Hospital Omaha, NE-IA

Methodist Jennie Edmundson Hospital

Listed in its price file as “Jennie Edmundson Memorial Hospital”.

Methodist Jennie Edmundson Hospital in Council Bluffs, IA publishes cash prices for 439 common procedures listed here, from its own machine-readable price file updated Feb 15, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Iowa median for 409 of 436 procedures and above it for 22. By typical cash price it ranks #1 of 90 Iowa hospitals and #2 of 14 hospitals in the Omaha, NE area, cheapest first. Select a procedure to compare it with other hospitals nearby.

933 East Pierce Street, Council Bluffs, IA 51503 Collected Sep 22, 2026 Source price file Check a bill from this hospital (712) 396-6000

Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 160047 · CMS hospital register NPI 1457448755

Financial assistance

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

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

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Abdominal CT scan without and with contrast CPT 74170 CT Exam	$1,086.60	$3,622.00	$339.62–$2,535.40	44% below	70%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Exam	$1,086.60	$3,622.00	—	—	70%
Abdominal X-ray, 2 views CPT 74019 RA Exam	$134.70	$449.00	$190.82–$314.30	46% below	70%
Abdominal X-ray, 2 views CPT 74019 Abdomen 2 View	$134.70	$449.00	$190.82–$314.30	46% below	70%
Abdominal X-ray, 2 views inpatient CPT 74019 Abdomen 2 View	$134.70	$449.00	—	—	70%
Abdominal X-ray, 2 views inpatient CPT 74019 RA Exam	$134.70	$449.00	—	—	70%
Ankle X-ray, complete, 3 or more views CPT 73610 SP Exam	$108.30	$361.00	$62.55–$252.70	52% below	70%
Ankle X-ray, complete, 3 or more views one side CPT 73610 MERA Exam	$108.30	$361.00	$62.55–$252.70	52% below	70%
Ankle X-ray, complete, 3 or more views one side CPT 73610 RA Exam	$108.30	$361.00	$62.55–$252.70	52% below	70%
Ankle X-ray, complete, 3 or more views one side CPT 73610 MERA Exam	$108.30	$361.00	$62.55–$252.70	52% below	70%
Ankle X-ray, complete, 3 or more views one side CPT 73610 RA Exam	$108.30	$361.00	$62.55–$252.70	52% below	70%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 SP Exam	$108.30	$361.00	—	—	70%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 RA Exam	$108.30	$361.00	—	—	70%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 RA Exam	$108.30	$361.00	—	—	70%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 MERA Exam	$108.30	$361.00	—	—	70%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 MERA Exam	$108.30	$361.00	—	—	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 WC-TCOM - Single Level	$67.50	$225.00	$95.63–$496.00	81% below	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Digital Exam Fingers or Toes	$74.40	$248.00	$105.40–$496.00	79% below	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 WC-Ankle-Bracheal Index (Ea Ankle) (JE)	$89.70	$299.00	$127.08–$496.00	75% below	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Vascular Acquisition	$116.70	$389.00	$165.32–$496.00	68% below	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 WC-TCOM - Single Level	$67.50	$225.00	—	—	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Digital Exam Fingers or Toes	$74.40	$248.00	—	—	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 WC-Ankle-Bracheal Index (Ea Ankle) (JE)	$89.70	$299.00	—	—	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Vascular Acquisition	$116.70	$389.00	—	—	70%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Exam	$570.60	$1,902.00	$203.22–$1,331.40	53% below	70%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Exam	$570.60	$1,902.00	$203.22–$1,331.40	53% below	70%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Exam	$570.60	$1,902.00	—	—	70%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Exam	$570.60	$1,902.00	—	—	70%
Barium swallow (esophagus X-ray with contrast) CPT 74220 MJFL Exam	$192.90	$643.00	$184.83–$450.10	47% below	70%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 MJFL Exam	$192.90	$643.00	—	—	70%
Bone scan, whole body (nuclear medicine) CPT 78306 MO Exam	$575.10	$1,917.00	$620.68–$1,341.90	53% below	70%
Bone scan, whole body (nuclear medicine) CPT 78306 Bone and/ or Joint Imag-Wh Body	$575.10	$1,917.00	$620.68–$1,341.90	53% below	70%
Bone scan, whole body (nuclear medicine) CPT 78306 Bone and/ or Joint Imag-SPECT	$880.50	$2,935.00	$620.68–$2,054.50	28% below	70%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 MO Exam	$575.10	$1,917.00	—	—	70%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone and/ or Joint Imag-Wh Body	$575.10	$1,917.00	—	—	70%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone and/ or Joint Imag-SPECT	$880.50	$2,935.00	—	—	70%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Exam	$90.90	$303.00	$128.78–$230.45	75% below	70%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Exam	$90.90	$303.00	$128.78–$230.45	75% below	70%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Exam	$90.90	$303.00	—	—	70%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Exam	$90.90	$303.00	—	—	70%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Exam	$90.90	$303.00	$128.78–$212.10	75% below	70%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 F 76642 Ultrasound breast unilat w/image doc limi	$90.90	$303.00	$128.78–$212.10	75% below	70%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Exam	$90.90	$303.00	$128.78–$212.10	75% below	70%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Exam	$90.90	$303.00	$128.78–$212.10	75% below	70%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Exam	$90.90	$303.00	—	—	70%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Exam	$90.90	$303.00	—	—	70%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Exam	$90.90	$303.00	—	—	70%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 F 76642 Ultrasound breast unilat w/image doc limi	$90.90	$303.00	—	—	70%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA Abd Pelvis	$1,684.80	$5,616.00	$443.74–$3,931.20	43% below	70%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Exam	$1,735.50	$5,785.00	$443.74–$4,049.50	42% below	70%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA Abd Pelvis	$1,684.80	$5,616.00	—	—	70%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Exam	$1,735.50	$5,785.00	—	—	70%
CT angiography (CTA) of the head CPT 70496 CT Exam	$964.80	$3,216.00	$339.62–$2,251.20	51% below	70%
CT angiography (CTA) of the head inpatient CPT 70496 CT Exam	$964.80	$3,216.00	—	—	70%
CT angiography (CTA) of the neck CPT 70498 CT Exam	$814.80	$2,716.00	$339.62–$1,901.20	61% below	70%
CT angiography (CTA) of the neck CPT 70498 CTA Neck	$936.90	$3,123.00	$339.62–$2,186.10	55% below	70%
CT angiography (CTA) of the neck inpatient CPT 70498 CT Exam	$814.80	$2,716.00	—	—	70%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA Neck	$936.90	$3,123.00	—	—	70%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest	$957.00	$3,190.00	$339.62–$2,233.00	55% below	70%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Exam	$991.50	$3,305.00	$339.62–$2,313.50	53% below	70%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest	$957.00	$3,190.00	—	—	70%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Exam	$991.50	$3,305.00	—	—	70%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA Exam	$826.50	$2,755.00	$339.62–$1,928.50	49% below	70%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA Exam	$826.50	$2,755.00	—	—	70%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 MECT Exam	$84.90	$283.00	$130.18–$1,119.00	17% below	70%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 MECT Exam	$84.90	$283.00	—	—	70%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 MECT Exam	$1,145.40	$3,818.00	$443.74–$2,672.60	56% below	70%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Exam	$1,145.40	$3,818.00	$443.74–$2,672.60	56% below	70%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 MECT Exam	$1,145.40	$3,818.00	—	—	70%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Exam	$1,145.40	$3,818.00	—	—	70%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 MECT Exam	$1,641.00	$5,470.00	$443.74–$3,829.00	49% below	70%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Exam	$1,675.20	$5,584.00	$443.74–$3,908.80	48% below	70%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd/Pelvis w/ Contrast	$1,675.20	$5,584.00	$443.74–$3,908.80	48% below	70%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 MECT Exam	$1,641.00	$5,470.00	—	—	70%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd/Pelvis w/ Contrast	$1,675.20	$5,584.00	—	—	70%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Exam	$1,675.20	$5,584.00	—	—	70%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Exam	$1,641.00	$5,470.00	$443.74–$3,829.00	52% below	70%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Exam	$1,641.00	$5,470.00	—	—	70%
CT scan of the abdomen with contrast CPT 74160 CT Wh Body w/Cont-Abd	$760.20	$2,534.00	$339.62–$1,773.80	54% below	70%
CT scan of the abdomen with contrast CPT 74160 CT Exam	$794.70	$2,649.00	$339.62–$1,854.30	52% below	70%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Wh Body w/Cont-Abd	$760.20	$2,534.00	—	—	70%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Exam	$794.70	$2,649.00	—	—	70%
CT scan of the abdomen without contrast CPT 74150 CT Wh Body w/o Cont-Abd	$652.80	$2,176.00	$203.22–$1,523.20	51% below	70%
CT scan of the abdomen without contrast CPT 74150 CT Exam	$652.80	$2,176.00	$203.22–$1,523.20	51% below	70%
CT scan of the abdomen without contrast CPT 74150 CT Abd w/o Contrast	$652.80	$2,176.00	$203.22–$1,523.20	51% below	70%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Wh Body w/o Cont-Abd	$652.80	$2,176.00	—	—	70%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Exam	$652.80	$2,176.00	—	—	70%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abd w/o Contrast	$652.80	$2,176.00	—	—	70%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Exam	$517.50	$1,725.00	$203.22–$1,207.50	60% below	70%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Exam	$517.50	$1,725.00	—	—	70%
CT scan of the head or brain, no contrast dye CPT 70450 CT Exam	$542.70	$1,809.00	$203.22–$1,266.30	60% below	70%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Exam	$542.70	$1,809.00	—	—	70%
CT scan of the head with contrast CPT 70460 CT Exam	$730.50	$2,435.00	$339.62–$1,704.50	51% below	70%
CT scan of the head with contrast inpatient CPT 70460 CT Exam	$730.50	$2,435.00	—	—	70%
CT scan of the head without and with contrast CPT 70470 CT Exam	$806.10	$2,687.00	$339.62–$1,880.90	55% below	70%
CT scan of the head without and with contrast inpatient CPT 70470 CT Exam	$806.10	$2,687.00	—	—	70%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Exam	$640.20	$2,134.00	$203.22–$1,493.80	58% below	70%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Exam	$640.20	$2,134.00	—	—	70%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Exam	$640.20	$2,134.00	$203.22–$1,493.80	57% below	70%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Exam	$640.20	$2,134.00	—	—	70%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/Contrast	$878.70	$2,929.00	$339.62–$2,050.30	49% below	70%
CT scan of the pelvis, with contrast dye CPT 72193 CT Exam	$878.70	$2,929.00	$339.62–$2,050.30	49% below	70%
CT scan of the pelvis, with contrast dye CPT 72193 CT Wh Body w/Cont-Pelv	$878.70	$2,929.00	$339.62–$2,050.30	49% below	70%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Exam	$878.70	$2,929.00	—	—	70%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Wh Body w/Cont-Pelv	$878.70	$2,929.00	—	—	70%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/Contrast	$878.70	$2,929.00	—	—	70%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Carotid Artery Duplex Bil	$405.00	$1,350.00	$423.00–$945.00	54% below	70%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Vascular Acquisition	$405.00	$1,350.00	$423.00–$945.00	54% below	70%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Carotid Artery Duplex Bil	$405.00	$1,350.00	—	—	70%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Vascular Acquisition	$405.00	$1,350.00	—	—	70%
Chest CT scan without and with contrast CPT 71270 CT Exam	$892.20	$2,974.00	$339.62–$2,081.80	53% below	70%
Chest CT scan without and with contrast inpatient CPT 71270 CT Exam	$892.20	$2,974.00	—	—	70%
Chest X-ray, 2 views CPT 71046 MJRA Exam	$108.00	$360.00	$153.00–$252.00	48% below	70%
Chest X-ray, 2 views CPT 71046 CXR Exam	$108.00	$360.00	$153.00–$252.00	48% below	70%
Chest X-ray, 2 views CPT 71046 RA Exam	$124.80	$416.00	$167.97–$291.20	40% below	70%
Chest X-ray, 2 views one side CPT 71046 MJRA Exam	$77.40	$258.00	$109.65–$190.48	63% below	70%
Chest X-ray, 2 views inpatient CPT 71046 CXR Exam	$108.00	$360.00	—	—	70%
Chest X-ray, 2 views inpatient CPT 71046 MJRA Exam	$108.00	$360.00	—	—	70%
Chest X-ray, 2 views inpatient CPT 71046 RA Exam	$124.80	$416.00	—	—	70%
Chest X-ray, 2 views inpatient one side CPT 71046 MJRA Exam	$77.40	$258.00	—	—	70%
Chest X-ray, single view CPT 71045 Chest Spec Views	$76.50	$255.00	$108.38–$190.48	54% below	70%
Chest X-ray, single view CPT 71045 MJRA Exam	$76.50	$255.00	$108.38–$190.48	54% below	70%
Chest X-ray, single view CPT 71045 RA Exam	$76.50	$255.00	$108.38–$190.48	54% below	70%
Chest X-ray, single view CPT 71045 CXR Exam	$77.40	$258.00	$109.65–$190.48	54% below	70%
Chest X-ray, single view CPT 71045 Chest 1View (Shunt Survey)	$77.40	$258.00	$109.65–$190.48	54% below	70%
Chest X-ray, single view CPT 71045 RADIOLOGIC EXAM CHEST SINGLE VIEW	$1,710.60	$5,702.00	$2,423.35–$3,991.40	920% above	70%
Chest X-ray, single view one side CPT 71045 MJRA Exam	$76.50	$255.00	$108.38–$190.48	54% below	70%
Chest X-ray, single view inpatient CPT 71045 RA Exam	$76.50	$255.00	—	—	70%
Chest X-ray, single view inpatient CPT 71045 MJRA Exam	$76.50	$255.00	—	—	70%
Chest X-ray, single view inpatient CPT 71045 Chest Spec Views	$76.50	$255.00	—	—	70%
Chest X-ray, single view inpatient CPT 71045 CXR Exam	$77.40	$258.00	—	—	70%
Chest X-ray, single view inpatient CPT 71045 Chest 1View (Shunt Survey)	$77.40	$258.00	—	—	70%
Chest X-ray, single view inpatient CPT 71045 RADIOLOGIC EXAM CHEST SINGLE VIEW	$1,710.60	$5,702.00	—	—	70%
Chest X-ray, single view inpatient one side CPT 71045 MJRA Exam	$76.50	$255.00	—	—	70%
Collarbone (clavicle) X-ray, complete CPT 73000 RA Exam	$82.20	$274.00	$53.40–$191.80	58% below	70%
Collarbone (clavicle) X-ray, complete one side CPT 73000 RA Exam	$82.20	$274.00	$53.40–$191.80	58% below	70%
Collarbone (clavicle) X-ray, complete one side CPT 73000 RA Exam	$82.20	$274.00	$53.40–$191.80	58% below	70%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 RA Exam	$82.20	$274.00	—	—	70%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 RA Exam	$82.20	$274.00	—	—	70%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 RA Exam	$82.20	$274.00	—	—	70%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 MUS Exam	$256.50	$855.00	$203.22–$598.50	58% below	70%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 MUS Exam	$256.50	$855.00	—	—	70%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA Exam	$180.90	$603.00	$88.03–$422.10	55% below	70%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA Exam	$180.90	$603.00	—	—	70%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB Ultrasound Pregnant Uterus w/Anatomic Exam Tran	$78.00	$260.00	$110.50–$513.63	88% below	70%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 MFM Ultrasound Pregnant Uterus w/Anatomic Exam Tra	$209.10	$697.00	$238.19–$513.63	68% below	70%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 MJUS Exam	$299.40	$998.00	$238.19–$698.60	53% below	70%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB Ultrasound Pregnant Uterus w/Anatomic Exam Tran	$78.00	$260.00	—	—	70%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 MFM Ultrasound Pregnant Uterus w/Anatomic Exam Tra	$209.10	$697.00	—	—	70%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 MJUS Exam	$299.40	$998.00	—	—	70%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Exam	$542.70	$1,809.00	$203.22–$1,266.30	61% below	70%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 MECT Exam	$659.70	$2,199.00	$203.22–$1,539.30	52% below	70%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Exam	$542.70	$1,809.00	—	—	70%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 MECT Exam	$659.70	$2,199.00	—	—	70%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Exam	$884.10	$2,947.00	$339.62–$2,062.90	51% below	70%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast	$884.10	$2,947.00	$339.62–$2,062.90	51% below	70%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Exam	$884.10	$2,947.00	—	—	70%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Contrast	$884.10	$2,947.00	—	—	70%
Diagnostic mammogram, both breasts both sides CPT 77066 Mammo Digital Bilat-Diag	$100.20	$334.00	$97.06–$242.04	—	70%
Diagnostic mammogram, both breasts CPT 77066 Mammo Diagnostic	$100.20	$334.00	$97.06–$242.04	71% below	70%
Diagnostic mammogram, both breasts CPT 77066 MM Exam	$100.20	$334.00	$97.06–$242.04	71% below	70%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Mammo Digital Bilat-Diag	$100.20	$334.00	—	—	70%
Diagnostic mammogram, both breasts inpatient CPT 77066 MM Exam	$100.20	$334.00	—	—	70%
Diagnostic mammogram, both breasts inpatient CPT 77066 Mammo Diagnostic	$100.20	$334.00	—	—	70%
Diagnostic mammogram, one breast one side CPT 77065 MM Exam	$81.00	$270.00	$76.14–$189.00	72% below	70%
Diagnostic mammogram, one breast one side CPT 77065 MM Exam	$81.00	$270.00	$76.14–$189.00	72% below	70%
Diagnostic mammogram, one breast one side CPT 77065 Mammo Unilat Lt	$81.00	$270.00	$76.14–$189.00	72% below	70%
Diagnostic mammogram, one breast one side CPT 77065 Mammo Unilat Rt	$81.00	$270.00	$76.14–$189.00	72% below	70%
Diagnostic mammogram, one breast one side CPT 77065 Mammo Digital Unilat Rt-Diag	$81.00	$270.00	$76.14–$189.00	72% below	70%
Diagnostic mammogram, one breast one side CPT 77065 Mammo Digital Unilat Lt-Diag	$81.00	$270.00	$76.14–$189.00	72% below	70%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM Exam	$81.00	$270.00	—	—	70%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Mammo Digital Unilat Lt-Diag	$81.00	$270.00	—	—	70%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Mammo Unilat Rt	$81.00	$270.00	—	—	70%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Mammo Unilat Lt	$81.00	$270.00	—	—	70%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Mammo Digital Unilat Rt-Diag	$81.00	$270.00	—	—	70%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM Exam	$81.00	$270.00	—	—	70%
Duplex ultrasound of the leg arteries, both legs CPT 93925 Native Artery Duplex Bil Lower	$243.00	$810.00	$344.25–$567.00	67% below	70%
Duplex ultrasound of the leg arteries, both legs CPT 93925 Vascular Acquisition	$243.00	$810.00	$344.25–$567.00	67% below	70%
Duplex ultrasound of the leg arteries, both legs CPT 93925 Bypass Graft Bil Lower	$243.00	$810.00	$344.25–$567.00	67% below	70%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 Bypass Graft Bil Lower	$243.00	$810.00	—	—	70%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 Native Artery Duplex Bil Lower	$243.00	$810.00	—	—	70%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 Vascular Acquisition	$243.00	$810.00	—	—	70%
Duplex ultrasound of the leg veins, both legs CPT 93970 Venous Duplex Bil Upper or Lower	$344.70	$1,149.00	$423.00–$804.30	59% below	70%
Duplex ultrasound of the leg veins, both legs CPT 93970 Reflux Exam w Perforator Bil	$344.70	$1,149.00	$466.42–$1,871.00	59% below	70%
Duplex ultrasound of the leg veins, both legs CPT 93970 Vein Mapping Bil Upper or Lower	$344.70	$1,149.00	$423.00–$804.30	59% below	70%
Duplex ultrasound of the leg veins, both legs CPT 93970 Vascular Acquisition	$344.70	$1,149.00	$423.00–$804.30	59% below	70%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Vascular Acquisition	$344.70	$1,149.00	—	—	70%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Reflux Exam w Perforator Bil	$344.70	$1,149.00	—	—	70%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Venous Duplex Bil Upper or Lower	$344.70	$1,149.00	—	—	70%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Vein Mapping Bil Upper or Lower	$344.70	$1,149.00	—	—	70%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo w Doppler resting w Contrast	$614.70	$2,049.00	$468.45–$1,434.30	60% below	70%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo w Doppler resting	$614.70	$2,049.00	$468.45–$1,434.30	60% below	70%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 MWH Acquisition	$684.30	$2,281.00	$468.45–$1,596.70	55% below	70%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo 2D P/D w color Doppler Echo	$684.30	$2,281.00	$468.45–$1,596.70	55% below	70%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TTHRC R-T 2D W-WOM-MODE COMPL SPECANDCOLR D	$2,285.70	$7,619.00	$468.45–$5,333.30	50% above	70%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo w Doppler resting	$614.70	$2,049.00	—	—	70%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo w Doppler resting w Contrast	$614.70	$2,049.00	—	—	70%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 MWH Acquisition	$684.30	$2,281.00	—	—	70%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo 2D P/D w color Doppler Echo	$684.30	$2,281.00	—	—	70%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO TTHRC R-T 2D W-WOM-MODE COMPL SPECANDCOLR D	$2,285.70	$7,619.00	—	—	70%
Elbow X-ray, 2 views one side CPT 73070 RA Exam	$79.50	$265.00	$53.40–$190.48	52% below	70%
Elbow X-ray, 2 views one side CPT 73070 RA Exam	$79.50	$265.00	$53.40–$190.48	52% below	70%
Elbow X-ray, 2 views inpatient one side CPT 73070 RA Exam	$79.50	$265.00	—	—	70%
Elbow X-ray, 2 views inpatient one side CPT 73070 RA Exam	$79.50	$265.00	—	—	70%
Elbow X-ray, complete, 3 or more views one side CPT 73080 RA Exam	$108.30	$361.00	$62.55–$252.70	50% below	70%
Elbow X-ray, complete, 3 or more views one side CPT 73080 RA Exam	$108.30	$361.00	$62.55–$252.70	50% below	70%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 RA Exam	$108.30	$361.00	—	—	70%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 RA Exam	$108.30	$361.00	—	—	70%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Exam	$676.50	$2,255.00	$203.22–$1,578.50	49% below	70%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Exam	$676.50	$2,255.00	—	—	70%
Facial bones X-ray, complete, 3 or more views CPT 70150 RA Exam	$140.70	$469.00	$78.85–$328.30	48% below	70%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 RA Exam	$140.70	$469.00	—	—	70%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 RA Exam	$108.30	$361.00	$48.31–$252.70	46% below	70%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 RA Exam	$108.30	$361.00	$48.31–$252.70	46% below	70%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 RA Exam	$108.30	$361.00	—	—	70%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 RA Exam	$108.30	$361.00	—	—	70%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 OLMS2 Exam	$683.10	$2,277.00	$762.36–$1,593.90	43% below	70%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 OLMS2 Exam	$683.10	$2,277.00	—	—	70%
Hand X-ray, 2 views one side CPT 73120 RA Exam	$92.10	$307.00	$49.31–$230.45	45% below	70%
Hand X-ray, 2 views one side CPT 73120 RA Exam	$92.10	$307.00	$49.31–$230.45	45% below	70%
Hand X-ray, 2 views inpatient one side CPT 73120 RA Exam	$92.10	$307.00	—	—	70%
Hand X-ray, 2 views inpatient one side CPT 73120 RA Exam	$92.10	$307.00	—	—	70%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 RA Exam	$77.40	$258.00	$52.37–$190.48	54% below	70%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 RA Exam	$77.40	$258.00	$52.37–$190.48	54% below	70%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 RA Exam	$77.40	$258.00	—	—	70%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 RA Exam	$77.40	$258.00	—	—	70%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SL-Home Sleep Test	$776.10	$2,587.00	$307.08–$2,591.00	29% above	70%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SL-Home Sleep Test	$776.10	$2,587.00	—	—	70%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SL-All Night Polysomnogram w CPAP	$1,237.80	$4,126.00	$1,502.75–$2,888.20	61% below	70%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SL-All Night Polysomnogram w CPAP	$1,237.80	$4,126.00	—	—	70%
Knee X-ray, 3 views one side CPT 73562 RA Exam	$132.00	$440.00	$68.67–$308.00	42% below	70%
Knee X-ray, 3 views one side CPT 73562 RA Exam	$132.00	$440.00	$68.67–$308.00	42% below	70%
Knee X-ray, 3 views inpatient one side CPT 73562 RA Exam	$132.00	$440.00	—	—	70%
Knee X-ray, 3 views inpatient one side CPT 73562 RA Exam	$132.00	$440.00	—	—	70%
Knee X-ray, complete, 4 or more views one side CPT 73564 RA Exam	$111.00	$370.00	$78.85–$259.00	60% below	70%
Knee X-ray, complete, 4 or more views one side CPT 73564 RA Exam	$111.00	$370.00	$78.85–$259.00	60% below	70%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 RA Exam	$111.00	$370.00	—	—	70%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 RA Exam	$111.00	$370.00	—	—	70%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Exam	$608.10	$2,027.00	$203.22–$1,418.90	54% below	70%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Exam	$608.10	$2,027.00	$203.22–$1,418.90	54% below	70%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Exam	$608.10	$2,027.00	—	—	70%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Exam	$608.10	$2,027.00	—	—	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Ultrasound Abdominal Limited-76705	$132.90	$443.00	$177.68–$310.10	72% below	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 MFM US Abdominal Limited	$132.90	$443.00	$177.68–$310.10	72% below	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Exam	$146.10	$487.00	$177.68–$340.90	69% below	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Ultrasound Abdominal Limited	$227.40	$758.00	$177.68–$530.60	52% below	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 MFM US Abdominal Limited	$132.90	$443.00	—	—	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Ultrasound Abdominal Limited-76705	$132.90	$443.00	—	—	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Exam	$146.10	$487.00	—	—	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Ultrasound Abdominal Limited	$227.40	$758.00	—	—	70%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 F 76882 ULTRASOUND EXTREMITY NON-VASCULAR LIMITED	$96.30	$321.00	$31.98–$230.45	73% below	70%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 SP Exam	$228.30	$761.00	$31.98–$532.70	35% below	70%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Exam	$228.30	$761.00	$31.98–$532.70	35% below	70%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Extremity Non Vascular	$228.30	$761.00	$31.98–$532.70	35% below	70%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Exam	$228.30	$761.00	$31.98–$532.70	35% below	70%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Exam	$228.30	$761.00	$31.98–$532.70	35% below	70%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 F 76882 ULTRASOUND EXTREMITY NON-VASCULAR LIMITED	$96.30	$321.00	—	—	70%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 SP Exam	$228.30	$761.00	—	—	70%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Extremity Non Vascular	$228.30	$761.00	—	—	70%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Exam	$228.30	$761.00	—	—	70%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Exam	$228.30	$761.00	—	—	70%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Exam	$228.30	$761.00	—	—	70%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 MECT Exam	$542.70	$1,809.00	$203.22–$1,266.30	24% above	70%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 MECT Exam	$542.70	$1,809.00	—	—	70%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 RA Exam	$108.30	$361.00	$49.31–$252.70	45% below	70%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tibia/Fibula Lt	$108.30	$361.00	$49.31–$252.70	45% below	70%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tibia/Fibula Rt	$108.30	$361.00	$49.31–$252.70	45% below	70%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 RA Exam	$108.30	$361.00	$49.31–$252.70	45% below	70%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Tibia/Fibula Lt	$108.30	$361.00	—	—	70%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 RA Exam	$108.30	$361.00	—	—	70%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Tibia/Fibula Rt	$108.30	$361.00	—	—	70%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 RA Exam	$108.30	$361.00	—	—	70%
MR angiography (MRA) of the head without contrast CPT 70544 MRI Exam	$1,116.00	$3,720.00	$452.93–$2,604.00	51% below	70%
MR angiography (MRA) of the head without contrast CPT 70544 MEMRI Exam	$1,116.00	$3,720.00	$452.93–$2,604.00	51% below	70%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MEMRI Exam	$1,116.00	$3,720.00	—	—	70%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRI Exam	$1,116.00	$3,720.00	—	—	70%
MRI of both breasts, without and then with contrast dye CPT 77049 MMRI Exam	$1,039.50	$3,465.00	$466.26–$2,425.50	38% below	70%
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MMRI Exam	$1,039.50	$3,465.00	—	—	70%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Exam	$900.30	$3,001.00	$452.93–$2,100.70	60% below	70%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Exam	$900.30	$3,001.00	$452.93–$2,100.70	60% below	70%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Exam	$900.30	$3,001.00	—	—	70%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Exam	$900.30	$3,001.00	—	—	70%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Exam	$1,166.40	$3,888.00	$700.70–$2,721.60	64% below	70%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Exam	$1,166.40	$3,888.00	$700.70–$2,721.60	64% below	70%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Exam	$1,166.40	$3,888.00	—	—	70%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Exam	$1,166.40	$3,888.00	—	—	70%
MRI of the abdomen without contrast CPT 74181 MRIME Exam	$1,030.80	$3,436.00	$452.93–$2,405.20	50% below	70%
MRI of the abdomen without contrast CPT 74181 MRI Exam	$1,030.80	$3,436.00	$452.93–$2,405.20	50% below	70%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Exam	$1,030.80	$3,436.00	—	—	70%
MRI of the abdomen without contrast inpatient CPT 74181 MRIME Exam	$1,030.80	$3,436.00	—	—	70%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Exam	$1,436.10	$4,787.00	$700.70–$3,350.90	58% below	70%
MRI of the abdomen, without and then with contrast dye CPT 74183 MMRI Exam	$1,436.10	$4,787.00	$700.70–$3,350.90	58% below	70%
MRI of the abdomen, without and then with contrast dye CPT 74183 MEMRI Exam	$1,436.10	$4,787.00	$700.70–$3,350.90	58% below	70%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Exam	$1,436.10	$4,787.00	—	—	70%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MEMRI Exam	$1,436.10	$4,787.00	—	—	70%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MMRI Exam	$1,436.10	$4,787.00	—	—	70%
MRI of the brain, no contrast dye CPT 70551 MRI Exam	$900.30	$3,001.00	$452.93–$2,100.70	61% below	70%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Exam	$900.30	$3,001.00	—	—	70%
MRI of the brain, with and without contrast dye CPT 70553 MRI Exam	$1,455.30	$4,851.00	$700.70–$3,395.70	58% below	70%
MRI of the brain, with and without contrast dye CPT 70553 MMRI Exam	$1,455.30	$4,851.00	$700.70–$3,395.70	58% below	70%
MRI of the brain, with and without contrast dye CPT 70553 MRIME Exam	$1,455.30	$4,851.00	$700.70–$3,395.70	58% below	70%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Exam	$1,455.30	$4,851.00	—	—	70%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MMRI Exam	$1,455.30	$4,851.00	—	—	70%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRIME Exam	$1,455.30	$4,851.00	—	—	70%
MRI of the lower back, no contrast dye CPT 72148 MRI Exam	$900.30	$3,001.00	$452.93–$2,100.70	62% below	70%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Exam	$900.30	$3,001.00	—	—	70%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Exam	$1,455.30	$4,851.00	$700.70–$3,395.70	58% below	70%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Exam	$1,455.30	$4,851.00	—	—	70%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Exam	$1,033.50	$3,445.00	$452.93–$2,411.50	55% below	70%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Exam	$1,033.50	$3,445.00	—	—	70%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Exam	$1,241.40	$4,138.00	$700.70–$2,896.60	62% below	70%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Exam	$1,241.40	$4,138.00	—	—	70%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Exam	$900.30	$3,001.00	$452.93–$2,100.70	60% below	70%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Exam	$900.30	$3,001.00	—	—	70%
MRI of the pelvis without and with contrast CPT 72197 MRI Exam	$1,241.40	$4,138.00	$700.70–$2,896.60	62% below	70%
MRI of the pelvis without and with contrast CPT 72197 MRIME Exam	$1,344.60	$4,482.00	$700.70–$3,137.40	58% below	70%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Exam	$1,241.40	$4,138.00	—	—	70%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRIME Exam	$1,344.60	$4,482.00	—	—	70%
MRI of the pelvis, no contrast dye CPT 72195 MRIME Exam	$929.10	$3,097.00	$452.93–$2,167.90	55% below	70%
MRI of the pelvis, no contrast dye CPT 72195 MMRI Exam	$929.10	$3,097.00	$452.93–$2,167.90	55% below	70%
MRI of the pelvis, no contrast dye CPT 72195 MRI Exam	$929.10	$3,097.00	$452.93–$2,167.90	55% below	70%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Exam	$929.10	$3,097.00	—	—	70%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MMRI Exam	$929.10	$3,097.00	—	—	70%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRIME Exam	$929.10	$3,097.00	—	—	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Exam	$900.30	$3,001.00	$452.93–$2,100.70	59% below	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Exam	$900.30	$3,001.00	$452.93–$2,100.70	59% below	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Exam	$900.30	$3,001.00	—	—	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Exam	$900.30	$3,001.00	—	—	70%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 RA Exam	$128.70	$429.00	$80.91–$300.30	60% below	70%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 RA Exam	$128.70	$429.00	—	—	70%
Neck soft tissue CT scan with contrast CPT 70491 CT Exam	$884.10	$2,947.00	$339.62–$2,062.90	45% below	70%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Exam	$884.10	$2,947.00	—	—	70%
Neck soft tissue CT scan without contrast CPT 70490 CT Exam	$695.10	$2,317.00	$203.22–$1,621.90	45% below	70%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Exam	$695.10	$2,317.00	—	—	70%
Neck soft tissue X-ray CPT 70360 RA Exam	$100.50	$335.00	$54.40–$234.50	44% below	70%
Neck soft tissue X-ray inpatient CPT 70360 RA Exam	$100.50	$335.00	—	—	70%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Exam	$1,139.10	$3,797.00	$1,165.54–$2,976.45	59% below	70%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Stress Exam	$1,592.10	$5,307.00	$1,165.54–$3,714.90	43% below	70%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Exam	$1,139.10	$3,797.00	—	—	70%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Stress Exam	$1,592.10	$5,307.00	—	—	70%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET Exam	$2,413.50	$8,045.00	$2,505.91–$5,631.50	43% below	70%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET Exam	$2,413.50	$8,045.00	—	—	70%
Pelvic CT scan without contrast CPT 72192 CT Exam	$549.00	$1,830.00	$203.22–$1,281.00	57% below	70%
Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Cont	$632.10	$2,107.00	$203.22–$1,474.90	51% below	70%
Pelvic CT scan without contrast CPT 72192 CT Wh Body w/o Cont-Pelv	$632.10	$2,107.00	$203.22–$1,474.90	51% below	70%
Pelvic CT scan without contrast inpatient CPT 72192 CT Exam	$549.00	$1,830.00	—	—	70%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Cont	$632.10	$2,107.00	—	—	70%
Pelvic CT scan without contrast inpatient CPT 72192 CT Wh Body w/o Cont-Pelv	$632.10	$2,107.00	—	—	70%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Exam	$61.20	$204.00	$64.61–$230.45	83% below	70%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 MJUS Exam	$130.20	$434.00	$64.61–$303.80	63% below	70%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Ultrasound Pelvic (Non OB) ER-MD	$130.20	$434.00	$64.61–$303.80	63% below	70%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Exam	$61.20	$204.00	—	—	70%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Ultrasound Pelvic (Non OB) ER-MD	$130.20	$434.00	—	—	70%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 MJUS Exam	$130.20	$434.00	—	—	70%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Exam	$256.20	$854.00	$203.22–$597.80	53% below	70%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Exam	$256.20	$854.00	—	—	70%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound Pregnant Uterus after first trimester t	$98.70	$329.00	$139.82–$262.24	82% below	70%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 MFM Ultrasound Pregnant Uterus Transabdominal > Fi	$148.20	$494.00	$203.22–$345.80	73% below	70%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Yes - Ultrasound Level 1 Diag/Screen Charge	$259.80	$866.00	$203.22–$606.20	53% below	70%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound Level 1 Diagnostic/Screening - Labor Pr	$259.80	$866.00	$203.22–$606.20	53% below	70%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Exam	$263.40	$878.00	$203.22–$614.60	52% below	70%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound Level 1 Diagnostic/Screening	$263.40	$878.00	$203.22–$614.60	52% below	70%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ultrasound Pregnant Uterus after first trimester t	$98.70	$329.00	—	—	70%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 MFM Ultrasound Pregnant Uterus Transabdominal > Fi	$148.20	$494.00	—	—	70%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Yes - Ultrasound Level 1 Diag/Screen Charge	$259.80	$866.00	—	—	70%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ultrasound Level 1 Diagnostic/Screening - Labor Pr	$259.80	$866.00	—	—	70%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Exam	$263.40	$878.00	—	—	70%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ultrasound Level 1 Diagnostic/Screening	$263.40	$878.00	—	—	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ultrasound Pregrenant Uterus first trimester <14 w	$99.90	$333.00	$141.53–$233.10	79% below	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 MFM Ultrasound Pregnant Uterus First Trimester Sin	$146.10	$487.00	$203.22–$340.90	69% below	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Exam	$236.70	$789.00	$203.22–$552.30	49% below	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Ultrasound Pregrenant Uterus first trimester <14 w	$99.90	$333.00	—	—	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 MFM Ultrasound Pregnant Uterus First Trimester Sin	$146.10	$487.00	—	—	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Exam	$236.70	$789.00	—	—	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 MFM Ultrasound Pregnant Uterus Limited 1 or > Fetu	$142.20	$474.00	$147.11–$331.80	58% below	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Ultrasound Pregnant Uterus ER-MD	$142.20	$474.00	$147.11–$331.80	58% below	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 MJUS Exam	$142.20	$474.00	$147.11–$331.80	58% below	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 MJUS Exam	$142.20	$474.00	—	—	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 MFM Ultrasound Pregnant Uterus Limited 1 or > Fetu	$142.20	$474.00	—	—	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Ultrasound Pregnant Uterus ER-MD	$142.20	$474.00	—	—	70%
Rib X-ray, one side, 2 views one side CPT 71100 RA Exam	$102.00	$340.00	$53.40–$238.00	53% below	70%
Rib X-ray, one side, 2 views one side CPT 71100 RA Exam	$102.00	$340.00	$53.40–$238.00	53% below	70%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RA Exam	$102.00	$340.00	—	—	70%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RA Exam	$102.00	$340.00	—	—	70%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 MJRA Exam	$137.70	$459.00	$63.58–$321.30	52% below	70%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 MJRA Exam	$137.70	$459.00	$63.58–$321.30	52% below	70%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 MJRA Exam	$137.70	$459.00	—	—	70%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 MJRA Exam	$137.70	$459.00	—	—	70%
Screening mammogram, both breasts CPT 77067 JEMAM Exam	$44.40	$148.00	$62.90–$199.54	86% below	70%
Screening mammogram, both breasts CPT 77067 MM Exam	$100.20	$334.00	$80.03–$233.80	67% below	70%
Screening mammogram, both breasts inpatient CPT 77067 JEMAM Exam	$44.40	$148.00	—	—	70%
Screening mammogram, both breasts inpatient CPT 77067 MM Exam	$100.20	$334.00	—	—	70%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 RA Exam	$108.30	$361.00	$53.40–$252.70	52% below	70%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 RA Exam	$108.30	$361.00	$53.40–$252.70	52% below	70%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 RA Exam	$108.30	$361.00	—	—	70%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 RA Exam	$108.30	$361.00	—	—	70%
Sinus X-ray, complete, 3 or more views CPT 70220 RA Exam	$119.70	$399.00	$68.67–$279.30	52% below	70%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 RA Exam	$119.70	$399.00	—	—	70%
Skull X-ray, fewer than 4 views CPT 70250 Skull <4 Views-Shunt Survey	$81.30	$271.00	$64.61–$230.45	61% below	70%
Skull X-ray, fewer than 4 views CPT 70250 MCRA Exam	$81.30	$271.00	$64.61–$230.45	61% below	70%
Skull X-ray, fewer than 4 views CPT 70250 MJRA Exam	$81.30	$271.00	$64.61–$230.45	61% below	70%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Skull <4 Views-Shunt Survey	$81.30	$271.00	—	—	70%
Skull X-ray, fewer than 4 views inpatient CPT 70250 MJRA Exam	$81.30	$271.00	—	—	70%
Skull X-ray, fewer than 4 views inpatient CPT 70250 MCRA Exam	$81.30	$271.00	—	—	70%
Sleep study in a lab (polysomnography) CPT 95810 SL-All Night Polysomnogram	$1,237.80	$4,126.00	$1,426.97–$2,888.20	57% below	70%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SL-All Night Polysomnogram	$1,237.80	$4,126.00	—	—	70%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Echo Stress	$587.10	$1,957.00	$528.56–$1,369.90	60% below	70%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Echo Stress Dobutamine	$587.10	$1,957.00	$528.56–$1,369.90	60% below	70%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 JE Echo Exam	$587.10	$1,957.00	$528.56–$2,141.00	60% below	70%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 MWH Acquisition	$602.70	$2,009.00	$528.56–$1,406.30	59% below	70%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Echo Stress w Contrast	$602.70	$2,009.00	$528.56–$1,406.30	59% below	70%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Echo Stress	$587.10	$1,957.00	—	—	70%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Echo Stress Dobutamine	$587.10	$1,957.00	—	—	70%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 JE Echo Exam	$587.10	$1,957.00	—	—	70%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Echo Stress w Contrast	$602.70	$2,009.00	—	—	70%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 MWH Acquisition	$602.70	$2,009.00	—	—	70%
Swallow study (modified barium swallow, video X-ray) CPT 74230 MJFL Exam	$160.80	$536.00	$227.80–$385.13	61% below	70%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MJFL Exam	$160.80	$536.00	—	—	70%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 RA Exam	$108.30	$361.00	$153.43–$252.70	45% below	70%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 RA Exam	$108.30	$361.00	$153.43–$252.70	45% below	70%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 RA Exam	$108.30	$361.00	—	—	70%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 RA Exam	$108.30	$361.00	—	—	70%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Exam	$640.20	$2,134.00	$203.22–$1,493.80	54% below	70%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Exam	$640.20	$2,134.00	—	—	70%
Transvaginal pelvic ultrasound CPT 76830 Transvaginal ultrasound	$146.40	$488.00	$203.22–$341.60	72% below	70%
Transvaginal pelvic ultrasound CPT 76830 US Transvag	$266.10	$887.00	$203.22–$620.90	48% below	70%
Transvaginal pelvic ultrasound CPT 76830 MUS Exam	$266.10	$887.00	$203.22–$620.90	48% below	70%
Transvaginal pelvic ultrasound inpatient CPT 76830 Transvaginal ultrasound	$146.40	$488.00	—	—	70%
Transvaginal pelvic ultrasound inpatient CPT 76830 MUS Exam	$266.10	$887.00	—	—	70%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvag	$266.10	$887.00	—	—	70%
Transvaginal ultrasound during pregnancy CPT 76817 Ultrasound Pregnant Uterus Transvaginal ER-MD	$117.30	$391.00	$166.18–$273.70	74% below	70%
Transvaginal ultrasound during pregnancy CPT 76817 MFM Ultrasound Pregnant Uterus Transvaginal	$117.30	$391.00	$166.18–$273.70	74% below	70%
Transvaginal ultrasound during pregnancy CPT 76817 US Exam	$256.50	$855.00	$168.53–$598.50	43% below	70%
Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal	$256.50	$855.00	$168.53–$598.50	43% below	70%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 MFM Ultrasound Pregnant Uterus Transvaginal	$117.30	$391.00	—	—	70%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Ultrasound Pregnant Uterus Transvaginal ER-MD	$117.30	$391.00	—	—	70%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal	$256.50	$855.00	—	—	70%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Exam	$256.50	$855.00	—	—	70%
Ultrasound of the abdomen, complete CPT 76700 US Exam	$256.50	$855.00	$203.22–$598.50	63% below	70%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Exam	$256.50	$855.00	—	—	70%
Ultrasound of the scrotum and testicles CPT 76870 US Exam	$256.20	$854.00	$100.27–$597.80	51% below	70%
Ultrasound of the scrotum and testicles CPT 76870 MJUS Exam	$256.50	$855.00	$100.27–$598.50	51% below	70%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Exam	$256.20	$854.00	—	—	70%
Ultrasound of the scrotum and testicles inpatient CPT 76870 MJUS Exam	$256.50	$855.00	—	—	70%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 F 76536 Ultrasound soft tissues of head and neck	$96.30	$321.00	$136.43–$253.09	79% below	70%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Exam	$256.50	$855.00	$203.22–$598.50	45% below	70%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 F 76536 Ultrasound soft tissues of head and neck	$96.30	$321.00	—	—	70%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Exam	$256.50	$855.00	—	—	70%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL Exam	$244.80	$816.00	$222.52–$571.20	43% below	70%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL Exam	$244.80	$816.00	—	—	70%
Upper arm X-ray (humerus), 2 views one side CPT 73060 RA Exam	$108.30	$361.00	$49.31–$252.70	45% below	70%
Upper arm X-ray (humerus), 2 views one side CPT 73060 RA Exam	$108.30	$361.00	$49.31–$252.70	45% below	70%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 RA Exam	$108.30	$361.00	—	—	70%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 RA Exam	$108.30	$361.00	—	—	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Vascular Acquisition	$280.80	$936.00	$283.63–$655.20	57% below	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Vein Mapping Unilat Upper or Lower	$268.50	$895.00	$283.63–$626.50	59% below	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Reflux Exam w Perforator Unilat	$268.50	$895.00	$283.63–$626.50	59% below	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Unilat Upper or Lower	$268.50	$895.00	$283.63–$1,871.00	59% below	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Vascular Acquisition	$280.80	$936.00	—	—	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Vein Mapping Unilat Upper or Lower	$268.50	$895.00	—	—	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Reflux Exam w Perforator Unilat	$268.50	$895.00	—	—	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Duplex Unilat Upper or Lower	$268.50	$895.00	—	—	70%
Wrist X-ray, 2 views CPT 73100 SP Exam	$94.50	$315.00	$57.46–$220.50	50% below	70%
Wrist X-ray, 2 views one side CPT 73100 MERA Exam	$94.50	$315.00	$57.46–$220.50	50% below	70%
Wrist X-ray, 2 views one side CPT 73100 RA Exam	$94.50	$315.00	$57.46–$220.50	50% below	70%
Wrist X-ray, 2 views one side CPT 73100 MERA Exam	$94.50	$315.00	$57.46–$220.50	50% below	70%
Wrist X-ray, 2 views one side CPT 73100 RA Exam	$94.50	$315.00	$57.46–$220.50	50% below	70%
Wrist X-ray, 2 views inpatient CPT 73100 SP Exam	$94.50	$315.00	—	—	70%
Wrist X-ray, 2 views inpatient one side CPT 73100 RA Exam	$94.50	$315.00	—	—	70%
Wrist X-ray, 2 views inpatient one side CPT 73100 MERA Exam	$94.50	$315.00	—	—	70%
Wrist X-ray, 2 views inpatient one side CPT 73100 MERA Exam	$94.50	$315.00	—	—	70%
Wrist X-ray, 2 views inpatient one side CPT 73100 RA Exam	$94.50	$315.00	—	—	70%
Wrist X-ray, complete, 3 or more views one side CPT 73110 SP Exam	$108.30	$361.00	$73.76–$252.70	51% below	70%
Wrist X-ray, complete, 3 or more views one side CPT 73110 MERA Exam	$108.30	$361.00	$73.76–$252.70	51% below	70%
Wrist X-ray, complete, 3 or more views one side CPT 73110 SP Exam	$108.30	$361.00	$73.76–$252.70	51% below	70%
Wrist X-ray, complete, 3 or more views one side CPT 73110 RA Exam	$108.30	$361.00	$73.76–$252.70	51% below	70%
Wrist X-ray, complete, 3 or more views one side CPT 73110 RA Exam	$108.30	$361.00	$73.76–$252.70	51% below	70%
Wrist X-ray, complete, 3 or more views one side CPT 73110 MERA Exam	$108.30	$361.00	$73.76–$252.70	51% below	70%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 RA Exam	$108.30	$361.00	—	—	70%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 SP Exam	$108.30	$361.00	—	—	70%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 MERA Exam	$108.30	$361.00	—	—	70%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 MERA Exam	$108.30	$361.00	—	—	70%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 RA Exam	$108.30	$361.00	—	—	70%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 SP Exam	$108.30	$361.00	—	—	70%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RA Exam	$91.50	$305.00	$129.63–$213.50	56% below	70%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RA Exam	$91.50	$305.00	$129.63–$213.50	56% below	70%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RA Exam	$91.50	$305.00	—	—	70%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RA Exam	$91.50	$305.00	—	—	70%
X-ray of the abdomen, 1 view CPT 74018 MERA Exam	$92.70	$309.00	$131.32–$216.30	48% below	70%
X-ray of the abdomen, 1 view CPT 74018 Abd (Shunt Survey)	$92.70	$309.00	$131.32–$216.30	48% below	70%
X-ray of the abdomen, 1 view CPT 74018 RA Exam	$92.70	$309.00	$131.32–$216.30	48% below	70%
X-ray of the abdomen, 1 view CPT 74018 Abdomen	$92.70	$309.00	$131.32–$216.30	48% below	70%
X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen	$92.70	$309.00	—	—	70%
X-ray of the abdomen, 1 view inpatient CPT 74018 RA Exam	$92.70	$309.00	—	—	70%
X-ray of the abdomen, 1 view inpatient CPT 74018 Abd (Shunt Survey)	$92.70	$309.00	—	—	70%
X-ray of the abdomen, 1 view inpatient CPT 74018 MERA Exam	$92.70	$309.00	—	—	70%
X-ray of the ankle, 2 views CPT 73600 SP Exam	$75.00	$250.00	$52.37–$190.48	56% below	70%
X-ray of the ankle, 2 views one side CPT 73600 MERA Exam	$75.00	$250.00	$52.37–$190.48	56% below	70%
X-ray of the ankle, 2 views one side CPT 73600 RA Exam	$75.00	$250.00	$52.37–$190.48	56% below	70%
X-ray of the ankle, 2 views one side CPT 73600 MERA Exam	$75.00	$250.00	$52.37–$190.48	56% below	70%
X-ray of the ankle, 2 views one side CPT 73600 RA Exam	$75.00	$250.00	$52.37–$190.48	56% below	70%
X-ray of the ankle, 2 views inpatient CPT 73600 SP Exam	$75.00	$250.00	—	—	70%
X-ray of the ankle, 2 views inpatient one side CPT 73600 RA Exam	$75.00	$250.00	—	—	70%
X-ray of the ankle, 2 views inpatient one side CPT 73600 MERA Exam	$75.00	$250.00	—	—	70%
X-ray of the ankle, 2 views inpatient one side CPT 73600 RA Exam	$75.00	$250.00	—	—	70%
X-ray of the ankle, 2 views inpatient one side CPT 73600 MERA Exam	$75.00	$250.00	—	—	70%
X-ray of the finger(s), 2 or more views CPT 73140 MERA Exam	$106.20	$354.00	$67.64–$247.80	37% below	70%
X-ray of the finger(s), 2 or more views CPT 73140 SP Exam	$106.20	$354.00	$67.64–$247.80	37% below	70%
X-ray of the finger(s), 2 or more views one side CPT 73140 RA Exam	$106.20	$354.00	$67.64–$247.80	37% below	70%
X-ray of the finger(s), 2 or more views one side CPT 73140 RA Exam	$106.20	$354.00	$67.64–$247.80	37% below	70%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 SP Exam	$106.20	$354.00	—	—	70%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 MERA Exam	$106.20	$354.00	—	—	70%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 RA Exam	$106.20	$354.00	—	—	70%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 RA Exam	$106.20	$354.00	—	—	70%
X-ray of the foot, 2 views one side CPT 73620 RA Exam	$75.00	$250.00	$50.34–$190.48	55% below	70%
X-ray of the foot, 2 views one side CPT 73620 RA Exam	$75.00	$250.00	$50.34–$190.48	55% below	70%
X-ray of the foot, 2 views one side CPT 73620 Foot 2 View Lt	$75.00	$250.00	$50.34–$190.48	55% below	70%
X-ray of the foot, 2 views one side CPT 73620 Foot 2 View Rt	$75.00	$250.00	$50.34–$190.48	55% below	70%
X-ray of the foot, 2 views inpatient one side CPT 73620 Foot 2 View Rt	$75.00	$250.00	—	—	70%
X-ray of the foot, 2 views inpatient one side CPT 73620 RA Exam	$75.00	$250.00	—	—	70%
X-ray of the foot, 2 views inpatient one side CPT 73620 RA Exam	$75.00	$250.00	—	—	70%
X-ray of the foot, 2 views inpatient one side CPT 73620 Foot 2 View Lt	$75.00	$250.00	—	—	70%
X-ray of the foot, complete, 3 or more views one side CPT 73630 RA Exam	$94.20	$314.00	$57.46–$219.80	57% below	70%
X-ray of the foot, complete, 3 or more views one side CPT 73630 RA Exam	$94.20	$314.00	$57.46–$219.80	57% below	70%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 RA Exam	$94.20	$314.00	—	—	70%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 RA Exam	$94.20	$314.00	—	—	70%
X-ray of the hand, 3 or more views one side CPT 73130 RA Exam	$108.30	$361.00	$60.52–$252.70	47% below	70%
X-ray of the hand, 3 or more views one side CPT 73130 RA Exam	$108.30	$361.00	$60.52–$252.70	47% below	70%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 RA Exam	$108.30	$361.00	—	—	70%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 RA Exam	$108.30	$361.00	—	—	70%
X-ray of the knee, 1 or 2 views one side CPT 73560 RA Exam	$108.30	$361.00	$55.43–$252.70	45% below	70%
X-ray of the knee, 1 or 2 views one side CPT 73560 RA Exam	$108.30	$361.00	$55.43–$252.70	45% below	70%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 RA Exam	$108.30	$361.00	—	—	70%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 RA Exam	$108.30	$361.00	—	—	70%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SP Exam	$128.70	$429.00	$65.61–$300.30	53% below	70%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RA Exam	$128.70	$429.00	$65.61–$300.30	53% below	70%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 RA Exam	$128.70	$429.00	—	—	70%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SP Exam	$128.70	$429.00	—	—	70%
X-ray of the lower back, 4 or more views CPT 72110 RA Exam	$89.70	$299.00	$92.09–$230.45	75% below	70%
X-ray of the lower back, 4 or more views inpatient CPT 72110 RA Exam	$89.70	$299.00	—	—	70%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 CHRA Exam	$112.20	$374.00	$55.43–$261.80	55% below	70%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 CHRA Exam	$112.20	$374.00	—	—	70%
X-ray of the nasal bones, 3 or more views CPT 70160 RA Exam	$111.90	$373.00	$66.64–$261.10	45% below	70%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 RA Exam	$111.90	$373.00	—	—	70%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RA Exam	$96.90	$323.00	$60.52–$226.10	61% below	70%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SP Exam	$96.90	$323.00	$60.52–$226.10	61% below	70%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RA Exam	$96.90	$323.00	—	—	70%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SP Exam	$96.90	$323.00	—	—	70%
X-ray of the pelvis, 1 or 2 views CPT 72170 RA Exam	$92.70	$309.00	$51.34–$230.45	52% below	70%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RA Exam	$92.70	$309.00	—	—	70%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RA Exam	$80.10	$267.00	$53.40–$190.48	63% below	70%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 RA Exam	$80.10	$267.00	—	—	70%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
ACTH blood test CPT 82024 Adrenocorticotropic Hormone Level - Random	$48.00	$160.00	$37.46–$160.00	72% below	70%
ACTH blood test inpatient CPT 82024 Adrenocorticotropic Hormone Level - Random	$48.00	$160.00	—	—	70%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$12.00	$40.00	$5.14–$28.00	72% below	70%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$12.00	$40.00	—	—	70%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase	$13.50	$45.00	$5.02–$31.50	68% below	70%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase	$13.50	$45.00	—	—	70%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel with Rflx to Hepatitis C Con	$156.90	$523.00	$46.20–$366.10	31% below	70%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel with Rflx to Hepatitis C Con	$156.90	$523.00	—	—	70%
Albumin blood test CPT 82040 Albumin Ref	$8.70	$29.00	$4.80–$21.02	80% below	70%
Albumin blood test CPT 82040 Albumin	$11.40	$38.00	$4.80–$26.60	73% below	70%
Albumin blood test CPT 82040 Testosterone Albumin	$11.40	$38.00	$4.80–$26.60	73% below	70%
Albumin blood test CPT 82040 ATX - Albumin - MH/WH	$11.40	$38.00	$4.80–$26.60	73% below	70%
Albumin blood test inpatient CPT 82040 Albumin Ref	$8.70	$29.00	—	—	70%
Albumin blood test inpatient CPT 82040 ATX - Albumin - MH/WH	$11.40	$38.00	—	—	70%
Albumin blood test inpatient CPT 82040 Testosterone Albumin	$11.40	$38.00	—	—	70%
Albumin blood test inpatient CPT 82040 Albumin	$11.40	$38.00	—	—	70%
Aldosterone blood test CPT 82088 Aldosterone	$19.80	$66.00	$30.36–$84.35	88% below	70%
Aldosterone blood test CPT 82088 Aldosterone Urine Timed	$24.60	$82.00	$37.72–$84.35	85% below	70%
Aldosterone blood test inpatient CPT 82088 Aldosterone	$19.80	$66.00	—	—	70%
Aldosterone blood test inpatient CPT 82088 Aldosterone Urine Timed	$24.60	$82.00	—	—	70%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$11.70	$39.00	$5.02–$27.30	73% below	70%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase Liver	$12.60	$42.00	$5.02–$29.40	71% below	70%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase	$11.70	$39.00	—	—	70%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase Liver	$12.60	$42.00	—	—	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Ragweed Common/Short	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Hazelnut with Component Reflex	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Milk (Cow) with Component Reflex	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Beef	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pork	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cat with Component Reflex	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Wheat with Component Reflex	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mold Alternaria Tenuis	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Kentucky Bluegrass	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Soybean	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Timothy Grass	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cockroach German	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Silver Birch	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dog with Component Reflex	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Maple/Box Elder	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Elm American	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Peanut with Component Reflex	$18.30	$61.00	$5.06–$42.70	49% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Drugs Penicillin V (minor) (99629)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Occupational Latex IgE Enhanced (99614)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens Food Cereal Profile (55350)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens Weed Profile 5 (55112)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Food Profile 9	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Grass Bermuda (55070)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Grass Johnson Grass (55047)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Fungi and Molds Penicillium notatum (5508	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen House Dust Greer (55091)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cow Hair and Dander	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Drugs Amoxicillin (55421)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Weed Giant Ragweed (55084)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Corn (55078)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Weed Western Ragweed (55035)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Weed False Ragweed (55014)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Tomato (55033)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Drugs Penicillin G (major) (99628)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Fungi and Molds Phoma betae (55390)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens Mold Profile (55125)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Parasite Ascaris (55213)	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Epidermals and Animal Proteins Pig (Swine	$18.90	$63.00	$5.06–$44.10	48% below	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Kentucky Bluegrass	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Timothy Grass	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dog with Component Reflex	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cockroach German	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Silver Birch	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Milk (Cow) with Component Reflex	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Hazelnut with Component Reflex	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Peanut with Component Reflex	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Ragweed Common/Short	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Elm American	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Maple/Box Elder	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Beef	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pork	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cat with Component Reflex	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Wheat with Component Reflex	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mold Alternaria Tenuis	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Soybean	$18.30	$61.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Drugs Penicillin V (minor) (99629)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Corn (55078)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Fungi and Molds Phoma betae (55390)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens Mold Profile (55125)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Food Profile 9	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens Weed Profile 5 (55112)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens Food Cereal Profile (55350)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Occupational Latex IgE Enhanced (99614)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Epidermals and Animal Proteins Pig (Swine	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Parasite Ascaris (55213)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Drugs Penicillin G (major) (99628)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Tomato (55033)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Weed False Ragweed (55014)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Weed Western Ragweed (55035)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Fungi and Molds Penicillium notatum (5508	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Grass Johnson Grass (55047)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Grass Bermuda (55070)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cow Hair and Dander	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen House Dust Greer (55091)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Drugs Amoxicillin (55421)	$18.90	$63.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Weed Giant Ragweed (55084)	$18.90	$63.00	—	—	70%
Alpha-fetoprotein (AFP) blood test CPT 82105 Quad Screen - AOS AFP	$10.50	$35.00	$16.10–$35.00	89% below	70%
Alpha-fetoprotein (AFP) blood test CPT 82105 Maternal Screen Alpha Fetoprotein	$21.90	$73.00	$16.27–$71.29	76% below	70%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP	$39.60	$132.00	$16.27–$92.40	57% below	70%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Quad Screen - AOS AFP	$10.50	$35.00	—	—	70%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Maternal Screen Alpha Fetoprotein	$21.90	$73.00	—	—	70%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP	$39.60	$132.00	—	—	70%
Ammonia blood test CPT 82140 Ammonia	$34.80	$116.00	$14.13–$81.20	61% below	70%
Ammonia blood test inpatient CPT 82140 Ammonia	$34.80	$116.00	—	—	70%
Amylase blood test CPT 82150 Pancreatic Amylase	$12.00	$40.00	$6.29–$28.00	78% below	70%
Amylase blood test CPT 82150 Amylase Total	$12.00	$40.00	$6.29–$28.00	78% below	70%
Amylase blood test CPT 82150 ARUP Amylase Body Fluid (0020506)	$20.40	$68.00	$6.29–$47.60	62% below	70%
Amylase blood test CPT 82150 Amylase Body Fluid	$24.30	$81.00	$6.29–$56.70	54% below	70%
Amylase blood test CPT 82150 Amylase Level	$24.30	$81.00	$6.29–$56.70	54% below	70%
Amylase blood test inpatient CPT 82150 Amylase Total	$12.00	$40.00	—	—	70%
Amylase blood test inpatient CPT 82150 Pancreatic Amylase	$12.00	$40.00	—	—	70%
Amylase blood test inpatient CPT 82150 ARUP Amylase Body Fluid (0020506)	$20.40	$68.00	—	—	70%
Amylase blood test inpatient CPT 82150 Amylase Level	$24.30	$81.00	—	—	70%
Amylase blood test inpatient CPT 82150 Amylase Body Fluid	$24.30	$81.00	—	—	70%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Antibodies IgG and Ig	$20.40	$68.00	$12.56–$55.02	74% below	70%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Antibodies IgG and Ig	$20.40	$68.00	—	—	70%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Oklahoma Medical Research Foundation - Lupus Scree	$10.20	$34.00	$11.73–$34.00	86% below	70%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA ELISA w/Rflx to ANA IFA	$18.90	$63.00	$11.73–$51.37	74% below	70%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Reflexive Panel	$18.90	$63.00	$11.73–$51.37	74% below	70%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Anti-Nuclear Antibody	$30.60	$102.00	$11.73–$71.40	58% below	70%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Oklahoma Medical Research Foundation - Lupus Scree	$10.20	$34.00	—	—	70%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA ELISA w/Rflx to ANA IFA	$18.90	$63.00	—	—	70%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Reflexive Panel	$18.90	$63.00	—	—	70%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Anti-Nuclear Antibody	$30.60	$102.00	—	—	70%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ProBNP	$125.40	$418.00	$38.08–$292.60	19% below	70%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ProBNP	$125.40	$418.00	—	—	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Routine	$32.10	$107.00	$8.36–$74.90	47% below	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture	$32.10	$107.00	$8.36–$74.90	47% below	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Pertussis Culture	$57.30	$191.00	$8.36–$133.70	5% below	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture	$32.10	$107.00	—	—	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Routine	$32.10	$107.00	—	—	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Pertussis Culture	$57.30	$191.00	—	—	70%
Basic metabolic panel (blood test) CPT 80048 Basic Panel	$48.90	$163.00	$8.21–$114.10	43% below	70%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Panel	$48.90	$163.00	—	—	70%
Bilirubin blood test, total CPT 82247 Total Bilirubin	$18.90	$63.00	$4.87–$44.10	59% below	70%
Bilirubin blood test, total CPT 82247 Bilirubin Total	$18.90	$63.00	$4.87–$44.10	59% below	70%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total	$18.90	$63.00	—	—	70%
Bilirubin blood test, total inpatient CPT 82247 Total Bilirubin	$18.90	$63.00	—	—	70%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Chg Gross/Micro Surg Ref Consult	$67.80	$226.00	$44.25–$158.20	62% below	70%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 UNMC Consult 88305	$67.80	$226.00	$44.25–$158.20	62% below	70%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Chg Gross/Micro Surg Ref Consult	$67.80	$226.00	—	—	70%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 UNMC Consult 88305	$67.80	$226.00	—	—	70%
Blood culture for bacteria CPT 87040 Culture Blood	$27.30	$91.00	$10.01–$63.70	70% below	70%
Blood culture for bacteria inpatient CPT 87040 Culture Blood	$27.30	$91.00	—	—	70%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture Charge	$8.40	$28.00	$8.57–$19.60	59% below	70%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Collection/Venipuncture	$8.70	$29.00	$9.15–$908.00	57% below	70%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture Charge	$8.40	$28.00	—	—	70%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood Collection/Venipuncture	$8.70	$29.00	—	—	70%
Blood glucose (sugar) test CPT 82947 GTT Fasting Glucose	$9.60	$32.00	$3.81–$22.40	74% below	70%
Blood glucose (sugar) test CPT 82947 Glucose Level	$9.60	$32.00	$3.81–$22.40	74% below	70%
Blood glucose (sugar) test inpatient CPT 82947 GTT Fasting Glucose	$9.60	$32.00	—	—	70%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level	$9.60	$32.00	—	—	70%
Blood lead test CPT 83655 Lead U	$7.80	$26.00	$11.75–$26.00	86% below	70%
Blood lead test CPT 83655 Lead Metal	$9.60	$32.00	$11.75–$32.00	83% below	70%
Blood lead test CPT 83655 Lead Whole Blood Industrial	$12.60	$42.00	$11.75–$42.00	77% below	70%
Blood lead test CPT 83655 Lead (0020098)	$19.20	$64.00	$11.75–$51.43	65% below	70%
Blood lead test CPT 83655 Lead Capillary (0020745)	$19.20	$64.00	$11.75–$51.43	65% below	70%
Blood lead test CPT 83655 Lead Urine Timed	$19.80	$66.00	$11.75–$51.43	64% below	70%
Blood lead test inpatient CPT 83655 Lead U	$7.80	$26.00	—	—	70%
Blood lead test inpatient CPT 83655 Lead Metal	$9.60	$32.00	—	—	70%
Blood lead test inpatient CPT 83655 Lead Whole Blood Industrial	$12.60	$42.00	—	—	70%
Blood lead test inpatient CPT 83655 Lead (0020098)	$19.20	$64.00	—	—	70%
Blood lead test inpatient CPT 83655 Lead Capillary (0020745)	$19.20	$64.00	—	—	70%
Blood lead test inpatient CPT 83655 Lead Urine Timed	$19.80	$66.00	—	—	70%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG Qual-PC/FH	$28.80	$96.00	$7.29–$67.20	54% below	70%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG Qual-PC/FH	$28.80	$96.00	—	—	70%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Quick Spin Backtype	$15.60	$52.00	$2.90–$36.40	73% below	70%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABORh Pt Charge	$16.80	$56.00	$2.90–$39.20	71% below	70%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABORh Patient	$37.80	$126.00	$2.90–$88.20	34% below	70%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Transplant Donor ABORh Type	$37.80	$126.00	$2.90–$88.20	34% below	70%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Rhogam Workup	$37.80	$126.00	$2.90–$88.20	34% below	70%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord Blood ABORh Interpretation	$37.80	$126.00	$2.90–$88.20	34% below	70%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Quick Spin Backtype	$15.60	$52.00	—	—	70%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABORh Pt Charge	$16.80	$56.00	—	—	70%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Transplant Donor ABORh Type	$37.80	$126.00	—	—	70%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Rhogam Workup	$37.80	$126.00	—	—	70%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABORh Patient	$37.80	$126.00	—	—	70%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord Blood ABORh Interpretation	$37.80	$126.00	—	—	70%
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen	$9.00	$30.00	$3.83–$21.00	78% below	70%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen	$9.00	$30.00	—	—	70%
C-peptide blood test CPT 84681 C-Peptide	$21.90	$73.00	$20.19–$73.00	79% below	70%
C-peptide blood test inpatient CPT 84681 C-Peptide	$21.90	$73.00	—	—	70%
C. difficile toxin gene test (stool PCR) CPT 87493 Positive - C Difficile PCR	$40.80	$136.00	$36.15–$136.00	65% below	70%
C. difficile toxin gene test (stool PCR) CPT 87493 Invalid - C Difficile PCR	$40.80	$136.00	$36.15–$136.00	65% below	70%
C. difficile toxin gene test (stool PCR) CPT 87493 Negative - C Difficile PCR	$40.80	$136.00	$36.15–$136.00	65% below	70%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Negative - C Difficile PCR	$40.80	$136.00	—	—	70%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Positive - C Difficile PCR	$40.80	$136.00	—	—	70%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Invalid - C Difficile PCR	$40.80	$136.00	—	—	70%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$41.70	$139.00	$20.19–$97.30	57% below	70%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$41.70	$139.00	—	—	70%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$47.40	$158.00	$20.19–$110.60	59% below	70%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$47.40	$158.00	—	—	70%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 (2019 Novel Coronavirus) by PCR	$35.70	$119.00	$49.77–$106.21	70% below	70%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 (2019 Novel Coronavirus) by PCR	$35.70	$119.00	—	—	70%
Calcium blood test, total CPT 82310 Calcium Level	$10.20	$34.00	$5.01–$23.80	76% below	70%
Calcium blood test, total inpatient CPT 82310 Calcium Level	$10.20	$34.00	—	—	70%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen	$45.00	$150.00	$18.39–$105.00	57% below	70%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen	$45.00	$150.00	—	—	70%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus IgG	$19.80	$66.00	$12.49–$46.20	68% below	70%
Chickenpox (varicella) immunity blood test CPT 86787 VZV Antibody IgM	$21.00	$70.00	$12.49–$49.00	66% below	70%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus IgG	$19.80	$66.00	—	—	70%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VZV Antibody IgM	$21.00	$70.00	—	—	70%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$49.80	$166.00	$12.99–$116.20	43% below	70%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$49.80	$166.00	—	—	70%
Complete blood count (CBC) with differential CPT 85025 UNMC CBC	$18.60	$62.00	$7.54–$43.40	72% below	70%
Complete blood count (CBC) with differential CPT 85025 Differntial (Auto)	$36.00	$120.00	$7.54–$84.00	45% below	70%
Complete blood count (CBC) with differential inpatient CPT 85025 UNMC CBC	$18.60	$62.00	—	—	70%
Complete blood count (CBC) with differential inpatient CPT 85025 Differntial (Auto)	$36.00	$120.00	—	—	70%
Complete blood count (CBC), no differential CPT 85027 Hemogram Charge	$27.00	$90.00	$6.28–$63.00	45% below	70%
Complete blood count (CBC), no differential CPT 85027 Manual Diff - Diff Type	$27.00	$90.00	$6.28–$63.00	45% below	70%
Complete blood count (CBC), no differential CPT 85027 Hemogram	$27.00	$90.00	$6.28–$63.00	45% below	70%
Complete blood count (CBC), no differential CPT 85027 Cellavision Diff - Diff Type	$27.00	$90.00	$6.28–$63.00	45% below	70%
Complete blood count (CBC), no differential inpatient CPT 85027 Hemogram Charge	$27.00	$90.00	—	—	70%
Complete blood count (CBC), no differential inpatient CPT 85027 Manual Diff - Diff Type	$27.00	$90.00	—	—	70%
Complete blood count (CBC), no differential inpatient CPT 85027 Hemogram	$27.00	$90.00	—	—	70%
Complete blood count (CBC), no differential inpatient CPT 85027 Cellavision Diff - Diff Type	$27.00	$90.00	—	—	70%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel	$60.90	$203.00	$10.24–$142.10	51% below	70%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel	$60.90	$203.00	—	—	70%
Cortisol blood test, total CPT 82533 Cortisol by LC-MS/MS Salivary	$30.60	$102.00	$15.81–$71.40	69% below	70%
Cortisol blood test, total CPT 82533 Cortisol Baseline	$40.50	$135.00	$15.81–$94.50	58% below	70%
Cortisol blood test, total CPT 82533 Cortisol 30 Min	$40.50	$135.00	$15.81–$94.50	58% below	70%
Cortisol blood test, total CPT 82533 Cortisol Dexamethasone Suppression	$40.50	$135.00	$15.81–$94.50	58% below	70%
Cortisol blood test, total CPT 82533 Cortisol Level	$40.50	$135.00	$15.81–$94.50	58% below	70%
Cortisol blood test, total CPT 82533 Cortisol 60 Min	$40.50	$135.00	$15.81–$94.50	58% below	70%
Cortisol blood test, total inpatient CPT 82533 Cortisol by LC-MS/MS Salivary	$30.60	$102.00	—	—	70%
Cortisol blood test, total inpatient CPT 82533 Cortisol 30 Min	$40.50	$135.00	—	—	70%
Cortisol blood test, total inpatient CPT 82533 Cortisol Baseline	$40.50	$135.00	—	—	70%
Cortisol blood test, total inpatient CPT 82533 Cortisol 60 Min	$40.50	$135.00	—	—	70%
Cortisol blood test, total inpatient CPT 82533 Cortisol Level	$40.50	$135.00	—	—	70%
Cortisol blood test, total inpatient CPT 82533 Cortisol Dexamethasone Suppression	$40.50	$135.00	—	—	70%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase Total Ref	$13.80	$46.00	$6.31–$32.20	75% below	70%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase	$24.30	$81.00	$6.31–$56.70	56% below	70%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase Total Ref	$13.80	$46.00	—	—	70%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase	$24.30	$81.00	—	—	70%
Creatinine blood test CPT 82565 Creatinine Nurse Collect - MH/WH/JE	$12.60	$42.00	$4.97–$29.40	70% below	70%
Creatinine blood test CPT 82565 POC Creat - JE	$12.60	$42.00	$4.97–$29.40	70% below	70%
Creatinine blood test CPT 82565 Creatinine	$12.60	$42.00	$4.97–$29.40	70% below	70%
Creatinine blood test inpatient CPT 82565 Creatinine	$12.60	$42.00	—	—	70%
Creatinine blood test inpatient CPT 82565 POC Creat - JE	$12.60	$42.00	—	—	70%
Creatinine blood test inpatient CPT 82565 Creatinine Nurse Collect - MH/WH/JE	$12.60	$42.00	—	—	70%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Antibodies IgG and IgM	$40.20	$134.00	$13.96–$93.80	40% below	70%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Antibody IgG	$40.20	$134.00	$13.96–$93.80	40% below	70%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Antibody IgG	$40.20	$134.00	—	—	70%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Antibodies IgG and IgM	$40.20	$134.00	—	—	70%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer - MH/WH/JE	$26.40	$88.00	$9.87–$61.60	69% below	70%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer - MH/WH/JE	$26.40	$88.00	—	—	70%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate	$45.60	$152.00	$21.56–$106.40	59% below	70%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone Sulfate	$45.60	$152.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Cannabioids-THC	$21.90	$73.00	$33.58–$128.63	84% below	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Opiates Scr Rflx to Quant Urine	$22.20	$74.00	$34.04–$128.63	83% below	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Meconium - JE	$66.90	$223.00	$60.28–$156.10	50% below	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Toxicology Screen DAU - MH/WH/JE	$130.50	$435.00	$60.28–$304.50	2% below	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cannabioids-THC	$21.90	$73.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Opiates Scr Rflx to Quant Urine	$22.20	$74.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Meconium - JE	$66.90	$223.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Toxicology Screen DAU - MH/WH/JE	$130.50	$435.00	—	—	70%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolytes	$26.10	$87.00	$6.80–$60.90	66% below	70%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolytes	$26.10	$87.00	—	—	70%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Viral Capsid Antigen IgG	$17.70	$59.00	$17.60–$41.30	75% below	70%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Viral Capsid Antigen IgM	$17.70	$59.00	$17.60–$41.30	75% below	70%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Viral Capsid Antigen IgM	$17.70	$59.00	—	—	70%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Viral Capsid Antigen IgG	$17.70	$59.00	—	—	70%
Estradiol blood test CPT 82670 Estradiol Level	$57.90	$193.00	$27.10–$135.10	54% below	70%
Estradiol blood test inpatient CPT 82670 Estradiol Level	$57.90	$193.00	—	—	70%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone	$39.30	$131.00	$18.02–$91.70	62% below	70%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone	$39.30	$131.00	—	—	70%
Fecal calprotectin (stool inflammation test) CPT 83993 Fecal Calprotectin	$40.20	$134.00	$19.04–$93.80	76% below	70%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Fecal Calprotectin	$40.20	$134.00	—	—	70%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$50.40	$168.00	$13.22–$117.60	45% below	70%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$50.40	$168.00	—	—	70%
Fibrinogen blood test CPT 85384 Fibrinogen Level	$31.80	$106.00	$9.43–$74.20	52% below	70%
Fibrinogen blood test CPT 85384 Fibrinogen Leve l- MH/WH/JE	$31.80	$106.00	$9.43–$74.20	52% below	70%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen Level	$31.80	$106.00	—	—	70%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen Leve l- MH/WH/JE	$31.80	$106.00	—	—	70%
Folate (folic acid) blood test CPT 82746 Folate	$30.90	$103.00	$14.26–$72.10	66% below	70%
Folate (folic acid) blood test inpatient CPT 82746 Folate	$30.90	$103.00	—	—	70%
Free T3 thyroid hormone test CPT 84481 T3 Free	$39.30	$131.00	$16.43–$91.70	62% below	70%
Free T3 thyroid hormone test inpatient CPT 84481 T3 Free	$39.30	$131.00	—	—	70%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Free by Dialysis	$29.70	$99.00	$8.75–$69.30	55% below	70%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free	$32.70	$109.00	$8.75–$76.30	50% below	70%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free Thryoxine	$32.70	$109.00	$8.75–$76.30	50% below	70%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 Free by Dialysis	$29.70	$99.00	—	—	70%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine Free	$32.70	$109.00	—	—	70%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free Thryoxine	$32.70	$109.00	—	—	70%
Free testosterone test CPT 84402 Testosterone Free MS	$8.10	$27.00	$12.42–$52.72	92% below	70%
Free testosterone test inpatient CPT 84402 Testosterone Free MS	$8.10	$27.00	—	—	70%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase	$26.70	$89.00	$6.98–$62.30	48% below	70%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase	$26.70	$89.00	—	—	70%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 TSH	$90.30	$301.00	$38.43–$210.70	59% below	70%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel Charge	$90.30	$301.00	$38.43–$210.70	59% below	70%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel Charge	$90.30	$301.00	—	—	70%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 TSH	$90.30	$301.00	—	—	70%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT Post 2 Hour Glucose	$13.50	$45.00	$4.61–$31.50	68% below	70%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1h p Glucose Challenge	$13.50	$45.00	$4.61–$31.50	68% below	70%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GTT Post 2 Hour Glucose	$13.50	$45.00	—	—	70%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 1h p Glucose Challenge	$13.50	$45.00	—	—	70%
Glucose tolerance test, 3 samples CPT 82951 OB 3 Hr GTT Post 2 Hour Glucose	$30.90	$103.00	$12.48–$72.10	66% below	70%
Glucose tolerance test, 3 samples inpatient CPT 82951 OB 3 Hr GTT Post 2 Hour Glucose	$30.90	$103.00	—	—	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC/Chlamydia PCR-MH/WH/PC	$51.00	$170.00	$34.04–$149.14	53% below	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Urine GC/Chlamydia PCR - MH/WH/PC	$51.00	$170.00	$34.04–$149.14	53% below	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Urine GC/Chlamydia PCR - MH/WH/PC	$51.00	$170.00	—	—	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC/Chlamydia PCR-MH/WH/PC	$51.00	$170.00	—	—	70%
H. pylori stool antigen test CPT 87338 Helicobacter pylori Stool Antigen - MH/WH/JE	$24.00	$80.00	$13.95–$61.11	79% below	70%
H. pylori stool antigen test CPT 87338 Helicobacter pylori Stool Antigen - FH	$61.50	$205.00	$13.95–$143.50	46% below	70%
H. pylori stool antigen test inpatient CPT 87338 Helicobacter pylori Stool Antigen - MH/WH/JE	$24.00	$80.00	—	—	70%
H. pylori stool antigen test inpatient CPT 87338 Helicobacter pylori Stool Antigen - FH	$61.50	$205.00	—	—	70%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 by Quantitative NAAT	$35.70	$119.00	$54.74–$176.16	87% below	70%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 by Quantitative NAAT	$35.70	$119.00	—	—	70%
HIV-1 and HIV-2 antibody test CPT 86703 HIV Rapid - MH/WH/JE	$23.40	$78.00	$13.30–$54.60	57% below	70%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV Rapid - MH/WH/JE	$23.40	$78.00	—	—	70%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1/2 Ag/Ab Combo - MH/WH/JE	$23.40	$78.00	$23.36–$78.00	69% below	70%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1/2 Ag/Ab Combo - MH/WH/JE	$23.40	$78.00	—	—	70%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV High-Risk with Rflx to Genotype	$28.20	$94.00	$34.04–$94.00	76% below	70%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV High-Risk with Rflx to Genotype	$28.20	$94.00	—	—	70%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C	$36.00	$120.00	$9.42–$84.00	45% below	70%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C	$36.00	$120.00	—	—	70%
Hemoglobin blood test CPT 85018 Hemoglobin	$13.50	$45.00	$2.30–$31.50	53% below	70%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin	$13.50	$45.00	—	—	70%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Antibody Total	$27.00	$90.00	$11.69–$63.00	62% below	70%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Antibody Total	$27.00	$90.00	—	—	70%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody	$39.90	$133.00	$10.42–$93.10	42% below	70%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody	$39.90	$133.00	—	—	70%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$38.10	$127.00	$10.02–$88.90	46% below	70%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$38.10	$127.00	—	—	70%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus (HCV) Antibody with Rflx to PCR	$33.60	$112.00	$13.84–$78.40	57% below	70%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Virus (HCV) Antibody with Rflx to PCR	$33.60	$112.00	—	—	70%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA Quant PCR with Reflex to Gen	$45.00	$150.00	$41.55–$150.00	84% below	70%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA Quant PCR	$45.00	$150.00	$41.55–$150.00	84% below	70%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA Quant PCR	$45.00	$150.00	—	—	70%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA Quant PCR with Reflex to Gen	$45.00	$150.00	—	—	70%
Herpes blood test, HSV-1 antibody CPT 86695 HSV Type 1 Glycoprotein IgG	$5.10	$17.00	$7.82–$27.30	92% below	70%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 Glycoprotein G Ab IgG	$10.20	$34.00	$12.79–$27.30	85% below	70%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV Type 1 Glycoprotein IgG	$5.10	$17.00	—	—	70%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 Glycoprotein G Ab IgG	$10.20	$34.00	—	—	70%
Herpes blood test, HSV-2 antibody CPT 86696 HSV Type 2 Glycoprotein IgG	$7.50	$25.00	$11.50–$40.05	87% below	70%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 Glycoprotein G Ab IgG	$10.20	$34.00	$15.64–$40.05	82% below	70%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV Type 2 Glycoprotein IgG	$7.50	$25.00	—	—	70%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 Glycoprotein G Ab IgG	$10.20	$34.00	—	—	70%
High-sensitivity CRP (hs-CRP) test CPT 86141 hsCRP	$47.70	$159.00	$12.56–$111.30	41% below	70%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 hsCRP	$47.70	$159.00	—	—	70%
Homocysteine blood test CPT 83090 Homocysteine Total	$62.70	$209.00	$17.38–$146.30	35% below	70%
Homocysteine blood test inpatient CPT 83090 Homocysteine Total	$62.70	$209.00	—	—	70%
Insulin blood test CPT 83525 Insulin 60 Minutes	$19.50	$65.00	$11.09–$48.56	75% below	70%
Insulin blood test CPT 83525 Insulin 30 Minutes	$19.50	$65.00	$11.09–$48.56	75% below	70%
Insulin blood test CPT 83525 Insulin Fasting	$19.50	$65.00	$11.09–$48.56	75% below	70%
Insulin blood test CPT 83525 Insulin Level	$19.50	$65.00	$11.09–$48.56	75% below	70%
Insulin blood test CPT 83525 Insulin 120 Minutes	$19.50	$65.00	$11.09–$48.56	75% below	70%
Insulin blood test CPT 83525 Insulin 90 Minutes	$19.50	$65.00	$11.09–$48.56	75% below	70%
Insulin blood test inpatient CPT 83525 Insulin Fasting	$19.50	$65.00	—	—	70%
Insulin blood test inpatient CPT 83525 Insulin Level	$19.50	$65.00	—	—	70%
Insulin blood test inpatient CPT 83525 Insulin 120 Minutes	$19.50	$65.00	—	—	70%
Insulin blood test inpatient CPT 83525 Insulin 90 Minutes	$19.50	$65.00	—	—	70%
Insulin blood test inpatient CPT 83525 Insulin 60 Minutes	$19.50	$65.00	—	—	70%
Insulin blood test inpatient CPT 83525 Insulin 30 Minutes	$19.50	$65.00	—	—	70%
Iron blood test (serum iron) CPT 83540 Transferrin Profile - FH	$14.10	$47.00	$6.28–$32.90	69% below	70%
Iron blood test (serum iron) CPT 83540 Iron	$24.30	$81.00	$6.28–$56.70	46% below	70%
Iron blood test (serum iron) inpatient CPT 83540 Transferrin Profile - FH	$14.10	$47.00	—	—	70%
Iron blood test (serum iron) inpatient CPT 83540 Iron	$24.30	$81.00	—	—	70%
Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity	$32.70	$109.00	$8.48–$76.30	34% below	70%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Total Iron Binding Capacity	$32.70	$109.00	—	—	70%
Kidney function blood test panel CPT 80069 Renal Function Panel	$28.50	$95.00	$8.42–$66.50	68% below	70%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel	$28.50	$95.00	—	—	70%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$38.10	$127.00	$17.96–$88.90	57% below	70%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone	$38.10	$127.00	—	—	70%
Lactate (lactic acid) blood test CPT 83605 Lactate	$50.10	$167.00	$11.22–$116.90	39% below	70%
Lactate (lactic acid) blood test CPT 83605 Lactate POC	$50.10	$167.00	$11.22–$116.90	39% below	70%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactate	$50.10	$167.00	—	—	70%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactate POC	$50.10	$167.00	—	—	70%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase	$14.10	$47.00	$5.86–$32.90	68% below	70%
Lactate dehydrogenase (LDH) blood test CPT 83615 ARUP LD Body Fluid (0020505)	$19.80	$66.00	$5.86–$46.20	56% below	70%
Lactate dehydrogenase (LDH) blood test CPT 83615 LD Body Fluid	$22.80	$76.00	$5.86–$53.20	49% below	70%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase	$14.10	$47.00	—	—	70%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 ARUP LD Body Fluid (0020505)	$19.80	$66.00	—	—	70%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD Body Fluid	$22.80	$76.00	—	—	70%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$25.50	$85.00	$6.68–$59.50	61% below	70%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level	$25.50	$85.00	—	—	70%
Liver function blood test panel CPT 80076 Hepatic Function Panel	$30.30	$101.00	$7.92–$70.70	66% below	70%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$30.30	$101.00	—	—	70%
Lyme disease antibody test CPT 86618 Borrelia burgdorferi(Lyme)Abs Rflx IgM-IgG	$33.60	$112.00	$16.52–$78.40	62% below	70%
Lyme disease antibody test inpatient CPT 86618 Borrelia burgdorferi(Lyme)Abs Rflx IgM-IgG	$33.60	$112.00	—	—	70%
Magnesium blood test CPT 83735 Magnesium Urine (Timed or Random)	$19.20	$64.00	$6.50–$44.80	62% below	70%
Magnesium blood test CPT 83735 Magnesium Level	$24.90	$83.00	$6.50–$58.10	51% below	70%
Magnesium blood test CPT 83735 Magnesium RBC	$25.20	$84.00	$6.50–$58.80	50% below	70%
Magnesium blood test inpatient CPT 83735 Magnesium Urine (Timed or Random)	$19.20	$64.00	—	—	70%
Magnesium blood test inpatient CPT 83735 Magnesium Level	$24.90	$83.00	—	—	70%
Magnesium blood test inpatient CPT 83735 Magnesium RBC	$25.20	$84.00	—	—	70%
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) IgM	$12.60	$42.00	$12.49–$42.00	80% below	70%
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) IgG	$12.60	$42.00	$12.49–$42.00	80% below	70%
Measles (rubeola) antibody test CPT 86765 Measles Antibody IgM	$21.00	$70.00	$12.49–$54.74	67% below	70%
Measles (rubeola) antibody test CPT 86765 Measles Antibody IgG	$34.20	$114.00	$12.49–$79.80	46% below	70%
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) IgM	$12.60	$42.00	—	—	70%
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) IgG	$12.60	$42.00	—	—	70%
Measles (rubeola) antibody test inpatient CPT 86765 Measles Antibody IgM	$21.00	$70.00	—	—	70%
Measles (rubeola) antibody test inpatient CPT 86765 Measles Antibody IgG	$34.20	$114.00	—	—	70%
Mono test (heterophile antibody, Monospot) CPT 86308 Infectious Mononucleosis Screen	$13.80	$46.00	$5.02–$32.20	73% below	70%
Mono test (heterophile antibody, Monospot) CPT 86308 Infectious Mononucleosis w/EBV Reflex	$13.80	$46.00	$5.02–$32.20	73% below	70%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Infectious Mononucleosis Screen	$13.80	$46.00	—	—	70%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Infectious Mononucleosis w/EBV Reflex	$13.80	$46.00	—	—	70%
Mumps immunity blood test CPT 86735 Mumps Virus Antibody IgM	$20.40	$68.00	$12.66–$47.60	63% below	70%
Mumps immunity blood test CPT 86735 Mumps Antibody IgG	$20.40	$68.00	$12.66–$47.60	63% below	70%
Mumps immunity blood test inpatient CPT 86735 Mumps Virus Antibody IgM	$20.40	$68.00	—	—	70%
Mumps immunity blood test inpatient CPT 86735 Mumps Antibody IgG	$20.40	$68.00	—	—	70%
Obstetric blood test panel CPT 80055 Prenatal Panel Charge - MH/WH/FH	$119.40	$398.00	$46.38–$278.60	4% above	70%
Obstetric blood test panel inpatient CPT 80055 Prenatal Panel Charge - MH/WH/FH	$119.40	$398.00	—	—	70%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Free	$13.20	$44.00	$17.84–$44.00	86% below	70%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Free	$13.20	$44.00	—	—	70%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total	$13.20	$44.00	$17.84–$44.00	86% below	70%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Ultrasensitive - Post Prostatectomy	$23.70	$79.00	$17.84–$78.16	75% below	70%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen	$68.10	$227.00	$17.84–$158.90	30% below	70%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total	$13.20	$44.00	—	—	70%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Ultrasensitive - Post Prostatectomy	$23.70	$79.00	—	—	70%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen	$68.10	$227.00	—	—	70%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CPT 88142	$26.10	$87.00	$19.65–$64.58	60% below	70%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CPT 88142	$26.10	$87.00	—	—	70%
Parathyroid hormone (PTH) blood test CPT 83970 PTH	$52.20	$174.00	$40.04–$174.00	71% below	70%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone - OR - MH	$152.40	$508.00	$40.04–$355.60	15% below	70%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH	$52.20	$174.00	—	—	70%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone - OR - MH	$152.40	$508.00	—	—	70%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT Inhib 1 Hr Rflx	$16.20	$54.00	$5.83–$37.80	67% below	70%
Partial thromboplastin time (PTT) clotting test CPT 85730 Inhibitor Assay PTT Rflx 11 Mix	$20.40	$68.00	$5.83–$47.60	58% below	70%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time Panel	$34.80	$116.00	$5.83–$81.20	28% below	70%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time - MH/WH/JE	$34.80	$116.00	$5.83–$81.20	28% below	70%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT Inhib 1 Hr Rflx	$16.20	$54.00	—	—	70%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Inhibitor Assay PTT Rflx 11 Mix	$20.40	$68.00	—	—	70%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time Panel	$34.80	$116.00	—	—	70%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time - MH/WH/JE	$34.80	$116.00	—	—	70%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus	$18.00	$60.00	$4.60–$42.00	57% below	70%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus	$18.00	$60.00	—	—	70%
Potassium blood test CPT 84132 Potassium Level	$17.40	$58.00	$4.62–$40.60	58% below	70%
Potassium blood test CPT 84132 ATX - Potassium - MH/WH	$17.40	$58.00	$4.62–$40.60	58% below	70%
Potassium blood test inpatient CPT 84132 ATX - Potassium - MH/WH	$17.40	$58.00	—	—	70%
Potassium blood test inpatient CPT 84132 Potassium Level	$17.40	$58.00	—	—	70%
Progesterone blood test CPT 84144 Progesterone Level	$35.70	$119.00	$20.23–$88.65	64% below	70%
Progesterone blood test inpatient CPT 84144 Progesterone Level	$35.70	$119.00	—	—	70%
Prolactin blood test CPT 84146 Prolactin Dilution Study (0020724)	$21.30	$71.00	$18.80–$71.00	80% below	70%
Prolactin blood test CPT 84146 Monomeric Prolactin	$22.50	$75.00	$18.80–$75.00	78% below	70%
Prolactin blood test CPT 84146 Prolactin Level	$22.50	$75.00	$18.80–$75.00	78% below	70%
Prolactin blood test inpatient CPT 84146 Prolactin Dilution Study (0020724)	$21.30	$71.00	—	—	70%
Prolactin blood test inpatient CPT 84146 Monomeric Prolactin	$22.50	$75.00	—	—	70%
Prolactin blood test inpatient CPT 84146 Prolactin Level	$22.50	$75.00	—	—	70%
Prothrombin time (PT/INR) clotting test CPT 85610 Protime - MH/WH/JE	$23.10	$77.00	$4.16–$53.90	30% below	70%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time Panel	$23.10	$77.00	$4.16–$53.90	30% below	70%
Prothrombin time (PT/INR) clotting test CPT 85610 Protime POC - JE	$23.10	$77.00	$4.16–$53.90	30% below	70%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time - MH/WH/JE	$23.10	$77.00	$4.16–$53.90	30% below	70%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time Panel	$23.10	$77.00	—	—	70%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Protime POC - JE	$23.10	$77.00	—	—	70%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Protime - MH/WH/JE	$23.10	$77.00	—	—	70%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time - MH/WH/JE	$23.10	$77.00	—	—	70%
Renin blood test CPT 84244 Renin Activity	$19.80	$66.00	$21.33–$66.00	81% below	70%
Renin blood test CPT 84244 Renin	$24.60	$82.00	$21.33–$82.00	77% below	70%
Renin blood test inpatient CPT 84244 Renin Activity	$19.80	$66.00	—	—	70%
Renin blood test inpatient CPT 84244 Renin	$24.60	$82.00	—	—	70%
Rh blood typing CPT 86901 BB Ref Rh Type	$7.20	$24.00	$2.90–$16.80	84% below	70%
Rh blood typing inpatient CPT 86901 BB Ref Rh Type	$7.20	$24.00	—	—	70%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quantitative	$17.70	$59.00	$5.50–$41.30	68% below	70%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quantitative	$17.70	$59.00	—	—	70%
Rubella antibody test (immunity check) CPT 86762 Rubella IgG Reference	$12.30	$41.00	$13.96–$41.00	81% below	70%
Rubella antibody test (immunity check) CPT 86762 Rubella IgM Reference	$12.30	$41.00	$13.96–$41.00	81% below	70%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody IgM	$20.10	$67.00	$13.96–$61.14	69% below	70%
Rubella antibody test (immunity check) CPT 86762 Rubella Ab IgG Screen - MH/WH/JE	$53.70	$179.00	$13.96–$125.30	16% below	70%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgM Reference	$12.30	$41.00	—	—	70%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgG Reference	$12.30	$41.00	—	—	70%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody IgM	$20.10	$67.00	—	—	70%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Ab IgG Screen - MH/WH/JE	$53.70	$179.00	—	—	70%
Sodium blood test CPT 84295 Sodium	$18.00	$60.00	$4.67–$42.00	55% below	70%
Sodium blood test inpatient CPT 84295 Sodium	$18.00	$60.00	—	—	70%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool - PC	$8.70	$29.00	$4.25–$20.30	73% below	70%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Color - Occult Method	$10.20	$34.00	$4.25–$23.80	69% below	70%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool - PC	$8.70	$29.00	—	—	70%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Color - Occult Method	$10.20	$34.00	—	—	70%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Immuno - Occult Method	$58.80	$196.00	$15.44–$137.20	1% above	70%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Immuno - Occult Method	$58.80	$196.00	—	—	70%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema pallidum Antibody by TP-PA (0050777)	$21.90	$73.00	$12.84–$51.10	60% below	70%
Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Total Antibodies	$22.20	$74.00	$12.84–$51.80	59% below	70%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema pallidum Antibody IgG by IFA (FTA-ABS)	$23.10	$77.00	$12.84–$53.90	58% below	70%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema pallidum Antibody by TP-PA (0050777)	$21.90	$73.00	—	—	70%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Syphilis Total Antibodies	$22.20	$74.00	—	—	70%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema pallidum Antibody IgG by IFA (FTA-ABS)	$23.10	$77.00	—	—	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin	$10.80	$36.00	$4.14–$25.20	78% below	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF Reflex to titer	$19.20	$64.00	$4.14–$44.80	60% below	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin	$10.80	$36.00	—	—	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF Reflex to titer	$19.20	$64.00	—	—	70%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon TB Gold	$64.20	$214.00	$60.12–$214.00	58% below	70%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon TB Gold	$64.20	$214.00	—	—	70%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total and Free (Adult Male)	$21.00	$70.00	$25.04–$70.00	79% below	70%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total MS	$21.00	$70.00	$25.04–$70.00	79% below	70%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total (Female or Child)	$22.80	$76.00	$25.04–$76.00	77% below	70%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total (Adult Males)	$56.10	$187.00	$25.04–$130.90	44% below	70%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total MS	$21.00	$70.00	—	—	70%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total and Free (Adult Male)	$21.00	$70.00	—	—	70%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total (Female or Child)	$22.80	$76.00	—	—	70%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total (Adult Males)	$56.10	$187.00	—	—	70%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Antibody	$10.80	$36.00	$14.11–$36.00	86% below	70%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Antibody	$19.20	$64.00	$14.11–$61.83	75% below	70%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsome IgG	$21.30	$71.00	$14.11–$61.83	72% below	70%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Antibody	$10.80	$36.00	—	—	70%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal Antibody	$19.20	$64.00	—	—	70%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsome IgG	$21.30	$71.00	—	—	70%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH Reflex	$61.80	$206.00	$16.30–$144.20	38% below	70%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$61.80	$206.00	$16.30–$144.20	38% below	70%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH Reflex	$61.80	$206.00	—	—	70%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$61.80	$206.00	—	—	70%
Total cholesterol blood test CPT 82465 Cholesterol	$11.70	$39.00	$4.22–$27.30	72% below	70%
Total cholesterol blood test CPT 82465 Cholesterol Body Fluid	$11.70	$39.00	$4.22–$27.30	72% below	70%
Total cholesterol blood test inpatient CPT 82465 Cholesterol	$11.70	$39.00	—	—	70%
Total cholesterol blood test inpatient CPT 82465 Cholesterol Body Fluid	$11.70	$39.00	—	—	70%
Total thyroxine (T4) blood test CPT 84436 Thyroxine Total T4 (not for screening)	$18.60	$62.00	$6.66–$43.40	65% below	70%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine Total T4 (not for screening)	$18.60	$62.00	—	—	70%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine Total (not for initial screening)	$19.20	$64.00	$13.75–$44.80	75% below	70%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine Total (not for initial screening)	$19.20	$64.00	—	—	70%
Transferrin blood test CPT 84466 Transferrin	$24.60	$82.00	$12.38–$57.40	68% below	70%
Transferrin blood test inpatient CPT 84466 Transferrin	$24.60	$82.00	—	—	70%
Trichomonas test (NAAT) CPT 87661 Trichomonas PCR	$42.30	$141.00	$34.04–$141.00	63% below	70%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas PCR	$42.30	$141.00	—	—	70%
Triglycerides blood test CPT 84478 ARUP Triglycerides Body Fluid	$18.00	$60.00	$5.57–$42.00	58% below	70%
Triglycerides blood test CPT 84478 Triglycerides	$21.90	$73.00	$5.57–$51.10	49% below	70%
Triglycerides blood test CPT 84478 Triglyceride Body Fluid	$21.90	$73.00	$5.57–$51.10	49% below	70%
Triglycerides blood test inpatient CPT 84478 ARUP Triglycerides Body Fluid	$18.00	$60.00	—	—	70%
Triglycerides blood test inpatient CPT 84478 Triglycerides	$21.90	$73.00	—	—	70%
Triglycerides blood test inpatient CPT 84478 Triglyceride Body Fluid	$21.90	$73.00	—	—	70%
Troponin test, quantitative CPT 84484 hs Troponin T - MH/WH/JE	$57.00	$190.00	$12.10–$133.00	53% below	70%
Troponin test, quantitative inpatient CPT 84484 hs Troponin T - MH/WH/JE	$57.00	$190.00	—	—	70%
Uric acid blood test CPT 84550 Uric Acid	$9.90	$33.00	$4.38–$23.10	77% below	70%
Uric acid blood test inpatient CPT 84550 Uric Acid	$9.90	$33.00	—	—	70%
Urinalysis with microscope exam, automated CPT 81001 UA Microscopic	$18.60	$62.00	$3.07–$43.40	58% below	70%
Urinalysis with microscope exam, automated CPT 81001 UA with Microscopic Charge	$18.60	$62.00	$3.07–$43.40	58% below	70%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA with Microscopic Charge	$18.60	$62.00	—	—	70%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA Microscopic	$18.60	$62.00	—	—	70%
Urinalysis without microscope exam, automated CPT 81003 Ketone Urine	$6.30	$21.00	$2.18–$14.70	79% below	70%
Urinalysis without microscope exam, automated CPT 81003 Urogram	$6.30	$21.00	$2.18–$14.70	79% below	70%
Urinalysis without microscope exam, automated CPT 81003 UA (Culture if Positive)	$8.40	$28.00	$2.18–$19.60	72% below	70%
Urinalysis without microscope exam, automated CPT 81003 UA without Microscopic Charge	$8.40	$28.00	$2.18–$19.60	72% below	70%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis	$8.40	$28.00	$2.18–$19.60	72% below	70%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urogram	$6.30	$21.00	—	—	70%
Urinalysis without microscope exam, automated inpatient CPT 81003 Ketone Urine	$6.30	$21.00	—	—	70%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA without Microscopic Charge	$8.40	$28.00	—	—	70%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis	$8.40	$28.00	—	—	70%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA (Culture if Positive)	$8.40	$28.00	—	—	70%
Urine culture for bacteria, with colony count CPT 87086 Neg Urine Culture Charge	$30.00	$100.00	$7.83–$70.00	49% below	70%
Urine culture for bacteria, with colony count CPT 87086 Bill Neg Urine	$30.00	$100.00	$7.83–$70.00	49% below	70%
Urine culture for bacteria, with colony count CPT 87086 Culture Urine	$30.00	$100.00	$7.83–$70.00	49% below	70%
Urine culture for bacteria, with colony count inpatient CPT 87086 Bill Neg Urine	$30.00	$100.00	—	—	70%
Urine culture for bacteria, with colony count inpatient CPT 87086 Neg Urine Culture Charge	$30.00	$100.00	—	—	70%
Urine culture for bacteria, with colony count inpatient CPT 87086 Culture Urine	$30.00	$100.00	—	—	70%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine Random (Spot)	$29.70	$99.00	$5.61–$69.30	46% below	70%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine Random (Spot)	$29.70	$99.00	—	—	70%
Urine pregnancy test, read by color change CPT 81025 Pregnancy Test	$42.00	$140.00	$8.35–$98.00	1% below	70%
Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy Test	$42.00	$140.00	—	—	70%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level	$55.80	$186.00	$14.63–$130.20	36% below	70%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level	$55.80	$186.00	—	—	70%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy Level	$109.50	$365.00	$28.71–$255.50	25% below	70%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25-Hydroxy Level	$109.50	$365.00	—	—	70%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D 1-25-DiHydroxy Level	$27.90	$93.00	$37.35–$93.00	84% below	70%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D 1-25-DiHydroxy Level	$27.90	$93.00	—	—	70%
Zinc blood test CPT 84630 Zinc Urine	$7.80	$26.00	$11.05–$23.58	85% below	70%
Zinc blood test CPT 84630 Zinc Level	$19.50	$65.00	$11.05–$45.50	63% below	70%
Zinc blood test CPT 84630 Zinc Urine Timed	$21.00	$70.00	$11.05–$49.00	60% below	70%
Zinc blood test inpatient CPT 84630 Zinc Urine	$7.80	$26.00	—	—	70%
Zinc blood test inpatient CPT 84630 Zinc Level	$19.50	$65.00	—	—	70%
Zinc blood test inpatient CPT 84630 Zinc Urine Timed	$21.00	$70.00	—	—	70%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Quad Screen - AOS HCG	$10.50	$35.00	$14.60–$35.00	88% below	70%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta-HCG Quantitative - Pregnancy	$30.90	$103.00	$14.60–$72.10	66% below	70%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta-HCG Quantitative - Tumor Marker	$30.90	$103.00	$14.60–$72.10	66% below	70%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Quad Screen - AOS HCG	$10.50	$35.00	—	—	70%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta-HCG Quantitative - Pregnancy	$30.90	$103.00	—	—	70%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta-HCG Quantitative - Tumor Marker	$30.90	$103.00	—	—	70%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 ADENOIDECTOMY PRIMARY LESS THAN AGE 12	$1,125.90	$3,753.00	$1,726.38–$5,178.00	53% below	70%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 ADENOIDECTOMY PRIMARY LESS THAN AGE 12	$1,125.90	$3,753.00	—	—	70%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2	$2,285.70	$7,619.00	$3,504.74–$13,051.00	52% below	70%
Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2	$2,285.70	$7,619.00	—	—	70%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 ARTHRS AIDED ANT CRUCIATE LIGM RPR-AGMNTJ-RCNSTJ	$2,285.70	$7,619.00	$3,504.74–$13,051.00	73% below	70%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 ARTHRS AIDED ANT CRUCIATE LIGM RPR-AGMNTJ-RCNSTJ	$2,285.70	$7,619.00	—	—	70%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 SURGICAL ARTHROSCOPY SHOULDER W-ROTATOR CUFF RPR	$2,285.70	$7,619.00	$3,504.74–$13,051.00	46% below	70%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 SURGICAL ARTHROSCOPY SHOULDER W-ROTATOR CUFF RPR	$2,285.70	$7,619.00	—	—	70%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 STMM Exam	$924.30	$3,081.00	$1,417.26–$3,141.00	70% below	70%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 STMM Exam	$924.30	$3,081.00	$1,417.26–$3,141.00	70% below	70%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 STMM Exam	$924.30	$3,081.00	—	—	70%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 STMM Exam	$924.30	$3,081.00	—	—	70%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Closed Tx Distal Fibular Fracture w/o Manipulation	$107.70	$359.00	$165.14–$908.00	76% below	70%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Closed Tx Distal Fibular Fracture w/o Manipulation	$107.70	$359.00	—	—	70%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed Tx Metatarsal Fracture w/o Manipulation	$171.60	$572.00	$263.12–$908.00	53% below	70%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Closed Tx Metatarsal Fracture w/o Manipulation	$171.60	$572.00	—	—	70%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT	$1,710.60	$5,702.00	$2,622.92–$6,639.00	52% below	70%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT	$1,710.60	$5,702.00	—	—	70%
Bunion correction with removal of part of the big toe joint CPT 28292 CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE	$1,710.60	$5,702.00	$2,622.92–$6,639.00	41% below	70%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE	$1,710.60	$5,702.00	—	—	70%
Cardiac catheterization with coronary angiogram CPT 93458 Coronaries LHC /- LV	$5,176.20	$17,254.00	$6,354.00–$13,476.59	52% below	70%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 Coronaries LHC /- LV	$5,176.20	$17,254.00	—	—	70%
Cardioversion, elective (restoring heart rhythm) CPT 92960 JESP Exam	$528.60	$1,762.00	$810.52–$1,966.00	39% below	70%
Cardioversion, elective (restoring heart rhythm) CPT 92960 INF-Cardioversion ICU (JE)	$528.60	$1,762.00	$810.52–$1,966.00	39% below	70%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion External	$528.60	$1,762.00	$774.00–$1,233.40	39% below	70%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion elective electrical conversion of ar	$568.20	$1,894.00	$804.95–$2,141.00	35% below	70%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion	$585.30	$1,951.00	$897.46–$1,966.00	33% below	70%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 JESP Exam	$528.60	$1,762.00	—	—	70%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion External	$528.60	$1,762.00	—	—	70%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 INF-Cardioversion ICU (JE)	$528.60	$1,762.00	—	—	70%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion elective electrical conversion of ar	$568.20	$1,894.00	—	—	70%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion	$585.30	$1,951.00	—	—	70%
Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY AND-TRANSPOS MEDIAN NRV CARPAL TUNNE	$1,710.60	$5,702.00	$2,622.92–$5,178.00	50% below	70%
Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY AND-TRANSPOS MEDIAN NRV CARPAL TUNNE	$1,710.60	$5,702.00	—	—	70%
Catheter ablation for atrial fibrillation CPT 93656 Tx Atrial Fib Pulm Ven Isol	$11,187.60	$37,292.00	$11,611.47–$29,377.00	67% below	70%
Catheter ablation for atrial fibrillation inpatient CPT 93656 Tx Atrial Fib Pulm Ven Isol	$11,187.60	$37,292.00	—	—	70%
Cervical biopsy CPT 57500 Biopsy of cervix single or multiple or local exc o	$606.90	$2,023.00	$930.58–$2,023.00	27% above	70%
Cervical biopsy CPT 57500 Biopsy cervix single or mult or exc of lesion w or	$624.90	$2,083.00	$774.00–$1,458.10	30% above	70%
Cervical biopsy CPT 57500 BIOPSY CERVIX SINGLE-MULT-EXCISION OF LESION SPX	$1,710.60	$5,702.00	$1,562.00–$3,991.40	257% above	70%
Cervical biopsy inpatient CPT 57500 Biopsy of cervix single or multiple or local exc o	$606.90	$2,023.00	—	—	70%
Cervical biopsy inpatient CPT 57500 Biopsy cervix single or mult or exc of lesion w or	$624.90	$2,083.00	—	—	70%
Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX SINGLE-MULT-EXCISION OF LESION SPX	$1,710.60	$5,702.00	—	—	70%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION AGE GREATER THAN 28 DAYS	$1,125.90	$3,753.00	$1,726.38–$5,178.00	60% below	70%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Circumcision Adult	$1,597.50	$5,325.00	$2,449.50–$5,178.00	44% below	70%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION AGE GREATER THAN 28 DAYS	$1,125.90	$3,753.00	—	—	70%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 Circumcision Adult	$1,597.50	$5,325.00	—	—	70%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision	$299.10	$997.00	$423.73–$697.90	77% below	70%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 MFM Circumcision Using Clamp/Device w/Regional or	$1,645.50	$5,485.00	$2,331.13–$3,839.50	24% above	70%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision using clamp or other device w/regiona	$1,645.50	$5,485.00	$774.00–$3,839.50	24% above	70%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W-CLAMP-OTH DEV W-BLOCK	$1,710.60	$5,702.00	$2,622.92–$5,178.00	29% above	70%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision	$299.10	$997.00	—	—	70%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision using clamp or other device w/regiona	$1,645.50	$5,485.00	—	—	70%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 MFM Circumcision Using Clamp/Device w/Regional or	$1,645.50	$5,485.00	—	—	70%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W-CLAMP-OTH DEV W-BLOCK	$1,710.60	$5,702.00	—	—	70%
Circumcision, surgical, older than a newborn CPT 54160 Circumcision Procedure - Circumcision Charge	$299.10	$997.00	$423.73–$697.90	72% below	70%
Circumcision, surgical, older than a newborn CPT 54160 Circumcision surgical excision other than clamp de	$1,645.50	$5,485.00	$774.00–$3,839.50	53% above	70%
Circumcision, surgical, older than a newborn inpatient CPT 54160 Circumcision Procedure - Circumcision Charge	$299.10	$997.00	—	—	70%
Circumcision, surgical, older than a newborn inpatient CPT 54160 Circumcision surgical excision other than clamp de	$1,645.50	$5,485.00	—	—	70%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed treatment of distal fracture	$101.70	$339.00	$155.94–$1,832.00	77% below	70%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed Tx Distal Radial Fracture w/o Manipulation	$171.60	$572.00	$263.12–$908.00	61% below	70%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Closed treatment of distal fracture	$101.70	$339.00	—	—	70%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Closed Tx Distal Radial Fracture w/o Manipulation	$171.60	$572.00	—	—	70%
Colonoscopy with endoscopic ultrasound CPT 45391 END-Colonoscopy/ultrasound	$1,012.50	$3,375.00	$1,552.50–$3,375.00	72% below	70%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 END-Colonoscopy/ultrasound	$1,012.50	$3,375.00	—	—	70%
Colonoscopy with polyp removal CPT 45385 END-Colonoscopy w/Poly	$727.80	$2,426.00	$1,115.96–$3,141.00	54% below	70%
Colonoscopy with polyp removal CPT 45385 COLSC FLX W-RMVL OF TUMOR POLYP LESION SNARE TQ	$1,125.90	$3,753.00	$1,726.38–$3,753.00	30% below	70%
Colonoscopy with polyp removal inpatient CPT 45385 END-Colonoscopy w/Poly	$727.80	$2,426.00	—	—	70%
Colonoscopy with polyp removal inpatient CPT 45385 COLSC FLX W-RMVL OF TUMOR POLYP LESION SNARE TQ	$1,125.90	$3,753.00	—	—	70%
Colonoscopy with tissue sample CPT 45380 Colonoscopy Flex w/Biopsy Sngl or Multi	$706.50	$2,355.00	$1,083.30–$3,141.00	58% below	70%
Colonoscopy with tissue sample CPT 45380 END-Colonoscopy w/ Biopsy	$727.80	$2,426.00	$1,115.96–$3,141.00	57% below	70%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W-BIOPSY SINGLE-MULTIPLE	$1,710.60	$5,702.00	$2,011.00–$4,778.89	1% above	70%
Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy Flex w/Biopsy Sngl or Multi	$706.50	$2,355.00	—	—	70%
Colonoscopy with tissue sample inpatient CPT 45380 END-Colonoscopy w/ Biopsy	$727.80	$2,426.00	—	—	70%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W-BIOPSY SINGLE-MULTIPLE	$1,710.60	$5,702.00	—	—	70%
Colonoscopy, diagnostic CPT 45378 END-Colonoscopy Spl Flex	$1,081.50	$3,605.00	$1,658.30–$3,605.00	38% below	70%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLX DX W-COLLJ SPEC WHEN PFRMD	$1,710.60	$5,702.00	$2,011.00–$4,778.89	2% below	70%
Colonoscopy, diagnostic inpatient CPT 45378 END-Colonoscopy Spl Flex	$1,081.50	$3,605.00	—	—	70%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLX DX W-COLLJ SPEC WHEN PFRMD	$1,710.60	$5,702.00	—	—	70%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX	$1,125.90	$3,753.00	$1,726.38–$5,178.00	at median	70%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX	$1,125.90	$3,753.00	—	—	70%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY CERVIX BX CERVIX AND ENDOCRV CURRETAGE	$1,125.90	$3,753.00	$1,128.00–$3,753.00	198% above	70%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY CERVIX BX CERVIX AND ENDOCRV CURRETAGE	$1,125.90	$3,753.00	—	—	70%
Coronary stent placement, one artery CPT 92928 Prq card stent/angio	$9,488.70	$31,629.00	$7,234.00–$22,140.30	37% below	70%
Coronary stent placement, one artery inpatient CPT 92928 Prq card stent/angio	$9,488.70	$31,629.00	—	—	70%
Cystoscopy with ureteral stent placement CPT 52332 CYSTO W-INSERT URETERAL STENT	$1,710.60	$5,702.00	$2,622.92–$5,178.00	59% below	70%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTO W-INSERT URETERAL STENT	$1,710.60	$5,702.00	—	—	70%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystourethroscopy	$524.70	$1,749.00	$804.54–$1,966.00	50% below	70%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Scope of bladder/urethra	$540.30	$1,801.00	$774.00–$1,260.70	48% below	70%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$1,125.90	$3,753.00	$1,562.00–$3,753.00	8% above	70%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Cystourethroscopy	$524.70	$1,749.00	—	—	70%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Scope of bladder/urethra	$540.30	$1,801.00	—	—	70%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$1,125.90	$3,753.00	—	—	70%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE DXAND-THER NONOBSTETRIC	$1,710.60	$5,702.00	$2,622.92–$5,178.00	50% below	70%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DandC DIAG and/OR THERAPEUTIC	$2,718.60	$9,062.00	$3,711.00–$6,343.40	20% below	70%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION AND CURETTAGE DXAND-THER NONOBSTETRIC	$1,710.60	$5,702.00	—	—	70%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DandC DIAG and/OR THERAPEUTIC	$2,718.60	$9,062.00	—	—	70%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruction Benign or Malignant First Lesion	$100.20	$334.00	$153.64–$908.00	32% below	70%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Destruction Benign or Malignant First Lesion	$100.20	$334.00	—	—	70%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY GENERAL ANESTHESIA	$2,285.70	$7,619.00	$2,011.00–$6,408.55	25% below	70%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPANOSTOMY GENERAL ANESTHESIA	$2,285.70	$7,619.00	—	—	70%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Tympanostomy local or topical anesthesia	$306.90	$1,023.00	$470.58–$908.00	26% below	70%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 Tympanostomy local or topical anesthesia	$306.90	$1,023.00	—	—	70%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Removal impacted cerumen w irrigation/lavage unila	$55.20	$184.00	$84.64–$908.00	20% below	70%
Earwax removal by irrigation (rinsing), one ear CPT 69209 MFM Removal impacted cerumen using irrigation/lav	$55.20	$184.00	$84.64–$119.60	20% below	70%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 MFM Removal impacted cerumen using irrigation/lav	$55.20	$184.00	—	—	70%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Removal impacted cerumen w irrigation/lavage unila	$55.20	$184.00	—	—	70%
Earwax removal with instruments, one ear CPT 69210 Removal Impacted Cerumen 1-2 Ears	$50.10	$167.00	$76.82–$908.00	51% below	70%
Earwax removal with instruments, one ear CPT 69210 WC-Cerumen Removal	$50.10	$167.00	$70.97–$138.00	51% below	70%
Earwax removal with instruments, one ear inpatient CPT 69210 Removal Impacted Cerumen 1-2 Ears	$50.10	$167.00	—	—	70%
Earwax removal with instruments, one ear inpatient CPT 69210 WC-Cerumen Removal	$50.10	$167.00	—	—	70%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endometrial biopsy	$107.70	$359.00	$165.14–$1,832.00	58% below	70%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endometrial Bx w/o Cervical Dilation	$222.90	$743.00	$341.78–$908.00	14% below	70%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Endometrial biopsy	$107.70	$359.00	—	—	70%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Endometrial Bx w/o Cervical Dilation	$222.90	$743.00	—	—	70%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 NASAL-SINUS NDSC W-TOTAL ETHOIDECTOMY	$2,285.70	$7,619.00	$3,504.74–$7,619.00	—	70%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 NASAL-SINUS NDSC W-TOTAL ETHOIDECTOMY	$2,285.70	$7,619.00	—	—	70%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NASAL-SINUS NDSC W-RMVL TISS FROM FRONTAL SINUS	$2,285.70	$7,619.00	$3,504.74–$6,639.00	57% above	70%
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 NASAL-SINUS NDSC W-RMVL TISS FROM FRONTAL SINUS	$2,285.70	$7,619.00	—	—	70%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 NASAL-SINUS ENDOSCOPY W-MAXILLARY ANTROSTOMY	$2,285.70	$7,619.00	$3,504.74–$6,408.55	60% above	70%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 NASAL-SINUS ENDOSCOPY W-MAXILLARY ANTROSTOMY	$2,285.70	$7,619.00	—	—	70%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 NSL-SINUS NDSC MAX ANTROST W-RMVL TISS MAX SINUS	$2,285.70	$7,619.00	$3,504.74–$6,408.55	at median	70%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 NSL-SINUS NDSC MAX ANTROST W-RMVL TISS MAX SINUS	$2,285.70	$7,619.00	—	—	70%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 SP Limited Exam	$680.70	$2,269.00	$118.00–$1,588.30	49% below	70%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Injection diagnostic or therapeutic substance not	$680.70	$2,269.00	$774.00–$1,588.30	49% below	70%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX DX-THER SBST INTRLMNR CRV-THRC W-IMG GDN	$898.20	$2,994.00	$1,377.24–$2,994.00	32% below	70%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 MECT Exam	$1,773.00	$5,910.00	$951.00–$4,137.00	33% above	70%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Injection diagnostic or therapeutic substance not	$680.70	$2,269.00	—	—	70%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 SP Limited Exam	$680.70	$2,269.00	—	—	70%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX DX-THER SBST INTRLMNR CRV-THRC W-IMG GDN	$898.20	$2,994.00	—	—	70%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 MECT Exam	$1,773.00	$5,910.00	—	—	70%
Eye injection into the vitreous (intravitreal injection) CPT 67028 Intravitreal injection of a pharmacologic agent	$299.70	$999.00	$459.54–$1,832.00	56% below	70%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 Intravitreal injection of a pharmacologic agent	$299.70	$999.00	—	—	70%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 MSP Exam	$662.10	$2,207.00	$1,015.22–$2,207.00	51% below	70%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 CTA Exam	$662.10	$2,207.00	$1,015.22–$2,207.00	51% below	70%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 NJX DX-THER AGT PVRT FACET JT LMBR-SAC 1 LEVEL	$898.20	$2,994.00	$1,377.24–$2,994.00	34% below	70%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 MSP Exam	$662.10	$2,207.00	—	—	70%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 CTA Exam	$662.10	$2,207.00	—	—	70%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 NJX DX-THER AGT PVRT FACET JT LMBR-SAC 1 LEVEL	$898.20	$2,994.00	—	—	70%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$2,681.10	$8,937.00	$4,111.02–$7,120.36	52% below	70%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$2,681.10	$8,937.00	—	—	70%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR AA HERNIA 1ST GREATER THAN 10 CM REDUCIBLE	$2,681.10	$8,937.00	$4,111.02–$7,120.36	23% above	70%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 RPR AA HERNIA 1ST GREATER THAN 10 CM REDUCIBLE	$2,681.10	$8,937.00	—	—	70%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HERNIA 1ST LESS THAN 3 CM REDUCIBLE	$2,681.10	$8,937.00	$4,111.02–$7,120.36	54% below	70%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 RPR AA HERNIA 1ST LESS THAN 3 CM REDUCIBLE	$2,681.10	$8,937.00	—	—	70%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Flex Sigmoidoscopy Diagnostic	$1,235.40	$4,118.00	$1,562.00–$3,795.64	30% below	70%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Sigmoidoscopy Flexible Diagnostic	$1,235.40	$4,118.00	$774.00–$2,882.60	30% below	70%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 END-Proctosig Flex Diagnostic w/w-o Specimens	$1,235.40	$4,118.00	$1,562.00–$3,795.64	30% below	70%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Flex Sigmoidoscopy Diagnostic	$1,235.40	$4,118.00	—	—	70%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Sigmoidoscopy Flexible Diagnostic	$1,235.40	$4,118.00	—	—	70%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 END-Proctosig Flex Diagnostic w/w-o Specimens	$1,235.40	$4,118.00	—	—	70%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY	$2,681.10	$8,937.00	$4,111.02–$13,051.00	24% below	70%
Gallbladder removal, laparoscopic CPT 47562 Laparoscopy Surgical Cholecystectomy	$4,231.50	$14,105.00	$6,488.30–$13,051.00	19% above	70%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY	$2,681.10	$8,937.00	—	—	70%
Gallbladder removal, laparoscopic inpatient CPT 47562 Laparoscopy Surgical Cholecystectomy	$4,231.50	$14,105.00	—	—	70%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPS SURG CHOLECYSTECTOMY W-CHOLANGIOGRAPHY	$2,681.10	$8,937.00	$4,111.02–$13,051.00	52% below	70%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPS SURG CHOLECYSTECTOMY W-CHOLANGIOGRAPHY	$2,681.10	$8,937.00	—	—	70%
Gallbladder removal, open surgery through a larger incision CPT 47600 END-Cholecystectomy	$2,144.70	$7,149.00	$3,288.54–$8,545.00	45% below	70%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 END-Cholecystectomy	$2,144.70	$7,149.00	—	—	70%
Hammertoe correction surgery CPT 28285 CORRECTION HAMMERTOE	$1,710.60	$5,702.00	$2,622.92–$5,702.00	67% below	70%
Hammertoe correction surgery inpatient CPT 28285 CORRECTION HAMMERTOE	$1,710.60	$5,702.00	—	—	70%
Hemorrhoid banding (rubber band ligation) CPT 46221 END-Hemorrhoidectomy by Simple Ligature	$775.20	$2,584.00	$1,188.64–$2,584.00	19% above	70%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 END-Hemorrhoidectomy by Simple Ligature	$775.20	$2,584.00	—	—	70%
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY NTRNL AND XTRNL 1 COLUMN-GROUP	$1,125.90	$3,753.00	$1,726.38–$5,178.00	6% below	70%
Hemorrhoidectomy (internal and external), one area CPT 46255 END-Hemorrhoidectomy Internal andExternal Single g	$1,884.60	$6,282.00	$2,889.72–$6,282.00	58% above	70%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY NTRNL AND XTRNL 1 COLUMN-GROUP	$1,125.90	$3,753.00	—	—	70%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 END-Hemorrhoidectomy Internal andExternal Single g	$1,884.60	$6,282.00	—	—	70%
Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABDOMINAL HYSTERECT W-WO RMVL TUBE OVARY	$2,681.10	$8,937.00	$4,111.02–$8,937.00	50% below	70%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL ABDOMINAL HYSTERECT W-WO RMVL TUBE OVARY	$2,681.10	$8,937.00	—	—	70%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Hysterosalpingography	$197.10	$657.00	$302.22–$1,832.00	37% below	70%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 MJFL Exam	$203.10	$677.00	$311.42–$1,832.00	35% below	70%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Hysterosalpingography	$197.10	$657.00	—	—	70%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 MJFL Exam	$203.10	$677.00	—	—	70%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ENDOMETRIAL ABLATION	$1,710.60	$5,702.00	$2,622.92–$6,639.00	62% below	70%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY ENDOMETRIAL ABLATION	$1,710.60	$5,702.00	—	—	70%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BX ENDOMETRIUMAND-POLYPC W-WO DANDC	$1,710.60	$5,702.00	$2,622.92–$5,702.00	67% below	70%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY BX ENDOMETRIUMAND-POLYPC W-WO DANDC	$1,710.60	$5,702.00	—	—	70%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION INTRAUTERINE DEVICE IUD	$1,710.60	$5,702.00	$1,128.00–$3,991.40	571% above	70%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION INTRAUTERINE DEVICE IUD	$1,710.60	$5,702.00	—	—	70%
Incision and drainage of a simple or single skin abscess CPT 10060 Incision/Drainage	$153.30	$511.00	$235.06–$1,832.00	39% below	70%
Incision and drainage of a simple or single skin abscess CPT 10060 END-Incision and drainage abscess simple/single	$157.80	$526.00	$241.96–$1,832.00	37% below	70%
Incision and drainage of a simple or single skin abscess CPT 10060 WC-IandD Abscess - Single	$157.80	$526.00	$118.00–$368.20	37% below	70%
Incision and drainage of a simple or single skin abscess CPT 10060 I and D of abcess simple or single	$432.60	$1,442.00	$663.32–$1,009.40	72% above	70%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE ABSCESS SIMPLE-SINGLE	$1,125.90	$3,753.00	$1,128.00–$3,753.00	346% above	70%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision/Drainage	$153.30	$511.00	—	—	70%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 WC-IandD Abscess - Single	$157.80	$526.00	—	—	70%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 END-Incision and drainage abscess simple/single	$157.80	$526.00	—	—	70%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I and D of abcess simple or single	$432.60	$1,442.00	—	—	70%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION AND DRAINAGE ABSCESS SIMPLE-SINGLE	$1,125.90	$3,753.00	—	—	70%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR 1ST INGUN HRNA AGE 5 YRS-GREATER THAN REDUCIBL	$1,710.60	$5,702.00	$2,622.92–$6,639.00	at median	70%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 END-Repair Inguinal Hernia	$2,566.50	$8,555.00	$3,935.30–$7,120.36	50% above	70%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 END-Repair Initial Inguinal Hernia > age 5 yrs	$2,566.50	$8,555.00	$3,935.30–$7,120.36	50% above	70%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 RPR 1ST INGUN HRNA AGE 5 YRS-GREATER THAN REDUCIBL	$1,710.60	$5,702.00	—	—	70%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 END-Repair Inguinal Hernia	$2,566.50	$8,555.00	—	—	70%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 END-Repair Initial Inguinal Hernia > age 5 yrs	$2,566.50	$8,555.00	—	—	70%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Sngl Sheath/Ligament-Diag	$214.20	$714.00	$328.44–$1,832.00	32% below	70%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Sngl Sheath/Ligament-SP	$214.20	$714.00	$328.44–$1,832.00	32% below	70%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection Single Tendon Sheath Ligament Sponeurosi	$214.20	$714.00	$328.44–$908.00	32% below	70%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION 1 TENDON SHEATH-LIGAMENT APONEUROSIS	$2,285.70	$7,619.00	$1,128.00–$5,333.30	621% above	70%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj Sngl Sheath/Ligament-SP	$214.20	$714.00	—	—	70%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj Sngl Sheath/Ligament-Diag	$214.20	$714.00	—	—	70%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Injection Single Tendon Sheath Ligament Sponeurosi	$214.20	$714.00	—	—	70%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION 1 TENDON SHEATH-LIGAMENT APONEUROSIS	$2,285.70	$7,619.00	—	—	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis aspiration and/or injection major j	$205.20	$684.00	$314.64–$1,832.00	42% below	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthro-Major Joint	$211.20	$704.00	$323.84–$1,832.00	40% below	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis Major Joint or Bursa	$211.20	$704.00	$323.84–$908.00	40% below	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 CT-Arthro/Asp/Inj Major Joint	$211.20	$704.00	$323.84–$1,832.00	40% below	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthro/Asp/Inj Major Joint	$211.20	$704.00	$323.84–$1,832.00	40% below	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthro Joint Major-SP	$211.20	$704.00	$323.84–$1,832.00	40% below	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIRAND-INJ MAJOR JT-BURSA W-O US	$2,285.70	$7,619.00	$1,128.00–$5,333.30	546% above	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis aspiration and/or injection major j	$205.20	$684.00	—	—	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthro-Major Joint	$211.20	$704.00	—	—	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthro/Asp/Inj Major Joint	$211.20	$704.00	—	—	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 CT-Arthro/Asp/Inj Major Joint	$211.20	$704.00	—	—	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis Major Joint or Bursa	$211.20	$704.00	—	—	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthro Joint Major-SP	$211.20	$704.00	—	—	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRAND-INJ MAJOR JT-BURSA W-O US	$2,285.70	$7,619.00	—	—	70%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$1,710.60	$5,702.00	$1,128.00–$3,991.40	476% above	70%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$1,710.60	$5,702.00	—	—	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis intermediate joint or bursa	$207.90	$693.00	$318.78–$1,832.00	40% below	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Asp/Inj Intermed Joint-SP	$214.20	$714.00	$328.44–$1,832.00	38% below	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 WC-Aspiration of joint wrist elbow or ankle	$214.20	$714.00	$118.00–$499.80	38% below	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthro-Intermediate Joint	$214.20	$714.00	$328.44–$1,832.00	38% below	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis Intermediate Joint or Bursa	$214.20	$714.00	$328.44–$908.00	38% below	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Inj For Interm Joint	$214.20	$714.00	$328.44–$1,832.00	38% below	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthro/Asp/Inj Med Joint	$214.20	$714.00	$328.44–$1,832.00	38% below	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIRAND-INJ INTERM JT-BURS W-O US	$1,710.60	$5,702.00	$1,128.00–$3,991.40	394% above	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis intermediate joint or bursa	$207.90	$693.00	—	—	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis Intermediate Joint or Bursa	$214.20	$714.00	—	—	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 WC-Aspiration of joint wrist elbow or ankle	$214.20	$714.00	—	—	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthro-Intermediate Joint	$214.20	$714.00	—	—	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Asp/Inj Intermed Joint-SP	$214.20	$714.00	—	—	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Inj For Interm Joint	$214.20	$714.00	—	—	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthro/Asp/Inj Med Joint	$214.20	$714.00	—	—	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRAND-INJ INTERM JT-BURS W-O US	$1,710.60	$5,702.00	—	—	70%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthro/Asp/Inj Small Joint	$214.20	$714.00	$328.44–$1,832.00	24% below	70%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis Small Joint or Bursa	$214.20	$714.00	$328.44–$908.00	24% below	70%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRAND-INJ SMALL JT-BURSA W-O US	$1,710.60	$5,702.00	$1,128.00–$3,991.40	511% above	70%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthro/Asp/Inj Small Joint	$214.20	$714.00	—	—	70%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis Small Joint or Bursa	$214.20	$714.00	—	—	70%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRAND-INJ SMALL JT-BURSA W-O US	$1,710.60	$5,702.00	—	—	70%
Knee arthroscopy with meniscus trim CPT 29881 ARTHRS KNEE SURG W-MENISCECTOMY MED-LAT W-SHVG	$1,710.60	$5,702.00	$2,622.92–$6,639.00	41% below	70%
Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHRS KNEE SURG W-MENISCECTOMY MED-LAT W-SHVG	$1,710.60	$5,702.00	—	—	70%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHRS KNEE SURG MENISCECTOMY MEDANDLAT W-SHAVING	$2,285.70	$7,619.00	$3,504.74–$7,120.36	4% below	70%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHRS KNEE SURG MENISCECTOMY MEDANDLAT W-SHAVING	$2,285.70	$7,619.00	—	—	70%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 ARTHRS KNEE SURG DEBRIDEMENT-SHVG ARTCLR CRTLG	$1,710.60	$5,702.00	$2,622.92–$6,639.00	19% below	70%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 ARTHRS KNEE SURG DEBRIDEMENT-SHVG ARTCLR CRTLG	$1,710.60	$5,702.00	—	—	70%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPIC APPENDECTOMY	$1,710.60	$5,702.00	$2,622.92–$13,051.00	58% below	70%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPIC APPENDECTOMY	$1,710.60	$5,702.00	—	—	70%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAPS SURG ESOPG-GSTR FUNDOPLASTY	$2,681.10	$8,937.00	$4,111.02–$13,051.00	66% below	70%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 LAPS SURG ESOPG-GSTR FUNDOPLASTY	$2,681.10	$8,937.00	—	—	70%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM-LES	$2,681.10	$8,937.00	$4,111.02–$13,051.00	64% below	70%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 Laparoscopy Total Hysterectomy </ 250g	$3,398.40	$11,328.00	$5,210.88–$13,051.00	54% below	70%
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM-LES	$2,681.10	$8,937.00	—	—	70%
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 Laparoscopy Total Hysterectomy </ 250g	$3,398.40	$11,328.00	—	—	70%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 LAPS TOTAL HYSTERECT 250 GM-LESS THAN W-RMVL TUBE-	$2,681.10	$8,937.00	$4,111.02–$13,051.00	78% below	70%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 Laparoscopy Total Hysterectomy </ 250g w/ removal	$4,856.40	$16,188.00	$7,234.00–$13,051.00	60% below	70%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 LAPS TOTAL HYSTERECT 250 GM-LESS THAN W-RMVL TUBE-	$2,681.10	$8,937.00	—	—	70%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 Laparoscopy Total Hysterectomy </ 250g w/ removal	$4,856.40	$16,188.00	—	—	70%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA	$2,681.10	$8,937.00	$4,111.02–$13,051.00	33% below	70%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA	$2,681.10	$8,937.00	—	—	70%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAPS SURG RPR RECURRENT INGUINAL HERNIA	$2,681.10	$8,937.00	$4,111.02–$13,051.00	at median	70%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAPS SURG RPR RECURRENT INGUINAL HERNIA	$2,681.10	$8,937.00	—	—	70%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY W-RMVL ADNEXAL STRUCTURES	$1,710.60	$5,702.00	$2,622.92–$13,051.00	70% below	70%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAPAROSCOPY W-RMVL ADNEXAL STRUCTURES	$1,710.60	$5,702.00	—	—	70%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Repair Intermediate Wound Scalp Axillae Trunk Extr	$196.80	$656.00	$301.76–$908.00	45% below	70%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Repair intermediate wound scalp/axillae/trunk	$220.50	$735.00	$338.10–$1,832.00	39% below	70%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE S-A-T-E 2.5 CM-LESS THAN	$1,710.60	$5,702.00	$1,128.00–$3,991.40	374% above	70%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Repair Intermediate Wound Scalp Axillae Trunk Extr	$196.80	$656.00	—	—	70%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Repair intermediate wound scalp/axillae/trunk	$220.50	$735.00	—	—	70%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE S-A-T-E 2.5 CM-LESS THAN	$1,710.60	$5,702.00	—	—	70%
Left heart catheterization, diagnostic CPT 93452 LHC /- LV	$5,107.80	$17,026.00	$6,354.00–$13,476.59	35% below	70%
Left heart catheterization, diagnostic inpatient CPT 93452 LHC /- LV	$5,107.80	$17,026.00	—	—	70%
Lower-back epidural injection, with imaging guidance CPT 62323 Inject diag/therapeutic substance w/needle or cath	$660.90	$2,203.00	$118.00–$1,542.10	48% below	70%
Lower-back epidural injection, with imaging guidance CPT 62323 Injection diagnostic or therapeutic substance not	$680.70	$2,269.00	$774.00–$1,588.30	46% below	70%
Lower-back epidural injection, with imaging guidance CPT 62323 MECT Exam	$680.70	$2,269.00	$951.00–$1,588.30	46% below	70%
Lower-back epidural injection, with imaging guidance CPT 62323 SP Limited Exam	$680.70	$2,269.00	$118.00–$1,588.30	46% below	70%
Lower-back epidural injection, with imaging guidance CPT 62323 L/S Spinal Inj	$680.70	$2,269.00	$118.00–$1,588.30	46% below	70%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX DX-THER SBST INTRLMNR LMBR-SAC W-IMG GDN	$898.20	$2,994.00	$1,377.24–$2,994.00	29% below	70%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Inject diag/therapeutic substance w/needle or cath	$660.90	$2,203.00	—	—	70%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 MECT Exam	$680.70	$2,269.00	—	—	70%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 SP Limited Exam	$680.70	$2,269.00	—	—	70%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 L/S Spinal Inj	$680.70	$2,269.00	—	—	70%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Injection diagnostic or therapeutic substance not	$680.70	$2,269.00	—	—	70%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX DX-THER SBST INTRLMNR LMBR-SAC W-IMG GDN	$898.20	$2,994.00	—	—	70%
Lower-back epidural injection, without imaging guidance CPT 62322 Injection diagnostic or therapeutic substance not	$680.70	$2,269.00	$774.00–$1,588.30	26% below	70%
Lower-back epidural injection, without imaging guidance CPT 62322 Intrathecal Injection	$680.70	$2,269.00	$1,043.74–$2,269.00	26% below	70%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX DX-THER SBST INTRLMNR LMBR-SAC W-O IMG GDN	$898.20	$2,994.00	$1,377.24–$2,994.00	2% below	70%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Injection diagnostic or therapeutic substance not	$680.70	$2,269.00	—	—	70%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Intrathecal Injection	$680.70	$2,269.00	—	—	70%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX DX-THER SBST INTRLMNR LMBR-SAC W-O IMG GDN	$898.20	$2,994.00	—	—	70%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 CT Exam	$568.20	$1,894.00	$871.24–$1,966.00	61% below	70%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Foramen Epidural L/S	$568.20	$1,894.00	$871.24–$1,966.00	61% below	70%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Foramen Epidura L/S-CT	$568.20	$1,894.00	$871.24–$1,966.00	61% below	70%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 MSP Exam	$568.20	$1,894.00	$871.24–$1,966.00	61% below	70%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AAAND-STRD TFRML EPI LUMBAR-SACRAL 1 LEVEL	$898.20	$2,994.00	$1,377.24–$2,994.00	39% below	70%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inj Foramen Epidura L/S-CT	$568.20	$1,894.00	—	—	70%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inj Foramen Epidural L/S	$568.20	$1,894.00	—	—	70%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 MSP Exam	$568.20	$1,894.00	—	—	70%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 CT Exam	$568.20	$1,894.00	—	—	70%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX AAAND-STRD TFRML EPI LUMBAR-SACRAL 1 LEVEL	$898.20	$2,994.00	—	—	70%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LAMINOTOMY DCMPRN NRV ROOT 1 NTRSPC LUMBAR	$1,710.60	$5,702.00	$2,622.92–$13,051.00	70% below	70%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 LAMINOTOMY DCMPRN NRV ROOT 1 NTRSPC LUMBAR	$1,710.60	$5,702.00	—	—	70%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR	$2,681.10	$8,937.00	$4,111.02–$29,377.00	61% below	70%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level inpatient CPT 22633 ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR	$2,681.10	$8,937.00	—	—	70%
Lumbar laminectomy (spinal decompression), one level CPT 63047 LAM FACETECTOMY AND FORAMOTOMY 1 VRT SGM LUMBAR	$1,710.60	$5,702.00	$2,622.92–$13,051.00	45% below	70%
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 LAM FACETECTOMY AND FORAMOTOMY 1 VRT SGM LUMBAR	$1,710.60	$5,702.00	—	—	70%
Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL	$1,710.60	$5,702.00	$2,622.92–$5,702.00	12% below	70%
Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PARTIAL	$1,710.60	$5,702.00	—	—	70%
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY SIMPLE COMPLETE	$2,285.70	$7,619.00	$3,504.74–$7,120.36	10% below	70%
Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY SIMPLE COMPLETE	$2,285.70	$7,619.00	—	—	70%
Miscarriage treatment with D&C, first trimester CPT 59820 TX MISSED ABORTION FIRST TRIMESTER SURGICAL	$1,125.90	$3,753.00	$1,726.38–$5,178.00	70% below	70%
Miscarriage treatment with D&C, first trimester CPT 59820 Treatment Missed Abortion First Trimester	$1,417.80	$4,726.00	$2,173.96–$5,178.00	62% below	70%
Miscarriage treatment with D&C, first trimester CPT 59820 Treatment of missed abortion completed surgically	$1,417.80	$4,726.00	$2,173.96–$5,178.00	62% below	70%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TX MISSED ABORTION FIRST TRIMESTER SURGICAL	$1,125.90	$3,753.00	—	—	70%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 Treatment of missed abortion completed surgically	$1,417.80	$4,726.00	—	—	70%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 Treatment Missed Abortion First Trimester	$1,417.80	$4,726.00	—	—	70%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Excision benign lesion trunk/arms/legs	$426.60	$1,422.00	$654.12–$1,966.00	60% above	70%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Excision Benign Lesion Trunk Arms Legs 0.5cm or <	$439.20	$1,464.00	$673.44–$1,024.80	65% above	70%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC B9 LESION MRGN XCP SK TG T-A-L 0.5 CM-LESS THA	$2,681.10	$8,937.00	$1,562.00–$6,255.90	904% above	70%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Excision benign lesion trunk/arms/legs	$426.60	$1,422.00	—	—	70%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Excision Benign Lesion Trunk Arms Legs 0.5cm or <	$439.20	$1,464.00	—	—	70%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC B9 LESION MRGN XCP SK TG T-A-L 0.5 CM-LESS THA	$2,681.10	$8,937.00	—	—	70%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Excision benign lesion face/ears/eyelids/nose	$492.00	$1,640.00	$754.40–$1,966.00	6% below	70%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC B9 LESION MRGN XCP SK TG F-E-E-N-L-M 0.5CM-LES	$1,710.60	$5,702.00	$1,562.00–$4,778.89	225% above	70%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Excision benign lesion face/ears/eyelids/nose	$492.00	$1,640.00	—	—	70%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC B9 LESION MRGN XCP SK TG F-E-E-N-L-M 0.5CM-LES	$1,710.60	$5,702.00	—	—	70%
Nail removal (partial or complete), one nail CPT 11730 WC-Avulsion of Nail Plate - 1	$92.70	$309.00	$142.14–$1,832.00	54% below	70%
Nail removal (partial or complete), one nail CPT 11730 Avulsion of nail plate partial or complete simple	$141.60	$472.00	$217.12–$1,832.00	30% below	70%
Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Partial or Complete Simple Sin	$145.80	$486.00	$223.56–$908.00	28% below	70%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL-COMPLETE SIMPLE 1	$2,285.70	$7,619.00	$1,128.00–$5,333.30	1036% above	70%
Nail removal (partial or complete), one nail inpatient CPT 11730 WC-Avulsion of Nail Plate - 1	$92.70	$309.00	—	—	70%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion of nail plate partial or complete simple	$141.60	$472.00	—	—	70%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Partial or Complete Simple Sin	$145.80	$486.00	—	—	70%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL-COMPLETE SIMPLE 1	$2,285.70	$7,619.00	—	—	70%
Occipital nerve block (injection for headaches) CPT 64405 Inj Greater Occipital Nerve	$366.90	$1,223.00	$562.58–$1,832.00	33% below	70%
Occipital nerve block (injection for headaches) CPT 64405 Injection Anesthetic Agent Greater Occiptal Nerve	$378.00	$1,260.00	$579.60–$908.00	31% below	70%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Inj Greater Occipital Nerve	$366.90	$1,223.00	—	—	70%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Injection Anesthetic Agent Greater Occiptal Nerve	$378.00	$1,260.00	—	—	70%
Pacemaker implant (dual chamber) CPT 33208 Insert/Replace Permanent Pacemaker	$6,423.90	$21,413.00	$9,849.98–$29,377.00	65% below	70%
Pacemaker implant (dual chamber) CPT 33208 Insert/Replace Atr/Ventr Elect	$6,423.90	$21,413.00	$9,849.98–$29,377.00	65% below	70%
Pacemaker implant (dual chamber) inpatient CPT 33208 Insert/Replace Permanent Pacemaker	$6,423.90	$21,413.00	—	—	70%
Pacemaker implant (dual chamber) inpatient CPT 33208 Insert/Replace Atr/Ventr Elect	$6,423.90	$21,413.00	—	—	70%
Paracentesis with imaging guidance CPT 49083 MJUS Exam	$527.10	$1,757.00	$808.22–$3,141.00	50% below	70%
Paracentesis with imaging guidance CPT 49083 CT Exam	$527.10	$1,757.00	$808.22–$1,229.90	50% below	70%
Paracentesis with imaging guidance CPT 49083 MSP Exam	$670.50	$2,235.00	$1,028.10–$3,141.00	36% below	70%
Paracentesis with imaging guidance CPT 49083 49083 Abdominal paracentesis with imaging guidance	$779.70	$2,599.00	$1,195.54–$3,141.00	26% below	70%
Paracentesis with imaging guidance CPT 49083 Abdominal paracentesis with imaging guidance	$779.70	$2,599.00	$774.00–$1,819.30	26% below	70%
Paracentesis with imaging guidance inpatient CPT 49083 CT Exam	$527.10	$1,757.00	—	—	70%
Paracentesis with imaging guidance inpatient CPT 49083 MJUS Exam	$527.10	$1,757.00	—	—	70%
Paracentesis with imaging guidance inpatient CPT 49083 MSP Exam	$670.50	$2,235.00	—	—	70%
Paracentesis with imaging guidance inpatient CPT 49083 49083 Abdominal paracentesis with imaging guidance	$779.70	$2,599.00	—	—	70%
Paracentesis with imaging guidance inpatient CPT 49083 Abdominal paracentesis with imaging guidance	$779.70	$2,599.00	—	—	70%
Partial knee replacement (one compartment) CPT 27446 ARTHRP KNEE CONDYLEANDPLATEAU MEDIAL-LAT CMPRT	$2,285.70	$7,619.00	$3,504.74–$18,955.00	22% below	70%
Partial knee replacement (one compartment) inpatient CPT 27446 ARTHRP KNEE CONDYLEANDPLATEAU MEDIAL-LAT CMPRT	$2,285.70	$7,619.00	—	—	70%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Nail/Nail Matrix Partial or Complete Perm	$300.00	$1,000.00	$460.00–$908.00	30% below	70%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 WC-Excision of Nail - Partial or Complete	$355.20	$1,184.00	$118.00–$828.80	17% below	70%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAILANDNAIL MATRIX PRTL-COMPL PERM RMVL	$1,125.90	$3,753.00	$1,128.00–$3,753.00	163% above	70%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Nail/Nail Matrix Partial or Complete Perm	$300.00	$1,000.00	—	—	70%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 WC-Excision of Nail - Partial or Complete	$355.20	$1,184.00	—	—	70%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAILANDNAIL MATRIX PRTL-COMPL PERM RMVL	$1,125.90	$3,753.00	—	—	70%
Prostate biopsy CPT 55700 PROSTATE NEEDLE BIOPSY ANY APPROACH	$1,125.90	$3,753.00	$1,726.38–$3,753.00	40% below	70%
Prostate biopsy inpatient CPT 55700 PROSTATE NEEDLE BIOPSY ANY APPROACH	$1,125.90	$3,753.00	—	—	70%
Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPS SURG PRST8ECT RPBIC RAD W-NERVE SPARING	$2,681.10	$8,937.00	$4,111.02–$18,955.00	22% below	70%
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 LAPS SURG PRST8ECT RPBIC RAD W-NERVE SPARING	$2,681.10	$8,937.00	—	—	70%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR-SACRAL	$898.20	$2,994.00	$1,377.24–$5,178.00	62% below	70%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 SP IR Exam	$1,712.70	$5,709.00	$2,626.14–$5,178.00	28% below	70%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 MECT Exam	$1,712.70	$5,709.00	$2,626.14–$5,178.00	28% below	70%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR-SACRAL	$898.20	$2,994.00	—	—	70%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 SP IR Exam	$1,712.70	$5,709.00	—	—	70%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 MECT Exam	$1,712.70	$5,709.00	—	—	70%
Removal of a breast lump, open surgery CPT 19120 EXC CYST-ABERRANT BREAST TISSUE OPEN 1-GREATER THA	$1,710.60	$5,702.00	$2,622.92–$5,702.00	4% below	70%
Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST-ABERRANT BREAST TISSUE OPEN 1-GREATER THA	$1,710.60	$5,702.00	—	—	70%
Removal of a foreign object under the skin, simple CPT 10120 Incision/Removal Foreign Body Subq Tissue Simple	$183.00	$610.00	$280.60–$908.00	38% below	70%
Removal of a foreign object under the skin, simple CPT 10120 Incision and removal of foreign body subcutaneous	$187.20	$624.00	$287.04–$1,832.00	36% below	70%
Removal of a foreign object under the skin, simple CPT 10120 WC-Removal Foreign Body - Simple	$191.10	$637.00	$118.00–$445.90	35% below	70%
Removal of a foreign object under the skin, simple CPT 10120 Inc and Removal FB Subcu Tissue	$192.90	$643.00	$295.78–$1,832.00	34% below	70%
Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$1,125.90	$3,753.00	$1,128.00–$3,753.00	284% above	70%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision/Removal Foreign Body Subq Tissue Simple	$183.00	$610.00	—	—	70%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision and removal of foreign body subcutaneous	$187.20	$624.00	—	—	70%
Removal of a foreign object under the skin, simple inpatient CPT 10120 WC-Removal Foreign Body - Simple	$191.10	$637.00	—	—	70%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Inc and Removal FB Subcu Tissue	$192.90	$643.00	—	—	70%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION AND REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$1,125.90	$3,753.00	—	—	70%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 TOTAL THYROID LOBECTOMY UNI W-WO ISTHMUSECTOMY	$2,285.70	$7,619.00	$3,504.74–$13,051.00	at median	70%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 TOTAL THYROID LOBECTOMY UNI W-WO ISTHMUSECTOMY	$2,285.70	$7,619.00	—	—	70%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 END-Colorectal Screen - Not High Risk	$783.30	$2,611.00	$1,201.06–$2,611.00	37% below	70%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 END-Colorectal Screen - Not High Risk	$783.30	$2,611.00	—	—	70%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 END-Colorectal Screen - High Risk	$639.00	$2,130.00	$979.80–$2,130.00	58% below	70%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 END-Colorectal Screen - High Risk	$639.00	$2,130.00	—	—	70%
Septoplasty to straighten the nasal septum CPT 30520 SEPTOPLASTY-SUBMUCOUS RESECJ W-WO CARTILAGE GRF	$2,285.70	$7,619.00	$3,504.74–$7,120.36	68% below	70%
Septoplasty to straighten the nasal septum inpatient CPT 30520 SEPTOPLASTY-SUBMUCOUS RESECJ W-WO CARTILAGE GRF	$2,285.70	$7,619.00	—	—	70%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY XTRCORP SHOCK WAVE	$1,125.90	$3,753.00	$1,726.38–$13,051.00	88% below	70%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Lithotripsy	$3,598.50	$11,995.00	$5,517.70–$13,051.00	62% below	70%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY XTRCORP SHOCK WAVE	$1,125.90	$3,753.00	—	—	70%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 Lithotripsy	$3,598.50	$11,995.00	—	—	70%
Short arm cast (elbow to hand) CPT 29075 Application Cast Elbow/Finger (Short Arm)	$220.50	$735.00	$338.10–$908.00	5% below	70%
Short arm cast (elbow to hand) inpatient CPT 29075 Application Cast Elbow/Finger (Short Arm)	$220.50	$735.00	—	—	70%
Short arm splint (forearm and hand) CPT 29125 Short arm splint	$105.30	$351.00	$161.46–$1,832.00	39% below	70%
Short arm splint (forearm and hand) CPT 29125 Application Short Arm Splint (Forearm/Hand) Static	$108.60	$362.00	$166.52–$908.00	37% below	70%
Short arm splint (forearm and hand) inpatient CPT 29125 Short arm splint	$105.30	$351.00	—	—	70%
Short arm splint (forearm and hand) inpatient CPT 29125 Application Short Arm Splint (Forearm/Hand) Static	$108.60	$362.00	—	—	70%
Short leg cast (below the knee) CPT 29405 Application Short Leg Cast (Below Knee/Toe)	$162.90	$543.00	$249.78–$908.00	31% below	70%
Short leg cast (below the knee) CPT 29405 Short leg cast	$174.00	$580.00	$266.80–$1,832.00	26% below	70%
Short leg cast (below the knee) inpatient CPT 29405 Application Short Leg Cast (Below Knee/Toe)	$162.90	$543.00	—	—	70%
Short leg cast (below the knee) inpatient CPT 29405 Short leg cast	$174.00	$580.00	—	—	70%
Short leg splint (calf to foot) CPT 29515 Short leg splint	$76.80	$256.00	$117.76–$1,832.00	57% below	70%
Short leg splint (calf to foot) CPT 29515 Application Short Leg Splint (Calf/Foot)	$77.40	$258.00	$118.68–$908.00	56% below	70%
Short leg splint (calf to foot) inpatient CPT 29515 Short leg splint	$76.80	$256.00	—	—	70%
Short leg splint (calf to foot) inpatient CPT 29515 Application Short Leg Splint (Calf/Foot)	$77.40	$258.00	—	—	70%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC	$2,285.70	$7,619.00	$3,504.74–$13,051.00	11% above	70%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC	$2,285.70	$7,619.00	—	—	70%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SURGICAL ARTHROSCOPY SHO W-CORACOACRM LIGM RLS	$2,285.70	$7,619.00	$1,128.00–$6,408.55	323% above	70%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 SURGICAL ARTHROSCOPY SHO W-CORACOACRM LIGM RLS	$2,285.70	$7,619.00	—	—	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 WC-Repair Simple Wound 2.5cm or < Scalp Neck Trunk	$179.40	$598.00	$118.00–$418.60	25% below	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple suture labia	$179.40	$598.00	$275.08–$1,832.00	25% below	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Repair Simple Wound Scalp Neck Axillae Genitalia T	$179.40	$598.00	$275.08–$908.00	25% below	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Repair Simple Wound (2.5cm or <) ScalpNeckAxillaeE	$179.40	$598.00	$275.08–$1,832.00	25% below	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple Repair of Superficial Wound	$179.40	$598.00	$275.08–$1,832.00	25% below	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR SCALP-NECK-AX-GENIT-TRUNK 2.5CM-LESS	$2,285.70	$7,619.00	$1,128.00–$5,333.30	854% above	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Repair Simple Wound Scalp Neck Axillae Genitalia T	$179.40	$598.00	—	—	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple suture labia	$179.40	$598.00	—	—	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple Repair of Superficial Wound	$179.40	$598.00	—	—	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 WC-Repair Simple Wound 2.5cm or < Scalp Neck Trunk	$179.40	$598.00	—	—	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Repair Simple Wound (2.5cm or <) ScalpNeckAxillaeE	$179.40	$598.00	—	—	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR SCALP-NECK-AX-GENIT-TRUNK 2.5CM-LESS	$2,285.70	$7,619.00	—	—	70%
Skin biopsy, punch, one lesion CPT 11104 Punch Bx of skin sgle lesion	$166.50	$555.00	$255.30–$1,832.00	37% below	70%
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy of skin single lesion	$171.60	$572.00	$263.12–$908.00	35% below	70%
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy	$171.60	$572.00	$118.00–$400.40	35% below	70%
Skin biopsy, punch, one lesion CPT 11104 WC-Punch Bx skin single lesion	$171.60	$572.00	$118.00–$400.40	35% below	70%
Skin biopsy, punch, one lesion CPT 11104 END-Punch Bx of skin single lesion	$171.60	$572.00	$263.12–$1,832.00	35% below	70%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$1,710.60	$5,702.00	$1,128.00–$3,991.40	545% above	70%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bx of skin sgle lesion	$166.50	$555.00	—	—	70%
Skin biopsy, punch, one lesion inpatient CPT 11104 WC-Punch Bx skin single lesion	$171.60	$572.00	—	—	70%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy	$171.60	$572.00	—	—	70%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy of skin single lesion	$171.60	$572.00	—	—	70%
Skin biopsy, punch, one lesion inpatient CPT 11104 END-Punch Bx of skin single lesion	$171.60	$572.00	—	—	70%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$1,710.60	$5,702.00	—	—	70%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Excision malignant lesion trunk/arms/legs	$560.10	$1,867.00	$858.82–$1,966.00	38% above	70%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Excision malignant lesion trunk/arms/legs	$560.10	$1,867.00	—	—	70%
Skin tag removal, up to 15 tags CPT 11200 Removal Skin Tags 15 Lesions or <	$97.50	$325.00	$149.50–$908.00	44% below	70%
Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TOANDINC 15	$1,125.90	$3,753.00	$1,128.00–$3,753.00	543% above	70%
Skin tag removal, up to 15 tags inpatient CPT 11200 Removal Skin Tags 15 Lesions or <	$97.50	$325.00	—	—	70%
Skin tag removal, up to 15 tags inpatient CPT 11200 RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TOANDINC 15	$1,125.90	$3,753.00	—	—	70%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar puncture diagnostic	$321.30	$1,071.00	$492.66–$1,966.00	47% below	70%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Tap	$321.30	$1,071.00	$492.66–$1,966.00	47% below	70%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Fluid Tap	$330.90	$1,103.00	$507.38–$1,966.00	45% below	70%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Puncture Lumbar Diagnostic	$330.90	$1,103.00	$507.38–$908.00	45% below	70%
Spinal tap (lumbar puncture), diagnostic CPT 62270 INF-Spinal puncture lumbar diagnostic (Lumbar Punc	$330.90	$1,103.00	$507.38–$716.95	45% below	70%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Tap	$321.30	$1,071.00	—	—	70%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar puncture diagnostic	$321.30	$1,071.00	—	—	70%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Fluid Tap	$330.90	$1,103.00	—	—	70%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 INF-Spinal puncture lumbar diagnostic (Lumbar Punc	$330.90	$1,103.00	—	—	70%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Puncture Lumbar Diagnostic	$330.90	$1,103.00	—	—	70%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Laceration Repair	$135.30	$451.00	$118.00–$315.70	47% below	70%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 WC-Repair Simple Wound 2.6-7.5 cm Scalp Neck Trunk	$135.30	$451.00	$118.00–$315.70	47% below	70%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Repair Simple Wound Scalp Neck Axillae External Ge	$135.30	$451.00	$207.46–$908.00	47% below	70%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Laceration Repair	$135.30	$451.00	—	—	70%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 WC-Repair Simple Wound 2.6-7.5 cm Scalp Neck Trunk	$135.30	$451.00	—	—	70%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Repair Simple Wound Scalp Neck Axillae External Ge	$135.30	$451.00	—	—	70%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple repair face ear eyelid nose lip	$81.00	$270.00	$124.20–$1,832.00	68% below	70%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Repair Simple Wound Face Ears Eyelids Nose Lips Mu	$92.70	$309.00	$142.14–$908.00	64% below	70%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple repair face ear eyelid nose lip	$81.00	$270.00	—	—	70%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Repair Simple Wound Face Ears Eyelids Nose Lips Mu	$92.70	$309.00	—	—	70%
TURP (transurethral resection of the prostate) CPT 52601 TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE	$1,710.60	$5,702.00	$2,622.92–$8,545.00	81% below	70%
TURP (transurethral resection of the prostate) inpatient CPT 52601 TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE	$1,710.60	$5,702.00	—	—	70%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangential bx of skin sgle lesion	$166.50	$555.00	$255.30–$1,832.00	23% below	70%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 END-Tangential bx of skin single lesion	$171.60	$572.00	$263.12–$1,832.00	21% below	70%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangential biopsy of skin single lesion	$171.60	$572.00	$263.12–$908.00	21% below	70%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 WC-Tangential bx skin single lesion	$171.60	$572.00	$118.00–$400.40	21% below	70%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangential bx of skin sgle lesion	$166.50	$555.00	—	—	70%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 WC-Tangential bx skin single lesion	$171.60	$572.00	—	—	70%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 END-Tangential bx of skin single lesion	$171.60	$572.00	—	—	70%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangential biopsy of skin single lesion	$171.60	$572.00	—	—	70%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis needle/catheter asp of pleural space	$558.90	$1,863.00	$774.00–$1,304.10	43% below	70%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE/CATHETER W/IMAGING GUIDANCE	$558.90	$1,863.00	$856.98–$1,966.00	43% below	70%
Thoracentesis with imaging guidance CPT 32555 US Exam	$558.90	$1,863.00	$856.98–$1,966.00	43% below	70%
Thoracentesis with imaging guidance CPT 32555 SP Exam	$558.90	$1,863.00	$856.98–$1,966.00	43% below	70%
Thoracentesis with imaging guidance CPT 32555 CT Exam	$1,117.80	$3,726.00	$951.00–$2,608.20	14% above	70%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE-CATH PLEURA W-IMAGING	$1,710.60	$5,702.00	$1,562.00–$3,991.40	74% above	70%
Thoracentesis with imaging guidance inpatient CPT 32555 US Exam	$558.90	$1,863.00	—	—	70%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE/CATHETER W/IMAGING GUIDANCE	$558.90	$1,863.00	—	—	70%
Thoracentesis with imaging guidance inpatient CPT 32555 SP Exam	$558.90	$1,863.00	—	—	70%
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis needle/catheter asp of pleural space	$558.90	$1,863.00	—	—	70%
Thoracentesis with imaging guidance inpatient CPT 32555 CT Exam	$1,117.80	$3,726.00	—	—	70%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE-CATH PLEURA W-IMAGING	$1,710.60	$5,702.00	—	—	70%
Total hip replacement CPT 27130 ARTHRP ACETBLR-PROX FEM PROSTC AGRFT-ALGRFT	$2,285.70	$7,619.00	$3,504.74–$18,955.00	34% below	70%
Total hip replacement inpatient CPT 27130 ARTHRP ACETBLR-PROX FEM PROSTC AGRFT-ALGRFT	$2,285.70	$7,619.00	—	—	70%
Total knee replacement CPT 27447 ARTHRP KNE CONDYLEANDPLATU MEDIALANDLAT COMPARTMEN	$2,285.70	$7,619.00	$3,504.74–$18,955.00	71% below	70%
Total knee replacement inpatient CPT 27447 ARTHRP KNE CONDYLEANDPLATU MEDIALANDLAT COMPARTMEN	$2,285.70	$7,619.00	—	—	70%
Total shoulder replacement CPT 23472 ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER	$2,285.70	$7,619.00	$3,504.74–$18,955.00	67% below	70%
Total shoulder replacement inpatient CPT 23472 ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER	$2,285.70	$7,619.00	—	—	70%
Total thyroid removal (thyroidectomy) CPT 60240 THYROIDECTOMY TOTAL-COMPLETE	$2,285.70	$7,619.00	$3,504.74–$13,051.00	14% below	70%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 THYROIDECTOMY TOTAL-COMPLETE	$2,285.70	$7,619.00	—	—	70%
Trigger finger release surgery CPT 26055 Tendon Sheath Incision	$1,236.00	$4,120.00	$1,895.20–$4,120.00	50% below	70%
Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION	$1,710.60	$5,702.00	$2,011.00–$4,778.89	31% below	70%
Trigger finger release surgery inpatient CPT 26055 Tendon Sheath Incision	$1,236.00	$4,120.00	—	—	70%
Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION	$1,710.60	$5,702.00	—	—	70%
Trigger point injections, 1 or 2 muscles CPT 20552 Trigger point injection 1 or 2 muscles	$207.90	$693.00	$318.78–$1,832.00	34% below	70%
Trigger point injections, 1 or 2 muscles CPT 20552 Trigger Inj	$214.20	$714.00	$328.44–$1,832.00	32% below	70%
Trigger point injections, 1 or 2 muscles CPT 20552 Injection Single/Multiple Trigger Point 1-2 Muscle	$214.20	$714.00	$328.44–$908.00	32% below	70%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE-MLT TRIGGER POINT 1-2 MUSCLES	$898.20	$2,994.00	$1,128.00–$2,994.00	184% above	70%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Trigger point injection 1 or 2 muscles	$207.90	$693.00	—	—	70%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Trigger Inj	$214.20	$714.00	—	—	70%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Injection Single/Multiple Trigger Point 1-2 Muscle	$214.20	$714.00	—	—	70%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE-MLT TRIGGER POINT 1-2 MUSCLES	$898.20	$2,994.00	—	—	70%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY FULGURATION OVIDUCTS	$1,710.60	$5,702.00	$2,622.92–$13,051.00	63% below	70%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 LAPAROSCOPY FULGURATION OVIDUCTS	$1,710.60	$5,702.00	—	—	70%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Exam	$924.30	$3,081.00	$1,309.42–$2,156.70	55% below	70%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Exam	$924.30	$3,081.00	$1,309.42–$2,156.70	55% below	70%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Exam	$924.30	$3,081.00	—	—	70%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Exam	$924.30	$3,081.00	—	—	70%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 END-Esoph Endo Dilation	$1,000.80	$3,336.00	$1,534.56–$3,336.00	61% below	70%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 END-Esoph Endo Dilation	$1,000.80	$3,336.00	—	—	70%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD with biopsy	$1,081.50	$3,605.00	$774.00–$2,523.50	40% below	70%
Upper endoscopy (EGD) with biopsy CPT 43239 END-Esophogogastroscopy w/Bx	$1,081.50	$3,605.00	$1,658.30–$3,605.00	40% below	70%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD TRANSORAL BIOPSY SINGLE-MULTIPLE	$2,681.10	$8,937.00	$2,011.00–$6,255.90	48% above	70%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 END-Esophogogastroscopy w/Bx	$1,081.50	$3,605.00	—	—	70%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD with biopsy	$1,081.50	$3,605.00	—	—	70%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD TRANSORAL BIOPSY SINGLE-MULTIPLE	$2,681.10	$8,937.00	—	—	70%
Upper endoscopy (EGD) with injection into the lining CPT 43236 END-Endoscopy w/Submucosal Inj	$662.40	$2,208.00	$1,015.68–$3,141.00	74% below	70%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 END-Endoscopy w/Submucosal Inj	$662.40	$2,208.00	—	—	70%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 END-Esophagogastroscopy w/Pol	$1,000.50	$3,335.00	$1,534.10–$3,335.00	49% below	70%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 END-Esophagogastroscopy w/Pol	$1,000.50	$3,335.00	—	—	70%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 UGI with Insertion of Guide Wire	$790.20	$2,634.00	$774.00–$1,843.80	34% below	70%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 END-Esophageal Dilation Savor	$790.20	$2,634.00	$1,211.64–$3,141.00	34% below	70%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 END-Esophageal Dilation Savor	$790.20	$2,634.00	—	—	70%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 UGI with Insertion of Guide Wire	$790.20	$2,634.00	—	—	70%
Upper endoscopy (EGD), diagnostic CPT 43235 Upper GI Endoscopy w/w-o Specimen Collection	$779.70	$2,599.00	$1,195.54–$3,141.00	52% below	70%
Upper endoscopy (EGD), diagnostic CPT 43235 END-Esophagogastroduoden Diagnostic	$779.70	$2,599.00	$1,195.54–$3,141.00	52% below	70%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 END-Esophagogastroduoden Diagnostic	$779.70	$2,599.00	—	—	70%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Upper GI Endoscopy w/w-o Specimen Collection	$779.70	$2,599.00	—	—	70%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 END-EDG flexible transoral with transmural drainag	$1,887.90	$6,293.00	$2,894.78–$5,178.00	46% below	70%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 END-EDG flexible transoral with transmural drainag	$1,887.90	$6,293.00	—	—	70%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTO W-URETEROSCOPY W-LITHOTRIPSY	$1,710.60	$5,702.00	$2,622.92–$8,545.00	72% below	70%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 CYSTO W-URETEROSCOPY W-LITHOTRIPSY	$1,710.60	$5,702.00	—	—	70%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO-URETERO W-LITHOTRIPSY ANDINDWELL STENT INSRT	$1,710.60	$5,702.00	$2,622.92–$8,545.00	80% below	70%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYSTO-URETERO W-LITHOTRIPSY ANDINDWELL STENT INSRT	$1,710.60	$5,702.00	—	—	70%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY UNI-BI SPX W-POSTOP SEMEN EXAMS	$1,125.90	$3,753.00	$1,726.38–$5,178.00	—	70%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY UNI-BI SPX W-POSTOP SEMEN EXAMS	$1,125.90	$3,753.00	—	—	70%
Vein ablation, radiofrequency, first vein CPT 36475 ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN	$1,125.90	$3,753.00	$1,726.38–$6,639.00	81% below	70%
Vein ablation, radiofrequency, first vein CPT 36475 SP Exam	$3,463.80	$11,546.00	$4,700.00–$8,082.20	41% below	70%
Vein ablation, radiofrequency, first vein CPT 36475 RF Guide Ablat Vein	$3,567.90	$11,893.00	$4,700.00–$8,325.10	40% below	70%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN	$1,125.90	$3,753.00	—	—	70%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 SP Exam	$3,463.80	$11,546.00	—	—	70%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 RF Guide Ablat Vein	$3,567.90	$11,893.00	—	—	70%
Wart removal, up to 14 warts CPT 17110 Destruction benign lesion(s) 1-14	$125.10	$417.00	$191.82–$908.00	37% below	70%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14	$1,710.60	$5,702.00	$1,128.00–$3,991.40	765% above	70%
Wart removal, up to 14 warts inpatient CPT 17110 Destruction benign lesion(s) 1-14	$125.10	$417.00	—	—	70%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14	$1,710.60	$5,702.00	—	—	70%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 WC-Debride subcut <20 sqcm	$285.90	$953.00	$118.00–$667.10	33% below	70%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement SubQ 20 sq cm	$285.90	$953.00	$438.38–$1,832.00	33% below	70%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Skin Subcut Tissue Muscle </ 20sq cm	$285.90	$953.00	$438.38–$1,832.00	33% below	70%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement Skin Partial Thickness and Subq Tissue	$285.90	$953.00	$438.38–$908.00	33% below	70%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM-LESS	$1,710.60	$5,702.00	$1,128.00–$4,778.89	302% above	70%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Skin Subcut Tissue Muscle </ 20sq cm	$285.90	$953.00	—	—	70%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debridement SubQ 20 sq cm	$285.90	$953.00	—	—	70%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 WC-Debride subcut <20 sqcm	$285.90	$953.00	—	—	70%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debridement Skin Partial Thickness and Subq Tissue	$285.90	$953.00	—	—	70%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM-LESS	$1,710.60	$5,702.00	—	—	70%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 OPTX DSTL RDL X-ARTIC FX-EPIPHYSL SEPARATION	$2,285.70	$7,619.00	$3,504.74–$13,051.00	3% above	70%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 OPTX DSTL RDL X-ARTIC FX-EPIPHYSL SEPARATION	$2,285.70	$7,619.00	—	—	70%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Blood transfusion (giving blood or blood components) CPT 36430 INF-Infusion Blood Administration-Initial	$395.10	$1,317.00	$180.00–$921.90	28% below	70%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion blood or blood components	$395.10	$1,317.00	$180.00–$921.90	28% below	70%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood or Blood ComponentsTransfusion B	$395.10	$1,317.00	$180.00–$921.90	28% below	70%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Adm Fee	$395.10	$1,317.00	$180.00–$921.90	28% below	70%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD-BLOOD COMPONENTS	$1,710.60	$5,702.00	$1,128.00–$3,991.40	211% above	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 INF-Infusion Blood Administration-Initial	$395.10	$1,317.00	—	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion blood or blood components	$395.10	$1,317.00	—	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood or Blood ComponentsTransfusion B	$395.10	$1,317.00	—	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Adm Fee	$395.10	$1,317.00	—	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD-BLOOD COMPONENTS	$1,710.60	$5,702.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT- MDI/Aero Chamber	$77.70	$259.00	$110.08–$240.00	35% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inline Nebulized Medication Subsequent -ED	$77.70	$259.00	$110.08–$240.00	35% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inline Nebulized Medication Initial -ED	$77.70	$259.00	$110.08–$240.00	35% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulized Medication Subsequent -ED	$77.70	$259.00	$110.08–$240.00	35% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulized Medication Initial -ED	$77.70	$259.00	$110.08–$240.00	35% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Inhalation Subsequent	$77.70	$259.00	$110.08–$240.00	35% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Metered Dose Inhaler-Initial - Metered Dose Therap	$77.70	$259.00	$110.08–$240.00	35% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB Treatment-Initial - Hyperinflation Therapy	$77.70	$259.00	$110.08–$240.00	35% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT- Sputum Induction	$77.70	$259.00	$110.08–$240.00	35% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Sputum Collection Expectorated-94644	$77.70	$259.00	$110.08–$240.00	35% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment	$77.70	$259.00	$110.08–$240.00	35% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT- IPPB Treatment Initial	$77.70	$259.00	$110.08–$240.00	35% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Metered Dose Inhaler-Subsequent - MDI/DPI Procedur	$77.70	$259.00	$110.08–$240.00	35% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inline Nebulized Medication-Initial - Aerosol Ther	$83.10	$277.00	$117.72–$240.00	30% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT- Nebulized Med-Inline-Initial	$83.10	$277.00	$117.72–$240.00	30% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT- Nebulized Medication Initial	$86.40	$288.00	$122.40–$240.00	27% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulized Medication-Initial - Aerosol Therapy Pro	$86.40	$288.00	$122.40–$240.00	27% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Metered Dose Inhaler-Initial - MDI/DPI Procedure C	$102.00	$340.00	$144.50–$240.00	14% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT- Metered Dose Initial TX	$102.00	$340.00	$144.50–$240.00	14% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Metered Dose Inhaler-Initial - Aerosol Therapy Pro	$102.00	$340.00	$144.50–$240.00	14% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 Infant Heated High flow Subsequent Daily - RT Only	$105.30	$351.00	$149.18–$1,014.00	11% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 Heated High Flow Subsequent Daily - RT Only Oxygen	$105.30	$351.00	$149.18–$1,014.00	11% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 Heated High Flow Set Up - RT Only Oxygen Therapy P	$514.20	$1,714.00	$728.45–$1,199.80	333% above	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Sputum Collection Expectorated-94644	$77.70	$259.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT- MDI/Aero Chamber	$77.70	$259.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT- IPPB Treatment Initial	$77.70	$259.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Metered Dose Inhaler-Initial - Metered Dose Therap	$77.70	$259.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Inhalation Subsequent	$77.70	$259.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulized Medication Initial -ED	$77.70	$259.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulized Medication Subsequent -ED	$77.70	$259.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Inline Nebulized Medication Initial -ED	$77.70	$259.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Inline Nebulized Medication Subsequent -ED	$77.70	$259.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Metered Dose Inhaler-Subsequent - MDI/DPI Procedur	$77.70	$259.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB Treatment-Initial - Hyperinflation Therapy	$77.70	$259.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT- Sputum Induction	$77.70	$259.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment	$77.70	$259.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Inline Nebulized Medication-Initial - Aerosol Ther	$83.10	$277.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT- Nebulized Med-Inline-Initial	$83.10	$277.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulized Medication-Initial - Aerosol Therapy Pro	$86.40	$288.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT- Nebulized Medication Initial	$86.40	$288.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Metered Dose Inhaler-Initial - MDI/DPI Procedure C	$102.00	$340.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Metered Dose Inhaler-Initial - Aerosol Therapy Pro	$102.00	$340.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT- Metered Dose Initial TX	$102.00	$340.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 Heated High Flow Subsequent Daily - RT Only Oxygen	$105.30	$351.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 Infant Heated High flow Subsequent Daily - RT Only	$105.30	$351.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 Heated High Flow Set Up - RT Only Oxygen Therapy P	$514.20	$1,714.00	—	—	70%
Chemotherapy IV infusion, first hour CPT 96413 INF-Chemo By Infusion/Other (JE)	$274.80	$916.00	$385.77–$1,320.00	49% below	70%
Chemotherapy IV infusion, first hour CPT 96413 INF-Infusion Tech Initial Hour	$274.80	$916.00	$385.77–$1,320.00	49% below	70%
Chemotherapy IV infusion, first hour CPT 96413 Chemo IV infusion 1 hr	$274.80	$916.00	$385.77–$1,320.00	49% below	70%
Chemotherapy IV infusion, first hour CPT 96413 Chemo Admin IV Infusion Initial Hour	$274.80	$916.00	$385.77–$908.00	49% below	70%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Admin IV Infusion Initial Hour	$274.80	$916.00	—	—	70%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo IV infusion 1 hr	$274.80	$916.00	—	—	70%
Chemotherapy IV infusion, first hour inpatient CPT 96413 INF-Infusion Tech Initial Hour	$274.80	$916.00	—	—	70%
Chemotherapy IV infusion, first hour inpatient CPT 96413 INF-Chemo By Infusion/Other (JE)	$274.80	$916.00	—	—	70%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Audiology Eval	$127.50	$425.00	$176.00–$297.50	17% above	70%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 Audiology Eval	$127.50	$425.00	—	—	70%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care Initial Hour	$492.00	$1,640.00	$754.40–$3,733.00	61% below	70%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care - Lynx Visit Level	$501.00	$1,670.00	$768.20–$3,733.00	61% below	70%
Critical care, first 30 to 74 minutes CPT 99291 Critcal Care	$661.80	$2,206.00	$1,014.76–$3,733.00	48% below	70%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care Initial Hour	$492.00	$1,640.00	—	—	70%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care - Lynx Visit Level	$501.00	$1,670.00	—	—	70%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critcal Care	$661.80	$2,206.00	—	—	70%
EEG (brain wave test), awake and drowsy, routine CPT 95816 NER- EEG - Awake and Drowsy	$464.40	$1,548.00	$639.00–$1,083.60	28% below	70%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 NER- EEG - Awake and Drowsy	$464.40	$1,548.00	—	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG	$76.50	$255.00	$23.83–$284.00	52% below	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG in ED	$76.50	$255.00	$23.83–$284.00	52% below	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG Pediatric	$76.50	$255.00	$23.83–$284.00	52% below	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG Acquisition	$88.20	$294.00	$23.83–$284.00	45% below	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG tracing only without interp and report	$88.20	$294.00	$23.83–$284.00	45% below	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG ROUTINE ECG W-LEAST 12 LDS TRCG ONLY W-O IANDR	$1,710.60	$5,702.00	$23.83–$3,991.40	974% above	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG Pediatric	$76.50	$255.00	—	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG	$76.50	$255.00	—	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG in ED	$76.50	$255.00	—	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG Acquisition	$88.20	$294.00	—	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG tracing only without interp and report	$88.20	$294.00	—	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG ROUTINE ECG W-LEAST 12 LDS TRCG ONLY W-O IANDR	$1,710.60	$5,702.00	—	—	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Level 1 - Lynx Visit Level	$70.80	$236.00	$108.56–$908.00	61% below	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Level 1 Focused	$70.80	$236.00	$108.56–$908.00	61% below	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER Procedure Level 1	$134.70	$449.00	$206.54–$908.00	26% below	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER Visit Pre-Arranged - JE - ED Other Charges 8.0	$139.20	$464.00	$213.44–$908.00	23% below	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Level 1 - Lynx Visit Level	$70.80	$236.00	—	—	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Level 1 Focused	$70.80	$236.00	—	—	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER Procedure Level 1	$134.70	$449.00	—	—	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER Visit Pre-Arranged - JE - ED Other Charges 8.0	$139.20	$464.00	—	—	70%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER Procedure Level 2	$173.70	$579.00	$266.34–$1,018.00	41% below	70%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Level 2 - Lynx Visit Level	$190.80	$636.00	$292.56–$1,018.00	35% below	70%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Level 2 Expanded Low	$190.80	$636.00	$292.56–$1,018.00	35% below	70%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER Procedure Level 2	$173.70	$579.00	—	—	70%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Level 2 - Lynx Visit Level	$190.80	$636.00	—	—	70%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Level 2 Expanded Low	$190.80	$636.00	—	—	70%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EVM - ED Visit Low Level MDM	$203.10	$677.00	$311.42–$1,392.00	54% below	70%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Level 3 Expanded Moderate	$333.60	$1,112.00	$511.52–$1,392.00	24% below	70%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER Procedure Level 3	$410.10	$1,367.00	$628.82–$1,392.00	7% below	70%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Level 3 - Lynx Visit Level	$458.70	$1,529.00	$703.34–$1,529.00	4% above	70%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EVM - ED Visit Low Level MDM	$203.10	$677.00	—	—	70%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Level 3 Expanded Moderate	$333.60	$1,112.00	—	—	70%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER Procedure Level 3	$410.10	$1,367.00	—	—	70%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Level 3 - Lynx Visit Level	$458.70	$1,529.00	—	—	70%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER Procedure Level 4	$820.80	$2,736.00	$1,258.56–$2,736.00	18% above	70%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT MODERATE MDM	$1,710.60	$5,702.00	$2,423.35–$3,991.40	145% above	70%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER Procedure Level 4	$820.80	$2,736.00	—	—	70%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPARTMENT VISIT MODERATE MDM	$1,710.60	$5,702.00	—	—	70%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Level 5 Comprehensive	$646.20	$2,154.00	$990.84–$3,733.00	38% below	70%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER Procedure Level 5	$1,128.00	$3,760.00	$1,729.60–$3,760.00	8% above	70%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT HIGH MDM	$1,710.60	$5,702.00	$2,423.35–$5,702.00	63% above	70%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Level 5 Comprehensive	$646.20	$2,154.00	—	—	70%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER Procedure Level 5	$1,128.00	$3,760.00	—	—	70%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPARTMENT VISIT HIGH MDM	$1,710.60	$5,702.00	—	—	70%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiac Stress Test Tracing	$309.00	$1,030.00	$112.48–$1,013.00	55% below	70%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiac Treadmill	$309.00	$1,030.00	$112.48–$1,013.00	55% below	70%
Exercise stress test, tracing only, the hospital charge CPT 93017 PFL-Pulmonary Lab Exercise Challenge	$309.00	$1,030.00	$112.48–$1,013.00	55% below	70%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiac Stress Test Treadmill tracing only without	$360.00	$1,200.00	$112.48–$1,013.00	47% below	70%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 PFL-Pulmonary Lab Exercise Challenge	$309.00	$1,030.00	—	—	70%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiac Stress Test Tracing	$309.00	$1,030.00	—	—	70%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiac Treadmill	$309.00	$1,030.00	—	—	70%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiac Stress Test Treadmill tracing only without	$360.00	$1,200.00	—	—	70%
Family therapy with the patient, 50 minutes CPT 90847 IOP CD - Family Therapy w/Pt Present	$108.90	$363.00	$154.28–$254.10	55% below	70%
Family therapy with the patient, 50 minutes CPT 90847 IOP PSY - Family Therapy w/Pt Present	$108.90	$363.00	$154.28–$254.10	55% below	70%
Family therapy with the patient, 50 minutes CPT 90847 Family Therapy w/Pt Present	$108.90	$363.00	$154.28–$254.10	55% below	70%
Family therapy with the patient, 50 minutes inpatient CPT 90847 IOP CD - Family Therapy w/Pt Present	$108.90	$363.00	—	—	70%
Family therapy with the patient, 50 minutes inpatient CPT 90847 IOP PSY - Family Therapy w/Pt Present	$108.90	$363.00	—	—	70%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Therapy w/Pt Present	$108.90	$363.00	—	—	70%
Family therapy without the patient, 50 minutes CPT 90846 IOP PSY - Family Therapy w/o Pt Present	$37.80	$126.00	$53.55–$88.20	85% below	70%
Family therapy without the patient, 50 minutes CPT 90846 Family Therapy w/o Pt Present	$37.80	$126.00	$53.55–$88.20	85% below	70%
Family therapy without the patient, 50 minutes CPT 90846 IOP CD - Family Therapy w/o Pt Present	$37.80	$126.00	$53.55–$88.20	85% below	70%
Family therapy without the patient, 50 minutes inpatient CPT 90846 IOP CD - Family Therapy w/o Pt Present	$37.80	$126.00	—	—	70%
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Therapy w/o Pt Present	$37.80	$126.00	—	—	70%
Family therapy without the patient, 50 minutes inpatient CPT 90846 IOP PSY - Family Therapy w/o Pt Present	$37.80	$126.00	—	—	70%
Group psychotherapy session CPT 90853 Group Therapy	$61.80	$206.00	$87.55–$144.20	75% below	70%
Group psychotherapy session CPT 90853 IOP PSY - Group Psychotherapy	$61.80	$206.00	$87.55–$144.20	75% below	70%
Group psychotherapy session CPT 90853 IOP CD - Group Psychotherapy	$61.80	$206.00	$87.55–$144.20	75% below	70%
Group psychotherapy session inpatient CPT 90853 IOP CD - Group Psychotherapy	$61.80	$206.00	—	—	70%
Group psychotherapy session inpatient CPT 90853 IOP PSY - Group Psychotherapy	$61.80	$206.00	—	—	70%
Group psychotherapy session inpatient CPT 90853 Group Therapy	$61.80	$206.00	—	—	70%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INF-IV Infusion Hydration Initial Hour	$190.50	$635.00	$269.88–$979.00	32% below	70%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Infusion Hydration Initial Hour	$190.50	$635.00	$292.10–$908.00	32% below	70%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration IV infusion initial	$190.50	$635.00	$231.00–$444.50	32% below	70%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR	$1,710.60	$5,702.00	$2,423.35–$3,991.40	513% above	70%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Infusion Hydration Initial Hour	$190.50	$635.00	—	—	70%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INF-IV Infusion Hydration Initial Hour	$190.50	$635.00	—	—	70%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration IV infusion initial	$190.50	$635.00	—	—	70%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR	$1,710.60	$5,702.00	—	—	70%
IV infusion of a medicine, first hour CPT 96365 IV Infusion Initial Hour-96365	$170.40	$568.00	$261.28–$908.00	47% below	70%
IV infusion of a medicine, first hour CPT 96365 INF-IV Infusion Initial Hour	$190.50	$635.00	$231.00–$444.50	40% below	70%
IV infusion of a medicine, first hour CPT 96365 IV Infusion Therapy/Diagnostic Initial Hour	$190.50	$635.00	$292.10–$908.00	40% below	70%
IV infusion of a medicine, first hour CPT 96365 Ther/proph/diag IV inf init	$190.50	$635.00	$231.00–$444.50	40% below	70%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY-PROPHYLAXIS -DX 1ST TO 1 HR	$2,285.70	$7,619.00	$3,238.07–$5,333.30	616% above	70%
IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion Initial Hour-96365	$170.40	$568.00	—	—	70%
IV infusion of a medicine, first hour inpatient CPT 96365 INF-IV Infusion Initial Hour	$190.50	$635.00	—	—	70%
IV infusion of a medicine, first hour inpatient CPT 96365 Ther/proph/diag IV inf init	$190.50	$635.00	—	—	70%
IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion Therapy/Diagnostic Initial Hour	$190.50	$635.00	—	—	70%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY-PROPHYLAXIS -DX 1ST TO 1 HR	$2,285.70	$7,619.00	—	—	70%
IV push of a medicine, first drug CPT 96374 Ther/proph/diag inj IV push	$190.50	$635.00	$269.88–$979.00	3% above	70%
IV push of a medicine, first drug CPT 96374 IV Injection Initial Drug	$190.50	$635.00	$292.10–$908.00	3% above	70%
IV push of a medicine, first drug CPT 96374 INF-IV Injection Initial Drug (IS)	$190.50	$635.00	$269.88–$979.00	3% above	70%
IV push of a medicine, first drug CPT 96374 THER PROPH-DX NJX IV PUSH SINGLE-1ST SBST-DRUG	$1,710.60	$5,702.00	$2,423.35–$3,991.40	824% above	70%
IV push of a medicine, first drug inpatient CPT 96374 Ther/proph/diag inj IV push	$190.50	$635.00	—	—	70%
IV push of a medicine, first drug inpatient CPT 96374 IV Injection Initial Drug	$190.50	$635.00	—	—	70%
IV push of a medicine, first drug inpatient CPT 96374 INF-IV Injection Initial Drug (IS)	$190.50	$635.00	—	—	70%
IV push of a medicine, first drug inpatient CPT 96374 THER PROPH-DX NJX IV PUSH SINGLE-1ST SBST-DRUG	$1,710.60	$5,702.00	—	—	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj Tx/Dx IM	$43.80	$146.00	$62.05–$979.00	51% below	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 WC-Injection - SubQ or IM	$43.80	$146.00	$62.05–$138.00	51% below	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection Antibiotic IM-96372	$43.80	$146.00	$67.16–$908.00	51% below	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/proph/diag inj subcut/im	$43.80	$146.00	$62.05–$979.00	51% below	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 END-IM Injection Administration	$43.80	$146.00	$67.16–$94.90	51% below	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Q/IM Therapeutic Prophylactic Diagnostic Injection	$43.80	$146.00	$62.05–$979.00	51% below	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INF-SC/IM Injection Administration	$43.80	$146.00	$62.05–$979.00	51% below	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 MENM Exam	$43.80	$146.00	$62.05–$979.00	51% below	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection Ther/Dx/Proph SQ/IM-96372	$44.70	$149.00	$68.54–$908.00	50% below	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC-DX INJECTION SUBQ-IM	$2,285.70	$7,619.00	$3,238.07–$5,333.30	2465% above	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inj Tx/Dx IM	$43.80	$146.00	—	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/proph/diag inj subcut/im	$43.80	$146.00	—	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Q/IM Therapeutic Prophylactic Diagnostic Injection	$43.80	$146.00	—	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection Antibiotic IM-96372	$43.80	$146.00	—	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 END-IM Injection Administration	$43.80	$146.00	—	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 WC-Injection - SubQ or IM	$43.80	$146.00	—	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 MENM Exam	$43.80	$146.00	—	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INF-SC/IM Injection Administration	$43.80	$146.00	—	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection Ther/Dx/Proph SQ/IM-96372	$44.70	$149.00	—	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC-DX INJECTION SUBQ-IM	$2,285.70	$7,619.00	—	—	70%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 F MFM OP Psychiatric Evaluation	$114.30	$381.00	$161.93–$645.00	52% below	70%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 F MFM OP Psychiatric Evaluation	$114.30	$381.00	—	—	70%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NER-7-8 Nerve Conduction Studies	$355.50	$1,185.00	$503.63–$829.50	36% below	70%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NER-7-8 Nerve Conduction Studies	$355.50	$1,185.00	—	—	70%
New patient office visit, about 30 minutes CPT 99203 OP Eval - New Pt Exp Focused	$88.20	$294.00	$135.24–$191.10	45% below	70%
New patient office visit, about 30 minutes CPT 99203 EVM - OP VISIT NEW PATIENT LOW LEVEL 30 MIN	$91.20	$304.00	$139.84–$197.60	43% below	70%
New patient office visit, about 30 minutes CPT 99203 WC-OP visit new patient low level 30-44 min	$101.10	$337.00	$155.02–$219.05	37% below	70%
New patient office visit, about 30 minutes inpatient CPT 99203 OP Eval - New Pt Exp Focused	$88.20	$294.00	—	—	70%
New patient office visit, about 30 minutes inpatient CPT 99203 EVM - OP VISIT NEW PATIENT LOW LEVEL 30 MIN	$91.20	$304.00	—	—	70%
New patient office visit, about 30 minutes inpatient CPT 99203 WC-OP visit new patient low level 30-44 min	$101.10	$337.00	—	—	70%
New patient office visit, about 45 minutes CPT 99204 EVM - OP VISIT NEW PATIENT MODERATE LEVEL 45 MIN	$106.80	$356.00	$163.76–$231.40	54% below	70%
New patient office visit, about 45 minutes CPT 99204 WC-OP visit new patient moderate level 45-59 min	$130.50	$435.00	$200.10–$282.75	44% below	70%
New patient office visit, about 45 minutes inpatient CPT 99204 EVM - OP VISIT NEW PATIENT MODERATE LEVEL 45 MIN	$106.80	$356.00	—	—	70%
New patient office visit, about 45 minutes inpatient CPT 99204 WC-OP visit new patient moderate level 45-59 min	$130.50	$435.00	—	—	70%
New patient office visit, about 60 minutes CPT 99205 EVM - OP VISIT NEW PATIENT HIGH LEVEL 60 MIN	$121.80	$406.00	$186.76–$263.90	61% below	70%
New patient office visit, about 60 minutes CPT 99205 WC-OP visit new patient high level 60-74 min	$177.00	$590.00	$271.40–$383.50	43% below	70%
New patient office visit, about 60 minutes inpatient CPT 99205 EVM - OP VISIT NEW PATIENT HIGH LEVEL 60 MIN	$121.80	$406.00	—	—	70%
New patient office visit, about 60 minutes inpatient CPT 99205 WC-OP visit new patient high level 60-74 min	$177.00	$590.00	—	—	70%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 EVM - OP VISIT NEW PATIENT STRAIGHTFORWARD 15 MIN	$74.40	$248.00	$114.08–$161.20	21% below	70%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP Eval - New Pt Focused	$74.40	$248.00	$105.40–$173.60	21% below	70%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC-OP visit new patient straightforward 15-29 min	$74.40	$248.00	$114.08–$161.20	21% below	70%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC-OP visit new patient straightforward 15-29 min	$74.40	$248.00	—	—	70%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 EVM - OP VISIT NEW PATIENT STRAIGHTFORWARD 15 MIN	$74.40	$248.00	—	—	70%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OP Eval - New Pt Focused	$74.40	$248.00	—	—	70%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 DM-Med Nutrition Therapy-Initial 15 min	$17.40	$58.00	$24.65–$322.00	61% below	70%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Medical Nutrition Therapy init assessment individu	$17.40	$58.00	$24.65–$322.00	61% below	70%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Medical Nutrition Therapy init assessment individu	$17.40	$58.00	—	—	70%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 DM-Med Nutrition Therapy-Initial 15 min	$17.40	$58.00	—	—	70%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 EVM - Smoking Cess Counseling 3-10 Min	$24.60	$82.00	$34.85–$322.00	42% below	70%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 EVM - Smoking Cess Counseling 3-10 Min	$24.60	$82.00	—	—	70%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC-OP visit estab patient high level 40-54 min	$132.00	$440.00	$202.40–$286.00	40% below	70%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EVM - OP VISIT ESTAB PATIENT HIGH LEVEL 40 MIN	$132.00	$440.00	$202.40–$286.00	40% below	70%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP Estab - Comprehensive	$132.00	$440.00	$202.40–$286.00	40% below	70%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OP Estab - Comprehensive	$132.00	$440.00	—	—	70%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EVM - OP VISIT ESTAB PATIENT HIGH LEVEL 40 MIN	$132.00	$440.00	—	—	70%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC-OP visit estab patient high level 40-54 min	$132.00	$440.00	—	—	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 JEMAM Exam	$105.00	$350.00	$161.00–$227.50	11% below	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 IP Ostomy Care per 15 minutes	$139.20	$464.00	$197.20–$979.00	18% above	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP Estab - Detailed	$173.10	$577.00	$265.42–$375.05	46% above	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC-OP visit estab patient low level 20-29 min	$173.10	$577.00	$265.42–$375.05	46% above	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Radiology consult low level 20 – 29 min	$173.10	$577.00	$265.42–$375.05	46% above	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EVM - OP VISIT ESTAB PATIENT LOW LEVEL 20 MIN	$173.10	$577.00	$265.42–$375.05	46% above	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 MFM OP visit estab patient low level 20-29 min	$173.10	$577.00	$265.42–$375.05	46% above	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 RAO-OP VISIT ESTAB PATIENT LOW LEVEL 20-29 MIN	$173.10	$577.00	$265.42–$375.05	46% above	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OB Outpatient Services 0-4 HRS	$173.10	$577.00	$265.42–$375.05	46% above	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Mammo Consultation F/U	$173.10	$577.00	$265.42–$375.05	46% above	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Consult Existing Patient	$173.10	$577.00	$265.42–$375.05	46% above	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 JEMAM Exam	$105.00	$350.00	—	—	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 IP Ostomy Care per 15 minutes	$139.20	$464.00	—	—	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 RAO-OP VISIT ESTAB PATIENT LOW LEVEL 20-29 MIN	$173.10	$577.00	—	—	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Radiology consult low level 20 – 29 min	$173.10	$577.00	—	—	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EVM - OP VISIT ESTAB PATIENT LOW LEVEL 20 MIN	$173.10	$577.00	—	—	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC-OP visit estab patient low level 20-29 min	$173.10	$577.00	—	—	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Consult Existing Patient	$173.10	$577.00	—	—	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 MFM OP visit estab patient low level 20-29 min	$173.10	$577.00	—	—	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP Estab - Detailed	$173.10	$577.00	—	—	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Mammo Consultation F/U	$173.10	$577.00	—	—	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OB Outpatient Services 0-4 HRS	$173.10	$577.00	—	—	70%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EVM - OP VISIT ESTAB PATIENT MODERATE 30 MIN	$115.20	$384.00	$176.64–$249.60	30% below	70%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP Estab - In Depth	$118.80	$396.00	$182.16–$257.40	27% below	70%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC-OP visit estab patient moderate 30-39 min	$118.80	$396.00	$182.16–$257.40	27% below	70%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OB Outpatient Services 4-8 HRS	$217.20	$724.00	$307.70–$506.80	33% above	70%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EVM - OP VISIT ESTAB PATIENT MODERATE 30 MIN	$115.20	$384.00	—	—	70%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC-OP visit estab patient moderate 30-39 min	$118.80	$396.00	—	—	70%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP Estab - In Depth	$118.80	$396.00	—	—	70%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OB Outpatient Services 4-8 HRS	$217.20	$724.00	—	—	70%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Wound Care/15 minutes	$81.00	$270.00	$124.20–$175.50	1% below	70%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EVM - OP VISIT ESTAB PATIENT STRAIGHTFORWARD 10 MI	$98.40	$328.00	$150.88–$213.20	20% above	70%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 INF OP VISIT ESTAB PATIENT STRAIGHTFORWARD 10-19 M	$98.40	$328.00	$150.88–$213.20	20% above	70%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC-OP visit estab patient straightforward 10-19 mi	$98.40	$328.00	$150.88–$213.20	20% above	70%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP Estab - Problem Focused	$98.40	$328.00	$150.88–$213.20	20% above	70%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Wound Care/15 minutes	$81.00	$270.00	—	—	70%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP Estab - Problem Focused	$98.40	$328.00	—	—	70%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EVM - OP VISIT ESTAB PATIENT STRAIGHTFORWARD 10 MI	$98.40	$328.00	—	—	70%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 INF OP VISIT ESTAB PATIENT STRAIGHTFORWARD 10-19 M	$98.40	$328.00	—	—	70%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC-OP visit estab patient straightforward 10-19 mi	$98.40	$328.00	—	—	70%
Speech therapy session, individual CPT 92507 ST 92507 Speech Therapy Tx Units	$111.00	$370.00	$70.56–$268.00	49% below	70%
Speech therapy session, individual inpatient CPT 92507 ST 92507 Speech Therapy Tx Units	$111.00	$370.00	—	—	70%
Spirometry (breathing test) CPT 94010 Peak Flow Therapy	$84.90	$283.00	$120.28–$1,014.00	58% below	70%
Spirometry (breathing test) CPT 94010 Peak Flow Therapy - Peak Flow Therapy	$84.90	$283.00	$120.28–$240.00	58% below	70%
Spirometry (breathing test) CPT 94010 Peak Flow Therapy - Aerosol Therapy Procedure Char	$84.90	$283.00	$120.28–$240.00	58% below	70%
Spirometry (breathing test) CPT 94010 Spirometry Measurements w or w/o Maximal Voluntary	$84.90	$283.00	$130.18–$908.00	58% below	70%
Spirometry (breathing test) CPT 94010 RT- PFT-Spirometry	$84.90	$283.00	$120.28–$1,014.00	58% below	70%
Spirometry (breathing test) CPT 94010 RT- Peak Flow Measurement	$84.90	$283.00	$120.28–$1,014.00	58% below	70%
Spirometry (breathing test) CPT 94010 PFL-Spirometry (Flow Volume Loop)	$84.90	$283.00	$120.28–$1,014.00	58% below	70%
Spirometry (breathing test) CPT 94010 Peak Flow Measurement-94010	$87.90	$293.00	$124.53–$240.00	56% below	70%
Spirometry (breathing test) one side CPT 94010 Peak Flow Measurement 94010 - Incentive Spiro RT P	$84.90	$283.00	$120.28–$1,014.00	58% below	70%
Spirometry (breathing test) inpatient CPT 94010 RT- PFT-Spirometry	$84.90	$283.00	—	—	70%
Spirometry (breathing test) inpatient CPT 94010 Spirometry Measurements w or w/o Maximal Voluntary	$84.90	$283.00	—	—	70%
Spirometry (breathing test) inpatient CPT 94010 Peak Flow Therapy	$84.90	$283.00	—	—	70%
Spirometry (breathing test) inpatient CPT 94010 RT- Peak Flow Measurement	$84.90	$283.00	—	—	70%
Spirometry (breathing test) inpatient CPT 94010 Peak Flow Therapy - Peak Flow Therapy	$84.90	$283.00	—	—	70%
Spirometry (breathing test) inpatient CPT 94010 Peak Flow Therapy - Aerosol Therapy Procedure Char	$84.90	$283.00	—	—	70%
Spirometry (breathing test) inpatient CPT 94010 PFL-Spirometry (Flow Volume Loop)	$84.90	$283.00	—	—	70%
Spirometry (breathing test) inpatient CPT 94010 Peak Flow Measurement-94010	$87.90	$293.00	—	—	70%
Spirometry (breathing test) inpatient one side CPT 94010 Peak Flow Measurement 94010 - Incentive Spiro RT P	$84.90	$283.00	—	—	70%
Spirometry before and after a bronchodilator CPT 94060 RT- PFT-Spirometry Post	$186.30	$621.00	$263.93–$1,014.00	53% below	70%
Spirometry before and after a bronchodilator CPT 94060 PFL-Spirometry Pre and Post Bronchodilator (MH)	$186.30	$621.00	$263.93–$1,014.00	53% below	70%
Spirometry before and after a bronchodilator CPT 94060 Bronchodilation Responsiveness Pre and Post Bronch	$186.30	$621.00	$285.66–$908.00	53% below	70%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFL-Spirometry Pre and Post Bronchodilator (MH)	$186.30	$621.00	—	—	70%
Spirometry before and after a bronchodilator inpatient CPT 94060 RT- PFT-Spirometry Post	$186.30	$621.00	—	—	70%
Spirometry before and after a bronchodilator inpatient CPT 94060 Bronchodilation Responsiveness Pre and Post Bronch	$186.30	$621.00	—	—	70%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic (Separate Procedure)	$94.80	$316.00	$145.36–$908.00	48% below	70%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 INF-Phlebotomy	$193.80	$646.00	$274.55–$979.00	6% above	70%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy therapuetic	$193.80	$646.00	$274.55–$979.00	6% above	70%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 ARC Therapeutic Phlebotomy Charge	$255.00	$850.00	$361.25–$979.00	39% above	70%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic (Separate Procedure)	$94.80	$316.00	—	—	70%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy therapuetic	$193.80	$646.00	—	—	70%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 INF-Phlebotomy	$193.80	$646.00	—	—	70%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 ARC Therapeutic Phlebotomy Charge	$255.00	$850.00	—	—	70%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 Cardiovascular stress test pharmacological with in	$253.50	$845.00	$224.33–$1,013.00	59% below	70%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 Cardiovascular stress test pharmacological with in	$253.50	$845.00	—	—	70%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 diphthhaemophiluspertussistetanuspolio 05 mL soln	$58.29	$194.30	$82.58–$136.01	44% below	70%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 diphthhaemophiluspertussistetanuspolio 05 mL soln	$58.29	$194.30	$82.58–$97.15	—	70%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$2,681.10	$8,937.00	$1,751.65–$6,255.90	11869% above	70%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$2,681.10	$8,937.00	—	—	70%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult 10 mcgmL vaccine	$37.05	$123.50	$24.21–$86.45	66% below	70%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B adult 10 mcgmL vaccine	$37.05	$123.50	$52.49–$61.75	—	70%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM	$2,285.70	$7,619.00	$1,493.32–$5,333.30	2948% above	70%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM	$2,285.70	$7,619.00	—	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Administration Influenza Vaccine-G00	$27.90	$93.00	$22.00–$119.00	19% below	70%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Administration Tetanus Vac	$27.90	$93.00	$22.00–$119.00	19% below	70%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Administration Hepatitus Vaccine	$27.90	$93.00	$22.00–$119.00	19% below	70%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Administration Pneumonia Vaccine-G000	$27.90	$93.00	$22.00–$119.00	19% below	70%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INF-Immunization Administration	$27.90	$93.00	$22.00–$119.00	19% below	70%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization admin	$27.90	$93.00	$22.00–$119.00	19% below	70%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 MFM Immunization Admin 1st vaccine	$27.90	$93.00	$22.00–$119.00	19% below	70%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Administration Vaccine/Toxoids	$27.90	$93.00	$22.00–$119.00	19% below	70%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IM ADM PRQ ID SUBQ-IM NJXS 1 VACCINE	$2,681.10	$8,937.00	$22.00–$6,255.90	7717% above	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 MFM Immunization Admin 1st vaccine	$27.90	$93.00	—	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization admin	$27.90	$93.00	—	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization Administration Pneumonia Vaccine-G000	$27.90	$93.00	—	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization Administration Hepatitus Vaccine	$27.90	$93.00	—	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization Administration Tetanus Vac	$27.90	$93.00	—	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INF-Immunization Administration	$27.90	$93.00	—	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization Administration Vaccine/Toxoids	$27.90	$93.00	—	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization Administration Influenza Vaccine-G00	$27.90	$93.00	—	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IM ADM PRQ ID SUBQ-IM NJXS 1 VACCINE	$2,681.10	$8,937.00	—	—	70%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization admin each add	$27.90	$93.00	$39.52–$119.00	2% below	70%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization Administration Vaccine/Toxoid Each Ad	$27.90	$93.00	$39.52–$119.00	2% below	70%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INF-Immunization Administration Each Addl	$27.90	$93.00	$39.52–$119.00	2% below	70%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INF-Immunization Administration Each Addl	$27.90	$93.00	—	—	70%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization Administration Vaccine/Toxoid Each Ad	$27.90	$93.00	—	—	70%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization admin each add	$27.90	$93.00	—	—	70%

Dental

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Porcelain crown CDT D2740 CROWN 1 PR1 UR5 X_8906-125 X_DENOVO	$67.80	$226.00	$96.05–$158.20	—	70%
Porcelain crown CDT D2740 CROWN 1 CNT UP L X_504-2726 X_PATTERSON DENTAL	$67.80	$226.00	$96.05–$158.20	—	70%
Porcelain crown CDT D2740 CROWN 1 LAT UP L X_504-2809 X_PATTERSON DENTAL	$67.80	$226.00	$96.05–$158.20	—	70%
Porcelain crown CDT D2740 CROWN UNITEK SS PRIM UR3 X_5040456 X_PATTERSON DEN	$69.30	$231.00	$98.17–$161.70	—	70%
Porcelain crown CDT D2740 CROWN UNITEK SS PRIM LR3 X_900244 X_PATTERSON DENT	$69.30	$231.00	$98.17–$161.70	—	70%
Porcelain crown CDT D2740 CROWN UNITEK SS PRIM UL4 X_5040506 X_PATTERSON DEN	$69.30	$231.00	$98.17–$161.70	—	70%
Porcelain crown CDT D2740 CROWN UNITEK SS PRIM UL5 X_5040548 X_PATTERSON DEN	$69.30	$231.00	$98.17–$161.70	—	70%
Porcelain crown CDT D2740 CROWN UNITEK SS PRIM LR4 X_900144 X_PATTERSON DENT	$69.30	$231.00	$98.17–$161.70	—	70%
Porcelain crown CDT D2740 CROWN UNITEK SS PRIM LR3 X_900243 X_PATTERSON DENT	$69.30	$231.00	$98.17–$161.70	—	70%
Porcelain crown CDT D2740 CROWN UNITEK SS PRIM UR5 X_5040530 X_PATTERSON DEN	$69.30	$231.00	$98.17–$161.70	—	70%
Porcelain crown CDT D2740 CROWN UNITEK SS PRIM UL3 X_5040464 X_PATTERSON DEN	$69.30	$231.00	$98.17–$161.70	—	70%
Porcelain crown CDT D2740 CROWN UNITEK SS PRIM UR4 X_5040498 X_PATTERSON DEN	$69.30	$231.00	$98.17–$161.70	—	70%
Porcelain crown inpatient CDT D2740 CROWN 1 CNT UP L X_504-2726 X_PATTERSON DENTAL	$67.80	$226.00	—	—	70%
Porcelain crown inpatient CDT D2740 CROWN 1 PR1 UR5 X_8906-125 X_DENOVO	$67.80	$226.00	—	—	70%
Porcelain crown inpatient CDT D2740 CROWN 1 LAT UP L X_504-2809 X_PATTERSON DENTAL	$67.80	$226.00	—	—	70%
Porcelain crown inpatient CDT D2740 CROWN UNITEK SS PRIM UL3 X_5040464 X_PATTERSON DEN	$69.30	$231.00	—	—	70%
Porcelain crown inpatient CDT D2740 CROWN UNITEK SS PRIM LR4 X_900144 X_PATTERSON DENT	$69.30	$231.00	—	—	70%
Porcelain crown inpatient CDT D2740 CROWN UNITEK SS PRIM UL5 X_5040548 X_PATTERSON DEN	$69.30	$231.00	—	—	70%
Porcelain crown inpatient CDT D2740 CROWN UNITEK SS PRIM UL4 X_5040506 X_PATTERSON DEN	$69.30	$231.00	—	—	70%
Porcelain crown inpatient CDT D2740 CROWN UNITEK SS PRIM UR5 X_5040530 X_PATTERSON DEN	$69.30	$231.00	—	—	70%
Porcelain crown inpatient CDT D2740 CROWN UNITEK SS PRIM UR3 X_5040456 X_PATTERSON DEN	$69.30	$231.00	—	—	70%
Porcelain crown inpatient CDT D2740 CROWN UNITEK SS PRIM UR4 X_5040498 X_PATTERSON DEN	$69.30	$231.00	—	—	70%
Porcelain crown inpatient CDT D2740 CROWN UNITEK SS PRIM LR3 X_900244 X_PATTERSON DENT	$69.30	$231.00	—	—	70%
Porcelain crown inpatient CDT D2740 CROWN UNITEK SS PRIM LR3 X_900243 X_PATTERSON DENT	$69.30	$231.00	—	—	70%

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://bestcare.org/sites/default/files/2026-02/420680355_Jennie-Edmundson-Memorial-Hospital_standardcharges.zip