VHS Sinai Grace Hospital
VHS Sinai Grace Hospital in Detroit, MI publishes cash prices for 374 common procedures listed here, from its own machine-readable price file updated Apr 8, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Michigan median for 325 of 368 procedures and below it for 40. By typical cash price it ranks #96 of 97 Michigan hospitals and #30 of 31 hospitals in the Detroit, MI area, cheapest first. Select a procedure to compare it with other hospitals nearby.
6071 W Outer Dr, Detroit, MI 48235 Collected Sep 23, 2026 Source price file Check a bill from this hospital (313) 966-3300
Acute care hospital For-profit hospital Emergency department CMS star rating 1 of 5 CCN 230024 · CMS hospital register NPI 1760794044
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WO/W CM | $5,720.25 | $7,627.00 | — | 265% above | 25% |
| Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS | $687.00 | $916.00 | — | 229% above | 25% |
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE 3 VIEWS MINIMUM | $586.50 | $782.00 | — | 175% above | 25% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UE/LE ART STUD LTD 1-2LV | $510.00 | $680.00 | — | 65% above | 25% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTRMTY W/O CM | $4,134.75 | $5,513.00 | — | 309% above | 25% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY ESOPHAGUS SNGL CM STDY | $962.25 | $1,283.00 | — | 240% above | 25% |
| Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY | $2,490.00 | $3,320.00 | — | 165% above | 25% |
| Breast ultrasound, complete, one breast CPT 76641 US BREAST UNI COMPLETE | $362.25 | $483.00 | — | 19% above | 25% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST UNI LTD | $362.25 | $483.00 | — | 36% above | 25% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD/PEL W CONTRAST | $6,507.75 | $8,677.00 | — | 162% above | 25% |
| CT angiography (CTA) of the head CPT 70496 CTA HEAD W CONTRAST ONLY | $10,870.50 | $14,494.00 | — | 602% above | 25% |
| CT angiography (CTA) of the neck CPT 70498 CTA NECK W CONTRAST ONLY | $7,218.75 | $9,625.00 | — | 381% above | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST (NONCOR) W CM | $7,178.25 | $9,571.00 | — | 331% above | 25% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA HEART W CONTRAST | $2,904.75 | $3,873.00 | — | 118% above | 25% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CARD SCORING WO CONT | $164.25 | $219.00 | — | 10% above | 25% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CM | $3,485.25 | $4,647.00 | — | 95% above | 25% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CM | $4,240.50 | $5,654.00 | — | 48% above | 25% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELVIS WO/W CM | $5,284.50 | $7,046.00 | — | 102% above | 25% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/ CM | $3,747.75 | $4,997.00 | — | 155% above | 25% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CM | $2,607.00 | $3,476.00 | — | 180% above | 25% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS W/O CONTRAST | $2,607.00 | $3,476.00 | — | 149% above | 25% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CM | $2,607.00 | $3,476.00 | — | 149% above | 25% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO CONTRST | $2,772.00 | $3,696.00 | — | 197% above | 25% |
| CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W CONTRAST | $4,779.75 | $6,373.00 | — | 284% above | 25% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN WO/W CONTR | $4,444.50 | $5,926.00 | — | 184% above | 25% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR W/O CM | $4,821.75 | $6,429.00 | — | 343% above | 25% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL W/O CM | $3,534.00 | $4,712.00 | — | 218% above | 25% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST | $5,704.50 | $7,606.00 | — | 326% above | 25% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX CAROTID BI/COMP | $668.25 | $891.00 | — | — | 25% |
| Chest CT scan without and with contrast CPT 71270 CT THORAX WO/W CONTRAST | $4,642.50 | $6,190.00 | — | 165% above | 25% |
| Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS | $564.00 | $752.00 | — | 217% above | 25% |
| Chest X-ray, single view CPT 71045 CHEST 1 VIEW | $293.25 | $391.00 | — | 86% above | 25% |
| Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE COMPLETE | $750.00 | $1,000.00 | — | 316% above | 25% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMP | $1,644.75 | $2,193.00 | — | 165% above | 25% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA AXIAL SKELETON | $1,409.25 | $1,879.00 | — | 353% above | 25% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA APPENDICULAR SKELTN | $595.50 | $794.00 | — | 354% above | 25% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB COMP W FETL ANATMY | $1,410.00 | $1,880.00 | — | 100% above | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX W/O CONTRAST | $2,773.50 | $3,698.00 | — | 178% above | 25% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX WITH CONTRAST | $3,747.75 | $4,997.00 | — | 186% above | 25% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO+CAD BILAT | $809.25 | $1,079.00 | — | — | 25% |
| Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO+CAD UNILAT | $681.00 | $908.00 | — | 119% above | 25% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 LE ART IMAGING COMP BILAT | $670.50 | $894.00 | — | — | 25% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 UE/LE IMG VEINS COMP BILAT | $1,093.50 | $1,458.00 | — | — | 25% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO2D SPECTR/COLOR FLO | $2,100.00 | $2,800.00 | — | 47% above | 25% |
| Elbow X-ray, 2 views CPT 73070 ELBOW 2 VIEWS | $378.75 | $505.00 | — | 183% above | 25% |
| Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW 3 VIEW MINIMUM | $562.50 | $750.00 | — | 195% above | 25% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORB/EAR/FOSSA W/O CM | $2,607.00 | $3,476.00 | — | 160% above | 25% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES 3VW MIN | $865.50 | $1,154.00 | — | 233% above | 25% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM 2 VIEWS | $465.75 | $621.00 | — | 161% above | 25% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMG | $2,424.00 | $3,232.00 | — | 159% above | 25% |
| Hand X-ray, 2 views CPT 73120 HAND 2 VIEWS | $414.75 | $553.00 | — | 184% above | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 OS CALCIS 2 VIEWS | $392.25 | $523.00 | — | 155% above | 25% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY CPAP 4 | $10,347.00 | $13,796.00 | — | 198% above | 25% |
| Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS | $557.25 | $743.00 | — | 180% above | 25% |
| Knee X-ray, complete, 4 or more views CPT 73564 KNEE COMP 4 VW MIN | $655.50 | $874.00 | — | 206% above | 25% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTRMTY W/O CM | $4,579.50 | $6,106.00 | — | 316% above | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LTD SNGLE/QUAD/FU | $1,152.75 | $1,537.00 | — | 145% above | 25% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US XTR JOINT LMTD | $366.00 | $488.00 | — | at median | 25% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US XTR SOFT TISSUE LMTD | $887.25 | $1,183.00 | — | 142% above | 25% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LUNG SCREENING | $392.25 | $523.00 | — | 13% above | 25% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIBIA/FIBULA 2 VIEWS | $762.75 | $1,017.00 | — | 313% above | 25% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O CONTRAST | $4,274.25 | $5,699.00 | — | 176% above | 25% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BRST WO&W CM+CAD BI | $6,786.00 | $9,048.00 | — | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWR EXT JNT W/O CM | $4,946.25 | $6,595.00 | — | 209% above | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LE JNT WO/W CM | $8,661.75 | $11,549.00 | — | 249% above | 25% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CM | $4,660.50 | $6,214.00 | — | 176% above | 25% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO/W CM | $6,749.25 | $8,999.00 | — | 116% above | 25% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN/ STEM W/O CONTRAST | $4,146.00 | $5,528.00 | — | 149% above | 25% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST | $4,271.25 | $5,695.00 | — | 156% above | 25% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/W CONTRAST | $5,787.75 | $7,717.00 | — | 105% above | 25% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O CONT | $6,334.50 | $8,446.00 | — | 253% above | 25% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR W/O CM | $7,777.50 | $10,370.00 | — | 333% above | 25% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR WO/W CM | $10,299.75 | $13,733.00 | — | 281% above | 25% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORAC W/O CM | $6,936.00 | $9,248.00 | — | 329% above | 25% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERV WO/W CM | $10,562.25 | $14,083.00 | — | 274% above | 25% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE W/O CONT | $6,570.00 | $8,760.00 | — | 275% above | 25% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICL W/O CM | $7,329.00 | $9,772.00 | — | 318% above | 25% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/W CONTRAST | $9,830.25 | $13,107.00 | — | 256% above | 25% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST | $6,810.75 | $9,081.00 | — | 300% above | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UP EXT JNT W/O CM | $7,176.75 | $9,569.00 | — | 284% above | 25% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SPINE CERVICAL 4 OR 5 VW | $966.00 | $1,288.00 | — | 229% above | 25% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SPINE CERVICAL 4 OR 5 VW | $8,196.00 | $10,928.00 | — | 2694% above | 25% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SPINE CERVICAL 4 OR 5 VW | $8,196.00 | $10,928.00 | — | — | 25% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISS NECK W CM | $5,103.00 | $6,804.00 | — | 287% above | 25% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISS NECK WO CM | $4,003.50 | $5,338.00 | — | 294% above | 25% |
| Neck soft tissue X-ray CPT 70360 NECK FOR SOFT TISSUES | $441.75 | $589.00 | — | 149% above | 25% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MC PERF SPECT WM EF MULT | $6,387.75 | $8,517.00 | — | 118% above | 25% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST | $4,592.25 | $6,123.00 | — | 360% above | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LTD/FU | $822.75 | $1,097.00 | — | 145% above | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE | $1,365.75 | $1,821.00 | — | 140% above | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB COMP>14WK SGL GEST | $1,426.50 | $1,902.00 | — | 154% above | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB COMP<14WKS 1STGEST | $931.50 | $1,242.00 | — | 81% above | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LTD 1OR> FETUS | $877.50 | $1,170.00 | — | 174% above | 25% |
| Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT 2VW | $684.75 | $913.00 | — | 245% above | 25% |
| Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 RIBS UNI 3V MIN W/PA CXR | $917.25 | $1,223.00 | — | 290% above | 25% |
| Screening mammogram, both breasts both sides CPT 77067 SCRN MAMMO+CAD BILAT | $531.00 | $708.00 | — | — | 25% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER 2 VWS MINIMUM | $516.00 | $688.00 | — | 142% above | 25% |
| Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES 3VW MIN | $858.00 | $1,144.00 | — | 267% above | 25% |
| Skull X-ray, fewer than 4 views CPT 70250 SKULL < 4 VIEWS | $670.50 | $894.00 | — | 219% above | 25% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY | $5,625.75 | $7,501.00 | — | 74% above | 25% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 SWAL FUNC W/CINE/VIDEO+CM STDY | $870.75 | $1,161.00 | — | 131% above | 25% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 FEMUR 2 VIEWS MIN | $293.25 | $391.00 | — | 37% above | 25% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPINE THORACIC W/O CM | $4,598.25 | $6,131.00 | — | 336% above | 25% |
| Toe X-ray, 2 or more views CPT 73660 TOE(S) 2 VIEWS | $465.75 | $621.00 | — | 270% above | 25% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NOT OB | $1,075.50 | $1,434.00 | — | 104% above | 25% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL | $1,269.00 | $1,692.00 | — | 192% above | 25% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE | $1,507.50 | $2,010.00 | — | 126% above | 25% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM CONTENTS | $1,119.00 | $1,492.00 | — | 113% above | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK | $1,152.75 | $1,537.00 | — | 142% above | 25% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER GI W/SNGL CM STDY | $817.50 | $1,090.00 | — | 103% above | 25% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS 2 VIEW MINIMUM | $750.75 | $1,001.00 | — | 307% above | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 UE/LE IMG VEINS UNI/LTD | $668.25 | $891.00 | — | 26% above | 25% |
| Wrist X-ray, 2 views CPT 73100 WRIST 2 VIEWS | $414.75 | $553.00 | — | 196% above | 25% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST 3 VIEWS MINIMUM | $557.25 | $743.00 | — | 185% above | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP UNI W/PELV 2-3 VWS | $293.25 | $391.00 | — | 42% above | 25% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW | $522.75 | $697.00 | — | 229% above | 25% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE 2 VIEWS | $442.50 | $590.00 | — | 152% above | 25% |
| X-ray of the finger(s), 2 or more views CPT 73140 FINGER(S) 2 VIEWS | $348.75 | $465.00 | — | 162% above | 25% |
| X-ray of the foot, 2 views CPT 73620 FOOT 2 VIEWS | $342.75 | $457.00 | — | 116% above | 25% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3 VIEWS MINIMUM | $655.50 | $874.00 | — | 264% above | 25% |
| X-ray of the hand, 3 or more views CPT 73130 HAND 3 VIEWS MINIMUM | $516.00 | $688.00 | — | 180% above | 25% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1-2 VIEWS | $527.25 | $703.00 | — | 239% above | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBAR 2 VIEWS | $651.75 | $869.00 | — | 205% above | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBAR 3 VIEWS | $863.25 | $1,151.00 | — | 303% above | 25% |
| X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBAR MIN 4VWS | $1,071.75 | $1,429.00 | — | 248% above | 25% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE THORACIC 2 VIEWS | $668.25 | $891.00 | — | 261% above | 25% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES 3VW MIN | $525.00 | $700.00 | — | 200% above | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 2 VIEWS | $684.75 | $913.00 | — | 197% above | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 3 VIEWS | $821.25 | $1,095.00 | — | 256% above | 25% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 2 VIEWS | $620.25 | $827.00 | — | 277% above | 25% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 VIEW | $620.25 | $827.00 | — | 277% above | 25% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM COCCYX 2 VWS | $537.75 | $717.00 | — | 208% above | 25% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH | $119.25 | $159.00 | — | 27% above | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE,ALANINE AMINO (ALT | $7.50 | $10.00 | — | 69% below | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINOTRANSFERASE | $19.50 | $26.00 | — | 19% below | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSAMINASE-SGPT (ALT) | $20.25 | $27.00 | — | 16% below | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSTERASE AST(SGOT) | $20.25 | $27.00 | — | 8% below | 25% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $423.75 | $565.00 | — | 149% above | 25% |
| Albumin blood test CPT 82040 ALBUMIN SERUM | $20.25 | $27.00 | — | 1% above | 25% |
| Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE ALKALINE | $108.00 | $144.00 | — | 414% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE ALFALFA | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLGN IGE PENICILLIN G (MAJOR) | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE WHEAT | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE VANILLA | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE TOBACCO | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE SUNFLOWER POLLEN | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE SHEEP EPITHELIUM | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE POPPY SEED | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE LINSEED | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE HOPS | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE HONEY | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE GOAT EPITHELIUM | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE CHICKEN FEATHERS | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE BENTGRASS | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE BAY LEAF | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE ALDER TREE | $2.25 | $3.00 | — | 65% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLRGN SPEC IGE EA | $2.45 | $3.26 | — | 62% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE SUNFLOWER SEED | $2.45 | $3.26 | — | 62% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE TURKEY FEATHERS | $2.45 | $3.26 | — | 62% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE SAFFLOWER | $10.50 | $14.00 | — | 65% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE POMEGRANATE | $13.50 | $18.00 | — | 112% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE A FUMIGATUS | $13.50 | $18.00 | — | 112% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE NECTARINE SPEC | $17.25 | $23.00 | — | 171% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLGN SPEC IGE EA ALLERG | $18.00 | $24.00 | — | 183% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST EACH ALLERGEN | $20.25 | $27.00 | — | 218% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLGN IGE EA ALLERG | $27.75 | $37.00 | — | 336% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE GELATIN PORCINE | $29.25 | $39.00 | — | 359% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE COTTON SEED | $51.00 | $68.00 | — | 701% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE PUMPKIN SEED | $51.00 | $68.00 | — | 701% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE MOUSE URINE | $55.50 | $74.00 | — | 771% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE RAT URINE | $55.50 | $74.00 | — | 771% above | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETO PROTEIN SERUM | $252.00 | $336.00 | — | 394% above | 25% |
| Ammonia blood test CPT 82140 AMMONIA | $166.50 | $222.00 | — | 156% above | 25% |
| Amylase blood test CPT 82150 AMYLASE | $93.75 | $125.00 | — | 368% above | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYC CITRULLINATED PEP AB | $103.50 | $138.00 | — | 86% above | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB(ANA) | $93.75 | $125.00 | — | 68% above | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYP NATRIURETC PEPTIDE | $380.25 | $507.00 | — | 392% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHER SOURCE | $216.75 | $289.00 | — | 309% above | 25% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $566.25 | $755.00 | — | 1024% above | 25% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN, TOTAL | $6.75 | $9.00 | — | 70% below | 25% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL | $96.00 | $128.00 | — | 323% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATH LEVEL IV | $247.50 | $330.00 | — | 127% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PROSTATE NEEDLE BX | $1,897.50 | $2,530.00 | — | 1639% above | 25% |
| Blood culture for bacteria CPT 87040 CULT BLOOD AERO/ANAERO | $123.75 | $165.00 | — | 96% above | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 OBP VENIPUNCTURE | $32.25 | $43.00 | — | 150% above | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 ANT-VENIPUNCTURE,BLOOD DRAW | $32.25 | $43.00 | — | 150% above | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 OB NW VENIPUNCTURE | $32.25 | $43.00 | — | 150% above | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 OBL VENIPUNCTURE | $32.25 | $43.00 | — | 150% above | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $32.25 | $43.00 | — | 150% above | 25% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT BLOOD | $78.75 | $105.00 | — | 228% above | 25% |
| Blood lead test CPT 83655 LEAD QUANTITATIVE | $29.25 | $39.00 | — | 282% above | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADTOPN CHRONC(HCG)QL | $83.25 | $111.00 | — | 125% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLD TYPE ABO ONLY | $138.75 | $185.00 | — | 559% above | 25% |
| Blood urea nitrogen (BUN) test CPT 84520 BLD UREA NITROGEN QUAN | $20.25 | $27.00 | — | 14% above | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN QN | $167.25 | $223.00 | — | 392% above | 25% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOXIN AMP PROBE | $126.00 | $168.00 | — | 9% above | 25% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $63.75 | $85.00 | — | 32% below | 25% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 | $72.75 | $97.00 | — | 28% below | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARSCOV2 COVID19 AMP PRB | $38.48 | $51.31 | — | 64% below | 25% |
| Calcium blood test, total CPT 82310 CALCIUM | $64.50 | $86.00 | — | 222% above | 25% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINO-EMBRYONIC AG | $142.50 | $190.00 | — | 72% above | 25% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB | $34.00 | $45.33 | — | 16% below | 25% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGG | $90.75 | $121.00 | — | 125% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA AMP PROBE | $254.25 | $339.00 | — | 244% above | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $508.50 | $678.00 | — | 898% above | 25% |
| Complete blood count (CBC) with differential CPT 85025 CBC/PLT/AUTO DIFF (5) | $54.00 | $72.00 | — | 34% above | 25% |
| Complete blood count (CBC), no differential CPT 85027 CBC WITHOUT DIFF | $96.75 | $129.00 | — | 234% above | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL | $687.00 | $916.00 | — | 818% above | 25% |
| Cortisol blood test, total CPT 82533 CORTISOL FREE PLASMA/SER | $69.75 | $93.00 | — | 105% above | 25% |
| Cortisol blood test, total CPT 82533 CORTISOL TOTAL | $142.50 | $190.00 | — | 319% above | 25% |
| Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE TOTAL | $181.50 | $242.00 | — | 505% above | 25% |
| Creatinine blood test CPT 82565 CREATININE BLOOD | $142.50 | $190.00 | — | 497% above | 25% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS AB | $10.50 | $14.00 | — | 76% below | 25% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB | $282.00 | $376.00 | — | 548% above | 25% |
| D-dimer blood test (blood clot marker) CPT 85379 FDP D-DIMER QNT | $54.00 | $72.00 | — | 26% above | 25% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDRST SULFATE | $118.50 | $158.00 | — | 84% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 METHAQUALONE QUANT. URINE | $26.25 | $35.00 | — | 55% below | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 COCAINE MECON | $55.50 | $74.00 | — | 5% below | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN/MECONIUM | $60.00 | $80.00 | — | 3% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN QUAL | $90.00 | $120.00 | — | 55% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG ANALYSIS, GCMS | $100.50 | $134.00 | — | 73% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL ETHYL | $118.50 | $158.00 | — | 104% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 OPIATES QUAL | $134.25 | $179.00 | — | 131% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 THC(MARIJUANA) QUAL | $134.25 | $179.00 | — | 131% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 TRICYCLIC DRUGS QUAL | $194.25 | $259.00 | — | 234% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN EACH CLASS | $293.25 | $391.00 | — | 404% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 OPIATES | $557.25 | $743.00 | — | 857% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR | $557.25 | $743.00 | — | 857% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/2 | $557.25 | $743.00 | — | 857% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHANOL, URINE | $595.50 | $794.00 | — | 923% above | 25% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $237.75 | $317.00 | — | 643% above | 25% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV IGM VCA | $96.75 | $129.00 | — | 52% above | 25% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV IGG VCA | $156.75 | $209.00 | — | 146% above | 25% |
| Estradiol blood test CPT 82670 ESTRADIOL | $347.25 | $463.00 | — | 344% above | 25% |
| FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMLAT HORMONE | $337.50 | $450.00 | — | 323% above | 25% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL | $41.25 | $55.00 | — | 35% below | 25% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $123.75 | $165.00 | — | 106% above | 25% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY | $72.75 | $97.00 | — | 151% above | 25% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID | $166.50 | $222.00 | — | 126% above | 25% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE | $293.25 | $391.00 | — | 339% above | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE | $78.75 | $105.00 | — | 158% above | 25% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $126.00 | $168.00 | — | 243% above | 25% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE,GAMMA(GGT) | $9.75 | $13.00 | — | 68% below | 25% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT | $54.00 | $72.00 | — | 76% above | 25% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3SPEC | $241.50 | $322.00 | — | 324% above | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONOR AMP PROBE | $254.25 | $339.00 | — | 162% above | 25% |
| H. pylori stool antigen test CPT 87338 H. PYLORI STOOL AG | $216.75 | $289.00 | — | 242% above | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT | $41.25 | $55.00 | — | 77% below | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANTITATIVE PCR | $160.50 | $214.00 | — | 12% below | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 QUANT RNA/DNA | $751.50 | $1,002.00 | — | 312% above | 25% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 SCREEN | $126.00 | $168.00 | — | 168% above | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV I AG HIV I HIV II AB | $282.00 | $376.00 | — | 475% above | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCATED | $56.25 | $75.00 | — | 45% above | 25% |
| Hemoglobin blood test CPT 85018 BLOOD HEMOGLBN | $123.00 | $164.00 | — | 669% above | 25% |
| Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTAL | $123.75 | $165.00 | — | 180% above | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURF AB | $54.75 | $73.00 | — | 30% above | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY | $183.00 | $244.00 | — | 281% above | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C QUANT | $37.50 | $50.00 | — | 72% below | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C QUANT PCR | $696.75 | $929.00 | — | 429% above | 25% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES I AB IGG | $90.75 | $121.00 | — | 118% above | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES AB SMPLX TYPE 2 | $7.50 | $10.00 | — | 85% below | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES II AB IGG | $119.25 | $159.00 | — | 132% above | 25% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HI SENSITIVITY | $39.75 | $53.00 | — | 31% below | 25% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE QUANT | $219.75 | $293.00 | — | 187% above | 25% |
| Insulin blood test CPT 83525 INSULIN TOTAL | $56.25 | $75.00 | — | 54% above | 25% |
| Iron blood test (serum iron) CPT 83540 IRON | $32.25 | $43.00 | — | 10% above | 25% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPCTY | $96.75 | $129.00 | — | 144% above | 25% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $310.50 | $414.00 | — | 403% above | 25% |
| LH (luteinizing hormone) test CPT 83002 LUTEINING HORMONE | $166.50 | $222.00 | — | 119% above | 25% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID BODY FLUID | $123.75 | $165.00 | — | 175% above | 25% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE(LACTIC ACID) | $207.00 | $276.00 | — | 359% above | 25% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH-LACTIC DEHYDROGENASE | $56.25 | $75.00 | — | 134% above | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $83.25 | $111.00 | — | 175% above | 25% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $118.50 | $158.00 | — | 152% above | 25% |
| Lyme disease antibody test CPT 86618 LYME DISEASE AB | $31.50 | $42.00 | — | 21% above | 25% |
| Lyme disease antibody test CPT 86618 LYME DISEASE | $56.25 | $75.00 | — | 116% above | 25% |
| Magnesium blood test CPT 83735 MAGNESIUM | $34.50 | $46.00 | — | 72% above | 25% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA AB | $56.25 | $75.00 | — | 128% above | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB SCREEN | $69.00 | $92.00 | — | 66% above | 25% |
| Mumps immunity blood test CPT 86735 MUMPS AB | $74.25 | $99.00 | — | 196% above | 25% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $158.25 | $211.00 | — | 176% above | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL | $87.00 | $116.00 | — | 72% above | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE CA SCREEN, PSA TOTAL | $294.00 | $392.00 | — | 482% above | 25% |
| Pap test (liquid-based, automated screening with review) CPT 88175 SCREENING CYTOPATHOLOGY | $109.50 | $146.00 | — | 48% above | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR SCREENING | $173.25 | $231.00 | — | 123% above | 25% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PTH) | $142.50 | $190.00 | — | 6% above | 25% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT | $261.75 | $349.00 | — | 95% above | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $171.75 | $229.00 | — | 454% above | 25% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS | $93.75 | $125.00 | — | 346% above | 25% |
| Potassium blood test CPT 84132 POC POTASSIUM | $66.00 | $88.00 | — | 184% above | 25% |
| Potassium blood test CPT 84132 POTASSIUM SERUM | $83.25 | $111.00 | — | 259% above | 25% |
| Potassium blood test CPT 84132 POTASSIUM | $90.00 | $120.00 | — | 288% above | 25% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL INFORMA SEQ XY SEQUENCE | $300.00 | $400.00 | — | at median | 25% |
| Progesterone blood test CPT 84144 PROGESTERONE | $123.75 | $165.00 | — | 94% above | 25% |
| Prolactin blood test CPT 84146 PROLACTIN | $119.25 | $159.00 | — | 62% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME/INR (WAIVED) | $11.25 | $15.00 | — | 42% below | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PCL PT-INR | $39.00 | $52.00 | — | 103% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $46.50 | $62.00 | — | 142% above | 25% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A IA DIRECT OBS | $118.50 | $158.00 | — | 121% above | 25% |
| Rh blood typing CPT 86901 BLD TYPE RHO(D)ONLY | $128.25 | $171.00 | — | 519% above | 25% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $54.75 | $73.00 | — | 59% above | 25% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA AB | $163.50 | $218.00 | — | 221% above | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTO | $20.25 | $27.00 | — | 16% below | 25% |
| Sodium blood test CPT 84295 POC SODIUM | $54.75 | $73.00 | — | 163% above | 25% |
| Sodium blood test CPT 84295 SODIUM BLOOD | $66.00 | $88.00 | — | 217% above | 25% |
| Sodium blood test CPT 84295 SODIUM | $96.00 | $128.00 | — | 362% above | 25% |
| Stool ova and parasites exam CPT 87177 FLUORESCENT STAIN SMEAR | $87.00 | $116.00 | — | 100% above | 25% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLD STL 1-3 | $28.50 | $38.00 | — | 62% above | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HGB FECAL IA | $118.50 | $158.00 | — | 159% above | 25% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB | $87.00 | $116.00 | — | 86% above | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-CSF | $42.00 | $56.00 | — | 144% above | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL/RPR QUAL | $118.50 | $158.00 | — | 589% above | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL AG RESPONSE | $30.00 | $40.00 | — | 76% below | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS AG RESPONSE | $81.00 | $108.00 | — | 36% below | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $78.75 | $105.00 | — | 121% above | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EA | $9.37 | $12.49 | — | 80% below | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB | $118.50 | $158.00 | — | 157% above | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $158.25 | $211.00 | — | 146% above | 25% |
| Total IgE blood test CPT 82785 IMMUNOGLOBULINS E SERUM | $54.75 | $73.00 | — | 24% above | 25% |
| Total IgE blood test CPT 82785 IGE SERUM | $169.50 | $226.00 | — | 283% above | 25% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL | $36.00 | $48.00 | — | 80% above | 25% |
| Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL | $83.25 | $111.00 | — | 151% above | 25% |
| Total triiodothyronine (T3) blood test CPT 84480 TRIIODTHYRNIN TOTAL T3 | $118.50 | $158.00 | — | 157% above | 25% |
| Transferrin blood test CPT 84466 TRANSFERRIN | $123.75 | $165.00 | — | 117% above | 25% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS AMP PROBE | $93.75 | $125.00 | — | 27% above | 25% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES | $39.75 | $53.00 | — | 113% above | 25% |
| Troponin test, quantitative CPT 84484 TROPONIN QUAN | $15.27 | $20.36 | — | 64% below | 25% |
| Troponin test, quantitative CPT 84484 TROPONIN - I | $310.50 | $414.00 | — | 631% above | 25% |
| Uric acid blood test CPT 84550 URIC ACID BLOOD | $54.75 | $73.00 | — | 150% above | 25% |
| Urinalysis with microscope exam, automated CPT 81001 UA AUTO W/MICRO | $96.75 | $129.00 | — | 384% above | 25% |
| Urinalysis with microscope exam, manual CPT 81000 UA NON-AUTO W/MICRO | $20.25 | $27.00 | — | 35% above | 25% |
| Urinalysis without microscope exam, automated CPT 81003 URINE W/O MICRO AUTO | $21.75 | $29.00 | — | 67% above | 25% |
| Urinalysis without microscope exam, automated CPT 81003 UA AUTO W/O MICRO | $83.25 | $111.00 | — | 540% above | 25% |
| Urinalysis without microscope exam, manual CPT 81002 UA NON-AUTO W/O MICRO | $39.75 | $53.00 | — | 151% above | 25% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE COLONY CT | $212.25 | $283.00 | — | 286% above | 25% |
| Urine microalbumin (albumin) test CPT 82043 MICRO ALBUMIN URINE QNT | $81.00 | $108.00 | — | 212% above | 25% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREG TEST QUAL | $78.75 | $105.00 | — | 217% above | 25% |
| Urine pregnancy test, read by color change CPT 81025 OCH URINE PREGNANCY-SERUM | $78.75 | $105.00 | — | 217% above | 25% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B 12 INJ UP TO 1000MCG | $60.75 | $81.00 | — | 1% above | 25% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBLMN(VIT B12) | $142.50 | $190.00 | — | 138% above | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D/25 HYDROXY | $423.75 | $565.00 | — | 379% above | 25% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY | $144.00 | $192.00 | — | 82% above | 25% |
| Zinc blood test CPT 84630 ZINC QUANTITATIVE URINE | $7.50 | $10.00 | — | 69% below | 25% |
| Zinc blood test CPT 84630 ZINC RBC | $81.00 | $108.00 | — | 240% above | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADTOPN CHORNC(HCG)QNT | $186.75 | $249.00 | — | 288% above | 25% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| Cardiac catheterization with coronary angiogram CPT 93458 CATH L HRT ARTERY/VENTR | $24,062.25 | $32,083.00 | — | 142% above | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELEC/SCHED | $810.75 | $1,081.00 | — | 18% below | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELEC | $1,878.00 | $2,504.00 | — | 91% above | 25% |
| Catheter ablation for atrial fibrillation CPT 93656 CMP EP ABL INTRA AFIB PVI EP3D | $57,636.00 | $76,848.00 | — | 60% above | 25% |
| Cervical biopsy CPT 57500 OBL BIOPSY OF CERVIX | $1,169.25 | $1,559.00 | — | 33% above | 25% |
| Cervical biopsy CPT 57500 BIOPSY OF CERVIX/LESN EXCSN | $2,475.75 | $3,301.00 | — | 181% above | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 OBP COLPS/VAGINOSCOPY WITH CE | $1,674.00 | $2,232.00 | — | 342% above | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 OBL COLPOS/VAGINOSCOPY WITH CE | $1,674.00 | $2,232.00 | — | 342% above | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 OB NW COLPOS/VAGINOSCOPY WITH | $1,674.00 | $2,232.00 | — | 342% above | 25% |
| Coronary stent placement, one artery CPT 92928 COR STNT ANGIO INIT | $20,456.25 | $27,275.00 | — | 58% above | 25% |
| Coronary stent placement, one artery CPT 92928 PERC COR DRUG-ELUT STNT | $27,582.75 | $36,777.00 | — | 113% above | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALIG LESION 1ST | $508.50 | $678.00 | — | 160% above | 25% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSTOMY INSERT VENT TUBE | $1,604.25 | $2,139.00 | — | 312% above | 25% |
| Earwax removal with instruments, one ear CPT 69210 REMVL IMPAC CERUMEN W/INST UNI | $442.50 | $590.00 | — | 360% above | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 OBL ENDOMETRIAL BIOPSY | $481.50 | $642.00 | — | 103% above | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 OB NW ENDOMETRIAL BIOPSY | $481.50 | $642.00 | — | 103% above | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 OBP ENDOMETRIAL BIOPSY | $519.75 | $693.00 | — | 119% above | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL SAMPLING | $916.50 | $1,222.00 | — | 287% above | 25% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 INTRAVITREAL INJECTN - 67028 | $644.25 | $859.00 | — | 4% above | 25% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 L SP FACET INJ+IMAG LVL1 | $2,382.00 | $3,176.00 | — | 120% above | 25% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJ&CATH HYSTER/SONOHYST | $489.75 | $653.00 | — | 1% below | 25% |
| IUD insertion (the device itself billed separately) CPT 58300 OBP INSERT INTRAUTERINE DEVICE | $804.75 | $1,073.00 | — | 145% above | 25% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE | $882.75 | $1,177.00 | — | 168% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ENT I & D ABSCESS SINGLE | $318.00 | $424.00 | — | 16% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D SKIN ABSCESS SINGLE/SIMPLE | $620.25 | $827.00 | — | 127% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ORTHO I & D ABSCESS SIMPLE | $847.50 | $1,130.00 | — | 210% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCS SIMPLE/ SINGLE | $924.00 | $1,232.00 | — | 238% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCS SIMPL OR SINGL | $1,207.50 | $1,610.00 | — | 342% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMP/SNGL | $1,215.75 | $1,621.00 | — | 345% above | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 ORT INJ TENDON SHEATH LIGAMENT | $655.50 | $874.00 | — | 63% above | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SIN FEND SHEAT OR LIGA APO | $751.50 | $1,002.00 | — | 87% above | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT | $1,488.75 | $1,985.00 | — | 271% above | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJ TEN SHEATH/LIG TRIG RT GAN | $1,488.75 | $1,985.00 | — | 271% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIR/INJ MAJ JT WO/US | $360.75 | $481.00 | — | 16% below | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ORTHO INJECT ASPIRAT MAJ JOINT | $632.25 | $843.00 | — | 48% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECTION ASPIRATION MAJOR JOI | $632.25 | $843.00 | — | 48% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHOCENTESIS MAJOR JOINT | $655.50 | $874.00 | — | 53% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ORTHO ARTHROCENTESIS BILATE | $1,122.75 | $1,497.00 | — | 162% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PCC INT/ASPIRATE MAJOR JNT | $1,932.00 | $2,576.00 | — | 352% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US | $1,995.75 | $2,661.00 | — | 367% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 RT CENTSIS ASP INJ MAJ JT W/O | $1,254.75 | $1,673.00 | — | 193% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 LT CENTSIS ASP INJ MAJ JT W/O | $1,254.75 | $1,673.00 | — | 193% above | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 OBL INSERT DRUG DELIVERY IMPLN | $300.75 | $401.00 | — | 81% above | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 OB NW INSERT DRUG DELIVERY IMP | $300.75 | $401.00 | — | 81% above | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 OBP INSERT DRUG DELIVERY IMPLN | $300.75 | $401.00 | — | 81% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ INTERM JT WO/US | $616.50 | $822.00 | — | 90% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ART ASP AND OR INJ INTER JOINT | $751.50 | $1,002.00 | — | 131% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRN/INJ INTRMD JT BURSA W/O US | $1,002.75 | $1,337.00 | — | 209% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ORTHO INJECT ASPIRAT INTREMDIA | $1,318.50 | $1,758.00 | — | 306% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJECTION ASPIRATION INTERMEDI | $1,318.50 | $1,758.00 | — | 306% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PCC INJ/ASPIRATE INTERM JOINT | $1,320.00 | $1,760.00 | — | 306% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 ASPIR/INJ INTER JOINT 24 | $1,573.50 | $2,098.00 | — | 384% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 LT CENTSIS ASP INJ ITMD JT W/O | $811.50 | $1,082.00 | — | 150% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 RT CENTSIS ASP INJ ITMD JT W/O | $811.50 | $1,082.00 | — | 150% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ORTH INJECT ASPIRAT SMAL JOINT | $751.50 | $1,002.00 | — | 122% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJECTION ASPIRATION SMALL JOI | $963.00 | $1,284.00 | — | 185% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRN/INJ SMALL JT BURSA W/O US | $966.00 | $1,288.00 | — | 186% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 PCC INJ/ASPIRATE SMALL JOINT | $986.25 | $1,315.00 | — | 192% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 LT CENTSIS ASP INJ SM JT W/O U | $842.25 | $1,123.00 | — | 149% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 RT CENTSIS ASP INJ SM JT W/O U | $842.25 | $1,123.00 | — | 149% above | 25% |
| Left heart catheterization, diagnostic one side CPT 93452 CATH LT HRT W/LTVENT | $14,084.25 | $18,779.00 | — | 103% above | 25% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ EPID LUMB/CAUD | $3,498.75 | $4,665.00 | — | 240% above | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ ANESTH LUMB/CAUD SGL | $3,733.50 | $4,978.00 | — | 249% above | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCSN BENGN LESN 0.5CM OR< | $1,128.75 | $1,505.00 | — | 56% above | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT MARG 0.5 CM< | $4,662.75 | $6,217.00 | — | 544% above | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION 0.5 CM OR LESS | $3,678.75 | $4,905.00 | — | 398% above | 25% |
| Nail removal (partial or complete), one nail CPT 11730 AVLSN NAIL PLT PRTL/CMPLT SIMP | $744.00 | $992.00 | — | 263% above | 25% |
| Nail removal (partial or complete), one nail CPT 11730 AVUL NAIL PLAT/PART OR COMPLET | $1,042.50 | $1,390.00 | — | 409% above | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANESTH OCCIPLT NERVE | $1,284.00 | $1,712.00 | — | 148% above | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANESTH OCCIPTL NERVE | $1,382.25 | $1,843.00 | — | 167% above | 25% |
| Pacemaker implant (dual chamber) CPT 33208 INS/RPL PMW/TRNSV LD A-V | $33,197.25 | $44,263.00 | — | 103% above | 25% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGE | $3,437.25 | $4,583.00 | — | 182% above | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCSN NAIL, MTRX, PRTL/CMPLT P | $1,787.25 | $2,383.00 | — | 240% above | 25% |
| Prostate biopsy CPT 55700 BX PROSTATE NEEDLE/PUNCH | $6,961.50 | $9,282.00 | — | 356% above | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FB SUBCUTANE SIMPLE | $468.75 | $625.00 | — | 26% above | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 ORTHO REMOV FOREIGN BODY SUBCU | $2,207.25 | $2,943.00 | — | 491% above | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FOREIGN BODY SUBCUT | $2,343.00 | $3,124.00 | — | 528% above | 25% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST | $552.00 | $736.00 | — | 123% above | 25% |
| Short arm cast (elbow to hand) CPT 29075 APPLCN SHORT ARM CAST FIBER | $560.25 | $747.00 | — | 126% above | 25% |
| Short arm cast (elbow to hand) CPT 29075 APPLCN SHORT ARM CAST PLAST | $714.75 | $953.00 | — | 188% above | 25% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLIN | $357.75 | $477.00 | — | 87% above | 25% |
| Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT | $599.25 | $799.00 | — | 214% above | 25% |
| Short leg cast (below the knee) CPT 29405 APPLICAT OF SHORT LEG CAST FIB | $446.25 | $595.00 | — | 63% above | 25% |
| Short leg cast (below the knee) CPT 29405 APPLICN SHORT LEG CAST FIBER | $681.00 | $908.00 | — | 149% above | 25% |
| Short leg cast (below the knee) CPT 29405 APPLN SHORT LEG CAST PLASTIC | $802.50 | $1,070.00 | — | 194% above | 25% |
| Short leg cast (below the knee) CPT 29405 APPLN SHORT LEG CAST FIBER | $884.25 | $1,179.00 | — | 224% above | 25% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLIN | $609.75 | $813.00 | — | 274% above | 25% |
| Short leg splint (calf to foot) CPT 29515 APPLCN SHRT LEG SPLNT | $681.00 | $908.00 | — | 317% above | 25% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION | $1,020.75 | $1,361.00 | — | 176% above | 25% |
| Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15 | $2,542.50 | $3,390.00 | — | 1353% above | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTR LUMB DIAG | $816.00 | $1,088.00 | — | 5% below | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR EAR LOBE | $760.50 | $1,014.00 | — | 222% above | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES | $312.75 | $417.00 | — | 9% above | 25% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTSIS W/IMAGING | $3,410.25 | $4,547.00 | — | 204% above | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PNT 1-2 MUSCLES | $655.50 | $874.00 | — | 80% above | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ SGL/MULT TRIG PT 1,2 MUSCL | $751.50 | $1,002.00 | — | 106% above | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ(S) SGL/MULT TRIGGER POINT | $1,164.75 | $1,553.00 | — | 220% above | 25% |
| Wart removal, up to 14 warts CPT 17110 LASER BENIGN LESION 1-14 | $434.25 | $579.00 | — | 114% above | 25% |
| Wart removal, up to 14 warts CPT 17110 DSTRCTN BENIN LESN UPTO 14 | $534.75 | $713.00 | — | 163% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBR SKIN/SUBQ TISSUE | $783.75 | $1,045.00 | — | 40% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID SUBQ 1ST 20 SQ CM OR < | $794.25 | $1,059.00 | — | 42% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN & SUBCUT TISS | $2,166.00 | $2,888.00 | — | 288% above | 25% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMP | $839.25 | $1,119.00 | — | 12% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COM,P | $1,342.50 | $1,790.00 | — | 79% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 1 UNIT/WERTZ | $1,432.50 | $1,910.00 | — | 90% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION | $1,581.00 | $2,108.00 | — | 110% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD/COMPONENTS | $3,829.50 | $5,106.00 | — | 409% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEB TREATMENT | $297.75 | $397.00 | — | 72% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TREATMENT | $354.00 | $472.00 | — | 104% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT | $378.00 | $504.00 | — | 118% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB TX | $378.00 | $504.00 | — | 118% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RN NEBULIZER TX | $378.00 | $504.00 | — | 118% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TX | $378.00 | $504.00 | — | 118% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 5W-NEBULIZER TREATMENT | $378.00 | $504.00 | — | 118% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION | $378.00 | $504.00 | — | 118% above | 25% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV <=1H INIT | $955.50 | $1,274.00 | — | 82% above | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE E&M 30-74 MIN | $5,190.00 | $6,920.00 | — | 157% above | 25% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE/DROWSY | $1,524.75 | $2,033.00 | — | 96% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 PCL ECG -12 LEAD TRACING ONLY | $142.50 | $190.00 | — | 9% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 OCH EKG 12 LEAD TRACING | $199.50 | $266.00 | — | 53% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD TRACING | $204.00 | $272.00 | — | 56% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 5W-EKG-TRACING ONLY | $213.00 | $284.00 | — | 63% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG TRACING ONLY | $216.75 | $289.00 | — | 66% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACE ONLY | $216.75 | $289.00 | — | 66% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACE ONLY (FAA) | $228.75 | $305.00 | — | 75% above | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT LVL I | $380.25 | $507.00 | — | 103% above | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 OB ER VISIT LVL I | $1,039.50 | $1,386.00 | — | 455% above | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 OB ER VISIT LVL II | $750.00 | $1,000.00 | — | 115% above | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT LVL II | $801.00 | $1,068.00 | — | 129% above | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 OB ER VISIT LVL III | $1,359.00 | $1,812.00 | — | 113% above | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT LVL III | $1,420.50 | $1,894.00 | — | 123% above | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 OB ER VISIT LVL IV | $2,465.25 | $3,287.00 | — | 134% above | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT LVL IV | $2,480.25 | $3,307.00 | — | 135% above | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 OB ER VISIT LVL V | $3,372.75 | $4,497.00 | — | 99% above | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT LVL V | $3,869.25 | $5,159.00 | — | 128% above | 25% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIO STRESS TRACE ONLY | $2,018.25 | $2,691.00 | — | 176% above | 25% |
| Family therapy without the patient, 50 minutes CPT 90846 FMLY THRPY W/O PT 50MIN | $219.75 | $293.00 | — | 49% above | 25% |
| Group psychotherapy session CPT 90853 GRP PSYCHTHRPY 30 MIN | $109.50 | $146.00 | — | 87% above | 25% |
| Group psychotherapy session CPT 90853 GRP PSYCHTHRPY 15 MIN | $342.00 | $456.00 | — | 485% above | 25% |
| Group psychotherapy session CPT 90853 GRP PSYCHTHRPY 120 MIN | $424.50 | $566.00 | — | 626% above | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYD INIT 31-60MIN | $378.75 | $505.00 | — | 45% above | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 5W-IV INF HYDRATION INITL HR | $378.75 | $505.00 | — | 45% above | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYD INIT 31-60MIN | $11,350.50 | $15,134.00 | — | 4249% above | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYD INIT 31-60MIN | $11,350.50 | $15,134.00 | — | — | 25% |
| IV infusion of a medicine, first hour CPT 96365 5W-IV INF THER/DIAG INITL HR | $455.25 | $607.00 | — | 52% above | 25% |
| IV infusion of a medicine, first hour CPT 96365 IV INF TX INIT <=1 HR | $455.25 | $607.00 | — | 52% above | 25% |
| IV push of a medicine, first drug CPT 96374 INJ TX/PRPH/DX IVP INT | $444.00 | $592.00 | — | 141% above | 25% |
| IV push of a medicine, first drug CPT 96374 INJ TX/PROPH/DX IVP | $444.00 | $592.00 | — | 141% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ TX/PROPH/DX SQ/IM | $78.75 | $105.00 | — | 13% below | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 5W-INJ SUB-Q/IM THER/DIAG | $254.25 | $339.00 | — | 179% above | 25% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAG EVAL | $684.75 | $913.00 | — | 206% above | 25% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE COND STUDIES 7-8 | $1,024.50 | $1,366.00 | — | 36% above | 25% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSC RE-ED EA15 | $366.00 | $488.00 | — | 288% above | 25% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSC RE-EDUC EA15 | $366.00 | $488.00 | — | 288% above | 25% |
| New patient office visit, about 30 minutes CPT 99203 OV NEW PT LVL 3 | $282.00 | $376.00 | — | 152% above | 25% |
| New patient office visit, about 30 minutes CPT 99203 E&M-NEW PATIENT-LVL III | $345.00 | $460.00 | — | 209% above | 25% |
| New patient office visit, about 30 minutes CPT 99203 ANTI COAG-NEW PAT LEVEL 3 | $345.75 | $461.00 | — | 209% above | 25% |
| New patient office visit, about 45 minutes CPT 99204 OV NEW PT LVL 4 | $416.25 | $555.00 | — | 252% above | 25% |
| New patient office visit, about 45 minutes CPT 99204 E&M-NEW PATIENT-LVL IV | $442.50 | $590.00 | — | 275% above | 25% |
| New patient office visit, about 45 minutes CPT 99204 E&M-NEW PATENT-LVL IV | $756.75 | $1,009.00 | — | 540% above | 25% |
| New patient office visit, about 60 minutes CPT 99205 OV NEW PT LVL 5 | $533.25 | $711.00 | — | 290% above | 25% |
| New patient office visit, about 60 minutes CPT 99205 E&M-NEW PATIENT-LVL V | $1,347.00 | $1,796.00 | — | 885% above | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OV NEW PT LVL 2 | $204.00 | $272.00 | — | 147% above | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 ANTI COAG-NEW PAT LEVEL 2 | $207.75 | $277.00 | — | 152% above | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 E&M-NEW PATIENT-LVL II | $243.00 | $324.00 | — | 194% above | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRIT THERAPY (97802) | $81.00 | $108.00 | — | 76% above | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTRTN TH INIT 15MIN | $116.25 | $155.00 | — | 153% above | 25% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL HM/WK SITE LOW | $446.25 | $595.00 | — | 115% above | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMP | $703.50 | $938.00 | — | 200% above | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMP | $624.00 | $832.00 | — | 217% above | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMP | $681.00 | $908.00 | — | 203% above | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY EA 15M | $303.75 | $405.00 | — | 214% above | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY EA 15M | $303.75 | $405.00 | — | 214% above | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THER EX EA 15 | $279.75 | $373.00 | — | 199% above | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPTC EXER EA 15 | $279.75 | $373.00 | — | 199% above | 25% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREV MED NP 18-39 YRS | $430.50 | $574.00 | — | 179% above | 25% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PREV MED NP 40-64YRS | $566.25 | $755.00 | — | 206% above | 25% |
| Preventive checkup, new patient aged 65 or older CPT 99387 PREV MED NP 65-OVER | $328.50 | $438.00 | — | 51% above | 25% |
| Preventive checkup, new patient aged 65 or older CPT 99387 PREV MED NO 65-OVER | $328.50 | $438.00 | — | 51% above | 25% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PREV MED EP 18-39 YRS | $382.50 | $510.00 | — | 155% above | 25% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 PREV MED EP 40-64YRS | $465.00 | $620.00 | — | 176% above | 25% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PREV MED EP 65-OVER | $546.75 | $729.00 | — | 186% above | 25% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHTX CRISIS-INIT 60MIN | $545.25 | $727.00 | — | 434% above | 25% |
| Psychotherapy session, 30 minutes CPT 90832 PSY THRPY 30 MIN PT | $260.25 | $347.00 | — | 35% above | 25% |
| Psychotherapy session, 45 minutes CPT 90834 PSY THRPY 45MIN PT | $507.00 | $676.00 | — | 137% above | 25% |
| Psychotherapy session, 60 minutes CPT 90837 PSY THRPY 60MIN PT | $270.75 | $361.00 | — | 17% above | 25% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMKE/TOBAC CNSL 3-10MIN | $81.00 | $108.00 | — | 98% above | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OV EST PT LVL 5 | $396.75 | $529.00 | — | 141% above | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ANTI COAG-ESTAB PT LEVEL 5 | $433.50 | $578.00 | — | 163% above | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 E&M-EST. PATIENT-LVL V | $1,401.00 | $1,868.00 | — | 749% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OV EST PT LVL 3 | $226.50 | $302.00 | — | 137% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ANTI COAG-ESTAB PT LEVEL 3 | $281.25 | $375.00 | — | 194% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 E&M-EST. PATIENT-LVL III | $345.00 | $460.00 | — | 261% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OCH HLTH VISIT-EST PT-LEVEL 3 | $348.75 | $465.00 | — | 265% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP BRIDGE ON DISCHARGE | $362.25 | $483.00 | — | 279% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OV EST PT LVL 4 | $300.75 | $401.00 | — | 155% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ANTI COAG-ESTAB PT LEVEL 4 | $345.75 | $461.00 | — | 193% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E&M-EST. PATIENT-LVL IV | $442.50 | $590.00 | — | 275% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OV EST PT LVL 2 | $199.50 | $266.00 | — | 170% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ANTI COAG-ESTAB PT LEVEL 2 | $215.25 | $287.00 | — | 192% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 E&M-EST. PATIENT-LVL II | $243.00 | $324.00 | — | 229% above | 25% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY | $247.50 | $330.00 | — | 20% above | 25% |
| Spirometry before and after a bronchodilator CPT 94060 PRE/POST SPIROMETER(AMB STAFF) | $707.25 | $943.00 | — | 73% above | 25% |
| Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM EVAL PRE/PS | $870.00 | $1,160.00 | — | 113% above | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPTC ACT EA 15 | $252.00 | $336.00 | — | 213% above | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTC ACT EA 15 | $252.00 | $336.00 | — | 213% above | 25% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC | $337.50 | $450.00 | — | 44% above | 25% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE INJ 0.5ML DO | $182.25 | $243.00 | — | 10% below | 25% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHTHERIA/PERTUSSIS INJ 0.5ML | $19.50 | $26.00 | — | 50% below | 25% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP/HEPATITIS-B/IPV INJ 0.5ML | $75.00 | $100.00 | — | 45% below | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUVAC IIV3>6MOS 0.5ML IJ | $44.25 | $59.00 | — | 40% above | 25% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 OPB HPV VACCINE 3 DOSE | $210.00 | $280.00 | — | 37% below | 25% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VAC 9-VAL | $826.50 | $1,102.00 | — | 147% above | 25% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE INACT 1440 | $123.75 | $165.00 | — | 5% above | 25% |
| Hepatitis A vaccine, adult dose CPT 90632 OBL HEP A - ADULT - IM | $229.50 | $306.00 | — | 95% above | 25% |
| Hepatitis A vaccine, adult dose CPT 90632 PCC HEP A-IM-ADULT | $681.00 | $908.00 | — | 478% above | 25% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 PCC HEP B-IM ADULT DOSE | $36.00 | $48.00 | — | 57% below | 25% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS-B VACCINE ADULT | $96.00 | $128.00 | — | 14% above | 25% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB VACCINE ACTHIB INJ 0.5ML | $47.25 | $63.00 | — | 13% above | 25% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VIRUS VAC HIGH-DOSE | $66.00 | $88.00 | — | 15% below | 25% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/RUBELLA INJ 0.5M | $129.75 | $173.00 | — | 5% below | 25% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 OBP MMR - LIVE - SUB-Q | $131.25 | $175.00 | — | 3% below | 25% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VAC (MENACTRA) I | $152.25 | $203.00 | — | 27% below | 25% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJ VACCINE | $201.00 | $268.00 | — | 3% below | 25% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL-TT VAC IM IJ | $227.25 | $303.00 | — | 4% below | 25% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL GROUP B VACCINE | $264.00 | $352.00 | — | 21% below | 25% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENING B VAC IM RCMB IJ | $365.25 | $487.00 | — | 9% above | 25% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL-13 CONJ VAC 0.5ML | $116.25 | $155.00 | — | 56% below | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCO20VACIJ! | $1,872.75 | $2,497.00 | — | 391% above | 25% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMONIA VACC 23VALENT >2 YRS | $67.50 | $90.00 | — | 57% below | 25% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM PER 1ML | $643.50 | $858.00 | — | 25% above | 25% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VACC RECOMBINANT IM 0.5ML | $200.25 | $267.00 | — | 1% above | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACCINE > 7YRS., IM INJ. | $54.00 | $72.00 | — | at median | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE > 7YRS.,IM INJ. | $63.75 | $85.00 | — | 12% below | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 OBP TDAP 7 YRS OR OLDER | $72.75 | $97.00 | — | at median | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 WCC TDAP 7 YRS OR OLDER | $91.50 | $122.00 | — | 26% above | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 OBL TDAP 7YRS OR OLDER | $100.50 | $134.00 | — | 39% above | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 L&D TDAP 7YRS OR OLDER | $100.50 | $134.00 | — | 39% above | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP-VACCINE-IM>7 YEARS | $131.25 | $175.00 | — | 81% above | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PNEUMOCOCCAL VACC ADMIN | $54.75 | $73.00 | — | 138% above | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 5W-IMMUNIZE ADMIN ID/IM/SUB-Q | $83.25 | $111.00 | — | 261% above | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADMIN SNGL/COMBO VAC | $87.00 | $116.00 | — | 278% above | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INFLUENZA VACC ADMIN | $87.00 | $116.00 | — | 278% above | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 5W-IMMUNIZE ADMIN EACH ADDL | $52.50 | $70.00 | — | 169% above | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMM ADM EA ADDL VACCINE | $97.50 | $130.00 | — | 399% above | 25% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://mrfs.hyvehealthcare.com/TenetHealth/272844632_vhs-sinai-grace-hospital-inc_standardcharges.json