Hospital Bradford, PA

UPMC Kane

UPMC Kane in Kane, PA publishes cash prices for 375 common procedures listed here, from its own machine-readable price file updated Mar 6, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Pennsylvania median for 253 of 370 procedures and above it for 117. By typical cash price it ranks #34 of 108 Pennsylvania hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

4372 Route 6, Kane, PA 16735 Collected Sep 27, 2026 Source price file Check a bill from this hospital (814) 837-8585

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 391318 · CMS hospital register NPI 1588416382

Financial assistance

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

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

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

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

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named UPMC Kane in Kane, PA:

Feb 11, 2025 Warning notice
Mar 25, 2025 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/WO	$1,477.80	$2,463.00	$194.12–$55,447.06	22% below	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/WO	$1,477.80	$2,463.00	$1,724.10–$2,339.85	—	40%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR ANKLE 3V BILATERAL	$202.80	$338.00	$68.14–$7,609.06	—	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3V RIGHT	$187.80	$313.00	$68.14–$7,046.26	48% below	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3V LEFT	$187.80	$313.00	$68.14–$7,046.26	48% below	40%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR ANKLE 3V BILATERAL	$202.80	$338.00	$236.60–$321.10	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3V RIGHT	$187.80	$313.00	$219.10–$297.35	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3V LEFT	$187.80	$313.00	$219.10–$297.35	—	40%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY WO	$833.40	$1,389.00	$431.17–$31,269.17	29% below	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY WO	$833.40	$1,389.00	$972.30–$1,319.55	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 FL BARIUM SWALLOW SINGLE CONTRAST	$349.20	$582.00	$41.25–$13,101.98	24% below	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 FL BARIUM SWALLOW SINGLE CONTRAST	$349.20	$582.00	$407.40–$552.90	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE IMAGING WHOLE BODY	$639.60	$1,066.00	$111.63–$23,997.79	48% below	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE IMAGING WHOLE BODY	$639.60	$1,066.00	$746.20–$1,012.70	—	40%
Breast ultrasound, complete, one breast both sides CPT 76641 US BREAST BILATERAL	$483.00	$805.00	$140.97–$18,122.16	—	40%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST RIGHT	$241.20	$402.00	$140.70–$9,049.82	56% below	40%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST LEFT	$241.20	$402.00	$140.70–$9,049.82	56% below	40%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US BREAST BILATERAL	$483.00	$805.00	$563.50–$764.75	—	40%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST RIGHT	$241.20	$402.00	$281.40–$381.90	—	40%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST LEFT	$241.20	$402.00	$281.40–$381.90	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABDOMEN PELVIS	$1,030.20	$1,717.00	$458.46–$38,653.10	65% below	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABDOMEN PELVIS	$1,030.20	$1,717.00	$1,201.90–$1,631.15	—	40%
CT angiography (CTA) of the head CPT 70496 CT ANGIO HEAD	$1,920.00	$3,200.00	$309.42–$72,038.40	12% above	40%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIO HEAD	$1,920.00	$3,200.00	$2,240.00–$3,040.00	—	40%
CT angiography (CTA) of the neck CPT 70498 CT ANGIO NECK	$1,924.20	$3,207.00	$309.42–$72,195.98	15% above	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIO NECK	$1,924.20	$3,207.00	$2,244.90–$3,046.65	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST	$1,893.60	$3,156.00	$336.57–$71,047.87	1% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST	$1,893.60	$3,156.00	$2,209.20–$2,998.20	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA HEART CARDIAC SCORING	$856.20	$1,427.00	$329.27–$32,124.62	57% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO CORONARY ARTERIES	$2,457.60	$4,096.00	$329.27–$92,209.15	24% above	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA HEART CARDIAC SCORING	$856.20	$1,427.00	$998.90–$1,355.65	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO CORONARY ARTERIES	$2,457.60	$4,096.00	$2,867.20–$3,891.20	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CARDIAC SCORING WO	$124.80	$208.00	$62.52–$4,682.50	29% below	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CARDIAC SCORING WO	$124.80	$208.00	$145.60–$197.60	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN PELVIS WO	$477.00	$795.00	$185.12–$17,897.04	77% below	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN PELVIS WO	$477.00	$795.00	$556.50–$755.25	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN PELVIS W	$738.60	$1,231.00	$289.48–$27,712.27	75% below	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN PELVIS W	$738.60	$1,231.00	$861.70–$1,169.45	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN PELVIS W/WO	$822.60	$1,371.00	$365.99–$30,863.95	72% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN PELVIS W/WO	$822.60	$1,371.00	$959.70–$1,302.45	—	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W	$1,155.00	$1,925.00	$163.96–$43,335.60	30% below	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W	$1,155.00	$1,925.00	$1,347.50–$1,828.75	—	40%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO	$910.20	$1,517.00	$141.90–$34,150.70	19% below	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO	$910.20	$1,517.00	$1,061.90–$1,441.15	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES/FACIAL BONES WO	$820.20	$1,367.00	$143.00–$30,773.90	27% below	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES/FACIAL BONES WO	$820.20	$1,367.00	$956.90–$1,298.65	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO	$993.60	$1,656.00	$128.43–$37,279.87	8% below	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO	$993.60	$1,656.00	$1,159.20–$1,573.20	—	40%
CT scan of the head with contrast CPT 70460 CT HEAD W	$927.00	$1,545.00	$147.40–$34,781.04	31% below	40%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W	$927.00	$1,545.00	$1,081.50–$1,467.75	—	40%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO	$1,150.20	$1,917.00	$174.96–$43,155.50	31% below	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO	$1,150.20	$1,917.00	$1,341.90–$1,821.15	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR WO	$954.60	$1,591.00	$152.45–$35,816.59	17% below	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR WO	$954.60	$1,591.00	$1,113.70–$1,511.45	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL WO	$954.60	$1,591.00	$146.95–$35,816.59	19% below	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL WO	$954.60	$1,591.00	$1,113.70–$1,511.45	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W	$1,190.40	$1,984.00	$154.10–$44,663.81	30% below	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W	$1,190.40	$1,984.00	$1,388.80–$1,884.80	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID BILATERAL	$1,056.60	$1,761.00	$162.65–$39,643.63	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID BILATERAL	$1,056.60	$1,761.00	$1,232.70–$1,672.95	—	40%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO	$1,448.40	$2,414.00	$184.11–$54,343.97	10% below	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO	$1,448.40	$2,414.00	$1,689.80–$2,293.30	—	40%
Chest X-ray, 2 views CPT 71046 XR CHEST 2V	$178.80	$298.00	$26.00–$6,708.58	45% below	40%
Chest X-ray, 2 views CPT 71046 FL FLUORO CHEST	$247.20	$412.00	$26.00–$9,274.94	23% below	40%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2V	$178.80	$298.00	$208.60–$283.10	—	40%
Chest X-ray, 2 views inpatient CPT 71046 FL FLUORO CHEST	$247.20	$412.00	$288.40–$391.40	—	40%
Chest X-ray, single view CPT 71045 XR CHEST DECUBITUS	$108.00	$180.00	$17.03–$4,052.16	43% below	40%
Chest X-ray, single view CPT 71045 XR CHEST 1V	$163.20	$272.00	$17.03–$6,123.26	13% below	40%
Chest X-ray, single view CPT 71045 XR CHEST 1V REPEAT SAME DAY	$178.80	$298.00	$17.03–$6,708.58	5% below	40%
Chest X-ray, single view inpatient CPT 71045 XR CHEST DECUBITUS	$108.00	$180.00	$126.00–$171.00	—	40%
Chest X-ray, single view inpatient CPT 71045 XR CHEST 1V	$163.20	$272.00	$190.40–$258.40	—	40%
Chest X-ray, single view inpatient CPT 71045 XR CHEST 1V REPEAT SAME DAY	$178.80	$298.00	$208.60–$283.10	—	40%
Collarbone (clavicle) X-ray, complete both sides CPT 73000 XR CLAVICLE BILATERAL	$209.40	$349.00	$64.11–$7,856.69	—	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE LEFT	$106.20	$177.00	$61.95–$3,984.62	63% below	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE POST REDUCTION LEFT	$106.20	$177.00	$61.95–$3,984.62	63% below	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE RIGHT	$106.20	$177.00	$61.95–$3,984.62	63% below	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE POST REDUCTION RIGHT	$106.20	$177.00	$61.95–$3,984.62	63% below	40%
Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 XR CLAVICLE BILATERAL	$209.40	$349.00	$244.30–$331.55	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE POST REDUCTION RIGHT	$106.20	$177.00	$123.90–$168.15	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE RIGHT	$106.20	$177.00	$123.90–$168.15	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE LEFT	$106.20	$177.00	$123.90–$168.15	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE POST REDUCTION LEFT	$106.20	$177.00	$123.90–$168.15	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONIUM	$528.00	$880.00	$89.65–$19,810.56	27% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONIUM	$528.00	$880.00	$616.00–$836.00	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DX DEXA SCREENING	$212.40	$354.00	$66.12–$7,969.25	22% below	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DX DEXA HIP AND BACK	$212.40	$354.00	$66.12–$7,969.25	22% below	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DX DEXA HIP AND BACK	$212.40	$354.00	$247.80–$336.30	—	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DX DEXA SCREENING	$212.40	$354.00	$247.80–$336.30	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DX DEXA WRIST/FOREARM	$139.80	$233.00	$30.23–$5,245.30	23% below	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DX DEXA WRIST/FOREARM	$139.80	$233.00	$163.10–$221.35	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB DETAILED SINGLE FETUS	$681.60	$1,136.00	$202.52–$25,573.63	46% below	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB DETAILED SINGLE FETUS	$681.60	$1,136.00	$795.20–$1,079.20	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO	$954.00	$1,590.00	$146.95–$35,794.08	13% below	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO	$954.00	$1,590.00	$1,113.00–$1,510.50	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W	$1,153.20	$1,922.00	$159.66–$43,268.06	19% below	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W	$1,153.20	$1,922.00	$1,345.40–$1,825.90	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MA MAMMO DIGITAL BILATERAL	$238.80	$398.00	$116.00–$8,959.78	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA MAMMO DIGITAL BILATERAL	$238.80	$398.00	$278.60–$378.10	—	40%
Diagnostic mammogram, one breast one side CPT 77065 MA MAMMO DIGITAL LEFT	$186.60	$311.00	$108.85–$7,001.23	41% below	40%
Diagnostic mammogram, one breast one side CPT 77065 MA MAMMO DIGITAL RIGHT	$186.60	$311.00	$108.85–$7,001.23	41% below	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MA MAMMO DIGITAL RIGHT	$186.60	$311.00	$217.70–$295.45	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MA MAMMO DIGITAL LEFT	$186.60	$311.00	$217.70–$295.45	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ARTERIAL BILATERAL	$1,306.80	$2,178.00	$161.49–$49,031.14	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US ARTERIAL BILATERAL	$1,306.80	$2,178.00	$1,524.60–$2,069.10	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS BILATERAL	$1,357.20	$2,262.00	$161.33–$50,922.14	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS BILATERAL	$1,357.20	$2,262.00	$1,583.40–$2,148.90	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAM W/O	$1,049.40	$1,749.00	$155.12–$39,373.49	44% below	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARDIOGRAM W/O	$1,049.40	$1,749.00	$1,224.30–$1,661.55	—	40%
Elbow X-ray, 2 views both sides CPT 73070 XR ELBOW 2V BILATERAL	$196.20	$327.00	$63.25–$7,361.42	—	40%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2V LEFT	$99.00	$165.00	$57.75–$3,714.48	68% below	40%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW POST REDUCTION RIGHT	$99.00	$165.00	$57.75–$3,714.48	68% below	40%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2V RIGHT	$99.00	$165.00	$57.75–$3,714.48	68% below	40%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW POST REDUCTION LEFT	$99.00	$165.00	$57.75–$3,714.48	68% below	40%
Elbow X-ray, 2 views inpatient both sides CPT 73070 XR ELBOW 2V BILATERAL	$196.20	$327.00	$228.90–$310.65	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW POST REDUCTION RIGHT	$99.00	$165.00	$115.50–$156.75	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2V LEFT	$99.00	$165.00	$115.50–$156.75	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2V RIGHT	$99.00	$165.00	$115.50–$156.75	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW POST REDUCTION LEFT	$99.00	$165.00	$115.50–$156.75	—	40%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 XR ELBOW 4V BILATERAL	$227.40	$379.00	$69.84–$8,532.05	—	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 4V RIGHT	$114.60	$191.00	$66.85–$4,299.79	67% below	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 4V LEFT	$114.60	$191.00	$66.85–$4,299.79	67% below	40%
Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 XR ELBOW 4V BILATERAL	$227.40	$379.00	$265.30–$360.05	—	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 4V LEFT	$114.60	$191.00	$133.70–$181.45	—	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 4V RIGHT	$114.60	$191.00	$133.70–$181.45	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC/ORBIT/SELLA WO	$879.00	$1,465.00	$190.77–$32,980.08	19% below	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC/ORBIT/SELLA WO	$879.00	$1,465.00	$1,025.50–$1,391.75	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES 4V	$159.00	$265.00	$37.69–$5,965.68	61% below	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES 4V	$159.00	$265.00	$185.50–$251.75	—	40%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 XR FOREARM BILATERAL POST REDUCTION	$209.40	$349.00	$64.56–$7,856.69	—	40%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 XR FOREARM BILATERAL	$209.40	$349.00	$64.56–$7,856.69	—	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM RIGHT	$106.20	$177.00	$61.95–$3,984.62	62% below	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM LEFT	$106.20	$177.00	$61.95–$3,984.62	62% below	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM POST REDUCTION LEFT	$106.20	$177.00	$61.95–$3,984.62	62% below	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM POST REDUCTION RIGHT	$106.20	$177.00	$61.95–$3,984.62	62% below	40%
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 XR FOREARM BILATERAL	$209.40	$349.00	$244.30–$331.55	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 XR FOREARM BILATERAL POST REDUCTION	$209.40	$349.00	$244.30–$331.55	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM POST REDUCTION LEFT	$106.20	$177.00	$123.90–$168.15	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM RIGHT	$106.20	$177.00	$123.90–$168.15	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM LEFT	$106.20	$177.00	$123.90–$168.15	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM POST REDUCTION RIGHT	$106.20	$177.00	$123.90–$168.15	—	40%
Hand X-ray, 2 views both sides CPT 73120 XR HAND 2V BILATERAL	$189.00	$315.00	$61.64–$7,091.28	—	40%
Hand X-ray, 2 views both sides CPT 73120 XR HAND 2V BILATERAL POST REDUCTION	$189.00	$315.00	$61.64–$7,091.28	—	40%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2V POST REDUCTION RIGHT	$94.80	$158.00	$55.30–$3,556.90	66% below	40%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2V LEFT	$94.80	$158.00	$55.30–$3,556.90	66% below	40%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2V POST REDUCTION LEFT	$94.80	$158.00	$55.30–$3,556.90	66% below	40%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2V RIGHT	$94.80	$158.00	$55.30–$3,556.90	66% below	40%
Hand X-ray, 2 views inpatient both sides CPT 73120 XR HAND 2V BILATERAL	$189.00	$315.00	$220.50–$299.25	—	40%
Hand X-ray, 2 views inpatient both sides CPT 73120 XR HAND 2V BILATERAL POST REDUCTION	$189.00	$315.00	$220.50–$299.25	—	40%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2V POST REDUCTION RIGHT	$94.80	$158.00	$110.60–$150.10	—	40%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2V RIGHT	$94.80	$158.00	$110.60–$150.10	—	40%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2V POST REDUCTION LEFT	$94.80	$158.00	$110.60–$150.10	—	40%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2V LEFT	$94.80	$158.00	$110.60–$150.10	—	40%
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 XR CALCANEUS BILATERAL	$201.00	$335.00	$60.06–$7,541.52	—	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS RIGHT	$101.40	$169.00	$59.15–$3,804.53	62% below	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS LEFT	$101.40	$169.00	$59.15–$3,804.53	62% below	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 XR CALCANEUS BILATERAL	$201.00	$335.00	$234.50–$318.25	—	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEUS LEFT	$101.40	$169.00	$118.30–$160.55	—	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEUS RIGHT	$101.40	$169.00	$118.30–$160.55	—	40%
Knee X-ray, complete, 4 or more views both sides CPT 73564 XR KNEE 4V BILATERAL	$278.40	$464.00	$82.10–$10,445.57	—	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4V LEFT	$141.00	$235.00	$82.10–$5,290.32	68% below	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4V RIGHT	$141.00	$235.00	$82.10–$5,290.32	68% below	40%
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 XR KNEE 4V BILATERAL	$278.40	$464.00	$324.80–$440.80	—	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE 4V RIGHT	$141.00	$235.00	$164.50–$223.25	—	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE 4V LEFT	$141.00	$235.00	$164.50–$223.25	—	40%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY WO	$833.40	$1,389.00	$356.11–$31,269.17	21% below	40%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY WO	$833.40	$1,389.00	$972.30–$1,319.55	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$301.80	$503.00	$68.75–$11,323.54	50% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIMITED ABDOMEN	$301.80	$503.00	$68.75–$11,323.54	50% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$301.80	$503.00	$352.10–$477.85	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIMITED ABDOMEN	$301.80	$503.00	$352.10–$477.85	—	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US NONVASCULAR EXTREMITY LIMITED	$180.00	$300.00	$38.15–$6,753.60	54% below	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US NONVASCULAR EXTREMITY LIMITED	$180.00	$300.00	$210.00–$285.00	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE LUNG SCREEN	$118.20	$197.00	$68.95–$4,434.86	70% below	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LOW DOSE LUNG SCREEN	$118.20	$197.00	$137.90–$187.15	—	40%
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 XR TIB FIB BILATERAL	$227.40	$379.00	$64.96–$8,532.05	—	40%
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 XR TIB FIB BILATERAL POST REDUCTION	$227.40	$379.00	$64.96–$8,532.05	—	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIB FIB LEFT	$114.60	$191.00	$64.96–$4,299.79	66% below	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIB FIB POST REDUCTION LEFT	$114.60	$191.00	$64.96–$4,299.79	66% below	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIB FIB RIGHT	$114.60	$191.00	$64.96–$4,299.79	66% below	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIB FIB POST REDUCTION RIGHT	$114.60	$191.00	$64.96–$4,299.79	66% below	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 XR TIB FIB BILATERAL POST REDUCTION	$227.40	$379.00	$265.30–$360.05	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 XR TIB FIB BILATERAL	$227.40	$379.00	$265.30–$360.05	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIB FIB RIGHT	$114.60	$191.00	$133.70–$181.45	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIB FIB POST REDUCTION LEFT	$114.60	$191.00	$133.70–$181.45	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIB FIB POST REDUCTION RIGHT	$114.60	$191.00	$133.70–$181.45	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIB FIB LEFT	$114.60	$191.00	$133.70–$181.45	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIO HEAD WO	$2,307.00	$3,845.00	$355.52–$86,558.64	28% above	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR ANGIO HEAD WO	$2,307.00	$3,845.00	$2,691.50–$3,652.75	—	40%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MR BREAST W/WO BILATERAL	$1,314.00	$2,190.00	$343.23–$49,301.28	—	40%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MR BREAST W/WO BILATERAL	$1,314.00	$2,190.00	$1,533.00–$2,080.50	—	40%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MR LOWER EXTREMITY JOINT WO BILATERAL	$4,363.20	$7,272.00	$598.97–$163,707.26	—	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR LOWER EXTREMITY JOINT WO RIGHT	$2,181.60	$3,636.00	$598.97–$81,853.63	7% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR LOWER EXTREMITY JOINT WO LEFT	$2,181.60	$3,636.00	$598.97–$81,853.63	7% above	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MR LOWER EXTREMITY JOINT WO BILATERAL	$4,363.20	$7,272.00	$5,090.40–$6,908.40	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR LOWER EXTREMITY JOINT WO RIGHT	$2,181.60	$3,636.00	$2,545.20–$3,454.20	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR LOWER EXTREMITY JOINT WO LEFT	$2,181.60	$3,636.00	$2,545.20–$3,454.20	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MR LOWER EXTREMITY JOINT W/WO BILATERAL	$8,550.60	$14,251.00	$1,240.25–$320,818.51	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR LOWER EXTREMITY JOINT W/WO RIGHT	$4,275.60	$7,126.00	$1,240.25–$160,420.51	21% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR LOWER EXTREMITY JOINT W/WO LEFT	$4,275.60	$7,126.00	$1,240.25–$160,420.51	21% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MR LOWER EXTREMITY JOINT W/WO BILATERAL	$8,550.60	$14,251.00	$9,975.70–$13,538.45	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR LOWER EXTREMITY JOINT W/WO LEFT	$4,275.60	$7,126.00	$4,988.20–$6,769.70	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR LOWER EXTREMITY JOINT W/WO RIGHT	$4,275.60	$7,126.00	$4,988.20–$6,769.70	—	40%
MRI of the abdomen without contrast CPT 74181 MR ABDOMEN WO	$2,128.20	$3,547.00	$369.83–$79,850.06	8% above	40%
MRI of the abdomen without contrast inpatient CPT 74181 MR ABDOMEN WO	$2,128.20	$3,547.00	$2,482.90–$3,369.65	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABDOMEN W/WO	$4,350.60	$7,251.00	$634.56–$163,234.51	23% above	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABDOMEN W/WO	$4,350.60	$7,251.00	$5,075.70–$6,888.45	—	40%
MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO	$2,244.60	$3,741.00	$371.37–$84,217.39	23% above	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN WO	$2,244.60	$3,741.00	$2,618.70–$3,553.95	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN W/WO	$2,954.40	$4,924.00	$372.90–$110,849.09	2% above	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN W/WO	$2,954.40	$4,924.00	$3,446.80–$4,677.80	—	40%
MRI of the lower back, no contrast dye CPT 72148 MR LUMBAR WO	$2,338.80	$3,898.00	$281.76–$87,751.78	31% above	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR LUMBAR WO	$2,338.80	$3,898.00	$2,728.60–$3,703.10	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MR LUMBAR W/WO	$4,383.00	$7,305.00	$372.90–$164,450.16	34% above	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR LUMBAR W/WO	$4,383.00	$7,305.00	$5,113.50–$6,939.75	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR THORACIC WO	$2,338.80	$3,898.00	$287.49–$87,751.78	13% above	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR THORACIC WO	$2,338.80	$3,898.00	$2,728.60–$3,703.10	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR CERVICAL W/WO	$4,383.00	$7,305.00	$372.90–$164,450.16	50% above	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR CERVICAL W/WO	$4,383.00	$7,305.00	$5,113.50–$6,939.75	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR CERVICAL WO	$2,157.60	$3,596.00	$372.90–$80,953.15	23% above	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR CERVICAL WO	$2,157.60	$3,596.00	$2,517.20–$3,416.20	—	40%
MRI of the pelvis without and with contrast CPT 72197 MR PELVIS W/WO	$4,349.40	$7,249.00	$634.56–$163,189.49	23% above	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR PELVIS W/WO	$4,349.40	$7,249.00	$5,074.30–$6,886.55	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS WO	$2,212.80	$3,688.00	$361.54–$83,024.26	13% above	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR PELVIS WO	$2,212.80	$3,688.00	$2,581.60–$3,503.60	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MR UPPER EXTREMITY JOINT WO BILATERAL	$4,336.80	$7,228.00	$598.97–$162,716.74	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UPPER EXTREMITY JOINT WO LEFT	$2,168.40	$3,614.00	$598.97–$81,358.37	2% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UPPER EXTREMITY JOINT WO RIGHT	$2,168.40	$3,614.00	$598.97–$81,358.37	2% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MR UPPER EXTREMITY JOINT WO BILATERAL	$4,336.80	$7,228.00	$5,059.60–$6,866.60	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UPPER EXTREMITY JOINT WO RIGHT	$2,168.40	$3,614.00	$2,529.80–$3,433.30	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UPPER EXTREMITY JOINT WO LEFT	$2,168.40	$3,614.00	$2,529.80–$3,433.30	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR CERVICAL COMPLETE	$185.40	$309.00	$44.68–$6,956.21	58% below	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR CERVICAL COMPLETE	$185.40	$309.00	$216.30–$293.55	—	40%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W	$976.80	$1,628.00	$151.25–$36,649.54	28% below	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W	$976.80	$1,628.00	$1,139.60–$1,546.60	—	40%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO	$802.20	$1,337.00	$144.65–$30,098.54	26% below	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO	$802.20	$1,337.00	$935.90–$1,270.15	—	40%
Neck soft tissue X-ray CPT 70360 XR SOFT TISSUE NECK	$92.40	$154.00	$19.25–$3,466.85	67% below	40%
Neck soft tissue X-ray inpatient CPT 70360 XR SOFT TISSUE NECK	$92.40	$154.00	$107.80–$146.30	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARDIO SPECT MULTIPLE	$1,626.00	$2,710.00	$374.88–$61,007.52	59% below	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARDIO SPECT MULTIPLE	$1,626.00	$2,710.00	$1,897.00–$2,574.50	—	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 NM PET LOCAL MULTIPLE	$5,818.20	$9,697.00	$1,437.96–$218,298.86	20% below	40%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 NM PET LOCAL MULTIPLE	$5,818.20	$9,697.00	$6,787.90–$9,212.15	—	40%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO	$939.00	$1,565.00	$123.75–$35,231.28	14% below	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO	$939.00	$1,565.00	$1,095.50–$1,486.75	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED	$348.60	$581.00	$35.20–$13,079.47	22% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 LIMITED PELVIC	$348.60	$581.00	$35.20–$13,079.47	22% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 LIMITED PELVIC	$348.60	$581.00	$406.70–$551.95	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED	$348.60	$581.00	$406.70–$551.95	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC	$353.40	$589.00	$84.15–$13,259.57	39% below	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC	$353.40	$589.00	$412.30–$559.55	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB >14WEEKS SINGLE FETUS	$491.40	$819.00	$85.25–$18,437.33	20% below	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB >14WEEKS SINGLE FETUS	$491.40	$819.00	$573.30–$778.05	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB <14 WEEKS SINGLE FETUS	$403.80	$673.00	$92.50–$15,150.58	28% below	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB <14 WEEKS SINGLE FETUS	$403.80	$673.00	$471.10–$639.35	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED SINGLE OR MULTIPLE	$278.40	$464.00	$70.40–$10,445.57	48% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 FETAL LIMITED	$348.60	$581.00	$70.40–$13,079.47	35% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED SINGLE OR MULTIPLE	$278.40	$464.00	$324.80–$440.80	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 FETAL LIMITED	$348.60	$581.00	$406.70–$551.95	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS WO CHEST LEFT	$124.20	$207.00	$29.15–$4,659.98	63% below	40%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS WO CHEST RIGHT	$124.20	$207.00	$29.15–$4,659.98	63% below	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS WO CHEST RIGHT	$124.20	$207.00	$144.90–$196.65	—	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS WO CHEST LEFT	$124.20	$207.00	$144.90–$196.65	—	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W CHEST RIGHT	$143.40	$239.00	$29.15–$5,380.37	65% below	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W CHEST LEFT	$143.40	$239.00	$29.15–$5,380.37	65% below	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W CHEST RIGHT	$143.40	$239.00	$167.30–$227.05	—	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W CHEST LEFT	$143.40	$239.00	$167.30–$227.05	—	40%
Screening mammogram, both breasts CPT 77067 MA MAMMO SPECIAL	$56.40	$94.00	$32.90–$2,116.13	78% below	40%
Screening mammogram, both breasts CPT 77067 MA MAMMO DIGITAL SCREEN	$174.60	$291.00	$101.85–$6,550.99	32% below	40%
Screening mammogram, both breasts inpatient CPT 77067 MA MAMMO SPECIAL	$56.40	$94.00	$65.80–$89.30	—	40%
Screening mammogram, both breasts inpatient CPT 77067 MA MAMMO DIGITAL SCREEN	$174.60	$291.00	$203.70–$276.45	—	40%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR SHOULDER BILATERAL	$307.20	$512.00	$70.75–$11,526.14	—	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER LEFT	$154.20	$257.00	$70.75–$5,785.58	54% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER POST REDUCTION LEFT	$154.20	$257.00	$70.75–$5,785.58	54% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER RIGHT	$154.20	$257.00	$70.75–$5,785.58	54% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER POST REDUCTION RIGHT	$154.20	$257.00	$70.75–$5,785.58	54% below	40%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR SHOULDER BILATERAL	$307.20	$512.00	$358.40–$486.40	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER POST REDUCTION LEFT	$154.20	$257.00	$179.90–$244.15	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER RIGHT	$154.20	$257.00	$179.90–$244.15	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER LEFT	$154.20	$257.00	$179.90–$244.15	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER POST REDUCTION RIGHT	$154.20	$257.00	$179.90–$244.15	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES 3V	$156.60	$261.00	$37.27–$5,875.63	63% below	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES 3V	$156.60	$261.00	$182.70–$247.95	—	40%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL 2V	$138.00	$230.00	$34.97–$5,177.76	61% below	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL 2V	$138.00	$230.00	$161.00–$218.50	—	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO WITH EXERCISE	$2,037.00	$3,395.00	$204.09–$76,428.24	12% above	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO WITHOUT EXERCISE	$2,037.00	$3,395.00	$204.09–$76,428.24	12% above	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS ECHO WITH EXERCISE	$2,037.00	$3,395.00	$2,376.50–$3,225.25	—	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS ECHO WITHOUT EXERCISE	$2,037.00	$3,395.00	$2,376.50–$3,225.25	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWALLOWING FUNC W/ CINE	$222.60	$371.00	$50.60–$8,351.95	62% below	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR SWALLOWING FUNC W/ CINE	$222.60	$371.00	$259.70–$352.45	—	40%
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 XR FEMUR BILATERAL	$253.80	$423.00	$41.19–$9,522.58	—	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR RIGHT	$128.40	$214.00	$41.19–$4,817.57	68% below	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR LEFT	$128.40	$214.00	$41.19–$4,817.57	68% below	40%
Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 XR FEMUR BILATERAL	$253.80	$423.00	$296.10–$401.85	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR RIGHT	$128.40	$214.00	$149.80–$203.30	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR LEFT	$128.40	$214.00	$149.80–$203.30	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC WO	$1,167.00	$1,945.00	$155.20–$43,785.84	at median	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC WO	$1,167.00	$1,945.00	$1,361.50–$1,847.75	—	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 5TH LEFT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 4TH LEFT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 5TH POST REDUCTION LEFT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 3RD RIGHT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 3RD POST REDUCTION RIGHT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 5TH RIGHT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 3RD POST REDUCTION LEFT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 1ST LEFT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 3RD LEFT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 2ND RIGHT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 2ND POST REDUCTION RIGHT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 1ST RIGHT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 4TH RIGHT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 4TH POST REDUCTION LEFT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 4TH POST REDUCTION RIGHT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 2ND POST REDUCTION LEFT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 1ST POST REDUCTION LEFT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 2ND LEFT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 1ST POST REDUCTION RIGHT	$86.40	$144.00	$50.40–$3,241.73	69% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 5TH POST REDUCTION RIGHT	$382.20	$637.00	$51.81–$14,340.14	36% above	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 4TH LEFT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 5TH RIGHT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 5TH POST REDUCTION LEFT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 5TH LEFT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 4TH RIGHT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 4TH POST REDUCTION RIGHT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 4TH POST REDUCTION LEFT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 3RD RIGHT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 3RD POST REDUCTION RIGHT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 3RD POST REDUCTION LEFT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 3RD LEFT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 2ND RIGHT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 2ND POST REDUCTION RIGHT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 2ND POST REDUCTION LEFT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 2ND LEFT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 1ST RIGHT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 1ST POST REDUCTION RIGHT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 1ST POST REDUCTION LEFT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 1ST LEFT	$86.40	$144.00	$100.80–$136.80	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 5TH POST REDUCTION RIGHT	$382.20	$637.00	$445.90–$605.15	—	40%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$337.20	$562.00	$84.15–$12,651.74	40% below	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$337.20	$562.00	$393.40–$533.90	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL	$328.80	$548.00	$96.35–$12,336.58	41% below	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL	$328.80	$548.00	$383.60–$520.60	—	40%
Ultrasound of the abdomen, complete CPT 76700 TF US COMPLETE	$478.20	$797.00	$104.80–$17,942.06	39% below	40%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN	$528.00	$880.00	$104.80–$19,810.56	33% below	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 TF US COMPLETE	$478.20	$797.00	$557.90–$757.15	—	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN	$528.00	$880.00	$616.00–$836.00	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$339.00	$565.00	$81.40–$12,719.28	45% below	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$339.00	$565.00	$395.50–$536.75	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK	$308.40	$514.00	$83.98–$11,571.17	46% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD/NECK	$308.40	$514.00	$359.80–$488.30	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL UGI SINGLE CONTRAST	$349.20	$582.00	$71.50–$13,101.98	44% below	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL UGI SINGLE CONTRAST	$349.20	$582.00	$407.40–$552.90	—	40%
Upper arm X-ray (humerus), 2 views both sides CPT 73060 XR HUMERUS BILATERAL	$217.80	$363.00	$69.84–$8,171.86	—	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS RIGHT	$108.00	$180.00	$63.00–$4,052.16	61% below	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS LEFT	$108.00	$180.00	$63.00–$4,052.16	61% below	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS POST REDUCTION LEFT	$108.00	$180.00	$63.00–$4,052.16	61% below	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS POST REDUCTION RIGHT	$108.00	$180.00	$63.00–$4,052.16	61% below	40%
Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 XR HUMERUS BILATERAL	$217.80	$363.00	$254.10–$344.85	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS POST REDUCTION RIGHT	$108.00	$180.00	$126.00–$171.00	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS LEFT	$108.00	$180.00	$126.00–$171.00	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS RIGHT	$108.00	$180.00	$126.00–$171.00	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS POST REDUCTION LEFT	$108.00	$180.00	$126.00–$171.00	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS LEFT	$277.80	$463.00	$109.78–$10,423.06	57% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS RIGHT	$277.80	$463.00	$109.78–$10,423.06	57% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS RIGHT	$277.80	$463.00	$324.10–$439.85	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS LEFT	$277.80	$463.00	$324.10–$439.85	—	40%
Wrist X-ray, 2 views both sides CPT 73100 XR WRIST 2V BILATERAL POST REDUCTION	$189.00	$315.00	$61.64–$7,091.28	—	40%
Wrist X-ray, 2 views both sides CPT 73100 XR WRIST 2V BILATERAL	$189.00	$315.00	$61.64–$7,091.28	—	40%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2V RIGHT	$94.80	$158.00	$55.30–$3,556.90	65% below	40%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2V LEFT	$94.80	$158.00	$55.30–$3,556.90	65% below	40%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2V POST REDUCTION LEFT	$94.80	$158.00	$55.30–$3,556.90	65% below	40%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2V POST REDUCTION RIGHT	$94.80	$158.00	$55.30–$3,556.90	65% below	40%
Wrist X-ray, 2 views inpatient both sides CPT 73100 XR WRIST 2V BILATERAL POST REDUCTION	$189.00	$315.00	$220.50–$299.25	—	40%
Wrist X-ray, 2 views inpatient both sides CPT 73100 XR WRIST 2V BILATERAL	$189.00	$315.00	$220.50–$299.25	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2V POST REDUCTION LEFT	$94.80	$158.00	$110.60–$150.10	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2V LEFT	$94.80	$158.00	$110.60–$150.10	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2V POST REDUCTION RIGHT	$94.80	$158.00	$110.60–$150.10	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2V RIGHT	$94.80	$158.00	$110.60–$150.10	—	40%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR WRIST 3V BILATERAL	$307.20	$512.00	$68.14–$11,526.14	—	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3V LEFT	$154.20	$257.00	$68.14–$5,785.58	52% below	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3V RIGHT	$154.20	$257.00	$68.14–$5,785.58	52% below	40%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR WRIST 3V BILATERAL	$307.20	$512.00	$358.40–$486.40	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3V LEFT	$154.20	$257.00	$179.90–$244.15	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3V RIGHT	$154.20	$257.00	$179.90–$244.15	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP 2V LEFT	$124.20	$207.00	$52.44–$4,659.98	65% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP 2V RIGHT	$124.20	$207.00	$52.44–$4,659.98	65% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP IN OR LEFT	$256.20	$427.00	$52.44–$9,612.62	28% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP IN OR RIGHT	$256.20	$427.00	$52.44–$9,612.62	28% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP 2V RIGHT	$124.20	$207.00	$144.90–$196.65	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP 2V LEFT	$124.20	$207.00	$144.90–$196.65	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP IN OR LEFT	$256.20	$427.00	$298.90–$405.65	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP IN OR RIGHT	$256.20	$427.00	$298.90–$405.65	—	40%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1V	$290.40	$484.00	$23.25–$10,895.81	4% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1V	$290.40	$484.00	$338.80–$459.80	—	40%
X-ray of the ankle, 2 views both sides CPT 73600 XR ANKLE 2V BILATERAL POST REDUCTION	$201.00	$335.00	$61.64–$7,541.52	—	40%
X-ray of the ankle, 2 views both sides CPT 73600 XR ANKLE 2V BILATERAL	$201.00	$335.00	$61.64–$7,541.52	—	40%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2V RIGHT	$101.40	$169.00	$59.15–$3,804.53	70% below	40%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2V LEFT	$101.40	$169.00	$59.15–$3,804.53	70% below	40%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2V POST REDUCTION LEFT	$101.40	$169.00	$59.15–$3,804.53	70% below	40%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2V POST REDUCTION RIGHT	$101.40	$169.00	$59.15–$3,804.53	70% below	40%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR ANKLE 2V BILATERAL	$201.00	$335.00	$234.50–$318.25	—	40%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR ANKLE 2V BILATERAL POST REDUCTION	$201.00	$335.00	$234.50–$318.25	—	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2V POST REDUCTION LEFT	$101.40	$169.00	$118.30–$160.55	—	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2V RIGHT	$101.40	$169.00	$118.30–$160.55	—	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2V POST REDUCTION RIGHT	$101.40	$169.00	$118.30–$160.55	—	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2V LEFT	$101.40	$169.00	$118.30–$160.55	—	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 3RD POST REDUCTION RIGHT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR THUMB RIGHT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR THUMB POST REDUCTION RIGHT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR THUMB POST REDUCTION LEFT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR THUMB LEFT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 5TH RIGHT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 5TH POST REDUCTION RIGHT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 5TH POST REDUCTION LEFT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 5TH LEFT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 4TH RIGHT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 4TH POST REDUCTION RIGHT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 4TH POST REDUCTION LEFT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 4TH LEFT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 3RD RIGHT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 3RD POST REDUCTION LEFT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 3RD LEFT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 2ND RIGHT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 2ND POST REDUCTION RIGHT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 2ND POST REDUCTION LEFT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 2ND LEFT	$118.80	$198.00	$51.81–$4,457.38	51% below	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 5TH RIGHT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 2ND POST REDUCTION LEFT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 5TH LEFT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 4TH POST REDUCTION RIGHT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR THUMB RIGHT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 4TH LEFT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 2ND LEFT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 3RD POST REDUCTION LEFT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR THUMB POST REDUCTION RIGHT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 4TH POST REDUCTION LEFT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR THUMB POST REDUCTION LEFT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 3RD LEFT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR THUMB LEFT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 5TH POST REDUCTION RIGHT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 2ND RIGHT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 2ND POST REDUCTION RIGHT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 3RD POST REDUCTION RIGHT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 3RD RIGHT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 5TH POST REDUCTION LEFT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 4TH RIGHT	$118.80	$198.00	$138.60–$188.10	—	40%
X-ray of the foot, 2 views both sides CPT 73620 XR FOOT 2V BILATERAL	$201.00	$335.00	$61.64–$7,541.52	—	40%
X-ray of the foot, 2 views both sides CPT 73620 XR FOOT 2V BILATERAL POST REDUCTION	$201.00	$335.00	$61.64–$7,541.52	—	40%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2V LEFT	$101.40	$169.00	$59.15–$3,804.53	69% below	40%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2V POST REDUCTION LEFT	$101.40	$169.00	$59.15–$3,804.53	69% below	40%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2V POST REDUCTION RIGHT	$101.40	$169.00	$59.15–$3,804.53	69% below	40%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2V RIGHT	$101.40	$169.00	$59.15–$3,804.53	69% below	40%
X-ray of the foot, 2 views inpatient both sides CPT 73620 XR FOOT 2V BILATERAL	$201.00	$335.00	$234.50–$318.25	—	40%
X-ray of the foot, 2 views inpatient both sides CPT 73620 XR FOOT 2V BILATERAL POST REDUCTION	$201.00	$335.00	$234.50–$318.25	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2V LEFT	$101.40	$169.00	$118.30–$160.55	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2V POST REDUCTION RIGHT	$101.40	$169.00	$118.30–$160.55	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2V POST REDUCTION LEFT	$101.40	$169.00	$118.30–$160.55	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2V RIGHT	$101.40	$169.00	$118.30–$160.55	—	40%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR FOOT 3V BILATERAL	$355.20	$592.00	$68.14–$13,327.10	—	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3V RIGHT	$178.80	$298.00	$68.14–$6,708.58	51% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3V LEFT	$178.80	$298.00	$68.14–$6,708.58	51% below	40%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR FOOT 3V BILATERAL	$355.20	$592.00	$414.40–$562.40	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3V RIGHT	$178.80	$298.00	$208.60–$283.10	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3V LEFT	$178.80	$298.00	$208.60–$283.10	—	40%
X-ray of the hand, 3 or more views both sides CPT 73130 XR HAND 3V BILATERAL	$307.20	$512.00	$68.14–$11,526.14	—	40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3V RIGHT	$154.20	$257.00	$68.14–$5,785.58	48% below	40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3V LEFT	$154.20	$257.00	$68.14–$5,785.58	48% below	40%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR HAND 3V BILATERAL	$307.20	$512.00	$358.40–$486.40	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3V RIGHT	$154.20	$257.00	$179.90–$244.15	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3V LEFT	$154.20	$257.00	$179.90–$244.15	—	40%
X-ray of the knee, 1 or 2 views both sides CPT 73560 XR KNEE 2V BILATERAL	$227.40	$379.00	$64.96–$8,532.05	—	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 2V / PATELLA RIGHT	$114.60	$191.00	$64.96–$4,299.79	59% below	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 2V / PATELLA LEFT	$114.60	$191.00	$64.96–$4,299.79	59% below	40%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR KNEE 2V BILATERAL	$227.40	$379.00	$265.30–$360.05	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 2V / PATELLA RIGHT	$114.60	$191.00	$133.70–$181.45	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 2V / PATELLA LEFT	$114.60	$191.00	$133.70–$181.45	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR AP/LAT	$138.00	$230.00	$35.78–$5,177.76	62% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR AP/LAT	$138.00	$230.00	$161.00–$218.50	—	40%
X-ray of the lower back, 4 or more views CPT 72110 XR LUMBAR COMPLETE	$293.40	$489.00	$40.28–$11,008.37	35% below	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LUMBAR COMPLETE	$293.40	$489.00	$342.30–$464.55	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR THORACIC AP / LAT	$134.40	$224.00	$34.03–$5,042.69	63% below	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR THORACIC AP / LAT	$134.40	$224.00	$156.80–$212.80	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES	$107.40	$179.00	$20.90–$4,029.65	60% below	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES	$107.40	$179.00	$125.30–$170.05	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR CERVICAL AP / LAT	$126.60	$211.00	$29.15–$4,750.03	62% below	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR CERVICAL AP / LAT	$126.60	$211.00	$147.70–$200.45	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS	$143.40	$239.00	$19.25–$5,380.37	51% below	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS	$143.40	$239.00	$167.30–$227.05	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX	$112.80	$188.00	$26.99–$4,232.26	66% below	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX	$112.80	$188.00	$131.60–$178.60	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
ACTH blood test CPT 82024 ACTH PLASMA	$209.40	$349.00	$38.17–$7,856.69	6% below	40%
ACTH blood test inpatient CPT 82024 ACTH PLASMA	$209.40	$349.00	$244.30–$331.55	—	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$46.20	$77.00	$5.24–$1,733.42	27% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$46.20	$77.00	$53.90–$73.15	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$46.20	$77.00	$5.12–$1,733.42	28% above	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$46.20	$77.00	$53.90–$73.15	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITUS PROFILE ABC	$257.40	$429.00	$47.07–$9,657.65	17% below	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PROFILE	$264.00	$440.00	$47.07–$9,905.28	15% below	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITUS PROFILE ABC	$257.40	$429.00	$300.30–$407.55	—	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PROFILE	$264.00	$440.00	$308.00–$418.00	—	40%
Albumin blood test CPT 82040 ALBUMIN	$54.60	$91.00	$4.01–$2,048.59	71% above	40%
Albumin blood test inpatient CPT 82040 ALBUMIN	$54.60	$91.00	$63.70–$86.45	—	40%
Aldosterone blood test CPT 82088 ALDOSTERONE SUPINE	$220.20	$367.00	$28.60–$8,261.90	6% above	40%
Aldosterone blood test CPT 82088 ALDOSTERONE RECUMB	$220.20	$367.00	$28.60–$8,261.90	6% above	40%
Aldosterone blood test CPT 82088 ALDOSTERONE SERUM	$220.20	$367.00	$28.60–$8,261.90	6% above	40%
Aldosterone blood test CPT 82088 ALDOSTERONE URINE	$220.20	$367.00	$28.60–$8,261.90	6% above	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE URINE	$220.20	$367.00	$256.90–$348.65	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE SUPINE	$220.20	$367.00	$256.90–$348.65	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE SERUM	$220.20	$367.00	$256.90–$348.65	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE RECUMB	$220.20	$367.00	$256.90–$348.65	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$46.20	$77.00	$5.12–$1,733.42	27% above	40%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE SENDOUT	$46.20	$77.00	$5.12–$1,733.42	27% above	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE SENDOUT	$46.20	$77.00	$53.90–$73.15	—	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$46.20	$77.00	$53.90–$73.15	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN TUMOR	$91.20	$152.00	$16.57–$3,421.82	17% below	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP MATERNAL SERUM	$91.20	$152.00	$16.57–$3,421.82	17% below	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN TUMOR	$91.20	$152.00	$106.40–$144.40	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP MATERNAL SERUM	$91.20	$152.00	$106.40–$144.40	—	40%
Ammonia blood test CPT 82140 STONE RISK DIAGNOSTIC PROFILE	$53.40	$89.00	$5.50–$2,003.57	41% below	40%
Ammonia blood test CPT 82140 AMMONIA FREQ	$79.20	$132.00	$5.50–$2,971.58	13% below	40%
Ammonia blood test CPT 82140 AMMONIA	$79.20	$132.00	$5.50–$2,971.58	13% below	40%
Ammonia blood test inpatient CPT 82140 STONE RISK DIAGNOSTIC PROFILE	$53.40	$89.00	$62.30–$84.55	—	40%
Ammonia blood test inpatient CPT 82140 AMMONIA FREQ	$79.20	$132.00	$92.40–$125.40	—	40%
Ammonia blood test inpatient CPT 82140 AMMONIA	$79.20	$132.00	$92.40–$125.40	—	40%
Amylase blood test CPT 82150 AMYLASE SERUM	$46.20	$77.00	$5.50–$1,733.42	6% above	40%
Amylase blood test CPT 82150 AMYLASE 24 HOUR	$170.40	$284.00	$5.50–$6,393.41	290% above	40%
Amylase blood test CPT 82150 AMYLASE FLUID	$170.40	$284.00	$5.50–$6,393.41	290% above	40%
Amylase blood test inpatient CPT 82150 AMYLASE SERUM	$46.20	$77.00	$53.90–$73.15	—	40%
Amylase blood test inpatient CPT 82150 AMYLASE FLUID	$170.40	$284.00	$198.80–$269.80	—	40%
Amylase blood test inpatient CPT 82150 AMYLASE 24 HOUR	$170.40	$284.00	$198.80–$269.80	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE AB (IGG)	$244.80	$408.00	$12.80–$9,184.90	187% above	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE AB (IGG)	$244.80	$408.00	$285.60–$387.60	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 LE CELL PREP	$66.00	$110.00	$11.95–$2,476.32	11% below	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN	$66.00	$110.00	$11.95–$2,476.32	11% below	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CENTROMERE B AB	$66.00	$110.00	$11.95–$2,476.32	11% below	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN	$66.00	$110.00	$77.00–$104.50	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CENTROMERE B AB	$66.00	$110.00	$77.00–$104.50	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 LE CELL PREP	$66.00	$110.00	$77.00–$104.50	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PROBNP	$62.40	$104.00	$36.40–$2,341.25	69% below	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP FREQ	$254.40	$424.00	$38.79–$9,545.09	28% above	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$254.40	$424.00	$38.79–$9,545.09	28% above	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ISTAT BNP	$254.40	$424.00	$38.79–$9,545.09	28% above	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PROBNP	$62.40	$104.00	$72.80–$98.80	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP FREQ	$254.40	$424.00	$296.80–$402.80	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$254.40	$424.00	$296.80–$402.80	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ISTAT BNP	$254.40	$424.00	$296.80–$402.80	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SPUTUM CULTURE/STAIN	$47.40	$79.00	$7.59–$1,778.45	9% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 WOUND C & S /STAIN	$47.40	$79.00	$7.59–$1,778.45	9% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 THROAT CULTURE	$47.40	$79.00	$7.59–$1,778.45	9% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 MRSA CULTURE	$90.60	$151.00	$7.59–$3,399.31	74% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CERVICAL CULTURE	$94.20	$157.00	$7.59–$3,534.38	80% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BODY FLUID CULTURE	$94.20	$157.00	$7.59–$3,534.38	80% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CATH TIP CDS	$94.20	$157.00	$7.59–$3,534.38	80% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CSF CULTURE	$94.20	$157.00	$7.59–$3,534.38	80% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ROUTINE	$94.20	$157.00	$7.59–$3,534.38	80% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WITH SMEAR	$94.20	$157.00	$7.59–$3,534.38	80% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 EYE CULTURE	$94.20	$157.00	$7.59–$3,534.38	80% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GENITAL CULTURE	$94.20	$157.00	$7.59–$3,534.38	80% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 PLEURAL FLUID CULTURE	$94.20	$157.00	$7.59–$3,534.38	80% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SPUTUM CULTURE	$94.20	$157.00	$7.59–$3,534.38	80% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SURGICAL CULTURE	$94.20	$157.00	$7.59–$3,534.38	80% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SPUTUM CULTURE/STAIN	$47.40	$79.00	$55.30–$75.05	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 THROAT CULTURE	$47.40	$79.00	$55.30–$75.05	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 WOUND C & S /STAIN	$47.40	$79.00	$55.30–$75.05	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 MRSA CULTURE	$90.60	$151.00	$105.70–$143.45	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BODY FLUID CULTURE	$94.20	$157.00	$109.90–$149.15	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CATH TIP CDS	$94.20	$157.00	$109.90–$149.15	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CERVICAL CULTURE	$94.20	$157.00	$109.90–$149.15	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 EYE CULTURE	$94.20	$157.00	$109.90–$149.15	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SURGICAL CULTURE	$94.20	$157.00	$109.90–$149.15	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SPUTUM CULTURE	$94.20	$157.00	$109.90–$149.15	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 PLEURAL FLUID CULTURE	$94.20	$157.00	$109.90–$149.15	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WITH SMEAR	$94.20	$157.00	$109.90–$149.15	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GENITAL CULTURE	$94.20	$157.00	$109.90–$149.15	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CSF CULTURE	$94.20	$157.00	$109.90–$149.15	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE ROUTINE	$94.20	$157.00	$109.90–$149.15	—	40%
Basic metabolic panel (blood test) CPT 80048 ISTAT CHEM 8 WITH HGB AND HCT	$132.00	$220.00	$8.36–$4,952.64	80% above	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$132.00	$220.00	$8.36–$4,952.64	80% above	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL FREQ	$132.00	$220.00	$8.36–$4,952.64	80% above	40%
Basic metabolic panel (blood test) inpatient CPT 80048 ISTAT CHEM 8 WITH HGB AND HCT	$132.00	$220.00	$154.00–$209.00	—	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL FREQ	$132.00	$220.00	$154.00–$209.00	—	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$132.00	$220.00	$154.00–$209.00	—	40%
Bilirubin blood test, total CPT 82247 TOTAL BILRUBIN SEND OUT	$19.20	$32.00	$4.96–$720.38	40% below	40%
Bilirubin blood test, total CPT 82247 MICRO BILIRUBIN TOTAL	$46.20	$77.00	$4.96–$1,733.42	44% above	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$46.20	$77.00	$4.96–$1,733.42	44% above	40%
Bilirubin blood test, total inpatient CPT 82247 TOTAL BILRUBIN SEND OUT	$19.20	$32.00	$22.40–$30.40	—	40%
Bilirubin blood test, total inpatient CPT 82247 MICRO BILIRUBIN TOTAL	$46.20	$77.00	$53.90–$73.15	—	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$46.20	$77.00	$53.90–$73.15	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL 4	$185.40	$309.00	$37.40–$6,956.21	5% above	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL 4	$185.40	$309.00	$216.30–$293.55	—	40%
Blood culture for bacteria CPT 87040 BLOOD CULTURE FREQ	$56.40	$94.00	$10.20–$2,116.13	33% below	40%
Blood culture for bacteria CPT 87040 BLOOD CULTURE	$56.40	$94.00	$10.20–$2,116.13	33% below	40%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE	$56.40	$94.00	$65.80–$89.30	—	40%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE FREQ	$56.40	$94.00	$65.80–$89.30	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ACL/QUEST VENIPUNCTURE	$7.80	$13.00	$3.00–$292.66	48% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$7.80	$13.00	$3.00–$292.66	48% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 LEGAL SPECIMEN COLLECTION	$18.00	$30.00	$3.00–$675.36	20% above	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$7.80	$13.00	$9.10–$12.35	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ACL/QUEST VENIPUNCTURE	$7.80	$13.00	$9.10–$12.35	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LEGAL SPECIMEN COLLECTION	$18.00	$30.00	$21.00–$28.50	—	40%
Blood glucose (sugar) test CPT 82947 UR GLUCOSE 1 HOUR	$46.20	$77.00	$3.89–$1,733.42	79% above	40%
Blood glucose (sugar) test CPT 82947 UR GLUCOSE 5 HOUR	$46.20	$77.00	$3.89–$1,733.42	79% above	40%
Blood glucose (sugar) test CPT 82947 UR GLUCOSE FASTING	$46.20	$77.00	$3.89–$1,733.42	79% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE CSF	$46.20	$77.00	$3.89–$1,733.42	79% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING SERUM	$46.20	$77.00	$3.89–$1,733.42	79% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE URINE	$46.20	$77.00	$3.89–$1,733.42	79% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE TOLERANCE TEST 1 HOUR	$46.20	$77.00	$3.89–$1,733.42	79% above	40%
Blood glucose (sugar) test CPT 82947 UR GLUCOSE 4 HOUR	$46.20	$77.00	$3.89–$1,733.42	79% above	40%
Blood glucose (sugar) test CPT 82947 UR GLUCOSE 3 HOUR	$46.20	$77.00	$3.89–$1,733.42	79% above	40%
Blood glucose (sugar) test CPT 82947 UR GLUCOSE 2 HOUR	$46.20	$77.00	$3.89–$1,733.42	79% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE SERUM	$46.20	$77.00	$3.89–$1,733.42	79% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE 2 HR POSTPRANDIAL SERUM	$60.00	$100.00	$3.89–$2,251.20	133% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE 1 HR POSTPRANDIAL SERUM	$60.00	$100.00	$3.89–$2,251.20	133% above	40%
Blood glucose (sugar) test inpatient CPT 82947 UR GLUCOSE FASTING	$46.20	$77.00	$53.90–$73.15	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE CSF	$46.20	$77.00	$53.90–$73.15	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FASTING SERUM	$46.20	$77.00	$53.90–$73.15	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE SERUM	$46.20	$77.00	$53.90–$73.15	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE TOLERANCE TEST 1 HOUR	$46.20	$77.00	$53.90–$73.15	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE URINE	$46.20	$77.00	$53.90–$73.15	—	40%
Blood glucose (sugar) test inpatient CPT 82947 UR GLUCOSE 1 HOUR	$46.20	$77.00	$53.90–$73.15	—	40%
Blood glucose (sugar) test inpatient CPT 82947 UR GLUCOSE 2 HOUR	$46.20	$77.00	$53.90–$73.15	—	40%
Blood glucose (sugar) test inpatient CPT 82947 UR GLUCOSE 3 HOUR	$46.20	$77.00	$53.90–$73.15	—	40%
Blood glucose (sugar) test inpatient CPT 82947 UR GLUCOSE 4 HOUR	$46.20	$77.00	$53.90–$73.15	—	40%
Blood glucose (sugar) test inpatient CPT 82947 UR GLUCOSE 5 HOUR	$46.20	$77.00	$53.90–$73.15	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE 2 HR POSTPRANDIAL SERUM	$60.00	$100.00	$70.00–$95.00	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE 1 HR POSTPRANDIAL SERUM	$60.00	$100.00	$70.00–$95.00	—	40%
Blood lead test CPT 83655 LEAD BLOOD	$63.60	$106.00	$11.00–$2,386.27	18% below	40%
Blood lead test CPT 83655 LEAD HAIR OR NAILS	$66.00	$110.00	$11.00–$2,476.32	15% below	40%
Blood lead test CPT 83655 LEAD (VENOUS)	$66.00	$110.00	$11.00–$2,476.32	15% below	40%
Blood lead test CPT 83655 LEAD URINE	$66.00	$110.00	$11.00–$2,476.32	15% below	40%
Blood lead test inpatient CPT 83655 LEAD BLOOD	$63.60	$106.00	$74.20–$100.70	—	40%
Blood lead test inpatient CPT 83655 LEAD (VENOUS)	$66.00	$110.00	$77.00–$104.50	—	40%
Blood lead test inpatient CPT 83655 LEAD URINE	$66.00	$110.00	$77.00–$104.50	—	40%
Blood lead test inpatient CPT 83655 LEAD HAIR OR NAILS	$66.00	$110.00	$77.00–$104.50	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SERUM	$114.60	$191.00	$7.43–$4,299.79	129% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG SERUM	$114.60	$191.00	$133.70–$181.45	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$82.20	$137.00	$2.96–$3,084.14	38% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO BLOOD TYPE BLOOD	$88.80	$148.00	$2.96–$3,331.78	33% below	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$82.20	$137.00	$95.90–$130.15	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO BLOOD TYPE BLOOD	$88.80	$148.00	$103.60–$140.60	—	40%
Blood urea nitrogen (BUN) test CPT 84520 BUN	$46.20	$77.00	$3.90–$1,733.42	71% above	40%
Blood urea nitrogen (BUN) test CPT 84520 BUN/DIALYSIS FLUID	$62.40	$104.00	$3.90–$2,341.25	131% above	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$46.20	$77.00	$53.90–$73.15	—	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN/DIALYSIS FLUID	$62.40	$104.00	$72.80–$98.80	—	40%
C-peptide blood test CPT 84681 C PEPTIDE	$196.20	$327.00	$20.57–$7,361.42	81% above	40%
C-peptide blood test inpatient CPT 84681 C PEPTIDE	$196.20	$327.00	$228.90–$310.65	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN HIGH SENSITIVITY	$28.20	$47.00	$3.30–$1,058.06	21% below	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN HIGH SENSITIVITY FREQ	$28.20	$47.00	$3.30–$1,058.06	21% below	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN HIGH SENSITIVITY	$28.20	$47.00	$32.90–$44.65	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN HIGH SENSITIVITY FREQ	$28.20	$47.00	$32.90–$44.65	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICLE QL PCR	$78.60	$131.00	$36.84–$2,949.07	62% below	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICLE (TOXIN B) PCR	$129.00	$215.00	$36.84–$4,840.08	38% below	40%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFF TOXIN B QUAL PCR W/NAP1	$129.00	$215.00	$36.84–$4,840.08	38% below	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICLE QL PCR	$78.60	$131.00	$91.70–$124.45	—	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICLE (TOXIN B) PCR	$129.00	$215.00	$150.50–$204.25	—	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFF TOXIN B QUAL PCR W/NAP1	$129.00	$215.00	$150.50–$204.25	—	40%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$200.40	$334.00	$20.57–$7,519.01	51% above	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$200.40	$334.00	$233.80–$317.30	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$112.20	$187.00	$20.57–$4,209.74	14% below	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$112.20	$187.00	$130.90–$177.65	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS COV 2 (RT PCR)	$87.60	$146.00	$39.04–$3,286.75	4% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS COV 2 (RT PCR)	$87.60	$146.00	$102.20–$138.70	—	40%
Calcium blood test, total CPT 82310 CALCIUM SENDOUT	$28.20	$47.00	$5.10–$1,058.06	16% below	40%
Calcium blood test, total CPT 82310 CALCIUM (LSO)	$28.20	$47.00	$5.10–$1,058.06	16% below	40%
Calcium blood test, total CPT 82310 CALCIUM	$28.20	$47.00	$5.10–$1,058.06	16% below	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM (LSO)	$28.20	$47.00	$32.90–$44.65	—	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM SENDOUT	$28.20	$47.00	$32.90–$44.65	—	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM	$28.20	$47.00	$32.90–$44.65	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$103.20	$172.00	$18.70–$3,872.06	13% below	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$103.20	$172.00	$120.40–$163.40	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER VIRUS AB CHARGE	$32.40	$54.00	$12.73–$1,215.65	62% below	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB	$174.60	$291.00	$12.73–$6,550.99	106% above	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER VIRUS AB CHARGE	$32.40	$54.00	$37.80–$51.30	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB	$174.60	$291.00	$203.70–$276.45	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMATIS DNA SDA	$197.40	$329.00	$25.51–$7,406.45	at median	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C TRACHOMATIS DNA SDA	$197.40	$329.00	$230.30–$312.55	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 TRIGLYCERIDES SEND OUT	$94.80	$158.00	$13.24–$3,556.90	6% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$94.80	$158.00	$13.24–$3,556.90	6% above	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$94.80	$158.00	$110.60–$150.10	—	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 TRIGLYCERIDES SEND OUT	$94.80	$158.00	$110.60–$150.10	—	40%
Complete blood count (CBC) with differential CPT 85025 CBC AUTO DIFFERENTIAL CHARGE ONLY	$79.20	$132.00	$6.60–$2,971.58	55% above	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO DIFFERENTIAL CHARGE ONLY	$79.20	$132.00	$92.40–$125.40	—	40%
Complete blood count (CBC), no differential CPT 85027 KOM CBC	$15.60	$26.00	$6.39–$585.31	64% below	40%
Complete blood count (CBC), no differential CPT 85027 CBC HEMOGRAM CHARGE ONLY	$40.20	$67.00	$6.39–$1,508.30	7% below	40%
Complete blood count (CBC), no differential inpatient CPT 85027 KOM CBC	$15.60	$26.00	$18.20–$24.70	—	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC HEMOGRAM CHARGE ONLY	$40.20	$67.00	$46.90–$63.65	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL FREQ	$169.80	$283.00	$10.43–$6,370.90	92% above	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$169.80	$283.00	$10.43–$6,370.90	92% above	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL FREQ	$169.80	$283.00	$198.10–$268.85	—	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$169.80	$283.00	$198.10–$268.85	—	40%
Cortisol blood test, total CPT 82533 CORTISOL	$88.20	$147.00	$13.20–$3,309.26	14% below	40%
Cortisol blood test, total CPT 82533 CORTISOL RESPONSE	$88.20	$147.00	$13.20–$3,309.26	14% below	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL RESPONSE	$88.20	$147.00	$102.90–$139.65	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL	$88.20	$147.00	$102.90–$139.65	—	40%
Creatine kinase (CK) blood test, total CPT 82550 REF CK TOTAL	$42.60	$71.00	$6.44–$1,598.35	5% below	40%
Creatine kinase (CK) blood test, total CPT 82550 CPK FREQ	$46.20	$77.00	$6.44–$1,733.42	3% above	40%
Creatine kinase (CK) blood test, total CPT 82550 CPK	$46.20	$77.00	$6.44–$1,733.42	3% above	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 REF CK TOTAL	$42.60	$71.00	$49.70–$67.45	—	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK FREQ	$46.20	$77.00	$53.90–$73.15	—	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK	$46.20	$77.00	$53.90–$73.15	—	40%
Creatinine blood test CPT 82565 CREATININE PROFILE	$46.20	$77.00	$5.07–$1,733.42	37% above	40%
Creatinine blood test inpatient CPT 82565 CREATININE PROFILE	$46.20	$77.00	$53.90–$73.15	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB IGG	$186.00	$310.00	$14.22–$6,978.72	115% above	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB IGG	$186.00	$310.00	$217.00–$294.50	—	40%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER	$125.40	$209.00	$10.06–$4,705.01	83% above	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER	$125.40	$209.00	$146.30–$198.55	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$241.20	$402.00	$21.97–$9,049.82	80% above	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$241.20	$402.00	$281.40–$381.90	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HYPOGLYCEMIC PANEL QL SERUM/PLASMA	$17.40	$29.00	$10.15–$652.85	90% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TAPENTADOL QN URINE	$43.80	$73.00	$25.55–$1,643.38	76% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OXYCODONE QL URINE	$75.00	$125.00	$43.75–$2,814.00	59% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 NICOTINE	$75.00	$125.00	$43.75–$2,814.00	59% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN COMPREHENSIVE URINE	$75.00	$125.00	$43.75–$2,814.00	59% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COCAINE PAIN MANAGEMENT	$75.00	$125.00	$43.75–$2,814.00	59% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BUPRENORPHINE SCREEN/CONF	$75.00	$125.00	$43.75–$2,814.00	59% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN 10 PANEL	$75.60	$126.00	$44.10–$2,836.51	58% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN BY GC BLOOD	$88.80	$148.00	$51.80–$3,331.78	51% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PHENCYCLIDINE CONFIRMATION	$200.40	$334.00	$61.41–$7,519.01	10% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 FENTANYL PAIN MGMT URINE	$201.60	$336.00	$61.41–$7,564.03	11% above	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HYPOGLYCEMIC PANEL QL SERUM/PLASMA	$17.40	$29.00	$20.30–$27.55	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TAPENTADOL QN URINE	$43.80	$73.00	$51.10–$69.35	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BUPRENORPHINE SCREEN/CONF	$75.00	$125.00	$87.50–$118.75	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OXYCODONE QL URINE	$75.00	$125.00	$87.50–$118.75	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NICOTINE	$75.00	$125.00	$87.50–$118.75	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN COMPREHENSIVE URINE	$75.00	$125.00	$87.50–$118.75	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 COCAINE PAIN MANAGEMENT	$75.00	$125.00	$87.50–$118.75	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN 10 PANEL	$75.60	$126.00	$88.20–$119.70	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN BY GC BLOOD	$88.80	$148.00	$103.60–$140.60	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PHENCYCLIDINE CONFIRMATION	$200.40	$334.00	$233.80–$317.30	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FENTANYL PAIN MGMT URINE	$201.60	$336.00	$235.20–$319.20	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$109.20	$182.00	$6.92–$4,097.18	107% above	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$109.20	$182.00	$127.40–$172.90	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV CAPSID ANTIGEN IGG	$98.40	$164.00	$17.93–$3,691.97	14% below	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV CAPSID ANTIGEN IGM	$98.40	$164.00	$17.93–$3,691.97	14% below	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV CAPSID ANTIGEN IGG	$98.40	$164.00	$114.80–$155.80	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV CAPSID ANTIGEN IGM	$98.40	$164.00	$114.80–$155.80	—	40%
Estradiol blood test CPT 82670 ESTRADIOL	$151.20	$252.00	$23.65–$5,673.02	9% below	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$151.20	$252.00	$176.40–$239.40	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$100.20	$167.00	$18.37–$3,759.50	16% below	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$100.20	$167.00	$116.90–$158.65	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL	$76.80	$128.00	$19.40–$2,881.54	41% below	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN STOOL	$76.80	$128.00	$89.60–$121.60	—	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$134.40	$224.00	$13.20–$5,042.69	55% above	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$134.40	$224.00	$156.80–$212.80	—	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$174.60	$291.00	$9.61–$6,550.99	164% above	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$174.60	$291.00	$203.70–$276.45	—	40%
Folate (folic acid) blood test CPT 82746 FOLATE	$79.20	$132.00	$13.20–$2,971.58	9% below	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$79.20	$132.00	$92.40–$125.40	—	40%
Free T3 thyroid hormone test CPT 84481 FREE T3	$91.80	$153.00	$16.74–$3,444.34	14% below	40%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$91.80	$153.00	$107.10–$145.35	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 FREQ	$45.60	$76.00	$8.80–$1,710.91	24% below	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 DIALYZABLE	$49.20	$82.00	$8.80–$1,845.98	18% below	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$49.20	$82.00	$8.80–$1,845.98	18% below	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 FREQ	$45.60	$76.00	$53.20–$72.20	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 DIALYZABLE	$49.20	$82.00	$57.40–$77.90	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4	$49.20	$82.00	$57.40–$77.90	—	40%
Free testosterone test CPT 84402 ..ZZ TEST IMMUNOFIXATION SERUM	$127.80	$213.00	$25.17–$4,795.06	20% below	40%
Free testosterone test CPT 84402 ..ZZ TEST CEA	$127.80	$213.00	$25.17–$4,795.06	20% below	40%
Free testosterone test CPT 84402 ..ZZ TEST CALCIUM	$127.80	$213.00	$25.17–$4,795.06	20% below	40%
Free testosterone test CPT 84402 ..ZZ TEST LYME DISEASE AB W/REFL	$127.80	$213.00	$25.17–$4,795.06	20% below	40%
Free testosterone test CPT 84402 ..ZZ TEST ANA SCREEN W/ REFL	$127.80	$213.00	$25.17–$4,795.06	20% below	40%
Free testosterone test CPT 84402 ..ZZ TEST PROTEIN TOTAL	$127.80	$213.00	$25.17–$4,795.06	20% below	40%
Free testosterone test CPT 84402 ..ZZ TEST AEROBIC BACTERIUM	$127.80	$213.00	$25.17–$4,795.06	20% below	40%
Free testosterone test CPT 84402 ..ZZ TEST RHEUMATOID FACTOR	$127.80	$213.00	$25.17–$4,795.06	20% below	40%
Free testosterone test CPT 84402 ..ZZ TEST T4 TOTAL	$127.80	$213.00	$25.17–$4,795.06	20% below	40%
Free testosterone test CPT 84402 ..ZZ TEST T4, TOTAL	$127.80	$213.00	$25.17–$4,795.06	20% below	40%
Free testosterone test CPT 84402 ..ZZ TEST CULTURE BLOOD	$127.80	$213.00	$25.17–$4,795.06	20% below	40%
Free testosterone test CPT 84402 ..ZZ TEST TSH	$127.80	$213.00	$25.17–$4,795.06	20% below	40%
Free testosterone test CPT 84402 TESTOSTERONE FREE/TOTAL	$138.00	$230.00	$25.17–$5,177.76	14% below	40%
Free testosterone test inpatient CPT 84402 ..ZZ TEST CULTURE BLOOD	$127.80	$213.00	$149.10–$202.35	—	40%
Free testosterone test inpatient CPT 84402 ..ZZ TEST AEROBIC BACTERIUM	$127.80	$213.00	$149.10–$202.35	—	40%
Free testosterone test inpatient CPT 84402 ..ZZ TEST ANA SCREEN W/ REFL	$127.80	$213.00	$149.10–$202.35	—	40%
Free testosterone test inpatient CPT 84402 ..ZZ TEST CALCIUM	$127.80	$213.00	$149.10–$202.35	—	40%
Free testosterone test inpatient CPT 84402 ..ZZ TEST CEA	$127.80	$213.00	$149.10–$202.35	—	40%
Free testosterone test inpatient CPT 84402 ..ZZ TEST IMMUNOFIXATION SERUM	$127.80	$213.00	$149.10–$202.35	—	40%
Free testosterone test inpatient CPT 84402 ..ZZ TEST LYME DISEASE AB W/REFL	$127.80	$213.00	$149.10–$202.35	—	40%
Free testosterone test inpatient CPT 84402 ..ZZ TEST PROTEIN TOTAL	$127.80	$213.00	$149.10–$202.35	—	40%
Free testosterone test inpatient CPT 84402 ..ZZ TEST RHEUMATOID FACTOR	$127.80	$213.00	$149.10–$202.35	—	40%
Free testosterone test inpatient CPT 84402 ..ZZ TEST T4 TOTAL	$127.80	$213.00	$149.10–$202.35	—	40%
Free testosterone test inpatient CPT 84402 ..ZZ TEST T4, TOTAL	$127.80	$213.00	$149.10–$202.35	—	40%
Free testosterone test inpatient CPT 84402 ..ZZ TEST TSH	$127.80	$213.00	$149.10–$202.35	—	40%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE/TOTAL	$138.00	$230.00	$161.00–$218.50	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGTP	$46.20	$77.00	$7.12–$1,733.42	3% below	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGTP	$46.20	$77.00	$53.90–$73.15	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUC 1 HR CHALLENGE	$87.60	$146.00	$4.70–$3,286.75	136% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUC 1 HR CHALLENGE	$87.60	$146.00	$102.20–$138.70	—	40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 2 HOUR	$205.20	$342.00	$12.72–$7,699.10	153% above	40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 3 HOUR	$205.20	$342.00	$12.72–$7,699.10	153% above	40%
Glucose tolerance test, 3 samples CPT 82951 GLUC TOLERANCE FIRST 3 SPECS	$205.20	$342.00	$12.72–$7,699.10	153% above	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 2 HOUR	$205.20	$342.00	$239.40–$324.90	—	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUC TOLERANCE FIRST 3 SPECS	$205.20	$342.00	$239.40–$324.90	—	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 3 HOUR	$205.20	$342.00	$239.40–$324.90	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHLAMYDIA/GC DNA SDA PAP	$159.00	$265.00	$25.51–$5,965.68	14% below	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC URINE	$191.40	$319.00	$25.51–$7,181.33	4% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CHLAMYDIA/GC DNA SDA PAP	$159.00	$265.00	$185.50–$251.75	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC URINE	$191.40	$319.00	$223.30–$303.05	—	40%
H. pylori antibody blood test CPT 86677 H. PYLORI AB(IGG IGA IGM)	$66.60	$111.00	$16.65–$2,498.83	42% below	40%
H. pylori antibody blood test CPT 86677 H.PYLORI ANTIBODY	$78.60	$131.00	$16.65–$2,949.07	32% below	40%
H. pylori antibody blood test inpatient CPT 86677 H. PYLORI AB(IGG IGA IGM)	$66.60	$111.00	$58.90–$105.45	—	40%
H. pylori antibody blood test inpatient CPT 86677 H.PYLORI ANTIBODY	$78.60	$131.00	$91.70–$124.45	—	40%
H. pylori stool antigen test CPT 87338 H.PYLORI STOOL	$235.80	$393.00	$14.22–$8,847.22	145% above	40%
H. pylori stool antigen test inpatient CPT 87338 H.PYLORI STOOL	$235.80	$393.00	$275.10–$373.35	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA QN	$538.80	$898.00	$84.10–$20,215.78	9% above	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 RNA QN	$538.80	$898.00	$628.60–$853.10	—	40%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1/2 AB EIA SCR W/REFL	$178.20	$297.00	$13.54–$6,686.06	73% above	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1/2 AB EIA SCR W/REFL	$178.20	$297.00	$207.90–$282.15	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 AG/AB,4 WIRFL	$10.80	$18.00	$6.30–$405.22	92% below	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 AG/AB,4 WIRFL	$10.80	$18.00	$12.60–$17.10	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 SUREPATH AND HPV	$142.20	$237.00	$34.68–$5,335.34	32% below	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA HIGHRISK	$152.40	$254.00	$34.68–$5,718.05	27% below	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 SUREPATH AND HPV	$142.20	$237.00	$165.90–$225.15	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA HIGHRISK	$152.40	$254.00	$177.80–$241.30	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C WHOLE BLOOD	$128.40	$214.00	$7.70–$4,817.57	152% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C WHOLE BLOOD	$128.40	$214.00	$149.80–$203.30	—	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$31.20	$52.00	$2.35–$1,170.62	82% above	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN SENDOUT	$31.20	$52.00	$2.35–$1,170.62	82% above	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$31.20	$52.00	$36.40–$49.40	—	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN SENDOUT	$31.20	$52.00	$36.40–$49.40	—	40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB TOTAL FREQ	$138.60	$231.00	$11.91–$5,200.27	64% above	40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB TOTAL	$150.00	$250.00	$11.91–$5,628.00	78% above	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB TOTAL FREQ	$138.60	$231.00	$161.70–$219.45	—	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB TOTAL	$150.00	$250.00	$175.00–$237.50	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY	$58.20	$97.00	$10.62–$2,183.66	20% below	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY	$58.20	$97.00	$67.90–$92.15	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$56.40	$94.00	$10.21–$2,116.13	19% below	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$56.40	$94.00	$65.80–$89.30	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY SCREEN	$72.00	$120.00	$14.10–$2,701.44	28% below	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB SCREEN	$78.00	$130.00	$14.10–$2,926.56	22% below	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY SCREEN	$72.00	$120.00	$84.00–$114.00	—	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB SCREEN	$78.00	$130.00	$91.00–$123.50	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QUANTITATIVE REAL TIME PCR	$231.60	$386.00	$42.34–$8,689.63	19% below	40%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV QN RT PCR	$231.60	$386.00	$42.34–$8,689.63	19% below	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QUANTITATIVE REAL TIME PCR	$231.60	$386.00	$270.20–$366.70	—	40%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV QN RT PCR	$231.60	$386.00	$270.20–$366.70	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMP TYPE 1	$165.00	$275.00	$13.03–$6,190.80	106% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES AB IGG PAIRED	$165.00	$275.00	$13.03–$6,190.80	106% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMP TYPE 1	$165.00	$275.00	$192.50–$261.25	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES AB IGG PAIRED	$165.00	$275.00	$192.50–$261.25	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES S II ABS	$165.00	$275.00	$19.13–$6,190.80	54% above	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES S II ABS	$165.00	$275.00	$192.50–$261.25	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 HS CRP	$64.80	$108.00	$11.58–$2,431.30	18% below	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HS CRP	$64.80	$108.00	$75.60–$102.60	—	40%
Homocysteine blood test CPT 83090 HOMOCYSTINE	$91.20	$152.00	$17.71–$3,421.82	24% below	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE	$91.20	$152.00	$106.40–$144.40	—	40%
Insulin blood test CPT 83525 INSULIN SERUM	$62.40	$104.00	$11.30–$2,341.25	14% below	40%
Insulin blood test inpatient CPT 83525 INSULIN SERUM	$62.40	$104.00	$72.80–$98.80	—	40%
Iron blood test (serum iron) CPT 83540 IRON	$46.20	$77.00	$6.39–$1,733.42	1% above	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$46.20	$77.00	$53.90–$73.15	—	40%
Iron-binding capacity (TIBC) test CPT 83550 TIBC	$46.20	$77.00	$5.50–$1,733.42	23% below	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC	$46.20	$77.00	$53.90–$73.15	—	40%
Kidney function blood test panel CPT 80069 RENAL PROFILE	$222.60	$371.00	$8.58–$8,351.95	225% above	40%
Kidney function blood test panel inpatient CPT 80069 RENAL PROFILE	$222.60	$371.00	$259.70–$352.45	—	40%
LH (luteinizing hormone) test CPT 83002 LH	$100.20	$167.00	$18.31–$3,759.50	16% below	40%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$100.20	$167.00	$116.90–$158.65	—	40%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID FREQ	$58.20	$97.00	$8.80–$2,183.66	24% below	40%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$58.20	$97.00	$8.80–$2,183.66	24% below	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID FREQ	$58.20	$97.00	$67.90–$92.15	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$58.20	$97.00	$67.90–$92.15	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$87.00	$145.00	$5.98–$3,264.24	137% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH FLUID	$87.00	$145.00	$5.98–$3,264.24	137% above	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$87.00	$145.00	$101.50–$137.75	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH FLUID	$87.00	$145.00	$101.50–$137.75	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$37.20	$62.00	$5.50–$1,395.74	21% below	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$37.20	$62.00	$43.40–$58.90	—	40%
Liver function blood test panel CPT 80076 LIVER PROFILE FREQ	$121.20	$202.00	$8.08–$4,547.42	55% above	40%
Liver function blood test panel CPT 80076 LIVER PROFILE	$121.20	$202.00	$8.08–$4,547.42	55% above	40%
Liver function blood test panel inpatient CPT 80076 LIVER PROFILE FREQ	$121.20	$202.00	$141.40–$191.90	—	40%
Liver function blood test panel inpatient CPT 80076 LIVER PROFILE	$121.20	$202.00	$141.40–$191.90	—	40%
Lyme disease antibody test CPT 86618 LYME DISEASE EIA W/REFL	$85.20	$142.00	$16.83–$3,196.70	10% below	40%
Lyme disease antibody test CPT 86618 LYME DISEASE AB PANEL	$92.40	$154.00	$16.83–$3,466.85	3% below	40%
Lyme disease antibody test CPT 86618 B BURGDORFERI EARLY	$92.40	$154.00	$16.83–$3,466.85	3% below	40%
Lyme disease antibody test CPT 86618 LYME DISEASE AB IGG	$92.40	$154.00	$16.83–$3,466.85	3% below	40%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE EIA W/REFL	$85.20	$142.00	$99.40–$134.90	—	40%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB PANEL	$92.40	$154.00	$107.80–$146.30	—	40%
Lyme disease antibody test inpatient CPT 86618 B BURGDORFERI EARLY	$92.40	$154.00	$107.80–$146.30	—	40%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB IGG	$92.40	$154.00	$107.80–$146.30	—	40%
Magnesium blood test CPT 83735 MAGNESIUM 24 HOUR URINE	$22.20	$37.00	$6.62–$832.94	47% below	40%
Magnesium blood test CPT 83735 MAGNESIUM FREQ	$46.20	$77.00	$6.62–$1,733.42	11% above	40%
Magnesium blood test CPT 83735 MAGNESIUM	$46.20	$77.00	$6.62–$1,733.42	11% above	40%
Magnesium blood test CPT 83735 MAGNESIUM RBC	$115.80	$193.00	$6.62–$4,344.82	178% above	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM 24 HOUR URINE	$22.20	$37.00	$25.90–$35.15	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$46.20	$77.00	$53.90–$73.15	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM FREQ	$46.20	$77.00	$53.90–$73.15	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC	$115.80	$193.00	$135.10–$183.35	—	40%
Measles (rubeola) antibody test CPT 86765 MEASLES ANTIBODY (IGG)	$161.40	$269.00	$12.73–$6,055.73	100% above	40%
Measles (rubeola) antibody test CPT 86765 KOH RUBEOLA AB IGG	$161.40	$269.00	$12.73–$6,055.73	100% above	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM	$161.40	$269.00	$12.73–$6,055.73	100% above	40%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES ANTIBODY (IGG)	$161.40	$269.00	$188.30–$255.55	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 KOH RUBEOLA AB IGG	$161.40	$269.00	$188.30–$255.55	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGM	$161.40	$269.00	$188.30–$255.55	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$108.00	$180.00	$5.12–$4,052.16	190% above	40%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHITE ABSORPTION	$108.00	$180.00	$5.12–$4,052.16	190% above	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$108.00	$180.00	$126.00–$171.00	—	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHITE ABSORPTION	$108.00	$180.00	$126.00–$171.00	—	40%
Mumps immunity blood test CPT 86735 RUBEL RUBEOLA MUMPS	$125.40	$209.00	$12.90–$4,705.01	54% above	40%
Mumps immunity blood test CPT 86735 KOH MUMPS ABS IGG	$163.20	$272.00	$12.90–$6,123.26	101% above	40%
Mumps immunity blood test CPT 86735 MUMPS ABS IGG	$163.20	$272.00	$12.90–$6,123.26	101% above	40%
Mumps immunity blood test inpatient CPT 86735 RUBEL RUBEOLA MUMPS	$125.40	$209.00	$146.30–$198.55	—	40%
Mumps immunity blood test inpatient CPT 86735 KOH MUMPS ABS IGG	$163.20	$272.00	$190.40–$258.40	—	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS ABS IGG	$163.20	$272.00	$190.40–$258.40	—	40%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$366.60	$611.00	$13.20–$13,754.83	18% above	40%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$366.60	$611.00	$427.70–$580.45	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA	$191.40	$319.00	$18.17–$7,181.33	68% above	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA	$191.40	$319.00	$223.30–$303.05	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$70.20	$117.00	$18.17–$2,633.90	36% below	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$70.20	$117.00	$81.90–$111.15	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 SUREPATH PAP SCREEN	$124.20	$207.00	$26.30–$4,659.98	52% above	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SUREPATH PAP SCREEN	$124.20	$207.00	$144.90–$196.65	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER	$101.40	$169.00	$17.60–$3,804.53	66% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THINPREP	$124.20	$207.00	$17.60–$4,659.98	103% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THINPREPW/RFL HPV	$124.20	$207.00	$17.60–$4,659.98	103% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH C/V THIN LAYER	$101.40	$169.00	$118.30–$160.55	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THINPREPW/RFL HPV	$124.20	$207.00	$144.90–$196.65	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THINPREP	$124.20	$207.00	$144.90–$196.65	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 PTH N TERMINAL	$224.40	$374.00	$40.80–$8,419.49	3% above	40%
Parathyroid hormone (PTH) blood test CPT 83970 PTH C TERMINAL	$224.40	$374.00	$40.80–$8,419.49	3% above	40%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$224.40	$374.00	$40.80–$8,419.49	3% above	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH C TERMINAL	$224.40	$374.00	$261.80–$355.30	—	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH N TERMINAL	$224.40	$374.00	$261.80–$355.30	—	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$224.40	$374.00	$261.80–$355.30	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT PARTIAL THOMBOPLASTI	$40.80	$68.00	$5.94–$1,530.82	1% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT/PTT FREQ	$40.80	$68.00	$5.94–$1,530.82	1% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$40.80	$68.00	$5.94–$1,530.82	1% below	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT PARTIAL THOMBOPLASTI	$40.80	$68.00	$47.60–$64.60	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$40.80	$68.00	$47.60–$64.60	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT/PTT FREQ	$40.80	$68.00	$47.60–$64.60	—	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS FREQ	$46.20	$77.00	$4.69–$1,733.42	42% above	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$46.20	$77.00	$4.69–$1,733.42	42% above	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHATE	$80.40	$134.00	$4.69–$3,016.61	147% above	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS	$46.20	$77.00	$53.90–$73.15	—	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS FREQ	$46.20	$77.00	$53.90–$73.15	—	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHATE	$80.40	$134.00	$93.80–$127.30	—	40%
Potassium blood test CPT 84132 POTASSIUM SERUM	$46.20	$77.00	$4.70–$1,733.42	45% above	40%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$46.20	$77.00	$53.90–$73.15	—	40%
Progesterone blood test CPT 84144 PROGESTERONE	$112.80	$188.00	$18.70–$4,232.26	18% below	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$112.80	$188.00	$131.60–$178.60	—	40%
Prolactin blood test CPT 84146 PROLACTIN	$105.60	$176.00	$19.15–$3,962.11	15% below	40%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$105.60	$176.00	$123.20–$167.20	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR PLASMA FREQ	$40.80	$68.00	$4.24–$1,530.82	43% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR PLASMA	$40.80	$68.00	$4.24–$1,530.82	43% above	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR PLASMA	$40.80	$68.00	$47.60–$64.60	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR PLASMA FREQ	$40.80	$68.00	$47.60–$64.60	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP	$60.60	$101.00	$6.93–$2,273.71	4% below	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP	$60.60	$101.00	$70.70–$95.95	—	40%
Renin blood test CPT 84244 RENIN PLASMA	$238.80	$398.00	$13.20–$8,959.78	65% above	40%
Renin blood test inpatient CPT 84244 RENIN PLASMA	$238.80	$398.00	$278.60–$378.10	—	40%
Rh blood typing CPT 86901 BLOOD TYPING RH	$74.40	$124.00	$2.96–$2,791.49	31% above	40%
Rh blood typing CPT 86901 RH TYPE	$80.40	$134.00	$2.96–$3,016.61	41% above	40%
Rh blood typing inpatient CPT 86901 BLOOD TYPING RH	$74.40	$124.00	$86.80–$117.80	—	40%
Rh blood typing inpatient CPT 86901 RH TYPE	$80.40	$134.00	$93.80–$127.30	—	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID TITER	$31.20	$52.00	$5.61–$1,170.62	20% below	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID TITER	$31.20	$52.00	$36.40–$49.40	—	40%
Rubella antibody test (immunity check) CPT 86762 KOH RUBELLA IGG	$51.60	$86.00	$14.22–$1,936.03	39% below	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGM	$134.40	$224.00	$14.22–$5,042.69	59% above	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IMMUNE STATUS	$134.40	$224.00	$14.22–$5,042.69	59% above	40%
Rubella antibody test (immunity check) inpatient CPT 86762 KOH RUBELLA IGG	$51.60	$86.00	$60.20–$81.70	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IMMUNE STATUS	$134.40	$224.00	$156.80–$212.80	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGM	$134.40	$224.00	$156.80–$212.80	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE / WESTEGREN	$15.00	$25.00	$2.67–$562.80	31% below	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE / WESTEGREN	$15.00	$25.00	$17.50–$23.75	—	40%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN SCREEN	$241.20	$402.00	$12.17–$9,049.82	172% above	40%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN SCREEN	$241.20	$402.00	$281.40–$381.90	—	40%
Sodium blood test CPT 84295 SODIUM	$55.80	$93.00	$4.76–$2,093.62	72% above	40%
Sodium blood test inpatient CPT 84295 SODIUM	$55.80	$93.00	$65.10–$88.35	—	40%
Stool ova and parasites exam CPT 87177 OVA & PARASITE RL	$48.60	$81.00	$8.25–$1,823.47	17% below	40%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITE RL	$48.60	$81.00	$56.70–$76.95	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREEN	$30.00	$50.00	$3.34–$1,125.60	47% above	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREEN	$30.00	$50.00	$35.00–$47.50	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD STOOL	$58.20	$97.00	$3.08–$2,183.66	62% above	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD STOOL	$58.20	$97.00	$67.90–$92.15	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA ABS	$145.20	$242.00	$13.08–$5,447.90	94% above	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA ABS	$145.20	$242.00	$169.40–$229.90	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL/SERUM	$23.40	$39.00	$4.22–$877.97	17% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR W/REFLEX TITER	$23.40	$39.00	$4.22–$877.97	17% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL (CSF ONLY)	$23.40	$39.00	$4.22–$877.97	17% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL (CSF ONLY)	$23.40	$39.00	$27.30–$37.05	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL/SERUM	$23.40	$39.00	$27.30–$37.05	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR W/REFLEX TITER	$23.40	$39.00	$27.30–$37.05	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$263.40	$439.00	$61.26–$9,882.77	15% below	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD	$263.40	$439.00	$307.30–$417.05	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$139.80	$233.00	$25.52–$5,245.30	14% below	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$139.80	$233.00	$163.10–$221.35	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI THYROID MICROS ANT	$153.00	$255.00	$8.70–$5,740.56	103% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOME AB	$159.00	$265.00	$8.70–$5,965.68	111% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY	$159.00	$265.00	$8.70–$5,965.68	111% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODIES (TPO)	$159.00	$265.00	$8.70–$5,965.68	111% above	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI THYROID MICROS ANT	$153.00	$255.00	$178.50–$242.25	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOME AB	$159.00	$265.00	$185.50–$251.75	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ANTIBODIES (TPO)	$159.00	$265.00	$185.50–$251.75	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY	$159.00	$265.00	$185.50–$251.75	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE SERUM FREQ	$99.60	$166.00	$16.60–$3,736.99	1% below	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE SERUM	$108.00	$180.00	$16.60–$4,052.16	8% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE SERUM FREQ	$99.60	$166.00	$116.20–$157.70	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE SERUM	$108.00	$180.00	$126.00–$171.00	—	40%
Total IgE blood test CPT 82785 RESP ALLERGY PROFILE	$180.60	$301.00	$16.27–$6,776.11	74% above	40%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E	$180.60	$301.00	$16.27–$6,776.11	74% above	40%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E	$180.60	$301.00	$210.70–$285.95	—	40%
Total IgE blood test inpatient CPT 82785 RESP ALLERGY PROFILE	$180.60	$301.00	$210.70–$285.95	—	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL	$66.00	$110.00	$4.30–$2,476.32	118% above	40%
Total cholesterol blood test CPT 82465 TOTAL CHOLESTEROL	$71.40	$119.00	$4.30–$2,678.93	136% above	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL	$66.00	$110.00	$77.00–$104.50	—	40%
Total cholesterol blood test inpatient CPT 82465 TOTAL CHOLESTEROL	$71.40	$119.00	$83.30–$113.05	—	40%
Total thyroxine (T4) blood test CPT 84436 T4 RIAA	$37.20	$62.00	$6.79–$1,395.74	18% below	40%
Total thyroxine (T4) blood test CPT 84436 TOTAL T4	$37.20	$62.00	$6.79–$1,395.74	18% below	40%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 RIAA	$37.20	$62.00	$43.40–$58.90	—	40%
Total thyroxine (T4) blood test inpatient CPT 84436 TOTAL T4	$37.20	$62.00	$43.40–$58.90	—	40%
Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3	$77.40	$129.00	$8.80–$2,904.05	20% below	40%
Total triiodothyronine (T3) blood test CPT 84480 T3 RIA	$77.40	$129.00	$8.80–$2,904.05	20% below	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 RIA	$77.40	$129.00	$90.30–$122.55	—	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3	$77.40	$129.00	$90.30–$122.55	—	40%
Transferrin blood test CPT 84466 TRANSFERRIN SATURATION	$141.00	$235.00	$12.62–$5,290.32	64% above	40%
Transferrin blood test CPT 84466 TRANSFERRIN SERUM	$141.00	$235.00	$12.62–$5,290.32	64% above	40%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN SERUM	$141.00	$235.00	$164.50–$223.25	—	40%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN SATURATION	$141.00	$235.00	$164.50–$223.25	—	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDE	$31.20	$52.00	$5.68–$1,170.62	21% below	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDE SEND OUT	$31.20	$52.00	$5.68–$1,170.62	21% below	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE SEND OUT	$31.20	$52.00	$36.40–$49.40	—	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE	$31.20	$52.00	$36.40–$49.40	—	40%
Troponin test, quantitative CPT 84484 TROPONIN I SERUM	$47.40	$79.00	$10.86–$1,778.45	42% below	40%
Troponin test, quantitative CPT 84484 ISTAT TROPONIN I	$47.40	$79.00	$10.86–$1,778.45	42% below	40%
Troponin test, quantitative CPT 84484 TROPONIN I SERUM FREQ	$47.40	$79.00	$10.86–$1,778.45	42% below	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I SERUM	$47.40	$79.00	$55.30–$75.05	—	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I SERUM FREQ	$47.40	$79.00	$55.30–$75.05	—	40%
Troponin test, quantitative inpatient CPT 84484 ISTAT TROPONIN I	$47.40	$79.00	$55.30–$75.05	—	40%
Uric acid blood test CPT 84550 URIC ACID FREQ	$46.20	$77.00	$4.47–$1,733.42	46% above	40%
Uric acid blood test CPT 84550 URIC ACID	$46.20	$77.00	$4.47–$1,733.42	46% above	40%
Uric acid blood test inpatient CPT 84550 URIC ACID	$46.20	$77.00	$53.90–$73.15	—	40%
Uric acid blood test inpatient CPT 84550 URIC ACID FREQ	$46.20	$77.00	$53.90–$73.15	—	40%
Urinalysis with microscope exam, automated CPT 81001 URINE WITH MICROSCOPIC	$51.60	$86.00	$3.13–$1,936.03	57% above	40%
Urinalysis with microscope exam, automated CPT 81001 UA W/MICRO CHARGE ONLY	$100.80	$168.00	$3.13–$3,782.02	206% above	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINE WITH MICROSCOPIC	$51.60	$86.00	$60.20–$81.70	—	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA W/MICRO CHARGE ONLY	$100.80	$168.00	$117.60–$159.60	—	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIPSTICK CHARGE ONLY	$43.80	$73.00	$2.22–$1,643.38	145% above	40%
Urinalysis without microscope exam, automated CPT 81003 BILIRUBIN	$80.40	$134.00	$2.22–$3,016.61	350% above	40%
Urinalysis without microscope exam, automated CPT 81003 TOTAL PROTEIN SERUM	$80.40	$134.00	$2.22–$3,016.61	350% above	40%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE	$80.40	$134.00	$2.22–$3,016.61	350% above	40%
Urinalysis without microscope exam, automated CPT 81003 KETONES	$80.40	$134.00	$2.22–$3,016.61	350% above	40%
Urinalysis without microscope exam, automated CPT 81003 LEUKOCYTES	$80.40	$134.00	$2.22–$3,016.61	350% above	40%
Urinalysis without microscope exam, automated CPT 81003 PH	$80.40	$134.00	$2.22–$3,016.61	350% above	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS DIPSTICK CHARGE ONLY	$43.80	$73.00	$51.10–$69.35	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE	$80.40	$134.00	$93.80–$127.30	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 TOTAL PROTEIN SERUM	$80.40	$134.00	$93.80–$127.30	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 PH	$80.40	$134.00	$93.80–$127.30	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 LEUKOCYTES	$80.40	$134.00	$93.80–$127.30	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 KETONES	$80.40	$134.00	$93.80–$127.30	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 BILIRUBIN	$80.40	$134.00	$93.80–$127.30	—	40%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE FREQ	$60.00	$100.00	$7.98–$2,251.20	6% above	40%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE	$64.80	$108.00	$7.98–$2,431.30	14% above	40%
Urine culture for bacteria, with colony count CPT 87086 URINE CATH CULTURE	$140.40	$234.00	$7.98–$5,267.81	148% above	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE FREQ	$60.00	$100.00	$70.00–$95.00	—	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE	$64.80	$108.00	$75.60–$102.60	—	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CATH CULTURE	$140.40	$234.00	$163.80–$222.30	—	40%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN CREATININE	$30.60	$51.00	$5.71–$1,148.11	23% below	40%
Urine microalbumin (albumin) test CPT 82043 24 HOUR MICROALBUMIN	$31.80	$53.00	$5.71–$1,193.14	20% below	40%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN	$31.80	$53.00	$5.71–$1,193.14	20% below	40%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN CREATININE	$30.60	$51.00	$35.70–$48.45	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN	$31.80	$53.00	$37.10–$50.35	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 24 HOUR MICROALBUMIN	$31.80	$53.00	$37.10–$50.35	—	40%
Urine pregnancy test, read by color change CPT 81025 U A PREGANCY TEST	$33.60	$56.00	$4.40–$1,260.67	9% below	40%
Urine pregnancy test, read by color change CPT 81025 HCG URINE	$146.40	$244.00	$4.40–$5,492.93	297% above	40%
Urine pregnancy test, read by color change inpatient CPT 81025 U A PREGANCY TEST	$33.60	$56.00	$39.20–$53.20	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG URINE	$146.40	$244.00	$170.80–$231.80	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 B12	$75.60	$126.00	$14.30–$2,836.51	20% below	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$82.20	$137.00	$14.30–$3,084.14	12% below	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B12	$75.60	$126.00	$88.20–$119.70	—	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$82.20	$137.00	$95.90–$130.15	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 OH	$160.20	$267.00	$29.26–$6,010.70	7% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 OH	$160.20	$267.00	$186.90–$253.65	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1 25 DI HYDROXY SEND OUT	$405.00	$675.00	$38.05–$15,195.60	69% above	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 1 25 DI HYDROXY SEND OUT	$405.00	$675.00	$472.50–$641.25	—	40%
Zinc blood test CPT 84630 ZINC	$125.40	$209.00	$11.26–$4,705.01	74% above	40%
Zinc blood test inpatient CPT 84630 ZINC	$125.40	$209.00	$146.30–$198.55	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANTITATIVE	$78.60	$131.00	$14.88–$2,949.07	12% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG TUMOR MARKER	$157.20	$262.00	$14.88–$5,898.14	75% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANTITATIVE	$78.60	$131.00	$91.70–$124.45	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG TUMOR MARKER	$157.20	$262.00	$183.40–$248.90	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion both sides CPT 19081 MA MAMMO STEREOTACTIC BX BILATERAL X 2	$1,863.60	$3,106.00	$163.13–$69,922.27	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion both sides CPT 19081 MA MAMMO STEREOTACTIC BX BILATERAL	$1,863.60	$3,106.00	$163.13–$69,922.27	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MA MAMMO STEREOTACTIC BX RIGHT X 2	$1,863.60	$3,106.00	$163.13–$69,922.27	52% below	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MA MAMMO STEREOTACTIC BX RIGHT	$1,863.60	$3,106.00	$163.13–$69,922.27	52% below	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MA MAMMO STEREOTACTIC BX LEFT X 2	$1,863.60	$3,106.00	$163.13–$69,922.27	52% below	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MA MAMMO STEREOTACTIC BX LEFT	$1,863.60	$3,106.00	$163.13–$69,922.27	52% below	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient both sides CPT 19081 MA MAMMO STEREOTACTIC BX BILATERAL X 2	$1,863.60	$3,106.00	$2,174.20–$2,950.70	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient both sides CPT 19081 MA MAMMO STEREOTACTIC BX BILATERAL	$1,863.60	$3,106.00	$2,174.20–$2,950.70	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MA MAMMO STEREOTACTIC BX LEFT	$1,863.60	$3,106.00	$2,174.20–$2,950.70	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MA MAMMO STEREOTACTIC BX RIGHT X 2	$1,863.60	$3,106.00	$2,174.20–$2,950.70	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MA MAMMO STEREOTACTIC BX RIGHT	$1,863.60	$3,106.00	$2,174.20–$2,950.70	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MA MAMMO STEREOTACTIC BX LEFT X 2	$1,863.60	$3,106.00	$2,174.20–$2,950.70	—	40%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TF CLTX DSTL FIBULAR FX LAT MALLS W/O MA	$375.60	$626.00	$130.35–$14,092.51	43% below	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TF CLTX DSTL FIBULAR FX LAT MALLS W/O MA	$375.60	$626.00	$438.20–$594.70	—	40%
Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY/TRANS/M NERVE	$1,610.40	$2,684.00	$330.00–$60,422.21	62% below	40%
Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY/TRANS/M NERVE	$1,610.40	$2,684.00	$1,878.80–$2,549.80	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TF CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O	$359.40	$599.00	$125.95–$13,484.69	46% below	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TF CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O	$359.40	$599.00	$419.30–$569.05	—	40%
Colonoscopy with polyp removal CPT 45385 COLONSCOPY/LESION REMOVE	$1,398.60	$2,331.00	$294.89–$52,475.47	45% below	40%
Colonoscopy with polyp removal inpatient CPT 45385 COLONSCOPY/LESION REMOVE	$1,398.60	$2,331.00	$1,631.70–$2,214.45	—	40%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY/BIOPSY/COLD F	$1,398.60	$2,331.00	$247.96–$52,475.47	37% below	40%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY/BIOPSY/COLD F	$1,398.60	$2,331.00	$1,631.70–$2,214.45	—	40%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY	$746.40	$1,244.00	$198.55–$28,004.93	50% below	40%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY	$746.40	$1,244.00	$870.80–$1,181.80	—	40%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 TF COLPOSCOPY W/BX	$501.00	$835.00	$116.53–$18,797.52	3% above	40%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 TF COLPOSCOPY W/BX	$501.00	$835.00	$584.50–$793.25	—	40%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOCOPY AND TREATMENT	$3,071.40	$5,119.00	$158.09–$115,238.93	36% below	40%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOCOPY AND TREATMENT	$3,071.40	$5,119.00	$3,583.30–$4,863.05	—	40%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$1,731.00	$2,885.00	$82.50–$64,947.12	3% above	40%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY	$1,731.00	$2,885.00	$2,019.50–$2,740.75	—	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 TF DES SKIN TAG LESION ONE	$157.20	$262.00	$22.00–$5,898.14	63% below	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION/B9/PREMAL1ST	$249.60	$416.00	$22.00–$9,364.99	42% below	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 TF DES SKIN TAG LESION ONE	$157.20	$262.00	$183.40–$248.90	—	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION/B9/PREMAL1ST	$249.60	$416.00	$291.20–$395.20	—	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 RMVL IMPACTED CERUMEN W/IRRIGATION UNILA	$41.40	$69.00	$16.06–$1,553.33	70% below	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 RMVL IMPACTED CERUMEN W/IRRIGATION UNILA	$41.40	$69.00	$48.30–$65.55	—	40%
Earwax removal with instruments, one ear CPT 69210 REMOVAL FB	$135.60	$226.00	$35.92–$5,087.71	1% above	40%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL FB	$135.60	$226.00	$158.20–$214.70	—	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 TF ENDOMETRIAL BX	$379.80	$633.00	$56.10–$14,250.10	4% below	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 TF ENDOMETRIAL BX	$379.80	$633.00	$443.10–$601.35	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 TF NJX DX/THER SBST INTRLMNR CRV/THRC W/	$1,044.00	$1,740.00	$98.12–$39,170.88	57% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 TF NJX DX/THER SBST INTRLMNR CRV/THRC W/	$1,044.00	$1,740.00	$1,218.00–$1,653.00	—	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 TF INJ DX/THER AGT PVRT FACET JT LUMB/SA	$843.60	$1,406.00	$239.89–$31,651.87	41% below	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 TF INJ DX/THER AGT PVRT FACET JT LUMB/SA	$843.60	$1,406.00	$984.20–$1,335.70	—	40%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAP /CHOLEY W CHOLANGIOGR	$3,965.40	$6,609.00	$1,521.52–$148,781.81	64% below	40%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAP /CHOLEY W CHOLANGIOGR	$3,965.40	$6,609.00	$4,626.30–$6,278.55	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 TF INCIS & DRAINAGE SIMPLE	$127.80	$213.00	$25.85–$4,795.06	75% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF ABSCESS	$340.80	$568.00	$25.85–$12,786.82	33% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 US CYST/ABCESS DRAINAGE 1 AREA	$356.40	$594.00	$25.85–$13,372.13	30% below	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 TF INCIS & DRAINAGE SIMPLE	$127.80	$213.00	$149.10–$202.35	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF ABSCESS	$340.80	$568.00	$397.60–$539.60	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 US CYST/ABCESS DRAINAGE 1 AREA	$356.40	$594.00	$415.80–$564.30	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 TF TRIGGER POINT INJ	$199.80	$333.00	$35.20–$7,496.50	65% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 TF TRIGGER POINT INJ	$199.80	$333.00	$233.10–$316.35	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 TF ARTHROCENTESIS	$199.20	$332.00	$25.85–$7,473.98	57% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 FL INJECTION LARGE JOINT LEFT	$418.80	$698.00	$25.85–$15,713.38	11% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 FL INJECTION LARGE JOINT RIGHT	$418.80	$698.00	$25.85–$15,713.38	11% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 TF ARTHROCENTESIS	$199.20	$332.00	$232.40–$315.40	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 FL INJECTION LARGE JOINT LEFT	$418.80	$698.00	$488.60–$663.10	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 FL INJECTION LARGE JOINT RIGHT	$418.80	$698.00	$488.60–$663.10	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 TF INJ/ASP MEDIUM JOINT	$199.20	$332.00	$23.65–$7,473.98	44% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 TF INJ/ASP MEDIUM JOINT	$199.20	$332.00	$232.40–$315.40	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 TF INJ/ASP SMALL JOINT	$199.80	$333.00	$19.80–$7,496.50	51% below	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 FL ARTHROGRAM DIGIT	$309.60	$516.00	$19.80–$11,616.19	25% below	40%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 FL INJECTION SMALL JOINT RIGHT	$418.80	$698.00	$19.80–$15,713.38	2% above	40%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 FL INJECTION SMALL JOINT LEFT	$418.80	$698.00	$19.80–$15,713.38	2% above	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 TF INJ/ASP SMALL JOINT	$199.80	$333.00	$233.10–$316.35	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 FL ARTHROGRAM DIGIT	$309.60	$516.00	$361.20–$490.20	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 FL INJECTION SMALL JOINT LEFT	$418.80	$698.00	$488.60–$663.10	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 FL INJECTION SMALL JOINT RIGHT	$418.80	$698.00	$488.60–$663.10	—	40%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 HERNIA REPAIR/RECURR INGU	$3,965.40	$6,609.00	$1,049.82–$148,781.81	62% below	40%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 HERNIA REPAIR/RECURR INGU	$3,965.40	$6,609.00	$4,626.30–$6,278.55	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LACERATION INTERMED 12031	$363.00	$605.00	$26.95–$13,619.76	38% below	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LACERATION INTERMED 12031	$363.00	$605.00	$423.50–$574.75	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 TF NJX DX/THER SBST INTRLMNR LMBR/SAC W/	$1,044.60	$1,741.00	$89.45–$39,193.39	50% below	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 TF NJX DX/THER SBST INTRLMNR LMBR/SAC W/	$1,044.60	$1,741.00	$1,218.70–$1,653.95	—	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TF INJ ANES/STEROID EPIDURL LUMB/SAC 1 L	$844.20	$1,407.00	$104.54–$31,674.38	56% below	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 TF INJ ANES/STEROID EPIDURL LUMB/SAC 1 L	$844.20	$1,407.00	$984.90–$1,336.65	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 TF EXC BEN LES TR A L .5 CM	$496.20	$827.00	$41.25–$18,617.42	63% below	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 TF EXC BEN LES TR A L .5 CM	$496.20	$827.00	$578.90–$785.65	—	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 TF EXC BN LES FAC <0.5 CM	$496.20	$827.00	$59.95–$18,617.42	72% below	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BEN LESION EXCEPT SKI	$1,045.20	$1,742.00	$59.95–$39,215.90	41% below	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 TF EXC BN LES FAC <0.5 CM	$496.20	$827.00	$578.90–$785.65	—	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BEN LESION EXCEPT SKI	$1,045.20	$1,742.00	$1,219.40–$1,654.90	—	40%
Occipital nerve block (injection for headaches) CPT 64405 TF INJ ANESTHETIC AGT GT OCCIPITAL NERV	$646.20	$1,077.00	$38.50–$24,245.42	14% above	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 TF INJ ANESTHETIC AGT GT OCCIPITAL NERV	$646.20	$1,077.00	$753.90–$1,023.15	—	40%
Paracentesis with imaging guidance CPT 49083 TF ABD PARACENTESIS WITH US GUIDANCE	$814.80	$1,358.00	$92.76–$30,571.30	52% below	40%
Paracentesis with imaging guidance CPT 49083 US PARACENTESIS	$1,070.40	$1,784.00	$92.76–$40,161.41	36% below	40%
Paracentesis with imaging guidance inpatient CPT 49083 TF ABD PARACENTESIS WITH US GUIDANCE	$814.80	$1,358.00	$950.60–$1,290.10	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 US PARACENTESIS	$1,070.40	$1,784.00	$1,248.80–$1,694.80	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION-NAIL	$658.80	$1,098.00	$354.07–$24,718.18	21% below	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION-NAIL	$658.80	$1,098.00	$768.60–$1,043.10	—	40%
Prostate biopsy CPT 55700 BIOPSY OF PROSTATE	$1,848.60	$3,081.00	$98.45–$69,359.47	52% below	40%
Prostate biopsy inpatient CPT 55700 BIOPSY OF PROSTATE	$1,848.60	$3,081.00	$2,156.70–$2,926.95	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 TF DSTR NROLYTC AGNT PARV FCT SING LUMB/	$1,947.60	$3,246.00	$618.25–$73,073.95	35% below	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 TF DSTR NROLYTC AGNT PARV FCT SING LUMB/	$1,947.60	$3,246.00	$2,272.20–$3,083.70	—	40%
Removal of a foreign object under the skin, simple CPT 10120 TF INCISION/REMOVAL/BODYSKIN	$301.80	$503.00	$33.55–$11,323.54	44% below	40%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FB	$340.80	$568.00	$33.55–$12,786.82	37% below	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 TF INCISION/REMOVAL/BODYSKIN	$301.80	$503.00	$352.10–$477.85	—	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVAL FB	$340.80	$568.00	$397.60–$539.60	—	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENT OF KIDNEY STONE	$5,029.20	$8,382.00	$274.45–$188,695.58	24% below	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 FRAGMENT OF KIDNEY STONE	$5,029.20	$8,382.00	$5,867.40–$7,962.90	—	40%
Short arm cast (elbow to hand) CPT 29075 TF CAST SHORT ARM	$216.00	$360.00	$50.05–$8,104.32	48% below	40%
Short arm cast (elbow to hand) inpatient CPT 29075 TF CAST SHORT ARM	$216.00	$360.00	$252.00–$342.00	—	40%
Short arm splint (forearm and hand) CPT 29125 TF SPLINTING SHORT ARM	$94.20	$157.00	$28.60–$3,534.38	70% below	40%
Short arm splint (forearm and hand) CPT 29125 SPLINTING	$199.80	$333.00	$28.60–$7,496.50	37% below	40%
Short arm splint (forearm and hand) inpatient CPT 29125 TF SPLINTING SHORT ARM	$94.20	$157.00	$109.90–$149.15	—	40%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINTING	$199.80	$333.00	$233.10–$316.35	—	40%
Short leg cast (below the knee) CPT 29405 CASTING	$199.80	$333.00	$55.55–$7,496.50	62% below	40%
Short leg cast (below the knee) CPT 29405 TF CAST SHORT LEG WALKING	$221.40	$369.00	$55.55–$8,306.93	57% below	40%
Short leg cast (below the knee) inpatient CPT 29405 CASTING	$199.80	$333.00	$233.10–$316.35	—	40%
Short leg cast (below the knee) inpatient CPT 29405 TF CAST SHORT LEG WALKING	$221.40	$369.00	$258.30–$350.55	—	40%
Short leg splint (calf to foot) CPT 29515 SPLINTING	$421.20	$702.00	$38.50–$15,803.42	9% below	40%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINTING	$421.20	$702.00	$491.40–$666.90	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LACERATION	$363.00	$605.00	$26.95–$13,619.76	29% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LACERATION	$363.00	$605.00	$423.50–$574.75	—	40%
Skin tag removal, up to 15 tags CPT 11200 TF EXC SKIN TAGS <15	$156.60	$261.00	$34.10–$5,875.63	74% below	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 TF EXC SKIN TAGS <15	$156.60	$261.00	$182.70–$247.95	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 TF LACERATION SIMPLE	$132.00	$220.00	$39.05–$4,952.64	75% below	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LACERATION SIMPLE	$363.00	$605.00	$39.05–$13,619.76	31% below	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 TF LACERATION SIMPLE	$132.00	$220.00	$154.00–$209.00	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LACERATION SIMPLE	$363.00	$605.00	$423.50–$574.75	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LACERATION SIMPLE	$363.00	$605.00	$34.65–$13,619.76	29% below	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LACERATION SIMPLE	$363.00	$605.00	$423.50–$574.75	—	40%
TURP (transurethral resection of the prostate) CPT 52601 PROSTATECTOMY (TURP)	$4,305.00	$7,175.00	$2,314.58–$161,523.60	55% below	40%
TURP (transurethral resection of the prostate) inpatient CPT 52601 PROSTATECTOMY (TURP)	$4,305.00	$7,175.00	$5,022.50–$6,816.25	—	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TF SKTANGENTIAL BIOPSY IN SINGLE LESION	$98.40	$164.00	$35.45–$3,691.97	83% below	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TF TANGENTIAL BIOPSY SKIN SINGLE LESION	$98.40	$164.00	$35.45–$3,691.97	83% below	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TF SKTANGENTIAL BIOPSY IN SINGLE LESION	$98.40	$164.00	$114.80–$155.80	—	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TF TANGENTIAL BIOPSY SKIN SINGLE LESION	$98.40	$164.00	$114.80–$155.80	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 TF TRIGGER POINT INJ 1/2 MUS	$200.40	$334.00	$34.17–$7,519.01	63% below	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TF TRIGGER POINT INJ 1/2 MUS	$200.40	$334.00	$233.80–$317.30	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion both sides CPT 19083 US BREAST BIOPSY BILATERAL	$1,858.80	$3,098.00	$152.78–$69,742.18	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US BREAST BIOPSY RIGHT	$929.40	$1,549.00	$152.78–$34,871.09	74% below	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US BREAST BIOPSY LEFT	$929.40	$1,549.00	$152.78–$34,871.09	74% below	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient both sides CPT 19083 US BREAST BIOPSY BILATERAL	$1,858.80	$3,098.00	$2,168.60–$2,943.10	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US BREAST BIOPSY RIGHT	$929.40	$1,549.00	$1,084.30–$1,471.55	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US BREAST BIOPSY LEFT	$929.40	$1,549.00	$1,084.30–$1,471.55	—	40%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY	$1,346.40	$2,244.00	$163.44–$50,516.93	38% below	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BIOPSY	$1,346.40	$2,244.00	$1,570.80–$2,131.80	—	40%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD	$903.00	$1,505.00	$137.74–$33,880.56	52% below	40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD	$903.00	$1,505.00	$1,053.50–$1,429.75	—	40%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTOURETERO W/ LITHTRIPS	$4,305.00	$7,175.00	$954.79–$161,523.60	57% below	40%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 CYSTOURETERO W/ LITHTRIPS	$4,305.00	$7,175.00	$5,022.50–$6,816.25	—	40%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$2,741.40	$4,569.00	$163.35–$102,857.33	28% below	40%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY	$2,741.40	$4,569.00	$3,198.30–$4,340.55	—	40%
Wart removal, up to 14 warts CPT 17110 TF DES FLAT WART < 14 LES	$127.20	$212.00	$53.90–$4,772.54	77% below	40%
Wart removal, up to 14 warts inpatient CPT 17110 TF DES FLAT WART < 14 LES	$127.20	$212.00	$148.40–$201.40	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 TF SKIN SUBS DEBRMT FULL TH	$88.80	$148.00	$36.30–$3,331.78	92% below	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 SKIN SUBQ DEBRIDM'T	$481.80	$803.00	$36.30–$18,077.14	55% below	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 TF SKIN SUBS DEBRMT FULL TH	$88.80	$148.00	$103.60–$140.60	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 SKIN SUBQ DEBRIDM'T	$481.80	$803.00	$562.10–$762.85	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BB ADMIN FEE	$790.80	$1,318.00	$30.62–$29,670.82	16% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD/COMPONENTS	$790.80	$1,318.00	$30.62–$29,670.82	16% below	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BB ADMIN FEE	$790.80	$1,318.00	$922.60–$1,252.10	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD/COMPONENTS	$790.80	$1,318.00	$922.60–$1,252.10	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT INCENTIVE SPIROMETRY INITIAL	$134.40	$224.00	$36.82–$5,042.69	40% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PASSIVE NEB TX	$154.20	$257.00	$36.82–$5,785.58	31% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT INCENTIVE SPIROMETRY SUBSEQUENT	$154.20	$257.00	$36.82–$5,785.58	31% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT PASSIVE NEB SUBSEQUENT	$154.20	$257.00	$36.82–$5,785.58	31% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT SPUTUM COLLECTION	$154.20	$257.00	$36.82–$5,785.58	31% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT INCENTIVE SPIROMETRY INITIAL	$134.40	$224.00	$156.80–$212.80	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PASSIVE NEB TX	$154.20	$257.00	$179.90–$244.15	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT INCENTIVE SPIROMETRY SUBSEQUENT	$154.20	$257.00	$179.90–$244.15	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT SPUTUM COLLECTION	$154.20	$257.00	$179.90–$244.15	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT PASSIVE NEB SUBSEQUENT	$154.20	$257.00	$179.90–$244.15	—	40%
Chemotherapy IV infusion, first hour CPT 96413 IV INF CHEMO 1ST HOUR	$576.60	$961.00	$137.28–$21,634.03	20% below	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INF CHEMO 1ST HOUR	$576.60	$961.00	$672.70–$912.95	—	40%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE/EVAL MGT	$1,635.00	$2,725.00	$166.79–$61,345.20	13% below	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE/EVAL MGT	$1,635.00	$2,725.00	$1,907.50–$2,588.75	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY	$484.80	$808.00	$24.75–$18,189.70	36% below	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY	$484.80	$808.00	$565.60–$767.60	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$102.00	$170.00	$11.51–$3,827.04	42% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$102.00	$170.00	$119.00–$161.50	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 SUTURE STAPLE REMOVAL	$55.80	$93.00	$34.41–$2,093.62	82% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY ROOM LEVEL 1	$102.60	$171.00	$48.64–$3,849.55	66% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 SUTURE STAPLE REMOVAL	$55.80	$93.00	$65.10–$88.35	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY ROOM LEVEL 1	$102.60	$171.00	$119.70–$162.45	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY ROOM LEVEL 2	$151.20	$252.00	$36.28–$5,673.02	68% below	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY ROOM LEVEL 2	$151.20	$252.00	$176.40–$239.40	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY ROOM LEVEL 3	$205.20	$342.00	$62.31–$7,699.10	72% below	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY ROOM LEVEL 3	$205.20	$342.00	$239.40–$324.90	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY ROOM LEVEL 4	$312.60	$521.00	$104.86–$11,728.75	74% below	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY ROOM LEVEL 4	$312.60	$521.00	$364.70–$494.95	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY ROOM LEVEL 5	$501.00	$835.00	$152.61–$18,797.52	69% below	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY ROOM LEVEL 5	$501.00	$835.00	$584.50–$793.25	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST PHARM	$319.20	$532.00	$51.15–$11,976.38	66% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST EXERCISE NON NUCLEAR	$747.00	$1,245.00	$51.15–$28,027.44	21% below	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST PHARM	$319.20	$532.00	$372.40–$505.40	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST EXERCISE NON NUCLEAR	$747.00	$1,245.00	$871.50–$1,182.75	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$368.40	$614.00	$34.79–$13,822.37	15% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUS/DX/THERA 1 HR	$368.40	$614.00	$34.79–$13,822.37	15% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUS/DX/THERA 1 HR	$368.40	$614.00	$429.80–$583.30	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT	$368.40	$614.00	$429.80–$583.30	—	40%
IV infusion of a medicine, first hour CPT 96365 THER PROPH DIAG IV INF INIT	$368.40	$614.00	$43.23–$13,822.37	18% below	40%
IV infusion of a medicine, first hour CPT 96365 IV ANTIBIOTICS	$368.40	$614.00	$43.23–$13,822.37	18% below	40%
IV infusion of a medicine, first hour CPT 96365 IV INF NON CHEMO 1ST HOUR	$368.40	$614.00	$43.23–$13,822.37	18% below	40%
IV infusion of a medicine, first hour inpatient CPT 96365 IV ANTIBIOTICS	$368.40	$614.00	$429.80–$583.30	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 THER PROPH DIAG IV INF INIT	$368.40	$614.00	$429.80–$583.30	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF NON CHEMO 1ST HOUR	$368.40	$614.00	$429.80–$583.30	—	40%
IV push of a medicine, first drug CPT 96374 IV PUSH NON CHEMO 1ST DRUG	$368.40	$614.00	$34.12–$13,822.37	12% above	40%
IV push of a medicine, first drug CPT 96374 THERAPEUTIC/DIAGN IV	$368.40	$614.00	$34.12–$13,822.37	12% above	40%
IV push of a medicine, first drug CPT 96374 THER PROPH DIAG INJ IV PUSH	$368.40	$614.00	$34.12–$13,822.37	12% above	40%
IV push of a medicine, first drug inpatient CPT 96374 THERAPEUTIC/DIAGN IV	$368.40	$614.00	$429.80–$583.30	—	40%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH NON CHEMO 1ST DRUG	$368.40	$614.00	$429.80–$583.30	—	40%
IV push of a medicine, first drug inpatient CPT 96374 THER PROPH DIAG INJ IV PUSH	$368.40	$614.00	$429.80–$583.30	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION: IM SQ	$112.20	$187.00	$13.97–$4,209.74	9% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER PROPH DIAG INJ SC IM	$112.20	$187.00	$13.97–$4,209.74	9% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAP/PROPHY/DIAG INJECT	$112.20	$187.00	$13.97–$4,209.74	9% below	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION: IM SQ	$112.20	$187.00	$130.90–$177.65	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAP/PROPHY/DIAG INJECT	$112.20	$187.00	$130.90–$177.65	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER PROPH DIAG INJ SC IM	$112.20	$187.00	$130.90–$177.65	—	40%
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSCULAR REEDUCATION	$49.80	$83.00	$18.43–$1,868.50	61% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 PTA BIOFEEDBACK 15 MIN	$69.60	$116.00	$18.43–$2,611.39	46% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT BIOFEEDBACK 15 MIN	$69.60	$116.00	$18.43–$2,611.39	46% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 PTA NEUROMUSCULAR RE ED	$90.60	$151.00	$18.43–$3,399.31	30% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR RE ED	$90.60	$151.00	$18.43–$3,399.31	30% below	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR REEDUCATION	$49.80	$83.00	$58.10–$78.85	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT BIOFEEDBACK 15 MIN	$69.60	$116.00	$81.20–$110.20	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PTA BIOFEEDBACK 15 MIN	$69.60	$116.00	$81.20–$110.20	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PTA NEUROMUSCULAR RE ED	$90.60	$151.00	$105.70–$143.45	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE ED	$90.60	$151.00	$105.70–$143.45	—	40%
New patient office visit, about 30 minutes CPT 99203 TF NEW PAT LEVEL 3 INTERMED	$103.20	$172.00	$57.70–$3,872.06	57% below	40%
New patient office visit, about 30 minutes CPT 99203 TF OV NEW PATIENT DETAILED	$103.20	$172.00	$57.70–$3,872.06	57% below	40%
New patient office visit, about 30 minutes inpatient CPT 99203 TF NEW PAT LEVEL 3 INTERMED	$103.20	$172.00	$120.40–$163.40	—	40%
New patient office visit, about 30 minutes inpatient CPT 99203 TF OV NEW PATIENT DETAILED	$103.20	$172.00	$120.40–$163.40	—	40%
New patient office visit, about 45 minutes CPT 99204 TF NEW PAT LEVEL 4 EXTENDED	$130.20	$217.00	$63.10–$4,885.10	57% below	40%
New patient office visit, about 45 minutes CPT 99204 TF OV NEW PATIENT COMPREHENS	$130.20	$217.00	$63.10–$4,885.10	57% below	40%
New patient office visit, about 45 minutes inpatient CPT 99204 TF OV NEW PATIENT COMPREHENS	$130.20	$217.00	$151.90–$206.15	—	40%
New patient office visit, about 45 minutes inpatient CPT 99204 TF NEW PAT LEVEL 4 EXTENDED	$130.20	$217.00	$151.90–$206.15	—	40%
New patient office visit, about 60 minutes CPT 99205 TF NEW PAT LEVEL 5 COMPREHEN	$190.20	$317.00	$63.91–$7,136.30	64% below	40%
New patient office visit, about 60 minutes CPT 99205 TF OV NEW PATIENT HIGH COMP	$190.80	$318.00	$63.91–$7,158.82	63% below	40%
New patient office visit, about 60 minutes inpatient CPT 99205 TF NEW PAT LEVEL 5 COMPREHEN	$190.20	$317.00	$221.90–$301.15	—	40%
New patient office visit, about 60 minutes inpatient CPT 99205 TF OV NEW PATIENT HIGH COMP	$190.80	$318.00	$222.60–$302.10	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 TF OV NEW PATIENT EXPANDED	$79.20	$132.00	$38.86–$2,971.58	57% below	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 TF NEW PATIENT LVL 2 LIMITED	$79.20	$132.00	$38.86–$2,971.58	57% below	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 TF OV NEW PATIENT EXPANDED	$79.20	$132.00	$92.40–$125.40	—	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 TF NEW PATIENT LVL 2 LIMITED	$79.20	$132.00	$92.40–$125.40	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INIT ASSESS EA 15 MIN	$80.40	$134.00	$19.46–$3,016.61	60% above	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INIT ASSESS EA 15 MIN	$80.40	$134.00	$93.80–$127.30	—	40%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW 30 MIN	$168.00	$280.00	$98.00–$6,303.36	50% below	40%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW 30 MIN	$168.00	$280.00	$196.00–$266.00	—	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL & TREAT HIGH 45 MIN	$174.00	$290.00	$101.50–$6,528.48	49% below	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL & TREAT HIGH 45 MIN	$174.00	$290.00	$203.00–$275.50	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL & TREAT LOW 20 MIN	$174.00	$290.00	$101.50–$6,528.48	41% below	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL & TREAT LOW 20 MIN	$174.00	$290.00	$203.00–$275.50	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL & TREAT MOD 30 MIN	$174.00	$290.00	$101.50–$6,528.48	48% below	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL & TREAT MOD 30 MIN	$174.00	$290.00	$203.00–$275.50	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY	$87.00	$145.00	$23.13–$3,264.24	34% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MYOFASCIAL REL/SOFT TISSUE	$120.00	$200.00	$23.13–$4,502.40	9% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PTA MYOFASCIAL REL/SOFT TISSUE	$120.00	$200.00	$23.13–$4,502.40	9% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PTA MANUAL	$120.00	$200.00	$23.13–$4,502.40	9% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL	$120.00	$200.00	$23.13–$4,502.40	9% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY	$87.00	$145.00	$101.50–$137.75	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PTA MYOFASCIAL REL/SOFT TISSUE	$120.00	$200.00	$140.00–$190.00	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PTA MANUAL	$120.00	$200.00	$140.00–$190.00	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MYOFASCIAL REL/SOFT TISSUE	$120.00	$200.00	$140.00–$190.00	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL	$120.00	$200.00	$140.00–$190.00	—	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISE 15 MIN	$66.00	$110.00	$9.22–$2,476.32	50% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT CONTINUOUS PASSIVE MOTION	$90.60	$151.00	$9.22–$3,399.31	31% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PTA THERAPEUTIC EXERCISES 15 MIN	$90.60	$151.00	$9.22–$3,399.31	31% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUTIC EXERCISES 15 MIN	$90.60	$151.00	$9.22–$3,399.31	31% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PTA CONTINUOUS PASSIVE MOTION	$90.60	$151.00	$9.22–$3,399.31	31% below	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE 15 MIN	$66.00	$110.00	$77.00–$104.50	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT CONTINUOUS PASSIVE MOTION	$90.60	$151.00	$105.70–$143.45	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PTA THERAPEUTIC EXERCISES 15 MIN	$90.60	$151.00	$105.70–$143.45	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PTA CONTINUOUS PASSIVE MOTION	$90.60	$151.00	$105.70–$143.45	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISES 15 MIN	$90.60	$151.00	$105.70–$143.45	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 RT SMOKING CESSATION-VISIT 10 MIN	$30.00	$50.00	$17.50–$1,125.60	34% below	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 RT TOBACCO CESSATION COUNSELING (HOSPIT	$30.00	$50.00	$17.50–$1,125.60	34% below	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TF TOBACCO CESS COUNC < 10 M	$64.80	$108.00	$19.22–$2,431.30	42% above	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 RT TOBACCO CESSATION COUNSELING (HOSPIT	$30.00	$50.00	$35.00–$47.50	—	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 RT SMOKING CESSATION-VISIT 10 MIN	$30.00	$50.00	$35.00–$47.50	—	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TF TOBACCO CESS COUNC < 10 M	$64.80	$108.00	$75.60–$102.60	—	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 TF EST PAT LEVEL 5 COMPREHEN	$130.80	$218.00	$61.03–$4,907.62	52% below	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 TF OV EST PATIENT HIGH COMP	$130.80	$218.00	$61.03–$4,907.62	52% below	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 TF OV EST PATIENT HIGH COMP	$130.80	$218.00	$152.60–$207.10	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 TF EST PAT LEVEL 5 COMPREHEN	$130.80	$218.00	$152.60–$207.10	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TF OV EST PATIENT LOW COMPLE	$79.20	$132.00	$38.50–$2,971.58	57% below	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TF EST PAT LEVEL 3 INTERMED	$79.20	$132.00	$38.50–$2,971.58	57% below	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TF EST PAT LEVEL 3 INTERMED	$79.20	$132.00	$92.40–$125.40	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TF OV EST PATIENT LOW COMPLE	$79.20	$132.00	$92.40–$125.40	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TF EST PAT LEVEL 4 EXTENDED	$103.20	$172.00	$53.09–$3,872.06	49% below	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TF OV EST PATIENT MODERATE	$103.20	$172.00	$53.09–$3,872.06	49% below	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OT FIT FOR DUTY PHYSICAL EVAL	$134.40	$224.00	$53.09–$5,042.69	33% below	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 TF EST PAT LEVEL 4 EXTENDED	$103.20	$172.00	$120.40–$163.40	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 TF OV EST PATIENT MODERATE	$103.20	$172.00	$120.40–$163.40	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OT FIT FOR DUTY PHYSICAL EVAL	$134.40	$224.00	$156.80–$212.80	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TF OV EST PATIENT STRAIGHT F	$79.20	$132.00	$28.60–$2,971.58	51% below	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TF EST PAT LEVEL 2 LIMITED	$79.20	$132.00	$28.60–$2,971.58	51% below	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 TF EST PAT LEVEL 2 LIMITED	$79.20	$132.00	$92.40–$125.40	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 TF OV EST PATIENT STRAIGHT F	$79.20	$132.00	$92.40–$125.40	—	40%
Speech and language evaluation CPT 92523 ST SOUND & LANG COMP	$425.40	$709.00	$248.15–$15,961.01	20% below	40%
Speech and language evaluation inpatient CPT 92523 ST SOUND & LANG COMP	$425.40	$709.00	$496.30–$673.55	—	40%
Speech therapy session, individual CPT 92507 ST TREAT SPEECH AUDIO ORAL	$69.60	$116.00	$23.87–$2,611.39	77% below	40%
Speech therapy session, individual inpatient CPT 92507 ST TREAT SPEECH AUDIO ORAL	$69.60	$116.00	$81.20–$110.20	—	40%
Spirometry (breathing test) CPT 94010 RT PFT SIMPLE	$131.40	$219.00	$16.50–$4,930.13	56% below	40%
Spirometry (breathing test) inpatient CPT 94010 RT PFT SIMPLE	$131.40	$219.00	$153.30–$208.05	—	40%
Spirometry before and after a bronchodilator CPT 94060 RT PFT PRE AND POST BRONCHODILATOR	$251.40	$419.00	$20.90–$9,432.53	61% below	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 RT PFT PRE AND POST BRONCHODILATOR	$251.40	$419.00	$293.30–$398.05	—	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT TREATMENT 15 MIN	$66.00	$110.00	$14.30–$2,476.32	49% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 PTA THERAPEUTIC ACTIVITY 15 MIN	$90.60	$151.00	$14.30–$3,399.31	29% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTIC ACTIVITY 15 MIN	$90.60	$151.00	$14.30–$3,399.31	29% below	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT TREATMENT 15 MIN	$66.00	$110.00	$77.00–$104.50	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PTA THERAPEUTIC ACTIVITY 15 MIN	$90.60	$151.00	$105.70–$143.45	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITY 15 MIN	$90.60	$151.00	$105.70–$143.45	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$178.20	$297.00	$11.00–$6,686.06	23% below	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY	$178.20	$297.00	$207.90–$282.15	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE (VARIVAX) 0.5ML INJ	$243.60	$406.00	$11.00–$9,139.87	18% above	40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 CL-VARICELLA VACCINE (VARIVAX) 0.5ML INJ	$243.60	$406.00	$11.00–$9,139.87	18% above	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 CL-VARICELLA VACCINE (VARIVAX) 0.5ML INJ	$243.60	$406.00	$215.42–$385.70	—	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VACCINE (VARIVAX) 0.5ML INJ	$243.60	$406.00	$215.42–$385.70	—	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 CL-DTAP-IPV (KINRIX) 0.5ML SYR AGE 4 - 6	$158.40	$264.00	$11.00–$5,943.17	91% above	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV (KINRIX) 0.5 ML SYR AGE 4 - 6	$158.40	$264.00	$11.00–$5,943.17	91% above	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP-IPV (KINRIX) 0.5 ML SYR AGE 4 - 6	$158.40	$264.00	$140.08–$250.80	—	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 CL-DTAP-IPV (KINRIX) 0.5ML SYR AGE 4 - 6	$158.40	$264.00	$140.08–$250.80	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP (INFANRIX) O.5 ML SYR 6 WEEKS-AGE 7	$75.60	$126.00	$11.00–$2,836.51	121% above	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 CL-DTAP (INFANRIX) 0.5ML SYR 6 WKS-AGE 7	$75.60	$126.00	$11.00–$2,836.51	121% above	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 CL-DTAP (INFANRIX) 0.5ML SYR 6 WKS-AGE 7	$75.60	$126.00	$66.86–$119.70	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP (INFANRIX) O.5 ML SYR 6 WEEKS-AGE 7	$75.60	$126.00	$66.86–$119.70	—	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 CL-DTAP-HEP B-IPV (PEDIARIX) 0.5 ML SYR	$412.80	$688.00	$11.00–$15,488.26	397% above	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEP B-IPV (PEDIARIX) 0.5 ML SYR	$412.80	$688.00	$11.00–$15,488.26	397% above	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTAP-HEP B-IPV (PEDIARIX) 0.5 ML SYR	$412.80	$688.00	$365.05–$653.60	—	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 CL-DTAP-HEP B-IPV (PEDIARIX) 0.5 ML SYR	$412.80	$688.00	$365.05–$653.60	—	40%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IVP-HIB (PENTACEL) 0.5 ML INJ	$282.00	$470.00	$11.00–$10,580.64	240% above	40%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 CL-DTAP-IVP-HIB (PENTACEL) 0.5 ML INJ	$282.00	$470.00	$11.00–$10,580.64	240% above	40%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTAP-IVP-HIB (PENTACEL) 0.5 ML INJ	$282.00	$470.00	$249.38–$446.50	—	40%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 CL-DTAP-IVP-HIB (PENTACEL) 0.5 ML INJ	$282.00	$470.00	$249.38–$446.50	—	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS(GARDASIL 9) VACCINE	$492.00	$820.00	$11.00–$18,459.84	94% above	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 CL-HUMAN PAPILLOMAVIRUS(GARDASIL 9) VACC	$492.00	$820.00	$11.00–$18,459.84	94% above	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS(GARDASIL 9) VACCINE	$492.00	$820.00	$435.09–$779.00	—	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 CL-HUMAN PAPILLOMAVIRUS(GARDASIL 9) VACC	$492.00	$820.00	$435.09–$779.00	—	40%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/HEB B RECOMB (TWINRIX) 1 ML SYR	$265.20	$442.00	$11.00–$9,950.30	195% above	40%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 CL-HEP A/HEB B RECOMB (TWINRIX) 1 ML SYR	$265.20	$442.00	$11.00–$9,950.30	195% above	40%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 CL-HEP A/HEB B RECOMB (TWINRIX) 1 ML SYR	$265.20	$442.00	$234.53–$419.90	—	40%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEP A/HEB B RECOMB (TWINRIX) 1 ML SYR	$265.20	$442.00	$234.53–$419.90	—	40%
Hepatitis A vaccine, adult dose CPT 90632 CL-HEP A ADULT(HAVRIX)1440 EL.U/1ML SYR	$211.80	$353.00	$11.00–$7,946.74	138% above	40%
Hepatitis A vaccine, adult dose CPT 90632 HEP A ADULT (HAVRIX)1440 EL.U/1ML SYR	$211.80	$353.00	$11.00–$7,946.74	138% above	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A ADULT (HAVRIX)1440 EL.U/1ML SYR	$211.80	$353.00	$187.30–$335.35	—	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 CL-HEP A ADULT(HAVRIX)1440 EL.U/1ML SYR	$211.80	$353.00	$187.30–$335.35	—	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEP A PED (HAVRIX) 720 EL.U/0.5ML SDV	$170.40	$284.00	$11.00–$6,393.41	130% above	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 CL-HEP A PED (HAVRIX) 720 EL.U/0.5ML SDV	$170.40	$284.00	$11.00–$6,393.41	130% above	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 CL-HEP A PED (HAVRIX) 720 EL.U/0.5ML SDV	$170.40	$284.00	$150.69–$269.80	—	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEP A PED (HAVRIX) 720 EL.U/0.5ML SDV	$170.40	$284.00	$150.69–$269.80	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B ADULT (ENGERIX B) 20MCG/ML SYR	$175.20	$292.00	$11.00–$6,573.50	112% above	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 CL-HEP B ADULT (ENGERIX B) 20MCG/ML SYR	$175.20	$292.00	$11.00–$6,573.50	112% above	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 CL-HEP B ADULT (ENGERIX B) 20MCG/ML SYR	$175.20	$292.00	$154.94–$277.40	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B ADULT (ENGERIX B) 20MCG/ML SYR	$175.20	$292.00	$154.94–$277.40	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B PED (ENGERIX B) 10 MCG/0.5ML	$141.00	$235.00	$11.00–$5,290.32	197% above	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 CL-HEPATITIS B PED(ENGERIX B)10MCG/0.5ML	$141.00	$235.00	$11.00–$5,290.32	197% above	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B PED (ENGERIX B) 10 MCG/0.5ML	$141.00	$235.00	$124.69–$223.25	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 CL-HEPATITIS B PED(ENGERIX B)10MCG/0.5ML	$141.00	$235.00	$124.69–$223.25	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACH(ACTHIB) 0.5ML INJ	$28.80	$48.00	$11.00–$1,080.58	8% below	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 CL-HAEMOPHILUS B POLYS(ACTHIB) 0.5ML INJ	$51.00	$85.00	$11.00–$1,913.52	63% above	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSACH(ACTHIB) 0.5ML INJ	$28.80	$48.00	$25.47–$45.60	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 CL-HAEMOPHILUS B POLYS(ACTHIB) 0.5ML INJ	$51.00	$85.00	$45.10–$80.75	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 CL-MEASLES,MUMPS,RUBELL(MMR-II)0.5ML SDV	$231.60	$386.00	$11.00–$8,689.63	254% above	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 CL-MEASLES,MUMPS,RUBELL(MMR-II)0.5ML SDV	$231.60	$386.00	$204.81–$366.70	—	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEASLES,MUMPS,RUBELLA(MMR-II) 0.5ML SDV	$231.60	$386.00	$11.00–$8,689.63	4% below	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMR/VARICELLA (PROQUAD) 0.5 ML VIAL	$593.40	$989.00	$11.00–$22,264.37	145% above	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 CL-MMR/VARICELLA (PROQUAD) 0.5 ML VIAL	$593.40	$989.00	$11.00–$22,264.37	145% above	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLES,MUMPS,RUBELLA(MMR-II) 0.5ML SDV	$231.60	$386.00	$204.81–$366.70	—	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MMR/VARICELLA (PROQUAD) 0.5 ML VIAL	$593.40	$989.00	$524.76–$939.55	—	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 CL-MMR/VARICELLA (PROQUAD) 0.5 ML VIAL	$593.40	$989.00	$524.76–$939.55	—	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENIGOCOCCAL OLIGOSAC(MENVEO)0.5 ML VIAL	$384.60	$641.00	$11.00–$14,430.19	311% above	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENIGOCOCCAL OLIGOSAC(MENVEO)0.5 ML VIAL	$384.60	$641.00	$340.11–$608.95	—	40%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 CL-MENIGOCOCCAL OLIGOSAC(MENVEO)0.5ML VL	$384.60	$641.00	$11.00–$14,430.19	23% below	40%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 CL-MENIGOCOCCAL OLIGOSAC(MENVEO)0.5ML VL	$384.60	$641.00	$340.11–$608.95	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B (BEXSERO) 0.5ML SYR	$385.20	$642.00	$11.00–$14,452.70	101% above	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 CL-MENINGOCOCCAL B (BEXSERO) 0.5ML SYR	$385.20	$642.00	$11.00–$14,452.70	101% above	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B (BEXSERO) 0.5ML SYR	$385.20	$642.00	$340.65–$609.90	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 CL-MENINGOCOCCAL B (BEXSERO) 0.5ML SYR	$385.20	$642.00	$340.65–$609.90	—	40%
Meningococcal B vaccine (Trumenba) CPT 90621 MENINGOCOCCAL B (TRUMENBA) 0.5 MG SYR	$818.40	$1,364.00	$11.00–$30,706.37	317% above	40%
Meningococcal B vaccine (Trumenba) CPT 90621 CL-MENINGOCOCCAL B (TRUMENBA) 0.5 MG SYR	$818.40	$1,364.00	$11.00–$30,706.37	317% above	40%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 CL-MENINGOCOCCAL B (TRUMENBA) 0.5 MG SYR	$818.40	$1,364.00	$723.74–$1,295.80	—	40%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 MENINGOCOCCAL B (TRUMENBA) 0.5 MG SYR	$818.40	$1,364.00	$723.74–$1,295.80	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 13 (PREVNAR 13) 0.5 ML SYR	$354.60	$591.00	$11.00–$13,304.59	10% above	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 CL-PNEUMOCOCCAL 13 (PREVNAR 13)0.5ML SYR	$354.60	$591.00	$11.00–$13,304.59	10% above	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20 (PREVNAR 20) 0.5ML SYR	$358.20	$597.00	$11.00–$13,439.66	11% above	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 CL-PNEUMOCOCCAL 20 (PREVNAR 20)0.5ML SYR	$358.20	$597.00	$11.00–$13,439.66	11% above	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 13 (PREVNAR 13) 0.5 ML SYR	$354.60	$591.00	$313.58–$561.45	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 CL-PNEUMOCOCCAL 13 (PREVNAR 13)0.5ML SYR	$354.60	$591.00	$313.58–$561.45	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 CL-PNEUMOCOCCAL 20 (PREVNAR 20)0.5ML SYR	$358.20	$597.00	$316.77–$567.15	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20 (PREVNAR 20) 0.5ML SYR	$358.20	$597.00	$316.77–$567.15	—	40%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 CL-PNEUMOCOCCAL21(CAPVAXIVE) 0.5ML SYR	$414.00	$690.00	$11.00–$15,533.28	118% above	40%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 CL-PNEUMOCOCCAL21(CAPVAXIVE) 0.5ML SYR	$414.00	$690.00	$366.11–$655.50	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23(PNEUMOVAX-23)0.5ML VIAL	$183.00	$305.00	$11.00–$6,866.16	43% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL-PNEUMOCOCCAL 23(PNEUMOVAX-23)0.5ML VL	$183.00	$305.00	$11.00–$6,866.16	43% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 CL-PNEUMOCOCCAL 23(PNEUMOVAX-23)0.5ML VL	$183.00	$305.00	$161.83–$289.75	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23(PNEUMOVAX-23)0.5ML VIAL	$183.00	$305.00	$161.83–$289.75	—	40%
Polio vaccine, inactivated (IPV) CPT 90713 CL-POLIO (IPOL) 0.5 ML INJ	$105.60	$176.00	$11.00–$3,962.11	76% above	40%
Polio vaccine, inactivated (IPV) CPT 90713 POLIO (IPOL) 0.5 ML INJ	$105.60	$176.00	$11.00–$3,962.11	76% above	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIO (IPOL) 0.5 ML INJ	$105.60	$176.00	$93.39–$167.20	—	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 CL-POLIO (IPOL) 0.5 ML INJ	$105.60	$176.00	$93.39–$167.20	—	40%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE (RABAVERT) 2.5 IU/ML INJ	$746.40	$1,244.00	$11.00–$28,004.93	25% above	40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (RABAVERT) 2.5 IU/ML INJ	$746.40	$1,244.00	$660.07–$1,181.80	—	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS (ROTATEQ) ORAL DOSE PACKET	$126.60	$211.00	$11.00–$4,750.03	53% above	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 CL-ROTAVIRUS (ROTATEQ) ORAL DOSE PACKET	$126.60	$211.00	$11.00–$4,750.03	53% above	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS (ROTATEQ) ORAL DOSE PACKET	$126.60	$211.00	$111.96–$200.45	—	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 CL-ROTAVIRUS (ROTATEQ) ORAL DOSE PACKET	$126.60	$211.00	$111.96–$200.45	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS+DIPTHERIA(TENIVAC) 0.5 ML SYR	$103.80	$173.00	$11.00–$3,894.58	86% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS+DIPTHERIA(TENIVAC) 0.5 ML SYR	$103.80	$173.00	$91.79–$164.35	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 CL-TDAP (BOOSTRIX) 0.5 ML SYR	$197.40	$329.00	$11.00–$7,406.45	252% above	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP (BOOSTRIX) 0.5 ML SYR	$197.40	$329.00	$11.00–$7,406.45	252% above	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP (BOOSTRIX) 0.5 ML SYR	$197.40	$329.00	$174.57–$312.55	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 CL-TDAP (BOOSTRIX) 0.5 ML SYR	$197.40	$329.00	$174.57–$312.55	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUN ADMIN ONE VACCINE	$42.00	$70.00	$0.87–$1,575.84	34% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUN ADMIN ONE VACCINE	$42.00	$70.00	$49.00–$66.50	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ VACC/TOX EACH ADD	$32.40	$54.00	$0.41–$1,215.65	21% above	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ VACC/TOX EACH ADD	$32.40	$54.00	$37.80–$51.30	—	40%

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

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

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

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

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

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

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

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

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

Source file: https://dam.upmc.com/-/media/upmc/locations/hospitals/documents/cdm-json-files/machine-readable-csv-not-json/250998168_upmc-kane_standardcharges.csv?rev=78f6d478ab40404b8a165f9d5d5a7e8e&hash=5B62EBCC89A816DF56250F9102482BF5