Hospital Manchester-Nashua, NH

Monadnock Community Hospital

Monadnock Community Hospital in Peterborough, NH publishes cash prices for 333 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the New Hampshire median for 212 of 327 procedures and above it for 111. By typical cash price it ranks #9 of 20 New Hampshire hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

452 Old Street Road, Peterborough, NH 03458 Collected Sep 22, 2026 Source price file Check a bill from this hospital (603) 924-7191

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CMS star rating 2 of 5 CCN 301309 · CMS hospital register NPI 1457304149

Financial assistance

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

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

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

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

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 Monadnock Community Hospital in Peterborough, NH:

Aug 25, 2021 Warning notice
Jan 27, 2022 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 New Hampshire	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABD W AND W/O CONTRAST	$3,296.64	$5,494.40	—	54% above	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABD W AND W/O CONTRAST	$3,296.64	$5,494.40	—	—	40%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS (ROUTINE)	$375.74	$626.24	—	43% above	40%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS (ROUTINE)	$375.74	$626.24	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ABI	$462.00	$770.00	—	2% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ABI W/EXERCISE	$462.00	$770.00	—	2% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ABI W/EXERCISE	$462.00	$770.00	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ABI	$462.00	$770.00	—	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS/BASWALLOW	$630.98	$1,051.63	—	4% above	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS/BASWALLOW	$630.98	$1,051.63	—	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 Z-NM BONE WHOLE BODY	$1,195.83	$1,993.05	—	37% below	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Z-NM BONE WHOLE BODY	$1,195.83	$1,993.05	—	—	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 MHP US BREAST LT LIMITED	$280.57	$467.62	—	23% below	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 MHP US BREAST LT LIMITED	$280.57	$467.62	—	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIOGRAPHY ABDOMEN AND PELVIS	$3,846.43	$6,410.72	—	46% above	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIOGRAPHY ABDOMEN AND PELVIS	$3,846.43	$6,410.72	—	—	40%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD	$1,975.97	$3,293.29	—	5% below	40%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD AND NECK	$3,951.95	$6,586.58	—	90% above	40%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD	$1,975.97	$3,293.29	—	—	40%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD AND NECK	$3,951.95	$6,586.58	—	—	40%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK	$1,975.97	$3,293.29	—	5% below	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK	$1,975.97	$3,293.29	—	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST	$1,982.15	$3,303.59	—	6% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST PE STUDY	$1,982.15	$3,303.59	—	6% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST PE STUDY	$1,982.15	$3,303.59	—	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST	$1,982.15	$3,303.59	—	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CALCIUM SCORING (RAD)	$150.00	$250.00	—	43% below	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CALCIUM SCORING (RAD)	$150.00	$250.00	—	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD AND PELVIS W/O CONTRAST	$2,911.40	$4,852.33	—	18% above	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD AND PELVIS W/O CONTRAST	$2,911.40	$4,852.33	—	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ENTEROGRAPHY	$3,266.36	$5,443.93	—	16% above	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD AND PELVIS W/CONTRAST	$3,266.36	$5,443.93	—	16% above	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ENTEROGRAPHY	$3,266.36	$5,443.93	—	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD AND PELVIS W/CONTRAST	$3,266.36	$5,443.93	—	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD AND PELVIS W AND W/O CONTRAST	$5,741.45	$9,569.08	—	85% above	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UROGRAM	$5,741.45	$9,569.08	—	85% above	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT UROGRAM	$5,741.45	$9,569.08	—	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD AND PELVIS W AND W/O CONTRAST	$5,741.45	$9,569.08	—	—	40%
CT scan of the abdomen with contrast CPT 74160 CT ABD W/CONTRAST	$1,674.39	$2,790.65	—	at median	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD W/CONTRAST	$1,674.39	$2,790.65	—	—	40%
CT scan of the abdomen without contrast CPT 74150 CT ABD W/O CONTRAST	$1,318.81	$2,198.02	—	4% below	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD W/O CONTRAST	$1,318.81	$2,198.02	—	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL	$1,679.11	$2,798.51	—	7% above	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL	$1,679.11	$2,798.51	—	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONTRAST	$1,272.46	$2,120.77	—	4% below	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONTRAST	$1,272.46	$2,120.77	—	—	40%
CT scan of the head with contrast CPT 70460 CT HEAD W/CONTRAST	$1,594.05	$2,656.75	—	4% above	40%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/CONTRAST	$1,594.05	$2,656.75	—	—	40%
CT scan of the head without and with contrast CPT 70470 CT HEAD W AND W/O CONTRAST	$2,039.63	$3,399.38	—	5% above	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W AND W/O CONTRAST	$2,039.63	$3,399.38	—	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L SPINE W/O CONTRAST	$2,183.39	$3,638.99	—	55% above	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L SPINE W/O CONTRAST	$2,183.39	$3,638.99	—	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C SPINE W/O CONTRAST	$2,019.62	$3,366.04	—	39% above	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C SPINE W/O CONTRAST	$2,019.62	$3,366.04	—	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST	$1,663.27	$2,772.11	—	3% above	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST	$1,663.27	$2,772.11	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTIDS BILAT	$526.54	$877.56	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTIDS BILAT	$526.54	$877.56	—	—	40%
Chest CT scan without and with contrast CPT 71270 CT CHEST W AND W/O CONTRAST	$2,496.95	$4,161.58	—	at median	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W AND W/O CONTRAST	$2,496.95	$4,161.58	—	—	40%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS DECON ROOM	$477.00	$795.00	—	86% above	40%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS (ROUTINE)	$477.00	$795.00	—	86% above	40%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS (ROUTINE)	$477.00	$795.00	—	—	40%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS DECON ROOM	$477.00	$795.00	—	—	40%
Chest X-ray, single view CPT 71045 CHEST PORTABLE 1 VIEW	$307.20	$512.00	—	37% above	40%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW DECON ROOM	$307.20	$512.00	—	37% above	40%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW	$307.20	$512.00	—	37% above	40%
Chest X-ray, single view inpatient CPT 71045 CHEST PORTABLE 1 VIEW	$307.20	$512.00	—	—	40%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW	$307.20	$512.00	—	—	40%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW DECON ROOM	$307.20	$512.00	—	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL AND BLADDER COMPLETE	$710.70	$1,184.50	—	15% above	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US AORTA SCAN DIAGNOSTIC	$710.70	$1,184.50	—	15% above	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US AORTA SCAN DIAGNOSTIC	$710.70	$1,184.50	—	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RENAL AND BLADDER COMPLETE	$710.70	$1,184.50	—	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BMD DEXA SCAN	$422.09	$703.49	—	2% below	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BMD DEXA SCAN	$422.09	$703.49	—	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$1,593.20	$2,655.34	—	15% above	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST	$1,593.20	$2,655.34	—	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST	$1,663.27	$2,772.11	—	at median	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/CONTRAST	$1,663.27	$2,772.11	—	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MA DIAG 2/V BILAT WITH CAD	$415.20	$692.00	—	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MA ADD/V/BILAT	$415.20	$692.00	—	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MA AUG BILAT DIAGNOSTIC	$415.20	$692.00	—	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA DIAG 2/V BILAT WITH CAD	$415.20	$692.00	—	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA AUG BILAT DIAGNOSTIC	$415.20	$692.00	—	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA ADD/V/BILAT	$415.20	$692.00	—	—	40%
Diagnostic mammogram, one breast one side CPT 77065 MA ADD/V RT	$340.80	$568.00	—	44% below	40%
Diagnostic mammogram, one breast one side CPT 77065 MA ADD/V LT	$340.80	$568.00	—	44% below	40%
Diagnostic mammogram, one breast one side CPT 77065 MA DIAG 2/V RT WITH CAD	$340.80	$568.00	—	44% below	40%
Diagnostic mammogram, one breast one side CPT 77065 MA DIAG 2/V LT WITH CAD	$340.80	$568.00	—	44% below	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MA DIAG 2/V LT WITH CAD	$340.80	$568.00	—	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MA DIAG 2/V RT WITH CAD	$340.80	$568.00	—	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MA ADD/V LT	$340.80	$568.00	—	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MA ADD/V RT	$340.80	$568.00	—	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ARTERIES LOW EXT BILAT	$872.00	$1,453.33	—	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US ARTERIES LOW EXT BILAT	$872.00	$1,453.33	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LEG VEINS BILAT	$1,183.47	$1,972.45	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US ARM VEINS BILAT	$1,183.47	$1,972.45	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VEIN POST OP BILAT	$1,183.47	$1,972.45	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VEIN MAPPING BILAT	$1,183.47	$1,972.45	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VEIN POST OP BILAT	$1,183.47	$1,972.45	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US LEG VEINS BILAT	$1,183.47	$1,972.45	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US ARM VEINS BILAT	$1,183.47	$1,972.45	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VEIN MAPPING BILAT	$1,183.47	$1,972.45	—	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO COMPLETE	$1,536.35	$2,560.58	—	2% below	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO COMPLETE W/CONTRAST	$1,628.50	$2,714.16	—	4% above	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO COMPLETE	$1,536.35	$2,560.58	—	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO COMPLETE W/CONTRAST	$1,628.50	$2,714.16	—	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC,ORBIT W/O CONTRAST	$1,224.26	$2,040.43	—	17% below	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC,ORBIT W/O CONTRAST	$1,224.26	$2,040.43	—	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES COMP MIN 3V	$354.73	$591.22	—	4% below	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES COMP MIN 3V	$354.73	$591.22	—	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY FATTY MEAL	$939.36	$1,565.60	—	49% below	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Z-NM HEPATOBILIARY W/O SINCALIDE	$1,231.06	$2,051.76	—	33% below	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY FATTY MEAL	$939.36	$1,565.60	—	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Z-NM HEPATOBILIARY W/O SINCALIDE	$1,231.06	$2,051.76	—	—	40%
Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT TRUMATCH/CONFORMIS KNEE BILAT	$3,020.17	$5,033.61	—	—	40%
Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT LWR BILAT W/O CONTRAST	$3,029.44	$5,049.06	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT TRUMATCH/CONFORMIS KNEE BILAT	$3,020.17	$5,033.61	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT LWR BILAT W/O CONTRAST	$3,029.44	$5,049.06	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMIT SCAN	$499.96	$833.27	—	1% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMIT SCAN	$499.96	$833.27	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 MHP US XTR NON VASC LMTD	$199.61	$332.69	—	40% below	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US SOFT TISSUE EXT	$199.61	$332.69	—	40% below	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 MOA US SOFT TISSUE EXT LTD	$199.61	$332.69	—	40% below	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US AXILLA LT	$199.61	$332.69	—	40% below	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US AXILLA RT	$199.61	$332.69	—	40% below	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 MOA US SOFT TISSUE EXT LTD	$199.61	$332.69	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 MHP US XTR NON VASC LMTD	$199.61	$332.69	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US SOFT TISSUE EXT	$199.61	$332.69	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US AXILLA LT	$199.61	$332.69	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US AXILLA RT	$199.61	$332.69	—	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LUNG SCREENING	$1,593.20	$2,655.34	—	114% above	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LUNG SCREENING	$1,593.20	$2,655.34	—	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O CONTRAST	$1,750.18	$2,916.96	—	11% below	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O CONTRAST	$1,750.18	$2,916.96	—	—	40%
MRI of the abdomen without contrast CPT 74181 MR ABD W/O CONTRAST	$1,766.86	$2,944.77	—	28% below	40%
MRI of the abdomen without contrast inpatient CPT 74181 MR ABD W/O CONTRAST	$1,766.86	$2,944.77	—	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABD W AND W/O CONTRAST	$3,885.37	$6,475.61	—	5% above	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABD W AND W/O CONTRAST	$3,885.37	$6,475.61	—	—	40%
MRI of the brain, no contrast dye CPT 70551 MR BRAIN W/O CONTRAST	$2,299.58	$3,832.63	—	at median	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN W/O CONTRAST	$2,299.58	$3,832.63	—	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN W AND W/O CONTRAST	$4,856.24	$8,093.74	—	33% above	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN W AND W/O CONTRAST	$4,856.24	$8,093.74	—	—	40%
MRI of the lower back, no contrast dye CPT 72148 MR L SPINE W/O CONTRAST	$2,462.73	$4,104.55	—	at median	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR L SPINE W/O CONTRAST	$2,462.73	$4,104.55	—	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MR L SPINE W AND W/O CONTRAST	$4,747.48	$7,912.46	—	23% above	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR L SPINE W AND W/O CONTRAST	$4,747.48	$7,912.46	—	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR T SPINE W/O CONTRAST	$2,014.06	$3,356.77	—	19% below	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR T SPINE W/O CONTRAST	$2,014.06	$3,356.77	—	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR C SPINE W AND W/O CONTRAST	$4,265.44	$7,109.06	—	11% above	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR C SPINE W AND W/O CONTRAST	$4,265.44	$7,109.06	—	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR C SPINE W/O CONTRAST	$2,462.11	$4,103.52	—	at median	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR C SPINE W/O CONTRAST	$2,462.11	$4,103.52	—	—	40%
MRI of the pelvis without and with contrast CPT 72197 MR PELVIS W AND W/O CONTRAST	$4,315.49	$7,192.49	—	23% above	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR PELVIS W AND W/O CONTRAST	$4,315.49	$7,192.49	—	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS W/O CONTRAST	$1,865.12	$3,108.54	—	30% below	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR PELVIS W/O CONTRAST	$1,865.12	$3,108.54	—	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 MOA CERVICAL SPINE 4V	$431.98	$719.97	—	6% above	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SPINE COMP 4 OR 5 VIEWS ROUTINE	$431.98	$719.97	—	6% above	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERVICAL SPINE COMP 4 OR 5 VIEWS ROUTINE	$431.98	$719.97	—	—	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 MOA CERVICAL SPINE 4V	$431.98	$719.97	—	—	40%
Neck soft tissue CT scan with contrast CPT 70491 CT SFT NECK W/CONTRAST	$2,082.89	$3,471.48	—	32% above	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SFT NECK W/CONTRAST	$2,082.89	$3,471.48	—	—	40%
Neck soft tissue CT scan without contrast CPT 70490 CT SFT NECK W/O CONTRAST	$1,511.63	$2,519.38	—	8% above	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SFT NECK W/O CONTRAST	$1,511.63	$2,519.38	—	—	40%
Neck soft tissue X-ray CPT 70360 NECK-SOFT TISSUE	$208.88	$348.14	—	6% below	40%
Neck soft tissue X-ray inpatient CPT 70360 NECK-SOFT TISSUE	$208.88	$348.14	—	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MIBI.	$2,772.35	$4,620.58	—	3% below	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MIBI.	$2,772.35	$4,620.58	—	—	40%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$1,593.20	$2,655.34	—	8% above	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST	$1,593.20	$2,655.34	—	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US BLADDER OR LTD PELVIS	$302.20	$503.67	—	18% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US BLADDER	$302.20	$503.67	—	18% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LIMITED	$302.20	$503.67	—	18% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US BLADDER OR LTD PELVIS	$302.20	$503.67	—	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LIMITED	$302.20	$503.67	—	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US BLADDER	$302.20	$503.67	—	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS SCAN	$639.63	$1,066.05	—	11% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS SCAN	$639.63	$1,066.05	—	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB GREATER THAN 14WKS	$757.05	$1,261.75	—	22% above	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB GREATER THAN 14WKS	$757.05	$1,261.75	—	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB LESS THAN 14WKS	$642.72	$1,071.20	—	8% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB LESS THAN 14WKS	$642.72	$1,071.20	—	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LTD	$364.62	$607.70	—	13% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LTD	$364.62	$607.70	—	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 MOA RIBS RT 2V	$307.15	$511.91	—	27% above	40%
Rib X-ray, one side, 2 views one side CPT 71100 MOA RIBS LT 2V	$307.15	$511.91	—	27% above	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 MOA RIBS RT 2V	$307.15	$511.91	—	—	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 MOA RIBS LT 2V	$307.15	$511.91	—	—	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS W/PA CHEST RT MIN 3V	$342.99	$571.65	—	4% below	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS W/PA CHEST LT MIN 3V	$342.99	$571.65	—	4% below	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS W/PA CHEST LT MIN 3V	$342.99	$571.65	—	—	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS W/PA CHEST RT MIN 3V	$342.99	$571.65	—	—	40%
Screening mammogram, both breasts both sides CPT 77067 MA AUG BILAT SCREENING	$415.20	$692.00	—	—	40%
Screening mammogram, both breasts both sides CPT 77067 MA SCR 2/V BILAT WITH CAD	$415.20	$692.00	—	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 MA SCR 2/V BILAT WITH CAD	$415.20	$692.00	—	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 MA AUG BILAT SCREENING	$415.20	$692.00	—	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES COMP MIN 3V	$380.07	$633.45	—	7% above	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES COMP MIN 3V	$380.07	$633.45	—	—	40%
Skull X-ray, fewer than 4 views CPT 70250 SKULL LTD LESS THAN 4V	$196.52	$327.54	—	28% below	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL LTD LESS THAN 4V	$196.52	$327.54	—	—	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 US STRESS ECHO	$1,430.67	$2,384.45	—	28% below	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 US STRESS ECHO WITH CONTRAST	$1,522.82	$2,538.03	—	24% below	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 US STRESS ECHO	$1,430.67	$2,384.45	—	—	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 US STRESS ECHO WITH CONTRAST	$1,522.82	$2,538.03	—	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 MODIFIED BA SWALLOW W/VIDEO	$389.96	$649.93	—	41% below	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MODIFIED BA SWALLOW W/VIDEO	$389.96	$649.93	—	—	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR RT 2V	$285.52	$475.86	—	3% below	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 MOA FEMUR LT 2V	$285.52	$475.86	—	3% below	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 MOA FEMUR RT 2V	$285.52	$475.86	—	3% below	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR LT 2V	$285.52	$475.86	—	3% below	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 MOA FEMUR RT 2V	$285.52	$475.86	—	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 MOA FEMUR LT 2V	$285.52	$475.86	—	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR LT 2V	$285.52	$475.86	—	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR RT 2V	$285.52	$475.86	—	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T SPINE W/O CONTRAST	$1,981.93	$3,303.21	—	54% above	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT T SPINE W/O CONTRAST	$1,981.93	$3,303.21	—	—	40%
Toe X-ray, 2 or more views one side CPT 73660 TOES RIGHT FOOT	$208.27	$347.11	—	6% below	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOES RIGHT FOOT	$208.27	$347.11	—	—	40%
Transvaginal pelvic ultrasound CPT 76830 US ENDOVAGINAL SONOGRAM	$690.31	$1,150.51	—	24% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US ENDOVAGINAL SONOGRAM	$690.31	$1,150.51	—	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 US ENDOVAGINAL OB	$642.72	$1,071.20	—	45% above	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US ENDOVAGINAL OB	$642.72	$1,071.20	—	—	40%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE SCAN	$922.06	$1,536.76	—	37% above	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE SCAN	$922.06	$1,536.76	—	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US TESTES SCAN	$302.20	$503.67	—	44% below	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTES SCAN	$302.20	$503.67	—	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$302.20	$503.67	—	40% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE NECK OR HEAD	$670.53	$1,117.55	—	32% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID	$302.20	$503.67	—	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE NECK OR HEAD	$670.53	$1,117.55	—	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER GI SERIES	$585.86	$976.44	—	19% below	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER GI SERIES	$585.86	$976.44	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US JUGULAR AND OR SUBCLAVIAN VEINS	$787.95	$1,313.25	—	4% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US ARM VEINS RT	$787.95	$1,313.25	—	4% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US ARM VEINS LT	$787.95	$1,313.25	—	4% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LEG VEINS RT	$787.95	$1,313.25	—	4% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LEG VEINS LT	$787.95	$1,313.25	—	4% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEIN POST OP RT	$787.95	$1,313.25	—	4% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEIN POST OP LT	$787.95	$1,313.25	—	4% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEIN MAPPING RT	$787.95	$1,313.25	—	4% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEIN MAPPING LT	$787.95	$1,313.25	—	4% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US JUGULAR AND OR SUBCLAVIAN VEINS	$787.95	$1,313.25	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEIN MAPPING LT	$787.95	$1,313.25	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LEG VEINS LT	$787.95	$1,313.25	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LEG VEINS RT	$787.95	$1,313.25	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US ARM VEINS LT	$787.95	$1,313.25	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US ARM VEINS RT	$787.95	$1,313.25	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEIN MAPPING RT	$787.95	$1,313.25	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEIN POST OP RT	$787.95	$1,313.25	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEIN POST OP LT	$787.95	$1,313.25	—	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 MOA HIP 2 VIEW LT WITH AP PELVIS	$412.21	$687.01	—	27% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 MOA HIP 2 VIEW RT WITH AP PELVIS	$412.21	$687.01	—	27% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2 VIEW RT WITH AP PELVIS	$412.21	$687.01	—	27% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2 VIEW LT WITH AP PELVIS	$412.21	$687.01	—	27% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2 VIEW RT WITH AP PELVIS	$412.21	$687.01	—	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 MOA HIP 2 VIEW RT WITH AP PELVIS	$412.21	$687.01	—	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 MOA HIP 2 VIEW LT WITH AP PELVIS	$412.21	$687.01	—	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2 VIEW LT WITH AP PELVIS	$412.21	$687.01	—	—	40%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW	$320.12	$533.54	—	36% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW	$320.12	$533.54	—	—	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS-RT HAND	$208.27	$347.11	—	at median	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS-LT HAND	$208.27	$347.11	—	at median	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 MOA FINGERS RT HAND	$208.27	$347.11	—	at median	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 MOA FINGERS RT HAND	$208.27	$347.11	—	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS-LT HAND	$208.27	$347.11	—	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS-RT HAND	$208.27	$347.11	—	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 MOA LUMBAR SPINE 2V	$216.92	$361.53	—	29% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SP LTD 2 OR 3V ROUTINE	$216.92	$361.53	—	29% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SP LTD 2 OR 3V ROUTINE	$216.92	$361.53	—	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 MOA LUMBAR SPINE 2V	$216.92	$361.53	—	—	40%
X-ray of the lower back, 4 or more views CPT 72110 MOA LUMBAR SPINE 4+V	$333.10	$555.17	—	15% below	40%
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SP COMP MIN 4 VIEWS	$333.10	$555.17	—	15% below	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 MOA LUMBAR SPINE 4+V	$333.10	$555.17	—	—	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SP COMP MIN 4 VIEWS	$333.10	$555.17	—	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2 VIEWS	$330.63	$551.05	—	14% above	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 MOA THORACIC SPINE MIN 2V	$330.63	$551.05	—	14% above	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2 VIEWS	$330.63	$551.05	—	—	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 MOA THORACIC SPINE MIN 2V	$330.63	$551.05	—	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3V	$309.00	$515.00	—	5% above	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES MIN 3V	$309.00	$515.00	—	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 MOA CERVICAL SPINE 2-3V	$210.12	$350.20	—	24% below	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE LTD 2 OR 3V	$210.12	$350.20	—	24% below	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 MOA CERVICAL SPINE 2-3V	$210.12	$350.20	—	—	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE LTD 2 OR 3V	$210.12	$350.20	—	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 or 2v	$217.54	$362.56	—	16% below	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 MOA PELVIS AP	$217.54	$362.56	—	16% below	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 MOA PELVIS AP	$217.54	$362.56	—	—	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 or 2v	$217.54	$362.56	—	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 MOA SACRUM AND COCCYX MIN 2V	$210.12	$350.20	—	15% below	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX MIN 2V	$210.12	$350.20	—	15% below	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 MOA SACRUM AND COCCYX MIN 2V	$210.12	$350.20	—	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX MIN 2V	$210.12	$350.20	—	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
ACTH blood test CPT 82024 ACTH (ADRENOCORTICOTROPHIC HORMON	$196.52	$327.54	—	24% below	40%
ACTH blood test inpatient CPT 82024 ACTH (ADRENOCORTICOTROPHIC HORMON	$196.52	$327.54	—	—	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT/ALT	$78.49	$130.81	—	29% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT/ALT	$78.49	$130.81	—	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT/AST (ASPARTATE AMINOTRANSFER	$78.49	$130.81	—	49% above	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT/AST (ASPARTATE AMINOTRANSFER	$78.49	$130.81	—	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$292.20	$487.00	—	18% below	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$292.20	$487.00	—	—	40%
Albumin blood test CPT 82040 ALBUMIN-SERUM	$47.59	$79.31	—	1% above	40%
Albumin blood test inpatient CPT 82040 ALBUMIN-SERUM	$47.59	$79.31	—	—	40%
Aldosterone blood test CPT 82088 ALDOSTERONE-SERUM	$161.30	$268.83	—	35% below	40%
Aldosterone blood test CPT 82088 ALDOSTERONE-URINE 24HOUR (PRES)	$161.30	$268.83	—	35% below	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE-URINE 24HOUR (PRES)	$161.30	$268.83	—	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE-SERUM	$161.30	$268.83	—	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE TOTAL	$78.49	$130.81	—	17% above	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE TOTAL	$78.49	$130.81	—	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE EACH	$31.20	$52.00	—	5% below	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE EACH	$31.20	$52.00	—	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETO PROTEIN	$83.43	$139.05	—	28% below	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP-SINGLE	$83.43	$139.05	—	28% below	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETO PROTEIN	$83.43	$139.05	—	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP-SINGLE	$83.43	$139.05	—	—	40%
Ammonia blood test CPT 82140 AMMONIA-URINE-STONE	$40.79	$67.98	—	57% below	40%
Ammonia blood test CPT 82140 AMMONIA	$58.71	$97.85	—	39% below	40%
Ammonia blood test inpatient CPT 82140 AMMONIA-URINE-STONE	$40.79	$67.98	—	—	40%
Ammonia blood test inpatient CPT 82140 AMMONIA	$58.71	$97.85	—	—	40%
Amylase blood test CPT 82150 ISOENZYMES SALIVARY/PANCREATIC	$81.58	$135.96	—	9% above	40%
Amylase blood test CPT 82150 AMYLASE-OTHER BODY FLUIDS	$81.58	$135.96	—	9% above	40%
Amylase blood test inpatient CPT 82150 ISOENZYMES SALIVARY/PANCREATIC	$81.58	$135.96	—	—	40%
Amylase blood test inpatient CPT 82150 AMYLASE-OTHER BODY FLUIDS	$81.58	$135.96	—	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRINULLINATED PEPTIDE AB	$94.80	$158.00	—	6% below	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRINULLINATED PEPTIDE AB	$94.80	$158.00	—	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 86038 NUCLEAR AB - ANA OR CENTROMERE	$121.20	$202.00	—	26% above	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 86038 NUCLEAR AB - ANA OR CENTROMERE	$121.20	$202.00	—	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$165.62	$276.04	—	16% below	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIURETIC PEPTIDE	$165.62	$276.04	—	16% below	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATRIURETIC PEPTIDE	$165.62	$276.04	—	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$165.62	$276.04	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CORNEA	$153.00	$255.00	—	45% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC	$153.00	$255.00	—	45% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATHETER TIP	$153.00	$255.00	—	45% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENITAL	$153.00	$255.00	—	45% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE GENITAL	$153.00	$255.00	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CORNEA	$153.00	$255.00	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CATHETER TIP	$153.00	$255.00	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC	$153.00	$255.00	—	—	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$70.20	$117.00	—	2% above	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$70.20	$117.00	—	—	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$40.79	$67.98	—	5% above	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$40.79	$67.98	—	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 *SURG PATH LEVEL 4-CELL BLOCK	$154.20	$257.00	—	41% below	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 *SURG PATH LEVEL 4-CELL BLOCK	$154.20	$257.00	—	—	40%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$204.60	$341.00	—	46% above	40%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$204.60	$341.00	—	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 MHP BLOOD DRAW	$19.80	$33.00	—	19% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW	$19.80	$33.00	—	19% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 MIH BLOOD DRAW	$19.80	$33.00	—	19% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW.....36415	$19.80	$33.00	—	19% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 PHLEBOTOMY-COLLECT 1 SPEC	$19.80	$33.00	—	19% above	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 MHP BLOOD DRAW	$19.80	$33.00	—	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW	$19.80	$33.00	—	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 MIH BLOOD DRAW	$19.80	$33.00	—	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PHLEBOTOMY-COLLECT 1 SPEC	$19.80	$33.00	—	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW.....36415	$19.80	$33.00	—	—	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE CAPILLARY	$21.63	$36.05	—	38% below	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE-2 HR PP	$53.15	$88.58	—	53% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE-SERUM	$53.15	$88.58	—	53% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE-FASTING	$53.15	$88.58	—	53% above	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE CAPILLARY	$21.63	$36.05	—	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE-SERUM	$53.15	$88.58	—	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE-FASTING	$53.15	$88.58	—	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE-2 HR PP	$53.15	$88.58	—	—	40%
Blood lead test CPT 83655 LEAD	$44.40	$74.00	—	40% below	40%
Blood lead test inpatient CPT 83655 LEAD	$44.40	$74.00	—	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE	$21.63	$36.05	—	77% below	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUALITATIVE	$21.63	$36.05	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE	$31.80	$53.00	—	36% below	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPE	$31.80	$53.00	—	—	40%
Blood urea nitrogen (BUN) test CPT 84520 BUN (UREA NITROGEN-SERUM)	$17.30	$28.84	—	42% below	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN (UREA NITROGEN-SERUM)	$17.30	$28.84	—	—	40%
C-peptide blood test CPT 84681 C-PEPTIDE	$100.12	$166.86	—	28% below	40%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$100.12	$166.86	—	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 TOTAL CRP	$84.00	$140.00	—	23% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 TOTAL CRP	$84.00	$140.00	—	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$145.80	$243.00	—	30% below	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE	$145.80	$243.00	—	—	40%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$209.40	$349.00	—	46% above	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$209.40	$349.00	—	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125	$228.00	$380.00	—	52% above	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125	$228.00	$380.00	—	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS CoV 2	$182.40	$304.00	—	46% above	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS CoV 2	$182.40	$304.00	—	—	40%
Calcium blood test, total CPT 82310 CALCIUM TOTAL-SERUM	$54.38	$90.64	—	62% above	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL-SERUM	$54.38	$90.64	—	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$59.33	$98.88	—	57% below	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$59.33	$98.88	—	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG	$141.00	$235.00	—	35% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGM	$141.00	$235.00	—	35% above	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGM	$141.00	$235.00	—	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGG	$141.00	$235.00	—	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMATIS DNA	$151.20	$252.00	—	12% below	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C TRACHOMATIS DNA	$151.20	$252.00	—	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPIDS-CHOL/HDL/TRIG	$104.40	$174.00	—	14% below	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPIDS-CHOL/HDL/TRIG	$104.40	$174.00	—	—	40%
Complete blood count (CBC) with differential CPT 85025 CBC W/PLT DIFF	$50.40	$84.00	—	14% above	40%
Complete blood count (CBC) with differential CPT 85025 CBC(REFLEX)	$50.40	$84.00	—	14% above	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC(REFLEX)	$50.40	$84.00	—	—	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/PLT DIFF	$50.40	$84.00	—	—	40%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM&PLATELET CT	$22.20	$37.00	—	57% below	40%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM&PLATELET CT	$22.20	$37.00	—	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$99.00	$165.00	—	5% above	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$99.00	$165.00	—	—	40%
Cortisol blood test, total CPT 82533 CORTISOL-SERUM	$80.34	$133.90	—	33% below	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL-SERUM	$80.34	$133.90	—	—	40%
Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL	$68.60	$114.33	—	2% above	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK TOTAL	$68.60	$114.33	—	—	40%
Creatinine blood test CPT 82565 CREATININE SERUM	$61.80	$103.00	—	39% above	40%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM	$61.80	$103.00	—	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG (CYTOMEGALOVIRUS AB)	$111.60	$186.00	—	9% below	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG (CYTOMEGALOVIRUS AB)	$111.60	$186.00	—	—	40%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER	$60.00	$100.00	—	46% below	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER	$60.00	$100.00	—	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SO4	$93.94	$156.56	—	35% below	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SO4	$93.94	$156.56	—	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 CORDSTAT	$58.20	$97.00	—	75% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 80307/DRUG SCREEN 7 SERUM CLASS A	$93.60	$156.00	—	59% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 80307/DRUG SCREEN 9 SERUM CLASS A	$120.00	$200.00	—	48% below	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CORDSTAT	$58.20	$97.00	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 80307/DRUG SCREEN 7 SERUM CLASS A	$93.60	$156.00	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 80307/DRUG SCREEN 9 SERUM CLASS A	$120.00	$200.00	—	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES PANEL	$37.80	$63.00	—	28% below	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES PANEL	$37.80	$63.00	—	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV CAPSID IGG AB	$115.20	$192.00	—	10% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV CAPSID IGM AB	$115.20	$192.00	—	10% above	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV CAPSID IGG AB	$115.20	$192.00	—	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV CAPSID IGM AB	$115.20	$192.00	—	—	40%
Estradiol blood test CPT 82670 ESTRADIOL ENHANCED	$134.72	$224.54	—	16% below	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL ENHANCED	$134.72	$224.54	—	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$104.44	$174.07	—	17% below	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$104.44	$174.07	—	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$110.00	$183.34	—	48% below	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$110.00	$183.34	—	—	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$88.37	$147.29	—	18% below	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$88.37	$147.29	—	—	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$36.60	$61.00	—	55% below	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$36.60	$61.00	—	—	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID (FOLATE)-SERUM	$82.81	$138.02	—	6% below	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID (FOLATE)-SERUM	$82.81	$138.02	—	—	40%
Free T3 thyroid hormone test CPT 84481 T3-FREE (TRIIODOTHYRONINE)	$148.94	$248.23	—	9% below	40%
Free T3 thyroid hormone test inpatient CPT 84481 T3-FREE (TRIIODOTHYRONINE)	$148.94	$248.23	—	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$82.81	$138.02	—	16% below	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4	$82.81	$138.02	—	—	40%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$140.29	$233.81	—	1% below	40%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$140.29	$233.81	—	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT (GAMMAGLUTAMYLTRANSFERASE)	$78.49	$130.81	—	21% above	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT (GAMMAGLUTAMYLTRANSFERASE)	$78.49	$130.81	—	—	40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$160.20	$267.00	—	31% below	40%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$160.20	$267.00	—	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOLA	$73.54	$122.57	—	42% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE-1 HR POST GLUCOLA	$73.54	$122.57	—	42% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUCOLA	$73.54	$122.57	—	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE-1 HR POST GLUCOLA	$73.54	$122.57	—	—	40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 3 SPEC SERUM	$317.03	$528.39	—	157% above	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL 3 SPEC SERUM	$317.03	$528.39	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHOEAE DNA	$151.20	$252.00	—	28% below	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHOEAE DNA	$151.20	$252.00	—	—	40%
H. pylori antibody blood test CPT 86677 H PYLORI AB IGA	$178.20	$297.00	—	1% below	40%
H. pylori antibody blood test CPT 86677 H.PYLORI ANTIBODY IGM	$178.20	$297.00	—	1% below	40%
H. pylori antibody blood test CPT 86677 H.PYLORI ANTIBODY	$178.20	$297.00	—	1% below	40%
H. pylori antibody blood test CPT 86677 H PYLORI AB IGG	$178.20	$297.00	—	1% below	40%
H. pylori antibody blood test inpatient CPT 86677 H.PYLORI ANTIBODY	$178.20	$297.00	—	—	40%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB IGA	$178.20	$297.00	—	—	40%
H. pylori antibody blood test inpatient CPT 86677 H.PYLORI ANTIBODY IGM	$178.20	$297.00	—	—	40%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB IGG	$178.20	$297.00	—	—	40%
H. pylori stool antigen test CPT 87338 H PYLORI STOOL BY EIA	$94.80	$158.00	—	16% below	40%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL BY EIA	$94.80	$158.00	—	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 QUANTIFICATION	$354.60	$591.00	—	18% below	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 QUANTIFICATION	$354.60	$591.00	—	—	40%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1/2 Screen	$63.00	$105.00	—	11% above	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1/2 Screen	$63.00	$105.00	—	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV4TH GEN	$98.40	$164.00	—	23% below	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV4TH GEN	$98.40	$164.00	—	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK DNA	$282.00	$470.00	—	44% above	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV (VIRAPAP)	$282.00	$470.00	—	44% above	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV (VIRAPAP)	$282.00	$470.00	—	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH RISK DNA	$282.00	$470.00	—	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOHEMOGLOBIN A1C	$35.23	$58.71	—	50% below	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOHEMOGLOBIN A1C	$35.23	$58.71	—	—	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN ONLY	$13.80	$23.00	—	37% below	40%
Hemoglobin blood test CPT 85018 MHP HEMOGLOBIN ONLY	$13.80	$23.00	—	37% below	40%
Hemoglobin blood test inpatient CPT 85018 MHP HEMOGLOBIN ONLY	$13.80	$23.00	—	—	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN ONLY	$13.80	$23.00	—	—	40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB	$63.00	$105.00	—	11% below	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB	$63.00	$105.00	—	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY (HBSAB)	$56.40	$94.00	—	22% below	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY (HBSAB)	$56.40	$94.00	—	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN HBSAG BY EIA	$103.80	$173.00	—	30% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN HBSAG BY EIA	$103.80	$173.00	—	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB (EIA)	$149.40	$249.00	—	5% below	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB (EIA)	$149.40	$249.00	—	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA BY PCR	$646.20	$1,077.00	—	34% above	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C RNA BY PCR	$646.20	$1,077.00	—	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 86695/HSV AB TYPE 1	$82.80	$138.00	—	21% below	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695/HSV AB TYPE 1	$82.80	$138.00	—	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 86696/HSV AB TYPE 2	$110.40	$184.00	—	10% below	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696/HSV AB TYPE 2	$110.40	$184.00	—	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 HS-CRP	$70.20	$117.00	—	28% below	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HS-CRP	$70.20	$117.00	—	—	40%
Homocysteine blood test CPT 83090 HOMOCYSTEINE TOTAL	$129.78	$216.30	—	1% below	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE TOTAL	$129.78	$216.30	—	—	40%
Insulin blood test CPT 83525 INSULIN,TOTAL	$101.35	$168.92	—	10% above	40%
Insulin blood test inpatient CPT 83525 INSULIN,TOTAL	$101.35	$168.92	—	—	40%
Iron blood test (serum iron) CPT 83540 IRON TOTAL-SERUM	$78.49	$130.81	—	24% above	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON TOTAL-SERUM	$78.49	$130.81	—	—	40%
Iron-binding capacity (TIBC) test CPT 83550 TIBC	$33.99	$56.65	—	34% below	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC	$33.99	$56.65	—	—	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$61.80	$103.00	—	13% below	40%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$61.80	$103.00	—	—	40%
LH (luteinizing hormone) test CPT 83002 LH	$109.39	$182.31	—	17% below	40%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$109.39	$182.31	—	—	40%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$46.97	$78.28	—	56% below	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$46.97	$78.28	—	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH-CSF	$68.60	$114.33	—	38% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH-MISC FLUIDS	$68.60	$114.33	—	38% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH (LACTATE DEHYDROGENASE)	$68.60	$114.33	—	38% above	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH (LACTATE DEHYDROGENASE)	$68.60	$114.33	—	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH-MISC FLUIDS	$68.60	$114.33	—	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH-CSF	$68.60	$114.33	—	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$41.41	$69.01	—	45% below	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$41.41	$69.01	—	—	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$96.60	$161.00	—	43% above	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$96.60	$161.00	—	—	40%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$163.20	$272.00	—	56% above	40%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY	$163.20	$272.00	—	—	40%
Magnesium blood test CPT 83735 MAGNESIUM URINE-STONE	$18.54	$30.90	—	65% below	40%
Magnesium blood test CPT 83735 MAGNESIUM URINE	$58.71	$97.85	—	11% above	40%
Magnesium blood test CPT 83735 MAGNESIUM	$58.71	$97.85	—	11% above	40%
Magnesium blood test CPT 83735 MAGNESIUM RBC	$58.71	$97.85	—	11% above	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE-STONE	$18.54	$30.90	—	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE	$58.71	$97.85	—	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC	$58.71	$97.85	—	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$58.71	$97.85	—	—	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB QUANT	$134.40	$224.00	—	45% above	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB QUANT	$134.40	$224.00	—	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$62.40	$104.00	—	at median	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$62.40	$104.00	—	—	40%
Mumps immunity blood test CPT 86735 86735/MUMPS AB	$85.80	$143.00	—	11% below	40%
Mumps immunity blood test inpatient CPT 86735 86735/MUMPS AB	$85.80	$143.00	—	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$78.49	$130.81	—	29% below	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$78.49	$130.81	—	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$95.79	$159.65	—	9% below	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA-PROGNOSTIC	$95.79	$159.65	—	9% below	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$95.79	$159.65	—	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA-PROGNOSTIC	$95.79	$159.65	—	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 CYTOPATH WITH AUTO SCREEN	$113.40	$189.00	—	5% below	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 CYTOPATH WITH AUTO SCREEN	$113.40	$189.00	—	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 88142 *CYTO GYN	$82.20	$137.00	—	23% below	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 88142 *CYTO GYN	$82.20	$137.00	—	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 iPTH	$185.40	$309.00	—	25% below	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 iPTH	$185.40	$309.00	—	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT LA SCREEN	$34.80	$58.00	—	43% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME	$34.80	$58.00	—	43% below	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT LA SCREEN	$34.80	$58.00	—	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME	$34.80	$58.00	—	—	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHOROUS INORG-SERUM	$61.80	$103.00	—	3% below	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHOROUS INORG-SERUM	$61.80	$103.00	—	—	40%
Potassium blood test CPT 84132 POTASSIUM-SERUM	$47.59	$79.31	—	12% below	40%
Potassium blood test inpatient CPT 84132 POTASSIUM-SERUM	$47.59	$79.31	—	—	40%
Progesterone blood test CPT 84144 PROGESTERONE	$88.37	$147.29	—	42% below	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$88.37	$147.29	—	—	40%
Prolactin blood test CPT 84146 PROLACTIN	$114.95	$191.58	—	19% below	40%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$114.95	$191.58	—	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$33.60	$56.00	—	25% below	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$33.60	$56.00	—	—	40%
Rapid flu test (influenza antigen) CPT 87804 MHP INFLUENZA ASSAY W OPTIC	$22.34	$37.23	—	83% below	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 MHP INFLUENZA ASSAY W OPTIC	$22.34	$37.23	—	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 MHP RAPID STREP	$35.40	$59.00	—	55% below	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 MHP RAPID STREP	$35.40	$59.00	—	—	40%
Renin blood test CPT 84244 RENIN	$158.21	$263.68	—	3% above	40%
Renin blood test inpatient CPT 84244 RENIN	$158.21	$263.68	—	—	40%
Rh blood typing CPT 86901 RH FACTOR	$29.40	$49.00	—	47% below	40%
Rh blood typing inpatient CPT 86901 RH FACTOR	$29.40	$49.00	—	—	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR TITER	$19.80	$33.00	—	62% below	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR TITER	$19.80	$33.00	—	—	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IMMUNE SCREEN (IGG)	$77.40	$129.00	—	1% above	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IMMUNE SCREEN (IGG)	$77.40	$129.00	—	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE - WESTERGREN	$34.80	$58.00	—	4% below	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE AUTOMATED	$34.80	$58.00	—	4% below	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE AUTOMATED	$34.80	$58.00	—	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE - WESTERGREN	$34.80	$58.00	—	—	40%
Sodium blood test CPT 84295 SODIUM-SERUM	$54.38	$90.64	—	60% above	40%
Sodium blood test inpatient CPT 84295 SODIUM-SERUM	$54.38	$90.64	—	—	40%
Stool ova and parasites exam CPT 87177 O&P	$111.00	$185.00	—	at median	40%
Stool ova and parasites exam inpatient CPT 87177 O&P	$111.00	$185.00	—	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 MHP HEMOCULT SCREENING	$18.00	$30.00	—	51% below	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OB - NEOPLASM SCREENING	$18.00	$30.00	—	51% below	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 MHP HEMOCULT SCREENING	$18.00	$30.00	—	—	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OB - NEOPLASM SCREENING	$18.00	$30.00	—	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLD IMMUNOASSAY FECAL	$46.20	$77.00	—	53% below	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLD IMMUNOASSAY FECAL	$46.20	$77.00	—	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-ABS	$111.60	$186.00	—	3% below	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA-ABS	$111.60	$186.00	—	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL SERUM	$24.00	$40.00	—	36% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$52.80	$88.00	—	41% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL SERUM	$24.00	$40.00	—	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$52.80	$88.00	—	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON GOLD	$117.60	$196.00	—	47% below	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON GOLD	$117.60	$196.00	—	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$140.29	$233.81	—	11% below	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$140.29	$233.81	—	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB	$119.40	$199.00	—	5% below	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB	$119.40	$199.00	—	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$122.98	$204.97	—	4% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$122.98	$204.97	—	—	40%
Total IgE blood test CPT 82785 82785 IMMUNOGLOBULIN E (IGE)	$62.42	$104.03	—	35% below	40%
Total IgE blood test inpatient CPT 82785 82785 IMMUNOGLOBULIN E (IGE)	$62.42	$104.03	—	—	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL-SERUM	$53.15	$88.58	—	29% above	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL-SERUM	$53.15	$88.58	—	—	40%
Total thyroxine (T4) blood test CPT 84436 T4-TOTAL (THYROXIN)	$64.27	$107.12	—	6% below	40%
Total thyroxine (T4) blood test inpatient CPT 84436 T4-TOTAL (THYROXIN)	$64.27	$107.12	—	—	40%
Total triiodothyronine (T3) blood test CPT 84480 T3-TOTAL (TRIIODOTHYRONINE)	$106.30	$177.16	—	at median	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3-TOTAL (TRIIODOTHYRONINE)	$106.30	$177.16	—	—	40%
Transferrin blood test CPT 84466 TRANSFERRIN	$54.38	$90.64	—	66% below	40%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$54.38	$90.64	—	—	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDE	$66.13	$110.21	—	9% above	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE	$66.13	$110.21	—	—	40%
Troponin test, quantitative CPT 84484 TROPONIN I QUANT	$164.39	$273.98	—	31% above	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I QUANT	$164.39	$273.98	—	—	40%
Uric acid blood test CPT 84550 URIC ACID-SERUM	$61.80	$103.00	—	6% above	40%
Uric acid blood test inpatient CPT 84550 URIC ACID-SERUM	$61.80	$103.00	—	—	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS with MICRO	$33.60	$56.00	—	33% below	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICRO(REFLEX)	$33.60	$56.00	—	33% below	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICRO(REFLEX)	$33.60	$56.00	—	—	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS with MICRO	$33.60	$56.00	—	—	40%
Urinalysis with microscope exam, manual CPT 81000 MHP UA NONAUTO WITH SCOPE	$13.20	$22.00	—	29% below	40%
Urinalysis with microscope exam, manual CPT 81000 URINE-SPECIFIC GRAVITY	$18.60	$31.00	—	1% above	40%
Urinalysis with microscope exam, manual CPT 81000 SPECIFIC GRAVITY-MISC FLUIDS	$18.60	$31.00	—	1% above	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 MHP UA NONAUTO WITH SCOPE	$13.20	$22.00	—	—	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINE-SPECIFIC GRAVITY	$18.60	$31.00	—	—	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 SPECIFIC GRAVITY-MISC FLUIDS	$18.60	$31.00	—	—	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS WITH MICRO(REFLEX)	$22.80	$38.00	—	10% below	40%
Urinalysis without microscope exam, automated CPT 81003 URINE-SPECIFIC GRAVITY	$22.80	$38.00	—	10% below	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/O MICRO	$22.80	$38.00	—	10% below	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE-SPECIFIC GRAVITY	$22.80	$38.00	—	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS WITH MICRO(REFLEX)	$22.80	$38.00	—	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/O MICRO	$22.80	$38.00	—	—	40%
Urinalysis without microscope exam, manual CPT 81002 MHP URINE DIP	$13.80	$23.00	—	27% below	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 MHP URINE DIP	$13.80	$23.00	—	—	40%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE	$134.40	$224.00	—	63% above	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE	$134.40	$224.00	—	—	40%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN/CREAT RATIO	$86.52	$144.20	—	2% above	40%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN/CREAT RATIO	$86.52	$144.20	—	—	40%
Urine pregnancy test, read by color change CPT 81025 MHP URINE PREG TEST	$22.20	$37.00	—	40% below	40%
Urine pregnancy test, read by color change CPT 81025 HCG URINE	$22.20	$37.00	—	40% below	40%
Urine pregnancy test, read by color change inpatient CPT 81025 MHP URINE PREG TEST	$22.20	$37.00	—	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG URINE	$22.20	$37.00	—	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$61.18	$101.97	—	38% below	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$61.18	$101.97	—	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY	$142.76	$237.93	—	28% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY	$142.76	$237.93	—	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT 1 25 DIHYDROXY	$343.61	$572.68	—	8% above	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT 1 25 DIHYDROXY	$343.61	$572.68	—	—	40%
Zinc blood test CPT 84630 ZINC	$85.28	$142.14	—	9% below	40%
Zinc blood test inpatient CPT 84630 ZINC	$85.28	$142.14	—	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG	$98.26	$163.77	—	25% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT	$98.26	$163.77	—	25% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA-HCG (TUMOR)	$98.26	$163.77	—	25% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA-HCG (TUMOR)	$98.26	$163.77	—	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT	$98.26	$163.77	—	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG	$98.26	$163.77	—	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 MHP CL TX DISTAL FIB FX W/O MANIP	$54.00	$90.00	—	79% below	40%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 FX DISTAL FIB W/O MAN	$211.80	$353.00	—	16% below	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 MHP CL TX DISTAL FIB FX W/O MANIP	$54.00	$90.00	—	—	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 FX DISTAL FIB W/O MAN	$211.80	$353.00	—	—	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 FX METATARSAL W/O MAN	$211.80	$353.00	—	15% below	40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 FX METATARSAL W/O MAN	$211.80	$353.00	—	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION.............92960	$1,303.20	$2,172.00	—	18% above	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION.............92960	$1,303.20	$2,172.00	—	—	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION,NON NEWBORN	$240.60	$401.00	—	47% below	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION,CLAMP/OTHER DEVICE	$446.40	$744.00	—	1% below	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION,NON NEWBORN	$240.60	$401.00	—	—	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION,CLAMP/OTHER DEVICE	$446.40	$744.00	—	—	40%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION,SURGICAL EXCISION	$522.60	$871.00	—	11% above	40%
Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION,SURGICAL EXCISION	$522.60	$871.00	—	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CL REDUC DIST RAD FX W/O MAN	$197.40	$329.00	—	26% below	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CL REDUC DIST RAD FX W/O MAN	$197.40	$329.00	—	—	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 PULSE DI LASER	$383.40	$639.00	—	426% above	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 PULSE DI LASER	$383.40	$639.00	—	—	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 MHP CERUMEN IMPACT IRRIG W/O INSTRUMENT	$24.00	$40.00	—	67% below	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 MHP CERUMEN IMPACT IRRIG W/O INSTRUMENT	$24.00	$40.00	—	—	40%
Earwax removal with instruments, one ear CPT 69210 MHP CERUMEN IMPACT REMOVE	$26.40	$44.00	—	60% below	40%
Earwax removal with instruments, one ear CPT 69210 FB EAR IMPACTED CERUMEN	$100.80	$168.00	—	54% above	40%
Earwax removal with instruments, one ear inpatient CPT 69210 MHP CERUMEN IMPACT REMOVE	$26.40	$44.00	—	—	40%
Earwax removal with instruments, one ear inpatient CPT 69210 FB EAR IMPACTED CERUMEN	$100.80	$168.00	—	—	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 CT FACET JT PAIN INJ LS SPINE 1 LEVEL	$1,579.80	$2,633.00	—	17% above	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 CT FACET JT PAIN INJ LS SPINE 1 LEVEL	$1,579.80	$2,633.00	—	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Z-HYSTERO. (INJ)	$499.96	$833.27	—	55% above	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Z-HYSTERO. (INJ)	$499.96	$833.27	—	—	40%
IUD insertion (the device itself billed separately) CPT 58300 MHP INSERT IUD	$36.60	$61.00	—	93% below	40%
IUD insertion (the device itself billed separately) inpatient CPT 58300 MHP INSERT IUD	$36.60	$61.00	—	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 MHP I&D ABSCESS	$35.40	$59.00	—	83% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMP	$55.80	$93.00	—	74% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS,SIMPLE.......10060	$231.00	$385.00	—	8% above	40%
Incision and drainage of a simple or single skin abscess CPT 10060 Z-US ABCESS DRAINAGE SUBCUTANEOUS	$356.40	$594.00	—	67% above	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 MHP I&D ABSCESS	$35.40	$59.00	—	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMP	$55.80	$93.00	—	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS,SIMPLE.......10060	$231.00	$385.00	—	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Z-US ABCESS DRAINAGE SUBCUTANEOUS	$356.40	$594.00	—	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/TRIGGER PNT	$221.40	$369.00	—	24% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/TRIGGER PNT	$221.40	$369.00	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS,MAJOR JOINT	$267.60	$446.00	—	20% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Z-LARGE JOINT INJECTION/ASP	$507.60	$846.00	—	51% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Z-US LARGE JOINT INJECTION	$507.60	$846.00	—	51% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Z-CT LARGE JOINT INJECTION	$507.60	$846.00	—	51% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS,MAJOR JOINT	$267.60	$446.00	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Z-US LARGE JOINT INJECTION	$507.60	$846.00	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Z-CT LARGE JOINT INJECTION	$507.60	$846.00	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Z-LARGE JOINT INJECTION/ASP	$507.60	$846.00	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS,INTERMED JOINT	$267.60	$446.00	—	3% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Z-MEDIUM JOINT INJECTION	$507.60	$846.00	—	84% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Z-CT MEDIUM JOINT INJECTION	$507.60	$846.00	—	84% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Z-US MEDIUM JOINT INJECTION	$507.60	$846.00	—	84% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS,INTERMED JOINT	$267.60	$446.00	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Z-CT MEDIUM JOINT INJECTION	$507.60	$846.00	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Z-MEDIUM JOINT INJECTION	$507.60	$846.00	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Z-US MEDIUM JOINT INJECTION	$507.60	$846.00	—	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS,SML JOINT..20600	$244.80	$408.00	—	5% below	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Z-CT SMALL JOINT INJECTION	$507.60	$846.00	—	96% above	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Z-SMALL JOINT INJECTION	$507.60	$846.00	—	96% above	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS,SML JOINT..20600	$244.80	$408.00	—	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Z-SMALL JOINT INJECTION	$507.60	$846.00	—	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Z-CT SMALL JOINT INJECTION	$507.60	$846.00	—	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 MHP INTMD WND REPAIR STREXT	$154.20	$257.00	—	57% below	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC REP INT 0-2.5,SCLP/TRUNK .	$307.80	$513.00	—	15% below	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 MHP INTMD WND REPAIR STREXT	$154.20	$257.00	—	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC REP INT 0-2.5,SCLP/TRUNK .	$307.80	$513.00	—	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 CT EPIDURAL PAIN INJ LUMBAR OR SACRAL	$1,125.60	$1,876.00	—	12% above	40%
Lower-back epidural injection, with imaging guidance CPT 62323 EPIDURAL INJ LUMBAR OR SACRAL SPINE	$1,125.60	$1,876.00	—	12% above	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CT EPIDURAL PAIN INJ LUMBAR OR SACRAL	$1,125.60	$1,876.00	—	—	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 EPIDURAL INJ LUMBAR OR SACRAL SPINE	$1,125.60	$1,876.00	—	—	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 LS TRANSFOR EPIDURAL INJ SINGLE LEVEL	$1,119.60	$1,866.00	—	4% below	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 CT LS TRANSFOR EPIDURAL INJ SINGLE LEVEL	$1,119.60	$1,866.00	—	4% below	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 LS TRANSFOR EPIDURAL INJ SINGLE LEVEL	$1,119.60	$1,866.00	—	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 CT LS TRANSFOR EPIDURAL INJ SINGLE LEVEL	$1,119.60	$1,866.00	—	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 MHP EXC TREXT B9MARG 05 CM	$75.60	$126.00	—	75% below	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BENIGN LESION 5CM	$798.60	$1,331.00	—	165% above	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 MHP EXC TREXT B9MARG 05 CM	$75.60	$126.00	—	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BENIGN LESION 5CM	$798.60	$1,331.00	—	—	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 MHP EXC BENIGN LESION >1	$66.00	$110.00	—	80% below	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 MHP EXC BENIGN LESION >1	$66.00	$110.00	—	—	40%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SIMPLE	$43.20	$72.00	—	75% below	40%
Nail removal (partial or complete), one nail CPT 11730 MHP AVULSION NAIL PLATE SIMPLE	$85.20	$142.00	—	51% below	40%
Nail removal (partial or complete), one nail CPT 11730 AVULSION,NAIL PLATE,1ST NAIL11730	$106.20	$177.00	—	39% below	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SIMPLE	$43.20	$72.00	—	—	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 MHP AVULSION NAIL PLATE SIMPLE	$85.20	$142.00	—	—	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION,NAIL PLATE,1ST NAIL11730	$106.20	$177.00	—	—	40%
Occipital nerve block (injection for headaches) CPT 64405 MHP INJECT GREAT OCCIPITAL NERVE	$66.00	$110.00	—	83% below	40%
Occipital nerve block (injection for headaches) CPT 64405 NERVE BLOCK INJ OCCIPITAL	$493.20	$822.00	—	29% above	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 MHP INJECT GREAT OCCIPITAL NERVE	$66.00	$110.00	—	—	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 NERVE BLOCK INJ OCCIPITAL	$493.20	$822.00	—	—	40%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS WITH IMAGING	$1,236.60	$2,061.00	—	22% above	40%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS W/ IMAGE	$1,282.20	$2,137.00	—	27% above	40%
Paracentesis with imaging guidance CPT 49083 US PARACENTESIS	$1,951.80	$3,253.00	—	93% above	40%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS WITH IMAGING	$1,236.60	$2,061.00	—	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS W/ IMAGE	$1,282.20	$2,137.00	—	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 US PARACENTESIS	$1,951.80	$3,253.00	—	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL PT OR COMP MATRIX	$64.80	$108.00	—	84% below	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 MHP REMOVAL NAIL BED	$87.60	$146.00	—	79% below	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL EXCISION............11750	$368.40	$614.00	—	11% below	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL PT OR COMP MATRIX	$64.80	$108.00	—	—	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 MHP REMOVAL NAIL BED	$87.60	$146.00	—	—	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 NAIL EXCISION............11750	$368.40	$614.00	—	—	40%
Removal of a foreign object under the skin, simple CPT 10120 MHP REM FOREIGN BODY	$84.60	$141.00	—	72% below	40%
Removal of a foreign object under the skin, simple CPT 10120 FB SQ TISSUE,SIMPLE......10120	$229.80	$383.00	—	25% below	40%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FOREIGN BODY SIMPLE	$394.80	$658.00	—	29% above	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 MHP REM FOREIGN BODY	$84.60	$141.00	—	—	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 FB SQ TISSUE,SIMPLE......10120	$229.80	$383.00	—	—	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVAL FOREIGN BODY SIMPLE	$394.80	$658.00	—	—	40%
Short arm cast (elbow to hand) CPT 29075 MHP APPLY FOREARM CAST	$42.00	$70.00	—	68% below	40%
Short arm cast (elbow to hand) CPT 29075 CAST,SHORT ARM..........29075	$151.80	$253.00	—	16% above	40%
Short arm cast (elbow to hand) inpatient CPT 29075 MHP APPLY FOREARM CAST	$42.00	$70.00	—	—	40%
Short arm cast (elbow to hand) inpatient CPT 29075 CAST,SHORT ARM..........29075	$151.80	$253.00	—	—	40%
Short arm splint (forearm and hand) CPT 29125 MHP APPLY FOREARM SPLINT	$43.20	$72.00	—	63% below	40%
Short arm splint (forearm and hand) CPT 29125 SPLINT,SHORT ARM..........29125	$130.80	$218.00	—	11% above	40%
Short arm splint (forearm and hand) inpatient CPT 29125 MHP APPLY FOREARM SPLINT	$43.20	$72.00	—	—	40%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT,SHORT ARM..........29125	$130.80	$218.00	—	—	40%
Short leg cast (below the knee) CPT 29405 MHP APPLY SHORT LEG CAST	$37.20	$62.00	—	84% below	40%
Short leg cast (below the knee) CPT 29405 CAST,SHORT LEG.............29405	$178.80	$298.00	—	25% below	40%
Short leg cast (below the knee) inpatient CPT 29405 MHP APPLY SHORT LEG CAST	$37.20	$62.00	—	—	40%
Short leg cast (below the knee) inpatient CPT 29405 CAST,SHORT LEG.............29405	$178.80	$298.00	—	—	40%
Short leg splint (calf to foot) CPT 29515 MHP APPLY LOWER LEG SPLINT	$37.80	$63.00	—	67% below	40%
Short leg splint (calf to foot) CPT 29515 SPLINT,SHORT LEG..........29515	$163.80	$273.00	—	43% above	40%
Short leg splint (calf to foot) inpatient CPT 29515 MHP APPLY LOWER LEG SPLINT	$37.80	$63.00	—	—	40%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT,SHORT LEG..........29515	$163.80	$273.00	—	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 MHP SUTURE SIMPLE <2.5 BODY	$79.20	$132.00	—	65% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC REP SIMP 0-2.5,SCLP/HD/FT	$278.40	$464.00	—	22% above	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 MHP SUTURE SIMPLE <2.5 BODY	$79.20	$132.00	—	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC REP SIMP 0-2.5,SCLP/HD/FT	$278.40	$464.00	—	—	40%
Skin biopsy, punch, one lesion CPT 11104 MHP PUNCH BIOPSY SKIN	$72.60	$121.00	—	53% below	40%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$356.40	$594.00	—	130% above	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 MHP PUNCH BIOPSY SKIN	$72.60	$121.00	—	—	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$356.40	$594.00	—	—	40%
Skin tag removal, up to 15 tags CPT 11200 MHP EXC SKIN TAGS <16	$26.40	$44.00	—	82% below	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 MHP EXC SKIN TAGS <16	$26.40	$44.00	—	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE,NEONATAL	$387.60	$646.00	—	29% below	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE,PEDI	$403.20	$672.00	—	26% below	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNTURE DIAGNOSTIC	$403.20	$672.00	—	26% below	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE.............62270	$436.20	$727.00	—	20% below	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE,ADULT	$436.20	$727.00	—	20% below	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE,NEONATAL	$387.60	$646.00	—	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE,PEDI	$403.20	$672.00	—	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNTURE DIAGNOSTIC	$403.20	$672.00	—	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE.............62270	$436.20	$727.00	—	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE,ADULT	$436.20	$727.00	—	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 MHP SUTURE SIMPLE 2.6-7.5	$67.80	$113.00	—	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 LAC REP SIMP 2.6-7.5 SCLP/HD/FT	$278.40	$464.00	—	3% above	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 MHP SUTURE SIMPLE 2.6-7.5	$67.80	$113.00	—	—	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 LAC REP SIMP 2.6-7.5 SCLP/HD/FT	$278.40	$464.00	—	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 MHP SUTURE SIMPLE <2.5 FACE	$94.80	$158.00	—	61% below	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC REP SIMP <2.6 FACE...12011	$278.40	$464.00	—	16% above	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 MHP SUTURE SIMPLE <2.5 FACE	$94.80	$158.00	—	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC REP SIMP <2.6 FACE...12011	$278.40	$464.00	—	—	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 MHP TANGENITAL BIOPSY OF SKIN	$57.60	$96.00	—	43% below	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 MHP TANGENITAL BIOPSY SKIN	$57.60	$96.00	—	43% below	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$356.40	$594.00	—	255% above	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 MHP TANGENITAL BIOPSY OF SKIN	$57.60	$96.00	—	—	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 MHP TANGENITAL BIOPSY SKIN	$57.60	$96.00	—	—	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$356.40	$594.00	—	—	40%
Thoracentesis with imaging guidance CPT 32555 MHP THORACENTESIS W/IMAGE GUIDE	$306.00	$510.00	—	71% below	40%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS WITH IMAGING	$1,017.60	$1,696.00	—	4% below	40%
Thoracentesis with imaging guidance CPT 32555 CT THORACENTESIS	$1,657.80	$2,763.00	—	56% above	40%
Thoracentesis with imaging guidance CPT 32555 US THORACENTESIS	$1,657.80	$2,763.00	—	56% above	40%
Thoracentesis with imaging guidance CPT 32555 CT PERCUTANEOUS CHOLECYSTOSTOMY	$4,163.40	$6,939.00	—	292% above	40%
Thoracentesis with imaging guidance inpatient CPT 32555 MHP THORACENTESIS W/IMAGE GUIDE	$306.00	$510.00	—	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS WITH IMAGING	$1,017.60	$1,696.00	—	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 CT THORACENTESIS	$1,657.80	$2,763.00	—	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 US THORACENTESIS	$1,657.80	$2,763.00	—	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 CT PERCUTANEOUS CHOLECYSTOSTOMY	$4,163.40	$6,939.00	—	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCLE	$444.60	$741.00	—	61% above	40%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJECTION	$499.80	$833.00	—	81% above	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1/2 MUSCLE	$444.60	$741.00	—	—	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJECTION	$499.80	$833.00	—	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 MHP BIOPSY BREAST W/PLACE CLIP US GUIDE	$2,476.20	$4,127.00	—	58% above	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US BIOPSY BREAST	$3,101.40	$5,169.00	—	98% above	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 MHP BIOPSY BREAST W/PLACE CLIP US GUIDE	$2,476.20	$4,127.00	—	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US BIOPSY BREAST	$3,101.40	$5,169.00	—	—	40%
Wart removal, up to 14 warts CPT 17110 MHP DESTRUCT WARt </= 14	$43.20	$72.00	—	41% below	40%
Wart removal, up to 14 warts CPT 17110 EXCISION WART.........17110	$58.80	$98.00	—	19% below	40%
Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LESION </= 14	$382.80	$638.00	—	425% above	40%
Wart removal, up to 14 warts inpatient CPT 17110 MHP DESTRUCT WARt </= 14	$43.20	$72.00	—	—	40%
Wart removal, up to 14 warts inpatient CPT 17110 EXCISION WART.........17110	$58.80	$98.00	—	—	40%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LESION </= 14	$382.80	$638.00	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 MHP DEBRIDE SUBQ 1ST 20 CM	$94.20	$157.00	—	71% below	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN & SUBCU....11042	$293.40	$489.00	—	11% below	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SUBQ 1ST 20 CM	$394.80	$658.00	—	20% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 MHP DEBRIDE SUBQ 1ST 20 CM	$94.20	$157.00	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN & SUBCU....11042	$293.40	$489.00	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SUBQ 1ST 20 CM	$394.80	$658.00	—	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION 0-4 HOURS	$450.60	$751.00	—	45% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION 4-8 HOURS	$825.00	$1,375.00	—	1% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION >8 HOURS	$1,330.20	$2,217.00	—	63% above	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION 0-4 HOURS	$450.60	$751.00	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION 4-8 HOURS	$825.00	$1,375.00	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION >8 HOURS	$1,330.20	$2,217.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHAL TX/MDI INITIAL	$67.80	$113.00	—	48% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PF-AIRWAY INHALATION RX INITIAL	$67.80	$113.00	—	48% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MHP INHAL TX	$75.60	$126.00	—	42% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL TX/MDI INITIAL	$67.80	$113.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PF-AIRWAY INHALATION RX INITIAL	$67.80	$113.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MHP INHAL TX	$75.60	$126.00	—	—	40%
Chemotherapy IV infusion, first hour CPT 96413 CHEM ADMIN IV INFUS 1ST HR SGL/IN	$335.40	$559.00	—	41% below	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEM ADMIN IV INFUS 1ST HR SGL/IN	$335.40	$559.00	—	—	40%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE	$1,452.60	$2,421.00	—	31% below	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE	$1,452.60	$2,421.00	—	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG - AWAKE	$448.80	$748.00	—	46% below	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG - AWAKE	$448.80	$748.00	—	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG FACILITY FEE	$130.20	$217.00	—	15% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CARDIOLOGY EKG FACILITY FEE	$143.40	$239.00	—	7% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 MHP EKG FACILITY FEE	$143.40	$239.00	—	7% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG FACILITY FEE	$130.20	$217.00	—	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 MHP EKG FACILITY FEE	$143.40	$239.00	—	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CARDIOLOGY EKG FACILITY FEE	$143.40	$239.00	—	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED LEVEL I	$192.00	$320.00	—	at median	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED LEVEL I	$192.00	$320.00	—	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED LEVEL II	$352.20	$587.00	—	22% above	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED LEVEL II	$352.20	$587.00	—	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED LEVEL III	$668.40	$1,114.00	—	26% above	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED LEVEL III	$668.40	$1,114.00	—	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED LEVEL IV	$874.20	$1,457.00	—	6% below	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED LEVEL IV	$874.20	$1,457.00	—	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED LEVEL V	$1,359.00	$2,265.00	—	4% above	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED LEVEL V	$1,359.00	$2,265.00	—	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$928.20	$1,547.00	—	10% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE STRESS TEST	$928.20	$1,547.00	—	10% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST WITH MIBI OR ECHO	$928.20	$1,547.00	—	10% above	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST	$928.20	$1,547.00	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EXERCISE STRESS TEST	$928.20	$1,547.00	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST WITH MIBI OR ECHO	$928.20	$1,547.00	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION ONLY 31-90 MIN	$247.20	$412.00	—	26% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION ONLY 31-90 MIN	$247.20	$412.00	—	—	40%
IV infusion of a medicine, first hour CPT 96365 MHP IV INFUS 1ST HR	$249.00	$415.00	—	26% below	40%
IV infusion of a medicine, first hour CPT 96365 IV INFUS TX 1ST HR	$345.00	$575.00	—	2% above	40%
IV infusion of a medicine, first hour inpatient CPT 96365 MHP IV INFUS 1ST HR	$249.00	$415.00	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS TX 1ST HR	$345.00	$575.00	—	—	40%
IV push of a medicine, first drug CPT 96374 INJECT IV PUSH SINGLE/INITIAL	$119.40	$199.00	—	38% below	40%
IV push of a medicine, first drug CPT 96374 IV INJECT PUSH SINGLE/INITIAL	$119.40	$199.00	—	38% below	40%
IV push of a medicine, first drug inpatient CPT 96374 IV INJECT PUSH SINGLE/INITIAL	$119.40	$199.00	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 INJECT IV PUSH SINGLE/INITIAL	$119.40	$199.00	—	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SQ/IM	$44.40	$74.00	—	48% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 MHP INJECT SUB Q/IM	$44.40	$74.00	—	48% below	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 MHP INJECT SUB Q/IM	$44.40	$74.00	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SQ/IM	$44.40	$74.00	—	—	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 MHP PSYCH DIAGNOSTIC EVAL	$33.60	$56.00	—	93% below	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 MHP PSYCH DIAGNOSTIC EVAL	$33.60	$56.00	—	—	40%
New patient office visit, about 30 minutes CPT 99203 WH LEVEL 3 NEW INTERM	$28.20	$47.00	—	82% below	40%
New patient office visit, about 30 minutes CPT 99203 MHP OFC/OP VISIT NEW LEVEL III	$31.80	$53.00	—	79% below	40%
New patient office visit, about 30 minutes CPT 99203 ANTICOAG CLINIC NEW PT LEVEL 3	$123.60	$206.00	—	20% below	40%
New patient office visit, about 30 minutes CPT 99203 OH LEVEL III	$163.80	$273.00	—	6% above	40%
New patient office visit, about 30 minutes CPT 99203 HEM/ONC LEVEL III	$190.80	$318.00	—	23% above	40%
New patient office visit, about 30 minutes inpatient CPT 99203 WH LEVEL 3 NEW INTERM	$28.20	$47.00	—	—	40%
New patient office visit, about 30 minutes inpatient CPT 99203 MHP OFC/OP VISIT NEW LEVEL III	$31.80	$53.00	—	—	40%
New patient office visit, about 30 minutes inpatient CPT 99203 ANTICOAG CLINIC NEW PT LEVEL 3	$123.60	$206.00	—	—	40%
New patient office visit, about 30 minutes inpatient CPT 99203 OH LEVEL III	$163.80	$273.00	—	—	40%
New patient office visit, about 30 minutes inpatient CPT 99203 HEM/ONC LEVEL III	$190.80	$318.00	—	—	40%
New patient office visit, about 45 minutes CPT 99204 MHP OFC/OP VISIT NEW LEVEL IV	$34.20	$57.00	—	84% below	40%
New patient office visit, about 45 minutes CPT 99204 WH LEVEL 4 NEW EXTEND	$36.60	$61.00	—	83% below	40%
New patient office visit, about 45 minutes CPT 99204 ANTICOAG NEW PT VISIT LEVEL 4	$175.20	$292.00	—	18% below	40%
New patient office visit, about 45 minutes CPT 99204 OH LEVEL IV	$280.20	$467.00	—	31% above	40%
New patient office visit, about 45 minutes CPT 99204 HEM/ONC LEVEL IV	$328.20	$547.00	—	54% above	40%
New patient office visit, about 45 minutes inpatient CPT 99204 MHP OFC/OP VISIT NEW LEVEL IV	$34.20	$57.00	—	—	40%
New patient office visit, about 45 minutes inpatient CPT 99204 WH LEVEL 4 NEW EXTEND	$36.60	$61.00	—	—	40%
New patient office visit, about 45 minutes inpatient CPT 99204 ANTICOAG NEW PT VISIT LEVEL 4	$175.20	$292.00	—	—	40%
New patient office visit, about 45 minutes inpatient CPT 99204 OH LEVEL IV	$280.20	$467.00	—	—	40%
New patient office visit, about 45 minutes inpatient CPT 99204 HEM/ONC LEVEL IV	$328.20	$547.00	—	—	40%
New patient office visit, about 60 minutes CPT 99205 WH LEVEL 5 NEW COMPLEX	$39.60	$66.00	—	85% below	40%
New patient office visit, about 60 minutes CPT 99205 MHP OFC/OP VISIT NEW LEVEL V	$41.40	$69.00	—	85% below	40%
New patient office visit, about 60 minutes CPT 99205 ANTICOAG NEW PT VISIT LEVEL 5	$222.00	$370.00	—	18% below	40%
New patient office visit, about 60 minutes CPT 99205 OH LEVEL V	$468.60	$781.00	—	72% above	40%
New patient office visit, about 60 minutes CPT 99205 HEM/ONC LEVEL V	$546.60	$911.00	—	101% above	40%
New patient office visit, about 60 minutes inpatient CPT 99205 WH LEVEL 5 NEW COMPLEX	$39.60	$66.00	—	—	40%
New patient office visit, about 60 minutes inpatient CPT 99205 MHP OFC/OP VISIT NEW LEVEL V	$41.40	$69.00	—	—	40%
New patient office visit, about 60 minutes inpatient CPT 99205 ANTICOAG NEW PT VISIT LEVEL 5	$222.00	$370.00	—	—	40%
New patient office visit, about 60 minutes inpatient CPT 99205 OH LEVEL V	$468.60	$781.00	—	—	40%
New patient office visit, about 60 minutes inpatient CPT 99205 HEM/ONC LEVEL V	$546.60	$911.00	—	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WH LEVEL 2 NEW LIMITED	$21.00	$35.00	—	82% below	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 MHP OFC/OP VISIT NEW LEVEL II	$24.00	$40.00	—	80% below	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 ANTICOAG CLINIC NEW PT LEVEL 2	$82.80	$138.00	—	30% below	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OH LEVEL II	$111.60	$186.00	—	6% below	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HEM/ONC LEVEL II	$132.60	$221.00	—	11% above	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WH LEVEL 2 NEW LIMITED	$21.00	$35.00	—	—	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 MHP OFC/OP VISIT NEW LEVEL II	$24.00	$40.00	—	—	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 ANTICOAG CLINIC NEW PT LEVEL 2	$82.80	$138.00	—	—	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OH LEVEL II	$111.60	$186.00	—	—	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HEM/ONC LEVEL II	$132.60	$221.00	—	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 DIAB ED MED NUTRI TX INITIAL 15MI	$39.00	$65.00	—	35% below	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUT TX INITIAL/15 MIN	$39.00	$65.00	—	35% below	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 DIAB ED MED NUTRI TX INITIAL 15MI	$39.00	$65.00	—	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUT TX INITIAL/15 MIN	$39.00	$65.00	—	—	40%
Preventive checkup, new patient aged 18–39 CPT 99385 MHP PREV VISIT NEW AGE 18-39	$33.00	$55.00	—	70% below	40%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 MHP PREV VISIT NEW AGE 18-39	$33.00	$55.00	—	—	40%
Preventive checkup, new patient aged 40–64 CPT 99386 MHP PREV VISIT NEW AGE 40-64	$33.00	$55.00	—	57% below	40%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 MHP PREV VISIT NEW AGE 40-64	$33.00	$55.00	—	—	40%
Preventive checkup, new patient aged 65 or older CPT 99387 MHP PREV VISIT NEW 65 AND OVER	$37.20	$62.00	—	73% below	40%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 MHP PREV VISIT NEW 65 AND OVER	$37.20	$62.00	—	—	40%
Preventive checkup, returning patient aged 18–39 CPT 99395 MHP PREV VISIT EST AGE 18-39	$33.00	$55.00	—	45% below	40%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 MHP PREV VISIT EST AGE 18-39	$33.00	$55.00	—	—	40%
Preventive checkup, returning patient aged 40–64 CPT 99396 MHP PREV VISIT EST AGE 40-64	$33.60	$56.00	—	47% below	40%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 MHP PREV VISIT EST AGE 40-64	$33.60	$56.00	—	—	40%
Preventive checkup, returning patient aged 65 or older CPT 99397 MHP PREV VISIT EST 65 AND OVER	$27.00	$45.00	—	61% below	40%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 MHP PREV VISIT EST 65 AND OVER	$27.00	$45.00	—	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 MHP SMOKING CESSATION 3-10 MIN	$33.60	$56.00	—	7% below	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKE/TOBACCO COUNSELING 3-10 MIN	$33.60	$56.00	—	7% below	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 MM-SMOKING CESSATION 3-10 MIN	$33.60	$56.00	—	7% below	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 PF-SMOKING CESSATION 3-10 MIN	$33.60	$56.00	—	7% below	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION 3-10 MIN	$33.60	$56.00	—	7% below	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION 3-10 MIN	$33.60	$56.00	—	—	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 MHP SMOKING CESSATION 3-10 MIN	$33.60	$56.00	—	—	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKE/TOBACCO COUNSELING 3-10 MIN	$33.60	$56.00	—	—	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 MM-SMOKING CESSATION 3-10 MIN	$33.60	$56.00	—	—	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 PF-SMOKING CESSATION 3-10 MIN	$33.60	$56.00	—	—	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 MHP OFC/OP VISIT EST LEVEL V	$33.60	$56.00	—	84% below	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WH LEVEL 5 EST COMPLEX	$34.20	$57.00	—	84% below	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ANTICOAG VISIT EST LEVEL 5	$153.60	$256.00	—	28% below	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OH F/U LEVEL V	$280.20	$467.00	—	30% above	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HEM/ONC F/U LEVEL V	$360.00	$600.00	—	68% above	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OB LEVEL V	$862.80	$1,438.00	—	302% above	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 MHP OFC/OP VISIT EST LEVEL V	$33.60	$56.00	—	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WH LEVEL 5 EST COMPLEX	$34.20	$57.00	—	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ANTICOAG VISIT EST LEVEL 5	$153.60	$256.00	—	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OH F/U LEVEL V	$280.20	$467.00	—	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HEM/ONC F/U LEVEL V	$360.00	$600.00	—	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OB LEVEL V	$862.80	$1,438.00	—	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 MHP OFC/OP VISIT EST LEVEL III	$20.40	$34.00	—	78% below	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WH LEVEL 3 EST INTERM	$21.00	$35.00	—	77% below	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ANTICOAG VISIT EST LEVEL 3	$67.20	$112.00	—	27% below	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OH F/U LEVEL III	$111.60	$186.00	—	21% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HEM/ONC F/U LEVEL III	$143.40	$239.00	—	55% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OB LEVEL III	$380.40	$634.00	—	311% above	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 MHP OFC/OP VISIT EST LEVEL III	$20.40	$34.00	—	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WH LEVEL 3 EST INTERM	$21.00	$35.00	—	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ANTICOAG VISIT EST LEVEL 3	$67.20	$112.00	—	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OH F/U LEVEL III	$111.60	$186.00	—	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HEM/ONC F/U LEVEL III	$143.40	$239.00	—	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OB LEVEL III	$380.40	$634.00	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 MHP OFC/OP VISIT EST LEVEL IV	$27.60	$46.00	—	80% below	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WH LEVEL 4 EST EXTEND	$28.20	$47.00	—	80% below	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ANTICOAG VISIT EST LEVEL 4	$108.60	$181.00	—	22% below	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OH F/U LEVEL IV	$163.80	$273.00	—	17% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HEM/ONC F/U LEVEL IV	$211.20	$352.00	—	51% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OB LEVEL IV	$760.80	$1,268.00	—	445% above	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 MHP OFC/OP VISIT EST LEVEL IV	$27.60	$46.00	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WH LEVEL 4 EST EXTEND	$28.20	$47.00	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ANTICOAG VISIT EST LEVEL 4	$108.60	$181.00	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OH F/U LEVEL IV	$163.80	$273.00	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HEM/ONC F/U LEVEL IV	$211.20	$352.00	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OB LEVEL IV	$760.80	$1,268.00	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 MHP OFC/OP VISIT EST LEVEL II	$15.60	$26.00	—	83% below	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WH LEVEL 2 EST LIMITED	$17.40	$29.00	—	81% below	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ANTICOAG VISIT EST LEVEL 2	$50.40	$84.00	—	45% below	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OH F/U LEVEL II	$67.20	$112.00	—	26% below	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HEM/ONC F/U LEVEL II	$77.40	$129.00	—	15% below	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OB LEVEL II	$190.80	$318.00	—	109% above	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 MHP OFC/OP VISIT EST LEVEL II	$15.60	$26.00	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WH LEVEL 2 EST LIMITED	$17.40	$29.00	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ANTICOAG VISIT EST LEVEL 2	$50.40	$84.00	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OH F/U LEVEL II	$67.20	$112.00	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HEM/ONC F/U LEVEL II	$77.40	$129.00	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OB LEVEL II	$190.80	$318.00	—	—	40%
Specialist consultation, low complexity or 30+ minutes CPT 99243 MHP OFC CONSULT LEVEL III	$26.40	$44.00	—	48% below	40%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 MHP OFC CONSULT LEVEL III	$26.40	$44.00	—	—	40%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 MHP OFC CONSULT LEVEL IV	$28.80	$48.00	—	64% below	40%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 MHP OFC CONSULT LEVEL IV	$28.80	$48.00	—	—	40%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$194.40	$324.00	—	1% below	40%
Spirometry (breathing test) CPT 94010 PF-PFT SPIROMETRY	$194.40	$324.00	—	1% below	40%
Spirometry (breathing test) inpatient CPT 94010 PF-PFT SPIROMETRY	$194.40	$324.00	—	—	40%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$194.40	$324.00	—	—	40%
Spirometry before and after a bronchodilator CPT 94060 PFT PRE/POST	$332.40	$554.00	—	2% below	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT PRE/POST	$332.40	$554.00	—	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$427.80	$713.00	—	75% above	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$427.80	$713.00	—	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLUAD 65 YRS AND OVER	$30.45	$50.75	—	55% below	40%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLUAD 65 YRS AND OVER	$30.45	$50.75	—	—	40%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 MHP COVID VACCINE 12+ YRS MODERNA	$238.80	$398.00	—	56% above	40%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 MHP COVID VACCINE 12+ YRS MODERNA	$238.80	$398.00	—	—	40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 MHP VARICELLA CHICKEN POX VACCINE	$108.00	$180.00	—	77% below	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 MHP VARICELLA CHICKEN POX VACCINE	$108.00	$180.00	—	—	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 MHP HPV 9 (Gardasil 9)	$201.60	$336.00	—	28% below	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 MHP HPV 9 (Gardasil 9)	$201.60	$336.00	—	—	40%
Hepatitis A vaccine, adult dose CPT 90632 MHP HEP A ADULT 19 AND OLDER	$75.78	$126.30	—	3% above	40%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE (PF) SUSP 1,440 UNIT/ML	$78.05	$130.09	—	6% above	40%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A INJ	$94.64	$157.74	—	28% above	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 MHP HEP A ADULT 19 AND OLDER	$75.78	$126.30	—	—	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VIRUS VACCINE (PF) SUSP 1,440 UNIT/ML	$78.05	$130.09	—	—	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A INJ	$94.64	$157.74	—	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RHC HEP B ADULT 19+ YRS	$41.46	$69.10	—	76% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACC.REC(PF) SYRG 20 MCG/ML	$57.78	$96.30	—	67% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B INJ	$65.53	$109.21	—	62% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 RHC HEP B ADULT 19+ YRS	$41.46	$69.10	—	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACC.REC(PF) SYRG 20 MCG/ML	$57.78	$96.30	—	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B INJ	$65.53	$109.21	—	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VACCINE HIGH DOSE	$35.74	$59.57	—	68% below	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VACCINE HIGH DOSE	$35.74	$59.57	—	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES, MUMPS /RUBELLA VAC INJ	$122.09	$203.48	—	12% above	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES, MUMPS /RUBELLA VAC INJ	$122.09	$203.48	—	—	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 RHC MENINGOCOCCAL A C Y W 19+ YRS	$126.00	$210.00	—	4% above	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 RHC MENINGOCOCCAL A C Y W 19+ YRS	$126.00	$210.00	—	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 RHC MENINGOCOCCAL B BEXSERO 19+ YRS	$126.60	$211.00	—	31% below	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 RHC MENINGOCOCCAL B BEXSERO 19+ YRS	$126.60	$211.00	—	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23-VALPS VACCINE INJ 25 MCG/0.5 ML	$69.83	$116.39	—	69% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23-VALPS VACCINE INJ 25 MCG/0.5 ML	$69.83	$116.39	—	—	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP SYRG 50 MG/0.5 ML	$796.12	$1,326.87	—	39% below	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP SYRG 50 MG/0.5 ML	$796.12	$1,326.87	—	—	40%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC (PF) SOLR 2.5 UNIT	$489.89	$816.48	—	22% below	40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC (PF) SOLR 2.5 UNIT	$489.89	$816.48	—	—	40%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX	$200.85	$334.75	—	5% above	40%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX	$200.85	$334.75	—	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS-TD SYRG 5-2 LF UNIT/0.5 ML	$34.78	$57.96	—	53% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS DIPTHERIA	$41.03	$68.39	—	45% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD	$49.80	$83.00	—	33% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS-TD SYRG 5-2 LF UNIT/0.5 ML	$34.78	$57.96	—	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS DIPTHERIA	$41.03	$68.39	—	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD	$49.80	$83.00	—	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS, DIPH,PERTUSS(ACEL) VAC(PF) SUSP 2.5-8-5 LF-MCG-LF/0.5ML	$48.78	$81.31	—	14% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP 0.5ML	$54.27	$90.45	—	4% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS, DIPH,PERTUSS(ACEL) VAC(PF) SUSP 2.5-8-5 LF-MCG-LF/0.5ML	$48.78	$81.31	—	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP 0.5ML	$54.27	$90.45	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 RHC NH MCAID ADMIN VACCINE SINGLE	$13.21	$22.02	—	58% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE SINGLE	$40.80	$68.00	—	30% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 MHP ADMIN VACCINE SINGLE	$40.80	$68.00	—	30% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 RHC NH MCAID ADMIN VACCINE SINGLE	$13.21	$22.02	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 MHP ADMIN VACCINE SINGLE	$40.80	$68.00	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE SINGLE	$40.80	$68.00	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 RHC NH MCAID ADMIN VACCINE MULTI	$13.21	$22.02	—	59% below	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN VACCINE EA ADDTL	$29.40	$49.00	—	10% below	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN VACCINE MULTI	$29.40	$49.00	—	10% below	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 MHP ADMIN VACCINE MULTI	$29.40	$49.00	—	10% below	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN VACCINE EA ADDL	$29.40	$49.00	—	10% below	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 RHC NH MCAID ADMIN VACCINE MULTI	$13.21	$22.02	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN VACCINE EA ADDL	$29.40	$49.00	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 MHP ADMIN VACCINE MULTI	$29.40	$49.00	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN VACCINE MULTI	$29.40	$49.00	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN VACCINE EA ADDTL	$29.40	$49.00	—	—	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://hospitalpricedisclosure.com/download.aspx?pi=96OHZrUcIshoMmRv3TQ0Bg*-*