Hospital Indianapolis-Carmel-Greenwood, IN

Carmel AmbSurg

Carmel AmbSurg in Carmel, IN publishes cash prices for 387 common procedures listed here, from its own machine-readable price file updated Jan 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Indiana median for 175 of 383 procedures and above it for 169. Select a procedure to compare it with other hospitals nearby.

13421 Old Meridian St. Carmel IN 46032 Collected Sep 23, 2026 Source price file Check a bill from this hospital

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WO/WC	$542.40	$904.00	$50.02–$650.00	60% below	40%
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WO/WC	$542.40	$904.00	$50.02–$650.00	60% below	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WO/WC	$542.40	$904.00	$50.02–$650.00	—	40%
Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN 2 VIEWS	$270.00	$450.00	$4.55–$446.39	at median	40%
Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN 2 VIEWS	$270.00	$450.00	$4.55–$446.39	at median	40%
Abdominal X-ray, 2 views inpatient CPT 74019 XR ABDOMEN 2 VIEWS	$270.00	$450.00	$4.55–$446.39	—	40%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR ANKLE COMPLETE 3+ VIEWS BI	$392.40	$654.00	$3.88–$250.00	—	40%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR ANKLE COMPLETE 3+ VIEWS BI	$392.40	$654.00	$3.88–$250.00	—	40%
Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE COMPLETE 3+ VIEWS UNI	$196.20	$327.00	$3.88–$250.00	at median	40%
Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE COMPLETE 3+ VIEWS UNI	$196.20	$327.00	$3.88–$250.00	at median	40%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR ANKLE COMPLETE 3+ VIEWS BI	$392.40	$654.00	$3.88–$250.00	—	40%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE COMPLETE 3+ VIEWS UNI	$196.20	$327.00	$3.88–$250.00	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 EXTR ART NON-INVASV BILAT LTD	$686.40	$1,144.00	$8.59–$171.74	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 EXTR ART NON-INVASV BILAT LTD	$686.40	$1,144.00	$8.59–$171.74	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 TCG-EXTR ART NONINVASV LTD BI	$750.00	$1,250.00	$8.59–$171.74	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 TCG-EXTR ART NONINVASV LTD BI	$750.00	$1,250.00	$8.59–$171.74	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 EXTREM ART CW DOP ABI UNI LTD	$343.20	$572.00	$8.59–$171.74	6% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 EXTREM ART CW DOP ABI UNI LTD	$343.20	$572.00	$8.59–$171.74	6% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 EXTREM ART CW DOP ABI UNI COMP	$627.00	$1,045.00	$8.59–$171.74	71% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 EXTREM ART CW DOP ABI UNI COMP	$627.00	$1,045.00	$8.59–$171.74	71% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 EXTR ART NON-INVASV BILAT LTD	$686.40	$1,144.00	$8.59–$171.74	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 TCG-EXTR ART NONINVASV LTD BI	$750.00	$1,250.00	$8.59–$171.74	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 EXTREM ART CW DOP ABI UNI LTD	$343.20	$572.00	$8.59–$171.74	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 EXTREM ART CW DOP ABI UNI COMP	$627.00	$1,045.00	$8.59–$171.74	—	40%
Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT UPPER EXT WO/C BI	$1,084.80	$1,808.00	$33.43–$1,205.57	—	40%
Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT UPPER EXT WO/C BI	$1,084.80	$1,808.00	$33.43–$1,205.57	—	40%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXT WO/C UNI	$542.40	$904.00	$33.43–$650.00	33% below	40%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXT WO/C UNI	$542.40	$904.00	$33.43–$650.00	33% below	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT UPPER EXT WO/C BI	$1,084.80	$1,808.00	$33.43–$1,205.57	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXT WO/C UNI	$542.40	$904.00	$33.43–$650.00	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS BARIUM SWALLOW	$484.80	$808.00	$10.39–$250.00	4% above	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS BARIUM SWALLOW	$484.80	$808.00	$10.39–$250.00	4% above	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR ESOPHAGUS BARIUM SWALLOW	$484.80	$808.00	$10.39–$250.00	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE +/OR JNT IM WHOLE BODY	$2,208.00	$3,680.00	$29.70–$574.82	40% above	40%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE +/OR JNT IM WHOLE BODY	$2,208.00	$3,680.00	$29.70–$574.82	40% above	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE +/OR JNT IM WHOLE BODY	$2,208.00	$3,680.00	$29.70–$574.82	—	40%
Breast ultrasound, complete, one breast both sides CPT 76641 ULS SCREENING BREAST COMPL BI	$588.00	$980.00	$20.16–$400.00	—	40%
Breast ultrasound, complete, one breast both sides CPT 76641 ULS SCREENING BREAST COMPL BI	$588.00	$980.00	$20.16–$400.00	—	40%
Breast ultrasound, complete, one breast both sides CPT 76641 ULS BREAST COMPL BI	$1,176.00	$1,960.00	$20.16–$1,306.93	—	40%
Breast ultrasound, complete, one breast both sides CPT 76641 ULS BREAST COMPL BI	$1,176.00	$1,960.00	$20.16–$1,306.93	—	40%
Breast ultrasound, complete, one breast CPT 76641 ULS BREAST COMPLETE UNI	$588.00	$980.00	$20.16–$653.46	36% above	40%
Breast ultrasound, complete, one breast CPT 76641 ULS BREAST COMPLETE UNI	$588.00	$980.00	$20.16–$653.46	36% above	40%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 ULS SCREENING BREAST COMPL BI	$588.00	$980.00	$20.16–$400.00	—	40%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 ULS BREAST COMPL BI	$1,176.00	$1,960.00	$20.16–$1,306.93	—	40%
Breast ultrasound, complete, one breast inpatient CPT 76641 ULS BREAST COMPLETE UNI	$588.00	$980.00	$20.16–$653.46	—	40%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 ULS BREAST LIMITED BI	$674.40	$1,124.00	$16.61–$749.48	—	40%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 ULS BREAST LIMITED BI	$674.40	$1,124.00	$16.61–$749.48	—	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 ULS BREAST LIMITED UNI	$337.20	$562.00	$16.61–$400.00	4% above	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 ULS BREAST LIMITED UNI	$337.20	$562.00	$16.61–$400.00	4% above	40%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 ULS BREAST LIMITED BI	$674.40	$1,124.00	$16.61–$749.48	—	40%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULS BREAST LIMITED UNI	$337.20	$562.00	$16.61–$400.00	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD & PELVIS W/C OR WO&WC	$542.40	$904.00	$77.86–$875.45	71% below	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD & PELVIS W/C OR WO&WC	$542.40	$904.00	$77.86–$875.45	71% below	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD & PELVIS W/C OR WO&WC	$542.40	$904.00	$77.86–$875.45	—	40%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W/C OR WO&WC	$542.40	$904.00	$60.45–$725.32	57% below	40%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W/C OR WO&WC	$542.40	$904.00	$60.45–$725.32	57% below	40%
CT angiography (CTA) of the head CPT 70496 CTA HEAD WO&WC W/RAPID AI LVO	$1,206.00	$2,010.00	$60.45–$975.43	5% below	40%
CT angiography (CTA) of the head CPT 70496 CTA HEAD WO&WC W/RAPID AI LVO	$1,206.00	$2,010.00	$60.45–$975.43	5% below	40%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W/C OR WO&WC	$542.40	$904.00	$60.45–$725.32	—	40%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD WO&WC W/RAPID AI LVO	$1,206.00	$2,010.00	$60.45–$975.43	—	40%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W/C OR WO&WC	$542.40	$904.00	$60.24–$760.52	55% below	40%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W/C OR WO&WC	$542.40	$904.00	$60.24–$760.52	55% below	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W/C OR WO&WC	$542.40	$904.00	$60.24–$760.52	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/C OR WO&WC	$542.40	$904.00	$61.58–$753.21	57% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/C OR WO&WC	$542.40	$904.00	$61.58–$753.21	57% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W/C OR WO&WC	$542.40	$904.00	$61.58–$753.21	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA HEART W/C (CCTA)	$542.40	$904.00	$84.25–$696.01	35% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA HEART W/C (CCTA)	$542.40	$904.00	$84.25–$696.01	35% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA HEART W/C (CCTA)	$542.40	$904.00	$84.25–$696.01	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART WO/C (CALCIUM SCORE)	$231.60	$386.00	$12.02–$210.29	24% above	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART WO/C (CALCIUM SCORE)	$231.60	$386.00	$12.02–$210.29	24% above	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART WO/C (CALCIUM SCORE)	$231.60	$386.00	$12.02–$210.29	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN AND PELVIS WO/C	$542.40	$904.00	$62.32–$650.00	55% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN AND PELVIS WO/C	$542.40	$904.00	$62.32–$650.00	55% below	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN AND PELVIS WO/C	$542.40	$904.00	$62.32–$650.00	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN AND PELVIS W/C	$542.40	$904.00	$65.14–$650.00	69% below	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN AND PELVIS W/C	$542.40	$904.00	$65.14–$650.00	69% below	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN AND PELVIS W/C	$542.40	$904.00	$65.14–$650.00	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN AND PELVIS WO/WC	$542.40	$904.00	$71.93–$751.30	68% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN AND PELVIS WO/WC	$542.40	$904.00	$71.93–$751.30	68% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN AND PELVIS WO/WC	$542.40	$904.00	$71.93–$751.30	—	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/C	$542.40	$904.00	$44.89–$650.00	49% below	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/C	$542.40	$904.00	$44.89–$650.00	49% below	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/C	$542.40	$904.00	$44.89–$650.00	—	40%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO/C	$542.40	$904.00	$30.88–$256.66	36% below	40%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO/C	$542.40	$904.00	$30.88–$256.66	36% below	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO/C	$542.40	$904.00	$30.88–$256.66	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL AREA WO/C	$542.40	$904.00	$28.77–$650.00	35% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL AREA WO/C	$542.40	$904.00	$28.77–$650.00	35% below	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL AREA WO/C	$542.40	$904.00	$28.77–$650.00	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO/C	$542.40	$904.00	$23.94–$650.00	29% below	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO/C	$542.40	$904.00	$23.94–$650.00	29% below	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN WO/C	$542.40	$904.00	$23.94–$650.00	—	40%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/C	$542.40	$904.00	$33.31–$650.00	37% below	40%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/C	$542.40	$904.00	$33.31–$650.00	37% below	40%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W/C	$542.40	$904.00	$33.31–$650.00	—	40%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN WO/WC	$542.40	$904.00	$39.50–$650.00	48% below	40%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN WO/WC	$542.40	$904.00	$39.50–$650.00	48% below	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN WO/WC	$542.40	$904.00	$39.50–$650.00	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO/C	$542.40	$904.00	$35.75–$650.00	39% below	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO/C	$542.40	$904.00	$35.75–$650.00	39% below	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO/C	$542.40	$904.00	$35.75–$650.00	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO/C	$542.40	$904.00	$36.40–$650.00	35% below	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO/C	$542.40	$904.00	$36.40–$650.00	35% below	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO/C	$542.40	$904.00	$36.40–$650.00	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/C	$542.40	$904.00	$41.27–$650.00	41% below	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/C	$542.40	$904.00	$41.27–$650.00	41% below	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/C	$542.40	$904.00	$41.27–$650.00	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 TCG-DUPLEX EXTRACRA/CAROTID BI	$1,586.40	$2,644.00	$21.32–$379.98	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 TCG-DUPLEX EXTRACRA/CAROTID BI	$1,586.40	$2,644.00	$21.32–$379.98	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX EXTRACRANIAL/CAROTID BI	$1,586.40	$2,644.00	$21.32–$379.98	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX EXTRACRANIAL/CAROTID BI	$1,586.40	$2,644.00	$21.32–$379.98	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUPLEX EXTRACRANIAL/CAROTID BI	$1,586.40	$2,644.00	$21.32–$379.98	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 TCG-DUPLEX EXTRACRA/CAROTID BI	$1,586.40	$2,644.00	$21.32–$379.98	—	40%
Chest CT scan without and with contrast CPT 71270 CT CHEST WO/WC	$542.40	$904.00	$49.10–$650.00	50% below	40%
Chest CT scan without and with contrast CPT 71270 CT CHEST WO/WC	$542.40	$904.00	$49.10–$650.00	50% below	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST WO/WC	$542.40	$904.00	$49.10–$650.00	—	40%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS	$185.40	$309.00	$4.17–$250.00	10% below	40%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS	$185.40	$309.00	$4.17–$250.00	10% below	40%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS	$185.40	$309.00	$4.17–$250.00	—	40%
Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW	$162.60	$271.00	$2.74–$250.00	at median	40%
Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW	$162.60	$271.00	$2.74–$250.00	at median	40%
Chest X-ray, single view inpatient CPT 71045 XR CHEST 1 VIEW	$162.60	$271.00	$2.74–$250.00	—	40%
Collarbone (clavicle) X-ray, complete both sides CPT 73000 XR CLAVICLE COMPLETE BI	$384.00	$640.00	$3.49–$426.75	—	40%
Collarbone (clavicle) X-ray, complete both sides CPT 73000 XR CLAVICLE COMPLETE BI	$384.00	$640.00	$3.49–$426.75	—	40%
Collarbone (clavicle) X-ray, complete CPT 73000 XR CLAVICLE COMPLETE UNI	$192.00	$320.00	$3.49–$250.00	at median	40%
Collarbone (clavicle) X-ray, complete CPT 73000 XR CLAVICLE COMPLETE UNI	$192.00	$320.00	$3.49–$250.00	at median	40%
Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 XR CLAVICLE COMPLETE BI	$384.00	$640.00	$3.49–$426.75	—	40%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 XR CLAVICLE COMPLETE UNI	$192.00	$320.00	$3.49–$250.00	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEUM B-SCAN COMP	$319.20	$532.00	$21.28–$400.00	36% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEUM B-SCAN COMP	$319.20	$532.00	$21.28–$400.00	36% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEUM B-SCAN COMP	$319.20	$532.00	$21.28–$400.00	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR DEXA>1 SITES AXIAL (COMBO)	$290.40	$484.00	$7.29–$322.73	1% above	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR DEXA>1 SITES AXIAL	$290.40	$484.00	$7.29–$322.73	1% above	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR DEXA>1 SITES AXIAL	$290.40	$484.00	$7.29–$322.73	1% above	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR DEXA>1 SITES AXIAL (COMBO)	$290.40	$484.00	$7.29–$322.73	1% above	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR DEXA>1 SITES AXIAL	$290.40	$484.00	$7.29–$322.73	—	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR DEXA>1 SITES AXIAL (COMBO)	$290.40	$484.00	$7.29–$322.73	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 XR DEXA>1 SITES APPEND (COMBO)	$145.20	$242.00	$3.38–$161.37	at median	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 XR DEXA>1 SITES APPENDICULAR	$145.20	$242.00	$3.38–$161.37	at median	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 XR DEXA>1 SITES APPENDICULAR	$145.20	$242.00	$3.38–$161.37	at median	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 XR DEXA>1 SITES APPEND (COMBO)	$145.20	$242.00	$3.38–$161.37	at median	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 XR DEXA>1 SITES APPEND (COMBO)	$145.20	$242.00	$3.38–$161.37	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 XR DEXA>1 SITES APPENDICULAR	$145.20	$242.00	$3.38–$161.37	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG UT TRANSABD SNGL/1ST G	$541.80	$903.00	$34.45–$602.12	4% below	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG UT TRANSABD SNGL/1ST G	$541.80	$903.00	$34.45–$602.12	4% below	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREG UT TRANSABD SNGL/1ST G	$541.80	$903.00	$34.45–$602.12	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO/C	$542.40	$904.00	$36.28–$650.00	35% below	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO/C	$542.40	$904.00	$36.28–$650.00	35% below	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO/C	$542.40	$904.00	$36.28–$650.00	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/C	$542.40	$904.00	$43.30–$650.00	42% below	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/C	$542.40	$904.00	$43.30–$650.00	42% below	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/C	$542.40	$904.00	$43.30–$650.00	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO FFD W/WO CAD DX BI	$378.00	$630.00	$27.03–$327.17	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO ADDL FFD W/WO CAD DX BI	$378.00	$630.00	$27.03–$327.17	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO ADDL FFD W/WO CAD DX BI	$378.00	$630.00	$27.03–$327.17	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO FFD W/WO CAD DX BI	$378.00	$630.00	$27.03–$327.17	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO FFD W/WO CAD DX BI	$378.00	$630.00	$27.03–$327.17	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO ADDL FFD W/WO CAD DX BI	$378.00	$630.00	$27.03–$327.17	—	40%
Diagnostic mammogram, one breast CPT 77065 MAMMO FFD W/WO CAD DX UNI	$276.60	$461.00	$21.32–$255.68	24% above	40%
Diagnostic mammogram, one breast CPT 77065 MAMMO FFD W/WO CAD DX UNI	$276.60	$461.00	$21.32–$255.68	24% above	40%
Diagnostic mammogram, one breast CPT 77065 MAMMO ADDL FFD W/WO CAD DX UNI	$276.60	$461.00	$21.32–$255.68	24% above	40%
Diagnostic mammogram, one breast CPT 77065 MAMMO ADDL FFD W/WO CAD DX UNI	$276.60	$461.00	$21.32–$255.68	24% above	40%
Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO ADDL FFD W/WO CAD DX UNI	$276.60	$461.00	$21.32–$255.68	—	40%
Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO FFD W/WO CAD DX UNI	$276.60	$461.00	$21.32–$255.68	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 TCG-DUPLEX ARTERIAL LOW EXT CMPL BI	$1,558.20	$2,597.00	$28.29–$435.46	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX ARTERIAL LOW EXT CMPL BILAT	$1,558.20	$2,597.00	$28.29–$435.46	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX ARTERIAL LOW EXT CMPL BILAT	$1,558.20	$2,597.00	$28.29–$435.46	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 TCG-DUPLEX ARTERIAL LOW EXT CMPL BI	$1,558.20	$2,597.00	$28.29–$435.46	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 TCG-DUPLEX ARTERIAL LOW EXT CMPL BI	$1,558.20	$2,597.00	$28.29–$435.46	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUPLEX ARTERIAL LOW EXT CMPL BILAT	$1,558.20	$2,597.00	$28.29–$435.46	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 TCG-DUPLEX VEINS EXT CMPL BI	$1,751.40	$2,919.00	$24.89–$739.52	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 TCG-DUPLEX VEINS EXT CMPL BI	$1,751.40	$2,919.00	$24.89–$739.52	—	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 DUPLEX SCAN VEINS EXT;COMP BIL	$1,751.40	$2,919.00	$24.89–$739.52	34% above	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 DUPLEX SCAN VEINS EXT;COMP BIL	$1,751.40	$2,919.00	$24.89–$739.52	34% above	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 TCG-DUPLEX VEINS EXT CMPL BI	$1,751.40	$2,919.00	$24.89–$739.52	—	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 DUPLEX SCAN VEINS EXT;COMP BIL	$1,751.40	$2,919.00	$24.89–$739.52	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TCG-ECHO 2D CMPL W/D/CF W/CON	$2,351.40	$3,919.00	$45.57–$557.60	42% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO 2D CMPL W/D/CF WO/CON	$2,351.40	$3,919.00	$45.57–$557.60	42% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO 2D CMPL W/D/CF WO/CON	$2,351.40	$3,919.00	$45.57–$557.60	42% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TCG-ECHO 2D CMPL W/D/CF WO/CON	$2,351.40	$3,919.00	$45.57–$557.60	42% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TCG-ECHO 2D CMPL W/D/CF WO/CON	$2,351.40	$3,919.00	$45.57–$557.60	42% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TCG-ECHO 2D CMPL W/D/CF W/CON	$2,351.40	$3,919.00	$45.57–$557.60	42% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO 2D CMPL W/D/CF W/CON	$2,352.00	$3,920.00	$45.57–$557.60	42% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO 2D CMPL W/D/CF W/CON	$2,352.00	$3,920.00	$45.57–$557.60	42% above	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TCG-ECHO 2D CMPL W/D/CF WO/CON	$2,351.40	$3,919.00	$45.57–$557.60	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TCG-ECHO 2D CMPL W/D/CF W/CON	$2,351.40	$3,919.00	$45.57–$557.60	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO 2D CMPL W/D/CF WO/CON	$2,351.40	$3,919.00	$45.57–$557.60	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO 2D CMPL W/D/CF W/CON	$2,352.00	$3,920.00	$45.57–$557.60	—	40%
Elbow X-ray, 2 views both sides CPT 73070 XR ELBOW 2 VIEWS BI	$320.40	$534.00	$3.44–$356.07	—	40%
Elbow X-ray, 2 views both sides CPT 73070 XR ELBOW 2 VIEWS BI	$320.40	$534.00	$3.44–$356.07	—	40%
Elbow X-ray, 2 views CPT 73070 XR ELBOW 2 VIEWS UNI	$160.20	$267.00	$3.44–$250.00	3% below	40%
Elbow X-ray, 2 views CPT 73070 XR ELBOW 2 VIEWS UNI	$160.20	$267.00	$3.44–$250.00	3% below	40%
Elbow X-ray, 2 views inpatient both sides CPT 73070 XR ELBOW 2 VIEWS BI	$320.40	$534.00	$3.44–$356.07	—	40%
Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW 2 VIEWS UNI	$160.20	$267.00	$3.44–$250.00	—	40%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 XR ELBOW COMPLETE 3+ VIEWS BI	$516.00	$860.00	$4.24–$250.00	—	40%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 XR ELBOW COMPLETE 3+ VIEWS BI	$516.00	$860.00	$4.24–$250.00	—	40%
Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW COMPLETE 3+ VIEWS UNI	$258.00	$430.00	$4.24–$286.72	1% above	40%
Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW COMPLETE 3+ VIEWS UNI	$258.00	$430.00	$4.24–$286.72	1% above	40%
Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 XR ELBOW COMPLETE 3+ VIEWS BI	$516.00	$860.00	$4.24–$250.00	—	40%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR ELBOW COMPLETE 3+ VIEWS UNI	$258.00	$430.00	$4.24–$286.72	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/SELLA/FOSS/INEAR WO/C	$542.40	$904.00	$38.77–$650.00	36% below	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/SELLA/FOSS/INEAR WO/C	$542.40	$904.00	$38.77–$650.00	36% below	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT/SELLA/FOSS/INEAR WO/C	$542.40	$904.00	$38.77–$650.00	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES COMPL >=3VWS	$273.00	$455.00	$5.46–$303.39	at median	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES COMPL >=3VWS	$273.00	$455.00	$5.46–$303.39	at median	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES COMPL >=3VWS	$273.00	$455.00	$5.46–$303.39	—	40%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 XR FOREARM 2 VIEWS BI	$367.20	$612.00	$3.49–$408.08	—	40%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 XR FOREARM 2 VIEWS BI	$367.20	$612.00	$3.49–$408.08	—	40%
Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM 2 VIEWS UNI	$183.60	$306.00	$3.49–$250.00	at median	40%
Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM 2 VIEWS UNI	$183.60	$306.00	$3.49–$250.00	at median	40%
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 XR FOREARM 2 VIEWS BI	$367.20	$612.00	$3.49–$408.08	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM 2 VIEWS UNI	$183.60	$306.00	$3.49–$250.00	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBIL(HIDA) WO/IV INTER	$2,378.40	$3,964.00	$26.17–$811.51	81% above	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBIL(HIDA) WO/IV INTER	$2,378.40	$3,964.00	$26.17–$811.51	81% above	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBIL(HIDA) WO/IV INTER	$2,378.40	$3,964.00	$26.17–$811.51	—	40%
Hand X-ray, 2 views both sides CPT 73120 XR HAND 2 VIEWS BI	$343.20	$572.00	$3.45–$381.41	—	40%
Hand X-ray, 2 views both sides CPT 73120 XR HAND 2 VIEWS BI	$343.20	$572.00	$3.45–$381.41	—	40%
Hand X-ray, 2 views CPT 73120 XR HAND 2 VIEWS UNI	$171.60	$286.00	$3.45–$250.00	at median	40%
Hand X-ray, 2 views CPT 73120 XR HAND 2 VIEWS UNI	$171.60	$286.00	$3.45–$250.00	at median	40%
Hand X-ray, 2 views inpatient both sides CPT 73120 XR HAND 2 VIEWS BI	$343.20	$572.00	$3.45–$381.41	—	40%
Hand X-ray, 2 views inpatient CPT 73120 XR HAND 2 VIEWS UNI	$171.60	$286.00	$3.45–$250.00	—	40%
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 XR CALCANEUS 2+ VIEWS BI	$516.00	$860.00	$3.35–$250.00	—	40%
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 XR CALCANEUS 2+ VIEWS BI	$516.00	$860.00	$3.35–$250.00	—	40%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR CALCANEUS 2+ VIEWS UNI	$258.00	$430.00	$3.35–$286.72	21% above	40%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR CALCANEUS 2+ VIEWS UNI	$258.00	$430.00	$3.35–$286.72	21% above	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 XR CALCANEUS 2+ VIEWS BI	$516.00	$860.00	$3.35–$250.00	—	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR CALCANEUS 2+ VIEWS UNI	$258.00	$430.00	$3.35–$286.72	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STAGE 4+PAR W/CPAP 6YR/>	$5,865.00	$9,775.00	$90.91–$2,647.09	81% above	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STAGE 4+PAR W/CPAP 6YR/>	$5,865.00	$9,775.00	$90.91–$2,647.09	81% above	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STAGE 4+PAR W/CPAP 6YR/>	$5,865.00	$9,775.00	$90.91–$2,647.09	—	40%
Knee X-ray, 3 views both sides CPT 73562 XR KNEE 3 VIEWS BI	$458.40	$764.00	$4.24–$250.00	—	40%
Knee X-ray, 3 views both sides CPT 73562 XR KNEE 3 VIEWS BI	$458.40	$764.00	$4.24–$250.00	—	40%
Knee X-ray, 3 views CPT 73562 XR KNEE 3 VIEWS UNI	$229.20	$382.00	$4.24–$250.00	at median	40%
Knee X-ray, 3 views CPT 73562 XR KNEE 3 VIEWS UNI	$229.20	$382.00	$4.24–$250.00	at median	40%
Knee X-ray, 3 views inpatient both sides CPT 73562 XR KNEE 3 VIEWS BI	$458.40	$764.00	$4.24–$250.00	—	40%
Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3 VIEWS UNI	$229.20	$382.00	$4.24–$250.00	—	40%
Knee X-ray, complete, 4 or more views both sides CPT 73564 XR KNEE COMPLETE 4+ VIEWS BI	$523.20	$872.00	$4.83–$250.00	—	40%
Knee X-ray, complete, 4 or more views both sides CPT 73564 XR KNEE COMPLETE 4+ VIEWS BI	$523.20	$872.00	$4.83–$250.00	—	40%
Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE COMPLETE 4+ VIEWS UNI	$261.60	$436.00	$4.83–$250.00	at median	40%
Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE COMPLETE 4+ VIEWS UNI	$261.60	$436.00	$4.83–$250.00	at median	40%
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 XR KNEE COMPLETE 4+ VIEWS BI	$523.20	$872.00	$4.83–$250.00	—	40%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE COMPLETE 4+ VIEWS UNI	$261.60	$436.00	$4.83–$250.00	—	40%
Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT LOW EXTR WO/C BI	$1,084.80	$1,808.00	$33.43–$650.00	—	40%
Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT LOW EXTR WO/C BI	$1,084.80	$1,808.00	$33.43–$650.00	—	40%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOW EXTR WO/C UNI	$542.40	$904.00	$33.43–$650.00	31% below	40%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOW EXTR WO/C UNI	$542.40	$904.00	$33.43–$650.00	31% below	40%
Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT LOW EXTR WO/C BI	$1,084.80	$1,808.00	$33.43–$650.00	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOW EXTR WO/C UNI	$542.40	$904.00	$33.43–$650.00	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD B-SCAN+/OR REAL T LTD	$329.40	$549.00	$17.16–$400.00	28% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD B-SCAN+/OR REAL T LTD	$329.40	$549.00	$17.16–$400.00	28% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD B-SCAN+/OR REAL T LTD	$329.40	$549.00	$17.16–$400.00	—	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREMITY NONVASC LTD	$281.40	$469.00	$6.85–$400.00	7% below	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREMITY NONVASC LTD	$281.40	$469.00	$6.85–$400.00	7% below	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXTREMITY NONVASC LTD	$281.40	$469.00	$6.85–$400.00	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE LUNG CA SCREENING	$542.40	$904.00	$21.01–$315.51	185% above	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE LUNG CA SCREENING	$542.40	$904.00	$21.01–$315.51	185% above	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LOW DOSE LUNG CA SCREENING	$542.40	$904.00	$21.01–$315.51	—	40%
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 XR TIBIA + FIBULA 2 VIEWS BI	$397.20	$662.00	$3.55–$250.00	—	40%
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 XR TIBIA + FIBULA 2 VIEWS BI	$397.20	$662.00	$3.55–$250.00	—	40%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBIA + FIBULA 2 VIEWS UNI	$198.60	$331.00	$3.55–$250.00	at median	40%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBIA + FIBULA 2 VIEWS UNI	$198.60	$331.00	$3.55–$250.00	at median	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 XR TIBIA + FIBULA 2 VIEWS BI	$397.20	$662.00	$3.55–$250.00	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBIA + FIBULA 2 VIEWS UNI	$198.60	$331.00	$3.55–$250.00	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 MRA AND/OR MRV HEAD WO/C	$582.60	$971.00	$42.97–$937.75	48% below	40%
MR angiography (MRA) of the head without contrast CPT 70544 MRA AND/OR MRV HEAD WO/C	$582.60	$971.00	$42.97–$937.75	48% below	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA AND/OR MRV HEAD WO/C	$582.60	$971.00	$42.97–$937.75	—	40%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST BI WO/WC W/CAD	$606.00	$1,010.00	$79.03–$872.95	—	40%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST BI WO/WC W/CAD	$606.00	$1,010.00	$79.03–$872.95	—	40%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST BI WO/WC W/CAD	$606.00	$1,010.00	$79.03–$872.95	—	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	$37.19–$700.00	—	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	$37.19–$700.00	—	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	$37.19–$700.00	43% below	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	$37.19–$700.00	43% below	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	$37.19–$700.00	43% below	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	$37.19–$700.00	43% below	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	$37.19–$700.00	—	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	$37.19–$700.00	—	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	$37.19–$700.00	—	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	$73.85–$1,025.66	—	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	$73.85–$1,025.66	—	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	$73.85–$811.73	60% below	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	$73.85–$811.73	60% below	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	$73.85–$1,025.66	—	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	$73.85–$811.73	—	40%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO/C	$582.60	$971.00	$52.07–$717.48	45% below	40%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO/C	$582.60	$971.00	$52.07–$717.48	45% below	40%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO/C	$582.60	$971.00	$52.07–$717.48	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO/WC	$582.60	$971.00	$79.46–$841.63	63% below	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO/WC	$582.60	$971.00	$79.46–$841.63	63% below	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO/WC	$582.60	$971.00	$79.46–$841.63	—	40%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO/C LIMITED	$291.00	$485.00	$36.33–$464.37	71% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO/C LIMITED	$291.00	$485.00	$36.33–$464.37	71% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI PITUITARY OR IAC WO/C(-XU)	$582.00	$970.00	$36.33–$700.00	43% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI PITUITARY OR IAC WO/C(-XU)	$582.00	$970.00	$36.33–$700.00	43% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO/C	$582.00	$970.00	$36.33–$700.00	43% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO/C	$582.00	$970.00	$36.33–$700.00	43% below	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO/C LIMITED	$291.00	$485.00	$36.33–$464.37	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI PITUITARY OR IAC WO/C(-XU)	$582.00	$970.00	$36.33–$700.00	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO/C	$582.00	$970.00	$36.33–$700.00	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI PITUITRY OR IAC WO/WC(-XU)	$582.60	$971.00	$59.48–$842.23	55% below	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI PITUITRY OR IAC WO/WC(-XU)	$582.60	$971.00	$59.48–$842.23	55% below	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/WC	$582.60	$971.00	$59.48–$842.23	55% below	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/WC	$582.60	$971.00	$59.48–$842.23	55% below	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI PITUITRY OR IAC WO/WC(-XU)	$582.60	$971.00	$59.48–$842.23	—	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO/WC	$582.60	$971.00	$59.48–$842.23	—	40%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WO/C	$582.60	$971.00	$35.16–$700.00	43% below	40%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WO/C	$582.60	$971.00	$35.16–$700.00	43% below	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE WO/C	$582.60	$971.00	$35.16–$700.00	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE WO/WC	$582.60	$971.00	$59.65–$835.97	60% below	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE WO/WC	$582.60	$971.00	$59.65–$835.97	60% below	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE WO/WC	$582.60	$971.00	$59.65–$835.97	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE WO/C	$582.60	$971.00	$35.32–$700.00	42% below	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE WO/C	$582.60	$971.00	$35.32–$700.00	42% below	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE WO/C	$582.60	$971.00	$35.32–$700.00	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE WO/WC	$582.60	$971.00	$59.76–$845.81	60% below	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE WO/WC	$582.60	$971.00	$59.76–$845.81	60% below	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SPINE WO/WC	$582.60	$971.00	$59.76–$845.81	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE WO/C	$582.60	$971.00	$35.32–$700.00	44% below	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE WO/C	$582.60	$971.00	$35.32–$700.00	44% below	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE WO/C	$582.60	$971.00	$35.32–$700.00	—	40%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/WC	$582.60	$971.00	$79.35–$841.30	60% below	40%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/WC	$582.60	$971.00	$79.35–$841.30	60% below	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO/WC	$582.60	$971.00	$79.35–$841.30	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO/C	$582.60	$971.00	$52.62–$826.64	45% below	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO/C	$582.60	$971.00	$52.62–$826.64	45% below	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO/C	$582.60	$971.00	$52.62–$826.64	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI UP EXT ANY JNT WO/C BI	$1,165.20	$1,942.00	$37.14–$1,294.93	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI UP EXT ANY JNT WO/C BI	$1,165.20	$1,942.00	$37.14–$1,294.93	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UP EXT ANY JNT WO/C UNI	$582.60	$971.00	$37.14–$700.00	45% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UP EXT ANY JNT WO/C UNI	$582.60	$971.00	$37.14–$700.00	45% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI UP EXT ANY JNT WO/C BI	$1,165.20	$1,942.00	$37.14–$1,294.93	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UP EXT ANY JNT WO/C UNI	$582.60	$971.00	$37.14–$700.00	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERVICAL 4 OR 5 VIEWS	$348.00	$580.00	$6.56–$386.74	at median	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERVICAL 4 OR 5 VIEWS	$348.00	$580.00	$6.56–$386.74	at median	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERVICAL 4 OR 5 VIEWS	$348.00	$580.00	$6.56–$386.74	—	40%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/C	$542.40	$904.00	$40.71–$650.00	45% below	40%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/C	$542.40	$904.00	$40.71–$650.00	45% below	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/C	$542.40	$904.00	$40.71–$650.00	—	40%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO/C	$542.40	$904.00	$34.21–$650.00	35% below	40%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO/C	$542.40	$904.00	$34.21–$650.00	35% below	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO/C	$542.40	$904.00	$34.21–$650.00	—	40%
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE	$172.80	$288.00	$3.36–$250.00	at median	40%
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE	$172.80	$288.00	$3.36–$250.00	at median	40%
Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE	$172.80	$288.00	$3.36–$250.00	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 TCG-MYOCARD PERF SPECT MULTI	$5,700.60	$9,501.00	$56.47–$1,095.24	48% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 TCG-MYOCARD PERF SPECT MULTI	$5,700.60	$9,501.00	$56.47–$1,095.24	48% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARD PERFUSN SPECT MULTI	$5,742.60	$9,571.00	$56.47–$1,095.24	49% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARD PERFUSN SPECT MULTI	$5,742.60	$9,571.00	$56.47–$1,095.24	49% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 TCG-MYOCARD PERF SPECT MULTI	$5,700.60	$9,501.00	$56.47–$1,095.24	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARD PERFUSN SPECT MULTI	$5,742.60	$9,571.00	$56.47–$1,095.24	—	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL/THIGH INIT TX STR	$5,895.00	$9,825.00	$86.66–$3,033.22	45% above	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL/THIGH INIT TX STR	$5,895.00	$9,825.00	$86.66–$3,033.22	45% above	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL/THIGH SUBSQNT TX	$5,895.00	$9,825.00	$86.66–$3,033.22	45% above	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL/THIGH SUBSQNT TX	$5,895.00	$9,825.00	$86.66–$3,033.22	45% above	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL/THIGH	$5,895.00	$9,825.00	$86.66–$3,033.22	45% above	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL/THIGH	$5,895.00	$9,825.00	$86.66–$3,033.22	45% above	40%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT SKULL/THIGH INIT TX STR	$5,895.00	$9,825.00	$86.66–$3,033.22	—	40%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT SKULL/THIGH	$5,895.00	$9,825.00	$86.66–$3,033.22	—	40%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT SKULL/THIGH SUBSQNT TX	$5,895.00	$9,825.00	$86.66–$3,033.22	—	40%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO/C	$542.40	$904.00	$30.12–$650.00	35% below	40%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO/C	$542.40	$904.00	$30.12–$650.00	35% below	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO/C	$542.40	$904.00	$30.12–$650.00	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NONOB LTD/FOLLOW-UP	$295.20	$492.00	$9.01–$134.88	17% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NONOB LTD/FOLLOW-UP	$295.20	$492.00	$9.01–$134.88	17% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC NONOB LTD/FOLLOW-UP	$295.20	$492.00	$9.01–$134.88	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ULS PELVIC NON-OBSTETRIC COMPL	$343.20	$572.00	$20.59–$400.00	26% below	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ULS PELVIC NON-OBSTETRIC COMPL	$343.20	$572.00	$20.59–$400.00	26% below	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ULS PELVIC NON-OBSTETRIC COMPL	$343.20	$572.00	$20.59–$400.00	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTER>=14WK SNG/1STGEST	$531.00	$885.00	$26.71–$400.00	4% below	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTER>=14WK SNG/1STGEST	$531.00	$885.00	$26.71–$400.00	4% below	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTER>=14WK SNG/1STGEST	$531.00	$885.00	$26.71–$400.00	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULS OB TRANSABD<14WK SNG/1ST GEST	$478.20	$797.00	$23.20–$400.00	7% below	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULS OB TRANSABD<14WK SNG/1ST GEST	$478.20	$797.00	$23.20–$400.00	7% below	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULS OB TRANSABD<14WK SNG/1ST GEST	$478.20	$797.00	$23.20–$400.00	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREG UTERUS LTD >1 FETUSES	$293.40	$489.00	$15.87–$400.00	23% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREG UTERUS LTD >1 FETUSES	$293.40	$489.00	$15.87–$400.00	23% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREG UTERUS LTD >1 FETUSES	$293.40	$489.00	$15.87–$400.00	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNILAT 2 VIEWS	$204.60	$341.00	$4.17–$250.00	at median	40%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNILAT 2 VIEWS	$204.60	$341.00	$4.17–$250.00	at median	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS UNILAT 2 VIEWS	$204.60	$341.00	$4.17–$250.00	—	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNILAT W/PA CHEST>3VWS	$226.80	$378.00	$5.05–$250.00	7% below	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNILAT W/PA CHEST>3VWS	$226.80	$378.00	$5.05–$250.00	7% below	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS UNILAT W/PA CHEST>3VWS	$226.80	$378.00	$5.05–$250.00	—	40%
Screening mammogram, both breasts CPT 77067 MAMMO FFD W/WO CAD SCREENING	$249.60	$416.00	$21.77–$270.19	at median	40%
Screening mammogram, both breasts CPT 77067 MAMMO FFD W/WO CAD SCREENING	$249.60	$416.00	$21.77–$270.19	at median	40%
Screening mammogram, both breasts inpatient CPT 77067 MAMMO FFD W/WO CAD SCREENING	$249.60	$416.00	$21.77–$270.19	—	40%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR SHOULDER COMPL 2+VIEWS BI	$391.20	$652.00	$3.87–$434.75	—	40%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR SHOULDER COMPL 2+VIEWS BI	$391.20	$652.00	$3.87–$434.75	—	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER COMPL 2+VIEWS UNI	$195.60	$326.00	$3.87–$250.00	6% below	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER COMPL 2+VIEWS UNI	$195.60	$326.00	$3.87–$250.00	6% below	40%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR SHOULDER COMPL 2+VIEWS BI	$391.20	$652.00	$3.87–$434.75	—	40%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER COMPL 2+VIEWS UNI	$195.60	$326.00	$3.87–$250.00	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES PARANASAL COMP>3VWS	$283.80	$473.00	$5.17–$250.00	at median	40%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES PARANASAL COMP>3VWS	$283.80	$473.00	$5.17–$250.00	at median	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES PARANASAL COMP>3VWS	$283.80	$473.00	$5.17–$250.00	—	40%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL <4 VIEWS	$232.80	$388.00	$4.56–$68.29	at median	40%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL <4 VIEWS	$232.80	$388.00	$4.56–$68.29	at median	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL <4 VIEWS	$232.80	$388.00	$4.56–$68.29	—	40%
Sleep study in a lab (polysomnography) CPT 95810 PSG 6/> 4+PARAM ABORT ADULT	$2,769.60	$4,616.00	$87.42–$3,559.88	5% above	40%
Sleep study in a lab (polysomnography) CPT 95810 PSG 6/> 4+PARAM ABORT PEDS	$2,769.60	$4,616.00	$87.42–$3,559.88	5% above	40%
Sleep study in a lab (polysomnography) CPT 95810 PSG 6/> 4+PARAM ABORT PEDS	$2,769.60	$4,616.00	$87.42–$3,559.88	5% above	40%
Sleep study in a lab (polysomnography) CPT 95810 SLP STGNG >6Y PARAM 4+ <6 HRS	$2,769.60	$4,616.00	$87.42–$3,559.88	5% above	40%
Sleep study in a lab (polysomnography) CPT 95810 SLP STGNG >6Y PARAM 4+ <6 HRS	$2,769.60	$4,616.00	$87.42–$3,559.88	5% above	40%
Sleep study in a lab (polysomnography) CPT 95810 PSG 6/> 4+PARAM ABORT ADULT	$2,769.60	$4,616.00	$87.42–$3,559.88	5% above	40%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STAGING 4+ PARAM 6YR/>	$5,539.20	$9,232.00	$87.42–$2,647.09	110% above	40%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STAGING 4+ PARAM 6YR/>	$5,539.20	$9,232.00	$87.42–$2,647.09	110% above	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG 6/> 4+PARAM ABORT PEDS	$2,769.60	$4,616.00	$87.42–$3,559.88	—	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG 6/> 4+PARAM ABORT ADULT	$2,769.60	$4,616.00	$87.42–$3,559.88	—	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SLP STGNG >6Y PARAM 4+ <6 HRS	$2,769.60	$4,616.00	$87.42–$3,559.88	—	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP STAGING 4+ PARAM 6YR/>	$5,539.20	$9,232.00	$87.42–$2,647.09	—	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO 2D STRESS W/ECG WO/CON	$2,572.80	$4,288.00	$61.06–$536.54	43% above	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO 2D STRESS W/ECG WO/CON	$2,572.80	$4,288.00	$61.06–$536.54	43% above	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 TCG-ECHO 2D STRESS W/ECG WO/CON	$2,572.80	$4,288.00	$61.06–$536.54	43% above	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO 2D STRESS W/ECG W/CON	$2,572.80	$4,288.00	$61.06–$536.54	43% above	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO 2D STRESS W/ECG W/CON	$2,572.80	$4,288.00	$61.06–$536.54	43% above	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 TCG-ECHO 2D STRESS W/ECG W/CON	$2,572.80	$4,288.00	$61.06–$536.54	43% above	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 TCG-ECHO 2D STRESS W/ECG W/CON	$2,572.80	$4,288.00	$61.06–$536.54	43% above	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 TCG-ECHO 2D STRESS W/ECG WO/CON	$2,572.80	$4,288.00	$61.06–$536.54	43% above	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 ECHO 2D STRESS W/ECG W/CON	$2,572.80	$4,288.00	$61.06–$536.54	—	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 TCG-ECHO 2D STRESS W/ECG WO/CON	$2,572.80	$4,288.00	$61.06–$536.54	—	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 TCG-ECHO 2D STRESS W/ECG W/CON	$2,572.80	$4,288.00	$61.06–$536.54	—	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 ECHO 2D STRESS W/ECG WO/CON	$2,572.80	$4,288.00	$61.06–$536.54	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWALLW FUNC W/CINE+/OR VIDE	$258.00	$430.00	$10.94–$286.72	29% below	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWALLW FUNC W/CINE+/OR VIDE	$258.00	$430.00	$10.94–$286.72	29% below	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR SWALLW FUNC W/CINE+/OR VIDE	$258.00	$430.00	$10.94–$286.72	—	40%
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 XR FEMUR >= 2 VWS BILAT	$390.00	$650.00	$4.37–$433.42	—	40%
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 XR FEMUR >= 2 VWS BILAT	$390.00	$650.00	$4.37–$433.42	—	40%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR >= 2 VWS UNI	$195.00	$325.00	$4.37–$250.00	3% below	40%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR >= 2 VWS UNI	$195.00	$325.00	$4.37–$250.00	3% below	40%
Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 XR FEMUR >= 2 VWS BILAT	$390.00	$650.00	$4.37–$433.42	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR >= 2 VWS UNI	$195.00	$325.00	$4.37–$250.00	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO/C	$542.40	$904.00	$35.75–$650.00	36% below	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO/C	$542.40	$904.00	$35.75–$650.00	36% below	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE WO/C	$542.40	$904.00	$35.75–$650.00	—	40%
Toe X-ray, 2 or more views both sides CPT 73660 XR TOE 2+ VIEWS BI	$296.40	$494.00	$3.28–$329.40	—	40%
Toe X-ray, 2 or more views both sides CPT 73660 XR TOE 2+ VIEWS BI	$296.40	$494.00	$3.28–$329.40	—	40%
Toe X-ray, 2 or more views CPT 73660 XR TOE 2+ VIEWS UNI	$148.20	$247.00	$3.28–$164.70	3% below	40%
Toe X-ray, 2 or more views CPT 73660 XR TOE 2+ VIEWS UNI	$148.20	$247.00	$3.28–$164.70	3% below	40%
Toe X-ray, 2 or more views inpatient both sides CPT 73660 XR TOE 2+ VIEWS BI	$296.40	$494.00	$3.28–$329.40	—	40%
Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE 2+ VIEWS UNI	$148.20	$247.00	$3.28–$164.70	—	40%
Transvaginal pelvic ultrasound CPT 76830 ULS TRANSVAGINAL NON-OBSTETRIC	$330.60	$551.00	$22.28–$400.00	19% below	40%
Transvaginal pelvic ultrasound CPT 76830 ULS TRANSVAGINAL NON-OBSTETRIC	$330.60	$551.00	$22.28–$400.00	19% below	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 ULS TRANSVAGINAL NON-OBSTETRIC	$330.60	$551.00	$22.28–$400.00	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 ULS OB TRANSVAGINAL	$330.60	$551.00	$18.32–$400.00	11% below	40%
Transvaginal ultrasound during pregnancy CPT 76817 ULS OB TRANSVAGINAL	$330.60	$551.00	$18.32–$400.00	11% below	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 ULS OB TRANSVAGINAL	$330.60	$551.00	$18.32–$400.00	—	40%
Ultrasound of the abdomen, complete CPT 76700 US ABD B-SCAN+/OR REAL T COMP	$520.20	$867.00	$23.01–$400.00	1% below	40%
Ultrasound of the abdomen, complete CPT 76700 US ABD B-SCAN+/OR REAL T COMP	$520.20	$867.00	$23.01–$400.00	1% below	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD B-SCAN+/OR REAL T COMP	$520.20	$867.00	$23.01–$400.00	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US ECHOGRAPHY SCROTUM+CONTENTS	$382.20	$637.00	$12.73–$400.00	10% below	40%
Ultrasound of the scrotum and testicles CPT 76870 US ECHOGRAPHY SCROTUM+CONTENTS	$382.20	$637.00	$12.73–$400.00	10% below	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US ECHOGRAPHY SCROTUM+CONTENTS	$382.20	$637.00	$12.73–$400.00	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NECK TIS B-SCAN W/IM	$348.60	$581.00	$20.12–$400.00	18% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NECK TIS B-SCAN W/IM	$348.60	$581.00	$20.12–$400.00	18% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NECK TIS B-SCAN W/IM	$348.60	$581.00	$20.12–$400.00	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UPPER GI WO/W ESO	$659.40	$1,099.00	$13.09–$220.90	26% above	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UPPER GI WO/W ESO	$659.40	$1,099.00	$13.09–$220.90	26% above	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UPPER GI WO/W ESO	$659.40	$1,099.00	$13.09–$220.90	—	40%
Upper arm X-ray (humerus), 2 views both sides CPT 73060 XR HUMERUS 2+ VIEWS BI	$362.40	$604.00	$3.82–$402.75	—	40%
Upper arm X-ray (humerus), 2 views both sides CPT 73060 XR HUMERUS 2+ VIEWS BI	$362.40	$604.00	$3.82–$402.75	—	40%
Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS 2+ VIEWS UNI	$181.20	$302.00	$3.82–$250.00	6% below	40%
Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS 2+ VIEWS UNI	$181.20	$302.00	$3.82–$250.00	6% below	40%
Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 XR HUMERUS 2+ VIEWS BI	$362.40	$604.00	$3.82–$402.75	—	40%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS 2+ VIEWS UNI	$181.20	$302.00	$3.82–$250.00	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX SCAN VEINS EXT; UNI/LTD	$1,120.20	$1,867.00	$15.98–$525.91	77% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX SCAN VEINS EXT; UNI/LTD	$1,120.20	$1,867.00	$15.98–$525.91	77% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 TCG-DUPLEX VEINS EXT LTD UNI	$1,278.60	$2,131.00	$15.98–$525.91	102% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 TCG-DUPLEX VEINS EXT LTD UNI	$1,278.60	$2,131.00	$15.98–$525.91	102% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX SCAN VEINS EXT; UNI/LTD	$1,120.20	$1,867.00	$15.98–$525.91	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 TCG-DUPLEX VEINS EXT LTD UNI	$1,278.60	$2,131.00	$15.98–$525.91	—	40%
Wrist X-ray, 2 views both sides CPT 73100 XR WRIST 2 VIEWS BI	$290.40	$484.00	$3.54–$250.00	—	40%
Wrist X-ray, 2 views both sides CPT 73100 XR WRIST 2 VIEWS BI	$290.40	$484.00	$3.54–$250.00	—	40%
Wrist X-ray, 2 views CPT 73100 XR WRIST 2 VIEWS UNI	$145.20	$242.00	$3.54–$61.50	7% below	40%
Wrist X-ray, 2 views CPT 73100 XR WRIST 2 VIEWS UNI	$145.20	$242.00	$3.54–$61.50	7% below	40%
Wrist X-ray, 2 views inpatient both sides CPT 73100 XR WRIST 2 VIEWS BI	$290.40	$484.00	$3.54–$250.00	—	40%
Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS UNI	$145.20	$242.00	$3.54–$61.50	—	40%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR WRIST COMPLETE 3+ VIEWS BI	$516.00	$860.00	$4.11–$573.45	—	40%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR WRIST COMPLETE 3+ VIEWS BI	$516.00	$860.00	$4.11–$573.45	—	40%
Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST COMPLETE 3+ VIEWS UNI	$258.00	$430.00	$4.11–$250.00	1% above	40%
Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST COMPLETE 3+ VIEWS UNI	$258.00	$430.00	$4.11–$250.00	1% above	40%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR WRIST COMPLETE 3+ VIEWS BI	$516.00	$860.00	$4.11–$573.45	—	40%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST COMPLETE 3+ VIEWS UNI	$258.00	$430.00	$4.11–$250.00	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP UNI 2-3 VWS W/PELVIS	$274.80	$458.00	$5.57–$250.00	4% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP UNI 2-3 VWS W/PELVIS	$274.80	$458.00	$5.57–$250.00	4% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP UNI 2-3 VWS W/PELVIS	$274.80	$458.00	$5.57–$250.00	—	40%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW	$258.00	$430.00	$3.72–$250.00	19% above	40%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW	$258.00	$430.00	$3.72–$250.00	19% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW	$258.00	$430.00	$3.72–$250.00	—	40%
X-ray of the ankle, 2 views both sides CPT 73600 XR ANKLE 2 VIEWS BI	$295.20	$492.00	$3.45–$250.00	—	40%
X-ray of the ankle, 2 views both sides CPT 73600 XR ANKLE 2 VIEWS BI	$295.20	$492.00	$3.45–$250.00	—	40%
X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2 VIEWS UNI	$147.60	$246.00	$3.45–$55.69	8% below	40%
X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2 VIEWS UNI	$147.60	$246.00	$3.45–$55.69	8% below	40%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR ANKLE 2 VIEWS BI	$295.20	$492.00	$3.45–$250.00	—	40%
X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2 VIEWS UNI	$147.60	$246.00	$3.45–$55.69	—	40%
X-ray of the finger(s), 2 or more views both sides CPT 73140 XR FINGER 2+ VIEWS BI	$303.60	$506.00	$3.38–$250.00	—	40%
X-ray of the finger(s), 2 or more views both sides CPT 73140 XR FINGER 2+ VIEWS BI	$303.60	$506.00	$3.38–$250.00	—	40%
X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER 2+ VIEWS UNI	$151.80	$253.00	$3.38–$250.00	5% below	40%
X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER 2+ VIEWS UNI	$151.80	$253.00	$3.38–$250.00	5% below	40%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 XR FINGER 2+ VIEWS BI	$303.60	$506.00	$3.38–$250.00	—	40%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER 2+ VIEWS UNI	$151.80	$253.00	$3.38–$250.00	—	40%
X-ray of the foot, 2 views both sides CPT 73620 XR FOOT 2 VIEWS BI	$290.40	$484.00	$3.40–$322.73	—	40%
X-ray of the foot, 2 views both sides CPT 73620 XR FOOT 2 VIEWS BI	$290.40	$484.00	$3.40–$322.73	—	40%
X-ray of the foot, 2 views CPT 73620 XR FOOT 2 VIEWS UNI	$145.20	$242.00	$3.40–$53.78	11% below	40%
X-ray of the foot, 2 views CPT 73620 XR FOOT 2 VIEWS UNI	$145.20	$242.00	$3.40–$53.78	11% below	40%
X-ray of the foot, 2 views inpatient both sides CPT 73620 XR FOOT 2 VIEWS BI	$290.40	$484.00	$3.40–$322.73	—	40%
X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2 VIEWS UNI	$145.20	$242.00	$3.40–$53.78	—	40%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR FOOT COMPLETE 3+ VIEWS BI	$390.00	$650.00	$3.88–$250.00	—	40%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR FOOT COMPLETE 3+ VIEWS BI	$390.00	$650.00	$3.88–$250.00	—	40%
X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT COMPLETE 3+ VIEWS UNI	$195.00	$325.00	$3.88–$250.00	3% below	40%
X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT COMPLETE 3+ VIEWS UNI	$195.00	$325.00	$3.88–$250.00	3% below	40%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR FOOT COMPLETE 3+ VIEWS BI	$390.00	$650.00	$3.88–$250.00	—	40%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT COMPLETE 3+ VIEWS UNI	$195.00	$325.00	$3.88–$250.00	—	40%
X-ray of the hand, 3 or more views both sides CPT 73130 XR HAND 3+ VIEWS BI	$403.20	$672.00	$3.88–$448.09	—	40%
X-ray of the hand, 3 or more views both sides CPT 73130 XR HAND 3+ VIEWS BI	$403.20	$672.00	$3.88–$448.09	—	40%
X-ray of the hand, 3 or more views CPT 73130 XR HAND 3+ VIEWS UNI	$201.60	$336.00	$3.88–$250.00	at median	40%
X-ray of the hand, 3 or more views CPT 73130 XR HAND 3+ VIEWS UNI	$201.60	$336.00	$3.88–$250.00	at median	40%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR HAND 3+ VIEWS BI	$403.20	$672.00	$3.88–$448.09	—	40%
X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND 3+ VIEWS UNI	$201.60	$336.00	$3.88–$250.00	—	40%
X-ray of the knee, 1 or 2 views both sides CPT 73560 XR KNEE 1 OR 2 VIEWS BI	$417.60	$696.00	$3.64–$250.00	—	40%
X-ray of the knee, 1 or 2 views both sides CPT 73560 XR KNEE 1 OR 2 VIEWS BI	$417.60	$696.00	$3.64–$250.00	—	40%
X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE 1 OR 2 VIEWS UNI	$208.80	$348.00	$3.64–$250.00	at median	40%
X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE 1 OR 2 VIEWS UNI	$208.80	$348.00	$3.64–$250.00	at median	40%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR KNEE 1 OR 2 VIEWS BI	$417.60	$696.00	$3.64–$250.00	—	40%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE 1 OR 2 VIEWS UNI	$208.80	$348.00	$3.64–$250.00	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3VWS	$240.00	$400.00	$4.83–$250.00	5% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3VWS	$240.00	$400.00	$4.83–$250.00	5% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3VWS	$240.00	$400.00	$4.83–$250.00	—	40%
X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL 4+ VIEWS	$346.80	$578.00	$6.74–$250.00	at median	40%
X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL 4+ VIEWS	$346.80	$578.00	$6.74–$250.00	at median	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL 4+ VIEWS	$346.80	$578.00	$6.74–$250.00	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS	$238.20	$397.00	$4.41–$264.72	2% above	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS	$238.20	$397.00	$4.41–$264.72	2% above	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEWS	$238.20	$397.00	$4.41–$264.72	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMPL >3VWS	$193.20	$322.00	$3.92–$250.00	5% below	40%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMPL >3VWS	$193.20	$322.00	$3.92–$250.00	5% below	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES COMPL >3VWS	$193.20	$322.00	$3.92–$250.00	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS	$249.60	$416.00	$4.59–$250.00	at median	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS	$249.60	$416.00	$4.59–$250.00	at median	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS	$249.60	$416.00	$4.59–$250.00	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS	$186.00	$310.00	$3.46–$250.00	5% below	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS	$186.00	$310.00	$3.46–$250.00	5% below	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS	$186.00	$310.00	$3.46–$250.00	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM + COCCYX 2+ VIEWS	$219.00	$365.00	$3.86–$250.00	at median	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM + COCCYX 2+ VIEWS	$219.00	$365.00	$3.86–$250.00	at median	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM + COCCYX 2+ VIEWS	$219.00	$365.00	$3.86–$250.00	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
ACTH blood test CPT 82024 ASSA ADRENOCORTICOTR HORM;ACTH	$664.80	$1,108.00	$14.55–$88.05	167% above	40%
ACTH blood test CPT 82024 ASSA ADRENOCORTICOTR HORM;ACTH	$664.80	$1,108.00	$14.55–$88.05	167% above	40%
ACTH blood test inpatient CPT 82024 ASSA ADRENOCORTICOTR HORM;ACTH	$664.80	$1,108.00	$14.55–$88.05	—	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 #TRANSFERASE;ALANINE AMINO;ALT	$16.20	$27.00	$2.51–$12.08	41% below	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 #TRANSFERASE;ALANINE AMINO;ALT	$16.20	$27.00	$2.51–$12.08	41% below	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE;ALANINE AMINO(ALT)	$105.00	$175.00	$2.51–$12.08	282% above	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE;ALANINE AMINO(ALT)	$105.00	$175.00	$2.51–$12.08	282% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 #TRANSFERASE;ALANINE AMINO;ALT	$16.20	$27.00	$2.51–$12.08	—	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE;ALANINE AMINO(ALT)	$105.00	$175.00	$2.51–$12.08	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 #TRANSFERASE;ASPARTATE AMINO	$19.80	$33.00	$2.44–$11.81	32% below	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 #TRANSFERASE;ASPARTATE AMINO	$19.80	$33.00	$2.44–$11.81	32% below	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE;ASPARTA AMINO(AST)	$105.00	$175.00	$2.44–$11.81	262% above	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE;ASPARTA AMINO(AST)	$105.00	$175.00	$2.44–$11.81	262% above	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 #TRANSFERASE;ASPARTATE AMINO	$19.80	$33.00	$2.44–$11.81	—	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE;ASPARTA AMINO(AST)	$105.00	$175.00	$2.44–$11.81	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$982.80	$1,638.00	$13.68–$108.60	211% above	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$982.80	$1,638.00	$13.68–$108.60	211% above	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$982.80	$1,638.00	$13.68–$108.60	—	40%
Albumin blood test CPT 82040 #ALBUMIN; SERUM	$19.80	$33.00	$2.65–$11.29	13% below	40%
Albumin blood test CPT 82040 #ALBUMIN; SERUM	$19.80	$33.00	$2.65–$11.29	13% below	40%
Albumin blood test CPT 82040 ALBUMIN; SERUM	$87.60	$146.00	$2.65–$11.29	284% above	40%
Albumin blood test CPT 82040 ALBUMIN; SERUM	$87.60	$146.00	$2.65–$11.29	284% above	40%
Albumin blood test inpatient CPT 82040 #ALBUMIN; SERUM	$19.80	$33.00	$2.65–$11.29	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN; SERUM	$87.60	$146.00	$2.65–$11.29	—	40%
Aldosterone blood test CPT 82088 #ALDOSTERONE	$419.40	$699.00	$17.19–$92.91	104% above	40%
Aldosterone blood test CPT 82088 #ALDOSTERONE	$419.40	$699.00	$17.19–$92.91	104% above	40%
Aldosterone blood test CPT 82088 ALDOSTERONE	$654.00	$1,090.00	$17.19–$92.91	218% above	40%
Aldosterone blood test CPT 82088 ALDOSTERONE	$654.00	$1,090.00	$17.19–$92.91	218% above	40%
Aldosterone blood test inpatient CPT 82088 #ALDOSTERONE	$419.40	$699.00	$17.19–$92.91	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$654.00	$1,090.00	$17.19–$92.91	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 #PHOSPHATASE ALKALINE	$60.60	$101.00	$2.45–$11.81	89% above	40%
Alkaline phosphatase (ALP) blood test CPT 84075 #PHOSPHATASE ALKALINE	$60.60	$101.00	$2.45–$11.81	89% above	40%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE ALKALINE	$96.00	$160.00	$2.45–$11.81	200% above	40%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE ALKALINE	$96.00	$160.00	$2.45–$11.81	200% above	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 #PHOSPHATASE ALKALINE	$60.60	$101.00	$2.45–$11.81	—	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE ALKALINE	$96.00	$160.00	$2.45–$11.81	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 #ALLERGN SPEC IGE QNT/SEMIQNEA	$24.00	$40.00	$1.32–$11.90	25% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 #ALLERGN SPEC IGE QNT/SEMIQNEA	$24.00	$40.00	$1.32–$11.90	25% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE;EA ALLERGEN	$135.00	$225.00	$1.32–$11.90	603% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE;EA ALLERGEN	$135.00	$225.00	$1.32–$11.90	603% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERGN SPEC IGE QNT/SEMIQNEA	$24.00	$40.00	$1.32–$11.90	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE;EA ALLERGEN	$135.00	$225.00	$1.32–$11.90	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 #ALPHA-FETOPROTEIN; SERUM	$226.20	$377.00	$5.29–$38.24	122% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 #ALPHA-FETOPROTEIN; SERUM	$226.20	$377.00	$5.29–$38.24	122% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN; SERUM	$352.80	$588.00	$5.29–$38.24	246% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN; SERUM	$352.80	$588.00	$5.29–$38.24	246% above	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 #ALPHA-FETOPROTEIN; SERUM	$226.20	$377.00	$5.29–$38.24	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN; SERUM	$352.80	$588.00	$5.29–$38.24	—	40%
Ammonia blood test CPT 82140 AMMONIA	$244.80	$408.00	$7.20–$33.22	104% above	40%
Ammonia blood test CPT 82140 AMMONIA	$244.80	$408.00	$7.20–$33.22	104% above	40%
Ammonia blood test inpatient CPT 82140 AMMONIA	$244.80	$408.00	$7.20–$33.22	—	40%
Amylase blood test CPT 82150 #AMYLASE	$118.80	$198.00	$3.07–$14.77	129% above	40%
Amylase blood test CPT 82150 #AMYLASE	$118.80	$198.00	$3.07–$14.77	129% above	40%
Amylase blood test CPT 82150 AMYLASE	$184.80	$308.00	$3.07–$14.77	256% above	40%
Amylase blood test CPT 82150 AMYLASE	$184.80	$308.00	$3.07–$14.77	256% above	40%
Amylase blood test inpatient CPT 82150 #AMYLASE	$118.80	$198.00	$3.07–$14.77	—	40%
Amylase blood test inpatient CPT 82150 AMYLASE	$184.80	$308.00	$3.07–$14.77	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 #CYCLIC CITRULL PEPTIDE(CCP)AB	$49.20	$82.00	$6.39–$29.53	7% below	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 #CYCLIC CITRULL PEPTIDE(CCP)AB	$49.20	$82.00	$6.39–$29.53	7% below	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLIN PEPTID(CCP)AB	$220.20	$367.00	$6.39–$29.53	318% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLIN PEPTID(CCP)AB	$220.20	$367.00	$6.39–$29.53	318% above	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 #CYCLIC CITRULL PEPTIDE(CCP)AB	$49.20	$82.00	$6.39–$29.53	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLIN PEPTID(CCP)AB	$220.20	$367.00	$6.39–$29.53	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 #ANTINUCLEAR ANTIBODIES (ANA)	$196.80	$328.00	$5.29–$27.57	228% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 #ANTINUCLEAR ANTIBODIES (ANA)	$196.80	$328.00	$5.29–$27.57	228% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES (ANA)	$306.00	$510.00	$5.29–$27.57	411% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES (ANA)	$306.00	$510.00	$5.29–$27.57	411% above	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 #ANTINUCLEAR ANTIBODIES (ANA)	$196.80	$328.00	$5.29–$27.57	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES (ANA)	$306.00	$510.00	$5.29–$27.57	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$359.40	$599.00	$16.06–$89.51	111% above	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$359.40	$599.00	$16.06–$89.51	111% above	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$359.40	$599.00	$16.06–$89.51	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 #CULT BACT OTH SRC;AER	$157.20	$262.00	$2.65–$19.65	68% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 #CULT BACT OTH SRC;AER	$157.20	$262.00	$2.65–$19.65	68% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT BACT OTHSRC EX URN/BLD/ST	$244.80	$408.00	$2.65–$19.65	162% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT BACT OTHSRC EX URN/BLD/ST	$244.80	$408.00	$2.65–$19.65	162% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 #CULT BACT OTH SRC;AER	$157.20	$262.00	$2.65–$19.65	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT BACT OTHSRC EX URN/BLD/ST	$244.80	$408.00	$2.65–$19.65	—	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$217.80	$363.00	$3.47–$19.29	178% above	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$217.80	$363.00	$3.47–$19.29	178% above	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$217.80	$363.00	$3.47–$19.29	—	40%
Bilirubin blood test, total CPT 82247 #BILIRUBIN; TOTAL	$81.00	$135.00	$1.91–$11.45	134% above	40%
Bilirubin blood test, total CPT 82247 #BILIRUBIN; TOTAL	$81.00	$135.00	$1.91–$11.45	134% above	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN; TOTAL	$126.60	$211.00	$1.91–$11.45	265% above	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN; TOTAL	$126.60	$211.00	$1.91–$11.45	265% above	40%
Bilirubin blood test, total inpatient CPT 82247 #BILIRUBIN; TOTAL	$81.00	$135.00	$1.91–$11.45	—	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN; TOTAL	$126.60	$211.00	$1.91–$11.45	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV-SUR PATH GROSS+MICROS	$487.20	$812.00	$10.55–$277.37	88% above	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV-SUR PATH GROSS+MICROS	$487.20	$812.00	$10.55–$277.37	88% above	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV-SUR PATH GROSS+MICROS	$487.20	$812.00	$10.55–$277.37	—	40%
Blood culture for bacteria CPT 87040 CULT BACT BLD AER ISOL/PRESUMP	$287.40	$479.00	$3.97–$23.53	120% above	40%
Blood culture for bacteria CPT 87040 CULT BACT BLD AER ISOL/PRESUMP	$287.40	$479.00	$3.97–$23.53	120% above	40%
Blood culture for bacteria inpatient CPT 87040 CULT BACT BLD AER ISOL/PRESUMP	$287.40	$479.00	$3.97–$23.53	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW VENOUS VP(OFF UNIT)	$43.20	$72.00	$0.48–$63.69	160% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW VENOUS VP	$43.20	$72.00	$0.48–$63.69	160% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW VENOUS VP(OFF UNIT)	$43.20	$72.00	$0.48–$63.69	160% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW VENOUS VP	$43.20	$72.00	$0.48–$63.69	160% above	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW VENOUS VP(OFF UNIT)	$43.20	$72.00	$0.48–$63.69	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW VENOUS VP	$43.20	$72.00	$0.48–$63.69	—	40%
Blood glucose (sugar) test CPT 82947 #GLUCOSE;QNT BLOOD	$50.40	$84.00	$1.94–$8.96	89% above	40%
Blood glucose (sugar) test CPT 82947 #GLUCOSE;QNT BLOOD	$50.40	$84.00	$1.94–$8.96	89% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE;QNT BLD;NO REAGENT STR	$78.00	$130.00	$1.94–$8.96	193% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE;QNT BLD;NO REAGENT STR	$78.00	$130.00	$1.94–$8.96	193% above	40%
Blood glucose (sugar) test inpatient CPT 82947 #GLUCOSE;QNT BLOOD	$50.40	$84.00	$1.94–$8.96	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE;QNT BLD;NO REAGENT STR	$78.00	$130.00	$1.94–$8.96	—	40%
Blood lead test CPT 83655 #LEAD	$126.60	$211.00	$4.85–$27.61	78% above	40%
Blood lead test CPT 83655 #LEAD	$126.60	$211.00	$4.85–$27.61	78% above	40%
Blood lead test CPT 83655 LEAD	$198.60	$331.00	$4.85–$27.61	179% above	40%
Blood lead test CPT 83655 LEAD	$198.60	$331.00	$4.85–$27.61	179% above	40%
Blood lead test inpatient CPT 83655 #LEAD	$126.60	$211.00	$4.85–$27.61	—	40%
Blood lead test inpatient CPT 83655 LEAD	$198.60	$331.00	$4.85–$27.61	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (HCG);QUAL	$189.00	$315.00	$3.55–$23.80	159% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (HCG);QUAL	$189.00	$315.00	$3.55–$23.80	159% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADOTROPIN (HCG);QUAL	$189.00	$315.00	$3.55–$23.80	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 #BLOOD TYPING; ABO	$13.80	$23.00	$1.41–$6.82	72% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 #BLOOD TYPING; ABO	$13.80	$23.00	$1.41–$6.82	72% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING; ABO	$71.40	$119.00	$1.41–$6.82	45% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING; ABO	$71.40	$119.00	$1.41–$6.82	45% above	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 #BLOOD TYPING; ABO	$13.80	$23.00	$1.41–$6.82	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING; ABO	$71.40	$119.00	$1.41–$6.82	—	40%
Blood urea nitrogen (BUN) test CPT 84520 #UREA NITROGEN; QUANTITATIVE	$58.80	$98.00	$1.87–$9.01	149% above	40%
Blood urea nitrogen (BUN) test CPT 84520 #UREA NITROGEN; QUANTITATIVE	$58.80	$98.00	$1.87–$9.01	149% above	40%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN QUANTITATIVE	$90.60	$151.00	$1.87–$9.01	283% above	40%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN QUANTITATIVE	$90.60	$151.00	$1.87–$9.01	283% above	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 #UREA NITROGEN; QUANTITATIVE	$58.80	$98.00	$1.87–$9.01	—	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN QUANTITATIVE	$90.60	$151.00	$1.87–$9.01	—	40%
C-peptide blood test CPT 84681 C-PEPTIDE	$303.60	$506.00	$9.84–$47.45	121% above	40%
C-peptide blood test CPT 84681 C-PEPTIDE	$303.60	$506.00	$9.84–$47.45	121% above	40%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$303.60	$506.00	$9.84–$47.45	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$190.80	$318.00	$2.45–$11.81	177% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$190.80	$318.00	$2.45–$11.81	177% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$190.80	$318.00	$2.45–$11.81	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 #C DIFF AMPLIFIED PROBE	$130.80	$218.00	$17.33–$84.98	2% below	40%
C. difficile toxin gene test (stool PCR) CPT 87493 #C DIFF AMPLIFIED PROBE	$130.80	$218.00	$17.33–$84.98	2% below	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$228.00	$380.00	$17.33–$84.98	71% above	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$228.00	$380.00	$17.33–$84.98	71% above	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 #C DIFF AMPLIFIED PROBE	$130.80	$218.00	$17.33–$84.98	—	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE	$228.00	$380.00	$17.33–$84.98	—	40%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUM AG QNT;CA19-9	$334.80	$558.00	$10.26–$47.45	131% above	40%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUM AG QNT;CA19-9	$334.80	$558.00	$10.26–$47.45	131% above	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY TUM AG QNT;CA19-9	$334.80	$558.00	$10.26–$47.45	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUM AG QNT;CA 125	$357.60	$596.00	$10.26–$47.45	119% above	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUM AG QNT;CA 125	$357.60	$596.00	$10.26–$47.45	119% above	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY TUM AG QNT;CA 125	$357.60	$596.00	$10.26–$47.45	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID19 AMP PRB HIGHTECH	$119.40	$199.00	$20.52–$116.99	13% above	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID19 AMP PRB HIGHTECH	$119.40	$199.00	$20.52–$116.99	13% above	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$124.80	$208.00	$20.52–$116.99	18% above	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$124.80	$208.00	$20.52–$116.99	18% above	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB VIRACOR	$406.20	$677.00	$20.52–$116.99	284% above	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB VIRACOR	$406.20	$677.00	$20.52–$116.99	284% above	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID19 AMP PRB HIGHTECH	$119.40	$199.00	$20.52–$116.99	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$124.80	$208.00	$20.52–$116.99	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB VIRACOR	$406.20	$677.00	$20.52–$116.99	—	40%
Calcium blood test, total CPT 82310 #CALCIUM; TOTAL	$24.00	$40.00	$2.44–$11.76	9% below	40%
Calcium blood test, total CPT 82310 #CALCIUM; TOTAL	$24.00	$40.00	$2.44–$11.76	9% below	40%
Calcium blood test, total CPT 82310 CALCIUM; TOTAL	$88.80	$148.00	$2.44–$11.76	236% above	40%
Calcium blood test, total CPT 82310 CALCIUM; TOTAL	$88.80	$148.00	$2.44–$11.76	236% above	40%
Calcium blood test, total inpatient CPT 82310 #CALCIUM; TOTAL	$24.00	$40.00	$2.44–$11.76	—	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM; TOTAL	$88.80	$148.00	$2.44–$11.76	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA)	$390.60	$651.00	$5.29–$43.23	224% above	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA)	$390.60	$651.00	$5.29–$43.23	224% above	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA)	$390.60	$651.00	$5.29–$43.23	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 #ANTIBODY; VARICELLA-ZOSTER	$180.60	$301.00	$3.97–$29.37	85% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 #ANTIBODY; VARICELLA-ZOSTER	$180.60	$301.00	$3.97–$29.37	85% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY VARICELLA-ZOSTER	$280.80	$468.00	$3.97–$29.37	188% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY VARICELLA-ZOSTER	$280.80	$468.00	$3.97–$29.37	188% above	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 #ANTIBODY; VARICELLA-ZOSTER	$180.60	$301.00	$3.97–$29.37	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODY VARICELLA-ZOSTER	$280.80	$468.00	$3.97–$29.37	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 #CHLAMYDIA TRACHOMATIS AMP PRB	$130.80	$218.00	$16.60–$80.01	34% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 #CHLAMYDIA TRACHOMATIS AMP PRB	$130.80	$218.00	$16.60–$80.01	34% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS AMPL PRB	$253.20	$422.00	$16.60–$80.01	160% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS AMPL PRB	$253.20	$422.00	$16.60–$80.01	160% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 #CHLAMYDIA TRACHOMATIS AMP PRB	$130.80	$218.00	$16.60–$80.01	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS AMPL PRB	$253.20	$422.00	$16.60–$80.01	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$305.40	$509.00	$6.02–$30.53	191% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$305.40	$509.00	$6.02–$30.53	191% above	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$305.40	$509.00	$6.02–$30.53	—	40%
Complete blood count (CBC) with differential CPT 85025 #CBC+DIFF WBC;CMPLT AUTO	$30.00	$50.00	$3.68–$17.72	28% below	40%
Complete blood count (CBC) with differential CPT 85025 #CBC+DIFF WBC;CMPLT AUTO	$30.00	$50.00	$3.68–$17.72	28% below	40%
Complete blood count (CBC) with differential CPT 85025 CBC+DIFF WBC; CMPLT AUTO	$170.40	$284.00	$3.68–$17.72	312% above	40%
Complete blood count (CBC) with differential CPT 85025 CBC+DIFF WBC; CMPLT AUTO	$170.40	$284.00	$3.68–$17.72	312% above	40%
Complete blood count (CBC) with differential inpatient CPT 85025 #CBC+DIFF WBC;CMPLT AUTO	$30.00	$50.00	$3.68–$17.72	—	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC+DIFF WBC; CMPLT AUTO	$170.40	$284.00	$3.68–$17.72	—	40%
Complete blood count (CBC), no differential CPT 85027 #CBC AUTM HGB-HCT-RBC-WBC-PLTL	$23.40	$39.00	$3.06–$14.75	21% below	40%
Complete blood count (CBC), no differential CPT 85027 #CBC AUTM HGB-HCT-RBC-WBC-PLTL	$23.40	$39.00	$3.06–$14.75	21% below	40%
Complete blood count (CBC), no differential CPT 85027 CBC AUTM HGB-HCT-RBC-WBC-PLTLT	$128.40	$214.00	$3.06–$14.75	335% above	40%
Complete blood count (CBC), no differential CPT 85027 CBC AUTM HGB-HCT-RBC-WBC-PLTLT	$128.40	$214.00	$3.06–$14.75	335% above	40%
Complete blood count (CBC), no differential inpatient CPT 85027 #CBC AUTM HGB-HCT-RBC-WBC-PLTL	$23.40	$39.00	$3.06–$14.75	—	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTM HGB-HCT-RBC-WBC-PLTLT	$128.40	$214.00	$3.06–$14.75	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 #COMPREHENSIVE METABOLIC PANEL	$39.60	$66.00	$5.00–$24.08	55% below	40%
Comprehensive metabolic panel (blood test) CPT 80053 #COMPREHENSIVE METABOLIC PANEL	$39.60	$66.00	$5.00–$24.08	55% below	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$339.00	$565.00	$5.00–$24.08	283% above	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$339.00	$565.00	$5.00–$24.08	283% above	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 #COMPREHENSIVE METABOLIC PANEL	$39.60	$66.00	$5.00–$24.08	—	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$339.00	$565.00	$5.00–$24.08	—	40%
Cortisol blood test, total CPT 82533 #CORTISOL; TOTAL	$67.80	$113.00	$6.61–$37.16	28% below	40%
Cortisol blood test, total CPT 82533 #CORTISOL; TOTAL	$67.80	$113.00	$6.61–$37.16	28% below	40%
Cortisol blood test, total CPT 82533 CORTISOL; TOTAL	$316.20	$527.00	$6.61–$37.16	235% above	40%
Cortisol blood test, total CPT 82533 CORTISOL; TOTAL	$316.20	$527.00	$6.61–$37.16	235% above	40%
Cortisol blood test, total inpatient CPT 82533 #CORTISOL; TOTAL	$67.80	$113.00	$6.61–$37.16	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL; TOTAL	$316.20	$527.00	$6.61–$37.16	—	40%
Creatine kinase (CK) blood test, total CPT 82550 #CREATINE KINASE(CK) (CPK);TTL	$24.00	$40.00	$2.65–$14.84	38% below	40%
Creatine kinase (CK) blood test, total CPT 82550 #CREATINE KINASE(CK) (CPK);TTL	$24.00	$40.00	$2.65–$14.84	38% below	40%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE(CK) (CPK);TOTL	$130.80	$218.00	$2.65–$14.84	237% above	40%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE(CK) (CPK);TOTL	$130.80	$218.00	$2.65–$14.84	237% above	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 #CREATINE KINASE(CK) (CPK);TTL	$24.00	$40.00	$2.65–$14.84	—	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE(CK) (CPK);TOTL	$130.80	$218.00	$2.65–$14.84	—	40%
Creatinine blood test CPT 82565 #CREATININE; BLOOD	$57.60	$96.00	$1.32–$11.67	100% above	40%
Creatinine blood test CPT 82565 #CREATININE; BLOOD	$57.60	$96.00	$1.32–$11.67	100% above	40%
Creatinine blood test CPT 82565 CREATININE; BLOOD	$88.80	$148.00	$1.32–$11.67	208% above	40%
Creatinine blood test CPT 82565 CREATININE; BLOOD	$88.80	$148.00	$1.32–$11.67	208% above	40%
Creatinine blood test inpatient CPT 82565 #CREATININE; BLOOD	$57.60	$96.00	$1.32–$11.67	—	40%
Creatinine blood test inpatient CPT 82565 CREATININE; BLOOD	$88.80	$148.00	$1.32–$11.67	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 IBC CYTOMEGALO-IGG	$13.80	$23.00	$5.29–$18.99	83% below	40%
Cytomegalovirus (CMV) antibody test CPT 86644 IBC CYTOMEGALO-IGG	$13.80	$23.00	$5.29–$18.99	83% below	40%
Cytomegalovirus (CMV) antibody test CPT 86644 #ANTIBODY; CYTOMEGALOVIRIS	$66.60	$111.00	$5.29–$32.81	16% below	40%
Cytomegalovirus (CMV) antibody test CPT 86644 #ANTIBODY; CYTOMEGALOVIRIS	$66.60	$111.00	$5.29–$32.81	16% below	40%
Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY;CYTOMEGALOVIRUS (CMV)	$263.40	$439.00	$5.29–$32.81	231% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY;CYTOMEGALOVIRUS (CMV)	$263.40	$439.00	$5.29–$32.81	231% above	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 IBC CYTOMEGALO-IGG	$13.80	$23.00	$5.29–$18.99	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 #ANTIBODY; CYTOMEGALOVIRIS	$66.60	$111.00	$5.29–$32.81	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY;CYTOMEGALOVIRUS (CMV)	$263.40	$439.00	$5.29–$32.81	—	40%
D-dimer blood test (blood clot marker) CPT 85379 #FIBRIN DEGR PRODU D-DIMER;QNT	$38.40	$64.00	$3.97–$23.21	69% below	40%
D-dimer blood test (blood clot marker) CPT 85379 #FIBRIN DEGR PRODU D-DIMER;QNT	$38.40	$64.00	$3.97–$23.21	69% below	40%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGR PRODUC D-DIMER;QNT	$386.40	$644.00	$3.97–$23.21	217% above	40%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGR PRODUC D-DIMER;QNT	$386.40	$644.00	$3.97–$23.21	217% above	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 #FIBRIN DEGR PRODU D-DIMER;QNT	$38.40	$64.00	$3.97–$23.21	—	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGR PRODUC D-DIMER;QNT	$386.40	$644.00	$3.97–$23.21	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROST-SULF(DHEA-S)	$541.20	$902.00	$7.93–$50.68	269% above	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROST-SULF(DHEA-S)	$541.20	$902.00	$7.93–$50.68	269% above	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROST-SULF(DHEA-S)	$541.20	$902.00	$7.93–$50.68	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TST PRESUMP CHEM ANAL/DAY	$354.00	$590.00	$31.70–$141.68	210% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TST PRESUMP CHEM ANAL/DAY	$354.00	$590.00	$31.70–$141.68	210% above	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TST PRESUMP CHEM ANAL/DAY	$354.00	$590.00	$31.70–$141.68	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$208.80	$348.00	$2.14–$15.98	225% above	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$208.80	$348.00	$2.14–$15.98	225% above	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$208.80	$348.00	$2.14–$15.98	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 #AB;EPSTEIN-BARRVRS VRL CAPSID	$148.80	$248.00	$6.50–$41.36	83% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 #AB;EPSTEIN-BARRVRS VRL CAPSID	$148.80	$248.00	$6.50–$41.36	83% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 AB EB VIRUS VIRAL CAPSID(VCA)	$231.00	$385.00	$6.50–$41.36	183% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 AB EB VIRUS VIRAL CAPSID(VCA)	$231.00	$385.00	$6.50–$41.36	183% above	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 #AB;EPSTEIN-BARRVRS VRL CAPSID	$148.80	$248.00	$6.50–$41.36	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 AB EB VIRUS VIRAL CAPSID(VCA)	$231.00	$385.00	$6.50–$41.36	—	40%
Estradiol blood test CPT 82670 #ESTRADIOL	$105.60	$176.00	$11.90–$63.70	18% below	40%
Estradiol blood test CPT 82670 #ESTRADIOL	$105.60	$176.00	$11.90–$63.70	18% below	40%
Estradiol blood test CPT 82670 ESTRADIOL	$490.80	$818.00	$11.90–$63.70	282% above	40%
Estradiol blood test CPT 82670 ESTRADIOL	$490.80	$818.00	$11.90–$63.70	282% above	40%
Estradiol blood test inpatient CPT 82670 #ESTRADIOL	$105.60	$176.00	$11.90–$63.70	—	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$490.80	$818.00	$11.90–$63.70	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN;FOL STIM HORM;FSH	$413.40	$689.00	$7.93–$42.36	223% above	40%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN;FOL STIM HORM;FSH	$413.40	$689.00	$7.93–$42.36	223% above	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN;FOL STIM HORM;FSH	$413.40	$689.00	$7.93–$42.36	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$358.80	$598.00	$9.60–$44.76	98% above	40%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$358.80	$598.00	$9.60–$44.76	98% above	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$358.80	$598.00	$9.60–$44.76	—	40%
Ferritin blood test (iron stores) CPT 82728 #FERRITIN	$41.40	$69.00	$5.29–$31.08	48% below	40%
Ferritin blood test (iron stores) CPT 82728 #FERRITIN	$41.40	$69.00	$5.29–$31.08	48% below	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$247.80	$413.00	$5.29–$31.08	211% above	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$247.80	$413.00	$5.29–$31.08	211% above	40%
Ferritin blood test (iron stores) inpatient CPT 82728 #FERRITIN	$41.40	$69.00	$5.29–$31.08	—	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$247.80	$413.00	$5.29–$31.08	—	40%
Fibrinogen blood test CPT 85384 #FIBRINOGEN; ACTIVITY	$31.80	$53.00	$3.97–$22.16	47% below	40%
Fibrinogen blood test CPT 85384 #FIBRINOGEN; ACTIVITY	$31.80	$53.00	$3.97–$22.16	47% below	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN; ACTIVITY	$207.00	$345.00	$3.97–$22.16	245% above	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN; ACTIVITY	$207.00	$345.00	$3.97–$22.16	245% above	40%
Fibrinogen blood test inpatient CPT 85384 #FIBRINOGEN; ACTIVITY	$31.80	$53.00	$3.97–$22.16	—	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN; ACTIVITY	$207.00	$345.00	$3.97–$22.16	—	40%
Folate (folic acid) blood test CPT 82746 #FOLIC ACID; SERUM	$55.80	$93.00	$6.95–$33.52	27% below	40%
Folate (folic acid) blood test CPT 82746 #FOLIC ACID; SERUM	$55.80	$93.00	$6.95–$33.52	27% below	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID; SERUM	$255.00	$425.00	$6.95–$33.52	233% above	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID; SERUM	$255.00	$425.00	$6.95–$33.52	233% above	40%
Folate (folic acid) blood test inpatient CPT 82746 #FOLIC ACID; SERUM	$55.80	$93.00	$6.95–$33.52	—	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID; SERUM	$255.00	$425.00	$6.95–$33.52	—	40%
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE T3; FREE	$517.20	$862.00	$8.01–$38.62	291% above	40%
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE T3; FREE	$517.20	$862.00	$8.01–$38.62	291% above	40%
Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE T3; FREE	$517.20	$862.00	$8.01–$38.62	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE; FREE	$304.80	$508.00	$2.65–$20.57	276% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE; FREE	$304.80	$508.00	$2.65–$20.57	276% above	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE; FREE	$304.80	$508.00	$2.65–$20.57	—	40%
Free testosterone test CPT 84402 #TESTOSTERONE; FREE	$78.00	$130.00	$12.04–$58.07	7% below	40%
Free testosterone test CPT 84402 #TESTOSTERONE; FREE	$78.00	$130.00	$12.04–$58.07	7% below	40%
Free testosterone test CPT 84402 TESTOSTERONE; FREE	$403.80	$673.00	$12.04–$58.07	383% above	40%
Free testosterone test CPT 84402 TESTOSTERONE; FREE	$403.80	$673.00	$12.04–$58.07	383% above	40%
Free testosterone test inpatient CPT 84402 #TESTOSTERONE; FREE	$78.00	$130.00	$12.04–$58.07	—	40%
Free testosterone test inpatient CPT 84402 TESTOSTERONE; FREE	$403.80	$673.00	$12.04–$58.07	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 #GLUTAMYLTRANSFERAS GAMMA(GGT)	$21.00	$35.00	$2.65–$16.42	35% below	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 #GLUTAMYLTRANSFERAS GAMMA(GGT)	$21.00	$35.00	$2.65–$16.42	35% below	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE GAMMA(GGT)	$140.40	$234.00	$2.65–$16.42	331% above	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE GAMMA(GGT)	$140.40	$234.00	$2.65–$16.42	331% above	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 #GLUTAMYLTRANSFERAS GAMMA(GGT)	$21.00	$35.00	$2.65–$16.42	—	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GLUTAMYLTRANSFERASE GAMMA(GGT)	$140.40	$234.00	$2.65–$16.42	—	40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$423.60	$706.00	$14.55–$195.16	38% above	40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$423.60	$706.00	$14.55–$195.16	38% above	40%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$423.60	$706.00	$14.55–$195.16	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 #GLUCOSE;POST GLUCOSE DOSE	$83.40	$139.00	$2.25–$10.83	103% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 #GLUCOSE;POST GLUCOSE DOSE	$83.40	$139.00	$2.25–$10.83	103% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE;POST GLUCOSE(INCL GLS)	$130.20	$217.00	$2.25–$10.83	218% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE;POST GLUCOSE(INCL GLS)	$130.20	$217.00	$2.25–$10.83	218% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 #GLUCOSE;POST GLUCOSE DOSE	$83.40	$139.00	$2.25–$10.83	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE;POST GLUCOSE(INCL GLS)	$130.20	$217.00	$2.25–$10.83	—	40%
Glucose tolerance test, 3 samples CPT 82951 #GLUCOSE;TOLERANCE TEST(GTT)	$61.20	$102.00	$4.63–$29.34	17% below	40%
Glucose tolerance test, 3 samples CPT 82951 #GLUCOSE;TOLERANCE TEST(GTT)	$61.20	$102.00	$4.63–$29.34	17% below	40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE;TOLERAN TEST(GTT)3SPEC	$259.80	$433.00	$4.63–$29.34	252% above	40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE;TOLERAN TEST(GTT)3SPEC	$259.80	$433.00	$4.63–$29.34	252% above	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 #GLUCOSE;TOLERANCE TEST(GTT)	$61.20	$102.00	$4.63–$29.34	—	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE;TOLERAN TEST(GTT)3SPEC	$259.80	$433.00	$4.63–$29.34	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 #NEISSERIA GONORRHOEAE AMP PRB	$130.80	$218.00	$16.60–$80.01	34% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 #NEISSERIA GONORRHOEAE AMP PRB	$130.80	$218.00	$16.60–$80.01	34% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE AMPL PRB	$253.20	$422.00	$16.60–$80.01	160% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE AMPL PRB	$253.20	$422.00	$16.60–$80.01	160% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 #NEISSERIA GONORRHOEAE AMP PRB	$130.80	$218.00	$16.60–$80.01	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE AMPL PRB	$253.20	$422.00	$16.60–$80.01	—	40%
H. pylori antibody blood test CPT 86677 ANTIBODY; HELICOBACTER PYLORI	$382.20	$637.00	$5.29–$38.42	296% above	40%
H. pylori antibody blood test CPT 86677 ANTIBODY; HELICOBACTER PYLORI	$382.20	$637.00	$5.29–$38.42	296% above	40%
H. pylori antibody blood test inpatient CPT 86677 ANTIBODY; HELICOBACTER PYLORI	$382.20	$637.00	$5.29–$38.42	—	40%
H. pylori stool antigen test CPT 87338 EIA HELICOBACTER PYLORI STOOL	$203.40	$339.00	$6.49–$32.79	55% above	40%
H. pylori stool antigen test CPT 87338 EIA HELICOBACTER PYLORI STOOL	$203.40	$339.00	$6.49–$32.79	55% above	40%
H. pylori stool antigen test inpatient CPT 87338 EIA HELICOBACTER PYLORI STOOL	$203.40	$339.00	$6.49–$32.79	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANTIFY	$655.20	$1,092.00	$40.25–$194.03	85% above	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANTIFY	$655.20	$1,092.00	$40.25–$194.03	85% above	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANTIFY	$655.20	$1,092.00	$40.25–$194.03	—	40%
HIV-1 and HIV-2 antibody test CPT 86703 IBC HIV-1/HIV-2 SINGLE ASSAY	$50.40	$84.00	$5.29–$31.26	16% below	40%
HIV-1 and HIV-2 antibody test CPT 86703 IBC HIV-1/HIV-2 SINGLE ASSAY	$50.40	$84.00	$5.29–$31.26	16% below	40%
HIV-1 and HIV-2 antibody test CPT 86703 #AB;HIV-1+HIV-2 SINGLE ASSAY	$60.00	$100.00	$5.29–$31.26	at median	40%
HIV-1 and HIV-2 antibody test CPT 86703 #AB;HIV-1+HIV-2 SINGLE ASSAY	$60.00	$100.00	$5.29–$31.26	at median	40%
HIV-1 and HIV-2 antibody test CPT 86703 ANTIBD;HIV-1+HIV-2 SNGL ASSAY	$223.80	$373.00	$5.29–$31.26	273% above	40%
HIV-1 and HIV-2 antibody test CPT 86703 ANTIBD;HIV-1+HIV-2 SNGL ASSAY	$223.80	$373.00	$5.29–$31.26	273% above	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 IBC HIV-1/HIV-2 SINGLE ASSAY	$50.40	$84.00	$5.29–$31.26	—	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 #AB;HIV-1+HIV-2 SINGLE ASSAY	$60.00	$100.00	$5.29–$31.26	—	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 ANTIBD;HIV-1+HIV-2 SNGL ASSAY	$223.80	$373.00	$5.29–$31.26	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 #HIV-1 AG W/HIV-1 & HIV-2 AB	$58.20	$97.00	$8.62–$54.90	2% below	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 #HIV-1 AG W/HIV-1 & HIV-2 AB	$58.20	$97.00	$8.62–$54.90	2% below	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$190.20	$317.00	$8.62–$54.90	219% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$190.20	$317.00	$8.62–$54.90	219% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 #HIV-1 AG W/HIV-1 & HIV-2 AB	$58.20	$97.00	$8.62–$54.90	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$190.20	$317.00	$8.62–$54.90	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 #HPV HIGH-RISK TYPES	$102.60	$171.00	$19.10–$80.01	2% below	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 #HPV HIGH-RISK TYPES	$102.60	$171.00	$19.10–$80.01	2% below	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH-RISK TYPES	$295.20	$492.00	$19.10–$80.01	183% above	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH-RISK TYPES	$295.20	$492.00	$19.10–$80.01	183% above	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 #HPV HIGH-RISK TYPES	$102.60	$171.00	$19.10–$80.01	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH-RISK TYPES	$295.20	$492.00	$19.10–$80.01	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN; GLYCATED	$250.80	$418.00	$3.97–$22.14	284% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN; GLYCATED	$250.80	$418.00	$3.97–$22.14	284% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN; GLYCATED	$250.80	$418.00	$3.97–$22.14	—	40%
Hemoglobin blood test CPT 85018 #HEMOGLOBIN	$41.40	$69.00	$1.32–$5.40	125% above	40%
Hemoglobin blood test CPT 85018 #HEMOGLOBIN	$41.40	$69.00	$1.32–$5.40	125% above	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$63.60	$106.00	$1.32–$5.40	246% above	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$63.60	$106.00	$1.32–$5.40	246% above	40%
Hemoglobin blood test inpatient CPT 85018 #HEMOGLOBIN	$41.40	$69.00	$1.32–$5.40	—	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$63.60	$106.00	$1.32–$5.40	—	40%
Hepatitis B core antibody test (total) CPT 86704 IBC HEP B CORE ANTIBODY TOTAL	$43.20	$72.00	$5.70–$27.47	35% below	40%
Hepatitis B core antibody test (total) CPT 86704 IBC HEP B CORE ANTIBODY TOTAL	$43.20	$72.00	$5.70–$27.47	35% below	40%
Hepatitis B core antibody test (total) CPT 86704 #HEPATITIS B CORE AB(HBCAB)TTL	$51.60	$86.00	$5.70–$27.47	23% below	40%
Hepatitis B core antibody test (total) CPT 86704 #HEPATITIS B CORE AB(HBCAB)TTL	$51.60	$86.00	$5.70–$27.47	23% below	40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB(HBCAB);TTL	$223.80	$373.00	$5.70–$27.47	235% above	40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB(HBCAB);TTL	$223.80	$373.00	$5.70–$27.47	235% above	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 IBC HEP B CORE ANTIBODY TOTAL	$43.20	$72.00	$5.70–$27.47	—	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 #HEPATITIS B CORE AB(HBCAB)TTL	$51.60	$86.00	$5.70–$27.47	—	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB(HBCAB);TTL	$223.80	$373.00	$5.70–$27.47	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 #HEPATITIS B SURFACE AB (HBSAB)	$27.60	$46.00	$5.08–$24.49	58% below	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 #HEPATITIS B SURFACE AB (HBSAB)	$27.60	$46.00	$5.08–$24.49	58% below	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB (HBSAB)	$217.20	$362.00	$5.08–$24.49	232% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB (HBSAB)	$217.20	$362.00	$5.08–$24.49	232% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 #HEPATITIS B SURFACE AB (HBSAB)	$27.60	$46.00	$5.08–$24.49	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB (HBSAB)	$217.20	$362.00	$5.08–$24.49	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 #EIA QL/SMQN MULTI STEP;HEP B	$28.80	$48.00	$4.40–$23.55	53% below	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 #EIA QL/SMQN MULTI STEP;HEP B	$28.80	$48.00	$4.40–$23.55	53% below	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 EIA QL/SEMIQNT HEPAT B SURF AG	$208.80	$348.00	$4.40–$23.55	242% above	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 EIA QL/SEMIQNT HEPAT B SURF AG	$208.80	$348.00	$4.40–$23.55	242% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 #EIA QL/SMQN MULTI STEP;HEP B	$28.80	$48.00	$4.40–$23.55	—	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 EIA QL/SEMIQNT HEPAT B SURF AG	$208.80	$348.00	$4.40–$23.55	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 IBC HEPATITIS C ANTIBODY	$51.60	$86.00	$5.29–$32.54	48% below	40%
Hepatitis C antibody blood test (screening) CPT 86803 IBC HEPATITIS C ANTIBODY	$51.60	$86.00	$5.29–$32.54	48% below	40%
Hepatitis C antibody blood test (screening) CPT 86803 #HEPATITIS C ANTIBODY	$61.20	$102.00	$5.29–$32.54	39% below	40%
Hepatitis C antibody blood test (screening) CPT 86803 #HEPATITIS C ANTIBODY	$61.20	$102.00	$5.29–$32.54	39% below	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$316.20	$527.00	$5.29–$32.54	217% above	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$316.20	$527.00	$5.29–$32.54	217% above	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 IBC HEPATITIS C ANTIBODY	$51.60	$86.00	$5.29–$32.54	—	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 #HEPATITIS C ANTIBODY	$61.20	$102.00	$5.29–$32.54	—	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$316.20	$527.00	$5.29–$32.54	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 #HEPATITIS C VIRUS QUANTIFY	$138.60	$231.00	$20.26–$97.68	38% below	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 #HEPATITIS C VIRUS QUANTIFY	$138.60	$231.00	$20.26–$97.68	38% below	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRUS QUANTIFY	$907.20	$1,512.00	$20.26–$97.68	305% above	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRUS QUANTIFY	$907.20	$1,512.00	$20.26–$97.68	305% above	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 #HEPATITIS C VIRUS QUANTIFY	$138.60	$231.00	$20.26–$97.68	—	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRUS QUANTIFY	$907.20	$1,512.00	$20.26–$97.68	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 #ANTIBODY;HERPES SIMPLEX TYPE1	$38.40	$64.00	$5.29–$30.07	24% below	40%
Herpes blood test, HSV-1 antibody CPT 86695 #ANTIBODY;HERPES SIMPLEX TYPE1	$38.40	$64.00	$5.29–$30.07	24% below	40%
Herpes blood test, HSV-1 antibody CPT 86695 ANTIBODY;HERPES SIMPLEX TYPE I	$172.20	$287.00	$5.29–$30.07	240% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 ANTIBODY;HERPES SIMPLEX TYPE I	$172.20	$287.00	$5.29–$30.07	240% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 #ANTIBODY;HERPES SIMPLEX TYPE1	$38.40	$64.00	$5.29–$30.07	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANTIBODY;HERPES SIMPLEX TYPE I	$172.20	$287.00	$5.29–$30.07	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 #ANTIBODY;HERPES SIMPLEX TYPE2	$72.60	$121.00	$9.16–$44.12	at median	40%
Herpes blood test, HSV-2 antibody CPT 86696 #ANTIBODY;HERPES SIMPLEX TYPE2	$72.60	$121.00	$9.16–$44.12	at median	40%
Herpes blood test, HSV-2 antibody CPT 86696 ANTIBODY;HERPES SIMPLEX TYPE 2	$198.60	$331.00	$9.16–$44.12	174% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 ANTIBODY;HERPES SIMPLEX TYPE 2	$198.60	$331.00	$9.16–$44.12	174% above	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 #ANTIBODY;HERPES SIMPLEX TYPE2	$72.60	$121.00	$9.16–$44.12	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTIBODY;HERPES SIMPLEX TYPE 2	$198.60	$331.00	$9.16–$44.12	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 #C-REACTIVE PROTN;HIGH SENSIT	$49.20	$82.00	$6.12–$29.97	33% below	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 #C-REACTIVE PROTN;HIGH SENSIT	$49.20	$82.00	$6.12–$29.97	33% below	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROT;HIGH SEN;HSCRP	$217.80	$363.00	$6.12–$29.97	195% above	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROT;HIGH SEN;HSCRP	$217.80	$363.00	$6.12–$29.97	195% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 #C-REACTIVE PROTN;HIGH SENSIT	$49.20	$82.00	$6.12–$29.97	—	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROT;HIGH SEN;HSCRP	$217.80	$363.00	$6.12–$29.97	—	40%
Homocysteine blood test CPT 83090 #HOMOCYSTINE	$353.40	$589.00	$8.33–$40.86	172% above	40%
Homocysteine blood test CPT 83090 #HOMOCYSTINE	$353.40	$589.00	$8.33–$40.86	172% above	40%
Homocysteine blood test CPT 83090 HOMOCYSTINE	$548.40	$914.00	$8.33–$40.86	322% above	40%
Homocysteine blood test CPT 83090 HOMOCYSTINE	$548.40	$914.00	$8.33–$40.86	322% above	40%
Homocysteine blood test inpatient CPT 83090 #HOMOCYSTINE	$353.40	$589.00	$8.33–$40.86	—	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE	$548.40	$914.00	$8.33–$40.86	—	40%
Insulin blood test CPT 83525 #INSULIN; TOTAL	$36.60	$61.00	$5.29–$26.06	49% below	40%
Insulin blood test CPT 83525 #INSULIN; TOTAL	$36.60	$61.00	$5.29–$26.06	49% below	40%
Insulin blood test CPT 83525 INSULIN; TOTAL	$85.80	$143.00	$5.29–$26.06	20% above	40%
Insulin blood test CPT 83525 INSULIN; TOTAL	$85.80	$143.00	$5.29–$26.06	20% above	40%
Insulin blood test inpatient CPT 83525 #INSULIN; TOTAL	$36.60	$61.00	$5.29–$26.06	—	40%
Insulin blood test inpatient CPT 83525 INSULIN; TOTAL	$85.80	$143.00	$5.29–$26.06	—	40%
Iron blood test (serum iron) CPT 83540 #IRON	$88.20	$147.00	$2.65–$14.75	84% above	40%
Iron blood test (serum iron) CPT 83540 #IRON	$88.20	$147.00	$2.65–$14.75	84% above	40%
Iron blood test (serum iron) CPT 83540 IRON	$136.80	$228.00	$2.65–$14.75	185% above	40%
Iron blood test (serum iron) CPT 83540 IRON	$136.80	$228.00	$2.65–$14.75	185% above	40%
Iron blood test (serum iron) inpatient CPT 83540 #IRON	$88.20	$147.00	$2.65–$14.75	—	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$136.80	$228.00	$2.65–$14.75	—	40%
Iron-binding capacity (TIBC) test CPT 83550 #IRON BINDING CAPACITY	$33.00	$55.00	$3.97–$19.93	25% below	40%
Iron-binding capacity (TIBC) test CPT 83550 #IRON BINDING CAPACITY	$33.00	$55.00	$3.97–$19.93	25% below	40%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$63.60	$106.00	$3.97–$19.93	44% above	40%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$63.60	$106.00	$3.97–$19.93	44% above	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 #IRON BINDING CAPACITY	$33.00	$55.00	$3.97–$19.93	—	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$63.60	$106.00	$3.97–$19.93	—	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$316.80	$528.00	$4.11–$19.79	213% above	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$316.80	$528.00	$4.11–$19.79	213% above	40%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$316.80	$528.00	$4.11–$19.79	—	40%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN;LUTEINIZ HORM(LH)	$430.20	$717.00	$7.93–$42.23	203% above	40%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN;LUTEINIZ HORM(LH)	$430.20	$717.00	$7.93–$42.23	203% above	40%
LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN;LUTEINIZ HORM(LH)	$430.20	$717.00	$7.93–$42.23	—	40%
Lactate (lactic acid) blood test CPT 83605 #LACTATE (LACTIC ACID)	$88.80	$148.00	$3.97–$26.38	1% below	40%
Lactate (lactic acid) blood test CPT 83605 #LACTATE (LACTIC ACID)	$88.80	$148.00	$3.97–$26.38	1% below	40%
Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID)	$217.20	$362.00	$3.97–$26.38	141% above	40%
Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID)	$217.20	$362.00	$3.97–$26.38	141% above	40%
Lactate (lactic acid) blood test inpatient CPT 83605 #LACTATE (LACTIC ACID)	$88.80	$148.00	$3.97–$26.38	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE (LACTIC ACID)	$217.20	$362.00	$3.97–$26.38	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 #LACTATE DEHYDROGENASE;LD/LDH	$65.40	$109.00	$2.86–$13.77	53% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 #LACTATE DEHYDROGENASE;LD/LDH	$65.40	$109.00	$2.86–$13.77	53% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE(LD/LDH)	$101.40	$169.00	$2.86–$13.77	137% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE(LD/LDH)	$101.40	$169.00	$2.86–$13.77	137% above	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 #LACTATE DEHYDROGENASE;LD/LDH	$65.40	$109.00	$2.86–$13.77	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE(LD/LDH)	$101.40	$169.00	$2.86–$13.77	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$174.60	$291.00	$3.23–$15.71	97% above	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$174.60	$291.00	$3.23–$15.71	97% above	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$174.60	$291.00	$3.23–$15.71	—	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$241.20	$402.00	$2.99–$18.63	155% above	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$241.20	$402.00	$2.99–$18.63	155% above	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$241.20	$402.00	$2.99–$18.63	—	40%
Lyme disease antibody test CPT 86618 AB BORRELIA BURGDORFE;LYME DIS	$213.60	$356.00	$5.29–$38.83	74% above	40%
Lyme disease antibody test CPT 86618 AB BORRELIA BURGDORFE;LYME DIS	$213.60	$356.00	$5.29–$38.83	74% above	40%
Lyme disease antibody test CPT 86618 #AB BORRELIA BURGDOR(LYME DIS)	$216.00	$360.00	$5.29–$38.83	75% above	40%
Lyme disease antibody test CPT 86618 #AB BORRELIA BURGDOR(LYME DIS)	$216.00	$360.00	$5.29–$38.83	75% above	40%
Lyme disease antibody test inpatient CPT 86618 AB BORRELIA BURGDORFE;LYME DIS	$213.60	$356.00	$5.29–$38.83	—	40%
Lyme disease antibody test inpatient CPT 86618 #AB BORRELIA BURGDOR(LYME DIS)	$216.00	$360.00	$5.29–$38.83	—	40%
Magnesium blood test CPT 83735 #MAGNESIUM	$93.60	$156.00	$2.73–$15.28	97% above	40%
Magnesium blood test CPT 83735 #MAGNESIUM	$93.60	$156.00	$2.73–$15.28	97% above	40%
Magnesium blood test CPT 83735 MAGNESIUM	$145.20	$242.00	$2.73–$15.28	205% above	40%
Magnesium blood test CPT 83735 MAGNESIUM	$145.20	$242.00	$2.73–$15.28	205% above	40%
Magnesium blood test inpatient CPT 83735 #MAGNESIUM	$93.60	$156.00	$2.73–$15.28	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$145.20	$242.00	$2.73–$15.28	—	40%
Measles (rubeola) antibody test CPT 86765 #ANTIBODY; RUBEOLA	$109.20	$182.00	$3.97–$29.37	39% above	40%
Measles (rubeola) antibody test CPT 86765 #ANTIBODY; RUBEOLA	$109.20	$182.00	$3.97–$29.37	39% above	40%
Measles (rubeola) antibody test CPT 86765 ANTIBODY; RUBEOLA	$142.20	$237.00	$3.97–$29.37	81% above	40%
Measles (rubeola) antibody test CPT 86765 ANTIBODY; RUBEOLA	$142.20	$237.00	$3.97–$29.37	81% above	40%
Measles (rubeola) antibody test inpatient CPT 86765 #ANTIBODY; RUBEOLA	$109.20	$182.00	$3.97–$29.37	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY; RUBEOLA	$142.20	$237.00	$3.97–$29.37	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 #HETEROPHILE AB;SCRNING	$105.60	$176.00	$2.45–$11.81	36% above	40%
Mono test (heterophile antibody, Monospot) CPT 86308 #HETEROPHILE AB;SCRNING	$105.60	$176.00	$2.45–$11.81	36% above	40%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB;SCRNING	$162.60	$271.00	$2.45–$11.81	109% above	40%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB;SCRNING	$162.60	$271.00	$2.45–$11.81	109% above	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 #HETEROPHILE AB;SCRNING	$105.60	$176.00	$2.45–$11.81	—	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE AB;SCRNING	$162.60	$271.00	$2.45–$11.81	—	40%
Mumps immunity blood test CPT 86735 #ANTIBODY; MUMPS	$93.00	$155.00	$5.29–$29.75	22% above	40%
Mumps immunity blood test CPT 86735 #ANTIBODY; MUMPS	$93.00	$155.00	$5.29–$29.75	22% above	40%
Mumps immunity blood test CPT 86735 ANTIBODY; MUMPS	$144.60	$241.00	$5.29–$29.75	90% above	40%
Mumps immunity blood test CPT 86735 ANTIBODY; MUMPS	$144.60	$241.00	$5.29–$29.75	90% above	40%
Mumps immunity blood test inpatient CPT 86735 #ANTIBODY; MUMPS	$93.00	$155.00	$5.29–$29.75	—	40%
Mumps immunity blood test inpatient CPT 86735 ANTIBODY; MUMPS	$144.60	$241.00	$5.29–$29.75	—	40%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$384.00	$640.00	$13.22–$109.01	19% above	40%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$384.00	$640.00	$13.22–$109.01	19% above	40%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$384.00	$640.00	$13.22–$109.01	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 #PROSTATE SPECIFIC AG/PSA;FREE	$69.60	$116.00	$8.70–$41.93	at median	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 #PROSTATE SPECIFIC AG/PSA;FREE	$69.60	$116.00	$8.70–$41.93	at median	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATE SPECIFIC AG(PSA);FREE	$140.40	$234.00	$8.70–$41.93	102% above	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATE SPECIFIC AG(PSA);FREE	$140.40	$234.00	$8.70–$41.93	102% above	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 #PROSTATE SPECIFIC AG/PSA;FREE	$69.60	$116.00	$8.70–$41.93	—	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PROSTATE SPECIFIC AG(PSA);FREE	$140.40	$234.00	$8.70–$41.93	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 #PROSTATE SPECIFIC AG(PSA);TTL	$69.60	$116.00	$6.61–$41.93	13% below	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 #PROSTATE SPECIFIC AG(PSA);TTL	$69.60	$116.00	$6.61–$41.93	13% below	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC AG(PSA);TTL	$352.80	$588.00	$6.61–$41.93	343% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC AG(PSA);TTL	$352.80	$588.00	$6.61–$41.93	343% above	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 #PROSTATE SPECIFIC AG(PSA);TTL	$69.60	$116.00	$6.61–$41.93	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC AG(PSA);TTL	$352.80	$588.00	$6.61–$41.93	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 #CYTHOP CERV/VAG THIN LAYER PR	$90.00	$150.00	$14.32–$60.67	8% above	40%
Pap test (liquid-based, automated screening with review) CPT 88175 #CYTHOP CERV/VAG THIN LAYER PR	$90.00	$150.00	$14.32–$60.67	8% above	40%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTHOP CERV/VAG AUTO+MAN SCRN	$211.20	$352.00	$14.32–$60.67	154% above	40%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTHOP CERV/VAG AUTO+MAN SCRN	$211.20	$352.00	$14.32–$60.67	154% above	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 #CYTHOP CERV/VAG THIN LAYER PR	$90.00	$150.00	$14.32–$60.67	—	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTHOP CERV/VAG AUTO+MAN SCRN	$211.20	$352.00	$14.32–$60.67	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 #CYTHOP CER/VAG AU THINLR;SCRN	$71.40	$119.00	$11.48–$46.19	2% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 #CYTHOP CER/VAG AU THINLR;SCRN	$71.40	$119.00	$11.48–$46.19	2% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTHOP CERV/VAG AUT THIN LAYER	$175.80	$293.00	$11.48–$46.19	152% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTHOP CERV/VAG AUT THIN LAYER	$175.80	$293.00	$11.48–$46.19	152% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 #CYTHOP CER/VAG AU THINLR;SCRN	$71.40	$119.00	$11.48–$46.19	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTHOP CERV/VAG AUT THIN LAYER	$175.80	$293.00	$11.48–$46.19	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 #PARATHRMN(PARATHYROID HRMN)	$196.20	$327.00	$18.52–$94.12	2% above	40%
Parathyroid hormone (PTH) blood test CPT 83970 #PARATHRMN(PARATHYROID HRMN)	$196.20	$327.00	$18.52–$94.12	2% above	40%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE(PARATHYROID HORM)	$305.40	$509.00	$18.52–$94.12	59% above	40%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE(PARATHYROID HORM)	$305.40	$509.00	$18.52–$94.12	59% above	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 #PARATHRMN(PARATHYROID HRMN)	$196.20	$327.00	$18.52–$94.12	—	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE(PARATHYROID HORM)	$305.40	$509.00	$18.52–$94.12	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 #THROMBOPLAST PTT;PLSM/WHL BLD	$94.80	$158.00	$2.65–$13.70	90% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 #THROMBOPLAST PTT;PLSM/WHL BLD	$94.80	$158.00	$2.65–$13.70	90% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PTT;PLASMA	$147.00	$245.00	$2.65–$13.70	194% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PTT;PLASMA	$147.00	$245.00	$2.65–$13.70	194% above	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 #THROMBOPLAST PTT;PLSM/WHL BLD	$94.80	$158.00	$2.65–$13.70	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PTT;PLASMA	$147.00	$245.00	$2.65–$13.70	—	40%
Phosphorus (phosphate) blood test CPT 84100 #PHOSPHORUS INORGAN(PHOSPHATE)	$62.40	$104.00	$2.24–$10.81	118% above	40%
Phosphorus (phosphate) blood test CPT 84100 #PHOSPHORUS INORGAN(PHOSPHATE)	$62.40	$104.00	$2.24–$10.81	118% above	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS INORGANIC-PHOSPHATE	$98.40	$164.00	$2.24–$10.81	243% above	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS INORGANIC-PHOSPHATE	$98.40	$164.00	$2.24–$10.81	243% above	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 #PHOSPHORUS INORGAN(PHOSPHATE)	$62.40	$104.00	$2.24–$10.81	—	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS INORGANIC-PHOSPHATE	$98.40	$164.00	$2.24–$10.81	—	40%
Potassium blood test CPT 84132 #POTASSIUM; SERUM	$52.20	$87.00	$2.17–$10.85	83% above	40%
Potassium blood test CPT 84132 #POTASSIUM; SERUM	$52.20	$87.00	$2.17–$10.85	83% above	40%
Potassium blood test CPT 84132 POTASSIUM; SERUM	$82.80	$138.00	$2.17–$10.85	190% above	40%
Potassium blood test CPT 84132 POTASSIUM; SERUM	$82.80	$138.00	$2.17–$10.85	190% above	40%
Potassium blood test inpatient CPT 84132 #POTASSIUM; SERUM	$52.20	$87.00	$2.17–$10.85	—	40%
Potassium blood test inpatient CPT 84132 POTASSIUM; SERUM	$82.80	$138.00	$2.17–$10.85	—	40%
Progesterone blood test CPT 84144 PROGESTERONE	$444.60	$741.00	$5.29–$47.56	223% above	40%
Progesterone blood test CPT 84144 PROGESTERONE	$444.60	$741.00	$5.29–$47.56	223% above	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$444.60	$741.00	$5.29–$47.56	—	40%
Prolactin blood test CPT 84146 #PROLACTIN	$41.40	$69.00	$9.17–$44.19	59% below	40%
Prolactin blood test CPT 84146 #PROLACTIN	$41.40	$69.00	$9.17–$44.19	59% below	40%
Prolactin blood test CPT 84146 PROLACTIN	$407.40	$679.00	$9.17–$44.19	305% above	40%
Prolactin blood test CPT 84146 PROLACTIN	$407.40	$679.00	$9.17–$44.19	305% above	40%
Prolactin blood test inpatient CPT 84146 #PROLACTIN	$41.40	$69.00	$9.17–$44.19	—	40%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$407.40	$679.00	$9.17–$44.19	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 #PROTHROMBIN TIME	$71.40	$119.00	$1.32–$9.78	169% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 #PROTHROMBIN TIME	$71.40	$119.00	$1.32–$9.78	169% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$111.60	$186.00	$1.32–$9.78	321% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$111.60	$186.00	$1.32–$9.78	321% above	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 #PROTHROMBIN TIME	$71.40	$119.00	$1.32–$9.78	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$111.60	$186.00	$1.32–$9.78	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TST PRESUMP DIR OPTICAL	$354.00	$590.00	$5.94–$28.73	256% above	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TST PRESUMP DIR OPTICAL	$354.00	$590.00	$5.94–$28.73	256% above	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TST PRESUMP DIR OPTICAL	$354.00	$590.00	$5.94–$28.73	—	40%
Rapid flu test (influenza antigen) CPT 87804 #INFCTAGNT IMMUNOAS DIR;INFLZ	$57.60	$96.00	$15.83–$37.73	10% above	40%
Rapid flu test (influenza antigen) CPT 87804 #INFCTAGNT IMMUNOAS DIR;INFLZ	$57.60	$96.00	$15.83–$37.73	10% above	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 #INFCTAGNT IMMUNOAS DIR;INFLZ	$57.60	$96.00	$15.83–$37.73	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 INFECTAGNT IMMUN DIROBS;STREPO	$120.00	$200.00	$15.83–$37.69	54% above	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 INFECTAGNT IMMUN DIROBS;STREPO	$120.00	$200.00	$15.83–$37.69	54% above	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 INFECTAGNT IMMUN DIROBS;STREPO	$120.00	$200.00	$15.83–$37.69	—	40%
Renin blood test CPT 84244 #RENIN	$82.80	$138.00	$8.21–$50.14	25% below	40%
Renin blood test CPT 84244 #RENIN	$82.80	$138.00	$8.21–$50.14	25% below	40%
Renin blood test CPT 84244 RENIN	$468.00	$780.00	$8.21–$50.14	322% above	40%
Renin blood test CPT 84244 RENIN	$468.00	$780.00	$8.21–$50.14	322% above	40%
Renin blood test inpatient CPT 84244 #RENIN	$82.80	$138.00	$8.21–$50.14	—	40%
Renin blood test inpatient CPT 84244 RENIN	$468.00	$780.00	$8.21–$50.14	—	40%
Rh blood typing CPT 86901 #BLOOD TYPING; RH (D)	$13.80	$23.00	$1.48–$7.93	64% below	40%
Rh blood typing CPT 86901 #BLOOD TYPING; RH (D)	$13.80	$23.00	$1.48–$7.93	64% below	40%
Rh blood typing CPT 86901 BLOOD TYPING; RH (D)	$75.60	$126.00	$1.48–$7.93	96% above	40%
Rh blood typing CPT 86901 BLOOD TYPING; RH (D)	$75.60	$126.00	$1.48–$7.93	96% above	40%
Rh blood typing inpatient CPT 86901 #BLOOD TYPING; RH (D)	$13.80	$23.00	$1.48–$7.93	—	40%
Rh blood typing inpatient CPT 86901 BLOOD TYPING; RH (D)	$75.60	$126.00	$1.48–$7.93	—	40%
Rheumatoid factor (RF) test CPT 86431 #RHEUMATOID FACTOR;QUANT	$128.40	$214.00	$2.68–$12.93	163% above	40%
Rheumatoid factor (RF) test CPT 86431 #RHEUMATOID FACTOR;QUANT	$128.40	$214.00	$2.68–$12.93	163% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR;QUANTITATIVE	$199.20	$332.00	$2.68–$12.93	309% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR;QUANTITATIVE	$199.20	$332.00	$2.68–$12.93	309% above	40%
Rheumatoid factor (RF) test inpatient CPT 86431 #RHEUMATOID FACTOR;QUANT	$128.40	$214.00	$2.68–$12.93	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR;QUANTITATIVE	$199.20	$332.00	$2.68–$12.93	—	40%
Rubella antibody test (immunity check) CPT 86762 #ANTIBODY; RUBELLA	$66.60	$111.00	$5.29–$32.81	at median	40%
Rubella antibody test (immunity check) CPT 86762 #ANTIBODY; RUBELLA	$66.60	$111.00	$5.29–$32.81	at median	40%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY; RUBELLA	$214.20	$357.00	$5.29–$32.81	222% above	40%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY; RUBELLA	$214.20	$357.00	$5.29–$32.81	222% above	40%
Rubella antibody test (immunity check) inpatient CPT 86762 #ANTIBODY; RUBELLA	$66.60	$111.00	$5.29–$32.81	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY; RUBELLA	$214.20	$357.00	$5.29–$32.81	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENT RATE ERYTHROCYTE;AUTM	$128.40	$214.00	$2.00–$6.16	229% above	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENT RATE ERYTHROCYTE;AUTM	$128.40	$214.00	$2.00–$6.16	229% above	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENT RATE ERYTHROCYTE;AUTM	$128.40	$214.00	$2.00–$6.16	—	40%
Sodium blood test CPT 84295 #SODIUM; SERUM	$58.80	$98.00	$2.28–$10.97	61% above	40%
Sodium blood test CPT 84295 #SODIUM; SERUM	$58.80	$98.00	$2.28–$10.97	61% above	40%
Sodium blood test CPT 84295 SODIUM; SERUM	$90.60	$151.00	$2.28–$10.97	148% above	40%
Sodium blood test CPT 84295 SODIUM; SERUM	$90.60	$151.00	$2.28–$10.97	148% above	40%
Sodium blood test inpatient CPT 84295 #SODIUM; SERUM	$58.80	$98.00	$2.28–$10.97	—	40%
Sodium blood test inpatient CPT 84295 SODIUM; SERUM	$90.60	$151.00	$2.28–$10.97	—	40%
Stool ova and parasites exam CPT 87177 #OVA+PARASITES DIR SMEARS	$33.60	$56.00	$3.97–$20.29	31% below	40%
Stool ova and parasites exam CPT 87177 #OVA+PARASITES DIR SMEARS	$33.60	$56.00	$3.97–$20.29	31% below	40%
Stool ova and parasites exam CPT 87177 OVA+PARASITES DIR SMEARS CO+ID	$226.20	$377.00	$3.97–$20.29	366% above	40%
Stool ova and parasites exam CPT 87177 OVA+PARASITES DIR SMEARS CO+ID	$226.20	$377.00	$3.97–$20.29	366% above	40%
Stool ova and parasites exam inpatient CPT 87177 #OVA+PARASITES DIR SMEARS	$33.60	$56.00	$3.97–$20.29	—	40%
Stool ova and parasites exam inpatient CPT 87177 OVA+PARASITES DIR SMEARS CO+ID	$226.20	$377.00	$3.97–$20.29	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLD OCCULT FEC SCR COLOREC NEO	$81.00	$135.00	$1.32–$9.99	125% above	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLD OCCULT FEC SCR COLOREC NEO	$81.00	$135.00	$1.32–$9.99	125% above	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLD OCCULT FEC SCR COLOREC NEO	$81.00	$135.00	$1.32–$9.99	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLOOD OCCULT FECES DX BY FE	$106.20	$177.00	$7.86–$36.30	105% above	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLOOD OCCULT FECES DX BY FE	$106.20	$177.00	$7.86–$36.30	105% above	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLOOD OCCULT FECES DX BY FE	$106.20	$177.00	$7.86–$36.30	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 #ANTIBODY; TREPONEMA PALLIDUM	$24.00	$40.00	$2.49–$30.19	65% below	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 #ANTIBODY; TREPONEMA PALLIDUM	$24.00	$40.00	$2.49–$30.19	65% below	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 ANTIBODY; TREPONEMA PALLIDUM	$87.60	$146.00	$2.49–$30.19	30% above	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 ANTIBODY; TREPONEMA PALLIDUM	$87.60	$146.00	$2.49–$30.19	30% above	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 #ANTIBODY; TREPONEMA PALLIDUM	$24.00	$40.00	$2.49–$30.19	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 ANTIBODY; TREPONEMA PALLIDUM	$87.60	$146.00	$2.49–$30.19	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 IBC BLOOD SEROLOGY QUAL	$61.80	$103.00	$1.32–$9.74	52% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 IBC BLOOD SEROLOGY QUAL	$61.80	$103.00	$1.32–$9.74	52% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 #SYPHILIS TEST; QUALITATIVE	$73.20	$122.00	$1.32–$9.74	80% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 #SYPHILIS TEST; QUALITATIVE	$73.20	$122.00	$1.32–$9.74	80% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST QUALITATIVE	$114.60	$191.00	$1.32–$9.74	181% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST QUALITATIVE	$114.60	$191.00	$1.32–$9.74	181% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 IBC BLOOD SEROLOGY QUAL	$61.80	$103.00	$1.32–$9.74	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 #SYPHILIS TEST; QUALITATIVE	$73.20	$122.00	$1.32–$9.74	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST QUALITATIVE	$114.60	$191.00	$1.32–$9.74	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST;GAMMA INTERFERON	$332.40	$554.00	$30.61–$141.31	125% above	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST;GAMMA INTERFERON	$332.40	$554.00	$30.61–$141.31	125% above	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST;GAMMA INTERFERON	$332.40	$554.00	$30.61–$141.31	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 #TESTOSTERONE; TOTAL	$96.00	$160.00	$9.64–$58.85	19% below	40%
Testosterone blood test, total (not free testosterone) CPT 84403 #TESTOSTERONE; TOTAL	$96.00	$160.00	$9.64–$58.85	19% below	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE; TOTAL	$410.40	$684.00	$9.64–$58.85	245% above	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE; TOTAL	$410.40	$684.00	$9.64–$58.85	245% above	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 #TESTOSTERONE; TOTAL	$96.00	$160.00	$9.64–$58.85	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE; TOTAL	$410.40	$684.00	$9.64–$58.85	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 #MICROSOMAL ANTIBODIES EACH	$136.80	$228.00	$6.61–$33.17	48% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 #MICROSOMAL ANTIBODIES EACH	$136.80	$228.00	$6.61–$33.17	48% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES EACH	$214.20	$357.00	$6.61–$33.17	131% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES EACH	$214.20	$357.00	$6.61–$33.17	131% above	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 #MICROSOMAL ANTIBODIES EACH	$136.80	$228.00	$6.61–$33.17	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES EACH	$214.20	$357.00	$6.61–$33.17	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 #THYROID STIMULAT HORMONE(TSH)	$81.60	$136.00	$5.29–$38.30	at median	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 #THYROID STIMULAT HORMONE(TSH)	$81.60	$136.00	$5.29–$38.30	at median	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULAT HORMONE(TSH)	$301.20	$502.00	$5.29–$38.30	269% above	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULAT HORMONE(TSH)	$301.20	$502.00	$5.29–$38.30	269% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 #THYROID STIMULAT HORMONE(TSH)	$81.60	$136.00	$5.29–$38.30	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULAT HORMONE(TSH)	$301.20	$502.00	$5.29–$38.30	—	40%
Total IgE blood test CPT 82785 #GAMMAGLOBULIN; IGE	$62.40	$104.00	$6.61–$37.53	17% below	40%
Total IgE blood test CPT 82785 #GAMMAGLOBULIN; IGE	$62.40	$104.00	$6.61–$37.53	17% below	40%
Total IgE blood test CPT 82785 GAMMAGLOBULIN; IGE	$247.80	$413.00	$6.61–$37.53	230% above	40%
Total IgE blood test CPT 82785 GAMMAGLOBULIN; IGE	$247.80	$413.00	$6.61–$37.53	230% above	40%
Total IgE blood test inpatient CPT 82785 #GAMMAGLOBULIN; IGE	$62.40	$104.00	$6.61–$37.53	—	40%
Total IgE blood test inpatient CPT 82785 GAMMAGLOBULIN; IGE	$247.80	$413.00	$6.61–$37.53	—	40%
Total cholesterol blood test CPT 82465 #CHOLESTEROL SERUM/WHL BLD TTL	$21.60	$36.00	$1.32–$9.92	29% below	40%
Total cholesterol blood test CPT 82465 #CHOLESTEROL SERUM/WHL BLD TTL	$21.60	$36.00	$1.32–$9.92	29% below	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM/WHL BLD TTL	$98.40	$164.00	$1.32–$9.92	221% above	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM/WHL BLD TTL	$98.40	$164.00	$1.32–$9.92	221% above	40%
Total cholesterol blood test inpatient CPT 82465 #CHOLESTEROL SERUM/WHL BLD TTL	$21.60	$36.00	$1.32–$9.92	—	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL SERUM/WHL BLD TTL	$98.40	$164.00	$1.32–$9.92	—	40%
Total thyroxine (T4) blood test CPT 84436 #THYROXINE; TOTAL	$38.40	$64.00	$2.65–$15.66	19% below	40%
Total thyroxine (T4) blood test CPT 84436 #THYROXINE; TOTAL	$38.40	$64.00	$2.65–$15.66	19% below	40%
Total thyroxine (T4) blood test CPT 84436 THYROXINE; TOTAL	$172.20	$287.00	$2.65–$15.66	263% above	40%
Total thyroxine (T4) blood test CPT 84436 THYROXINE; TOTAL	$172.20	$287.00	$2.65–$15.66	263% above	40%
Total thyroxine (T4) blood test inpatient CPT 84436 #THYROXINE; TOTAL	$38.40	$64.00	$2.65–$15.66	—	40%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE; TOTAL	$172.20	$287.00	$2.65–$15.66	—	40%
Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE T3;TTL(TT-3)	$363.60	$606.00	$5.29–$32.33	200% above	40%
Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE T3;TTL(TT-3)	$363.60	$606.00	$5.29–$32.33	200% above	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIIODOTHYRONINE T3;TTL(TT-3)	$363.60	$606.00	$5.29–$32.33	—	40%
Transferrin blood test CPT 84466 TRANSFERRIN	$246.00	$410.00	$5.29–$29.09	190% above	40%
Transferrin blood test CPT 84466 TRANSFERRIN	$246.00	$410.00	$5.29–$29.09	190% above	40%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$246.00	$410.00	$5.29–$29.09	—	40%
Trichomonas test (NAAT) CPT 87661 #TRICHOMONAS VAG AMP PROBE	$108.00	$180.00	$19.15–$80.01	14% above	40%
Trichomonas test (NAAT) CPT 87661 #TRICHOMONAS VAG AMP PROBE	$108.00	$180.00	$19.15–$80.01	14% above	40%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAG AMP PROBE	$404.40	$674.00	$19.15–$80.01	326% above	40%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAG AMP PROBE	$404.40	$674.00	$19.15–$80.01	326% above	40%
Trichomonas test (NAAT) inpatient CPT 87661 #TRICHOMONAS VAG AMP PROBE	$108.00	$180.00	$19.15–$80.01	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAG AMP PROBE	$404.40	$674.00	$19.15–$80.01	—	40%
Triglycerides blood test CPT 84478 #TRIGLYCERIDES	$73.20	$122.00	$2.65–$13.09	105% above	40%
Triglycerides blood test CPT 84478 #TRIGLYCERIDES	$73.20	$122.00	$2.65–$13.09	105% above	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$114.60	$191.00	$2.65–$13.09	221% above	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$114.60	$191.00	$2.65–$13.09	221% above	40%
Triglycerides blood test inpatient CPT 84478 #TRIGLYCERIDES	$73.20	$122.00	$2.65–$13.09	—	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$114.60	$191.00	$2.65–$13.09	—	40%
Troponin test, quantitative CPT 84484 #TROPONIN QUANTITATIVE	$240.60	$401.00	$4.66–$28.43	99% above	40%
Troponin test, quantitative CPT 84484 #TROPONIN QUANTITATIVE	$240.60	$401.00	$4.66–$28.43	99% above	40%
Troponin test, quantitative CPT 84484 TROPONIN QUANTITATIVE	$375.00	$625.00	$4.66–$28.43	209% above	40%
Troponin test, quantitative CPT 84484 TROPONIN QUANTITATIVE	$375.00	$625.00	$4.66–$28.43	209% above	40%
Troponin test, quantitative inpatient CPT 84484 #TROPONIN QUANTITATIVE	$240.60	$401.00	$4.66–$28.43	—	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN QUANTITATIVE	$375.00	$625.00	$4.66–$28.43	—	40%
Uric acid blood test CPT 84550 URIC ACID; BLOOD	$100.80	$168.00	$2.14–$10.31	110% above	40%
Uric acid blood test CPT 84550 URIC ACID; BLOOD	$100.80	$168.00	$2.14–$10.31	110% above	40%
Uric acid blood test inpatient CPT 84550 URIC ACID; BLOOD	$100.80	$168.00	$2.14–$10.31	—	40%
Urinalysis with microscope exam, automated CPT 81001 URINALS DIPSTICK AUTO W/MICR	$135.00	$225.00	$2.35–$7.23	221% above	40%
Urinalysis with microscope exam, automated CPT 81001 URINALS DIPSTICK AUTO W/MICR	$135.00	$225.00	$2.35–$7.23	221% above	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALS DIPSTICK AUTO W/MICR	$135.00	$225.00	$2.35–$7.23	—	40%
Urinalysis without microscope exam, automated CPT 81003 #URINALYSIS DIP STICK;AUTO	$65.40	$109.00	$1.32–$5.13	167% above	40%
Urinalysis without microscope exam, automated CPT 81003 #URINALYSIS DIP STICK;AUTO	$65.40	$109.00	$1.32–$5.13	167% above	40%
Urinalysis without microscope exam, automated CPT 81003 URINALS DIPSTICK AUTO WO/MICR	$101.40	$169.00	$1.32–$5.13	314% above	40%
Urinalysis without microscope exam, automated CPT 81003 URINALS DIPSTICK AUTO WO/MICR	$101.40	$169.00	$1.32–$5.13	314% above	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 #URINALYSIS DIP STICK;AUTO	$65.40	$109.00	$1.32–$5.13	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALS DIPSTICK AUTO WO/MICR	$101.40	$169.00	$1.32–$5.13	—	40%
Urinalysis without microscope exam, manual CPT 81002 #URINALYSIS DIP STICK;NON-AUTO	$10.80	$18.00	$1.32–$7.93	31% below	40%
Urinalysis without microscope exam, manual CPT 81002 #URINALYSIS DIP STICK;NON-AUTO	$10.80	$18.00	$1.32–$7.93	31% below	40%
Urinalysis without microscope exam, manual CPT 81002 URINALS DIPSTICK NON-AUTOWO/MI	$59.40	$99.00	$1.32–$7.93	281% above	40%
Urinalysis without microscope exam, manual CPT 81002 URINALS DIPSTICK NON-AUTOWO/MI	$59.40	$99.00	$1.32–$7.93	281% above	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 #URINALYSIS DIP STICK;NON-AUTO	$10.80	$18.00	$1.32–$7.93	—	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALS DIPSTICK NON-AUTOWO/MI	$59.40	$99.00	$1.32–$7.93	—	40%
Urine culture for bacteria, with colony count CPT 87086 #CULT BACT QNT COLONY CNT URIN	$21.60	$36.00	$2.65–$18.40	51% below	40%
Urine culture for bacteria, with colony count CPT 87086 #CULT BACT QNT COLONY CNT URIN	$21.60	$36.00	$2.65–$18.40	51% below	40%
Urine culture for bacteria, with colony count CPT 87086 CULT BACT QNT COLONY CNT URINE	$223.80	$373.00	$2.65–$18.40	412% above	40%
Urine culture for bacteria, with colony count CPT 87086 CULT BACT QNT COLONY CNT URINE	$223.80	$373.00	$2.65–$18.40	412% above	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 #CULT BACT QNT COLONY CNT URIN	$21.60	$36.00	$2.65–$18.40	—	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT BACT QNT COLONY CNT URINE	$223.80	$373.00	$2.65–$18.40	—	40%
Urine microalbumin (albumin) test CPT 82043 #ALBUMIN;URIN MICROALBUMIN QNT	$28.20	$47.00	$2.65–$13.18	19% below	40%
Urine microalbumin (albumin) test CPT 82043 #ALBUMIN;URIN MICROALBUMIN QNT	$28.20	$47.00	$2.65–$13.18	19% below	40%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN;URINE MICROALB QUANT	$226.20	$377.00	$2.65–$13.18	553% above	40%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN;URINE MICROALB QUANT	$226.20	$377.00	$2.65–$13.18	553% above	40%
Urine microalbumin (albumin) test inpatient CPT 82043 #ALBUMIN;URIN MICROALBUMIN QNT	$28.20	$47.00	$2.65–$13.18	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN;URINE MICROALB QUANT	$226.20	$377.00	$2.65–$13.18	—	40%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$159.60	$266.00	$1.32–$19.63	196% above	40%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$159.60	$266.00	$1.32–$19.63	196% above	40%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$159.60	$266.00	$1.32–$19.63	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 #CYANOCOBALAMIN (VITAMIN B-12)	$57.60	$96.00	$7.13–$34.38	22% below	40%
Vitamin B12 (cobalamin) blood test CPT 82607 #CYANOCOBALAMIN (VITAMIN B-12)	$57.60	$96.00	$7.13–$34.38	22% below	40%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12)	$252.00	$420.00	$7.13–$34.38	242% above	40%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12)	$252.00	$420.00	$7.13–$34.38	242% above	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 #CYANOCOBALAMIN (VITAMIN B-12)	$57.60	$96.00	$7.13–$34.38	—	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBALAMIN (VITAMIN B-12)	$252.00	$420.00	$7.13–$34.38	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 #CALCIFEDIOL(25-OH VITAMIN D-3)	$53.40	$89.00	$14.00–$67.49	60% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 #CALCIFEDIOL(25-OH VITAMIN D-3)	$53.40	$89.00	$14.00–$67.49	60% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CALCIFEDIOL(25-OH VITAMIN D-3)	$408.00	$680.00	$14.00–$67.49	203% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CALCIFEDIOL(25-OH VITAMIN D-3)	$408.00	$680.00	$14.00–$67.49	203% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 #CALCIFEDIOL(25-OH VITAMIN D-3)	$53.40	$89.00	$14.00–$67.49	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CALCIFEDIOL(25-OH VITAMIN D-3)	$408.00	$680.00	$14.00–$67.49	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 #DIHYDROXYVITAMIN D 1 25-	$69.60	$116.00	$15.87–$87.78	61% below	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 #DIHYDROXYVITAMIN D 1 25-	$69.60	$116.00	$15.87–$87.78	61% below	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D 1 25-	$599.40	$999.00	$15.87–$87.78	236% above	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D 1 25-	$599.40	$999.00	$15.87–$87.78	236% above	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 #DIHYDROXYVITAMIN D 1 25-	$69.60	$116.00	$15.87–$87.78	—	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 DIHYDROXYVITAMIN D 1 25-	$599.40	$999.00	$15.87–$87.78	—	40%
Zinc blood test CPT 84630 ZINC	$244.80	$408.00	$4.03–$25.97	196% above	40%
Zinc blood test CPT 84630 ZINC	$244.80	$408.00	$4.03–$25.97	196% above	40%
Zinc blood test inpatient CPT 84630 ZINC	$244.80	$408.00	$4.03–$25.97	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 #GONADOTROPIN CHORION(HCG);QNT	$35.40	$59.00	$7.01–$34.31	56% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 #GONADOTROPIN CHORION(HCG);QNT	$35.40	$59.00	$7.01–$34.31	56% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN (HCG);QUANT	$315.60	$526.00	$7.01–$34.31	296% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN (HCG);QUANT	$315.60	$526.00	$7.01–$34.31	296% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 #GONADOTROPIN CHORION(HCG);QNT	$35.40	$59.00	$7.01–$34.31	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN (HCG);QUANT	$315.60	$526.00	$7.01–$34.31	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 STEREO BREAST BX 1STLESION UNI	$4,735.80	$7,893.00	$27.19–$6,693.20	89% above	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 STEREO BREAST BX 1STLESION UNI	$4,735.80	$7,893.00	$27.19–$6,693.20	89% above	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 STEREO BREAST BX 1STLESION UNI	$4,735.80	$7,893.00	$27.19–$6,693.20	—	40%
Cardiac catheterization with coronary angiogram CPT 93458 LHC/LV/COR/IMAGING	$18,138.60	$30,231.00	$217.44–$2,340.29	84% above	40%
Cardiac catheterization with coronary angiogram CPT 93458 LHC/LV/COR/IMAGING	$18,138.60	$30,231.00	$217.44–$2,340.29	84% above	40%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 LHC/LV/COR/IMAGING	$18,138.60	$30,231.00	$217.44–$2,340.29	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE;EXTERNL	$2,382.00	$3,970.00	$25.76–$270.41	70% above	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE;EXTERNL	$2,382.00	$3,970.00	$25.76–$270.41	70% above	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 $CARDIOVERSION ELECTIVE;EXTRNL	$2,553.60	$4,256.00	$25.76–$270.41	82% above	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 $CARDIOVERSION ELECTIVE;EXTRNL	$2,553.60	$4,256.00	$25.76–$270.41	82% above	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE;EXTERNL	$2,382.00	$3,970.00	$25.76–$270.41	—	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 $CARDIOVERSION ELECTIVE;EXTRNL	$2,553.60	$4,256.00	$25.76–$270.41	—	40%
Catheter ablation for atrial fibrillation CPT 93656 EP STUDY W/AFIB ABLATION	$62,587.20	$104,312.00	$275.83–$2,348.42	125% above	40%
Catheter ablation for atrial fibrillation CPT 93656 EP STUDY W/AFIB ABLATION	$62,587.20	$104,312.00	$275.83–$2,348.42	125% above	40%
Catheter ablation for atrial fibrillation inpatient CPT 93656 EP STUDY W/AFIB ABLATION	$62,587.20	$104,312.00	$275.83–$2,348.42	—	40%
Coronary stent placement, one artery CPT 92928 STENT BM COR VESSEL INT LC	$16,439.40	$27,399.00	$126.02–$15,990.66	5% above	40%
Coronary stent placement, one artery CPT 92928 STENT BM COR VESSEL INT LM	$16,439.40	$27,399.00	$126.02–$15,990.66	5% above	40%
Coronary stent placement, one artery CPT 92928 STENT BM COR VESSEL INT RI	$16,439.40	$27,399.00	$126.02–$15,990.66	5% above	40%
Coronary stent placement, one artery CPT 92928 STENT BM COR VESSEL INT RC	$16,439.40	$27,399.00	$126.02–$15,990.66	5% above	40%
Coronary stent placement, one artery CPT 92928 STENT BM COR VESSEL INT RC	$16,439.40	$27,399.00	$126.02–$15,990.66	5% above	40%
Coronary stent placement, one artery CPT 92928 STENT BM COR VESSEL INT RI	$16,439.40	$27,399.00	$126.02–$15,990.66	5% above	40%
Coronary stent placement, one artery CPT 92928 STENT BM COR VESSEL INT LD	$16,439.40	$27,399.00	$126.02–$15,990.66	5% above	40%
Coronary stent placement, one artery CPT 92928 STENT BM COR VESSEL INT LC	$16,439.40	$27,399.00	$126.02–$15,990.66	5% above	40%
Coronary stent placement, one artery CPT 92928 STENT BM COR VESSEL INT LM	$16,439.40	$27,399.00	$126.02–$15,990.66	5% above	40%
Coronary stent placement, one artery CPT 92928 STENT BM COR VESSEL INT LD	$16,439.40	$27,399.00	$126.02–$15,990.66	5% above	40%
Coronary stent placement, one artery inpatient CPT 92928 STENT BM COR VESSEL INT LC	$16,439.40	$27,399.00	$126.02–$15,990.66	—	40%
Coronary stent placement, one artery inpatient CPT 92928 STENT BM COR VESSEL INT LM	$16,439.40	$27,399.00	$126.02–$15,990.66	—	40%
Coronary stent placement, one artery inpatient CPT 92928 STENT BM COR VESSEL INT RC	$16,439.40	$27,399.00	$126.02–$15,990.66	—	40%
Coronary stent placement, one artery inpatient CPT 92928 STENT BM COR VESSEL INT LD	$16,439.40	$27,399.00	$126.02–$15,990.66	—	40%
Coronary stent placement, one artery inpatient CPT 92928 STENT BM COR VESSEL INT RI	$16,439.40	$27,399.00	$126.02–$15,990.66	—	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT BENIGN LESION 1	$153.00	$255.00	$8.30–$212.57	18% below	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT BENIGN LESION 1	$153.00	$255.00	$8.30–$212.57	18% below	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT BENIGN LESION 1	$153.00	$255.00	$8.30–$212.57	—	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMPAC EARWAX IRRIG/LAV UNI	$175.80	$293.00	$1.85–$285.87	at median	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMPAC EARWAX IRRIG/LAV UNI	$175.80	$293.00	$1.85–$285.87	at median	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REM IMPAC EARWAX IRRIG/LAV UNI	$175.80	$293.00	$1.85–$285.87	—	40%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX	$57.60	$96.00	$5.03–$85.25	64% below	40%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX	$57.60	$96.00	$5.03–$85.25	64% below	40%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX	$57.60	$96.00	$5.03–$85.25	—	40%
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 FACET INJ L/S+CT BI	$5,310.00	$8,850.00	$17.07–$6,693.20	—	40%
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 FACET INJ L/S+IM BI	$5,310.00	$8,850.00	$17.07–$6,693.20	—	40%
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 FACET INJ L/S+IM BI	$5,310.00	$8,850.00	$17.07–$6,693.20	—	40%
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 FACET INJ L/S+CT BI	$5,310.00	$8,850.00	$17.07–$6,693.20	—	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FACET INJ L/S+CT	$2,655.00	$4,425.00	$17.07–$4,375.00	130% above	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FACET INJ L/S+CT	$2,655.00	$4,425.00	$17.07–$4,375.00	130% above	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient both sides CPT 64493 FACET INJ L/S+IM BI	$5,310.00	$8,850.00	$17.07–$6,693.20	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient both sides CPT 64493 FACET INJ L/S+CT BI	$5,310.00	$8,850.00	$17.07–$6,693.20	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 FACET INJ L/S+CT	$2,655.00	$4,425.00	$17.07–$4,375.00	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INTRO+CATH SONOHYSTEROG/HSG	$679.80	$1,133.00	$11.53–$1,044.85	137% above	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INTRO+CATH SONOHYSTEROG/HSG	$679.80	$1,133.00	$11.53–$1,044.85	137% above	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INTRO+CATH SONOHYSTEROG/HSG	$679.80	$1,133.00	$11.53–$1,044.85	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABCESS SIMPLE	$843.60	$1,406.00	$15.18–$1,285.51	83% above	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABCESS SIMPLE	$843.60	$1,406.00	$15.18–$1,285.51	83% above	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABCESS SIMPLE	$843.60	$1,406.00	$15.18–$1,285.51	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SINGLE TENDON OR LIGAMENT	$534.60	$891.00	$8.30–$776.94	at median	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SINGLE TENDON OR LIGAMENT	$534.60	$891.00	$8.30–$776.94	at median	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ SINGLE TENDON OR LIGAMENT	$534.60	$891.00	$8.30–$776.94	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 XR ASP/INJ MAJOR JNT/BURSA WO/US	$897.60	$1,496.00	$9.07–$1,416.85	117% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 XR ASP/INJ MAJOR JNT/BURSA WO/US	$897.60	$1,496.00	$9.07–$1,416.85	117% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 XR ASP/INJ MAJOR JNT/BURSA WO/US	$897.60	$1,496.00	$9.07–$1,416.85	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 XR ASP/INJ INTERM JNT/BURSA WO/ULS	$823.80	$1,373.00	$7.41–$1,285.51	93% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 XR ASP/INJ INTERM JNT/BURSA WO/ULS	$823.80	$1,373.00	$7.41–$1,285.51	93% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 XR ASP/INJ INTERM JNT/BURSA WO/ULS	$823.80	$1,373.00	$7.41–$1,285.51	—	40%
Left heart catheterization, diagnostic CPT 93452 LHC/LV/IMAGING	$14,930.40	$24,884.00	$178.63–$14,592.00	92% above	40%
Left heart catheterization, diagnostic CPT 93452 LHC/LV/IMAGING	$14,930.40	$24,884.00	$178.63–$14,592.00	92% above	40%
Left heart catheterization, diagnostic inpatient CPT 93452 LHC/LV/IMAGING	$14,930.40	$24,884.00	$178.63–$14,592.00	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ DX/TX LAMINAR LUM/SACRL+IM	$2,942.40	$4,904.00	$25.32–$4,631.00	129% above	40%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ DX/TX LAMINAR LUM/SACRL+IM	$2,942.40	$4,904.00	$25.32–$4,631.00	129% above	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ DX/TX LAMINAR LUM/SACRL+IM	$2,942.40	$4,904.00	$25.32–$4,631.00	—	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	$22.67–$6,693.20	—	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	$22.67–$6,693.20	—	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ TRANSF EPI L/S+IM	$2,298.00	$3,830.00	$22.67–$3,566.00	41% above	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ TRANSF EPI L/S+IM	$2,298.00	$3,830.00	$22.67–$3,566.00	41% above	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	$22.67–$6,693.20	—	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	$22.67–$3,566.00	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC LESN BGN TRUNK/ARM <0.5CM	$2,816.40	$4,694.00	$12.42–$4,631.00	25% above	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC LESN BGN TRUNK/ARM <0.5CM	$2,816.40	$4,694.00	$12.42–$4,631.00	25% above	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC LESN BGN TRUNK/ARM <0.5CM	$2,816.40	$4,694.00	$12.42–$4,631.00	—	40%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF SINGLE NAIL PLATE	$609.60	$1,016.00	$8.22–$954.45	54% above	40%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF SINGLE NAIL PLATE	$609.60	$1,016.00	$8.22–$954.45	54% above	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF SINGLE NAIL PLATE	$609.60	$1,016.00	$8.22–$954.45	—	40%
Pacemaker implant (dual chamber) CPT 33208 INSERT/REPLACE PPM A&V LEADS	$12,064.20	$20,107.00	$129.87–$11,817.00	at median	40%
Pacemaker implant (dual chamber) CPT 33208 INSERT/REPLACE PPM A&V LEADS	$12,064.20	$20,107.00	$129.87–$11,817.00	at median	40%
Pacemaker implant (dual chamber) inpatient CPT 33208 INSERT/REPLACE PPM A&V LEADS	$12,064.20	$20,107.00	$129.87–$11,817.00	—	40%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS+IM CT	$987.60	$1,646.00	$30.94–$1,416.85	29% below	40%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS+IM CT	$987.60	$1,646.00	$30.94–$1,416.85	29% below	40%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS WITH IMAGING	$2,057.40	$3,429.00	$30.94–$3,281.00	49% above	40%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS WITH IMAGING	$2,057.40	$3,429.00	$30.94–$3,281.00	49% above	40%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS+IM ULS	$2,205.60	$3,676.00	$30.94–$3,566.00	59% above	40%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS+IM ULS	$2,205.60	$3,676.00	$30.94–$3,566.00	59% above	40%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS+IM CT	$987.60	$1,646.00	$30.94–$1,416.85	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS WITH IMAGING	$2,057.40	$3,429.00	$30.94–$3,281.00	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS+IM ULS	$2,205.60	$3,676.00	$30.94–$3,566.00	—	40%
Prostate biopsy CPT 55700 BX PROSTATE; NDL/PUNCH SINGLE	$3,603.60	$6,006.00	$29.79–$4,914.00	1% above	40%
Prostate biopsy CPT 55700 BX PROSTATE; NDL/PUNCH SINGLE	$3,603.60	$6,006.00	$29.79–$4,914.00	1% above	40%
Prostate biopsy inpatient CPT 55700 BX PROSTATE; NDL/PUNCH SINGLE	$3,603.60	$6,006.00	$29.79–$4,914.00	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level both sides CPT 64635 FACET JNT DESTRUCT L/S+IM BI	$6,622.80	$11,038.00	$58.96–$7,064.32	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level both sides CPT 64635 FACET JNT DESTRUCT L/S+IM BI	$6,622.80	$11,038.00	$58.96–$7,064.32	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 FACET JNT DESTRUCT L/S+IM UNI	$3,311.40	$5,519.00	$58.96–$4,914.00	at median	40%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 FACET JNT DESTRUCT L/S+IM UNI	$3,311.40	$5,519.00	$58.96–$4,914.00	at median	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient both sides CPT 64635 FACET JNT DESTRUCT L/S+IM BI	$6,622.80	$11,038.00	$58.96–$7,064.32	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 FACET JNT DESTRUCT L/S+IM UNI	$3,311.40	$5,519.00	$58.96–$4,914.00	—	40%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY SIMPLE	$2,817.60	$4,696.00	$15.52–$4,631.00	358% above	40%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY SIMPLE	$2,817.60	$4,696.00	$15.52–$4,631.00	358% above	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY SIMPLE	$2,817.60	$4,696.00	$15.52–$4,631.00	—	40%
Short arm splint (forearm and hand) CPT 29125 PT APP SHORT ARM SPLINT;STATIC	$181.80	$303.00	$7.73–$300.86	at median	40%
Short arm splint (forearm and hand) CPT 29125 OT APP SHORT ARM SPLINT;STATIC	$181.80	$303.00	$7.73–$300.86	at median	40%
Short arm splint (forearm and hand) CPT 29125 OT APP SHORT ARM SPLINT;STATIC	$181.80	$303.00	$7.73–$300.86	at median	40%
Short arm splint (forearm and hand) CPT 29125 PT APP SHORT ARM SPLINT;STATIC	$181.80	$303.00	$7.73–$300.86	at median	40%
Short arm splint (forearm and hand) inpatient CPT 29125 PT APP SHORT ARM SPLINT;STATIC	$181.80	$303.00	$7.73–$300.86	—	40%
Short arm splint (forearm and hand) inpatient CPT 29125 OT APP SHORT ARM SPLINT;STATIC	$181.80	$303.00	$7.73–$300.86	—	40%
Short leg cast (below the knee) CPT 29405 OT APP SHORT LEG CAST;KNEE-TOE	$378.60	$631.00	$11.76–$548.66	at median	40%
Short leg cast (below the knee) CPT 29405 PT AP PSHORT LEG CAST;KNEE-TOE	$378.60	$631.00	$11.76–$548.66	at median	40%
Short leg cast (below the knee) CPT 29405 OT APP SHORT LEG CAST;KNEE-TOE	$378.60	$631.00	$11.76–$548.66	at median	40%
Short leg cast (below the knee) CPT 29405 PT AP PSHORT LEG CAST;KNEE-TOE	$378.60	$631.00	$11.76–$548.66	at median	40%
Short leg cast (below the knee) inpatient CPT 29405 PT AP PSHORT LEG CAST;KNEE-TOE	$378.60	$631.00	$11.76–$548.66	—	40%
Short leg cast (below the knee) inpatient CPT 29405 OT APP SHORT LEG CAST;KNEE-TOE	$378.60	$631.00	$11.76–$548.66	—	40%
Short leg splint (calf to foot) CPT 29515 OT AP SHORT LEG SPLINT;CALF-FT	$172.20	$287.00	$9.77–$285.87	29% below	40%
Short leg splint (calf to foot) CPT 29515 PT AP SHORT LEG SPLINT;CALF-FT	$172.20	$287.00	$9.77–$285.87	29% below	40%
Short leg splint (calf to foot) CPT 29515 PT AP SHORT LEG SPLINT;CALF-FT	$172.20	$287.00	$9.77–$285.87	29% below	40%
Short leg splint (calf to foot) CPT 29515 OT AP SHORT LEG SPLINT;CALF-FT	$172.20	$287.00	$9.77–$285.87	29% below	40%
Short leg splint (calf to foot) inpatient CPT 29515 OT AP SHORT LEG SPLINT;CALF-FT	$172.20	$287.00	$9.77–$285.87	—	40%
Short leg splint (calf to foot) inpatient CPT 29515 PT AP SHORT LEG SPLINT;CALF-FT	$172.20	$287.00	$9.77–$285.87	—	40%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LES	$456.60	$761.00	$7.88–$654.69	1% above	40%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LES	$456.60	$761.00	$7.88–$654.69	1% above	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LES	$456.60	$761.00	$7.88–$654.69	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMB PUNCTURE DX(OTH THN FLUORO/CT)	$1,087.80	$1,813.00	$16.41–$1,728.79	6% above	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMB PUNCTURE DX(OTH THN FLUORO/CT)	$1,087.80	$1,813.00	$16.41–$1,728.79	6% above	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMB PUNCTURE DX(OTH THN FLUORO/CT)	$1,087.80	$1,813.00	$16.41–$1,728.79	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ED SIMP REPR SCLP/TRN2.6-7.5CM	$367.80	$613.00	$9.24–$548.66	8% below	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ED SIMP REPR SCLP/TRN2.6-7.5CM	$367.80	$613.00	$9.24–$548.66	8% below	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ED SIMP REPR SCLP/TRN2.6-7.5CM	$367.80	$613.00	$9.24–$548.66	—	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$456.60	$761.00	$6.28–$654.69	12% above	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$456.60	$761.00	$6.28–$654.69	12% above	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES	$456.60	$761.00	$6.28–$654.69	—	40%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NDL OR CATH+ CT	$987.60	$1,646.00	$32.53–$1,416.85	10% below	40%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NDL OR CATH+ CT	$987.60	$1,646.00	$32.53–$1,416.85	10% below	40%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NDL OR CATH+ IM	$1,674.00	$2,790.00	$32.53–$2,273.62	53% above	40%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NDL OR CATH+ IM	$1,674.00	$2,790.00	$32.53–$2,273.62	53% above	40%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NDL OR CATH+ ULS	$1,980.00	$3,300.00	$32.53–$3,281.00	81% above	40%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NDL OR CATH+ ULS	$1,980.00	$3,300.00	$32.53–$3,281.00	81% above	40%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NDL OR CATH+ CT	$987.60	$1,646.00	$32.53–$1,416.85	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NDL OR CATH+ IM	$1,674.00	$2,790.00	$32.53–$2,273.62	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NDL OR CATH+ ULS	$1,980.00	$3,300.00	$32.53–$3,281.00	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 ULS BREAST BX 1ST LESION UNI	$4,255.20	$7,092.00	$25.52–$6,693.20	83% above	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 ULS BREAST BX 1ST LESION UNI	$4,255.20	$7,092.00	$25.52–$6,693.20	83% above	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 ULS BREAST BX 1ST LESION UNI	$4,255.20	$7,092.00	$25.52–$6,693.20	—	40%
Wart removal, up to 14 warts CPT 17110 INJ/DESTROY BENIGN LESION 1-14	$296.40	$494.00	$10.16–$481.98	at median	40%
Wart removal, up to 14 warts CPT 17110 INJ/DESTROY BENIGN LESION 1-14	$296.40	$494.00	$10.16–$481.98	at median	40%
Wart removal, up to 14 warts inpatient CPT 17110 INJ/DESTROY BENIGN LESION 1-14	$296.40	$494.00	$10.16–$481.98	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SKN SQ TISSUE <=20 SQ CM	$2,681.40	$4,469.00	$8.48–$4,375.00	245% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SKN SQ TISSUE <=20 SQ CM	$2,681.40	$4,469.00	$8.48–$4,375.00	245% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SKN SQ TISSUE <=20 SQ CM	$2,681.40	$4,469.00	$8.48–$4,375.00	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE	$1,739.40	$2,899.00	$8.14–$2,273.62	93% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE	$1,739.40	$2,899.00	$8.14–$2,273.62	93% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 MASSIVE TRANSFUSION PROTOCOL	$5,218.20	$8,697.00	$8.14–$6,693.20	480% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 MASSIVE TRANSFUSION PROTOCOL	$5,218.20	$8,697.00	$8.14–$6,693.20	480% above	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SERVICE	$1,739.40	$2,899.00	$8.14–$2,273.62	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 MASSIVE TRANSFUSION PROTOCOL	$5,218.20	$8,697.00	$8.14–$6,693.20	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERO/ACUPAP/SPUT/MDI/NEB/EZ/NPI	$112.80	$188.00	$2.38–$25.05	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERO/ACUPAP/SPUT/MDI/NEB/EZ/NPI	$112.80	$188.00	$2.38–$25.05	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHAL RX PRS/NONPR AIRWAY OBST	$112.80	$188.00	$2.38–$25.05	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHAL RX PRS/NONPR AIRWAY OBST	$112.80	$188.00	$2.38–$25.05	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERO/ACUPAP/SPUT/MDI/NEB/EZ/NPI	$112.80	$188.00	$2.38–$25.05	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL RX PRS/NONPR AIRWAY OBST	$112.80	$188.00	$2.38–$25.05	—	40%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INF INITL SUBST 1STHR	$1,210.20	$2,017.00	$19.20–$324.60	79% above	40%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INF INITL SUBST 1STHR	$1,210.20	$2,017.00	$19.20–$324.60	79% above	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INF INITL SUBST 1STHR	$1,210.20	$2,017.00	$19.20–$324.60	—	40%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHEN AUDIO EVAL ONE(LTD)	$153.00	$255.00	$5.60–$73.84	21% below	40%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHEN AUDIO EVAL ONE(LTD)	$153.00	$255.00	$5.60–$73.84	21% below	40%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE AUDIOMETRY EVAL	$304.80	$508.00	$5.60–$73.84	58% above	40%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE AUDIOMETRY EVAL	$304.80	$508.00	$5.60–$73.84	58% above	40%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHEN AUDIO EVAL ONE(LTD)	$153.00	$255.00	$5.60–$73.84	—	40%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHENSIVE AUDIOMETRY EVAL	$304.80	$508.00	$5.60–$73.84	—	40%
Critical care, first 30 to 74 minutes CPT 99291 ED CRITICAL CARE FIRST HOUR	$3,762.00	$6,270.00	$36.28–$330.48	77% above	40%
Critical care, first 30 to 74 minutes CPT 99291 ED CRITICAL CARE FIRST HOUR	$3,762.00	$6,270.00	$36.28–$330.48	77% above	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ED CRITICAL CARE FIRST HOUR	$3,762.00	$6,270.00	$36.28–$330.48	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE & DROWSY	$838.20	$1,397.00	$40.96–$424.21	22% above	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE & DROWSY	$838.20	$1,397.00	$40.96–$424.21	22% above	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE & DROWSY	$838.20	$1,397.00	$40.96–$424.21	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG ROUTINE>=12LEADS TRACING	$301.20	$502.00	$1.36–$19.71	49% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG ROUTINE>=12LEADS TRACING	$301.20	$502.00	$1.36–$19.71	49% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG ROUTINE>=12LEADS TRACING	$301.20	$502.00	$1.36–$19.71	—	40%
Electroconvulsive therapy (ECT), one session CPT 90870 ELECTROCONVULSIVE THERAPY	$1,636.20	$2,727.00	$18.00–$135.94	29% above	40%
Electroconvulsive therapy (ECT), one session CPT 90870 ELECTROCONVULSIVE THERAPY	$1,636.20	$2,727.00	$18.00–$135.94	29% above	40%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ELECTROCONVULSIVE THERAPY	$1,636.20	$2,727.00	$18.00–$135.94	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VISIT LEVEL 1 W/ PROCEDURE	$345.60	$576.00	$3.45–$33.30	59% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VISIT LEVEL 1	$345.60	$576.00	$3.45–$33.30	59% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VISIT LEVEL 1	$345.60	$576.00	$3.45–$33.30	59% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VISIT LEVEL 1 W/ PROCEDURE	$345.60	$576.00	$3.45–$33.30	59% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED VISIT LEVEL 1 W/ PROCEDURE	$345.60	$576.00	$3.45–$33.30	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED VISIT LEVEL 1	$345.60	$576.00	$3.45–$33.30	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED VISIT LEVEL 2 W/ PROCEDURE	$525.00	$875.00	$6.73–$60.50	25% above	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED VISIT LEVEL 2	$525.00	$875.00	$6.73–$60.50	25% above	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED VISIT LEVEL 2	$525.00	$875.00	$6.73–$60.50	25% above	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED VISIT LEVEL 2 W/ PROCEDURE	$525.00	$875.00	$6.73–$60.50	25% above	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED VISIT LEVEL 2	$525.00	$875.00	$6.73–$60.50	—	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED VISIT LEVEL 2 W/ PROCEDURE	$525.00	$875.00	$6.73–$60.50	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED VISIT LEVEL 3	$1,047.00	$1,745.00	$10.08–$102.81	35% above	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 BRIEF EVIDENCE COLLECTION	$1,047.00	$1,745.00	$10.08–$102.81	35% above	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 BRIEF EVIDENCE COLLECTION	$1,047.00	$1,745.00	$10.08–$102.81	35% above	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED VISIT LEVEL 3 W/ PROCEDURE	$1,047.00	$1,745.00	$10.08–$102.81	35% above	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED VISIT LEVEL 3	$1,047.00	$1,745.00	$10.08–$102.81	35% above	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED VISIT LEVEL 3 W/ PROCEDURE	$1,047.00	$1,745.00	$10.08–$102.81	35% above	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED VISIT LEVEL 3 W/ PROCEDURE	$1,047.00	$1,745.00	$10.08–$102.81	—	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED VISIT LEVEL 3	$1,047.00	$1,745.00	$10.08–$102.81	—	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 BRIEF EVIDENCE COLLECTION	$1,047.00	$1,745.00	$10.08–$102.81	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED VISIT LEVEL 4 W/ PROCEDURE	$2,568.00	$4,280.00	$19.14–$174.23	117% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EVIDENCE COLLECTION EXAM	$2,568.00	$4,280.00	$19.14–$174.23	117% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EVIDENCE COLLECTION EXAM	$2,568.00	$4,280.00	$19.14–$174.23	117% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED VISIT LEVEL 4 W/ PROCEDURE	$2,568.00	$4,280.00	$19.14–$174.23	117% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED VISIT LEVEL 4	$2,568.00	$4,280.00	$19.14–$174.23	117% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED VISIT LEVEL 4	$2,568.00	$4,280.00	$19.14–$174.23	117% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED VISIT LEVEL 4	$2,568.00	$4,280.00	$19.14–$174.23	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED VISIT LEVEL 4 W/ PROCEDURE	$2,568.00	$4,280.00	$19.14–$174.23	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EVIDENCE COLLECTION EXAM	$2,568.00	$4,280.00	$19.14–$174.23	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED VISIT LEVEL 5	$3,146.40	$5,244.00	$28.23–$252.81	80% above	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED VISIT LEVEL 5 W/ PROCEDURE	$3,146.40	$5,244.00	$28.23–$252.81	80% above	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED VISIT LEVEL 5 W/ PROCEDURE	$3,146.40	$5,244.00	$28.23–$252.81	80% above	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED VISIT LEVEL 5	$3,146.40	$5,244.00	$28.23–$252.81	80% above	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED VISIT LEVEL 5	$3,146.40	$5,244.00	$28.23–$252.81	—	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED VISIT LEVEL 5 W/ PROCEDURE	$3,146.40	$5,244.00	$28.23–$252.81	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST TRACE ONLY NO I&R	$999.00	$1,665.00	$7.87–$125.35	31% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 TCG-CRDVSC STRESS TST W/ECG MO	$999.00	$1,665.00	$7.87–$125.35	31% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 TCG-CRDVSC STRESS TST W/ECG MO	$999.00	$1,665.00	$7.87–$125.35	31% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST TRACE ONLY NO I&R	$999.00	$1,665.00	$7.87–$125.35	31% above	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 TCG-CRDVSC STRESS TST W/ECG MO	$999.00	$1,665.00	$7.87–$125.35	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST TRACE ONLY NO I&R	$999.00	$1,665.00	$7.87–$125.35	—	40%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/ PATIENT	$97.80	$163.00	$18.18–$154.03	48% below	40%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/ PATIENT	$97.80	$163.00	$18.18–$154.03	48% below	40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTX W/ PATIENT	$97.80	$163.00	$18.18–$154.03	—	40%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PATIENT	$85.20	$142.00	$16.75–$128.14	58% below	40%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PATIENT	$85.20	$142.00	$16.75–$128.14	58% below	40%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYTX W/O PATIENT	$85.20	$142.00	$16.75–$128.14	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ED OP IV HYDRATION 1ST HR	$413.40	$689.00	$9.31–$83.90	13% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ED OP IV HYDRATION 1ST HR	$413.40	$689.00	$9.31–$83.90	13% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1ST HR	$413.40	$689.00	$9.31–$83.90	13% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1ST HR	$413.40	$689.00	$9.31–$83.90	13% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1ST HR	$413.40	$689.00	$9.31–$83.90	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ED OP IV HYDRATION 1ST HR	$413.40	$689.00	$9.31–$83.90	—	40%
IV infusion of a medicine, first hour CPT 96365 ED OP IV INFUSION MED ADMIN 1S	$517.20	$862.00	$11.27–$102.45	28% above	40%
IV infusion of a medicine, first hour CPT 96365 ED OP IV INFUSION MED ADMIN 1S	$517.20	$862.00	$11.27–$102.45	28% above	40%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION MED ADMIN 1ST HR	$517.20	$862.00	$11.27–$102.45	28% above	40%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION MED ADMIN 1ST HR	$517.20	$862.00	$11.27–$102.45	28% above	40%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION MED ADMIN 1ST HR	$517.20	$862.00	$11.27–$102.45	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 ED OP IV INFUSION MED ADMIN 1S	$517.20	$862.00	$11.27–$102.45	—	40%
IV push of a medicine, first drug CPT 96374 ED OP INJ MED IV PUSH INIT SUB	$306.60	$511.00	$9.23–$80.53	45% above	40%
IV push of a medicine, first drug CPT 96374 INJECT MED IV PUSH INITL SUBST	$306.60	$511.00	$9.23–$80.53	45% above	40%
IV push of a medicine, first drug CPT 96374 INJECT MED IV PUSH INITL SUBST	$306.60	$511.00	$9.23–$80.53	45% above	40%
IV push of a medicine, first drug CPT 96374 ED OP INJ MED IV PUSH INIT SUB	$306.60	$511.00	$9.23–$80.53	45% above	40%
IV push of a medicine, first drug inpatient CPT 96374 INJECT MED IV PUSH INITL SUBST	$306.60	$511.00	$9.23–$80.53	—	40%
IV push of a medicine, first drug inpatient CPT 96374 ED OP INJ MED IV PUSH INIT SUB	$306.60	$511.00	$9.23–$80.53	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECT MED SUBQ/IM ONLY	$157.20	$262.00	$4.12–$29.69	49% above	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECT MED SUBQ/IM ONLY	$157.20	$262.00	$4.12–$29.69	49% above	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECT MED SUBQ/IM ONLY	$157.20	$262.00	$4.12–$29.69	—	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 CLIN SOCIAL WORK-PSYCH DIAG EV	$388.80	$648.00	$101.42–$203.36	55% above	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 CLIN SOCIAL WORK-PSYCH DIAG EV	$388.80	$648.00	$101.42–$203.36	55% above	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 SS ED PSYCH DIAGNOSTIC EVAL	$560.40	$934.00	$115.91–$203.36	123% above	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 SS ED PSYCH DIAGNOSTIC EVAL	$560.40	$934.00	$115.91–$203.36	123% above	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$560.40	$934.00	$101.42–$203.36	123% above	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$560.40	$934.00	$101.42–$203.36	123% above	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 CLIN SOCIAL WORK-PSYCH DIAG EV	$388.80	$648.00	$101.42–$203.36	—	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$560.40	$934.00	$101.42–$203.36	—	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 SS ED PSYCH DIAGNOSTIC EVAL	$560.40	$934.00	$115.91–$203.36	—	40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES 7-8	$3,388.80	$5,648.00	$32.14–$299.22	294% above	40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES 7-8	$3,388.80	$5,648.00	$32.14–$299.22	294% above	40%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES 7-8	$3,388.80	$5,648.00	$32.14–$299.22	—	40%
Neuromuscular re-education, 15 minutes CPT 97112 OT ALT NEUROMUSCULAR RE EDUCAT	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT ALT-FUNCTION EXERCISE/15MIN	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSCULAR RE-EDU 15MIN	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSCULAR RE-EDU 15MIN	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 OT SENSORY MOTOR SKILLS EA15MI	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 OT SENSORY MOTOR SKILLS EA15MI	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 OT ALT-SENSORY MOTOR SKLLS/15M	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT ALT-FUNCTION EXERCISE/15MIN	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT ALT-NEUROMUSCUL RE-ED/15MIN	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 OT ALT-SENSORY MOTOR SKLLS/15M	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT ALT-NEUROMUSCUL RE-ED/15MIN	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 OT ALT NEUROMUSCULAR RE EDUCAT	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR RE-EDU 15MIN	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR RE-EDU 15MIN	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT FUNCTIONAL EXERCISE EA15MIN	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT FUNCTIONAL EXERCISE EA15MIN	$73.80	$123.00	$4.56–$42.06	3% below	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT ALT-FUNCTION EXERCISE/15MIN	$73.80	$123.00	$4.56–$42.06	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE-EDU 15MIN	$73.80	$123.00	$4.56–$42.06	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT SENSORY MOTOR SKILLS EA15MI	$73.80	$123.00	$4.56–$42.06	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT ALT-NEUROMUSCUL RE-ED/15MIN	$73.80	$123.00	$4.56–$42.06	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT ALT-SENSORY MOTOR SKLLS/15M	$73.80	$123.00	$4.56–$42.06	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT FUNCTIONAL EXERCISE EA15MIN	$73.80	$123.00	$4.56–$42.06	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT ALT NEUROMUSCULAR RE EDUCAT	$73.80	$123.00	$4.56–$42.06	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-EDU 15MIN	$73.80	$123.00	$4.56–$42.06	—	40%
New patient office visit, about 30 minutes CPT 99203 OP VISIT LEVEL 3 NEW	$390.00	$650.00	$12.11–$106.19	135% above	40%
New patient office visit, about 30 minutes CPT 99203 OP VISIT LEVEL 3 NEW	$390.00	$650.00	$12.11–$106.19	135% above	40%
New patient office visit, about 30 minutes inpatient CPT 99203 OP VISIT LEVEL 3 NEW	$390.00	$650.00	$12.11–$106.19	—	40%
New patient office visit, about 45 minutes CPT 99204 OP VISIT LEVEL 4 NEW W/PROC	$505.20	$842.00	$20.23–$162.17	167% above	40%
New patient office visit, about 45 minutes CPT 99204 OP VISIT LEVEL 4 NEW	$505.20	$842.00	$20.23–$162.17	167% above	40%
New patient office visit, about 45 minutes CPT 99204 OP VISIT LEVEL 4 NEW W/PROC	$505.20	$842.00	$20.23–$162.17	167% above	40%
New patient office visit, about 45 minutes CPT 99204 OP VISIT LEVEL 4 NEW	$505.20	$842.00	$20.23–$162.17	167% above	40%
New patient office visit, about 45 minutes inpatient CPT 99204 OP VISIT LEVEL 4 NEW W/PROC	$505.20	$842.00	$20.23–$162.17	—	40%
New patient office visit, about 45 minutes inpatient CPT 99204 OP VISIT LEVEL 4 NEW	$505.20	$842.00	$20.23–$162.17	—	40%
New patient office visit, about 60 minutes CPT 99205 OP VISIT LEVEL 5 NEW	$663.60	$1,106.00	$26.31–$201.30	161% above	40%
New patient office visit, about 60 minutes CPT 99205 OP VISIT LEVEL 5 NEW	$663.60	$1,106.00	$26.31–$201.30	161% above	40%
New patient office visit, about 60 minutes inpatient CPT 99205 OP VISIT LEVEL 5 NEW	$663.60	$1,106.00	$26.31–$201.30	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP VISIT LEVEL 2 NEW	$294.60	$491.00	$7.89–$73.29	110% above	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP VISIT LEVEL 2 NEW	$294.60	$491.00	$7.89–$73.29	110% above	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OP VISIT LEVEL 2 NEW	$294.60	$491.00	$7.89–$73.29	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITL ASSESS+INTERVN 15MIN	$33.60	$56.00	$5.53–$39.98	2% below	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITL ASSESS+INTERVN 15MIN	$33.60	$56.00	$5.53–$39.98	2% below	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INITL ASSESS+INTERVN 15MIN	$33.60	$56.00	$5.53–$39.98	—	40%
Occupational therapy evaluation, low complexity CPT 97165 OT LOW COMPLEX EVAL	$159.00	$265.00	$10.58–$125.25	at median	40%
Occupational therapy evaluation, low complexity CPT 97165 OT LOW COMPLEX EVAL	$159.00	$265.00	$10.58–$125.25	at median	40%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT LOW COMPLEX EVAL	$159.00	$265.00	$10.58–$125.25	—	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT HIGH COMPLEX EVAL	$279.00	$465.00	$10.90–$128.90	19% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT BALANCE EVALUATION HIGH	$279.00	$465.00	$10.90–$128.90	19% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT PELVIC FLOOR HIGH COMP EVAL	$279.00	$465.00	$10.90–$128.90	19% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT PELVIC FLOOR HIGH COMP EVAL	$279.00	$465.00	$10.90–$128.90	19% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT BALANCE EVALUATION HIGH	$279.00	$465.00	$10.90–$128.90	19% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT HIGH COMPLEX EVAL	$279.00	$465.00	$10.90–$128.90	19% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT PELVIC FLOOR HIGH COMP EVAL	$279.00	$465.00	$10.90–$128.90	—	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT HIGH COMPLEX EVAL	$279.00	$465.00	$10.90–$128.90	—	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT BALANCE EVALUATION HIGH	$279.00	$465.00	$10.90–$128.90	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT LOW COMPLEX EVAL	$111.00	$185.00	$10.90–$128.90	23% below	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT LOW COMPLEX EVAL	$111.00	$185.00	$10.90–$128.90	23% below	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT LOW COMPLEX EVAL	$111.00	$185.00	$10.90–$128.90	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT BALANCE EVALUATION MOD	$159.00	$265.00	$10.90–$128.90	15% below	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT MOD COMPLEX EVAL	$159.00	$265.00	$10.90–$128.90	15% below	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT MOD COMPLEX EVAL	$159.00	$265.00	$10.90–$128.90	15% below	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT BALANCE EVALUATION MOD	$159.00	$265.00	$10.90–$128.90	15% below	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT PELVIC FLOOR MOD COMP EVAL	$159.00	$265.00	$10.90–$128.90	15% below	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT PELVIC FLOOR MOD COMP EVAL	$159.00	$265.00	$10.90–$128.90	15% below	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT MOD COMPLEX EVAL	$159.00	$265.00	$10.90–$128.90	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT PELVIC FLOOR MOD COMP EVAL	$159.00	$265.00	$10.90–$128.90	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT BALANCE EVALUATION MOD	$159.00	$265.00	$10.90–$128.90	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY TECHNIQUES	$54.00	$90.00	$4.05–$37.71	37% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT ALT-MANUAL THERAPY/15MIN	$54.00	$90.00	$4.05–$37.71	37% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT ALT-MANUAL THERAPY/15MIN	$54.00	$90.00	$4.05–$37.71	37% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY TECHNIQUES 1	$54.00	$90.00	$4.05–$37.71	37% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY TECHNIQUES 1	$54.00	$90.00	$4.05–$37.71	37% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT ALT-MANUAL THERAPY/15MIN	$54.00	$90.00	$4.05–$37.71	37% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT ALT-MANUAL THERAPY/15MIN	$54.00	$90.00	$4.05–$37.71	37% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY TECHNIQUES	$54.00	$90.00	$4.05–$37.71	37% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT ALT MANUAL LYMPH DRAIN EA15	$96.00	$160.00	$4.05–$37.71	12% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT ALT-MANUAL LYMPH DRN 15MIN	$96.00	$160.00	$4.05–$37.71	12% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT ALT-MANUAL LYMPH DRN 15MIN	$96.00	$160.00	$4.05–$37.71	12% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL LYMPH DRAIN LE/15MIN	$96.00	$160.00	$4.05–$37.71	12% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL LYMPH DRAIN LE/15MIN	$96.00	$160.00	$4.05–$37.71	12% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL LYMPH DRAIN LE/15MIN	$96.00	$160.00	$4.05–$37.71	12% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL LYMPH DRAIN LE/15MIN	$96.00	$160.00	$4.05–$37.71	12% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT ALT MANUAL LYMPH DRAIN EA15	$96.00	$160.00	$4.05–$37.71	12% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES	$54.00	$90.00	$4.05–$37.71	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT ALT-MANUAL THERAPY/15MIN	$54.00	$90.00	$4.05–$37.71	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES 1	$54.00	$90.00	$4.05–$37.71	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT ALT-MANUAL THERAPY/15MIN	$54.00	$90.00	$4.05–$37.71	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT ALT MANUAL LYMPH DRAIN EA15	$96.00	$160.00	$4.05–$37.71	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL LYMPH DRAIN LE/15MIN	$96.00	$160.00	$4.05–$37.71	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL LYMPH DRAIN LE/15MIN	$96.00	$160.00	$4.05–$37.71	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT ALT-MANUAL LYMPH DRN 15MIN	$96.00	$160.00	$4.05–$37.71	—	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISES 1-15	$48.00	$80.00	$4.37–$40.43	37% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT ALT-THER EXERCISE EA15MIN	$48.00	$80.00	$4.37–$40.43	37% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT ALT-THER EXERCISE EA15MIN	$48.00	$80.00	$4.37–$40.43	37% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT TX EXERCISES EA 15MIN	$48.00	$80.00	$4.37–$40.43	37% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISES 1-15	$48.00	$80.00	$4.37–$40.43	37% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT TX EXERCISES EA 15MIN	$48.00	$80.00	$4.37–$40.43	37% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT ALT-TX EXERCISE EA15MIN	$48.00	$80.00	$4.37–$40.43	37% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT ALT-TX EXERCISE EA15MIN	$48.00	$80.00	$4.37–$40.43	37% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT ALT-ISOKINETIC TX EA 15MIN	$73.80	$123.00	$4.37–$40.43	2% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT ALT-ISOKINETIC TX EA 15MIN	$73.80	$123.00	$4.37–$40.43	2% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT ISOKINETIC THERAPY EA 15MIN	$73.80	$123.00	$4.37–$40.43	2% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT ISOKINETIC THERAPY EA 15MIN	$73.80	$123.00	$4.37–$40.43	2% below	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT ALT-THER EXERCISE EA15MIN	$48.00	$80.00	$4.37–$40.43	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISES 1-15	$48.00	$80.00	$4.37–$40.43	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT ALT-TX EXERCISE EA15MIN	$48.00	$80.00	$4.37–$40.43	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT TX EXERCISES EA 15MIN	$48.00	$80.00	$4.37–$40.43	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT ISOKINETIC THERAPY EA 15MIN	$73.80	$123.00	$4.37–$40.43	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT ALT-ISOKINETIC TX EA 15MIN	$73.80	$123.00	$4.37–$40.43	—	40%
Psychiatric evaluation with medical services CPT 90792 SS ED PSYCH DX EVAL W/ MED SVC	$516.60	$861.00	$128.80–$210.50	163% above	40%
Psychiatric evaluation with medical services CPT 90792 SS ED PSYCH DX EVAL W/ MED SVC	$516.60	$861.00	$128.80–$210.50	163% above	40%
Psychiatric evaluation with medical services inpatient CPT 90792 SS ED PSYCH DX EVAL W/ MED SVC	$516.60	$861.00	$128.80–$210.50	—	40%
Psychotherapy session, 30 minutes CPT 90832 PSYTX PT&/FAMILY 30 MINUTES	$84.60	$141.00	$49.13–$85.78	14% below	40%
Psychotherapy session, 30 minutes CPT 90832 PSYTX PT&/FAMILY 30 MINUTES	$84.60	$141.00	$49.13–$85.78	14% below	40%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYTX PT&/FAMILY 30 MINUTES	$84.60	$141.00	$49.13–$85.78	—	40%
Psychotherapy session, 45 minutes CPT 90834 PSYTX PT&/FAMILY 45 MINUTES	$84.60	$141.00	$65.16–$128.83	40% below	40%
Psychotherapy session, 45 minutes CPT 90834 PSYTX PT&/FAMILY 45 MINUTES	$84.60	$141.00	$65.16–$128.83	40% below	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYTX PT&/FAMILY 45 MINUTES	$84.60	$141.00	$65.16–$128.83	—	40%
Psychotherapy session, 60 minutes CPT 90837 PSYTX PT&/FAMILY 60 MINUTES	$84.60	$141.00	$97.58–$124.27	60% below	40%
Psychotherapy session, 60 minutes CPT 90837 PSYTX PT&/FAMILY 60 MINUTES	$84.60	$141.00	$97.58–$124.27	60% below	40%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYTX PT&/FAMILY 60 MINUTES	$84.60	$141.00	$97.58–$124.27	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING/TOBACCO COUNSL 3-10MIN	$30.00	$50.00	$1.77–$16.24	at median	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING/TOBACCO COUNSL 3-10MIN	$30.00	$50.00	$1.77–$16.24	at median	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING/TOBACCO COUNSL 3-10MIN	$30.00	$50.00	$1.77–$16.24	—	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 O/P VISIT LEVEL 5 (MD)	$73.80	$123.00	$17.49–$100.08	51% below	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP VISIT LEVEL 5 W/PROC	$613.80	$1,023.00	$17.49–$141.38	308% above	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP VISIT LEVEL 5 W/PROC	$613.80	$1,023.00	$17.49–$141.38	308% above	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP VISIT LEVEL 5 ESTABLISHED	$613.80	$1,023.00	$17.49–$141.38	308% above	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP VISIT LEVEL 5 ESTABLISHED	$613.80	$1,023.00	$17.49–$141.38	308% above	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 O/P VISIT LEVEL 5 (MD)	$73.80	$123.00	$17.49–$100.08	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OP VISIT LEVEL 5 W/PROC	$613.80	$1,023.00	$17.49–$141.38	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OP VISIT LEVEL 5 ESTABLISHED	$613.80	$1,023.00	$17.49–$141.38	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 O/P VISIT LEVEL 3 (MD)	$33.00	$55.00	$7.82–$50.43	62% below	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TRANSPLANT EVALUATION	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WOC/ASSESS/15 MIN TRT	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OSTOMY LEVEL III PROCEDURE	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OSTOMY LEVEL III PROCEDURE	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SKIN/INCONTINENCE TX F/UP	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SKIN/INCONTINENCE TX F/UP	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WOUND/FISTULA TREATMENT F/UP	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WOUND/FISTULA TREATMENT F/UP	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TUBE MANAGEMENT	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TUBE MANAGEMENT	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT LEVEL 3 ESTABLISHED	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT LEVEL 3 ESTABLISHED	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT LEVEL 3 W/PROC	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT LEVEL 3 W/PROC	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WOC/ASSESS/15 MIN TRT	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TRANSPLANT EVALUATION	$333.60	$556.00	$7.82–$71.77	279% above	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 O/P VISIT LEVEL 3 (MD)	$33.00	$55.00	$7.82–$50.43	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OSTOMY LEVEL III PROCEDURE	$333.60	$556.00	$7.82–$71.77	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TRANSPLANT EVALUATION	$333.60	$556.00	$7.82–$71.77	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WOC/ASSESS/15 MIN TRT	$333.60	$556.00	$7.82–$71.77	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WOUND/FISTULA TREATMENT F/UP	$333.60	$556.00	$7.82–$71.77	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP VISIT LEVEL 3 W/PROC	$333.60	$556.00	$7.82–$71.77	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SKIN/INCONTINENCE TX F/UP	$333.60	$556.00	$7.82–$71.77	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP VISIT LEVEL 3 ESTABLISHED	$333.60	$556.00	$7.82–$71.77	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TUBE MANAGEMENT	$333.60	$556.00	$7.82–$71.77	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 O/P VISIT LEVEL 4 (MD)	$51.60	$86.00	$12.21–$74.57	54% below	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WOUND/FISTULA EVAL/TX INIT	$400.20	$667.00	$12.21–$105.54	261% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SKIN/INCONTINENCE EVAL/TX INIT	$400.20	$667.00	$12.21–$105.54	261% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SKIN/INCONTINENCE EVAL/TX INIT	$400.20	$667.00	$12.21–$105.54	261% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OSTOMY LEVEL II EVAL/EDUCATION	$400.20	$667.00	$12.21–$105.54	261% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WOUND/FISTULA EVAL/TX INIT	$400.20	$667.00	$12.21–$105.54	261% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP VISIT LEVEL 4 ESTABLISHED	$400.20	$667.00	$12.21–$105.54	261% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP VISIT LEVEL 4 ESTABLISHED	$400.20	$667.00	$12.21–$105.54	261% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OSTOMY LEVEL II EVAL/EDUCATION	$400.20	$667.00	$12.21–$105.54	261% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP VISIT LEVEL 4 W/PROC	$400.20	$667.00	$12.21–$105.54	261% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP VISIT LEVEL 4 W/PROC	$400.20	$667.00	$12.21–$105.54	261% above	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 O/P VISIT LEVEL 4 (MD)	$51.60	$86.00	$12.21–$74.57	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP VISIT LEVEL 4 W/PROC	$400.20	$667.00	$12.21–$105.54	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WOUND/FISTULA EVAL/TX INIT	$400.20	$667.00	$12.21–$105.54	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP VISIT LEVEL 4 ESTABLISHED	$400.20	$667.00	$12.21–$105.54	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OSTOMY LEVEL II EVAL/EDUCATION	$400.20	$667.00	$12.21–$105.54	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SKIN/INCONTINENCE EVAL/TX INIT	$400.20	$667.00	$12.21–$105.54	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 O/P VISIT LEVEL 2 (MD)	$25.20	$42.00	$4.08–$29.97	51% below	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 O/P VISIT LEVEL 2 (MD)	$25.20	$42.00	$4.08–$29.97	51% below	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CONSULTATION HEARING AID	$235.80	$393.00	$4.08–$43.00	357% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CONSULTATION HEARING AID	$235.80	$393.00	$4.08–$43.00	357% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT LEVEL 2 W/PROC	$250.80	$418.00	$4.08–$43.00	386% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT LEVEL 2 W/PROC	$250.80	$418.00	$4.08–$43.00	386% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT LEVEL 2 ESTABLISHED	$250.80	$418.00	$4.08–$43.00	386% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT LEVEL 2 ESTABLISHED	$250.80	$418.00	$4.08–$43.00	386% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OSTOMY LEVEL I/INITIAL CONSULT	$250.80	$418.00	$4.08–$43.00	386% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OSTOMY LEVEL I/INITIAL CONSULT	$250.80	$418.00	$4.08–$43.00	386% above	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 O/P VISIT LEVEL 2 (MD)	$25.20	$42.00	$4.08–$29.97	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CONSULTATION HEARING AID	$235.80	$393.00	$4.08–$43.00	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP VISIT LEVEL 2 ESTABLISHED	$250.80	$418.00	$4.08–$43.00	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OSTOMY LEVEL I/INITIAL CONSULT	$250.80	$418.00	$4.08–$43.00	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP VISIT LEVEL 2 W/PROC	$250.80	$418.00	$4.08–$43.00	—	40%
Speech and language evaluation CPT 92523 ST LIMITD SOUND/LANG/COMP EVAL	$132.00	$220.00	$32.77–$172.93	35% below	40%
Speech and language evaluation CPT 92523 ST LIMITD SOUND/LANG/COMP EVAL	$132.00	$220.00	$32.77–$172.93	35% below	40%
Speech and language evaluation CPT 92523 EVAL SOUND LANG COMPREHENSION	$264.00	$440.00	$32.77–$306.67	29% above	40%
Speech and language evaluation CPT 92523 EVAL SOUND LANG COMPREHENSION	$264.00	$440.00	$32.77–$306.67	29% above	40%
Speech and language evaluation inpatient CPT 92523 ST LIMITD SOUND/LANG/COMP EVAL	$132.00	$220.00	$32.77–$172.93	—	40%
Speech and language evaluation inpatient CPT 92523 EVAL SOUND LANG COMPREHENSION	$264.00	$440.00	$32.77–$306.67	—	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY I-CHILD	$52.20	$87.00	$5.44–$67.78	64% below	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY I-CHILD	$52.20	$87.00	$5.44–$67.78	64% below	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY I-ADULT	$52.20	$87.00	$5.44–$67.78	64% below	40%
Speech therapy session, individual CPT 92507 VOICE THERAPY I	$52.20	$87.00	$5.44–$67.78	64% below	40%
Speech therapy session, individual CPT 92507 VOICE THERAPY I	$52.20	$87.00	$5.44–$67.78	64% below	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY I-ADULT	$52.20	$87.00	$5.44–$67.78	64% below	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY II-ADULT	$102.60	$171.00	$5.44–$95.73	30% below	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY II-ADULT	$102.60	$171.00	$5.44–$95.73	30% below	40%
Speech therapy session, individual CPT 92507 VOICE THERAPY II	$102.60	$171.00	$5.44–$95.73	30% below	40%
Speech therapy session, individual CPT 92507 VOICE THERAPY II	$102.60	$171.00	$5.44–$95.73	30% below	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY II-CHILD	$102.60	$171.00	$5.44–$95.73	30% below	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY II-CHILD	$102.60	$171.00	$5.44–$95.73	30% below	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY III-CHILD	$153.00	$255.00	$5.44–$95.73	5% above	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY LEVEL III-ADULT	$153.00	$255.00	$5.44–$95.73	5% above	40%
Speech therapy session, individual CPT 92507 VOICE THERAPY III	$153.00	$255.00	$5.44–$95.73	5% above	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY III-CHILD	$153.00	$255.00	$5.44–$95.73	5% above	40%
Speech therapy session, individual CPT 92507 VOICE THERAPY III	$153.00	$255.00	$5.44–$95.73	5% above	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY LEVEL III-ADULT	$153.00	$255.00	$5.44–$95.73	5% above	40%
Speech therapy session, individual CPT 92507 VOICE THERAPY IV	$190.20	$317.00	$5.44–$95.73	31% above	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY IV-CHILD	$190.20	$317.00	$5.44–$95.73	31% above	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY IV-ADULT	$190.20	$317.00	$5.44–$95.73	31% above	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY IV-ADULT	$190.20	$317.00	$5.44–$95.73	31% above	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY IV-CHILD	$190.20	$317.00	$5.44–$95.73	31% above	40%
Speech therapy session, individual CPT 92507 VOICE THERAPY IV	$190.20	$317.00	$5.44–$95.73	31% above	40%
Speech therapy session, individual CPT 92507 HEARING AID MGMT/1-15 MIN	$253.80	$423.00	$5.44–$95.73	74% above	40%
Speech therapy session, individual CPT 92507 HEARING AID MGMT/1-15 MIN	$253.80	$423.00	$5.44–$95.73	74% above	40%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY I-ADULT	$52.20	$87.00	$5.44–$67.78	—	40%
Speech therapy session, individual inpatient CPT 92507 VOICE THERAPY I	$52.20	$87.00	$5.44–$67.78	—	40%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY I-CHILD	$52.20	$87.00	$5.44–$67.78	—	40%
Speech therapy session, individual inpatient CPT 92507 VOICE THERAPY II	$102.60	$171.00	$5.44–$95.73	—	40%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY II-ADULT	$102.60	$171.00	$5.44–$95.73	—	40%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY II-CHILD	$102.60	$171.00	$5.44–$95.73	—	40%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY LEVEL III-ADULT	$153.00	$255.00	$5.44–$95.73	—	40%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY III-CHILD	$153.00	$255.00	$5.44–$95.73	—	40%
Speech therapy session, individual inpatient CPT 92507 VOICE THERAPY III	$153.00	$255.00	$5.44–$95.73	—	40%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY IV-ADULT	$190.20	$317.00	$5.44–$95.73	—	40%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY IV-CHILD	$190.20	$317.00	$5.44–$95.73	—	40%
Speech therapy session, individual inpatient CPT 92507 VOICE THERAPY IV	$190.20	$317.00	$5.44–$95.73	—	40%
Speech therapy session, individual inpatient CPT 92507 HEARING AID MGMT/1-15 MIN	$253.80	$423.00	$5.44–$95.73	—	40%
Spirometry (breathing test) CPT 94010 SPIROMETRY GRAPH/VITAL CAP/FLW	$556.80	$928.00	$5.93–$45.40	127% above	40%
Spirometry (breathing test) CPT 94010 PFT SCREEN BEDSIDE	$556.80	$928.00	$5.93–$45.40	127% above	40%
Spirometry (breathing test) CPT 94010 PFT SCREEN BEDSIDE	$556.80	$928.00	$5.93–$45.40	127% above	40%
Spirometry (breathing test) CPT 94010 SPIROMETRY GRAPH/VITAL CAP/FLW	$556.80	$928.00	$5.93–$45.40	127% above	40%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY GRAPH/VITAL CAP/FLW	$556.80	$928.00	$5.93–$45.40	—	40%
Spirometry (breathing test) inpatient CPT 94010 PFT SCREEN BEDSIDE	$556.80	$928.00	$5.93–$45.40	—	40%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY EV BRONCHOSPASM	$937.20	$1,562.00	$9.36–$83.24	73% above	40%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY EV BRONCHOSPASM	$937.20	$1,562.00	$9.36–$83.24	73% above	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY EV BRONCHOSPASM	$937.20	$1,562.00	$9.36–$83.24	—	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT ALT-TX ACTIVITIES EA 15MIN	$48.00	$80.00	$4.71–$42.51	37% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 ST TX ACTIVITY DIRECT EA 15MIN	$48.00	$80.00	$4.71–$42.51	37% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT ALT-THER ACTIVITIES EA15MIN	$48.00	$80.00	$4.71–$42.51	37% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT ALT-THER ACTIVITIES EA15MIN	$48.00	$80.00	$4.71–$42.51	37% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT TX ACTIVITIES DIRECT/15MIN	$48.00	$80.00	$4.71–$42.51	37% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT TX ACTIVITIES DIRECT/15MIN	$48.00	$80.00	$4.71–$42.51	37% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT ACTIVITY DIRECT EA 15MIN	$48.00	$80.00	$4.71–$42.51	37% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 ST TX ACTIVITY DIRECT EA 15MIN	$48.00	$80.00	$4.71–$42.51	37% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT ALT-TX ACTIVITIES EA 15MIN	$48.00	$80.00	$4.71–$42.51	37% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT ACTIVITY DIRECT EA 15MIN	$48.00	$80.00	$4.71–$42.51	37% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 ST ALT-TX ACTIVITIES EA 15MIN	$73.80	$123.00	$4.71–$42.51	2% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 ST ALT-TX ACTIVITIES EA 15MIN	$73.80	$123.00	$4.71–$42.51	2% below	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT ALT-TX ACTIVITIES EA 15MIN	$48.00	$80.00	$4.71–$42.51	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 ST TX ACTIVITY DIRECT EA 15MIN	$48.00	$80.00	$4.71–$42.51	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT ACTIVITY DIRECT EA 15MIN	$48.00	$80.00	$4.71–$42.51	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT TX ACTIVITIES DIRECT/15MIN	$48.00	$80.00	$4.71–$42.51	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT ALT-THER ACTIVITIES EA15MIN	$48.00	$80.00	$4.71–$42.51	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 ST ALT-TX ACTIVITIES EA 15MIN	$73.80	$123.00	$4.71–$42.51	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY TX (SEP PROC)	$384.00	$640.00	$11.10–$409.66	83% above	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY TX (SEP PROC)	$384.00	$640.00	$11.10–$409.66	83% above	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY TX (SEP PROC)	$384.00	$640.00	$11.10–$409.66	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 PFIZER COVID VACC 30MCG/0.3ML	$313.80	$523.00	$120.75–$350.78	6% below	40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACC	$313.70	$522.84	$114.27–$411.75	23% below	40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACC	$313.70	$522.84	$114.27–$411.75	23% below	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACC	$313.70	$522.84	$114.27–$411.75	—	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIP/TET/PERT(ACEL)/POLIO VACC	$131.65	$219.41	$47.21–$137.43	10% below	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIP/TET/PERT(ACEL)/POLIO VACC	$131.65	$219.41	$47.21–$137.43	10% below	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DIP/TET/PERT(ACEL)/POLIO VACC	$131.65	$219.41	$47.21–$137.43	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH/TET/PERT(DTAP) PED VACC	$49.35	$82.25	$20.00–$64.80	40% below	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH/TET/PERT(DTAP) PED VACC	$49.35	$82.25	$20.00–$64.80	40% below	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH/TET/PERT(DTAP) PED VACC	$49.35	$82.25	$20.00–$64.80	—	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DIPH/PERT/TET/HEP B/POLIO VACC	$180.74	$301.23	$70.26–$229.59	5% below	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DIPH/PERT/TET/HEP B/POLIO VACC	$180.74	$301.23	$70.26–$229.59	5% below	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DIPH/PERT/TET/HEP B/POLIO VACC	$180.74	$301.23	$70.26–$229.59	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACC TRIVAL 0.5ML 6+MO	$47.88	$79.80	$15.19–$50.29	23% above	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACC TRIVAL 0.5ML 6+MO	$47.88	$79.80	$15.19–$50.29	23% above	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACC TRIVAL 0.5ML 6+MO	$47.88	$79.80	$15.19–$50.29	—	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VACC 9V	$441.38	$735.64	$196.44–$692.12	30% below	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VACC 9V	$441.38	$735.64	$196.44–$692.12	30% below	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS VACC 9V	$441.38	$735.64	$196.44–$692.12	—	40%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 TWINRIX (HEPATITIS A&B) VACC	$201.80	$336.33	$15.38–$294.15	15% below	40%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 TWINRIX (HEPATITIS A&B) VACC	$201.80	$336.33	$15.38–$294.15	15% below	40%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 TWINRIX (HEPATITIS A&B) VACC	$201.80	$336.33	$15.38–$294.15	—	40%
Hepatitis A vaccine, adult dose CPT 90632 HEP A VACC ADULT 1440U/1ML	$135.49	$225.82	$63.51–$158.58	21% below	40%
Hepatitis A vaccine, adult dose CPT 90632 HEP A VACC ADULT 1440U/1ML	$135.49	$225.82	$63.51–$158.58	21% below	40%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE	$178.07	$296.78	$63.51–$158.58	4% above	40%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE	$178.07	$296.78	$63.51–$158.58	4% above	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VACC ADULT 1440U/1ML	$135.49	$225.82	$63.51–$158.58	—	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE	$178.07	$296.78	$63.51–$158.58	—	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A PED VAC 0.5ML	$55.28	$92.13	$29.93–$85.52	35% below	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A PED VAC 0.5ML	$55.28	$92.13	$29.93–$85.52	35% below	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACC 720U/0.5ML	$120.25	$200.41	$29.93–$85.52	41% above	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACC 720U/0.5ML	$120.25	$200.41	$29.93–$85.52	41% above	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A PED VAC 0.5ML	$55.28	$92.13	$29.93–$85.52	—	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VACC 720U/0.5ML	$120.25	$200.41	$29.93–$85.52	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACC 10MCG (ADULT)	$128.99	$214.98	$52.71–$167.16	27% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACC 10MCG (ADULT)	$128.99	$214.98	$52.71–$167.16	27% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACC 20MCG ADULT	$175.91	$293.18	$52.71–$167.16	at median	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACC 20MCG ADULT	$175.91	$293.18	$52.71–$167.16	at median	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACC 10MCG (ADULT)	$128.99	$214.98	$52.71–$167.16	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACC 20MCG ADULT	$175.91	$293.18	$52.71–$167.16	—	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VACC 20MCG/ML ADULT	$446.88	$744.80	$59.42–$378.68	49% above	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VACC 20MCG/ML ADULT	$446.88	$744.80	$59.42–$378.68	49% above	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VACC 20MCG/ML ADULT	$446.88	$744.80	$59.42–$378.68	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACC 5MCG PF (PED)	$45.91	$76.51	$28.76–$69.23	37% below	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACC 10MCG PF PED	$45.91	$76.51	$28.76–$69.23	37% below	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACC 10MCG PF PED	$45.91	$76.51	$28.76–$69.23	37% below	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACC 5MCG PF (PED)	$45.91	$76.51	$28.76–$69.23	37% below	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VACC 5MCG PF (PED)	$45.91	$76.51	$28.76–$69.23	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VACC 10MCG PF PED	$45.91	$76.51	$28.76–$69.23	—	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPHILUS B CONJ VACC 8MCG	$52.77	$87.95	$24.96–$68.81	20% below	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPHILUS B CONJ VACC 8MCG	$52.77	$87.95	$24.96–$68.81	20% below	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPHILUS B CONJ VACC 8MCG	$52.77	$87.95	$24.96–$68.81	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B CONJ VACC 10MCG	$48.82	$81.37	$17.37–$30.00	at median	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B CONJ VACC 10MCG	$48.82	$81.37	$17.37–$30.00	at median	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B CONJ VACC 10MCG	$48.82	$81.37	$17.37–$30.00	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA HIGH DOSE VACC >65YR	$179.55	$299.25	$37.53–$187.85	at median	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA HIGH DOSE VACC >65YR	$179.55	$299.25	$37.53–$187.85	at median	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA HIGH DOSE VACC >65YR	$179.55	$299.25	$37.53–$187.85	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/RUBELLA VACC	$417.25	$695.41	$65.98–$208.10	62% above	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/RUBELLA VACC	$417.25	$695.41	$65.98–$208.10	62% above	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES/MUMPS/RUBELLA VACC	$417.25	$695.41	$65.98–$208.10	—	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEAS/MUMP/RUBEL/VARICELLA VACC	$424.32	$707.20	$267.62–$625.86	at median	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEAS/MUMP/RUBEL/VARICELLA VACC	$424.32	$707.20	$267.62–$625.86	at median	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEAS/MUMP/RUBEL/VARICELLA VACC	$424.32	$707.20	$267.62–$625.86	—	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACC (MENVEO)	$228.96	$381.60	$99.42–$354.04	35% below	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACC (MENVEO)	$228.96	$381.60	$99.42–$354.04	35% below	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACC MENVEO PREDILUTE	$329.24	$548.73	$99.42–$354.04	6% below	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACC MENVEO PREDILUTE	$329.24	$548.73	$99.42–$354.04	6% below	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACC (MENVEO)	$228.96	$381.60	$99.42–$354.04	—	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACC MENVEO PREDILUTE	$329.24	$548.73	$99.42–$354.04	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL GROUP B VACC	$322.90	$538.17	$210.57–$503.44	17% below	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL GROUP B VACC	$322.90	$538.17	$210.57–$503.44	17% below	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL GROUP B VACC	$322.90	$538.17	$210.57–$503.44	—	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL VAC(13-VAL CONJ)	$429.30	$715.50	$161.77–$580.48	8% below	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL VAC(13-VAL CONJ)	$429.30	$715.50	$161.77–$580.48	8% below	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL VAC(13-VAL CONJ)	$429.30	$715.50	$161.77–$580.48	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL VACC 20-VAL CONJ	$633.56	$1,055.93	$260.66–$670.59	1% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL-23 0.5ML VIAL	$166.40	$277.33	$73.72–$144.30	29% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL-23 0.5ML VIAL	$166.40	$277.33	$73.72–$144.30	29% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL-23 0.5ML VIAL	$166.40	$277.33	$73.72–$144.30	—	40%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACC (IPV)	$119.17	$198.62	$7.76–$95.94	4% below	40%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACC (IPV)	$119.17	$198.62	$7.76–$95.94	4% below	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACC (IPV)	$119.17	$198.62	$7.76–$95.94	—	40%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB RSV VACC 100MG/1ML INJ	$1,105.21	$1,842.01	$495.00–$1,169.44	3% below	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB RSV VACC 50MG/0.5ML INJ	$1,105.21	$1,842.01	$495.00–$1,169.44	3% below	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO RSV VACCINE 0.5ML INJ	$659.71	$1,099.51	$300.90–$663.75	9% above	40%
Rabies vaccine, one dose CPT 90675 RABIES VACC	$659.39	$1,098.99	$259.48–$1,026.16	18% below	40%
Rabies vaccine, one dose CPT 90675 RABIES VACC	$659.39	$1,098.99	$259.48–$1,026.16	18% below	40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACC	$659.39	$1,098.99	$259.48–$1,026.16	—	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACC	$191.74	$319.57	$95.00–$255.11	at median	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACC	$191.74	$319.57	$95.00–$255.11	at median	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VACC	$191.74	$319.57	$95.00–$255.11	—	40%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VACCINE (SHINGRIX)	$331.10	$551.84	$180.15–$445.28	15% below	40%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VACCINE (SHINGRIX)	$331.10	$551.84	$180.15–$445.28	15% below	40%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VACCINE (SHINGRIX)	$331.10	$551.84	$180.15–$445.28	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPHTHERIA/TETANUS VACC	$117.88	$196.47	$17.04–$98.24	3% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPHTHERIA/TETANUS VACC	$117.88	$196.47	$17.04–$98.24	3% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPHTHERIA/TETANUS SYRINGE	$120.13	$200.21	$17.04–$98.24	5% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPHTHERIA/TETANUS SYRINGE	$120.13	$200.21	$17.04–$98.24	5% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIPHTHERIA/TETANUS VACC	$117.88	$196.47	$17.04–$98.24	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIPHTHERIA/TETANUS SYRINGE	$120.13	$200.21	$17.04–$98.24	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH/PERT/TET VACC BOOSTRIX	$122.69	$204.48	$35.96–$86.67	at median	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH/PERT/TET VACC BOOSTRIX	$122.69	$204.48	$35.96–$86.67	at median	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH/PERT/TET VACC ADACEL	$131.34	$218.90	$35.96–$86.67	7% above	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH/PERT/TET VACC ADACEL	$131.34	$218.90	$35.96–$86.67	7% above	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH/PERT/TET VACC BOOSTRIX	$122.69	$204.48	$35.96–$86.67	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH/PERT/TET VACC ADACEL	$131.34	$218.90	$35.96–$86.67	—	40%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACC VICPS IM	$202.54	$337.56	$94.59–$314.08	38% below	40%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACC VICPS IM	$202.54	$337.56	$94.59–$314.08	38% below	40%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACC VICPS IM	$202.54	$337.56	$94.59–$314.08	—	40%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 TYPHOID VACC LIVE ORAL	$48.88	$81.47	$10.83	76% below	40%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 TYPHOID VACC LIVE ORAL	$48.88	$81.47	$10.83	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PNEUMOCOCCAL ADMIN FEE EXPLSN	$85.80	$143.00	$3.46–$29.44	39% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN HEP B VACCINE	$85.80	$143.00	$3.46–$29.44	39% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INFLUENZA ADMIN FEE EXPLOSION	$85.80	$143.00	$3.46–$29.44	39% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PNEUMOCOCCAL ADMIN FEE EXPLSN	$85.80	$143.00	$3.46–$29.44	39% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INFLUENZA ADMIN FEE EXPLOSION	$85.80	$143.00	$3.46–$29.44	39% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN HEP B VACCINE	$85.80	$143.00	$3.46–$29.44	39% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADM 1SNG/COMB VACC/TOX	$99.00	$165.00	$3.46–$29.44	61% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADM 1SNG/COMB VACC/TOX	$99.00	$165.00	$3.46–$29.44	61% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INFLUENZA ADMIN FEE EXPLOSION	$85.80	$143.00	$3.46–$29.44	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN HEP B VACCINE	$85.80	$143.00	$3.46–$29.44	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PNEUMOCOCCAL ADMIN FEE EXPLSN	$85.80	$143.00	$3.46–$29.44	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZ ADM 1SNG/COMB VACC/TOX	$99.00	$165.00	$3.46–$29.44	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADM EAADD SNG/VACC/TOX	$116.40	$194.00	$1.73–$12.56	193% above	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADM EAADD SNG/VACC/TOX	$116.40	$194.00	$1.73–$12.56	193% above	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZ ADM EAADD SNG/VACC/TOX	$116.40	$194.00	$1.73–$12.56	—	40%

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://healthcare.ascension.org/-/media/project/ascension/healthcare/price-transparency-files/in-csv/320014795_carmel-ambulatory-surgery-center-llc_standardcharges.csv