Monadnock Community Hospital
Monadnock Community Hospital in Peterborough, NH publishes cash prices for 53 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Click a procedure to compare it with other hospitals nearby.
452 Old Street Road, Peterborough, NH 03458 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD AND PELVIS W/CONTRAST | $3,266.36 | $5,443.93 | 40% |
| CT scan of abdomen and pelvis, with contrast dye 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, with contrast dye inpatient CPT 74177 CT ENTEROGRAPHY | $3,266.36 | $5,443.93 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONTRAST | $1,272.46 | $2,120.77 | 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 pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST | $1,663.27 | $2,772.11 | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS 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 AUG BILAT DIAGNOSTIC | $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 inpatient both sides CPT 77066 MA ADD/V/BILAT | $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, one breast one side CPT 77065 MA ADD/V LT | $340.80 | $568.00 | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MA DIAG 2/V LT WITH CAD | $340.80 | $568.00 | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MA ADD/V RT | $340.80 | $568.00 | 40% |
| Diagnostic mammogram, one breast 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 DIAG 2/V LT WITH CAD | $340.80 | $568.00 | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA ADD/V RT | $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 DIAG 2/V RT WITH CAD | $340.80 | $568.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MR BRAIN W/O CONTRAST | $2,299.58 | $3,832.63 | 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 | 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 | 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% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB GREATER THAN 14WKS | $757.05 | $1,261.75 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB GREATER THAN 14WKS | $757.05 | $1,261.75 | 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% |
| Transvaginal pelvic ultrasound CPT 76830 US ENDOVAGINAL SONOGRAM | $690.31 | $1,150.51 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US ENDOVAGINAL SONOGRAM | $690.31 | $1,150.51 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE SCAN | $922.06 | $1,536.76 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE SCAN | $922.06 | $1,536.76 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 MHP XRAY LOWER SPINE | $82.80 | $138.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SP COMP MIN 4 VIEWS | $333.10 | $555.17 | 40% |
| X-ray of the lower back, 4 or more views 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 MHP XRAY LOWER SPINE | $82.80 | $138.00 | 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 lower back, 4 or more views inpatient CPT 72110 MOA LUMBAR SPINE 4+V | $333.10 | $555.17 | 40% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $70.20 | $117.00 | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $70.20 | $117.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPIDS-CHOL/HDL/TRIG | $104.40 | $174.00 | 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(REFLEX) | $50.40 | $84.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/PLT DIFF | $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) with differential inpatient CPT 85025 CBC(REFLEX) | $50.40 | $84.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM&PLATELET CT | $22.20 | $37.00 | 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 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $99.00 | $165.00 | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $61.80 | $103.00 | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $61.80 | $103.00 | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $96.60 | $161.00 | 40% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $96.60 | $161.00 | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $78.49 | $130.81 | 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-PROGNOSTIC | $95.79 | $159.65 | 40% |
| PSA (prostate-specific antigen) blood test, total 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% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL | $95.79 | $159.65 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT LA SCREEN | $34.80 | $58.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME | $34.80 | $58.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME | $34.80 | $58.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT LA SCREEN | $34.80 | $58.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $33.60 | $56.00 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $33.60 | $56.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $122.98 | $204.97 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $122.98 | $204.97 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS with MICRO | $33.60 | $56.00 | 40% |
| Urinalysis with microscope exam, automated 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, automated inpatient CPT 81001 URINALYSIS WITH MICRO(REFLEX) | $33.60 | $56.00 | 40% |
| Urinalysis with microscope exam, manual CPT 81000 MHP UA NONAUTO WITH SCOPE | $13.20 | $22.00 | 40% |
| Urinalysis with microscope exam, manual CPT 81000 SPECIFIC GRAVITY-MISC FLUIDS | $18.60 | $31.00 | 40% |
| Urinalysis with microscope exam, manual CPT 81000 URINE-SPECIFIC GRAVITY | $18.60 | $31.00 | 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 W/O MICRO | $22.80 | $38.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS WITH MICRO(REFLEX) | $22.80 | $38.00 | 40% |
| Urinalysis without microscope exam, automated 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, automated inpatient CPT 81003 URINE-SPECIFIC GRAVITY | $22.80 | $38.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 MHP URINE DIP | $13.80 | $23.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 MHP URINE DIP | $13.80 | $23.00 | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy with polyp removal CPT 45385 MHP LESION REMOVAL COLO | $852.00 | $1,420.00 | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 MHP LESION REMOVAL COLO | $852.00 | $1,420.00 | 40% |
| Colonoscopy with tissue sample CPT 45380 MHP COLO AND BIOPSY | $741.60 | $1,236.00 | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 MHP COLO AND BIOPSY | $741.60 | $1,236.00 | 40% |
| Colonoscopy, diagnostic CPT 45378 MHP DIAGNOSTIC COLO | $685.20 | $1,142.00 | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 MHP DIAGNOSTIC COLO | $685.20 | $1,142.00 | 40% |
| Gallbladder removal, laparoscopic CPT 47562 MHP LAP CHOLE | $1,142.40 | $1,904.00 | 40% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 MHP LAP CHOLE | $1,142.40 | $1,904.00 | 40% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 MHP PRP IHERN INIT REDUC 5 YR | $901.80 | $1,503.00 | 40% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 MHP PRP IHERN INIT REDUC 5 YR | $901.80 | $1,503.00 | 40% |
| Knee arthroscopy with meniscus trim CPT 29881 MHP KNEE ARTHROSCOPY SURG | $2,100.00 | $3,500.00 | 40% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 MHP KNEE ARTHROSCOPY SURG | $2,100.00 | $3,500.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 MHP INJECT SPINE L S W/IMAGING | $255.00 | $425.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 MHP INJ SPINE LS WITH IMAGING | $255.00 | $425.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 EPIDURAL INJ LUMBAR OR SACRAL SPINE | $1,125.60 | $1,876.00 | 40% |
| Lower-back epidural injection, with imaging guidance 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 MHP INJ SPINE LS WITH IMAGING | $255.00 | $425.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 MHP INJECT SPINE L S W/IMAGING | $255.00 | $425.00 | 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 MHP INJ TRANSFOR EPIDUR LS SINGLE | $196.20 | $327.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 MHP INJ FORAMEN EPIDURAL LS | $196.20 | $327.00 | 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 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance 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 MHP INJ FORAMEN EPIDURAL LS | $196.20 | $327.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 MHP INJ TRANSFOR EPIDUR LS SINGLE | $196.20 | $327.00 | 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% |
| 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% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 MHP SHOULDER ARTHROSCOPY | $2,475.00 | $4,125.00 | 40% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 MHP SHOULDER ARTHROSCOPY | $2,475.00 | $4,125.00 | 40% |
| Total hip replacement CPT 27130 MHP TOTAL HIP ARTHROPLASTY | $3,187.20 | $5,312.00 | 40% |
| Total hip replacement inpatient CPT 27130 MHP TOTAL HIP ARTHROPLASTY | $3,187.20 | $5,312.00 | 40% |
| Total knee replacement CPT 27447 MHP TOTAL KNEE ARTHROPLASTY | $2,771.40 | $4,619.00 | 40% |
| Total knee replacement inpatient CPT 27447 MHP TOTAL KNEE ARTHROPLASTY | $2,771.40 | $4,619.00 | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 MHP UPPER GI ENDO BIOPSY | $486.00 | $810.00 | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 MHP UPPER GI ENDO BIOPSY | $486.00 | $810.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 MHP UPPER GI ENDO DIAG | $480.60 | $801.00 | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 MHP UPPER GI ENDO DIAG | $480.60 | $801.00 | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 MHP EKG COMPLETE | $148.80 | $248.00 | 40% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 MHP EKG COMPLETE | $148.80 | $248.00 | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 MBH FAMILY PSY TX W/PT 50 MIN | $105.00 | $175.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 MBH FAMILY PSY TX W/PT 50 MIN | $105.00 | $175.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 MHP FAMILY PSY TX W/O PT 50 MIN | $99.60 | $166.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 MHP FAMILY PSY TX W/O PT 50 MIN | $99.60 | $166.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 WH LEVEL 3 NEW INTERM | $28.20 | $47.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 MHP OFC/OP VISIT NEW LEVEL III | $31.80 | $53.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 OFC/OP VISIT NEW LEVEL III | $77.87 | $129.78 | 40% |
| New patient office visit, about 30 minutes CPT 99203 *OH VISIT NEW LEVEL III | $114.33 | $190.55 | 40% |
| New patient office visit, about 30 minutes CPT 99203 ANTICOAG CLINIC NEW PT LEVEL 3 | $123.60 | $206.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 OH LEVEL III | $163.80 | $273.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 HEM/ONC LEVEL III | $190.80 | $318.00 | 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 OFC/OP VISIT NEW LEVEL III | $77.87 | $129.78 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 *OH VISIT NEW LEVEL III | $114.33 | $190.55 | 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 | 40% |
| New patient office visit, about 45 minutes CPT 99204 WH LEVEL 4 NEW EXTEND | $36.60 | $61.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 OFC/OP VISIT NEW LEVEL IV | $131.63 | $219.39 | 40% |
| New patient office visit, about 45 minutes CPT 99204 ANTICOAG NEW PT VISIT LEVEL 4 | $175.20 | $292.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 *OH VISIT NEW LEVEL IV | $177.37 | $295.61 | 40% |
| New patient office visit, about 45 minutes CPT 99204 OH LEVEL IV | $280.20 | $467.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 HEM/ONC LEVEL IV | $328.20 | $547.00 | 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 OFC/OP VISIT NEW LEVEL IV | $131.63 | $219.39 | 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 VISIT NEW LEVEL IV | $177.37 | $295.61 | 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 | 40% |
| New patient office visit, about 60 minutes CPT 99205 MHP OFC/OP VISIT NEW LEVEL V | $41.40 | $69.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 OFC/OP VISIT NEW LEVEL V | $171.19 | $285.31 | 40% |
| New patient office visit, about 60 minutes CPT 99205 ANTICOAG NEW PT VISIT LEVEL 5 | $222.00 | $370.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 *OH VISIT NEW LEVEL V | $278.10 | $463.50 | 40% |
| New patient office visit, about 60 minutes CPT 99205 OH LEVEL V | $468.60 | $781.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 HEM/ONC LEVEL V | $546.60 | $911.00 | 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 OFC/OP VISIT NEW LEVEL V | $171.19 | $285.31 | 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 VISIT NEW LEVEL V | $278.10 | $463.50 | 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% |
| Preventive checkup, new patient aged 18–39 CPT 99385 MHP PREV VISIT NEW AGE 18-39 | $33.00 | $55.00 | 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 | 40% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 MHP PREV VISIT NEW AGE 40-64 | $33.00 | $55.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 MHP PSYCHOTX 45 MIN W PT | $97.20 | $162.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 MHP PSYCHOTX 45 MIN W PT | $97.20 | $162.00 | 40% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 MHP OFC CONSULT LEVEL III | $26.40 | $44.00 | 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 | 40% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 MHP OFC CONSULT LEVEL IV | $28.80 | $48.00 | 40% |
Source file: https://hospitalpricedisclosure.com/download.aspx?pi=96OHZrUcIshoMmRv3TQ0Bg*-*