Hospital Akron, OH

Western Reserve

Western Reserve in Cuyahoga Falls, OH publishes cash prices for 383 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Ohio median for 361 of 382 procedures and below it for 20. By typical cash price it ranks #137 of 137 Ohio hospitals and #6 of 6 hospitals in the Akron, OH area, cheapest first. Click a procedure to compare it with other hospitals nearby.

1900 23rd Street, Cuyahoga Falls, OH 44223 Collected Sep 23, 2026 Source price file (330) 971-7000

Acute care hospital Emergency department CMS star rating 3 of 5 CCN 360150 · CMS hospital register NPI 1518104199

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WO/W ENHANCE	$4,406.05	$8,011.00	$232.96–$2,883.96	235% above	45%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WO/W ENHANCE	$4,406.05	$8,011.00	$232.96–$2,883.96	—	45%
Abdominal X-ray, 2 views CPT 74019 XR EXAM ABDOMEN 2 VIEWS	$827.20	$1,504.00	$138.85–$541.44	141% above	45%
Abdominal X-ray, 2 views inpatient CPT 74019 XR EXAM ABDOMEN 2 VIEWS	$827.20	$1,504.00	$138.85–$541.44	—	45%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3+ VIEWS LT	$754.05	$1,371.00	$115.58–$493.56	133% above	45%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3+ VIEWS RT	$754.05	$1,371.00	$115.58–$493.56	133% above	45%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3+ VIEWS LT	$754.05	$1,371.00	$115.58–$493.56	—	45%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3+ VIEWS RT	$754.05	$1,371.00	$115.58–$493.56	—	45%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 CR UPR/L XTREMITY ART 2 LEVELS	$532.40	$968.00	$176.71–$459.80	11% above	45%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 CR UPR/L XTREMITY ART 2 LEVELS	$532.40	$968.00	$176.71–$459.80	—	45%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT RT UPPER EXT WO	$3,028.85	$5,507.00	$138.85–$1,982.52	221% above	45%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT LT UPPER EXT WO	$3,028.85	$5,507.00	$138.85–$1,982.52	221% above	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT LT UPPER EXT WO	$3,028.85	$5,507.00	$138.85–$1,982.52	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT RT UPPER EXT WO	$3,028.85	$5,507.00	$138.85–$1,982.52	—	45%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS	$860.20	$1,564.00	$232.96–$563.04	96% above	45%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR ESOPHAGUS	$860.20	$1,564.00	$232.96–$563.04	—	45%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE +OR JT IMAG WH BODY	$2,361.15	$4,293.00	$530.96–$1,996.25	54% above	45%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE +OR JT IMAG WH BODY	$2,361.15	$4,293.00	$530.96–$1,996.25	—	45%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED BIL	$752.95	$1,369.00	$115.58–$650.28	84% above	45%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED LT	$501.60	$912.00	$115.58–$433.20	22% above	45%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED RT	$501.60	$912.00	$115.58–$433.20	22% above	45%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST LIMITED BIL	$752.95	$1,369.00	$115.58–$650.28	—	45%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LIMITED LT	$501.60	$912.00	$115.58–$433.20	—	45%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LIMITED RT	$501.60	$912.00	$115.58–$433.20	—	45%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD & PELV W/WO DYE	$11,442.20	$20,804.00	$463.36–$7,489.44	439% above	45%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD & PELV W/WO DYE	$11,442.20	$20,804.00	$463.36–$7,489.44	—	45%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W/WO CONT	$5,062.75	$9,205.00	$232.96–$3,313.80	280% above	45%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W/WO CONT	$5,062.75	$9,205.00	$232.96–$3,313.80	—	45%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W/WO CONT	$5,062.75	$9,205.00	$232.96–$3,313.80	288% above	45%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W/WO CONT	$5,062.75	$9,205.00	$232.96–$3,313.80	—	45%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/WO CONT	$5,062.75	$9,205.00	$232.96–$3,313.80	257% above	45%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W/WO CONT	$5,062.75	$9,205.00	$232.96–$3,313.80	—	45%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST	$284.90	$518.00	$115.58–$201.35	1% above	45%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O DYE W/CA TEST	$284.90	$518.00	$115.58–$201.35	—	45%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD + PELVIS WO CONTRAST	$6,063.20	$11,024.00	$316.90–$3,968.64	286% above	45%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD + PELVIS WO CONTRAST	$6,063.20	$11,024.00	$316.90–$3,968.64	—	45%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN + PELVIS W/CONT	$7,364.50	$13,390.00	$463.36–$4,820.40	279% above	45%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN + PELVIS W/CONT	$7,364.50	$13,390.00	$463.36–$4,820.40	—	45%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELV W/WO CONT	$9,467.70	$17,214.00	$463.36–$6,197.04	306% above	45%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELV W/WO CONT	$9,467.70	$17,214.00	$463.36–$6,197.04	—	45%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/ENHANCE	$3,912.70	$7,114.00	$232.96–$2,561.04	235% above	45%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/ENHANCE	$3,912.70	$7,114.00	$232.96–$2,561.04	—	45%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO/ENHANCE	$3,034.35	$5,517.00	$138.85–$1,986.12	189% above	45%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO/ENHANCE	$3,034.35	$5,517.00	$138.85–$1,986.12	—	45%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO/ENHANCE	$2,855.60	$5,192.00	$138.85–$1,869.12	226% above	45%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO/ENHANCE	$2,855.60	$5,192.00	$138.85–$1,869.12	—	45%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN WO/ENHANCE	$3,028.85	$5,507.00	$138.85–$1,982.52	263% above	45%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN WO/ENHANCE	$3,028.85	$5,507.00	$138.85–$1,982.52	—	45%
CT scan of the head with contrast CPT 70460 CT BRAIN W/ENHANCE	$3,835.70	$6,974.00	$232.96–$2,510.64	282% above	45%
CT scan of the head with contrast inpatient CPT 70460 CT BRAIN W/ENHANCE	$3,835.70	$6,974.00	$232.96–$2,510.64	—	45%
CT scan of the head without and with contrast CPT 70470 CT BRAIN WO/W ENHANCE	$5,062.75	$9,205.00	$232.96–$3,313.80	337% above	45%
CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN WO/W ENHANCE	$5,062.75	$9,205.00	$232.96–$3,313.80	—	45%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO/ENHANCE	$3,028.85	$5,507.00	$138.85–$1,982.52	177% above	45%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO/ENHANCE	$3,028.85	$5,507.00	$138.85–$1,982.52	—	45%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE WO/ENHANCE	$3,028.85	$5,507.00	$138.85–$1,982.52	182% above	45%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE WO/ENHANCE	$3,028.85	$5,507.00	$138.85–$1,982.52	—	45%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/ENHANCE	$3,450.70	$6,274.00	$232.96–$2,258.64	182% above	45%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/ENHANCE	$3,450.70	$6,274.00	$232.96–$2,258.64	—	45%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CR CAROTID DUPLEX	$1,855.15	$3,373.00	$316.90–$1,602.18	156% above	45%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CR CAROTID DUPLEX	$1,855.15	$3,373.00	$316.90–$1,602.18	—	45%
Chest CT scan without and with contrast CPT 71270 CT CHEST WO/W ENHANCE	$5,062.75	$9,205.00	$232.96–$3,313.80	244% above	45%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST WO/W ENHANCE	$5,062.75	$9,205.00	$232.96–$3,313.80	—	45%
Chest X-ray, 2 views CPT 71046 XR EXAM CHEST 2 VIEWS	$497.20	$904.00	$115.58–$325.44	82% above	45%
Chest X-ray, 2 views inpatient CPT 71046 XR EXAM CHEST 2 VIEWS	$497.20	$904.00	$115.58–$325.44	—	45%
Chest X-ray, single view CPT 71045 XR EXAM CHEST 1 VIEW	$420.20	$764.00	$115.58–$275.04	80% above	45%
Chest X-ray, single view inpatient CPT 71045 XR EXAM CHEST 1 VIEW	$420.20	$764.00	$115.58–$275.04	—	45%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE COMPLETE LT	$718.85	$1,307.00	$115.58–$470.52	161% above	45%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE COMPLETE RT	$718.85	$1,307.00	$115.58–$470.52	161% above	45%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE COMPLETE LT	$718.85	$1,307.00	$115.58–$470.52	—	45%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE COMPLETE RT	$718.85	$1,307.00	$115.58–$470.52	—	45%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US ECHO RETROPERITON COMP	$1,090.10	$1,982.00	$138.85–$941.45	54% above	45%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US ECHO RETROPERITON COMP	$1,090.10	$1,982.00	$138.85–$941.45	—	45%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL SKEL	$540.10	$982.00	$138.85–$353.52	19% above	45%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY AXIAL SKEL	$540.10	$982.00	$138.85–$353.52	—	45%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY APPENDICULAR SKEL	$303.05	$551.00	$115.58–$201.35	18% above	45%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY APPENDICULAR SKEL	$303.05	$551.00	$115.58–$201.35	—	45%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO/ENHANCE	$3,028.85	$5,507.00	$138.85–$1,982.52	223% above	45%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST LOW DOSE	$3,028.85	$5,507.00	$138.85–$1,982.52	223% above	45%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST LOW DOSE	$3,028.85	$5,507.00	$138.85–$1,982.52	—	45%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO/ENHANCE	$3,028.85	$5,507.00	$138.85–$1,982.52	—	45%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/ENHANCE	$3,450.70	$6,274.00	$232.96–$2,258.64	202% above	45%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/ENHANCE	$3,450.70	$6,274.00	$232.96–$2,258.64	—	45%
Diagnostic mammogram, both breasts CPT 77066 DX MAM INCL CAD BIL	$568.70	$1,034.00	$268.84–$351.56	46% above	45%
Diagnostic mammogram, both breasts inpatient CPT 77066 DX MAM INCL CAD BIL	$568.70	$1,034.00	$268.84–$351.56	—	45%
Diagnostic mammogram, one breast one side CPT 77065 DX MAM INCL CAD RT	$379.50	$690.00	$179.40–$234.60	7% above	45%
Diagnostic mammogram, one breast one side CPT 77065 DX MAM INCL CAD LT	$379.50	$690.00	$179.40–$234.60	7% above	45%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX MAM INCL CAD LT	$379.50	$690.00	$179.40–$234.60	—	45%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX MAM INCL CAD RT	$379.50	$690.00	$179.40–$234.60	—	45%
Duplex ultrasound of the leg arteries, both legs CPT 93925 CR BIL ART DUP-LOWER	$2,084.50	$3,790.00	$316.90–$1,800.25	146% above	45%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 CR BIL ART DUP-LOWER	$2,084.50	$3,790.00	$316.90–$1,800.25	—	45%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 CR BILAT VENOUS DUPLEX	$2,084.50	$3,790.00	$316.90–$1,800.25	—	45%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 CR BILAT VENOUS DUPLEX	$2,084.50	$3,790.00	$316.90–$1,800.25	—	45%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO W BUBBLE STUDY	$4,935.70	$8,974.00	$725.73–$4,262.65	192% above	45%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CR ECHO COMPLETE STUDY	$4,935.70	$8,974.00	$725.73–$4,262.65	192% above	45%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CR ECHO COMPLETE STUDY	$4,935.70	$8,974.00	$725.73–$4,262.65	—	45%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO W BUBBLE STUDY	$4,935.70	$8,974.00	$725.73–$4,262.65	—	45%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS RT	$517.55	$941.00	$115.58–$338.76	93% above	45%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS LT	$517.55	$941.00	$115.58–$338.76	93% above	45%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEWS LT	$517.55	$941.00	$115.58–$338.76	—	45%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEWS RT	$517.55	$941.00	$115.58–$338.76	—	45%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3+ VIEWS RT	$718.85	$1,307.00	$115.58–$470.52	126% above	45%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3+ VIEWS LT	$718.85	$1,307.00	$115.58–$470.52	126% above	45%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 3+ VIEWS RT	$718.85	$1,307.00	$115.58–$470.52	—	45%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 3+ VIEWS LT	$718.85	$1,307.00	$115.58–$470.52	—	45%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/SELLA/EAR WO CONT	$3,028.85	$5,507.00	$138.85–$1,982.52	251% above	45%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT/SELLA/EAR WO CONT	$3,028.85	$5,507.00	$138.85–$1,982.52	—	45%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES COMPL 3+ VWS	$844.25	$1,535.00	$138.85–$552.60	117% above	45%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES COMPL 3+ VWS	$844.25	$1,535.00	$138.85–$552.60	—	45%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS LT	$517.55	$941.00	$115.58–$338.76	89% above	45%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS RT	$517.55	$941.00	$115.58–$338.76	89% above	45%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS LT	$517.55	$941.00	$115.58–$338.76	—	45%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS RT	$517.55	$941.00	$115.58–$338.76	—	45%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPAT/IMG/INC GLLBDR	$2,229.70	$4,054.00	$530.96–$1,885.11	40% above	45%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPAT/IMG/INC GLLBDR	$2,229.70	$4,054.00	$530.96–$1,885.11	—	45%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS LT	$536.25	$975.00	$138.85–$351.00	101% above	45%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS RT	$536.25	$975.00	$138.85–$351.00	101% above	45%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS LT	$536.25	$975.00	$138.85–$351.00	—	45%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS RT	$536.25	$975.00	$138.85–$351.00	—	45%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS 2+ VIEWS LT	$517.55	$941.00	$115.58–$338.76	88% above	45%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS 2+ VIEWS RT	$517.55	$941.00	$115.58–$338.76	88% above	45%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEUS 2+ VIEWS RT	$517.55	$941.00	$115.58–$338.76	—	45%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEUS 2+ VIEWS LT	$517.55	$941.00	$115.58–$338.76	—	45%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SL SLEEP STUDY UNATT & RESP EFFT	$1,117.60	$2,032.00	$238.00–$965.20	59% above	45%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SL SLEEP STUDY UNATT & RESP EFFT	$1,117.60	$2,032.00	$238.00–$965.20	—	45%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SL PSG WITH CPAP/BIPAP	$7,491.55	$13,621.00	$1,140.54–$6,469.98	96% above	45%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SL PSG WITH CPAP/BIPAP	$7,491.55	$13,621.00	$1,140.54–$6,469.98	—	45%
Knee X-ray, 3 views one side CPT 73562 XR KNEE THREE VIEWS RT	$739.20	$1,344.00	$115.58–$483.84	109% above	45%
Knee X-ray, 3 views one side CPT 73562 XR KNEE THREE VIEWS LT	$739.20	$1,344.00	$115.58–$483.84	109% above	45%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE THREE VIEWS RT	$739.20	$1,344.00	$115.58–$483.84	—	45%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE THREE VIEWS LT	$739.20	$1,344.00	$115.58–$483.84	—	45%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE COMPLETE 4+ VIEWS RT	$967.45	$1,759.00	$138.85–$633.24	145% above	45%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE COMPLETE 4+ VIEWS LT	$967.45	$1,759.00	$138.85–$633.24	145% above	45%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE COMPLETE 4+ VIEWS RT	$967.45	$1,759.00	$138.85–$633.24	—	45%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE COMPLETE 4+ VIEWS LT	$967.45	$1,759.00	$138.85–$633.24	—	45%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT RT LOWER EXT WO	$3,028.85	$5,507.00	$138.85–$1,982.52	221% above	45%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LT LOWER EXT WO	$3,028.85	$5,507.00	$138.85–$1,982.52	221% above	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LT LOWER EXT WO	$3,028.85	$5,507.00	$138.85–$1,982.52	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT RT LOWER EXT WO	$3,028.85	$5,507.00	$138.85–$1,982.52	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ECHO ABD W/IMAGE DOC LTD	$1,009.25	$1,835.00	$138.85–$871.63	83% above	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ECHO ABD W/IMAGE DOC LTD	$1,009.25	$1,835.00	$138.85–$871.63	—	45%
Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 US XTR NONVASC LMTD BILATERAL	$974.60	$1,772.00	$138.85–$841.70	—	45%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US SOFT TISSUE; AXILLARY LT	$648.45	$1,179.00	$138.85–$560.03	36% above	45%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US SOFT TISSUE; AXILLARY RT	$648.45	$1,179.00	$138.85–$560.03	36% above	45%
Limited ultrasound of an arm or leg (non-vascular) inpatient both sides CPT 76882 US XTR NONVASC LMTD BILATERAL	$974.60	$1,772.00	$138.85–$841.70	—	45%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US SOFT TISSUE; AXILLARY RT	$648.45	$1,179.00	$138.85–$560.03	—	45%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US SOFT TISSUE; AXILLARY LT	$648.45	$1,179.00	$138.85–$560.03	—	45%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LUNG SCREENING LOW DOSE	$925.10	$1,682.00	$138.85–$968.00	223% above	45%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LUNG SCREENING LOW DOSE	$925.10	$1,682.00	$138.85–$968.00	—	45%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA+FIBIA 2 VIEWS RT	$489.50	$890.00	$115.58–$320.40	77% above	45%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA+FIBIA 2 VIEWS LT	$489.50	$890.00	$115.58–$320.40	77% above	45%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA+FIBIA 2 VIEWS RT	$489.50	$890.00	$115.58–$320.40	—	45%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA+FIBIA 2 VIEWS LT	$489.50	$890.00	$115.58–$320.40	—	45%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONT	$4,320.25	$7,855.00	$316.90–$2,827.80	201% above	45%
MR angiography (MRA) of the head without contrast CPT 70544 MRA WITH MRV HEAD W/O CONTRAST	$4,320.25	$7,855.00	$316.90–$2,827.80	201% above	45%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA WITH MRV HEAD W/O CONTRAST	$4,320.25	$7,855.00	$316.90–$2,827.80	—	45%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONT	$4,320.25	$7,855.00	$316.90–$2,827.80	—	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI RT LOWER EXT JT WO	$4,320.25	$7,855.00	$316.90–$2,827.80	153% above	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LT LOWER EXT JT WO	$4,320.25	$7,855.00	$316.90–$2,827.80	153% above	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI RT LOWER EXT JT WO	$4,320.25	$7,855.00	$316.90–$2,827.80	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LT LOWER EXT JT WO	$4,320.25	$7,855.00	$316.90–$2,827.80	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI RT LOWER EXT JT W / WO	$5,433.45	$9,879.00	$463.36–$3,556.44	130% above	45%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LT LOWER EXT JT W / WO	$5,433.45	$9,879.00	$463.36–$3,556.44	130% above	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI RT LOWER EXT JT W / WO	$5,433.45	$9,879.00	$463.36–$3,556.44	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LT LOWER EXT JT W / WO	$5,433.45	$9,879.00	$463.36–$3,556.44	—	45%
MRI of the abdomen without contrast CPT 74181 MRI ABD WO CONT	$4,320.25	$7,855.00	$316.90–$2,827.80	135% above	45%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABD WO CONT	$4,320.25	$7,855.00	$316.90–$2,827.80	—	45%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO CONTRAST	$5,433.45	$9,879.00	$463.36–$3,556.44	139% above	45%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO CONTRAST	$5,433.45	$9,879.00	$463.36–$3,556.44	—	45%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONT	$5,152.95	$9,369.00	$316.90–$3,372.84	225% above	45%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONT	$5,152.95	$9,369.00	$316.90–$3,372.84	—	45%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONT	$7,463.50	$13,570.00	$463.36–$4,885.20	242% above	45%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONT	$7,463.50	$13,570.00	$463.36–$4,885.20	—	45%
MRI of the lower back, no contrast dye CPT 72148 MRI SPIN CANAL LUMB WO CONT	$4,320.25	$7,855.00	$316.90–$2,827.80	162% above	45%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPIN CANAL LUMB WO CONT	$4,320.25	$7,855.00	$316.90–$2,827.80	—	45%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPIN CANAL W/WO CON LUMB	$7,398.05	$13,451.00	$463.36–$4,842.36	217% above	45%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPIN CANAL W/WO CON LUMB	$7,398.05	$13,451.00	$463.36–$4,842.36	—	45%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPIN CANAL THORAC WO CON	$4,320.25	$7,855.00	$316.90–$2,827.80	165% above	45%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPIN CANAL THORAC WO CON	$4,320.25	$7,855.00	$316.90–$2,827.80	—	45%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPIN CANAL W/WO CON CERV	$7,398.05	$13,451.00	$463.36–$4,842.36	227% above	45%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPIN CANAL W/WO CON CERV	$7,398.05	$13,451.00	$463.36–$4,842.36	—	45%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPIN CANAL CERV WO CONT	$4,320.25	$7,855.00	$316.90–$2,827.80	168% above	45%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPIN CANAL CERV WO CONT	$4,320.25	$7,855.00	$316.90–$2,827.80	—	45%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO CONT	$5,433.45	$9,879.00	$463.36–$3,556.44	173% above	45%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO CONT	$5,433.45	$9,879.00	$463.36–$3,556.44	—	45%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONT	$4,320.25	$7,855.00	$316.90–$2,827.80	184% above	45%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONT	$4,320.25	$7,855.00	$316.90–$2,827.80	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI RT UPPER EXT JT WO	$4,320.25	$7,855.00	$316.90–$2,827.80	198% above	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI LT UPPER EXT JT WO	$4,320.25	$7,855.00	$316.90–$2,827.80	198% above	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI LT UPPER EXT JT WO	$4,320.25	$7,855.00	$316.90–$2,827.80	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI RT UPPER EXT JT WO	$4,320.25	$7,855.00	$316.90–$2,827.80	—	45%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERV 4 OR 5 VIEWS	$844.25	$1,535.00	$138.85–$552.60	87% above	45%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERV 4 OR 5 VIEWS	$844.25	$1,535.00	$138.85–$552.60	—	45%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/ENHANC	$3,450.70	$6,274.00	$232.96–$2,258.64	195% above	45%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/ENHANC	$3,450.70	$6,274.00	$232.96–$2,258.64	—	45%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO/ENHAN	$3,028.85	$5,507.00	$138.85–$1,982.52	229% above	45%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO/ENHAN	$3,028.85	$5,507.00	$138.85–$1,982.52	—	45%
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE	$473.00	$860.00	$115.58–$309.60	81% above	45%
Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE	$473.00	$860.00	$115.58–$309.60	—	45%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 CR MYOCARD PERF IMAG (SPECT) MX	$7,236.35	$13,157.00	$1,719.50–$6,118.01	80% above	45%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARD F IMAG (SPECT) MX	$7,236.35	$13,157.00	$1,719.50–$6,118.01	80% above	45%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARD F IMAG (SPECT) MX	$7,236.35	$13,157.00	$1,719.50–$6,118.01	—	45%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 CR MYOCARD PERF IMAG (SPECT) MX	$7,236.35	$13,157.00	$1,719.50–$6,118.01	—	45%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO/ENHANCE	$3,028.85	$5,507.00	$138.85–$1,982.52	201% above	45%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO/ENHANCE	$3,028.85	$5,507.00	$138.85–$1,982.52	—	45%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US ECHO PELVIC W/DOC LTD	$532.40	$968.00	$138.85–$459.80	21% above	45%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US ECHO PELVIC W/DOC LTD	$532.40	$968.00	$138.85–$459.80	—	45%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US ECHO PELVIC W/DOC COMP	$714.45	$1,299.00	$138.85–$617.03	40% above	45%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US ECHO PELVIC W/DOC COMP	$714.45	$1,299.00	$138.85–$617.03	—	45%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB US >= 14 WKS SNG FETUS	$947.65	$1,723.00	$138.85–$818.43	60% above	45%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB US >= 14 WKS SNG FETUS	$947.65	$1,723.00	$138.85–$818.43	—	45%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1ST TRIM TA APP SING	$624.80	$1,136.00	$138.85–$539.60	14% above	45%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG 1ST TRIM TA APP SING	$624.80	$1,136.00	$138.85–$539.60	—	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREG LTD 1 OR MORE FETUS	$715.00	$1,300.00	$138.85–$617.50	50% above	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREG LTD 1 OR MORE FETUS	$715.00	$1,300.00	$138.85–$617.50	—	45%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEWS RT	$501.05	$911.00	$115.58–$327.96	62% above	45%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEWS LT	$501.05	$911.00	$115.58–$327.96	62% above	45%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS LT	$501.05	$911.00	$115.58–$327.96	—	45%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS RT	$501.05	$911.00	$115.58–$327.96	—	45%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS (3V) W PA CXR LT	$494.45	$899.00	$138.85–$323.64	26% above	45%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS (3V) W PA CXR RT	$494.45	$899.00	$138.85–$323.64	26% above	45%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS (3V) W PA CXR RT	$494.45	$899.00	$138.85–$323.64	—	45%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS (3V) W PA CXR LT	$494.45	$899.00	$138.85–$323.64	—	45%
Screening mammogram, both breasts CPT 77067 SCR MAM BIL INCL CAD	$389.40	$708.00	$184.08–$240.72	103% above	45%
Screening mammogram, both breasts one side CPT 77067 SCR RT MAM S/P MASTECTOMY INCL CAD M52	$389.40	$708.00	$184.08–$240.72	103% above	45%
Screening mammogram, both breasts one side CPT 77067 SCR LT MAM S/P MASTECTOMY INCL CAD M52	$389.40	$708.00	$184.08–$240.72	103% above	45%
Screening mammogram, both breasts inpatient CPT 77067 SCR MAM BIL INCL CAD	$389.40	$708.00	$184.08–$240.72	—	45%
Screening mammogram, both breasts inpatient one side CPT 77067 SCR RT MAM S/P MASTECTOMY INCL CAD M52	$389.40	$708.00	$184.08–$240.72	—	45%
Screening mammogram, both breasts inpatient one side CPT 77067 SCR LT MAM S/P MASTECTOMY INCL CAD M52	$389.40	$708.00	$184.08–$240.72	—	45%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2+ VIEWS RT	$518.10	$942.00	$115.58–$339.12	53% above	45%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2+ VIEWS LT	$518.10	$942.00	$115.58–$339.12	53% above	45%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2+ VIEWS RT	$518.10	$942.00	$115.58–$339.12	—	45%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2+ VIEWS LT	$518.10	$942.00	$115.58–$339.12	—	45%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUS PARANASAL COMP 3+VW	$844.25	$1,535.00	$115.58–$552.60	133% above	45%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUS PARANASAL COMP 3+VW	$844.25	$1,535.00	$115.58–$552.60	—	45%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL < 4 VIEWS	$719.40	$1,308.00	$138.85–$470.88	149% above	45%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL < 4 VIEWS	$719.40	$1,308.00	$138.85–$470.88	—	45%
Sleep study in a lab (polysomnography) CPT 95810 SL POLYSOMNOGRAPHY	$6,930.55	$12,601.00	$1,140.54–$5,985.48	93% above	45%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SL POLYSOMNOGRAPHY	$6,930.55	$12,601.00	$1,140.54–$5,985.48	—	45%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWALLOWING FUNCT W/VIDEO	$1,439.90	$2,618.00	$232.96–$942.48	185% above	45%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR SWALLOWING FUNCT W/VIDEO	$1,439.90	$2,618.00	$232.96–$942.48	—	45%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY EXAM OF FEMUR 2/> LT	$489.50	$890.00	$115.58–$320.40	81% above	45%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY EXAM OF FEMUR 2/>RT	$489.50	$890.00	$115.58–$320.40	81% above	45%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 X-RAY EXAM OF FEMUR 2/>RT	$489.50	$890.00	$115.58–$320.40	—	45%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 X-RAY EXAM OF FEMUR 2/> LT	$489.50	$890.00	$115.58–$320.40	—	45%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO/ENHANCE	$3,028.85	$5,507.00	$138.85–$1,982.52	243% above	45%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE WO/ENHANCE	$3,028.85	$5,507.00	$138.85–$1,982.52	—	45%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2+ VIEWS RT	$517.55	$941.00	$115.58–$338.76	106% above	45%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2+ VIEWS LT	$517.55	$941.00	$115.58–$338.76	106% above	45%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) 2+ VIEWS LT	$517.55	$941.00	$115.58–$338.76	—	45%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) 2+ VIEWS RT	$517.55	$941.00	$115.58–$338.76	—	45%
Transvaginal pelvic ultrasound CPT 76830 US ULTRASOUND TRANSVAGINAL	$1,090.10	$1,982.00	$138.85–$941.45	96% above	45%
Transvaginal pelvic ultrasound inpatient CPT 76830 US ULTRASOUND TRANSVAGINAL	$1,090.10	$1,982.00	$138.85–$941.45	—	45%
Transvaginal ultrasound during pregnancy CPT 76817 US TRANSVAGINAL OB US	$1,090.10	$1,982.00	$138.85–$941.45	118% above	45%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TRANSVAGINAL OB US	$1,090.10	$1,982.00	$138.85–$941.45	—	45%
Ultrasound of the abdomen, complete CPT 76700 US ECHO ABD W/IMAGE DOC COMP	$1,422.85	$2,587.00	$138.85–$1,228.83	127% above	45%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ECHO ABD W/IMAGE DOC COMP	$1,422.85	$2,587.00	$138.85–$1,228.83	—	45%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM & CONTENTS	$932.25	$1,695.00	$138.85–$805.13	74% above	45%
Ultrasound of the scrotum and testicles CPT 76870 US ECHO SCROTUM/CONTENTS	$932.25	$1,695.00	$138.85–$805.13	74% above	45%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM & CONTENTS	$932.25	$1,695.00	$138.85–$805.13	—	45%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US ECHO SCROTUM/CONTENTS	$932.25	$1,695.00	$138.85–$805.13	—	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US ECHO SOFT TIS HD/NECK W/I	$714.45	$1,299.00	$138.85–$617.03	26% above	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US ECHO SOFT TIS HD/NECK W/I	$714.45	$1,299.00	$138.85–$617.03	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI SINGLE CONTRAST	$1,201.75	$2,185.00	$232.96–$786.60	103% above	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UGI SINGLE CONTRAST	$1,201.75	$2,185.00	$232.96–$786.60	—	45%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2+ VIEWS RT	$484.55	$881.00	$115.58–$317.16	72% above	45%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2+ VIEWS LT	$484.55	$881.00	$115.58–$317.16	72% above	45%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 2+ VIEWS LT	$484.55	$881.00	$115.58–$317.16	—	45%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 2+ VIEWS RT	$484.55	$881.00	$115.58–$317.16	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 CR 1-EXT VENOUS DUPLEX	$1,177.55	$2,141.00	$138.85–$1,016.98	62% above	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 CR 1-EXT VENOUS DUPLEX	$1,177.55	$2,141.00	$138.85–$1,016.98	—	45%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS RT	$503.25	$915.00	$115.58–$329.40	93% above	45%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS LT	$503.25	$915.00	$115.58–$329.40	93% above	45%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS LT	$503.25	$915.00	$115.58–$329.40	—	45%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS RT	$503.25	$915.00	$115.58–$329.40	—	45%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST COMPL 3+ VIEWS RT	$565.95	$1,029.00	$115.58–$370.44	65% above	45%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST COMPL 3+ VIEWS LT	$565.95	$1,029.00	$115.58–$370.44	65% above	45%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST COMPL 3+ VIEWS RT	$565.95	$1,029.00	$115.58–$370.44	—	45%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST COMPL 3+ VIEWS LT	$565.95	$1,029.00	$115.58–$370.44	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS LT	$536.25	$975.00	$115.58–$351.00	74% above	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS RT	$536.25	$975.00	$115.58–$351.00	74% above	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS LT	$536.25	$975.00	$115.58–$351.00	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS RT	$536.25	$975.00	$115.58–$351.00	—	45%
X-ray of the abdomen, 1 view CPT 74018 XR EXAM ADBOMEN 1 VIEW	$400.40	$728.00	$115.58–$262.08	55% above	45%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR EXAM ADBOMEN 1 VIEW	$400.40	$728.00	$115.58–$262.08	—	45%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS RT	$517.55	$941.00	$115.58–$338.76	97% above	45%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LT	$517.55	$941.00	$115.58–$338.76	97% above	45%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS RT	$517.55	$941.00	$115.58–$338.76	—	45%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS LT	$517.55	$941.00	$115.58–$338.76	—	45%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) MIN 2 VIEWS LT	$435.05	$791.00	$115.58–$284.76	68% above	45%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) MIN 2 VIEWS RT	$435.05	$791.00	$115.58–$284.76	68% above	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER(S) MIN 2 VIEWS LT	$435.05	$791.00	$115.58–$284.76	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER(S) MIN 2 VIEWS RT	$435.05	$791.00	$115.58–$284.76	—	45%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS LT	$517.55	$941.00	$115.58–$338.76	120% above	45%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS RT	$517.55	$941.00	$115.58–$338.76	120% above	45%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS RT	$517.55	$941.00	$115.58–$338.76	—	45%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS LT	$517.55	$941.00	$115.58–$338.76	—	45%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMPLETE 3+ VIEWS RT	$844.25	$1,535.00	$115.58–$552.60	175% above	45%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMPLETE 3+ VIEWS LT	$844.25	$1,535.00	$115.58–$552.60	175% above	45%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT COMPLETE 3+ VIEWS RT	$844.25	$1,535.00	$115.58–$552.60	—	45%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT COMPLETE 3+ VIEWS LT	$844.25	$1,535.00	$115.58–$552.60	—	45%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3+ VIEWS LT	$562.65	$1,023.00	$115.58–$368.28	70% above	45%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3+ VIEWS RT	$562.65	$1,023.00	$115.58–$368.28	70% above	45%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3+ VIEWS LT	$562.65	$1,023.00	$115.58–$368.28	—	45%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3+ VIEWS RT	$562.65	$1,023.00	$115.58–$368.28	—	45%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 OR 2 VIEWS LT	$435.60	$792.00	$115.58–$285.12	56% above	45%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 OR 2 VIEWS RT	$435.60	$792.00	$115.58–$285.12	56% above	45%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1 OR 2 VIEWS LT	$435.60	$792.00	$115.58–$285.12	—	45%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1 OR 2 VIEWS RT	$435.60	$792.00	$115.58–$285.12	—	45%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBAR SACRAL 2-3 VIEWS	$817.85	$1,487.00	$138.85–$535.32	150% above	45%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBAR SACRAL 2-3 VIEWS	$817.85	$1,487.00	$138.85–$535.32	—	45%
X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBAR SACRAL 4+ VIEWS	$967.45	$1,759.00	$138.85–$633.24	105% above	45%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBAR SACRAL 4+ VIEWS	$967.45	$1,759.00	$138.85–$633.24	—	45%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS	$512.60	$932.00	$138.85–$335.52	68% above	45%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEWS	$512.60	$932.00	$138.85–$335.52	—	45%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMPLT 3+ VWS	$844.25	$1,535.00	$115.58–$552.60	188% above	45%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES COMPLT 3+ VWS	$844.25	$1,535.00	$115.58–$552.60	—	45%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERV 2 OR 3 VIEWS	$532.40	$968.00	$115.58–$348.48	57% above	45%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERV 2 OR 3 VIEWS	$532.40	$968.00	$115.58–$348.48	—	45%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS	$517.55	$941.00	$138.85–$338.76	106% above	45%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS	$517.55	$941.00	$138.85–$338.76	—	45%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM + COCCYX 2+ VIEWS	$719.40	$1,308.00	$115.58–$470.88	142% above	45%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM + COCCYX 2+ VIEWS	$719.40	$1,308.00	$115.58–$470.88	—	45%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
ACTH blood test CPT 82024 ACTH	$837.65	$1,523.00	$38.62–$517.82	540% above	45%
ACTH blood test inpatient CPT 82024 ACTH	$837.65	$1,523.00	$38.62–$517.82	—	45%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT)	$109.45	$199.00	$5.30–$67.66	278% above	45%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT)	$109.45	$199.00	$5.30–$67.66	—	45%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT)	$109.45	$199.00	$5.18–$67.66	334% above	45%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT)	$109.45	$199.00	$5.18–$67.66	—	45%
Albumin blood test CPT 82040 ALBUMIN	$124.30	$226.00	$4.95–$76.84	462% above	45%
Albumin blood test inpatient CPT 82040 ALBUMIN	$124.30	$226.00	$4.95–$76.84	—	45%
Aldosterone blood test CPT 82088 ALDOSTERONE	$837.65	$1,523.00	$40.75–$517.82	497% above	45%
Aldosterone blood test CPT 82088 ALDOSTERONE-24 HR URINE	$837.65	$1,523.00	$40.75–$517.82	497% above	45%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE-24 HR URINE	$837.65	$1,523.00	$40.75–$517.82	—	45%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$837.65	$1,523.00	$40.75–$517.82	—	45%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$121.00	$220.00	$5.18–$74.80	404% above	45%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$121.00	$220.00	$5.18–$74.80	—	45%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE EACH	$111.10	$202.00	$5.22–$68.68	375% above	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE EACH	$111.10	$202.00	$5.22–$68.68	—	45%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM	$261.80	$476.00	$16.77–$161.84	332% above	45%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SERUM	$261.80	$476.00	$16.77–$161.84	—	45%
Ammonia blood test CPT 82140 AMMONIA (NH3)	$233.75	$425.00	$14.57–$144.50	327% above	45%
Ammonia blood test inpatient CPT 82140 AMMONIA (NH3)	$233.75	$425.00	$14.57–$144.50	—	45%
Amylase blood test CPT 82150 AMYLASE	$167.75	$305.00	$6.48–$103.70	239% above	45%
Amylase blood test CPT 82150 AMYLASE-URINE	$167.75	$305.00	$6.48–$103.70	239% above	45%
Amylase blood test CPT 82150 AMYLASE-BODY FLUID	$167.75	$305.00	$6.48–$103.70	239% above	45%
Amylase blood test inpatient CPT 82150 AMYLASE-URINE	$167.75	$305.00	$6.48–$103.70	—	45%
Amylase blood test inpatient CPT 82150 AMYLASE-BODY FLUID	$167.75	$305.00	$6.48–$103.70	—	45%
Amylase blood test inpatient CPT 82150 AMYLASE	$167.75	$305.00	$6.48–$103.70	—	45%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP IGG AB	$89.10	$162.00	$12.95–$55.08	54% above	45%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP IGG AB	$89.10	$162.00	$12.95–$55.08	—	45%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CENTROMERE B ANTIBODY	$303.60	$552.00	$12.09–$187.68	450% above	45%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA (ANTI-NUCLEAR ANTIBODY)	$303.60	$552.00	$12.09–$187.68	450% above	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA (ANTI-NUCLEAR ANTIBODY)	$303.60	$552.00	$12.09–$187.68	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CENTROMERE B ANTIBODY	$303.60	$552.00	$12.09–$187.68	—	45%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIUETIC PEPTIDE (BNP)	$418.55	$761.00	$39.26–$258.74	180% above	45%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATRIUETIC PEPTIDE (BNP)	$418.55	$761.00	$39.26–$258.74	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, THROAT	$246.95	$449.00	$8.62–$152.66	261% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE LEGIONELLA	$246.95	$449.00	$8.62–$152.66	261% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE VAGINAL (MIC IF INDICATED)	$246.95	$449.00	$8.62–$152.66	261% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, URETHRA(MIC IF INDICATED	$246.95	$449.00	$8.62–$152.66	261% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, TISSUE MIC IF INDIC	$246.95	$449.00	$8.62–$152.66	261% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, SPUTUMEAR (MIC IF INDIC)	$246.95	$449.00	$8.62–$152.66	261% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, CSF (MIC IF INDICATED)	$246.95	$449.00	$8.62–$152.66	261% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, NASAL (MIC IF INDIC)	$246.95	$449.00	$8.62–$152.66	261% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, EYE (MIC IF INDIC)	$246.95	$449.00	$8.62–$152.66	261% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, EAR (MIC IF INDIC)	$246.95	$449.00	$8.62–$152.66	261% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATH TIP MIC IF IND	$246.95	$449.00	$8.62–$152.66	261% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BR WASH MIC IF IND	$246.95	$449.00	$8.62–$152.66	261% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE B.FLUID (MIC IF INDICATED	$246.95	$449.00	$8.62–$152.66	261% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND, AEROBIC	$277.75	$505.00	$8.62–$171.70	305% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE LEGIONELLA	$246.95	$449.00	$8.62–$152.66	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, EAR (MIC IF INDIC)	$246.95	$449.00	$8.62–$152.66	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE B.FLUID (MIC IF INDICATED	$246.95	$449.00	$8.62–$152.66	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BR WASH MIC IF IND	$246.95	$449.00	$8.62–$152.66	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CATH TIP MIC IF IND	$246.95	$449.00	$8.62–$152.66	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, EYE (MIC IF INDIC)	$246.95	$449.00	$8.62–$152.66	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE VAGINAL (MIC IF INDICATED)	$246.95	$449.00	$8.62–$152.66	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, URETHRA(MIC IF INDICATED	$246.95	$449.00	$8.62–$152.66	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, TISSUE MIC IF INDIC	$246.95	$449.00	$8.62–$152.66	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, THROAT	$246.95	$449.00	$8.62–$152.66	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, SPUTUMEAR (MIC IF INDIC)	$246.95	$449.00	$8.62–$152.66	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, CSF (MIC IF INDICATED)	$246.95	$449.00	$8.62–$152.66	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, NASAL (MIC IF INDIC)	$246.95	$449.00	$8.62–$152.66	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND, AEROBIC	$277.75	$505.00	$8.62–$171.70	—	45%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PROFILE	$244.20	$444.00	$8.46–$150.96	272% above	45%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PROFILE	$244.20	$444.00	$8.46–$150.96	—	45%
Bilirubin blood test, total CPT 82247 BILIRUBIN (TOTAL)	$49.50	$90.00	$5.02–$30.60	106% above	45%
Bilirubin blood test, total CPT 82247 BILIRUBIN, BODY FLUID	$49.50	$90.00	$5.02–$30.60	106% above	45%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN, BODY FLUID	$49.50	$90.00	$5.02–$30.60	—	45%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN (TOTAL)	$49.50	$90.00	$5.02–$30.60	—	45%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 GROSS & MICRO LEVEL 4	$453.75	$825.00	$53.24–$280.50	123% above	45%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK(SEDIMENT S	$522.50	$950.00	$53.24–$323.00	157% above	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 GROSS & MICRO LEVEL 4	$453.75	$825.00	$53.24–$280.50	—	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CELL BLOCK(SEDIMENT S	$522.50	$950.00	$53.24–$323.00	—	45%
Blood culture for bacteria CPT 87040 CULTURE BLOOD (MIC IF INDICATED)	$473.55	$861.00	$10.32–$292.74	406% above	45%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD (MIC IF INDICATED)	$473.55	$861.00	$10.32–$292.74	—	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ST VENIPUNCTURE	$34.65	$63.00	$9.34–$21.42	118% above	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW FOR LAB	$34.65	$63.00	$9.34–$21.42	118% above	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$34.65	$63.00	$12.14–$29.93	118% above	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 SPECIMEN COLLECTION - CHRG ONL	$34.65	$63.00	$9.34–$21.42	118% above	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW FOR LAB	$34.65	$63.00	$9.34–$21.42	—	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 SPECIMEN COLLECTION - CHRG ONL	$34.65	$63.00	$9.34–$21.42	—	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$34.65	$63.00	$12.14–$29.93	—	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ST VENIPUNCTURE	$34.65	$63.00	$9.34–$21.42	—	45%
Blood glucose (sugar) test CPT 82947 GLUCOSE-1 HR POST PRANDIAL	$96.80	$176.00	$3.93–$59.84	311% above	45%
Blood glucose (sugar) test CPT 82947 GLUCOSE (FASTING)	$100.65	$183.00	$3.93–$62.22	327% above	45%
Blood glucose (sugar) test CPT 82947 GLUCOSE-2HR POST PRANDIAL	$100.65	$183.00	$3.93–$62.22	327% above	45%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE-1 HR POST PRANDIAL	$96.80	$176.00	$3.93–$59.84	—	45%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE-2HR POST PRANDIAL	$100.65	$183.00	$3.93–$62.22	—	45%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE (FASTING)	$100.65	$183.00	$3.93–$62.22	—	45%
Blood lead test CPT 83655 LEAD	$301.95	$549.00	$12.11–$186.66	521% above	45%
Blood lead test CPT 83655 LEAD, URINE	$338.25	$615.00	$12.11–$209.10	596% above	45%
Blood lead test inpatient CPT 83655 LEAD	$301.95	$549.00	$12.11–$186.66	—	45%
Blood lead test inpatient CPT 83655 LEAD, URINE	$338.25	$615.00	$12.11–$209.10	—	45%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREG TEST - SERUM HCG QUAL	$243.65	$443.00	$7.52–$150.62	327% above	45%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREG TEST - SERUM HCG QUAL	$243.65	$443.00	$7.52–$150.62	—	45%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TYPE - ABO	$129.80	$236.00	$2.99–$80.24	127% above	45%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 TYPE - ABO	$129.80	$236.00	$2.99–$80.24	—	45%
Blood urea nitrogen (BUN) test CPT 84520 BUN (BLOOD UREA NITROGEN)	$119.35	$217.00	$3.95–$73.78	410% above	45%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN (BLOOD UREA NITROGEN)	$119.35	$217.00	$3.95–$73.78	—	45%
C-peptide blood test CPT 84681 C-PEPTIDE	$594.00	$1,080.00	$20.81–$367.20	672% above	45%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$594.00	$1,080.00	$20.81–$367.20	—	45%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$224.40	$408.00	$5.18–$138.72	335% above	45%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$224.40	$408.00	$5.18–$138.72	—	45%
C. difficile toxin gene test (stool PCR) CPT 87493 C. DIFFICILE BY AMPLIFICATION	$180.95	$329.00	$37.27–$111.86	37% above	45%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. DIFFICILE BY AMPLIFICATION	$180.95	$329.00	$37.27–$111.86	—	45%
CA 19-9 blood test (tumor marker) CPT 86301 CARBOHYDRATE AG 19-9	$401.50	$730.00	$20.81–$248.20	460% above	45%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CARBOHYDRATE AG 19-9	$401.50	$730.00	$20.81–$248.20	—	45%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$333.30	$606.00	$20.81–$206.04	256% above	45%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$333.30	$606.00	$20.81–$206.04	—	45%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$123.75	$225.00	$51.31–$76.50	12% below	45%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$123.75	$225.00	$51.31–$76.50	—	45%
Calcium blood test, total CPT 82310 CALCIUM (CA)	$84.15	$153.00	$5.16–$52.02	166% above	45%
Calcium blood test, total CPT 82310 CALCIUM (RANDOM URINE)	$143.00	$260.00	$5.16–$88.40	353% above	45%
Calcium blood test, total inpatient CPT 82310 CALCIUM (CA)	$84.15	$153.00	$5.16–$52.02	—	45%
Calcium blood test, total inpatient CPT 82310 CALCIUM (RANDOM URINE)	$143.00	$260.00	$5.16–$88.40	—	45%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$344.85	$627.00	$18.96–$213.18	305% above	45%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$344.85	$627.00	$18.96–$213.18	—	45%
Chickenpox (varicella) immunity blood test CPT 86787 VAR ZOSTER AB IG M	$321.20	$584.00	$12.88–$198.56	455% above	45%
Chickenpox (varicella) immunity blood test CPT 86787 VAR ZOSTER AB IG G	$321.20	$584.00	$12.88–$198.56	455% above	45%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VAR ZOSTER AB IG G	$321.20	$584.00	$12.88–$198.56	—	45%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VAR ZOSTER AB IG M	$321.20	$584.00	$12.88–$198.56	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA NUCLEIC ACID DETECTION	$136.40	$248.00	$35.09–$84.32	46% above	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AMPLIFIED PROBE	$136.40	$248.00	$35.09–$84.32	46% above	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA AMPLIFIED PROBE	$136.40	$248.00	$35.09–$84.32	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA NUCLEIC ACID DETECTION	$136.40	$248.00	$35.09–$84.32	—	45%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$246.40	$448.00	$13.39–$152.32	361% above	45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$246.40	$448.00	$13.39–$152.32	—	45%
Complete blood count (CBC) with differential CPT 85025 CBC WITH DIFFERENTIAL	$143.55	$261.00	$7.77–$88.74	285% above	45%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH DIFFERENTIAL	$143.55	$261.00	$7.77–$88.74	—	45%
Complete blood count (CBC), no differential CPT 85027 CBC WITHOUT DIFF	$119.90	$218.00	$6.47–$74.12	264% above	45%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITHOUT DIFF	$119.90	$218.00	$6.47–$74.12	—	45%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$285.45	$519.00	$10.56–$176.46	348% above	45%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$285.45	$519.00	$10.56–$176.46	—	45%
Cortisol blood test, total CPT 82533 SALIVARY CORTISOL	$380.05	$691.00	$16.30–$234.94	427% above	45%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$380.05	$691.00	$16.30–$234.94	427% above	45%
Cortisol blood test, total inpatient CPT 82533 SALIVARY CORTISOL	$380.05	$691.00	$16.30–$234.94	—	45%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$380.05	$691.00	$16.30–$234.94	—	45%
Creatine kinase (CK) blood test, total CPT 82550 CK (TOTAL)	$212.30	$386.00	$6.51–$131.24	510% above	45%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK (TOTAL)	$212.30	$386.00	$6.51–$131.24	—	45%
Creatinine blood test CPT 82565 CREATININE-BLOOD	$97.90	$178.00	$5.12–$60.52	301% above	45%
Creatinine blood test inpatient CPT 82565 CREATININE-BLOOD	$97.90	$178.00	$5.12–$60.52	—	45%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS AB IFA	$424.05	$771.00	$14.39–$262.14	530% above	45%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS AB IFA	$424.05	$771.00	$14.39–$262.14	—	45%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANT	$212.85	$387.00	$10.18–$131.58	196% above	45%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUANT	$212.85	$387.00	$10.18–$131.58	—	45%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SO4	$439.45	$799.00	$22.23–$271.66	342% above	45%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SO4	$439.45	$799.00	$22.23–$271.66	—	45%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL-ETHYL	$258.50	$470.00	$62.14–$159.80	167% above	45%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLY	$441.10	$802.00	$62.14–$272.68	355% above	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ALCOHOL-ETHYL	$258.50	$470.00	$62.14–$159.80	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLY	$441.10	$802.00	$62.14–$272.68	—	45%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROYTE PANEL	$153.45	$279.00	$7.01–$94.86	222% above	45%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROYTE PANEL	$153.45	$279.00	$7.01–$94.86	—	45%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID	$289.30	$526.00	$18.14–$178.84	345% above	45%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID	$289.30	$526.00	$18.14–$178.84	—	45%
Estradiol blood test CPT 82670 ESTRADIOL/E2	$228.25	$415.00	$27.94–$141.10	104% above	45%
Estradiol blood test inpatient CPT 82670 ESTRADIOL/E2	$228.25	$415.00	$27.94–$141.10	—	45%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMUL HORMONE	$383.90	$698.00	$18.58–$237.32	347% above	45%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMUL HORMONE	$383.90	$698.00	$18.58–$237.32	—	45%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$396.00	$720.00	$19.63–$244.80	165% above	45%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$396.00	$720.00	$19.63–$244.80	—	45%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$242.00	$440.00	$13.63–$149.60	218% above	45%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$242.00	$440.00	$13.63–$149.60	—	45%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$251.35	$457.00	$9.72–$155.38	459% above	45%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$251.35	$457.00	$9.72–$155.38	—	45%
Folate (folic acid) blood test CPT 82746 FOLATE SERUM	$244.20	$444.00	$14.70–$150.96	264% above	45%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE SERUM	$244.20	$444.00	$14.70–$150.96	—	45%
Free T3 thyroid hormone test CPT 84481 FREE T3	$396.55	$721.00	$16.94–$245.14	442% above	45%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$396.55	$721.00	$16.94–$245.14	—	45%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 THYROXINE	$233.75	$425.00	$9.02–$144.50	461% above	45%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 THYROXINE	$233.75	$425.00	$9.02–$144.50	—	45%
Free testosterone test CPT 84402 TESTOSTERONE, FREE	$607.20	$1,104.00	$25.47–$375.36	538% above	45%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE	$607.20	$1,104.00	$25.47–$375.36	—	45%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGTP	$163.90	$298.00	$7.20–$101.32	285% above	45%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGTP	$163.90	$298.00	$7.20–$101.32	—	45%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$634.15	$1,153.00	$299.78–$392.02	192% above	45%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$634.15	$1,153.00	$299.78–$392.02	—	45%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GEST GLUCOSE TOL-1HR	$100.65	$183.00	$4.75–$62.22	186% above	45%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE-1 HR PC	$183.70	$334.00	$4.75–$113.56	422% above	45%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE-2HRS PC	$183.70	$334.00	$4.75–$113.56	422% above	45%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GEST GLUCOSE TOL-1HR	$100.65	$183.00	$4.75–$62.22	—	45%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE-1 HR PC	$183.70	$334.00	$4.75–$113.56	—	45%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE-2HRS PC	$183.70	$334.00	$4.75–$113.56	—	45%
Glucose tolerance test, 3 samples CPT 82951 GTT-3 SPEC	$225.50	$410.00	$12.87–$139.40	236% above	45%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT-3 SPEC	$225.50	$410.00	$12.87–$139.40	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC AMPLIFIED PROBE	$136.40	$248.00	$35.09–$84.32	47% above	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC AMPLIFIED PROBE	$136.40	$248.00	$35.09–$84.32	—	45%
H. pylori antibody blood test CPT 86677 HELI PYLORI AB IG M	$150.70	$274.00	$16.85–$93.16	112% above	45%
H. pylori antibody blood test CPT 86677 HELI PYLORI AB IG G	$383.90	$698.00	$16.85–$237.32	441% above	45%
H. pylori antibody blood test inpatient CPT 86677 HELI PYLORI AB IG M	$150.70	$274.00	$16.85–$93.16	—	45%
H. pylori antibody blood test inpatient CPT 86677 HELI PYLORI AB IG G	$383.90	$698.00	$16.85–$237.32	—	45%
H. pylori stool antigen test CPT 87338 H PYLORI ANTIGEN	$206.80	$376.00	$14.38–$127.84	196% above	45%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI ANTIGEN	$206.80	$376.00	$14.38–$127.84	—	45%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV VIRAL LOAD	$564.30	$1,026.00	$85.10–$348.84	58% above	45%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV VIRAL LOAD	$564.30	$1,026.00	$85.10–$348.84	—	45%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 ANTI HTLV III	$196.35	$357.00	$24.08–$121.38	165% above	45%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 ANTI HTLV III	$196.35	$357.00	$24.08–$121.38	—	45%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK TYPES	$200.75	$365.00	$35.09–$124.10	70% above	45%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH RISK TYPES	$200.75	$365.00	$35.09–$124.10	—	45%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$201.85	$367.00	$9.71–$124.78	342% above	45%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$201.85	$367.00	$9.71–$124.78	—	45%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$65.45	$119.00	$2.37–$40.46	304% above	45%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$65.45	$119.00	$2.37–$40.46	—	45%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB (TOTAL)	$466.40	$848.00	$12.05–$288.32	765% above	45%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB (TOTAL)	$466.40	$848.00	$12.05–$288.32	—	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP. B SURFACE AB/ANTI-HBS	$285.45	$519.00	$10.74–$176.46	493% above	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP. B SURFACE AB/ANTI-HBS	$285.45	$519.00	$10.74–$176.46	—	45%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$237.05	$431.00	$10.33–$146.54	411% above	45%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$237.05	$431.00	$10.33–$146.54	—	45%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB	$312.95	$569.00	$14.27–$193.46	389% above	45%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB	$312.95	$569.00	$14.27–$193.46	—	45%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA BY PCR, QUANT	$834.90	$1,518.00	$42.84–$516.12	334% above	45%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA BY PCR, QUANT	$834.90	$1,518.00	$42.84–$516.12	—	45%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 ANTIBODY	$89.10	$162.00	$13.19–$55.08	51% above	45%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 ANTIBODY	$89.10	$162.00	$13.19–$55.08	—	45%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 ANTIBODY	$89.10	$162.00	$19.35–$55.08	34% above	45%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 ANTIBODY	$89.10	$162.00	$19.35–$55.08	—	45%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN CARDIAC	$267.30	$486.00	$12.95–$165.24	296% above	45%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN CARDIAC	$267.30	$486.00	$12.95–$165.24	—	45%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$405.35	$737.00	$17.92–$250.58	403% above	45%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$405.35	$737.00	$17.92–$250.58	—	45%
Insulin blood test CPT 83525 INSULIN TOTAL	$352.00	$640.00	$11.43–$217.60	585% above	45%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$352.00	$640.00	$11.43–$217.60	—	45%
Iron blood test (serum iron) CPT 83540 IRON (FE)	$76.45	$139.00	$6.47–$47.26	101% above	45%
Iron blood test (serum iron) inpatient CPT 83540 IRON (FE)	$76.45	$139.00	$6.47–$47.26	—	45%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$103.40	$188.00	$8.74–$63.92	165% above	45%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$103.40	$188.00	$8.74–$63.92	—	45%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$261.25	$475.00	$8.68–$161.50	258% above	45%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$261.25	$475.00	$8.68–$161.50	—	45%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$366.85	$667.00	$18.52–$226.78	284% above	45%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$366.85	$667.00	$18.52–$226.78	—	45%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$222.75	$405.00	$11.57–$137.70	328% above	45%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$222.75	$405.00	$11.57–$137.70	—	45%
Lactate dehydrogenase (LDH) blood test CPT 83615 LD (BODY FLUID)	$141.90	$258.00	$6.04–$87.72	420% above	45%
Lactate dehydrogenase (LDH) blood test CPT 83615 LD (TOTAL)	$141.90	$258.00	$6.04–$87.72	420% above	45%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD (TOTAL)	$141.90	$258.00	$6.04–$87.72	—	45%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD (BODY FLUID)	$141.90	$258.00	$6.04–$87.72	—	45%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$212.30	$386.00	$6.89–$131.24	265% above	45%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$212.30	$386.00	$6.89–$131.24	—	45%
Liver function blood test panel CPT 80076 LIVER/HEPATIC PROFILE	$201.85	$367.00	$8.17–$124.78	223% above	45%
Liver function blood test panel inpatient CPT 80076 LIVER/HEPATIC PROFILE	$201.85	$367.00	$8.17–$124.78	—	45%
Lyme disease antibody test CPT 86618 LYME ANTIBODY, CSF	$589.05	$1,071.00	$17.03–$364.14	668% above	45%
Lyme disease antibody test CPT 86618 LYME DISEASE AB	$589.05	$1,071.00	$17.03–$364.14	668% above	45%
Lyme disease antibody test inpatient CPT 86618 LYME ANTIBODY, CSF	$589.05	$1,071.00	$17.03–$364.14	—	45%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB	$589.05	$1,071.00	$17.03–$364.14	—	45%
Magnesium blood test CPT 83735 MAGNESIUM (MG)	$117.15	$213.00	$6.70–$72.42	248% above	45%
Magnesium blood test CPT 83735 MAGNESIUM (24HR URINE)	$279.40	$508.00	$6.70–$172.72	730% above	45%
Magnesium blood test inpatient CPT 83735 MAGNESIUM (MG)	$117.15	$213.00	$6.70–$72.42	—	45%
Magnesium blood test inpatient CPT 83735 MAGNESIUM (24HR URINE)	$279.40	$508.00	$6.70–$172.72	—	45%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGG	$276.65	$503.00	$12.88–$171.02	385% above	45%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IGG	$276.65	$503.00	$12.88–$171.02	—	45%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE SCREEN (MONO TEST)	$222.75	$405.00	$5.18–$137.70	328% above	45%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE SCREEN (MONO TEST)	$222.75	$405.00	$5.18–$137.70	—	45%
Mumps immunity blood test CPT 86735 MUMPS AB IGG	$201.85	$367.00	$13.05–$124.78	245% above	45%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB IGG	$201.85	$367.00	$13.05–$124.78	—	45%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, FREE	$303.60	$552.00	$18.39–$187.68	268% above	45%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, FREE	$303.60	$552.00	$18.39–$187.68	—	45%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA	$203.50	$370.00	$18.39–$125.80	157% above	45%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL	$203.50	$370.00	$18.39–$125.80	157% above	45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL	$203.50	$370.00	$18.39–$125.80	—	45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA	$203.50	$370.00	$18.39–$125.80	—	45%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH C/V AUTO FLUID REDO	$115.50	$210.00	$26.61–$71.40	15% above	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATH C/V AUTO FLUID REDO	$115.50	$210.00	$26.61–$71.40	—	45%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN PREP PAP DIAG	$115.50	$210.00	$20.26–$71.40	27% above	45%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN PREP PAP DIAG	$115.50	$210.00	$20.26–$71.40	—	45%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$524.70	$954.00	$41.28–$324.36	272% above	45%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$524.70	$954.00	$41.28–$324.36	—	45%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIMEPTT	$138.05	$251.00	$6.01–$85.34	272% above	45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIMEPTT	$138.05	$251.00	$6.01–$85.34	—	45%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS (INORGANIC)	$93.50	$170.00	$4.74–$57.80	162% above	45%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS (INORGANIC)	$93.50	$170.00	$4.74–$57.80	—	45%
Potassium blood test CPT 84132 POTASSIUM (K)	$88.00	$160.00	$4.76–$54.40	277% above	45%
Potassium blood test inpatient CPT 84132 POTASSIUM (K)	$88.00	$160.00	$4.76–$54.40	—	45%
Progesterone blood test CPT 84144 PROGETERONE	$360.25	$655.00	$20.86–$222.70	346% above	45%
Progesterone blood test inpatient CPT 84144 PROGETERONE	$360.25	$655.00	$20.86–$222.70	—	45%
Prolactin blood test CPT 84146 PROLACTIN	$389.40	$708.00	$19.38–$240.72	347% above	45%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$389.40	$708.00	$19.38–$240.72	—	45%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME - no procedure	$80.85	$147.00	$4.29–$49.98	236% above	45%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT)	$95.70	$174.00	$4.29–$59.16	298% above	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME - no procedure	$80.85	$147.00	$4.29–$49.98	—	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (PT)	$95.70	$174.00	$4.29–$59.16	—	45%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP PNEUMO	$94.05	$171.00	$16.53–$58.14	64% above	45%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP PNEUMO	$94.05	$171.00	$16.53–$58.14	—	45%
Renin blood test CPT 84244 RENIN ACTIVITY	$577.50	$1,050.00	$21.99–$357.00	575% above	45%
Renin blood test inpatient CPT 84244 RENIN ACTIVITY	$577.50	$1,050.00	$21.99–$357.00	—	45%
Rh blood typing CPT 86901 RH TYPE	$121.00	$220.00	$2.99–$74.80	224% above	45%
Rh blood typing inpatient CPT 86901 RH TYPE	$121.00	$220.00	$2.99–$74.80	—	45%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$54.45	$99.00	$5.67–$33.66	64% above	45%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$54.45	$99.00	$5.67–$33.66	—	45%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB SCREEN	$233.75	$425.00	$14.39–$144.50	381% above	45%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB SCREEN	$233.75	$425.00	$14.39–$144.50	—	45%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE - WESTERGREN	$75.35	$137.00	$2.70–$46.58	102% above	45%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE - WESTERGREN	$75.35	$137.00	$2.70–$46.58	—	45%
Sodium blood test CPT 84295 SODIUM (NA)	$88.00	$160.00	$4.81–$54.40	224% above	45%
Sodium blood test inpatient CPT 84295 SODIUM (NA)	$88.00	$160.00	$4.81–$54.40	—	45%
Stool ova and parasites exam CPT 87177 OVA AND PARASITE EXAM	$394.90	$718.00	$8.90–$244.12	896% above	45%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITE EXAM	$394.90	$718.00	$8.90–$244.12	—	45%
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLOOD OCCULT SCREEN 1-3	$65.45	$119.00	$4.38–$40.46	149% above	45%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL 1-3	$80.85	$147.00	$4.38–$49.98	208% above	45%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLOOD OCCULT SCREEN 1-3	$65.45	$119.00	$4.38–$40.46	—	45%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD STOOL 1-3	$80.85	$147.00	$4.38–$49.98	—	45%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD, FECAL BY IA	$71.50	$130.00	$15.92–$44.20	34% above	45%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD, FECAL BY IA	$71.50	$130.00	$15.92–$44.20	—	45%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-FLOURESCENT TREPONEM AB	$285.45	$519.00	$13.24–$176.46	393% above	45%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA-FLOURESCENT TREPONEM AB	$285.45	$519.00	$13.24–$176.46	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-CSF QUAL	$124.85	$227.00	$4.27–$77.18	418% above	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUAL CONFIRM BY FTA	$124.85	$227.00	$4.27–$77.18	418% above	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR QUAL CONFIRM BY FTA	$124.85	$227.00	$4.27–$77.18	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL-CSF QUAL	$124.85	$227.00	$4.27–$77.18	—	45%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON	$271.15	$493.00	$61.98–$167.62	117% above	45%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON	$271.15	$493.00	$61.98–$167.62	—	45%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$397.65	$723.00	$25.81–$245.82	332% above	45%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$397.65	$723.00	$25.81–$245.82	—	45%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOMAL ANTIBODIES	$80.85	$147.00	$14.55–$49.98	24% above	45%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI MICROSOMAL AB EACH	$237.05	$431.00	$14.55–$146.54	265% above	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER-KIDNEY MICROSOMAL ANTIBODIES	$80.85	$147.00	$14.55–$49.98	—	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI MICROSOMAL AB EACH	$237.05	$431.00	$14.55–$146.54	—	45%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH-	$227.70	$414.00	$16.80–$140.76	203% above	45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH-	$227.70	$414.00	$16.80–$140.76	—	45%
Total IgE blood test CPT 82785 IG E	$364.10	$662.00	$16.46–$225.08	465% above	45%
Total IgE blood test inpatient CPT 82785 IG E	$364.10	$662.00	$16.46–$225.08	—	45%
Total cholesterol blood test CPT 82465 CHOLESTEROL-TOTAL	$80.85	$147.00	$4.35–$49.98	121% above	45%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL-TOTAL	$80.85	$147.00	$4.35–$49.98	—	45%
Total thyroxine (T4) blood test CPT 84436 T4 TOTAL	$255.20	$464.00	$6.87–$157.76	529% above	45%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 TOTAL	$255.20	$464.00	$6.87–$157.76	—	45%
Total triiodothyronine (T3) blood test CPT 84480 T3 RIA TOTAL	$300.30	$546.00	$14.18–$185.64	399% above	45%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 RIA TOTAL	$300.30	$546.00	$14.18–$185.64	—	45%
Transferrin blood test CPT 84466 TRANSFERRIN	$363.55	$661.00	$12.76–$224.74	400% above	45%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$363.55	$661.00	$12.76–$224.74	—	45%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$188.10	$342.00	$35.09–$116.28	118% above	45%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$188.10	$342.00	$35.09–$116.28	—	45%
Triglycerides blood test CPT 84478 TRIGLYCERIDES-	$163.90	$298.00	$5.74–$101.32	348% above	45%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES-	$163.90	$298.00	$5.74–$101.32	—	45%
Troponin test, quantitative CPT 84484 TROPONIN I (SERUM)	$289.30	$526.00	$12.47–$178.84	244% above	45%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I (SERUM)	$289.30	$526.00	$12.47–$178.84	—	45%
Uric acid blood test CPT 84550 URIC ACID-BLOOD	$119.90	$218.00	$4.52–$74.12	241% above	45%
Uric acid blood test inpatient CPT 84550 URIC ACID-BLOOD	$119.90	$218.00	$4.52–$74.12	—	45%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICRO	$121.00	$220.00	$3.17–$74.80	348% above	45%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICRO	$121.00	$220.00	$3.17–$74.80	—	45%
Urinalysis without microscope exam, automated CPT 81003 PH URINE	$80.85	$147.00	$2.25–$49.98	237% above	45%
Urinalysis without microscope exam, automated CPT 81003 PROTEIN-QUALITATIVE URINE	$80.85	$147.00	$2.25–$49.98	237% above	45%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/OUT MICRO	$80.85	$147.00	$2.25–$49.98	237% above	45%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$80.85	$147.00	$2.25–$49.98	237% above	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 PROTEIN-QUALITATIVE URINE	$80.85	$147.00	$2.25–$49.98	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/OUT MICRO	$80.85	$147.00	$2.25–$49.98	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 PH URINE	$80.85	$147.00	$2.25–$49.98	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCOPE	$80.85	$147.00	$2.25–$49.98	—	45%
Urinalysis without microscope exam, manual CPT 81002 SP URINALYSIS NON-AUTO W/O MICRO	$59.40	$108.00	$3.48–$36.72	260% above	45%
Urinalysis without microscope exam, manual CPT 81002 SPECIFIC GRAVITY - URINE	$78.10	$142.00	$3.48–$48.28	373% above	45%
Urinalysis without microscope exam, manual inpatient CPT 81002 SP URINALYSIS NON-AUTO W/O MICRO	$59.40	$108.00	$3.48–$36.72	—	45%
Urinalysis without microscope exam, manual inpatient CPT 81002 SPECIFIC GRAVITY - URINE	$78.10	$142.00	$3.48–$48.28	—	45%
Urine culture for bacteria, with colony count CPT 87086 CULT-URINE(MIC IF INDICATED QUANT	$232.10	$422.00	$8.07–$143.48	307% above	45%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT-URINE(MIC IF INDICATED QUANT	$232.10	$422.00	$8.07–$143.48	—	45%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN, RANDOM URINE	$201.85	$367.00	$5.78–$124.78	297% above	45%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN, 24HR URINE QNT	$201.85	$367.00	$5.78–$124.78	297% above	45%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN, RANDOM URINE	$201.85	$367.00	$5.78–$124.78	—	45%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN, 24HR URINE QNT	$201.85	$367.00	$5.78–$124.78	—	45%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$139.70	$254.00	$8.61–$86.36	187% above	45%
Urine pregnancy test, read by color change CPT 81025 ST PREGNANCY TEST	$139.70	$254.00	$8.61–$86.36	187% above	45%
Urine pregnancy test, read by color change CPT 81025 PREG TEST-URINE HCG QUAL	$240.35	$437.00	$8.61–$148.58	394% above	45%
Urine pregnancy test, read by color change inpatient CPT 81025 ST PREGNANCY TEST	$139.70	$254.00	$8.61–$86.36	—	45%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$139.70	$254.00	$8.61–$86.36	—	45%
Urine pregnancy test, read by color change inpatient CPT 81025 PREG TEST-URINE HCG QUAL	$240.35	$437.00	$8.61–$148.58	—	45%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$323.95	$589.00	$15.08–$200.26	339% above	45%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$323.95	$589.00	$15.08–$200.26	—	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25 HYDROXY	$389.40	$708.00	$29.60–$240.72	324% above	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D2 &D3 TMS	$389.40	$708.00	$29.60–$240.72	324% above	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D2 &D3 TMS	$389.40	$708.00	$29.60–$240.72	—	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25 HYDROXY	$389.40	$708.00	$29.60–$240.72	—	45%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1,25 DIHYDROXY	$222.75	$405.00	$38.50–$137.70	45% above	45%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 1,25 DIHYDROXY	$222.75	$405.00	$38.50–$137.70	—	45%
Zinc blood test CPT 84630 ZINC	$352.00	$640.00	$11.39–$217.60	585% above	45%
Zinc blood test CPT 84630 ZINC,URINE	$352.00	$640.00	$11.39–$217.60	585% above	45%
Zinc blood test inpatient CPT 84630 ZINC	$352.00	$640.00	$11.39–$217.60	—	45%
Zinc blood test inpatient CPT 84630 ZINC,URINE	$352.00	$640.00	$11.39–$217.60	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 B-HCG QUANT	$279.40	$508.00	$15.05–$172.72	313% above	45%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 B-HCG QUANT	$279.40	$508.00	$15.05–$172.72	—	45%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$955.35	$1,737.00	$407.68–$825.08	69% above	45%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV MUSC MIGRAINE	$955.35	$1,737.00	$407.68–$825.08	—	45%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BX BREAST STEREO W DEV 1ST LES RT	$4,016.10	$7,302.00	$1,898.52–$3,821.26	at median	45%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BX BREAST STEREO W DEV 1ST LES LT	$4,016.10	$7,302.00	$1,898.52–$3,821.26	at median	45%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BX BREAST STEREO W DEV 1ST LES LT	$4,016.10	$7,302.00	$1,898.52–$3,821.26	—	45%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BX BREAST STEREO W DEV 1ST LES RT	$4,016.10	$7,302.00	$1,898.52–$3,821.26	—	45%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TX DIST AL FIBULAR FX WO	$1,483.35	$2,697.00	$327.61–$1,281.08	294% above	45%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TX DIST AL FIBULAR FX WO	$1,483.35	$2,697.00	$327.61–$1,281.08	—	45%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TX METTATS FX WO MN EA	$808.50	$1,470.00	$327.61–$698.25	122% above	45%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TX METTATS FX WO MN EA	$808.50	$1,470.00	$327.61–$698.25	—	45%
Cardiac catheterization with coronary angiogram CPT 93458 L HRT ARTERY/VENTRICLE ANGIO	$14,432.55	$26,241.00	$4,305.80–$12,464.48	20% above	45%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 L HRT ARTERY/VENTRICLE ANGIO	$14,432.55	$26,241.00	$4,305.80–$12,464.48	—	45%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CR CARDIOVERSION	$3,256.00	$5,920.00	$877.84–$1,651.68	58% above	45%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$3,256.00	$5,920.00	$877.84–$1,651.68	58% above	45%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERS ELEC CONV ARRHY	$3,315.95	$6,029.00	$877.84–$2,863.78	61% above	45%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CR CARDIOVERSION	$3,256.00	$5,920.00	$877.84–$1,651.68	—	45%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$3,256.00	$5,920.00	$877.84–$1,651.68	—	45%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERS ELEC CONV ARRHY	$3,315.95	$6,029.00	$877.84–$2,863.78	—	45%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 SU CLOS TX DIST RAD FX WO MANIP U	$741.40	$1,348.00	$327.61–$570.71	84% above	45%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TX DS RD W/WO FX U ST WO	$1,483.35	$2,697.00	$327.61–$1,281.08	269% above	45%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 SU CLOS TX DIST RAD FX WO MANIP U	$741.40	$1,348.00	$327.61–$570.71	—	45%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TX DS RD W/WO FX U ST WO	$1,483.35	$2,697.00	$327.61–$1,281.08	—	45%
Colonoscopy with polyp removal CPT 45385 COLON/POLYP/SNARE	$4,428.60	$8,052.00	$1,589.33–$2,768.62	26% above	45%
Colonoscopy with polyp removal inpatient CPT 45385 COLON/POLYP/SNARE	$4,428.60	$8,052.00	$1,589.33–$2,768.62	—	45%
Colonoscopy with tissue sample CPT 45380 COLON/BX/POLYP W COLD FORCEP	$3,668.50	$6,670.00	$1,589.33–$2,768.62	4% above	45%
Colonoscopy with tissue sample inpatient CPT 45380 COLON/BX/POLYP W COLD FORCEP	$3,668.50	$6,670.00	$1,589.33–$2,768.62	—	45%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY	$3,582.70	$6,514.00	$1,235.13–$2,151.62	28% above	45%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY	$3,582.70	$6,514.00	$1,235.13–$2,151.62	—	45%
Cystoscopy with ureteral stent placement CPT 52332 CYSTO W/INSERT URETERAL STENT BIL	$11,611.60	$21,112.00	$4,681.73–$8,155.64	17% above	45%
Cystoscopy with ureteral stent placement one side CPT 52332 CYSTO W/INSERT URETERAL STENT RT	$5,805.80	$10,556.00	$2,744.56–$8,155.64	42% below	45%
Cystoscopy with ureteral stent placement one side CPT 52332 CYSTO W/INSERT URETERAL STENT LT	$5,805.80	$10,556.00	$2,744.56–$8,155.64	42% below	45%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTO W/INSERT URETERAL STENT BIL	$11,611.60	$21,112.00	$4,681.73–$8,155.64	—	45%
Cystoscopy with ureteral stent placement inpatient one side CPT 52332 CYSTO W/INSERT URETERAL STENT RT	$5,805.80	$10,556.00	$2,744.56–$8,155.64	—	45%
Cystoscopy with ureteral stent placement inpatient one side CPT 52332 CYSTO W/INSERT URETERAL STENT LT	$5,805.80	$10,556.00	$2,744.56–$8,155.64	—	45%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$1,551.00	$2,820.00	$733.20–$1,613.31	22% below	45%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY	$1,551.00	$2,820.00	$733.20–$1,613.31	—	45%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 SP DESTRUCT BENIGN LESION 1ST LES	$742.50	$1,350.00	$266.47–$641.25	267% above	45%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 SU DESTRUCT BENIGN LESION 1ST LES	$742.50	$1,350.00	$266.47–$464.20	267% above	45%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 SP DESTRUCT BENIGN LESION 1ST LES	$742.50	$1,350.00	$266.47–$641.25	—	45%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 SU DESTRUCT BENIGN LESION 1ST LES	$742.50	$1,350.00	$266.47–$464.20	—	45%
Earwax removal by irrigation (rinsing), one ear CPT 69209 SP REMOVE IMPACTED EAR WAX UNI	$273.35	$497.00	$78.35–$236.08	77% above	45%
Earwax removal by irrigation (rinsing), one ear CPT 69209 SU REMOVE IMPACTED EAR WAX UNI	$273.35	$497.00	$78.35–$168.98	77% above	45%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$327.80	$596.00	$78.35–$283.10	112% above	45%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 SU REMOVE IMPACTED EAR WAX UNI	$273.35	$497.00	$78.35–$168.98	—	45%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 SP REMOVE IMPACTED EAR WAX UNI	$273.35	$497.00	$78.35–$236.08	—	45%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNI	$327.80	$596.00	$78.35–$283.10	—	45%
Earwax removal with instruments, one ear CPT 69210 SP CERUMEN REMOVAL	$319.00	$580.00	$78.35–$275.50	106% above	45%
Earwax removal with instruments, one ear CPT 69210 SU CERUMEN REMOVAL	$319.00	$580.00	$78.35–$197.20	106% above	45%
Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL	$353.65	$643.00	$78.35–$305.43	129% above	45%
Earwax removal with instruments, one ear inpatient CPT 69210 SU CERUMEN REMOVAL	$319.00	$580.00	$78.35–$197.20	—	45%
Earwax removal with instruments, one ear inpatient CPT 69210 SP CERUMEN REMOVAL	$319.00	$580.00	$78.35–$275.50	—	45%
Earwax removal with instruments, one ear inpatient CPT 69210 CERUMEN REMOVAL	$353.65	$643.00	$78.35–$305.43	—	45%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Cervical/ Thoracic Epidural with Imaging	$4,747.05	$8,631.00	$937.52–$4,099.73	113% above	45%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Cervical/ Thoracic Epidural with Imaging	$4,747.05	$8,631.00	$937.52–$4,099.73	—	45%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ ANES AGNT LUM/SACR SING UNI	$2,725.80	$4,956.00	$1,174.72–$2,046.37	25% above	45%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ ANES AGNT LUM/SACR SING UNI	$2,725.80	$4,956.00	$1,174.72–$2,046.37	—	45%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 FLEX SIG/DIAG (W WO BRUSH)	$1,951.95	$3,549.00	$922.74–$2,151.62	24% below	45%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 FLEX SIG/DIAG (W WO BRUSH)	$1,951.95	$3,549.00	$922.74–$2,151.62	—	45%
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S)	$4,599.10	$8,362.00	$1,235.13–$2,333.00	140% above	45%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 LIGATION OF HEMORRHOID(S)	$4,599.10	$8,362.00	$1,235.13–$2,333.00	—	45%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 XR INJ HYSTERO	$321.75	$585.00	$152.10–$277.88	16% below	45%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 XR INJ HYSTERO	$321.75	$585.00	$152.10–$277.88	—	45%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABCESS IMPL/SGL	$831.05	$1,511.00	$266.47–$717.73	116% above	45%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$929.50	$1,690.00	$266.47–$802.75	141% above	45%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABCESS SINGLE SIMPLE	$929.50	$1,690.00	$266.47–$802.75	141% above	45%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABCESS SIMPLE SINGLE	$929.50	$1,690.00	$266.47–$802.75	141% above	45%
Incision and drainage of a simple or single skin abscess CPT 10060 SU I&D ABSCESS SIMPLE/SINGLE	$929.50	$1,690.00	$266.47–$574.60	141% above	45%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABCESS IMPL/SGL	$831.05	$1,511.00	$266.47–$717.73	—	45%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABCESS SINGLE SIMPLE	$929.50	$1,690.00	$266.47–$802.75	—	45%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABCESS SIMPLE SINGLE	$929.50	$1,690.00	$266.47–$802.75	—	45%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 SU I&D ABSCESS SIMPLE/SINGLE	$929.50	$1,690.00	$266.47–$574.60	—	45%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$929.50	$1,690.00	$266.47–$802.75	—	45%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 US INJ TENDON SHEATH/LIGAMENT	$776.60	$1,412.00	$367.12–$710.18	129% above	45%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH	$776.60	$1,412.00	$367.12–$710.18	129% above	45%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SGL TENDON SHTH/LIG UNI	$785.95	$1,429.00	$371.54–$710.18	132% above	45%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$785.95	$1,429.00	$371.54–$710.18	132% above	45%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIG	$1,052.70	$1,914.00	$407.68–$909.15	210% above	45%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TRIGGER POINT	$1,052.70	$1,914.00	$407.68–$909.15	210% above	45%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 US INJ TENDON SHEATH/LIGAMENT	$776.60	$1,412.00	$367.12–$710.18	—	45%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH	$776.60	$1,412.00	$367.12–$710.18	—	45%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT	$785.95	$1,429.00	$371.54–$710.18	—	45%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ SGL TENDON SHTH/LIG UNI	$785.95	$1,429.00	$371.54–$710.18	—	45%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIG	$1,052.70	$1,914.00	$407.68–$909.15	—	45%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT TRIGGER POINT	$1,052.70	$1,914.00	$407.68–$909.15	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTCEN/ASP/INJ MAJ JT UNI	$1,141.80	$2,076.00	$407.68–$986.10	64% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 SU ARTCEN/ASP/INJ MAJ JT UNI	$1,141.80	$2,076.00	$407.68–$710.18	64% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 LG JT ASP/INJ W/O US	$1,141.80	$2,076.00	$407.68–$986.10	64% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ST ARTEN/ASP/INJ MAJ JT UNI	$1,141.80	$2,076.00	$407.68–$986.10	64% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJ MAJOR JOINT UNI W/O ULTRASOUND	$1,141.80	$2,076.00	$407.68–$986.10	64% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR MAJ JT ARTHRO/ASPIR/INJ LT	$1,141.80	$2,076.00	$407.68–$986.10	64% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 CT MAJ JT ARTHRO/ASPIR/INJ LT	$1,141.80	$2,076.00	$407.68–$986.10	64% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 CT MAJ JT ARTHRO/ASPIR/INJ RT	$1,141.80	$2,076.00	$407.68–$986.10	64% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 LARGE JOINT INJ RT	$1,141.80	$2,076.00	$407.68–$986.10	64% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 LARGE JOINT INJ LT	$1,141.80	$2,076.00	$407.68–$986.10	64% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR MAJ JT ARTHRO/ASPIR/INJ RT	$1,141.80	$2,076.00	$407.68–$986.10	64% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ST ARTEN/ASP/INJ MAJ JT UNI	$1,141.80	$2,076.00	$407.68–$986.10	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJ MAJOR JOINT UNI W/O ULTRASOUND	$1,141.80	$2,076.00	$407.68–$986.10	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 LG JT ASP/INJ W/O US	$1,141.80	$2,076.00	$407.68–$986.10	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 SU ARTCEN/ASP/INJ MAJ JT UNI	$1,141.80	$2,076.00	$407.68–$710.18	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTCEN/ASP/INJ MAJ JT UNI	$1,141.80	$2,076.00	$407.68–$986.10	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 CT MAJ JT ARTHRO/ASPIR/INJ LT	$1,141.80	$2,076.00	$407.68–$986.10	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR MAJ JT ARTHRO/ASPIR/INJ LT	$1,141.80	$2,076.00	$407.68–$986.10	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 LARGE JOINT INJ RT	$1,141.80	$2,076.00	$407.68–$986.10	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR MAJ JT ARTHRO/ASPIR/INJ RT	$1,141.80	$2,076.00	$407.68–$986.10	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 CT MAJ JT ARTHRO/ASPIR/INJ RT	$1,141.80	$2,076.00	$407.68–$986.10	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 LARGE JOINT INJ LT	$1,141.80	$2,076.00	$407.68–$986.10	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJ INTERMEDIATE JOINT UNI W/O ULTRASOUN	$820.05	$1,491.00	$387.66–$710.18	31% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 SU ARTCEN/ASP/INJ INT JT UNI	$820.05	$1,491.00	$387.66–$710.18	31% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHRO/ASP/INJ JT/BURSA W/O US BIL	$838.75	$1,525.00	$396.50–$710.18	34% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTCEN/ASP/INJ INT JT W/O US	$910.80	$1,656.00	$407.68–$786.60	46% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJ INTERMEDIATE JOINT UNI	$994.40	$1,808.00	$407.68–$858.80	59% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTCEN/ASP/INJ INT JT	$1,081.30	$1,966.00	$407.68–$933.85	73% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 CT ARTHRO/ASP/INJ JT/BURSA W/O US BIL	$1,366.20	$2,484.00	$407.68–$968.00	119% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ARTHRO/ASP/INJ JT/BURSA W/O US LT	$820.05	$1,491.00	$387.66–$710.18	31% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ARTHRO/ASP/INJ JT/BURSA W/O US RT	$820.05	$1,491.00	$387.66–$710.18	31% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 CT ARTHRO/ASP/INJ JT/BURSA W/O US LT	$910.80	$1,656.00	$407.68–$968.00	46% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 CT ARTHRO/ASP/INJ JT/BURSA W/O US RT	$910.80	$1,656.00	$407.68–$968.00	46% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 SU ARTCEN/ASP/INJ INT JT UNI	$820.05	$1,491.00	$387.66–$710.18	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJ INTERMEDIATE JOINT UNI W/O ULTRASOUN	$820.05	$1,491.00	$387.66–$710.18	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHRO/ASP/INJ JT/BURSA W/O US BIL	$838.75	$1,525.00	$396.50–$710.18	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTCEN/ASP/INJ INT JT W/O US	$910.80	$1,656.00	$407.68–$786.60	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJ INTERMEDIATE JOINT UNI	$994.40	$1,808.00	$407.68–$858.80	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTCEN/ASP/INJ INT JT	$1,081.30	$1,966.00	$407.68–$933.85	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 CT ARTHRO/ASP/INJ JT/BURSA W/O US BIL	$1,366.20	$2,484.00	$407.68–$968.00	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 ARTHRO/ASP/INJ JT/BURSA W/O US LT	$820.05	$1,491.00	$387.66–$710.18	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 ARTHRO/ASP/INJ JT/BURSA W/O US RT	$820.05	$1,491.00	$387.66–$710.18	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 CT ARTHRO/ASP/INJ JT/BURSA W/O US RT	$910.80	$1,656.00	$407.68–$968.00	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 CT ARTHRO/ASP/INJ JT/BURSA W/O US LT	$910.80	$1,656.00	$407.68–$968.00	—	45%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJ SMALL JOINT UNI W/O ULTRASOUND	$779.90	$1,418.00	$368.68–$710.18	58% above	45%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTCEN/ASP/INJ SM JT	$779.90	$1,418.00	$368.68–$710.18	58% above	45%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTCEN/ASP/INJ SM JT UNI	$779.90	$1,418.00	$368.68–$710.18	58% above	45%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 XR SMALL JOINT INJ / ASPIR LT	$779.90	$1,418.00	$368.68–$710.18	58% above	45%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 XR SMALL JOINT INJ / ASPIR RT	$779.90	$1,418.00	$368.68–$710.18	58% above	45%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTCEN/ASP/INJ SM JT	$779.90	$1,418.00	$368.68–$710.18	—	45%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 INJ SMALL JOINT UNI W/O ULTRASOUND	$779.90	$1,418.00	$368.68–$710.18	—	45%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTCEN/ASP/INJ SM JT UNI	$779.90	$1,418.00	$368.68–$710.18	—	45%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 XR SMALL JOINT INJ / ASPIR RT	$779.90	$1,418.00	$368.68–$710.18	—	45%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 XR SMALL JOINT INJ / ASPIR LT	$779.90	$1,418.00	$368.68–$710.18	—	45%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 SP LAY CL SC/TR/EXT <=2.5CM	$893.75	$1,625.00	$422.50–$940.53	59% above	45%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 SU LAY CL SC/TR/EXT <=2.5CM	$893.75	$1,625.00	$422.50–$940.53	59% above	45%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAY CL SC/AX/GEN/TR <2.5	$976.80	$1,776.00	$461.76–$940.53	74% above	45%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 SU LAY CL SC/TR/EXT <=2.5CM	$893.75	$1,625.00	$422.50–$940.53	—	45%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 SP LAY CL SC/TR/EXT <=2.5CM	$893.75	$1,625.00	$422.50–$940.53	—	45%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAY CL SC/AX/GEN/TR <2.5	$976.80	$1,776.00	$461.76–$940.53	—	45%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HRT CATH W/VENTRCLGRPHY	$9,727.30	$17,686.00	$4,305.80–$8,400.85	4% above	45%
Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HRT CATH W/VENTRCLGRPHY	$9,727.30	$17,686.00	$4,305.80–$8,400.85	—	45%
Lower-back epidural injection, with imaging guidance CPT 62323 Lumbar/ Sacral Caudal Epidural with Imag	$4,747.05	$8,631.00	$937.52–$4,099.73	139% above	45%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Lumbar/ Sacral Caudal Epidural with Imag	$4,747.05	$8,631.00	$937.52–$4,099.73	—	45%
Lower-back epidural injection, without imaging guidance CPT 62322 Lumbar/Sacral Caudal Epidural w/o Imag	$4,747.05	$8,631.00	$1,174.72–$4,099.73	190% above	45%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Lumbar/Sacral Caudal Epidural w/o Imag	$4,747.05	$8,631.00	$1,174.72–$4,099.73	—	45%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 CT INJ FORAMEN EPIDURAL L/S	$3,242.25	$5,895.00	$1,174.72–$2,800.13	57% above	45%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 LUMBAR TRANSFORAMINAL INJ UNI	$3,242.25	$5,895.00	$1,174.72–$2,800.13	57% above	45%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 LUMBAR TRANSFORAMINAL INJ UNI	$3,242.25	$5,895.00	$1,174.72–$2,800.13	—	45%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 CT INJ FORAMEN EPIDURAL L/S	$3,242.25	$5,895.00	$1,174.72–$2,800.13	—	45%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 SU EXC BEN LES TR/AR/LG <=0.5CM	$986.15	$1,793.00	$466.18–$1,638.38	28% below	45%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 SP EXC BEN LES TR/AR/LG <=0.5CM	$986.15	$1,793.00	$466.18–$1,638.38	28% below	45%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 SU EXC BEN LES TR/AR/LG <=0.5CM	$986.15	$1,793.00	$466.18–$1,638.38	—	45%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 SP EXC BEN LES TR/AR/LG <=0.5CM	$986.15	$1,793.00	$466.18–$1,638.38	—	45%
Nail removal (partial or complete), one nail CPT 11730 SU AVULSION OF NAIL PLATE-SINGLE	$831.05	$1,511.00	$266.47–$513.74	161% above	45%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE SIMPLE	$831.05	$1,511.00	$266.47–$717.73	161% above	45%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE FING/TOE	$1,227.05	$2,231.00	$266.47–$1,059.73	285% above	45%
Nail removal (partial or complete), one nail inpatient CPT 11730 SU AVULSION OF NAIL PLATE-SINGLE	$831.05	$1,511.00	$266.47–$513.74	—	45%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE SIMPLE	$831.05	$1,511.00	$266.47–$717.73	—	45%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE FING/TOE	$1,227.05	$2,231.00	$266.47–$1,059.73	—	45%
Occipital nerve block (injection for headaches) CPT 64405 GREATER OCCIPITAL NERVE BLK BIL	$1,540.55	$2,801.00	$407.68–$1,330.48	63% above	45%
Occipital nerve block (injection for headaches) CPT 64405 GREATER OCCIPITAL NERVE BLK UNI	$3,567.85	$6,487.00	$407.68–$3,081.33	278% above	45%
Occipital nerve block (injection for headaches) inpatient CPT 64405 GREATER OCCIPITAL NERVE BLK BIL	$1,540.55	$2,801.00	$407.68–$1,330.48	—	45%
Occipital nerve block (injection for headaches) inpatient CPT 64405 GREATER OCCIPITAL NERVE BLK UNI	$3,567.85	$6,487.00	$407.68–$3,081.33	—	45%
Paracentesis with imaging guidance CPT 49083 CT ABD PARACENTESIS W/IMAGE GUIDE	$2,833.60	$5,152.00	$900.00–$2,098.46	63% above	45%
Paracentesis with imaging guidance CPT 49083 US ABD PARACENTESIS W/IMAGE GUIDE	$2,833.60	$5,152.00	$1,204.62–$2,447.20	63% above	45%
Paracentesis with imaging guidance inpatient CPT 49083 CT ABD PARACENTESIS W/IMAGE GUIDE	$2,833.60	$5,152.00	$900.00–$2,098.46	—	45%
Paracentesis with imaging guidance inpatient CPT 49083 US ABD PARACENTESIS W/IMAGE GUIDE	$2,833.60	$5,152.00	$1,204.62–$2,447.20	—	45%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$1,983.85	$3,607.00	$539.92–$1,713.33	155% above	45%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 SP EXC NAIL/MAT PRM FING/TOE	$1,983.85	$3,607.00	$539.92–$1,713.33	155% above	45%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED	$1,983.85	$3,607.00	$539.92–$1,713.33	—	45%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 SP EXC NAIL/MAT PRM FING/TOE	$1,983.85	$3,607.00	$539.92–$1,713.33	—	45%
Prostate biopsy CPT 55700 BIOPSY OF PROSTATE	$4,624.95	$8,409.00	$2,186.34–$2,346.11	116% above	45%
Prostate biopsy inpatient CPT 55700 BIOPSY OF PROSTATE	$4,624.95	$8,409.00	$2,186.34–$2,346.11	—	45%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT	$3,240.05	$5,891.00	$1,531.66–$4,517.96	at median	45%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTROY LUMB/SAC FACET JNT	$3,240.05	$5,891.00	$1,531.66–$4,517.96	—	45%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FB SUBQ TISS SIMP	$1,245.20	$2,264.00	$539.92–$1,075.40	86% above	45%
Removal of a foreign object under the skin, simple CPT 10120 SP REMOVE FB SUBQ TISS SIMPLE	$1,245.20	$2,264.00	$539.92–$1,075.40	86% above	45%
Removal of a foreign object under the skin, simple CPT 10120 SU REMOVE FB SUBSQ TISS SIMP	$1,245.20	$2,264.00	$539.92–$940.53	86% above	45%
Removal of a foreign object under the skin, simple inpatient CPT 10120 SU REMOVE FB SUBSQ TISS SIMP	$1,245.20	$2,264.00	$539.92–$940.53	—	45%
Removal of a foreign object under the skin, simple inpatient CPT 10120 SP REMOVE FB SUBQ TISS SIMPLE	$1,245.20	$2,264.00	$539.92–$1,075.40	—	45%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FB SUBQ TISS SIMP	$1,245.20	$2,264.00	$539.92–$1,075.40	—	45%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY/SCREENING	$2,916.65	$5,303.00	$1,235.13–$2,151.62	12% above	45%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY/SCREENING	$2,916.65	$5,303.00	$1,235.13–$2,151.62	—	45%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY/SCREENING HIGH RISK	$3,266.45	$5,939.00	$1,235.13–$2,151.62	26% above	45%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY/SCREENING HIGH RISK	$3,266.45	$5,939.00	$1,235.13–$2,151.62	—	45%
Short arm cast (elbow to hand) CPT 29075 APPL SHORT ARM CAST UNI	$640.75	$1,165.00	$302.90–$647.12	113% above	45%
Short arm cast (elbow to hand) CPT 29075 CAST PLASTER SHORT ARM	$649.55	$1,181.00	$307.06–$647.12	116% above	45%
Short arm cast (elbow to hand) CPT 29075 OUTPT APPLY SHORT ARM CAST	$649.55	$1,181.00	$307.06–$647.12	116% above	45%
Short arm cast (elbow to hand) inpatient CPT 29075 APPL SHORT ARM CAST UNI	$640.75	$1,165.00	$302.90–$647.12	—	45%
Short arm cast (elbow to hand) inpatient CPT 29075 CAST PLASTER SHORT ARM	$649.55	$1,181.00	$307.06–$647.12	—	45%
Short arm cast (elbow to hand) inpatient CPT 29075 OUTPT APPLY SHORT ARM CAST	$649.55	$1,181.00	$307.06–$647.12	—	45%
Short arm splint (forearm and hand) CPT 29125 APP SHRT ARM SPLINT STAT UNI	$640.20	$1,164.00	$176.71–$552.90	120% above	45%
Short arm splint (forearm and hand) CPT 29125 SU APP SHRT ARM SPLINT STATIC UNI	$640.75	$1,165.00	$176.71–$396.10	120% above	45%
Short arm splint (forearm and hand) CPT 29125 APP SHRT ARM SPLINT STATIC UNI	$640.75	$1,165.00	$176.71–$553.38	120% above	45%
Short arm splint (forearm and hand) CPT 29125 APPLY SHRT ARM SPLINT STAT	$1,278.75	$2,325.00	$176.71–$1,104.38	340% above	45%
Short arm splint (forearm and hand) inpatient CPT 29125 APP SHRT ARM SPLINT STAT UNI	$640.20	$1,164.00	$176.71–$552.90	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 APP SHRT ARM SPLINT STATIC UNI	$640.75	$1,165.00	$176.71–$553.38	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 SU APP SHRT ARM SPLINT STATIC UNI	$640.75	$1,165.00	$176.71–$396.10	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHRT ARM SPLINT STAT	$1,278.75	$2,325.00	$176.71–$1,104.38	—	45%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST	$669.35	$1,217.00	$316.42–$647.12	68% above	45%
Short leg cast (below the knee) CPT 29405 SHORT LEG CAST	$742.50	$1,350.00	$351.00–$647.12	87% above	45%
Short leg cast (below the knee) CPT 29405 SP APPL SHORT LEG CAST UNI	$742.50	$1,350.00	$351.00–$647.12	87% above	45%
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST	$669.35	$1,217.00	$316.42–$647.12	—	45%
Short leg cast (below the knee) inpatient CPT 29405 SP APPL SHORT LEG CAST UNI	$742.50	$1,350.00	$351.00–$647.12	—	45%
Short leg cast (below the knee) inpatient CPT 29405 SHORT LEG CAST	$742.50	$1,350.00	$351.00–$647.12	—	45%
Short leg splint (calf to foot) CPT 29515 SU APP SHORT LEG SPLINT	$742.50	$1,350.00	$215.83–$459.00	144% above	45%
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT	$742.50	$1,350.00	$215.83–$641.25	144% above	45%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT	$742.50	$1,350.00	$215.83–$641.25	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 SU APP SHORT LEG SPLINT	$742.50	$1,350.00	$215.83–$459.00	—	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$819.50	$1,490.00	$266.47–$707.75	148% above	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SU SIM RP S/N/A/G/TR/E <2.5CM	$819.50	$1,490.00	$266.47–$506.60	148% above	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIM S/N/A/G/TR/EX <2.5CM	$819.50	$1,490.00	$266.47–$707.75	148% above	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SREP S/N/A/G/TR/E 2.5 CM/<	$892.65	$1,623.00	$266.47–$770.93	170% above	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIM RP SC/AX/GEN/TR/EX < 2.5	$935.55	$1,701.00	$266.47–$807.98	184% above	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$819.50	$1,490.00	$266.47–$707.75	—	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIM S/N/A/G/TR/EX <2.5CM	$819.50	$1,490.00	$266.47–$707.75	—	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SU SIM RP S/N/A/G/TR/E <2.5CM	$819.50	$1,490.00	$266.47–$506.60	—	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SREP S/N/A/G/TR/E 2.5 CM/<	$892.65	$1,623.00	$266.47–$770.93	—	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIM RP SC/AX/GEN/TR/EX < 2.5	$935.55	$1,701.00	$266.47–$807.98	—	45%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SNG LES	$441.65	$803.00	$208.78–$940.53	2% below	45%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$441.65	$803.00	$208.78–$940.53	2% below	45%
Skin biopsy, punch, one lesion CPT 11104 SP PUNCH BX SKIN SNG LESION	$596.75	$1,085.00	$282.10–$940.53	33% above	45%
Skin biopsy, punch, one lesion CPT 11104 SU PUNCH BX SKIN SNG LESION	$596.75	$1,085.00	$282.10–$940.53	33% above	45%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SNG LES	$441.65	$803.00	$208.78–$940.53	—	45%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$441.65	$803.00	$208.78–$940.53	—	45%
Skin biopsy, punch, one lesion inpatient CPT 11104 SU PUNCH BX SKIN SNG LESION	$596.75	$1,085.00	$282.10–$940.53	—	45%
Skin biopsy, punch, one lesion inpatient CPT 11104 SP PUNCH BX SKIN SNG LESION	$596.75	$1,085.00	$282.10–$940.53	—	45%
Skin tag removal, up to 15 tags CPT 11200 SP REMOVAL SKIN TAGS 1-15	$742.50	$1,350.00	$266.47–$641.25	154% above	45%
Skin tag removal, up to 15 tags CPT 11200 SU REMOVAL SKIN TAGS 1-15	$742.50	$1,350.00	$266.47–$464.20	154% above	45%
Skin tag removal, up to 15 tags CPT 11200 REM SKIN TAGS- <= 15 LESIONS	$742.50	$1,350.00	$266.47–$641.25	154% above	45%
Skin tag removal, up to 15 tags inpatient CPT 11200 REM SKIN TAGS- <= 15 LESIONS	$742.50	$1,350.00	$266.47–$641.25	—	45%
Skin tag removal, up to 15 tags inpatient CPT 11200 SU REMOVAL SKIN TAGS 1-15	$742.50	$1,350.00	$266.47–$464.20	—	45%
Skin tag removal, up to 15 tags inpatient CPT 11200 SP REMOVAL SKIN TAGS 1-15	$742.50	$1,350.00	$266.47–$641.25	—	45%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DX	$1,012.55	$1,841.00	$478.66–$1,633.18	7% below	45%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCT LUMBAR DX	$1,104.95	$2,009.00	$522.34–$1,633.18	2% above	45%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAG	$1,287.00	$2,340.00	$608.40–$1,633.18	18% above	45%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR SPINAL TAP	$2,467.30	$4,486.00	$937.52–$2,130.85	127% above	45%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DX	$1,012.55	$1,841.00	$478.66–$1,633.18	—	45%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCT LUMBAR DX	$1,104.95	$2,009.00	$522.34–$1,633.18	—	45%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAG	$1,287.00	$2,340.00	$608.40–$1,633.18	—	45%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR SPINAL TAP	$2,467.30	$4,486.00	$937.52–$2,130.85	—	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIM RP SC/AX/GEN/TR/2.6-7.5 CM	$922.90	$1,678.00	$266.47–$797.05	162% above	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SU SIM RP S/N/A/G/TR/E 2.6-7.5CM	$922.90	$1,678.00	$266.47–$570.52	162% above	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIM RP SC/AX/GEN/TR/2.6-7.5	$935.55	$1,701.00	$266.47–$807.98	165% above	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIM RP SC/AX/GEN/TR/2.6-7.5 CM	$922.90	$1,678.00	$266.47–$797.05	—	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SU SIM RP S/N/A/G/TR/E 2.6-7.5CM	$922.90	$1,678.00	$266.47–$570.52	—	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIM RP SC/AX/GEN/TR/2.6-7.5	$935.55	$1,701.00	$266.47–$807.98	—	45%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SU SIM RP F/E/E/N/L/MM <=2.5 CM	$819.50	$1,490.00	$266.47–$506.60	158% above	45%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIM RP FA/NS/EAR/MUC <2.5	$935.55	$1,701.00	$266.47–$807.98	195% above	45%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SU SIM RP F/E/E/N/L/MM <=2.5 CM	$819.50	$1,490.00	$266.47–$506.60	—	45%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIM RP FA/NS/EAR/MUC <2.5	$935.55	$1,701.00	$266.47–$807.98	—	45%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$357.50	$650.00	$169.00–$940.53	18% above	45%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 SU TANGNTL BX SKIN SINGLE LES	$441.65	$803.00	$208.78–$940.53	45% above	45%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 SP TANGNTL BX SKIN SINGLE LES	$441.65	$803.00	$208.78–$940.53	45% above	45%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES	$357.50	$650.00	$169.00–$940.53	—	45%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 SP TANGNTL BX SKIN SINGLE LES	$441.65	$803.00	$208.78–$940.53	—	45%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 SU TANGNTL BX SKIN SINGLE LES	$441.65	$803.00	$208.78–$940.53	—	45%
Thoracentesis with imaging guidance one side CPT 32555 CT ASPIRATE PLEURA W/IMAGING RT	$3,161.95	$5,749.00	$833.16–$2,730.78	75% above	45%
Thoracentesis with imaging guidance one side CPT 32555 US ASPIRATE PLEURA W/IMAGING LT	$3,161.95	$5,749.00	$833.16–$2,730.78	75% above	45%
Thoracentesis with imaging guidance one side CPT 32555 US ASPIRATE PLEURA W/IMAGING RT	$3,161.95	$5,749.00	$833.16–$2,730.78	75% above	45%
Thoracentesis with imaging guidance one side CPT 32555 CT ASPIRATE PLEURA W/IMAGING LT	$3,161.95	$5,749.00	$833.16–$2,730.78	75% above	45%
Thoracentesis with imaging guidance inpatient one side CPT 32555 US ASPIRATE PLEURA W/IMAGING RT	$3,161.95	$5,749.00	$833.16–$2,730.78	—	45%
Thoracentesis with imaging guidance inpatient one side CPT 32555 CT ASPIRATE PLEURA W/IMAGING LT	$3,161.95	$5,749.00	$833.16–$2,730.78	—	45%
Thoracentesis with imaging guidance inpatient one side CPT 32555 CT ASPIRATE PLEURA W/IMAGING RT	$3,161.95	$5,749.00	$833.16–$2,730.78	—	45%
Thoracentesis with imaging guidance inpatient one side CPT 32555 US ASPIRATE PLEURA W/IMAGING LT	$3,161.95	$5,749.00	$833.16–$2,730.78	—	45%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ 1-2 MUSC GRPS	$752.40	$1,368.00	$355.68–$710.18	8% above	45%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIG PT 1 OR 2 MUSCLE	$752.40	$1,368.00	$355.68–$710.18	8% above	45%
Trigger point injections, 1 or 2 muscles CPT 20552 US INJ TRIG PT 1 OR 2 MUSCLES	$752.40	$1,368.00	$355.68–$710.18	8% above	45%
Trigger point injections, 1 or 2 muscles CPT 20552 XR INJ TRIG PT 1 OR 2 MUSCLES	$752.40	$1,368.00	$355.68–$710.18	8% above	45%
Trigger point injections, 1 or 2 muscles CPT 20552 CT-ING TRIG PT 1 OR 2 MUSCLE	$752.40	$1,368.00	$355.68–$710.18	8% above	45%
Trigger point injections, 1 or 2 muscles CPT 20552 SCIATIC NRV/PIRIFORMIS MUS BL UNI	$3,567.85	$6,487.00	$407.68–$3,081.33	410% above	45%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 XR INJ TRIG PT 1 OR 2 MUSCLES	$752.40	$1,368.00	$355.68–$710.18	—	45%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ 1-2 MUSC GRPS	$752.40	$1,368.00	$355.68–$710.18	—	45%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 CT-ING TRIG PT 1 OR 2 MUSCLE	$752.40	$1,368.00	$355.68–$710.18	—	45%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIG PT 1 OR 2 MUSCLE	$752.40	$1,368.00	$355.68–$710.18	—	45%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 US INJ TRIG PT 1 OR 2 MUSCLES	$752.40	$1,368.00	$355.68–$710.18	—	45%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 SCIATIC NRV/PIRIFORMIS MUS BL UNI	$3,567.85	$6,487.00	$407.68–$3,081.33	—	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BX BREAST US W DEV 1ST LES RT	$3,314.30	$6,026.00	$1,566.76–$3,821.26	1% below	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BX BREAST US W DEV 1ST LES LT	$3,314.30	$6,026.00	$1,566.76–$3,821.26	1% below	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BX BREAST US W DEV 1ST LES LT	$3,314.30	$6,026.00	$1,566.76–$3,821.26	—	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BX BREAST US W DEV 1ST LES RT	$3,314.30	$6,026.00	$1,566.76–$3,821.26	—	45%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD W/BALLOON DIL <30MM	$3,566.75	$6,485.00	$1,686.10–$4,439.71	at median	45%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD W/BALLOON DIL <30MM	$3,566.75	$6,485.00	$1,686.10–$4,439.71	—	45%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BX	$2,896.85	$5,267.00	$1,204.62–$2,098.46	3% above	45%
Upper endoscopy (EGD) with biopsy CPT 43239 ER EGD BIOPSY SINGLE/MULTIPLE	$2,896.85	$5,267.00	$1,204.62–$2,501.83	3% above	45%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ER EGD BIOPSY SINGLE/MULTIPLE	$2,896.85	$5,267.00	$1,204.62–$2,501.83	—	45%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BX	$2,896.85	$5,267.00	$1,204.62–$2,098.46	—	45%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD W SUBMUCOS INJ	$2,830.30	$5,146.00	$1,204.62–$2,098.46	1% above	45%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD W SUBMUCOS INJ	$2,830.30	$5,146.00	$1,204.62–$2,098.46	—	45%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD W/POLYPECTOMY SNARE	$3,498.55	$6,361.00	$1,653.86–$4,439.71	4% above	45%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD W/POLYPECTOMY SNARE	$3,498.55	$6,361.00	$1,653.86–$4,439.71	—	45%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD W INS GW DIL ESO (SAVORY)	$3,190.55	$5,801.00	$1,204.62–$2,098.46	14% above	45%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD W INS GW DIL ESO (SAVORY)	$3,190.55	$5,801.00	$1,204.62–$2,098.46	—	45%
Upper endoscopy (EGD), diagnostic CPT 43235 ER EGD	$2,625.15	$4,773.00	$1,204.62–$2,267.18	1% above	45%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD	$2,703.80	$4,916.00	$1,204.62–$2,098.46	4% above	45%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ER EGD	$2,625.15	$4,773.00	$1,204.62–$2,267.18	—	45%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD	$2,703.80	$4,916.00	$1,204.62–$2,098.46	—	45%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY BIL	$23,497.10	$42,722.00	$7,121.31–$12,405.40	55% above	45%
Ureteroscopy with laser stone breaking and stent placement one side CPT 52356 CYSTO/URETERO W/LITHOTRIPSY LT	$11,748.55	$21,361.00	$5,553.86–$12,405.40	23% below	45%
Ureteroscopy with laser stone breaking and stent placement one side CPT 52356 CYSTO/URETERO W/LITHOTRIPSY RT	$11,748.55	$21,361.00	$5,553.86–$12,405.40	23% below	45%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYSTO/URETERO W/LITHOTRIPSY BIL	$23,497.10	$42,722.00	$7,121.31–$12,405.40	—	45%
Ureteroscopy with laser stone breaking and stent placement inpatient one side CPT 52356 CYSTO/URETERO W/LITHOTRIPSY RT	$11,748.55	$21,361.00	$5,553.86–$12,405.40	—	45%
Ureteroscopy with laser stone breaking and stent placement inpatient one side CPT 52356 CYSTO/URETERO W/LITHOTRIPSY LT	$11,748.55	$21,361.00	$5,553.86–$12,405.40	—	45%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAM	$1,591.15	$2,893.00	$752.18–$4,836.46	—	45%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S)	$1,591.15	$2,893.00	$752.18–$4,836.46	55% below	45%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAM	$1,591.15	$2,893.00	$752.18–$4,836.46	—	45%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 REMOVAL OF SPERM DUCT(S)	$1,591.15	$2,893.00	$752.18–$4,836.46	—	45%
Wart removal, up to 14 warts CPT 17110 DESTRUCT WARTS UP TO 14	$742.50	$1,350.00	$266.47–$641.25	137% above	45%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT WARTS UP TO 14	$742.50	$1,350.00	$266.47–$641.25	—	45%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$2,350.15	$4,273.00	$539.92–$2,029.68	202% above	45%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID FULL THCK SKIN W/SUBQ TISS	$3,170.20	$5,764.00	$539.92–$2,737.90	307% above	45%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 OBS DEBRIDE,SKIN TO SQ TISSUE	$3,286.25	$5,975.00	$539.92–$2,838.13	322% above	45%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$2,350.15	$4,273.00	$539.92–$2,029.68	—	45%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRID FULL THCK SKIN W/SUBQ TISS	$3,170.20	$5,764.00	$539.92–$2,737.90	—	45%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 OBS DEBRIDE,SKIN TO SQ TISSUE	$3,286.25	$5,975.00	$539.92–$2,838.13	—	45%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION CELL SAVER	$2,087.25	$3,795.00	$585.95–$1,802.63	88% above	45%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$2,087.80	$3,796.00	$585.95–$1,803.10	88% above	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION CELL SAVER	$2,087.25	$3,795.00	$585.95–$1,802.63	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$2,087.80	$3,796.00	$585.95–$1,803.10	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TX, IP	$389.40	$708.00	$191.16–$506.64	120% above	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHAL TX OP	$389.40	$708.00	$191.16–$506.64	120% above	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ST AIRWAY INHALATION TRTMT	$389.40	$708.00	$191.16–$506.64	120% above	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ST AIRWAY INHALATION TRTMT	$389.40	$708.00	$191.16–$506.64	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL TX OP	$389.40	$708.00	$191.16–$506.64	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TX, IP	$389.40	$708.00	$191.16–$506.64	—	45%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN INFUS TECH UP TO 1 HR	$1,075.80	$1,956.00	$438.70–$909.54	41% above	45%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADMIN INFUS TECH UP TO 1 HR	$1,075.80	$1,956.00	$438.70–$909.54	—	45%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 1ST 30-74 MIN	$4,403.30	$8,006.00	$1,097.10–$3,802.85	50% above	45%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 1ST 30-74 MIN	$4,403.30	$8,006.00	$1,097.10–$3,802.85	—	45%
EEG (brain wave test), awake and drowsy, routine CPT 95816 NR EEG AWAKE & DROWSY 20-40 MINS	$1,629.10	$2,962.00	$286.78–$1,406.95	71% above	45%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 NR EEG AWAKE & DROWSY 20-40 MINS	$1,629.10	$2,962.00	$286.78–$1,406.95	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CR EKG	$413.60	$752.00	$78.35–$357.20	123% above	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ST EKG	$413.60	$752.00	$78.35–$357.20	123% above	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ST EKG	$413.60	$752.00	$78.35–$357.20	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CR EKG	$413.60	$752.00	$78.35–$357.20	—	45%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY SERVICE - LEVEL 1	$696.85	$1,267.00	$112.00–$1,143.00	123% above	45%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY SERVICE - LEVEL 1	$696.85	$1,267.00	$112.00–$1,143.00	—	45%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY SERVICE - LEVEL 2	$905.30	$1,646.00	$203.93–$1,290.00	78% above	45%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY SERVICE - LEVEL 2	$905.30	$1,646.00	$203.93–$1,290.00	—	45%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY SERVICE - LEVEL 3	$1,114.30	$2,026.00	$362.56–$1,769.00	32% above	45%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY SERVICE - LEVEL 3	$1,114.30	$2,026.00	$362.56–$1,769.00	—	45%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY SERVICE - LEVEL 4	$1,810.05	$3,291.00	$554.19–$2,289.00	36% above	45%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY SERVICE - LEVEL 4	$1,810.05	$3,291.00	$554.19–$2,289.00	—	45%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY SERVICE - LEVEL 5	$2,645.50	$4,810.00	$790.96–$2,601.00	53% above	45%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY SERVICE - LEVEL 5	$2,645.50	$4,810.00	$790.96–$2,601.00	—	45%
Exercise stress test, tracing only, the hospital charge CPT 93017 CR STRESS CARDIOLITE - TRACING ONLY	$1,365.10	$2,482.00	$286.78–$1,178.95	52% above	45%
Exercise stress test, tracing only, the hospital charge CPT 93017 CR STRESS DOBUTAMINE - TRACING ONLY	$1,365.10	$2,482.00	$286.78–$1,178.95	52% above	45%
Exercise stress test, tracing only, the hospital charge CPT 93017 CR STRESS TEST - TRACING ONLY	$1,365.10	$2,482.00	$286.78–$1,178.95	52% above	45%
Exercise stress test, tracing only, the hospital charge CPT 93017 CR STRESS DIPYRIDAMOLE - TRACING ONLY	$1,365.10	$2,482.00	$286.78–$1,178.95	52% above	45%
Exercise stress test, tracing only, the hospital charge CPT 93017 CR STRESS LEXISCAN - TRACING ONLY	$1,365.10	$2,482.00	$286.78–$1,178.95	52% above	45%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CR STRESS CARDIOLITE - TRACING ONLY	$1,365.10	$2,482.00	$286.78–$1,178.95	—	45%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CR STRESS LEXISCAN - TRACING ONLY	$1,365.10	$2,482.00	$286.78–$1,178.95	—	45%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CR STRESS TEST - TRACING ONLY	$1,365.10	$2,482.00	$286.78–$1,178.95	—	45%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CR STRESS DIPYRIDAMOLE - TRACING ONLY	$1,365.10	$2,482.00	$286.78–$1,178.95	—	45%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CR STRESS DOBUTAMINE - TRACING ONLY	$1,365.10	$2,482.00	$286.78–$1,178.95	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OUTPT IV INFUS HYDRA 1ST HR	$347.05	$631.00	$164.06–$492.13	17% below	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION 1ST HR	$874.50	$1,590.00	$282.50–$755.25	109% above	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION INFUSION UP TO 1 HR	$881.10	$1,602.00	$282.50–$760.95	111% above	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ST IV INFUSION HYDRATION 1ST HR	$881.10	$1,602.00	$282.50–$760.95	111% above	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 CT-IV HYDRATION 1ST 31-60 MINS	$881.10	$1,602.00	$282.50–$760.95	111% above	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 OUTPT IV INFUS HYDRA 1ST HR	$347.05	$631.00	$164.06–$492.13	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION 1ST HR	$874.50	$1,590.00	$282.50–$755.25	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ST IV INFUSION HYDRATION 1ST HR	$881.10	$1,602.00	$282.50–$760.95	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION INFUSION UP TO 1 HR	$881.10	$1,602.00	$282.50–$760.95	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 CT-IV HYDRATION 1ST 31-60 MINS	$881.10	$1,602.00	$282.50–$760.95	—	45%
IV infusion of a medicine, first hour CPT 96365 OUTPT IV INFUS THER/DX 1ST H	$875.60	$1,592.00	$282.50–$756.20	102% above	45%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THER/PROPH/DX1ST 1ST HOUR	$916.85	$1,667.00	$282.50–$791.83	112% above	45%
IV infusion of a medicine, first hour CPT 96365 IVIG INFUSION UP TO 1 HR	$916.85	$1,667.00	$282.50–$791.83	112% above	45%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT =<1 HR	$916.85	$1,667.00	$282.50–$791.83	112% above	45%
IV infusion of a medicine, first hour inpatient CPT 96365 OUTPT IV INFUS THER/DX 1ST H	$875.60	$1,592.00	$282.50–$756.20	—	45%
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INIT =<1 HR	$916.85	$1,667.00	$282.50–$791.83	—	45%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THER/PROPH/DX1ST 1ST HOUR	$916.85	$1,667.00	$282.50–$791.83	—	45%
IV infusion of a medicine, first hour inpatient CPT 96365 IVIG INFUSION UP TO 1 HR	$916.85	$1,667.00	$282.50–$791.83	—	45%
IV push of a medicine, first drug CPT 96374 INJ IV PUSH INITIAL DRUG	$469.70	$854.00	$222.04–$492.13	93% above	45%
IV push of a medicine, first drug CPT 96374 SU INJ IV PUSH INITIAL DRUG	$480.70	$874.00	$227.24–$492.13	97% above	45%
IV push of a medicine, first drug CPT 96374 ACTH STIMULATION TEST INJ ONLY	$480.70	$874.00	$227.24–$492.13	97% above	45%
IV push of a medicine, first drug CPT 96374 INJ IV PUSH THER PROPH INITIAL SUBSTANCE	$480.70	$874.00	$227.24–$492.13	97% above	45%
IV push of a medicine, first drug inpatient CPT 96374 INJ IV PUSH INITIAL DRUG	$469.70	$854.00	$222.04–$492.13	—	45%
IV push of a medicine, first drug inpatient CPT 96374 SU INJ IV PUSH INITIAL DRUG	$480.70	$874.00	$227.24–$492.13	—	45%
IV push of a medicine, first drug inpatient CPT 96374 INJ IV PUSH THER PROPH INITIAL SUBSTANCE	$480.70	$874.00	$227.24–$492.13	—	45%
IV push of a medicine, first drug inpatient CPT 96374 ACTH STIMULATION TEST INJ ONLY	$480.70	$874.00	$227.24–$492.13	—	45%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM OR SUBQ	$392.70	$714.00	$95.63–$339.15	177% above	45%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM OR SUBQ	$392.70	$714.00	$95.63–$339.15	177% above	45%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM / SQ THER/PROPH/DIAG	$392.70	$714.00	$95.63–$339.15	177% above	45%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ IM / SQ THER/PROPH/DIAG	$392.70	$714.00	$95.63–$339.15	—	45%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ IM OR SUBQ	$392.70	$714.00	$95.63–$339.15	—	45%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM OR SUBQ	$392.70	$714.00	$95.63–$339.15	—	45%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NR MOT&/SENS 7-8 NRV CNDJ TST	$803.55	$1,461.00	$379.86–$863.36	42% below	45%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV COND TEST 7-8 STUDIES	$803.55	$1,461.00	$379.86–$863.36	42% below	45%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NRV COND TEST 7-8 STUDIES	$803.55	$1,461.00	$379.86–$863.36	—	45%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NR MOT&/SENS 7-8 NRV CNDJ TST	$803.55	$1,461.00	$379.86–$863.36	—	45%
New patient office visit, about 30 minutes CPT 99203 OV NEW PT LEVEL 3 M25	$228.25	$415.00	$107.90–$197.13	108% above	45%
New patient office visit, about 30 minutes CPT 99203 SP OV NEW PT LEVEL 3	$228.25	$415.00	$107.90–$197.13	108% above	45%
New patient office visit, about 30 minutes CPT 99203 SU OV NEW PT LEVEL 3	$233.75	$425.00	$110.50–$144.50	113% above	45%
New patient office visit, about 30 minutes CPT 99203 OV NEW PAT LEVEL 3	$320.10	$582.00	$151.32–$276.45	192% above	45%
New patient office visit, about 30 minutes CPT 99203 OV NEW PT LEVEL 3	$336.05	$611.00	$158.86–$290.23	206% above	45%
New patient office visit, about 30 minutes inpatient CPT 99203 OV NEW PT LEVEL 3 M25	$228.25	$415.00	$107.90–$197.13	—	45%
New patient office visit, about 30 minutes inpatient CPT 99203 SP OV NEW PT LEVEL 3	$228.25	$415.00	$107.90–$197.13	—	45%
New patient office visit, about 30 minutes inpatient CPT 99203 SU OV NEW PT LEVEL 3	$233.75	$425.00	$110.50–$144.50	—	45%
New patient office visit, about 30 minutes inpatient CPT 99203 OV NEW PAT LEVEL 3	$320.10	$582.00	$151.32–$276.45	—	45%
New patient office visit, about 30 minutes inpatient CPT 99203 OV NEW PT LEVEL 3	$336.05	$611.00	$158.86–$290.23	—	45%
New patient office visit, about 45 minutes CPT 99204 OV NEW PT LEVEL 4 M25	$267.30	$486.00	$126.36–$230.85	121% above	45%
New patient office visit, about 45 minutes CPT 99204 SP OV NEW PT LEVEL 4	$267.30	$486.00	$126.36–$230.85	121% above	45%
New patient office visit, about 45 minutes CPT 99204 SU OV NEW PT LEVEL 4	$274.45	$499.00	$129.74–$169.66	126% above	45%
New patient office visit, about 45 minutes CPT 99204 OV NEW PT LEVEL 4	$393.80	$716.00	$186.16–$340.10	225% above	45%
New patient office visit, about 45 minutes CPT 99204 OV NEW PT LEVEL 5	$459.25	$835.00	$217.10–$396.63	279% above	45%
New patient office visit, about 45 minutes inpatient CPT 99204 OV NEW PT LEVEL 4 M25	$267.30	$486.00	$126.36–$230.85	—	45%
New patient office visit, about 45 minutes inpatient CPT 99204 SP OV NEW PT LEVEL 4	$267.30	$486.00	$126.36–$230.85	—	45%
New patient office visit, about 45 minutes inpatient CPT 99204 SU OV NEW PT LEVEL 4	$274.45	$499.00	$129.74–$169.66	—	45%
New patient office visit, about 45 minutes inpatient CPT 99204 OV NEW PT LEVEL 4	$393.80	$716.00	$186.16–$340.10	—	45%
New patient office visit, about 45 minutes inpatient CPT 99204 OV NEW PT LEVEL 5	$459.25	$835.00	$217.10–$396.63	—	45%
New patient office visit, about 60 minutes CPT 99205 OV NEW PT LEVEL 5 M25	$312.40	$568.00	$147.68–$269.80	81% above	45%
New patient office visit, about 60 minutes CPT 99205 SP OV NEW PT LEVEL 5	$312.40	$568.00	$147.68–$269.80	81% above	45%
New patient office visit, about 60 minutes CPT 99205 SU OV NEW PT LEVEL 5	$321.20	$584.00	$151.84–$198.56	86% above	45%
New patient office visit, about 60 minutes CPT 99205 OV NEW PT LEVEL 5	$459.25	$835.00	$217.10–$396.63	166% above	45%
New patient office visit, about 60 minutes inpatient CPT 99205 SP OV NEW PT LEVEL 5	$312.40	$568.00	$147.68–$269.80	—	45%
New patient office visit, about 60 minutes inpatient CPT 99205 OV NEW PT LEVEL 5 M25	$312.40	$568.00	$147.68–$269.80	—	45%
New patient office visit, about 60 minutes inpatient CPT 99205 SU OV NEW PT LEVEL 5	$321.20	$584.00	$151.84–$198.56	—	45%
New patient office visit, about 60 minutes inpatient CPT 99205 OV NEW PT LEVEL 5	$459.25	$835.00	$217.10–$396.63	—	45%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 SP OV NEW PT LEVEL 2	$194.70	$354.00	$92.04–$168.15	99% above	45%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OV NEW PT LEVEL 2 M25	$194.70	$354.00	$92.04–$168.15	99% above	45%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 SU OV NEW PT LEVEL 2	$199.65	$363.00	$94.38–$123.42	104% above	45%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OV NEW PT LEVEL 2	$248.60	$452.00	$117.52–$214.70	154% above	45%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OV NEW PT LEVEL 2 M25	$194.70	$354.00	$92.04–$168.15	—	45%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 SP OV NEW PT LEVEL 2	$194.70	$354.00	$92.04–$168.15	—	45%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 SU OV NEW PT LEVEL 2	$199.65	$363.00	$94.38–$123.42	—	45%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OV NEW PT LEVEL 2	$248.60	$452.00	$117.52–$214.70	—	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INTL ASSESSMNT EA 15 MIN	$80.30	$146.00	$37.96–$69.35	23% above	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INTL ASSESSMNT EA 15 MIN	$80.30	$146.00	$37.96–$69.35	—	45%
Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW AGE 18-39	$412.50	$750.00	$195.00–$356.25	245% above	45%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PREV VISIT NEW AGE 18-39	$412.50	$750.00	$195.00–$356.25	—	45%
Preventive checkup, new patient aged 40–64 CPT 99386 PREV VISIT NEW AGE 40-64	$499.40	$908.00	$236.08–$431.30	236% above	45%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREV VISIT NEW AGE 40-64	$499.40	$908.00	$236.08–$431.30	—	45%
Preventive checkup, new patient aged 65 or older CPT 99387 INIT PM E/M NEW PAT 65+ YRS	$535.70	$974.00	$253.24–$462.65	241% above	45%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 INIT PM E/M NEW PAT 65+ YRS	$535.70	$974.00	$253.24–$462.65	—	45%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREV VISIT EST AGE 18-39	$375.10	$682.00	$177.32–$323.95	198% above	45%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PREV VISIT EST AGE 18-39	$375.10	$682.00	$177.32–$323.95	—	45%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREV VISIT EST AGE 40-64	$406.45	$739.00	$192.14–$351.03	204% above	45%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PREV VISIT EST AGE 40-64	$406.45	$739.00	$192.14–$351.03	—	45%
Preventive checkup, returning patient aged 65 or older CPT 99397 PER PM RE-EVAL EST PAT 65+ YR	$429.00	$780.00	$202.80–$370.50	218% above	45%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PER PM RE-EVAL EST PAT 65+ YR	$429.00	$780.00	$202.80–$370.50	—	45%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$54.45	$99.00	$25.74–$86.68	24% above	45%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$54.45	$99.00	$25.74–$86.68	—	45%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SP OV EST PT LEVEL 5	$284.35	$517.00	$134.42–$245.58	69% above	45%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OV EST PT LEVEL 5 M25	$284.35	$517.00	$134.42–$245.58	69% above	45%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SU OV EST PT LEVEL 5	$291.50	$530.00	$137.80–$180.20	73% above	45%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OV EST PT LEVEL 5	$418.55	$761.00	$197.86–$361.48	148% above	45%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OV EST PAT LEVEL 5	$418.55	$761.00	$197.86–$361.48	148% above	45%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PAT LEVEL 5	$752.40	$1,368.00	$355.68–$649.80	346% above	45%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SP OV EST PT LEVEL 5	$284.35	$517.00	$134.42–$245.58	—	45%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OV EST PT LEVEL 5 M25	$284.35	$517.00	$134.42–$245.58	—	45%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SU OV EST PT LEVEL 5	$291.50	$530.00	$137.80–$180.20	—	45%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OV EST PAT LEVEL 5	$418.55	$761.00	$197.86–$361.48	—	45%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OV EST PT LEVEL 5	$418.55	$761.00	$197.86–$361.48	—	45%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST PAT LEVEL 5	$752.40	$1,368.00	$355.68–$649.80	—	45%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OV EST PT LEVEL 3 M25	$207.35	$377.00	$98.02–$179.08	80% above	45%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SP OV EST PT LEVEL 3	$207.35	$377.00	$98.02–$179.08	80% above	45%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SU OV EST PT LEVEL 3	$212.85	$387.00	$100.62–$131.58	85% above	45%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OV EST PT LEVEL 3	$305.80	$556.00	$144.56–$264.10	165% above	45%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PAT LEVEL 3	$409.20	$744.00	$193.44–$353.40	255% above	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OV EST PT LEVEL 3 M25	$207.35	$377.00	$98.02–$179.08	—	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SP OV EST PT LEVEL 3	$207.35	$377.00	$98.02–$179.08	—	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SU OV EST PT LEVEL 3	$212.85	$387.00	$100.62–$131.58	—	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OV EST PT LEVEL 3	$305.80	$556.00	$144.56–$264.10	—	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST PAT LEVEL 3	$409.20	$744.00	$193.44–$353.40	—	45%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SP OV EST PT LEVEL 4	$242.00	$440.00	$114.40–$209.00	77% above	45%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OV EST PT LEVEL 4 M25	$242.00	$440.00	$114.40–$209.00	77% above	45%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SU OV EST PT LEVEL 4	$248.60	$452.00	$117.52–$153.68	82% above	45%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OV EST PT LEVEL 4	$357.50	$650.00	$169.00–$308.75	161% above	45%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PAT LEVEL 4	$536.25	$975.00	$253.50–$463.13	292% above	45%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SP OV EST PT LEVEL 4	$242.00	$440.00	$114.40–$209.00	—	45%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OV EST PT LEVEL 4 M25	$242.00	$440.00	$114.40–$209.00	—	45%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SU OV EST PT LEVEL 4	$248.60	$452.00	$117.52–$153.68	—	45%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OV EST PT LEVEL 4	$357.50	$650.00	$169.00–$308.75	—	45%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EST PAT LEVEL 4	$536.25	$975.00	$253.50–$463.13	—	45%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SP OV EST PT LEVEL 2	$177.65	$323.00	$83.98–$153.43	82% above	45%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OV EST PT LEVEL 2 M25	$177.65	$323.00	$83.98–$153.43	82% above	45%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SU OV EST PT LEVEL 2	$181.50	$330.00	$85.80–$112.20	86% above	45%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OV EST PT LEVEL 2	$227.15	$413.00	$107.38–$196.18	132% above	45%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PAT LEVEL 2	$349.80	$636.00	$165.36–$302.10	258% above	45%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SP OV EST PT LEVEL 2	$177.65	$323.00	$83.98–$153.43	—	45%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OV EST PT LEVEL 2 M25	$177.65	$323.00	$83.98–$153.43	—	45%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SU OV EST PT LEVEL 2	$181.50	$330.00	$85.80–$112.20	—	45%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OV EST PT LEVEL 2	$227.15	$413.00	$107.38–$196.18	—	45%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST PAT LEVEL 2	$349.80	$636.00	$165.36–$302.10	—	45%
Spirometry (breathing test) CPT 94010 RT SPIROGRAM	$517.55	$941.00	$244.66–$499.58	67% above	45%
Spirometry (breathing test) CPT 94010 SU SPIROMETRY	$517.55	$941.00	$244.66–$499.58	67% above	45%
Spirometry (breathing test) inpatient CPT 94010 RT SPIROGRAM	$517.55	$941.00	$244.66–$499.58	—	45%
Spirometry (breathing test) inpatient CPT 94010 SU SPIROMETRY	$517.55	$941.00	$244.66–$499.58	—	45%
Spirometry before and after a bronchodilator CPT 94060 RT BRONCHOSPASM EVALUATION	$880.55	$1,601.00	$416.26–$863.36	54% above	45%
Spirometry before and after a bronchodilator inpatient CPT 94060 RT BRONCHOSPASM EVALUATION	$880.55	$1,601.00	$416.26–$863.36	—	45%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHELBOTOMY	$466.95	$849.00	$176.71–$403.28	97% above	45%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY - THERAPEUTIC	$466.95	$849.00	$176.71–$403.28	97% above	45%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY - THERAPEUTIC	$466.95	$849.00	$176.71–$403.28	—	45%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHELBOTOMY	$466.95	$849.00	$176.71–$403.28	—	45%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLU VACC TS2024(65UP)/MF59C/PF 45MCG/.5M	$457.05	$831.00	$98.16–$235.58	509% above	45%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLU VACC TS2024(65UP)/MF59C/PF 45MCG/.5M	$457.05	$831.00	$98.16–$235.58	—	45%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 SQ LIVE VARICELLA VACCINE	$731.50	$1,330.00	$345.80	103% above	45%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 SQ LIVE VARICELLA VACCINE	$731.50	$1,330.00	$345.80	—	45%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VAC 4-6YR IM VFC	$12.10	$22.00	$5.72–$10.45	91% below	45%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIPH, PERTUS, TET, POL (KINRIX)	$421.85	$767.00	$199.42	227% above	45%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP-IPV VAC 4-6YR IM VFC	$12.10	$22.00	$5.72–$10.45	—	45%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DIPH, PERTUS, TET, POL (KINRIX)	$421.85	$767.00	$199.42	—	45%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 SP DTAP IMMUNIZATION <7YR VFC	$12.10	$22.00	$5.72–$10.45	82% below	45%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPPH, PERTUSS, TETAN (INFANRIX)	$199.65	$363.00	$94.38	204% above	45%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 SP DTAP IMMUNIZATION <7YR VFC	$12.10	$22.00	$5.72–$10.45	—	45%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPPH, PERTUSS, TETAN (INFANRIX)	$199.65	$363.00	$94.38	—	45%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PENTACEL VACCINE	$777.15	$1,413.00	$367.38	389% above	45%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 PENTACEL VACCINE	$777.15	$1,413.00	$367.38	—	45%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACC, TRIVALENT (IIV3)	$141.90	$258.00	$23.22–$67.08	210% above	45%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VIRUS VACC, TRIVALENT (IIV3)	$141.90	$258.00	$23.22–$67.08	—	45%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV VACCINE 9-VALENT (GARDASIL 9)	$2,156.55	$3,921.00	$1,019.46	316% above	45%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV VACCINE 9-VALENT (GARDASIL 9)	$2,156.55	$3,921.00	$1,019.46	—	45%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE (HAVRIX)	$576.40	$1,048.00	$73.73–$272.48	197% above	45%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VIRUS VACCINE (HAVRIX)	$576.40	$1,048.00	$73.73–$272.48	—	45%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 SP HEPATITIS A PED/2 D SCH VFC	$12.10	$22.00	$5.72–$10.45	87% below	45%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (VAQTA)	$256.85	$467.00	$121.42	186% above	45%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 SP HEPATITIS A PED/2 D SCH VFC	$12.10	$22.00	$5.72–$10.45	—	45%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VIRUS VACCINE (VAQTA)	$256.85	$467.00	$121.42	—	45%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VIRUS VACC (RECOMBIVAX HB) ADULT	$385.00	$700.00	$75.15–$182.00	146% above	45%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VIRUS VACCINE (ENGERIX-B)	$483.45	$879.00	$75.15–$228.54	209% above	45%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VIRUS VACC (RECOMBIVAX HB) ADULT	$385.00	$700.00	$75.15–$182.00	—	45%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VIRUS VACCINE (ENGERIX-B)	$483.45	$879.00	$75.15–$228.54	—	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 SP HEP PED/ADOL/3 DOS SC VFC	$12.10	$22.00	$5.72–$43.17	80% below	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEP B VIRUS VACC (ENGERIX-B PEDIATRIC)	$155.10	$282.00	$33.20–$79.69	155% above	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEP B VIRUS VACC (RECOMBIVAX HB) PED	$168.85	$307.00	$33.20–$79.82	178% above	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 SP HEP PED/ADOL/3 DOS SC VFC	$12.10	$22.00	$5.72–$43.17	—	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEP B VIRUS VACC (ENGERIX-B PEDIATRIC)	$155.10	$282.00	$33.20–$79.69	—	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEP B VIRUS VACC (RECOMBIVAX HB) PED	$168.85	$307.00	$33.20–$79.82	—	45%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMPH B-MENIN (PEDVAXHIB)	$207.35	$377.00	$98.02	195% above	45%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMPH B-MENIN (PEDVAXHIB)	$207.35	$377.00	$98.02	—	45%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES MUMPS RUB VACC (M-M-R II)	$644.05	$1,171.00	$304.46	209% above	45%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES MUMPS RUB VACC (M-M-R II)	$644.05	$1,171.00	$304.46	—	45%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEASLES MUMPS RUB VARIC (PROQUAD)	$2,030.60	$3,692.00	$959.92	297% above	45%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLES MUMPS RUB VARIC (PROQUAD)	$2,030.60	$3,692.00	$959.92	—	45%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL A-C-Y-W-135 IM (MENVEO)	$1,118.15	$2,033.00	$528.58	253% above	45%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL A-C-Y-W-135 IM (MENVEO)	$1,118.15	$2,033.00	$528.58	—	45%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL VAC (MENQUADFI)	$1,080.75	$1,965.00	$510.90	170% above	45%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL VAC (MENQUADFI)	$1,080.75	$1,965.00	$510.90	—	45%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENNINGOCOCCAL B VAC 4-CMP (BEXSERO)	$1,525.70	$2,774.00	$721.24	175% above	45%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENNINGOCOCCAL B VAC 4-CMP (BEXSERO)	$1,525.70	$2,774.00	$721.24	—	45%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE IM 0.5 ML SDV	$1,780.35	$3,237.00	$312.90–$841.62	169% above	45%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PCV20 VACCINE IM 0.5 ML SDV	$1,780.35	$3,237.00	$312.90–$841.62	—	45%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE 23 VALENT >2 YRS SQ	$850.30	$1,546.00	$133.47–$401.96	209% above	45%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE 23 VALENT >2 YRS SQ	$850.30	$1,546.00	$133.47–$401.96	—	45%
Polio vaccine, inactivated (IPV) CPT 90713 SP POLIOMYELITIS IMMUNIZATION VFC	$12.10	$22.00	$5.72–$10.45	80% below	45%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE	$141.90	$258.00	$67.08	131% above	45%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 SP POLIOMYELITIS IMMUNIZATION VFC	$12.10	$22.00	$5.72–$10.45	—	45%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE	$141.90	$258.00	$67.08	—	45%
Rabies vaccine, one dose CPT 90675 IM RABIES VACCINE	$2,787.40	$5,068.00	$315.22–$1,317.68	192% above	45%
Rabies vaccine, one dose inpatient CPT 90675 IM RABIES VACCINE	$2,787.40	$5,068.00	$315.22–$1,317.68	—	45%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACCINE	$667.70	$1,214.00	$315.64	410% above	45%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VACCINE	$667.70	$1,214.00	$315.64	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPHTHERIA-TETANUS TOXOID	$130.90	$238.00	$38.75–$92.99	46% above	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIPHTHERIA-TETANUS TOXOID	$130.90	$238.00	$38.75–$92.99	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 SP DTAP>= 7 VFC	$12.10	$22.00	$5.72–$51.32	89% below	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH, PERTUSS, TETAN (BOOSTRIX)	$327.25	$595.00	$39.48–$154.70	196% above	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH, PERTUSS, TET VACC (ADACEL)	$333.30	$606.00	$39.48–$157.56	202% above	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 SP DTAP>= 7 VFC	$12.10	$22.00	$5.72–$51.32	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPH, PERTUSS, TETAN (BOOSTRIX)	$327.25	$595.00	$39.48–$154.70	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPH, PERTUSS, TET VACC (ADACEL)	$333.30	$606.00	$39.48–$157.56	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ST IMMUN ADMIN 1 VACC/TOXOID	$89.65	$163.00	$42.38–$166.59	134% above	45%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN INITIAL VACC	$89.65	$163.00	$42.38–$166.59	134% above	45%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUN ADMIN 1 VACC/TOX	$89.65	$163.00	$42.38–$166.59	134% above	45%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin IMMUN 1 VACC/TOX	$89.65	$163.00	$42.38–$166.59	134% above	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN INITIAL VACC	$89.65	$163.00	$42.38–$166.59	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUN ADMIN 1 VACC/TOX	$89.65	$163.00	$42.38–$166.59	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Admin IMMUN 1 VACC/TOX	$89.65	$163.00	$42.38–$166.59	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ST IMMUN ADMIN 1 VACC/TOXOID	$89.65	$163.00	$42.38–$166.59	—	45%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN EA ADD	$59.95	$109.00	$28.34–$51.78	72% above	45%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN EACH ADDL IMMUN/VAC	$70.95	$129.00	$33.54–$61.28	104% above	45%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD�L VACC	$70.95	$129.00	$33.54–$61.28	104% above	45%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADMIN EA ADD	$59.95	$109.00	$28.34–$51.78	—	45%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADD�L VACC	$70.95	$129.00	$33.54–$61.28	—	45%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN EACH ADDL IMMUN/VAC	$70.95	$129.00	$33.54–$61.28	—	45%

Source file: https://hospitalpricetransparencyfiles.com/western-reserve-llc/263536780_western-reserve-llc_standardcharges.csv