Uchicago Medicine Northwest Indiana
Uchicago Medicine Northwest Indiana in Crown Point, IN publishes cash prices for 264 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 Indiana median for 250 of 260 procedures and below it for 9. By typical cash price it ranks #84 of 84 Indiana hospitals and #61 of 62 hospitals in the Chicago, IL area, cheapest first. Select a procedure to compare it with other hospitals nearby.
10855 Virginia Street, Crown Point, IN 46307 Collected Sep 23, 2026 Source price file Check a bill from this hospital (312) 755-4706
Acute care hospital Nonprofit hospital Emergency department CCN 150195 · CMS hospital register NPI 1144914532
The price file shows no self-pay discount
For 600 of the 600 prices listed here, the cash price in Uchicago Medicine Northwest Indiana'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
Uchicago Medicine Northwest Indiana 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 Indiana | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC COMPUTED TOMOGRPHY, ABDMN; W/O CNTRST MATERL, FLLWED BY CNTRST MATERL(S) & FURTHER SECTNS | $3,819.00 | $3,819.00 | — | 182% above | — |
| Abdominal CT scan without and with contrast inpatient CPT 74170 HC COMPUTED TOMOGRPHY, ABDMN; W/O CNTRST MATERL, FLLWED BY CNTRST MATERL(S) & FURTHER SECTNS | $3,819.00 | $3,819.00 | — | — | — |
| Abdominal X-ray, 2 views CPT 74019 HC X-RAY EXAM ABDOMEN 2 VIEWS | $646.00 | $646.00 | — | 139% above | — |
| Abdominal X-ray, 2 views inpatient CPT 74019 HC X-RAY EXAM ABDOMEN 2 VIEWS | $646.00 | $646.00 | — | — | — |
| Ankle X-ray, complete, 3 or more views CPT 73610 HC RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF 3 VIEWS | $543.00 | $543.00 | — | 177% above | — |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF 3 VIEWS | $543.00 | $543.00 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC LIMITED BILATERAL NONINVASIVE PHYSIOLOGY STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES | $973.00 | $973.00 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC LIMITED BILATERAL NONINVASIVE PHYSIOLOGY STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES | $973.00 | $973.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC COMPUTED TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL | $2,470.00 | $2,470.00 | — | 207% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC COMPUTED TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL | $2,470.00 | $2,470.00 | — | — | — |
| Breast ultrasound, complete, one breast one side CPT 76641 HC U/S, BREAST, UNILAT, REAL TIME W/ IMAGE DOCUMENTATION, INCL AXILLA WHEN PERF, COMPLETE | $972.00 | $972.00 | — | 124% above | — |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC U/S, BREAST, UNILAT, REAL TIME W/ IMAGE DOCUMENTATION, INCL AXILLA WHEN PERF, COMPLETE | $972.00 | $972.00 | — | — | — |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC ULTRASOUND, BREAST, UNILATERAL | $972.00 | $972.00 | — | 199% above | — |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC ULTRASOUND, BREAST, UNILATERAL | $972.00 | $972.00 | — | — | — |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT ANGGRPHY ABD&PELV,W/CONTRST MAT,INCL NONCONTRST IMAGES,IF PERFORMED,&IMGE POSTPROC | $5,237.00 | $5,237.00 | — | 177% above | — |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CT ANGGRPHY ABD&PELV,W/CONTRST MAT,INCL NONCONTRST IMAGES,IF PERFORMED,&IMGE POSTPROC | $5,237.00 | $5,237.00 | — | — | — |
| CT angiography (CTA) of the head CPT 70496 HC CTA, HEAD, W/ CONTRAST MATERIAL, INCL NONCONTRAST IMAGES, IF PERFORMED, AND IMAGE POSTPROCESSING | $2,856.00 | $2,856.00 | — | 124% above | — |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CTA, HEAD, W/ CONTRAST MATERIAL, INCL NONCONTRAST IMAGES, IF PERFORMED, AND IMAGE POSTPROCESSING | $2,856.00 | $2,856.00 | — | — | — |
| CT angiography (CTA) of the neck CPT 70498 HC CTA, NECK, W/ CONTRAST MATERIAL, INCL NONCONTRAST IMAGES, IF PERFORMED, AND IMAGE POSTPROCESSING | $3,547.00 | $3,547.00 | — | 192% above | — |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC CTA, NECK, W/ CONTRAST MATERIAL, INCL NONCONTRAST IMAGES, IF PERFORMED, AND IMAGE POSTPROCESSING | $3,547.00 | $3,547.00 | — | — | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA, CHST, W/ CONTRAST MATERIAL(S), INCL NONCONSTRACT IMGES, IF PERFORMED, AND IMG POSTPROCESSING | $3,939.00 | $3,939.00 | — | 209% above | — |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CTA, CHST, W/ CONTRAST MATERIAL(S), INCL NONCONSTRACT IMGES, IF PERFORMED, AND IMG POSTPROCESSING | $3,939.00 | $3,939.00 | — | — | — |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CT ANGIOGRAPHY, HEART,CORONARY ARTERIES, BYPASS GRAFTS, W CONTRAST, INCL 3D IMAGE POSTPROCESSING | $2,288.00 | $2,288.00 | — | 173% above | — |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CT ANGIOGRAPHY, HEART,CORONARY ARTERIES, BYPASS GRAFTS, W CONTRAST, INCL 3D IMAGE POSTPROCESSING | $2,288.00 | $2,288.00 | — | — | — |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT, HEART, WITHOUT CONTRAST MATERIAL, WITH QUANTIATIVE EVALUATION OF CORONARY CALCIUM | $90.00 | $90.00 | — | 52% below | — |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT, HEART, WITHOUT CONTRAST MATERIAL, WITH QUANTIATIVE EVALUATION OF CORONARY CALCIUM | $90.00 | $90.00 | — | — | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL | $5,182.00 | $5,182.00 | — | 333% above | — |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL | $5,182.00 | $5,182.00 | — | — | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST MATERIAL(S) | $6,149.00 | $6,149.00 | — | 257% above | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST MATERIAL(S) | $6,149.00 | $6,149.00 | — | — | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT TOM, AB & PEL; WO CNT MAT 1 OR BOTH BDY RGNS,FLLWD BY CNT MAT(S)&FRTHR SEC 1 OR BOTH BDY RGNS | $7,558.00 | $7,558.00 | — | 341% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT TOM, AB & PEL; WO CNT MAT 1 OR BOTH BDY RGNS,FLLWD BY CNT MAT(S)&FRTHR SEC 1 OR BOTH BDY RGNS | $7,558.00 | $7,558.00 | — | — | — |
| CT scan of the abdomen with contrast CPT 74160 HC COMPUTED TOMOGRAPHY, ABDOMEN; WITH CONTRAST MATERIAL(S) | $3,043.00 | $3,043.00 | — | 186% above | — |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC COMPUTED TOMOGRAPHY, ABDOMEN; WITH CONTRAST MATERIAL(S) | $3,043.00 | $3,043.00 | — | — | — |
| CT scan of the abdomen without contrast CPT 74150 HC COMPUTED TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL | $2,606.00 | $2,606.00 | — | 208% above | — |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC COMPUTED TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL | $2,606.00 | $2,606.00 | — | — | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL | $2,420.00 | $2,420.00 | — | 191% above | — |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL | $2,420.00 | $2,420.00 | — | — | — |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL | $2,382.00 | $2,382.00 | — | 211% above | — |
| CT scan of the head or brain, no contrast dye CPT 70450 HC MRI FACE AND SINUS WITHOUT CONTRAST MATERIAL | $2,949.00 | $2,949.00 | — | 285% above | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL | $2,382.00 | $2,382.00 | — | — | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC MRI FACE AND SINUS WITHOUT CONTRAST MATERIAL | $2,949.00 | $2,949.00 | — | — | — |
| CT scan of the head with contrast CPT 70460 HC CT, HEAD OR BRAIN; WITH CONTRAST MATERIAL | $2,872.00 | $2,872.00 | — | 236% above | — |
| CT scan of the head with contrast inpatient CPT 70460 HC CT, HEAD OR BRAIN; WITH CONTRAST MATERIAL | $2,872.00 | $2,872.00 | — | — | — |
| CT scan of the head without and with contrast CPT 70470 HC CT, HEAD OR BRAIN; W/O CONTRAST MATERIAL, FOLLOWING BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS | $3,541.00 | $3,541.00 | — | 240% above | — |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT, HEAD OR BRAIN; W/O CONTRAST MATERIAL, FOLLOWING BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS | $3,541.00 | $3,541.00 | — | — | — |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC COMPUTED TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL | $2,935.00 | $2,935.00 | — | 232% above | — |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC COMPUTED TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL | $2,935.00 | $2,935.00 | — | — | — |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC COMPUTED TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL | $2,928.00 | $2,928.00 | — | 252% above | — |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC COMPUTED TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL | $2,928.00 | $2,928.00 | — | — | — |
| CT scan of the pelvis, with contrast dye CPT 72193 HC COMPUTED TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S) | $2,804.00 | $2,804.00 | — | 204% above | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC COMPUTED TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S) | $2,804.00 | $2,804.00 | — | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN OF EXTRACRANIAL ARTERIES; COMPLETE BILATERAL STUDY | $1,708.00 | $1,708.00 | — | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX SCAN OF EXTRACRANIAL ARTERIES; COMPLETE BILATERAL STUDY | $1,708.00 | $1,708.00 | — | — | — |
| Chest CT scan without and with contrast CPT 71270 HC CT, THORAX; WITHOUT CONTRAST MATERIAL, FOLLOWED BY WITH CONTRAST MATERIAL(S) AND FURTHER SECTIONS | $2,979.00 | $2,979.00 | — | 174% above | — |
| Chest CT scan without and with contrast inpatient CPT 71270 HC CT, THORAX; WITHOUT CONTRAST MATERIAL, FOLLOWED BY WITH CONTRAST MATERIAL(S) AND FURTHER SECTIONS | $2,979.00 | $2,979.00 | — | — | — |
| Chest X-ray, 2 views CPT 71046 HC X-RAY EXAM CHEST 2 VIEWS | $684.00 | $684.00 | — | 232% above | — |
| Chest X-ray, 2 views inpatient CPT 71046 HC X-RAY EXAM CHEST 2 VIEWS | $684.00 | $684.00 | — | — | — |
| Chest X-ray, single view CPT 71045 HC X-RAY EXAM CHEST 1 VIEW | $590.00 | $590.00 | — | 263% above | — |
| Chest X-ray, single view inpatient CPT 71045 HC X-RAY EXAM CHEST 1 VIEW | $590.00 | $590.00 | — | — | — |
| Collarbone (clavicle) X-ray, complete CPT 73000 HC RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE | $540.00 | $540.00 | — | 181% above | — |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE | $540.00 | $540.00 | — | — | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC ULTRASOUND, RETROPERITONEAL, REAL TIME WITH IMAGE DOCUMENTATION, COMPLETE | $1,609.00 | $1,609.00 | — | 221% above | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC ULTRASOUND, RETROPERITONEAL, REAL TIME WITH IMAGE DOCUMENTATION, COMPLETE | $1,609.00 | $1,609.00 | — | — | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT, THORAX; WITHOUT CONTRAST MATERIAL | $2,424.00 | $2,424.00 | — | 191% above | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT, THORAX; WITHOUT CONTRAST MATERIAL | $2,424.00 | $2,424.00 | — | — | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT, THORAX; WITH CONTRAST MATERIAL | $3,033.00 | $3,033.00 | — | 223% above | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT, THORAX; WITH CONTRAST MATERIAL | $3,033.00 | $3,033.00 | — | — | — |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; COMPLETE BILATERAL STUDY | $1,934.00 | $1,934.00 | — | — | — |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; COMPLETE BILATERAL STUDY | $1,934.00 | $1,934.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DPLX SCAN OF EXTREMITY VEINS INCL RESPONSES TO CMPRESSN AND OTHER MANEUVERS; COMPLETE BILAT STUDY | $2,326.00 | $2,326.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC VASC LAB DPLX SCAN L/EXTREM VEINS/RESPONSES TO COMPRESSION & OTHER MANEUVERS; COMPLET BILAT STDY | $2,326.00 | $2,326.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DPLX SCAN OF EXTREMITY VEINS INCL RESPONSES TO CMPRESSN AND OTHER MANEUVERS; COMPLETE BILAT STUDY | $2,326.00 | $2,326.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC VASC LAB DPLX SCAN L/EXTREM VEINS/RESPONSES TO COMPRESSION & OTHER MANEUVERS; COMPLET BILAT STDY | $2,326.00 | $2,326.00 | — | — | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE W CNTRST,WO CNTRST W CNTRST,RLTM W 2D IMG DOC,INC MMOD REC,W SPEC DOP ECHO,&W CLR FLO DOP ECH | $3,564.00 | $3,564.00 | — | 116% above | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHCRD,TRNSTHOR, RLTM W IMG DOC(2D),INCL MMOD REC,COMP,W SPCT DOP ECHCRD,&W CLR FLOW DOP ECHCRD | $3,564.00 | $3,564.00 | — | 116% above | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE W CNTRST,WO CNTRST W CNTRST,RLTM W 2D IMG DOC,INC MMOD REC,W SPEC DOP ECHO,&W CLR FLO DOP ECH | $3,564.00 | $3,564.00 | — | — | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHCRD,TRNSTHOR, RLTM W IMG DOC(2D),INCL MMOD REC,COMP,W SPCT DOP ECHCRD,&W CLR FLOW DOP ECHCRD | $3,564.00 | $3,564.00 | — | — | — |
| Elbow X-ray, 2 views CPT 73070 HC RADIOLOGIC EXAMINATION, ELBOW; 2 VIEWS | $457.00 | $457.00 | — | 176% above | — |
| Elbow X-ray, 2 views inpatient CPT 73070 HC RADIOLOGIC EXAMINATION, ELBOW; 2 VIEWS | $457.00 | $457.00 | — | — | — |
| Elbow X-ray, complete, 3 or more views CPT 73080 HC RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF 3 VIEWS | $600.00 | $600.00 | — | 135% above | — |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF 3 VIEWS | $600.00 | $600.00 | — | — | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE OR INNER EAR; WITHOUT CONTRAST MATERIAL | $2,601.00 | $2,601.00 | — | 205% above | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE OR INNER EAR; WITHOUT CONTRAST MATERIAL | $2,601.00 | $2,601.00 | — | — | — |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC RADIOLOGIC EXAM, FACIAL BONES; COMPLETE, MINIMUM OF 3 VIEWS | $959.00 | $959.00 | — | 251% above | — |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC RADIOLOGIC EXAM, FACIAL BONES; COMPLETE, MINIMUM OF 3 VIEWS | $959.00 | $959.00 | — | — | — |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC RADIOLOGIC EXAMINATION; FOREARM, 2 VIEWS | $578.00 | $578.00 | — | 213% above | — |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC RADIOLOGIC EXAMINATION; FOREARM, 2 VIEWS | $578.00 | $578.00 | — | — | — |
| Hand X-ray, 2 views CPT 73120 HC RADIOLOGIC EXAMINATION, HAND; 2 VIEWS | $405.00 | $405.00 | — | 136% above | — |
| Hand X-ray, 2 views inpatient CPT 73120 HC RADIOLOGIC EXAMINATION, HAND; 2 VIEWS | $405.00 | $405.00 | — | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF 2 VIEWS | $506.00 | $506.00 | — | 137% above | — |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF 2 VIEWS | $506.00 | $506.00 | — | — | — |
| Knee X-ray, 3 views CPT 73562 HC RADIOLOGIC EXAMINATION, KNEE; 3 VIEWS | $722.00 | $722.00 | — | 215% above | — |
| Knee X-ray, 3 views inpatient CPT 73562 HC RADIOLOGIC EXAMINATION, KNEE; 3 VIEWS | $722.00 | $722.00 | — | — | — |
| Knee X-ray, complete, 4 or more views CPT 73564 HC RADIOLOGIC EXAMINATION, KNEE; COMPLETE, 4 OR MORE VIEWS | $741.00 | $741.00 | — | 183% above | — |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC RADIOLOGIC EXAMINATION, KNEE; COMPLETE, 4 OR MORE VIEWS | $741.00 | $741.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC COMPUTED TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL | $2,444.00 | $2,444.00 | — | 212% above | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC COMPUTED TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL | $2,444.00 | $2,444.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC ULTRASOUND, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION, LIMITED | $1,524.00 | $1,524.00 | — | 234% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC ULTRASOUND, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION, LIMITED | $1,524.00 | $1,524.00 | — | — | — |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US, LTD, JOINT NONVASC EXTRMTY STRUCTURE(S) (EG, JOINT SPACE, PERI-ARTICULAR TNDS) REAL-TIME W/IMG DOC | $1,371.00 | $1,371.00 | — | 353% above | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US, LTD, JOINT NONVASC EXTRMTY STRUCTURE(S) (EG, JOINT SPACE, PERI-ARTICULAR TNDS) REAL-TIME W/IMG DOC | $1,371.00 | $1,371.00 | — | — | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX, LOW DOSE FOR LUNG CANCER SCREENING, WO MATERIALS | $2,224.00 | $2,224.00 | — | 1068% above | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT THORAX, LOW DOSE FOR LUNG CANCER SCREENING, WO MATERIALS | $2,224.00 | $2,224.00 | — | — | — |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, 2 VIEWS | $650.00 | $650.00 | — | 227% above | — |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, 2 VIEWS | $650.00 | $650.00 | — | — | — |
| MR angiography (MRA) of the head without contrast CPT 70544 HC MRA, HEAD; WITHOUT CONTRAST MATERIAL | $3,830.00 | $3,830.00 | — | 242% above | — |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA, HEAD; WITHOUT CONTRAST MATERIAL | $3,830.00 | $3,830.00 | — | — | — |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MRI BREAST WWO CONTRAST INCLUDING CAD WHEN PERFORMED: BILATERAL | $5,820.00 | $5,820.00 | — | — | — |
| MRI of both breasts, without and then with contrast dye CPT 77049 HC MRI WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; BILTERAL | $5,820.00 | $5,820.00 | — | 1314% above | — |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HC MRI BREAST WWO CONTRAST INCLUDING CAD WHEN PERFORMED: BILATERAL | $5,820.00 | $5,820.00 | — | — | — |
| MRI of both breasts, without and then with contrast dye inpatient CPT 77049 HC MRI WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; BILTERAL | $5,820.00 | $5,820.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MAGNETIC RESONANCE IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL | $4,303.00 | $4,303.00 | — | 318% above | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MAGNETIC RESONANCE IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL | $4,303.00 | $4,303.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI, ANY JOINT OF LOWER EXTREMITY;WO CONTRAST MAT(S),FOLLOWED BY CONTRAST MAT(S)&FURTHER SEQ | $5,542.00 | $5,542.00 | — | 283% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI, ANY JOINT OF LOWER EXTREMITY;WO CONTRAST MAT(S),FOLLOWED BY CONTRAST MAT(S)&FURTHER SEQ | $5,542.00 | $5,542.00 | — | — | — |
| MRI of the abdomen without contrast CPT 74181 HC MRI, ABDOMEN; WITHOUT CONTRAST MATERIAL(S) | $4,052.00 | $4,052.00 | — | 279% above | — |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI, ABDOMEN; WITHOUT CONTRAST MATERIAL(S) | $4,052.00 | $4,052.00 | — | — | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI, ABDOMEN; W/O CONTRAST MATERIAL(S), FOLLOWED BY CONSTRAST MATERIAL(S) AND FURTHER SEQUENCES | $6,432.00 | $6,432.00 | — | 307% above | — |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI, ABDOMEN; W/O CONTRAST MATERIAL(S), FOLLOWED BY CONSTRAST MATERIAL(S) AND FURTHER SEQUENCES | $6,432.00 | $6,432.00 | — | — | — |
| MRI of the brain, no contrast dye CPT 70551 HC MRI, BRAIN; WITHOUT CONTRAST MATERIAL | $3,750.00 | $3,750.00 | — | 269% above | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI, BRAIN; WITHOUT CONTRAST MATERIAL | $3,750.00 | $3,750.00 | — | — | — |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI PITUITARY, WITHOUT CONTRAST MATERIAL, FOLLOW BY CONTRAST MATERIAL | $6,926.00 | $6,926.00 | — | 430% above | — |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI, BRAIN WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL | $6,926.00 | $6,926.00 | — | 430% above | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI PITUITARY, WITHOUT CONTRAST MATERIAL, FOLLOW BY CONTRAST MATERIAL | $6,926.00 | $6,926.00 | — | — | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI, BRAIN WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL | $6,926.00 | $6,926.00 | — | — | — |
| MRI of the lower back, no contrast dye CPT 72148 HC MAGNETIC RESONANCE IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITHOUT CONTRAST MATERIAL | $4,535.00 | $4,535.00 | — | 346% above | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MAGNETIC RESONANCE IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITHOUT CONTRAST MATERIAL | $4,535.00 | $4,535.00 | — | — | — |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI, SPNL CANAL & CONTENTS, W/OUT CNTRST MAT, FOLLOWED BY CNTRST MAT(S) & FURTHER SEQU; LUMBAR | $6,679.00 | $6,679.00 | — | 356% above | — |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI, SPNL CANAL & CONTENTS, W/OUT CNTRST MAT, FOLLOWED BY CNTRST MAT(S) & FURTHER SEQU; LUMBAR | $6,679.00 | $6,679.00 | — | — | — |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MAGNETIC RESONANCE IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITHOUT CONTRAST MATERIAL | $4,717.00 | $4,717.00 | — | 370% above | — |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MAGNETIC RESONANCE IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITHOUT CONTRAST MATERIAL | $4,717.00 | $4,717.00 | — | — | — |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI,SPNL CANAL&CONTENTS,W/OUT CNTRST MAT,FOLLOWED BY CNTRST MAT&FURTHER SEQU;CERV | $6,827.00 | $6,827.00 | — | 366% above | — |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI,SPNL CANAL&CONTENTS,W/OUT CNTRST MAT,FOLLOWED BY CNTRST MAT&FURTHER SEQU;CERV | $6,827.00 | $6,827.00 | — | — | — |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MAGNETIC RESONANCE IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITHOUT CONTRAST MATERIAL | $4,630.00 | $4,630.00 | — | 345% above | — |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MAGNETIC RESONANCE IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITHOUT CONTRAST MATERIAL | $4,630.00 | $4,630.00 | — | — | — |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIC WITH AND WITHOUT CONTRAST | $5,754.00 | $5,754.00 | — | 295% above | — |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIC WITH AND WITHOUT CONTRAST | $5,754.00 | $5,754.00 | — | — | — |
| MRI of the pelvis, no contrast dye CPT 72195 HC MAGNETIC RESONANCE IMAGING, PELVIS; WITHOUT CONTRAST MATERIAL(S) | $4,163.00 | $4,163.00 | — | 296% above | — |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MAGNETIC RESONANCE IMAGING, PELVIS; WITHOUT CONTRAST MATERIAL(S) | $4,163.00 | $4,163.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MAGNETIC RESONANCE IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL(S) | $4,307.00 | $4,307.00 | — | 304% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MAGNETIC RESONANCE IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL(S) | $4,307.00 | $4,307.00 | — | — | — |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 4 OR 5 VIEWS | $931.00 | $931.00 | — | 168% above | — |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 4 OR 5 VIEWS | $931.00 | $931.00 | — | — | — |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT, SOFT TISSUE NECK; WITH CONTRAST MATERIAL | $2,937.00 | $2,937.00 | — | 200% above | — |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT, SOFT TISSUE NECK; WITH CONTRAST MATERIAL | $2,937.00 | $2,937.00 | — | — | — |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL | $2,450.00 | $2,450.00 | — | 194% above | — |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL | $2,450.00 | $2,450.00 | — | — | — |
| Neck soft tissue X-ray CPT 70360 HC RADIOLOGIC EXAM; NECK; SOFT TISSUE | $561.00 | $561.00 | — | 225% above | — |
| Neck soft tissue X-ray inpatient CPT 70360 HC RADIOLOGIC EXAM; NECK; SOFT TISSUE | $561.00 | $561.00 | — | — | — |
| OCT scan of the retina (optical coherence tomography) CPT 92134 HC SCANNING COMPUTERIZED OPHTHALMIC DIAGIMAGING, POSTERIOR SEGMENT, W/ INTERPRETATN AND RPRT; RETINA | $212.00 | $212.00 | — | 44% above | — |
| OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 HC SCANNING COMPUTERIZED OPHTHALMIC DIAGIMAGING, POSTERIOR SEGMENT, W/ INTERPRETATN AND RPRT; RETINA | $212.00 | $212.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGING INITIAL STAGING LYMPHOMA | $9,615.00 | $9,615.00 | — | 137% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGING RESTAGING ESOPHAGEAL CA | $9,615.00 | $9,615.00 | — | 137% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGING THYROID CA RESTAGING FOLLICULAR CELL CA | $9,615.00 | $9,615.00 | — | 137% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET TUMOR IMAGING PET WITH CONCURRENT CT SKULL BASE TO MID THIGH | $9,615.00 | $9,615.00 | — | 137% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET PROSTATE IMAGING | $9,615.00 | $9,615.00 | — | 137% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET NEUROENDO TUMOR IMAGING | $9,615.00 | $9,615.00 | — | 137% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PPET IMAGING INITIAL STAGING ESOPHAGEAL CA | $9,615.00 | $9,615.00 | — | 137% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGING RESTAGING LYMPHOMA | $9,615.00 | $9,615.00 | — | 137% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGING RESTAGING COLORECTAL | $9,615.00 | $9,615.00 | — | 137% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGING RESTAGE LUNG CA NON SMALL CELL | $9,615.00 | $9,615.00 | — | 137% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGING REGN SINGLE PULMONARY NODULE | $9,615.00 | $9,615.00 | — | 137% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGING INITIAL STAGING COLORECTAL | $9,615.00 | $9,615.00 | — | 137% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGING RESTAGING HEAD&NECK | $9,615.00 | $9,615.00 | — | 137% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGING INITIAL STAGING HEAD&NECK | $9,615.00 | $9,615.00 | — | 137% above | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGING RESTAGE LUNG CA NON SMALL CELL | $9,615.00 | $9,615.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGING INITIAL STAGING HEAD&NECK | $9,615.00 | $9,615.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGING INITIAL STAGING LYMPHOMA | $9,615.00 | $9,615.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGING RESTAGING HEAD&NECK | $9,615.00 | $9,615.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGING INITIAL STAGING COLORECTAL | $9,615.00 | $9,615.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGING REGN SINGLE PULMONARY NODULE | $9,615.00 | $9,615.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGING RESTAGING COLORECTAL | $9,615.00 | $9,615.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGING RESTAGING LYMPHOMA | $9,615.00 | $9,615.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PPET IMAGING INITIAL STAGING ESOPHAGEAL CA | $9,615.00 | $9,615.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET NEUROENDO TUMOR IMAGING | $9,615.00 | $9,615.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET PROSTATE IMAGING | $9,615.00 | $9,615.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET TUMOR IMAGING PET WITH CONCURRENT CT SKULL BASE TO MID THIGH | $9,615.00 | $9,615.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGING THYROID CA RESTAGING FOLLICULAR CELL CA | $9,615.00 | $9,615.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGING RESTAGING ESOPHAGEAL CA | $9,615.00 | $9,615.00 | — | — | — |
| Pelvic CT scan without contrast CPT 72192 HC COMPUTED TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL | $2,290.00 | $2,290.00 | — | 175% above | — |
| Pelvic CT scan without contrast inpatient CPT 72192 HC COMPUTED TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL | $2,290.00 | $2,290.00 | — | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC ULTRASOUND, PELVIC (NON-OB), REAL TIME WITH IMAGE DOCUMENTATION, LIMITED/FOLLOW-UP | $1,078.00 | $1,078.00 | — | 202% above | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC ULTRASOUND, PELVIC (NON-OB), REAL TIME WITH IMAGE DOCUMENTATION, LIMITED/FOLLOW-UP | $1,078.00 | $1,078.00 | — | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC ULTRASOUND, PELVIC (NON-OB), REAL TIME WITH IMAGE DOCUMENTATION, COMPLETE | $1,589.00 | $1,589.00 | — | 242% above | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC ULTRASOUND, PELVIC (NON-OB), REAL TIME WITH IMAGE DOCUMENTATION, COMPLETE | $1,589.00 | $1,589.00 | — | — | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC ULTRASOUND, PREGNANT UTERUS, REAL WITH W IMAGE DOC, LIMITED, 1 OR MORE FETUSES | $832.00 | $832.00 | — | 118% above | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC ULTRASOUND, PREGNANT UTERUS, REAL WITH W IMAGE DOC, LIMITED, 1 OR MORE FETUSES | $832.00 | $832.00 | — | — | — |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF 2 VIEWS | $783.00 | $783.00 | — | 275% above | — |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF 2 VIEWS | $783.00 | $783.00 | — | — | — |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC RADIOLOGIC EXAM, SINUSES, PARANASAL, COMPLETE, MINIMUM OF 3 VIEWS | $710.00 | $710.00 | — | 150% above | — |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC RADIOLOGIC EXAM, SINUSES, PARANASAL, COMPLETE, MINIMUM OF 3 VIEWS | $710.00 | $710.00 | — | — | — |
| Skull X-ray, fewer than 4 views CPT 70250 HC RADIOLOGIC EXAM, SKULL; LESS THAN 4 VIEWS | $562.00 | $562.00 | — | 141% above | — |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 HC RADIOLOGIC EXAM, SKULL; LESS THAN 4 VIEWS | $562.00 | $562.00 | — | — | — |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC RADIOLOGIC EXAM, FEMUR, 2 VIEWS | $127.00 | $127.00 | — | 37% below | — |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC RADIOLOGIC EXAM, FEMUR, 2 VIEWS | $127.00 | $127.00 | — | — | — |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC COMPUTED TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL | $2,917.00 | $2,917.00 | — | 243% above | — |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC COMPUTED TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL | $2,917.00 | $2,917.00 | — | — | — |
| Toe X-ray, 2 or more views CPT 73660 HC RADIOLOGIC EXAMINATION; TOE(S), MINIMUM OF 2 VIEWS | $453.00 | $453.00 | — | 195% above | — |
| Toe X-ray, 2 or more views inpatient CPT 73660 HC RADIOLOGIC EXAMINATION; TOE(S), MINIMUM OF 2 VIEWS | $453.00 | $453.00 | — | — | — |
| Transvaginal pelvic ultrasound CPT 76830 HC ULTRASOUND, TRANSVAGINAL | $1,225.00 | $1,225.00 | — | 201% above | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC ULTRASOUND, TRANSVAGINAL | $1,225.00 | $1,225.00 | — | — | — |
| Transvaginal ultrasound during pregnancy CPT 76817 HC ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, TRANSVAGINAL | $905.00 | $905.00 | — | 145% above | — |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, TRANSVAGINAL | $905.00 | $905.00 | — | — | — |
| Ultrasound of the abdomen, complete CPT 76700 HC ULTRASOUND, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION, COMPLETE | $2,308.00 | $2,308.00 | — | 341% above | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC ULTRASOUND, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION, COMPLETE | $2,308.00 | $2,308.00 | — | — | — |
| Ultrasound of the scrotum and testicles CPT 76870 HC ULTRASOUND, SCROTUM AND CONTENTS | $1,328.00 | $1,328.00 | — | 214% above | — |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC ULTRASOUND, SCROTUM AND CONTENTS | $1,328.00 | $1,328.00 | — | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC ULTRASOUND, SOFT TISSUE OF HEAD AND NECK, REAL TIME WITH IMAGE DOCUMENT | $1,375.00 | $1,375.00 | — | 222% above | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC ULTRASOUND, SOFT TISSUE OF HEAD AND NECK, REAL TIME WITH IMAGE DOCUMENT | $1,375.00 | $1,375.00 | — | — | — |
| Upper arm X-ray (humerus), 2 views CPT 73060 HC RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF 2 VIEWS | $600.00 | $600.00 | — | 212% above | — |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF 2 VIEWS | $600.00 | $600.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DPLX SCAN OF EXTRMITY VEINS INCL RESPONSES TO COMPRESSION AND OTHER MANEUVERS; LMTD UNILAT STUDY | $1,578.00 | $1,578.00 | — | 149% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC VASC LAB DPLX SCAN LOWER EXTREM VEINS INCL RESPON TO COMPRESSN & OTHER MNVERS;LMTD UNILAT STUDY | $1,578.00 | $1,578.00 | — | 149% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DPLX SCAN OF EXTRMITY VEINS INCL RESPONSES TO COMPRESSION AND OTHER MANEUVERS; LMTD UNILAT STUDY | $1,578.00 | $1,578.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC VASC LAB DPLX SCAN LOWER EXTREM VEINS INCL RESPON TO COMPRESSN & OTHER MNVERS;LMTD UNILAT STUDY | $1,578.00 | $1,578.00 | — | — | — |
| Wrist X-ray, 2 views CPT 73100 HC RADIOLOGIC EXAMINATION, WRIST; 2 VIEWS | $562.00 | $562.00 | — | 260% above | — |
| Wrist X-ray, 2 views inpatient CPT 73100 HC RADIOLOGIC EXAMINATION, WRIST; 2 VIEWS | $562.00 | $562.00 | — | — | — |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF 3 VIEWS | $584.00 | $584.00 | — | 129% above | — |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF 3 VIEWS | $584.00 | $584.00 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC RADIOLOGIC EXAM, HIP, WITH PELVIS WHEN PERFORMED, 2 TO 3 VIEWS | $207.00 | $207.00 | — | 22% below | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC RADIOLOGIC EXAM, HIP, WITH PELVIS WHEN PERFORMED, 2 TO 3 VIEWS | $207.00 | $207.00 | — | — | — |
| X-ray of the abdomen, 1 view CPT 74018 HC X-RAY EXAM ABDOMEN 1 VIEW | $545.00 | $545.00 | — | 151% above | — |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC X-RAY EXAM ABDOMEN 1 VIEW | $545.00 | $545.00 | — | — | — |
| X-ray of the ankle, 2 views CPT 73600 HC RADIOLOGIC EXAMINATION, ANKLE; 2 VIEWS | $485.00 | $485.00 | — | 203% above | — |
| X-ray of the ankle, 2 views inpatient CPT 73600 HC RADIOLOGIC EXAMINATION, ANKLE; 2 VIEWS | $485.00 | $485.00 | — | — | — |
| X-ray of the finger(s), 2 or more views CPT 73140 HC RADIOLOGIC EXAMINATION, FINGER(S), MINIMUM OF 2 VIEWS | $436.00 | $436.00 | — | 174% above | — |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC RADIOLOGIC EXAMINATION, FINGER(S), MINIMUM OF 2 VIEWS | $436.00 | $436.00 | — | — | — |
| X-ray of the foot, 2 views CPT 73620 HC RADIOLOGIC EXAMINATION, FOOT; 2 VIEWS | $465.00 | $465.00 | — | 184% above | — |
| X-ray of the foot, 2 views inpatient CPT 73620 HC RADIOLOGIC EXAMINATION, FOOT; 2 VIEWS | $465.00 | $465.00 | — | — | — |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF 3 VIEWS | $607.00 | $607.00 | — | 201% above | — |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF 3 VIEWS | $607.00 | $607.00 | — | — | — |
| X-ray of the hand, 3 or more views CPT 73130 HC RADIOLOGIC EXAMINATION, HAND; MINIMUM OF 3 VIEWS | $600.00 | $600.00 | — | 198% above | — |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HC RADIOLOGIC EXAMINATION, HAND; MINIMUM OF 3 VIEWS | $600.00 | $600.00 | — | — | — |
| X-ray of the knee, 1 or 2 views CPT 73560 HC RADIOLOGIC EXAMINATION, KNEE; 1 OR 2 VIEWS | $673.00 | $673.00 | — | 222% above | — |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC RADIOLOGIC EXAMINATION, KNEE; 1 OR 2 VIEWS | $673.00 | $673.00 | — | — | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; 2 OR 3 VIEWS | $744.00 | $744.00 | — | 196% above | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; 2 OR 3 VIEWS | $744.00 | $744.00 | — | — | — |
| X-ray of the lower back, 4 or more views CPT 72110 HC RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; MINIMUM OF 4 VIEWS | $1,240.00 | $1,240.00 | — | 258% above | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; MINIMUM OF 4 VIEWS | $1,240.00 | $1,240.00 | — | — | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC RADIOLOGIC EXAMINATION, SPINE; THORACIC, 2 VIEWS | $555.00 | $555.00 | — | 138% above | — |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC RADIOLOGIC EXAMINATION, SPINE; THORACIC, 2 VIEWS | $555.00 | $555.00 | — | — | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC RADIOLOGIC EXAM, NASAL BONES; COMPLETE, MINIMUM OF 3 VIEWS | $510.00 | $510.00 | — | 152% above | — |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC RADIOLOGIC EXAM, NASAL BONES; COMPLETE, MINIMUM OF 3 VIEWS | $510.00 | $510.00 | — | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 2 OR 3 VIEWS | $661.00 | $661.00 | — | 164% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 2 OR 3 VIEWS | $661.00 | $661.00 | — | — | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC RADIOLOGIC EXAMINATION, PELVIS; 1 OR 2 VIEWS | $541.00 | $541.00 | — | 175% above | — |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC RADIOLOGIC EXAMINATION, PELVIS; 1 OR 2 VIEWS | $541.00 | $541.00 | — | — | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUM OF 2 VIEWS | $600.00 | $600.00 | — | 174% above | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUM OF 2 VIEWS | $600.00 | $600.00 | — | — | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 HC ADRENOCORTICOTROPIC HORMONE | $406.00 | $406.00 | — | 63% above | — |
| ACTH blood test inpatient CPT 82024 HC ADRENOCORTICOTROPIC HORMONE | $406.00 | $406.00 | — | — | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS PANEL ACUTE | $710.00 | $710.00 | — | 125% above | — |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS PANEL ACUTE | $710.00 | $710.00 | — | — | — |
| Ammonia blood test CPT 82140 HC AMMONIA | $270.00 | $270.00 | — | 125% above | — |
| Ammonia blood test inpatient CPT 82140 HC AMMONIA | $270.00 | $270.00 | — | — | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ABS, IGG W/ REFLEX | $285.00 | $285.00 | — | 376% above | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA SCREEN | $285.00 | $285.00 | — | 376% above | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA SCREEN | $285.00 | $285.00 | — | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ABS, IGG W/ REFLEX | $285.00 | $285.00 | — | — | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE | $550.00 | $550.00 | — | 223% above | — |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE | $550.00 | $550.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, LOWER RESPIRATORY | $375.00 | $375.00 | — | 301% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, EAR | $382.00 | $382.00 | — | 309% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, UPPER RESPIRATORY | $382.00 | $382.00 | — | 309% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, SPINAL FLUID | $382.00 | $382.00 | — | 309% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, MISC | $382.00 | $382.00 | — | 309% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, BODY FLUID | $382.00 | $382.00 | — | 309% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-THROAT | $382.00 | $382.00 | — | 309% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, WOUND | $382.00 | $382.00 | — | 309% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE RESPIRATORY | $382.00 | $382.00 | — | 309% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, LOWER RESPIRATORY | $375.00 | $375.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, SPINAL FLUID | $382.00 | $382.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-THROAT | $382.00 | $382.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, WOUND | $382.00 | $382.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, BODY FLUID | $382.00 | $382.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, MISC | $382.00 | $382.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, UPPER RESPIRATORY | $382.00 | $382.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE RESPIRATORY | $382.00 | $382.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, EAR | $382.00 | $382.00 | — | — | — |
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL | $290.00 | $290.00 | — | 270% above | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL | $290.00 | $290.00 | — | — | — |
| Bilirubin blood test, total CPT 82247 HC BILIRUBIN; TOTAL | $150.00 | $150.00 | — | 333% above | — |
| Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN; TOTAL | $150.00 | $150.00 | — | — | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL IV SURGICAL PATHOLOGY GROSS AND MICRO | $753.00 | $753.00 | — | 191% above | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL IV SURGICAL PATHOLOGY GROSS AND MICRO | $753.00 | $753.00 | — | — | — |
| Blood culture for bacteria CPT 87040 HC CULTURE BACTERIAL DEFINITIVE; BLOOD | $357.00 | $357.00 | — | 174% above | — |
| Blood culture for bacteria inpatient CPT 87040 HC CULTURE BACTERIAL DEFINITIVE; BLOOD | $357.00 | $357.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE | $61.00 | $61.00 | — | 267% above | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE | $61.00 | $61.00 | — | — | — |
| Blood glucose (sugar) test CPT 82947 HC GLUCOSE; QUANTITATIVE BLOOD | $137.00 | $137.00 | — | 415% above | — |
| Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE; QUANTITATIVE BLOOD | $137.00 | $137.00 | — | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC HCG QUALITATIVE | $232.00 | $232.00 | — | 218% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC HCG QUALITATIVE | $232.00 | $232.00 | — | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING, SEROLOGIC, ABO | $261.00 | $261.00 | — | 432% above | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING, SEROLOGIC, ABO | $261.00 | $261.00 | — | — | — |
| C-peptide blood test CPT 84681 HC C-PEPTIDE | $246.00 | $246.00 | — | 79% above | — |
| C-peptide blood test inpatient CPT 84681 HC C-PEPTIDE | $246.00 | $246.00 | — | — | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN | $152.00 | $152.00 | — | 120% above | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN | $152.00 | $152.00 | — | — | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC INFECTIOUS AGENT DETECTION BY DNA OR RNA; C-DIFF TOXIN GENE | $421.00 | $421.00 | — | 217% above | — |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC INFECTIOUS AGENT DETECTION BY DNA OR RNA; C-DIFF TOXIN GENE | $421.00 | $421.00 | — | — | — |
| Chickenpox (varicella) immunity blood test CPT 86787 HC ANTIBODY, VARICELLA-ZOSTER IGG | $156.00 | $156.00 | — | 60% above | — |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC ANTIBODY, VARICELLA-ZOSTER IGG | $156.00 | $156.00 | — | — | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC INFECTIOUS AGENT DETECTION BY DNA OR RNA; CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECHNIQUE | $256.00 | $256.00 | — | 163% above | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC INFECTIOUS AGENT DETECTION BY DNA OR RNA; CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECHNIQUE | $256.00 | $256.00 | — | — | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL | $282.00 | $282.00 | — | 169% above | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL | $282.00 | $282.00 | — | — | — |
| Complete blood count (CBC) with differential CPT 85025 HC COMPLETE BLOOD COUNT PLATELET, DIFFERENTIAL | $199.00 | $199.00 | — | 381% above | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE BLOOD COUNT PLATELET, DIFFERENTIAL | $199.00 | $199.00 | — | — | — |
| Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT; COMPLETE (CBC), AUTOMATED | $178.00 | $178.00 | — | 503% above | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT; COMPLETE (CBC), AUTOMATED | $178.00 | $178.00 | — | — | — |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL | $437.00 | $437.00 | — | 394% above | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PANEL | $437.00 | $437.00 | — | — | — |
| Cortisol blood test, total CPT 82533 HC CORTISOL; TOTAL | $347.00 | $347.00 | — | 268% above | — |
| Cortisol blood test, total inpatient CPT 82533 HC CORTISOL; TOTAL | $347.00 | $347.00 | — | — | — |
| Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE PHOSPHOKINASE-SERUM | $206.00 | $206.00 | — | 431% above | — |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE PHOSPHOKINASE-SERUM | $206.00 | $206.00 | — | — | — |
| Creatinine blood test CPT 82565 HC CREATININE; BLOOD | $112.00 | $112.00 | — | 289% above | — |
| Creatinine blood test inpatient CPT 82565 HC CREATININE; BLOOD | $112.00 | $112.00 | — | — | — |
| Cytomegalovirus (CMV) antibody test CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS, IGG | $164.00 | $164.00 | — | 106% above | — |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS, IGG | $164.00 | $164.00 | — | — | — |
| D-dimer blood test (blood clot marker) CPT 85379 HC FIBRIN DEGRADATION PRODUCTS; D DIMER; QUANTITATIVE | $249.00 | $249.00 | — | 104% above | — |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC FIBRIN DEGRADATION PRODUCTS; D DIMER; QUANTITATIVE | $249.00 | $249.00 | — | — | — |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTEREONE-SULFATE | $400.00 | $400.00 | — | 173% above | — |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTEREONE-SULFATE | $400.00 | $400.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC ALCOHOL URN PRESUMPTIVE | $362.00 | $362.00 | — | 217% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG PRESMP MECONIUM MULTICLS | $556.00 | $556.00 | — | 387% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN PRESUMPTV | $556.00 | $556.00 | — | 387% above | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC ALCOHOL URN PRESUMPTIVE | $362.00 | $362.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG PRESMP MECONIUM MULTICLS | $556.00 | $556.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN PRESUMPTV | $556.00 | $556.00 | — | — | — |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA | $236.00 | $236.00 | — | 190% above | — |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA | $236.00 | $236.00 | — | — | — |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC CALPROTECTIN, FECAL | $254.00 | $254.00 | — | 40% above | — |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC CALPROTECTIN, FECAL | $254.00 | $254.00 | — | — | — |
| Ferritin blood test (iron stores) CPT 82728 HC FERRITIN | $250.00 | $250.00 | — | 214% above | — |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN | $250.00 | $250.00 | — | — | — |
| Fibrinogen blood test CPT 85384 HC HEMS-FIBRINOGEN; ACTIVITY | $234.00 | $234.00 | — | 290% above | — |
| Fibrinogen blood test inpatient CPT 85384 HC HEMS-FIBRINOGEN; ACTIVITY | $234.00 | $234.00 | — | — | — |
| Folate (folic acid) blood test CPT 82746 HC FOLIC ACID; SERUM | $281.00 | $281.00 | — | 266% above | — |
| Folate (folic acid) blood test inpatient CPT 82746 HC FOLIC ACID; SERUM | $281.00 | $281.00 | — | — | — |
| Free T3 thyroid hormone test CPT 84481 HC TRIIODOTHYRONINE T3; FREE | $245.00 | $245.00 | — | 85% above | — |
| Free T3 thyroid hormone test inpatient CPT 84481 HC TRIIODOTHYRONINE T3; FREE | $245.00 | $245.00 | — | — | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC THYROXINE, FREE | $213.00 | $213.00 | — | 163% above | — |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC THYROXINE, FREE | $213.00 | $213.00 | — | — | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC INFCT AGENT DTCTN BY NUCLEIC ACID RNA OR DNA; NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TCHNQ | $256.00 | $256.00 | — | 163% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC INFCT AGENT DTCTN BY NUCLEIC ACID RNA OR DNA; NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TCHNQ | $256.00 | $256.00 | — | — | — |
| H. pylori stool antigen test CPT 87338 HC INFECTIOUS AGENT ANTIGEN DETECT ENZYME IMMUNOASSAY TECH, QUAL/SEMIQUANT, MULTIPLE-STEP; STOOL | $190.00 | $190.00 | — | 45% above | — |
| H. pylori stool antigen test inpatient CPT 87338 HC INFECTIOUS AGENT ANTIGEN DETECT ENZYME IMMUNOASSAY TECH, QUAL/SEMIQUANT, MULTIPLE-STEP; STOOL | $190.00 | $190.00 | — | — | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 QUANTITATIVE | $827.00 | $827.00 | — | 134% above | — |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 QUANTITATIVE | $827.00 | $827.00 | — | — | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC INFECT AGENT ANTIGEN DETEC ENZYME IMMUNOASSAY TECH, QUAL/SEMIQUANT, MULTI; HIV-1 & 2, SINGLE | $348.00 | $348.00 | — | 484% above | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC INFECT AGENT ANTIGEN DETEC ENZYME IMMUNOASSAY TECH, QUAL/SEMIQUANT, MULTI; HIV-1 & 2, SINGLE | $348.00 | $348.00 | — | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN; GLYCOSYLATED A1C | $216.00 | $216.00 | — | 231% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN; GLYCOSYLATED A1C | $216.00 | $216.00 | — | — | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC INFEC AGENT ANTIG DETECT ENZYME IMMUNO, QUAL/SEMIQUANT, MULT-STEP; HEPATITIS B SURFACE | $314.00 | $314.00 | — | 415% above | — |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC INFEC AGENT ANTIG DETECT ENZYME IMMUNO, QUAL/SEMIQUANT, MULT-STEP; HEPATITIS B SURFACE | $314.00 | $314.00 | — | — | — |
| Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY | $258.00 | $258.00 | — | 159% above | — |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY | $258.00 | $258.00 | — | — | — |
| Herpes blood test, HSV-1 antibody CPT 86695 HC ANTIBODY; HERPES SIMPLEX, TYPE 1 | $176.00 | $176.00 | — | 247% above | — |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC ANTIBODY; HERPES SIMPLEX, TYPE 1 | $176.00 | $176.00 | — | — | — |
| Herpes blood test, HSV-2 antibody CPT 86696 HC ANTIBODY; HERPES SIMPLEX, TYPE 2 | $183.00 | $183.00 | — | 152% above | — |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC ANTIBODY; HERPES SIMPLEX, TYPE 2 | $183.00 | $183.00 | — | — | — |
| Homocysteine blood test CPT 83090 HC HOMOCYSTEINE | $285.00 | $285.00 | — | 119% above | — |
| Homocysteine blood test inpatient CPT 83090 HC HOMOCYSTEINE | $285.00 | $285.00 | — | — | — |
| Iron blood test (serum iron) CPT 83540 HC IRON | $159.00 | $159.00 | — | 231% above | — |
| Iron blood test (serum iron) inpatient CPT 83540 HC IRON | $159.00 | $159.00 | — | — | — |
| Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY | $225.00 | $225.00 | — | 408% above | — |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY | $225.00 | $225.00 | — | — | — |
| Lactate (lactic acid) blood test CPT 83605 HC LACTATE (LACTIC ACID) | $190.00 | $190.00 | — | 111% above | — |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTATE (LACTIC ACID) | $190.00 | $190.00 | — | — | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE | $156.00 | $156.00 | — | 265% above | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE | $156.00 | $156.00 | — | — | — |
| Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE | $250.00 | $250.00 | — | 182% above | — |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE | $250.00 | $250.00 | — | — | — |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL | $385.00 | $385.00 | — | 307% above | — |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL | $385.00 | $385.00 | — | — | — |
| Lyme disease antibody test CPT 86618 HC LYME DISEASE | $252.00 | $252.00 | — | 105% above | — |
| Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE | $252.00 | $252.00 | — | — | — |
| Magnesium blood test CPT 83735 HC MAGNESIUM | $191.00 | $191.00 | — | 301% above | — |
| Magnesium blood test inpatient CPT 83735 HC MAGNESIUM | $191.00 | $191.00 | — | — | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES, SCREENING | $200.00 | $200.00 | — | 157% above | — |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES, SCREENING | $200.00 | $200.00 | — | — | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC ANTIGEN (PSA); FREE | $212.00 | $212.00 | — | 205% above | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC ANTIGEN (PSA); FREE | $212.00 | $212.00 | — | — | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL | $262.00 | $262.00 | — | 229% above | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL | $262.00 | $262.00 | — | — | — |
| Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHRYOID HORMONE TEST | $551.00 | $551.00 | — | 186% above | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHRYOID HORMONE TEST | $551.00 | $551.00 | — | — | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC PARTIAL THROMBOPLASTIN TIME (PTT) | $199.00 | $199.00 | — | 298% above | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PARTIAL THROMBOPLASTIN TIME (PTT) | $199.00 | $199.00 | — | — | — |
| Phosphorus (phosphate) blood test CPT 84100 HC PHOSPHORUS INORGANIC PHOSPHATE | $135.00 | $135.00 | — | 371% above | — |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HC PHOSPHORUS INORGANIC PHOSPHATE | $135.00 | $135.00 | — | — | — |
| Potassium blood test CPT 84132 HC POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD | $129.00 | $129.00 | — | 352% above | — |
| Potassium blood test inpatient CPT 84132 HC POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD | $129.00 | $129.00 | — | — | — |
| Prolactin blood test CPT 84146 HC PROLACTIN | $335.00 | $335.00 | — | 233% above | — |
| Prolactin blood test inpatient CPT 84146 HC PROLACTIN | $335.00 | $335.00 | — | — | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $134.00 | $134.00 | — | 406% above | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $134.00 | $134.00 | — | — | — |
| Rh blood typing CPT 86901 HC BLOOD TYPING, SEROLOGIC, RH (D) | $98.00 | $98.00 | — | 154% above | — |
| Rh blood typing inpatient CPT 86901 HC BLOOD TYPING, SEROLOGIC, RH (D) | $98.00 | $98.00 | — | — | — |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC SEDIMENTATION RATE AUTO | $142.00 | $142.00 | — | 264% above | — |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC SEDIMENTATION RATE AUTO | $142.00 | $142.00 | — | — | — |
| Sodium blood test CPT 84295 HC SODIUM; SERUM, PLASMA OR WHOLE BLOOD | $136.00 | $136.00 | — | 272% above | — |
| Sodium blood test inpatient CPT 84295 HC SODIUM; SERUM, PLASMA OR WHOLE BLOOD | $136.00 | $136.00 | — | — | — |
| Stool ova and parasites exam CPT 87177 HC OVA & PARASITES DIR SMR W ID | $153.00 | $153.00 | — | 215% above | — |
| Stool ova and parasites exam inpatient CPT 87177 HC OVA & PARASITES DIR SMR W ID | $153.00 | $153.00 | — | — | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC BLOOD OCCULT, PEROXIDASE , QUAL, FECES, CONSEC SPEC, SINGLE ,COLORECTAL NEOPLASM SCREEN | $73.00 | $73.00 | — | 103% above | — |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC BLOOD OCCULT, PEROXIDASE , QUAL, FECES, CONSEC SPEC, SINGLE ,COLORECTAL NEOPLASM SCREEN | $73.00 | $73.00 | — | — | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD, OCCULT, BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY, QUAL, FECES, 1-3 SIMULTANEOUS | $116.00 | $116.00 | — | 124% above | — |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD, OCCULT, BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY, QUAL, FECES, 1-3 SIMULTANEOUS | $116.00 | $116.00 | — | — | — |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC SYPHILIS IGG ANTIBODY | $186.00 | $186.00 | — | 175% above | — |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC SYPHILIS IGG ANTIBODY | $186.00 | $186.00 | — | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC RPR SCREEN | $132.00 | $132.00 | — | 224% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC RPR SCREEN | $132.00 | $132.00 | — | — | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED IMMUNITY MEASUREMENT | $414.00 | $414.00 | — | 180% above | — |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED IMMUNITY MEASUREMENT | $414.00 | $414.00 | — | — | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC THROPEROXIDASE AB | $212.00 | $212.00 | — | 129% above | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC THROPEROXIDASE AB | $212.00 | $212.00 | — | — | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE (TSH) | $264.00 | $264.00 | — | 224% above | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE (TSH) | $264.00 | $264.00 | — | — | — |
| Total IgE blood test CPT 82785 HC GAMMAGLOBULIN; IGE | $207.00 | $207.00 | — | 176% above | — |
| Total IgE blood test inpatient CPT 82785 HC GAMMAGLOBULIN; IGE | $207.00 | $207.00 | — | — | — |
| Total thyroxine (T4) blood test CPT 84436 HC THYROXINE; TOTAL | $215.00 | $215.00 | — | 354% above | — |
| Total thyroxine (T4) blood test inpatient CPT 84436 HC THYROXINE; TOTAL | $215.00 | $215.00 | — | — | — |
| Total triiodothyronine (T3) blood test CPT 84480 HC TRIIODOTHYRONINE T3; TOTAL | $242.00 | $242.00 | — | 100% above | — |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 HC TRIIODOTHYRONINE T3; TOTAL | $242.00 | $242.00 | — | — | — |
| Transferrin blood test CPT 84466 HC TRANSFERRIN | $186.00 | $186.00 | — | 119% above | — |
| Transferrin blood test inpatient CPT 84466 HC TRANSFERRIN | $186.00 | $186.00 | — | — | — |
| Trichomonas test (NAAT) CPT 87661 HC INFCT AGENT DTCTN BY NUCLEIC ACID RNA OR DNA; TRICHOMONAS VAGINALIS, AMPLIFIED PROBE TCHNQ | $179.00 | $179.00 | — | 89% above | — |
| Trichomonas test (NAAT) inpatient CPT 87661 HC INFCT AGENT DTCTN BY NUCLEIC ACID RNA OR DNA; TRICHOMONAS VAGINALIS, AMPLIFIED PROBE TCHNQ | $179.00 | $179.00 | — | — | — |
| Triglycerides blood test CPT 84478 HC TRIGLYCERIDES-SERUM | $202.00 | $202.00 | — | 465% above | — |
| Triglycerides blood test CPT 84478 HC TRIGLYCERIDES, FLUID | $202.00 | $202.00 | — | 465% above | — |
| Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES, FLUID | $202.00 | $202.00 | — | — | — |
| Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES-SERUM | $202.00 | $202.00 | — | — | — |
| Troponin test, quantitative CPT 84484 HC CARDIAC TROPONIN T | $367.00 | $367.00 | — | 203% above | — |
| Troponin test, quantitative inpatient CPT 84484 HC CARDIAC TROPONIN T | $367.00 | $367.00 | — | — | — |
| Uric acid blood test CPT 84550 HC URIC ACID; BLOOD | $137.00 | $137.00 | — | 185% above | — |
| Uric acid blood test inpatient CPT 84550 HC URIC ACID; BLOOD | $137.00 | $137.00 | — | — | — |
| Urinalysis with microscope exam, automated CPT 81001 HC UA,BY DIP STCK/TBLT RGNT FOR BLRBN,GLUC,HGB,KET,LUKCYTES,NIT,PH, PROT,SPEC GRAV,UROBIL;AUT,W/MICR | $141.00 | $141.00 | — | 236% above | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC UA,BY DIP STCK/TBLT RGNT FOR BLRBN,GLUC,HGB,KET,LUKCYTES,NIT,PH, PROT,SPEC GRAV,UROBIL;AUT,W/MICR | $141.00 | $141.00 | — | — | — |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS, AUTO, WITHOUT MICROSCOPY | $112.00 | $112.00 | — | 357% above | — |
| Urinalysis without microscope exam, automated CPT 81003 HC UA/ER/POC | $112.00 | $112.00 | — | 357% above | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC UA/ER/POC | $112.00 | $112.00 | — | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS, AUTO, WITHOUT MICROSCOPY | $112.00 | $112.00 | — | — | — |
| Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS, BY DIP STICK OR TAB REAGENT; NON-AUTO, W/OUT MICROSCOPY | $87.00 | $87.00 | — | 458% above | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS, BY DIP STICK OR TAB REAGENT; NON-AUTO, W/OUT MICROSCOPY | $87.00 | $87.00 | — | — | — |
| Urine culture for bacteria, with colony count CPT 87086 HC CULTURE, BACTERIAL, QUANTITATIVE COLONY COUNT, URNE | $279.00 | $279.00 | — | 538% above | — |
| Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE, BACTERIAL, QUANTITATIVE COLONY COUNT, URNE | $279.00 | $279.00 | — | — | — |
| Urine microalbumin (albumin) test CPT 82043 HC ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE | $160.00 | $160.00 | — | 362% above | — |
| Urine microalbumin (albumin) test inpatient CPT 82043 HC ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE | $160.00 | $160.00 | — | — | — |
| Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS | $238.00 | $238.00 | — | 342% above | — |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS | $238.00 | $238.00 | — | — | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC CYANOCOBALAMIN VITAMIN B-12 | $355.00 | $355.00 | — | 381% above | — |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC CYANOCOBALAMIN VITAMIN B-12 | $355.00 | $355.00 | — | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED | $293.00 | $293.00 | — | 117% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED | $293.00 | $293.00 | — | — | — |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VITAMIN D; 1, 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED | $394.00 | $394.00 | — | 121% above | — |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC VITAMIN D; 1, 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED | $394.00 | $394.00 | — | — | — |
| Zinc blood test CPT 84630 HC ZINC | $152.00 | $152.00 | — | 84% above | — |
| Zinc blood test inpatient CPT 84630 HC ZINC | $152.00 | $152.00 | — | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC BHCG QUANTITATIVE, SERUM | $288.00 | $288.00 | — | 261% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC BHCG QUANTITATIVE, SERUM | $288.00 | $288.00 | — | — | — |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE; WITHOUT MANIPULATION | $692.00 | $692.00 | — | 77% above | — |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE; WITHOUT MANIPULATION | $692.00 | $692.00 | — | — | — |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC CLOSED TREATMENT OF METATARSAL FRACTURE; WITHOUT MANIPULATION, EACH | $692.00 | $692.00 | — | 58% above | — |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC CLOSED TREATMENT OF METATARSAL FRACTURE; WITHOUT MANIPULATION, EACH | $692.00 | $692.00 | — | — | — |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION, ELECTIVE, ELECTRICAL CONVERSION OF ARRHYTHMIA; EXTERNAL | $3,024.00 | $3,024.00 | — | 115% above | — |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION, ELECTIVE, ELECTRICAL CONVERSION OF ARRHYTHMIA; EXTERNAL | $3,024.00 | $3,024.00 | — | — | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLOSED TX OF DIST RAD FX OR EPIPHYSEAL SEP, INCLUDES CLOSED TX OF FX OF ULNAR STYLOID; WO MANIP | $692.00 | $692.00 | — | 59% above | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC CLOSED TX OF DIST RAD FX OR EPIPHYSEAL SEP, INCLUDES CLOSED TX OF FX OF ULNAR STYLOID; WO MANIP | $692.00 | $692.00 | — | — | — |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY | $3,584.00 | $3,584.00 | — | 31% above | — |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY | $3,584.00 | $3,584.00 | — | — | — |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMOVE IMPACTED EAR WAX UNILATERAL | $217.00 | $217.00 | — | 23% above | — |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC REMOVE IMPACTED EAR WAX UNILATERAL | $217.00 | $217.00 | — | — | — |
| Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN REQUIRING INSTRUMENTATION, UNILATERAL | $535.00 | $535.00 | — | 235% above | — |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMOVAL IMPACTED CERUMEN REQUIRING INSTRUMENTATION, UNILATERAL | $535.00 | $535.00 | — | — | — |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 HC INTRAVITREAL INJECTION OF PHARMACOLOGIC AGENT | $2,057.00 | $2,057.00 | — | 66% below | — |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HC INTRAVITREAL INJECTION OF PHARMACOLOGIC AGENT | $2,057.00 | $2,057.00 | — | — | — |
| Occipital nerve block (injection for headaches) CPT 64405 HC INJECTION, ANESTHETIC AGENT; GREATER OCCIPITAL NERVICE | $715.00 | $715.00 | — | 18% above | — |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJECTION, ANESTHETIC AGENT; GREATER OCCIPITAL NERVICE | $715.00 | $715.00 | — | — | — |
| Paracentesis with imaging guidance CPT 49083 HC ABDOMINAL PARACENTESIS; WITH IMAGING GUIDANCE | $3,779.00 | $3,779.00 | — | 173% above | — |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOMINAL PARACENTESIS; WITH IMAGING GUIDANCE | $3,779.00 | $3,779.00 | — | — | — |
| Short arm cast (elbow to hand) CPT 29075 HC APPLICATION, CAST; ELBOW TO FINGER (SHORT ARM) | $727.00 | $727.00 | — | 102% above | — |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLICATION, CAST; ELBOW TO FINGER (SHORT ARM) | $727.00 | $727.00 | — | — | — |
| Short arm splint (forearm and hand) CPT 29125 HC APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND); STATIC | $330.00 | $330.00 | — | 82% above | — |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND); STATIC | $330.00 | $330.00 | — | — | — |
| Short leg cast (below the knee) CPT 29405 HC APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES) | $727.00 | $727.00 | — | 92% above | — |
| Short leg cast (below the knee) inpatient CPT 29405 HC APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES) | $727.00 | $727.00 | — | — | — |
| Short leg splint (calf to foot) CPT 29515 HC APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT) | $416.00 | $416.00 | — | 72% above | — |
| Short leg splint (calf to foot) inpatient CPT 29515 HC APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT) | $416.00 | $416.00 | — | — | — |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE LUMBAR DIAGNOSTIC | $1,863.00 | $1,863.00 | — | 82% above | — |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE LUMBAR DIAGNOSTIC | $1,863.00 | $1,863.00 | — | — | — |
| Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS, NEEDLE OR CATHETER, ASPIRATION OF THE PLEURAL SPACE; WITH IMAGING GUIDANCE | $4,486.00 | $4,486.00 | — | 309% above | — |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS, NEEDLE OR CATHETER, ASPIRATION OF THE PLEURAL SPACE; WITH IMAGING GUIDANCE | $4,486.00 | $4,486.00 | — | — | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION | $1,893.00 | $1,893.00 | — | 110% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD ADMINISTRATION INPATIENT | $1,893.00 | $1,893.00 | — | 110% above | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD ADMINISTRATION INPATIENT | $1,893.00 | $1,893.00 | — | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION | $1,893.00 | $1,893.00 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC METERED DOSE INHALER THERAPY | $374.00 | $374.00 | — | 232% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC EZ PAP | $374.00 | $374.00 | — | 232% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION | $374.00 | $374.00 | — | 232% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC METERED DOSE INHALER THERAPY | $374.00 | $374.00 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC EZ PAP | $374.00 | $374.00 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION | $374.00 | $374.00 | — | — | — |
| Chemotherapy IV infusion, first hour CPT 96413 HC CHEMOTHER ADMINISTRATION, INTRAVENOUS INF TCHNQ; UP TO 1 HR, SINGLE OR INI SUBSTANCE/DRUG | $926.00 | $926.00 | — | 37% above | — |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMOTHER ADMINISTRATION, INTRAVENOUS INF TCHNQ; UP TO 1 HR, SINGLE OR INI SUBSTANCE/DRUG | $926.00 | $926.00 | — | — | — |
| Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE E&M FIRST 30-74 MIN | $5,258.00 | $5,258.00 | — | 148% above | — |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE E&M FIRST 30-74 MIN | $5,258.00 | $5,258.00 | — | — | — |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC ELECTROENCEPHALOGRAM (EEG); INCLUDING RECORDING AWAKE AND DROWSY | $1,374.00 | $1,374.00 | — | 101% above | — |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC ELECTROENCEPHALOGRAM (EEG); INCLUDING RECORDING AWAKE AND DROWSY | $1,374.00 | $1,374.00 | — | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ELECTROCARDIOGRAM, ROUTINE ECG W/ AT LEAST 12 LEADS; TRACING ONLY, W/O INTERPRETATION AND REPORT | $480.00 | $480.00 | — | 138% above | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ELECTROCARDIOGRAM, ROUTINE ECG W/ AT LEAST 12 LEADS; TRACING ONLY, W/O INTERPRETATION AND REPORT | $480.00 | $480.00 | — | — | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMERGENCY ROOM PROBLEM FOCUSED VISIT | $485.00 | $485.00 | — | 123% above | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC EMERGENCY ROOM PROBLEM FOCUSED VISIT | $485.00 | $485.00 | — | — | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY DEPARTMENT EVALUATION AND MANAGEMENT LEVEL 2 | $940.00 | $940.00 | — | 124% above | — |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC EMERGENCY DEPARTMENT EVALUATION AND MANAGEMENT LEVEL 2 | $940.00 | $940.00 | — | — | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY DEPARTMENT EVALUATION AND MANAGEMENT LEVEL 3 | $1,658.00 | $1,658.00 | — | 114% above | — |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC EMERGENCY DEPARTMENT EVALUATION AND MANAGEMENT LEVEL 3 | $1,658.00 | $1,658.00 | — | — | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY DEPARTMENT EVALUATION AND MANAGEMENT LEVEL 4 | $2,750.00 | $2,750.00 | — | 132% above | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC EMERGENCY DEPARTMENT EVALUATION AND MANAGEMENT LEVEL 4 | $2,750.00 | $2,750.00 | — | — | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMERGENCY DEPARTMENT EVALUATION AND MANAGEMENT LEVEL 5 | $3,777.00 | $3,777.00 | — | 116% above | — |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC EMERGENCY DEPARTMENT EVALUATION AND MANAGEMENT LEVEL 5 | $3,777.00 | $3,777.00 | — | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC INTRAVENOUS INFUSION, HYDRATION; INITIAL, 31 MINUTES TO 1 HOUR | $857.00 | $857.00 | — | 133% above | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC INTRAVENOUS INFUSION, HYDRATION; INITIAL, 31 MINUTES TO 1 HOUR | $857.00 | $857.00 | — | — | — |
| IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION,THERAPY, PROPHYLAXIS, OR DX; INITIAL, UP TO 1 HOUR | $963.00 | $963.00 | — | 138% above | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION,THERAPY, PROPHYLAXIS, OR DX; INITIAL, UP TO 1 HOUR | $963.00 | $963.00 | — | — | — |
| IV push of a medicine, first drug CPT 96374 HC THERAPEUTIC, PROPHYLACTIC, OR DX INJ; IV PUSH, SINGLE OR INITIAL SUBSTANCE/DRUG | $469.00 | $469.00 | — | 121% above | — |
| IV push of a medicine, first drug inpatient CPT 96374 HC THERAPEUTIC, PROPHYLACTIC, OR DX INJ; IV PUSH, SINGLE OR INITIAL SUBSTANCE/DRUG | $469.00 | $469.00 | — | — | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THERAPEUTIC, PROPHYLACTIC, OR DX INJ; SQ OR IM | $289.00 | $289.00 | — | 174% above | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THERAPEUTIC, PROPHYLACTIC, OR DX INJ; SQ OR IM | $289.00 | $289.00 | — | — | — |
| Occupational therapy evaluation, low complexity CPT 97165 HC OCCUPATIONAL THERAPY EVALUATION LOW COMPLEX 30 MIN | $486.00 | $486.00 | — | 206% above | — |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OCCUPATIONAL THERAPY EVALUATION LOW COMPLEX 30 MIN | $486.00 | $486.00 | — | — | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PHYSICAL THERAPY HIGH COMPLEX 45 MIN | $482.00 | $482.00 | — | 106% above | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PHYSICAL THERAPY HIGH COMPLEX 45 MIN | $482.00 | $482.00 | — | — | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MIN | $482.00 | $482.00 | — | 236% above | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MIN | $482.00 | $482.00 | — | — | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PHYSICAL THERAPY EVALUATION MODERATE COMPLEX 30 MIN | $482.00 | $482.00 | — | 158% above | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PHYSICAL THERAPY EVALUATION MODERATE COMPLEX 30 MIN | $482.00 | $482.00 | — | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPUETIC EXERCISE EA 15M | $207.00 | $207.00 | — | 174% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPUETIC EXERCISE EA 15M | $207.00 | $207.00 | — | — | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUTIC ACTIVITIES, DIRECT PATIENT CONTACT, EACH 15 MINUTES | $190.00 | $190.00 | — | 151% above | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUTIC ACTIVITIES, DIRECT PATIENT CONTACT, EACH 15 MINUTES | $190.00 | $190.00 | — | — | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THERAPEUTIC | $516.00 | $516.00 | — | 145% above | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY THERAPEUTIC | $516.00 | $516.00 | — | — | — |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP | $1,221.09 | $1,221.09 | — | 198% above | — |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP | $1,221.09 | $1,221.09 | — | — | — |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIPH,PERTUS(ACELL),TET,POLIO (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE | $400.81 | $400.81 | — | 173% above | — |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DIPH,PERTUS(ACELL),TET,POLIO (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE | $400.81 | $400.81 | — | — | — |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE | $669.13 | $669.13 | — | 252% above | — |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE | $669.13 | $669.13 | — | — | — |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SYRNG | $1,019.78 | $1,019.78 | — | 168% above | — |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SYRNG | $1,019.78 | $1,019.78 | — | — | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE | $22.35 | $22.35 | — | 43% below | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE | $22.35 | $22.35 | — | — | — |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE | $2,055.97 | $2,055.97 | — | 226% above | — |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE | $2,055.97 | $2,055.97 | — | — | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $85.41 | $85.41 | — | at median | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $255.24 | $255.24 | — | 199% above | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $85.41 | $85.41 | — | — | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $255.24 | $255.24 | — | — | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $478.99 | $478.99 | — | 172% above | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $478.99 | $478.99 | — | — | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE | $190.97 | $190.97 | — | 161% above | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE | $190.97 | $190.97 | — | — | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN | $83.19 | $83.19 | — | 70% above | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN | $83.19 | $83.19 | — | — | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE TS2024-25(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $73.41 | $73.41 | — | 59% below | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACCINE TS2024-25(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $73.41 | $73.41 | — | — | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT | $622.78 | $622.78 | — | 142% above | — |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT | $622.78 | $622.78 | — | — | — |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEASLES,MUMPS,RUBEL,VARICEL LIV(PF)10E3-4.3-3-3.99TCID50/0.5 ML SUBCUT | $1,843.59 | $1,843.59 | — | 334% above | — |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLES,MUMPS,RUBEL,VARICEL LIV(PF)10E3-4.3-3-3.99TCID50/0.5 ML SUBCUT | $1,843.59 | $1,843.59 | — | — | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION | $1,112.18 | $1,112.18 | — | 218% above | — |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION | $1,112.18 | $1,112.18 | — | — | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE | $1,583.72 | $1,583.72 | — | 308% above | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE | $1,583.72 | $1,583.72 | — | — | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE | $1,834.81 | $1,834.81 | — | 193% above | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE | $1,834.81 | $1,834.81 | — | — | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE | $117.09 | $117.09 | — | 50% below | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE | $117.09 | $117.09 | — | — | — |
| Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION | $38.00 | $38.00 | — | 69% below | — |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION | $38.00 | $38.00 | — | — | — |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSVPREF3 ANTIGEN-AS01E ADJUVANT(PF) 120 MCG/0.5 ML IM SUSPENSION, KIT | $292.00 | $292.00 | — | 62% below | — |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSVPREF3 ANTIGEN-AS01E ADJUVANT(PF) 120 MCG/0.5 ML IM SUSPENSION, KIT | $292.00 | $292.00 | — | — | — |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP | $2,773.20 | $2,773.20 | — | 246% above | — |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP | $2,773.20 | $2,773.20 | — | — | — |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION | $608.03 | $608.03 | — | 217% above | — |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION | $608.03 | $608.03 | — | — | — |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT | $1,443.91 | $1,443.91 | — | 270% above | — |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT | $1,443.91 | $1,443.91 | — | — | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE | $260.01 | $260.01 | — | 127% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE | $260.01 | $260.01 | — | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE | $311.53 | $311.53 | — | 154% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE | $311.53 | $311.53 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMINISTRATION; 1 VACCINE | $102.00 | $102.00 | — | 66% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMINISTRATION; 1 VACCINE | $102.00 | $102.00 | — | — | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADMINISTRATION; EACH ADDITIONAL VACCINE | $105.00 | $105.00 | — | 164% above | — |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZATION ADMINISTRATION; EACH ADDITIONAL VACCINE | $105.00 | $105.00 | — | — | — |
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.