Hospital Moscow, ID

Gritman Medical Center

Gritman Medical Center in Moscow, ID publishes cash prices for 481 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Idaho median for 336 of 474 procedures and above it for 137. Click a procedure to compare it with other hospitals nearby.

700 S Main St, Moscow, ID 83843 Collected Sep 23, 2026 Source price file (208) 882-4511

Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 3 of 5 CCN 131327 · CMS hospital register NPI 1619988144

The price file shows no self-pay discount

For 2818 of the 2818 prices listed here, the cash price in Gritman Medical Center's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W/O & W/DYE - CT ABDOMEN W WO CONTRAST	$1,200.00	$1,200.00	$95.95–$1,140.00	4% below	—
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W/O & W/DYE - CT ABDOMEN W WO CONTRAST	$1,200.00	$1,200.00	$95.95–$1,140.00	—	—
Abdominal X-ray, 2 views CPT 74019 HC RADIOLOGIC EXAM ABDOMEN 2 VIEWS - XR ABDOMEN 2 VW	$429.00	$429.00	$14.26–$409.62	53% above	—
Abdominal X-ray, 2 views inpatient CPT 74019 HC RADIOLOGIC EXAM ABDOMEN 2 VIEWS - XR ABDOMEN 2 VW	$429.00	$429.00	$14.26–$409.62	—	—
Ankle X-ray, complete, 3 or more views both sides CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS BILATERAL	$319.00	$319.00	$13.93–$340.97	—	—
Ankle X-ray, complete, 3 or more views CPT 73610 RADEX ANKLE COMPLETE MINIMUM 3 VIEWS	$73.00	$73.00	$13.93–$340.97	77% below	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS LEFT	$319.00	$319.00	$13.93–$340.97	1% below	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS RIGHT	$319.00	$319.00	$13.93–$340.97	1% below	—
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS BILATERAL	$319.00	$319.00	$13.93–$340.97	—	—
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 RADEX ANKLE COMPLETE MINIMUM 3 VIEWS	$73.00	$73.00	$13.93–$340.97	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS RIGHT	$319.00	$319.00	$13.93–$340.97	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS LEFT	$319.00	$319.00	$13.93–$340.97	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS - CV US ANKLE BRACHIAL INDICES EXTRM CMP	$344.00	$344.00	$31.10–$521.29	18% below	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC VASC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL	$344.00	$344.00	$31.10–$521.29	18% below	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS - TRANSCUTANEOUS O2 MEASUREMENT	$344.00	$344.00	$31.10–$521.29	18% below	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL - TOE BRACHIAL INDEX	$344.00	$344.00	$31.10–$521.29	18% below	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL - ANKLE BRACHIAL INDEX	$344.00	$344.00	$31.10–$521.29	18% below	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL - TOE BRACHIAL INDEX	$344.00	$344.00	$31.10–$521.29	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC VASC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL	$344.00	$344.00	$31.10–$521.29	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS - CV US ANKLE BRACHIAL INDICES EXTRM CMP	$344.00	$344.00	$31.10–$521.29	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL - ANKLE BRACHIAL INDEX	$344.00	$344.00	$31.10–$521.29	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS - TRANSCUTANEOUS O2 MEASUREMENT	$344.00	$344.00	$31.10–$521.29	—	—
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT SCAN UPPER EXTREMITY W/O CONTRAST	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT ELBOW RIGHT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT RADIUS ULNA LEFT WO IV CONT	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT HAND LEFT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT WRIST RIGHT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT HAND RIGHT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT RADIUS ULNA RIGHT WO IV CONT	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT HUMERUS LEFT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT SHOULDER RIGHT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT HUMERUS RIGHT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT UPPER EXT LEFT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT WRIST LEFT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT UPPER EXT RIGHT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT ELBOW LEFT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT SHOULDER LEFT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	23% below	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT SCAN UPPER EXTREMITY W/O CONTRAST	$784.00	$784.00	$60.42–$744.80	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT UPPER EXT RIGHT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT UPPER EXT LEFT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT SHOULDER RIGHT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT SHOULDER LEFT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT RADIUS ULNA RIGHT WO IV CONT	$784.00	$784.00	$60.42–$744.80	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT RADIUS ULNA LEFT WO IV CONT	$784.00	$784.00	$60.42–$744.80	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT HUMERUS RIGHT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT HUMERUS LEFT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT HAND RIGHT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT HAND LEFT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT ELBOW RIGHT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT ELBOW LEFT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT WRIST RIGHT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT WRIST LEFT WO IV CONTRAST	$784.00	$784.00	$60.42–$744.80	—	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC ESOPHAGRAM - FL ESOPHAGUS BARIUM SWALLOW	$703.00	$703.00	$37.06–$687.23	67% above	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC ESOPHAGRAM - FL ESOPHAGUS BARIUM SWALLOW	$703.00	$703.00	$37.06–$687.23	—	—
Bone scan, whole body (nuclear medicine) CPT 78306 HC BONE IMAGING, WHOLE BODY - NM BONE WHOLE BODY	$1,483.00	$1,483.00	$101.10–$1,566.33	4% above	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC BONE IMAGING, WHOLE BODY - NM BONE WHOLE BODY	$1,483.00	$1,483.00	$101.10–$1,566.33	—	—
Breast ultrasound, complete, one breast one side CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST RIGHT COMPLETE	$429.00	$429.00	$39.45–$409.62	2% above	—
Breast ultrasound, complete, one breast one side CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST LEFT COMPLETE	$429.00	$429.00	$39.45–$409.62	2% above	—
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST RIGHT COMPLETE	$429.00	$429.00	$39.45–$409.62	—	—
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST LEFT COMPLETE	$429.00	$429.00	$39.45–$409.62	—	—
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST BILATERAL LIMITED	$319.00	$319.00	$32.79–$340.97	—	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST LEFT LIMITED	$319.00	$319.00	$32.79–$340.97	3% below	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST RIGHT LIMITED	$319.00	$319.00	$32.79–$340.97	3% below	—
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST BILATERAL LIMITED	$319.00	$319.00	$32.79–$340.97	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST RIGHT LIMITED	$319.00	$319.00	$32.79–$340.97	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST LEFT LIMITED	$319.00	$319.00	$32.79–$340.97	—	—
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT ANGIO ABD&PELV W/O&W/DYE - CT ANGIOGRAM ABDOMEN PELVIS W CONTRAST	$1,848.00	$1,848.00	$148.57–$1,755.60	18% below	—
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CT ANGIO ABD&PELV W/O&W/DYE - CT ANGIOGRAM ABDOMEN PELVIS W CONTRAST	$1,848.00	$1,848.00	$148.57–$1,755.60	—	—
CT angiography (CTA) of the head CPT 70496 HC CT ANGIO,HEAD COMBO - CT HEAD ANGIO W AND WO IV CONTRAST	$1,210.00	$1,210.00	$102.69–$1,149.50	13% below	—
CT angiography (CTA) of the head CPT 70496 HC CT ANGIO,HEAD COMBO - CT HEAD NECK ANGIO W AND WO IV CONTRAST	$1,210.00	$1,210.00	$102.69–$1,149.50	13% below	—
CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIO,HEAD COMBO - CT HEAD NECK ANGIO W AND WO IV CONTRAST	$1,210.00	$1,210.00	$102.69–$1,149.50	—	—
CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIO,HEAD COMBO - CT HEAD ANGIO W AND WO IV CONTRAST	$1,210.00	$1,210.00	$102.69–$1,149.50	—	—
CT angiography (CTA) of the neck CPT 70498 HC CT ANGIO,NECK COMBO - CT HEAD NECK ANGIO W AND WO IV CONTRAST	$1,210.00	$1,210.00	$102.69–$1,149.50	14% below	—
CT angiography (CTA) of the neck CPT 70498 HC CT ANGIO,NECK COMBO - CT NECK ANGIO W AND WO IV CONTRAST	$1,210.00	$1,210.00	$102.69–$1,149.50	14% below	—
CT angiography (CTA) of the neck inpatient CPT 70498 HC CT ANGIO,NECK COMBO - CT HEAD NECK ANGIO W AND WO IV CONTRAST	$1,210.00	$1,210.00	$102.69–$1,149.50	—	—
CT angiography (CTA) of the neck inpatient CPT 70498 HC CT ANGIO,NECK COMBO - CT NECK ANGIO W AND WO IV CONTRAST	$1,210.00	$1,210.00	$102.69–$1,149.50	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIO, CHEST, COMBO, INCL IMAGE - CT CHEST ANGIO W AND WO IV CONT	$2,330.00	$2,330.00	$104.05–$2,213.50	63% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST	$2,330.00	$2,330.00	$104.05–$2,213.50	63% above	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST	$2,330.00	$2,330.00	$104.05–$2,213.50	—	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIO, CHEST, COMBO, INCL IMAGE - CT CHEST ANGIO W AND WO IV CONT	$2,330.00	$2,330.00	$104.05–$2,213.50	—	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CT ANGIO HRT W/3D IMAGE - CT CCTA HEART W WO CONT CORONARIES & FUNCT	$888.00	$888.00	$126.94–$1,366.91	47% below	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CT ANGIO HRT W/3D IMAGE - CT HEART CORONARY ANGIOGRAM	$888.00	$888.00	$126.94–$1,366.91	47% below	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CT ANGIO HRT W/3D IMAGE - CT CCTA HEART W WO CONT CORONARIES & FUNCT	$888.00	$888.00	$126.94–$1,366.91	—	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CT ANGIO HRT W/3D IMAGE - CT HEART CORONARY ANGIOGRAM	$888.00	$888.00	$126.94–$1,366.91	—	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HRT W/O DYE W/CA TEST - CT HEART CALCIUM SCORING WO CONTRAST	$319.00	$319.00	$39.26–$340.97	219% above	—
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HRT W/O DYE W/CA TEST - CT HEART CALCIUM SCORING WO CONTRAST	$319.00	$319.00	$39.26–$340.97	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS W/O CONTRAST - CT ABDOMEN PELVIS WO CONTRAST	$1,777.00	$1,777.00	$72.54–$1,688.15	15% above	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS W/O CONTRAST - CT ABDOMEN PELVIS WO CONTRAST	$1,777.00	$1,777.00	$72.54–$1,688.15	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST	$3,246.15	$3,246.15	$118.20–$3,083.84	44% above	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST	$3,246.15	$3,246.15	$118.20–$3,083.84	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD & PELV 1/> REGNS - CT ABDOMEN PELVIS W WO CONTRAST	$2,802.00	$2,802.00	$132.34–$2,661.90	24% above	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD & PELV 1/> REGNS - CT ABDOMEN PELVIS W WO CONTRAST	$2,802.00	$2,802.00	$132.34–$2,661.90	—	—
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W/DYE - CT ABDOMEN W CONTRAST	$1,064.00	$1,064.00	$90.20–$1,010.80	5% below	—
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W/DYE - CT ABDOMEN W CONTRAST	$1,064.00	$1,064.00	$90.20–$1,010.80	—	—
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O DYE - CT ABDOMEN WO CONTRAST	$784.00	$784.00	$53.81–$744.80	13% below	—
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN W/O DYE - CT ABDOMEN WO CONTRAST	$784.00	$784.00	$53.81–$744.80	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST	$784.00	$784.00	$50.27–$744.80	6% below	—
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS FACIAL BONES WO CONT	$784.00	$784.00	$50.27–$744.80	6% below	—
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS WO CONTRAST	$784.00	$784.00	$50.27–$744.80	6% below	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS FACIAL BONES WO CONT	$784.00	$784.00	$50.27–$744.80	—	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS WO CONTRAST	$784.00	$784.00	$50.27–$744.80	—	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST	$784.00	$784.00	$50.27–$744.80	—	—
CT scan of the head or brain, no contrast dye CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST	$1,008.00	$1,008.00	$42.02–$957.60	6% above	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST	$1,008.00	$1,008.00	$42.02–$957.60	—	—
CT scan of the head with contrast CPT 70460 HC CT SCAN HEAD CONTRAST - CT HEAD W CONTRAST	$1,064.00	$1,064.00	$58.37–$1,010.80	3% below	—
CT scan of the head with contrast inpatient CPT 70460 HC CT SCAN HEAD CONTRAST - CT HEAD W CONTRAST	$1,064.00	$1,064.00	$58.37–$1,010.80	—	—
CT scan of the head without and with contrast CPT 70470 HC CT SCAN HEAD COMBO - CT HEAD W WO CONTRAST	$1,200.00	$1,200.00	$68.13–$1,140.00	5% below	—
CT scan of the head without and with contrast inpatient CPT 70470 HC CT SCAN HEAD COMBO - CT HEAD W WO CONTRAST	$1,200.00	$1,200.00	$68.13–$1,140.00	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT SCAN,LUMBAR SPINE,W/O CONTRAST - CT LUMBAR SPINE WO CONTRAST	$784.00	$784.00	$50.96–$744.80	10% below	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT SCAN,LUMBAR SPINE,W/O CONTRAST - CT LUMBAR SPINE WO CONTRAST	$784.00	$784.00	$50.96–$744.80	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT SCAN,CERVICAL SPINE,W/O CONTRAST - CT CERVICAL SPINE WO CONTRAST	$1,250.00	$1,250.00	$51.22–$1,187.50	43% above	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT SCAN,CERVICAL SPINE,W/O CONTRAST - CT CERVICAL SPINE WO CONTRAST	$1,250.00	$1,250.00	$51.22–$1,187.50	—	—
CT scan of the pelvis, with contrast dye CPT 72193 HC CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST	$1,064.00	$1,064.00	$88.61–$1,010.80	7% below	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST	$1,064.00	$1,064.00	$88.61–$1,010.80	—	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL,BILAT - CAROTID DUPLEX	$702.00	$702.00	$71.78–$934.86	—	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL,BILAT - CAROTID DUPLEX	$702.00	$702.00	$71.78–$934.86	—	—
Chest CT scan without and with contrast CPT 71270 HC CAT SCAN OF CHEST COMBO - CT CHEST W WO CONTRAST	$1,200.00	$1,200.00	$76.86–$1,140.00	15% below	—
Chest CT scan without and with contrast inpatient CPT 71270 HC CAT SCAN OF CHEST COMBO - CT CHEST W WO CONTRAST	$1,200.00	$1,200.00	$76.86–$1,140.00	—	—
Chest X-ray, 2 views CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS	$319.00	$319.00	$12.98–$340.97	27% above	—
Chest X-ray, 2 views CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - FL/XR CHEST 2 VIEWS W/ FLUORO	$319.00	$319.00	$12.98–$340.97	27% above	—
Chest X-ray, 2 views inpatient CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS	$319.00	$319.00	$12.98–$340.97	—	—
Chest X-ray, 2 views inpatient CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - FL/XR CHEST 2 VIEWS W/ FLUORO	$319.00	$319.00	$12.98–$340.97	—	—
Chest X-ray, single view CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST INSPIRATION EXPIRATION	$319.00	$319.00	$10.01–$340.97	43% above	—
Chest X-ray, single view CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST LATERAL DECUBITUS	$319.00	$319.00	$10.01–$340.97	43% above	—
Chest X-ray, single view CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST EXPIRATION ONLY	$319.00	$319.00	$10.01–$340.97	43% above	—
Chest X-ray, single view CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST 1 VIEW	$319.00	$319.00	$10.01–$340.97	43% above	—
Chest X-ray, single view inpatient CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST EXPIRATION ONLY	$319.00	$319.00	$10.01–$340.97	—	—
Chest X-ray, single view inpatient CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST 1 VIEW	$319.00	$319.00	$10.01–$340.97	—	—
Chest X-ray, single view inpatient CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST INSPIRATION EXPIRATION	$319.00	$319.00	$10.01–$340.97	—	—
Chest X-ray, single view inpatient CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST LATERAL DECUBITUS	$319.00	$319.00	$10.01–$340.97	—	—
Collarbone (clavicle) X-ray, complete CPT 73000 RADEX CLAVICLE COMPLETE	$65.00	$65.00	$12.52–$340.97	80% below	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 HC X-RAY CLAVICLE - XR CLAVICLE LEFT	$319.00	$319.00	$12.52–$340.97	at median	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 HC X-RAY CLAVICLE - XR CLAVICLE RIGHT	$319.00	$319.00	$12.52–$340.97	at median	—
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 RADEX CLAVICLE COMPLETE	$65.00	$65.00	$12.52–$340.97	—	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC X-RAY CLAVICLE - XR CLAVICLE LEFT	$319.00	$319.00	$12.52–$340.97	—	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC X-RAY CLAVICLE - XR CLAVICLE RIGHT	$319.00	$319.00	$12.52–$340.97	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - US RENAL COMPLETE	$449.00	$449.00	$41.56–$426.55	1% below	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - US RETROPERITONEUM	$449.00	$449.00	$41.56–$426.55	1% below	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - US RENAL COMPLETE	$449.00	$449.00	$41.56–$426.55	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - US RETROPERITONEUM	$449.00	$449.00	$41.56–$426.55	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY AXIAL - XR BONE DENSITY WITH SPECT LUMBAR	$429.00	$429.00	$15.10–$409.62	32% above	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY AXIAL - DEXA BONE DENSITY	$429.00	$429.00	$15.10–$409.62	32% above	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DXA BONE DENSITY AXIAL - DEXA BONE DENSITY	$429.00	$429.00	$15.10–$409.62	—	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DXA BONE DENSITY AXIAL - XR BONE DENSITY WITH SPECT LUMBAR	$429.00	$429.00	$15.10–$409.62	—	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION	$362.00	$362.00	$67.62–$934.86	44% below	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC OB US DETAILED SNGL FETUS - US OB DETAIL FETAL ANAT SING OR 1ST GEST	$905.00	$905.00	$67.62–$934.86	39% above	—
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION	$362.00	$362.00	$67.62–$934.86	—	—
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC OB US DETAILED SNGL FETUS - US OB DETAIL FETAL ANAT SING OR 1ST GEST	$905.00	$905.00	$67.62–$934.86	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT SCAN,THORAX,W/O CONTRAST - CT CHEST WO CONTRAST	$784.00	$784.00	$52.40–$744.80	8% below	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT SCAN,THORAX,W/O CONTRAST - CT CHEST WO CONTRAST	$784.00	$784.00	$52.40–$744.80	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CAT SCAN OF CHEST CONTRAST - CT CHEST W CONTRAST	$1,725.00	$1,725.00	$65.51–$1,638.75	56% above	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CAT SCAN OF CHEST CONTRAST - CT CHEST PULMONARY EMBOLISM W IV CONT	$1,725.00	$1,725.00	$65.51–$1,638.75	56% above	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CAT SCAN OF CHEST CONTRAST - CT CHEST W CONTRAST	$1,725.00	$1,725.00	$65.51–$1,638.75	—	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CAT SCAN OF CHEST CONTRAST - CT CHEST PULMONARY EMBOLISM W IV CONT	$1,725.00	$1,725.00	$65.51–$1,638.75	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI - MG BREAST BILATERAL POST BIOPSY CLIP	$361.00	$361.00	$33.68–$342.95	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI - MAMMO BREAST DIAGNOSTIC BILATERAL	$361.00	$361.00	$33.68–$342.95	—	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI - MAMMO BREAST DIAGNOSTIC BILATERAL	$361.00	$361.00	$33.68–$342.95	—	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI - MG BREAST BILATERAL POST BIOPSY CLIP	$361.00	$361.00	$33.68–$342.95	—	—
Diagnostic mammogram, one breast CPT 77065 HC XR MAMMO BIL SCREEN TO DIAG	$304.00	$304.00	$30.03–$288.80	5% below	—
Diagnostic mammogram, one breast CPT 77065 HC XR MAMMO DIAG UNI	$304.00	$304.00	$30.03–$288.80	5% below	—
Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MG BREAST LEFT POST BIOPSY CLIP	$304.00	$304.00	$30.03–$288.80	5% below	—
Diagnostic mammogram, one breast one side CPT 77065 HC RAD XR MAMMO UNI DIAGNOSTIC 3D WWO CAD - LEFT	$304.00	$304.00	—	5% below	—
Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS RIGHT	$304.00	$304.00	$30.03–$288.80	5% below	—
Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS LEFT	$304.00	$304.00	$30.03–$288.80	5% below	—
Diagnostic mammogram, one breast one side CPT 77065 HC RAD XR MAMMO UNI DIAGNOSTIC W IMPLANT WWO CAD - LEFT	$304.00	$304.00	—	5% below	—
Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MG BREAST RIGHT POST BIOPSY CLIP	$304.00	$304.00	$30.03–$288.80	5% below	—
Diagnostic mammogram, one breast one side CPT 77065 HC RAD XR MAMMO UNI DIAGNOSTIC W IMPLANT WWO CAD - RIGHT	$304.00	$304.00	—	5% below	—
Diagnostic mammogram, one breast one side CPT 77065 HC RAD XR MAMMO UNI IMPLANT W ADDL VIEWS WWO CAD - RIGHT	$304.00	$304.00	—	5% below	—
Diagnostic mammogram, one breast one side CPT 77065 HC RAD XR MAMMO UNI IMPLANT W ADDL VIEWS WWO CAD - LEFT	$304.00	$304.00	—	5% below	—
Diagnostic mammogram, one breast one side CPT 77065 HC RAD XR MAMMO UNI DIAGNOSTIC WWO CAD - RIGHT	$304.00	$304.00	—	5% below	—
Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC RIGHT	$304.00	$304.00	$30.03–$288.80	5% below	—
Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC LEFT	$304.00	$304.00	$30.03–$288.80	5% below	—
Diagnostic mammogram, one breast one side CPT 77065 HC RAD XR MAMMO UNI DIAGNOSTIC 3D WWO CAD - RIGHT	$304.00	$304.00	—	5% below	—
Diagnostic mammogram, one breast inpatient CPT 77065 HC XR MAMMO BIL SCREEN TO DIAG	$304.00	$304.00	$30.03–$288.80	—	—
Diagnostic mammogram, one breast inpatient CPT 77065 HC XR MAMMO DIAG UNI	$304.00	$304.00	$30.03–$288.80	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS RIGHT	$304.00	$304.00	$30.03–$288.80	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC RAD XR MAMMO UNI IMPLANT W ADDL VIEWS WWO CAD - RIGHT	$304.00	$304.00	—	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC RAD XR MAMMO UNI IMPLANT W ADDL VIEWS WWO CAD - LEFT	$304.00	$304.00	—	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC RAD XR MAMMO UNI DIAGNOSTIC WWO CAD - RIGHT	$304.00	$304.00	—	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC RAD XR MAMMO UNI DIAGNOSTIC W IMPLANT WWO CAD - RIGHT	$304.00	$304.00	—	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC RAD XR MAMMO UNI DIAGNOSTIC W IMPLANT WWO CAD - LEFT	$304.00	$304.00	—	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC RAD XR MAMMO UNI DIAGNOSTIC 3D WWO CAD - RIGHT	$304.00	$304.00	—	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC RAD XR MAMMO UNI DIAGNOSTIC 3D WWO CAD - LEFT	$304.00	$304.00	—	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MG BREAST RIGHT POST BIOPSY CLIP	$304.00	$304.00	$30.03–$288.80	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MG BREAST LEFT POST BIOPSY CLIP	$304.00	$304.00	$30.03–$288.80	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC RIGHT	$304.00	$304.00	$30.03–$288.80	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC LEFT	$304.00	$304.00	$30.03–$288.80	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS LEFT	$304.00	$304.00	$30.03–$288.80	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - US LOWER EXTREMITY ARTERIES BILATERAL	$702.00	$702.00	$90.24–$934.86	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - FEMORAL POPLITEAL ANEURYSM DUPLEX	$702.00	$702.00	$90.24–$934.86	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC VASC DUPLEX LO EXTREM ART BILAT	$702.00	$702.00	$90.24–$934.86	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - LOWER EXTREMITY ARTERIAL BYPASS GFT DUP	$702.00	$702.00	$90.24–$934.86	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - CV US DOPPLER ARTERIAL LEGS BILATERAL	$702.00	$702.00	$90.24–$934.86	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - LOWER EXTREMITY ARTERIAL DUPLEX	$702.00	$702.00	$90.24–$934.86	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - CV US DOPPLER ARTERIAL LEGS BILATERAL	$702.00	$702.00	$90.24–$934.86	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - LOWER EXTREMITY ARTERIAL BYPASS GFT DUP	$702.00	$702.00	$90.24–$934.86	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - US LOWER EXTREMITY ARTERIES BILATERAL	$702.00	$702.00	$90.24–$934.86	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - LOWER EXTREMITY ARTERIAL DUPLEX	$702.00	$702.00	$90.24–$934.86	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC VASC DUPLEX LO EXTREM ART BILAT	$702.00	$702.00	$90.24–$934.86	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - FEMORAL POPLITEAL ANEURYSM DUPLEX	$702.00	$702.00	$90.24–$934.86	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC EXTREMITY STUDY - US LOWER EXTREMITY VEINS BILATERAL	$702.00	$702.00	$70.57–$934.86	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC VASC DUPLEX EXTREM VENOUS,BILAT	$702.00	$702.00	$70.57–$934.86	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - UPPER EXTREMITY DVT	$702.00	$702.00	$70.57–$934.86	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - CV US DOPPLER VENOUS LEGS BILATERAL	$702.00	$702.00	$70.57–$934.86	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - LOWER EXTREMITY DVT	$702.00	$702.00	$70.57–$934.86	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - VENOUS REFLUX DUPLEX	$702.00	$702.00	$70.57–$934.86	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC EXTREMITY STUDY - US UPPER EXTREMITY VEINS BILATERAL	$702.00	$702.00	$70.57–$934.86	—	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - LOWER EXTREMITY DVT	$702.00	$702.00	$70.57–$934.86	—	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC VASC DUPLEX EXTREM VENOUS,BILAT	$702.00	$702.00	$70.57–$934.86	—	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC EXTREMITY STUDY - US UPPER EXTREMITY VEINS BILATERAL	$702.00	$702.00	$70.57–$934.86	—	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC EXTREMITY STUDY - US LOWER EXTREMITY VEINS BILATERAL	$702.00	$702.00	$70.57–$934.86	—	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - VENOUS REFLUX DUPLEX	$702.00	$702.00	$70.57–$934.86	—	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - UPPER EXTREMITY DVT	$702.00	$702.00	$70.57–$934.86	—	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - CV US DOPPLER VENOUS LEGS BILATERAL	$702.00	$702.00	$70.57–$934.86	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE W/DOPPLER COMPLETE - TTE COMPLETE	$2,083.35	$2,083.35	$75.16–$2,140.89	20% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE W/DOPPLER COMPLETE - TTE COMPLETE W/BUBBLES	$2,083.35	$2,083.35	$75.16–$2,140.89	20% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE W/DOPPLER COMPLETE - TTE COMPLETE	$2,083.35	$2,083.35	$75.16–$2,140.89	—	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE W/DOPPLER COMPLETE - TTE COMPLETE W/BUBBLES	$2,083.35	$2,083.35	$75.16–$2,140.89	—	—
Elbow X-ray, 2 views CPT 73070 RADEX ELBOW 2 VIEWS	$59.00	$59.00	$11.25–$340.97	76% below	—
Elbow X-ray, 2 views one side CPT 73070 HC X-RAY ELBOW 2 VW - XR ELBOW 1-2 VIEWS RIGHT	$319.00	$319.00	$11.25–$340.97	29% above	—
Elbow X-ray, 2 views one side CPT 73070 HC X-RAY ELBOW 2 VW - XR ELBOW 1-2 VIEWS LEFT	$319.00	$319.00	$11.25–$340.97	29% above	—
Elbow X-ray, 2 views inpatient CPT 73070 RADEX ELBOW 2 VIEWS	$59.00	$59.00	$11.25–$340.97	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 HC X-RAY ELBOW 2 VW - XR ELBOW 1-2 VIEWS RIGHT	$319.00	$319.00	$11.25–$340.97	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 HC X-RAY ELBOW 2 VW - XR ELBOW 1-2 VIEWS LEFT	$319.00	$319.00	$11.25–$340.97	—	—
Elbow X-ray, complete, 3 or more views CPT 73080 RADEX ELBOW COMPLETE MINIMUM 3 VIEWS	$66.00	$66.00	$12.53–$340.97	79% below	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC X-RAY ELBOW 3+ VW - XR ELBOW 3+ VIEWS LEFT	$319.00	$319.00	$12.53–$340.97	1% above	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC X-RAY ELBOW 3+ VW - XR ELBOW 3+ VIEWS RIGHT	$319.00	$319.00	$12.53–$340.97	1% above	—
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 RADEX ELBOW COMPLETE MINIMUM 3 VIEWS	$66.00	$66.00	$12.53–$340.97	—	—
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC X-RAY ELBOW 3+ VW - XR ELBOW 3+ VIEWS LEFT	$319.00	$319.00	$12.53–$340.97	—	—
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC X-RAY ELBOW 3+ VW - XR ELBOW 3+ VIEWS RIGHT	$319.00	$319.00	$12.53–$340.97	—	—
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT SCAN,ORBIT/SELLA/POST FOSSA/EAR,W/O - CT ORBITS/SELLA WO IV CONT	$784.00	$784.00	$62.56–$744.80	8% below	—
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT SCAN,ORBIT/SELLA/POST FOSSA/EAR,W/O - CT AUDITORY CANALS WO CONT	$784.00	$784.00	$62.56–$744.80	8% below	—
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT SCAN,ORBIT/SELLA/POST FOSSA/EAR,W/O - CT ORBITS/SELLA WO IV CONT	$784.00	$784.00	$62.56–$744.80	—	—
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT SCAN,ORBIT/SELLA/POST FOSSA/EAR,W/O - CT AUDITORY CANALS WO CONT	$784.00	$784.00	$62.56–$744.80	—	—
Facial bones X-ray, complete, 3 or more views CPT 70150 HC X-RAY FACIAL BONES 3+ VW - XR FACIAL BONES 3+ VIEWS	$429.00	$429.00	$17.97–$409.62	43% above	—
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC X-RAY FACIAL BONES 3+ VW - XR FACIAL BONES 3+ VIEWS	$429.00	$429.00	$17.97–$409.62	—	—
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 HC X-RAY FOREARM 2 VW - XR FOREARM 2 VIEWS BILATERAL	$319.00	$319.00	$11.25–$340.97	—	—
Forearm X-ray (radius and ulna), 2 views CPT 73090 RADEX FOREARM 2 VIEWS	$59.00	$59.00	$11.25–$340.97	80% below	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC X-RAY FOREARM 2 VW - XR FOREARM 2 VIEWS RIGHT	$319.00	$319.00	$11.25–$340.97	9% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC X-RAY FOREARM 2 VW - XR FOREARM 2 VIEWS LEFT	$319.00	$319.00	$11.25–$340.97	9% above	—
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 HC X-RAY FOREARM 2 VW - XR FOREARM 2 VIEWS BILATERAL	$319.00	$319.00	$11.25–$340.97	—	—
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 RADEX FOREARM 2 VIEWS	$59.00	$59.00	$11.25–$340.97	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC X-RAY FOREARM 2 VW - XR FOREARM 2 VIEWS RIGHT	$319.00	$319.00	$11.25–$340.97	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC X-RAY FOREARM 2 VW - XR FOREARM 2 VIEWS LEFT	$319.00	$319.00	$11.25–$340.97	—	—
Hand X-ray, 2 views one side CPT 73120 HC X-RAY HAND 2 VW - XR HAND 1-2 VIEWS LEFT	$429.00	$429.00	$12.01–$409.62	57% above	—
Hand X-ray, 2 views one side CPT 73120 HC X-RAY HAND 2 VW - XR HAND 1-2 VIEWS RIGHT	$429.00	$429.00	$12.01–$409.62	57% above	—
Hand X-ray, 2 views inpatient one side CPT 73120 HC X-RAY HAND 2 VW - XR HAND 1-2 VIEWS RIGHT	$429.00	$429.00	$12.01–$409.62	—	—
Hand X-ray, 2 views inpatient one side CPT 73120 HC X-RAY HAND 2 VW - XR HAND 1-2 VIEWS LEFT	$429.00	$429.00	$12.01–$409.62	—	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC X-RAY HEEL - XR CALCANEUS 1 VIEW LEFT	$319.00	$319.00	—	1% below	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC X-RAY HEEL - XR CALCANEUS 2 VIEWS LEFT	$319.00	$319.00	$10.87–$340.97	1% below	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC X-RAY HEEL - XR CALCANEUS 1 VIEW RIGHT	$319.00	$319.00	—	1% below	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC X-RAY HEEL - XR CALCANEUS 2 VIEWS RIGHT	$319.00	$319.00	$10.87–$340.97	1% below	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC X-RAY HEEL - XR CALCANEUS 1 VIEW LEFT	$319.00	$319.00	—	—	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC X-RAY HEEL - XR CALCANEUS 2 VIEWS LEFT	$319.00	$319.00	$10.87–$340.97	—	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC X-RAY HEEL - XR CALCANEUS 2 VIEWS RIGHT	$319.00	$319.00	$10.87–$340.97	—	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC X-RAY HEEL - XR CALCANEUS 1 VIEW RIGHT	$319.00	$319.00	—	—	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT	$98.00	$98.00	$37.43–$846.00	86% below	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT	$192.00	$192.00	$37.43–$846.00	73% below	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT	$98.00	$98.00	$37.43–$846.00	—	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT	$192.00	$192.00	$37.43–$846.00	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND	$1,044.50	$1,044.50	$251.68–$3,364.60	67% below	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND	$1,308.00	$1,308.00	$251.68–$3,364.60	59% below	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAPHY =>6YRS =>4 PARAM W CPAP OR BILEVEL RED SVC	$2,806.00	$2,806.00	$251.68–$3,364.60	12% below	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND	$1,044.50	$1,044.50	$251.68–$3,364.60	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND	$1,308.00	$1,308.00	$251.68–$3,364.60	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNOGRAPHY =>6YRS =>4 PARAM W CPAP OR BILEVEL RED SVC	$2,806.00	$2,806.00	$251.68–$3,364.60	—	—
Knee X-ray, 3 views CPT 73562 RADIOLOGIC EXAMINATION KNEE 3 VIEWS	$82.00	$82.00	$15.59–$340.97	77% below	—
Knee X-ray, 3 views one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS RIGHT	$319.00	$319.00	$15.59–$340.97	9% below	—
Knee X-ray, 3 views one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS LEFT	$319.00	$319.00	$15.59–$340.97	9% below	—
Knee X-ray, 3 views inpatient CPT 73562 RADIOLOGIC EXAMINATION KNEE 3 VIEWS	$82.00	$82.00	$15.59–$340.97	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS RIGHT	$319.00	$319.00	$15.59–$340.97	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS LEFT	$319.00	$319.00	$15.59–$340.97	—	—
Knee X-ray, complete, 4 or more views both sides CPT 73564 HC X-RAY KNEE 4+ VIEW - HIP TO ANKLE BILATERAL	$429.00	$429.00	$18.18–$409.62	—	—
Knee X-ray, complete, 4 or more views CPT 73564 RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS	$95.00	$95.00	$18.18–$409.62	73% below	—
Knee X-ray, complete, 4 or more views one side CPT 73564 HC X-RAY KNEE 4+ VIEW - HIP TO ANKLE LEFT	$429.00	$429.00	$18.18–$409.62	20% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 HC X-RAY KNEE 4+ VIEW - XR KNEE 4+ VIEWS RIGHT	$429.00	$429.00	—	20% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 HC X-RAY KNEE 4+ VIEW - XR KNEE 4+ VIEWS LEFT	$429.00	$429.00	$18.18–$409.62	20% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 HC X-RAY KNEE 4+ VIEW - HIP TO ANKLE RIGHT	$429.00	$429.00	$18.18–$409.62	20% above	—
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 HC X-RAY KNEE 4+ VIEW - HIP TO ANKLE BILATERAL	$429.00	$429.00	$18.18–$409.62	—	—
Knee X-ray, complete, 4 or more views inpatient CPT 73564 RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS	$95.00	$95.00	$18.18–$409.62	—	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC X-RAY KNEE 4+ VIEW - XR KNEE 4+ VIEWS RIGHT	$429.00	$429.00	—	—	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC X-RAY KNEE 4+ VIEW - XR KNEE 4+ VIEWS LEFT	$429.00	$429.00	$18.18–$409.62	—	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC X-RAY KNEE 4+ VIEW - HIP TO ANKLE RIGHT	$429.00	$429.00	$18.18–$409.62	—	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC X-RAY KNEE 4+ VIEW - HIP TO ANKLE LEFT	$429.00	$429.00	$18.18–$409.62	—	—
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT HIP MAKO	$784.00	$784.00	$51.09–$744.80	22% below	—
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT KNEE MAKO	$784.00	$784.00	$51.09–$744.80	22% below	—
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	22% below	—
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LWR EXT WO	$784.00	$784.00	$51.09–$744.80	22% below	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT HIP RIGHT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	22% below	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT ANKLE RIGHT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	22% below	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT ANKLE LEFT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	22% below	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FEMUR LEFT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	22% below	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FEMUR RIGHT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	22% below	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FOOT LEFT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	22% below	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FOOT RIGHT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	22% below	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT HIP LEFT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	22% below	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT KNEE LEFT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	22% below	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT KNEE RIGHT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	22% below	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT TIBIA FIBULA LT WO IV CONT	$784.00	$784.00	—	22% below	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT TIBIA FIBULA RT WO IV CONT	$784.00	$784.00	—	22% below	—
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT KNEE MAKO	$784.00	$784.00	$51.09–$744.80	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LWR EXT WO	$784.00	$784.00	$51.09–$744.80	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT HIP MAKO	$784.00	$784.00	$51.09–$744.80	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT KNEE LEFT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT HIP RIGHT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT ANKLE LEFT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT TIBIA FIBULA LT WO IV CONT	$784.00	$784.00	—	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT HIP LEFT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FOOT RIGHT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FOOT LEFT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FEMUR LEFT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FEMUR RIGHT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT KNEE RIGHT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT ANKLE RIGHT WO IV CONTRAST	$784.00	$784.00	$51.09–$744.80	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT TIBIA FIBULA RT WO IV CONT	$784.00	$784.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US PELVIS APPENDIX	$449.00	$449.00	$33.50–$426.55	2% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US ENDOANAL	$449.00	$449.00	$33.50–$426.55	2% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US LOWER BACK	$449.00	$449.00	$33.50–$426.55	2% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US RECTUM	$449.00	$449.00	$33.50–$426.55	2% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US GALLBLADDER	$449.00	$449.00	$33.50–$426.55	2% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED SPLEEN	$449.00	$449.00	$33.50–$426.55	2% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED LIVER	$449.00	$449.00	$33.50–$426.55	2% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED	$449.00	$449.00	$33.50–$426.55	2% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC ED US ABDOMEN LIMITED	$449.00	$449.00	$33.50–$426.55	2% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US PELVIS APPENDIX	$449.00	$449.00	$33.50–$426.55	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED LIVER	$449.00	$449.00	$33.50–$426.55	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED	$449.00	$449.00	$33.50–$426.55	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC ED US ABDOMEN LIMITED	$449.00	$449.00	$33.50–$426.55	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED SPLEEN	$449.00	$449.00	$33.50–$426.55	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US RECTUM	$449.00	$449.00	$33.50–$426.55	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US GALLBLADDER	$449.00	$449.00	$33.50–$426.55	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US LOWER BACK	$449.00	$449.00	$33.50–$426.55	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US ENDOANAL	$449.00	$449.00	$33.50–$426.55	—	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US EXT NON-VASC LIMITED, REALTIME W/ IMG	$429.00	$429.00	$25.07–$409.62	8% above	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US AXILLA	$429.00	$429.00	$25.07–$409.62	8% above	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US LMTD JT/NONVASC XTR STRUX - US WRIST LEFT LIMITED	$429.00	$429.00	—	8% above	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US LMTD JT/NONVASC XTR STRUX - US KNEE RIGHT LIMITED	$429.00	$429.00	—	8% above	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US LMTD JT/NONVASC XTR STRUX - US WRIST RIGHT LIMITED	$429.00	$429.00	—	8% above	—
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US EXT NON-VASC LIMITED, REALTIME W/ IMG	$429.00	$429.00	$25.07–$409.62	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US AXILLA	$429.00	$429.00	$25.07–$409.62	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC US LMTD JT/NONVASC XTR STRUX - US WRIST RIGHT LIMITED	$429.00	$429.00	—	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC US LMTD JT/NONVASC XTR STRUX - US KNEE RIGHT LIMITED	$429.00	$429.00	—	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC US LMTD JT/NONVASC XTR STRUX - US WRIST LEFT LIMITED	$429.00	$429.00	—	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT CHEST LOW DOSE LUNG CANCER SCREENING	$429.00	$429.00	$54.11–$409.62	47% below	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC LDCT FOR LUNG CA SCREEN - LDCT LUNG SCREENING	$429.00	$429.00	$54.11–$409.62	47% below	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT CHEST LOW DOSE LUNG CANCER SCREENING	$429.00	$429.00	$54.11–$409.62	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC LDCT FOR LUNG CA SCREEN - LDCT LUNG SCREENING	$429.00	$429.00	$54.11–$409.62	—	—
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS	$63.00	$63.00	$12.14–$340.97	81% below	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC X-RAY TIB + FIB, 2VW - XR TIBIA FIBULA 2 VIEWS RIGHT	$319.00	$319.00	$12.14–$340.97	6% below	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC X-RAY TIB + FIB, 2VW - XR TIBIA FIBULA 2 VIEWS LEFT	$319.00	$319.00	$12.14–$340.97	6% below	—
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS	$63.00	$63.00	$12.14–$340.97	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC X-RAY TIB + FIB, 2VW - XR TIBIA FIBULA 2 VIEWS LEFT	$319.00	$319.00	$12.14–$340.97	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC X-RAY TIB + FIB, 2VW - XR TIBIA FIBULA 2 VIEWS RIGHT	$319.00	$319.00	$12.14–$340.97	—	—
MR angiography (MRA) of the head without contrast CPT 70544 HC MR ANGIO, HEAD - MR HEAD ANGIO WO IV CONTRAST	$1,527.00	$1,527.00	$84.28–$1,450.65	3% below	—
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MR ANGIO, HEAD - MR HEAD ANGIO WO IV CONTRAST	$1,527.00	$1,527.00	$84.28–$1,450.65	—	—
MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MRI BREAST W/OUT&WITH CONTRAST W/CAD BILATERAL	$1,038.00	$1,038.00	$102.55–$986.10	—	—
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HC MRI BREAST W/OUT&WITH CONTRAST W/CAD BILATERAL	$1,038.00	$1,038.00	$102.55–$986.10	—	—
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT WO IV CONT	$1,527.00	$1,527.00	$79.72–$1,450.65	13% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT LT W IV CONT	$1,527.00	$1,527.00	—	13% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT LT WO IV CONT	$1,527.00	$1,527.00	—	13% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT RT W IV CONT	$1,527.00	$1,527.00	—	13% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT RT WO IV CONT	$1,527.00	$1,527.00	—	13% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE LT WO CONT	$1,527.00	$1,527.00	—	13% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE RT WO CONT	$1,527.00	$1,527.00	—	13% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP LT WO CONT	$1,527.00	$1,527.00	—	13% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP LT WO CONT	$1,527.00	$1,527.00	$79.72–$1,450.65	13% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP RT WO CONT	$1,527.00	$1,527.00	—	13% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP RT WO CONT	$1,527.00	$1,527.00	$79.72–$1,450.65	13% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI KNEE LT WO CONT	$1,527.00	$1,527.00	—	13% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI KNEE RT WO CONT	$1,527.00	$1,527.00	—	13% below	—
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT WO IV CONT	$1,527.00	$1,527.00	$79.72–$1,450.65	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP RT WO CONT	$1,527.00	$1,527.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT LT W IV CONT	$1,527.00	$1,527.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT LT WO IV CONT	$1,527.00	$1,527.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT RT W IV CONT	$1,527.00	$1,527.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT RT WO IV CONT	$1,527.00	$1,527.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI KNEE RT WO CONT	$1,527.00	$1,527.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI KNEE LT WO CONT	$1,527.00	$1,527.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP RT WO CONT	$1,527.00	$1,527.00	$79.72–$1,450.65	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE LT WO CONT	$1,527.00	$1,527.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE RT WO CONT	$1,527.00	$1,527.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP LT WO CONT	$1,527.00	$1,527.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP LT WO CONT	$1,527.00	$1,527.00	$79.72–$1,450.65	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI LWR EXT JNT W W/O RT	$2,210.00	$2,210.00	—	2% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR HIP RIGHT W AND WO IV CONTRAST	$2,210.00	$2,210.00	$149.90–$2,099.50	2% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR KNEE LEFT W AND WO IV CONTRAST	$2,210.00	$2,210.00	$149.90–$2,099.50	2% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR KNEE RIGHT W AND WO IV CONTRAST	$2,210.00	$2,210.00	$149.90–$2,099.50	2% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI LWR EXT JNT W W/O LT	$2,210.00	$2,210.00	—	2% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR ANKLE LEFT W AND WO IV CONTRAST	$2,210.00	$2,210.00	$149.90–$2,099.50	2% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR ANKLE RIGHT W AND WO IV CONTRAST	$2,210.00	$2,210.00	$149.90–$2,099.50	2% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR HIP LEFT W AND WO IV CONTRAST	$2,210.00	$2,210.00	$149.90–$2,099.50	2% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR ANKLE RIGHT W AND WO IV CONTRAST	$2,210.00	$2,210.00	$149.90–$2,099.50	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR KNEE LEFT W AND WO IV CONTRAST	$2,210.00	$2,210.00	$149.90–$2,099.50	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR KNEE RIGHT W AND WO IV CONTRAST	$2,210.00	$2,210.00	$149.90–$2,099.50	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI LWR EXT JNT W W/O RT	$2,210.00	$2,210.00	—	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR HIP LEFT W AND WO IV CONTRAST	$2,210.00	$2,210.00	$149.90–$2,099.50	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI LWR EXT JNT W W/O LT	$2,210.00	$2,210.00	—	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR ANKLE LEFT W AND WO IV CONTRAST	$2,210.00	$2,210.00	$149.90–$2,099.50	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR HIP RIGHT W AND WO IV CONTRAST	$2,210.00	$2,210.00	$149.90–$2,099.50	—	—
MRI of the abdomen without contrast CPT 74181 HC MRI, ABDOMEN (MRI) - MRI ABDOMEN WO CONTRAST MRCP	$1,527.00	$1,527.00	$76.81–$1,450.65	5% below	—
MRI of the abdomen without contrast CPT 74181 HC MRI, ABDOMEN (MRI) - MRI ABDOMEN WO CONTRAST	$1,527.00	$1,527.00	$76.81–$1,450.65	5% below	—
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI, ABDOMEN (MRI) - MRI ABDOMEN WO CONTRAST	$1,527.00	$1,527.00	$76.81–$1,450.65	—	—
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI, ABDOMEN (MRI) - MRI ABDOMEN WO CONTRAST MRCP	$1,527.00	$1,527.00	$76.81–$1,450.65	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN W WO CONTRAST MRCP	$2,210.00	$2,210.00	$132.33–$2,099.50	2% below	—
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN RENAL W WO CONTRAST	$2,210.00	$2,210.00	$132.33–$2,099.50	2% below	—
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN W WO CONTRAST	$2,210.00	$2,210.00	$132.33–$2,099.50	2% below	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN RENAL W WO CONTRAST	$2,210.00	$2,210.00	$132.33–$2,099.50	—	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN W WO CONTRAST MRCP	$2,210.00	$2,210.00	$132.33–$2,099.50	—	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN W WO CONTRAST	$2,210.00	$2,210.00	$132.33–$2,099.50	—	—
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN - MR PITUITARY WO IV CONTRAST	$1,527.00	$1,527.00	$77.22–$1,450.65	10% below	—
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN - MRI BRAIN WO CONTRAST	$1,527.00	$1,527.00	$77.22–$1,450.65	10% below	—
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN - MRI BRAIN WO CONTRAST	$1,527.00	$1,527.00	$77.22–$1,450.65	—	—
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN - MR PITUITARY WO IV CONTRAST	$1,527.00	$1,527.00	$77.22–$1,450.65	—	—
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST	$2,210.00	$2,210.00	$125.15–$2,099.50	2% below	—
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN COMBO - MR PITUITARY W/WO IV CONTRAST	$2,210.00	$2,210.00	$125.15–$2,099.50	2% below	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN COMBO - MR PITUITARY W/WO IV CONTRAST	$2,210.00	$2,210.00	$125.15–$2,099.50	—	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST	$2,210.00	$2,210.00	$125.15–$2,099.50	—	—
MRI of the lower back, no contrast dye CPT 72148 HC MRI, LUMBAR SPINE - MRI LUMBAR SPINE WO CONTRAST	$1,527.00	$1,527.00	$75.19–$1,450.65	5% below	—
MRI of the lower back, no contrast dye CPT 72148 HC MRI, LUMBAR SPINE - MRI COMPLETE SPINE WO CONTRAST	$1,527.00	$1,527.00	$75.19–$1,450.65	5% below	—
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI, LUMBAR SPINE - MRI LUMBAR SPINE WO CONTRAST	$1,527.00	$1,527.00	$75.19–$1,450.65	—	—
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI, LUMBAR SPINE - MRI COMPLETE SPINE WO CONTRAST	$1,527.00	$1,527.00	$75.19–$1,450.65	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI, LUMBAR SPINE COMBO - MRI LUMBAR SPINE W WO CONTRAST	$2,210.00	$2,210.00	$125.27–$2,099.50	3% below	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI, LUMBAR SPINE COMBO - MRI LUMBAR SPINE W WO CONTRAST	$2,210.00	$2,210.00	$125.27–$2,099.50	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI, DORSAL SPINE - MRI COMPLETE SPINE WO CONTRAST	$1,527.00	$1,527.00	$75.06–$1,450.65	7% below	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI, DORSAL SPINE - MRI THORACIC SPINE WO CONTRAST	$1,527.00	$1,527.00	$75.06–$1,450.65	7% below	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI, DORSAL SPINE - MRI THORACIC SPINE WO CONTRAST	$1,527.00	$1,527.00	$75.06–$1,450.65	—	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI, DORSAL SPINE - MRI COMPLETE SPINE WO CONTRAST	$1,527.00	$1,527.00	$75.06–$1,450.65	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI, CERV SPINE COMBO - MRI CERVICAL SPINE W WO CONTRAST	$2,210.00	$2,210.00	$125.53–$2,099.50	2% below	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI, CERV SPINE COMBO - MRI CERVICAL SPINE W WO CONTRAST	$2,210.00	$2,210.00	$125.53–$2,099.50	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI, CERV SPINE - MRI COMPLETE SPINE WO CONTRAST	$1,965.00	$1,965.00	$74.94–$1,866.75	21% above	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI, CERV SPINE - MRI CERVICAL SPINE WO CONTRAST	$1,965.00	$1,965.00	$74.94–$1,866.75	21% above	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI, CERV SPINE - MRI COMPLETE SPINE WO CONTRAST	$1,965.00	$1,965.00	$74.94–$1,866.75	—	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI, CERV SPINE - MRI CERVICAL SPINE WO CONTRAST	$1,965.00	$1,965.00	$74.94–$1,866.75	—	—
MRI of the pelvis without and with contrast CPT 72197 HC MRI, PELVIS, COMBO - MRI PELVIS W WO CONTRAST	$2,210.00	$2,210.00	$131.82–$2,099.50	2% below	—
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI, PELVIS, COMBO - MRI PELVIS W WO CONTRAST	$2,210.00	$2,210.00	$131.82–$2,099.50	—	—
MRI of the pelvis, no contrast dye CPT 72195 HC MRI, PELVIS, W/O CONTRAST - MRI PELVIS WO CONTRAST	$1,527.00	$1,527.00	$89.37–$1,450.65	7% below	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI, PELVIS, W/O CONTRAST - MRI PELVIS WO CONTRAST	$1,527.00	$1,527.00	$89.37–$1,450.65	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXT JNT	$1,527.00	$1,527.00	$79.84–$1,450.65	17% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI, JOINT UPPER EXTREM - MR BRACHIAL PLEXUS WO IV CONTRAST	$1,527.00	$1,527.00	$79.84–$1,450.65	17% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR SHOULDER LEFT WO IV CONTRAST	$1,527.00	$1,527.00	$79.84–$1,450.65	17% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR ELBOW RIGHT WO IV CONTRAST	$1,527.00	$1,527.00	$79.84–$1,450.65	17% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR ELBOW LEFT WO IV CONTRAST	$1,527.00	$1,527.00	$79.84–$1,450.65	17% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR SHOULDER RIGHT WO IV CONTRAST	$1,527.00	$1,527.00	$79.84–$1,450.65	17% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR WRIST LEFT WO IV CONTRAST	$1,527.00	$1,527.00	$79.84–$1,450.65	17% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR WRIST RIGHT WO IV CONTRAST	$1,527.00	$1,527.00	$79.84–$1,450.65	17% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXT JNT	$1,527.00	$1,527.00	$79.84–$1,450.65	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI, JOINT UPPER EXTREM - MR BRACHIAL PLEXUS WO IV CONTRAST	$1,527.00	$1,527.00	$79.84–$1,450.65	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR ELBOW RIGHT WO IV CONTRAST	$1,527.00	$1,527.00	$79.84–$1,450.65	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR SHOULDER RIGHT WO IV CONTRAST	$1,527.00	$1,527.00	$79.84–$1,450.65	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR SHOULDER LEFT WO IV CONTRAST	$1,527.00	$1,527.00	$79.84–$1,450.65	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR WRIST RIGHT WO IV CONTRAST	$1,527.00	$1,527.00	$79.84–$1,450.65	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR ELBOW LEFT WO IV CONTRAST	$1,527.00	$1,527.00	$79.84–$1,450.65	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR WRIST LEFT WO IV CONTRAST	$1,527.00	$1,527.00	$79.84–$1,450.65	—	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC RADEX SPINE CERVICAL 4 OR 5 VIEWS - XR CERVICAL SPINE COMP 4-5 VIEWS	$429.00	$429.00	$20.78–$409.62	18% above	—
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC RADEX SPINE CERVICAL 4 OR 5 VIEWS - XR CERVICAL SPINE COMP 4-5 VIEWS	$429.00	$429.00	$20.78–$409.62	—	—
Neck soft tissue CT scan with contrast CPT 70491 HC CT NECK TISSUE CONTRAST - CT SOFT TISSUE NECK W CONTRAST	$1,064.00	$1,064.00	$72.33–$1,010.80	4% below	—
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT NECK TISSUE CONTRAST - CT SOFT TISSUE NECK W CONTRAST	$1,064.00	$1,064.00	$72.33–$1,010.80	—	—
Neck soft tissue CT scan without contrast CPT 70490 HC CT SCAN,SOFT TISSUE NECK,W/O CONTRAST - CT SOFT TISSUE NECK WO CONT	$784.00	$784.00	$59.20–$744.80	8% below	—
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT SCAN,SOFT TISSUE NECK,W/O CONTRAST - CT SOFT TISSUE NECK WO CONT	$784.00	$784.00	$59.20–$744.80	—	—
Neck soft tissue X-ray CPT 70360 HC X-RAY NECK SOFT TISSUE - XR NECK SOFT TISSUE LATERAL	$319.00	$319.00	$12.04–$340.97	44% above	—
Neck soft tissue X-ray CPT 70360 HC X-RAY NECK SOFT TISSUE - XR NECK SOFT TISSUE	$319.00	$319.00	$12.04–$340.97	44% above	—
Neck soft tissue X-ray inpatient CPT 70360 HC X-RAY NECK SOFT TISSUE - XR NECK SOFT TISSUE LATERAL	$319.00	$319.00	$12.04–$340.97	—	—
Neck soft tissue X-ray inpatient CPT 70360 HC X-RAY NECK SOFT TISSUE - XR NECK SOFT TISSUE	$319.00	$319.00	$12.04–$340.97	—	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST REGADENOSON W MYOCARD PERF	$5,139.00	$5,139.00	$161.71–$5,072.52	35% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST DIPYRIDAMOLE W MYOCARD PERF	$5,139.00	$5,139.00	$161.71–$5,072.52	35% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST ADENOSINE W MYOCARD PERF	$5,139.00	$5,139.00	$161.71–$5,072.52	35% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - NM HEART PERFUSION SPECT STRESS & REST	$5,139.00	$5,139.00	$161.71–$5,072.52	35% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST EXERCISE W MYOCARD PERF	$5,139.00	$5,139.00	$161.71–$5,072.52	35% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST DOBUTAMINE W MYOCARD PERF	$5,139.00	$5,139.00	$161.71–$5,072.52	35% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC MYOCARDIAL SPECT MULTIPLE STUDIES	$5,139.00	$5,139.00	$161.71–$5,072.52	35% above	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST ADENOSINE W MYOCARD PERF	$5,139.00	$5,139.00	$161.71–$5,072.52	—	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST EXERCISE W MYOCARD PERF	$5,139.00	$5,139.00	$161.71–$5,072.52	—	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - NM HEART PERFUSION SPECT STRESS & REST	$5,139.00	$5,139.00	$161.71–$5,072.52	—	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST DIPYRIDAMOLE W MYOCARD PERF	$5,139.00	$5,139.00	$161.71–$5,072.52	—	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC MYOCARDIAL SPECT MULTIPLE STUDIES	$5,139.00	$5,139.00	$161.71–$5,072.52	—	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST DOBUTAMINE W MYOCARD PERF	$5,139.00	$5,139.00	$161.71–$5,072.52	—	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST REGADENOSON W MYOCARD PERF	$5,139.00	$5,139.00	$161.71–$5,072.52	—	—
Pelvic CT scan without contrast CPT 72192 HC CT SCAN,PELVIS,W/O CONTRAST - CT PELVIS WO CONTRAST	$784.00	$784.00	$52.42–$744.80	11% below	—
Pelvic CT scan without contrast inpatient CPT 72192 HC CT SCAN,PELVIS,W/O CONTRAST - CT PELVIS WO CONTRAST	$784.00	$784.00	$52.42–$744.80	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U	$100.00	$100.00	$19.49–$409.62	74% below	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED BLADDER	$429.00	$429.00	$19.49–$409.62	11% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED	$429.00	$429.00	$19.49–$409.62	11% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED FOLLICLES	$429.00	$429.00	$19.49–$409.62	11% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U	$100.00	$100.00	$19.49–$409.62	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED BLADDER	$429.00	$429.00	$19.49–$409.62	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED	$429.00	$429.00	$19.49–$409.62	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED FOLLICLES	$429.00	$429.00	$19.49–$409.62	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE	$212.00	$212.00	$40.42–$409.62	55% below	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC ECHO,PELVIC (NONOBSTETRIC) - US PELVIS	$449.00	$449.00	$40.42–$426.55	5% below	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE	$212.00	$212.00	$40.42–$409.62	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC ECHO,PELVIC (NONOBSTETRIC) - US PELVIS	$449.00	$449.00	$40.42–$426.55	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$274.00	$274.00	$51.91–$409.62	38% below	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST	$449.00	$449.00	$51.91–$426.55	2% above	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$274.00	$274.00	$51.91–$409.62	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST	$449.00	$449.00	$51.91–$426.55	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC OB US < 14 WKS SINGLE FETUS - US OB < 14 WEEKS SINGLE OR FIRST GEST	$449.00	$449.00	$45.25–$426.55	7% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC OB US < 14 WKS SINGLE FETUS - US OB < 14 WEEKS SINGLE OR FIRST GEST	$449.00	$449.00	$45.25–$426.55	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANT UTERUS LIMITED 1/> FETUSES	$164.00	$164.00	$31.29–$409.62	45% below	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC OB US LIMITED FETUS(S) - US OB LIMITED 1+ FETUSES	$429.00	$429.00	$31.29–$409.62	45% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANT UTERUS LIMITED 1/> FETUSES	$164.00	$164.00	$31.29–$409.62	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC OB US LIMITED FETUS(S) - US OB LIMITED 1+ FETUSES	$429.00	$429.00	$31.29–$409.62	—	—
Rib X-ray, one side, 2 views one side CPT 71100 HC X-RAY RIBS 2 VW UNILAT - XR RIBS 2 VIEWS LEFT	$319.00	$319.00	$14.11–$340.97	25% above	—
Rib X-ray, one side, 2 views one side CPT 71100 HC X-RAY RIBS 2 VW UNILAT - XR RIBS 2 VIEWS RIGHT	$319.00	$319.00	$14.11–$340.97	25% above	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC X-RAY RIBS 2 VW UNILAT - XR RIBS 2 VIEWS LEFT	$319.00	$319.00	$14.11–$340.97	—	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC X-RAY RIBS 2 VW UNILAT - XR RIBS 2 VIEWS RIGHT	$319.00	$319.00	$14.11–$340.97	—	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC X-RAY RIBS, CHEST 3+ VW - XR RIBS 2 VWS LT W/ CHEST ANTEROPOSTERIOR	$429.00	$429.00	$16.21–$409.62	16% above	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC X-RAY RIBS, CHEST 3+ VW - XR RIBS 2 VWS RT W/ CHEST ANTEROPOSTERIOR	$429.00	$429.00	$16.21–$409.62	16% above	—
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC X-RAY RIBS, CHEST 3+ VW - XR RIBS 2 VWS RT W/ CHEST ANTEROPOSTERIOR	$429.00	$429.00	$16.21–$409.62	—	—
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC X-RAY RIBS, CHEST 3+ VW - XR RIBS 2 VWS LT W/ CHEST ANTEROPOSTERIOR	$429.00	$429.00	$16.21–$409.62	—	—
Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING BILATERAL	$304.00	$304.00	$30.03–$288.80	—	—
Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING LEFT	$304.00	$304.00	$30.03–$288.80	—	—
Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING RIGHT	$304.00	$304.00	$30.03–$288.80	—	—
Screening mammogram, both breasts CPT 77067 HC XR MAMMO SCREENING UNI	$304.00	$304.00	$30.03–$288.80	8% below	—
Screening mammogram, both breasts CPT 77067 HC MAMMO SCREENING PROMO CODE	$304.00	$304.00	$30.03–$288.80	8% below	—
Screening mammogram, both breasts one side CPT 77067 HC RAD XR MAMMO UNI SCREENING W IMPLANT WWO CAD - LEFT	$304.00	$304.00	—	8% below	—
Screening mammogram, both breasts one side CPT 77067 HC RAD XR MAMMO UNI SCREENING W IMPLANT WWO CAD - RIGHT	$304.00	$304.00	—	8% below	—
Screening mammogram, both breasts one side CPT 77067 HC RAD XR MAMMO UNI SCREENING 3D WWO CAD - RIGHT	$304.00	$304.00	—	8% below	—
Screening mammogram, both breasts one side CPT 77067 HC RAD XR MAMMO UNI SCREENING 3D WWO CAD - LEFT	$304.00	$304.00	—	8% below	—
Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING LEFT	$304.00	$304.00	$30.03–$288.80	—	—
Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING BILATERAL	$304.00	$304.00	$30.03–$288.80	—	—
Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING RIGHT	$304.00	$304.00	$30.03–$288.80	—	—
Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREENING PROMO CODE	$304.00	$304.00	$30.03–$288.80	—	—
Screening mammogram, both breasts inpatient CPT 77067 HC XR MAMMO SCREENING UNI	$304.00	$304.00	$30.03–$288.80	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 HC RAD XR MAMMO UNI SCREENING W IMPLANT WWO CAD - RIGHT	$304.00	$304.00	—	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 HC RAD XR MAMMO UNI SCREENING W IMPLANT WWO CAD - LEFT	$304.00	$304.00	—	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 HC RAD XR MAMMO UNI SCREENING 3D WWO CAD - RIGHT	$304.00	$304.00	—	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 HC RAD XR MAMMO UNI SCREENING 3D WWO CAD - LEFT	$304.00	$304.00	—	—	—
Shoulder X-ray, complete, 2 or more views CPT 73030 RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS	$70.00	$70.00	$13.30–$340.97	81% below	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS LEFT	$319.00	$319.00	$13.30–$340.97	13% below	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS RIGHT	$319.00	$319.00	$13.30–$340.97	13% below	—
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS	$70.00	$70.00	$13.30–$340.97	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS RIGHT	$319.00	$319.00	$13.30–$340.97	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS LEFT	$319.00	$319.00	$13.30–$340.97	—	—
Sinus X-ray, complete, 3 or more views CPT 70220 HC X-RAY SINUSES 3+ VW - XR PARANASAL SINUSES 3+ VIEWS	$320.00	$320.00	$14.50–$340.97	18% above	—
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC X-RAY SINUSES 3+ VW - XR PARANASAL SINUSES 3+ VIEWS	$320.00	$320.00	$14.50–$340.97	—	—
Skull X-ray, fewer than 4 views CPT 70250 HC X-RAY SKULL <4 VW - XR SKULL 1-3 VIEWS	$429.00	$429.00	$13.81–$409.62	66% above	—
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC X-RAY SKULL <4 VW - XR SKULL 1-3 VIEWS	$429.00	$429.00	$13.81–$409.62	—	—
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$997.97	$997.97	$240.38–$3,364.60	70% below	—
Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$1,252.00	$1,252.00	$240.38–$3,364.60	62% below	—
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY => 6YRS =>4 PARAMETERS REDUCED SERVICE	$2,806.00	$2,806.00	$240.38–$3,364.60	15% below	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$997.97	$997.97	$240.38–$3,364.60	—	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$1,252.00	$1,252.00	$240.38–$3,364.60	—	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY => 6YRS =>4 PARAMETERS REDUCED SERVICE	$2,806.00	$2,806.00	$240.38–$3,364.60	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC CINE/VID X-RAY THROAT/ESOPH - FL ESOPH BARIUM SWLW W/ VIDEO & SPEECH	$703.00	$703.00	$46.74–$687.23	74% above	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC CINE/VID X-RAY THROAT/ESOPH - FL ESOPH BARIUM SWLW W/ VIDEO & SPEECH	$703.00	$703.00	$46.74–$687.23	—	—
Thigh bone (femur) X-ray, 2 or more views CPT 73552 RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS	$71.00	$71.00	$13.68–$340.97	76% below	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS - XR FEMUR 2+ VW LT	$319.00	$319.00	—	9% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS - XR FEMUR 2+ VW RT	$319.00	$319.00	—	9% above	—
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS	$71.00	$71.00	$13.68–$340.97	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS - XR FEMUR 2+ VW RT	$319.00	$319.00	—	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS - XR FEMUR 2+ VW LT	$319.00	$319.00	—	—	—
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT SCAN,THORACIC SPINE,W/O CONTRAST - CT THORACIC SPINE WO CONTRAST	$784.00	$784.00	$51.09–$744.80	13% below	—
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT SCAN,THORACIC SPINE,W/O CONTRAST - CT THORACIC SPINE WO CONTRAST	$784.00	$784.00	$51.09–$744.80	—	—
Toe X-ray, 2 or more views CPT 73660 RADEX TOE MINIMUM 2 VIEWS	$58.00	$58.00	$11.09–$340.97	77% below	—
Toe X-ray, 2 or more views one side CPT 73660 HC X-RAY TOE(S) - XR TOES 2+ VIEWS LEFT	$319.00	$319.00	$11.09–$340.97	28% above	—
Toe X-ray, 2 or more views one side CPT 73660 HC X-RAY TOE(S) - XR TOES 2+ VIEWS RIGHT	$319.00	$319.00	$11.09–$340.97	28% above	—
Toe X-ray, 2 or more views inpatient CPT 73660 RADEX TOE MINIMUM 2 VIEWS	$58.00	$58.00	$11.09–$340.97	—	—
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC X-RAY TOE(S) - XR TOES 2+ VIEWS LEFT	$319.00	$319.00	$11.09–$340.97	—	—
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC X-RAY TOE(S) - XR TOES 2+ VIEWS RIGHT	$319.00	$319.00	$11.09–$340.97	—	—
Transvaginal pelvic ultrasound CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL	$449.00	$449.00	$45.37–$426.55	4% above	—
Transvaginal pelvic ultrasound CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL - US PELVIS TRANSVAGINAL	$449.00	$449.00	$45.37–$426.55	4% above	—
Transvaginal pelvic ultrasound inpatient CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL	$449.00	$449.00	$45.37–$426.55	—	—
Transvaginal pelvic ultrasound inpatient CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL - US PELVIS TRANSVAGINAL	$449.00	$449.00	$45.37–$426.55	—	—
Transvaginal ultrasound during pregnancy CPT 76817 US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG	$187.00	$187.00	$35.61–$409.62	57% below	—
Transvaginal ultrasound during pregnancy CPT 76817 HC TRANSVAGINAL US OBSTETRIC - US OB TRANSVAGINAL	$429.00	$429.00	$35.61–$409.62	1% below	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG	$187.00	$187.00	$35.61–$409.62	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC TRANSVAGINAL US OBSTETRIC - US OB TRANSVAGINAL	$429.00	$429.00	$35.61–$409.62	—	—
Ultrasound of the abdomen, complete CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN	$449.00	$449.00	$44.57–$426.55	9% below	—
Ultrasound of the abdomen, complete CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN COMPLETE	$449.00	$449.00	$44.57–$426.55	9% below	—
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN COMPLETE	$449.00	$449.00	$44.57–$426.55	—	—
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN	$449.00	$449.00	$44.57–$426.55	—	—
Ultrasound of the scrotum and testicles CPT 76870 HC ECHO,SCROTUM & CONTENTS - US SCROTUM	$449.00	$449.00	$38.45–$426.55	2% above	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC ECHO,SCROTUM & CONTENTS - US SCROTUM	$449.00	$449.00	$38.45–$426.55	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US NECK	$449.00	$449.00	$42.03–$426.55	2% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US HEAD NECK SOFT TISSUE	$449.00	$449.00	$42.03–$426.55	2% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US NECK PARATHYROID	$449.00	$449.00	$42.03–$426.55	2% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US NECK PAROTID	$449.00	$449.00	$42.03–$426.55	2% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US THYROID	$449.00	$449.00	$42.03–$426.55	2% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US NECK	$449.00	$449.00	$42.03–$426.55	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US THYROID	$449.00	$449.00	$42.03–$426.55	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US HEAD NECK SOFT TISSUE	$449.00	$449.00	$42.03–$426.55	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US NECK PAROTID	$449.00	$449.00	$42.03–$426.55	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US NECK PARATHYROID	$449.00	$449.00	$42.03–$426.55	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC X-RAY UPPER GI DELAY W/O KUB - FL UPPER GI WITHOUT KUB	$703.00	$703.00	$46.65–$687.23	51% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC X-RAY UPPER GI DELAY W/O KUB - FL UPPER GI WITHOUT KUB	$703.00	$703.00	$46.65–$687.23	—	—
Upper arm X-ray (humerus), 2 views both sides CPT 73060 HC X-RAY HUMERUS - XR HUMERUS BILATERAL	$319.00	$319.00	$12.26–$340.97	—	—
Upper arm X-ray (humerus), 2 views CPT 73060 RADEX HUMERUS MINIMUM 2 VIEWS	$64.00	$64.00	$12.26–$340.97	79% below	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 HC X-RAY HUMERUS - XR HUMERUS LEFT	$319.00	$319.00	$12.26–$340.97	6% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 HC X-RAY HUMERUS - XR HUMERUS RIGHT	$319.00	$319.00	$12.26–$340.97	6% above	—
Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 HC X-RAY HUMERUS - XR HUMERUS BILATERAL	$319.00	$319.00	$12.26–$340.97	—	—
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 RADEX HUMERUS MINIMUM 2 VIEWS	$64.00	$64.00	$12.26–$340.97	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC X-RAY HUMERUS - XR HUMERUS LEFT	$319.00	$319.00	$12.26–$340.97	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC X-RAY HUMERUS - XR HUMERUS RIGHT	$319.00	$319.00	$12.26–$340.97	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC PBB DUPLEX EXTREM VENOUS,UNI OR LTD	$449.00	$449.00	$45.18–$426.55	22% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC US DUPLEX SCAN EXTREMITY UNI OR LTD STUDY	$449.00	$449.00	$45.18–$426.55	22% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC VENOUS DOPPLER EXT UNI OR LTD	$449.00	$449.00	$45.18–$426.55	22% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC PRO DUP-SCAN XTR VEINS UNI/LTMD STUDY	$449.00	$449.00	$45.18–$426.55	22% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - LOWER EXTREM SUPERFICIAL VEIN MAP	$449.00	$449.00	$45.18–$426.55	22% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD	$449.00	$449.00	$45.18–$426.55	22% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - UPPER EXTREM SUPERFICIAL VEIN MAP	$449.00	$449.00	$45.18–$426.55	22% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC EXTREMITY STUDY - RT US VEINS UNILATERAL	$449.00	$449.00	$45.18–$426.55	22% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC EXTREMITY STUDY - US LOWER EXTREMITY VEINS RIGHT DIALYSIS	$449.00	$449.00	$45.18–$426.55	22% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC EXTREMITY STUDY - US LOWER EXTREMITY VEINS LEFT DIALYSIS	$449.00	$449.00	$45.18–$426.55	22% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC EXTREMITY STUDY - LT US VEINS UNILATERAL	$449.00	$449.00	$45.18–$426.55	22% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD	$449.00	$449.00	$45.18–$426.55	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC PBB DUPLEX EXTREM VENOUS,UNI OR LTD	$449.00	$449.00	$45.18–$426.55	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC PRO DUP-SCAN XTR VEINS UNI/LTMD STUDY	$449.00	$449.00	$45.18–$426.55	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC US DUPLEX SCAN EXTREMITY UNI OR LTD STUDY	$449.00	$449.00	$45.18–$426.55	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC VENOUS DOPPLER EXT UNI OR LTD	$449.00	$449.00	$45.18–$426.55	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - UPPER EXTREM SUPERFICIAL VEIN MAP	$449.00	$449.00	$45.18–$426.55	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - LOWER EXTREM SUPERFICIAL VEIN MAP	$449.00	$449.00	$45.18–$426.55	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC EXTREMITY STUDY - US LOWER EXTREMITY VEINS RIGHT DIALYSIS	$449.00	$449.00	$45.18–$426.55	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC EXTREMITY STUDY - US LOWER EXTREMITY VEINS LEFT DIALYSIS	$449.00	$449.00	$45.18–$426.55	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC EXTREMITY STUDY - LT US VEINS UNILATERAL	$449.00	$449.00	$45.18–$426.55	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC EXTREMITY STUDY - RT US VEINS UNILATERAL	$449.00	$449.00	$45.18–$426.55	—	—
Wrist X-ray, 2 views CPT 73100 RADEX WRIST 2 VIEWS	$68.00	$68.00	$12.90–$340.97	75% below	—
Wrist X-ray, 2 views one side CPT 73100 HC X-RAY WRIST 2 VW - XR WRIST 1-2 VIEWS RIGHT	$319.00	$319.00	$12.90–$340.97	20% above	—
Wrist X-ray, 2 views one side CPT 73100 HC X-RAY WRIST 2 VW - XR WRIST 1-2 VIEWS LEFT	$319.00	$319.00	$12.90–$340.97	20% above	—
Wrist X-ray, 2 views inpatient CPT 73100 RADEX WRIST 2 VIEWS	$68.00	$68.00	$12.90–$340.97	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 HC X-RAY WRIST 2 VW - XR WRIST 1-2 VIEWS RIGHT	$319.00	$319.00	$12.90–$340.97	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 HC X-RAY WRIST 2 VW - XR WRIST 1-2 VIEWS LEFT	$319.00	$319.00	$12.90–$340.97	—	—
Wrist X-ray, complete, 3 or more views CPT 73110 RADEX WRIST COMPLETE MINIMUM 3 VIEWS	$82.00	$82.00	$15.83–$340.97	78% below	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS LEFT	$319.00	$319.00	$15.83–$340.97	13% below	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS RIGHT	$319.00	$319.00	$15.83–$340.97	13% below	—
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 RADEX WRIST COMPLETE MINIMUM 3 VIEWS	$82.00	$82.00	$15.83–$340.97	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS RIGHT	$319.00	$319.00	$15.83–$340.97	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS LEFT	$319.00	$319.00	$15.83–$340.97	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included both sides CPT 73502 HC RAD EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW BILATERAL	$319.00	$319.00	$18.30–$340.97	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS	$95.00	$95.00	$18.30–$340.97	59% below	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW RIGHT	$319.00	$319.00	$18.30–$340.97	38% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW LEFT	$319.00	$319.00	$18.30–$340.97	38% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient both sides CPT 73502 HC RAD EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW BILATERAL	$319.00	$319.00	$18.30–$340.97	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS	$95.00	$95.00	$18.30–$340.97	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW RIGHT	$319.00	$319.00	$18.30–$340.97	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW LEFT	$319.00	$319.00	$18.30–$340.97	—	—
X-ray of the abdomen, 1 view CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR COLON MOTILITY	$319.00	$319.00	$11.53–$340.97	55% above	—
X-ray of the abdomen, 1 view CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR ABDOMEN 1 VIEW	$319.00	$319.00	$11.53–$340.97	55% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR ABDOMEN 1 VIEW	$319.00	$319.00	$11.53–$340.97	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR COLON MOTILITY	$319.00	$319.00	$11.53–$340.97	—	—
X-ray of the ankle, 2 views CPT 73600 RADIOLOGIC EXAMINATION ANKLE 2 VIEWS	$65.00	$65.00	$12.26–$340.97	78% below	—
X-ray of the ankle, 2 views one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS LEFT	$319.00	$319.00	$12.26–$340.97	6% above	—
X-ray of the ankle, 2 views one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS RIGHT	$319.00	$319.00	$12.26–$340.97	6% above	—
X-ray of the ankle, 2 views inpatient CPT 73600 RADIOLOGIC EXAMINATION ANKLE 2 VIEWS	$65.00	$65.00	$12.26–$340.97	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS RIGHT	$319.00	$319.00	$12.26–$340.97	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS LEFT	$319.00	$319.00	$12.26–$340.97	—	—
X-ray of the finger(s), 2 or more views CPT 73140 RADEX FINGR MINIMUM 2 VIEWS	$76.00	$76.00	$14.63–$340.97	71% below	—
X-ray of the finger(s), 2 or more views CPT 73140 HC FINGER X-RAY 2 VIEWS	$319.00	$319.00	$14.63–$340.97	23% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS LEFT	$319.00	$319.00	$14.63–$340.97	23% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS RIGHT	$319.00	$319.00	$14.63–$340.97	23% above	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 RADEX FINGR MINIMUM 2 VIEWS	$76.00	$76.00	$14.63–$340.97	—	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC FINGER X-RAY 2 VIEWS	$319.00	$319.00	$14.63–$340.97	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS LEFT	$319.00	$319.00	$14.63–$340.97	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS RIGHT	$319.00	$319.00	$14.63–$340.97	—	—
X-ray of the foot, 2 views CPT 73620 RADIOLOGIC EXAMINATION FOOT 2 VIEWS	$57.00	$57.00	$10.87–$340.97	79% below	—
X-ray of the foot, 2 views one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS LEFT	$319.00	$319.00	$10.87–$340.97	16% above	—
X-ray of the foot, 2 views one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS RIGHT	$319.00	$319.00	$10.87–$340.97	16% above	—
X-ray of the foot, 2 views inpatient CPT 73620 RADIOLOGIC EXAMINATION FOOT 2 VIEWS	$57.00	$57.00	$10.87–$340.97	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS RIGHT	$319.00	$319.00	$10.87–$340.97	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS LEFT	$319.00	$319.00	$10.87–$340.97	—	—
X-ray of the foot, complete, 3 or more views CPT 73630 RADEX FOOT COMPLETE MINIMUM 3 VIEWS	$69.00	$69.00	$13.03–$340.97	81% below	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS LEFT	$319.00	$319.00	$13.03–$340.97	11% below	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS RIGHT	$319.00	$319.00	$13.03–$340.97	11% below	—
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 RADEX FOOT COMPLETE MINIMUM 3 VIEWS	$69.00	$69.00	$13.03–$340.97	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS RIGHT	$319.00	$319.00	$13.03–$340.97	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS LEFT	$319.00	$319.00	$13.03–$340.97	—	—
X-ray of the hand, 3 or more views CPT 73130 RADEX HAND MINIMUM 3 VIEWS	$74.00	$74.00	$14.31–$340.97	80% below	—
X-ray of the hand, 3 or more views one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS RIGHT	$319.00	$319.00	$14.31–$340.97	13% below	—
X-ray of the hand, 3 or more views one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS LEFT	$319.00	$319.00	$14.31–$340.97	13% below	—
X-ray of the hand, 3 or more views inpatient CPT 73130 RADEX HAND MINIMUM 3 VIEWS	$74.00	$74.00	$14.31–$340.97	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS RIGHT	$319.00	$319.00	$14.31–$340.97	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS LEFT	$319.00	$319.00	$14.31–$340.97	—	—
X-ray of the knee, 1 or 2 views both sides CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS BILAT	$319.00	$319.00	$13.02–$340.97	—	—
X-ray of the knee, 1 or 2 views CPT 73560 RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS	$68.00	$68.00	$13.02–$340.97	73% below	—
X-ray of the knee, 1 or 2 views one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS RIGHT	$319.00	$319.00	$13.02–$340.97	29% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS LEFT	$319.00	$319.00	$13.02–$340.97	29% above	—
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS BILAT	$319.00	$319.00	$13.02–$340.97	—	—
X-ray of the knee, 1 or 2 views inpatient CPT 73560 RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS	$68.00	$68.00	$13.02–$340.97	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS RIGHT	$319.00	$319.00	$13.02–$340.97	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS LEFT	$319.00	$319.00	$13.02–$340.97	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC X-RAY LUMBAR SPINE 2/3 VW - XR LUMBAR SPINE 2-3 VIEWS	$429.00	$429.00	$15.26–$409.62	45% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC X-RAY LUMBAR SPINE 2/3 VW - XR LUMBAR SPINE 2-3 VIEWS	$429.00	$429.00	$15.26–$409.62	—	—
X-ray of the lower back, 4 or more views CPT 72110 HC X-RAY LUMBAR SPINE 4 VW - XR LUMBAR SPINE COMPLETE 4+ VIEWS	$429.00	$429.00	$20.00–$409.62	7% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC X-RAY LUMBAR SPINE 4 VW - XR LUMBAR SPINE COMPLETE 4+ VIEWS	$429.00	$429.00	$20.00–$409.62	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC X-RAY THORACIC SPINE 2 VW - XR THORACIC SPINE 2 VIEWS	$429.00	$429.00	$12.69–$409.62	51% above	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC X-RAY THORACIC SPINE 2 VW - XR THORACIC SPINE 2 VIEWS	$429.00	$429.00	$12.69–$409.62	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 HC X-RAY NASAL BONES - XR NASAL BONES	$319.00	$319.00	$14.44–$340.97	32% above	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC X-RAY NASAL BONES - XR NASAL BONES	$319.00	$319.00	$14.44–$340.97	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RADEX SPINE CERVICAL 2 OR 3 VIEWS	$79.00	$79.00	$15.26–$340.97	70% below	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 1 VIEW	$319.00	$319.00	$15.26–$340.97	22% above	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 2-3 VIEWS	$319.00	$319.00	$15.26–$340.97	22% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RADEX SPINE CERVICAL 2 OR 3 VIEWS	$79.00	$79.00	$15.26–$340.97	—	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 1 VIEW	$319.00	$319.00	$15.26–$340.97	—	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 2-3 VIEWS	$319.00	$319.00	$15.26–$340.97	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 HC X-RAY PELVIS 1/2 VW - XR PELVIS 1-2 VIEWS	$429.00	$429.00	$10.75–$409.62	78% above	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC X-RAY PELVIS 1/2 VW - XR PELVIS 1-2 VIEWS	$429.00	$429.00	$10.75–$409.62	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC X-RAY SACRUM/COCCYX 2+ VW - XR SACRUM COCCYX 2+ VIEWS	$319.00	$319.00	$12.53–$340.97	27% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC X-RAY SACRUM/COCCYX 2+ VW - XR SACRUM COCCYX 2+ VIEWS	$319.00	$319.00	$12.53–$340.97	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
ACTH blood test CPT 82024 HC ADRENOCORTICOTROPIC HORMONE ACTH	$160.00	$160.00	$8.37–$152.00	6% above	—
ACTH blood test CPT 82024 HC ASSAY OF ACTH - ACTH	$160.00	$160.00	$8.37–$152.00	6% above	—
ACTH blood test inpatient CPT 82024 HC ASSAY OF ACTH - ACTH	$160.00	$160.00	$8.37–$152.00	—	—
ACTH blood test inpatient CPT 82024 HC ADRENOCORTICOTROPIC HORMONE ACTH	$160.00	$160.00	$8.37–$152.00	—	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE ALANINE AMINO (ALT) (SGPT) - ALT (SGPT)	$30.00	$30.00	$2.29–$28.50	11% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALANINE AMINO ALT SGPT	$30.00	$30.00	$2.29–$28.50	11% above	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALANINE AMINO ALT SGPT	$30.00	$30.00	$2.29–$28.50	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE ALANINE AMINO (ALT) (SGPT) - ALT (SGPT)	$30.00	$30.00	$2.29–$28.50	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE ASPARTATE AMINO AST SGOT	$29.00	$29.00	$2.24–$27.55	14% below	—
AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO (AST) (SGOT) - POCT AST	$29.00	$29.00	$2.24–$27.55	14% below	—
AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO (AST) (SGOT) - AST (SGOT)	$29.00	$29.00	$2.24–$27.55	14% below	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO (AST) (SGOT) - AST (SGOT)	$29.00	$29.00	$2.24–$27.55	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO (AST) (SGOT) - POCT AST	$29.00	$29.00	$2.24–$27.55	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE ASPARTATE AMINO AST SGOT	$29.00	$29.00	$2.24–$27.55	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS PANEL,ACUTE - BUNDLED CHARGE	$209.00	$209.00	$5.51–$198.55	4% below	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$209.00	$209.00	$5.51–$198.55	4% below	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS PANEL,ACUTE - BUNDLED CHARGE	$209.00	$209.00	$5.51–$198.55	—	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$209.00	$209.00	$5.51–$198.55	—	—
Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN - ALBUMIN	$28.00	$28.00	$2.14–$26.60	13% above	—
Albumin blood test CPT 82040 ALBUMIN SERUM PLASMA/WHOLE BLOOD	$28.00	$28.00	$2.14–$26.60	13% above	—
Albumin blood test CPT 82040 HC ASSAY OF BLOOD ALBUMIN - ALBUMIN	$28.00	$28.00	$2.14–$26.60	13% above	—
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM PLASMA/WHOLE BLOOD	$28.00	$28.00	$2.14–$26.60	—	—
Albumin blood test inpatient CPT 82040 HC ASSAY OF BLOOD ALBUMIN - ALBUMIN	$28.00	$28.00	$2.14–$26.60	—	—
Albumin blood test inpatient CPT 82040 HC ASSAY OF SERUM ALBUMIN - ALBUMIN	$28.00	$28.00	$2.14–$26.60	—	—
Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE - ALDOSTERONE, SERUM	$113.00	$113.00	$8.37–$156.28	42% below	—
Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE - ALDOSTERONE,24HR URINE	$113.00	$113.00	$8.37–$156.28	42% below	—
Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE - ALDOSTERONE	$113.00	$113.00	$8.37–$156.28	42% below	—
Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE - ALDOSTERONE,24HR URINE	$113.00	$113.00	$8.37–$156.28	—	—
Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE - ALDOSTERONE, SERUM	$113.00	$113.00	$8.37–$156.28	—	—
Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE - ALDOSTERONE	$113.00	$113.00	$8.37–$156.28	—	—
Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY OF PHOSPHATASE ALKALINE	$16.00	$16.00	$2.24–$19.87	51% below	—
Alkaline phosphatase (ALP) blood test CPT 84075 HC ASSAY ALKAL PHOSPHATASE - ALKALINE PHOSPHATASE	$16.00	$16.00	$2.24–$19.87	51% below	—
Alkaline phosphatase (ALP) blood test CPT 84075 HC ASSAY ALKAL PHOSPHATASE - ALKALINE PHOSPHATASE BODY FLUID	$16.00	$16.00	$2.24–$19.87	51% below	—
Alkaline phosphatase (ALP) blood test CPT 84075 HC ASSAY ALKAL PHOSPHATASE - ALKALINE PHOSPHATASE BONE SPECIFIC	$16.00	$16.00	$2.24–$19.87	51% below	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ASSAY OF PHOSPHATASE ALKALINE	$16.00	$16.00	$2.24–$19.87	—	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ASSAY ALKAL PHOSPHATASE - ALKALINE PHOSPHATASE	$16.00	$16.00	$2.24–$19.87	—	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ASSAY ALKAL PHOSPHATASE - ALKALINE PHOSPHATASE BONE SPECIFIC	$16.00	$16.00	$2.24–$19.87	—	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ASSAY ALKAL PHOSPHATASE - ALKALINE PHOSPHATASE BODY FLUID	$16.00	$16.00	$2.24–$19.87	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EUCALYPTUS IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN JOHNSON GRASS IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WATERMELON IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HOUSE DUST: HOLLISTER IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HOUSE DUST: GREER IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WASP, PAPER IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORSE HAIR AND DANDER IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN EA QUEST REF	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORNET, YELLOW IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WALNUT TREE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORNET, WHITE FACE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN PROFILE SPEC IGE - ALLERGEN FOOD W/O COMPONENT REFLEX	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORMODENDRUM HORDEI	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WALNUT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HONEYBEE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HELMINTHOSPORIUM SAT	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TUNA IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FESCUE, MEADOW IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FLAX SEED IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD GRAPEFRUIT	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HAZELNUT	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD LOBSTER IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD PEA (PISUM SATIVUM) IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HALIBUT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: ROLE E 9, OLIVE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GUM, SWEET IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN PROFILE SPEC IGE - ALLERGEN FOOD WITH COMPONENT REFLEX	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GRASS: RPHL P 6 TIMOTHY	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: PINE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GRAPE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD PEAR	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD STRAWBERRY IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GLUTEN IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: MULBERRY (MORUS ALBA) IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: SQUID (LOLIGO SPP.) IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALFALFA IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: RAPE SEED	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: GREY ALDER	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PISTACHIO	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALMONDS IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PINE NUT, PIGNOLES	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: CYPRESS	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: GROUPER	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CLADOSPORIUM HERBARUM IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CLAMS IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCKLEBUR IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCKROACH, AMERICAN IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALTERNARIA TENUIS	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TOMATO IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ANIMAL: NBOS D 6 BSA, COW IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TIMOTHY IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ANIMAL: RAT EPITHELIUM	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN THISTLE, RUSSIAN IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ANIMAL: RCAN F 1 DOG IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TEA IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ANIMAL: RFEL D 1 CAT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SYCAMORE TREE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN APPLE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SWEET VERNAL GRASS IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN APRICOT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SUGAR, CANE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASH, WHITE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SOYBEAN IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPARAGUS IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHRIMP IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPEN IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHEEP SORREL (DOCK) IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPERGILLUS FUMAGATUS IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHEEP EPITHELIA IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCONUT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SESAME SEED IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN AVOCADO IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SCALLOP IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BANANA IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SALMON IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BARLEY IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SAGEBRUSH, COMMON IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEAN, GREEN IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RYE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEAN, LIMA IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RYE GRASS, CULTIVATED IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEEF IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RICE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEET, RED IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAT URINE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BERMUDA GRASS IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RASPBERRY IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BIRCH IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAGWEED, WESTERN IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BLUEBERRY IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAGWEED, SHORT/COMMON IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BRAZIL NUT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RADISH IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CABBAGE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PROFILE, FALL - WEED	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CARROT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN POTATO, SWEET IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CASHEW IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN POTATO IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CAT HAIR/DANDER,STAN	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CODFISH IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COFFEE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COMMON PIGWEEK IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CORN IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COTTONWOOD TREE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CRAB IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CRANBERRY IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN D FARINAE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PORK IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CEDAR, MOUNTAIN IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PIGWEED, ROUGH IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CELERY IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PERCH IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CEPHALOSPORIN-DRUG	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, GREEN BELL IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHERRY IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, CHILI IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHICKEN, SERUM PROTEINS IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, BLACK IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHOCOLATE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER TREE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PENICILLIUM IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE ISOCYAN HDI	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PENICILLIN V IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PECAN NUT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH - FOOD PANEL	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEANUT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEACH IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OYSTER IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ORANGE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - YELLOW SORREL WEED IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ONION IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OLIVE, BLACK IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - SCALE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OLIVE TREE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OCCUPATIONAL: COTTON SEED IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - OAK TREE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OAT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN NUTS PANEL	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN NETTLE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - NAVY BEAN IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUSTARD IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - LATEX, IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUSSEL IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUGWORT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - CLADISPORIUM HERBARUM IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MOUSE URINE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MITE: DERMATOPHAGOIDES PTERONYSSINUS	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - CARMINE RED (FOOD DYE) IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MITE: DERMATOPHAGOIDES FARINAE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MISC: MBP	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - AUREOBASIDIUM PULLULANS IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MIMOSA/ACACIA IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MILK IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ZUCCHINI IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: PENICILLIUM GLABRUM IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: PENICILLIUM CHRYSOGENUM	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN YELLOW JACKET IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: ALTERNARIA ALTERNATA	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MESQUITE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN YEAST, BAKER'S IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MELALEUCA IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MAPLE,RED IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WILLOW, BLACK IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MAPLE, BOX ELDER IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MALT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WHEAT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MACADAMIA NUT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LIME IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: ENGLISH PLANTAIN IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LETTUCE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LEMON IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: DANDELION IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LAMB'S QUARTER IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LAMB IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED GIANT RAGWEED IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN KIWI FRUIT IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN D PTERONYSSINUS	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DOCKWEED, YELLOW IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DOG DANDER	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DRUG: AMOXICILLOYL IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG WHITE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG YOLK IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG, WHOLE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ELM TREE IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EPICOCCUM PURPURASCEN IGE	$23.00	$23.00	$2.26–$21.85	4% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SESAME SEED IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE ISOCYAN HDI	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH - FOOD PANEL	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - YELLOW SORREL WEED IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - SCALE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - OAK TREE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - NAVY BEAN IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - LATEX, IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - CLADISPORIUM HERBARUM IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - CARMINE RED (FOOD DYE) IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - AUREOBASIDIUM PULLULANS IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ZUCCHINI IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN YELLOW JACKET IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN YEAST, BAKER'S IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WILLOW, BLACK IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WHEAT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: ENGLISH PLANTAIN IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: DANDELION IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED GIANT RAGWEED IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WATERMELON IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WASP, PAPER IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WALNUT TREE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WALNUT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TUNA IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: ROLE E 9, OLIVE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: PINE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: MULBERRY (MORUS ALBA) IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: GREY ALDER	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: CYPRESS	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TOMATO IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TIMOTHY IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN THISTLE, RUSSIAN IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TEA IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SYCAMORE TREE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SWEET VERNAL GRASS IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SUGAR, CANE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SOYBEAN IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHRIMP IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHEEP SORREL (DOCK) IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHEEP EPITHELIA IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SCALLOP IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SALMON IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SAGEBRUSH, COMMON IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RYE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RYE GRASS, CULTIVATED IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RICE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAT URINE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RASPBERRY IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAGWEED, WESTERN IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAGWEED, SHORT/COMMON IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RADISH IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PROFILE, FALL - WEED	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN POTATO, SWEET IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN POTATO IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PORK IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PIGWEED, ROUGH IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PERCH IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, GREEN BELL IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, CHILI IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, BLACK IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER TREE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PENICILLIUM IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PENICILLIN V IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PECAN NUT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEANUT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEACH IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OYSTER IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ORANGE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ONION IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OLIVE, BLACK IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OLIVE TREE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OCCUPATIONAL: COTTON SEED IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OAT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN NUTS PANEL	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN NETTLE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUSTARD IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUSSEL IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUGWORT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MOUSE URINE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MITE: DERMATOPHAGOIDES PTERONYSSINUS	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MITE: DERMATOPHAGOIDES FARINAE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MISC: MBP	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MIMOSA/ACACIA IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MILK IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: PENICILLIUM GLABRUM IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: PENICILLIUM CHRYSOGENUM	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: ALTERNARIA ALTERNATA	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MESQUITE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MELALEUCA IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MAPLE,RED IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MAPLE, BOX ELDER IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MALT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MACADAMIA NUT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LIME IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LETTUCE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LEMON IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LAMB'S QUARTER IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LAMB IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN KIWI FRUIT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN JOHNSON GRASS IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HOUSE DUST: HOLLISTER IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HOUSE DUST: GREER IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORSE HAIR AND DANDER IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORNET, YELLOW IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORNET, WHITE FACE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORMODENDRUM HORDEI	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HONEYBEE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HELMINTHOSPORIUM SAT	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HAZELNUT	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HALIBUT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GUM, SWEET IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GRASS: RPHL P 6 TIMOTHY	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GRAPE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GLUTEN IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: SQUID (LOLIGO SPP.) IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: RAPE SEED	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PISTACHIO	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PINE NUT, PIGNOLES	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: GROUPER	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD STRAWBERRY IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD PEAR	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD PEA (PISUM SATIVUM) IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD LOBSTER IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD GRAPEFRUIT	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FLAX SEED IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FESCUE, MEADOW IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EUCALYPTUS IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EPICOCCUM PURPURASCEN IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ELM TREE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG, WHOLE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG YOLK IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG WHITE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DRUG: AMOXICILLOYL IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DOG DANDER	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DOCKWEED, YELLOW IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN D PTERONYSSINUS	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN D FARINAE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CRANBERRY IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CRAB IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COTTONWOOD TREE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CORN IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COMMON PIGWEEK IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COFFEE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CODFISH IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCONUT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCKROACH, AMERICAN IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCKLEBUR IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CLAMS IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CLADOSPORIUM HERBARUM IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHOCOLATE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHICKEN, SERUM PROTEINS IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHERRY IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CEPHALOSPORIN-DRUG	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CELERY IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CEDAR, MOUNTAIN IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CAT HAIR/DANDER,STAN	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CASHEW IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CARROT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CABBAGE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BRAZIL NUT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BLUEBERRY IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BIRCH IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BERMUDA GRASS IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEET, RED IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEEF IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEAN, LIMA IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEAN, GREEN IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BARLEY IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BANANA IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN AVOCADO IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPERGILLUS FUMAGATUS IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPEN IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPARAGUS IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASH, WHITE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN APRICOT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN APPLE IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ANIMAL: RFEL D 1 CAT IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ANIMAL: RCAN F 1 DOG IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ANIMAL: RAT EPITHELIUM	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ANIMAL: NBOS D 6 BSA, COW IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALTERNARIA TENUIS	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALMONDS IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALFALFA IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN PROFILE SPEC IGE - ALLERGEN FOOD WITH COMPONENT REFLEX	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN PROFILE SPEC IGE - ALLERGEN FOOD W/O COMPONENT REFLEX	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN EA QUEST REF	$23.00	$23.00	$2.26–$21.85	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$23.00	$23.00	$2.26–$21.85	—	—
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN, SERUM	$92.00	$92.00	$7.25–$87.40	17% above	—
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM	$92.00	$92.00	$7.25–$87.40	17% above	—
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN, SERUM - ALPHA FETOPROTEIN, MATERNAL	$92.00	$92.00	$7.25–$87.40	17% above	—
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN, SERUM - ALPHA-FETOPROTEIN MARKER	$92.00	$92.00	$7.25–$87.40	17% above	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN, SERUM - ALPHA-FETOPROTEIN MARKER	$92.00	$92.00	$7.25–$87.40	—	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SERUM	$92.00	$92.00	$7.25–$87.40	—	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN, SERUM	$92.00	$92.00	$7.25–$87.40	—	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN, SERUM - ALPHA FETOPROTEIN, MATERNAL	$92.00	$92.00	$7.25–$87.40	—	—
Ammonia blood test CPT 82140 ASSAY OF AMMONIA	$77.00	$77.00	$6.30–$73.15	7% above	—
Ammonia blood test CPT 82140 HC ASSAY OF AMMONIA - AMMONIA	$77.00	$77.00	$6.30–$73.15	7% above	—
Ammonia blood test inpatient CPT 82140 HC ASSAY OF AMMONIA - AMMONIA	$77.00	$77.00	$6.30–$73.15	—	—
Ammonia blood test inpatient CPT 82140 ASSAY OF AMMONIA	$77.00	$77.00	$6.30–$73.15	—	—
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE - AMYLASE	$36.00	$36.00	$2.80–$34.20	29% below	—
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE - AMYLASE,24 HOUR URINE	$36.00	$36.00	$2.80–$34.20	29% below	—
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE - AMYLASE BODY FLUID	$36.00	$36.00	$2.80–$34.20	29% below	—
Amylase blood test CPT 82150 ASSAY OF AMYLASE	$36.00	$36.00	$2.80–$34.20	29% below	—
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE - AMYLASE BLOOD	$36.00	$36.00	$2.80–$34.20	29% below	—
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE - AMYLASE	$36.00	$36.00	$2.80–$34.20	—	—
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE - AMYLASE BLOOD	$36.00	$36.00	$2.80–$34.20	—	—
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE - AMYLASE BODY FLUID	$36.00	$36.00	$2.80–$34.20	—	—
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE - AMYLASE,24 HOUR URINE	$36.00	$36.00	$2.80–$34.20	—	—
Amylase blood test inpatient CPT 82150 ASSAY OF AMYLASE	$36.00	$36.00	$2.80–$34.20	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE ANTIBODY	$71.00	$71.00	$5.60–$67.45	14% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CIRULLINATED PEPTIDE ANTIBODY - CYCLIC CITRUL PEPTIDE ANTIBDY	$71.00	$71.00	$5.60–$67.45	14% above	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE ANTIBODY	$71.00	$71.00	$5.60–$67.45	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CIRULLINATED PEPTIDE ANTIBODY - CYCLIC CITRUL PEPTIDE ANTIBDY	$71.00	$71.00	$5.60–$67.45	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES ANA	$55.00	$55.00	$5.22–$52.25	1% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA (ANTINUCLEAR ANTIBODIES)	$55.00	$55.00	$5.22–$52.25	1% above	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES ANA	$55.00	$55.00	$5.22–$52.25	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA (ANTINUCLEAR ANTIBODIES)	$55.00	$55.00	$5.22–$52.25	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE - B-TYPE NATRIURETIC PEPTIDE (BNP)	$187.00	$187.00	$16.96–$177.65	14% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE - B-TYPE NATRIURETIC PEPTIDE (BNP)	$187.00	$187.00	$16.96–$177.65	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, WOUND SPUTUM, MS	$48.00	$48.00	$3.73–$45.60	18% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BACTERIA EXCPT URINE BLOOD/STOOL AEROBIC ISOL	$48.00	$48.00	$3.73–$45.60	18% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL	$48.00	$48.00	$3.73–$45.60	18% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, WOUND SPUTUM, MS	$48.00	$48.00	$3.73–$45.60	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE BACTERIA EXCPT URINE BLOOD/STOOL AEROBIC ISOL	$48.00	$48.00	$3.73–$45.60	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL	$48.00	$48.00	$3.73–$45.60	—	—
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL CALCIUM TOTAL	$47.00	$47.00	$3.66–$44.65	7% above	—
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL	$47.00	$47.00	$3.66–$44.65	7% above	—
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL	$47.00	$47.00	$3.66–$44.65	—	—
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL CALCIUM TOTAL	$47.00	$47.00	$3.66–$44.65	—	—
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL - BILIRUBIN TOTAL AND DIRECT	$28.00	$28.00	$2.17–$26.60	22% below	—
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL - BILIRUBIN BODY FLUID	$28.00	$28.00	$2.17–$26.60	22% below	—
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL - BILIRUBIN NEONATAL	$28.00	$28.00	$2.17–$26.60	22% below	—
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL - BILIRUBIN TOTAL	$28.00	$28.00	$2.17–$26.60	22% below	—
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$28.00	$28.00	$2.17–$26.60	22% below	—
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL - BILIRUBIN TOTAL AND DIRECT	$28.00	$28.00	$2.17–$26.60	—	—
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL - BILIRUBIN NEONATAL	$28.00	$28.00	$2.17–$26.60	—	—
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL - BILIRUBIN TOTAL	$28.00	$28.00	$2.17–$26.60	—	—
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$28.00	$28.00	$2.17–$26.60	—	—
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL - BILIRUBIN BODY FLUID	$28.00	$28.00	$2.17–$26.60	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURG PATH,LEVEL IV - LAB SURG PATH,LEVEL IV	$152.00	$152.00	$26.88–$204.18	29% below	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SURG PATH,LEVEL IV - LAB SURG PATH,LEVEL IV	$152.00	$152.00	$26.88–$204.18	—	—
Blood culture for bacteria CPT 87040 HC BLOOD CULTURE FOR BACTERIA	$57.00	$57.00	$4.46–$54.15	48% below	—
Blood culture for bacteria inpatient CPT 87040 HC BLOOD CULTURE FOR BACTERIA	$57.00	$57.00	$4.46–$54.15	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC CHG COLLECTION VENOUS BLOOD,VENIPUNCTURE	$13.00	$13.00	$1.55–$35.82	42% below	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC CHG COLLECTION VENOUS BLOOD,VENIPUNCTURE - DRAW CHARGE	$13.00	$13.00	$1.55–$35.82	42% below	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION VENOUS BLOOD VENIPUNCTURE	$13.00	$13.00	$1.55–$35.82	42% below	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC CHG COLLECTION VENOUS BLOOD,VENIPUNCTURE - DRAW CHARGE	$13.00	$13.00	$1.55–$35.82	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC CHG COLLECTION VENOUS BLOOD,VENIPUNCTURE	$13.00	$13.00	$1.55–$35.82	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION VENOUS BLOOD VENIPUNCTURE	$13.00	$13.00	$1.55–$35.82	—	—
Blood glucose (sugar) test CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GLUCOSE RANDOM	$22.00	$22.00	$1.70–$20.90	13% below	—
Blood glucose (sugar) test CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GLUCOSE TIMED URINE	$22.00	$22.00	$1.70–$20.90	13% below	—
Blood glucose (sugar) test CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GLUCOSE FASTING	$22.00	$22.00	$1.70–$20.90	13% below	—
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP	$22.00	$22.00	$1.70–$20.90	13% below	—
Blood glucose (sugar) test CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GTT FASTING	$22.00	$22.00	$1.70–$20.90	13% below	—
Blood glucose (sugar) test CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - POCT GLUCOMETER	$22.00	$22.00	$1.70–$20.90	13% below	—
Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GTT FASTING	$22.00	$22.00	$1.70–$20.90	—	—
Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - POCT GLUCOMETER	$22.00	$22.00	$1.70–$20.90	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP	$22.00	$22.00	$1.70–$20.90	—	—
Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GLUCOSE TIMED URINE	$22.00	$22.00	$1.70–$20.90	—	—
Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GLUCOSE FASTING	$22.00	$22.00	$1.70–$20.90	—	—
Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GLUCOSE RANDOM	$22.00	$22.00	$1.70–$20.90	—	—
Blood lead test CPT 83655 HC ASSAY OF LEAD - LEAD, CAPILLARY BLOOD	$37.00	$37.00	$5.23–$46.44	33% below	—
Blood lead test CPT 83655 HC ASSAY OF LEAD - LEAD 24HR URINE	$37.00	$37.00	$5.23–$46.44	33% below	—
Blood lead test CPT 83655 HC ASSAY OF LEAD	$37.00	$37.00	$5.23–$46.44	33% below	—
Blood lead test CPT 83655 HC ASSAY OF LEAD - POCT BLOOD LEAD	$37.00	$37.00	$5.23–$46.44	33% below	—
Blood lead test CPT 83655 HC ASSAY OF LEAD - LEAD BLOOD	$37.00	$37.00	$5.23–$46.44	33% below	—
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD - LEAD BLOOD	$37.00	$37.00	$5.23–$46.44	—	—
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD - POCT BLOOD LEAD	$37.00	$37.00	$5.23–$46.44	—	—
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD - LEAD 24HR URINE	$37.00	$37.00	$5.23–$46.44	—	—
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD - LEAD, CAPILLARY BLOOD	$37.00	$37.00	$5.23–$46.44	—	—
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD	$37.00	$37.00	$5.23–$46.44	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC CHORIONIC GONADOTROPIN, QUAL - HCG QUALITATIVE URINE	$20.00	$20.00	$3.25–$37.43	67% below	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC CHORIONIC GONADOTROPIN, QUAL - HCG QUALITATIVE URINE	$20.00	$20.00	$3.25–$37.43	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO	$344.00	$344.00	$1.29–$326.80	635% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$344.00	$344.00	$1.29–$326.80	635% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO - ABO/RH TYPE	$344.00	$344.00	$1.29–$326.80	635% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO - ABO/RH TYPE	$344.00	$344.00	$1.29–$326.80	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO	$344.00	$344.00	$1.29–$326.80	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING SEROLOGIC ABO	$344.00	$344.00	$1.29–$326.80	—	—
Blood urea nitrogen (BUN) test CPT 84520 ASSAY OF UREA NITROGEN QUANTITATIVE	$22.00	$22.00	$1.71–$20.90	39% below	—
Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY UREA NITROGEN, QUAN - POCT UREA (BUN)	$22.00	$22.00	$1.71–$20.90	39% below	—
Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY UREA NITROGEN, QUAN - BLOOD UREA NITROGEN	$22.00	$22.00	$1.71–$20.90	39% below	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY UREA NITROGEN, QUAN - POCT UREA (BUN)	$22.00	$22.00	$1.71–$20.90	—	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY UREA NITROGEN, QUAN - BLOOD UREA NITROGEN	$22.00	$22.00	$1.71–$20.90	—	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 ASSAY OF UREA NITROGEN QUANTITATIVE	$22.00	$22.00	$1.71–$20.90	—	—
C-peptide blood test CPT 84681 HC ASSAY OF C-PEPTIDE - C-PEPTIDE	$94.00	$94.00	$8.08–$89.30	2% below	—
C-peptide blood test inpatient CPT 84681 HC ASSAY OF C-PEPTIDE - C-PEPTIDE	$94.00	$94.00	$8.08–$89.30	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN - C-REACTIVE PROTEIN	$50.00	$50.00	$2.24–$47.50	16% below	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN - C-REACTIVE PROTEIN	$50.00	$50.00	$2.24–$47.50	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE	$158.00	$158.00	$16.10–$150.10	5% below	—
C. difficile toxin gene test (stool PCR) CPT 87493 HC C DIFF AMPLIFIED PROBE	$158.00	$158.00	$16.10–$150.10	5% below	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C DIFF AMPLIFIED PROBE	$158.00	$158.00	$16.10–$150.10	—	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE	$158.00	$158.00	$16.10–$150.10	—	—
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9	$64.00	$64.00	$6.94–$79.81	32% below	—
CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 19-9 - CANCER ANTIGEN 19-9	$64.00	$64.00	$6.94–$79.81	32% below	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 19-9 - CANCER ANTIGEN 19-9	$64.00	$64.00	$6.94–$79.81	—	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9	$64.00	$64.00	$6.94–$79.81	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 125 - CA 125	$115.00	$115.00	$6.94–$109.25	22% above	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 125 - CA 125	$115.00	$115.00	$6.94–$109.25	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ	$142.00	$142.00	$22.17–$196.77	51% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ - SARS-COV-2 RT PCR	$142.00	$142.00	$22.17–$196.77	51% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ	$142.00	$142.00	$22.17–$196.77	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ - SARS-COV-2 RT PCR	$142.00	$142.00	$22.17–$196.77	—	—
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$29.00	$29.00	$2.23–$27.55	10% above	—
Calcium blood test, total CPT 82310 HC ASSAY OF CALCIUM, TOTAL - POCT CALCIUM, TOTAL	$29.00	$29.00	$2.23–$27.55	10% above	—
Calcium blood test, total CPT 82310 HC ASSAY OF CALCIUM, TOTAL - PTH, INTACT AND CALCIUM	$29.00	$29.00	$2.23–$27.55	10% above	—
Calcium blood test, total CPT 82310 HC ASSAY OF CALCIUM, TOTAL - CALCIUM	$29.00	$29.00	$2.23–$27.55	10% above	—
Calcium blood test, total inpatient CPT 82310 HC ASSAY OF CALCIUM, TOTAL - POCT CALCIUM, TOTAL	$29.00	$29.00	$2.23–$27.55	—	—
Calcium blood test, total inpatient CPT 82310 HC ASSAY OF CALCIUM, TOTAL - PTH, INTACT AND CALCIUM	$29.00	$29.00	$2.23–$27.55	—	—
Calcium blood test, total inpatient CPT 82310 HC ASSAY OF CALCIUM, TOTAL - CALCIUM	$29.00	$29.00	$2.23–$27.55	—	—
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$29.00	$29.00	$2.23–$27.55	—	—
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN CEA	$104.00	$104.00	$8.08–$98.80	11% above	—
Carcinoembryonic antigen (CEA) test CPT 82378 HC CARCINOEMBRYONIC ANTIGEN - CEA (CARCINOEMBRYONIC ANTIGEN)	$104.00	$104.00	$8.08–$98.80	11% above	—
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN CEA	$104.00	$104.00	$8.08–$98.80	—	—
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CARCINOEMBRYONIC ANTIGEN - CEA (CARCINOEMBRYONIC ANTIGEN)	$104.00	$104.00	$8.08–$98.80	—	—
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY VARICELLA-ZOSTER	$71.00	$71.00	$5.57–$67.45	13% above	—
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER - VARICELLA ZOSTER IGG	$71.00	$71.00	$5.57–$67.45	13% above	—
Chickenpox (varicella) immunity blood test CPT 86787 HC EMPLOYEE VARICELLA-ZOSTER - VARICELLA ZOSTER IGG	$71.00	$71.00	$5.57–$67.45	13% above	—
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER - VARICELLA ZOSTER IGM	$71.00	$71.00	$5.57–$67.45	13% above	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA-ZOSTER - VARICELLA ZOSTER IGM	$71.00	$71.00	$5.57–$67.45	—	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA-ZOSTER - VARICELLA ZOSTER IGG	$71.00	$71.00	$5.57–$67.45	—	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODY VARICELLA-ZOSTER	$71.00	$71.00	$5.57–$67.45	—	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC EMPLOYEE VARICELLA-ZOSTER - VARICELLA ZOSTER IGG	$71.00	$71.00	$5.57–$67.45	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHYLMD TRACH, DNA, AMP PROBE - LYMPHOGRANULOMA VENEREUM ANTIBODY	$97.00	$97.00	$15.16–$134.57	17% below	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHYLMD TRACH, DNA, AMP PROBE - CHLAMYDIA DNA PCR	$97.00	$97.00	$15.16–$134.57	17% below	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ	$97.00	$97.00	$15.16–$134.57	17% below	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHYLMD TRACH, DNA, AMP PROBE - LYMPHOGRANULOMA VENEREUM ANTIBODY	$97.00	$97.00	$15.16–$134.57	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHYLMD TRACH, DNA, AMP PROBE - CHLAMYDIA DNA PCR	$97.00	$97.00	$15.16–$134.57	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ	$97.00	$97.00	$15.16–$134.57	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL - BUNDLED CHARGE	$30.00	$30.00	$5.51–$56.54	49% below	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC EMPLOYEE LIPID PANEL	$63.00	$63.00	$5.51–$59.85	6% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$63.00	$63.00	$5.51–$59.85	6% above	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL - BUNDLED CHARGE	$30.00	$30.00	$5.51–$56.54	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$63.00	$63.00	$5.51–$59.85	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC EMPLOYEE LIPID PANEL	$63.00	$63.00	$5.51–$59.85	—	—
Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC & AUTO DIFF WBC	$43.00	$43.00	$3.36–$40.85	at median	—
Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC & MANUAL DIFF WBC	$43.00	$43.00	$3.36–$40.85	at median	—
Complete blood count (CBC) with differential CPT 85025 HC EMPLOYEE COMPLETE CBC & AUTO DIFF WBC	$43.00	$43.00	$3.36–$40.85	at median	—
Complete blood count (CBC) with differential CPT 85025 BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$43.00	$43.00	$3.36–$40.85	at median	—
Complete blood count (CBC) with differential CPT 85025 HC HF COMPLETE CBC & AUTO DIFF WBC	$43.00	$43.00	$3.36–$40.85	at median	—
Complete blood count (CBC) with differential inpatient CPT 85025 HC EMPLOYEE COMPLETE CBC & AUTO DIFF WBC	$43.00	$43.00	$3.36–$40.85	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE CBC & MANUAL DIFF WBC	$43.00	$43.00	$3.36–$40.85	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE CBC & AUTO DIFF WBC	$43.00	$43.00	$3.36–$40.85	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$43.00	$43.00	$3.36–$40.85	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 HC HF COMPLETE CBC & AUTO DIFF WBC	$43.00	$43.00	$3.36–$40.85	—	—
Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC - CBC	$25.00	$25.00	$2.80–$30.65	32% below	—
Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC - POCT CBC	$34.00	$34.00	$2.80–$32.30	8% below	—
Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT COMPLETE AUTOMATED	$34.00	$34.00	$2.80–$32.30	8% below	—
Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC - CBC	$25.00	$25.00	$2.80–$30.65	—	—
Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC - POCT CBC	$34.00	$34.00	$2.80–$32.30	—	—
Complete blood count (CBC), no differential inpatient CPT 85027 BLOOD COUNT COMPLETE AUTOMATED	$34.00	$34.00	$2.80–$32.30	—	—
Comprehensive metabolic panel (blood test) CPT 80053 HC HF METABOLIC PANEL,COMPREHENSIVE	$76.50	$76.50	$4.56–$72.67	36% above	—
Comprehensive metabolic panel (blood test) CPT 80053 HC EMPLOYEE METABOLIC PANEL,COMPREHENSIVE	$76.50	$76.50	$4.56–$72.67	36% above	—
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$76.50	$76.50	$4.56–$72.67	36% above	—
Comprehensive metabolic panel (blood test) CPT 80053 HC METABOLIC PANEL,COMPREHENSIVE	$76.50	$76.50	$4.56–$72.67	36% above	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC METABOLIC PANEL,COMPREHENSIVE	$76.50	$76.50	$4.56–$72.67	—	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC EMPLOYEE METABOLIC PANEL,COMPREHENSIVE	$76.50	$76.50	$4.56–$72.67	—	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$76.50	$76.50	$4.56–$72.67	—	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC HF METABOLIC PANEL,COMPREHENSIVE	$76.50	$76.50	$4.56–$72.67	—	—
Cortisol blood test, total CPT 82533 HC TOTAL CORTISOL - CORTISOL SERUM	$80.00	$80.00	$7.04–$76.00	11% above	—
Cortisol blood test, total CPT 82533 HC TOTAL CORTISOL - ACTH STIMULATION 1 HOUR	$80.00	$80.00	$7.04–$76.00	11% above	—
Cortisol blood test, total CPT 82533 HC TOTAL CORTISOL - CORTISOL	$80.00	$80.00	$7.04–$76.00	11% above	—
Cortisol blood test, total CPT 82533 HC TOTAL CORTISOL - CORTISOL SALIVA	$80.00	$80.00	$7.04–$76.00	11% above	—
Cortisol blood test, total CPT 82533 HC TOTAL CORTISOL - ACTH STIMULATION BASELINE	$80.00	$80.00	$7.04–$76.00	11% above	—
Cortisol blood test, total CPT 82533 HC DEXAMETHASONE SUPPRESSION	$80.00	$80.00	$7.04–$76.00	11% above	—
Cortisol blood test, total CPT 82533 HC TOTAL CORTISOL - ACTH STIMULATION 30 MINUTES	$80.00	$80.00	$7.04–$76.00	11% above	—
Cortisol blood test, total inpatient CPT 82533 HC TOTAL CORTISOL - ACTH STIMULATION 30 MINUTES	$80.00	$80.00	$7.04–$76.00	—	—
Cortisol blood test, total inpatient CPT 82533 HC TOTAL CORTISOL - CORTISOL SALIVA	$80.00	$80.00	$7.04–$76.00	—	—
Cortisol blood test, total inpatient CPT 82533 HC TOTAL CORTISOL - CORTISOL	$80.00	$80.00	$7.04–$76.00	—	—
Cortisol blood test, total inpatient CPT 82533 HC TOTAL CORTISOL - ACTH STIMULATION 1 HOUR	$80.00	$80.00	$7.04–$76.00	—	—
Cortisol blood test, total inpatient CPT 82533 HC TOTAL CORTISOL - CORTISOL SERUM	$80.00	$80.00	$7.04–$76.00	—	—
Cortisol blood test, total inpatient CPT 82533 HC TOTAL CORTISOL - ACTH STIMULATION BASELINE	$80.00	$80.00	$7.04–$76.00	—	—
Cortisol blood test, total inpatient CPT 82533 HC DEXAMETHASONE SUPPRESSION	$80.00	$80.00	$7.04–$76.00	—	—
Creatine kinase (CK) blood test, total CPT 82550 HC ASSAY OF CK (CPK) - CK	$36.00	$36.00	$2.82–$34.20	24% below	—
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE TOTAL	$36.00	$36.00	$2.82–$34.20	24% below	—
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC ASSAY OF CK (CPK) - CK	$36.00	$36.00	$2.82–$34.20	—	—
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE TOTAL	$36.00	$36.00	$2.82–$34.20	—	—
Creatinine blood test CPT 82565 CREATININE BLOOD	$29.00	$29.00	$2.22–$27.55	20% above	—
Creatinine blood test CPT 82565 HC ASSAY OF CREATININE - CREATININE BLOOD	$29.00	$29.00	$2.22–$27.55	20% above	—
Creatinine blood test CPT 82565 HC GLOMERULAR FILTRATION RATE, ESTIMATED (EGFR)	$29.00	$29.00	$2.22–$27.55	20% above	—
Creatinine blood test CPT 82565 HC ASSAY OF CREATININE - CREATININE FLUID	$29.00	$29.00	$2.22–$27.55	20% above	—
Creatinine blood test CPT 82565 HC CREATININE FOR CONTRAST	$29.00	$29.00	$2.22–$27.55	20% above	—
Creatinine blood test CPT 82565 HC ASSAY OF CREATININE - CREATININE SERUM	$29.00	$29.00	$2.22–$27.55	20% above	—
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$29.00	$29.00	$2.22–$27.55	—	—
Creatinine blood test inpatient CPT 82565 HC GLOMERULAR FILTRATION RATE, ESTIMATED (EGFR)	$29.00	$29.00	$2.22–$27.55	—	—
Creatinine blood test inpatient CPT 82565 HC CREATININE FOR CONTRAST	$29.00	$29.00	$2.22–$27.55	—	—
Creatinine blood test inpatient CPT 82565 HC ASSAY OF CREATININE - CREATININE SERUM	$29.00	$29.00	$2.22–$27.55	—	—
Creatinine blood test inpatient CPT 82565 HC ASSAY OF CREATININE - CREATININE FLUID	$29.00	$29.00	$2.22–$27.55	—	—
Creatinine blood test inpatient CPT 82565 HC ASSAY OF CREATININE - CREATININE BLOOD	$29.00	$29.00	$2.22–$27.55	—	—
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV ANTIBODY - CYTOMEGALOVIRUS IGG	$52.00	$52.00	$6.22–$55.19	32% below	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV ANTIBODY - CYTOMEGALOVIRUS IGG	$52.00	$52.00	$6.22–$55.19	—	—
D-dimer blood test (blood clot marker) CPT 85379 HC FIBRIN DEGRADPRODUCTS,D-DIMER, QUANT - D-DIMER,QUANTITATIVE	$56.00	$56.00	$2.47–$53.20	40% below	—
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE	$56.00	$56.00	$2.47–$53.20	40% below	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE	$56.00	$56.00	$2.47–$53.20	—	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC FIBRIN DEGRADPRODUCTS,D-DIMER, QUANT - D-DIMER,QUANTITATIVE	$56.00	$56.00	$2.47–$53.20	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE - DHEA-SULFATE	$101.00	$101.00	$8.37–$95.95	5% above	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE - DHEA-SULFATE	$101.00	$101.00	$8.37–$95.95	—	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - OPIATE QUALITATIVE URINE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - BENZODIAZEPINE URINE QUAL	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - TRAMADOL SCREEN URINE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - AMPHETAMINE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - OXYCODONE/OXYMORPHONE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC MECONIUM DRUG SCREEN	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - METHADONE SCREEN, URINE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC UMBILICAL CORD DRUG SCREEN	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - ZYPREXA/OLANZAPINE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - LSD SCREEN URINE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - ALCOHOL URINE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC MECONIUM DRUG PANEL 8	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - ALCOHOL BLOOD	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - POCT BARBITURATES	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYR - GAMMA HYDROXYBUTYRIC ACID	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC MECONIUM DRUG PANEL 9	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYR - ETHYL CLUCURONIDE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN/MULTI DRG CLS	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - FLUNITRAZEPAM SCREEN URINE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN PRESUMPTIVE OPT INST	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - SALYCILATES	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN PANEL CARD	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - DRUG SCREEN PANEL, EMERGENCY	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUGS OF ABUSE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG MONITORING, FENTANYL, W CONFIRMATION, URINE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - DRUG SCREEN PANEL 1, SERUM	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - OXYCODONE SCREEN URINE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC HC DRUG TEST PRSMV CHEM ANLYZR - CARISOPRODOL SCREEN URINE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - COCAINE URINE QUAL	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC MECONIUM DRUG PANEL 10	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG HAIRSTAT 5 REFLEX PANEL - REF LAB	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG ANALYSIS SERUM	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG ANALYSIS PROFILE, COMPREHENSIVE, URINE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - POCT NICOTINE AND/OR METABOLITES	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - BUPRENORPHINR SCREEN URINE	$171.00	$171.00	$13.55–$238.31	46% above	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - LSD SCREEN URINE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - POCT BARBITURATES	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - OXYCODONE/OXYMORPHONE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - OXYCODONE SCREEN URINE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - SALYCILATES	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - TRAMADOL SCREEN URINE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - ZYPREXA/OLANZAPINE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - OPIATE QUALITATIVE URINE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC MECONIUM DRUG PANEL 10	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - METHADONE SCREEN, URINE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - POCT NICOTINE AND/OR METABOLITES	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC MECONIUM DRUG PANEL 8	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - FLUNITRAZEPAM SCREEN URINE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - DRUG SCREEN PANEL, EMERGENCY	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - DRUG SCREEN PANEL 1, SERUM	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - COCAINE URINE QUAL	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - BUPRENORPHINR SCREEN URINE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - BENZODIAZEPINE URINE QUAL	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - AMPHETAMINE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC MECONIUM DRUG PANEL 9	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC MECONIUM DRUG SCREEN	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC UMBILICAL CORD DRUG SCREEN	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - ALCOHOL URINE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - ALCOHOL BLOOD	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYR - GAMMA HYDROXYBUTYRIC ACID	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYR - ETHYL CLUCURONIDE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN/MULTI DRG CLS	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN PRESUMPTIVE OPT INST	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN PANEL CARD	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG MONITORING, FENTANYL, W CONFIRMATION, URINE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG HAIRSTAT 5 REFLEX PANEL - REF LAB	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUGS OF ABUSE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC HC DRUG TEST PRSMV CHEM ANLYZR - CARISOPRODOL SCREEN URINE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG ANALYSIS PROFILE, COMPREHENSIVE, URINE	$171.00	$171.00	$13.55–$238.31	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG ANALYSIS SERUM	$171.00	$171.00	$13.55–$238.31	—	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL	$22.00	$22.00	$3.03–$26.88	58% below	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$22.00	$22.00	$3.03–$26.88	58% below	—
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL	$22.00	$22.00	$3.03–$26.88	—	—
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$22.00	$22.00	$3.03–$26.88	—	—
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR CAPSID VCA - EPSTEIN-BARR VIRUS VCA, IGM	$97.00	$97.00	$6.94–$92.15	24% above	—
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR CAPSID VCA - EPSTEIN-BARR VIRUS VCA ANTIBODY PANEL	$97.00	$97.00	$6.94–$92.15	24% above	—
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR CAPSID VCA - EPSTEIN-BARR VIRUS VCA, IGA	$97.00	$97.00	$6.94–$92.15	24% above	—
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR CAPSID VCA - EPSTEIN-BARR VIRUS VCA, IGG	$97.00	$97.00	$6.94–$92.15	24% above	—
Epstein-Barr virus (EBV) antibody test CPT 86665 ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA	$97.00	$97.00	$6.94–$92.15	24% above	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA	$97.00	$97.00	$6.94–$92.15	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR CAPSID VCA - EPSTEIN-BARR VIRUS VCA, IGG	$97.00	$97.00	$6.94–$92.15	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR CAPSID VCA - EPSTEIN-BARR VIRUS VCA, IGA	$97.00	$97.00	$6.94–$92.15	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR CAPSID VCA - EPSTEIN-BARR VIRUS VCA ANTIBODY PANEL	$97.00	$97.00	$6.94–$92.15	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR CAPSID VCA - EPSTEIN-BARR VIRUS VCA, IGM	$97.00	$97.00	$6.94–$92.15	—	—
Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL - ESTRADIOL	$154.00	$154.00	$8.37–$146.30	33% above	—
Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL	$154.00	$154.00	$8.37–$146.30	33% above	—
Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL - ESTRADIOL HIGH SENSITIVE	$154.00	$154.00	$8.37–$146.30	33% above	—
Estradiol blood test inpatient CPT 82670 HC ASSAY OF ESTRADIOL - ESTRADIOL	$154.00	$154.00	$8.37–$146.30	—	—
Estradiol blood test inpatient CPT 82670 ASSAY OF TOTAL ESTRADIOL	$154.00	$154.00	$8.37–$146.30	—	—
Estradiol blood test inpatient CPT 82670 HC ASSAY OF ESTRADIOL - ESTRADIOL HIGH SENSITIVE	$154.00	$154.00	$8.37–$146.30	—	—
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN FOLLICLE STIMULATING HORMONE	$102.00	$102.00	$8.03–$96.90	3% below	—
FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN (FSH) - FSH	$102.00	$102.00	$8.03–$96.90	3% below	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN (FSH) - FSH	$102.00	$102.00	$8.03–$96.90	—	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN FOLLICLE STIMULATING HORMONE	$102.00	$102.00	$8.03–$96.90	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY OF CALPROTECTIN FECAL	$60.00	$60.00	$8.08–$75.28	72% below	—
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY OF CALPROTECTIN FECAL	$60.00	$60.00	$8.08–$75.28	72% below	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY OF CALPROTECTIN FECAL	$60.00	$60.00	$8.08–$75.28	—	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC ASSAY OF CALPROTECTIN FECAL	$60.00	$60.00	$8.08–$75.28	—	—
Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN - FERRITIN	$61.00	$61.00	$5.89–$57.95	15% below	—
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN	$61.00	$61.00	$5.89–$57.95	15% below	—
Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN - FERRITIN	$61.00	$61.00	$5.89–$57.95	—	—
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN	$61.00	$61.00	$5.89–$57.95	—	—
Fibrinogen blood test CPT 85384 HC FIBRINOGEN, ACTIVITY - FIBRINOGEN,QUANTITATIVE	$27.00	$27.00	$2.47–$37.28	62% below	—
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN, ACTIVITY - FIBRINOGEN,QUANTITATIVE	$27.00	$27.00	$2.47–$37.28	—	—
Folate (folic acid) blood test CPT 82746 HC BLOOD FOLIC ACID SERUM - FOLATE	$81.00	$81.00	$6.35–$76.95	11% above	—
Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM	$81.00	$81.00	$6.35–$76.95	11% above	—
Folate (folic acid) blood test inpatient CPT 82746 HC BLOOD FOLIC ACID SERUM - FOLATE	$81.00	$81.00	$6.35–$76.95	—	—
Folate (folic acid) blood test inpatient CPT 82746 ASSAY OF FOLIC ACID SERUM	$81.00	$81.00	$6.35–$76.95	—	—
Free T3 thyroid hormone test CPT 84481 ASSAY OF TRIIODOTHYRONINE T3 FREE	$86.00	$86.00	$7.32–$81.70	23% above	—
Free T3 thyroid hormone test CPT 84481 HC TRIIODOTHYRONINE FREE ASSAY (FT-3) - T3 FREE	$86.00	$86.00	$7.32–$81.70	23% above	—
Free T3 thyroid hormone test inpatient CPT 84481 HC TRIIODOTHYRONINE FREE ASSAY (FT-3) - T3 FREE	$86.00	$86.00	$7.32–$81.70	—	—
Free T3 thyroid hormone test inpatient CPT 84481 ASSAY OF TRIIODOTHYRONINE T3 FREE	$86.00	$86.00	$7.32–$81.70	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$49.00	$49.00	$3.90–$46.55	13% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE - T4 FREE	$49.00	$49.00	$3.90–$46.55	13% above	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE	$49.00	$49.00	$3.90–$46.55	—	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE - T4 FREE	$49.00	$49.00	$3.90–$46.55	—	—
Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE	$101.00	$101.00	$8.37–$97.68	at median	—
Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE	$101.00	$101.00	$8.37–$97.68	—	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GLUTAMYLTRASE GAMMA	$40.00	$40.00	$3.11–$38.00	9% above	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GGT - GAMMA GT	$40.00	$40.00	$3.11–$38.00	9% above	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC ASSAY OF GGT - GAMMA GT	$40.00	$40.00	$3.11–$38.00	—	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 ASSAY OF GLUTAMYLTRASE GAMMA	$40.00	$40.00	$3.11–$38.00	—	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC GENERAL HEALTH PANEL - BUNDLED CHARGE	$80.00	$80.00	$5.51–$111.24	57% below	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$198.70	$198.70	$5.51–$188.76	8% above	—
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC GENERAL HEALTH PANEL - BUNDLED CHARGE	$80.00	$80.00	$5.51–$111.24	—	—
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$198.70	$198.70	$5.51–$188.76	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE TEST - LTT 1 HR	$27.00	$27.00	$2.06–$25.65	4% below	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE TEST - LTT FASTING	$27.00	$27.00	$2.06–$25.65	4% below	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE	$27.00	$27.00	$2.06–$25.65	4% below	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE TEST - LTT 2 HR	$27.00	$27.00	$2.06–$25.65	4% below	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE TEST - GTT 1 HOUR	$27.00	$27.00	$2.06–$25.65	4% below	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUCOSE DOSE	$27.00	$27.00	$2.06–$25.65	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE TEST - LTT 2 HR	$27.00	$27.00	$2.06–$25.65	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE TEST - LTT 1 HR	$27.00	$27.00	$2.06–$25.65	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE TEST - GTT 1 HOUR	$27.00	$27.00	$2.06–$25.65	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE TEST - LTT FASTING	$27.00	$27.00	$2.06–$25.65	—	—
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - GTT 2 HOUR	$71.00	$71.00	$5.56–$67.45	4% below	—
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS	$71.00	$71.00	$5.56–$67.45	4% below	—
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - LACTOSE INTOLERANCE	$71.00	$71.00	$5.56–$67.45	4% below	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS	$71.00	$71.00	$5.56–$67.45	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - GTT 2 HOUR	$71.00	$71.00	$5.56–$67.45	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - LACTOSE INTOLERANCE	$71.00	$71.00	$5.56–$67.45	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ	$105.00	$105.00	$15.16–$134.57	10% below	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.GONORRHOEAE, DNA, AMP PROB - GC DNA PCR	$105.00	$105.00	$15.16–$134.57	10% below	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ	$105.00	$105.00	$15.16–$134.57	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N.GONORRHOEAE, DNA, AMP PROB - GC DNA PCR	$105.00	$105.00	$15.16–$134.57	—	—
H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI - HELICOBACTER PYLORI IGG	$80.00	$80.00	$6.94–$76.00	12% below	—
H. pylori antibody blood test CPT 86677 HC H PYLORI ANTIBODY IGM ARU	$80.00	$80.00	$6.94–$76.00	12% below	—
H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI - HELICOBACTER PYLORI IGA	$80.00	$80.00	$6.94–$76.00	12% below	—
H. pylori antibody blood test inpatient CPT 86677 HC HELICOBACTER PYLORI - HELICOBACTER PYLORI IGG	$80.00	$80.00	$6.94–$76.00	—	—
H. pylori antibody blood test inpatient CPT 86677 HC HELICOBACTER PYLORI - HELICOBACTER PYLORI IGA	$80.00	$80.00	$6.94–$76.00	—	—
H. pylori antibody blood test inpatient CPT 86677 HC H PYLORI ANTIBODY IGM ARU	$80.00	$80.00	$6.94–$76.00	—	—
H. pylori stool antigen test CPT 87338 IAAD IA HPYLORI STOOL	$44.00	$44.00	$4.79–$55.15	54% below	—
H. pylori stool antigen test CPT 87338 HC IAAD IA HPYLORI STOOL - H PYLORI ANTIGEN STOOL	$44.00	$44.00	$4.79–$55.15	54% below	—
H. pylori stool antigen test inpatient CPT 87338 HC IAAD IA HPYLORI STOOL - H PYLORI ANTIGEN STOOL	$44.00	$44.00	$4.79–$55.15	—	—
H. pylori stool antigen test inpatient CPT 87338 IAAD IA HPYLORI STOOL	$44.00	$44.00	$4.79–$55.15	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRPJ - HIV 1 RNA QUANT BY PCR	$386.00	$386.00	$36.77–$366.70	2% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRPJ - HIV RNA, QUANTITATIVE, PCR	$386.00	$386.00	$36.77–$366.70	2% above	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRPJ - HIV 1 RNA QUANT BY PCR	$386.00	$386.00	$36.77–$366.70	—	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRPJ - HIV RNA, QUANTITATIVE, PCR	$386.00	$386.00	$36.77–$366.70	—	—
HIV-1 and HIV-2 antibody test CPT 86703 ANTIBODY HIV-1&HIV-2 SINGLE RESULT	$15.00	$15.00	$5.93–$68.35	84% below	—
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV-1/HIV-2, SINGLE ASSAY - RAPID HIV 1 AND 2 SCREEN	$75.00	$75.00	$5.93–$71.25	21% below	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 ANTIBODY HIV-1&HIV-2 SINGLE RESULT	$15.00	$15.00	$5.93–$68.35	—	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV-1/HIV-2, SINGLE ASSAY - RAPID HIV 1 AND 2 SCREEN	$75.00	$75.00	$5.93–$71.25	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV-1 ANTIGENS W/HIV 1 & 2 ANTIBODY	$67.00	$67.00	$4.79–$92.35	28% below	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV-1 ANTIGENS W/HIV 1 & 2 ANTIBODY	$67.00	$67.00	$4.79–$92.35	—	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV DNA PROBE, AMP	$145.00	$145.00	$15.16–$137.75	35% above	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV DNA PROBE, DIRECT	$145.00	$145.00	$15.16–$137.75	35% above	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV DNA PROBE, AMP/DIRECT/PCR	$145.00	$145.00	$15.16–$137.75	35% above	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV HIGH RISK PCR	$145.00	$145.00	$15.16–$137.75	35% above	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 IADNA HUMAN PAPILLOMAVIRUS HI-RSK TYP POOLD RSLT	$145.00	$145.00	$15.16–$137.75	35% above	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV HIGH RISK PCR	$145.00	$145.00	$15.16–$137.75	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 IADNA HUMAN PAPILLOMAVIRUS HI-RSK TYP POOLD RSLT	$145.00	$145.00	$15.16–$137.75	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV DNA PROBE, AMP	$145.00	$145.00	$15.16–$137.75	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV DNA PROBE, AMP/DIRECT/PCR	$145.00	$145.00	$15.16–$137.75	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV DNA PROBE, DIRECT	$145.00	$145.00	$15.16–$137.75	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - HEMOGLOBIN A1C	$35.00	$35.00	$3.25–$37.24	21% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HF GLYCOSYLATED HEMOGLOBIN TEST	$38.00	$38.00	$3.25–$37.24	14% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - POCT GLYCATED HEMOGLOBIN, TOTAL	$38.00	$38.00	$3.25–$37.24	14% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - HEMOGLOBIN A1C REF LAB	$38.00	$38.00	$3.25–$37.24	14% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - GLYCATED HEMOGLOBIN	$38.00	$38.00	$3.25–$37.24	14% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$39.00	$39.00	$3.25–$37.24	12% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - HEMOGLOBIN A1C	$35.00	$35.00	$3.25–$37.24	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - POCT GLYCATED HEMOGLOBIN, TOTAL	$38.00	$38.00	$3.25–$37.24	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HF GLYCOSYLATED HEMOGLOBIN TEST	$38.00	$38.00	$3.25–$37.24	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - GLYCATED HEMOGLOBIN	$38.00	$38.00	$3.25–$37.24	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - HEMOGLOBIN A1C REF LAB	$38.00	$38.00	$3.25–$37.24	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$39.00	$39.00	$3.25–$37.24	—	—
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN - POCT HEMOGLOBIN	$13.00	$13.00	$1.02–$12.35	17% below	—
Hemoglobin blood test CPT 85018 BLOOD COUNT HEMOGLOBIN	$13.00	$13.00	$1.02–$12.35	17% below	—
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN - HEMOGLOBIN	$13.00	$13.00	$1.02–$12.35	17% below	—
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN - HEMOGLOBIN	$13.00	$13.00	$1.02–$12.35	—	—
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN - POCT HEMOGLOBIN	$13.00	$13.00	$1.02–$12.35	—	—
Hemoglobin blood test inpatient CPT 85018 BLOOD COUNT HEMOGLOBIN	$13.00	$13.00	$1.02–$12.35	—	—
Hepatitis B core antibody test (total) CPT 86704 HC HEP B CORE AB TEST, TOTAL - HEPATITIS B CORE ANTIBODY, TOTAL	$67.00	$67.00	$5.21–$63.65	16% above	—
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEP B CORE AB TEST, TOTAL - HEPATITIS B CORE ANTIBODY, TOTAL	$67.00	$67.00	$5.21–$63.65	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY - STUDENT	$59.00	$59.00	$4.64–$56.05	15% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY	$59.00	$59.00	$4.64–$56.05	15% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC EMPLOYEE HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY	$59.00	$59.00	$4.64–$56.05	15% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURF ANTIBODY HBSAB	$59.00	$59.00	$4.64–$56.05	15% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURF ANTIBODY HBSAB	$59.00	$59.00	$4.64–$56.05	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY	$59.00	$59.00	$4.64–$56.05	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY - STUDENT	$59.00	$59.00	$4.64–$56.05	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC EMPLOYEE HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY	$59.00	$59.00	$4.64–$56.05	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 IAAD IA HEPATITIS B SURFACE ANTIGEN	$57.00	$57.00	$4.47–$54.15	3% below	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN - HEPATITIS B SURFACE ANTIGEN	$57.00	$57.00	$4.47–$54.15	3% below	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 IAAD IA HEPATITIS B SURFACE ANTIGEN	$57.00	$57.00	$4.47–$54.15	—	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN - HEPATITIS B SURFACE ANTIGEN	$57.00	$57.00	$4.47–$54.15	—	—
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$74.00	$74.00	$6.17–$71.14	11% above	—
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C AB TEST - HEPATITIS C ANTIBODY	$74.00	$74.00	$6.17–$71.14	11% above	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C AB TEST - HEPATITIS C ANTIBODY	$74.00	$74.00	$6.17–$71.14	—	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$74.00	$74.00	$6.17–$71.14	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION	$235.00	$235.00	$18.27–$223.25	7% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION - HCV QUANT PCR	$235.00	$235.00	$18.27–$223.25	7% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION	$235.00	$235.00	$18.27–$223.25	7% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION - HEPATITIS C BDNA	$235.00	$235.00	$18.27–$223.25	7% above	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION	$235.00	$235.00	$18.27–$223.25	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION - HEPATITIS C BDNA	$235.00	$235.00	$18.27–$223.25	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION - HCV QUANT PCR	$235.00	$235.00	$18.27–$223.25	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION	$235.00	$235.00	$18.27–$223.25	—	—
Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TEST, TYPE 1 - HSV 1 IGG ANTIBODY	$37.00	$37.00	$5.70–$50.58	8% below	—
Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TEST, TYPE 1 - HSV 1 IGM ANTIBODY	$37.00	$37.00	$5.70–$50.58	8% below	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TEST, TYPE 1 - HSV 1 IGG ANTIBODY	$37.00	$37.00	$5.70–$50.58	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TEST, TYPE 1 - HSV 1 IGM ANTIBODY	$37.00	$37.00	$5.70–$50.58	—	—
Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TEST, TYPE 2 - HSV 2 IGM ANTIBODY	$65.00	$65.00	$6.94–$74.21	4% below	—
Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TEST, TYPE 2 - HSV 2 IGG ANTIBODY	$65.00	$65.00	$6.94–$74.21	4% below	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TEST, TYPE 2 - HSV 2 IGG ANTIBODY	$65.00	$65.00	$6.94–$74.21	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TEST, TYPE 2 - HSV 2 IGM ANTIBODY	$65.00	$65.00	$6.94–$74.21	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HIGH SENSITIVITY	$71.00	$71.00	$5.60–$67.45	9% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN,HIGH SENSITIVITY - HIGH SENSITIVITY CRP	$71.00	$71.00	$5.60–$67.45	9% above	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HIGH SENSITIVITY	$71.00	$71.00	$5.60–$67.45	—	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN,HIGH SENSITIVITY - HIGH SENSITIVITY CRP	$71.00	$71.00	$5.60–$67.45	—	—
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE	$52.00	$52.00	$7.74–$68.72	35% below	—
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE	$52.00	$52.00	$7.74–$68.72	35% below	—
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE TOTAL	$52.00	$52.00	$7.74–$68.72	35% below	—
Homocysteine blood test inpatient CPT 83090 ASSAY OF HOMOCYSTEINE	$52.00	$52.00	$7.74–$68.72	—	—
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE TOTAL	$52.00	$52.00	$7.74–$68.72	—	—
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE	$52.00	$52.00	$7.74–$68.72	—	—
Insulin blood test CPT 83525 HC ASSAY OF INSULIN,TOTAL - INSULIN, TOTAL	$63.00	$63.00	$4.94–$59.85	1% above	—
Insulin blood test CPT 83525 HC ASSAY OF INSULIN,TOTAL - INSULIN, FASTING	$63.00	$63.00	$4.94–$59.85	1% above	—
Insulin blood test CPT 83525 HC ASSAY OF INSULIN,TOTAL - INSULIN, RANDOM	$63.00	$63.00	$4.94–$59.85	1% above	—
Insulin blood test CPT 83525 ASSAY OF INSULIN TOTAL	$63.00	$63.00	$4.94–$59.85	1% above	—
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN,TOTAL - INSULIN, FASTING	$63.00	$63.00	$4.94–$59.85	—	—
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN,TOTAL - INSULIN, TOTAL	$63.00	$63.00	$4.94–$59.85	—	—
Insulin blood test inpatient CPT 83525 ASSAY OF INSULIN TOTAL	$63.00	$63.00	$4.94–$59.85	—	—
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN,TOTAL - INSULIN, RANDOM	$63.00	$63.00	$4.94–$59.85	—	—
Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON - IRON	$36.00	$36.00	$2.80–$34.20	7% below	—
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON	$36.00	$36.00	$2.80–$34.20	7% below	—
Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON - IRON	$36.00	$36.00	$2.80–$34.20	—	—
Iron blood test (serum iron) inpatient CPT 83540 ASSAY OF IRON	$36.00	$36.00	$2.80–$34.20	—	—
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$34.30	$34.30	$3.78–$33.52	27% below	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$34.30	$34.30	$3.78–$33.52	—	—
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$48.00	$48.00	$3.75–$45.60	25% below	—
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL - BUNDLED CHARGE	$48.00	$48.00	$3.75–$45.60	25% below	—
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$48.00	$48.00	$3.75–$45.60	—	—
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL - BUNDLED CHARGE	$48.00	$48.00	$3.75–$45.60	—	—
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN LUTEINIZING HORMONE	$76.00	$76.00	$8.00–$72.20	7% below	—
LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN (LH) - LUTEINIZING HORMONE	$76.00	$76.00	$8.00–$72.20	7% below	—
LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN (LH) - LUTEINIZING HORMONE	$76.00	$76.00	$8.00–$72.20	—	—
LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN LUTEINIZING HORMONE	$76.00	$76.00	$8.00–$72.20	—	—
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID - POCT LACTIC ACID (LACTATE)	$52.00	$52.00	$5.00–$49.40	30% below	—
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID - LACTIC ACID BODY FLUID	$52.00	$52.00	$5.00–$49.40	30% below	—
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID - LACTIC ACID, VENOUS, WHOLE BLOOD	$52.00	$52.00	$5.00–$49.40	30% below	—
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID - LACTIC ACID, ARTERIAL, WHOLE BLOOD	$52.00	$52.00	$5.00–$49.40	30% below	—
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID - LACTATE	$52.00	$52.00	$5.00–$49.40	30% below	—
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID - LACTIC ACID, VENOUS, WHOLE BLOOD	$52.00	$52.00	$5.00–$49.40	—	—
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID - LACTIC ACID, ARTERIAL, WHOLE BLOOD	$52.00	$52.00	$5.00–$49.40	—	—
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID - POCT LACTIC ACID (LACTATE)	$52.00	$52.00	$5.00–$49.40	—	—
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID - LACTATE	$52.00	$52.00	$5.00–$49.40	—	—
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID - LACTIC ACID BODY FLUID	$52.00	$52.00	$5.00–$49.40	—	—
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE (LD) (LDH) ENZYME - LACTATE DEHYDROGENASE	$34.00	$34.00	$2.61–$32.30	18% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE (LD) (LDH) ENZYME - LACTATE DEHYDROGENASE FL	$34.00	$34.00	$2.61–$32.30	18% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE LDH	$34.00	$34.00	$2.61–$32.30	18% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE (LD) (LDH) ENZYME - LACTATE DEHYDROGENASE PLEURAL FLUID	$34.00	$34.00	$2.61–$32.30	18% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE (LD) (LDH) ENZYME - LACTATE DEHYDROGENASE BLOOD	$34.00	$34.00	$2.61–$32.30	18% above	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE LDH	$34.00	$34.00	$2.61–$32.30	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE (LD) (LDH) ENZYME - LACTATE DEHYDROGENASE BLOOD	$34.00	$34.00	$2.61–$32.30	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE (LD) (LDH) ENZYME - LACTATE DEHYDROGENASE	$34.00	$34.00	$2.61–$32.30	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE (LD) (LDH) ENZYME - LACTATE DEHYDROGENASE FL	$34.00	$34.00	$2.61–$32.30	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE (LD) (LDH) ENZYME - LACTATE DEHYDROGENASE PLEURAL FLUID	$34.00	$34.00	$2.61–$32.30	—	—
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE - LIPASE BODY FLUID	$38.00	$38.00	$2.98–$36.10	45% below	—
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE	$38.00	$38.00	$2.98–$36.10	45% below	—
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE - LIPASE	$38.00	$38.00	$2.98–$36.10	45% below	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE - LIPASE BODY FLUID	$38.00	$38.00	$2.98–$36.10	—	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 ASSAY OF LIPASE	$38.00	$38.00	$2.98–$36.10	—	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE - LIPASE	$38.00	$38.00	$2.98–$36.10	—	—
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL	$45.00	$45.00	$3.53–$42.75	15% below	—
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$45.00	$45.00	$3.53–$42.75	15% below	—
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL	$45.00	$45.00	$3.53–$42.75	—	—
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$45.00	$45.00	$3.53–$42.75	—	—
Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES	$52.00	$52.00	$6.94–$65.31	37% below	—
Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY - POCT LYME DISEASE ANTIBODIES (BORRELIA BURG)	$52.00	$52.00	$6.94–$65.31	37% below	—
Lyme disease antibody test CPT 86618 ANTIBODY BORRELIA BURGDORFERI LYME DISEASE	$52.00	$52.00	$6.94–$65.31	37% below	—
Lyme disease antibody test CPT 86618 HC LYME POLYVALENT (FIA)	$52.00	$52.00	$6.94–$65.31	37% below	—
Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY - LYME DISEASE (BORRELIA BURGDORFERI), QUANT	$52.00	$52.00	$6.94–$65.31	37% below	—
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY - LYME DISEASE (BORRELIA BURGDORFERI), QUANT	$52.00	$52.00	$6.94–$65.31	—	—
Lyme disease antibody test inpatient CPT 86618 HC LYME POLYVALENT (FIA)	$52.00	$52.00	$6.94–$65.31	—	—
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY - POCT LYME DISEASE ANTIBODIES (BORRELIA BURG)	$52.00	$52.00	$6.94–$65.31	—	—
Lyme disease antibody test inpatient CPT 86618 ANTIBODY BORRELIA BURGDORFERI LYME DISEASE	$52.00	$52.00	$6.94–$65.31	—	—
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES	$52.00	$52.00	$6.94–$65.31	—	—
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM	$37.00	$37.00	$2.90–$35.15	16% below	—
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM 24HR URINE	$37.00	$37.00	$2.90–$35.15	16% below	—
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM URINE	$37.00	$37.00	$2.90–$35.15	16% below	—
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM RBC	$37.00	$37.00	$2.90–$35.15	16% below	—
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM FECAL	$37.00	$37.00	$2.90–$35.15	16% below	—
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM	$37.00	$37.00	$2.90–$35.15	16% below	—
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM URINE	$37.00	$37.00	$2.90–$35.15	—	—
Magnesium blood test inpatient CPT 83735 ASSAY OF MAGNESIUM	$37.00	$37.00	$2.90–$35.15	—	—
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM	$37.00	$37.00	$2.90–$35.15	—	—
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM 24HR URINE	$37.00	$37.00	$2.90–$35.15	—	—
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM FECAL	$37.00	$37.00	$2.90–$35.15	—	—
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM RBC	$37.00	$37.00	$2.90–$35.15	—	—
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY IGG	$36.00	$36.00	$5.57–$49.39	43% below	—
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY	$36.00	$36.00	$5.57–$49.39	43% below	—
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY, IGM	$36.00	$36.00	$5.57–$49.39	43% below	—
Measles (rubeola) antibody test CPT 86765 ANTIBODY RUBEOLA	$36.00	$36.00	$5.57–$49.39	43% below	—
Measles (rubeola) antibody test CPT 86765 HC EMPLOYEE RUBEOLA - RUBEOLA ANTIBODY IGG	$36.00	$36.00	$5.57–$49.39	43% below	—
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY	$36.00	$36.00	$5.57–$49.39	—	—
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY IGG	$36.00	$36.00	$5.57–$49.39	—	—
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY, IGM	$36.00	$36.00	$5.57–$49.39	—	—
Measles (rubeola) antibody test inpatient CPT 86765 HC EMPLOYEE RUBEOLA - RUBEOLA ANTIBODY IGG	$36.00	$36.00	$5.57–$49.39	—	—
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY RUBEOLA	$36.00	$36.00	$5.57–$49.39	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES SCREEN	$29.00	$29.00	$2.24–$27.55	38% below	—
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES,SCREEN - MONONUCLEOSIS SCREEN	$29.00	$29.00	$2.24–$27.55	38% below	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODIES SCREEN	$29.00	$29.00	$2.24–$27.55	—	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES,SCREEN - MONONUCLEOSIS SCREEN	$29.00	$29.00	$2.24–$27.55	—	—
Mumps immunity blood test CPT 86735 HC MUMPS - MUMPS IGM ANTIBODY	$40.00	$40.00	$5.64–$50.05	39% below	—
Mumps immunity blood test CPT 86735 HC MUMPS - MUMPS IGG ANTIBODY	$40.00	$40.00	$5.64–$50.05	39% below	—
Mumps immunity blood test CPT 86735 HC EMPLOYEE MUMPS - MUMPS IGG ANTIBODY	$40.00	$40.00	$5.64–$50.05	39% below	—
Mumps immunity blood test CPT 86735 ANTIBODY MUMPS	$40.00	$40.00	$5.64–$50.05	39% below	—
Mumps immunity blood test inpatient CPT 86735 HC MUMPS - MUMPS IGM ANTIBODY	$40.00	$40.00	$5.64–$50.05	—	—
Mumps immunity blood test inpatient CPT 86735 HC MUMPS - MUMPS IGG ANTIBODY	$40.00	$40.00	$5.64–$50.05	—	—
Mumps immunity blood test inpatient CPT 86735 HC EMPLOYEE MUMPS - MUMPS IGG ANTIBODY	$40.00	$40.00	$5.64–$50.05	—	—
Mumps immunity blood test inpatient CPT 86735 ANTIBODY MUMPS	$40.00	$40.00	$5.64–$50.05	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE	$56.00	$56.00	$7.95–$70.53	36% below	—
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE	$56.00	$56.00	$7.95–$70.53	36% below	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE	$56.00	$56.00	$7.95–$70.53	—	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE	$56.00	$56.00	$7.95–$70.53	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 HC HF PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA	$101.00	$101.00	$7.95–$95.95	19% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL	$101.00	$101.00	$7.95–$95.95	19% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA	$101.00	$101.00	$7.95–$95.95	19% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA, ULTRASENSITIVE	$101.00	$101.00	$7.95–$95.95	19% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA TOTAL AND FREE	$101.00	$101.00	$7.95–$95.95	19% above	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL	$101.00	$101.00	$7.95–$95.95	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC HF PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA	$101.00	$101.00	$7.95–$95.95	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA	$101.00	$101.00	$7.95–$95.95	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA TOTAL AND FREE	$101.00	$101.00	$7.95–$95.95	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA, ULTRASENSITIVE	$101.00	$101.00	$7.95–$95.95	—	—
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTOPATH C/V AUTO FLUID REDO - LAB CYTOPAT,CER/VAG,THIN LAYER,INTER	$80.00	$80.00	$11.49–$102.05	24% below	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTOPATH C/V AUTO FLUID REDO - LAB CYTOPAT,CER/VAG,THIN LAYER,INTER	$80.00	$80.00	$11.49–$102.05	—	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CYTOPATH C/V THIN LAYER - LAB CYTOPATH CERV/VAG THIN LAYER	$152.00	$152.00	$8.75–$144.40	65% above	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC CYTOPATH C/V THIN LAYER - LAB CYTOPATH CERV/VAG THIN LAYER	$152.00	$152.00	$8.75–$144.40	—	—
Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE	$227.00	$227.00	$17.83–$215.65	32% above	—
Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE	$227.00	$227.00	$17.83–$215.65	32% above	—
Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE - PTH INTACT	$227.00	$227.00	$17.83–$215.65	32% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC ASSAY OF PARATHORMONE - PTH INTACT	$227.00	$227.00	$17.83–$215.65	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 ASSAY OF PARATHORMONE	$227.00	$227.00	$17.83–$215.65	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC ASSAY OF PARATHORMONE	$227.00	$227.00	$17.83–$215.65	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD	$33.00	$33.00	$2.47–$31.35	36% below	—
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT - LA SCREEN	$33.00	$33.00	$2.47–$31.35	36% below	—
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLAS TIME PARTIAL - PTT CRRT SYSTEM	$33.00	$33.00	$2.47–$31.35	36% below	—
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLAS TIME PARTIAL (APTT) - PLASMA/WHOLE BLOOD	$33.00	$33.00	$2.47–$31.35	36% below	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLAS TIME PARTIAL - PTT CRRT SYSTEM	$33.00	$33.00	$2.47–$31.35	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLAS TIME PARTIAL (APTT) - PLASMA/WHOLE BLOOD	$33.00	$33.00	$2.47–$31.35	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT - LA SCREEN	$33.00	$33.00	$2.47–$31.35	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD	$33.00	$33.00	$2.47–$31.35	—	—
Phosphorus (phosphate) blood test CPT 84100 HC ASSAY OF INORGANIC PHOSPHORUS - PHOSPHORUS BODY FLUID	$27.00	$27.00	$2.05–$25.65	9% below	—
Phosphorus (phosphate) blood test CPT 84100 ASSAY OF PHOSPHORUS INORGANIC	$27.00	$27.00	$2.05–$25.65	9% below	—
Phosphorus (phosphate) blood test CPT 84100 HC ASSAY OF INORGANIC PHOSPHORUS - ORGANOPHOSPHATE PESTICIDES	$27.00	$27.00	$2.05–$25.65	9% below	—
Phosphorus (phosphate) blood test CPT 84100 HC ASSAY OF INORGANIC PHOSPHORUS - PHOSPHORUS	$27.00	$27.00	$2.05–$25.65	9% below	—
Phosphorus (phosphate) blood test inpatient CPT 84100 HC ASSAY OF INORGANIC PHOSPHORUS - ORGANOPHOSPHATE PESTICIDES	$27.00	$27.00	$2.05–$25.65	—	—
Phosphorus (phosphate) blood test inpatient CPT 84100 HC ASSAY OF INORGANIC PHOSPHORUS - PHOSPHORUS BODY FLUID	$27.00	$27.00	$2.05–$25.65	—	—
Phosphorus (phosphate) blood test inpatient CPT 84100 ASSAY OF PHOSPHORUS INORGANIC	$27.00	$27.00	$2.05–$25.65	—	—
Phosphorus (phosphate) blood test inpatient CPT 84100 HC ASSAY OF INORGANIC PHOSPHORUS - PHOSPHORUS	$27.00	$27.00	$2.05–$25.65	—	—
Potassium blood test CPT 84132 HC ASSAY OF SERUM POTASSIUM - POTASSIUM	$26.00	$26.00	$2.06–$24.70	27% below	—
Potassium blood test CPT 84132 POTASSIUM SERUM PLASMA/WHOLE BLOOD	$26.00	$26.00	$2.06–$24.70	27% below	—
Potassium blood test inpatient CPT 84132 HC ASSAY OF SERUM POTASSIUM - POTASSIUM	$26.00	$26.00	$2.06–$24.70	—	—
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM PLASMA/WHOLE BLOOD	$26.00	$26.00	$2.06–$24.70	—	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS	$2,088.00	$2,088.00	$268.69–$2,910.96	286% above	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS	$2,088.00	$2,088.00	$268.69–$2,910.96	—	—
Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE - PROGESTERONE	$86.00	$86.00	$8.37–$81.70	4% below	—
Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE	$86.00	$86.00	$8.37–$81.70	4% below	—
Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE - PROGESTERONE	$86.00	$86.00	$8.37–$81.70	—	—
Progesterone blood test inpatient CPT 84144 ASSAY OF PROGESTERONE	$86.00	$86.00	$8.37–$81.70	—	—
Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN - PROLACTIN	$59.00	$59.00	$8.37–$74.32	38% below	—
Prolactin blood test CPT 84146 ASSAY OF PROLACTIN	$59.00	$59.00	$8.37–$74.32	38% below	—
Prolactin blood test inpatient CPT 84146 ASSAY OF PROLACTIN	$59.00	$59.00	$8.37–$74.32	—	—
Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN - PROLACTIN	$59.00	$59.00	$8.37–$74.32	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - ADDITIONAL CHARGE	$22.00	$22.00	$1.86–$20.90	38% below	—
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - PROTIME-INR	$22.00	$22.00	$1.86–$20.90	38% below	—
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - PROTHROMBIN MIXING STUDY	$22.00	$22.00	$1.86–$20.90	38% below	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$22.00	$22.00	$1.86–$20.90	38% below	—
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - PROTIME-INR, FINGERSTICK	$22.00	$22.00	$1.86–$20.90	38% below	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - ADDITIONAL CHARGE	$22.00	$22.00	$1.86–$20.90	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - PROTIME-INR	$22.00	$22.00	$1.86–$20.90	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$22.00	$22.00	$1.86–$20.90	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - PROTHROMBIN MIXING STUDY	$22.00	$22.00	$1.86–$20.90	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - PROTIME-INR, FINGERSTICK	$22.00	$22.00	$1.86–$20.90	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 RANDOM DRUGS OF ABUSE SCREEN (POCT)	$35.00	$35.00	$5.45–$48.32	42% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRSMV DIR OPT OBS - RAPID DRUG SCREEN, URINE	$35.00	$35.00	$5.45–$48.32	42% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE	$35.00	$35.00	$5.45–$48.32	42% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG SCREEN PANEL	$35.00	$35.00	$5.45–$48.32	42% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 RANDOM DRUGS OF ABUSE SCREEN (POCT)	$35.00	$35.00	$5.45–$48.32	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TEST PRSMV DIR OPT OBS - RAPID DRUG SCREEN, URINE	$35.00	$35.00	$5.45–$48.32	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG SCREEN PANEL	$35.00	$35.00	$5.45–$48.32	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE	$35.00	$35.00	$5.45–$48.32	—	—
Rapid flu test (influenza antigen) CPT 87804 HC DETECT AGENT,IMMUN,DIR OBS,INFLUENZA	$46.00	$46.00	$4.79–$63.47	31% below	—
Rapid flu test (influenza antigen) CPT 87804 HC DETECT AGENT,IMMUN,DIR OBS,INFLUENZA - RAPID FLU	$46.00	$46.00	$4.79–$63.47	31% below	—
Rapid flu test (influenza antigen) CPT 87804 IAADIADOO INFLUENZA	$86.00	$86.00	$4.79–$81.70	29% above	—
Rapid flu test (influenza antigen) inpatient CPT 87804 HC DETECT AGENT,IMMUN,DIR OBS,INFLUENZA - RAPID FLU	$46.00	$46.00	$4.79–$63.47	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 HC DETECT AGENT,IMMUN,DIR OBS,INFLUENZA	$46.00	$46.00	$4.79–$63.47	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 IAADIADOO INFLUENZA	$86.00	$86.00	$4.79–$81.70	—	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 IAADIADOO STREPTOCOCCUS GROUP A	$64.00	$64.00	$4.79–$63.39	4% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP A ASSAY W/OPTIC - RAPID STREP A SCREEN	$64.00	$64.00	$4.79–$63.39	4% above	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 IAADIADOO STREPTOCOCCUS GROUP A	$64.00	$64.00	$4.79–$63.39	—	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP A ASSAY W/OPTIC - RAPID STREP A SCREEN	$64.00	$64.00	$4.79–$63.39	—	—
Renin blood test CPT 84244 HC ASSAY OF RENIN - RENIN DIRECT ASSAY	$87.00	$87.00	$8.37–$84.33	24% below	—
Renin blood test inpatient CPT 84244 HC ASSAY OF RENIN - RENIN DIRECT ASSAY	$87.00	$87.00	$8.37–$84.33	—	—
Rh blood typing CPT 86901 BLOOD TYPING SEROLOGIC RH (D)	$104.00	$104.00	$1.29–$98.80	136% above	—
Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D)	$104.00	$104.00	$1.29–$98.80	136% above	—
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D)	$104.00	$104.00	$1.29–$98.80	—	—
Rh blood typing inpatient CPT 86901 BLOOD TYPING SEROLOGIC RH (D)	$104.00	$104.00	$1.29–$98.80	—	—
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR, QUANT - RHEUMATOID FACTOR	$18.00	$18.00	$2.45–$21.74	40% below	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANTITATIVE	$18.00	$18.00	$2.45–$21.74	40% below	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANTITATIVE	$18.00	$18.00	$2.45–$21.74	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR, QUANT - RHEUMATOID FACTOR	$18.00	$18.00	$2.45–$21.74	—	—
Rubella antibody test (immunity check) CPT 86762 HC EMPLOYEE RUBELLA - RUBELLA ANTIBODY, IGG	$54.00	$54.00	$6.22–$55.19	2% below	—
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGG/IGM	$54.00	$54.00	$6.22–$55.19	2% below	—
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGM	$54.00	$54.00	$6.22–$55.19	2% below	—
Rubella antibody test (immunity check) CPT 86762 ANTIBODY RUBELLA	$54.00	$54.00	$6.22–$55.19	2% below	—
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGG	$54.00	$54.00	$6.22–$55.19	2% below	—
Rubella antibody test (immunity check) inpatient CPT 86762 HC EMPLOYEE RUBELLA - RUBELLA ANTIBODY, IGG	$54.00	$54.00	$6.22–$55.19	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGM	$54.00	$54.00	$6.22–$55.19	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGG/IGM	$54.00	$54.00	$6.22–$55.19	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGG	$54.00	$54.00	$6.22–$55.19	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY RUBELLA	$54.00	$54.00	$6.22–$55.19	—	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC RBC SED RATE, AUTO - SEDIMENTATION RATE, AUTOMATED	$15.00	$15.00	$1.17–$14.25	40% below	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC RBC SED RATE, AUTO - SEDIMENTATION RATE, AUTOMATED	$15.00	$15.00	$1.17–$14.25	—	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC SEMEN ANALYSIS,VOLUME, COUNT, MOTILITY, DIFF - SEMEN ANALYSIS	$64.00	$64.00	$6.39–$60.80	15% below	—
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC SEMEN ANALYSIS,VOLUME, COUNT, MOTILITY, DIFF - SEMEN ANALYSIS	$64.00	$64.00	$6.39–$60.80	—	—
Sodium blood test CPT 84295 SODIUM SERUM PLASMA OR WHOLE BLOOD	$27.00	$27.00	$2.08–$25.65	12% below	—
Sodium blood test CPT 84295 HC ASSAY OF SERUM SODIUM - SODIUM	$27.00	$27.00	$2.08–$25.65	12% below	—
Sodium blood test inpatient CPT 84295 HC ASSAY OF SERUM SODIUM - SODIUM	$27.00	$27.00	$2.08–$25.65	—	—
Sodium blood test inpatient CPT 84295 SODIUM SERUM PLASMA OR WHOLE BLOOD	$27.00	$27.00	$2.08–$25.65	—	—
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS - OVA AND PARASITE EXAMINATION	$49.00	$49.00	$3.85–$46.55	5% above	—
Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES SMEARS - OVA AND PARASITE EXAMINATION	$49.00	$49.00	$3.85–$46.55	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC BLOOD OCCULT,BY PEROXID,FECES,SINGLE, COLORECTAL SCREEN - FECAL IMM	$18.00	$18.00	$1.89–$17.10	17% below	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER	$18.00	$18.00	$1.89–$17.10	17% below	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC BLOOD OCCULT,BY PEROXID,FECES,SINGLE, COLORECTAL SCREEN - OCCULT BLD	$18.00	$18.00	$1.89–$17.10	17% below	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER	$18.00	$18.00	$1.89–$17.10	—	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC BLOOD OCCULT,BY PEROXID,FECES,SINGLE, COLORECTAL SCREEN - FECAL IMM	$18.00	$18.00	$1.89–$17.10	—	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC BLOOD OCCULT,BY PEROXID,FECES,SINGLE, COLORECTAL SCREEN - OCCULT BLD	$18.00	$18.00	$1.89–$17.10	—	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC IFOB IMMUNO 1-3 TESTS	$49.00	$49.00	$6.88–$61.05	31% below	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL GLOBIN BY IMMUNOCHEMISTRY (FIT)	$49.00	$49.00	$6.88–$61.05	31% below	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECAL IMMUNOASSAY	$49.00	$49.00	$6.88–$61.05	31% below	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL GLOBIN BY IMMUNOCHEMISTRY (FIT)	$49.00	$49.00	$6.88–$61.05	—	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD OCCULT FECAL IMMUNOASSAY	$49.00	$49.00	$6.88–$61.05	—	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC IFOB IMMUNO 1-3 TESTS	$49.00	$49.00	$6.88–$61.05	—	—
Syphilis antibody test (Treponema pallidum) CPT 86780 ANTIBODY TREPONEMA PALLIDUM	$41.00	$41.00	$5.72–$50.78	46% below	—
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM - T. PALLIDUM CONFIRMATORY	$41.00	$41.00	$5.72–$50.78	46% below	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM - T. PALLIDUM CONFIRMATORY	$41.00	$41.00	$5.72–$50.78	—	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 ANTIBODY TREPONEMA PALLIDUM	$41.00	$41.00	$5.72–$50.78	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - VDRL CSF	$24.00	$24.00	$1.85–$22.80	29% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - RAPID PLASMA REAGIN-SYP	$24.00	$24.00	$1.85–$22.80	29% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - VDRL	$24.00	$24.00	$1.85–$22.80	29% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL	$24.00	$24.00	$1.85–$22.80	29% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - VDRL	$24.00	$24.00	$1.85–$22.80	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - VDRL CSF	$24.00	$24.00	$1.85–$22.80	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL	$24.00	$24.00	$1.85–$22.80	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - RAPID PLASMA REAGIN-SYP	$24.00	$24.00	$1.85–$22.80	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON	$171.00	$171.00	$20.14–$237.69	25% below	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB TEST, CELL MEDIATED ANTIGEN RESPONSE,GAMMA INTERFRON - TB TEST	$171.00	$171.00	$20.14–$237.69	25% below	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB TEST, CELL MEDIATED ANTIGEN RESPONSE,GAMMA INTERFRON - TB TEST	$171.00	$171.00	$20.14–$237.69	—	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON	$171.00	$171.00	$20.14–$237.69	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL	$129.00	$129.00	$8.37–$122.55	12% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TESTOSTERONE TOTAL	$129.00	$129.00	$8.37–$122.55	12% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 HC TOTAL TESTOSTERONE	$129.00	$129.00	$8.37–$122.55	12% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE	$129.00	$129.00	$8.37–$122.55	12% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE	$129.00	$129.00	$8.37–$122.55	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TOTAL TESTOSTERONE	$129.00	$129.00	$8.37–$122.55	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL	$129.00	$129.00	$8.37–$122.55	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TESTOSTERONE TOTAL	$129.00	$129.00	$8.37–$122.55	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY - ANTI-MICROSOMAL AB	$80.00	$80.00	$6.29–$76.00	12% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY - LIVER-KIDNEY MICROSOME IGG	$80.00	$80.00	$6.29–$76.00	12% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES EACH	$80.00	$80.00	$6.29–$76.00	12% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY - THYROID PEROXIDASE ANTIBODY	$80.00	$80.00	$6.29–$76.00	12% above	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES EACH	$80.00	$80.00	$6.29–$76.00	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY - ANTI-MICROSOMAL AB	$80.00	$80.00	$6.29–$76.00	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY - LIVER-KIDNEY MICROSOME IGG	$80.00	$80.00	$6.29–$76.00	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY - THYROID PEROXIDASE ANTIBODY	$80.00	$80.00	$6.29–$76.00	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE	$35.00	$35.00	$7.26–$78.38	55% below	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY OF THYROID STIMULATING HORMONE TSH	$87.00	$87.00	$7.26–$82.65	11% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC HF ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE	$87.00	$87.00	$7.26–$82.65	11% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC EMPLOYEE ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE	$87.00	$87.00	$7.26–$82.65	11% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY THYROID STIM HORMONE - POCT THYROID STIMULATING HORMONE (TSH)	$87.00	$87.00	$7.26–$82.65	11% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE	$35.00	$35.00	$7.26–$78.38	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC HF ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE	$87.00	$87.00	$7.26–$82.65	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY OF THYROID STIMULATING HORMONE TSH	$87.00	$87.00	$7.26–$82.65	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY THYROID STIM HORMONE - POCT THYROID STIMULATING HORMONE (TSH)	$87.00	$87.00	$7.26–$82.65	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC EMPLOYEE ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE	$87.00	$87.00	$7.26–$82.65	—	—
Total IgE blood test CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE - HUMORAL IMMUNITY STATUS SURVEY	$91.00	$91.00	$7.11–$86.45	11% above	—
Total IgE blood test CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE - IMMUNOGLOBULIN IGE	$91.00	$91.00	$7.11–$86.45	11% above	—
Total IgE blood test CPT 82785 ASSAY OF GAMMAGLOBULIN IGE	$91.00	$91.00	$7.11–$86.45	11% above	—
Total IgE blood test inpatient CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE - HUMORAL IMMUNITY STATUS SURVEY	$91.00	$91.00	$7.11–$86.45	—	—
Total IgE blood test inpatient CPT 82785 ASSAY OF GAMMAGLOBULIN IGE	$91.00	$91.00	$7.11–$86.45	—	—
Total IgE blood test inpatient CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE - IMMUNOGLOBULIN IGE	$91.00	$91.00	$7.11–$86.45	—	—
Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM/WHOLE BLOOD TOTAL	$24.00	$24.00	$1.88–$22.80	22% below	—
Total cholesterol blood test CPT 82465 HC ASSAY, BLD/SERUM CHOLESTEROL - CHOLESTEROL TOTAL	$24.00	$24.00	$1.88–$22.80	22% below	—
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL SERUM/WHOLE BLOOD TOTAL	$24.00	$24.00	$1.88–$22.80	—	—
Total cholesterol blood test inpatient CPT 82465 HC ASSAY, BLD/SERUM CHOLESTEROL - CHOLESTEROL TOTAL	$24.00	$24.00	$1.88–$22.80	—	—
Total thyroxine (T4) blood test CPT 84436 HC ASSAY OF TOTAL THYROXINE - T4 (THYROID HORMONE)	$38.00	$38.00	$2.97–$36.10	11% above	—
Total thyroxine (T4) blood test inpatient CPT 84436 HC ASSAY OF TOTAL THYROXINE - T4 (THYROID HORMONE)	$38.00	$38.00	$2.97–$36.10	—	—
Total triiodothyronine (T3) blood test CPT 84480 HC TRIIODOTHYRONINE TOTAL ASSAY, TT-3 - T3 (THYROID HORMONE)	$78.00	$78.00	$6.13–$74.10	10% below	—
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC TRIIODOTHYRONINE TOTAL ASSAY, TT-3 - T3 (THYROID HORMONE)	$78.00	$78.00	$6.13–$74.10	—	—
Transferrin blood test CPT 84466 HC ASSAY OF TRANSFERRIN - TRANSFERRIN	$71.00	$71.00	$5.51–$67.45	at median	—
Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN	$71.00	$71.00	$5.51–$67.45	at median	—
Transferrin blood test inpatient CPT 84466 ASSAY OF TRANSFERRIN	$71.00	$71.00	$5.51–$67.45	—	—
Transferrin blood test inpatient CPT 84466 HC ASSAY OF TRANSFERRIN - TRANSFERRIN	$71.00	$71.00	$5.51–$67.45	—	—
Trichomonas test (NAAT) CPT 87661 IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH	$140.00	$140.00	$15.16–$134.57	39% above	—
Trichomonas test (NAAT) CPT 87661 HC TRICHOMONAS VAGINALIS DNA AMP PROB	$140.00	$140.00	$15.16–$134.57	39% above	—
Trichomonas test (NAAT) inpatient CPT 87661 IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH	$140.00	$140.00	$15.16–$134.57	—	—
Trichomonas test (NAAT) inpatient CPT 87661 HC TRICHOMONAS VAGINALIS DNA AMP PROB	$140.00	$140.00	$15.16–$134.57	—	—
Triglycerides blood test CPT 84478 ASSAY OF TRIGLYCERIDES	$32.00	$32.00	$2.48–$30.40	9% above	—
Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES - TRIGLYCERIDES	$32.00	$32.00	$2.48–$30.40	9% above	—
Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES - TRIGLYCERIDES BODY FLUID	$32.00	$32.00	$2.48–$30.40	9% above	—
Triglycerides blood test inpatient CPT 84478 ASSAY OF TRIGLYCERIDES	$32.00	$32.00	$2.48–$30.40	—	—
Triglycerides blood test inpatient CPT 84478 HC ASSAY OF TRIGLYCERIDES - TRIGLYCERIDES	$32.00	$32.00	$2.48–$30.40	—	—
Triglycerides blood test inpatient CPT 84478 HC ASSAY OF TRIGLYCERIDES - TRIGLYCERIDES BODY FLUID	$32.00	$32.00	$2.48–$30.40	—	—
Troponin test, quantitative CPT 84484 HC ASSAY OF TROPONIN, QUANT - TROPONIN T	$100.00	$100.00	$5.39–$95.00	9% above	—
Troponin test, quantitative CPT 84484 HC ASSAY OF TROPONIN, QUANT - TROPONIN I	$100.00	$100.00	$5.39–$95.00	9% above	—
Troponin test, quantitative CPT 84484 ASSAY OF TROPONIN QUANTITATIVE	$100.00	$100.00	$5.39–$95.00	9% above	—
Troponin test, quantitative inpatient CPT 84484 HC ASSAY OF TROPONIN, QUANT - TROPONIN I	$100.00	$100.00	$5.39–$95.00	—	—
Troponin test, quantitative inpatient CPT 84484 HC ASSAY OF TROPONIN, QUANT - TROPONIN T	$100.00	$100.00	$5.39–$95.00	—	—
Troponin test, quantitative inpatient CPT 84484 ASSAY OF TROPONIN QUANTITATIVE	$100.00	$100.00	$5.39–$95.00	—	—
Uric acid blood test CPT 84550 HC ASSAY OF URIC ACID, BLOOD - URIC ACID	$25.00	$25.00	$1.96–$23.75	24% below	—
Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID	$25.00	$25.00	$1.96–$23.75	24% below	—
Uric acid blood test inpatient CPT 84550 HC ASSAY OF URIC ACID, BLOOD - URIC ACID	$25.00	$25.00	$1.96–$23.75	—	—
Uric acid blood test inpatient CPT 84550 ASSAY OF BLOOD/URIC ACID	$25.00	$25.00	$1.96–$23.75	—	—
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS, AUTO, W/SCOPE - BUNDLED CHARGE	$18.00	$18.00	$1.37–$17.10	11% above	—
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS, AUTO, W/SCOPE - URINALYSIS MICROSCOPIC	$18.00	$18.00	$1.37–$17.10	11% above	—
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS, WITH AUTO MICROSCOPY	$18.00	$18.00	$1.37–$17.10	11% above	—
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS, AUTO, W/SCOPE - BUNDLED CHARGE	$18.00	$18.00	$1.37–$17.10	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS, AUTO, W/SCOPE - URINALYSIS MICROSCOPIC	$18.00	$18.00	$1.37–$17.10	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS, WITH AUTO MICROSCOPY	$18.00	$18.00	$1.37–$17.10	—	—
Urinalysis with microscope exam, manual CPT 81000 URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY	$18.00	$18.00	$1.74–$17.10	38% below	—
Urinalysis with microscope exam, manual CPT 81000 HC URINALYSIS, NONAUTO, W/SCOPE	$18.00	$18.00	$1.74–$17.10	38% below	—
Urinalysis with microscope exam, manual inpatient CPT 81000 URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY	$18.00	$18.00	$1.74–$17.10	—	—
Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINALYSIS, NONAUTO, W/SCOPE	$18.00	$18.00	$1.74–$17.10	—	—
Urinalysis without microscope exam, automated CPT 81003 URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY	$7.00	$7.00	$0.98–$8.63	46% below	—
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY	$7.00	$7.00	$0.98–$8.63	46% below	—
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY	$7.00	$7.00	$0.98–$8.63	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY	$7.00	$7.00	$0.98–$8.63	—	—
Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS W/O SCOPE	$15.00	$15.00	$1.50–$14.25	18% below	—
Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS NONAUTO W/O SCOPE	$15.00	$15.00	$1.50–$14.25	18% below	—
Urinalysis without microscope exam, manual CPT 81002 URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$15.00	$15.00	$1.50–$14.25	18% below	—
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS NONAUTO W/O SCOPE	$15.00	$15.00	$1.50–$14.25	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS W/O SCOPE	$15.00	$15.00	$1.50–$14.25	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$15.00	$15.00	$1.50–$14.25	—	—
Urine culture for bacteria, with colony count CPT 87086 CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE	$31.65	$31.65	$3.49–$30.95	40% below	—
Urine culture for bacteria, with colony count CPT 87086 HC URINE CULTURE QUANTITATIVE COLONY COUNT	$42.00	$42.00	$3.49–$39.90	20% below	—
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE	$31.65	$31.65	$3.49–$30.95	—	—
Urine culture for bacteria, with colony count inpatient CPT 87086 HC URINE CULTURE QUANTITATIVE COLONY COUNT	$42.00	$42.00	$3.49–$39.90	—	—
Urine microalbumin (albumin) test CPT 82043 URINE ALBUMIN QUANTITATIVE	$32.00	$32.00	$1.83–$30.40	12% below	—
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN, QUANTITATIVE - MICROALBUMIN / CREATININE URINE RATIO	$32.00	$32.00	$1.83–$30.40	12% below	—
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN, QUANTITATIVE - MICROALBUMIN 24HR URINE	$32.00	$32.00	$1.83–$30.40	12% below	—
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN, QUANTITATIVE URINE	$32.00	$32.00	$1.83–$30.40	12% below	—
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN, QUANTITATIVE - MICROALBUMIN RANDOM URINE	$32.00	$32.00	$1.83–$30.40	12% below	—
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN, QUANTITATIVE - MICROALBUMIN 24HR URINE	$32.00	$32.00	$1.83–$30.40	—	—
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN, QUANTITATIVE URINE	$32.00	$32.00	$1.83–$30.40	—	—
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN, QUANTITATIVE - MICROALBUMIN / CREATININE URINE RATIO	$32.00	$32.00	$1.83–$30.40	—	—
Urine microalbumin (albumin) test inpatient CPT 82043 URINE ALBUMIN QUANTITATIVE	$32.00	$32.00	$1.83–$30.40	—	—
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN, QUANTITATIVE - MICROALBUMIN RANDOM URINE	$32.00	$32.00	$1.83–$30.40	—	—
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST - PREGNANCY URINE	$35.00	$35.00	$1.83–$33.25	8% below	—
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS	$35.00	$35.00	$1.83–$33.25	8% below	—
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS	$35.00	$35.00	$1.83–$33.25	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST - PREGNANCY URINE	$35.00	$35.00	$1.83–$33.25	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12 - VITAMIN B12	$83.00	$83.00	$6.52–$78.85	12% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN VITAMIN B-12	$83.00	$83.00	$6.52–$78.85	12% above	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBALAMIN VITAMIN B-12	$83.00	$83.00	$6.52–$78.85	—	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B-12 - VITAMIN B12	$83.00	$83.00	$6.52–$78.85	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED	$132.00	$132.00	$8.08–$125.40	22% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D TOTAL	$132.00	$132.00	$8.08–$125.40	22% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC HF VITAMIN D TOTAL	$132.00	$132.00	$8.08–$125.40	22% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC ASSAY OF VIT D,CALCIFEDIOL W FRACTIONS, IF PERFORMED - VITAMIN D 25	$132.00	$132.00	$8.08–$125.40	22% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC HF VITAMIN D TOTAL	$132.00	$132.00	$8.08–$125.40	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC ASSAY OF VIT D,CALCIFEDIOL W FRACTIONS, IF PERFORMED - VITAMIN D 25	$132.00	$132.00	$8.08–$125.40	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC VITAMIN D TOTAL	$132.00	$132.00	$8.08–$125.40	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED	$132.00	$132.00	$8.08–$125.40	—	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC CALCITRIOL (1,25 DI-OH VIT D)	$106.00	$106.00	$16.63–$147.65	34% below	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC ASSAY, DIHYDROXYVITAMIN D W/FRACTIONS, IF PERFORMED - VITAMIN D 1	$106.00	$106.00	$16.63–$147.65	34% below	—
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC CALCITRIOL (1,25 DI-OH VIT D)	$106.00	$106.00	$16.63–$147.65	—	—
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC ASSAY, DIHYDROXYVITAMIN D W/FRACTIONS, IF PERFORMED - VITAMIN D 1	$106.00	$106.00	$16.63–$147.65	—	—
Zinc blood test CPT 84630 HC ASSAY OF ZINC - ZINC	$63.00	$63.00	$4.92–$59.85	7% below	—
Zinc blood test CPT 84630 HC ASSAY OF ZINC - ZINC URINE	$63.00	$63.00	$4.92–$59.85	7% below	—
Zinc blood test CPT 84630 HC ASSAY OF ZINC - ZINC RBC	$63.00	$63.00	$4.92–$59.85	7% below	—
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC - ZINC	$63.00	$63.00	$4.92–$59.85	—	—
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC - ZINC URINE	$63.00	$63.00	$4.92–$59.85	—	—
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC - ZINC RBC	$63.00	$63.00	$4.92–$59.85	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC CHORIONIC GONADOTROPIN, QUANT - HCG QUANTITATIVE BLOOD	$83.00	$83.00	$6.51–$78.85	1% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIONIC QUANTITATIVE	$83.00	$83.00	$6.51–$78.85	1% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC CHORIONIC GONADOTROPIN, QUANT - HCG QUANTITATIVE BLOOD	$83.00	$83.00	$6.51–$78.85	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORIONIC QUANTITATIVE	$83.00	$83.00	$6.51–$78.85	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2	$3,315.00	$3,315.00	$637.47–$50,302.77	79% below	—
Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2	$3,315.00	$3,315.00	$637.47–$50,302.77	—	—
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDEC RPTD APPENDIX ABSC/PRITONITIS	$1,729.00	$1,729.00	$170.82–$3,355.93	57% below	—
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPENDEC RPTD APPENDIX ABSC/PRITONITIS	$1,729.00	$1,729.00	$170.82–$3,355.93	—	—
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$1,268.00	$1,268.00	$243.98–$25,364.84	50% below	—
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY	$1,268.00	$1,268.00	$243.98–$25,364.84	—	—
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ	$1,959.00	$1,959.00	$376.90–$28,430.31	82% below	—
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ	$1,959.00	$1,959.00	$376.90–$28,430.31	—	—
Botox injections for chronic migraine CPT 64615 HC CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$63.04	$63.04	$27.73–$1,202.66	86% below	—
Botox injections for chronic migraine CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$300.00	$300.00	$56.81–$1,202.66	35% below	—
Botox injections for chronic migraine inpatient CPT 64615 HC CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$63.04	$63.04	$27.73–$1,202.66	—	—
Botox injections for chronic migraine inpatient CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$300.00	$300.00	$56.81–$1,202.66	—	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE	$4,290.00	$4,290.00	$186.91–$6,471.06	24% above	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE	$4,290.00	$4,290.00	$186.91–$6,471.06	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CLOSED TX DIST FIBULA FX	$629.00	$629.00	$125.81–$966.46	63% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$653.00	$653.00	$125.81–$966.46	69% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC CLOSED TX DIST FIBULA FX	$629.00	$629.00	$125.81–$966.46	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$653.00	$653.00	$125.81–$966.46	—	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIPULATION	$454.00	$454.00	$87.27–$966.46	8% below	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC CLOSED TX METATARSAL FX W/O MANIPULATION	$629.00	$629.00	$87.27–$966.46	28% above	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIPULATION	$454.00	$454.00	$87.27–$966.46	—	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC CLOSED TX METATARSAL FX W/O MANIPULATION	$629.00	$629.00	$87.27–$966.46	—	—
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT	$1,791.00	$1,791.00	$339.50–$12,819.91	64% below	—
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT	$1,791.00	$1,791.00	$339.50–$12,819.91	—	—
Bunion correction with removal of part of the big toe joint CPT 28292 CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE	$1,421.00	$1,421.00	$270.82–$12,819.91	66% below	—
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE	$1,421.00	$1,421.00	$270.82–$12,819.91	—	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXT - TEE COMPLETE W/ COLOR AND CARDIOVERSION	$1,713.00	$1,713.00	$59.69–$2,589.62	17% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL	$1,713.00	$1,713.00	$59.69–$2,589.62	17% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXT - TEE COMPLETE W/ CARDIOVERSION	$1,713.00	$1,713.00	$59.69–$2,589.62	17% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXT - TEE W/ DOPPLER, COLOR AND CARDIOVERSION	$1,713.00	$1,713.00	$59.69–$2,589.62	17% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION, ELECTIVE;EXTERN	$1,713.00	$1,713.00	$59.69–$2,589.62	17% above	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRIC EXT - TEE COMPLETE W/ CARDIOVERSION	$1,713.00	$1,713.00	$59.69–$2,589.62	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRIC EXT - TEE COMPLETE W/ COLOR AND CARDIOVERSION	$1,713.00	$1,713.00	$59.69–$2,589.62	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRIC EXT - TEE W/ DOPPLER, COLOR AND CARDIOVERSION	$1,713.00	$1,713.00	$59.69–$2,589.62	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION, ELECTIVE;EXTERN	$1,713.00	$1,713.00	$59.69–$2,589.62	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL	$1,713.00	$1,713.00	$59.69–$2,589.62	—	—
Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$904.00	$904.00	$174.29–$7,650.90	66% below	—
Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$904.00	$904.00	$174.29–$7,650.90	—	—
Cervical biopsy CPT 57500 BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX	$309.00	$309.00	$57.65–$3,608.74	60% below	—
Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX	$309.00	$309.00	$57.65–$3,608.74	—	—
Cesarean delivery, including prenatal and postpartum care CPT 59510 OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$5,256.00	$5,256.00	$519.29–$4,993.20	13% above	—
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$5,256.00	$5,256.00	$519.29–$4,993.20	—	—
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION AGE >28 DAYS	$402.00	$402.00	$77.52–$8,190.26	91% below	—
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION AGE >28 DAYS	$402.00	$402.00	$77.52–$8,190.26	—	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK	$301.00	$301.00	$57.41–$8,190.26	3% above	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK	$301.00	$301.00	$57.41–$8,190.26	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLOSED TX DIST RAD/ULNA FX	$629.00	$629.00	$135.92–$966.46	84% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLOSED TX DISTAL RADIAL FX	$629.00	$629.00	$135.92–$966.46	84% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ	$707.00	$707.00	$135.92–$966.46	107% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC CLOSED TX DISTAL RADIAL FX	$629.00	$629.00	$135.92–$966.46	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC CLOSED TX DIST RAD/ULNA FX	$629.00	$629.00	$135.92–$966.46	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ	$707.00	$707.00	$135.92–$966.46	—	—
Colonoscopy with polyp removal CPT 45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$915.00	$915.00	$173.16–$4,688.52	56% below	—
Colonoscopy with polyp removal CPT 45385 HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ - COLONOSCOPY	$2,434.37	$2,434.37	$173.16–$4,688.52	16% above	—
Colonoscopy with polyp removal inpatient CPT 45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$915.00	$915.00	$173.16–$4,688.52	—	—
Colonoscopy with polyp removal inpatient CPT 45385 HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ - COLONOSCOPY	$2,434.37	$2,434.37	$173.16–$4,688.52	—	—
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$872.00	$872.00	$164.31–$4,688.52	61% below	—
Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE - COLONOSCOPY	$3,162.00	$3,162.00	$164.31–$4,688.52	40% above	—
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$872.00	$872.00	$164.31–$4,688.52	—	—
Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE - COLONOSCOPY	$3,162.00	$3,162.00	$164.31–$4,688.52	—	—
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$685.00	$685.00	$130.04–$3,643.63	71% below	—
Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD - COLONOSCOPY	$2,420.00	$2,420.00	$130.04–$3,643.63	2% above	—
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$685.00	$685.00	$130.04–$3,643.63	—	—
Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD - COLONOSCOPY	$2,420.00	$2,420.00	$130.04–$3,643.63	—	—
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX	$631.00	$631.00	$117.82–$12,683.27	64% below	—
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX	$631.00	$631.00	$117.82–$12,683.27	—	—
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE	$341.00	$341.00	$64.89–$1,193.95	11% below	—
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE	$341.00	$341.00	$64.89–$1,193.95	—	—
Cystoscopy with ureteral stent placement CPT 52332 CYSTO W/INSERT URETERAL STENT	$803.00	$803.00	$143.68–$13,811.10	87% below	—
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTO W/INSERT URETERAL STENT	$803.00	$803.00	$143.68–$13,811.10	—	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY	$319.72	$319.72	$84.46–$2,732.05	65% below	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$481.00	$481.00	$84.46–$2,732.05	47% below	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY	$319.72	$319.72	$84.46–$2,732.05	—	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$481.00	$481.00	$84.46–$2,732.05	—	—
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC	$603.00	$603.00	$114.30–$12,683.27	80% below	—
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC	$603.00	$603.00	$114.30–$12,683.27	—	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUC BENIGN/PREMAL,FIRST LESION	$25.55	$25.55	$11.24–$786.10	77% below	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESION 1ST	$138.00	$138.00	$26.48–$786.10	22% above	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUC BENIGN/PREMAL,FIRST LESION	$25.55	$25.55	$11.24–$786.10	—	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGNANT LESION 1ST	$138.00	$138.00	$26.48–$786.10	—	—
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY GENERAL ANESTHESIA	$326.00	$326.00	$62.32–$6,079.20	86% below	—
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPANOSTOMY GENERAL ANESTHESIA	$326.00	$326.00	$62.32–$6,079.20	—	—
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$32.00	$32.00	$5.90–$231.14	71% below	—
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMV IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$32.00	$32.00	$5.90–$231.14	71% below	—
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$170.00	$170.00	$5.90–$231.14	52% above	—
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC REMV IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$32.00	$32.00	$5.90–$231.14	—	—
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$32.00	$32.00	$5.90–$231.14	—	—
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$170.00	$170.00	$5.90–$231.14	—	—
Earwax removal with instruments, one ear both sides CPT 69210 HC FAC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT/BILAT	$30.06	$30.06	$13.22–$231.14	—	—
Earwax removal with instruments, one ear both sides CPT 69210 HC REMV IMPACTED CERUMEN INSTRUMENTATION UNILAT/BILAT	$170.00	$170.00	$18.62–$231.14	—	—
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$97.00	$97.00	$18.62–$231.14	11% above	—
Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$170.00	$170.00	$18.62–$231.14	94% above	—
Earwax removal with instruments, one ear inpatient both sides CPT 69210 HC FAC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT/BILAT	$30.06	$30.06	$13.22–$231.14	—	—
Earwax removal with instruments, one ear inpatient both sides CPT 69210 HC REMV IMPACTED CERUMEN INSTRUMENTATION UNILAT/BILAT	$170.00	$170.00	$18.62–$231.14	—	—
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$97.00	$97.00	$18.62–$231.14	—	—
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$170.00	$170.00	$18.62–$231.14	—	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX	$205.00	$205.00	$38.50–$792.12	26% above	—
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX	$205.00	$205.00	$38.50–$792.12	—	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN	$531.00	$531.00	$99.85–$2,765.69	69% below	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN	$1,937.00	$1,937.00	$99.85–$2,765.69	12% above	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN	$531.00	$531.00	$99.85–$2,765.69	—	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN	$1,937.00	$1,937.00	$99.85–$2,765.69	—	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$359.00	$359.00	$68.46–$3,465.42	75% below	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1ST LEVEL	$2,510.00	$2,510.00	$68.46–$3,465.42	75% above	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC CT FACET JOINT INF LUMBAR/SACRAL SNGL LEVEL W CT GUIDE	$2,510.00	$2,510.00	$68.46–$3,465.42	75% above	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$359.00	$359.00	$68.46–$3,465.42	—	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC CT FACET JOINT INF LUMBAR/SACRAL SNGL LEVEL W CT GUIDE	$2,510.00	$2,510.00	$68.46–$3,465.42	—	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1ST LEVEL	$2,510.00	$2,510.00	$68.46–$3,465.42	—	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$1,124.00	$1,124.00	$216.14–$25,364.84	78% below	—
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$1,124.00	$1,124.00	$216.14–$25,364.84	—	—
First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR AA HERNIA 1ST > 10 CM REDUCIBLE	$1,512.00	$1,512.00	$291.69–$25,364.84	90% below	—
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 RPR AA HERNIA 1ST > 10 CM REDUCIBLE	$1,512.00	$1,512.00	$291.69–$25,364.84	—	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$672.00	$672.00	$129.30–$14,028.24	87% below	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$672.00	$672.00	$129.30–$14,028.24	—	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD	$373.00	$373.00	$70.94–$3,643.63	63% below	—
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD	$373.00	$373.00	$70.94–$3,643.63	—	—
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY	$1,306.00	$1,306.00	$251.62–$23,686.76	84% below	—
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY	$1,306.00	$1,306.00	$251.62–$23,686.76	—	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY	$1,420.00	$1,420.00	$273.42–$23,686.76	77% below	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY	$1,420.00	$1,420.00	$273.42–$23,686.76	—	—
Hammertoe correction surgery CPT 28285 CORRECTION HAMMERTOE	$1,096.00	$1,096.00	$209.54–$12,819.91	36% below	—
Hammertoe correction surgery CPT 28285 HC CORRECTION HAMMERTOE	$8,635.00	$8,635.00	$209.54–$12,819.91	408% above	—
Hammertoe correction surgery CPT 28285 HC REPAIR OF HAMMERTOE	$8,635.00	$8,635.00	$209.54–$12,819.91	408% above	—
Hammertoe correction surgery inpatient CPT 28285 CORRECTION HAMMERTOE	$1,096.00	$1,096.00	$209.54–$12,819.91	—	—
Hammertoe correction surgery inpatient CPT 28285 HC REPAIR OF HAMMERTOE	$8,635.00	$8,635.00	$209.54–$12,819.91	—	—
Hammertoe correction surgery inpatient CPT 28285 HC CORRECTION HAMMERTOE	$8,635.00	$8,635.00	$209.54–$12,819.91	—	—
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS	$571.00	$571.00	$110.16–$3,643.63	42% below	—
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS	$571.00	$571.00	$110.16–$3,643.63	—	—
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP	$1,042.00	$1,042.00	$199.70–$10,875.22	64% below	—
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP	$1,042.00	$1,042.00	$199.70–$10,875.22	—	—
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT	$3,330.00	$3,330.00	$641.68–$50,302.77	65% below	—
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT	$3,330.00	$3,330.00	$641.68–$50,302.77	—	—
Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY	$2,054.00	$2,054.00	$202.93–$3,971.77	78% below	—
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY	$2,054.00	$2,054.00	$202.93–$3,971.77	—	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC CATH/INJECT HYSTEROSALPINGOGRAM	$402.00	$402.00	$39.71–$381.90	47% above	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC CATH/INJECT HYSTEROSALPINGOGRAM	$402.00	$402.00	$39.71–$381.90	—	—
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$2,630.00	$2,630.00	$474.45–$12,683.27	25% below	—
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$2,630.00	$2,630.00	$474.45–$12,683.27	—	—
IUD insertion (the device itself billed separately) CPT 58300 INSERTION INTRAUTERINE DEVICE IUD	$223.00	$223.00	$22.03–$211.85	7% below	—
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION INTRAUTERINE DEVICE IUD	$223.00	$223.00	$22.03–$211.85	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$258.00	$258.00	$49.48–$786.10	6% below	—
Incision and drainage of a simple or single skin abscess CPT 10060 HC INCISION DRAIN SKIN ABSCESS SIMPLE	$548.00	$548.00	$49.48–$786.10	100% above	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$258.00	$258.00	$49.48–$786.10	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC INCISION DRAIN SKIN ABSCESS SIMPLE	$548.00	$548.00	$49.48–$786.10	—	—
Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$1,038.00	$1,038.00	$200.05–$14,028.24	71% below	—
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$1,038.00	$1,038.00	$200.05–$14,028.24	—	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$117.00	$117.00	$22.54–$1,202.66	58% below	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJECT TENDON SHEATH/LIGAMENT	$797.00	$797.00	$22.54–$1,202.66	186% above	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$117.00	$117.00	$22.54–$1,202.66	—	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJECT TENDON SHEATH/LIGAMENT	$797.00	$797.00	$22.54–$1,202.66	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$131.00	$131.00	$25.08–$1,202.66	59% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US	$797.00	$797.00	$25.08–$1,202.66	150% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$797.00	$797.00	$25.08–$1,202.66	150% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HC FL HIP RT STEROID INJECTION/ASPIRATION	$797.00	$797.00	—	150% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HC FL SHOULDER LEFT STEROID INJECTION ASP	$797.00	$797.00	—	150% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HC FL HIP LT STEROID INJECTION/ASPIRATION	$797.00	$797.00	—	150% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HC FL SHOULDER RIGHT STEROID INJECTION/ ASP	$797.00	$797.00	—	150% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$131.00	$131.00	$25.08–$1,202.66	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$797.00	$797.00	$25.08–$1,202.66	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US	$797.00	$797.00	$25.08–$1,202.66	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 HC FL SHOULDER LEFT STEROID INJECTION ASP	$797.00	$797.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 HC FL HIP RT STEROID INJECTION/ASPIRATION	$797.00	$797.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 HC FL SHOULDER RIGHT STEROID INJECTION/ ASP	$797.00	$797.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 HC FL HIP LT STEROID INJECTION/ASPIRATION	$797.00	$797.00	—	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT	$76.29	$76.29	$33.56–$521.29	66% below	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$202.00	$202.00	$38.60–$521.29	11% below	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT	$76.29	$76.29	$33.56–$521.29	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$202.00	$202.00	$38.60–$521.29	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$112.00	$112.00	$21.31–$1,202.66	67% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN JOINT BURSA NO ULTRASOUND	$797.00	$797.00	$21.31–$1,202.66	138% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS IM/JOINT	$797.00	$797.00	$21.31–$1,202.66	138% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$797.00	$797.00	$21.31–$1,202.66	138% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/O US	$797.00	$797.00	$21.31–$1,202.66	138% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$112.00	$112.00	$21.31–$1,202.66	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$797.00	$797.00	$21.31–$1,202.66	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC DRAIN JOINT BURSA NO ULTRASOUND	$797.00	$797.00	$21.31–$1,202.66	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS IM/JOINT	$797.00	$797.00	$21.31–$1,202.66	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/O US	$797.00	$797.00	$21.31–$1,202.66	—	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$109.00	$109.00	$20.91–$1,202.66	65% below	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHROCENTESIS WITHOUT US GUIDANCE	$797.00	$797.00	$20.91–$1,202.66	156% above	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$797.00	$797.00	$20.91–$1,202.66	156% above	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$109.00	$109.00	$20.91–$1,202.66	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$797.00	$797.00	$20.91–$1,202.66	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ARTHROCENTESIS WITHOUT US GUIDANCE	$797.00	$797.00	$20.91–$1,202.66	—	—
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL	$1,391.00	$1,391.00	$268.13–$12,819.91	77% below	—
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL	$1,391.00	$1,391.00	$268.13–$12,819.91	—	—
Knee arthroscopy with meniscus trim CPT 29881 ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$1,097.00	$1,097.00	$211.49–$12,819.91	84% below	—
Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$1,097.00	$1,097.00	$211.49–$12,819.91	—	—
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING	$1,138.00	$1,138.00	$219.31–$12,819.91	83% below	—
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING	$1,138.00	$1,138.00	$219.31–$12,819.91	—	—
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG	$1,255.00	$1,255.00	$242.26–$12,819.91	74% below	—
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG	$1,255.00	$1,255.00	$242.26–$12,819.91	—	—
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPIC APPENDECTOMY	$1,194.00	$1,194.00	$229.79–$23,686.76	82% below	—
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPIC APPENDECTOMY	$1,194.00	$1,194.00	$229.79–$23,686.76	—	—
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAPS SURG ESOPG/GSTR FUNDOPLASTY	$2,118.00	$2,118.00	$407.40–$41,648.37	84% below	—
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 LAPS SURG ESOPG/GSTR FUNDOPLASTY	$2,118.00	$2,118.00	$407.40–$41,648.37	—	—
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY	$1,839.00	$1,839.00	$351.13–$41,648.37	86% below	—
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY	$1,839.00	$1,839.00	$351.13–$41,648.37	—	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA	$861.00	$861.00	$165.99–$23,686.76	89% below	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA	$861.00	$861.00	$165.99–$23,686.76	—	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAPS SURG RPR RECURRENT INGUINAL HERNIA	$1,123.00	$1,123.00	$216.28–$23,686.76	88% below	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAPS SURG RPR RECURRENT INGUINAL HERNIA	$1,123.00	$1,123.00	$216.28–$23,686.76	—	—
Laparoscopic removal of an adjustable gastric band and its port CPT 43774 LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT	$1,893.00	$1,893.00	$364.56–$15,105.99	74% below	—
Laparoscopic removal of an adjustable gastric band and its port inpatient CPT 43774 LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT	$1,893.00	$1,893.00	$364.56–$15,105.99	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM	$225.00	$225.00	$99.00–$1,592.75	38% below	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<	$530.00	$530.00	$100.29–$1,592.75	46% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC REPAIR INTERMED WOUND, SCALP, <2.5CM	$1,054.00	$1,054.00	$100.29–$1,592.75	191% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM	$225.00	$225.00	$99.00–$1,592.75	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<	$530.00	$530.00	$100.29–$1,592.75	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC REPAIR INTERMED WOUND, SCALP, <2.5CM	$1,054.00	$1,054.00	$100.29–$1,592.75	—	—
Lower-back epidural injection, with imaging guidance CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$521.00	$521.00	$98.07–$2,765.69	59% below	—
Lower-back epidural injection, with imaging guidance CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$1,937.00	$1,937.00	$98.07–$2,765.69	52% above	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$521.00	$521.00	$98.07–$2,765.69	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$1,937.00	$1,937.00	$98.07–$2,765.69	—	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$498.00	$498.00	$94.07–$3,465.42	72% below	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL	$2,510.00	$2,510.00	$94.07–$3,465.42	43% above	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$498.00	$498.00	$94.07–$3,465.42	—	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL	$2,510.00	$2,510.00	$94.07–$3,465.42	—	—
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR	$1,802.00	$1,802.00	$347.41–$28,430.31	88% below	—
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR	$1,802.00	$1,802.00	$347.41–$28,430.31	—	—
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR	$3,534.00	$3,534.00	$680.72–$106,312.83	80% below	—
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level inpatient CPT 22633 ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR	$3,534.00	$3,534.00	$680.72–$106,312.83	—	—
Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR	$3,036.00	$3,036.00	$585.10–$106,312.83	85% below	—
Lumbar interbody fusion (PLIF or TLIF), one level inpatient CPT 22630 ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR	$3,036.00	$3,036.00	$585.10–$106,312.83	—	—
Lumbar laminectomy (spinal decompression), one level CPT 63047 LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR	$2,174.00	$2,174.00	$418.84–$28,430.31	83% below	—
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR	$2,174.00	$2,174.00	$418.84–$28,430.31	—	—
Lumbar spinal fusion (posterior), one level CPT 22612 ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR	$3,110.00	$3,110.00	$598.19–$68,698.62	82% below	—
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR	$3,110.00	$3,110.00	$598.19–$68,698.62	—	—
Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL	$1,307.00	$1,307.00	$251.23–$15,340.92	75% below	—
Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PARTIAL	$1,307.00	$1,307.00	$251.23–$15,340.92	—	—
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY SIMPLE COMPLETE	$1,895.00	$1,895.00	$364.77–$26,016.60	69% below	—
Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY SIMPLE COMPLETE	$1,895.00	$1,895.00	$364.77–$26,016.60	—	—
Miscarriage treatment with D&C, first trimester CPT 59820 TX MISSED ABORTION FIRST TRIMESTER SURGICAL	$872.00	$872.00	$165.16–$12,683.27	78% below	—
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TX MISSED ABORTION FIRST TRIMESTER SURGICAL	$872.00	$872.00	$165.16–$12,683.27	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC SKIN BENIG <0.5 CM TRUNK,ARM,LEG	$89.06	$89.06	$39.18–$2,774.51	73% below	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<	$259.00	$259.00	$49.07–$2,774.51	20% below	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC BENIGN LESION <0.5CM TRUNK/ARM/LEG	$1,898.00	$1,898.00	$49.07–$2,774.51	483% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC SKIN BENIG <0.5 CM TRUNK,ARM,LEG	$89.06	$89.06	$39.18–$2,774.51	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<	$259.00	$259.00	$49.07–$2,774.51	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC BENIGN LESION <0.5CM TRUNK/ARM/LEG	$1,898.00	$1,898.00	$49.07–$2,774.51	—	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXC SKIN BENIG <0.5 CM FACE,FACIAL	$75.75	$75.75	$33.33–$2,774.51	78% below	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<	$291.00	$291.00	$54.78–$2,774.51	16% below	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC EXC SKIN BENIG <0.5 CM FACE,FACIAL	$75.75	$75.75	$33.33–$2,774.51	—	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<	$291.00	$291.00	$54.78–$2,774.51	—	—
Nail removal (partial or complete), one nail CPT 11730 HC AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE	$123.48	$123.48	$43.62–$786.10	41% below	—
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1	$234.00	$234.00	$43.62–$786.10	12% above	—
Nail removal (partial or complete), one nail CPT 11730 HC REMOVAL OF NAIL PLATE	$548.00	$548.00	$43.62–$786.10	163% above	—
Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE	$123.48	$123.48	$43.62–$786.10	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1	$234.00	$234.00	$43.62–$786.10	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 HC REMOVAL OF NAIL PLATE	$548.00	$548.00	$43.62–$786.10	—	—
Occipital nerve block (injection for headaches) CPT 64405 INJECTION AA&/STRD GREATER OCCIPITAL NERVE	$150.00	$150.00	$28.64–$1,202.66	61% below	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION AA&/STRD GREATER OCCIPITAL NERVE	$150.00	$150.00	$28.64–$1,202.66	—	—
Paracentesis with imaging guidance CPT 49083 HC ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE	$2,468.00	$2,468.00	$110.06–$3,553.63	86% above	—
Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE	$2,468.00	$2,468.00	$110.06–$3,553.63	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC EXCISION NAIL MATRIX PRT/CMPL PERMANENT REMOVAL	$119.20	$119.20	$52.44–$1,592.75	75% below	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL	$328.00	$328.00	$62.12–$1,592.75	31% below	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL OF NAIL BED	$1,054.00	$1,054.00	$62.12–$1,592.75	123% above	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC EXCISION NAIL MATRIX PRT/CMPL PERMANENT REMOVAL	$119.20	$119.20	$52.44–$1,592.75	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL	$328.00	$328.00	$62.12–$1,592.75	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC REMOVAL OF NAIL BED	$1,054.00	$1,054.00	$62.12–$1,592.75	—	—
Prostate biopsy CPT 55700 HC BIOPSY OF PROSTATE,NEEDLE/PUNCH	$225.07	$225.07	$22.23–$4,962.96	94% below	—
Prostate biopsy CPT 55700 PROSTATE NEEDLE BIOPSY ANY APPROACH	$487.00	$487.00	$48.11–$4,962.96	86% below	—
Prostate biopsy inpatient CPT 55700 HC BIOPSY OF PROSTATE,NEEDLE/PUNCH	$225.07	$225.07	$22.23–$4,962.96	—	—
Prostate biopsy inpatient CPT 55700 PROSTATE NEEDLE BIOPSY ANY APPROACH	$487.00	$487.00	$48.11–$4,962.96	—	—
Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT	$2,420.00	$2,420.00	$465.49–$41,648.37	91% below	—
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT	$2,420.00	$2,420.00	$465.49–$41,648.37	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$892.00	$892.00	$167.40–$7,650.90	72% below	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$5,354.00	$5,354.00	$167.40–$7,650.90	70% above	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$892.00	$892.00	$167.40–$7,650.90	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$5,354.00	$5,354.00	$167.40–$7,650.90	—	—
Removal of a breast lump, open surgery CPT 19120 EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$1,036.00	$1,036.00	$198.71–$15,340.92	66% below	—
Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$1,036.00	$1,036.00	$198.71–$15,340.92	—	—
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$308.00	$308.00	$58.37–$1,592.75	12% below	—
Removal of a foreign object under the skin, simple CPT 10120 HC REMOVE FOREIGN BODY SIMPLE	$1,054.00	$1,054.00	$58.37–$1,592.75	201% above	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$308.00	$308.00	$58.37–$1,592.75	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMOVE FOREIGN BODY SIMPLE	$1,054.00	$1,054.00	$58.37–$1,592.75	—	—
Removal of one lobe of the thyroid (lobectomy) CPT 60220 TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY	$1,420.00	$1,420.00	$272.61–$23,686.76	80% below	—
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY	$1,420.00	$1,420.00	$272.61–$23,686.76	—	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC COLON CA SCRN NOT HI RSK IND	$314.81	$314.81	$130.10–$3,643.63	87% below	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$685.00	$685.00	$130.10–$3,643.63	73% below	—
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC COLON CA SCRN NOT HI RSK IND	$314.81	$314.81	$130.10–$3,643.63	—	—
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$685.00	$685.00	$130.10–$3,643.63	—	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC COLORECTAL SCRN; HI RISK IND	$314.81	$314.81	$130.04–$3,643.63	85% below	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN; HI RISK IND	$685.00	$685.00	$130.04–$3,643.63	68% below	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC COLORECTAL SCRN; HI RISK IND	$314.81	$314.81	$130.04–$3,643.63	—	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL SCRN; HI RISK IND	$685.00	$685.00	$130.04–$3,643.63	—	—
Septoplasty to straighten the nasal septum CPT 30520 SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF	$1,369.00	$1,369.00	$259.07–$12,990.18	78% below	—
Septoplasty to straighten the nasal septum inpatient CPT 30520 SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF	$1,369.00	$1,369.00	$259.07–$12,990.18	—	—
Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST ELBOW FINGER SHORT ARM	$179.00	$179.00	$34.89–$1,095.85	19% below	—
Short arm cast (elbow to hand) CPT 29075 HC APPLY FOREARM CAST	$736.00	$736.00	$34.89–$1,095.85	235% above	—
Short arm cast (elbow to hand) CPT 29075 HC APPLICATION CAST ELBOW FINGER SHORT ARM	$736.00	$736.00	$34.89–$1,095.85	235% above	—
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST ELBOW FINGER SHORT ARM	$179.00	$179.00	$34.89–$1,095.85	—	—
Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLICATION CAST ELBOW FINGER SHORT ARM	$736.00	$736.00	$34.89–$1,095.85	—	—
Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLY FOREARM CAST	$736.00	$736.00	$34.89–$1,095.85	—	—
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$136.00	$136.00	$26.54–$521.29	20% below	—
Short arm splint (forearm and hand) CPT 29125 HC APPLY FOREARM SPLINT,STATIC	$344.00	$344.00	$26.54–$521.29	104% above	—
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$136.00	$136.00	$26.54–$521.29	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY FOREARM SPLINT,STATIC	$344.00	$344.00	$26.54–$521.29	—	—
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$164.00	$164.00	$31.94–$1,095.85	21% below	—
Short leg cast (below the knee) CPT 29405 HC APPLICATION SHORT LEG CAST	$736.00	$736.00	$31.94–$1,095.85	254% above	—
Short leg cast (below the knee) CPT 29405 HC APPLY SHORT LEG CAST	$736.00	$736.00	$31.94–$1,095.85	254% above	—
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$164.00	$164.00	$31.94–$1,095.85	—	—
Short leg cast (below the knee) inpatient CPT 29405 HC APPLY SHORT LEG CAST	$736.00	$736.00	$31.94–$1,095.85	—	—
Short leg cast (below the knee) inpatient CPT 29405 HC APPLICATION SHORT LEG CAST	$736.00	$736.00	$31.94–$1,095.85	—	—
Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT	$148.00	$148.00	$28.86–$636.69	33% below	—
Short leg splint (calf to foot) CPT 29515 HC APPLY LOWER LEG SPLINT	$431.00	$431.00	$28.86–$636.69	95% above	—
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT	$148.00	$148.00	$28.86–$636.69	—	—
Short leg splint (calf to foot) inpatient CPT 29515 HC APPLY LOWER LEG SPLINT	$431.00	$431.00	$28.86–$636.69	—	—
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC	$1,369.00	$1,369.00	$264.02–$12,819.91	69% below	—
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC	$1,369.00	$1,369.00	$264.02–$12,819.91	—	—
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	$340.00	$340.00	$33.59–$4,300.53	88% below	—
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	$340.00	$340.00	$33.59–$4,300.53	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC REPAIR SUPERFICAL WND BODY <2.5CM	$99.01	$99.01	$35.86–$786.10	57% below	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$189.00	$189.00	$35.86–$786.10	17% below	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC RESUPERF WND BODY <2.5CM	$548.00	$548.00	$35.86–$786.10	140% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC REPAIR SUPERFICAL WND BODY <2.5CM	$99.01	$99.01	$35.86–$786.10	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$189.00	$189.00	$35.86–$786.10	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC RESUPERF WND BODY <2.5CM	$548.00	$548.00	$35.86–$786.10	—	—
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$157.32	$157.32	$47.26–$1,592.75	32% below	—
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$252.00	$252.00	$47.26–$1,592.75	9% above	—
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$157.32	$157.32	$47.26–$1,592.75	—	—
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$252.00	$252.00	$47.26–$1,592.75	—	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC EXC MAL LESION TRUNK, ARM, LEG <0.5 CM	$152.35	$152.35	$67.03–$2,774.51	71% below	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<	$399.00	$399.00	$75.77–$2,774.51	25% below	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 HC EXC MAL LESION TRUNK, ARM, LEG <0.5 CM	$152.35	$152.35	$67.03–$2,774.51	—	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<	$399.00	$399.00	$75.77–$2,774.51	—	—
Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL OF SKIN TAGS, UP TO 15	$31.03	$31.03	$13.65–$786.10	80% below	—
Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15	$188.00	$188.00	$35.96–$786.10	18% above	—
Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVAL OF SKIN TAGS, UP TO 15	$31.03	$31.03	$13.65–$786.10	—	—
Skin tag removal, up to 15 tags inpatient CPT 11200 RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15	$188.00	$188.00	$35.96–$786.10	—	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$291.00	$291.00	$55.40–$2,765.69	65% below	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC	$1,937.00	$1,937.00	$55.40–$2,765.69	131% above	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$291.00	$291.00	$55.40–$2,765.69	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC	$1,937.00	$1,937.00	$55.40–$2,765.69	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC REPAIR SUPERFICAL WND BODY 2.6-7.5 CM	$111.01	$111.01	$43.62–$786.10	60% below	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$229.00	$229.00	$43.62–$786.10	17% below	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC RESUP NPTERF WND BODY 2.6-7.5 CM	$548.00	$548.00	$43.62–$786.10	99% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC REPAIR SUPERFICAL WND BODY 2.6-7.5 CM	$111.01	$111.01	$43.62–$786.10	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$229.00	$229.00	$43.62–$786.10	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC RESUP NPTERF WND BODY 2.6-7.5 CM	$548.00	$548.00	$43.62–$786.10	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC REPAIR SUPERFICIAL WND FACE <2.5CM	$114.93	$114.93	$42.83–$786.10	61% below	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<	$225.00	$225.00	$42.83–$786.10	24% below	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC RESUPERF WND FACE <2.5 CM	$548.00	$548.00	$42.83–$786.10	86% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC REPAIR SUPERFICIAL WND FACE <2.5CM	$114.93	$114.93	$42.83–$786.10	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<	$225.00	$225.00	$42.83–$786.10	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC RESUPERF WND FACE <2.5 CM	$548.00	$548.00	$42.83–$786.10	—	—
TURP (transurethral resection of the prostate) CPT 52601 TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE	$1,478.00	$1,478.00	$284.35–$21,007.86	79% below	—
TURP (transurethral resection of the prostate) inpatient CPT 52601 TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE	$1,478.00	$1,478.00	$284.35–$21,007.86	—	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BIOPSY OF SKIN (EG, SHAVE, SCOOP, SAUCERIZE, CURETTE); SINGLE LESION	$126.64	$126.64	$38.03–$1,592.75	36% below	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$203.00	$203.00	$38.03–$1,592.75	3% above	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGENTIAL BIOPSY OF SKIN (EG, SHAVE, SCOOP, SAUCERIZE, CURETTE); SINGLE LESION	$126.64	$126.64	$38.03–$1,592.75	—	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$203.00	$203.00	$38.03–$1,592.75	—	—
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$629.00	$629.00	$118.21–$2,457.81	46% below	—
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$1,649.00	$1,649.00	$118.21–$2,457.81	43% above	—
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$629.00	$629.00	$118.21–$2,457.81	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$1,649.00	$1,649.00	$118.21–$2,457.81	—	—
Total hip replacement CPT 27130 ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	$2,564.00	$2,564.00	$494.22–$50,302.77	84% below	—
Total hip replacement inpatient CPT 27130 ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	$2,564.00	$2,564.00	$494.22–$50,302.77	—	—
Total knee replacement CPT 27447 ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$2,561.00	$2,561.00	$493.65–$50,302.77	81% below	—
Total knee replacement inpatient CPT 27447 ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$2,561.00	$2,561.00	$493.65–$50,302.77	—	—
Total shoulder replacement CPT 23472 ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER	$2,889.00	$2,889.00	$556.32–$68,698.62	78% below	—
Total shoulder replacement inpatient CPT 23472 ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER	$2,889.00	$2,889.00	$556.32–$68,698.62	—	—
Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION	$1,184.00	$1,184.00	$223.69–$6,300.21	32% below	—
Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION	$1,184.00	$1,184.00	$223.69–$6,300.21	—	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$107.00	$107.00	$20.33–$1,202.66	34% below	—
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ SGL/MUL TRIG PT(S) 1 OR 2 MUSC	$797.00	$797.00	$20.33–$1,202.66	390% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$797.00	$797.00	$20.33–$1,202.66	390% above	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$107.00	$107.00	$20.33–$1,202.66	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJ SGL/MUL TRIG PT(S) 1 OR 2 MUSC	$797.00	$797.00	$20.33–$1,202.66	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$797.00	$797.00	$20.33–$1,202.66	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE	$4,290.00	$4,290.00	$184.82–$6,471.06	72% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HC LT BREAST W/DEVICE 1ST LESION ULTRASOUND GUID	$2,210.00	$2,210.00	$184.82–$6,471.06	12% below	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HC RT BREAST W/DEVICE 1ST LESION ULTRASOUND GUID	$2,210.00	$2,210.00	$184.82–$6,471.06	12% below	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE	$4,290.00	$4,290.00	$184.82–$6,471.06	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 HC LT BREAST W/DEVICE 1ST LESION ULTRASOUND GUID	$2,210.00	$2,210.00	$184.82–$6,471.06	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 HC RT BREAST W/DEVICE 1ST LESION ULTRASOUND GUID	$2,210.00	$2,210.00	$184.82–$6,471.06	—	—
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM	$2,134.00	$2,134.00	$390.08–$7,518.40	8% below	—
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM	$2,134.00	$2,134.00	$390.08–$7,518.40	—	—
Upper endoscopy (EGD) with biopsy CPT 43239 EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$755.00	$755.00	$141.34–$3,553.63	60% below	—
Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD TRANSORAL BIOPSY SINGLE/MULTIPLE - EGD	$2,468.00	$2,468.00	$141.34–$3,553.63	30% above	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$755.00	$755.00	$141.34–$3,553.63	—	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD TRANSORAL BIOPSY SINGLE/MULTIPLE - EGD	$2,468.00	$2,468.00	$141.34–$3,553.63	—	—
Upper endoscopy (EGD) with injection into the lining CPT 43236 ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION	$804.00	$804.00	$150.22–$3,553.63	60% below	—
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION	$804.00	$804.00	$150.22–$3,553.63	—	—
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH	$991.00	$991.00	$185.37–$7,518.40	36% below	—
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH	$991.00	$991.00	$185.37–$7,518.40	—	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS	$830.00	$830.00	$155.66–$3,553.63	46% below	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS - EGD	$2,468.00	$2,468.00	$155.66–$3,553.63	60% above	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS	$830.00	$830.00	$155.66–$3,553.63	—	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HC EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS - EGD	$2,468.00	$2,468.00	$155.66–$3,553.63	—	—
Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$578.00	$578.00	$109.36–$3,553.63	66% below	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$578.00	$578.00	$109.36–$3,553.63	—	—
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTO W/URETEROSCOPY W/LITHOTRIPSY	$786.00	$786.00	$151.27–$21,007.86	87% below	—
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 CYSTO W/URETEROSCOPY W/LITHOTRIPSY	$786.00	$786.00	$151.27–$21,007.86	—	—
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT	$834.00	$834.00	$160.55–$21,007.86	93% below	—
Ureteroscopy with laser stone breaking and stent placement CPT 52356 HC CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT	$13,452.00	$13,452.00	$160.55–$21,007.86	20% above	—
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT	$834.00	$834.00	$160.55–$21,007.86	—	—
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 HC CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT	$13,452.00	$13,452.00	$160.55–$21,007.86	—	—
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB	$4,952.00	$4,952.00	$489.25–$4,704.40	46% above	—
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB	$4,952.00	$4,952.00	$489.25–$4,704.40	—	—
Vaginal delivery, including prenatal and postpartum care CPT 59400 OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$4,761.00	$4,761.00	$470.38–$4,522.95	22% above	—
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$4,761.00	$4,761.00	$470.38–$4,522.95	—	—
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 HC VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS	$213.47	$213.47	$93.92–$8,190.26	—	—
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS	$679.00	$679.00	$128.85–$8,190.26	—	—
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 HC VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS	$213.47	$213.47	$93.92–$8,190.26	—	—
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS	$679.00	$679.00	$128.85–$8,190.26	—	—
Wart removal, up to 14 warts CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14	$93.78	$93.78	$41.26–$786.10	63% below	—
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14	$230.00	$230.00	$43.67–$786.10	9% below	—
Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14	$93.78	$93.78	$41.26–$786.10	—	—
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14	$230.00	$230.00	$43.67–$786.10	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<	$261.00	$261.00	$49.59–$1,592.75	22% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM	$1,054.00	$1,054.00	$49.59–$1,592.75	213% above	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<	$261.00	$261.00	$49.59–$1,592.75	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM	$1,054.00	$1,054.00	$49.59–$1,592.75	—	—
Wrist fracture surgery (plate and screws), distal radius CPT 25607 OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION	$1,503.00	$1,503.00	$290.67–$28,430.31	83% below	—
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 OPTX DSTL RDL X-ARTIC FX/EPIPHYSL SEPARATION	$1,503.00	$1,503.00	$290.67–$28,430.31	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION SERVICE > 8 HRS	$1,211.00	$1,211.00	$16.18–$1,728.55	24% above	—
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION SERVICE	$1,211.00	$1,211.00	$16.18–$1,728.55	24% above	—
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION SERVICE EACH ADDITIONAL UNIT	$1,211.00	$1,211.00	$16.18–$1,728.55	24% above	—
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION SERVICE 0-6 HRS	$1,211.00	$1,211.00	$16.18–$1,728.55	24% above	—
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION SERVICE 0-4 HRS	$1,211.00	$1,211.00	$16.18–$1,728.55	24% above	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION SERVICE > 8 HRS	$1,211.00	$1,211.00	$16.18–$1,728.55	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION SERVICE 0-4 HRS	$1,211.00	$1,211.00	$16.18–$1,728.55	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION SERVICE 0-6 HRS	$1,211.00	$1,211.00	$16.18–$1,728.55	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION SERVICE EACH ADDITIONAL UNIT	$1,211.00	$1,211.00	$16.18–$1,728.55	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION SERVICE	$1,211.00	$1,211.00	$16.18–$1,728.55	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT SUBSEQUENT (EA)	$574.00	$574.00	$2.98–$857.97	194% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT	$574.00	$574.00	$2.98–$857.97	194% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$574.00	$574.00	$2.98–$857.97	194% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT INDUCED SPUTUM	$574.00	$574.00	$2.98–$857.97	194% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT AIRWAY INHALATION TX EZPAP W NEB	$574.00	$574.00	$2.98–$857.97	194% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT AIRWAY INHALATION TX IPPB	$574.00	$574.00	$2.98–$857.97	194% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT HAND HELD NEBULIZER	$574.00	$574.00	$2.98–$857.97	194% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT INHALATION TREATMENT SUBSEQUENT - NO CHARGE	$574.00	$574.00	$2.98–$857.97	194% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT MDI/DPI	$574.00	$574.00	$2.98–$857.97	194% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT MDI/DPI SUBSEQUENT	$574.00	$574.00	$2.98–$857.97	194% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$574.00	$574.00	$2.98–$857.97	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT	$574.00	$574.00	$2.98–$857.97	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT SUBSEQUENT (EA)	$574.00	$574.00	$2.98–$857.97	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT AIRWAY INHALATION TX IPPB	$574.00	$574.00	$2.98–$857.97	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT MDI/DPI SUBSEQUENT	$574.00	$574.00	$2.98–$857.97	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT HAND HELD NEBULIZER	$574.00	$574.00	$2.98–$857.97	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT INDUCED SPUTUM	$574.00	$574.00	$2.98–$857.97	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT INHALATION TREATMENT SUBSEQUENT - NO CHARGE	$574.00	$574.00	$2.98–$857.97	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT MDI/DPI	$574.00	$574.00	$2.98–$857.97	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT AIRWAY INHALATION TX EZPAP W NEB	$574.00	$574.00	$2.98–$857.97	—	—
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMOTHER, IV INFUSION, 1 HR	$973.00	$973.00	$46.81–$1,294.16	41% above	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMOTHER, IV INFUSION, 1 HR	$973.00	$973.00	$46.81–$1,294.16	—	—
Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE 30-74 MINUTES	$2,272.00	$2,272.00	$107.21–$3,236.43	9% above	—
Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$2,272.00	$2,272.00	$107.21–$3,236.43	9% above	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$2,272.00	$2,272.00	$107.21–$3,236.43	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE 30-74 MINUTES	$2,272.00	$2,272.00	$107.21–$3,236.43	—	—
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$29.00	$29.00	$2.86–$34.67	75% below	—
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$29.00	$29.00	$2.86–$34.67	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMERGENCY DEPARTMENT LEVEL 1 VISIT LIMITED/MINOR PROB	$290.00	$290.00	$4.45–$330.39	30% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC EMERGENCY DEPARTMENT LEVEL 1 VISIT LIMITED/MINOR PROB	$290.00	$290.00	$4.45–$330.39	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY DEPARTMENT LEVEL 2 VISIT LOW/MODER SEVERITY	$559.00	$559.00	$16.43–$601.60	32% above	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC EMERGENCY DEPARTMENT LEVEL 2 VISIT LOW/MODER SEVERITY	$559.00	$559.00	$16.43–$601.60	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY	$750.00	$750.00	$27.83–$1,069.54	1% below	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY	$750.00	$750.00	$27.83–$1,069.54	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY	$1,403.00	$1,403.00	$47.39–$1,634.86	14% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY	$1,403.00	$1,403.00	$47.39–$1,634.86	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC	$1,889.00	$1,889.00	$68.69–$2,333.33	14% above	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC	$1,889.00	$1,889.00	$68.69–$2,333.33	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - DIPYRIDAMOLE W NM BLD POOL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - DOBUTAMINE W NM BLD PL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - EXERCISE W NM BLD PL 1ST PASS	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - EXERCISE W NM BLD PL MUGA	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - EXERCISE W NM BLD PL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - REGADENOSON W NM BLD PL 1ST PASS	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - DOBUTAMINE W NM BLD PL MUGA	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - DOBUTAMINE W NM BLD PL 1ST PASS	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - DIPYRIDAMOLE W NM BLD PL MUGA RVEF	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - REGADENOSON W NM BLD PL MUGA	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - REGADENOSON W NM BLD PL MUGA RVEF	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - DIPYRIDAMOLE W NM BLD PL MUGA	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - DIPYRIDAMOLE W NM BLD PL 1ST PASS	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - COMPLETE ECHOCARDIOGRAM EXERCISE	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - COMPLETE ECHOCARDIOGRAM DOBUTAMINE	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - ADENOSINE W NM BLD PL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - ADENOSINE W NM BLD PL MUGA	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - ADENOSINE W NM BLD PL 1ST PASS	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - STRESS TEST ONLY, REGADENOSON	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - STRESS TEST ONLY, EXERCISE	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - STRESS TEST ONLY, DOBUTAMINE	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - STRESS TEST ONLY, DIPYRIDAMOLE	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - STRESS TEST ONLY, ADENOSINE	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - REGADENOSON W NUC MED BLOOD POOL MUGA	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - REGADENOSON W NM BLOOD POOL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - ADENOSINE W MYOCARDIAL PERFUSION MULT	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - ADENOSINE W MYOCARDIAL PERFUSION SING	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - ADENOSINE W NM BLOOD POOL FIRST PASS	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - ADENOSINE W NM BLOOD POOL MUGA	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - ADENOSINE W NM BLOOD POOL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - DIPYRIDAMOLE W MYOCARDIAL PERF MULT	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - DIPYRIDAMOLE W MYOCARDIAL PERF SING	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - DIPYRIDAMOLE W NM BLOOD POOL 1ST PASS	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - DIPYRIDAMOLE W NUC MED BLOOD POOL MUGA	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - DOBUTAMINE W MYOCARD PERFUSION MULT	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - DOBUTAMINE W MYOCARD PERFUSION SING	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - DOBUTAMINE W NM BLD POOL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - DOBUTAMINE W NM BLOOD POOL 1ST PASS	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - DOBUTAMINE W NUC MED BLOOD POOL MUGA	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - ECHOCARDIOGRAM DOBUTAMINE STRESS TEST	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - ECHOCARDIOGRAM EXERCISE STRESS TEST	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - EXERCISE W MYOCARDIAL PERF SPECT SING	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - EXERCISE W MYOCARDIAL PERFUSION MULT	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - EXERCISE W NM BLOOD POOL FIRST PASS	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - REGADENOSON W NM BLOOD POOL 1ST PASS	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - EXERCISE W NM BLOOD POOL MUGA	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - EXERCISE W NM BLOOD POOL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - REGADENOSON W MYOCARDIAL PERFUSION MULT	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - REGADENOSON W MYOCARDIAL PERFUSION SING	$807.00	$807.00	$14.47–$846.00	7% above	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - ADENOSINE W NM BLD PL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - DOBUTAMINE W NM BLOOD POOL 1ST PASS	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - STRESS TEST ONLY, DOBUTAMINE	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - DIPYRIDAMOLE W NM BLOOD POOL 1ST PASS	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - EXERCISE W NM BLD PL MUGA	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - DOBUTAMINE W NM BLD PL MUGA	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - EXERCISE W NM BLD PL 1ST PASS	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - DOBUTAMINE W NM BLD PL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - DOBUTAMINE W MYOCARD PERFUSION SING	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - ADENOSINE W NM BLD PL MUGA	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - EXERCISE W NM BLOOD POOL FIRST PASS	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - EXERCISE W MYOCARDIAL PERFUSION MULT	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - DIPYRIDAMOLE W NUC MED BLOOD POOL MUGA	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - REGADENOSON W MYOCARDIAL PERFUSION MULT	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - COMPLETE ECHOCARDIOGRAM DOBUTAMINE	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - COMPLETE ECHOCARDIOGRAM EXERCISE	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - DIPYRIDAMOLE W NM BLD PL 1ST PASS	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - DOBUTAMINE W MYOCARD PERFUSION MULT	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - REGADENOSON W MYOCARDIAL PERFUSION SING	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - STRESS TEST ONLY, DIPYRIDAMOLE	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - DIPYRIDAMOLE W NM BLD PL MUGA	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - DIPYRIDAMOLE W NM BLD PL MUGA RVEF	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - REGADENOSON W NM BLD PL MUGA	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - REGADENOSON W NM BLD PL MUGA RVEF	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - DOBUTAMINE W NUC MED BLOOD POOL MUGA	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - STRESS TEST ONLY, ADENOSINE	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - DOBUTAMINE W NM BLD PL 1ST PASS	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - REGADENOSON W NM BLD PL 1ST PASS	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - EXERCISE W NM BLOOD POOL MUGA	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - REGADENOSON W NUC MED BLOOD POOL MUGA	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - ECHOCARDIOGRAM DOBUTAMINE STRESS TEST	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - STRESS TEST ONLY, EXERCISE	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - STRESS TEST ONLY, REGADENOSON	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - REGADENOSON W NM BLOOD POOL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - DOBUTAMINE W NM BLD POOL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - ECHOCARDIOGRAM EXERCISE STRESS TEST	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - ADENOSINE W MYOCARDIAL PERFUSION MULT	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - ADENOSINE W MYOCARDIAL PERFUSION SING	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - REGADENOSON W NM BLOOD POOL 1ST PASS	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - ADENOSINE W NM BLOOD POOL FIRST PASS	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - EXERCISE W NM BLOOD POOL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - ADENOSINE W NM BLOOD POOL MUGA	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - EXERCISE W MYOCARDIAL PERF SPECT SING	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - ADENOSINE W NM BLOOD POOL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - DIPYRIDAMOLE W MYOCARDIAL PERF MULT	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - DIPYRIDAMOLE W MYOCARDIAL PERF SING	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - EXERCISE W NM BLD PL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - DIPYRIDAMOLE W NM BLD POOL MUGA W RVEF	$807.00	$807.00	$14.47–$846.00	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY - ADENOSINE W NM BLD PL 1ST PASS	$807.00	$807.00	$14.47–$846.00	—	—
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$218.30	$218.30	$43.50–$695.44	3% above	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$219.00	$219.00	$43.50–$695.44	4% above	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$218.30	$218.30	$43.50–$695.44	—	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$219.00	$219.00	$43.50–$695.44	—	—
Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$208.33	$208.33	$41.71–$695.44	36% below	—
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$209.00	$209.00	$41.71–$695.44	36% below	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$208.33	$208.33	$41.71–$695.44	—	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$209.00	$209.00	$41.71–$695.44	—	—
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 XTRNL ECG REC<48 HRS RECORDING SCAN A/R R&I	$145.00	$145.00	$14.32–$179.01	53% below	—
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 XTRNL ECG REC<48 HRS RECORDING SCAN A/R R&I	$145.00	$145.00	$14.32–$179.01	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR	$65.00	$65.00	$11.96–$833.38	81% below	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV INFUSION, HYDRATION, 31-60 MIN	$624.00	$624.00	$11.96–$833.38	83% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR	$65.00	$65.00	$11.96–$833.38	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV INFUSION, HYDRATION, 31-60 MIN	$624.00	$624.00	$11.96–$833.38	—	—
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR	$125.00	$125.00	$22.74–$833.38	75% below	—
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR	$624.00	$624.00	$22.74–$833.38	27% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR	$125.00	$125.00	$22.74–$833.38	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR	$624.00	$624.00	$22.74–$833.38	—	—
IV push of a medicine, first drug CPT 96374 HC THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG	$74.00	$74.00	$13.43–$833.38	70% below	—
IV push of a medicine, first drug CPT 96374 THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG	$74.00	$74.00	$13.43–$833.38	70% below	—
IV push of a medicine, first drug CPT 96374 HC PRO INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, INITIAL DRUG	$624.00	$624.00	$13.43–$833.38	152% above	—
IV push of a medicine, first drug CPT 96374 HC IV INJECTION TX/DX/PROPHYLAXIS INITIAL	$624.00	$624.00	$13.43–$833.38	152% above	—
IV push of a medicine, first drug CPT 96374 HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, INITIAL DRUG	$624.00	$624.00	$13.43–$833.38	152% above	—
IV push of a medicine, first drug inpatient CPT 96374 THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG	$74.00	$74.00	$13.43–$833.38	—	—
IV push of a medicine, first drug inpatient CPT 96374 HC THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG	$74.00	$74.00	$13.43–$833.38	—	—
IV push of a medicine, first drug inpatient CPT 96374 HC PRO INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, INITIAL DRUG	$624.00	$624.00	$13.43–$833.38	—	—
IV push of a medicine, first drug inpatient CPT 96374 HC IV INJECTION TX/DX/PROPHYLAXIS INITIAL	$624.00	$624.00	$13.43–$833.38	—	—
IV push of a medicine, first drug inpatient CPT 96374 HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, INITIAL DRUG	$624.00	$624.00	$13.43–$833.38	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$29.00	$29.00	$5.61–$282.10	76% below	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION SQ/IM	$190.00	$190.00	$5.61–$282.10	58% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT	$190.00	$190.00	$5.61–$282.10	58% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$29.00	$29.00	$5.61–$282.10	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJECTION SQ/IM	$190.00	$190.00	$5.61–$282.10	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT	$190.00	$190.00	$5.61–$282.10	—	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCHIATRIC DIAGNOSTIC EVALUATION	$46.65	$46.65	$20.52–$695.44	83% below	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$366.00	$366.00	$69.78–$695.44	30% above	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCHIATRIC DIAGNOSTIC EVALUATION	$46.65	$46.65	$20.52–$695.44	—	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$366.00	$366.00	$69.78–$695.44	—	—
Neuromuscular re-education, 15 minutes CPT 97112 HC PT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN	$68.00	$68.00	$6.71–$64.60	16% below	—
Neuromuscular re-education, 15 minutes CPT 97112 HC OT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN	$68.00	$68.00	$6.71–$64.60	16% below	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC OT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN	$68.00	$68.00	$6.71–$64.60	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN	$68.00	$68.00	$6.71–$64.60	—	—
New patient office visit, about 30 minutes CPT 99203 HC PBB OFFICE OUTPATIENT NEW 30 MINUTES	$58.40	$58.40	$5.02–$55.48	62% below	—
New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$228.00	$228.00	$5.02–$216.60	49% above	—
New patient office visit, about 30 minutes CPT 99203 HC OFFICE OUTPATIENT NEW 30 MINUTES	$242.00	$242.00	$5.02–$229.90	58% above	—
New patient office visit, about 30 minutes inpatient CPT 99203 HC PBB OFFICE OUTPATIENT NEW 30 MINUTES	$58.40	$58.40	$5.02–$55.48	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$228.00	$228.00	$5.02–$216.60	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE OUTPATIENT NEW 30 MINUTES	$242.00	$242.00	$5.02–$229.90	—	—
New patient office visit, about 45 minutes CPT 99204 HC PBB OFFICE OUTPATIENT NEW 45-59 MINUTES	$66.80	$66.80	$6.59–$73.25	74% below	—
New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$343.00	$343.00	$19.09–$325.85	34% above	—
New patient office visit, about 45 minutes CPT 99204 HC OFFICE OUTPATIENT NEW 45-59 MINUTES	$368.48	$368.48	$19.09–$350.05	44% above	—
New patient office visit, about 45 minutes inpatient CPT 99204 HC PBB OFFICE OUTPATIENT NEW 45-59 MINUTES	$66.80	$66.80	$6.59–$73.25	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$343.00	$343.00	$19.09–$325.85	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE OUTPATIENT NEW 45-59 MINUTES	$368.48	$368.48	$19.09–$350.05	—	—
New patient office visit, about 60 minutes CPT 99205 HC PBB OFFICE OUTPATIENT NEW 60 MINUTES	$77.97	$77.97	$7.70–$96.67	75% below	—
New patient office visit, about 60 minutes CPT 99205 OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$452.00	$452.00	$42.36–$429.40	43% above	—
New patient office visit, about 60 minutes CPT 99205 HC OFFICE OUTPATIENT NEW 60 MINUTES	$455.69	$455.69	$42.36–$432.90	45% above	—
New patient office visit, about 60 minutes inpatient CPT 99205 HC PBB OFFICE OUTPATIENT NEW 60 MINUTES	$77.97	$77.97	$7.70–$96.67	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$452.00	$452.00	$42.36–$429.40	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE OUTPATIENT NEW 60 MINUTES	$455.69	$455.69	$42.36–$432.90	—	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC PBB OFFICE OUTPATIENT NEW 15-29 MINUTES	$48.65	$48.65	$3.33–$46.21	62% below	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES	$148.00	$148.00	$3.33–$140.60	14% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC OFFICE OUTPATIENT NEW 15-29 MINUTES	$166.52	$166.52	$3.33–$158.19	28% above	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC PBB OFFICE OUTPATIENT NEW 15-29 MINUTES	$48.65	$48.65	$3.33–$46.21	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES	$148.00	$148.00	$3.33–$140.60	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC OFFICE OUTPATIENT NEW 15-29 MINUTES	$166.52	$166.52	$3.33–$158.19	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MED NUTR THER, 1ST, INDIV, EA 15 MIN	$72.00	$72.00	$7.11–$68.40	49% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MED NUTR THER, 1ST, INDIV, EA 15 MIN	$72.00	$72.00	$7.11–$68.40	—	—
Occupational therapy evaluation, low complexity CPT 97165 HC OT OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS	$199.00	$199.00	$19.66–$189.05	16% below	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS	$199.00	$199.00	$19.66–$189.05	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	$198.00	$198.00	$19.56–$188.10	20% below	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	$198.00	$198.00	$19.56–$188.10	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$198.00	$198.00	$19.56–$188.10	1% below	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$198.00	$198.00	$19.56–$188.10	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$198.00	$198.00	$19.56–$188.10	20% below	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$198.00	$198.00	$19.56–$188.10	—	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC SLP MANUAL THER TECH,1+REGIONS,EA 15 MIN	$61.00	$61.00	$6.02–$57.95	10% below	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC OT MANUAL THER TECH,1+REGIONS,EA 15 MIN	$61.00	$61.00	$6.02–$57.95	10% below	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MANUAL THER TECH,1+REGIONS,EA 15 MIN	$61.00	$61.00	$6.02–$57.95	10% below	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC SLP MANUAL THER TECH,1+REGIONS,EA 15 MIN	$61.00	$61.00	$6.02–$57.95	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PT MANUAL THER TECH,1+REGIONS,EA 15 MIN	$61.00	$61.00	$6.02–$57.95	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC OT MANUAL THER TECH,1+REGIONS,EA 15 MIN	$61.00	$61.00	$6.02–$57.95	—	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES	$61.00	$61.00	$6.02–$60.89	18% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISES	$67.00	$67.00	$6.61–$63.65	10% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISES	$67.00	$67.00	$6.61–$63.65	10% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC SLP THERAPEUTIC EXERCISES	$67.00	$67.00	$6.61–$63.65	10% below	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES	$61.00	$61.00	$6.02–$60.89	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISES	$67.00	$67.00	$6.61–$63.65	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC SLP THERAPEUTIC EXERCISES	$67.00	$67.00	$6.61–$63.65	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISES	$67.00	$67.00	$6.61–$63.65	—	—
Preventive checkup, new patient aged 18–39 CPT 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$266.00	$266.00	$26.28–$252.70	10% above	—
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$266.00	$266.00	$26.28–$252.70	—	—
Preventive checkup, new patient aged 40–64 CPT 99386 INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$307.00	$307.00	$30.33–$291.65	28% above	—
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$307.00	$307.00	$30.33–$291.65	—	—
Preventive checkup, new patient aged 65 or older CPT 99387 INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>	$333.00	$333.00	$32.90–$316.35	28% above	—
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>	$333.00	$333.00	$32.90–$316.35	—	—
Preventive checkup, returning patient aged 18–39 CPT 99395 PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS	$240.00	$240.00	$23.71–$228.00	42% above	—
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS	$240.00	$240.00	$23.71–$228.00	—	—
Preventive checkup, returning patient aged 40–64 CPT 99396 PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS	$255.00	$255.00	$25.19–$242.25	41% above	—
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS	$255.00	$255.00	$25.19–$242.25	—	—
Preventive checkup, returning patient aged 65 or older CPT 99397 PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER	$274.00	$274.00	$27.07–$260.30	44% above	—
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER	$274.00	$274.00	$27.07–$260.30	—	—
Psychiatric evaluation with medical services CPT 90792 HC PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES	$47.45	$47.45	$20.87–$695.44	84% below	—
Psychiatric evaluation with medical services CPT 90792 HC PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$361.55	$361.55	$78.07–$695.44	22% above	—
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$409.00	$409.00	$78.07–$695.44	37% above	—
Psychiatric evaluation with medical services inpatient CPT 90792 HC PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES	$47.45	$47.45	$20.87–$695.44	—	—
Psychiatric evaluation with medical services inpatient CPT 90792 HC PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$361.55	$361.55	$78.07–$695.44	—	—
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$409.00	$409.00	$78.07–$695.44	—	—
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR	$252.00	$252.00	$48.54–$846.00	72% below	—
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR	$252.00	$252.00	$48.54–$846.00	—	—
Psychotherapy for crisis, first 60 minutes CPT 90839 HC PSYCHOTHERAPY FOR CRISIS: FIRST 60 MIN	$33.23	$33.23	$14.62–$695.44	89% below	—
Psychotherapy for crisis, first 60 minutes CPT 90839 HC PSYCHOTHERAPY FOR CRISIS INIT 60 MINS	$277.77	$277.77	$62.02–$695.44	5% below	—
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES	$311.00	$311.00	$62.02–$695.44	6% above	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PSYCHOTHERAPY FOR CRISIS: FIRST 60 MIN	$33.23	$33.23	$14.62–$695.44	—	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PSYCHOTHERAPY FOR CRISIS INIT 60 MINS	$277.77	$277.77	$62.02–$695.44	—	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES	$311.00	$311.00	$62.02–$695.44	—	—
Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES	$18.57	$18.57	$8.17–$695.44	85% below	—
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES	$166.00	$166.00	$33.10–$695.44	37% above	—
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES	$18.57	$18.57	$8.17–$695.44	—	—
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES	$166.00	$166.00	$33.10–$695.44	—	—
Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES	$24.15	$24.15	$10.62–$695.44	84% below	—
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES	$220.00	$220.00	$43.70–$695.44	50% above	—
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES	$24.15	$24.15	$10.62–$695.44	—	—
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES	$220.00	$220.00	$43.70–$695.44	—	—
Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES	$35.87	$35.87	$15.78–$695.44	88% below	—
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES	$324.00	$324.00	$64.69–$695.44	12% above	—
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES	$35.87	$35.87	$15.78–$695.44	—	—
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES	$324.00	$324.00	$64.69–$695.44	—	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC PRO TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES	$5.90	$5.90	$2.59–$146.80	78% below	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES	$30.00	$30.00	$5.64–$146.80	10% above	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES	$81.00	$81.00	$5.64–$146.80	197% above	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC PRO TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES	$5.90	$5.90	$2.59–$146.80	—	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES	$30.00	$30.00	$5.64–$146.80	—	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES	$81.00	$81.00	$5.64–$146.80	—	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC PBB OFFICE OUTPATIENT VISIT EST 40-54 MINUTES	$72.27	$72.27	$7.14–$79.10	72% below	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OFFICE OUTPATIENT VISIT EST 40-54 MINUTES	$371.00	$371.00	$19.95–$352.45	44% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN	$371.00	$371.00	$19.95–$352.45	44% above	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC PBB OFFICE OUTPATIENT VISIT EST 40-54 MINUTES	$72.27	$72.27	$7.14–$79.10	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OFFICE OUTPATIENT VISIT EST 40-54 MINUTES	$371.00	$371.00	$19.95–$352.45	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN	$371.00	$371.00	$19.95–$352.45	—	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PBB OFFICE OUTPATIENT VISIT EST 20-29 MINUTES	$49.04	$49.04	$4.84–$46.58	68% below	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OFFICE OUTPATIENT VISIT EST 20-29 MINUTES	$167.20	$167.20	$10.81–$158.84	8% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$187.00	$187.00	$10.81–$177.65	21% above	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC PBB OFFICE OUTPATIENT VISIT EST 20-29 MINUTES	$49.04	$49.04	$4.84–$46.58	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OFFICE OUTPATIENT VISIT EST 20-29 MINUTES	$167.20	$167.20	$10.81–$158.84	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$187.00	$187.00	$10.81–$177.65	—	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC PBB OFFICE OUTPATIENT VISIT EST 30-39 MINUTES	$60.84	$60.84	$6.01–$57.79	70% below	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE OUTPATIENT VISIT EST 30-39 MINUTES	$247.86	$247.86	$15.64–$235.46	23% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$264.00	$264.00	$15.64–$250.80	31% above	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC PBB OFFICE OUTPATIENT VISIT EST 30-39 MINUTES	$60.84	$60.84	$6.01–$57.79	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OFFICE OUTPATIENT VISIT EST 30-39 MINUTES	$247.86	$247.86	$15.64–$235.46	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$264.00	$264.00	$15.64–$250.80	—	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC PBB OFFICE OUTPATIENT VISIT 10 MINUTES	$42.15	$42.15	$4.16–$40.04	53% below	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN	$116.00	$116.00	$11.46–$110.20	31% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC WOUND CARE LEVEL 2	$126.79	$126.79	$11.95–$120.45	43% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC LACTATION CONSULTATION - LOW	$126.79	$126.79	$11.95–$120.45	43% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OFFICE OUTPATIENT VISIT EST 10-19 MINUTES	$126.79	$126.79	$11.95–$120.45	43% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC EST PT FAC VISIT LEVEL II	$126.79	$126.79	$11.95–$120.45	43% above	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC PBB OFFICE OUTPATIENT VISIT 10 MINUTES	$42.15	$42.15	$4.16–$40.04	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN	$116.00	$116.00	$11.46–$110.20	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC WOUND CARE LEVEL 2	$126.79	$126.79	$11.95–$120.45	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OFFICE OUTPATIENT VISIT EST 10-19 MINUTES	$126.79	$126.79	$11.95–$120.45	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC LACTATION CONSULTATION - LOW	$126.79	$126.79	$11.95–$120.45	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC EST PT FAC VISIT LEVEL II	$126.79	$126.79	$11.95–$120.45	—	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$232.00	$232.00	$22.92–$220.40	2% above	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$232.00	$232.00	$22.92–$220.40	—	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$332.00	$332.00	$32.80–$316.73	at median	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$332.00	$332.00	$32.80–$316.73	—	—
Speech and language evaluation CPT 92523 HC SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION	$446.00	$446.00	$44.06–$423.70	5% above	—
Speech and language evaluation inpatient CPT 92523 HC SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION	$446.00	$446.00	$44.06–$423.70	—	—
Speech therapy session, individual CPT 92507 HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL	$153.00	$153.00	$15.11–$145.35	19% below	—
Speech therapy session, individual inpatient CPT 92507 HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL	$153.00	$153.00	$15.11–$145.35	—	—
Spirometry (breathing test) CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$37.66	$37.66	$10.50–$846.00	85% below	—
Spirometry (breathing test) CPT 94010 SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$55.00	$55.00	$10.50–$846.00	77% below	—
Spirometry (breathing test) CPT 94010 HC BREATHING CAPACITY TEST - BREATHING CAPACITY TEST	$426.00	$426.00	$10.50–$846.00	74% above	—
Spirometry (breathing test) CPT 94010 HC BREATHING CAPACITY TEST - SPIROMETRY WITHOUT BRONCHODILATOR	$426.00	$426.00	$10.50–$846.00	74% above	—
Spirometry (breathing test) CPT 94010 HC BREATHING CAPACITY TEST - OFFICE SPIROMETRY	$426.00	$426.00	$10.50–$846.00	74% above	—
Spirometry (breathing test) one side CPT 94010 HC RT BREATHING CAPACITY TEST	$426.00	$426.00	$10.50–$846.00	74% above	—
Spirometry (breathing test) inpatient CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$37.66	$37.66	$10.50–$846.00	—	—
Spirometry (breathing test) inpatient CPT 94010 SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$55.00	$55.00	$10.50–$846.00	—	—
Spirometry (breathing test) inpatient CPT 94010 HC BREATHING CAPACITY TEST - BREATHING CAPACITY TEST	$426.00	$426.00	$10.50–$846.00	—	—
Spirometry (breathing test) inpatient CPT 94010 HC BREATHING CAPACITY TEST - OFFICE SPIROMETRY	$426.00	$426.00	$10.50–$846.00	—	—
Spirometry (breathing test) inpatient CPT 94010 HC BREATHING CAPACITY TEST - SPIROMETRY WITHOUT BRONCHODILATOR	$426.00	$426.00	$10.50–$846.00	—	—
Spirometry (breathing test) inpatient one side CPT 94010 HC RT BREATHING CAPACITY TEST	$426.00	$426.00	$10.50–$846.00	—	—
Spirometry before and after a bronchodilator CPT 94060 HC BRONCHODILATION RESPONSIVENESS, SPIROMETRY	$56.52	$56.52	$15.01–$1,462.06	88% below	—
Spirometry before and after a bronchodilator CPT 94060 BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN	$78.00	$78.00	$15.01–$1,462.06	83% below	—
Spirometry before and after a bronchodilator CPT 94060 HC EVAL OF BRONCHOSPASM - SPIROMETRY WITH BRONCHODILATOR	$807.00	$807.00	$15.01–$1,462.06	78% above	—
Spirometry before and after a bronchodilator CPT 94060 HC PFT BRONCHOSPASM EVAL	$807.00	$807.00	$15.01–$1,462.06	78% above	—
Spirometry before and after a bronchodilator one side CPT 94060 HC RT EVAL OF BRONCHOSPASM	$807.00	$807.00	$15.01–$1,462.06	78% above	—
Spirometry before and after a bronchodilator inpatient CPT 94060 HC BRONCHODILATION RESPONSIVENESS, SPIROMETRY	$56.52	$56.52	$15.01–$1,462.06	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN	$78.00	$78.00	$15.01–$1,462.06	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 HC EVAL OF BRONCHOSPASM - SPIROMETRY WITH BRONCHODILATOR	$807.00	$807.00	$15.01–$1,462.06	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 HC PFT BRONCHOSPASM EVAL	$807.00	$807.00	$15.01–$1,462.06	—	—
Spirometry before and after a bronchodilator inpatient one side CPT 94060 HC RT EVAL OF BRONCHOSPASM	$807.00	$807.00	$15.01–$1,462.06	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$74.00	$74.00	$7.31–$70.30	14% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$74.00	$74.00	$7.31–$70.30	14% below	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC OT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$74.00	$74.00	$7.31–$70.30	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$74.00	$74.00	$7.31–$70.30	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE	$189.00	$189.00	$33.89–$521.29	20% below	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC RAD PHLEBOTOMY THERAPEUTIC	$344.00	$344.00	$33.89–$521.29	46% above	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THERAPEUTIC	$344.00	$344.00	$33.89–$521.29	46% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE	$189.00	$189.00	$33.89–$521.29	—	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY THERAPEUTIC	$344.00	$344.00	$33.89–$521.29	—	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC RAD PHLEBOTOMY THERAPEUTIC	$344.00	$344.00	$33.89–$521.29	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE	$254.14	$254.14	$18.00–$254.14	82% above	—
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 HC CAMS IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE	$254.14	$254.14	$18.00–$254.14	82% above	—
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE	$254.14	$254.14	$18.00–$254.14	—	—
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 HC CAMS IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE	$254.14	$254.14	$18.00–$254.14	—	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$195.00	$195.00	$19.26–$185.25	20% below	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC CAMS VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$195.00	$195.00	$19.26–$185.25	20% below	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$195.00	$195.00	$19.26–$185.25	—	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC CAMS VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$195.00	$195.00	$19.26–$185.25	—	—
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 HC CAMS DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE	$68.00	$68.00	$6.71–$64.60	54% below	—
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE	$68.00	$68.00	$6.71–$64.60	54% below	—
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE	$68.00	$68.00	$6.71–$64.60	—	—
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 HC CAMS DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE	$68.00	$68.00	$6.71–$64.60	—	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC CAMS DTAP IMMUNIZATION, IM, <7 YO	$117.90	$117.90	$8.44–$112.00	175% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHTH TETANUS TOX ACELL PERTUSSIS (INFANRIX) VACC<7 YR IM	$117.90	$117.90	$8.44–$112.00	175% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHTH TETANUS TOX ACELL PERTUSSIS (INFANRIX) VACC<7 YR IM	$117.90	$117.90	$8.44–$112.00	—	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC CAMS DTAP IMMUNIZATION, IM, <7 YO	$117.90	$117.90	$8.44–$112.00	—	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$109.00	$109.00	$10.76–$103.55	24% below	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$109.00	$109.00	$10.76–$103.55	—	—
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 HC CAMS DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE	$128.00	$128.00	$12.64–$121.60	14% below	—
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 HC CAMS DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE	$128.00	$128.00	$12.64–$121.60	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$19.00	$19.00	$8.36–$21.19	47% below	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC CAMS IIV3 VACC PRESERVATIVE FREE 3 YRS & OLDER IM USE	$19.00	$19.00	$8.36–$21.19	47% below	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HC CAMS IIV3 VACC PRESERVATIVE FREE 3 YRS & OLDER IM USE	$19.00	$19.00	$8.36–$21.19	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$19.00	$19.00	$8.36–$21.19	—	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC CAMS 9VHPV VACC 2/3 DOSE SCHED IM USE	$322.00	$322.00	$31.81–$305.90	30% below	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9VHPV VACC 2/3 DOSE SCHED IM USE	$322.00	$322.00	$31.81–$305.90	30% below	—
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC CAMS 9VHPV VACC 2/3 DOSE SCHED IM USE	$322.00	$322.00	$31.81–$305.90	—	—
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 9VHPV VACC 2/3 DOSE SCHED IM USE	$322.00	$322.00	$31.81–$305.90	—	—
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM	$141.00	$141.00	$13.93–$133.95	4% below	—
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM	$141.00	$141.00	$13.93–$133.95	—	—
Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE	$85.00	$85.00	$8.39–$80.75	22% below	—
Hepatitis A vaccine, adult dose CPT 90632 HC CAMS HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE	$85.00	$85.00	$8.39–$80.75	22% below	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 HC CAMS HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE	$85.00	$85.00	$8.39–$80.75	—	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE	$85.00	$85.00	$8.39–$80.75	—	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC CAMS HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE	$42.00	$42.00	$4.14–$39.90	23% below	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE	$42.00	$42.00	$4.14–$39.90	23% below	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE	$42.00	$42.00	$4.14–$39.90	—	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HC CAMS HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE	$42.00	$42.00	$4.14–$39.90	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC CAMS HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$196.00	$196.00	$18.00–$196.00	90% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$196.00	$196.00	$18.00–$196.00	90% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC CAMS HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$196.00	$196.00	$18.00–$196.00	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$196.00	$196.00	$18.00–$196.00	—	—
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPB VACCINE ADULT 2/4 DOSE SCHEDULE FOR IM USE	$290.87	$290.87	$18.00–$290.87	46% above	—
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPB VACCINE ADULT 2/4 DOSE SCHEDULE FOR IM USE	$290.87	$290.87	$18.00–$290.87	—	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC CAMS HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM	$135.75	$135.75	$13.29–$135.75	151% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM	$135.75	$135.75	$13.29–$135.75	151% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HC CAMS HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM	$135.75	$135.75	$13.29–$135.75	—	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM	$135.75	$135.75	$13.29–$135.75	—	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIB PRP-OMP VACCINE 3 DOSE SCHEDULE IM USE	$33.00	$33.00	$3.26–$31.35	33% below	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HIB PRP-OMP VACCINE 3 DOSE SCHEDULE IM USE	$33.00	$33.00	$3.26–$31.35	—	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC CAMS HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE	$26.00	$26.00	$2.56–$32.09	22% above	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE	$26.00	$26.00	$2.56–$32.09	22% above	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE	$26.00	$26.00	$2.56–$32.09	—	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HC CAMS HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE	$26.00	$26.00	$2.56–$32.09	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM	$81.00	$81.00	$18.00–$114.47	19% below	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM	$81.00	$81.00	$18.00–$114.47	—	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ	$341.10	$341.10	$18.00–$324.04	116% above	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC CAMS MMR VIRUS IMMUNIZATION, SUBCUT	$341.10	$341.10	$18.00–$324.04	116% above	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ	$341.10	$341.10	$18.00–$324.04	—	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC CAMS MMR VIRUS IMMUNIZATION, SUBCUT	$341.10	$341.10	$18.00–$324.04	—	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC CAMS COMBINED VACCINE,MMR+VARICELLA,SUB-Q	$303.00	$303.00	$18.00–$287.85	27% below	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ	$303.00	$303.00	$18.00–$287.85	27% below	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 HC CAMS COMBINED VACCINE,MMR+VARICELLA,SUB-Q	$303.00	$303.00	$18.00–$287.85	—	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ	$303.00	$303.00	$18.00–$287.85	—	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE	$176.00	$176.00	$17.38–$167.20	7% below	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC CAMS MENACWY CONJUGATE VACCINE GROUPS ACYW-135 IM USE	$176.00	$176.00	$17.38–$167.20	7% below	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC CAMS MENACWY CONJUGATE VACCINE GROUPS ACYW-135 IM USE	$176.00	$176.00	$17.38–$167.20	—	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE	$176.00	$176.00	$17.38–$167.20	—	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENACWY-TT CONJ VACC SEROGROUPS ACWY FOR IM USE	$187.00	$187.00	$18.47–$177.65	11% below	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 HC PBB MENACWY-TT CONJ VACC SEROGROUPS ACWY FOR IM USE	$187.00	$187.00	$18.47–$177.65	11% below	—
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENACWY-TT CONJ VACC SEROGROUPS ACWY FOR IM USE	$187.00	$187.00	$18.47–$177.65	—	—
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 HC PBB MENACWY-TT CONJ VACC SEROGROUPS ACWY FOR IM USE	$187.00	$187.00	$18.47–$177.65	—	—
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HC PBB MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM	$251.00	$251.00	$24.79–$238.45	6% below	—
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM	$251.00	$251.00	$24.79–$238.45	6% below	—
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 HC PBB MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM	$251.00	$251.00	$24.79–$238.45	—	—
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM	$251.00	$251.00	$24.79–$238.45	—	—
Meningococcal B vaccine (Trumenba) CPT 90621 HC CAMS MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 DOSE IM	$213.00	$213.00	$21.04–$202.35	31% below	—
Meningococcal B vaccine (Trumenba) CPT 90621 MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 DOSE IM	$213.00	$213.00	$21.04–$202.35	31% below	—
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 HC CAMS MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 DOSE IM	$213.00	$213.00	$21.04–$202.35	—	—
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 DOSE IM	$213.00	$213.00	$21.04–$202.35	—	—
Nasal spray flu vaccine, live (FluMist) CPT 90660 HC LAIV3 VACCINE LIVE FOR INTRANASAL USE	$32.00	$32.00	$12.47–$32.00	—	—
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 HC LAIV3 VACCINE LIVE FOR INTRANASAL USE	$32.00	$32.00	$12.47–$32.00	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE FOR INTRAMUSCULAR USE	$361.00	$361.00	$72.98–$496.60	12% below	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PCV20 VACCINE FOR INTRAMUSCULAR USE	$361.00	$361.00	$72.98–$496.60	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC CAMS PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	$161.00	$161.00	$18.00–$233.77	8% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	$161.00	$161.00	$18.00–$233.77	8% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC CAMS PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	$161.00	$161.00	$18.00–$233.77	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	$161.00	$161.00	$18.00–$233.77	—	—
Polio vaccine, inactivated (IPV) CPT 90713 HC CAMS POLIOMYELITIS IMMUNIZATN,INACTV,SUB-Q	$48.00	$48.00	$4.74–$45.60	43% below	—
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE INACTIVATED SUBQ/IM	$48.00	$48.00	$4.74–$45.60	43% below	—
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE INACTIVATED SUBQ/IM	$48.00	$48.00	$4.74–$45.60	—	—
Polio vaccine, inactivated (IPV) inpatient CPT 90713 HC CAMS POLIOMYELITIS IMMUNIZATN,INACTV,SUB-Q	$48.00	$48.00	$4.74–$45.60	—	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE	$555.00	$555.00	$54.83–$746.61	7% below	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 HC CAMS RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE	$555.00	$555.00	$54.83–$746.61	7% below	—
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE	$555.00	$555.00	$54.83–$746.61	—	—
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 HC CAMS RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE	$555.00	$555.00	$54.83–$746.61	—	—
Rabies vaccine, one dose CPT 90675 RABIES VACCINE INTRAMUSCULAR	$391.00	$391.00	$72.98–$1,202.96	16% below	—
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE INTRAMUSCULAR	$391.00	$391.00	$72.98–$1,202.96	—	—
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC CAMS RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE	$108.00	$108.00	$10.67–$102.60	24% below	—
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE	$108.00	$108.00	$10.67–$102.60	24% below	—
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 HC CAMS RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE	$108.00	$108.00	$10.67–$102.60	—	—
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE	$108.00	$108.00	$10.67–$102.60	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$23.00	$23.00	$2.27–$26.99	70% below	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC CAMS TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$23.00	$23.00	$2.27–$26.99	70% below	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC CAMS TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$23.00	$23.00	$2.27–$26.99	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$23.00	$23.00	$2.27–$26.99	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC CAMS TDAP VACCINE >7 YO, IM	$47.00	$47.00	$4.64–$46.30	51% below	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC CAMS TDAP VACCINE >7 YO, IM	$47.00	$47.00	$4.64–$46.30	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID CHILDREN	$190.00	$190.00	$8.02–$282.10	230% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC FLU IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID	$190.00	$190.00	$8.02–$282.10	230% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID	$190.00	$190.00	$8.02–$282.10	230% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE	$190.00	$190.00	$8.02–$282.10	230% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID	$190.00	$190.00	$8.02–$282.10	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID CHILDREN	$190.00	$190.00	$8.02–$282.10	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE	$190.00	$190.00	$8.02–$282.10	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC FLU IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID	$190.00	$190.00	$8.02–$282.10	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZ,ADMIN,EACH ADDL	$30.00	$30.00	$2.96–$29.06	17% below	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE	$30.00	$30.00	$2.96–$29.06	17% below	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE	$30.00	$30.00	$2.96–$29.06	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZ,ADMIN,EACH ADDL	$30.00	$30.00	$2.96–$29.06	—	—

Source file: https://mrfs.hyvehealthcare.com/GritmanMedicalCenter/820146328_gritman-medical-center_standardcharges.csv