RIM - Rehabilitation Institute of Michigan
Listed in its price file as “VHS Rehabilitation Institute of Michigan Inc”.
RIM - Rehabilitation Institute of Michigan in Detroit, MI publishes cash prices for 218 common procedures listed here, from its own machine-readable price file updated Apr 8, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Michigan median for 10 of 10 procedures. Select a procedure to compare it with other hospitals nearby.
261 Mack Ave, Detroit, MI 48201 Collected Sep 23, 2026 Source price file Check a bill from this hospital
Some prices here are not compared
RIM - Rehabilitation Institute of Michigan is an inpatient rehabilitation hospital. Its price file also lists scans, lab tests and procedures, but these are generally provided to its own inpatients, not booked by outside patients, so they are not compared with other hospitals here. Only its physical, occupational and speech therapy prices are compared.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS | $516.75 | $689.00 | — | — | 25% |
| Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS | $516.75 | $689.00 | — | — | 25% |
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE 3 VIEWS MINIMUM | $239.25 | $319.00 | — | — | 25% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE 3 VIEWS MINIMUM | $239.25 | $319.00 | — | — | 25% |
| Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS | $414.00 | $552.00 | — | — | 25% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS | $414.00 | $552.00 | — | — | 25% |
| Chest X-ray, single view CPT 71045 CHEST 1 VIEW | $188.25 | $251.00 | — | — | 25% |
| Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW | $188.25 | $251.00 | — | — | 25% |
| Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE COMPLETE | $481.50 | $642.00 | — | — | 25% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE COMPLETE | $481.50 | $642.00 | — | — | 25% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE COMP-W/SPEC/COLOR DOP ECHO | $1,868.25 | $2,491.00 | — | — | 25% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE COMP-W/SPEC/COLOR DOP ECHO | $1,868.25 | $2,491.00 | — | — | 25% |
| Elbow X-ray, 2 views CPT 73070 ELBOW 2 VIEWS | $347.25 | $463.00 | — | — | 25% |
| Elbow X-ray, 2 views inpatient CPT 73070 ELBOW 2 VIEWS | $347.25 | $463.00 | — | — | 25% |
| Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW 3 VIEW MINIMUM | $318.75 | $425.00 | — | — | 25% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 ELBOW 3 VIEW MINIMUM | $318.75 | $425.00 | — | — | 25% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM 2 VIEWS | $205.50 | $274.00 | — | — | 25% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 FOREARM 2 VIEWS | $205.50 | $274.00 | — | — | 25% |
| Hand X-ray, 2 views CPT 73120 HAND 2 VIEWS | $261.00 | $348.00 | — | — | 25% |
| Hand X-ray, 2 views inpatient CPT 73120 HAND 2 VIEWS | $261.00 | $348.00 | — | — | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 OS CALCIS 2 VIEWS | $261.00 | $348.00 | — | — | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 OS CALCIS 2 VIEWS | $261.00 | $348.00 | — | — | 25% |
| Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS | $190.50 | $254.00 | — | — | 25% |
| Knee X-ray, 3 views inpatient CPT 73562 KNEE 3 VIEWS | $190.50 | $254.00 | — | — | 25% |
| Knee X-ray, complete, 4 or more views CPT 73564 KNEE COMP 4 VW MIN | $232.50 | $310.00 | — | — | 25% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 KNEE COMP 4 VW MIN | $232.50 | $310.00 | — | — | 25% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIBIA/FIBULA 2 VIEWS | $205.50 | $274.00 | — | — | 25% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 TIBIA/FIBULA 2 VIEWS | $205.50 | $274.00 | — | — | 25% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SPINE CERVICAL 4 OR 5 VW | $416.25 | $555.00 | — | — | 25% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SPINE CERVICAL 4 OR 5 VW | $416.25 | $555.00 | — | — | 25% |
| Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT 2VW | $298.50 | $398.00 | — | — | 25% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILAT 2VW | $298.50 | $398.00 | — | — | 25% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER 2 VWS MINIMUM | $298.50 | $398.00 | — | — | 25% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER 2 VWS MINIMUM | $298.50 | $398.00 | — | — | 25% |
| Skull X-ray, fewer than 4 views CPT 70250 SKULL < 4 VIEWS | $456.00 | $608.00 | — | — | 25% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL < 4 VIEWS | $456.00 | $608.00 | — | — | 25% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 FEMUR 2 VIEWS MIN | $217.50 | $290.00 | — | — | 25% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 FEMUR 2 VIEWS MIN | $217.50 | $290.00 | — | — | 25% |
| Toe X-ray, 2 or more views CPT 73660 TOE(S) 2 VIEWS | $191.25 | $255.00 | — | — | 25% |
| Toe X-ray, 2 or more views inpatient CPT 73660 TOE(S) 2 VIEWS | $191.25 | $255.00 | — | — | 25% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS 2 VIEW MINIMUM | $277.50 | $370.00 | — | — | 25% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HUMERUS 2 VIEW MINIMUM | $277.50 | $370.00 | — | — | 25% |
| Wrist X-ray, 2 views CPT 73100 WRIST 2 VIEWS | $371.25 | $495.00 | — | — | 25% |
| Wrist X-ray, 2 views inpatient CPT 73100 WRIST 2 VIEWS | $371.25 | $495.00 | — | — | 25% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST 3 VIEWS MINIMUM | $216.00 | $288.00 | — | — | 25% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST 3 VIEWS MINIMUM | $216.00 | $288.00 | — | — | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP UNI W/PELV 2-3 VWS | $217.50 | $290.00 | — | — | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP UNI W/PELV 2-3 VWS | $217.50 | $290.00 | — | — | 25% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW | $183.00 | $244.00 | — | — | 25% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW | $183.00 | $244.00 | — | — | 25% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE 2 VIEWS | $300.00 | $400.00 | — | — | 25% |
| X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE 2 VIEWS | $300.00 | $400.00 | — | — | 25% |
| X-ray of the finger(s), 2 or more views CPT 73140 FINGER(S) 2 VIEWS | $180.00 | $240.00 | — | — | 25% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER(S) 2 VIEWS | $180.00 | $240.00 | — | — | 25% |
| X-ray of the foot, 2 views CPT 73620 FOOT 2 VIEWS | $261.00 | $348.00 | — | — | 25% |
| X-ray of the foot, 2 views inpatient CPT 73620 FOOT 2 VIEWS | $261.00 | $348.00 | — | — | 25% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3 VIEWS MINIMUM | $371.25 | $495.00 | — | — | 25% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT 3 VIEWS MINIMUM | $371.25 | $495.00 | — | — | 25% |
| X-ray of the hand, 3 or more views CPT 73130 HAND 3 VIEWS MINIMUM | $454.50 | $606.00 | — | — | 25% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HAND 3 VIEWS MINIMUM | $454.50 | $606.00 | — | — | 25% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1-2 VIEWS | $348.75 | $465.00 | — | — | 25% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE 1-2 VIEWS | $348.75 | $465.00 | — | — | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBAR 2 VIEWS | $298.50 | $398.00 | — | — | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBAR 3 VIEWS | $763.50 | $1,018.00 | — | — | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMBAR 2 VIEWS | $298.50 | $398.00 | — | — | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMBAR 3 VIEWS | $763.50 | $1,018.00 | — | — | 25% |
| X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBAR MIN 4VWS | $559.50 | $746.00 | — | — | 25% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBAR MIN 4VWS | $559.50 | $746.00 | — | — | 25% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE THORACIC 2 VIEWS | $212.25 | $283.00 | — | — | 25% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE THORACIC 2 VIEWS | $212.25 | $283.00 | — | — | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 2 VIEWS | $282.00 | $376.00 | — | — | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 3 VIEWS | $711.75 | $949.00 | — | — | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 2 VIEWS | $282.00 | $376.00 | — | — | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 3 VIEWS | $711.75 | $949.00 | — | — | 25% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 VIEW | $277.50 | $370.00 | — | — | 25% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 2 VIEWS | $595.50 | $794.00 | — | — | 25% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 VIEW | $277.50 | $370.00 | — | — | 25% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 2 VIEWS | $595.50 | $794.00 | — | — | 25% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM COCCYX 2 VWS | $348.75 | $465.00 | — | — | 25% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM COCCYX 2 VWS | $348.75 | $465.00 | — | — | 25% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH | $366.75 | $489.00 | — | — | 25% |
| ACTH blood test inpatient CPT 82024 ACTH | $366.75 | $489.00 | — | — | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSAMINASE-SGPT (ALT) | $19.50 | $26.00 | — | — | 25% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSAMINASE-SGPT (ALT) | $19.50 | $26.00 | — | — | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSTERASE AST(SGOT) | $19.50 | $26.00 | — | — | 25% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSTERASE AST(SGOT) | $19.50 | $26.00 | — | — | 25% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $258.00 | $344.00 | — | — | 25% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL | $258.00 | $344.00 | — | — | 25% |
| Albumin blood test CPT 82040 ALBUMIN SERUM | $19.50 | $26.00 | — | — | 25% |
| Albumin blood test inpatient CPT 82040 ALBUMIN SERUM | $19.50 | $26.00 | — | — | 25% |
| Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE ALKALINE | $102.00 | $136.00 | — | — | 25% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE ALKALINE | $102.00 | $136.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE HOPS | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE TOBACCO | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE SUNFLOWER POLLEN | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE VANILLA | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE ALDER TREE | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE SHEEP EPITHELIUM | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE ALFALFA | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE BAY LEAF | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE WHEAT | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE BENTGRASS | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE POPPY SEED | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE CHICKEN FEATHERS | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLGN IGE PENICILLIN G (MAJOR) | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE GOAT EPITHELIUM | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE LINSEED | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE HONEY | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE TURKEY FEATHERS | $2.45 | $3.26 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLRGN SPEC IGE EA | $2.45 | $3.26 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE SUNFLOWER SEED | $2.45 | $3.26 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE SAFFLOWER | $10.50 | $14.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE POMEGRANATE | $14.25 | $19.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST EACH ALLERGEN | $16.50 | $22.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE NECTARINE SPEC | $18.00 | $24.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE PUMPKIN SEED | $25.50 | $34.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE COTTON SEED | $29.25 | $39.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BOX ELDER TREE | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAK TREE | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORCHARD GRASS | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MARSH ELDER | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALTERMARIA | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BIRCH TREE | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ELM TREE | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COMMON RAGWEED | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE MOUSE URINE | $44.25 | $59.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE RAT URINE | $48.00 | $64.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE GELATIN PORCINE | $510.75 | $681.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE BENTGRASS | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE HONEY | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE HOPS | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE LINSEED | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE GOAT EPITHELIUM | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE SUNFLOWER POLLEN | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLGN IGE PENICILLIN G (MAJOR) | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE WHEAT | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE CHICKEN FEATHERS | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE POPPY SEED | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE BAY LEAF | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE VANILLA | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE ALFALFA | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE ALDER TREE | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE SHEEP EPITHELIUM | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE TOBACCO | $2.25 | $3.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE TURKEY FEATHERS | $2.45 | $3.26 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLRGN SPEC IGE EA | $2.45 | $3.26 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE SUNFLOWER SEED | $2.45 | $3.26 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE SAFFLOWER | $10.50 | $14.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE POMEGRANATE | $14.25 | $19.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST EACH ALLERGEN | $16.50 | $22.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE NECTARINE SPEC | $18.00 | $24.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE PUMPKIN SEED | $25.50 | $34.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE COTTON SEED | $29.25 | $39.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ELM TREE | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MARSH ELDER | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON RAGWEED | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORCHARD GRASS | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAK TREE | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BOX ELDER TREE | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BIRCH TREE | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERMARIA | $36.75 | $49.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE MOUSE URINE | $44.25 | $59.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE RAT URINE | $48.00 | $64.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE GELATIN PORCINE | $510.75 | $681.00 | — | — | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETO PROTEIN SERUM | $257.25 | $343.00 | — | — | 25% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETO PROTEIN SERUM | $257.25 | $343.00 | — | — | 25% |
| Ammonia blood test CPT 82140 AMMONIA | $123.75 | $165.00 | — | — | 25% |
| Ammonia blood test inpatient CPT 82140 AMMONIA | $123.75 | $165.00 | — | — | 25% |
| Amylase blood test CPT 82150 AMYLASE | $63.00 | $84.00 | — | — | 25% |
| Amylase blood test inpatient CPT 82150 AMYLASE | $63.00 | $84.00 | — | — | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYC CITRULLINATED PEP AB | $94.50 | $126.00 | — | — | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYC CITRULLINATED PEP AB | $94.50 | $126.00 | — | — | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB(ANA) | $64.50 | $86.00 | — | — | 25% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR AB(ANA) | $64.50 | $86.00 | — | — | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYP NATRIURETC PEPTIDE | $250.50 | $334.00 | — | — | 25% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYP NATRIURETC PEPTIDE | $250.50 | $334.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHER SOURCE | $135.75 | $181.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE OTHER SOURCE | $135.75 | $181.00 | — | — | 25% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $337.50 | $450.00 | — | — | 25% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $337.50 | $450.00 | — | — | 25% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL | $105.75 | $141.00 | — | — | 25% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL | $105.75 | $141.00 | — | — | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATH LEVEL IV | $231.00 | $308.00 | — | — | 25% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATH LEVEL IV | $231.00 | $308.00 | — | — | 25% |
| Blood culture for bacteria CPT 87040 CULT BLOOD AERO/ANAERO | $149.25 | $199.00 | — | — | 25% |
| Blood culture for bacteria inpatient CPT 87040 CULT BLOOD AERO/ANAERO | $149.25 | $199.00 | — | — | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $16.50 | $22.00 | — | — | 25% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE | $16.50 | $22.00 | — | — | 25% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT BLOOD | $60.75 | $81.00 | — | — | 25% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT BLOOD | $60.75 | $81.00 | — | — | 25% |
| Blood lead test CPT 83655 LEAD QUANTITATIVE | $39.00 | $52.00 | — | — | 25% |
| Blood lead test inpatient CPT 83655 LEAD QUANTITATIVE | $39.00 | $52.00 | — | — | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADTOPN CHRONC(HCG)QL | $90.00 | $120.00 | — | — | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADTOPN CHRONC(HCG)QL | $90.00 | $120.00 | — | — | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLD TYPE ABO ONLY | $169.50 | $226.00 | — | — | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLD TYPE ABO ONLY | $169.50 | $226.00 | — | — | 25% |
| Blood urea nitrogen (BUN) test CPT 84520 BLD UREA NITROGEN QUAN | $41.25 | $55.00 | — | — | 25% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BLD UREA NITROGEN QUAN | $41.25 | $55.00 | — | — | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN QN | $130.50 | $174.00 | — | — | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN QN | $130.50 | $174.00 | — | — | 25% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOXIN AMP PROBE | $117.00 | $156.00 | — | — | 25% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF TOXIN AMP PROBE | $117.00 | $156.00 | — | — | 25% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $253.50 | $338.00 | — | — | 25% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 | $253.50 | $338.00 | — | — | 25% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 | $290.25 | $387.00 | — | — | 25% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 | $290.25 | $387.00 | — | — | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARSCOV2 COVID19 AMP PRB | $38.48 | $51.31 | — | — | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARSCOV2 COVID19 AMP PRB | $38.48 | $51.31 | — | — | 25% |
| Calcium blood test, total CPT 82310 CALCIUM | $56.25 | $75.00 | — | — | 25% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM | $56.25 | $75.00 | — | — | 25% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINO-EMBRYONIC AG | $378.00 | $504.00 | — | — | 25% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINO-EMBRYONIC AG | $378.00 | $504.00 | — | — | 25% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB | $34.00 | $45.33 | — | — | 25% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGG | $65.25 | $87.00 | — | — | 25% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB | $34.00 | $45.33 | — | — | 25% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGG | $65.25 | $87.00 | — | — | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA AMP PROBE | $180.00 | $240.00 | — | — | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA DNA AMP PROBE | $180.00 | $240.00 | — | — | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $359.25 | $479.00 | — | — | 25% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $359.25 | $479.00 | — | — | 25% |
| Complete blood count (CBC) with differential CPT 85025 CBC/PLT/AUTO DIFF (5) | $49.50 | $66.00 | — | — | 25% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC/PLT/AUTO DIFF (5) | $49.50 | $66.00 | — | — | 25% |
| Complete blood count (CBC), no differential CPT 85027 CBC WITHOUT DIFF | $37.50 | $50.00 | — | — | 25% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITHOUT DIFF | $37.50 | $50.00 | — | — | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL | $406.50 | $542.00 | — | — | 25% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL | $406.50 | $542.00 | — | — | 25% |
| Cortisol blood test, total CPT 82533 CORTISOL TOTAL | $216.75 | $289.00 | — | — | 25% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL | $216.75 | $289.00 | — | — | 25% |
| Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE TOTAL | $149.25 | $199.00 | — | — | 25% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE TOTAL | $149.25 | $199.00 | — | — | 25% |
| Creatinine blood test CPT 82565 CREATININE BLOOD | $93.00 | $124.00 | — | — | 25% |
| Creatinine blood test inpatient CPT 82565 CREATININE BLOOD | $93.00 | $124.00 | — | — | 25% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS AB | $10.50 | $14.00 | — | — | 25% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS AB | $10.50 | $14.00 | — | — | 25% |
| D-dimer blood test (blood clot marker) CPT 85379 FDP D-DIMER QNT | $63.75 | $85.00 | — | — | 25% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 FDP D-DIMER QNT | $63.75 | $85.00 | — | — | 25% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDRST SULFATE | $246.00 | $328.00 | — | — | 25% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDRST SULFATE | $246.00 | $328.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN/MECONIUM | $60.00 | $80.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN QUAL | $90.00 | $120.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL ETHYL | $93.00 | $124.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 TRICYCLIC DRUGS QUAL | $168.75 | $225.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN EACH CLASS | $277.50 | $370.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR | $519.75 | $693.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/2 | $531.00 | $708.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 OPIATES | $531.00 | $708.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 COCAINE MECON | $546.00 | $728.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL ETHYL URINE | $566.25 | $755.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN/MECONIUM | $60.00 | $80.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN QUAL | $90.00 | $120.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ALCOHOL ETHYL | $93.00 | $124.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TRICYCLIC DRUGS QUAL | $168.75 | $225.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN EACH CLASS | $277.50 | $370.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR | $519.75 | $693.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/2 | $531.00 | $708.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OPIATES | $531.00 | $708.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 COCAINE MECON | $546.00 | $728.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ALCOHOL ETHYL URINE | $566.25 | $755.00 | — | — | 25% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $216.75 | $289.00 | — | — | 25% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL | $216.75 | $289.00 | — | — | 25% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV IGM VCA | $44.25 | $59.00 | — | — | 25% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV IGG VCA | $182.25 | $243.00 | — | — | 25% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV IGM VCA | $44.25 | $59.00 | — | — | 25% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV IGG VCA | $182.25 | $243.00 | — | — | 25% |
| Estradiol blood test CPT 82670 ESTRADIOL | $218.25 | $291.00 | — | — | 25% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL | $218.25 | $291.00 | — | — | 25% |
| FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMLAT HORMONE | $257.25 | $343.00 | — | — | 25% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMLAT HORMONE | $257.25 | $343.00 | — | — | 25% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL | $41.25 | $55.00 | — | — | 25% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL | $41.25 | $55.00 | — | — | 25% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $118.50 | $158.00 | — | — | 25% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $118.50 | $158.00 | — | — | 25% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY | $63.00 | $84.00 | — | — | 25% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY | $63.00 | $84.00 | — | — | 25% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID | $201.75 | $269.00 | — | — | 25% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID | $201.75 | $269.00 | — | — | 25% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE | $309.00 | $412.00 | — | — | 25% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE | $309.00 | $412.00 | — | — | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE | $290.25 | $387.00 | — | — | 25% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE | $290.25 | $387.00 | — | — | 25% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $219.75 | $293.00 | — | — | 25% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE | $219.75 | $293.00 | — | — | 25% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT | $129.75 | $173.00 | — | — | 25% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT | $129.75 | $173.00 | — | — | 25% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3SPEC | $228.75 | $305.00 | — | — | 25% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3SPEC | $228.75 | $305.00 | — | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC DNA AMP PROBE | $151.28 | $201.70 | — | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONOR AMP PROBE | $180.00 | $240.00 | — | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC DNA AMP PROBE | $151.28 | $201.70 | — | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONOR AMP PROBE | $180.00 | $240.00 | — | — | 25% |
| H. pylori stool antigen test CPT 87338 H.PYLORI STOOL IA | $243.75 | $325.00 | — | — | 25% |
| H. pylori stool antigen test inpatient CPT 87338 H.PYLORI STOOL IA | $243.75 | $325.00 | — | — | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT | $41.25 | $55.00 | — | — | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV/RNA BY PCR | $268.50 | $358.00 | — | — | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 QUANT RNA/DNA | $602.25 | $803.00 | — | — | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT | $41.25 | $55.00 | — | — | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV/RNA BY PCR | $268.50 | $358.00 | — | — | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 QUANT RNA/DNA | $602.25 | $803.00 | — | — | 25% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV 2 SCREEN | $223.50 | $298.00 | — | — | 25% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/HIV 2 SCREEN | $223.50 | $298.00 | — | — | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV I AG HIV I HIV II AB | $257.25 | $343.00 | — | — | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV I AG HIV I HIV II AB | $257.25 | $343.00 | — | — | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCATED | $49.50 | $66.00 | — | — | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCATED | $49.50 | $66.00 | — | — | 25% |
| Hemoglobin blood test CPT 85018 BLOOD HEMOGLBN | $69.00 | $92.00 | — | — | 25% |
| Hemoglobin blood test inpatient CPT 85018 BLOOD HEMOGLBN | $69.00 | $92.00 | — | — | 25% |
| Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTAL | $123.75 | $165.00 | — | — | 25% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB TOTAL | $123.75 | $165.00 | — | — | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURF AB | $123.75 | $165.00 | — | — | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURF AB | $123.75 | $165.00 | — | — | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY | $112.50 | $150.00 | — | — | 25% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY | $112.50 | $150.00 | — | — | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C QUANT | $37.50 | $50.00 | — | — | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C QUANT PCR | $681.00 | $908.00 | — | — | 25% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C QUANT | $37.50 | $50.00 | — | — | 25% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C QUANT PCR | $681.00 | $908.00 | — | — | 25% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES I AB IGG | $60.75 | $81.00 | — | — | 25% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES I AB IGG | $60.75 | $81.00 | — | — | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES AB SMPLX TYPE 2 | $7.50 | $10.00 | — | — | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES II AB IGG | $85.50 | $114.00 | — | — | 25% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES AB SMPLX TYPE 2 | $7.50 | $10.00 | — | — | 25% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES II AB IGG | $85.50 | $114.00 | — | — | 25% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HI SENSITIVITY | $44.25 | $59.00 | — | — | 25% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HI SENSITIVITY | $44.25 | $59.00 | — | — | 25% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE QUANT | $179.25 | $239.00 | — | — | 25% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE QUANT | $179.25 | $239.00 | — | — | 25% |
| Insulin blood test CPT 83525 INSULIN TOTAL | $243.00 | $324.00 | — | — | 25% |
| Insulin blood test inpatient CPT 83525 INSULIN TOTAL | $243.00 | $324.00 | — | — | 25% |
| Iron blood test (serum iron) CPT 83540 IRON | $93.00 | $124.00 | — | — | 25% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON | $93.00 | $124.00 | — | — | 25% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPCTY | $135.00 | $180.00 | — | — | 25% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPCTY | $135.00 | $180.00 | — | — | 25% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $294.00 | $392.00 | — | — | 25% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $294.00 | $392.00 | — | — | 25% |
| LH (luteinizing hormone) test CPT 83002 LUTEINING HORMONE | $109.50 | $146.00 | — | — | 25% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINING HORMONE | $109.50 | $146.00 | — | — | 25% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID BODY FLUID | $147.75 | $197.00 | — | — | 25% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE(LACTIC ACID) | $172.50 | $230.00 | — | — | 25% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID) | $192.00 | $256.00 | — | — | 25% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID BODY FLUID | $147.75 | $197.00 | — | — | 25% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE(LACTIC ACID) | $172.50 | $230.00 | — | — | 25% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE (LACTIC ACID) | $192.00 | $256.00 | — | — | 25% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH-LACTIC DEHYDROGENASE | $63.00 | $84.00 | — | — | 25% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH-LACTIC DEHYDROGENASE | $63.00 | $84.00 | — | — | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $87.75 | $117.00 | — | — | 25% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $87.75 | $117.00 | — | — | 25% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $78.00 | $104.00 | — | — | 25% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $78.00 | $104.00 | — | — | 25% |
| Lyme disease antibody test CPT 86618 LYME DISEASE AB | $31.50 | $42.00 | — | — | 25% |
| Lyme disease antibody test CPT 86618 LYME DISEASE | $49.50 | $66.00 | — | — | 25% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB | $31.50 | $42.00 | — | — | 25% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE | $49.50 | $66.00 | — | — | 25% |
| Magnesium blood test CPT 83735 MAGNESIUM | $101.25 | $135.00 | — | — | 25% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $101.25 | $135.00 | — | — | 25% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA AB | $52.50 | $70.00 | — | — | 25% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB | $52.50 | $70.00 | — | — | 25% |
| Mumps immunity blood test CPT 86735 MUMPS AB | $5.51 | $7.34 | — | — | 25% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS AB | $5.51 | $7.34 | — | — | 25% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $128.25 | $171.00 | — | — | 25% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE | $128.25 | $171.00 | — | — | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL | $128.25 | $171.00 | — | — | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREEN TEST | $223.50 | $298.00 | — | — | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL | $128.25 | $171.00 | — | — | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREEN TEST | $223.50 | $298.00 | — | — | 25% |
| Pap test (liquid-based, automated screening with review) CPT 88175 SCREENING CYTOPATHOLOGY | $15.00 | $20.00 | — | — | 25% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SCREENING CYTOPATHOLOGY | $15.00 | $20.00 | — | — | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR SCREENING | $145.50 | $194.00 | — | — | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMEAR SCREENING | $145.50 | $194.00 | — | — | 25% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT | $305.25 | $407.00 | — | — | 25% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT | $305.25 | $407.00 | — | — | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $135.75 | $181.00 | — | — | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $135.75 | $181.00 | — | — | 25% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS | $63.00 | $84.00 | — | — | 25% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS | $63.00 | $84.00 | — | — | 25% |
| Potassium blood test CPT 84132 POTASSIUM SERUM | $57.75 | $77.00 | — | — | 25% |
| Potassium blood test CPT 84132 POTASSIUM | $88.50 | $118.00 | — | — | 25% |
| Potassium blood test inpatient CPT 84132 POTASSIUM SERUM | $57.75 | $77.00 | — | — | 25% |
| Potassium blood test inpatient CPT 84132 POTASSIUM | $88.50 | $118.00 | — | — | 25% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL INFORMA SEQ XY SEQUENCE | $300.00 | $400.00 | — | — | 25% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 FETAL INFORMA SEQ XY SEQUENCE | $300.00 | $400.00 | — | — | 25% |
| Progesterone blood test CPT 84144 PROGESTERONE | $266.25 | $355.00 | — | — | 25% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE | $266.25 | $355.00 | — | — | 25% |
| Prolactin blood test CPT 84146 PROLACTIN | $198.00 | $264.00 | — | — | 25% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $198.00 | $264.00 | — | — | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $53.25 | $71.00 | — | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $53.25 | $71.00 | — | — | 25% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREPTOCOCCUS A DIR OPT | $144.00 | $192.00 | — | — | 25% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREPTOCOCCUS A DIR OPT | $144.00 | $192.00 | — | — | 25% |
| Rh blood typing CPT 86901 BLD TYPE RHO(D)ONLY | $52.50 | $70.00 | — | — | 25% |
| Rh blood typing inpatient CPT 86901 BLD TYPE RHO(D)ONLY | $52.50 | $70.00 | — | — | 25% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $63.75 | $85.00 | — | — | 25% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT | $63.75 | $85.00 | — | — | 25% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA AB | $125.25 | $167.00 | — | — | 25% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB | $125.25 | $167.00 | — | — | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTO | $23.25 | $31.00 | — | — | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE AUTO | $23.25 | $31.00 | — | — | 25% |
| Sodium blood test CPT 84295 SODIUM BLOOD | $41.25 | $55.00 | — | — | 25% |
| Sodium blood test CPT 84295 SODIUM | $94.50 | $126.00 | — | — | 25% |
| Sodium blood test inpatient CPT 84295 SODIUM BLOOD | $41.25 | $55.00 | — | — | 25% |
| Sodium blood test inpatient CPT 84295 SODIUM | $94.50 | $126.00 | — | — | 25% |
| Stool ova and parasites exam CPT 87177 OVA&PARASITES SMEARS | $169.50 | $226.00 | — | — | 25% |
| Stool ova and parasites exam inpatient CPT 87177 OVA&PARASITES SMEARS | $169.50 | $226.00 | — | — | 25% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLD STL 1-3 | $78.00 | $104.00 | — | — | 25% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLD STL 1-3 | $78.00 | $104.00 | — | — | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HGB FECAL IA | $78.00 | $104.00 | — | — | 25% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HGB FECAL IA | $78.00 | $104.00 | — | — | 25% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB | $63.75 | $85.00 | — | — | 25% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM AB | $63.75 | $85.00 | — | — | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-CSF | $71.25 | $95.00 | — | — | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL-CSF | $71.25 | $95.00 | — | — | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL AG RESPONSE | $30.00 | $40.00 | — | — | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS AG RESPONSE | $168.00 | $224.00 | — | — | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL AG RESPONSE | $30.00 | $40.00 | — | — | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TUBERCULOSIS AG RESPONSE | $168.00 | $224.00 | — | — | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $207.00 | $276.00 | — | — | 25% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL | $207.00 | $276.00 | — | — | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EA | $9.37 | $12.49 | — | — | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB | $85.50 | $114.00 | — | — | 25% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EA | $9.37 | $12.49 | — | — | 25% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB | $85.50 | $114.00 | — | — | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $348.75 | $465.00 | — | — | 25% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $348.75 | $465.00 | — | — | 25% |
| Total IgE blood test CPT 82785 IGE SERUM | $45.00 | $60.00 | — | — | 25% |
| Total IgE blood test CPT 82785 IMMUNOGLOBULINS E SERUM | $210.00 | $280.00 | — | — | 25% |
| Total IgE blood test inpatient CPT 82785 IGE SERUM | $45.00 | $60.00 | — | — | 25% |
| Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULINS E SERUM | $210.00 | $280.00 | — | — | 25% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL | $27.75 | $37.00 | — | — | 25% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL | $27.75 | $37.00 | — | — | 25% |
| Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL | $133.50 | $178.00 | — | — | 25% |
| Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL | $133.50 | $178.00 | — | — | 25% |
| Total triiodothyronine (T3) blood test CPT 84480 TRIIODTHYRNIN TOTAL T3 | $279.00 | $372.00 | — | — | 25% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIIODTHYRNIN TOTAL T3 | $279.00 | $372.00 | — | — | 25% |
| Transferrin blood test CPT 84466 TRANSFERRIN | $198.00 | $264.00 | — | — | 25% |
| Transferrin blood test inpatient CPT 84466 TRANSFERRIN | $198.00 | $264.00 | — | — | 25% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS AMP PROBE | $219.75 | $293.00 | — | — | 25% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS AMP PROBE | $219.75 | $293.00 | — | — | 25% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES | $44.25 | $59.00 | — | — | 25% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES | $44.25 | $59.00 | — | — | 25% |
| Troponin test, quantitative CPT 84484 TROPONIN QUAN | $15.27 | $20.36 | — | — | 25% |
| Troponin test, quantitative CPT 84484 TROPONIN - I | $294.00 | $392.00 | — | — | 25% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN QUAN | $15.27 | $20.36 | — | — | 25% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN - I | $294.00 | $392.00 | — | — | 25% |
| Uric acid blood test CPT 84550 URIC ACID BLOOD | $39.00 | $52.00 | — | — | 25% |
| Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD | $39.00 | $52.00 | — | — | 25% |
| Urinalysis with microscope exam, automated CPT 81001 UA AUTO W/MICRO | $21.75 | $29.00 | — | — | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA AUTO W/MICRO | $21.75 | $29.00 | — | — | 25% |
| Urinalysis without microscope exam, automated CPT 81003 URINE W/O MICRO AUTO | $16.50 | $22.00 | — | — | 25% |
| Urinalysis without microscope exam, automated CPT 81003 UA AUTO W/O MICRO | $82.50 | $110.00 | — | — | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE W/O MICRO AUTO | $16.50 | $22.00 | — | — | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA AUTO W/O MICRO | $82.50 | $110.00 | — | — | 25% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE COLONY CT | $147.00 | $196.00 | — | — | 25% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE COLONY CT | $147.00 | $196.00 | — | — | 25% |
| Urine microalbumin (albumin) test CPT 82043 MICRO ALBUMIN URINE QNT | $144.75 | $193.00 | — | — | 25% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICRO ALBUMIN URINE QNT | $144.75 | $193.00 | — | — | 25% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREG TEST QUAL | $143.25 | $191.00 | — | — | 25% |
| Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREG TEST QUAL | $143.25 | $191.00 | — | — | 25% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBLMN(VIT B12) | $180.00 | $240.00 | — | — | 25% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBLMN(VIT B12) | $180.00 | $240.00 | — | — | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D/25 HYDROXY | $351.00 | $468.00 | — | — | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D/25 HYDROXY | $351.00 | $468.00 | — | — | 25% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D1 25-DIHYDROXY | $102.00 | $136.00 | — | — | 25% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D1 25-DIHYDROXY | $102.00 | $136.00 | — | — | 25% |
| Zinc blood test CPT 84630 ZINC QUANTITATIVE URINE | $8.25 | $11.00 | — | — | 25% |
| Zinc blood test CPT 84630 ZINC RBC | $90.75 | $121.00 | — | — | 25% |
| Zinc blood test inpatient CPT 84630 ZINC QUANTITATIVE URINE | $8.25 | $11.00 | — | — | 25% |
| Zinc blood test inpatient CPT 84630 ZINC RBC | $90.75 | $121.00 | — | — | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADTOPN CHORNC(HCG)QNT | $280.50 | $374.00 | — | — | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADTOPN CHORNC(HCG)QNT | $280.50 | $374.00 | — | — | 25% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine CPT 64615 CHEMODENERVATION-MIGRAINE | $943.50 | $1,258.00 | — | — | 25% |
| Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERVATION-MIGRAINE | $943.50 | $1,258.00 | — | — | 25% |
| Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL RELEASE/SONEX | $7,875.00 | $10,500.00 | — | — | 25% |
| Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL RELEASE/SONEX | $7,875.00 | $10,500.00 | — | — | 25% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ EPID CERV/THORC | $2,884.50 | $3,846.00 | — | — | 25% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ EPID CERV/THORC | $2,884.50 | $3,846.00 | — | — | 25% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 L SP FACET INJ+IMAG LVL1 | $3,319.50 | $4,426.00 | — | — | 25% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 L SP FACET INJ+IMAG LVL1 | $3,319.50 | $4,426.00 | — | — | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TEN SHTH/TRIG | $378.00 | $504.00 | — | — | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SNGL TENDON/LIGAMENT | $637.50 | $850.00 | — | — | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TEN SHTH/TRIG | $378.00 | $504.00 | — | — | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ SNGL TENDON/LIGAMENT | $637.50 | $850.00 | — | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIR/INJ MAJ JT WO/US | $378.00 | $504.00 | — | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJ ASPIR LGE JNT | $952.50 | $1,270.00 | — | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIR/INJ MAJ JT WO/US | $378.00 | $504.00 | — | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJ ASPIR LGE JNT | $952.50 | $1,270.00 | — | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJ ASPIR INT JNT | $715.50 | $954.00 | — | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ INTERM JT WO/US | $1,328.25 | $1,771.00 | — | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJ ASPIR INT JNT | $715.50 | $954.00 | — | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ INTERM JT WO/US | $1,328.25 | $1,771.00 | — | — | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJ ASPIR SM JNT | $727.50 | $970.00 | — | — | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIR/INJ SM JNT WO/US | $1,752.75 | $2,337.00 | — | — | 25% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 INJ ASPIR SM JNT | $727.50 | $970.00 | — | — | 25% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIR/INJ SM JNT WO/US | $1,752.75 | $2,337.00 | — | — | 25% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ EPID LUMB/CAUD | $3,810.00 | $5,080.00 | — | — | 25% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ EPID LUMB/CAUD | $3,810.00 | $5,080.00 | — | — | 25% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJ INTRLMNR LUMBR/SAC W/O IMG | $4,011.75 | $5,349.00 | — | — | 25% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ INTRLMNR LUMBR/SAC W/O IMG | $4,011.75 | $5,349.00 | — | — | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ ANESTH LUMB/CAUD SGL | $3,590.25 | $4,787.00 | — | — | 25% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ ANESTH LUMB/CAUD SGL | $3,590.25 | $4,787.00 | — | — | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANESTH OCCIPTL NERVE | $1,184.25 | $1,579.00 | — | — | 25% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANESTH OCCIPTL NERVE | $1,184.25 | $1,579.00 | — | — | 25% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DES LUMB/SAC FACET JNT | $2,131.50 | $2,842.00 | — | — | 25% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DES LUMB/SAC FACET JNT | $2,131.50 | $2,842.00 | — | — | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ;SGL/MULTI TRIGGER PT 1OR2 | $732.75 | $977.00 | — | — | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PTS 1/2 MUSC | $1,197.75 | $1,597.00 | — | — | 25% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ;SGL/MULTI TRIGGER PT 1OR2 | $732.75 | $977.00 | — | — | 25% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PTS 1/2 MUSC | $1,197.75 | $1,597.00 | — | — | 25% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TREATMENT | $188.25 | $251.00 | — | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT | $286.50 | $382.00 | — | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION | $286.50 | $382.00 | — | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TX | $286.50 | $382.00 | — | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TREATMENT | $188.25 | $251.00 | — | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM INDUCTION | $286.50 | $382.00 | — | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TREATMENT | $286.50 | $382.00 | — | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TX | $286.50 | $382.00 | — | — | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACE ONLY | $156.75 | $209.00 | — | — | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD TRACING | $218.25 | $291.00 | — | — | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACE ONLY | $156.75 | $209.00 | — | — | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD TRACING | $218.25 | $291.00 | — | — | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYD INIT 31-60MIN | $998.25 | $1,331.00 | — | — | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYD INIT 31-60MIN | $998.25 | $1,331.00 | — | — | 25% |
| IV infusion of a medicine, first hour CPT 96365 IV INF TX INIT <=1HR | $491.25 | $655.00 | — | — | 25% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF TX INIT <=1HR | $491.25 | $655.00 | — | — | 25% |
| IV push of a medicine, first drug CPT 96374 INJ TX/PRPH/DX IVP INT | $924.75 | $1,233.00 | — | — | 25% |
| IV push of a medicine, first drug inpatient CPT 96374 INJ TX/PRPH/DX IVP INT | $924.75 | $1,233.00 | — | — | 25% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE COND STUDIES 7-8 | $724.50 | $966.00 | — | — | 25% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE COND STUDIES 7-8 | $724.50 | $966.00 | — | — | 25% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSC RE-EDUC EA1 | $130.50 | $174.00 | — | 38% above | 25% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUC EA 15MIN | $144.75 | $193.00 | — | 53% above | 25% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSC RE-ED EA15 | $144.75 | $193.00 | — | 53% above | 25% |
| Neuromuscular re-education, 15 minutes CPT 97112 OTA NEUROMUSC RE-ED EA15 | $144.75 | $193.00 | — | 53% above | 25% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSC RE-ED EA15 | $152.25 | $203.00 | — | 61% above | 25% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSC RE-EDUC EA1 | $130.50 | $174.00 | — | — | 25% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OTA NEUROMUSC RE-ED EA15 | $144.75 | $193.00 | — | — | 25% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSC RE-ED EA15 | $144.75 | $193.00 | — | — | 25% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUC EA 15MIN | $144.75 | $193.00 | — | — | 25% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSC RE-ED EA15 | $152.25 | $203.00 | — | — | 25% |
| New patient office visit, about 30 minutes CPT 99203 E&M-NEW PATIENT-LVL III | $434.25 | $579.00 | — | — | 25% |
| New patient office visit, about 30 minutes inpatient CPT 99203 E&M-NEW PATIENT-LVL III | $434.25 | $579.00 | — | — | 25% |
| New patient office visit, about 45 minutes CPT 99204 E&M-NEW PATIENT-LVL IV | $453.75 | $605.00 | — | — | 25% |
| New patient office visit, about 45 minutes inpatient CPT 99204 E&M-NEW PATIENT-LVL IV | $453.75 | $605.00 | — | — | 25% |
| New patient office visit, about 60 minutes CPT 99205 E&M-NEW PATIENT-LVL V | $654.00 | $872.00 | — | — | 25% |
| New patient office visit, about 60 minutes inpatient CPT 99205 E&M-NEW PATIENT-LVL V | $654.00 | $872.00 | — | — | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 E&M-NEW PATIENT-LVL II | $280.50 | $374.00 | — | — | 25% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 E&M-NEW PATIENT-LVL II | $280.50 | $374.00 | — | — | 25% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMP | $520.50 | $694.00 | — | 151% above | 25% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMP | $520.50 | $694.00 | — | — | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMP | $574.50 | $766.00 | — | 145% above | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL: HIGH COMPLEXITY | $574.50 | $766.00 | — | 145% above | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMP | $574.50 | $766.00 | — | — | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL: HIGH COMPLEXITY | $574.50 | $766.00 | — | — | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL: LOW COMPLEXITY | $520.50 | $694.00 | — | 165% above | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMP | $520.50 | $694.00 | — | 165% above | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL: LOW COMPLEXITY | $520.50 | $694.00 | — | — | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMP | $520.50 | $694.00 | — | — | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMP | $547.50 | $730.00 | — | 143% above | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL: MOD COMPLEXITY | $547.50 | $730.00 | — | 143% above | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMP | $547.50 | $730.00 | — | — | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL: MOD COMPLEXITY | $547.50 | $730.00 | — | — | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY EA 15M | $208.50 | $278.00 | — | 115% above | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OTA MANUAL THERAPY EA 15M | $208.50 | $278.00 | — | 115% above | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EACH 15 MINUTES | $222.00 | $296.00 | — | 129% above | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY EA 15M | $222.00 | $296.00 | — | 129% above | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY EA 15M | $208.50 | $278.00 | — | — | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OTA MANUAL THERAPY EA 15M | $208.50 | $278.00 | — | — | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY EA 15M | $222.00 | $296.00 | — | — | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EACH 15 MINUTES | $222.00 | $296.00 | — | — | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPTC EXER EA 15 | $130.50 | $174.00 | — | 40% above | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THER EX EA 15 | $130.50 | $174.00 | — | 40% above | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUTC EXER EA15 | $160.50 | $214.00 | — | 72% above | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OTA THER EX EA 15 | $169.50 | $226.00 | — | 81% above | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THER EX EA 15 | $169.50 | $226.00 | — | 81% above | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROC EXER EA 15MIN | $178.50 | $238.00 | — | 91% above | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPTC EXER EA 15 | $130.50 | $174.00 | — | — | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THER EX EA 15 | $130.50 | $174.00 | — | — | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTC EXER EA15 | $160.50 | $214.00 | — | — | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OTA THER EX EA 15 | $169.50 | $226.00 | — | — | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THER EX EA 15 | $169.50 | $226.00 | — | — | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROC EXER EA 15MIN | $178.50 | $238.00 | — | — | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 E&M-EST. PATIENT-LVL V | $455.25 | $607.00 | — | — | 25% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E&M-EST. PATIENT-LVL V | $455.25 | $607.00 | — | — | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 E&M-EST. PATIENT-LVL III | $303.75 | $405.00 | — | — | 25% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 E&M-EST. PATIENT-LVL III | $303.75 | $405.00 | — | — | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E&M-EST. PATIENT-LVL IV | $350.25 | $467.00 | — | — | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 E&M-EST. PATIENT-LVL IV | $350.25 | $467.00 | — | — | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 E&M-EST. PATIENT-LVL II | $182.25 | $243.00 | — | — | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 E&M-EST. PATIENT-LVL II | $182.25 | $243.00 | — | — | 25% |
| Speech and language evaluation CPT 92523 SP EVAL LNG COM W/EXP BSC | $569.25 | $759.00 | — | 51% above | 25% |
| Speech and language evaluation inpatient CPT 92523 SP EVAL LNG COM W/EXP BSC | $569.25 | $759.00 | — | — | 25% |
| Speech therapy session, individual CPT 92507 SPEECH/LANG TX BASIC | $418.50 | $558.00 | — | 96% above | 25% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH/LANG TX BASIC | $418.50 | $558.00 | — | — | 25% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY | $208.50 | $278.00 | — | — | 25% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY | $208.50 | $278.00 | — | — | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTC ACT EA 15 | $135.75 | $181.00 | — | 68% above | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPTC ACT EA 15 | $147.75 | $197.00 | — | 83% above | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OTA THERAPTC ACT EA 15 | $147.75 | $197.00 | — | 83% above | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT THER ACT EA 15 | $152.25 | $203.00 | — | 89% above | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES EACH 15 | $174.75 | $233.00 | — | 117% above | 25% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTC ACT EA 15 | $135.75 | $181.00 | — | — | 25% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPTC ACT EA 15 | $147.75 | $197.00 | — | — | 25% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OTA THERAPTC ACT EA 15 | $147.75 | $197.00 | — | — | 25% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THER ACT EA 15 | $152.25 | $203.00 | — | — | 25% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES EACH 15 | $174.75 | $233.00 | — | — | 25% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DTAP-IPV-HIB-HEPB VACC IM IJ | $535.50 | $714.00 | — | — | 25% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DTAP-IPV-HIB-HEPB VACC IM IJ | $535.50 | $714.00 | — | — | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUVAC IIV3>6MOS 0.5ML IJ | $44.25 | $59.00 | — | — | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUVAC IIV3>6MOS 0.5ML IJ | $44.25 | $59.00 | — | — | 25% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB VACCINE ACTHIB INJ 0.5ML | $54.00 | $72.00 | — | — | 25% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HIB VACCINE ACTHIB INJ 0.5ML | $54.00 | $72.00 | — | — | 25% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL-TT VAC IM IJ | $296.25 | $395.00 | — | — | 25% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL-TT VAC IM IJ | $296.25 | $395.00 | — | — | 25% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENING B VAC IM RCMB IJ | $417.75 | $557.00 | — | — | 25% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENING B VAC IM RCMB IJ | $417.75 | $557.00 | — | — | 25% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL-13 CONJ VAC 0.5ML | $423.75 | $565.00 | — | — | 25% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL-13 CONJ VAC 0.5ML | $423.75 | $565.00 | — | — | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCO20VACIJ! | $642.75 | $857.00 | — | — | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCO20VACIJ! | $642.75 | $857.00 | — | — | 25% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMONIA VACC 23VALENT >2 YRS | $294.75 | $393.00 | — | — | 25% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMONIA VACC 23VALENT >2 YRS | $294.75 | $393.00 | — | — | 25% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VAC P-A P-B REC IJ | $505.50 | $674.00 | — | — | 25% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VAC P-A P-B REC IJ | $505.50 | $674.00 | — | — | 25% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VACC RECOMBINANT IM 0.5ML | $366.75 | $489.00 | — | — | 25% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HZV VACC RECOMBINANT IM 0.5ML | $366.75 | $489.00 | — | — | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE > 7YRS.,IM INJ. | $78.75 | $105.00 | — | — | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE > 7YRS.,IM INJ. | $78.75 | $105.00 | — | — | 25% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.