El Paso Children's Hospital
El Paso Children's Hospital in El Paso, TX publishes cash prices for 335 common procedures listed here, from its own machine-readable price file updated Jan 27, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Texas median for 332 of 333 procedures and above it for 1. By typical cash price it ranks #3 of 299 Texas hospitals and #3 of 5 hospitals in the El Paso, TX area, cheapest first. Select a procedure to compare it with other hospitals nearby.
4845 Alameda Ave, El Paso, Tx 79905 Collected Sep 22, 2026 Source price file Check a bill from this hospital (915) 521-7148
Children's hospital Nonprofit hospital Emergency department CCN 453313 · CMS hospital register NPI 1558659714
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
El Paso Children's Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named El Paso Children's Hospital in El Paso, TX:
- Feb 1, 2024 Warning notice
- May 10, 2024 Corrective action plan requested
- Jun 18, 2024 Case closed
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS | $52.00 | $260.00 | $31.52–$308.72 | 86% below | 80% |
| Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS | $52.00 | $260.00 | $31.52–$308.72 | — | 80% |
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE 3 VIEWS | $34.20 | $171.00 | $31.42–$246.95 | 90% below | 80% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE 3 VIEWS | $34.20 | $171.00 | $31.42–$246.95 | — | 80% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 BARIUM SWALLOW (ESOPHAGUS) | $90.80 | $454.00 | $83.65–$363.20 | 82% below | 80% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 BARIUM SWALLOW (ESOPHAGUS) | $90.80 | $454.00 | $83.65–$363.20 | — | 80% |
| Bone scan, whole body (nuclear medicine) CPT 78306 BONE SCAN TOTAL BODY (ROUTINE) | $256.60 | $1,283.00 | $230.14–$1,026.40 | 84% below | 80% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE SCAN TOTAL BODY (ROUTINE) | $256.60 | $1,283.00 | $230.14–$1,026.40 | — | 80% |
| Breast ultrasound, complete, one breast both sides CPT 76641 USD BREAST BILAT COMPLETE BIL | $95.80 | $479.00 | $88.39–$383.20 | — | 80% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILAT COM BIL | $95.80 | $479.00 | $88.39–$383.20 | 78% below | 80% |
| Breast ultrasound, complete, one breast one side CPT 76641 NE US BREAST UNILAT CMPL RT | $95.80 | $479.00 | $88.39–$383.20 | 78% below | 80% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILAT COMPLETE LT | $95.80 | $479.00 | $88.39–$383.20 | 78% below | 80% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 USD BREAST BILAT COMPLETE BIL | $95.80 | $479.00 | $88.39–$383.20 | — | 80% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST UNILAT COMPLETE LT | $95.80 | $479.00 | $88.39–$383.20 | — | 80% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST UNILAT COM BIL | $95.80 | $479.00 | $88.39–$383.20 | — | 80% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 NE US BREAST UNILAT CMPL RT | $95.80 | $479.00 | $88.39–$383.20 | — | 80% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST UNI LTD BIL | $79.20 | $396.00 | $73.30–$316.80 | 77% below | 80% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LMTD W/AXILA LT | $79.20 | $396.00 | $73.30–$316.80 | 77% below | 80% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 USD BREAST UNILAT LIMITED RT | $79.20 | $396.00 | $73.30–$316.80 | 77% below | 80% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LMTD W/AXILA RT | $79.20 | $396.00 | $73.30–$316.80 | 77% below | 80% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST UNI LTD BIL | $79.20 | $396.00 | $73.30–$316.80 | — | 80% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LMTD W/AXILA LT | $79.20 | $396.00 | $73.30–$316.80 | — | 80% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LMTD W/AXILA RT | $79.20 | $396.00 | $73.30–$316.80 | — | 80% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 USD BREAST UNILAT LIMITED RT | $79.20 | $396.00 | $73.30–$316.80 | — | 80% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD/PEL W/WO CONTRAST POST | $2,078.40 | $10,392.00 | $335.10–$8,313.60 | 48% below | 80% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD/PEL W/WO CONTRAST POST | $2,078.40 | $10,392.00 | $335.10–$8,313.60 | — | 80% |
| CT angiography (CTA) of the neck CPT 70498 CTA NECK W IV & POST PROCESS | $954.20 | $4,771.00 | $175.06–$3,816.80 | 60% below | 80% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W IV & POST PROCESS | $954.20 | $4,771.00 | $175.06–$3,816.80 | — | 80% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W IV & POST PROCESS | $1,157.60 | $5,788.00 | $175.06–$4,630.40 | 55% below | 80% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W IV & POST PROCESS | $1,157.60 | $5,788.00 | $175.06–$4,630.40 | — | 80% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CH CT ANGIO HRT W/3D IMAGE | $963.40 | $4,817.00 | $175.06–$3,853.60 | 42% below | 80% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CH CT ANGIO HRT W/3D IMAGE | $963.40 | $4,817.00 | $175.06–$3,853.60 | — | 80% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 ABDOMEN PELVIS W CONTR | $435.60 | $2,178.00 | $267.39–$1,742.40 | 89% below | 80% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 ABDOMEN PELVIS W CONTR | $435.60 | $2,178.00 | $267.39–$1,742.40 | — | 80% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 ABD & PELVIS W & WO CONTR | $325.80 | $1,629.00 | $299.97–$1,303.20 | 91% below | 80% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 ABD & PELVIS W & WO CONTR | $325.80 | $1,629.00 | $299.97–$1,303.20 | — | 80% |
| CT scan of the head or brain, no contrast dye CPT 70450 HEAD/BRAIN W/O CONT | $146.20 | $731.00 | $93.68–$584.80 | 91% below | 80% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HEAD/BRAIN W/O CONT | $146.20 | $731.00 | $93.68–$584.80 | — | 80% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DOPPLER BILATERAL | $178.20 | $891.00 | $155.07–$712.80 | — | 80% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID DOPPLER BILATERAL | $178.20 | $891.00 | $155.07–$712.80 | — | 80% |
| Chest X-ray, 2 views CPT 71046 CHEST BOTH DECUBITUS R & L | $31.40 | $157.00 | $28.95–$161.49 | 92% below | 80% |
| Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS | $47.20 | $236.00 | $28.95–$188.80 | 88% below | 80% |
| Chest X-ray, 2 views CPT 71046 CHEST 2 VWS AP & LAT PORTABLE | $47.60 | $238.00 | $28.95–$190.40 | 88% below | 80% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST BOTH DECUBITUS R & L | $31.40 | $157.00 | $28.95–$161.49 | — | 80% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS | $47.20 | $236.00 | $28.95–$188.80 | — | 80% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VWS AP & LAT PORTABLE | $47.60 | $238.00 | $28.95–$190.40 | — | 80% |
| Chest X-ray, single view CPT 71045 CHEST AP OR PA 1 VIEW ONLY | $24.00 | $120.00 | $22.09–$161.49 | 93% below | 80% |
| Chest X-ray, single view CPT 71045 XR CHEST ONE VIEW | $24.00 | $120.00 | $22.09–$161.49 | 93% below | 80% |
| Chest X-ray, single view CPT 71045 SINGLE CHEST LAT PORT | $24.00 | $120.00 | $22.09–$161.49 | 93% below | 80% |
| Chest X-ray, single view CPT 71045 CHEST SINGLE VIEW/DOCUMENT | $24.00 | $120.00 | $22.09–$161.49 | 93% below | 80% |
| Chest X-ray, single view CPT 71045 CHEST PA LAT ONE DECUB | $31.40 | $157.00 | $22.09–$161.49 | 90% below | 80% |
| Chest X-ray, single view CPT 71045 CHEST DECUB 1 VIEW | $31.40 | $157.00 | $22.09–$161.49 | 90% below | 80% |
| Chest X-ray, single view CPT 71045 RAD CHEST 1 VW AP/PA PORT | $36.00 | $180.00 | $22.09–$161.49 | 89% below | 80% |
| Chest X-ray, single view inpatient CPT 71045 SINGLE CHEST LAT PORT | $24.00 | $120.00 | $22.09–$161.49 | — | 80% |
| Chest X-ray, single view inpatient CPT 71045 XR CHEST ONE VIEW | $24.00 | $120.00 | $22.09–$161.49 | — | 80% |
| Chest X-ray, single view inpatient CPT 71045 CHEST AP OR PA 1 VIEW ONLY | $24.00 | $120.00 | $22.09–$161.49 | — | 80% |
| Chest X-ray, single view inpatient CPT 71045 CHEST SINGLE VIEW/DOCUMENT | $24.00 | $120.00 | $22.09–$161.49 | — | 80% |
| Chest X-ray, single view inpatient CPT 71045 CHEST DECUB 1 VIEW | $31.40 | $157.00 | $22.09–$161.49 | — | 80% |
| Chest X-ray, single view inpatient CPT 71045 CHEST PA LAT ONE DECUB | $31.40 | $157.00 | $22.09–$161.49 | — | 80% |
| Chest X-ray, single view inpatient CPT 71045 RAD CHEST 1 VW AP/PA PORT | $36.00 | $180.00 | $22.09–$161.49 | — | 80% |
| Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE 1 VIEW | $30.40 | $152.00 | $28.00–$154.28 | 90% below | 80% |
| Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE 2 VIEWS | $30.40 | $152.00 | $28.00–$154.28 | 90% below | 80% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE 1 VIEW | $30.40 | $152.00 | $28.00–$154.28 | — | 80% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE 2 VIEWS | $30.40 | $152.00 | $28.00–$154.28 | — | 80% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RENAL (ROUTINE) | $104.80 | $524.00 | $93.21–$419.20 | 85% below | 80% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 RENAL (ROUTINE) | $104.80 | $524.00 | $93.21–$419.20 | — | 80% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 PREGNANCY W FETAL DTL ANATOMY | $165.40 | $827.00 | $153.72–$661.60 | 76% below | 80% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 PREGNANCY W FETAL DTL ANATOMY | $165.40 | $827.00 | $153.72–$661.60 | — | 80% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 THORAX/CHEST IV CONT ROUT | $422.60 | $2,113.00 | $147.40–$1,690.40 | 79% below | 80% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 THORAX/CHEST IV CONT ROUT | $422.60 | $2,113.00 | $147.40–$1,690.40 | — | 80% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 PERIPH ARTERY DOP LWD EX BILAT | $217.40 | $1,087.00 | $155.07–$869.60 | — | 80% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 PERIPH ARTERY DOP LWD EX BILAT | $217.40 | $1,087.00 | $155.07–$869.60 | — | 80% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 PERIPH VEIN DOPP UP EXT BILAT | $421.00 | $2,105.00 | $155.07–$1,684.00 | — | 80% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 PERIPH VEIN DOPP LWR EXT BILA | $421.00 | $2,105.00 | $155.07–$1,684.00 | 73% below | 80% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 FOUR EXTREMITY VENOUS DOPPLER | $421.00 | $2,105.00 | $155.07–$1,684.00 | 73% below | 80% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 PERIPH VEIN DOPP UP EXT BILAT | $421.00 | $2,105.00 | $155.07–$1,684.00 | — | 80% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 PERIPH VEIN DOPP LWR EXT BILA | $421.00 | $2,105.00 | $155.07–$1,684.00 | — | 80% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 FOUR EXTREMITY VENOUS DOPPLER | $421.00 | $2,105.00 | $155.07–$1,684.00 | — | 80% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO 2D W/SPEC/COLOR COMPL | $869.40 | $4,347.00 | $169.13–$3,477.60 | 54% below | 80% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO 2D W/SPEC/COLOR COMPL | $869.40 | $4,347.00 | $169.13–$3,477.60 | — | 80% |
| Elbow X-ray, 2 views CPT 73070 RAD ELBOW 2 VIEWS | $27.40 | $137.00 | $25.16–$154.28 | 91% below | 80% |
| Elbow X-ray, 2 views CPT 73070 ELBOW ONE VIEW SPECIFY | $27.40 | $137.00 | $25.16–$154.28 | 91% below | 80% |
| Elbow X-ray, 2 views inpatient CPT 73070 RAD ELBOW 2 VIEWS | $27.40 | $137.00 | $25.16–$154.28 | — | 80% |
| Elbow X-ray, 2 views inpatient CPT 73070 ELBOW ONE VIEW SPECIFY | $27.40 | $137.00 | $25.16–$154.28 | — | 80% |
| Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW COMPLETE 3 VWS | $56.00 | $280.00 | $28.30–$224.00 | 85% below | 80% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 ELBOW COMPLETE 3 VWS | $56.00 | $280.00 | $28.30–$224.00 | — | 80% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL CMPL 3+VIEWS | $44.20 | $221.00 | $40.63–$246.95 | 89% below | 80% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES (ROUTINE) | $44.20 | $221.00 | $40.63–$246.95 | 89% below | 80% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES (ROUTINE) | $44.20 | $221.00 | $40.63–$246.95 | — | 80% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL CMPL 3+VIEWS | $44.20 | $221.00 | $40.63–$246.95 | — | 80% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM ONE VIEW SPECIFY | $27.40 | $137.00 | $25.16–$154.28 | 93% below | 80% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM AP/LAT ROUTINE | $27.40 | $137.00 | $25.16–$154.28 | 93% below | 80% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 FOREARM ONE VIEW SPECIFY | $27.40 | $137.00 | $25.16–$154.28 | — | 80% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 FOREARM AP/LAT ROUTINE | $27.40 | $137.00 | $25.16–$154.28 | — | 80% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY SYSTEM IMG | $282.00 | $1,410.00 | $253.16–$1,128.00 | 82% below | 80% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATO DUCT GBLADR W/WO PHARM | $282.00 | $1,410.00 | $253.16–$1,128.00 | 82% below | 80% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY SYSTEM IMG | $282.00 | $1,410.00 | $253.16–$1,128.00 | — | 80% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATO DUCT GBLADR W/WO PHARM | $282.00 | $1,410.00 | $253.16–$1,128.00 | — | 80% |
| Hand X-ray, 2 views CPT 73120 HAND ONE VIEW SPECIFY | $29.60 | $148.00 | $27.15–$246.95 | 91% below | 80% |
| Hand X-ray, 2 views CPT 73120 HAND 2 VIEWS | $29.60 | $148.00 | $27.15–$246.95 | 91% below | 80% |
| Hand X-ray, 2 views inpatient CPT 73120 HAND 2 VIEWS | $29.60 | $148.00 | $27.15–$246.95 | — | 80% |
| Hand X-ray, 2 views inpatient CPT 73120 HAND ONE VIEW SPECIFY | $29.60 | $148.00 | $27.15–$246.95 | — | 80% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HEEL/OSCALSIS TANG/LAT ROUTINE | $26.80 | $134.00 | $24.61–$154.28 | 91% below | 80% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HEEL/OSCALSIS TANG/LAT ROUTINE | $26.80 | $134.00 | $24.61–$154.28 | — | 80% |
| Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS | $38.20 | $191.00 | $35.11–$246.95 | 90% below | 80% |
| Knee X-ray, 3 views inpatient CPT 73562 KNEE 3 VIEWS | $38.20 | $191.00 | $35.11–$246.95 | — | 80% |
| Knee X-ray, complete, 4 or more views CPT 73564 KNEE 4 VIEWS AP/LAT OBLIQUES | $44.20 | $221.00 | $40.56–$246.95 | 90% below | 80% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 KNEE 4 VIEWS AP/LAT OBLIQUES | $44.20 | $221.00 | $40.56–$246.95 | — | 80% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 GALLBLADDER SONO | $81.20 | $406.00 | $74.85–$324.80 | 87% below | 80% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LTD HERNIA | $81.20 | $406.00 | $74.85–$324.80 | 87% below | 80% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HEPATIC/LIVER | $81.20 | $406.00 | $74.85–$324.80 | 87% below | 80% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 PYLORUS ULTRASOUND | $81.20 | $406.00 | $74.85–$324.80 | 87% below | 80% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ABDOMEN LIMITED | $121.80 | $609.00 | $74.85–$487.20 | 80% below | 80% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LTD HERNIA | $81.20 | $406.00 | $74.85–$324.80 | — | 80% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 PYLORUS ULTRASOUND | $81.20 | $406.00 | $74.85–$324.80 | — | 80% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HEPATIC/LIVER | $81.20 | $406.00 | $74.85–$324.80 | — | 80% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 GALLBLADDER SONO | $81.20 | $406.00 | $74.85–$324.80 | — | 80% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ABDOMEN LIMITED | $121.80 | $609.00 | $74.85–$487.20 | — | 80% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 LOWER LEG AP/LAT (ROUTINE) | $29.60 | $148.00 | $27.15–$154.28 | 91% below | 80% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 LOWER LEG ONE VIEW SPECIFY | $29.60 | $148.00 | $27.15–$154.28 | 91% below | 80% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 LOWER LEG ONE VIEW SPECIFY | $29.60 | $148.00 | $27.15–$154.28 | — | 80% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 LOWER LEG AP/LAT (ROUTINE) | $29.60 | $148.00 | $27.15–$154.28 | — | 80% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O CONTRAST | $206.80 | $1,034.00 | $190.22–$908.78 | 88% below | 80% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O CONTRAST | $206.80 | $1,034.00 | $190.22–$908.78 | — | 80% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI EXT LOWER JT W/O CONT | $194.40 | $972.00 | $179.15–$908.78 | 91% below | 80% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI KNEE UNI W/O CONT | $400.60 | $2,003.00 | $179.15–$1,602.40 | 82% below | 80% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI EXT LOWER JT W/O CONT | $194.40 | $972.00 | $179.15–$908.78 | — | 80% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI KNEE UNI W/O CONT | $400.60 | $2,003.00 | $179.15–$1,602.40 | — | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI KNEE UNI W/WO CONT | $341.00 | $1,705.00 | $340.40–$1,392.09 | 89% below | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI EXT LOWER JT W/WO CONT | $341.00 | $1,705.00 | $340.40–$1,392.09 | 89% below | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI KNEE UNI W/WO CONT | $341.00 | $1,705.00 | $340.40–$1,392.09 | — | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI EXT LOWER JT W/WO CONT | $341.00 | $1,705.00 | $340.40–$1,392.09 | — | 80% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W W/O CONT | $629.40 | $3,147.00 | $298.86–$2,517.60 | 79% below | 80% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W W/O CONT | $629.40 | $3,147.00 | $298.86–$2,517.60 | — | 80% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONT | $282.40 | $1,412.00 | $173.69–$1,129.60 | 85% below | 80% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONT | $282.40 | $1,412.00 | $173.69–$1,129.60 | — | 80% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONT | $458.20 | $2,291.00 | $281.74–$1,832.80 | 84% below | 80% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONT | $458.20 | $2,291.00 | $281.74–$1,832.80 | — | 80% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/WO CONT | $611.40 | $3,057.00 | $282.58–$2,445.60 | 81% below | 80% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/WO CONT | $611.40 | $3,057.00 | $282.58–$2,445.60 | — | 80% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE W/WO CONT | $631.60 | $3,158.00 | $283.16–$2,526.40 | 81% below | 80% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SPINE W/WO CONT | $631.60 | $3,158.00 | $283.16–$2,526.40 | — | 80% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO CONT | $570.40 | $2,852.00 | $297.73–$2,281.60 | 82% below | 80% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO CONT | $570.40 | $2,852.00 | $297.73–$2,281.60 | — | 80% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONT | $217.20 | $1,086.00 | $202.53–$908.78 | 91% below | 80% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONT | $217.20 | $1,086.00 | $202.53–$908.78 | — | 80% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI SHOULDER W/O CONT | $194.60 | $973.00 | $179.42–$908.78 | 89% below | 80% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI EXT UPPER JT W/O CONT | $194.60 | $973.00 | $179.42–$908.78 | 89% below | 80% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI SHOULDER W/O CONT | $194.60 | $973.00 | $179.42–$908.78 | — | 80% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI EXT UPPER JT W/O CONT | $194.60 | $973.00 | $179.42–$908.78 | — | 80% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR C-SPINE 4+V | $50.00 | $250.00 | $46.02–$246.95 | 91% below | 80% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERV SPINE 4/5 VWS | $50.00 | $250.00 | $46.02–$246.95 | 91% below | 80% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR C-SPINE 4+V | $50.00 | $250.00 | $46.02–$246.95 | — | 80% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERV SPINE 4/5 VWS | $50.00 | $250.00 | $46.02–$246.95 | — | 80% |
| Neck soft tissue CT scan with contrast CPT 70491 NECK SOFT TISSUE W/CONT ROUT | $385.40 | $1,927.00 | $162.77–$1,541.60 | 81% below | 80% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 NECK SOFT TISSUE W/CONT ROUT | $385.40 | $1,927.00 | $162.77–$1,541.60 | — | 80% |
| Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE AP/LAT (ROUT) | $29.20 | $146.00 | $26.90–$154.28 | 88% below | 80% |
| Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE AP/LAT (ROUT) | $29.20 | $146.00 | $26.90–$154.28 | — | 80% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NUC CARD STRESS/REST MULT | $407.60 | $2,038.00 | $370.38–$2,015.23 | 90% below | 80% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NUC CARD STRESS/REST MULT | $407.60 | $2,038.00 | $370.38–$2,015.23 | — | 80% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET W/CT TUMR SKULL MID-THIGH | $1,386.00 | $6,930.00 | $1,037.34–$5,544.00 | 68% below | 80% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET W/CT TUMR SKULL MID-THIGH | $1,386.00 | $6,930.00 | $1,037.34–$5,544.00 | — | 80% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS NON-OB LTD | $47.20 | $236.00 | $42.71–$188.80 | 90% below | 80% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 USD PELVIS NON-OB LTD | $47.20 | $236.00 | $42.71–$188.80 | 90% below | 80% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 URINARY BLADDER | $47.20 | $236.00 | $42.71–$188.80 | 90% below | 80% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS NON-OB LTD | $47.20 | $236.00 | $42.71–$188.80 | — | 80% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 USD PELVIS NON-OB LTD | $47.20 | $236.00 | $42.71–$188.80 | — | 80% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 URINARY BLADDER | $47.20 | $236.00 | $42.71–$188.80 | — | 80% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US TRANSREC- PROSTATE | $89.60 | $448.00 | $90.59–$358.40 | 88% below | 80% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIC NON-OB TRANSAB | $89.60 | $448.00 | $90.59–$358.40 | 88% below | 80% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIC NON-OB TRANSAB | $89.60 | $448.00 | $90.59–$358.40 | — | 80% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US TRANSREC- PROSTATE | $89.60 | $448.00 | $90.59–$358.40 | — | 80% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 PELVIC OB > 14 WEEKS TRANSABD | $97.40 | $487.00 | $97.29–$389.60 | 84% below | 80% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 PELVIC OB > 14 WEEKS TRANSABD | $97.40 | $487.00 | $97.29–$389.60 | — | 80% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 PELVIC OB <14 WKS TRANSABD | $97.40 | $487.00 | $97.29–$389.60 | 83% below | 80% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 PELVIC OB <14 WKS TRANSABD | $97.40 | $487.00 | $97.29–$389.60 | — | 80% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 PREGANCY LIMITED | $75.60 | $378.00 | $62.47–$302.40 | 84% below | 80% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 PREGANCY LIMITED | $75.60 | $378.00 | $62.47–$302.40 | — | 80% |
| Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT 2 VIEWS | $34.20 | $171.00 | $31.50–$154.28 | 88% below | 80% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILAT 2 VIEWS | $34.20 | $171.00 | $31.50–$154.28 | — | 80% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNILAT W/ CHEST | $39.40 | $197.00 | $36.40–$246.95 | 90% below | 80% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS UNILAT W/ CHEST | $39.40 | $197.00 | $36.40–$246.95 | — | 80% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER AP INT/EXT W/AXILLARY | $32.60 | $163.00 | $30.02–$246.95 | 90% below | 80% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER ROUTINE | $32.60 | $163.00 | $30.02–$246.95 | 90% below | 80% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER ROUTINE INT/EXT ROT | $32.60 | $163.00 | $30.02–$246.95 | 90% below | 80% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER ROUTINE INT/EXT ROT | $32.60 | $163.00 | $30.02–$246.95 | — | 80% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER ROUTINE | $32.60 | $163.00 | $30.02–$246.95 | — | 80% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER AP INT/EXT W/AXILLARY | $32.60 | $163.00 | $30.02–$246.95 | — | 80% |
| Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES MIN 3 VWS | $35.20 | $176.00 | $32.35–$246.95 | 91% below | 80% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES MIN 3 VWS | $35.20 | $176.00 | $32.35–$246.95 | — | 80% |
| Skull X-ray, fewer than 4 views CPT 70250 SKULL SINGLE VIEW SPECIFY | $33.60 | $168.00 | $30.86–$246.95 | 89% below | 80% |
| Skull X-ray, fewer than 4 views CPT 70250 SKULL 2 VIEWS | $33.60 | $168.00 | $30.86–$246.95 | 89% below | 80% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL SINGLE VIEW SPECIFY | $33.60 | $168.00 | $30.86–$246.95 | — | 80% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL 2 VIEWS | $33.60 | $168.00 | $30.86–$246.95 | — | 80% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 BAR SWALLOW MODI SPEECH THER | $116.20 | $581.00 | $87.53–$464.80 | 81% below | 80% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BAR SWALLOW MODI SPEECH THER | $116.20 | $581.00 | $87.53–$464.80 | — | 80% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR MIN 2 VIEWS | $33.20 | $166.00 | $30.58–$158.08 | 90% below | 80% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR MIN 2 VIEW | $33.20 | $166.00 | $30.58–$158.08 | 90% below | 80% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR MIN 2 VIEW | $33.20 | $166.00 | $30.58–$158.08 | — | 80% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR MIN 2 VIEWS | $33.20 | $166.00 | $30.58–$158.08 | — | 80% |
| Toe X-ray, 2 or more views CPT 73660 TOES 2 VIEWS | $27.40 | $137.00 | $25.12–$154.28 | 90% below | 80% |
| Toe X-ray, 2 or more views inpatient CPT 73660 TOES 2 VIEWS | $27.40 | $137.00 | $25.12–$154.28 | — | 80% |
| Transvaginal pelvic ultrasound CPT 76830 PELVIC NON-OB TRANSVAGINAL | $97.40 | $487.00 | $97.29–$389.60 | 84% below | 80% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 PELVIC NON-OB TRANSVAGINAL | $97.40 | $487.00 | $97.29–$389.60 | — | 80% |
| Transvaginal ultrasound during pregnancy CPT 76817 PELVIC OB TRANSVAGINAL | $86.40 | $432.00 | $62.47–$345.60 | 83% below | 80% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 PELVIC OB TRANSVAGINAL | $86.40 | $432.00 | $62.47–$345.60 | — | 80% |
| Ultrasound of the abdomen, complete CPT 76700 ABDOMEN COMPLETE SONO | $146.20 | $731.00 | $97.29–$584.80 | 81% below | 80% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMEN COMPLETE SONO | $146.20 | $731.00 | $97.29–$584.80 | — | 80% |
| Ultrasound of the scrotum and testicles CPT 76870 TESTICULAR SONO W COLOR DOP | $93.20 | $466.00 | $85.97–$372.80 | 85% below | 80% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 TESTICULAR SONO W COLOR DOP | $93.20 | $466.00 | $85.97–$372.80 | — | 80% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ECHO HEAD AND NECK SOFT TISSUE | $97.40 | $487.00 | $94.62–$389.60 | 85% below | 80% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ECHO HEAD AND NECK SOFT TISSUE | $97.40 | $487.00 | $94.62–$389.60 | — | 80% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W/WO DELAYED FILMS | $114.40 | $572.00 | $87.53–$457.60 | 84% below | 80% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER G I SERIES W/O AIR | $114.40 | $572.00 | $87.53–$457.60 | 84% below | 80% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UP G I AND SMALL BOWEL SERIES | $114.40 | $572.00 | $87.53–$457.60 | 84% below | 80% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UP G I AND SMALL BOWEL SERIES | $114.40 | $572.00 | $87.53–$457.60 | — | 80% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER G I SERIES W/O AIR | $114.40 | $572.00 | $87.53–$457.60 | — | 80% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W/WO DELAYED FILMS | $114.40 | $572.00 | $87.53–$457.60 | — | 80% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS ONE VIEW SPECIFY | $29.80 | $149.00 | $27.44–$154.28 | 92% below | 80% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS AP LAT ROUTINE (ARM) | $29.80 | $149.00 | $27.44–$154.28 | 92% below | 80% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HUMERUS ONE VIEW SPECIFY | $29.80 | $149.00 | $27.44–$154.28 | — | 80% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HUMERUS AP LAT ROUTINE (ARM) | $29.80 | $149.00 | $27.44–$154.28 | — | 80% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 PERIPH VEIN DOPPLER LWR EXTRM | $280.80 | $1,404.00 | $97.29–$1,123.20 | 64% below | 80% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 PERIPH VEIN DOPP UPPR EXTRM | $280.80 | $1,404.00 | $97.29–$1,123.20 | 64% below | 80% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 PERIPH VEIN DOPP UPPR EXTRM | $280.80 | $1,404.00 | $97.29–$1,123.20 | — | 80% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 PERIPH VEIN DOPPLER LWR EXTRM | $280.80 | $1,404.00 | $97.29–$1,123.20 | — | 80% |
| Wrist X-ray, 2 views CPT 73100 WRIST AP/LAT | $31.80 | $159.00 | $29.13–$154.28 | 89% below | 80% |
| Wrist X-ray, 2 views CPT 73100 WRIST ONE VIEW SPECIFY | $31.80 | $159.00 | $29.13–$154.28 | 89% below | 80% |
| Wrist X-ray, 2 views inpatient CPT 73100 WRIST AP/LAT | $31.80 | $159.00 | $29.13–$154.28 | — | 80% |
| Wrist X-ray, 2 views inpatient CPT 73100 WRIST ONE VIEW SPECIFY | $31.80 | $159.00 | $29.13–$154.28 | — | 80% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST NAVICULAR SERIES 4 VIEWS | $38.60 | $193.00 | $35.38–$154.40 | 89% below | 80% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST AP/LAT/OBL 3 VIEW ROUT | $38.60 | $193.00 | $35.38–$154.40 | 89% below | 80% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST AP/LAT/OBL 3 VIEW ROUT | $38.60 | $193.00 | $35.38–$154.40 | — | 80% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST NAVICULAR SERIES 4 VIEWS | $38.60 | $193.00 | $35.38–$154.40 | — | 80% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP UNILAT W/PELVIS 2-3 VW | $44.40 | $222.00 | $40.84–$177.60 | 88% below | 80% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP UNILAT W/PELVIS 2-3 VW | $44.40 | $222.00 | $40.84–$177.60 | — | 80% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN SINGLE VIEW/DOCUMENT | $28.20 | $141.00 | $26.06–$161.49 | 92% below | 80% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN SITZMARK DAY 5 | $28.20 | $141.00 | $26.06–$161.49 | 92% below | 80% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN SITZMARK INITIAL | $28.20 | $141.00 | $26.06–$161.49 | 92% below | 80% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN ONE DECUBITUS ONLY | $28.20 | $141.00 | $26.06–$161.49 | 92% below | 80% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW | $42.40 | $212.00 | $26.06–$169.60 | 87% below | 80% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN SITZMARK INITIAL | $28.20 | $141.00 | $26.06–$161.49 | — | 80% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN ONE DECUBITUS ONLY | $28.20 | $141.00 | $26.06–$161.49 | — | 80% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN SINGLE VIEW/DOCUMENT | $28.20 | $141.00 | $26.06–$161.49 | — | 80% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN SITZMARK DAY 5 | $28.20 | $141.00 | $26.06–$161.49 | — | 80% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW | $42.40 | $212.00 | $26.06–$169.60 | — | 80% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE ONE VIEW SPECIFY | $30.20 | $151.00 | $27.72–$246.95 | 90% below | 80% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE 2 VIEWS AP/LAT | $30.20 | $151.00 | $27.72–$246.95 | 90% below | 80% |
| X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE 2 VIEWS AP/LAT | $30.20 | $151.00 | $27.72–$246.95 | — | 80% |
| X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE ONE VIEW SPECIFY | $30.20 | $151.00 | $27.72–$246.95 | — | 80% |
| X-ray of the finger(s), 2 or more views CPT 73140 FINGER | $35.80 | $179.00 | $32.77–$154.28 | 85% below | 80% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER | $35.80 | $179.00 | $32.77–$154.28 | — | 80% |
| X-ray of the foot, 2 views CPT 73620 FOOT ONE VIEW SPECIFY | $26.80 | $134.00 | $24.61–$154.28 | 92% below | 80% |
| X-ray of the foot, 2 views CPT 73620 FOOT 2 VIEWS | $26.80 | $134.00 | $24.61–$154.28 | 92% below | 80% |
| X-ray of the foot, 2 views inpatient CPT 73620 FOOT 2 VIEWS | $26.80 | $134.00 | $24.61–$154.28 | — | 80% |
| X-ray of the foot, 2 views inpatient CPT 73620 FOOT ONE VIEW SPECIFY | $26.80 | $134.00 | $24.61–$154.28 | — | 80% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3 VIEWS | $32.00 | $160.00 | $29.44–$154.28 | 91% below | 80% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT 3 VIEWS | $32.00 | $160.00 | $29.44–$154.28 | — | 80% |
| X-ray of the hand, 3 or more views CPT 73130 HAND 3 VIEWS/FOREIGN BODY | $34.80 | $174.00 | $31.98–$154.28 | 91% below | 80% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HAND 3 VIEWS/FOREIGN BODY | $34.80 | $174.00 | $31.98–$154.28 | — | 80% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE SINGLE VIEW SPECIFY | $32.00 | $160.00 | $29.42–$154.28 | 89% below | 80% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE SUNRISE VIEW ONLY | $32.00 | $160.00 | $29.42–$154.28 | 89% below | 80% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE 2 VIEWS | $32.00 | $160.00 | $29.42–$154.28 | 89% below | 80% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2V RT | $32.00 | $160.00 | $29.42–$154.28 | 89% below | 80% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2V LT | $32.00 | $160.00 | $29.42–$154.28 | 89% below | 80% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE 2 VIEWS | $32.00 | $160.00 | $29.42–$154.28 | — | 80% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE SUNRISE VIEW ONLY | $32.00 | $160.00 | $29.42–$154.28 | — | 80% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE SINGLE VIEW SPECIFY | $32.00 | $160.00 | $29.42–$154.28 | — | 80% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2V LT | $32.00 | $160.00 | $29.42–$154.28 | — | 80% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2V RT | $32.00 | $160.00 | $29.42–$154.28 | — | 80% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XRAY L-SPINE 2-3VIEWS | $37.40 | $187.00 | $34.34–$246.95 | 92% below | 80% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE 2-3 VIEWS | $37.40 | $187.00 | $34.34–$246.95 | 92% below | 80% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 3 VIEWS ROUTINE | $37.40 | $187.00 | $34.34–$246.95 | 92% below | 80% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 2 VIEWS | $37.40 | $187.00 | $34.34–$246.95 | 92% below | 80% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR L-SPINE 2-3 VIEWS | $37.40 | $187.00 | $34.34–$246.95 | — | 80% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XRAY L-SPINE 2-3VIEWS | $37.40 | $187.00 | $34.34–$246.95 | — | 80% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 3 VIEWS ROUTINE | $37.40 | $187.00 | $34.34–$246.95 | — | 80% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 2 VIEWS | $37.40 | $187.00 | $34.34–$246.95 | — | 80% |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE 5 VWS W/OBLS | $48.60 | $243.00 | $44.59–$246.95 | 91% below | 80% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE 5 VWS W/OBLS | $48.60 | $243.00 | $44.59–$246.95 | — | 80% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE AP AND LAT | $30.80 | $154.00 | $28.35–$246.95 | 92% below | 80% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE AP AND LAT | $30.80 | $154.00 | $28.35–$246.95 | — | 80% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3VWS | $35.20 | $176.00 | $32.27–$154.28 | 87% below | 80% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL CMPL 3+V LTD | $35.20 | $176.00 | $32.27–$154.28 | 87% below | 80% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL CMPL 3+V LTD | $35.20 | $176.00 | $32.27–$154.28 | — | 80% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES MIN 3VWS | $35.20 | $176.00 | $32.27–$154.28 | — | 80% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERV SPINE 2-3 VWS | $37.00 | $185.00 | $34.05–$246.95 | 90% below | 80% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RAD XR C-SPINE 2-3V | $37.00 | $185.00 | $34.05–$246.95 | 90% below | 80% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XRAY C-SPINE 2-3V | $37.00 | $185.00 | $34.05–$246.95 | 90% below | 80% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RAD C-SPINE 2-3V | $37.00 | $185.00 | $34.05–$246.95 | 90% below | 80% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RAD XR C-SPINE 2-3V | $37.00 | $185.00 | $34.05–$246.95 | — | 80% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XRAY C-SPINE 2-3V | $37.00 | $185.00 | $34.05–$246.95 | — | 80% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RAD C-SPINE 2-3V | $37.00 | $185.00 | $34.05–$246.95 | — | 80% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERV SPINE 2-3 VWS | $37.00 | $185.00 | $34.05–$246.95 | — | 80% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS (INLET/OUTLET VIEW) | $26.20 | $131.00 | $24.06–$246.95 | 92% below | 80% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 RAD PELVIS ROUTINE AP | $26.20 | $131.00 | $24.06–$246.95 | 92% below | 80% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 2 VIEWS AP & FROG | $26.20 | $131.00 | $24.06–$246.95 | 92% below | 80% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS JUDET VIEWS | $26.20 | $131.00 | $24.06–$246.95 | 92% below | 80% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RAD PELVIS ROUTINE AP | $26.20 | $131.00 | $24.06–$246.95 | — | 80% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS (INLET/OUTLET VIEW) | $26.20 | $131.00 | $24.06–$246.95 | — | 80% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS JUDET VIEWS | $26.20 | $131.00 | $24.06–$246.95 | — | 80% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 2 VIEWS AP & FROG | $26.20 | $131.00 | $24.06–$246.95 | — | 80% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX AP & LAT | $30.40 | $152.00 | $28.02–$154.28 | 90% below | 80% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM 1 VIEW SPECIFY | $30.40 | $152.00 | $28.02–$154.28 | 90% below | 80% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM 1 VIEW SPECIFY | $30.40 | $152.00 | $28.02–$154.28 | — | 80% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX AP & LAT | $30.40 | $152.00 | $28.02–$154.28 | — | 80% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE | $36.00 | $180.00 | $37.62–$144.00 | 83% below | 80% |
| ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE | $36.00 | $180.00 | $37.62–$144.00 | — | 80% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ED-GPT (ALT) | $5.00 | $25.00 | $5.17–$20.00 | 90% below | 80% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 GPT (ALT) | $5.00 | $25.00 | $5.17–$20.00 | 90% below | 80% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ED-GPT (ALT) | $5.00 | $25.00 | $5.17–$20.00 | — | 80% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 GPT (ALT) | $5.00 | $25.00 | $5.17–$20.00 | — | 80% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 GOT(AST)-ED | $4.80 | $24.00 | $5.05–$19.20 | 91% below | 80% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 GOT (AST) | $4.80 | $24.00 | $5.05–$19.20 | 91% below | 80% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 GOT (AST) | $4.80 | $24.00 | $5.05–$19.20 | — | 80% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 GOT(AST)-ED | $4.80 | $24.00 | $5.05–$19.20 | — | 80% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PROFILE | $80.96 | $404.79 | $46.40–$323.83 | 79% below | 80% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PROFILE | $80.96 | $404.79 | $46.40–$323.83 | — | 80% |
| Albumin blood test CPT 82040 SPC *ALBUMIN SERUM | $4.60 | $23.00 | $4.82–$18.40 | 88% below | 80% |
| Albumin blood test CPT 82040 ALBUMIN-ED | $4.60 | $23.00 | $4.82–$18.40 | 88% below | 80% |
| Albumin blood test CPT 82040 ALBUMIN | $4.60 | $23.00 | $4.82–$18.40 | 88% below | 80% |
| Albumin blood test inpatient CPT 82040 ALBUMIN | $4.60 | $23.00 | $4.82–$18.40 | — | 80% |
| Albumin blood test inpatient CPT 82040 ALBUMIN-ED | $4.60 | $23.00 | $4.82–$18.40 | — | 80% |
| Albumin blood test inpatient CPT 82040 SPC *ALBUMIN SERUM | $4.60 | $23.00 | $4.82–$18.40 | — | 80% |
| Aldosterone blood test CPT 82088 SPC ALDOSTERONE URINE | $38.00 | $190.00 | $39.69–$152.00 | 72% below | 80% |
| Aldosterone blood test CPT 82088 ALDOSTERONE SERUM | $38.00 | $190.00 | $39.69–$152.00 | 72% below | 80% |
| Aldosterone blood test inpatient CPT 82088 SPC ALDOSTERONE URINE | $38.00 | $190.00 | $39.69–$152.00 | — | 80% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE SERUM | $38.00 | $190.00 | $39.69–$152.00 | — | 80% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE | $4.80 | $24.00 | $5.05–$19.20 | 90% below | 80% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE-ED | $4.80 | $24.00 | $5.05–$19.20 | 90% below | 80% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOS TOTAL SENDOUT | $4.80 | $24.00 | $5.05–$19.20 | 90% below | 80% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE-ED | $4.80 | $24.00 | $5.05–$19.20 | — | 80% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOS TOTAL SENDOUT | $4.80 | $24.00 | $5.05–$19.20 | — | 80% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE | $4.80 | $24.00 | $5.05–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BEETROOT (BETA VULGARIS) IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BASIL IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 APRICOT IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ANISE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ANCHOVY IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ABALONE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TUNA IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TROUT IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TOMATO IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SWORDFISH IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SWEET POTATO IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STRAWBERRY IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP MILK IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOP IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SALMON IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RYE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PUMPKIN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 POTATO IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PLUM IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINEAPPLE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINE NUT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEACH IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEA IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PAPAYA IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ONION IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OCTOPUS IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MANGO FRUIT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MACKEREL IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MACADAMIA NUT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LAMB IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 KIWI FRUIT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HERRING IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GUAR BEAN GUM IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GREEN BEAN IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GRAPEFRUIT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GRAPE IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GOAT MILK IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GINGER IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GARLIC IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG YOLK IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CUCUMBER IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CRAYFISH IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CRAB IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MAIZE/CORN IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCONUT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLAM IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICK PEA IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN MEAT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHESTNUT (SWEET) IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHERRY IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAULIFLOWER IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CATFISH IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE URINE PROTEINS (E72) | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER (E5) | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DERMATOPHAGOIDES PTERONYSSINUS?(D1) | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DERMATOPHAGOIDES FARINAE?(D2) | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH (I6) | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBARUM (M2) | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER (E1) | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA ALTERNATA (M6) | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OVOMUCOID IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CARROT RAST ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BRUSSEL SPROUTS RAST ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BROCCOLI RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BARLEY RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AVOCADO RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPARAGUS RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 APPLE RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BANANA RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC RAST ALLERG IGE QN SQ EA23 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC RAST ALLERG IGE QN SQ EA22 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC RAST ALLERG IGE QN SQ EA21 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC RAST ALLERG IGE QN SQ EA20 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CRAB ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HOLLISTER HOUSE DUST ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GREER HOUSE DUST ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC ALTERNARIA TENIUS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENECILLIUM ALLEREGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOG EPITHELIUM ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC CAT EPITHELIUM ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BIRCH ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS ALLEREGN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ELM TREE ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAK TREE ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MAPLE BX ELDER ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LAMB'S QUARTERS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ENGLISH PLANTAIN ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COM SHT RAGWD ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JN/KT BLUE GRASS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RYE GRASS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCONUT ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC ALTERNARIA TENUIS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC CLADOSPORIUM ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAT EPITHELIUM ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LAMBS QUARTERS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC COM SHT RAGWD ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC JN/KT BLUE GRASS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC OAK TREE ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAT ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MILK ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC ALLERGEN IGE 9 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC ALLERGEN IGE 8 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC ALLERGEN IGE 7 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC ALLERGEN IGE 6 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC ALLERGEN IGE 5 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC ALLERGEN IGE 4 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC ALLERGEN IGE 3 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC ALLERGEN IGE 2 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC ALLERGEN IGE 1 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC AMPICILLIN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC AMOXICILLIN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIN V IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIN G IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST EGG YOLK IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST EGG WHITE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC RAST ALLERG IGE QN SQ EA3 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC RAST ALLERG IGE QN SQ EA2 | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPC AMMONLATED LATEX IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LATEX GLOVE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 NON-AMMONIATEED LATEX IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GUM ARABIC IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LEMON IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LENTILS IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LETTUCE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LIMA BEAN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LIME IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER, SPINY IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LUPINE SEED IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MALT IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MANDARIN (TANGERINE) IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MELONS IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COW\'S MILK IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MINT (MENTHA PIPERITA) IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUSHROOM IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUSTARD IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 NUTMEG IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORANGE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OREGANO IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OVALBUMIN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OYSTER IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PACIFIC SQUID IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PAPRIKA/SWEET PEPPER IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PARSLEY IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PASSION FRUIT IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEAR IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PERSIMMON (KAKI FRUIT) IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 POPPY SEED IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PUMPKIN SEED IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 QUINOA IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RABBIT IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAPE SEED IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RASPBERRY IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RED KIDNEY BEAN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RICE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SARDINE/PILCHARD IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SNAIL IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SOLE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPINACH IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SQUID IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TARRAGON IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TEA IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 THYME IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 VANILLA IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WATERMELON IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE BEAN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 YEAST IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BAHIA GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BARLEY POLLEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BROME GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CANARY GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COMMON REED IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CORN, GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CULTIVATED OAT IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CULTIVATED RYE GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CULTIVATED WHEAT IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JOHNSON GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JUNE GRASS (KENTUCKY BLUE) IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MEADOW FESCUE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MEADOW FOXTAIL IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORCHARD GRASS (COCKSFOOT) IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PERENNIAL RYE GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RED TOP GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SWEET VERNAL GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 VELVET GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WILD RYE GRASS IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TILAPIA IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GREEN PEPPER (UNRIPE) IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FLAXSEED IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FIG (FICUS CARICA) IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGGPLANT IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG MIX (YOLK & WHITE) IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DILL IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DATE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CORIANDER/CILANTRO IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COMMON MILLET IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COFFEE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCOA IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLOVE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CINNAMON IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHUB MACKEREL IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHEESE MOLD TYPE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHEDDAR CHEESE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CELERY IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAROB IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCHINEAL EXTRACT (DACTYLOPIUS COCCUS) IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CARAWAY (CARUM CARVI) IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CABBAGE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BUCKWHEAT IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLUEBERRY IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLUE MUSSEL IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLACKBERRY IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLACK PEPPER IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLACK OLIVE IGE | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FALSE RAGWEED (W4) | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUGWORT (W6) | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 A. FUMIGATUS IGE (M3) | $4.80 | $24.00 | $5.09–$19.20 | 80% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP SORREL IGE (W18) | $5.83 | $29.14 | $5.09–$23.31 | 76% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 P. NATATUM IGE (M1) | $5.83 | $29.14 | $5.09–$23.31 | 76% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUCOR RACEMOSUS (M4) | $7.21 | $36.05 | $5.09–$28.84 | 70% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIUM NOTATUM (M1) | $7.21 | $36.05 | $5.09–$28.84 | 70% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STEMPHYLIUM BOTRYOSUM (M10) | $7.21 | $36.05 | $5.09–$28.84 | 70% below | 80% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS (M3 | $7.21 | $36.05 | $5.09–$28.84 | 70% below | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 A. FUMIGATUS IGE (M3) | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUGWORT (W6) | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FALSE RAGWEED (W4) | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WILD RYE GRASS IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 VELVET GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET VERNAL GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RED TOP GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PERENNIAL RYE GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORCHARD GRASS (COCKSFOOT) IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MEADOW FOXTAIL IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MEADOW FESCUE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JUNE GRASS (KENTUCKY BLUE) IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JOHNSON GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CULTIVATED WHEAT IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CULTIVATED RYE GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CULTIVATED OAT IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN, GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON REED IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CANARY GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BROME GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BARLEY POLLEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BAHIA GRASS IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YEAST IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE BEAN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WATERMELON IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 VANILLA IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TILAPIA IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 THYME IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TEA IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TARRAGON IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SQUID IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPINACH IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOLE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SNAIL IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SARDINE/PILCHARD IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RICE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RED KIDNEY BEAN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RASPBERRY IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAPE SEED IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RABBIT IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 QUINOA IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PUMPKIN SEED IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 POPPY SEED IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PERSIMMON (KAKI FRUIT) IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEAR IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PASSION FRUIT IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PARSLEY IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPRIKA/SWEET PEPPER IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PACIFIC SQUID IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OYSTER IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OVALBUMIN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OREGANO IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORANGE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NUTMEG IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUSTARD IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUSHROOM IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MINT (MENTHA PIPERITA) IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COW\'S MILK IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MELONS IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MANDARIN (TANGERINE) IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MALT IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LUPINE SEED IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER, SPINY IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LIME IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LIMA BEAN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LETTUCE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LENTILS IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LEMON IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GUM ARABIC IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GREEN PEPPER (UNRIPE) IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NON-AMMONIATEED LATEX IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX GLOVE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC AMMONLATED LATEX IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC RAST ALLERG IGE QN SQ EA2 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC RAST ALLERG IGE QN SQ EA3 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST EGG WHITE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST EGG YOLK IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIN G IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIN V IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC AMOXICILLIN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC AMPICILLIN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC ALLERGEN IGE 1 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC ALLERGEN IGE 2 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC ALLERGEN IGE 3 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC ALLERGEN IGE 4 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC ALLERGEN IGE 5 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC ALLERGEN IGE 6 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC ALLERGEN IGE 7 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC ALLERGEN IGE 8 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC ALLERGEN IGE 9 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAT ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC OAK TREE ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC JN/KT BLUE GRASS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC COM SHT RAGWD ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMBS QUARTERS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT EPITHELIUM ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC CLADOSPORIUM ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC ALTERNARIA TENUIS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCONUT ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RYE GRASS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JN/KT BLUE GRASS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COM SHT RAGWD ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ENGLISH PLANTAIN ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMB'S QUARTERS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAPLE BX ELDER ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAK TREE ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ELM TREE ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS ALLEREGN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BIRCH ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC CAT EPITHELIUM ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG EPITHELIUM ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENECILLIUM ALLEREGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC ALTERNARIA TENIUS ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GREER HOUSE DUST ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HOLLISTER HOUSE DUST ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAB ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC RAST ALLERG IGE QN SQ EA20 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC RAST ALLERG IGE QN SQ EA21 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC RAST ALLERG IGE QN SQ EA22 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPC RAST ALLERG IGE QN SQ EA23 | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BANANA RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APPLE RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPARAGUS RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AVOCADO RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BARLEY RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BROCCOLI RAST ALLERGEN IGE QN SQ EA | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRUSSEL SPROUTS RAST ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARROT RAST ALLERGEN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OVOMUCOID IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA ALTERNATA (M6) | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER (E1) | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM HERBARUM (M2) | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH (I6) | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DERMATOPHAGOIDES FARINAE?(D2) | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DERMATOPHAGOIDES PTERONYSSINUS?(D1) | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER (E5) | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE URINE PROTEINS (E72) | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CATFISH IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAULIFLOWER IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHERRY IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHESTNUT (SWEET) IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN MEAT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICK PEA IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLAM IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCONUT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAIZE/CORN IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAB IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAYFISH IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CUCUMBER IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG YOLK IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GARLIC IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GINGER IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOAT MILK IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPE IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPEFRUIT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GREEN BEAN IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GUAR BEAN GUM IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HERRING IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KIWI FRUIT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMB IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MACADAMIA NUT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MACKEREL IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MANGO FRUIT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OCTOPUS IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ONION IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPAYA IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEA IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEACH IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN NUT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINE NUT IGE ALLERGEN | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINEAPPLE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PLUM IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 POTATO IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PUMPKIN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RYE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SCALLOP IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SEED IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP MILK IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STRAWBERRY IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET POTATO IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWORDFISH IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TOMATO IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TROUT IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ABALONE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ANCHOVY IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ANISE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APRICOT IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BASIL IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEETROOT (BETA VULGARIS) IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLACK OLIVE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLACK PEPPER IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLACKBERRY IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLUE MUSSEL IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLUEBERRY IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BUCKWHEAT IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CABBAGE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARAWAY (CARUM CARVI) IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCHINEAL EXTRACT (DACTYLOPIUS COCCUS) IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAROB IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CELERY IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHEDDAR CHEESE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHEESE MOLD TYPE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHUB MACKEREL IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CINNAMON IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLOVE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCOA IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COFFEE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON MILLET IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORIANDER/CILANTRO IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DATE IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DILL IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG MIX (YOLK & WHITE) IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGGPLANT IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FIG (FICUS CARICA) IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FLAXSEED IGE | $4.80 | $24.00 | $5.09–$19.20 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 P. NATATUM IGE (M1) | $5.83 | $29.14 | $5.09–$23.31 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP SORREL IGE (W18) | $5.83 | $29.14 | $5.09–$23.31 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STEMPHYLIUM BOTRYOSUM (M10) | $7.21 | $36.05 | $5.09–$28.84 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIUM NOTATUM (M1) | $7.21 | $36.05 | $5.09–$28.84 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUCOR RACEMOSUS (M4) | $7.21 | $36.05 | $5.09–$28.84 | — | 80% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS (M3 | $7.21 | $36.05 | $5.09–$28.84 | — | 80% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN - CANCER TUMOR MARKER | $15.60 | $78.00 | $16.34–$62.40 | 85% below | 80% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETO PROTEIN ONCO | $15.60 | $78.00 | $16.34–$62.40 | 85% below | 80% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 MATERNAL AFP | $15.60 | $78.00 | $16.34–$62.40 | 85% below | 80% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN - CANCER TUMOR MARKER | $15.60 | $78.00 | $16.34–$62.40 | — | 80% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 MATERNAL AFP | $15.60 | $78.00 | $16.34–$62.40 | — | 80% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETO PROTEIN ONCO | $15.60 | $78.00 | $16.34–$62.40 | — | 80% |
| Ammonia blood test CPT 82140 CHEM AMMONIA | $13.60 | $68.00 | $14.19–$54.40 | 90% below | 80% |
| Ammonia blood test inpatient CPT 82140 CHEM AMMONIA | $13.60 | $68.00 | $14.19–$54.40 | — | 80% |
| Amylase blood test CPT 82150 CHEM AMYLASE SERUM | $6.00 | $30.00 | $6.31–$24.00 | 92% below | 80% |
| Amylase blood test CPT 82150 SPC AMYLASE BLOOD | $6.00 | $30.00 | $6.31–$24.00 | 92% below | 80% |
| Amylase blood test CPT 82150 AMYLASE FLUID | $6.00 | $30.00 | $6.31–$24.00 | 92% below | 80% |
| Amylase blood test CPT 82150 AMYLASE BODY FLUID | $21.84 | $109.18 | $6.31–$87.34 | 72% below | 80% |
| Amylase blood test inpatient CPT 82150 AMYLASE FLUID | $6.00 | $30.00 | $6.31–$24.00 | — | 80% |
| Amylase blood test inpatient CPT 82150 SPC AMYLASE BLOOD | $6.00 | $30.00 | $6.31–$24.00 | — | 80% |
| Amylase blood test inpatient CPT 82150 CHEM AMYLASE SERUM | $6.00 | $30.00 | $6.31–$24.00 | — | 80% |
| Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID | $21.84 | $109.18 | $6.31–$87.34 | — | 80% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE | $12.00 | $60.00 | $12.62–$48.00 | 78% below | 80% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP IGG | $21.05 | $105.27 | $12.62–$84.22 | 62% below | 80% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE | $12.00 | $60.00 | $12.62–$48.00 | — | 80% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI-CCP IGG | $21.05 | $105.27 | $12.62–$84.22 | — | 80% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY SCREEN - | $11.20 | $56.00 | $11.78–$44.80 | 85% below | 80% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY SCREEN | $11.20 | $56.00 | $11.78–$44.80 | 85% below | 80% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY SCREEN - | $11.20 | $56.00 | $11.78–$44.80 | — | 80% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY SCREEN | $11.20 | $56.00 | $11.78–$44.80 | — | 80% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIURETIC PEPTIDE (BN | $36.60 | $183.00 | $38.24–$146.40 | 77% below | 80% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ISTAT BTYPE NATIURETIC PEPTIDE | $36.60 | $183.00 | $38.24–$146.40 | 77% below | 80% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ISTAT BTYPE NATIURETIC PEPTIDE | $36.60 | $183.00 | $38.24–$146.40 | — | 80% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATRIURETIC PEPTIDE (BN | $36.60 | $183.00 | $38.24–$146.40 | — | 80% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY SITE (ROUTINE) | $8.00 | $40.00 | $8.40–$32.00 | 88% below | 80% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND (ROUTINE | $8.00 | $40.00 | $8.40–$32.00 | 88% below | 80% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE THROAT | $8.00 | $40.00 | $8.40–$32.00 | 88% below | 80% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SPUTUM | $8.00 | $40.00 | $8.40–$32.00 | 88% below | 80% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID (ROUTINE) | $8.00 | $40.00 | $8.40–$32.00 | 88% below | 80% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 MRSA SCREEN | $8.00 | $40.00 | $8.40–$32.00 | 88% below | 80% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE C.S.F. | $8.00 | $40.00 | $8.40–$32.00 | 88% below | 80% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BODY FLUID (ROUTINE) | $8.00 | $40.00 | $8.40–$32.00 | — | 80% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 MRSA SCREEN | $8.00 | $40.00 | $8.40–$32.00 | — | 80% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE THROAT | $8.00 | $40.00 | $8.40–$32.00 | — | 80% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BODY SITE (ROUTINE) | $8.00 | $40.00 | $8.40–$32.00 | — | 80% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE C.S.F. | $8.00 | $40.00 | $8.40–$32.00 | — | 80% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND (ROUTINE | $8.00 | $40.00 | $8.40–$32.00 | — | 80% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE SPUTUM | $8.00 | $40.00 | $8.40–$32.00 | — | 80% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PROFILE | $11.80 | $59.00 | $8.24–$47.20 | 94% below | 80% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PROFILE | $11.80 | $59.00 | $8.24–$47.20 | — | 80% |
| Bilirubin blood test, total CPT 82247 CHEM BILI TTL NEONATAL | $4.60 | $23.00 | $4.89–$18.40 | 92% below | 80% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL | $4.60 | $23.00 | $4.89–$18.40 | 92% below | 80% |
| Bilirubin blood test, total CPT 82247 CHEM BILI TTL BODY FLD | $4.60 | $23.00 | $4.89–$18.40 | 92% below | 80% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN NEONATAL NSY | $4.60 | $23.00 | $4.89–$18.40 | 92% below | 80% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL-ED | $4.60 | $23.00 | $4.89–$18.40 | 92% below | 80% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN, FRACTIONATED | $4.60 | $23.00 | $4.89–$18.40 | 92% below | 80% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN, FRACTIONATED | $4.60 | $23.00 | $4.89–$18.40 | — | 80% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL-ED | $4.60 | $23.00 | $4.89–$18.40 | — | 80% |
| Bilirubin blood test, total inpatient CPT 82247 CHEM BILI TTL BODY FLD | $4.60 | $23.00 | $4.89–$18.40 | — | 80% |
| Bilirubin blood test, total inpatient CPT 82247 CHEM BILI TTL NEONATAL | $4.60 | $23.00 | $4.89–$18.40 | — | 80% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN NEONATAL NSY | $4.60 | $23.00 | $4.89–$18.40 | — | 80% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL | $4.60 | $23.00 | $4.89–$18.40 | — | 80% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 BONE MARROW W/BIOPSY | $99.00 | $495.00 | $38.26–$396.00 | 67% below | 80% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HIST GROSS & MICRO LEVEL IV | $203.40 | $1,017.00 | $38.26–$813.60 | 32% below | 80% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SPC GROSS & MICRO LEVEL IV | $203.40 | $1,017.00 | $38.26–$813.60 | 32% below | 80% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 GROSS & MICRO LEVEL IV | $203.40 | $1,017.00 | $38.26–$813.60 | 32% below | 80% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 BONE MARROW W/BIOPSY | $99.00 | $495.00 | $38.26–$396.00 | — | 80% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HIST GROSS & MICRO LEVEL IV | $203.40 | $1,017.00 | $38.26–$813.60 | — | 80% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SPC GROSS & MICRO LEVEL IV | $203.40 | $1,017.00 | $38.26–$813.60 | — | 80% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 GROSS & MICRO LEVEL IV | $203.40 | $1,017.00 | $38.26–$813.60 | — | 80% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD | $14.40 | $72.00 | $10.05–$57.60 | 93% below | 80% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD | $14.40 | $72.00 | $10.05–$57.60 | — | 80% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HMC VENIPUNCTURE HEMONC | $4.60 | $23.00 | $4.14–$26.73 | 75% below | 80% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE | $4.60 | $23.00 | $4.14–$26.73 | 75% below | 80% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 ICN-ROUTINE VENIPUNCTURE | $4.60 | $23.00 | $4.14–$26.73 | 75% below | 80% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PED VENIPUNCTURE | $4.60 | $23.00 | $4.14–$26.73 | 75% below | 80% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 IMCN-ROUTINE VENIPUNCTURE | $4.60 | $23.00 | $4.14–$26.73 | 75% below | 80% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PICU VENIPUNCTURE STAT | $4.60 | $23.00 | $4.14–$26.73 | 75% below | 80% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 RESP - VENIPUNCTURE | $5.00 | $25.00 | $4.50–$26.73 | 72% below | 80% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 IMCU VENIPUNCTURE | $6.60 | $33.00 | $5.94–$26.73 | 63% below | 80% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 INF VENIPUNCTURE HEMONC | $12.80 | $64.00 | $7.95–$51.20 | 29% below | 80% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ROUTINE | $12.80 | $64.00 | $7.95–$51.20 | 29% below | 80% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 CH SPC VENIPUNCTURE HOMEBOUND | $13.20 | $66.00 | $7.95–$52.80 | 27% below | 80% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 IMCN-ROUTINE VENIPUNCTURE | $4.60 | $23.00 | $4.14–$26.73 | — | 80% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ICN-ROUTINE VENIPUNCTURE | $4.60 | $23.00 | $4.14–$26.73 | — | 80% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PED VENIPUNCTURE | $4.60 | $23.00 | $4.14–$26.73 | — | 80% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PICU VENIPUNCTURE STAT | $4.60 | $23.00 | $4.14–$26.73 | — | 80% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HMC VENIPUNCTURE HEMONC | $4.60 | $23.00 | $4.14–$26.73 | — | 80% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE | $4.60 | $23.00 | $4.14–$26.73 | — | 80% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 RESP - VENIPUNCTURE | $5.00 | $25.00 | $4.50–$26.73 | — | 80% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 IMCU VENIPUNCTURE | $6.60 | $33.00 | $5.94–$26.73 | — | 80% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ROUTINE | $12.80 | $64.00 | $7.95–$51.20 | — | 80% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 INF VENIPUNCTURE HEMONC | $12.80 | $64.00 | $7.95–$51.20 | — | 80% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 CH SPC VENIPUNCTURE HOMEBOUND | $13.20 | $66.00 | $7.95–$52.80 | — | 80% |
| Blood glucose (sugar) test CPT 82947 ARTERIAL GLUCOSE | $3.60 | $18.00 | $3.83–$14.40 | 91% below | 80% |
| Blood glucose (sugar) test CPT 82947 LAB GLUCOSE SERUM | $3.60 | $18.00 | $3.83–$14.40 | 91% below | 80% |
| Blood glucose (sugar) test CPT 82947 ED-GLUCOSE SERUM | $3.60 | $18.00 | $3.83–$14.40 | 91% below | 80% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE TOLOERANCE ADA 2 HR | $3.60 | $18.00 | $3.83–$14.40 | 91% below | 80% |
| Blood glucose (sugar) test CPT 82947 POCT GLUCOSE | $3.60 | $18.00 | $3.83–$14.40 | 91% below | 80% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD | $5.40 | $27.00 | $3.83–$21.60 | 87% below | 80% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE SERUM | $8.40 | $42.00 | $3.83–$33.60 | 80% below | 80% |
| Blood glucose (sugar) test inpatient CPT 82947 ARTERIAL GLUCOSE | $3.60 | $18.00 | $3.83–$14.40 | — | 80% |
| Blood glucose (sugar) test inpatient CPT 82947 ED-GLUCOSE SERUM | $3.60 | $18.00 | $3.83–$14.40 | — | 80% |
| Blood glucose (sugar) test inpatient CPT 82947 LAB GLUCOSE SERUM | $3.60 | $18.00 | $3.83–$14.40 | — | 80% |
| Blood glucose (sugar) test inpatient CPT 82947 POCT GLUCOSE | $3.60 | $18.00 | $3.83–$14.40 | — | 80% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE TOLOERANCE ADA 2 HR | $3.60 | $18.00 | $3.83–$14.40 | — | 80% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BLOOD | $5.40 | $27.00 | $3.83–$21.60 | — | 80% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE SERUM | $8.40 | $42.00 | $3.83–$33.60 | — | 80% |
| Blood lead test CPT 83655 SPC LEAD | $11.20 | $56.00 | $11.80–$44.80 | 76% below | 80% |
| Blood lead test CPT 83655 LEAD URINE | $11.20 | $56.00 | $11.80–$44.80 | 76% below | 80% |
| Blood lead test CPT 83655 LEAD WHOLE BLOOD | $11.20 | $56.00 | $11.80–$44.80 | 76% below | 80% |
| Blood lead test inpatient CPT 83655 LEAD URINE | $11.20 | $56.00 | $11.80–$44.80 | — | 80% |
| Blood lead test inpatient CPT 83655 SPC LEAD | $11.20 | $56.00 | $11.80–$44.80 | — | 80% |
| Blood lead test inpatient CPT 83655 LEAD WHOLE BLOOD | $11.20 | $56.00 | $11.80–$44.80 | — | 80% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 ED-HCG URINE | $7.00 | $35.00 | $7.33–$28.00 | 95% below | 80% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 LEN- HCG QL URINE | $7.00 | $35.00 | $7.33–$28.00 | 95% below | 80% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CH UCC HCG URINE | $7.00 | $35.00 | $7.33–$28.00 | 95% below | 80% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE | $7.00 | $35.00 | $7.33–$28.00 | 95% below | 80% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QL URINE ANALYZER | $7.00 | $35.00 | $7.33–$28.00 | 95% below | 80% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 URINE PREGNANCY TEST | $7.00 | $35.00 | $7.33–$28.00 | 95% below | 80% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CH UCC EL HCG URINE | $15.89 | $79.47 | $7.33–$63.58 | 88% below | 80% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CH UCC HCG URINE | $7.00 | $35.00 | $7.33–$28.00 | — | 80% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 ED-HCG URINE | $7.00 | $35.00 | $7.33–$28.00 | — | 80% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 URINE PREGNANCY TEST | $7.00 | $35.00 | $7.33–$28.00 | — | 80% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QL URINE ANALYZER | $7.00 | $35.00 | $7.33–$28.00 | — | 80% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUALITATIVE | $7.00 | $35.00 | $7.33–$28.00 | — | 80% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 LEN- HCG QL URINE | $7.00 | $35.00 | $7.33–$28.00 | — | 80% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CH UCC EL HCG URINE | $15.89 | $79.47 | $7.33–$63.58 | — | 80% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO DISCREPANCY RESOLUTION-VITALANT | $12.36 | $61.81 | $2.92–$49.45 | 86% below | 80% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO DISCREPANCY RESOLUTION-VITALANT | $12.36 | $61.81 | $2.92–$49.45 | — | 80% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN SERUM | $3.60 | $18.00 | $3.85–$14.40 | 93% below | 80% |
| Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN QUANTITATIVE | $3.60 | $18.00 | $3.85–$14.40 | 93% below | 80% |
| Blood urea nitrogen (BUN) test CPT 84520 ED-BUN SERUM | $3.60 | $18.00 | $3.85–$14.40 | 93% below | 80% |
| Blood urea nitrogen (BUN) test CPT 84520 POCT BUN | $3.60 | $18.00 | $3.85–$14.40 | 93% below | 80% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN QUANTITATIVE | $3.60 | $18.00 | $3.85–$14.40 | — | 80% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN SERUM | $3.60 | $18.00 | $3.85–$14.40 | — | 80% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 POCT BUN | $3.60 | $18.00 | $3.85–$14.40 | — | 80% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 ED-BUN SERUM | $3.60 | $18.00 | $3.85–$14.40 | — | 80% |
| C-peptide blood test CPT 84681 C-PEPTIDE SERUM | $19.40 | $97.00 | $20.27–$77.60 | 73% below | 80% |
| C-peptide blood test inpatient CPT 84681 C-PEPTIDE SERUM | $19.40 | $97.00 | $20.27–$77.60 | — | 80% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $13.80 | $69.00 | $5.05–$55.20 | 73% below | 80% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN | $13.80 | $69.00 | $5.05–$55.20 | — | 80% |
| C. difficile toxin gene test (stool PCR) CPT 87493 AMP PROBE CLOSTRIDIUM | $34.60 | $173.00 | $36.31–$138.40 | 80% below | 80% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 AMP PROBE CLOSTRIDIUM | $34.60 | $173.00 | $36.31–$138.40 | — | 80% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 MARKER | $19.40 | $97.00 | $20.27–$77.60 | 85% below | 80% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 ANTIGEN | $19.40 | $97.00 | $20.27–$77.60 | 85% below | 80% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 ANTIGEN | $19.40 | $97.00 | $20.27–$77.60 | — | 80% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 MARKER | $19.40 | $97.00 | $20.27–$77.60 | — | 80% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNO TUMR AG CA 125 | $19.40 | $97.00 | $20.27–$77.60 | 87% below | 80% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 MARKER | $19.40 | $97.00 | $20.27–$77.60 | 87% below | 80% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 MARKER | $19.40 | $97.00 | $20.27–$77.60 | — | 80% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNO TUMR AG CA 125 | $19.40 | $97.00 | $20.27–$77.60 | — | 80% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CH UCC EL INF DETECT DNA COVID-19 | $44.00 | $220.00 | $49.98–$176.00 | 52% below | 80% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 MIC INF AGENT DETECT DNA COVID-19 | $47.80 | $239.00 | $49.98–$191.20 | 48% below | 80% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 INF AGENT DETECT DNA COVID-19 | $47.80 | $239.00 | $49.98–$191.20 | 48% below | 80% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 INF AGENT DTCT DNA COVID-19 | $47.80 | $239.00 | $49.98–$191.20 | 48% below | 80% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CH UCC INF DETECT DNA COVID-19 | $47.80 | $239.00 | $49.98–$191.20 | 48% below | 80% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 INF DETECT DNA COVID-19 | $57.40 | $287.00 | $49.98–$229.60 | 38% below | 80% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CH UCC EL INF DETECT DNA COVID-19 | $44.00 | $220.00 | $49.98–$176.00 | — | 80% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 INF AGENT DTCT DNA COVID-19 | $47.80 | $239.00 | $49.98–$191.20 | — | 80% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CH UCC INF DETECT DNA COVID-19 | $47.80 | $239.00 | $49.98–$191.20 | — | 80% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 INF AGENT DETECT DNA COVID-19 | $47.80 | $239.00 | $49.98–$191.20 | — | 80% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 MIC INF AGENT DETECT DNA COVID-19 | $47.80 | $239.00 | $49.98–$191.20 | — | 80% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 INF DETECT DNA COVID-19 | $57.40 | $287.00 | $49.98–$229.60 | — | 80% |
| Calcium blood test, total CPT 82310 CALCIUM SERUM | $4.80 | $24.00 | $5.02–$19.20 | 92% below | 80% |
| Calcium blood test, total CPT 82310 URINE CALCIUM SEND OUT | $4.80 | $24.00 | $5.02–$19.20 | 92% below | 80% |
| Calcium blood test, total CPT 82310 CALCIUM RANDOM URINE | $4.80 | $24.00 | $5.02–$19.20 | 92% below | 80% |
| Calcium blood test, total CPT 82310 ED-CALCIUM TOTAL | $4.80 | $24.00 | $5.02–$19.20 | 92% below | 80% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM SERUM | $4.80 | $24.00 | $5.02–$19.20 | — | 80% |
| Calcium blood test, total inpatient CPT 82310 ED-CALCIUM TOTAL | $4.80 | $24.00 | $5.02–$19.20 | — | 80% |
| Calcium blood test, total inpatient CPT 82310 URINE CALCIUM SEND OUT | $4.80 | $24.00 | $5.02–$19.20 | — | 80% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM RANDOM URINE | $4.80 | $24.00 | $5.02–$19.20 | — | 80% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN | $17.60 | $88.00 | $18.47–$70.40 | 87% below | 80% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC AG (CEA) | $37.70 | $188.49 | $18.47–$150.79 | 72% below | 80% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN | $17.60 | $88.00 | $18.47–$70.40 | — | 80% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC AG (CEA) | $37.70 | $188.49 | $18.47–$150.79 | — | 80% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER AB. | $12.00 | $60.00 | $12.55–$48.00 | 80% below | 80% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER AB(EIA) | $12.00 | $60.00 | $12.55–$48.00 | 80% below | 80% |
| Chickenpox (varicella) immunity blood test CPT 86787 VZVIGG | $12.00 | $60.00 | $12.55–$48.00 | 80% below | 80% |
| Chickenpox (varicella) immunity blood test CPT 86787 VZV IGM | $12.00 | $60.00 | $12.55–$48.00 | 80% below | 80% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER AB(EIA) | $12.00 | $60.00 | $12.55–$48.00 | — | 80% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VZV IGM | $12.00 | $60.00 | $12.55–$48.00 | — | 80% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VZVIGG | $12.00 | $60.00 | $12.55–$48.00 | — | 80% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER AB. | $12.00 | $60.00 | $12.55–$48.00 | — | 80% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 NUCLEIC ACID CHLAMYDIA TRACH | $32.60 | $163.00 | $34.18–$130.40 | 74% below | 80% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS PCR | $32.60 | $163.00 | $34.18–$130.40 | 74% below | 80% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AMPLIFIED PROBE | $32.60 | $163.00 | $34.18–$130.40 | 74% below | 80% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CH NUCLEIC ACID CHLAMYDIA TRACH | $32.60 | $163.00 | $34.18–$130.40 | 74% below | 80% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA LCR | $32.60 | $163.00 | $34.18–$130.40 | 74% below | 80% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 LAB SPC CHLAMYDIA TRAC AMP PROBE | $32.60 | $163.00 | $34.18–$130.40 | 74% below | 80% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 NUCLEIC ACID CHLAMYDIA TRACH | $32.60 | $163.00 | $34.18–$130.40 | — | 80% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 LAB SPC CHLAMYDIA TRAC AMP PROBE | $32.60 | $163.00 | $34.18–$130.40 | — | 80% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA LCR | $32.60 | $163.00 | $34.18–$130.40 | — | 80% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CH NUCLEIC ACID CHLAMYDIA TRACH | $32.60 | $163.00 | $34.18–$130.40 | — | 80% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA AMPLIFIED PROBE | $32.60 | $163.00 | $34.18–$130.40 | — | 80% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS PCR | $32.60 | $163.00 | $34.18–$130.40 | — | 80% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL SENDOUT | $12.40 | $62.00 | $13.04–$49.60 | 92% below | 80% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE (HDL-LDL) | $44.20 | $221.00 | $13.04–$176.80 | 70% below | 80% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL SENDOUT | $12.40 | $62.00 | $13.04–$49.60 | — | 80% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE (HDL-LDL) | $44.20 | $221.00 | $13.04–$176.80 | — | 80% |
| Complete blood count (CBC) with differential CPT 85025 CBC COMPLETE BLOOD COUNT | $10.80 | $54.00 | $7.57–$43.20 | 88% below | 80% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC COMPLETE BLOOD COUNT | $10.80 | $54.00 | $7.57–$43.20 | — | 80% |
| Complete blood count (CBC), no differential CPT 85027 CBC - NO DIFF | $17.20 | $86.00 | $6.30–$68.80 | 82% below | 80% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC - NO DIFF | $17.20 | $86.00 | $6.30–$68.80 | — | 80% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PROFILE | $14.80 | $74.00 | $10.29–$59.20 | 94% below | 80% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PROFILE | $14.80 | $74.00 | $10.29–$59.20 | — | 80% |
| Cortisol blood test, total CPT 82533 CORTISOL QD | $15.20 | $76.00 | $15.88–$60.80 | 81% below | 80% |
| Cortisol blood test, total CPT 82533 CORTISOL TOTAL (PLASMA) | $15.20 | $76.00 | $15.88–$60.80 | 81% below | 80% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL QD | $15.20 | $76.00 | $15.88–$60.80 | — | 80% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL (PLASMA) | $15.20 | $76.00 | $15.88–$60.80 | — | 80% |
| Creatine kinase (CK) blood test, total CPT 82550 SPC CK TOTAL | $6.00 | $30.00 | $6.35–$24.00 | 91% below | 80% |
| Creatine kinase (CK) blood test, total CPT 82550 CK (CREATINE KINASE) | $6.00 | $30.00 | $6.35–$24.00 | 91% below | 80% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 SPC CK TOTAL | $6.00 | $30.00 | $6.35–$24.00 | — | 80% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CK (CREATINE KINASE) | $6.00 | $30.00 | $6.35–$24.00 | — | 80% |
| Creatinine blood test CPT 82565 CREATININE CL | $4.80 | $24.00 | $4.99–$19.20 | 91% below | 80% |
| Creatinine blood test CPT 82565 CREATININE BLOOD - POC | $4.80 | $24.00 | $4.99–$19.20 | 91% below | 80% |
| Creatinine blood test CPT 82565 ED-CREATININE SERUM | $4.80 | $24.00 | $4.99–$19.20 | 91% below | 80% |
| Creatinine blood test inpatient CPT 82565 ED-CREATININE SERUM | $4.80 | $24.00 | $4.99–$19.20 | — | 80% |
| Creatinine blood test inpatient CPT 82565 CREATININE BLOOD - POC | $4.80 | $24.00 | $4.99–$19.20 | — | 80% |
| Creatinine blood test inpatient CPT 82565 CREATININE CL | $4.80 | $24.00 | $4.99–$19.20 | — | 80% |
| Cytomegalovirus (CMV) antibody test CPT 86644 SPC CMV ABS IGG | $13.40 | $67.00 | $14.01–$53.60 | 81% below | 80% |
| Cytomegalovirus (CMV) antibody test CPT 86644 SPC CMV AB | $13.40 | $67.00 | $14.01–$53.60 | 81% below | 80% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB | $13.40 | $67.00 | $14.01–$53.60 | 81% below | 80% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS IGG | $22.87 | $114.33 | $14.01–$91.46 | 68% below | 80% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS IGM | $22.87 | $114.33 | $14.01–$91.46 | 68% below | 80% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 SPC CMV ABS IGG | $13.40 | $67.00 | $14.01–$53.60 | — | 80% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB | $13.40 | $67.00 | $14.01–$53.60 | — | 80% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 SPC CMV AB | $13.40 | $67.00 | $14.01–$53.60 | — | 80% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS IGG | $22.87 | $114.33 | $14.01–$91.46 | — | 80% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS IGM | $22.87 | $114.33 | $14.01–$91.46 | — | 80% |
| D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION D DIMER QN | $9.40 | $47.00 | $9.92–$37.60 | 94% below | 80% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE | $9.40 | $47.00 | $9.92–$37.60 | 94% below | 80% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE | $9.40 | $47.00 | $9.92–$37.60 | — | 80% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION D DIMER QN | $9.40 | $47.00 | $9.92–$37.60 | — | 80% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE SERUM | $20.60 | $103.00 | $21.65–$82.40 | 86% below | 80% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SULFATE SERUM | $20.60 | $103.00 | $21.65–$82.40 | — | 80% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN SGL MECONIUM | $57.80 | $289.00 | $60.53–$231.20 | 7% below | 80% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 NEONATAL URINE DRUG SCREEN | $57.80 | $289.00 | $60.53–$231.20 | 7% below | 80% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONITORING, PANEL 5, SCREEN, URINE | $66.43 | $332.14 | $60.53–$265.71 | 7% above | 80% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONITORING, PANEL WITH CONFIRMATION, URINE | $66.43 | $332.14 | $60.53–$265.71 | 7% above | 80% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN, COMPR, W/ CONFIRMATION, SERUM | $66.43 | $332.14 | $60.53–$265.71 | 7% above | 80% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG ABUSE PANEL 8 W/ CONFIRM, SERUM OR PLASMA | $66.43 | $332.14 | $60.53–$265.71 | 7% above | 80% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE DRUG SCREEN | $69.40 | $347.00 | $60.53–$277.60 | 12% above | 80% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NEONATAL URINE DRUG SCREEN | $57.80 | $289.00 | $60.53–$231.20 | — | 80% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN SGL MECONIUM | $57.80 | $289.00 | $60.53–$231.20 | — | 80% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG ABUSE PANEL 8 W/ CONFIRM, SERUM OR PLASMA | $66.43 | $332.14 | $60.53–$265.71 | — | 80% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONITORING, PANEL 5, SCREEN, URINE | $66.43 | $332.14 | $60.53–$265.71 | — | 80% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN, COMPR, W/ CONFIRMATION, SERUM | $66.43 | $332.14 | $60.53–$265.71 | — | 80% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONITORING, PANEL WITH CONFIRMATION, URINE | $66.43 | $332.14 | $60.53–$265.71 | — | 80% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE DRUG SCREEN | $69.40 | $347.00 | $60.53–$277.60 | — | 80% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 POCT LYTES | $6.60 | $33.00 | $6.83–$26.40 | 96% below | 80% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 CLIN CHEM ELECTROLYTE PANEL | $6.60 | $33.00 | $6.83–$26.40 | 96% below | 80% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $6.60 | $33.00 | $6.83–$26.40 | 96% below | 80% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ARTERIAL ELECTROLYTES | $6.60 | $33.00 | $6.83–$26.40 | 96% below | 80% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES SERUM | $6.60 | $33.00 | $6.83–$26.40 | 96% below | 80% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES SERUM | $6.60 | $33.00 | $6.83–$26.40 | — | 80% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL | $6.60 | $33.00 | $6.83–$26.40 | — | 80% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 POCT LYTES | $6.60 | $33.00 | $6.83–$26.40 | — | 80% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 CLIN CHEM ELECTROLYTE PANEL | $6.60 | $33.00 | $6.83–$26.40 | — | 80% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ARTERIAL ELECTROLYTES | $6.60 | $33.00 | $6.83–$26.40 | — | 80% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV CAPSID AG IGM | $16.80 | $84.00 | $17.67–$67.20 | 80% below | 80% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID ANTGN IGG | $16.80 | $84.00 | $17.67–$67.20 | 80% below | 80% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV CAPSID AG IGA | $16.80 | $84.00 | $17.67–$67.20 | 80% below | 80% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EB VIRAL CASPID AG AB IGG | $24.10 | $120.51 | $17.67–$96.41 | 72% below | 80% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA ANTIBODY (IGM) | $24.10 | $120.51 | $17.67–$96.41 | 72% below | 80% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID ANTGN IGG | $16.80 | $84.00 | $17.67–$67.20 | — | 80% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV CAPSID AG IGA | $16.80 | $84.00 | $17.67–$67.20 | — | 80% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV CAPSID AG IGM | $16.80 | $84.00 | $17.67–$67.20 | — | 80% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VCA ANTIBODY (IGM) | $24.10 | $120.51 | $17.67–$96.41 | — | 80% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EB VIRAL CASPID AG AB IGG | $24.10 | $120.51 | $17.67–$96.41 | — | 80% |
| Estradiol blood test CPT 82670 SPC ASSAY OF ESTRADIOL | $26.00 | $130.00 | $27.22–$104.00 | 79% below | 80% |
| Estradiol blood test inpatient CPT 82670 SPC ASSAY OF ESTRADIOL | $26.00 | $130.00 | $27.22–$104.00 | — | 80% |
| FSH (follicle-stimulating hormone) test CPT 83001 SPC FOLLICLE STIM HORMONE | $17.20 | $86.00 | $18.10–$68.80 | 89% below | 80% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH FOLLICULAR STIMULATING HOR | $17.20 | $86.00 | $18.10–$68.80 | 89% below | 80% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 SPC FOLLICLE STIM HORMONE | $17.20 | $86.00 | $18.10–$68.80 | — | 80% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH FOLLICULAR STIMULATING HOR | $17.20 | $86.00 | $18.10–$68.80 | — | 80% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL | $18.20 | $91.00 | $19.13–$72.80 | 91% below | 80% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN STOOL | $18.20 | $91.00 | $19.13–$72.80 | — | 80% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $12.60 | $63.00 | $13.28–$50.40 | 85% below | 80% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN SENDOUT | $28.63 | $143.17 | $13.28–$114.54 | 66% below | 80% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $12.60 | $63.00 | $13.28–$50.40 | — | 80% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN SENDOUT | $28.63 | $143.17 | $13.28–$114.54 | — | 80% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN ASSAY | $9.00 | $45.00 | $9.47–$36.00 | 90% below | 80% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY | $25.74 | $128.68 | $9.47–$102.94 | 70% below | 80% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ASSAY | $9.00 | $45.00 | $9.47–$36.00 | — | 80% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY | $25.74 | $128.68 | $9.47–$102.94 | — | 80% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM | $13.60 | $68.00 | $14.32–$54.40 | 83% below | 80% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID | $13.60 | $68.00 | $14.32–$54.40 | 83% below | 80% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM | $13.60 | $68.00 | $14.32–$54.40 | — | 80% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID | $13.60 | $68.00 | $14.32–$54.40 | — | 80% |
| Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE (T-3) FREE | $15.80 | $79.00 | $16.50–$63.20 | 89% below | 80% |
| Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE (T-3) FREE | $15.80 | $79.00 | $16.50–$63.20 | — | 80% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FT4 QD | $8.40 | $42.00 | $8.78–$33.60 | 89% below | 80% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE- | $8.40 | $42.00 | $8.78–$33.60 | 89% below | 80% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE | $20.00 | $100.00 | $8.78–$80.00 | 73% below | 80% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FT4 QD | $8.40 | $42.00 | $8.78–$33.60 | — | 80% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE- | $8.40 | $42.00 | $8.78–$33.60 | — | 80% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE | $20.00 | $100.00 | $8.78–$80.00 | — | 80% |
| Free testosterone test CPT 84402 SPC FREE TESTOSTERONE | $23.80 | $119.00 | $24.81–$95.20 | 78% below | 80% |
| Free testosterone test inpatient CPT 84402 SPC FREE TESTOSTERONE | $23.80 | $119.00 | $24.81–$95.20 | — | 80% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT (GAMMA-GLUTAMYL TRANSFRA) | $6.80 | $34.00 | $7.01–$27.20 | 88% below | 80% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GLUTAMYL TRANSFERASE (GGT) | $15.86 | $79.31 | $7.01–$63.45 | 73% below | 80% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT (GAMMA-GLUTAMYL TRANSFRA) | $6.80 | $34.00 | $7.01–$27.20 | — | 80% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GLUTAMYL TRANSFERASE (GGT) | $15.86 | $79.31 | $7.01–$63.45 | — | 80% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GEN HEALTH PROFILE | $247.40 | $1,237.00 | $60.62–$989.60 | 42% below | 80% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GEN HEALTH PROFILE | $247.40 | $1,237.00 | $60.62–$989.60 | — | 80% |
| Glucose tolerance test, 3 samples CPT 82951 CHEM GLUCOSE TOTAL 1ST 3 SPEC | $12.00 | $60.00 | $12.54–$48.00 | 92% below | 80% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 CHEM GLUCOSE TOTAL 1ST 3 SPEC | $12.00 | $60.00 | $12.54–$48.00 | — | 80% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORRHEA AMPLIFIED DNA | $32.60 | $163.00 | $34.18–$130.40 | 75% below | 80% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CH NUCLEIC ACID AMP NEISSERIA | $32.60 | $163.00 | $34.18–$130.40 | 75% below | 80% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NUCLEIC ACID AMP NEISSERIA | $32.60 | $163.00 | $34.18–$130.40 | 75% below | 80% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHLAMYDIA AMPLIFIED/GC PROBE | $32.60 | $163.00 | $34.18–$130.40 | 75% below | 80% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NUCLEIC ACID AMP NEISSERIA | $32.60 | $163.00 | $34.18–$130.40 | 75% below | 80% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NUCLEIC ACID AMP NEISSERIA | $32.60 | $163.00 | $34.18–$130.40 | — | 80% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. GONORRHEA AMPLIFIED DNA | $32.60 | $163.00 | $34.18–$130.40 | — | 80% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CH NUCLEIC ACID AMP NEISSERIA | $32.60 | $163.00 | $34.18–$130.40 | — | 80% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CHLAMYDIA AMPLIFIED/GC PROBE | $32.60 | $163.00 | $34.18–$130.40 | — | 80% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NUCLEIC ACID AMP NEISSERIA | $32.60 | $163.00 | $34.18–$130.40 | — | 80% |
| H. pylori antibody blood test CPT 86677 H. PYLORI AB IGM | $15.60 | $78.00 | $16.42–$62.40 | 88% below | 80% |
| H. pylori antibody blood test CPT 86677 H. PYLORI IGG | $15.60 | $78.00 | $16.42–$62.40 | 88% below | 80% |
| H. pylori antibody blood test CPT 86677 H. PYLORI IGA | $15.60 | $78.00 | $16.42–$62.40 | 88% below | 80% |
| H. pylori antibody blood test CPT 86677 H. PYLORI AB | $15.60 | $78.00 | $16.42–$62.40 | 88% below | 80% |
| H. pylori antibody blood test CPT 86677 H. PYLORI AB IGG | $15.60 | $78.00 | $16.42–$62.40 | 88% below | 80% |
| H. pylori antibody blood test inpatient CPT 86677 H. PYLORI IGA | $15.60 | $78.00 | $16.42–$62.40 | — | 80% |
| H. pylori antibody blood test inpatient CPT 86677 H. PYLORI AB IGG | $15.60 | $78.00 | $16.42–$62.40 | — | 80% |
| H. pylori antibody blood test inpatient CPT 86677 H. PYLORI IGG | $15.60 | $78.00 | $16.42–$62.40 | — | 80% |
| H. pylori antibody blood test inpatient CPT 86677 H. PYLORI AB IGM | $15.60 | $78.00 | $16.42–$62.40 | — | 80% |
| H. pylori antibody blood test inpatient CPT 86677 H. PYLORI AB | $15.60 | $78.00 | $16.42–$62.40 | — | 80% |
| H. pylori stool antigen test CPT 87338 H. PYLORI FECAL AG | $13.40 | $67.00 | $14.00–$53.60 | 84% below | 80% |
| H. pylori stool antigen test inpatient CPT 87338 H. PYLORI FECAL AG | $13.40 | $67.00 | $14.00–$53.60 | — | 80% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA PCR | $79.20 | $396.00 | $82.89–$316.80 | 74% below | 80% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA PCR | $79.20 | $396.00 | $82.89–$316.80 | — | 80% |
| HIV-1 and HIV-2 antibody test CPT 86703 LAB HIV 1 HIV 2 ANTIBODY SGL RESUL | $12.80 | $64.00 | $13.36–$51.20 | 85% below | 80% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 HIV 2 ANTIBODY SGL RESUL | $12.80 | $64.00 | $13.36–$51.20 | 85% below | 80% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 HIV 2 ANTIBODY SGL RESUL | $12.80 | $64.00 | $13.36–$51.20 | — | 80% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 LAB HIV 1 HIV 2 ANTIBODY SGL RESUL | $12.80 | $64.00 | $13.36–$51.20 | — | 80% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 CH SPC HTLV -OR HIV AB CONFIRM | $22.40 | $112.00 | $23.45–$89.60 | 83% below | 80% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV AG/AB SCREEN | $25.75 | $128.75 | $23.45–$103.00 | 81% below | 80% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 CH SPC HTLV -OR HIV AB CONFIRM | $22.40 | $112.00 | $23.45–$89.60 | — | 80% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV AG/AB SCREEN | $25.75 | $128.75 | $23.45–$103.00 | — | 80% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 MICRO HPV SREEN | $32.60 | $163.00 | $34.18–$130.40 | 54% below | 80% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 MICRO HPV SREEN | $32.60 | $163.00 | $34.18–$130.40 | — | 80% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED (A1C) | $9.00 | $45.00 | $9.46–$36.00 | 89% below | 80% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED (A1C) | $9.00 | $45.00 | $9.46–$36.00 | — | 80% |
| Hepatitis B core antibody test (total) CPT 86704 HEP. B CORE AB TOTAL | $11.20 | $56.00 | $11.74–$44.80 | 85% below | 80% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB TOTAL | $22.04 | $110.21 | $11.74–$88.17 | 70% below | 80% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEP. B CORE AB TOTAL | $11.20 | $56.00 | $11.74–$44.80 | — | 80% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB TOTAL | $22.04 | $110.21 | $11.74–$88.17 | — | 80% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 SPC HEPATITIS B SURFACE AB | $10.00 | $50.00 | $10.46–$40.00 | 84% below | 80% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB | $10.00 | $50.00 | $10.46–$40.00 | 84% below | 80% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY | $23.63 | $118.13 | $10.46–$94.50 | 63% below | 80% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB | $10.00 | $50.00 | $10.46–$40.00 | — | 80% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 SPC HEPATITIS B SURFACE AB | $10.00 | $50.00 | $10.46–$40.00 | — | 80% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY | $23.63 | $118.13 | $10.46–$94.50 | — | 80% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN | $9.60 | $48.00 | $10.06–$38.40 | 86% below | 80% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 EIA HEPAT B SURF AG QL/SQ | $9.60 | $48.00 | $10.06–$38.40 | 86% below | 80% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE_ ANTIGEN | $22.66 | $113.30 | $10.06–$90.64 | 68% below | 80% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 EIA HEPAT B SURF AG QL/SQ | $9.60 | $48.00 | $10.06–$38.40 | — | 80% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN | $9.60 | $48.00 | $10.06–$38.40 | — | 80% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE_ ANTIGEN | $22.66 | $113.30 | $10.06–$90.64 | — | 80% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY | $13.20 | $66.00 | $13.90–$52.80 | 85% below | 80% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C | $13.20 | $66.00 | $13.90–$52.80 | 85% below | 80% |
| Hepatitis C antibody blood test (screening) CPT 86803 CHEM HEPAT C AB | $13.20 | $66.00 | $13.90–$52.80 | 85% below | 80% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY | $28.02 | $140.08 | $13.90–$112.06 | 67% below | 80% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY | $13.20 | $66.00 | $13.90–$52.80 | — | 80% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 CHEM HEPAT C AB | $13.20 | $66.00 | $13.90–$52.80 | — | 80% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C | $13.20 | $66.00 | $13.90–$52.80 | — | 80% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY | $28.02 | $140.08 | $13.90–$112.06 | — | 80% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 NUCLEIC ACID QN HEPATITIS C | $39.80 | $199.00 | $41.73–$159.20 | 83% below | 80% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 NUCLEIC ACID QN HEPATITIS C | $39.80 | $199.00 | $41.73–$159.20 | — | 80% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SMPX I ANTIBODY IGG | $12.20 | $61.00 | $12.85–$48.80 | 83% below | 80% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TPE 1 | $12.20 | $61.00 | $12.85–$48.80 | 83% below | 80% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SMPX I ANTIBODY IGM | $12.20 | $61.00 | $12.85–$48.80 | 83% below | 80% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 | $12.20 | $61.00 | $12.85–$48.80 | 83% below | 80% |
| Herpes blood test, HSV-1 antibody CPT 86695 SPC HERPES SIMPLEX TYPE 1 | $12.20 | $61.00 | $12.85–$48.80 | 83% below | 80% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SMPX I IGG | $17.20 | $86.01 | $12.85–$68.81 | 76% below | 80% |
| Herpes blood test, HSV-1 antibody CPT 86695 (HSV1) AND HSV2 IGG TYPE SPECIFIC AB | $17.20 | $86.01 | $12.85–$68.81 | 76% below | 80% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 SPC HERPES SIMPLEX TYPE 1 | $12.20 | $61.00 | $12.85–$48.80 | — | 80% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SMPX I ANTIBODY IGM | $12.20 | $61.00 | $12.85–$48.80 | — | 80% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 | $12.20 | $61.00 | $12.85–$48.80 | — | 80% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SMPX I ANTIBODY IGG | $12.20 | $61.00 | $12.85–$48.80 | — | 80% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TPE 1 | $12.20 | $61.00 | $12.85–$48.80 | — | 80% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 (HSV1) AND HSV2 IGG TYPE SPECIFIC AB | $17.20 | $86.01 | $12.85–$68.81 | — | 80% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SMPX I IGG | $17.20 | $86.01 | $12.85–$68.81 | — | 80% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SMPX VIRUS REFLEX | $18.00 | $90.00 | $18.85–$72.00 | 79% below | 80% |
| Herpes blood test, HSV-2 antibody CPT 86696 SPC HERPES SIMPLEX TYPE 2 | $18.00 | $90.00 | $18.85–$72.00 | 79% below | 80% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SMPX II ANTIBODY IGG | $18.00 | $90.00 | $18.85–$72.00 | 79% below | 80% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SMPX II ANTIBODY | $18.00 | $90.00 | $18.85–$72.00 | 79% below | 80% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX VIRUS II IGM | $18.00 | $90.00 | $18.85–$72.00 | 79% below | 80% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SMPX II IGG | $20.70 | $103.52 | $18.85–$82.82 | 76% below | 80% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV1 AND (HSV2) IGG TYPE SPECIFIC AB | $20.70 | $103.52 | $18.85–$82.82 | 76% below | 80% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV2 IGG TYPE SPECIFIC AB, WITH RFLX HSV-2 INHIBIT | $20.70 | $103.52 | $18.85–$82.82 | 76% below | 80% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV-2 IGG INHIBITION, IA | $20.70 | $103.50 | $18.85–$82.80 | 76% below | 80% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 SPC HERPES SIMPLEX TYPE 2 | $18.00 | $90.00 | $18.85–$72.00 | — | 80% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX VIRUS II IGM | $18.00 | $90.00 | $18.85–$72.00 | — | 80% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SMPX VIRUS REFLEX | $18.00 | $90.00 | $18.85–$72.00 | — | 80% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SMPX II ANTIBODY | $18.00 | $90.00 | $18.85–$72.00 | — | 80% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SMPX II ANTIBODY IGG | $18.00 | $90.00 | $18.85–$72.00 | — | 80% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV1 AND (HSV2) IGG TYPE SPECIFIC AB | $20.70 | $103.52 | $18.85–$82.82 | — | 80% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV2 IGG TYPE SPECIFIC AB, WITH RFLX HSV-2 INHIBIT | $20.70 | $103.52 | $18.85–$82.82 | — | 80% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV-2 IGG INHIBITION, IA | $20.70 | $103.50 | $18.85–$82.80 | — | 80% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SMPX II IGG | $20.70 | $103.52 | $18.85–$82.82 | — | 80% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HIGH SENSI | $12.00 | $60.00 | $12.62–$48.00 | 84% below | 80% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HIGH SENSI | $12.00 | $60.00 | $12.62–$48.00 | — | 80% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE | $16.60 | $83.00 | $17.45–$66.40 | 89% below | 80% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE | $16.60 | $83.00 | $17.45–$66.40 | — | 80% |
| Insulin blood test CPT 83525 INSULIN LEVEL | $10.60 | $53.00 | $11.13–$42.40 | 85% below | 80% |
| Insulin blood test inpatient CPT 83525 INSULIN LEVEL | $10.60 | $53.00 | $11.13–$42.40 | — | 80% |
| Iron blood test (serum iron) CPT 83540 IRON SERUM | $6.00 | $30.00 | $6.30–$24.00 | 92% below | 80% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON SERUM | $6.00 | $30.00 | $6.30–$24.00 | — | 80% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $8.20 | $41.00 | $8.51–$32.80 | 91% below | 80% |
| Iron-binding capacity (TIBC) test CPT 83550 MSC UIBC | $22.25 | $111.24 | $8.51–$88.99 | 75% below | 80% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY | $8.20 | $41.00 | $8.51–$32.80 | — | 80% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 MSC UIBC | $22.25 | $111.24 | $8.51–$88.99 | — | 80% |
| LH (luteinizing hormone) test CPT 83002 SPC LUTEINIZING HORMONE (LH) | $17.20 | $86.00 | $18.04–$68.80 | 88% below | 80% |
| LH (luteinizing hormone) test CPT 83002 LH LEUTENIZING HORMONE | $17.20 | $86.00 | $18.04–$68.80 | 88% below | 80% |
| LH (luteinizing hormone) test inpatient CPT 83002 SPC LUTEINIZING HORMONE (LH) | $17.20 | $86.00 | $18.04–$68.80 | — | 80% |
| LH (luteinizing hormone) test inpatient CPT 83002 LH LEUTENIZING HORMONE | $17.20 | $86.00 | $18.04–$68.80 | — | 80% |
| Lactate (lactic acid) blood test CPT 83605 CHEM LACTATE/LACTIC ACID BF | $10.80 | $54.00 | $11.27–$43.20 | 89% below | 80% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID-CSF | $10.80 | $54.00 | $11.27–$43.20 | 89% below | 80% |
| Lactate (lactic acid) blood test CPT 83605 ARTERIAL LACTIC ACID | $10.80 | $54.00 | $11.27–$43.20 | 89% below | 80% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID PLASMA | $10.80 | $54.00 | $11.27–$43.20 | 89% below | 80% |
| Lactate (lactic acid) blood test CPT 83605 POCT LACTATE | $10.80 | $54.00 | $11.27–$43.20 | 89% below | 80% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE/LACTIC ACID BLOOD | $16.20 | $81.00 | $11.27–$64.80 | 83% below | 80% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE/LACTIC ACID- SENDOUT � | $27.98 | $139.90 | $11.27–$111.92 | 71% below | 80% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID PLASMA | $10.80 | $54.00 | $11.27–$43.20 | — | 80% |
| Lactate (lactic acid) blood test inpatient CPT 83605 POCT LACTATE | $10.80 | $54.00 | $11.27–$43.20 | — | 80% |
| Lactate (lactic acid) blood test inpatient CPT 83605 CHEM LACTATE/LACTIC ACID BF | $10.80 | $54.00 | $11.27–$43.20 | — | 80% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID-CSF | $10.80 | $54.00 | $11.27–$43.20 | — | 80% |
| Lactate (lactic acid) blood test inpatient CPT 83605 ARTERIAL LACTIC ACID | $10.80 | $54.00 | $11.27–$43.20 | — | 80% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE/LACTIC ACID BLOOD | $16.20 | $81.00 | $11.27–$64.80 | — | 80% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE/LACTIC ACID- SENDOUT � | $27.98 | $139.90 | $11.27–$111.92 | — | 80% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH-CSF | $5.60 | $28.00 | $5.89–$22.40 | 86% below | 80% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LD BODY FLUID | $5.60 | $28.00 | $5.89–$22.40 | 86% below | 80% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LD SERUM | $5.60 | $28.00 | $5.89–$22.40 | 86% below | 80% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH-ED | $5.60 | $28.00 | $5.89–$22.40 | 86% below | 80% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 CSF LDH | $5.60 | $28.00 | $5.89–$22.40 | 86% below | 80% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME | $5.60 | $28.00 | $5.89–$22.40 | 86% below | 80% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD SERUM | $5.60 | $28.00 | $5.89–$22.40 | — | 80% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD BODY FLUID | $5.60 | $28.00 | $5.89–$22.40 | — | 80% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH-CSF | $5.60 | $28.00 | $5.89–$22.40 | — | 80% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE (LD) (LDH) ENZYME | $5.60 | $28.00 | $5.89–$22.40 | — | 80% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH-ED | $5.60 | $28.00 | $5.89–$22.40 | — | 80% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 CSF LDH | $5.60 | $28.00 | $5.89–$22.40 | — | 80% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $6.40 | $32.00 | $6.71–$25.60 | 91% below | 80% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE BODY FLUID | $6.40 | $32.00 | $6.71–$25.60 | 91% below | 80% |
| Lipase blood test (pancreas enzyme) CPT 83690 CH LIPASE BODY FLUID | $24.31 | $121.54 | $6.71–$97.23 | 64% below | 80% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE BODY FLUID | $6.40 | $32.00 | $6.71–$25.60 | — | 80% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $6.40 | $32.00 | $6.71–$25.60 | — | 80% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 CH LIPASE BODY FLUID | $24.31 | $121.54 | $6.71–$97.23 | — | 80% |
| Lyme disease antibody test CPT 86618 SPC LYME DISEASE AB | $15.80 | $79.00 | $16.59–$63.20 | 81% below | 80% |
| Lyme disease antibody test inpatient CPT 86618 SPC LYME DISEASE AB | $15.80 | $79.00 | $16.59–$63.20 | — | 80% |
| Magnesium blood test CPT 83735 URINE MAGNESIUM | $6.20 | $31.00 | $6.53–$24.80 | 87% below | 80% |
| Magnesium blood test CPT 83735 URINE MAGNESIUM SEND OUT | $6.20 | $31.00 | $6.53–$24.80 | 87% below | 80% |
| Magnesium blood test CPT 83735 MAGNESIUM 24 HR URINE | $6.20 | $31.00 | $6.53–$24.80 | 87% below | 80% |
| Magnesium blood test CPT 83735 MAGNESIUM | $15.40 | $77.00 | $6.53–$61.60 | 67% below | 80% |
| Magnesium blood test inpatient CPT 83735 URINE MAGNESIUM | $6.20 | $31.00 | $6.53–$24.80 | — | 80% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM 24 HR URINE | $6.20 | $31.00 | $6.53–$24.80 | — | 80% |
| Magnesium blood test inpatient CPT 83735 URINE MAGNESIUM SEND OUT | $6.20 | $31.00 | $6.53–$24.80 | — | 80% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $15.40 | $77.00 | $6.53–$61.60 | — | 80% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG ABS | $12.00 | $60.00 | $12.55–$48.00 | 67% below | 80% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM | $12.00 | $60.00 | $12.55–$48.00 | 67% below | 80% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGG | $12.00 | $60.00 | $12.55–$48.00 | 67% below | 80% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY IGG | $12.00 | $60.00 | $12.55–$48.00 | 67% below | 80% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY IGG | $12.00 | $60.00 | $12.55–$48.00 | — | 80% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IGG | $12.00 | $60.00 | $12.55–$48.00 | — | 80% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGG ABS | $12.00 | $60.00 | $12.55–$48.00 | — | 80% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGM | $12.00 | $60.00 | $12.55–$48.00 | — | 80% |
| Mono test (heterophile antibody, Monospot) CPT 86308 EBV HETEROPHILE IGM | $17.72 | $88.58 | $5.05–$70.86 | 79% below | 80% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 EBV HETEROPHILE IGM | $17.72 | $88.58 | $5.05–$70.86 | — | 80% |
| Mumps immunity blood test CPT 86735 MUMPS AB IGM | $12.20 | $61.00 | $12.71–$48.80 | 79% below | 80% |
| Mumps immunity blood test CPT 86735 MUMPS ANTIBODY IGG | $12.20 | $61.00 | $12.71–$48.80 | 79% below | 80% |
| Mumps immunity blood test CPT 86735 MUMPS AB IGG | $12.20 | $61.00 | $12.71–$48.80 | 79% below | 80% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY IGG | $12.20 | $61.00 | $12.71–$48.80 | — | 80% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS AB IGG | $12.20 | $61.00 | $12.71–$48.80 | — | 80% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS AB IGM | $12.20 | $61.00 | $12.71–$48.80 | — | 80% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $17.20 | $86.00 | $17.91–$68.80 | 85% below | 80% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 CHEM PSA FREE | $17.20 | $86.00 | $17.91–$68.80 | 85% below | 80% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE | $17.20 | $86.00 | $17.91–$68.80 | — | 80% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 CHEM PSA FREE | $17.20 | $86.00 | $17.91–$68.80 | — | 80% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL SENDOUT | $17.20 | $86.00 | $17.91–$68.80 | 80% below | 80% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 CHEM PSA TOTAL | $17.20 | $86.00 | $17.91–$68.80 | 80% below | 80% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CHEM PSA TOTAL | $17.20 | $86.00 | $17.91–$68.80 | — | 80% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL SENDOUT | $17.20 | $86.00 | $17.91–$68.80 | — | 80% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PTH) | $38.40 | $192.00 | $40.21–$153.60 | 81% below | 80% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE (PTH) | $38.40 | $192.00 | $40.21–$153.60 | — | 80% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 SPC *APTT SENDOUT | $5.60 | $28.00 | $5.85–$22.40 | 89% below | 80% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HEXAGONAL PHOSPHOLIPID SCR | $5.60 | $28.00 | $5.85–$22.40 | 89% below | 80% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 ACTIVATED PART THROMBOPLASTIN | $5.60 | $28.00 | $5.85–$22.40 | 89% below | 80% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLAS TIME | $5.60 | $28.00 | $5.85–$22.40 | 89% below | 80% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLAS TIME (PTT) | $5.60 | $28.00 | $5.85–$22.40 | 89% below | 80% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ACTIVATED PART THROMBOPLASTIN | $5.60 | $28.00 | $5.85–$22.40 | — | 80% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLAS TIME (PTT) | $5.60 | $28.00 | $5.85–$22.40 | — | 80% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 SPC *APTT SENDOUT | $5.60 | $28.00 | $5.85–$22.40 | — | 80% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLAS TIME | $5.60 | $28.00 | $5.85–$22.40 | — | 80% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HEXAGONAL PHOSPHOLIPID SCR | $5.60 | $28.00 | $5.85–$22.40 | — | 80% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS SERUM | $6.60 | $33.00 | $4.62–$26.40 | 89% below | 80% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS SERUM | $6.60 | $33.00 | $4.62–$26.40 | — | 80% |
| Potassium blood test CPT 84132 POTASSIUM SERUM | $4.40 | $22.00 | $4.64–$17.60 | 93% below | 80% |
| Potassium blood test CPT 84132 LAB ISTAT POTASSIUM | $4.40 | $22.00 | $4.64–$17.60 | 93% below | 80% |
| Potassium blood test CPT 84132 POCT POTASSIUM | $4.40 | $22.00 | $4.64–$17.60 | 93% below | 80% |
| Potassium blood test CPT 84132 ED-POTASSIUM SERUM | $4.40 | $22.00 | $4.64–$17.60 | 93% below | 80% |
| Potassium blood test CPT 84132 RESP POTASSIUM | $10.20 | $51.00 | $4.64–$40.80 | 83% below | 80% |
| Potassium blood test inpatient CPT 84132 LAB ISTAT POTASSIUM | $4.40 | $22.00 | $4.64–$17.60 | — | 80% |
| Potassium blood test inpatient CPT 84132 ED-POTASSIUM SERUM | $4.40 | $22.00 | $4.64–$17.60 | — | 80% |
| Potassium blood test inpatient CPT 84132 POCT POTASSIUM | $4.40 | $22.00 | $4.64–$17.60 | — | 80% |
| Potassium blood test inpatient CPT 84132 POTASSIUM SERUM | $4.40 | $22.00 | $4.64–$17.60 | — | 80% |
| Potassium blood test inpatient CPT 84132 RESP POTASSIUM | $10.20 | $51.00 | $4.64–$40.80 | — | 80% |
| Progesterone blood test CPT 84144 PROGESTERONE SERUM | $19.40 | $97.00 | $20.32–$77.60 | 81% below | 80% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE SERUM | $19.40 | $97.00 | $20.32–$77.60 | — | 80% |
| Prolactin blood test CPT 84146 PROLACTIN TOTAL & MONOMERIC | $18.00 | $90.00 | $18.87–$72.00 | 84% below | 80% |
| Prolactin blood test CPT 84146 PROLACTIN QD | $18.00 | $90.00 | $18.87–$72.00 | 84% below | 80% |
| Prolactin blood test CPT 84146 CHEM PROLACTIN | $18.00 | $90.00 | $18.87–$72.00 | 84% below | 80% |
| Prolactin blood test CPT 84146 PROLACTIN, DILUTION STUDY | $35.02 | $175.10 | $18.87–$140.08 | 68% below | 80% |
| Prolactin blood test inpatient CPT 84146 CHEM PROLACTIN | $18.00 | $90.00 | $18.87–$72.00 | — | 80% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN QD | $18.00 | $90.00 | $18.87–$72.00 | — | 80% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN TOTAL & MONOMERIC | $18.00 | $90.00 | $18.87–$72.00 | — | 80% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN, DILUTION STUDY | $35.02 | $175.10 | $18.87–$140.08 | — | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME SENDOUT | $4.00 | $20.00 | $4.18–$16.00 | 91% below | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT) | $4.00 | $20.00 | $4.18–$16.00 | 91% below | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME W INR | $4.00 | $20.00 | $4.18–$16.00 | 91% below | 80% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (PT) | $4.00 | $20.00 | $4.18–$16.00 | — | 80% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME SENDOUT | $4.00 | $20.00 | $4.18–$16.00 | — | 80% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME W INR | $4.00 | $20.00 | $4.18–$16.00 | — | 80% |
| Rapid flu test (influenza antigen) CPT 87804 ANTIGEN DETECTION HAEMOPHILUS | $15.40 | $77.00 | $16.12–$61.60 | 83% below | 80% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 ANTIGEN DETECTION HAEMOPHILUS | $15.40 | $77.00 | $16.12–$61.60 | — | 80% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 IMMUNO OPTICAL STREP A | $15.40 | $77.00 | $16.10–$61.60 | 84% below | 80% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 CH UCC STREP SCREEN RAPID | $15.40 | $77.00 | $16.10–$61.60 | 84% below | 80% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP SCREEN RAPID | $15.40 | $77.00 | $16.10–$61.60 | 84% below | 80% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 CH UCC EL STREP SCREEN RAPID | $28.49 | $142.45 | $16.10–$113.96 | 71% below | 80% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 CH UCC STREP SCREEN RAPID | $15.40 | $77.00 | $16.10–$61.60 | — | 80% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP SCREEN RAPID | $15.40 | $77.00 | $16.10–$61.60 | — | 80% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 IMMUNO OPTICAL STREP A | $15.40 | $77.00 | $16.10–$61.60 | — | 80% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 CH UCC EL STREP SCREEN RAPID | $28.49 | $142.45 | $16.10–$113.96 | — | 80% |
| Renin blood test CPT 84244 RENIN PLASMA | $20.40 | $102.00 | $21.42–$81.60 | 80% below | 80% |
| Renin blood test inpatient CPT 84244 RENIN PLASMA | $20.40 | $102.00 | $21.42–$81.60 | — | 80% |
| Rheumatoid factor (RF) test CPT 86431 CHEM RHEUMATOID FACTOR QN | $5.20 | $26.00 | $5.53–$20.80 | 89% below | 80% |
| Rheumatoid factor (RF) test inpatient CPT 86431 CHEM RHEUMATOID FACTOR QN | $5.20 | $26.00 | $5.53–$20.80 | — | 80% |
| Rubella antibody test (immunity check) CPT 86762 MICRO RUBELLA ANTIBODY | $13.40 | $67.00 | $14.01–$53.60 | 74% below | 80% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA AB | $13.40 | $67.00 | $14.01–$53.60 | 74% below | 80% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM ABS | $13.40 | $67.00 | $14.01–$53.60 | 74% below | 80% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA AB SCREEN | $13.40 | $67.00 | $14.01–$53.60 | 74% below | 80% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGG | $13.40 | $67.00 | $14.01–$53.60 | 74% below | 80% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ABS IGM | $13.40 | $67.00 | $14.01–$53.60 | 74% below | 80% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM (QUAL) | $19.09 | $95.45 | $14.01–$76.36 | 62% below | 80% |
| Rubella antibody test (immunity check) inpatient CPT 86762 MICRO RUBELLA ANTIBODY | $13.40 | $67.00 | $14.01–$53.60 | — | 80% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB SCREEN | $13.40 | $67.00 | $14.01–$53.60 | — | 80% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ABS IGM | $13.40 | $67.00 | $14.01–$53.60 | — | 80% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGG | $13.40 | $67.00 | $14.01–$53.60 | — | 80% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM ABS | $13.40 | $67.00 | $14.01–$53.60 | — | 80% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB | $13.40 | $67.00 | $14.01–$53.60 | — | 80% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM (QUAL) | $19.09 | $95.45 | $14.01–$76.36 | — | 80% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANLYS CMPL | $13.20 | $66.00 | $11.88–$52.80 | 90% below | 80% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANLYS CMPL | $13.20 | $66.00 | $11.88–$52.80 | — | 80% |
| Sodium blood test CPT 84295 POCT SODIUM | $4.40 | $22.00 | $4.69–$17.60 | 93% below | 80% |
| Sodium blood test CPT 84295 SODIUM SERUM | $4.40 | $22.00 | $4.69–$17.60 | 93% below | 80% |
| Sodium blood test CPT 84295 ED-SODIUM SERUM | $4.40 | $22.00 | $4.69–$17.60 | 93% below | 80% |
| Sodium blood test CPT 84295 RESP SODIUM | $9.40 | $47.00 | $4.69–$37.60 | 85% below | 80% |
| Sodium blood test inpatient CPT 84295 ED-SODIUM SERUM | $4.40 | $22.00 | $4.69–$17.60 | — | 80% |
| Sodium blood test inpatient CPT 84295 SODIUM SERUM | $4.40 | $22.00 | $4.69–$17.60 | — | 80% |
| Sodium blood test inpatient CPT 84295 POCT SODIUM | $4.40 | $22.00 | $4.69–$17.60 | — | 80% |
| Sodium blood test inpatient CPT 84295 RESP SODIUM | $9.40 | $47.00 | $4.69–$37.60 | — | 80% |
| Stool ova and parasites exam CPT 87177 OVA CYSTS & PARASITES | $8.20 | $41.00 | $8.67–$32.80 | 88% below | 80% |
| Stool ova and parasites exam CPT 87177 SMEAR OVA PARASITE CONCNT/IDEN | $8.20 | $41.00 | $8.67–$32.80 | 88% below | 80% |
| Stool ova and parasites exam inpatient CPT 87177 OVA CYSTS & PARASITES | $8.20 | $41.00 | $8.67–$32.80 | — | 80% |
| Stool ova and parasites exam inpatient CPT 87177 SMEAR OVA PARASITE CONCNT/IDEN | $8.20 | $41.00 | $8.67–$32.80 | — | 80% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL | $4.00 | $20.00 | $4.27–$16.00 | 89% below | 80% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD STOOL | $4.00 | $20.00 | $4.27–$16.00 | — | 80% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD FECES IMMUNO QUAL | $14.80 | $74.00 | $15.51–$59.20 | 78% below | 80% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD FECES IMMUNO QL | $14.80 | $74.00 | $15.51–$59.20 | 78% below | 80% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD FECES IMMUNO QUAL | $14.80 | $74.00 | $15.51–$59.20 | — | 80% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD FECES IMMUNO QL | $14.80 | $74.00 | $15.51–$59.20 | — | 80% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TP:PA T. PALLIDUM | $12.40 | $62.00 | $12.90–$49.60 | 72% below | 80% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 SPC FTA-ABS ABSORP (SEND OUT) | $12.40 | $62.00 | $12.90–$49.60 | 72% below | 80% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM ANTIBODY (IGG) | $17.10 | $85.49 | $12.90–$68.39 | 61% below | 80% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 SPC TREPONEMA PALLIDUM ANTIBODY | $17.10 | $85.49 | $12.90–$68.39 | 61% below | 80% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TP:PA T. PALLIDUM | $12.40 | $62.00 | $12.90–$49.60 | — | 80% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SPC FTA-ABS ABSORP (SEND OUT) | $12.40 | $62.00 | $12.90–$49.60 | — | 80% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM ANTIBODY (IGG) | $17.10 | $85.49 | $12.90–$68.39 | — | 80% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SPC TREPONEMA PALLIDUM ANTIBODY | $17.10 | $85.49 | $12.90–$68.39 | — | 80% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-CSF | $4.00 | $20.00 | $4.16–$16.00 | 91% below | 80% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR (DIAGNOSIS) W/ RFLX SENDOUT | $4.00 | $20.00 | $4.16–$16.00 | 91% below | 80% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SERUM | $4.00 | $20.00 | $4.16–$16.00 | 91% below | 80% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR SERUM | $4.00 | $20.00 | $4.16–$16.00 | — | 80% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR (DIAGNOSIS) W/ RFLX SENDOUT | $4.00 | $20.00 | $4.16–$16.00 | — | 80% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL-CSF | $4.00 | $20.00 | $4.16–$16.00 | — | 80% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMM AG MEAS GAMMA | $57.60 | $288.00 | $60.37–$230.40 | 72% below | 80% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST CELL IMM AG MEASURE GAMMA INTERF | $57.60 | $288.00 | $60.37–$230.40 | 72% below | 80% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMM AG MEAS GAMMA | $57.60 | $288.00 | $60.37–$230.40 | — | 80% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TUBERCULOSIS TEST CELL IMM AG MEASURE GAMMA INTERF | $57.60 | $288.00 | $60.37–$230.40 | — | 80% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TOTAL TESTOSTERONE | $24.00 | $120.00 | $25.14–$96.00 | 76% below | 80% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TOTAL TESTOSTERONE | $24.00 | $120.00 | $25.14–$96.00 | — | 80% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB | $13.60 | $68.00 | $14.18–$54.40 | 84% below | 80% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 SPC MICROSOMAL ANTIBODY | $13.60 | $68.00 | $14.18–$54.40 | 84% below | 80% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOME ABS | $13.60 | $68.00 | $14.18–$54.40 | 84% below | 80% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 TPO ANTIBODY | $22.20 | $110.99 | $14.18–$88.79 | 73% below | 80% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 SPC MICROSOMAL ANTIBODY | $13.60 | $68.00 | $14.18–$54.40 | — | 80% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB | $13.60 | $68.00 | $14.18–$54.40 | — | 80% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOME ABS | $13.60 | $68.00 | $14.18–$54.40 | — | 80% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 TPO ANTIBODY | $22.20 | $110.99 | $14.18–$88.79 | — | 80% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH QD | $15.60 | $78.00 | $16.36–$62.40 | 85% below | 80% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $15.60 | $78.00 | $16.36–$62.40 | 85% below | 80% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 LAB TSH | $15.60 | $78.00 | $16.36–$62.40 | 85% below | 80% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $15.60 | $78.00 | $16.36–$62.40 | — | 80% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 LAB TSH | $15.60 | $78.00 | $16.36–$62.40 | — | 80% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH QD | $15.60 | $78.00 | $16.36–$62.40 | — | 80% |
| Total IgE blood test CPT 82785 IGE SERUM | $15.40 | $77.00 | $16.03–$61.60 | 81% below | 80% |
| Total IgE blood test inpatient CPT 82785 IGE SERUM | $15.40 | $77.00 | $16.03–$61.60 | — | 80% |
| Total cholesterol blood test CPT 82465 SPC CHOLESTEROL TOTAL | $4.00 | $20.00 | $4.24–$16.00 | 93% below | 80% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL | $4.00 | $20.00 | $4.24–$16.00 | 93% below | 80% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL | $4.00 | $20.00 | $4.24–$16.00 | — | 80% |
| Total cholesterol blood test inpatient CPT 82465 SPC CHOLESTEROL TOTAL | $4.00 | $20.00 | $4.24–$16.00 | — | 80% |
| Total thyroxine (T4) blood test CPT 84436 T4 TOTAL | $6.40 | $32.00 | $6.70–$25.60 | 92% below | 80% |
| Total thyroxine (T4) blood test CPT 84436 TOTAL T4 | $6.40 | $32.00 | $6.70–$25.60 | 92% below | 80% |
| Total thyroxine (T4) blood test CPT 84436 THYROXINE (T4) TOTAL | $17.51 | $87.55 | $6.70–$70.04 | 78% below | 80% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4 TOTAL | $6.40 | $32.00 | $6.70–$25.60 | — | 80% |
| Total thyroxine (T4) blood test inpatient CPT 84436 TOTAL T4 | $6.40 | $32.00 | $6.70–$25.60 | — | 80% |
| Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE (T4) TOTAL | $17.51 | $87.55 | $6.70–$70.04 | — | 80% |
| Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL | $13.20 | $66.00 | $13.82–$52.80 | 89% below | 80% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL | $13.20 | $66.00 | $13.82–$52.80 | — | 80% |
| Transferrin blood test CPT 84466 TRANSFERRIN | $11.80 | $59.00 | $12.43–$47.20 | 90% below | 80% |
| Transferrin blood test inpatient CPT 84466 TRANSFERRIN | $11.80 | $59.00 | $12.43–$47.20 | — | 80% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMON AMP PROBE | $32.60 | $163.00 | $34.18–$130.40 | 63% below | 80% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMON AMP QUAL MALE | $32.60 | $163.00 | $34.18–$130.40 | 63% below | 80% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMON AMP PROBE | $32.60 | $163.00 | $34.18–$130.40 | — | 80% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMON AMP QUAL MALE | $32.60 | $163.00 | $34.18–$130.40 | — | 80% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES SERUM | $5.40 | $27.00 | $5.59–$21.60 | 92% below | 80% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES BODY FLUID | $5.40 | $27.00 | $5.59–$21.60 | 92% below | 80% |
| Triglycerides blood test CPT 84478 CH TRIGLYCERIDES | $5.40 | $27.00 | $5.59–$21.60 | 92% below | 80% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES BODY FLUID | $5.40 | $27.00 | $5.59–$21.60 | — | 80% |
| Triglycerides blood test inpatient CPT 84478 CH TRIGLYCERIDES | $5.40 | $27.00 | $5.59–$21.60 | — | 80% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES SERUM | $5.40 | $27.00 | $5.59–$21.60 | — | 80% |
| Troponin test, quantitative CPT 84484 TROPONIN QUANTITATIVE | $11.60 | $58.00 | $12.15–$46.40 | 90% below | 80% |
| Troponin test, quantitative CPT 84484 TROPONIN QN | $11.60 | $58.00 | $12.15–$46.40 | 90% below | 80% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN QUANTITATIVE | $11.60 | $58.00 | $12.15–$46.40 | — | 80% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN QN | $11.60 | $58.00 | $12.15–$46.40 | — | 80% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSYS W/ MICROSCOPE | $15.40 | $77.00 | $3.09–$61.60 | 84% below | 80% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSYS W/ MICROSCOPE | $15.40 | $77.00 | $3.09–$61.60 | — | 80% |
| Urinalysis with microscope exam, manual CPT 81000 ROP DRESSING STICK | $2.60 | $13.00 | $2.34–$12.53 | 93% below | 80% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 ROP DRESSING STICK | $2.60 | $13.00 | $2.34–$12.53 | — | 80% |
| Urinalysis without microscope exam, automated CPT 81003 CH UCC EL URINALYSIS DIPSTICK | $7.40 | $37.02 | $2.20–$29.62 | 85% below | 80% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 CH UCC EL URINALYSIS DIPSTICK | $7.40 | $37.02 | $2.20–$29.62 | — | 80% |
| Urinalysis without microscope exam, manual CPT 81002 SPECIFIC GRAVITY - URINE | $3.20 | $16.00 | $3.39–$12.80 | 89% below | 80% |
| Urinalysis without microscope exam, manual CPT 81002 URINE PROTEIN SCREEN | $3.20 | $16.00 | $3.39–$12.80 | 89% below | 80% |
| Urinalysis without microscope exam, manual CPT 81002 REDUCING SUBSTANCES URINE | $3.20 | $16.00 | $3.39–$12.80 | 89% below | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 SPECIFIC GRAVITY - URINE | $3.20 | $16.00 | $3.39–$12.80 | — | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINE PROTEIN SCREEN | $3.20 | $16.00 | $3.39–$12.80 | — | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 REDUCING SUBSTANCES URINE | $3.20 | $16.00 | $3.39–$12.80 | — | 80% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE (ROUTINE) | $23.60 | $118.00 | $7.86–$94.40 | 82% below | 80% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE (ROUTINE) | $23.60 | $118.00 | $7.86–$94.40 | — | 80% |
| Urine microalbumin (albumin) test CPT 82043 MICROABLUMIN RANDOM URINE QN | $5.40 | $27.00 | $5.63–$21.60 | 89% below | 80% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE | $5.40 | $27.00 | $5.63–$21.60 | 89% below | 80% |
| Urine microalbumin (albumin) test CPT 82043 HR MICROALBUMIN URINE | $5.40 | $27.00 | $5.63–$21.60 | 89% below | 80% |
| Urine microalbumin (albumin) test CPT 82043 24HR MICROALBUMIN URINE | $5.40 | $27.00 | $5.63–$21.60 | 89% below | 80% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN 24 HR URINE | $5.40 | $27.00 | $5.63–$21.60 | 89% below | 80% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN RANDOM URINE | $5.40 | $27.00 | $5.63–$21.60 | 89% below | 80% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE 24 HR | $5.40 | $27.00 | $5.63–$21.60 | 89% below | 80% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROABLUMIN RANDOM URINE QN | $5.40 | $27.00 | $5.63–$21.60 | — | 80% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN RANDOM URINE | $5.40 | $27.00 | $5.63–$21.60 | — | 80% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN 24 HR URINE | $5.40 | $27.00 | $5.63–$21.60 | — | 80% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE 24 HR | $5.40 | $27.00 | $5.63–$21.60 | — | 80% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE | $5.40 | $27.00 | $5.63–$21.60 | — | 80% |
| Urine microalbumin (albumin) test inpatient CPT 82043 24HR MICROALBUMIN URINE | $5.40 | $27.00 | $5.63–$21.60 | — | 80% |
| Urine microalbumin (albumin) test inpatient CPT 82043 HR MICROALBUMIN URINE | $5.40 | $27.00 | $5.63–$21.60 | — | 80% |
| Urine pregnancy test, read by color change CPT 81025 CH MU URINE PREGNANCY VISUAL | $8.00 | $40.00 | $8.39–$32.00 | 91% below | 80% |
| Urine pregnancy test, read by color change CPT 81025 CH PS EPS URINE PREGNANCY VISUAL | $8.00 | $40.00 | $8.39–$32.00 | 91% below | 80% |
| Urine pregnancy test, read by color change inpatient CPT 81025 CH MU URINE PREGNANCY VISUAL | $8.00 | $40.00 | $8.39–$32.00 | — | 80% |
| Urine pregnancy test, read by color change inpatient CPT 81025 CH PS EPS URINE PREGNANCY VISUAL | $8.00 | $40.00 | $8.39–$32.00 | — | 80% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $14.00 | $70.00 | $14.69–$56.00 | 85% below | 80% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 | $14.00 | $70.00 | $14.69–$56.00 | 85% below | 80% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 | $14.00 | $70.00 | $14.69–$56.00 | — | 80% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 | $14.00 | $70.00 | $14.69–$56.00 | — | 80% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $27.60 | $138.00 | $28.84–$110.40 | 77% below | 80% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-HYDROXYVITAMIN D2 & D3 | $27.60 | $138.00 | $28.84–$110.40 | 77% below | 80% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 1 25 DIHYDROXY INC FRACTION | $27.60 | $138.00 | $28.84–$110.40 | 77% below | 80% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 1 25 DIHYDROXY INC FRACTION | $27.60 | $138.00 | $28.84–$110.40 | — | 80% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-HYDROXYVITAMIN D2 & D3 | $27.60 | $138.00 | $28.84–$110.40 | — | 80% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY | $27.60 | $138.00 | $28.84–$110.40 | — | 80% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 1 25-DIHYDROXYVITAMIN D | $35.80 | $179.00 | $37.50–$143.20 | 77% below | 80% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 1 25-DIHYDROXYVITAMIN D | $35.80 | $179.00 | $37.50–$143.20 | — | 80% |
| Zinc blood test CPT 84630 ZINC | $10.60 | $53.00 | $11.10–$42.40 | 84% below | 80% |
| Zinc blood test inpatient CPT 84630 ZINC | $10.60 | $53.00 | $11.10–$42.40 | — | 80% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 SPC LAB HCG QN | $14.00 | $70.00 | $14.66–$56.00 | 88% below | 80% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 MATERNAL HCG | $14.00 | $70.00 | $14.66–$56.00 | 88% below | 80% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE | $14.00 | $70.00 | $14.66–$56.00 | 88% below | 80% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTITATIVE | $14.00 | $70.00 | $14.66–$56.00 | — | 80% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 MATERNAL HCG | $14.00 | $70.00 | $14.66–$56.00 | — | 80% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 SPC LAB HCG QN | $14.00 | $70.00 | $14.66–$56.00 | — | 80% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLSD TX DIST FIB FX W/O MAN | $97.40 | $487.00 | $258.11–$389.60 | 79% below | 80% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLSD TX DIST FIB FX W/O MAN | $97.40 | $487.00 | $258.11–$389.60 | — | 80% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD TX METATARSAL FX WO MAN | $252.40 | $1,262.00 | $183.87–$1,009.60 | 10% below | 80% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLSD TX METATARSAL FX WO MAN | $252.40 | $1,262.00 | $183.87–$1,009.60 | — | 80% |
| Cardiac catheterization with coronary angiogram CPT 93458 LT HRT ART/VENTRICLE ANG | $1,899.20 | $9,496.00 | $1,899.20–$7,596.80 | 82% below | 80% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 LT HRT ART/VENTRICLE ANG | $1,899.20 | $9,496.00 | $1,899.20–$7,596.80 | — | 80% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 EPS CARDIOVERS ELECTV EXTERNAL | $222.00 | $1,110.00 | $93.27–$964.73 | 83% below | 80% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION - IMCN | $599.60 | $2,998.00 | $93.27–$2,398.40 | 55% below | 80% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HMC CARDIOVERSION ELECTRIC EXT | $599.60 | $2,998.00 | $93.27–$2,398.40 | 55% below | 80% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION - ICN | $599.60 | $2,998.00 | $371.05–$2,398.40 | 55% below | 80% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 INF CRDIOVRSION ELECTV EXT | $607.80 | $3,039.00 | $93.27–$2,431.20 | 54% below | 80% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 EPS CARDIOVERS ELECTV EXTERNAL | $222.00 | $1,110.00 | $93.27–$964.73 | — | 80% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION - ICN | $599.60 | $2,998.00 | $371.05–$2,398.40 | — | 80% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION - IMCN | $599.60 | $2,998.00 | $93.27–$2,398.40 | — | 80% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HMC CARDIOVERSION ELECTRIC EXT | $599.60 | $2,998.00 | $93.27–$2,398.40 | — | 80% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 INF CRDIOVRSION ELECTV EXT | $607.80 | $3,039.00 | $93.27–$2,431.20 | — | 80% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 MSC CIRCUMCISION SURGICAL >28 DAYS OLD | $409.70 | $2,048.51 | $409.70–$4,080.62 | 89% below | 80% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 ICN-CIRCUMCISION > 28 DAYS | $1,087.40 | $5,437.00 | $1,087.40–$4,349.60 | 71% below | 80% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 MSC CIRCUMCISION SURGICAL >28 DAYS OLD | $409.70 | $2,048.51 | $409.70–$4,080.62 | — | 80% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 ICN-CIRCUMCISION > 28 DAYS | $1,087.40 | $5,437.00 | $1,087.40–$4,349.60 | — | 80% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUM W/CLAMP / OTHER DVC | $261.40 | $1,307.00 | $261.40–$4,080.62 | 79% below | 80% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 MSC CIRCUM W/CLAMP / OTHER DVC <28 DAYS | $409.70 | $2,048.51 | $409.70–$4,080.62 | 67% below | 80% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUM W/CLAMP / OTHER DVC | $261.40 | $1,307.00 | $261.40–$4,080.62 | — | 80% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 MSC CIRCUM W/CLAMP / OTHER DVC <28 DAYS | $409.70 | $2,048.51 | $409.70–$4,080.62 | — | 80% |
| Circumcision, surgical, older than a newborn CPT 54160 MSC CIRCUMCISION SURGICAL <28 DAYS | $133.49 | $667.47 | $133.49–$4,080.62 | 94% below | 80% |
| Circumcision, surgical, older than a newborn CPT 54160 IMCN - CIRCUMCISION < 28DAYS | $189.40 | $947.00 | $189.40–$4,080.62 | 92% below | 80% |
| Circumcision, surgical, older than a newborn CPT 54160 ICN-CIRCUMCISION < 28 DAYS | $1,087.40 | $5,437.00 | $1,087.40–$4,349.60 | 52% below | 80% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 MSC CIRCUMCISION SURGICAL <28 DAYS | $133.49 | $667.47 | $133.49–$4,080.62 | — | 80% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 IMCN - CIRCUMCISION < 28DAYS | $189.40 | $947.00 | $189.40–$4,080.62 | — | 80% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 ICN-CIRCUMCISION < 28 DAYS | $1,087.40 | $5,437.00 | $1,087.40–$4,349.60 | — | 80% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX RAD FX DISTAL W/O MAN | $99.60 | $498.00 | $263.94–$398.40 | 78% below | 80% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX RAD FX DISTAL W/O MAN | $99.60 | $498.00 | $263.94–$398.40 | — | 80% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FLEX W/BIOPSY | $521.60 | $2,608.00 | $521.60–$2,086.40 | 64% below | 80% |
| Colonoscopy with tissue sample CPT 45380 ENDO CH COLONOSCOPY AND BIOPSY | $521.60 | $2,608.00 | $521.60–$2,086.40 | 64% below | 80% |
| Colonoscopy with tissue sample inpatient CPT 45380 ENDO CH COLONOSCOPY AND BIOPSY | $521.60 | $2,608.00 | $521.60–$2,086.40 | — | 80% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FLEX W/BIOPSY | $521.60 | $2,608.00 | $521.60–$2,086.40 | — | 80% |
| Coronary stent placement, one artery CPT 92928 PRQ TRLUML CORONARY STENT | $2,235.80 | $11,179.00 | $503.91–$15,016.74 | 81% below | 80% |
| Coronary stent placement, one artery inpatient CPT 92928 PRQ TRLUML CORONARY STENT | $2,235.80 | $11,179.00 | $503.91–$15,016.74 | — | 80% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE CERUMEN IMPACTED IRRIG | $10.80 | $54.00 | $10.80–$145.44 | 90% below | 80% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 CH UCC EL REMOVE CERM IMPCTD IRR | $55.68 | $278.40 | $55.68–$222.72 | 50% below | 80% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 CH UCC REMOVE CERM IMPCTD IRR | $84.60 | $423.00 | $13.59–$338.40 | 24% below | 80% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 ER REMOVE CERUMEN IMPACTED IRR | $88.00 | $440.00 | $13.59–$352.00 | 21% below | 80% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE CERUMEN IMPACTED IRRIG | $10.80 | $54.00 | $10.80–$145.44 | — | 80% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 CH UCC EL REMOVE CERM IMPCTD IRR | $55.68 | $278.40 | $55.68–$222.72 | — | 80% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 ER REMOVE CERUMEN IMPACTED IRR | $88.00 | $440.00 | $13.59–$352.00 | — | 80% |
| Earwax removal with instruments, one ear one side CPT 69210 CH UCC EL RMVL CERUMEN EAR UNILAT | $71.28 | $356.40 | $52.35–$285.12 | 43% below | 80% |
| Earwax removal with instruments, one ear one side CPT 69210 CH UCC RMVL CERUMEN EAR UNILAT | $122.40 | $612.00 | $28.44–$489.60 | 1% below | 80% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL CERUMEN EAR UNILAT | $124.60 | $623.00 | $28.44–$498.40 | at median | 80% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 CH UCC EL RMVL CERUMEN EAR UNILAT | $71.28 | $356.40 | $52.35–$285.12 | — | 80% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL CERUMEN EAR UNILAT | $124.60 | $623.00 | $28.44–$498.40 | — | 80% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ EPIDL SUBARACH C/T W/IMG | $443.60 | $2,218.00 | $443.60–$1,774.40 | 69% below | 80% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ EPIDL SUBARACH C/T W/IMG | $443.60 | $2,218.00 | $443.60–$1,774.40 | — | 80% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 CH INJ MEDS INTRAVITREAL | $587.80 | $2,939.00 | $314.29–$2,351.20 | 11% above | 80% |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 CH INJ MEDS INTRAVITREAL | $587.80 | $2,939.00 | $314.29–$2,351.20 | — | 80% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJECTION PROCEDURE HSG | $56.40 | $282.00 | $56.40–$225.60 | 85% below | 80% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INJECTION PROCEDURE HSG | $56.40 | $282.00 | $56.40–$225.60 | — | 80% |
| Incision and drainage of a simple or single skin abscess CPT 10060 CH UCC EL I&D ABSC SMP | $66.03 | $330.17 | $66.03–$264.14 | 85% below | 80% |
| Incision and drainage of a simple or single skin abscess CPT 10060 PED I&D ABSC SMP | $68.00 | $340.00 | $68.00–$272.00 | 84% below | 80% |
| Incision and drainage of a simple or single skin abscess CPT 10060 EPS DRAIN SKIN ABCESS | $158.40 | $792.00 | $93.13–$633.60 | 63% below | 80% |
| Incision and drainage of a simple or single skin abscess CPT 10060 IMCU I&D ABSC SMP | $158.40 | $792.00 | $98.12–$633.60 | 63% below | 80% |
| Incision and drainage of a simple or single skin abscess CPT 10060 CH UCC I&D ABSC SMP | $158.40 | $792.00 | $93.13–$633.60 | 63% below | 80% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I & D OF ABCSS - SMPL | $170.20 | $851.00 | $93.13–$680.80 | 61% below | 80% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 CH UCC EL I&D ABSC SMP | $66.03 | $330.17 | $66.03–$264.14 | — | 80% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 PED I&D ABSC SMP | $68.00 | $340.00 | $68.00–$272.00 | — | 80% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 IMCU I&D ABSC SMP | $158.40 | $792.00 | $98.12–$633.60 | — | 80% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D OF ABCSS - SMPL | $170.20 | $851.00 | $93.13–$680.80 | — | 80% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 CH RAD DRAIN INJECT JOINT BURSA | $103.20 | $516.00 | $39.76–$447.93 | 83% below | 80% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 CCI ARTHROCENT ASP/INJ JT MAJOR | $103.20 | $516.00 | $103.20–$447.93 | 83% below | 80% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ERD ARTHROCNTIS MAJ JNT | $271.60 | $1,358.00 | $39.76–$1,086.40 | 54% below | 80% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 CH RAD DRAIN INJECT JOINT BURSA | $103.20 | $516.00 | $39.76–$447.93 | — | 80% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 CCI ARTHROCENT ASP/INJ JT MAJOR | $103.20 | $516.00 | $103.20–$447.93 | — | 80% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ERD ARTHROCNTIS MAJ JNT | $271.60 | $1,358.00 | $39.76–$1,086.40 | — | 80% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PED ARTHRO ASP/INJ JT INTERMED | $123.40 | $617.00 | $32.24–$493.60 | 79% below | 80% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTER JOINT | $123.40 | $617.00 | $32.24–$493.60 | 79% below | 80% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 IMCU ARTHRO ASP/INJ JT INTERMED | $248.60 | $1,243.00 | $172.28–$994.40 | 58% below | 80% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS INTER JOINT | $123.40 | $617.00 | $32.24–$493.60 | — | 80% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 PED ARTHRO ASP/INJ JT INTERMED | $123.40 | $617.00 | $32.24–$493.60 | — | 80% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 IMCU ARTHRO ASP/INJ JT INTERMED | $248.60 | $1,243.00 | $172.28–$994.40 | — | 80% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 CH UCC EL RPR LAC INT SCLP/AXIL <2.5C | $123.49 | $617.47 | $91.28–$493.98 | 77% below | 80% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 CH UCC RPR LAC INT SCLP/AXIL <2.5C | $127.20 | $636.00 | $91.28–$508.80 | 76% below | 80% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAY CLS SC/AX/TR/EXT < 2.6 CM | $278.60 | $1,393.00 | $131.75–$1,114.40 | 48% below | 80% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 CH UCC EL RPR LAC INT SCLP/AXIL <2.5C | $123.49 | $617.47 | $91.28–$493.98 | — | 80% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAY CLS SC/AX/TR/EXT < 2.6 CM | $278.60 | $1,393.00 | $131.75–$1,114.40 | — | 80% |
| Left heart catheterization, diagnostic one side CPT 93452 CATH LEFT HEART W/ VENTRCLGRPH | $1,704.60 | $8,523.00 | $1,704.60–$6,938.49 | 82% below | 80% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 CATH LEFT HEART W/ VENTRCLGRPH | $1,704.60 | $8,523.00 | $1,704.60–$6,938.49 | — | 80% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECT L/SPINE W/IMG | $255.00 | $1,275.00 | $255.00–$1,318.15 | 85% below | 80% |
| Lower-back epidural injection, with imaging guidance CPT 62323 USD INJ EPIDRL SUBARAC L/S W/IMG | $550.40 | $2,752.00 | $506.98–$2,201.60 | 67% below | 80% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECT L/SPINE W/IMG | $255.00 | $1,275.00 | $255.00–$1,318.15 | — | 80% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 USD INJ EPIDRL SUBARAC L/S W/IMG | $550.40 | $2,752.00 | $506.98–$2,201.60 | — | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 CH RAD ARTHRO ASP/INJ JT MAJOR | $361.60 | $1,808.00 | $361.60–$1,446.40 | 71% below | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJ EPIDURAL SUBARACH L/S SGL | $361.60 | $1,808.00 | $361.60–$1,446.40 | 71% below | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 CH RAD ARTHRO ASP/INJ JT MAJOR | $361.60 | $1,808.00 | $361.60–$1,446.40 | — | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ EPIDURAL SUBARACH L/S SGL | $361.60 | $1,808.00 | $361.60–$1,446.40 | — | 80% |
| Nail removal (partial or complete), one nail CPT 11730 EMR AVULSION NAIL PLATE SNGL | $185.20 | $926.00 | $47.00–$740.80 | 34% below | 80% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 EMR AVULSION NAIL PLATE SNGL | $185.20 | $926.00 | $47.00–$740.80 | — | 80% |
| Occipital nerve block (injection for headaches) both sides CPT 64405 ER INJ ANES NRV GREAT OCC BI | $186.00 | $930.00 | $46.21–$744.00 | — | 80% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANES NRV GREAT OCCIPITAL | $285.80 | $1,429.00 | $250.89–$1,143.20 | 33% below | 80% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ GREATER OCCIPITAL NERVE | $285.80 | $1,429.00 | $250.89–$1,143.20 | 33% below | 80% |
| Occipital nerve block (injection for headaches) inpatient both sides CPT 64405 ER INJ ANES NRV GREAT OCC BI | $186.00 | $930.00 | $46.21–$744.00 | — | 80% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANES NRV GREAT OCCIPITAL | $285.80 | $1,429.00 | $250.89–$1,143.20 | — | 80% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ GREATER OCCIPITAL NERVE | $285.80 | $1,429.00 | $250.89–$1,143.20 | — | 80% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS WITH IMAGING | $703.80 | $3,519.00 | $91.57–$2,815.20 | 52% below | 80% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/ IMG | $703.80 | $3,519.00 | $370.94–$2,815.20 | 52% below | 80% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/ IMG | $703.80 | $3,519.00 | $370.94–$2,815.20 | — | 80% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS WITH IMAGING | $703.80 | $3,519.00 | $91.57–$2,815.20 | — | 80% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 CH UCC EL EXC. NAIL & NAIL MATRIX PERM | $132.31 | $661.53 | $132.31–$764.56 | 74% below | 80% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 CH UCC EXC. NAIL & NAIL MATRIX PERM | $319.00 | $1,595.00 | $89.19–$1,276.00 | 37% below | 80% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC. NAIL & NAIL MATRIX PERM | $351.60 | $1,758.00 | $89.19–$1,406.40 | 31% below | 80% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 CH UCC EL EXC. NAIL & NAIL MATRIX PERM | $132.31 | $661.53 | $132.31–$764.56 | — | 80% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC. NAIL & NAIL MATRIX PERM | $351.60 | $1,758.00 | $89.19–$1,406.40 | — | 80% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION/REM FB SUBQ SMP | $69.00 | $345.00 | $69.00–$490.41 | 87% below | 80% |
| Removal of a foreign object under the skin, simple CPT 10120 CH UCC EL I&R OF FB SUBSQ TISS - SMPL | $134.11 | $670.54 | $134.11–$536.43 | 74% below | 80% |
| Removal of a foreign object under the skin, simple CPT 10120 CH UCC I&R OF FB SUBSQ TISS - SMPL | $323.40 | $1,617.00 | $92.28–$1,293.60 | 38% below | 80% |
| Removal of a foreign object under the skin, simple CPT 10120 I&R OF FB SUBSQ TISS - SMPL | $346.80 | $1,734.00 | $92.28–$1,387.20 | 34% below | 80% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION/REM FB SUBQ SMP | $69.00 | $345.00 | $69.00–$490.41 | — | 80% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 CH UCC EL I&R OF FB SUBSQ TISS - SMPL | $134.11 | $670.54 | $134.11–$536.43 | — | 80% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 I&R OF FB SUBSQ TISS - SMPL | $346.80 | $1,734.00 | $92.28–$1,387.20 | — | 80% |
| Short arm cast (elbow to hand) CPT 29075 APPLY SHORT ARM CAST | $184.20 | $921.00 | $54.72–$736.80 | 34% below | 80% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLY SHORT ARM CAST | $184.20 | $921.00 | $54.72–$736.80 | — | 80% |
| Short arm splint (forearm and hand) CPT 29125 CH UCC EL APPL SPLINT ARM SHRT | $67.01 | $335.07 | $67.01–$342.39 | 70% below | 80% |
| Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT | $124.80 | $624.00 | $35.33–$499.20 | 45% below | 80% |
| Short arm splint (forearm and hand) CPT 29125 CH UCC APPL SPLINT ARM SHORT STATIC | $124.80 | $624.00 | $35.33–$499.20 | 45% below | 80% |
| Short arm splint (forearm and hand) CPT 29125 APP SHORT ARM SPLINT | $145.40 | $727.00 | $35.33–$581.60 | 36% below | 80% |
| Short arm splint (forearm and hand) inpatient CPT 29125 CH UCC EL APPL SPLINT ARM SHRT | $67.01 | $335.07 | $67.01–$342.39 | — | 80% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLY FOREARM SPLINT | $124.80 | $624.00 | $35.33–$499.20 | — | 80% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APP SHORT ARM SPLINT | $145.40 | $727.00 | $35.33–$581.60 | — | 80% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST | $160.20 | $801.00 | $51.39–$640.80 | 53% below | 80% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST | $160.20 | $801.00 | $51.39–$640.80 | — | 80% |
| Short leg splint (calf to foot) CPT 29515 EMR APP SHORT LEG SPLINT | $34.20 | $171.00 | $43.63–$184.68 | 87% below | 80% |
| Short leg splint (calf to foot) CPT 29515 APPLY LOWER LEG SPLINT | $137.80 | $689.00 | $43.63–$551.20 | 47% below | 80% |
| Short leg splint (calf to foot) inpatient CPT 29515 EMR APP SHORT LEG SPLINT | $34.20 | $171.00 | $43.63–$184.68 | — | 80% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLY LOWER LEG SPLINT | $137.80 | $689.00 | $43.63–$551.20 | — | 80% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 CH UCC EL RPR LAC SMP SCALP <2.5 CM | $142.42 | $712.08 | $98.46–$569.66 | 57% below | 80% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 IMCU S/L NONFACE <= 2.5 CM | $172.00 | $860.00 | $98.46–$688.00 | 49% below | 80% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PED S/L NONFACE <= 2.5 CM | $172.00 | $860.00 | $98.46–$688.00 | 49% below | 80% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 CH UCC RPR LAC SMP SCALP <2.5 CM | $172.00 | $860.00 | $39.28–$688.00 | 49% below | 80% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 S/L NONFACE <= 2.5 CM | $177.60 | $888.00 | $39.28–$710.40 | 47% below | 80% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 CH UCC EL RPR LAC SMP SCALP <2.5 CM | $142.42 | $712.08 | $98.46–$569.66 | — | 80% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 IMCU S/L NONFACE <= 2.5 CM | $172.00 | $860.00 | $98.46–$688.00 | — | 80% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 PED S/L NONFACE <= 2.5 CM | $172.00 | $860.00 | $98.46–$688.00 | — | 80% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 S/L NONFACE <= 2.5 CM | $177.60 | $888.00 | $39.28–$710.40 | — | 80% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HMC LUMBAR PUNCTURE | $392.00 | $1,960.00 | $250.89–$1,568.00 | 63% below | 80% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 PICU LUMBAR PUNCTURE | $392.00 | $1,960.00 | $250.89–$1,568.00 | 63% below | 80% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PNCTURE | $392.00 | $1,960.00 | $250.89–$1,568.00 | 63% below | 80% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 PED LUMBAR PUNCTURE | $392.00 | $1,960.00 | $250.89–$1,568.00 | 63% below | 80% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE DIAGNOSTIC | $392.00 | $1,960.00 | $250.89–$1,568.00 | 63% below | 80% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAG | $392.00 | $1,960.00 | $55.72–$1,568.00 | 63% below | 80% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 CH SPINAL FLUID TAP DIAGNOSTIC | $392.00 | $1,960.00 | $55.72–$1,568.00 | 63% below | 80% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 CCI LUMBAR PUNCTURE DIAG | $392.00 | $1,960.00 | $55.72–$1,568.00 | 63% below | 80% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 IMCN LUMBAR PUNCTURE DX | $415.20 | $2,076.00 | $250.89–$1,660.80 | 60% below | 80% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCT PROC DX | $416.40 | $2,082.00 | $55.72–$1,665.60 | 60% below | 80% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE DIAGNOSTIC | $392.00 | $1,960.00 | $250.89–$1,568.00 | — | 80% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAG | $392.00 | $1,960.00 | $55.72–$1,568.00 | — | 80% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PNCTURE | $392.00 | $1,960.00 | $250.89–$1,568.00 | — | 80% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 CH SPINAL FLUID TAP DIAGNOSTIC | $392.00 | $1,960.00 | $55.72–$1,568.00 | — | 80% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PICU LUMBAR PUNCTURE | $392.00 | $1,960.00 | $250.89–$1,568.00 | — | 80% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 CCI LUMBAR PUNCTURE DIAG | $392.00 | $1,960.00 | $55.72–$1,568.00 | — | 80% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PED LUMBAR PUNCTURE | $392.00 | $1,960.00 | $250.89–$1,568.00 | — | 80% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HMC LUMBAR PUNCTURE | $392.00 | $1,960.00 | $250.89–$1,568.00 | — | 80% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 IMCN LUMBAR PUNCTURE DX | $415.20 | $2,076.00 | $250.89–$1,660.80 | — | 80% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCT PROC DX | $416.40 | $2,082.00 | $55.72–$1,665.60 | — | 80% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 CH UCC EL RPR LAC SMP SCALP 2.6-7.5CM | $68.81 | $344.04 | $68.81–$275.23 | 82% below | 80% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 CH UCC RPR LAC SMP SCALP 2.6-7.5CM | $177.00 | $885.00 | $51.63–$708.00 | 55% below | 80% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 S/L NONFACE 2.6-7.5 CM | $180.40 | $902.00 | $51.63–$721.60 | 54% below | 80% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 CH UCC EL RPR LAC SMP SCALP 2.6-7.5CM | $68.81 | $344.04 | $68.81–$275.23 | — | 80% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 S/L NONFACE 2.6-7.5 CM | $180.40 | $902.00 | $51.63–$721.60 | — | 80% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PED RPR LAC SMP FACE <2.5 CM | $67.20 | $336.00 | $67.20–$268.80 | 83% below | 80% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 CH UCC EL RPR LAC SMP FACE <2.5 CM | $130.45 | $652.23 | $98.46–$521.78 | 67% below | 80% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 IMCU RPR LAC SMP FACE <2.5 CM | $173.80 | $869.00 | $98.46–$695.20 | 56% below | 80% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 CH UCC RPR LAC SMP FACE <2.5 CM | $173.80 | $869.00 | $48.69–$695.20 | 56% below | 80% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ER S/L FACE <= 2.5 CM | $178.20 | $891.00 | $48.69–$712.80 | 54% below | 80% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 PED RPR LAC SMP FACE <2.5 CM | $67.20 | $336.00 | $67.20–$268.80 | — | 80% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 CH UCC EL RPR LAC SMP FACE <2.5 CM | $130.45 | $652.23 | $98.46–$521.78 | — | 80% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 IMCU RPR LAC SMP FACE <2.5 CM | $173.80 | $869.00 | $98.46–$695.20 | — | 80% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 ER S/L FACE <= 2.5 CM | $178.20 | $891.00 | $48.69–$712.80 | — | 80% |
| Thoracentesis with imaging guidance CPT 32555 IMN THORACENTESIS W/IMG | $220.80 | $1,104.00 | $220.80–$1,013.48 | 84% below | 80% |
| Thoracentesis with imaging guidance CPT 32555 ICN THORACENTESIS W/IMGN GUID | $220.80 | $1,104.00 | $220.80–$1,013.48 | 84% below | 80% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGING GUID | $220.80 | $1,104.00 | $220.80–$1,013.48 | 84% below | 80% |
| Thoracentesis with imaging guidance CPT 32555 CCI THORACENTESIS W/IMAGE GUID | $714.80 | $3,574.00 | $389.80–$2,859.20 | 49% below | 80% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAGING GUID | $220.80 | $1,104.00 | $220.80–$1,013.48 | — | 80% |
| Thoracentesis with imaging guidance inpatient CPT 32555 ICN THORACENTESIS W/IMGN GUID | $220.80 | $1,104.00 | $220.80–$1,013.48 | — | 80% |
| Thoracentesis with imaging guidance inpatient CPT 32555 IMN THORACENTESIS W/IMG | $220.80 | $1,104.00 | $220.80–$1,013.48 | — | 80% |
| Thoracentesis with imaging guidance inpatient CPT 32555 CCI THORACENTESIS W/IMAGE GUID | $714.80 | $3,574.00 | $389.80–$2,859.20 | — | 80% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US BREAST BX US 1ST LESION | $846.20 | $4,231.00 | $133.25–$3,384.80 | 69% below | 80% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US BREAST BX US 1ST LESION | $846.20 | $4,231.00 | $133.25–$3,384.80 | — | 80% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY | $350.40 | $1,752.00 | $350.40–$1,532.83 | 75% below | 80% |
| Upper endoscopy (EGD) with biopsy CPT 43239 END CH EGD BIOPSY SINGLE / MULTIPLE | $961.00 | $4,805.00 | $589.55–$3,844.00 | 31% below | 80% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BIOPSY | $350.40 | $1,752.00 | $350.40–$1,532.83 | — | 80% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 END CH EGD BIOPSY SINGLE / MULTIPLE | $961.00 | $4,805.00 | $589.55–$3,844.00 | — | 80% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD DX W/BRUSHING/WASHING | $325.80 | $1,629.00 | $325.80–$1,532.83 | 78% below | 80% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DX W/BRUSHING/WASHING | $325.80 | $1,629.00 | $325.80–$1,532.83 | — | 80% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ER DEBRIDE SKIN/SUBQ TISSUE 1S | $174.80 | $874.00 | $52.87–$699.20 | 83% below | 80% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 ER DEBRIDE SKIN/SUBQ TISSUE 1S | $174.80 | $874.00 | $52.87–$699.20 | — | 80% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION | $155.40 | $777.00 | $35.95–$621.60 | 80% below | 80% |
| Blood transfusion (giving blood or blood components) CPT 36430 PED BLOOD TRANSFUSION | $155.40 | $777.00 | $35.95–$621.60 | 80% below | 80% |
| Blood transfusion (giving blood or blood components) CPT 36430 INF BLOOD TRANSFSN | $426.60 | $2,133.00 | $35.95–$1,706.40 | 44% below | 80% |
| Blood transfusion (giving blood or blood components) CPT 36430 IMCU BLOOD TRANSFUSION | $426.60 | $2,133.00 | $35.95–$1,706.40 | 44% below | 80% |
| Blood transfusion (giving blood or blood components) CPT 36430 PICU BLOOD TRANSFUSION | $426.60 | $2,133.00 | $35.95–$1,706.40 | 44% below | 80% |
| Blood transfusion (giving blood or blood components) CPT 36430 ICN BLOOD TRANSFUSION | $426.60 | $2,133.00 | $35.95–$1,706.40 | 44% below | 80% |
| Blood transfusion (giving blood or blood components) CPT 36430 IMCN BLOOD TRANSFUSION | $426.60 | $2,133.00 | $35.95–$1,706.40 | 44% below | 80% |
| Blood transfusion (giving blood or blood components) CPT 36430 HMC BLOOD TRANSFUSION | $426.60 | $2,133.00 | $35.95–$1,706.40 | 44% below | 80% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION | $155.40 | $777.00 | $35.95–$621.60 | — | 80% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 PED BLOOD TRANSFUSION | $155.40 | $777.00 | $35.95–$621.60 | — | 80% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 IMCU BLOOD TRANSFUSION | $426.60 | $2,133.00 | $35.95–$1,706.40 | — | 80% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HMC BLOOD TRANSFUSION | $426.60 | $2,133.00 | $35.95–$1,706.40 | — | 80% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 INF BLOOD TRANSFSN | $426.60 | $2,133.00 | $35.95–$1,706.40 | — | 80% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 IMCN BLOOD TRANSFUSION | $426.60 | $2,133.00 | $35.95–$1,706.40 | — | 80% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 ICN BLOOD TRANSFUSION | $426.60 | $2,133.00 | $35.95–$1,706.40 | — | 80% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 PICU BLOOD TRANSFUSION | $426.60 | $2,133.00 | $35.95–$1,706.40 | — | 80% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB TREATMENT | $20.20 | $101.00 | $6.80–$427.86 | 90% below | 80% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RESP AEROSOL-MDI TREATMENT | $20.20 | $101.00 | $6.80–$427.86 | 90% below | 80% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TREATMENT | $80.40 | $402.00 | $6.80–$427.86 | 60% below | 80% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB/IPV TREATMENT | $80.40 | $402.00 | $6.80–$427.86 | 60% below | 80% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT | $85.20 | $426.00 | $6.80–$427.86 | 58% below | 80% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB TREATMENT | $20.20 | $101.00 | $6.80–$427.86 | — | 80% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RESP AEROSOL-MDI TREATMENT | $20.20 | $101.00 | $6.80–$427.86 | — | 80% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB/IPV TREATMENT | $80.40 | $402.00 | $6.80–$427.86 | — | 80% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TREATMENT | $80.40 | $402.00 | $6.80–$427.86 | — | 80% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TREATMENT | $85.20 | $426.00 | $6.80–$427.86 | — | 80% |
| Chemotherapy IV infusion, first hour CPT 96413 INF IV CHEMO INIT DRUG16-90MN | $315.80 | $1,579.00 | $110.29–$1,263.20 | 42% below | 80% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSIO<=1 HR | $315.80 | $1,579.00 | $110.29–$1,263.20 | 42% below | 80% |
| Chemotherapy IV infusion, first hour CPT 96413 IMCU CHEMO IV INFUSIO<=1 HR | $315.80 | $1,579.00 | $110.29–$1,263.20 | 42% below | 80% |
| Chemotherapy IV infusion, first hour CPT 96413 HMC CHEMO IV INFUSIO<=1 HR | $315.80 | $1,579.00 | $110.29–$1,263.20 | 42% below | 80% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSIO<=1 HR | $315.80 | $1,579.00 | $110.29–$1,263.20 | — | 80% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IMCU CHEMO IV INFUSIO<=1 HR | $315.80 | $1,579.00 | $110.29–$1,263.20 | — | 80% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HMC CHEMO IV INFUSIO<=1 HR | $315.80 | $1,579.00 | $110.29–$1,263.20 | — | 80% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 INF IV CHEMO INIT DRUG16-90MN | $315.80 | $1,579.00 | $110.29–$1,263.20 | — | 80% |
| Comprehensive eye exam, returning patient CPT 92014 NIS EYE EXAM ESTAB COMPREHNSVE | $59.40 | $297.00 | $53.46–$237.60 | 74% below | 80% |
| Comprehensive eye exam, returning patient inpatient CPT 92014 NIS EYE EXAM ESTAB COMPREHNSVE | $59.40 | $297.00 | $53.46–$237.60 | — | 80% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 AUD-EVAL AUDIO COMPREHEN - ST | $118.20 | $591.00 | $27.59–$472.80 | 61% below | 80% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 AUD-EVAL AUDIO COMPREHEN - ST | $118.20 | $591.00 | $27.59–$472.80 | — | 80% |
| Critical care, first 30 to 74 minutes CPT 99291 CH PS CRITICAL CARE | $575.20 | $2,876.00 | $185.91–$2,300.80 | 77% below | 80% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 CH EEG AWAKE AND DROSY | $156.40 | $782.00 | $140.76–$625.60 | 83% below | 80% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 CH EEG AWAKE AND DROSY | $156.40 | $782.00 | $140.76–$625.60 | — | 80% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ROUTINE | $114.20 | $571.00 | $5.37–$456.80 | 58% below | 80% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 RESP - EKG ROUTINE | $114.20 | $571.00 | $5.37–$456.80 | 58% below | 80% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG ROUTINE | $114.20 | $571.00 | $5.37–$456.80 | — | 80% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 RESP - EKG ROUTINE | $114.20 | $571.00 | $5.37–$456.80 | — | 80% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT LEVEL 1 W/PX | $31.80 | $159.00 | $10.03–$650.00 | 86% below | 80% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL 1/99281 LIMIT-MINOR | $105.00 | $525.00 | $10.03–$650.00 | 55% below | 80% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER TRIAGE ONLY | $105.00 | $525.00 | $10.03–$650.00 | 55% below | 80% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER VISIT LEVEL 1 W/PX | $31.80 | $159.00 | $10.03–$650.00 | — | 80% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER LEVEL 1/99281 LIMIT-MINOR | $105.00 | $525.00 | $10.03–$650.00 | — | 80% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER TRIAGE ONLY | $105.00 | $525.00 | $10.03–$650.00 | — | 80% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL 2 W/MOD 99282 LOW-MOD | $89.20 | $446.00 | $36.61–$650.00 | 79% below | 80% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL 2/ 99282 LOW-MOD | $210.40 | $1,052.00 | $36.61–$841.60 | 52% below | 80% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL 2 W/MOD 99282 LOW-MOD | $89.20 | $446.00 | $36.61–$650.00 | — | 80% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL 2/ 99282 LOW-MOD | $210.40 | $1,052.00 | $36.61–$841.60 | — | 80% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 TRAUMA LEVEL III W/PX FULL | $121.20 | $606.00 | $62.32–$650.00 | 84% below | 80% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 TRAUMA LEVEL III FULL ACT | $121.20 | $606.00 | $62.32–$650.00 | 84% below | 80% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 TRAUMA LEVEL III W/PX EVAL | $151.40 | $757.00 | $62.32–$650.00 | 80% below | 80% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL 3 W/MOD 99283 MOD | $151.40 | $757.00 | $62.32–$650.00 | 80% below | 80% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 TRAUMA LEVEL III EVAL | $151.40 | $757.00 | $62.32–$650.00 | 80% below | 80% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL 3/99283 MOD SEV | $362.20 | $1,811.00 | $62.32–$1,448.80 | 53% below | 80% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 TRAUMA LEVEL III W/PX FULL | $121.20 | $606.00 | $62.32–$650.00 | — | 80% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 TRAUMA LEVEL III FULL ACT | $121.20 | $606.00 | $62.32–$650.00 | — | 80% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER LEVEL 3 W/MOD 99283 MOD | $151.40 | $757.00 | $62.32–$650.00 | — | 80% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 TRAUMA LEVEL III EVAL | $151.40 | $757.00 | $62.32–$650.00 | — | 80% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 TRAUMA LEVEL III W/PX EVAL | $151.40 | $757.00 | $62.32–$650.00 | — | 80% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER LEVEL 3/99283 MOD SEV | $362.20 | $1,811.00 | $62.32–$1,448.80 | — | 80% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 TRAUMA LEVEL II EVAL | $227.80 | $1,139.00 | $106.06–$911.20 | 82% below | 80% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 TRAUMA LEVEL II W/PX EVAL | $227.80 | $1,139.00 | $106.06–$911.20 | 82% below | 80% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL 4 W/MOD 99284 HIGH | $613.60 | $3,068.00 | $106.06–$2,454.40 | 52% below | 80% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL 4/99284 HIGH URGENT | $691.40 | $3,457.00 | $106.06–$2,765.60 | 46% below | 80% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 TRAUMA LEVEL II W/PX EVAL | $227.80 | $1,139.00 | $106.06–$911.20 | — | 80% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 TRAUMA LEVEL II EVAL | $227.80 | $1,139.00 | $106.06–$911.20 | — | 80% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER LEVEL 4 W/MOD 99284 HIGH | $613.60 | $3,068.00 | $106.06–$2,454.40 | — | 80% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER LEVEL 4/99284 HIGH URGENT | $691.40 | $3,457.00 | $106.06–$2,765.60 | — | 80% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 TRAUMA LEVEL I | $336.60 | $1,683.00 | $153.68–$1,346.40 | 81% below | 80% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 TRAUMA LEVEL I W/PX EVAL | $336.60 | $1,683.00 | $153.68–$1,346.40 | 81% below | 80% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 TRAUMA LEVEL I WITH EVAL | $336.60 | $1,683.00 | $153.68–$1,346.40 | 81% below | 80% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 CH ER LEVEL 5 W/MOD 99285 HIGH | $420.80 | $2,104.00 | $153.68–$1,683.20 | 76% below | 80% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL5/99285 HIGH SEVERITY | $966.00 | $4,830.00 | $153.68–$3,864.00 | 46% below | 80% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 TRAUMA LEVEL I | $336.60 | $1,683.00 | $153.68–$1,346.40 | — | 80% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 TRAUMA LEVEL I WITH EVAL | $336.60 | $1,683.00 | $153.68–$1,346.40 | — | 80% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 TRAUMA LEVEL I W/PX EVAL | $336.60 | $1,683.00 | $153.68–$1,346.40 | — | 80% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 CH ER LEVEL 5 W/MOD 99285 HIGH | $420.80 | $2,104.00 | $153.68–$1,683.20 | — | 80% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER LEVEL5/99285 HIGH SEVERITY | $966.00 | $4,830.00 | $153.68–$3,864.00 | — | 80% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 REG BRUCE STRESS TEST | $499.00 | $2,495.00 | $31.98–$1,996.00 | 60% below | 80% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 REG BRUCE STRESS TEST | $499.00 | $2,495.00 | $31.98–$1,996.00 | — | 80% |
| Family therapy with the patient, 50 minutes CPT 90847 CH NEURO PSY FAM PSYCH TX W/ PT 50 MIN | $99.40 | $497.00 | $89.46–$397.60 | 65% below | 80% |
| Family therapy with the patient, 50 minutes CPT 90847 CH MU NEURO PSY FAM PSYCH TX W/ PT 50 MIN | $99.40 | $497.00 | $89.46–$397.60 | 65% below | 80% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 CH MU NEURO PSY FAM PSYCH TX W/ PT 50 MIN | $99.40 | $497.00 | $89.46–$397.60 | — | 80% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 CH NEURO PSY FAM PSYCH TX W/ PT 50 MIN | $99.40 | $497.00 | $89.46–$397.60 | — | 80% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ER IV INFS THPY FLD INTL 31-1H | $111.17 | $555.84 | $27.74–$444.67 | 74% below | 80% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 PED IV INF THPY FLD INT 31M-1H | $136.60 | $683.00 | $27.74–$546.40 | 69% below | 80% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IMCU IV INF THPY FLD INT 31M-1H | $136.60 | $683.00 | $27.74–$546.40 | 69% below | 80% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 CH PS IV INF THPY FLD INT 31M-1H | $136.60 | $683.00 | $27.74–$546.40 | 69% below | 80% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HMC IV INF THPY FLD INT 31M-1H | $136.60 | $683.00 | $27.74–$546.40 | 69% below | 80% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 PICU IVINF THPY FLD INT 31M-1H | $136.60 | $683.00 | $27.74–$546.40 | 69% below | 80% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INF IV INF THPY FLD INT 31M-1H | $136.60 | $683.00 | $27.74–$546.40 | 69% below | 80% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ER IV INFS THPY FLD INTL 31-1H | $111.17 | $555.84 | $27.74–$444.67 | — | 80% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IMCU IV INF THPY FLD INT 31M-1H | $136.60 | $683.00 | $27.74–$546.40 | — | 80% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INF IV INF THPY FLD INT 31M-1H | $136.60 | $683.00 | $27.74–$546.40 | — | 80% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 PICU IVINF THPY FLD INT 31M-1H | $136.60 | $683.00 | $27.74–$546.40 | — | 80% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 PED IV INF THPY FLD INT 31M-1H | $136.60 | $683.00 | $27.74–$546.40 | — | 80% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 CH PS IV INF THPY FLD INT 31M-1H | $136.60 | $683.00 | $27.74–$546.40 | — | 80% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HMC IV INF THPY FLD INT 31M-1H | $136.60 | $683.00 | $27.74–$546.40 | — | 80% |
| IV infusion of a medicine, first hour CPT 96365 ER IV INFUS THPYPROPH//DX INTL | $96.40 | $482.00 | $53.56–$385.60 | 79% below | 80% |
| IV infusion of a medicine, first hour CPT 96365 PED IV INFUSION THERAPY | $170.60 | $853.00 | $53.56–$682.40 | 62% below | 80% |
| IV infusion of a medicine, first hour CPT 96365 INF IV THERAPY INIT 16-90 MIN | $170.60 | $853.00 | $53.56–$682.40 | 62% below | 80% |
| IV infusion of a medicine, first hour CPT 96365 CH PS IV THERAPY INIT 16-90 MIN | $170.60 | $853.00 | $53.56–$682.40 | 62% below | 80% |
| IV infusion of a medicine, first hour CPT 96365 IMCN IV THERAPY INIT 16-90 MIN | $170.60 | $853.00 | $53.56–$682.40 | 62% below | 80% |
| IV infusion of a medicine, first hour CPT 96365 ICN IV THERAPY INIT 16-90 MIN | $170.60 | $853.00 | $53.56–$682.40 | 62% below | 80% |
| IV infusion of a medicine, first hour CPT 96365 IMCU IV INFUSION THERAPY | $170.60 | $853.00 | $53.56–$682.40 | 62% below | 80% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY PICU | $170.60 | $853.00 | $53.56–$682.40 | 62% below | 80% |
| IV infusion of a medicine, first hour CPT 96365 HMC IV THERAPY INIT 16-90 MIN | $170.60 | $853.00 | $53.56–$682.40 | 62% below | 80% |
| IV infusion of a medicine, first hour inpatient CPT 96365 ER IV INFUS THPYPROPH//DX INTL | $96.40 | $482.00 | $53.56–$385.60 | — | 80% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY PICU | $170.60 | $853.00 | $53.56–$682.40 | — | 80% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HMC IV THERAPY INIT 16-90 MIN | $170.60 | $853.00 | $53.56–$682.40 | — | 80% |
| IV infusion of a medicine, first hour inpatient CPT 96365 PED IV INFUSION THERAPY | $170.60 | $853.00 | $53.56–$682.40 | — | 80% |
| IV infusion of a medicine, first hour inpatient CPT 96365 ICN IV THERAPY INIT 16-90 MIN | $170.60 | $853.00 | $53.56–$682.40 | — | 80% |
| IV infusion of a medicine, first hour inpatient CPT 96365 CH PS IV THERAPY INIT 16-90 MIN | $170.60 | $853.00 | $53.56–$682.40 | — | 80% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INF IV THERAPY INIT 16-90 MIN | $170.60 | $853.00 | $53.56–$682.40 | — | 80% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IMCU IV INFUSION THERAPY | $170.60 | $853.00 | $53.56–$682.40 | — | 80% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IMCN IV THERAPY INIT 16-90 MIN | $170.60 | $853.00 | $53.56–$682.40 | — | 80% |
| IV push of a medicine, first drug CPT 96374 THERAPYPRO/DX IV PUSH INITIAL | $30.60 | $153.00 | $27.54–$122.40 | 87% below | 80% |
| IV push of a medicine, first drug CPT 96374 ICN INJECTION IV | $50.16 | $250.80 | $31.44–$200.64 | 78% below | 80% |
| IV push of a medicine, first drug CPT 96374 HMC INJECTION IV | $77.00 | $385.00 | $31.44–$308.00 | 66% below | 80% |
| IV push of a medicine, first drug CPT 96374 INJECTION IV PICU | $77.00 | $385.00 | $31.44–$308.00 | 66% below | 80% |
| IV push of a medicine, first drug CPT 96374 IMCU INJECTION IV | $77.00 | $385.00 | $31.44–$308.00 | 66% below | 80% |
| IV push of a medicine, first drug CPT 96374 INF IV PUSH INITIAL DRUG | $77.00 | $385.00 | $31.44–$308.00 | 66% below | 80% |
| IV push of a medicine, first drug CPT 96374 PED INJECTION IV | $77.00 | $385.00 | $31.44–$308.00 | 66% below | 80% |
| IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL/DRUG | $77.00 | $385.00 | $31.44–$308.00 | 66% below | 80% |
| IV push of a medicine, first drug CPT 96374 IMCN INJECTION IV | $77.00 | $385.00 | $31.44–$308.00 | 66% below | 80% |
| IV push of a medicine, first drug inpatient CPT 96374 THERAPYPRO/DX IV PUSH INITIAL | $30.60 | $153.00 | $27.54–$122.40 | — | 80% |
| IV push of a medicine, first drug inpatient CPT 96374 ICN INJECTION IV | $50.16 | $250.80 | $31.44–$200.64 | — | 80% |
| IV push of a medicine, first drug inpatient CPT 96374 INJECTION IV PICU | $77.00 | $385.00 | $31.44–$308.00 | — | 80% |
| IV push of a medicine, first drug inpatient CPT 96374 IMCU INJECTION IV | $77.00 | $385.00 | $31.44–$308.00 | — | 80% |
| IV push of a medicine, first drug inpatient CPT 96374 INF IV PUSH INITIAL DRUG | $77.00 | $385.00 | $31.44–$308.00 | — | 80% |
| IV push of a medicine, first drug inpatient CPT 96374 HMC INJECTION IV | $77.00 | $385.00 | $31.44–$308.00 | — | 80% |
| IV push of a medicine, first drug inpatient CPT 96374 IV PUSH INITIAL/DRUG | $77.00 | $385.00 | $31.44–$308.00 | — | 80% |
| IV push of a medicine, first drug inpatient CPT 96374 IMCN INJECTION IV | $77.00 | $385.00 | $31.44–$308.00 | — | 80% |
| IV push of a medicine, first drug inpatient CPT 96374 PED INJECTION IV | $77.00 | $385.00 | $31.44–$308.00 | — | 80% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 CH UCC EL IM/SUBQ INJECTION | $19.29 | $96.43 | $12.45–$77.14 | 87% below | 80% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IMCU INJECTION, SUBQ/IM | $53.00 | $265.00 | $12.45–$212.00 | 64% below | 80% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 CH PS INJECTION SUBQ/IM | $53.00 | $265.00 | $12.45–$212.00 | 64% below | 80% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 CH UCC IM/SUBQ INJECTION | $53.00 | $265.00 | $12.45–$212.00 | 64% below | 80% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 PED INJECTION, SUBQ/IM | $53.00 | $265.00 | $12.45–$212.00 | 64% below | 80% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HMC INJECTION, SUBQ/IM | $53.00 | $265.00 | $12.45–$212.00 | 64% below | 80% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION, SUBQ/IM PICU | $53.00 | $265.00 | $12.45–$212.00 | 64% below | 80% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INF INJECTION SUBQ/IM | $53.00 | $265.00 | $12.45–$212.00 | 64% below | 80% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CH UCC EL IM/SUBQ INJECTION | $19.29 | $96.43 | $12.45–$77.14 | — | 80% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INF INJECTION SUBQ/IM | $53.00 | $265.00 | $12.45–$212.00 | — | 80% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HMC INJECTION, SUBQ/IM | $53.00 | $265.00 | $12.45–$212.00 | — | 80% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IMCU INJECTION, SUBQ/IM | $53.00 | $265.00 | $12.45–$212.00 | — | 80% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION, SUBQ/IM PICU | $53.00 | $265.00 | $12.45–$212.00 | — | 80% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CH PS INJECTION SUBQ/IM | $53.00 | $265.00 | $12.45–$212.00 | — | 80% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CH UCC IM/SUBQ INJECTION | $53.00 | $265.00 | $12.45–$212.00 | — | 80% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PED INJECTION, SUBQ/IM | $53.00 | $265.00 | $12.45–$212.00 | — | 80% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 CH MU NEURO PSY DIGNOSIS EVALUATION | $89.80 | $449.00 | $80.82–$359.20 | 77% below | 80% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 CH NEURO PSY DIGNOSIS EVALUATION | $89.80 | $449.00 | $80.82–$359.20 | 77% below | 80% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 CH MU NEURO PSY DIGNOSIS EVALUATION | $89.80 | $449.00 | $80.82–$359.20 | — | 80% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 CH NEURO PSY DIGNOSIS EVALUATION | $89.80 | $449.00 | $80.82–$359.20 | — | 80% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES 7-8 | $177.60 | $888.00 | $40.75–$710.40 | 74% below | 80% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES 7-8 | $177.60 | $888.00 | $40.75–$710.40 | — | 80% |
| Neuromuscular re-education, 15 minutes CPT 97112 CH NEUROMUSCUL RE-ED EA 15 MIN OT | $52.40 | $262.00 | $29.41–$209.60 | 54% below | 80% |
| Neuromuscular re-education, 15 minutes CPT 97112 ROP NEUROMUSCUL RE-ED EA 15 MIN OT | $52.40 | $262.00 | $29.41–$209.60 | 54% below | 80% |
| Neuromuscular re-education, 15 minutes CPT 97112 CH NEUROMSCL RE-ED EA 15MINPT | $52.40 | $262.00 | $29.41–$209.60 | 54% below | 80% |
| Neuromuscular re-education, 15 minutes CPT 97112 ROP NEUROMUSCUL RE-ED EA 15 MIN PT | $52.40 | $262.00 | $29.41–$209.60 | 54% below | 80% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 CH NEUROMSCL RE-ED EA 15MINPT | $52.40 | $262.00 | $29.41–$209.60 | — | 80% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 ROP NEUROMUSCUL RE-ED EA 15 MIN OT | $52.40 | $262.00 | $29.41–$209.60 | — | 80% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 CH NEUROMUSCUL RE-ED EA 15 MIN OT | $52.40 | $262.00 | $29.41–$209.60 | — | 80% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 ROP NEUROMUSCUL RE-ED EA 15 MIN PT | $52.40 | $262.00 | $29.41–$209.60 | — | 80% |
| New patient office visit, about 30 minutes CPT 99203 CH NEURO NEW OV BRIEF LEVEL III | $60.00 | $300.00 | $54.00–$240.00 | 73% below | 80% |
| New patient office visit, about 30 minutes CPT 99203 CH PS MSC NEW OV BRIEF LEVEL III | $60.00 | $300.00 | $54.00–$240.00 | 73% below | 80% |
| New patient office visit, about 30 minutes CPT 99203 Phy Spec Mnt NEW OV BRIEF LVL III | $60.00 | $300.00 | $54.00–$240.00 | 73% below | 80% |
| New patient office visit, about 30 minutes CPT 99203 CFC_VISIT NEW LEVEL III | $60.00 | $300.00 | $54.00–$240.00 | 73% below | 80% |
| New patient office visit, about 30 minutes CPT 99203 CH CARDIO NEW OV BRIEF LEVEL III | $60.00 | $300.00 | $54.00–$240.00 | 73% below | 80% |
| New patient office visit, about 30 minutes CPT 99203 CFC_VISIT NEW LEVEL III W/PROC | $60.00 | $300.00 | $54.00–$240.00 | 73% below | 80% |
| New patient office visit, about 30 minutes CPT 99203 CH UCC E&M NEW 30-44 | $70.00 | $350.00 | $63.00–$280.00 | 69% below | 80% |
| New patient office visit, about 30 minutes CPT 99203 CARES VISIT NEW LEVEL 3 | $78.40 | $392.00 | $70.56–$313.60 | 65% below | 80% |
| New patient office visit, about 30 minutes CPT 99203 CH UCC EL E&M NEW 30-44 | $89.48 | $447.38 | $71.66–$357.90 | 60% below | 80% |
| New patient office visit, about 30 minutes CPT 99203 INF VISIT NEW LEVEL 3 | $90.00 | $450.00 | $71.66–$360.00 | 60% below | 80% |
| New patient office visit, about 30 minutes CPT 99203 CV VISIT NEW LEVEL 3 | $119.80 | $599.00 | $71.66–$479.20 | 47% below | 80% |
| New patient office visit, about 30 minutes CPT 99203 NSI VISIT NEW LEVEL III | $119.80 | $599.00 | $71.66–$479.20 | 47% below | 80% |
| New patient office visit, about 30 minutes CPT 99203 CH MU URO MNT NEW OV BRIEF LVL III | $119.80 | $599.00 | $71.66–$479.20 | 47% below | 80% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NSI VISIT NEW LEVEL III | $119.80 | $599.00 | $71.66–$479.20 | — | 80% |
| New patient office visit, about 45 minutes CPT 99204 INF VISIT NEW LEVEL 4 | $25.00 | $125.00 | $22.50–$129.55 | 91% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 CH MU CF VISIT NEW LEVEL IV | $58.00 | $290.00 | $52.20–$232.00 | 80% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 CARES VISIT NEW LEVEL 4 | $59.60 | $298.00 | $53.64–$238.40 | 80% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 CH PS MSC VISIT NEW LEVEL IV | $70.00 | $350.00 | $63.00–$280.00 | 76% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 Phy Spec Mnt VISIT NEW LVL IV | $70.00 | $350.00 | $63.00–$280.00 | 76% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 CH NEURO VISIT NEW LEVEL IV | $70.00 | $350.00 | $63.00–$280.00 | 76% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 CH CARDIO VISIT NEW LEVEL IV | $70.00 | $350.00 | $63.00–$280.00 | 76% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 CFC_VISIT NEW LEVEL IV | $70.00 | $350.00 | $63.00–$280.00 | 76% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 CFC_VISIT NEW LEVEL IV W/PROC | $70.00 | $350.00 | $63.00–$280.00 | 76% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 CF VISIT NEW LEVEL IV | $70.00 | $350.00 | $63.00–$280.00 | 76% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 CH UCC E&M NEW 45-59 | $80.00 | $400.00 | $72.00–$320.00 | 73% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 CH UCC EL E&M NEW 45-59 | $121.24 | $606.19 | $109.11–$484.95 | 59% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 CH MU VISIT NEW LEVEL IV | $155.40 | $777.00 | $116.60–$621.60 | 47% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 NSI VISIT NEW LEVEL IV | $155.40 | $777.00 | $116.60–$621.60 | 47% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 CV VISIT NEW LEVEL 4 | $155.40 | $777.00 | $116.60–$621.60 | 47% below | 80% |
| New patient office visit, about 45 minutes CPT 99204 CH MU URO MNT VISIT NEW LVL IV | $155.40 | $777.00 | $116.60–$621.60 | 47% below | 80% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NSI VISIT NEW LEVEL IV | $155.40 | $777.00 | $116.60–$621.60 | — | 80% |
| New patient office visit, about 60 minutes CPT 99205 CFC_VISIT NEW LEVEL V W/PROC | $80.00 | $400.00 | $72.00–$320.00 | 73% below | 80% |
| New patient office visit, about 60 minutes CPT 99205 CH CARDIO VISIT NEW LEVEL V | $80.00 | $400.00 | $72.00–$320.00 | 73% below | 80% |
| New patient office visit, about 60 minutes CPT 99205 CFC_VISIT NEW LEVEL V | $80.00 | $400.00 | $72.00–$320.00 | 73% below | 80% |
| New patient office visit, about 60 minutes CPT 99205 CH NEURO VISIT NEW LEVEL V | $80.00 | $400.00 | $72.00–$320.00 | 73% below | 80% |
| New patient office visit, about 60 minutes CPT 99205 CH PS MSC VISIT NEW LEVEL V | $80.00 | $400.00 | $72.00–$320.00 | 73% below | 80% |
| New patient office visit, about 60 minutes CPT 99205 Phy Spec Mnt VISIT NEW LVL V | $80.00 | $400.00 | $72.00–$320.00 | 73% below | 80% |
| New patient office visit, about 60 minutes CPT 99205 CH UCC E&M NEW 60-74 | $90.00 | $450.00 | $81.00–$360.00 | 69% below | 80% |
| New patient office visit, about 60 minutes CPT 99205 CH UCC EL E&M NEW 60-74 | $147.63 | $738.16 | $132.87–$590.53 | 50% below | 80% |
| New patient office visit, about 60 minutes CPT 99205 CARES VISIT NEW LEVEL 5 | $186.40 | $932.00 | $158.54–$745.60 | 36% below | 80% |
| New patient office visit, about 60 minutes CPT 99205 CH MU URO MNT VISIT NEW LVL V | $187.40 | $937.00 | $158.54–$749.60 | 36% below | 80% |
| New patient office visit, about 60 minutes CPT 99205 CH MU VISIT NEW LEVEL V | $187.40 | $937.00 | $158.54–$749.60 | 36% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 CARES VISIT NEW LEVEL 2 | $38.00 | $190.00 | $34.20–$152.00 | 74% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Phy Spec Mnt NEW OV BRIEF LVL I | $50.00 | $250.00 | $41.43–$200.00 | 66% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 CH NEURO NEW OV BRIEF LEVEL I | $50.00 | $250.00 | $41.43–$200.00 | 66% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 CH CARDIO NEW OV BRIEF LEVEL I | $50.00 | $250.00 | $41.43–$200.00 | 66% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 CFC_VISIT NEW LEVEL II W/PROC | $50.00 | $250.00 | $41.43–$200.00 | 66% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 CFC_VISIT NEW LEVEL II | $50.00 | $250.00 | $41.43–$200.00 | 66% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 CH PS MSC NEW OV BRIEF | $50.00 | $250.00 | $41.43–$200.00 | 66% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 CH UCC E&M NEW 15-29 | $60.00 | $300.00 | $41.43–$240.00 | 60% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 CH UCC EL E&M NEW 15-29 | $61.08 | $305.41 | $41.43–$244.33 | 59% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 INF VISIT NEW LEVEL 2 | $80.00 | $400.00 | $41.43–$320.00 | 46% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 CH MU URO MNT NEW OV BRIEF LVL I | $86.00 | $430.00 | $41.43–$344.00 | 42% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 CH MU NEW OV BRIEF LEVEL III | $86.00 | $430.00 | $41.43–$344.00 | 42% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NSI VISIT NEW LEVEL II | $86.00 | $430.00 | $41.43–$344.00 | 42% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NSI VISIT NEW LEVEL I | $86.00 | $430.00 | $41.43–$344.00 | 42% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 CV VISIT NEW LEVEL 1 | $86.00 | $430.00 | $41.43–$344.00 | 42% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 CV VISIT NEW LEVEL 2 | $86.00 | $430.00 | $41.43–$344.00 | 42% below | 80% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NSI VISIT NEW LEVEL II | $86.00 | $430.00 | $41.43–$344.00 | — | 80% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NSI VISIT NEW LEVEL I | $86.00 | $430.00 | $41.43–$344.00 | — | 80% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTRITION INDIV INITIAL | $22.60 | $113.00 | $20.34–$132.96 | 55% below | 80% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTRITION INDIV INITIAL | $22.60 | $113.00 | $20.34–$132.96 | — | 80% |
| Occupational therapy evaluation, low complexity CPT 97165 ROP R 97165 OT EVAL LOW COMPLEX | $98.00 | $490.00 | $88.59–$392.00 | 60% below | 80% |
| Occupational therapy evaluation, low complexity CPT 97165 CH OT LOW COMPLEX EVAL | $98.00 | $490.00 | $88.59–$392.00 | 60% below | 80% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 ROP R 97165 OT EVAL LOW COMPLEX | $98.00 | $490.00 | $88.59–$392.00 | — | 80% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 CH OT LOW COMPLEX EVAL | $98.00 | $490.00 | $88.59–$392.00 | — | 80% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 CH PT HIGH COMPLEX EVAL | $154.00 | $770.00 | $87.74–$616.00 | 47% below | 80% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 ROP R 97163 PT EVAL HIGH COMPLEX | $154.00 | $770.00 | $87.74–$616.00 | 47% below | 80% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 ROP R 97163 PT EVAL HIGH COMPLEX | $154.00 | $770.00 | $87.74–$616.00 | — | 80% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 CH PT HIGH COMPLEX EVAL | $154.00 | $770.00 | $87.74–$616.00 | — | 80% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 ROP R 97161 PT EVAL LOW COMPLEX | $89.80 | $449.00 | $87.74–$368.47 | 56% below | 80% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 CH PT LOW COMPLEX EVAL | $89.80 | $449.00 | $87.74–$368.47 | 56% below | 80% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 CH PT LOW COMPLEX EVAL | $89.80 | $449.00 | $87.74–$368.47 | — | 80% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 ROP R 97161 PT EVAL LOW COMPLEX | $89.80 | $449.00 | $87.74–$368.47 | — | 80% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 ROP 97162 PT EVAL MOD COMPLEX | $114.40 | $572.00 | $87.74–$457.60 | 54% below | 80% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 CH PT MOD COMPLEX EVAL | $114.40 | $572.00 | $87.74–$457.60 | 54% below | 80% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 CH PT MOD COMPLEX EVAL | $114.40 | $572.00 | $87.74–$457.60 | — | 80% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 ROP 97162 PT EVAL MOD COMPLEX | $114.40 | $572.00 | $87.74–$457.60 | — | 80% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 CH MANL THERPY EACH 15 MIN PT | $49.40 | $247.00 | $23.63–$197.60 | 55% below | 80% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 ROP MANUAL THERAPY EACH 15 MIN PT | $49.40 | $247.00 | $23.63–$197.60 | 55% below | 80% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 CH MANL THERPY EACH 15 MIN OT | $56.40 | $282.00 | $23.63–$225.60 | 49% below | 80% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 ROP MANUAL THERAPY EACH 15 MIN OT | $56.40 | $282.00 | $23.63–$225.60 | 49% below | 80% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 ROP MANUAL THERAPY EACH 15 MIN PT | $49.40 | $247.00 | $23.63–$197.60 | — | 80% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 CH MANL THERPY EACH 15 MIN PT | $49.40 | $247.00 | $23.63–$197.60 | — | 80% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 ROP MANUAL THERAPY EACH 15 MIN OT | $56.40 | $282.00 | $23.63–$225.60 | — | 80% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 CH MANL THERPY EACH 15 MIN OT | $56.40 | $282.00 | $23.63–$225.60 | — | 80% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 ROP THERAPEUTIC EXER EACH 15MIN OT | $47.00 | $235.00 | $25.65–$188.00 | 58% below | 80% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 CH THERAP EXER EA 15 MIN OT | $47.00 | $235.00 | $25.65–$188.00 | 58% below | 80% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 CH THERAP EXER EACH 15MIN PT | $48.40 | $242.00 | $25.65–$193.60 | 57% below | 80% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 ROP ERAP EXERCISE EACH 15MIN PT | $48.40 | $242.00 | $25.65–$193.60 | 57% below | 80% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 ROP THERAPEUTIC EXER EACH 15MIN OT | $47.00 | $235.00 | $25.65–$188.00 | — | 80% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 CH THERAP EXER EA 15 MIN OT | $47.00 | $235.00 | $25.65–$188.00 | — | 80% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 ROP ERAP EXERCISE EACH 15MIN PT | $48.40 | $242.00 | $25.65–$193.60 | — | 80% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 CH THERAP EXER EACH 15MIN PT | $48.40 | $242.00 | $25.65–$193.60 | — | 80% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 CH NEURO PSY TEST EVAL 1ST HOUR | $73.60 | $368.00 | $66.24–$353.47 | 76% below | 80% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 CH MU NEURO PSY TEST EVAL 1ST HOUR | $73.60 | $368.00 | $66.24–$353.47 | 76% below | 80% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 CH NEURO PSY TEST EVAL 1ST HOUR | $73.60 | $368.00 | $66.24–$353.47 | — | 80% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 CH MU NEURO PSY TEST EVAL 1ST HOUR | $73.60 | $368.00 | $66.24–$353.47 | — | 80% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 CH NEURO PSY TX CRISIS INITIAL 60 MIN | $101.60 | $508.00 | $91.44–$406.40 | 69% below | 80% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 CH MU NEURO PSY TX CRISIS INITIAL 60 MIN | $101.60 | $508.00 | $91.44–$406.40 | 69% below | 80% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 CH MU NEURO PSY TX CRISIS INITIAL 60 MIN | $101.60 | $508.00 | $91.44–$406.40 | — | 80% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 CH NEURO PSY TX CRISIS INITIAL 60 MIN | $101.60 | $508.00 | $91.44–$406.40 | — | 80% |
| Psychotherapy session, 30 minutes CPT 90832 CH NEURO PSY PSYTX W PT 30 MINUTES | $63.40 | $317.00 | $57.06–$253.60 | 66% below | 80% |
| Psychotherapy session, 30 minutes CPT 90832 CH MU NEURO PSY PSYTX W PT 30 MINUTES | $63.40 | $317.00 | $57.06–$253.60 | 66% below | 80% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 CH MU NEURO PSY PSYTX W PT 30 MINUTES | $63.40 | $317.00 | $57.06–$253.60 | — | 80% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 CH NEURO PSY PSYTX W PT 30 MINUTES | $63.40 | $317.00 | $57.06–$253.60 | — | 80% |
| Psychotherapy session, 45 minutes CPT 90834 CH MU NEURO PSY W PT 45 MIN | $46.00 | $230.00 | $41.40–$270.74 | 83% below | 80% |
| Psychotherapy session, 45 minutes CPT 90834 CH PSY W PT 45 MIN | $46.00 | $230.00 | $41.40–$270.74 | 83% below | 80% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 CH MU NEURO PSY W PT 45 MIN | $46.00 | $230.00 | $41.40–$270.74 | — | 80% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 CH PSY W PT 45 MIN | $46.00 | $230.00 | $41.40–$270.74 | — | 80% |
| Psychotherapy session, 60 minutes CPT 90837 CH MU NEURO PSY W PT 60 MIN | $110.60 | $553.00 | $99.54–$442.40 | 60% below | 80% |
| Psychotherapy session, 60 minutes CPT 90837 CH NEURO PSY W PT 60 MIN | $110.60 | $553.00 | $99.54–$442.40 | 60% below | 80% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 CH MU NEURO PSY W PT 60 MIN | $110.60 | $553.00 | $99.54–$442.40 | — | 80% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 CH NEURO PSY W PT 60 MIN | $110.60 | $553.00 | $99.54–$442.40 | — | 80% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 CFC_VISIT ESTAB LEVEL V W/PROC | $60.00 | $300.00 | $54.00–$240.00 | 79% below | 80% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 CH NEURO VISIT ESTAB LEVEL V | $60.00 | $300.00 | $54.00–$240.00 | 79% below | 80% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 CH CARDIO VISIT ESTAB LEVEL V | $60.00 | $300.00 | $54.00–$240.00 | 79% below | 80% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 CFC_VISIT ESTAB LEVEL V | $60.00 | $300.00 | $54.00–$240.00 | 79% below | 80% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Phy Spec Mnt VISIT ESTAB LVL V | $60.00 | $300.00 | $54.00–$240.00 | 79% below | 80% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 CH PS MSC VISIT ESTAB LEVEL V | $60.00 | $300.00 | $54.00–$240.00 | 79% below | 80% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 CH UCC E&M EST 40-54 MIN | $80.00 | $400.00 | $72.00–$320.00 | 72% below | 80% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 INF VISIT ESTAB LEVEL V | $80.00 | $400.00 | $72.00–$320.00 | 72% below | 80% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 CH UCC EL E&M EST 40-54 MIN | $115.43 | $577.16 | $103.89–$461.73 | 59% below | 80% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 CARES VISIT ESTAB LEVEL V | $141.80 | $709.00 | $125.99–$567.20 | 50% below | 80% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 CH MU URO VISIT ESTAB LVL V | $150.80 | $754.00 | $125.99–$603.20 | 47% below | 80% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 CH MU VISIT ESTAB LEVEL V | $150.80 | $754.00 | $125.99–$603.20 | 47% below | 80% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 NSI VISIT ESTAB LEVEL V | $150.80 | $754.00 | $125.99–$603.20 | 47% below | 80% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 NSI VISIT ESTAB LEVEL V | $150.80 | $754.00 | $125.99–$603.20 | — | 80% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 CH NEURO VISIT ESTAB LEVEL III | $40.00 | $200.00 | $36.00–$178.43 | 77% below | 80% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 CFC_VISIT EST LEVEL III W/PROC | $40.00 | $200.00 | $36.00–$178.43 | 77% below | 80% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 CFC_VISIT ESTAB LEVEL III | $40.00 | $200.00 | $36.00–$178.43 | 77% below | 80% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 CH CARDIO VISIT ESTAB LEVEL III | $40.00 | $200.00 | $36.00–$178.43 | 77% below | 80% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 CH PS MSC VISIT ESTAB LEVEL III | $40.00 | $200.00 | $36.00–$178.43 | 77% below | 80% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Phy Spec Mnt VISIT ESTAB LVL III | $40.00 | $200.00 | $36.00–$178.43 | 77% below | 80% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 CH UCC EL E&M EST 20-29 MIN | $57.49 | $287.45 | $51.74–$229.96 | 67% below | 80% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 INF VISIT ESTAB LEVEL III | $60.00 | $300.00 | $54.00–$240.00 | 66% below | 80% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 CH UCC E&M EST 20-29 MIN | $60.00 | $300.00 | $54.00–$240.00 | 66% below | 80% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 CARES VISIT ESTAB LEVEL III | $84.40 | $422.00 | $57.60–$337.60 | 52% below | 80% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 NSI VST ESTAB LEVEL III | $89.00 | $445.00 | $57.60–$356.00 | 49% below | 80% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 CH MU VISIT ESTAB LEVEL III | $89.00 | $445.00 | $57.60–$356.00 | 49% below | 80% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 CV VISIT ESTAB LEVEL III | $89.00 | $445.00 | $57.60–$356.00 | 49% below | 80% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 CH MU URO MNT VISIT ESTAB LVL III | $89.00 | $445.00 | $57.60–$356.00 | 49% below | 80% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 NSI VST ESTAB LEVEL III | $89.00 | $445.00 | $57.60–$356.00 | — | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CFC_VISIT EST LEVEL IV W/PROC | $50.00 | $250.00 | $45.00–$200.00 | 74% below | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Phy Spec Mnt VISIT ESTAB LVL IV | $50.00 | $250.00 | $45.00–$200.00 | 74% below | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CH PS MSC VISIT ESTAB LEVEL IV | $50.00 | $250.00 | $45.00–$200.00 | 74% below | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CH NEURO VISIT ESTAB LEVEL IV | $50.00 | $250.00 | $45.00–$200.00 | 74% below | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CH CARDIO VISIT ESTAB LEVEL IV | $50.00 | $250.00 | $45.00–$200.00 | 74% below | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CFC_VISIT ESTAB LEVEL IV | $50.00 | $250.00 | $45.00–$200.00 | 74% below | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CV VISIT ESTAB LEVEL IV | $52.40 | $262.00 | $47.16–$209.60 | 73% below | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 INF VISIT ESTAB LEVEL IV | $70.00 | $350.00 | $63.00–$280.00 | 64% below | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CH UCC E&M EST 30-39 MIN | $70.00 | $350.00 | $63.00–$280.00 | 64% below | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CH UCC EL E&M EST 30-39 MIN | $82.98 | $414.88 | $74.68–$331.90 | 57% below | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CARES VISIT ESTAB LEVEL IV | $111.40 | $557.00 | $84.93–$445.60 | 42% below | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CH MU VISIT ESTAB LEVEL IV | $119.20 | $596.00 | $84.93–$476.80 | 38% below | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CH MU URO MNT VISIT ESTAB LVL IV | $119.20 | $596.00 | $84.93–$476.80 | 38% below | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 NSI VISIT ESTAB LEVEL IV | $119.20 | $596.00 | $84.93–$476.80 | 38% below | 80% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 NSI VISIT ESTAB LEVEL IV | $119.20 | $596.00 | $84.93–$476.80 | — | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Phy Spec Mnt OP E&M EST 10-19 MIN | $30.00 | $150.00 | $27.00–$179.15 | 76% below | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CFC_VISIT ESTAB LEV II W/PROC | $30.00 | $150.00 | $27.00–$179.15 | 76% below | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CFC_VISIT ESTAB LEVEL II | $30.00 | $150.00 | $27.00–$179.15 | 76% below | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CH CARDIO OP VISIT E&M EST 10-19 MIN | $30.00 | $150.00 | $27.00–$179.15 | 76% below | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CH NEURO VISIT E&M EST 10-19 MIN | $30.00 | $150.00 | $27.00–$179.15 | 76% below | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CH PS MSP OP VISIT E&M EST 10-19 MIN | $30.00 | $150.00 | $27.00–$179.15 | 76% below | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CH UCC EL E&M EST 10-19 MIN | $43.87 | $219.37 | $30.86–$190.00 | 65% below | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 INF VISIT ESTAB LEVEL II | $50.00 | $250.00 | $30.86–$200.00 | 60% below | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CH UCC E&M EST 10-19 MIN | $50.00 | $250.00 | $30.86–$200.00 | 60% below | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CH UCC SELF PAY E/M LEVEL | $50.00 | $250.00 | $30.86–$200.00 | 60% below | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CV VISIT ESTAB LEVEL II | $52.40 | $262.00 | $30.86–$209.60 | 58% below | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CARES VISIT ESTAB LEVEL II | $67.40 | $337.00 | $30.86–$269.60 | 46% below | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CH MU URO MNT OP E&M EST 10-19 MIN | $71.40 | $357.00 | $30.86–$285.60 | 43% below | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 NSI VISIT ESTAB LEVEL II | $71.40 | $357.00 | $30.86–$285.60 | 43% below | 80% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 NSI VISIT ESTAB LEVEL II | $71.40 | $357.00 | $30.86–$285.60 | — | 80% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 CH MSC CONSULTATION 30 MIN | $20.00 | $100.00 | $18.00–$85.67 | 78% below | 80% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 CH PS OFFICE CONSULT LEVEL III | $85.20 | $426.00 | $76.68–$340.80 | 5% below | 80% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 CH MU OFFICE CONSULT LEVEL III | $85.20 | $426.00 | $76.68–$340.80 | 5% below | 80% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULT LEVEL III | $85.20 | $426.00 | $76.68–$340.80 | 5% below | 80% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE CONSULT LEVEL III | $85.20 | $426.00 | $76.68–$340.80 | — | 80% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CH MSC CONSULTATION 40 MIN | $28.00 | $140.00 | $25.20–$130.38 | 83% below | 80% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CH MU OFFICE CONSULT LEVEL IV | $78.80 | $394.00 | $70.92–$315.20 | 51% below | 80% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULT LEVEL IV | $78.80 | $394.00 | $70.92–$315.20 | 51% below | 80% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CH PS OFFICE CONSULT LEVEL IV | $78.80 | $394.00 | $70.92–$315.20 | 51% below | 80% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE CONSULT LEVEL IV | $78.80 | $394.00 | $70.92–$315.20 | — | 80% |
| Speech and language evaluation CPT 92523 ROP ST COMPREHENSIVE REC/EXP EVAL 60 MIN | $62.80 | $314.00 | $87.92–$306.54 | 84% below | 80% |
| Speech and language evaluation CPT 92523 CH SPEECH EVAL LANG COMP/EXP | $203.40 | $1,017.00 | $117.90–$813.60 | 48% below | 80% |
| Speech and language evaluation inpatient CPT 92523 ROP ST COMPREHENSIVE REC/EXP EVAL 60 MIN | $62.80 | $314.00 | $87.92–$306.54 | — | 80% |
| Speech and language evaluation inpatient CPT 92523 CH SPEECH EVAL LANG COMP/EXP | $203.40 | $1,017.00 | $117.90–$813.60 | — | 80% |
| Speech therapy session, individual CPT 92507 CH SPEECH LANG THERAPY INTERM | $110.00 | $550.00 | $58.77–$440.00 | 49% below | 80% |
| Speech therapy session, individual CPT 92507 ROP SPEECH LANGUAGE THERAPY INTERM | $110.00 | $550.00 | $58.77–$440.00 | 49% below | 80% |
| Speech therapy session, individual CPT 92507 CH SPEECH LANG THERAPY BASIC | $110.00 | $550.00 | $58.77–$440.00 | 49% below | 80% |
| Speech therapy session, individual CPT 92507 ROP SPEECH LANGUAGE THERAPY BASIC | $110.00 | $550.00 | $58.77–$440.00 | 49% below | 80% |
| Speech therapy session, individual CPT 92507 CH SPEECH LANG THERAPY BRIEF | $110.00 | $550.00 | $58.77–$440.00 | 49% below | 80% |
| Speech therapy session, individual CPT 92507 ROP SPEECH LANGUAGE THERAPY BRIEF | $110.00 | $550.00 | $58.77–$440.00 | 49% below | 80% |
| Speech therapy session, individual CPT 92507 CH SPEECH LANGUAGE THERAPY EXT | $110.00 | $550.00 | $58.77–$440.00 | 49% below | 80% |
| Speech therapy session, individual CPT 92507 ROP SPEECH LANGUAGE THERAPY EXT | $110.00 | $550.00 | $58.77–$440.00 | 49% below | 80% |
| Speech therapy session, individual inpatient CPT 92507 CH SPEECH LANGUAGE THERAPY EXT | $110.00 | $550.00 | $58.77–$440.00 | — | 80% |
| Speech therapy session, individual inpatient CPT 92507 ROP SPEECH LANGUAGE THERAPY INTERM | $110.00 | $550.00 | $58.77–$440.00 | — | 80% |
| Speech therapy session, individual inpatient CPT 92507 ROP SPEECH LANGUAGE THERAPY EXT | $110.00 | $550.00 | $58.77–$440.00 | — | 80% |
| Speech therapy session, individual inpatient CPT 92507 ROP SPEECH LANGUAGE THERAPY BRIEF | $110.00 | $550.00 | $58.77–$440.00 | — | 80% |
| Speech therapy session, individual inpatient CPT 92507 CH SPEECH LANG THERAPY INTERM | $110.00 | $550.00 | $58.77–$440.00 | — | 80% |
| Speech therapy session, individual inpatient CPT 92507 CH SPEECH LANG THERAPY BASIC | $110.00 | $550.00 | $58.77–$440.00 | — | 80% |
| Speech therapy session, individual inpatient CPT 92507 CH SPEECH LANG THERAPY BRIEF | $110.00 | $550.00 | $58.77–$440.00 | — | 80% |
| Speech therapy session, individual inpatient CPT 92507 ROP SPEECH LANGUAGE THERAPY BASIC | $110.00 | $550.00 | $58.77–$440.00 | — | 80% |
| Spirometry (breathing test) CPT 94010 CFC PRE SPIROMETRY BREATHING CAP | $54.20 | $271.00 | $23.49–$419.17 | 85% below | 80% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY - BEDSIDE | $54.20 | $271.00 | $23.49–$419.17 | 85% below | 80% |
| Spirometry (breathing test) CPT 94010 PRE SPIROMETRY BREATHING CAP | $161.60 | $808.00 | $23.49–$646.40 | 55% below | 80% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY - BEDSIDE | $54.20 | $271.00 | $23.49–$419.17 | — | 80% |
| Spirometry (breathing test) inpatient CPT 94010 CFC PRE SPIROMETRY BREATHING CAP | $54.20 | $271.00 | $23.49–$419.17 | — | 80% |
| Spirometry (breathing test) inpatient CPT 94010 PRE SPIROMETRY BREATHING CAP | $161.60 | $808.00 | $23.49–$646.40 | — | 80% |
| Spirometry before and after a bronchodilator CPT 94060 PFT-PRE-POST SPIROMETRY | $280.40 | $1,402.00 | $33.48–$1,121.60 | 53% below | 80% |
| Spirometry before and after a bronchodilator CPT 94060 CFC PFT-PRE-POST SPIROMETRY | $280.40 | $1,402.00 | $33.48–$1,121.60 | 53% below | 80% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PFT-PRE-POST SPIROMETRY | $280.40 | $1,402.00 | $33.48–$1,121.60 | — | 80% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 CFC PFT-PRE-POST SPIROMETRY | $280.40 | $1,402.00 | $33.48–$1,121.60 | — | 80% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 CH FUNCT THER ACT EA 15 MIN PT | $51.20 | $256.00 | $28.29–$204.80 | 55% below | 80% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 ROP FUNCT THER ACT EA 15 MIN PT | $51.20 | $256.00 | $28.29–$204.80 | 55% below | 80% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 ROP FUNCT THER ACT EA 15 MIN OT | $51.40 | $257.00 | $28.29–$205.60 | 54% below | 80% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 CH FUNCT THER ACT EA 15 MIN OT | $51.40 | $257.00 | $28.29–$205.60 | 54% below | 80% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 CH FUNCT THER ACT EA 15 MIN PT | $51.20 | $256.00 | $28.29–$204.80 | — | 80% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 ROP FUNCT THER ACT EA 15 MIN PT | $51.20 | $256.00 | $28.29–$204.80 | — | 80% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 CH FUNCT THER ACT EA 15 MIN OT | $51.40 | $257.00 | $28.29–$205.60 | — | 80% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 ROP FUNCT THER ACT EA 15 MIN OT | $51.40 | $257.00 | $28.29–$205.60 | — | 80% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 INF PHLEBOTOMY THERAPEUTIC | $62.00 | $310.00 | $55.80–$248.00 | 73% below | 80% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HMC PHLEBOTOMY THERAPEUTIC | $62.00 | $310.00 | $55.80–$248.00 | 73% below | 80% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 BLD THERAPEUTIC PHLEBOTOMY | $66.80 | $334.00 | $60.12–$267.20 | 71% below | 80% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 INF PHLEBOTOMY THERAPEUTIC | $62.00 | $310.00 | $55.80–$248.00 | — | 80% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HMC PHLEBOTOMY THERAPEUTIC | $62.00 | $310.00 | $55.80–$248.00 | — | 80% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 BLD THERAPEUTIC PHLEBOTOMY | $66.80 | $334.00 | $60.12–$267.20 | — | 80% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (12y+) (cvx 312) PF 50 mcg/0.5 mL inj | $93.24 | $466.20 | $83.92–$420.29 | 24% below | 80% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (12y+) (cvx 312) PF 50 mcg/0.5 mL inj | $93.24 | $466.20 | $83.92–$420.29 | — | 80% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus vaccine 0.5mL inj | $79.26 | $396.30 | $71.33–$317.04 | 80% below | 80% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 varicella virus vaccine 0.5mL inj | $79.26 | $396.30 | $71.33–$317.04 | — | 80% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 diphtheria/tetanus/acell pertussis (DTaP) 0.5 mL pedi | $19.22 | $96.09 | $17.30–$76.87 | 79% below | 80% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 diphtheria/tetanus/acell pertussis (DTaP) 0.5 mL pedi | $19.22 | $96.09 | $17.30–$76.87 | — | 80% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 diphth/hepB/pertus,acel/polio/tetanus 0.5mL inj | $53.04 | $265.20 | $47.74–$212.16 | 75% below | 80% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 diphth/hepB/pertus,acel/polio/tetanus 0.5mL inj | $53.04 | $265.20 | $47.74–$212.16 | — | 80% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza virus vaccine PF, inact trival inj 0.5 mL (fluzone) | $15.94 | $79.69 | $14.34–$63.75 | 57% below | 80% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza virus vaccine PF, inact trival inj 0.5 mL (fluzone) | $15.94 | $79.69 | $14.34–$63.75 | — | 80% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 hepatitis A pedi vacc 720 units/0.5 mL pf inj | $28.74 | $143.72 | $25.87–$114.98 | 69% below | 80% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 hepatitis A pedi vaccine 25 units/0.5 mL inj | $37.29 | $186.46 | $33.56–$149.16 | 60% below | 80% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 hepatitis A pedi vacc 720 units/0.5 mL pf inj | $28.74 | $143.72 | $25.87–$114.98 | — | 80% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 hepatitis A pedi vaccine 25 units/0.5 mL inj | $37.29 | $186.46 | $33.56–$149.16 | — | 80% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B vaccine adult 20mcg/mL inj | $37.26 | $186.30 | $33.53–$159.82 | 77% below | 80% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B vaccine adult 20mcg/mL inj | $37.26 | $186.30 | $33.53–$159.82 | — | 80% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B vaccine pedi 10 mcg/0.5 mL inj | $21.37 | $106.84 | $19.23–$85.47 | 74% below | 80% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B vaccine pedi 5 mcg/0.5 mL inj | $23.05 | $115.24 | $20.74–$92.19 | 72% below | 80% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 hepatitis B vaccine pedi 10 mcg/0.5 mL inj | $21.37 | $106.84 | $19.23–$85.47 | — | 80% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 hepatitis B vaccine pedi 5 mcg/0.5 mL inj | $23.05 | $115.24 | $20.74–$92.19 | — | 80% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 haemophilus b conjugate (PRP-T) vaccine inj 0.5mL | $27.55 | $137.74 | $13.63–$110.20 | 41% below | 80% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 haemophilus b conjugate (PRP-T) vaccine inj 0.5mL | $27.55 | $137.74 | $13.63–$110.20 | — | 80% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 influenza virus vaccine, pf (high dose) inactivated trivalent 0.5mL inj (fluzone) | $52.73 | $263.66 | $47.46–$210.93 | 65% below | 80% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 influenza virus vaccine, pf (high dose) inactivated trivalent 0.5mL inj (fluzone) | $52.73 | $263.66 | $47.46–$210.93 | — | 80% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella virus vaccine 0.5mL inj | $51.06 | $255.31 | $45.96–$204.25 | 75% below | 80% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles/mumps/rubella virus vaccine 0.5mL inj | $51.06 | $255.31 | $45.96–$204.25 | — | 80% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal polysaccharide conjugate vaccine inj | $162.44 | $812.21 | $93.82–$649.77 | 54% below | 80% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal oligosaccharide conjugate vaccine inj | $213.64 | $1,068.20 | $93.82–$854.56 | 40% below | 80% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal polysaccharide conjugate vaccine inj | $162.44 | $812.21 | $93.82–$649.77 | — | 80% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal oligosaccharide conjugate vaccine inj | $213.64 | $1,068.20 | $93.82–$854.56 | — | 80% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 meningococcal group B vaccine recombinant 0.5mL inj | $107.92 | $539.59 | $97.13–$431.67 | 82% below | 80% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 meningococcal group B vaccine recombinant 0.5mL inj | $107.92 | $539.59 | $97.13–$431.67 | — | 80% |
| Meningococcal B vaccine (Trumenba) CPT 90621 meningococcal group B vaccine fully recombinant 0.5mL inj | $79.70 | $398.51 | $71.73–$319.02 | 89% below | 80% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 meningococcal group B vaccine fully recombinant 0.5mL inj | $79.70 | $398.51 | $71.73–$319.02 | — | 80% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 pneumococcal 13-valent vaccine 0.5mL | $162.49 | $812.45 | $146.24–$649.96 | 67% below | 80% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 pneumococcal 13-valent vaccine 0.5mL | $162.49 | $812.45 | $146.24–$649.96 | — | 80% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-valent conjugate vaccine 0.5mL inj | $188.04 | $940.21 | $169.24–$752.17 | 67% below | 80% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal 20-valent conjugate vaccine 0.5mL inj | $188.04 | $940.21 | $169.24–$752.17 | — | 80% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 pneumococcal 23-valent vaccine inj 0.5mL | $84.30 | $421.49 | $75.87–$337.19 | 67% below | 80% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 pneumococcal 23-valent vaccine inj 0.5mL | $84.30 | $421.49 | $75.87–$337.19 | — | 80% |
| Polio vaccine, inactivated (IPV) CPT 90713 poliovirus vaccine inactivated 0.5mL inj | $28.85 | $144.24 | $25.96–$115.39 | 91% below | 80% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 poliovirus vaccine inactivated 0.5mL inj | $28.85 | $144.24 | $25.96–$115.39 | — | 80% |
| Rabies vaccine, one dose CPT 90675 rabies vaccine, human diploid cell 2.5 units/mL inj | $232.06 | $1,160.28 | $208.85–$928.22 | 77% below | 80% |
| Rabies vaccine, one dose CPT 90675 rabies vaccine, purified chick embryo cell 2.5 units/mL inj | $298.01 | $1,490.07 | $237.38–$1,192.06 | 71% below | 80% |
| Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine, human diploid cell 2.5 units/mL inj | $232.06 | $1,160.28 | $208.85–$928.22 | — | 80% |
| Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine, purified chick embryo cell 2.5 units/mL inj | $298.01 | $1,490.07 | $237.38–$1,192.06 | — | 80% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphth toxoids (Td) adult/adol 5 units-2 units/0.5 mL | $37.91 | $189.54 | $18.83–$151.64 | 62% below | 80% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus-diphth toxoids (Td) adult/adol 5 units-2 units/0.5 mL | $37.91 | $189.54 | $18.83–$151.64 | — | 80% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphtheria/pertussis, acel (Tdap) 0.5mL inj (adacel) | $30.99 | $154.96 | $27.89–$123.96 | 74% below | 80% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 0.5mL (boostrix) | $31.56 | $157.78 | $28.40–$126.22 | 73% below | 80% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphtheria/pertussis, acel (Tdap) 0.5mL inj (adacel) | $30.99 | $154.96 | $27.89–$123.96 | — | 80% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 0.5mL (boostrix) | $31.56 | $157.78 | $28.40–$126.22 | — | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ICN-VACCINE ADMIN, 1ST | $20.60 | $103.00 | $17.83–$82.40 | 72% below | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMCN VACCINE ADMIN, 1ST | $20.60 | $103.00 | $17.83–$82.40 | 72% below | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 CH MU IM VACCINE ADMIN 1S | $20.60 | $103.00 | $17.83–$82.40 | 72% below | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INTRAMUSCULAR VACCINE ADMIN 1S | $20.60 | $103.00 | $17.83–$82.40 | 72% below | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HMC IMMUNIZATION ADM INITIAL | $20.60 | $103.00 | $17.83–$82.40 | 72% below | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INF VACCINE ADMIN 1ST | $20.60 | $103.00 | $17.83–$82.40 | 72% below | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 CH PS IM VACCINE ADMIN 1S | $20.60 | $103.00 | $17.83–$82.40 | 72% below | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMIN, 1ST PICU | $20.60 | $103.00 | $17.83–$82.40 | 72% below | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMCU VACCINE ADMIN, 1ST | $20.60 | $103.00 | $17.83–$82.40 | 72% below | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PEDS VACCINE ADMIN, 1ST | $20.60 | $103.00 | $17.83–$82.40 | 72% below | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 OBS VACCINE ADMIN 1ST | $20.60 | $103.00 | $17.83–$82.40 | 72% below | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMCU VACCINE ADMIN, 1ST | $20.60 | $103.00 | $17.83–$82.40 | — | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INF VACCINE ADMIN 1ST | $20.60 | $103.00 | $17.83–$82.40 | — | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMCN VACCINE ADMIN, 1ST | $20.60 | $103.00 | $17.83–$82.40 | — | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMIN, 1ST PICU | $20.60 | $103.00 | $17.83–$82.40 | — | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PEDS VACCINE ADMIN, 1ST | $20.60 | $103.00 | $17.83–$82.40 | — | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 CH MU IM VACCINE ADMIN 1S | $20.60 | $103.00 | $17.83–$82.40 | — | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ICN-VACCINE ADMIN, 1ST | $20.60 | $103.00 | $17.83–$82.40 | — | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 CH PS IM VACCINE ADMIN 1S | $20.60 | $103.00 | $17.83–$82.40 | — | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INTRAMUSCULAR VACCINE ADMIN 1S | $20.60 | $103.00 | $17.83–$82.40 | — | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HMC IMMUNIZATION ADM INITIAL | $20.60 | $103.00 | $17.83–$82.40 | — | 80% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 OBS VACCINE ADMIN 1ST | $20.60 | $103.00 | $17.83–$82.40 | — | 80% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 OBS ADMIN ADDL VACC | $10.00 | $50.00 | $9.00–$66.74 | 79% below | 80% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 CH PS VACCINE ADMIN EACH ADD'L | $10.00 | $50.00 | $9.00–$66.74 | 79% below | 80% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HMC IMMUNIZATION ADMIN ADD | $10.00 | $50.00 | $9.00–$66.74 | 79% below | 80% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ICN-VACCINE ADMIN, EACH ADDL | $10.00 | $50.00 | $9.00–$66.74 | 79% below | 80% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PED VACCINE ADM, EACH ADD | $10.00 | $50.00 | $9.00–$66.74 | 79% below | 80% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INF VACCINE ADMIN EACH ADD'L | $10.00 | $50.00 | $9.00–$66.74 | 79% below | 80% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMCU VACCINE ADM, EACH ADD | $10.00 | $50.00 | $9.00–$66.74 | 79% below | 80% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMCN VACCINE ADMIN, EACH ADD'L | $10.00 | $50.00 | $9.00–$66.74 | 79% below | 80% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINE ADMIN, EACH ADDL PICU | $10.00 | $50.00 | $9.00–$66.74 | 79% below | 80% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INTRAMUSCULAR VACCINE ADMIN AD | $13.60 | $68.00 | $12.24–$66.74 | 71% below | 80% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HMC IMMUNIZATION ADMIN ADD | $10.00 | $50.00 | $9.00–$66.74 | — | 80% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ICN-VACCINE ADMIN, EACH ADDL | $10.00 | $50.00 | $9.00–$66.74 | — | 80% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINE ADMIN, EACH ADDL PICU | $10.00 | $50.00 | $9.00–$66.74 | — | 80% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 PED VACCINE ADM, EACH ADD | $10.00 | $50.00 | $9.00–$66.74 | — | 80% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INF VACCINE ADMIN EACH ADD'L | $10.00 | $50.00 | $9.00–$66.74 | — | 80% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 CH PS VACCINE ADMIN EACH ADD'L | $10.00 | $50.00 | $9.00–$66.74 | — | 80% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 OBS ADMIN ADDL VACC | $10.00 | $50.00 | $9.00–$66.74 | — | 80% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMCN VACCINE ADMIN, EACH ADD'L | $10.00 | $50.00 | $9.00–$66.74 | — | 80% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMCU VACCINE ADM, EACH ADD | $10.00 | $50.00 | $9.00–$66.74 | — | 80% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INTRAMUSCULAR VACCINE ADMIN AD | $13.60 | $68.00 | $12.24–$66.74 | — | 80% |
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://elpasochildrens.org/wp-content/uploads/2026/01/26-3075429_el-paso-childrens-hospital_standardcharges.csv