $318.00 | — | — | — |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL | $318.00 | $318.00 | — | — | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 1 Hr After Glucose | $56.00 | $56.00 | — | 51% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hour Post Prandial | $56.00 | $56.00 | — | 51% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 1 Hr After Glucose | $56.00 | $56.00 | — | — | — |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 Hour Post Prandial | $56.00 | $56.00 | — | — | — |
| Glucose tolerance test, 3 samples CPT 82951 .Glucose 5 Hour | $151.00 | $151.00 | — | 86% above | — |
| Glucose tolerance test, 3 samples CPT 82951 .Glucose 3 Hour | $151.00 | $151.00 | — | 86% above | — |
| Glucose tolerance test, 3 samples CPT 82951 .Glucose 4 Hour | $151.00 | $151.00 | — | 86% above | — |
| Glucose tolerance test, 3 samples CPT 82951 .Glucose 2 Hour | $151.00 | $151.00 | — | 86% above | — |
| Glucose tolerance test, 3 samples CPT 82951 .Glucose 90 Minutes | $151.00 | $151.00 | — | 86% above | — |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance Test - 3 Spec | $151.00 | $151.00 | — | 86% above | — |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .Glucose 5 Hour | $151.00 | $151.00 | — | — | — |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .Glucose 2 Hour | $151.00 | $151.00 | — | — | — |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance Test - 3 Spec | $151.00 | $151.00 | — | — | — |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .Glucose 90 Minutes | $151.00 | $151.00 | — | — | — |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .Glucose 4 Hour | $151.00 | $151.00 | — | — | — |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .Glucose 3 Hour | $151.00 | $151.00 | — | — | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.gonorrhoeae Amp Probe Chrg Only | $412.00 | $412.00 | — | 124% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N Gonorrhoeae Amp Probe Chrg Only | $412.00 | $412.00 | — | 124% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N Gonorrhoeae Amp Probe Chrg Only | $412.00 | $412.00 | — | — | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.gonorrhoeae Amp Probe Chrg Only | $412.00 | $412.00 | — | — | — |
| H. pylori antibody blood test CPT 86677 zzHelicobacter pylori Antibody IgG | $198.00 | $198.00 | — | 71% above | — |
| H. pylori antibody blood test inpatient CPT 86677 zzHelicobacter pylori Antibody IgG | $198.00 | $198.00 | — | — | — |
| H. pylori stool antigen test CPT 87338 Helicobacter pylori Ag Ql Stool-Quest | $169.00 | $169.00 | — | 75% above | — |
| H. pylori stool antigen test inpatient CPT 87338 Helicobacter pylori Ag Ql Stool-Quest | $169.00 | $169.00 | — | — | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA PCR Quantitative-Quest | $1,000.00 | $1,000.00 | — | 102% above | — |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 RNA PCR Quantitative-Quest | $1,000.00 | $1,000.00 | — | — | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 .HIV 1/2 Ag/Ab, 4th Generation-Quest | $283.00 | $283.00 | — | 100% above | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 Ag/Ab Screen | $283.00 | $283.00 | — | 100% above | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 Ag/Ab Screen | $283.00 | $283.00 | — | — | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 .HIV 1/2 Ag/Ab, 4th Generation-Quest | $283.00 | $283.00 | — | — | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Papillomavirus Human Amplified Probe | $412.00 | $412.00 | — | 98% above | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV MRNA E6/E7-Quest | $412.00 | $412.00 | — | 98% above | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV Screen-Quest | $412.00 | $412.00 | — | 98% above | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV-ACL | $412.00 | $412.00 | — | 98% above | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Human Papillomavirus Detection | $412.00 | $412.00 | — | 98% above | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Reflex HPV-ACL | $412.00 | $412.00 | — | 98% above | — |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV Screen-Quest | $412.00 | $412.00 | — | — | — |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV-ACL | $412.00 | $412.00 | — | — | — |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Papillomavirus Human Amplified Probe | $412.00 | $412.00 | — | — | — |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Human Papillomavirus Detection | $412.00 | $412.00 | — | — | — |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV MRNA E6/E7-Quest | $412.00 | $412.00 | — | — | — |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Reflex HPV-ACL | $412.00 | $412.00 | — | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 RHC A1c | $45.00 | $45.00 | — | 12% below | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 A1c | $45.00 | $45.00 | — | 12% below | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C | $114.00 | $114.00 | — | 124% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 RHC A1c | $45.00 | $45.00 | — | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 A1c | $45.00 | $45.00 | — | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C | $114.00 | $114.00 | — | — | — |
| Hemoglobin blood test CPT 85018 RHC HGB | $20.00 | $20.00 | — | 17% above | — |
| Hemoglobin blood test CPT 85018 HGB | $28.00 | $28.00 | — | 63% above | — |
| Hemoglobin blood test CPT 85018 Hemoglobin | $28.00 | $28.00 | — | 63% above | — |
| Hemoglobin blood test CPT 85018 Hemoglobin SO | $28.00 | $28.00 | — | 63% above | — |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN RESP | $28.00 | $28.00 | — | 63% above | — |
| Hemoglobin blood test CPT 85018 OB Resp H/H | $28.00 | $28.00 | — | 63% above | — |
| Hemoglobin blood test inpatient CPT 85018 RHC HGB | $20.00 | $20.00 | — | — | — |
| Hemoglobin blood test inpatient CPT 85018 HGB | $28.00 | $28.00 | — | — | — |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin SO | $28.00 | $28.00 | — | — | — |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin | $28.00 | $28.00 | — | — | — |
| Hemoglobin blood test inpatient CPT 85018 OB Resp H/H | $28.00 | $28.00 | — | — | — |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN RESP | $28.00 | $28.00 | — | — | — |
| Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Total | $142.00 | $142.00 | — | 68% above | — |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Total | $142.00 | $142.00 | — | — | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab | $126.00 | $126.00 | — | 72% above | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody Titer-Quest | $126.00 | $126.00 | — | 72% above | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody Titer-Quest | $126.00 | $126.00 | — | — | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab | $126.00 | $126.00 | — | — | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 .Hepatitis B Surface Antigen-Quest | $121.00 | $121.00 | — | 74% above | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B SAg | $121.00 | $121.00 | — | 74% above | — |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 .Hepatitis B Surface Antigen-Quest | $121.00 | $121.00 | — | — | — |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep B SAg | $121.00 | $121.00 | — | — | — |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody wRfx HCV RNA | $168.00 | $168.00 | — | 69% above | — |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody wRfx HCV RNA | $168.00 | $168.00 | — | — | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C RNA PCR Quantitative-Quest | $503.00 | $503.00 | — | 77% above | — |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C RNA PCR Quantitative-Quest | $503.00 | $503.00 | — | — | — |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex I IGG AB | $155.00 | $155.00 | — | 94% above | — |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex I IGM AB | $155.00 | $155.00 | — | 94% above | — |
| Herpes blood test, HSV-1 antibody CPT 86695 .HSV 1 IgM Titer-Quest | $155.00 | $155.00 | — | 94% above | — |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex I IGG AB | $155.00 | $155.00 | — | — | — |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 .HSV 1 IgM Titer-Quest | $155.00 | $155.00 | — | — | — |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex I IGM AB | $155.00 | $155.00 | — | — | — |
| Herpes blood test, HSV-2 antibody CPT 86696 .HSV 2 IgG Inhibition-Quest | $227.00 | $227.00 | — | 111% above | — |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IgG, Herpeselect w/Rfx-Quest | $227.00 | $227.00 | — | 111% above | — |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex II IGG AB | $227.00 | $227.00 | — | 111% above | — |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex II IGM AB | $227.00 | $227.00 | — | 111% above | — |
| Herpes blood test, HSV-2 antibody CPT 86696 .HSV 2 IgM Titer-Quest | $227.00 | $227.00 | — | 111% above | — |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IgG, Herpeselect w/Rfx-Quest | $227.00 | $227.00 | — | — | — |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 .HSV 2 IgM Titer-Quest | $227.00 | $227.00 | — | — | — |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex II IGM AB | $227.00 | $227.00 | — | — | — |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex II IGG AB | $227.00 | $227.00 | — | — | — |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 .HSV 2 IgG Inhibition-Quest | $227.00 | $227.00 | — | — | — |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein High Sensitivity-Quest | $152.00 | $152.00 | — | 93% above | — |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein High Sensitivity-Quest | $152.00 | $152.00 | — | — | — |
| Homocysteine blood test CPT 83090 Homocysteine (Cardiovascular)-Quest | $211.00 | $211.00 | — | 76% above | — |
| Homocysteine blood test CPT 83090 Homocysteine | $211.00 | $211.00 | — | 76% above | — |
| Homocysteine blood test CPT 83090 Homocystine - Serum | $211.00 | $211.00 | — | 76% above | — |
| Homocysteine blood test inpatient CPT 83090 Homocysteine | $211.00 | $211.00 | — | — | — |
| Homocysteine blood test inpatient CPT 83090 Homocysteine (Cardiovascular)-Quest | $211.00 | $211.00 | — | — | — |
| Homocysteine blood test inpatient CPT 83090 Homocystine - Serum | $211.00 | $211.00 | — | — | — |
| Insulin blood test CPT 83525 .Insulin Tol Spec 8 | $84.00 | $84.00 | — | 16% above | — |
| Insulin blood test CPT 83525 .Insulin Tol Spec 7 | $134.00 | $134.00 | — | 85% above | — |
| Insulin blood test CPT 83525 .Insulin Tol Spec 3 | $134.00 | $134.00 | — | 85% above | — |
| Insulin blood test CPT 83525 .Insulin Tol Spec 4 | $134.00 | $134.00 | — | 85% above | — |
| Insulin blood test CPT 83525 .Insulin Tol Spec 5 | $134.00 | $134.00 | — | 85% above | — |
| Insulin blood test CPT 83525 .Insulin Tol Fasting | $134.00 | $134.00 | — | 85% above | — |
| Insulin blood test CPT 83525 .Insulin Tol Spec 6 | $134.00 | $134.00 | — | 85% above | — |
| Insulin blood test CPT 83525 .Insulin Tol Spec 9 | $134.00 | $134.00 | — | 85% above | — |
| Insulin blood test CPT 83525 Insulin Level Total | $134.00 | $134.00 | — | 85% above | — |
| Insulin blood test CPT 83525 .Insulin Tol Spec 2 | $134.00 | $134.00 | — | 85% above | — |
| Insulin blood test inpatient CPT 83525 .Insulin Tol Spec 8 | $84.00 | $84.00 | — | — | — |
| Insulin blood test inpatient CPT 83525 .Insulin Tol Spec 4 | $134.00 | $134.00 | — | — | — |
| Insulin blood test inpatient CPT 83525 .Insulin Tol Spec 5 | $134.00 | $134.00 | — | — | — |
| Insulin blood test inpatient CPT 83525 .Insulin Tol Fasting | $134.00 | $134.00 | — | — | — |
| Insulin blood test inpatient CPT 83525 .Insulin Tol Spec 7 | $134.00 | $134.00 | — | — | — |
| Insulin blood test inpatient CPT 83525 .Insulin Tol Spec 6 | $134.00 | $134.00 | — | — | — |
| Insulin blood test inpatient CPT 83525 .Insulin Tol Spec 9 | $134.00 | $134.00 | — | — | — |
| Insulin blood test inpatient CPT 83525 Insulin Level Total | $134.00 | $134.00 | — | — | — |
| Insulin blood test inpatient CPT 83525 .Insulin Tol Spec 2 | $134.00 | $134.00 | — | — | — |
| Insulin blood test inpatient CPT 83525 .Insulin Tol Spec 3 | $134.00 | $134.00 | — | — | — |
| Iron blood test (serum iron) CPT 83540 Iron Level Total | $76.00 | $76.00 | — | 67% above | — |
| Iron blood test (serum iron) CPT 83540 Iron Total Serum | $76.00 | $76.00 | — | 67% above | — |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Level Total | $76.00 | $76.00 | — | — | — |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Total Serum | $76.00 | $76.00 | — | — | — |
| Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity Total | $103.00 | $103.00 | — | 72% above | — |
| Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity | $103.00 | $103.00 | — | 72% above | — |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity Total | $103.00 | $103.00 | — | — | — |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 Total Iron Binding Capacity | $103.00 | $103.00 | — | — | — |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $102.00 | $102.00 | — | 49% above | — |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $102.00 | $102.00 | — | — | — |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone | $218.00 | $218.00 | — | 83% above | — |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone | $218.00 | $218.00 | — | — | — |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid | $136.00 | $136.00 | — | 77% above | — |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID RESP | $136.00 | $136.00 | — | 77% above | — |
| Lactate (lactic acid) blood test CPT 83605 ED Lactate | $136.00 | $136.00 | — | 77% above | — |
| Lactate (lactic acid) blood test CPT 83605 Lactate Arterial | $136.00 | $136.00 | — | 77% above | — |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid | $136.00 | $136.00 | — | — | — |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID RESP | $136.00 | $136.00 | — | — | — |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactate Arterial | $136.00 | $136.00 | — | — | — |
| Lactate (lactic acid) blood test inpatient CPT 83605 ED Lactate | $136.00 | $136.00 | — | — | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Other Body Fluid | $43.00 | $43.00 | — | 17% above | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Pericardial Fluid | $43.00 | $43.00 | — | 17% above | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH PD Fluid | $43.00 | $43.00 | — | 17% above | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Peritoneal Fluid | $43.00 | $43.00 | — | 17% above | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Pleural Fluid | $43.00 | $43.00 | — | 17% above | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Synovial Fluid | $43.00 | $43.00 | — | 17% above | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase | $43.00 | $43.00 | — | 17% above | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Pericardial Fluid | $43.00 | $43.00 | — | — | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Peritoneal Fluid | $43.00 | $43.00 | — | — | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Pleural Fluid | $43.00 | $43.00 | — | — | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Synovial Fluid | $43.00 | $43.00 | — | — | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH PD Fluid | $43.00 | $43.00 | — | — | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase | $43.00 | $43.00 | — | — | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Other Body Fluid | $43.00 | $43.00 | — | — | — |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $55.00 | $55.00 | — | 17% above | — |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level | $55.00 | $55.00 | — | — | — |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $96.00 | $96.00 | — | 23% above | — |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $96.00 | $96.00 | — | — | — |
| Lyme disease antibody test CPT 86618 Lyme Disease Antibodies | $200.00 | $200.00 | — | 111% above | — |
| Lyme disease antibody test CPT 86618 Lyme IgG/M Screen w Rfx WB | $200.00 | $200.00 | — | 111% above | — |
| Lyme disease antibody test inpatient CPT 86618 Lyme IgG/M Screen w Rfx WB | $200.00 | $200.00 | — | — | — |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease Antibodies | $200.00 | $200.00 | — | — | — |
| Magnesium blood test CPT 83735 Magnesium-Quest | $79.00 | $79.00 | — | 90% above | — |
| Magnesium blood test CPT 83735 Magnesium 24HR Urine S/O Chrg | $79.00 | $79.00 | — | 90% above | — |
| Magnesium blood test CPT 83735 Magnesium Level Urine | $79.00 | $79.00 | — | 90% above | — |
| Magnesium blood test CPT 83735 Magnesium RBC-Quest | $79.00 | $79.00 | — | 90% above | — |
| Magnesium blood test CPT 83735 Magnesium Level | $79.00 | $79.00 | — | 90% above | — |
| Magnesium blood test CPT 83735 Magnesium Level 24 Hour Urine | $79.00 | $79.00 | — | 90% above | — |
| Magnesium blood test inpatient CPT 83735 Magnesium 24HR Urine S/O Chrg | $79.00 | $79.00 | — | — | — |
| Magnesium blood test inpatient CPT 83735 Magnesium RBC-Quest | $79.00 | $79.00 | — | — | — |
| Magnesium blood test inpatient CPT 83735 Magnesium-Quest | $79.00 | $79.00 | — | — | — |
| Magnesium blood test inpatient CPT 83735 Magnesium Level 24 Hour Urine | $79.00 | $79.00 | — | — | — |
| Magnesium blood test inpatient CPT 83735 Magnesium Level Urine | $79.00 | $79.00 | — | — | — |
| Magnesium blood test inpatient CPT 83735 Magnesium Level | $79.00 | $79.00 | — | — | — |
| Measles (rubeola) antibody test CPT 86765 Rubeola Ab IGG (measles) | $151.00 | $151.00 | — | 87% above | — |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibody IgG-Quest | $151.00 | $151.00 | — | 87% above | — |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibody IgM-Quest | $151.00 | $151.00 | — | 87% above | — |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibody IgM-Quest | $151.00 | $151.00 | — | — | — |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Ab IGG (measles) | $151.00 | $151.00 | — | — | — |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibody IgG-Quest | $151.00 | $151.00 | — | — | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 RHC MONOSPOT | $27.00 | $27.00 | — | 27% below | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONOSPOT | $62.00 | $62.00 | — | 67% above | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen | $62.00 | $62.00 | — | 67% above | — |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 RHC MONOSPOT | $27.00 | $27.00 | — | — | — |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen | $62.00 | $62.00 | — | — | — |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSPOT | $62.00 | $62.00 | — | — | — |
| Mumps immunity blood test CPT 86735 Mumps Antibody IgG-Quest | $153.00 | $153.00 | — | 88% above | — |
| Mumps immunity blood test CPT 86735 Mumps Antibody IgM-Quest | $153.00 | $153.00 | — | 88% above | — |
| Mumps immunity blood test CPT 86735 Mumps AB IGG | $153.00 | $153.00 | — | 88% above | — |
| Mumps immunity blood test inpatient CPT 86735 Mumps Antibody IgG-Quest | $153.00 | $153.00 | — | — | — |
| Mumps immunity blood test inpatient CPT 86735 Mumps Antibody IgM-Quest | $153.00 | $153.00 | — | — | — |
| Mumps immunity blood test inpatient CPT 86735 Mumps AB IGG | $153.00 | $153.00 | — | — | — |
| Obstetric blood test panel CPT 80055 Hepatitis B Surface Antigen wRfx Conf | $562.00 | $562.00 | — | 81% above | — |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $562.00 | $562.00 | — | 81% above | — |
| Obstetric blood test panel CPT 80055 Antibody Screen Gel | $562.00 | $562.00 | — | 81% above | — |
| Obstetric blood test panel inpatient CPT 80055 Antibody Screen Gel | $562.00 | $562.00 | — | — | — |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL | $562.00 | $562.00 | — | — | — |
| Obstetric blood test panel inpatient CPT 80055 Hepatitis B Surface Antigen wRfx Conf | $562.00 | $562.00 | — | — | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Free | $216.00 | $216.00 | — | 90% above | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Free | $216.00 | $216.00 | — | — | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Diagnostic | $216.00 | $216.00 | — | 97% above | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total | $216.00 | $216.00 | — | 97% above | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen Diagnostic | $216.00 | $216.00 | — | 97% above | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen Diagnostic | $216.00 | $216.00 | — | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total | $216.00 | $216.00 | — | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Diagnostic | $216.00 | $216.00 | — | — | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 SurePath Pap Diagnostic-ACL | $311.00 | $311.00 | — | 280% above | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 Prev Abn Pap - Reason for Pap | $311.00 | $311.00 | — | 280% above | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 Pregnancy - Reason for Pap | $311.00 | $311.00 | — | 280% above | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 Patient Cmplnt - Reason for Pap | $311.00 | $311.00 | — | 280% above | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 Gyn Disorder - Reason for Pap | $311.00 | $311.00 | — | 280% above | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 Abn Gyn Finding - Reason for Pap | $311.00 | $311.00 | — | 280% above | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 SP Pap Diag-ACL | $311.00 | $311.00 | — | 280% above | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 TPPap Screen | $311.00 | $311.00 | — | 280% above | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 Prev Gyn Cancer - Reason for Pap | $311.00 | $311.00 | — | 280% above | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 TPPap D Rfx HPV | $311.00 | $311.00 | — | 280% above | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 Thin Prep Pap Diagnostic and HPV mRNA E6/E7- Quest | $311.00 | $311.00 | — | 280% above | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 SP Pap Diag wRfx HPV if ASCU | $311.00 | $311.00 | — | 280% above | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SP Pap Diag-ACL | $311.00 | $311.00 | — | — | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Thin Prep Pap Diagnostic and HPV mRNA E6/E7- Quest | $311.00 | $311.00 | — | — | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Pregnancy - Reason for Pap | $311.00 | $311.00 | — | — | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Prev Abn Pap - Reason for Pap | $311.00 | $311.00 | — | — | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Patient Cmplnt - Reason for Pap | $311.00 | $311.00 | — | — | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SP Pap Diag wRfx HPV if ASCU | $311.00 | $311.00 | — | — | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Gyn Disorder - Reason for Pap | $311.00 | $311.00 | — | — | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 TPPap D Rfx HPV | $311.00 | $311.00 | — | — | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Abn Gyn Finding - Reason for Pap | $311.00 | $311.00 | — | — | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Prev Gyn Cancer - Reason for Pap | $311.00 | $311.00 | — | — | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SurePath Pap Diagnostic-ACL | $311.00 | $311.00 | — | — | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 TPPap Screen | $311.00 | $311.00 | — | — | — |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 TPPap Diag | $311.00 | $311.00 | — | 408% above | — |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 88142 AP Bill Gyn Cytology - Thin Prep | $311.00 | $311.00 | — | 408% above | — |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 TPPap Diag | $311.00 | $311.00 | — | — | — |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 88142 AP Bill Gyn Cytology - Thin Prep | $311.00 | $311.00 | — | — | — |
| Parathyroid hormone (PTH) blood test CPT 83970 PostOp PTH | $485.00 | $485.00 | — | 122% above | — |
| Parathyroid hormone (PTH) blood test CPT 83970 IntraOp PTH | $485.00 | $485.00 | — | 122% above | — |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone N-Ter | $485.00 | $485.00 | — | 122% above | — |
| Parathyroid hormone (PTH) blood test CPT 83970 PreOp PTH | $485.00 | $485.00 | — | 122% above | — |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact | $485.00 | $485.00 | — | 122% above | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PostOp PTH | $485.00 | $485.00 | — | — | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone N-Ter | $485.00 | $485.00 | — | — | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PreOp PTH | $485.00 | $485.00 | — | — | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact | $485.00 | $485.00 | — | — | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 IntraOp PTH | $485.00 | $485.00 | — | — | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time S/O | $49.00 | $49.00 | — | 19% above | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $49.00 | $49.00 | — | 19% above | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time S/O | $49.00 | $49.00 | — | — | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time | $49.00 | $49.00 | — | — | — |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level | $51.00 | $51.00 | — | 57% above | — |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level | $51.00 | $51.00 | — | — | — |
| Potassium blood test CPT 84132 Potassium Arterial | $56.00 | $56.00 | — | 76% above | — |
| Potassium blood test CPT 84132 POTASSIUM ARTERIAL RESP | $56.00 | $56.00 | — | 76% above | — |
| Potassium blood test CPT 84132 Potassium Level | $56.00 | $56.00 | — | 76% above | — |
| Potassium blood test inpatient CPT 84132 POTASSIUM ARTERIAL RESP | $56.00 | $56.00 | — | — | — |
| Potassium blood test inpatient CPT 84132 Potassium Level | $56.00 | $56.00 | — | — | — |
| Potassium blood test inpatient CPT 84132 Potassium Arterial | $56.00 | $56.00 | — | — | — |
| Progesterone blood test CPT 84144 Progesterone Level | $245.00 | $245.00 | — | 79% above | — |
| Progesterone blood test inpatient CPT 84144 Progesterone Level | $245.00 | $245.00 | — | — | — |
| Prolactin blood test CPT 84146 Prolactin Level | $228.00 | $228.00 | — | 83% above | — |
| Prolactin blood test inpatient CPT 84146 Prolactin Level | $228.00 | $228.00 | — | — | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 RHC PT/INR | $35.00 | $35.00 | — | 23% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time S/O Chrg Only | $50.00 | $50.00 | — | 76% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $50.00 | $50.00 | — | 76% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR | $50.00 | $50.00 | — | 76% above | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 RHC PT/INR | $35.00 | $35.00 | — | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time S/O Chrg Only | $50.00 | $50.00 | — | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR | $50.00 | $50.00 | — | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $50.00 | $50.00 | — | — | — |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 EBO QED Saliva | $20.50 | $20.50 | — | 63% below | — |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 RHC DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE | $30.00 | $30.00 | — | 46% below | — |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS | $63.00 | $63.00 | — | 13% above | — |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Nicotine-Urine | $148.00 | $148.00 | — | 166% above | — |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 EBO QED Saliva | $20.50 | $20.50 | — | — | — |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 RHC DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE | $30.00 | $30.00 | — | — | — |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRSMV DIR OPT OBS | $63.00 | $63.00 | — | — | — |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Nicotine-Urine | $148.00 | $148.00 | — | — | — |
| Rapid flu test (influenza antigen) CPT 87804 Q-CARE INFLUENZA ASSAY W/OPTIC | $15.00 | $15.00 | — | 73% below | — |
| Rapid flu test (influenza antigen) CPT 87804 RHC INFLUENZA ASSAY W/OPTIC | $35.00 | $35.00 | — | 36% below | — |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC | $194.00 | $194.00 | — | 254% above | — |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Q-CARE INFLUENZA ASSAY W/OPTIC | $15.00 | $15.00 | — | — | — |
| Rapid flu test (influenza antigen) inpatient CPT 87804 RHC INFLUENZA ASSAY W/OPTIC | $35.00 | $35.00 | — | — | — |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC | $194.00 | $194.00 | — | — | — |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP RAPID | $80.00 | $80.00 | — | 26% above | — |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 RHC STREP RAPID | $80.00 | $80.00 | — | 26% above | — |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep | $194.00 | $194.00 | — | 206% above | — |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RHC STREP RAPID | $80.00 | $80.00 | — | — | — |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP RAPID | $80.00 | $80.00 | — | — | — |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep | $194.00 | $194.00 | — | — | — |
| Renin blood test CPT 84244 Renin Activity-Quest | $258.00 | $258.00 | — | 78% above | — |
| Renin blood test inpatient CPT 84244 Renin Activity-Quest | $258.00 | $258.00 | — | — | — |
| Rh blood typing CPT 86901 RH | $85.00 | $85.00 | — | 49% above | — |
| Rh blood typing inpatient CPT 86901 RH | $85.00 | $85.00 | — | — | — |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor | $67.00 | $67.00 | — | 71% above | — |
| Rheumatoid factor (RF) test CPT 86431 &RF Fluid Titer-Quest | $67.00 | $67.00 | — | 71% above | — |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quan Chrg Only | $67.00 | $67.00 | — | 71% above | — |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quanitative | $67.00 | $67.00 | — | 71% above | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quan Chrg Only | $67.00 | $67.00 | — | — | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 &RF Fluid Titer-Quest | $67.00 | $67.00 | — | — | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor | $67.00 | $67.00 | — | — | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quanitative | $67.00 | $67.00 | — | — | — |
| Rubella antibody test (immunity check) CPT 86762 Rubella Ab Scr | $169.00 | $169.00 | — | 100% above | — |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody Titer IgG-Quest | $169.00 | $169.00 | — | 100% above | — |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody IgM-Quest | $169.00 | $169.00 | — | 100% above | — |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody IGG(Titer) | $169.00 | $169.00 | — | 100% above | — |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody IGM | $169.00 | $169.00 | — | 100% above | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody Titer IgG-Quest | $169.00 | $169.00 | — | — | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody IGG(Titer) | $169.00 | $169.00 | — | — | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody IGM | $169.00 | $169.00 | — | — | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody IgM-Quest | $169.00 | $169.00 | — | — | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Ab Scr | $169.00 | $169.00 | — | — | — |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sed Rate | $54.00 | $54.00 | — | 150% above | — |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sed Rate | $54.00 | $54.00 | — | — | — |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Analysis Fertility | $95.00 | $95.00 | — | 7% above | — |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Semen Analysis Fertility | $95.00 | $95.00 | — | — | — |
| Sodium blood test CPT 84295 Sodium Level | $57.00 | $57.00 | — | 76% above | — |
| Sodium blood test inpatient CPT 84295 Sodium Level | $57.00 | $57.00 | — | — | — |
| Stool ova and parasites exam CPT 87177 Parasite Exam | $105.00 | $105.00 | — | 79% above | — |
| Stool ova and parasites exam inpatient CPT 87177 Parasite Exam | $105.00 | $105.00 | — | — | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 RHC HEMOCULT | $22.00 | $22.00 | — | 8% above | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood 1-3 Specimens | $51.00 | $51.00 | — | 150% above | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HEMOCULT | $51.00 | $51.00 | — | 150% above | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool | $51.00 | $51.00 | — | 150% above | — |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 RHC HEMOCULT | $22.00 | $22.00 | — | — | — |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood 1-3 Specimens | $51.00 | $51.00 | — | — | — |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool | $51.00 | $51.00 | — | — | — |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HEMOCULT | $51.00 | $51.00 | — | — | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 RHC ASSAY TEST FOR BLOOD FECAL | $30.00 | $30.00 | — | 17% below | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Fecal Occult Blood - Immunochemical Diagnostic | $187.00 | $187.00 | — | 419% above | — |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 RHC ASSAY TEST FOR BLOOD FECAL | $30.00 | $30.00 | — | — | — |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Fecal Occult Blood - Immunochemical Diagnostic | $187.00 | $187.00 | — | — | — |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Antibody | $156.00 | $156.00 | — | 109% above | — |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Fluorescent Treponemal Antibody-Absorption-Quest | $156.00 | $156.00 | — | 109% above | — |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Syphilis Antibody | $156.00 | $156.00 | — | — | — |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Fluorescent Treponemal Antibody-Absorption-Quest | $156.00 | $156.00 | — | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL Serum-Quest | $50.00 | $50.00 | — | 78% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL Screen Cerebrospinal Fluid-Quest | $50.00 | $50.00 | — | 78% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Test | $50.00 | $50.00 | — | 78% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL Serum-Quest | $50.00 | $50.00 | — | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Test | $50.00 | $50.00 | — | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL Screen Cerebrospinal Fluid-Quest | $50.00 | $50.00 | — | — | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon-TB Gold-Quest | $728.00 | $728.00 | — | 135% above | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QTBTest | $728.00 | $728.00 | — | 135% above | — |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon-TB Gold-Quest | $728.00 | $728.00 | — | — | — |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QTBTest | $728.00 | $728.00 | — | — | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total | $303.00 | $303.00 | — | 86% above | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total | $303.00 | $303.00 | — | 86% above | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testos Totl | $303.00 | $303.00 | — | 86% above | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testos Totl | $303.00 | $303.00 | — | — | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total | $303.00 | $303.00 | — | — | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Total | $303.00 | $303.00 | — | — | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver Kidney Microsome IgG Antibody-Quest | $171.00 | $171.00 | — | 127% above | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Anti-thyroid Peroxidase Antibody-Quest | $171.00 | $171.00 | — | 127% above | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Anti-Thyroid Peroxidase AB | $171.00 | $171.00 | — | 127% above | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Anti-Thyroid Peroxidase AB | $171.00 | $171.00 | — | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Anti-thyroid Peroxidase Antibody-Quest | $171.00 | $171.00 | — | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver Kidney Microsome IgG Antibody-Quest | $171.00 | $171.00 | — | — | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/HAMA Treatment-Quest | $197.00 | $197.00 | — | 97% above | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $197.00 | $197.00 | — | 97% above | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/HAMA Treatment | $197.00 | $197.00 | — | 97% above | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/HAMA Treatment-Quest | $197.00 | $197.00 | — | — | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/HAMA Treatment | $197.00 | $197.00 | — | — | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $197.00 | $197.00 | — | — | — |
| Total IgE blood test CPT 82785 IGE S/O | $193.00 | $193.00 | — | 86% above | — |
| Total IgE blood test CPT 82785 IgE | $193.00 | $193.00 | — | 86% above | — |
| Total IgE blood test inpatient CPT 82785 IgE | $193.00 | $193.00 | — | — | — |
| Total IgE blood test inpatient CPT 82785 IGE S/O | $193.00 | $193.00 | — | — | — |
| Total cholesterol blood test CPT 82465 Cholesterol | $51.00 | $51.00 | — | 68% above | — |
| Total cholesterol blood test CPT 82465 Cholesterol Total | $51.00 | $51.00 | — | 68% above | — |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol | $51.00 | $51.00 | — | — | — |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol Total | $51.00 | $51.00 | — | — | — |
| Total thyroxine (T4) blood test CPT 84436 Thyroxine | $81.00 | $81.00 | — | 80% above | — |
| Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine | $81.00 | $81.00 | — | — | — |
| Total triiodothyronine (T3) blood test CPT 84480 T3 RIA | $167.00 | $167.00 | — | 72% above | — |
| Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine | $167.00 | $167.00 | — | 72% above | — |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 RIA | $167.00 | $167.00 | — | — | — |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine | $167.00 | $167.00 | — | — | — |
| Transferrin blood test CPT 84466 Transferrin | $150.00 | $150.00 | — | 74% above | — |
| Transferrin blood test CPT 84466 Transferrin-Quest | $150.00 | $150.00 | — | 74% above | — |
| Transferrin blood test inpatient CPT 84466 Transferrin | $150.00 | $150.00 | — | — | — |
| Transferrin blood test inpatient CPT 84466 Transferrin-Quest | $150.00 | $150.00 | — | — | — |
| Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis RNA,Ql Females-Quest | $490.00 | $490.00 | — | 166% above | — |
| Trichomonas test (NAAT) CPT 87661 T. Vaginalis DNA Probe | $490.00 | $490.00 | — | 166% above | — |
| Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis RNA,Ql Males-Quest | $490.00 | $490.00 | — | 166% above | — |
| Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis RNA,Ql | $490.00 | $490.00 | — | 166% above | — |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalis RNA,Ql Males-Quest | $490.00 | $490.00 | — | — | — |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis RNA,Ql | $490.00 | $490.00 | — | — | — |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis RNA,Ql Females-Quest | $490.00 | $490.00 | — | — | — |
| Trichomonas test (NAAT) inpatient CPT 87661 T. Vaginalis DNA Probe | $490.00 | $490.00 | — | — | — |
| Triglycerides blood test CPT 84478 Triglyceride Other Body Fluid | $67.00 | $67.00 | — | 69% above | — |
| Triglycerides blood test CPT 84478 Triglycerides | $67.00 | $67.00 | — | 69% above | — |
| Triglycerides blood test CPT 84478 Triglyceride Synovial Fluid | $67.00 | $67.00 | — | 69% above | — |
| Triglycerides blood test CPT 84478 Triglyceride Peritoneal Fluid | $67.00 | $67.00 | — | 69% above | — |
| Triglycerides blood test CPT 84478 Triglyceride Pleural Fluid | $67.00 | $67.00 | — | 69% above | — |
| Triglycerides blood test CPT 84478 Triglyceride PD Fluid | $67.00 | $67.00 | — | 69% above | — |
| Triglycerides blood test CPT 84478 Triglyceride Pericardial Fluid | $67.00 | $67.00 | — | 69% above | — |
| Triglycerides blood test CPT 84478 Triglycerides SO Chrg Only | $67.00 | $67.00 | — | 69% above | — |
| Triglycerides blood test inpatient CPT 84478 Triglycerides SO Chrg Only | $67.00 | $67.00 | — | — | — |
| Triglycerides blood test inpatient CPT 84478 Triglyceride PD Fluid | $67.00 | $67.00 | — | — | — |
| Triglycerides blood test inpatient CPT 84478 Triglyceride Other Body Fluid | $67.00 | $67.00 | — | — | — |
| Triglycerides blood test inpatient CPT 84478 Triglyceride Pericardial Fluid | $67.00 | $67.00 | — | — | — |
| Triglycerides blood test inpatient CPT 84478 Triglyceride Pleural Fluid | $67.00 | $67.00 | — | — | — |
| Triglycerides blood test inpatient CPT 84478 Triglyceride Synovial Fluid | $67.00 | $67.00 | — | — | — |
| Triglycerides blood test inpatient CPT 84478 Triglycerides | $67.00 | $67.00 | — | — | — |
| Triglycerides blood test inpatient CPT 84478 Triglyceride Peritoneal Fluid | $67.00 | $67.00 | — | — | — |
| Troponin test, quantitative CPT 84484 Tropinin-I | $147.00 | $147.00 | — | 79% above | — |
| Troponin test, quantitative CPT 84484 Troponin I High Sensitivity | $147.00 | $147.00 | — | 79% above | — |
| Troponin test, quantitative CPT 84484 iSTAT Troponin-I | $147.00 | $147.00 | — | 79% above | — |
| Troponin test, quantitative inpatient CPT 84484 iSTAT Troponin-I | $147.00 | $147.00 | — | — | — |
| Troponin test, quantitative inpatient CPT 84484 Tropinin-I | $147.00 | $147.00 | — | — | — |
| Troponin test, quantitative inpatient CPT 84484 Troponin I High Sensitivity | $147.00 | $147.00 | — | — | — |
| Uric acid blood test CPT 84550 Uric Acid | $48.00 | $48.00 | — | 51% above | — |
| Uric acid blood test inpatient CPT 84550 Uric Acid | $48.00 | $48.00 | — | — | — |
| Urinalysis with microscope exam, automated CPT 81001 zzUA w/Mic | $41.00 | $41.00 | — | 24% above | — |
| Urinalysis with microscope exam, automated CPT 81001 UA w/Micro | $59.00 | $59.00 | — | 79% above | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 zzUA w/Mic | $41.00 | $41.00 | — | — | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA w/Micro | $59.00 | $59.00 | — | — | — |
| Urinalysis with microscope exam, manual CPT 81000 RHC URINALYSIS | $31.00 | $31.00 | — | 5% above | — |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS | $33.00 | $33.00 | — | 11% above | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 RHC URINALYSIS | $31.00 | $31.00 | — | — | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS | $33.00 | $33.00 | — | — | — |
| Urinalysis without microscope exam, automated CPT 81003 Q-CARE URINALYSIS AUTO W/O SCOPE | $3.00 | $3.00 | — | 83% below | — |
| Urinalysis without microscope exam, automated CPT 81003 RHC URINALYSIS DIPSTICK AUTO W/O SCOPE | $15.00 | $15.00 | — | 16% below | — |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO DIPSTICK W/O SCOPE | $16.00 | $16.00 | — | 10% below | — |
| Urinalysis without microscope exam, automated CPT 81003 pH Urine | $49.00 | $49.00 | — | 175% above | — |
| Urinalysis without microscope exam, automated CPT 81003 Urine Protein Qualitative | $49.00 | $49.00 | — | 175% above | — |
| Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine Automated | $49.00 | $49.00 | — | 175% above | — |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Routine Analysis | $49.00 | $49.00 | — | 175% above | — |
| Urinalysis without microscope exam, automated CPT 81003 UA | $49.00 | $49.00 | — | 175% above | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Q-CARE URINALYSIS AUTO W/O SCOPE | $3.00 | $3.00 | — | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 RHC URINALYSIS DIPSTICK AUTO W/O SCOPE | $15.00 | $15.00 | — | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO DIPSTICK W/O SCOPE | $16.00 | $16.00 | — | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA | $49.00 | $49.00 | — | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 pH Urine | $49.00 | $49.00 | — | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Routine Analysis | $49.00 | $49.00 | — | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Protein Qualitative | $49.00 | $49.00 | — | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine Automated | $49.00 | $49.00 | — | — | — |
| Urinalysis without microscope exam, manual CPT 81002 Q-CARE URINALYSIS NO MICRO NON AUTOMATED | $3.00 | $3.00 | — | 86% below | — |
| Urinalysis without microscope exam, manual CPT 81002 RHC URINALYSIS NO MICRO NON AUTOMATED | $26.00 | $26.00 | — | 24% above | — |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NO MICRO NON AUTOMATED | $28.00 | $28.00 | — | 33% above | — |
| Urinalysis without microscope exam, manual CPT 81002 Ketones Urine | $41.00 | $41.00 | — | 95% above | — |
| Urinalysis without microscope exam, manual CPT 81002 PH S/O Chrg Only | $41.00 | $41.00 | — | 95% above | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Q-CARE URINALYSIS NO MICRO NON AUTOMATED | $3.00 | $3.00 | — | — | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 RHC URINALYSIS NO MICRO NON AUTOMATED | $26.00 | $26.00 | — | — | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NO MICRO NON AUTOMATED | $28.00 | $28.00 | — | — | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Ketones Urine | $41.00 | $41.00 | — | — | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 PH S/O Chrg Only | $41.00 | $41.00 | — | — | — |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture | $95.00 | $95.00 | — | 68% above | — |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture | $95.00 | $95.00 | — | — | — |
| Urine microalbumin (albumin) test CPT 82043 Albumin; urine (eg, microalbumin), quantitative | $81.00 | $81.00 | — | 104% above | — |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Excretion 24 Hour Urine | $81.00 | $81.00 | — | 104% above | — |
| Urine microalbumin (albumin) test inpatient CPT 82043 Albumin; urine (eg, microalbumin), quantitative | $81.00 | $81.00 | — | — | — |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Excretion 24 Hour Urine | $81.00 | $81.00 | — | — | — |
| Urine pregnancy test, read by color change CPT 81025 Q-CARE PREGNANCY TEST URINE VISUAL | $9.00 | $9.00 | — | 76% below | — |
| Urine pregnancy test, read by color change CPT 81025 RHC PREGNANCY TEST URINE VISUAL | $52.00 | $52.00 | — | 41% above | — |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE VISUAL | $56.00 | $56.00 | — | 52% above | — |
| Urine pregnancy test, read by color change CPT 81025 HCG, Qual Urine | $101.00 | $101.00 | — | 174% above | — |
| Urine pregnancy test, read by color change inpatient CPT 81025 Q-CARE PREGNANCY TEST URINE VISUAL | $9.00 | $9.00 | — | — | — |
| Urine pregnancy test, read by color change inpatient CPT 81025 RHC PREGNANCY TEST URINE VISUAL | $52.00 | $52.00 | — | — | — |
| Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST URINE VISUAL | $56.00 | $56.00 | — | — | — |
| Urine pregnancy test, read by color change inpatient CPT 81025 HCG, Qual Urine | $101.00 | $101.00 | — | — | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 | $177.00 | $177.00 | — | 88% above | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vit B12 | $177.00 | $177.00 | — | 88% above | — |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vit B12 | $177.00 | $177.00 | — | — | — |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 | $177.00 | $177.00 | — | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Cardio IQ Vitamin D, 25-Hydroxy- Quest | $348.00 | $348.00 | — | 133% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vit D | $348.00 | $348.00 | — | 133% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vit D | $348.00 | $348.00 | — | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Cardio IQ Vitamin D, 25-Hydroxy- Quest | $348.00 | $348.00 | — | — | — |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D 1 25-dihydroxy Lc-ms-ms-Quest | $452.00 | $452.00 | — | 88% above | — |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D 1 25-dihydroxy Lc-ms-ms-Quest | $452.00 | $452.00 | — | — | — |
| Zinc blood test CPT 84630 Zinc RBC-Quest | $134.00 | $134.00 | — | 85% above | — |
| Zinc blood test CPT 84630 Zinc Level-Quest | $134.00 | $134.00 | — | 85% above | — |
| Zinc blood test inpatient CPT 84630 Zinc RBC-Quest | $134.00 | $134.00 | — | — | — |
| Zinc blood test inpatient CPT 84630 Zinc Level-Quest | $134.00 | $134.00 | — | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Quant HCG S/O | $177.00 | $177.00 | — | 98% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG Tumor Marker-Quest | $177.00 | $177.00 | — | 98% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Human Chorionic Gonadotropin Quantitative | $177.00 | $177.00 | — | 98% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta Human Chorionic Gonadotropin Quantitative | $177.00 | $177.00 | — | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG Tumor Marker-Quest | $177.00 | $177.00 | — | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Quant HCG S/O | $177.00 | $177.00 | — | — | — |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 STB Stereotactic Localization | $19,615.00 | $19,615.00 | — | 401% above | — |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MA Stereotactic Localization Right | $19,615.00 | $19,615.00 | — | 401% above | — |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MA Stereotactic Localization Left | $19,615.00 | $19,615.00 | — | 401% above | — |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 STB Stereotactic Localization | $19,615.00 | $19,615.00 | — | — | — |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MA Stereotactic Localization Right | $19,615.00 | $19,615.00 | — | — | — |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MA Stereotactic Localization Left | $19,615.00 | $19,615.00 | — | — | — |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD TX METATAR FX WO/MANIP EA | $2,904.00 | $2,904.00 | — | 458% above | — |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD TX METATAR FX WO/MANIP EA ED TC | $2,904.00 | $2,904.00 | — | 458% above | — |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLSD TX METATAR FX WO/MANIP EA | $2,904.00 | $2,904.00 | — | — | — |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLSD TX METATAR FX WO/MANIP EA ED TC | $2,904.00 | $2,904.00 | — | — | — |
| Cardiac catheterization with coronary angiogram CPT 93458 CORONARY ANGIO WITH LV INJ | $38,939.00 | $38,939.00 | — | 342% above | — |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 CORONARY ANGIO WITH LV INJ | $38,939.00 | $38,939.00 | — | — | — |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL | $7,922.00 | $7,922.00 | — | 441% above | — |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE EXTERNAL | $7,922.00 | $7,922.00 | — | 441% above | — |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL ED TC | $7,922.00 | $7,922.00 | — | 441% above | — |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE EXTERNAL | $7,922.00 | $7,922.00 | — | — | — |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL ED TC | $7,922.00 | $7,922.00 | — | — | — |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL | $7,922.00 | $7,922.00 | — | — | — |
| Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE | $23,641.00 | $23,641.00 | — | 462% above | — |
| Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE | $23,641.00 | $23,641.00 | — | — | — |
| Catheter ablation for atrial fibrillation CPT 93656 TX ATRIAL FIB PULM VEIN ISOL | $296,995.00 | $296,995.00 | — | 859% above | — |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 TX ATRIAL FIB PULM VEIN ISOL | $296,995.00 | $296,995.00 | — | — | — |
| Cervical biopsy CPT 57500 CERVIX BIOPSY SING OR MULT | $10,541.00 | $10,541.00 | — | 315% above | — |
| Cervical biopsy inpatient CPT 57500 CERVIX BIOPSY SING OR MULT | $10,541.00 | $10,541.00 | — | — | — |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 3RD TRI MATERNITY CARE C-SECT | $3,815.00 | $3,815.00 | — | 33% below | — |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 3RD TRI MATERNITY CARE C-SECT | $3,815.00 | $3,815.00 | — | — | — |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision Performed By: | $24,800.00 | $24,800.00 | — | 1934% above | — |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision Performed By: | $24,800.00 | $24,800.00 | — | — | — |
| Coronary stent placement, one artery CPT 92928 PRQ CARD STENT W ANGIO 1 LESION,1 OR MORE SEG | $137,292.00 | $137,292.00 | — | 577% above | — |
| Coronary stent placement, one artery inpatient CPT 92928 PRQ CARD STENT W ANGIO 1 LESION,1 OR MORE SEG | $137,292.00 | $137,292.00 | — | — | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 RHC DESTRUCTION LESION 1ST LESION | $640.00 | $640.00 | — | 50% above | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION LESION 1ST LESION | $2,406.00 | $2,406.00 | — | 462% above | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 RHC DESTRUCTION LESION 1ST LESION | $640.00 | $640.00 | — | — | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION LESION 1ST LESION | $2,406.00 | $2,406.00 | — | — | — |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Q-CARE REMOVE IMPACTED EAR WAX IRR/LAVAGE UNI | $15.00 | $15.00 | — | 89% below | — |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 RHC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $189.00 | $189.00 | — | 35% above | — |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT ED TC | $719.00 | $719.00 | — | 414% above | — |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Q-CARE REMOVE IMPACTED EAR WAX IRR/LAVAGE UNI | $15.00 | $15.00 | — | — | — |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 RHC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $189.00 | $189.00 | — | — | — |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT ED TC | $719.00 | $719.00 | — | — | — |
| Earwax removal with instruments, one ear one side CPT 69210 Q-CARE REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $62.00 | $62.00 | — | 54% below | — |
| Earwax removal with instruments, one ear one side CPT 69210 RHC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $229.00 | $229.00 | — | 71% above | — |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT ED TC | $719.00 | $719.00 | — | 436% above | — |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $719.00 | $719.00 | — | 436% above | — |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 Q-CARE REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $62.00 | $62.00 | — | — | — |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 RHC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $229.00 | $229.00 | — | — | — |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $719.00 | $719.00 | — | — | — |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT ED TC | $719.00 | $719.00 | — | — | — |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BIOPSY | $2,435.00 | $2,435.00 | — | 515% above | — |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BIOPSY | $2,435.00 | $2,435.00 | — | — | — |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CT Cervical/Thor Epidural inc Imag | $8,384.00 | $8,384.00 | — | 249% above | — |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 IR Cervical/Thor Epidural inc Imag | $8,384.00 | $8,384.00 | — | 249% above | — |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC W GUIDANCE | $8,384.00 | $8,384.00 | — | 249% above | — |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 XR Cervical/Thoracic Epidural inc. Fluoro | $8,384.00 | $8,384.00 | — | 249% above | — |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 IR Cervical/Thor Epidural inc Imag | $8,384.00 | $8,384.00 | — | — | — |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CT Cervical/Thor Epidural inc Imag | $8,384.00 | $8,384.00 | — | — | — |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 XR Cervical/Thoracic Epidural inc. Fluoro | $8,384.00 | $8,384.00 | — | — | — |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX INTERLAMINAR CRV/THRC W GUIDANCE | $8,384.00 | $8,384.00 | — | — | — |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FACET INJ LUMBAR SACRAL W FL | $10,778.00 | $10,778.00 | — | 648% above | — |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 XR FACET INJ LUMBARSACRAL W FL RT | $10,778.00 | $10,778.00 | — | 648% above | — |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 XR FACET INJ LUMBARSACRAL W FL LT | $10,778.00 | $10,778.00 | — | 648% above | — |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 FACET INJ LUMBAR SACRAL W FL | $10,778.00 | $10,778.00 | — | — | — |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 XR FACET INJ LUMBARSACRAL W FL RT | $10,778.00 | $10,778.00 | — | — | — |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 XR FACET INJ LUMBARSACRAL W FL LT | $10,778.00 | $10,778.00 | — | — | — |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Hysterosalpingio cath Injec | $494.00 | $494.00 | — | 29% above | — |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Hysterosalpingio cath Injec | $494.00 | $494.00 | — | — | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 Q-CARE INCISE/DRAIN ABSCESS SIMPLE | $112.00 | $112.00 | — | 78% below | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 RHC INCISE/DRAIN ABSCESS SIMPLE | $762.00 | $762.00 | — | 49% above | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060 I&D simple abscess of skin | $2,406.00 | $2,406.00 | — | 371% above | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISE/DRAIN ABSCESS SIMPLE ED TC | $2,406.00 | $2,406.00 | — | 371% above | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISE/DRAIN ABSCESS SIMPLE | $2,406.00 | $2,406.00 | — | 371% above | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Q-CARE INCISE/DRAIN ABSCESS SIMPLE | $112.00 | $112.00 | — | — | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 RHC INCISE/DRAIN ABSCESS SIMPLE | $762.00 | $762.00 | — | — | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISE/DRAIN ABSCESS SIMPLE ED TC | $2,406.00 | $2,406.00 | — | — | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISE/DRAIN ABSCESS SIMPLE | $2,406.00 | $2,406.00 | — | — | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 I&D simple abscess of skin | $2,406.00 | $2,406.00 | — | — | — |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 RHC INJECT TENDON SHEATH OR LIGAMNT | $853.00 | $853.00 | — | 50% above | — |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TENDON SHEATH OR LIGAMNT | $3,574.00 | $3,574.00 | — | 527% above | — |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 RHC INJECT TENDON SHEATH OR LIGAMNT | $853.00 | $853.00 | — | — | — |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT TENDON SHEATH OR LIGAMNT | $3,574.00 | $3,574.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 RHC ARTHROCENTESIS MAJOR JOINT BILATERAL | $1,301.00 | $1,301.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 RHC ARTHROCENTESIS MAJOR JOINT | $867.00 | $867.00 | — | 85% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JOINT ED TC | $3,574.00 | $3,574.00 | — | 663% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JOINT | $3,574.00 | $3,574.00 | — | 663% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Arthrocentesis large Joint LT | $3,574.00 | $3,574.00 | — | 663% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Injection of Major Joint Lt | $3,574.00 | $3,574.00 | — | 663% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Injection of Major Joint Rt | $3,574.00 | $3,574.00 | — | 663% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Arthrocentesis large Joint RT | $3,574.00 | $3,574.00 | — | 663% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 RHC ARTHROCENTESIS MAJOR JOINT BILATERAL | $1,301.00 | $1,301.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 RHC ARTHROCENTESIS MAJOR JOINT | $867.00 | $867.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR JOINT | $3,574.00 | $3,574.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR JOINT ED TC | $3,574.00 | $3,574.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Arthrocentesis large Joint LT | $3,574.00 | $3,574.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Arthrocentesis large Joint RT | $3,574.00 | $3,574.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Injection of Major Joint Rt | $3,574.00 | $3,574.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Injection of Major Joint Lt | $3,574.00 | $3,574.00 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Q-CARE ARTHROCENTESIS INTERM JOINT | $64.00 | $64.00 | — | 82% below | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 RHC ARTHROCENTESIS INTERM JOINT | $847.00 | $847.00 | — | 139% above | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS, INTERM JOINT ED TC | $3,574.00 | $3,574.00 | — | 910% above | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTERM JOINT | $3,574.00 | $3,574.00 | — | 910% above | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Arthrocentesis Med Joint LT | $3,574.00 | $3,574.00 | — | 910% above | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Arthrocentesis Med Joint RT | $3,574.00 | $3,574.00 | — | 910% above | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Q-CARE ARTHROCENTESIS INTERM JOINT | $64.00 | $64.00 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 RHC ARTHROCENTESIS INTERM JOINT | $847.00 | $847.00 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS INTERM JOINT | $3,574.00 | $3,574.00 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS, INTERM JOINT ED TC | $3,574.00 | $3,574.00 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Arthrocentesis Med Joint RT | $3,574.00 | $3,574.00 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Arthrocentesis Med Joint LT | $3,574.00 | $3,574.00 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 RHC DRAIN/INJ JOINT/BURSA W/O US | $845.00 | $845.00 | — | 106% above | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US | $3,574.00 | $3,574.00 | — | 770% above | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL JOINT | $3,574.00 | $3,574.00 | — | 770% above | — |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 Arthrocentsis Small Joint LT | $3,574.00 | $3,574.00 | — | 770% above | — |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 Arthrocentsis Small Joint RT | $3,574.00 | $3,574.00 | — | 770% above | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 RHC DRAIN/INJ JOINT/BURSA W/O US | $845.00 | $845.00 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJ JOINT/BURSA W/O US | $3,574.00 | $3,574.00 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS SMALL JOINT | $3,574.00 | $3,574.00 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 Arthrocentsis Small Joint LT | $3,574.00 | $3,574.00 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 Arthrocentsis Small Joint RT | $3,574.00 | $3,574.00 | — | — | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Q-CARE INTERM REP SCLP TRK <2.5 CM | $224.00 | $224.00 | — | 62% below | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 RHC INTERM REP SCLP TRK < 2.5 CM | $1,384.00 | $1,384.00 | — | 136% above | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERM REP SCLP TRK <2.5CM ED TC | $4,837.00 | $4,837.00 | — | 725% above | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERM REP SCLP TRK <2.5CM | $4,837.00 | $4,837.00 | — | 725% above | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Q-CARE INTERM REP SCLP TRK <2.5 CM | $224.00 | $224.00 | — | — | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 RHC INTERM REP SCLP TRK < 2.5 CM | $1,384.00 | $1,384.00 | — | — | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERM REP SCLP TRK <2.5CM ED TC | $4,837.00 | $4,837.00 | — | — | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERM REP SCLP TRK <2.5CM | $4,837.00 | $4,837.00 | — | — | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 XR Lumbar/Sacral Epidural inc. Fluoro | $8,384.00 | $8,384.00 | — | 300% above | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 Lumbar Spine Injection Single | $8,384.00 | $8,384.00 | — | 300% above | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC W GUIDANCE | $8,384.00 | $8,384.00 | — | 300% above | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 CT Lumbar/Sacrl Epidural inc Imag | $8,384.00 | $8,384.00 | — | 300% above | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR Lumbar/Sacrl Epidural inc Imag | $8,384.00 | $8,384.00 | — | 300% above | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR Lumbar/Sacrl Epidural inc Imag | $8,384.00 | $8,384.00 | — | — | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CT Lumbar/Sacrl Epidural inc Imag | $8,384.00 | $8,384.00 | — | — | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTERLAMINAR LMBR/SAC W GUIDANCE | $8,384.00 | $8,384.00 | — | — | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Lumbar Spine Injection Single | $8,384.00 | $8,384.00 | — | — | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 XR Lumbar/Sacral Epidural inc. Fluoro | $8,384.00 | $8,384.00 | — | — | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC WO GUIDANCE | $10,778.00 | $10,778.00 | — | 462% above | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX INTERLAMINAR LMBR/SAC WO GUIDANCE | $10,778.00 | $10,778.00 | — | — | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 FACET BLOCK LUMBAR SACR SINGLE | $10,778.00 | $10,778.00 | — | 462% above | — |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 CT Lumbar/Sacral Transforaminal LT | $10,778.00 | $10,778.00 | — | 462% above | — |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 IR Lumbar/Sacral Transforaminal RT | $10,778.00 | $10,778.00 | — | 462% above | — |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 CT Lumbar/Sacral Transforaminal RT | $10,778.00 | $10,778.00 | — | 462% above | — |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 IR Lumbar/Sacral Transforaminal LT | $10,778.00 | $10,778.00 | — | 462% above | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 FACET BLOCK LUMBAR SACR SINGLE | $10,778.00 | $10,778.00 | — | — | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 IR Lumbar/Sacral Transforaminal LT | $10,778.00 | $10,778.00 | — | — | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 IR Lumbar/Sacral Transforaminal RT | $10,778.00 | $10,778.00 | — | — | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 CT Lumbar/Sacral Transforaminal LT | $10,778.00 | $10,778.00 | — | — | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 CT Lumbar/Sacral Transforaminal RT | $10,778.00 | $10,778.00 | — | — | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 RHC EXCIS LES TRNK ARM LEG .5 CM&< | $2,011.00 | $2,011.00 | — | 51% above | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCIS LES TRNK ARM LEG .5CM&< | $8,518.00 | $8,518.00 | — | 539% above | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 RHC EXCIS LES TRNK ARM LEG .5 CM&< | $2,011.00 | $2,011.00 | — | — | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCIS LES TRNK ARM LEG .5CM&< | $8,518.00 | $8,518.00 | — | — | — |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 RHC EXCISE LESION EAR FACE .5 CM&< | $2,063.00 | $2,063.00 | — | 17% above | — |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISE LESION EAR FACE .5 CM&< | $8,518.00 | $8,518.00 | — | 382% above | — |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 RHC EXCISE LESION EAR FACE .5 CM&< | $2,063.00 | $2,063.00 | — | — | — |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISE LESION EAR FACE .5 CM&< | $8,518.00 | $8,518.00 | — | — | — |
| Nail removal (partial or complete), one nail CPT 11730 Q-CARE REMOVAL OF NAIL PLATE | $90.00 | $90.00 | — | 81% below | — |
| Nail removal (partial or complete), one nail CPT 11730 RHC AVULSION NAIL PLATE PART/COMPL | $639.00 | $639.00 | — | 36% above | — |
| Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion/nail plate/simple/single | $2,406.00 | $2,406.00 | — | 411% above | — |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PART/COMPL ED TC | $2,406.00 | $2,406.00 | — | 411% above | — |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PART/COMPL | $2,406.00 | $2,406.00 | — | 411% above | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Q-CARE REMOVAL OF NAIL PLATE | $90.00 | $90.00 | — | — | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 RHC AVULSION NAIL PLATE PART/COMPL | $639.00 | $639.00 | — | — | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PART/COMPL | $2,406.00 | $2,406.00 | — | — | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 11730 Avulsion/nail plate/simple/single | $2,406.00 | $2,406.00 | — | — | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PART/COMPL ED TC | $2,406.00 | $2,406.00 | — | — | — |
| Occipital nerve block (injection for headaches) both sides CPT 64405 ANESTH INJ GREATER OCCIPITAL BILAT GE | $3,574.00 | $3,574.00 | — | — | — |
| Occipital nerve block (injection for headaches) CPT 64405 ANESTH INJ GREATER OCCIPITAL | $3,574.00 | $3,574.00 | — | 533% above | — |
| Occipital nerve block (injection for headaches) inpatient both sides CPT 64405 ANESTH INJ GREATER OCCIPITAL BILAT GE | $3,574.00 | $3,574.00 | — | — | — |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 ANESTH INJ GREATER OCCIPITAL | $3,574.00 | $3,574.00 | — | — | — |
| Pacemaker implant (dual chamber) CPT 33208 PACEMAKER IMPLANT AV SEQ | $126,696.00 | $126,696.00 | — | 896% above | — |
| Pacemaker implant (dual chamber) inpatient CPT 33208 PACEMAKER IMPLANT AV SEQ | $126,696.00 | $126,696.00 | — | — | — |
| Paracentesis with imaging guidance CPT 49083 US Paracentesis BO | $11,350.00 | $11,350.00 | — | 574% above | — |
| Paracentesis with imaging guidance CPT 49083 ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE | $11,350.00 | $11,350.00 | — | 574% above | — |
| Paracentesis with imaging guidance CPT 49083 CT Paracentesis | $11,350.00 | $11,350.00 | — | 574% above | — |
| Paracentesis with imaging guidance inpatient CPT 49083 CT Paracentesis | $11,350.00 | $11,350.00 | — | — | — |
| Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis BO | $11,350.00 | $11,350.00 | — | — | — |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE | $11,350.00 | $11,350.00 | — | — | — |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Q-CARE NAIL EXCISION PERM REMOVL | $189.00 | $189.00 | — | 77% below | — |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 RHC NAIL EXCISION PERM REMOVL | $1,269.00 | $1,269.00 | — | 52% above | — |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL EXCISION PERM REMOVL | $4,837.00 | $4,837.00 | — | 480% above | — |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 Excise/nail/matrix/perm removal | $4,837.00 | $4,837.00 | — | 480% above | — |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Q-CARE NAIL EXCISION PERM REMOVL | $189.00 | $189.00 | — | — | — |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 RHC NAIL EXCISION PERM REMOVL | $1,269.00 | $1,269.00 | — | — | — |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 Excise/nail/matrix/perm removal | $4,837.00 | $4,837.00 | — | — | — |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 NAIL EXCISION PERM REMOVL | $4,837.00 | $4,837.00 | — | — | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 NEUROLYTIC AGENT SING JNT FLUORO | $23,641.00 | $23,641.00 | — | 693% above | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 NEUROLYTIC AGENT SING JNT FLUORO | $23,641.00 | $23,641.00 | — | — | — |
| Removal of a breast lump, open surgery CPT 19120 EXCIS CYST FIBR LESION BREAST | $46,358.00 | $46,358.00 | — | 413% above | — |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXCIS CYST FIBR LESION BREAST | $46,358.00 | $46,358.00 | — | — | — |
| Removal of a foreign object under the skin, simple CPT 10120 Q-CARE INCISE/REMOVE FB SIMPLE | $122.00 | $122.00 | — | 78% below | — |
| Removal of a foreign object under the skin, simple CPT 10120 RHC INCISE/REMOVE FB SIMPLE | $1,277.00 | $1,277.00 | — | 135% above | — |
| Removal of a foreign object under the skin, simple CPT 10120 INCISE/REMOVE FB SIMPLE ED TC | $4,837.00 | $4,837.00 | — | 790% above | — |
| Removal of a foreign object under the skin, simple CPT 10120 INCISE/REMOVE FB SIMPLE | $4,837.00 | $4,837.00 | — | 790% above | — |
| Removal of a foreign object under the skin, simple CPT 10120 FB Removal Subcut Simple | $4,837.00 | $4,837.00 | — | 790% above | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Q-CARE INCISE/REMOVE FB SIMPLE | $122.00 | $122.00 | — | — | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 RHC INCISE/REMOVE FB SIMPLE | $1,277.00 | $1,277.00 | — | — | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISE/REMOVE FB SIMPLE ED TC | $4,837.00 | $4,837.00 | — | — | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISE/REMOVE FB SIMPLE | $4,837.00 | $4,837.00 | — | — | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 FB Removal Subcut Simple | $4,837.00 | $4,837.00 | — | — | — |
| Short arm splint (forearm and hand) CPT 29125 RHC APPLY FOREARM SPLINT | $428.00 | $428.00 | — | 36% above | — |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT ED TC | $1,561.00 | $1,561.00 | — | 396% above | — |
| Short arm splint (forearm and hand) CPT 29125 PT APPLICATION SHORT ARM SPLINT | $1,561.00 | $1,561.00 | — | 396% above | — |
| Short arm splint (forearm and hand) inpatient CPT 29125 RHC APPLY FOREARM SPLINT | $428.00 | $428.00 | — | — | — |
| Short arm splint (forearm and hand) inpatient CPT 29125 PT APPLICATION SHORT ARM SPLINT | $1,561.00 | $1,561.00 | — | — | — |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT ED TC | $1,561.00 | $1,561.00 | — | — | — |
| Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT ED TC | $1,910.00 | $1,910.00 | — | 314% above | — |
| Short leg splint (calf to foot) CPT 29515 APLICATION SHORT LEG SPLINT | $1,910.00 | $1,910.00 | — | 314% above | — |
| Short leg splint (calf to foot) inpatient CPT 29515 APLICATION SHORT LEG SPLINT | $1,910.00 | $1,910.00 | — | — | — |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT ED TC | $1,910.00 | $1,910.00 | — | — | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Q-CARE SIMP REP SCLP NK TK 2.5CM< | $144.00 | $144.00 | — | 72% below | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RHC SIMP REP SCLP NK TK 2.5 CM & < | $618.00 | $618.00 | — | 20% above | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMP REP SCLP NK TK 2.5CM&< ED TC | $2,406.00 | $2,406.00 | — | 368% above | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMP REP SCLP NK TK 2.5CM&< | $2,406.00 | $2,406.00 | — | 368% above | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Q-CARE SIMP REP SCLP NK TK 2.5CM< | $144.00 | $144.00 | — | — | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 RHC SIMP REP SCLP NK TK 2.5 CM & < | $618.00 | $618.00 | — | — | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMP REP SCLP NK TK 2.5CM&< | $2,406.00 | $2,406.00 | — | — | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMP REP SCLP NK TK 2.5CM&< ED TC | $2,406.00 | $2,406.00 | — | — | — |
| Skin biopsy, punch, one lesion CPT 11104 RHC PUNCH BIOPSY SKIN SINGLE LESION | $1,139.00 | $1,139.00 | — | 73% above | — |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION | $4,837.00 | $4,837.00 | — | 635% above | — |
| Skin biopsy, punch, one lesion inpatient CPT 11104 RHC PUNCH BIOPSY SKIN SINGLE LESION | $1,139.00 | $1,139.00 | — | — | — |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION | $4,837.00 | $4,837.00 | — | — | — |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC MAL LES TRUNK ARM LEG <.5CM | $8,518.00 | $8,518.00 | — | 711% above | — |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC MAL LES TRUNK ARM LEG <.5CM | $8,518.00 | $8,518.00 | — | — | — |
| Skin tag removal, up to 15 tags CPT 11200 RHC SKIN FIBRO TAG REMOVL 1-15 | $692.00 | $692.00 | — | 15% above | — |
| Skin tag removal, up to 15 tags CPT 11200 SKIN FIBRO TAG REMOVL 1-15 | $2,406.00 | $2,406.00 | — | 298% above | — |
| Skin tag removal, up to 15 tags inpatient CPT 11200 RHC SKIN FIBRO TAG REMOVL 1-15 | $692.00 | $692.00 | — | — | — |
| Skin tag removal, up to 15 tags inpatient CPT 11200 SKIN FIBRO TAG REMOVL 1-15 | $2,406.00 | $2,406.00 | — | — | — |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR ED TC | $8,384.00 | $8,384.00 | — | 586% above | — |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR | $8,384.00 | $8,384.00 | — | 586% above | — |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Diagnostic | $8,384.00 | $8,384.00 | — | 586% above | — |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR ED TC | $8,384.00 | $8,384.00 | — | — | — |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture Diagnostic | $8,384.00 | $8,384.00 | — | — | — |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR | $8,384.00 | $8,384.00 | — | — | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Q-CARE SIMP REP SCLP NK TK 2.6-7.5 CM | $160.00 | $160.00 | — | 70% below | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RHC SIMP REP SCLP NK TK 2.6-7.5 CM | $651.00 | $651.00 | — | 23% above | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMP REP SCLP NK TK 2.6-7.5CM ED TC | $2,406.00 | $2,406.00 | — | 355% above | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMP REP SCLP NK TK 2.6-7.5CM | $2,406.00 | $2,406.00 | — | 355% above | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Q-CARE SIMP REP SCLP NK TK 2.6-7.5 CM | $160.00 | $160.00 | — | — | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RHC SIMP REP SCLP NK TK 2.6-7.5 CM | $651.00 | $651.00 | — | — | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMP REP SCLP NK TK 2.6-7.5CM | $2,406.00 | $2,406.00 | — | — | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMP REP SCLP NK TK 2.6-7.5CM ED TC | $2,406.00 | $2,406.00 | — | — | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Q-CARE SIMP FAC EAR EYE 2.5CM < | $155.00 | $155.00 | — | 70% below | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RHC SIMP FAC EAR EYE 2.5 CM & < | $644.00 | $644.00 | — | 26% above | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMP FAC EAR EYE 2.5CM&< ED TC | $2,406.00 | $2,406.00 | — | 372% above | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMP FAC EAR EYE 2.5CM&< | $2,406.00 | $2,406.00 | — | 372% above | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Q-CARE SIMP FAC EAR EYE 2.5CM < | $155.00 | $155.00 | — | — | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RHC SIMP FAC EAR EYE 2.5 CM & < | $644.00 | $644.00 | — | — | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMP FAC EAR EYE 2.5CM&< ED TC | $2,406.00 | $2,406.00 | — | — | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMP FAC EAR EYE 2.5CM&< | $2,406.00 | $2,406.00 | — | — | — |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 RHC TANGENTIAL BIOPSY SKIN SINGLE LESION | $600.00 | $600.00 | — | 6% above | — |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION | $2,406.00 | $2,406.00 | — | 325% above | — |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 RHC TANGENTIAL BIOPSY SKIN SINGLE LESION | $600.00 | $600.00 | — | — | — |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION | $2,406.00 | $2,406.00 | — | — | — |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING | $2,376.00 | $2,376.00 | — | 61% above | — |
| Thoracentesis with imaging guidance one side CPT 32555 US Thoracentesis Left | $7,485.00 | $7,485.00 | — | 408% above | — |
| Thoracentesis with imaging guidance one side CPT 32555 US Thoracentesis Right | $7,485.00 | $7,485.00 | — | 408% above | — |
| Thoracentesis with imaging guidance one side CPT 32555 CT Thoracentesis Left | $7,485.00 | $7,485.00 | — | 408% above | — |
| Thoracentesis with imaging guidance one side CPT 32555 CT Thoracentesis Right | $7,485.00 | $7,485.00 | — | 408% above | — |
| Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING | $2,376.00 | $2,376.00 | — | — | — |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 US Thoracentesis Right | $7,485.00 | $7,485.00 | — | — | — |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 CT Thoracentesis Left | $7,485.00 | $7,485.00 | — | — | — |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 CT Thoracentesis Right | $7,485.00 | $7,485.00 | — | — | — |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 US Thoracentesis Left | $7,485.00 | $7,485.00 | — | — | — |
| Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH | $19,375.00 | $19,375.00 | — | 298% above | — |
| Trigger finger release surgery inpatient CPT 26055 INCISE FINGER TENDON SHEATH | $19,375.00 | $19,375.00 | — | — | — |
| Trigger point injections, 1 or 2 muscles CPT 20552 RHC TRIGGER PT INJECT 1-2 MUSCLE | $846.00 | $846.00 | — | 56% above | — |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT INJECT 1-2 MUSCLE ED TC | $3,574.00 | $3,574.00 | — | 561% above | — |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT INJECT 1-2 MUSCLE | $3,574.00 | $3,574.00 | — | 561% above | — |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 RHC TRIGGER PT INJECT 1-2 MUSCLE | $846.00 | $846.00 | — | — | — |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PT INJECT 1-2 MUSCLE | $3,574.00 | $3,574.00 | — | — | — |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PT INJECT 1-2 MUSCLE ED TC | $3,574.00 | $3,574.00 | — | — | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Biopsy Breast Right | $19,615.00 | $19,615.00 | — | 447% above | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Biopsy Breast Left | $19,615.00 | $19,615.00 | — | 447% above | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Biopsy Breast Right | $19,615.00 | $19,615.00 | — | — | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Biopsy Breast Left | $19,615.00 | $19,615.00 | — | — | — |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD ESOPH DILATION <30 MM | $8,100.00 | $8,100.00 | — | 137% above | — |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD ESOPH DILATION <30 MM | $8,100.00 | $8,100.00 | — | — | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE | $8,100.00 | $8,100.00 | — | 273% above | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD BIOPSY SINGLE/MULTIPLE | $8,100.00 | $8,100.00 | — | — | — |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD W/ SUBMUC INJ | $8,100.00 | $8,100.00 | — | 210% above | — |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD W/ SUBMUC INJ | $8,100.00 | $8,100.00 | — | — | — |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD GUIDE WIRE INSERTION | $8,100.00 | $8,100.00 | — | 227% above | — |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD GUIDE WIRE INSERTION | $8,100.00 | $8,100.00 | — | — | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH | $8,100.00 | $8,100.00 | — | 327% above | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAGNOSTIC BRUSH WASH | $8,100.00 | $8,100.00 | — | — | — |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 3RD TRI MATERNITY CARE VAG | $3,815.00 | $3,815.00 | — | at median | — |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 3RD TRI MATERNITY CARE VAG | $3,815.00 | $3,815.00 | — | — | — |
| Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENO ABLATION THPY 1ST VEI | $38,105.00 | $38,105.00 | — | 307% above | — |
| Vein ablation, radiofrequency, first vein CPT 36475 IR RFA Incompetent Vein initial | $38,105.00 | $38,105.00 | — | 307% above | — |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVENO ABLATION THPY 1ST VEI | $38,105.00 | $38,105.00 | — | — | — |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 IR RFA Incompetent Vein initial | $38,105.00 | $38,105.00 | — | — | — |
| Wart removal, up to 14 warts CPT 17110 Q-CARE DESTRUCT BENIGN LESION 1-14 | $101.00 | $101.00 | — | 82% below | — |
| Wart removal, up to 14 warts CPT 17110 RHC WART DESTRUCTION 1- 14 | $673.00 | $673.00 | — | 21% above | — |
| Wart removal, up to 14 warts CPT 17110 WART DESTRUCTION 1- 14 | $2,406.00 | $2,406.00 | — | 331% above | — |
| Wart removal, up to 14 warts inpatient CPT 17110 Q-CARE DESTRUCT BENIGN LESION 1-14 | $101.00 | $101.00 | — | — | — |
| Wart removal, up to 14 warts inpatient CPT 17110 RHC WART DESTRUCTION 1- 14 | $673.00 | $673.00 | — | — | — |
| Wart removal, up to 14 warts inpatient CPT 17110 WART DESTRUCTION 1- 14 | $2,406.00 | $2,406.00 | — | — | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 RHC DEB SUBQ TISSUE 20 SQ CM/< | $1,172.00 | $1,172.00 | — | 9% above | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SUBCU FIRST 20SQCM OR < | $4,837.00 | $4,837.00 | — | 349% above | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 Debrid subq epi/derm first 20 sq cm | $4,837.00 | $4,837.00 | — | 349% above | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 RHC DEB SUBQ TISSUE 20 SQ CM/< | $1,172.00 | $1,172.00 | — | — | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 Debrid subq epi/derm first 20 sq cm | $4,837.00 | $4,837.00 | — | — | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SUBCU FIRST 20SQCM OR < | $4,837.00 | $4,837.00 | — | — | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration/Visit Hemodialysis Charge | $5,293.00 | $5,293.00 | — | 462% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION/VISIT | $5,293.00 | $5,293.00 | — | 462% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION/VISIT ED TC | $5,293.00 | $5,293.00 | — | 462% above | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION/VISIT ED TC | $5,293.00 | $5,293.00 | — | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration/Visit Hemodialysis Charge | $5,293.00 | $5,293.00 | — | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION/VISIT | $5,293.00 | $5,293.00 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Q-CARE AIRWAY INHALATION TREATMENT | $22.00 | $22.00 | — | 90% below | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RHC AIRWAY INHALATION TREATMENT | $524.00 | $524.00 | — | 135% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB - Aerosol Delivery Device | $2,462.00 | $2,462.00 | — | 1004% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Metered dose inhaler - Aerosol Delivery Device | $2,462.00 | $2,462.00 | — | 1004% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT ED TC | $2,462.00 | $2,462.00 | — | 1004% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT | $2,462.00 | $2,462.00 | — | 1004% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Small volume nebulizer - Aerosol Delivery Device | $2,462.00 | $2,462.00 | — | 1004% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Q-CARE AIRWAY INHALATION TREATMENT | $22.00 | $22.00 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RHC AIRWAY INHALATION TREATMENT | $524.00 | $524.00 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT | $2,462.00 | $2,462.00 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT ED TC | $2,462.00 | $2,462.00 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Metered dose inhaler - Aerosol Delivery Device | $2,462.00 | $2,462.00 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Small volume nebulizer - Aerosol Delivery Device | $2,462.00 | $2,462.00 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB - Aerosol Delivery Device | $2,462.00 | $2,462.00 | — | — | — |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN IV INFUSION TO 1 HR | $4,016.00 | $4,016.00 | — | 454% above | — |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADMIN IV INFUSION TO 1 HR | $4,016.00 | $4,016.00 | — | — | — |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 1ST 30-74 MIN | $10,201.00 | $10,201.00 | — | 444% above | — |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 1ST 30-74 MIN ED TC | $10,201.00 | $10,201.00 | — | 444% above | — |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 1ST 30-74 MIN | $10,201.00 | $10,201.00 | — | — | — |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 1ST 30-74 MIN ED TC | $10,201.00 | $10,201.00 | — | — | — |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG INCL AWAKE AND DROWSY | $3,770.00 | $3,770.00 | — | 396% above | — |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG INCL AWAKE AND DROWSY | $3,770.00 | $3,770.00 | — | — | — |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 OCCHLTH EKG W/INTERPRETATION | $65.00 | $65.00 | — | at median | — |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 OCCHLTH EKG W/INTERPRETATION | $65.00 | $65.00 | — | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 RHC EKG TRACING ONLY W/O INTER/RPT | $153.00 | $153.00 | — | 12% below | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG Acquisition-CV | $719.00 | $719.00 | — | 312% above | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY W/O INTER/RPT | $719.00 | $719.00 | — | 312% above | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY W/O INTER/RPT ED TC | $719.00 | $719.00 | — | 312% above | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 RHC EKG TRACING ONLY W/O INTER/RPT | $153.00 | $153.00 | — | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG Acquisition-CV | $719.00 | $719.00 | — | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING ONLY W/O INTER/RPT ED TC | $719.00 | $719.00 | — | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING ONLY W/O INTER/RPT | $719.00 | $719.00 | — | — | — |
| Electroconvulsive therapy (ECT), one session CPT 90870 ELECTROCONVULSIVE THERAPY | $6,424.00 | $6,424.00 | — | 409% above | — |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ELECTROCONVULSIVE THERAPY | $6,424.00 | $6,424.00 | — | — | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 EMERGENCY DEPARTMENT L1 ED TC | $1,066.00 | $1,066.00 | — | 251% above | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT L1 | $1,066.00 | $1,066.00 | — | 251% above | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 EMERGENCY DEPARTMENT L1 ED TC | $1,066.00 | $1,066.00 | — | — | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPARTMENT VISIT L1 | $1,066.00 | $1,066.00 | — | — | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 EMERGENCY DEPARTMENT L2 ED TC | $1,917.00 | $1,917.00 | — | 299% above | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT L2 | $1,917.00 | $1,917.00 | — | 299% above | — |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 EMERGENCY DEPARTMENT L2 ED TC | $1,917.00 | $1,917.00 | — | — | — |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPARTMENT VISIT L2 | $1,917.00 | $1,917.00 | — | — | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT L3 | $3,352.00 | $3,352.00 | — | 351% above | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 EMERGENCY DEPARTMENT L3 ED TC | $3,352.00 | $3,352.00 | — | 351% above | — |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPARTMENT VISIT L3 | $3,352.00 | $3,352.00 | — | — | — |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 EMERGENCY DEPARTMENT L3 ED TC | $3,352.00 | $3,352.00 | — | — | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 EMERGENCY DEPARTMENT L4 ED TC | $5,155.00 | $5,155.00 | — | 321% above | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT L4 | $5,155.00 | $5,155.00 | — | 321% above | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPARTMENT VISIT L4 | $5,155.00 | $5,155.00 | — | — | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 EMERGENCY DEPARTMENT L4 ED TC | $5,155.00 | $5,155.00 | — | — | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT L5 | $7,422.00 | $7,422.00 | — | 364% above | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 EMERGENCY DEPARTMENT L5 ED TC | $7,422.00 | $7,422.00 | — | 364% above | — |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 EMERGENCY DEPARTMENT L5 ED TC | $7,422.00 | $7,422.00 | — | — | — |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPARTMENT VISIT L5 | $7,422.00 | $7,422.00 | — | — | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Pharmacologic (Dobutamine) Stress Echo with contrast | $3,770.00 | $3,770.00 | — | 298% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Treadmill Exercise Nuclear Stress Test | $3,770.00 | $3,770.00 | — | 298% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test without Nuclear | $3,770.00 | $3,770.00 | — | 298% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test with Nuclear Imaging | $3,770.00 | $3,770.00 | — | 298% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Exercise Pharm TR | $3,770.00 | $3,770.00 | — | 298% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Pharmacologic (Lexiscan) Stress Test | $3,770.00 | $3,770.00 | — | 298% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Treadmill Exercise Stress Test | $3,770.00 | $3,770.00 | — | 298% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CP Stress Exercise or Pharmacological | $3,770.00 | $3,770.00 | — | 298% above | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test without Nuclear | $3,770.00 | $3,770.00 | — | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Exercise Pharm TR | $3,770.00 | $3,770.00 | — | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Pharmacologic (Dobutamine) Stress Echo with contrast | $3,770.00 | $3,770.00 | — | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test with Nuclear Imaging | $3,770.00 | $3,770.00 | — | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Treadmill Exercise Stress Test | $3,770.00 | $3,770.00 | — | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Treadmill Exercise Nuclear Stress Test | $3,770.00 | $3,770.00 | — | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Pharmacologic (Lexiscan) Stress Test | $3,770.00 | $3,770.00 | — | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CP Stress Exercise or Pharmacological | $3,770.00 | $3,770.00 | — | — | — |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY CONJOINT THERAPY | $828.00 | $828.00 | — | 174% above | — |
| Family therapy with the patient, 50 minutes CPT 90847 90847 Family Psychotherapy with Patient | $828.00 | $828.00 | — | 174% above | — |
| Family therapy with the patient, 50 minutes CPT 90847 RHC FAMILY PSYTX W/PT 50 MIN | $1,133.00 | $1,133.00 | — | 274% above | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 90847 Family Psychotherapy with Patient | $828.00 | $828.00 | — | — | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY CONJOINT THERAPY | $828.00 | $828.00 | — | — | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 RHC FAMILY PSYTX W/PT 50 MIN | $1,133.00 | $1,133.00 | — | — | — |
| Family therapy without the patient, 50 minutes CPT 90846 90846 Family Psychotherapy without Patient | $22.00 | $22.00 | — | 88% below | — |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY MED RX WO PATIENT | $828.00 | $828.00 | — | 362% above | — |
| Family therapy without the patient, 50 minutes CPT 90846 RHC FAMILY PSYTX W/O PT 50 MIN | $1,121.00 | $1,121.00 | — | 525% above | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 90846 Family Psychotherapy without Patient | $22.00 | $22.00 | — | — | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY MED RX WO PATIENT | $828.00 | $828.00 | — | — | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 RHC FAMILY PSYTX W/O PT 50 MIN | $1,121.00 | $1,121.00 | — | — | — |
| Group psychotherapy session CPT 90853 90853 Group Psychotherapy | $477.00 | $477.00 | — | 232% above | — |
| Group psychotherapy session CPT 90853 GROUP THERAPY | $477.00 | $477.00 | — | 232% above | — |
| Group psychotherapy session CPT 90853 RHC GROUP PSYCHOTHERAPY | $560.00 | $560.00 | — | 290% above | — |
| Group psychotherapy session inpatient CPT 90853 90853 Group Psychotherapy | $477.00 | $477.00 | — | — | — |
| Group psychotherapy session inpatient CPT 90853 GROUP THERAPY | $477.00 | $477.00 | — | — | — |
| Group psychotherapy session inpatient CPT 90853 RHC GROUP PSYCHOTHERAPY | $560.00 | $560.00 | — | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV INFUS HYDRATION INIT 31MIN TO 1HR EDTC | $605.00 | $605.00 | — | 39% above | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 RHC IV INFUS HYDRAT INIT 31MIN TO 1HR | $614.00 | $614.00 | — | 41% above | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUS HYDRAT INIT 31MIN TO 1HR | $2,551.00 | $2,551.00 | — | 486% above | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 IV INFUS HYDRATION INIT 31MIN TO 1HR EDTC | $605.00 | $605.00 | — | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 RHC IV INFUS HYDRAT INIT 31MIN TO 1HR | $614.00 | $614.00 | — | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUS HYDRAT INIT 31MIN TO 1HR | $2,551.00 | $2,551.00 | — | — | — |
| IV infusion of a medicine, first hour CPT 96365 RHC IV INFUS THERAPY INIT TO 1 HR | $679.00 | $679.00 | — | 51% above | — |
| IV infusion of a medicine, first hour CPT 96365 IV INFUS THERAPY INIT TO 1 HR | $2,551.00 | $2,551.00 | — | 466% above | — |
| IV infusion of a medicine, first hour CPT 96365 96365 IV INFUSION THERAPY INIT 10 1HR ED TC | $2,551.00 | $2,551.00 | — | 466% above | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 RHC IV INFUS THERAPY INIT TO 1 HR | $679.00 | $679.00 | — | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS THERAPY INIT TO 1 HR | $2,551.00 | $2,551.00 | — | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV INFUSION THERAPY INIT 10 1HR ED TC | $2,551.00 | $2,551.00 | — | — | — |
| IV push of a medicine, first drug CPT 96374 96374 IV THERAP/DIAG INJECTION EDTC | $605.00 | $605.00 | — | 84% above | — |
| IV push of a medicine, first drug CPT 96374 RHC IV THERAPEUTIC/DIAG INJECTION | $623.00 | $623.00 | — | 90% above | — |
| IV push of a medicine, first drug CPT 96374 IV THERAPEUTIC/DIAG INJECTION | $2,551.00 | $2,551.00 | — | 677% above | — |
| IV push of a medicine, first drug inpatient CPT 96374 96374 IV THERAP/DIAG INJECTION EDTC | $605.00 | $605.00 | — | — | — |
| IV push of a medicine, first drug inpatient CPT 96374 RHC IV THERAPEUTIC/DIAG INJECTION | $623.00 | $623.00 | — | — | — |
| IV push of a medicine, first drug inpatient CPT 96374 IV THERAPEUTIC/DIAG INJECTION | $2,551.00 | $2,551.00 | — | — | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 RHC IM/SUBCUT DIAG /THERAP INJECT | $217.00 | $217.00 | — | 76% above | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SUBCUT DIAG/THERAPEU INJECTION | $862.00 | $862.00 | — | 599% above | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SUBCUT DIAG/THERAPEU INJECTION ED TC | $862.00 | $862.00 | — | 599% above | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 RHC IM/SUBCUT DIAG /THERAP INJECT | $217.00 | $217.00 | — | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SUBCUT DIAG/THERAPEU INJECTION | $862.00 | $862.00 | — | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SUBCUT DIAG/THERAPEU INJECTION ED TC | $862.00 | $862.00 | — | — | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 90791 Psych Diagnostic Eval W/O Med Mgmt | $828.00 | $828.00 | — | 211% above | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL | $828.00 | $828.00 | — | 211% above | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 RHC PSYCH DIAGNOSTIC EVALUATION | $1,319.00 | $1,319.00 | — | 395% above | — |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 90791 Psych Diagnostic Eval W/O Med Mgmt | $828.00 | $828.00 | — | — | — |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL | $828.00 | $828.00 | — | — | — |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 RHC PSYCH DIAGNOSTIC EVALUATION | $1,319.00 | $1,319.00 | — | — | — |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES 7-8 | $3,770.00 | $3,770.00 | — | 158% above | — |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES 7-8 | $3,770.00 | $3,770.00 | — | — | — |
| Neuromuscular re-education, 15 minutes CPT 97112 OT GE NEUROMUSCUL RE EDUCT 15 MIN | $185.00 | $185.00 | — | 44% above | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT GE NEUROMUSCUL RE EDUCT 15 MIN | $185.00 | $185.00 | — | — | — |
| New patient office visit, about 30 minutes CPT 99203 Q-CARE OV PROB DETAILED NEW L3 | $146.00 | $146.00 | — | 39% below | — |
| New patient office visit, about 30 minutes CPT 99203 BHS BC HMO OV PROB DETAILED NEW L3 | $297.00 | $297.00 | — | 24% above | — |
| New patient office visit, about 30 minutes CPT 99203 RHC OV PROB DETAILED NEW L3 | $526.00 | $526.00 | — | 120% above | — |
| New patient office visit, about 30 minutes CPT 99203 99203 Office Visit Level 3 New | $1,527.00 | $1,527.00 | — | 538% above | — |
| New patient office visit, about 30 minutes CPT 99203 OV PROB DETAILED NEW L3 | $1,527.00 | $1,527.00 | — | 538% above | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 Q-CARE OV PROB DETAILED NEW L3 | $146.00 | $146.00 | — | — | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 BHS BC HMO OV PROB DETAILED NEW L3 | $297.00 | $297.00 | — | — | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 RHC OV PROB DETAILED NEW L3 | $526.00 | $526.00 | — | — | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 OV PROB DETAILED NEW L3 | $1,527.00 | $1,527.00 | — | — | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 Office Visit Level 3 New | $1,527.00 | $1,527.00 | — | — | — |
| New patient office visit, about 45 minutes CPT 99204 Q-CARE OV PROB COMPREHEN NEW L4 | $209.00 | $209.00 | — | 30% below | — |
| New patient office visit, about 45 minutes CPT 99204 BHS BC HMO OV PROB COMPREHEN NEW L4 | $297.00 | $297.00 | — | 1% below | — |
| New patient office visit, about 45 minutes CPT 99204 RHC OV PROB COMPREHEN NEW L4 | $647.00 | $647.00 | — | 116% above | — |
| New patient office visit, about 45 minutes CPT 99204 99204 Office Visit Level 4 New | $1,527.00 | $1,527.00 | — | 409% above | — |
| New patient office visit, about 45 minutes CPT 99204 OV PROB COMPREHEN NEW L4 | $1,527.00 | $1,527.00 | — | 409% above | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 Q-CARE OV PROB COMPREHEN NEW L4 | $209.00 | $209.00 | — | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 BHS BC HMO OV PROB COMPREHEN NEW L4 | $297.00 | $297.00 | — | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 RHC OV PROB COMPREHEN NEW L4 | $647.00 | $647.00 | — | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 Office Visit Level 4 New | $1,527.00 | $1,527.00 | — | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 OV PROB COMPREHEN NEW L4 | $1,527.00 | $1,527.00 | — | — | — |
| New patient office visit, about 60 minutes CPT 99205 Q-CARE OV PROB COMPLEX NEW L5 | $252.00 | $252.00 | — | 52% below | — |
| New patient office visit, about 60 minutes CPT 99205 BHS BC HMO OV PROB COMPLEX NEW L5 | $297.00 | $297.00 | — | 43% below | — |
| New patient office visit, about 60 minutes CPT 99205 RHC OV PROB COMPLEX NEW L5 | $760.00 | $760.00 | — | 46% above | — |
| New patient office visit, about 60 minutes CPT 99205 99205 Office Visit Level 5 New | $1,527.00 | $1,527.00 | — | 193% above | — |
| New patient office visit, about 60 minutes CPT 99205 OV PROB COMPLEX NEW L5 | $1,527.00 | $1,527.00 | — | 193% above | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 Q-CARE OV PROB COMPLEX NEW L5 | $252.00 | $252.00 | — | — | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 BHS BC HMO OV PROB COMPLEX NEW L5 | $297.00 | $297.00 | — | — | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 RHC OV PROB COMPLEX NEW L5 | $760.00 | $760.00 | — | — | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205 Office Visit Level 5 New | $1,527.00 | $1,527.00 | — | — | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 OV PROB COMPLEX NEW L5 | $1,527.00 | $1,527.00 | — | — | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Q-CARE OV PROB EXPANDED NEW L2 | $109.00 | $109.00 | — | 40% below | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 BHS BC HMO OV PROB EXPANDED NEW L2 | $297.00 | $297.00 | — | 62% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 RHC OV PROB EXPANDED NEW L2 | $443.00 | $443.00 | — | 142% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Office Visit Level 2 New | $1,527.00 | $1,527.00 | — | 734% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OV PROB EXPANDED NEW L2 | $1,527.00 | $1,527.00 | — | 734% above | — |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Q-CARE OV PROB EXPANDED NEW L2 | $109.00 | $109.00 | — | — | — |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 BHS BC HMO OV PROB EXPANDED NEW L2 | $297.00 | $297.00 | — | — | — |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 RHC OV PROB EXPANDED NEW L2 | $443.00 | $443.00 | — | — | — |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 Office Visit Level 2 New | $1,527.00 | $1,527.00 | — | — | — |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OV PROB EXPANDED NEW L2 | $1,527.00 | $1,527.00 | — | — | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRI THPY 15MIN IND INIT ASSES | $356.00 | $356.00 | — | 606% above | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRI THPY 15MIN IND INIT ASSES | $356.00 | $356.00 | — | — | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT GE EVAL HIGH COMPLEX 45 MINS | $567.00 | $567.00 | — | 67% above | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT GE EVAL HIGH COMPLEX 45 MINS | $567.00 | $567.00 | — | — | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT GE EVAL LOW COMPLEX 20 MINS | $567.00 | $567.00 | — | 92% above | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT GE EVAL LOW COMPLEX 20 MINS | $567.00 | $567.00 | — | — | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT GE EVAL MOD COMPLEX 30 MINS | $567.00 | $567.00 | — | 68% above | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT GE EVAL MOD COMPLEX 30 MINS | $567.00 | $567.00 | — | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT GE MANUAL LYMPH DRAINAGE 15 MIN | $133.00 | $133.00 | — | 1% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT GE MANUAL THERAPY TECHNIQUES 15 MIN | $133.00 | $133.00 | — | 1% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT GE MANUAL THERAPY TECHNIQUES 15 MIN | $133.00 | $133.00 | — | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT GE MANUAL LYMPH DRAINAGE 15 MIN | $133.00 | $133.00 | — | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 RHC THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $167.00 | $167.00 | — | 26% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT GE THERAPEUTIC EXERC STRENGTH 15 MIN | $167.00 | $167.00 | — | 26% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT GE THERAPEUTIC EXERCISE 15 MIN | $167.00 | $167.00 | — | 26% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT GE THERAPEUTIC EXERC STRENGTH 15 MIN | $167.00 | $167.00 | — | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT GE THERAPEUTIC EXERCISE 15 MIN | $167.00 | $167.00 | — | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 RHC THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $167.00 | $167.00 | — | — | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREVENTIVE MED 18-39YRS NEW | $82.00 | $82.00 | — | 44% below | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 RHC PREVENTIVE MED 18-39 YRS NEW | $247.00 | $247.00 | — | 69% above | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PREVENTIVE MED 18-39YRS NEW | $82.00 | $82.00 | — | — | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 RHC PREVENTIVE MED 18-39 YRS NEW | $247.00 | $247.00 | — | — | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 PREVENTIVE MED 40-64YR NEW | $95.00 | $95.00 | — | 39% below | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 RHC PREVENTIVE MED 40-64 YRS NEW | $286.00 | $286.00 | — | 85% above | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREVENTIVE MED 40-64YR NEW | $95.00 | $95.00 | — | — | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 RHC PREVENTIVE MED 40-64 YRS NEW | $286.00 | $286.00 | — | — | — |
| Preventive checkup, new patient aged 65 or older CPT 99387 PREVENTIVE MED 65YR & > NEW | $103.00 | $103.00 | — | 50% below | — |
| Preventive checkup, new patient aged 65 or older CPT 99387 RHC PREVENTIVE MED 65 YR & > NEW | $309.00 | $309.00 | — | 50% above | — |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PREVENTIVE MED 65YR & > NEW | $103.00 | $103.00 | — | — | — |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 RHC PREVENTIVE MED 65 YR & > NEW | $309.00 | $309.00 | — | — | — |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PREVENTIVE MED 18-39YRS EST | $74.00 | $74.00 | — | 43% below | — |
| Preventive checkup, returning patient aged 18–39 CPT 99395 RHC PREVENTIVE MED 18-39 YRS EST | $221.00 | $221.00 | — | 69% above | — |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PREVENTIVE MED 18-39YRS EST | $74.00 | $74.00 | — | — | — |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 RHC PREVENTIVE MED 18-39 YRS EST | $221.00 | $221.00 | — | — | — |
| Preventive checkup, returning patient aged 40–64 CPT 99396 PREVENTIVE MED 40-64YRS EST | $78.00 | $78.00 | — | 50% below | — |
| Preventive checkup, returning patient aged 40–64 CPT 99396 RHC PREVENTIVE MED 40-64 YRS EST | $235.00 | $235.00 | — | 50% above | — |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PREVENTIVE MED 40-64YRS EST | $78.00 | $78.00 | — | — | — |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 RHC PREVENTIVE MED 40-64 YRS EST | $235.00 | $235.00 | — | — | — |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PREVENTIVE MED 65YRS&> EST | $84.00 | $84.00 | — | 53% below | — |
| Preventive checkup, returning patient aged 65 or older CPT 99397 RHC PREVENTIVE MED 65 YRS & > EST | $252.00 | $252.00 | — | 41% above | — |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PREVENTIVE MED 65YRS&> EST | $84.00 | $84.00 | — | — | — |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 RHC PREVENTIVE MED 65 YRS & > EST | $252.00 | $252.00 | — | — | — |
| Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL WITH MED SERVICES | $828.00 | $828.00 | — | 152% above | — |
| Psychiatric evaluation with medical services CPT 90792 90792 Psych Diagnostic Eval With Med Mgmt | $828.00 | $828.00 | — | 152% above | — |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG EVAL WITH MED SERVICES | $828.00 | $828.00 | — | — | — |
| Psychiatric evaluation with medical services inpatient CPT 90792 90792 Psych Diagnostic Eval With Med Mgmt | $828.00 | $828.00 | — | — | — |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 96130 Psychological Eval Services by Psychologist - 1st Hour | $1,604.00 | $1,604.00 | — | 178% above | — |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR | $1,604.00 | $1,604.00 | — | 178% above | — |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 96130 Psychological Eval Services by Psychologist - 1st Hour | $1,604.00 | $1,604.00 | — | — | — |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR | $1,604.00 | $1,604.00 | — | — | — |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60 MIN | $828.00 | $828.00 | — | 362% above | — |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYTX CRISIS INITIAL 60 MIN | $828.00 | $828.00 | — | — | — |
| Psychotherapy session, 30 minutes CPT 90832 90832 Psychotherapy, 30 Minutes | $828.00 | $828.00 | — | 237% above | — |
| Psychotherapy session, 30 minutes CPT 90832 PSYTX PT FAMILY 30 MINUTES | $828.00 | $828.00 | — | 237% above | — |
| Psychotherapy session, 30 minutes CPT 90832 RHC PSYTX W PT 30 MINUTES | $1,061.00 | $1,061.00 | — | 331% above | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 90832 Psychotherapy, 30 Minutes | $828.00 | $828.00 | — | — | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYTX PT FAMILY 30 MINUTES | $828.00 | $828.00 | — | — | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 RHC PSYTX W PT 30 MINUTES | $1,061.00 | $1,061.00 | — | — | — |
| Psychotherapy session, 45 minutes CPT 90834 90834 Psychotherapy, 45 Minutes | $828.00 | $828.00 | — | 223% above | — |
| Psychotherapy session, 45 minutes CPT 90834 PSYTX PT FAMILY 45 MINUTES | $828.00 | $828.00 | — | 223% above | — |
| Psychotherapy session, 45 minutes CPT 90834 RHC PSYTX W PT 45 MINUTES | $1,135.00 | $1,135.00 | — | 343% above | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYTX PT FAMILY 45 MINUTES | $828.00 | $828.00 | — | — | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 90834 Psychotherapy, 45 Minutes | $828.00 | $828.00 | — | — | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 RHC PSYTX W PT 45 MINUTES | $1,135.00 | $1,135.00 | — | — | — |
| Psychotherapy session, 60 minutes CPT 90837 PSYTX W PT 60 MINUTES | $828.00 | $828.00 | — | 174% above | — |
| Psychotherapy session, 60 minutes CPT 90837 90837 Psychotherapy, 60 Minutes | $828.00 | $828.00 | — | 174% above | — |
| Psychotherapy session, 60 minutes CPT 90837 RHC PSYTX W PT 60 MINUTES | $1,283.00 | $1,283.00 | — | 324% above | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYTX W PT 60 MINUTES | $828.00 | $828.00 | — | — | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 90837 Psychotherapy, 60 Minutes | $828.00 | $828.00 | — | — | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 RHC PSYTX W PT 60 MINUTES | $1,283.00 | $1,283.00 | — | — | — |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $63.00 | $63.00 | — | 38% above | — |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 RHC SMOKING CESSATION 4-10 MIN MC | $105.00 | $105.00 | — | 130% above | — |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION 4-10 MIN MC | $361.00 | $361.00 | — | 691% above | — |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $63.00 | $63.00 | — | — | — |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 RHC SMOKING CESSATION 4-10 MIN MC | $105.00 | $105.00 | — | — | — |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION 4-10 MIN MC | $361.00 | $361.00 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Q-CARE OV PROB COMPREHEN ESTAB L5 | $184.00 | $184.00 | — | 32% below | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 BHS BC HMO OV PROB COMPREHEN ESTAB L5 | $297.00 | $297.00 | — | 9% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 RHC OV PROB COMPREHEN ESTAB L5 | $671.00 | $671.00 | — | 147% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OV PROB COMPREHEN ESTAB L5 | $1,527.00 | $1,527.00 | — | 461% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Office Visit Level 5 Est | $1,527.00 | $1,527.00 | — | 461% above | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Q-CARE OV PROB COMPREHEN ESTAB L5 | $184.00 | $184.00 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 BHS BC HMO OV PROB COMPREHEN ESTAB L5 | $297.00 | $297.00 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 RHC OV PROB COMPREHEN ESTAB L5 | $671.00 | $671.00 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 Office Visit Level 5 Est | $1,527.00 | $1,527.00 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OV PROB COMPREHEN ESTAB L5 | $1,527.00 | $1,527.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 RHC WEIGHT MGMT OV PROB EXPANDED ESTAB L3 | $73.00 | $73.00 | — | 61% below | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Q-CARE OV PROB EXPANDED ESTAB L3 | $106.00 | $106.00 | — | 43% below | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 BHS BC HMO OV PROB EXPANDED ESTAB L3 | $297.00 | $297.00 | — | 60% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 RHC OV PROB EXPANDED ESTAB L3 | $488.00 | $488.00 | — | 164% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office Visit Level 3 Est | $1,527.00 | $1,527.00 | — | 725% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OV PROB EXPANDED ESTAB L3 | $1,527.00 | $1,527.00 | — | 725% above | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 RHC WEIGHT MGMT OV PROB EXPANDED ESTAB L3 | $73.00 | $73.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Q-CARE OV PROB EXPANDED ESTAB L3 | $106.00 | $106.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 BHS BC HMO OV PROB EXPANDED ESTAB L3 | $297.00 | $297.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 RHC OV PROB EXPANDED ESTAB L3 | $488.00 | $488.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OV PROB EXPANDED ESTAB L3 | $1,527.00 | $1,527.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 Office Visit Level 3 Est | $1,527.00 | $1,527.00 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 RHC WEIGHT MGMT OV PROB DETAILED ESTAB L4 | $107.00 | $107.00 | — | 47% below | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Q-CARE OV PROB DETAILED ESTAB L4 | $144.00 | $144.00 | — | 29% below | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 BHS BC HMO OV PROB DETAILED ESTAB L4 | $297.00 | $297.00 | — | 47% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 RHC OV PROB DETAILED ESTAB L4 | $561.00 | $561.00 | — | 178% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Office Visit Level 4 Est | $1,527.00 | $1,527.00 | — | 657% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OV PROB DETAILED ESTAB L4 | $1,527.00 | $1,527.00 | — | 657% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 RHC WEIGHT MGMT OV PROB DETAILED ESTAB L4 | $107.00 | $107.00 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Q-CARE OV PROB DETAILED ESTAB L4 | $144.00 | $144.00 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 BHS BC HMO OV PROB DETAILED ESTAB L4 | $297.00 | $297.00 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 RHC OV PROB DETAILED ESTAB L4 | $561.00 | $561.00 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 Office Visit Level 4 Est | $1,527.00 | $1,527.00 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OV PROB DETAILED ESTAB L4 | $1,527.00 | $1,527.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 RHC WEIGHT MGMT OV PROB FOCUSED ESTAB L2 | $45.00 | $45.00 | — | 72% below | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Q-CARE OV PROB FOCUSED ESTAB L2 | $75.00 | $75.00 | — | 54% below | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 BHS BC HMO OV PROB FOCUSED ESTAB L2 | $297.00 | $297.00 | — | 83% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 RHC OV PROB FOCUSED ESTAB L2 | $415.00 | $415.00 | — | 156% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 IR OP Visit Level 1 | $1,527.00 | $1,527.00 | — | 843% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office Visit Level 2 Est | $1,527.00 | $1,527.00 | — | 843% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OV PROB FOCUSED ESTAB L2 | $1,527.00 | $1,527.00 | — | 843% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 RHC WEIGHT MGMT OV PROB FOCUSED ESTAB L2 | $45.00 | $45.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Q-CARE OV PROB FOCUSED ESTAB L2 | $75.00 | $75.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 BHS BC HMO OV PROB FOCUSED ESTAB L2 | $297.00 | $297.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 RHC OV PROB FOCUSED ESTAB L2 | $415.00 | $415.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 IR OP Visit Level 1 | $1,527.00 | $1,527.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Office Visit Level 2 Est | $1,527.00 | $1,527.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OV PROB FOCUSED ESTAB L2 | $1,527.00 | $1,527.00 | — | — | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OV CONSULT PROB DETAILED L3 | $185.00 | $185.00 | — | at median | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 RHC OV CONSULT PROB DETAILED L3 | $185.00 | $185.00 | — | at median | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 RHC OV CONSULT PROB DETAILED L3 | $185.00 | $185.00 | — | — | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OV CONSULT PROB DETAILED L3 | $185.00 | $185.00 | — | — | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 RHC OV CONSULT PROB COMPREHEN L4 | $260.00 | $260.00 | — | at median | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OV CONSULT PROB COMPREHEN L4 | $260.00 | $260.00 | — | at median | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 RHC OV CONSULT PROB COMPREHEN L4 | $260.00 | $260.00 | — | — | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OV CONSULT PROB COMPREHEN L4 | $260.00 | $260.00 | — | — | — |
| Speech and language evaluation CPT 92523 ST GE SPEECH SOUND LANG COMPREHEN | $1,298.00 | $1,298.00 | — | 143% above | — |
| Speech and language evaluation inpatient CPT 92523 ST GE SPEECH SOUND LANG COMPREHEN | $1,298.00 | $1,298.00 | — | — | — |
| Speech therapy session, individual CPT 92507 ST GE SPEECH TREATMENT OF DISORDER | $436.00 | $436.00 | — | 43% above | — |
| Speech therapy session, individual inpatient CPT 92507 ST GE SPEECH TREATMENT OF DISORDER | $436.00 | $436.00 | — | — | — |
| Spirometry (breathing test) CPT 94010 RHC SPIROMETRY | $466.00 | $466.00 | — | 55% above | — |
| Spirometry (breathing test) CPT 94010 SPIROMETRY | $759.00 | $759.00 | — | 152% above | — |
| Spirometry (breathing test) inpatient CPT 94010 RHC SPIROMETRY | $466.00 | $466.00 | — | — | — |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY | $759.00 | $759.00 | — | — | — |
| Spirometry before and after a bronchodilator CPT 94060 Pulmonary Function Testing | $2,277.00 | $2,277.00 | — | 250% above | — |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Pulmonary Function Testing | $2,277.00 | $2,277.00 | — | — | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT GE THERA ACTIVITY DYNAMIC 15 MIN | $199.00 | $199.00 | — | 55% above | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT GE THERA ACTIVITY DYNAMIC 15 MIN | $199.00 | $199.00 | — | — | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC | $1,561.00 | $1,561.00 | — | 576% above | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Theraputic Phlebotomy | $1,561.00 | $1,561.00 | — | 576% above | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Theraputic Phlebotomy | $1,561.00 | $1,561.00 | — | — | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC | $1,561.00 | $1,561.00 | — | — | — |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus vaccine inj-[B] | $549.05 | $549.05 | — | 167% above | — |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 00006-4827-00 - varicella virus vaccine inj-CLINIC | $549.05 | $549.05 | — | 167% above | — |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 varicella virus vaccine inj-[B] | $549.05 | $549.05 | — | — | — |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 00006-4827-00 - varicella virus vaccine inj-CLINIC | $549.05 | $549.05 | — | — | — |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 RHC DTAP-IPV VACCINE 4-6 YRS IM MA ONLY | $23.14 | $23.14 | — | 72% below | — |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 diphtheria/pertussis,acel/tetanus/polio 0.5mL SDV-[D] | $159.35 | $159.35 | — | 92% above | — |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 diphtheria/pertussis,acel/tetanus/polio 0.5mL SDV-[B] | $159.35 | $159.35 | — | 92% above | — |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 RHC DTAP-IPV VACCINE 4-6 YRS IM MA ONLY | $23.14 | $23.14 | — | — | — |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 diphtheria/pertussis,acel/tetanus/polio 0.5mL SDV-[D] | $159.35 | $159.35 | — | — | — |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 diphtheria/pertussis,acel/tetanus/polio 0.5mL SDV-[B] | $159.35 | $159.35 | — | — | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 RHC ADM IM DT ACELLULAR PERT MA ONLY | $23.14 | $23.14 | — | 32% below | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 diphtheria/tetanus/pertussis, acel (DTaP) 25 units-10 units-58 mcg/0.5 mL IM Susp 0.5 mL [B] | $88.80 | $88.80 | — | 160% above | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 diphtheria/tetanus/pertussis, acel (DTaP) 15 units-5 units-23 mcg/0.5 mL (Daptacel)-[B] | $91.20 | $91.20 | — | 167% above | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 RHC ADM IM DT ACELLULAR PERT MA ONLY | $23.14 | $23.14 | — | — | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 diphtheria/tetanus/pertussis, acel (DTaP) 25 units-10 units-58 mcg/0.5 mL IM Susp 0.5 mL [B] | $88.80 | $88.80 | — | — | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 diphtheria/tetanus/pertussis, acel (DTaP) 15 units-5 units-23 mcg/0.5 mL (Daptacel)-[B] | $91.20 | $91.20 | — | — | — |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 RHC ADM IM DPT HEP B POLIO MA ONLY | $23.14 | $23.14 | — | 72% below | — |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 diphtheria/hepB/pertussis,acel/polio/tetanus IM Susp 0 mL-[D] | $310.90 | $310.90 | — | 275% above | — |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 diphtheria/hepB/pertussis,acel/polio/tetanus IM Susp 0 mL-[B] | $310.90 | $310.90 | — | 275% above | — |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 RHC ADM IM DPT HEP B POLIO MA ONLY | $23.14 | $23.14 | — | — | — |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 diphtheria/hepB/pertussis,acel/polio/tetanus IM Susp 0 mL-[D] | $310.90 | $310.90 | — | — | — |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 diphtheria/hepB/pertussis,acel/polio/tetanus IM Susp 0 mL-[B] | $310.90 | $310.90 | — | — | — |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 RHC ADM IM PENTACEL VACCINE MA ONLY | $23.14 | $23.14 | — | 72% below | — |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 dp(a)t-polio-hib conj-tet (pf) 15-20-5 lf-mcg-lf kit-[D] | $341.70 | $341.70 | — | 312% above | — |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 dp(a)t-polio-hib conj-tet (pf) 15-20-5 lf-mcg-lf kit-[B] | $341.70 | $341.70 | — | 312% above | — |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 RHC ADM IM PENTACEL VACCINE MA ONLY | $23.14 | $23.14 | — | — | — |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 dp(a)t-polio-hib conj-tet (pf) 15-20-5 lf-mcg-lf kit-[D] | $341.70 | $341.70 | — | — | — |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 dp(a)t-polio-hib conj-tet (pf) 15-20-5 lf-mcg-lf kit-[B] | $341.70 | $341.70 | — | — | — |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 RHC DTAP-IPV-HIB-HEPB VACCINE IM MA ONLY | $23.14 | $23.14 | — | 74% below | — |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 diphtheria/haem/hepB/pert,acel/polio/tetan - Sus-[PM] | $417.25 | $417.25 | — | 364% above | — |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 RHC DTAP-IPV-HIB-HEPB VACCINE IM MA ONLY | $23.14 | $23.14 | — | — | — |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 diphtheria/haem/hepB/pert,acel/polio/tetan - Sus-[PM] | $417.25 | $417.25 | — | — | — |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 RHC ADM RIV3 VACCINE NO PRESERV IM MA ONLY | $23.14 | $23.14 | — | 23% below | — |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 influenza virus vaccine, inactivated recombinant hemagglutinin trivalent preservative-free Sol UD | $220.00 | $220.00 | — | 633% above | — |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 RHC ADM RIV3 VACCINE NO PRESERV IM MA ONLY | $23.14 | $23.14 | — | — | — |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 influenza virus vaccine, inactivated recombinant hemagglutinin trivalent preservative-free Sol UD | $220.00 | $220.00 | — | — | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza virus vaccine, inactivated preservative-free trivalent Sus UD | $80.00 | $80.00 | — | 20% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza virus vaccine, inactivated preservative-free trivalent Sus UD | $80.00 | $80.00 | — | — | — |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 00006-4121-02 - human papillomavirus vaccine 9-valent Sus-CLFD | $922.85 | $922.85 | — | 264% above | — |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 human papillomavirus vaccine 9-valent Sus-[D] | $922.85 | $922.85 | — | 264% above | — |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 human papillomavirus vaccine 9-valent Sus-[D] | $922.85 | $922.85 | — | — | — |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 00006-4121-02 - human papillomavirus vaccine 9-valent Sus-CLFD | $922.85 | $922.85 | — | — | — |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 RHC ADM HEPATITIS A/B TWINRIX MA ONLY | $23.14 | $23.14 | — | 74% below | — |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 hepatitis A-hepatitis B vaccine 720 units-20 mcg/mL-[B] | $397.30 | $397.30 | — | 341% above | — |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 hepatitis A-hepatitis B vaccine 720 units-20 mcg/mL -[D] | $397.30 | $397.30 | — | 341% above | — |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 RHC ADM HEPATITIS A/B TWINRIX MA ONLY | $23.14 | $23.14 | — | — | — |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 hepatitis A-hepatitis B vaccine 720 units-20 mcg/mL -[D] | $397.30 | $397.30 | — | — | — |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 hepatitis A-hepatitis B vaccine 720 units-20 mcg/mL-[B] | $397.30 | $397.30 | — | — | — |
| Hepatitis A vaccine, adult dose CPT 90632 hepatitis A adult vaccine 1440 units/mL PF IM Susp-[B] | $258.50 | $258.50 | — | 190% above | — |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 hepatitis A adult vaccine 1440 units/mL PF IM Susp-[B] | $258.50 | $258.50 | — | — | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 RHC ADM IM HEP A PED ADOL 2DOSE MA ONLY | $23.14 | $23.14 | — | 69% below | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 hepatitis A pediatric vaccine 720 units/0.5 mL preservative free Sus-[D] | $107.25 | $107.25 | — | 45% above | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 hepatitis A pediatric vaccine 720 units/0.5 mL preservative free Sus-[B] | $107.25 | $107.25 | — | 45% above | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 hepatitis A pediatric vaccine 25 units/0.5 mL SDV-[D] | $116.55 | $116.55 | — | 57% above | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 RHC ADM IM HEP A PED ADOL 2DOSE MA ONLY | $23.14 | $23.14 | — | — | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 hepatitis A pediatric vaccine 720 units/0.5 mL preservative free Sus-[B] | $107.25 | $107.25 | — | — | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 hepatitis A pediatric vaccine 720 units/0.5 mL preservative free Sus-[D] | $107.25 | $107.25 | — | — | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 hepatitis A pediatric vaccine 25 units/0.5 mL SDV-[D] | $116.55 | $116.55 | — | — | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RHC ADM IM HEP B ADULT MA ONLY | $23.14 | $23.14 | — | 72% below | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B virus vaccine (pf) 20 mcg/ml syrg-[B] | $75.00 | $75.00 | — | 9% below | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B virus vaccine (pf) 20 mcg/ml syrg-[D] | $75.00 | $75.00 | — | 9% below | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 RHC ADM IM HEP B ADULT MA ONLY | $23.14 | $23.14 | — | — | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B virus vaccine (pf) 20 mcg/ml syrg-[D] | $75.00 | $75.00 | — | — | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B virus vaccine (pf) 20 mcg/ml syrg-[B] | $75.00 | $75.00 | — | — | — |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 hepatitis B adult vaccine 20 mcg/0.5 mL Sol-[PM] | $345.00 | $345.00 | — | 98% above | — |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 hepatitis B adult vaccine 20 mcg/0.5 mL Sol-[PM] | $345.00 | $345.00 | — | — | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 RHC ADM IM HEP B PED ADOL 3 DOSE MA ONLY | $23.14 | $23.14 | — | 51% below | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B pediatric vaccine 5 mcg/0.5 mL Sus-[B] | $71.85 | $71.85 | — | 52% above | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B vaccine pediatric 10 mcg/0.5 mL Sus-[B] | $87.80 | $87.80 | — | 85% above | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 RHC ADM IM HEP B PED ADOL 3 DOSE MA ONLY | $23.14 | $23.14 | — | — | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 hepatitis B pediatric vaccine 5 mcg/0.5 mL Sus-[B] | $71.85 | $71.85 | — | — | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 hepatitis B vaccine pediatric 10 mcg/0.5 mL Sus-[B] | $87.80 | $87.80 | — | — | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 RHC ADM IM HIB PRP T CONJUGATE 4 DOSE MA ONLY | $23.14 | $23.14 | — | 26% below | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 haemophilus b polysacc vaccine 10 mcg/0.5 ml solr-[B] | $40.25 | $40.25 | — | 29% above | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 haemophilus b conjugate (PRP-T) vaccine - Pow | $40.25 | $40.25 | — | 29% above | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 RHC ADM IM HIB PRP T CONJUGATE 4 DOSE MA ONLY | $23.14 | $23.14 | — | — | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 haemophilus b polysacc vaccine 10 mcg/0.5 ml solr-[B] | $40.25 | $40.25 | — | — | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 haemophilus b conjugate (PRP-T) vaccine - Pow | $40.25 | $40.25 | — | — | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 RHC ADM IIV NO PRSV INCREASED AG IM MA ONLY | $23.14 | $23.14 | — | 74% below | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 influenza virus vaccine, inactivated high-dose preservative-free trivalent Sus UD | $220.00 | $220.00 | — | 152% above | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 RHC ADM IIV NO PRSV INCREASED AG IM MA ONLY | $23.14 | $23.14 | — | — | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 influenza virus vaccine, inactivated high-dose preservative-free trivalent Sus UD | $220.00 | $220.00 | — | — | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 RHC ADM SUBCUT MMR MA ONLY | $23.14 | $23.14 | — | 65% below | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 measles-mumps-rubella vaccine inj-[B] | $285.65 | $285.65 | — | 337% above | — |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 RHC ADM SUBCUT MMR MA ONLY | $23.14 | $23.14 | — | — | — |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles-mumps-rubella vaccine inj-[B] | $285.65 | $285.65 | — | — | — |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 measles/mumps/rubella/varicella virus vaccine-[B] | $834.50 | $834.50 | — | 245% above | — |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 measles/mumps/rubella/varicella virus vaccine-[D] | $834.50 | $834.50 | — | 245% above | — |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 measles/mumps/rubella/varicella virus vaccine-[B] | $834.50 | $834.50 | — | — | — |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 measles/mumps/rubella/varicella virus vaccine-[D] | $834.50 | $834.50 | — | — | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal vaccine 4 mcg/0.5 ml (ages 2yr-55yr)-[B] | $849.45 | $849.45 | — | 808% above | — |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal vaccine 4 mcg/0.5 ml (ages 2yr-55yr)-[B] | $849.45 | $849.45 | — | — | — |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 meningococcal conjugate vaccine polysaccharide tetanus toxoid group ACYW Sol-[PM] | $500.60 | $500.60 | — | 1% above | — |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 meningococcal conjugate vaccine polysaccharide tetanus toxoid group ACYW Sol-[PM] | $500.60 | $500.60 | — | — | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 meningococcal group B (Bexsero) vaccine recombinant, OMV, (ages 10-25 yrs) Sus-[B] | $573.00 | $573.00 | — | 198% above | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 58160-0976-06 - meningococcal group B vaccine recombinant, OMV, adjuvanted Sus-DUB | $573.00 | $573.00 | — | 198% above | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 meningococcal group B (Bexsero) vaccine recombinant, OMV, (ages 10-25 yrs) Sus-[B] | $573.00 | $573.00 | — | — | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 58160-0976-06 - meningococcal group B vaccine recombinant, OMV, adjuvanted Sus-DUB | $573.00 | $573.00 | — | — | — |
| Meningococcal B vaccine (Trumenba) CPT 90621 00005-0100-10 - meningococcal group B vaccine fully recombinant Sus-BRK | $570.45 | $570.45 | — | 191% above | — |
| Meningococcal B vaccine (Trumenba) CPT 90621 meningococcal group B vaccine fully recombinant Sus (Trumenba)-[D] | $570.45 | $570.45 | — | 191% above | — |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 00005-0100-10 - meningococcal group B vaccine fully recombinant Sus-BRK | $570.45 | $570.45 | — | — | — |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 meningococcal group B vaccine fully recombinant Sus (Trumenba)-[D] | $570.45 | $570.45 | — | — | — |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 pneumococcal 13-valent conjugate vaccine 0.5 mL syr-[D] | $774.00 | $774.00 | — | 438% above | — |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 pneumococcal 13-valent conjugate vaccine 0.5 mL syr-[D] | $774.00 | $774.00 | — | — | — |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 pneumococcal 15-valent conjugate vaccine - Sus-[D] | $668.15 | $668.15 | — | 13% above | — |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 pneumococcal 15-valent conjugate vaccine - Sus-[D] | $668.15 | $668.15 | — | — | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-valent conjugate vaccine 0.5 mL syr -[D] | $851.00 | $851.00 | — | 164% above | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-valent conjugate vaccine - Sus | $851.00 | $851.00 | — | 164% above | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal 20-valent conjugate vaccine - Sus | $851.00 | $851.00 | — | — | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal 20-valent conjugate vaccine 0.5 mL syr -[D] | $851.00 | $851.00 | — | — | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4837-03 - pneumococcal vaccine polyvalen 25 mcg/0.5 ml inj-DRMC | $400.00 | $400.00 | — | 212% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4837-03 - pneumococcal vaccine polyvalen 25 mcg/0.5 ml inj-DRMC | $400.00 | $400.00 | — | — | — |
| Polio vaccine, inactivated (IPV) CPT 90713 RHC ADM SUBCUT POLIO INACTIV MA ONLY | $23.14 | $23.14 | — | 61% below | — |
| Polio vaccine, inactivated (IPV) CPT 90713 poliovirus vaccine syringe-[B] | $134.20 | $134.20 | — | 123% above | — |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 RHC ADM SUBCUT POLIO INACTIV MA ONLY | $23.14 | $23.14 | — | — | — |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 poliovirus vaccine syringe-[B] | $134.20 | $134.20 | — | — | — |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 nirsevimab (cvx 307) alip preservative-free 100 mg/mL Sol | $1,485.00 | $1,485.00 | — | 24% above | — |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 nirsevimab (cvx 307) alip preservative-free 100 mg/mL Sol | $1,485.00 | $1,485.00 | — | — | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 nirsevimab (cvx 306) alip preservative-free 50 mg/0.5 mL Sol | $1,485.00 | $1,485.00 | — | 66% above | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 nirsevimab (cvx 306) alip preservative-free 50 mg/0.5 mL Sol | $1,485.00 | $1,485.00 | — | — | — |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV vaccine, preF A-preF B, recombinant preservative-free 60 mcg-60 mcg Inj-[D] | $885.00 | $885.00 | — | 76% above | — |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV vaccine, preF A-preF B, recombinant preservative-free 60 mcg-60 mcg Inj-[D] | $885.00 | $885.00 | — | — | — |
| Rabies vaccine, one dose CPT 90675 rabies vaccine 2.5 unit kit-[B] | $1,137.15 | $1,137.15 | — | 90% above | — |
| Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine 2.5 unit kit-[B] | $1,137.15 | $1,137.15 | — | — | — |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 RHC ADM RV1 VACC 2 DOSE LIVE ORAL MA ONLY | $23.14 | $23.14 | — | 63% below | — |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 RHC ADM RV1 VACC 2 DOSE LIVE ORAL MA ONLY | $23.14 | $23.14 | — | — | — |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 RHC ADM IM ROTAVIRUS VACCINE MA ONLY | $23.14 | $23.14 | — | 72% below | — |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 rotavirus vaccine pentavalent-[D] | $296.50 | $296.50 | — | 257% above | — |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 RHC ADM IM ROTAVIRUS VACCINE MA ONLY | $23.14 | $23.14 | — | — | — |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 rotavirus vaccine pentavalent-[D] | $296.50 | $296.50 | — | — | — |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 zoster vaccine, inactivated adjuvanted inj-[D] | $646.55 | $646.55 | — | 144% above | — |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 zoster vaccine, inactivated adjuvanted inj-[D] | $646.55 | $646.55 | — | — | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 RHC ADM IM TETANUS DIP>7YRS MA ONLY | $23.14 | $23.14 | — | 59% below | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphtheria toxoid adul 5-2 lf unit/0.5 ml syrg-[B] | $117.55 | $117.55 | — | 111% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 RHC ADM IM TETANUS DIP>7YRS MA ONLY | $23.14 | $23.14 | — | — | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus-diphtheria toxoid adul 5-2 lf unit/0.5 ml syrg-[B] | $117.55 | $117.55 | — | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 RHC ADM TDAP MA ONLY | $23.14 | $23.14 | — | 59% below | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2.5 units-18.5 mcg/0.5 mL Sus-[D] | $133.30 | $133.30 | — | 138% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL Sus-BRK | $150.35 | $150.35 | — | 168% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 RHC ADM TDAP MA ONLY | $23.14 | $23.14 | — | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2.5 units-18.5 mcg/0.5 mL Sus-[D] | $133.30 | $133.30 | — | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL Sus-BRK | $150.35 | $150.35 | — | — | — |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 RHC ADM IM TYPHOID VACCINE MA ONLY | $23.14 | $23.14 | — | 72% below | — |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 typhoid vaccine 25 mcg/0.5 ml syrg-[B] | $439.75 | $439.75 | — | 430% above | — |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 typhoid vaccine 25 mcg/0.5 ml syrg-[D] | $439.75 | $439.75 | — | 430% above | — |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 RHC ADM IM TYPHOID VACCINE MA ONLY | $23.14 | $23.14 | — | — | — |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 typhoid vaccine 25 mcg/0.5 ml syrg-[B] | $439.75 | $439.75 | — | — | — |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 typhoid vaccine 25 mcg/0.5 ml syrg-[D] | $439.75 | $439.75 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Q-CARE IMMUNIZATION ADMIN SINGLE | $28.00 | $28.00 | — | 56% below | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 RHC IMMUNIZATION ADMIN SINGLE | $231.00 | $231.00 | — | 262% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN SINGLE ED TC | $862.00 | $862.00 | — | 1253% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN SINGLE | $862.00 | $862.00 | — | 1253% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Q-CARE IMMUNIZATION ADMIN SINGLE | $28.00 | $28.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 RHC IMMUNIZATION ADMIN SINGLE | $231.00 | $231.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN SINGLE ED TC | $862.00 | $862.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN SINGLE | $862.00 | $862.00 | — | — | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Q-CARE IMMUNIZATION ADMIN ADDTL | $13.00 | $13.00 | — | 52% below | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN ADDITL ED TC | $89.00 | $89.00 | — | 231% above | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 RHC IMMUNIZATION ADMIN EA ADDIT | $89.00 | $89.00 | — | 231% above | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN ADDITL | $89.00 | $89.00 | — | 231% above | — |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Q-CARE IMMUNIZATION ADMIN ADDTL | $13.00 | $13.00 | — | — | — |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN ADDITL ED TC | $89.00 | $89.00 | — | — | — |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN ADDITL | $89.00 | $89.00 | — | — | — |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 RHC IMMUNIZATION ADMIN EA ADDIT | $89.00 | $89.00 | — | — | — |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://www.phhealthcare.org/download/?id=15375