Hospital Seattle-Tacoma-Bellevue, WA

Kaiser Permanente Central Hospital

Kaiser Permanente Central Hospital in Seattle, WA publishes cash prices for 337 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Washington median for 234 of 330 procedures and below it for 92. By typical cash price it ranks #42 of 60 Washington hospitals and #16 of 18 hospitals in the Seattle, WA area, cheapest first. Select a procedure to compare it with other hospitals nearby.

201 16th Ave E Seattle WA 98112-5226 Collected Sep 22, 2026 Source price file Check a bill from this hospital (206) 326-3000

Acute care hospital Nonprofit hospital Emergency department CCN 500052 · CMS hospital register NPI 1861522088

Financial assistance

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

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

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

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

State law

This state limits hospital bills for lower-income patients

Washington law (RCW 70.170.060) requires hospital charity care: patients with family income up to 300% of the federal poverty level owe nothing at hospitals in large health systems (200% at other hospitals), with 75% and 50% discounts up to 400% (300% at other hospitals). It covers the part of the bill a patient owes, insured or not. Ask the hospital for its charity care application. Other states' laws.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Kaiser Permanente Central Hospital in Seattle, WA:

Apr 14, 2025 Met requirements

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

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
Abdominal CT scan without and with contrast CPT 74170 COMPUTERIZED AXIAL TOMOGRAPHY ABDOMEN	$1,920.00	$2,400.00	$179.00–$876.00	7% below	20%
Abdominal CT scan without and with contrast inpatient CPT 74170 COMPUTERIZED AXIAL TOMOGRAPHY ABDOMEN	$1,920.00	$2,400.00	$179.00–$876.00	—	20%
Abdominal X-ray, 2 views CPT 74019 "RADIOLOGIC EXAM, ABDOMEN; 2 VIEWS"	$368.00	$460.00	$107.00–$380.00	13% above	20%
Abdominal X-ray, 2 views inpatient CPT 74019 "RADIOLOGIC EXAM, ABDOMEN; 2 VIEWS"	$368.00	$460.00	$107.00–$380.00	—	20%
Ankle X-ray, complete, 3 or more views CPT 73610 RADIOLOGIC EXAM ANKLE COMPLETE MIN 3VIEW	$304.00	$380.00	$89.00–$315.00	2% below	20%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 RADIOLOGIC EXAM ANKLE COMPLETE MIN 3VIEW	$304.00	$380.00	$89.00–$315.00	—	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 NON-INVASIVE STUDY EXTREMITY ARTERY BILAT SINGLE	$488.80	$611.00	—	—	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 NON-INVASIVE STUDY EXTREMITY ARTERY BILAT SINGLE	$488.80	$611.00	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 "COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXT"	$1,440.00	$1,800.00	$107.00–$524.00	2% above	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 "COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXT"	$1,440.00	$1,800.00	$107.00–$524.00	—	20%
Barium swallow (esophagus X-ray with contrast) CPT 74220 "RAD EXAM, ESOPHAGUS INCL SCOUT CHEST RADIOGRAPH, SINGLE-CONTRAST STUDY"	$616.00	$770.00	$179.00–$635.00	1% above	20%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 "RAD EXAM, ESOPHAGUS INCL SCOUT CHEST RADIOGRAPH, SINGLE-CONTRAST STUDY"	$616.00	$770.00	$179.00–$635.00	—	20%
Bone scan, whole body (nuclear medicine) CPT 78306 "BONE/JOINT IMAGING, WHOLE BODY"	$1,382.40	$1,728.00	$402.00–$1,440.00	7% below	20%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 "BONE/JOINT IMAGING, WHOLE BODY"	$1,382.40	$1,728.00	$402.00–$1,440.00	—	20%
Breast ultrasound, complete, one breast one side CPT 76641 "U/S BREAST, UNILATERAL, REAL TIME, COMPLETE"	$654.40	$818.00	$107.00–$380.00	51% above	20%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 "U/S BREAST, UNILATERAL, REAL TIME, COMPLETE"	$654.40	$818.00	$107.00–$380.00	—	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 "HB ULTRASOUND, BREAST, UNILATERAL, LIMITED"	$382.40	$478.00	$89.00–$315.00	13% above	20%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 "HB ULTRASOUND, BREAST, UNILATERAL, LIMITED"	$382.40	$478.00	$89.00–$315.00	—	20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HB CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMGES	$3,600.00	$4,500.00	$358.00–$1,348.00	at median	20%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HB CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMGES	$3,600.00	$4,500.00	$358.00–$1,348.00	—	20%
CT angiography (CTA) of the head CPT 70496 "CT ANGIOGRAPHY, HEAD"	$2,560.00	$3,200.00	$179.00–$877.00	21% above	20%
CT angiography (CTA) of the head inpatient CPT 70496 "CT ANGIOGRAPHY, HEAD"	$2,560.00	$3,200.00	$179.00–$877.00	—	20%
CT angiography (CTA) of the neck CPT 70498 "CT ANGIOGRAPHY, NECK"	$2,560.00	$3,200.00	$179.00–$877.00	14% above	20%
CT angiography (CTA) of the neck inpatient CPT 70498 "CT ANGIOGRAPHY, NECK"	$2,560.00	$3,200.00	$179.00–$877.00	—	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 "CT ANGIOGRAPHY,"	$2,720.00	$3,400.00	$179.00–$877.00	13% above	20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 "CT ANGIOGRAPHY,"	$2,720.00	$3,400.00	$179.00–$877.00	—	20%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 "HB TECHNICAL COMP, COMPUTED TOMOGRAPH ANGIOGRAPHY, HEART"	$1,280.00	$1,600.00	$358.00–$1,280.00	10% above	20%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 "HB TECHNICAL COMP, COMPUTED TOMOGRAPH ANGIOGRAPHY, HEART"	$1,280.00	$1,600.00	$358.00–$1,280.00	—	20%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 "HB TECHNICAL COMP COMPUTED TOMOGRAPH, HEART W/O CONTRAST"	$344.00	$430.00	$89.00–$356.00	159% above	20%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 "HB TECHNICAL COMP COMPUTED TOMOGRAPH, HEART W/O CONTRAST"	$344.00	$430.00	$89.00–$356.00	—	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$3,200.00	$4,000.00	$242.00–$865.00	27% above	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CONTRAST	$3,200.00	$4,000.00	$242.00–$865.00	—	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST	$3,600.00	$4,500.00	$358.00–$1,280.00	16% above	20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/CONTRAST	$3,600.00	$4,500.00	$358.00–$1,280.00	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELVIS W/O CONTRST 1+ BODY REGNS	$4,000.00	$5,000.00	$358.00–$1,280.00	7% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PELVIS W/O CONTRST 1+ BODY REGNS	$4,000.00	$5,000.00	$358.00–$1,280.00	—	20%
CT scan of the abdomen with contrast CPT 74160 "COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN"	$1,520.00	$1,900.00	$179.00–$833.00	19% below	20%
CT scan of the abdomen with contrast inpatient CPT 74160 "COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN"	$1,520.00	$1,900.00	$179.00–$833.00	—	20%
CT scan of the abdomen without contrast CPT 74150 "COMPUTERIZED AXIAL TOMOGARPHY, ABDOMEN"	$1,120.00	$1,400.00	$107.00–$395.00	22% below	20%
CT scan of the abdomen without contrast inpatient CPT 74150 "COMPUTERIZED AXIAL TOMOGARPHY, ABDOMEN"	$1,120.00	$1,400.00	$107.00–$395.00	—	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CONTRAST	$1,440.00	$1,800.00	$107.00–$428.00	30% above	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CONTRAST	$1,440.00	$1,800.00	$107.00–$428.00	—	20%
CT scan of the head or brain, no contrast dye CPT 70450 CAT SCAN HEAD BRAIN WO CONTRAST	$1,600.00	$2,000.00	$107.00–$380.00	20% above	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CAT SCAN HEAD BRAIN WO CONTRAST	$1,600.00	$2,000.00	$107.00–$380.00	—	20%
CT scan of the head with contrast CPT 70460 CAT SCAN HEAD BRAIN W CONTRAST	$1,760.00	$2,200.00	$179.00–$635.00	21% above	20%
CT scan of the head with contrast inpatient CPT 70460 CAT SCAN HEAD BRAIN W CONTRAST	$1,760.00	$2,200.00	$179.00–$635.00	—	20%
CT scan of the head without and with contrast CPT 70470 CAT SCAN HEAD/ BRAIN	$1,920.00	$2,400.00	$179.00–$635.00	11% above	20%
CT scan of the head without and with contrast inpatient CPT 70470 CAT SCAN HEAD/ BRAIN	$1,920.00	$2,400.00	$179.00–$635.00	—	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 "COMPUTERIZED AXIAL TOMOGRAPHY, LMB SPINE"	$1,600.00	$2,000.00	$107.00–$404.00	11% above	20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 "COMPUTERIZED AXIAL TOMOGRAPHY, LMB SPINE"	$1,600.00	$2,000.00	$107.00–$404.00	—	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 "COMPUTERIZED AXIAL TOMOGRAPHY,CERVICAL"	$1,840.00	$2,300.00	$107.00–$408.00	23% above	20%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 "COMPUTERIZED AXIAL TOMOGRAPHY,CERVICAL"	$1,840.00	$2,300.00	$107.00–$408.00	—	20%
CT scan of the pelvis, with contrast dye CPT 72193 "COMPUTED TOMOGRAPHY, PELVIS, W/CONTRAST MATERIAL(S)"	$1,920.00	$2,400.00	$179.00–$839.00	7% above	20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 "COMPUTED TOMOGRAPHY, PELVIS, W/CONTRAST MATERIAL(S)"	$1,920.00	$2,400.00	$179.00–$839.00	—	20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 "HB DUPLEX SCAN EXTRACRANIAL BILAT, TEC"	$748.80	$936.00	—	—	20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 "DUPLEX SCAN EXTRACRANIAL,BILAT"	$973.60	$1,217.00	—	—	20%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 "HB DUPLEX SCAN EXTRACRANIAL BILAT, TEC"	$748.80	$936.00	—	—	20%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 "DUPLEX SCAN EXTRACRANIAL,BILAT"	$973.60	$1,217.00	—	—	20%
Chest CT scan without and with contrast CPT 71270 "COMPUT TOMOGRAPHY, THORAX, DIAGNOSTIC; W/O CONTRAST FOLL BY CONTRAST"	$2,400.00	$3,000.00	$179.00–$670.00	16% above	20%
Chest CT scan without and with contrast inpatient CPT 71270 "COMPUT TOMOGRAPHY, THORAX, DIAGNOSTIC; W/O CONTRAST FOLL BY CONTRAST"	$2,400.00	$3,000.00	$179.00–$670.00	—	20%
Chest X-ray, 2 views CPT 71046 "RADIOLOGIC EXAM, CHEST; 2 VIEWS"	$304.00	$380.00	$89.00–$315.00	5% above	20%
Chest X-ray, 2 views inpatient CPT 71046 "RADIOLOGIC EXAM, CHEST; 2 VIEWS"	$304.00	$380.00	$89.00–$315.00	—	20%
Chest X-ray, single view CPT 71045 "RADIOLOGIC EXAM, CHEST; SINGLE VIEW"	$304.00	$380.00	$89.00–$315.00	27% above	20%
Chest X-ray, single view inpatient CPT 71045 "RADIOLOGIC EXAM, CHEST; SINGLE VIEW"	$304.00	$380.00	$89.00–$315.00	—	20%
Collarbone (clavicle) X-ray, complete CPT 73000 RADIOLOGIC EXAMINATION CLAVICLE	$304.00	$380.00	$89.00–$315.00	11% above	20%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 RADIOLOGIC EXAMINATION CLAVICLE	$304.00	$380.00	$89.00–$315.00	—	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 ECHOGRAPHY RETROPERITONEAL BSCAN	$725.60	$907.00	$107.00–$380.00	17% above	20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 ECHOGRAPHY RETROPERITONEAL BSCAN	$725.60	$907.00	$107.00–$380.00	—	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY STUDY 1+ SITS AXIAL SKE	$368.00	$460.00	$107.00–$380.00	12% below	20%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY STUDY 1+ SITS AXIAL SKE	$368.00	$460.00	$107.00–$380.00	—	20%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY STUDY 1+ SITS APPENDICU	$304.00	$380.00	$89.00–$315.00	76% above	20%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY STUDY 1+ SITS APPENDICU	$304.00	$380.00	$89.00–$315.00	—	20%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 "US, PREGNT UTERUS,RT W/IMAG DOC, FETAL/MATERNL EVAL PLUS FETAL ANATOMIC EVAL, SINGLE OR 1ST GEST"	$830.40	$1,038.00	$242.00–$865.00	17% above	20%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 "US, PREGNT UTERUS,RT W/IMAG DOC, FETAL/MATERNL EVAL PLUS FETAL ANATOMIC EVAL, SINGLE OR 1ST GEST"	$830.40	$1,038.00	$242.00–$865.00	—	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 "COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/O CONTRAST MATERIAL"	$1,600.00	$2,000.00	$107.00–$403.00	7% above	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 "COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/O CONTRAST MATERIAL"	$1,600.00	$2,000.00	$107.00–$403.00	—	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 "COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/CONTRAST MATERIAL(S)"	$2,000.00	$2,500.00	$179.00–$635.00	6% above	20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 "COMPUTED TOMOGRAPHY, THORAX, DIAGNOSTIC; W/CONTRAST MATERIAL(S)"	$2,000.00	$2,500.00	$179.00–$635.00	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 "MAMMO DIAG, INCL (CAD) WHEN PERFORMED: BILAT"	$440.00	$550.00	$111.00–$396.00	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 "MAMMO DIAG, INCL (CAD) WHEN PERFORMED: BILAT"	$440.00	$550.00	$111.00–$396.00	—	20%
Diagnostic mammogram, one breast one side CPT 77065 "MAMMO DIAGNOSTIC, INCL (CAD) WHEN PERFORMED; UNILAT"	$400.00	$500.00	$87.00–$311.00	4% above	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 "MAMMO DIAGNOSTIC, INCL (CAD) WHEN PERFORMED; UNILAT"	$400.00	$500.00	$87.00–$311.00	—	20%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 "BACK OFFICE DUPLEX SCAN, BILAT, LE ARTERY/GRAFT"	$1,024.00	$1,280.00	—	—	20%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 "BACK OFFICE DUPLEX SCAN, BILAT, LE ARTERY/GRAFT"	$1,024.00	$1,280.00	—	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 "DUPLEX SCAN, VEINS, BILATERAL"	$1,343.20	$1,679.00	—	—	20%
Duplex ultrasound of the leg veins, both legs CPT 93970 HB DUPLEX SCAN EXTREMITY VEINS COMPLTE BIL	$1,343.20	$1,679.00	—	25% above	20%
Duplex ultrasound of the leg veins, both legs CPT 93970 "HB DUPLEX SCAN EXTREMITY VEINS CMPLT BIL,TC"	$1,343.20	$1,679.00	—	25% above	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 "DUPLEX SCAN, VEINS, BILATERAL"	$1,343.20	$1,679.00	—	—	20%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HB DUPLEX SCAN EXTREMITY VEINS COMPLTE BIL	$1,343.20	$1,679.00	—	—	20%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 "HB DUPLEX SCAN EXTREMITY VEINS CMPLT BIL,TC"	$1,343.20	$1,679.00	—	—	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER	$2,135.20	$2,669.00	—	27% above	20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE (ECHO) WITH SPECTRAL & COLOR FLOW DOPPLER	$2,135.20	$2,669.00	—	—	20%
Elbow X-ray, 2 views CPT 73070 "RADIOLOGIC EXAMINATION, ELBOW"	$304.00	$380.00	$89.00–$315.00	13% above	20%
Elbow X-ray, 2 views inpatient CPT 73070 "RADIOLOGIC EXAMINATION, ELBOW"	$304.00	$380.00	$89.00–$315.00	—	20%
Elbow X-ray, complete, 3 or more views CPT 73080 XRAY ELBOW COMPLETE	$304.00	$380.00	$89.00–$315.00	4% below	20%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XRAY ELBOW COMPLETE	$304.00	$380.00	$89.00–$315.00	—	20%
Eye socket (orbit) CT scan without contrast CPT 70480 "CT ORBIT, SELLA, EAR W/O CONTRAST, PRO"	$1,200.00	$1,500.00	$107.00–$482.00	2% below	20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 "CT ORBIT, SELLA, EAR W/O CONTRAST, PRO"	$1,200.00	$1,500.00	$107.00–$482.00	—	20%
Facial bones X-ray, complete, 3 or more views CPT 70150 RADIOLOGIC EXAMINATION FACIAL BONES 3V	$368.00	$460.00	$107.00–$380.00	1% below	20%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 RADIOLOGIC EXAMINATION FACIAL BONES 3V	$368.00	$460.00	$107.00–$380.00	—	20%
Forearm X-ray (radius and ulna), 2 views CPT 73090 "RADIOLOGIC EXAMINATION, FOREARM ANT"	$304.00	$380.00	$89.00–$315.00	11% above	20%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 "RADIOLOGIC EXAMINATION, FOREARM ANT"	$304.00	$380.00	$89.00–$315.00	—	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER	$1,382.40	$1,728.00	$402.00–$1,440.00	17% above	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER	$1,382.40	$1,728.00	$402.00–$1,440.00	—	20%
Hand X-ray, 2 views CPT 73120 "RADIOLOGIC EXAMINATION, HAND, TWO VIEWS"	$368.00	$460.00	$107.00–$380.00	29% above	20%
Hand X-ray, 2 views inpatient CPT 73120 "RADIOLOGIC EXAMINATION, HAND, TWO VIEWS"	$368.00	$460.00	$107.00–$380.00	—	20%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 "RADIOLOGIC EXAMINATION, CALCANEUS, MIN"	$304.00	$380.00	$89.00–$315.00	17% above	20%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 "RADIOLOGIC EXAMINATION, CALCANEUS, MIN"	$304.00	$380.00	$89.00–$315.00	—	20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY SLEEP STAGING W/ 4+ PARA/CPAP	$5,522.40	$6,903.00	—	60% above	20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY SLEEP STAGING W/ 4+ PARA/CPAP	$5,522.40	$6,903.00	—	—	20%
Knee X-ray, 3 views CPT 73562 XRAY KNEE AP/LAT W OBLIQUE(S)	$304.00	$380.00	$89.00–$315.00	2% below	20%
Knee X-ray, 3 views inpatient CPT 73562 XRAY KNEE AP/LAT W OBLIQUE(S)	$304.00	$380.00	$89.00–$315.00	—	20%
Knee X-ray, complete, 4 or more views CPT 73564 XRAY KNEE COMPLETE	$368.00	$460.00	$107.00–$380.00	12% below	20%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 XRAY KNEE COMPLETE	$368.00	$460.00	$107.00–$380.00	—	20%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 "COMPUTERIZED AXIAL TOMOGRAPHY, LOWER"	$1,440.00	$1,800.00	$107.00–$406.00	7% above	20%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 "COMPUTERIZED AXIAL TOMOGRAPHY, LOWER"	$1,440.00	$1,800.00	$107.00–$406.00	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHOGRAPHY ABDOMEN LIMITED	$576.00	$720.00	$107.00–$380.00	14% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHOGRAPHY ABDOMEN LIMITED	$576.00	$720.00	$107.00–$380.00	—	20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG	$334.40	$418.00	$107.00–$380.00	5% above	20%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG	$334.40	$418.00	$107.00–$380.00	—	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 "COMPUTED TOMOGRAPHY, THORAX, LOW DOSE LUNG CA SCREENING, W/O CONTRAST"	$400.00	$500.00	$107.00–$425.00	69% above	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 "COMPUTED TOMOGRAPHY, THORAX, LOW DOSE LUNG CA SCREENING, W/O CONTRAST"	$400.00	$500.00	$107.00–$425.00	—	20%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 RADIOLOGIC EXAMINATION TIBIA AND FIBULA	$304.00	$380.00	$89.00–$315.00	10% above	20%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 RADIOLOGIC EXAMINATION TIBIA AND FIBULA	$304.00	$380.00	$89.00–$315.00	—	20%
MR angiography (MRA) of the head without contrast CPT 70544 "MAGNETIC RESONANCE ANGIO, HEAD W/O DYE"	$1,680.00	$2,100.00	$242.00–$865.00	15% below	20%
MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIOGRAPHY HEAD WITHOUT DYE	$1,680.00	$2,100.00	$242.00–$865.00	15% below	20%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 "MAGNETIC RESONANCE ANGIO, HEAD W/O DYE"	$1,680.00	$2,100.00	$242.00–$865.00	—	20%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR ANGIOGRAPHY HEAD WITHOUT DYE	$1,680.00	$2,100.00	$242.00–$865.00	—	20%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 "MRI BREAST W/O & W/CONTRAST MAT INCL CAD, WHEN PERF; BILAT"	$3,840.00	$4,800.00	$318.00–$1,140.00	—	20%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 "MRI BREAST W/O & W/CONTRAST MAT INCL CAD, WHEN PERF; BILAT"	$3,840.00	$4,800.00	$318.00–$1,140.00	—	20%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI ANY JOINT	$1,760.00	$2,200.00	$242.00–$865.00	7% below	20%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 "MRI ANY JOINT ,TECH"	$1,760.00	$2,200.00	$242.00–$865.00	7% below	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 "MRI ANY JOINT ,TECH"	$1,760.00	$2,200.00	$242.00–$865.00	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI ANY JOINT	$1,760.00	$2,200.00	$242.00–$865.00	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O AND W DYE	$2,800.00	$3,500.00	$358.00–$1,373.00	4% below	20%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LOWER EXTREMITY W/W/O DYE	$2,800.00	$3,500.00	$358.00–$1,373.00	4% below	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI JOINT LWR EXTR W/O AND W DYE	$2,800.00	$3,500.00	$358.00–$1,373.00	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI JOINT LOWER EXTREMITY W/W/O DYE	$2,800.00	$3,500.00	$358.00–$1,373.00	—	20%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN TC	$2,160.00	$2,700.00	$242.00–$865.00	3% above	20%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN	$2,160.00	$2,700.00	$242.00–$865.00	3% above	20%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN	$2,160.00	$2,700.00	$242.00–$865.00	—	20%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN TC	$2,160.00	$2,700.00	$242.00–$865.00	—	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/O/W/CONTR & FURTHER SEQUENCES	$3,280.00	$4,100.00	$358.00–$1,280.00	5% above	20%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD W/O/W/CONTR & FURTHER SEQUENCES	$3,280.00	$4,100.00	$358.00–$1,280.00	—	20%
MRI of the brain, no contrast dye CPT 70551 HB MRI BRAIN W/O CONTRST TECH	$1,840.00	$2,300.00	$242.00–$865.00	5% below	20%
MRI of the brain, no contrast dye CPT 70551 "MRI, BRAIN W/O CONTRAST"	$1,840.00	$2,300.00	$242.00–$865.00	5% below	20%
MRI of the brain, no contrast dye inpatient CPT 70551 "MRI, BRAIN W/O CONTRAST"	$1,840.00	$2,300.00	$242.00–$865.00	—	20%
MRI of the brain, no contrast dye inpatient CPT 70551 HB MRI BRAIN W/O CONTRST TECH	$1,840.00	$2,300.00	$242.00–$865.00	—	20%
MRI of the brain, with and without contrast dye CPT 70553 "MRI BRAIN W/ & W/O CONTRAST,"	$2,800.00	$3,500.00	$358.00–$1,280.00	4% below	20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 "MRI BRAIN W/ & W/O CONTRAST,"	$2,800.00	$3,500.00	$358.00–$1,280.00	—	20%
MRI of the lower back, no contrast dye CPT 72148 "MAGNETIC RESONANCE (EG, PROTON) LUMBAR"	$2,080.00	$2,600.00	$242.00–$865.00	1% below	20%
MRI of the lower back, no contrast dye CPT 72148 "MAGNET RESONAN (EG,PROTON) LMBR,TECH I"	$2,080.00	$2,600.00	$242.00–$865.00	1% below	20%
MRI of the lower back, no contrast dye inpatient CPT 72148 "MAGNET RESONAN (EG,PROTON) LMBR,TECH I"	$2,080.00	$2,600.00	$242.00–$865.00	—	20%
MRI of the lower back, no contrast dye inpatient CPT 72148 "MAGNETIC RESONANCE (EG, PROTON) LUMBAR"	$2,080.00	$2,600.00	$242.00–$865.00	—	20%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR W/WO CONTRST SPINE	$3,440.00	$4,300.00	$358.00–$1,280.00	13% above	20%
MRI of the lower back, without and then with contrast dye CPT 72158 "MAGNET RESONA (EG,PRTN) W/O CNTR,TECH"	$3,440.00	$4,300.00	$358.00–$1,280.00	13% above	20%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR W/WO CONTRST SPINE	$3,440.00	$4,300.00	$358.00–$1,280.00	—	20%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 "MAGNET RESONA (EG,PRTN) W/O CNTR,TECH"	$3,440.00	$4,300.00	$358.00–$1,280.00	—	20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 "MAGNETIC RESONANCE (EG, PROTON) IMGNG SP"	$2,080.00	$2,600.00	$242.00–$865.00	2% below	20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 "MAGNET RESONAN (EG,PROTON) IMG SP,TECH"	$2,080.00	$2,600.00	$242.00–$865.00	2% below	20%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 "MAGNETIC RESONANCE (EG, PROTON) IMGNG SP"	$2,080.00	$2,600.00	$242.00–$865.00	—	20%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 "MAGNET RESONAN (EG,PROTON) IMG SP,TECH"	$2,080.00	$2,600.00	$242.00–$865.00	—	20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 "MAGNETIC RESONANCE C-SPINE,TECH"	$2,800.00	$3,500.00	$358.00–$1,280.00	5% below	20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 "MRI SPINE CANAL & CONTENTS W/O CNTRST THEN BY CONTRAST, CERVICAL"	$2,800.00	$3,500.00	$358.00–$1,280.00	5% below	20%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 "MRI SPINE CANAL & CONTENTS W/O CNTRST THEN BY CONTRAST, CERVICAL"	$2,800.00	$3,500.00	$358.00–$1,280.00	—	20%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 "MAGNETIC RESONANCE C-SPINE,TECH"	$2,800.00	$3,500.00	$358.00–$1,280.00	—	20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MAG RES IMAGING CERVICAL W/O C	$1,760.00	$2,200.00	$242.00–$865.00	13% below	20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 "MAGNETIC RESONANCE IMAG CERVCL,TECH INP"	$1,760.00	$2,200.00	$242.00–$865.00	13% below	20%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 "MAGNETIC RESONANCE IMAG CERVCL,TECH INP"	$1,760.00	$2,200.00	$242.00–$865.00	—	20%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MAG RES IMAGING CERVICAL W/O C	$1,760.00	$2,200.00	$242.00–$865.00	—	20%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O AND W DYE	$2,800.00	$3,500.00	$358.00–$1,280.00	8% below	20%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W DYE	$2,800.00	$3,500.00	$358.00–$1,280.00	8% below	20%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O & W DYE	$2,800.00	$3,500.00	$358.00–$1,280.00	—	20%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O AND W DYE	$2,800.00	$3,500.00	$358.00–$1,280.00	—	20%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WITHOUT DYE	$2,000.00	$2,500.00	$242.00–$865.00	4% above	20%
MRI of the pelvis, no contrast dye CPT 72195 "MAGNETIC RESONANCE IMAGING,PELVIS W/O DY"	$2,000.00	$2,500.00	$242.00–$865.00	4% above	20%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WITHOUT DYE	$2,000.00	$2,500.00	$242.00–$865.00	—	20%
MRI of the pelvis, no contrast dye inpatient CPT 72195 "MAGNETIC RESONANCE IMAGING,PELVIS W/O DY"	$2,000.00	$2,500.00	$242.00–$865.00	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 "MAGNETIC RESONANCE (EG, PROTON) JOINT"	$1,920.00	$2,400.00	$242.00–$865.00	1% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 "MAGNET RESONAN (EG,PROTON) JNT,TECH IN"	$1,920.00	$2,400.00	$242.00–$865.00	1% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 "MAGNET RESONAN (EG,PROTON) JNT,TECH IN"	$1,920.00	$2,400.00	$242.00–$865.00	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 "MAGNETIC RESONANCE (EG, PROTON) JOINT"	$1,920.00	$2,400.00	$242.00–$865.00	—	20%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 "RADIOLOGIC EXAMINATION,SPINE, CERVICAL"	$368.00	$460.00	$107.00–$380.00	18% below	20%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 "RADIOLOGIC EXAMINATION,SPINE, CERVICAL"	$368.00	$460.00	$107.00–$380.00	—	20%
Neck soft tissue CT scan with contrast CPT 70491 HB CAT SCAN NECK SOFT TISSUE W CONTRAST	$960.00	$1,200.00	$179.00–$635.00	43% below	20%
Neck soft tissue CT scan with contrast CPT 70491 CAT SCAN NECK SOFT TISSUE W CONTRAST	$1,920.00	$2,400.00	$179.00–$635.00	15% above	20%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HB CAT SCAN NECK SOFT TISSUE W CONTRAST	$960.00	$1,200.00	$179.00–$635.00	—	20%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CAT SCAN NECK SOFT TISSUE W CONTRAST	$1,920.00	$2,400.00	$179.00–$635.00	—	20%
Neck soft tissue CT scan without contrast CPT 70490 CAT SCAN NECK SOFT TISSUE WO CONTRAST	$1,680.00	$2,100.00	$107.00–$440.00	26% above	20%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CAT SCAN NECK SOFT TISSUE WO CONTRAST	$1,680.00	$2,100.00	$107.00–$440.00	—	20%
Neck soft tissue X-ray CPT 70360 XRAY NECK SOFT TISSUE	$304.00	$380.00	$89.00–$315.00	28% above	20%
Neck soft tissue X-ray inpatient CPT 70360 XRAY NECK SOFT TISSUE	$304.00	$380.00	$89.00–$315.00	—	20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 "MYOCARD PERF(SPECT)MULTIP W/EF,QUANT/QUAL WALL MOT"	$4,483.20	$5,604.00	$1,306.00–$4,670.00	26% above	20%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 "MYOCARD PERF(SPECT)MULTIP W/EF,QUANT/QUAL WALL MOT"	$4,483.20	$5,604.00	$1,306.00–$4,670.00	—	20%
OCT scan of the retina (optical coherence tomography) both sides CPT 92134 CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA	$160.00	$200.00	—	—	20%
OCT scan of the retina (optical coherence tomography) inpatient both sides CPT 92134 CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA	$160.00	$200.00	—	—	20%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 TUMORIMAGE PET/CT SKUL-THIGH	$6,400.00	$8,000.00	$1,459.00–$5,220.00	46% above	20%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 TUMORIMAGE PET/CT SKUL-THIGH	$6,400.00	$8,000.00	$1,459.00–$5,220.00	—	20%
Pelvic CT scan without contrast CPT 72192 "COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS"	$1,600.00	$2,000.00	$107.00–$401.00	11% above	20%
Pelvic CT scan without contrast inpatient CPT 72192 "COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS"	$1,600.00	$2,000.00	$107.00–$401.00	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 SONO PELVIS LIMITED	$478.40	$598.00	$107.00–$380.00	5% above	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 SONO PELVIS LIMITED	$478.40	$598.00	$107.00–$380.00	—	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ECHOGRAPHY PELVIS BSCAN	$616.80	$771.00	$107.00–$380.00	3% above	20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ECHOGRAPHY PELVIS BSCAN	$616.80	$771.00	$107.00–$380.00	—	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 "US, PREGNT UTERUS,RT W/IMAG DOC, FETAL/MATERNL EVAL, AFTER 1ST TRIM; SINGLE OR 1ST GESTATION"	$411.20	$514.00	$107.00–$380.00	36% below	20%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 "US, PREGNT UTERUS,RT W/IMAG DOC, FETAL/MATERNL EVAL, AFTER 1ST TRIM; SINGLE OR 1ST GESTATION"	$411.20	$514.00	$107.00–$380.00	—	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 "US, PREGNT UTERUS,RT W/IMAG DOC, FETAL/MATERNL EVAL, 1ST TRIM, SINGLE OR 1ST GESTATION"	$328.80	$411.00	$107.00–$380.00	34% below	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 "US, PREGNT UTERUS,RT W/IMAG DOC, FETAL/MATERNL EVAL, 1ST TRIM, SINGLE OR 1ST GESTATION"	$328.80	$411.00	$107.00–$380.00	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 SONO PREGNANCY LTD (BACK OFFICE)	$364.80	$456.00	$107.00–$380.00	16% below	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 SONO PREGNANCY LTD (BACK OFFICE)	$364.80	$456.00	$107.00–$380.00	—	20%
Rib X-ray, one side, 2 views one side CPT 71100 XRAY RIBS UNILATERAL 2 VIEWS	$304.00	$380.00	$89.00–$315.00	3% above	20%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XRAY RIBS UNILATERAL 2 VIEWS	$304.00	$380.00	$89.00–$315.00	—	20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 "RADIOLOGIC EXAMINATION, RIBS, UNILATERAL"	$368.00	$460.00	$107.00–$380.00	at median	20%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 "RADIOLOGIC EXAMINATION, RIBS, UNILATERAL"	$368.00	$460.00	$107.00–$380.00	—	20%
Screening mammogram, both breasts both sides CPT 77067 "MAMMO SCREENING, BILAT(2-VIEW) INCL CAD"	$400.00	$500.00	$92.00–$330.00	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 "MAMMO SCREENING, BILAT(2-VIEW) INCL CAD"	$400.00	$500.00	$92.00–$330.00	—	20%
Shoulder X-ray, complete, 2 or more views CPT 73030 RADIOLOGIC EXAMINATION SHOULDER CMPL	$180.00	$225.00	$89.00–$315.00	45% below	20%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 RADIOLOGIC EXAMINATION SHOULDER CMPL	$180.00	$225.00	$89.00–$315.00	—	20%
Sinus X-ray, complete, 3 or more views CPT 70220 XRAY SINUSES PARANASAL MIN 3 VIEWS	$304.00	$380.00	$89.00–$315.00	6% below	20%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XRAY SINUSES PARANASAL MIN 3 VIEWS	$304.00	$380.00	$89.00–$315.00	—	20%
Skull X-ray, fewer than 4 views CPT 70250 "X-RAY OF SKULL, FEWER THAN 4 VIEWS"	$368.00	$460.00	$107.00–$380.00	27% above	20%
Skull X-ray, fewer than 4 views inpatient CPT 70250 "X-RAY OF SKULL, FEWER THAN 4 VIEWS"	$368.00	$460.00	$107.00–$380.00	—	20%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO INCL ECG MONITORING W / SUPERVISION	$1,600.00	$2,000.00	—	41% above	20%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS ECHO INCL ECG MONITORING W / SUPERVISION	$1,600.00	$2,000.00	—	—	20%
Swallow study (modified barium swallow, video X-ray) CPT 74230 "RAD EXAM, SWALLOW FUNCT, W/CINE&VIDEORADIOGRAPHY, WHEN PERF,CONTRAST STUDY"	$616.00	$770.00	$179.00–$635.00	14% above	20%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 "RAD EXAM, SWALLOW FUNCT, W/CINE&VIDEORADIOGRAPHY, WHEN PERF,CONTRAST STUDY"	$616.00	$770.00	$179.00–$635.00	—	20%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 "RADIOLOGIC EXAM, FEMUR; MINIMUM 2 VIEWS"	$304.00	$380.00	$89.00–$315.00	17% above	20%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 "RADIOLOGIC EXAM, FEMUR; MINIMUM 2 VIEWS"	$304.00	$380.00	$89.00–$315.00	—	20%
Thoracic spine (mid back) CT scan without contrast CPT 72128 COMPUTERIZED AXIAL TOMOGRPAHY	$1,600.00	$2,000.00	$107.00–$406.00	11% above	20%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 COMPUTERIZED AXIAL TOMOGRPAHY	$1,600.00	$2,000.00	$107.00–$406.00	—	20%
Toe X-ray, 2 or more views CPT 73660 "RADIOLOGIC EXAMINATION OF TOES, MIN 2VS"	$304.00	$380.00	$89.00–$315.00	24% above	20%
Toe X-ray, 2 or more views inpatient CPT 73660 "RADIOLOGIC EXAMINATION OF TOES, MIN 2VS"	$304.00	$380.00	$89.00–$315.00	—	20%
Transvaginal pelvic ultrasound CPT 76830 ECHOGRAPHY TRANSVAGINAL	$511.20	$639.00	$107.00–$380.00	2% above	20%
Transvaginal pelvic ultrasound inpatient CPT 76830 ECHOGRAPHY TRANSVAGINAL	$511.20	$639.00	$107.00–$380.00	—	20%
Transvaginal ultrasound during pregnancy CPT 76817 U/S OB TRANSVAGINAL (BACK OFFICE ONLY)	$364.80	$456.00	$107.00–$380.00	14% below	20%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 U/S OB TRANSVAGINAL (BACK OFFICE ONLY)	$364.80	$456.00	$107.00–$380.00	—	20%
Ultrasound of the abdomen, complete CPT 76700 ECHOGRAPHY ABDOMEN BSCAN	$714.40	$893.00	$107.00–$380.00	3% above	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 ECHOGRAPHY ABDOMEN BSCAN	$714.40	$893.00	$107.00–$380.00	—	20%
Ultrasound of the scrotum and testicles CPT 76870 ECHOGRAPHY SCROTUM AND CONTENTS	$614.40	$768.00	$107.00–$380.00	7% above	20%
Ultrasound of the scrotum and testicles inpatient CPT 76870 ECHOGRAPHY SCROTUM AND CONTENTS	$614.40	$768.00	$107.00–$380.00	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ECHOGRAPHY SOFT TISSUE HEAD & NECK	$558.40	$698.00	$107.00–$380.00	at median	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ECHOGRAPHY SOFT TISSUE HEAD & NECK	$558.40	$698.00	$107.00–$380.00	—	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 "RAD EXAM, UPPER GI TRACT, INCL SCOUT ABD RADIOGRAPH, SINGLE CONTRAST STUDY"	$616.00	$770.00	$179.00–$635.00	10% below	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 "RAD EXAM, UPPER GI TRACT, INCL SCOUT ABD RADIOGRAPH, SINGLE CONTRAST STUDY"	$616.00	$770.00	$179.00–$635.00	—	20%
Upper arm X-ray (humerus), 2 views CPT 73060 "RADIOLOGIC EXAMINATION HUMERUS, MIN"	$304.00	$380.00	$89.00–$315.00	10% above	20%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 "RADIOLOGIC EXAMINATION HUMERUS, MIN"	$304.00	$380.00	$89.00–$315.00	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HB DUPLEX SCAN EXTREMITY VEINS LMTD	$905.60	$1,132.00	—	35% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HB DUPLEX SCAN EXTREMITY VEINS LMTD	$905.60	$1,132.00	—	—	20%
Wrist X-ray, 2 views CPT 73100 "RADIOLOGIC EXAMINATION, WRIST, ANTEROPOS"	$304.00	$380.00	$89.00–$315.00	21% above	20%
Wrist X-ray, 2 views inpatient CPT 73100 "RADIOLOGIC EXAMINATION, WRIST, ANTEROPOS"	$304.00	$380.00	$89.00–$315.00	—	20%
Wrist X-ray, complete, 3 or more views CPT 73110 "RADIOLOGIC EXAMINATION, WRIST, COMPL 3V"	$304.00	$380.00	$89.00–$315.00	3% below	20%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 "RADIOLOGIC EXAMINATION, WRIST, COMPL 3V"	$304.00	$380.00	$89.00–$315.00	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 "RADIOLOGY EXAM, HIP, UNILATERAL, W PELVIS WHEN PERFORMED; 2 - 3 VIEWS"	$304.00	$380.00	$89.00–$315.00	6% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 "RADIOLOGY EXAM, HIP, UNILATERAL, W PELVIS WHEN PERFORMED; 2 - 3 VIEWS"	$304.00	$380.00	$89.00–$315.00	—	20%
X-ray of the abdomen, 1 view CPT 74018 "RADIOLOGIC EXAM, ABDOMEN; 1 VIEW"	$304.00	$380.00	$89.00–$315.00	17% above	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 "RADIOLOGIC EXAM, ABDOMEN; 1 VIEW"	$304.00	$380.00	$89.00–$315.00	—	20%
X-ray of the ankle, 2 views CPT 73600 "RADIOLOGIC EXAMINATION, ANKLE ANTEROPOST"	$304.00	$380.00	$89.00–$315.00	20% above	20%
X-ray of the ankle, 2 views inpatient CPT 73600 "RADIOLOGIC EXAMINATION, ANKLE ANTEROPOST"	$304.00	$380.00	$89.00–$315.00	—	20%
X-ray of the finger(s), 2 or more views CPT 73140 "RADIOLOGIC EXAMINATION, FINGER(S) 2 VWS"	$304.00	$380.00	$89.00–$315.00	14% above	20%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 "RADIOLOGIC EXAMINATION, FINGER(S) 2 VWS"	$304.00	$380.00	$89.00–$315.00	—	20%
X-ray of the foot, 2 views CPT 73620 "RADIOLOGIC EXAMINATION, FOOT,"	$304.00	$380.00	$89.00–$315.00	9% above	20%
X-ray of the foot, 2 views inpatient CPT 73620 "RADIOLOGIC EXAMINATION, FOOT,"	$304.00	$380.00	$89.00–$315.00	—	20%
X-ray of the foot, complete, 3 or more views CPT 73630 "RADIOLOGIC EXAMINATION, FOOT COMPLETE"	$304.00	$380.00	$89.00–$315.00	1% above	20%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 "RADIOLOGIC EXAMINATION, FOOT COMPLETE"	$304.00	$380.00	$89.00–$315.00	—	20%
X-ray of the hand, 3 or more views CPT 73130 "RADIOLOGIC EXAMINATION, HAND, 3V OR >"	$304.00	$380.00	$89.00–$315.00	2% below	20%
X-ray of the hand, 3 or more views inpatient CPT 73130 "RADIOLOGIC EXAMINATION, HAND, 3V OR >"	$304.00	$380.00	$89.00–$315.00	—	20%
X-ray of the knee, 1 or 2 views CPT 73560 XRAY KNEE AP/LAT	$304.00	$380.00	$89.00–$315.00	6% above	20%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 XRAY KNEE AP/LAT	$304.00	$380.00	$89.00–$315.00	—	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 "RADIOLOGIC EXAMINATION, SPINE, LUMBOSACR"	$368.00	$460.00	$107.00–$380.00	1% below	20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 "RADIOLOGIC EXAMINATION, SPINE, LUMBOSACR"	$368.00	$460.00	$107.00–$380.00	—	20%
X-ray of the lower back, 4 or more views CPT 72110 XRAY SPINE LUMBOSACRAL COMPLETE	$368.00	$460.00	$107.00–$380.00	18% below	20%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XRAY SPINE LUMBOSACRAL COMPLETE	$368.00	$460.00	$107.00–$380.00	—	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 "RADIOLOGIC EXAMINATION, SPINE,THORACIC"	$368.00	$460.00	$107.00–$380.00	16% above	20%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 "RADIOLOGIC EXAMINATION, SPINE,THORACIC"	$368.00	$460.00	$107.00–$380.00	—	20%
X-ray of the nasal bones, 3 or more views CPT 70160 "RADIOLOGIC EXAMINATION, NASAL BONES COMP"	$304.00	$380.00	$89.00–$315.00	19% above	20%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 "RADIOLOGIC EXAMINATION, NASAL BONES COMP"	$304.00	$380.00	$89.00–$315.00	—	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 "RADIOLOGIC EXAMINATION, SPINE, CERVICAL"	$304.00	$380.00	$89.00–$315.00	5% below	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 "RADIOLOGIC EXAMINATION, SPINE, CERVICAL"	$304.00	$380.00	$89.00–$315.00	—	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 "RADIOLOGIC EXAMINATION, PELVIS ANTERO"	$368.00	$460.00	$107.00–$380.00	29% above	20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 "RADIOLOGIC EXAMINATION, PELVIS ANTERO"	$368.00	$460.00	$107.00–$380.00	—	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 "RADIOLOGIC EXAMINATION, SACRUM AND COCCY"	$304.00	$380.00	$89.00–$315.00	7% above	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 "RADIOLOGIC EXAMINATION, SACRUM AND COCCY"	$304.00	$380.00	$89.00–$315.00	—	20%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE ACTH	$204.80	$256.00	$29.00–$105.00	7% below	20%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE ACTH	$204.80	$256.00	$29.00–$105.00	—	20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALANINE ALT SGPT	$48.80	$61.00	$4.00–$15.00	3% above	20%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALANINE ALT SGPT	$48.80	$61.00	$4.00–$15.00	—	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANFEREASE ASPARATATE AMINO AST SGOT	$45.60	$57.00	$4.00–$15.00	8% above	20%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANFEREASE ASPARATATE AMINO AST SGOT	$45.60	$57.00	$4.00–$15.00	—	20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$292.00	$365.00	$36.00–$130.00	18% above	20%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$292.00	$365.00	$36.00–$130.00	—	20%
Albumin blood test CPT 82040 ALBUMIN SERUM	$44.00	$55.00	$4.00–$15.00	24% above	20%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$44.00	$55.00	$4.00–$15.00	—	20%
Aldosterone blood test CPT 82088 ALDOSTERONE	$144.00	$180.00	$31.00–$110.00	14% below	20%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$144.00	$180.00	$31.00–$110.00	—	20%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPATASE ALKALINE	$40.80	$51.00	$4.00–$15.00	8% above	20%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPATASE ALKALINE	$40.80	$51.00	$4.00–$15.00	—	20%
Allergy blood test, specific IgE, per allergen CPT 86003 "ALLERGEN SPEC IGE; QUANTITATIVE OR SEMIQUANT, CRUDE EXTRCT, EA"	$25.60	$32.00	$4.00–$15.00	4% below	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 "ALLERGEN SPEC IGE; QUANTITATIVE OR SEMIQUANT, CRUDE EXTRCT, EA"	$25.60	$32.00	$4.00–$15.00	—	20%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA - FETOPROTEIN SERUM	$112.80	$141.00	$13.00–$45.00	35% above	20%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA - FETOPROTEIN SERUM	$112.80	$141.00	$13.00–$45.00	—	20%
Ammonia blood test CPT 82140 "LAB, AMMONIA"	$147.20	$184.00	$11.00–$40.00	29% above	20%
Ammonia blood test inpatient CPT 82140 "LAB, AMMONIA"	$147.20	$184.00	$11.00–$40.00	—	20%
Amylase blood test CPT 82150 LAB-AMYLASE	$49.60	$62.00	$5.00–$17.00	20% below	20%
Amylase blood test inpatient CPT 82150 LAB-AMYLASE	$49.60	$62.00	$5.00–$17.00	—	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE ANTB	$94.40	$118.00	$10.00–$35.00	22% above	20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE ANTB	$94.40	$118.00	$10.00–$35.00	—	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES (ANA)	$80.80	$101.00	$10.00–$35.00	15% above	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES (ANA)	$80.80	$101.00	$10.00–$35.00	—	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$296.80	$371.00	$30.00–$106.00	54% above	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$296.80	$371.00	$30.00–$106.00	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LAB CULTURE OTHER SOURCE	$111.20	$139.00	$7.00–$25.00	26% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LAB CULTURE OTHER SOURCE	$111.20	$139.00	$7.00–$25.00	—	20%
Basic metabolic panel (blood test) CPT 80048 "METABOLIC PANEL,BASIC"	$87.20	$109.00	$7.00–$25.00	16% above	20%
Basic metabolic panel (blood test) inpatient CPT 80048 "METABOLIC PANEL,BASIC"	$87.20	$109.00	$7.00–$25.00	—	20%
Bilirubin blood test, total CPT 82247 "BILIRUBIN, TOTAL"	$47.20	$59.00	$4.00–$15.00	7% above	20%
Bilirubin blood test, total inpatient CPT 82247 "BILIRUBIN, TOTAL"	$47.20	$59.00	$4.00–$15.00	—	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATHOLOGY LEVEL IV (HC) BKR	$296.00	$370.00	$178.00	69% above	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATHOLOGY LEVEL IV	$296.00	$370.00	$178.00	69% above	20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATHOLOGY LEVEL IV	$296.00	$370.00	$178.00	—	20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATHOLOGY LEVEL IV (HC) BKR	$296.00	$370.00	$178.00	—	20%
Blood culture for bacteria CPT 87040 CULTURE BACTERIA DEFINITIVE BLOOD	$160.80	$201.00	$8.00–$30.00	8% above	20%
Blood culture for bacteria inpatient CPT 87040 CULTURE BACTERIA DEFINITIVE BLOOD	$160.80	$201.00	$8.00–$30.00	—	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 PSBC ONLY BLOOD SAMPLE DRAWING	$14.40	$18.00	—	42% below	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE	$40.80	$51.00	—	63% above	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PSBC ONLY BLOOD SAMPLE DRAWING	$14.40	$18.00	—	—	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE	$40.80	$51.00	—	—	20%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE	$26.40	$33.00	$3.00–$11.00	29% below	20%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANTITATIVE	$26.40	$33.00	$3.00–$11.00	—	20%
Blood lead test CPT 83655 LEAD	$84.80	$106.00	$10.00–$35.00	33% above	20%
Blood lead test inpatient CPT 83655 LEAD	$84.80	$106.00	$10.00–$35.00	—	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN CHORIONIC QUALITATIVE HCG	$91.20	$114.00	$6.00–$20.00	22% above	20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADOTROPIN CHORIONIC QUALITATIVE HCG	$91.20	$114.00	$6.00–$20.00	—	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 PSBC ONLY % ABO	$99.20	$124.00	$129.00–$320.00	53% above	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$307.20	$384.00	$129.00–$320.00	374% above	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 PSBC ONLY % ABO	$99.20	$124.00	$129.00–$320.00	—	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$307.20	$384.00	$129.00–$320.00	—	20%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN QUANTITATIVE	$36.80	$46.00	$3.00–$11.00	1% above	20%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN QUANTITATIVE	$36.80	$46.00	$3.00–$11.00	—	20%
C-peptide blood test CPT 84681 C-PEPTIDE	$114.40	$143.00	$16.00–$56.00	4% above	20%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$114.40	$143.00	$16.00–$56.00	—	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C- REACTIVE PROTEIN	$58.40	$73.00	$4.00–$15.00	at median	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C- REACTIVE PROTEIN	$58.40	$73.00	$4.00–$15.00	—	20%
CA 19-9 blood test (tumor marker) CPT 86301 "IMMUNOASSAY FOR TUMOR ANTIGEN,CA 19-9"	$141.60	$177.00	$16.00–$56.00	28% above	20%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 "IMMUNOASSAY FOR TUMOR ANTIGEN,CA 19-9"	$141.60	$177.00	$16.00–$56.00	—	20%
CA-125 blood test (ovarian cancer marker) CPT 86304 "IMMUNOASSAY FOR TUMOR ANTIGEN, CA 125"	$168.80	$211.00	$16.00–$56.00	41% above	20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 "IMMUNOASSAY FOR TUMOR ANTIGEN, CA 125"	$168.80	$211.00	$16.00–$56.00	—	20%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$46.40	$58.00	$4.00–$15.00	9% above	20%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$46.40	$58.00	$4.00–$15.00	—	20%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTEGEN ( CLEA)	$195.20	$244.00	$14.00–$51.00	50% above	20%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTEGEN ( CLEA)	$195.20	$244.00	$14.00–$51.00	—	20%
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY VARICELLA-ZOSTER	$101.60	$127.00	$10.00–$35.00	28% above	20%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODY VARICELLA-ZOSTER	$101.60	$127.00	$10.00–$35.00	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 "INFECT ANTIGEN AMPLFD/DNA,CH TRCHMTS,QNT"	$248.00	$310.00	$27.00–$95.00	85% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 "INFECT ANTIGEN AMPLFD/DNA,CH TRCHMTS,QNT"	$248.00	$310.00	$27.00–$95.00	—	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$100.80	$126.00	$10.00–$36.00	13% above	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$100.80	$126.00	$10.00–$36.00	—	20%
Complete blood count (CBC) with differential CPT 85025 BLOOD COUNT HEMOGRAM & PLATELETS AUTO WB	$88.80	$111.00	$6.00–$21.00	32% above	20%
Complete blood count (CBC) with differential inpatient CPT 85025 BLOOD COUNT HEMOGRAM & PLATELETS AUTO WB	$88.80	$111.00	$6.00–$21.00	—	20%
Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT HEMOGRAM PLATELETS AUT	$60.00	$75.00	$5.00–$17.00	17% above	20%
Complete blood count (CBC), no differential inpatient CPT 85027 BLOOD COUNT HEMOGRAM PLATELETS AUT	$60.00	$75.00	$5.00–$17.00	—	20%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE	$104.80	$131.00	$8.00–$30.00	15% above	20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE	$104.80	$131.00	$8.00–$30.00	—	20%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$137.60	$172.00	$13.00–$45.00	30% above	20%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$137.60	$172.00	$13.00–$45.00	—	20%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE (CK) (CPK) TOTAL	$64.80	$81.00	$6.00–$20.00	3% below	20%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE (CK) (CPK) TOTAL	$64.80	$81.00	$6.00–$20.00	—	20%
Creatinine blood test CPT 82565 CREATININE	$50.40	$63.00	$4.00–$15.00	17% above	20%
Creatinine blood test inpatient CPT 82565 CREATININE	$50.40	$63.00	$4.00–$15.00	—	20%
Cytomegalovirus (CMV) antibody test CPT 86644 PSBC ONLY ANTI-CYTOMEGALOVIRUS (CMV) TEST	$34.40	$43.00	$11.00–$40.00	55% below	20%
Cytomegalovirus (CMV) antibody test CPT 86644 PSBC ONLY PREPARATION OF CMV NEGATIVE	$56.00	$70.00	$11.00–$40.00	27% below	20%
Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY CYTOMEGALOVIRUS (CMV)	$99.20	$124.00	$11.00–$40.00	30% above	20%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 PSBC ONLY ANTI-CYTOMEGALOVIRUS (CMV) TEST	$34.40	$43.00	$11.00–$40.00	—	20%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 PSBC ONLY PREPARATION OF CMV NEGATIVE	$56.00	$70.00	$11.00–$40.00	—	20%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY CYTOMEGALOVIRUS (CMV)	$99.20	$124.00	$11.00–$40.00	—	20%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN (FDPD) D-DIMER QUANTIATIVE	$154.40	$193.00	$8.00–$27.00	30% above	20%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN (FDPD) D-DIMER QUANTIATIVE	$154.40	$193.00	$8.00–$27.00	—	20%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROPIANDROSTERONE SULFATE (DHEA-S)	$104.00	$130.00	$17.00–$60.00	19% below	20%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROPIANDROSTERONE SULFATE (DHEA-S)	$104.00	$130.00	$17.00–$60.00	—	20%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 "ELECTROLYTE PANEL, LAB"	$120.00	$150.00	$6.00–$20.00	120% above	20%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 "ELECTROLYTE PANEL, LAB"	$120.00	$150.00	$6.00–$20.00	—	20%
Epstein-Barr virus (EBV) antibody test CPT 86665 "LAB TEST,GH #6184"	$113.60	$142.00	$14.00–$50.00	20% above	20%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 "LAB TEST,GH #6184"	$113.60	$142.00	$14.00–$50.00	—	20%
Estradiol blood test CPT 82670 ESTRADIOL; TOTAL	$165.60	$207.00	$21.00–$75.00	19% above	20%
Estradiol blood test inpatient CPT 82670 ESTRADIOL; TOTAL	$165.60	$207.00	$21.00–$75.00	—	20%
FSH (follicle-stimulating hormone) test CPT 83001 GANADOTROPIN FOLLICLE STIM HORMONE FSH	$120.80	$151.00	$14.00–$50.00	29% above	20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GANADOTROPIN FOLLICLE STIM HORMONE FSH	$120.80	$151.00	$14.00–$50.00	—	20%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$163.20	$204.00	$15.00–$55.00	18% below	20%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$163.20	$204.00	$15.00–$55.00	—	20%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$119.20	$149.00	$10.00–$37.00	21% above	20%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$119.20	$149.00	$10.00–$37.00	—	20%
Fibrinogen blood test CPT 85384 PSBC ONLY FIBRINOGEN ACTIVITY	$64.00	$80.00	$7.00–$26.00	21% below	20%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$110.40	$138.00	$7.00–$26.00	37% above	20%
Fibrinogen blood test inpatient CPT 85384 PSBC ONLY FIBRINOGEN ACTIVITY	$64.00	$80.00	$7.00–$26.00	—	20%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$110.40	$138.00	$7.00–$26.00	—	20%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$116.80	$146.00	$11.00–$40.00	11% above	20%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$116.80	$146.00	$11.00–$40.00	—	20%
Free T3 thyroid hormone test CPT 84481 TRIDOTHYRONINE FREE	$111.20	$139.00	$13.00–$46.00	24% above	20%
Free T3 thyroid hormone test inpatient CPT 84481 TRIDOTHYRONINE FREE	$111.20	$139.00	$13.00–$46.00	—	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE	$92.00	$115.00	$7.00–$25.00	33% above	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE	$92.00	$115.00	$7.00–$25.00	—	20%
Free testosterone test CPT 84402 TESTOTERONE FREE	$136.80	$171.00	$20.00–$70.00	7% above	20%
Free testosterone test inpatient CPT 84402 TESTOTERONE FREE	$136.80	$171.00	$20.00–$70.00	—	20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE GAMMA	$61.60	$77.00	$6.00–$20.00	13% above	20%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GLUTAMYLTRANSFERASE GAMMA	$61.60	$77.00	$6.00–$20.00	—	20%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$220.80	$276.00	$36.00–$130.00	5% below	20%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$220.80	$276.00	$36.00–$130.00	—	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE	$20.80	$26.00	$4.00–$15.00	49% below	20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUCOSE DOSE	$20.80	$26.00	$4.00–$15.00	—	20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 3 SPECIMENS	$57.60	$72.00	$10.00–$35.00	21% below	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 3 SPECIMENS	$57.60	$72.00	$10.00–$35.00	—	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 "LAB TEST BY DNA, CPT 87591"	$244.00	$305.00	$27.00–$95.00	93% above	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 "LAB TEST BY DNA, CPT 87591"	$244.00	$305.00	$27.00–$95.00	—	20%
H. pylori antibody blood test CPT 86677 ANTIBODY HELICOBACTER PYLORI	$76.00	$95.00	$13.00–$45.00	12% below	20%
H. pylori antibody blood test inpatient CPT 86677 ANTIBODY HELICOBACTER PYLORI	$76.00	$95.00	$13.00–$45.00	—	20%
H. pylori stool antigen test CPT 87338 H. PYLORI ENZYME IMMUNOASSAY	$97.60	$122.00	$11.00–$40.00	32% below	20%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI ENZYME IMMUNOASSAY	$97.60	$122.00	$11.00–$40.00	—	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 "LAB TEST BY DNA, CPT 87536"	$691.20	$864.00	$64.00–$230.00	79% above	20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 "LAB TEST BY DNA, CPT 87536"	$691.20	$864.00	$64.00–$230.00	—	20%
HIV-1 and HIV-2 antibody test CPT 86703 PSBC ONLY ANTI-HIV 1/2 ANTIBODY TEST	$35.20	$44.00	$10.00–$37.00	59% below	20%
HIV-1 and HIV-2 antibody test CPT 86703 PSBC ONLY ANTI-HTLV I/-II TEST	$39.20	$49.00	$10.00–$37.00	54% below	20%
HIV-1 and HIV-2 antibody test CPT 86703 "LAB TEST, GH"	$343.20	$429.00	$10.00–$37.00	299% above	20%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 PSBC ONLY ANTI-HIV 1/2 ANTIBODY TEST	$35.20	$44.00	$10.00–$37.00	—	20%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 PSBC ONLY ANTI-HTLV I/-II TEST	$39.20	$49.00	$10.00–$37.00	—	20%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 "LAB TEST, GH"	$343.20	$429.00	$10.00–$37.00	—	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 IAAD EIA HIV-1 AG W/HIV-1&HIV-2 ANTBDY SINGLE	$149.60	$187.00	$18.00–$65.00	53% above	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 IAAD EIA HIV-1 AG W/HIV-1&HIV-2 ANTBDY SINGLE	$149.60	$187.00	$18.00–$65.00	—	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 IADNA HUMAN PAPILLOMAVIRUS HI-RSK TYP POOLD RSLT	$147.20	$184.00	$27.00–$95.00	3% above	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 IADNA HUMAN PAPILLOMAVIRUS HI-RSK TYP POOLD RSLT	$147.20	$184.00	$27.00–$95.00	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCATED	$77.60	$97.00	$7.00–$26.00	10% above	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCATED	$77.60	$97.00	$7.00–$26.00	—	20%
Hemoglobin blood test CPT 85018 BLOOD COUNT HEMOGLOBIN	$37.60	$47.00	$2.00–$6.00	28% above	20%
Hemoglobin blood test inpatient CPT 85018 BLOOD COUNT HEMOGLOBIN	$37.60	$47.00	$2.00–$6.00	—	20%
Hepatitis B core antibody test (total) CPT 86704 PSBC ONLY ANTI-HEPATITIS B CORE ANTIGEN TEST	$35.20	$44.00	$10.00–$35.00	49% below	20%
Hepatitis B core antibody test (total) CPT 86704 "ANTIBODY,HEPATITIS B CORE(HBCAB),IGG&IGM"	$95.20	$119.00	$10.00–$35.00	39% above	20%
Hepatitis B core antibody test (total) inpatient CPT 86704 PSBC ONLY ANTI-HEPATITIS B CORE ANTIGEN TEST	$35.20	$44.00	$10.00–$35.00	—	20%
Hepatitis B core antibody test (total) inpatient CPT 86704 "ANTIBODY,HEPATITIS B CORE(HBCAB),IGG&IGM"	$95.20	$119.00	$10.00–$35.00	—	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 "ANTIBODY,HEPATITIS B SURFACE(HBSAB)"	$88.00	$110.00	$8.00–$30.00	19% above	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 "ANTIBODY,HEPATITIS B SURFACE(HBSAB)"	$88.00	$110.00	$8.00–$30.00	—	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 PSBC ONLY HEPATITIS B SURFACE ANTIGEN TEST	$35.20	$44.00	$8.00–$30.00	54% below	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 "INFECT ANTIGEN DETECTION/EIA,HEP B SRFC"	$88.80	$111.00	$8.00–$30.00	17% above	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 PSBC ONLY HEPATITIS B SURFACE ANTIGEN TEST	$35.20	$44.00	$8.00–$30.00	—	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 "INFECT ANTIGEN DETECTION/EIA,HEP B SRFC"	$88.80	$111.00	$8.00–$30.00	—	20%
Hepatitis C antibody blood test (screening) CPT 86803 PSBC ONLY ANTI-HEPATITIS C VIRUS TEST	$39.20	$49.00	$11.00–$40.00	54% below	20%
Hepatitis C antibody blood test (screening) CPT 86803 "ANTIBODY, HEPATITIS C"	$96.00	$120.00	$11.00–$40.00	12% above	20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 PSBC ONLY ANTI-HEPATITIS C VIRUS TEST	$39.20	$49.00	$11.00–$40.00	—	20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 "ANTIBODY, HEPATITIS C"	$96.00	$120.00	$11.00–$40.00	—	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 "INFECT ANTIGEN DETECT/RNA,HEPATITIS C,QN"	$352.80	$441.00	$32.00–$116.00	5% above	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 "INFECT ANTIGEN DETECT/RNA,HEPATITIS C,QN"	$352.80	$441.00	$32.00–$116.00	—	20%
Herpes blood test, HSV-1 antibody CPT 86695 "LAB TEST, 86695"	$120.00	$150.00	$10.00–$36.00	74% above	20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 "LAB TEST, 86695"	$120.00	$150.00	$10.00–$36.00	—	20%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIPLEX 2 ANTIBODY	$125.60	$157.00	$15.00–$52.00	43% above	20%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIPLEX 2 ANTIBODY	$125.60	$157.00	$15.00–$52.00	—	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HIGH SENSIVITY(HSCPS)	$74.40	$93.00	$10.00–$35.00	at median	20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HIGH SENSIVITY(HSCPS)	$74.40	$93.00	$10.00–$35.00	—	20%
Homocysteine blood test CPT 83090 HOMOCYSTINE ASSAY	$110.40	$138.00	$14.00–$50.00	9% below	20%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE ASSAY	$110.40	$138.00	$14.00–$50.00	—	20%
Insulin blood test CPT 83525 INSULIN	$62.40	$78.00	$9.00–$31.00	24% below	20%
Insulin blood test inpatient CPT 83525 INSULIN	$62.40	$78.00	$9.00–$31.00	—	20%
Iron blood test (serum iron) CPT 83540 IRON (HC) BKR	$24.00	$30.00	$5.00–$17.00	49% below	20%
Iron blood test (serum iron) CPT 83540 IRON	$57.60	$72.00	$5.00–$17.00	22% above	20%
Iron blood test (serum iron) inpatient CPT 83540 IRON (HC) BKR	$24.00	$30.00	$5.00–$17.00	—	20%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$57.60	$72.00	$5.00–$17.00	—	20%
Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON BINDING CAPACITY (PAML)	$73.60	$92.00	$7.00–$25.00	23% above	20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BINDING CAPACITY (PAML)	$73.60	$92.00	$7.00–$25.00	—	20%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$76.00	$95.00	$7.00–$25.00	at median	20%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$76.00	$95.00	$7.00–$25.00	—	20%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN LUTEINIZING HORMONE	$118.40	$148.00	$14.00–$50.00	23% above	20%
LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN LUTEINIZING HORMONE	$118.40	$148.00	$14.00–$50.00	—	20%
Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID)	$144.80	$181.00	$9.00–$31.00	45% above	20%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE (LACTIC ACID)	$144.80	$181.00	$9.00–$31.00	—	20%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE	$80.00	$100.00	$4.00–$16.00	85% above	20%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE	$80.00	$100.00	$4.00–$16.00	—	20%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$92.80	$116.00	$6.00–$20.00	10% above	20%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$92.80	$116.00	$6.00–$20.00	—	20%
Liver function blood test panel CPT 80076 HEPATIC	$92.80	$116.00	$6.00–$22.00	41% above	20%
Liver function blood test panel inpatient CPT 80076 HEPATIC	$92.80	$116.00	$6.00–$22.00	—	20%
Lyme disease antibody test CPT 86618 ANTIBODY BORELLIA BUFGDORFEN (LYME)	$116.00	$145.00	$13.00–$46.00	21% above	20%
Lyme disease antibody test inpatient CPT 86618 ANTIBODY BORELLIA BUFGDORFEN (LYME)	$116.00	$145.00	$13.00–$46.00	—	20%
Magnesium blood test CPT 83735 MAGNESIUM	$76.00	$95.00	$6.00–$20.00	41% above	20%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$76.00	$95.00	$6.00–$20.00	—	20%
Measles (rubeola) antibody test CPT 86765 ANTIBODY RUBEOLA	$78.40	$98.00	$10.00–$35.00	11% above	20%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY RUBEOLA	$78.40	$98.00	$10.00–$35.00	—	20%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES SCREENING	$24.00	$30.00	$4.00–$15.00	58% below	20%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODIES SCREENING	$24.00	$30.00	$4.00–$15.00	—	20%
Mumps immunity blood test CPT 86735 ANTIBODY MUMPS	$74.40	$93.00	$10.00–$35.00	3% above	20%
Mumps immunity blood test inpatient CPT 86735 ANTIBODY MUMPS	$74.40	$93.00	$10.00–$35.00	—	20%
Obstetric blood test panel CPT 80055 "LAB TEST, GH#2403"	$215.20	$269.00	$36.00–$130.00	83% above	20%
Obstetric blood test panel inpatient CPT 80055 "LAB TEST, GH#2403"	$215.20	$269.00	$36.00–$130.00	—	20%
PSA (prostate-specific antigen) blood test, free CPT 84154 "PROSTATIC SPECIFIC ANTIGEN (PSA), FREE"	$92.00	$115.00	$14.00–$50.00	6% below	20%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 "PROSTATIC SPECIFIC ANTIGEN (PSA), FREE"	$92.00	$115.00	$14.00–$50.00	—	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPECIFIC ANTIGEN (PSA)	$124.80	$156.00	$14.00–$50.00	13% above	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATIC SPECIFIC ANTIGEN (PSA)	$124.80	$156.00	$14.00–$50.00	—	20%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH CERV/VAG THIN LAY PREP;AUTO& MN	$116.80	$146.00	$31.00–$112.00	28% above	20%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATH CERV/VAG THIN LAY PREP;AUTO& MN	$116.80	$146.00	$31.00–$112.00	—	20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATHOLOGY SMEARS THIN LAYER	$110.40	$138.00	$24.00–$85.00	33% above	20%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATHOLOGY SMEARS THIN LAYER	$110.40	$138.00	$24.00–$85.00	—	20%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE)	$255.20	$319.00	$31.00–$111.00	21% above	20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE (PARATHYROID HORMONE)	$255.20	$319.00	$31.00–$111.00	—	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 PSBC ONLY APTT	$41.20	$51.50	$4.00–$16.00	at median	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL PTT	$63.20	$79.00	$4.00–$16.00	53% above	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PSBC ONLY APTT	$41.20	$51.50	$4.00–$16.00	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL PTT	$63.20	$79.00	$4.00–$16.00	—	20%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS INORGANIC (PHOSPHATE)	$56.80	$71.00	$4.00–$15.00	42% above	20%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS INORGANIC (PHOSPHATE)	$56.80	$71.00	$4.00–$15.00	—	20%
Potassium blood test CPT 84132 POTASSIUM SERUM	$53.60	$67.00	$4.00–$15.00	30% above	20%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$53.60	$67.00	$4.00–$15.00	—	20%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 "FETAL CHROMOSOMAL ANEUPLOIDY, GENOMIC ANALYSIS PANEL, 13, 18, AND 21"	$2,361.60	$2,952.00	$469.00–$1,680.00	208% above	20%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 "FETAL CHROMOSOMAL ANEUPLOIDY, GENOMIC ANALYSIS PANEL, 13, 18, AND 21"	$2,361.60	$2,952.00	$469.00–$1,680.00	—	20%
Progesterone blood test CPT 84144 PROGESTERONE	$91.20	$114.00	$16.00–$56.00	7% below	20%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$91.20	$114.00	$16.00–$56.00	—	20%
Prolactin blood test CPT 84146 PROLACTIN	$148.80	$186.00	$15.00–$52.00	37% above	20%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$148.80	$186.00	$15.00–$52.00	—	20%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$48.80	$61.00	$3.00–$12.00	22% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 PSBC ONLY PROTHROMBIN TIME	$49.44	$61.80	$3.00–$12.00	24% above	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$48.80	$61.00	$3.00–$12.00	—	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PSBC ONLY PROTHROMBIN TIME	$49.44	$61.80	$3.00–$12.00	—	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 "LAB TEST BY IMMUNSSY W/OPTCL OBS,87880"	$67.20	$84.00	$13.00–$45.00	7% below	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 "LAB TEST BY IMMUNSSY W/OPTCL OBS,87880"	$67.20	$84.00	$13.00–$45.00	—	20%
Renin blood test CPT 84244 RENIN	$78.40	$98.00	$17.00–$60.00	40% below	20%
Renin blood test inpatient CPT 84244 RENIN	$78.40	$98.00	$17.00–$60.00	—	20%
Rh blood typing CPT 86901 BLOOD TYPING RH (D)	$91.20	$114.00	$40.00–$95.00	91% above	20%
Rh blood typing inpatient CPT 86901 BLOOD TYPING RH (D)	$91.20	$114.00	$40.00–$95.00	—	20%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANTITATIVE	$52.80	$66.00	$4.00–$15.00	32% above	20%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANTITATIVE	$52.80	$66.00	$4.00–$15.00	—	20%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY RUBELLA	$88.00	$110.00	$11.00–$40.00	28% above	20%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY RUBELLA	$88.00	$110.00	$11.00–$40.00	—	20%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE ERYTHROCYE AUTOMATED	$32.00	$40.00	$2.00–$7.00	10% below	20%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE ERYTHROCYE AUTOMATED	$32.00	$40.00	$2.00–$7.00	—	20%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS COMPLETE	$56.00	$70.00	$10.00–$35.00	11% below	20%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS COMPLETE	$56.00	$70.00	$10.00–$35.00	—	20%
Sodium blood test CPT 84295 SODIUM SERUM	$57.60	$72.00	$4.00–$15.00	37% above	20%
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$57.60	$72.00	$4.00–$15.00	—	20%
Stool ova and parasites exam CPT 87177 OVA-PARASITES DIRECT SMEAR CONCENTRATION	$90.40	$113.00	$7.00–$25.00	34% above	20%
Stool ova and parasites exam inpatient CPT 87177 OVA-PARASITES DIRECT SMEAR CONCENTRATION	$90.40	$113.00	$7.00–$25.00	—	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 "BLOOD,OCCULT,FECES,DIAG,1-3 SIMULT DETRM"	$44.00	$55.00	$3.00–$12.00	45% above	20%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 "BLOOD,OCCULT,FECES,DIAG,1-3 SIMULT DETRM"	$44.00	$55.00	$3.00–$12.00	—	20%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FOBT SINGLE CARD DONE DURING VISIT	$84.80	$106.00	$13.00–$45.00	14% above	20%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FOBT SINGLE CARD DONE DURING VISIT	$84.80	$106.00	$13.00–$45.00	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 PSBC ONLY SEROLOGIC TEST FOR SYPHILIS (STS)	$34.40	$43.00	$3.00–$12.00	7% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 "LAB TEST, 86592"	$53.60	$67.00	$3.00–$12.00	66% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 PSBC ONLY SEROLOGIC TEST FOR SYPHILIS (STS)	$34.40	$43.00	$3.00–$12.00	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 "LAB TEST, 86592"	$53.60	$67.00	$3.00–$12.00	—	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TST CELL	$293.60	$367.00	$47.00–$167.00	41% above	20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TUBERCULOSIS TST CELL	$293.60	$367.00	$47.00–$167.00	—	20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$160.80	$201.00	$20.00–$70.00	26% above	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$160.80	$201.00	$20.00–$70.00	—	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES EACH	$78.40	$98.00	$11.00–$40.00	3% below	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES EACH	$78.40	$98.00	$11.00–$40.00	—	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH)	$124.80	$156.00	$13.00–$45.00	18% above	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (TSH)	$124.80	$156.00	$13.00–$45.00	—	20%
Total IgE blood test CPT 82785 GAMMAGLOBULAN IGE	$103.20	$129.00	$13.00–$45.00	7% above	20%
Total IgE blood test inpatient CPT 82785 GAMMAGLOBULAN IGE	$103.20	$129.00	$13.00–$45.00	—	20%
Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM TOTAL	$58.40	$73.00	$3.00–$12.00	60% above	20%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL SERUM TOTAL	$58.40	$73.00	$3.00–$12.00	—	20%
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL	$44.80	$56.00	$6.00–$20.00	21% below	20%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL	$44.80	$56.00	$6.00–$20.00	—	20%
Total triiodothyronine (T3) blood test CPT 84480 TRIDOTHYRONINE TOTAL	$82.40	$103.00	$11.00–$40.00	9% below	20%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIDOTHYRONINE TOTAL	$82.40	$103.00	$11.00–$40.00	—	20%
Transferrin blood test CPT 84466 TRANSFERRIN	$110.40	$138.00	$10.00–$35.00	24% above	20%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$110.40	$138.00	$10.00–$35.00	—	20%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$53.60	$67.00	$4.00–$15.00	21% above	20%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$53.60	$67.00	$4.00–$15.00	—	20%
Troponin test, quantitative CPT 84484 TROPONIN ANALYTE CHEMISTRY	$168.00	$210.00	$10.00–$35.00	23% above	20%
Troponin test, quantitative inpatient CPT 84484 TROPONIN ANALYTE CHEMISTRY	$168.00	$210.00	$10.00–$35.00	—	20%
Uric acid blood test CPT 84550 URIC ACID BLOOD CHEMICAL	$50.40	$63.00	$3.00–$12.00	12% above	20%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD CHEMICAL	$50.40	$63.00	$3.00–$12.00	—	20%
Urinalysis with microscope exam, automated CPT 81001 "URINALYSIS ROUTINE AUTOMATED, W/ MICROSC"	$43.20	$54.00	$3.00–$10.00	9% above	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 "URINALYSIS ROUTINE AUTOMATED, W/ MICROSC"	$43.20	$54.00	$3.00–$10.00	—	20%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS ROUTINE	$12.80	$16.00	$3.00–$11.00	25% below	20%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS ROUTINE	$12.80	$16.00	$3.00–$11.00	—	20%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS WO MICROSCOPY AUTOMATED	$34.40	$43.00	$2.00–$6.00	20% above	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS WO MICROSCOPY AUTOMATED	$34.40	$43.00	$2.00–$6.00	—	20%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS WO MICROSCOPY NONAUTOMATED	$16.80	$21.00	$3.00–$10.00	18% below	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS WO MICROSCOPY NONAUTOMATED	$16.80	$21.00	$3.00–$10.00	—	20%
Urine culture for bacteria, with colony count CPT 87086 CULTURE BACTERIA URINE QUANT COLONY CT	$92.80	$116.00	$6.00–$22.00	10% above	20%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE BACTERIA URINE QUANT COLONY CT	$92.80	$116.00	$6.00–$22.00	—	20%
Urine microalbumin (albumin) test CPT 82043 "ALBUMIN URINE (EG, MICROALBUMIN), QUANTITATIVE"	$54.40	$68.00	$4.00–$16.00	4% above	20%
Urine microalbumin (albumin) test inpatient CPT 82043 "ALBUMIN URINE (EG, MICROALBUMIN), QUANTITATIVE"	$54.40	$68.00	$4.00–$16.00	—	20%
Urine pregnancy test, read by color change CPT 81025 "LAB TEST, GH #3220"	$64.80	$81.00	$7.00–$25.00	29% above	20%
Urine pregnancy test, read by color change inpatient CPT 81025 "LAB TEST, GH #3220"	$64.80	$81.00	$7.00–$25.00	—	20%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12)	$113.60	$142.00	$11.00–$41.00	14% above	20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBALAMIN (VITAMIN B-12)	$113.60	$142.00	$11.00–$41.00	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CALIFEDIOL 25-OH VITAMIN D-3	$152.80	$191.00	$22.00–$80.00	12% above	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CALIFEDIOL 25-OH VITAMIN D-3	$152.80	$191.00	$22.00–$80.00	—	20%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDOROXYVITAMIN 1 25	$182.40	$228.00	$29.00–$105.00	5% above	20%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 DIHYDOROXYVITAMIN 1 25	$182.40	$228.00	$29.00–$105.00	—	20%
Zinc blood test CPT 84630 "ZINC, QUANTITATIVE, BLOOD"	$84.80	$106.00	$9.00–$31.00	12% above	20%
Zinc blood test inpatient CPT 84630 "ZINC, QUANTITATIVE, BLOOD"	$84.80	$106.00	$9.00–$31.00	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIONIC QUANTITATIVE HCG	$167.20	$209.00	$11.00–$41.00	54% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORIONIC QUANTITATIVE HCG	$167.20	$209.00	$11.00–$41.00	—	20%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 "IVR BX BREAST W/ DEVICE IMAGING PERC; FIRST LESION, W/ STEREO GUIDE"	$3,440.00	$4,300.00	$1,621.00–$3,606.00	55% above	20%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 "IVR BX BREAST W/ DEVICE IMAGING PERC; FIRST LESION, W/ STEREO GUIDE"	$3,440.00	$4,300.00	$1,621.00–$3,606.00	—	20%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HB CLOSED TX FIBULAR FX W/O MANIPULATION	$515.20	$644.00	$240.00–$534.00	21% below	20%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HB CLOSED TX FIBULAR FX W/O MANIPULATION	$515.20	$644.00	$240.00–$534.00	—	20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HB METATARSAL FX W/O MANIPULATION	$515.20	$644.00	$240.00–$534.00	10% below	20%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HB METATARSAL FX W/O MANIPULATION	$515.20	$644.00	$240.00–$534.00	—	20%
Cardiac catheterization with coronary angiogram CPT 93458 CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I	$13,675.20	$17,094.00	$3,217.00–$7,159.00	29% above	20%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I	$13,675.20	$17,094.00	$3,217.00–$7,159.00	—	20%
Catheter ablation for atrial fibrillation CPT 93656 COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$38,639.20	$48,299.00	—	50% above	20%
Catheter ablation for atrial fibrillation inpatient CPT 93656 COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$38,639.20	$48,299.00	—	—	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HB CLSD TX DISTAL RADIUS W/O MANIP H	$761.60	$952.00	$240.00–$534.00	23% above	20%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HB CLSD TX DISTAL RADIUS W/O MANIP H	$761.60	$952.00	$240.00–$534.00	—	20%
Coronary stent placement, one artery CPT 92928 PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH	$26,198.40	$32,748.00	—	23% above	20%
Coronary stent placement, one artery inpatient CPT 92928 PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH	$26,198.40	$32,748.00	—	—	20%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$8,000.00	$10,000.00	$6,240.00–$12,050.00	31% below	20%
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	$8,000.00	$10,000.00	$6,240.00–$12,050.00	—	20%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR AA HERNIA 1ST > 10 CM REDUCIBLE	$8,000.00	$10,000.00	$6,240.00–$12,050.00	32% below	20%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 RPR AA HERNIA 1ST > 10 CM REDUCIBLE	$8,000.00	$10,000.00	$6,240.00–$12,050.00	—	20%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$8,000.00	$10,000.00	$3,530.00–$7,855.00	11% above	20%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$8,000.00	$10,000.00	$3,530.00–$7,855.00	—	20%
Gallbladder removal, laparoscopic CPT 47562 "LAP,CHOLECYSTECTOMY"	$13,360.00	$16,700.00	$5,835.00–$12,986.00	at median	20%
Gallbladder removal, laparoscopic inpatient CPT 47562 "LAP,CHOLECYSTECTOMY"	$13,360.00	$16,700.00	$5,835.00–$12,986.00	—	20%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAP SURG CHOLECYSTECTOMY W/ CHOLANGIOGRAPHY	$13,360.00	$16,700.00	$5,835.00–$12,986.00	20% above	20%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAP SURG CHOLECYSTECTOMY W/ CHOLANGIOGRAPHY	$13,360.00	$16,700.00	$5,835.00–$12,986.00	—	20%
Hammertoe correction surgery CPT 28285 "HB TX RM CHG-HAMMERTOE OPERATION,ONE TOE"	$6,756.80	$8,446.00	$3,245.00–$7,222.00	72% above	20%
Hammertoe correction surgery inpatient CPT 28285 "HB TX RM CHG-HAMMERTOE OPERATION,ONE TOE"	$6,756.80	$8,446.00	$3,245.00–$7,222.00	—	20%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABSCESS SIMP/SINGLE	$442.40	$553.00	$199.00–$442.00	18% above	20%
Incision and drainage of a simple or single skin abscess CPT 10060 "HB TX ROOM FEE,DRAINAGE SKIN ABSCESS"	$526.40	$658.00	$199.00–$442.00	40% above	20%
Incision and drainage of a simple or single skin abscess CPT 10060 "HB UC ROOM FEE,DRAINAGE SKIN ABSCESS"	$657.60	$822.00	$199.00–$442.00	75% above	20%
Incision and drainage of a simple or single skin abscess CPT 10060 "DRAINAGE SKIN ABSCESS, ER FEE"	$657.60	$822.00	$199.00–$442.00	75% above	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABSCESS SIMP/SINGLE	$442.40	$553.00	$199.00–$442.00	—	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 "HB TX ROOM FEE,DRAINAGE SKIN ABSCESS"	$526.40	$658.00	$199.00–$442.00	—	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 "DRAINAGE SKIN ABSCESS, ER FEE"	$657.60	$822.00	$199.00–$442.00	—	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 "HB UC ROOM FEE,DRAINAGE SKIN ABSCESS"	$657.60	$822.00	$199.00–$442.00	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HB INJ TENDON LIGAMENT TRIGGER GANGLION FAC	$611.20	$764.00	$296.00–$657.00	102% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HB INJ TENDON SHEATH OR LIGAMENT SINGLE	$611.20	$764.00	$296.00–$657.00	102% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 IVR INJ TENDON SHEATH/TRIGGER	$640.00	$800.00	$296.00–$657.00	112% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HB MOR CPT 20550	$688.00	$860.00	$296.00–$657.00	128% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HB INJ TENDON SHEATH OR LIGAMENT SINGLE	$611.20	$764.00	$296.00–$657.00	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HB INJ TENDON LIGAMENT TRIGGER GANGLION FAC	$611.20	$764.00	$296.00–$657.00	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 IVR INJ TENDON SHEATH/TRIGGER	$640.00	$800.00	$296.00–$657.00	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HB MOR CPT 20550	$688.00	$860.00	$296.00–$657.00	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HB TX RM ARTHRO.MAJOR JOINT OR BURSA	$535.20	$669.00	$296.00–$657.00	10% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 "ARTHROCENTESIS, LARGE-SHOULDER/HIP/KNEE/BURSA"	$535.20	$669.00	$296.00–$657.00	10% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HB ARTHRO.MAJOR JOINT OR BURSA	$535.20	$669.00	$296.00–$657.00	10% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 IVR ARTHROCENTESIS ASP/INJ MJR	$560.00	$700.00	$296.00–$657.00	15% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HB ARTHRO.MAJOR JOINT OR BURSA	$535.20	$669.00	$296.00–$657.00	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HB TX RM ARTHRO.MAJOR JOINT OR BURSA	$535.20	$669.00	$296.00–$657.00	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 "ARTHROCENTESIS, LARGE-SHOULDER/HIP/KNEE/BURSA"	$535.20	$669.00	$296.00–$657.00	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 IVR ARTHROCENTESIS ASP/INJ MJR	$560.00	$700.00	$296.00–$657.00	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HB ARTHROCENTESIS INTERMEDIATE JOINT GANG	$544.00	$680.00	$296.00–$657.00	19% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 IVR ASP/INJ CYST MED JT.	$560.00	$700.00	$296.00–$657.00	22% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HB MOR CPT 20605	$688.00	$860.00	$296.00–$657.00	50% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HB ARTHROCENTESIS INTERMEDIATE JOINT GANG	$544.00	$680.00	$296.00–$657.00	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 IVR ASP/INJ CYST MED JT.	$560.00	$700.00	$296.00–$657.00	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HB MOR CPT 20605	$688.00	$860.00	$296.00–$657.00	—	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HB TX RM ARTHROCENTESIS SM JOINT BURSA GANG	$510.40	$638.00	$296.00–$657.00	35% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 "HB ARTHROCENTESIS SMALL JOINT BURSA GANG,UC"	$510.40	$638.00	$296.00–$657.00	35% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 IVR ARTHROCENTESIS ASP/INJ SM	$560.00	$700.00	$296.00–$657.00	48% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HB MOR CPT 20600	$688.00	$860.00	$296.00–$657.00	81% above	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HB TX RM ARTHROCENTESIS SM JOINT BURSA GANG	$510.40	$638.00	$296.00–$657.00	—	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 "HB ARTHROCENTESIS SMALL JOINT BURSA GANG,UC"	$510.40	$638.00	$296.00–$657.00	—	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 IVR ARTHROCENTESIS ASP/INJ SM	$560.00	$700.00	$296.00–$657.00	—	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HB MOR CPT 20600	$688.00	$860.00	$296.00–$657.00	—	20%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 TOTAL HYSTERECTOMY UTERUS 250G OR LESS	$23,760.00	$29,700.00	$10,412.00–$23,174.00	at median	20%
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 TOTAL HYSTERECTOMY UTERUS 250G OR LESS	$23,760.00	$29,700.00	$10,412.00–$23,174.00	—	20%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 TOTAL HYSTERCTMY UTERUS 250G OR LESS W/REM TUB/OV	$23,760.00	$29,700.00	$10,412.00–$23,174.00	21% below	20%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 TOTAL HYSTERCTMY UTERUS 250G OR LESS W/REM TUB/OV	$23,760.00	$29,700.00	$10,412.00–$23,174.00	—	20%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP SURG REPAIR ING HERNIA INIT	$13,360.00	$16,700.00	$5,835.00–$12,986.00	15% above	20%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAP SURG REPAIR ING HERNIA INIT	$13,360.00	$16,700.00	$5,835.00–$12,986.00	—	20%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP SURG REPAIR ING HERNIA RECURRENT	$13,360.00	$16,700.00	$5,835.00–$12,986.00	130% above	20%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAP SURG REPAIR ING HERNIA RECURRENT	$13,360.00	$16,700.00	$5,835.00–$12,986.00	—	20%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAP SURG W/ REM ADNEXAL STRUCTRUES	$13,360.00	$16,700.00	$5,835.00–$12,986.00	86% above	20%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAP SURG W/ REM ADNEXAL STRUCTRUES	$13,360.00	$16,700.00	$5,835.00–$12,986.00	—	20%
Left heart catheterization, diagnostic CPT 93452 L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$7,760.00	$9,700.00	—	4% below	20%
Left heart catheterization, diagnostic inpatient CPT 93452 L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$7,760.00	$9,700.00	—	—	20%
Lumpectomy (partial mastectomy) CPT 19301 HB MOR CPT 19301	$8,800.00	$11,000.00	$3,830.00–$8,523.00	21% above	20%
Lumpectomy (partial mastectomy) inpatient CPT 19301 HB MOR CPT 19301	$8,800.00	$11,000.00	$3,830.00–$8,523.00	—	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HB MOR CPT 11400	$1,680.00	$2,100.00	$704.00–$1,566.00	128% above	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HB MOR CPT 11400	$1,680.00	$2,100.00	$704.00–$1,566.00	—	20%
Pacemaker implant (dual chamber) CPT 33208 HB INSERT PACEMAKER AV SEQUENTIAL	$17,582.40	$21,978.00	$10,466.00–$23,294.00	68% above	20%
Pacemaker implant (dual chamber) inpatient CPT 33208 HB INSERT PACEMAKER AV SEQUENTIAL	$17,582.40	$21,978.00	$10,466.00–$23,294.00	—	20%
Prostate removal (prostatectomy), laparoscopic CPT 55866 LAP SURG PROSCTOMY RETROPUB RADL INCL NERVE SPAR	$23,760.00	$29,700.00	$10,412.00–$23,174.00	55% below	20%
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 LAP SURG PROSCTOMY RETROPUB RADL INCL NERVE SPAR	$23,760.00	$29,700.00	$10,412.00–$23,174.00	—	20%
Removal of a breast lump, open surgery CPT 19120 HB EXCISE CYST FIBROADENOMA BREAST TIS	$8,320.80	$10,401.00	$3,830.00–$8,523.00	71% above	20%
Removal of a breast lump, open surgery inpatient CPT 19120 HB EXCISE CYST FIBROADENOMA BREAST TIS	$8,320.80	$10,401.00	$3,830.00–$8,523.00	—	20%
Removal of a foreign object under the skin, simple CPT 10120 "HB FEE,FB SQ INCISE & REMOVE,"	$870.40	$1,088.00	$400.00–$889.00	68% above	20%
Removal of a foreign object under the skin, simple CPT 10120 "HB UC FEE,FB SQ INCISE & REMOVE"	$870.40	$1,088.00	$400.00–$889.00	68% above	20%
Removal of a foreign object under the skin, simple CPT 10120 "FB SQ INCISE & REMOVE, ER FEE"	$870.40	$1,088.00	$400.00–$889.00	68% above	20%
Removal of a foreign object under the skin, simple CPT 10120 INCIS & REMOV FB SUBQ TISSUES SIMP	$896.80	$1,121.00	$400.00–$889.00	73% above	20%
Removal of a foreign object under the skin, simple CPT 10120 HB MOR INCISION & REMOVAL FOREIGN BODY	$960.00	$1,200.00	$400.00–$889.00	85% above	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 "FB SQ INCISE & REMOVE, ER FEE"	$870.40	$1,088.00	$400.00–$889.00	—	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 "HB UC FEE,FB SQ INCISE & REMOVE"	$870.40	$1,088.00	$400.00–$889.00	—	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 "HB FEE,FB SQ INCISE & REMOVE,"	$870.40	$1,088.00	$400.00–$889.00	—	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCIS & REMOV FB SUBQ TISSUES SIMP	$896.80	$1,121.00	$400.00–$889.00	—	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HB MOR INCISION & REMOVAL FOREIGN BODY	$960.00	$1,200.00	$400.00–$889.00	—	20%
Short arm cast (elbow to hand) CPT 29075 "HB APPLICATION ELBOW TO FINGER,UC FAC CHG"	$743.20	$929.00	$266.00–$591.00	69% above	20%
Short arm cast (elbow to hand) inpatient CPT 29075 "HB APPLICATION ELBOW TO FINGER,UC FAC CHG"	$743.20	$929.00	$266.00–$591.00	—	20%
Short arm splint (forearm and hand) CPT 29125 HB CLSD TX FINGER FX PP OR MP W/O MANIP H	$515.20	$644.00	$129.00–$287.00	86% above	20%
Short arm splint (forearm and hand) CPT 29125 "APPLY FOREARM SPLNT, ER FEE"	$569.60	$712.00	$129.00–$287.00	105% above	20%
Short arm splint (forearm and hand) CPT 29125 HB APPLY FOREARM SPLNT H	$569.60	$712.00	$129.00–$287.00	105% above	20%
Short arm splint (forearm and hand) CPT 29125 "TX FINGER THUMB FRATURE OPEN, ER FEE"	$7,065.60	$8,832.00	$129.00–$287.00	2445% above	20%
Short arm splint (forearm and hand) inpatient CPT 29125 HB CLSD TX FINGER FX PP OR MP W/O MANIP H	$515.20	$644.00	$129.00–$287.00	—	20%
Short arm splint (forearm and hand) inpatient CPT 29125 "APPLY FOREARM SPLNT, ER FEE"	$569.60	$712.00	$129.00–$287.00	—	20%
Short arm splint (forearm and hand) inpatient CPT 29125 HB APPLY FOREARM SPLNT H	$569.60	$712.00	$129.00–$287.00	—	20%
Short arm splint (forearm and hand) inpatient CPT 29125 "TX FINGER THUMB FRATURE OPEN, ER FEE"	$7,065.60	$8,832.00	$129.00–$287.00	—	20%
Short leg cast (below the knee) CPT 29405 HB CAST APPLICATION SHORT LEG CAST	$586.40	$733.00	$266.00–$591.00	69% above	20%
Short leg cast (below the knee) inpatient CPT 29405 HB CAST APPLICATION SHORT LEG CAST	$586.40	$733.00	$266.00–$591.00	—	20%
Short leg splint (calf to foot) CPT 29515 HB APPLY LEG SPLINT H	$548.00	$685.00	$158.00–$351.00	55% above	20%
Short leg splint (calf to foot) CPT 29515 "APPLY LEG SPLINT, ER FEE"	$548.00	$685.00	$158.00–$351.00	55% above	20%
Short leg splint (calf to foot) CPT 29515 HB TX RM AMPUTATION METACARPAL	$7,065.60	$8,832.00	$158.00–$351.00	1895% above	20%
Short leg splint (calf to foot) inpatient CPT 29515 HB APPLY LEG SPLINT H	$548.00	$685.00	$158.00–$351.00	—	20%
Short leg splint (calf to foot) inpatient CPT 29515 "APPLY LEG SPLINT, ER FEE"	$548.00	$685.00	$158.00–$351.00	—	20%
Short leg splint (calf to foot) inpatient CPT 29515 HB TX RM AMPUTATION METACARPAL	$7,065.60	$8,832.00	$158.00–$351.00	—	20%
Thoracentesis with imaging guidance CPT 32555 "IVR THORACENTESIS NEEDLE, OR CATH W/IMAGING GUIDANCE"	$2,240.00	$2,800.00	$619.00–$1,376.00	69% above	20%
Thoracentesis with imaging guidance inpatient CPT 32555 "IVR THORACENTESIS NEEDLE, OR CATH W/IMAGING GUIDANCE"	$2,240.00	$2,800.00	$619.00–$1,376.00	—	20%
Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY	$30,320.00	$37,900.00	$12,867.00–$28,639.00	8% above	20%
Total hip replacement inpatient CPT 27130 TOTAL HIP ARTHROPLASTY	$30,320.00	$37,900.00	$12,867.00–$28,639.00	—	20%
Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY	$30,320.00	$37,900.00	$12,867.00–$28,639.00	41% above	20%
Total knee replacement inpatient CPT 27447 TOTAL KNEE ARTHROPLASTY	$30,320.00	$37,900.00	$12,867.00–$28,639.00	—	20%
Trigger finger release surgery CPT 26055 HB TX RM TENDON SHEATH INCISION TRGER FNGR	$2,888.80	$3,611.00	$1,601.00–$3,562.00	2% below	20%
Trigger finger release surgery CPT 26055 HB MOR CPT 26055	$3,760.00	$4,700.00	$1,601.00–$3,562.00	28% above	20%
Trigger finger release surgery inpatient CPT 26055 HB TX RM TENDON SHEATH INCISION TRGER FNGR	$2,888.80	$3,611.00	$1,601.00–$3,562.00	—	20%
Trigger finger release surgery inpatient CPT 26055 HB MOR CPT 26055	$3,760.00	$4,700.00	$1,601.00–$3,562.00	—	20%
Trigger point injections, 1 or 2 muscles CPT 20552 HB TRIGGER POINT ONE OR TWO MUSC GROUPS FAC	$392.80	$491.00	$296.00–$657.00	9% above	20%
Trigger point injections, 1 or 2 muscles CPT 20552 HB TX RM TRIGGER PT ONE OR TWO MUSC GROUPS	$392.80	$491.00	$296.00–$657.00	9% above	20%
Trigger point injections, 1 or 2 muscles CPT 20552 IVR INJ SINGLE/MULT TRIGGER PT	$400.00	$500.00	$296.00–$657.00	11% above	20%
Trigger point injections, 1 or 2 muscles CPT 20552 HB MOR CPT 20552	$688.00	$860.00	$296.00–$657.00	91% above	20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HB TRIGGER POINT ONE OR TWO MUSC GROUPS FAC	$392.80	$491.00	$296.00–$657.00	—	20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HB TX RM TRIGGER PT ONE OR TWO MUSC GROUPS	$392.80	$491.00	$296.00–$657.00	—	20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 IVR INJ SINGLE/MULT TRIGGER PT	$400.00	$500.00	$296.00–$657.00	—	20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HB MOR CPT 20552	$688.00	$860.00	$296.00–$657.00	—	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 "IVR BX BREAST W/ DEVICE IMAGING PERC; FIRST LESION, W/ US GUIDE"	$3,200.00	$4,000.00	$1,621.00–$3,606.00	28% above	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 "IVR BX BREAST W/ DEVICE IMAGING PERC; FIRST LESION, W/ US GUIDE"	$3,200.00	$4,000.00	$1,621.00–$3,606.00	—	20%
Vein ablation, radiofrequency, first vein CPT 36475 "HB ENDOVENOUS RF,1ST VEIN"	$6,958.40	$8,698.00	$3,148.00–$7,006.00	46% above	20%
Vein ablation, radiofrequency, first vein CPT 36475 "IVR VENOUS ABLATION RADIOFREQUENCY, 1ST VEIN"	$7,280.00	$9,100.00	$3,148.00–$7,006.00	53% above	20%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 "HB ENDOVENOUS RF,1ST VEIN"	$6,958.40	$8,698.00	$3,148.00–$7,006.00	—	20%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 "IVR VENOUS ABLATION RADIOFREQUENCY, 1ST VEIN"	$7,280.00	$9,100.00	$3,148.00–$7,006.00	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN & SUBQ TISSUE	$896.80	$1,121.00	$400.00–$889.00	39% above	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN & SUBQ TISSUE	$896.80	$1,121.00	$400.00–$889.00	—	20%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
Blood transfusion (giving blood or blood components) CPT 36430 PSBC ONLY ADMINISTRATION - RED BLOOD CELLS	$104.00	$130.00	$438.00–$973.00	89% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$1,755.20	$2,194.00	$438.00–$973.00	79% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION - ED	$1,755.20	$2,194.00	$438.00–$973.00	79% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 HB EOS BLOOD TRANSFUSION	$1,760.00	$2,200.00	$438.00–$973.00	80% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 "CLSD TX FEMORAL FX, PROX END, HEAD ED FAC"	$7,065.60	$8,832.00	$438.00–$973.00	621% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 HB MOR CPT 26735	$7,520.00	$9,400.00	$438.00–$973.00	667% above	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 PSBC ONLY ADMINISTRATION - RED BLOOD CELLS	$104.00	$130.00	$438.00–$973.00	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$1,755.20	$2,194.00	$438.00–$973.00	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION - ED	$1,755.20	$2,194.00	$438.00–$973.00	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HB EOS BLOOD TRANSFUSION	$1,760.00	$2,200.00	$438.00–$973.00	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 "CLSD TX FEMORAL FX, PROX END, HEAD ED FAC"	$7,065.60	$8,832.00	$438.00–$973.00	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HB MOR CPT 26735	$7,520.00	$9,400.00	$438.00–$973.00	—	20%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE & DROWSY INCLUDE HYPERVENTILATION &/OR	$1,262.40	$1,578.00	—	63% above	20%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE & DROWSY INCLUDE HYPERVENTILATION &/OR	$1,262.40	$1,578.00	—	—	20%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HB ELECTROCARDIOGRAM ROUTINE 12	$61.60	$77.00	—	40% below	20%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 HB ELECTROCARDIOGRAM ROUTINE 12	$61.60	$77.00	—	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 "EKG 12 LEAD TRACING ONLY, FAC FEE"	$269.60	$337.00	—	45% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 "EKG 12 LEAD TRACING ONLY, FAC FEE"	$269.60	$337.00	—	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$367.20	$459.00	$144.00–$320.00	47% above	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 FACILITY USE-EMERGENCY ROOM, LEVEL 1	$367.20	$459.00	$144.00–$320.00	47% above	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$367.20	$459.00	$144.00–$320.00	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 FACILITY USE-EMERGENCY ROOM, LEVEL 1	$367.20	$459.00	$144.00–$320.00	—	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$604.00	$755.00	$234.00–$521.00	33% above	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 FACILITY USE-EMERGENCY ROOM, LEVEL 2	$604.00	$755.00	$234.00–$521.00	33% above	20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 FACILITY USE-EMERGENCY ROOM, LEVEL 2	$604.00	$755.00	$234.00–$521.00	—	20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$604.00	$755.00	$234.00–$521.00	—	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT LOW MDM	$1,180.80	$1,476.00	$451.00–$1,005.00	47% above	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 FACILITY USE-EMERGENCY ROOM, LEVEL 3	$1,180.80	$1,476.00	$451.00–$1,005.00	47% above	20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPARTMENT VISIT LOW MDM	$1,180.80	$1,476.00	$451.00–$1,005.00	—	20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 FACILITY USE-EMERGENCY ROOM, LEVEL 3	$1,180.80	$1,476.00	$451.00–$1,005.00	—	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT MODERATE MDM	$1,888.80	$2,361.00	$809.00–$1,804.00	40% above	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 FACILITY USE-EMERGENCY ROOM, LEVEL 4	$1,888.80	$2,361.00	$809.00–$1,804.00	40% above	20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 FACILITY USE-EMERGENCY ROOM, LEVEL 4	$1,888.80	$2,361.00	$809.00–$1,804.00	—	20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPARTMENT VISIT MODERATE MDM	$1,888.80	$2,361.00	$809.00–$1,804.00	—	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT HIGH MDM	$2,623.20	$3,279.00	$1,398.00–$3,116.00	17% above	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 FACILITY USE-EMERGENCY ROOM, LEVEL 5	$2,623.20	$3,279.00	$1,398.00–$3,116.00	17% above	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 FACILITY USE-EMERGENCY ROOM, LEVEL 5	$2,623.20	$3,279.00	$1,398.00–$3,116.00	—	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPARTMENT VISIT HIGH MDM	$2,623.20	$3,279.00	$1,398.00–$3,116.00	—	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 "HB CARDIOVASCULAR STRESS TEST,TRACING ONLY"	$911.20	$1,139.00	—	53% above	20%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 "HB CARDIOVASCULAR STRESS TEST,TRACING ONLY"	$911.20	$1,139.00	—	—	20%
IV infusion of a medicine, first hour CPT 96365 PSBC ONLY ADMINISTRATION - FACTOR CONCENTRATES	$60.00	$75.00	$211.00–$469.00	85% below	20%
IV infusion of a medicine, first hour inpatient CPT 96365 PSBC ONLY ADMINISTRATION - FACTOR CONCENTRATES	$60.00	$75.00	$211.00–$469.00	—	20%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES	$163.20	$204.00	—	32% below	20%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL W/O MEDICAL SERVICES	$163.20	$204.00	—	—	20%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 "NERVE CONDUCTION STUDIES, 7-8 STUDIES"	$696.00	$870.00	—	18% above	20%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 "NERVE CONDUCTION STUDIES, 7-8 STUDIES"	$696.00	$870.00	—	—	20%
Neuromuscular re-education, 15 minutes CPT 97112 HB PT NEUROMUSCULAR REEDUCATION	$128.00	$160.00	—	30% above	20%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HB PT NEUROMUSCULAR REEDUCATION	$128.00	$160.00	—	—	20%
Occupational therapy evaluation, low complexity CPT 97165 "HB OCCUPATIONAL THERAPY EVAL, LOW COMPLEXITY"	$280.00	$350.00	—	30% above	20%
Occupational therapy evaluation, low complexity inpatient CPT 97165 "HB OCCUPATIONAL THERAPY EVAL, LOW COMPLEXITY"	$280.00	$350.00	—	—	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 "HB PHYSICAL THERAPY EVAL, HIGH COMPLEXITY"	$344.80	$431.00	—	25% above	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 "HB PHYSICAL THERAPY EVAL, HIGH COMPLEXITY"	$344.80	$431.00	—	—	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 "HB PHYSICAL THERAPY EVAL, LOW COMPLEXITY"	$288.80	$361.00	—	31% above	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 "HB PHYSICAL THERAPY EVAL, LOW COMPLEXITY"	$288.80	$361.00	—	—	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 "HB PHYSICAL THERAPY EVAL, MODERATE COMPLEXITY"	$312.00	$390.00	—	26% above	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 "HB PHYSICAL THERAPY EVAL, MODERATE COMPLEXITY"	$312.00	$390.00	—	—	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB THERAPEUTIC PROCEDURE EA 15 MIN	$120.80	$151.00	—	26% above	20%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HB THERAPEUTIC PROCEDURE EA 15 MIN	$120.80	$151.00	—	—	20%
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES	$216.80	$271.00	—	10% below	20%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES	$216.80	$271.00	—	—	20%
Psychotherapy for crisis, first 60 minutes CPT 90839 "PSYCHOTHERAPY FOR CRISIS,FIRST 60 MINUTES"	$328.80	$411.00	—	24% above	20%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 "PSYCHOTHERAPY FOR CRISIS,FIRST 60 MINUTES"	$328.80	$411.00	—	—	20%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MIN PATIENT	$132.00	$165.00	—	4% below	20%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MIN PATIENT	$132.00	$165.00	—	—	20%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MIN PATIENT	$161.60	$202.00	—	11% below	20%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MIN PATIENT	$161.60	$202.00	—	—	20%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MIN PATIENT	$188.00	$235.00	—	29% below	20%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MIN PATIENT	$188.00	$235.00	—	—	20%
Spirometry (breathing test) CPT 94010 SPIROMETRY W/GRAPHIC RECORD/VITAL CAPACITY/FLOW	$448.80	$561.00	—	81% above	20%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY W/GRAPHIC RECORD/VITAL CAPACITY/FLOW	$448.80	$561.00	—	—	20%
Spirometry before and after a bronchodilator CPT 94060 BRONCHODILATOR STUDY	$699.20	$874.00	—	66% above	20%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHODILATOR STUDY	$699.20	$874.00	—	—	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 HB THERAPEUTIC ACTIVITIES EA 15 MIN	$139.20	$174.00	—	33% above	20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HB THERAPEUTIC ACTIVITIES EA 15 MIN	$139.20	$174.00	—	—	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PSBC ONLY THERAPEUTIC PHLEBOTOMY	$38.40	$48.00	—	81% below	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERA (SEP PROC)	$383.20	$479.00	—	89% above	20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PSBC ONLY THERAPEUTIC PHLEBOTOMY	$38.40	$48.00	—	—	20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERA (SEP PROC)	$383.20	$479.00	—	—	20%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
Hepatitis A vaccine, adult dose CPT 90632 "hepatitis A adult 1,440 ELISA unit/mL Syrg 1 mL Syringe"	$113.24	$141.54	—	47% above	20%
Hepatitis A vaccine, adult dose inpatient CPT 90632 "hepatitis A adult 1,440 ELISA unit/mL Syrg 1 mL Syringe"	$113.24	$141.54	—	—	20%
Rabies vaccine, one dose CPT 90675 rabies virus 2.5 unit Solr 1 each Vial	$598.21	$747.76	—	4% below	20%
Rabies vaccine, one dose inpatient CPT 90675 rabies virus 2.5 unit Solr 1 each Vial	$598.21	$747.76	—	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 "tetanus, diptheria 5-2 Lf unit/0.5 mL Syrg 0.5 mL Syringe"	$49.10	$61.37	—	13% below	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 "tetanus, diptheria 5-2 Lf unit/0.5 mL Syrg 0.5 mL Syringe"	$49.10	$61.37	—	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$76.00	$95.00	—	81% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN	$76.00	$95.00	—	—	20%

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

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

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

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

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

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

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

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

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

Source file: https://healthy.kaiserpermanente.org/content/dam/kporg/final/documents/health-plan-documents/coverage-information/machine-readable/910511770-central-hospital-standard-charges-wa-en.csv