Hospital Portland-Vancouver-Hillsboro, OR-WA

Providence Willamette Falls Medical Center

Listed in its price file as “Providence Health and Services - Oregon”.

Providence Willamette Falls Medical Center in Oregon City, OR publishes cash prices for 403 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Oregon median for 189 of 400 procedures and above it for 158. By typical cash price it ranks #26 of 49 Oregon hospitals and #10 of 16 hospitals in the Portland, OR area, cheapest first. Select a procedure to compare it with other hospitals nearby.

1500 Division St, Oregon City, OR 97045 Collected Sep 23, 2026 Source price file Check a bill from this hospital (503) 656-1631

Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 380038 · CMS hospital register NPI 1912282369

Financial assistance

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

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

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

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

State law

This state limits hospital bills for lower-income patients

Oregon law (ORS 442.614) requires nonprofit hospitals to cut what patients owe for medically necessary care by 100% for household income up to 200% of the federal poverty level, and by at least 75%, 50% or 25% up to 400%. Ask the hospital for its financial assistance application. Other states' laws.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Oregon	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W & W/O CONTRAST	$1,227.75	$1,637.00	—	30% below	25%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W & W/O CONTRAST	$1,227.75	$1,637.00	—	—	25%
Abdominal X-ray, 2 views CPT 74019 HC XR ABDOMEN 2 VIEWS	$292.50	$390.00	—	1% below	25%
Abdominal X-ray, 2 views inpatient CPT 74019 HC XR ABDOMEN 2 VIEWS	$292.50	$390.00	—	—	25%
Ankle X-ray, complete, 3 or more views CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS	$246.75	$329.00	—	12% below	25%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS	$246.75	$329.00	—	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC PR 93922 ABI BILAT LTD W DOPP	$235.50	$314.00	—	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$702.00	$936.00	—	35% above	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC PR 93922 ABI BILAT LTD W DOPP	$235.50	$314.00	—	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$702.00	$936.00	—	—	25%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$633.00	$844.00	—	44% below	25%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$633.00	$844.00	—	—	25%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XR ESOPHAGUS W CONTRAST	$747.00	$996.00	—	34% above	25%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC XR ESOPHAGUS W CONTRAST	$747.00	$996.00	—	—	25%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE AND OR JOINT IMAGING WHOLE BODY CDM	$1,483.50	$1,978.00	—	5% above	25%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE AND OR JOINT IMAGING WHOLE BODY CDM	$1,483.50	$1,978.00	—	—	25%
Breast ultrasound, complete, one breast CPT 76641 HC US BREAST UNI COMPLETE	$357.00	$476.00	—	1% below	25%
Breast ultrasound, complete, one breast inpatient CPT 76641 HC US BREAST UNI COMPLETE	$357.00	$476.00	—	—	25%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US ED BREAST UNI LIMITED CDM	$274.50	$366.00	—	10% below	25%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US BREAST UNI LIMITED	$357.00	$476.00	—	17% above	25%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US ED BREAST UNI LIMITED CDM	$274.50	$366.00	—	—	25%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US BREAST UNI LIMITED	$357.00	$476.00	—	—	25%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN PELVIS	$2,331.75	$3,109.00	—	6% below	25%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CTA ABDOMEN PELVIS	$2,331.75	$3,109.00	—	—	25%
CT angiography (CTA) of the head CPT 70496 HC CT ANGIOGRAPHY HEAD W CONTRAST	$1,726.50	$2,302.00	—	11% below	25%
CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIOGRAPHY HEAD W CONTRAST	$1,726.50	$2,302.00	—	—	25%
CT angiography (CTA) of the neck CPT 70498 HC CT ANGIOGRAPHY NECK W CONTRAST	$1,733.25	$2,311.00	—	10% below	25%
CT angiography (CTA) of the neck inpatient CPT 70498 HC CT ANGIOGRAPHY NECK W CONTRAST	$1,733.25	$2,311.00	—	—	25%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST	$1,367.25	$1,823.00	—	26% below	25%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIOGRAPHY CHEST	$1,367.25	$1,823.00	—	—	25%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CCTA HEART ARTERIES/GRAFTS W/3D IMAGE W/ CONTRAST	$1,143.00	$1,524.00	—	18% below	25%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CCTA HEART ARTERIES/GRAFTS W/3D IMAGE W/ CONTRAST	$1,143.00	$1,524.00	—	—	25%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CCTA HEART W/ CALCIUM SCORING W/O CONTRAST	$75.75	$101.00	—	35% below	25%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CCTA HEART W/ CALCIUM SCORING W/O CONTRAST	$75.75	$101.00	—	—	25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$1,628.25	$2,171.00	—	23% below	25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$1,628.25	$2,171.00	—	—	25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$2,220.75	$2,961.00	—	13% below	25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$2,220.75	$2,961.00	—	—	25%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST	$2,253.75	$3,005.00	—	26% below	25%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST	$2,253.75	$3,005.00	—	—	25%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST	$882.75	$1,177.00	—	40% below	25%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W CONTRAST	$882.75	$1,177.00	—	—	25%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST	$600.00	$800.00	—	47% below	25%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN WO CONTRAST	$600.00	$800.00	—	—	25%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL W/O DYE LIMITED	$671.25	$895.00	—	38% below	25%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$671.25	$895.00	—	38% below	25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$671.25	$895.00	—	—	25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL W/O DYE LIMITED	$671.25	$895.00	—	—	25%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN WO CONTRAST	$492.00	$656.00	—	51% below	25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN WO CONTRAST	$492.00	$656.00	—	—	25%
CT scan of the head with contrast CPT 70460 HC CT HEAD/BRAIN W CONTRAST	$645.75	$861.00	—	51% below	25%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD/BRAIN W CONTRAST	$645.75	$861.00	—	—	25%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST	$793.50	$1,058.00	—	50% below	25%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST	$793.50	$1,058.00	—	—	25%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$640.50	$854.00	—	51% below	25%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$640.50	$854.00	—	—	25%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT NECK SPINE WO CONTRAST	$644.25	$859.00	—	47% below	25%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT NECK SPINE WO CONTRAST	$644.25	$859.00	—	—	25%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST	$910.50	$1,214.00	—	38% below	25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST	$910.50	$1,214.00	—	—	25%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC PR 93880 DUPLEX EXTRACRANIAL STUDY BILAT	$539.25	$719.00	—	—	25%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$1,388.25	$1,851.00	—	—	25%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC PR 93880 DUPLEX EXTRACRANIAL STUDY BILAT	$539.25	$719.00	—	—	25%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$1,388.25	$1,851.00	—	—	25%
Chest CT scan without and with contrast CPT 71270 HC CT THORAX W & W/O CONTRAST	$1,014.00	$1,352.00	—	47% below	25%
Chest CT scan without and with contrast inpatient CPT 71270 HC CT THORAX W & W/O CONTRAST	$1,014.00	$1,352.00	—	—	25%
Chest X-ray, 2 views CPT 71046 HC XR CHEST 2 VIEWS	$198.00	$264.00	—	27% below	25%
Chest X-ray, 2 views inpatient CPT 71046 HC XR CHEST 2 VIEWS	$198.00	$264.00	—	—	25%
Chest X-ray, single view CPT 71045 HC XR CHEST PORTABLE 1 VIEW	$175.50	$234.00	—	30% below	25%
Chest X-ray, single view CPT 71045 HC XR CHEST 1 VIEW	$175.50	$234.00	—	30% below	25%
Chest X-ray, single view inpatient CPT 71045 HC XR CHEST 1 VIEW	$175.50	$234.00	—	—	25%
Chest X-ray, single view inpatient CPT 71045 HC XR CHEST PORTABLE 1 VIEW	$175.50	$234.00	—	—	25%
Collarbone (clavicle) X-ray, complete CPT 73000 HC XR CLAVICLE COMPLETE	$172.50	$230.00	—	20% below	25%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC XR CLAVICLE COMPLETE	$172.50	$230.00	—	—	25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$465.75	$621.00	—	18% below	25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE	$465.75	$621.00	—	—	25%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC XR DXA BONE DENSITY STUDY AXIAL	$307.50	$410.00	—	20% below	25%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC XR DXA BONE DENSITY STUDY AXIAL	$307.50	$410.00	—	—	25%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC BONE DENSITY PERIPHERAL SKELETON	$155.25	$207.00	—	38% below	25%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC BONE DENSITY PERIPHERAL SKELETON	$155.25	$207.00	—	—	25%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US OB DETAILED SINGLE FETUS CDM	$577.50	$770.00	—	9% below	25%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US OB DETAILED SINGLE FETUS CDM	$577.50	$770.00	—	—	25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX WO CONTRAST	$643.50	$858.00	—	47% below	25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX W/O DYE F/U LUNG SCREENING	$643.50	$858.00	—	47% below	25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX W/O DYE F/U LUNG SCREENING	$643.50	$858.00	—	—	25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX WO CONTRAST	$643.50	$858.00	—	—	25%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W CONTRAST	$803.25	$1,071.00	—	47% below	25%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT THORAX W CONTRAST	$803.25	$1,071.00	—	—	25%
Diagnostic mammogram, both breasts CPT 77066 HC MAMMO DIAG BIL W CAD	$428.25	$571.00	—	1% above	25%
Diagnostic mammogram, both breasts inpatient CPT 77066 HC MAMMO DIAG BIL W CAD	$428.25	$571.00	—	—	25%
Diagnostic mammogram, one breast CPT 77065 HC MAMMO DIAG UNI W CAD	$341.25	$455.00	—	9% above	25%
Diagnostic mammogram, one breast inpatient CPT 77065 HC MAMMO DIAG UNI W CAD	$341.25	$455.00	—	—	25%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC PR 93925 LE ARTERIAL DUPLEX BILAT	$679.50	$906.00	—	—	25%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$1,272.00	$1,696.00	—	—	25%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC PR 93925 LE ARTERIAL DUPLEX BILAT	$679.50	$906.00	—	—	25%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$1,272.00	$1,696.00	—	—	25%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC PR 93970 EXTREMITY STUDY VENOUS DUPLEX BILAT	$531.00	$708.00	—	—	25%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY	$1,507.50	$2,010.00	—	—	25%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC PR 93970 EXTREMITY STUDY VENOUS DUPLEX BILAT	$531.00	$708.00	—	—	25%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY	$1,507.50	$2,010.00	—	—	25%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC PR 93306 ECHO TTE 2D W/COLOR & DOP	$558.00	$744.00	—	67% below	25%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO TTE 2D W DOPPLER COMPLETE	$2,425.50	$3,234.00	—	43% above	25%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC PR 93306 ECHO TTE 2D W/COLOR & DOP	$558.00	$744.00	—	—	25%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO TTE 2D W DOPPLER COMPLETE	$2,425.50	$3,234.00	—	—	25%
Elbow X-ray, 2 views CPT 73070 HC XR ELBOW 2 VIEWS	$172.50	$230.00	—	29% below	25%
Elbow X-ray, 2 views CPT 73070 HC XR ELBOW LIMITED	$172.50	$230.00	—	29% below	25%
Elbow X-ray, 2 views inpatient CPT 73070 HC XR ELBOW 2 VIEWS	$172.50	$230.00	—	—	25%
Elbow X-ray, 2 views inpatient CPT 73070 HC XR ELBOW LIMITED	$172.50	$230.00	—	—	25%
Elbow X-ray, complete, 3 or more views CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS	$243.75	$325.00	—	at median	25%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS	$243.75	$325.00	—	—	25%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT/EAR/FOSSA WO CONTRAST	$837.75	$1,117.00	—	22% below	25%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT/EAR/FOSSA WO CONTRAST	$837.75	$1,117.00	—	—	25%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS	$270.00	$360.00	—	22% below	25%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS	$270.00	$360.00	—	—	25%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC XR FOREARM 2 VIEWS	$172.50	$230.00	—	35% below	25%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC XR FOREARM 1 VIEW	$172.50	$230.00	—	35% below	25%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC XR FOREARM 2 VIEWS	$172.50	$230.00	—	—	25%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC XR FOREARM 1 VIEW	$172.50	$230.00	—	—	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM HEPATOBILIARY SYSTEM	$2,079.00	$2,772.00	—	58% above	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NM HEPATOBILIARY SYSTEM	$2,079.00	$2,772.00	—	—	25%
Hand X-ray, 2 views CPT 73120 HC XR HAND 1 VIEW	$252.75	$337.00	—	3% above	25%
Hand X-ray, 2 views CPT 73120 HC XR HAND 2 VIEWS	$252.75	$337.00	—	3% above	25%
Hand X-ray, 2 views inpatient CPT 73120 HC XR HAND 2 VIEWS	$252.75	$337.00	—	—	25%
Hand X-ray, 2 views inpatient CPT 73120 HC XR HAND 1 VIEW	$252.75	$337.00	—	—	25%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC XR HEEL MIN 2 VIEWS	$169.50	$226.00	—	18% below	25%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC XR HEEL MIN 2 VIEWS	$169.50	$226.00	—	—	25%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP STUDY UNATT&RESP EFFT	$595.50	$794.00	—	at median	25%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP STUDY UNATT&RESP EFFT	$595.50	$794.00	—	—	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC PR 95811 POLYSOMNOGRAPHY W/CPAP	$1,891.50	$2,522.00	—	46% below	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAPHY W/CPAP REDUCED	$3,541.50	$4,722.00	—	1% above	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAPHY W/CPAP	$4,913.25	$6,551.00	—	39% above	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNO-CPAP/BIPAP-1 ON 1 PT	$4,913.25	$6,551.00	—	39% above	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC PR 95811 POLYSOMNOGRAPHY W/CPAP	$1,891.50	$2,522.00	—	—	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNOGRAPHY W/CPAP REDUCED	$3,541.50	$4,722.00	—	—	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNO-CPAP/BIPAP-1 ON 1 PT	$4,913.25	$6,551.00	—	—	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNOGRAPHY W/CPAP	$4,913.25	$6,551.00	—	—	25%
Knee X-ray, 3 views CPT 73562 HC XR KNEE 3 VIEWS	$246.75	$329.00	—	13% below	25%
Knee X-ray, 3 views inpatient CPT 73562 HC XR KNEE 3 VIEWS	$246.75	$329.00	—	—	25%
Knee X-ray, complete, 4 or more views CPT 73564 HC XR KNEE 4/PLUS VIEWS	$275.25	$367.00	—	23% below	25%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC XR KNEE 4/PLUS VIEWS	$275.25	$367.00	—	—	25%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$635.25	$847.00	—	42% below	25%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$635.25	$847.00	—	—	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ED ABDOMEN LIMITED CDM	$457.50	$610.00	—	7% below	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED	$594.75	$793.00	—	21% above	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ED ABDOMEN LIMITED CDM	$457.50	$610.00	—	—	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED	$594.75	$793.00	—	—	25%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US ED LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$285.75	$381.00	—	6% below	25%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$371.25	$495.00	—	22% above	25%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US ED LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$285.75	$381.00	—	—	25%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$371.25	$495.00	—	—	25%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX LW DOSE LNG CA SCR WO CONTRAST CDM	$271.50	$362.00	—	4% below	25%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT THORAX LW DOSE LNG CA SCR WO CONTRAST CDM	$271.50	$362.00	—	—	25%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR LOWER LEG LIMITED	$165.75	$221.00	—	33% below	25%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR LOWER LEG 2 VIEWS	$165.75	$221.00	—	33% below	25%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC XR LOWER LEG LIMITED	$165.75	$221.00	—	—	25%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC XR LOWER LEG 2 VIEWS	$165.75	$221.00	—	—	25%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD WO CONTRAST	$1,626.00	$2,168.00	—	13% below	25%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA HEAD WO CONTRAST	$1,626.00	$2,168.00	—	—	25%
MRI of both breasts, without and then with contrast dye CPT 77049 HC MRI BREAST W/O & W/ CONTRAST W/ CAD BIL	$2,274.00	$3,032.00	—	at median	25%
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 HC MRI BREAST W/O & W/ CONTRAST W/ CAD BIL	$2,274.00	$3,032.00	—	—	25%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE LIMITED	$1,408.50	$1,878.00	—	21% below	25%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST	$1,408.50	$1,878.00	—	21% below	25%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST	$1,408.50	$1,878.00	—	—	25%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE LIMITED	$1,408.50	$1,878.00	—	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST	$1,803.75	$2,405.00	—	32% below	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST	$1,803.75	$2,405.00	—	—	25%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN W/O DYE LIMITED	$1,266.00	$1,688.00	—	31% below	25%
MRI of the abdomen without contrast CPT 74181 HC MRI MRCP ABDOMEN WO CONTRAST	$1,266.00	$1,688.00	—	31% below	25%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST	$1,266.00	$1,688.00	—	31% below	25%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI MRCP ABDOMEN WO CONTRAST	$1,266.00	$1,688.00	—	—	25%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN WO CONTRAST	$1,266.00	$1,688.00	—	—	25%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN W/O DYE LIMITED	$1,266.00	$1,688.00	—	—	25%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN WO & W CONTRAST	$1,951.50	$2,602.00	—	33% below	25%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN WO & W CONTRAST	$1,951.50	$2,602.00	—	—	25%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN STEM W/O DYE	$1,486.50	$1,982.00	—	20% below	25%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O DYE LIMITED	$1,486.50	$1,982.00	—	20% below	25%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O DYE LIMITED	$1,486.50	$1,982.00	—	—	25%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN STEM W/O DYE	$1,486.50	$1,982.00	—	—	25%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/O & W/DYE	$1,898.25	$2,531.00	—	39% below	25%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W/O & W/DYE	$1,898.25	$2,531.00	—	—	25%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O DYE	$1,283.25	$1,711.00	—	31% below	25%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O DYE LIMITED	$1,283.25	$1,711.00	—	31% below	25%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O DYE LIMITED	$1,283.25	$1,711.00	—	—	25%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O DYE	$1,283.25	$1,711.00	—	—	25%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE	$1,857.75	$2,477.00	—	39% below	25%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE LIMITED	$1,857.75	$2,477.00	—	39% below	25%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE	$1,857.75	$2,477.00	—	—	25%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE LIMITED	$1,857.75	$2,477.00	—	—	25%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O DYE LIMITED	$1,284.00	$1,712.00	—	31% below	25%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O DYE	$1,284.00	$1,712.00	—	31% below	25%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE W/O DYE	$1,284.00	$1,712.00	—	—	25%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE W/O DYE LIMITED	$1,284.00	$1,712.00	—	—	25%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE LIMITED	$1,860.00	$2,480.00	—	35% below	25%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE	$1,860.00	$2,480.00	—	35% below	25%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE LIMITED	$1,860.00	$2,480.00	—	—	25%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE	$1,860.00	$2,480.00	—	—	25%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O DYE	$1,278.75	$1,705.00	—	29% below	25%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O DYE LIMITED	$1,278.75	$1,705.00	—	29% below	25%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O DYE LIMITED	$1,278.75	$1,705.00	—	—	25%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O DYE	$1,278.75	$1,705.00	—	—	25%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS WO & W CONTRAST	$1,949.25	$2,599.00	—	29% below	25%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS WO & W CONTRAST	$1,949.25	$2,599.00	—	—	25%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO CONTRAST	$1,464.75	$1,953.00	—	18% below	25%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS W/O DYE LIMITED	$1,464.75	$1,953.00	—	18% below	25%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS WO CONTRAST	$1,464.75	$1,953.00	—	—	25%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS W/O DYE LIMITED	$1,464.75	$1,953.00	—	—	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI JOINT UPR EXTREM W/O DYE LIMITED	$1,375.50	$1,834.00	—	23% below	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST	$1,375.50	$1,834.00	—	23% below	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI JOINT UPR EXTREM W/O DYE LIMITED	$1,375.50	$1,834.00	—	—	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST	$1,375.50	$1,834.00	—	—	25%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC XR SPINE CERVICAL 4 OR 5 VIEWS	$339.00	$452.00	—	10% below	25%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC XR SPINE CERVICAL 4 OR 5 VIEWS	$339.00	$452.00	—	—	25%
Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$1,072.50	$1,430.00	—	27% below	25%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$1,072.50	$1,430.00	—	—	25%
Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$636.00	$848.00	—	43% below	25%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$636.00	$848.00	—	—	25%
Neck soft tissue X-ray CPT 70360 HC XR NECK SOFT TISSUE	$156.75	$209.00	—	38% below	25%
Neck soft tissue X-ray inpatient CPT 70360 HC XR NECK SOFT TISSUE	$156.75	$209.00	—	—	25%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM MYCARD PERFUS SPECT MULTIPLE	$3,422.25	$4,563.00	—	at median	25%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM MYCARD PERFUS SPECT MULTIPLE	$3,422.25	$4,563.00	—	—	25%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGE W CT SKULL MID THIGH	$5,017.50	$6,690.00	—	8% above	25%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGE W CT SKULL MID THIGH	$5,017.50	$6,690.00	—	—	25%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST	$601.50	$802.00	—	50% below	25%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS WO CONTRAST	$601.50	$802.00	—	—	25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC PR 76857 US EXAM PELVIC LIMITED	$144.00	$192.00	—	56% below	25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US ED EXAM PELVIC LIMITED CDM	$363.00	$484.00	—	10% above	25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC LIMITED	$471.75	$629.00	—	43% above	25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC FOLLICLE LIMITED	$471.75	$629.00	—	43% above	25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC PR 76857 US EXAM PELVIC LIMITED	$144.00	$192.00	—	—	25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US ED EXAM PELVIC LIMITED CDM	$363.00	$484.00	—	—	25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM PELVIC LIMITED	$471.75	$629.00	—	—	25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM PELVIC FOLLICLE LIMITED	$471.75	$629.00	—	—	25%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC NON-OB COMPLETE	$523.50	$698.00	—	at median	25%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIC NON-OB COMPLETE	$523.50	$698.00	—	—	25%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS	$561.00	$748.00	—	8% above	25%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS	$561.00	$748.00	—	—	25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby one side CPT 76801 HC US OB LT 14 WKS SINGLE FETUS CDM	$447.75	$597.00	—	4% below	25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient one side CPT 76801 HC US OB LT 14 WKS SINGLE FETUS CDM	$447.75	$597.00	—	—	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC PR 76815 US OB LIMITED FETUS(S)	$232.50	$310.00	—	35% below	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US ED OB LIMITED FETUS(S) CDM	$255.75	$341.00	—	28% below	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED FETUS(S) CDM	$332.25	$443.00	—	7% below	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC PR 76815 US OB LIMITED FETUS(S)	$232.50	$310.00	—	—	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US ED OB LIMITED FETUS(S) CDM	$255.75	$341.00	—	—	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED FETUS(S) CDM	$332.25	$443.00	—	—	25%
Rib X-ray, one side, 2 views CPT 71100 HC XR RIBS UNI 2 VIEWS	$194.25	$259.00	—	26% below	25%
Rib X-ray, one side, 2 views inpatient CPT 71100 HC XR RIBS UNI 2 VIEWS	$194.25	$259.00	—	—	25%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC XR RIBS/CHEST UNI MIN 3 VIEWS	$246.75	$329.00	—	24% below	25%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC XR RIBS/CHEST UNI MIN 3 VIEWS	$246.75	$329.00	—	—	25%
Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD	$336.00	$448.00	—	1% above	25%
Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN BIL W CAD	$336.00	$448.00	—	1% above	25%
Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREEN BIL W CAD	$336.00	$448.00	—	—	25%
Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD	$336.00	$448.00	—	—	25%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS	$246.75	$329.00	—	12% below	25%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS	$246.75	$329.00	—	—	25%
Sinus X-ray, complete, 3 or more views CPT 70220 HC XR SINUSES PARANASAL MIN 3 VIEWS	$246.75	$329.00	—	14% below	25%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC XR SINUSES PARANASAL MIN 3 VIEWS	$246.75	$329.00	—	—	25%
Skull X-ray, fewer than 4 views CPT 70250 HC XR SKULL 1-3 VIEWS	$246.75	$329.00	—	12% below	25%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC XR SKULL 1-3 VIEWS	$246.75	$329.00	—	—	25%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAM REDUCED SERVICE	$2,838.75	$3,785.00	—	9% below	25%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY 4 OR MORE	$3,942.75	$5,257.00	—	27% above	25%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAM 1 ON 1 PT	$3,942.75	$5,257.00	—	27% above	25%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAM REDUCED SERVICE	$2,838.75	$3,785.00	—	—	25%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAM 1 ON 1 PT	$3,942.75	$5,257.00	—	—	25%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY 4 OR MORE	$3,942.75	$5,257.00	—	—	25%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$538.50	$718.00	—	at median	25%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$538.50	$718.00	—	—	25%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC XR FEMUR MIN 2 VIEWS	$294.75	$393.00	—	17% above	25%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC XR FEMUR MIN 2 VIEWS	$294.75	$393.00	—	—	25%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT CHEST SPINE WO CONTRAST	$642.00	$856.00	—	47% below	25%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT CHEST SPINE WO CONTRAST	$642.00	$856.00	—	—	25%
Toe X-ray, 2 or more views CPT 73660 HC XR TOE(S) MIN 2 VIEWS	$201.00	$268.00	—	at median	25%
Toe X-ray, 2 or more views inpatient CPT 73660 HC XR TOE(S) MIN 2 VIEWS	$201.00	$268.00	—	—	25%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON-OB	$549.75	$733.00	—	18% above	25%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON-OB	$549.75	$733.00	—	—	25%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL CDM	$361.50	$482.00	—	4% below	25%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US OB TRANSVAGINAL CDM	$361.50	$482.00	—	—	25%
Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE	$594.75	$793.00	—	1% below	25%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US EXAM ABDOMEN COMPLETE	$594.75	$793.00	—	—	25%
Ultrasound of the scrotum and testicles CPT 76870 HC US EXAM SCROTUM & CONTENTS	$531.00	$708.00	—	at median	25%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US EXAM SCROTUM & CONTENTS	$531.00	$708.00	—	—	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC PR ED 76536 HEAD AND NECK SOFT TISSUES CDM	$315.00	$420.00	—	36% below	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US ED EXAM OF HEAD AND NECK CDM	$390.75	$521.00	—	20% below	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM OF HEAD AND NECK	$507.75	$677.00	—	4% above	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC PR ED 76536 HEAD AND NECK SOFT TISSUES CDM	$315.00	$420.00	—	—	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US ED EXAM OF HEAD AND NECK CDM	$390.75	$521.00	—	—	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US EXAM OF HEAD AND NECK	$507.75	$677.00	—	—	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC XR RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY CDM	$631.50	$842.00	—	10% above	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC XR RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY CDM	$631.50	$842.00	—	—	25%
Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS 1 VIEW	$181.50	$242.00	—	31% below	25%
Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS MIN 2 VIEWS	$181.50	$242.00	—	31% below	25%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC XR HUMERUS 1 VIEW	$181.50	$242.00	—	—	25%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC XR HUMERUS MIN 2 VIEWS	$181.50	$242.00	—	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC PR 93971 EXTREMITY STUDY VENOUS DUPLEX	$339.75	$453.00	—	47% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$1,065.75	$1,421.00	—	66% above	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC PR 93971 EXTREMITY STUDY VENOUS DUPLEX	$339.75	$453.00	—	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$1,065.75	$1,421.00	—	—	25%
Wrist X-ray, 2 views CPT 73100 HC XR WRIST 1 VIEW	$184.50	$246.00	—	18% below	25%
Wrist X-ray, 2 views CPT 73100 HC XR WRIST 2 VIEWS	$184.50	$246.00	—	18% below	25%
Wrist X-ray, 2 views inpatient CPT 73100 HC XR WRIST 1 VIEW	$184.50	$246.00	—	—	25%
Wrist X-ray, 2 views inpatient CPT 73100 HC XR WRIST 2 VIEWS	$184.50	$246.00	—	—	25%
Wrist X-ray, complete, 3 or more views CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS	$242.25	$323.00	—	14% below	25%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS	$242.25	$323.00	—	—	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC XR HIPS UNI W PELVIS WHEN PERFORMED 2-3 VIEWS	$294.75	$393.00	—	8% above	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC XR HIPS UNI W PELVIS WHEN PERFORMED 2-3 VIEWS	$294.75	$393.00	—	—	25%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN PORTABLE 1 VIEW	$249.75	$333.00	—	at median	25%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN 1 VIEW	$249.75	$333.00	—	at median	25%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN 1 VIEW	$249.75	$333.00	—	—	25%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN PORTABLE 1 VIEW	$249.75	$333.00	—	—	25%
X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 1 VIEW	$246.75	$329.00	—	2% below	25%
X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 2 VIEWS	$246.75	$329.00	—	2% below	25%
X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 2 VIEWS	$246.75	$329.00	—	—	25%
X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 1 VIEW	$246.75	$329.00	—	—	25%
X-ray of the finger(s), 2 or more views CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS	$213.00	$284.00	—	5% below	25%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS	$213.00	$284.00	—	—	25%
X-ray of the foot, 2 views CPT 73620 HC XR FOOT 1 VIEW	$165.75	$221.00	—	26% below	25%
X-ray of the foot, 2 views CPT 73620 HC XR FOOT 2 VIEWS	$165.75	$221.00	—	26% below	25%
X-ray of the foot, 2 views inpatient CPT 73620 HC XR FOOT 2 VIEWS	$165.75	$221.00	—	—	25%
X-ray of the foot, 2 views inpatient CPT 73620 HC XR FOOT 1 VIEW	$165.75	$221.00	—	—	25%
X-ray of the foot, complete, 3 or more views CPT 73630 HC XR FOOT MIN 3 VIEWS	$201.00	$268.00	—	26% below	25%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC XR FOOT MIN 3 VIEWS	$201.00	$268.00	—	—	25%
X-ray of the hand, 3 or more views CPT 73130 HC XR HAND MIN 3 VIEWS	$252.75	$337.00	—	19% below	25%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC XR HAND MIN 3 VIEWS	$252.75	$337.00	—	—	25%
X-ray of the knee, 1 or 2 views CPT 73560 HC XR KNEE 1-2 VIEWS	$177.75	$237.00	—	27% below	25%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC XR KNEE 1-2 VIEWS	$177.75	$237.00	—	—	25%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS	$246.75	$329.00	—	23% below	25%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS	$246.75	$329.00	—	—	25%
X-ray of the lower back, 4 or more views CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS	$362.25	$483.00	—	10% below	25%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS	$362.25	$483.00	—	—	25%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC XR SPINE THORACIC 2 VIEWS	$246.75	$329.00	—	18% below	25%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC XR SPINE THORACIC 2 VIEWS	$246.75	$329.00	—	—	25%
X-ray of the nasal bones, 3 or more views CPT 70160 HC XR NASAL BONES MIN 3 VIEWS	$221.25	$295.00	—	2% below	25%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC XR NASAL BONES MIN 3 VIEWS	$221.25	$295.00	—	—	25%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS	$246.75	$329.00	—	5% below	25%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS	$246.75	$329.00	—	—	25%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS	$246.75	$329.00	—	13% below	25%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS	$246.75	$329.00	—	—	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC XR TAILBONE MIN 2 VIEWS	$184.50	$246.00	—	26% below	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC XR TAILBONE MIN 2 VIEWS	$184.50	$246.00	—	—	25%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Oregon	Off list
ACTH blood test CPT 82024 HC ACTH (ARUP)	$30.00	$40.00	—	77% below	25%
ACTH blood test CPT 82024 HC ADRENOCORTICOTROPIC HORMONE ACTH CDM	$30.00	$40.00	—	77% below	25%
ACTH blood test inpatient CPT 82024 HC ADRENOCORTICOTROPIC HORMONE ACTH CDM	$30.00	$40.00	—	—	25%
ACTH blood test inpatient CPT 82024 HC ACTH (ARUP)	$30.00	$40.00	—	—	25%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALANINE AMINO (ALT) (SGPT)	$24.00	$32.00	—	at median	25%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE ALANINE AMINO ALT SGPT LAB	$24.00	$32.00	—	at median	25%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALT (SGPT) 84460	$24.00	$32.00	—	at median	25%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC SGPT / ALT	$24.00	$32.00	—	at median	25%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC SGPT (ALT)	$24.00	$32.00	—	at median	25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC ALT (SGPT) 84460	$24.00	$32.00	—	—	25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC SGPT (ALT)	$24.00	$32.00	—	—	25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC ALANINE AMINO (ALT) (SGPT)	$24.00	$32.00	—	—	25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE ALANINE AMINO ALT SGPT LAB	$24.00	$32.00	—	—	25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC SGPT / ALT	$24.00	$32.00	—	—	25%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC SGOT / AST	$36.75	$49.00	—	29% above	25%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC SGOT (AST)	$36.75	$49.00	—	29% above	25%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT	$36.75	$49.00	—	29% above	25%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT LAB	$36.75	$49.00	—	29% above	25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT	$36.75	$49.00	—	—	25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC SGOT / AST	$36.75	$49.00	—	—	25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT LAB	$36.75	$49.00	—	—	25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC SGOT (AST)	$36.75	$49.00	—	—	25%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS ACUTE PANEL	$204.75	$273.00	—	8% below	25%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS ACUTE PANEL	$204.75	$273.00	—	—	25%
Albumin blood test CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD LAB	$25.50	$34.00	—	at median	25%
Albumin blood test CPT 82040 HC ZALBUMIN SERUM (PANL)	$25.50	$34.00	—	at median	25%
Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN	$25.50	$34.00	—	at median	25%
Albumin blood test inpatient CPT 82040 HC ZALBUMIN SERUM (PANL)	$25.50	$34.00	—	—	25%
Albumin blood test inpatient CPT 82040 HC ASSAY OF SERUM ALBUMIN	$25.50	$34.00	—	—	25%
Albumin blood test inpatient CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD LAB	$25.50	$34.00	—	—	25%
Aldosterone blood test CPT 82088 HC ALDOSTERONE URINE(ARUP)	$30.75	$41.00	—	68% below	25%
Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE CDM	$30.75	$41.00	—	68% below	25%
Aldosterone blood test CPT 82088 HC ALDOSTERONE(ARUP)	$30.75	$41.00	—	68% below	25%
Aldosterone blood test CPT 82088 HC ALDOSTERONE BLD	$30.75	$41.00	—	68% below	25%
Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE PLASMA LAB	$30.75	$41.00	—	68% below	25%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE BLD	$30.75	$41.00	—	—	25%
Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE PLASMA LAB	$30.75	$41.00	—	—	25%
Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE CDM	$30.75	$41.00	—	—	25%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE(ARUP)	$30.75	$41.00	—	—	25%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE URINE(ARUP)	$30.75	$41.00	—	—	25%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOS	$25.50	$34.00	—	1% above	25%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ZALKP TOTAL (PANL)	$25.50	$34.00	—	1% above	25%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ASSAY OF PHOSPHATASE ALKALINE LAB	$25.50	$34.00	—	1% above	25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ZALKP TOTAL (PANL)	$25.50	$34.00	—	—	25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOS	$25.50	$34.00	—	—	25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ASSAY OF PHOSPHATASE ALKALINE LAB	$25.50	$34.00	—	—	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$12.75	$17.00	—	12% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH CDM	$12.75	$17.00	—	12% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN LATEX (ARUP)	$12.75	$17.00	—	12% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN STRAWBERRY (ARUP)	$12.75	$17.00	—	12% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN PISTACHIO (ARUP)	$12.75	$17.00	—	12% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN EGG YOLK (ARUP)	$12.75	$17.00	—	12% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN PECAN (ARUP)	$12.75	$17.00	—	12% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN EGG WHOLE (ARUP)	$12.75	$17.00	—	12% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN ALMOND (ARUP)	$12.75	$17.00	—	12% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN WALNUT (ARUP)	$12.75	$17.00	—	12% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FOOD CASHEW (ARUP)	$12.75	$17.00	—	12% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FOOD HAZELNUT (ARUP)	$12.75	$17.00	—	12% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC SINGLE ALLERGEN(ARUP)	$12.75	$17.00	—	12% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE	$12.75	$17.00	—	12% below	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC SINGLE ALLERGEN(ARUP)	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN WALNUT (ARUP)	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN ALMOND (ARUP)	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN EGG WHOLE (ARUP)	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN PECAN (ARUP)	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN EGG YOLK (ARUP)	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN PISTACHIO (ARUP)	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN STRAWBERRY (ARUP)	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN LATEX (ARUP)	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FOOD CASHEW (ARUP)	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH CDM	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FOOD HAZELNUT (ARUP)	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE	$12.75	$17.00	—	—	25%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ZAFP(PANL)	$78.00	$104.00	—	7% above	25%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC AFP (ARUP)	$78.00	$104.00	—	7% above	25%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ZAFP (PANEL)	$78.00	$104.00	—	7% above	25%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM CDM	$78.00	$104.00	—	7% above	25%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM	$78.00	$104.00	—	7% above	25%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM LAB	$78.00	$104.00	—	7% above	25%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC AFP (ARUP)	$78.00	$104.00	—	—	25%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM	$78.00	$104.00	—	—	25%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ZAFP(PANL)	$78.00	$104.00	—	—	25%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM LAB	$78.00	$104.00	—	—	25%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ZAFP (PANEL)	$78.00	$104.00	—	—	25%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM CDM	$78.00	$104.00	—	—	25%
Ammonia blood test CPT 82140 HC ASSAY OF AMMONIA LAB	$98.25	$131.00	—	11% above	25%
Ammonia blood test inpatient CPT 82140 HC ASSAY OF AMMONIA LAB	$98.25	$131.00	—	—	25%
Amylase blood test CPT 82150 HC AMYLASE	$48.75	$65.00	—	1% above	25%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE	$48.75	$65.00	—	1% above	25%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE LAB	$48.75	$65.00	—	1% above	25%
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE	$48.75	$65.00	—	—	25%
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE LAB	$48.75	$65.00	—	—	25%
Amylase blood test inpatient CPT 82150 HC AMYLASE	$48.75	$65.00	—	—	25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP AB IGG	$59.25	$79.00	—	at median	25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCP AB IGG	$59.25	$79.00	—	—	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA IGG REFLEX (ARUP)	$81.00	$108.00	—	28% above	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA REFLEXIVE QUANTITATIVE	$81.00	$108.00	—	28% above	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA SCREEN QUANTITATIVE	$81.00	$108.00	—	28% above	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA SCREEN BODY FLUID	$81.00	$108.00	—	28% above	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES	$81.00	$108.00	—	28% above	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA LAB	$81.00	$108.00	—	28% above	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA LAB	$81.00	$108.00	—	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA REFLEXIVE QUANTITATIVE	$81.00	$108.00	—	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA SCREEN BODY FLUID	$81.00	$108.00	—	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA SCREEN QUANTITATIVE	$81.00	$108.00	—	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA IGG REFLEX (ARUP)	$81.00	$108.00	—	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES	$81.00	$108.00	—	—	25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE LAB	$171.00	$228.00	—	5% above	25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC PRO BNP	$171.00	$228.00	—	5% above	25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE	$171.00	$228.00	—	5% above	25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE LAB	$171.00	$228.00	—	—	25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC PRO BNP	$171.00	$228.00	—	—	25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE	$171.00	$228.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL CDM	$37.50	$50.00	—	33% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-SURGICAL TISSUE	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE TRANSFUSION REACT UNIT	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-EAR	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC BACTERIAL CULTURE - OTHR SOURCE	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-EYE SURFACE	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-ENVIRONMENTAL	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-GENITAL-FEMALE	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-RESPIR UPPER	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-WOUND-SURFACE	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-WOUND-DEEP	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-CSF	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-RESPIR LOWER	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-IV CATH TIP	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-BODY FLUID	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL LAB	$48.75	$65.00	—	13% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL CDM	$37.50	$50.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-GENITAL-FEMALE	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-RESPIR UPPER	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-BODY FLUID	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-WOUND-SURFACE	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-IV CATH TIP	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-CSF	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE TRANSFUSION REACT UNIT	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-WOUND-DEEP	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC BACTERIAL CULTURE - OTHR SOURCE	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL LAB	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-SURGICAL TISSUE	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-EAR	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-RESPIR LOWER	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-EYE SURFACE	$48.75	$65.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-ENVIRONMENTAL	$48.75	$65.00	—	—	25%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL	$36.00	$48.00	—	25% below	25%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL	$36.00	$48.00	—	—	25%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL	$25.50	$34.00	—	at median	25%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL LAB	$25.50	$34.00	—	at median	25%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL	$25.50	$34.00	—	—	25%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL LAB	$25.50	$34.00	—	—	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC PR 88305 TISSUE EXAM BY PATHOLOGIST	$206.25	$275.00	—	4% above	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC PR 88305 BILL SURG LEVEL 4	$206.25	$275.00	—	4% above	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC BILL SURG SLIDE PREP	$252.75	$337.00	—	28% above	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB	$252.75	$337.00	—	28% above	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC BILL SURG LEVEL 4	$252.75	$337.00	—	28% above	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC PR 88305 TISSUE EXAM BY PATHOLOGIST	$206.25	$275.00	—	—	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC PR 88305 BILL SURG LEVEL 4	$206.25	$275.00	—	—	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC BILL SURG SLIDE PREP	$252.75	$337.00	—	—	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB	$252.75	$337.00	—	—	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC BILL SURG LEVEL 4	$252.75	$337.00	—	—	25%
Blood culture for bacteria CPT 87040 HC CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES LAB	$84.00	$112.00	—	24% below	25%
Blood culture for bacteria CPT 87040 HC CULTURE-BLOOD	$120.00	$160.00	—	9% above	25%
Blood culture for bacteria inpatient CPT 87040 HC CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES LAB	$84.00	$112.00	—	—	25%
Blood culture for bacteria inpatient CPT 87040 HC CULTURE-BLOOD	$120.00	$160.00	—	—	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM	$19.50	$26.00	—	3% below	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC BLOOD DRAW VENIPUNCTURE CDM	$19.50	$26.00	—	3% below	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ED ROUTINE VENIPUNCTURE OR LEGAL DRAW CDM	$19.50	$26.00	—	3% below	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - IVT VENIP LAB DRAW	$19.50	$26.00	—	3% below	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM	$20.25	$27.00	—	at median	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC BLOOD DRAW VENIPUNCTURE CDM	$20.25	$27.00	—	at median	25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - IVT VENIP LAB DRAW	$19.50	$26.00	—	—	25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ED ROUTINE VENIPUNCTURE OR LEGAL DRAW CDM	$19.50	$26.00	—	—	25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC BLOOD DRAW VENIPUNCTURE CDM	$19.50	$26.00	—	—	25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM	$19.50	$26.00	—	—	25%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD (EXCEPT REAGENT STRIP)	$25.50	$34.00	—	6% above	25%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP LAB	$25.50	$34.00	—	6% above	25%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE WHOLE BLOOD	$25.50	$34.00	—	6% above	25%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE	$25.50	$34.00	—	6% above	25%
Blood glucose (sugar) test CPT 82947 HC ASSAY GLUCOSE BLOOD QUANT	$25.50	$34.00	—	6% above	25%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE WHOLE BLOOD	$25.50	$34.00	—	—	25%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE	$25.50	$34.00	—	—	25%
Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY GLUCOSE BLOOD QUANT	$25.50	$34.00	—	—	25%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP LAB	$25.50	$34.00	—	—	25%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD (EXCEPT REAGENT STRIP)	$25.50	$34.00	—	—	25%
Blood lead test CPT 83655 HC ZLEAD BLOOD(PANL)	$27.75	$37.00	—	31% below	25%
Blood lead test CPT 83655 HC ZLEAD BLOOD (PANL)	$27.75	$37.00	—	31% below	25%
Blood lead test CPT 83655 HC HVY MET BLD - LEAD	$27.75	$37.00	—	31% below	25%
Blood lead test CPT 83655 HC LEAD WHOLE BLOOD	$27.75	$37.00	—	31% below	25%
Blood lead test CPT 83655 HC ZLEAD URINE (PANL)	$27.75	$37.00	—	31% below	25%
Blood lead test CPT 83655 HC HVY MET UR - LEAD	$27.75	$37.00	—	31% below	25%
Blood lead test CPT 83655 HC ASSAY OF LEAD LAB	$27.75	$37.00	—	31% below	25%
Blood lead test inpatient CPT 83655 HC ZLEAD BLOOD(PANL)	$27.75	$37.00	—	—	25%
Blood lead test inpatient CPT 83655 HC LEAD WHOLE BLOOD	$27.75	$37.00	—	—	25%
Blood lead test inpatient CPT 83655 HC ZLEAD BLOOD (PANL)	$27.75	$37.00	—	—	25%
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD LAB	$27.75	$37.00	—	—	25%
Blood lead test inpatient CPT 83655 HC HVY MET UR - LEAD	$27.75	$37.00	—	—	25%
Blood lead test inpatient CPT 83655 HC HVY MET BLD - LEAD	$27.75	$37.00	—	—	25%
Blood lead test inpatient CPT 83655 HC ZLEAD URINE (PANL)	$27.75	$37.00	—	—	25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE LAB	$34.50	$46.00	—	51% below	25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE CDM	$34.50	$46.00	—	51% below	25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC CHORIONIC GONADOTROPIN QUAL	$34.50	$46.00	—	51% below	25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE LAB	$34.50	$46.00	—	—	25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE CDM	$34.50	$46.00	—	—	25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC CHORIONIC GONADOTROPIN QUAL	$34.50	$46.00	—	—	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO	$58.50	$78.00	—	8% above	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO LAB	$58.50	$78.00	—	8% above	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC ABO GROUP	$58.50	$78.00	—	8% above	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC ABO GROUP	$58.50	$78.00	—	—	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO LAB	$58.50	$78.00	—	—	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO	$58.50	$78.00	—	—	25%
Blood urea nitrogen (BUN) test CPT 84520 HC UREA NITROGEN BODY FLUID	$25.50	$34.00	—	at median	25%
Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY UREA NITROGEN	$25.50	$34.00	—	at median	25%
Blood urea nitrogen (BUN) test CPT 84520 HC BUN	$25.50	$34.00	—	at median	25%
Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY OF UREA NITROGEN	$25.50	$34.00	—	at median	25%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY OF UREA NITROGEN	$25.50	$34.00	—	—	25%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY UREA NITROGEN	$25.50	$34.00	—	—	25%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC UREA NITROGEN BODY FLUID	$25.50	$34.00	—	—	25%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC BUN	$25.50	$34.00	—	—	25%
C-peptide blood test CPT 84681 HC ASSAY OF C-PEPTIDE	$90.00	$120.00	—	at median	25%
C-peptide blood test inpatient CPT 84681 HC ASSAY OF C-PEPTIDE	$90.00	$120.00	—	—	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN	$63.00	$84.00	—	65% above	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN	$63.00	$84.00	—	—	25%
C. difficile toxin gene test (stool PCR) CPT 87493 HC INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE LAB	$182.25	$243.00	—	16% above	25%
C. difficile toxin gene test (stool PCR) CPT 87493 HC CLOSTRIDIUM DIFFICILE TOXINS AMPLIFIED PROBE	$182.25	$243.00	—	16% above	25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE LAB	$182.25	$243.00	—	—	25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC CLOSTRIDIUM DIFFICILE TOXINS AMPLIFIED PROBE	$182.25	$243.00	—	—	25%
CA 19-9 blood test (tumor marker) CPT 86301 HC CA 19.9	$98.25	$131.00	—	4% above	25%
CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9	$98.25	$131.00	—	4% above	25%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9	$98.25	$131.00	—	—	25%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC CA 19.9	$98.25	$131.00	—	—	25%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 LAB	$129.75	$173.00	—	16% above	25%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 LAB	$129.75	$173.00	—	—	25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID-19 AMP PRB HIGH THROUGHPUT PHS OREGON	$121.50	$162.00	—	1% above	25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID-19 AMP PRB PHS OREGON 87635	$121.50	$162.00	—	1% above	25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ CDM	$121.50	$162.00	—	1% above	25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ LAB	$121.50	$162.00	—	1% above	25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ LAB	$121.50	$162.00	—	—	25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC COVID-19 AMP PRB PHS OREGON 87635	$121.50	$162.00	—	—	25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ CDM	$121.50	$162.00	—	—	25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC COVID-19 AMP PRB HIGH THROUGHPUT PHS OREGON	$121.50	$162.00	—	—	25%
Calcium blood test, total CPT 82310 HC CALCIUM SERUM	$23.25	$31.00	—	9% below	25%
Calcium blood test, total CPT 82310 HC CALCIUM TOTAL LAB	$23.25	$31.00	—	9% below	25%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM SERUM	$23.25	$31.00	—	—	25%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM TOTAL LAB	$23.25	$31.00	—	—	25%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CEA	$81.75	$109.00	—	at median	25%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CARCINOEMBRYONIC ANTIGEN CEA CDM	$81.75	$109.00	—	at median	25%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CARCINOEMBRYONIC ANTIGEN CEA CDM	$81.75	$109.00	—	—	25%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CEA	$81.75	$109.00	—	—	25%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER ANTIBODY - IGG	$60.75	$81.00	—	at median	25%
Chickenpox (varicella) immunity blood test CPT 86787 HC ANTIBODY VARICELLA-ZOSTER	$60.75	$81.00	—	at median	25%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER ANTIBODY	$60.75	$81.00	—	at median	25%
Chickenpox (varicella) immunity blood test CPT 86787 HC ANTIBODY VARICELLA-ZOSTER CDM	$60.75	$81.00	—	at median	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER ANTIBODY	$60.75	$81.00	—	—	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC ANTIBODY VARICELLA-ZOSTER	$60.75	$81.00	—	—	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC ANTIBODY VARICELLA-ZOSTER CDM	$60.75	$81.00	—	—	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA-ZOSTER ANTIBODY - IGG	$60.75	$81.00	—	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ LAB	$93.75	$125.00	—	6% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA AMPLIFICATION APTIMA	$93.75	$125.00	—	6% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ	$93.75	$125.00	—	6% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ LAB	$93.75	$125.00	—	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA AMPLIFICATION APTIMA	$93.75	$125.00	—	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ	$93.75	$125.00	—	—	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL - REFLEX	$57.75	$77.00	—	at median	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL OF NMR	$57.75	$77.00	—	at median	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL	$57.75	$77.00	—	at median	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL LAB	$57.75	$77.00	—	at median	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL	$57.75	$77.00	—	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL OF NMR	$57.75	$77.00	—	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL - REFLEX	$57.75	$77.00	—	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL LAB	$57.75	$77.00	—	—	25%
Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$31.50	$42.00	—	24% below	25%
Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC W/AUTO DIF WBC	$31.50	$42.00	—	24% below	25%
Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC LAB	$31.50	$42.00	—	24% below	25%
Complete blood count (CBC) with differential CPT 85025 HC CBC WITH DIFF AUTO	$31.50	$42.00	—	24% below	25%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC WITH DIFF AUTO	$31.50	$42.00	—	—	25%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE CBC W/AUTO DIF WBC	$31.50	$42.00	—	—	25%
Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC LAB	$31.50	$42.00	—	—	25%
Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$31.50	$42.00	—	—	25%
Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED LAB	$12.75	$17.00	—	59% below	25%
Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC AUTOMATED	$12.75	$17.00	—	59% below	25%
Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC AUTOMATED	$12.75	$17.00	—	—	25%
Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED LAB	$12.75	$17.00	—	—	25%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHEN METABOLIC PANEL	$42.75	$57.00	—	23% below	25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHEN METABOLIC PANEL	$42.75	$57.00	—	—	25%
Cortisol blood test, total CPT 82533 HC CORTISOL	$117.00	$156.00	—	41% above	25%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL LAB	$117.00	$156.00	—	41% above	25%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL LAB	$117.00	$156.00	—	—	25%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL	$117.00	$156.00	—	—	25%
Creatine kinase (CK) blood test, total CPT 82550 HC ASSAY OF CK (CPK)	$31.50	$42.00	—	27% below	25%
Creatine kinase (CK) blood test, total CPT 82550 HC CK TOTAL	$31.50	$42.00	—	27% below	25%
Creatine kinase (CK) blood test, total CPT 82550 HC ZCK TOTAL (PANL)	$31.50	$42.00	—	27% below	25%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE TOTAL CDM	$31.50	$42.00	—	27% below	25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CK TOTAL	$31.50	$42.00	—	—	25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC ASSAY OF CK (CPK)	$31.50	$42.00	—	—	25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE TOTAL CDM	$31.50	$42.00	—	—	25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC ZCK TOTAL (PANL)	$31.50	$42.00	—	—	25%
Creatinine blood test CPT 82565 HC ASSAY OF CREATININE	$23.25	$31.00	—	6% below	25%
Creatinine blood test CPT 82565 HC ASSAY CREATININE	$23.25	$31.00	—	6% below	25%
Creatinine blood test CPT 82565 HC CREATININE BLOOD	$23.25	$31.00	—	6% below	25%
Creatinine blood test inpatient CPT 82565 HC ASSAY OF CREATININE	$23.25	$31.00	—	—	25%
Creatinine blood test inpatient CPT 82565 HC CREATININE BLOOD	$23.25	$31.00	—	—	25%
Creatinine blood test inpatient CPT 82565 HC ASSAY CREATININE	$23.25	$31.00	—	—	25%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV IGG	$62.25	$83.00	—	at median	25%
Cytomegalovirus (CMV) antibody test CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV LAB	$62.25	$83.00	—	at median	25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV LAB	$62.25	$83.00	—	—	25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV IGG	$62.25	$83.00	—	—	25%
D-dimer blood test (blood clot marker) CPT 85379 HC DDIMER QUANT	$238.50	$318.00	—	80% above	25%
D-dimer blood test (blood clot marker) CPT 85379 HC FIBRIN DEGRADATION QUANT	$238.50	$318.00	—	80% above	25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC FIBRIN DEGRADATION QUANT	$238.50	$318.00	—	—	25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC DDIMER QUANT	$238.50	$318.00	—	—	25%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE	$97.50	$130.00	—	14% above	25%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE	$97.50	$130.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE LAB	$57.75	$77.00	—	at median	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR COCAINE PER DOS LAB	$57.75	$77.00	—	at median	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR BENZODIAZEPINE PER DOS LAB	$57.75	$77.00	—	at median	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR BARBITURATES PER DOS	$57.75	$77.00	—	at median	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUGS OF ABUSE URINE	$57.75	$77.00	—	at median	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR MECONIUM PER DOS	$57.75	$77.00	—	at median	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$57.75	$77.00	—	at median	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR OPIATES URINE PER DOS LAB	$57.75	$77.00	—	at median	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE CDM	$57.75	$77.00	—	at median	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ALCOHOL PER DOS	$57.75	$77.00	—	at median	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE LAB	$57.75	$77.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR COCAINE PER DOS LAB	$57.75	$77.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR MECONIUM PER DOS	$57.75	$77.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR OPIATES URINE PER DOS LAB	$57.75	$77.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUGS OF ABUSE URINE	$57.75	$77.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$57.75	$77.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ALCOHOL PER DOS	$57.75	$77.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR BARBITURATES PER DOS	$57.75	$77.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE CDM	$57.75	$77.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR BENZODIAZEPINE PER DOS LAB	$57.75	$77.00	—	—	25%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL	$31.50	$42.00	—	12% below	25%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTES WHOLE BLOOD	$31.50	$42.00	—	12% below	25%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL LAB	$31.50	$42.00	—	12% below	25%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL	$31.50	$42.00	—	—	25%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL LAB	$31.50	$42.00	—	—	25%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTES WHOLE BLOOD	$31.50	$42.00	—	—	25%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EBV AB VIRAL CAPSID AG IGG	$84.00	$112.00	—	11% above	25%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EBV AB VIRAL CAPSID AG IGM	$84.00	$112.00	—	11% above	25%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA LAB	$84.00	$112.00	—	11% above	25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA LAB	$84.00	$112.00	—	—	25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EBV AB VIRAL CAPSID AG IGM	$84.00	$112.00	—	—	25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EBV AB VIRAL CAPSID AG IGG	$84.00	$112.00	—	—	25%
Estradiol blood test CPT 82670 HC ESTRADIOL BY TMS(ARUP)	$126.75	$169.00	—	12% above	25%
Estradiol blood test CPT 82670 HC ESTRADIOL	$126.75	$169.00	—	12% above	25%
Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL	$126.75	$169.00	—	12% above	25%
Estradiol blood test inpatient CPT 82670 HC ESTRADIOL	$126.75	$169.00	—	—	25%
Estradiol blood test inpatient CPT 82670 HC ESTRADIOL BY TMS(ARUP)	$126.75	$169.00	—	—	25%
Estradiol blood test inpatient CPT 82670 HC ASSAY OF ESTRADIOL	$126.75	$169.00	—	—	25%
FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE LAB	$81.00	$108.00	—	at median	25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE LAB	$81.00	$108.00	—	—	25%
Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY OF CALPROTECTIN FECAL CDM	$74.25	$99.00	—	37% below	25%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC ASSAY OF CALPROTECTIN FECAL CDM	$74.25	$99.00	—	—	25%
Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN CDM	$42.75	$57.00	—	24% below	25%
Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN	$42.75	$57.00	—	24% below	25%
Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN	$42.75	$57.00	—	—	25%
Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN CDM	$42.75	$57.00	—	—	25%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN	$78.00	$104.00	—	21% above	25%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN	$78.00	$104.00	—	—	25%
Folate (folic acid) blood test CPT 82746 HC BLOOD FOLIC ACID SERUM	$87.75	$117.00	—	at median	25%
Folate (folic acid) blood test inpatient CPT 82746 HC BLOOD FOLIC ACID SERUM	$87.75	$117.00	—	—	25%
Free T3 thyroid hormone test CPT 84481 HC FREE ASSAY (FT-3)	$73.50	$98.00	—	2% above	25%
Free T3 thyroid hormone test inpatient CPT 84481 HC FREE ASSAY (FT-3)	$73.50	$98.00	—	—	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE CDM	$45.75	$61.00	—	at median	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC THYROXINE FREE	$45.75	$61.00	—	at median	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE LAB	$45.75	$61.00	—	at median	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ZT4 FREE BY EQUIL DIALYSIS(ARUP)	$45.75	$61.00	—	at median	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ZT4 FREE BY EQUIL DIALYSIS(ARUP)	$45.75	$61.00	—	—	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC THYROXINE FREE	$45.75	$61.00	—	—	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE LAB	$45.75	$61.00	—	—	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE CDM	$45.75	$61.00	—	—	25%
Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE LAB	$12.75	$17.00	—	80% below	25%
Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE	$12.75	$17.00	—	80% below	25%
Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE LAB	$12.75	$17.00	—	—	25%
Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE	$12.75	$17.00	—	—	25%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GGT	$25.50	$34.00	—	15% below	25%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GGT GLUTAMYTRANSFERASE GAMMA	$25.50	$34.00	—	15% below	25%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GAMMA GT TOTAL	$25.50	$34.00	—	15% below	25%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GLUTAMYLTRASE GAMMA LAB	$25.50	$34.00	—	15% below	25%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GAMMA GT TOTAL	$25.50	$34.00	—	—	25%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GGT GLUTAMYTRANSFERASE GAMMA	$25.50	$34.00	—	—	25%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC ASSAY OF GLUTAMYLTRASE GAMMA LAB	$25.50	$34.00	—	—	25%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC ASSAY OF GGT	$25.50	$34.00	—	—	25%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GESTATIONAL GLUCOSE 1 HOUR	$34.50	$46.00	—	at median	25%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE GESTATIONAL SCREEN	$34.50	$46.00	—	at median	25%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GESTATIONAL GLUCOSE 1 HOUR	$34.50	$46.00	—	—	25%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE GESTATIONAL SCREEN	$34.50	$46.00	—	—	25%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOL GESTATIONAL	$87.00	$116.00	—	11% above	25%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOL-3 HR	$87.00	$116.00	—	11% above	25%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE(3 SPECIMENS)	$87.00	$116.00	—	11% above	25%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE(3 SPEC)	$87.00	$116.00	—	11% above	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE(3 SPEC)	$87.00	$116.00	—	—	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOL GESTATIONAL	$87.00	$116.00	—	—	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE(3 SPECIMENS)	$87.00	$116.00	—	—	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOL-3 HR	$87.00	$116.00	—	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ	$93.75	$125.00	—	at median	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ CDM	$93.75	$125.00	—	at median	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ LAB	$93.75	$125.00	—	at median	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ CDM	$93.75	$125.00	—	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ	$93.75	$125.00	—	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ LAB	$93.75	$125.00	—	—	25%
H. pylori stool antigen test CPT 87338 HC IAAD IA HPYLORI STOOL CDM	$52.50	$70.00	—	27% below	25%
H. pylori stool antigen test inpatient CPT 87338 HC IAAD IA HPYLORI STOOL CDM	$52.50	$70.00	—	—	25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION LAB	$387.00	$516.00	—	43% above	25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 RNA QUANTITATION	$387.00	$516.00	—	43% above	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 RNA QUANTITATION	$387.00	$516.00	—	—	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION LAB	$387.00	$516.00	—	—	25%
HIV-1 and HIV-2 antibody test CPT 86703 HC RAPID HIV 1-2	$66.00	$88.00	—	at median	25%
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV-1/HIV-2 SINGLE ASSAY	$66.00	$88.00	—	at median	25%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC RAPID HIV 1-2	$66.00	$88.00	—	—	25%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV-1/HIV-2 SINGLE ASSAY	$66.00	$88.00	—	—	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB	$99.75	$133.00	—	25% above	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC ANTI-HIV 1/2 AB & P24 AG	$99.75	$133.00	—	25% above	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB	$99.75	$133.00	—	—	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC ANTI-HIV 1/2 AB & P24 AG	$99.75	$133.00	—	—	25%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES LAB	$87.00	$116.00	—	2% below	25%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES LAB	$87.00	$116.00	—	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C LAB	$48.00	$64.00	—	at median	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST	$48.00	$64.00	—	at median	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN A1C (CONFIRM)(ARUP)	$48.00	$64.00	—	at median	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN A1C (CONFIRM)(ARUP)	$48.00	$64.00	—	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C LAB	$48.00	$64.00	—	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST	$48.00	$64.00	—	—	25%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN (HGB)	$17.25	$23.00	—	1% below	25%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN	$17.25	$23.00	—	1% below	25%
Hemoglobin blood test CPT 85018 HC BLOOD COUNT HEMOGLOBIN LAB	$17.25	$23.00	—	1% below	25%
Hemoglobin blood test CPT 85018 HC BLOOD COUNT HEMOGLOBIN CDM	$17.25	$23.00	—	1% below	25%
Hemoglobin blood test inpatient CPT 85018 HC BLOOD COUNT HEMOGLOBIN LAB	$17.25	$23.00	—	—	25%
Hemoglobin blood test inpatient CPT 85018 HC BLOOD COUNT HEMOGLOBIN CDM	$17.25	$23.00	—	—	25%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN	$17.25	$23.00	—	—	25%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN (HGB)	$17.25	$23.00	—	—	25%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL LAB	$74.25	$99.00	—	11% above	25%
Hepatitis B core antibody test (total) CPT 86704 HC HEP B CORE (IGG-IGM) ANTIBODY	$74.25	$99.00	—	11% above	25%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL CDM	$74.25	$99.00	—	11% above	25%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL LAB	$74.25	$99.00	—	—	25%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEP B CORE (IGG-IGM) ANTIBODY	$74.25	$99.00	—	—	25%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL CDM	$74.25	$99.00	—	—	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB CDM	$87.75	$117.00	—	39% above	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB CDM	$87.75	$117.00	—	—	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEP B SURF AG (HBSAG) RFLX CONFRM	$62.25	$83.00	—	13% above	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEP B SRF AG RFLX CNFRM(OF PANL)	$62.25	$83.00	—	13% above	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN LAB	$62.25	$83.00	—	13% above	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEP B SRF AG RFLX CNFRM(OF PANL)	$62.25	$83.00	—	—	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEP B SURF AG (HBSAG) RFLX CONFRM	$62.25	$83.00	—	—	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN LAB	$62.25	$83.00	—	—	25%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY CDM	$81.75	$109.00	—	7% above	25%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEP C AB REFLEXIVE	$81.75	$109.00	—	7% above	25%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY LAB	$81.75	$109.00	—	7% above	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY LAB	$81.75	$109.00	—	—	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY CDM	$81.75	$109.00	—	—	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEP C AB REFLEXIVE	$81.75	$109.00	—	—	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEP C PCR (QUANT)	$178.50	$238.00	—	9% below	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION CDM	$178.50	$238.00	—	9% below	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION CDM	$178.50	$238.00	—	—	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEP C PCR (QUANT)	$178.50	$238.00	—	—	25%
Herpes blood test, HSV-1 antibody CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 IGG LAB	$62.25	$83.00	—	4% above	25%
Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TEST - TYPE 1 IGG	$62.25	$83.00	—	4% above	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TEST - TYPE 1 IGG	$62.25	$83.00	—	—	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 IGG LAB	$62.25	$83.00	—	—	25%
Herpes blood test, HSV-2 antibody CPT 86696 HC HSV 2 ANTIBODY IGG	$91.50	$122.00	—	26% above	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HSV 2 ANTIBODY IGG	$91.50	$122.00	—	—	25%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY CDM	$60.75	$81.00	—	at median	25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY CDM	$60.75	$81.00	—	—	25%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTEINE LAB	$78.75	$105.00	—	8% below	25%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTEINE LAB	$78.75	$105.00	—	—	25%
Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL LAB	$55.50	$74.00	—	1% above	25%
Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL CDM	$55.50	$74.00	—	1% above	25%
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN TOTAL CDM	$55.50	$74.00	—	—	25%
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN TOTAL LAB	$55.50	$74.00	—	—	25%
Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON	$28.50	$38.00	—	30% below	25%
Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON CDM	$28.50	$38.00	—	30% below	25%
Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON	$28.50	$38.00	—	—	25%
Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON CDM	$28.50	$38.00	—	—	25%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY CDM	$42.75	$57.00	—	at median	25%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY LAB	$42.75	$57.00	—	at median	25%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY LAB	$42.75	$57.00	—	—	25%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY CDM	$42.75	$57.00	—	—	25%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL CDM	$48.00	$64.00	—	at median	25%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL CDM	$48.00	$64.00	—	—	25%
LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE LAB	$81.00	$108.00	—	at median	25%
LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE LAB	$81.00	$108.00	—	—	25%
Lactate (lactic acid) blood test CPT 83605 HC PR 83605 ASSAY OF LACTIC ACID, ARTERIAL	$24.00	$32.00	—	68% below	25%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTATE	$81.00	$108.00	—	9% above	25%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTATE LAB	$81.00	$108.00	—	9% above	25%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID	$81.00	$108.00	—	9% above	25%
Lactate (lactic acid) blood test inpatient CPT 83605 HC PR 83605 ASSAY OF LACTIC ACID, ARTERIAL	$24.00	$32.00	—	—	25%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID	$81.00	$108.00	—	—	25%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTATE LAB	$81.00	$108.00	—	—	25%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTATE	$81.00	$108.00	—	—	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH SERUM	$25.50	$34.00	—	18% below	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE(LD)(LDH)ENZYME	$25.50	$34.00	—	18% below	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE (LD) (LDH) ENZYME	$25.50	$34.00	—	18% below	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE LDH CDM	$25.50	$34.00	—	18% below	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE (LD) (LDH) ENZYME	$25.50	$34.00	—	—	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE(LD)(LDH)ENZYME	$25.50	$34.00	—	—	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LDH SERUM	$25.50	$34.00	—	—	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE LDH CDM	$25.50	$34.00	—	—	25%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE BODY FLUID	$67.50	$90.00	—	6% above	25%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE CDM	$67.50	$90.00	—	6% above	25%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE	$67.50	$90.00	—	6% above	25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE BODY FLUID	$67.50	$90.00	—	—	25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE CDM	$67.50	$90.00	—	—	25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE	$67.50	$90.00	—	—	25%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL CDM	$34.50	$46.00	—	17% below	25%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL CDM	$34.50	$46.00	—	—	25%
Lyme disease antibody test CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE LAB	$35.25	$47.00	—	46% below	25%
Lyme disease antibody test CPT 86618 HC B BURGDORFERI AB TOTAL (ARUP)	$35.25	$47.00	—	46% below	25%
Lyme disease antibody test inpatient CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE LAB	$35.25	$47.00	—	—	25%
Lyme disease antibody test inpatient CPT 86618 HC B BURGDORFERI AB TOTAL (ARUP)	$35.25	$47.00	—	—	25%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM CDM	$30.00	$40.00	—	13% below	25%
Magnesium blood test CPT 83735 HC MAGNESIUM URINE (ARUP)	$30.00	$40.00	—	13% below	25%
Magnesium blood test CPT 83735 HC MAGNESIUM QUANT URINE	$30.00	$40.00	—	13% below	25%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM LAB	$30.00	$40.00	—	13% below	25%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM	$30.00	$40.00	—	13% below	25%
Magnesium blood test CPT 83735 HC MAGNESIUM (RBC) (ARUP)	$30.00	$40.00	—	13% below	25%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM (RBC) (ARUP)	$30.00	$40.00	—	—	25%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM CDM	$30.00	$40.00	—	—	25%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM	$30.00	$40.00	—	—	25%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM LAB	$30.00	$40.00	—	—	25%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM QUANT URINE	$30.00	$40.00	—	—	25%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM URINE (ARUP)	$30.00	$40.00	—	—	25%
Measles (rubeola) antibody test CPT 86765 HC MEASLES (RUBEOLA) AB IGM (ARUP)	$59.25	$79.00	—	at median	25%
Measles (rubeola) antibody test CPT 86765 HC ANTIBODY RUBEOLA CDM	$59.25	$79.00	—	at median	25%
Measles (rubeola) antibody test CPT 86765 HC ANTIBODY RUBEOLA IGG LAB	$59.25	$79.00	—	at median	25%
Measles (rubeola) antibody test inpatient CPT 86765 HC MEASLES (RUBEOLA) AB IGM (ARUP)	$59.25	$79.00	—	—	25%
Measles (rubeola) antibody test inpatient CPT 86765 HC ANTIBODY RUBEOLA CDM	$59.25	$79.00	—	—	25%
Measles (rubeola) antibody test inpatient CPT 86765 HC ANTIBODY RUBEOLA IGG LAB	$59.25	$79.00	—	—	25%
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES	$56.25	$75.00	—	13% above	25%
Mono test (heterophile antibody, Monospot) CPT 86308 HC MONO TEST	$56.25	$75.00	—	13% above	25%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES	$56.25	$75.00	—	—	25%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC MONO TEST	$56.25	$75.00	—	—	25%
Mumps immunity blood test CPT 86735 HC MUMPS VIRUS AB IGM (ARUP)	$59.25	$79.00	—	14% above	25%
Mumps immunity blood test CPT 86735 HC MUMPS ANTIBODY IGG	$59.25	$79.00	—	14% above	25%
Mumps immunity blood test CPT 86735 HC ANTIBODY MUMPS LAB	$59.25	$79.00	—	14% above	25%
Mumps immunity blood test CPT 86735 HC ANTIBODY MUMPS CDM	$59.25	$79.00	—	14% above	25%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS VIRUS AB IGM (ARUP)	$59.25	$79.00	—	—	25%
Mumps immunity blood test inpatient CPT 86735 HC ANTIBODY MUMPS CDM	$59.25	$79.00	—	—	25%
Mumps immunity blood test inpatient CPT 86735 HC ANTIBODY MUMPS LAB	$59.25	$79.00	—	—	25%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS ANTIBODY IGG	$59.25	$79.00	—	—	25%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC ANTIGEN FREE	$87.00	$116.00	—	12% above	25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC ANTIGEN FREE	$87.00	$116.00	—	—	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN TOTAL	$80.25	$107.00	—	7% above	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM	$80.25	$107.00	—	7% above	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL LAB	$80.25	$107.00	—	7% above	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM	$80.25	$107.00	—	—	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL LAB	$80.25	$107.00	—	—	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN TOTAL	$80.25	$107.00	—	—	25%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS	$90.75	$121.00	—	at median	25%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS	$90.75	$121.00	—	—	25%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN LAB	$75.00	$100.00	—	6% below	25%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN CDM	$75.00	$100.00	—	6% below	25%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC PAP SUREPATH DIAGNOSTIC	$75.00	$100.00	—	6% below	25%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC PAP-THIN PREP SCREENING	$75.00	$100.00	—	6% below	25%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN LAB	$75.00	$100.00	—	—	25%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN CDM	$75.00	$100.00	—	—	25%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC PAP-THIN PREP SCREENING	$75.00	$100.00	—	—	25%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC PAP SUREPATH DIAGNOSTIC	$75.00	$100.00	—	—	25%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHORMONE (PARATHYROID HORMONE)	$165.75	$221.00	—	at median	25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHORMONE (PARATHYROID HORMONE)	$165.75	$221.00	—	—	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL	$65.25	$87.00	—	20% above	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC ZPTT-D (PANL)	$65.25	$87.00	—	20% above	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB	$65.25	$87.00	—	20% above	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB	$65.25	$87.00	—	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL	$65.25	$87.00	—	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC ZPTT-D (PANL)	$65.25	$87.00	—	—	25%
Phosphorus (phosphate) blood test CPT 84100 HC ASSAY PHOSPHORUS	$22.50	$30.00	—	25% below	25%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC ASSAY PHOSPHORUS	$22.50	$30.00	—	—	25%
Potassium blood test CPT 84132 HC POTASSIUM SERUM PLASMA/WHOLE BLOOD	$21.75	$29.00	—	at median	25%
Potassium blood test CPT 84132 HC POTASSIUM WHOLE BLOOD	$21.75	$29.00	—	at median	25%
Potassium blood test CPT 84132 HC POTASSIUM	$21.75	$29.00	—	at median	25%
Potassium blood test inpatient CPT 84132 HC POTASSIUM WHOLE BLOOD	$21.75	$29.00	—	—	25%
Potassium blood test inpatient CPT 84132 HC POTASSIUM SERUM PLASMA/WHOLE BLOOD	$21.75	$29.00	—	—	25%
Potassium blood test inpatient CPT 84132 HC POTASSIUM	$21.75	$29.00	—	—	25%
Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE CDM	$120.75	$161.00	—	14% above	25%
Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE CDM	$120.75	$161.00	—	—	25%
Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN CDM	$126.00	$168.00	—	41% above	25%
Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN CDM	$126.00	$168.00	—	—	25%
Prothrombin time (PT/INR) clotting test CPT 85610 HC ZPT-D (PANL)	$41.25	$55.00	—	47% above	25%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME	$41.25	$55.00	—	47% above	25%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME 85610	$41.25	$55.00	—	47% above	25%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME LAB	$41.25	$55.00	—	47% above	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME LAB	$41.25	$55.00	—	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC ZPT-D (PANL)	$41.25	$55.00	—	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME	$41.25	$55.00	—	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME 85610	$41.25	$55.00	—	—	25%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP GROUP A AG RFLX CULTURE	$55.50	$74.00	—	at median	25%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC IAADIADOO STREPTOCOCCUS GROUP A LAB	$55.50	$74.00	—	at median	25%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC IAADIADOO STREPTOCOCCUS GROUP A LAB	$55.50	$74.00	—	—	25%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP GROUP A AG RFLX CULTURE	$55.50	$74.00	—	—	25%
Renin blood test CPT 84244 HC RENIN ACTIVITY(ARUP)	$28.50	$38.00	—	59% below	25%
Renin blood test CPT 84244 HC ASSAY OF RENIN CDM	$28.50	$38.00	—	59% below	25%
Renin blood test CPT 84244 HC RENIN	$28.50	$38.00	—	59% below	25%
Renin blood test inpatient CPT 84244 HC RENIN ACTIVITY(ARUP)	$28.50	$38.00	—	—	25%
Renin blood test inpatient CPT 84244 HC ASSAY OF RENIN CDM	$28.50	$38.00	—	—	25%
Renin blood test inpatient CPT 84244 HC RENIN	$28.50	$38.00	—	—	25%
Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH(D)	$52.50	$70.00	—	25% above	25%
Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) LAB	$52.50	$70.00	—	25% above	25%
Rh blood typing CPT 86901 HC RH (D)	$52.50	$70.00	—	25% above	25%
Rh blood typing inpatient CPT 86901 HC RH (D)	$52.50	$70.00	—	—	25%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH(D)	$52.50	$70.00	—	—	25%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) LAB	$52.50	$70.00	—	—	25%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR	$74.25	$99.00	—	77% above	25%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR	$74.25	$99.00	—	—	25%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY (OF PANEL)	$39.75	$53.00	—	13% below	25%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY	$39.75	$53.00	—	13% below	25%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY (OF PANEL)	$39.75	$53.00	—	—	25%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY	$39.75	$53.00	—	—	25%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC RBC SED RATE AUTOMATED	$24.00	$32.00	—	15% below	25%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC SEDIMENTATION RATE RBC AUTOMATED LAB	$24.00	$32.00	—	15% below	25%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC SEDIMENTATION RATE RBC AUTOMATED LAB	$24.00	$32.00	—	—	25%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC RBC SED RATE AUTOMATED	$24.00	$32.00	—	—	25%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC SEMEN ANALYSIS	$97.50	$130.00	—	at median	25%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC SEMEN ANALYSIS	$97.50	$130.00	—	—	25%
Sodium blood test CPT 84295 HC SODIUM BLOOD	$25.50	$34.00	—	2% below	25%
Sodium blood test CPT 84295 HC SODIUM	$25.50	$34.00	—	2% below	25%
Sodium blood test CPT 84295 HC SODIUM SERUM PLASMA OR WHOLE BLOOD CDM	$25.50	$34.00	—	2% below	25%
Sodium blood test inpatient CPT 84295 HC SODIUM BLOOD	$25.50	$34.00	—	—	25%
Sodium blood test inpatient CPT 84295 HC SODIUM	$25.50	$34.00	—	—	25%
Sodium blood test inpatient CPT 84295 HC SODIUM SERUM PLASMA OR WHOLE BLOOD CDM	$25.50	$34.00	—	—	25%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES EXAM	$93.75	$125.00	—	74% above	25%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS	$93.75	$125.00	—	74% above	25%
Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES EXAM	$93.75	$125.00	—	—	25%
Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES SMEARS	$93.75	$125.00	—	—	25%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM	$34.50	$46.00	—	at median	25%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD FECES	$34.50	$46.00	—	at median	25%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM	$34.50	$46.00	—	—	25%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC OCCULT BLOOD FECES	$34.50	$46.00	—	—	25%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 CDM	$55.50	$74.00	—	1% below	25%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 CDM	$55.50	$74.00	—	—	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM LAB	$31.50	$42.00	—	9% below	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC MHA-TP CONFIRMATION REFLX (ARUP)	$31.50	$42.00	—	9% below	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC FTA-ABS (ARUP)	$31.50	$42.00	—	9% below	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC TREPONEMA PALLIDUM - AB	$31.50	$42.00	—	9% below	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM CDM	$31.50	$42.00	—	9% below	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM LAB	$31.50	$42.00	—	—	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC MHA-TP CONFIRMATION REFLX (ARUP)	$31.50	$42.00	—	—	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM CDM	$31.50	$42.00	—	—	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC FTA-ABS (ARUP)	$31.50	$42.00	—	—	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC TREPONEMA PALLIDUM - AB	$31.50	$42.00	—	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREP QUAL - CSF	$32.25	$43.00	—	at median	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL	$32.25	$43.00	—	at median	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREP QUAL	$32.25	$43.00	—	at median	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREP QUAL	$32.25	$43.00	—	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL	$32.25	$43.00	—	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREP QUAL - CSF	$32.25	$43.00	—	—	25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON CDM	$241.50	$322.00	—	37% above	25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON CDM	$241.50	$322.00	—	—	25%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE TOTAL	$59.25	$79.00	—	26% below	25%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL	$59.25	$79.00	—	26% below	25%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL LAB	$59.25	$79.00	—	26% below	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE TOTAL	$59.25	$79.00	—	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL	$59.25	$79.00	—	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL LAB	$59.25	$79.00	—	—	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC THYROID PEROXIDASE AB (ANTI-TPO)	$68.25	$91.00	—	at median	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODIES EACH CDM	$68.25	$91.00	—	at median	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC THYROID PEROXIDASE AB (ANTI-TPO)	$68.25	$91.00	—	—	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODIES EACH CDM	$68.25	$91.00	—	—	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB	$70.50	$94.00	—	3% below	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH REFLEX TO FT4	$70.50	$94.00	—	3% below	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE TSH	$70.50	$94.00	—	3% below	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH	$70.50	$94.00	—	3% below	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE TSH	$70.50	$94.00	—	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB	$70.50	$94.00	—	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH REFLEX TO FT4	$70.50	$94.00	—	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH	$70.50	$94.00	—	—	25%
Total IgE blood test CPT 82785 HC ASSAY OF IGE	$72.00	$96.00	—	31% above	25%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF IGE	$72.00	$96.00	—	—	25%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL	$20.25	$27.00	—	16% below	25%
Total cholesterol blood test CPT 82465 HC ASSAY BLD/SERUM CHOLESTEROL	$20.25	$27.00	—	16% below	25%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL SERUM/WHOLE BLOOD TOTAL LAB	$20.25	$27.00	—	16% below	25%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL BODY FLUID	$20.25	$27.00	—	16% below	25%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL BODY FLUID	$20.25	$27.00	—	—	25%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL SERUM/WHOLE BLOOD TOTAL LAB	$20.25	$27.00	—	—	25%
Total cholesterol blood test inpatient CPT 82465 HC ASSAY BLD/SERUM CHOLESTEROL	$20.25	$27.00	—	—	25%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL	$20.25	$27.00	—	—	25%
Total thyroxine (T4) blood test CPT 84436 HC ZT4 (PANL)	$31.50	$42.00	—	8% above	25%
Total thyroxine (T4) blood test CPT 84436 HC ASSAY OF THYROXINE TOTAL LAB	$31.50	$42.00	—	8% above	25%
Total thyroxine (T4) blood test CPT 84436 HC THYROXINE TOTAL	$31.50	$42.00	—	8% above	25%
Total thyroxine (T4) blood test inpatient CPT 84436 HC ASSAY OF THYROXINE TOTAL LAB	$31.50	$42.00	—	—	25%
Total thyroxine (T4) blood test inpatient CPT 84436 HC ZT4 (PANL)	$31.50	$42.00	—	—	25%
Total thyroxine (T4) blood test inpatient CPT 84436 HC THYROXINE TOTAL	$31.50	$42.00	—	—	25%
Total triiodothyronine (T3) blood test CPT 84480 HC ASSAY TRIIODOTHYRONINE (T3)	$85.50	$114.00	—	14% above	25%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC ASSAY TRIIODOTHYRONINE (T3)	$85.50	$114.00	—	—	25%
Transferrin blood test CPT 84466 HC ASSAY OF TRANSFERRIN	$52.50	$70.00	—	at median	25%
Transferrin blood test CPT 84466 HC ASSAY TRANSFERRIN	$52.50	$70.00	—	at median	25%
Transferrin blood test inpatient CPT 84466 HC ASSAY OF TRANSFERRIN	$52.50	$70.00	—	—	25%
Transferrin blood test inpatient CPT 84466 HC ASSAY TRANSFERRIN	$52.50	$70.00	—	—	25%
Trichomonas test (NAAT) CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH LAB	$48.00	$64.00	—	6% below	25%
Trichomonas test (NAAT) inpatient CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH LAB	$48.00	$64.00	—	—	25%
Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES	$25.50	$34.00	—	at median	25%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES	$25.50	$34.00	—	at median	25%
Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES LAB	$25.50	$34.00	—	at median	25%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES	$25.50	$34.00	—	—	25%
Triglycerides blood test inpatient CPT 84478 HC ASSAY OF TRIGLYCERIDES LAB	$25.50	$34.00	—	—	25%
Triglycerides blood test inpatient CPT 84478 HC ASSAY OF TRIGLYCERIDES	$25.50	$34.00	—	—	25%
Troponin test, quantitative CPT 84484 HC TROPONIN QUANTITATIVE	$123.75	$165.00	—	18% above	25%
Troponin test, quantitative CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE	$123.75	$165.00	—	18% above	25%
Troponin test, quantitative inpatient CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE	$123.75	$165.00	—	—	25%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN QUANTITATIVE	$123.75	$165.00	—	—	25%
Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID CDM	$25.50	$34.00	—	12% below	25%
Uric acid blood test inpatient CPT 84550 HC ASSAY OF BLOOD/URIC ACID CDM	$25.50	$34.00	—	—	25%
Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB	$39.00	$52.00	—	19% above	25%
Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM	$39.00	$52.00	—	19% above	25%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB	$39.00	$52.00	—	—	25%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM	$39.00	$52.00	—	—	25%
Urinalysis without microscope exam, automated CPT 81003 HC PH URINE DIPSTICK AUTO W/O MICROSCOPY LAB	$19.50	$26.00	—	at median	25%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE	$19.50	$26.00	—	at median	25%
Urinalysis without microscope exam, automated CPT 81003 HC SPECIFIC GRAVITY URINE	$19.50	$26.00	—	at median	25%
Urinalysis without microscope exam, automated CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB	$19.50	$26.00	—	at median	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC SPECIFIC GRAVITY URINE	$19.50	$26.00	—	—	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC PH URINE DIPSTICK AUTO W/O MICROSCOPY LAB	$19.50	$26.00	—	—	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB	$19.50	$26.00	—	—	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE	$19.50	$26.00	—	—	25%
Urinalysis without microscope exam, manual CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP CDM	$19.50	$26.00	—	19% below	25%
Urinalysis without microscope exam, manual CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$19.50	$26.00	—	19% below	25%
Urinalysis without microscope exam, manual CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP LAB	$19.50	$26.00	—	19% below	25%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP LAB	$19.50	$26.00	—	—	25%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$19.50	$26.00	—	—	25%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP CDM	$19.50	$26.00	—	—	25%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE-URINE	$35.25	$47.00	—	33% below	25%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE LAB	$35.25	$47.00	—	33% below	25%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE-URINE	$35.25	$47.00	—	—	25%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE LAB	$35.25	$47.00	—	—	25%
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN QUANTITATIVE	$54.00	$72.00	—	14% above	25%
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN URINE RANDOM	$54.00	$72.00	—	14% above	25%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN QUANTITATIVE	$54.00	$72.00	—	—	25%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN URINE RANDOM	$54.00	$72.00	—	—	25%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST	$84.75	$113.00	—	55% above	25%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST	$84.75	$113.00	—	—	25%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12	$87.75	$117.00	—	13% above	25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B-12	$87.75	$117.00	—	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED LAB	$90.75	$121.00	—	12% below	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$90.75	$121.00	—	12% below	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$90.75	$121.00	—	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED LAB	$90.75	$121.00	—	—	25%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$52.50	$70.00	—	49% below	25%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VITAMIN D 1 25-DIHYDROXY	$52.50	$70.00	—	49% below	25%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$52.50	$70.00	—	—	25%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC VITAMIN D 1 25-DIHYDROXY	$52.50	$70.00	—	—	25%
Zinc blood test CPT 84630 HC ASSAY OF ZINC CDM	$28.50	$38.00	—	18% below	25%
Zinc blood test CPT 84630 HC ASSAY ZINC	$28.50	$38.00	—	18% below	25%
Zinc blood test CPT 84630 HC ZINC SERUM(ARUP)	$28.50	$38.00	—	18% below	25%
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC CDM	$28.50	$38.00	—	—	25%
Zinc blood test inpatient CPT 84630 HC ZINC SERUM(ARUP)	$28.50	$38.00	—	—	25%
Zinc blood test inpatient CPT 84630 HC ASSAY ZINC	$28.50	$38.00	—	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE LAB	$65.25	$87.00	—	9% below	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE CDM	$65.25	$87.00	—	9% below	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE	$65.25	$87.00	—	9% below	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC ZHCG(PANL)	$65.25	$87.00	—	9% below	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC CHORIONIC GONADOTROPIN QUANT	$65.25	$87.00	—	9% below	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC ZHCG(PANL)	$65.25	$87.00	—	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC CHORIONIC GONADOTROPIN QUANT	$65.25	$87.00	—	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE LAB	$65.25	$87.00	—	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE CDM	$65.25	$87.00	—	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE	$65.25	$87.00	—	—	25%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Oregon	Off list
Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC ED SINUS ENDO W/BALLOON DILATION CDM	$17,541.00	$23,388.00	—	10% above	25%
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 HC ED SINUS ENDO W/BALLOON DILATION CDM	$17,541.00	$23,388.00	—	—	25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST 1ST LESION STEREO	$5,205.75	$6,941.00	—	31% above	25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST 1ST LESION STEREO	$5,205.75	$6,941.00	—	—	25%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC ED CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM	$875.25	$1,167.00	—	52% above	25%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC ED CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM	$875.25	$1,167.00	—	—	25%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC ED TREAT METATARSAL FRACTURE W/O MANIPULATION CDM	$602.25	$803.00	—	32% above	25%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC ED TREAT METATARSAL FRACTURE W/O MANIPULATION CDM	$602.25	$803.00	—	—	25%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HC ED CORRECTION OF BUNION CDM	$8,870.25	$11,827.00	—	12% above	25%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 HC ED CORRECTION OF BUNION CDM	$8,870.25	$11,827.00	—	—	25%
Cardiac catheterization with coronary angiogram CPT 93458 HC CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I	$15,000.00	$20,000.00	—	54% above	25%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 HC CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I	$15,000.00	$20,000.00	—	—	25%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC PR ED 92960 CARDIOVERSION ELECTIVE EXTERNAL CDM	$308.25	$411.00	—	79% below	25%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$2,183.25	$2,911.00	—	49% above	25%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC PR ED 92960 CARDIOVERSION ELECTIVE EXTERNAL CDM	$308.25	$411.00	—	—	25%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$2,183.25	$2,911.00	—	—	25%
Carpal tunnel release, open surgery CPT 64721 HC ED NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL CDM	$8,400.75	$11,201.00	—	76% above	25%
Carpal tunnel release, open surgery inpatient CPT 64721 HC ED NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL CDM	$8,400.75	$11,201.00	—	—	25%
Catheter ablation for atrial fibrillation CPT 93656 HC COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$69,750.00	$93,000.00	—	91% above	25%
Catheter ablation for atrial fibrillation CPT 93656 HC EP STUDY W AFIB ABL COMPL	$88,107.75	$117,477.00	—	141% above	25%
Catheter ablation for atrial fibrillation inpatient CPT 93656 HC COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$69,750.00	$93,000.00	—	—	25%
Catheter ablation for atrial fibrillation inpatient CPT 93656 HC EP STUDY W AFIB ABL COMPL	$88,107.75	$117,477.00	—	—	25%
Cervical biopsy CPT 57500 HC BIOPSY OF CERVIX	$2,251.50	$3,002.00	—	127% above	25%
Cervical biopsy CPT 57500 HC ED BIOPSY OF CERVIX CDM	$3,528.75	$4,705.00	—	255% above	25%
Cervical biopsy CPT 57500 HC BIOPSY OF CERVIX	$3,528.75	$4,705.00	—	255% above	25%
Cervical biopsy inpatient CPT 57500 HC ED BIOPSY OF CERVIX CDM	$3,528.75	$4,705.00	—	—	25%
Cervical biopsy inpatient CPT 57500 HC BIOPSY OF CERVIX	$3,528.75	$4,705.00	—	—	25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION W/REGIONL BLOCK CDM	$469.50	$626.00	—	3% below	25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION W/REGIONL BLOCK CDM	$469.50	$626.00	—	—	25%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC ED TREAT DISTAL RADIAL FRACTURE RADIUS/ULNA W/O MANIP CDM	$875.25	$1,167.00	—	65% above	25%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC ED TREAT DISTAL RADIAL FRACTURE RADIUS/ULNA W/O MANIP CDM	$875.25	$1,167.00	—	—	25%
Colonoscopy, diagnostic CPT 45378 HC ED COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD CDM	$2,103.75	$2,805.00	—	at median	25%
Colonoscopy, diagnostic inpatient CPT 45378 HC ED COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD CDM	$2,103.75	$2,805.00	—	—	25%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC BX OF CERVIX W/SCOPE LEEP	$7,000.50	$9,334.00	—	305% above	25%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC BX/CURETT OF CERVIX W/SCOPE	$1,328.25	$1,771.00	—	221% above	25%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HC BX/CURETT OF CERVIX W/SCOPE	$1,328.25	$1,771.00	—	—	25%
Coronary stent placement, one artery CPT 92928 HC INSERT COR STENT PERC TRLUML W/ANGIO ONE ART/BRNCH	$28,247.25	$37,663.00	—	56% above	25%
Coronary stent placement, one artery inpatient CPT 92928 HC INSERT COR STENT PERC TRLUML W/ANGIO ONE ART/BRNCH	$28,247.25	$37,663.00	—	—	25%
Cystoscopy with ureteral stent placement CPT 52332 HC CYSTOURETHROSCOPY, W/ INSERTION OF INDWELLING URETERAL STENT	$13,448.25	$17,931.00	—	150% above	25%
Cystoscopy with ureteral stent placement inpatient CPT 52332 HC CYSTOURETHROSCOPY, W/ INSERTION OF INDWELLING URETERAL STENT	$13,448.25	$17,931.00	—	—	25%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOSCOPY	$3,253.50	$4,338.00	—	381% above	25%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC ED CYSTOURETHROSCOPY CDM	$3,253.50	$4,338.00	—	381% above	25%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC ED CYSTOURETHROSCOPY CDM	$3,253.50	$4,338.00	—	—	25%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOSCOPY	$3,253.50	$4,338.00	—	—	25%
D&C (dilation and curettage), not related to pregnancy CPT 58120 HC ED DILATION AND CURETTAGE CDM	$8,424.75	$11,233.00	—	97% above	25%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC ED DILATION AND CURETTAGE CDM	$8,424.75	$11,233.00	—	—	25%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUCTION PREMALIGNANT LESION 1ST	$471.75	$629.00	—	187% above	25%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC ED DESTRUCT PREMALG LESION FIRST LESION CDM	$1,036.50	$1,382.00	—	531% above	25%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC ED DESTRUCT PREMALG LESION FIRST LESION CDM	$1,036.50	$1,382.00	—	—	25%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC ED REMOVE IMPACTED EAR WAX UNI CDM	$360.00	$480.00	—	363% above	25%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC PR ED 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT CDM	$45.00	$60.00	—	42% below	25%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC ED REMOVE IMPACTED EAR WAX UNI CDM	$360.00	$480.00	—	—	25%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC PR ED 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT CDM	$45.00	$60.00	—	—	25%
Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$378.75	$505.00	—	238% above	25%
Earwax removal with instruments, one ear one side CPT 69210 HC ED REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$378.75	$505.00	—	238% above	25%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC ED REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$378.75	$505.00	—	—	25%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$378.75	$505.00	—	—	25%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ENDOMET BX WO CER DIL CDM	$468.75	$625.00	—	13% above	25%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC BIOPSY OF UTERUS LINING	$862.50	$1,150.00	—	108% above	25%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ED ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX CDM	$862.50	$1,150.00	—	108% above	25%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC ED ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX CDM	$862.50	$1,150.00	—	—	25%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC BIOPSY OF UTERUS LINING	$862.50	$1,150.00	—	—	25%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC ED INJ INTERLAMINR CRV-THOR W IMG CDM	$1,920.00	$2,560.00	—	at median	25%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC ED INJ INTERLAMINR CRV-THOR W IMG CDM	$1,920.00	$2,560.00	—	—	25%
Eye injection into the vitreous (intravitreal injection) CPT 67028 HC ED INTRAVITREAL NJX PHARMACOLOGIC AGT SPX CDM	$624.00	$832.00	—	12% below	25%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HC ED INTRAVITREAL NJX PHARMACOLOGIC AGT SPX CDM	$624.00	$832.00	—	—	25%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV	$2,145.00	$2,860.00	—	11% above	25%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV	$2,145.00	$2,860.00	—	—	25%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC ED SIGMOID DX FLX W WO SPEC COLL CDM	$2,103.75	$2,805.00	—	97% above	25%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC ED SIGMOID DX FLX W WO SPEC COLL CDM	$2,103.75	$2,805.00	—	—	25%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC PR 47563 LAPAROSCOPY CHOLECYSTECTOMY/GRAPH	$2,094.00	$2,792.00	—	82% below	25%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC ED LAPARO CHOLECYSTECTOMY/GRAPH CDM	$11,764.50	$15,686.00	—	3% above	25%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 HC ED LAPARO CHOLECYSTECTOMY/GRAPH CDM	$11,764.50	$15,686.00	—	—	25%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC ED HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS CDM	$2,476.50	$3,302.00	—	235% above	25%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC ED HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS CDM	$2,476.50	$3,302.00	—	—	25%
Hemorrhoidectomy (internal and external), one area CPT 46255 HC ED HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP CDM	$7,656.00	$10,208.00	—	33% above	25%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HC ED HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP CDM	$7,656.00	$10,208.00	—	—	25%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC CATHETER FOR HYSTEROGRAPHY	$783.75	$1,045.00	—	180% above	25%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC CATHETER FOR HYSTEROGRAPHY	$783.75	$1,045.00	—	—	25%
IUD insertion (the device itself billed separately) CPT 58300 HC ED INSERTION INTRAUTERINE DEVICE IUD CDM	$437.25	$583.00	—	at median	25%
IUD insertion (the device itself billed separately) CPT 58300 HC INSERT INTRAUTERINE DEVICE IUD	$437.25	$583.00	—	at median	25%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC INSERT INTRAUTERINE DEVICE IUD	$437.25	$583.00	—	—	25%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC ED INSERTION INTRAUTERINE DEVICE IUD CDM	$437.25	$583.00	—	—	25%
Incision and drainage of a simple or single skin abscess CPT 10060 HC ED DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM	$714.00	$952.00	—	103% above	25%
Incision and drainage of a simple or single skin abscess CPT 10060 HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$714.00	$952.00	—	103% above	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC ED DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM	$714.00	$952.00	—	—	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$714.00	$952.00	—	—	25%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC ED RPR 1ST INGUN HRNA AGE 5 YRS OR MORE REDUCIBLE CDM	$10,554.00	$14,072.00	—	18% above	25%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC ED RPR 1ST INGUN HRNA AGE 5 YRS OR MORE REDUCIBLE CDM	$10,554.00	$14,072.00	—	—	25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC ED INJ TENDON SHEATH/LIGAMENT CDM	$94.50	$126.00	—	60% below	25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$600.00	$800.00	—	151% above	25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC ED INJ TENDON SHEATH/LIGAMENT CDM	$1,485.00	$1,980.00	—	521% above	25%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$600.00	$800.00	—	—	25%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC ED INJ TENDON SHEATH/LIGAMENT CDM	$1,485.00	$1,980.00	—	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$90.75	$121.00	—	71% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ED ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US CDM	$1,449.75	$1,933.00	—	365% above	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$1,449.75	$1,933.00	—	365% above	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ED ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US CDM	$1,449.75	$1,933.00	—	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$1,449.75	$1,933.00	—	—	25%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT CDM	$534.75	$713.00	—	109% above	25%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT DEVICE	$534.75	$713.00	—	109% above	25%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT DEVICE	$534.75	$713.00	—	—	25%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT CDM	$534.75	$713.00	—	—	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE	$90.75	$121.00	—	74% below	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE	$1,368.75	$1,825.00	—	298% above	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ED ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US CDM	$1,368.75	$1,825.00	—	298% above	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ED ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US CDM	$1,368.75	$1,825.00	—	—	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE	$1,368.75	$1,825.00	—	—	25%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE	$90.75	$121.00	—	71% below	25%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ED ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US CDM	$1,287.75	$1,717.00	—	310% above	25%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE	$1,287.75	$1,717.00	—	310% above	25%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE	$1,287.75	$1,717.00	—	—	25%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ED ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US CDM	$1,287.75	$1,717.00	—	—	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC ED INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM	$746.25	$995.00	—	24% above	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC REPAIR INTMD WND S/TR/EXT LTE 2.5CM CDM	$746.25	$995.00	—	24% above	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC ED INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM	$746.25	$995.00	—	—	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC REPAIR INTMD WND S/TR/EXT LTE 2.5CM CDM	$746.25	$995.00	—	—	25%
Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY	$8,417.25	$11,223.00	—	3% above	25%
Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY	$8,417.25	$11,223.00	—	—	25%
Lower-back epidural injection, with imaging guidance CPT 62323 HC ED INJ EPI LUMB/SACRAL W IMAGING CDM	$3,228.75	$4,305.00	—	104% above	25%
Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ W/NDL OR CATH PLCMNT EPIDRL L/S W/IMG	$3,228.75	$4,305.00	—	104% above	25%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ W/NDL OR CATH PLCMNT EPIDRL L/S W/IMG	$3,228.75	$4,305.00	—	—	25%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC ED INJ EPI LUMB/SACRAL W IMAGING CDM	$3,228.75	$4,305.00	—	—	25%
Lower-back epidural injection, without imaging guidance CPT 62322 HC ED INJ EPI LUMB/SACRAL WO IMAGING CDM	$2,538.75	$3,385.00	—	62% above	25%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC ED INJ EPI LUMB/SACRAL WO IMAGING CDM	$2,538.75	$3,385.00	—	—	25%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ FORAMEN EPIDURAL L/S	$2,832.75	$3,777.00	—	71% above	25%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ FORAMEN EPIDURAL L/S	$2,832.75	$3,777.00	—	—	25%
Miscarriage treatment with D&C, first trimester CPT 59820 HC ED SPONTANEOUS ABORTION FAC CDM	$10,342.50	$13,790.00	—	129% above	25%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HC ED SPONTANEOUS ABORTION FAC CDM	$10,342.50	$13,790.00	—	—	25%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM OR LESS CDM	$1,933.50	$2,578.00	—	210% above	25%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS CDM	$1,933.50	$2,578.00	—	210% above	25%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM OR LESS CDM	$1,933.50	$2,578.00	—	—	25%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS CDM	$1,933.50	$2,578.00	—	—	25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC ED EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM OR LESS CDM	$1,933.50	$2,578.00	—	183% above	25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC ED EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM OR LESS CDM	$1,933.50	$2,578.00	—	—	25%
Nail removal (partial or complete), one nail CPT 11730 HC ED REMOVAL OF NAIL PLATE CDM	$653.25	$871.00	—	223% above	25%
Nail removal (partial or complete), one nail CPT 11730 HC AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 CDM	$653.25	$871.00	—	223% above	25%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 CDM	$653.25	$871.00	—	—	25%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC ED REMOVAL OF NAIL PLATE CDM	$653.25	$871.00	—	—	25%
Occipital nerve block (injection for headaches) CPT 64405 HC INJECTION AA&/STRD GREATER OCCIPITAL NERVE	$1,372.50	$1,830.00	—	250% above	25%
Occipital nerve block (injection for headaches) CPT 64405 HC ED NERVE BLOCK INJ OCCIPITAL CDM	$1,372.50	$1,830.00	—	250% above	25%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC ED NERVE BLOCK INJ OCCIPITAL CDM	$1,372.50	$1,830.00	—	—	25%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJECTION AA&/STRD GREATER OCCIPITAL NERVE	$1,372.50	$1,830.00	—	—	25%
Paracentesis with imaging guidance CPT 49083 HC ED ABD PARACENTESIS W/IMAG GUIDANCE CDM	$2,634.00	$3,512.00	—	98% above	25%
Paracentesis with imaging guidance CPT 49083 HC ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE CDM	$2,705.25	$3,607.00	—	103% above	25%
Paracentesis with imaging guidance inpatient CPT 49083 HC ED ABD PARACENTESIS W/IMAG GUIDANCE CDM	$2,634.00	$3,512.00	—	—	25%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE CDM	$2,705.25	$3,607.00	—	—	25%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC EXCISION NAIL MATRIX PERMANENT REMOVAL	$1,427.25	$1,903.00	—	137% above	25%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC ED REMOVAL OF NAIL BED CDM	$1,427.25	$1,903.00	—	137% above	25%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC ED REMOVAL OF NAIL BED CDM	$1,427.25	$1,903.00	—	—	25%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC EXCISION NAIL MATRIX PERMANENT REMOVAL	$1,427.25	$1,903.00	—	—	25%
Prostate biopsy CPT 55700 HC BIOPSY OF PROSTATE	$3,816.00	$5,088.00	—	56% above	25%
Prostate biopsy inpatient CPT 55700 HC BIOPSY OF PROSTATE	$3,816.00	$5,088.00	—	—	25%
Removal of a breast lump, open surgery CPT 19120 HC REMOVAL OF BREAST LESION 1OR MORE LESION	$7,905.75	$10,541.00	—	393% above	25%
Removal of a breast lump, open surgery inpatient CPT 19120 HC REMOVAL OF BREAST LESION 1OR MORE LESION	$7,905.75	$10,541.00	—	—	25%
Removal of a foreign object under the skin, simple CPT 10120 HC ED REMOVE FOREIGN BODY SIMPLE CDM	$875.25	$1,167.00	—	113% above	25%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC ED REMOVE FOREIGN BODY SIMPLE CDM	$875.25	$1,167.00	—	—	25%
Septoplasty to straighten the nasal septum CPT 30520 HC ED REPAIR OF NASAL SEPTUM CDM	$8,478.00	$11,304.00	—	16% above	25%
Septoplasty to straighten the nasal septum inpatient CPT 30520 HC ED REPAIR OF NASAL SEPTUM CDM	$8,478.00	$11,304.00	—	—	25%
Short arm cast (elbow to hand) CPT 29075 HC ED SHORT ARM CAST APPLICATION CDM	$1,275.00	$1,700.00	—	383% above	25%
Short arm cast (elbow to hand) inpatient CPT 29075 HC ED SHORT ARM CAST APPLICATION CDM	$1,275.00	$1,700.00	—	—	25%
Short arm splint (forearm and hand) CPT 29125 HC ED SHORT ARM SPLINT APPLICATION CDM	$344.25	$459.00	—	91% above	25%
Short arm splint (forearm and hand) CPT 29125 HC APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC 15 MIN	$344.25	$459.00	—	91% above	25%
Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC 15 MIN	$344.25	$459.00	—	—	25%
Short arm splint (forearm and hand) inpatient CPT 29125 HC ED SHORT ARM SPLINT APPLICATION CDM	$344.25	$459.00	—	—	25%
Short leg cast (below the knee) CPT 29405 HC ED SHORT LEG CAST APPLICATION CDM	$1,275.00	$1,700.00	—	338% above	25%
Short leg cast (below the knee) inpatient CPT 29405 HC ED SHORT LEG CAST APPLICATION CDM	$1,275.00	$1,700.00	—	—	25%
Short leg splint (calf to foot) CPT 29515 HC ED SHORT LEG SPLINT APPLICATION CDM	$413.25	$551.00	—	75% above	25%
Short leg splint (calf to foot) inpatient CPT 29515 HC ED SHORT LEG SPLINT APPLICATION CDM	$413.25	$551.00	—	—	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM	$588.75	$785.00	—	73% above	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM	$588.75	$785.00	—	—	25%
Skin biopsy, punch, one lesion CPT 11104 HC PR 11104 PUNCH BIOPSY SKIN SINGLE LESION	$134.25	$179.00	—	52% below	25%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$966.75	$1,289.00	—	247% above	25%
Skin biopsy, punch, one lesion CPT 11104 HC ED PUNCH BIOPSY SKIN SINGLE LESION CDM	$966.75	$1,289.00	—	247% above	25%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$1,116.00	$1,488.00	—	301% above	25%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PR 11104 PUNCH BIOPSY SKIN SINGLE LESION	$134.25	$179.00	—	—	25%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$966.75	$1,289.00	—	—	25%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC ED PUNCH BIOPSY SKIN SINGLE LESION CDM	$966.75	$1,289.00	—	—	25%
Skin tag removal, up to 15 tags CPT 11200 HC ED REMOVAL OF SKIN TAGS CDM	$629.25	$839.00	—	150% above	25%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC ED REMOVAL OF SKIN TAGS CDM	$629.25	$839.00	—	—	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$1,427.25	$1,903.00	—	43% above	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC ED SPINAL PUNCTURE LUMBAR DIAGNOSTIC CDM	$1,427.25	$1,903.00	—	43% above	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC ED SPINAL PUNCTURE LUMBAR DIAGNOSTIC CDM	$1,427.25	$1,903.00	—	—	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$1,427.25	$1,903.00	—	—	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC ED REPAIR SUPERFICIAL WND(S) 2.6-7.5CM SLP NK AX EXGEN TRNK E CDM	$588.75	$785.00	—	50% above	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC ED REPAIR SUPERFICIAL WND(S) 2.6-7.5CM SLP NK AX EXGEN TRNK E CDM	$588.75	$785.00	—	—	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair one side CPT 12011 HC ED REPAIR SUPERFICIAL WOUND(S) LT/2.5 FACE ERS EYLD NSE LPS MUC CDM	$687.00	$916.00	—	102% above	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient one side CPT 12011 HC ED REPAIR SUPERFICIAL WOUND(S) LT/2.5 FACE ERS EYLD NSE LPS MUC CDM	$687.00	$916.00	—	—	25%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC PR 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$107.25	$143.00	—	51% below	25%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC ED TANGENTIAL BIOPSY SKIN SINGLE LESION CDM	$966.75	$1,289.00	—	345% above	25%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION	$966.75	$1,289.00	—	345% above	25%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC PR 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$107.25	$143.00	—	—	25%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC ED TANGENTIAL BIOPSY SKIN SINGLE LESION CDM	$966.75	$1,289.00	—	—	25%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION	$966.75	$1,289.00	—	—	25%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$4,614.75	$6,153.00	—	201% above	25%
Thoracentesis with imaging guidance CPT 32555 HC ED THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING CDM	$4,614.75	$6,153.00	—	201% above	25%
Thoracentesis with imaging guidance inpatient CPT 32555 HC ED THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING CDM	$4,614.75	$6,153.00	—	—	25%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$4,614.75	$6,153.00	—	—	25%
Trigger point injections, 1 or 2 muscles CPT 20552 HC IR INJ TRIGGER POINT(S)1TO2 MUSC	$94.50	$126.00	—	60% below	25%
Trigger point injections, 1 or 2 muscles CPT 20552 HC PR ED 20552 INJ TRIGGER POINT 1/2 MUSCL CDM	$105.00	$140.00	—	56% below	25%
Trigger point injections, 1 or 2 muscles CPT 20552 HC ED INJ TRIGGER POINT 1/2 MUSCL CDM	$1,515.75	$2,021.00	—	534% above	25%
Trigger point injections, 1 or 2 muscles CPT 20552 HC IR INJ TRIGGER POINT(S)1TO2 MUSC	$1,515.75	$2,021.00	—	534% above	25%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC PR ED 20552 INJ TRIGGER POINT 1/2 MUSCL CDM	$105.00	$140.00	—	—	25%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC ED INJ TRIGGER POINT 1/2 MUSCL CDM	$1,515.75	$2,021.00	—	—	25%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC IR INJ TRIGGER POINT(S)1TO2 MUSC	$1,515.75	$2,021.00	—	—	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST 1ST LESION US IMAG	$4,212.75	$5,617.00	—	44% above	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST 1ST LESION US IMAG	$4,212.75	$5,617.00	—	—	25%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC ED UGI W DILATION ESOPHAGUS BAL CDM	$3,667.50	$4,890.00	—	34% above	25%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC ED UGI W DILATION ESOPHAGUS BAL CDM	$3,667.50	$4,890.00	—	—	25%
Upper endoscopy (EGD) with biopsy CPT 43239 HC ED EGD TRANSORAL BIOPSY SINGLE/MULTIPLE CDM	$1,548.00	$2,064.00	—	1% above	25%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC ED EGD TRANSORAL BIOPSY SINGLE/MULTIPLE CDM	$1,548.00	$2,064.00	—	—	25%
Upper endoscopy (EGD), diagnostic CPT 43235 HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM	$1,548.00	$2,064.00	—	11% below	25%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM	$1,548.00	$2,064.00	—	—	25%
Vaginal delivery, including prenatal and postpartum care CPT 59400 HC PR 59400 TOTAL OB/VAGINAL DELIVERY/PP CARE	$6,990.75	$9,321.00	—	at median	25%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 HC PR 59400 TOTAL OB/VAGINAL DELIVERY/PP CARE	$6,990.75	$9,321.00	—	—	25%
Wart removal, up to 14 warts CPT 17110 HC ED DESTRUCTION BENIGN LESIONS UP TO 14 CDM	$1,319.25	$1,759.00	—	474% above	25%
Wart removal, up to 14 warts CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14 CDM	$1,319.25	$1,759.00	—	474% above	25%
Wart removal, up to 14 warts inpatient CPT 17110 HC ED DESTRUCTION BENIGN LESIONS UP TO 14 CDM	$1,319.25	$1,759.00	—	—	25%
Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14 CDM	$1,319.25	$1,759.00	—	—	25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEB SUBQ TISSUE FIRST 20 SQ CM OR LESS	$741.75	$989.00	—	22% above	25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC ED DEB SUBQ TISSUE 20 SQ CM OR LESS - DEBRIDE SKIN CDM	$993.75	$1,325.00	—	63% above	25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEB SUBQ TISSUE FIRST 20 SQ CM OR LESS	$741.75	$989.00	—	—	25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC ED DEB SUBQ TISSUE 20 SQ CM OR LESS - DEBRIDE SKIN CDM	$993.75	$1,325.00	—	—	25%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC ED TREAT FX RAD EXTRA-ARTICUL CDM	$19,710.00	$26,280.00	—	205% above	25%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 HC ED TREAT FX RAD EXTRA-ARTICUL CDM	$19,710.00	$26,280.00	—	—	25%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Oregon	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION EA UNIT CDM	$705.75	$941.00	—	16% below	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION EA UNIT CDM	$705.75	$941.00	—	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC ED INHALATION TREATMENT CDM	$210.00	$280.00	—	36% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT DAILY	$210.00	$280.00	—	36% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT DAILY	$210.00	$280.00	—	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC ED INHALATION TREATMENT CDM	$210.00	$280.00	—	—	25%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO IV INFUSION INITIAL HR CDM	$773.25	$1,031.00	—	1% above	25%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO IV INFUSION INITIAL HR CDM	$1,162.50	$1,550.00	—	51% above	25%
Chemotherapy IV infusion, first hour CPT 96413 HC TYSABRI INFUSION FIRST HR	$1,162.50	$1,550.00	—	51% above	25%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC TYSABRI INFUSION FIRST HR	$1,162.50	$1,550.00	—	—	25%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO IV INFUSION INITIAL HR CDM	$1,162.50	$1,550.00	—	—	25%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ	$297.75	$397.00	—	at median	25%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HC COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ	$297.75	$397.00	—	—	25%
Critical care, first 30 to 74 minutes CPT 99291 HC ED OB FAC CRITICAL CARE FIRST HOUR CDM	$1,589.25	$2,119.00	—	40% below	25%
Critical care, first 30 to 74 minutes CPT 99291 HC ED CRITICAL CARE FIRST HOUR CDM	$4,512.75	$6,017.00	—	69% above	25%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ED OB FAC CRITICAL CARE FIRST HOUR CDM	$1,589.25	$2,119.00	—	—	25%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ED CRITICAL CARE FIRST HOUR CDM	$4,512.75	$6,017.00	—	—	25%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY	$858.00	$1,144.00	—	5% below	25%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC PR 95816 EEG AWAKE AND DROWSY	$1,115.25	$1,487.00	—	24% above	25%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY	$858.00	$1,144.00	—	—	25%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC PR 95816 EEG AWAKE AND DROWSY	$1,115.25	$1,487.00	—	—	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ECG 12 LEAD TRACING ONLY	$376.50	$502.00	—	54% above	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ECG 12 LEAD TRACING ONLY	$376.50	$502.00	—	—	25%
Electroconvulsive therapy (ECT), one session CPT 90870 HC ELECTROCONVULSIVE THERAPY	$1,399.50	$1,866.00	—	4% above	25%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 HC ELECTROCONVULSIVE THERAPY	$1,399.50	$1,866.00	—	—	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED OB FAC E&M VISIT LEVEL 1 CDM	$156.00	$208.00	—	37% below	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED FAC E&M VISIT LEVEL 1 CDM	$411.75	$549.00	—	66% above	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED OB FAC E&M VISIT LEVEL 1 CDM	$156.00	$208.00	—	—	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED FAC E&M VISIT LEVEL 1 CDM	$411.75	$549.00	—	—	25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED OB FAC E&M VISIT LEVEL 2 CDM	$288.75	$385.00	—	39% below	25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED FAC E&M VISIT LEVEL 2 CDM	$826.50	$1,102.00	—	75% above	25%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED OB FAC E&M VISIT LEVEL 2 CDM	$288.75	$385.00	—	—	25%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED FAC E&M VISIT LEVEL 2 CDM	$826.50	$1,102.00	—	—	25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED OB FAC E&M VISIT LEVEL 3 CDM	$507.75	$677.00	—	41% below	25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED FAC E&M VISIT LEVEL 3 CDM	$1,206.75	$1,609.00	—	41% above	25%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED OB FAC E&M VISIT LEVEL 3 CDM	$507.75	$677.00	—	—	25%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED FAC E&M VISIT LEVEL 3 CDM	$1,206.75	$1,609.00	—	—	25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED OB FAC E&M VISIT LEVEL 4 CDM	$790.50	$1,054.00	—	43% below	25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED SEXUAL ASSAULT EXAM CDM	$1,956.75	$2,609.00	—	42% above	25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED FAC E&M VISIT LEVEL 4 CDM	$1,956.75	$2,609.00	—	42% above	25%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED OB FAC E&M VISIT LEVEL 4 CDM	$790.50	$1,054.00	—	—	25%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED SEXUAL ASSAULT EXAM CDM	$1,956.75	$2,609.00	—	—	25%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED FAC E&M VISIT LEVEL 4 CDM	$1,956.75	$2,609.00	—	—	25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED OB FAC E&M VISIT LEVEL 5 CDM	$1,134.75	$1,513.00	—	47% below	25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED FAC E&M VISIT LEVEL 5 CDM	$3,111.00	$4,148.00	—	44% above	25%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED OB FAC E&M VISIT LEVEL 5 CDM	$1,134.75	$1,513.00	—	—	25%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED FAC E&M VISIT LEVEL 5 CDM	$3,111.00	$4,148.00	—	—	25%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIO STRESS TEST MEDICINE	$651.00	$868.00	—	3% below	25%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY	$651.00	$868.00	—	3% below	25%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIO STRESS TEST MEDICINE	$651.00	$868.00	—	—	25%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY	$651.00	$868.00	—	—	25%
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT 30 MIN	$133.50	$178.00	—	16% below	25%
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT REHAB 45 MIN	$199.50	$266.00	—	26% above	25%
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT 45 MIN	$199.50	$266.00	—	26% above	25%
Family therapy with the patient, 50 minutes CPT 90847 HC CRISIS TELEH 90847 FAM PSYC THER WITH PT PRESENT 50 MIN CDM	$265.50	$354.00	—	68% above	25%
Family therapy with the patient, 50 minutes CPT 90847 HC PSYCHOTHERAPY FAMILY W PT 50 MINS CDM	$265.50	$354.00	—	68% above	25%
Family therapy with the patient, 50 minutes CPT 90847 HC PSYTX FAMILY W PT 50 MIN PHP/IOP CDM	$265.50	$354.00	—	68% above	25%
Family therapy with the patient, 50 minutes CPT 90847 HC CD IOP TX FAMILY W PATIENT	$265.50	$354.00	—	68% above	25%
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT REHAB 60 MIN	$265.50	$354.00	—	68% above	25%
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT 60 MIN	$265.50	$354.00	—	68% above	25%
Family therapy with the patient, 50 minutes CPT 90847 HC PSYTX FAMILY W PT 50 MIN IOP CDM	$265.50	$354.00	—	68% above	25%
Family therapy with the patient, 50 minutes CPT 90847 HC CD PHP TX FAMILY W PATIENT	$265.50	$354.00	—	68% above	25%
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT 120 MIN	$290.25	$387.00	—	83% above	25%
Family therapy with the patient, 50 minutes CPT 90847 HC PR 90847 PSYTX FAMILY W PT 50 MIN RHC	$304.50	$406.00	—	92% above	25%
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT 75 MIN	$332.25	$443.00	—	110% above	25%
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT 90 MIN	$398.25	$531.00	—	151% above	25%
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT 105 MIN	$445.50	$594.00	—	181% above	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT 30 MIN	$133.50	$178.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT 45 MIN	$199.50	$266.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT REHAB 45 MIN	$199.50	$266.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC CRISIS TELEH 90847 FAM PSYC THER WITH PT PRESENT 50 MIN CDM	$265.50	$354.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC CD PHP TX FAMILY W PATIENT	$265.50	$354.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT 60 MIN	$265.50	$354.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PSYTX FAMILY W PT 50 MIN IOP CDM	$265.50	$354.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT REHAB 60 MIN	$265.50	$354.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC CD IOP TX FAMILY W PATIENT	$265.50	$354.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PSYTX FAMILY W PT 50 MIN PHP/IOP CDM	$265.50	$354.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PSYCHOTHERAPY FAMILY W PT 50 MINS CDM	$265.50	$354.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT 120 MIN	$290.25	$387.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PR 90847 PSYTX FAMILY W PT 50 MIN RHC	$304.50	$406.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT 75 MIN	$332.25	$443.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT 90 MIN	$398.25	$531.00	—	—	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT 105 MIN	$445.50	$594.00	—	—	25%
Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYTX W/O PATIENT 30 MIN	$133.50	$178.00	—	13% below	25%
Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYTX W/O PATIENT REHAB 30 MIN	$133.50	$178.00	—	13% below	25%
Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYTX W/O PATIENT REHAB 45 MIN	$199.50	$266.00	—	30% above	25%
Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYTX W/O PATIENT 45 MIN	$199.50	$266.00	—	30% above	25%
Family therapy without the patient, 50 minutes CPT 90846 HC PSTX FAMILY WO PT 50 MIN CDM	$265.50	$354.00	—	73% above	25%
Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYTX W/O PATIENT 60 MIN	$265.50	$354.00	—	73% above	25%
Family therapy without the patient, 50 minutes CPT 90846 HC PSYTX FAMILY WO PT 50 MIN PHP/IOP CDM	$265.50	$354.00	—	73% above	25%
Family therapy without the patient, 50 minutes CPT 90846 HC PR 90846 PSYTX FAMILY WO PT 50 MIN RHC	$291.75	$389.00	—	90% above	25%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYTX W/O PATIENT 30 MIN	$133.50	$178.00	—	—	25%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYTX W/O PATIENT REHAB 30 MIN	$133.50	$178.00	—	—	25%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYTX W/O PATIENT REHAB 45 MIN	$199.50	$266.00	—	—	25%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYTX W/O PATIENT 45 MIN	$199.50	$266.00	—	—	25%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC PSTX FAMILY WO PT 50 MIN CDM	$265.50	$354.00	—	—	25%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYTX W/O PATIENT 60 MIN	$265.50	$354.00	—	—	25%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC PSYTX FAMILY WO PT 50 MIN PHP/IOP CDM	$265.50	$354.00	—	—	25%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC PR 90846 PSYTX FAMILY WO PT 50 MIN RHC	$291.75	$389.00	—	—	25%
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 15 MIN	$51.75	$69.00	—	41% below	25%
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 30 MIN	$105.00	$140.00	—	19% above	25%
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY 45 MIN	$162.00	$216.00	—	84% above	25%
Group psychotherapy session CPT 90853 HC PSY TX GROUP NON PHP	$245.25	$327.00	—	178% above	25%
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY 60 MIN	$245.25	$327.00	—	178% above	25%
Group psychotherapy session CPT 90853 HC CD PHP TX GROUP	$245.25	$327.00	—	178% above	25%
Group psychotherapy session CPT 90853 HC PSYTX GROUP IOP CDM	$245.25	$327.00	—	178% above	25%
Group psychotherapy session CPT 90853 HC CD IOP TX GROUP	$245.25	$327.00	—	178% above	25%
Group psychotherapy session CPT 90853 HC TELEH PSYCHOTHERAPY GROUP BY HOSP EMPLYED QMP CDM	$245.25	$327.00	—	178% above	25%
Group psychotherapy session CPT 90853 HC PSY/PHP TX GROUP	$245.25	$327.00	—	178% above	25%
Group psychotherapy session CPT 90853 HC PSYCHOTHERAPY GROUP PER DISTINCT/SEPARATE SESSION CDM	$245.25	$327.00	—	178% above	25%
Group psychotherapy session CPT 90853 HC CRISIS TELEH 90853 GROUP PSYCHOTHERAPY CDM	$245.25	$327.00	—	178% above	25%
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 60 MIN	$264.00	$352.00	—	199% above	25%
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY 90 MIN	$285.00	$380.00	—	223% above	25%
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 90 MIN	$322.50	$430.00	—	265% above	25%
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY 120 MIN	$327.00	$436.00	—	271% above	25%
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 120 MIN	$413.25	$551.00	—	368% above	25%
Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 15 MIN	$51.75	$69.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 30 MIN	$105.00	$140.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY 45 MIN	$162.00	$216.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC CD PHP TX GROUP	$245.25	$327.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC PSYTX GROUP IOP CDM	$245.25	$327.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC CRISIS TELEH 90853 GROUP PSYCHOTHERAPY CDM	$245.25	$327.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC PSY/PHP TX GROUP	$245.25	$327.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC PSYCHOTHERAPY GROUP PER DISTINCT/SEPARATE SESSION CDM	$245.25	$327.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC TELEH PSYCHOTHERAPY GROUP BY HOSP EMPLYED QMP CDM	$245.25	$327.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY 60 MIN	$245.25	$327.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC CD IOP TX GROUP	$245.25	$327.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC PSY TX GROUP NON PHP	$245.25	$327.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 60 MIN	$264.00	$352.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY 90 MIN	$285.00	$380.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 90 MIN	$322.50	$430.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY 120 MIN	$327.00	$436.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 120 MIN	$413.25	$551.00	—	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV HYDRATION INITIAL HR CDM	$209.25	$279.00	—	47% below	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC ED IV HYDRATION INITIAL HR CDM	$648.00	$864.00	—	63% above	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV HYDRATION INITIAL HR CDM	$648.00	$864.00	—	63% above	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV HYDRATION INITIAL HR CDM	$648.00	$864.00	—	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC ED IV HYDRATION INITIAL HR CDM	$648.00	$864.00	—	—	25%
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION INITIAL HR CDM	$254.25	$339.00	—	42% below	25%
IV infusion of a medicine, first hour CPT 96365 HC ED IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR CDM	$674.25	$899.00	—	53% above	25%
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION INITIAL HR CDM	$674.25	$899.00	—	53% above	25%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION INITIAL HR CDM	$674.25	$899.00	—	—	25%
IV infusion of a medicine, first hour inpatient CPT 96365 HC ED IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR CDM	$674.25	$899.00	—	—	25%
IV push of a medicine, first drug CPT 96374 HC INJ IV PUSH INITIAL DRUG CDM	$206.25	$275.00	—	17% below	25%
IV push of a medicine, first drug CPT 96374 HC INJ IV PUSH INITIAL DRUG CDM	$317.25	$423.00	—	28% above	25%
IV push of a medicine, first drug CPT 96374 HC ED IV INJECTION THERAPEUTIC PROPH/DX PUSH SINGLE/1ST SBST/DRUG CDM	$378.00	$504.00	—	52% above	25%
IV push of a medicine, first drug inpatient CPT 96374 HC INJ IV PUSH INITIAL DRUG CDM	$317.25	$423.00	—	—	25%
IV push of a medicine, first drug inpatient CPT 96374 HC ED IV INJECTION THERAPEUTIC PROPH/DX PUSH SINGLE/1ST SBST/DRUG CDM	$378.00	$504.00	—	—	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ SQ OR IM CDM	$96.00	$128.00	—	11% below	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC ED THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM CDM	$163.50	$218.00	—	52% above	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ SQ OR IM CDM	$163.50	$218.00	—	52% above	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC ED THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM CDM	$163.50	$218.00	—	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJ SQ OR IM CDM	$163.50	$218.00	—	—	25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PR 90791 PSYCH DIAG EVAL RHC	$424.50	$566.00	—	40% above	25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PR 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$424.50	$566.00	—	40% above	25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCH DIAG EVAL CDM	$489.00	$652.00	—	61% above	25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCH DIAG EVAL IOP CDM	$489.00	$652.00	—	61% above	25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCH DIAG EVAL PHP/IOP CDM	$489.00	$652.00	—	61% above	25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC CRISIS TELEH 90791 PSYCH DIAGNOSTIC EVAL CDM	$489.00	$652.00	—	61% above	25%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PR 90791 PSYCH DIAG EVAL RHC	$424.50	$566.00	—	—	25%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PR 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$424.50	$566.00	—	—	25%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC CRISIS TELEH 90791 PSYCH DIAGNOSTIC EVAL CDM	$489.00	$652.00	—	—	25%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCH DIAG EVAL IOP CDM	$489.00	$652.00	—	—	25%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCH DIAG EVAL PHP/IOP CDM	$489.00	$652.00	—	—	25%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCH DIAG EVAL CDM	$489.00	$652.00	—	—	25%
Neuromuscular re-education, 15 minutes CPT 97112 HC VIRTUAL THERAPY NEUROMUSC REEDUCA PX 1 OR MORE AREAS EACH 15MINS CDM	$123.00	$164.00	—	21% above	25%
Neuromuscular re-education, 15 minutes CPT 97112 HC CRISIS TELEH 97112 NEUROMUSCUL REEDUCAT EA 15 MIN CDM	$127.50	$170.00	—	25% above	25%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSC REEDUCA THER PX 1 OR MORE AREAS EACH 15 MIN	$127.50	$170.00	—	25% above	25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC VIRTUAL THERAPY NEUROMUSC REEDUCA PX 1 OR MORE AREAS EACH 15MINS CDM	$123.00	$164.00	—	—	25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSC REEDUCA THER PX 1 OR MORE AREAS EACH 15 MIN	$127.50	$170.00	—	—	25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC CRISIS TELEH 97112 NEUROMUSCUL REEDUCAT EA 15 MIN CDM	$127.50	$170.00	—	—	25%
New patient office visit, about 30 minutes CPT 99203 HC PR 99203 NEW PT VISIT - LEVEL 3	$235.50	$314.00	—	17% above	25%
New patient office visit, about 30 minutes inpatient CPT 99203 HC PR 99203 NEW PT VISIT - LEVEL 3	$235.50	$314.00	—	—	25%
New patient office visit, about 45 minutes CPT 99204 HC PR 99204 NEW PT VISIT - LEVEL 4	$383.25	$511.00	—	35% above	25%
New patient office visit, about 45 minutes inpatient CPT 99204 HC PR 99204 NEW PT VISIT - LEVEL 4	$383.25	$511.00	—	—	25%
New patient office visit, about 60 minutes CPT 99205 HC PR 99205 NEW PT VISIT - LEVEL 5	$521.25	$695.00	—	50% above	25%
New patient office visit, about 60 minutes inpatient CPT 99205 HC PR 99205 NEW PT VISIT - LEVEL 5	$521.25	$695.00	—	—	25%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC PR 99202 NEW PT VISIT - LEVEL 2	$134.25	$179.00	—	9% above	25%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC PR 99202 NEW PT VISIT - LEVEL 2	$134.25	$179.00	—	—	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EA 15 MIN CDM	$107.25	$143.00	—	45% above	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EDO EA 15 MIN	$107.25	$143.00	—	45% above	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC CRISIS PHONE 97802 MED NUTRITION INDIV INIT EA 15 MIN CDM	$107.25	$143.00	—	45% above	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC CRISIS TELEH 97802 MEDICAL NUTRITION INDIV INIT THERAPY EA 15 MIN CDM	$107.25	$143.00	—	45% above	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC CRISIS PHONE 97802 MED NUTRITION INDIV INIT EA 15 MIN CDM	$107.25	$143.00	—	—	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EA 15 MIN CDM	$107.25	$143.00	—	—	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EDO EA 15 MIN	$107.25	$143.00	—	—	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC CRISIS TELEH 97802 MEDICAL NUTRITION INDIV INIT THERAPY EA 15 MIN CDM	$107.25	$143.00	—	—	25%
Occupational therapy evaluation, low complexity CPT 97165 HC VIRTUAL THERAPY OT EVALUATION LOW COMPLEX CDM	$318.00	$424.00	—	26% above	25%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION LOW COMPLEX	$329.25	$439.00	—	30% above	25%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC VIRTUAL THERAPY OT EVALUATION LOW COMPLEX CDM	$318.00	$424.00	—	—	25%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION LOW COMPLEX	$329.25	$439.00	—	—	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC VIRTUAL THERAPY PT EVALUATION HIGH COMPLEX CDM	$318.00	$424.00	—	6% above	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC CRISIS TELEH 97163 PT EVALUATION HIGH COMPLEX CDM	$329.25	$439.00	—	10% above	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION HIGH COMPLEX	$329.25	$439.00	—	10% above	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC VIRTUAL THERAPY PT EVALUATION HIGH COMPLEX CDM	$318.00	$424.00	—	—	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION HIGH COMPLEX	$329.25	$439.00	—	—	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC CRISIS TELEH 97163 PT EVALUATION HIGH COMPLEX CDM	$329.25	$439.00	—	—	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC VIRTUAL THERAPY PT EVALUATION LOW COMPLEX CDM	$318.00	$424.00	—	29% above	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION LOW COMPLEX CDM	$329.25	$439.00	—	34% above	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC CRISIS TELEH 97161 PT EVALUATION LOW COMPLEX CDM	$329.25	$439.00	—	34% above	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC VIRTUAL THERAPY PT EVALUATION LOW COMPLEX CDM	$318.00	$424.00	—	—	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC CRISIS TELEH 97161 PT EVALUATION LOW COMPLEX CDM	$329.25	$439.00	—	—	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION LOW COMPLEX CDM	$329.25	$439.00	—	—	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC VIRTUAL THERAPY PT EVALUATION MOD COMPLEX CDM	$318.00	$424.00	—	1% above	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC CRISIS TELEH 97162 PT EVALUATION MOD COMPLEX CDM	$329.25	$439.00	—	5% above	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION MOD COMPLEX CDM	$329.25	$439.00	—	5% above	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC VIRTUAL THERAPY PT EVALUATION MOD COMPLEX CDM	$318.00	$424.00	—	—	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION MOD COMPLEX CDM	$329.25	$439.00	—	—	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC CRISIS TELEH 97162 PT EVALUATION MOD COMPLEX CDM	$329.25	$439.00	—	—	25%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY - JOINT MOBILIZATION EA 15MINS	$127.50	$170.00	—	33% above	25%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY TQS 1 OR MORE REGIONS EACH 15 MINUTES	$127.50	$170.00	—	33% above	25%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY - JOINT MOBILIZATION EA 15MINS	$127.50	$170.00	—	—	25%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY TQS 1 OR MORE REGIONS EACH 15 MINUTES	$127.50	$170.00	—	—	25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC VIRTUAL THERAPY THER EXERCISES PX 1 OR MORE AREAS EACH 15MINS CDM	$122.25	$163.00	—	26% above	25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC CRISIS TELEH 97110 THERAPEUTIC EXERCISES EA 15 MIN CDM	$126.75	$169.00	—	31% above	25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN	$126.75	$169.00	—	31% above	25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC VIRTUAL THERAPY THER EXERCISES PX 1 OR MORE AREAS EACH 15MINS CDM	$122.25	$163.00	—	—	25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC CRISIS TELEH 97110 THERAPEUTIC EXERCISES EA 15 MIN CDM	$126.75	$169.00	—	—	25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN	$126.75	$169.00	—	—	25%
Psychiatric evaluation with medical services CPT 90792 HC PR 90792 PSYCH DIAG EVAL W MED SRVCS RHC	$486.00	$648.00	—	96% above	25%
Psychiatric evaluation with medical services inpatient CPT 90792 HC PR 90792 PSYCH DIAG EVAL W MED SRVCS RHC	$486.00	$648.00	—	—	25%
Psychotherapy for crisis, first 60 minutes CPT 90839 HC PSYCHOTHERAPY FOR CRISIS INITIAL 60 MIN CDM	$297.75	$397.00	—	14% below	25%
Psychotherapy for crisis, first 60 minutes CPT 90839 HC CRISIS TELEH 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MIN CDM	$297.75	$397.00	—	14% below	25%
Psychotherapy for crisis, first 60 minutes CPT 90839 HC PR 90839 PSYTX FOR CRISIS INITIAL 60 MIN RHC	$387.00	$516.00	—	11% above	25%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PSYCHOTHERAPY FOR CRISIS INITIAL 60 MIN CDM	$297.75	$397.00	—	—	25%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC CRISIS TELEH 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MIN CDM	$297.75	$397.00	—	—	25%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PR 90839 PSYTX FOR CRISIS INITIAL 60 MIN RHC	$387.00	$516.00	—	—	25%
Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTH IND 30 MIN IOP CD/SA	$118.50	$158.00	—	9% below	25%
Psychotherapy session, 30 minutes CPT 90832 HC TELEH PSYCHOTHERAPY W PT 15-29 MIN BY HOSP EMPLYED QMP CDM	$118.50	$158.00	—	9% below	25%
Psychotherapy session, 30 minutes CPT 90832 HC PSYTX W PT 30 MIN IOP CDM	$118.50	$158.00	—	9% below	25%
Psychotherapy session, 30 minutes CPT 90832 HC CRISIS PHONE 90832 PSYCHOTHERAPY W/PT 30 MIN CDM	$118.50	$158.00	—	9% below	25%
Psychotherapy session, 30 minutes CPT 90832 HC PSYTX W PT 30 MIN PHP/IOP CDM	$118.50	$158.00	—	9% below	25%
Psychotherapy session, 30 minutes CPT 90832 HC CRISIS TELEH 90832 PSYCHOTHERAPY W/PT 30 MIN CDM	$118.50	$158.00	—	9% below	25%
Psychotherapy session, 30 minutes CPT 90832 HC TELEH PSYCHOTHERAPY W PT 30 MIN BY HOSP EMPLYED QMP CDM	$118.50	$158.00	—	9% below	25%
Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY W PT 30 MIN CDM	$118.50	$158.00	—	9% below	25%
Psychotherapy session, 30 minutes CPT 90832 HC PR 90832 PSYTX W PT 30 MIN RHC	$204.75	$273.00	—	57% above	25%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC TELEH PSYCHOTHERAPY W PT 30 MIN BY HOSP EMPLYED QMP CDM	$118.50	$158.00	—	—	25%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY W PT 30 MIN CDM	$118.50	$158.00	—	—	25%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC CRISIS TELEH 90832 PSYCHOTHERAPY W/PT 30 MIN CDM	$118.50	$158.00	—	—	25%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC CRISIS PHONE 90832 PSYCHOTHERAPY W/PT 30 MIN CDM	$118.50	$158.00	—	—	25%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC TELEH PSYCHOTHERAPY W PT 15-29 MIN BY HOSP EMPLYED QMP CDM	$118.50	$158.00	—	—	25%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTH IND 30 MIN IOP CD/SA	$118.50	$158.00	—	—	25%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYTX W PT 30 MIN IOP CDM	$118.50	$158.00	—	—	25%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYTX W PT 30 MIN PHP/IOP CDM	$118.50	$158.00	—	—	25%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PR 90832 PSYTX W PT 30 MIN RHC	$204.75	$273.00	—	—	25%
Psychotherapy session, 45 minutes CPT 90834 HC PSYTX W PT 45 MIN IOP CDM	$180.00	$240.00	—	8% below	25%
Psychotherapy session, 45 minutes CPT 90834 HC CRISIS TELEH 90834 PSYCHOTHERAPY W/PT 45 MIN CDM	$180.00	$240.00	—	8% below	25%
Psychotherapy session, 45 minutes CPT 90834 HC TELEH PSYCHOTHERAPY W PT 45 MIN BY HOSP EMPLYED QMP CDM	$180.00	$240.00	—	8% below	25%
Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY W PT 45 MIN CDM	$180.00	$240.00	—	8% below	25%
Psychotherapy session, 45 minutes CPT 90834 HC CRISIS PHONE 90834 PSYCHOTHERAPY W/PT 45 MIN CDM	$180.00	$240.00	—	8% below	25%
Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTH IND 45 MIN IOP CD/SA	$180.00	$240.00	—	8% below	25%
Psychotherapy session, 45 minutes CPT 90834 HC PSYTX W PT 45 MIN PHP/IOP CDM	$180.00	$240.00	—	8% below	25%
Psychotherapy session, 45 minutes CPT 90834 HC PR 90834 PSYTX W PT 45 MIN RHC	$270.00	$360.00	—	38% above	25%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY W PT 45 MIN CDM	$180.00	$240.00	—	—	25%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC CRISIS TELEH 90834 PSYCHOTHERAPY W/PT 45 MIN CDM	$180.00	$240.00	—	—	25%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC CRISIS PHONE 90834 PSYCHOTHERAPY W/PT 45 MIN CDM	$180.00	$240.00	—	—	25%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTH IND 45 MIN IOP CD/SA	$180.00	$240.00	—	—	25%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYTX W PT 45 MIN IOP CDM	$180.00	$240.00	—	—	25%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYTX W PT 45 MIN PHP/IOP CDM	$180.00	$240.00	—	—	25%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC TELEH PSYCHOTHERAPY W PT 45 MIN BY HOSP EMPLYED QMP CDM	$180.00	$240.00	—	—	25%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PR 90834 PSYTX W PT 45 MIN RHC	$270.00	$360.00	—	—	25%
Psychotherapy session, 60 minutes CPT 90837 HC CRISIS PHONE 90837 PSYCHOTHERAPY W/PT 60 MIN CDM	$239.25	$319.00	—	at median	25%
Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTH IND 60 MIN IOP CD/SA	$239.25	$319.00	—	at median	25%
Psychotherapy session, 60 minutes CPT 90837 HC PSYTX W PT 60 MIN IOP CDM	$239.25	$319.00	—	at median	25%
Psychotherapy session, 60 minutes CPT 90837 HC TELEH PSYCHOTHERAPY W PT 60 MIN BY HOSP EMPLYED QMP CDM	$239.25	$319.00	—	at median	25%
Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY W PT 60 MIN CDM	$239.25	$319.00	—	at median	25%
Psychotherapy session, 60 minutes CPT 90837 HC CRISIS TELEH 90837 PSYCHOTHERAPY W/PT 60 MIN CDM	$239.25	$319.00	—	at median	25%
Psychotherapy session, 60 minutes CPT 90837 HC PR 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES	$399.00	$532.00	—	67% above	25%
Psychotherapy session, 60 minutes CPT 90837 HC PR 90837 PSYTX W PT 60 MIN RHC	$399.00	$532.00	—	67% above	25%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC CRISIS PHONE 90837 PSYCHOTHERAPY W/PT 60 MIN CDM	$239.25	$319.00	—	—	25%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC CRISIS TELEH 90837 PSYCHOTHERAPY W/PT 60 MIN CDM	$239.25	$319.00	—	—	25%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC TELEH PSYCHOTHERAPY W PT 60 MIN BY HOSP EMPLYED QMP CDM	$239.25	$319.00	—	—	25%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYTX W PT 60 MIN IOP CDM	$239.25	$319.00	—	—	25%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTH IND 60 MIN IOP CD/SA	$239.25	$319.00	—	—	25%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY W PT 60 MIN CDM	$239.25	$319.00	—	—	25%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PR 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES	$399.00	$532.00	—	—	25%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PR 90837 PSYTX W PT 60 MIN RHC	$399.00	$532.00	—	—	25%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC PR 99406 BEHAV CHNG SMOKING 3-10 MIN	$33.75	$45.00	—	at median	25%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC BEHAV CHNG SMOKING 3-10 MIN	$36.00	$48.00	—	7% above	25%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC PR 99406 BEHAV CHNG SMOKING 3-10 MIN	$33.75	$45.00	—	—	25%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC BEHAV CHNG SMOKING 3-10 MIN	$36.00	$48.00	—	—	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC PR 99215 ESTAB PT VISIT - LEVEL 5	$411.75	$549.00	—	44% above	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC PR 99215 ESTAB PT VISIT - LEVEL 5	$411.75	$549.00	—	—	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PR 99213 CNM LEVEL 3 EST POSTPARTUM EVAL	$189.00	$252.00	—	at median	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PR 99213 ESTAB PT VISIT - LEVEL 3	$189.00	$252.00	—	at median	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC PR 99213 ESTAB PT VISIT - LEVEL 3	$189.00	$252.00	—	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC PR 99213 CNM LEVEL 3 EST POSTPARTUM EVAL	$189.00	$252.00	—	—	25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC PR 99214 ESTAB PT VISIT - LEVEL 4	$278.25	$371.00	—	19% above	25%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC PR 99214 ESTAB PT VISIT - LEVEL 4	$278.25	$371.00	—	—	25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC PR 99212 ESTAB PT VISIT - LEVEL 2	$100.50	$134.00	—	at median	25%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC PR 99212 ESTAB PT VISIT - LEVEL 2	$100.50	$134.00	—	—	25%
Speech and language evaluation CPT 92523 HC CRISIS TELEH 92523 SPEECH SOUND LANG COMPREHEN CDM	$277.50	$370.00	—	21% below	25%
Speech and language evaluation CPT 92523 HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION CDM	$277.50	$370.00	—	21% below	25%
Speech and language evaluation CPT 92523 HC VIRTUAL THERAPY SPEECH SOUND LANG COMPREHEN EXTENDED CDM	$277.50	$370.00	—	21% below	25%
Speech and language evaluation inpatient CPT 92523 HC CRISIS TELEH 92523 SPEECH SOUND LANG COMPREHEN CDM	$277.50	$370.00	—	—	25%
Speech and language evaluation inpatient CPT 92523 HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION CDM	$277.50	$370.00	—	—	25%
Speech and language evaluation inpatient CPT 92523 HC VIRTUAL THERAPY SPEECH SOUND LANG COMPREHEN EXTENDED CDM	$277.50	$370.00	—	—	25%
Speech therapy session, individual CPT 92507 HC VIRTUAL THERAPY SPEECH-HEARING THERAPY INDIV CDM	$330.00	$440.00	—	15% above	25%
Speech therapy session, individual CPT 92507 HC CRISIS TELEH 92507 SPEECH/HEARING THERAPY - INDIV CDM	$330.00	$440.00	—	15% above	25%
Speech therapy session, individual CPT 92507 HC TX SPEECH/LANG/VOICE COMMJ/AUDITORY PROCESS - INDIVIDUAL	$330.00	$440.00	—	15% above	25%
Speech therapy session, individual inpatient CPT 92507 HC CRISIS TELEH 92507 SPEECH/HEARING THERAPY - INDIV CDM	$330.00	$440.00	—	—	25%
Speech therapy session, individual inpatient CPT 92507 HC VIRTUAL THERAPY SPEECH-HEARING THERAPY INDIV CDM	$330.00	$440.00	—	—	25%
Speech therapy session, individual inpatient CPT 92507 HC TX SPEECH/LANG/VOICE COMMJ/AUDITORY PROCESS - INDIVIDUAL	$330.00	$440.00	—	—	25%
Spirometry (breathing test) CPT 94010 HC PR 94010 SPIROMETRY	$78.75	$105.00	—	69% below	25%
Spirometry (breathing test) CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$626.25	$835.00	—	149% above	25%
Spirometry (breathing test) CPT 94010 HC BEDSIDE SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ CDM	$626.25	$835.00	—	149% above	25%
Spirometry (breathing test) inpatient CPT 94010 HC PR 94010 SPIROMETRY	$78.75	$105.00	—	—	25%
Spirometry (breathing test) inpatient CPT 94010 HC BEDSIDE SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ CDM	$626.25	$835.00	—	—	25%
Spirometry (breathing test) inpatient CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$626.25	$835.00	—	—	25%
Spirometry before and after a bronchodilator CPT 94060 HC PR 94060 SPIROMETRY PRE POST BRONCHODILATOR	$112.50	$150.00	—	80% below	25%
Spirometry before and after a bronchodilator CPT 94060 HC SPIROMETRY PRE POST BRONCHODILATOR CDM	$1,034.25	$1,379.00	—	81% above	25%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC PR 94060 SPIROMETRY PRE POST BRONCHODILATOR	$112.50	$150.00	—	—	25%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC SPIROMETRY PRE POST BRONCHODILATOR CDM	$1,034.25	$1,379.00	—	—	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC VIRTUAL THERAPY THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15MINS CDM	$123.00	$164.00	—	34% above	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC CRISIS TELEH 97530 THERAPEUTIC ACTIVITIES EA 15 MIN	$127.50	$170.00	—	39% above	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$127.50	$170.00	—	39% above	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC VIRTUAL THERAPY THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15MINS CDM	$123.00	$164.00	—	—	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$127.50	$170.00	—	—	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC CRISIS TELEH 97530 THERAPEUTIC ACTIVITIES EA 15 MIN	$127.50	$170.00	—	—	25%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC THERAPUTIC PHLEBOTOMY	$489.75	$653.00	—	145% above	25%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC THERAPUTIC PHLEBOTOMY	$762.00	$1,016.00	—	281% above	25%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC ED PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE CDM	$762.00	$1,016.00	—	281% above	25%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC ED PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE CDM	$762.00	$1,016.00	—	—	25%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC THERAPUTIC PHLEBOTOMY	$762.00	$1,016.00	—	—	25%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 HC CARDIO STRESS TEST SUPV INTERP & REPT	$508.50	$678.00	—	at median	25%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 HC CARDIO STRESS TEST SUPV INTERP & REPT	$508.50	$678.00	—	—	25%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Oregon	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 HC PR RX COVID-19 VACCINE SINGLE DOSE (MODERNA) PF IM 50 MCG/0.5 ML	$218.88	$291.84	—	at median	25%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 HC PR RX COVID-19 VACCINE SINGLE DOSE (MODERNA) PF IM 50 MCG/0.5 ML	$218.88	$291.84	—	—	25%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 HC PR RX COVID-19 VACCINE SINGLE DOSE (PFIZER) PF TRIS-SUC IM 30 MCG/0.3 ML	$196.65	$262.20	—	at median	25%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 HC PR RX COVID-19 VACCINE SINGLE DOSE (PFIZER) PF TRIS-SUC IM 30 MCG/0.3 ML	$196.65	$262.20	—	—	25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH, ACELLULAR PERT & TET TOX INJ 25 LF-58 MCG-10 LF/0.5ML	$131.28	$175.04	—	132% above	25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH, ACELLULAR PERT & TET TOX INJ 25 LF-58 MCG-10 LF/0.5ML	$131.28	$175.04	—	—	25%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE (RECOMBINANT) SUSP 20 MCG/ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 20 MCG/ML	$306.16	$408.21	—	190% above	25%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE (RECOMBINANT) SUSP 20 MCG/ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 20 MCG/ML	$306.16	$408.21	—	—	25%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP 10 MCG/0.5ML	$71.09	$94.78	—	5% above	25%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP 10 MCG/0.5ML	$71.09	$94.78	—	—	25%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES-MUMPS-RUBELLA VIRUS VACCINES FOR INJ SOLN	$517.38	$689.84	—	235% above	25%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES-MUMPS-RUBELLA VIRUS VACCINES FOR INJ SOLN	$517.38	$689.84	—	—	25%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL 13-VALENT CONJUGATE VACCINE INJ	$689.58	$919.44	—	103% above	25%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL 13-VALENT CONJUGATE VACCINE INJ	$689.58	$919.44	—	—	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE SUS PREF SYR 0.5 ML	$1,010.84	$1,347.78	—	202% above	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE SUS PREF SYR 0.5 ML	$1,010.84	$1,347.78	—	—	25%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC FOR INJ	$1,647.32	$2,196.43	—	199% above	25%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC FOR INJ	$1,647.32	$2,196.43	—	—	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS (TD) INJ 5-2 LF/0.5ML	$370.58	$494.11	—	802% above	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS (TD) INJ 5-2 LF/0.5ML	$370.58	$494.11	—	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TET-DIPH-ACELL PERTUSS AD PREF SYR 5-2.5-18.5 LF-MCG/0.5ML	$220.76	$294.35	—	207% above	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TET-DIPH-ACELL PERTUSS AD PREF SYR 5-2.5-18.5 LF-MCG/0.5ML	$220.76	$294.35	—	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM	$22.50	$30.00	—	61% below	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMIN CDM	$22.50	$30.00	—	61% below	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN INFLUENZA VIRUS VAC CDM	$22.50	$30.00	—	61% below	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE CDM	$22.50	$30.00	—	61% below	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE CDM	$22.50	$30.00	—	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN INFLUENZA VIRUS VAC CDM	$22.50	$30.00	—	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMIN CDM	$22.50	$30.00	—	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM	$22.50	$30.00	—	—	25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADMIN EACH ADD CDM	$22.50	$30.00	—	41% below	25%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZATION ADMIN EACH ADD CDM	$22.50	$30.00	—	—	25%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://pricetransparency.providence.org/oregon/live/611659489_providence-willamette-falls-medical-center_standardcharges.json