Hospital New York-Newark-Jersey City, NY-NJ

Maimonides Medical Center

Maimonides Medical Center in Brooklyn, NY publishes cash prices for 472 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the New York median for 391 of 470 procedures and below it for 73. By typical cash price it ranks #89 of 115 New York hospitals and #66 of 86 hospitals in the New York, NY area, cheapest first. Select a procedure to compare it with other hospitals nearby.

4802 Tenth Avenue, Brooklyn, NY 11219 Collected Sep 22, 2026 Source price file Check a bill from this hospital (718) 283-6000

Acute care hospital Nonprofit hospital Emergency department CMS star rating 2 of 5 CCN 330194 · CMS hospital register

The price file shows no self-pay discount

For 2152 of the 2152 prices listed here, the cash price in Maimonides Medical Center's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

Financial assistance

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

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

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

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

State law

This state limits hospital bills for lower-income patients

New York law (Public Health Law §2807-k(9-a), as amended in October 2024): uninsured patients with income below 200% of the federal poverty level owe nothing for emergency and medically necessary hospital care; up to 400% they pay on a sliding scale of at most 10% or 20% of what Medicaid would pay. Emergency care is covered for New York residents, other care for people living in the hospital's service area; immigration status does not count. Ask for the Uniform Hospital Financial Assistance form. 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 4 actions for a hospital named Maimonides Medical Center in Brooklyn, NY:

Apr 19, 2021 Warning notice
Sep 30, 2021 Corrective action plan requested
Feb 2, 2022 Case closed
Mar 19, 2025 Met requirements

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems. Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/WO CONTRAST	$3,805.00	$3,805.00	—	189% above	—
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/ AND W/O CONTRAST	$3,805.00	$3,805.00	—	189% above	—
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/ AND W/O CONTRAST	$3,805.00	$3,805.00	—	—	—
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/WO CONTRAST	$3,805.00	$3,805.00	—	—	—
Abdominal X-ray, 2 views CPT 74019 RAD EXAM,ABDOMEN,2 VIEW	$440.00	$440.00	—	71% above	—
Abdominal X-ray, 2 views inpatient CPT 74019 RAD EXAM,ABDOMEN,2 VIEW	$440.00	$440.00	—	—	—
Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE MIN THREE VIEWS	$550.00	$550.00	—	173% above	—
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE MIN THREE VIEWS	$550.00	$550.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 NONINVAS STD,EXT ART,SGL LV,BI	$550.00	$550.00	—	72% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ABI SINGLE LEVEL BIL	$550.00	$550.00	—	72% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 PVR SINGLE LEVEL BIL UE/LE	$550.00	$550.00	—	72% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 LTD BIL EXT ART STDY	$550.00	$550.00	—	72% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 PVR SINGLE LEVEL BIL UE/LE	$550.00	$550.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ABI SINGLE LEVEL BIL	$550.00	$550.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 LTD BIL EXT ART STDY	$550.00	$550.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 NONINVAS STD,EXT ART,SGL LV,BI	$550.00	$550.00	—	—	—
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UP EXTREMITY W/O CONTRAST	$1,485.00	$1,485.00	—	99% above	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UP EXTREMITY W/O CONTRAST	$1,485.00	$1,485.00	—	—	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS	$580.00	$580.00	—	69% above	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS	$580.00	$580.00	—	—	—
Bone scan, whole body (nuclear medicine) CPT 78306 BONE/JOINT WHOLE BODY	$1,760.00	$1,760.00	—	79% above	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE/JOINT WHOLE BODY	$1,760.00	$1,760.00	—	—	—
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILAT, COMPLETE	$193.00	$193.00	—	40% below	—
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST,UNILAT,COMPLETE	$193.00	$193.00	—	40% below	—
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST UNILAT, COMPLETE	$193.00	$193.00	—	—	—
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST,UNILAT,COMPLETE	$193.00	$193.00	—	—	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST,UNILAT,LTD	$391.00	$391.00	—	55% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILAT, LTD	$391.00	$391.00	—	55% above	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILAT, LTD	$391.00	$391.00	—	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST,UNILAT,LTD	$391.00	$391.00	—	—	—
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD/ PELV COMBINED	$3,400.00	$3,400.00	—	94% above	—
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD/ PELV COMBINED	$3,400.00	$3,400.00	—	—	—
CT angiography (CTA) of the head CPT 70496 CTA HEAD W/CONT W/IMAG POSTPRC	$3,600.00	$3,600.00	—	192% above	—
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W/CONT W/IMAG POSTPRC	$3,600.00	$3,600.00	—	—	—
CT angiography (CTA) of the neck CPT 70498 CTA NECK W/CONT W/IMAG POSTPRC	$3,800.00	$3,800.00	—	205% above	—
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W/CONT W/IMAG POSTPRC	$3,800.00	$3,800.00	—	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/ or W/O CONTRAST	$3,300.00	$3,300.00	—	154% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/CONT W/IMAG POSTPR	$3,300.00	$3,300.00	—	154% above	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W/CONT W/IMAG POSTPR	$3,300.00	$3,300.00	—	—	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W/ or W/O CONTRAST	$3,300.00	$3,300.00	—	—	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO,HRT,COR ART/GFT,W/CON	$1,485.00	$1,485.00	—	14% above	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO,HRT,COR ART/GFT,W/CON	$1,485.00	$1,485.00	—	—	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT,HEART WO/CONT W/COR CA EVAL	$287.00	$287.00	—	34% above	—
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT,HEART WO/CONT W/COR CA EVAL	$287.00	$287.00	—	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELV WO/CONTRAST	$2,800.00	$2,800.00	—	145% above	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELV WO/CONTRAST	$2,800.00	$2,800.00	—	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELV W/CONTRAST	$2,800.00	$2,800.00	—	79% above	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELV W/CONTRAST	$2,800.00	$2,800.00	—	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELV W/WO CONTRAST	$3,100.00	$3,100.00	—	49% above	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELV W/WO CONTRAST	$3,100.00	$3,100.00	—	—	—
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$2,170.00	$2,170.00	—	87% above	—
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/ CONTRAST	$2,170.00	$2,170.00	—	87% above	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/ CONTRAST	$2,170.00	$2,170.00	—	—	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST	$2,170.00	$2,170.00	—	—	—
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$1,100.00	$1,100.00	—	20% above	—
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST	$1,100.00	$1,100.00	—	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL WO/ CONTRAST	$1,800.00	$1,800.00	—	127% above	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL WO/ CONTRAST	$1,800.00	$1,800.00	—	—	—
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONTRAST	$1,700.00	$1,700.00	—	105% above	—
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONTRAST	$1,700.00	$1,700.00	—	105% above	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O CONTRAST	$1,700.00	$1,700.00	—	—	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONTRAST	$1,700.00	$1,700.00	—	—	—
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/ CONTRAST	$2,500.00	$2,500.00	—	156% above	—
CT scan of the head with contrast CPT 70460 CT HEAD W/CONTRAST	$2,500.00	$2,500.00	—	156% above	—
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W/ CONTRAST	$2,500.00	$2,500.00	—	—	—
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/CONTRAST	$2,500.00	$2,500.00	—	—	—
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/WO CONTRAST	$2,420.00	$2,420.00	—	128% above	—
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO CONTRAST	$3,214.00	$3,214.00	—	202% above	—
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/WO CONTRAST	$2,420.00	$2,420.00	—	—	—
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO CONTRAST	$3,214.00	$3,214.00	—	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$1,599.00	$1,599.00	—	81% above	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$1,599.00	$1,599.00	—	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERV/SPINE WO CONTRAST	$1,575.00	$1,575.00	—	71% above	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERV SPINE W/O CONTRAST	$1,575.00	$1,575.00	—	71% above	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERV/SPINE WO CONTRAST	$1,575.00	$1,575.00	—	—	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERV SPINE W/O CONTRAST	$1,575.00	$1,575.00	—	—	—
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/ CONTRAST	$2,400.00	$2,400.00	—	133% above	—
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST	$2,400.00	$2,400.00	—	133% above	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST	$2,400.00	$2,400.00	—	—	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/ CONTRAST	$2,400.00	$2,400.00	—	—	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DUPLEX BILAT US	$1,053.00	$1,053.00	—	—	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID/VERTEBRAL DUPLEX BIL	$1,053.00	$1,053.00	—	62% above	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID DUPLEX BILAT US	$1,053.00	$1,053.00	—	—	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID/VERTEBRAL DUPLEX BIL	$1,053.00	$1,053.00	—	—	—
Chest CT scan without and with contrast CPT 71270 CT THORAX,DIAG; W/W/O CONTRAST	$963.00	$963.00	—	26% below	—
Chest CT scan without and with contrast CPT 71270 CT CHEST,DIAG;W/WO CONTRAST	$963.00	$963.00	—	26% below	—
Chest CT scan without and with contrast CPT 71270 SCREENING LUNG CT WO/CONTRAST	$963.00	$963.00	—	26% below	—
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX,DIAG; W/W/O CONTRAST	$963.00	$963.00	—	—	—
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST,DIAG;W/WO CONTRAST	$963.00	$963.00	—	—	—
Chest CT scan without and with contrast inpatient CPT 71270 SCREENING LUNG CT WO/CONTRAST	$963.00	$963.00	—	—	—
Chest X-ray, 2 views CPT 71046 CHEST XRAY TWO VIEWS AP & LAT	$355.00	$355.00	—	76% above	—
Chest X-ray, 2 views inpatient CPT 71046 CHEST XRAY TWO VIEWS AP & LAT	$355.00	$355.00	—	—	—
Chest X-ray, single view CPT 71045 CHEST XRAY SINGLE VIEW	$320.00	$320.00	—	61% above	—
Chest X-ray, single view inpatient CPT 71045 CHEST XRAY SINGLE VIEW	$320.00	$320.00	—	—	—
Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE COMPLETE	$440.00	$440.00	—	118% above	—
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE COMPLETE	$440.00	$440.00	—	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITN COMPL(RENAL)	$600.00	$600.00	—	42% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL ,COMPLETE	$600.00	$600.00	—	42% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL ,COMPLETE	$600.00	$600.00	—	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITN COMPL(RENAL)	$600.00	$600.00	—	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY STUDY AXIAL	$115.00	$115.00	—	58% below	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE STUDY, AXIAL SKELET	$581.00	$581.00	—	111% above	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY STUDY AXIAL	$115.00	$115.00	—	—	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE STUDY, AXIAL SKELET	$581.00	$581.00	—	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITY STUDY PERIPHERAL	$95.00	$95.00	—	34% below	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITY TEST,PERIPHERAL	$330.00	$330.00	—	129% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE STUDY, APPENDI SKELET	$330.00	$330.00	—	129% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY,PERIPHERAL	$330.00	$330.00	—	129% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BONE DENSITY STUDY PERIPHERAL	$95.00	$95.00	—	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE STUDY, APPENDI SKELET	$330.00	$330.00	—	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BONE DENSITY TEST,PERIPHERAL	$330.00	$330.00	—	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY,PERIPHERAL	$330.00	$330.00	—	—	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US,PREG UT/FETL MAT&ANAT,1GEST	$880.00	$880.00	—	55% above	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG UTERUS,DETAILED,SGL	$880.00	$880.00	—	55% above	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB,US,DETAILED ANATOMY,SING	$880.00	$880.00	—	55% above	—
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US,PREG UT/FETL MAT&ANAT,1GEST	$880.00	$880.00	—	—	—
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB,US,DETAILED ANATOMY,SING	$880.00	$880.00	—	—	—
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREG UTERUS,DETAILED,SGL	$880.00	$880.00	—	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX,DIAGN;W/O CONTRAST	$1,925.00	$1,925.00	—	122% above	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST,DIAGNOS;W/O CONTRAST	$1,925.00	$1,925.00	—	122% above	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST,DIAGNOS;W/O CONTRAST	$1,925.00	$1,925.00	—	—	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX,DIAGN;W/O CONTRAST	$1,925.00	$1,925.00	—	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX,DIAGNOS;W/ CONTRAST	$2,150.00	$2,150.00	—	65% above	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST,DIAGNOSTIC;W/CONTRAST	$2,150.00	$2,150.00	—	65% above	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX,DIAGNOS;W/ CONTRAST	$2,150.00	$2,150.00	—	—	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST,DIAGNOSTIC;W/CONTRAST	$2,150.00	$2,150.00	—	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO,INCL CAD, BILAT	$787.00	$787.00	—	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 SCREEN TO DX MAMMO,BILAT	$787.00	$787.00	—	—	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO,INCL CAD, BILAT	$787.00	$787.00	—	—	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 SCREEN TO DX MAMMO,BILAT	$787.00	$787.00	—	—	—
Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO,INCL CAD, UNILAT	$638.00	$638.00	—	127% above	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX MAMMO,INCL CAD, UNILAT	$638.00	$638.00	—	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 COMPL ART DOPP L/E BILAT	$1,315.00	$1,315.00	—	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 ART DOPP L/E BILAT	$1,315.00	$1,315.00	—	—	—
Duplex ultrasound of the leg arteries, both legs CPT 93925 ARTERIAL DUPLEX SCAN BIL LE	$1,315.00	$1,315.00	—	156% above	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 COMPL ART DOPP L/E BILAT	$1,315.00	$1,315.00	—	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 ART DOPP L/E BILAT	$1,315.00	$1,315.00	—	—	—
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 ARTERIAL DUPLEX SCAN BIL LE	$1,315.00	$1,315.00	—	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 BILATERAL VENOUS DUPLEX US	$1,315.00	$1,315.00	—	—	—
Duplex ultrasound of the leg veins, both legs CPT 93970 VENOUS DUPLEX SCAN BIL	$1,315.00	$1,315.00	—	74% above	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 BILATERAL VENOUS DUPLEX US	$1,315.00	$1,315.00	—	—	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VENOUS DUPLEX SCAN BIL	$1,315.00	$1,315.00	—	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO,COMPLETE WITH DOPPLER FLOW,MD INTERP	$555.00	$555.00	—	50% below	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE 2D COMP,W/SPEC &CF DOPPLER	$2,600.00	$2,600.00	—	135% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE COMPLETE	$2,600.00	$2,600.00	—	135% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO,COMPLETE WITH DOPPLER FLOW,MD INTERP	$555.00	$555.00	—	—	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE COMPLETE	$2,600.00	$2,600.00	—	—	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE 2D COMP,W/SPEC &CF DOPPLER	$2,600.00	$2,600.00	—	—	—
Elbow X-ray, 2 views CPT 73070 ELBOW AP AND LAT VIEWS	$415.00	$415.00	—	107% above	—
Elbow X-ray, 2 views inpatient CPT 73070 ELBOW AP AND LAT VIEWS	$415.00	$415.00	—	—	—
Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW AP/ LAT AND OBLIQUES	$440.00	$440.00	—	118% above	—
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 ELBOW AP/ LAT AND OBLIQUES	$440.00	$440.00	—	—	—
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS,PF,EAR W/O CONTRAST	$580.00	$580.00	—	22% below	—
Eye socket (orbit) CT scan without contrast CPT 70480 CT EAR/ORBIT/SELLA WO/CONTRAST	$580.00	$580.00	—	22% below	—
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT EAR/ORBIT/SELLA WO/CONTRAST	$580.00	$580.00	—	—	—
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS,PF,EAR W/O CONTRAST	$580.00	$580.00	—	—	—
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES MIN THREE VIEWS	$580.00	$580.00	—	114% above	—
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES MIN THREE VIEWS	$580.00	$580.00	—	—	—
Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM AP AND LAT	$375.00	$375.00	—	86% above	—
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 FOREARM AP AND LAT	$375.00	$375.00	—	—	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILUARY SYST IMAG	$1,800.00	$1,800.00	—	75% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYS IMAG,INCL GB	$1,800.00	$1,800.00	—	75% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILUARY SYST IMAG	$1,800.00	$1,800.00	—	—	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYS IMAG,INCL GB	$1,800.00	$1,800.00	—	—	—
Hand X-ray, 2 views CPT 73120 HAND TWO VIEWS	$600.00	$600.00	—	189% above	—
Hand X-ray, 2 views inpatient CPT 73120 HAND TWO VIEWS	$600.00	$600.00	—	—	—
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 CALCANEUS MIN TWO VIEWS	$396.00	$396.00	—	107% above	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 CALCANEUS MIN TWO VIEWS	$396.00	$396.00	—	—	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STDY,UNATTD P/02/RAF-EFF	$1,320.00	$1,320.00	—	236% above	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STDY,UNATTD P/02/RAF-EFF	$1,320.00	$1,320.00	—	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM AGE 6< ,4 OR<W/CPAP,AT	$5,858.00	$5,858.00	—	175% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOM AGE 6< ,4 OR<W/CPAP,AT	$5,858.00	$5,858.00	—	—	—
Knee X-ray, 3 views CPT 73562 KNEE AP AND LAT OBLIQU	$455.00	$455.00	—	121% above	—
Knee X-ray, 3 views inpatient CPT 73562 KNEE AP AND LAT OBLIQU	$455.00	$455.00	—	—	—
Knee X-ray, complete, 4 or more views CPT 73564 KNEE COMPLETE	$605.00	$605.00	—	120% above	—
Knee X-ray, complete, 4 or more views inpatient CPT 73564 KNEE COMPLETE	$605.00	$605.00	—	—	—
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREM W/O CONTRAST	$1,430.00	$1,430.00	—	92% above	—
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREM W/O CONTRAST	$1,430.00	$1,430.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US,ABD, WITH IMAGE DOC LTD	$570.00	$570.00	—	50% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LTD(SPLEEN)	$570.00	$570.00	—	50% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LTD(SPLEEN)	$570.00	$570.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US,ABD, WITH IMAGE DOC LTD	$570.00	$570.00	—	—	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LTD,JOINT/NONVAS EXT STRUCT	$575.00	$575.00	—	113% above	—
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LTD,JOINT/NONVAS EXT STRUCT	$575.00	$575.00	—	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 SCREENING LUNG CTLD WO CONTRAS	$1,320.00	$1,320.00	—	203% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 SCREENING LUNG CTLD WO CONTRAS	$1,320.00	$1,320.00	—	—	—
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIBIA & FIBULA AP AND LAT	$575.00	$575.00	—	185% above	—
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 TIBIA & FIBULA AP AND LAT	$575.00	$575.00	—	—	—
MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIO HEAD W/O CONTRAST	$3,080.00	$3,080.00	—	144% above	—
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR ANGIO HEAD W/O CONTRAST	$3,080.00	$3,080.00	—	—	—
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST,W&WO CONTRAST,BILAT	$3,229.00	$3,229.00	—	—	—
MRI of both breasts, without and then with contrast dye CPT 77049 MRI(CAD)BREAST,W/WO CONTR,BIL	$3,229.00	$3,229.00	—	at median	—
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST,W&WO CONTRAST,BILAT	$3,229.00	$3,229.00	—	—	—
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI(CAD)BREAST,W/WO CONTR,BIL	$3,229.00	$3,229.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JOINT OF LOW EXT WO/CONTR	$2,640.00	$2,640.00	—	120% above	—
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JOINT OF LOW EXT WO/CONTR	$2,640.00	$2,640.00	—	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LO EXT JNT WO/W	$3,740.00	$3,740.00	—	84% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LO EXT JNT WO/W	$3,740.00	$3,740.00	—	—	—
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO/CONTRAST	$2,310.00	$2,310.00	—	111% above	—
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO/CONTRAST	$2,310.00	$2,310.00	—	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD WO/W CONT	$3,300.00	$3,300.00	—	97% above	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD WO/W CONT	$3,300.00	$3,300.00	—	—	—
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST	$4,500.00	$4,500.00	—	287% above	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST	$4,500.00	$4,500.00	—	—	—
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/W/O CONTRAST	$6,564.00	$6,564.00	—	271% above	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/W/O CONTRAST	$6,564.00	$6,564.00	—	—	—
MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE W/O CONTRAST	$3,512.00	$3,512.00	—	169% above	—
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L SPINE W/O CONTRAST	$3,512.00	$3,512.00	—	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L SPINE W/W/O CONTRAST	$3,850.00	$3,850.00	—	117% above	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L SPINE W/W/O CONTRAST	$3,850.00	$3,850.00	—	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T SPINE W/O CONTRAST	$3,410.00	$3,410.00	—	166% above	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T SPINE W/O CONTRAST	$3,410.00	$3,410.00	—	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C SPINE W/W/O CONTRAST	$3,740.00	$3,740.00	—	127% above	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C SPINE W/W/O CONTRAST	$3,740.00	$3,740.00	—	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C SPINE W/O CONTRAST	$3,400.00	$3,400.00	—	157% above	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C SPINE W/O CONTRAST	$3,400.00	$3,400.00	—	—	—
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/W CONT	$3,685.00	$3,685.00	—	130% above	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO/W CONT	$3,685.00	$3,685.00	—	—	—
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO/CONT	$2,750.00	$2,750.00	—	157% above	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO/CONT	$2,750.00	$2,750.00	—	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UP EXT WO/CONTRAST	$2,035.00	$2,035.00	—	57% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI JOINT UP EXT WO/CONTRAST	$2,035.00	$2,035.00	—	—	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERV SPINE 4 or 5 VIEWS	$825.00	$825.00	—	192% above	—
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERV SPINE 4 or 5 VIEWS	$825.00	$825.00	—	—	—
Neck soft tissue CT scan with contrast CPT 70491 CT NECK CONTRAST	$2,800.00	$2,800.00	—	178% above	—
Neck soft tissue CT scan with contrast CPT 70491 CT NECK W/ CONTRAST	$2,800.00	$2,800.00	—	178% above	—
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK W/ CONTRAST	$2,800.00	$2,800.00	—	—	—
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK CONTRAST	$2,800.00	$2,800.00	—	—	—
Neck soft tissue CT scan without contrast CPT 70490 CT NECK W/O CONTRAST	$2,000.00	$2,000.00	—	147% above	—
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK W/O CONTRAST	$2,000.00	$2,000.00	—	—	—
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE	$345.00	$345.00	—	71% above	—
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE	$345.00	$345.00	—	—	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOC PERF,PLANAR,MULT RST/STRS	$5,995.00	$5,995.00	—	124% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL SPECT MULTIPLE STUD	$6,215.00	$6,215.00	—	132% above	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOC PERF,PLANAR,MULT RST/STRS	$5,995.00	$5,995.00	—	—	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL SPECT MULTIPLE STUD	$6,215.00	$6,215.00	—	—	—
OCT scan of the retina (optical coherence tomography) CPT 92134 CPTRZ OPH DX IMG PST SGM RTA	$285.00	$285.00	—	305% above	—
OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 CPTRZ OPH DX IMG PST SGM RTA	$285.00	$285.00	—	—	—
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL BASE TO MID THIGH	$7,150.00	$7,150.00	—	79% above	—
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT SKULL BASE TO MID THIGH	$7,150.00	$7,150.00	—	—	—
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$2,090.00	$2,090.00	—	151% above	—
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST	$2,090.00	$2,090.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US, PELVIC (NON-OBSTETRIC),LTD	$578.00	$578.00	—	92% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 APPENDIX ULTRASOUND	$578.00	$578.00	—	92% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US, PELVIC, LTD	$578.00	$578.00	—	92% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US,PELVIC,NON OBSTETRIC,LTD,FU	$578.00	$578.00	—	92% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 APPENDIX ULTRASOUND	$578.00	$578.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US, PELVIC (NON-OBSTETRIC),LTD	$578.00	$578.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US,PELVIC,NON OBSTETRIC,LTD,FU	$578.00	$578.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US, PELVIC, LTD	$578.00	$578.00	—	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM OF PELVIS, NON OB	$680.00	$680.00	—	70% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELV, NON OB,COMPLETE	$680.00	$680.00	—	70% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US,PELVIC,NON OBSTETRIC,COMPL	$680.00	$680.00	—	70% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC,NON OB,COMPLETE	$680.00	$680.00	—	70% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC (NON OB)	$680.00	$680.00	—	70% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC,NON OB,COMPLETE	$680.00	$680.00	—	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US EXAM OF PELVIS, NON OB	$680.00	$680.00	—	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELV, NON OB,COMPLETE	$680.00	$680.00	—	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC (NON OB)	$680.00	$680.00	—	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US,PELVIC,NON OBSTETRIC,COMPL	$680.00	$680.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB,US,>/=14 WKS, SING	$549.00	$549.00	—	45% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PRG UTR,/M 14WKS<SG/1ST GST	$549.00	$549.00	—	45% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTERUS>OR=14WKS,SGL	$549.00	$549.00	—	45% above	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTERUS>OR=14WKS,SGL	$549.00	$549.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PRG UTR,/M 14WKS<SG/1ST GST	$549.00	$549.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB,US,>/=14 WKS, SING	$549.00	$549.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB,US, <14WKS,SING	$556.00	$556.00	—	58% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UTERUS,<14WKS,SING	$556.00	$556.00	—	58% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US,ABD,PREG UTER,1ST GEST/TRI	$556.00	$556.00	—	58% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG UTERUS,<14WKS,SING	$556.00	$556.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US,ABD,PREG UTER,1ST GEST/TRI	$556.00	$556.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB,US, <14WKS,SING	$556.00	$556.00	—	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US,PREG UTERUS,LTD	$528.00	$528.00	—	82% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREG UTERUS,LTD	$528.00	$528.00	—	82% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US, PREGNANT UTERUS LIMITED	$528.00	$528.00	—	82% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US,PREG UTER,LTD	$528.00	$528.00	—	82% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US,PREG UTERUS,LTD,1<FETUSES	$528.00	$528.00	—	82% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US,PREG UTERUS,LTD,1<FETUSES	$528.00	$528.00	—	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US,PREG UTERUS,LTD	$528.00	$528.00	—	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US, PREGNANT UTERUS LIMITED	$528.00	$528.00	—	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREG UTERUS,LTD	$528.00	$528.00	—	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US,PREG UTER,LTD	$528.00	$528.00	—	—	—
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT TWO VIEWS	$377.00	$377.00	—	80% above	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILAT TWO VIEWS	$377.00	$377.00	—	—	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNILAT THREE VIEWS	$651.00	$651.00	—	149% above	—
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS UNILAT THREE VIEWS	$651.00	$651.00	—	—	—
Screening mammogram, both breasts both sides CPT 77067 SCREEN MAMMO,BILAT, INCL CAD	$633.00	$633.00	—	—	—
Screening mammogram, both breasts inpatient both sides CPT 77067 SCREEN MAMMO,BILAT, INCL CAD	$633.00	$633.00	—	—	—
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER MIN TWO VIEWS	$525.00	$525.00	—	150% above	—
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER MIN TWO VIEWS	$525.00	$525.00	—	—	—
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES THREE VIEWS	$380.00	$380.00	—	83% above	—
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES THREE VIEWS	$380.00	$380.00	—	—	—
Skull X-ray, fewer than 4 views CPT 70250 SKULL < FOUR VIEWS W/W/O STERE	$580.00	$580.00	—	151% above	—
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL < FOUR VIEWS W/W/O STERE	$580.00	$580.00	—	—	—
Sleep study in a lab (polysomnography) CPT 95810 POLYSOM AGE 6<;,4 OR<PARAM,ATT	$7,858.00	$7,858.00	—	275% above	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM AGE 6<;,4 OR<PARAM,ATT	$7,858.00	$7,858.00	—	—	—
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 TTE 2D+/-M MOD REST/STRES,COMP	$2,662.00	$2,662.00	—	130% above	—
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 TTE 2D+/-M MOD REST/STRS,W/EKG	$2,662.00	$2,662.00	—	130% above	—
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 TTE 2D+/-M MOD REST/STRS,W/EKG	$2,662.00	$2,662.00	—	—	—
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 TTE 2D+/-M MOD REST/STRES,COMP	$2,662.00	$2,662.00	—	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FUNCTION CINE	$660.00	$660.00	—	82% above	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOWING FUNCTION CINE	$660.00	$660.00	—	—	—
Thigh bone (femur) X-ray, 2 or more views CPT 73552 XRAY FEMUR >1 VIEW	$352.00	$352.00	—	80% above	—
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XRAY FEMUR >1 VIEW	$352.00	$352.00	—	—	—
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC W/O CONTRAST	$1,650.00	$1,650.00	—	85% above	—
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE W/O CONTRAST	$1,650.00	$1,650.00	—	85% above	—
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE W/O CONTRAST	$1,650.00	$1,650.00	—	—	—
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC W/O CONTRAST	$1,650.00	$1,650.00	—	—	—
Toe X-ray, 2 or more views CPT 73660 TOE(S) MIN TWO VIEWS	$435.00	$435.00	—	159% above	—
Toe X-ray, 2 or more views inpatient CPT 73660 TOE(S) MIN TWO VIEWS	$435.00	$435.00	—	—	—
Transvaginal pelvic ultrasound CPT 76830 US, TRANSVAGINAL	$765.00	$765.00	—	101% above	—
Transvaginal pelvic ultrasound CPT 76830 TRANSVAG US, NON OB	$765.00	$765.00	—	101% above	—
Transvaginal pelvic ultrasound CPT 76830 US,TRANSVAGINAL(NON-OBSTETRIC)	$765.00	$765.00	—	101% above	—
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US	$765.00	$765.00	—	101% above	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US, TRANSVAGINAL	$765.00	$765.00	—	—	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US,TRANSVAGINAL(NON-OBSTETRIC)	$765.00	$765.00	—	—	—
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAG US, NON OB	$765.00	$765.00	—	—	—
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL US	$765.00	$765.00	—	—	—
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US, PREG UTERUS	$534.00	$534.00	—	82% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US, PREG UTERUS, TRANSVAG	$534.00	$534.00	—	82% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US,PREGNANT UTERUS TRANSVAGINA	$534.00	$534.00	—	82% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US,PREG UTER,TRANSVAG	$534.00	$534.00	—	82% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US PREG UTERUS, TRANSVAG	$534.00	$534.00	—	82% above	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL US, PREG UTERUS	$534.00	$534.00	—	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US,PREGNANT UTERUS TRANSVAGINA	$534.00	$534.00	—	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREG UTERUS, TRANSVAG	$534.00	$534.00	—	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US, PREG UTERUS, TRANSVAG	$534.00	$534.00	—	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US,PREG UTER,TRANSVAG	$534.00	$534.00	—	—	—
Ultrasound of the abdomen, complete CPT 76700 ABD US,B SCAN W/IMAGE DOC,COMP	$640.00	$640.00	—	36% above	—
Ultrasound of the abdomen, complete inpatient CPT 76700 ABD US,B SCAN W/IMAGE DOC,COMP	$640.00	$640.00	—	—	—
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM & CONTENTS	$633.00	$633.00	—	72% above	—
Ultrasound of the scrotum and testicles CPT 76870 US,SCROTUM AND CONTENTS	$633.00	$633.00	—	72% above	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 US,SCROTUM AND CONTENTS	$633.00	$633.00	—	—	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM & CONTENTS	$633.00	$633.00	—	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ECHO EXAM OF HEAD AND NECK	$320.00	$320.00	—	13% below	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISS HD/NK(THYROID)	$570.00	$570.00	—	55% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 DIAG US HEAD & NECK	$570.00	$570.00	—	55% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ECHO EXAM OF HEAD AND NECK	$320.00	$320.00	—	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISS HD/NK(THYROID)	$570.00	$570.00	—	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 DIAG US HEAD & NECK	$570.00	$570.00	—	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GI UPPER W/O KUB	$655.00	$655.00	—	56% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 GI UPPER W/O KUB	$655.00	$655.00	—	—	—
Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS MIN TWO VIEWS	$425.00	$425.00	—	111% above	—
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HUMERUS MIN TWO VIEWS	$425.00	$425.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS DUPLEX SCAN, LTD	$656.00	$656.00	—	80% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS DUPLEX SCAN UNI	$656.00	$656.00	—	80% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX,UNILAT/LTD	$656.00	$656.00	—	80% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UNILATERAL VENOUS DUPLEX US	$656.00	$656.00	—	80% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VENOUS DUPLEX SCAN, LTD	$656.00	$656.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VENOUS DUPLEX SCAN UNI	$656.00	$656.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX,UNILAT/LTD	$656.00	$656.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 UNILATERAL VENOUS DUPLEX US	$656.00	$656.00	—	—	—
Wrist X-ray, 2 views CPT 73100 WRIST AP AND LAT	$400.00	$400.00	—	105% above	—
Wrist X-ray, 2 views inpatient CPT 73100 WRIST AP AND LAT	$400.00	$400.00	—	—	—
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST COMPLETE MIN THREE VIEWS	$593.00	$593.00	—	194% above	—
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST COMPLETE MIN THREE VIEWS	$593.00	$593.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 RAD HIP UNILT W/WO PELV 3-4 VW	$330.00	$330.00	—	44% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 RAD HIP UNILT W/WO PELV 3-4 VW	$330.00	$330.00	—	—	—
X-ray of the abdomen, 1 view CPT 74018 RAD EXAM,ABDOMEN,1 VIEW	$335.00	$335.00	—	60% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 RAD EXAM,ABDOMEN,1 VIEW	$335.00	$335.00	—	—	—
X-ray of the ankle, 2 views CPT 73600 ANKLE AP AND LAT	$374.00	$374.00	—	94% above	—
X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE AP AND LAT	$374.00	$374.00	—	—	—
X-ray of the finger(s), 2 or more views CPT 73140 FINGER(S) MIN TWO VIEWS	$388.00	$388.00	—	115% above	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER(S) MIN TWO VIEWS	$388.00	$388.00	—	—	—
X-ray of the foot, 2 views CPT 73620 FOOT AP AND LAT	$400.00	$400.00	—	103% above	—
X-ray of the foot, 2 views inpatient CPT 73620 FOOT AP AND LAT	$400.00	$400.00	—	—	—
X-ray of the foot, complete, 3 or more views CPT 73630 FOOT MIN THREE VIEWS	$590.00	$590.00	—	192% above	—
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT MIN THREE VIEWS	$590.00	$590.00	—	—	—
X-ray of the hand, 3 or more views CPT 73130 HAND MIN THREE VIEWS	$625.00	$625.00	—	198% above	—
X-ray of the hand, 3 or more views inpatient CPT 73130 HAND MIN THREE VIEWS	$625.00	$625.00	—	—	—
X-ray of the knee, 1 or 2 views CPT 73560 KNEE AP AND LAT	$391.00	$391.00	—	92% above	—
X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE AP AND LAT	$391.00	$391.00	—	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBOSACRAL SPINE 2-3 VIEWS	$580.00	$580.00	—	111% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBOSACRAL SPINE 2-3 VIEWS	$580.00	$580.00	—	—	—
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE AP/LATE PELV.	$660.00	$660.00	—	118% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE AP/LATE PELV.	$660.00	$660.00	—	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE AP AND LAT	$580.00	$580.00	—	161% above	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE AP AND LAT	$580.00	$580.00	—	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN THREE VIEWS	$359.00	$359.00	—	78% above	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES MIN THREE VIEWS	$359.00	$359.00	—	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CER SPINE 2- 3VIEWS	$470.00	$470.00	—	121% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CER SPINE 2- 3VIEWS	$470.00	$470.00	—	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1-2 VIEWS	$600.00	$600.00	—	164% above	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1-2 VIEWS	$600.00	$600.00	—	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SCARUM & COCCYX MIN 2 VW	$385.00	$385.00	—	91% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SCARUM & COCCYX MIN 2 VW	$385.00	$385.00	—	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
ACTH blood test CPT 82024 ACTH	$200.00	$200.00	—	40% above	—
ACTH blood test inpatient CPT 82024 ACTH	$200.00	$200.00	—	—	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$26.00	$26.00	—	12% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 UV ASSAY TRANSAMINASE (SGPT)	$26.00	$26.00	—	12% above	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$26.00	$26.00	—	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 UV ASSAY TRANSAMINASE (SGPT)	$26.00	$26.00	—	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$26.00	$26.00	—	8% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 AST FLUID	$26.00	$26.00	—	8% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 UV ASSAY TRANSAMINASE (SGOT)	$26.00	$26.00	—	8% above	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 UV ASSAY TRANSAMINASE (SGOT)	$26.00	$26.00	—	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$26.00	$26.00	—	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST FLUID	$26.00	$26.00	—	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL W/RFX,ACUTE	$220.00	$220.00	—	26% above	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL W/RFX,ACUTE	$220.00	$220.00	—	—	—
Albumin blood test CPT 82040 SERUM ALBUMIN	$25.00	$25.00	—	37% above	—
Albumin blood test CPT 82040 ALBUMIN SERUM	$25.00	$25.00	—	37% above	—
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$25.00	$25.00	—	—	—
Albumin blood test inpatient CPT 82040 SERUM ALBUMIN	$25.00	$25.00	—	—	—
Aldosterone blood test CPT 82088 ALDOSTERONE	$210.00	$210.00	—	67% above	—
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$210.00	$210.00	—	—	—
Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY ALKALINE PHOSPHATASE	$26.00	$26.00	—	29% above	—
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE ALKAL	$26.00	$26.00	—	29% above	—
Alkaline phosphatase (ALP) blood test CPT 84075 FLUID ALK PHOS	$26.00	$26.00	—	29% above	—
Alkaline phosphatase (ALP) blood test CPT 84075 ALP (BONE) ISOENZYMES	$26.00	$26.00	—	29% above	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALP (BONE) ISOENZYMES	$26.00	$26.00	—	—	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 FLUID ALK PHOS	$26.00	$26.00	—	—	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE ALKAL	$26.00	$26.00	—	—	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ASSAY ALKALINE PHOSPHATASE	$26.00	$26.00	—	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN POLLEN RAST PANEL	$28.00	$28.00	—	75% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IgE;CRUDE EXT,EA	$28.00	$28.00	—	75% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 SEAFOOD ALLERGY	$28.00	$28.00	—	75% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN TREE NUT PANEL	$28.00	$28.00	—	75% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GRAIN RAST PANEL	$28.00	$28.00	—	75% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 DAIRY PRODUCTS ALLERGY PANEL	$28.00	$28.00	—	75% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GRAIN RAST PANEL	$28.00	$28.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TREE NUT PANEL	$28.00	$28.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IgE;CRUDE EXT,EA	$28.00	$28.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SEAFOOD ALLERGY	$28.00	$28.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DAIRY PRODUCTS ALLERGY PANEL	$28.00	$28.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN POLLEN RAST PANEL	$28.00	$28.00	—	—	—
Alpha-fetoprotein (AFP) blood test CPT 82105 MATERNAL SER ALPHA FETO PROT	$83.00	$83.00	—	34% above	—
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP, SERUM	$83.00	$83.00	—	34% above	—
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP TUMOR MARKER	$83.00	$83.00	—	34% above	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP, SERUM	$83.00	$83.00	—	—	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 MATERNAL SER ALPHA FETO PROT	$83.00	$83.00	—	—	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP TUMOR MARKER	$83.00	$83.00	—	—	—
Ammonia blood test CPT 82140 AMMONIA	$75.00	$75.00	—	39% above	—
Ammonia blood test inpatient CPT 82140 AMMONIA	$75.00	$75.00	—	—	—
Amylase blood test CPT 82150 AMYLASE	$34.00	$34.00	—	12% above	—
Amylase blood test CPT 82150 URINE AMYLASE	$34.00	$34.00	—	12% above	—
Amylase blood test CPT 82150 FLUID AMYLASE	$34.00	$34.00	—	12% above	—
Amylase blood test inpatient CPT 82150 URINE AMYLASE	$34.00	$34.00	—	—	—
Amylase blood test inpatient CPT 82150 AMYLASE	$34.00	$34.00	—	—	—
Amylase blood test inpatient CPT 82150 FLUID AMYLASE	$34.00	$34.00	—	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINE PEP IGG	$66.00	$66.00	—	38% above	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINE PEP IGG	$66.00	$66.00	—	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTBODIES(ANA)	$50.00	$50.00	—	12% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$50.00	$50.00	—	12% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 CENTROMERE AB	$50.00	$50.00	—	12% above	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$50.00	$50.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTBODIES(ANA)	$50.00	$50.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CENTROMERE AB	$50.00	$50.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$265.00	$265.00	—	116% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP ASSAY(POINT OF CARE)	$265.00	$265.00	—	116% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP POC	$265.00	$265.00	—	116% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$265.00	$265.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP POC	$265.00	$265.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP ASSAY(POINT OF CARE)	$265.00	$265.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SW CUL NEG BILL	$45.00	$45.00	—	41% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BODY FLUID CULTURE	$45.00	$45.00	—	41% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CSF CULTURE	$45.00	$45.00	—	41% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHER	$45.00	$45.00	—	41% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 RESPIRATORY CULTURE	$45.00	$45.00	—	41% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SWAB CULTURE	$45.00	$45.00	—	41% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 THROAT/NOSE CULT	$45.00	$45.00	—	41% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 TIP CULTURE	$45.00	$45.00	—	41% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 TISSUE CULTURE	$45.00	$45.00	—	41% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 ENV CULTURE	$45.00	$45.00	—	41% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GENITAL CULTURE	$45.00	$45.00	—	41% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 WOUND CULTURE	$45.00	$45.00	—	41% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 THROAT CULTURE	$45.00	$45.00	—	41% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GENITAL CULTURE	$45.00	$45.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SW CUL NEG BILL	$45.00	$45.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 THROAT CULTURE	$45.00	$45.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 TIP CULTURE	$45.00	$45.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 WOUND CULTURE	$45.00	$45.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 THROAT/NOSE CULT	$45.00	$45.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SWAB CULTURE	$45.00	$45.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 RESPIRATORY CULTURE	$45.00	$45.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CSF CULTURE	$45.00	$45.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 TISSUE CULTURE	$45.00	$45.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BODY FLUID CULTURE	$45.00	$45.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 ENV CULTURE	$45.00	$45.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE OTHER	$45.00	$45.00	—	—	—
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$42.00	$42.00	—	28% below	—
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$42.00	$42.00	—	—	—
Bilirubin blood test, total CPT 82247 FLUID BILIRUBIN	$25.00	$25.00	—	11% above	—
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$26.00	$26.00	—	16% above	—
Bilirubin blood test, total inpatient CPT 82247 FLUID BILIRUBIN	$25.00	$25.00	—	—	—
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$26.00	$26.00	—	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV SURG PATH W/MICRO	$205.00	$205.00	—	34% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV SURG PATH W/MICRO	$205.00	$205.00	—	—	—
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$54.00	$54.00	—	14% below	—
Blood culture for bacteria CPT 87040 BLD CULT W/ISOLAT & PRES ID 3	$57.00	$57.00	—	9% below	—
Blood culture for bacteria CPT 87040 BLD CULT W/ISOLAT & PRES ID 1	$57.00	$57.00	—	9% below	—
Blood culture for bacteria CPT 87040 BLD CULT W/ISOLAT & PRES ID 2	$57.00	$57.00	—	9% below	—
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$54.00	$54.00	—	—	—
Blood culture for bacteria inpatient CPT 87040 BLD CULT W/ISOLAT & PRES ID 3	$57.00	$57.00	—	—	—
Blood culture for bacteria inpatient CPT 87040 BLD CULT W/ISOLAT & PRES ID 1	$57.00	$57.00	—	—	—
Blood culture for bacteria inpatient CPT 87040 BLD CULT W/ISOLAT & PRES ID 2	$57.00	$57.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE,COLL BLD SPECIMEN	$44.00	$44.00	—	193% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE - BLOOD DRAWN	$44.00	$44.00	—	193% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE, SPECIMEN COLLECT	$44.00	$44.00	—	193% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VEINI PUNCTURE -BLOOD DRAWS	$44.00	$44.00	—	193% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE- COLLECT SPECIMEN	$44.00	$44.00	—	193% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE, ROUTINE	$44.00	$44.00	—	193% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ROUTINE,SPEC COLL	$44.00	$44.00	—	193% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$44.00	$44.00	—	193% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE,BLD SPEC	$44.00	$44.00	—	193% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLD BY VENIPUNC	$44.00	$44.00	—	193% above	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ROUTINE,SPEC COLL	$44.00	$44.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE - BLOOD DRAWN	$44.00	$44.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLD BY VENIPUNC	$44.00	$44.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE,COLL BLD SPECIMEN	$44.00	$44.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE- COLLECT SPECIMEN	$44.00	$44.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE, SPECIMEN COLLECT	$44.00	$44.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$44.00	$44.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE, ROUTINE	$44.00	$44.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VEINI PUNCTURE -BLOOD DRAWS	$44.00	$44.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE,BLD SPEC	$44.00	$44.00	—	—	—
Blood glucose (sugar) test CPT 82947 GLUCOSE 1 HOUR	$20.00	$20.00	—	11% above	—
Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING	$20.00	$20.00	—	11% above	—
Blood glucose (sugar) test CPT 82947 GLUCOSE RANDOM	$20.00	$20.00	—	11% above	—
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE	$20.00	$20.00	—	11% above	—
Blood glucose (sugar) test CPT 82947 GLUCOSE PLASMA	$20.00	$20.00	—	11% above	—
Blood glucose (sugar) test CPT 82947 GLUCOSE 30 MINUTES	$20.00	$20.00	—	11% above	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE 30 MINUTES	$20.00	$20.00	—	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE 1 HOUR	$20.00	$20.00	—	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FASTING	$20.00	$20.00	—	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE RANDOM	$20.00	$20.00	—	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE PLASMA	$20.00	$20.00	—	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANTITATIVE	$20.00	$20.00	—	—	—
Blood lead test CPT 83655 LEAD URINE	$112.00	$112.00	—	156% above	—
Blood lead test CPT 83655 LEAD BLOOD	$112.00	$112.00	—	156% above	—
Blood lead test inpatient CPT 83655 LEAD URINE	$112.00	$112.00	—	—	—
Blood lead test inpatient CPT 83655 LEAD BLOOD	$112.00	$112.00	—	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 BLOOD HCG QUALITAT	$40.00	$40.00	—	25% above	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST-POC	$40.00	$40.00	—	25% above	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 BLOOD HCG QUALITAT	$40.00	$40.00	—	—	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST-POC	$40.00	$40.00	—	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLD TYPING;SEROLOGIC;ABO	$350.00	$350.00	—	129% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLD TYPING;SEROLOGIC;ABO	$350.00	$350.00	—	—	—
Blood urea nitrogen (BUN) test CPT 84520 BLOOD UREA INTROGEN	$20.00	$20.00	—	11% below	—
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN	$20.00	$20.00	—	11% below	—
Blood urea nitrogen (BUN) test CPT 84520 FLUID UREA NITROGEN (NCH2)	$20.00	$20.00	—	11% below	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN	$20.00	$20.00	—	—	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 BLOOD UREA INTROGEN	$20.00	$20.00	—	—	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 FLUID UREA NITROGEN (NCH2)	$20.00	$20.00	—	—	—
C-peptide blood test CPT 84681 C-PEPTIDE	$106.00	$106.00	—	23% above	—
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$106.00	$106.00	—	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN (WCRP)	$21.00	$21.00	—	21% below	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN (WCRP)	$21.00	$21.00	—	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium dif,amp probe tech	$115.00	$115.00	—	9% below	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium dif,amp probe tech	$115.00	$115.00	—	—	—
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$103.00	$103.00	—	37% above	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$103.00	$103.00	—	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$103.00	$103.00	—	34% above	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125	$103.00	$103.00	—	34% above	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$103.00	$103.00	—	—	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN 125	$103.00	$103.00	—	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$175.00	$175.00	—	79% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$175.00	$175.00	—	—	—
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$27.00	$27.00	—	7% above	—
Calcium blood test, total CPT 82310 FLUID CALCIUM	$27.00	$27.00	—	7% above	—
Calcium blood test, total inpatient CPT 82310 FLUID CALCIUM	$27.00	$27.00	—	—	—
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$27.00	$27.00	—	—	—
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRY (CEA)	$95.00	$95.00	—	18% above	—
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$95.00	$95.00	—	18% above	—
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRY (CEA)	$95.00	$95.00	—	—	—
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$95.00	$95.00	—	—	—
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA IGM (EIA)	$46.00	$46.00	—	2% above	—
Chickenpox (varicella) immunity blood test CPT 86787 VZV CONF IGG (EIA)	$46.00	$46.00	—	2% above	—
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG	$46.00	$46.00	—	2% above	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VZV CONF IGG (EIA)	$46.00	$46.00	—	—	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA IGM (EIA)	$46.00	$46.00	—	—	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGG	$46.00	$46.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/GC RNA,TMA	$180.00	$180.00	—	80% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE	$180.00	$180.00	—	80% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACH. SWAB	$190.00	$190.00	—	90% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA/GC RNA,TMA	$180.00	$180.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLMYD TRACH DNA AMP PROBE	$180.00	$180.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACH. SWAB	$190.00	$190.00	—	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$68.00	$68.00	—	at median	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$68.00	$68.00	—	—	—
Complete blood count (CBC) with differential CPT 85025 BLD CNT COMP W/AUTO DIFF	$41.00	$41.00	—	at median	—
Complete blood count (CBC) with differential CPT 85025 AUTOMATED COMPLETE CBC W/DIFF	$41.00	$41.00	—	at median	—
Complete blood count (CBC) with differential CPT 85025 BLD CNT COMP W/AUTO DIFF POC	$41.00	$41.00	—	at median	—
Complete blood count (CBC) with differential inpatient CPT 85025 BLD CNT COMP W/AUTO DIFF	$41.00	$41.00	—	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 AUTOMATED COMPLETE CBC W/DIFF	$41.00	$41.00	—	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 BLD CNT COMP W/AUTO DIFF POC	$41.00	$41.00	—	—	—
Complete blood count (CBC), no differential CPT 85027 CBC WITHOUT DIFF	$34.00	$34.00	—	18% above	—
Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITHOUT DIFF	$34.00	$34.00	—	—	—
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE MP 1AGR CC	$55.00	$55.00	—	6% below	—
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANE	$55.00	$55.00	—	6% below	—
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$58.00	$58.00	—	1% below	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE MP 1AGR CC	$55.00	$55.00	—	—	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANE	$55.00	$55.00	—	—	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$58.00	$58.00	—	—	—
Cortisol blood test, total CPT 82533 CORTISOL	$83.00	$83.00	—	69% above	—
Cortisol blood test, total CPT 82533 CORTISOL AM	$83.00	$83.00	—	69% above	—
Cortisol blood test, total CPT 82533 CORTISOL FREE SERUM	$83.00	$83.00	—	69% above	—
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$83.00	$83.00	—	69% above	—
Cortisol blood test, total CPT 82533 CORTISOL PM	$83.00	$83.00	—	69% above	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL FREE SERUM	$83.00	$83.00	—	—	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL PM	$83.00	$83.00	—	—	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL	$83.00	$83.00	—	—	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL AM	$83.00	$83.00	—	—	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$83.00	$83.00	—	—	—
Creatine kinase (CK) blood test, total CPT 82550 CPK FL	$33.00	$33.00	—	32% above	—
Creatine kinase (CK) blood test, total CPT 82550 CK MB INDEX	$34.00	$34.00	—	36% above	—
Creatine kinase (CK) blood test, total CPT 82550 CKMB BATT	$34.00	$34.00	—	36% above	—
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK FL	$33.00	$33.00	—	—	—
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK MB INDEX	$34.00	$34.00	—	—	—
Creatine kinase (CK) blood test, total inpatient CPT 82550 CKMB BATT	$34.00	$34.00	—	—	—
Creatinine blood test CPT 82565 CREATININE SERUM	$26.00	$26.00	—	5% above	—
Creatinine blood test CPT 82565 CREATININE BLOOD	$26.00	$26.00	—	5% above	—
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$26.00	$26.00	—	—	—
Creatinine blood test inpatient CPT 82565 CREATININE SERUM	$26.00	$26.00	—	—	—
Cytomegalovirus (CMV) antibody test CPT 86644 Cmv antibody	$59.00	$59.00	—	13% above	—
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG	$59.00	$59.00	—	13% above	—
Cytomegalovirus (CMV) antibody test CPT 86644 CMV SCREENING	$59.00	$59.00	—	13% above	—
Cytomegalovirus (CMV) antibody test CPT 86644 CMV LATEX FOR BB DON	$59.00	$59.00	—	13% above	—
Cytomegalovirus (CMV) antibody test CPT 86644 CMV NEG COMPONENTS PROCESS/SUP	$110.00	$110.00	—	111% above	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV LATEX FOR BB DON	$59.00	$59.00	—	—	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG	$59.00	$59.00	—	—	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cmv antibody	$59.00	$59.00	—	—	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV SCREENING	$59.00	$59.00	—	—	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV NEG COMPONENTS PROCESS/SUP	$110.00	$110.00	—	—	—
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER	$52.00	$52.00	—	38% above	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER	$52.00	$52.00	—	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$111.00	$111.00	—	31% above	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$111.00	$111.00	—	—	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TST,PRESMP,CHEM ANALY/DOS	$230.00	$230.00	—	89% above	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TST,PRESMP,CHEM ANALY/DOS	$230.00	$230.00	—	—	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$32.00	$32.00	—	2% above	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES PANEL	$32.00	$32.00	—	2% above	—
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES PANEL	$32.00	$32.00	—	—	—
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$32.00	$32.00	—	—	—
Epstein-Barr virus (EBV) antibody test CPT 86665 EBVCA	$52.00	$52.00	—	14% above	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBVCA	$52.00	$52.00	—	—	—
Estradiol blood test CPT 82670 RIA ASSAY OF ESTRADI	$140.00	$140.00	—	37% above	—
Estradiol blood test inpatient CPT 82670 RIA ASSAY OF ESTRADI	$140.00	$140.00	—	—	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$92.00	$92.00	—	22% above	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$92.00	$92.00	—	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL	$99.00	$99.00	—	9% above	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL	$99.00	$99.00	—	—	—
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$70.00	$70.00	—	15% above	—
Ferritin blood test (iron stores) CPT 82728 ASSAY FERRITIN	$70.00	$70.00	—	15% above	—
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY FERRITIN	$70.00	$70.00	—	—	—
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$70.00	$70.00	—	—	—
Fibrinogen blood test CPT 85384 FIBRINOGEN PT. BASED	$45.00	$45.00	—	19% above	—
Fibrinogen blood test CPT 85384 FIBRINOGEN;ACTIVITY	$45.00	$45.00	—	19% above	—
Fibrinogen blood test CPT 85384 TEG 6s GLOBAL HEMOSTASIS CARTR	$380.00	$380.00	—	904% above	—
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN PT. BASED	$45.00	$45.00	—	—	—
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN;ACTIVITY	$45.00	$45.00	—	—	—
Fibrinogen blood test inpatient CPT 85384 TEG 6s GLOBAL HEMOSTASIS CARTR	$380.00	$380.00	—	—	—
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$70.00	$70.00	—	27% above	—
Folate (folic acid) blood test CPT 82746 FOLATE/FOLIC ACID	$70.00	$70.00	—	27% above	—
Folate (folic acid) blood test inpatient CPT 82746 FOLATE/FOLIC ACID	$70.00	$70.00	—	—	—
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$70.00	$70.00	—	—	—
Free T3 thyroid hormone test CPT 84481 FREE T3	$90.00	$90.00	—	42% above	—
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$90.00	$90.00	—	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE	$48.00	$48.00	—	at median	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE	$48.00	$48.00	—	—	—
Free testosterone test CPT 84402 TESTOSTERONE FREE/WEAK BOUND	$127.00	$127.00	—	38% above	—
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE/WEAK BOUND	$127.00	$127.00	—	—	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE,GAMMA	$31.00	$31.00	—	15% above	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$36.00	$36.00	—	34% above	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT FL	$36.00	$36.00	—	34% above	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GGT ENZYME	$36.00	$36.00	—	34% above	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GLUTAMYLTRANSFERASE,GAMMA	$31.00	$31.00	—	—	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$36.00	$36.00	—	—	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GT FL	$36.00	$36.00	—	—	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 ASSAY OF GGT ENZYME	$36.00	$36.00	—	—	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$50.00	$50.00	—	68% below	—
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$50.00	$50.00	—	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HOUR	$42.00	$42.00	—	99% above	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2 HOUR	$42.00	$42.00	—	—	—
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE 3 HOURS	$156.00	$156.00	—	172% above	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE 3 HOURS	$156.00	$156.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE rRNA SWA	$120.00	$120.00	—	19% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORRHOEAE,AMP PROBE TECH	$178.00	$178.00	—	77% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE rRNA SWA	$120.00	$120.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. GONORRHOEAE,AMP PROBE TECH	$178.00	$178.00	—	—	—
H. pylori antibody blood test CPT 86677 H PYLORI	$52.00	$52.00	—	1% below	—
H. pylori antibody blood test CPT 86677 H PYLORI AB	$52.00	$52.00	—	1% below	—
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB	$52.00	$52.00	—	—	—
H. pylori antibody blood test inpatient CPT 86677 H PYLORI	$52.00	$52.00	—	—	—
H. pylori stool antigen test CPT 87338 H.PYLORI ,STOOL	$70.00	$70.00	—	31% above	—
H. pylori stool antigen test inpatient CPT 87338 H.PYLORI ,STOOL	$70.00	$70.00	—	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA, Qual, TMA, serum	$286.00	$286.00	—	22% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 XXX 1 REV TRANS/QUANTIF	$422.00	$422.00	—	80% above	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA, Qual, TMA, serum	$286.00	$286.00	—	—	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 XXX 1 REV TRANS/QUANTIF	$422.00	$422.00	—	—	—
HIV-1 and HIV-2 antibody test CPT 86703 XXX 1 AND XXX 2,SGL RESULT	$44.00	$44.00	—	12% below	—
HIV-1 and HIV-2 antibody test CPT 86703 PANEL HIVE-HIV1/2EIA,SCR W/RFL	$99.00	$99.00	—	98% above	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 XXX 1 AND XXX 2,SGL RESULT	$44.00	$44.00	—	—	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 PANEL HIVE-HIV1/2EIA,SCR W/RFL	$99.00	$99.00	—	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 ANTIGEN , W/HIV 1&2 AB	$105.00	$105.00	—	46% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 ANTIGEN , W/HIV 1&2 AB	$105.00	$105.00	—	—	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV, HIGH RISK	$205.00	$205.00	—	116% above	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV, HIGH RISK	$205.00	$205.00	—	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED A1C	$50.00	$50.00	—	39% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HEMOGLO	$50.00	$50.00	—	39% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$50.00	$50.00	—	39% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$50.00	$50.00	—	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HEMOGLO	$50.00	$50.00	—	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED A1C	$50.00	$50.00	—	—	—
Hemoglobin blood test CPT 85018 HEMOGLOUBIN, BLD COUNT	$13.00	$13.00	—	10% below	—
Hemoglobin blood test inpatient CPT 85018 HEMOGLOUBIN, BLD COUNT	$13.00	$13.00	—	—	—
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB,TOTAL	$63.00	$63.00	—	44% above	—
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY	$63.00	$63.00	—	44% above	—
Hepatitis B core antibody test (total) CPT 86704 HBCAB IGG & IGM	$63.00	$63.00	—	44% above	—
Hepatitis B core antibody test (total) inpatient CPT 86704 HBCAB IGG & IGM	$63.00	$63.00	—	—	—
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY	$63.00	$63.00	—	—	—
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB,TOTAL	$63.00	$63.00	—	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$56.00	$56.00	—	41% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HBAB	$56.00	$56.00	—	41% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY	$56.00	$56.00	—	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HBAB	$56.00	$56.00	—	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE (AG)	$63.00	$63.00	—	69% above	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE (AG)	$63.00	$63.00	—	—	—
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C VIRUS AB	$75.00	$75.00	—	41% above	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C VIRUS AB	$75.00	$75.00	—	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REV TRANS/QUANT	$213.00	$213.00	—	56% above	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REV TRANS/QUANT	$213.00	$213.00	—	—	—
Herpes blood test, HSV-1 antibody CPT 86695 H SIMPLEX IGG AB	$47.00	$47.00	—	17% above	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 H SIMPLEX IGG AB	$47.00	$47.00	—	—	—
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 AB	$97.00	$97.00	—	67% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX 2 AB	$97.00	$97.00	—	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO CRP	$66.00	$66.00	—	38% above	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CARDIO CRP	$66.00	$66.00	—	—	—
Homocysteine blood test CPT 83090 HOMOCYSTINE CARDIAC	$85.00	$85.00	—	16% above	—
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE CARDIAC	$85.00	$85.00	—	—	—
Insulin blood test CPT 83525 INSULIN	$143.00	$143.00	—	239% above	—
Insulin blood test inpatient CPT 83525 INSULIN	$143.00	$143.00	—	—	—
Iron blood test (serum iron) CPT 83540 IRON	$100.00	$100.00	—	289% above	—
Iron blood test (serum iron) inpatient CPT 83540 IRON	$100.00	$100.00	—	—	—
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY (TRFNB)	$46.00	$46.00	—	15% above	—
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$46.00	$46.00	—	15% above	—
Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON BINDING CAPACITY	$46.00	$46.00	—	15% above	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY (TRFNB)	$46.00	$46.00	—	—	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BINDING CAPACITY	$46.00	$46.00	—	—	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$46.00	$46.00	—	—	—
Kidney function blood test panel CPT 80069 RFP	$44.00	$44.00	—	35% below	—
Kidney function blood test panel inpatient CPT 80069 RFP	$44.00	$44.00	—	—	—
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN LUTEN HORMONE	$92.00	$92.00	—	19% above	—
LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN LUTEN HORMONE	$92.00	$92.00	—	—	—
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$122.00	$122.00	—	202% above	—
Lactate (lactic acid) blood test CPT 83605 CSF LACTIC ACID	$122.00	$122.00	—	202% above	—
Lactate (lactic acid) blood test CPT 83605 POC LACTATE	$122.00	$122.00	—	202% above	—
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$122.00	$122.00	—	—	—
Lactate (lactic acid) blood test inpatient CPT 83605 POC LACTATE	$122.00	$122.00	—	—	—
Lactate (lactic acid) blood test inpatient CPT 83605 CSF LACTIC ACID	$122.00	$122.00	—	—	—
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$80.00	$80.00	—	259% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 CARBOHYDRATE AG 19 9	$80.00	$80.00	—	259% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROG	$80.00	$80.00	—	259% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 FLUID LDH	$80.00	$80.00	—	259% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 CSF LDH	$80.00	$80.00	—	259% above	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 CARBOHYDRATE AG 19 9	$80.00	$80.00	—	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROG	$80.00	$80.00	—	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 FLUID LDH	$80.00	$80.00	—	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$80.00	$80.00	—	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 CSF LDH	$80.00	$80.00	—	—	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$34.00	$34.00	—	21% above	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$34.00	$34.00	—	—	—
Liver function blood test panel CPT 80076 HEPATIC PANEL	$42.00	$42.00	—	26% below	—
Liver function blood test panel CPT 80076 HEPATIC FUNCTION	$42.00	$42.00	—	26% below	—
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION	$42.00	$42.00	—	—	—
Liver function blood test panel inpatient CPT 80076 HEPATIC PANEL	$42.00	$42.00	—	—	—
Lyme disease antibody test CPT 86618 LYME CSF ABS (EIA)	$54.00	$54.00	—	11% above	—
Lyme disease antibody test CPT 86618 LYME DIS SERUM ABS	$54.00	$54.00	—	11% above	—
Lyme disease antibody test inpatient CPT 86618 LYME CSF ABS (EIA)	$54.00	$54.00	—	—	—
Lyme disease antibody test inpatient CPT 86618 LYME DIS SERUM ABS	$54.00	$54.00	—	—	—
Magnesium blood test CPT 83735 MAGNESIUM	$70.00	$70.00	—	183% above	—
Magnesium blood test CPT 83735 URINE MAGNESIUM	$70.00	$70.00	—	183% above	—
Magnesium blood test CPT 83735 URINE MAGNESIUM BAT	$70.00	$70.00	—	183% above	—
Magnesium blood test inpatient CPT 83735 URINE MAGNESIUM BAT	$70.00	$70.00	—	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$70.00	$70.00	—	—	—
Magnesium blood test inpatient CPT 83735 URINE MAGNESIUM	$70.00	$70.00	—	—	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB	$46.00	$46.00	—	1% below	—
Measles (rubeola) antibody test CPT 86765 MEASLES IGG	$46.00	$46.00	—	1% below	—
Measles (rubeola) antibody test CPT 86765 MEASLES CONF (EIA)	$46.00	$46.00	—	1% below	—
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB	$46.00	$46.00	—	—	—
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES IGG	$46.00	$46.00	—	—	—
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES CONF (EIA)	$46.00	$46.00	—	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 HETERO ABD SCR	$26.00	$26.00	—	24% below	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETERO ABD SCR	$26.00	$26.00	—	—	—
Mumps immunity blood test CPT 86735 MUMPS IGG	$46.00	$46.00	—	8% above	—
Mumps immunity blood test CPT 86735 MUMPS IGM	$46.00	$46.00	—	8% above	—
Mumps immunity blood test CPT 86735 MUMPS AB	$46.00	$46.00	—	8% above	—
Mumps immunity blood test inpatient CPT 86735 MUMPS AB	$46.00	$46.00	—	—	—
Mumps immunity blood test inpatient CPT 86735 MUMPS IGM	$46.00	$46.00	—	—	—
Mumps immunity blood test inpatient CPT 86735 MUMPS IGG	$46.00	$46.00	—	—	—
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL (PNTL)	$146.00	$146.00	—	38% above	—
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL (PNTL)	$146.00	$146.00	—	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA; FREE	$78.00	$78.00	—	17% above	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA; FREE	$78.00	$78.00	—	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL	$91.00	$91.00	—	37% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA/TOTAL	$91.00	$91.00	—	37% above	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA/TOTAL	$91.00	$91.00	—	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL	$91.00	$91.00	—	—	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH CER/VAG FLD,AUTO,THIN	$92.00	$92.00	—	31% above	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH CER/VAG FLD,AUTO,THIN	$92.00	$92.00	—	—	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH C TERMINAL	$375.00	$375.00	—	155% above	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$375.00	$375.00	—	155% above	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH O INTEROP	$375.00	$375.00	—	155% above	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH N TERMINAL	$375.00	$375.00	—	155% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$375.00	$375.00	—	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH O INTEROP	$375.00	$375.00	—	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH N TERMINAL	$375.00	$375.00	—	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH C TERMINAL	$375.00	$375.00	—	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME, PARTIAL	$32.00	$32.00	—	36% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 TO PTT (LUPPNL)	$32.00	$32.00	—	36% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 TO PTT (LUPPNL)	$32.00	$32.00	—	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME, PARTIAL	$32.00	$32.00	—	—	—
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS INORGANIC	$24.00	$24.00	—	18% above	—
Phosphorus (phosphate) blood test CPT 84100 FLUID PHOSPHORUS	$25.00	$25.00	—	23% above	—
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS INORG	$25.00	$25.00	—	23% above	—
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS INORGANIC	$24.00	$24.00	—	—	—
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS INORG	$25.00	$25.00	—	—	—
Phosphorus (phosphate) blood test inpatient CPT 84100 FLUID PHOSPHORUS	$25.00	$25.00	—	—	—
Potassium blood test CPT 84132 ASSAY BLD POTASSIUM	$23.00	$23.00	—	at median	—
Potassium blood test CPT 84132 POTASSIUM SERUM	$23.00	$23.00	—	at median	—
Potassium blood test inpatient CPT 84132 ASSAY BLD POTASSIUM	$23.00	$23.00	—	—	—
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$23.00	$23.00	—	—	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHROMOSOME ANEUPLOIDY	$2,505.00	$2,505.00	—	120% above	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 FETAL CHROMOSOME ANEUPLOIDY	$2,505.00	$2,505.00	—	—	—
Progesterone blood test CPT 84144 ASSAY PROGESTERONE	$105.00	$105.00	—	22% above	—
Progesterone blood test inpatient CPT 84144 ASSAY PROGESTERONE	$105.00	$105.00	—	—	—
Prolactin blood test CPT 84146 MACPRO (BATTERY)	$97.00	$97.00	—	34% above	—
Prolactin blood test CPT 84146 PROLACTIN	$97.00	$97.00	—	34% above	—
Prolactin blood test inpatient CPT 84146 PROLACTIN	$97.00	$97.00	—	—	—
Prolactin blood test inpatient CPT 84146 MACPRO (BATTERY)	$97.00	$97.00	—	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$21.00	$21.00	—	35% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 POC PT	$21.00	$21.00	—	35% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMIN TIME (LUPPNL/MIXPT)	$21.00	$21.00	—	35% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR POC	$21.00	$21.00	—	35% above	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR POC	$21.00	$21.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMIN TIME (LUPPNL/MIXPT)	$21.00	$21.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POC PT	$21.00	$21.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$21.00	$21.00	—	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TST,PRESMP,OBSV ONLY/DOS	$50.00	$50.00	—	43% above	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TST,PRESMP,OBSV ONLY/DOS	$50.00	$50.00	—	—	—
Rapid flu test (influenza antigen) CPT 87804 RAPID INFLUENZA TEST POC	$73.00	$73.00	—	77% above	—
Rapid flu test (influenza antigen) CPT 87804 RAPID INFLUENZA TEST	$73.00	$73.00	—	77% above	—
Rapid flu test (influenza antigen) inpatient CPT 87804 RAPID INFLUENZA TEST POC	$73.00	$73.00	—	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 RAPID INFLUENZA TEST	$73.00	$73.00	—	—	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP THROAT TEST	$57.00	$57.00	—	42% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP A	$57.00	$57.00	—	42% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP	$57.00	$57.00	—	42% above	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP THROAT TEST	$57.00	$57.00	—	—	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP	$57.00	$57.00	—	—	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP A	$57.00	$57.00	—	—	—
Renin blood test CPT 84244 RENIN ACTIVITY	$115.00	$115.00	—	42% above	—
Renin blood test inpatient CPT 84244 RENIN ACTIVITY	$115.00	$115.00	—	—	—
Rh blood typing CPT 86901 BLD TYPING;SEROLOGIC;Rh(D)	$140.00	$140.00	—	155% above	—
Rh blood typing inpatient CPT 86901 BLD TYPING;SEROLOGIC;Rh(D)	$140.00	$140.00	—	—	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID QUAN	$29.00	$29.00	—	39% above	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID QUAN	$29.00	$29.00	—	—	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA TITER	$50.00	$50.00	—	12% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA I66	$50.00	$50.00	—	12% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA CONF (EIA)	$50.00	$50.00	—	12% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM AB	$50.00	$50.00	—	12% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGG	$50.00	$50.00	—	12% above	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGG	$50.00	$50.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM AB	$50.00	$50.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA I66	$50.00	$50.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA TITER	$50.00	$50.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA CONF (EIA)	$50.00	$50.00	—	—	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE,AUTOMATED	$14.00	$14.00	—	43% below	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED RATE,AUTOMATED	$14.00	$14.00	—	—	—
Sodium blood test CPT 84295 SODIUM SERUM	$24.00	$24.00	—	10% above	—
Sodium blood test CPT 84295 SODIUM, SERUM	$24.00	$24.00	—	10% above	—
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$24.00	$24.00	—	—	—
Sodium blood test inpatient CPT 84295 SODIUM, SERUM	$24.00	$24.00	—	—	—
Stool ova and parasites exam CPT 87177 OVA AND PARASITES	$45.00	$45.00	—	37% above	—
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES	$45.00	$45.00	—	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult blood feces	$17.00	$17.00	—	19% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 TEST FECES FOR BLOOD	$17.00	$17.00	—	19% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 COLONRECTAL CA SCREEN,GUIAC1-3	$17.00	$17.00	—	19% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL GUIAC	$17.00	$17.00	—	19% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL RBC	$17.00	$17.00	—	19% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLOOD OCCULT FECES	$17.00	$17.00	—	19% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL OCCULT BLOOD	$17.00	$17.00	—	19% above	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 STOOL RBC	$17.00	$17.00	—	—	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 STOOL GUIAC	$17.00	$17.00	—	—	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 STOOL OCCULT BLOOD	$17.00	$17.00	—	—	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLOOD OCCULT FECES	$17.00	$17.00	—	—	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 COLONRECTAL CA SCREEN,GUIAC1-3	$17.00	$17.00	—	—	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult blood feces	$17.00	$17.00	—	—	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 TEST FECES FOR BLOOD	$17.00	$17.00	—	—	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD; FECAL	$58.00	$58.00	—	18% above	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 ASSAY TEST FOR BLOOD; FECAL	$58.00	$58.00	—	—	—
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB	$69.00	$69.00	—	63% above	—
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM - FTA	$69.00	$69.00	—	63% above	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM AB	$69.00	$69.00	—	—	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM - FTA	$69.00	$69.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL	$14.00	$14.00	—	11% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL	$14.00	$14.00	—	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERRON TB GOLD TEST	$306.00	$306.00	—	87% above	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD	$306.00	$306.00	—	87% above	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERRON TB GOLD TEST	$306.00	$306.00	—	—	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD	$306.00	$306.00	—	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$132.00	$132.00	—	41% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$132.00	$132.00	—	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROMGLOBULIN AB	$41.00	$41.00	—	23% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB'S	$73.00	$73.00	—	37% above	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROMGLOBULIN AB	$41.00	$41.00	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB'S	$73.00	$73.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$88.00	$88.00	—	20% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM HORMONE (TSH)	$88.00	$88.00	—	20% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM HORMONE (TSH)	$88.00	$88.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE	$88.00	$88.00	—	—	—
Total IgE blood test CPT 82785 IGE	$83.00	$83.00	—	37% above	—
Total IgE blood test inpatient CPT 82785 IGE	$83.00	$83.00	—	—	—
Total cholesterol blood test CPT 82465 FLUID CHOLESTEROL	$22.00	$22.00	—	3% below	—
Total cholesterol blood test CPT 82465 SERUM CHOLESTEROL,TOTAL	$22.00	$22.00	—	3% below	—
Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM	$22.00	$22.00	—	3% below	—
Total cholesterol blood test inpatient CPT 82465 SERUM CHOLESTEROL,TOTAL	$22.00	$22.00	—	—	—
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL SERUM	$22.00	$22.00	—	—	—
Total cholesterol blood test inpatient CPT 82465 FLUID CHOLESTEROL	$22.00	$22.00	—	—	—
Total thyroxine (T4) blood test CPT 84436 THYROXINE,TOTAL	$36.00	$36.00	—	23% above	—
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL	$36.00	$36.00	—	23% above	—
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL	$36.00	$36.00	—	—	—
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE,TOTAL	$36.00	$36.00	—	—	—
Total triiodothyronine (T3) blood test CPT 84480 T3 UPTAKE	$30.00	$30.00	—	53% below	—
Total triiodothyronine (T3) blood test CPT 84480 RIA ASSAY TT-3	$30.00	$30.00	—	53% below	—
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 UPTAKE	$30.00	$30.00	—	—	—
Total triiodothyronine (T3) blood test inpatient CPT 84480 RIA ASSAY TT-3	$30.00	$30.00	—	—	—
Transferrin blood test CPT 84466 TRANSFERRIN	$66.00	$66.00	—	40% above	—
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$66.00	$66.00	—	—	—
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAG AMP PROBE	$215.00	$215.00	—	183% above	—
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAG AMP PROBE	$215.00	$215.00	—	—	—
Triglycerides blood test CPT 84478 ASSAY BLOOD TRIGLYCERIDES	$30.00	$30.00	—	23% above	—
Triglycerides blood test CPT 84478 TRIGLYCERIDE FLUID	$30.00	$30.00	—	23% above	—
Triglycerides blood test CPT 84478 TRIGLYCERIDE SERUM	$30.00	$30.00	—	23% above	—
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE SERUM	$30.00	$30.00	—	—	—
Triglycerides blood test inpatient CPT 84478 ASSAY BLOOD TRIGLYCERIDES	$30.00	$30.00	—	—	—
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE FLUID	$30.00	$30.00	—	—	—
Troponin test, quantitative CPT 84484 TROPONIN	$52.00	$52.00	—	20% above	—
Troponin test, quantitative CPT 84484 TROPONIN I POC	$52.00	$52.00	—	20% above	—
Troponin test, quantitative inpatient CPT 84484 TROPONIN I POC	$52.00	$52.00	—	—	—
Troponin test, quantitative inpatient CPT 84484 TROPONIN	$52.00	$52.00	—	—	—
Uric acid blood test CPT 84550 ASSAY BLOOD URIC ACID	$24.00	$24.00	—	19% above	—
Uric acid blood test CPT 84550 URIC ACID	$24.00	$24.00	—	19% above	—
Uric acid blood test inpatient CPT 84550 URIC ACID	$24.00	$24.00	—	—	—
Uric acid blood test inpatient CPT 84550 ASSAY BLOOD URIC ACID	$24.00	$24.00	—	—	—
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/MICRO	$17.00	$17.00	—	48% below	—
Urinalysis with microscope exam, automated CPT 81001 URINALY AUTO W/ MICRO	$17.00	$17.00	—	48% below	—
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/MICRO	$17.00	$17.00	—	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALY AUTO W/ MICRO	$17.00	$17.00	—	—	—
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O MICRO	$12.00	$12.00	—	29% below	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O MICRO	$12.00	$12.00	—	—	—
Urinalysis without microscope exam, manual CPT 81002 UA WO MICRO	$13.00	$13.00	—	25% above	—
Urinalysis without microscope exam, manual CPT 81002 UA, NON AUTO, WO MICRO	$13.00	$13.00	—	25% above	—
Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTICK,WO/MICROSCOPY	$13.00	$13.00	—	25% above	—
Urinalysis without microscope exam, manual CPT 81002 URINE DIP STICK	$13.00	$13.00	—	25% above	—
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS WITHOUT MICROSCO	$13.00	$13.00	—	25% above	—
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS, DIPSTICK	$13.00	$13.00	—	25% above	—
Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTCK	$13.00	$13.00	—	25% above	—
Urinalysis without microscope exam, manual CPT 81002 URINE DIPTICK	$13.00	$13.00	—	25% above	—
Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTICK	$13.00	$13.00	—	25% above	—
Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTICK,POCT	$13.00	$13.00	—	25% above	—
Urinalysis without microscope exam, manual CPT 81002 UA,WO/MICRO, NON AUTOMATED	$14.00	$14.00	—	34% above	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTICK	$13.00	$13.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS, DIPSTICK	$13.00	$13.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIP STICK	$13.00	$13.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTICK,POCT	$13.00	$13.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS WITHOUT MICROSCO	$13.00	$13.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTCK	$13.00	$13.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 UA WO MICRO	$13.00	$13.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPTICK	$13.00	$13.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 UA, NON AUTO, WO MICRO	$13.00	$13.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTICK,WO/MICROSCOPY	$13.00	$13.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 UA,WO/MICRO, NON AUTOMATED	$14.00	$14.00	—	—	—
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY CT	$43.00	$43.00	—	13% above	—
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE	$43.00	$43.00	—	13% above	—
Urine culture for bacteria, with colony count CPT 87086 CULT PRESUM QUANT COLONY/CNT 3	$45.00	$45.00	—	18% above	—
Urine culture for bacteria, with colony count CPT 87086 CULT PRESUM QUANT COLONY/CNT 4	$45.00	$45.00	—	18% above	—
Urine culture for bacteria, with colony count CPT 87086 CULT PRESUM QUANT COLONY/CNT 2	$45.00	$45.00	—	18% above	—
Urine culture for bacteria, with colony count CPT 87086 CULT PRESUM QUANT COLONY/CNT 1	$45.00	$45.00	—	18% above	—
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE/COLONY CT	$43.00	$43.00	—	—	—
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE	$43.00	$43.00	—	—	—
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT PRESUM QUANT COLONY/CNT 2	$45.00	$45.00	—	—	—
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT PRESUM QUANT COLONY/CNT 4	$45.00	$45.00	—	—	—
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT PRESUM QUANT COLONY/CNT 1	$45.00	$45.00	—	—	—
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT PRESUM QUANT COLONY/CNT 3	$45.00	$45.00	—	—	—
Urine microalbumin (albumin) test CPT 82043 ALBUMIN, URINE ,QUANTITATIVE	$30.00	$30.00	—	1% above	—
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN, URINE ,QUANTITATIVE	$30.00	$30.00	—	—	—
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$32.00	$32.00	—	11% above	—
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST	$32.00	$32.00	—	11% above	—
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST, URINE	$32.00	$32.00	—	11% above	—
Urine pregnancy test, read by color change CPT 81025 POC URINE HCG(PREG)	$32.00	$32.00	—	11% above	—
Urine pregnancy test, read by color change CPT 81025 URINE PREGNACY TEST	$32.00	$32.00	—	11% above	—
Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test	$32.00	$32.00	—	11% above	—
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST, URINE, QUAL	$32.00	$32.00	—	11% above	—
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$32.00	$32.00	—	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 Urine pregnancy test	$32.00	$32.00	—	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNACY TEST	$32.00	$32.00	—	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST, URINE, QUAL	$32.00	$32.00	—	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST	$32.00	$32.00	—	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 POC URINE HCG(PREG)	$32.00	$32.00	—	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST, URINE	$32.00	$32.00	—	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$75.00	$75.00	—	35% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN	$75.00	$75.00	—	35% above	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBALAMIN	$75.00	$75.00	—	—	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$75.00	$75.00	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 OH	$144.00	$144.00	—	34% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 OH	$144.00	$144.00	—	—	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D (1,25 DIH)	$200.00	$200.00	—	87% above	—
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D (1,25 DIH)	$200.00	$200.00	—	—	—
Zinc blood test CPT 84630 ZINC BLOOD PLASMA	$50.00	$50.00	—	23% above	—
Zinc blood test CPT 84630 ZINC URINE	$50.00	$50.00	—	23% above	—
Zinc blood test inpatient CPT 84630 ZINC BLOOD PLASMA	$50.00	$50.00	—	—	—
Zinc blood test inpatient CPT 84630 ZINC URINE	$50.00	$50.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANT	$80.00	$80.00	—	44% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN	$80.00	$80.00	—	44% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN, CHORIONIC,QUANT	$80.00	$80.00	—	44% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN, CHORIONIC,QUANT	$80.00	$80.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANT	$80.00	$80.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPIN	$80.00	$80.00	—	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Botox injections for chronic migraine CPT 64615 CHEMDENERV MUS;FAC/TRG/SP/ACES	$1,131.00	$1,131.00	—	159% above	—
Botox injections for chronic migraine inpatient CPT 64615 CHEMDENERV MUS;FAC/TRG/SP/ACES	$1,131.00	$1,131.00	—	—	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BREAST BX W/LOC DEV,1LES,STERO	$5,763.00	$5,763.00	—	87% above	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 UNLISTED PROCEDURE BREAST	$11,647.00	$11,647.00	—	278% above	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BREAST BX W/LOC DEV,1LES,STERO	$5,763.00	$5,763.00	—	—	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 UNLISTED PROCEDURE BREAST	$11,647.00	$11,647.00	—	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CT LAT MALLEOLUS FX; W/O MANIP	$1,029.00	$1,029.00	—	95% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 FX,DIST FIBUL,LATERAL MAL WO/M	$1,029.00	$1,029.00	—	95% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 FX,DISTAL FIBUL,(LATERAL MAL	$1,029.00	$1,029.00	—	95% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CT LAT MALLEOLUS FX; W/O MANIP	$1,029.00	$1,029.00	—	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 FX,DISTAL FIBUL,(LATERAL MAL	$1,029.00	$1,029.00	—	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 FX,DIST FIBUL,LATERAL MAL WO/M	$1,029.00	$1,029.00	—	—	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 FX, METATARSAL,CLSD EA WO/MAN	$932.00	$932.00	—	104% above	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 FX, METATARSAL,CLSD EA	$932.00	$932.00	—	104% above	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 FX, METATARSAL,CLSD EA	$932.00	$932.00	—	—	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 FX, METATARSAL,CLSD EA WO/MAN	$932.00	$932.00	—	—	—
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 BUNIONECTMY W/DISTAL META OSTE	$11,362.00	$11,362.00	—	196% above	—
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 BUNIONECTMY W/DISTAL META OSTE	$11,362.00	$11,362.00	—	—	—
Bunion correction with removal of part of the big toe joint CPT 28292 CORR HALUX VALGUS SIMP EXOSTEC	$11,362.00	$11,362.00	—	196% above	—
Bunion correction with removal of part of the big toe joint CPT 28292 CORRECT HALLUX VALGUS ANY METH	$11,362.00	$11,362.00	—	196% above	—
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CORR HALUX VALGUS SIMP EXOSTEC	$11,362.00	$11,362.00	—	—	—
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CORRECT HALLUX VALGUS ANY METH	$11,362.00	$11,362.00	—	—	—
Cardiac catheterization with coronary angiogram CPT 93458 LHC, COR/VENT, INJ/IMAG	$15,950.00	$15,950.00	—	161% above	—
Cardiac catheterization with coronary angiogram inpatient CPT 93458 LHC, COR/VENT, INJ/IMAG	$15,950.00	$15,950.00	—	—	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION, ELECTIVE	$300.00	$300.00	—	71% below	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 ELECTIVE CARDIOVERSION	$2,668.00	$2,668.00	—	158% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE	$2,668.00	$2,668.00	—	158% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 EMERGENCY CARDIOVERSION	$2,668.00	$2,668.00	—	158% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION,ELECTIVE	$2,668.00	$2,668.00	—	158% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIVERSION,ELECTIVE,EXTERN	$2,668.00	$2,668.00	—	158% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$2,668.00	$2,668.00	—	158% above	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION, ELECTIVE	$300.00	$300.00	—	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$2,668.00	$2,668.00	—	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 EMERGENCY CARDIOVERSION	$2,668.00	$2,668.00	—	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE	$2,668.00	$2,668.00	—	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION,ELECTIVE	$2,668.00	$2,668.00	—	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ELECTIVE CARDIOVERSION	$2,668.00	$2,668.00	—	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIVERSION,ELECTIVE,EXTERN	$2,668.00	$2,668.00	—	—	—
Cataract surgery with lens implant CPT 66984 XCAPSL CTRC RMVL W/O ECP	$5,600.00	$5,600.00	—	107% above	—
Cataract surgery with lens implant inpatient CPT 66984 XCAPSL CTRC RMVL W/O ECP	$5,600.00	$5,600.00	—	—	—
Catheter ablation for atrial fibrillation CPT 93656 COMP EP EVAL,TRANSSEP,W ABL AF	$97,011.00	$97,011.00	—	234% above	—
Catheter ablation for atrial fibrillation inpatient CPT 93656 COMP EP EVAL,TRANSSEP,W ABL AF	$97,011.00	$97,011.00	—	—	—
Cervical biopsy CPT 57500 CERVICAL BIOPSY	$4,538.00	$4,538.00	—	203% above	—
Cervical biopsy CPT 57500 REM NAMPOTHIAN CYST,CERVIC.BX	$4,538.00	$4,538.00	—	203% above	—
Cervical biopsy CPT 57500 CERV BX OR EXC LES WO/COLPO	$4,538.00	$4,538.00	—	203% above	—
Cervical biopsy inpatient CPT 57500 CERV BX OR EXC LES WO/COLPO	$4,538.00	$4,538.00	—	—	—
Cervical biopsy inpatient CPT 57500 REM NAMPOTHIAN CYST,CERVIC.BX	$4,538.00	$4,538.00	—	—	—
Cervical biopsy inpatient CPT 57500 CERVICAL BIOPSY	$4,538.00	$4,538.00	—	—	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCIS CLAMP,W/REG DORS PEN	$7,664.00	$7,664.00	—	216% above	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCIS CLAMP,W/REG DORS PEN	$7,664.00	$7,664.00	—	—	—
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCIS SURGICAL	$8,047.00	$8,047.00	—	527% above	—
Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCIS SURGICAL	$8,047.00	$8,047.00	—	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CT DISTAL RADIAL FX W/O MAN	$1,315.00	$1,315.00	—	134% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX COLLES/SMITH FX WO/	$1,315.00	$1,315.00	—	134% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CT DISTAL RADIAL FX W/O MAN	$1,315.00	$1,315.00	—	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX COLLES/SMITH FX WO/	$1,315.00	$1,315.00	—	—	—
Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY W/ EUS	$4,510.00	$4,510.00	—	210% above	—
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLONOSCOPY W/ EUS	$4,510.00	$4,510.00	—	—	—
Colonoscopy with polyp removal CPT 45385 COLON W/ REM POLYP/TUM,SNARE	$4,090.00	$4,090.00	—	113% above	—
Colonoscopy with polyp removal inpatient CPT 45385 COLON W/ REM POLYP/TUM,SNARE	$4,090.00	$4,090.00	—	—	—
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/ BIOPSY(s)	$4,090.00	$4,090.00	—	193% above	—
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/ BIOPSY(s)	$4,090.00	$4,090.00	—	—	—
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLEX,DX	$3,630.00	$3,630.00	—	87% above	—
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLEX,DX	$3,630.00	$3,630.00	—	—	—
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPO CVIX W/UP/ADJ VAG W/LOOP	$9,719.00	$9,719.00	—	157% above	—
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPO CVIX W/UP/ADJ VAG W/LOOP	$9,719.00	$9,719.00	—	—	—
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPO CVIX W/UP/ADJ VAG W/BX	$1,540.00	$1,540.00	—	130% above	—
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPO CVIX W/UP/ADJ VAG W/BX	$1,540.00	$1,540.00	—	—	—
Complex cataract surgery with lens implant CPT 66982 XCAPSL CTRC RMVL CPLX WO ECP	$11,000.00	$11,000.00	—	308% above	—
Complex cataract surgery with lens implant inpatient CPT 66982 XCAPSL CTRC RMVL CPLX WO ECP	$11,000.00	$11,000.00	—	—	—
Coronary stent placement, one artery CPT 92928 PL COR STENT,SGL COR ART/BR	$60,000.00	$60,000.00	—	330% above	—
Coronary stent placement, one artery inpatient CPT 92928 PL COR STENT,SGL COR ART/BR	$60,000.00	$60,000.00	—	—	—
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT................	$440.00	$440.00	—	90% below	—
Cystoscopy with ureteral stent placement CPT 52332 CYSTOURETH W/INSERT STENT	$11,848.00	$11,848.00	—	170% above	—
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOSCOPY AND TREATMENT................	$440.00	$440.00	—	—	—
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOURETH W/INSERT STENT	$11,848.00	$11,848.00	—	—	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHOSCOPY	$4,865.00	$4,865.00	—	237% above	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHOSCOPY	$4,865.00	$4,865.00	—	—	—
D&C (dilation and curettage), not related to pregnancy CPT 58120 D&C DX &/OR THERAPEUTIC	$10,150.00	$10,150.00	—	170% above	—
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 D&C DX &/OR THERAPEUTIC	$10,150.00	$10,150.00	—	—	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALIG LESION,1ST	$751.00	$751.00	—	159% above	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruct premalg lesion	$751.00	$751.00	—	159% above	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT PREMALIG LESION,1ST	$751.00	$751.00	—	—	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Destruct premalg lesion	$751.00	$751.00	—	—	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMPAC CERUMEN W/LAVAGE,UNI	$255.00	$255.00	—	111% above	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REM IMPAC CERUMEN W/LAVAGE,UNI	$255.00	$255.00	—	—	—
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX, ONE OR BOTH EARS	$95.00	$95.00	—	27% below	—
Earwax removal with instruments, one ear one side CPT 69210 REMIMPACTCERUMN,INST,UNILAT	$255.00	$255.00	—	96% above	—
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX, ONE OR BOTH EARS	$95.00	$95.00	—	—	—
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMIMPACTCERUMN,INST,UNILAT	$255.00	$255.00	—	—	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BX	$844.00	$844.00	—	83% above	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Biopsy of uterus lining	$844.00	$844.00	—	83% above	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$844.00	$844.00	—	83% above	—
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY OF UTERUS LINING	$844.00	$844.00	—	—	—
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BX	$844.00	$844.00	—	—	—
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Biopsy of uterus lining	$844.00	$844.00	—	—	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ EPIDURAL CERV/THOR W/ IMAG	$4,400.00	$4,400.00	—	215% above	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ EPIDURAL CERV/THOR W/ IMAG	$4,400.00	$4,400.00	—	—	—
Eye injection into the vitreous (intravitreal injection) CPT 67028 INTRAVITREAL INJECT PHARM AGEN	$1,302.00	$1,302.00	—	81% above	—
Eye injection into the vitreous (intravitreal injection) CPT 67028 INJECTION EYE DRUG	$1,302.00	$1,302.00	—	81% above	—
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INJECTION EYE DRUG	$1,302.00	$1,302.00	—	—	—
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INTRAVITREAL INJECT PHARM AGEN	$1,302.00	$1,302.00	—	—	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ,PARAVERT JT,LUM/SAC,SGL	$3,477.00	$3,477.00	—	73% above	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ,PARAVERT JT,LUM/SAC,SGL	$3,477.00	$3,477.00	—	—	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY	$165.00	$165.00	—	92% below	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY,FLEX,DX	$3,647.00	$3,647.00	—	83% above	—
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY	$165.00	$165.00	—	—	—
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY,FLEX,DX	$3,647.00	$3,647.00	—	—	—
Gallbladder removal, laparoscopic CPT 47562 CHOLECYSTECTOMY	$1,985.00	$1,985.00	—	71% below	—
Gallbladder removal, laparoscopic inpatient CPT 47562 CHOLECYSTECTOMY	$1,985.00	$1,985.00	—	—	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPAROSCOPY CHOLECYSTECTOMY WITH CHOLANGIOGRAPHY	$2,160.00	$2,160.00	—	69% below	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAP CHOLE W/ CHOLANG	$21,572.00	$21,572.00	—	212% above	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPAROSCOPY CHOLECYSTECTOMY WITH CHOLANGIOGRAPHY	$2,160.00	$2,160.00	—	—	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAP CHOLE W/ CHOLANG	$21,572.00	$21,572.00	—	—	—
Hammertoe correction surgery CPT 28285 CORRECTION HAMMERTOE	$11,362.00	$11,362.00	—	196% above	—
Hammertoe correction surgery inpatient CPT 28285 CORRECTION HAMMERTOE	$11,362.00	$11,362.00	—	—	—
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDEC,INTERN,RUB BAND	$3,112.00	$3,112.00	—	173% above	—
Hemorrhoid banding (rubber band ligation) CPT 46221 RUBBER BAND HEMORRHOIDS	$3,112.00	$3,112.00	—	173% above	—
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDEC,INTERN,RUB BAND	$3,112.00	$3,112.00	—	—	—
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 RUBBER BAND HEMORRHOIDS	$3,112.00	$3,112.00	—	—	—
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORHOIDECTMY,INT&EXT,SGL GRP	$12,247.00	$12,247.00	—	236% above	—
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORHOIDECTMY,INT&EXT,SGL GRP	$12,247.00	$12,247.00	—	—	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH/INJ FOR HYSTERNOGRAP	$990.00	$990.00	—	227% above	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH/INJ FOR HYSTERSONOGRAP/	$990.00	$990.00	—	227% above	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH/INJ FOR HYSTERSONOGRAP/	$990.00	$990.00	—	—	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH/INJ FOR HYSTERNOGRAP	$990.00	$990.00	—	—	—
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSC W/POLYPEC UTER	$9,719.00	$9,719.00	—	126% above	—
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSC W/POLYPEC UTER	$9,719.00	$9,719.00	—	—	—
IUD insertion (the device itself billed separately) CPT 58300 IUD INSERTION	$900.00	$900.00	—	120% above	—
IUD insertion (the device itself billed separately) inpatient CPT 58300 IUD INSERTION	$900.00	$900.00	—	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION/DRAINAGE OF ABCESS, SIMPLE/SINGLE	$310.00	$310.00	—	23% below	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS,SIMPLE/SINGLE	$977.00	$977.00	—	142% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE,SIMP/SING	$977.00	$977.00	—	142% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D abscess; simple or sgl	$977.00	$977.00	—	142% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS;SIMPLE/SGLE	$977.00	$977.00	—	142% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS, SIMPLE	$977.00	$977.00	—	142% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABCESS, SIMPLE/SINGLE	$977.00	$977.00	—	142% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE,SINGLE	$977.00	$977.00	—	142% above	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION/DRAINAGE OF ABCESS, SIMPLE/SINGLE	$310.00	$310.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS,SIMPLE/SINGLE	$977.00	$977.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE,SINGLE	$977.00	$977.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABCESS, SIMPLE/SINGLE	$977.00	$977.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS, SIMPLE	$977.00	$977.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS;SIMPLE/SGLE	$977.00	$977.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D abscess; simple or sgl	$977.00	$977.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE,SIMP/SING	$977.00	$977.00	—	—	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$1,203.00	$1,203.00	—	144% above	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ,TENDON SHEATH LIGAMENT	$1,203.00	$1,203.00	—	144% above	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ(S) SINGLE TENDON/LIGAMENT	$1,203.00	$1,203.00	—	144% above	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT(S);TENDON SHEATH,LIGMNT	$1,203.00	$1,203.00	—	144% above	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ,TENDON SHEATH LIGAMENT	$1,203.00	$1,203.00	—	—	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT	$1,203.00	$1,203.00	—	—	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT(S);TENDON SHEATH,LIGMNT	$1,203.00	$1,203.00	—	—	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ(S) SINGLE TENDON/LIGAMENT	$1,203.00	$1,203.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS, ASPIRARION/INJECTION INTERMEDIATE JOINT	$135.00	$135.00	—	73% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIR/INJ MAJOR JT/BURSA WO US	$2,052.00	$2,052.00	—	306% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS, ASPIRARION/INJECTION INTERMEDIATE JOINT	$135.00	$135.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIR/INJ MAJOR JT/BURSA WO US	$2,052.00	$2,052.00	—	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DLVRY IMPLANT	$550.00	$550.00	—	95% above	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DELIVERY IMPLAN	$550.00	$550.00	—	95% above	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT IMPLANTBLE CONTRCPT.CAP	$550.00	$550.00	—	95% above	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DLVRY IMPLANT	$550.00	$550.00	—	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT IMPLANTBLE CONTRCPT.CAP	$550.00	$550.00	—	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DELIVERY IMPLAN	$550.00	$550.00	—	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS, ASPIRARION/INJECTION MAJOR JOINT	$105.00	$105.00	—	77% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$1,821.00	$1,821.00	—	298% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHR ASP/INJ INT JT,BUR WO US	$1,821.00	$1,821.00	—	298% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS, ASPIRARION/INJECTION MAJOR JOINT	$105.00	$105.00	—	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHR ASP/INJ INT JT,BUR WO US	$1,821.00	$1,821.00	—	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$1,821.00	$1,821.00	—	—	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$1,205.00	$1,205.00	—	168% above	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHRO ASP/INJ SM JT,BUR WO US	$1,205.00	$1,205.00	—	168% above	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHRO ASP/INJ SM JT,BUR WO US	$1,205.00	$1,205.00	—	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$1,205.00	$1,205.00	—	—	—
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY SURGICAL APPENDECTOMY	$1,805.00	$1,805.00	—	74% below	—
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY SURGICAL APPENDECTOMY	$1,805.00	$1,805.00	—	—	—
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAPAROSCOPY SURGICAL ESOPHAGOGASTRIC FUNDOPLASTY	$3,215.00	$3,215.00	—	74% below	—
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 LAPAROSCOPY SURGICAL ESOPHAGOGASTRIC FUNDOPLASTY	$3,215.00	$3,215.00	—	—	—
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 OST-CATARACT LASER SURGERY	$4,000.00	$4,000.00	—	219% above	—
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 OST-CATARACT LASER SURGERY	$4,000.00	$4,000.00	—	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD REPR S/A/T/EXT 2.5 CM/<	$1,400.00	$1,400.00	—	137% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REP WND,INTM S/T/E <2.5C	$1,432.00	$1,432.00	—	142% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTRM SCP/TK/EXT <2.5CM	$1,432.00	$1,432.00	—	142% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTMD REPR S/A/T/EXT 2.5 CM/<	$1,400.00	$1,400.00	—	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REP WND,INTM S/T/E <2.5C	$1,432.00	$1,432.00	—	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTRM SCP/TK/EXT <2.5CM	$1,432.00	$1,432.00	—	—	—
Left heart catheterization, diagnostic CPT 93452 LHC INCL.VENT INJ & IMAG	$15,950.00	$15,950.00	—	129% above	—
Left heart catheterization, diagnostic inpatient CPT 93452 LHC INCL.VENT INJ & IMAG	$15,950.00	$15,950.00	—	—	—
Lower-back epidural injection, with imaging guidance CPT 62323 INJ EPIDURAL LUMB/SACR W/ IMAG	$4,155.00	$4,155.00	—	179% above	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ EPIDURAL LUMB/SACR W/ IMAG	$4,155.00	$4,155.00	—	—	—
Lower-back epidural injection, without imaging guidance CPT 62322 INJ,SGL,EPIDURAL/SUBARA,LUM/SA	$4,400.00	$4,400.00	—	202% above	—
Lower-back epidural injection, without imaging guidance CPT 62322 INJ SINGLE,LUMBAR/SACRAL	$4,400.00	$4,400.00	—	202% above	—
Lower-back epidural injection, without imaging guidance CPT 62322 LUMBAR EPIDURAL BLOCK	$4,400.00	$4,400.00	—	202% above	—
Lower-back epidural injection, without imaging guidance CPT 62322 CAUDAL BLOCK	$4,400.00	$4,400.00	—	202% above	—
Lower-back epidural injection, without imaging guidance CPT 62322 SPINAL, SGL BLOCKLUM/SAC	$4,400.00	$4,400.00	—	202% above	—
Lower-back epidural injection, without imaging guidance CPT 62322 INJ EPIDURAL LUMB/SACR WO IMAG	$4,400.00	$4,400.00	—	202% above	—
Lower-back epidural injection, without imaging guidance CPT 62322 INJ DX/THERAP LUMBAR/CAUDAL	$4,400.00	$4,400.00	—	202% above	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 SPINAL, SGL BLOCKLUM/SAC	$4,400.00	$4,400.00	—	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 LUMBAR EPIDURAL BLOCK	$4,400.00	$4,400.00	—	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ,SGL,EPIDURAL/SUBARA,LUM/SA	$4,400.00	$4,400.00	—	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 CAUDAL BLOCK	$4,400.00	$4,400.00	—	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ DX/THERAP LUMBAR/CAUDAL	$4,400.00	$4,400.00	—	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ EPIDURAL LUMB/SACR WO IMAG	$4,400.00	$4,400.00	—	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ SINGLE,LUMBAR/SACRAL	$4,400.00	$4,400.00	—	—	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ ANESTH/STEROID EPIDURAL, L	$2,978.00	$2,978.00	—	93% above	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ EPIDURAL LUMB/SACR SGL LEV	$3,190.00	$3,190.00	—	106% above	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ ANESTH/STEROID EPIDURAL, L	$2,978.00	$2,978.00	—	—	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ EPIDURAL LUMB/SACR SGL LEV	$3,190.00	$3,190.00	—	—	—
Miscarriage treatment with D&C, first trimester CPT 59820 TX MISSED ABORT,SURG,1ST TRI	$11,000.00	$11,000.00	—	170% above	—
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TX MISSED ABORT,SURG,1ST TRI	$11,000.00	$11,000.00	—	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc benign les trnk/ext <0.6cm	$2,512.00	$2,512.00	—	133% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BENIGN LES TRNK/EXT <0.6CM	$2,512.00	$2,512.00	—	133% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc benign les trnk/ext <0.6cm	$2,512.00	$2,512.00	—	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BENIGN LES TRNK/EXT <0.6CM	$2,512.00	$2,512.00	—	—	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Ex ben les fac/eye/mth <0.6cm	$2,762.00	$2,762.00	—	162% above	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Ex ben les fac/eye/mth <0.6cm	$2,762.00	$2,762.00	—	—	—
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE	$820.00	$820.00	—	146% above	—
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE,SIMPLE,S	$820.00	$820.00	—	146% above	—
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SIMPL/SNGL	$820.00	$820.00	—	146% above	—
Nail removal (partial or complete), one nail CPT 11730 Avulsion nail plate simp/sgl	$820.00	$820.00	—	146% above	—
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SIMPLE 1	$820.00	$820.00	—	146% above	—
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE	$820.00	$820.00	—	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SIMPLE 1	$820.00	$820.00	—	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion nail plate simp/sgl	$820.00	$820.00	—	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE,SIMPLE,S	$820.00	$820.00	—	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SIMPL/SNGL	$820.00	$820.00	—	—	—
Occipital nerve block (injection for headaches) CPT 64405 OCCIPITAL NERVE BLOCK	$1,077.00	$1,077.00	—	127% above	—
Occipital nerve block (injection for headaches) CPT 64405 INJ GREATER OCC NERVE	$1,077.00	$1,077.00	—	127% above	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ GREATER OCC NERVE	$1,077.00	$1,077.00	—	—	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 OCCIPITAL NERVE BLOCK	$1,077.00	$1,077.00	—	—	—
Pacemaker implant (dual chamber) CPT 33208 INSERT PPM W/ELECT,ATRIAL&VENT	$49,742.00	$49,742.00	—	302% above	—
Pacemaker implant (dual chamber) CPT 33208 INSERT PERM PM & A/V ELECTRODS	$49,742.00	$49,742.00	—	302% above	—
Pacemaker implant (dual chamber) inpatient CPT 33208 INSERT PPM W/ELECT,ATRIAL&VENT	$49,742.00	$49,742.00	—	—	—
Pacemaker implant (dual chamber) inpatient CPT 33208 INSERT PERM PM & A/V ELECTRODS	$49,742.00	$49,742.00	—	—	—
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAG GUID	$300.00	$300.00	—	79% below	—
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAG	$3,630.00	$3,630.00	—	155% above	—
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAG GUID	$300.00	$300.00	—	—	—
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAG	$3,630.00	$3,630.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISIONOF NAIL&NAIL MATRIX PE	$1,499.00	$1,499.00	—	104% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL&NAIL MATRIX P	$1,499.00	$1,499.00	—	104% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Exc nail and matrix,perm remv	$1,499.00	$1,499.00	—	104% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION , NAIL & MATRIX	$1,499.00	$1,499.00	—	104% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL&NAIL MATRIX	$1,499.00	$1,499.00	—	104% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL/NAIL MATRIX,PE	$1,499.00	$1,499.00	—	104% above	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISIONOF NAIL&NAIL MATRIX PE	$1,499.00	$1,499.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION , NAIL & MATRIX	$1,499.00	$1,499.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL/NAIL MATRIX,PE	$1,499.00	$1,499.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL&NAIL MATRIX P	$1,499.00	$1,499.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Exc nail and matrix,perm remv	$1,499.00	$1,499.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL&NAIL MATRIX	$1,499.00	$1,499.00	—	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DES NEUR,PAR FCT,L/S SGL W/IMG	$7,285.00	$7,285.00	—	114% above	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DES NEUR,PAR FCT,L/S SGL W/IMG	$7,285.00	$7,285.00	—	—	—
Removal of a foreign object under the skin, simple CPT 10120 INCISION/REMOVAL OF FOREIGN BODY,SIMPLE	$306.00	$306.00	—	52% below	—
Removal of a foreign object under the skin, simple CPT 10120 INCISION/REM FB,SQ TISS SIMP	$1,601.00	$1,601.00	—	149% above	—
Removal of a foreign object under the skin, simple CPT 10120 INCISION&REMOV OF FB,SQ,SIMP	$1,601.00	$1,601.00	—	149% above	—
Removal of a foreign object under the skin, simple CPT 10120 INCISION/REM FB,SQ TISS;SIMPLE	$1,601.00	$1,601.00	—	149% above	—
Removal of a foreign object under the skin, simple CPT 10120 INC&REMV FB,SQ,SIMPLE	$1,601.00	$1,601.00	—	149% above	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION/REMOVAL OF FOREIGN BODY,SIMPLE	$306.00	$306.00	—	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION/REM FB,SQ TISS;SIMPLE	$1,601.00	$1,601.00	—	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC&REMV FB,SQ,SIMPLE	$1,601.00	$1,601.00	—	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION/REM FB,SQ TISS SIMP	$1,601.00	$1,601.00	—	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION&REMOV OF FB,SQ,SIMP	$1,601.00	$1,601.00	—	—	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 SCREENING COLONSCPY,NON HI RSK	$3,960.00	$3,960.00	—	157% above	—
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 SCREENING COLONSCPY,NON HI RSK	$3,960.00	$3,960.00	—	—	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 SCREENING COLONSCOPY,HI RISK	$3,850.00	$3,850.00	—	257% above	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 SCREENING COLONSCOPY,HI RISK	$3,850.00	$3,850.00	—	—	—
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY,EXTRACORP SHOCK WV	$14,850.00	$14,850.00	—	174% above	—
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY,EXTRACORP SHOCK WV	$14,850.00	$14,850.00	—	—	—
Short arm cast (elbow to hand) CPT 29075 CAST - SHT ARM ELBOW TO FINGER	$1,030.00	$1,030.00	—	141% above	—
Short arm cast (elbow to hand) CPT 29075 APPLY SHORT ARM CAST	$1,030.00	$1,030.00	—	141% above	—
Short arm cast (elbow to hand) inpatient CPT 29075 CAST - SHT ARM ELBOW TO FINGER	$1,030.00	$1,030.00	—	—	—
Short arm cast (elbow to hand) inpatient CPT 29075 APPLY SHORT ARM CAST	$1,030.00	$1,030.00	—	—	—
Short arm splint (forearm and hand) CPT 29125 APPLY ULNAR GUTTER SPLINT	$466.00	$466.00	—	121% above	—
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT, STATIC	$466.00	$466.00	—	121% above	—
Short arm splint (forearm and hand) CPT 29125 APP SHORT ARM SPLINT STATIC	$466.00	$466.00	—	121% above	—
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT, STAT	$466.00	$466.00	—	121% above	—
Short arm splint (forearm and hand) CPT 29125 APPLY VOLAR SPLINT	$466.00	$466.00	—	121% above	—
Short arm splint (forearm and hand) CPT 29125 SHORT FOREARM SPLINT STATIC	$514.00	$514.00	—	144% above	—
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY ULNAR GUTTER SPLINT	$466.00	$466.00	—	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY VOLAR SPLINT	$466.00	$466.00	—	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT, STATIC	$466.00	$466.00	—	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT, STAT	$466.00	$466.00	—	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 APP SHORT ARM SPLINT STATIC	$466.00	$466.00	—	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 SHORT FOREARM SPLINT STATIC	$514.00	$514.00	—	—	—
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST (BLW KN	$1,030.00	$1,030.00	—	110% above	—
Short leg cast (below the knee) CPT 29405 CAST - SHORT LEG KNEE TO TOES	$1,030.00	$1,030.00	—	110% above	—
Short leg cast (below the knee) inpatient CPT 29405 CAST - SHORT LEG KNEE TO TOES	$1,030.00	$1,030.00	—	—	—
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST (BLW KN	$1,030.00	$1,030.00	—	—	—
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT	$584.00	$584.00	—	104% above	—
Short leg splint (calf to foot) CPT 29515 SHORT LEG SPLINT CALF TO FOOT	$584.00	$584.00	—	104% above	—
Short leg splint (calf to foot) inpatient CPT 29515 SHORT LEG SPLINT CALF TO FOOT	$584.00	$584.00	—	—	—
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT	$584.00	$584.00	—	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMP REP WOUND H/T/E/G <2.6CM	$714.00	$714.00	—	89% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMP REP WOUND H/T/E/G <2.6CM	$714.00	$714.00	—	—	—
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN; SINGLE LESION	$1,432.00	$1,432.00	—	108% above	—
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN; SINGLE LESION	$1,432.00	$1,432.00	—	—	—
Skin tag removal, up to 15 tags CPT 11200 REM SKIN/FIBROCUTAN TAGS <16	$792.00	$792.00	—	118% above	—
Skin tag removal, up to 15 tags inpatient CPT 11200 REM SKIN/FIBROCUTAN TAGS <16	$792.00	$792.00	—	—	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$195.00	$195.00	—	84% below	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL TAP, NON RADIOLOGY	$4,400.00	$4,400.00	—	271% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR,DX	$4,400.00	$4,400.00	—	271% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$4,400.00	$4,400.00	—	271% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNC,LUM,DX	$4,400.00	$4,400.00	—	271% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE,LUMBAR DX	$4,400.00	$4,400.00	—	271% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE, DX	$4,400.00	$4,400.00	—	271% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAG	$4,400.00	$4,400.00	—	271% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE,LUMBAR,DX	$4,400.00	$4,400.00	—	271% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL TAP DIAGNOSTIC	$4,400.00	$4,400.00	—	271% above	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$195.00	$195.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL TAP, NON RADIOLOGY	$4,400.00	$4,400.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE,LUMBAR DX	$4,400.00	$4,400.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL TAP DIAGNOSTIC	$4,400.00	$4,400.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE, DX	$4,400.00	$4,400.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAG	$4,400.00	$4,400.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNC,LUM,DX	$4,400.00	$4,400.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE,LUMBAR,DX	$4,400.00	$4,400.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR,DX	$4,400.00	$4,400.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$4,400.00	$4,400.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIM REPAIR,SCALP/BDY 2.6-7.5CM	$774.00	$774.00	—	95% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMP REPAIR WOUND H/T/E 2.6-	$774.00	$774.00	—	95% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMP REP WOUND H/T/E/G2.6-7.5C	$774.00	$774.00	—	95% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMP.REPAIR WOUND 2.6-7CM SCLP	$774.00	$774.00	—	95% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMP REP WOUND H/T/E/G2.6-7.5C	$774.00	$774.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIM REPAIR,SCALP/BDY 2.6-7.5CM	$774.00	$774.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMP.REPAIR WOUND 2.6-7CM SCLP	$774.00	$774.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMP REPAIR WOUND H/T/E 2.6-	$774.00	$774.00	—	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMP REP WOUND FACE/MM <2.6CM	$714.00	$714.00	—	89% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMP REP WOUND FACE/MM <2.6CM	$714.00	$714.00	—	—	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BX,SKIN,SGL LESION	$1,364.00	$1,364.00	—	174% above	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BX,SKIN,SGL LESION	$1,364.00	$1,364.00	—	—	—
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS FOR ASP W/GUID	$3,348.00	$3,348.00	—	161% above	—
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS FOR ASP W/GUID	$3,348.00	$3,348.00	—	—	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PT 1 OR 2 MUSCLES	$1,175.00	$1,175.00	—	180% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 Inj Trigger Pt(s), 1/2 Muscle	$1,175.00	$1,175.00	—	180% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT INJ(S) 1 OR 2 MUSCL	$1,175.00	$1,175.00	—	180% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT, 1-2 MUSC	$1,175.00	$1,175.00	—	180% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PT,1-2 MUSC	$1,175.00	$1,175.00	—	180% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SGL/MUL TRIG PT,1OR 2 MUSC	$1,175.00	$1,175.00	—	180% above	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj Trigger Pt(s), 1/2 Muscle	$1,175.00	$1,175.00	—	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PT 1 OR 2 MUSCLES	$1,175.00	$1,175.00	—	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT, 1-2 MUSC	$1,175.00	$1,175.00	—	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PT,1-2 MUSC	$1,175.00	$1,175.00	—	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PT INJ(S) 1 OR 2 MUSCL	$1,175.00	$1,175.00	—	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SGL/MUL TRIG PT,1OR 2 MUSC	$1,175.00	$1,175.00	—	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BREAST BX W/LOC DEV,1LES,US	$5,763.00	$5,763.00	—	99% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BREAST BX W/LOC DEV,1LES,US	$5,763.00	$5,763.00	—	—	—
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD W/ESO BALLOON DILATION/30MIN	$435.00	$435.00	—	82% below	—
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD W/ESOPH BALLOON DIL	$6,221.00	$6,221.00	—	155% above	—
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD W/ESO BALLOON DILATION/30MIN	$435.00	$435.00	—	—	—
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD W/ESOPH BALLOON DIL	$6,221.00	$6,221.00	—	—	—
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY	$3,585.00	$3,585.00	—	115% above	—
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/ BIOPSY	$3,585.00	$3,585.00	—	115% above	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/ BIOPSY	$3,585.00	$3,585.00	—	—	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BIOPSY	$3,585.00	$3,585.00	—	—	—
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD W/SUBMUCOSAL INJ	$3,912.00	$3,912.00	—	192% above	—
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD W/SUBMUCOSAL INJ	$3,912.00	$3,912.00	—	—	—
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD W/ REMOVE POLYP BY SNARE	$6,221.00	$6,221.00	—	168% above	—
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD W/ REMOVE POLYP BY SNARE	$6,221.00	$6,221.00	—	—	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD W/ESOPH DIL OVR GUIDEWIRE	$4,021.00	$4,021.00	—	224% above	—
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD W/ESOPH DIL OVR GUIDEWIRE	$4,021.00	$4,021.00	—	—	—
Upper endoscopy (EGD), diagnostic CPT 43235 EGD	$3,520.00	$3,520.00	—	114% above	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD	$3,520.00	$3,520.00	—	—	—
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 EGD W/ DRAIN,PSEUDOCYST	$11,700.00	$11,700.00	—	66% above	—
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 EGD W/ DRAIN,PSEUDOCYST	$11,700.00	$11,700.00	—	—	—
Wart removal, up to 14 warts CPT 17110 DEST BEN SKIN LES,NON TAGS,<15	$754.00	$754.00	—	117% above	—
Wart removal, up to 14 warts CPT 17110 DESTR BENIGN LES,NOT TAGS <15	$754.00	$754.00	—	117% above	—
Wart removal, up to 14 warts CPT 17110 Dest Benign les <15	$754.00	$754.00	—	117% above	—
Wart removal, up to 14 warts inpatient CPT 17110 Dest Benign les <15	$754.00	$754.00	—	—	—
Wart removal, up to 14 warts inpatient CPT 17110 DEST BEN SKIN LES,NON TAGS,<15	$754.00	$754.00	—	—	—
Wart removal, up to 14 warts inpatient CPT 17110 DESTR BENIGN LES,NOT TAGS <15	$754.00	$754.00	—	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SQ TISS;1ST 20 SQ CM	$1,613.00	$1,613.00	—	91% above	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN & SQ TISSUE	$1,613.00	$1,613.00	—	91% above	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN & SQ TISSUE	$1,613.00	$1,613.00	—	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SQ TISS;1ST 20 SQ CM	$1,613.00	$1,613.00	—	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLD/BLD PROD ADMINISTRATION	$1,800.00	$1,800.00	—	146% above	—
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION, BLOOD/COMPONENT	$1,800.00	$1,800.00	—	146% above	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION	$1,800.00	$1,800.00	—	146% above	—
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD	$1,800.00	$1,800.00	—	146% above	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION, BLOOD/COMPONENT	$1,800.00	$1,800.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD	$1,800.00	$1,800.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLD/BLD PROD ADMINISTRATION	$1,800.00	$1,800.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION	$1,800.00	$1,800.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION	$25.00	$25.00	—	89% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MINI NEB TX ADULT SUBSEQUENT	$450.00	$450.00	—	101% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MINI NEB TX NEO/PED SUBSEQUENT	$474.00	$474.00	—	112% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION THERAPY,NEBULIZER	$500.00	$500.00	—	123% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL THER SPUTUM INDUCT SUB	$756.00	$756.00	—	238% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL THER RIBAVARIN TX INIT	$756.00	$756.00	—	238% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL THER RIBAVARIN TX SUBS	$756.00	$756.00	—	238% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL THER SPUTUM INDUCT INI	$756.00	$756.00	—	238% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL THERAPY SUBSEQUENT	$756.00	$756.00	—	238% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL THERAPY INITIAL	$756.00	$756.00	—	238% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TX,NEBULIZER	$760.00	$760.00	—	239% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHAL TX AIRWAY OBST/SPUTUM	$760.00	$760.00	—	239% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TREATMENTS	$760.00	$760.00	—	239% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HELIOX TX	$760.00	$760.00	—	239% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TX	$760.00	$760.00	—	239% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHAL.TX OBST/SPUT/NEB SUBSQ	$760.00	$760.00	—	239% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHAL.TX FR OBST/SPUT PROD NEB	$760.00	$760.00	—	239% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MINI NEB TX NEO/PED INITIAL	$760.00	$760.00	—	239% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT	$760.00	$760.00	—	239% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MINI NEB TX ADULT INITIAL	$760.00	$760.00	—	239% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION	$25.00	$25.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MINI NEB TX ADULT SUBSEQUENT	$450.00	$450.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MINI NEB TX NEO/PED SUBSEQUENT	$474.00	$474.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION THERAPY,NEBULIZER	$500.00	$500.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL THER SPUTUM INDUCT INI	$756.00	$756.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL THER SPUTUM INDUCT SUB	$756.00	$756.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL THERAPY SUBSEQUENT	$756.00	$756.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL THER RIBAVARIN TX INIT	$756.00	$756.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL THERAPY INITIAL	$756.00	$756.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL THER RIBAVARIN TX SUBS	$756.00	$756.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT	$760.00	$760.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MINI NEB TX ADULT INITIAL	$760.00	$760.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MINI NEB TX NEO/PED INITIAL	$760.00	$760.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HELIOX TX	$760.00	$760.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TREATMENTS	$760.00	$760.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL TX AIRWAY OBST/SPUTUM	$760.00	$760.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL.TX FR OBST/SPUT PROD NEB	$760.00	$760.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHAL.TX OBST/SPUT/NEB SUBSQ	$760.00	$760.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TX,NEBULIZER	$760.00	$760.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TX	$760.00	$760.00	—	—	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUSION	$1,573.00	$1,573.00	—	157% above	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADM IV INF TO 1 HR.	$1,573.00	$1,573.00	—	157% above	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN IV INF TO 1 HR	$1,573.00	$1,573.00	—	157% above	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMOTX,INFUS TO 1HR SGL/INIT	$1,573.00	$1,573.00	—	157% above	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADM IV INF TO 1 HR.	$1,573.00	$1,573.00	—	—	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMOTX,INFUS TO 1HR SGL/INIT	$1,573.00	$1,573.00	—	—	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADMIN IV INF TO 1 HR	$1,573.00	$1,573.00	—	—	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INFUSION	$1,573.00	$1,573.00	—	—	—
Comprehensive eye exam by an eye doctor, new patient CPT 92004 COMPRE OPH EXAM NEW PT 1/>	$495.00	$495.00	—	115% above	—
Comprehensive eye exam by an eye doctor, new patient CPT 92004 OPTHAL SEV,NP,COMP,1 OR<VISITS	$495.00	$495.00	—	115% above	—
Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 OPTHAL SEV,NP,COMP,1 OR<VISITS	$495.00	$495.00	—	—	—
Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 COMPRE OPH EXAM NEW PT 1/>	$495.00	$495.00	—	—	—
Comprehensive eye exam, returning patient CPT 92014 OPTHAL SERV,EP,COMP,1 OR<VSITS	$550.00	$550.00	—	182% above	—
Comprehensive eye exam, returning patient CPT 92014 COMPRE OPH EXAM EST PT 1/>	$550.00	$550.00	—	182% above	—
Comprehensive eye exam, returning patient inpatient CPT 92014 COMPRE OPH EXAM EST PT 1/>	$550.00	$550.00	—	—	—
Comprehensive eye exam, returning patient inpatient CPT 92014 OPTHAL SERV,EP,COMP,1 OR<VSITS	$550.00	$550.00	—	—	—
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 AUDIO AIR & BONE W/SP RECG	$593.00	$593.00	—	220% above	—
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 AIR & BONE SPEECH RECOGNITION	$593.00	$593.00	—	220% above	—
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 AIR & BONE SPEECH RECOGNITION	$593.00	$593.00	—	—	—
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 AUDIO AIR & BONE W/SP RECG	$593.00	$593.00	—	—	—
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE E/M -1ST HOUR	$595.00	$595.00	—	65% below	—
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE INT 30-74MIN	$4,000.00	$4,000.00	—	133% above	—
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST 30-74MIN	$4,000.00	$4,000.00	—	133% above	—
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE INT 30-74MIN W/25MOD	$4,000.00	$4,000.00	—	133% above	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE E/M -1ST HOUR	$595.00	$595.00	—	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRIT CARE INT 30-74MIN W/25MOD	$4,000.00	$4,000.00	—	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST 30-74MIN	$4,000.00	$4,000.00	—	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRIT CARE INT 30-74MIN	$4,000.00	$4,000.00	—	—	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG W/HYPERVENT/PHOTIC	$1,125.00	$1,125.00	—	63% above	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG,AWAKE/DROWSY	$6,368.00	$6,368.00	—	825% above	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG W/O VID EA 12-26HR UNMNTR	$6,368.00	$6,368.00	—	825% above	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG ROUTINE-AWAKE & DROWSY	$6,368.00	$6,368.00	—	825% above	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG W/HYPERVENT/PHOTIC	$1,125.00	$1,125.00	—	—	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG,AWAKE/DROWSY	$6,368.00	$6,368.00	—	—	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG ROUTINE-AWAKE & DROWSY	$6,368.00	$6,368.00	—	—	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG W/O VID EA 12-26HR UNMNTR	$6,368.00	$6,368.00	—	—	—
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM, ROUTINE ECG COMPLETE	$45.00	$45.00	—	27% below	—
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ELECTROCARDIOGRAM, ROUTINE ECG COMPLETE	$45.00	$45.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG 12 LEAD, TRACING ONLY	$315.00	$315.00	—	120% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG INTERPRETATION (93040)	$315.00	$315.00	—	120% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD W/INTERP/REPORT	$315.00	$315.00	—	120% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 LEAD EKG TRACING ONLY	$315.00	$315.00	—	120% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG 12 LEAD	$315.00	$315.00	—	120% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEADS	$315.00	$315.00	—	120% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD	$315.00	$315.00	—	120% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 LEAD EKG	$315.00	$315.00	—	120% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 LEAD EKG, TRACING ONLY	$315.00	$315.00	—	120% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$315.00	$315.00	—	120% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG 12 LEAD STAT	$315.00	$315.00	—	120% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12LEAD EKG	$315.00	$315.00	—	120% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 LEAD EKG TRACING	$315.00	$315.00	—	120% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 LEAD EKG TRACING ONLY	$315.00	$315.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG 12 LEAD, TRACING ONLY	$315.00	$315.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$315.00	$315.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 LEAD EKG TRACING	$315.00	$315.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12LEAD EKG	$315.00	$315.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 LEAD EKG, TRACING ONLY	$315.00	$315.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 LEAD EKG	$315.00	$315.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD	$315.00	$315.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEADS	$315.00	$315.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG 12 LEAD	$315.00	$315.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG 12 LEAD STAT	$315.00	$315.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD W/INTERP/REPORT	$315.00	$315.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG INTERPRETATION (93040)	$315.00	$315.00	—	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPT. VISIT	$35.00	$35.00	—	86% below	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL I	$396.00	$396.00	—	59% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY ROOM OB TRIAGE ONLY	$495.00	$495.00	—	99% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY ROOM TRIAGE ONLY	$495.00	$495.00	—	99% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL 1 WITH MODIFIER 25	$1,617.00	$1,617.00	—	549% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPT. VISIT	$35.00	$35.00	—	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER LEVEL I	$396.00	$396.00	—	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY ROOM OB TRIAGE ONLY	$495.00	$495.00	—	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY ROOM TRIAGE ONLY	$495.00	$495.00	—	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER LEVEL 1 WITH MODIFIER 25	$1,617.00	$1,617.00	—	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT. VISIT.	$120.00	$120.00	—	64% below	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL II	$600.00	$600.00	—	78% above	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL 2 WITH MODIFIER 25	$2,000.00	$2,000.00	—	493% above	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT. VISIT.	$120.00	$120.00	—	—	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL II	$600.00	$600.00	—	—	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL 2 WITH MODIFIER 25	$2,000.00	$2,000.00	—	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL III	$1,020.00	$1,020.00	—	81% above	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL 3 WITH MODIFIER 25	$2,300.00	$2,300.00	—	309% above	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER LEVEL III	$1,020.00	$1,020.00	—	—	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER LEVEL 3 WITH MODIFIER 25	$2,300.00	$2,300.00	—	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL IV	$1,700.00	$1,700.00	—	101% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL 4 WITH MODIFIER 25	$2,500.00	$2,500.00	—	196% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER LEVEL IV	$1,700.00	$1,700.00	—	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER LEVEL 4 WITH MODIFIER 25	$2,500.00	$2,500.00	—	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL V	$3,000.00	$3,000.00	—	153% above	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL 5 WITH MODIFIER 25	$3,000.00	$3,000.00	—	153% above	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER LEVEL V	$3,000.00	$3,000.00	—	—	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER LEVEL 5 WITH MODIFIER 25	$3,000.00	$3,000.00	—	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRESS W MONITRNG TRAC ONLY	$1,170.00	$1,170.00	—	112% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST/TREADMILL	$1,229.00	$1,229.00	—	123% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST, TRACING ONLY	$1,229.00	$1,229.00	—	123% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRESS TEST/LOW LEVEL	$1,290.00	$1,290.00	—	134% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS PHARMOCOLOGIC	$1,290.00	$1,290.00	—	134% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRESS TEST	$1,290.00	$1,290.00	—	134% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRESS TEST PHAMACOLOGIC	$1,290.00	$1,290.00	—	134% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRESS TEST TRACING ONLY	$1,290.00	$1,290.00	—	134% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$1,290.00	$1,290.00	—	134% above	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRESS W MONITRNG TRAC ONLY	$1,170.00	$1,170.00	—	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST/TREADMILL	$1,229.00	$1,229.00	—	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST, TRACING ONLY	$1,229.00	$1,229.00	—	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRESS TEST	$1,290.00	$1,290.00	—	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST	$1,290.00	$1,290.00	—	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRESS TEST TRACING ONLY	$1,290.00	$1,290.00	—	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRESS TEST PHAMACOLOGIC	$1,290.00	$1,290.00	—	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS PHARMOCOLOGIC	$1,290.00	$1,290.00	—	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRESS TEST/LOW LEVEL	$1,290.00	$1,290.00	—	—	—
Eye exam, returning patient, intermediate CPT 92012 OPTHAL SERV,EP,INTERMED	$497.00	$497.00	—	116% above	—
Eye exam, returning patient, intermediate CPT 92012 INTRM OPH EXAM EST PATIENT	$497.00	$497.00	—	116% above	—
Eye exam, returning patient, intermediate inpatient CPT 92012 OPTHAL SERV,EP,INTERMED	$497.00	$497.00	—	—	—
Eye exam, returning patient, intermediate inpatient CPT 92012 INTRM OPH EXAM EST PATIENT	$497.00	$497.00	—	—	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHTHERAPY W PT PRESE	$587.00	$587.00	—	110% above	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHTX W/PT 50MIN	$587.00	$587.00	—	110% above	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHTHERAPY W PT PRESE	$587.00	$587.00	—	—	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHTX W/PT 50MIN	$587.00	$587.00	—	—	—
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY,W/O PT PR	$587.00	$587.00	—	122% above	—
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHTX WO/ PT 50MIN	$587.00	$587.00	—	122% above	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY,W/O PT PR	$587.00	$587.00	—	—	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHTX WO/ PT 50MIN	$587.00	$587.00	—	—	—
Group psychotherapy session CPT 90853 GROUP THERAPY	$328.00	$328.00	—	159% above	—
Group psychotherapy session CPT 90853 GROUP PSYCHO TX	$328.00	$328.00	—	159% above	—
Group psychotherapy session inpatient CPT 90853 GROUP PSYCHO TX	$328.00	$328.00	—	—	—
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY	$328.00	$328.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION, 31MIN -1 HR, HYDR	$915.00	$915.00	—	146% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYD INIT, 31M-1HR	$915.00	$915.00	—	146% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYD INIT, 31M-1HR	$915.00	$915.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION, 31MIN -1 HR, HYDR	$915.00	$915.00	—	—	—
IV infusion of a medicine, first hour CPT 96365 IV INFUS,TX/PROP/DX <1HR,INIT	$940.00	$940.00	—	125% above	—
IV infusion of a medicine, first hour CPT 96365 IV INFUS,TX/PROH/DX UP TO 1 HR	$940.00	$940.00	—	125% above	—
IV infusion of a medicine, first hour CPT 96365 IV INF,INIT,TX/DX,UP TO 1HR	$940.00	$940.00	—	125% above	—
IV infusion of a medicine, first hour CPT 96365 IV MED INFUSION - INITIATE	$955.00	$955.00	—	128% above	—
IV infusion of a medicine, first hour CPT 96365 IV INFUSION, TX/PROPH/DX, UP T	$955.00	$955.00	—	128% above	—
IV infusion of a medicine, first hour CPT 96365 IV PLATELET INHIB INFUSION, UP	$955.00	$955.00	—	128% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS,TX/PROH/DX UP TO 1 HR	$940.00	$940.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS,TX/PROP/DX <1HR,INIT	$940.00	$940.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF,INIT,TX/DX,UP TO 1HR	$940.00	$940.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV MED INFUSION - INITIATE	$955.00	$955.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV PLATELET INHIB INFUSION, UP	$955.00	$955.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION, TX/PROPH/DX, UP T	$955.00	$955.00	—	—	—
IV push of a medicine, first drug CPT 96374 IVP INJ,SPEC DRUG, FIRST/INIT	$105.00	$105.00	—	59% below	—
IV push of a medicine, first drug CPT 96374 IVP SGL/INITIAL SUBST	$905.00	$905.00	—	255% above	—
IV push of a medicine, first drug CPT 96374 IVP INJ,SPEC DRUG, FIRST/INIT	$905.00	$905.00	—	255% above	—
IV push of a medicine, first drug CPT 96374 IVP OF MEDICATION	$905.00	$905.00	—	255% above	—
IV push of a medicine, first drug CPT 96374 INJECTION - IVP,INIT	$905.00	$905.00	—	255% above	—
IV push of a medicine, first drug inpatient CPT 96374 IVP INJ,SPEC DRUG, FIRST/INIT	$105.00	$105.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 IVP OF MEDICATION	$905.00	$905.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 IVP INJ,SPEC DRUG, FIRST/INIT	$905.00	$905.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 INJECTION - IVP,INIT	$905.00	$905.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 IVP SGL/INITIAL SUBST	$905.00	$905.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPUTIC PROPHYLACTIC DIAG INJ	$45.00	$45.00	—	60% below	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ADMINISTRATION OF RISPERDAL	$300.00	$300.00	—	169% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJECTION,SPECIFY DRUG	$303.00	$303.00	—	172% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 TX/DX/PROPHY SQ/IM INJ	$303.00	$303.00	—	172% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERA/PROPH/DX INJECTION	$303.00	$303.00	—	172% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 RHOGRAM INJECTION	$303.00	$303.00	—	172% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJECTION SUB IN	$303.00	$303.00	—	172% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION TX/DX/PROP SQ/IM	$303.00	$303.00	—	172% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION, IM/SQ	$303.00	$303.00	—	172% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM INJECTION	$303.00	$303.00	—	172% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$303.00	$303.00	—	172% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJECTION	$303.00	$303.00	—	172% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPUTIC PROPHYLACTIC DIAG INJ	$45.00	$45.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ADMINISTRATION OF RISPERDAL	$300.00	$300.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 RHOGRAM INJECTION	$303.00	$303.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJECTION	$303.00	$303.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJECTION,SPECIFY DRUG	$303.00	$303.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJECTION SUB IN	$303.00	$303.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM INJECTION	$303.00	$303.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION TX/DX/PROP SQ/IM	$303.00	$303.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 TX/DX/PROPHY SQ/IM INJ	$303.00	$303.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERA/PROPH/DX INJECTION	$303.00	$303.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION, IM/SQ	$303.00	$303.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$303.00	$303.00	—	—	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DX EVAL	$611.00	$611.00	—	141% above	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 INIT PSYCH ASSESSMENT 45MIN	$611.00	$611.00	—	141% above	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 INIT PSYCH ASSESSMENT 45MIN	$611.00	$611.00	—	—	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DX EVAL	$611.00	$611.00	—	—	—
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE COND STDY, 7-8	$1,084.00	$1,084.00	—	137% above	—
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE COND STDY, 7-8	$1,084.00	$1,084.00	—	—	—
Neuromuscular re-education, 15 minutes CPT 97112 BALANCE TRAINING EA 15MIN	$325.00	$325.00	—	297% above	—
Neuromuscular re-education, 15 minutes CPT 97112 BALANCE TRAINING EACH 15MIN	$325.00	$325.00	—	297% above	—
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULR REEDUCT EA 15MIN	$325.00	$325.00	—	297% above	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 BALANCE TRAINING EA 15MIN	$325.00	$325.00	—	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULR REEDUCT EA 15MIN	$325.00	$325.00	—	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 BALANCE TRAINING EACH 15MIN	$325.00	$325.00	—	—	—
New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30-44 MIN	$230.00	$230.00	—	3% above	—
New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30 MIN	$468.00	$468.00	—	110% above	—
New patient office visit, about 30 minutes CPT 99203 NEW PT LEVEL 3	$468.00	$468.00	—	110% above	—
New patient office visit, about 30 minutes CPT 99203 NP LEVEL 3 WITH MODIFIER 25	$468.00	$468.00	—	110% above	—
New patient office visit, about 30 minutes CPT 99203 NP LEVEL 3	$468.00	$468.00	—	110% above	—
New patient office visit, about 30 minutes CPT 99203 NP LEVEL III	$603.00	$603.00	—	170% above	—
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE O/P NEW LOW 30-44 MIN	$230.00	$230.00	—	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PT LEVEL 3	$468.00	$468.00	—	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 NP LEVEL 3 WITH MODIFIER 25	$468.00	$468.00	—	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 NP LEVEL 3	$468.00	$468.00	—	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE O/P NEW LOW 30 MIN	$468.00	$468.00	—	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 NP LEVEL III	$603.00	$603.00	—	—	—
New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45-59 MIN	$375.00	$375.00	—	26% above	—
New patient office visit, about 45 minutes CPT 99204 NP LEVEL IV	$497.00	$497.00	—	67% above	—
New patient office visit, about 45 minutes CPT 99204 NP LEVEL 4 WITH MODIFIER 25	$528.00	$528.00	—	77% above	—
New patient office visit, about 45 minutes CPT 99204 NP LEVEL 4	$528.00	$528.00	—	77% above	—
New patient office visit, about 45 minutes CPT 99204 NEW PT LEVEL 4	$528.00	$528.00	—	77% above	—
New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45 MIN	$528.00	$528.00	—	77% above	—
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE O/P NEW MOD 45-59 MIN	$375.00	$375.00	—	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 NP LEVEL IV	$497.00	$497.00	—	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 NP LEVEL 4	$528.00	$528.00	—	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 NP LEVEL 4 WITH MODIFIER 25	$528.00	$528.00	—	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT LEVEL 4	$528.00	$528.00	—	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE O/P NEW MOD 45 MIN	$528.00	$528.00	—	—	—
New patient office visit, about 60 minutes CPT 99205 NP LEVEL V	$497.00	$497.00	—	32% above	—
New patient office visit, about 60 minutes CPT 99205 OFFICE O/P NEW HI 60-74 MIN	$510.00	$510.00	—	35% above	—
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT LEVEL 5	$603.00	$603.00	—	60% above	—
New patient office visit, about 60 minutes CPT 99205 OFFICE O/P NEW HI 60 MIN	$603.00	$603.00	—	60% above	—
New patient office visit, about 60 minutes CPT 99205 NP LEVEL 5	$812.00	$812.00	—	115% above	—
New patient office visit, about 60 minutes CPT 99205 NEW PT LEVEL 5	$812.00	$812.00	—	115% above	—
New patient office visit, about 60 minutes CPT 99205 NP LEVEL 5 WITH MODIFIER 25	$812.00	$812.00	—	115% above	—
New patient office visit, about 60 minutes inpatient CPT 99205 NP LEVEL V	$497.00	$497.00	—	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE O/P NEW HI 60-74 MIN	$510.00	$510.00	—	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE O/P NEW HI 60 MIN	$603.00	$603.00	—	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT LEVEL 5	$603.00	$603.00	—	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 NP LEVEL 5 WITH MODIFIER 25	$812.00	$812.00	—	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT LEVEL 5	$812.00	$812.00	—	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 NP LEVEL 5	$812.00	$812.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15-29MIN	$130.00	$130.00	—	25% below	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NP LEVEL 2	$358.00	$358.00	—	105% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN	$358.00	$358.00	—	105% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NP LEVEL 2 WITH MODIFIER 25	$358.00	$358.00	—	105% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT LEVEL 2	$358.00	$358.00	—	105% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NP LEVEL II	$380.00	$380.00	—	118% above	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE O/P NEW SF 15-29MIN	$130.00	$130.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE O/P NEW SF 15 MIN	$358.00	$358.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NP LEVEL 2	$358.00	$358.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PT LEVEL 2	$358.00	$358.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NP LEVEL 2 WITH MODIFIER 25	$358.00	$358.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NP LEVEL II	$380.00	$380.00	—	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN	$90.00	$90.00	—	70% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUT TX INIT INDIV EA 15MIN	$174.00	$174.00	—	228% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITIONAL COUSEL, INIT 15MIN	$202.00	$202.00	—	281% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTRT TX,INIT,INDIV,15MIN	$202.00	$202.00	—	281% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION INDIV IN	$90.00	$90.00	—	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUT TX INIT INDIV EA 15MIN	$174.00	$174.00	—	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRITIONAL COUSEL, INIT 15MIN	$202.00	$202.00	—	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTRT TX,INIT,INDIV,15MIN	$202.00	$202.00	—	—	—
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL; LOW COMPLEXITY	$494.00	$494.00	—	189% above	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL; LOW COMPLEXITY	$494.00	$494.00	—	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL; HIGH COMPLEXITY	$1,110.00	$1,110.00	—	320% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL; HIGH COMPLEXITY	$1,110.00	$1,110.00	—	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL; LOW COMPLEXITY	$494.00	$494.00	—	174% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL; LOW COMPLEXITY	$494.00	$494.00	—	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL; MODERATE COMPLEXITY	$743.00	$743.00	—	210% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL; MODERATE COMPLEXITY	$743.00	$743.00	—	—	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 LYMPHATIC DRAINAGE EA 15MIN	$187.00	$187.00	—	125% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MYOFASCIAL RELEASE EACH 15MIN	$187.00	$187.00	—	125% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 LYMPHATIC DRAINAGE EA 15 MIN	$187.00	$187.00	—	125% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 JOINT MOBILIZATION EACH 15MIN	$187.00	$187.00	—	125% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MYOFASCIAL RELEASE EA 15MIN	$187.00	$187.00	—	125% above	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MYOFASCIAL RELEASE EACH 15MIN	$187.00	$187.00	—	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 LYMPHATIC DRAINAGE EA 15 MIN	$187.00	$187.00	—	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MYOFASCIAL RELEASE EA 15MIN	$187.00	$187.00	—	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 JOINT MOBILIZATION EACH 15MIN	$187.00	$187.00	—	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 LYMPHATIC DRAINAGE EA 15MIN	$187.00	$187.00	—	—	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15MIN	$193.00	$193.00	—	156% above	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15MIN	$193.00	$193.00	—	—	—
Preventive checkup, new patient aged 18–39 CPT 99385 INIT PREV MED E/M, NP 18-39YRS	$392.00	$392.00	—	94% above	—
Preventive checkup, new patient aged 18–39 CPT 99385 PREV EXAM NP AGE 18-39	$392.00	$392.00	—	94% above	—
Preventive checkup, new patient aged 18–39 CPT 99385 WELL VST,NP,18-39YR,(99385)	$468.00	$468.00	—	131% above	—
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PREV EXAM NP AGE 18-39	$392.00	$392.00	—	—	—
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 INIT PREV MED E/M, NP 18-39YRS	$392.00	$392.00	—	—	—
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 WELL VST,NP,18-39YR,(99385)	$468.00	$468.00	—	—	—
Preventive checkup, new patient aged 40–64 CPT 99386 INIT PREV MED E/M, NP 40-64YRS	$392.00	$392.00	—	74% above	—
Preventive checkup, new patient aged 40–64 CPT 99386 PREV EXAM NP AGE 40-64	$392.00	$392.00	—	74% above	—
Preventive checkup, new patient aged 40–64 CPT 99386 WELL VST,NP 40-64YR,(99386)	$578.00	$578.00	—	157% above	—
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 INIT PREV MED E/M, NP 40-64YRS	$392.00	$392.00	—	—	—
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREV EXAM NP AGE 40-64	$392.00	$392.00	—	—	—
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 WELL VST,NP 40-64YR,(99386)	$578.00	$578.00	—	—	—
Preventive checkup, new patient aged 65 or older CPT 99387 PREV EXAM NP AGE 65 & OVER	$392.00	$392.00	—	53% above	—
Preventive checkup, new patient aged 65 or older CPT 99387 INIT PREV MED E/M, NP 65+ YRS	$392.00	$392.00	—	53% above	—
Preventive checkup, new patient aged 65 or older CPT 99387 WELL VST,NP, >64YR,(99387)	$605.00	$605.00	—	136% above	—
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PREV EXAM NP AGE 65 & OVER	$392.00	$392.00	—	—	—
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 INIT PREV MED E/M, NP 65+ YRS	$392.00	$392.00	—	—	—
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 WELL VST,NP, >64YR,(99387)	$605.00	$605.00	—	—	—
Preventive checkup, returning patient aged 18–39 CPT 99395 PREV EXAM EP AGE 18-39	$341.00	$341.00	—	68% above	—
Preventive checkup, returning patient aged 18–39 CPT 99395 PER PREV MED E/M EP 18-39YRS	$341.00	$341.00	—	68% above	—
Preventive checkup, returning patient aged 18–39 CPT 99395 WELL VST,EP,18-39YR,(99395)	$424.00	$424.00	—	110% above	—
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PER PREV MED E/M EP 18-39YRS	$341.00	$341.00	—	—	—
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PREV EXAM EP AGE 18-39	$341.00	$341.00	—	—	—
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 WELL VST,EP,18-39YR,(99395)	$424.00	$424.00	—	—	—
Preventive checkup, returning patient aged 40–64 CPT 99396 PREV EXAM EP AGE 40-64	$358.00	$358.00	—	53% above	—
Preventive checkup, returning patient aged 40–64 CPT 99396 PER PREV MED E/M EP 40-64YRS	$358.00	$358.00	—	53% above	—
Preventive checkup, returning patient aged 40–64 CPT 99396 WELL VST,EP, 40>60YR,(99396)	$410.00	$410.00	—	75% above	—
Preventive checkup, returning patient aged 40–64 CPT 99396 WELL VST,EP,40-64YR,(99396)	$440.00	$440.00	—	88% above	—
Preventive checkup, returning patient aged 40–64 CPT 99396 WELL VST,EP,40-64YR	$440.00	$440.00	—	88% above	—
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PER PREV MED E/M EP 40-64YRS	$358.00	$358.00	—	—	—
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PREV EXAM EP AGE 40-64	$358.00	$358.00	—	—	—
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 WELL VST,EP, 40>60YR,(99396)	$410.00	$410.00	—	—	—
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 WELL VST,EP,40-64YR,(99396)	$440.00	$440.00	—	—	—
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 WELL VST,EP,40-64YR	$440.00	$440.00	—	—	—
Preventive checkup, returning patient aged 65 or older CPT 99397 PER PREV MED E/M EP 65+YRS	$385.00	$385.00	—	89% above	—
Preventive checkup, returning patient aged 65 or older CPT 99397 PREV EXAM EP AGE 65 & OVER	$385.00	$385.00	—	89% above	—
Preventive checkup, returning patient aged 65 or older CPT 99397 WELL VST,EP, >64YR,(99397)	$550.00	$550.00	—	170% above	—
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PER PREV MED E/M EP 65+YRS	$385.00	$385.00	—	—	—
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PREV EXAM EP AGE 65 & OVER	$385.00	$385.00	—	—	—
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 WELL VST,EP, >64YR,(99397)	$550.00	$550.00	—	—	—
Psychiatric evaluation with medical services CPT 90792 PSYCH DX EVAL W/E&M	$600.00	$600.00	—	101% above	—
Psychiatric evaluation with medical services CPT 90792 INIT PSYCH ASSESS W/E&M 45MIN	$688.00	$688.00	—	131% above	—
Psychiatric evaluation with medical services CPT 90792 PSYCH DX EVAL W/ E&M	$757.00	$757.00	—	154% above	—
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DX EVAL W/E&M	$600.00	$600.00	—	—	—
Psychiatric evaluation with medical services inpatient CPT 90792 INIT PSYCH ASSESS W/E&M 45MIN	$688.00	$688.00	—	—	—
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DX EVAL W/ E&M	$757.00	$757.00	—	—	—
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCH TEST EVAL SERVICE 1ST HR	$1,271.00	$1,271.00	—	266% above	—
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCH TEST EVAL SERVICE 1ST HR	$1,271.00	$1,271.00	—	—	—
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTX,CRISIS, 1ST 60MIN	$616.00	$616.00	—	131% above	—
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHTHERAPY CRISIS,1ST 60MIN	$616.00	$616.00	—	131% above	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTX,CRISIS, 1ST 60MIN	$616.00	$616.00	—	—	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHTHERAPY CRISIS,1ST 60MIN	$616.00	$616.00	—	—	—
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTX 30MIN W/PT	$617.00	$617.00	—	212% above	—
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTX 30MIN W/PT	$617.00	$617.00	—	—	—
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTX 45MIN W/PT	$675.00	$675.00	—	158% above	—
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTX 45MIN W/PT	$675.00	$675.00	—	—	—
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTX 60MIN W/PT	$699.00	$699.00	—	134% above	—
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTX 60MIN W/PT	$699.00	$699.00	—	—	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING AND TOBACCO USE CESSATION COUNSELING VISIT; INTERMEDIATE, 3-10 MINUTES	$35.00	$35.00	—	25% below	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION 3-10MIN	$118.00	$118.00	—	152% above	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING/TOBACCO COUNSEL3-10MIN	$118.00	$118.00	—	152% above	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESS 3-10MIN	$118.00	$118.00	—	152% above	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESS COUNSEL 3-10MIN	$118.00	$118.00	—	152% above	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESS COUNSL ASYMP 3-10	$118.00	$118.00	—	152% above	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING AND TOBACCO USE CESSATION COUNSELING VISIT; INTERMEDIATE, 3-10 MINUTES	$35.00	$35.00	—	—	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESS COUNSEL 3-10MIN	$118.00	$118.00	—	—	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION 3-10MIN	$118.00	$118.00	—	—	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESS COUNSL ASYMP 3-10	$118.00	$118.00	—	—	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESS 3-10MIN	$118.00	$118.00	—	—	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING/TOBACCO COUNSEL3-10MIN	$118.00	$118.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE O/P EST HI 40-54 MIN	$400.00	$400.00	—	70% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EP LEVEL V	$528.00	$528.00	—	125% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EP LEVEL 5 WITH MODIFIER 25	$528.00	$528.00	—	125% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PT LEVEL 5	$528.00	$528.00	—	125% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EP LEVEL 5	$528.00	$528.00	—	125% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EP - LEVEL 5	$528.00	$528.00	—	125% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE O/P EST HI 40 MIN	$603.00	$603.00	—	157% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT LEVEL 5	$603.00	$603.00	—	157% above	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE O/P EST HI 40-54 MIN	$400.00	$400.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EP LEVEL V	$528.00	$528.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EP - LEVEL 5	$528.00	$528.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EP LEVEL 5	$528.00	$528.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EP LEVEL 5 WITH MODIFIER 25	$528.00	$528.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ESTABLISHED PT LEVEL 5	$528.00	$528.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE O/P EST HI 40 MIN	$603.00	$603.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ESTABLISHED PATIENT LEVEL 5	$603.00	$603.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20-29 MIN	$185.00	$185.00	—	1% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PT LEVEL 3	$413.00	$413.00	—	126% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20 MIN	$413.00	$413.00	—	126% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EP LEVEL III	$413.00	$413.00	—	126% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EP LEVEL 3	$413.00	$413.00	—	126% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 NSG HX/ASSESSMENT (EXTENDED)	$413.00	$413.00	—	126% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EP LEVEL 3 WITH MODIFIER 25	$413.00	$413.00	—	126% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EP - LEVEL 3	$413.00	$413.00	—	126% above	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE O/P EST LOW 20-29 MIN	$185.00	$185.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE O/P EST LOW 20 MIN	$413.00	$413.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EP - LEVEL 3	$413.00	$413.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EP LEVEL 3	$413.00	$413.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EP LEVEL 3 WITH MODIFIER 25	$413.00	$413.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 NSG HX/ASSESSMENT (EXTENDED)	$413.00	$413.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ESTABLISHED PT LEVEL 3	$413.00	$413.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EP LEVEL III	$413.00	$413.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30-39 MIN	$270.00	$270.00	—	37% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PT LEVEL 4	$468.00	$468.00	—	137% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EP LEVEL IV	$468.00	$468.00	—	137% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EP - LEVEL 4	$468.00	$468.00	—	137% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30 MIN	$468.00	$468.00	—	137% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EP LEVEL 4 WITH MODIFIER 25	$468.00	$468.00	—	137% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EP LEVEL 4	$468.00	$468.00	—	137% above	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE O/P EST MOD 30-39 MIN	$270.00	$270.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EP - LEVEL 4	$468.00	$468.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ESTABLISHED PT LEVEL 4	$468.00	$468.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EP LEVEL 4	$468.00	$468.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EP LEVEL 4 WITH MODIFIER 25	$468.00	$468.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE O/P EST MOD 30 MIN	$468.00	$468.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EP LEVEL IV	$468.00	$468.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10-19 MIN	$100.00	$100.00	—	40% below	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 NSG HX/ASSESSMENT	$358.00	$358.00	—	114% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN	$375.00	$375.00	—	124% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EP LEVEL 2 WITH MODIFIER 25	$375.00	$375.00	—	124% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EP LEVEL 2	$375.00	$375.00	—	124% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EP - LEVEL 2	$375.00	$375.00	—	124% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EP LEVEL II	$375.00	$375.00	—	124% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PT LEVEL 2	$375.00	$375.00	—	124% above	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE O/P EST SF 10-19 MIN	$100.00	$100.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 NSG HX/ASSESSMENT	$358.00	$358.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ESTABLISHED PT LEVEL 2	$375.00	$375.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EP LEVEL 2	$375.00	$375.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EP LEVEL 2 WITH MODIFIER 25	$375.00	$375.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EP - LEVEL 2	$375.00	$375.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE O/P EST SF 10 MIN	$375.00	$375.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EP LEVEL II	$375.00	$375.00	—	—	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULTATON PT. LEVEL3	$495.00	$495.00	—	66% above	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULTATION-LEVEL 3	$495.00	$495.00	—	66% above	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULT VST - LEVEL 3	$495.00	$495.00	—	66% above	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULTATION PT. LEVEL 3	$495.00	$495.00	—	66% above	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULT LEVEL 3	$495.00	$495.00	—	66% above	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULT VISIT LEVEL 3	$495.00	$495.00	—	66% above	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULT PT LEVEL 3	$661.00	$661.00	—	122% above	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CONSULTATON PT. LEVEL3	$495.00	$495.00	—	—	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CONSULTATION-LEVEL 3	$495.00	$495.00	—	—	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CONSULT VISIT LEVEL 3	$495.00	$495.00	—	—	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CONSULT VST - LEVEL 3	$495.00	$495.00	—	—	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CONSULTATION PT. LEVEL 3	$495.00	$495.00	—	—	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CONSULT LEVEL 3	$495.00	$495.00	—	—	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CONSULT PT LEVEL 3	$661.00	$661.00	—	—	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULTATION-LEVEL 4	$660.00	$660.00	—	121% above	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT VISIT LEVEL 4	$660.00	$660.00	—	121% above	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULTATION PT. LEVEL 4	$660.00	$660.00	—	121% above	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT VST - LEVEL 4	$660.00	$660.00	—	121% above	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULTATON PT. LEVEL4	$660.00	$660.00	—	121% above	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT LEVEL 4	$660.00	$660.00	—	121% above	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT PT LEVEL 4	$660.00	$660.00	—	121% above	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULT VISIT LEVEL 4	$660.00	$660.00	—	—	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULTATION PT. LEVEL 4	$660.00	$660.00	—	—	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULT VST - LEVEL 4	$660.00	$660.00	—	—	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULTATON PT. LEVEL4	$660.00	$660.00	—	—	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULTATION-LEVEL 4	$660.00	$660.00	—	—	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULT LEVEL 4	$660.00	$660.00	—	—	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULT PT LEVEL 4	$660.00	$660.00	—	—	—
Speech and language evaluation CPT 92523 EVAL SPEECH SOUND/LANG COMP	$842.00	$842.00	—	114% above	—
Speech and language evaluation inpatient CPT 92523 EVAL SPEECH SOUND/LANG COMP	$842.00	$842.00	—	—	—
Speech therapy session, individual CPT 92507 SPEECH THERAPY INDIV 1 HR	$350.00	$350.00	—	108% above	—
Speech therapy session, individual CPT 92507 TX SPEECH/LANG/AUD,INDIV	$440.00	$440.00	—	162% above	—
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY INDIV 1 HR	$350.00	$350.00	—	—	—
Speech therapy session, individual inpatient CPT 92507 TX SPEECH/LANG/AUD,INDIV	$440.00	$440.00	—	—	—
Spirometry (breathing test) CPT 94010 SPIROMETRY	$80.00	$80.00	—	64% below	—
Spirometry (breathing test) CPT 94010 SPIROMETRY	$593.00	$593.00	—	167% above	—
Spirometry (breathing test) CPT 94010 SPIROMETRY,Breath capacity tst	$593.00	$593.00	—	167% above	—
Spirometry (breathing test) CPT 94010 SPIROMETRY/BREATHING CAPACITY	$593.00	$593.00	—	167% above	—
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$80.00	$80.00	—	—	—
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY,Breath capacity tst	$593.00	$593.00	—	—	—
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY/BREATHING CAPACITY	$593.00	$593.00	—	—	—
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$593.00	$593.00	—	—	—
Spirometry before and after a bronchodilator CPT 94060 BRONCHODILATION RESPONSIVENESS	$115.00	$115.00	—	70% below	—
Spirometry before and after a bronchodilator CPT 94060 EVAL WHEEZE,PRE/POST MED ADM	$1,084.00	$1,084.00	—	179% above	—
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY PRE & POST	$1,084.00	$1,084.00	—	179% above	—
Spirometry before and after a bronchodilator CPT 94060 BRONCHODILATION RESPONSIVENESS	$1,084.00	$1,084.00	—	179% above	—
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY W/DILATORS	$1,084.00	$1,084.00	—	179% above	—
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHODILATION RESPONSIVENESS	$115.00	$115.00	—	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHODILATION RESPONSIVENESS	$1,084.00	$1,084.00	—	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY PRE & POST	$1,084.00	$1,084.00	—	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 EVAL WHEEZE,PRE/POST MED ADM	$1,084.00	$1,084.00	—	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY W/DILATORS	$1,084.00	$1,084.00	—	—	—
TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 TMS TX; INITIAL,DELIVERY/MGMT	$1,077.00	$1,077.00	—	192% above	—
TMS (transcranial magnetic stimulation), first session with mapping inpatient CPT 90867 TMS TX; INITIAL,DELIVERY/MGMT	$1,077.00	$1,077.00	—	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY EA 15MIN	$255.00	$255.00	—	197% above	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY EA 15MIN	$255.00	$255.00	—	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$349.00	$349.00	—	64% above	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY, THERAPEUTIC	$349.00	$349.00	—	64% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$349.00	$349.00	—	—	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY, THERAPEUTIC	$349.00	$349.00	—	—	—
Treadmill or drug stress test with ECG, supervision and report CPT 93015 CV STRESS TST CONTIN ECG MON	$646.00	$646.00	—	88% above	—
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 CV STRESS TST CONTIN ECG MON	$646.00	$646.00	—	—	—
Visual field test, extended CPT 92083 VISUAL FIELD EXTENDED EX	$466.00	$466.00	—	39% above	—
Visual field test, extended CPT 92083 EXTENDED VISUAL FIELD XM	$466.00	$466.00	—	39% above	—
Visual field test, extended inpatient CPT 92083 EXTENDED VISUAL FIELD XM	$466.00	$466.00	—	—	—
Visual field test, extended inpatient CPT 92083 VISUAL FIELD EXTENDED EX	$466.00	$466.00	—	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLU VAC AIIV3 0.5ML>64YR-FLAUD	$57.00	$57.00	—	46% below	—
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA AIIV3 >65YR(FLUAD)	$65.00	$65.00	—	39% below	—
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLU VAC AIIV3 0.5ML>64YR-FLAUD	$57.00	$57.00	—	—	—
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA AIIV3 >65YR(FLUAD)	$65.00	$65.00	—	—	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID MRNA PFIZER 2023/24 VIAL	$276.00	$276.00	—	37% above	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCV2 VAC 30MCG TRS-SUC IM	$390.00	$390.00	—	94% above	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID MRNA PFIZER 2023/24 VIAL	$276.00	$276.00	—	—	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARSCV2 VAC 30MCG TRS-SUC IM	$390.00	$390.00	—	—	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE PRODUCT	$155.00	$155.00	—	42% below	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE	$155.00	$155.00	—	42% below	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella vacc, live,SQ	$241.00	$241.00	—	9% below	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VAC. INJ	$418.00	$418.00	—	58% above	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VACCINE	$155.00	$155.00	—	—	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VACCINE PRODUCT	$155.00	$155.00	—	—	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varicella vacc, live,SQ	$241.00	$241.00	—	—	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VAC. INJ	$418.00	$418.00	—	—	—
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTaP-IPV(KINRIX) vacc,4-6ys IM	$98.00	$98.00	—	7% above	—
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 KINRIX VACCINE INJ	$145.00	$145.00	—	59% above	—
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTaP-IPV(KINRIX) vacc,4-6ys IM	$98.00	$98.00	—	—	—
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 KINRIX VACCINE INJ	$145.00	$145.00	—	—	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VACCINE PRODUCT< 7YRS	$57.00	$57.00	—	16% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VACCINE PRODUCT<7YR IM	$57.00	$57.00	—	16% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VACCINE PRODUCT <7YRS	$60.00	$60.00	—	22% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTaP<7yrs,IM	$87.00	$87.00	—	77% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP VACCINE PRODUCT< 7YRS	$57.00	$57.00	—	—	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP VACCINE PRODUCT<7YR IM	$57.00	$57.00	—	—	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP VACCINE PRODUCT <7YRS	$60.00	$60.00	—	—	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTaP<7yrs,IM	$87.00	$87.00	—	—	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTaP-Hep B-IPV vacc,IM	$145.00	$145.00	—	5% above	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX IMMUN(HEP/IPV/DTAP)	$234.00	$234.00	—	70% above	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTaP-Hep B-IPV vacc,IM	$145.00	$145.00	—	—	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX IMMUN(HEP/IPV/DTAP)	$234.00	$234.00	—	—	—
Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLU VACC-FLUBLOK INJ 0.5ML IM	$63.00	$63.00	—	41% below	—
Flu shot, recombinant, egg-free (Flublok) CPT 90673 INFL VACC,TRIVAL,RECOMB (RIV3)	$105.00	$105.00	—	1% below	—
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLU VACC-FLUBLOK INJ 0.5ML IM	$63.00	$63.00	—	—	—
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 INFL VACC,TRIVAL,RECOMB (RIV3)	$105.00	$105.00	—	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VAC TRI SPLIT PROD PF.5ML	$60.00	$60.00	—	111% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VAC TRI SPLIT PROD PF.5ML	$60.00	$60.00	—	—	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV9 VACC,2-3DOSE,IM	$690.00	$690.00	—	38% above	—
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV9 VACC,2-3DOSE,IM	$690.00	$690.00	—	—	—
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP-A /HEP-B VACC(TWINRIX) IM	$152.00	$152.00	—	33% below	—
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HepA-HepB vacc, adult,IM	$197.00	$197.00	—	13% below	—
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/HEP B ADULT	$210.00	$210.00	—	8% below	—
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEP-A /HEP-B VACC(TWINRIX) IM	$152.00	$152.00	—	—	—
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HepA-HepB vacc, adult,IM	$197.00	$197.00	—	—	—
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEP A/HEP B ADULT	$210.00	$210.00	—	—	—
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCIN PRODUC.ADUL	$115.00	$115.00	—	12% above	—
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A-ADULT	$115.00	$115.00	—	12% above	—
Hepatitis A vaccine, adult dose CPT 90632 Hep A vacc, adult, IM	$133.00	$133.00	—	29% above	—
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE ADULT INJ	$199.00	$199.00	—	93% above	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCIN PRODUC.ADUL	$115.00	$115.00	—	—	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A-ADULT	$115.00	$115.00	—	—	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 Hep A vacc, adult, IM	$133.00	$133.00	—	—	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE ADULT INJ	$199.00	$199.00	—	—	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hep A vacc,ped/adol,2dose,IM	$66.00	$66.00	—	17% above	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACC,PEDS, 2 DOSES	$137.00	$137.00	—	143% above	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A - PEDS/ADOLESCENT	$137.00	$137.00	—	143% above	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEP A VACC PROD,PED/ADOL.2DOSE	$137.00	$137.00	—	143% above	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hep A vacc,ped/adol,2dose,IM	$66.00	$66.00	—	—	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VACC,PEDS, 2 DOSES	$137.00	$137.00	—	—	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEP A VACC PROD,PED/ADOL.2DOSE	$137.00	$137.00	—	—	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A - PEDS/ADOLESCENT	$137.00	$137.00	—	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX 20MCG, HEP B ADULT	$150.00	$150.00	—	68% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACC - ADULT	$150.00	$150.00	—	68% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VAC PROD,ADULT,3 DOSE	$150.00	$150.00	—	68% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VACCINE INJ, 1ML	$166.00	$166.00	—	86% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ADM HEPATITIS B VACCINATION	$198.00	$198.00	—	122% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACC - ADULT	$150.00	$150.00	—	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 RECOMBIVAX 20MCG, HEP B ADULT	$150.00	$150.00	—	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VAC PROD,ADULT,3 DOSE	$150.00	$150.00	—	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VACCINE INJ, 1ML	$166.00	$166.00	—	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ADM HEPATITIS B VACCINATION	$198.00	$198.00	—	—	—
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEP B VACCINE 0.5ML(HEPLISAV-B	$354.00	$354.00	—	46% above	—
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEP B VACCINE 0.5ML(HEPLISAV-B	$354.00	$354.00	—	—	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hep B vacc,ped/adol,3dose,IM	$46.00	$46.00	—	1% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEP B VAC PROD,PED/ADOL,3 DOSE	$85.00	$85.00	—	87% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hep B vacc,ped/adol,3dose,IM	$46.00	$46.00	—	—	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEP B VAC PROD,PED/ADOL,3 DOSE	$85.00	$85.00	—	—	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Hib vacc(3 dose schedule),IM	$52.00	$52.00	—	17% below	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 PEDVAXHIB 0.5ML INJ(3 DOSE)	$71.00	$71.00	—	13% above	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 Hib vacc(3 dose schedule),IM	$52.00	$52.00	—	—	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 PEDVAXHIB 0.5ML INJ(3 DOSE)	$71.00	$71.00	—	—	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Hib vacc(4 dose schedule),IM	$32.00	$32.00	—	at median	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HiB CONJ-4DOSE/PF 0.5ML INJ	$67.00	$67.00	—	109% above	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Hib,HbOC CONJ , 4 DOSE	$75.00	$75.00	—	134% above	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Hib vacc(4 dose schedule),IM	$32.00	$32.00	—	—	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HiB CONJ-4DOSE/PF 0.5ML INJ	$67.00	$67.00	—	—	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Hib,HbOC CONJ , 4 DOSE	$75.00	$75.00	—	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INACT INFL VAC,(IIV3),HI DOSE	$73.00	$73.00	—	34% below	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VAC,(IIV3) HI-DOSE,FLUZONE	$90.00	$90.00	—	19% below	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INACT FLU VAC,HI-DOSE,ADULT65+	$94.00	$94.00	—	15% below	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HI DOSE	$107.00	$107.00	—	4% below	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INACT INFL VAC,(IIV3),HI DOSE	$73.00	$73.00	—	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VAC,(IIV3) HI-DOSE,FLUZONE	$90.00	$90.00	—	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INACT FLU VAC,HI-DOSE,ADULT65+	$94.00	$94.00	—	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HI DOSE	$107.00	$107.00	—	—	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE LIVE,SQ	$120.00	$120.00	—	11% below	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE	$120.00	$120.00	—	11% below	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE PRODUCT	$120.00	$120.00	—	11% below	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR vacc live, SQ	$136.00	$136.00	—	1% above	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR INJ 0.5ML	$146.00	$146.00	—	8% above	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR INJ	$221.00	$221.00	—	64% above	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACCINE LIVE,SQ	$120.00	$120.00	—	—	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACCINE PRODUCT	$120.00	$120.00	—	—	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACCINE	$120.00	$120.00	—	—	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR vacc live, SQ	$136.00	$136.00	—	—	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR INJ 0.5ML	$146.00	$146.00	—	—	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR INJ	$221.00	$221.00	—	—	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV VACC PRODUCT	$420.00	$420.00	—	4% below	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV VACCINE INJ 0.5ML	$647.00	$647.00	—	48% above	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MMRV VACC PRODUCT	$420.00	$420.00	—	—	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MMRV VACCINE INJ 0.5ML	$647.00	$647.00	—	—	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACC QUAD	$189.00	$189.00	—	7% below	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal conj vac,quad,IM	$257.00	$257.00	—	26% above	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJ VAC,QUAD;IM	$325.00	$325.00	—	59% above	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJ VAC,QUAD IM	$340.00	$340.00	—	67% above	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACC QUAD	$189.00	$189.00	—	—	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal conj vac,quad,IM	$257.00	$257.00	—	—	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL CONJ VAC,QUAD;IM	$325.00	$325.00	—	—	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL CONJ VAC,QUAD IM	$340.00	$340.00	—	—	—
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCCAL GRP B VAC 0.5ML	$537.00	$537.00	—	63% above	—
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOC RECOM PROT,B,2 DOS IM	$626.00	$626.00	—	90% above	—
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCCAL GRP B VAC 0.5ML	$537.00	$537.00	—	—	—
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOC RECOM PROT,B,2 DOS IM	$626.00	$626.00	—	—	—
Meningococcal B vaccine (Trumenba) CPT 90621 MENINGOC RECOM LIPO,2-3 DOS IM	$491.00	$491.00	—	42% above	—
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 MENINGOC RECOM LIPO,2-3 DOS IM	$491.00	$491.00	—	—	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 ADM PNEUMOCOCCAL VACC	$198.00	$198.00	—	40% below	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumococcal vac(PREVNAR 13)IM	$380.00	$380.00	—	16% above	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOC CONJ 13 VAL(PREVNAR13)	$380.00	$380.00	—	16% above	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR 13	$380.00	$380.00	—	16% above	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR 13 VACCINE INJ 0.5ML	$380.00	$380.00	—	16% above	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL VACC 13VAL .5ML	$543.00	$543.00	—	66% above	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 ADM PNEUMOCOCCAL VACC	$198.00	$198.00	—	—	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR 13	$380.00	$380.00	—	—	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Pneumococcal vac(PREVNAR 13)IM	$380.00	$380.00	—	—	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOC CONJ 13 VAL(PREVNAR13)	$380.00	$380.00	—	—	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR 13 VACCINE INJ 0.5ML	$380.00	$380.00	—	—	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL VACC 13VAL .5ML	$543.00	$543.00	—	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 VACCINE 0.5ML	$628.00	$628.00	—	47% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 VACCINE 0.5ML	$628.00	$628.00	—	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX INJ 0.5ML >2YRS	$152.00	$152.00	—	10% below	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23VAL ADULT VACC	$175.00	$175.00	—	3% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCCAL VACCINE PROD>2YRS	$175.00	$175.00	—	3% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal vac,23valent,>2yr	$183.00	$183.00	—	8% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACC 23VAL .5ML	$281.00	$281.00	—	66% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX INJ 0.5ML >2YRS	$152.00	$152.00	—	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCCAL VACCINE PROD>2YRS	$175.00	$175.00	—	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23VAL ADULT VACC	$175.00	$175.00	—	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal vac,23valent,>2yr	$183.00	$183.00	—	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACC 23VAL .5ML	$281.00	$281.00	—	—	—
Polio vaccine, inactivated (IPV) CPT 90713 Poliovirus vacc,inact,SQ/IM	$62.00	$62.00	—	27% below	—
Polio vaccine, inactivated (IPV) CPT 90713 IPV - INACTIVATED POLIO	$70.00	$70.00	—	18% below	—
Polio vaccine, inactivated (IPV) CPT 90713 POLIO VAC PROD.INACT,IPV,IM/SQ	$70.00	$70.00	—	18% below	—
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVAX INJ 0.5ML(IPV)	$1,020.00	$1,020.00	—	1098% above	—
Polio vaccine, inactivated (IPV) inpatient CPT 90713 Poliovirus vacc,inact,SQ/IM	$62.00	$62.00	—	—	—
Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPV - INACTIVATED POLIO	$70.00	$70.00	—	—	—
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIO VAC PROD.INACT,IPV,IM/SQ	$70.00	$70.00	—	—	—
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVAX INJ 0.5ML(IPV)	$1,020.00	$1,020.00	—	—	—
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB-ALIP 100MG/1ML SYR	$395.00	$395.00	—	62% below	—
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 NIRSEVIMAB-ALIP 100MG/1ML SYR	$395.00	$395.00	—	—	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50MG/0.5ML SYR	$1,247.00	$1,247.00	—	21% above	—
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50MG/0.5ML SYR	$1,247.00	$1,247.00	—	—	—
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 AREXVY 120MCG/0.5ML KIT	$672.00	$672.00	—	65% above	—
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 AREXVY 120MCG/0.5ML KIT	$672.00	$672.00	—	—	—
Rabies vaccine, one dose CPT 90675 RABAVERT INJ 1ML	$993.00	$993.00	—	111% above	—
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, IM	$1,121.00	$1,121.00	—	138% above	—
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT INJ 1ML	$993.00	$993.00	—	—	—
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, IM	$1,121.00	$1,121.00	—	—	—
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 Rotavirus,human,atten,2dose,PO	$245.00	$245.00	—	14% above	—
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 Rotavirus,human,atten,2dose,PO	$245.00	$245.00	—	—	—
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACC,PROD ORAL,3DOSE	$214.00	$214.00	—	63% above	—
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 Rotavirus,5valent,liv,3dose,PO	$229.00	$229.00	—	74% above	—
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTARIX VACCINE SUSP,3DOSE	$333.00	$333.00	—	153% above	—
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VACC,PROD ORAL,3DOSE	$214.00	$214.00	—	—	—
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 Rotavirus,5valent,liv,3dose,PO	$229.00	$229.00	—	—	—
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTARIX VACCINE SUSP,3DOSE	$333.00	$333.00	—	—	—
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER REC VACC(SHINGRIX)	$475.00	$475.00	—	20% above	—
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER REC VACC(SHINGRIX)	$475.00	$475.00	—	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Td VACCINE,PF,> 7 YRS,IM	$90.00	$90.00	—	70% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPTHERIA(Td) VAC >7YR	$90.00	$90.00	—	70% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPTHERIA(Td) VAC >7YR	$90.00	$90.00	—	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Td VACCINE,PF,> 7 YRS,IM	$90.00	$90.00	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TAP VACC PRODUCT,IM,OVER 7	$76.00	$76.00	—	37% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap >7YRS VACCINE	$76.00	$76.00	—	37% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap VAC PROD(TET/DIP/PER)7YR<	$76.00	$76.00	—	37% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap >7yrs,IM	$87.00	$87.00	—	57% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIP.-PERTUSS.-TET. TOX INJ.	$113.00	$113.00	—	104% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 0.5ML > 7YRS, IM	$114.00	$114.00	—	105% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap >7YRS VACCINE	$76.00	$76.00	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TAP VACC PRODUCT,IM,OVER 7	$76.00	$76.00	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap VAC PROD(TET/DIP/PER)7YR<	$76.00	$76.00	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap >7yrs,IM	$87.00	$87.00	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIP.-PERTUSS.-TET. TOX INJ.	$113.00	$113.00	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE 0.5ML > 7YRS, IM	$114.00	$114.00	—	—	—
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE INJ	$319.00	$319.00	—	37% above	—
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACCINE INJ	$319.00	$319.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN, ONE VACCINE	$60.00	$60.00	—	29% below	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization admin	$259.00	$259.00	—	208% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN,ONE VACCINE	$259.00	$259.00	—	208% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INFLUENZA A (H1N1) IMMUN ADM	$259.00	$259.00	—	208% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADM.ONE VACC(SGLE/COM+IM,SQ,ID	$259.00	$259.00	—	208% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADM.ONE VACC(SGLE/COM.IM,SQ,ID	$259.00	$259.00	—	208% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADM,1 VACCINE	$259.00	$259.00	—	208% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADM SGLE,IM/SQ	$259.00	$259.00	—	208% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADM VACCINE,SGL	$259.00	$259.00	—	208% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACC ADM,IM/SQ;SGL	$259.00	$259.00	—	208% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION SGL VACC,IM/SQ	$259.00	$259.00	—	208% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN, ONE VACCINE	$60.00	$60.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADM SGLE,IM/SQ	$259.00	$259.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACC ADM,IM/SQ;SGL	$259.00	$259.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADM VACCINE,SGL	$259.00	$259.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INFLUENZA A (H1N1) IMMUN ADM	$259.00	$259.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADM.ONE VACC(SGLE/COM+IM,SQ,ID	$259.00	$259.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization admin	$259.00	$259.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN,ONE VACCINE	$259.00	$259.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION SGL VACC,IM/SQ	$259.00	$259.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADM.ONE VACC(SGLE/COM.IM,SQ,ID	$259.00	$259.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADM,1 VACCINE	$259.00	$259.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 EACH ADDITIONAL VACCINE	$45.00	$45.00	—	at median	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADM, EA ADD VAC	$121.00	$121.00	—	169% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADM EA ADD VACC, IM/SQ	$121.00	$121.00	—	169% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINE ADM,EA.ADD IM/SQ	$121.00	$121.00	—	169% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADM;EA ADD VACC	$121.00	$121.00	—	169% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADM EA. ADD VACC, IM/SQ	$121.00	$121.00	—	169% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADM.EA ADD VACC(SGLE/COM.IM,SQ	$121.00	$121.00	—	169% above	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 EACH ADDITIONAL VACCINE	$45.00	$45.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINE ADM,EA.ADD IM/SQ	$121.00	$121.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADM;EA ADD VACC	$121.00	$121.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADM EA ADD VACC, IM/SQ	$121.00	$121.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADM EA. ADD VACC, IM/SQ	$121.00	$121.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADM, EA ADD VAC	$121.00	$121.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADM.EA ADD VACC(SGLE/COM.IM,SQ	$121.00	$121.00	—	—	—
Yellow fever vaccine, live CPT 90717 YELLOW FEVER VACCINE	$206.00	$206.00	—	16% below	—
Yellow fever vaccine, live inpatient CPT 90717 YELLOW FEVER VACCINE	$206.00	$206.00	—	—	—

Dental

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Deep cleaning (scaling and root planing), 4 or more teeth in one quadrant CDT D4341 PERD SCAL/ROOT PLN 4/MORE/QUAD	$1,074.00	$1,074.00	—	31% below	—
Deep cleaning (scaling and root planing), 4 or more teeth in one quadrant CDT D4341 QUADERENT SCALE	$1,074.00	$1,074.00	—	31% below	—
Deep cleaning (scaling and root planing), 4 or more teeth in one quadrant inpatient CDT D4341 QUADERENT SCALE	$1,074.00	$1,074.00	—	—	—
Deep cleaning (scaling and root planing), 4 or more teeth in one quadrant inpatient CDT D4341 PERD SCAL/ROOT PLN 4/MORE/QUAD	$1,074.00	$1,074.00	—	—	—
Porcelain crown CDT D2740 PORCELAIN JACKET	$2,640.00	$2,640.00	—	144% above	—
Porcelain crown inpatient CDT D2740 PORCELAIN JACKET	$2,640.00	$2,640.00	—	—	—
Removal of an impacted tooth fully covered by bone, often a wisdom tooth CDT D7240 REM IMPACTED TOOTH,COMPL BONE	$1,650.00	$1,650.00	—	79% above	—
Removal of an impacted tooth fully covered by bone, often a wisdom tooth inpatient CDT D7240 REM IMPACTED TOOTH,COMPL BONE	$1,650.00	$1,650.00	—	—	—
Root canal treatment on a molar (back tooth), not including the final crown CDT D3330 ROOT CANAL MOLAR	$2,596.00	$2,596.00	—	37% above	—
Root canal treatment on a molar (back tooth), not including the final crown inpatient CDT D3330 ROOT CANAL MOLAR	$2,596.00	$2,596.00	—	—	—
Routine teeth cleaning (prophylaxis), adult or teen CDT D1110 ADULT PROPHY	$300.00	$300.00	—	97% above	—
Routine teeth cleaning (prophylaxis), adult or teen inpatient CDT D1110 ADULT PROPHY	$300.00	$300.00	—	—	—
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACTION TOOTH/ROOT*	$550.00	$550.00	—	71% below	—
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 EXTRACTION TOOTH/ROOT*	$550.00	$550.00	—	—	—

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

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

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

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

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

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

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

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

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

Source file: https://hospitalpricedisclosure.com/download.aspx?pi=zkz93A*_*EfGBBA9koWjdYHA*-*