Hospital Riverside-San Bernardino-Ontario, CA

Palo Verde Hospital

Palo Verde Hospital in Blythe, CA publishes cash prices for 295 common procedures listed here, from its own machine-readable price file updated Jul 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the California median for 199 of 289 procedures and above it for 89. By typical cash price it ranks #95 of 226 California hospitals and #15 of 27 hospitals in the Riverside, CA area, cheapest first. Select a procedure to compare it with other hospitals nearby.

250 North First Street, Blythe, CA 92225 Collected Sep 22, 2026 Source price file Check a bill from this hospital (760) 922-4115

Critical access hospital (rural, 25 beds or fewer) Government-owned hospital No emergency department CCN 051339 · CMS hospital register NPI 1194705202

Financial assistance

Public hospital: ask for its charity care or sliding-scale discount

Palo Verde Hospital is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.

State law

This state limits hospital bills for lower-income patients

California law (Health and Safety Code §127405): if you are uninsured or have high medical costs and your family income is at or below 400% of the federal poverty level, a hospital may not expect you to pay more than it would expect from Medicare or Medi-Cal, whichever is greater. That can be less than the cash prices below; ask the hospital for its discount payment policy. A separate physician fee may still apply. Other states' laws.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Palo Verde Hospital in Blythe, CA:

Jan 28, 2026 Corrective action plan requested

Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found.

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 California	Off list
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Contrast	$2,854.50	$3,806.00	—	1% above	25%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/ + w/o Contrast	$2,854.50	$3,806.00	—	—	25%
Abdominal X-ray, 2 views CPT 74019 XR Abdomen 2 Views	$637.50	$850.00	—	48% above	25%
Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen 2 Views	$637.50	$850.00	—	—	25%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views Left	$318.00	$424.00	—	38% below	25%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views Right	$318.00	$424.00	—	38% below	25%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3+ Views Left	$318.00	$424.00	—	—	25%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3+ Views Right	$318.00	$424.00	—	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US Segmental Pressures LE 1-2 Lvls Bilat	$224.25	$299.00	—	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US Segmental Pressures LE 1-2 Lvls Bilat	$224.25	$299.00	—	—	25%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity w/o Contrast Right	$2,016.75	$2,689.00	—	11% below	25%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity w/o Contrast Left	$2,016.75	$2,689.00	—	11% below	25%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity w/o Contrast Right	$2,016.75	$2,689.00	—	—	25%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity w/o Contrast Left	$2,016.75	$2,689.00	—	—	25%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus	$720.00	$960.00	—	19% above	25%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophagus	$720.00	$960.00	—	—	25%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Left	$711.75	$949.00	—	1% above	25%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Right	$711.75	$949.00	—	1% above	25%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Left	$711.75	$949.00	—	—	25%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Right	$711.75	$949.00	—	—	25%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right	$711.75	$949.00	—	33% above	25%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left	$711.75	$949.00	—	33% above	25%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right	$711.75	$949.00	—	—	25%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left	$711.75	$949.00	—	—	25%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abdomen and Pelvis	$5,971.50	$7,962.00	—	10% above	25%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abdomen and Pelvis	$5,971.50	$7,962.00	—	—	25%
CT angiography (CTA) of the head CPT 70496 CT Angio Brain/Head	$2,700.00	$3,600.00	—	10% below	25%
CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Brain/Head	$2,700.00	$3,600.00	—	—	25%
CT angiography (CTA) of the neck CPT 70498 CT Angio Neck	$2,700.00	$3,600.00	—	9% below	25%
CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Neck	$2,700.00	$3,600.00	—	—	25%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest	$2,700.00	$3,600.00	—	21% below	25%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest	$2,700.00	$3,600.00	—	—	25%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart Calcium Scoring	$487.50	$650.00	—	29% above	25%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Heart Calcium Scoring	$487.50	$650.00	—	—	25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 VERD MRI 3D Reconstruction	$1,650.00	$2,200.00	—	48% below	25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast	$3,992.25	$5,323.00	—	25% above	25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 VERD MRI 3D Reconstruction	$1,650.00	$2,200.00	—	—	25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen and Pelvis w/o Contrast	$3,992.25	$5,323.00	—	—	25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast	$4,518.75	$6,025.00	—	9% above	25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Contrast	$4,518.75	$6,025.00	—	—	25%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast	$4,821.75	$6,429.00	—	3% above	25%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast	$4,821.75	$6,429.00	—	—	25%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast	$2,473.50	$3,298.00	—	2% below	25%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast	$2,473.50	$3,298.00	—	—	25%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast	$2,445.75	$3,261.00	—	28% above	25%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast	$2,445.75	$3,261.00	—	—	25%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast	$1,833.00	$2,444.00	—	16% below	25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast	$1,833.00	$2,444.00	—	—	25%
CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head w/o Contrast	$2,232.75	$2,977.00	—	2% below	25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head w/o Contrast	$2,232.75	$2,977.00	—	—	25%
CT scan of the head with contrast CPT 70460 CT Brain/Head w/ Contrast	$2,186.25	$2,915.00	—	19% below	25%
CT scan of the head with contrast inpatient CPT 70460 CT Brain/Head w/ Contrast	$2,186.25	$2,915.00	—	—	25%
CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/ + w/o Contrast	$2,448.75	$3,265.00	—	21% below	25%
CT scan of the head without and with contrast inpatient CPT 70470 CT Brain/Head w/ + w/o Contrast	$2,448.75	$3,265.00	—	—	25%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast	$2,431.50	$3,242.00	—	15% below	25%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast	$2,431.50	$3,242.00	—	—	25%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast	$2,499.00	$3,332.00	—	14% below	25%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast	$2,499.00	$3,332.00	—	—	25%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast	$2,578.50	$3,438.00	—	1% above	25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast	$2,578.50	$3,438.00	—	—	25%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral	$1,182.00	$1,576.00	—	—	25%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral	$1,182.00	$1,576.00	—	—	25%
Chest CT scan without and with contrast CPT 71270 CT Chest w/ + w/o Contrast	$2,823.00	$3,764.00	—	14% below	25%
Chest CT scan without and with contrast inpatient CPT 71270 CT Chest w/ + w/o Contrast	$2,823.00	$3,764.00	—	—	25%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views	$364.50	$486.00	—	11% below	25%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views	$364.50	$486.00	—	—	25%
Chest X-ray, single view CPT 71045 XR Chest 1 View	$332.25	$443.00	—	9% below	25%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View	$332.25	$443.00	—	—	25%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left	$332.25	$443.00	—	31% below	25%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right	$332.25	$443.00	—	31% below	25%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right	$332.25	$443.00	—	—	25%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left	$332.25	$443.00	—	—	25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete	$664.50	$886.00	—	22% below	25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete	$664.50	$886.00	—	—	25%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton	$517.50	$690.00	—	3% above	25%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton	$517.50	$690.00	—	—	25%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD Bone Density DEXA App Skeleton	$307.50	$410.00	—	11% above	25%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BD Bone Density DEXA App Skeleton	$307.50	$410.00	—	—	25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast	$2,264.25	$3,019.00	—	12% above	25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Contrast	$2,264.25	$3,019.00	—	—	25%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast	$2,490.75	$3,321.00	—	14% below	25%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Contrast	$2,490.75	$3,321.00	—	—	25%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic Left	$328.50	$438.00	—	12% below	25%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic Right	$328.50	$438.00	—	12% below	25%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Diagnostic Right	$328.50	$438.00	—	—	25%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Diagnostic Left	$328.50	$438.00	—	—	25%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral	$456.00	$608.00	—	—	25%
Duplex ultrasound of the leg arteries, both legs CPT 93925 93925 Arterial Duplex B/L Lower	$456.00	$608.00	—	56% below	25%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral	$456.00	$608.00	—	—	25%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 93925 Arterial Duplex B/L Lower	$456.00	$608.00	—	—	25%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Upper Ext Venous Duplex Bilateral	$937.50	$1,250.00	—	—	25%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Lower Ext Venous Duplex Bilateral	$937.50	$1,250.00	—	—	25%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Upper Ext Venous Duplex Bilateral	$937.50	$1,250.00	—	—	25%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Lower Ext Venous Duplex Bilateral	$937.50	$1,250.00	—	—	25%
Elbow X-ray, 2 views both sides CPT 73070 XR Elbow 2 Views Bilateral	$343.50	$458.00	—	—	25%
Elbow X-ray, 2 views inpatient both sides CPT 73070 XR Elbow 2 Views Bilateral	$343.50	$458.00	—	—	25%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete 3+ Views Right	$343.50	$458.00	—	29% below	25%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete 3+ Views Left	$343.50	$458.00	—	29% below	25%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete 3+ Views Left	$343.50	$458.00	—	—	25%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete 3+ Views Right	$343.50	$458.00	—	—	25%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbits Sella w/o Contrast	$2,146.50	$2,862.00	—	6% below	25%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbits Sella w/o Contrast	$2,146.50	$2,862.00	—	—	25%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones 3+ Views	$601.50	$802.00	—	22% above	25%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones 3+ Views	$601.50	$802.00	—	—	25%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Right	$289.50	$386.00	—	32% below	25%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Left	$289.50	$386.00	—	32% below	25%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Left	$289.50	$386.00	—	—	25%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Right	$289.50	$386.00	—	—	25%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Right	$213.75	$285.00	—	47% below	25%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Left	$213.75	$285.00	—	47% below	25%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Left	$213.75	$285.00	—	—	25%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Right	$213.75	$285.00	—	—	25%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Left	$320.25	$427.00	—	9% below	25%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Right	$320.25	$427.00	—	9% below	25%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus Right	$320.25	$427.00	—	—	25%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus Left	$320.25	$427.00	—	—	25%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right	$486.00	$648.00	—	6% above	25%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left	$486.00	$648.00	—	6% above	25%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Right	$486.00	$648.00	—	—	25%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Left	$486.00	$648.00	—	—	25%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4+ Views Left	$654.75	$873.00	—	12% above	25%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4+ Views Right	$654.75	$873.00	—	12% above	25%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4+ Views Right	$654.75	$873.00	—	—	25%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4+ Views Left	$654.75	$873.00	—	—	25%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity w/o Contrast Left	$2,041.50	$2,722.00	—	4% below	25%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity w/o Contrast Right	$2,041.50	$2,722.00	—	4% below	25%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity w/o Contrast Right	$2,041.50	$2,722.00	—	—	25%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity w/o Contrast Left	$2,041.50	$2,722.00	—	—	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$750.00	$1,000.00	—	10% below	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$750.00	$1,000.00	—	—	25%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Nonvascular Limited Left	$647.25	$863.00	—	19% above	25%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Nonvascular Limited Right	$647.25	$863.00	—	19% above	25%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Nonvascular Limited Right	$647.25	$863.00	—	—	25%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Nonvascular Limited Left	$647.25	$863.00	—	—	25%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Left	$363.00	$484.00	—	16% below	25%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Right	$363.00	$484.00	—	16% below	25%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Left	$363.00	$484.00	—	—	25%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Right	$363.00	$484.00	—	—	25%
MR angiography (MRA) of the head without contrast CPT 70544 MRA Brain/Head w/o Contrast	$2,665.50	$3,554.00	—	8% below	25%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Brain/Head w/o Contrast	$2,665.50	$3,554.00	—	—	25%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LE Joint w/o Contrast Left	$2,665.50	$3,554.00	—	12% below	25%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LE Joint w/o Contrast Right	$2,665.50	$3,554.00	—	12% below	25%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LE Joint w/o Contrast Right	$2,665.50	$3,554.00	—	—	25%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LE Joint w/o Contrast Left	$2,665.50	$3,554.00	—	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LE Joint w/ + w/o Contrast Left	$2,640.84	$3,521.12	—	43% below	25%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LE Joint w/ + w/o Contrast Right	$2,640.84	$3,521.12	—	43% below	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LE Joint w/ + w/o Contrast Left	$2,640.84	$3,521.12	—	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LE Joint w/ + w/o Contrast Right	$2,640.84	$3,521.12	—	—	25%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast	$2,665.50	$3,554.00	—	5% below	25%
MRI of the abdomen without contrast CPT 74181 MRA Abdomen w/o Contrast	$2,665.50	$3,554.00	—	5% below	25%
MRI of the abdomen without contrast inpatient CPT 74181 MRA Abdomen w/o Contrast	$2,665.50	$3,554.00	—	—	25%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast	$2,665.50	$3,554.00	—	—	25%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast	$4,326.75	$5,769.00	—	1% below	25%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast	$4,326.75	$5,769.00	—	—	25%
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast	$2,665.50	$3,554.00	—	8% below	25%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast	$2,665.50	$3,554.00	—	—	25%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast	$4,326.75	$5,769.00	—	at median	25%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast	$4,326.75	$5,769.00	—	—	25%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast	$2,665.50	$3,554.00	—	13% below	25%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast	$2,665.50	$3,554.00	—	—	25%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$4,326.75	$5,769.00	—	4% below	25%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$4,326.75	$5,769.00	—	—	25%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast	$2,665.50	$3,554.00	—	8% below	25%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast	$2,665.50	$3,554.00	—	—	25%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$4,326.75	$5,769.00	—	3% below	25%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$4,326.75	$5,769.00	—	—	25%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast	$2,665.50	$3,554.00	—	11% below	25%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast	$2,665.50	$3,554.00	—	—	25%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast	$4,326.75	$5,769.00	—	4% above	25%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast	$4,326.75	$5,769.00	—	—	25%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast	$2,665.50	$3,554.00	—	4% above	25%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast	$2,665.50	$3,554.00	—	—	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UE Joint w/o Contrast Right	$2,665.50	$3,554.00	—	2% above	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UE Joint w/o Contrast Left	$2,665.50	$3,554.00	—	2% above	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UE Joint w/o Contrast Left	$2,665.50	$3,554.00	—	—	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UE Joint w/o Contrast Right	$2,665.50	$3,554.00	—	—	25%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical 4 or 5 Views	$628.50	$838.00	—	3% below	25%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical 4 or 5 Views	$628.50	$838.00	—	—	25%
Neck soft tissue CT scan with contrast CPT 70491 CT Neck Soft Tissue w/ Contrast	$2,264.25	$3,019.00	—	17% below	25%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck Soft Tissue w/ Contrast	$2,264.25	$3,019.00	—	—	25%
Neck soft tissue CT scan without contrast CPT 70490 CT Neck Soft Tissue w/o Contrast	$1,915.50	$2,554.00	—	9% below	25%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Neck Soft Tissue w/o Contrast	$1,915.50	$2,554.00	—	—	25%
Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue	$223.50	$298.00	—	31% below	25%
Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue	$223.50	$298.00	—	—	25%
Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast	$1,945.50	$2,594.00	—	1% below	25%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast	$1,945.50	$2,594.00	—	—	25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Bladder Scan	$750.00	$1,000.00	—	39% above	25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Bladder Scan	$750.00	$1,000.00	—	—	25%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Non OB	$799.50	$1,066.00	—	15% below	25%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Non OB	$799.50	$1,066.00	—	—	25%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Greater Than 14 Weeks	$570.00	$760.00	—	34% below	25%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Greater Than 14 Weeks	$570.00	$760.00	—	—	25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB < 14 weeks	$682.50	$910.00	—	12% below	25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB < 14 weeks	$682.50	$910.00	—	—	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited	$444.75	$593.00	—	26% below	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited	$444.75	$593.00	—	—	25%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 Views Right	$622.50	$830.00	—	35% above	25%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 Views Left	$622.50	$830.00	—	35% above	25%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 Views Right	$622.50	$830.00	—	—	25%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 Views Left	$622.50	$830.00	—	—	25%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs 3 Views Right	$648.75	$865.00	—	5% above	25%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs 3 Views Left	$648.75	$865.00	—	5% above	25%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs 3 Views Right	$648.75	$865.00	—	—	25%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs 3 Views Left	$648.75	$865.00	—	—	25%
Screening mammogram, both breasts both sides CPT 77067 MG Mammo Digital Screening Bilateral	$438.75	$585.00	—	—	25%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Digital Screening Bilateral	$438.75	$585.00	—	—	25%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder Complete 2+ Views Bilat	$398.25	$531.00	—	—	25%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2+ Views Left	$237.00	$316.00	—	57% below	25%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2+ Views Right	$237.00	$316.00	—	57% below	25%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder Complete 2+ Views Bilat	$398.25	$531.00	—	—	25%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2+ Views Right	$237.00	$316.00	—	—	25%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2+ Views Left	$237.00	$316.00	—	—	25%
Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete	$540.75	$721.00	—	18% above	25%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete	$540.75	$721.00	—	—	25%
Skull X-ray, fewer than 4 views CPT 70250 XR Skull < 4 Views	$403.50	$538.00	—	1% below	25%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull < 4 Views	$403.50	$538.00	—	—	25%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function w/ Speech	$967.50	$1,290.00	—	46% above	25%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function w/ Speech	$967.50	$1,290.00	—	—	25%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Left	$332.25	$443.00	—	18% below	25%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Right	$332.25	$443.00	—	18% below	25%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Left	$332.25	$443.00	—	—	25%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Right	$332.25	$443.00	—	—	25%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic w/o Contrast	$2,172.75	$2,897.00	—	23% below	25%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic w/o Contrast	$2,172.75	$2,897.00	—	—	25%
Toe X-ray, 2 or more views one side CPT 73660 XR Toe(s) 2+ Views Right	$249.00	$332.00	—	25% below	25%
Toe X-ray, 2 or more views one side CPT 73660 XR Toe(s) 2+ Views Left	$249.00	$332.00	—	25% below	25%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toe(s) 2+ Views Right	$249.00	$332.00	—	—	25%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toe(s) 2+ Views Left	$249.00	$332.00	—	—	25%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB	$631.50	$842.00	—	12% below	25%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB	$631.50	$842.00	—	—	25%
Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal	$631.50	$842.00	—	5% below	25%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal	$631.50	$842.00	—	—	25%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$1,635.00	$2,180.00	—	49% above	25%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$1,635.00	$2,180.00	—	—	25%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents)	$731.25	$975.00	—	18% below	25%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents)	$731.25	$975.00	—	—	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Head/Neck	$667.50	$890.00	—	20% below	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue Head/Neck	$667.50	$890.00	—	—	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI + KUB	$1,062.75	$1,417.00	—	73% above	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI + KUB	$1,062.75	$1,417.00	—	—	25%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Right	$337.50	$450.00	—	21% below	25%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Left	$337.50	$450.00	—	21% below	25%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Right	$337.50	$450.00	—	—	25%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Left	$337.50	$450.00	—	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Right	$519.00	$692.00	—	42% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Left	$519.00	$692.00	—	42% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Right	$519.00	$692.00	—	42% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Left	$519.00	$692.00	—	42% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Left	$519.00	$692.00	—	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Left	$519.00	$692.00	—	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Right	$519.00	$692.00	—	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Right	$519.00	$692.00	—	—	25%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Left	$239.25	$319.00	—	39% below	25%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Right	$239.25	$319.00	—	39% below	25%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Left	$239.25	$319.00	—	—	25%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Right	$239.25	$319.00	—	—	25%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views Left	$342.75	$457.00	—	32% below	25%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views Right	$342.75	$457.00	—	32% below	25%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views Left	$342.75	$457.00	—	—	25%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views Right	$342.75	$457.00	—	—	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR Pelvis 1 or 2 Views	$332.25	$443.00	—	17% below	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Left	$379.50	$506.00	—	6% below	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Right	$379.50	$506.00	—	6% below	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR Pelvis 1 or 2 Views	$332.25	$443.00	—	—	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Right	$379.50	$506.00	—	—	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Left	$379.50	$506.00	—	—	25%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen KUB 1 View	$569.25	$759.00	—	87% above	25%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View	$569.25	$759.00	—	87% above	25%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View	$569.25	$759.00	—	—	25%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen KUB 1 View	$569.25	$759.00	—	—	25%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left	$243.00	$324.00	—	38% below	25%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right	$243.00	$324.00	—	38% below	25%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left	$243.00	$324.00	—	—	25%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right	$243.00	$324.00	—	—	25%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2+ Views Left	$253.50	$338.00	—	31% below	25%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2+ Views Right	$253.50	$338.00	—	31% below	25%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2+ Views Left	$253.50	$338.00	—	—	25%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2+ Views Right	$253.50	$338.00	—	—	25%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left	$213.75	$285.00	—	47% below	25%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right	$213.75	$285.00	—	47% below	25%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left	$213.75	$285.00	—	—	25%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right	$213.75	$285.00	—	—	25%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3+ Views Right	$449.25	$599.00	—	9% below	25%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3+ Views Left	$449.25	$599.00	—	9% below	25%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3+ Views Left	$449.25	$599.00	—	—	25%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3+ Views Right	$449.25	$599.00	—	—	25%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3+ Views Right	$416.25	$555.00	—	18% below	25%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3+ Views Left	$416.25	$555.00	—	18% below	25%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3+ Views Left	$416.25	$555.00	—	—	25%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3+ Views Right	$416.25	$555.00	—	—	25%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Right	$276.00	$368.00	—	30% below	25%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Left	$276.00	$368.00	—	30% below	25%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Left	$276.00	$368.00	—	—	25%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Right	$276.00	$368.00	—	—	25%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$465.00	$620.00	—	1% below	25%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$465.00	$620.00	—	—	25%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Bending 2-3 Views	$806.25	$1,075.00	—	24% above	25%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Bending 2-3 Views	$806.25	$1,075.00	—	—	25%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views	$616.50	$822.00	—	33% above	25%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views	$616.50	$822.00	—	—	25%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones 3+ Views	$367.50	$490.00	—	15% below	25%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones 3+ Views	$367.50	$490.00	—	—	25%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views	$474.75	$633.00	—	5% above	25%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views	$474.75	$633.00	—	—	25%
X-ray of the pelvis, 1 or 2 views both sides CPT 72170 XR Lower Extremity Infant (0-1yr) Bilat	$207.75	$277.00	—	—	25%
X-ray of the pelvis, 1 or 2 views inpatient both sides CPT 72170 XR Lower Extremity Infant (0-1yr) Bilat	$207.75	$277.00	—	—	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx 2+ Views	$534.00	$712.00	—	14% above	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx 2+ Views	$534.00	$712.00	—	—	25%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs California	Off list
ACTH blood test CPT 82024 ACTH LC	$44.38	$59.18	—	35% below	25%
ACTH blood test inpatient CPT 82024 ACTH LC	$44.38	$59.18	—	—	25%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine aminotransferase	$91.50	$122.00	—	112% above	25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine aminotransferase	$91.50	$122.00	—	—	25%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate aminotransferase	$91.50	$122.00	—	102% above	25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate aminotransferase	$91.50	$122.00	—	—	25%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hep Panel (4) LC	$468.75	$625.00	—	72% above	25%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hep Panel (4) LC	$468.75	$625.00	—	—	25%
Albumin blood test CPT 82040 Albumin Level	$113.25	$151.00	—	354% above	25%
Albumin blood test inpatient CPT 82040 Albumin Level	$113.25	$151.00	—	—	25%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$70.50	$94.00	—	91% above	25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase	$70.50	$94.00	—	—	25%
Allergy blood test, specific IgE, per allergen CPT 86003 Food Allergy Profile LC Basic Test 660423	$127.96	$170.62	—	2459% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 F096-IgE Avocado LC	$127.96	$170.62	—	2459% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 F093-IgE Chocolate/Cacao LC	$127.96	$170.62	—	2459% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, 14 LC	$127.96	$170.62	—	2459% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Food IgE II w/Rflx LC	$127.96	$170.62	—	2459% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Food-Basic LC	$127.96	$170.62	—	2459% above	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profile, Food-Basic LC	$127.96	$170.62	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profile, Food IgE II w/Rflx LC	$127.96	$170.62	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens, 14 LC	$127.96	$170.62	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F096-IgE Avocado LC	$127.96	$170.62	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Food Allergy Profile LC Basic Test 660423	$127.96	$170.62	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F093-IgE Chocolate/Cacao LC	$127.96	$170.62	—	—	25%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP Tumor Marker LC	$13.90	$18.53	—	82% below	25%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP Tumor Marker LC	$13.90	$18.53	—	—	25%
Ammonia blood test CPT 82140 Ammonia Level	$156.00	$208.00	—	14% below	25%
Ammonia blood test inpatient CPT 82140 Ammonia Level	$156.00	$208.00	—	—	25%
Amylase blood test CPT 82150 Amylase, BF LC	$7.09	$9.45	—	86% below	25%
Amylase blood test inpatient CPT 82150 Amylase, BF LC	$7.09	$9.45	—	—	25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibodies IgG/IgA LC	$19.84	$26.45	—	2% below	25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibodies IgG/IgA LC	$19.84	$26.45	—	—	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Multiplex w/Rflx LC Test 164962	$8.31	$11.08	—	74% below	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex if Positive LC T164863 Multiplex	$8.31	$11.08	—	74% below	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab (ANA) Qual, Multi Immunoassay LC	$8.31	$11.08	—	74% below	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Ab (ANA) Qual, Multi Immunoassay LC	$8.31	$11.08	—	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Multiplex w/Rflx LC Test 164962	$8.31	$11.08	—	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex if Positive LC T164863 Multiplex	$8.31	$11.08	—	—	25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Type Natriuretic Peptide	$178.50	$238.00	—	4% below	25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-Type Natriuretic Peptide	$178.50	$238.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic Bacterial Culture LC	$11.25	$15.00	—	91% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Upper Respiratory Culture LC	$16.86	$22.48	—	86% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture, Routine LC	$20.02	$26.70	—	83% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture, Sterile LC	$25.84	$34.45	—	79% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aerobic Bacterial Culture LC	$11.25	$15.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Upper Respiratory Culture LC	$16.86	$22.48	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture, Routine LC	$20.02	$26.70	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture, Sterile LC	$25.84	$34.45	—	—	25%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel	$321.75	$429.00	—	63% above	25%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel	$321.75	$429.00	—	—	25%
Bilirubin blood test, total CPT 82247 Bilirubin Total	$81.00	$108.00	—	79% above	25%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total	$81.00	$108.00	—	—	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bill Only 88305 Surg Path Level IV	$250.50	$334.00	—	93% above	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Bill Only 88305 Surg Path Level IV	$250.50	$334.00	—	—	25%
Blood culture for bacteria CPT 87040 Blood Culture, Routine LC	$20.62	$27.50	—	92% below	25%
Blood culture for bacteria inpatient CPT 87040 Blood Culture, Routine LC	$20.62	$27.50	—	—	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw	$33.00	$44.00	—	57% above	25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw	$33.00	$44.00	—	—	25%
Blood lead test CPT 83655 Lead, Bld (Adult) LC	$247.50	$330.00	—	2315% above	25%
Blood lead test CPT 83655 Lead, Bld (Pediatric) LC	$247.50	$330.00	—	2315% above	25%
Blood lead test inpatient CPT 83655 Lead, Bld (Pediatric) LC	$247.50	$330.00	—	—	25%
Blood lead test inpatient CPT 83655 Lead, Bld (Adult) LC	$247.50	$330.00	—	—	25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta hCG Qualitative	$117.75	$157.00	—	26% below	25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG-Serum Qual	$117.75	$157.00	—	26% below	25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Beta hCG Qualitative	$117.75	$157.00	—	—	25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG-Serum Qual	$117.75	$157.00	—	—	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO/Rh	$57.75	$77.00	—	44% below	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh Retype	$57.75	$77.00	—	44% below	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh	$57.75	$77.00	—	44% below	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABO/Rh	$57.75	$77.00	—	—	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/Rh Retype	$57.75	$77.00	—	—	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/Rh	$57.75	$77.00	—	—	25%
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen	$81.00	$108.00	—	144% above	25%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen	$81.00	$108.00	—	—	25%
C-peptide blood test CPT 84681 C-Peptide LC	$12.90	$17.20	—	80% below	25%
C-peptide blood test inpatient CPT 84681 C-Peptide LC	$12.90	$17.20	—	—	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP, Quant LC	$9.51	$12.68	—	82% below	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP, Quant LC	$9.51	$12.68	—	—	25%
C. difficile toxin gene test (stool PCR) CPT 87493 C difficile Toxin Gene NAA LC	$236.25	$315.00	—	55% above	25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C difficile Toxin Gene NAA LC	$236.25	$315.00	—	—	25%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 LC	$19.84	$26.45	—	60% below	25%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 LC	$19.84	$26.45	—	—	25%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125 LC	$15.86	$21.15	—	88% below	25%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen (CA) 125 LC	$15.86	$21.15	—	—	25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Coronavirus SARS Ag (Sofia)	$78.00	$104.00	—	18% below	25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2, NAA LC	$140.62	$187.50	—	49% above	25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Coronavirus SARS Ag (Sofia)	$78.00	$104.00	—	—	25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2, NAA LC	$140.62	$187.50	—	—	25%
Calcium blood test, total CPT 82310 Calcium Level Total	$96.75	$129.00	—	56% above	25%
Calcium blood test, total inpatient CPT 82310 Calcium Level Total	$96.75	$129.00	—	—	25%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA LC	$14.25	$19.00	—	83% below	25%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA LC	$14.25	$19.00	—	—	25%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster V Ab, IgG LC	$15.84	$21.12	—	53% below	25%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Ab, IgM Qualitative LC	$30.04	$40.05	—	12% below	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster V Ab, IgG LC	$15.84	$21.12	—	—	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Ab, IgM Qualitative LC	$30.04	$40.05	—	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis, NAA LC	$33.74	$44.98	—	38% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis, NAA LC	$33.74	$44.98	—	—	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel With LDL/HDL Ratio LC T235010	$8.92	$11.90	—	91% below	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel LC	$8.92	$11.90	—	91% below	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$234.00	$312.00	—	131% above	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel With LDL/HDL Ratio LC T235010	$8.92	$11.90	—	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel LC	$8.92	$11.90	—	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$234.00	$312.00	—	—	25%
Complete blood count (CBC) with differential CPT 85025 CBC w/ Differential	$107.25	$143.00	—	3% below	25%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Differential	$107.25	$143.00	—	—	25%
Complete blood count (CBC), no differential CPT 85027 CBC w/ Manual Differential	$77.25	$103.00	—	12% below	25%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC w/ Manual Differential	$77.25	$103.00	—	—	25%
Comprehensive metabolic panel (blood test) CPT 80053 CMP	$375.75	$501.00	—	47% above	25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP	$375.75	$501.00	—	—	25%
Cortisol blood test, total CPT 82533 Cortisol Total LC	$10.34	$13.78	—	89% below	25%
Cortisol blood test, total inpatient CPT 82533 Cortisol Total LC	$10.34	$13.78	—	—	25%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase	$107.25	$143.00	—	23% above	25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase	$107.25	$143.00	—	—	25%
Creatinine blood test CPT 82565 Creatinine	$96.75	$129.00	—	109% above	25%
Creatinine blood test inpatient CPT 82565 Creatinine	$96.75	$129.00	—	—	25%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus (CMV) Ab, IgG LC	$11.10	$14.80	—	60% below	25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus (CMV) Ab, IgG LC	$11.10	$14.80	—	—	25%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer	$82.50	$110.00	—	43% below	25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer	$82.50	$110.00	—	—	25%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-Sulfate LC	$20.59	$27.45	—	80% below	25%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-Sulfate LC	$20.59	$27.45	—	—	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Fentanyl Screen w/ Rfx, Urine LC	$34.72	$46.30	—	44% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Urine	$55.20	$73.60	—	11% below	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 10 w/Conf,Meconium LC	$406.31	$541.75	—	555% above	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Fentanyl Screen w/ Rfx, Urine LC	$34.72	$46.30	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Urine	$55.20	$73.60	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 10 w/Conf,Meconium LC	$406.31	$541.75	—	—	25%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel	$175.50	$234.00	—	108% above	25%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel	$175.50	$234.00	—	—	25%
Estradiol blood test CPT 82670 Estradiol LC	$26.25	$35.00	—	70% below	25%
Estradiol blood test inpatient CPT 82670 Estradiol LC	$26.25	$35.00	—	—	25%
FSH (follicle-stimulating hormone) test CPT 83001 FSH LC	$12.68	$16.90	—	88% below	25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH LC	$12.68	$16.90	—	—	25%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$107.25	$143.00	—	1% above	25%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$107.25	$143.00	—	—	25%
Folate (folic acid) blood test CPT 82746 Folate (Folic Acid) LC	$9.51	$12.68	—	91% below	25%
Folate (folic acid) blood test inpatient CPT 82746 Folate (Folic Acid) LC	$9.51	$12.68	—	—	25%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine (T3), Free LC	$9.51	$12.68	—	88% below	25%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine (T3), Free LC	$9.51	$12.68	—	—	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine (T4) Free Direct LC	$283.12	$377.50	—	316% above	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine (T4) Free Direct LC	$283.12	$377.50	—	—	25%
Free testosterone test CPT 84402 Testosterone, Free, Direct LC	$27.00	$36.00	—	1% below	25%
Free testosterone test inpatient CPT 84402 Testosterone, Free, Direct LC	$27.00	$36.00	—	—	25%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT LC	$213.75	$285.00	—	370% above	25%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT LC	$213.75	$285.00	—	—	25%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Level	$107.25	$143.00	—	106% above	25%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Level	$107.25	$143.00	—	—	25%
H. pylori antibody blood test CPT 86677 Helicobacter pylori Antibody IgG	$86.25	$115.00	—	24% below	25%
H. pylori antibody blood test inpatient CPT 86677 Helicobacter pylori Antibody IgG	$86.25	$115.00	—	—	25%
H. pylori stool antigen test CPT 87338 Helicobacter pylori Stool Ag, EIA LC	$62.56	$83.42	—	21% below	25%
H. pylori stool antigen test inpatient CPT 87338 Helicobacter pylori Stool Ag, EIA LC	$62.56	$83.42	—	—	25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA, Real Time PCR (Graph) LC	$183.75	$245.00	—	82% above	25%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 RNA, RT PCR (Non-Graph) LC	$166.22	$221.62	—	65% above	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA, Real Time PCR (Graph) LC	$183.75	$245.00	—	—	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 RNA, RT PCR (Non-Graph) LC	$166.22	$221.62	—	—	25%
HIV-1 and HIV-2 antibody test CPT 86703 Rapid HIV Antibody 1/2	$81.00	$108.00	—	38% above	25%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Rapid HIV Antibody 1/2	$81.00	$108.00	—	—	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1/O/2, 4th Generation LC	$16.88	$22.50	—	81% below	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1/O/2, 4th Generation LC	$16.88	$22.50	—	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c LC	$7.50	$10.00	—	89% below	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Gestational Diabetes Screen (Glucose)	$103.50	$138.00	—	59% above	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C	$103.50	$138.00	—	59% above	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c LC	$7.50	$10.00	—	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Gestational Diabetes Screen (Glucose)	$103.50	$138.00	—	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C	$103.50	$138.00	—	—	25%
Hemoglobin blood test CPT 85018 Hemoglobin	$39.00	$52.00	—	3% below	25%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin	$39.00	$52.00	—	—	25%
Hepatitis B core antibody test (total) CPT 86704 Hep B Core Ab, Tot LC	$9.40	$12.53	—	73% below	25%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Ab, Tot LC	$9.40	$12.53	—	—	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surf Ab LC	$6.34	$8.45	—	85% below	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep B Surf Ab LC	$6.34	$8.45	—	—	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Surf Antigen Scr LC	$86.25	$115.00	—	20% above	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep B Surf Antigen Scr LC	$86.25	$115.00	—	—	25%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Ab LC	$75.00	$100.00	—	37% above	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Ab LC	$75.00	$100.00	—	—	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 T3, Free PLAB	$91.31	$121.75	—	4% above	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA by PCR, QN w/Reflex to Geno Non graph LC Test 550090	$228.28	$304.38	—	160% above	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA Diagnosis, NAA LC	$228.28	$304.38	—	160% above	25%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 .HCV RT-PCR, Quant (Non-Graph) 550362 LC	$228.28	$304.38	—	160% above	25%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR, Quant (Graph) LC	$228.28	$304.38	—	160% above	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 T3, Free PLAB	$91.31	$121.75	—	—	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA Diagnosis, NAA LC	$228.28	$304.38	—	—	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA by PCR, QN w/Reflex to Geno Non graph LC Test 550090	$228.28	$304.38	—	—	25%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 .HCV RT-PCR, Quant (Non-Graph) 550362 LC	$228.28	$304.38	—	—	25%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR, Quant (Graph) LC	$228.28	$304.38	—	—	25%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein High Sensitivity	$100.50	$134.00	—	65% above	25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein High Sensitivity	$100.50	$134.00	—	—	25%
Homocysteine blood test CPT 83090 Homocyst(e)ine LC	$56.16	$74.88	—	26% below	25%
Homocysteine blood test inpatient CPT 83090 Homocyst(e)ine LC	$56.16	$74.88	—	—	25%
Insulin blood test CPT 83525 Insulin LC Test 004333	$7.94	$10.58	—	79% below	25%
Insulin blood test inpatient CPT 83525 Insulin LC Test 004333	$7.94	$10.58	—	—	25%
Iron blood test (serum iron) CPT 83540 Iron LC	$5.44	$7.25	—	91% below	25%
Iron blood test (serum iron) inpatient CPT 83540 Iron LC	$5.44	$7.25	—	—	25%
Kidney function blood test panel CPT 80069 Renal Pnl	$151.50	$202.00	—	7% above	25%
Kidney function blood test panel inpatient CPT 80069 Renal Pnl	$151.50	$202.00	—	—	25%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone (LH), S LC	$18.28	$24.38	—	82% below	25%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone (LH), S LC	$18.28	$24.38	—	—	25%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid Level	$120.00	$160.00	—	10% below	25%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid Level	$120.00	$160.00	—	—	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 LD Body Fluid LC	$5.44	$7.25	—	85% below	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase	$114.75	$153.00	—	218% above	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD Body Fluid LC	$5.44	$7.25	—	—	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase	$114.75	$153.00	—	—	25%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase LC	$285.00	$380.00	—	196% above	25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase LC	$285.00	$380.00	—	—	25%
Liver function blood test panel CPT 80076 Hep Fnct Pnl	$268.50	$358.00	—	77% above	25%
Liver function blood test panel inpatient CPT 80076 Hep Fnct Pnl	$268.50	$358.00	—	—	25%
Lyme disease antibody test CPT 86618 Lyme IgG/IgM LC	$11.90	$15.87	—	44% below	25%
Lyme disease antibody test CPT 86618 Lyme Disease Total Antibody with reflex LC	$29.76	$39.68	—	41% above	25%
Lyme disease antibody test inpatient CPT 86618 Lyme IgG/IgM LC	$11.90	$15.87	—	—	25%
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Total Antibody with reflex LC	$29.76	$39.68	—	—	25%
Magnesium blood test CPT 83735 Magnesium Level	$134.25	$179.00	—	112% above	25%
Magnesium blood test inpatient CPT 83735 Magnesium Level	$134.25	$179.00	—	—	25%
Measles (rubeola) antibody test CPT 86765 Measles Antibodies, IgG LC	$15.00	$20.00	—	52% below	25%
Measles (rubeola) antibody test inpatient CPT 86765 Measles Antibodies, IgG LC	$15.00	$20.00	—	—	25%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Test, Qual LC	$268.12	$357.50	—	161% above	25%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Test, Qual LC	$268.12	$357.50	—	—	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA-Total	$131.25	$175.00	—	120% above	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA-Total	$131.25	$175.00	—	—	25%
Parathyroid hormone (PTH) blood test CPT 83970 PTH, Intact LC	$26.25	$35.00	—	76% below	25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, Intact LC	$26.25	$35.00	—	—	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT, Activated	$81.00	$108.00	—	30% above	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 Vancomycin Level Trough	$105.00	$140.00	—	68% above	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT, Activated	$81.00	$108.00	—	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Vancomycin Level Trough	$105.00	$140.00	—	—	25%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus LC	$5.44	$7.25	—	93% below	25%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus	$85.50	$114.00	—	13% above	25%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus LC	$5.44	$7.25	—	—	25%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus	$85.50	$114.00	—	—	25%
Potassium blood test CPT 84132 Phenytoin Level Total	$72.00	$96.00	—	2% below	25%
Potassium blood test CPT 84132 Potassium Level	$72.00	$96.00	—	2% below	25%
Potassium blood test inpatient CPT 84132 Phenytoin Level Total	$72.00	$96.00	—	—	25%
Potassium blood test inpatient CPT 84132 Potassium Level	$72.00	$96.00	—	—	25%
Progesterone blood test CPT 84144 Progesterone LC	$17.44	$23.25	—	79% below	25%
Progesterone blood test inpatient CPT 84144 Progesterone LC	$17.44	$23.25	—	—	25%
Prolactin blood test CPT 84146 Prolactin LC	$14.25	$19.00	—	87% below	25%
Prolactin blood test inpatient CPT 84146 Prolactin LC	$14.25	$19.00	—	—	25%
Prothrombin time (PT/INR) clotting test CPT 85610 Vancomycin Level Peak	$81.00	$108.00	—	48% above	25%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time and INR	$105.00	$140.00	—	91% above	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Vancomycin Level Peak	$81.00	$108.00	—	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time and INR	$105.00	$140.00	—	—	25%
Rapid flu test (influenza antigen) CPT 87804 Influenza A+B Ag, EIA LC	$32.02	$42.70	—	58% below	25%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A+B Ag, EIA LC	$32.02	$42.70	—	—	25%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A Rapid	$72.31	$96.41	—	33% below	25%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A Rapid	$72.31	$96.41	—	—	25%
Rh blood typing CPT 86901 Rh Only	$59.25	$79.00	—	6% above	25%
Rh blood typing inpatient CPT 86901 Rh Only	$59.25	$79.00	—	—	25%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Arthritis Factor LC	$8.34	$11.12	—	37% below	25%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Arthritis Factor LC	$8.34	$11.12	—	—	25%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies, IgG LC	$9.38	$12.50	—	82% below	25%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies, IgM LC	$19.04	$25.38	—	62% below	25%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies, IgG LC	$9.38	$12.50	—	—	25%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies, IgM LC	$19.04	$25.38	—	—	25%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate-Westergren LC	$46.12	$61.50	—	18% below	25%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Influenza A Ag (Sofia)	$71.25	$95.00	—	27% above	25%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR Automated	$71.25	$95.00	—	27% above	25%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 TSH LC	$71.25	$95.00	—	27% above	25%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate-Westergren LC	$46.12	$61.50	—	—	25%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 TSH LC	$71.25	$95.00	—	—	25%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Influenza A Ag (Sofia)	$71.25	$95.00	—	—	25%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR Automated	$71.25	$95.00	—	—	25%
Sodium blood test CPT 84295 Protein 24 Hour Urine	$85.50	$114.00	—	30% above	25%
Sodium blood test inpatient CPT 84295 Protein 24 Hour Urine	$85.50	$114.00	—	—	25%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Immunological Fecal Occult Blood	$78.00	$104.00	—	100% above	25%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Immunological Fecal Occult Blood	$78.00	$104.00	—	—	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema pallidum Antibodies LC	$15.84	$21.12	—	2% below	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema pallidum Antibodies LC	$15.84	$21.12	—	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR Syphilis: RPR With Reflex to RPR Titer LC Test006072	$5.92	$7.90	—	56% below	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR, Rfx Qn RPR/Confirm TP Ab LC Test 012005	$32.25	$43.00	—	140% above	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR Syphilis: RPR With Reflex to RPR Titer LC Test006072	$5.92	$7.90	—	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR, Rfx Qn RPR/Confirm TP Ab LC Test 012005	$32.25	$43.00	—	—	25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus LC	$103.12	$137.50	—	22% above	25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QFT-TB Plus (Client Incubated) LC	$103.12	$137.50	—	22% above	25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus LC	$103.12	$137.50	—	—	25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QFT-TB Plus (Client Incubated) LC	$103.12	$137.50	—	—	25%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone LC	$12.68	$16.90	—	68% below	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone LC	$12.68	$16.90	—	—	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsomal Ab LC	$10.91	$14.55	—	52% below	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Ab LC	$10.91	$14.55	—	52% below	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Ab LC	$10.91	$14.55	—	—	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsomal Ab LC	$10.91	$14.55	—	—	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$150.00	$200.00	—	62% above	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$150.00	$200.00	—	—	25%
Total IgE blood test CPT 82785 Immunoglobulin E, Total LC	$12.68	$16.90	—	80% below	25%
Total IgE blood test inpatient CPT 82785 Immunoglobulin E, Total LC	$12.68	$16.90	—	—	25%
Total cholesterol blood test CPT 82465 lipoprotein	$139.50	$186.00	—	232% above	25%
Total cholesterol blood test inpatient CPT 82465 lipoprotein	$139.50	$186.00	—	—	25%
Total thyroxine (T4) blood test CPT 84436 T4, Total	$78.75	$105.00	—	101% above	25%
Total thyroxine (T4) blood test CPT 84436 T3 Uptake	$81.00	$108.00	—	107% above	25%
Total thyroxine (T4) blood test inpatient CPT 84436 T4, Total	$78.75	$105.00	—	—	25%
Total thyroxine (T4) blood test inpatient CPT 84436 T3 Uptake	$81.00	$108.00	—	—	25%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (T3) LC	$12.68	$16.90	—	84% below	25%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (T3) LC	$12.68	$16.90	—	—	25%
Transferrin blood test CPT 84466 Transferrin LC	$11.68	$15.58	—	78% below	25%
Transferrin blood test inpatient CPT 84466 Transferrin LC	$11.68	$15.58	—	—	25%
Troponin test, quantitative CPT 84484 hs Troponin-I	$151.50	$202.00	—	15% below	25%
Troponin test, quantitative inpatient CPT 84484 hs Troponin-I	$151.50	$202.00	—	—	25%
Uric acid blood test CPT 84550 Uric Acid LC	$5.44	$7.25	—	92% below	25%
Uric acid blood test CPT 84550 Uric Acid	$36.00	$48.00	—	46% below	25%
Uric acid blood test CPT 84550 Sodium Level	$81.00	$108.00	—	23% above	25%
Uric acid blood test inpatient CPT 84550 Uric Acid LC	$5.44	$7.25	—	—	25%
Uric acid blood test inpatient CPT 84550 Uric Acid	$36.00	$48.00	—	—	25%
Uric acid blood test inpatient CPT 84550 Sodium Level	$81.00	$108.00	—	—	25%
Urinalysis with microscope exam, manual CPT 81000 Urinalysis Complete with Culture if Indicated	$109.50	$146.00	—	245% above	25%
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis Complete with Culture if Indicated	$109.50	$146.00	—	—	25%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis, Routine LC	$22.50	$30.00	—	60% below	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis, Routine LC	$22.50	$30.00	—	—	25%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture, Routine LC	$206.25	$275.00	—	48% above	25%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture,Comprehensive LC	$206.25	$275.00	—	48% above	25%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture,Comprehensive LC	$206.25	$275.00	—	—	25%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture, Routine LC	$206.25	$275.00	—	—	25%
Urine microalbumin (albumin) test CPT 82043 Urine Microalbumin	$42.75	$57.00	—	16% above	25%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Level Urine	$42.75	$57.00	—	16% above	25%
Urine microalbumin (albumin) test inpatient CPT 82043 Urine Microalbumin	$42.75	$57.00	—	—	25%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Level Urine	$42.75	$57.00	—	—	25%
Urine pregnancy test, read by color change CPT 81025 Beta hCG Qualitative Urine	$85.50	$114.00	—	3% below	25%
Urine pregnancy test, read by color change inpatient CPT 81025 Beta hCG Qualitative Urine	$85.50	$114.00	—	—	25%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 LC	$9.70	$12.93	—	90% below	25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 LC	$9.70	$12.93	—	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25-Hydroxy LC	$19.84	$26.45	—	69% below	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D, 25-Hydroxy LC	$19.84	$26.45	—	—	25%
Zinc blood test CPT 84630 Zinc LC	$8.76	$11.68	—	20% below	25%
Zinc blood test CPT 84630 Zinc, Whole Blood LC	$8.76	$11.68	—	20% below	25%
Zinc blood test inpatient CPT 84630 Zinc LC	$8.76	$11.68	—	—	25%
Zinc blood test inpatient CPT 84630 Zinc, Whole Blood LC	$8.76	$11.68	—	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta hCG Quantitative	$145.50	$194.00	—	19% below	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta hCG Quantitative	$145.50	$194.00	—	—	25%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Left	$2,896.50	$3,862.00	—	33% below	25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Right	$2,896.50	$3,862.00	—	33% below	25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Right	$2,896.50	$3,862.00	—	—	25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Left	$2,896.50	$3,862.00	—	—	25%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786-Distal Fibular w/o Manipulation	$1,308.57	$1,744.76	—	144% above	25%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 27786-Distal Fibular w/o Manipulation	$1,308.57	$1,744.76	—	—	25%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28470 - Metatarsal w/o manipulation	$930.94	$1,241.26	—	73% above	25%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 28470 - Metatarsal w/o manipulation	$930.94	$1,241.26	—	—	25%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 - Cardioversion; Elective	$667.00	$889.34	—	65% below	25%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 - Cardioversion; Elective	$667.00	$889.34	—	—	25%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600-Distal Radial w/o Manipulation	$1,361.04	$1,814.72	—	144% above	25%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 25600-Distal Radial w/o Manipulation	$1,361.04	$1,814.72	—	—	25%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Ear Irrigation POC	$45.75	$61.00	—	74% below	25%
Earwax removal by irrigation (rinsing), one ear CPT 69209 69209-Cerumen Irrigation/Lavage	$108.75	$145.00	—	39% below	25%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Ear Irrigation POC	$45.75	$61.00	—	—	25%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209-Cerumen Irrigation/Lavage	$108.75	$145.00	—	—	25%
Earwax removal with instruments, one ear CPT 69210 69210-Cerumen w/ Instrumentation	$210.00	$280.00	—	11% above	25%
Earwax removal with instruments, one ear inpatient CPT 69210 69210-Cerumen w/ Instrumentation	$210.00	$280.00	—	—	25%
Incision and drainage of a simple or single skin abscess CPT 10060 10060-I&D Abscess/Cyst/Hematoma Simple	$464.28	$619.04	—	1% below	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060-I&D Abscess/Cyst/Hematoma Simple	$464.28	$619.04	—	—	25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 - Inj single tendon/ligament	$634.50	$846.00	—	4% below	25%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 - Inj single tendon/ligament	$634.50	$846.00	—	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-Major Joint Aspirate/Inject w/o US	$244.06	$325.42	—	74% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610-Major Joint Aspirate/Inject w/o US	$244.06	$325.42	—	—	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605-Intermediate Aspiration/Inj w/o US	$202.72	$270.30	—	67% below	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605-Intermediate Aspiration/Inj w/o US	$202.72	$270.30	—	—	25%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600-Small Joint Aspirate/Inject w/o US	$194.78	$259.70	—	73% below	25%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600-Small Joint Aspirate/Inject w/o US	$194.78	$259.70	—	—	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031-Scalp/Trunk/Extremity Less Than/Equal to 2.5 cm	$739.35	$985.80	—	15% below	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031-Scalp/Trunk/Extremity Less Than/Equal to 2.5 cm	$739.35	$985.80	—	—	25%
Nail removal (partial or complete), one nail CPT 11730 11730-Avulsion Nail Plate Single	$297.33	$396.44	—	41% below	25%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730-Avulsion Nail Plate Single	$297.33	$396.44	—	—	25%
Paracentesis with imaging guidance CPT 49083 US Thoracentesis	$1,620.00	$2,160.00	—	12% below	25%
Paracentesis with imaging guidance inpatient CPT 49083 US Thoracentesis	$1,620.00	$2,160.00	—	—	25%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750-Excision Nail & Matrix	$874.50	$1,166.00	—	33% below	25%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750-Excision Nail & Matrix	$874.50	$1,166.00	—	—	25%
Removal of a foreign object under the skin, simple CPT 10120 10120-Subcutaneous Tissue Simple	$488.13	$650.84	—	50% below	25%
Removal of a foreign object under the skin, simple inpatient CPT 10120 10120-Subcutaneous Tissue Simple	$488.13	$650.84	—	—	25%
Short arm splint (forearm and hand) CPT 29125 29125-Short Arm	$179.25	$239.00	—	57% below	25%
Short arm splint (forearm and hand) inpatient CPT 29125 29125-Short Arm	$179.25	$239.00	—	—	25%
Short leg cast (below the knee) CPT 29405 29405-App of Short Leg Cast (below knee to toes)	$293.36	$391.14	—	41% below	25%
Short leg cast (below the knee) inpatient CPT 29405 29405-App of Short Leg Cast (below knee to toes)	$293.36	$391.14	—	—	25%
Short leg splint (calf to foot) CPT 29515 29515-Short Leg	$251.22	$334.96	—	49% below	25%
Short leg splint (calf to foot) inpatient CPT 29515 29515-Short Leg	$251.22	$334.96	—	—	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm	$244.86	$326.48	—	56% below	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm	$244.86	$326.48	—	—	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270-Lumbar Puncture Diagnostic	$418.96	$558.62	—	68% below	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270-Lumbar Puncture Diagnostic	$418.96	$558.62	—	—	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm	$325.95	$434.60	—	56% below	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm	$325.95	$434.60	—	—	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm	$306.87	$409.16	—	54% below	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm	$306.87	$409.16	—	—	25%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102-Tangential Biopsy of Skin	$255.20	$340.26	—	54% below	25%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102-Tangential Biopsy of Skin	$255.20	$340.26	—	—	25%
Thoracentesis with imaging guidance CPT 32555 US Paracentesis	$1,347.75	$1,797.00	—	34% below	25%
Thoracentesis with imaging guidance CPT 32555 32555-Thoracentesis w/ Imaging Guidance	$1,347.75	$1,797.00	—	34% below	25%
Thoracentesis with imaging guidance inpatient CPT 32555 US Paracentesis	$1,347.75	$1,797.00	—	—	25%
Thoracentesis with imaging guidance inpatient CPT 32555 32555-Thoracentesis w/ Imaging Guidance	$1,347.75	$1,797.00	—	—	25%
Trigger point injections, 1 or 2 muscles CPT 20552 20552-Inject Trigger Point 1-2 Muscles	$634.50	$846.00	—	1% below	25%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552-Inject Trigger Point 1-2 Muscles	$634.50	$846.00	—	—	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w/ US Guide Right	$2,896.50	$3,862.00	—	10% below	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w/ US Guide Left	$2,896.50	$3,862.00	—	10% below	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w/ US Guide Right	$2,896.50	$3,862.00	—	—	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w/ US Guide Left	$2,896.50	$3,862.00	—	—	25%
Upper endoscopy (EGD) with biopsy CPT 43239 43239 - Upper Gastrointestinal Endoscopy	$778.30	$1,037.74	—	56% below	25%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239 - Upper Gastrointestinal Endoscopy	$778.30	$1,037.74	—	—	25%
Wart removal, up to 14 warts CPT 17110 17110 - Destruction benign; up to 14	$313.23	$417.64	—	13% below	25%
Wart removal, up to 14 warts inpatient CPT 17110 17110 - Destruction benign; up to 14	$313.23	$417.64	—	—	25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042-SQ Tissue Less Than/Equal to 1st 20 sq cm	$321.98	$429.30	—	53% below	25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042-SQ Tissue Less Than/Equal to 1st 20 sq cm	$321.98	$429.30	—	—	25%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Product Administration	$618.75	$825.00	—	29% below	25%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration Transfusion	$618.75	$825.00	—	29% below	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Product Administration	$618.75	$825.00	—	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Transfusion	$618.75	$825.00	—	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Electrocardiogram 12 Lead	$162.00	$216.00	—	50% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Meter Dose Inhaler Subsequent CHARGE	$162.00	$216.00	—	50% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Continuous Neb Subsequent Charge	$162.00	$216.00	—	50% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Continuous Neb Initial Charge	$162.00	$216.00	—	50% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Mini-Neb Subsequent CHARGE	$162.00	$216.00	—	50% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Mini-Neb Initial CHARGE	$162.00	$216.00	—	50% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Sputum Induction Subsequent Charge	$162.00	$216.00	—	50% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Meter Dose Inhaler Initial CHARGE	$162.00	$216.00	—	50% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Continuous Neb Subsequent Charge	$162.00	$216.00	—	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Meter Dose Inhaler Initial CHARGE	$162.00	$216.00	—	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Meter Dose Inhaler Subsequent CHARGE	$162.00	$216.00	—	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Continuous Neb Initial Charge	$162.00	$216.00	—	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Mini-Neb Initial CHARGE	$162.00	$216.00	—	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Sputum Induction Subsequent Charge	$162.00	$216.00	—	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Electrocardiogram 12 Lead	$162.00	$216.00	—	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Mini-Neb Subsequent CHARGE	$162.00	$216.00	—	—	25%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care Ill/Injured Patient Init 30-74 Min 99291	$4,588.50	$6,118.00	—	16% below	25%
Critical care, first 30 to 74 minutes CPT 99291 99291 - Critical Care, 30-74	$4,588.50	$6,118.00	—	16% below	25%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - Critical Care, 30-74	$4,588.50	$6,118.00	—	—	25%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care Ill/Injured Patient Init 30-74 Min 99291	$4,588.50	$6,118.00	—	—	25%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 93041 RHYTHM ECG TRACING CHARGE	$162.00	$216.00	—	81% above	25%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 93041 RHYTHM ECG TRACING CHARGE	$162.00	$216.00	—	—	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge one side CPT 93005 Routine ECG 12 lead/15 lead tracing only - EKG Charges - RT	$238.50	$318.00	—	29% below	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient one side CPT 93005 Routine ECG 12 lead/15 lead tracing only - EKG Charges - RT	$238.50	$318.00	—	—	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1	$542.25	$723.00	—	29% above	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor one side CPT 99281 11112 ED Left Without Being Seen	$375.00	$500.00	—	11% below	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1	$542.25	$723.00	—	—	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient one side CPT 99281 11112 ED Left Without Being Seen	$375.00	$500.00	—	—	25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2	$787.50	$1,050.00	—	10% below	25%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2	$787.50	$1,050.00	—	—	25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3	$1,115.25	$1,487.00	—	26% below	25%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3	$1,115.25	$1,487.00	—	—	25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4	$2,079.00	$2,772.00	—	23% below	25%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4	$2,079.00	$2,772.00	—	—	25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5	$2,297.25	$3,063.00	—	35% below	25%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5	$2,297.25	$3,063.00	—	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV INF HYDRAT 31-60 CHARGE	$173.25	$231.00	—	65% below	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV HYDRATION >30 MIN CHARGE	$302.25	$403.00	—	39% below	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 Hydration, first hour	$387.96	$517.28	—	22% below	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 INFUS HYDRATION,INITIAL 31-1HR CHARGE	$667.50	$890.00	—	34% above	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 OB INFUS HYDRATION,INIT 31-1HR CHARGE	$667.50	$890.00	—	34% above	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 IV INF HYDRAT 31-60 CHARGE	$173.25	$231.00	—	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 IV HYDRATION >30 MIN CHARGE	$302.25	$403.00	—	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 Hydration, first hour	$387.96	$517.28	—	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 OB INFUS HYDRATION,INIT 31-1HR CHARGE	$667.50	$890.00	—	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 INFUS HYDRATION,INITIAL 31-1HR CHARGE	$667.50	$890.00	—	—	25%
IV infusion of a medicine, first hour CPT 96365 96365 IV INFUSION NONCHEMO CHARGE	$130.50	$174.00	—	78% below	25%
IV infusion of a medicine, first hour CPT 96365 96365 IV tx, first hour	$186.03	$248.04	—	68% below	25%
IV infusion of a medicine, first hour CPT 96365 96365-59 Infusion Initial Addl Site w/ Modification	$349.00	$465.34	—	41% below	25%
IV infusion of a medicine, first hour CPT 96365 96365 IVP INFUSION CHARGE	$375.00	$500.00	—	36% below	25%
IV infusion of a medicine, first hour CPT 96365 96365 OB IV MED INF INITIAL 60 MIN CHARGE	$671.25	$895.00	—	14% above	25%
IV infusion of a medicine, first hour CPT 96365 96365 IV MED INF INITIAL 60 MIN CHARGE	$671.25	$895.00	—	14% above	25%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV INFUSION NONCHEMO CHARGE	$130.50	$174.00	—	—	25%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV tx, first hour	$186.03	$248.04	—	—	25%
IV infusion of a medicine, first hour inpatient CPT 96365 96365-59 Infusion Initial Addl Site w/ Modification	$349.00	$465.34	—	—	25%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 IVP INFUSION CHARGE	$375.00	$500.00	—	—	25%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV MED INF INITIAL 60 MIN CHARGE	$671.25	$895.00	—	—	25%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 OB IV MED INF INITIAL 60 MIN CHARGE	$671.25	$895.00	—	—	25%
IV push of a medicine, first drug CPT 96374 96374 IVP INJECTION SINGLE CHARGE	$141.00	$188.00	—	60% below	25%
IV push of a medicine, first drug CPT 96374 96374 IVP THERAP INJ CHARGE	$141.00	$188.00	—	60% below	25%
IV push of a medicine, first drug CPT 96374 96374 IVP INJECTION CHARGE	$141.00	$188.00	—	60% below	25%
IV push of a medicine, first drug CPT 96374 96374 IVP INITIAL SUBST/DRUG CHARGE	$157.20	$209.60	—	56% below	25%
IV push of a medicine, first drug CPT 96374 96374 IV Injection, single/initial	$313.50	$418.00	—	11% below	25%
IV push of a medicine, first drug CPT 96374 96374-59 IV Push Initial Drug Addl Site w/ Modification	$318.00	$424.00	—	10% below	25%
IV push of a medicine, first drug inpatient CPT 96374 96374 IVP THERAP INJ CHARGE	$141.00	$188.00	—	—	25%
IV push of a medicine, first drug inpatient CPT 96374 96374 IVP INJECTION SINGLE CHARGE	$141.00	$188.00	—	—	25%
IV push of a medicine, first drug inpatient CPT 96374 96374 IVP INJECTION CHARGE	$141.00	$188.00	—	—	25%
IV push of a medicine, first drug inpatient CPT 96374 96374 IVP INITIAL SUBST/DRUG CHARGE	$157.20	$209.60	—	—	25%
IV push of a medicine, first drug inpatient CPT 96374 96374 IV Injection, single/initial	$313.50	$418.00	—	—	25%
IV push of a medicine, first drug inpatient CPT 96374 96374-59 IV Push Initial Drug Addl Site w/ Modification	$318.00	$424.00	—	—	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection-Intramuscular/SubQ - AMB Inj Med Admin Charge	$27.75	$37.00	—	85% below	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-59 SQ/IM Injection w/ Modification	$147.75	$197.00	—	18% below	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 INJECTION THERAP ANTIBIOT CHARGE	$162.75	$217.00	—	9% below	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 INJECTION THERAP SUBQ/IM CHARGE	$162.75	$217.00	—	9% below	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 INJECTION SC/IM CHARGE	$162.75	$217.00	—	9% below	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 OB THERAP INJ SUBQ/IM CHARGE	$213.75	$285.00	—	19% above	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Subq/IM Injection	$273.75	$365.00	—	53% above	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection-Intramuscular/SubQ - AMB Inj Med Admin Charge	$27.75	$37.00	—	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372-59 SQ/IM Injection w/ Modification	$147.75	$197.00	—	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 INJECTION THERAP SUBQ/IM CHARGE	$162.75	$217.00	—	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 INJECTION SC/IM CHARGE	$162.75	$217.00	—	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 INJECTION THERAP ANTIBIOT CHARGE	$162.75	$217.00	—	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 OB THERAP INJ SUBQ/IM CHARGE	$213.75	$285.00	—	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 Subq/IM Injection	$273.75	$365.00	—	—	25%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units	$54.00	$72.00	—	58% below	25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Units	$54.00	$72.00	—	—	25%
New patient office visit, about 30 minutes CPT 99203 99203 Office/Outpatient Visit - New Patient, Level 3 (30 min)	$172.50	$230.00	—	19% below	25%
New patient office visit, about 30 minutes inpatient CPT 99203 99203 Office/Outpatient Visit - New Patient, Level 3 (30 min)	$172.50	$230.00	—	—	25%
New patient office visit, about 45 minutes CPT 99204 99204 Office/Outpatient Visit - New Patient, Level 4 (45 min)	$172.50	$230.00	—	29% below	25%
New patient office visit, about 45 minutes inpatient CPT 99204 99204 Office/Outpatient Visit - New Patient, Level 4 (45 min)	$172.50	$230.00	—	—	25%
New patient office visit, about 60 minutes CPT 99205 99205 Office/Outpatient Visit - New Patient, Level 5 (60 min)	$172.50	$230.00	—	50% below	25%
New patient office visit, about 60 minutes CPT 99205 99205 OB TRIAGE NEW PT CHARGE	$562.50	$750.00	—	64% above	25%
New patient office visit, about 60 minutes inpatient CPT 99205 99205 Office/Outpatient Visit - New Patient, Level 5 (60 min)	$172.50	$230.00	—	—	25%
New patient office visit, about 60 minutes inpatient CPT 99205 99205 OB TRIAGE NEW PT CHARGE	$562.50	$750.00	—	—	25%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Office/Outpatient Visit - New Patient, Level 2 (20 min)	$172.50	$230.00	—	24% above	25%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 Office/Outpatient Visit - New Patient, Level 2 (20 min)	$172.50	$230.00	—	—	25%
Occupational therapy evaluation, low complexity CPT 97165 OT Evaluation Units, Low Complexity	$140.25	$187.00	—	46% below	25%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Evaluation Units, Low Complexity	$140.25	$187.00	—	—	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Evaluation Units, High Complexity	$382.50	$510.00	—	3% below	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Evaluation Units, High Complexity	$382.50	$510.00	—	—	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Evaluation Units, Low Complexity	$255.00	$340.00	—	8% above	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Evaluation Units, Low Complexity	$255.00	$340.00	—	—	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Units, Moderate Complexity	$228.75	$305.00	—	35% below	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Evaluation Units, Moderate Complexity	$228.75	$305.00	—	—	25%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units	$112.50	$150.00	—	6% below	25%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units	$112.50	$150.00	—	—	25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units	$122.25	$163.00	—	5% below	25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units	$122.25	$163.00	—	—	25%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 99406 Smoking/Tobacco Cessation Counseling; 3-10 Min	$15.00	$20.00	—	80% below	25%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 99406 Smoking/Tobacco Cessation Counseling; 3-10 Min	$15.00	$20.00	—	—	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Office/Outpatient Visit - Established Patient, Level 5 (40 min)	$172.50	$230.00	—	32% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 OB TRIAGE ESTAB PT CHARGE	$446.25	$595.00	—	77% above	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 Office/Outpatient Visit - Established Patient, Level 5 (40 min)	$172.50	$230.00	—	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 OB TRIAGE ESTAB PT CHARGE	$446.25	$595.00	—	—	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office/Outpatient Visit - Established Patient, Level 3 (15 min)	$172.50	$230.00	—	21% above	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 Office/Outpatient Visit - Established Patient, Level 3 (15 min)	$172.50	$230.00	—	—	25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Office/Outpatient Visit - Established Patient, Level 4 (25 min)	$172.50	$230.00	—	14% below	25%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 Office/Outpatient Visit - Established Patient, Level 4 (25 min)	$172.50	$230.00	—	—	25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office/Outpatient Visit - Established Patient, Level 2 (10 min)	$172.50	$230.00	—	50% above	25%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Office/Outpatient Visit - Established Patient, Level 2 (10 min)	$172.50	$230.00	—	—	25%
Spirometry (breathing test) CPT 94010 RT Incentive Spirometry Subseq CHARGE	$66.00	$88.00	—	83% below	25%
Spirometry (breathing test) one side CPT 94010 Spirometry - RT CHARGE PFT	$371.25	$495.00	—	3% below	25%
Spirometry (breathing test) inpatient CPT 94010 RT Incentive Spirometry Subseq CHARGE	$66.00	$88.00	—	—	25%
Spirometry (breathing test) inpatient one side CPT 94010 Spirometry - RT CHARGE PFT	$371.25	$495.00	—	—	25%
Spirometry before and after a bronchodilator one side CPT 94060 Spirometry before & after - RT CHARGE PFT	$560.25	$747.00	—	30% below	25%
Spirometry before and after a bronchodilator inpatient one side CPT 94060 Spirometry before & after - RT CHARGE PFT	$560.25	$747.00	—	—	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units	$120.00	$160.00	—	13% below	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units	$120.00	$160.00	—	—	25%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Adult First Vaccine 90471 - Admin Immunization Charge	$123.75	$165.00	—	18% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471-Vaccine Administration	$162.75	$217.00	—	56% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Adult First Vaccine 90471 - Admin Immunization Charge	$123.75	$165.00	—	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471-Vaccine Administration	$162.75	$217.00	—	—	25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Adult Each Additional 90472 - Admin Immunization Charge	$58.83	$78.44	—	26% below	25%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Adult Each Additional 90472 - Admin Immunization Charge	$58.83	$78.44	—	—	25%

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?pxi=mFf*_*YSFqd65wsOm0aEz6fg*-*