Carmel AmbSurg
Carmel AmbSurg in Carmel, IN publishes cash prices for 45 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
13421 Old Meridian St. Carmel IN 46032 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN AND PELVIS W/C | $542.40 | $904.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN AND PELVIS W/C | $542.40 | $904.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN AND PELVIS W/C | $542.40 | $904.00 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO/C | $542.40 | $904.00 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO/C | $542.40 | $904.00 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN WO/C | $542.40 | $904.00 | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/C | $542.40 | $904.00 | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/C | $542.40 | $904.00 | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/C | $542.40 | $904.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO FFD W/WO CAD DX BI | $378.00 | $630.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO FFD W/WO CAD DX BI | $378.00 | $630.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO ADDL FFD W/WO CAD DX BI | $378.00 | $630.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO ADDL FFD W/WO CAD DX BI | $378.00 | $630.00 | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO ADDL FFD W/WO CAD DX BI | $378.00 | $630.00 | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO FFD W/WO CAD DX BI | $378.00 | $630.00 | 40% |
| Diagnostic mammogram, one breast CPT 77065 MAMMO ADDL FFD W/WO CAD DX UNI | $276.60 | $461.00 | 40% |
| Diagnostic mammogram, one breast CPT 77065 MAMMO FFD W/WO CAD DX UNI | $276.60 | $461.00 | 40% |
| Diagnostic mammogram, one breast CPT 77065 MAMMO FFD W/WO CAD DX UNI | $276.60 | $461.00 | 40% |
| Diagnostic mammogram, one breast CPT 77065 MAMMO ADDL FFD W/WO CAD DX UNI | $276.60 | $461.00 | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO ADDL FFD W/WO CAD DX UNI | $276.60 | $461.00 | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO FFD W/WO CAD DX UNI | $276.60 | $461.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI LOW EXTR ANY JNT W/O BI | $1,165.20 | $1,942.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI LOW EXTR ANY JNT W/O BI | $1,165.20 | $1,942.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXTR ANY JNT W/O UNI | $582.60 | $971.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT LOWEXT TRAUMA LTD WO/C | $582.60 | $971.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT LOWEXT TRAUMA LTD WO/C | $582.60 | $971.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXTR ANY JNT W/O UNI | $582.60 | $971.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI LOW EXTR ANY JNT W/O BI | $1,165.20 | $1,942.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JNT LOWEXT TRAUMA LTD WO/C | $582.60 | $971.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOW EXTR ANY JNT W/O UNI | $582.60 | $971.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI LOW EXTR ANY JNT WO/WC BI | $1,165.20 | $1,942.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI LOW EXTR ANY JNT WO/WC BI | $1,165.20 | $1,942.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW EXTR ANY JNT WO/WC UNI | $582.60 | $971.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW EXTR ANY JNT WO/WC UNI | $582.60 | $971.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI LOW EXTR ANY JNT WO/WC BI | $1,165.20 | $1,942.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOW EXTR ANY JNT WO/WC UNI | $582.60 | $971.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO/C LIMITED | $291.00 | $485.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO/C LIMITED | $291.00 | $485.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO/C | $582.00 | $970.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI PITUITARY OR IAC WO/C(-XU) | $582.00 | $970.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO/C | $582.00 | $970.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI PITUITARY OR IAC WO/C(-XU) | $582.00 | $970.00 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO/C LIMITED | $291.00 | $485.00 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI PITUITARY OR IAC WO/C(-XU) | $582.00 | $970.00 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO/C | $582.00 | $970.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI PITUITRY OR IAC WO/WC(-XU) | $582.60 | $971.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/WC | $582.60 | $971.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/WC | $582.60 | $971.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI PITUITRY OR IAC WO/WC(-XU) | $582.60 | $971.00 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO/WC | $582.60 | $971.00 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI PITUITRY OR IAC WO/WC(-XU) | $582.60 | $971.00 | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WO/C | $582.60 | $971.00 | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WO/C | $582.60 | $971.00 | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE WO/C | $582.60 | $971.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTER>=14WK SNG/1STGEST | $531.00 | $885.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTER>=14WK SNG/1STGEST | $531.00 | $885.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTER>=14WK SNG/1STGEST | $531.00 | $885.00 | 40% |
| Screening mammogram, both breasts CPT 77067 MAMMO FFD W/WO CAD SCREENING | $249.60 | $416.00 | 40% |
| Screening mammogram, both breasts CPT 77067 MAMMO FFD W/WO CAD SCREENING | $249.60 | $416.00 | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO FFD W/WO CAD SCREENING | $249.60 | $416.00 | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 PSG 6/> 4+PARAM ABORT PEDS | $2,769.60 | $4,616.00 | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 PSG 6/> 4+PARAM ABORT PEDS | $2,769.60 | $4,616.00 | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 PSG 6/> 4+PARAM ABORT ADULT | $2,769.60 | $4,616.00 | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 PSG 6/> 4+PARAM ABORT ADULT | $2,769.60 | $4,616.00 | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 SLP STGNG >6Y PARAM 4+ <6 HRS | $2,769.60 | $4,616.00 | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 SLP STGNG >6Y PARAM 4+ <6 HRS | $2,769.60 | $4,616.00 | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 SLEEP STAGING 4+ PARAM 6YR/> | $5,539.20 | $9,232.00 | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 SLEEP STAGING 4+ PARAM 6YR/> | $5,539.20 | $9,232.00 | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 SLP STGNG >6Y PARAM 4+ <6 HRS | $2,769.60 | $4,616.00 | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG 6/> 4+PARAM ABORT ADULT | $2,769.60 | $4,616.00 | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG 6/> 4+PARAM ABORT PEDS | $2,769.60 | $4,616.00 | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP STAGING 4+ PARAM 6YR/> | $5,539.20 | $9,232.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULS TRANSVAGINAL NON-OBSTETRIC | $330.60 | $551.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULS TRANSVAGINAL NON-OBSTETRIC | $330.60 | $551.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULS TRANSVAGINAL NON-OBSTETRIC | $330.60 | $551.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABD B-SCAN+/OR REAL T COMP | $520.20 | $867.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABD B-SCAN+/OR REAL T COMP | $520.20 | $867.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD B-SCAN+/OR REAL T COMP | $520.20 | $867.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL 4+ VIEWS | $346.80 | $578.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL 4+ VIEWS | $346.80 | $578.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL 4+ VIEWS | $346.80 | $578.00 | 40% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $217.80 | $363.00 | 40% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $217.80 | $363.00 | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $217.80 | $363.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $305.40 | $509.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $305.40 | $509.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $305.40 | $509.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 #CBC+DIFF WBC;CMPLT AUTO | $30.00 | $50.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 #CBC+DIFF WBC;CMPLT AUTO | $30.00 | $50.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC+DIFF WBC; CMPLT AUTO | $170.40 | $284.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC+DIFF WBC; CMPLT AUTO | $170.40 | $284.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 #CBC+DIFF WBC;CMPLT AUTO | $30.00 | $50.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC+DIFF WBC; CMPLT AUTO | $170.40 | $284.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 #CBC AUTM HGB-HCT-RBC-WBC-PLTL | $23.40 | $39.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 #CBC AUTM HGB-HCT-RBC-WBC-PLTL | $23.40 | $39.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC AUTM HGB-HCT-RBC-WBC-PLTLT | $128.40 | $214.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC AUTM HGB-HCT-RBC-WBC-PLTLT | $128.40 | $214.00 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 #CBC AUTM HGB-HCT-RBC-WBC-PLTL | $23.40 | $39.00 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTM HGB-HCT-RBC-WBC-PLTLT | $128.40 | $214.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 #COMPREHENSIVE METABOLIC PANEL | $39.60 | $66.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 #COMPREHENSIVE METABOLIC PANEL | $39.60 | $66.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $339.00 | $565.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $339.00 | $565.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 #COMPREHENSIVE METABOLIC PANEL | $39.60 | $66.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $339.00 | $565.00 | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $316.80 | $528.00 | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $316.80 | $528.00 | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $316.80 | $528.00 | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $241.20 | $402.00 | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $241.20 | $402.00 | 40% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $241.20 | $402.00 | 40% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $384.00 | $640.00 | 40% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $384.00 | $640.00 | 40% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL | $384.00 | $640.00 | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 #PROSTATE SPECIFIC AG/PSA;FREE | $69.60 | $116.00 | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 #PROSTATE SPECIFIC AG/PSA;FREE | $69.60 | $116.00 | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATE SPECIFIC AG(PSA);FREE | $140.40 | $234.00 | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATE SPECIFIC AG(PSA);FREE | $140.40 | $234.00 | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 #PROSTATE SPECIFIC AG/PSA;FREE | $69.60 | $116.00 | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PROSTATE SPECIFIC AG(PSA);FREE | $140.40 | $234.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 #PROSTATE SPECIFIC AG(PSA);TTL | $69.60 | $116.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 #PROSTATE SPECIFIC AG(PSA);TTL | $69.60 | $116.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC AG(PSA);TTL | $352.80 | $588.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC AG(PSA);TTL | $352.80 | $588.00 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 #PROSTATE SPECIFIC AG(PSA);TTL | $69.60 | $116.00 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC AG(PSA);TTL | $352.80 | $588.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 #THROMBOPLAST PTT;PLSM/WHL BLD | $94.80 | $158.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 #THROMBOPLAST PTT;PLSM/WHL BLD | $94.80 | $158.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PTT;PLASMA | $147.00 | $245.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PTT;PLASMA | $147.00 | $245.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 #THROMBOPLAST PTT;PLSM/WHL BLD | $94.80 | $158.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PTT;PLASMA | $147.00 | $245.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 #PROTHROMBIN TIME | $71.40 | $119.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 #PROTHROMBIN TIME | $71.40 | $119.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $111.60 | $186.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $111.60 | $186.00 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 #PROTHROMBIN TIME | $71.40 | $119.00 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $111.60 | $186.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 #THYROID STIMULAT HORMONE(TSH) | $81.60 | $136.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 #THYROID STIMULAT HORMONE(TSH) | $81.60 | $136.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULAT HORMONE(TSH) | $301.20 | $502.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULAT HORMONE(TSH) | $301.20 | $502.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 #THYROID STIMULAT HORMONE(TSH) | $81.60 | $136.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULAT HORMONE(TSH) | $301.20 | $502.00 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALS DIPSTICK AUTO W/MICR | $135.00 | $225.00 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALS DIPSTICK AUTO W/MICR | $135.00 | $225.00 | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALS DIPSTICK AUTO W/MICR | $135.00 | $225.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 #URINALYSIS DIP STICK;AUTO | $65.40 | $109.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 #URINALYSIS DIP STICK;AUTO | $65.40 | $109.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALS DIPSTICK AUTO WO/MICR | $101.40 | $169.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALS DIPSTICK AUTO WO/MICR | $101.40 | $169.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 #URINALYSIS DIP STICK;AUTO | $65.40 | $109.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALS DIPSTICK AUTO WO/MICR | $101.40 | $169.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 #URINALYSIS DIP STICK;NON-AUTO | $10.80 | $18.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 #URINALYSIS DIP STICK;NON-AUTO | $10.80 | $18.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINALS DIPSTICK NON-AUTOWO/MI | $59.40 | $99.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINALS DIPSTICK NON-AUTOWO/MI | $59.40 | $99.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 #URINALYSIS DIP STICK;NON-AUTO | $10.80 | $18.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINALS DIPSTICK NON-AUTOWO/MI | $59.40 | $99.00 | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Left heart catheterization, diagnostic CPT 93452 LHC/LV/IMAGING | $14,930.40 | $24,884.00 | 40% |
| Left heart catheterization, diagnostic CPT 93452 LHC/LV/IMAGING | $14,930.40 | $24,884.00 | 40% |
| Left heart catheterization, diagnostic inpatient CPT 93452 LHC/LV/IMAGING | $14,930.40 | $24,884.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ DX/TX LAMINAR LUM/SACRL+IM | $2,942.40 | $4,904.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ DX/TX LAMINAR LUM/SACRL+IM | $2,942.40 | $4,904.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ DX/TX LAMINAR LUM/SACRL+IM | $2,942.40 | $4,904.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 INJ TRANSFORAMINAL EPI L/S+IM BI | $4,596.00 | $7,660.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 INJ TRANSFORAMINAL EPI L/S+IM BI | $4,596.00 | $7,660.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ TRANSF EPI L/S+IM | $2,298.00 | $3,830.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ TRANSF EPI L/S+IM | $2,298.00 | $3,830.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 INJ TRANSFORAMINAL EPI L/S+IM BI | $4,596.00 | $7,660.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ TRANSF EPI L/S+IM | $2,298.00 | $3,830.00 | 40% |
| Prostate biopsy CPT 55700 BX PROSTATE; NDL/PUNCH SINGLE | $3,603.60 | $6,006.00 | 40% |
| Prostate biopsy CPT 55700 BX PROSTATE; NDL/PUNCH SINGLE | $3,603.60 | $6,006.00 | 40% |
| Prostate biopsy inpatient CPT 55700 BX PROSTATE; NDL/PUNCH SINGLE | $3,603.60 | $6,006.00 | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/ PATIENT | $97.80 | $163.00 | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/ PATIENT | $97.80 | $163.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTX W/ PATIENT | $97.80 | $163.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PATIENT | $85.20 | $142.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PATIENT | $85.20 | $142.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYTX W/O PATIENT | $85.20 | $142.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 OP VISIT LEVEL 3 NEW | $390.00 | $650.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 OP VISIT LEVEL 3 NEW | $390.00 | $650.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OP VISIT LEVEL 3 NEW | $390.00 | $650.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 OP VISIT LEVEL 4 NEW W/PROC | $505.20 | $842.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 OP VISIT LEVEL 4 NEW | $505.20 | $842.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 OP VISIT LEVEL 4 NEW | $505.20 | $842.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 OP VISIT LEVEL 4 NEW W/PROC | $505.20 | $842.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OP VISIT LEVEL 4 NEW | $505.20 | $842.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OP VISIT LEVEL 4 NEW W/PROC | $505.20 | $842.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 OP VISIT LEVEL 5 NEW | $663.60 | $1,106.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 OP VISIT LEVEL 5 NEW | $663.60 | $1,106.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OP VISIT LEVEL 5 NEW | $663.60 | $1,106.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT ALT-TX EXERCISE EA15MIN | $48.00 | $80.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT TX EXERCISES EA 15MIN | $48.00 | $80.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT ALT-TX EXERCISE EA15MIN | $48.00 | $80.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT ALT-THER EXERCISE EA15MIN | $48.00 | $80.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT TX EXERCISES EA 15MIN | $48.00 | $80.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISES 1-15 | $48.00 | $80.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISES 1-15 | $48.00 | $80.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT ALT-THER EXERCISE EA15MIN | $48.00 | $80.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT ISOKINETIC THERAPY EA 15MIN | $73.80 | $123.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT ISOKINETIC THERAPY EA 15MIN | $73.80 | $123.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT ALT-ISOKINETIC TX EA 15MIN | $73.80 | $123.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT ALT-ISOKINETIC TX EA 15MIN | $73.80 | $123.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT ALT-TX EXERCISE EA15MIN | $48.00 | $80.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT TX EXERCISES EA 15MIN | $48.00 | $80.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT ALT-THER EXERCISE EA15MIN | $48.00 | $80.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISES 1-15 | $48.00 | $80.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT ALT-ISOKINETIC TX EA 15MIN | $73.80 | $123.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT ISOKINETIC THERAPY EA 15MIN | $73.80 | $123.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYTX PT&/FAMILY 30 MINUTES | $84.60 | $141.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYTX PT&/FAMILY 30 MINUTES | $84.60 | $141.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYTX PT&/FAMILY 30 MINUTES | $84.60 | $141.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYTX PT&/FAMILY 45 MINUTES | $84.60 | $141.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYTX PT&/FAMILY 45 MINUTES | $84.60 | $141.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYTX PT&/FAMILY 45 MINUTES | $84.60 | $141.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYTX PT&/FAMILY 60 MINUTES | $84.60 | $141.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYTX PT&/FAMILY 60 MINUTES | $84.60 | $141.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYTX PT&/FAMILY 60 MINUTES | $84.60 | $141.00 | 40% |