Hospital St. Louis, MO-IL

Gateway Regional Medical Center

Listed in its price file as “American Healthcare Systems Illinois LLC”.

Gateway Regional Medical Center in Granite City, IL publishes cash prices for 352 common procedures listed here, from its own machine-readable price file updated Mar 30, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Illinois median for 223 of 348 procedures and above it for 124. By typical cash price it ranks #21 of 114 Illinois hospitals and #2 of 17 hospitals in the St. Louis, MO area, cheapest first. Select a procedure to compare it with other hospitals nearby.

2100 Madison Ave, Granite City, IL 62040 Collected Sep 22, 2026 Source price file Check a bill from this hospital (618) 798-3000

Acute care hospital Nonprofit hospital Emergency department CMS star rating 2 of 5 CCN 140125 · CMS hospital register NPI 1326765884

Financial assistance

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

Gateway Regional Medical Center is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

State law

This state limits hospital bills for lower-income patients

Illinois law (Hospital Uninsured Patient Discount Act, 210 ILCS 89): an uninsured Illinois resident with family income up to 600% of the federal poverty level (300% at rural and critical access hospitals) can apply for a discount that brings the bill down to about 135% of the hospital's cost; up to 200% (125% at rural hospitals) medically necessary care is free. A hospital may collect no more than 25% of family income in 12 months. Ask the billing office for the application. Other states' laws.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Abdominal CT scan without and with contrast CPT 74170 CT-ABDOMEN WWO	$408.55	$680.91	$680.91	86% below	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT-ABDOMEN WWO	$408.55	$680.91	$680.91	—	40%
Abdominal X-ray, 2 views CPT 74019 CH-ABDOMEN 2 VWS CR	$83.53	$139.21	$139.21	75% below	40%
Abdominal X-ray, 2 views inpatient CPT 74019 CH-ABDOMEN 2 VWS CR	$83.53	$139.21	$139.21	—	40%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 LE-ANKLE 3VWS BI CR	$167.06	$278.43	$278.43	—	40%
Ankle X-ray, complete, 3 or more views CPT 73610 LE-ANKLE 3VPLUS CR	$89.93	$149.88	$149.88	73% below	40%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 LE-ANKLE 3VWS BI CR	$167.06	$278.43	$278.43	—	40%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 LE-ANKLE 3VPLUS CR	$89.93	$149.88	$149.88	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US-EXT ARTERIAL LTD	$100.43	$167.38	$167.38	76% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US-EXT ARTERIAL LTD	$100.43	$167.38	$167.38	—	40%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT-UPPER EXT WO	$184.23	$307.05	$307.05	90% below	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT-UPPER EXT WO	$184.23	$307.05	$307.05	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 FL-ESOPHAGUS	$736.27	$1,227.11	$1,227.11	23% above	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 FL-ESOPHAGUS	$736.27	$1,227.11	$1,227.11	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 NM-BONE SCAN BODY	$2,107.22	$3,512.04	$3,512.04	34% above	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM-BONE SCAN BODY	$2,107.22	$3,512.04	$3,512.04	—	40%
Breast ultrasound, complete, one breast CPT 76641 US-BREAST COMPLETE	$131.18	$218.64	$218.64	75% below	40%
Breast ultrasound, complete, one breast inpatient CPT 76641 US-BREAST COMPLETE	$131.18	$218.64	$218.64	—	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 US-BREAST LIMITED	$131.18	$218.64	$218.64	70% below	40%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US-BREAST LIMITED	$131.18	$218.64	$218.64	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA-ABDOMEN PELVIS	$535.86	$893.10	$893.10	86% below	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA-ABDOMEN PELVIS	$535.86	$893.10	$893.10	—	40%
CT angiography (CTA) of the head CPT 70496 CTA-HEAD	$535.86	$893.10	$893.10	79% below	40%
CT angiography (CTA) of the head inpatient CPT 70496 CTA-HEAD	$535.86	$893.10	$893.10	—	40%
CT angiography (CTA) of the neck CPT 70498 CTA-NECK	$535.86	$893.10	$893.10	79% below	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA-NECK	$535.86	$893.10	$893.10	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA-CHEST	$425.39	$708.98	$708.98	85% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA-CHEST	$425.39	$708.98	$708.98	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT-HT CARD FUNC W	$348.09	$580.15	$580.15	80% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT-HT CARD FUNC W	$348.09	$580.15	$580.15	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT-ABD PELVIS WO	$352.30	$587.17	$587.17	90% below	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT-ABD PELVIS WO	$352.30	$587.17	$587.17	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT-ABD PELVIS W	$568.54	$947.56	$947.56	87% below	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT-ABD PELVIS W	$568.54	$947.56	$947.56	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT-ABD PELVIS WWO	$568.54	$947.56	$947.56	89% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT-ABD PELVIS WWO	$568.54	$947.56	$947.56	—	40%
CT scan of the abdomen with contrast CPT 74160 CT-ABDOMEN W	$362.91	$604.85	$604.85	84% below	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT-ABDOMEN W	$362.91	$604.85	$604.85	—	40%
CT scan of the abdomen without contrast CPT 74150 CT-ABDOMEN WO	$184.23	$307.05	$307.05	90% below	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT-ABDOMEN WO	$184.23	$307.05	$307.05	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT-MAXILLOFACIAL WO	$184.23	$307.05	$307.05	89% below	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT-MAXILLOFACIAL WO	$184.23	$307.05	$307.05	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT-HEAD WO	$184.23	$307.05	$307.05	90% below	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT-HEAD WO	$184.23	$307.05	$307.05	—	40%
CT scan of the head with contrast CPT 70460 CT-HEAD W	$1,059.43	$1,765.72	$1,765.72	45% below	40%
CT scan of the head with contrast inpatient CPT 70460 CT-HEAD W	$1,059.43	$1,765.72	$1,765.72	—	40%
CT scan of the head without and with contrast CPT 70470 CT-HEAD WWO	$408.55	$680.91	$680.91	83% below	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT-HEAD WWO	$408.55	$680.91	$680.91	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT-LUMB SPINE WO	$184.23	$307.05	$307.05	92% below	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT-LUMB SPINE WO	$184.23	$307.05	$307.05	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT-CERV SPINE WO	$184.23	$307.05	$307.05	92% below	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT-CERV SPINE WO	$184.23	$307.05	$307.05	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT-PELVIS W	$362.91	$604.85	$604.85	83% below	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT-PELVIS W	$362.91	$604.85	$604.85	—	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US-CRAN DPLX SCN BIL	$7,628.59	$12,714.32	$12,714.32	830% above	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US-CRAN DPLX SCN BIL	$7,628.59	$12,714.32	$12,714.32	—	40%
Chest CT scan without and with contrast CPT 71270 CT-CHEST DIAG WWO	$408.55	$680.91	$680.91	86% below	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT-CHEST DIAG WWO	$408.55	$680.91	$680.91	—	40%
Chest X-ray, 2 views CPT 71046 CH-CHEST 2V CR	$89.93	$149.88	$149.88	71% below	40%
Chest X-ray, 2 views inpatient CPT 71046 CH-CHEST 2V CR	$89.93	$149.88	$149.88	—	40%
Chest X-ray, single view CPT 71045 CH-CHEST 1V CR	$89.93	$149.88	$149.88	65% below	40%
Chest X-ray, single view inpatient CPT 71045 CH-CHEST 1V CR	$89.93	$149.88	$149.88	—	40%
Collarbone (clavicle) X-ray, complete CPT 73000 UE-CLAVICLE CR	$89.93	$149.88	$149.88	66% below	40%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 UE-CLAVICLE CR	$89.93	$149.88	$149.88	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US-ABDOMEN RETROPER	$196.03	$326.71	$326.71	76% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US-ABDOMEN RETROPER	$196.03	$326.71	$326.71	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA AXIAL	$131.36	$218.93	$218.93	72% below	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA AXIAL	$131.36	$218.93	$218.93	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT-CHEST DIAG WO	$184.23	$307.05	$307.05	90% below	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT-CHEST DIAG WO	$184.23	$307.05	$307.05	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT-CHEST DIAG W	$362.91	$604.85	$604.85	85% below	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT-CHEST DIAG W	$362.91	$604.85	$604.85	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 BR-DIG MAMMO BILAT	$246.89	$411.49	$411.49	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 BR-DIG MAMMO BILAT	$246.89	$411.49	$411.49	—	40%
Diagnostic mammogram, one breast one side CPT 77065 BR-DIG MAMMO UNILAT	$246.89	$411.49	$411.49	19% below	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 BR-DIG MAMMO UNILAT	$246.89	$411.49	$411.49	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 NI-LW EXT DPX ART BI	$3,051.84	$5,086.40	$5,086.40	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 NI-LW EXT DPX ART BI	$3,051.84	$5,086.40	$5,086.40	—	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 US-EXT VEINS DPLX WC	$255.08	$425.13	$425.13	82% below	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US-EXT VEINS DPLX WC	$255.08	$425.13	$425.13	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 NI-TTE 2D W DOPP	$7,281.59	$12,135.98	$12,135.98	244% above	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 NI-TTE 2D W DOPP	$7,281.59	$12,135.98	$12,135.98	—	40%
Elbow X-ray, 2 views CPT 73070 UE-ELBOW 2V CR	$89.93	$149.88	$149.88	67% below	40%
Elbow X-ray, 2 views inpatient CPT 73070 UE-ELBOW 2V CR	$89.93	$149.88	$149.88	—	40%
Elbow X-ray, complete, 3 or more views CPT 73080 UE-ELBOW 3V CR	$89.93	$149.88	$149.88	74% below	40%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 UE-ELBOW 3V CR	$89.93	$149.88	$149.88	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT-ORBIT EAR WO	$184.23	$307.05	$307.05	89% below	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT-ORBIT EAR WO	$184.23	$307.05	$307.05	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 HE-FACIAL BNES 3V CR	$142.47	$237.45	$237.45	65% below	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HE-FACIAL BNES 3V CR	$142.47	$237.45	$237.45	—	40%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 UE-FOREARM 2VW BI CR	$167.06	$278.43	$278.43	—	40%
Forearm X-ray (radius and ulna), 2 views CPT 73090 UE-FOREARM 2V CR	$89.93	$149.88	$149.88	72% below	40%
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 UE-FOREARM 2VW BI CR	$167.06	$278.43	$278.43	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 UE-FOREARM 2V CR	$89.93	$149.88	$149.88	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM-HEPATOBILIARY SYS	$2,453.15	$4,088.59	$4,088.59	62% above	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM-HEPATOBILIARY SYS	$2,453.15	$4,088.59	$4,088.59	—	40%
Hand X-ray, 2 views both sides CPT 73120 UE-HAND 2VWS BI CR	$167.06	$278.43	$278.43	—	40%
Hand X-ray, 2 views CPT 73120 UE-HAND 2V CR	$89.93	$149.88	$149.88	68% below	40%
Hand X-ray, 2 views inpatient both sides CPT 73120 UE-HAND 2VWS BI CR	$167.06	$278.43	$278.43	—	40%
Hand X-ray, 2 views inpatient CPT 73120 UE-HAND 2V CR	$89.93	$149.88	$149.88	—	40%
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 LE-CALCNEUS 2V BI CR	$167.06	$278.43	$278.43	—	40%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 LE-CALCANEUS 2PLS CR	$89.93	$149.88	$149.88	63% below	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 LE-CALCNEUS 2V BI CR	$167.06	$278.43	$278.43	—	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 LE-CALCANEUS 2PLS CR	$89.93	$149.88	$149.88	—	40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLPSTDY UNATT RS EFF	$257.09	$428.48	$428.48	62% below	40%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLPSTDY UNATT RS EFF	$257.09	$428.48	$428.48	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYS-CPAP GT4 GE6YO	$1,542.53	$2,570.88	$2,570.88	67% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYS-CPAP GT4 GE6YO	$1,542.53	$2,570.88	$2,570.88	—	40%
Knee X-ray, 3 views both sides CPT 73562 LE-KNEE 3VWS BI CR	$167.06	$278.43	$278.43	—	40%
Knee X-ray, 3 views CPT 73562 LE-KNEE 3V CR	$89.93	$149.88	$149.88	74% below	40%
Knee X-ray, 3 views inpatient both sides CPT 73562 LE-KNEE 3VWS BI CR	$167.06	$278.43	$278.43	—	40%
Knee X-ray, 3 views inpatient CPT 73562 LE-KNEE 3V CR	$89.93	$149.88	$149.88	—	40%
Knee X-ray, complete, 4 or more views both sides CPT 73564 LE-KNEE 4VWPLS BI CR	$167.06	$278.43	$278.43	—	40%
Knee X-ray, complete, 4 or more views CPT 73564 LE-KNEE 4V PLUS CR	$89.93	$149.88	$149.88	80% below	40%
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 LE-KNEE 4VWPLS BI CR	$167.06	$278.43	$278.43	—	40%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 LE-KNEE 4V PLUS CR	$89.93	$149.88	$149.88	—	40%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT-LOWER EXT WO	$184.23	$307.05	$307.05	90% below	40%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT-LOWER EXT WO	$184.23	$307.05	$307.05	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US-ABDOMEN LTD WO	$196.03	$326.71	$326.71	72% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US-ABDOMEN LTD WO	$196.03	$326.71	$326.71	—	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US-EXT LTD JNT UNI	$131.18	$218.64	$218.64	57% below	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US-EXT LTD JNT UNI	$131.18	$218.64	$218.64	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT-LUNG LOWDSE SC WO	$163.85	$273.09	$273.09	71% below	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT-LUNG LOWDSE SC WO	$163.85	$273.09	$273.09	—	40%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 LE-TIB FIB 2V CR	$89.93	$149.88	$149.88	72% below	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 LE-TIB FIB 2V CR	$89.93	$149.88	$149.88	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 MRA-HEAD WO	$429.59	$715.99	$715.99	84% below	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA-HEAD WO	$429.59	$715.99	$715.99	—	40%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MR-BREAST BI WWO	$1,869.12	$3,115.20	$3,115.20	—	40%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MR-BREAST BI WWO	$1,869.12	$3,115.20	$3,115.20	—	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR-LW JOINT WO	$429.59	$715.99	$715.99	85% below	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR-LW JOINT WO	$429.59	$715.99	$715.99	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR-LW JOINT WWO	$718.25	$1,197.08	$1,197.08	79% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR-LW JOINT WWO	$718.25	$1,197.08	$1,197.08	—	40%
MRI of the abdomen without contrast CPT 74181 MR-ABDOMEN WO	$429.59	$715.99	$715.99	84% below	40%
MRI of the abdomen without contrast inpatient CPT 74181 MR-ABDOMEN WO	$429.59	$715.99	$715.99	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR-ABDOMEN WWO	$718.25	$1,197.08	$1,197.08	81% below	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR-ABDOMEN WWO	$718.25	$1,197.08	$1,197.08	—	40%
MRI of the brain, no contrast dye CPT 70551 MR-BRAIN WO	$429.59	$715.99	$715.99	85% below	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MR-BRAIN WO	$429.59	$715.99	$715.99	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MR-BRAIN WWO	$718.25	$1,197.08	$1,197.08	82% below	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR-BRAIN WWO	$718.25	$1,197.08	$1,197.08	—	40%
MRI of the lower back, no contrast dye CPT 72148 MR-LUMB SPINE WO	$429.59	$715.99	$715.99	85% below	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR-LUMB SPINE WO	$429.59	$715.99	$715.99	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MR-LUMB SPINE WWO	$718.25	$1,197.08	$1,197.08	82% below	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR-LUMB SPINE WWO	$718.25	$1,197.08	$1,197.08	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR-THOR SPINE WO	$429.59	$715.99	$715.99	85% below	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR-THOR SPINE WO	$429.59	$715.99	$715.99	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR-CERV SPINE WWO	$718.25	$1,197.08	$1,197.08	82% below	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR-CERV SPINE WWO	$718.25	$1,197.08	$1,197.08	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR-CERV SPINE WO	$429.59	$715.99	$715.99	85% below	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR-CERV SPINE WO	$429.59	$715.99	$715.99	—	40%
MRI of the pelvis without and with contrast CPT 72197 MR-PELVIS WWO	$718.25	$1,197.08	$1,197.08	80% below	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR-PELVIS WWO	$718.25	$1,197.08	$1,197.08	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MR-PELVIS WO	$429.59	$715.99	$715.99	84% below	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR-PELVIS WO	$429.59	$715.99	$715.99	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR-UPPER JOINT WO	$429.59	$715.99	$715.99	85% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR-UPPER JOINT WO	$429.59	$715.99	$715.99	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SP-CERV SP 4TO5VW CR	$142.47	$237.45	$237.45	74% below	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SP-CERV SP 4TO5VW CR	$142.47	$237.45	$237.45	—	40%
Neck soft tissue CT scan with contrast CPT 70491 CT-NECK SOFT TIS W	$362.91	$604.85	$604.85	83% below	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT-NECK SOFT TIS W	$362.91	$604.85	$604.85	—	40%
Neck soft tissue CT scan without contrast CPT 70490 CT-NECK SOFT TIS WO	$184.23	$307.05	$307.05	89% below	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT-NECK SOFT TIS WO	$184.23	$307.05	$307.05	—	40%
Neck soft tissue X-ray CPT 70360 SP-NECK SOFT TISS CR	$89.93	$149.88	$149.88	66% below	40%
Neck soft tissue X-ray inpatient CPT 70360 SP-NECK SOFT TISS CR	$89.93	$149.88	$149.88	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM-MYOCRD SPECT MULT	$4,242.88	$7,071.47	$7,071.47	6% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM-MYOCRD SPECT MULT	$4,242.88	$7,071.47	$7,071.47	—	40%
Pelvic CT scan without contrast CPT 72192 CT-PELVIS WO	$184.23	$307.05	$307.05	90% below	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT-PELVIS WO	$184.23	$307.05	$307.05	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US-PELVIS NON OB FU	$125.96	$209.94	$209.94	77% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US-PELVIS NON OB FU	$125.96	$209.94	$209.94	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US-PELVIS NON OB	$196.03	$326.71	$326.71	75% below	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US-PELVIS NON OB	$196.03	$326.71	$326.71	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US-PELVIS PREG	$196.03	$326.71	$326.71	74% below	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US-PELVIS PREG	$196.03	$326.71	$326.71	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US-PELV PREG 14 WKS	$196.03	$326.71	$326.71	71% below	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US-PELV PREG 14 WKS	$196.03	$326.71	$326.71	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US-PELVIS PREG LTD	$346.20	$577.00	$577.00	34% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US-PELVIS PREG LTD	$346.20	$577.00	$577.00	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 CH-RIBS UNILAT CR	$89.93	$149.88	$149.88	74% below	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 CH-RIBS UNILAT CR	$89.93	$149.88	$149.88	—	40%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 CH-RIB UNI PA CXR CR	$156.44	$260.74	$260.74	68% below	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 CH-RIB UNI PA CXR CR	$156.44	$260.74	$260.74	—	40%
Screening mammogram, both breasts both sides CPT 77067 BR-DIG MAMMO SCRN BI	$207.19	$345.31	$345.31	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 BR-DIG MAMMO SCRN BI	$207.19	$345.31	$345.31	—	40%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 UE-SHOULDER 2V BI CR	$167.06	$278.43	$278.43	—	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 UE-SHLDR 2VW PLUS CR	$89.93	$149.88	$149.88	75% below	40%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 UE-SHOULDER 2V BI CR	$167.06	$278.43	$278.43	—	40%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 UE-SHLDR 2VW PLUS CR	$89.93	$149.88	$149.88	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 HE-SINUSES 3VPLUS CR	$89.93	$149.88	$149.88	76% below	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HE-SINUSES 3VPLUS CR	$89.93	$149.88	$149.88	—	40%
Skull X-ray, fewer than 4 views CPT 70250 HE-SKULL LIMITED CR	$83.53	$139.21	$139.21	73% below	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HE-SKULL LIMITED CR	$83.53	$139.21	$139.21	—	40%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNO GT4 GE6YO	$1,542.53	$2,570.88	$2,570.88	60% below	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNO GT4 GE6YO	$1,542.53	$2,570.88	$2,570.88	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 FL-MOD BA SWALLOW	$234.76	$391.26	$391.26	62% below	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 FL-MOD BA SWALLOW	$234.76	$391.26	$391.26	—	40%
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 LE-FEMUR 2VW BI CR	$167.06	$278.43	$278.43	—	40%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 LE-FEMUR 2V CR	$89.93	$149.88	$149.88	68% below	40%
Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 LE-FEMUR 2VW BI CR	$167.06	$278.43	$278.43	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 LE-FEMUR 2V CR	$89.93	$149.88	$149.88	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT-THOR SPINE WO	$184.23	$307.05	$307.05	91% below	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT-THOR SPINE WO	$184.23	$307.05	$307.05	—	40%
Toe X-ray, 2 or more views both sides CPT 73660 LE-TOE S 2VWS BI CR	$167.06	$278.43	$278.43	—	40%
Toe X-ray, 2 or more views CPT 73660 LE-TOE S 2VPLUS CR	$89.93	$149.88	$149.88	61% below	40%
Toe X-ray, 2 or more views inpatient both sides CPT 73660 LE-TOE S 2VWS BI CR	$167.06	$278.43	$278.43	—	40%
Toe X-ray, 2 or more views inpatient CPT 73660 LE-TOE S 2VPLUS CR	$89.93	$149.88	$149.88	—	40%
Transvaginal pelvic ultrasound CPT 76830 US-TRANSVAGINAL	$196.03	$326.71	$326.71	69% below	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US-TRANSVAGINAL	$196.03	$326.71	$326.71	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 US-PLV PRG TRNSV	$196.03	$326.71	$326.71	63% below	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US-PLV PRG TRNSV	$196.03	$326.71	$326.71	—	40%
Ultrasound of the abdomen, complete CPT 76700 US-ABDOMEN COMP WO	$196.03	$326.71	$326.71	81% below	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US-ABDOMEN COMP WO	$196.03	$326.71	$326.71	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US-SCROTUM	$196.03	$326.71	$326.71	74% below	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US-SCROTUM	$196.03	$326.71	$326.71	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US-HEAD NECK SFT TIS	$196.03	$326.71	$326.71	71% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US-HEAD NECK SFT TIS	$196.03	$326.71	$326.71	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL-UPPER GI SINGLE	$1,091.26	$1,818.77	$1,818.77	57% above	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL-UPPER GI SINGLE	$1,091.26	$1,818.77	$1,818.77	—	40%
Upper arm X-ray (humerus), 2 views CPT 73060 UE-HUMERUS CR	$89.93	$149.88	$149.88	69% below	40%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 UE-HUMERUS CR	$89.93	$149.88	$149.88	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US-EXT VEINS DPX LTD	$179.84	$299.73	$299.73	75% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US-EXT VEINS DPX LTD	$179.84	$299.73	$299.73	—	40%
Wrist X-ray, 2 views both sides CPT 73100 UE-WRIST 2VW BI CR	$167.06	$278.43	$278.43	—	40%
Wrist X-ray, 2 views CPT 73100 UE-WRIST 2V CR	$89.93	$149.88	$149.88	66% below	40%
Wrist X-ray, 2 views inpatient both sides CPT 73100 UE-WRIST 2VW BI CR	$167.06	$278.43	$278.43	—	40%
Wrist X-ray, 2 views inpatient CPT 73100 UE-WRIST 2V CR	$89.93	$149.88	$149.88	—	40%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 UE-WRIST 3VW BI CR	$167.06	$278.43	$278.43	—	40%
Wrist X-ray, complete, 3 or more views CPT 73110 UE-WRIST 3V PLUS CR	$89.93	$149.88	$149.88	73% below	40%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 UE-WRIST 3VW BI CR	$167.06	$278.43	$278.43	—	40%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 UE-WRIST 3V PLUS CR	$89.93	$149.88	$149.88	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 LE-HIP PV UN2OR3V CR	$89.59	$149.32	$149.32	70% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 LE-HIP PV UN2OR3V CR	$89.59	$149.32	$149.32	—	40%
X-ray of the abdomen, 1 view CPT 74018 CH-ABDOMEN 1 VIEW CR	$89.93	$149.88	$149.88	66% below	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 CH-ABDOMEN 1 VIEW CR	$89.93	$149.88	$149.88	—	40%
X-ray of the ankle, 2 views both sides CPT 73600 LE-ANKLE 2VW BI CR	$167.06	$278.43	$278.43	—	40%
X-ray of the ankle, 2 views CPT 73600 LE-ANKLE 2V CR	$89.93	$149.88	$149.88	67% below	40%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 LE-ANKLE 2VW BI CR	$167.06	$278.43	$278.43	—	40%
X-ray of the ankle, 2 views inpatient CPT 73600 LE-ANKLE 2V CR	$89.93	$149.88	$149.88	—	40%
X-ray of the finger(s), 2 or more views CPT 73140 UE-FINGER S 2VPLS CR	$89.93	$149.88	$149.88	66% below	40%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 UE-FINGER S 2VPLS CR	$89.93	$149.88	$149.88	—	40%
X-ray of the foot, 2 views both sides CPT 73620 LE-FOOT 2VWS BI CR	$167.06	$278.43	$278.43	—	40%
X-ray of the foot, 2 views CPT 73620 LE-FOOT 2V CR	$89.93	$149.88	$149.88	67% below	40%
X-ray of the foot, 2 views inpatient both sides CPT 73620 LE-FOOT 2VWS BI CR	$167.06	$278.43	$278.43	—	40%
X-ray of the foot, 2 views inpatient CPT 73620 LE-FOOT 2V CR	$89.93	$149.88	$149.88	—	40%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 LE-FOOT 3VWPLS BI CR	$167.06	$278.43	$278.43	—	40%
X-ray of the foot, complete, 3 or more views CPT 73630 LE-FOOT 3V PLUS CR	$89.93	$149.88	$149.88	74% below	40%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 LE-FOOT 3VWPLS BI CR	$167.06	$278.43	$278.43	—	40%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 LE-FOOT 3V PLUS CR	$89.93	$149.88	$149.88	—	40%
X-ray of the hand, 3 or more views both sides CPT 73130 UE-HAND 3VWS BI CR	$167.06	$278.43	$278.43	—	40%
X-ray of the hand, 3 or more views CPT 73130 UE-HAND 3V CR	$89.93	$149.88	$149.88	74% below	40%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 UE-HAND 3VWS BI CR	$167.06	$278.43	$278.43	—	40%
X-ray of the hand, 3 or more views inpatient CPT 73130 UE-HAND 3V CR	$89.93	$149.88	$149.88	—	40%
X-ray of the knee, 1 or 2 views both sides CPT 73560 LE-KNEE 1TO2V BI CR	$167.06	$278.43	$278.43	—	40%
X-ray of the knee, 1 or 2 views CPT 73560 LE-KNEE 1 TO 2V CR	$89.93	$149.88	$149.88	69% below	40%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 LE-KNEE 1TO2V BI CR	$167.06	$278.43	$278.43	—	40%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 LE-KNEE 1 TO 2V CR	$89.93	$149.88	$149.88	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SP-LS SPN 2 TO 3V CR	$83.53	$139.21	$139.21	81% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SP-LS SPN 2 TO 3V CR	$83.53	$139.21	$139.21	—	40%
X-ray of the lower back, 4 or more views CPT 72110 SP-LS SPNE 4VPLUS CR	$142.47	$237.45	$237.45	75% below	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SP-LS SPNE 4VPLUS CR	$142.47	$237.45	$237.45	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SP-T SPINE 2 VIEW CR	$89.93	$149.88	$149.88	75% below	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SP-T SPINE 2 VIEW CR	$89.93	$149.88	$149.88	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 HE-NASAL BONES CR	$89.93	$149.88	$149.88	70% below	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HE-NASAL BONES CR	$89.93	$149.88	$149.88	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SP-CERV SP 2TO3VW CR	$89.93	$149.88	$149.88	75% below	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SP-CERV SP 2TO3VW CR	$89.93	$149.88	$149.88	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 LE-PELVIS CR	$89.93	$149.88	$149.88	74% below	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 LE-PELVIS CR	$89.93	$149.88	$149.88	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SP-SCRM COCCYX 2V CR	$89.93	$149.88	$149.88	74% below	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SP-SCRM COCCYX 2V CR	$89.93	$149.88	$149.88	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
ACTH blood test CPT 82024 Q211 ACTH PL IA	$200.40	$334.00	$334.00	at median	40%
ACTH blood test CPT 82024 ADRENOCORT ACTH	$1,405.84	$2,343.07	$2,343.07	603% above	40%
ACTH blood test inpatient CPT 82024 Q211 ACTH PL IA	$200.40	$334.00	$334.00	—	40%
ACTH blood test inpatient CPT 82024 ADRENOCORT ACTH	$1,405.84	$2,343.07	$2,343.07	—	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALT	$207.47	$345.79	$345.79	277% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALT	$207.47	$345.79	$345.79	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE AST	$207.47	$345.79	$345.79	277% above	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE AST	$207.47	$345.79	$345.79	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANE	$169.25	$282.08	$282.08	35% below	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PANE	$169.25	$282.08	$282.08	—	40%
Albumin blood test CPT 82040 ALBUMIN SERUM	$21.05	$35.08	$35.08	51% below	40%
Albumin blood test CPT 82040 Q70858 ALBUMIN SERUM	$207.47	$345.79	$345.79	384% above	40%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$21.05	$35.08	$35.08	—	40%
Albumin blood test inpatient CPT 82040 Q70858 ALBUMIN SERUM	$207.47	$345.79	$345.79	—	40%
Aldosterone blood test CPT 82088 Q229 ALDOSTERONE U24	$352.47	$587.45	$587.45	114% above	40%
Aldosterone blood test CPT 82088 ALDOSTERONE	$1,419.82	$2,366.36	$2,366.36	760% above	40%
Aldosterone blood test inpatient CPT 82088 Q229 ALDOSTERONE U24	$352.47	$587.45	$587.45	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$1,419.82	$2,366.36	$2,366.36	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE,ALKALINE	$30.65	$51.08	$51.08	44% below	40%
Alkaline phosphatase (ALP) blood test CPT 84075 Q6432 PHOSPHATAS ALK	$252.43	$420.72	$420.72	359% above	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE,ALKALINE	$30.65	$51.08	$51.08	—	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Q6432 PHOSPHATAS ALK	$252.43	$420.72	$420.72	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q10715 ALLERGEN IGE	$89.25	$148.75	$148.75	225% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q10715 ALLERGEN IGE	$89.25	$148.75	$148.75	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP SERUM	$685.24	$1,142.06	$1,142.06	528% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 Q5059 MAT SER AFP IA	$685.24	$1,142.06	$1,142.06	528% above	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP SERUM	$685.24	$1,142.06	$1,142.06	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Q5059 MAT SER AFP IA	$685.24	$1,142.06	$1,142.06	—	40%
Ammonia blood test CPT 82140 Q442 AMMONIA	$414.77	$691.29	$691.29	273% above	40%
Ammonia blood test CPT 82140 L910235 AMMONIA	$414.77	$691.29	$691.29	273% above	40%
Ammonia blood test inpatient CPT 82140 L910235 AMMONIA	$414.77	$691.29	$691.29	—	40%
Ammonia blood test inpatient CPT 82140 Q442 AMMONIA	$414.77	$691.29	$691.29	—	40%
Amylase blood test CPT 82150 AMYLASE	$41.09	$68.48	$68.48	49% below	40%
Amylase blood test CPT 82150 Q845 AMYLASE	$311.21	$518.69	$518.69	287% above	40%
Amylase blood test inpatient CPT 82150 AMYLASE	$41.09	$68.48	$68.48	—	40%
Amylase blood test inpatient CPT 82150 Q845 AMYLASE	$311.21	$518.69	$518.69	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Q11173 CCP AB IGG IA	$145.50	$242.50	$242.50	73% above	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Q11173 CCP AB IGG IA	$145.50	$242.50	$242.50	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 L164947 ANA IFA	$494.56	$824.26	$824.26	435% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Q249 ANA SCRN IFA	$539.06	$898.44	$898.44	483% above	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 L164947 ANA IFA	$494.56	$824.26	$824.26	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Q249 ANA SCRN IFA	$539.06	$898.44	$898.44	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$167.73	$279.55	$279.55	11% below	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$167.73	$279.55	$279.55	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 L188227 CULTURE BACT	$51.72	$86.20	$86.20	41% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 L188227 CULTURE BACT	$51.72	$86.20	$86.20	—	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABO CA TOTA	$53.72	$89.53	$89.53	58% below	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABO CA TOTA	$53.72	$89.53	$89.53	—	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$169.75	$282.92	$282.92	176% above	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$169.75	$282.92	$282.92	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH GROSS LVL4	$238.96	$398.27	$398.27	2% below	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH GROSS LVL4	$238.96	$398.27	$398.27	—	40%
Blood culture for bacteria CPT 87040 CULTURE BLOOD BACTER	$414.77	$691.29	$691.29	187% above	40%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD BACTER	$414.77	$691.29	$691.29	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE,ROUTINE	$4.91	$8.19	$8.19	79% below	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE,ROUTINE	$4.91	$8.19	$8.19	—	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE, QUANT	$13.13	$21.89	$21.89	68% below	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, QUANT	$13.13	$21.89	$21.89	—	40%
Blood lead test CPT 83655 Q36438 LEAD	$414.77	$691.29	$691.29	658% above	40%
Blood lead test CPT 83655 Q7655 LEAD	$414.77	$691.29	$691.29	658% above	40%
Blood lead test inpatient CPT 83655 Q7655 LEAD	$414.77	$691.29	$691.29	—	40%
Blood lead test inpatient CPT 83655 Q36438 LEAD	$414.77	$691.29	$691.29	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG, QUAL	$44.46	$74.10	$74.10	51% below	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG, QUAL	$44.46	$74.10	$74.10	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 REF BLD TYPING ABO	$58.43	$97.39	$97.39	30% below	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 REF BLD TYPING ABO	$58.43	$97.39	$97.39	—	40%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN,QUAN	$17.51	$29.19	$29.19	64% below	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN,QUAN	$17.51	$29.19	$29.19	—	40%
C-peptide blood test CPT 84681 Q372 C-PEPTIDE IA	$539.06	$898.44	$898.44	420% above	40%
C-peptide blood test CPT 84681 C-PEPTIDE	$539.06	$898.44	$898.44	420% above	40%
C-peptide blood test inpatient CPT 84681 Q372 C-PEPTIDE IA	$539.06	$898.44	$898.44	—	40%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$539.06	$898.44	$898.44	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$30.65	$51.08	$51.08	57% below	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$30.65	$51.08	$51.08	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLI PROBE	$188.11	$313.51	$313.51	2% above	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLI PROBE	$188.11	$313.51	$313.51	—	40%
CA 19-9 blood test (tumor marker) CPT 86301 TUMOR AG CA 19-9	$482.81	$804.69	$804.69	331% above	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 TUMOR AG CA 19-9	$482.81	$804.69	$804.69	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 TUMOR AG CA 125	$482.81	$804.69	$804.69	200% above	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 TUMOR AG CA 125	$482.81	$804.69	$804.69	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 PRB	$67.98	$113.30	$113.30	41% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 PRB	$67.98	$113.30	$113.30	—	40%
Calcium blood test, total CPT 82310 L54601 CALCIUM TOTAL	$189.29	$315.48	$315.48	331% above	40%
Calcium blood test, total inpatient CPT 82310 L54601 CALCIUM TOTAL	$189.29	$315.48	$315.48	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 L480095 CEA SM	$315.76	$526.26	$526.26	121% above	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 L480095 CEA SM	$315.76	$526.26	$526.26	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER AB	$66.69	$111.15	$111.15	8% below	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER AB	$66.69	$111.15	$111.15	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 L180021 CTRACH AMPPR	$533.18	$888.63	$888.63	331% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Q70051 CHLMYD TRACH	$581.16	$968.60	$968.60	370% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 L180021 CTRACH AMPPR	$533.18	$888.63	$888.63	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Q70051 CHLMYD TRACH	$581.16	$968.60	$968.60	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$52.04	$86.73	$86.73	59% below	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Q92145 LIPID PANEL	$339.50	$565.84	$565.84	170% above	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$52.04	$86.73	$86.73	—	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Q92145 LIPID PANEL	$339.50	$565.84	$565.84	—	40%
Complete blood count (CBC) with differential CPT 85025 CBC W-PLT AUTO COMPD	$17.34	$28.90	$28.90	79% below	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W-PLT AUTO COMPD	$17.34	$28.90	$28.90	—	40%
Complete blood count (CBC), no differential CPT 85027 CBC W-PLT	$14.48	$24.13	$24.13	78% below	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W-PLT	$14.48	$24.13	$24.13	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METAB PANEL	$67.02	$111.70	$111.70	56% below	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METAB PANEL	$67.02	$111.70	$111.70	—	40%
Cortisol blood test, total CPT 82533 L500440 CORTISOL TOT	$97.80	$163.00	$163.00	13% below	40%
Cortisol blood test, total inpatient CPT 82533 L500440 CORTISOL TOT	$97.80	$163.00	$163.00	—	40%
Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL	$38.56	$64.27	$64.27	37% below	40%
Creatine kinase (CK) blood test, total CPT 82550 Q6422 CPK TOTAL	$169.75	$282.92	$282.92	176% above	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK TOTAL	$38.56	$64.27	$64.27	—	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Q6422 CPK TOTAL	$169.75	$282.92	$282.92	—	40%
Creatinine blood test CPT 82565 CREATININE BLOOD	$11.45	$19.09	$19.09	76% below	40%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$11.45	$19.09	$19.09	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 L6494 CMV IGG CLIA	$612.90	$1,021.50	$1,021.50	600% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 Q403 CMV AB IGG IA	$668.06	$1,113.43	$1,113.43	663% above	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 L6494 CMV IGG CLIA	$612.90	$1,021.50	$1,021.50	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Q403 CMV AB IGG IA	$668.06	$1,113.43	$1,113.43	—	40%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANT	$60.29	$100.48	$100.48	50% below	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUANT	$60.29	$100.48	$100.48	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$398.61	$664.35	$664.35	262% above	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 Q402 DHEA SULFATE IA	$398.61	$664.35	$664.35	262% above	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Q402 DHEA SULFATE IA	$398.61	$664.35	$664.35	—	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$398.61	$664.35	$664.35	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PRS DRG IA ANAZ	$704.60	$1,174.34	$1,174.34	605% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Q19027 CONF DRUG 1 U	$704.60	$1,174.34	$1,174.34	605% above	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Q19027 CONF DRUG 1 U	$704.60	$1,174.34	$1,174.34	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PRS DRG IA ANAZ	$704.60	$1,174.34	$1,174.34	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$44.46	$74.10	$74.10	54% below	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$44.46	$74.10	$74.10	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Q8474 EBV VCA IGG IA	$126.30	$210.50	$210.50	17% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR, VCA	$217.75	$362.91	$362.91	102% above	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Q8474 EBV VCA IGG IA	$126.30	$210.50	$210.50	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR, VCA	$217.75	$362.91	$362.91	—	40%
Estradiol blood test CPT 82670 Q36169 ESTRA FR DIR	$537.50	$895.84	$895.84	402% above	40%
Estradiol blood test CPT 82670 Q4021 ESTRADIOL IA	$585.88	$976.46	$976.46	447% above	40%
Estradiol blood test inpatient CPT 82670 Q36169 ESTRA FR DIR	$537.50	$895.84	$895.84	—	40%
Estradiol blood test inpatient CPT 82670 Q4021 ESTRADIOL IA	$585.88	$976.46	$976.46	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 L4309 FSH ECLIA	$487.53	$812.55	$812.55	309% above	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 L4309 FSH ECLIA	$487.53	$812.55	$812.55	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$237.45	$395.75	$395.75	36% above	40%
Fecal calprotectin (stool inflammation test) CPT 83993 Q16796 CALPRO STL IA	$237.45	$395.75	$395.75	36% above	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Q16796 CALPRO STL IA	$237.45	$395.75	$395.75	—	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$237.45	$395.75	$395.75	—	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$60.45	$100.75	$100.75	54% below	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$60.45	$100.75	$100.75	—	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$50.18	$83.64	$83.64	40% below	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$50.18	$83.64	$83.64	—	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$65.17	$108.61	$108.61	42% below	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$65.17	$108.61	$108.61	—	40%
Free T3 thyroid hormone test CPT 84481 T3,FREE	$514.98	$858.30	$858.30	324% above	40%
Free T3 thyroid hormone test inpatient CPT 84481 T3,FREE	$514.98	$858.30	$858.30	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE T4, FREE	$39.91	$66.52	$66.52	65% below	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE T4, FREE	$39.91	$66.52	$66.52	—	40%
Free testosterone test CPT 84402 TESTOSTERONE, FREE	$610.30	$1,017.17	$1,017.17	388% above	40%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE	$610.30	$1,017.17	$1,017.17	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GTT	$247.72	$412.87	$412.87	329% above	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GTT	$247.72	$412.87	$412.87	—	40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$1,078.13	$1,796.88	$1,796.88	257% above	40%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$1,078.13	$1,796.88	$1,796.88	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE, POST DOSE	$270.29	$450.48	$450.48	352% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE, POST DOSE	$270.29	$450.48	$450.48	—	40%
Glucose tolerance test, 3 samples CPT 82951 LAC TOLERANCE 3 SPEC	$72.00	$120.00	$120.00	47% below	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 LAC TOLERANCE 3 SPEC	$72.00	$120.00	$120.00	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHO,DNA,AMPPR	$581.16	$968.60	$968.60	380% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Q70051 N.GONORRHO,DN	$581.16	$968.60	$968.60	380% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Q70051 N.GONORRHO,DN	$581.16	$968.60	$968.60	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHO,DNA,AMPPR	$581.16	$968.60	$968.60	—	40%
H. pylori antibody blood test CPT 86677 Q37695 H PYLORI AB Q	$34.01	$56.69	$56.69	71% below	40%
H. pylori antibody blood test inpatient CPT 86677 Q37695 H PYLORI AB Q	$34.01	$56.69	$56.69	—	40%
H. pylori stool antigen test CPT 87338 HPYLORI,STOOL,EIA	$110.14	$183.56	$183.56	5% below	40%
H. pylori stool antigen test CPT 87338 Q34838 HPYLAG EIA IA	$110.14	$183.56	$183.56	5% below	40%
H. pylori stool antigen test inpatient CPT 87338 Q34838 HPYLAG EIA IA	$110.14	$183.56	$183.56	—	40%
H. pylori stool antigen test inpatient CPT 87338 HPYLORI,STOOL,EIA	$110.14	$183.56	$183.56	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Q40085 HIV1RNA RTPCR	$1,082.68	$1,804.46	$1,804.46	218% above	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1, DNA, QUANT	$1,082.68	$1,804.46	$1,804.46	218% above	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1, DNA, QUANT	$1,082.68	$1,804.46	$1,804.46	—	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Q40085 HIV1RNA RTPCR	$1,082.68	$1,804.46	$1,804.46	—	40%
HIV-1 and HIV-2 antibody test CPT 86703 HIV1-HIV2 AB SNG RES	$25.60	$42.66	$42.66	78% below	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV1-HIV2 AB SNG RES	$25.60	$42.66	$42.66	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV1 AG W HIV 1 2 AB	$150.00	$250.00	$250.00	30% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV1 AG W HIV 1 2 AB	$150.00	$250.00	$250.00	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Q92090 HPV HIGH RISK	$129.00	$215.00	$215.00	11% below	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 L199305 HPV HR	$132.87	$221.45	$221.45	8% below	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Q92090 HPV HIGH RISK	$129.00	$215.00	$215.00	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 L199305 HPV HR	$132.87	$221.45	$221.45	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Q496 HEMOGLO A1C ITA	$272.98	$454.97	$454.97	207% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Q496 HEMOGLO A1C ITA	$272.98	$454.97	$454.97	—	40%
Hemoglobin blood test CPT 85018 L121003 HEMOGLOBIN	$6.00	$10.00	$10.00	81% below	40%
Hemoglobin blood test inpatient CPT 85018 L121003 HEMOGLOBIN	$6.00	$10.00	$10.00	—	40%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE TOT	$539.06	$898.44	$898.44	574% above	40%
Hepatitis B core antibody test (total) CPT 86704 Q501 HBC AB TOT IA	$539.06	$898.44	$898.44	574% above	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 Q501 HBC AB TOT IA	$539.06	$898.44	$898.44	—	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE TOT	$539.06	$898.44	$898.44	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 LC006510 HBSAG SCRN	$342.02	$570.04	$570.04	289% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 LC006510 HBSAG SCRN	$342.02	$570.04	$570.04	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST	$418.99	$698.32	$698.32	274% above	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB TEST	$418.99	$698.32	$698.32	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C,RNA,QUAN	$1,280.21	$2,133.69	$2,133.69	383% above	40%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 Q35645 HCV RNAQT RT-	$1,280.21	$2,133.69	$2,133.69	383% above	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C,RNA,QUAN	$1,280.21	$2,133.69	$2,133.69	—	40%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 Q35645 HCV RNAQT RT-	$1,280.21	$2,133.69	$2,133.69	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMP TYPE 1	$77.96	$129.94	$129.94	15% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 Q90849HERPES SMP TP1	$211.01	$351.68	$351.68	213% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMP TYPE 1	$77.96	$129.94	$129.94	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Q90849HERPES SMP TP1	$211.01	$351.68	$351.68	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 Q17170 HERPES SIMPLEX VIRUS 2 (IGG)	$138.15	$230.25	$230.25	55% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 Q90849HERPES SMP TP2	$155.10	$258.50	$258.50	73% above	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Q17170 HERPES SIMPLEX VIRUS 2 (IGG)	$138.15	$230.25	$230.25	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Q90849HERPES SMP TP2	$155.10	$258.50	$258.50	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 Q10124 HS-CRP NEPHEL	$599.86	$999.76	$999.76	549% above	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROT HS	$599.86	$999.76	$999.76	549% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROT HS	$599.86	$999.76	$999.76	—	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Q10124 HS-CRP NEPHEL	$599.86	$999.76	$999.76	—	40%
Homocysteine blood test CPT 83090 Q31789 HCYSTEINE ENZ	$136.75	$227.91	$227.91	13% above	40%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$136.75	$227.91	$227.91	13% above	40%
Homocysteine blood test inpatient CPT 83090 Q31789 HCYSTEINE ENZ	$136.75	$227.91	$227.91	—	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$136.75	$227.91	$227.91	—	40%
Insulin blood test CPT 83525 Q561 INSULIN IA	$379.42	$632.36	$632.36	421% above	40%
Insulin blood test inpatient CPT 83525 Q561 INSULIN IA	$379.42	$632.36	$632.36	—	40%
Iron blood test (serum iron) CPT 83540 IRON	$38.39	$63.99	$63.99	51% below	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$38.39	$63.99	$63.99	—	40%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACIT	$51.70	$86.16	$86.16	34% below	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACIT	$51.70	$86.16	$86.16	—	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$55.06	$91.77	$91.77	63% below	40%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$55.06	$91.77	$91.77	—	40%
LH (luteinizing hormone) test CPT 83002 LEUTEINIZING HORMONE	$82.18	$136.97	$136.97	28% below	40%
LH (luteinizing hormone) test inpatient CPT 83002 LEUTEINIZING HORMONE	$82.18	$136.97	$136.97	—	40%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$63.15	$105.25	$105.25	30% below	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$63.15	$105.25	$105.25	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROLDH	$35.70	$59.50	$59.50	34% below	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROLDH	$35.70	$59.50	$59.50	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$40.75	$67.92	$67.92	54% below	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$40.75	$67.92	$67.92	—	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PAN	$51.87	$86.45	$86.45	62% below	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PAN	$51.87	$86.45	$86.45	—	40%
Lyme disease antibody test CPT 86618 LYME DISEASE AB	$100.70	$167.84	$167.84	39% above	40%
Lyme disease antibody test CPT 86618 Q6646 LYM AB IGG/IGM	$343.88	$573.13	$573.13	374% above	40%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB	$100.70	$167.84	$167.84	—	40%
Lyme disease antibody test inpatient CPT 86618 Q6646 LYM AB IGG/IGM	$343.88	$573.13	$573.13	—	40%
Magnesium blood test CPT 83735 L910235 MAGNESIUM, URINE	$40.20	$67.00	$67.00	41% below	40%
Magnesium blood test CPT 83735 Q442 MAGNESIUM	$206.46	$344.10	$344.10	204% above	40%
Magnesium blood test inpatient CPT 83735 L910235 MAGNESIUM, URINE	$40.20	$67.00	$67.00	—	40%
Magnesium blood test inpatient CPT 83735 Q442 MAGNESIUM	$206.46	$344.10	$344.10	—	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB	$66.69	$111.15	$111.15	11% below	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB	$66.69	$111.15	$111.15	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREEN	$12.43	$20.72	$20.72	84% below	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SCREEN	$12.43	$20.72	$20.72	—	40%
Mumps immunity blood test CPT 86735 MUMPS AB	$57.93	$96.55	$96.55	23% below	40%
Mumps immunity blood test CPT 86735 Q8624 MUMPSAB IGG IA	$353.31	$588.85	$588.85	371% above	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB	$57.93	$96.55	$96.55	—	40%
Mumps immunity blood test inpatient CPT 86735 Q8624 MUMPSAB IGG IA	$353.31	$588.85	$588.85	—	40%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$210.50	$350.84	$350.84	at median	40%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$210.50	$350.84	$350.84	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, FREE	$81.51	$135.85	$135.85	17% below	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 Q31348 PSA, FREE	$621.75	$1,036.25	$1,036.25	536% above	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, FREE	$81.51	$135.85	$135.85	—	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Q31348 PSA, FREE	$621.75	$1,036.25	$1,036.25	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL	$81.51	$135.85	$135.85	28% below	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 Q31348 PSA, TOTAL	$621.75	$1,036.25	$1,036.25	448% above	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL	$81.51	$135.85	$135.85	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Q31348 PSA, TOTAL	$621.75	$1,036.25	$1,036.25	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 Q92090 PAP DIAG AUTO	$136.35	$227.25	$227.25	3% above	40%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP DIAG AUTO MAN RS	$153.08	$255.13	$255.13	15% above	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Q92090 PAP DIAG AUTO	$136.35	$227.25	$227.25	—	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP DIAG AUTO MAN RS	$153.08	$255.13	$255.13	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP THINLAY LIQ DIAG	$113.84	$189.74	$189.74	1% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP THINLAY LIQ SCRN	$117.04	$195.06	$195.06	4% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP THINLAY LIQ DIAG	$113.84	$189.74	$189.74	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP THINLAY LIQ SCRN	$117.04	$195.06	$195.06	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE PTH	$96.33	$160.55	$160.55	57% below	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE PTH	$96.33	$160.55	$160.55	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLAST TIMEPTT	$35.36	$58.94	$58.94	46% below	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLAST TIMEPTT	$35.36	$58.94	$58.94	—	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS, BLOOD	$28.12	$46.87	$46.87	52% below	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS, BLOOD	$28.12	$46.87	$46.87	—	40%
Potassium blood test CPT 84132 POTASSIUM SER PL WB	$28.29	$47.15	$47.15	35% below	40%
Potassium blood test inpatient CPT 84132 POTASSIUM SER PL WB	$28.29	$47.15	$47.15	—	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 451934 MTNLT21 CRSCA	$1,050.00	$1,750.00	$1,750.00	19% above	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 451934 MTNLT21 CRSCA	$1,050.00	$1,750.00	$1,750.00	—	40%
Progesterone blood test CPT 84144 PROGESTERONE	$37.55	$62.58	$62.58	73% below	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$37.55	$62.58	$62.58	—	40%
Prolactin blood test CPT 84146 PROLACTIN	$85.88	$143.14	$143.14	33% below	40%
Prolactin blood test CPT 84146 Q40049 PROLACTIN	$575.85	$959.75	$959.75	349% above	40%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$85.88	$143.14	$143.14	—	40%
Prolactin blood test inpatient CPT 84146 Q40049 PROLACTIN	$575.85	$959.75	$959.75	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$258.16	$430.27	$430.27	515% above	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$258.16	$430.27	$430.27	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 PRS DRG IA VIS	$82.68	$137.80	$137.80	1% above	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 PRS DRG IA VIS	$82.68	$137.80	$137.80	—	40%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA SWAB A&B	$39.72	$66.20	$66.20	44% below	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA SWAB A&B	$39.72	$66.20	$66.20	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W-OPTI	$24.75	$41.25	$41.25	59% below	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W-OPTI	$24.75	$41.25	$41.25	—	40%
Renin blood test CPT 84244 RENIN	$892.21	$1,487.01	$1,487.01	676% above	40%
Renin blood test inpatient CPT 84244 RENIN	$892.21	$1,487.01	$1,487.01	—	40%
Rh blood typing CPT 86901 REF BLD TYPING RH D	$58.43	$97.39	$97.39	14% below	40%
Rh blood typing inpatient CPT 86901 REF BLD TYPING RH D	$58.43	$97.39	$97.39	—	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACT QUAN	$33.51	$55.85	$55.85	46% below	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACT QUAN	$33.51	$55.85	$55.85	—	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB	$53.21	$88.69	$88.69	29% below	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB	$53.21	$88.69	$88.69	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE, AUTOMATED	$16.00	$26.66	$26.66	66% below	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE, AUTOMATED	$16.00	$26.66	$26.66	—	40%
Sodium blood test CPT 84295 SODIUM,SER PL OR WB	$28.46	$47.43	$47.43	42% below	40%
Sodium blood test inpatient CPT 84295 SODIUM,SER PL OR WB	$28.46	$47.43	$47.43	—	40%
Stool ova and parasites exam CPT 87177 OVA-PARASITES SMEARS	$64.33	$107.21	$107.21	13% below	40%
Stool ova and parasites exam CPT 87177 Q681 OVA-PARASITES S	$192.15	$320.25	$320.25	160% above	40%
Stool ova and parasites exam inpatient CPT 87177 OVA-PARASITES SMEARS	$64.33	$107.21	$107.21	—	40%
Stool ova and parasites exam inpatient CPT 87177 Q681 OVA-PARASITES S	$192.15	$320.25	$320.25	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HEMOCULT STOOL	$10.51	$17.52	$17.52	64% below	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HEMOCULT STOOL	$10.51	$17.52	$17.52	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLD OCCULT FECES EIA	$99.52	$165.87	$165.87	34% above	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLD OCCULT FECES EIA	$99.52	$165.87	$165.87	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMAL AB	$29.34	$48.90	$48.90	56% below	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMAL AB	$29.34	$48.90	$48.90	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST, QUAL	$25.26	$42.10	$42.10	51% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST, QUAL	$25.26	$42.10	$42.10	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IM MEAS	$241.83	$403.05	$403.05	9% above	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IM MEAS	$241.83	$403.05	$403.05	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL	$114.52	$190.86	$190.86	10% below	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL	$114.52	$190.86	$190.86	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Q90123 MICROSOMAL AB	$409.73	$682.88	$682.88	416% above	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Q90123 MICROSOMAL AB	$409.73	$682.88	$682.88	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM TSH	$74.43	$124.05	$124.05	37% below	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM TSH	$74.43	$124.05	$124.05	—	40%
Total IgE blood test CPT 82785 Q542 IGE IA	$89.25	$148.75	$148.75	2% above	40%
Total IgE blood test CPT 82785 Q10659 GAMMAGLOB IGE	$89.25	$148.75	$148.75	2% above	40%
Total IgE blood test inpatient CPT 82785 Q10659 GAMMAGLOB IGE	$89.25	$148.75	$148.75	—	40%
Total IgE blood test inpatient CPT 82785 Q542 IGE IA	$89.25	$148.75	$148.75	—	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL	$189.29	$315.48	$315.48	342% above	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL	$189.29	$315.48	$315.48	—	40%
Total thyroxine (T4) blood test CPT 84436 THYROXINE T4,TOTAL	$23.24	$38.73	$38.73	72% below	40%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE T4,TOTAL	$23.24	$38.73	$38.73	—	40%
Total triiodothyronine (T3) blood test CPT 84480 T3,TOTAL	$623.60	$1,039.33	$1,039.33	553% above	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3,TOTAL	$623.60	$1,039.33	$1,039.33	—	40%
Transferrin blood test CPT 84466 TRANSFERRIN	$56.59	$94.31	$94.31	40% below	40%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$56.59	$94.31	$94.31	—	40%
Trichomonas test (NAAT) CPT 87661 T VAGINALIS AMP	$167.73	$279.55	$279.55	35% above	40%
Trichomonas test (NAAT) inpatient CPT 87661 T VAGINALIS AMP	$167.73	$279.55	$279.55	—	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$207.47	$345.79	$345.79	337% above	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$207.47	$345.79	$345.79	—	40%
Troponin test, quantitative CPT 84484 TROPONIN,QNT	$80.33	$133.88	$133.88	47% below	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN,QNT	$80.33	$133.88	$133.88	—	40%
Uric acid blood test CPT 84550 URIC ACID, BLOOD	$26.60	$44.34	$44.34	62% below	40%
Uric acid blood test inpatient CPT 84550 URIC ACID, BLOOD	$26.60	$44.34	$44.34	—	40%
Urinalysis with microscope exam, automated CPT 81001 UA, AUTO W-SCOPE	$20.03	$33.39	$33.39	69% below	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA, AUTO W-SCOPE	$20.03	$33.39	$33.39	—	40%
Urinalysis without microscope exam, automated CPT 81003 UA, AUTO, W-O SCOPE	$14.31	$23.85	$23.85	43% below	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA, AUTO, W-O SCOPE	$14.31	$23.85	$23.85	—	40%
Urinalysis without microscope exam, manual CPT 81002 UA DIP	$8.35	$13.92	$13.92	63% below	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 UA DIP	$8.35	$13.92	$13.92	—	40%
Urine culture for bacteria, with colony count CPT 87086 CULT URINE-COLONY CT	$35.87	$59.78	$59.78	61% below	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE-COLONY CT	$35.87	$59.78	$59.78	—	40%
Urine microalbumin (albumin) test CPT 82043 MICROALB QNT	$46.64	$77.74	$77.74	28% below	40%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALB QNT	$46.64	$77.74	$77.74	—	40%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$20.66	$34.44	$34.44	72% below	40%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$20.66	$34.44	$34.44	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$66.86	$111.43	$111.43	48% below	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$66.86	$111.43	$111.43	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25OH	$167.56	$279.26	$279.26	9% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25OH	$167.56	$279.26	$279.26	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXY VITAMIN D	$227.51	$379.18	$379.18	18% above	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Q16558 VITD LCMSMS	$332.93	$554.89	$554.89	72% above	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 DIHYDROXY VITAMIN D	$227.51	$379.18	$379.18	—	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Q16558 VITD LCMSMS	$332.93	$554.89	$554.89	—	40%
Zinc blood test CPT 84630 ZINC WHOLE BLOOD	$48.00	$80.00	$80.00	33% below	40%
Zinc blood test inpatient CPT 84630 ZINC WHOLE BLOOD	$48.00	$80.00	$80.00	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 L140450 HCG TUMOR MK	$455.20	$758.66	$758.66	323% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 L140450 HCG TUMOR MK	$455.20	$758.66	$758.66	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT LATERAL MALLEOUS FIBULA ONLY	$701.02	$1,168.36	$1,168.36	67% above	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TREATMENT LATERAL MALLEOUS FIBULA ONLY	$701.02	$1,168.36	$1,168.36	—	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREATMENT METATARSAL FRACTURE	$499.18	$831.96	$831.96	23% below	40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TREATMENT METATARSAL FRACTURE	$499.18	$831.96	$831.96	—	40%
Cardiac catheterization with coronary angiogram CPT 93458 CC-L HRT ARTERY-VENT	$29,557.70	$49,262.84	$49,262.84	188% above	40%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 CC-L HRT ARTERY-VENT	$29,557.70	$49,262.84	$49,262.84	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 NI-CARDIOVERSION	$3,010.74	$5,017.90	$5,017.90	151% above	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 NI-CARDIOVERSION	$3,010.74	$5,017.90	$5,017.90	—	40%
Catheter ablation for atrial fibrillation CPT 93656 EP-ATR FIB PULM VN I	$27,732.59	$46,220.99	$46,220.99	2% below	40%
Catheter ablation for atrial fibrillation inpatient CPT 93656 EP-ATR FIB PULM VN I	$27,732.59	$46,220.99	$46,220.99	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FRACTURE RADIUS/ULNA DISTA,SHAFT	$801.94	$1,336.56	$1,336.56	55% above	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TREAT FRACTURE RADIUS/ULNA DISTA,SHAFT	$801.94	$1,336.56	$1,336.56	—	40%
Coronary stent placement, one artery CPT 92928 IC-PRQ CRD STN W-ANG	$53,231.43	$88,719.05	$88,719.05	279% above	40%
Coronary stent placement, one artery inpatient CPT 92928 IC-PRQ CRD STN W-ANG	$53,231.43	$88,719.05	$88,719.05	—	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRCT PREMAL LES	$457.80	$763.00	$763.00	172% above	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRCT PREMAL LES	$457.80	$763.00	$763.00	—	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 EAR IRRIGATION(ONE EAR)	$36.48	$60.80	$60.80	68% below	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 EAR IRRIGATION(ONE EAR)	$36.48	$60.80	$60.80	—	40%
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S)	$457.25	$762.08	$762.08	50% below	40%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 LIGATION OF HEMORRHOID(S)	$457.25	$762.08	$762.08	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 S-INJ CATH HYSTERSO	$201.91	$336.52	$336.52	48% below	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 S-INJ CATH HYSTERSO	$201.91	$336.52	$336.52	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCS SMPL/SGL	$457.80	$763.00	$763.00	15% above	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCS SMPL/SGL	$457.80	$763.00	$763.00	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 NJ TENDON SHEATH/LIG	$677.28	$1,128.80	$1,128.80	58% above	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 NJ TENDON SHEATH/LIG	$677.28	$1,128.80	$1,128.80	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 MAJOR JOINT INJECTION	$105.58	$175.96	$175.96	79% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 MAJOR JOINT INJECTION	$105.58	$175.96	$175.96	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 S-JOINT ASP-INJ IM	$420.40	$700.66	$700.66	1% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 S-JOINT ASP-INJ IM	$420.40	$700.66	$700.66	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 SMALL JOINT INJECTION	$83.06	$138.44	$138.44	73% below	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 SMALL JOINT INJECTION	$83.06	$138.44	$138.44	—	40%
Left heart catheterization, diagnostic CPT 93452 CC-LHC VENT PUNC	$26,007.45	$43,345.75	$43,345.75	257% above	40%
Left heart catheterization, diagnostic inpatient CPT 93452 CC-LHC VENT PUNC	$26,007.45	$43,345.75	$43,345.75	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 IR-DI L-S INJ W IM	$1,470.22	$2,450.37	$2,450.37	at median	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR-DI L-S INJ W IM	$1,470.22	$2,450.37	$2,450.37	—	40%
Nail removal (partial or complete), one nail CPT 11730 RMV NAIL PLATE SGL	$457.80	$763.00	$763.00	59% above	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 RMV NAIL PLATE SGL	$457.80	$763.00	$763.00	—	40%
Paracentesis with imaging guidance CPT 49083 IR-ABD PARACEN W IMG	$2,260.67	$3,767.78	$3,767.78	56% above	40%
Paracentesis with imaging guidance inpatient CPT 49083 IR-ABD PARACEN W IMG	$2,260.67	$3,767.78	$3,767.78	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$238.32	$397.20	$397.20	62% below	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED	$238.32	$397.20	$397.20	—	40%
Removal of a foreign object under the skin, simple CPT 10120 INC & REM FB SQ SMPL	$911.81	$1,519.68	$1,519.68	89% above	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC & REM FB SQ SMPL	$911.81	$1,519.68	$1,519.68	—	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY	$32,624.84	$54,374.73	$54,374.73	363% above	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY	$32,624.84	$54,374.73	$54,374.73	—	40%
Short leg splint (calf to foot) CPT 29515 APPLY SHRT LEG SPLNT	$360.31	$600.52	$600.52	36% above	40%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHRT LEG SPLNT	$360.31	$600.52	$600.52	—	40%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKN SGL LES	$911.81	$1,519.68	$1,519.68	145% above	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKN SGL LES	$911.81	$1,519.68	$1,519.68	—	40%
Skin tag removal, up to 15 tags CPT 11200 RMV SKN TAGS	$457.80	$763.00	$763.00	83% above	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 RMV SKN TAGS	$457.80	$763.00	$763.00	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 S-SPINAL TAP DIAGNST	$850.52	$1,417.54	$1,417.54	11% below	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 S-SPINAL TAP DIAGNST	$850.52	$1,417.54	$1,417.54	—	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TNGNTL BX SKN SGL LES	$457.80	$763.00	$763.00	54% above	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TNGNTL BX SKN SGL LES	$457.80	$763.00	$763.00	—	40%
Thoracentesis with imaging guidance CPT 32555 US-THORACNTSIS W IMG	$3,110.78	$5,184.63	$5,184.63	149% above	40%
Thoracentesis with imaging guidance inpatient CPT 32555 US-THORACNTSIS W IMG	$3,110.78	$5,184.63	$5,184.63	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ 1-2 MUSCLE	$84.62	$141.04	$141.04	84% below	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ 1-2 MUSCLE	$84.62	$141.04	$141.04	—	40%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LES 1-14	$457.80	$763.00	$763.00	91% above	40%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT B9 LES 1-14	$457.80	$763.00	$763.00	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUB TIS 20 SQ CM	$911.81	$1,519.68	$1,519.68	32% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUB TIS 20 SQ CM	$911.81	$1,519.68	$1,519.68	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$2,147.50	$3,579.17	$3,579.17	143% above	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$2,147.50	$3,579.17	$3,579.17	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TRTMT INI	$341.70	$569.50	$569.50	78% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TRTMT INI	$341.70	$569.50	$569.50	—	40%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFU 1ST HR	$826.27	$1,377.11	$1,377.11	29% above	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFU 1ST HR	$826.27	$1,377.11	$1,377.11	—	40%
Critical care, first 30 to 74 minutes one side CPT 99291 CRITICAL CARE LT 74M	$7,371.25	$12,285.42	$12,285.42	256% above	40%
Critical care, first 30 to 74 minutes inpatient one side CPT 99291 CRITICAL CARE LT 74M	$7,371.25	$12,285.42	$12,285.42	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE DROWSY	$645.35	$1,075.58	$1,075.58	26% below	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE DROWSY	$645.35	$1,075.58	$1,075.58	—	40%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG	$33.38	$55.64	$55.64	68% below	40%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG	$33.38	$55.64	$55.64	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 NI-EKG, 12 LEADS	$428.89	$714.82	$714.82	84% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 NI-EKG, 12 LEADS	$428.89	$714.82	$714.82	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 SUTURE REMOVAL/RECHE	$658.97	$1,098.28	$1,098.28	194% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 SUTURE REMOVAL/RECHE	$658.97	$1,098.28	$1,098.28	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LIMITED ED VISIT	$1,155.08	$1,925.14	$1,925.14	189% above	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 LIMITED ED VISIT	$1,155.08	$1,925.14	$1,925.14	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 INTERMEDIATE ED VIST	$2,096.47	$3,494.12	$3,494.12	199% above	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 INTERMEDIATE ED VIST	$2,096.47	$3,494.12	$3,494.12	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EXTENDED ED VISIT	$3,905.48	$6,509.13	$6,509.13	241% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EXTENDED ED VISIT	$3,905.48	$6,509.13	$6,509.13	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 COMPREHENSIVE ED VST	$5,155.55	$8,592.58	$8,592.58	223% above	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 COMPREHENSIVE ED VST	$5,155.55	$8,592.58	$8,592.58	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 NI-STRESS TEST	$3,113.64	$5,189.40	$5,189.40	227% above	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NI-STRESS TEST	$3,113.64	$5,189.40	$5,189.40	—	40%
Family therapy with the patient, 50 minutes CPT 90847 FAM THERAPY W/PATIEN	$505.22	$842.03	$842.03	182% above	40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAM THERAPY W/PATIEN	$505.22	$842.03	$842.03	—	40%
Group psychotherapy session CPT 90853 PSYCH GROUP THERAPY	$132.56	$220.94	$220.94	3% above	40%
Group psychotherapy session inpatient CPT 90853 PSYCH GROUP THERAPY	$132.56	$220.94	$220.94	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1 HR	$292.20	$487.00	$487.00	13% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1 HR	$292.20	$487.00	$487.00	—	40%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY DX 1 HR	$781.05	$1,301.75	$1,301.75	92% above	40%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY DX 1 HR	$781.05	$1,301.75	$1,301.75	—	40%
IV push of a medicine, first drug CPT 96374 THERAPEUTIC IV PUSH	$120.75	$201.25	$201.25	44% below	40%
IV push of a medicine, first drug inpatient CPT 96374 THERAPEUTIC IV PUSH	$120.75	$201.25	$201.25	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC DX SQ IM	$120.75	$201.25	$201.25	11% above	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC DX SQ IM	$120.75	$201.25	$201.25	—	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAG EVAL	$149.87	$249.78	$249.78	44% below	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAG EVAL	$149.87	$249.78	$249.78	—	40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 MTR-SENS 7-8 NRV TST	$492.86	$821.43	$821.43	32% below	40%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 MTR-SENS 7-8 NRV TST	$492.86	$821.43	$821.43	—	40%
New patient office visit, about 30 minutes CPT 99203 URGENT CARE LVL 3 NP	$157.13	$261.88	$261.88	29% below	40%
New patient office visit, about 30 minutes inpatient CPT 99203 URGENT CARE LVL 3 NP	$157.13	$261.88	$261.88	—	40%
New patient office visit, about 45 minutes CPT 99204 URGENT CARE LVL 4 NP	$173.81	$289.69	$289.69	42% below	40%
New patient office visit, about 45 minutes inpatient CPT 99204 URGENT CARE LVL 4 NP	$173.81	$289.69	$289.69	—	40%
New patient office visit, about 60 minutes CPT 99205 URGENT CARE LVL 5 NP	$190.50	$317.50	$317.50	51% below	40%
New patient office visit, about 60 minutes inpatient CPT 99205 URGENT CARE LVL 5 NP	$190.50	$317.50	$317.50	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 URGENT CARE LVL 2 NP	$140.44	$234.07	$234.07	19% below	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 URGENT CARE LVL 2 NP	$140.44	$234.07	$234.07	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL EA 15 MN	$116.65	$194.41	$194.41	117% above	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INITIAL EA 15 MN	$116.65	$194.41	$194.41	—	40%
Preventive checkup, new patient aged 18–39 CPT 99385 NEW PREV.18-39	$137.40	$229.00	$229.00	45% below	40%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 NEW PREV.18-39	$137.40	$229.00	$229.00	—	40%
Preventive checkup, new patient aged 40–64 CPT 99386 NEW PREV.40-64	$159.00	$265.00	$265.00	35% below	40%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 NEW PREV.40-64	$159.00	$265.00	$265.00	—	40%
Preventive checkup, new patient aged 65 or older CPT 99387 NEW PREV.65+	$172.80	$288.00	$288.00	23% below	40%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 NEW PREV.65+	$172.80	$288.00	$288.00	—	40%
Preventive checkup, returning patient aged 18–39 CPT 99395 EST.PREV.18-39	$123.60	$206.00	$206.00	35% below	40%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 EST.PREV.18-39	$123.60	$206.00	$206.00	—	40%
Preventive checkup, returning patient aged 40–64 CPT 99396 EST.PREV.40-64	$133.20	$222.00	$222.00	37% below	40%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 EST.PREV.40-64	$133.20	$222.00	$222.00	—	40%
Preventive checkup, returning patient aged 65 or older CPT 99397 EST.PREV.65+	$141.60	$236.00	$236.00	38% below	40%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 EST.PREV.65+	$141.60	$236.00	$236.00	—	40%
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL MED SERVICES	$392.81	$654.68	$654.68	10% above	40%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL MED SERVICES	$392.81	$654.68	$654.68	—	40%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MIN	$143.38	$238.96	$238.96	24% below	40%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MIN	$143.38	$238.96	$238.96	—	40%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MIN	$179.84	$299.73	$299.73	7% below	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MIN	$179.84	$299.73	$299.73	—	40%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MIN	$215.84	$359.73	$359.73	25% below	40%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MIN	$215.84	$359.73	$359.73	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHG SMOKE U 10	$76.48	$127.46	$127.46	87% above	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHG SMOKE U 10	$76.48	$127.46	$127.46	—	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 URGENT CARE LVL 5 EP	$190.50	$317.50	$317.50	31% below	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 URGENT CARE LVL 5 EP	$190.50	$317.50	$317.50	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 URGENT CARE LVL 3 EP	$169.03	$281.71	$281.71	11% above	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 URGENT CARE LVL 3 EP	$169.03	$281.71	$281.71	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EVAL & MGMT LEVEL 4	$142.35	$237.25	$237.25	23% below	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 URGENT CARE LVL 4 EP	$187.10	$311.83	$311.83	1% above	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EVAL & MGMT LEVEL 4	$142.35	$237.25	$237.25	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 URGENT CARE LVL 4 EP	$187.10	$311.83	$311.83	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 URGENT CARE LVL 2 EP	$151.10	$251.84	$251.84	21% above	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 URGENT CARE LVL 2 EP	$151.10	$251.84	$251.84	—	40%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$318.27	$530.45	$530.45	5% above	40%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$318.27	$530.45	$530.45	—	40%
Spirometry before and after a bronchodilator CPT 94060 BRONCHO EVAL PRE/PST	$1,416.77	$2,361.28	$2,361.28	160% above	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHO EVAL PRE/PST	$1,416.77	$2,361.28	$2,361.28	—	40%
TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 TMS INITIAL & 1ST TX	$573.50	$955.84	$955.84	81% above	40%
TMS (transcranial magnetic stimulation), first session with mapping inpatient CPT 90867 TMS INITIAL & 1ST TX	$573.50	$955.84	$955.84	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUT	$160.06	$266.77	$266.77	26% below	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUT	$160.06	$266.77	$266.77	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIR VAC SC	$366.94	$611.56	$611.56	33% above	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIR VAC SC	$366.94	$611.56	$611.56	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEP B VAC PED	$122.98	$204.97	$204.97	42% above	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEP B VAC PED	$122.98	$204.97	$204.97	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPH B TETAN INJ	$79.10	$131.84	$131.84	49% above	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPH B TETAN INJ	$79.10	$131.84	$131.84	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VAC NOPRSV ANTIG	$260.80	$434.66	$434.66	239% above	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VAC NOPRSV ANTIG	$260.80	$434.66	$434.66	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II INJ	$282.74	$471.23	$471.23	46% above	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II INJ	$282.74	$471.23	$471.23	—	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOC 13-VAL IM	$523.14	$871.90	$871.90	45% above	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOC 13-VAL IM	$523.14	$871.90	$871.90	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMO-VAC 2YR-ADULT	$326.46	$544.10	$544.10	74% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMO-VAC 2YR-ADULT	$326.46	$544.10	$544.10	—	40%
Rabies vaccine, one dose CPT 90675 RABIES VAC IM	$1,113.79	$1,856.32	$1,856.32	47% above	40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC IM	$1,113.79	$1,856.32	$1,856.32	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD IM NO PRSRV GE 7Y	$126.07	$210.12	$210.12	64% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD IM NO PRSRV GE 7Y	$126.07	$210.12	$210.12	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH/TET/ACPERT .5ML	$210.12	$350.20	$350.20	101% above	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPH/TET/ACPERT .5ML	$210.12	$350.20	$350.20	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADM PNEU VACCINE	$63.04	$105.06	$105.06	10% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADM INJ SINGLE	$97.35	$162.25	$162.25	69% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADM PNEU VACCINE	$63.04	$105.06	$105.06	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADM INJ SINGLE	$97.35	$162.25	$162.25	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMM ADM INJ EA ADD	$29.25	$48.75	$48.75	24% below	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMM ADM INJ EA ADD	$29.25	$48.75	$48.75	—	40%

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

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

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

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

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

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

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

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

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

Source file: https://gatewayregional.net/PriceTransparency/88-3850676_GATEWAY-REGIONAL-MEDICAL-CENTER_standardcharges.csv