Hospital Charleston, WV

Thomas Memorial Hospital

Listed in its price file as “Herbert J Thomas Memorial Hospital Association”.

Thomas Memorial Hospital in South Charleston, WV publishes cash prices for 515 common procedures listed here, from its own machine-readable price file updated Jul 10, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the West Virginia median for 329 of 514 procedures and below it for 157. By typical cash price it ranks #30 of 36 West Virginia hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

4605 Maccorkle Ave SW,South Charleston,WV,25309 Collected Oct 26, 2026 Source price file Check a bill from this hospital (304) 766-3600

Acute care hospital Nonprofit hospital Emergency department CMS star rating 1 of 5 CCN 510029 · CMS hospital register NPI 1316925506

Financial assistance

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

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

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
Abdominal CT scan without and with contrast CPT 74170 CT SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST	$1,782.50	$3,565.00	$47.87–$847.35	44% above	50%
Abdominal CT scan without and with contrast CPT 74170 CT SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST	$1,782.50	$3,565.00	$47.87–$847.35	44% above	50%
Abdominal CT scan without and with contrast CPT 74170 CT ABD WO CNTRST FLWD CNTRST	$1,916.50	$3,833.00	$47.87–$847.35	55% above	50%
Abdominal CT scan without and with contrast CPT 74170 CT ABD WO CNTRST FLWD CNTRST	$1,916.50	$3,833.00	$47.87–$847.35	55% above	50%
Abdominal X-ray, 2 views CPT 74019 X-RAY OF ABDOMEN; 2 VIEWS	$395.50	$791.00	$8.23–$505.08	81% above	50%
Abdominal X-ray, 2 views CPT 74019 X-RAY OF ABDOMEN; 2 VIEWS	$395.50	$791.00	$8.23–$505.08	81% above	50%
Abdominal X-ray, 2 views CPT 74019 RADEX ABDOMEN 2 VIEWS	$425.50	$851.00	$8.23–$505.08	94% above	50%
Abdominal X-ray, 2 views CPT 74019 RADEX ABDOMEN 2 VIEWS	$425.50	$851.00	$8.23–$505.08	94% above	50%
Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE	$218.00	$436.00	$6.17–$420.41	21% above	50%
Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE	$218.00	$436.00	$6.17–$420.41	21% above	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY OF ANKLE; MINIMUM OF 3 VIEWS	$202.50	$405.00	$83.07–$420.41	12% above	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY OF ANKLE; MINIMUM OF 3 VIEWS	$202.50	$405.00	$83.07–$420.41	12% above	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ULTRASOUND STUDY OF ARM AND LEG ARTERIES	$313.50	$627.00	$9.01–$642.73	8% above	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ULTRASOUND STUDY OF ARM AND LEG ARTERIES	$313.50	$627.00	$9.01–$642.73	8% above	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$337.00	$674.00	$9.01–$642.73	16% above	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$337.00	$674.00	$9.01–$642.73	16% above	50%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O DYE	$927.00	$1,854.00	$33.97–$505.08	31% above	50%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O DYE	$927.00	$1,854.00	$33.97–$505.08	31% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SCAN OF ARM WITHOUT CONTRAST	$862.00	$1,724.00	$99.80–$505.08	22% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SCAN OF ARM WITHOUT CONTRAST	$862.00	$1,724.00	$99.80–$505.08	22% above	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 SINGLE CONTRAST X-RAY OF ESOPHAGUS	$521.00	$1,042.00	$21.36–$847.35	41% above	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 SINGLE CONTRAST X-RAY OF ESOPHAGUS	$521.00	$1,042.00	$21.36–$847.35	41% above	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$560.50	$1,121.00	$21.36–$847.35	52% above	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$560.50	$1,121.00	$21.36–$847.35	52% above	50%
Bone scan, whole body (nuclear medicine) CPT 78306 NUCLEAR MEDICINE STUDY OF BONE AND/OR JOINT WHOLE BODY	$1,119.00	$2,238.00	$29.85–$1,931.24	28% above	50%
Bone scan, whole body (nuclear medicine) CPT 78306 NUCLEAR MEDICINE STUDY OF BONE AND/OR JOINT WHOLE BODY	$1,119.00	$2,238.00	$29.85–$1,931.24	28% above	50%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY	$1,231.00	$2,462.00	$29.85–$1,931.24	41% above	50%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY	$1,231.00	$2,462.00	$29.85–$1,931.24	41% above	50%
Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE	$475.00	$950.00	$26.00–$505.08	63% above	50%
Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE	$475.00	$950.00	$26.00–$505.08	63% above	50%
Breast ultrasound, complete, one breast one side CPT 76641 COMPLETE ULTRASOUND SCAN OF 1 BREAST	$442.00	$884.00	$99.80–$505.08	52% above	50%
Breast ultrasound, complete, one breast one side CPT 76641 COMPLETE ULTRASOUND SCAN OF 1 BREAST	$442.00	$884.00	$99.80–$505.08	52% above	50%
Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED	$607.00	$1,214.00	$24.44–$420.41	131% above	50%
Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED	$607.00	$1,214.00	$24.44–$420.41	131% above	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 LIMITED ULTRASOUND SCAN OF 1 BREAST	$173.50	$347.00	$83.07–$420.41	34% below	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 LIMITED ULTRASOUND SCAN OF 1 BREAST	$173.50	$347.00	$83.07–$420.41	34% below	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 LIMITED ULTRASOUND SCAN OF 1 BREAST	$173.50	$347.00	$83.07–$420.41	34% below	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 LIMITED ULTRASOUND SCAN OF 1 BREAST	$173.50	$347.00	$83.07–$420.41	34% below	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT SCAN OF BLOOD VESSELS OF ABDOMEN AND PELVIS WITH CONTRAST	$2,373.00	$4,746.00	$77.98–$1,685.38	38% above	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT SCAN OF BLOOD VESSELS OF ABDOMEN AND PELVIS WITH CONTRAST	$2,373.00	$4,746.00	$77.98–$1,685.38	38% above	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD&PLVS W/CONTRAST	$2,551.00	$5,102.00	$77.98–$1,685.38	49% above	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD&PLVS W/CONTRAST	$2,551.00	$5,102.00	$77.98–$1,685.38	49% above	50%
CT angiography (CTA) of the head CPT 70496 CT SCAN OF BLOOD VESSELS OF HEAD WITH CONTRAST	$1,782.50	$3,565.00	$60.22–$847.35	47% above	50%
CT angiography (CTA) of the head CPT 70496 CT SCAN OF BLOOD VESSELS OF HEAD WITH CONTRAST	$1,782.50	$3,565.00	$60.22–$847.35	47% above	50%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD	$1,916.50	$3,833.00	$60.22–$847.35	58% above	50%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD	$1,916.50	$3,833.00	$60.22–$847.35	58% above	50%
CT angiography (CTA) of the neck CPT 70498 CT SCAN OF BLOOD VESSELS OF NECK WITH CONTRAST	$2,210.00	$4,420.00	$60.22–$847.35	92% above	50%
CT angiography (CTA) of the neck CPT 70498 CT SCAN OF BLOOD VESSELS OF NECK WITH CONTRAST	$2,210.00	$4,420.00	$60.22–$847.35	92% above	50%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK	$2,376.00	$4,752.00	$60.22–$847.35	107% above	50%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK	$2,376.00	$4,752.00	$60.22–$847.35	107% above	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT SCAN OF BLOOD VESSELS OF CHEST WITH CONTRAST	$1,782.50	$3,565.00	$63.05–$847.35	41% above	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT SCAN OF BLOOD VESSELS OF CHEST WITH CONTRAST	$1,782.50	$3,565.00	$63.05–$847.35	41% above	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST	$1,916.50	$3,833.00	$63.05–$847.35	52% above	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST	$1,916.50	$3,833.00	$63.05–$847.35	52% above	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT SCAN OF BLOOD VESSELS AND GRAFTS OF HEART WITH CONTRAST	$2,370.00	$4,740.00	$84.67–$1,685.38	114% above	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT SCAN OF BLOOD VESSELS AND GRAFTS OF HEART WITH CONTRAST	$2,370.00	$4,740.00	$84.67–$1,685.38	114% above	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE	$2,548.00	$5,096.00	$84.67–$1,685.38	130% above	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE	$2,548.00	$5,096.00	$84.67–$1,685.38	130% above	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST	$99.00	$198.00	$20.59–$420.41	at median	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST	$99.00	$198.00	$20.59–$420.41	at median	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT SCAN OF HEART WITH EVALUATION OF BLOOD VESSEL CALCIUM	$1,781.50	$3,563.00	$20.59–$420.41	1699% above	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT SCAN OF HEART WITH EVALUATION OF BLOOD VESSEL CALCIUM	$1,781.50	$3,563.00	$20.59–$420.41	1699% above	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT SCAN OF ABDOMEN AND PELVIS WITHOUT CONTRAST	$1,544.50	$3,089.00	$61.51–$1,152.67	13% above	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT SCAN OF ABDOMEN AND PELVIS WITHOUT CONTRAST	$1,544.50	$3,089.00	$61.51–$1,152.67	13% above	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$1,660.50	$3,321.00	$61.51–$1,152.67	22% above	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$1,660.50	$3,321.00	$61.51–$1,152.67	22% above	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$2,515.50	$5,031.00	$64.86–$1,685.38	56% above	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$2,515.50	$5,031.00	$64.86–$1,685.38	56% above	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST	$2,704.50	$5,409.00	$64.86–$1,685.38	68% above	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST	$2,704.50	$5,409.00	$64.86–$1,685.38	68% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT SCAN OF ABDOMEN AND PELVIS BEFORE AND AFTER CONTRAST	$2,373.00	$4,746.00	$71.03–$1,685.38	39% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT SCAN OF ABDOMEN AND PELVIS BEFORE AND AFTER CONTRAST	$2,373.00	$4,746.00	$71.03–$1,685.38	39% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR	$2,551.00	$5,102.00	$71.03–$1,685.38	49% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR	$2,551.00	$5,102.00	$71.03–$1,685.38	49% above	50%
CT scan of the abdomen with contrast CPT 74160 CT SCAN OF ABDOMEN WITH CONTRAST	$1,782.50	$3,565.00	$45.03–$847.35	68% above	50%
CT scan of the abdomen with contrast CPT 74160 CT SCAN OF ABDOMEN WITH CONTRAST	$1,782.50	$3,565.00	$45.03–$847.35	68% above	50%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$1,916.50	$3,833.00	$45.03–$847.35	81% above	50%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$1,916.50	$3,833.00	$45.03–$847.35	81% above	50%
CT scan of the abdomen without contrast CPT 74150 CT SCAN OF ABDOMEN WITHOUT CONTRAST	$862.00	$1,724.00	$41.95–$505.08	17% above	50%
CT scan of the abdomen without contrast CPT 74150 CT SCAN OF ABDOMEN WITHOUT CONTRAST	$862.00	$1,724.00	$41.95–$505.08	17% above	50%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$927.00	$1,854.00	$41.95–$505.08	26% above	50%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$927.00	$1,854.00	$41.95–$505.08	26% above	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN OF FACE WITHOUT CONTRAST	$862.00	$1,724.00	$30.37–$505.08	24% above	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN OF FACE WITHOUT CONTRAST	$862.00	$1,724.00	$30.37–$505.08	24% above	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE	$927.00	$1,854.00	$30.37–$505.08	34% above	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE	$927.00	$1,854.00	$30.37–$505.08	34% above	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$913.50	$1,827.00	$30.11–$505.08	29% above	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$913.50	$1,827.00	$30.11–$505.08	29% above	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE	$982.50	$1,965.00	$30.11–$505.08	38% above	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE	$982.50	$1,965.00	$30.11–$505.08	38% above	50%
CT scan of the head with contrast CPT 70460 CT SCAN HEAD OR BRAIN WITH CONTRAST	$1,782.50	$3,565.00	$39.89–$847.35	75% above	50%
CT scan of the head with contrast CPT 70460 CT SCAN HEAD OR BRAIN WITH CONTRAST	$1,782.50	$3,565.00	$39.89–$847.35	75% above	50%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE	$1,916.50	$3,833.00	$39.89–$847.35	88% above	50%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE	$1,916.50	$3,833.00	$39.89–$847.35	88% above	50%
CT scan of the head without and with contrast CPT 70470 CT SCAN OF HEAD OR BRAIN BEFORE AND AFTER CONTRAST	$1,782.50	$3,565.00	$45.03–$847.35	53% above	50%
CT scan of the head without and with contrast CPT 70470 CT SCAN OF HEAD OR BRAIN BEFORE AND AFTER CONTRAST	$1,782.50	$3,565.00	$45.03–$847.35	53% above	50%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$1,916.50	$3,833.00	$45.03–$847.35	64% above	50%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$1,916.50	$3,833.00	$45.03–$847.35	64% above	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN OF LOWER SPINE WITHOUT CONTRAST	$862.00	$1,724.00	$35.00–$505.08	3% above	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN OF LOWER SPINE WITHOUT CONTRAST	$862.00	$1,724.00	$35.00–$505.08	3% above	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE	$927.00	$1,854.00	$35.00–$505.08	10% above	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE	$927.00	$1,854.00	$35.00–$505.08	10% above	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN OF UPPER SPINE WITHOUT CONTRAST	$913.50	$1,827.00	$35.00–$505.08	11% above	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN OF UPPER SPINE WITHOUT CONTRAST	$913.50	$1,827.00	$35.00–$505.08	11% above	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE	$982.50	$1,965.00	$35.00–$505.08	20% above	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE	$982.50	$1,965.00	$35.00–$505.08	20% above	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN OF PELVIS WITH CONTRAST	$1,782.50	$3,565.00	$40.92–$847.35	88% above	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN OF PELVIS WITH CONTRAST	$1,782.50	$3,565.00	$40.92–$847.35	88% above	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE	$1,916.50	$3,833.00	$40.92–$847.35	102% above	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE	$1,916.50	$3,833.00	$40.92–$847.35	102% above	50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$702.00	$1,404.00	$28.31–$1,152.67	—	50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$702.00	$1,404.00	$28.31–$1,152.67	—	50%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 ULTRASOUND OF BOTH SIDES OF HEAD AND NECK BLOOD FLOW	$653.00	$1,306.00	$28.31–$1,152.67	14% above	50%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 ULTRASOUND OF BOTH SIDES OF HEAD AND NECK BLOOD FLOW	$653.00	$1,306.00	$28.31–$1,152.67	14% above	50%
Chest CT scan without and with contrast CPT 71270 CT SCAN OF CHEST BEFORE AND AFTER CONTRAST	$2,373.00	$4,746.00	$44.27–$847.35	88% above	50%
Chest CT scan without and with contrast CPT 71270 CT SCAN OF CHEST BEFORE AND AFTER CONTRAST	$2,373.00	$4,746.00	$44.27–$847.35	88% above	50%
Chest CT scan without and with contrast CPT 71270 CT THORAX DX C-/C+	$2,551.00	$5,102.00	$44.27–$847.35	102% above	50%
Chest CT scan without and with contrast CPT 71270 CT THORAX DX C-/C+	$2,551.00	$5,102.00	$44.27–$847.35	102% above	50%
Chest X-ray, 2 views CPT 71046 X-RAY OF CHEST; 2 VIEWS	$377.50	$755.00	$7.72–$420.41	100% above	50%
Chest X-ray, 2 views CPT 71046 X-RAY OF CHEST; 2 VIEWS	$377.50	$755.00	$7.72–$420.41	100% above	50%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$406.00	$812.00	$7.72–$420.41	115% above	50%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$406.00	$812.00	$7.72–$420.41	115% above	50%
Chest X-ray, single view CPT 71045 X-RAY OF CHEST; 1 VIEW	$377.50	$755.00	$6.44–$420.41	114% above	50%
Chest X-ray, single view CPT 71045 X-RAY OF CHEST; 1 VIEW	$377.50	$755.00	$6.44–$420.41	114% above	50%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$406.00	$812.00	$6.44–$420.41	131% above	50%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$406.00	$812.00	$6.44–$420.41	131% above	50%
Collarbone (clavicle) X-ray, complete CPT 73000 X-RAY EXAM OF COLLAR BONE	$213.50	$427.00	$5.92–$420.41	22% above	50%
Collarbone (clavicle) X-ray, complete CPT 73000 X-RAY EXAM OF COLLAR BONE	$213.50	$427.00	$5.92–$420.41	22% above	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X-RAY OF COLLAR BONE	$198.50	$397.00	$83.07–$420.41	13% above	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X-RAY OF COLLAR BONE	$198.50	$397.00	$83.07–$420.41	13% above	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 COMPLETE ULTRASOUND SCAN BEHIND ABDOMINAL CAVITY	$530.00	$1,060.00	$26.00–$505.08	21% above	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 COMPLETE ULTRASOUND SCAN BEHIND ABDOMINAL CAVITY	$530.00	$1,060.00	$26.00–$505.08	21% above	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP	$570.00	$1,140.00	$26.00–$505.08	30% above	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP	$570.00	$1,140.00	$26.00–$505.08	30% above	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY MEASUREMENT OF HIP; PELVIS; SPINE	$381.00	$762.00	$6.95–$505.08	21% above	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY MEASUREMENT OF HIP; PELVIS; SPINE	$381.00	$762.00	$6.95–$505.08	21% above	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$410.00	$820.00	$6.95–$505.08	30% above	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$410.00	$820.00	$6.95–$505.08	30% above	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY APPENDICULR	$141.50	$283.00	$6.95–$420.41	36% below	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY APPENDICULR	$141.50	$283.00	$6.95–$420.41	36% below	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS	$749.00	$1,498.00	$66.40–$1,152.67	58% above	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS	$749.00	$1,498.00	$66.40–$1,152.67	58% above	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN OF CHEST WITHOUT CONTRAST	$913.50	$1,827.00	$38.35–$505.08	16% above	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN OF CHEST WITHOUT CONTRAST	$913.50	$1,827.00	$38.35–$505.08	16% above	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C-	$927.00	$1,854.00	$38.35–$505.08	18% above	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C-	$927.00	$1,854.00	$38.35–$505.08	18% above	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN OF CHEST WITH CONTRAST	$1,889.50	$3,779.00	$41.18–$847.35	72% above	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN OF CHEST WITH CONTRAST	$1,889.50	$3,779.00	$41.18–$847.35	72% above	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX C+	$2,031.50	$4,063.00	$41.18–$847.35	85% above	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX C+	$2,031.50	$4,063.00	$41.18–$847.35	85% above	50%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI	$348.50	$697.00	$35.00–$231.59	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI	$348.50	$697.00	$35.00–$231.59	—	50%
Diagnostic mammogram, both breasts CPT 77066 DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$324.00	$648.00	$35.00–$231.59	7% above	50%
Diagnostic mammogram, both breasts CPT 77066 DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$324.00	$648.00	$35.00–$231.59	7% above	50%
Diagnostic mammogram, one breast CPT 77065 DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$256.50	$513.00	$28.57–$188.27	17% above	50%
Diagnostic mammogram, one breast CPT 77065 DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$256.50	$513.00	$28.57–$188.27	17% above	50%
Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI	$276.00	$552.00	$28.57–$188.27	26% above	50%
Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI	$276.00	$552.00	$28.57–$188.27	26% above	50%
Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$256.50	$513.00	$37.20–$188.27	17% above	50%
Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$256.50	$513.00	$37.20–$188.27	17% above	50%
Duplex ultrasound of the leg arteries, both legs CPT 93925 ULTRASOUND OF LEG ARTERIES OR ARTERY GRAFTS	$706.00	$1,412.00	$28.06–$1,152.67	13% above	50%
Duplex ultrasound of the leg arteries, both legs CPT 93925 ULTRASOUND OF LEG ARTERIES OR ARTERY GRAFTS	$706.00	$1,412.00	$28.06–$1,152.67	13% above	50%
Duplex ultrasound of the leg arteries, both legs CPT 93925 LOWER EXTREMITY STUDY	$759.00	$1,518.00	$28.06–$1,152.67	21% above	50%
Duplex ultrasound of the leg arteries, both legs CPT 93925 LOWER EXTREMITY STUDY	$759.00	$1,518.00	$28.06–$1,152.67	21% above	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 ULTRASOUND STUDY OF ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$742.00	$1,484.00	$24.44–$1,152.67	25% above	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 ULTRASOUND STUDY OF ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$742.00	$1,484.00	$24.44–$1,152.67	25% above	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY	$798.00	$1,596.00	$24.44–$1,152.67	34% above	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY	$798.00	$1,596.00	$24.44–$1,152.67	34% above	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ULTRASOUND OF HEART WITH COLOR-DEPICTED BLOOD FLOW; RATE; DIRECTION AND VALVE FUNCTION	$1,391.50	$2,783.00	$50.44–$2,639.66	20% above	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ULTRASOUND OF HEART WITH COLOR-DEPICTED BLOOD FLOW; RATE; DIRECTION AND VALVE FUNCTION	$1,391.50	$2,783.00	$50.44–$2,639.66	20% above	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$1,496.00	$2,992.00	$50.44–$2,639.66	29% above	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$1,496.00	$2,992.00	$50.44–$2,639.66	29% above	50%
Elbow X-ray, 2 views CPT 73070 X-RAY EXAM OF ELBOW	$208.50	$417.00	$5.92–$420.41	9% above	50%
Elbow X-ray, 2 views CPT 73070 X-RAY EXAM OF ELBOW	$208.50	$417.00	$5.92–$420.41	9% above	50%
Elbow X-ray, complete, 3 or more views CPT 73080 X-RAY EXAM OF ELBOW	$226.50	$453.00	$6.17–$420.41	26% above	50%
Elbow X-ray, complete, 3 or more views CPT 73080 X-RAY EXAM OF ELBOW	$226.50	$453.00	$6.17–$420.41	26% above	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY OF ELBOW; MINIMUM OF 3 VIEWS	$210.50	$421.00	$83.07–$420.41	17% above	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY OF ELBOW; MINIMUM OF 3 VIEWS	$210.50	$421.00	$83.07–$420.41	17% above	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY OF ELBOW; MINIMUM OF 3 VIEWS	$210.50	$421.00	$83.07–$420.41	17% above	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY OF ELBOW; MINIMUM OF 3 VIEWS	$210.50	$421.00	$83.07–$420.41	17% above	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT SCAN OF CRANIAL CAVITY WITHOUT CONTRAST	$862.00	$1,724.00	$45.55–$505.08	24% above	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT SCAN OF CRANIAL CAVITY WITHOUT CONTRAST	$862.00	$1,724.00	$45.55–$505.08	24% above	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE	$927.00	$1,854.00	$45.55–$505.08	34% above	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE	$927.00	$1,854.00	$45.55–$505.08	34% above	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 X-RAY EXAM OF FACIAL BONES	$341.50	$683.00	$9.26–$505.08	45% above	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 X-RAY EXAM OF FACIAL BONES	$341.50	$683.00	$9.26–$505.08	45% above	50%
Forearm X-ray (radius and ulna), 2 views CPT 73090 X-RAY EXAM OF FOREARM	$213.50	$427.00	$5.66–$420.41	19% above	50%
Forearm X-ray (radius and ulna), 2 views CPT 73090 X-RAY EXAM OF FOREARM	$213.50	$427.00	$5.66–$420.41	19% above	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY OF FOREARM; 2 VIEWS	$198.50	$397.00	$83.07–$420.41	11% above	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY OF FOREARM; 2 VIEWS	$198.50	$397.00	$83.07–$420.41	11% above	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY OF FOREARM; 2 VIEWS	$213.50	$427.00	$83.07–$420.41	19% above	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY OF FOREARM; 2 VIEWS	$213.50	$427.00	$83.07–$420.41	19% above	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NUCLEAR MEDICINE STUDY OF LIVER AND BILE DUCT SYSTEM	$1,287.50	$2,575.00	$26.00–$1,931.24	51% above	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NUCLEAR MEDICINE STUDY OF LIVER AND BILE DUCT SYSTEM	$1,287.50	$2,575.00	$26.00–$1,931.24	51% above	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$1,416.50	$2,833.00	$26.00–$1,931.24	66% above	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$1,416.50	$2,833.00	$26.00–$1,931.24	66% above	50%
Hand X-ray, 2 views CPT 73120 X-RAY EXAM OF HAND	$213.50	$427.00	$5.92–$505.08	9% above	50%
Hand X-ray, 2 views CPT 73120 X-RAY EXAM OF HAND	$213.50	$427.00	$5.92–$505.08	9% above	50%
Hand X-ray, 2 views one side CPT 73120 X-RAY OF HAND; 2 VIEWS	$198.50	$397.00	$99.80–$505.08	2% above	50%
Hand X-ray, 2 views one side CPT 73120 X-RAY OF HAND; 2 VIEWS	$198.50	$397.00	$99.80–$505.08	2% above	50%
Hand X-ray, 2 views one side CPT 73120 X-RAY OF HAND; 2 VIEWS	$198.50	$397.00	$99.80–$505.08	2% above	50%
Hand X-ray, 2 views one side CPT 73120 X-RAY OF HAND; 2 VIEWS	$198.50	$397.00	$99.80–$505.08	2% above	50%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-RAY EXAM OF HEEL	$213.50	$427.00	$5.66–$420.41	24% above	50%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-RAY EXAM OF HEEL	$213.50	$427.00	$5.66–$420.41	24% above	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY INCLUDING HEART RATE; BREATHING; AIRFLOW; AND EFFORT	$424.00	$848.00	$32.17–$1,043.15	20% above	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY INCLUDING HEART RATE; BREATHING; AIRFLOW; AND EFFORT	$424.00	$848.00	$32.17–$1,043.15	20% above	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT&RESP EFFT	$456.00	$912.00	$32.17–$1,043.15	29% above	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT&RESP EFFT	$456.00	$912.00	$32.17–$1,043.15	29% above	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY IN SLEEP LAB WITH CONTINUOUS AIRWAY PRESSURE (6 YEARS OR OLDER)	$2,811.00	$5,622.00	$90.59–$4,148.47	2% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY IN SLEEP LAB WITH CONTINUOUS AIRWAY PRESSURE (6 YEARS OR OLDER)	$2,811.00	$5,622.00	$90.59–$4,148.47	2% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM	$3,022.00	$6,044.00	$90.59–$4,148.47	5% above	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM	$3,022.00	$6,044.00	$90.59–$4,148.47	5% above	50%
Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3	$314.00	$628.00	$6.69–$420.41	57% above	50%
Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3	$314.00	$628.00	$6.69–$420.41	57% above	50%
Knee X-ray, 3 views one side CPT 73562 X-RAY OF KNEE; 3 VIEWS	$292.00	$584.00	$83.07–$420.41	46% above	50%
Knee X-ray, 3 views one side CPT 73562 X-RAY OF KNEE; 3 VIEWS	$292.00	$584.00	$83.07–$420.41	46% above	50%
Knee X-ray, 3 views one side CPT 73562 X-RAY OF KNEE; 3 VIEWS	$292.00	$584.00	$83.07–$420.41	46% above	50%
Knee X-ray, 3 views one side CPT 73562 X-RAY OF KNEE; 3 VIEWS	$292.00	$584.00	$83.07–$420.41	46% above	50%
Knee X-ray, complete, 4 or more views CPT 73564 X-RAY EXAM KNEE 4 OR MORE	$565.50	$1,131.00	$8.23–$505.08	111% above	50%
Knee X-ray, complete, 4 or more views CPT 73564 X-RAY EXAM KNEE 4 OR MORE	$565.50	$1,131.00	$8.23–$505.08	111% above	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY OF KNEE; 4 OR MORE VIEWS	$526.00	$1,052.00	$99.80–$505.08	96% above	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY OF KNEE; 4 OR MORE VIEWS	$526.00	$1,052.00	$99.80–$505.08	96% above	50%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O DYE	$927.00	$1,854.00	$35.00–$505.08	28% above	50%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O DYE	$927.00	$1,854.00	$35.00–$505.08	28% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST	$927.00	$1,854.00	$99.80–$505.08	28% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST	$927.00	$1,854.00	$99.80–$505.08	28% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST	$927.00	$1,854.00	$99.80–$505.08	28% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST	$927.00	$1,854.00	$99.80–$505.08	28% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIMITED ULTRASOUND SCAN OF ABDOMEN	$661.50	$1,323.00	$20.84–$505.08	64% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIMITED ULTRASOUND SCAN OF ABDOMEN	$661.50	$1,323.00	$20.84–$505.08	64% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN	$711.50	$1,423.00	$20.84–$505.08	77% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN	$711.50	$1,423.00	$20.84–$505.08	77% above	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS	$358.41	$716.81	$24.71–$505.08	21% above	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS	$358.41	$716.81	$24.71–$505.08	21% above	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$439.50	$879.00	$24.71–$505.08	48% above	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$439.50	$879.00	$24.71–$505.08	48% above	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS	$409.00	$818.00	$99.80–$505.08	38% above	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS	$409.00	$818.00	$99.80–$505.08	38% above	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS	$409.00	$818.00	$99.80–$505.08	38% above	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS	$409.00	$818.00	$99.80–$505.08	38% above	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LOW DOSE CT SCAN OF CHEST FOR LUNG CANCER SCREENING	$154.00	$308.00	$38.35–$505.08	1% below	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LOW DOSE CT SCAN OF CHEST FOR LUNG CANCER SCREENING	$154.00	$308.00	$38.35–$505.08	1% below	50%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-RAY EXAM OF LOWER LEG	$213.50	$427.00	$5.66–$420.41	11% above	50%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-RAY EXAM OF LOWER LEG	$213.50	$427.00	$5.66–$420.41	11% above	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY OF LOWER LEG; 2 VIEWS	$198.50	$397.00	$83.07–$420.41	3% above	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY OF LOWER LEG; 2 VIEWS	$198.50	$397.00	$83.07–$420.41	3% above	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY OF LOWER LEG; 2 VIEWS	$198.50	$397.00	$83.07–$420.41	3% above	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY OF LOWER LEG; 2 VIEWS	$198.50	$397.00	$83.07–$420.41	3% above	50%
MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE	$1,860.00	$3,720.00	$42.21–$1,152.67	32% above	50%
MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE	$1,860.00	$3,720.00	$42.21–$1,152.67	32% above	50%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST C-+ W/CAD BI	$1,358.00	$2,716.00	$82.10–$527.60	—	50%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST C-+ W/CAD BI	$1,358.00	$2,716.00	$82.10–$527.60	—	50%
MRI of both breasts, without and then with contrast dye CPT 77049 MRI SCAN OF BOTH BREASTS	$1,989.00	$3,978.00	$82.10–$527.60	at median	50%
MRI of both breasts, without and then with contrast dye CPT 77049 MRI SCAN OF BOTH BREASTS	$1,989.00	$3,978.00	$82.10–$527.60	at median	50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$1,877.00	$3,754.00	$47.87–$1,152.67	44% above	50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$1,877.00	$3,754.00	$47.87–$1,152.67	44% above	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$1,746.00	$3,492.00	$227.76–$1,152.67	34% above	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$1,746.00	$3,492.00	$227.76–$1,152.67	34% above	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$1,746.00	$3,492.00	$227.76–$1,152.67	34% above	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$1,746.00	$3,492.00	$227.76–$1,152.67	34% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$1,438.00	$2,876.00	$76.69–$1,685.38	22% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$1,438.00	$2,876.00	$76.69–$1,685.38	22% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$2,175.00	$4,350.00	$76.69–$1,685.38	17% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$2,175.00	$4,350.00	$76.69–$1,685.38	17% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$1,438.00	$2,876.00	$333.02–$1,685.38	22% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$1,438.00	$2,876.00	$333.02–$1,685.38	22% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$1,438.00	$2,876.00	$333.02–$1,685.38	22% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$1,438.00	$2,876.00	$333.02–$1,685.38	22% below	50%
MRI of the abdomen without contrast CPT 74181 MRI SCAN OF ABDOMEN WITHOUT CONTRAST	$1,747.00	$3,494.00	$51.47–$1,152.67	39% above	50%
MRI of the abdomen without contrast CPT 74181 MRI SCAN OF ABDOMEN WITHOUT CONTRAST	$1,747.00	$3,494.00	$51.47–$1,152.67	39% above	50%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$1,878.50	$3,757.00	$51.47–$1,152.67	49% above	50%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$1,878.50	$3,757.00	$51.47–$1,152.67	49% above	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST	$2,874.50	$5,749.00	$78.24–$1,685.38	47% above	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST	$2,874.50	$5,749.00	$78.24–$1,685.38	47% above	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/O CNTR FLWD CNTR	$3,090.50	$6,181.00	$78.24–$1,685.38	58% above	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/O CNTR FLWD CNTR	$3,090.50	$6,181.00	$78.24–$1,685.38	58% above	50%
MRI of the brain, no contrast dye CPT 70551 MRI SCAN OF BRAIN WITHOUT CONTRAST	$1,730.00	$3,460.00	$52.25–$1,152.67	26% above	50%
MRI of the brain, no contrast dye CPT 70551 MRI SCAN OF BRAIN WITHOUT CONTRAST	$1,730.00	$3,460.00	$52.25–$1,152.67	26% above	50%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE	$1,860.00	$3,720.00	$52.25–$1,152.67	35% above	50%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE	$1,860.00	$3,720.00	$52.25–$1,152.67	35% above	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$2,848.00	$5,696.00	$81.59–$1,685.38	46% above	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$2,848.00	$5,696.00	$81.59–$1,685.38	46% above	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE	$3,062.00	$6,124.00	$81.59–$1,685.38	57% above	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE	$3,062.00	$6,124.00	$81.59–$1,685.38	57% above	50%
MRI of the lower back, no contrast dye CPT 72148 MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$1,746.50	$3,493.00	$52.50–$1,152.67	29% above	50%
MRI of the lower back, no contrast dye CPT 72148 MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$1,746.50	$3,493.00	$52.50–$1,152.67	29% above	50%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE	$1,877.50	$3,755.00	$52.50–$1,152.67	39% above	50%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE	$1,877.50	$3,755.00	$52.50–$1,152.67	39% above	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SCAN OF LOWER SPINAL CANAL BEFORE AND AFTER CONTRAST	$2,875.50	$5,751.00	$81.84–$1,685.38	51% above	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SCAN OF LOWER SPINAL CANAL BEFORE AND AFTER CONTRAST	$2,875.50	$5,751.00	$81.84–$1,685.38	51% above	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$3,091.50	$6,183.00	$81.84–$1,685.38	62% above	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$3,091.50	$6,183.00	$81.84–$1,685.38	62% above	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SCAN OF MIDDLE SPINAL CANAL WITHOUT CONTRAST	$1,746.50	$3,493.00	$52.50–$1,152.67	30% above	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SCAN OF MIDDLE SPINAL CANAL WITHOUT CONTRAST	$1,746.50	$3,493.00	$52.50–$1,152.67	30% above	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI CHEST SPINE W/O DYE	$1,877.50	$3,755.00	$52.50–$1,152.67	39% above	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI CHEST SPINE W/O DYE	$1,877.50	$3,755.00	$52.50–$1,152.67	39% above	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SCAN OF UPPER SPINAL CANAL BEFORE AND AFTER CONTRAST	$2,848.00	$5,696.00	$81.84–$1,685.38	51% above	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SCAN OF UPPER SPINAL CANAL BEFORE AND AFTER CONTRAST	$2,848.00	$5,696.00	$81.84–$1,685.38	51% above	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI NECK SPINE W/O & W/DYE	$3,062.00	$6,124.00	$81.84–$1,685.38	63% above	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI NECK SPINE W/O & W/DYE	$3,062.00	$6,124.00	$81.84–$1,685.38	63% above	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SCAN OF UPPER SPINAL CANAL WITHOUT CONTRAST	$1,730.50	$3,461.00	$52.50–$1,152.67	19% above	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SCAN OF UPPER SPINAL CANAL WITHOUT CONTRAST	$1,730.50	$3,461.00	$52.50–$1,152.67	19% above	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE	$1,860.50	$3,721.00	$52.50–$1,152.67	28% above	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE	$1,860.50	$3,721.00	$52.50–$1,152.67	28% above	50%
MRI of the pelvis without and with contrast CPT 72197 MRI SCAN OF PELVIS BEFORE AND AFTER CONTRAST	$2,875.00	$5,750.00	$78.24–$1,685.38	48% above	50%
MRI of the pelvis without and with contrast CPT 72197 MRI SCAN OF PELVIS BEFORE AND AFTER CONTRAST	$2,875.00	$5,750.00	$78.24–$1,685.38	48% above	50%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE	$3,091.00	$6,182.00	$78.24–$1,685.38	59% above	50%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE	$3,091.00	$6,182.00	$78.24–$1,685.38	59% above	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI SCAN OF PELVIS WITHOUT CONTRAST	$1,746.50	$3,493.00	$51.73–$1,152.67	29% above	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI SCAN OF PELVIS WITHOUT CONTRAST	$1,746.50	$3,493.00	$51.73–$1,152.67	29% above	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE	$1,877.50	$3,755.00	$51.73–$1,152.67	39% above	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE	$1,877.50	$3,755.00	$51.73–$1,152.67	39% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST	$1,746.50	$3,493.00	$47.87–$1,152.67	31% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST	$1,746.50	$3,493.00	$47.87–$1,152.67	31% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$1,877.50	$3,755.00	$47.87–$1,152.67	40% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$1,877.50	$3,755.00	$47.87–$1,152.67	40% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST	$1,746.50	$3,493.00	$227.76–$1,152.67	31% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST	$1,746.50	$3,493.00	$227.76–$1,152.67	31% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST	$1,746.50	$3,493.00	$227.76–$1,152.67	31% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST	$1,746.50	$3,493.00	$227.76–$1,152.67	31% above	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY OF UPPER SPINE; 4-5 VIEWS	$333.00	$666.00	$9.52–$505.08	20% above	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY OF UPPER SPINE; 4-5 VIEWS	$333.00	$666.00	$9.52–$505.08	20% above	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$358.00	$716.00	$9.52–$505.08	29% above	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$358.00	$716.00	$9.52–$505.08	29% above	50%
Neck soft tissue CT scan with contrast CPT 70491 CT SCAN OF SOFT TISSUE OF NECK WITH CONTRAST	$1,782.50	$3,565.00	$48.64–$847.35	64% above	50%
Neck soft tissue CT scan with contrast CPT 70491 CT SCAN OF SOFT TISSUE OF NECK WITH CONTRAST	$1,782.50	$3,565.00	$48.64–$847.35	64% above	50%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/DYE	$1,916.50	$3,833.00	$48.64–$847.35	77% above	50%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/DYE	$1,916.50	$3,833.00	$48.64–$847.35	77% above	50%
Neck soft tissue CT scan without contrast CPT 70490 CT SCAN OF SOFT TISSUE OF NECK WITHOUT CONTRAST	$862.00	$1,724.00	$45.55–$505.08	25% above	50%
Neck soft tissue CT scan without contrast CPT 70490 CT SCAN OF SOFT TISSUE OF NECK WITHOUT CONTRAST	$862.00	$1,724.00	$45.55–$505.08	25% above	50%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O DYE	$927.00	$1,854.00	$45.55–$505.08	34% above	50%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O DYE	$927.00	$1,854.00	$45.55–$505.08	34% above	50%
Neck soft tissue X-ray CPT 70360 X-RAY EXAM OF NECK	$226.50	$453.00	$6.44–$420.41	24% above	50%
Neck soft tissue X-ray CPT 70360 X-RAY EXAM OF NECK	$226.50	$453.00	$6.44–$420.41	24% above	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NUCLEAR MEDICINE STUDIES OF HEART MUSCLE AT REST AND WITH STRESS AND SPECT	$3,986.50	$7,973.00	$55.85–$6,254.31	42% above	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NUCLEAR MEDICINE STUDIES OF HEART MUSCLE AT REST AND WITH STRESS AND SPECT	$3,986.50	$7,973.00	$55.85–$6,254.31	42% above	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT	$4,385.50	$8,771.00	$55.85–$6,254.31	56% above	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT	$4,385.50	$8,771.00	$55.85–$6,254.31	56% above	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 NUCLEAR MEDICINE STUDY FROM SKULL BASE TO MID-THIGH WITH CT SCAN	$3,393.00	$6,786.00	$82.61–$6,907.98	1% above	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 NUCLEAR MEDICINE STUDY FROM SKULL BASE TO MID-THIGH WITH CT SCAN	$3,393.00	$6,786.00	$82.61–$6,907.98	1% above	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMAGE W/CT SKULL-THIGH	$4,083.00	$8,166.00	$82.61–$6,907.98	21% above	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMAGE W/CT SKULL-THIGH	$4,083.00	$8,166.00	$82.61–$6,907.98	21% above	50%
Pelvic CT scan without contrast CPT 72192 CT SCAN OF PELVIS WITHOUT CONTRAST	$862.00	$1,724.00	$38.61–$505.08	7% above	50%
Pelvic CT scan without contrast CPT 72192 CT SCAN OF PELVIS WITHOUT CONTRAST	$862.00	$1,724.00	$38.61–$505.08	7% above	50%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O DYE	$927.00	$1,854.00	$38.61–$505.08	16% above	50%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O DYE	$927.00	$1,854.00	$38.61–$505.08	16% above	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 LIMITED ULTRASOUND SCAN OF PELVIS	$442.00	$884.00	$17.76–$505.08	43% above	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 LIMITED ULTRASOUND SCAN OF PELVIS	$442.00	$884.00	$17.76–$505.08	43% above	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED	$475.00	$950.00	$17.76–$505.08	54% above	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED	$475.00	$950.00	$17.76–$505.08	54% above	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 COMPLETE ULTRASOUND SCAN OF PELVIS	$661.50	$1,323.00	$24.44–$505.08	60% above	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 COMPLETE ULTRASOUND SCAN OF PELVIS	$661.50	$1,323.00	$24.44–$505.08	60% above	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE	$711.50	$1,423.00	$24.44–$505.08	72% above	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE	$711.50	$1,423.00	$24.44–$505.08	72% above	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$662.00	$1,324.00	$35.26–$505.08	56% above	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$662.00	$1,324.00	$35.26–$505.08	56% above	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >= 14 WKS SNGL FETUS	$714.00	$1,428.00	$35.26–$505.08	68% above	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >= 14 WKS SNGL FETUS	$714.00	$1,428.00	$35.26–$505.08	68% above	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND SCAN OF PREGNANT UTERUS (LESS THAN 14 WEEKS); SINGLE OR FIRST FETUS	$530.00	$1,060.00	$35.00–$505.08	30% above	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND SCAN OF PREGNANT UTERUS (LESS THAN 14 WEEKS); SINGLE OR FIRST FETUS	$530.00	$1,060.00	$35.00–$505.08	30% above	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS	$570.00	$1,140.00	$35.00–$505.08	40% above	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS	$570.00	$1,140.00	$35.00–$505.08	40% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 LIMITED ULTRASOUND OF PREGNANT UTERUS	$282.50	$565.00	$23.16–$505.08	7% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 LIMITED ULTRASOUND OF PREGNANT UTERUS	$282.50	$565.00	$23.16–$505.08	7% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S)	$475.00	$950.00	$23.16–$505.08	57% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S)	$475.00	$950.00	$23.16–$505.08	57% above	50%
Rib X-ray, one side, 2 views CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS	$247.00	$494.00	$7.98–$420.41	28% above	50%
Rib X-ray, one side, 2 views CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS	$247.00	$494.00	$7.98–$420.41	28% above	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY OF RIBS ON SIDE OF BODY; MINIMUM OF 3 VIEWS	$357.50	$715.00	$99.80–$505.08	54% above	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY OF RIBS ON SIDE OF BODY; MINIMUM OF 3 VIEWS	$357.50	$715.00	$99.80–$505.08	54% above	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY OF RIBS ON SIDE OF BODY; MINIMUM OF 3 VIEWS	$384.50	$769.00	$99.80–$505.08	66% above	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY EXAM UNILAT RIBS/CHEST	$384.50	$769.00	$9.52–$505.08	66% above	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY EXAM UNILAT RIBS/CHEST	$384.50	$769.00	$9.52–$505.08	66% above	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY OF RIBS ON SIDE OF BODY; MINIMUM OF 3 VIEWS	$384.50	$769.00	$99.80–$505.08	66% above	50%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD	$345.00	$690.00	$27.03–$174.40	—	50%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD	$345.00	$690.00	$27.03–$174.40	—	50%
Screening mammogram, both breasts CPT 77067 SCREENING MAMMOGRAPHY	$320.50	$641.00	$27.03–$174.40	12% above	50%
Screening mammogram, both breasts CPT 77067 SCREENING MAMMOGRAPHY	$320.50	$641.00	$27.03–$174.40	12% above	50%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER	$289.50	$579.00	$6.69–$420.41	62% above	50%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER	$289.50	$579.00	$6.69–$420.41	62% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS	$269.00	$538.00	$83.07–$420.41	50% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS	$269.00	$538.00	$83.07–$420.41	50% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS	$269.00	$538.00	$83.07–$420.41	50% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS	$269.00	$538.00	$83.07–$420.41	50% above	50%
Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY EXAM OF SINUSES	$349.00	$698.00	$7.72–$420.41	59% above	50%
Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY EXAM OF SINUSES	$349.00	$698.00	$7.72–$420.41	59% above	50%
Skull X-ray, fewer than 4 views CPT 70250 X-RAY OF SKULL; 1-3 VIEWS	$598.00	$1,196.00	$6.44–$505.08	196% above	50%
Skull X-ray, fewer than 4 views CPT 70250 X-RAY OF SKULL; 1-3 VIEWS	$598.00	$1,196.00	$6.44–$505.08	196% above	50%
Skull X-ray, fewer than 4 views CPT 70250 X-RAY EXAM OF SKULL	$643.00	$1,286.00	$6.44–$505.08	218% above	50%
Skull X-ray, fewer than 4 views CPT 70250 X-RAY EXAM OF SKULL	$643.00	$1,286.00	$6.44–$505.08	218% above	50%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER)	$2,763.00	$5,526.00	$86.98–$4,148.47	8% above	50%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER)	$2,763.00	$5,526.00	$86.98–$4,148.47	8% above	50%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$2,970.50	$5,941.00	$86.98–$4,148.47	16% above	50%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$2,970.50	$5,941.00	$86.98–$4,148.47	16% above	50%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE	$706.50	$1,413.00	$60.48–$2,639.66	25% below	50%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE	$706.50	$1,413.00	$60.48–$2,639.66	25% below	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 IMAGING FOR EVALUATION OF SWALLOWING FUNCTION	$346.00	$692.00	$18.78–$847.35	13% below	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 IMAGING FOR EVALUATION OF SWALLOWING FUNCTION	$346.00	$692.00	$18.78–$847.35	13% below	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+	$372.00	$744.00	$18.78–$847.35	6% below	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+	$372.00	$744.00	$18.78–$847.35	6% below	50%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/>	$208.50	$417.00	$6.44–$420.41	11% above	50%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/>	$208.50	$417.00	$6.44–$420.41	11% above	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY OF THIGH BONE; MINIMUM 2 VIEWS	$193.50	$387.00	$83.07–$420.41	3% above	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY OF THIGH BONE; MINIMUM 2 VIEWS	$193.50	$387.00	$83.07–$420.41	3% above	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SCAN OF MIDDLE SPINE WITHOUT CONTRAST	$862.00	$1,724.00	$35.00–$505.08	4% above	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SCAN OF MIDDLE SPINE WITHOUT CONTRAST	$862.00	$1,724.00	$35.00–$505.08	4% above	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT CHEST SPINE W/O DYE	$927.00	$1,854.00	$35.00–$505.08	12% above	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT CHEST SPINE W/O DYE	$927.00	$1,854.00	$35.00–$505.08	12% above	50%
Toe X-ray, 2 or more views CPT 73660 X-RAY EXAM OF TOE(S)	$208.50	$417.00	$4.63–$420.41	21% above	50%
Toe X-ray, 2 or more views CPT 73660 X-RAY EXAM OF TOE(S)	$208.50	$417.00	$4.63–$420.41	21% above	50%
Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$499.00	$998.00	$24.44–$505.08	24% above	50%
Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$499.00	$998.00	$24.44–$505.08	24% above	50%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB	$536.50	$1,073.00	$24.44–$505.08	33% above	50%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB	$536.50	$1,073.00	$24.44–$505.08	33% above	50%
Transvaginal ultrasound during pregnancy CPT 76817 VAGINAL ULTRASOUND OF PREGNANT UTERUS	$442.00	$884.00	$26.51–$505.08	53% above	50%
Transvaginal ultrasound during pregnancy CPT 76817 VAGINAL ULTRASOUND OF PREGNANT UTERUS	$442.00	$884.00	$26.51–$505.08	53% above	50%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC	$475.50	$951.00	$26.51–$505.08	65% above	50%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC	$475.50	$951.00	$26.51–$505.08	65% above	50%
Ultrasound of the abdomen, complete CPT 76700 COMPLETE ULTRASOUND SCAN OF ABDOMEN	$661.50	$1,323.00	$28.57–$505.08	50% above	50%
Ultrasound of the abdomen, complete CPT 76700 COMPLETE ULTRASOUND SCAN OF ABDOMEN	$661.50	$1,323.00	$28.57–$505.08	50% above	50%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE	$711.50	$1,423.00	$28.57–$505.08	62% above	50%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE	$711.50	$1,423.00	$28.57–$505.08	62% above	50%
Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND SCAN OF SCROTUM	$441.50	$883.00	$22.65–$505.08	17% above	50%
Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND SCAN OF SCROTUM	$441.50	$883.00	$22.65–$505.08	17% above	50%
Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM	$475.00	$950.00	$22.65–$505.08	26% above	50%
Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM	$475.00	$950.00	$22.65–$505.08	26% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SCAN OF HEAD AND NECK SOFT TISSUE	$495.00	$990.00	$20.08–$505.08	34% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SCAN OF HEAD AND NECK SOFT TISSUE	$495.00	$990.00	$20.08–$505.08	34% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$532.50	$1,065.00	$20.08–$505.08	44% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$532.50	$1,065.00	$20.08–$505.08	44% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 SINGLE CONTRAST X-RAY OF UPPER DIGESTIVE TRACT	$210.50	$421.00	$28.57–$847.35	44% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 SINGLE CONTRAST X-RAY OF UPPER DIGESTIVE TRACT	$210.50	$421.00	$28.57–$847.35	44% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$425.00	$850.00	$28.57–$847.35	13% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$425.00	$850.00	$28.57–$847.35	13% above	50%
Upper arm X-ray (humerus), 2 views CPT 73060 X-RAY EXAM OF HUMERUS	$196.00	$392.00	$5.66–$420.41	9% above	50%
Upper arm X-ray (humerus), 2 views CPT 73060 X-RAY EXAM OF HUMERUS	$196.00	$392.00	$5.66–$420.41	9% above	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 X-RAY OF UPPER ARM; MINIMUM OF 2 VIEWS	$182.00	$364.00	$83.07–$420.41	1% above	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 X-RAY OF UPPER ARM; MINIMUM OF 2 VIEWS	$182.00	$364.00	$83.07–$420.41	1% above	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ULTRASOUND STUDY OF ONE ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$395.00	$790.00	$15.70–$505.08	3% above	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ULTRASOUND STUDY OF ONE ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$395.00	$790.00	$15.70–$505.08	3% above	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY	$425.00	$850.00	$15.70–$505.08	11% above	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY	$425.00	$850.00	$15.70–$505.08	11% above	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 ULTRASOUND STUDY OF ONE ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$395.00	$790.00	$99.80–$505.08	3% above	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 ULTRASOUND STUDY OF ONE ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$395.00	$790.00	$99.80–$505.08	3% above	50%
Wrist X-ray, 2 views CPT 73100 X-RAY EXAM OF WRIST	$196.00	$392.00	$5.92–$420.41	22% above	50%
Wrist X-ray, 2 views CPT 73100 X-RAY EXAM OF WRIST	$196.00	$392.00	$5.92–$420.41	22% above	50%
Wrist X-ray, 2 views one side CPT 73100 X-RAY OF WRIST; 2 VIEWS	$182.00	$364.00	$83.07–$420.41	14% above	50%
Wrist X-ray, 2 views one side CPT 73100 X-RAY OF WRIST; 2 VIEWS	$182.00	$364.00	$83.07–$420.41	14% above	50%
Wrist X-ray, 2 views one side CPT 73100 X-RAY OF WRIST; 2 VIEWS	$182.00	$364.00	$83.07–$420.41	14% above	50%
Wrist X-ray, 2 views one side CPT 73100 X-RAY OF WRIST; 2 VIEWS	$182.00	$364.00	$83.07–$420.41	14% above	50%
Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST	$213.50	$427.00	$6.17–$420.41	21% above	50%
Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST	$213.50	$427.00	$6.17–$420.41	21% above	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS	$198.50	$397.00	$83.07–$420.41	12% above	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS	$198.50	$397.00	$83.07–$420.41	12% above	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS	$198.50	$397.00	$83.07–$420.41	12% above	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS	$198.50	$397.00	$83.07–$420.41	12% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$324.00	$648.00	$7.98–$420.41	72% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$324.00	$648.00	$7.98–$420.41	72% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$348.50	$697.00	$7.98–$420.41	85% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$348.50	$697.00	$7.98–$420.41	85% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$324.00	$648.00	$83.07–$420.41	72% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$324.00	$648.00	$83.07–$420.41	72% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$324.00	$648.00	$83.07–$420.41	72% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$324.00	$648.00	$83.07–$420.41	72% above	50%
X-ray of the abdomen, 1 view CPT 74018 X-RAY OF ABDOMEN; 1 VIEW	$395.50	$791.00	$6.44–$420.41	115% above	50%
X-ray of the abdomen, 1 view CPT 74018 X-RAY OF ABDOMEN; 1 VIEW	$395.50	$791.00	$6.44–$420.41	115% above	50%
X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW	$425.50	$851.00	$6.44–$420.41	131% above	50%
X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW	$425.50	$851.00	$6.44–$420.41	131% above	50%
X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE	$196.00	$392.00	$5.66–$420.41	11% above	50%
X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE	$196.00	$392.00	$5.66–$420.41	11% above	50%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S)	$213.50	$427.00	$4.89–$420.41	20% above	50%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S)	$213.50	$427.00	$4.89–$420.41	20% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS	$198.50	$397.00	$83.07–$420.41	12% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS	$198.50	$397.00	$83.07–$420.41	12% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS	$213.50	$427.00	$83.07–$420.41	20% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS	$213.50	$427.00	$83.07–$420.41	20% above	50%
X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT	$196.00	$392.00	$5.41–$420.41	22% above	50%
X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT	$196.00	$392.00	$5.41–$420.41	22% above	50%
X-ray of the foot, 2 views one side CPT 73620 X-RAY OF FOOT; 2 VIEWS	$182.00	$364.00	$83.07–$420.41	13% above	50%
X-ray of the foot, 2 views one side CPT 73620 X-RAY OF FOOT; 2 VIEWS	$182.00	$364.00	$83.07–$420.41	13% above	50%
X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT	$218.00	$436.00	$5.92–$420.41	23% above	50%
X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT	$218.00	$436.00	$5.92–$420.41	23% above	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS	$202.50	$405.00	$83.07–$420.41	14% above	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS	$202.50	$405.00	$83.07–$420.41	14% above	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS	$202.50	$405.00	$83.07–$420.41	14% above	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS	$202.50	$405.00	$83.07–$420.41	14% above	50%
X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND	$218.00	$436.00	$6.17–$420.41	20% above	50%
X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND	$218.00	$436.00	$6.17–$420.41	20% above	50%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS	$202.50	$405.00	$83.07–$420.41	11% above	50%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS	$202.50	$405.00	$83.07–$420.41	11% above	50%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS	$202.50	$405.00	$83.07–$420.41	11% above	50%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS	$202.50	$405.00	$83.07–$420.41	11% above	50%
X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$194.50	$389.00	$5.92–$420.41	8% above	50%
X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$194.50	$389.00	$5.92–$420.41	8% above	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY OF LOWER AND SACRAL SPINE; 2-3 VIEWS	$598.00	$1,196.00	$7.98–$505.08	176% above	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY OF LOWER AND SACRAL SPINE; 2-3 VIEWS	$598.00	$1,196.00	$7.98–$505.08	176% above	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$643.00	$1,286.00	$7.98–$505.08	196% above	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$643.00	$1,286.00	$7.98–$505.08	196% above	50%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$350.50	$701.00	$9.26–$505.08	24% above	50%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$350.50	$701.00	$9.26–$505.08	24% above	50%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$377.00	$754.00	$9.26–$505.08	33% above	50%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$377.00	$754.00	$9.26–$505.08	33% above	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$341.50	$683.00	$7.20–$505.08	49% above	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$341.50	$683.00	$7.20–$505.08	49% above	50%
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES	$226.00	$452.00	$6.17–$420.41	22% above	50%
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES	$226.00	$452.00	$6.17–$420.41	22% above	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY OF UPPER SPINE; 2-3 VIEWS	$594.00	$1,188.00	$7.98–$420.41	205% above	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY OF UPPER SPINE; 2-3 VIEWS	$594.00	$1,188.00	$7.98–$420.41	205% above	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$639.00	$1,278.00	$7.98–$420.41	228% above	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$639.00	$1,278.00	$7.98–$420.41	228% above	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS	$269.00	$538.00	$6.17–$505.08	37% above	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS	$269.00	$538.00	$6.17–$505.08	37% above	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE	$212.00	$424.00	$6.17–$420.41	18% above	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE	$212.00	$424.00	$6.17–$420.41	18% above	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH) LEVEL	$245.50	$491.00	$36.50–$195.45	31% above	50%
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH) LEVEL	$245.50	$491.00	$36.50–$195.45	31% above	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER ENZYME (SGPT); LEVEL	$34.00	$68.00	$5.01–$26.82	17% above	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER ENZYME (SGPT); LEVEL	$34.00	$68.00	$5.01–$26.82	17% above	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER ENZYME (SGOT); LEVEL	$34.00	$68.00	$4.89–$26.22	11% above	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER ENZYME (SGOT); LEVEL	$34.00	$68.00	$4.89–$26.22	11% above	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$289.50	$579.00	$45.01–$241.05	31% above	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$289.50	$579.00	$45.01–$241.05	31% above	50%
Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN	$30.50	$61.00	$4.68–$25.05	69% above	50%
Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN	$30.50	$61.00	$4.68–$25.05	69% above	50%
Aldosterone blood test CPT 82088 ASSAY OF ALDOSTERONE	$12.00	$24.00	$38.51–$206.23	67% below	50%
Aldosterone blood test CPT 82088 ASSAY OF ALDOSTERONE	$12.00	$24.00	$38.51–$206.23	67% below	50%
Aldosterone blood test CPT 82088 ALDOSTERONE HORMONE LEVEL	$26.00	$52.00	$38.51–$206.23	29% below	50%
Aldosterone blood test CPT 82088 ALDOSTERONE HORMONE LEVEL	$26.00	$52.00	$38.51–$206.23	29% below	50%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE (ENZYME) LEVEL; ALKALINE	$18.00	$36.00	$4.89–$26.22	13% below	50%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE (ENZYME) LEVEL; ALKALINE	$18.00	$36.00	$4.89–$26.22	13% below	50%
Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY ALKALINE PHOSPHATASE	$34.00	$68.00	$4.89–$26.22	64% above	50%
Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY ALKALINE PHOSPHATASE	$34.00	$68.00	$4.89–$26.22	64% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$5.00	$10.00	$4.94–$26.42	71% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$5.00	$10.00	$4.94–$26.42	71% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 MEASUREMENT OF ANTIBODY (IGE) TO ALLERGIC SUBSTANCE; CRUDE ALLERGEN EXTRACT; EACH	$7.50	$15.00	$4.94–$26.42	56% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 MEASUREMENT OF ANTIBODY (IGE) TO ALLERGIC SUBSTANCE; CRUDE ALLERGEN EXTRACT; EACH	$7.50	$15.00	$4.94–$26.42	56% below	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (AFP) LEVEL; SERUM	$98.50	$197.00	$15.84–$84.87	30% above	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (AFP) LEVEL; SERUM	$98.50	$197.00	$15.84–$84.87	30% above	50%
Ammonia blood test CPT 82140 ASSAY OF AMMONIA	$28.50	$57.00	$13.77–$73.74	38% below	50%
Ammonia blood test CPT 82140 ASSAY OF AMMONIA	$28.50	$57.00	$13.77–$73.74	38% below	50%
Ammonia blood test CPT 82140 AMMONIA LEVEL	$88.50	$177.00	$13.77–$73.74	92% above	50%
Ammonia blood test CPT 82140 AMMONIA LEVEL	$88.50	$177.00	$13.77–$73.74	92% above	50%
Amylase blood test CPT 82150 AMYLASE (ENZYME) LEVEL	$38.50	$77.00	$6.12–$32.79	at median	50%
Amylase blood test CPT 82150 AMYLASE (ENZYME) LEVEL	$38.50	$77.00	$6.12–$32.79	at median	50%
Amylase blood test CPT 82150 ASSAY OF AMYLASE	$237.00	$474.00	$6.12–$32.79	516% above	50%
Amylase blood test CPT 82150 ASSAY OF AMYLASE	$237.00	$474.00	$6.12–$32.79	516% above	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$25.00	$50.00	$12.24–$65.54	41% below	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$25.00	$50.00	$12.24–$65.54	41% below	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 MEASUREMENT OF ANTIBODY FOR RHEUMATOID ARTHRITIS ASSESSMENT	$93.50	$187.00	$12.24–$65.54	121% above	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 MEASUREMENT OF ANTIBODY FOR RHEUMATOID ARTHRITIS ASSESSMENT	$93.50	$187.00	$12.24–$65.54	121% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$86.50	$173.00	$11.42–$61.19	42% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$86.50	$173.00	$11.42–$61.19	42% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 SCREENING TEST FOR AUTOIMMUNE DISORDER	$88.50	$177.00	$11.42–$61.19	46% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 SCREENING TEST FOR AUTOIMMUNE DISORDER	$88.50	$177.00	$11.42–$61.19	46% above	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (HEART AND BLOOD VESSEL PROTEIN) LEVEL	$223.00	$446.00	$37.10–$198.69	86% above	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (HEART AND BLOOD VESSEL PROTEIN) LEVEL	$223.00	$446.00	$37.10–$198.69	86% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL CULTURE; ANY OTHER SOURCE EXCEPT URINE; BLOOD OR STOOL; AEROBIC	$56.50	$113.00	$8.15–$43.62	10% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL CULTURE; ANY OTHER SOURCE EXCEPT URINE; BLOOD OR STOOL; AEROBIC	$56.50	$113.00	$8.15–$43.62	10% above	50%
Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$54.00	$108.00	$7.99–$42.82	at median	50%
Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$54.00	$108.00	$7.99–$42.82	at median	50%
Bilirubin blood test, total CPT 82247 BILIRUBIN LEVEL; TOTAL	$27.00	$54.00	$4.75–$25.41	10% above	50%
Bilirubin blood test, total CPT 82247 BILIRUBIN LEVEL; TOTAL	$27.00	$54.00	$4.75–$25.41	10% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST	$232.50	$465.00	$49.75–$251.78	114% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST	$232.50	$465.00	$49.75–$251.78	114% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY EXAMINATION OF TISSUE USING A MICROSCOPE; INTERMEDIATE COMPLEXITY	$697.50	$1,395.00	$49.75–$251.78	542% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY EXAMINATION OF TISSUE USING A MICROSCOPE; INTERMEDIATE COMPLEXITY	$697.50	$1,395.00	$49.75–$251.78	542% above	50%
Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA	$68.00	$136.00	$9.75–$52.23	8% below	50%
Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA	$68.00	$136.00	$9.75–$52.23	8% below	50%
Blood culture for bacteria CPT 87040 BACTERIAL BLOOD CULTURE	$136.00	$272.00	$9.75–$52.23	83% above	50%
Blood culture for bacteria CPT 87040 BACTERIAL BLOOD CULTURE	$136.00	$272.00	$9.75–$52.23	83% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE	$14.00	$28.00	$9.34–$47.27	33% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE	$14.00	$28.00	$9.34–$47.27	33% above	50%
Blood draw from a vein (venipuncture), collection fee only one side CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE	$14.00	$28.00	$9.34–$47.27	33% above	50%
Blood draw from a vein (venipuncture), collection fee only one side CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE	$14.00	$28.00	$9.34–$47.27	33% above	50%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$23.00	$46.00	$3.72–$19.89	at median	50%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$23.00	$46.00	$3.72–$19.89	at median	50%
Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE (SUGAR) LEVEL	$23.50	$47.00	$3.72–$19.89	2% above	50%
Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE (SUGAR) LEVEL	$23.50	$47.00	$3.72–$19.89	2% above	50%
Blood lead test CPT 83655 LEAD LEVEL	$6.50	$13.00	$11.45–$61.29	82% below	50%
Blood lead test CPT 83655 LEAD LEVEL	$6.50	$13.00	$11.45–$61.29	82% below	50%
Blood lead test CPT 83655 ASSAY OF LEAD	$77.50	$155.00	$11.45–$61.29	116% above	50%
Blood lead test CPT 83655 ASSAY OF LEAD	$77.50	$155.00	$11.45–$61.29	116% above	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$44.50	$89.00	$7.11–$38.06	7% above	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$44.50	$89.00	$7.11–$38.06	7% above	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (REPRODUCTIVE HORMONE) ANALYSIS	$46.00	$92.00	$7.11–$38.06	11% above	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (REPRODUCTIVE HORMONE) ANALYSIS	$46.00	$92.00	$7.11–$38.06	11% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$25.00	$50.00	$2.82–$642.73	39% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$25.00	$50.00	$2.82–$642.73	39% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD GROUP TYPING (ABO)	$226.50	$453.00	$2.82–$642.73	455% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD GROUP TYPING (ABO)	$226.50	$453.00	$2.82–$642.73	455% above	50%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN LEVEL TO ASSESS KIDNEY FUNCTION; QUANTITATIVE	$28.00	$56.00	$3.74–$19.99	2% above	50%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN LEVEL TO ASSESS KIDNEY FUNCTION; QUANTITATIVE	$28.00	$56.00	$3.74–$19.99	2% above	50%
C-peptide blood test CPT 84681 C-PEPTIDE (PROTEIN) LEVEL	$132.50	$265.00	$19.67–$105.32	80% above	50%
C-peptide blood test CPT 84681 C-PEPTIDE (PROTEIN) LEVEL	$132.50	$265.00	$19.67–$105.32	80% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION	$27.50	$55.00	$4.89–$26.22	10% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION	$27.50	$55.00	$4.89–$26.22	10% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$40.00	$80.00	$4.89–$26.22	31% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$40.00	$80.00	$4.89–$26.22	31% above	50%
C. difficile toxin gene test (stool PCR) CPT 87493 DETECTION TEST BY NUCLEIC ACID FOR CLOSTRIDIUM DIFFICILE; AMPLIFIED PROBE TECHNIQUE	$205.50	$411.00	$35.22–$188.62	81% above	50%
C. difficile toxin gene test (stool PCR) CPT 87493 DETECTION TEST BY NUCLEIC ACID FOR CLOSTRIDIUM DIFFICILE; AMPLIFIED PROBE TECHNIQUE	$205.50	$411.00	$35.22–$188.62	81% above	50%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$33.50	$67.00	$19.67–$105.32	60% below	50%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$33.50	$67.00	$19.67–$105.32	60% below	50%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 19-9	$151.00	$302.00	$19.67–$105.32	82% above	50%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 19-9	$151.00	$302.00	$19.67–$105.32	82% above	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 125	$151.00	$302.00	$19.67–$105.32	42% above	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 125	$151.00	$302.00	$19.67–$105.32	42% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 AMPLIFED DNA OR RNA PROBE DETECTION OF SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (COVID-19) ANTIGEN	$158.50	$317.00	$48.49–$259.67	47% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 AMPLIFED DNA OR RNA PROBE DETECTION OF SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (COVID-19) ANTIGEN	$158.50	$317.00	$48.49–$259.67	47% above	50%
Calcium blood test, total CPT 82310 ASSAY OF CALCIUM	$10.50	$21.00	$4.87–$26.11	58% below	50%
Calcium blood test, total CPT 82310 ASSAY OF CALCIUM	$10.50	$21.00	$4.87–$26.11	58% below	50%
Calcium blood test, total CPT 82310 CALCIUM LEVEL; TOTAL	$30.00	$60.00	$4.87–$26.11	19% above	50%
Calcium blood test, total CPT 82310 CALCIUM LEVEL; TOTAL	$30.00	$60.00	$4.87–$26.11	19% above	50%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA) PROTEIN LEVEL	$111.50	$223.00	$17.91–$95.95	7% above	50%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA) PROTEIN LEVEL	$111.50	$223.00	$17.91–$95.95	7% above	50%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN	$144.00	$288.00	$17.91–$95.95	39% above	50%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN	$144.00	$288.00	$17.91–$95.95	39% above	50%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY	$6.50	$13.00	$12.17–$65.18	83% below	50%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY	$6.50	$13.00	$12.17–$65.18	83% below	50%
Chickenpox (varicella) immunity blood test CPT 86787 ANALYSIS FOR ANTIBODY TO VARICELLA-ZOSTER VIRUS (CHICKEN POX)	$94.00	$188.00	$12.17–$65.18	146% above	50%
Chickenpox (varicella) immunity blood test CPT 86787 ANALYSIS FOR ANTIBODY TO VARICELLA-ZOSTER VIRUS (CHICKEN POX)	$94.00	$188.00	$12.17–$65.18	146% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE	$37.00	$74.00	$33.16–$177.59	35% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE	$37.00	$74.00	$33.16–$177.59	35% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DETECTION TEST BY NUCLEIC ACID FOR CHLAMYDIA TRACHOMATIS; AMPLIFIED PROBE TECHNIQUE	$71.00	$142.00	$33.16–$177.59	25% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DETECTION TEST BY NUCLEIC ACID FOR CHLAMYDIA TRACHOMATIS; AMPLIFIED PROBE TECHNIQUE	$71.00	$142.00	$33.16–$177.59	25% above	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$86.00	$172.00	$12.65–$67.77	38% above	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$86.00	$172.00	$12.65–$67.77	38% above	50%
Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$47.50	$95.00	$7.34–$39.32	14% above	50%
Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$47.50	$95.00	$7.34–$39.32	14% above	50%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$51.50	$103.00	$7.34–$39.32	24% above	50%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$51.50	$103.00	$7.34–$39.32	24% above	50%
Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$42.50	$85.00	$6.11–$32.74	21% above	50%
Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$42.50	$85.00	$6.11–$32.74	21% above	50%
Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED	$46.00	$92.00	$6.11–$32.74	31% above	50%
Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED	$46.00	$92.00	$6.11–$32.74	31% above	50%
Comprehensive metabolic panel (blood test) CPT 80053 BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$67.50	$135.00	$9.98–$53.44	38% above	50%
Comprehensive metabolic panel (blood test) CPT 80053 BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$67.50	$135.00	$9.98–$53.44	38% above	50%
Cortisol blood test, total CPT 82533 TOTAL CORTISOL	$20.00	$40.00	$15.40–$82.49	66% below	50%
Cortisol blood test, total CPT 82533 TOTAL CORTISOL	$20.00	$40.00	$15.40–$82.49	66% below	50%
Cortisol blood test, total CPT 82533 CORTISOL (HORMONE) MEASUREMENT; TOTAL	$105.00	$210.00	$15.40–$82.49	77% above	50%
Cortisol blood test, total CPT 82533 CORTISOL (HORMONE) MEASUREMENT; TOTAL	$105.00	$210.00	$15.40–$82.49	77% above	50%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE (CARDIAC ENZYME) LEVEL; TOTAL	$43.50	$87.00	$6.15–$32.95	at median	50%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE (CARDIAC ENZYME) LEVEL; TOTAL	$43.50	$87.00	$6.15–$32.95	at median	50%
Creatinine blood test CPT 82565 BLOOD CREATININE LEVEL	$33.00	$66.00	$4.84–$25.91	12% above	50%
Creatinine blood test CPT 82565 BLOOD CREATININE LEVEL	$33.00	$66.00	$4.84–$25.91	12% above	50%
Creatinine blood test CPT 82565 ASSAY OF CREATININE	$33.50	$67.00	$4.84–$25.91	14% above	50%
Creatinine blood test CPT 82565 ASSAY OF CREATININE	$33.50	$67.00	$4.84–$25.91	14% above	50%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY	$8.50	$17.00	$13.60–$72.83	83% below	50%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY	$8.50	$17.00	$13.60–$72.83	83% below	50%
Cytomegalovirus (CMV) antibody test CPT 86644 ANALYSIS FOR ANTIBODY TO CYTOMEGALOVIRUS (CMV)	$47.00	$94.00	$13.60–$72.83	7% below	50%
Cytomegalovirus (CMV) antibody test CPT 86644 ANALYSIS FOR ANTIBODY TO CYTOMEGALOVIRUS (CMV)	$47.00	$94.00	$13.60–$72.83	7% below	50%
D-dimer blood test (blood clot marker) CPT 85379 COAGULATION FUNCTION MEASUREMENT; D-DIMER; QUANTITATIVE	$62.00	$124.00	$9.62–$51.52	3% below	50%
D-dimer blood test (blood clot marker) CPT 85379 COAGULATION FUNCTION MEASUREMENT; D-DIMER; QUANTITATIVE	$62.00	$124.00	$9.62–$51.52	3% below	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE (DHEA-S) HORMONE LEVEL	$12.00	$24.00	$21.01–$112.50	87% below	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE (DHEA-S) HORMONE LEVEL	$12.00	$24.00	$21.01–$112.50	87% below	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE	$139.00	$278.00	$21.01–$112.50	49% above	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE	$139.00	$278.00	$21.01–$112.50	49% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$28.00	$56.00	$58.73–$314.48	8% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$28.00	$56.00	$58.73–$314.48	8% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TESTING FOR PRESENCE OF DRUG; BY CHEMISTRY ANALYZERS	$336.00	$672.00	$58.73–$314.48	1006% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TESTING FOR PRESENCE OF DRUG; BY CHEMISTRY ANALYZERS	$336.00	$672.00	$58.73–$314.48	1006% above	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 BLOOD TEST PANEL FOR ELECTROLYTES (SODIUM POTASSIUM; CHLORIDE; CARBON DIOXIDE)	$37.50	$75.00	$6.63–$35.48	15% above	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 BLOOD TEST PANEL FOR ELECTROLYTES (SODIUM POTASSIUM; CHLORIDE; CARBON DIOXIDE)	$37.50	$75.00	$6.63–$35.48	15% above	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 ANALYSIS FOR ANTIBODY TO EPSTEIN-BARR VIRUS (MONONUCLEOSIS VIRUS); VIRAL CAPSID	$92.00	$184.00	$17.15–$91.80	51% above	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 ANALYSIS FOR ANTIBODY TO EPSTEIN-BARR VIRUS (MONONUCLEOSIS VIRUS); VIRAL CAPSID	$92.00	$184.00	$17.15–$91.80	51% above	50%
Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL	$177.50	$355.00	$26.41–$141.40	107% above	50%
Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL	$177.50	$355.00	$26.41–$141.40	107% above	50%
Estradiol blood test CPT 82670 MEASUREMENT OF TOTAL ESTRADIOL (HORMONE)	$179.50	$359.00	$26.41–$141.40	109% above	50%
Estradiol blood test CPT 82670 MEASUREMENT OF TOTAL ESTRADIOL (HORMONE)	$179.50	$359.00	$26.41–$141.40	109% above	50%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLICLE STIMULATING (REPRODUCTIVE HORMONE) LEVEL	$119.50	$239.00	$17.56–$94.03	42% above	50%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLICLE STIMULATING (REPRODUCTIVE HORMONE) LEVEL	$119.50	$239.00	$17.56–$94.03	42% above	50%
Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN (PROTEIN) LEVEL	$131.50	$263.00	$18.55–$99.35	46% above	50%
Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN (PROTEIN) LEVEL	$131.50	$263.00	$18.55–$99.35	46% above	50%
Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL	$89.00	$178.00	$12.88–$68.98	27% above	50%
Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL	$89.00	$178.00	$12.88–$68.98	27% above	50%
Fibrinogen blood test CPT 85384 FIBRINOGEN (FACTOR 1) ACTIVITY MEASUREMENT	$54.50	$109.00	$9.19–$49.19	6% above	50%
Fibrinogen blood test CPT 85384 FIBRINOGEN (FACTOR 1) ACTIVITY MEASUREMENT	$54.50	$109.00	$9.19–$49.19	6% above	50%
Folate (folic acid) blood test CPT 82746 FOLIC ACID LEVEL; SERUM	$96.50	$193.00	$13.89–$74.40	36% above	50%
Folate (folic acid) blood test CPT 82746 FOLIC ACID LEVEL; SERUM	$96.50	$193.00	$13.89–$74.40	36% above	50%
Free T3 thyroid hormone test CPT 84481 THYROID HORMONE; T3 MEASUREMENT; FREE	$109.50	$219.00	$16.01–$85.73	20% above	50%
Free T3 thyroid hormone test CPT 84481 THYROID HORMONE; T3 MEASUREMENT; FREE	$109.50	$219.00	$16.01–$85.73	20% above	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$7.50	$15.00	$8.53–$45.65	87% below	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$7.50	$15.00	$8.53–$45.65	87% below	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (THYROID CHEMICAL); FREE	$54.50	$109.00	$8.53–$45.65	6% below	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (THYROID CHEMICAL); FREE	$54.50	$109.00	$8.53–$45.65	6% below	50%
Free testosterone test CPT 84402 TESTOSTERONE (HORMONE) LEVEL; FREE	$162.00	$324.00	$24.07–$128.90	130% above	50%
Free testosterone test CPT 84402 TESTOSTERONE (HORMONE) LEVEL; FREE	$162.00	$324.00	$24.07–$128.90	130% above	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GGT	$45.00	$90.00	$6.80–$36.44	30% above	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GGT	$45.00	$90.00	$6.80–$36.44	30% above	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE (LIVER ENZYME) LEVEL	$46.00	$92.00	$6.80–$36.44	33% above	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE (LIVER ENZYME) LEVEL	$46.00	$92.00	$6.80–$36.44	33% above	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$223.00	$446.00	$47.38–$48.28	2% below	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$223.00	$446.00	$47.38–$48.28	2% below	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 BLOOD GLUCOSE (SUGAR) LEVEL AFTER RECEIVING DOSE OF GLUCOSE	$28.50	$57.00	$4.49–$24.04	15% below	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 BLOOD GLUCOSE (SUGAR) LEVEL AFTER RECEIVING DOSE OF GLUCOSE	$28.50	$57.00	$4.49–$24.04	15% below	50%
Glucose tolerance test, 3 samples CPT 82951 BLOOD GLUCOSE (SUGAR) TOLERANCE TEST; 3 SPECIMENS	$76.00	$152.00	$12.16–$65.13	17% above	50%
Glucose tolerance test, 3 samples CPT 82951 BLOOD GLUCOSE (SUGAR) TOLERANCE TEST; 3 SPECIMENS	$76.00	$152.00	$12.16–$65.13	17% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB	$56.50	$113.00	$33.16–$177.59	7% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB	$56.50	$113.00	$33.16–$177.59	7% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 DETECTION TEST BY NUCLEIC ACID FOR NEISSERIA GONORRHOEAE (GONORRHOEAE BACTERIA); AMPLIFIED PROBE TECHNIQUE	$71.00	$142.00	$33.16–$177.59	17% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 DETECTION TEST BY NUCLEIC ACID FOR NEISSERIA GONORRHOEAE (GONORRHOEAE BACTERIA); AMPLIFIED PROBE TECHNIQUE	$71.00	$142.00	$33.16–$177.59	17% above	50%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY	$95.50	$191.00	$15.93–$85.28	80% above	50%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY	$95.50	$191.00	$15.93–$85.28	80% above	50%
H. pylori stool antigen test CPT 87338 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HELICOBACTER PYLORI (GI TRACT BACTERIA) IN STOOL	$92.00	$184.00	$13.59–$72.78	55% above	50%
H. pylori stool antigen test CPT 87338 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HELICOBACTER PYLORI (GI TRACT BACTERIA) IN STOOL	$92.00	$184.00	$13.59–$72.78	55% above	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 DETECTION TEST BY NUCLEIC ACID FOR HIV-1 VIRUS; QUANTIFICATION	$498.50	$997.00	$80.42–$430.68	97% above	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 DETECTION TEST BY NUCLEIC ACID FOR HIV-1 VIRUS; QUANTIFICATION	$498.50	$997.00	$80.42–$430.68	97% above	50%
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY	$90.00	$180.00	$12.96–$69.38	42% above	50%
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY	$90.00	$180.00	$12.96–$69.38	42% above	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HIV-1 ANTIGEN AND HIV-1 AND HIV-2 ANTIBODIES	$45.00	$90.00	$22.75–$121.87	29% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HIV-1 ANTIGEN AND HIV-1 AND HIV-2 ANTIBODIES	$45.00	$90.00	$22.75–$121.87	29% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1&-2 AB AG IA	$46.00	$92.00	$22.75–$121.87	28% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1&-2 AB AG IA	$46.00	$92.00	$22.75–$121.87	28% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 DETECTION TEST BY NUCLEIC ACID FOR HUMAN PAPILLOMAVIRUS (HPV); HIGH-RISK TYPES	$71.00	$142.00	$33.16–$177.59	11% above	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 DETECTION TEST BY NUCLEIC ACID FOR HUMAN PAPILLOMAVIRUS (HPV); HIGH-RISK TYPES	$71.00	$142.00	$33.16–$177.59	11% above	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOLED RSLT	$205.50	$411.00	$33.16–$177.59	221% above	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOLED RSLT	$205.50	$411.00	$33.16–$177.59	221% above	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL	$26.50	$53.00	$9.18–$49.14	47% below	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL	$26.50	$53.00	$9.18–$49.14	47% below	50%
Hemoglobin blood test CPT 85018 BLOOD COUNT; HEMOGLOBIN	$15.50	$31.00	$2.24–$11.99	11% above	50%
Hemoglobin blood test CPT 85018 BLOOD COUNT; HEMOGLOBIN	$15.50	$31.00	$2.24–$11.99	11% above	50%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$16.00	$32.00	$2.24–$11.99	14% above	50%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$16.00	$32.00	$2.24–$11.99	14% above	50%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY MEASUREMENT	$77.50	$155.00	$11.39–$60.98	55% above	50%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY MEASUREMENT	$77.50	$155.00	$11.39–$60.98	55% above	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY MEASUREMENT	$78.00	$156.00	$10.15–$54.35	64% above	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY MEASUREMENT	$78.00	$156.00	$10.15–$54.35	64% above	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA	$5.50	$11.00	$9.77–$52.28	84% below	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA	$5.50	$11.00	$9.77–$52.28	84% below	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HEPATITIS B SURFACE ANTIGEN	$62.00	$124.00	$9.77–$52.28	78% above	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HEPATITIS B SURFACE ANTIGEN	$62.00	$124.00	$9.77–$52.28	78% above	50%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY MEASUREMENT	$96.00	$192.00	$13.48–$72.22	64% above	50%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY MEASUREMENT	$96.00	$192.00	$13.48–$72.22	64% above	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 DETECTION TEST BY NUCLEIC ACID FOR HEPATITIS C VIRUS; QUANTIFICATION	$272.00	$544.00	$40.49–$216.81	36% above	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 DETECTION TEST BY NUCLEIC ACID FOR HEPATITIS C VIRUS; QUANTIFICATION	$272.00	$544.00	$40.49–$216.81	36% above	50%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$94.50	$189.00	$12.46–$66.75	116% above	50%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$94.50	$189.00	$12.46–$66.75	116% above	50%
Herpes blood test, HSV-1 antibody CPT 86695 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 1	$96.00	$192.00	$12.46–$66.75	119% above	50%
Herpes blood test, HSV-1 antibody CPT 86695 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 1	$96.00	$192.00	$12.46–$66.75	119% above	50%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$25.00	$50.00	$18.29–$97.93	48% below	50%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$25.00	$50.00	$18.29–$97.93	48% below	50%
Herpes blood test, HSV-2 antibody CPT 86696 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 2	$140.50	$281.00	$18.29–$97.93	193% above	50%
Herpes blood test, HSV-2 antibody CPT 86696 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 2	$140.50	$281.00	$18.29–$97.93	193% above	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS	$91.50	$183.00	$12.24–$65.54	48% above	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS	$91.50	$183.00	$12.24–$65.54	48% above	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION; HIGH SENSITIVITY	$93.50	$187.00	$12.24–$65.54	51% above	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION; HIGH SENSITIVITY	$93.50	$187.00	$12.24–$65.54	51% above	50%
Homocysteine blood test CPT 83090 HOMOCYSTEINE (AMINO ACID) LEVEL	$107.00	$214.00	$16.94–$90.69	22% above	50%
Homocysteine blood test CPT 83090 HOMOCYSTEINE (AMINO ACID) LEVEL	$107.00	$214.00	$16.94–$90.69	22% above	50%
Insulin blood test CPT 83525 INSULIN MEASUREMENT; TOTAL	$73.00	$146.00	$10.80–$57.85	32% above	50%
Insulin blood test CPT 83525 INSULIN MEASUREMENT; TOTAL	$73.00	$146.00	$10.80–$57.85	32% above	50%
Iron blood test (serum iron) CPT 83540 IRON LEVEL	$42.50	$85.00	$6.11–$32.74	at median	50%
Iron blood test (serum iron) CPT 83540 IRON LEVEL	$42.50	$85.00	$6.11–$32.74	at median	50%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$55.50	$111.00	$8.26–$44.23	25% above	50%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$55.50	$111.00	$8.26–$44.23	25% above	50%
Kidney function blood test panel CPT 80069 KIDNEY FUNCTION BLOOD TEST PANEL	$55.50	$111.00	$8.20–$43.93	29% above	50%
Kidney function blood test panel CPT 80069 KIDNEY FUNCTION BLOOD TEST PANEL	$55.50	$111.00	$8.20–$43.93	29% above	50%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING (REPRODUCTIVE HORMONE) LEVEL	$118.00	$236.00	$17.50–$93.73	40% above	50%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING (REPRODUCTIVE HORMONE) LEVEL	$118.00	$236.00	$17.50–$93.73	40% above	50%
Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID	$70.00	$140.00	$10.93–$58.55	23% above	50%
Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID	$70.00	$140.00	$10.93–$58.55	23% above	50%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID LEVEL	$140.00	$280.00	$10.93–$58.55	147% above	50%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID LEVEL	$140.00	$280.00	$10.93–$58.55	147% above	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME	$5.00	$10.00	$5.71–$30.57	74% below	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME	$5.00	$10.00	$5.71–$30.57	74% below	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (ENZYME) LEVEL	$36.00	$72.00	$5.71–$30.57	89% above	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (ENZYME) LEVEL	$36.00	$72.00	$5.71–$30.57	89% above	50%
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE	$27.00	$54.00	$6.51–$34.87	33% below	50%
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE	$27.00	$54.00	$6.51–$34.87	33% below	50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (FAT ENZYME) LEVEL	$46.00	$92.00	$6.51–$34.87	14% above	50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (FAT ENZYME) LEVEL	$46.00	$92.00	$6.51–$34.87	14% above	50%
Liver function blood test panel CPT 80076 LIVER FUNCTION BLOOD TEST PANEL	$52.50	$105.00	$7.72–$41.35	11% above	50%
Liver function blood test panel CPT 80076 LIVER FUNCTION BLOOD TEST PANEL	$52.50	$105.00	$7.72–$41.35	11% above	50%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$59.00	$118.00	$16.10–$86.19	87% above	50%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$59.00	$118.00	$16.10–$86.19	87% above	50%
Lyme disease antibody test CPT 86618 ANALYSIS FOR ANTIBODY BORRELIA BURGDORFERI (LYME DISEASE BACTERIA)	$100.00	$200.00	$16.10–$86.19	217% above	50%
Lyme disease antibody test CPT 86618 ANALYSIS FOR ANTIBODY BORRELIA BURGDORFERI (LYME DISEASE BACTERIA)	$100.00	$200.00	$16.10–$86.19	217% above	50%
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM	$19.50	$39.00	$6.33–$33.91	at median	50%
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM	$19.50	$39.00	$6.33–$33.91	at median	50%
Magnesium blood test CPT 83735 MAGNESIUM LEVEL	$40.50	$81.00	$6.33–$33.91	108% above	50%
Magnesium blood test CPT 83735 MAGNESIUM LEVEL	$40.50	$81.00	$6.33–$33.91	108% above	50%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$91.50	$183.00	$12.17–$65.18	134% above	50%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$91.50	$183.00	$12.17–$65.18	134% above	50%
Measles (rubeola) antibody test CPT 86765 ANALYSIS FOR ANTIBODY TO RUBEOLA (MEASLES VIRUS)	$93.50	$187.00	$12.17–$65.18	139% above	50%
Measles (rubeola) antibody test CPT 86765 ANALYSIS FOR ANTIBODY TO RUBEOLA (MEASLES VIRUS)	$93.50	$187.00	$12.17–$65.18	139% above	50%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN	$38.00	$76.00	$4.89–$26.22	9% above	50%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN	$38.00	$76.00	$4.89–$26.22	9% above	50%
Mono test (heterophile antibody, Monospot) CPT 86308 SCREENING TEST FOR MONONUCLEOSIS (MONO)	$38.50	$77.00	$4.89–$26.22	10% above	50%
Mono test (heterophile antibody, Monospot) CPT 86308 SCREENING TEST FOR MONONUCLEOSIS (MONO)	$38.50	$77.00	$4.89–$26.22	10% above	50%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$86.50	$173.00	$12.34–$66.04	94% above	50%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$86.50	$173.00	$12.34–$66.04	94% above	50%
Mumps immunity blood test CPT 86735 ANALYSIS FOR ANTIBODY TO MUMPS VIRUS	$88.00	$176.00	$12.34–$66.04	98% above	50%
Mumps immunity blood test CPT 86735 ANALYSIS FOR ANTIBODY TO MUMPS VIRUS	$88.00	$176.00	$12.34–$66.04	98% above	50%
Obstetric blood test panel CPT 80055 OBSTETRIC BLOOD TEST PANEL	$585.50	$1,171.00	$45.18–$241.96	164% above	50%
Obstetric blood test panel CPT 80055 OBSTETRIC BLOOD TEST PANEL	$585.50	$1,171.00	$45.18–$241.96	164% above	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; FREE	$47.50	$95.00	$17.38–$93.07	21% below	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; FREE	$47.50	$95.00	$17.38–$93.07	21% below	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL	$120.50	$241.00	$17.38–$93.07	91% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL	$120.50	$241.00	$17.38–$93.07	91% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$305.00	$610.00	$17.38–$93.07	383% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$305.00	$610.00	$17.38–$93.07	383% above	50%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP TEST; AUTOMATED THIN LAYER PREPARATION; AUTOMATED SYSTEM AND MANUAL RESCREENING	$148.00	$296.00	$25.15–$134.67	80% above	50%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP TEST; AUTOMATED THIN LAYER PREPARATION; AUTOMATED SYSTEM AND MANUAL RESCREENING	$148.00	$296.00	$25.15–$134.67	80% above	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER	$50.00	$100.00	$19.14–$102.53	at median	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER	$50.00	$100.00	$19.14–$102.53	at median	50%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) LEVEL	$270.50	$541.00	$39.01–$208.91	78% above	50%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) LEVEL	$270.50	$541.00	$39.01–$208.91	78% above	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$35.50	$71.00	$5.68–$30.42	14% below	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$35.50	$71.00	$5.68–$30.42	14% below	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$38.50	$77.00	$5.68–$30.42	7% below	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$38.50	$77.00	$5.68–$30.42	7% below	50%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHATE LEVEL	$31.50	$63.00	$4.48–$23.99	at median	50%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHATE LEVEL	$31.50	$63.00	$4.48–$23.99	at median	50%
Potassium blood test CPT 84132 ASSAY OF SERUM POTASSIUM	$30.00	$60.00	$4.49–$24.09	11% above	50%
Potassium blood test CPT 84132 ASSAY OF SERUM POTASSIUM	$30.00	$60.00	$4.49–$24.09	11% above	50%
Potassium blood test CPT 84132 BLOOD POTASSIUM LEVEL	$30.50	$61.00	$4.49–$24.09	13% above	50%
Potassium blood test CPT 84132 BLOOD POTASSIUM LEVEL	$30.50	$61.00	$4.49–$24.09	13% above	50%
Progesterone blood test CPT 84144 PROGESTERONE (REPRODUCTIVE HORMONE) LEVEL	$134.50	$269.00	$19.71–$105.57	35% above	50%
Progesterone blood test CPT 84144 PROGESTERONE (REPRODUCTIVE HORMONE) LEVEL	$134.50	$269.00	$19.71–$105.57	35% above	50%
Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE	$155.00	$310.00	$19.71–$105.57	56% above	50%
Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE	$155.00	$310.00	$19.71–$105.57	56% above	50%
Prolactin blood test CPT 84146 ASSAY OF PROLACTIN	$34.00	$68.00	$18.31–$98.08	47% below	50%
Prolactin blood test CPT 84146 ASSAY OF PROLACTIN	$34.00	$68.00	$18.31–$98.08	47% below	50%
Prolactin blood test CPT 84146 PROLACTIN (MILK PRODUCING HORMONE) LEVEL	$124.00	$248.00	$18.31–$98.08	92% above	50%
Prolactin blood test CPT 84146 PROLACTIN (MILK PRODUCING HORMONE) LEVEL	$124.00	$248.00	$18.31–$98.08	92% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME	$24.00	$48.00	$4.05–$21.71	17% below	50%
Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME	$24.00	$48.00	$4.05–$21.71	17% below	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$26.00	$52.00	$4.05–$21.71	10% below	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$26.00	$52.00	$4.05–$21.71	10% below	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 TESTING FOR PRESENCE OF DRUG; READ BY DIRECT OBSERVATION	$20.50	$41.00	$11.91–$63.77	44% below	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 TESTING FOR PRESENCE OF DRUG; READ BY DIRECT OBSERVATION	$20.50	$41.00	$11.91–$63.77	44% below	50%
Rapid flu test (influenza antigen) CPT 87804 DETECTION TEST BY IMMUNOASSAY WITH DIRECT VISUAL OBSERVATION FOR INFLUENZA VIRUS	$33.00	$66.00	$15.65–$83.76	29% below	50%
Rapid flu test (influenza antigen) CPT 87804 DETECTION TEST BY IMMUNOASSAY WITH DIRECT VISUAL OBSERVATION FOR INFLUENZA VIRUS	$33.00	$66.00	$15.65–$83.76	29% below	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 DETECTION TEST BY IMMUNOASSAY WITH DIRECT VISUAL OBSERVATION FOR STREPTOCOCCUS; GROUP A (STREP)	$67.50	$135.00	$15.62–$83.66	66% above	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 DETECTION TEST BY IMMUNOASSAY WITH DIRECT VISUAL OBSERVATION FOR STREPTOCOCCUS; GROUP A (STREP)	$67.50	$135.00	$15.62–$83.66	66% above	50%
Renin blood test CPT 84244 ASSAY OF RENIN	$12.50	$25.00	$20.78–$111.29	78% below	50%
Renin blood test CPT 84244 ASSAY OF RENIN	$12.50	$25.00	$20.78–$111.29	78% below	50%
Renin blood test CPT 84244 RENIN (KIDNEY ENZYME) LEVEL	$123.00	$246.00	$20.78–$111.29	113% above	50%
Renin blood test CPT 84244 RENIN (KIDNEY ENZYME) LEVEL	$123.00	$246.00	$20.78–$111.29	113% above	50%
Rh blood typing CPT 86901 BLOOD TYPING SEROLOGIC RH(D)	$22.00	$44.00	$2.82–$180.42	23% below	50%
Rh blood typing CPT 86901 BLOOD TYPING SEROLOGIC RH(D)	$22.00	$44.00	$2.82–$180.42	23% below	50%
Rh blood typing CPT 86901 BLOOD TYPING FOR RH (D) ANTIGEN	$69.00	$138.00	$2.82–$180.42	141% above	50%
Rh blood typing CPT 86901 BLOOD TYPING FOR RH (D) ANTIGEN	$69.00	$138.00	$2.82–$180.42	141% above	50%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$41.00	$82.00	$5.36–$28.70	14% above	50%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$41.00	$82.00	$5.36–$28.70	14% above	50%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR LEVEL	$42.00	$84.00	$5.36–$28.70	17% above	50%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR LEVEL	$42.00	$84.00	$5.36–$28.70	17% above	50%
Rubella antibody test (immunity check) CPT 86762 ANALYSIS FOR ANTIBODY TO RUBELLA (GERMAN MEASLES VIRUS)	$103.00	$206.00	$13.60–$72.83	108% above	50%
Rubella antibody test (immunity check) CPT 86762 ANALYSIS FOR ANTIBODY TO RUBELLA (GERMAN MEASLES VIRUS)	$103.00	$206.00	$13.60–$72.83	108% above	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$104.50	$209.00	$13.60–$72.83	111% above	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$104.50	$209.00	$13.60–$72.83	111% above	50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RED BLOOD CELL SEDIMENTATION RATE; TO DETECT INFLAMMATION; AUTOMATED	$18.00	$36.00	$2.55–$13.66	7% above	50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RED BLOOD CELL SEDIMENTATION RATE; TO DETECT INFLAMMATION; AUTOMATED	$18.00	$36.00	$2.55–$13.66	7% above	50%
Sodium blood test CPT 84295 BLOOD SODIUM LEVEL	$31.00	$62.00	$4.55–$24.34	19% above	50%
Sodium blood test CPT 84295 BLOOD SODIUM LEVEL	$31.00	$62.00	$4.55–$24.34	19% above	50%
Sodium blood test CPT 84295 ASSAY OF SERUM SODIUM	$31.50	$63.00	$4.55–$24.34	21% above	50%
Sodium blood test CPT 84295 ASSAY OF SERUM SODIUM	$31.50	$63.00	$4.55–$24.34	21% above	50%
Stool ova and parasites exam CPT 87177 SMEAR FOR PARASITES	$50.00	$100.00	$8.41–$45.04	4% above	50%
Stool ova and parasites exam CPT 87177 SMEAR FOR PARASITES	$50.00	$100.00	$8.41–$45.04	4% above	50%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS	$53.00	$106.00	$8.41–$45.04	10% above	50%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS	$53.00	$106.00	$8.41–$45.04	10% above	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL ANALYSIS FOR BLOOD TO SCREEN FOR COLON TUMORS	$11.50	$23.00	$4.14–$22.17	28% below	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL ANALYSIS FOR BLOOD TO SCREEN FOR COLON TUMORS	$11.50	$23.00	$4.14–$22.17	28% below	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 STOOL ANALYSIS FOR BLOOD; BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY	$29.00	$58.00	$15.05–$80.57	21% below	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 STOOL ANALYSIS FOR BLOOD; BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY	$29.00	$58.00	$15.05–$80.57	21% below	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL	$37.50	$75.00	$15.05–$80.57	3% above	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL	$37.50	$75.00	$15.05–$80.57	3% above	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM	$88.00	$176.00	$12.52–$67.01	184% above	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM	$88.00	$176.00	$12.52–$67.01	184% above	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 ANALYSIS FOR ANTIBODY; TREPONEMA PALLIDUM	$89.00	$178.00	$12.52–$67.01	187% above	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 ANALYSIS FOR ANTIBODY; TREPONEMA PALLIDUM	$89.00	$178.00	$12.52–$67.01	187% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL	$25.50	$51.00	$4.03–$21.61	6% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL	$25.50	$51.00	$4.03–$21.61	6% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS DETECTION TEST	$29.00	$58.00	$4.03–$21.61	7% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS DETECTION TEST	$29.00	$58.00	$4.03–$21.61	7% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST; GAMMA INTERFERON	$414.00	$828.00	$58.57–$313.67	118% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST; GAMMA INTERFERON	$414.00	$828.00	$58.57–$313.67	118% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (HORMONE) LEVEL; TOTAL	$130.00	$260.00	$24.39–$130.62	48% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (HORMONE) LEVEL; TOTAL	$130.00	$260.00	$24.39–$130.62	48% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$155.00	$310.00	$24.39–$130.62	77% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$155.00	$310.00	$24.39–$130.62	77% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$15.00	$30.00	$13.76–$73.64	79% below	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$15.00	$30.00	$13.76–$73.64	79% below	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT	$106.00	$212.00	$13.76–$73.64	46% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT	$106.00	$212.00	$13.76–$73.64	46% above	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$21.50	$43.00	$15.88–$85.02	67% below	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$21.50	$43.00	$15.88–$85.02	67% below	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$122.00	$244.00	$15.88–$85.02	88% above	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$122.00	$244.00	$15.88–$85.02	88% above	50%
Total IgE blood test CPT 82785 ASSAY OF IGE	$95.00	$190.00	$15.55–$83.30	74% above	50%
Total IgE blood test CPT 82785 ASSAY OF IGE	$95.00	$190.00	$15.55–$83.30	74% above	50%
Total IgE blood test CPT 82785 IGE (IMMUNE SYSTEM PROTEIN) LEVEL	$96.50	$193.00	$15.55–$83.30	77% above	50%
Total IgE blood test CPT 82785 IGE (IMMUNE SYSTEM PROTEIN) LEVEL	$96.50	$193.00	$15.55–$83.30	77% above	50%
Total cholesterol blood test CPT 82465 CHOLESTEROL LEVEL	$28.00	$56.00	$4.12–$22.01	19% above	50%
Total cholesterol blood test CPT 82465 CHOLESTEROL LEVEL	$28.00	$56.00	$4.12–$22.01	19% above	50%
Total thyroxine (T4) blood test CPT 84436 THYROXINE (THYROID CHEMICAL); TOTAL	$44.00	$88.00	$6.49–$34.77	3% below	50%
Total thyroxine (T4) blood test CPT 84436 THYROXINE (THYROID CHEMICAL); TOTAL	$44.00	$88.00	$6.49–$34.77	3% below	50%
Total triiodothyronine (T3) blood test CPT 84480 THYROID HORMONE; T3 MEASUREMENT; TOTAL	$90.50	$181.00	$13.40–$71.76	15% above	50%
Total triiodothyronine (T3) blood test CPT 84480 THYROID HORMONE; T3 MEASUREMENT; TOTAL	$90.50	$181.00	$13.40–$71.76	15% above	50%
Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN	$27.00	$54.00	$12.05–$64.58	52% below	50%
Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN	$27.00	$54.00	$12.05–$64.58	52% below	50%
Transferrin blood test CPT 84466 TRANSFERRIN (IRON BINDING PROTEIN) LEVEL	$80.00	$160.00	$12.05–$64.58	43% above	50%
Transferrin blood test CPT 84466 TRANSFERRIN (IRON BINDING PROTEIN) LEVEL	$80.00	$160.00	$12.05–$64.58	43% above	50%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$205.50	$411.00	$33.16–$177.59	166% above	50%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$205.50	$411.00	$33.16–$177.59	166% above	50%
Trichomonas test (NAAT) CPT 87661 DETECTION TEST BY NUCLEIC ACID FOR TRICHOMONAS VAGINALIS (GENITAL PARASITE); AMPLIFIED PROBE TECHNIQUE	$207.50	$415.00	$33.16–$177.59	168% above	50%
Trichomonas test (NAAT) CPT 87661 DETECTION TEST BY NUCLEIC ACID FOR TRICHOMONAS VAGINALIS (GENITAL PARASITE); AMPLIFIED PROBE TECHNIQUE	$207.50	$415.00	$33.16–$177.59	168% above	50%
Triglycerides blood test CPT 84478 TRIGLYCERIDES LEVEL	$37.00	$74.00	$5.43–$29.05	26% above	50%
Triglycerides blood test CPT 84478 TRIGLYCERIDES LEVEL	$37.00	$74.00	$5.43–$29.05	26% above	50%
Triglycerides blood test CPT 84478 ASSAY OF TRIGLYCERIDES	$51.00	$102.00	$5.43–$29.05	74% above	50%
Triglycerides blood test CPT 84478 ASSAY OF TRIGLYCERIDES	$51.00	$102.00	$5.43–$29.05	74% above	50%
Troponin test, quantitative CPT 84484 TROPONIN (PROTEIN) ANALYSIS; QUANTITATIVE	$65.00	$130.00	$11.78–$63.11	13% below	50%
Troponin test, quantitative CPT 84484 TROPONIN (PROTEIN) ANALYSIS; QUANTITATIVE	$65.00	$130.00	$11.78–$63.11	13% below	50%
Uric acid blood test CPT 84550 URIC ACID LEVEL; BLOOD	$30.50	$61.00	$4.27–$22.88	8% below	50%
Uric acid blood test CPT 84550 URIC ACID LEVEL; BLOOD	$30.50	$61.00	$4.27–$22.88	8% below	50%
Urinalysis with microscope exam, automated CPT 81001 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$23.00	$46.00	$2.99–$16.04	23% below	50%
Urinalysis with microscope exam, automated CPT 81001 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$23.00	$46.00	$2.99–$16.04	23% below	50%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE	$28.50	$57.00	$2.99–$16.04	5% below	50%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE	$28.50	$57.00	$2.99–$16.04	5% below	50%
Urinalysis with microscope exam, manual CPT 81000 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; NON-AUTOMATED	$22.50	$45.00	$3.80–$20.34	41% above	50%
Urinalysis with microscope exam, manual CPT 81000 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; NON-AUTOMATED	$22.50	$45.00	$3.80–$20.34	41% above	50%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W/SCOPE	$24.50	$49.00	$3.80–$20.34	53% above	50%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W/SCOPE	$24.50	$49.00	$3.80–$20.34	53% above	50%
Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST	$22.50	$45.00	$2.13–$11.39	45% above	50%
Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST	$22.50	$45.00	$2.13–$11.39	45% above	50%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$24.50	$49.00	$2.13–$11.39	58% above	50%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$24.50	$49.00	$2.13–$11.39	58% above	50%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS; MANUAL TEST	$22.50	$45.00	$3.29–$17.61	80% above	50%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS; MANUAL TEST	$22.50	$45.00	$3.29–$17.61	80% above	50%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$24.50	$49.00	$3.29–$17.61	96% above	50%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$24.50	$49.00	$3.29–$17.61	96% above	50%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT	$53.50	$107.00	$7.62–$40.84	9% below	50%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT	$53.50	$107.00	$7.62–$40.84	9% below	50%
Urine culture for bacteria, with colony count CPT 87086 BACTERIAL COLONY COUNT; URINE	$107.00	$214.00	$7.62–$40.84	83% above	50%
Urine culture for bacteria, with colony count CPT 87086 BACTERIAL COLONY COUNT; URINE	$107.00	$214.00	$7.62–$40.84	83% above	50%
Urine microalbumin (albumin) test CPT 82043 UR ALBUMIN QUANTITATIVE	$34.50	$69.00	$5.46–$29.25	5% above	50%
Urine microalbumin (albumin) test CPT 82043 UR ALBUMIN QUANTITATIVE	$34.50	$69.00	$5.46–$29.25	5% above	50%
Urine microalbumin (albumin) test CPT 82043 URINE MICROALBUMIN (PROTEIN) LEVEL	$35.50	$71.00	$5.46–$29.25	8% above	50%
Urine microalbumin (albumin) test CPT 82043 URINE MICROALBUMIN (PROTEIN) LEVEL	$35.50	$71.00	$5.46–$29.25	8% above	50%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$16.50	$33.00	$8.14–$43.57	26% below	50%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$16.50	$33.00	$8.14–$43.57	26% below	50%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) LEVEL	$99.50	$199.00	$14.25–$76.32	23% above	50%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) LEVEL	$99.50	$199.00	$14.25–$76.32	23% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 LEVEL	$12.00	$24.00	$27.97–$149.80	86% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 LEVEL	$12.00	$24.00	$27.97–$149.80	86% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$185.00	$370.00	$27.97–$149.80	116% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$185.00	$370.00	$27.97–$149.80	116% above	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D; 1; 25 LEVEL	$14.00	$28.00	$36.38–$194.84	82% below	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D; 1; 25 LEVEL	$14.00	$28.00	$36.38–$194.84	82% below	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY	$240.50	$481.00	$36.38–$194.84	212% above	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY	$240.50	$481.00	$36.38–$194.84	212% above	50%
Zinc blood test CPT 84630 ZINC LEVEL	$67.50	$135.00	$10.76–$57.64	73% above	50%
Zinc blood test CPT 84630 ZINC LEVEL	$67.50	$135.00	$10.76–$57.64	73% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST	$88.50	$177.00	$14.23–$76.17	20% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST	$88.50	$177.00	$14.23–$76.17	20% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN; CHORIONIC (REPRODUCTIVE HORMONE) LEVEL	$91.00	$182.00	$14.23–$76.17	24% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN; CHORIONIC (REPRODUCTIVE HORMONE) LEVEL	$91.00	$182.00	$14.23–$76.17	24% above	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 PRIMARY REMOVAL OF ADENOIDS (YOUNGER THAN 12 YEARS)	$3,438.00	$6,876.00	$205.80–$16,016.74	13% below	50%
Adenoid removal (adenoidectomy), child under 12 CPT 42830 PRIMARY REMOVAL OF ADENOIDS (YOUNGER THAN 12 YEARS)	$3,438.00	$6,876.00	$205.80–$16,016.74	13% below	50%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 FUSION OF UPPER SPINE BONE WITH REMOVAL OF DISC AND RELEASE OF SPINAL CORD OR NERVE; 1 DISC	$39,348.50	$78,697.00	$205.80–$62,022.54	233% above	50%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 FUSION OF UPPER SPINE BONE WITH REMOVAL OF DISC AND RELEASE OF SPINAL CORD OR NERVE; 1 DISC	$39,348.50	$78,697.00	$205.80–$62,022.54	233% above	50%
Appendectomy, open surgery CPT 44950 REMOVAL OF APPENDIX	$19,253.00	$38,506.00	$205.80–$31,274.44	513% above	50%
Appendectomy, open surgery CPT 44950 REMOVAL OF APPENDIX	$19,253.00	$38,506.00	$205.80–$31,274.44	513% above	50%
Arthroscopic ACL reconstruction or repair of the knee one side CPT 29888 REPAIR OF ANTERIOR CRUCIATE LIGAMENT OF KNEE USING AN ENDOSCOPE	$16,517.50	$33,035.00	$6,926.46–$35,054.12	113% above	50%
Arthroscopic ACL reconstruction or repair of the knee one side CPT 29888 REPAIR OF ANTERIOR CRUCIATE LIGAMENT OF KNEE USING AN ENDOSCOPE	$16,517.50	$33,035.00	$6,926.46–$35,054.12	113% above	50%
Arthroscopic ACL reconstruction or repair of the knee one side CPT 29888 REPAIR OF ANTERIOR CRUCIATE LIGAMENT OF KNEE USING AN ENDOSCOPE	$22,862.50	$45,725.00	$6,926.46–$35,054.12	195% above	50%
Arthroscopic ACL reconstruction or repair of the knee one side CPT 29888 REPAIR OF ANTERIOR CRUCIATE LIGAMENT OF KNEE USING AN ENDOSCOPE	$22,862.50	$45,725.00	$6,926.46–$35,054.12	195% above	50%
Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE	$5,932.26	$11,864.51	$6,926.46–$35,054.12	19% above	50%
Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE	$5,932.26	$11,864.51	$6,926.46–$35,054.12	19% above	50%
Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE	$8,822.75	$17,645.50	$6,926.46–$35,054.12	78% above	50%
Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE	$8,822.75	$17,645.50	$6,926.46–$35,054.12	78% above	50%
Botox injections for chronic migraine CPT 64615 INJECTION OF CHEMICAL FOR PARALYSIS OF FACIAL AND NECK NERVE MUSCLES ON BOTH SIDES OF FACE	$362.00	$724.00	$96.51–$1,482.89	3% above	50%
Botox injections for chronic migraine CPT 64615 INJECTION OF CHEMICAL FOR PARALYSIS OF FACIAL AND NECK NERVE MUSCLES ON BOTH SIDES OF FACE	$362.00	$724.00	$96.51–$1,482.89	3% above	50%
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$383.50	$767.00	$96.51–$1,482.89	9% above	50%
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$383.50	$767.00	$96.51–$1,482.89	9% above	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LESION STRTCTC	$1,395.50	$2,791.00	$205.80–$7,978.76	47% below	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LESION STRTCTC	$1,395.50	$2,791.00	$205.80–$7,978.76	47% below	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING X-RAY WITH NEEDLE; FIRST GROWTH	$1,298.00	$2,596.00	$1,576.55–$7,978.76	51% below	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING X-RAY WITH NEEDLE; FIRST GROWTH	$1,298.00	$2,596.00	$1,576.55–$7,978.76	51% below	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING X-RAY WITH NEEDLE; FIRST GROWTH	$1,298.00	$2,596.00	$1,576.55–$7,978.76	51% below	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING X-RAY WITH NEEDLE; FIRST GROWTH	$1,298.00	$2,596.00	$1,576.55–$7,978.76	51% below	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE	$611.00	$1,222.00	$131.25–$1,191.64	101% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE	$611.00	$1,222.00	$131.25–$1,191.64	101% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TREATMENT OF BROKEN OUTSIDE LOWER LEG BONE AT ANKLE	$642.00	$1,284.00	$131.25–$1,191.64	111% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TREATMENT OF BROKEN OUTSIDE LOWER LEG BONE AT ANKLE	$642.00	$1,284.00	$131.25–$1,191.64	111% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 CLOSED TREATMENT OF BROKEN OUTSIDE LOWER LEG BONE AT ANKLE	$642.00	$1,284.00	$235.46–$1,191.64	111% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 CLOSED TREATMENT OF BROKEN OUTSIDE LOWER LEG BONE AT ANKLE	$642.00	$1,284.00	$235.46–$1,191.64	111% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 CLOSED TREATMENT OF BROKEN OUTSIDE LOWER LEG BONE AT ANKLE	$642.00	$1,284.00	$235.46–$1,191.64	111% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 CLOSED TREATMENT OF BROKEN OUTSIDE LOWER LEG BONE AT ANKLE	$642.00	$1,284.00	$235.46–$1,191.64	111% above	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE	$443.50	$887.00	$131.25–$1,191.64	88% above	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE	$443.50	$887.00	$131.25–$1,191.64	88% above	50%
Broken foot (metatarsal) treatment without surgery or setting one side CPT 28470 CLOSED TREATMENT OF BROKEN BONE IN FOREFOOT OR MIDFOOT	$443.50	$887.00	$235.46–$1,191.64	88% above	50%
Broken foot (metatarsal) treatment without surgery or setting one side CPT 28470 CLOSED TREATMENT OF BROKEN BONE IN FOREFOOT OR MIDFOOT	$443.50	$887.00	$235.46–$1,191.64	88% above	50%
Broken foot (metatarsal) treatment without surgery or setting one side CPT 28470 CLOSED TREATMENT OF BROKEN BONE IN FOREFOOT OR MIDFOOT	$443.50	$887.00	$235.46–$1,191.64	88% above	50%
Broken foot (metatarsal) treatment without surgery or setting one side CPT 28470 CLOSED TREATMENT OF BROKEN BONE IN FOREFOOT OR MIDFOOT	$443.50	$887.00	$235.46–$1,191.64	88% above	50%
Bunion correction with a bone cut near the head of the first metatarsal one side CPT 28296 CORRECTION OF BUNION WITH ALIGNMENT CORRECTION OF MIDFOOT BONE TOWARD TOE AREA	$16,428.50	$32,857.00	$3,123.31–$15,806.76	219% above	50%
Bunion correction with a bone cut near the head of the first metatarsal one side CPT 28296 CORRECTION OF BUNION WITH ALIGNMENT CORRECTION OF MIDFOOT BONE TOWARD TOE AREA	$16,428.50	$32,857.00	$3,123.31–$15,806.76	219% above	50%
Cardiac catheterization with coronary angiogram CPT 93458 L HRT ARTERY/VENTRICLE ANGIO	$5,742.00	$11,484.00	$222.87–$15,661.46	21% below	50%
Cardiac catheterization with coronary angiogram CPT 93458 L HRT ARTERY/VENTRICLE ANGIO	$5,742.00	$11,484.00	$222.87–$15,661.46	21% below	50%
Cardiac catheterization with coronary angiogram one side CPT 93458 INSERTION OF TUBE IN LEFT LOWER HEART CHAMBER AND CORONARY ARTERY FOR DIAGNOSIS WITH REVIEW BY RADIOLOGIST	$5,341.00	$10,682.00	$222.87–$15,661.46	27% below	50%
Cardiac catheterization with coronary angiogram one side CPT 93458 INSERTION OF TUBE IN LEFT LOWER HEART CHAMBER AND CORONARY ARTERY FOR DIAGNOSIS WITH REVIEW BY RADIOLOGIST	$5,341.00	$10,682.00	$222.87–$15,661.46	27% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL SHOCK TO HEART TO REGULATE HEART BEAT	$1,174.00	$2,348.00	$80.29–$3,192.97	10% above	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL SHOCK TO HEART TO REGULATE HEART BEAT	$1,174.00	$2,348.00	$80.29–$3,192.97	10% above	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$1,338.50	$2,677.00	$80.29–$3,192.97	26% above	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$1,338.50	$2,677.00	$80.29–$3,192.97	26% above	50%
Carpal tunnel release, open surgery one side CPT 64721 RELEASE AND/OR RELOCATION OF HAND NERVE	$5,028.50	$10,057.00	$1,863.98–$9,433.42	85% above	50%
Carpal tunnel release, open surgery one side CPT 64721 RELEASE AND/OR RELOCATION OF HAND NERVE	$5,028.50	$10,057.00	$1,863.98–$9,433.42	85% above	50%
Carpal tunnel release, open surgery one side CPT 64721 RELEASE AND/OR RELOCATION OF HAND NERVE	$5,414.00	$10,828.00	$1,863.98–$9,433.42	99% above	50%
Carpal tunnel release, open surgery one side CPT 64721 RELEASE AND/OR RELOCATION OF HAND NERVE	$5,414.00	$10,828.00	$1,863.98–$9,433.42	99% above	50%
Cataract surgery with lens implant CPT 66984 REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$4,189.00	$8,378.00	$205.80–$11,148.86	52% above	50%
Cataract surgery with lens implant CPT 66984 REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$4,189.00	$8,378.00	$205.80–$11,148.86	52% above	50%
Cataract surgery with lens implant one side CPT 66984 REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$2,171.50	$4,343.00	$2,202.94–$11,148.86	21% below	50%
Cataract surgery with lens implant one side CPT 66984 REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$2,171.50	$4,343.00	$2,202.94–$11,148.86	21% below	50%
Cataract surgery with lens implant one side CPT 66984 REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$5,534.00	$11,068.00	$2,202.94–$11,148.86	101% above	50%
Cataract surgery with lens implant one side CPT 66984 REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$5,534.00	$11,068.00	$2,202.94–$11,148.86	101% above	50%
Catheter ablation for atrial fibrillation CPT 93656 COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH CATHETER DESTRUCTION OF ABNORMALITY CAUSING ATRIAL FIBRILLATION (UNCOORDINATED CONTRACTION OF UPPER CHAMBERS OF HEART) BY PULMONARY VEIN ISOLATION	$13,551.00	$27,102.00	$721.62–$126,269.71	at median	50%
Catheter ablation for atrial fibrillation CPT 93656 COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH CATHETER DESTRUCTION OF ABNORMALITY CAUSING ATRIAL FIBRILLATION (UNCOORDINATED CONTRACTION OF UPPER CHAMBERS OF HEART) BY PULMONARY VEIN ISOLATION	$13,551.00	$27,102.00	$721.62–$126,269.71	at median	50%
Catheter ablation for atrial fibrillation CPT 93656 COMPRE EP EVAL ABLTJ ATR FIB	$18,906.50	$37,813.00	$721.62–$126,269.71	40% above	50%
Catheter ablation for atrial fibrillation CPT 93656 COMPRE EP EVAL ABLTJ ATR FIB	$18,906.50	$37,813.00	$721.62–$126,269.71	40% above	50%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX OR REMOVAL OF GROWTH	$1,466.50	$2,933.00	$105.00–$4,449.49	34% above	50%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX OR REMOVAL OF GROWTH	$1,466.50	$2,933.00	$105.00–$4,449.49	34% above	50%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUM 28 DAYS OR OLDER	$2,402.50	$4,805.00	$205.80–$10,098.42	8% below	50%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUM 28 DAYS OR OLDER	$2,402.50	$4,805.00	$205.80–$10,098.42	8% below	50%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 REMOVAL OF FORESKIN (OLDER THAN 28 DAYS)	$16,079.50	$32,159.00	$205.80–$10,098.42	514% above	50%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 REMOVAL OF FORESKIN (OLDER THAN 28 DAYS)	$16,079.50	$32,159.00	$205.80–$10,098.42	514% above	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$2,403.00	$4,806.00	$205.80–$10,098.42	at median	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$2,403.00	$4,806.00	$205.80–$10,098.42	at median	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 REMOVAL OF FORESKIN USING CLAMP OR DEVICE	$3,284.50	$6,569.00	$205.80–$10,098.42	37% above	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 REMOVAL OF FORESKIN USING CLAMP OR DEVICE	$3,284.50	$6,569.00	$205.80–$10,098.42	37% above	50%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE	$801.50	$1,603.00	$205.80–$3,368.59	at median	50%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE	$801.50	$1,603.00	$205.80–$3,368.59	at median	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DST RDL FX/EPHYS SEP WO	$657.00	$1,314.00	$131.25–$1,191.64	107% above	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DST RDL FX/EPHYS SEP WO	$657.00	$1,314.00	$131.25–$1,191.64	107% above	50%
Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 CLOSED TREATMENT OF BROKEN FOREARM (RADIUS) BONE AT THE WRIST AREA ON THE THUMB SIDE OF THE WRIST WITHOUT MANIPULATION	$657.00	$1,314.00	$235.46–$1,191.64	107% above	50%
Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 CLOSED TREATMENT OF BROKEN FOREARM (RADIUS) BONE AT THE WRIST AREA ON THE THUMB SIDE OF THE WRIST WITHOUT MANIPULATION	$657.00	$1,314.00	$235.46–$1,191.64	107% above	50%
Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 CLOSED TREATMENT OF BROKEN FOREARM (RADIUS) BONE AT THE WRIST AREA ON THE THUMB SIDE OF THE WRIST WITHOUT MANIPULATION	$657.00	$1,314.00	$235.46–$1,191.64	107% above	50%
Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 CLOSED TREATMENT OF BROKEN FOREARM (RADIUS) BONE AT THE WRIST AREA ON THE THUMB SIDE OF THE WRIST WITHOUT MANIPULATION	$657.00	$1,314.00	$235.46–$1,191.64	107% above	50%
Colonoscopy with polyp removal CPT 45385 REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$930.25	$1,860.50	$205.80–$5,780.91	36% below	50%
Colonoscopy with polyp removal CPT 45385 REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$930.25	$1,860.50	$205.80–$5,780.91	36% below	50%
Colonoscopy with tissue sample CPT 45380 BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$1,143.00	$2,286.00	$205.80–$5,780.91	29% below	50%
Colonoscopy with tissue sample CPT 45380 BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$1,143.00	$2,286.00	$205.80–$5,780.91	29% below	50%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$1,077.00	$2,154.00	$105.00–$4,492.56	15% below	50%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$1,077.00	$2,154.00	$105.00–$4,492.56	15% below	50%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,885.50	$5,771.00	$105.00–$4,492.56	128% above	50%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,885.50	$5,771.00	$105.00–$4,492.56	128% above	50%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BIOPSY OF CERVIX USING AN ENDOSCOPE WITH LOOP ELECTRODE	$3,577.00	$7,154.00	$205.80–$15,638.23	7% above	50%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BIOPSY OF CERVIX USING AN ENDOSCOPE WITH LOOP ELECTRODE	$3,577.00	$7,154.00	$205.80–$15,638.23	7% above	50%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE LEEP	$3,780.00	$7,560.00	$205.80–$15,638.23	13% above	50%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE LEEP	$3,780.00	$7,560.00	$205.80–$15,638.23	13% above	50%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BIOPSY AND SCRAPING OF CERVIX USING AN ENDOSCOPE	$891.50	$1,783.00	$105.00–$1,472.11	169% above	50%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BIOPSY AND SCRAPING OF CERVIX USING AN ENDOSCOPE	$891.50	$1,783.00	$105.00–$1,472.11	169% above	50%
Complex cataract surgery with lens implant CPT 66982 COMPLEX REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$4,996.00	$9,992.00	$205.80–$11,148.86	62% above	50%
Complex cataract surgery with lens implant CPT 66982 COMPLEX REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$4,996.00	$9,992.00	$205.80–$11,148.86	62% above	50%
Complex cataract surgery with lens implant one side CPT 66982 COMPLEX REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$2,037.00	$4,074.00	$2,202.94–$11,148.86	34% below	50%
Complex cataract surgery with lens implant one side CPT 66982 COMPLEX REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$2,037.00	$4,074.00	$2,202.94–$11,148.86	34% below	50%
Complex cataract surgery with lens implant one side CPT 66982 COMPLEX REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$3,785.50	$7,571.00	$2,202.94–$11,148.86	23% above	50%
Complex cataract surgery with lens implant one side CPT 66982 COMPLEX REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$3,785.50	$7,571.00	$2,202.94–$11,148.86	23% above	50%
Coronary stent placement, one artery CPT 92928 PRQ TCAT PLMT NTRAC ST 1 LES	$19,889.00	$39,778.00	$450.63–$55,768.99	25% above	50%
Coronary stent placement, one artery CPT 92928 PRQ TCAT PLMT NTRAC ST 1 LES	$19,889.00	$39,778.00	$450.63–$55,768.99	25% above	50%
Coronary stent placement, one artery CPT 92928 INSERTION OF STENTS WITH BALLOON DILATION OF CORONARY ARTERY OR BRANCH; SINGLE ARTERY OR BRANCH	$21,229.50	$42,459.00	$450.63–$55,768.99	33% above	50%
Coronary stent placement, one artery CPT 92928 INSERTION OF STENTS WITH BALLOON DILATION OF CORONARY ARTERY OR BRANCH; SINGLE ARTERY OR BRANCH	$21,229.50	$42,459.00	$450.63–$55,768.99	33% above	50%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT	$3,531.50	$7,063.00	$205.80–$17,028.87	7% above	50%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT	$3,531.50	$7,063.00	$205.80–$17,028.87	7% above	50%
Cystoscopy with ureteral stent placement CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE	$7,070.50	$14,141.00	$205.80–$17,028.87	115% above	50%
Cystoscopy with ureteral stent placement CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE	$7,070.50	$14,141.00	$205.80–$17,028.87	115% above	50%
Cystoscopy with ureteral stent placement one side CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE	$2,675.34	$5,350.67	$3,364.79–$17,028.87	19% below	50%
Cystoscopy with ureteral stent placement one side CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE	$2,675.34	$5,350.67	$3,364.79–$17,028.87	19% below	50%
Cystoscopy with ureteral stent placement one side CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE	$6,268.00	$12,536.00	$3,364.79–$17,028.87	91% above	50%
Cystoscopy with ureteral stent placement one side CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE	$6,268.00	$12,536.00	$3,364.79–$17,028.87	91% above	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 DIAGNOSTIC EXAM OF BLADDER AND URETHRA USING AN ENDOSCOPE	$1,207.50	$2,415.00	$205.80–$3,368.59	47% above	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 DIAGNOSTIC EXAM OF BLADDER AND URETHRA USING AN ENDOSCOPE	$1,207.50	$2,415.00	$205.80–$3,368.59	47% above	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$1,298.50	$2,597.00	$205.80–$3,368.59	58% above	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$1,298.50	$2,597.00	$205.80–$3,368.59	58% above	50%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND SCRAPING OF UTERUS	$3,149.50	$6,299.00	$205.80–$15,638.23	17% below	50%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND SCRAPING OF UTERUS	$3,149.50	$6,299.00	$205.80–$15,638.23	17% below	50%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE	$3,780.00	$7,560.00	$205.80–$15,638.23	at median	50%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE	$3,780.00	$7,560.00	$205.80–$15,638.23	at median	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION	$360.50	$721.00	$191.52–$969.26	74% above	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION	$360.50	$721.00	$191.52–$969.26	74% above	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION OF PRECANCER SKIN GROWTH; 1 GROWTH	$3,903.50	$7,807.00	$191.52–$969.26	1783% above	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION OF PRECANCER SKIN GROWTH; 1 GROWTH	$3,903.50	$7,807.00	$191.52–$969.26	1783% above	50%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA	$1,719.00	$3,438.00	$205.80–$7,495.60	2% below	50%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA	$1,719.00	$3,438.00	$205.80–$7,495.60	2% below	50%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING	$1,788.50	$3,577.00	$205.80–$7,495.60	2% above	50%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING	$1,788.50	$3,577.00	$205.80–$7,495.60	2% above	50%
Ear tube placement (tympanostomy) under general anesthesia, one ear one side CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA	$824.67	$1,649.34	$1,481.08–$7,495.60	53% below	50%
Ear tube placement (tympanostomy) under general anesthesia, one ear one side CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA	$824.67	$1,649.34	$1,481.08–$7,495.60	53% below	50%
Ear tube placement (tympanostomy) under general anesthesia, one ear one side CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA	$1,847.00	$3,694.00	$1,481.08–$7,495.60	5% above	50%
Ear tube placement (tympanostomy) under general anesthesia, one ear one side CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA	$1,847.00	$3,694.00	$1,481.08–$7,495.60	5% above	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 INCISION OF EARDRUM WITH INSERTION OF EARDRUM TUBE UNDER LOCAL OR TOPICAL ANESTHESIA	$1,121.50	$2,243.00	$205.80–$2,605.40	81% above	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 INCISION OF EARDRUM WITH INSERTION OF EARDRUM TUBE UNDER LOCAL OR TOPICAL ANESTHESIA	$1,121.50	$2,243.00	$205.80–$2,605.40	81% above	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear one side CPT 69433 INCISION OF EARDRUM WITH INSERTION OF EARDRUM TUBE UNDER LOCAL OR TOPICAL ANESTHESIA	$1,121.50	$2,243.00	$514.81–$2,605.40	81% above	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear one side CPT 69433 INCISION OF EARDRUM WITH INSERTION OF EARDRUM TUBE UNDER LOCAL OR TOPICAL ANESTHESIA	$1,121.50	$2,243.00	$514.81–$2,605.40	81% above	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear one side CPT 69433 INCISION OF EARDRUM WITH INSERTION OF EARDRUM TUBE UNDER LOCAL OR TOPICAL ANESTHESIA	$7,093.00	$14,186.00	$514.81–$2,605.40	1044% above	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear one side CPT 69433 INCISION OF EARDRUM WITH INSERTION OF EARDRUM TUBE UNDER LOCAL OR TOPICAL ANESTHESIA	$7,093.00	$14,186.00	$514.81–$2,605.40	1044% above	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING	$126.50	$253.00	$56.31–$284.98	50% above	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING	$126.50	$253.00	$56.31–$284.98	50% above	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$137.50	$275.00	$56.31–$284.98	63% above	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$137.50	$275.00	$56.31–$284.98	63% above	50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING	$126.50	$253.00	$56.31–$284.98	50% above	50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING	$126.50	$253.00	$56.31–$284.98	50% above	50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING	$126.50	$253.00	$56.31–$284.98	50% above	50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING	$126.50	$253.00	$56.31–$284.98	50% above	50%
Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED EAR WAX	$253.50	$507.00	$56.31–$284.98	258% above	50%
Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED EAR WAX	$253.50	$507.00	$56.31–$284.98	258% above	50%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$275.00	$550.00	$56.31–$284.98	289% above	50%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$275.00	$550.00	$56.31–$284.98	289% above	50%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL OF IMPACTED EAR WAX	$253.00	$506.00	$56.31–$284.98	258% above	50%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL OF IMPACTED EAR WAX	$253.00	$506.00	$56.31–$284.98	258% above	50%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL OF IMPACTED EAR WAX	$253.00	$506.00	$56.31–$284.98	258% above	50%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL OF IMPACTED EAR WAX	$253.00	$506.00	$56.31–$284.98	258% above	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF LINING OF UTERUS	$506.00	$1,012.00	$105.00–$976.65	151% above	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF LINING OF UTERUS	$506.00	$1,012.00	$105.00–$976.65	151% above	50%
Endoscopic sinus surgery: full ethmoid sinus opening one side CPT 31255 REMOVAL OF NASAL SINUS USING AN ENDOSCOPE	$3,285.25	$6,570.50	$6,736.74–$34,093.97	32% below	50%
Endoscopic sinus surgery: full ethmoid sinus opening one side CPT 31255 REMOVAL OF NASAL SINUS USING AN ENDOSCOPE	$3,285.25	$6,570.50	$6,736.74–$34,093.97	32% below	50%
Endoscopic sinus surgery: full ethmoid sinus opening one side CPT 31255 REMOVAL OF NASAL SINUS USING AN ENDOSCOPE	$3,863.50	$7,727.00	$6,736.74–$34,093.97	20% below	50%
Endoscopic sinus surgery: full ethmoid sinus opening one side CPT 31255 REMOVAL OF NASAL SINUS USING AN ENDOSCOPE	$3,863.50	$7,727.00	$6,736.74–$34,093.97	20% below	50%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 EXPLORATION OF NASAL SINUS USING AN ENDOSCOPE	$6,265.00	$12,530.00	$205.80–$34,093.97	43% above	50%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 EXPLORATION OF NASAL SINUS USING AN ENDOSCOPE	$6,265.00	$12,530.00	$205.80–$34,093.97	43% above	50%
Endoscopic sinus surgery: opening the frontal sinus one side CPT 31276 EXPLORATION OF NASAL SINUS USING AN ENDOSCOPE	$4,377.50	$8,755.00	$6,736.74–$34,093.97	at median	50%
Endoscopic sinus surgery: opening the frontal sinus one side CPT 31276 EXPLORATION OF NASAL SINUS USING AN ENDOSCOPE	$4,377.50	$8,755.00	$6,736.74–$34,093.97	at median	50%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus one side CPT 31256 INCISION OF NASAL SINUS USING AN ENDOSCOPE	$3,560.83	$7,121.66	$3,558.92–$18,011.34	48% above	50%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus one side CPT 31256 INCISION OF NASAL SINUS USING AN ENDOSCOPE	$3,560.83	$7,121.66	$3,558.92–$18,011.34	48% above	50%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 REMOVAL OF NASAL SINUS TISSUE USING AN ENDOSCOPE	$3,542.25	$7,084.50	$205.80–$34,093.97	48% above	50%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 REMOVAL OF NASAL SINUS TISSUE USING AN ENDOSCOPE	$3,542.25	$7,084.50	$205.80–$34,093.97	48% above	50%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue one side CPT 31267 REMOVAL OF NASAL SINUS TISSUE USING AN ENDOSCOPE	$1,642.63	$3,285.25	$6,736.74–$34,093.97	32% below	50%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue one side CPT 31267 REMOVAL OF NASAL SINUS TISSUE USING AN ENDOSCOPE	$1,642.63	$3,285.25	$6,736.74–$34,093.97	32% below	50%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue one side CPT 31267 REMOVAL OF NASAL SINUS TISSUE USING AN ENDOSCOPE	$2,090.25	$4,180.50	$6,736.74–$34,093.97	13% below	50%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue one side CPT 31267 REMOVAL OF NASAL SINUS TISSUE USING AN ENDOSCOPE	$2,090.25	$4,180.50	$6,736.74–$34,093.97	13% below	50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC	$1,479.00	$2,958.00	$205.80–$3,410.03	48% above	50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC	$1,479.00	$2,958.00	$205.80–$3,410.03	48% above	50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE	$2,990.50	$5,981.00	$205.80–$3,410.03	199% above	50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE	$2,990.50	$5,981.00	$205.80–$3,410.03	199% above	50%
Eye injection into the vitreous (intravitreal injection) one side CPT 67028 INJECTION OF DRUG INTO EYE	$5,937.50	$11,875.00	$315.30–$1,595.70	1157% above	50%
Eye injection into the vitreous (intravitreal injection) one side CPT 67028 INJECTION OF DRUG INTO EYE	$5,937.50	$11,875.00	$315.30–$1,595.70	1157% above	50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL	$3,568.00	$7,136.00	$205.80–$4,272.82	251% above	50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL	$3,568.00	$7,136.00	$205.80–$4,272.82	251% above	50%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL	$3,568.00	$7,136.00	$844.28–$4,272.82	251% above	50%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL	$3,568.00	$7,136.00	$844.28–$4,272.82	251% above	50%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL	$3,568.00	$7,136.00	$844.28–$4,272.82	251% above	50%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL	$3,568.00	$7,136.00	$844.28–$4,272.82	251% above	50%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); 3 CM TO 10 CM; REDUCIBLE	$10,376.00	$20,752.00	$205.80–$31,274.44	24% above	50%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); 3 CM TO 10 CM; REDUCIBLE	$10,376.00	$20,752.00	$205.80–$31,274.44	24% above	50%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); GREATER THAN 10 CM; REDUCIBLE	$24,303.50	$48,607.00	$607.10–$31,274.44	22% above	50%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); GREATER THAN 10 CM; REDUCIBLE	$24,303.50	$48,607.00	$607.10–$31,274.44	22% above	50%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); LESS THAN 3 CM; REDUCIBLE	$10,267.00	$20,534.00	$205.80–$17,296.59	77% above	50%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); LESS THAN 3 CM; REDUCIBLE	$10,267.00	$20,534.00	$205.80–$17,296.59	77% above	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC EXAM OF LOWER PORTION OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,585.00	$5,170.00	$105.00–$4,492.56	201% above	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC EXAM OF LOWER PORTION OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,585.00	$5,170.00	$105.00–$4,492.56	201% above	50%
Gallbladder removal, laparoscopic CPT 47562 REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$12,906.50	$25,813.00	$205.80–$29,205.39	33% above	50%
Gallbladder removal, laparoscopic CPT 47562 REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$12,906.50	$25,813.00	$205.80–$29,205.39	33% above	50%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 REMOVAL OF GALLBLADDER WITH X-RAY STUDY OF BILE DUCTS USING AN ENDOSCOPE	$5,565.83	$11,131.66	$205.80–$29,205.39	31% below	50%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 REMOVAL OF GALLBLADDER WITH X-RAY STUDY OF BILE DUCTS USING AN ENDOSCOPE	$5,565.83	$11,131.66	$205.80–$29,205.39	31% below	50%
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S)	$585.50	$1,171.00	$205.80–$4,492.56	50% below	50%
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S)	$585.50	$1,171.00	$205.80–$4,492.56	50% below	50%
Hemorrhoid banding (rubber band ligation) CPT 46221 REMOVAL OF EXTERNAL HEMORRHOIDS BY RUBBER BANDING	$1,687.50	$3,375.00	$205.80–$4,492.56	43% above	50%
Hemorrhoid banding (rubber band ligation) CPT 46221 REMOVAL OF EXTERNAL HEMORRHOIDS BY RUBBER BANDING	$1,687.50	$3,375.00	$205.80–$4,492.56	43% above	50%
Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVAL OF SINGLE EXTERNAL AND INTERNAL HEMORRHOID GROUP	$7,464.34	$14,928.67	$205.80–$13,408.96	44% above	50%
Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVAL OF SINGLE EXTERNAL AND INTERNAL HEMORRHOID GROUP	$7,464.34	$14,928.67	$205.80–$13,408.96	44% above	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INSERTION OF TUBE AND INTRODUCTION OF CONTRAST FOR X-RAY OF UTERUS AND FALLOPIAN TUBES	$109.00	$218.00	$51.67–$261.50	61% below	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INSERTION OF TUBE AND INTRODUCTION OF CONTRAST FOR X-RAY OF UTERUS AND FALLOPIAN TUBES	$109.00	$218.00	$51.67–$261.50	61% below	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY	$117.50	$235.00	$51.67–$261.50	58% below	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY	$117.50	$235.00	$51.67–$261.50	58% below	50%
Hysteroscopy with endometrial ablation CPT 58563 EXAM OF UTERUS WITH DESTRUCTION OF LINING OF UTERUS USING AN ENDOSCOPE	$8,112.50	$16,225.00	$205.80–$24,166.40	69% above	50%
Hysteroscopy with endometrial ablation CPT 58563 EXAM OF UTERUS WITH DESTRUCTION OF LINING OF UTERUS USING AN ENDOSCOPE	$8,112.50	$16,225.00	$205.80–$24,166.40	69% above	50%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$4,250.00	$8,500.00	$205.80–$15,638.23	1% above	50%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$4,250.00	$8,500.00	$205.80–$15,638.23	1% above	50%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF IUD FOR PREGNANCY PREVENTION	$759.00	$1,518.00	$105.00–$107.00	361% above	50%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF IUD FOR PREGNANCY PREVENTION	$759.00	$1,518.00	$105.00–$107.00	361% above	50%
Incision and drainage of a simple or single skin abscess CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS	$432.00	$864.00	$105.00–$969.26	84% above	50%
Incision and drainage of a simple or single skin abscess CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS	$432.00	$864.00	$105.00–$969.26	84% above	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$464.50	$929.00	$105.00–$969.26	98% above	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$464.50	$929.00	$105.00–$969.26	98% above	50%
Incision and drainage of a simple or single skin abscess one side CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS	$432.00	$864.00	$191.52–$969.26	84% above	50%
Incision and drainage of a simple or single skin abscess one side CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS	$432.00	$864.00	$191.52–$969.26	84% above	50%
Incision and drainage of a simple or single skin abscess one side CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS	$432.00	$864.00	$191.52–$969.26	84% above	50%
Incision and drainage of a simple or single skin abscess one side CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS	$432.00	$864.00	$191.52–$969.26	84% above	50%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$18,669.50	$37,339.00	$205.80–$17,296.59	274% above	50%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$18,669.50	$37,339.00	$205.80–$17,296.59	274% above	50%
Inguinal (groin) hernia repair, age 5 or older one side CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$9,397.50	$18,795.00	$3,417.69–$17,296.59	88% above	50%
Inguinal (groin) hernia repair, age 5 or older one side CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$9,397.50	$18,795.00	$3,417.69–$17,296.59	88% above	50%
Inguinal (groin) hernia repair, age 5 or older one side CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$18,330.50	$36,661.00	$3,417.69–$17,296.59	268% above	50%
Inguinal (groin) hernia repair, age 5 or older one side CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$18,330.50	$36,661.00	$3,417.69–$17,296.59	268% above	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION INTO TENDON OR LIGAMENT	$566.50	$1,133.00	$105.00–$1,482.89	71% above	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION INTO TENDON OR LIGAMENT	$566.50	$1,133.00	$105.00–$1,482.89	71% above	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$600.50	$1,201.00	$105.00–$1,482.89	81% above	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$600.50	$1,201.00	$105.00–$1,482.89	81% above	50%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJECTION INTO TENDON OR LIGAMENT	$566.50	$1,133.00	$293.01–$1,482.89	71% above	50%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJECTION INTO TENDON OR LIGAMENT	$566.50	$1,133.00	$293.01–$1,482.89	71% above	50%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJECTION INTO TENDON OR LIGAMENT	$566.50	$1,133.00	$293.01–$1,482.89	71% above	50%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJECTION INTO TENDON OR LIGAMENT	$566.50	$1,133.00	$293.01–$1,482.89	71% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT	$225.00	$450.00	$105.00–$1,482.89	34% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT	$225.00	$450.00	$105.00–$1,482.89	34% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$351.50	$703.00	$105.00–$1,482.89	2% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$351.50	$703.00	$105.00–$1,482.89	2% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT	$317.50	$635.00	$293.01–$1,482.89	8% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT	$317.50	$635.00	$293.01–$1,482.89	8% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT	$317.50	$635.00	$293.01–$1,482.89	8% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT	$317.50	$635.00	$293.01–$1,482.89	8% below	50%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION OF DRUG DELIVERY IMPLANT INTO TISSUE	$287.50	$575.00	$48.64–$642.73	74% above	50%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION OF DRUG DELIVERY IMPLANT INTO TISSUE	$287.50	$575.00	$48.64–$642.73	74% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$603.50	$1,207.00	$105.00–$1,482.89	76% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$603.50	$1,207.00	$105.00–$1,482.89	76% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT	$648.50	$1,297.00	$105.00–$1,482.89	89% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT	$648.50	$1,297.00	$105.00–$1,482.89	89% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT	$648.50	$1,297.00	$293.01–$1,482.89	89% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT	$648.50	$1,297.00	$293.01–$1,482.89	89% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT	$648.50	$1,297.00	$293.01–$1,482.89	89% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT	$648.50	$1,297.00	$293.01–$1,482.89	89% above	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$600.50	$1,201.00	$105.00–$1,482.89	72% above	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$600.50	$1,201.00	$105.00–$1,482.89	72% above	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT	$1,298.00	$2,596.00	$105.00–$1,482.89	271% above	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT	$1,298.00	$2,596.00	$105.00–$1,482.89	271% above	50%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT	$1,298.00	$2,596.00	$293.01–$1,482.89	271% above	50%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT	$1,298.00	$2,596.00	$293.01–$1,482.89	271% above	50%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT	$1,298.00	$2,596.00	$293.01–$1,482.89	271% above	50%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT	$1,298.00	$2,596.00	$293.01–$1,482.89	271% above	50%
Knee arthroscopy with meniscus repair (one side of the knee) one side CPT 29882 REPAIR OF INSIDE OR OUTSIDE KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$7,282.50	$14,565.00	$3,123.31–$15,806.76	31% above	50%
Knee arthroscopy with meniscus repair (one side of the knee) one side CPT 29882 REPAIR OF INSIDE OR OUTSIDE KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$7,282.50	$14,565.00	$3,123.31–$15,806.76	31% above	50%
Knee arthroscopy with meniscus repair (one side of the knee) one side CPT 29882 REPAIR OF INSIDE OR OUTSIDE KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$9,226.00	$18,452.00	$3,123.31–$15,806.76	66% above	50%
Knee arthroscopy with meniscus repair (one side of the knee) one side CPT 29882 REPAIR OF INSIDE OR OUTSIDE KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$9,226.00	$18,452.00	$3,123.31–$15,806.76	66% above	50%
Knee arthroscopy with meniscus trim CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$9,434.50	$18,869.00	$205.80–$15,806.76	92% above	50%
Knee arthroscopy with meniscus trim CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$9,434.50	$18,869.00	$205.80–$15,806.76	92% above	50%
Knee arthroscopy with meniscus trim one side CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$5,130.50	$10,261.00	$3,123.31–$15,806.76	4% above	50%
Knee arthroscopy with meniscus trim one side CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$5,130.50	$10,261.00	$3,123.31–$15,806.76	4% above	50%
Knee arthroscopy with meniscus trim one side CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$6,610.00	$13,220.00	$3,123.31–$15,806.76	34% above	50%
Knee arthroscopy with meniscus trim one side CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$6,610.00	$13,220.00	$3,123.31–$15,806.76	34% above	50%
Knee arthroscopy with removal of both torn meniscus parts one side CPT 29880 REMOVAL OF BOTH KNEE CARTILAGES USING AN ENDOSCOPE	$2,651.67	$5,303.33	$3,123.31–$15,806.76	42% below	50%
Knee arthroscopy with removal of both torn meniscus parts one side CPT 29880 REMOVAL OF BOTH KNEE CARTILAGES USING AN ENDOSCOPE	$2,651.67	$5,303.33	$3,123.31–$15,806.76	42% below	50%
Knee arthroscopy with removal of both torn meniscus parts one side CPT 29880 REMOVAL OF BOTH KNEE CARTILAGES USING AN ENDOSCOPE	$6,610.00	$13,220.00	$3,123.31–$15,806.76	44% above	50%
Knee arthroscopy with removal of both torn meniscus parts one side CPT 29880 REMOVAL OF BOTH KNEE CARTILAGES USING AN ENDOSCOPE	$6,610.00	$13,220.00	$3,123.31–$15,806.76	44% above	50%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) one side CPT 29877 REMOVAL OR SHAVING OF KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$5,928.00	$11,856.00	$3,123.31–$15,806.76	25% above	50%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) one side CPT 29877 REMOVAL OR SHAVING OF KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$5,928.00	$11,856.00	$3,123.31–$15,806.76	25% above	50%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) one side CPT 29877 REMOVAL OR SHAVING OF KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$7,084.50	$14,169.00	$3,123.31–$15,806.76	50% above	50%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) one side CPT 29877 REMOVAL OR SHAVING OF KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$7,084.50	$14,169.00	$3,123.31–$15,806.76	50% above	50%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 REMOVAL OF APPENDIX USING AN ENDOSCOPE	$9,434.50	$18,869.00	$205.80–$29,205.39	29% above	50%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 REMOVAL OF APPENDIX USING AN ENDOSCOPE	$9,434.50	$18,869.00	$205.80–$29,205.39	29% above	50%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 STRENGTHENING OF MUSCLE BETWEEN ESOPHAGUS AND STOMACH BY WRAPPING PART OF STOMACH AROUND ESOPHAGUS USING AN ENDOSCOPE	$35,789.00	$71,578.00	$205.80–$51,351.84	73% above	50%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 STRENGTHENING OF MUSCLE BETWEEN ESOPHAGUS AND STOMACH BY WRAPPING PART OF STOMACH AROUND ESOPHAGUS USING AN ENDOSCOPE	$35,789.00	$71,578.00	$205.80–$51,351.84	73% above	50%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 REMOVAL OF UTERUS THROUGH ABDOMEN USING AN ENDOSCOPE; 250.0 G OR LESS	$23,827.00	$47,654.00	$205.80–$51,351.84	69% above	50%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 REMOVAL OF UTERUS THROUGH ABDOMEN USING AN ENDOSCOPE; 250.0 G OR LESS	$23,827.00	$47,654.00	$205.80–$51,351.84	69% above	50%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 REMOVAL OF UTERUS; TUBES; AND/OR OVARIES THROUGH ABDOMEN USING AN ENDOSCOPE; 250.0 G OR LESS	$7,575.09	$15,150.17	$205.80–$51,351.84	51% below	50%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 REMOVAL OF UTERUS; TUBES; AND/OR OVARIES THROUGH ABDOMEN USING AN ENDOSCOPE; 250.0 G OR LESS	$7,575.09	$15,150.17	$205.80–$51,351.84	51% below	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE	$10,267.00	$20,534.00	$205.80–$29,205.39	12% above	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE	$10,267.00	$20,534.00	$205.80–$29,205.39	12% above	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side one side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE	$11,183.00	$22,366.00	$5,770.79–$29,205.39	22% above	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side one side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE	$11,183.00	$22,366.00	$5,770.79–$29,205.39	22% above	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side one side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE	$24,432.50	$48,865.00	$5,770.79–$29,205.39	166% above	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side one side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE	$24,432.50	$48,865.00	$5,770.79–$29,205.39	166% above	50%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 REPAIR OF RECURRENT GROIN HERNIA USING AN ENDOSCOPE	$29,811.50	$59,623.00	$205.80–$29,205.39	165% above	50%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 REPAIR OF RECURRENT GROIN HERNIA USING AN ENDOSCOPE	$29,811.50	$59,623.00	$205.80–$29,205.39	165% above	50%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia one side CPT 49651 REPAIR OF RECURRENT GROIN HERNIA USING AN ENDOSCOPE	$19,347.50	$38,695.00	$5,770.79–$29,205.39	72% above	50%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia one side CPT 49651 REPAIR OF RECURRENT GROIN HERNIA USING AN ENDOSCOPE	$19,347.50	$38,695.00	$5,770.79–$29,205.39	72% above	50%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia one side CPT 49651 REPAIR OF RECURRENT GROIN HERNIA USING AN ENDOSCOPE	$20,534.00	$41,068.00	$5,770.79–$29,205.39	83% above	50%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia one side CPT 49651 REPAIR OF RECURRENT GROIN HERNIA USING AN ENDOSCOPE	$20,534.00	$41,068.00	$5,770.79–$29,205.39	83% above	50%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE	$7,036.00	$14,072.00	$205.80–$29,205.39	34% above	50%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE	$7,036.00	$14,072.00	$205.80–$29,205.39	34% above	50%
Laparoscopic removal of fallopian tubes and/or ovaries one side CPT 58661 REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE	$13,335.00	$26,670.00	$5,770.79–$29,205.39	155% above	50%
Laparoscopic removal of fallopian tubes and/or ovaries one side CPT 58661 REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE	$13,335.00	$26,670.00	$5,770.79–$29,205.39	155% above	50%
Laparoscopic removal of fallopian tubes and/or ovaries one side CPT 58661 REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE	$13,469.50	$26,939.00	$5,770.79–$29,205.39	157% above	50%
Laparoscopic removal of fallopian tubes and/or ovaries one side CPT 58661 REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE	$13,469.50	$26,939.00	$5,770.79–$29,205.39	157% above	50%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 AFTER CATARACT LASER SURGERY	$819.50	$1,639.00	$205.80–$2,656.97	11% above	50%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 AFTER CATARACT LASER SURGERY	$819.50	$1,639.00	$205.80–$2,656.97	11% above	50%
Laser treatment of clouding after cataract surgery (YAG) one side CPT 66821 REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER	$659.50	$1,319.00	$525.00–$2,656.97	11% below	50%
Laser treatment of clouding after cataract surgery (YAG) one side CPT 66821 REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER	$659.50	$1,319.00	$525.00–$2,656.97	11% below	50%
Laser treatment of clouding after cataract surgery (YAG) one side CPT 66821 REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER	$710.50	$1,421.00	$525.00–$2,656.97	4% below	50%
Laser treatment of clouding after cataract surgery (YAG) one side CPT 66821 REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER	$710.50	$1,421.00	$525.00–$2,656.97	4% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$773.00	$1,546.00	$105.00–$1,963.83	82% above	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$773.00	$1,546.00	$105.00–$1,963.83	82% above	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$839.00	$1,678.00	$105.00–$1,963.83	97% above	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$839.00	$1,678.00	$105.00–$1,963.83	97% above	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs one side CPT 12031 INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$1,633.33	$3,266.66	$388.04–$1,963.83	284% above	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs one side CPT 12031 INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$1,633.33	$3,266.66	$388.04–$1,963.83	284% above	50%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HRT CATH W/VENTRCLGRPHY	$4,502.50	$9,005.00	$178.86–$15,661.46	28% below	50%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HRT CATH W/VENTRCLGRPHY	$4,502.50	$9,005.00	$178.86–$15,661.46	28% below	50%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE	$1,376.00	$2,752.00	$74.37–$3,410.03	24% above	50%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE	$1,376.00	$2,752.00	$74.37–$3,410.03	24% above	50%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,479.50	$2,959.00	$74.37–$3,410.03	33% above	50%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,479.50	$2,959.00	$74.37–$3,410.03	33% above	50%
Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL	$973.50	$1,947.00	$205.80–$4,272.82	16% below	50%
Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL	$973.50	$1,947.00	$205.80–$4,272.82	16% below	50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$1,359.00	$2,718.00	$205.80–$4,272.82	1% below	50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$1,359.00	$2,718.00	$205.80–$4,272.82	1% below	50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$1,918.50	$3,837.00	$205.80–$4,272.82	40% above	50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$1,918.50	$3,837.00	$205.80–$4,272.82	40% above	50%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$1,784.50	$3,569.00	$844.28–$4,272.82	30% above	50%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$1,784.50	$3,569.00	$844.28–$4,272.82	30% above	50%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$1,784.50	$3,569.00	$844.28–$4,272.82	30% above	50%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$1,784.50	$3,569.00	$844.28–$4,272.82	30% above	50%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LOW BACK DISK SURGERY	$8,073.50	$16,147.00	$205.80–$35,054.12	41% above	50%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LOW BACK DISK SURGERY	$8,073.50	$16,147.00	$205.80–$35,054.12	41% above	50%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC	$14,411.00	$28,822.00	$205.80–$35,054.12	152% above	50%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC	$14,411.00	$28,822.00	$205.80–$35,054.12	152% above	50%
Lumbar discectomy or laminotomy to free a nerve root, one level one side CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC	$14,680.00	$29,360.00	$6,926.46–$35,054.12	157% above	50%
Lumbar discectomy or laminotomy to free a nerve root, one level one side CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC	$14,680.00	$29,360.00	$6,926.46–$35,054.12	157% above	50%
Lumbar discectomy or laminotomy to free a nerve root, one level one side CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC	$16,805.00	$33,610.00	$6,926.46–$35,054.12	194% above	50%
Lumbar discectomy or laminotomy to free a nerve root, one level one side CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC	$16,805.00	$33,610.00	$6,926.46–$35,054.12	194% above	50%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 FUSION OF SPINE IN LOWER BACK WITH PARTIAL REMOVAL OF SPINE BONE AND DISC	$19,081.00	$38,162.00	$205.80–$131,082.12	5% below	50%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 FUSION OF SPINE IN LOWER BACK WITH PARTIAL REMOVAL OF SPINE BONE AND DISC	$19,081.00	$38,162.00	$205.80–$131,082.12	5% below	50%
Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 FUSION OF LOWER SPINE BONE AND PARTIAL REMOVAL OF SPINE BONE OR DISC THROUGH BACK; 1 DISC	$25,013.50	$50,027.00	$1,232.47–$131,082.12	46% above	50%
Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 FUSION OF LOWER SPINE BONE AND PARTIAL REMOVAL OF SPINE BONE OR DISC THROUGH BACK; 1 DISC	$25,013.50	$50,027.00	$1,232.47–$131,082.12	46% above	50%
Lumbar laminectomy (spinal decompression), one level CPT 63047 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD AND/OR NERVES; 1 SEGMENT	$13,604.00	$27,208.00	$205.80–$35,054.12	42% above	50%
Lumbar laminectomy (spinal decompression), one level CPT 63047 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD AND/OR NERVES; 1 SEGMENT	$13,604.00	$27,208.00	$205.80–$35,054.12	42% above	50%
Lumbar laminectomy (spinal decompression), one level one side CPT 63047 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD AND/OR NERVES; 1 SEGMENT	$15,890.50	$31,781.00	$6,926.46–$35,054.12	66% above	50%
Lumbar laminectomy (spinal decompression), one level one side CPT 63047 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD AND/OR NERVES; 1 SEGMENT	$15,890.50	$31,781.00	$6,926.46–$35,054.12	66% above	50%
Lumbar spinal fusion (posterior), one level CPT 22612 FUSION OF SPINE IN LOWER BACK	$6,199.00	$12,398.00	$1,229.64–$84,704.33	55% below	50%
Lumbar spinal fusion (posterior), one level CPT 22612 FUSION OF SPINE IN LOWER BACK	$6,199.00	$12,398.00	$1,229.64–$84,704.33	55% below	50%
Lumpectomy (partial mastectomy) CPT 19301 PARTIAL REMOVAL OF BREAST	$8,883.50	$17,767.00	$205.80–$18,915.16	100% above	50%
Lumpectomy (partial mastectomy) CPT 19301 PARTIAL REMOVAL OF BREAST	$8,883.50	$17,767.00	$205.80–$18,915.16	100% above	50%
Lumpectomy (partial mastectomy) one side CPT 19301 PARTIAL REMOVAL OF BREAST	$5,364.83	$10,729.66	$3,737.51–$18,915.16	21% above	50%
Lumpectomy (partial mastectomy) one side CPT 19301 PARTIAL REMOVAL OF BREAST	$5,364.83	$10,729.66	$3,737.51–$18,915.16	21% above	50%
Lumpectomy (partial mastectomy) one side CPT 19301 PARTIAL REMOVAL OF BREAST	$7,808.83	$15,617.66	$3,737.51–$18,915.16	76% above	50%
Lumpectomy (partial mastectomy) one side CPT 19301 PARTIAL REMOVAL OF BREAST	$7,808.83	$15,617.66	$3,737.51–$18,915.16	76% above	50%
Mastectomy (total removal of the breast) CPT 19303 SIMPLE COMPLETE REMOVAL OF BREAST	$3,964.92	$7,929.83	$205.80–$32,078.06	at median	50%
Mastectomy (total removal of the breast) CPT 19303 SIMPLE COMPLETE REMOVAL OF BREAST	$3,964.92	$7,929.83	$205.80–$32,078.06	at median	50%
Mastectomy (total removal of the breast) one side CPT 19303 SIMPLE COMPLETE REMOVAL OF BREAST	$6,302.17	$12,604.33	$6,338.41–$32,078.06	59% above	50%
Mastectomy (total removal of the breast) one side CPT 19303 SIMPLE COMPLETE REMOVAL OF BREAST	$6,302.17	$12,604.33	$6,338.41–$32,078.06	59% above	50%
Mastectomy (total removal of the breast) one side CPT 19303 SIMPLE COMPLETE REMOVAL OF BREAST	$10,034.34	$20,068.67	$6,338.41–$32,078.06	153% above	50%
Mastectomy (total removal of the breast) one side CPT 19303 SIMPLE COMPLETE REMOVAL OF BREAST	$10,034.34	$20,068.67	$6,338.41–$32,078.06	153% above	50%
Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT OF MISCARRIAGE DURING FIRST TRIMESTER	$5,676.00	$11,352.00	$205.80–$15,638.23	52% above	50%
Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT OF MISCARRIAGE DURING FIRST TRIMESTER	$5,676.00	$11,352.00	$205.80–$15,638.23	52% above	50%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 MOHS 1 STAGE H/N/HF/G	$1,315.50	$2,631.00	$205.80–$3,570.41	41% above	50%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 MOHS 1 STAGE H/N/HF/G	$1,315.50	$2,631.00	$205.80–$3,570.41	41% above	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 REMOVAL OF NONCANCER SKIN GROWTH OF BODY; ARMS; OR LEGS; 0.5 CM OR LESS	$1,357.50	$2,715.00	$205.80–$3,420.92	106% above	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 REMOVAL OF NONCANCER SKIN GROWTH OF BODY; ARMS; OR LEGS; 0.5 CM OR LESS	$1,357.50	$2,715.00	$205.80–$3,420.92	106% above	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/<	$1,322.50	$2,645.00	$205.80–$3,420.92	93% above	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/<	$1,322.50	$2,645.00	$205.80–$3,420.92	93% above	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REMOVAL OF NONCANCER SKIN GROWTH OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 0.5 CM OR LESS	$2,844.00	$5,688.00	$205.80–$3,420.92	315% above	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REMOVAL OF NONCANCER SKIN GROWTH OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 0.5 CM OR LESS	$2,844.00	$5,688.00	$205.80–$3,420.92	315% above	50%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$407.50	$815.00	$105.00–$969.26	52% above	50%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$407.50	$815.00	$105.00–$969.26	52% above	50%
Nail removal (partial or complete), one nail CPT 11730 SIMPLE SEPARATION OF FINGERNAIL OR TOENAIL FROM NAIL BED; FIRST NAIL	$420.50	$841.00	$105.00–$969.26	57% above	50%
Nail removal (partial or complete), one nail CPT 11730 SIMPLE SEPARATION OF FINGERNAIL OR TOENAIL FROM NAIL BED; FIRST NAIL	$420.50	$841.00	$105.00–$969.26	57% above	50%
Nail removal (partial or complete), one nail one side CPT 11730 SIMPLE SEPARATION OF FINGERNAIL OR TOENAIL FROM NAIL BED; FIRST NAIL	$420.50	$841.00	$191.52–$969.26	57% above	50%
Nail removal (partial or complete), one nail one side CPT 11730 SIMPLE SEPARATION OF FINGERNAIL OR TOENAIL FROM NAIL BED; FIRST NAIL	$420.50	$841.00	$191.52–$969.26	57% above	50%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION OF ANESTHETIC AGENT AND/OR STEROID INTO UPPER NECK AND BACK OF HEAD NERVE	$566.50	$1,133.00	$105.00–$1,482.89	54% above	50%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION OF ANESTHETIC AGENT AND/OR STEROID INTO UPPER NECK AND BACK OF HEAD NERVE	$566.50	$1,133.00	$105.00–$1,482.89	54% above	50%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV	$600.50	$1,201.00	$105.00–$1,482.89	64% above	50%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV	$600.50	$1,201.00	$105.00–$1,482.89	64% above	50%
Occipital nerve block (injection for headaches) one side CPT 64405 INJECTION OF ANESTHETIC AGENT AND/OR STEROID INTO UPPER NECK AND BACK OF HEAD NERVE	$566.50	$1,133.00	$293.01–$1,482.89	54% above	50%
Occipital nerve block (injection for headaches) one side CPT 64405 INJECTION OF ANESTHETIC AGENT AND/OR STEROID INTO UPPER NECK AND BACK OF HEAD NERVE	$566.50	$1,133.00	$293.01–$1,482.89	54% above	50%
Occipital nerve block (injection for headaches) one side CPT 64405 INJECTION OF ANESTHETIC AGENT AND/OR STEROID INTO UPPER NECK AND BACK OF HEAD NERVE	$600.50	$1,201.00	$293.01–$1,482.89	64% above	50%
Occipital nerve block (injection for headaches) one side CPT 64405 INJECTION OF ANESTHETIC AGENT AND/OR STEROID INTO UPPER NECK AND BACK OF HEAD NERVE	$600.50	$1,201.00	$293.01–$1,482.89	64% above	50%
Pacemaker implant (dual chamber) CPT 33208 INSRT HEART PM ATRIAL & VENT	$5,362.50	$10,725.00	$205.80–$50,492.65	1% above	50%
Pacemaker implant (dual chamber) CPT 33208 INSRT HEART PM ATRIAL & VENT	$5,362.50	$10,725.00	$205.80–$50,492.65	1% above	50%
Pacemaker implant (dual chamber) CPT 33208 INSERTION OF PACEMAKER AND UPPER AND LOWER HEART CHAMBER ELECTRODE	$8,365.00	$16,730.00	$205.80–$50,492.65	58% above	50%
Pacemaker implant (dual chamber) CPT 33208 INSERTION OF PACEMAKER AND UPPER AND LOWER HEART CHAMBER ELECTRODE	$8,365.00	$16,730.00	$205.80–$50,492.65	58% above	50%
Paracentesis with imaging guidance CPT 49083 DRAINAGE OF FLUID FROM ABDOMINAL CAVITY USING IMAGING GUIDANCE	$1,556.50	$3,113.00	$105.00–$4,381.58	9% above	50%
Paracentesis with imaging guidance CPT 49083 DRAINAGE OF FLUID FROM ABDOMINAL CAVITY USING IMAGING GUIDANCE	$1,556.50	$3,113.00	$105.00–$4,381.58	9% above	50%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,673.00	$3,346.00	$105.00–$4,381.58	17% above	50%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,673.00	$3,346.00	$105.00–$4,381.58	17% above	50%
Partial knee replacement (one compartment) one side CPT 27446 REPLACEMENT OF KNEE JOINT ON SIDE OF KNEE	$14,684.50	$29,369.00	$12,255.24–$62,022.54	79% above	50%
Partial knee replacement (one compartment) one side CPT 27446 REPLACEMENT OF KNEE JOINT ON SIDE OF KNEE	$14,684.50	$29,369.00	$12,255.24–$62,022.54	79% above	50%
Partial knee replacement (one compartment) one side CPT 27446 REPLACEMENT OF KNEE JOINT ON SIDE OF KNEE	$15,107.50	$30,215.00	$12,255.24–$62,022.54	84% above	50%
Partial knee replacement (one compartment) one side CPT 27446 REPLACEMENT OF KNEE JOINT ON SIDE OF KNEE	$15,107.50	$30,215.00	$12,255.24–$62,022.54	84% above	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$612.00	$1,224.00	$205.80–$1,963.83	31% above	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$612.00	$1,224.00	$205.80–$1,963.83	31% above	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PERMANENT REMOVAL FINGERNAIL OR TOENAIL	$708.50	$1,417.00	$205.80–$1,963.83	52% above	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PERMANENT REMOVAL FINGERNAIL OR TOENAIL	$708.50	$1,417.00	$205.80–$1,963.83	52% above	50%
Permanent removal of a nail and nail root (partial or complete) one side CPT 11750 PERMANENT REMOVAL FINGERNAIL OR TOENAIL	$564.03	$1,128.05	$388.04–$1,963.83	21% above	50%
Permanent removal of a nail and nail root (partial or complete) one side CPT 11750 PERMANENT REMOVAL FINGERNAIL OR TOENAIL	$564.03	$1,128.05	$388.04–$1,963.83	21% above	50%
Permanent removal of a nail and nail root (partial or complete) one side CPT 11750 PERMANENT REMOVAL FINGERNAIL OR TOENAIL	$708.50	$1,417.00	$388.04–$1,963.83	52% above	50%
Permanent removal of a nail and nail root (partial or complete) one side CPT 11750 PERMANENT REMOVAL FINGERNAIL OR TOENAIL	$708.50	$1,417.00	$388.04–$1,963.83	52% above	50%
Prostate biopsy CPT 55700 BIOPSY OF PROSTATE GLAND	$3,619.00	$7,238.00	$205.80–$209.72	21% above	50%
Prostate biopsy CPT 55700 BIOPSY OF PROSTATE GLAND	$3,619.00	$7,238.00	$205.80–$209.72	21% above	50%
Prostate removal (prostatectomy), laparoscopic CPT 55866 SURGICAL REMOVAL OF PROSTATE AND SURROUNDING LYMPH NODES USING AN ENDOSCOPE	$15,610.34	$31,220.67	$906.15–$51,351.84	17% below	50%
Prostate removal (prostatectomy), laparoscopic CPT 55866 SURGICAL REMOVAL OF PROSTATE AND SURROUNDING LYMPH NODES USING AN ENDOSCOPE	$15,610.34	$31,220.67	$906.15–$51,351.84	17% below	50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT	$3,450.00	$6,900.00	$205.80–$9,433.42	57% above	50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT	$3,450.00	$6,900.00	$205.80–$9,433.42	57% above	50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT	$11,656.00	$23,312.00	$205.80–$9,433.42	431% above	50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT	$11,656.00	$23,312.00	$205.80–$9,433.42	431% above	50%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT	$1,719.34	$3,438.67	$1,863.98–$9,433.42	22% below	50%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT	$1,719.34	$3,438.67	$1,863.98–$9,433.42	22% below	50%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT	$4,021.50	$8,043.00	$1,863.98–$9,433.42	83% above	50%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT	$4,021.50	$8,043.00	$1,863.98–$9,433.42	83% above	50%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$2,969.00	$5,938.00	$205.80–$18,915.16	31% below	50%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$2,969.00	$5,938.00	$205.80–$18,915.16	31% below	50%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$4,555.50	$9,111.00	$205.80–$18,915.16	6% above	50%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$4,555.50	$9,111.00	$205.80–$18,915.16	6% above	50%
Removal of a breast lump, open surgery one side CPT 19120 REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$5,560.50	$11,121.00	$3,737.51–$18,915.16	29% above	50%
Removal of a breast lump, open surgery one side CPT 19120 REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$5,560.50	$11,121.00	$3,737.51–$18,915.16	29% above	50%
Removal of a breast lump, open surgery one side CPT 19120 REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$7,408.50	$14,817.00	$3,737.51–$18,915.16	72% above	50%
Removal of a breast lump, open surgery one side CPT 19120 REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$7,408.50	$14,817.00	$3,737.51–$18,915.16	72% above	50%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE	$663.50	$1,327.00	$105.00–$1,963.83	70% above	50%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE	$663.50	$1,327.00	$105.00–$1,963.83	70% above	50%
Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL	$713.50	$1,427.00	$105.00–$1,963.83	83% above	50%
Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL	$713.50	$1,427.00	$105.00–$1,963.83	83% above	50%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 REMOVAL OF THYROID LOBE ON SIDE OF NECK	$18,649.50	$37,299.00	$205.80–$29,205.39	137% above	50%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 REMOVAL OF THYROID LOBE ON SIDE OF NECK	$18,649.50	$37,299.00	$205.80–$29,205.39	137% above	50%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 REMOVAL OF THYROID LOBE ON SIDE OF NECK	$12,353.00	$24,706.00	$5,770.79–$29,205.39	57% above	50%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 REMOVAL OF THYROID LOBE ON SIDE OF NECK	$12,353.00	$24,706.00	$5,770.79–$29,205.39	57% above	50%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 REMOVAL OF THYROID LOBE ON SIDE OF NECK	$17,107.50	$34,215.00	$5,770.79–$29,205.39	118% above	50%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 REMOVAL OF THYROID LOBE ON SIDE OF NECK	$17,107.50	$34,215.00	$5,770.79–$29,205.39	118% above	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$1,077.00	$2,154.00	$138.72–$4,492.56	28% below	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$1,077.00	$2,154.00	$138.72–$4,492.56	28% below	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$1,758.00	$3,516.00	$138.72–$4,492.56	17% above	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$1,758.00	$3,516.00	$138.72–$4,492.56	17% above	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK	$2,988.00	$5,976.00	$138.20–$4,492.56	116% above	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK	$2,988.00	$5,976.00	$138.20–$4,492.56	116% above	50%
Septoplasty to straighten the nasal septum CPT 30520 RESHAPING OF NASAL CARTILAGE	$2,575.67	$5,151.33	$205.80–$16,016.74	26% below	50%
Septoplasty to straighten the nasal septum CPT 30520 RESHAPING OF NASAL CARTILAGE	$2,575.67	$5,151.33	$205.80–$16,016.74	26% below	50%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 SHOCK WAVE CRUSHING OF KIDNEY STONES	$8,330.00	$16,660.00	$205.80–$17,028.87	at median	50%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 SHOCK WAVE CRUSHING OF KIDNEY STONES	$8,330.00	$16,660.00	$205.80–$17,028.87	at median	50%
Shock-wave lithotripsy to break up kidney stones (from outside the body) one side CPT 50590 SHOCK WAVE CRUSHING OF KIDNEY STONES	$8,499.50	$16,999.00	$3,364.79–$17,028.87	2% above	50%
Shock-wave lithotripsy to break up kidney stones (from outside the body) one side CPT 50590 SHOCK WAVE CRUSHING OF KIDNEY STONES	$8,499.50	$16,999.00	$3,364.79–$17,028.87	2% above	50%
Shock-wave lithotripsy to break up kidney stones (from outside the body) one side CPT 50590 SHOCK WAVE CRUSHING OF KIDNEY STONES	$9,855.50	$19,711.00	$3,364.79–$17,028.87	18% above	50%
Shock-wave lithotripsy to break up kidney stones (from outside the body) one side CPT 50590 SHOCK WAVE CRUSHING OF KIDNEY STONES	$9,855.50	$19,711.00	$3,364.79–$17,028.87	18% above	50%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST	$318.00	$636.00	$205.80–$1,351.21	10% above	50%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST	$318.00	$636.00	$205.80–$1,351.21	10% above	50%
Short arm cast (elbow to hand) one side CPT 29075 APPLICATION OF ELBOW TO FINGER CAST	$176.00	$352.00	$266.99–$1,351.21	39% below	50%
Short arm cast (elbow to hand) one side CPT 29075 APPLICATION OF ELBOW TO FINGER CAST	$176.00	$352.00	$266.99–$1,351.21	39% below	50%
Short arm cast (elbow to hand) one side CPT 29075 APPLICATION OF ELBOW TO FINGER CAST	$176.00	$352.00	$266.99–$1,351.21	39% below	50%
Short arm cast (elbow to hand) one side CPT 29075 APPLICATION OF ELBOW TO FINGER CAST	$176.00	$352.00	$266.99–$1,351.21	39% below	50%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT	$252.50	$505.00	$127.00–$642.73	37% above	50%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT	$252.50	$505.00	$127.00–$642.73	37% above	50%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$274.00	$548.00	$127.00–$642.73	49% above	50%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$274.00	$548.00	$127.00–$642.73	49% above	50%
Short arm splint (forearm and hand) one side CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT	$252.50	$505.00	$127.00–$642.73	37% above	50%
Short arm splint (forearm and hand) one side CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT	$252.50	$505.00	$127.00–$642.73	37% above	50%
Short arm splint (forearm and hand) one side CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT	$252.50	$505.00	$127.00–$642.73	37% above	50%
Short arm splint (forearm and hand) one side CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT	$252.50	$505.00	$127.00–$642.73	37% above	50%
Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST	$318.00	$636.00	$205.80–$1,351.21	at median	50%
Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST	$318.00	$636.00	$205.80–$1,351.21	at median	50%
Short leg cast (below the knee) one side CPT 29405 APPLICATION OF SHORT LEG CAST	$166.50	$333.00	$266.99–$1,351.21	48% below	50%
Short leg cast (below the knee) one side CPT 29405 APPLICATION OF SHORT LEG CAST	$166.50	$333.00	$266.99–$1,351.21	48% below	50%
Short leg cast (below the knee) one side CPT 29405 APPLICATION OF SHORT LEG CAST	$318.00	$636.00	$266.99–$1,351.21	at median	50%
Short leg cast (below the knee) one side CPT 29405 APPLICATION OF SHORT LEG CAST	$318.00	$636.00	$266.99–$1,351.21	at median	50%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$321.50	$643.00	$155.12–$785.05	39% above	50%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$321.50	$643.00	$155.12–$785.05	39% above	50%
Short leg splint (calf to foot) one side CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT	$321.50	$643.00	$155.12–$785.05	39% above	50%
Short leg splint (calf to foot) one side CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT	$321.50	$643.00	$155.12–$785.05	39% above	50%
Short leg splint (calf to foot) one side CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT	$321.50	$643.00	$155.12–$785.05	39% above	50%
Short leg splint (calf to foot) one side CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT	$321.50	$643.00	$155.12–$785.05	39% above	50%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) one side CPT 29824 PARTIAL REMOVAL OF COLLAR BONE AT SHOULDER USING AN ENDOSCOPE	$1,930.42	$3,860.83	$3,123.31–$15,806.76	2% above	50%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) one side CPT 29824 PARTIAL REMOVAL OF COLLAR BONE AT SHOULDER USING AN ENDOSCOPE	$1,930.42	$3,860.83	$3,123.31–$15,806.76	2% above	50%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) one side CPT 29824 PARTIAL REMOVAL OF COLLAR BONE AT SHOULDER USING AN ENDOSCOPE	$3,424.38	$6,848.75	$3,123.31–$15,806.76	80% above	50%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) one side CPT 29824 PARTIAL REMOVAL OF COLLAR BONE AT SHOULDER USING AN ENDOSCOPE	$3,424.38	$6,848.75	$3,123.31–$15,806.76	80% above	50%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$1,977.42	$3,954.83	$152.00–$769.26	at median	50%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$1,977.42	$3,954.83	$152.00–$769.26	at median	50%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$4,411.38	$8,822.75	$152.00–$769.26	123% above	50%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$4,411.38	$8,822.75	$152.00–$769.26	123% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$400.50	$801.00	$105.00–$969.26	42% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$400.50	$801.00	$105.00–$969.26	42% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$431.00	$862.00	$105.00–$969.26	52% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$431.00	$862.00	$105.00–$969.26	52% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs one side CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$400.50	$801.00	$191.52–$969.26	42% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs one side CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$400.50	$801.00	$191.52–$969.26	42% above	50%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH	$284.00	$568.00	$205.80–$1,963.83	26% below	50%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH	$284.00	$568.00	$205.80–$1,963.83	26% below	50%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$466.50	$933.00	$205.80–$1,963.83	21% above	50%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$466.50	$933.00	$205.80–$1,963.83	21% above	50%
Skin biopsy, punch, one lesion one side CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH	$284.00	$568.00	$388.04–$1,963.83	26% below	50%
Skin biopsy, punch, one lesion one side CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH	$284.00	$568.00	$388.04–$1,963.83	26% below	50%
Skin biopsy, punch, one lesion one side CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH	$449.50	$899.00	$388.04–$1,963.83	17% above	50%
Skin biopsy, punch, one lesion one side CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH	$449.50	$899.00	$388.04–$1,963.83	17% above	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM/<	$1,541.50	$3,083.00	$205.80–$3,420.92	90% above	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM/<	$1,541.50	$3,083.00	$205.80–$3,420.92	90% above	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 REMOVAL OF CANCER SKIN GROWTH OF BODY; ARMS; OR LEGS; 0.5 CM OR LESS	$2,000.25	$4,000.50	$205.80–$3,420.92	146% above	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 REMOVAL OF CANCER SKIN GROWTH OF BODY; ARMS; OR LEGS; 0.5 CM OR LESS	$2,000.25	$4,000.50	$205.80–$3,420.92	146% above	50%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAG; 1-15 SKIN TAGS	$381.00	$762.00	$105.00–$969.26	94% above	50%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAG; 1-15 SKIN TAGS	$381.00	$762.00	$105.00–$969.26	94% above	50%
Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15	$410.50	$821.00	$105.00–$969.26	110% above	50%
Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15	$410.50	$821.00	$105.00–$969.26	110% above	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 REMOVAL OF CEREBROSPINAL FLUID WITH LOWER BACK SPINAL TAP FOR DIAGNOSTIC TEST	$894.00	$1,788.00	$205.80–$3,410.03	11% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 REMOVAL OF CEREBROSPINAL FLUID WITH LOWER BACK SPINAL TAP FOR DIAGNOSTIC TEST	$894.00	$1,788.00	$205.80–$3,410.03	11% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR	$961.50	$1,923.00	$205.80–$3,410.03	4% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR	$961.50	$1,923.00	$205.80–$3,410.03	4% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM	$381.50	$763.00	$105.00–$969.26	48% above	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM	$381.50	$763.00	$105.00–$969.26	48% above	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$414.00	$828.00	$105.00–$969.26	60% above	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$414.00	$828.00	$105.00–$969.26	60% above	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$432.50	$865.00	$105.00–$969.26	50% above	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$432.50	$865.00	$105.00–$969.26	50% above	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SURFACE WOUND OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 2.5 CM OR LESS	$2,201.50	$4,403.00	$105.00–$969.26	663% above	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SURFACE WOUND OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 2.5 CM OR LESS	$2,201.50	$4,403.00	$105.00–$969.26	663% above	50%
TURP (transurethral resection of the prostate) CPT 52601 PROSTATECTOMY (TURP)	$4,696.00	$9,392.00	$205.80–$25,902.39	5% below	50%
TURP (transurethral resection of the prostate) CPT 52601 PROSTATECTOMY (TURP)	$4,696.00	$9,392.00	$205.80–$25,902.39	5% below	50%
TURP (transurethral resection of the prostate) CPT 52601 REMOVAL OF PROSTATE GLAND USING AN ELECTROCAUTERY KNIFE THROUGH URETHRA WITH CONTROL OF BLEEDING USING AN ENDOSCOPE	$6,129.50	$12,259.00	$205.80–$25,902.39	24% above	50%
TURP (transurethral resection of the prostate) CPT 52601 REMOVAL OF PROSTATE GLAND USING AN ELECTROCAUTERY KNIFE THROUGH URETHRA WITH CONTROL OF BLEEDING USING AN ENDOSCOPE	$6,129.50	$12,259.00	$205.80–$25,902.39	24% above	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$257.50	$515.00	$205.80–$1,963.83	26% below	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$257.50	$515.00	$205.80–$1,963.83	26% below	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY OF RELATED SKIN GROWTH; FIRST GROWTH	$1,944.50	$3,889.00	$205.80–$1,963.83	461% above	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY OF RELATED SKIN GROWTH; FIRST GROWTH	$1,944.50	$3,889.00	$205.80–$1,963.83	461% above	50%
Thoracentesis with imaging guidance CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE	$1,702.00	$3,404.00	$205.80–$3,030.42	36% above	50%
Thoracentesis with imaging guidance CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE	$1,702.00	$3,404.00	$205.80–$3,030.42	36% above	50%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$1,830.00	$3,660.00	$205.80–$3,030.42	46% above	50%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$1,830.00	$3,660.00	$205.80–$3,030.42	46% above	50%
Thoracentesis with imaging guidance one side CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE	$1,702.00	$3,404.00	$598.79–$3,030.42	36% above	50%
Thoracentesis with imaging guidance one side CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE	$1,702.00	$3,404.00	$598.79–$3,030.42	36% above	50%
Thoracentesis with imaging guidance one side CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE	$3,910.50	$7,821.00	$598.79–$3,030.42	213% above	50%
Thoracentesis with imaging guidance one side CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE	$3,910.50	$7,821.00	$598.79–$3,030.42	213% above	50%
Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVAL OF TONSILS AND ADENOID GLANDS (12 YEARS OR OLDER)	$5,414.00	$10,828.00	$205.80–$16,016.74	31% above	50%
Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVAL OF TONSILS AND ADENOID GLANDS (12 YEARS OR OLDER)	$5,414.00	$10,828.00	$205.80–$16,016.74	31% above	50%
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS)	$3,609.34	$7,218.67	$205.80–$28,598.18	31% below	50%
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS)	$3,609.34	$7,218.67	$205.80–$28,598.18	31% below	50%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS (12 YEARS OR OLDER)	$5,671.00	$11,342.00	$205.80–$16,016.74	42% above	50%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS (12 YEARS OR OLDER)	$5,671.00	$11,342.00	$205.80–$16,016.74	42% above	50%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS (YOUNGER THAN 12 YEARS)	$6,056.50	$12,113.00	$205.80–$28,598.18	116% above	50%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS (YOUNGER THAN 12 YEARS)	$6,056.50	$12,113.00	$205.80–$28,598.18	116% above	50%
Total hip replacement one side CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$15,107.50	$30,215.00	$12,255.24–$62,022.54	49% above	50%
Total hip replacement one side CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$15,107.50	$30,215.00	$12,255.24–$62,022.54	49% above	50%
Total hip replacement one side CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$17,504.50	$35,009.00	$12,255.24–$62,022.54	72% above	50%
Total hip replacement one side CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$17,504.50	$35,009.00	$12,255.24–$62,022.54	72% above	50%
Total knee replacement CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$10,172.50	$20,345.00	$205.80–$62,022.54	at median	50%
Total knee replacement CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$10,172.50	$20,345.00	$205.80–$62,022.54	at median	50%
Total knee replacement one side CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$11,159.50	$22,319.00	$12,255.24–$62,022.54	10% above	50%
Total knee replacement one side CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$11,159.50	$22,319.00	$12,255.24–$62,022.54	10% above	50%
Total knee replacement one side CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$14,543.50	$29,087.00	$12,255.24–$62,022.54	43% above	50%
Total knee replacement one side CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$14,543.50	$29,087.00	$12,255.24–$62,022.54	43% above	50%
Total shoulder replacement CPT 23472 RECONSTRUCT SHOULDER JOINT	$8,469.00	$16,938.00	$205.80–$84,704.33	15% below	50%
Total shoulder replacement CPT 23472 RECONSTRUCT SHOULDER JOINT	$8,469.00	$16,938.00	$205.80–$84,704.33	15% below	50%
Total shoulder replacement CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER	$16,296.50	$32,593.00	$205.80–$84,704.33	64% above	50%
Total shoulder replacement CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER	$16,296.50	$32,593.00	$205.80–$84,704.33	64% above	50%
Total shoulder replacement one side CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER	$19,008.50	$38,017.00	$16,737.01–$84,704.33	91% above	50%
Total shoulder replacement one side CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER	$19,008.50	$38,017.00	$16,737.01–$84,704.33	91% above	50%
Total shoulder replacement one side CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER	$20,025.50	$40,051.00	$16,737.01–$84,704.33	101% above	50%
Total shoulder replacement one side CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER	$20,025.50	$40,051.00	$16,737.01–$84,704.33	101% above	50%
Total thyroid removal (thyroidectomy) CPT 60240 REMOVAL OF THYROID	$18,778.00	$37,556.00	$205.80–$29,205.39	118% above	50%
Total thyroid removal (thyroidectomy) CPT 60240 REMOVAL OF THYROID	$18,778.00	$37,556.00	$205.80–$29,205.39	118% above	50%
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH	$1,848.50	$3,697.00	$205.80–$7,768.08	1% below	50%
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH	$1,848.50	$3,697.00	$205.80–$7,768.08	1% below	50%
Trigger finger release surgery CPT 26055 INCISION OF TENDON COVERING OF FINGER	$4,129.00	$8,258.00	$205.80–$7,768.08	121% above	50%
Trigger finger release surgery CPT 26055 INCISION OF TENDON COVERING OF FINGER	$4,129.00	$8,258.00	$205.80–$7,768.08	121% above	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES	$1,149.50	$2,299.00	$205.80–$1,482.89	291% above	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES	$1,149.50	$2,299.00	$205.80–$1,482.89	291% above	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$1,218.50	$2,437.00	$205.80–$1,482.89	314% above	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$1,218.50	$2,437.00	$205.80–$1,482.89	314% above	50%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES	$1,149.50	$2,299.00	$293.01–$1,482.89	291% above	50%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES	$1,149.50	$2,299.00	$293.01–$1,482.89	291% above	50%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES	$1,149.50	$2,299.00	$293.01–$1,482.89	291% above	50%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES	$1,149.50	$2,299.00	$293.01–$1,482.89	291% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG	$2,407.50	$4,815.00	$205.80–$7,978.76	1% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG	$2,407.50	$4,815.00	$205.80–$7,978.76	1% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING ULTRASOUND; FIRST GROWTH	$2,239.50	$4,479.00	$1,576.55–$7,978.76	6% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING ULTRASOUND; FIRST GROWTH	$2,239.50	$4,479.00	$1,576.55–$7,978.76	6% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING ULTRASOUND; FIRST GROWTH	$6,253.50	$12,507.00	$1,576.55–$7,978.76	164% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING ULTRASOUND; FIRST GROWTH	$6,253.50	$12,507.00	$1,576.55–$7,978.76	164% above	50%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 BALLOON DILATION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE; LESS THAN 3.0 CM	$827.75	$1,655.50	$205.80–$9,270.05	47% below	50%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 BALLOON DILATION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE; LESS THAN 3.0 CM	$827.75	$1,655.50	$205.80–$9,270.05	47% below	50%
Upper endoscopy (EGD) with biopsy CPT 43239 BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$930.25	$1,860.50	$205.80–$4,381.58	14% below	50%
Upper endoscopy (EGD) with biopsy CPT 43239 BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$930.25	$1,860.50	$205.80–$4,381.58	14% below	50%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$1,042.50	$2,085.00	$205.80–$4,381.58	4% below	50%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$1,042.50	$2,085.00	$205.80–$4,381.58	4% below	50%
Upper endoscopy (EGD) with injection into the lining CPT 43236 INJECTION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$1,513.67	$3,027.34	$205.80–$4,381.58	at median	50%
Upper endoscopy (EGD) with injection into the lining CPT 43236 INJECTION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$1,513.67	$3,027.34	$205.80–$4,381.58	at median	50%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 REMOVAL OF POLYPS OR GROWTHS OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$674.00	$1,348.00	$205.80–$9,270.05	54% below	50%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 REMOVAL OF POLYPS OR GROWTHS OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$674.00	$1,348.00	$205.80–$9,270.05	54% below	50%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE	$2,213.00	$4,426.00	$205.80–$9,270.05	52% above	50%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE	$2,213.00	$4,426.00	$205.80–$9,270.05	52% above	50%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 INSERTION OF GUIDE WIRE WITH DILATION OF ESOPHAGUS USING A FLEXIBLE ENDOSCOPE	$258.19	$516.37	$205.80–$4,381.58	58% below	50%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 INSERTION OF GUIDE WIRE WITH DILATION OF ESOPHAGUS USING A FLEXIBLE ENDOSCOPE	$258.19	$516.37	$205.80–$4,381.58	58% below	50%
Upper endoscopy (EGD), diagnostic CPT 43235 DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$528.00	$1,056.00	$105.00–$4,381.58	36% below	50%
Upper endoscopy (EGD), diagnostic CPT 43235 DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$528.00	$1,056.00	$105.00–$4,381.58	36% below	50%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CRUSHING OF STONE OF URETER USING AN ENDOSCOPE	$6,268.00	$12,536.00	$205.80–$25,902.39	at median	50%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CRUSHING OF STONE OF URETER USING AN ENDOSCOPE	$6,268.00	$12,536.00	$205.80–$25,902.39	at median	50%
Ureteroscopy with laser stone breaking (lithotripsy) one side CPT 52353 CRUSHING OF STONE OF URETER USING AN ENDOSCOPE	$4,752.00	$9,504.00	$5,118.14–$25,902.39	24% below	50%
Ureteroscopy with laser stone breaking (lithotripsy) one side CPT 52353 CRUSHING OF STONE OF URETER USING AN ENDOSCOPE	$4,752.00	$9,504.00	$5,118.14–$25,902.39	24% below	50%
Ureteroscopy with laser stone breaking (lithotripsy) one side CPT 52353 CRUSHING OF STONE OF URETER USING AN ENDOSCOPE	$8,762.50	$17,525.00	$5,118.14–$25,902.39	39% above	50%
Ureteroscopy with laser stone breaking (lithotripsy) one side CPT 52353 CRUSHING OF STONE OF URETER USING AN ENDOSCOPE	$8,762.50	$17,525.00	$5,118.14–$25,902.39	39% above	50%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY	$4,832.00	$9,664.00	$205.80–$25,902.39	25% below	50%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY	$4,832.00	$9,664.00	$205.80–$25,902.39	25% below	50%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN ENDOSCOPE	$7,600.50	$15,201.00	$205.80–$25,902.39	19% above	50%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN ENDOSCOPE	$7,600.50	$15,201.00	$205.80–$25,902.39	19% above	50%
Ureteroscopy with laser stone breaking and stent placement one side CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN ENDOSCOPE	$6,473.00	$12,946.00	$5,118.14–$25,902.39	1% above	50%
Ureteroscopy with laser stone breaking and stent placement one side CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN ENDOSCOPE	$6,473.00	$12,946.00	$5,118.14–$25,902.39	1% above	50%
Ureteroscopy with laser stone breaking and stent placement one side CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN ENDOSCOPE	$8,473.67	$16,947.34	$5,118.14–$25,902.39	32% above	50%
Ureteroscopy with laser stone breaking and stent placement one side CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN ENDOSCOPE	$8,473.67	$16,947.34	$5,118.14–$25,902.39	32% above	50%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT	$1,250.00	$2,500.00	$205.80–$10,098.42	51% below	50%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT	$1,250.00	$2,500.00	$205.80–$10,098.42	51% below	50%
Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS RF 1ST VEIN	$2,865.00	$5,730.00	$205.80–$15,253.50	at median	50%
Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS RF 1ST VEIN	$2,865.00	$5,730.00	$205.80–$15,253.50	at median	50%
Vein ablation, radiofrequency, first vein CPT 36475 DESTRUCTION OF FIRST INCOMPETENT VEIN OF ARM OR LEG USING RADIOFREQUENCY AND IMAGING GUIDANCE	$10,194.50	$20,389.00	$205.80–$15,253.50	256% above	50%
Vein ablation, radiofrequency, first vein CPT 36475 DESTRUCTION OF FIRST INCOMPETENT VEIN OF ARM OR LEG USING RADIOFREQUENCY AND IMAGING GUIDANCE	$10,194.50	$20,389.00	$205.80–$15,253.50	256% above	50%
Vein ablation, radiofrequency, first vein one side CPT 36475 DESTRUCTION OF FIRST INCOMPETENT VEIN OF ARM OR LEG USING RADIOFREQUENCY AND IMAGING GUIDANCE	$10,338.00	$20,676.00	$3,013.99–$15,253.50	261% above	50%
Vein ablation, radiofrequency, first vein one side CPT 36475 DESTRUCTION OF FIRST INCOMPETENT VEIN OF ARM OR LEG USING RADIOFREQUENCY AND IMAGING GUIDANCE	$10,338.00	$20,676.00	$3,013.99–$15,253.50	261% above	50%
Vein ablation, radiofrequency, first vein one side CPT 36475 DESTRUCTION OF FIRST INCOMPETENT VEIN OF ARM OR LEG USING RADIOFREQUENCY AND IMAGING GUIDANCE	$14,547.00	$29,094.00	$3,013.99–$15,253.50	408% above	50%
Vein ablation, radiofrequency, first vein one side CPT 36475 DESTRUCTION OF FIRST INCOMPETENT VEIN OF ARM OR LEG USING RADIOFREQUENCY AND IMAGING GUIDANCE	$14,547.00	$29,094.00	$3,013.99–$15,253.50	408% above	50%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF SKIN GROWTH; 1-14 GROWTHS	$361.00	$722.00	$191.52–$969.26	75% above	50%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF SKIN GROWTH; 1-14 GROWTHS	$361.00	$722.00	$191.52–$969.26	75% above	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS	$225.00	$450.00	$205.80–$1,963.83	40% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS	$225.00	$450.00	$205.80–$1,963.83	40% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$818.50	$1,637.00	$205.80–$1,963.83	117% above	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$818.50	$1,637.00	$205.80–$1,963.83	117% above	50%
Wound debridement, skin and tissue under it, first 20 sq cm one side CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS	$6,570.50	$13,141.00	$388.04–$1,963.83	1643% above	50%
Wound debridement, skin and tissue under it, first 20 sq cm one side CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS	$6,570.50	$13,141.00	$388.04–$1,963.83	1643% above	50%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 OPTX DST RD XARTC FX/EPI SEP	$6,674.50	$13,349.00	$205.80–$35,054.12	7% below	50%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 OPTX DST RD XARTC FX/EPI SEP	$6,674.50	$13,349.00	$205.80–$35,054.12	7% below	50%
Wrist fracture surgery (plate and screws), distal radius one side CPT 25607 TREATMENT OF BROKEN FOREARM BONE ON THUMB SIDE OF WRIST; ABOVE WRIST; WITH PLACEMENT OF STABILIZING DEVICE	$7,417.00	$14,834.00	$6,926.46–$35,054.12	3% above	50%
Wrist fracture surgery (plate and screws), distal radius one side CPT 25607 TREATMENT OF BROKEN FOREARM BONE ON THUMB SIDE OF WRIST; ABOVE WRIST; WITH PLACEMENT OF STABILIZING DEVICE	$7,417.00	$14,834.00	$6,926.46–$35,054.12	3% above	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD PRODUCTS	$800.50	$1,601.00	$205.80–$2,131.30	25% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD PRODUCTS	$800.50	$1,601.00	$205.80–$2,131.30	25% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT	$861.00	$1,722.00	$205.80–$2,131.30	35% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT	$861.00	$1,722.00	$205.80–$2,131.30	35% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION	$398.50	$797.00	$1,227.00–$12,172.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION	$398.50	$797.00	$1,227.00–$12,172.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$428.50	$857.00	$1,227.00–$12,172.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$428.50	$857.00	$1,227.00–$12,172.00	—	50%
Chemotherapy IV infusion, first hour CPT 96413 ADMINISTRATION OF CHEMOTHERAPY INTO VEIN; 1 HOUR OR LESS	$1,341.50	$2,683.00	$83.64–$1,595.70	118% above	50%
Chemotherapy IV infusion, first hour CPT 96413 ADMINISTRATION OF CHEMOTHERAPY INTO VEIN; 1 HOUR OR LESS	$1,341.50	$2,683.00	$83.64–$1,595.70	118% above	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$1,442.50	$2,885.00	$83.64–$1,595.70	135% above	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$1,442.50	$2,885.00	$83.64–$1,595.70	135% above	50%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE; FIRST 30-74 MINUTES	$1,782.00	$3,564.00	$162.39–$3,990.47	42% above	50%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE; FIRST 30-74 MINUTES	$1,782.00	$3,564.00	$162.39–$3,990.47	42% above	50%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$1,933.50	$3,867.00	$162.39–$3,990.47	54% above	50%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$1,933.50	$3,867.00	$162.39–$3,990.47	54% above	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 MEASUREMENT OF BRAIN WAVE ACTIVITY (EEG); AWAKE AND DROWSY	$531.50	$1,063.00	$41.18–$1,043.15	15% below	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 MEASUREMENT OF BRAIN WAVE ACTIVITY (EEG); AWAKE AND DROWSY	$531.50	$1,063.00	$41.18–$1,043.15	15% below	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY	$571.50	$1,143.00	$41.18–$1,043.15	8% below	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY	$571.50	$1,143.00	$41.18–$1,043.15	8% below	50%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM COMPLETE	$37.00	$74.00	$10.55–$10.75	75% below	50%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM COMPLETE	$37.00	$74.00	$10.55–$10.75	75% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING	$129.00	$258.00	$4.38–$284.98	7% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING	$129.00	$258.00	$4.38–$284.98	7% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$139.00	$278.00	$4.38–$284.98	15% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$139.00	$278.00	$4.38–$284.98	15% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD SEVERITY	$160.50	$321.00	$21.00–$407.35	1% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD SEVERITY	$160.50	$321.00	$21.00–$407.35	1% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$174.50	$349.00	$21.00–$407.35	10% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$174.50	$349.00	$21.00–$407.35	10% above	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY	$297.50	$595.00	$52.50–$741.78	18% above	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY	$297.50	$595.00	$52.50–$741.78	18% above	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM	$323.00	$646.00	$52.50–$741.78	28% above	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM	$323.00	$646.00	$52.50–$741.78	28% above	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$532.00	$1,064.00	$102.64–$1,318.77	32% above	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$532.00	$1,064.00	$102.64–$1,318.77	32% above	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$577.50	$1,155.00	$102.64–$1,318.77	44% above	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$577.50	$1,155.00	$102.64–$1,318.77	44% above	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$885.00	$1,770.00	$201.39–$2,015.76	29% above	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$885.00	$1,770.00	$201.39–$2,015.76	29% above	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$960.50	$1,921.00	$201.39–$2,015.76	40% above	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$960.50	$1,921.00	$201.39–$2,015.76	40% above	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$1,318.00	$2,636.00	$568.47–$2,876.97	39% above	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$1,318.00	$2,636.00	$568.47–$2,876.97	39% above	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM	$1,430.50	$2,861.00	$568.47–$2,876.97	51% above	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM	$1,430.50	$2,861.00	$568.47–$2,876.97	51% above	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE OR DRUG-INDUCED HEART STRESS TEST WITH ELECTROCARDIOGRAM (ECG)	$859.00	$1,718.00	$25.74–$1,043.15	34% above	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE OR DRUG-INDUCED HEART STRESS TEST WITH ELECTROCARDIOGRAM (ECG)	$859.00	$1,718.00	$25.74–$1,043.15	34% above	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST	$923.50	$1,847.00	$25.74–$1,043.15	44% above	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST	$923.50	$1,847.00	$25.74–$1,043.15	44% above	50%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/PT 50 MIN	$285.00	$570.00	$80.81–$857.47	49% above	50%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/PT 50 MIN	$285.00	$570.00	$80.81–$857.47	49% above	50%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PT 50 MIN	$285.00	$570.00	$77.47–$857.47	46% above	50%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PT 50 MIN	$285.00	$570.00	$77.47–$857.47	46% above	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION INTO A VEIN FOR HYDRATION; 31-60 MINUTES	$408.50	$817.00	$21.36–$1,027.57	81% above	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION INTO A VEIN FOR HYDRATION; 31-60 MINUTES	$408.50	$817.00	$21.36–$1,027.57	81% above	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$439.50	$879.00	$21.36–$1,027.57	95% above	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$439.50	$879.00	$21.36–$1,027.57	95% above	50%
IV infusion of a medicine, first hour CPT 96365 INFUSION INTO A VEIN FOR THERAPY; PREVENTION; OR DIAGNOSIS; 1 HOUR OR LESS	$451.50	$903.00	$40.92–$1,027.57	82% above	50%
IV infusion of a medicine, first hour CPT 96365 INFUSION INTO A VEIN FOR THERAPY; PREVENTION; OR DIAGNOSIS; 1 HOUR OR LESS	$451.50	$903.00	$40.92–$1,027.57	82% above	50%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$490.00	$980.00	$40.92–$1,027.57	98% above	50%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$490.00	$980.00	$40.92–$1,027.57	98% above	50%
IV push of a medicine, first drug CPT 96374 INJECTION OF DRUG OR SUBSTANCE INTO VEIN	$408.50	$817.00	$24.19–$1,027.57	100% above	50%
IV push of a medicine, first drug CPT 96374 INJECTION OF DRUG OR SUBSTANCE INTO VEIN	$408.50	$817.00	$24.19–$1,027.57	100% above	50%
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$438.50	$877.00	$24.19–$1,027.57	115% above	50%
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$438.50	$877.00	$24.19–$1,027.57	115% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE	$129.50	$259.00	$10.29–$347.84	81% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE	$129.50	$259.00	$10.29–$347.84	81% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$139.00	$278.00	$10.29–$347.84	94% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$139.00	$278.00	$10.29–$347.84	94% above	50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV CNDJ TEST 7-8 STUDIES	$429.50	$859.00	$76.43–$1,802.69	at median	50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV CNDJ TEST 7-8 STUDIES	$429.50	$859.00	$76.43–$1,802.69	at median	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION	$86.00	$172.00	$23.68–$155.98	11% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION	$86.00	$172.00	$23.68–$155.98	11% above	50%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$90.00	$180.00	$61.76–$364.99	8% above	50%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$90.00	$180.00	$61.76–$364.99	8% above	50%
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$71.00	$142.00	$100.62–$594.50	23% below	50%
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$71.00	$142.00	$100.62–$594.50	23% below	50%
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$90.00	$180.00	$136.91–$816.83	27% below	50%
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$90.00	$180.00	$136.91–$816.83	27% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN	$71.00	$142.00	$35.00–$207.95	4% above	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN	$71.00	$142.00	$35.00–$207.95	4% above	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 15-29 MINUTES	$90.00	$180.00	$35.00–$207.95	31% above	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 15-29 MINUTES	$90.00	$180.00	$35.00–$207.95	31% above	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN	$42.00	$84.00	$23.42–$128.70	12% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN	$42.00	$84.00	$23.42–$128.70	12% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 THERAPY PROCEDURE FOR NUTRITION MANAGEMENT; EACH 15 MINUTES	$234.00	$468.00	$23.42–$128.70	388% above	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 THERAPY PROCEDURE FOR NUTRITION MANAGEMENT; EACH 15 MINUTES	$234.00	$468.00	$23.42–$128.70	388% above	50%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$194.00	$388.00	$74.89–$477.19	5% above	50%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$194.00	$388.00	$74.89–$477.19	5% above	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$506.50	$1,013.00	$73.09–$465.45	140% above	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$506.50	$1,013.00	$73.09–$465.45	140% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$194.00	$388.00	$73.09–$465.45	5% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$194.00	$388.00	$73.09–$465.45	5% above	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$351.00	$702.00	$73.09–$465.45	68% above	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$351.00	$702.00	$73.09–$465.45	68% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS	$60.00	$120.00	$20.08–$132.39	10% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS	$60.00	$120.00	$20.08–$132.39	10% below	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES	$70.50	$141.00	$21.36–$138.72	at median	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES	$70.50	$141.00	$21.36–$138.72	at median	50%
Preventive checkup, new patient aged 18–39 CPT 99385 INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (18-39 YEARS)	$90.00	$180.00	$70.52–$71.86	9% above	50%
Preventive checkup, new patient aged 18–39 CPT 99385 INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (18-39 YEARS)	$90.00	$180.00	$70.52–$71.86	9% above	50%
Preventive checkup, new patient aged 40–64 CPT 99386 INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (40-64 YEARS)	$90.00	$180.00	$85.19–$86.81	at median	50%
Preventive checkup, new patient aged 40–64 CPT 99386 INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (40-64 YEARS)	$90.00	$180.00	$85.19–$86.81	at median	50%
Preventive checkup, new patient aged 65 or older CPT 99387 INIT PM E/M NEW PAT 65+ YRS	$90.00	$180.00	$91.36–$93.10	18% below	50%
Preventive checkup, new patient aged 65 or older CPT 99387 INIT PM E/M NEW PAT 65+ YRS	$90.00	$180.00	$91.36–$93.10	18% below	50%
Preventive checkup, returning patient aged 18–39 CPT 99395 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (18-39 YEARS)	$67.50	$135.00	$64.34–$65.57	3% above	50%
Preventive checkup, returning patient aged 18–39 CPT 99395 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (18-39 YEARS)	$67.50	$135.00	$64.34–$65.57	3% above	50%
Preventive checkup, returning patient aged 40–64 CPT 99396 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (40-64 YEARS)	$67.50	$135.00	$70.00–$71.34	9% below	50%
Preventive checkup, returning patient aged 40–64 CPT 99396 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (40-64 YEARS)	$67.50	$135.00	$70.00–$71.34	9% below	50%
Preventive checkup, returning patient aged 65 or older CPT 99397 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (65 YEAR OLD OR OLDER)	$67.50	$135.00	$73.34–$74.74	at median	50%
Preventive checkup, returning patient aged 65 or older CPT 99397 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (65 YEAR OLD OR OLDER)	$67.50	$135.00	$73.34–$74.74	at median	50%
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES	$285.00	$570.00	$128.94–$857.47	44% above	50%
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES	$285.00	$570.00	$128.94–$857.47	44% above	50%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$313.50	$627.00	$102.68–$857.47	39% above	50%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$313.50	$627.00	$102.68–$857.47	39% above	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING AND TOBACCO USE INTENSIVE COUNSELING; 4-10 MINUTES	$65.00	$130.00	$9.01–$180.98	78% above	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING AND TOBACCO USE INTENSIVE COUNSELING; 4-10 MINUTES	$65.00	$130.00	$9.01–$180.98	78% above	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$70.00	$140.00	$9.01–$180.98	92% above	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$70.00	$140.00	$9.01–$180.98	92% above	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 40-54 MINUTES	$71.00	$142.00	$107.57–$634.28	16% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 40-54 MINUTES	$71.00	$142.00	$107.57–$634.28	16% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$67.50	$135.00	$49.41–$289.99	13% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$67.50	$135.00	$49.41–$289.99	13% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$220.50	$441.00	$73.09–$427.44	126% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$220.50	$441.00	$73.09–$427.44	126% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 10-19 MINUTES	$67.50	$135.00	$26.51–$157.80	5% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 10-19 MINUTES	$67.50	$135.00	$26.51–$157.80	5% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN	$71.00	$142.00	$26.51–$157.80	10% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN	$71.00	$142.00	$26.51–$157.80	10% above	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFF/OP CNSLTJ NEW/EST LOW 30	$277.50	$555.00	$66.14–$67.40	147% above	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFF/OP CNSLTJ NEW/EST LOW 30	$277.50	$555.00	$66.14–$67.40	147% above	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFF/OP CNSLTJ NEW/EST MOD 40	$411.50	$823.00	$99.86–$101.76	315% above	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFF/OP CNSLTJ NEW/EST MOD 40	$411.50	$823.00	$99.86–$101.76	315% above	50%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN	$451.00	$902.00	$168.05–$1,081.92	62% above	50%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN	$451.00	$902.00	$168.05–$1,081.92	62% above	50%
Speech therapy session, individual CPT 92507 TX SP LANG VOICE COMM INDIV	$180.00	$360.00	$56.36–$364.64	17% above	50%
Speech therapy session, individual CPT 92507 TX SP LANG VOICE COMM INDIV	$180.00	$360.00	$56.36–$364.64	17% above	50%
Spirometry (breathing test) CPT 94010 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME	$291.50	$583.00	$5.92–$1,043.15	41% above	50%
Spirometry (breathing test) CPT 94010 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME	$291.50	$583.00	$5.92–$1,043.15	41% above	50%
Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST	$313.50	$627.00	$5.92–$1,043.15	51% above	50%
Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST	$313.50	$627.00	$5.92–$1,043.15	51% above	50%
Spirometry before and after a bronchodilator CPT 94060 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME CHANGES BEFORE AND AFTER MEDICATION ADMINISTRATION	$549.00	$1,098.00	$7.47–$1,802.69	41% above	50%
Spirometry before and after a bronchodilator CPT 94060 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME CHANGES BEFORE AND AFTER MEDICATION ADMINISTRATION	$549.00	$1,098.00	$7.47–$1,802.69	41% above	50%
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING	$590.50	$1,181.00	$7.47–$1,802.69	52% above	50%
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING	$590.50	$1,181.00	$7.47–$1,802.69	52% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES	$85.00	$170.00	$25.22–$164.93	12% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES	$85.00	$170.00	$25.22–$164.93	12% above	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 DRAWING OF BLOOD FOR A MEDICAL PROBLEM	$225.00	$450.00	$59.97–$642.73	50% above	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 DRAWING OF BLOOD FOR A MEDICAL PROBLEM	$225.00	$450.00	$59.97–$642.73	50% above	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$242.00	$484.00	$59.97–$642.73	61% above	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$242.00	$484.00	$59.97–$642.73	61% above	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Fluad 2025-2026 Formula	$67.50	$135.00	—	8% below	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Fluarix 2025-2026 Formula	$67.50	$135.00	—	8% below	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Fluad 2025-2026 Formula	$67.50	$135.00	—	8% below	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Fluarix 2025-2026 Formula	$67.50	$135.00	—	8% below	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 IIV ADJUVANT VACCINE IM	$73.00	$146.00	—	at median	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 IIV ADJUVANT VACCINE IM	$73.00	$146.00	—	at median	50%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM	$124.00	$248.00	$240.77	20% below	50%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM	$124.00	$248.00	$240.77	20% below	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCV2 VAC 30MCG TRS-SUC IM	$100.50	$201.00	$201.00	33% below	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCV2 VAC 30MCG TRS-SUC IM	$100.50	$201.00	$201.00	33% below	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varivax	$174.00	$348.00	$344.92	12% below	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varivax	$174.00	$348.00	$344.92	12% below	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VACCINE LIVE SUBQ	$183.00	$366.00	$344.92	8% below	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VACCINE LIVE SUBQ	$183.00	$366.00	$344.92	8% below	50%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VACCINE 4-6 YRS IM	$46.00	$92.00	$92.00	30% below	50%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VACCINE 4-6 YRS IM	$46.00	$92.00	$92.00	30% below	50%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Kinrix PFS	$55.50	$111.00	$111.00	15% below	50%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Kinrix PFS	$55.50	$111.00	$111.00	15% below	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Infanrix PFS	$26.50	$53.00	$53.00	16% below	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Infanrix PFS	$26.50	$53.00	$53.00	16% below	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VACCINE < 7 YRS IM	$27.50	$55.00	$55.00	13% below	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VACCINE < 7 YRS IM	$27.50	$55.00	$55.00	13% below	50%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEP B-IPV VACCINE IM	$63.00	$126.00	$126.00	31% below	50%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEP B-IPV VACCINE IM	$63.00	$126.00	$126.00	31% below	50%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Pediarix PFS	$122.00	$244.00	$187.79	33% above	50%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Pediarix PFS	$122.00	$244.00	$187.79	33% above	50%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IPV/HIB VACCINE IM	$106.00	$212.00	$212.00	at median	50%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IPV/HIB VACCINE IM	$106.00	$212.00	$212.00	at median	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE; TRIVALENT; SPLIT VIRUS; PRESERVATIVE-FREE; 0.5 ML DOSAGE	$14.00	$28.00	$21.07	28% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluad 2025-2026 Formula	$14.00	$28.00	$21.07	28% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluarix 2025-2026 Formula	$14.00	$28.00	$21.07	28% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluarix 2024-2025 Formula	$14.00	$28.00	$21.07	28% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone 2025-2026 Formula PFS	$14.00	$28.00	$21.07	28% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FluLaval 2025-2026 Formula	$14.00	$28.00	$21.07	28% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FluLaval 2024-2025 Formula	$14.00	$28.00	$21.07	28% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE; TRIVALENT; SPLIT VIRUS; PRESERVATIVE-FREE; 0.5 ML DOSAGE	$14.00	$28.00	$21.07	28% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluad 2025-2026 Formula	$14.00	$28.00	$21.07	28% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluarix 2025-2026 Formula	$14.00	$28.00	$21.07	28% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluarix 2024-2025 Formula	$14.00	$28.00	$21.07	28% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone 2025-2026 Formula PFS	$14.00	$28.00	$21.07	28% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FluLaval 2025-2026 Formula	$14.00	$28.00	$21.07	28% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FluLaval 2024-2025 Formula	$14.00	$28.00	$21.07	28% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM	$19.50	$39.00	$21.07	at median	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM	$19.50	$39.00	$21.07	at median	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Gardasil 9 PFS	$274.50	$549.00	$549.00	13% below	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Gardasil 9	$274.50	$549.00	$549.00	13% below	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Gardasil 9 PFS	$274.50	$549.00	$549.00	13% below	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Gardasil 9	$274.50	$549.00	$549.00	13% below	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE TYPES 6; 11; 16; 18; 31; 33; 45; 52; 58; NONAVALENT	$290.50	$581.00	$569.07	8% below	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE TYPES 6; 11; 16; 18; 31; 33; 45; 52; 58; NONAVALENT	$290.50	$581.00	$569.07	8% below	50%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Twinrix PFS	$91.00	$182.00	$182.00	36% below	50%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Twinrix PFS	$91.00	$182.00	$182.00	36% below	50%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/HEP B VACC ADULT IM	$95.50	$191.00	$191.00	33% below	50%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/HEP B VACC ADULT IM	$95.50	$191.00	$191.00	33% below	50%
Hepatitis A vaccine, adult dose CPT 90632 Havrix PFS	$66.00	$132.00	$115.93	32% below	50%
Hepatitis A vaccine, adult dose CPT 90632 Havrix PFS	$66.00	$132.00	$115.93	32% below	50%
Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM	$68.00	$136.00	$115.93	30% below	50%
Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM	$68.00	$136.00	$115.93	30% below	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Vaqta Pediatric PFS	$26.50	$53.00	$53.00	26% below	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACCINE PEDIATRIC OR ADOLESCENT DOSAGE	$26.50	$53.00	$53.00	26% below	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Havrix Pediatric PFS	$26.50	$53.00	$53.00	26% below	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Vaqta Pediatric PFS	$26.50	$53.00	$53.00	26% below	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACCINE PEDIATRIC OR ADOLESCENT DOSAGE	$26.50	$53.00	$53.00	26% below	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Havrix Pediatric PFS	$26.50	$53.00	$53.00	26% below	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPA VACC PED/ADOL 2 DOSE IM	$32.50	$65.00	$65.00	10% below	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPA VACC PED/ADOL 2 DOSE IM	$32.50	$65.00	$65.00	10% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$43.50	$87.00	$87.00	35% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$43.50	$87.00	$87.00	35% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Engerix-B Adult PFS	$44.50	$89.00	$89.00	33% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Engerix-B	$44.50	$89.00	$89.00	33% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Engerix-B Adult PFS	$44.50	$89.00	$89.00	33% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Engerix-B	$44.50	$89.00	$89.00	33% below	50%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPB VACC 2/4 DOSE ADULT IM	$127.00	$254.00	$254.00	at median	50%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPB VACC 2/4 DOSE ADULT IM	$127.00	$254.00	$254.00	at median	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Engerix-B Pediatric-Adolescent PFS	$20.50	$41.00	$41.00	36% below	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Engerix-B Pediatric-Adolescent PFS	$20.50	$41.00	$41.00	36% below	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPB VACC 3 DOSE PED/ADOL IM	$21.50	$43.00	$43.00	33% below	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPB VACC 3 DOSE PED/ADOL IM	$21.50	$43.00	$43.00	33% below	50%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIB PRP-OMP VACC 3 DOSE IM	$28.00	$56.00	$56.00	at median	50%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIB PRP-OMP VACC 3 DOSE IM	$28.00	$56.00	$56.00	at median	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ActHIB	$12.00	$24.00	$24.00	29% below	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ActHIB	$12.00	$24.00	$24.00	29% below	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB PRP-T VACCINE 4 DOSE IM	$12.50	$25.00	$25.00	26% below	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB PRP-T VACCINE 4 DOSE IM	$12.50	$25.00	$25.00	26% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose 2025-2026 Formula	$67.50	$135.00	$121.11	16% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VACCINE SPLIT VIRUS; PRESERVATIVE FREE	$67.50	$135.00	$121.11	16% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluad 2024-2025 Formula	$67.50	$135.00	$121.11	16% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluad 2024-2025 Formula	$67.50	$135.00	$121.11	16% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VACCINE SPLIT VIRUS; PRESERVATIVE FREE	$67.50	$135.00	$121.11	16% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose 2025-2026 Formula	$67.50	$135.00	$121.11	16% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM	$79.50	$159.00	$121.11	1% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM	$79.50	$159.00	$121.11	1% below	50%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 INACTIVATED JE VACC IM	$354.50	$709.00	$504.42	at median	50%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 INACTIVATED JE VACC IM	$354.50	$709.00	$504.42	at median	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II	$83.50	$167.00	$167.00	29% below	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II	$83.50	$167.00	$167.00	29% below	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC	$86.00	$172.00	$172.00	27% below	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC	$86.00	$172.00	$172.00	27% below	50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 ProQuad	$259.00	$518.00	$218.94	14% below	50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 ProQuad	$259.00	$518.00	$218.94	14% below	50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV VACCINE SC	$269.50	$539.00	$218.94	11% below	50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV VACCINE SC	$269.50	$539.00	$218.94	11% below	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menveo	$101.50	$203.00	$203.00	35% below	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menveo	$101.50	$203.00	$203.00	35% below	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWYCRM VACC IM	$150.50	$301.00	$299.95	4% below	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWYCRM VACC IM	$150.50	$301.00	$299.95	4% below	50%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 Menveo	$143.00	$286.00	$286.00	18% below	50%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 Menveo	$143.00	$286.00	$286.00	18% below	50%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENACWY-TT VACCINE IM	$147.00	$294.00	$294.00	15% below	50%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENACWY-TT VACCINE IM	$147.00	$294.00	$294.00	15% below	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB-4C VACCINE IM	$153.00	$306.00	$306.00	33% below	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB-4C VACCINE IM	$153.00	$306.00	$306.00	33% below	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL RECOMBINANT PROTEIN AND OUTER MEMBRANE VESICLE VACCINE; SEROGROUP B	$154.50	$309.00	$309.00	33% below	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Bexsero PFS	$154.50	$309.00	$309.00	33% below	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Bexsero PFS	$154.50	$309.00	$309.00	33% below	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL RECOMBINANT PROTEIN AND OUTER MEMBRANE VESICLE VACCINE; SEROGROUP B	$154.50	$309.00	$309.00	33% below	50%
Meningococcal B vaccine (Trumenba) CPT 90621 MENINGOCOCCAL RECOMBINANT LIPOPROTEIN VACCINE; SEROGROUP B	$142.00	$284.00	$284.00	16% below	50%
Meningococcal B vaccine (Trumenba) CPT 90621 MENINGOCOCCAL RECOMBINANT LIPOPROTEIN VACCINE; SEROGROUP B	$142.00	$284.00	$284.00	16% below	50%
Meningococcal B vaccine (Trumenba) CPT 90621 MENB-FHBP VACC 2/3 DOSE IM	$170.00	$340.00	$340.00	at median	50%
Meningococcal B vaccine (Trumenba) CPT 90621 MENB-FHBP VACC 2/3 DOSE IM	$170.00	$340.00	$340.00	at median	50%
Nasal spray flu vaccine, live (FluMist) CPT 90660 LAIV3 VACCINE INTRANASAL	$24.50	$49.00	$27.56	at median	50%
Nasal spray flu vaccine, live (FluMist) CPT 90660 LAIV3 VACCINE INTRANASAL	$24.50	$49.00	$27.56	at median	50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PCV13 VACCINE IM	$197.00	$394.00	$394.00	5% below	50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PCV13 VACCINE IM	$197.00	$394.00	$394.00	5% below	50%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PCV15 VACCINE IM	$181.50	$363.00	$363.00	at median	50%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PCV15 VACCINE IM	$181.50	$363.00	$363.00	at median	50%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Fluarix 2025-2026 Formula	$196.00	$392.00	$392.00	8% above	50%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Vaxneuvance PFS	$196.00	$392.00	$392.00	8% above	50%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PNEUMOCOCCAL CONJUGATE VACCINE; 15 VALENT (PCV15); FOR INTRAMUSCULAR USE	$196.00	$392.00	$392.00	8% above	50%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Vaxneuvance PFS	$196.00	$392.00	$392.00	8% above	50%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Fluarix 2025-2026 Formula	$196.00	$392.00	$392.00	8% above	50%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PNEUMOCOCCAL CONJUGATE VACCINE; 15 VALENT (PCV15); FOR INTRAMUSCULAR USE	$196.00	$392.00	$392.00	8% above	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20 PFS	$218.00	$436.00	$436.00	40% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 13	$218.00	$436.00	$436.00	40% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20 PFS	$218.00	$436.00	$436.00	40% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 13	$218.00	$436.00	$436.00	40% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL CONJUGATE VACCINE; 20 VALENT (PCV20); FOR INTRAMUSCULAR USE	$218.00	$436.00	$436.00	40% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL CONJUGATE VACCINE; 20 VALENT (PCV20); FOR INTRAMUSCULAR USE	$218.00	$436.00	$436.00	40% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE IM	$242.50	$485.00	$476.29	33% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE IM	$242.50	$485.00	$476.29	33% below	50%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 Capvaxive PFS	$222.50	$445.00	—	6% below	50%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PCV21 VACCINE IM	$222.50	$445.00	—	6% below	50%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 Capvaxive PFS	$222.50	$445.00	—	6% below	50%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PCV21 VACCINE IM	$222.50	$445.00	—	6% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23 PFS	$104.50	$209.00	$209.00	5% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23	$104.50	$209.00	$209.00	5% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE; 23-VALENT	$104.50	$209.00	$209.00	5% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE; 23-VALENT	$104.50	$209.00	$209.00	5% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23	$104.50	$209.00	$209.00	5% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23 PFS	$104.50	$209.00	$209.00	5% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$105.50	$211.00	$211.00	4% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$105.50	$211.00	$211.00	4% below	50%
Polio vaccine, inactivated (IPV) CPT 90713 Ipol	$37.50	$75.00	$75.00	9% below	50%
Polio vaccine, inactivated (IPV) CPT 90713 Ipol	$37.50	$75.00	$75.00	9% below	50%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS IPV SC/IM	$41.00	$82.00	$82.00	at median	50%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS IPV SC/IM	$41.00	$82.00	$82.00	at median	50%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Beyfortus PFS	$492.00	$984.00	$980.10	38% below	50%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Beyfortus PFS	$492.00	$984.00	$980.10	38% below	50%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 RSV MONOC ANTB SEASN 1 ML IM	$1,183.50	$2,367.00	$980.10	50% above	50%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 RSV MONOC ANTB SEASN 1 ML IM	$1,183.50	$2,367.00	$980.10	50% above	50%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Beyfortus PFS	$492.00	$984.00	$984.00	38% below	50%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Beyfortus PFS	$492.00	$984.00	$984.00	38% below	50%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOC ANTB SEASN .5ML IM	$1,183.50	$2,367.00	$1,960.20	50% above	50%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOC ANTB SEASN .5ML IM	$1,183.50	$2,367.00	$1,960.20	50% above	50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RESPIRATORY SYNCYTIAL VIRUS VACCINE; PREF; SUBUNIT; BIVALENT; FOR INTRAMUSCULAR USE	$238.50	$477.00	$477.00	12% below	50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RESPIRATORY SYNCYTIAL VIRUS VACCINE; PREF; SUBUNIT; BIVALENT; FOR INTRAMUSCULAR USE	$238.50	$477.00	$477.00	12% below	50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACC PREF BIVALENT IM	$271.00	$542.00	$542.00	at median	50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACC PREF BIVALENT IM	$271.00	$542.00	$542.00	at median	50%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 Arexvy	$228.00	$456.00	$456.00	at median	50%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV VACC PREF RECOMB ADJT IM	$228.00	$456.00	$456.00	at median	50%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV VACC PREF RECOMB ADJT IM	$228.00	$456.00	$456.00	at median	50%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 Arexvy	$228.00	$456.00	$456.00	at median	50%
Rabies vaccine, one dose CPT 90675 RabAvert	$326.32	$652.64	$331.98–$1,680.12	33% below	50%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE FOR INJECTION INTO MUSCLE	$326.32	$652.64	$331.98–$1,680.12	33% below	50%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE FOR INJECTION INTO MUSCLE	$326.32	$652.64	$331.98–$1,680.12	33% below	50%
Rabies vaccine, one dose CPT 90675 RabAvert	$326.32	$652.64	$331.98–$1,680.12	33% below	50%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM	$406.00	$812.00	$331.98–$1,680.12	17% below	50%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM	$406.00	$812.00	$331.98–$1,680.12	17% below	50%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 Rotarix	$100.00	$200.00	$182.97	33% below	50%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 Rotarix	$100.00	$200.00	$182.97	33% below	50%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 RV1 VACC 2 DOSE LIVE ORAL	$103.00	$206.00	$182.97	31% below	50%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 RV1 VACC 2 DOSE LIVE ORAL	$103.00	$206.00	$182.97	31% below	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACCINE; PENTAVALENT	$81.00	$162.00	$162.00	17% below	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 RotaTeq	$81.00	$162.00	$162.00	17% below	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACCINE; PENTAVALENT	$81.00	$162.00	$162.00	17% below	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 RotaTeq	$81.00	$162.00	$162.00	17% below	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 RV5 VACC 3 DOSE LIVE ORAL	$84.50	$169.00	$169.00	14% below	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 RV5 VACC 3 DOSE LIVE ORAL	$84.50	$169.00	$169.00	14% below	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Shingrix	$167.50	$335.00	—	21% below	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGLES VACCINE FOR INJECTION INTO MUSCLE	$167.50	$335.00	—	21% below	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGLES VACCINE FOR INJECTION INTO MUSCLE	$167.50	$335.00	—	21% below	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Shingrix	$167.50	$335.00	—	21% below	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Shingrix PFS	$174.50	$349.00	—	18% below	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VACC RECOMBINANT IM	$174.50	$349.00	—	18% below	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Shingrix PFS	$174.50	$349.00	—	18% below	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VACC RECOMBINANT IM	$174.50	$349.00	—	18% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tenivac PFS	$34.50	$69.00	$50.06	33% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Boostrix PFS	$34.50	$69.00	$50.06	33% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tenivac PFS	$34.50	$69.00	$50.06	33% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Boostrix PFS	$34.50	$69.00	$50.06	33% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$46.50	$93.00	$50.06	9% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$46.50	$93.00	$50.06	9% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHERIA; TETANUS; AND ACELLULAR PERTUSSIS VACCINE (7 YEARS OR OLDER)	$34.23	$68.45	$63.21	33% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHERIA; TETANUS; AND ACELLULAR PERTUSSIS VACCINE (7 YEARS OR OLDER)	$34.23	$68.45	$63.21	33% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix	$35.83	$71.65	$63.21	30% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix	$35.83	$71.65	$63.21	30% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tenivac PFS	$44.50	$89.00	$63.21	13% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tenivac PFS	$44.50	$89.00	$63.21	13% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Vaxelis PFS	$44.50	$89.00	$63.21	13% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix PFS	$44.50	$89.00	$63.21	13% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Adacel	$44.50	$89.00	$63.21	13% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix PFS	$44.50	$89.00	$63.21	13% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Vaxelis PFS	$44.50	$89.00	$63.21	13% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Adacel	$44.50	$89.00	$63.21	13% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM	$56.50	$113.00	$63.21	10% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM	$56.50	$113.00	$63.21	10% above	50%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE IM	$141.50	$283.00	$180.23	at median	50%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE IM	$141.50	$283.00	$180.23	at median	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE	$168.50	$337.00	$12.60–$347.84	287% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE	$168.50	$337.00	$12.60–$347.84	287% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$181.50	$363.00	$12.60–$347.84	317% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$181.50	$363.00	$12.60–$347.84	317% above	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMINISTRATION OF VACCINE; EACH ADDITIONAL VACCINE	$168.50	$337.00	$12.60–$12.84	588% above	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMINISTRATION OF VACCINE; EACH ADDITIONAL VACCINE	$168.50	$337.00	$12.60–$12.84	588% above	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD	$181.00	$362.00	$12.60–$12.84	639% above	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD	$181.00	$362.00	$12.60–$12.84	639% above	50%
Yellow fever vaccine, live CPT 90717 YELLOW FEVER VACCINE SUBQ	$205.50	$411.00	$263.36	at median	50%
Yellow fever vaccine, live CPT 90717 YELLOW FEVER VACCINE SUBQ	$205.50	$411.00	$263.36	at median	50%

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://wvumedicine.org/wp-content/uploads/2026/10/550404900_Herbert-J-Thomas-Memorial-Hospital-Association_standardcharges.csv