Hospital Pittsburgh, PA

UPMC Mercy

UPMC Mercy in Pittsburgh, PA publishes cash prices for 373 common procedures listed here, from its own machine-readable price file updated Mar 6, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Pennsylvania median for 293 of 372 procedures and below it for 65. By typical cash price it ranks #77 of 108 Pennsylvania hospitals and #20 of 26 hospitals in the Pittsburgh, PA area, cheapest first. Select a procedure to compare it with other hospitals nearby.

1400 Locust Street, Pittsburgh, PA 15219 Collected Sep 27, 2026 Source price file Check a bill from this hospital (412) 232-8111

Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 390028 · CMS hospital register NPI 1881695146

Financial assistance

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

UPMC Mercy 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 1 action for a hospital named UPMC Mercy in Pittsburgh, PA:

Jul 21, 2025 Met requirements

Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

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 Pennsylvania	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W WO CON	$3,394.80	$5,658.00	$141.48–$5,092.20	80% above	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W WO CON	$3,394.80	$5,658.00	$1,731.35–$5,092.20	—	40%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS	$456.60	$761.00	$13.05–$684.90	40% above	40%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE COMP MIN 3 VIEWS	$456.60	$761.00	$26.10–$684.90	26% above	40%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE COMP MIN 3 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 NON INVAS BIL SNGL LEVEL ABI S	$782.40	$1,304.00	$53.67–$1,173.60	75% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 NON INVAS BIL SNGL LEVEL ABI S	$782.40	$1,304.00	$399.02–$1,173.60	—	40%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREM WO CON	$1,950.00	$3,250.00	$84.51–$2,925.00	65% above	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREM WO CON	$1,950.00	$3,250.00	$994.50–$2,925.00	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS X-RAY XM SNGL CNTRST	$873.00	$1,455.00	$41.25–$1,309.50	90% above	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS X-RAY XM SNGL CNTRST	$873.00	$1,455.00	$445.23–$1,309.50	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE/JNT IMAG WHOLE BODY	$2,464.80	$4,108.00	$111.63–$3,697.20	101% above	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE/JNT IMAG WHOLE BODY	$2,464.80	$4,108.00	$1,257.05–$3,697.20	—	40%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMPLETE UNILATERAL	$597.60	$996.00	$45.15–$896.40	9% above	40%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST COMPLETE UNILATERAL	$597.60	$996.00	$304.78–$896.40	—	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED UNILATERAL	$370.80	$618.00	$34.59–$556.20	20% below	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LIMITED UNILATERAL	$370.80	$618.00	$189.11–$556.20	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD&PLV W/WO CON W/POSTPRC	$5,897.40	$9,829.00	$283.82–$8,846.10	98% above	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD&PLV W/WO CON W/POSTPRC	$5,897.40	$9,829.00	$3,007.67–$8,846.10	—	40%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W/WO CON W/PST PROC	$3,441.00	$5,735.00	$141.48–$5,161.50	101% above	40%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W/WO CON W/PST PROC	$3,441.00	$5,735.00	$1,754.91–$5,161.50	—	40%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W/WO CON W/PST PROC	$3,441.00	$5,735.00	$141.48–$5,161.50	106% above	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W/WO CON W/PST PROC	$3,441.00	$5,735.00	$1,754.91–$5,161.50	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/WO CON W/PST PROC	$3,441.00	$5,735.00	$141.48–$5,161.50	79% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W/WO CON W/PST PROC	$3,441.00	$5,735.00	$1,754.91–$5,161.50	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PLVS WO CONTRAST	$4,117.20	$6,862.00	$185.12–$6,175.80	98% above	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PLVS WO CONTRAST	$4,117.20	$6,862.00	$2,099.77–$6,175.80	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PLVS W CONTRAST	$5,897.40	$9,829.00	$283.82–$8,846.10	98% above	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PLVS W CONTRAST	$5,897.40	$9,829.00	$3,007.67–$8,846.10	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PLVS W WO CONTRAST	$5,897.40	$9,829.00	$283.82–$8,846.10	98% above	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PLVS W WO CONTRAST	$5,897.40	$9,829.00	$3,007.67–$8,846.10	—	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CON	$3,054.00	$5,090.00	$141.48–$4,581.00	85% above	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CON	$3,054.00	$5,090.00	$1,557.54–$4,581.00	—	40%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CON	$1,950.00	$3,250.00	$84.51–$2,925.00	73% above	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CON	$1,950.00	$3,250.00	$994.50–$2,925.00	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CON	$1,950.00	$3,250.00	$84.51–$2,925.00	73% above	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CON	$1,950.00	$3,250.00	$994.50–$2,925.00	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST	$1,950.00	$3,250.00	$84.51–$2,925.00	80% above	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST	$1,950.00	$3,250.00	$994.50–$2,925.00	—	40%
CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST	$3,054.00	$5,090.00	$141.48–$4,581.00	126% above	40%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST	$3,054.00	$5,090.00	$1,557.54–$4,581.00	—	40%
CT scan of the head without and with contrast CPT 70470 CT HEAD W WO CONTRAST	$3,394.80	$5,658.00	$141.48–$5,092.20	103% above	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W WO CONTRAST	$3,394.80	$5,658.00	$1,731.35–$5,092.20	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CON	$1,950.00	$3,250.00	$84.51–$2,925.00	70% above	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CON	$1,950.00	$3,250.00	$994.50–$2,925.00	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CON	$1,950.00	$3,250.00	$84.51–$2,925.00	65% above	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO CON	$1,950.00	$3,250.00	$994.50–$2,925.00	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CON	$3,054.00	$5,090.00	$141.48–$4,581.00	80% above	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CON	$3,054.00	$5,090.00	$1,557.54–$4,581.00	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUP CAROTID BILAT COMP	$1,441.80	$2,403.00	$160.56–$2,162.70	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUP CAROTID BILAT COMP	$1,441.80	$2,403.00	$735.32–$2,162.70	—	40%
Chest CT scan without and with contrast CPT 71270 CT THORAX DX W/WO CON	$3,394.80	$5,658.00	$141.48–$5,092.20	111% above	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX DX W/WO CON	$3,394.80	$5,658.00	$1,731.35–$5,092.20	—	40%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS	$456.60	$761.00	$11.78–$684.90	42% above	40%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW	$456.60	$761.00	$6.43–$684.90	142% above	40%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW	$456.60	$761.00	$232.87–$684.90	—	40%
Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE COMPLETE	$456.60	$761.00	$30.16–$684.90	59% above	40%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE COMPLETE	$456.60	$761.00	$232.87–$684.90	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE	$706.20	$1,177.00	$84.51–$1,059.30	3% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE	$706.20	$1,177.00	$360.16–$1,059.30	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA AXIAL SKL 1 OR MORE SITES	$240.00	$400.00	$66.12–$686.64	12% below	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA AXIAL SKL 1 OR MORE SITES	$240.00	$400.00	$122.40–$360.00	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA APPEND SKEL PERIPHERAL	$121.20	$202.00	$30.23–$276.75	33% below	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA APPEND SKEL PERIPHERAL	$121.20	$202.00	$61.81–$181.80	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREGNANT UTERUS FET ANAT EX	$1,279.20	$2,132.00	$187.52–$1,918.80	2% above	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREGNANT UTERUS FET ANAT EX	$1,279.20	$2,132.00	$652.39–$1,918.80	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX WO CON	$1,950.00	$3,250.00	$84.51–$2,925.00	77% above	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX DX WO CON	$1,950.00	$3,250.00	$994.50–$2,925.00	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX W CON	$3,054.00	$5,090.00	$141.48–$4,581.00	114% above	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX DX W CON	$3,054.00	$5,090.00	$1,557.54–$4,581.00	—	40%
Duplex ultrasound of the leg arteries, both legs CPT 93925 DUPLEX LOWER EXT ARTERY BIL	$985.80	$1,643.00	$142.33–$1,478.70	20% above	40%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 DUPLEX LOWER EXT ARTERY BIL	$985.80	$1,643.00	$502.76–$1,478.70	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX EXT VEINS W/COMP/MAN BI	$1,214.40	$2,024.00	$157.96–$1,821.60	—	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 DUPLEX VENOUS UPPER LOWER BIL	$1,214.40	$2,024.00	$157.96–$1,821.60	40% above	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLEX EXT VEINS W/COMP/MAN BI	$1,214.40	$2,024.00	$619.34–$1,821.60	—	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 DUPLEX VENOUS UPPER LOWER BIL	$1,214.40	$2,024.00	$619.34–$1,821.60	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W / DOPPLER COMP (BUNDLED)	$2,508.00	$4,180.00	$155.12–$3,762.00	34% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 2D ECHO (TTE), COMPLETE	$2,508.00	$4,180.00	$155.12–$3,762.00	34% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 PORT TTE W DOPLR COMP(BUNDLED)	$2,508.00	$4,180.00	$155.12–$3,762.00	34% above	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W / DOPPLER COMP (BUNDLED)	$2,508.00	$4,180.00	$1,279.08–$3,762.00	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 PORT TTE W DOPLR COMP(BUNDLED)	$2,508.00	$4,180.00	$1,279.08–$3,762.00	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 2D ECHO (TTE), COMPLETE	$2,508.00	$4,180.00	$1,279.08–$3,762.00	—	40%
Elbow X-ray, 2 views CPT 73070 ELBOW 2 VIEWS	$456.60	$761.00	$25.42–$684.90	50% above	40%
Elbow X-ray, 2 views inpatient CPT 73070 ELBOW 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW MIN 3 VIEWS	$456.60	$761.00	$27.78–$684.90	32% above	40%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 ELBOW MIN 3 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA P FOS EAR WO	$1,950.00	$3,250.00	$84.51–$2,925.00	80% above	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT SELLA P FOS EAR WO	$1,950.00	$3,250.00	$994.50–$2,925.00	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES COMP MIN 3 VWS	$456.60	$761.00	$37.69–$684.90	11% above	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES COMP MIN 3 VWS	$456.60	$761.00	$232.87–$684.90	—	40%
Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM 2 VIEWS	$456.60	$761.00	$30.68–$684.90	63% above	40%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 FOREARM 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBIL SYS IMG INC GB	$1,663.20	$2,772.00	$194.16–$2,494.80	35% above	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBIL SYS IMG INC GB	$1,663.20	$2,772.00	$848.23–$2,494.80	—	40%
Hand X-ray, 2 views CPT 73120 HAND 2 VIEWS	$456.60	$761.00	$29.59–$684.90	63% above	40%
Hand X-ray, 2 views inpatient CPT 73120 HAND 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 CALCANEOUS MIN 2 VIEWS	$456.60	$761.00	$28.47–$684.90	72% above	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 CALCANEOUS MIN 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATTENDED BY TECH	$919.80	$1,533.00	$124.35–$1,379.70	51% above	40%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATTENDED BY TECH	$919.80	$1,533.00	$469.10–$1,379.70	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG WITH CPAP ATTENDED	$6,685.80	$11,143.00	$567.18–$10,028.70	113% above	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG WITH CPAP ATTENDED	$6,685.80	$11,143.00	$3,409.76–$10,028.70	—	40%
Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS	$456.60	$761.00	$33.56–$684.90	14% above	40%
Knee X-ray, 3 views inpatient CPT 73562 KNEE 3 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
Knee X-ray, complete, 4 or more views CPT 73564 KNEE COMP 4 OR MORE VIEWS	$456.60	$761.00	$37.31–$684.90	5% above	40%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 KNEE COMP 4 OR MORE VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREM WO CONT	$1,950.00	$3,250.00	$84.51–$2,925.00	85% above	40%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREM WO CONT	$1,950.00	$3,250.00	$994.50–$2,925.00	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 PORT US ABD LIMITED	$867.00	$1,445.00	$68.75–$1,300.50	43% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LIMITED	$867.00	$1,445.00	$68.75–$1,300.50	43% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 PORT US ABD LIMITED	$867.00	$1,445.00	$442.17–$1,300.50	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LIMITED	$867.00	$1,445.00	$442.17–$1,300.50	—	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$640.80	$1,068.00	$18.23–$961.20	63% above	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 PORT LMTD JT/FCL EVL NVASC XTR	$640.80	$1,068.00	$18.23–$961.20	63% above	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 PORT LMTD JT/FCL EVL NVASC XTR	$640.80	$1,068.00	$326.81–$961.20	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$640.80	$1,068.00	$326.81–$961.20	—	40%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIBIA FIBULA 2 VIEWS	$456.60	$761.00	$26.33–$684.90	37% above	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 TIBIA FIBULA 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 MRA BRAIN WO CON	$4,125.00	$6,875.00	$192.10–$6,187.50	129% above	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA BRAIN WO CON	$4,125.00	$6,875.00	$2,103.75–$6,187.50	—	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LOW EXTREM ANY JNT WO	$4,125.00	$6,875.00	$192.10–$6,187.50	103% above	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LOW EXTREM ANY JNT WO	$4,125.00	$6,875.00	$2,103.75–$6,187.50	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LOW EXTREM ANY JNT W/WO	$6,512.40	$10,854.00	$283.82–$9,768.60	85% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR LOW EXTREM ANY JNT W/WO	$6,512.40	$10,854.00	$3,321.32–$9,768.60	—	40%
MRI of the abdomen without contrast CPT 74181 MRCP WO CONTRAST	$4,125.00	$6,875.00	$192.10–$6,187.50	109% above	40%
MRI of the abdomen without contrast CPT 74181 MR ABDOMEN WO	$4,125.00	$6,875.00	$192.10–$6,187.50	109% above	40%
MRI of the abdomen without contrast inpatient CPT 74181 MRCP WO CONTRAST	$4,125.00	$6,875.00	$2,103.75–$6,187.50	—	40%
MRI of the abdomen without contrast inpatient CPT 74181 MR ABDOMEN WO	$4,125.00	$6,875.00	$2,103.75–$6,187.50	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABDOMEN W/WO	$6,512.40	$10,854.00	$283.82–$9,768.60	85% above	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABDOMEN W/WO	$6,512.40	$10,854.00	$3,321.32–$9,768.60	—	40%
MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO CON	$4,125.00	$6,875.00	$192.10–$6,187.50	126% above	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN WO CON	$4,125.00	$6,875.00	$2,103.75–$6,187.50	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN W WO CON	$6,512.40	$10,854.00	$283.82–$9,768.60	125% above	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN W WO CON	$6,512.40	$10,854.00	$3,321.32–$9,768.60	—	40%
MRI of the lower back, no contrast dye CPT 72148 MR SP CANAL LUMBAR WO	$4,125.00	$6,875.00	$192.10–$6,187.50	130% above	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR SP CANAL LUMBAR WO	$4,125.00	$6,875.00	$2,103.75–$6,187.50	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MR SP CANAL LUMBAR W WO	$6,512.40	$10,854.00	$283.82–$9,768.60	99% above	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR SP CANAL LUMBAR W WO	$6,512.40	$10,854.00	$3,321.32–$9,768.60	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR SP CANAL THORACIC WO	$4,125.00	$6,875.00	$192.10–$6,187.50	99% above	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR SP CANAL THORACIC WO	$4,125.00	$6,875.00	$2,103.75–$6,187.50	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR SP CANAL CERVICAL W WO	$6,512.40	$10,854.00	$283.82–$9,768.60	123% above	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR SP CANAL CERVICAL W WO	$6,512.40	$10,854.00	$3,321.32–$9,768.60	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR SP CANAL CERVICAL WO	$4,125.00	$6,875.00	$192.10–$6,187.50	135% above	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR SP CANAL CERVICAL WO	$4,125.00	$6,875.00	$2,103.75–$6,187.50	—	40%
MRI of the pelvis without and with contrast CPT 72197 MR PELVIS W WO	$6,512.40	$10,854.00	$283.82–$9,768.60	85% above	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR PELVIS W WO	$6,512.40	$10,854.00	$3,321.32–$9,768.60	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS WO	$4,125.00	$6,875.00	$192.10–$6,187.50	110% above	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR PELVIS WO	$4,125.00	$6,875.00	$2,103.75–$6,187.50	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UP EXTREM ANY JOINT WO	$4,125.00	$6,875.00	$192.10–$6,187.50	94% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR UP EXTREM ANY JOINT WO	$4,125.00	$6,875.00	$2,103.75–$6,187.50	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SPINE CERVICAL 4 OR 5 VIEWS	$765.60	$1,276.00	$44.68–$1,148.40	74% above	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SPINE CERVICAL 4 OR 5 VIEWS	$765.60	$1,276.00	$390.46–$1,148.40	—	40%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W CON	$3,054.00	$5,090.00	$141.48–$4,581.00	126% above	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W CON	$3,054.00	$5,090.00	$1,557.54–$4,581.00	—	40%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO CON	$1,950.00	$3,250.00	$84.51–$2,925.00	80% above	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO CON	$1,950.00	$3,250.00	$994.50–$2,925.00	—	40%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE	$456.60	$761.00	$19.25–$684.90	63% above	40%
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE	$456.60	$761.00	$232.87–$684.90	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 EXER SEST/W REST THALL SPECT	$4,388.40	$7,314.00	$374.88–$6,582.60	12% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 RESTING THALLIUM W RECIRC SPEC	$4,388.40	$7,314.00	$374.88–$6,582.60	12% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 EXER SEST/REST SEST SPECT	$4,388.40	$7,314.00	$374.88–$6,582.60	12% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 EXER SEST/REST SEST SPECT	$4,388.40	$7,314.00	$2,238.08–$6,582.60	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 RESTING THALLIUM W RECIRC SPEC	$4,388.40	$7,314.00	$2,238.08–$6,582.60	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 EXER SEST/W REST THALL SPECT	$4,388.40	$7,314.00	$2,238.08–$6,582.60	—	40%
OCT scan of the retina (optical coherence tomography) CPT 92134 CPTRZ OPH DX IMG PST SGM RETNA	$152.40	$254.00	$27.32–$228.60	at median	40%
OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 CPTRZ OPH DX IMG PST SGM RETNA	$152.40	$254.00	$77.72–$228.60	—	40%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CON	$1,950.00	$3,250.00	$84.51–$2,925.00	78% above	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CON	$1,950.00	$3,250.00	$994.50–$2,925.00	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LTD/FOLLOW UP	$400.80	$668.00	$35.20–$601.20	10% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LTD/FOLLOW UP	$400.80	$668.00	$204.41–$601.20	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS COMP (NONOBSTETRIC)	$576.00	$960.00	$84.15–$864.00	1% below	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS COMP (NONOBSTETRIC)	$576.00	$960.00	$293.76–$864.00	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREGNANT UTERUS>14WKS	$1,057.80	$1,763.00	$84.51–$1,586.70	72% above	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREGNANT UTERUS>14WKS	$1,057.80	$1,763.00	$539.48–$1,586.70	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UTERUS 1ST TRI <14WKS	$824.40	$1,374.00	$84.51–$1,236.60	47% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG UTERUS 1ST TRI <14WKS	$824.40	$1,374.00	$420.44–$1,236.60	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANT UTERUS LTD	$630.00	$1,050.00	$70.40–$945.00	18% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANT UTERUS LTD	$630.00	$1,050.00	$321.30–$945.00	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT MIN 2 VWS	$456.60	$761.00	$29.15–$684.90	36% above	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILAT MIN 2 VWS	$456.60	$761.00	$232.87–$684.90	—	40%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 RIBS UNI W/PA CXR MIN 3VW	$456.60	$761.00	$29.15–$684.90	11% above	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 RIBS UNI W/PA CXR MIN 3VW	$456.60	$761.00	$232.87–$684.90	—	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER MIN 2 VIEWS	$456.60	$761.00	$28.41–$684.90	35% above	40%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER MIN 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUS COMP MIN 3 VWS	$456.60	$761.00	$37.27–$684.90	8% above	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUS COMP MIN 3 VWS	$456.60	$761.00	$232.87–$684.90	—	40%
Skull X-ray, fewer than 4 views CPT 70250 SKULL <4 VIEWS	$456.60	$761.00	$34.97–$684.90	28% above	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL <4 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
Sleep study in a lab (polysomnography) CPT 95810 PSG 9+PARAM ATTENDED	$5,773.80	$9,623.00	$381.22–$8,660.70	67% above	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG 9+PARAM ATTENDED	$5,773.80	$9,623.00	$2,944.64–$8,660.70	—	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMP (MD SUPERVISD)	$2,034.00	$3,390.00	$204.09–$3,051.00	12% above	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TTE COMP (MD SUPERVISD)	$2,034.00	$3,390.00	$1,037.34–$3,051.00	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FUNC ESOPH	$873.00	$1,455.00	$50.60–$1,309.50	48% above	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOWING FUNC ESOPH	$873.00	$1,455.00	$445.23–$1,309.50	—	40%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/>	$456.60	$761.00	$14.89–$684.90	15% above	40%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 X-RAY EXAM OF FEMUR 2/>	$456.60	$761.00	$232.87–$684.90	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO CON	$1,950.00	$3,250.00	$84.51–$2,925.00	66% above	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE WO CON	$1,950.00	$3,250.00	$994.50–$2,925.00	—	40%
Toe X-ray, 2 or more views CPT 73660 TOE(S) MIN 2 VIEWS	$456.60	$761.00	$20.01–$684.90	63% above	40%
Toe X-ray, 2 or more views inpatient CPT 73660 TOE(S) MIN 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$1,408.20	$2,347.00	$84.15–$2,112.30	151% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$1,408.20	$2,347.00	$718.18–$2,112.30	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANT UTERUS TRANSVAG	$1,408.20	$2,347.00	$84.51–$2,112.30	155% above	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANT UTERUS TRANSVAG	$1,408.20	$2,347.00	$718.18–$2,112.30	—	40%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL COMPLETE	$1,969.80	$3,283.00	$84.51–$2,954.70	151% above	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL COMPLETE	$1,969.80	$3,283.00	$1,004.60–$2,954.70	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM TESTES	$741.60	$1,236.00	$81.40–$1,112.40	20% above	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM TESTES	$741.60	$1,236.00	$378.22–$1,112.40	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID/NECK/SOFT TISSUE	$585.00	$975.00	$83.98–$877.50	2% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID/NECK/SOFT TISSUE	$585.00	$975.00	$298.35–$877.50	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W WO DLAYED FILMS W WO KUB	$939.00	$1,565.00	$71.50–$1,408.50	49% above	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W WO DLAYED FILMS W WO KUB	$939.00	$1,565.00	$478.89–$1,408.50	—	40%
Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS MIN 2 VIEWS	$456.60	$761.00	$27.84–$684.90	65% above	40%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HUMERUS MIN 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX VENOUS UNIL OR LTD	$807.00	$1,345.00	$84.51–$1,210.50	26% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 IMAGING VENOUS UP/LWR EXT UNI	$807.00	$1,345.00	$84.51–$1,210.50	26% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX VENOUS UPR UNIL OR LTD	$807.00	$1,345.00	$84.51–$1,210.50	26% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 PORT DUP EX VEINS UNI/LTD	$807.00	$1,345.00	$84.51–$1,210.50	26% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUP EX VEINS W/COM-MAN UNI/LTD	$807.00	$1,345.00	$84.51–$1,210.50	26% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX VENOUS LWR UNIL OR LTD	$807.00	$1,345.00	$84.51–$1,210.50	26% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX VENOUS UPR UNIL OR LTD	$807.00	$1,345.00	$411.57–$1,210.50	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 PORT DUP EX VEINS UNI/LTD	$807.00	$1,345.00	$411.57–$1,210.50	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX VENOUS LWR UNIL OR LTD	$807.00	$1,345.00	$411.57–$1,210.50	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUP EX VEINS W/COM-MAN UNI/LTD	$807.00	$1,345.00	$411.57–$1,210.50	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX VENOUS UNIL OR LTD	$807.00	$1,345.00	$411.57–$1,210.50	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 IMAGING VENOUS UP/LWR EXT UNI	$807.00	$1,345.00	$411.57–$1,210.50	—	40%
Wrist X-ray, 2 views CPT 73100 WRIST 2 VIEWS	$456.60	$761.00	$29.52–$684.90	66% above	40%
Wrist X-ray, 2 views inpatient CPT 73100 WRIST 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST MIN 3 VIEWS	$456.60	$761.00	$30.73–$684.90	42% above	40%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST MIN 3 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$456.60	$761.00	$19.54–$684.90	29% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW	$456.60	$761.00	$10.93–$684.90	63% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW	$456.60	$761.00	$232.87–$684.90	—	40%
X-ray of the ankle, 2 views CPT 73600 ANKLE 2 VIEWS	$456.60	$761.00	$24.66–$684.90	35% above	40%
X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
X-ray of the finger(s), 2 or more views CPT 73140 FINGER(S) MIN 2 VIEWS	$456.60	$761.00	$25.21–$684.90	89% above	40%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER(S) MIN 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
X-ray of the foot, 2 views CPT 73620 FOOT 2 VIEWS	$456.60	$761.00	$28.57–$684.90	41% above	40%
X-ray of the foot, 2 views inpatient CPT 73620 FOOT 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
X-ray of the foot, complete, 3 or more views CPT 73630 FOOT MIN 3 VIEWS	$456.60	$761.00	$31.05–$684.90	25% above	40%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT MIN 3 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
X-ray of the hand, 3 or more views CPT 73130 HAND MIN 3 VIEWS	$456.60	$761.00	$26.60–$684.90	54% above	40%
X-ray of the hand, 3 or more views inpatient CPT 73130 HAND MIN 3 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1 OR 2 VIEWS	$456.60	$761.00	$29.99–$684.90	62% above	40%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE 1 OR 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBOSACRAL 2-3 VIEWS	$456.60	$761.00	$34.08–$684.90	25% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMBOSACRAL 2-3 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBOSAC MIN 4 VWS	$765.60	$1,276.00	$40.28–$1,148.40	69% above	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBOSAC MIN 4 VWS	$765.60	$1,276.00	$390.46–$1,148.40	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE THORACIC 2 VIEWS	$456.60	$761.00	$34.03–$684.90	25% above	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE THORACIC 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES COMP MIN 3 VWS	$456.60	$761.00	$20.90–$684.90	68% above	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES COMP MIN 3 VWS	$456.60	$761.00	$232.87–$684.90	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 3 VIEWS OR LESS	$456.60	$761.00	$29.15–$684.90	37% above	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 3 VIEWS OR LESS	$456.60	$761.00	$232.87–$684.90	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2 VIEWS	$456.60	$761.00	$19.25–$684.90	56% above	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 OR 2 VIEWS	$456.60	$761.00	$232.87–$684.90	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM & COCCYX MIN 2 VWS	$456.60	$761.00	$26.99–$684.90	36% above	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM & COCCYX MIN 2 VWS	$456.60	$761.00	$232.87–$684.90	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
ACTH blood test CPT 82024 ACTH PLASMA 2 SPECIMENS	$289.20	$482.00	$32.19–$433.80	30% above	40%
ACTH blood test CPT 82024 ACTH ADRENOCORTICOTROPIC HORMN	$289.20	$482.00	$32.19–$433.80	30% above	40%
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE	$289.20	$482.00	$32.19–$433.80	30% above	40%
ACTH blood test CPT 82024 ADRENOCORT HORMONE PLASMA	$289.20	$482.00	$32.19–$433.80	30% above	40%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE	$289.20	$482.00	$147.49–$433.80	—	40%
ACTH blood test inpatient CPT 82024 ACTH PLASMA 2 SPECIMENS	$289.20	$482.00	$147.49–$433.80	—	40%
ACTH blood test inpatient CPT 82024 ADRENOCORT HORMONE PLASMA	$289.20	$482.00	$147.49–$433.80	—	40%
ACTH blood test inpatient CPT 82024 ACTH ADRENOCORTICOTROPIC HORMN	$289.20	$482.00	$147.49–$433.80	—	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT P8027	$44.40	$74.00	$4.42–$66.60	22% above	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO(ALT)(SGPT) P3356	$44.40	$74.00	$4.42–$66.60	22% above	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT/ALT	$44.40	$74.00	$4.42–$66.60	22% above	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO P3896	$44.40	$74.00	$4.42–$66.60	22% above	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO P9445	$44.40	$74.00	$4.42–$66.60	22% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO P3896	$44.40	$74.00	$22.64–$66.60	—	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT/ALT	$44.40	$74.00	$22.64–$66.60	—	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO P9445	$44.40	$74.00	$22.64–$66.60	—	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO(ALT)(SGPT) P3356	$44.40	$74.00	$22.64–$66.60	—	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT P8027	$44.40	$74.00	$22.64–$66.60	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST)(SGOT) P3356	$43.80	$73.00	$4.32–$65.70	21% above	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT/AST	$43.80	$73.00	$4.32–$65.70	21% above	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE P9445	$43.80	$73.00	$4.32–$65.70	21% above	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST P8027	$43.80	$73.00	$4.32–$65.70	21% above	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT/AST	$43.80	$73.00	$22.34–$65.70	—	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST P8027	$43.80	$73.00	$22.34–$65.70	—	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE P9445	$43.80	$73.00	$22.34–$65.70	—	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE (AST)(SGOT) P3356	$43.80	$73.00	$22.34–$65.70	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$591.00	$985.00	$39.70–$886.50	91% above	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$591.00	$985.00	$301.41–$886.50	—	40%
Albumin blood test CPT 82040 ALBUMIN SERUM P4556	$42.00	$70.00	$4.01–$63.00	31% above	40%
Albumin blood test CPT 82040 ALBUMIN SERUM P8027	$42.00	$70.00	$4.01–$63.00	31% above	40%
Albumin blood test CPT 82040 ALBUMIN SERUM PNL 2260	$42.00	$70.00	$4.01–$63.00	31% above	40%
Albumin blood test CPT 82040 ALBUMIN SERUM P8000	$42.00	$70.00	$4.01–$63.00	31% above	40%
Albumin blood test CPT 82040 ALBUMIN SERUM	$42.00	$70.00	$4.01–$63.00	31% above	40%
Albumin blood test CPT 82040 ALBUMIN	$42.00	$70.00	$4.01–$63.00	31% above	40%
Albumin blood test CPT 82040 ALBUMIN P0913	$42.00	$70.00	$4.01–$63.00	31% above	40%
Albumin blood test CPT 82040 ALBUMIN PNL	$42.00	$70.00	$4.01–$63.00	31% above	40%
Albumin blood test CPT 82040 ALBUMIN SERUM P2435	$42.00	$70.00	$4.01–$63.00	31% above	40%
Albumin blood test CPT 82040 ALBUMIN IN SERUM PNL 1810	$42.00	$70.00	$4.01–$63.00	31% above	40%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM P8027	$42.00	$70.00	$21.42–$63.00	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN PNL	$42.00	$70.00	$21.42–$63.00	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN IN SERUM PNL 1810	$42.00	$70.00	$21.42–$63.00	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM P2435	$42.00	$70.00	$21.42–$63.00	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM P8000	$42.00	$70.00	$21.42–$63.00	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$42.00	$70.00	$21.42–$63.00	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN P0913	$42.00	$70.00	$21.42–$63.00	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM P4556	$42.00	$70.00	$21.42–$63.00	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM PNL 2260	$42.00	$70.00	$21.42–$63.00	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN	$42.00	$70.00	$21.42–$63.00	—	40%
Aldosterone blood test CPT 82088 ALDOSTERONE P2402	$306.60	$511.00	$28.60–$459.90	47% above	40%
Aldosterone blood test CPT 82088 ALDOSTERONE	$306.60	$511.00	$28.60–$459.90	47% above	40%
Aldosterone blood test CPT 82088 ALDOSTERONE UPRIGHT	$306.60	$511.00	$28.60–$459.90	47% above	40%
Aldosterone blood test CPT 82088 ALDOSTERONE ADRENAL VEIN	$306.60	$511.00	$28.60–$459.90	47% above	40%
Aldosterone blood test CPT 82088 ALDOSTERONE P4328	$306.60	$511.00	$28.60–$459.90	47% above	40%
Aldosterone blood test CPT 82088 ALDOSTERONE 24HR URINE	$306.60	$511.00	$28.60–$459.90	47% above	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE ADRENAL VEIN	$306.60	$511.00	$156.37–$459.90	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE P2402	$306.60	$511.00	$156.37–$459.90	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$306.60	$511.00	$156.37–$459.90	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE UPRIGHT	$306.60	$511.00	$156.37–$459.90	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE P4328	$306.60	$511.00	$156.37–$459.90	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE 24HR URINE	$306.60	$511.00	$156.37–$459.90	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 TOTAL ALP PNL 1480	$43.80	$73.00	$4.32–$65.70	20% above	40%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$43.80	$73.00	$4.32–$65.70	20% above	40%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE BONE	$43.80	$73.00	$4.32–$65.70	20% above	40%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE ALKALINE P3374	$43.80	$73.00	$4.32–$65.70	20% above	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 TOTAL ALP PNL 1480	$43.80	$73.00	$22.34–$65.70	—	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE BONE	$43.80	$73.00	$22.34–$65.70	—	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$43.80	$73.00	$22.34–$65.70	—	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE ALKALINE P3374	$43.80	$73.00	$22.34–$65.70	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALRGY PNL18 NUT MIX GRP 7918X	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN LATEX IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 BREWERS YEAST IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDR IGE W/RFLX TO COM PN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY MOLD PANEL COMPLETE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL REGION 5 TREES	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 BLACK OLIVE IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 CASEIN ALLERGEN PNL 5416	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 AL SPEC IGE CRUDE XTR EA P7115	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD AND TREE NUT ALLERGY PN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PN REGION 6 GRASSES	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE QUANT P1246	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK COMPONENT PANEL	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SINGLE ORDER	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG MIX IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PINE(T213)IGE ALLERGEN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER (EPITHEL) ALLERGEN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PN 13 STINGNG INSCT GR	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 COWS MILK COMPONENT PANEL	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PAPAIN (K201) IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PNL 16 VEGETABLE GRP	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE P0861	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SWEET POTATO IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 MAPLE (BOX ELDER) TREE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PNL W/REFLEXES	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG COMPONENT PANEL	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SWEET GUM IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 OXEYE DAISY IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 GALACTSE-ALPHA-1 3-GALACTS IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDR IGE W/RFLX TO COM PN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL REGION 6 WEEDS	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 POSACONAZOLE(CLINICAL PHARMA)	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE EPITHELIA IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PAPRIKA IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 TREE OF HEAVEN IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 CHERRY IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA ALLERGEN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL MOLD GROUP	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 TREE NUT ALL PN W/REFL TO COMP	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE ALLERGEN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CULT RYE GRASS IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RED MAPLE IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG YOLK ALLERGEN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 THISTLE (RUSSIAN) ALLERGEN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE FUSARM SOLAN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 BRUSSEL SPROUTS (F217) IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ZUCCHINI (CUCURBITA SPP) IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT IGE W/RFX COMP PN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK ALLERGEN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 RABBIT IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 BANANA IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT TL RFX TO PEANT COM PN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 B TROPICALIS IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 OCTOPUS (F59) IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ACREMONIUM KILIENSE IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY ALLERGEN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE TUMERIC C.LONGA	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PSYLLIUM SEED IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN ALLERGEN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SUGAR BEET IGE (ALLERGEN)	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 EUROGLYPHUS MAYNEI IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 LIME IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 BLUE MUSSEL ALLERGEN PNL 5410	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH ALLERGEN PNL 5410	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 CRAB ALLERGEN PNL 5410	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECI IGE EA ALLERGEN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER ALLERGEN PNL 5410	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 LEMON IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP ALLERGEN PNL 5410	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MAPLE SUGAR SPEC IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT ALLERGEN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIN V IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEY IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE P0722	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITEFISH IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIN G IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY/SHELLFISH PANEL	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY INSECT VENOM PANEL	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 CABBAGE IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PEAR IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 LAMBS QUARTER ALLERGEN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SQUID IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PUMPKIN IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WATERMELON IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 RED CEDAR IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIUS T. ALLERGEN	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 GOAT EPITHELIA IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ASPARAGUS IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 TILAPIA IGE	$57.60	$96.00	$4.35–$86.40	78% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WATERMELON IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECI IGE EA ALLERGEN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE P0722	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SQUID IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE P0861	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TREE OF HEAVEN IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BANANA IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PSYLLIUM SEED IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LIME IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LEMON IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIN V IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIN G IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEAR IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RED CEDAR IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ASPARAGUS IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LATEX IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASEIN ALLERGEN PNL 5416	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SINGLE ORDER	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER (EPITHEL) ALLERGEN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAPLE (BOX ELDER) TREE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE EPITHELIA IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA ALLERGEN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE ALLERGEN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG YOLK ALLERGEN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK ALLERGEN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 B TROPICALIS IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY ALLERGEN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN ALLERGEN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EUROGLYPHUS MAYNEI IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLUE MUSSEL ALLERGEN PNL 5410	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH ALLERGEN PNL 5410	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAB ALLERGEN PNL 5410	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER ALLERGEN PNL 5410	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP ALLERGEN PNL 5410	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT ALLERGEN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEY IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITEFISH IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY/SHELLFISH PANEL	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CABBAGE IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMBS QUARTER ALLERGEN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PUMPKIN IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIUS T. ALLERGEN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOAT EPITHELIA IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TILAPIA IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALRGY PNL18 NUT MIX GRP 7918X	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BREWERS YEAST IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLACK OLIVE IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE QUANT P1246	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK COMPONENT PANEL	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG MIX IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PN 13 STINGNG INSCT GR	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PNL 16 VEGETABLE GRP	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET POTATO IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD ALLERGY PNL W/REFLEXES	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG COMPONENT PANEL	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET GUM IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OXEYE DAISY IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GALACTSE-ALPHA-1 3-GALACTS IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 POSACONAZOLE(CLINICAL PHARMA)	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPRIKA IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHERRY IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL MOLD GROUP	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TREE NUT ALL PN W/REFL TO COMP	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CULT RYE GRASS IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RED MAPLE IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 THISTLE (RUSSIAN) ALLERGEN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT IGE W/RFX COMP PN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RABBIT IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT TL RFX TO PEANT COM PN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OCTOPUS (F59) IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ACREMONIUM KILIENSE IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLG SPEC IGE TUMERIC C.LONGA	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ZUCCHINI (CUCURBITA SPP) IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRUSSEL SPROUTS (F217) IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE FUSARM SOLAN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL REGION 6 WEEDS	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPAIN (K201) IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COWS MILK COMPONENT PANEL	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PN REGION 6 GRASSES	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD AND TREE NUT ALLERGY PN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AL SPEC IGE CRUDE XTR EA P7115	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL REGION 5 TREES	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY MOLD PANEL COMPLETE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDR IGE W/RFLX TO COM PN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDR IGE W/RFLX TO COM PN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINE(T213)IGE ALLERGEN	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY INSECT VENOM PANEL	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MAPLE SUGAR SPEC IGE	$57.60	$96.00	$29.38–$86.40	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SUGAR BEET IGE (ALLERGEN)	$57.60	$96.00	$29.38–$86.40	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP ANALYSIS-SERUM P0010	$222.00	$370.00	$13.98–$333.00	102% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP SERUM (STAND ALONE)	$222.00	$370.00	$13.98–$333.00	102% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETAPROTEIN	$222.00	$370.00	$13.98–$333.00	102% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN MATRN SERUM	$222.00	$370.00	$13.98–$333.00	102% above	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN MATRN SERUM	$222.00	$370.00	$113.22–$333.00	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP SERUM (STAND ALONE)	$222.00	$370.00	$113.22–$333.00	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP ANALYSIS-SERUM P0010	$222.00	$370.00	$113.22–$333.00	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETAPROTEIN	$222.00	$370.00	$113.22–$333.00	—	40%
Ammonia blood test CPT 82140 AMMONIA	$141.00	$235.00	$5.50–$211.50	55% above	40%
Ammonia blood test CPT 82140 AMMONIA P7923	$141.00	$235.00	$5.50–$211.50	55% above	40%
Ammonia blood test inpatient CPT 82140 AMMONIA	$141.00	$235.00	$71.91–$211.50	—	40%
Ammonia blood test inpatient CPT 82140 AMMONIA P7923	$141.00	$235.00	$71.91–$211.50	—	40%
Amylase blood test CPT 82150 AMYLASE	$111.60	$186.00	$5.40–$167.40	155% above	40%
Amylase blood test CPT 82150 AMYLASE URINE	$111.60	$186.00	$5.40–$167.40	155% above	40%
Amylase blood test inpatient CPT 82150 AMYLASE URINE	$111.60	$186.00	$56.92–$167.40	—	40%
Amylase blood test inpatient CPT 82150 AMYLASE	$111.60	$186.00	$56.92–$167.40	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLIN PEPTIDE P3164	$100.20	$167.00	$10.80–$150.30	18% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYC CITRULLIN PEPTIDE AB P5076	$100.20	$167.00	$10.80–$150.30	18% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY P4660	$100.20	$167.00	$10.80–$150.30	18% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULINATED PEPT P4307	$100.20	$167.00	$10.80–$150.30	18% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLIN PEPTIDE P4262	$100.20	$167.00	$10.80–$150.30	18% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 QUANT NOT OTHERWISE SPEC P3885	$100.20	$167.00	$10.80–$150.30	18% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINE PEP IGG	$100.20	$167.00	$10.80–$150.30	18% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP	$100.20	$167.00	$10.80–$150.30	18% above	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYC CITRULLIN PEPTIDE AB P5076	$100.20	$167.00	$51.10–$150.30	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY P4660	$100.20	$167.00	$51.10–$150.30	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 QUANT NOT OTHERWISE SPEC P3885	$100.20	$167.00	$51.10–$150.30	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLIN PEPTIDE P4262	$100.20	$167.00	$51.10–$150.30	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULINATED PEPT P4307	$100.20	$167.00	$51.10–$150.30	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI-CCP	$100.20	$167.00	$51.10–$150.30	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLIN PEPTIDE P3164	$100.20	$167.00	$51.10–$150.30	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINE PEP IGG	$100.20	$167.00	$51.10–$150.30	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA ANTIBODIES P4769	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA IFA W/RFX TITR/PAT/SCL ABS	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P8130	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA W/REFLEX LUPUS/SLE	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CENTROMERE AB W/TITER REFLEX	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANACHOICE SPEC ANTI CASCADING	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 TITER P3355	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANACHOICE SCREEN W/RFX DSDNA	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCR IFA W/RFX TITR&PAT/MIX	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI-NUCLEAR ANTIBODIES P1920	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P4312	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P4184	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P4307	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P4262	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA (ANTI NUCLEAR ANTIBODIES)	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P5091	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA P4660	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB ANA P5076	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA IFA W/RFLX TITR/CASCADE	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P9430	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P5919	$131.40	$219.00	$10.08–$197.10	77% above	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P4307	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P5091	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA P4660	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR AB ANA P5076	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA ANTIBODIES P4769	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA W/REFLEX LUPUS/SLE	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCR IFA W/RFX TITR&PAT/MIX	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P4312	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA IFA W/RFLX TITR/CASCADE	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P4262	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P4184	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI-NUCLEAR ANTIBODIES P1920	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P8130	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA IFA W/RFX TITR/PAT/SCL ABS	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P5919	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P9430	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANACHOICE SCREEN W/RFX DSDNA	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 TITER P3355	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANACHOICE SPEC ANTI CASCADING	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CENTROMERE AB W/TITER REFLEX	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA (ANTI NUCLEAR ANTIBODIES)	$131.40	$219.00	$67.01–$197.10	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR AB	$131.40	$219.00	$67.01–$197.10	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO BNP N TERMINAL	$342.00	$570.00	$32.73–$513.00	72% above	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATIURETIC PEPTIDE	$342.00	$570.00	$32.73–$513.00	72% above	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 CARDIO IQ NT PROBNP	$342.00	$570.00	$32.73–$513.00	72% above	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PRO BNP N TERMINAL	$342.00	$570.00	$174.42–$513.00	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 CARDIO IQ NT PROBNP	$342.00	$570.00	$174.42–$513.00	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATIURETIC PEPTIDE	$342.00	$570.00	$174.42–$513.00	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 NOCARDIA CULT AND GRAM STAIN	$121.20	$202.00	$7.19–$181.80	132% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CF SPUTUM	$121.20	$202.00	$7.19–$181.80	132% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC	$121.20	$202.00	$7.19–$181.80	132% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 THROAT CULTURE	$121.20	$202.00	$7.19–$181.80	132% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC	$121.20	$202.00	$61.81–$181.80	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 THROAT CULTURE	$121.20	$202.00	$61.81–$181.80	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CF SPUTUM	$121.20	$202.00	$61.81–$181.80	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 NOCARDIA CULT AND GRAM STAIN	$121.20	$202.00	$61.81–$181.80	—	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$198.60	$331.00	$7.05–$297.90	156% above	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$198.60	$331.00	$101.29–$297.90	—	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL P3356	$58.80	$98.00	$4.18–$88.20	84% above	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL P6317	$58.80	$98.00	$4.18–$88.20	84% above	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL P3896	$58.80	$98.00	$4.18–$88.20	84% above	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL P9445	$58.80	$98.00	$4.18–$88.20	84% above	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TTL	$58.80	$98.00	$4.18–$88.20	84% above	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL P9445	$58.80	$98.00	$29.99–$88.20	—	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TTL	$58.80	$98.00	$29.99–$88.20	—	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL P3356	$58.80	$98.00	$29.99–$88.20	—	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL P6317	$58.80	$98.00	$29.99–$88.20	—	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL P3896	$58.80	$98.00	$29.99–$88.20	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL 4 GROSS & MICRO EXAM	$415.80	$693.00	$27.62–$623.70	135% above	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK	$415.80	$693.00	$27.62–$623.70	135% above	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 BONE MARROW CORE(S) ONLY	$415.80	$693.00	$27.62–$623.70	135% above	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 EM LEVEL 4 SURG PATH EXAM	$415.80	$693.00	$27.62–$623.70	135% above	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL 4 GROSS & MICRO EXAM	$415.80	$693.00	$212.06–$623.70	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CELL BLOCK	$415.80	$693.00	$212.06–$623.70	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 EM LEVEL 4 SURG PATH EXAM	$415.80	$693.00	$212.06–$623.70	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 BONE MARROW CORE(S) ONLY	$415.80	$693.00	$212.06–$623.70	—	40%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$146.40	$244.00	$8.60–$219.60	73% above	40%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$146.40	$244.00	$74.66–$219.60	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ROUTINE PCI STAFF	$18.00	$30.00	$0.02–$27.00	20% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ROUTINE SPEC COLL	$18.00	$30.00	$0.02–$27.00	20% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ROUTINE LAB STAFF	$18.00	$30.00	$0.02–$27.00	20% above	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ROUTINE SPEC COLL	$18.00	$30.00	$9.18–$27.00	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ROUTINE PCI STAFF	$18.00	$30.00	$9.18–$27.00	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ROUTINE LAB STAFF	$18.00	$30.00	$9.18–$27.00	—	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT P8027	$33.60	$56.00	$3.28–$50.40	30% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE SERUM QUANT	$33.60	$56.00	$3.28–$50.40	30% above	40%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLD QUANT P3356	$33.60	$56.00	$3.28–$50.40	30% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT P9445	$33.60	$56.00	$3.28–$50.40	30% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD STAT ICU	$33.60	$56.00	$3.28–$50.40	30% above	40%
Blood glucose (sugar) test inpatient CPT 82947 ASSAY GLUCOSE BLD QUANT P3356	$33.60	$56.00	$17.14–$50.40	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE SERUM QUANT	$33.60	$56.00	$17.14–$50.40	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BLOOD STAT ICU	$33.60	$56.00	$17.14–$50.40	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT P8027	$33.60	$56.00	$17.14–$50.40	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT P9445	$33.60	$56.00	$17.14–$50.40	—	40%
Blood lead test CPT 83655 LEAD BLOOD PNL 2787	$85.20	$142.00	$10.09–$127.80	9% above	40%
Blood lead test CPT 83655 RANDOM URINE LEAD PNL 7901	$90.60	$151.00	$10.09–$135.90	16% above	40%
Blood lead test CPT 83655 LEAD P6242	$90.60	$151.00	$10.09–$135.90	16% above	40%
Blood lead test CPT 83655 LEAD CAPILLARY	$90.60	$151.00	$10.09–$135.90	16% above	40%
Blood lead test CPT 83655 LEAD WHOLE BLOOD	$90.60	$151.00	$10.09–$135.90	16% above	40%
Blood lead test CPT 83655 LEAD RAND URINE PNL 1750	$90.60	$151.00	$10.09–$135.90	16% above	40%
Blood lead test CPT 83655 LEAD BLOOD OSHA	$90.60	$151.00	$10.09–$135.90	16% above	40%
Blood lead test CPT 83655 LEAD 24HR URINE PNL 5331	$90.60	$151.00	$10.09–$135.90	16% above	40%
Blood lead test inpatient CPT 83655 LEAD BLOOD PNL 2787	$85.20	$142.00	$43.45–$127.80	—	40%
Blood lead test inpatient CPT 83655 LEAD BLOOD OSHA	$90.60	$151.00	$46.21–$135.90	—	40%
Blood lead test inpatient CPT 83655 LEAD 24HR URINE PNL 5331	$90.60	$151.00	$46.21–$135.90	—	40%
Blood lead test inpatient CPT 83655 LEAD RAND URINE PNL 1750	$90.60	$151.00	$46.21–$135.90	—	40%
Blood lead test inpatient CPT 83655 LEAD WHOLE BLOOD	$90.60	$151.00	$46.21–$135.90	—	40%
Blood lead test inpatient CPT 83655 RANDOM URINE LEAD PNL 7901	$90.60	$151.00	$46.21–$135.90	—	40%
Blood lead test inpatient CPT 83655 LEAD CAPILLARY	$90.60	$151.00	$46.21–$135.90	—	40%
Blood lead test inpatient CPT 83655 LEAD P6242	$90.60	$151.00	$46.21–$135.90	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 URINE PREGNANCY TEST	$90.60	$151.00	$6.27–$135.90	81% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 POC URINE HCG QUAL CLINITEK	$90.60	$151.00	$6.27–$135.90	81% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE	$90.60	$151.00	$6.27–$135.90	81% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 POC URINE HCG QUAL CLINITEK	$90.60	$151.00	$46.21–$135.90	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 URINE PREGNANCY TEST	$90.60	$151.00	$46.21–$135.90	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUALITATIVE	$90.60	$151.00	$46.21–$135.90	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ISOHEMAGGLUTIN TITER IGG & IGM	$24.60	$41.00	$2.49–$36.90	82% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING ABO	$24.60	$41.00	$2.49–$36.90	82% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO DISCREPANCY	$24.60	$41.00	$2.49–$36.90	82% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$24.60	$41.00	$2.49–$36.90	82% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING P2168	$24.60	$41.00	$2.49–$36.90	82% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$24.60	$41.00	$2.49–$36.90	82% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 NEONATAL ABO FORWARD GROUP(55)	$24.60	$41.00	$2.49–$36.90	82% below	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ISOHEMAGGLUTIN TITER IGG & IGM	$24.60	$41.00	$12.55–$36.90	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING P2168	$24.60	$41.00	$12.55–$36.90	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING ABO	$24.60	$41.00	$12.55–$36.90	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 NEONATAL ABO FORWARD GROUP(55)	$24.60	$41.00	$12.55–$36.90	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO DISCREPANCY	$24.60	$41.00	$12.55–$36.90	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$24.60	$41.00	$12.55–$36.90	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING SEROLOGIC ABO	$24.60	$41.00	$12.55–$36.90	—	40%
Blood urea nitrogen (BUN) test CPT 84520 BUN	$33.60	$56.00	$3.29–$50.40	24% above	40%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN P4233	$33.60	$56.00	$3.29–$50.40	24% above	40%
Blood urea nitrogen (BUN) test CPT 84520 BUN PNL 1714	$33.60	$56.00	$3.29–$50.40	24% above	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN PNL 1714	$33.60	$56.00	$17.14–$50.40	—	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN P4233	$33.60	$56.00	$17.14–$50.40	—	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$33.60	$56.00	$17.14–$50.40	—	40%
C-peptide blood test CPT 84681 C PEPTIDE	$315.00	$525.00	$17.35–$472.50	190% above	40%
C-peptide blood test CPT 84681 C-PEPTIDE P4981	$315.00	$525.00	$17.35–$472.50	190% above	40%
C-peptide blood test CPT 84681 C-PEPTIDE	$315.00	$525.00	$17.35–$472.50	190% above	40%
C-peptide blood test inpatient CPT 84681 C PEPTIDE	$315.00	$525.00	$160.65–$472.50	—	40%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE P4981	$315.00	$525.00	$160.65–$472.50	—	40%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$315.00	$525.00	$160.65–$472.50	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$133.20	$222.00	$3.30–$199.80	273% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN	$133.20	$222.00	$3.30–$199.80	273% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN P6330	$133.20	$222.00	$3.30–$199.80	273% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN	$133.20	$222.00	$67.93–$199.80	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$133.20	$222.00	$67.93–$199.80	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN P6330	$133.20	$222.00	$67.93–$199.80	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE DNA	$438.00	$730.00	$31.07–$657.00	111% above	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C-DIFF BY PCR	$438.00	$730.00	$31.07–$657.00	111% above	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE DNA	$438.00	$730.00	$223.38–$657.00	—	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C-DIFF BY PCR	$438.00	$730.00	$223.38–$657.00	—	40%
CA 19-9 blood test (tumor marker) CPT 86301 CANCER ANTIGEN-GI (CA 19-9)	$213.60	$356.00	$17.35–$320.40	61% above	40%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-1/CA 19-9 TUMOR MARKER	$213.60	$356.00	$17.35–$320.40	61% above	40%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9/FLUID	$213.60	$356.00	$17.35–$320.40	61% above	40%
CA 19-9 blood test (tumor marker) CPT 86301 CA ANTIGEN-GI(CA 19-9)BODY FL	$213.60	$356.00	$17.35–$320.40	61% above	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CANCER ANTIGEN-GI (CA 19-9)	$213.60	$356.00	$108.94–$320.40	—	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA ANTIGEN-GI(CA 19-9)BODY FL	$213.60	$356.00	$108.94–$320.40	—	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9/FLUID	$213.60	$356.00	$108.94–$320.40	—	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-1/CA 19-9 TUMOR MARKER	$213.60	$356.00	$108.94–$320.40	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 TUMOR MARKER	$210.00	$350.00	$17.35–$315.00	60% above	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 TUMOR MARKER	$210.00	$350.00	$107.10–$315.00	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 IN AG DET NU AC(RNAORDNA)P5068	$75.00	$125.00	$34.88–$305.01	18% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 TEST	$75.00	$125.00	$34.88–$305.01	18% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 IN AG DET NU AC(RNAORDNA)P5060	$75.00	$125.00	$34.88–$305.01	18% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 INF AG DET AMP PRB TEC COVID19	$75.00	$125.00	$34.88–$305.01	18% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 IN AG DET NU AC(RNAORDNA)P5063	$75.00	$125.00	$34.88–$305.01	18% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 SARS COVID19/2 RNA QL RT-PCR	$75.00	$125.00	$34.88–$305.01	18% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 IN AG DET NU AC(RNAORDNA)P5060	$75.00	$125.00	$38.25–$112.50	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 TEST	$75.00	$125.00	$38.25–$112.50	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 IN AG DET NU AC(RNAORDNA)P5068	$75.00	$125.00	$38.25–$112.50	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 IN AG DET NU AC(RNAORDNA)P5063	$75.00	$125.00	$38.25–$112.50	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 INF AG DET AMP PRB TEC COVID19	$75.00	$125.00	$38.25–$112.50	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 SARS COVID19/2 RNA QL RT-PCR	$75.00	$125.00	$38.25–$112.50	—	40%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$43.80	$73.00	$4.30–$65.70	30% above	40%
Calcium blood test, total CPT 82310 CALCIUM TOTAL P6970	$43.80	$73.00	$4.30–$65.70	30% above	40%
Calcium blood test, total CPT 82310 CALCIUM (SERUM) PNL 2511	$43.80	$73.00	$4.30–$65.70	30% above	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM (SERUM) PNL 2511	$43.80	$73.00	$22.34–$65.70	—	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL P6970	$43.80	$73.00	$22.34–$65.70	—	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$43.80	$73.00	$22.34–$65.70	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC AG	$194.40	$324.00	$15.81–$291.60	64% above	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC AG	$194.40	$324.00	$99.14–$291.60	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGM	$128.40	$214.00	$10.74–$192.60	52% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER VIRUS AB	$128.40	$214.00	$10.74–$192.60	52% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER P7969	$128.40	$214.00	$10.74–$192.60	52% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER P1665	$128.40	$214.00	$10.74–$192.60	52% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 HERPES ZOSTER AB IGG	$128.40	$214.00	$10.74–$192.60	52% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB - IGG	$128.40	$214.00	$10.74–$192.60	52% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOST AB IMM SCR ACIF	$128.40	$214.00	$10.74–$192.60	52% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 HERPES ZOSTER AB IGM OSL	$128.40	$214.00	$10.74–$192.60	52% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER P0786	$128.40	$214.00	$10.74–$192.60	52% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB PANEL CSF	$128.40	$214.00	$10.74–$192.60	52% above	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER P7969	$128.40	$214.00	$65.48–$192.60	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOST AB IMM SCR ACIF	$128.40	$214.00	$65.48–$192.60	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER P0786	$128.40	$214.00	$65.48–$192.60	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER VIRUS AB	$128.40	$214.00	$65.48–$192.60	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HERPES ZOSTER AB IGG	$128.40	$214.00	$65.48–$192.60	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER P1665	$128.40	$214.00	$65.48–$192.60	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HERPES ZOSTER AB IGM OSL	$128.40	$214.00	$65.48–$192.60	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB - IGG	$128.40	$214.00	$65.48–$192.60	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB PANEL CSF	$128.40	$214.00	$65.48–$192.60	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGM	$128.40	$214.00	$65.48–$192.60	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS RNA TMA	$286.80	$478.00	$25.51–$430.20	46% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS PCR	$286.80	$478.00	$25.51–$430.20	46% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS P8866	$286.80	$478.00	$25.51–$430.20	46% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRCH AMP PROBE P9292	$286.80	$478.00	$25.51–$430.20	46% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH DNA AMP PR P4792	$286.80	$478.00	$25.51–$430.20	46% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS P4224	$286.80	$478.00	$25.51–$430.20	46% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACH MISC SITES NAA	$286.80	$478.00	$25.51–$430.20	46% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMATIS TMA UROGENIIAL	$286.80	$478.00	$25.51–$430.20	46% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS P2460	$286.80	$478.00	$25.51–$430.20	46% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMY TRACH DNA AMP PRBE P3411	$286.80	$478.00	$25.51–$430.20	46% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS P7084	$286.80	$478.00	$25.51–$430.20	46% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLMY TRACH DNA AMP PRBE P3411	$286.80	$478.00	$146.27–$430.20	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS RNA TMA	$286.80	$478.00	$146.27–$430.20	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS PCR	$286.80	$478.00	$146.27–$430.20	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS P8866	$286.80	$478.00	$146.27–$430.20	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRCH AMP PROBE P9292	$286.80	$478.00	$146.27–$430.20	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACH DNA AMP PR P4792	$286.80	$478.00	$146.27–$430.20	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS P4224	$286.80	$478.00	$146.27–$430.20	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACH MISC SITES NAA	$286.80	$478.00	$146.27–$430.20	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C TRACHOMATIS TMA UROGENIIAL	$286.80	$478.00	$146.27–$430.20	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS P2460	$286.80	$478.00	$146.27–$430.20	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS P7084	$286.80	$478.00	$146.27–$430.20	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$241.20	$402.00	$11.16–$361.80	170% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL W/RFX LDL	$241.20	$402.00	$11.16–$361.80	170% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL P8093	$241.20	$402.00	$11.16–$361.80	170% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIO IQ LIPID PANEL	$241.20	$402.00	$11.16–$361.80	170% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARD IQ LIPID PN W/REF DIR LDL	$241.20	$402.00	$11.16–$361.80	170% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL P4483	$241.20	$402.00	$11.16–$361.80	170% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL P5181	$241.20	$402.00	$11.16–$361.80	170% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL 2	$241.20	$402.00	$11.16–$361.80	170% above	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL P8093	$241.20	$402.00	$123.01–$361.80	—	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARDIO IQ LIPID PANEL	$241.20	$402.00	$123.01–$361.80	—	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL W/RFX LDL	$241.20	$402.00	$123.01–$361.80	—	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$241.20	$402.00	$123.01–$361.80	—	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARD IQ LIPID PN W/REF DIR LDL	$241.20	$402.00	$123.01–$361.80	—	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL 2	$241.20	$402.00	$123.01–$361.80	—	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL P5181	$241.20	$402.00	$123.01–$361.80	—	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL P4483	$241.20	$402.00	$123.01–$361.80	—	40%
Complete blood count (CBC) with differential CPT 85025 OXLDL	$66.60	$111.00	$6.48–$99.90	30% above	40%
Complete blood count (CBC) with differential CPT 85025 CBC & PLT & AUTO COMP DIFF	$66.60	$111.00	$6.48–$99.90	30% above	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC & PLT & AUTO COMP DIFF	$66.60	$111.00	$33.97–$99.90	—	40%
Complete blood count (CBC) with differential inpatient CPT 85025 OXLDL	$66.60	$111.00	$33.97–$99.90	—	40%
Complete blood count (CBC), no differential CPT 85027 CBC & PLT ONLY	$76.20	$127.00	$5.39–$114.30	76% above	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC & PLT ONLY	$76.20	$127.00	$38.86–$114.30	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$289.20	$482.00	$8.80–$433.80	227% above	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOL PN P5147	$289.20	$482.00	$8.80–$433.80	227% above	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$289.20	$482.00	$147.49–$433.80	—	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOL PN P5147	$289.20	$482.00	$147.49–$433.80	—	40%
Cortisol blood test, total CPT 82533 CORTISOL	$159.00	$265.00	$13.20–$238.50	54% above	40%
Cortisol blood test, total CPT 82533 CORTISOL SERUM	$159.00	$265.00	$13.20–$238.50	54% above	40%
Cortisol blood test, total CPT 82533 AM CORTISOL	$159.00	$265.00	$13.20–$238.50	54% above	40%
Cortisol blood test, total CPT 82533 CORTISOL BASELINE PNL 1964	$159.00	$265.00	$13.20–$238.50	54% above	40%
Cortisol blood test, total CPT 82533 CORTISOL 30 MINUTE PNL 1964	$159.00	$265.00	$13.20–$238.50	54% above	40%
Cortisol blood test, total CPT 82533 CORTISOL 60 MINUTE PNL 1964	$159.00	$265.00	$13.20–$238.50	54% above	40%
Cortisol blood test, total CPT 82533 DEXAMETHASONE SUPPRESSION	$159.00	$265.00	$13.20–$238.50	54% above	40%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL LC/MS/MS	$159.00	$265.00	$13.20–$238.50	54% above	40%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$159.00	$265.00	$13.20–$238.50	54% above	40%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL P4328	$159.00	$265.00	$13.20–$238.50	54% above	40%
Cortisol blood test, total CPT 82533 SALIVARY CORTISOL	$159.00	$265.00	$13.20–$238.50	54% above	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL 30 MINUTE PNL 1964	$159.00	$265.00	$81.09–$238.50	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL P4328	$159.00	$265.00	$81.09–$238.50	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$159.00	$265.00	$81.09–$238.50	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL LC/MS/MS	$159.00	$265.00	$81.09–$238.50	—	40%
Cortisol blood test, total inpatient CPT 82533 DEXAMETHASONE SUPPRESSION	$159.00	$265.00	$81.09–$238.50	—	40%
Cortisol blood test, total inpatient CPT 82533 SALIVARY CORTISOL	$159.00	$265.00	$81.09–$238.50	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL SERUM	$159.00	$265.00	$81.09–$238.50	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL	$159.00	$265.00	$81.09–$238.50	—	40%
Cortisol blood test, total inpatient CPT 82533 AM CORTISOL	$159.00	$265.00	$81.09–$238.50	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL 60 MINUTE PNL 1964	$159.00	$265.00	$81.09–$238.50	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL BASELINE PNL 1964	$159.00	$265.00	$81.09–$238.50	—	40%
Creatine kinase (CK) blood test, total CPT 82550 CK (CPK) TOTAL	$168.00	$280.00	$5.43–$252.00	273% above	40%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE P2392	$168.00	$280.00	$5.43–$252.00	273% above	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE P2392	$168.00	$280.00	$85.68–$252.00	—	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK (CPK) TOTAL	$168.00	$280.00	$85.68–$252.00	—	40%
Creatinine blood test CPT 82565 CREATININE SERUM	$43.80	$73.00	$4.27–$65.70	30% above	40%
Creatinine blood test CPT 82565 CREATININE P4233	$43.80	$73.00	$4.27–$65.70	30% above	40%
Creatinine blood test CPT 82565 GFR ESTIMATE	$43.80	$73.00	$4.27–$65.70	30% above	40%
Creatinine blood test CPT 82565 CREATININE PNL 1714	$43.80	$73.00	$4.27–$65.70	30% above	40%
Creatinine blood test inpatient CPT 82565 CREATININE P4233	$43.80	$73.00	$22.34–$65.70	—	40%
Creatinine blood test inpatient CPT 82565 CREATININE PNL 1714	$43.80	$73.00	$22.34–$65.70	—	40%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM	$43.80	$73.00	$22.34–$65.70	—	40%
Creatinine blood test inpatient CPT 82565 GFR ESTIMATE	$43.80	$73.00	$22.34–$65.70	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG AVIDITY INDEX	$203.40	$339.00	$12.00–$305.10	135% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG	$203.40	$339.00	$12.00–$305.10	135% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS IGG AB PNL8733	$203.40	$339.00	$12.00–$305.10	135% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS P0786	$203.40	$339.00	$12.00–$305.10	135% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS(CMV)(IGG)AB	$203.40	$339.00	$12.00–$305.10	135% above	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS(CMV)(IGG)AB	$203.40	$339.00	$103.73–$305.10	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG AVIDITY INDEX	$203.40	$339.00	$103.73–$305.10	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS IGG AB PNL8733	$203.40	$339.00	$103.73–$305.10	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS P0786	$203.40	$339.00	$103.73–$305.10	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG	$203.40	$339.00	$103.73–$305.10	—	40%
D-dimer blood test (blood clot marker) CPT 85379 QUANTITATIVE P2395	$76.20	$127.00	$8.49–$114.30	11% above	40%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER QUANTITATIVE BCS	$76.20	$127.00	$8.49–$114.30	11% above	40%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER P P7021	$76.20	$127.00	$8.49–$114.30	11% above	40%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE	$76.20	$127.00	$8.49–$114.30	11% above	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 QUANTITATIVE P2395	$76.20	$127.00	$38.86–$114.30	—	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER P P7021	$76.20	$127.00	$38.86–$114.30	—	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER QUANTITATIVE BCS	$76.20	$127.00	$38.86–$114.30	—	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE	$76.20	$127.00	$38.86–$114.30	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$289.20	$482.00	$18.53–$433.80	115% above	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S (ESOTERIX)	$289.20	$482.00	$18.53–$433.80	115% above	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$289.20	$482.00	$18.53–$433.80	115% above	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S (ESOTERIX)	$289.20	$482.00	$147.49–$433.80	—	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$289.20	$482.00	$147.49–$433.80	—	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$289.20	$482.00	$147.49–$433.80	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN P8040	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN P4015	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 SYNTHETIC CANNABINOIDS SCREEN	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OXYCODONE QUAL URN RES ONLY	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PAIN MANAGEMENT AMPHETAMINES	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DTM FENTANYL WITH CONF URINE	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 SYN CANNABINOID MET SCR-EXP UR	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHANOL	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 AMPHETAMINE QUAL	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 POSTMORTEM BASIC BLD FORENSIC	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TRICYCLICS QUAL	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 NOVEL PSYCHOACT SUBST SCR 2	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OXYCODONE QL URINE	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BUPRENORPHINE SCREEN URINE	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE TOX7 W/O THC+OXY+BUP	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN P4177	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BENZODIAZEPNS CONFRM URINE ARU	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONITORING W/CONF URINE	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRG TST PRSMV CHEM ANLY P3352	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HYPOGLYCEMIC AGNT SCR SER MAYO	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN COMPR URINE UCDS	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRG TOX MON ETHYL AL W/CONF UR	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG CLASS SNGL METHOD P0560	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 IMMUNOASSAY EACH DRUG CL P1261	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN FORENSIC(GC/MS)UR	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 POSTMORTEM EXPD SER FORENSIC	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PM ALCOHOL METABOLITE W/CONF	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TOX 10+ALCOHOL/URINE	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE DRUGS OF ABUSE SCREEN	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 NICOTINE AND METABOLITE	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 NICOTINE-COTININE URINE	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BUPRENORPHINE RESEARCH ONLY	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PROPOXYPHENE SCREEN/CONF	$441.60	$736.00	$51.75–$662.40	143% above	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE DRUGS OF ABUSE SCREEN	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ACETAMINOPHEN P4177	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHANOL	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 AMPHETAMINE QUAL	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TRICYCLICS QUAL	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OXYCODONE QL URINE	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BUPRENORPHINE SCREEN URINE	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE TOX7 W/O THC+OXY+BUP	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BENZODIAZEPNS CONFRM URINE ARU	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HYPOGLYCEMIC AGNT SCR SER MAYO	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN COMPR URINE UCDS	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG CLASS SNGL METHOD P0560	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 IMMUNOASSAY EACH DRUG CL P1261	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TOX 10+ALCOHOL/URINE	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NICOTINE AND METABOLITE	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NICOTINE-COTININE URINE	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BUPRENORPHINE RESEARCH ONLY	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PROPOXYPHENE SCREEN/CONF	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN P8040	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN P4015	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SYNTHETIC CANNABINOIDS SCREEN	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OXYCODONE QUAL URN RES ONLY	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PAIN MANAGEMENT AMPHETAMINES	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DTM FENTANYL WITH CONF URINE	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SYN CANNABINOID MET SCR-EXP UR	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NOVEL PSYCHOACT SUBST SCR 2	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 POSTMORTEM BASIC BLD FORENSIC	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRG TOX MON ETHYL AL W/CONF UR	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRG TST PRSMV CHEM ANLY P3352	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONITORING W/CONF URINE	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN FORENSIC(GC/MS)UR	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 POSTMORTEM EXPD SER FORENSIC	$441.60	$736.00	$225.22–$662.40	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PM ALCOHOL METABOLITE W/CONF	$441.60	$736.00	$225.22–$662.40	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$159.00	$265.00	$5.84–$238.50	201% above	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES	$159.00	$265.00	$5.84–$238.50	201% above	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES	$159.00	$265.00	$81.09–$238.50	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$159.00	$265.00	$81.09–$238.50	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID AG IGG	$133.20	$222.00	$15.12–$199.80	16% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV (VCA) IGM PNL 1380	$133.20	$222.00	$15.12–$199.80	16% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV (VCA) IGG PNL 1380	$133.20	$222.00	$15.12–$199.80	16% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV IGM VCA	$133.20	$222.00	$15.12–$199.80	16% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV IGG VCA	$133.20	$222.00	$15.12–$199.80	16% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID AG IGM	$133.20	$222.00	$15.12–$199.80	16% above	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV (VCA) IGG PNL 1380	$133.20	$222.00	$67.93–$199.80	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID AG IGG	$133.20	$222.00	$67.93–$199.80	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV IGG VCA	$133.20	$222.00	$67.93–$199.80	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV IGM VCA	$133.20	$222.00	$67.93–$199.80	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV (VCA) IGM PNL 1380	$133.20	$222.00	$67.93–$199.80	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID AG IGM	$133.20	$222.00	$67.93–$199.80	—	40%
Estradiol blood test CPT 82670 ESTRADIOL (E2)	$459.00	$765.00	$23.29–$688.50	176% above	40%
Estradiol blood test CPT 82670 ESTRADIOL E2 TOTAL	$459.00	$765.00	$23.29–$688.50	176% above	40%
Estradiol blood test CPT 82670 ESTRADIOL EXTRACTION	$459.00	$765.00	$23.29–$688.50	176% above	40%
Estradiol blood test CPT 82670 ESTRADIOL/FREE/SERUM	$459.00	$765.00	$23.29–$688.50	176% above	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL E2 TOTAL	$459.00	$765.00	$234.09–$688.50	—	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL (E2)	$459.00	$765.00	$234.09–$688.50	—	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL/FREE/SERUM	$459.00	$765.00	$234.09–$688.50	—	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL EXTRACTION	$459.00	$765.00	$234.09–$688.50	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMO	$156.00	$260.00	$15.49–$234.00	31% above	40%
FSH (follicle-stimulating hormone) test CPT 83001 FSH PNL 2828	$156.00	$260.00	$15.49–$234.00	31% above	40%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE	$156.00	$260.00	$15.49–$234.00	31% above	40%
FSH (follicle-stimulating hormone) test CPT 83001 FSH/3RD GENERATION	$156.00	$260.00	$15.49–$234.00	31% above	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH PNL 2828	$156.00	$260.00	$79.56–$234.00	—	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH/3RD GENERATION	$156.00	$260.00	$79.56–$234.00	—	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMO	$156.00	$260.00	$79.56–$234.00	—	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE	$156.00	$260.00	$79.56–$234.00	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL	$257.40	$429.00	$16.36–$386.10	99% above	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN STOOL	$257.40	$429.00	$131.27–$386.10	—	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$178.20	$297.00	$11.36–$267.30	106% above	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN P9262	$178.20	$297.00	$11.36–$267.30	106% above	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN P5087	$178.20	$297.00	$11.36–$267.30	106% above	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN P9262	$178.20	$297.00	$90.88–$267.30	—	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$178.20	$297.00	$90.88–$267.30	—	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN P5087	$178.20	$297.00	$90.88–$267.30	—	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN ASSAY	$80.40	$134.00	$8.10–$120.60	22% above	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN CLAUSS P P7021	$80.40	$134.00	$8.10–$120.60	22% above	40%
Fibrinogen blood test CPT 85384 PERC LYSIS 30 MIN W/HEPARINASE	$80.40	$134.00	$8.10–$120.60	22% above	40%
Fibrinogen blood test CPT 85384 MA WITH HEPARINASE TEG	$80.40	$134.00	$8.10–$120.60	22% above	40%
Fibrinogen blood test CPT 85384 ALPHA (ANGLE) W/HEPARINASE TEG	$80.40	$134.00	$8.10–$120.60	22% above	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY CLAUSS	$80.40	$134.00	$8.10–$120.60	22% above	40%
Fibrinogen blood test inpatient CPT 85384 PERC LYSIS 30 MIN W/HEPARINASE	$80.40	$134.00	$41.00–$120.60	—	40%
Fibrinogen blood test inpatient CPT 85384 MA WITH HEPARINASE TEG	$80.40	$134.00	$41.00–$120.60	—	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY CLAUSS	$80.40	$134.00	$41.00–$120.60	—	40%
Fibrinogen blood test inpatient CPT 85384 ALPHA (ANGLE) W/HEPARINASE TEG	$80.40	$134.00	$41.00–$120.60	—	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ASSAY	$80.40	$134.00	$41.00–$120.60	—	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN CLAUSS P P7021	$80.40	$134.00	$41.00–$120.60	—	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM PNL 2979	$142.20	$237.00	$12.25–$213.30	64% above	40%
Folate (folic acid) blood test CPT 82746 FOLATE SERUM	$142.20	$237.00	$12.25–$213.30	64% above	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE SERUM	$142.20	$237.00	$72.52–$213.30	—	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM PNL 2979	$142.20	$237.00	$72.52–$213.30	—	40%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$149.40	$249.00	$14.12–$224.10	40% above	40%
Free T3 thyroid hormone test CPT 84481 DIRECT FREE T3	$149.40	$249.00	$14.12–$224.10	40% above	40%
Free T3 thyroid hormone test CPT 84481 FREE T3 PNL 2257	$149.40	$249.00	$14.12–$224.10	40% above	40%
Free T3 thyroid hormone test inpatient CPT 84481 DIRECT FREE T3	$149.40	$249.00	$76.19–$224.10	—	40%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 PNL 2257	$149.40	$249.00	$76.19–$224.10	—	40%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$149.40	$249.00	$76.19–$224.10	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 EQUILBRIUM DIALYSIS	$176.40	$294.00	$7.52–$264.60	194% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4-DIALY & HPLC-MS/MS ESO	$176.40	$294.00	$7.52–$264.60	194% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 (THYROXINE) FREE S	$176.40	$294.00	$7.52–$264.60	194% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE ANALOG METHOD	$176.40	$294.00	$7.52–$264.60	194% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 DIRECT FREE T4 (THYROXINE)	$176.40	$294.00	$7.52–$264.60	194% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE	$176.40	$294.00	$7.52–$264.60	194% above	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4-DIALY & HPLC-MS/MS ESO	$176.40	$294.00	$89.96–$264.60	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 EQUILBRIUM DIALYSIS	$176.40	$294.00	$89.96–$264.60	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 DIRECT FREE T4 (THYROXINE)	$176.40	$294.00	$89.96–$264.60	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE	$176.40	$294.00	$89.96–$264.60	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE ANALOG METHOD	$176.40	$294.00	$89.96–$264.60	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 (THYROXINE) FREE S	$176.40	$294.00	$89.96–$264.60	—	40%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$322.80	$538.00	$21.23–$484.20	102% above	40%
Free testosterone test CPT 84402 FREE TESTOSTERONE PNL 1540	$322.80	$538.00	$21.23–$484.20	102% above	40%
Free testosterone test CPT 84402 TESTOSTERONE FREE P4882	$322.80	$538.00	$21.23–$484.20	102% above	40%
Free testosterone test inpatient CPT 84402 FREE TESTOSTERONE PNL 1540	$322.80	$538.00	$164.63–$484.20	—	40%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$322.80	$538.00	$164.63–$484.20	—	40%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE P4882	$322.80	$538.00	$164.63–$484.20	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGTP(GAMMA GLUTAMYL TRANSF)	$134.40	$224.00	$6.00–$201.60	182% above	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANS GAMMA GGT P3896	$134.40	$224.00	$6.00–$201.60	182% above	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$134.40	$224.00	$6.00–$201.60	182% above	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GGT P3356	$134.40	$224.00	$6.00–$201.60	182% above	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE P9445	$134.40	$224.00	$6.00–$201.60	182% above	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GLUTAMYLTRANSFERASE P9445	$134.40	$224.00	$68.54–$201.60	—	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GLUTAMYLTRANS GAMMA GGT P3896	$134.40	$224.00	$68.54–$201.60	—	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 ASSAY OF GGT P3356	$134.40	$224.00	$68.54–$201.60	—	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGTP(GAMMA GLUTAMYL TRANSF)	$134.40	$224.00	$68.54–$201.60	—	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$134.40	$224.00	$68.54–$201.60	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST 1HR POST GLUCOLA	$39.60	$66.00	$3.96–$59.40	7% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TEST 1HR POST GLUCOLA	$39.60	$66.00	$20.20–$59.40	—	40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 SPECIMENS	$112.80	$188.00	$10.73–$169.20	39% above	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 SPECIMENS	$112.80	$188.00	$57.53–$169.20	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHOEAE AMPL PROBE P1815	$286.80	$478.00	$25.51–$430.20	56% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE P2460	$286.80	$478.00	$25.51–$430.20	56% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORR DNA AMP PRB P3411	$286.80	$478.00	$25.51–$430.20	56% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE P7084	$286.80	$478.00	$25.51–$430.20	56% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE PCR ONLY	$286.80	$478.00	$25.51–$430.20	56% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE P4224	$286.80	$478.00	$25.51–$430.20	56% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHOEAE TMA UROGENITAL	$286.80	$478.00	$25.51–$430.20	56% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHOEAE DNA AMP PR P4792	$286.80	$478.00	$25.51–$430.20	56% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSRIA GONOR AMP PROBE P9292	$286.80	$478.00	$25.51–$430.20	56% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISERIA GONORRHOEAE P8866	$286.80	$478.00	$25.51–$430.20	56% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE PCR ONLY	$286.80	$478.00	$146.27–$430.20	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE P7084	$286.80	$478.00	$146.27–$430.20	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORR DNA AMP PRB P3411	$286.80	$478.00	$146.27–$430.20	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE P2460	$286.80	$478.00	$146.27–$430.20	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHOEAE TMA UROGENITAL	$286.80	$478.00	$146.27–$430.20	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE P4224	$286.80	$478.00	$146.27–$430.20	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHOEAE DNA AMP PR P4792	$286.80	$478.00	$146.27–$430.20	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSRIA GONOR AMP PROBE P9292	$286.80	$478.00	$146.27–$430.20	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISERIA GONORRHOEAE P8866	$286.80	$478.00	$146.27–$430.20	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHOEAE AMPL PROBE P1815	$286.80	$478.00	$146.27–$430.20	—	40%
H. pylori stool antigen test CPT 87338 ANTIGEN QUALITATIVE STOOL	$130.20	$217.00	$11.99–$195.30	35% above	40%
H. pylori stool antigen test inpatient CPT 87338 ANTIGEN QUALITATIVE STOOL	$130.20	$217.00	$66.40–$195.30	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-QUANT	$882.60	$1,471.00	$70.94–$1,323.90	78% above	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA/QUANT/REAL-TIME PCR	$882.60	$1,471.00	$70.94–$1,323.90	78% above	40%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 HIV-1 RNA QN RT-PCR CSF	$882.60	$1,471.00	$70.94–$1,323.90	78% above	40%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 HIV-1 RBA QN RT-PCR W/RFX GENO	$882.60	$1,471.00	$70.94–$1,323.90	78% above	40%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 HIV-1 RNA QN RT-PCR RFX IN GN	$882.60	$1,471.00	$70.94–$1,323.90	78% above	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA/QUANT/REAL-TIME PCR	$882.60	$1,471.00	$450.13–$1,323.90	—	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-QUANT	$882.60	$1,471.00	$450.13–$1,323.90	—	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 HIV-1 RNA QN RT-PCR RFX IN GN	$882.60	$1,471.00	$450.13–$1,323.90	—	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 HIV-1 RNA QN RT-PCR CSF	$882.60	$1,471.00	$450.13–$1,323.90	—	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 HIV-1 RBA QN RT-PCR W/RFX GENO	$882.60	$1,471.00	$450.13–$1,323.90	—	40%
HIV-1 and HIV-2 antibody test CPT 86703 DONOR HIV-1/2 AB SCREEN	$93.00	$155.00	$11.43–$139.50	10% below	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 DONOR HIV-1/2 AB SCREEN	$93.00	$155.00	$47.43–$139.50	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 AG/AB 4TH GEN W/RFX	$200.40	$334.00	$20.07–$300.60	41% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/HIV 2 ANTIBODY	$200.40	$334.00	$20.07–$300.60	41% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV AG/AB 5TH GENERATION	$200.40	$334.00	$20.07–$300.60	41% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 AG/AB 4TH GEN W/RFX	$200.40	$334.00	$102.20–$300.60	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV AG/AB 5TH GENERATION	$200.40	$334.00	$102.20–$300.60	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/HIV 2 ANTIBODY	$200.40	$334.00	$102.20–$300.60	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA HIGH RISK	$355.80	$593.00	$29.25–$533.70	71% above	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 ORARISK HPV	$355.80	$593.00	$29.25–$533.70	71% above	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV MRNA E6/E7 POST-HYSTER VAG	$355.80	$593.00	$29.25–$533.70	71% above	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK TYPES	$355.80	$593.00	$29.25–$533.70	71% above	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV MRNA E6/E7 RECTAL	$355.80	$593.00	$29.25–$533.70	71% above	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV MRNA E6/E7 RECTAL	$355.80	$593.00	$181.46–$533.70	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV MRNA E6/E7 POST-HYSTER VAG	$355.80	$593.00	$181.46–$533.70	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 ORARISK HPV	$355.80	$593.00	$181.46–$533.70	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA HIGH RISK	$355.80	$593.00	$181.46–$533.70	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH RISK TYPES	$355.80	$593.00	$181.46–$533.70	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED	$114.60	$191.00	$7.70–$171.90	125% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMAGLOBIN GLYCOSYLATED	$114.60	$191.00	$7.70–$171.90	125% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$114.60	$191.00	$7.70–$171.90	125% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C WITH EAG	$114.60	$191.00	$7.70–$171.90	125% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLBN A1C&MEAN PLASMA GLUCO	$114.60	$191.00	$7.70–$171.90	125% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 CARDIO IQ HA1C	$114.60	$191.00	$7.70–$171.90	125% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLBN A1C&MEAN PLASMA GLUCO	$114.60	$191.00	$58.45–$171.90	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 CARDIO IQ HA1C	$114.60	$191.00	$58.45–$171.90	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED	$114.60	$191.00	$58.45–$171.90	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$114.60	$191.00	$58.45–$171.90	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C WITH EAG	$114.60	$191.00	$58.45–$171.90	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMAGLOBIN GLYCOSYLATED	$114.60	$191.00	$58.45–$171.90	—	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN P0581	$61.20	$102.00	$1.98–$91.80	257% above	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN P9262	$61.20	$102.00	$1.98–$91.80	257% above	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$61.20	$102.00	$1.98–$91.80	257% above	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN P9262	$61.20	$102.00	$31.21–$91.80	—	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$61.20	$102.00	$31.21–$91.80	—	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN P0581	$61.20	$102.00	$31.21–$91.80	—	40%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTAL P5760	$121.20	$202.00	$10.04–$181.80	44% above	40%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY IGG+IGM	$121.20	$202.00	$10.04–$181.80	44% above	40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB P9276	$121.20	$202.00	$10.04–$181.80	44% above	40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY	$121.20	$202.00	$10.04–$181.80	44% above	40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB TOT W/REFL	$121.20	$202.00	$10.04–$181.80	44% above	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB TOT W/REFL	$121.20	$202.00	$61.81–$181.80	—	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB P9276	$121.20	$202.00	$61.81–$181.80	—	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB TOTAL P5760	$121.20	$202.00	$61.81–$181.80	—	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY IGG+IGM	$121.20	$202.00	$61.81–$181.80	—	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY	$121.20	$202.00	$61.81–$181.80	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY	$131.40	$219.00	$8.95–$197.10	80% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY (EIA)	$131.40	$219.00	$8.95–$197.10	80% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB P9276	$131.40	$219.00	$8.95–$197.10	80% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB	$131.40	$219.00	$8.95–$197.10	80% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB P5760	$131.40	$219.00	$8.95–$197.10	80% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB P5760	$131.40	$219.00	$67.01–$197.10	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY	$131.40	$219.00	$67.01–$197.10	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY (EIA)	$131.40	$219.00	$67.01–$197.10	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB P9276	$131.40	$219.00	$67.01–$197.10	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB	$131.40	$219.00	$67.01–$197.10	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 DONOR HEPATITIS BS AG	$117.00	$195.00	$8.61–$175.50	68% above	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG P9276	$117.00	$195.00	$8.61–$175.50	68% above	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE ANTIGEN W/ REFLX	$117.00	$195.00	$8.61–$175.50	68% above	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$117.00	$195.00	$8.61–$175.50	68% above	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG	$117.00	$195.00	$8.61–$175.50	68% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE ANTIGEN W/ REFLX	$117.00	$195.00	$59.67–$175.50	—	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG P9276	$117.00	$195.00	$59.67–$175.50	—	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 DONOR HEPATITIS BS AG	$117.00	$195.00	$59.67–$175.50	—	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG	$117.00	$195.00	$59.67–$175.50	—	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$117.00	$195.00	$59.67–$175.50	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$168.00	$280.00	$11.90–$252.00	69% above	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEP C SCREENING BY ORAQUICK	$168.00	$280.00	$11.90–$252.00	69% above	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPC AB RF HCV RNA PCR RF LIPA	$168.00	$280.00	$11.90–$252.00	69% above	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB P9276	$168.00	$280.00	$11.90–$252.00	69% above	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C SCREENING BY ORAQUICK	$168.00	$280.00	$85.68–$252.00	—	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$168.00	$280.00	$85.68–$252.00	—	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB P9276	$168.00	$280.00	$85.68–$252.00	—	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPC AB RF HCV RNA PCR RF LIPA	$168.00	$280.00	$85.68–$252.00	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QN RL TME PCR W/RFX QL	$443.40	$739.00	$35.71–$665.10	56% above	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA BY PCR (QUANT)	$443.40	$739.00	$35.71–$665.10	56% above	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV-QUANT	$443.40	$739.00	$35.71–$665.10	56% above	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QN PCR W/RFL GENOTYPE	$443.40	$739.00	$35.71–$665.10	56% above	40%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HEP C VIR RNA QN RT-PCR W/RFX	$443.40	$739.00	$35.71–$665.10	56% above	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QN PCR W/RFL GENOTYPE	$443.40	$739.00	$226.13–$665.10	—	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA BY PCR (QUANT)	$443.40	$739.00	$226.13–$665.10	—	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV-QUANT	$443.40	$739.00	$226.13–$665.10	—	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QN RL TME PCR W/RFX QL	$443.40	$739.00	$226.13–$665.10	—	40%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HEP C VIR RNA QN RT-PCR W/RFX	$443.40	$739.00	$226.13–$665.10	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 P3408	$99.00	$165.00	$11.00–$148.50	24% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX AB IGM	$99.00	$165.00	$11.00–$148.50	24% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 IGG AB P0086	$99.00	$165.00	$11.00–$148.50	24% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HSV-1 IGG AB	$99.00	$165.00	$11.00–$148.50	24% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 P3731	$99.00	$165.00	$11.00–$148.50	24% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE I P0786	$99.00	$165.00	$11.00–$148.50	24% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 P3497	$99.00	$165.00	$11.00–$148.50	24% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGM TITER	$99.00	$165.00	$11.00–$148.50	24% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE I P7969	$99.00	$165.00	$11.00–$148.50	24% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE I P5909	$99.00	$165.00	$11.00–$148.50	24% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE I P3862	$99.00	$165.00	$11.00–$148.50	24% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX AB IGM	$99.00	$165.00	$50.49–$148.50	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 P3408	$99.00	$165.00	$50.49–$148.50	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE I P3862	$99.00	$165.00	$50.49–$148.50	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE I P5909	$99.00	$165.00	$50.49–$148.50	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE I P7969	$99.00	$165.00	$50.49–$148.50	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IGM TITER	$99.00	$165.00	$50.49–$148.50	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV-1 IGG AB	$99.00	$165.00	$50.49–$148.50	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 P3731	$99.00	$165.00	$50.49–$148.50	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 P3497	$99.00	$165.00	$50.49–$148.50	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE I P0786	$99.00	$165.00	$50.49–$148.50	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE 1 IGG AB P0086	$99.00	$165.00	$50.49–$148.50	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGG HERPESEL W/REFLEX	$200.40	$334.00	$16.13–$300.60	87% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 IGG AB P0086	$200.40	$334.00	$16.13–$300.60	87% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 HSV-2 IGG AB	$200.40	$334.00	$16.13–$300.60	87% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGM TITER	$200.40	$334.00	$16.13–$300.60	87% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 P3862	$200.40	$334.00	$16.13–$300.60	87% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 P3731	$200.40	$334.00	$16.13–$300.60	87% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 P7969	$200.40	$334.00	$16.13–$300.60	87% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 P3497	$200.40	$334.00	$16.13–$300.60	87% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 P3408	$200.40	$334.00	$16.13–$300.60	87% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGG HERPESELECT AB	$200.40	$334.00	$16.13–$300.60	87% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 P5909	$200.40	$334.00	$16.13–$300.60	87% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE II P0786	$200.40	$334.00	$16.13–$300.60	87% above	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE II P0786	$200.40	$334.00	$102.20–$300.60	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 P3862	$200.40	$334.00	$102.20–$300.60	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV-2 IGG AB	$200.40	$334.00	$102.20–$300.60	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGG HERPESEL W/REFLEX	$200.40	$334.00	$102.20–$300.60	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 P3408	$200.40	$334.00	$102.20–$300.60	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 P5909	$200.40	$334.00	$102.20–$300.60	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 IGG AB P0086	$200.40	$334.00	$102.20–$300.60	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 P7969	$200.40	$334.00	$102.20–$300.60	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGM TITER	$200.40	$334.00	$102.20–$300.60	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 P3731	$200.40	$334.00	$102.20–$300.60	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 P3497	$200.40	$334.00	$102.20–$300.60	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGG HERPESELECT AB	$200.40	$334.00	$102.20–$300.60	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY	$168.60	$281.00	$10.80–$252.90	115% above	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO IQ HS-CRP	$168.60	$281.00	$10.80–$252.90	115% above	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVITY CRP P8093	$168.60	$281.00	$10.80–$252.90	115% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HIGH SENSITIVITY CRP P8093	$168.60	$281.00	$85.99–$252.90	—	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY	$168.60	$281.00	$85.99–$252.90	—	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CARDIO IQ HS-CRP	$168.60	$281.00	$85.99–$252.90	—	40%
Homocysteine blood test CPT 83090 TOTAL HOMOCYSTEINE	$168.60	$281.00	$14.94–$252.90	41% above	40%
Homocysteine blood test CPT 83090 HOMOCYSTINE SERUM	$168.60	$281.00	$14.94–$252.90	41% above	40%
Homocysteine blood test CPT 83090 HOMOCYSTEINE NUTR/CONGNT P8743	$168.60	$281.00	$14.94–$252.90	41% above	40%
Homocysteine blood test CPT 83090 HOMOCYSTEINE P6881	$168.60	$281.00	$14.94–$252.90	41% above	40%
Homocysteine blood test CPT 83090 CARDIO IQ HOMOCYSTEINE	$168.60	$281.00	$14.94–$252.90	41% above	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE SERUM	$168.60	$281.00	$85.99–$252.90	—	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE P6881	$168.60	$281.00	$85.99–$252.90	—	40%
Homocysteine blood test inpatient CPT 83090 CARDIO IQ HOMOCYSTEINE	$168.60	$281.00	$85.99–$252.90	—	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE NUTR/CONGNT P8743	$168.60	$281.00	$85.99–$252.90	—	40%
Homocysteine blood test inpatient CPT 83090 TOTAL HOMOCYSTEINE	$168.60	$281.00	$85.99–$252.90	—	40%
Insulin blood test CPT 83525 INSULIN TOTAL P4981	$85.20	$142.00	$9.53–$127.80	17% above	40%
Insulin blood test CPT 83525 CARDIO IQ INSULIN	$85.20	$142.00	$9.53–$127.80	17% above	40%
Insulin blood test CPT 83525 INSULIN LEVEL SINGLE	$85.20	$142.00	$9.53–$127.80	17% above	40%
Insulin blood test CPT 83525 INSULIN TOTAL	$85.20	$142.00	$9.53–$127.80	17% above	40%
Insulin blood test CPT 83525 INSULIN	$85.20	$142.00	$9.53–$127.80	17% above	40%
Insulin blood test inpatient CPT 83525 CARDIO IQ INSULIN	$85.20	$142.00	$43.45–$127.80	—	40%
Insulin blood test inpatient CPT 83525 INSULIN LEVEL SINGLE	$85.20	$142.00	$43.45–$127.80	—	40%
Insulin blood test inpatient CPT 83525 INSULIN	$85.20	$142.00	$43.45–$127.80	—	40%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$85.20	$142.00	$43.45–$127.80	—	40%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL P4981	$85.20	$142.00	$43.45–$127.80	—	40%
Iron blood test (serum iron) CPT 83540 IRON P5087	$80.40	$134.00	$5.39–$120.60	76% above	40%
Iron blood test (serum iron) CPT 83540 IRON PNL 1160	$80.40	$134.00	$5.39–$120.60	76% above	40%
Iron blood test (serum iron) CPT 83540 FE	$80.40	$134.00	$5.39–$120.60	76% above	40%
Iron blood test (serum iron) CPT 83540 IRON P6970	$80.40	$134.00	$5.39–$120.60	76% above	40%
Iron blood test (serum iron) CPT 83540 IRON/RANDOM URINE	$80.40	$134.00	$5.39–$120.60	76% above	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON P5087	$80.40	$134.00	$41.00–$120.60	—	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON P6970	$80.40	$134.00	$41.00–$120.60	—	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON PNL 1160	$80.40	$134.00	$41.00–$120.60	—	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON/RANDOM URINE	$80.40	$134.00	$41.00–$120.60	—	40%
Iron blood test (serum iron) inpatient CPT 83540 FE	$80.40	$134.00	$41.00–$120.60	—	40%
Iron-binding capacity (TIBC) test CPT 83550 TIBC PNL 1160	$104.40	$174.00	$5.50–$156.60	75% above	40%
Iron-binding capacity (TIBC) test CPT 83550 TIBC	$104.40	$174.00	$5.50–$156.60	75% above	40%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY P5087	$104.40	$174.00	$5.50–$156.60	75% above	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC	$104.40	$174.00	$53.24–$156.60	—	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY P5087	$104.40	$174.00	$53.24–$156.60	—	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC PNL 1160	$104.40	$174.00	$53.24–$156.60	—	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$202.80	$338.00	$7.24–$304.20	196% above	40%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$202.80	$338.00	$103.43–$304.20	—	40%
LH (luteinizing hormone) test CPT 83002 LH/3RD GENERATION PNL 2828	$156.00	$260.00	$15.44–$234.00	31% above	40%
LH (luteinizing hormone) test CPT 83002 LH 3RD GENERATION	$156.00	$260.00	$15.44–$234.00	31% above	40%
LH (luteinizing hormone) test CPT 83002 LUTENIZING HORMONE	$156.00	$260.00	$15.44–$234.00	31% above	40%
LH (luteinizing hormone) test CPT 83002 LH	$156.00	$260.00	$15.44–$234.00	31% above	40%
LH (luteinizing hormone) test inpatient CPT 83002 LH 3RD GENERATION	$156.00	$260.00	$79.56–$234.00	—	40%
LH (luteinizing hormone) test inpatient CPT 83002 LH/3RD GENERATION PNL 2828	$156.00	$260.00	$79.56–$234.00	—	40%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$156.00	$260.00	$79.56–$234.00	—	40%
LH (luteinizing hormone) test inpatient CPT 83002 LUTENIZING HORMONE	$156.00	$260.00	$79.56–$234.00	—	40%
Lactate (lactic acid) blood test CPT 83605 D-LACTATE	$129.60	$216.00	$8.80–$194.40	69% above	40%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID PNL	$129.60	$216.00	$8.80–$194.40	69% above	40%
Lactate (lactic acid) blood test CPT 83605 LACTATE WHOLE BLOOD STAT ICU	$129.60	$216.00	$8.80–$194.40	69% above	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE WHOLE BLOOD STAT ICU	$129.60	$216.00	$66.10–$194.40	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID PNL	$129.60	$216.00	$66.10–$194.40	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 D-LACTATE	$129.60	$216.00	$66.10–$194.40	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE	$71.40	$119.00	$5.03–$107.10	94% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH-LACTIC DEHYDROGENASE	$71.40	$119.00	$5.03–$107.10	94% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 TOTAL LD PNL 1900	$71.40	$119.00	$5.03–$107.10	94% above	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE	$71.40	$119.00	$36.41–$107.10	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 TOTAL LD PNL 1900	$71.40	$119.00	$36.41–$107.10	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH-LACTIC DEHYDROGENASE	$71.40	$119.00	$36.41–$107.10	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE/RANDOM URINE	$130.20	$217.00	$5.50–$195.30	178% above	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE JP DRAINAGE	$130.20	$217.00	$5.50–$195.30	178% above	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$130.20	$217.00	$5.50–$195.30	178% above	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$130.20	$217.00	$66.40–$195.30	—	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE/RANDOM URINE	$130.20	$217.00	$66.40–$195.30	—	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE JP DRAINAGE	$130.20	$217.00	$66.40–$195.30	—	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$190.20	$317.00	$6.81–$285.30	144% above	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$190.20	$317.00	$97.00–$285.30	—	40%
Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI P2435	$129.60	$216.00	$14.20–$194.40	37% above	40%
Lyme disease antibody test CPT 86618 LYME POLYV AIB SCREEN W/REF	$129.60	$216.00	$14.20–$194.40	37% above	40%
Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI P8139	$129.60	$216.00	$14.20–$194.40	37% above	40%
Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI P0913	$129.60	$216.00	$14.20–$194.40	37% above	40%
Lyme disease antibody test CPT 86618 LYME DIS AB W/RFLX TO IMMUNOA	$129.60	$216.00	$14.20–$194.40	37% above	40%
Lyme disease antibody test CPT 86618 LYME DISEASE AB	$129.60	$216.00	$14.20–$194.40	37% above	40%
Lyme disease antibody test inpatient CPT 86618 LYME POLYV AIB SCREEN W/REF	$129.60	$216.00	$66.10–$194.40	—	40%
Lyme disease antibody test inpatient CPT 86618 BORRELIA BURGDORFERI P8139	$129.60	$216.00	$66.10–$194.40	—	40%
Lyme disease antibody test inpatient CPT 86618 LYME DIS AB W/RFLX TO IMMUNOA	$129.60	$216.00	$66.10–$194.40	—	40%
Lyme disease antibody test inpatient CPT 86618 BORRELIA BURGDORFERI P0913	$129.60	$216.00	$66.10–$194.40	—	40%
Lyme disease antibody test inpatient CPT 86618 BORRELIA BURGDORFERI P2435	$129.60	$216.00	$66.10–$194.40	—	40%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB	$129.60	$216.00	$66.10–$194.40	—	40%
Magnesium blood test CPT 83735 MAGNESIUM P6970	$57.00	$95.00	$5.59–$85.50	37% above	40%
Magnesium blood test CPT 83735 MAGNESIUM 24 HOUR URINE	$57.00	$95.00	$5.59–$85.50	37% above	40%
Magnesium blood test CPT 83735 MAGNESIUM FECAL	$57.00	$95.00	$5.59–$85.50	37% above	40%
Magnesium blood test CPT 83735 MAGNESIUM	$57.00	$95.00	$5.59–$85.50	37% above	40%
Magnesium blood test CPT 83735 MAGNESIUM RBC	$57.00	$95.00	$5.59–$85.50	37% above	40%
Magnesium blood test CPT 83735 MAGNESIUM/RANDOM URINE P1561	$57.00	$95.00	$5.59–$85.50	37% above	40%
Magnesium blood test CPT 83735 MAGNESIUM - 24HR URINE	$57.00	$95.00	$5.59–$85.50	37% above	40%
Magnesium blood test CPT 83735 MAGNESIUM P7923	$57.00	$95.00	$5.59–$85.50	37% above	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM P6970	$57.00	$95.00	$29.07–$85.50	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM/RANDOM URINE P1561	$57.00	$95.00	$29.07–$85.50	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM 24 HOUR URINE	$57.00	$95.00	$29.07–$85.50	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$57.00	$95.00	$29.07–$85.50	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM P7923	$57.00	$95.00	$29.07–$85.50	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM - 24HR URINE	$57.00	$95.00	$29.07–$85.50	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM FECAL	$57.00	$95.00	$29.07–$85.50	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC	$57.00	$95.00	$29.07–$85.50	—	40%
Measles (rubeola) antibody test CPT 86765 MEASLES AB IGM / RUBEOLA	$104.40	$174.00	$10.74–$156.60	30% above	40%
Measles (rubeola) antibody test CPT 86765 MEASLES RUBEOLA AB	$104.40	$174.00	$10.74–$156.60	30% above	40%
Measles (rubeola) antibody test CPT 86765 MEASLES ANTIBODY (IGG)	$104.40	$174.00	$10.74–$156.60	30% above	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA P7969	$104.40	$174.00	$10.74–$156.60	30% above	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA P3261	$104.40	$174.00	$10.74–$156.60	30% above	40%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES RUBEOLA AB	$104.40	$174.00	$53.24–$156.60	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES AB IGM / RUBEOLA	$104.40	$174.00	$53.24–$156.60	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES ANTIBODY (IGG)	$104.40	$174.00	$53.24–$156.60	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA P3261	$104.40	$174.00	$53.24–$156.60	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA P7969	$104.40	$174.00	$53.24–$156.60	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSPOT	$38.40	$64.00	$4.32–$57.60	3% above	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSPOT	$38.40	$64.00	$19.58–$57.60	—	40%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY - IGG	$90.60	$151.00	$10.88–$135.90	11% above	40%
Mumps immunity blood test CPT 86735 MUMPS P0786	$96.00	$160.00	$10.88–$144.00	18% above	40%
Mumps immunity blood test CPT 86735 MUMPS IGG	$96.00	$160.00	$10.88–$144.00	18% above	40%
Mumps immunity blood test CPT 86735 MUMPS P3261	$96.00	$160.00	$10.88–$144.00	18% above	40%
Mumps immunity blood test CPT 86735 MUMPS AB (IGG/M) PANEL	$96.00	$160.00	$10.88–$144.00	18% above	40%
Mumps immunity blood test CPT 86735 MUMPS P3862	$96.00	$160.00	$10.88–$144.00	18% above	40%
Mumps immunity blood test CPT 86735 MUMPS P7969	$96.00	$160.00	$10.88–$144.00	18% above	40%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY IGM	$96.00	$160.00	$10.88–$144.00	18% above	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY - IGG	$90.60	$151.00	$46.21–$135.90	—	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS P3862	$96.00	$160.00	$48.96–$144.00	—	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS P3261	$96.00	$160.00	$48.96–$144.00	—	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS P7969	$96.00	$160.00	$48.96–$144.00	—	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB (IGG/M) PANEL	$96.00	$160.00	$48.96–$144.00	—	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY IGM	$96.00	$160.00	$48.96–$144.00	—	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS P0786	$96.00	$160.00	$48.96–$144.00	—	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS IGG	$96.00	$160.00	$48.96–$144.00	—	40%
Obstetric blood test panel CPT 80055 OBSTETRICS PANEL	$320.40	$534.00	$13.20–$480.60	3% above	40%
Obstetric blood test panel inpatient CPT 80055 OBSTETRICS PANEL	$320.40	$534.00	$163.40–$480.60	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA PNL 2770	$265.80	$443.00	$15.33–$398.70	134% above	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA PNL 2770	$265.80	$443.00	$135.56–$398.70	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$183.60	$306.00	$15.33–$275.40	67% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 DIAGNOSTIC PSA	$183.60	$306.00	$15.33–$275.40	67% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 TOTAL PSA PNL 2770	$183.60	$306.00	$15.33–$275.40	67% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ULTRA-SENSITIVE	$183.60	$306.00	$15.33–$275.40	67% above	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$183.60	$306.00	$93.64–$275.40	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 DIAGNOSTIC PSA	$183.60	$306.00	$93.64–$275.40	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA ULTRA-SENSITIVE	$183.60	$306.00	$93.64–$275.40	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 TOTAL PSA PNL 2770	$183.60	$306.00	$93.64–$275.40	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP SMEAR DX THIN W/RESCREEN	$78.00	$130.00	$22.18–$226.81	5% below	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP SMEAR DX THIN W/RESCREEN	$78.00	$130.00	$39.78–$117.00	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN PREP-DIAGNOSTIC	$61.20	$102.00	$16.89–$142.85	at median	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN PREP-DIAGNOSTIC	$61.20	$102.00	$31.21–$91.80	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 INTACT PTH PNL 2511	$385.80	$643.00	$34.41–$578.70	77% above	40%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT(WITHOUT CALCIUM)	$385.80	$643.00	$34.41–$578.70	77% above	40%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE QUICK	$385.80	$643.00	$34.41–$578.70	77% above	40%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$385.80	$643.00	$34.41–$578.70	77% above	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT(WITHOUT CALCIUM)	$385.80	$643.00	$196.76–$578.70	—	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE QUICK	$385.80	$643.00	$196.76–$578.70	—	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 INTACT PTH PNL 2511	$385.80	$643.00	$196.76–$578.70	—	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$385.80	$643.00	$196.76–$578.70	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P3417	$47.40	$79.00	$5.01–$71.10	15% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT (APTT)	$47.40	$79.00	$5.01–$71.10	15% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 ACT PART THROMBOP TIME P P7021	$47.40	$79.00	$5.01–$71.10	15% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBPL TIME PART(PTT) P6881	$47.40	$79.00	$5.01–$71.10	15% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 ACTIVATED PTT	$47.40	$79.00	$5.01–$71.10	15% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPL TIME PARTL(PTT)P2441	$47.40	$79.00	$5.01–$71.10	15% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P2635	$47.40	$79.00	$5.01–$71.10	15% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL PROTHROMBIN TIME P4160	$47.40	$79.00	$5.01–$71.10	15% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P0267	$47.40	$79.00	$5.01–$71.10	15% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBO TIME PTT P0070	$47.40	$79.00	$5.01–$71.10	15% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT (BASELINE) PNL 5464	$47.40	$79.00	$5.01–$71.10	15% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT ACTIVATED	$47.40	$79.00	$5.01–$71.10	15% above	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT ACTIVATED	$47.40	$79.00	$24.17–$71.10	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPL TIME PARTL(PTT)P2441	$47.40	$79.00	$24.17–$71.10	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT (BASELINE) PNL 5464	$47.40	$79.00	$24.17–$71.10	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P3417	$47.40	$79.00	$24.17–$71.10	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBO TIME PTT P0070	$47.40	$79.00	$24.17–$71.10	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBPL TIME PART(PTT) P6881	$47.40	$79.00	$24.17–$71.10	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ACT PART THROMBOP TIME P P7021	$47.40	$79.00	$24.17–$71.10	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT (APTT)	$47.40	$79.00	$24.17–$71.10	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL PROTHROMBIN TIME P4160	$47.40	$79.00	$24.17–$71.10	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P2635	$47.40	$79.00	$24.17–$71.10	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ACTIVATED PTT	$47.40	$79.00	$24.17–$71.10	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P0267	$47.40	$79.00	$24.17–$71.10	—	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS SERUM	$39.60	$66.00	$3.95–$59.40	22% above	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS SERUM	$39.60	$66.00	$20.20–$59.40	—	40%
Potassium blood test CPT 84132 POTASSIUM SERUM	$39.60	$66.00	$3.97–$59.40	24% above	40%
Potassium blood test CPT 84132 WHOLE BLOOD POTASSIUM	$39.60	$66.00	$3.97–$59.40	24% above	40%
Potassium blood test inpatient CPT 84132 WHOLE BLOOD POTASSIUM	$39.60	$66.00	$20.20–$59.40	—	40%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$39.60	$66.00	$20.20–$59.40	—	40%
Progesterone blood test CPT 84144 PROGESTERONE LC/MS/MS	$260.40	$434.00	$17.39–$390.60	90% above	40%
Progesterone blood test CPT 84144 PROGESTERONE	$260.40	$434.00	$17.39–$390.60	90% above	40%
Progesterone blood test CPT 84144 PROGESTERONE LEVEL	$260.40	$434.00	$17.39–$390.60	90% above	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE LC/MS/MS	$260.40	$434.00	$132.80–$390.60	—	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$260.40	$434.00	$132.80–$390.60	—	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE LEVEL	$260.40	$434.00	$132.80–$390.60	—	40%
Prolactin blood test CPT 84146 PROLACTIN	$139.20	$232.00	$16.16–$208.80	12% above	40%
Prolactin blood test CPT 84146 PROLACTIN DILUTION STUDY	$139.20	$232.00	$16.16–$208.80	12% above	40%
Prolactin blood test CPT 84146 MACROPROLACTIN	$139.20	$232.00	$16.16–$208.80	12% above	40%
Prolactin blood test inpatient CPT 84146 PROLACTIN DILUTION STUDY	$139.20	$232.00	$70.99–$208.80	—	40%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$139.20	$232.00	$70.99–$208.80	—	40%
Prolactin blood test inpatient CPT 84146 MACROPROLACTIN	$139.20	$232.00	$70.99–$208.80	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P P7021	$61.20	$102.00	$3.58–$91.80	115% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$61.20	$102.00	$3.58–$91.80	115% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 ISTAT PT/INR	$61.20	$102.00	$3.58–$91.80	115% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P4160	$61.20	$102.00	$3.58–$91.80	115% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P0070	$61.20	$102.00	$3.58–$91.80	115% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P2680	$61.20	$102.00	$3.58–$91.80	115% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PT PROTHROMBIN TIME	$61.20	$102.00	$3.58–$91.80	115% above	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P0070	$61.20	$102.00	$31.21–$91.80	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 ISTAT PT/INR	$61.20	$102.00	$31.21–$91.80	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT PROTHROMBIN TIME	$61.20	$102.00	$31.21–$91.80	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P4160	$61.20	$102.00	$31.21–$91.80	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$61.20	$102.00	$31.21–$91.80	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P2680	$61.20	$102.00	$31.21–$91.80	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P P7021	$61.20	$102.00	$31.21–$91.80	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN COMPR OPTICAL	$441.60	$736.00	$10.39–$662.40	694% above	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN COMPR OPTICAL	$441.60	$736.00	$225.22–$662.40	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A DIRECT	$34.20	$57.00	$6.93–$51.30	46% below	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A DIRECT	$34.20	$57.00	$17.44–$51.30	—	40%
Renin blood test CPT 84244 RENIN P2402	$165.60	$276.00	$13.20–$248.40	15% above	40%
Renin blood test CPT 84244 RENIN ACTIVITY PLASMA	$165.60	$276.00	$13.20–$248.40	15% above	40%
Renin blood test inpatient CPT 84244 RENIN P2402	$165.60	$276.00	$84.46–$248.40	—	40%
Renin blood test inpatient CPT 84244 RENIN ACTIVITY PLASMA	$165.60	$276.00	$84.46–$248.40	—	40%
Rh blood typing CPT 86901 HC BLOOD TYPING RH(D)	$90.60	$151.00	$2.49–$135.90	59% above	40%
Rh blood typing CPT 86901 RH TYPING	$90.60	$151.00	$2.49–$135.90	59% above	40%
Rh blood typing CPT 86901 RH P2168	$90.60	$151.00	$2.49–$135.90	59% above	40%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING RH(D)	$90.60	$151.00	$46.21–$135.90	—	40%
Rh blood typing inpatient CPT 86901 RH P2168	$90.60	$151.00	$46.21–$135.90	—	40%
Rh blood typing inpatient CPT 86901 RH TYPING	$90.60	$151.00	$46.21–$135.90	—	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P9430	$57.60	$96.00	$4.73–$86.40	47% above	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P8130	$57.60	$96.00	$4.73–$86.40	47% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QN P5076	$57.60	$96.00	$4.73–$86.40	47% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTR(RA/RF FACTR)	$57.60	$96.00	$4.73–$86.40	47% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR TITER QUANT	$57.60	$96.00	$4.73–$86.40	47% above	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P4307	$57.60	$96.00	$4.73–$86.40	47% above	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P5091	$57.60	$96.00	$4.73–$86.40	47% above	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P4312	$57.60	$96.00	$4.73–$86.40	47% above	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P5919	$57.60	$96.00	$4.73–$86.40	47% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT P0199	$57.60	$96.00	$4.73–$86.40	47% above	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P3164	$57.60	$96.00	$4.73–$86.40	47% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMO FACT QUANT P3355	$57.60	$96.00	$4.73–$86.40	47% above	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P4262	$57.60	$96.00	$4.73–$86.40	47% above	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P4262	$57.60	$96.00	$29.38–$86.40	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P3164	$57.60	$96.00	$29.38–$86.40	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P8130	$57.60	$96.00	$29.38–$86.40	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR TITER QUANT	$57.60	$96.00	$29.38–$86.40	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P4307	$57.60	$96.00	$29.38–$86.40	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P4312	$57.60	$96.00	$29.38–$86.40	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT P0199	$57.60	$96.00	$29.38–$86.40	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QN P5076	$57.60	$96.00	$29.38–$86.40	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P5091	$57.60	$96.00	$29.38–$86.40	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P5919	$57.60	$96.00	$29.38–$86.40	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P9430	$57.60	$96.00	$29.38–$86.40	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMO FACT QUANT P3355	$57.60	$96.00	$29.38–$86.40	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTR(RA/RF FACTR)	$57.60	$96.00	$29.38–$86.40	—	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA P3261	$115.80	$193.00	$12.00–$173.70	37% above	40%
Rubella antibody test (immunity check) CPT 86762 SCREEN RUBELLA AB IGG	$115.80	$193.00	$12.00–$173.70	37% above	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY - IGG	$115.80	$193.00	$12.00–$173.70	37% above	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGM (GERMAN MEASLS)	$115.80	$193.00	$12.00–$173.70	37% above	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB(IGG IGM) DIAGNOSTIC	$115.80	$193.00	$12.00–$173.70	37% above	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB(IGG IGM) DIAGNOSTIC	$115.80	$193.00	$59.06–$173.70	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 SCREEN RUBELLA AB IGG	$115.80	$193.00	$59.06–$173.70	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGM (GERMAN MEASLS)	$115.80	$193.00	$59.06–$173.70	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA P3261	$115.80	$193.00	$59.06–$173.70	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY - IGG	$115.80	$193.00	$59.06–$173.70	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTOMATED	$69.60	$116.00	$2.25–$104.40	222% above	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE AUTOMATED	$69.60	$116.00	$35.50–$104.40	—	40%
Sodium blood test CPT 84295 SODIUM STAT ICU	$40.20	$67.00	$4.01–$60.30	24% above	40%
Sodium blood test CPT 84295 SODIUM PNL	$40.20	$67.00	$4.01–$60.30	24% above	40%
Sodium blood test inpatient CPT 84295 SODIUM STAT ICU	$40.20	$67.00	$20.50–$60.30	—	40%
Sodium blood test inpatient CPT 84295 SODIUM PNL	$40.20	$67.00	$20.50–$60.30	—	40%
Stool ova and parasites exam CPT 87177 OVA & PARASITE CONCTRN PNL2831	$96.00	$160.00	$7.42–$144.00	64% above	40%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITE CONCTRN PNL2831	$96.00	$160.00	$48.96–$144.00	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 SCREENING HEMOCCULT	$20.40	$34.00	$1.25–$30.60	at median	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES	$20.40	$34.00	$1.25–$30.60	at median	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 SCREENING HEMOCCULT	$20.40	$34.00	$10.40–$30.60	—	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES	$20.40	$34.00	$10.40–$30.60	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL GLOBIN IMMUNOCHEMISTRY	$25.80	$43.00	$3.08–$38.70	28% below	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL GLOBIN IMMUNOCHEMISTRY	$25.80	$43.00	$13.16–$38.70	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA - SERUM	$194.40	$324.00	$11.04–$291.60	160% above	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TOTAL SYPHILIS	$194.40	$324.00	$11.04–$291.60	160% above	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONMA PALLIDM AB PART AGGLU	$194.40	$324.00	$11.04–$291.60	160% above	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILLIS AB CASCADING REFLEX	$194.40	$324.00	$11.04–$291.60	160% above	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM CONFIRM	$194.40	$324.00	$11.04–$291.60	160% above	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-ABS CSF	$194.40	$324.00	$11.04–$291.60	160% above	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM CONFIRM	$194.40	$324.00	$99.14–$291.60	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILLIS AB CASCADING REFLEX	$194.40	$324.00	$99.14–$291.60	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TOTAL SYPHILIS	$194.40	$324.00	$99.14–$291.60	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONMA PALLIDM AB PART AGGLU	$194.40	$324.00	$99.14–$291.60	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA-ABS CSF	$194.40	$324.00	$99.14–$291.60	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA - SERUM	$194.40	$324.00	$99.14–$291.60	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL - CSF	$36.60	$61.00	$3.56–$54.90	30% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR(MONITR) W/REFLX TITR(REFL)	$36.60	$61.00	$3.56–$54.90	30% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SCREEN	$36.60	$61.00	$3.56–$54.90	30% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL SERUM	$36.60	$61.00	$3.56–$54.90	30% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$36.60	$61.00	$3.56–$54.90	30% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL QUAL CSF	$36.60	$61.00	$3.56–$54.90	30% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUAL	$36.60	$61.00	$3.56–$54.90	30% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$36.60	$61.00	$18.67–$54.90	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR(MONITR) W/REFLX TITR(REFL)	$36.60	$61.00	$18.67–$54.90	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR QUAL	$36.60	$61.00	$18.67–$54.90	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR SCREEN	$36.60	$61.00	$18.67–$54.90	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL SERUM	$36.60	$61.00	$18.67–$54.90	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL QUAL CSF	$36.60	$61.00	$18.67–$54.90	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL - CSF	$36.60	$61.00	$18.67–$54.90	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST P6941	$415.80	$693.00	$51.67–$623.70	34% above	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON - TB GOLD	$415.80	$693.00	$51.67–$623.70	34% above	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TUBERCULOSIS TEST P6941	$415.80	$693.00	$212.06–$623.70	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON - TB GOLD	$415.80	$693.00	$212.06–$623.70	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TOTAL HORMONE P4556	$249.60	$416.00	$21.52–$374.40	53% above	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL P4882	$249.60	$416.00	$21.52–$374.40	53% above	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE	$249.60	$416.00	$21.52–$374.40	53% above	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL LC/MS/MS	$249.60	$416.00	$21.52–$374.40	53% above	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (ANDROGEN)	$249.60	$416.00	$21.52–$374.40	53% above	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TOTAL TESTOSTERONE PNL 1540	$249.60	$416.00	$21.52–$374.40	53% above	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TOTAL TESTOSTERONE PNL 1540	$249.60	$416.00	$127.30–$374.40	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL P4882	$249.60	$416.00	$127.30–$374.40	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TOTAL HORMONE P4556	$249.60	$416.00	$127.30–$374.40	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL LC/MS/MS	$249.60	$416.00	$127.30–$374.40	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE (ANDROGEN)	$249.60	$416.00	$127.30–$374.40	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE	$249.60	$416.00	$127.30–$374.40	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES P4184	$136.20	$227.00	$8.70–$204.30	81% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES P4758	$136.20	$227.00	$8.70–$204.30	81% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE AB S	$136.20	$227.00	$8.70–$204.30	81% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOM AB EA P3355	$136.20	$227.00	$8.70–$204.30	81% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES P9705	$136.20	$227.00	$8.70–$204.30	81% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-THYROID PEROXIDASE PL2554	$136.20	$227.00	$8.70–$204.30	81% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-LIVER/KIDNEY MICROSOML AB	$136.20	$227.00	$8.70–$204.30	81% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI THYROID PEROXIDASE AB	$136.20	$227.00	$8.70–$204.30	81% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 PEROXIDASE ANTIBODY	$136.20	$227.00	$8.70–$204.30	81% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOMAL ABS	$136.20	$227.00	$8.70–$204.30	81% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES P5091	$136.20	$227.00	$8.70–$204.30	81% above	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES P4758	$136.20	$227.00	$69.46–$204.30	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES P9705	$136.20	$227.00	$69.46–$204.30	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES P4184	$136.20	$227.00	$69.46–$204.30	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-LIVER/KIDNEY MICROSOML AB	$136.20	$227.00	$69.46–$204.30	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI THYROID PEROXIDASE AB	$136.20	$227.00	$69.46–$204.30	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOMAL ABS	$136.20	$227.00	$69.46–$204.30	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROPEROXIDASE AB S	$136.20	$227.00	$69.46–$204.30	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-THYROID PEROXIDASE PL2554	$136.20	$227.00	$69.46–$204.30	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 PEROXIDASE ANTIBODY	$136.20	$227.00	$69.46–$204.30	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOM AB EA P3355	$136.20	$227.00	$69.46–$204.30	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES P5091	$136.20	$227.00	$69.46–$204.30	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$142.20	$237.00	$14.00–$213.30	42% above	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE	$142.20	$237.00	$14.00–$213.30	42% above	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH W/HAMA TREATMENT	$142.20	$237.00	$14.00–$213.30	42% above	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID FUNCTION CASCADE SERUM	$142.20	$237.00	$14.00–$213.30	42% above	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH W/FREE T4 RFX	$142.20	$237.00	$14.00–$213.30	42% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID FUNCTION CASCADE SERUM	$142.20	$237.00	$72.52–$213.30	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH W/FREE T4 RFX	$142.20	$237.00	$72.52–$213.30	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE	$142.20	$237.00	$72.52–$213.30	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH W/HAMA TREATMENT	$142.20	$237.00	$72.52–$213.30	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$142.20	$237.00	$72.52–$213.30	—	40%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN IGE	$124.20	$207.00	$13.72–$186.30	20% above	40%
Total IgE blood test CPT 82785 IGE P0722	$124.20	$207.00	$13.72–$186.30	20% above	40%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E (IGE)	$124.20	$207.00	$13.72–$186.30	20% above	40%
Total IgE blood test CPT 82785 IGE P3280	$124.20	$207.00	$13.72–$186.30	20% above	40%
Total IgE blood test inpatient CPT 82785 IGE P0722	$124.20	$207.00	$63.34–$186.30	—	40%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN IGE	$124.20	$207.00	$63.34–$186.30	—	40%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E (IGE)	$124.20	$207.00	$63.34–$186.30	—	40%
Total IgE blood test inpatient CPT 82785 IGE P3280	$124.20	$207.00	$63.34–$186.30	—	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL PNL	$36.60	$61.00	$3.63–$54.90	21% above	40%
Total cholesterol blood test CPT 82465 ASSAY BLD/SER CHOLESTERL P3356	$36.60	$61.00	$3.63–$54.90	21% above	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL P4399	$36.60	$61.00	$3.63–$54.90	21% above	40%
Total cholesterol blood test CPT 82465 CHOLESTRL SERUM WHOLE BL P9445	$36.60	$61.00	$3.63–$54.90	21% above	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL PNL 7905	$36.60	$61.00	$3.63–$54.90	21% above	40%
Total cholesterol blood test inpatient CPT 82465 ASSAY BLD/SER CHOLESTERL P3356	$36.60	$61.00	$18.67–$54.90	—	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL PNL	$36.60	$61.00	$18.67–$54.90	—	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL PNL 7905	$36.60	$61.00	$18.67–$54.90	—	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTRL SERUM WHOLE BL P9445	$36.60	$61.00	$18.67–$54.90	—	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL P4399	$36.60	$61.00	$18.67–$54.90	—	40%
Total thyroxine (T4) blood test CPT 84436 T4 THYROXINE	$80.40	$134.00	$5.73–$120.60	78% above	40%
Total thyroxine (T4) blood test CPT 84436 THYROXINE T4 PNL	$80.40	$134.00	$5.73–$120.60	78% above	40%
Total thyroxine (T4) blood test CPT 84436 T4 (THYROXINE TOTAL)	$80.40	$134.00	$5.73–$120.60	78% above	40%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE T4 PNL	$80.40	$134.00	$41.00–$120.60	—	40%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 THYROXINE	$80.40	$134.00	$41.00–$120.60	—	40%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 (THYROXINE TOTAL)	$80.40	$134.00	$41.00–$120.60	—	40%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$190.20	$317.00	$8.80–$285.30	96% above	40%
Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3 PNL 2257	$190.20	$317.00	$8.80–$285.30	96% above	40%
Total triiodothyronine (T3) blood test CPT 84480 T3 (TRIIODOTHYRONINE) TOTAL S	$190.20	$317.00	$8.80–$285.30	96% above	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$190.20	$317.00	$97.00–$285.30	—	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3 PNL 2257	$190.20	$317.00	$97.00–$285.30	—	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 (TRIIODOTHYRONINE) TOTAL S	$190.20	$317.00	$97.00–$285.30	—	40%
Transferrin blood test CPT 84466 TRANSFERRIN	$99.00	$165.00	$10.64–$148.50	15% above	40%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$99.00	$165.00	$50.49–$148.50	—	40%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS P7084	$145.80	$243.00	$29.25–$336.34	21% below	40%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAG AMPLIF P3030	$145.80	$243.00	$29.25–$336.34	21% below	40%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS BY AMPL TECHNOLOGY	$145.80	$243.00	$29.25–$336.34	21% below	40%
Trichomonas test (NAAT) CPT 87661 CHLAM TRACH AMP PRB TECH P3686	$145.80	$243.00	$29.25–$336.34	21% below	40%
Trichomonas test (NAAT) CPT 87661 SURESWAB THRIC VAG RNA QL MALE	$145.80	$243.00	$29.25–$336.34	21% below	40%
Trichomonas test (NAAT) CPT 87661 TRICH VAG RNA QL TMA PAP VIAL	$145.80	$243.00	$29.25–$336.34	21% below	40%
Trichomonas test (NAAT) CPT 87661 SURESWAB TRICH VAGINAL RNA QL	$213.00	$355.00	$29.25–$336.34	16% above	40%
Trichomonas test (NAAT) inpatient CPT 87661 TRICH VAG RNA QL TMA PAP VIAL	$145.80	$243.00	$74.36–$218.70	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAG AMPLIF P3030	$145.80	$243.00	$74.36–$218.70	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS P7084	$145.80	$243.00	$74.36–$218.70	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 CHLAM TRACH AMP PRB TECH P3686	$145.80	$243.00	$74.36–$218.70	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 SURESWAB THRIC VAG RNA QL MALE	$145.80	$243.00	$74.36–$218.70	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS BY AMPL TECHNOLOGY	$145.80	$243.00	$74.36–$218.70	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 SURESWAB TRICH VAGINAL RNA QL	$213.00	$355.00	$108.63–$319.50	—	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDE	$48.60	$81.00	$4.78–$72.90	23% above	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDES PNL 7905	$48.60	$81.00	$4.78–$72.90	23% above	40%
Triglycerides blood test CPT 84478 CHYLOMICRONE PNL	$48.60	$81.00	$4.78–$72.90	23% above	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$48.60	$81.00	$4.78–$72.90	23% above	40%
Triglycerides blood test CPT 84478 ASSAY OF TRIGLYCERIDES P3356	$48.60	$81.00	$4.78–$72.90	23% above	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDES P4399	$48.60	$81.00	$4.78–$72.90	23% above	40%
Triglycerides blood test CPT 84478 VLDL CHOLESTEROL	$48.60	$81.00	$4.78–$72.90	23% above	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE	$48.60	$81.00	$24.79–$72.90	—	40%
Triglycerides blood test inpatient CPT 84478 ASSAY OF TRIGLYCERIDES P3356	$48.60	$81.00	$24.79–$72.90	—	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES PNL 7905	$48.60	$81.00	$24.79–$72.90	—	40%
Triglycerides blood test inpatient CPT 84478 VLDL CHOLESTEROL	$48.60	$81.00	$24.79–$72.90	—	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$48.60	$81.00	$24.79–$72.90	—	40%
Triglycerides blood test inpatient CPT 84478 CHYLOMICRONE PNL	$48.60	$81.00	$24.79–$72.90	—	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES P4399	$48.60	$81.00	$24.79–$72.90	—	40%
Troponin test, quantitative CPT 84484 TROPONIN T HIGH SENSITIVITY	$176.40	$294.00	$10.39–$264.60	114% above	40%
Troponin test, quantitative CPT 84484 TROPONIN 1	$176.40	$294.00	$10.39–$264.60	114% above	40%
Troponin test, quantitative CPT 84484 TROPONIN I QUANT	$176.40	$294.00	$10.39–$264.60	114% above	40%
Troponin test, quantitative CPT 84484 TROPONIN T	$176.40	$294.00	$10.39–$264.60	114% above	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN 1	$176.40	$294.00	$89.96–$264.60	—	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN T	$176.40	$294.00	$89.96–$264.60	—	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN T HIGH SENSITIVITY	$176.40	$294.00	$89.96–$264.60	—	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I QUANT	$176.40	$294.00	$89.96–$264.60	—	40%
Uric acid blood test CPT 84550 URIC ACID	$63.60	$106.00	$3.77–$95.40	101% above	40%
Uric acid blood test inpatient CPT 84550 URIC ACID	$63.60	$106.00	$32.44–$95.40	—	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS R & M	$52.80	$88.00	$2.64–$79.20	60% above	40%
Urinalysis with microscope exam, automated CPT 81001 UR COMPL W/REFLEX TO CULTURE	$52.80	$88.00	$2.64–$79.20	60% above	40%
Urinalysis with microscope exam, automated CPT 81001 UA ROUTINE & MICROSCOPIC	$52.80	$88.00	$2.64–$79.20	60% above	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA ROUTINE & MICROSCOPIC	$52.80	$88.00	$26.93–$79.20	—	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS R & M	$52.80	$88.00	$26.93–$79.20	—	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 UR COMPL W/REFLEX TO CULTURE	$52.80	$88.00	$26.93–$79.20	—	40%
Urinalysis with microscope exam, manual CPT 81000 URINE DIPSTICK W MICRO	$25.80	$43.00	$2.24–$38.70	13% below	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINE DIPSTICK W MICRO	$25.80	$43.00	$13.16–$38.70	—	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTOMATED	$34.80	$58.00	$1.88–$52.20	95% above	40%
Urinalysis without microscope exam, automated CPT 81003 URINE MACRO	$34.80	$58.00	$1.88–$52.20	95% above	40%
Urinalysis without microscope exam, automated CPT 81003 POC URINALYSIS/CLINITEK	$34.80	$58.00	$1.88–$52.20	95% above	40%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE-C	$34.80	$58.00	$1.88–$52.20	95% above	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE-C	$34.80	$58.00	$17.75–$52.20	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 POC URINALYSIS/CLINITEK	$34.80	$58.00	$17.75–$52.20	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE MACRO	$34.80	$58.00	$17.75–$52.20	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTOMATED	$34.80	$58.00	$17.75–$52.20	—	40%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS DIP STICK	$33.60	$56.00	$2.90–$50.40	60% above	40%
Urinalysis without microscope exam, manual CPT 81002 URINE DIP	$33.60	$56.00	$2.90–$50.40	60% above	40%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS DIPSTICK	$33.60	$56.00	$2.90–$50.40	60% above	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIP	$33.60	$56.00	$17.14–$50.40	—	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS DIP STICK	$33.60	$56.00	$17.14–$50.40	—	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS DIPSTICK	$33.60	$56.00	$17.14–$50.40	—	40%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE QNT COL CT	$80.40	$134.00	$6.73–$120.60	42% above	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE QNT COL CT	$80.40	$134.00	$41.00–$120.60	—	40%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN URINE	$60.60	$101.00	$4.82–$90.90	53% above	40%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN RANDOM URINE QNT	$60.60	$101.00	$4.82–$90.90	53% above	40%
Urine microalbumin (albumin) test CPT 82043 URINE-MICROALBUMIN	$60.60	$101.00	$4.82–$90.90	53% above	40%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN RAND UR W/O CREATININE	$60.60	$101.00	$4.82–$90.90	53% above	40%
Urine microalbumin (albumin) test inpatient CPT 82043 URINE-MICROALBUMIN	$60.60	$101.00	$30.91–$90.90	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN URINE	$60.60	$101.00	$30.91–$90.90	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN RANDOM URINE QNT	$60.60	$101.00	$30.91–$90.90	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN RAND UR W/O CREATININE	$60.60	$101.00	$30.91–$90.90	—	40%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY URINE QUAL BETA HCG	$83.40	$139.00	$4.40–$125.10	126% above	40%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST VIS COLOR COMP	$83.40	$139.00	$4.40–$125.10	126% above	40%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$83.40	$139.00	$4.40–$125.10	126% above	40%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST VIS COLOR COMP	$83.40	$139.00	$42.53–$125.10	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY URINE QUAL BETA HCG	$83.40	$139.00	$42.53–$125.10	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$83.40	$139.00	$42.53–$125.10	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B 12 TEST	$158.40	$264.00	$12.57–$237.60	69% above	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 PNL 2979	$158.40	$264.00	$12.57–$237.60	69% above	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 PNL 2979	$158.40	$264.00	$80.78–$237.60	—	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B 12 TEST	$158.40	$264.00	$80.78–$237.60	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-OH VITAMIN D3 P3433	$223.80	$373.00	$24.67–$335.70	50% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D/25-HYDROXY	$223.80	$373.00	$24.67–$335.70	50% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-HYDROXY-VITAMIN-D	$223.80	$373.00	$24.67–$335.70	50% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D IMMUNOASSAY	$223.80	$373.00	$24.67–$335.70	50% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CARD IQ VIT D 25HYDRX LC/MS/MS	$223.80	$373.00	$24.67–$335.70	50% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CARD IQ VIT D 25HYDRX LC/MS/MS	$223.80	$373.00	$114.14–$335.70	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D/25-HYDROXY	$223.80	$373.00	$114.14–$335.70	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-OH VITAMIN D3 P3433	$223.80	$373.00	$114.14–$335.70	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-HYDROXY-VITAMIN-D	$223.80	$373.00	$114.14–$335.70	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D IMMUNOASSAY	$223.80	$373.00	$114.14–$335.70	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D 1-25 P3433	$426.00	$710.00	$32.09–$639.00	77% above	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1 25-DIHYDROXY	$426.00	$710.00	$32.09–$639.00	77% above	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 DIHYDROXYVITAMIN D 1-25 P3433	$426.00	$710.00	$217.26–$639.00	—	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 1 25-DIHYDROXY	$426.00	$710.00	$217.26–$639.00	—	40%
Zinc blood test CPT 84630 ZINC SERUM	$114.60	$191.00	$9.49–$171.90	59% above	40%
Zinc blood test CPT 84630 ZINC BLOOD	$114.60	$191.00	$9.49–$171.90	59% above	40%
Zinc blood test CPT 84630 ZINC RBC	$114.60	$191.00	$9.49–$171.90	59% above	40%
Zinc blood test CPT 84630 ZINC P6970	$114.60	$191.00	$9.49–$171.90	59% above	40%
Zinc blood test inpatient CPT 84630 ZINC SERUM	$114.60	$191.00	$58.45–$171.90	—	40%
Zinc blood test inpatient CPT 84630 ZINC RBC	$114.60	$191.00	$58.45–$171.90	—	40%
Zinc blood test inpatient CPT 84630 ZINC BLOOD	$114.60	$191.00	$58.45–$171.90	—	40%
Zinc blood test inpatient CPT 84630 ZINC P6970	$114.60	$191.00	$58.45–$171.90	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE INTACT	$178.20	$297.00	$12.55–$267.30	99% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG BETA SUBUNIT/FLUID	$178.20	$297.00	$12.55–$267.30	99% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG TUMOR/PREG QUANT	$178.20	$297.00	$12.55–$267.30	99% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORNC(QNT) P0010	$178.20	$297.00	$12.55–$267.30	99% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADATROP CHRNC QNT FTS P0020	$178.20	$297.00	$12.55–$267.30	99% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG OTHER	$178.20	$297.00	$12.55–$267.30	99% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTITATIVE INTACT	$178.20	$297.00	$90.88–$267.30	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG TUMOR/PREG QUANT	$178.20	$297.00	$90.88–$267.30	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORNC(QNT) P0010	$178.20	$297.00	$90.88–$267.30	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG OTHER	$178.20	$297.00	$90.88–$267.30	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG BETA SUBUNIT/FLUID	$178.20	$297.00	$90.88–$267.30	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADATROP CHRNC QNT FTS P0020	$178.20	$297.00	$90.88–$267.30	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$495.00	$825.00	$112.74–$773.19	at median	40%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV MUSC MIGRAINE	$495.00	$825.00	$252.45–$742.50	—	40%
Cardiac catheterization with coronary angiogram CPT 93458 L HRT ART VNTRCL ANGIO IMG S&I	$10,991.40	$18,319.00	$1,309.04–$16,487.10	25% above	40%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 L HRT ART VNTRCL ANGIO IMG S&I	$10,991.40	$18,319.00	$5,605.61–$16,487.10	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDOVERSION ELECTIVE EXTERNAL	$2,345.40	$3,909.00	$95.70–$3,518.10	60% above	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDOVERSION ELECTIVE EXTERNAL	$2,345.40	$3,909.00	$1,196.15–$3,518.10	—	40%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL RELEASE	$4,037.40	$6,729.00	$330.00–$6,056.10	4% below	40%
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL RELEASE	$4,037.40	$6,729.00	$2,059.07–$6,056.10	—	40%
Cervical biopsy CPT 57500 BX CERVIX W/WO FULGURATION	$7,606.20	$12,677.00	$72.73–$11,409.30	199% above	40%
Cervical biopsy inpatient CPT 57500 BX CERVIX W/WO FULGURATION	$7,606.20	$12,677.00	$3,879.16–$11,409.30	—	40%
Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY WITH USN	$2,457.60	$4,096.00	$241.22–$3,686.40	6% above	40%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLONOSCOPY WITH USN	$2,457.60	$4,096.00	$1,253.38–$3,686.40	—	40%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/SNARE TECHNIQUE	$3,349.80	$5,583.00	$294.89–$5,024.70	32% above	40%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/SNARE TECHNIQUE	$3,349.80	$5,583.00	$1,708.40–$5,024.70	—	40%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BX SINGLE/MULT	$3,349.80	$5,583.00	$247.96–$5,024.70	51% above	40%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BX SINGLE/MULT	$3,349.80	$5,583.00	$1,708.40–$5,024.70	—	40%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY DIAG W/WO BRUSHING	$1,500.00	$2,500.00	$198.55–$4,520.78	at median	40%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY DIAG W/WO BRUSHING	$1,500.00	$2,500.00	$765.00–$2,250.00	—	40%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY W STENT INSERTION	$3,520.20	$5,867.00	$158.09–$5,280.30	26% below	40%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOSCOPY W STENT INSERTION	$3,520.20	$5,867.00	$1,795.30–$5,280.30	—	40%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$4,303.80	$7,173.00	$82.50–$6,455.70	155% above	40%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$4,303.80	$7,173.00	$2,194.94–$6,455.70	—	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 RMV IMPACT CERUMEN IRR/LAV	$168.00	$280.00	$8.38–$252.00	20% above	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 RMV IMPACT CERUMEN IRR/LAV	$168.00	$280.00	$85.68–$252.00	—	40%
Earwax removal with instruments, one ear CPT 69210 RMV IMPACT CERUMEN INSTR	$168.00	$280.00	$18.59–$252.00	25% above	40%
Earwax removal with instruments, one ear inpatient CPT 69210 RMV IMPACT CERUMEN INSTR	$168.00	$280.00	$85.68–$252.00	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTRLMNR CRV/TRC W/IMG GDE	$2,164.80	$3,608.00	$98.12–$3,247.20	10% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX INTRLMNR CRV/TRC W/IMG GDE	$2,164.80	$3,608.00	$1,104.05–$3,247.20	—	40%
Eye injection into the vitreous (intravitreal injection) CPT 67028 INTRAVITREAL INJ PHARM AGENT	$1,959.60	$3,266.00	$116.47–$2,939.40	282% above	40%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INTRAVITREAL INJ PHARM AGENT	$1,959.60	$3,266.00	$999.40–$2,939.40	—	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$1,656.60	$2,761.00	$272.84–$2,484.90	15% above	40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ PRVRT F JNT L/S 1 LEV RT	$1,656.60	$2,761.00	$79.21–$2,484.90	15% above	40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ PRVRT F JNT L/S 1 LEV LT	$1,656.60	$2,761.00	$79.21–$2,484.90	15% above	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$1,656.60	$2,761.00	$844.87–$2,484.90	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ PRVRT F JNT L/S 1 LEV RT	$1,656.60	$2,761.00	$844.87–$2,484.90	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ PRVRT F JNT L/S 1 LEV LT	$1,656.60	$2,761.00	$844.87–$2,484.90	—	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 FLEX SIG DIAG W/WO BRUSHING	$598.20	$997.00	$58.47–$2,072.59	48% below	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 FLEX SIG DIAG W/WO BRUSHING	$598.20	$997.00	$305.08–$897.30	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 ID SIMPLE ABSCESS	$484.20	$807.00	$25.85–$806.01	5% below	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ID SIMPLE ABSCESS	$484.20	$807.00	$246.94–$726.30	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ(S) TENDON SHEATH/LIGAMENT	$1,018.80	$1,698.00	$35.20–$1,528.20	79% above	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ(S) TENDON SHEATH/LIGAMENT	$1,018.80	$1,698.00	$519.59–$1,528.20	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHRO ASP/INJ LG JT WO/US	$855.00	$1,425.00	$18.59–$1,282.50	83% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS LG JOINT	$855.00	$1,425.00	$18.59–$1,282.50	83% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHRO ASP/INJ MAJOR JOINT	$855.00	$1,425.00	$18.59–$1,282.50	83% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHRO ASP/INJ LG JT WO/US LT	$855.00	$1,425.00	$18.59–$1,282.50	83% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHRO ASP/INJ LG JT WO/US RT	$855.00	$1,425.00	$18.59–$1,282.50	83% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS LG JOINT	$855.00	$1,425.00	$436.05–$1,282.50	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHRO ASP/INJ LG JT WO/US	$855.00	$1,425.00	$436.05–$1,282.50	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHRO ASP/INJ MAJOR JOINT	$855.00	$1,425.00	$436.05–$1,282.50	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 ARTHRO ASP/INJ LG JT WO/US RT	$855.00	$1,425.00	$436.05–$1,282.50	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 ARTHRO ASP/INJ LG JT WO/US LT	$855.00	$1,425.00	$436.05–$1,282.50	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHRO ASP/INJ INT JT WO/US	$855.00	$1,425.00	$18.59–$1,282.50	142% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS MED JOINT	$855.00	$1,425.00	$18.59–$1,282.50	142% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHRO ASP/INJ INTERMED JOINT	$855.00	$1,425.00	$18.59–$1,282.50	142% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS MED JOINT	$855.00	$1,425.00	$436.05–$1,282.50	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHRO ASP/INJ INT JT WO/US	$855.00	$1,425.00	$436.05–$1,282.50	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHRO ASP/INJ INTERMED JOINT	$855.00	$1,425.00	$436.05–$1,282.50	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHRO ASP/INJ SMALL JOINT	$855.00	$1,425.00	$19.80–$1,282.50	108% above	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHRO ASP INJ SM JO/BU WO US	$855.00	$1,425.00	$19.80–$1,282.50	108% above	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHRO ASP/INJ SMALL JOINT	$855.00	$1,425.00	$436.05–$1,282.50	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHRO ASP INJ SM JO/BU WO US	$855.00	$1,425.00	$436.05–$1,282.50	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INT LAC RPR 0-2.5CM SCLP TRNK	$366.60	$611.00	$26.95–$806.01	37% below	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INT LAC RPR 0-2.5CM SCLP TRNK	$366.60	$611.00	$186.97–$549.90	—	40%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HRT CATH W VENTRCLGRPHY	$7,483.80	$12,473.00	$1,046.36–$11,225.70	15% above	40%
Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HRT CATH W VENTRCLGRPHY	$7,483.80	$12,473.00	$3,816.74–$11,225.70	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTRLMNR LUM/SAC W/IMG GDE	$2,047.80	$3,413.00	$89.45–$3,071.70	2% below	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTRLMNR LUM/SAC W/IMG GDE	$2,047.80	$3,413.00	$1,044.38–$3,071.70	—	40%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC	$1,541.40	$2,569.00	$78.27–$2,312.10	20% below	40%
Lower-back epidural injection, without imaging guidance CPT 62322 NEURAXIAL L/S INJ	$1,541.40	$2,569.00	$78.27–$2,312.10	20% below	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX INTERLAMINAR LMBR/SAC	$1,541.40	$2,569.00	$786.11–$2,312.10	—	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NEURAXIAL L/S INJ	$1,541.40	$2,569.00	$786.11–$2,312.10	—	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ ANES/STEROID EPI L/S SGL	$1,656.60	$2,761.00	$104.54–$3,631.18	14% below	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORAM EPID LUMB/SAC SNGL	$1,656.60	$2,761.00	$104.54–$3,631.18	14% below	40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJ ANS TRNSFR EP LM SAC SNG L	$1,656.60	$2,761.00	$104.54–$3,631.18	14% below	40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJ ANS TRNSFR EP LM SAC SNG R	$1,656.60	$2,761.00	$104.54–$3,631.18	14% below	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 TRANSFORAM EPID LUMB/SAC SNGL	$1,656.60	$2,761.00	$844.87–$2,484.90	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ ANES/STEROID EPI L/S SGL	$1,656.60	$2,761.00	$844.87–$2,484.90	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJ ANS TRNSFR EP LM SAC SNG R	$1,656.60	$2,761.00	$844.87–$2,484.90	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJ ANS TRNSFR EP LM SAC SNG L	$1,656.60	$2,761.00	$844.87–$2,484.90	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$1,527.60	$2,546.00	$41.25–$2,291.40	15% above	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$1,527.60	$2,546.00	$779.08–$2,291.40	—	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BGN LES FEENL <0.5CM	$2,270.40	$3,784.00	$59.95–$3,405.60	28% above	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BGN LES FEENL <0.5CM	$2,270.40	$3,784.00	$1,157.90–$3,405.60	—	40%
Nail removal (partial or complete), one nail CPT 11730 NAIL AVULSION COMP/PART SNGL	$366.60	$611.00	$28.32–$806.01	22% below	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 NAIL AVULSION COMP/PART SNGL	$366.60	$611.00	$186.97–$549.90	—	40%
Occipital nerve block (injection for headaches) CPT 64405 INJ ANES OCCIPITAL NERVE	$945.60	$1,576.00	$38.50–$2,072.59	68% above	40%
Occipital nerve block (injection for headaches) CPT 64405 OCCIPITAL NERVE BLOCK	$945.60	$1,576.00	$38.50–$2,072.59	68% above	40%
Occipital nerve block (injection for headaches) one side CPT 64405 INJ GREATER OCCIPITAL NRV LT	$945.60	$1,576.00	$38.50–$2,072.59	68% above	40%
Occipital nerve block (injection for headaches) one side CPT 64405 INJ GREATER OCCIPITAL NRV RT	$945.60	$1,576.00	$38.50–$2,072.59	68% above	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANES OCCIPITAL NERVE	$945.60	$1,576.00	$482.26–$1,418.40	—	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 OCCIPITAL NERVE BLOCK	$945.60	$1,576.00	$482.26–$1,418.40	—	40%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 INJ GREATER OCCIPITAL NRV LT	$945.60	$1,576.00	$482.26–$1,418.40	—	40%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 INJ GREATER OCCIPITAL NRV RT	$945.60	$1,576.00	$482.26–$1,418.40	—	40%
Pacemaker implant (dual chamber) CPT 33208 INS NEW ATRL & VNT PMKR & LEAD	$14,596.20	$24,327.00	$509.38–$21,894.30	15% above	40%
Pacemaker implant (dual chamber) inpatient CPT 33208 INS NEW ATRL & VNT PMKR & LEAD	$14,596.20	$24,327.00	$7,444.06–$21,894.30	—	40%
Paracentesis with imaging guidance CPT 49083 ABD PARACNT DX/THR W IMG GUID	$3,763.20	$6,272.00	$92.76–$5,644.80	123% above	40%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACNT DX/THR W IMG GUID	$3,763.20	$6,272.00	$1,919.23–$5,644.80	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL COMP/PART	$945.60	$1,576.00	$317.52–$2,072.59	13% above	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL COMP/PART	$945.60	$1,576.00	$482.26–$1,418.40	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DEST LUMB/SAC FACET JNT W IMG	$7,348.20	$12,247.00	$620.91–$11,022.30	146% above	40%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DST LUMB/SAC FCT JNT WIMG R	$7,348.20	$12,247.00	$197.27–$11,022.30	146% above	40%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DST LUMB/SAC FCT JNT WIMG L	$7,348.20	$12,247.00	$197.27–$11,022.30	146% above	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DEST LUMB/SAC FACET JNT W IMG	$7,348.20	$12,247.00	$3,747.58–$11,022.30	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 DST LUMB/SAC FCT JNT WIMG R	$7,348.20	$12,247.00	$3,747.58–$11,022.30	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 DST LUMB/SAC FCT JNT WIMG L	$7,348.20	$12,247.00	$3,747.58–$11,022.30	—	40%
Removal of a foreign object under the skin, simple CPT 10120 SUBCUT FB REMOVAL SIMPLE	$366.60	$611.00	$33.55–$806.01	33% below	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 SUBCUT FB REMOVAL SIMPLE	$366.60	$611.00	$186.97–$549.90	—	40%
Short arm cast (elbow to hand) CPT 29075 SHORT ARM CAST APPLICATION	$424.20	$707.00	$50.05–$636.30	2% above	40%
Short arm cast (elbow to hand) inpatient CPT 29075 SHORT ARM CAST APPLICATION	$424.20	$707.00	$216.34–$636.30	—	40%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$265.80	$443.00	$28.60–$575.72	16% below	40%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY FOREARM SPLINT	$265.80	$443.00	$135.56–$398.70	—	40%
Short leg cast (below the knee) CPT 29405 APPL SHORT LEG CAST	$366.60	$611.00	$55.55–$806.01	30% below	40%
Short leg cast (below the knee) inpatient CPT 29405 APPL SHORT LEG CAST	$366.60	$611.00	$186.97–$549.90	—	40%
Short leg splint (calf to foot) CPT 29515 APPLY LOWER LEG SPLINT	$366.60	$611.00	$38.50–$806.01	21% below	40%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY LOWER LEG SPLINT	$366.60	$611.00	$186.97–$549.90	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMPL LAC RPR 0-2.5CM SCALP	$285.60	$476.00	$26.95–$806.01	45% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SMPL LAC RPR 0-2.5CM SCALP	$285.60	$476.00	$145.66–$428.40	—	40%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$639.00	$1,065.00	$44.47–$958.50	3% below	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$639.00	$1,065.00	$325.89–$958.50	—	40%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS UP TO 15	$706.20	$1,177.00	$34.10–$1,266.58	17% above	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS UP TO 15	$706.20	$1,177.00	$360.16–$1,059.30	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNC LUMBAR DX	$2,132.40	$3,554.00	$46.20–$3,376.25	74% above	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNC LUMBAR DX	$2,132.40	$3,554.00	$1,087.52–$3,198.60	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL LAC RPR 2.6-7.5CM SCALP	$903.60	$1,506.00	$39.05–$1,355.40	71% above	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SMPL LAC RPR 2.6-7.5CM SCALP	$903.60	$1,506.00	$460.84–$1,355.40	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SMPL LAC RPR 0-2.5CM FACE	$366.60	$611.00	$34.65–$806.01	28% below	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SMPL LAC RPR 0-2.5CM FACE	$366.60	$611.00	$186.97–$549.90	—	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$639.00	$1,065.00	$35.45–$958.50	13% above	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES	$639.00	$1,065.00	$325.89–$958.50	—	40%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W GUIDANCE	$2,577.00	$4,295.00	$403.71–$3,865.50	75% above	40%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W GUIDANCE	$2,577.00	$4,295.00	$1,314.27–$3,865.50	—	40%
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH	$4,866.00	$8,110.00	$220.00–$7,299.00	at median	40%
Trigger finger release surgery inpatient CPT 26055 INCISE FINGER TENDON SHEATH	$4,866.00	$8,110.00	$2,481.66–$7,299.00	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SNG/MUL TRG PTS 1-2 MUS GR	$403.20	$672.00	$34.17–$604.80	25% below	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SNG/MUL TRG PTS 1-2 MUS GR	$403.20	$672.00	$205.63–$604.80	—	40%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD W/BALLOON DILATION	$2,978.40	$4,964.00	$596.00–$4,520.78	13% below	40%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD W/BALLOON DILATION	$2,978.40	$4,964.00	$1,518.98–$4,467.60	—	40%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY SINGLE/MULT	$2,978.40	$4,964.00	$163.44–$4,520.78	37% above	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BIOPSY SINGLE/MULT	$2,978.40	$4,964.00	$1,518.98–$4,467.60	—	40%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD W/SUBMUCOSAL INJ ANY SUB	$2,978.40	$4,964.00	$166.71–$4,863.34	14% above	40%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD W/SUBMUCOSAL INJ ANY SUB	$2,978.40	$4,964.00	$1,518.98–$4,467.60	—	40%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD W/REMOVAL BY SNARE	$2,978.40	$4,964.00	$208.28–$4,520.78	6% below	40%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD W/REMOVAL BY SNARE	$2,978.40	$4,964.00	$1,518.98–$4,467.60	—	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD W/DILATION OVER WIRE	$2,978.40	$4,964.00	$596.00–$4,520.78	20% above	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD W/DILATION OVER WIRE	$2,978.40	$4,964.00	$1,518.98–$4,467.60	—	40%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD W/WO BRUSHINGS	$2,978.40	$4,964.00	$137.74–$4,467.60	57% above	40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD W/WO BRUSHINGS	$2,978.40	$4,964.00	$1,518.98–$4,467.60	—	40%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 EGD W/TRANSMURAL DRAIN CYST	$6,339.60	$10,566.00	$596.00–$9,509.40	25% below	40%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 EGD W/TRANSMURAL DRAIN CYST	$6,339.60	$10,566.00	$3,233.20–$9,509.40	—	40%
Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS RF 1ST VEIN	$15,871.80	$26,453.00	$2,274.00–$23,807.70	70% above	40%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVENOUS RF 1ST VEIN	$15,871.80	$26,453.00	$8,094.62–$23,807.70	—	40%
Wart removal, up to 14 warts CPT 17110 DESTR BENIGN LESIONS 1-14	$593.40	$989.00	$53.90–$890.10	6% above	40%
Wart removal, up to 14 warts inpatient CPT 17110 DESTR BENIGN LESIONS 1-14	$593.40	$989.00	$302.63–$890.10	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID SKIN AND SQ TISSUE	$2,553.60	$4,256.00	$36.30–$4,520.78	137% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRID SKIN AND SQ TISSUE	$2,553.60	$4,256.00	$1,302.34–$3,830.40	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD/COMPONENTS	$610.80	$1,018.00	$30.62–$916.20	35% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 CELL SAVING TRANSFUSION PROC	$610.80	$1,018.00	$30.62–$916.20	35% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TX (CELL SAVER/BLD BANK)	$610.80	$1,018.00	$30.62–$916.20	35% below	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TX (CELL SAVER/BLD BANK)	$610.80	$1,018.00	$311.51–$916.20	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 CELL SAVING TRANSFUSION PROC	$610.80	$1,018.00	$311.51–$916.20	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD/COMPONENTS	$610.80	$1,018.00	$311.51–$916.20	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPV INITIAL	$272.40	$454.00	$24.67–$408.60	22% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 DRUG AEROSOL INITIAL	$272.40	$454.00	$24.67–$408.60	22% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI INITIAL	$272.40	$454.00	$24.67–$408.60	22% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 DRUG AEROSOL ADMIN INITIAL	$272.40	$454.00	$24.67–$408.60	22% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 DRUG AEROSOL/MDI - INIT ADMIN	$272.40	$454.00	$24.67–$408.60	22% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI INITIAL	$272.40	$454.00	$138.92–$408.60	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPV INITIAL	$272.40	$454.00	$138.92–$408.60	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 DRUG AEROSOL INITIAL	$272.40	$454.00	$138.92–$408.60	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 DRUG AEROSOL ADMIN INITIAL	$272.40	$454.00	$138.92–$408.60	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 DRUG AEROSOL/MDI - INIT ADMIN	$272.40	$454.00	$138.92–$408.60	—	40%
Chemotherapy IV infusion, first hour CPT 96413 IV INF CHEMO 1ST HR	$771.00	$1,285.00	$137.28–$1,156.50	6% above	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INF CHEMO 1ST HR	$771.00	$1,285.00	$393.21–$1,156.50	—	40%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE AUDIOMETRY	$282.00	$470.00	$31.90–$423.00	22% below	40%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHENSIVE AUDIOMETRY	$282.00	$470.00	$143.82–$423.00	—	40%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE - FIRST 30-74MIN	$3,476.40	$5,794.00	$166.79–$5,214.60	85% above	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE - FIRST 30-74MIN	$3,476.40	$5,794.00	$1,772.96–$5,214.60	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE & DROWSY	$855.60	$1,426.00	$24.75–$1,283.40	13% above	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE & DROWSY	$855.60	$1,426.00	$436.36–$1,283.40	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING WO INTERP & RPT	$395.40	$659.00	$11.51–$593.10	127% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING WO INTERP & RPT	$395.40	$659.00	$201.65–$593.10	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ACUITY LEVEL 1	$300.00	$500.00	$52.16–$450.00	1% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ACUITY LEVEL 1 NON EMERGENT	$300.00	$500.00	$52.16–$450.00	1% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ACUITY LEVEL 1 NON EMERGENT	$300.00	$500.00	$153.00–$450.00	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ACUITY LEVEL 1	$300.00	$500.00	$153.00–$450.00	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ACUITY LEVEL 2	$564.00	$940.00	$36.28–$846.00	18% above	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ACUITY LEVEL 2 NON EMERGENT	$564.00	$940.00	$36.28–$846.00	18% above	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ACUITY LEVEL 2	$564.00	$940.00	$287.64–$846.00	—	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ACUITY LEVEL 2 NON EMERGENT	$564.00	$940.00	$287.64–$846.00	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ACUITY LEVEL 3	$883.20	$1,472.00	$62.31–$1,324.80	19% above	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ACUITY LEVEL 3	$883.20	$1,472.00	$450.43–$1,324.80	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ACUITY LEVEL 4	$1,248.60	$2,081.00	$104.86–$1,872.90	2% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ACUITY LEVEL 4	$1,248.60	$2,081.00	$636.79–$1,872.90	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ACUITY LEVEL 5	$2,410.20	$4,017.00	$152.61–$3,615.30	51% above	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ACUITY LEVEL 5	$2,410.20	$4,017.00	$1,229.20–$3,615.30	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST W/PHARMACEUTICALS	$2,233.80	$3,723.00	$48.89–$3,350.70	136% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 TREADMILL/BIKE EXERCISE	$2,233.80	$3,723.00	$48.89–$3,350.70	136% above	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 TREADMILL/BIKE EXERCISE	$2,233.80	$3,723.00	$1,139.24–$3,350.70	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST W/PHARMACEUTICALS	$2,233.80	$3,723.00	$1,139.24–$3,350.70	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION 1ST HR	$771.00	$1,285.00	$34.79–$1,156.50	77% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION 1ST HR	$771.00	$1,285.00	$393.21–$1,156.50	—	40%
IV infusion of a medicine, first hour CPT 96365 IV INF NONCHEMO 1ST HR	$771.00	$1,285.00	$43.23–$1,156.50	71% above	40%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF NONCHEMO 1ST HR	$771.00	$1,285.00	$393.21–$1,156.50	—	40%
IV push of a medicine, first drug CPT 96374 IV PUSH NONCHEMO 1ST DRUG	$203.40	$339.00	$34.12–$382.32	38% below	40%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH NONCHEMO 1ST DRUG	$203.40	$339.00	$103.73–$305.10	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM/SQ	$154.80	$258.00	$13.97–$232.20	26% above	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM/SQ	$154.80	$258.00	$78.95–$232.20	—	40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE COND MTR/SEN 7-8 STUDIES	$1,462.20	$2,437.00	$62.88–$2,193.30	at median	40%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE COND MTR/SEN 7-8 STUDIES	$1,462.20	$2,437.00	$745.72–$2,193.30	—	40%
New patient office visit, about 30 minutes CPT 99203 CLINIC VISIT NEW 99203	$225.60	$376.00	$36.08–$338.40	6% below	40%
New patient office visit, about 30 minutes inpatient CPT 99203 CLINIC VISIT NEW 99203	$225.60	$376.00	$115.06–$338.40	—	40%
New patient office visit, about 45 minutes CPT 99204 CLINIC VISIT NEW 99204	$300.00	$500.00	$36.08–$450.00	at median	40%
New patient office visit, about 45 minutes inpatient CPT 99204 CLINIC VISIT NEW 99204	$300.00	$500.00	$153.00–$450.00	—	40%
New patient office visit, about 60 minutes CPT 99205 CLINIC VISIT NEW 99205	$377.40	$629.00	$36.08–$566.10	28% below	40%
New patient office visit, about 60 minutes inpatient CPT 99205 CLINIC VISIT NEW 99205	$377.40	$629.00	$192.47–$566.10	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 CLINIC VISIT NEW 99202	$149.40	$249.00	$36.08–$238.45	18% below	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 CLINIC VISIT NEW 99202	$149.40	$249.00	$76.19–$224.10	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKE/TOBACCO COUNSEL 3-10 MIN	$30.00	$50.00	$13.95–$86.26	34% below	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKE/TOBACCO COUNSEL 3-10 MIN	$30.00	$50.00	$15.30–$45.00	—	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CLINIC VISIT EST 99215	$201.60	$336.00	$36.08–$302.40	26% below	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 CLINIC VISIT EST 99215	$201.60	$336.00	$102.82–$302.40	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CLINIC VISIT EST PT 99213	$141.00	$235.00	$36.08–$211.50	24% below	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CLINIC VISIT EST 99213	$141.00	$235.00	$36.08–$211.50	24% below	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CLINIC VISIT EST 99213	$141.00	$235.00	$71.91–$211.50	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CLINIC VISIT EST PT 99213	$141.00	$235.00	$71.91–$211.50	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CLINIC VISIT EST PT 99214	$168.00	$280.00	$36.08–$252.00	17% below	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CLINIC VISIT EST 99214	$168.00	$280.00	$36.08–$252.00	17% below	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CLINIC VISIT EST PT 99214	$168.00	$280.00	$85.68–$252.00	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CLINIC VISIT EST 99214	$168.00	$280.00	$85.68–$252.00	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CLINIC VISIT EST 99212	$117.00	$195.00	$28.60–$175.50	28% below	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CLINIC VISIT EST 99212	$117.00	$195.00	$59.67–$175.50	—	40%
Spirometry (breathing test) CPT 94010 BEDSIDE PFT PRE/POST BRNCHDLTR	$379.20	$632.00	$16.50–$568.80	26% above	40%
Spirometry (breathing test) CPT 94010 SPIROMETRY VC EXP FLOW MVV	$379.20	$632.00	$16.50–$568.80	26% above	40%
Spirometry (breathing test) CPT 94010 SPIROMETRY INCENTIVE P/DY	$379.20	$632.00	$16.50–$568.80	26% above	40%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY INCENTIVE P/DY	$379.20	$632.00	$193.39–$568.80	—	40%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY VC EXP FLOW MVV	$379.20	$632.00	$193.39–$568.80	—	40%
Spirometry (breathing test) inpatient CPT 94010 BEDSIDE PFT PRE/POST BRNCHDLTR	$379.20	$632.00	$193.39–$568.80	—	40%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY PRE & POST BRONCH	$456.60	$761.00	$20.90–$684.90	30% below	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY PRE & POST BRONCH	$456.60	$761.00	$232.87–$684.90	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$597.60	$996.00	$11.00–$896.40	159% above	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$597.60	$996.00	$304.78–$896.40	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 SPIKEVAX MODERNA 12+Y	$199.20	$332.00	$44.00–$1,203.43	at median	40%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19(MODERNA-12+YR) 23-24	$199.20	$332.00	$44.00–$1,203.43	at median	40%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 SPIKEVAX MODERNA 12+Y	$340.00	$425.00	$44.00–$1,203.43	71% above	20%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19(MODERNA-12+YR) 23-24	$199.20	$332.00	$101.59–$298.80	—	40%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 SPIKEVAX MODERNA 12+Y	$199.20	$332.00	$101.59–$298.80	—	40%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 SPIKEVAX MODERNA 12+Y	$340.00	$425.00	$130.05–$382.50	—	20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPTH/PERTUS/TET0.5ML-6W-7Y	$32.40	$54.00	$11.00–$80.28	5% below	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPTH/PERTUS/TET0.5ML-6W-7Y	$43.20	$54.00	$11.00–$80.28	26% above	20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPTH/PERTUS/TET0.5ML-6W-7Y	$32.40	$54.00	$16.52–$48.60	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPTH/PERTUS/TET0.5ML-6W-7Y	$43.20	$54.00	$16.52–$48.60	—	20%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 RIV3 VAC NO PRSV IM FLUBLK TRI	$30.00	$50.00	$11.00–$120.74	at median	40%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK 0.5ML PFS LTX/EGG FREE	$30.00	$50.00	$11.00–$120.74	at median	40%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK 0.5ML PFS LTX/EGG FREE	$40.00	$50.00	$11.00–$120.74	33% above	20%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLUBLOK 0.5ML PFS LTX/EGG FREE	$30.00	$50.00	$15.30–$45.00	—	40%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 RIV3 VAC NO PRSV IM FLUBLK TRI	$30.00	$50.00	$15.30–$45.00	—	40%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLUBLOK 0.5ML PFS LTX/EGG FREE	$40.00	$50.00	$15.30–$45.00	—	20%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV VIRUS VACCINE 9 VAL IM	$186.00	$310.00	$11.00–$494.44	27% below	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV VIRUS VACCINE 9 VAL IM	$186.00	$310.00	$94.86–$279.00	—	40%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE ADULT IM	$81.00	$135.00	$11.00–$433.10	9% below	40%
Hepatitis A vaccine, adult dose CPT 90632 HEPAT A VACC 1440U/ML VIAL	$81.00	$135.00	$11.00–$433.10	9% below	40%
Hepatitis A vaccine, adult dose CPT 90632 HEPAT A VACC 1440U/ML VIAL	$108.00	$135.00	$11.00–$433.10	21% above	20%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE ADULT IM	$81.00	$135.00	$41.31–$121.50	—	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPAT A VACC 1440U/ML VIAL	$81.00	$135.00	$41.31–$121.50	—	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPAT A VACC 1440U/ML VIAL	$108.00	$135.00	$41.31–$121.50	—	20%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX PED VAC 720U/0.5ML	$64.80	$108.00	$11.00–$216.59	13% below	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX PED VAC 720U/0.5ML	$86.40	$108.00	$11.00–$216.59	16% above	20%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX PED VAC 720U/0.5ML	$64.80	$108.00	$33.05–$97.20	—	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX PED VAC 720U/0.5ML	$86.40	$108.00	$33.05–$97.20	—	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 VAC HEP B 20MCG/ 1ML ADULT INJ	$64.80	$108.00	$11.00–$408.04	21% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC ADULT	$64.80	$108.00	$11.00–$408.04	21% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 VAC HEP B 20MCG/ 1ML ADULT INJ	$86.40	$108.00	$11.00–$408.04	5% above	20%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 VAC HEP B 20MCG/ 1ML ADULT INJ	$64.80	$108.00	$33.05–$97.20	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC ADULT	$64.80	$108.00	$33.05–$97.20	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 VAC HEP B 20MCG/ 1ML ADULT INJ	$86.40	$108.00	$33.05–$97.20	—	20%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPB VACC 2 DOSE ADULT IM	$126.60	$211.00	$11.00–$313.77	27% below	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VAC 20MCG/0.5 ML	$126.60	$211.00	$11.00–$313.77	27% below	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPLISAV-B 20MCG/0.5ML ADT	$126.60	$211.00	$11.00–$313.77	27% below	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VAC 20MCG/0.5 ML	$168.80	$211.00	$11.00–$313.77	3% below	20%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VAC 20MCG/0.5 ML	$126.60	$211.00	$64.57–$189.90	—	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPLISAV-B 20MCG/0.5ML ADT	$126.60	$211.00	$64.57–$189.90	—	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPB VACC 2 DOSE ADULT IM	$126.60	$211.00	$64.57–$189.90	—	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VAC 20MCG/0.5 ML	$168.80	$211.00	$64.57–$189.90	—	20%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 H. INFLUENZA B PRP-T VACCINE	$31.20	$52.00	$11.00–$135.21	at median	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 H. INFLUENZA B PRP-T VACCINE	$31.20	$52.00	$15.91–$46.80	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 VACCINE MEAS/MUMPS/RUBELLA INJ	$48.60	$81.00	$11.00–$100.75	26% below	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 VACCINE MEAS/MUMPS/RUBELLA INJ	$64.80	$81.00	$11.00–$100.75	1% below	20%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 VACCINE MEAS/MUMPS/RUBELLA INJ	$48.60	$81.00	$24.79–$72.90	—	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 VACCINE MEAS/MUMPS/RUBELLA INJ	$64.80	$81.00	$24.79–$72.90	—	20%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO INJECTION (VACCINE)	$81.60	$136.00	$11.00–$681.01	13% below	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO INJECTION (VACCINE)	$108.80	$136.00	$11.00–$681.01	16% above	20%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO INJECTION (VACCINE)	$81.60	$136.00	$41.62–$122.40	—	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO INJECTION (VACCINE)	$108.80	$136.00	$41.62–$122.40	—	20%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO INJECTION (VACCINE)	$82.20	$137.00	$11.00–$501.51	57% below	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL GRP B VACC 0.5ML	$82.20	$137.00	$11.00–$501.51	57% below	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL RECOMB VACC	$82.20	$137.00	$11.00–$501.51	57% below	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL GRP B VACC 0.5ML	$109.60	$137.00	$11.00–$501.51	43% below	20%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL RECOMB VACC	$82.20	$137.00	$41.92–$123.30	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL GRP B VACC 0.5ML	$82.20	$137.00	$41.92–$123.30	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO INJECTION (VACCINE)	$82.20	$137.00	$41.92–$123.30	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL GRP B VACC 0.5ML	$109.60	$137.00	$41.92–$123.30	—	20%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOC 13-VAL VAC 0.5ML	$144.00	$240.00	$11.00–$902.11	at median	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOC 13-VAL VAC 0.5ML	$144.00	$240.00	$73.44–$216.00	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOC 20-VAL VAC 0.5ML	$144.00	$240.00	$11.00–$441.11	55% below	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20 VACC 0.5ML INJ	$144.00	$240.00	$11.00–$441.11	55% below	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20 VACC 0.5ML INJ	$192.00	$240.00	$11.00–$441.11	41% below	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOC 20-VAL VAC 0.5ML	$144.00	$240.00	$73.44–$216.00	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20 VACC 0.5ML INJ	$144.00	$240.00	$73.44–$216.00	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20 VACC 0.5ML INJ	$192.00	$240.00	$73.44–$216.00	—	20%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 CAPVAXIVE VACCINE 0.5 ML SYR	$189.60	$316.00	$11.00–$452.19	at median	40%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 CAPVAXIVE VACCINE 0.5 ML SYR	$252.80	$316.00	$11.00–$452.19	33% above	20%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 CAPVAXIVE VACCINE 0.5 ML SYR	$189.60	$316.00	$96.70–$284.40	—	40%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 CAPVAXIVE VACCINE 0.5 ML SYR	$252.80	$316.00	$96.70–$284.40	—	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 VACCINE PNEUMOCC 0.5ML LED INJ	$75.00	$125.00	$11.00–$164.17	42% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC POLYVAL INJ	$75.00	$125.00	$11.00–$164.17	42% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 VACCINE PNEUMOCC 0.5ML LED INJ	$75.00	$125.00	$38.25–$112.50	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAC POLYVAL INJ	$75.00	$125.00	$38.25–$112.50	—	40%
Polio vaccine, inactivated (IPV) CPT 90713 IPOL POLIOVIRUS VAC .5ML INJ	$51.20	$64.00	$9.44–$57.60	15% below	20%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPOL POLIOVIRUS VAC .5ML INJ	$51.20	$64.00	$19.58–$57.60	—	20%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP RSV 50MG/0.5ML	$897.00	$1,495.00	$11.00–$4,760.08	at median	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP RSV 50MG/0.5ML	$1,196.00	$1,495.00	$11.00–$4,760.08	33% above	20%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP RSV 50MG/0.5ML	$897.00	$1,495.00	$457.47–$1,345.50	—	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP RSV 50MG/0.5ML	$1,196.00	$1,495.00	$457.47–$1,345.50	—	20%
Rabies vaccine, one dose CPT 90675 RABAVERT RABIES VIAL/KIT	$600.00	$1,000.00	$11.00–$1,001.70	at median	40%
Rabies vaccine, one dose CPT 90675 RABIES VAC HUM 1ML	$600.00	$1,000.00	$11.00–$1,001.70	at median	40%
Rabies vaccine, one dose CPT 90675 RABAVERT RABIES VIAL/KIT	$800.00	$1,000.00	$11.00–$1,001.70	34% above	20%
Rabies vaccine, one dose CPT 90675 RABIES VAC HUM 1ML	$800.00	$1,000.00	$11.00–$1,001.70	34% above	20%
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT RABIES VIAL/KIT	$600.00	$1,000.00	$306.00–$900.00	—	40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC HUM 1ML	$600.00	$1,000.00	$306.00–$900.00	—	40%
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT RABIES VIAL/KIT	$800.00	$1,000.00	$306.00–$900.00	—	20%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC HUM 1ML	$800.00	$1,000.00	$306.00–$900.00	—	20%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VAC RECOM NJX (SHINGRIX)	$150.00	$250.00	$11.00–$396.67	43% below	40%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HZV VAC RECOM NJX (SHINGRIX)	$150.00	$250.00	$76.50–$225.00	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPTHERIA INJ	$55.80	$93.00	$11.00–$151.97	at median	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPH-TETAN TOX 0.5ML ADULT INJ	$55.80	$93.00	$11.00–$151.97	at median	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPTHERIA INJ	$74.40	$93.00	$11.00–$151.97	33% above	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPTHERIA INJ	$55.80	$93.00	$28.46–$83.70	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIPH-TETAN TOX 0.5ML ADULT INJ	$55.80	$93.00	$28.46–$83.70	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPTHERIA INJ	$74.40	$93.00	$28.46–$83.70	—	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS DIPH PERT ADACEL IM IN	$31.80	$53.00	$11.00–$289.66	43% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX VACCINE	$31.80	$53.00	$11.00–$289.66	43% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX VACCINE	$42.40	$53.00	$11.00–$289.66	24% below	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS DIPH PERT ADACEL IM IN	$31.80	$53.00	$16.22–$47.70	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX VACCINE	$31.80	$53.00	$16.22–$47.70	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX VACCINE	$42.40	$53.00	$16.22–$47.70	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADM ONE VAC SGL/COMB	$12.00	$20.00	$0.93–$74.64	81% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADM ONE VAC SGL/COMB	$12.00	$20.00	$6.12–$18.00	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADM EA ADDL VACC SGL/COM	$12.00	$20.00	$0.44–$18.00	55% below	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADM EA ADDL VACC SGL/COM	$12.00	$20.00	$6.12–$18.00	—	40%

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

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

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

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

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

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

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

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

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

Source file: https://dam.upmc.com/-/media/upmc/locations/hospitals/documents/cdm-json-files/250965429_upmc-mercy_standardcharges.csv?la=en&rev=c23c35dd679441089e17dce21e2f6f78&hash=116444D295AD77110705A9CE347E1881