Hospital Coeur d'Alene, ID

Kootenai Health

Kootenai Health in Coeur D'Alene, ID publishes cash prices for 371 common procedures listed here, from its own machine-readable price file updated Mar 27, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Idaho median for 211 of 362 procedures and above it for 142. By typical cash price it ranks #12 of 33 Idaho hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

2003 Kootenai Health Way, Coeur d'Alene, ID 83814 Collected Sep 23, 2026 Source price file Check a bill from this hospital (208) 625-4000

Acute care hospital Government-owned hospital Emergency department CMS star rating 4 of 5 CCN 130049 · CMS hospital register NPI 1992798409

Financial assistance

Public hospital: ask for its charity care or sliding-scale discount

Kootenai Health is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Abdominal CT scan without and with contrast CPT 74170 C CT ABDOMEN W/&W/O IV CONTRAST	$1,431.00	$1,908.00	$175.06–$1,717.20	14% above	25%
Abdominal CT scan without and with contrast inpatient CPT 74170 C CT ABDOMEN W/&W/O IV CONTRAST	$1,431.00	$1,908.00	$496.08–$1,652.33	—	25%
Abdominal X-ray, 2 views CPT 74019 C XR ABDOMEN 2 VIEWS	$224.25	$299.00	$28.51–$388.99	25% below	25%
Abdominal X-ray, 2 views inpatient CPT 74019 C XR ABDOMEN 2 VIEWS	$224.25	$299.00	$77.74–$258.93	—	25%
Ankle X-ray, complete, 3 or more views CPT 73610 C XR ANKLE 3+ VIEW, COMPLETE	$273.00	$364.00	$27.85–$327.60	5% below	25%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 C XR ANKLE 3+ VIEW, COMPLETE	$273.00	$364.00	$94.64–$315.22	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC NONINVASV EXTREM 1-2 LEVEL BILAT	$281.25	$375.00	$62.19–$495.04	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC NONINVASV EXTREM 1-2 LEVEL BILAT	$281.25	$375.00	$97.50–$324.75	—	25%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 C CT UPR EXT W/O CONTRAST	$1,116.00	$1,488.00	$104.75–$1,339.20	9% above	25%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 C CT UPR EXT W/O CONTRAST	$1,116.00	$1,488.00	$386.88–$1,288.61	—	25%
Barium swallow (esophagus X-ray with contrast) CPT 74220 C RADIOLOGIC EXAMINATION, ESOPHAGUS, INCLUDING SCOUT CHEST RADIOGRAPH(S) AND DELAYED IMAGE(S), WHEN PERFORMED, SINGLE-CONTRAST (EG, BARIUM) STUDY	$404.25	$539.00	$74.12–$652.63	4% below	25%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 C RADIOLOGIC EXAMINATION, ESOPHAGUS, INCLUDING SCOUT CHEST RADIOGRAPH(S) AND DELAYED IMAGE(S), WHEN PERFORMED, SINGLE-CONTRAST (EG, BARIUM) STUDY	$404.25	$539.00	$140.14–$466.77	—	25%
Bone scan, whole body (nuclear medicine) CPT 78306 C NM BONE IMAGING, WHOLE BODY	$1,961.25	$2,615.00	$202.20–$2,353.50	38% above	25%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 C NM BONE IMAGING, WHOLE BODY	$1,961.25	$2,615.00	$679.90–$2,264.59	—	25%
Breast ultrasound, complete, one breast one side CPT 76641 US, BREAST, UNILATERAL, REAL TIME W IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; COMPLETE	$327.00	$436.00	$78.90–$470.69	21% below	25%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US, BREAST, UNILATERAL, REAL TIME W IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; COMPLETE	$327.00	$436.00	$113.36–$377.58	—	25%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US, BREAST, UNILATERAL, REAL TIME W IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; LIMITED	$299.25	$399.00	$65.58–$436.98	7% below	25%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US, BREAST, UNILATERAL, REAL TIME W IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; LIMITED	$299.25	$399.00	$103.74–$345.53	—	25%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 C CT ANGIO ABD/PELV W/&W/O CONTR	$2,754.00	$3,672.00	$297.14–$3,304.80	22% above	25%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 C CT ANGIO ABD/PELV W/&W/O CONTR	$2,754.00	$3,672.00	$954.72–$3,179.95	—	25%
CT angiography (CTA) of the head CPT 70496 C CT ANGIO HEAD W/&W/O CONTRAST	$1,575.00	$2,100.00	$175.06–$1,890.00	9% above	25%
CT angiography (CTA) of the head inpatient CPT 70496 C CT ANGIO HEAD W/&W/O CONTRAST	$1,575.00	$2,100.00	$546.00–$1,818.60	—	25%
CT angiography (CTA) of the neck CPT 70498 C CT ANGIO NECK W/&W/O CONTRAST	$1,575.00	$2,100.00	$175.06–$1,890.00	7% above	25%
CT angiography (CTA) of the neck inpatient CPT 70498 C CT ANGIO NECK W/&W/O CONTRAST	$1,575.00	$2,100.00	$546.00–$1,818.60	—	25%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 C CT ANGIO CHEST W/&W/O CONTRAST	$1,612.50	$2,150.00	$175.06–$1,935.00	4% above	25%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 C CT ANGIO CHEST W/&W/O CONTRAST	$1,612.50	$2,150.00	$559.00–$1,861.90	—	25%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST	$1,725.00	$2,300.00	$175.06–$2,070.00	4% above	25%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST	$1,725.00	$2,300.00	$598.00–$1,991.80	—	25%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM	$174.75	$233.00	$78.52–$323.80	75% above	25%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM	$174.75	$233.00	$60.58–$201.78	—	25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 C CT ABD & PELVIS W/O CONTRAST	$1,762.50	$2,350.00	$145.08–$2,115.00	7% above	25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 C CT ABD & PELVIS W/O CONTRAST	$1,762.50	$2,350.00	$611.00–$2,035.10	—	25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 C CT ABDOMEN&PELVIS W/CONTRAST	$2,287.50	$3,050.00	$236.39–$2,996.49	1% above	25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 C CT ABDOMEN&PELVIS W/CONTRAST	$2,287.50	$3,050.00	$793.00–$2,641.30	—	25%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 C CT ABD&PELV 1+ SECTION/REGNS	$2,625.00	$3,500.00	$264.67–$3,150.00	13% above	25%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 C CT ABD&PELV 1+ SECTION/REGNS	$2,625.00	$3,500.00	$910.00–$3,031.00	—	25%
CT scan of the abdomen with contrast CPT 74160 C CT ABDOMEN W/ IV CONTRAST	$1,282.50	$1,710.00	$175.06–$1,539.00	9% above	25%
CT scan of the abdomen with contrast inpatient CPT 74160 C CT ABDOMEN W/ IV CONTRAST	$1,282.50	$1,710.00	$444.60–$1,480.86	—	25%
CT scan of the abdomen without contrast CPT 74150 C CT ABDOMEN W/O IV CONTRAST	$1,062.75	$1,417.00	$104.75–$1,275.30	17% above	25%
CT scan of the abdomen without contrast inpatient CPT 74150 C CT ABDOMEN W/O IV CONTRAST	$1,062.75	$1,417.00	$368.42–$1,227.12	—	25%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLA/FACIAL W/O CONTRAST	$1,167.00	$1,556.00	$100.53–$1,400.40	36% above	25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLA/FACIAL W/O CONTRAST	$1,167.00	$1,556.00	$404.56–$1,347.50	—	25%
CT scan of the head or brain, no contrast dye CPT 70450 C CT HEAD W/O CONTRAST	$1,151.25	$1,535.00	$84.03–$1,381.50	16% above	25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 C CT HEAD W/O CONTRAST	$1,151.25	$1,535.00	$399.10–$1,329.31	—	25%
CT scan of the head with contrast CPT 70460 C CT HEAD W/ CONTRAST	$1,282.50	$1,710.00	$116.74–$1,539.00	17% above	25%
CT scan of the head with contrast inpatient CPT 70460 C CT HEAD W/ CONTRAST	$1,282.50	$1,710.00	$444.60–$1,480.86	—	25%
CT scan of the head without and with contrast CPT 70470 C CT HEAD W/&W/O CONTRAST	$1,314.00	$1,752.00	$136.25–$1,576.80	1% above	25%
CT scan of the head without and with contrast inpatient CPT 70470 C CT HEAD W/&W/O CONTRAST	$1,314.00	$1,752.00	$455.52–$1,517.23	—	25%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 C CT LSPINE W/O CONTRAST	$881.25	$1,175.00	$101.92–$1,057.50	5% below	25%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 C CT LSPINE W/O CONTRAST	$881.25	$1,175.00	$305.50–$1,017.55	—	25%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 C CT CSPINE W/O CONTRAST	$862.50	$1,150.00	$102.43–$1,035.00	22% below	25%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 C CT CSPINE W/O CONTRAST	$862.50	$1,150.00	$299.00–$995.90	—	25%
CT scan of the pelvis, with contrast dye CPT 72193 C CT PELVIS W/ IV CONTRAST	$1,425.00	$1,900.00	$175.06–$1,710.00	19% above	25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 C CT PELVIS W/ IV CONTRAST	$1,425.00	$1,900.00	$494.00–$1,645.40	—	25%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX ARTERIAL CAROTID COMPLETE BILATERAL	$675.00	$900.00	$143.55–$887.79	—	25%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX ARTERIAL CAROTID COMPLETE BILATERAL	$675.00	$900.00	$234.00–$779.40	—	25%
Chest CT scan without and with contrast CPT 71270 HC COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS	$1,425.00	$1,900.00	$153.72–$1,710.00	8% below	25%
Chest CT scan without and with contrast inpatient CPT 71270 HC COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS	$1,425.00	$1,900.00	$494.00–$1,645.40	—	25%
Chest X-ray, 2 views CPT 71046 C XR CHEST SINGLE 2 VIEWS	$210.75	$281.00	$25.95–$323.80	19% below	25%
Chest X-ray, 2 views inpatient CPT 71046 C XR CHEST SINGLE 2 VIEWS	$210.75	$281.00	$73.06–$243.35	—	25%
Chest X-ray, single view CPT 71045 C XR CHEST SINGLE VIEW	$181.50	$242.00	$20.01–$323.80	22% below	25%
Chest X-ray, single view inpatient CPT 71045 C XR CHEST SINGLE VIEW	$181.50	$242.00	$62.92–$209.57	—	25%
Collarbone (clavicle) X-ray, complete CPT 73000 C XR CLAVICLE	$231.00	$308.00	$25.03–$323.80	18% below	25%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 C XR CLAVICLE	$231.00	$308.00	$80.08–$266.73	—	25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 C US RETROPERITONEAL	$475.50	$634.00	$83.12–$609.32	2% above	25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 C US RETROPERITONEAL	$475.50	$634.00	$164.84–$549.04	—	25%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 C DEXA BONE DENSITY STUDY	$266.25	$355.00	$30.20–$388.99	18% below	25%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 C DEXA BONE DENSITY STUDY	$266.25	$355.00	$92.30–$307.43	—	25%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 C DXA BONE DENSITY/PERIPHERAL	$217.50	$290.00	$24.62–$323.80	16% above	25%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 C DXA BONE DENSITY/PERIPHERAL	$217.50	$290.00	$75.40–$251.14	—	25%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 C US OB DETAILED ANATOMIC SURVEY	$588.75	$785.00	$139.01–$887.79	8% below	25%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 C US OB DETAILED ANATOMIC SURVEY	$588.75	$785.00	$204.10–$679.81	—	25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; WITHOUT CONTRAST MATERIAL	$900.00	$1,200.00	$104.75–$1,080.00	at median	25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; WITHOUT CONTRAST MATERIAL	$900.00	$1,200.00	$312.00–$1,039.20	—	25%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; WITH CONTRAST MATERIAL(S)	$1,362.75	$1,817.00	$131.02–$1,635.30	15% above	25%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; WITH CONTRAST MATERIAL(S)	$1,362.75	$1,817.00	$472.42–$1,573.52	—	25%
Diagnostic mammogram, both breasts both sides CPT 77066 C DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; BILATERAL	$319.50	$426.00	$111.85–$525.06	—	25%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 C DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; BILATERAL	$319.50	$426.00	$110.76–$368.92	—	25%
Diagnostic mammogram, one breast one side CPT 77065 C DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; UNILATERAL	$250.50	$334.00	$87.21–$414.79	21% below	25%
Diagnostic mammogram, one breast inpatient one side CPT 77065 C DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; UNILATERAL	$250.50	$334.00	$86.84–$289.24	—	25%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BYPASS GRAFTS COMPL BI STUDY	$689.25	$919.00	$180.47–$887.79	—	25%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BYPASS GRAFTS COMPL BI STUDY	$689.25	$919.00	$238.94–$795.85	—	25%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY - 93970	$897.75	$1,197.00	$141.14–$1,077.30	—	25%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY - 93970	$897.75	$1,197.00	$311.22–$1,036.60	—	25%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D WO/ CONTRAST	$1,626.00	$2,168.00	$150.32–$2,033.09	11% below	25%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D W/ CONTRAST	$1,869.75	$2,493.00	$150.32–$2,243.70	3% above	25%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D WO/ CONTRAST	$1,626.00	$2,168.00	$563.68–$1,877.49	—	25%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D W/ CONTRAST	$1,869.75	$2,493.00	$648.18–$2,158.94	—	25%
Elbow X-ray, 2 views CPT 73070 C XR ELBOW 2 VIEW - AP, LAT	$210.00	$280.00	$22.49–$323.80	13% below	25%
Elbow X-ray, 2 views inpatient CPT 73070 C XR ELBOW 2 VIEW - AP, LAT	$210.00	$280.00	$72.80–$242.48	—	25%
Elbow X-ray, complete, 3 or more views CPT 73080 C XR ELBOW 3+ VIEW, COMPLETE	$252.75	$337.00	$25.06–$323.80	19% below	25%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 C XR ELBOW 3+ VIEW, COMPLETE	$252.75	$337.00	$87.62–$291.84	—	25%
Eye socket (orbit) CT scan without contrast CPT 70480 C CT ORBIT SELLA POST FOSSA WO	$1,260.00	$1,680.00	$104.75–$1,512.00	47% above	25%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 C CT ORBIT SELLA POST FOSSA WO	$1,260.00	$1,680.00	$436.80–$1,454.88	—	25%
Facial bones X-ray, complete, 3 or more views CPT 70150 C XR FACIAL BONES 3+ VIEW COMPLETE	$316.50	$422.00	$35.94–$388.99	4% above	25%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 C XR FACIAL BONES 3+ VIEW COMPLETE	$316.50	$422.00	$109.72–$365.45	—	25%
Forearm X-ray (radius and ulna), 2 views CPT 73090 C XR FOREARM	$236.25	$315.00	$22.49–$323.80	10% below	25%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 C XR FOREARM	$236.25	$315.00	$81.90–$272.79	—	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 C NM HEPATOBIL SYS INC GB	$1,488.00	$1,984.00	$221.67–$1,785.60	4% above	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 C NM HEPATOBIL SYS INC GB	$1,488.00	$1,984.00	$515.84–$1,718.14	—	25%
Hand X-ray, 2 views CPT 73120 C XR HAND 2 VIEW - AP, LAT	$241.50	$322.00	$24.02–$388.99	19% below	25%
Hand X-ray, 2 views inpatient CPT 73120 C XR HAND 2 VIEW - AP, LAT	$241.50	$322.00	$83.72–$278.85	—	25%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 C XR HEEL 2+ VIEW	$231.00	$308.00	$21.73–$323.80	28% below	25%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 C XR HEEL 2+ VIEW	$231.00	$308.00	$80.08–$266.73	—	25%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 C HB HOME SLEEP STUDY - DOT (PDX)	$517.50	$690.00	$74.85–$803.40	30% below	25%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 C HB HOME SLEEP STUDY - DOT (PDX)	$517.50	$690.00	$179.40–$597.54	—	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 C SLP-POLYSOMNOGRAPHY W/CPAP	$4,059.00	$5,412.00	$503.35–$4,870.80	23% above	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 C SLP-POLYSOMNOGRAPHY W/CPAP	$4,059.00	$5,412.00	$1,407.12–$4,686.79	—	25%
Knee X-ray, 3 views CPT 73562 HC XR KNEE 3 VIEW (SPECIFY VIEW 3)	$231.00	$308.00	$31.17–$323.80	35% below	25%
Knee X-ray, 3 views inpatient CPT 73562 HC XR KNEE 3 VIEW (SPECIFY VIEW 3)	$231.00	$308.00	$80.08–$266.73	—	25%
Knee X-ray, complete, 4 or more views CPT 73564 C XR KNEE 4+ VIEW, COMPLETE (SPECIFY VIEW 3 & 4)	$247.50	$330.00	$36.35–$388.99	31% below	25%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 C XR KNEE 4+ VIEW, COMPLETE (SPECIFY VIEW 3 & 4)	$247.50	$330.00	$85.80–$285.78	—	25%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 C CT LWR EXT W/O CONTRAST	$934.50	$1,246.00	$102.18–$1,121.40	7% below	25%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 C CT LWR EXT W/O CONTRAST	$934.50	$1,246.00	$323.96–$1,079.04	—	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMINAL, LIMITED (SPECIFY AREA)	$475.50	$634.00	$67.00–$570.60	8% above	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMINAL, LIMITED (SPECIFY AREA)	$475.50	$634.00	$164.84–$549.04	—	25%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC ULTRASOUND, LIMITED, JOINT OR FOCAL EVALUATION OF OTHER NONVASCULAR EXTREMITY STRUCTURE(S), REAL-TIME WITH IMAGE DOCUMENTATION	$378.75	$505.00	$50.13–$454.50	4% below	25%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC ULTRASOUND, LIMITED, JOINT OR FOCAL EVALUATION OF OTHER NONVASCULAR EXTREMITY STRUCTURE(S), REAL-TIME WITH IMAGE DOCUMENTATION	$378.75	$505.00	$131.30–$437.33	—	25%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC COMPUTED TOMOGRAPHY, THORAX, LOW DOSE FOR LUNG CANCER SCREENING, WITHOUT CONTRAST MATERIAL(S)	$244.50	$326.00	$104.75–$388.99	70% below	25%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC COMPUTED TOMOGRAPHY, THORAX, LOW DOSE FOR LUNG CANCER SCREENING, WITHOUT CONTRAST MATERIAL(S)	$244.50	$326.00	$84.76–$282.32	—	25%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 C XR TIBIA/FIBULA 2 VIEW	$210.75	$281.00	$24.27–$323.80	22% below	25%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 C XR TIBIA/FIBULA 2 VIEW	$210.75	$281.00	$73.06–$243.35	—	25%
MR angiography (MRA) of the head without contrast CPT 70544 C MRA HEAD W/O CONTRAST	$1,503.00	$2,004.00	$168.56–$2,166.74	4% below	25%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 C MRA HEAD W/O CONTRAST	$1,503.00	$2,004.00	$521.04–$1,735.46	—	25%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MRI,BREAST,W/OUT AND WITH CONTRAST MATERIAL,INC CAD,WHEN PERFORMED:BILATERAL	$2,601.75	$3,469.00	$268.08–$3,750.79	—	25%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HC MRI,BREAST,W/OUT AND WITH CONTRAST MATERIAL,INC CAD,WHEN PERFORMED:BILATERAL	$2,601.75	$3,469.00	$901.94–$3,004.15	—	25%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 C MRI LWR EXT JOINT W/O CONTRAST	$1,595.25	$2,127.00	$159.43–$1,914.30	10% below	25%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 C MRI LWR EXT JOINT W/O CONTRAST	$1,595.25	$2,127.00	$553.02–$1,841.98	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 C MRI LWR EXT JOINT W/&W/O CONTRAST	$2,483.25	$3,311.00	$299.79–$3,086.47	10% above	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 C MRI LWR EXT JOINT W/&W/O CONTRAST	$2,483.25	$3,311.00	$860.86–$2,867.33	—	25%
MRI of the abdomen without contrast CPT 74181 C MRI ABDOMEN W/O CONTRAST	$1,595.25	$2,127.00	$153.62–$1,914.30	3% below	25%
MRI of the abdomen without contrast inpatient CPT 74181 C MRI ABDOMEN W/O CONTRAST	$1,595.25	$2,127.00	$553.02–$1,841.98	—	25%
MRI of the abdomen, without and then with contrast dye CPT 74183 C MRI ABDOMEN W/&W/O CONTRAST	$2,229.75	$2,973.00	$264.65–$3,213.81	2% below	25%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 C MRI ABDOMEN W/&W/O CONTRAST	$2,229.75	$2,973.00	$772.98–$2,574.62	—	25%
MRI of the brain, no contrast dye CPT 70551 HC MRI HEAD W/O CONTRAST	$1,595.25	$2,127.00	$154.44–$1,914.30	6% below	25%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI HEAD W/O CONTRAST	$1,595.25	$2,127.00	$553.02–$1,841.98	—	25%
MRI of the brain, with and without contrast dye CPT 70553 C MRI HEAD W/&W/O CONTRAST	$2,074.50	$2,766.00	$250.29–$2,990.15	8% below	25%
MRI of the brain, with and without contrast dye inpatient CPT 70553 C MRI HEAD W/&W/O CONTRAST	$2,074.50	$2,766.00	$719.16–$2,395.36	—	25%
MRI of the lower back, no contrast dye CPT 72148 C MRI LSPINE W/O CONTRAST	$1,519.50	$2,026.00	$150.37–$1,823.40	2% below	25%
MRI of the lower back, no contrast dye inpatient CPT 72148 C MRI LSPINE W/O CONTRAST	$1,519.50	$2,026.00	$526.76–$1,754.52	—	25%
MRI of the lower back, without and then with contrast dye CPT 72158 C MRI LSPINE W/&W/O CONTRAST	$2,364.75	$3,153.00	$250.54–$2,936.88	4% above	25%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 C MRI LSPINE W/&W/O CONTRAST	$2,364.75	$3,153.00	$819.78–$2,730.50	—	25%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 C MRI TSPINE W/O CONTRAST	$1,595.25	$2,127.00	$150.12–$1,914.30	at median	25%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 C MRI TSPINE W/O CONTRAST	$1,595.25	$2,127.00	$553.02–$1,841.98	—	25%
MRI of the neck (cervical spine) without and with contrast CPT 72156 C MRI CSPINE W/&W/O CONTRAST	$2,483.25	$3,311.00	$251.05–$2,979.90	8% above	25%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 C MRI CSPINE W/&W/O CONTRAST	$2,483.25	$3,311.00	$860.86–$2,867.33	—	25%
MRI of the neck (cervical spine), no contrast dye CPT 72141 C MRI CSPINE W/O CONTRAST	$1,595.25	$2,127.00	$149.87–$1,914.30	1% below	25%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 C MRI CSPINE W/O CONTRAST	$1,595.25	$2,127.00	$553.02–$1,841.98	—	25%
MRI of the pelvis without and with contrast CPT 72197 C MRI PELVIS W/&W/O CONTRAST	$2,726.25	$3,635.00	$263.64–$3,271.50	20% above	25%
MRI of the pelvis without and with contrast inpatient CPT 72197 C MRI PELVIS W/&W/O CONTRAST	$2,726.25	$3,635.00	$945.10–$3,147.91	—	25%
MRI of the pelvis, no contrast dye CPT 72195 C MRI PELVIS W/O CONTRAST	$1,595.25	$2,127.00	$178.74–$1,914.30	3% below	25%
MRI of the pelvis, no contrast dye inpatient CPT 72195 C MRI PELVIS W/O CONTRAST	$1,595.25	$2,127.00	$553.02–$1,841.98	—	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 C MRI UPR EXT JOINT W/O CONTRAST	$1,595.25	$2,127.00	$159.68–$1,914.30	13% below	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 C MRI UPR EXT JOINT W/O CONTRAST	$1,595.25	$2,127.00	$553.02–$1,841.98	—	25%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC XR CSPINE 4 OR 5 VIEWS (SPECIFY VIEWS)	$324.75	$433.00	$41.55–$432.74	12% below	25%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC XR CSPINE 4 OR 5 VIEWS (SPECIFY VIEWS)	$324.75	$433.00	$112.58–$374.98	—	25%
Neck soft tissue CT scan with contrast CPT 70491 C CT SOFT TISSUE NECK W/ CONTRAST	$1,574.25	$2,099.00	$144.66–$1,889.10	41% above	25%
Neck soft tissue CT scan with contrast inpatient CPT 70491 C CT SOFT TISSUE NECK W/ CONTRAST	$1,574.25	$2,099.00	$545.74–$1,817.73	—	25%
Neck soft tissue CT scan without contrast CPT 70490 C CT SOFT TISSUE NECK W/O CONTRAST	$1,080.00	$1,440.00	$104.75–$1,296.00	24% above	25%
Neck soft tissue CT scan without contrast inpatient CPT 70490 C CT SOFT TISSUE NECK W/O CONTRAST	$1,080.00	$1,440.00	$374.40–$1,247.04	—	25%
Neck soft tissue X-ray CPT 70360 C XR SOFT TISSUE NECK	$315.75	$421.00	$24.07–$378.90	39% above	25%
Neck soft tissue X-ray inpatient CPT 70360 C XR SOFT TISSUE NECK	$315.75	$421.00	$109.46–$364.59	—	25%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 C NM MYOCARDIAL SPECT MULTIPLE STUDIES - 78452	$3,795.00	$5,060.00	$323.42–$4,817.11	9% below	25%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 C NM MYOCARDIAL SPECT MULTIPLE STUDIES - 78452	$3,795.00	$5,060.00	$1,315.60–$4,381.96	—	25%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 C PET SKULL TO MID-THIGH	$5,291.25	$7,055.00	$1,477.93–$6,965.86	24% below	25%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 C PET SKULL TO MID-THIGH	$5,291.25	$7,055.00	$1,834.30–$6,109.63	—	25%
Pelvic CT scan without contrast CPT 72192 C CT PELVIS W/O IV CONTRAST	$1,181.25	$1,575.00	$104.75–$1,417.50	28% above	25%
Pelvic CT scan without contrast inpatient CPT 72192 C CT PELVIS W/O IV CONTRAST	$1,181.25	$1,575.00	$409.50–$1,363.95	—	25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 C US PELVIS LIMITED, NON-OBSTETRIC	$385.50	$514.00	$38.98–$462.60	1% above	25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 C US PELVIS LIMITED, NON-OBSTETRIC	$385.50	$514.00	$133.64–$445.12	—	25%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 C US PELVIS NON OB	$498.00	$664.00	$80.83–$603.63	4% above	25%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 C US PELVIS NON OB	$498.00	$664.00	$172.64–$575.02	—	25%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 C US OB COMPLETE > 14 WEEKS	$420.00	$560.00	$103.81–$604.42	5% below	25%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 C US OB COMPLETE > 14 WEEKS	$420.00	$560.00	$145.60–$484.96	—	25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 C US OB < 14 WEEKS	$362.25	$483.00	$90.49–$434.70	15% below	25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 C US OB < 14 WEEKS	$362.25	$483.00	$125.58–$418.28	—	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED	$269.25	$359.00	$62.58–$388.99	12% below	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED	$269.25	$359.00	$93.34–$310.89	—	25%
Rib X-ray, one side, 2 views one side CPT 71100 C XR RIBS UNILATERAL 2 VIEW NO CHEST	$285.75	$381.00	$28.22–$342.90	7% above	25%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 C XR RIBS UNILATERAL 2 VIEW NO CHEST	$285.75	$381.00	$99.06–$329.95	—	25%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 C XR RIBS UNILATERAL 3+ VIEW WITH CHEST	$295.50	$394.00	$32.42–$388.99	26% below	25%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 C XR RIBS UNILATERAL 3+ VIEW WITH CHEST	$295.50	$394.00	$102.44–$341.20	—	25%
Screening mammogram, both breasts both sides CPT 77067 C SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING CAD WHEN PERFORMED	$251.25	$335.00	$92.21–$422.59	—	25%
Screening mammogram, both breasts inpatient both sides CPT 77067 C SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING CAD WHEN PERFORMED	$251.25	$335.00	$87.10–$290.11	—	25%
Shoulder X-ray, complete, 2 or more views CPT 73030 C XR SHOULDER 2+ VIEW, COMPLETE	$249.00	$332.00	$26.60–$323.80	27% below	25%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 C XR SHOULDER 2+ VIEW, COMPLETE	$249.00	$332.00	$86.32–$287.51	—	25%
Sinus X-ray, complete, 3 or more views CPT 70220 C XR SINUSES 3+ VIEW COMPLETE	$265.50	$354.00	$28.99–$323.80	16% below	25%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 C XR SINUSES 3+ VIEW COMPLETE	$265.50	$354.00	$92.04–$306.56	—	25%
Skull X-ray, fewer than 4 views CPT 70250 C XR SKULL < 4 VIEW LIMITED	$318.75	$425.00	$27.62–$388.99	24% above	25%
Skull X-ray, fewer than 4 views inpatient CPT 70250 C XR SKULL < 4 VIEW LIMITED	$318.75	$425.00	$110.50–$368.05	—	25%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY GREATER 6 YRS WITH 4 0R MORE ADDTL PARAM	$4,059.00	$5,412.00	$480.76–$4,870.80	23% above	25%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY GREATER 6 YRS WITH 4 0R MORE ADDTL PARAM	$4,059.00	$5,412.00	$1,407.12–$4,686.79	—	25%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$391.50	$522.00	$93.48–$652.63	3% below	25%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$391.50	$522.00	$135.72–$452.05	—	25%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 C XR FEMUR:2 VIEWS	$192.75	$257.00	$27.36–$323.80	33% below	25%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 C XR FEMUR:2 VIEWS	$192.75	$257.00	$66.82–$222.56	—	25%
Thoracic spine (mid back) CT scan without contrast CPT 72128 C CT TSPINE W/O CONTRAST	$881.25	$1,175.00	$102.18–$1,057.50	15% below	25%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 C CT TSPINE W/O CONTRAST	$881.25	$1,175.00	$305.50–$1,017.55	—	25%
Toe X-ray, 2 or more views CPT 73660 C XR TOES 2+ VIEW	$173.25	$231.00	$22.17–$323.80	30% below	25%
Toe X-ray, 2 or more views inpatient CPT 73660 C XR TOES 2+ VIEW	$173.25	$231.00	$60.06–$200.05	—	25%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON OBSTETRIC	$433.50	$578.00	$90.73–$520.20	1% below	25%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON OBSTETRIC	$433.50	$578.00	$150.28–$500.55	—	25%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL	$315.00	$420.00	$71.21–$411.40	27% below	25%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US OB TRANSVAGINAL	$315.00	$420.00	$109.20–$363.72	—	25%
Ultrasound of the abdomen, complete CPT 76700 C US ABDOMINAL	$717.75	$957.00	$89.14–$861.30	36% above	25%
Ultrasound of the abdomen, complete inpatient CPT 76700 C US ABDOMINAL	$717.75	$957.00	$248.82–$828.76	—	25%
Ultrasound of the scrotum and testicles CPT 76870 C US TESTICULAR	$372.75	$497.00	$76.90–$536.52	15% below	25%
Ultrasound of the scrotum and testicles inpatient CPT 76870 C US TESTICULAR	$372.75	$497.00	$129.22–$430.40	—	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 C US SOFT TISSUE NECK	$480.00	$640.00	$84.05–$617.65	9% above	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 C US SOFT TISSUE NECK	$480.00	$640.00	$166.40–$554.24	—	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 C RADIOLOGIC EXAMINATION, UPPER GASTROINTESTINAL TRACT, INCLUDING SCOUT ABDOMINAL RADIOGRAPH(S) AND DELAYED IMAGE(S), WHEN PERFORMED, SINGLE-CONTRAST (EG, BARIUM) STUDY	$496.50	$662.00	$93.29–$652.63	at median	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 C RADIOLOGIC EXAMINATION, UPPER GASTROINTESTINAL TRACT, INCLUDING SCOUT ABDOMINAL RADIOGRAPH(S) AND DELAYED IMAGE(S), WHEN PERFORMED, SINGLE-CONTRAST (EG, BARIUM) STUDY	$496.50	$662.00	$172.12–$573.29	—	25%
Upper arm X-ray (humerus), 2 views CPT 73060 C XR HUMERUS	$192.75	$257.00	$24.52–$323.80	32% below	25%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 C XR HUMERUS	$192.75	$257.00	$66.82–$222.56	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY - 93971	$661.50	$882.00	$90.36–$793.80	15% above	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY - 93971	$661.50	$882.00	$229.32–$763.81	—	25%
Wrist X-ray, 2 views CPT 73100 C XR WRIST 2 VIEW - AP, LAT	$240.00	$320.00	$25.80–$323.80	11% below	25%
Wrist X-ray, 2 views inpatient CPT 73100 C XR WRIST 2 VIEW - AP, LAT	$240.00	$320.00	$83.20–$277.12	—	25%
Wrist X-ray, complete, 3 or more views CPT 73110 C XR WRIST 3+ VIEW, COMPLETE	$273.00	$364.00	$31.66–$327.60	23% below	25%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 C XR WRIST 3+ VIEW, COMPLETE	$273.00	$364.00	$94.64–$315.22	—	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 C XR HIP,UNILATERAL W/PELVIS (WHEN PERFORMED):2-3 VIEWS	$192.75	$257.00	$36.60–$323.80	17% below	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 C XR HIP,UNILATERAL W/PELVIS (WHEN PERFORMED):2-3 VIEWS	$192.75	$257.00	$66.82–$222.56	—	25%
X-ray of the abdomen, 1 view CPT 74018 C XR ABDOMEN 1 VIEW	$210.75	$281.00	$23.05–$323.80	6% below	25%
X-ray of the abdomen, 1 view inpatient CPT 74018 C XR ABDOMEN 1 VIEW	$210.75	$281.00	$73.06–$243.35	—	25%
X-ray of the ankle, 2 views CPT 73600 C XR ANKLE 2 VIEW - AP, LAT	$231.00	$308.00	$24.52–$323.80	17% below	25%
X-ray of the ankle, 2 views inpatient CPT 73600 C XR ANKLE 2 VIEW - AP, LAT	$231.00	$308.00	$80.08–$266.73	—	25%
X-ray of the finger(s), 2 or more views CPT 73140 C XR FINGERS 2+ VIEW	$208.50	$278.00	$29.26–$323.80	20% below	25%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 C XR FINGERS 2+ VIEW	$208.50	$278.00	$72.28–$240.75	—	25%
X-ray of the foot, 2 views CPT 73620 C XR FOOT 2 VIEW - AP, LAT	$228.00	$304.00	$21.73–$323.80	17% below	25%
X-ray of the foot, 2 views inpatient CPT 73620 C XR FOOT 2 VIEW - AP, LAT	$228.00	$304.00	$79.04–$263.26	—	25%
X-ray of the foot, complete, 3 or more views CPT 73630 C XR FOOT 3+ VIEW, COMPLETE	$249.00	$332.00	$26.06–$323.80	30% below	25%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 C XR FOOT 3+ VIEW, COMPLETE	$249.00	$332.00	$86.32–$287.51	—	25%
X-ray of the hand, 3 or more views CPT 73130 C XR HAND 3+ VIEW, COMPLETE	$252.75	$337.00	$28.61–$323.80	31% below	25%
X-ray of the hand, 3 or more views inpatient CPT 73130 C XR HAND 3+ VIEW, COMPLETE	$252.75	$337.00	$87.62–$291.84	—	25%
X-ray of the knee, 1 or 2 views CPT 73560 C XR KNEE 2 VIEWS - AP, LAT	$225.75	$301.00	$26.04–$323.80	8% below	25%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 C XR KNEE 2 VIEWS - AP, LAT	$225.75	$301.00	$78.26–$260.67	—	25%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 C XR LSPINE 2-3 VIEW - AP, LAT	$192.00	$256.00	$30.52–$388.99	36% below	25%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 C XR LSPINE 2-3 VIEW - AP, LAT	$192.00	$256.00	$66.56–$221.70	—	25%
X-ray of the lower back, 4 or more views CPT 72110 C XR LSPINE 4+ VIEW	$380.25	$507.00	$40.00–$456.30	5% below	25%
X-ray of the lower back, 4 or more views inpatient CPT 72110 C XR LSPINE 4+ VIEW	$380.25	$507.00	$131.82–$439.06	—	25%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 C XR TSPINE 2 VIEW - AP, LAT	$171.75	$229.00	$25.38–$388.99	41% below	25%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 C XR TSPINE 2 VIEW - AP, LAT	$171.75	$229.00	$59.54–$198.31	—	25%
X-ray of the nasal bones, 3 or more views CPT 70160 C XR NASAL BONES	$348.75	$465.00	$28.87–$418.50	36% above	25%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 C XR NASAL BONES	$348.75	$465.00	$120.90–$402.69	—	25%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR CSPINE 2-3 VIEW - AP, LAT	$192.00	$256.00	$30.52–$331.67	27% below	25%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC XR CSPINE 2-3 VIEW - AP, LAT	$192.00	$256.00	$66.56–$221.70	—	25%
X-ray of the pelvis, 1 or 2 views CPT 72170 C XR PELVIS 1-2 VIEW	$241.50	$322.00	$21.50–$388.99	8% below	25%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 C XR PELVIS 1-2 VIEW	$241.50	$322.00	$83.72–$278.85	—	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 C XR SACRUM/COCCYX	$209.25	$279.00	$25.06–$323.80	16% below	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 C XR SACRUM/COCCYX	$209.25	$279.00	$72.54–$241.61	—	25%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
ACTH blood test CPT 82024 HC ACTH-ADRENOCORTICOTROPC HORM,P (REF LAB)	$141.75	$189.00	$33.37–$242.60	16% below	25%
ACTH blood test inpatient CPT 82024 HC ACTH-ADRENOCORTICOTROPC HORM,P (REF LAB)	$141.75	$189.00	$49.14–$163.67	—	25%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALANINE AMINOTRANSFERASE (ALT) (GPT), SERUM (REF LAB)	$33.00	$44.00	$4.58–$58.05	2% above	25%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALT/SGPT	$47.25	$63.00	$4.58–$58.05	47% above	25%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC NEONATE CHEM ALT	$47.25	$63.00	$4.58–$58.05	47% above	25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC ALANINE AMINOTRANSFERASE (ALT) (GPT), SERUM (REF LAB)	$33.00	$44.00	$11.44–$38.10	—	25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC NEONATE CHEM ALT	$47.25	$63.00	$16.38–$54.56	—	25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC ALT/SGPT	$47.25	$63.00	$16.38–$54.56	—	25%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC NEONATE CHEM AST	$47.25	$63.00	$4.47–$56.77	28% above	25%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC AST/SGOT	$47.25	$63.00	$4.47–$56.77	28% above	25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC AST/SGOT	$47.25	$63.00	$16.38–$54.56	—	25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC NEONATE CHEM AST	$47.25	$63.00	$16.38–$54.56	—	25%
Albumin blood test CPT 82040 HC ALBUMIN, SERUM (REF LAB)	$17.25	$23.00	$4.28–$30.35	38% below	25%
Albumin blood test CPT 82040 HC KH MAYO SFIG-CSF IGG INDEX PROFILE, SERUM AND SPINAL FLUID	$19.50	$26.00	$4.28–$30.35	29% below	25%
Albumin blood test CPT 82040 HC ALBUMIN, PLEURAL FLUID	$36.00	$48.00	$4.28–$43.20	30% above	25%
Albumin blood test CPT 82040 HC ALBUMIN, SERUM	$36.00	$48.00	$4.28–$43.20	30% above	25%
Albumin blood test inpatient CPT 82040 HC ALBUMIN, SERUM (REF LAB)	$17.25	$23.00	$5.98–$19.92	—	25%
Albumin blood test inpatient CPT 82040 HC KH MAYO SFIG-CSF IGG INDEX PROFILE, SERUM AND SPINAL FLUID	$19.50	$26.00	$6.76–$22.52	—	25%
Albumin blood test inpatient CPT 82040 HC ALBUMIN, PLEURAL FLUID	$36.00	$48.00	$12.48–$41.57	—	25%
Albumin blood test inpatient CPT 82040 HC ALBUMIN, SERUM	$36.00	$48.00	$12.48–$41.57	—	25%
Aldosterone blood test CPT 82088 HC ALDOSTERONE, URINE (REF LAB)	$110.25	$147.00	$35.21–$178.89	39% below	25%
Aldosterone blood test CPT 82088 HC ALDOSTERONE, SERUM (REF LAB)	$135.75	$181.00	$35.21–$178.89	25% below	25%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE, URINE (REF LAB)	$110.25	$147.00	$38.22–$127.30	—	25%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE, SERUM (REF LAB)	$135.75	$181.00	$47.06–$156.75	—	25%
Alkaline phosphatase (ALP) blood test CPT 84075 HC KH MAYO ALKI ASSAY ALKALINE PHOSPHATASE	$16.50	$22.00	$4.47–$56.77	52% below	25%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOSPHATASE, S (REF LAB)	$32.25	$43.00	$4.47–$56.77	7% below	25%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOSPHATASE	$60.00	$80.00	$4.47–$72.00	73% above	25%
Alkaline phosphatase (ALP) blood test CPT 84075 HC NEONATE CHEM ALK PHOS	$60.00	$80.00	$4.47–$72.00	73% above	25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC KH MAYO ALKI ASSAY ALKALINE PHOSPHATASE	$16.50	$22.00	$5.72–$19.05	—	25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOSPHATASE, S (REF LAB)	$32.25	$43.00	$11.18–$37.24	—	25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC NEONATE CHEM ALK PHOS	$60.00	$80.00	$20.80–$69.28	—	25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOSPHATASE	$60.00	$80.00	$20.80–$69.28	—	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO NSIP ALLG SPEC IGE CRUDE XTRC EA	$5.25	$7.00	$2.59–$18.79	77% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR17 ALLG SPEC IGE CRUDE XTRC EA	$6.00	$8.00	$2.96–$18.79	73% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR16 ALLG SPEC IGE CRUDE XTRC EA	$6.00	$8.00	$2.96–$18.79	73% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11 ALLG SPEC IGE CRUDE XTRC EA	$6.00	$8.00	$2.96–$18.79	73% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO EGGPF-ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, CRUDE ALLERGEN EXTRACT, EACH	$6.75	$9.00	$3.33–$18.79	70% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC CLADOSPORIUM, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC EGG WHITE, IGE, SERUM (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC PEANUT, IGE, SERUM (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC RUSSIAN THISTLE, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC OLIVE-TREE, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC MULBERRY, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC MUGWORT, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC IMMUNOGLOBULIN E (IGE), S (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC BERMUDA GRASS, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ASCARIS, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC HOUSE DUST/H-S LAB, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC HOUSE DUST/GREER LAB, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ROUGH PIGWEED, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC NETTLE, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC RED SORREL, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC SHORT RAGWEED, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC WHITE ASH, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC COTTONWOOD, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC WALNUT TREE, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ELM, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC OAK, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC MOUNTAIN CEDAR, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC SILVER BIRCH, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC GREY ALDER, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC BOX ELD/MAPLE, S, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALTERNARIA TENUIS, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ASPERGILLUS FUMIGATUS, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC PENICILLIUM, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC COCKROACH, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC TIMOTHY GRASS, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC DOG DANDER, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC CAT EPITHELIUM, IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC HOUSE DUST MITES/D.F., IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC HOUSE DUST MITES/D.P., IGE (REF LAB)	$12.00	$16.00	$4.51–$18.79	47% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-OLIVE-TREE, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-RED SORREL, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-MOUNTAIN CEDAR, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-OAK, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-ELM, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-COTTONWOOD, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-ROUGH PIGWEED, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-RUSSIAN THISTLE, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC MAYO APGAL - ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, CRUDE ALLERGEN EXTRACT, EAC	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-MUGWORT, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-SHORT RAGWEED, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-MULBERRY, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-IMMUNOGLOBULIN E (IGE), S	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-HOUSE DUST MITES/D.P., IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-HOUSE DUST MITES/D.F., IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-CAT EPITHELIUM, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-DOG DANDER, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-BERMUDA GRASS, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-TIMOTHY GRASS, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-COCKROACH, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-PENICILLIUM, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-CLADOSPORIUM, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-ASPERGILLUS FUMIGATUS, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-ALTERNARIA TENUIS, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-BOX ELD/MAPLE, S, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO RPR11-GREY ALDER, IGE	$15.00	$20.00	$4.51–$18.79	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN TEST,SINGLE ALLERGEN (REF LAB)	$19.50	$26.00	$4.51–$23.40	13% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO MOLD1-MOLD PANEL	$24.75	$33.00	$4.51–$29.70	10% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC FOOD PANEL (REF LAB)	$24.75	$33.00	$4.51–$29.70	10% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO FOOD6-FOOD PANEL, SERUM	$28.50	$38.00	$4.51–$34.20	27% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO SEAFP-SEAFOOD ALLERGEN PROFILE, SERUM	$29.25	$39.00	$4.51–$35.10	30% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO DAGR-DAIRY AND GRAIN ALLERGEN PROFILE, SERUM	$29.25	$39.00	$4.51–$35.10	30% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO NUTSP-NUTS ALLERGEN PROFILE, SERUM	$29.25	$39.00	$4.51–$35.10	30% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC MAYO FPINP-ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, CRUDE ALLERGEN EXTRACT, EACH	$42.00	$56.00	$4.51–$50.40	87% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC MAYO FCRDE-CARMINE DYE/RED DYE COCHINEAL (DACTYLOPIUS COCCUS) IGE (RED # 4)	$53.25	$71.00	$4.51–$63.90	137% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC MAYO FCURV-ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, CRUDE ALLERGEN EXTRACT, EACH	$53.25	$71.00	$4.51–$63.90	137% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC KH MAYO SEAS-SEASONAL INHALANTS ALLERGEN PROFILE, SERUM	$54.00	$72.00	$4.51–$64.80	140% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC MAYO- RPR15 ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, CRUDE ALLERGEN EXTRACT, EACH	$57.00	$76.00	$4.51–$68.40	153% above	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO NSIP ALLG SPEC IGE CRUDE XTRC EA	$5.25	$7.00	$1.82–$6.06	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR17 ALLG SPEC IGE CRUDE XTRC EA	$6.00	$8.00	$2.08–$6.93	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR16 ALLG SPEC IGE CRUDE XTRC EA	$6.00	$8.00	$2.08–$6.93	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11 ALLG SPEC IGE CRUDE XTRC EA	$6.00	$8.00	$2.08–$6.93	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO EGGPF-ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, CRUDE ALLERGEN EXTRACT, EACH	$6.75	$9.00	$2.34–$7.79	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC HOUSE DUST MITES/D.P., IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC EGG WHITE, IGE, SERUM (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC PEANUT, IGE, SERUM (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC RUSSIAN THISTLE, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC OLIVE-TREE, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC MULBERRY, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC MUGWORT, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC IMMUNOGLOBULIN E (IGE), S (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC BERMUDA GRASS, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ASCARIS, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC HOUSE DUST/H-S LAB, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC HOUSE DUST/GREER LAB, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ROUGH PIGWEED, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC NETTLE, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC RED SORREL, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC SHORT RAGWEED, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC WHITE ASH, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC COTTONWOOD, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC WALNUT TREE, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ELM, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC OAK, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC MOUNTAIN CEDAR, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC SILVER BIRCH, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC GREY ALDER, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC BOX ELD/MAPLE, S, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALTERNARIA TENUIS, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ASPERGILLUS FUMIGATUS, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC CLADOSPORIUM, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC PENICILLIUM, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC COCKROACH, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC TIMOTHY GRASS, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC DOG DANDER, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC CAT EPITHELIUM, IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC HOUSE DUST MITES/D.F., IGE (REF LAB)	$12.00	$16.00	$4.16–$13.86	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-ASPERGILLUS FUMIGATUS, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-RED SORREL, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-ROUGH PIGWEED, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-RUSSIAN THISTLE, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-MUGWORT, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-SHORT RAGWEED, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-MULBERRY, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-COTTONWOOD, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-OLIVE-TREE, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-ELM, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-OAK, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-MOUNTAIN CEDAR, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-GREY ALDER, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-BOX ELD/MAPLE, S, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-ALTERNARIA TENUIS, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-CLADOSPORIUM, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-PENICILLIUM, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-COCKROACH, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-TIMOTHY GRASS, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-BERMUDA GRASS, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-DOG DANDER, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-CAT EPITHELIUM, IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-HOUSE DUST MITES/D.F., IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-HOUSE DUST MITES/D.P., IGE	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO RPR11-IMMUNOGLOBULIN E (IGE), S	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC MAYO APGAL - ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, CRUDE ALLERGEN EXTRACT, EAC	$15.00	$20.00	$5.20–$17.32	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN TEST,SINGLE ALLERGEN (REF LAB)	$19.50	$26.00	$6.76–$22.52	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO MOLD1-MOLD PANEL	$24.75	$33.00	$8.58–$28.58	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC FOOD PANEL (REF LAB)	$24.75	$33.00	$8.58–$28.58	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO FOOD6-FOOD PANEL, SERUM	$28.50	$38.00	$9.88–$32.91	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO SEAFP-SEAFOOD ALLERGEN PROFILE, SERUM	$29.25	$39.00	$10.14–$33.77	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO NUTSP-NUTS ALLERGEN PROFILE, SERUM	$29.25	$39.00	$10.14–$33.77	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO DAGR-DAIRY AND GRAIN ALLERGEN PROFILE, SERUM	$29.25	$39.00	$10.14–$33.77	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC MAYO FPINP-ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, CRUDE ALLERGEN EXTRACT, EACH	$42.00	$56.00	$14.56–$48.50	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC MAYO FCURV-ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, CRUDE ALLERGEN EXTRACT, EACH	$53.25	$71.00	$18.46–$61.49	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC MAYO FCRDE-CARMINE DYE/RED DYE COCHINEAL (DACTYLOPIUS COCCUS) IGE (RED # 4)	$53.25	$71.00	$18.46–$61.49	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC KH MAYO SEAS-SEASONAL INHALANTS ALLERGEN PROFILE, SERUM	$54.00	$72.00	$18.72–$62.35	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC MAYO- RPR15 ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, CRUDE ALLERGEN EXTRACT, EACH	$57.00	$76.00	$19.76–$65.82	—	25%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM	$62.25	$83.00	$14.49–$77.00	32% below	25%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN (REF LAB)	$78.00	$104.00	$14.49–$93.60	14% below	25%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM	$62.25	$83.00	$21.58–$71.88	—	25%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN (REF LAB)	$78.00	$104.00	$27.04–$90.06	—	25%
Ammonia blood test CPT 82140 HC KH MAYO SUP24 ASSAY OF AMMONIA	$9.00	$12.00	$4.44–$159.92	88% below	25%
Ammonia blood test CPT 82140 HC AMONIA, URINE, 24 HOUR (REF LAB)	$91.50	$122.00	$12.59–$159.92	27% above	25%
Ammonia blood test CPT 82140 HC AMMONIUM, 24 HOUR, URINE (REF LAB)	$99.00	$132.00	$12.59–$159.92	38% above	25%
Ammonia blood test CPT 82140 HC AMMONIA	$126.75	$169.00	$12.59–$159.92	76% above	25%
Ammonia blood test inpatient CPT 82140 HC KH MAYO SUP24 ASSAY OF AMMONIA	$9.00	$12.00	$3.12–$10.39	—	25%
Ammonia blood test inpatient CPT 82140 HC AMONIA, URINE, 24 HOUR (REF LAB)	$91.50	$122.00	$31.72–$105.65	—	25%
Ammonia blood test inpatient CPT 82140 HC AMMONIUM, 24 HOUR, URINE (REF LAB)	$99.00	$132.00	$34.32–$114.31	—	25%
Ammonia blood test inpatient CPT 82140 HC AMMONIA	$126.75	$169.00	$43.94–$146.35	—	25%
Amylase blood test CPT 82150 HC AMYLASE, PANCREATIC, SERUM (REF LAB)	$40.50	$54.00	$5.60–$68.42	23% below	25%
Amylase blood test CPT 82150 HC KH MAYO AMLPC-AMYLASE, PANCREATIC CYST FLUID	$102.00	$136.00	$5.60–$122.40	93% above	25%
Amylase blood test CPT 82150 HC AMYLASE	$122.25	$163.00	$5.60–$146.70	131% above	25%
Amylase blood test inpatient CPT 82150 HC AMYLASE, PANCREATIC, SERUM (REF LAB)	$40.50	$54.00	$14.04–$46.76	—	25%
Amylase blood test inpatient CPT 82150 HC KH MAYO AMLPC-AMYLASE, PANCREATIC CYST FLUID	$102.00	$136.00	$35.36–$117.78	—	25%
Amylase blood test inpatient CPT 82150 HC AMYLASE	$122.25	$163.00	$42.38–$141.16	—	25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC KH MAYO CTDC CCP ANTIBODY	$13.50	$18.00	$6.66–$60.84	81% below	25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRULL PEPTIDE AB, S (REF LAB)	$33.75	$45.00	$11.19–$60.84	52% below	25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY	$52.50	$70.00	$11.19–$63.00	26% below	25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRULLINATED PEPTD AB (REF LAB)	$53.25	$71.00	$11.19–$63.90	25% below	25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC KH MAYO CTDC CCP ANTIBODY	$13.50	$18.00	$4.68–$15.59	—	25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRULL PEPTIDE AB, S (REF LAB)	$33.75	$45.00	$11.70–$38.97	—	25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY	$52.50	$70.00	$18.20–$60.62	—	25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRULLINATED PEPTD AB (REF LAB)	$53.25	$71.00	$18.46–$61.49	—	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC KH MAYO CTDC ANTINUCLEAR ANTIBODIES	$13.50	$18.00	$6.66–$70.63	80% below	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC MAYO FSCPR-SCLERODERMA COMP PROFILE-SCREENING TEST FOR AUTOIMMUNE DISORDER	$28.50	$38.00	$10.44–$70.63	59% below	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR AB, S (REF LAB)	$44.25	$59.00	$10.44–$70.63	36% below	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA/ANTINUCLEAR ANTIBODIES (REF LAB)	$44.25	$59.00	$10.44–$70.63	36% below	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTI-CENTROMERE ANTIBODY (REF LAB)	$64.50	$86.00	$10.44–$77.40	6% below	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA ANTINUCLEAR ANTIBODY	$101.25	$135.00	$10.44–$121.50	47% above	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC KH MAYO CTDC ANTINUCLEAR ANTIBODIES	$13.50	$18.00	$4.68–$15.59	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC MAYO FSCPR-SCLERODERMA COMP PROFILE-SCREENING TEST FOR AUTOIMMUNE DISORDER	$28.50	$38.00	$9.88–$32.91	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR AB, S (REF LAB)	$44.25	$59.00	$15.34–$51.09	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA/ANTINUCLEAR ANTIBODIES (REF LAB)	$44.25	$59.00	$15.34–$51.09	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTI-CENTROMERE ANTIBODY (REF LAB)	$64.50	$86.00	$22.36–$74.48	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA ANTINUCLEAR ANTIBODY	$101.25	$135.00	$35.10–$116.91	—	25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC B-TYPE NATRIURETIC PEPTIDE	$230.25	$307.00	$33.92–$343.96	31% above	25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC B-TYPE NATRIURETIC PEPTIDE	$230.25	$307.00	$79.82–$265.86	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC KH AEROBIC CULTURE, EXTENDED INCUBATION	$47.25	$63.00	$7.45–$78.25	20% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, WOUND, SUPERFICIAL	$118.50	$158.00	$7.45–$142.20	100% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, RESPIRATORY	$118.50	$158.00	$7.45–$142.20	100% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, GENITO-URETHERAL	$118.50	$158.00	$7.45–$142.20	100% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, EYE	$118.50	$158.00	$7.45–$142.20	100% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, EAR	$118.50	$158.00	$7.45–$142.20	100% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, BODY FLUID	$118.50	$158.00	$7.45–$142.20	100% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, ROUTINE	$118.50	$158.00	$7.45–$142.20	100% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, NASOPHARNYGEAL	$118.50	$158.00	$7.45–$142.20	100% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, WOUND, DEEP, AEROBIC	$118.50	$158.00	$7.45–$142.20	100% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC BACTERIAL CULT,CYSTIC FIB,RESP (REF LAB)	$134.25	$179.00	$7.45–$161.10	127% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC KH MAYO CFRC-BACTERIAL CULTURE, CYSTIC FIBROSIS	$135.00	$180.00	$7.45–$162.00	128% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC KH AEROBIC CULTURE, EXTENDED INCUBATION	$47.25	$63.00	$16.38–$54.56	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, NASOPHARNYGEAL	$118.50	$158.00	$41.08–$136.83	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, BODY FLUID	$118.50	$158.00	$41.08–$136.83	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, EAR	$118.50	$158.00	$41.08–$136.83	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, EYE	$118.50	$158.00	$41.08–$136.83	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, GENITO-URETHERAL	$118.50	$158.00	$41.08–$136.83	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, RESPIRATORY	$118.50	$158.00	$41.08–$136.83	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, ROUTINE	$118.50	$158.00	$41.08–$136.83	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, WOUND, DEEP, AEROBIC	$118.50	$158.00	$41.08–$136.83	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, WOUND, SUPERFICIAL	$118.50	$158.00	$41.08–$136.83	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC BACTERIAL CULT,CYSTIC FIB,RESP (REF LAB)	$134.25	$179.00	$46.54–$155.01	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC KH MAYO CFRC-BACTERIAL CULTURE, CYSTIC FIBROSIS	$135.00	$180.00	$46.80–$155.88	—	25%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL,TOTL CAL	$126.75	$169.00	$7.31–$152.10	131% above	25%
Basic metabolic panel (blood test) CPT 80048 HC NEONATE CHEM BMP	$126.75	$169.00	$7.31–$152.10	131% above	25%
Basic metabolic panel (blood test) inpatient CPT 80048 HC NEONATE CHEM BMP	$126.75	$169.00	$43.94–$146.35	—	25%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL,TOTL CAL	$126.75	$169.00	$43.94–$146.35	—	25%
Bilirubin blood test, total CPT 82247 HC KH BILIRUBIN, DIRECT	$36.00	$48.00	$4.34–$55.10	1% below	25%
Bilirubin blood test, total CPT 82247 HC NEONATE CHEM TBIL	$57.00	$76.00	$4.34–$68.40	57% above	25%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN, TOTAL	$57.00	$76.00	$4.34–$68.40	57% above	25%
Bilirubin blood test, total CPT 82247 HC KH MAYO BFBL-BILIRUBIN, BODY FLUID	$90.00	$120.00	$4.34–$108.00	148% above	25%
Bilirubin blood test, total inpatient CPT 82247 HC KH BILIRUBIN, DIRECT	$36.00	$48.00	$12.48–$41.57	—	25%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN, TOTAL	$57.00	$76.00	$19.76–$65.82	—	25%
Bilirubin blood test, total inpatient CPT 82247 HC NEONATE CHEM TBIL	$57.00	$76.00	$19.76–$65.82	—	25%
Bilirubin blood test, total inpatient CPT 82247 HC KH MAYO BFBL-BILIRUBIN, BODY FLUID	$90.00	$120.00	$31.20–$103.92	—	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC OREGON HLTH- SURGICAL PATHOLGY (REF LAB)	$211.50	$282.00	$51.63–$253.80	4% below	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC HISTO SURG PATH 2 L-IV 9 (REF LAB)	$222.00	$296.00	$51.63–$266.40	1% above	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC CYTO CELL BLOCK, CCB (REF LAB)	$222.00	$296.00	$51.63–$266.40	1% above	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURG LEVEL IV TC (OUTSIDE REF LAB)	$240.75	$321.00	$51.63–$288.90	10% above	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC PROVIDENCE - T2 (REF LAB)	$253.50	$338.00	$51.63–$304.20	15% above	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC OREGON HLTH- SURGICAL PATHOLGY (REF LAB)	$211.50	$282.00	$73.32–$244.21	—	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC HISTO SURG PATH 2 L-IV 9 (REF LAB)	$222.00	$296.00	$76.96–$256.34	—	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC CYTO CELL BLOCK, CCB (REF LAB)	$222.00	$296.00	$76.96–$256.34	—	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SURG LEVEL IV TC (OUTSIDE REF LAB)	$240.75	$321.00	$83.46–$277.99	—	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC PROVIDENCE - T2 (REF LAB)	$253.50	$338.00	$87.88–$292.71	—	25%
Blood culture for bacteria CPT 87040 HC CULTURE, BLOOD	$198.00	$264.00	$8.92–$237.60	75% above	25%
Blood culture for bacteria inpatient CPT 87040 HC CULTURE, BLOOD	$198.00	$264.00	$68.64–$228.62	—	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 C IV-VENIPUNCTURE	$33.75	$45.00	$7.85–$40.50	50% above	25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 C IV-VENIPUNCTURE	$33.75	$45.00	$11.70–$38.97	—	25%
Blood glucose (sugar) test CPT 82947 HC KH GTT FASTING	$13.50	$18.00	$3.40–$20.76	49% below	25%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP POC	$36.75	$49.00	$3.40–$44.10	38% above	25%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE, QUANTITATIVE, BLOOD	$39.75	$53.00	$3.40–$47.70	49% above	25%
Blood glucose (sugar) test inpatient CPT 82947 HC KH GTT FASTING	$13.50	$18.00	$4.68–$15.59	—	25%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP POC	$36.75	$49.00	$12.74–$42.43	—	25%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE, QUANTITATIVE, BLOOD	$39.75	$53.00	$13.78–$45.90	—	25%
Blood lead test CPT 83655 HC MAYO HMU24-ASSAY OF LEAD	$7.50	$10.00	$3.70–$64.44	87% below	25%
Blood lead test CPT 83655 HC KH MAYO HMDB ASSAY OF LEAD	$8.25	$11.00	$4.07–$64.44	86% below	25%
Blood lead test CPT 83655 HC LEAD LEVEL (REF LAB)	$45.75	$61.00	$10.46–$64.44	20% below	25%
Blood lead test CPT 83655 HC LEAD (REF LAB)	$45.75	$61.00	$10.46–$64.44	20% below	25%
Blood lead test CPT 83655 HC LEAD TESTING, POC	$45.75	$61.00	$10.46–$64.44	20% below	25%
Blood lead test inpatient CPT 83655 HC MAYO HMU24-ASSAY OF LEAD	$7.50	$10.00	$2.60–$8.66	—	25%
Blood lead test inpatient CPT 83655 HC KH MAYO HMDB ASSAY OF LEAD	$8.25	$11.00	$2.86–$9.53	—	25%
Blood lead test inpatient CPT 83655 HC LEAD (REF LAB)	$45.75	$61.00	$15.86–$52.83	—	25%
Blood lead test inpatient CPT 83655 HC LEAD TESTING, POC	$45.75	$61.00	$15.86–$52.83	—	25%
Blood lead test inpatient CPT 83655 HC LEAD LEVEL (REF LAB)	$45.75	$61.00	$15.86–$52.83	—	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO (REF LAB)	$105.75	$141.00	$2.58–$495.04	86% above	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC ABO GROUP, BLOOD TYPE	$121.50	$162.00	$2.58–$495.04	114% above	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO (REF LAB)	$105.75	$141.00	$36.66–$122.11	—	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC ABO GROUP, BLOOD TYPE	$121.50	$162.00	$42.12–$140.29	—	25%
Blood urea nitrogen (BUN) test CPT 84520 HC BUN (UREA NITROGEN), QUANT	$47.25	$63.00	$3.42–$56.70	26% above	25%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC BUN (UREA NITROGEN), QUANT	$47.25	$63.00	$16.38–$54.56	—	25%
C-peptide blood test CPT 84681 HC C-PEPTIDE, SERUM (REF LAB)	$127.50	$170.00	$17.98–$177.48	28% above	25%
C-peptide blood test CPT 84681 HC C-PEPTIDE	$144.00	$192.00	$17.98–$177.48	44% above	25%
C-peptide blood test inpatient CPT 84681 HC C-PEPTIDE, SERUM (REF LAB)	$127.50	$170.00	$44.20–$147.22	—	25%
C-peptide blood test inpatient CPT 84681 HC C-PEPTIDE	$144.00	$192.00	$49.92–$166.27	—	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC CRP (OUTSIDE REF LAB)	$34.50	$46.00	$4.47–$56.77	42% below	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC CRP/C-REACTIVE PROTEIN	$94.50	$126.00	$4.47–$113.40	60% above	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC CRP (OUTSIDE REF LAB)	$34.50	$46.00	$11.96–$39.84	—	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC CRP/C-REACTIVE PROTEIN	$94.50	$126.00	$32.76–$109.12	—	25%
C. difficile toxin gene test (stool PCR) CPT 87493 HC C DIFFICILE DNA BY PCR	$199.50	$266.00	$32.20–$239.40	20% above	25%
C. difficile toxin gene test (stool PCR) CPT 87493 HC CLOSTRIDIUM DIFFICILE TOX, PCR (REF LAB)	$474.00	$632.00	$32.20–$568.80	186% above	25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C DIFFICILE DNA BY PCR	$199.50	$266.00	$69.16–$230.36	—	25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC CLOSTRIDIUM DIFFICILE TOX, PCR (REF LAB)	$474.00	$632.00	$164.32–$547.31	—	25%
CA 19-9 blood test (tumor marker) CPT 86301 HC CA 19-9 (REF LAB)	$140.25	$187.00	$17.98–$219.66	49% above	25%
CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9	$189.75	$253.00	$17.98–$227.70	101% above	25%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC CA 19-9 (REF LAB)	$140.25	$187.00	$48.62–$161.94	—	25%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9	$189.75	$253.00	$65.78–$219.10	—	25%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC CANCER ANTIGEN 125 (CA-125)	$167.25	$223.00	$17.98–$219.66	63% above	25%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC CANCER ANTIGEN 125 (CA-125)	$167.25	$223.00	$57.98–$193.12	—	25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC SARS-COV-2 COVID-19 AMP PRB	$81.75	$109.00	$40.33–$184.72	13% below	25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC SARS-COV-2 COVID-19 AMP PRB	$81.75	$109.00	$28.34–$94.39	—	25%
Calcium blood test, total CPT 82310 HC CALCIUM, TOTAL	$51.00	$68.00	$4.45–$61.20	57% above	25%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM, TOTAL	$51.00	$68.00	$17.68–$58.89	—	25%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CARCINOEMBRYONIC ANTIGEN (CEA) (REF LAB)	$115.50	$154.00	$16.38–$138.60	6% above	25%
Carcinoembryonic antigen (CEA) test CPT 82378 HC MAYO CEAPT-CARCINOEMBRYONIC ANTIGEN (CEA)	$125.25	$167.00	$16.38–$150.30	15% above	25%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CARCINOEMBRYONIC ANTIGEN	$189.75	$253.00	$16.38–$227.70	74% above	25%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CARCINOEMBRYONIC ANTIGEN (CEA) (REF LAB)	$115.50	$154.00	$40.04–$133.36	—	25%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC MAYO CEAPT-CARCINOEMBRYONIC ANTIGEN (CEA)	$125.25	$167.00	$43.42–$144.62	—	25%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CARCINOEMBRYONIC ANTIGEN	$189.75	$253.00	$65.78–$219.10	—	25%
Chickenpox (varicella) immunity blood test CPT 86787 HC KH MAYO VZGM VARICELLA-ZOSTER ANTIBODY	$15.00	$20.00	$7.40–$81.39	79% below	25%
Chickenpox (varicella) immunity blood test CPT 86787 HC VZV-VARICELLA-ZOSTER AB (IGM) (REF LAB)	$51.00	$68.00	$11.13–$81.39	28% below	25%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER AB, IGM (REF LAB)	$51.00	$68.00	$11.13–$81.39	28% below	25%
Chickenpox (varicella) immunity blood test CPT 86787 HC VZV-VARICELLA-ZOSTER AB (IGG) (REF LAB)	$51.00	$68.00	$11.13–$81.39	28% below	25%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER AB, IGG (REF LAB)	$51.00	$68.00	$11.13–$81.39	28% below	25%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER AB, IGG, CSF (REF LAB)	$61.50	$82.00	$11.13–$81.39	13% below	25%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER IGG- IMMUNITY	$99.00	$132.00	$11.13–$118.80	40% above	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC KH MAYO VZGM VARICELLA-ZOSTER ANTIBODY	$15.00	$20.00	$5.20–$17.32	—	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER AB, IGG (REF LAB)	$51.00	$68.00	$17.68–$58.89	—	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VZV-VARICELLA-ZOSTER AB (IGM) (REF LAB)	$51.00	$68.00	$17.68–$58.89	—	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VZV-VARICELLA-ZOSTER AB (IGG) (REF LAB)	$51.00	$68.00	$17.68–$58.89	—	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER AB, IGM (REF LAB)	$51.00	$68.00	$17.68–$58.89	—	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA-ZOSTER AB, IGG, CSF (REF LAB)	$61.50	$82.00	$21.32–$71.01	—	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA-ZOSTER IGG- IMMUNITY	$99.00	$132.00	$34.32–$114.31	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC KH MAYO CGRNA CHLMYD TRACH DNA AMP PROBE	$16.50	$22.00	$8.14–$143.40	85% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHYLMD TRACH DNA AMP PROBE (REF LAB)	$59.25	$79.00	$29.23–$143.40	46% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS	$155.25	$207.00	$30.32–$186.30	41% above	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC KH MAYO CGRNA CHLMYD TRACH DNA AMP PROBE	$16.50	$22.00	$5.72–$19.05	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHYLMD TRACH DNA AMP PROBE (REF LAB)	$59.25	$79.00	$20.54–$68.41	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS	$155.25	$207.00	$53.82–$179.26	—	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC QUEST: ADVANCED LIPID PANEL CARDIO IQ	$18.75	$25.00	$9.25–$113.37	67% below	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC MAYO ZW242-LIPID PANEL	$42.75	$57.00	$11.57–$113.37	24% below	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL	$99.00	$132.00	$11.57–$118.80	76% above	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC QUEST: ADVANCED LIPID PANEL CARDIO IQ	$18.75	$25.00	$6.50–$21.65	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC MAYO ZW242-LIPID PANEL	$42.75	$57.00	$14.82–$49.36	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL	$99.00	$132.00	$34.32–$114.31	—	25%
Complete blood count (CBC) with differential CPT 85025 HC CBC,PLT,AUTOMATED DIFF	$91.50	$122.00	$6.71–$109.80	79% above	25%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC,PLT,AUTOMATED DIFF	$91.50	$122.00	$31.72–$105.65	—	25%
Complete blood count (CBC), no differential CPT 85027 HC HEMOGRAM & PLT, AUTOMATED	$79.50	$106.00	$5.59–$95.40	86% above	25%
Complete blood count (CBC), no differential CPT 85027 HC CBC,PLT,MANUAL DIFF	$79.50	$106.00	$5.59–$95.40	86% above	25%
Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC,PLT,MANUAL DIFF	$79.50	$106.00	$27.56–$91.80	—	25%
Complete blood count (CBC), no differential inpatient CPT 85027 HC HEMOGRAM & PLT, AUTOMATED	$79.50	$106.00	$27.56–$91.80	—	25%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL	$129.00	$172.00	$9.12–$154.80	74% above	25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PANEL	$129.00	$172.00	$44.72–$148.95	—	25%
Cortisol blood test, total CPT 82533 HC KH MAYO SALCT-CORTISOL, SALIVA	$55.50	$74.00	$14.08–$81.39	29% below	25%
Cortisol blood test, total CPT 82533 HC CORTISOL, PRE-DEXAMETHASONE	$112.50	$150.00	$14.08–$135.00	43% above	25%
Cortisol blood test, total CPT 82533 HC CORTISOL, ADD STIM SPEC	$112.50	$150.00	$14.08–$135.00	43% above	25%
Cortisol blood test, total CPT 82533 HC CORTISOL, POST-DEXAMETHASONE	$112.50	$150.00	$14.08–$135.00	43% above	25%
Cortisol blood test, total CPT 82533 HC CORTISOL, TOTAL	$112.50	$150.00	$14.08–$135.00	43% above	25%
Cortisol blood test, total inpatient CPT 82533 HC KH MAYO SALCT-CORTISOL, SALIVA	$55.50	$74.00	$19.24–$64.08	—	25%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL, POST-DEXAMETHASONE	$112.50	$150.00	$39.00–$129.90	—	25%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL, TOTAL	$112.50	$150.00	$39.00–$129.90	—	25%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL, ADD STIM SPEC	$112.50	$150.00	$39.00–$129.90	—	25%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL, PRE-DEXAMETHASONE	$112.50	$150.00	$39.00–$129.90	—	25%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE ISOENZYME RFLX	$41.25	$55.00	$5.63–$71.46	20% below	25%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE, TOTAL	$69.75	$93.00	$5.63–$83.70	35% above	25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE ISOENZYME RFLX	$41.25	$55.00	$14.30–$47.63	—	25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE, TOTAL	$69.75	$93.00	$24.18–$80.54	—	25%
Creatinine blood test CPT 82565 HC CREATININE,BLOOD (POC)	$53.25	$71.00	$4.43–$63.90	84% above	25%
Creatinine blood test CPT 82565 HC CREATININE,BLOOD,REAGENT STRIP	$53.25	$71.00	$4.43–$63.90	84% above	25%
Creatinine blood test CPT 82565 HC CREATININE, BLOOD	$53.25	$71.00	$4.43–$63.90	84% above	25%
Creatinine blood test inpatient CPT 82565 HC CREATININE,BLOOD (POC)	$53.25	$71.00	$18.46–$61.49	—	25%
Creatinine blood test inpatient CPT 82565 HC CREATININE, BLOOD	$53.25	$71.00	$18.46–$61.49	—	25%
Creatinine blood test inpatient CPT 82565 HC CREATININE,BLOOD,REAGENT STRIP	$53.25	$71.00	$18.46–$61.49	—	25%
Cytomegalovirus (CMV) antibody test CPT 86644 HC KH MAYO CMVP CMV ANTIBODY	$12.00	$16.00	$5.92–$51.80	84% below	25%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CYTOMEGALOVIRUS AB IGG (REF LAB)	$30.75	$41.00	$12.43–$51.80	60% below	25%
Cytomegalovirus (CMV) antibody test CPT 86644 HC KH MAYO TRCHG-ANTIBODY; CYTOMEGALOVIRUS (CMV)	$36.75	$49.00	$12.43–$51.80	52% below	25%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV SCREENING PER UNIT	$61.50	$82.00	$12.43–$73.80	19% below	25%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV ANTIBODIES, IGG (REF LAB)	$94.50	$126.00	$12.43–$113.40	24% above	25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC KH MAYO CMVP CMV ANTIBODY	$12.00	$16.00	$4.16–$13.86	—	25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CYTOMEGALOVIRUS AB IGG (REF LAB)	$30.75	$41.00	$10.66–$35.51	—	25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC KH MAYO TRCHG-ANTIBODY; CYTOMEGALOVIRUS (CMV)	$36.75	$49.00	$12.74–$42.43	—	25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV SCREENING PER UNIT	$61.50	$82.00	$21.32–$71.01	—	25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV ANTIBODIES, IGG (REF LAB)	$94.50	$126.00	$32.76–$109.12	—	25%
D-dimer blood test (blood clot marker) CPT 85379 HC KH MAYO AATHR-FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE	$23.25	$31.00	$8.79–$135.29	77% below	25%
D-dimer blood test (blood clot marker) CPT 85379 HC D-DIMER (REF LAB)	$86.25	$115.00	$8.79–$135.29	14% below	25%
D-dimer blood test (blood clot marker) CPT 85379 HC KH MAYO DIMER-D-DIMER, PLASMA	$93.00	$124.00	$8.79–$135.29	8% below	25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC KH MAYO AATHR-FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE	$23.25	$31.00	$8.06–$26.85	—	25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D-DIMER (REF LAB)	$86.25	$115.00	$29.90–$99.59	—	25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC KH MAYO DIMER-D-DIMER, PLASMA	$93.00	$124.00	$32.24–$107.38	—	25%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DHEA-SO4 / DHEA SULFATE (REF LAB)	$98.25	$131.00	$19.21–$157.89	2% below	25%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DHEA-SO4 / DHEA SULFATE (REF LAB)	$98.25	$131.00	$34.06–$113.45	—	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC KH MAYO CDAU-CONFIRMED DRUG ABUSE PANEL, URINE	$33.75	$45.00	$16.65–$223.70	80% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC MAYO FENR-FENTANYL SCREEN W/REFLEX, URINE	$64.50	$86.00	$31.82–$223.70	61% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC MAYO CSMPU - DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DAT	$67.50	$90.00	$33.30–$223.70	59% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC MAYO CSMEU- TESTING FOR PRESENCE OF DRUG, BY CHEMISTRY ANALYZERS	$88.50	$118.00	$43.66–$223.70	46% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC ENZYME LINKED IMMUNOSORB ASSAY (REF LAB)	$93.00	$124.00	$45.88–$223.70	44% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC HEADSPACE GAS CHROMATOGRAPHY (REF LAB)	$93.00	$124.00	$45.88–$223.70	44% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC CDAU-DRUG ABUSE W/CONFRM,URINE (REF LAB)	$93.00	$124.00	$45.88–$223.70	44% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUGS OF ABUSE SCREEN (10 PNL) (REF LAB)	$102.75	$137.00	$50.69–$223.70	38% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC CANNABINOID ANALYSIS, WHOLE BL (REF LAB)	$102.75	$137.00	$50.69–$223.70	38% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUGS SCREEN 5, COC, MECONIUM (REF LAB)	$102.75	$137.00	$50.69–$223.70	38% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC KH MAYO CSMHU-CONTROLLED SUBSTANCE MONITORING HYBRID DRUG PROFILE, 20 DRUG CLASSES, HIGH-RESOLUTION MASS SPECTROMETRY AND IMMUNOASSAY SCREEN, RANDOM, URINE	$105.75	$141.00	$52.17–$223.70	36% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC KH MAYO FDA1S-DRUGS OF ABUSE (10 PANEL) AND ALCOHOL SCREEN, SERUM	$105.75	$141.00	$52.17–$223.70	36% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN 1 (REF LAB)	$110.25	$147.00	$53.69–$223.70	33% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN 3 (REF LAB)	$110.25	$147.00	$53.69–$223.70	33% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN 5 (REF LAB)	$110.25	$147.00	$53.69–$223.70	33% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN 4 (REF LAB)	$110.25	$147.00	$53.69–$223.70	33% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN 2 (REF LAB)	$110.25	$147.00	$53.69–$223.70	33% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG ABUSE SURVEY WITH CONFIRMATION, PANEL 5, RANDOM, URINE (REF LAB)	$114.00	$152.00	$53.69–$223.70	31% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCRN,PRESCRIPT/OTC, SERUM (REF LAB)	$114.00	$152.00	$53.69–$223.70	31% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG ABUSE CONFIRM,PNL 9,URINE (REF LAB)	$114.00	$152.00	$53.69–$223.70	31% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC MEPHEDRONE, MDPV & METHYLONE (REF LAB)	$116.25	$155.00	$53.69–$223.70	30% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC KRATOM (MITRAGYNINE) QUANT (REF LAB)	$120.75	$161.00	$53.69–$223.70	27% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC ETHYL GLUCURONIDE SCREEN, RANDOM, URINE (REF LAB)	$148.50	$198.00	$53.69–$223.70	10% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC COMPREHENSIV DRUG SCRN,UMB CRD (REF LAB)	$200.25	$267.00	$53.69–$240.30	21% above	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC URINE DRUG SCREEN RAPID	$375.00	$500.00	$53.69–$450.00	127% above	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC KH MAYO CDAU-CONFIRMED DRUG ABUSE PANEL, URINE	$33.75	$45.00	$11.70–$38.97	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC MAYO FENR-FENTANYL SCREEN W/REFLEX, URINE	$64.50	$86.00	$22.36–$74.48	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC MAYO CSMPU - DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DAT	$67.50	$90.00	$23.40–$77.94	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC MAYO CSMEU- TESTING FOR PRESENCE OF DRUG, BY CHEMISTRY ANALYZERS	$88.50	$118.00	$30.68–$102.19	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC CDAU-DRUG ABUSE W/CONFRM,URINE (REF LAB)	$93.00	$124.00	$32.24–$107.38	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC ENZYME LINKED IMMUNOSORB ASSAY (REF LAB)	$93.00	$124.00	$32.24–$107.38	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC HEADSPACE GAS CHROMATOGRAPHY (REF LAB)	$93.00	$124.00	$32.24–$107.38	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUGS OF ABUSE SCREEN (10 PNL) (REF LAB)	$102.75	$137.00	$35.62–$118.64	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC CANNABINOID ANALYSIS, WHOLE BL (REF LAB)	$102.75	$137.00	$35.62–$118.64	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUGS SCREEN 5, COC, MECONIUM (REF LAB)	$102.75	$137.00	$35.62–$118.64	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC KH MAYO FDA1S-DRUGS OF ABUSE (10 PANEL) AND ALCOHOL SCREEN, SERUM	$105.75	$141.00	$36.66–$122.11	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC KH MAYO CSMHU-CONTROLLED SUBSTANCE MONITORING HYBRID DRUG PROFILE, 20 DRUG CLASSES, HIGH-RESOLUTION MASS SPECTROMETRY AND IMMUNOASSAY SCREEN, RANDOM, URINE	$105.75	$141.00	$36.66–$122.11	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN 5 (REF LAB)	$110.25	$147.00	$38.22–$127.30	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN 2 (REF LAB)	$110.25	$147.00	$38.22–$127.30	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN 3 (REF LAB)	$110.25	$147.00	$38.22–$127.30	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN 4 (REF LAB)	$110.25	$147.00	$38.22–$127.30	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN 1 (REF LAB)	$110.25	$147.00	$38.22–$127.30	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG ABUSE SURVEY WITH CONFIRMATION, PANEL 5, RANDOM, URINE (REF LAB)	$114.00	$152.00	$39.52–$131.63	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCRN,PRESCRIPT/OTC, SERUM (REF LAB)	$114.00	$152.00	$39.52–$131.63	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG ABUSE CONFIRM,PNL 9,URINE (REF LAB)	$114.00	$152.00	$39.52–$131.63	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC MEPHEDRONE, MDPV & METHYLONE (REF LAB)	$116.25	$155.00	$40.30–$134.23	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC KRATOM (MITRAGYNINE) QUANT (REF LAB)	$120.75	$161.00	$41.86–$139.43	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC ETHYL GLUCURONIDE SCREEN, RANDOM, URINE (REF LAB)	$148.50	$198.00	$51.48–$171.47	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC COMPREHENSIV DRUG SCRN,UMB CRD (REF LAB)	$200.25	$267.00	$69.42–$231.22	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC URINE DRUG SCREEN RAPID	$375.00	$500.00	$130.00–$433.00	—	25%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL	$110.25	$147.00	$6.06–$132.30	91% above	25%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTES, POC	$116.25	$155.00	$6.06–$139.50	101% above	25%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL	$110.25	$147.00	$38.22–$127.30	—	25%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTES, POC	$116.25	$155.00	$40.30–$134.23	—	25%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC KH MAYO SEBV EPSTEIN-BARR CAPSID VCA	$11.25	$15.00	$5.55–$98.37	87% below	25%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR(EBV) VCA IGG AB,S (REF LAB)	$63.00	$84.00	$15.68–$98.37	26% below	25%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR(EBV) VCA IGM AB,S (REF LAB)	$63.00	$84.00	$15.68–$98.37	26% below	25%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EBV, VIRAL CAPSID ANTIGEN (VCA) IGG ANTIBODY	$103.50	$138.00	$15.68–$124.20	21% above	25%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EBV, VIRAL CAPSID ANTIGEN (VCA) IGM ANTIBODY	$103.50	$138.00	$15.68–$124.20	21% above	25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC KH MAYO SEBV EPSTEIN-BARR CAPSID VCA	$11.25	$15.00	$3.90–$12.99	—	25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR(EBV) VCA IGG AB,S (REF LAB)	$63.00	$84.00	$21.84–$72.74	—	25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR(EBV) VCA IGM AB,S (REF LAB)	$63.00	$84.00	$21.84–$72.74	—	25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EBV, VIRAL CAPSID ANTIGEN (VCA) IGG ANTIBODY	$103.50	$138.00	$35.88–$119.51	—	25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EBV, VIRAL CAPSID ANTIGEN (VCA) IGM ANTIBODY	$103.50	$138.00	$35.88–$119.51	—	25%
Estradiol blood test CPT 82670 HC MAYO FFES-MEASUREMENT OF TOTAL ESTRADIOL (HORMONE)	$61.50	$82.00	$24.14–$150.50	54% below	25%
Estradiol blood test CPT 82670 HC ESTRADIOL (REF LAB)	$88.50	$118.00	$24.14–$150.50	34% below	25%
Estradiol blood test CPT 82670 HC ESTS-ESTRADIOL,RAPID,IMMUN,SER (REF LAB)	$102.75	$137.00	$24.14–$150.50	24% below	25%
Estradiol blood test CPT 82670 HC ASSAY OF TOTAL ESTRADIOL	$122.25	$163.00	$24.14–$150.50	9% below	25%
Estradiol blood test inpatient CPT 82670 HC MAYO FFES-MEASUREMENT OF TOTAL ESTRADIOL (HORMONE)	$61.50	$82.00	$21.32–$71.01	—	25%
Estradiol blood test inpatient CPT 82670 HC ESTRADIOL (REF LAB)	$88.50	$118.00	$30.68–$102.19	—	25%
Estradiol blood test inpatient CPT 82670 HC ESTS-ESTRADIOL,RAPID,IMMUN,SER (REF LAB)	$102.75	$137.00	$35.62–$118.64	—	25%
Estradiol blood test inpatient CPT 82670 HC ASSAY OF TOTAL ESTRADIOL	$122.25	$163.00	$42.38–$141.16	—	25%
FSH (follicle-stimulating hormone) test CPT 83001 HC FSH-FOLLICLE STIMU HORMONE,SER (REF LAB)	$114.00	$152.00	$16.05–$195.01	3% above	25%
FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE	$158.25	$211.00	$16.05–$195.01	43% above	25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC FSH-FOLLICLE STIMU HORMONE,SER (REF LAB)	$114.00	$152.00	$39.52–$131.63	—	25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE	$158.25	$211.00	$54.86–$182.73	—	25%
Fecal calprotectin (stool inflammation test) CPT 83993 HC CALPROTECTIN, FECAL (REF LAB)	$278.25	$371.00	$16.96–$449.06	40% above	25%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC CALPROTECTIN, FECAL (REF LAB)	$278.25	$371.00	$96.46–$321.29	—	25%
Ferritin blood test (iron stores) CPT 82728 HC FERRITIN, S (REF LAB)	$97.50	$130.00	$11.78–$146.91	22% above	25%
Ferritin blood test (iron stores) CPT 82728 HC FERRITIN	$98.25	$131.00	$11.78–$146.91	23% above	25%
Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN, S (REF LAB)	$97.50	$130.00	$33.80–$112.58	—	25%
Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN	$98.25	$131.00	$34.06–$113.45	—	25%
Fibrinogen blood test CPT 85384 HC TEG FIBRINOGEN ACTIVITY	$15.00	$20.00	$7.40–$93.27	79% below	25%
Fibrinogen blood test CPT 85384 HC KH MAYO AATHR-FIBRINOGEN; ACTIVITY	$22.50	$30.00	$8.40–$93.27	68% below	25%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN (REF LAB)	$48.75	$65.00	$8.40–$93.27	32% below	25%
Fibrinogen blood test CPT 85384 HC KH MAYO CLFIB-FIBRINOGEN, CLAUSS, PLASMA	$56.25	$75.00	$8.40–$93.27	21% below	25%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN ACTIVITY	$104.25	$139.00	$8.40–$125.10	46% above	25%
Fibrinogen blood test inpatient CPT 85384 HC TEG FIBRINOGEN ACTIVITY	$15.00	$20.00	$5.20–$17.32	—	25%
Fibrinogen blood test inpatient CPT 85384 HC KH MAYO AATHR-FIBRINOGEN; ACTIVITY	$22.50	$30.00	$7.80–$25.98	—	25%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN (REF LAB)	$48.75	$65.00	$16.90–$56.29	—	25%
Fibrinogen blood test inpatient CPT 85384 HC KH MAYO CLFIB-FIBRINOGEN, CLAUSS, PLASMA	$56.25	$75.00	$19.50–$64.95	—	25%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN ACTIVITY	$104.25	$139.00	$36.14–$120.37	—	25%
Folate (folic acid) blood test CPT 82746 HC FOLATE, S (REF LAB)	$87.75	$117.00	$12.70–$148.96	4% above	25%
Folate (folic acid) blood test CPT 82746 HC FOLIC ACID (FOLATE), SERUM	$99.75	$133.00	$12.70–$148.96	19% above	25%
Folate (folic acid) blood test CPT 82746 HC KH FOLATE	$101.25	$135.00	$12.70–$148.96	20% above	25%
Folate (folic acid) blood test inpatient CPT 82746 HC FOLATE, S (REF LAB)	$87.75	$117.00	$30.42–$101.32	—	25%
Folate (folic acid) blood test inpatient CPT 82746 HC FOLIC ACID (FOLATE), SERUM	$99.75	$133.00	$34.58–$115.18	—	25%
Folate (folic acid) blood test inpatient CPT 82746 HC KH FOLATE	$101.25	$135.00	$35.10–$116.91	—	25%
Free T3 thyroid hormone test CPT 84481 HC T3, FREE (REF LAB)	$84.00	$112.00	$14.64–$146.91	2% above	25%
Free T3 thyroid hormone test CPT 84481 HC TRIIODOTHYRONINE T3, FREE	$131.25	$175.00	$14.64–$157.50	59% above	25%
Free T3 thyroid hormone test inpatient CPT 84481 HC T3, FREE (REF LAB)	$84.00	$112.00	$29.12–$96.99	—	25%
Free T3 thyroid hormone test inpatient CPT 84481 HC TRIIODOTHYRONINE T3, FREE	$131.25	$175.00	$45.50–$151.55	—	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T4 (THYROXINE), FREE, S (REF LAB)	$56.25	$75.00	$7.80–$99.01	15% above	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC FREE T4	$95.25	$127.00	$7.80–$114.30	94% above	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC T4 (THYROXINE), FREE, S (REF LAB)	$56.25	$75.00	$19.50–$64.95	—	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC FREE T4	$95.25	$127.00	$33.02–$109.98	—	25%
Free testosterone test CPT 84402 HC KH MAYO TGRP ASSAY OF FREE TESTOSTERONE	$8.25	$11.00	$4.07–$94.37	92% below	25%
Free testosterone test CPT 84402 HC KH MAYO TTFB ASSAY OF FREE TESTOSTERONE	$10.50	$14.00	$5.18–$94.37	90% below	25%
Free testosterone test CPT 84402 HC FREE TESTOSTERONE (REF LAB)	$42.00	$56.00	$20.72–$94.37	60% below	25%
Free testosterone test CPT 84402 HC TESTOSTERONE, FREE (REF LAB)	$42.75	$57.00	$21.09–$94.37	60% below	25%
Free testosterone test inpatient CPT 84402 HC KH MAYO TGRP ASSAY OF FREE TESTOSTERONE	$8.25	$11.00	$2.86–$9.53	—	25%
Free testosterone test inpatient CPT 84402 HC KH MAYO TTFB ASSAY OF FREE TESTOSTERONE	$10.50	$14.00	$3.64–$12.12	—	25%
Free testosterone test inpatient CPT 84402 HC FREE TESTOSTERONE (REF LAB)	$42.00	$56.00	$14.56–$48.50	—	25%
Free testosterone test inpatient CPT 84402 HC TESTOSTERONE, FREE (REF LAB)	$42.75	$57.00	$14.82–$49.36	—	25%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC KH MAYO GGT-GGT, SERUM	$51.75	$69.00	$6.22–$76.01	22% above	25%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GGT	$74.25	$99.00	$6.22–$89.10	76% above	25%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC KH MAYO GGT-GGT, SERUM	$51.75	$69.00	$17.94–$59.75	—	25%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GGT	$74.25	$99.00	$25.74–$85.73	—	25%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC GENERAL HEALTH PANEL	$90.75	$121.00	$40.28–$108.90	51% below	25%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC GENERAL HEALTH PANEL	$90.75	$121.00	$31.46–$104.79	—	25%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE,QUANT,POST GLUC DOSE	$60.00	$80.00	$4.11–$72.00	52% above	25%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE,QUANT,POST GLUC DOSE	$60.00	$80.00	$20.80–$69.28	—	25%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE,TOL. TEST;1-3 SPECS	$127.50	$170.00	$11.12–$153.00	60% above	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE,TOL. TEST;1-3 SPECS	$127.50	$170.00	$44.20–$147.22	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC KH MAYO CGRNA N.GONORRHOEAE DNA AMP PROB	$16.50	$22.00	$8.14–$134.27	86% below	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.GONORRHOEAE DNA AMP PROBE (REF LAB)	$59.25	$79.00	$29.23–$134.27	49% below	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC NEISSERIA GONORRHOEAE	$154.50	$206.00	$30.32–$185.40	32% above	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC KH MAYO CGRNA N.GONORRHOEAE DNA AMP PROB	$16.50	$22.00	$5.72–$19.05	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N.GONORRHOEAE DNA AMP PROBE (REF LAB)	$59.25	$79.00	$20.54–$68.41	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC NEISSERIA GONORRHOEAE	$154.50	$206.00	$53.56–$178.40	—	25%
H. pylori stool antigen test CPT 87338 HC H.PYLORI ANTIGEN, STOOL (REF LAB)	$90.75	$121.00	$12.42–$139.25	9% below	25%
H. pylori stool antigen test CPT 87338 HC HELICO PYLORI ANTIGEN, FECAL (REF LAB)	$103.50	$138.00	$12.42–$139.25	4% above	25%
H. pylori stool antigen test inpatient CPT 87338 HC H.PYLORI ANTIGEN, STOOL (REF LAB)	$90.75	$121.00	$31.46–$104.79	—	25%
H. pylori stool antigen test inpatient CPT 87338 HC HELICO PYLORI ANTIGEN, FECAL (REF LAB)	$103.50	$138.00	$35.88–$119.51	—	25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 RNA QUANT W REFLEX TO HIV-1 GENOTYPIC DRUG RESISTANCE TO PROTEASE AND RTI (REF LAB)	$228.00	$304.00	$73.53–$397.92	40% below	25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 ULTRA SENS QUANT BY PCR (REF LAB)	$228.00	$304.00	$73.53–$397.92	40% below	25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIVDQ-HIV-1 RNA DETECT&QUANT,P (REF LAB)	$243.00	$324.00	$73.53–$397.92	36% below	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 RNA QUANT W REFLEX TO HIV-1 GENOTYPIC DRUG RESISTANCE TO PROTEASE AND RTI (REF LAB)	$228.00	$304.00	$79.04–$263.26	—	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 ULTRA SENS QUANT BY PCR (REF LAB)	$228.00	$304.00	$79.04–$263.26	—	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIVDQ-HIV-1 RNA DETECT&QUANT,P (REF LAB)	$243.00	$324.00	$84.24–$280.58	—	25%
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV-1/2 AB, SINGLE RESULT	$129.00	$172.00	$11.85–$154.80	30% above	25%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV-1/2 AB, SINGLE RESULT	$129.00	$172.00	$44.72–$148.95	—	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV1 ANTIGEN WITH HIV1 AND HIV2 ANTIBODIES	$37.50	$50.00	$18.50–$86.69	60% below	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV1 & HIV2 AG & AB PLASMA (REF LAB)	$41.25	$55.00	$20.35–$86.69	56% below	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV1 ANTIGEN WITH HIV1 AND HIV2 ANTIBODIES	$37.50	$50.00	$13.00–$43.30	—	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV1 & HIV2 AG & AB PLASMA (REF LAB)	$41.25	$55.00	$14.30–$47.63	—	25%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HUMAN PAPILLOMAVIRUS (HPV), HIGH-RISK TYPES, POOLED RESULT	$54.75	$73.00	$27.01–$197.78	54% below	25%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HUMAN PAPILLOMAVIRUS (HPV), HIGH-RISK TYPES, POOLED RESULT	$54.75	$73.00	$18.98–$63.22	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TST TC (POC)	$16.50	$22.00	$8.14–$76.74	64% below	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOHEMOGLOBIN	$78.00	$104.00	$8.39–$93.60	68% above	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TST TC (POC)	$16.50	$22.00	$5.72–$19.05	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOHEMOGLOBIN	$78.00	$104.00	$27.04–$90.06	—	25%
Hemoglobin blood test CPT 85018 HC SACRED HEART - BLOOD COUNT; HEMOGLOBIN (HGB)	$13.50	$18.00	$2.04–$26.04	33% below	25%
Hemoglobin blood test CPT 85018 HC HGB, MIXED VENOUS, POC	$41.25	$55.00	$2.04–$49.50	105% above	25%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN, AUTOMATED POC	$41.25	$55.00	$2.04–$49.50	105% above	25%
Hemoglobin blood test CPT 85018 HC HGB, VENOUS BLD GAS, POC	$41.25	$55.00	$2.04–$49.50	105% above	25%
Hemoglobin blood test inpatient CPT 85018 HC SACRED HEART - BLOOD COUNT; HEMOGLOBIN (HGB)	$13.50	$18.00	$4.68–$15.59	—	25%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN, AUTOMATED POC	$41.25	$55.00	$14.30–$47.63	—	25%
Hemoglobin blood test inpatient CPT 85018 HC HGB, VENOUS BLD GAS, POC	$41.25	$55.00	$14.30–$47.63	—	25%
Hemoglobin blood test inpatient CPT 85018 HC HGB, MIXED VENOUS, POC	$41.25	$55.00	$14.30–$47.63	—	25%
Hepatitis B core antibody test (total) CPT 86704 HC HBC TOTAL AB, W/REFLEX, S (REF LAB)	$33.75	$45.00	$10.42–$59.42	48% below	25%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B-CORE AB, TOTAL (REF LAB)	$33.75	$45.00	$10.42–$59.42	48% below	25%
Hepatitis B core antibody test (total) CPT 86704 HC KH MAYO PHSM HEP B CORE ANTIBODY TOTAL	$48.00	$64.00	$10.42–$59.42	25% below	25%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY	$99.00	$132.00	$10.42–$118.80	54% above	25%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B-CORE AB, TOTAL (REF LAB)	$33.75	$45.00	$11.70–$38.97	—	25%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HBC TOTAL AB, W/REFLEX, S (REF LAB)	$33.75	$45.00	$11.70–$38.97	—	25%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC KH MAYO PHSM HEP B CORE ANTIBODY TOTAL	$48.00	$64.00	$16.64–$55.42	—	25%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY	$99.00	$132.00	$34.32–$114.31	—	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC KH MAYO PHSM HEP B SURFACE ANTIBODY	$44.25	$59.00	$9.28–$84.66	21% below	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURFACE ANTIBODY (REF LAB)	$51.00	$68.00	$9.28–$84.66	9% below	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEP B SURFACE ANTIBODY	$121.50	$162.00	$9.28–$145.80	117% above	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC KH MAYO PHSM HEP B SURFACE ANTIBODY	$44.25	$59.00	$15.34–$51.09	—	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURFACE ANTIBODY (REF LAB)	$51.00	$68.00	$17.68–$58.89	—	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEP B SURFACE ANTIBODY	$121.50	$162.00	$42.12–$140.29	—	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC KH MAYO CHSBP HEPATITIS B SURFACE AG IA	$15.75	$21.00	$7.77–$84.66	74% below	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC KH MAYO PHSM HEPATITIS B SURFACE AG IA	$31.50	$42.00	$8.93–$84.66	48% below	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEPATITIS B SURFACE ANTIGEN (REF LAB)	$45.00	$60.00	$8.93–$84.66	26% below	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEPATITIS B SURFACE ANTIGEN	$75.00	$100.00	$8.93–$90.00	23% above	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC KH MAYO CHSBP HEPATITIS B SURFACE AG IA	$15.75	$21.00	$5.46–$18.19	—	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC KH MAYO PHSM HEPATITIS B SURFACE AG IA	$31.50	$42.00	$10.92–$36.37	—	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEPATITIS B SURFACE ANTIGEN (REF LAB)	$45.00	$60.00	$15.60–$51.96	—	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEPATITIS B SURFACE ANTIGEN	$75.00	$100.00	$26.00–$86.60	—	25%
Hepatitis C antibody blood test (screening) CPT 86803 HC MAYO PHSM HEPATITIS C AB TEST	$57.75	$77.00	$12.33–$103.80	16% below	25%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY (REF LAB)	$62.25	$83.00	$12.33–$103.80	10% below	25%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY, DIAGNOSTIC	$66.75	$89.00	$12.33–$103.80	3% below	25%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY	$99.00	$132.00	$12.33–$118.80	44% above	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC MAYO PHSM HEPATITIS C AB TEST	$57.75	$77.00	$20.02–$66.68	—	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY (REF LAB)	$62.25	$83.00	$21.58–$71.88	—	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY, DIAGNOSTIC	$66.75	$89.00	$23.14–$77.07	—	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY	$99.00	$132.00	$34.32–$114.31	—	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HCV RNA DETECT/QUANT RFLX GENO (REF LAB)	$70.50	$94.00	$34.78–$307.09	71% below	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C VIRUS,QUANT,RT-PCR (REF LAB)	$165.75	$221.00	$37.02–$307.09	33% below	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HCV RNA DETECT/QUANT RFLX GENO (REF LAB)	$70.50	$94.00	$24.44–$81.40	—	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEPATITIS C VIRUS,QUANT,RT-PCR (REF LAB)	$165.75	$221.00	$57.46–$191.39	—	25%
Herpes blood test, HSV-1 antibody CPT 86695 HC KH MAYO HSVG HERPES SIMPLEX TYPE 1 TEST	$9.00	$12.00	$4.44–$59.10	81% below	25%
Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX, TYPE 1, IGG (REF LAB)	$51.75	$69.00	$11.40–$62.10	8% above	25%
Herpes blood test, HSV-1 antibody CPT 86695 HC KH MAYO TRCHG-ANTIBODY; HERPES SIMPLEX, TYPE 1	$53.25	$71.00	$11.40–$63.90	11% above	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC KH MAYO HSVG HERPES SIMPLEX TYPE 1 TEST	$9.00	$12.00	$3.12–$10.39	—	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX, TYPE 1, IGG (REF LAB)	$51.75	$69.00	$17.94–$59.75	—	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC KH MAYO TRCHG-ANTIBODY; HERPES SIMPLEX, TYPE 1	$53.25	$71.00	$18.46–$61.49	—	25%
Herpes blood test, HSV-2 antibody CPT 86696 HC KH MAYO HSVG HERPES SIMPLEX TYPE 2 TEST	$12.00	$16.00	$5.92–$82.69	83% below	25%
Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX, TYPE 2, IGG (REF LAB)	$53.25	$71.00	$16.72–$82.69	24% below	25%
Herpes blood test, HSV-2 antibody CPT 86696 HC KH MAYO TRCHG-TORCH PROFILE IGG, SERUM	$75.00	$100.00	$16.72–$90.00	7% above	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC KH MAYO HSVG HERPES SIMPLEX TYPE 2 TEST	$12.00	$16.00	$4.16–$13.86	—	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX, TYPE 2, IGG (REF LAB)	$53.25	$71.00	$18.46–$61.49	—	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC KH MAYO TRCHG-TORCH PROFILE IGG, SERUM	$75.00	$100.00	$26.00–$86.60	—	25%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC MAYO CRMP1-C-REACTIVE PROTEIN; HIGH SENSITIVITY (HSCRP)	$24.00	$32.00	$11.19–$59.58	65% below	25%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC HIGH SENSITIVITY CRP (REF LAB)	$32.25	$43.00	$11.19–$59.58	53% below	25%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY	$51.75	$69.00	$11.19–$62.10	25% below	25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC MAYO CRMP1-C-REACTIVE PROTEIN; HIGH SENSITIVITY (HSCRP)	$24.00	$32.00	$8.32–$27.71	—	25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC HIGH SENSITIVITY CRP (REF LAB)	$32.25	$43.00	$11.18–$37.24	—	25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY	$51.75	$69.00	$17.94–$59.75	—	25%
Homocysteine blood test CPT 83090 HC HOMOCYSTINE	$66.75	$89.00	$15.48–$81.70	17% below	25%
Homocysteine blood test CPT 83090 HC HOMOCYSTINE, QUANT (REF LAB)	$102.00	$136.00	$15.48–$122.40	28% above	25%
Homocysteine blood test CPT 83090 HC KH MAYO CMMPS-COBALAMIN	$197.25	$263.00	$15.48–$236.70	147% above	25%
Homocysteine blood test inpatient CPT 83090 HC HOMOCYSTINE	$66.75	$89.00	$23.14–$77.07	—	25%
Homocysteine blood test inpatient CPT 83090 HC HOMOCYSTINE, QUANT (REF LAB)	$102.00	$136.00	$35.36–$117.78	—	25%
Homocysteine blood test inpatient CPT 83090 HC KH MAYO CMMPS-COBALAMIN	$197.25	$263.00	$68.38–$227.76	—	25%
Insulin blood test CPT 83525 HC INSULIN, TOTAL (REF LAB)	$32.25	$43.00	$9.88–$56.76	52% below	25%
Insulin blood test CPT 83525 HC INSULIN ASSAY (REF LAB)	$42.00	$56.00	$9.88–$56.76	37% below	25%
Insulin blood test inpatient CPT 83525 HC INSULIN, TOTAL (REF LAB)	$32.25	$43.00	$11.18–$37.24	—	25%
Insulin blood test inpatient CPT 83525 HC INSULIN ASSAY (REF LAB)	$42.00	$56.00	$14.56–$48.50	—	25%
Iron blood test (serum iron) CPT 83540 HC IRON	$69.75	$93.00	$5.59–$83.70	59% above	25%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON	$69.75	$93.00	$24.18–$80.54	—	25%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY	$69.00	$92.00	$7.56–$82.80	25% above	25%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY	$69.00	$92.00	$23.92–$79.67	—	25%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL	$144.75	$193.00	$7.50–$173.70	103% above	25%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL	$144.75	$193.00	$50.18–$167.14	—	25%
LH (luteinizing hormone) test CPT 83002 HC LUTEINIZING HORMONE (REF LAB)	$59.25	$79.00	$16.00–$91.74	30% below	25%
LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE	$74.25	$99.00	$16.00–$91.74	13% below	25%
LH (luteinizing hormone) test CPT 83002 HC MAYO LHPED-GONADOTROPIN LUTEINIZING HORMONE	$160.50	$214.00	$16.00–$192.60	89% above	25%
LH (luteinizing hormone) test inpatient CPT 83002 HC LUTEINIZING HORMONE (REF LAB)	$59.25	$79.00	$20.54–$68.41	—	25%
LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE	$74.25	$99.00	$25.74–$85.73	—	25%
LH (luteinizing hormone) test inpatient CPT 83002 HC MAYO LHPED-GONADOTROPIN LUTEINIZING HORMONE	$160.50	$214.00	$55.64–$185.32	—	25%
Lactate (lactic acid) blood test CPT 83605 HC LACTATE/LACTIC ACID	$102.00	$136.00	$9.99–$122.40	34% above	25%
Lactate (lactic acid) blood test CPT 83605 HC LACTATE/LACTIC ACID POC	$102.00	$136.00	$9.99–$122.40	34% above	25%
Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTATE/LACTIC ACID POC	$102.00	$136.00	$35.36–$117.78	—	25%
Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTATE/LACTIC ACID	$102.00	$136.00	$35.36–$117.78	—	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE (LD) (REF LAB)	$19.50	$26.00	$5.22–$33.55	39% below	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC KH MAYO LD_I LACTATE (LD) (LDH) ENZYME	$26.25	$35.00	$5.22–$33.55	18% below	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE, CSF (REF LAB)	$32.25	$43.00	$5.22–$38.70	1% above	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH	$55.50	$74.00	$5.22–$66.60	74% above	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE (LD) (REF LAB)	$19.50	$26.00	$6.76–$22.52	—	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC KH MAYO LD_I LACTATE (LD) (LDH) ENZYME	$26.25	$35.00	$9.10–$30.31	—	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE, CSF (REF LAB)	$32.25	$43.00	$11.18–$37.24	—	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LDH	$55.50	$74.00	$19.24–$64.08	—	25%
Lipase blood test (pancreas enzyme) CPT 83690 HC KH MAYO LPSBF-LIPASE, BODY FLUID	$22.50	$30.00	$5.95–$76.97	68% below	25%
Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE	$90.75	$121.00	$5.95–$108.90	28% above	25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC KH MAYO LPSBF-LIPASE, BODY FLUID	$22.50	$30.00	$7.80–$25.98	—	25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE	$90.75	$121.00	$31.46–$104.79	—	25%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL	$144.00	$192.00	$7.06–$172.80	98% above	25%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL	$144.00	$192.00	$49.92–$166.27	—	25%
Lyme disease antibody test CPT 86618 HC MAYO SLYME-ANTIBODY BORRELIA BURGDORFERI LYME DISEASE	$15.75	$21.00	$7.77–$78.19	81% below	25%
Lyme disease antibody test CPT 86618 HC MAYO STICK-ANALYSIS FOR ANTIBODY BORRELIA BURGDORFERI (LYME DISEASE BACTERIA)	$38.25	$51.00	$14.72–$78.19	55% below	25%
Lyme disease antibody test CPT 86618 HC LYME CNS INFECT IGG W/AI REFLX (REF LAB)	$40.50	$54.00	$14.72–$78.19	52% below	25%
Lyme disease antibody test CPT 86618 HC LYME DISEASE SEROLOGY, S (REF LAB)	$40.50	$54.00	$14.72–$78.19	52% below	25%
Lyme disease antibody test CPT 86618 HC ARUP - ANTIBODY; BORRELIA BURGDORFERI (LYME DISEASE)	$41.25	$55.00	$14.72–$78.19	51% below	25%
Lyme disease antibody test CPT 86618 HC KH MAYO TICKS LYME DISEASE ANTIBODY	$44.25	$59.00	$14.72–$78.19	48% below	25%
Lyme disease antibody test inpatient CPT 86618 HC MAYO SLYME-ANTIBODY BORRELIA BURGDORFERI LYME DISEASE	$15.75	$21.00	$5.46–$18.19	—	25%
Lyme disease antibody test inpatient CPT 86618 HC MAYO STICK-ANALYSIS FOR ANTIBODY BORRELIA BURGDORFERI (LYME DISEASE BACTERIA)	$38.25	$51.00	$13.26–$44.17	—	25%
Lyme disease antibody test inpatient CPT 86618 HC LYME CNS INFECT IGG W/AI REFLX (REF LAB)	$40.50	$54.00	$14.04–$46.76	—	25%
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE SEROLOGY, S (REF LAB)	$40.50	$54.00	$14.04–$46.76	—	25%
Lyme disease antibody test inpatient CPT 86618 HC ARUP - ANTIBODY; BORRELIA BURGDORFERI (LYME DISEASE)	$41.25	$55.00	$14.30–$47.63	—	25%
Lyme disease antibody test inpatient CPT 86618 HC KH MAYO TICKS LYME DISEASE ANTIBODY	$44.25	$59.00	$15.34–$51.09	—	25%
Magnesium blood test CPT 83735 HC KH MAYO SUP24 ASSAY OF MAGNESIUM	$9.00	$12.00	$4.44–$66.66	81% below	25%
Magnesium blood test CPT 83735 HC KH MAYO EFPO ASSAY OF MAGNESIUM	$12.00	$16.00	$5.79–$66.66	74% below	25%
Magnesium blood test CPT 83735 HC MAGNESIUM, F (REF LAB)	$22.50	$30.00	$5.79–$66.66	51% below	25%
Magnesium blood test CPT 83735 HC MAGNESIUM, URINE (REF LAB)	$39.00	$52.00	$5.79–$66.66	16% below	25%
Magnesium blood test CPT 83735 HC NEONATE CHEM MAG	$61.50	$82.00	$5.79–$73.80	33% above	25%
Magnesium blood test CPT 83735 HC MAGNESIUM, SERUM	$61.50	$82.00	$5.79–$73.80	33% above	25%
Magnesium blood test inpatient CPT 83735 HC KH MAYO SUP24 ASSAY OF MAGNESIUM	$9.00	$12.00	$3.12–$10.39	—	25%
Magnesium blood test inpatient CPT 83735 HC KH MAYO EFPO ASSAY OF MAGNESIUM	$12.00	$16.00	$4.16–$13.86	—	25%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM, F (REF LAB)	$22.50	$30.00	$7.80–$25.98	—	25%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM, URINE (REF LAB)	$39.00	$52.00	$13.52–$45.03	—	25%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM, SERUM	$61.50	$82.00	$21.32–$71.01	—	25%
Magnesium blood test inpatient CPT 83735 HC NEONATE CHEM MAG	$61.50	$82.00	$21.32–$71.01	—	25%
Measles (rubeola) antibody test CPT 86765 HC MAYO ROM-ANTIBODY RUBEOLA	$21.00	$28.00	$10.36–$64.81	67% below	25%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA, IGG (REF LAB)	$44.25	$59.00	$11.13–$64.81	31% below	25%
Measles (rubeola) antibody test CPT 86765 HC MEASLES (RUBEOLA) IGM, IFA (REF LAB)	$44.25	$59.00	$11.13–$64.81	31% below	25%
Measles (rubeola) antibody test CPT 86765 HC MEASLES (RUBEOLA), IGG	$50.25	$67.00	$11.13–$64.81	22% below	25%
Measles (rubeola) antibody test inpatient CPT 86765 HC MAYO ROM-ANTIBODY RUBEOLA	$21.00	$28.00	$7.28–$24.25	—	25%
Measles (rubeola) antibody test inpatient CPT 86765 HC MEASLES (RUBEOLA) IGM, IFA (REF LAB)	$44.25	$59.00	$15.34–$51.09	—	25%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA, IGG (REF LAB)	$44.25	$59.00	$15.34–$51.09	—	25%
Measles (rubeola) antibody test inpatient CPT 86765 HC MEASLES (RUBEOLA), IGG	$50.25	$67.00	$17.42–$58.02	—	25%
Mono test (heterophile antibody, Monospot) CPT 86308 HC MONO TEST	$87.00	$116.00	$4.47–$104.40	69% above	25%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC MONO TEST	$87.00	$116.00	$30.16–$100.46	—	25%
Mumps immunity blood test CPT 86735 HC MAYO CMUMP-ANTIBODY MUMPS	$24.00	$32.00	$11.28–$72.35	63% below	25%
Mumps immunity blood test CPT 86735 HC MUMPS VIRUS ANTIBODY, IGG (REF LAB)	$49.50	$66.00	$11.28–$72.35	24% below	25%
Mumps immunity blood test CPT 86735 HC MUMPS VIRUS AB, IGM	$55.50	$74.00	$11.28–$72.35	15% below	25%
Mumps immunity blood test CPT 86735 HC MUMPS VIRUS AB, IGG	$57.00	$76.00	$11.28–$72.35	13% below	25%
Mumps immunity blood test CPT 86735 HC MUMPS IGG - IMMUNITY	$111.00	$148.00	$11.28–$133.20	70% above	25%
Mumps immunity blood test inpatient CPT 86735 HC MAYO CMUMP-ANTIBODY MUMPS	$24.00	$32.00	$8.32–$27.71	—	25%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS VIRUS ANTIBODY, IGG (REF LAB)	$49.50	$66.00	$17.16–$57.16	—	25%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS VIRUS AB, IGM	$55.50	$74.00	$19.24–$64.08	—	25%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS VIRUS AB, IGG	$57.00	$76.00	$19.76–$65.82	—	25%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS IGG - IMMUNITY	$111.00	$148.00	$38.48–$128.17	—	25%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC AG, FREE (REF LAB)	$67.50	$90.00	$15.89–$104.83	18% below	25%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC KH MAYO PHI13-PROSTATE HEALTH INDEX REFLEX: FREE PSA	$135.00	$180.00	$15.89–$162.00	65% above	25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC AG, FREE (REF LAB)	$67.50	$90.00	$23.40–$77.94	—	25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC KH MAYO PHI13-PROSTATE HEALTH INDEX REFLEX: FREE PSA	$135.00	$180.00	$46.80–$155.88	—	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC AG, TOTAL (REF LAB)	$69.75	$93.00	$15.89–$113.63	26% below	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE HEALTH INDEX (PHI), SERUM (REF LAB)	$72.75	$97.00	$15.89–$113.63	23% below	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE-SPECIFIC ANTIGEN	$81.00	$108.00	$15.89–$113.63	14% below	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA ULTRASENSITIVE, SERUM (REF LAB)	$138.75	$185.00	$15.89–$166.50	47% above	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC AG, TOTAL (REF LAB)	$69.75	$93.00	$24.18–$80.54	—	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE HEALTH INDEX (PHI), SERUM (REF LAB)	$72.75	$97.00	$25.22–$84.00	—	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE-SPECIFIC ANTIGEN	$81.00	$108.00	$28.08–$93.53	—	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA ULTRASENSITIVE, SERUM (REF LAB)	$138.75	$185.00	$48.10–$160.21	—	25%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTOPATH C/V AUTO FL REDO TC	$47.25	$63.00	$22.99–$95.80	54% below	25%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTOPATH C/V AUTO FL REDO TC	$47.25	$63.00	$16.38–$54.56	—	25%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CYTOPATH C/V THIN LAYER	$36.00	$48.00	$17.50–$72.94	60% below	25%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC CYTOPATH C/V THIN LAYER	$36.00	$48.00	$12.48–$41.57	—	25%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHYROID HORMONE (PTH) (REF LAB)	$87.00	$116.00	$35.66–$193.54	52% below	25%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHYROID HORMONE, INTACT	$277.50	$370.00	$35.66–$333.00	52% above	25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHYROID HORMONE (PTH) (REF LAB)	$87.00	$116.00	$30.16–$100.46	—	25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHYROID HORMONE, INTACT	$277.50	$370.00	$96.20–$320.42	—	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC KH MAYO ALUPP THROMBOPLASTIN TIME PARTIAL	$8.25	$11.00	$4.07–$67.05	84% below	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC KH MAYO AATHR-THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD	$14.25	$19.00	$5.19–$67.05	72% below	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC KH MAYO FLUPV THROMBOPLASTIN TIME PARTIAL	$37.50	$50.00	$5.19–$67.05	25% below	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC LUPUS ANTICOAGULANT (REF LAB)	$52.50	$70.00	$5.19–$67.05	5% above	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC ACTIVATED PARTIAL THROMBOPL TM (REF LAB)	$52.50	$70.00	$5.19–$67.05	5% above	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC KH PTT	$88.50	$118.00	$5.19–$106.20	77% above	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT	$88.50	$118.00	$5.19–$106.20	77% above	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC KH MAYO ALUPP THROMBOPLASTIN TIME PARTIAL	$8.25	$11.00	$2.86–$9.53	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC KH MAYO AATHR-THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD	$14.25	$19.00	$4.94–$16.45	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC KH MAYO FLUPV THROMBOPLASTIN TIME PARTIAL	$37.50	$50.00	$13.00–$43.30	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC ACTIVATED PARTIAL THROMBOPL TM (REF LAB)	$52.50	$70.00	$18.20–$60.62	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC LUPUS ANTICOAGULANT (REF LAB)	$52.50	$70.00	$18.20–$60.62	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC KH PTT	$88.50	$118.00	$30.68–$102.19	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT	$88.50	$118.00	$30.68–$102.19	—	25%
Phosphorus (phosphate) blood test CPT 84100 HC KH MAYO EFPO ASSAY OF PHOSPHORUS	$12.00	$16.00	$4.10–$33.55	65% below	25%
Phosphorus (phosphate) blood test CPT 84100 HC PHOSPHORUS, F	$16.50	$22.00	$4.10–$33.55	53% below	25%
Phosphorus (phosphate) blood test CPT 84100 HC NEONATE CHEM PHOS	$55.50	$74.00	$4.10–$66.60	60% above	25%
Phosphorus (phosphate) blood test CPT 84100 HC PHOSPHORUS	$55.50	$74.00	$4.10–$66.60	60% above	25%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC KH MAYO EFPO ASSAY OF PHOSPHORUS	$12.00	$16.00	$4.16–$13.86	—	25%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC PHOSPHORUS, F	$16.50	$22.00	$5.72–$19.05	—	25%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC NEONATE CHEM PHOS	$55.50	$74.00	$19.24–$64.08	—	25%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC PHOSPHORUS	$55.50	$74.00	$19.24–$64.08	—	25%
Potassium blood test CPT 84132 HC POTASSIUM, SERUM	$56.25	$75.00	$4.11–$67.50	58% above	25%
Potassium blood test CPT 84132 HC POTASSIUM, POC	$56.25	$75.00	$4.11–$67.50	58% above	25%
Potassium blood test inpatient CPT 84132 HC POTASSIUM, POC	$56.25	$75.00	$19.50–$64.95	—	25%
Potassium blood test inpatient CPT 84132 HC POTASSIUM, SERUM	$56.25	$75.00	$19.50–$64.95	—	25%
Progesterone blood test CPT 84144 HC PROGESTERONE (REF LAB)	$56.25	$75.00	$18.02–$95.20	42% below	25%
Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE	$77.25	$103.00	$18.02–$95.20	20% below	25%
Progesterone blood test CPT 84144 HC MAYO ZW71-ASSAY OF PROGESTERONE	$105.00	$140.00	$18.02–$126.00	9% above	25%
Progesterone blood test inpatient CPT 84144 HC PROGESTERONE (REF LAB)	$56.25	$75.00	$19.50–$64.95	—	25%
Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE	$77.25	$103.00	$26.78–$89.20	—	25%
Progesterone blood test inpatient CPT 84144 HC MAYO ZW71-ASSAY OF PROGESTERONE	$105.00	$140.00	$36.40–$121.24	—	25%
Prolactin blood test CPT 84146 HC PROLACTIN (REF LAB)	$45.75	$61.00	$16.74–$89.55	52% below	25%
Prolactin blood test CPT 84146 HC KH MAYO MCRPL-MACROPROLACTIN, SERUM	$60.75	$81.00	$16.74–$89.55	37% below	25%
Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN	$72.75	$97.00	$16.74–$89.55	24% below	25%
Prolactin blood test inpatient CPT 84146 HC PROLACTIN (REF LAB)	$45.75	$61.00	$15.86–$52.83	—	25%
Prolactin blood test inpatient CPT 84146 HC KH MAYO MCRPL-MACROPROLACTIN, SERUM	$60.75	$81.00	$21.06–$70.15	—	25%
Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN	$72.75	$97.00	$25.22–$84.00	—	25%
Prothrombin time (PT/INR) clotting test CPT 85610 HC KH MAYO ALUPP PROTHROMBIN TIME	$8.25	$11.00	$3.71–$43.91	75% below	25%
Prothrombin time (PT/INR) clotting test CPT 85610 HC KH MAYO AATHR-PROTHROMBIN TIME	$9.75	$13.00	$3.71–$43.91	70% below	25%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME (REF LAB)	$22.50	$30.00	$3.71–$43.91	31% below	25%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME	$45.75	$61.00	$3.71–$54.90	41% above	25%
Prothrombin time (PT/INR) clotting test CPT 85610 HC KH PROTIME	$45.75	$61.00	$3.71–$54.90	41% above	25%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PT, INR (POC)	$45.75	$61.00	$3.71–$54.90	41% above	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC KH MAYO ALUPP PROTHROMBIN TIME	$8.25	$11.00	$2.86–$9.53	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC KH MAYO AATHR-PROTHROMBIN TIME	$9.75	$13.00	$3.38–$11.26	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME (REF LAB)	$22.50	$30.00	$7.80–$25.98	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME	$45.75	$61.00	$15.86–$52.83	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC KH PROTIME	$45.75	$61.00	$15.86–$52.83	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PT, INR (POC)	$45.75	$61.00	$15.86–$52.83	—	25%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC TOX SCREEN (POC)	$15.00	$20.00	$7.40–$167.49	75% below	25%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC NICOTINE SCREEN, URINE	$27.75	$37.00	$10.89–$167.49	54% below	25%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC TOX SCREEN (POC)	$15.00	$20.00	$5.20–$17.32	—	25%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC NICOTINE SCREEN, URINE	$27.75	$37.00	$9.62–$32.04	—	25%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA B ANTIGEN	$69.00	$92.00	$14.30–$82.80	at median	25%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA B ANTIGEN	$69.00	$92.00	$23.92–$79.67	—	25%
Renin blood test CPT 84244 HC RENIN (PLASMA) (REF LAB)	$84.00	$112.00	$19.00–$100.80	26% below	25%
Renin blood test inpatient CPT 84244 HC RENIN (PLASMA) (REF LAB)	$84.00	$112.00	$29.12–$96.99	—	25%
Rh blood typing CPT 86901 HC BLOOD TYPE SEROLOGIC RH(D) (REF LAB)	$27.00	$36.00	$2.58–$138.98	41% below	25%
Rh blood typing CPT 86901 HC RH TYPE	$75.00	$100.00	$2.58–$138.98	63% above	25%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPE SEROLOGIC RH(D) (REF LAB)	$27.00	$36.00	$9.36–$31.18	—	25%
Rh blood typing inpatient CPT 86901 HC RH TYPE	$75.00	$100.00	$26.00–$86.60	—	25%
Rheumatoid factor (RF) test CPT 86431 HC MAYO RAPAN-RHEUMATOID ARTHRITIS PANEL, SERUM	$7.50	$10.00	$3.70–$59.13	76% below	25%
Rheumatoid factor (RF) test CPT 86431 HC MAYO FRGAM-RHEUMATOID FACTOR IGG	$32.25	$43.00	$4.90–$59.13	4% above	25%
Rheumatoid factor (RF) test CPT 86431 HC MAYO FRGAM-RHEUMATOID FACTOR IGM	$32.25	$43.00	$4.90–$59.13	4% above	25%
Rheumatoid factor (RF) test CPT 86431 HC MAYO FRGAM-RHEUMATOID FACTOR IGA	$32.25	$43.00	$4.90–$59.13	4% above	25%
Rheumatoid factor (RF) test CPT 86431 HC RHUT-RHEUMATOID FACTOR, SERUM (REF LAB)	$57.75	$77.00	$4.90–$69.30	87% above	25%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR, QUANT	$104.25	$139.00	$4.90–$125.10	237% above	25%
Rheumatoid factor (RF) test inpatient CPT 86431 HC MAYO RAPAN-RHEUMATOID ARTHRITIS PANEL, SERUM	$7.50	$10.00	$2.60–$8.66	—	25%
Rheumatoid factor (RF) test inpatient CPT 86431 HC MAYO FRGAM-RHEUMATOID FACTOR IGG	$32.25	$43.00	$11.18–$37.24	—	25%
Rheumatoid factor (RF) test inpatient CPT 86431 HC MAYO FRGAM-RHEUMATOID FACTOR IGA	$32.25	$43.00	$11.18–$37.24	—	25%
Rheumatoid factor (RF) test inpatient CPT 86431 HC MAYO FRGAM-RHEUMATOID FACTOR IGM	$32.25	$43.00	$11.18–$37.24	—	25%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHUT-RHEUMATOID FACTOR, SERUM (REF LAB)	$57.75	$77.00	$20.02–$66.68	—	25%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR, QUANT	$104.25	$139.00	$36.14–$120.37	—	25%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY, IGG (REF LAB)	$57.75	$77.00	$12.43–$92.12	3% below	25%
Rubella antibody test (immunity check) CPT 86762 HC KH MAYO TRCHG-ANTIBODY; RUBELLA	$76.50	$102.00	$12.43–$92.12	29% above	25%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY	$105.75	$141.00	$12.43–$126.90	78% above	25%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY, IGG (REF LAB)	$57.75	$77.00	$20.02–$66.68	—	25%
Rubella antibody test (immunity check) inpatient CPT 86762 HC KH MAYO TRCHG-ANTIBODY; RUBELLA	$76.50	$102.00	$26.52–$88.33	—	25%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY	$105.75	$141.00	$36.66–$122.11	—	25%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC SEDIMENTATION RATE RBC AUTOMATED	$32.25	$43.00	$2.33–$38.70	60% above	25%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC SEDIMENTATION RATE RBC AUTOMATED	$32.25	$43.00	$11.18–$37.24	—	25%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC SEMEN EXAM, COMPLETE	$209.25	$279.00	$12.31–$251.10	145% above	25%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC SEMEN EXAM, COMPLETE	$209.25	$279.00	$72.54–$241.61	—	25%
Sodium blood test CPT 84295 HC SODIUM, POC	$50.25	$67.00	$4.16–$60.30	53% above	25%
Sodium blood test CPT 84295 HC SODIUM, SERUM	$50.25	$67.00	$4.16–$60.30	53% above	25%
Sodium blood test inpatient CPT 84295 HC SODIUM, SERUM	$50.25	$67.00	$17.42–$58.02	—	25%
Sodium blood test inpatient CPT 84295 HC SODIUM, POC	$50.25	$67.00	$17.42–$58.02	—	25%
Stool ova and parasites exam CPT 87177 HC OVA & PARASITES, DIRECT SMEARS	$26.25	$35.00	$7.69–$38.38	47% below	25%
Stool ova and parasites exam CPT 87177 HC OVA & PARASITES SMEARS (REF LAB)	$56.25	$75.00	$7.69–$67.50	14% above	25%
Stool ova and parasites exam inpatient CPT 87177 HC OVA & PARASITES, DIRECT SMEARS	$26.25	$35.00	$9.10–$30.31	—	25%
Stool ova and parasites exam inpatient CPT 87177 HC OVA & PARASITES SMEARS (REF LAB)	$56.25	$75.00	$19.50–$64.95	—	25%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECAL TC POC	$27.00	$36.00	$13.32–$74.46	62% below	25%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD,OCCULT,FECES	$66.75	$89.00	$13.76–$80.10	6% below	25%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD OCCULT FECAL TC POC	$27.00	$36.00	$9.36–$31.18	—	25%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD,OCCULT,FECES	$66.75	$89.00	$23.14–$77.07	—	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC SYPHILIS TOTAL AB (REF LAB)	$24.75	$33.00	$11.44–$59.08	64% below	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC SYPHILIS AB, TP-PA, S (REF LAB)	$51.75	$69.00	$11.44–$62.10	24% below	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC SYPHILIS IGG ANTIBODY	$79.50	$106.00	$11.44–$95.40	17% above	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM	$79.50	$106.00	$11.44–$95.40	17% above	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC SYPHILIS TOTAL AB (REF LAB)	$24.75	$33.00	$8.58–$28.58	—	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC SYPHILIS AB, TP-PA, S (REF LAB)	$51.75	$69.00	$17.94–$59.75	—	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM	$79.50	$106.00	$27.56–$91.80	—	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC SYPHILIS IGG ANTIBODY	$79.50	$106.00	$27.56–$91.80	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC VDRL, CSF (REF LAB)	$23.25	$31.00	$3.69–$34.77	46% below	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC RAPID PLASMA REAGIN, SERUM (REF LAB)	$36.00	$48.00	$3.69–$43.20	16% below	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC RPR SCREEN	$63.75	$85.00	$3.69–$76.50	48% above	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC VDRL, CSF (REF LAB)	$23.25	$31.00	$8.06–$26.85	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC RAPID PLASMA REAGIN, SERUM (REF LAB)	$36.00	$48.00	$12.48–$41.57	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC RPR SCREEN	$63.75	$85.00	$22.10–$73.61	—	25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC QUANTIFERON-TB GOLD TEST (REF LAB)	$93.00	$124.00	$45.88–$244.21	58% below	25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC QUANTIFERON TB	$297.75	$397.00	$53.55–$357.30	35% above	25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC QUANTIFERON-TB GOLD TEST (REF LAB)	$93.00	$124.00	$32.24–$107.38	—	25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC QUANTIFERON TB	$297.75	$397.00	$103.22–$343.80	—	25%
Testosterone blood test, total (not free testosterone) CPT 84403 HC KH MAYO TGRP ASSAY OF TOTAL TESTOSTERONE	$8.25	$11.00	$4.07–$108.65	92% below	25%
Testosterone blood test, total (not free testosterone) CPT 84403 HC KH MAYO TTFB ASSAY OF TOTAL TESTOSTERONE	$10.50	$14.00	$5.18–$108.65	90% below	25%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TOTAL TESTOSTERONE (REF LAB)	$42.75	$57.00	$21.09–$108.65	60% below	25%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE, TOTAL (REF LAB)	$42.75	$57.00	$21.09–$108.65	60% below	25%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL	$88.50	$118.00	$22.30–$108.65	17% below	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC KH MAYO TGRP ASSAY OF TOTAL TESTOSTERONE	$8.25	$11.00	$2.86–$9.53	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC KH MAYO TTFB ASSAY OF TOTAL TESTOSTERONE	$10.50	$14.00	$3.64–$12.12	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TOTAL TESTOSTERONE (REF LAB)	$42.75	$57.00	$14.82–$49.36	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE, TOTAL (REF LAB)	$42.75	$57.00	$14.82–$49.36	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL	$88.50	$118.00	$30.68–$102.19	—	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC THYROPEROXIDASE AB, S (REF LAB)	$48.00	$64.00	$12.58–$76.77	39% below	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC THYROID PEROXIDASE ANTIBODY (REF LAB)	$51.75	$69.00	$12.58–$76.77	34% below	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MAYO FCUIP-MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT	$75.75	$101.00	$12.58–$90.90	4% below	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL AB LIVER/KIDNEY (REF LAB)	$78.00	$104.00	$12.58–$93.60	1% below	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC THYROID PEROXIDASE ANTIBODY	$161.25	$215.00	$12.58–$193.50	105% above	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC THYROPEROXIDASE AB, S (REF LAB)	$48.00	$64.00	$16.64–$55.42	—	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC THYROID PEROXIDASE ANTIBODY (REF LAB)	$51.75	$69.00	$17.94–$59.75	—	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MAYO FCUIP-MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT	$75.75	$101.00	$26.26–$87.47	—	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL AB LIVER/KIDNEY (REF LAB)	$78.00	$104.00	$27.04–$90.06	—	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC THYROID PEROXIDASE ANTIBODY	$161.25	$215.00	$55.90–$186.19	—	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC MAYO FCUIP-BLOOD TEST, THYROID STIMULATING HORMONE (TSH)	$81.75	$109.00	$14.52–$144.71	1% above	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC KH MAYO STSH-THYROID-STIMULATING HORMONE-SENSITIVE (S-TSH), SERUM	$92.25	$123.00	$14.52–$144.71	14% above	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH	$104.25	$139.00	$14.52–$144.71	29% above	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC KH TSH	$104.25	$139.00	$14.52–$144.71	29% above	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC MAYO FCUIP-BLOOD TEST, THYROID STIMULATING HORMONE (TSH)	$81.75	$109.00	$28.34–$94.39	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC KH MAYO STSH-THYROID-STIMULATING HORMONE-SENSITIVE (S-TSH), SERUM	$92.25	$123.00	$31.98–$106.52	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC KH TSH	$104.25	$139.00	$36.14–$120.37	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH	$104.25	$139.00	$36.14–$120.37	—	25%
Total IgE blood test CPT 82785 HC KH MAYO RPR11 ASSAY OF IGE	$10.50	$14.00	$5.18–$81.39	88% below	25%
Total IgE blood test CPT 82785 HC KH MAYO RPR16 ASSAY OF IGE	$10.50	$14.00	$5.18–$81.39	88% below	25%
Total IgE blood test CPT 82785 HC IMMUNOGLOBULIN E, IGE (REF LAB)	$48.00	$64.00	$14.22–$81.39	46% below	25%
Total IgE blood test CPT 82785 HC IMMUNOGLOBULIN E (REF LAB)	$50.25	$67.00	$14.22–$81.39	44% below	25%
Total IgE blood test CPT 82785 HC MAYO-RPR15 ASSAY OF GAMMAGLOBULIN IGE	$54.00	$72.00	$14.22–$81.39	40% below	25%
Total IgE blood test CPT 82785 HC KH MAYO RPR11-RESPIRATORY PROFILE, REGION 11, ROCKY MOUNTAIN (AZ [MT]; CO; ID [MT]; NM, UT [MT]; WY), SERUM	$55.50	$74.00	$14.22–$81.39	38% below	25%
Total IgE blood test inpatient CPT 82785 HC KH MAYO RPR11 ASSAY OF IGE	$10.50	$14.00	$3.64–$12.12	—	25%
Total IgE blood test inpatient CPT 82785 HC KH MAYO RPR16 ASSAY OF IGE	$10.50	$14.00	$3.64–$12.12	—	25%
Total IgE blood test inpatient CPT 82785 HC IMMUNOGLOBULIN E, IGE (REF LAB)	$48.00	$64.00	$16.64–$55.42	—	25%
Total IgE blood test inpatient CPT 82785 HC IMMUNOGLOBULIN E (REF LAB)	$50.25	$67.00	$17.42–$58.02	—	25%
Total IgE blood test inpatient CPT 82785 HC MAYO-RPR15 ASSAY OF GAMMAGLOBULIN IGE	$54.00	$72.00	$18.72–$62.35	—	25%
Total IgE blood test inpatient CPT 82785 HC KH MAYO RPR11-RESPIRATORY PROFILE, REGION 11, ROCKY MOUNTAIN (AZ [MT]; CO; ID [MT]; NM, UT [MT]; WY), SERUM	$55.50	$74.00	$19.24–$64.08	—	25%
Total cholesterol blood test CPT 82465 HC MAYO CRMP1-CHOLESTEROL, SERUM OR WHOLE BLOOD, TOTAL	$8.25	$11.00	$3.76–$31.02	74% below	25%
Total cholesterol blood test CPT 82465 HC KH MAYO LMPP-CHOLESTEROL, TOTAL, CDC, S	$21.00	$28.00	$3.76–$31.02	34% below	25%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL, SERUM, TOTAL	$30.75	$41.00	$3.76–$36.90	4% below	25%
Total cholesterol blood test inpatient CPT 82465 HC MAYO CRMP1-CHOLESTEROL, SERUM OR WHOLE BLOOD, TOTAL	$8.25	$11.00	$2.86–$9.53	—	25%
Total cholesterol blood test inpatient CPT 82465 HC KH MAYO LMPP-CHOLESTEROL, TOTAL, CDC, S	$21.00	$28.00	$7.28–$24.25	—	25%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL, SERUM, TOTAL	$30.75	$41.00	$10.66–$35.51	—	25%
Total thyroxine (T4) blood test CPT 84436 HC KH MAYO FRTUP ASSAY OF TOTAL THYROXINE	$27.75	$37.00	$5.93–$62.96	27% below	25%
Total thyroxine (T4) blood test CPT 84436 HC T4, TOTAL (REF LAB)	$37.50	$50.00	$5.93–$62.96	1% below	25%
Total thyroxine (T4) blood test CPT 84436 HC KH T4	$42.75	$57.00	$5.93–$62.96	12% above	25%
Total thyroxine (T4) blood test CPT 84436 HC KH FREE T4	$59.25	$79.00	$5.93–$71.10	56% above	25%
Total thyroxine (T4) blood test CPT 84436 HC T-4, THYROXINE, TOTAL	$74.25	$99.00	$5.93–$89.10	95% above	25%
Total thyroxine (T4) blood test inpatient CPT 84436 HC KH MAYO FRTUP ASSAY OF TOTAL THYROXINE	$27.75	$37.00	$9.62–$32.04	—	25%
Total thyroxine (T4) blood test inpatient CPT 84436 HC T4, TOTAL (REF LAB)	$37.50	$50.00	$13.00–$43.30	—	25%
Total thyroxine (T4) blood test inpatient CPT 84436 HC KH T4	$42.75	$57.00	$14.82–$49.36	—	25%
Total thyroxine (T4) blood test inpatient CPT 84436 HC KH FREE T4	$59.25	$79.00	$20.54–$68.41	—	25%
Total thyroxine (T4) blood test inpatient CPT 84436 HC T-4, THYROXINE, TOTAL	$74.25	$99.00	$25.74–$85.73	—	25%
Total triiodothyronine (T3) blood test CPT 84480 HC T3 TRIIODOTHYRONINE), TOTAL, S (REF LAB)	$87.00	$116.00	$12.25–$145.27	at median	25%
Total triiodothyronine (T3) blood test CPT 84480 HC T-3, TRIIODOTHYRONINE	$126.00	$168.00	$12.25–$151.20	45% above	25%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC T3 TRIIODOTHYRONINE), TOTAL, S (REF LAB)	$87.00	$116.00	$30.16–$100.46	—	25%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC T-3, TRIIODOTHYRONINE	$126.00	$168.00	$43.68–$145.49	—	25%
Transferrin blood test CPT 84466 HC TRANSFERRIN (REF LAB)	$44.25	$59.00	$11.02–$66.14	45% below	25%
Transferrin blood test inpatient CPT 84466 HC TRANSFERRIN (REF LAB)	$44.25	$59.00	$15.34–$51.09	—	25%
Trichomonas test (NAAT) CPT 87661 HC KH MAYO FNSVG TRICHOMONAS VAGINALIS AMPLIF	$37.50	$50.00	$18.50–$126.32	70% below	25%
Trichomonas test (NAAT) CPT 87661 HC TRICHOMONAS BY APT (REF LAB)	$76.50	$102.00	$30.32–$126.32	39% below	25%
Trichomonas test (NAAT) CPT 87661 HC TVRNA-TRICHOMONAS VAG NUC AMP (REF LAB)	$76.50	$102.00	$30.32–$126.32	39% below	25%
Trichomonas test (NAAT) CPT 87661 HC TRICHOMONAS VAGINALIS	$148.50	$198.00	$30.32–$178.20	19% above	25%
Trichomonas test (NAAT) inpatient CPT 87661 HC KH MAYO FNSVG TRICHOMONAS VAGINALIS AMPLIF	$37.50	$50.00	$13.00–$43.30	—	25%
Trichomonas test (NAAT) inpatient CPT 87661 HC TVRNA-TRICHOMONAS VAG NUC AMP (REF LAB)	$76.50	$102.00	$26.52–$88.33	—	25%
Trichomonas test (NAAT) inpatient CPT 87661 HC TRICHOMONAS BY APT (REF LAB)	$76.50	$102.00	$26.52–$88.33	—	25%
Trichomonas test (NAAT) inpatient CPT 87661 HC TRICHOMONAS VAGINALIS	$148.50	$198.00	$51.48–$171.47	—	25%
Triglycerides blood test CPT 84478 HC MAYO CRMP1-ASSAY OF TRIGLYCERIDES	$10.50	$14.00	$4.96–$28.42	72% below	25%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES (REF LAB)	$15.75	$21.00	$4.96–$28.42	58% below	25%
Triglycerides blood test CPT 84478 HC KH MAYO LMPP-TRIGLYCERIDES, CDC, S	$18.75	$25.00	$4.96–$28.42	49% below	25%
Triglycerides blood test CPT 84478 HC KH MAYO CSU-TRIGLYCERIDES	$18.75	$25.00	$4.96–$28.42	49% below	25%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES	$58.50	$78.00	$4.96–$70.20	58% above	25%
Triglycerides blood test CPT 84478 HC NEONATE CHEM TRIG	$58.50	$78.00	$4.96–$70.20	58% above	25%
Triglycerides blood test inpatient CPT 84478 HC MAYO CRMP1-ASSAY OF TRIGLYCERIDES	$10.50	$14.00	$3.64–$12.12	—	25%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES (REF LAB)	$15.75	$21.00	$5.46–$18.19	—	25%
Triglycerides blood test inpatient CPT 84478 HC KH MAYO CSU-TRIGLYCERIDES	$18.75	$25.00	$6.50–$21.65	—	25%
Triglycerides blood test inpatient CPT 84478 HC KH MAYO LMPP-TRIGLYCERIDES, CDC, S	$18.75	$25.00	$6.50–$21.65	—	25%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES	$58.50	$78.00	$20.28–$67.55	—	25%
Triglycerides blood test inpatient CPT 84478 HC NEONATE CHEM TRIG	$58.50	$78.00	$20.28–$67.55	—	25%
Troponin test, quantitative CPT 84484 HC TROPONIN, QUANTITATIVE	$140.25	$187.00	$10.77–$168.30	41% above	25%
Troponin test, quantitative CPT 84484 HC TROPONIN I, SERUM (REF LAB)	$144.00	$192.00	$10.77–$172.80	44% above	25%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN, QUANTITATIVE	$140.25	$187.00	$48.62–$161.94	—	25%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN I, SERUM (REF LAB)	$144.00	$192.00	$49.92–$166.27	—	25%
Uric acid blood test CPT 84550 HC URIC ACID, BLOOD	$58.50	$78.00	$3.91–$70.20	69% above	25%
Uric acid blood test inpatient CPT 84550 HC URIC ACID, BLOOD	$58.50	$78.00	$20.28–$67.55	—	25%
Urinalysis with microscope exam, automated CPT 81001 HC KH URINALYSIS, COMPLETE W/MICROSCOPIC	$21.00	$28.00	$2.74–$34.73	at median	25%
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS,AUTOMATED W/MICRO	$74.25	$99.00	$2.74–$89.10	254% above	25%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC KH URINALYSIS, COMPLETE W/MICROSCOPIC	$21.00	$28.00	$7.28–$24.25	—	25%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS,AUTOMATED W/MICRO	$74.25	$99.00	$25.74–$85.73	—	25%
Urinalysis without microscope exam, automated CPT 81003 HC KH URINALYSIS, DIPSTICK	$15.00	$20.00	$1.95–$25.13	15% above	25%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS,AUTOMATED W/O MICRO (POC)	$38.25	$51.00	$1.95–$45.90	194% above	25%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS,AUTOMATED W/O MICRO	$38.25	$51.00	$1.95–$45.90	194% above	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC KH URINALYSIS, DIPSTICK	$15.00	$20.00	$5.20–$17.32	—	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS,AUTOMATED W/O MICRO	$38.25	$51.00	$13.26–$44.17	—	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS,AUTOMATED W/O MICRO (POC)	$38.25	$51.00	$13.26–$44.17	—	25%
Urinalysis without microscope exam, manual CPT 81002 HC PH, URINE	$19.50	$26.00	$3.00–$23.40	15% above	25%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC PH, URINE	$19.50	$26.00	$6.76–$22.52	—	25%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE, URINE	$93.75	$125.00	$6.97–$112.50	56% above	25%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE, URINE	$93.75	$125.00	$32.50–$108.25	—	25%
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN, URINE, QUANT	$63.00	$84.00	$4.99–$75.60	51% above	25%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN, URINE, QUANT	$63.00	$84.00	$21.84–$72.74	—	25%
Urine pregnancy test, read by color change CPT 81025 HC PREGNANCY TEST, URINE	$67.50	$90.00	$7.44–$81.00	78% above	25%
Urine pregnancy test, read by color change CPT 81025 HC PREGNANCY TEST, URINE (POC)	$67.50	$90.00	$7.44–$81.00	78% above	25%
Urine pregnancy test, read by color change inpatient CPT 81025 HC PREGNANCY TEST, URINE (POC)	$67.50	$90.00	$23.40–$77.94	—	25%
Urine pregnancy test, read by color change inpatient CPT 81025 HC PREGNANCY TEST, URINE	$67.50	$90.00	$23.40–$77.94	—	25%
Vitamin B12 (cobalamin) blood test CPT 82607 HC PERNICIOUS ANEMIA CASCADE (REF LAB)	$95.25	$127.00	$13.03–$159.09	15% above	25%
Vitamin B12 (cobalamin) blood test CPT 82607 HC B-12 LEVEL	$106.50	$142.00	$13.03–$159.09	28% above	25%
Vitamin B12 (cobalamin) blood test CPT 82607 HC KH VITAMIN B12	$108.00	$144.00	$13.03–$159.09	30% above	25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC PERNICIOUS ANEMIA CASCADE (REF LAB)	$95.25	$127.00	$33.02–$109.98	—	25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC B-12 LEVEL	$106.50	$142.00	$36.92–$122.97	—	25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC KH VITAMIN B12	$108.00	$144.00	$37.44–$124.70	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D2,D3 BY LC-MS/MS (REF LAB)	$81.00	$108.00	$25.57–$140.52	34% below	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D 25 HYDROXY	$142.50	$190.00	$25.57–$171.00	17% above	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC VITAMIN D2,D3 BY LC-MS/MS (REF LAB)	$81.00	$108.00	$28.08–$93.53	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC VITAMIN D 25 HYDROXY	$142.50	$190.00	$49.40–$164.54	—	25%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VITAMIN D (1,25 DI-HYDROXY) (REF LAB)	$96.75	$129.00	$33.26–$173.30	41% below	25%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC VITAMIN D (1,25 DI-HYDROXY) (REF LAB)	$96.75	$129.00	$33.54–$111.71	—	25%
Zinc blood test CPT 84630 HC ZINC (REF LAB)	$44.25	$59.00	$9.84–$75.59	33% below	25%
Zinc blood test inpatient CPT 84630 HC ZINC (REF LAB)	$44.25	$59.00	$15.34–$51.09	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC BETA-HUMAN CHORIONIC GONADOTROPIN, QUANTITATIVE, SERUM (REF LAB)	$36.75	$49.00	$13.01–$76.90	59% below	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HCG, QUANT	$153.00	$204.00	$13.01–$183.60	73% above	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC BETA-HUMAN CHORIONIC GONADOTROPIN, QUANTITATIVE, SERUM (REF LAB)	$36.75	$49.00	$12.74–$42.43	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HCG, QUANT	$153.00	$204.00	$53.04–$176.66	—	25%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC MAM BX BREAST 1ST LES STRTCTC	$2,730.00	$3,640.00	$373.81–$6,145.24	21% below	25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC MAM BX BREAST 1ST LES STRTCTC	$2,730.00	$3,640.00	$946.40–$3,152.24	—	25%
Cardiac catheterization with coronary angiogram one side CPT 93458 C CATHETER PLACEMENT CORONARY ARTERY W/LT HEART CATH INC LT VENTRICULOGRAPHY	$13,131.75	$17,509.00	$756.23–$15,758.10	13% below	25%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 C CATHETER PLACEMENT CORONARY ARTERY W/LT HEART CATH INC LT VENTRICULOGRAPHY	$13,131.75	$17,509.00	$4,552.34–$15,162.79	—	25%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$1,617.75	$2,157.00	$119.37–$2,459.23	9% above	25%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$1,617.75	$2,157.00	$560.82–$1,867.96	—	25%
Carpal tunnel release, open surgery CPT 64721 HC NEUROPLASTY MEDIAN @ CARPAL T	$2,675.25	$3,567.00	$348.58–$7,265.67	3% below	25%
Carpal tunnel release, open surgery inpatient CPT 64721 HC NEUROPLASTY MEDIAN @ CARPAL T	$2,675.25	$3,567.00	$927.42–$3,089.02	—	25%
Catheter ablation for atrial fibrillation CPT 93656 HC COMPRE EP EVAL W/TRANSSEPT CATH, MULT ELECT CATHS, INDUC OF ARRHYTHMIA, ABLATION OF A-FIB BY PULM VEIN ISOLAT	$37,333.50	$49,778.00	$699.54–$97,253.37	40% below	25%
Catheter ablation for atrial fibrillation inpatient CPT 93656 HC COMPRE EP EVAL W/TRANSSEPT CATH, MULT ELECT CATHS, INDUC OF ARRHYTHMIA, ABLATION OF A-FIB BY PULM VEIN ISOLAT	$37,333.50	$49,778.00	$12,942.28–$43,107.75	—	25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 C CIRCUMCISION,USING CLAMP OR DEVICE W/REGIONAL DORSAL PENILE OR RING BLOCK	$6,193.50	$8,258.00	$114.81–$7,777.87	1958% above	25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 C CIRCUMCISION,USING CLAMP OR DEVICE W/REGIONAL DORSAL PENILE OR RING BLOCK	$6,193.50	$8,258.00	$2,147.08–$7,151.43	—	25%
Coronary stent placement, one artery CPT 92928 C COR STENT PLCMT W/ANGIOPLASTY, SNGL	$17,937.75	$23,917.00	$434.29–$42,953.45	4% below	25%
Coronary stent placement, one artery inpatient CPT 92928 C COR STENT PLCMT W/ANGIOPLASTY, SNGL	$17,937.75	$23,917.00	$6,218.42–$20,712.12	—	25%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI	$211.50	$282.00	$104.34–$785.07	38% below	25%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI	$211.50	$282.00	$73.32–$244.21	—	25%
IUD insertion (the device itself billed separately) CPT 58300 LIDOCAINE HCL (PF) 1 % IJ SOLN	$152.25	$203.00	$57.02–$501.77	49% below	25%
IUD insertion (the device itself billed separately) inpatient CPT 58300 LIDOCAINE HCL (PF) 1 % IJ SOLN	$152.25	$203.00	$52.78–$175.80	—	25%
Incision and drainage of a simple or single skin abscess CPT 10060 HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$405.00	$540.00	$98.96–$746.52	42% above	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$405.00	$540.00	$140.40–$467.64	—	25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 LIDOCAINE-EPINEPHRINE 1 %-1:100000 IJ SOLN	$63.00	$84.00	$31.08–$1,142.10	74% below	25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ SINGL TENDON/LIGA/APONEU	$414.00	$552.00	$45.08–$1,142.10	68% above	25%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 LIDOCAINE-EPINEPHRINE 1 %-1:100000 IJ SOLN	$63.00	$84.00	$21.84–$72.74	—	25%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJ SINGL TENDON/LIGA/APONEU	$414.00	$552.00	$143.52–$478.03	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 TRIAMCINOLONE ACETONIDE 40 MG/ML IJ SUSP	$279.75	$373.00	$50.15–$1,142.10	8% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROHCENTESIS MAJOR JOINT OR BURSA W/O US GUIDANHCE	$456.00	$608.00	$50.15–$1,142.10	50% above	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 TRIAMCINOLONE ACETONIDE 40 MG/ML IJ SUSP	$279.75	$373.00	$96.98–$323.02	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROHCENTESIS MAJOR JOINT OR BURSA W/O US GUIDANHCE	$456.00	$608.00	$158.08–$526.53	—	25%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200000 IJ SOLN	$201.75	$269.00	$77.20–$495.04	7% above	25%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200000 IJ SOLN	$201.75	$269.00	$69.94–$232.95	—	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS INTER JOINT OR BURSA W/O US GUIDANCE	$449.25	$599.00	$42.62–$1,142.10	72% above	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS INTER JOINT OR BURSA W/O US GUIDANCE	$449.25	$599.00	$155.74–$518.73	—	25%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$289.50	$386.00	$41.81–$1,142.10	3% below	25%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$289.50	$386.00	$100.36–$334.28	—	25%
Left heart catheterization, diagnostic one side CPT 93452 C LEFT HEART CATHETERIZATION INC INTRAPROCEDURAL INJECTION LT VENTRICULOGRAPHY	$7,727.25	$10,303.00	$651.85–$12,062.53	45% below	25%
Left heart catheterization, diagnostic inpatient one side CPT 93452 C LEFT HEART CATHETERIZATION INC INTRAPROCEDURAL INJECTION LT VENTRICULOGRAPHY	$7,727.25	$10,303.00	$2,678.78–$8,922.40	—	25%
Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ(S) DIAG/THERA SUBST(S),EPIDURAL/SUBARACHNOID,LUMBAR/SACRAL(CAUDAL),W/IMAGING GUIDANCE	$1,070.25	$1,427.00	$196.13–$2,626.43	23% below	25%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ(S) DIAG/THERA SUBST(S),EPIDURAL/SUBARACHNOID,LUMBAR/SACRAL(CAUDAL),W/IMAGING GUIDANCE	$1,070.25	$1,427.00	$371.02–$1,235.78	—	25%
Nail removal (partial or complete), one nail CPT 11730 C AVULSION NAIL PLATE,PARTIALOR COMP,SINGLE	$264.75	$353.00	$88.49–$746.52	29% above	25%
Nail removal (partial or complete), one nail inpatient CPT 11730 C AVULSION NAIL PLATE,PARTIALOR COMP,SINGLE	$264.75	$353.00	$91.78–$305.70	—	25%
Pacemaker implant (dual chamber) CPT 33208 C INSERT NEW OR REPLACEMENT PERMANENT PACEMAKER W/TRANSVENOUS ELECTRODE:ATRIAL AND VENTRICULAR	$18,717.00	$24,956.00	$386.30–$38,889.63	47% above	25%
Pacemaker implant (dual chamber) inpatient CPT 33208 C INSERT NEW OR REPLACEMENT PERMANENT PACEMAKER W/TRANSVENOUS ELECTRODE:ATRIAL AND VENTRICULAR	$18,717.00	$24,956.00	$6,488.56–$21,611.90	—	25%
Paracentesis with imaging guidance CPT 49083 C ED - ABD PARACENTSIS W/IMAGING	$1,621.50	$2,162.00	$220.12–$3,374.70	19% above	25%
Paracentesis with imaging guidance CPT 49083 HC ABDOMINAL PARACENTESIS (DIAGNOSTIC OR THERAPEUTIC); WITH IMAGING GUIDANCE	$1,864.50	$2,486.00	$220.12–$3,374.70	37% above	25%
Paracentesis with imaging guidance inpatient CPT 49083 C ED - ABD PARACENTSIS W/IMAGING	$1,621.50	$2,162.00	$562.12–$1,872.29	—	25%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOMINAL PARACENTESIS (DIAGNOSTIC OR THERAPEUTIC); WITH IMAGING GUIDANCE	$1,864.50	$2,486.00	$646.36–$2,152.88	—	25%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 C EXCISION NAIL/NAIL MATRIX, PARTIAL/COMPLETE	$421.50	$562.00	$124.24–$1,512.56	18% below	25%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 C EXCISION NAIL/NAIL MATRIX, PARTIAL/COMPLETE	$421.50	$562.00	$146.12–$486.69	—	25%
Prostate biopsy CPT 55700 HC PROSTATE NEEDLE BIOPSY ANY APPROACH	$6,193.50	$8,258.00	$1,646.87–$7,432.20	112% above	25%
Prostate biopsy inpatient CPT 55700 HC PROSTATE NEEDLE BIOPSY ANY APPROACH	$6,193.50	$8,258.00	$2,147.08–$7,151.43	—	25%
Removal of a foreign object under the skin, simple CPT 10120 C INCISION/REMOVAL FB,SIMPLE	$585.00	$780.00	$116.73–$1,512.56	71% above	25%
Removal of a foreign object under the skin, simple inpatient CPT 10120 C INCISION/REMOVAL FB,SIMPLE	$585.00	$780.00	$202.80–$675.48	—	25%
Short leg cast (below the knee) CPT 29405 C MBOP-APP SHRT LEG CAST	$502.50	$670.00	$63.88–$1,040.67	112% above	25%
Short leg cast (below the knee) inpatient CPT 29405 C MBOP-APP SHRT LEG CAST	$502.50	$670.00	$174.20–$580.22	—	25%
Skin biopsy, punch, one lesion CPT 11104 C PUNCH BIOPSY OF SKIN (INCLUDING SIMPLE CLOSURE, WHEN PERFORMED); SINGLE LESION	$272.25	$363.00	$94.52–$1,512.56	19% above	25%
Skin biopsy, punch, one lesion inpatient CPT 11104 C PUNCH BIOPSY OF SKIN (INCLUDING SIMPLE CLOSURE, WHEN PERFORMED); SINGLE LESION	$272.25	$363.00	$94.38–$314.36	—	25%
Skin tag removal, up to 15 tags CPT 11200 C REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCLUDING 15 LESIONS	$178.50	$238.00	$71.91–$746.52	5% above	25%
Skin tag removal, up to 15 tags CPT 11200 LIDOCAINE-EPINEPHRINE 2 %-1:100000 IJ SOLN	$246.75	$329.00	$71.91–$746.52	46% above	25%
Skin tag removal, up to 15 tags inpatient CPT 11200 C REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCLUDING 15 LESIONS	$178.50	$238.00	$61.88–$206.11	—	25%
Skin tag removal, up to 15 tags inpatient CPT 11200 LIDOCAINE-EPINEPHRINE 2 %-1:100000 IJ SOLN	$246.75	$329.00	$85.54–$284.91	—	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC	$847.50	$1,130.00	$110.79–$2,626.43	1% above	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC	$847.50	$1,130.00	$293.80–$978.58	—	25%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$1,596.00	$2,128.00	$236.42–$2,334.06	38% above	25%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$1,596.00	$2,128.00	$553.28–$1,842.85	—	25%
Trigger finger release surgery CPT 26055 C INCISI TENDON SHEATH FINGER	$1,742.25	$2,323.00	$447.38–$5,982.99	16% below	25%
Trigger finger release surgery inpatient CPT 26055 C INCISI TENDON SHEATH FINGER	$1,742.25	$2,323.00	$603.98–$2,011.72	—	25%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$491.25	$655.00	$40.66–$1,142.10	173% above	25%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$491.25	$655.00	$170.30–$567.23	—	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC MAM BX BREAST 1ST LES US IMAG	$2,501.25	$3,335.00	$369.64–$6,145.24	at median	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC MAM BX BREAST 1ST LES US IMAG	$2,501.25	$3,335.00	$867.10–$2,888.11	—	25%
Vein ablation, radiofrequency, first vein CPT 36475 C ENDOVASCULAR ABLATION THERAPY INCOMPETENT VEIN,EXTREMITY,INC ALL IMAGING GUIDANCE,FIRST VEIN	$9,879.75	$13,173.00	$775.78–$11,855.70	36% above	25%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 C ENDOVASCULAR ABLATION THERAPY INCOMPETENT VEIN,EXTREMITY,INC ALL IMAGING GUIDANCE,FIRST VEIN	$9,879.75	$13,173.00	$3,424.98–$11,407.82	—	25%
Wart removal, up to 14 warts CPT 17110 C DESTRUCTION BENIGN LESION	$375.75	$501.00	$87.33–$746.52	72% above	25%
Wart removal, up to 14 warts inpatient CPT 17110 C DESTRUCTION BENIGN LESION	$375.75	$501.00	$130.26–$433.87	—	25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 C DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED) FIRST 20 SQ CM OR LESS	$750.00	$1,000.00	$99.18–$1,512.56	125% above	25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 C DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED) FIRST 20 SQ CM OR LESS	$750.00	$1,000.00	$260.00–$866.00	—	25%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP	$9,602.25	$12,803.00	$581.33–$26,998.82	at median	25%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 HC OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP	$9,602.25	$12,803.00	$3,328.78–$11,087.40	—	25%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Blood transfusion (giving blood or blood components) CPT 36430 C BLOOD/BLOOD PROD TRANSFUSED	$978.75	$1,305.00	$32.36–$1,641.52	at median	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 C BLOOD/BLOOD PROD TRANSFUSED	$978.75	$1,305.00	$339.30–$1,130.13	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 C RT-IN/EXSUFFOLATOR INITIAL	$188.25	$251.00	$5.96–$814.77	10% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 C RT-AB ADMINISTRATION SVN TX	$188.25	$251.00	$5.96–$814.77	10% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 C RT-M-D INHALER INITIAL	$216.75	$289.00	$5.96–$814.77	4% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 C RT-AEROSOL/HUMIDITY THERAPY/DAY	$216.75	$289.00	$5.96–$814.77	4% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 C RT-IPPB/EZ-PAP TREATMENT	$216.75	$289.00	$5.96–$814.77	4% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 C RT-M-D INHALER TREATMENT	$216.75	$289.00	$5.96–$814.77	4% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 C RT-SVN INITIAL TREATMENT	$216.75	$289.00	$5.96–$814.77	4% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 C RT-SVN SUBSQ TREATMENT	$216.75	$289.00	$5.96–$814.77	4% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 C RT-SVN TX W MECH VENT	$216.75	$289.00	$5.96–$814.77	4% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 C RT-IN/EXSUFFOLATOR SUBSQ	$216.75	$289.00	$5.96–$814.77	4% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 C RT-AB ADMINISTRATION SVN TX	$188.25	$251.00	$65.26–$217.37	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 C RT-IN/EXSUFFOLATOR INITIAL	$188.25	$251.00	$65.26–$217.37	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 C RT-IN/EXSUFFOLATOR SUBSQ	$216.75	$289.00	$75.14–$250.27	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 C RT-AEROSOL/HUMIDITY THERAPY/DAY	$216.75	$289.00	$75.14–$250.27	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 C RT-IPPB/EZ-PAP TREATMENT	$216.75	$289.00	$75.14–$250.27	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 C RT-M-D INHALER INITIAL	$216.75	$289.00	$75.14–$250.27	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 C RT-M-D INHALER TREATMENT	$216.75	$289.00	$75.14–$250.27	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 C RT-SVN INITIAL TREATMENT	$216.75	$289.00	$75.14–$250.27	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 C RT-SVN SUBSQ TREATMENT	$216.75	$289.00	$75.14–$250.27	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 C RT-SVN TX W MECH VENT	$216.75	$289.00	$75.14–$250.27	—	25%
Chemotherapy IV infusion, first hour CPT 96413 C MHOC-CHEMO IV INF TO 1HR INI	$945.75	$1,261.00	$93.61–$1,229.00	35% above	25%
Chemotherapy IV infusion, first hour inpatient CPT 96413 C MHOC-CHEMO IV INF TO 1HR INI	$945.75	$1,261.00	$327.86–$1,092.03	—	25%
Critical care, first 30 to 74 minutes CPT 99291 HC ED CRITICAL CARE FIRST HOUR	$1,395.00	$1,860.00	$214.41–$3,073.48	40% below	25%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ED CRITICAL CARE FIRST HOUR	$1,395.00	$1,860.00	$483.60–$1,610.76	—	25%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC ELECTROENCEPHALOGRAM W/REC AWAKE & DROWSY	$880.50	$1,174.00	$223.17–$1,056.60	13% below	25%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC ELECTROENCEPHALOGRAM W/REC AWAKE & DROWSY	$880.50	$1,174.00	$305.24–$1,016.68	—	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 C EKG 12-LEAD	$225.00	$300.00	$4.70–$270.00	36% above	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 C EKG 12-LEAD	$225.00	$300.00	$78.00–$259.80	—	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC VISIT-ED,LEVEL I	$254.25	$339.00	$8.90–$313.75	14% above	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC VISIT-ED,LEVEL I	$254.25	$339.00	$88.14–$293.57	—	25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC VISIT-ED,LEVEL II	$434.25	$579.00	$32.86–$571.31	at median	25%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC VISIT-ED,LEVEL II	$434.25	$579.00	$150.54–$501.41	—	25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC VISIT-ED,LEVEL III	$772.50	$1,030.00	$55.66–$1,015.69	2% above	25%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC VISIT-ED,LEVEL III	$772.50	$1,030.00	$267.80–$891.98	—	25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC VISIT-ED,LEVEL IV	$1,288.50	$1,718.00	$94.78–$1,552.54	at median	25%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC VISIT-ED,LEVEL IV	$1,288.50	$1,718.00	$446.68–$1,487.79	—	25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC VISIT-ED,LEVEL V	$2,204.25	$2,939.00	$137.38–$2,645.10	20% above	25%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC VISIT-ED,LEVEL V	$2,204.25	$2,939.00	$764.14–$2,545.17	—	25%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC EKG-CARDIOVASCULAR STRESS TEST	$742.50	$990.00	$28.93–$891.00	10% below	25%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC EKG-CARDIOVASCULAR STRESS TEST	$742.50	$990.00	$257.40–$857.34	—	25%
Family therapy with the patient, 50 minutes CPT 90847 C PSY FAMILY W/PATIENT	$105.75	$141.00	$52.17–$660.42	45% below	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 C PSY FAMILY W/PATIENT	$105.75	$141.00	$36.66–$122.11	—	25%
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY	$186.75	$249.00	$23.50–$377.99	30% below	25%
Group psychotherapy session CPT 90853 C PSY GROUP NOT MULTI FAM OUTPT	$230.25	$307.00	$23.50–$377.99	14% below	25%
Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY	$186.75	$249.00	$64.74–$215.63	—	25%
Group psychotherapy session inpatient CPT 90853 C PSY GROUP NOT MULTI FAM OUTPT	$230.25	$307.00	$79.82–$265.86	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV INFUSION HYDRATION INITIAL (31 -60 MIN)	$444.00	$592.00	$23.91–$791.42	34% above	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV INFUSION HYDRATION INITIAL (31 -60 MIN)	$444.00	$592.00	$153.92–$512.67	—	25%
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION THERAPY PROPHYLAXIS/ DX INITIAL TO UP TO 1 HR	$544.50	$726.00	$45.47–$791.42	13% above	25%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION THERAPY PROPHYLAXIS/ DX INITIAL TO UP TO 1 HR	$544.50	$726.00	$188.76–$628.72	—	25%
IV push of a medicine, first drug CPT 96374 HC IVPUSH/15 MIN/LESS INITIAL	$285.00	$380.00	$26.86–$791.42	24% above	25%
IV push of a medicine, first drug inpatient CPT 96374 HC IVPUSH/15 MIN/LESS INITIAL	$285.00	$380.00	$98.80–$329.08	—	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$112.50	$150.00	$11.22–$267.90	2% below	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$112.50	$150.00	$39.00–$129.90	—	25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 C PSY DX INTERVIEW	$294.00	$392.00	$139.56–$660.42	25% above	25%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 C PSY DX INTERVIEW	$294.00	$392.00	$101.92–$339.47	—	25%
Neuromuscular re-education, 15 minutes CPT 97112 HC PT-NEUROMUSCULAR RE-EDUCATION EACH 15MIN	$109.50	$146.00	$31.30–$131.40	35% above	25%
Neuromuscular re-education, 15 minutes CPT 97112 HC OT-NEUROMUSCULAR REEDUCATION	$109.50	$146.00	$31.30–$131.40	35% above	25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC OT-NEUROMUSCULAR REEDUCATION	$109.50	$146.00	$37.96–$126.44	—	25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PT-NEUROMUSCULAR RE-EDUCATION EACH 15MIN	$109.50	$146.00	$37.96–$126.44	—	25%
New patient office visit, about 30 minutes CPT 99203 HC VISIT LEV III NEW PT	$202.50	$270.00	$97.37–$396.19	43% above	25%
New patient office visit, about 30 minutes inpatient CPT 99203 HC VISIT LEV III NEW PT	$202.50	$270.00	$70.20–$233.82	—	25%
New patient office visit, about 45 minutes CPT 99204 HC VISIT LEVEL IV NEW PT	$262.50	$350.00	$129.50–$599.52	33% above	25%
New patient office visit, about 45 minutes inpatient CPT 99204 HC VISIT LEVEL IV NEW PT	$262.50	$350.00	$91.00–$303.10	—	25%
New patient office visit, about 60 minutes CPT 99205 HC VISIT LEVEL V NEW PT	$315.00	$420.00	$155.40–$798.64	9% above	25%
New patient office visit, about 60 minutes inpatient CPT 99205 HC VISIT LEVEL V NEW PT	$315.00	$420.00	$109.20–$363.72	—	25%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC VISIT LEVEL II NEW PT	$179.25	$239.00	$62.59–$254.09	89% above	25%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC VISIT LEVEL II NEW PT	$179.25	$239.00	$62.14–$206.97	—	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MEDICAL NUTRITION ASSESSMNT INDIV EACH 15 MIN	$69.00	$92.00	$34.04–$126.25	26% above	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MEDICAL NUTRITION ASSESSMNT INDIV EACH 15 MIN	$69.00	$92.00	$23.92–$79.67	—	25%
Occupational therapy evaluation, low complexity CPT 97165 C OT EVAL LOW COMPLEXITY	$180.00	$240.00	$88.80–$347.25	21% below	25%
Occupational therapy evaluation, low complexity inpatient CPT 97165 C OT EVAL LOW COMPLEXITY	$180.00	$240.00	$62.40–$207.84	—	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 C PT EVAL HIGH COMPLEXITY	$216.75	$289.00	$94.00–$338.40	6% below	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 C PT EVAL HIGH COMPLEXITY	$216.75	$289.00	$75.14–$250.27	—	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 C PT EVAL LOW COMPLEXITY	$168.75	$225.00	$83.25–$338.40	15% below	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 C PT EVAL LOW COMPLEXITY	$168.75	$225.00	$58.50–$194.85	—	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 C PT EVAL MODERATE COMPLEXITY	$187.50	$250.00	$92.50–$338.40	16% below	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 C PT EVAL MODERATE COMPLEXITY	$187.50	$250.00	$65.00–$216.50	—	25%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC OT-MANUAL THERAPY EA 15 MIN	$91.50	$122.00	$26.50–$109.80	35% above	25%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC ST-MANUAL THERAPY TECHNIQUES-EA 15 MIN	$91.50	$122.00	$26.50–$109.80	35% above	25%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 C PT-MANUAL THERAPY TECHNIQUES-EA 15 MIN	$91.50	$122.00	$26.50–$109.80	35% above	25%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 C PT-MANUAL THERAPY TECHNIQUES-EA 15 MIN	$91.50	$122.00	$31.72–$105.65	—	25%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC ST-MANUAL THERAPY TECHNIQUES-EA 15 MIN	$91.50	$122.00	$31.72–$105.65	—	25%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC OT-MANUAL THERAPY EA 15 MIN	$91.50	$122.00	$31.72–$105.65	—	25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT-THERAPEUTIC EXERCISE EACH 15MIN	$94.50	$126.00	$27.79–$113.40	24% above	25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT-THERAPEUTIC EXERCISE PER 15 MIN	$94.50	$126.00	$27.79–$113.40	24% above	25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT-THERAPEUTIC EXERCISE EACH 15MIN	$94.50	$126.00	$32.76–$109.12	—	25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT-THERAPEUTIC EXERCISE PER 15 MIN	$94.50	$126.00	$32.76–$109.12	—	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OFFICE/OUTPATIENT ESTABLISHED HIGH MDM, IF USING TIME, 40 MINUTES OR MORE	$300.00	$400.00	$148.00–$652.84	17% above	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OFFICE/OUTPATIENT ESTABLISHED HIGH MDM, IF USING TIME, 40 MINUTES OR MORE	$300.00	$400.00	$104.00–$346.40	—	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OFFICE/OUTPATIENT ESTABLISHED LOW MDM, IF USING TIME, 20 MINUTES OR MORE	$197.25	$263.00	$79.86–$322.95	27% above	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OFFICE/OUTPATIENT ESTABLISHED LOW MDM, IF USING TIME, 20 MINUTES OR MORE	$197.25	$263.00	$68.38–$227.76	—	25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE/OUTPATIENT ESTABLISHED MOD , IF USING TIME, 30 MINUTES OR MORE	$243.75	$325.00	$112.52–$460.08	44% above	25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE/OUTPATIENT ESTABLISHED MOD MDM, IF USING TIME, 30 MINUTES OR MORE	$243.75	$325.00	$112.52–$460.08	44% above	25%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OFFICE/OUTPATIENT ESTABLISHED MOD , IF USING TIME, 30 MINUTES OR MORE	$243.75	$325.00	$84.50–$281.45	—	25%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OFFICE/OUTPATIENT ESTABLISHED MOD MDM, IF USING TIME, 30 MINUTES OR MORE	$243.75	$325.00	$84.50–$281.45	—	25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OFFICE/OUTPATIENT ESTABLISHED SF MDM, IF USING TIME, 10 MINUTES OR MORE	$170.25	$227.00	$49.24–$204.30	87% above	25%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OFFICE/OUTPATIENT ESTABLISHED SF MDM, IF USING TIME, 10 MINUTES OR MORE	$170.25	$227.00	$59.02–$196.58	—	25%
Speech and language evaluation CPT 92523 C ST-EVAL SPEECH SOUND PROD W/LANG COMPHRHEN	$379.50	$506.00	$187.22–$786.43	11% below	25%
Speech and language evaluation inpatient CPT 92523 C ST-EVAL SPEECH SOUND PROD W/LANG COMPHRHEN	$379.50	$506.00	$131.56–$438.20	—	25%
Speech therapy session, individual CPT 92507 HC ST-TREATMENT SPEECH/LANGUAGE	$240.00	$320.00	$73.39–$288.00	26% above	25%
Speech therapy session, individual inpatient CPT 92507 HC ST-TREATMENT SPEECH/LANGUAGE	$240.00	$320.00	$83.20–$277.12	—	25%
Spirometry (breathing test) one side CPT 94010 C RT-SPIROMETRY SCREENING FVC/FEV	$243.00	$324.00	$21.00–$803.40	1% below	25%
Spirometry (breathing test) inpatient one side CPT 94010 C RT-SPIROMETRY SCREENING FVC/FEV	$243.00	$324.00	$84.24–$280.58	—	25%
Spirometry before and after a bronchodilator one side CPT 94060 C RT-SPIROMETRY SCREEN W/DILATOR FVC/FEV	$426.75	$569.00	$30.01–$1,388.44	16% below	25%
Spirometry before and after a bronchodilator one side CPT 94060 C RT-SPIROMETRY PRE/POST BRONCODILATOR	$426.75	$569.00	$30.01–$1,388.44	16% below	25%
Spirometry before and after a bronchodilator inpatient one side CPT 94060 C RT-SPIROMETRY PRE/POST BRONCODILATOR	$426.75	$569.00	$147.94–$492.75	—	25%
Spirometry before and after a bronchodilator inpatient one side CPT 94060 C RT-SPIROMETRY SCREEN W/DILATOR FVC/FEV	$426.75	$569.00	$147.94–$492.75	—	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT-FUNCTIONAL ACTIVITIES 15 MIN	$114.75	$153.00	$33.29–$137.70	33% above	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT-FUNCTIONAL ACTIVITIES PER 15MIN	$114.75	$153.00	$33.29–$137.70	33% above	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC OT-FUNCTIONAL ACTIVITIES 15 MIN	$114.75	$153.00	$39.78–$132.50	—	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT-FUNCTIONAL ACTIVITIES PER 15MIN	$114.75	$153.00	$39.78–$132.50	—	25%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE	$225.00	$300.00	$67.77–$495.04	at median	25%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE	$225.00	$300.00	$78.00–$259.80	—	25%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 HC SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$78.48	$104.63	$38.71–$581.95	35% below	25%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 HC SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$78.48	$104.63	$27.20–$90.61	—	25%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC VAR VACCINE LIVE FOR SUBCUTANEOUS USE, HD SUPPLIED	$148.05	$197.40	$73.04–$177.66	39% below	25%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC VAR VACCINE LIVE FOR SUBCUTANEOUS USE, HD SUPPLIED	$148.05	$197.40	$51.32–$170.95	—	25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM, HD SUPPLIED	$30.72	$40.95	$15.15–$36.86	28% below	25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHTHERIA, TETANUS TOXOIDS, ACELLULAR PERTUSSIS VACCINE 15-23-5 LF-MCG/0.5 SUSP	$49.81	$66.41	$16.88–$59.77	16% above	25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM, HD SUPPLIED	$30.72	$40.95	$10.65–$35.46	—	25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHTHERIA, TETANUS TOXOIDS, ACELLULAR PERTUSSIS VACCINE 15-23-5 LF-MCG/0.5 SUSP	$49.81	$66.41	$17.27–$57.51	—	25%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DIPHTHERIA, TETANUS, ACELLULAR PERTUSSIS, HEPATITIS B, INACTIVATED POLIO VACCINE SUSY	$43.50	$58.00	$21.46–$72.51	70% below	25%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HC DTAP-HEPB-IPV VACCINE INTRAMUSCULAR, HD SUPPLIED	$93.72	$124.95	$46.23–$112.46	35% below	25%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DIPHTHERIA, TETANUS, ACELLULAR PERTUSSIS, HEPATITIS B, INACTIVATED POLIO VACCINE SUSY	$43.50	$58.00	$15.08–$50.23	—	25%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HC DTAP-HEPB-IPV VACCINE INTRAMUSCULAR, HD SUPPLIED	$93.72	$124.95	$32.49–$108.21	—	25%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 HC DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE, HD SUPPLIED	$107.89	$143.85	$53.22–$129.47	27% below	25%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 HC DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE, HD SUPPLIED	$107.89	$143.85	$37.40–$124.57	—	25%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA HIGH DOSE VACCINE (ADULT 65 AND OLDER) 0.5 ML SUSY	$260.18	$346.90	$14.28–$312.21	623% above	25%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA HIGH DOSE VACCINE (ADULT 65 AND OLDER) 0.5 ML SUSY	$260.18	$346.90	$90.19–$300.42	—	25%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSY	$223.13	$297.50	$110.08–$267.75	43% below	25%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC 9VHPV VACC 2/3 DOSE SCHED IM USE, HD SUPPLIED	$248.85	$331.80	$122.77–$298.62	36% below	25%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC 9VHPV VACC 2/3 DOSE SCHED IM USE	$248.85	$331.80	$122.77–$298.62	36% below	25%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSY	$223.13	$297.50	$77.35–$257.64	—	25%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC 9VHPV VACC 2/3 DOSE SCHED IM USE, HD SUPPLIED	$248.85	$331.80	$86.27–$287.34	—	25%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC 9VHPV VACC 2/3 DOSE SCHED IM USE	$248.85	$331.80	$86.27–$287.34	—	25%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A-HEP B RECOMB VAC 720-20 ELU-MCG/ML IM SUSY	$75.94	$101.25	$37.46–$91.13	48% below	25%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS A-HEP B RECOMB VAC 720-20 ELU-MCG/ML IM SUSY	$75.94	$101.25	$26.33–$87.68	—	25%
Hepatitis A vaccine, adult dose CPT 90632 HC HEP A VACCINE ADULT DOSE FOR INTRAMUSCULAR USE	$76.39	$101.85	$37.68–$1,126.96	30% below	25%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HC HEP A VACCINE ADULT DOSE FOR INTRAMUSCULAR USE	$76.39	$101.85	$26.48–$88.20	—	25%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE, HD SUPPLIED	$40.95	$54.60	$20.20–$49.14	34% below	25%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HC HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE, HD SUPPLIED	$40.95	$54.60	$14.20–$47.28	—	25%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$73.24	$97.65	$36.13–$270.52	29% below	25%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINET 20 MCG/ML SUSY	$98.29	$131.05	$48.49–$270.52	5% below	25%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE 20 MCG/ML SUSP	$102.68	$136.90	$50.65–$270.52	1% below	25%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$73.24	$97.65	$25.39–$84.56	—	25%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINET 20 MCG/ML SUSY	$98.29	$131.05	$34.07–$113.49	—	25%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE 20 MCG/ML SUSP	$102.68	$136.90	$35.59–$118.56	—	25%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VACCINE 20 MCG/0.5ML SOSY	$203.22	$270.95	$100.25–$639.20	2% above	25%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VACCINE 20 MCG/0.5ML SOSY	$203.22	$270.95	$70.45–$234.64	—	25%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM, HD SUPPLIED	$30.72	$40.95	$15.15–$119.53	43% below	25%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACCINE 10 MCG/0.5ML SUSY	$59.44	$79.25	$26.58–$119.53	10% above	25%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HC HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM, HD SUPPLIED	$30.72	$40.95	$10.65–$35.46	—	25%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VACCINE 10 MCG/0.5ML SUSY	$59.44	$79.25	$20.61–$68.63	—	25%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE, HD SUPPLIED	$39.38	$52.50	$19.43–$47.25	51% above	25%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSAC CONJUGATE VACCINE 10 MCG SOLR	$55.02	$73.35	$20.91–$66.02	112% above	25%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACCHARIDE CONJUGATE VACCINE SOLR	$62.78	$83.70	$20.91–$75.33	141% above	25%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HC HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE, HD SUPPLIED	$39.38	$52.50	$13.65–$45.47	—	25%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSAC CONJUGATE VACCINE 10 MCG SOLR	$55.02	$73.35	$19.07–$63.52	—	25%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSACCHARIDE CONJUGATE VACCINE SOLR	$62.78	$83.70	$21.76–$72.48	—	25%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 C INFLUENZA VIRUS VACC PF INC ANTIGEN 90662	$59.85	$79.80	$29.53–$353.38	48% below	25%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 C INFLUENZA VIRUS VACC PF INC ANTIGEN 90662	$59.85	$79.80	$20.75–$69.11	—	25%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES-MUMPS-RUBELLA VACCINE SOLR	$64.53	$86.04	$31.83–$77.44	59% below	25%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR	$64.80	$86.40	$31.97–$77.76	59% below	25%
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ (PRIORIX), HD SUPPLIED	$85.84	$114.45	$42.35–$103.01	46% below	25%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES-MUMPS-RUBELLA VACCINE SOLR	$64.53	$86.04	$22.37–$74.51	—	25%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR	$64.80	$86.40	$22.46–$74.82	—	25%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ (PRIORIX), HD SUPPLIED	$85.84	$114.45	$29.76–$99.11	—	25%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE, MENACTRA, HD SUPPLIED	$140.18	$186.90	$69.15–$222.04	26% below	25%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJUGATE VACCINE SOLR	$140.45	$187.26	$69.29–$222.04	26% below	25%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE, MENACTRA, HD SUPPLIED	$140.18	$186.90	$48.59–$161.86	—	25%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL CONJUGATE VACCINE SOLR	$140.45	$187.26	$48.69–$162.17	—	25%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 HC MENACWY-TT CONJ VACC SEROGROUPS ACWY, IM, HD SUPPLIED	$347.29	$463.05	$0.61–$416.75	64% above	25%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 HC MENACWY-TT CONJ VACC SEROGROUPS ACWY, IM, HD SUPPLIED	$347.29	$463.05	$120.39–$401.00	—	25%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B RECOMB VACCINE SUSY	$121.83	$162.43	$60.10–$281.23	54% below	25%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HC MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM, HD SUPPLIED	$317.37	$423.15	$143.10–$380.84	19% above	25%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B RECOMB VACCINE SUSY	$121.83	$162.43	$42.23–$140.66	—	25%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 HC MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM, HD SUPPLIED	$317.37	$423.15	$110.02–$366.45	—	25%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 C PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT, FOR IM 90670	$227.59	$303.45	$112.28–$928.76	21% below	25%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 C PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT, FOR IM 90670	$227.59	$303.45	$78.90–$262.79	—	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY	$197.22	$262.95	$97.29–$1,126.45	50% below	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML SUSY	$352.39	$469.85	$173.84–$1,126.45	11% below	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HC PCV20 VACCINE FOR INTRAMUSCULAR USE	$454.77	$606.36	$224.35–$1,126.45	15% above	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY	$197.22	$262.95	$68.37–$227.71	—	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML SUSY	$352.39	$469.85	$122.16–$406.89	—	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 HC PCV20 VACCINE FOR INTRAMUSCULAR USE	$454.77	$606.36	$157.65–$525.11	—	25%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PNEUMOCOCCAL 21-VAL CONJ VACC 0.5 ML SOSY	$319.39	$425.85	$157.56–$1,239.31	—	25%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 PNEUMOCOCCAL 21-VAL CONJ VACC 0.5 ML SOSY	$319.39	$425.85	$110.72–$368.79	—	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC PNEUMOCOCCAL VACCINE (PPSV23), 2 YRS OR OLDER, SQ OR IM	$114.54	$152.71	$56.50–$480.49	23% below	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE, HD SUPPLIED	$114.54	$152.71	$56.50–$480.49	23% below	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE, HD SUPPLIED	$114.54	$152.71	$39.70–$132.25	—	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC PNEUMOCOCCAL VACCINE (PPSV23), 2 YRS OR OLDER, SQ OR IM	$114.54	$152.71	$39.70–$132.25	—	25%
Polio vaccine, inactivated (IPV) CPT 90713 HC POLIOVIRUS VACCINE INACTIVATED SUBQ/IM, HD SUPPLIED	$38.59	$51.45	$19.04–$46.31	54% below	25%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 HC POLIOVIRUS VACCINE INACTIVATED SUBQ/IM, HD SUPPLIED	$38.59	$51.45	$13.38–$44.56	—	25%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 HC RESPIRATORY SYNCYTIAL VIRUS, MONOCLONAL ANTIBODY, SEASONAL DOSE; 1 ML DOSAGE, FOR INTRAMUSCULAR USE	$369.39	$492.52	$182.23–$465.70	39% below	25%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 HC RESPIRATORY SYNCYTIAL VIRUS, MONOCLONAL ANTIBODY, SEASONAL DOSE; 1 ML DOSAGE, FOR INTRAMUSCULAR USE	$369.39	$492.52	$128.06–$426.52	—	25%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 HC RESPIRATORY SYNCYTIAL VIRUS, MONOCLONAL ANTIBODY, SEASONAL DOSE; 0.5 ML DOSAGE, FOR INTRAMUSCULAR USE	$369.39	$492.52	$182.23–$443.27	38% below	25%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML SOSY	$615.04	$820.05	$303.42–$738.05	3% above	25%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 HC RESPIRATORY SYNCYTIAL VIRUS, MONOCLONAL ANTIBODY, SEASONAL DOSE; 0.5 ML DOSAGE, FOR INTRAMUSCULAR USE	$369.39	$492.52	$128.06–$426.52	—	25%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML SOSY	$615.04	$820.05	$213.21–$710.16	—	25%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 HC RESPIRATORY SYNCYTIAL VIRUS VACCINE, PREF, RECOMBINANT, SUBUNIT, ADJUVANTED, FOR INTRAMUSCULAR USE	$80.50	$107.33	$39.71–$96.60	—	25%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 HC RESPIRATORY SYNCYTIAL VIRUS VACCINE, PREF, RECOMBINANT, SUBUNIT, ADJUVANTED, FOR INTRAMUSCULAR USE	$80.50	$107.33	$27.91–$92.95	—	25%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE SUSR	$404.85	$539.79	$199.72–$1,151.09	3% below	25%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE SUSR	$404.85	$539.79	$140.35–$467.46	—	25%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 C ZOSTER (SHINGLES) VACCINE (HZV), RECOMBINANT, SUBUNIT, ADJUVANTED, FOR INTRAMUSCULAR INJECTION	$168.53	$224.70	$83.14–$202.23	42% below	25%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 C ZOSTER (SHINGLES) VACCINE (HZV), RECOMBINANT, SUBUNIT, ADJUVANTED, FOR INTRAMUSCULAR INJECTION	$168.53	$224.70	$58.42–$194.59	—	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$32.29	$43.05	$15.93–$62.35	58% below	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ	$61.92	$82.55	$28.92–$74.30	20% below	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOID TD >/= 7 YEARS 5-2 LFU INJ	$77.27	$103.02	$28.92–$92.72	at median	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 2-2 LF/0.5ML IM SUSP	$86.44	$115.25	$28.92–$103.73	12% above	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOID TD >/= 7 YEARS 2-2 LF/0.5 ML SUSP	$93.15	$124.20	$28.92–$111.78	20% above	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$32.29	$43.05	$11.19–$37.28	—	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ	$61.92	$82.55	$21.46–$71.49	—	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOID TD >/= 7 YEARS 5-2 LFU INJ	$77.27	$103.02	$26.79–$89.22	—	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 2-2 LF/0.5ML IM SUSP	$86.44	$115.25	$29.97–$99.81	—	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOID TD >/= 7 YEARS 2-2 LF/0.5 ML SUSP	$93.15	$124.20	$32.29–$107.56	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 SUSY	$47.07	$62.75	$23.22–$63.50	54% below	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 C TDAP IM (ADACEL) 19-64 YRS 90715	$47.25	$63.00	$23.31–$63.50	54% below	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP	$86.44	$115.25	$33.38–$103.73	16% below	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHERIA, TETANUS, ACELLULAR PERTUSSIS VACCINE (PEDIATRIC >/= 7 YEARS) 5-2.5-18.5 LF-MCG/0.5 SUSP	$86.44	$115.25	$33.38–$103.73	16% below	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS, DIPHTHERIA, ACELLULAR PERTUSSIS VACCINE 5-2-15.5 LF-MCG/0.5 SUSP	$100.80	$134.40	$33.38–$120.96	2% below	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 SUSY	$47.07	$62.75	$16.32–$54.34	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 C TDAP IM (ADACEL) 19-64 YRS 90715	$47.25	$63.00	$16.38–$54.56	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP	$86.44	$115.25	$29.97–$99.81	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTHERIA, TETANUS, ACELLULAR PERTUSSIS VACCINE (PEDIATRIC >/= 7 YEARS) 5-2.5-18.5 LF-MCG/0.5 SUSP	$86.44	$115.25	$29.97–$99.81	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS, DIPHTHERIA, ACELLULAR PERTUSSIS VACCINE 5-2-15.5 LF-MCG/0.5 SUSP	$100.80	$134.40	$34.94–$116.39	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 C IMMUNIZATION ADMINISTRATION, 1 VACCINE	$60.75	$81.00	$16.04–$267.90	13% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 C MHOC-PNEUMOCOCCAL VACCINE ADMIN	$60.75	$81.00	$16.04–$267.90	13% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 C MHOC-HEPATITIS B VACC ADMIN	$60.75	$81.00	$16.04–$267.90	13% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY	$197.22	$262.95	$16.04–$267.90	268% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 C IMMUNIZATION ADMINISTRATION, 1 VACCINE	$60.75	$81.00	$21.06–$70.15	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 C MHOC-HEPATITIS B VACC ADMIN	$60.75	$81.00	$21.06–$70.15	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 C MHOC-PNEUMOCOCCAL VACCINE ADMIN	$60.75	$81.00	$21.06–$70.15	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY	$197.22	$262.95	$68.37–$227.71	—	25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 C IMMUNIZATION ADMINISTRATION, EACH ADDITIONAL	$47.25	$63.00	$11.42–$56.70	44% above	25%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 C IMMUNIZATION ADMINISTRATION, EACH ADDITIONAL	$47.25	$63.00	$16.38–$54.56	—	25%

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://sthpiprd.blob.core.windows.net/machine-readable-files/10826/820231746_kootenai-health,-inc_standardcharges.csv