Hospital Walla Walla, WA

Providence St Mary Medical Center

Listed in its price file as “Providence Health And Services - Washington”.

Providence St Mary Medical Center in Walla Walla, WA publishes cash prices for 385 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Washington median for 248 of 382 procedures and above it for 131. By typical cash price it ranks #10 of 60 Washington hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

401 W Poplar St, Walla Walla, WA 99362 Collected Sep 23, 2026 Source price file Check a bill from this hospital (509) 522-5900

Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 500002 · CMS hospital register NPI 1386895886

Financial assistance

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

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

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

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

State law

This state limits hospital bills for lower-income patients

Washington law (RCW 70.170.060) requires hospital charity care: patients with family income up to 300% of the federal poverty level owe nothing at hospitals in large health systems (200% at other hospitals), with 75% and 50% discounts up to 400% (300% at other hospitals). It covers the part of the bill a patient owes, insured or not. Ask the hospital for its charity care application. Other states' laws.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W & W/O CONTRAST	$1,722.70	$2,461.00	—	17% below	30%
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W & W/O CONTRAST	$2,153.20	$3,076.00	—	4% above	30%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W & W/O CONTRAST	$2,153.20	$3,076.00	—	—	30%
Abdominal X-ray, 2 views CPT 74019 HC XR ABDOMEN 2 VIEWS	$272.30	$389.00	—	16% below	30%
Abdominal X-ray, 2 views CPT 74019 HC XR ABDOMEN 2 VIEWS	$427.70	$611.00	—	32% above	30%
Abdominal X-ray, 2 views inpatient CPT 74019 HC XR ABDOMEN 2 VIEWS	$427.70	$611.00	—	—	30%
Ankle X-ray, complete, 3 or more views CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS	$342.30	$489.00	—	10% above	30%
Ankle X-ray, complete, 3 or more views CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS	$537.60	$768.00	—	73% above	30%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS	$537.60	$768.00	—	—	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$307.30	$439.00	—	19% below	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$307.30	$439.00	—	—	30%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$959.70	$1,371.00	—	32% below	30%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$1,199.80	$1,714.00	—	15% below	30%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$1,199.80	$1,714.00	—	—	30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XR ESOPHAGUS W CONTRAST	$558.60	$798.00	—	8% below	30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XR ESOPHAGUS W CONTRAST	$887.60	$1,268.00	—	46% above	30%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC XR ESOPHAGUS W CONTRAST	$887.60	$1,268.00	—	—	30%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE AND OR JOINT IMAGING WHOLE BODY CDM	$1,382.50	$1,975.00	—	7% below	30%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE AND OR JOINT IMAGING WHOLE BODY CDM	$1,382.50	$1,975.00	—	—	30%
Breast ultrasound, complete, one breast CPT 76641 HC US BREAST UNI COMPLETE	$291.90	$417.00	—	33% below	30%
Breast ultrasound, complete, one breast CPT 76641 HC US BREAST UNI COMPLETE	$458.50	$655.00	—	6% above	30%
Breast ultrasound, complete, one breast inpatient CPT 76641 HC US BREAST UNI COMPLETE	$458.50	$655.00	—	—	30%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US BREAST UNI LIMITED	$291.90	$417.00	—	14% below	30%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US ED BREAST UNI LIMITED CDM	$420.70	$601.00	—	24% above	30%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US BREAST UNI LIMITED	$458.50	$655.00	—	35% above	30%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US ED BREAST UNI LIMITED CDM	$420.70	$601.00	—	—	30%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US BREAST UNI LIMITED	$458.50	$655.00	—	—	30%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN PELVIS	$3,770.90	$5,387.00	—	5% above	30%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN PELVIS	$4,713.80	$6,734.00	—	31% above	30%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CTA ABDOMEN PELVIS	$4,713.80	$6,734.00	—	—	30%
CT angiography (CTA) of the head CPT 70496 HC CT ANGIOGRAPHY HEAD W CONTRAST	$1,710.80	$2,444.00	—	19% below	30%
CT angiography (CTA) of the head CPT 70496 HC CT ANGIOGRAPHY HEAD W CONTRAST	$2,139.20	$3,056.00	—	1% above	30%
CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIOGRAPHY HEAD W CONTRAST	$2,139.20	$3,056.00	—	—	30%
CT angiography (CTA) of the neck CPT 70498 HC CT ANGIOGRAPHY NECK W CONTRAST	$1,710.80	$2,444.00	—	24% below	30%
CT angiography (CTA) of the neck CPT 70498 HC CT ANGIOGRAPHY NECK W CONTRAST	$2,139.20	$3,056.00	—	5% below	30%
CT angiography (CTA) of the neck inpatient CPT 70498 HC CT ANGIOGRAPHY NECK W CONTRAST	$2,139.20	$3,056.00	—	—	30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST	$2,107.00	$3,010.00	—	12% below	30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST	$2,633.40	$3,762.00	—	10% above	30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIOGRAPHY CHEST	$2,633.40	$3,762.00	—	—	30%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CCTA HEART ARTERIES/GRAFTS W/3D IMAGE W/ CONTRAST	$2,316.30	$3,309.00	—	99% above	30%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CCTA HEART ARTERIES/GRAFTS W/3D IMAGE W/ CONTRAST	$2,316.30	$3,309.00	—	—	30%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CCTA HEART W/ CALCIUM SCORING W/O CONTRAST	$131.60	$188.00	—	1% below	30%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CCTA HEART W/ CALCIUM SCORING W/O CONTRAST	$131.60	$188.00	—	—	30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$2,234.40	$3,192.00	—	12% below	30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$2,793.70	$3,991.00	—	11% above	30%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$2,793.70	$3,991.00	—	—	30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$2,858.10	$4,083.00	—	8% below	30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$3,572.80	$5,104.00	—	16% above	30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$3,572.80	$5,104.00	—	—	30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST	$3,444.70	$4,921.00	—	8% below	30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST	$4,305.00	$6,150.00	—	16% above	30%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST	$4,305.00	$6,150.00	—	—	30%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST	$1,406.30	$2,009.00	—	25% below	30%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST	$1,758.40	$2,512.00	—	6% below	30%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W CONTRAST	$1,758.40	$2,512.00	—	—	30%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST	$1,093.40	$1,562.00	—	24% below	30%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST	$1,366.40	$1,952.00	—	5% below	30%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN WO CONTRAST	$1,366.40	$1,952.00	—	—	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL W/O DYE LIMITED	$442.40	$632.00	—	60% below	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL W/O DYE LIMITED	$553.00	$790.00	—	50% below	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$885.50	$1,265.00	—	20% below	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$1,107.40	$1,582.00	—	at median	30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL W/O DYE LIMITED	$553.00	$790.00	—	—	30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$1,107.40	$1,582.00	—	—	30%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN WO CONTRAST	$968.10	$1,383.00	—	27% below	30%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN WO CONTRAST	$1,209.60	$1,728.00	—	9% below	30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN WO CONTRAST	$1,209.60	$1,728.00	—	—	30%
CT scan of the head with contrast CPT 70460 HC CT HEAD/BRAIN W CONTRAST	$1,145.20	$1,636.00	—	21% below	30%
CT scan of the head with contrast CPT 70460 HC CT HEAD/BRAIN W CONTRAST	$1,430.80	$2,044.00	—	2% below	30%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD/BRAIN W CONTRAST	$1,430.80	$2,044.00	—	—	30%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST	$1,407.70	$2,011.00	—	19% below	30%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST	$1,759.80	$2,514.00	—	2% above	30%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST	$1,759.80	$2,514.00	—	—	30%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$1,141.00	$1,630.00	—	21% below	30%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$1,426.60	$2,038.00	—	1% below	30%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$1,426.60	$2,038.00	—	—	30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT NECK SPINE WO CONTRAST	$1,080.10	$1,543.00	—	28% below	30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT NECK SPINE WO CONTRAST	$1,350.30	$1,929.00	—	10% below	30%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT NECK SPINE WO CONTRAST	$1,350.30	$1,929.00	—	—	30%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST	$1,451.80	$2,074.00	—	19% below	30%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST	$1,815.10	$2,593.00	—	1% above	30%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST	$1,815.10	$2,593.00	—	—	30%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$998.90	$1,427.00	—	—	30%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$1,399.30	$1,999.00	—	—	30%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$1,399.30	$1,999.00	—	—	30%
Chest CT scan without and with contrast CPT 71270 HC CT THORAX W & W/O CONTRAST	$1,790.60	$2,558.00	—	14% below	30%
Chest CT scan without and with contrast CPT 71270 HC CT THORAX W & W/O CONTRAST	$2,237.90	$3,197.00	—	8% above	30%
Chest CT scan without and with contrast inpatient CPT 71270 HC CT THORAX W & W/O CONTRAST	$2,237.90	$3,197.00	—	—	30%
Chest X-ray, 2 views CPT 71046 HC XR CHEST 2 VIEWS	$312.90	$447.00	—	8% above	30%
Chest X-ray, 2 views CPT 71046 HC XR CHEST 2 VIEWS	$489.30	$699.00	—	69% above	30%
Chest X-ray, 2 views inpatient CPT 71046 HC XR CHEST 2 VIEWS	$489.30	$699.00	—	—	30%
Chest X-ray, single view CPT 71045 HC XR CHEST PORTABLE 1 VIEW	$237.30	$339.00	—	1% below	30%
Chest X-ray, single view CPT 71045 HC XR CHEST 1 VIEW	$237.30	$339.00	—	1% below	30%
Chest X-ray, single view CPT 71045 HC XR CHEST PORTABLE 1 VIEW	$373.80	$534.00	—	56% above	30%
Chest X-ray, single view CPT 71045 HC XR CHEST 1 VIEW	$373.80	$534.00	—	56% above	30%
Chest X-ray, single view inpatient CPT 71045 HC XR CHEST 1 VIEW	$373.80	$534.00	—	—	30%
Chest X-ray, single view inpatient CPT 71045 HC XR CHEST PORTABLE 1 VIEW	$373.80	$534.00	—	—	30%
Collarbone (clavicle) X-ray, complete CPT 73000 HC XR CLAVICLE COMPLETE	$294.70	$421.00	—	7% above	30%
Collarbone (clavicle) X-ray, complete CPT 73000 HC XR CLAVICLE COMPLETE	$463.40	$662.00	—	69% above	30%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC XR CLAVICLE COMPLETE	$463.40	$662.00	—	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$543.20	$776.00	—	13% below	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$850.50	$1,215.00	—	37% above	30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE	$850.50	$1,215.00	—	—	30%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC XR DXA BONE DENSITY STUDY AXIAL	$371.00	$530.00	—	11% below	30%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC XR DXA BONE DENSITY STUDY AXIAL	$581.70	$831.00	—	39% above	30%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC XR DXA BONE DENSITY STUDY AXIAL	$581.70	$831.00	—	—	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC BONE DENSITY PERIPHERAL SKELETON	$401.10	$573.00	—	132% above	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC BONE DENSITY PERIPHERAL SKELETON	$401.10	$573.00	—	—	30%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US OB DETAILED SINGLE FETUS CDM	$702.80	$1,004.00	—	1% below	30%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US OB DETAILED SINGLE FETUS CDM	$1,102.50	$1,575.00	—	55% above	30%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US OB DETAILED SINGLE FETUS CDM	$1,102.50	$1,575.00	—	—	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX W/O DYE F/U LUNG SCREENING	$596.40	$852.00	—	60% below	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX WO CONTRAST	$1,141.00	$1,630.00	—	24% below	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX WO CONTRAST	$1,426.60	$2,038.00	—	4% below	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX W/O DYE F/U LUNG SCREENING	$1,426.60	$2,038.00	—	4% below	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX WO CONTRAST	$1,426.60	$2,038.00	—	—	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX W/O DYE F/U LUNG SCREENING	$1,426.60	$2,038.00	—	—	30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W CONTRAST	$1,451.80	$2,074.00	—	23% below	30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W CONTRAST	$1,815.10	$2,593.00	—	4% below	30%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT THORAX W CONTRAST	$1,815.10	$2,593.00	—	—	30%
Diagnostic mammogram, both breasts CPT 77066 HC MAMMO DIAG BIL W CAD	$545.30	$779.00	—	21% above	30%
Diagnostic mammogram, both breasts inpatient CPT 77066 HC MAMMO DIAG BIL W CAD	$545.30	$779.00	—	—	30%
Diagnostic mammogram, one breast CPT 77065 HC MAMMO DIAG UNI W CAD	$489.30	$699.00	—	27% above	30%
Diagnostic mammogram, one breast inpatient CPT 77065 HC MAMMO DIAG UNI W CAD	$489.30	$699.00	—	—	30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$1,074.50	$1,535.00	—	—	30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$1,685.60	$2,408.00	—	—	30%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$1,685.60	$2,408.00	—	—	30%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY	$1,188.60	$1,698.00	—	—	30%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY	$1,864.10	$2,663.00	—	—	30%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY	$1,864.10	$2,663.00	—	—	30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO TTE 2D W DOPPLER COMPLETE	$1,771.00	$2,530.00	—	6% above	30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO TTE 2D W DOPPLER COMPLETE	$2,479.40	$3,542.00	—	48% above	30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO TTE 2D W DOPPLER COMPLETE	$2,479.40	$3,542.00	—	—	30%
Elbow X-ray, 2 views CPT 73070 HC XR ELBOW LIMITED	$294.70	$421.00	—	10% above	30%
Elbow X-ray, 2 views CPT 73070 HC XR ELBOW 2 VIEWS	$294.70	$421.00	—	10% above	30%
Elbow X-ray, 2 views CPT 73070 HC XR ELBOW LIMITED	$463.40	$662.00	—	73% above	30%
Elbow X-ray, 2 views CPT 73070 HC XR ELBOW 2 VIEWS	$463.40	$662.00	—	73% above	30%
Elbow X-ray, 2 views inpatient CPT 73070 HC XR ELBOW 2 VIEWS	$463.40	$662.00	—	—	30%
Elbow X-ray, 2 views inpatient CPT 73070 HC XR ELBOW LIMITED	$463.40	$662.00	—	—	30%
Elbow X-ray, complete, 3 or more views CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS	$321.30	$459.00	—	1% above	30%
Elbow X-ray, complete, 3 or more views CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS	$504.70	$721.00	—	59% above	30%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS	$504.70	$721.00	—	—	30%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT/EAR/FOSSA WO CONTRAST	$885.50	$1,265.00	—	28% below	30%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT/EAR/FOSSA WO CONTRAST	$1,107.40	$1,582.00	—	9% below	30%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT/EAR/FOSSA WO CONTRAST	$1,107.40	$1,582.00	—	—	30%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS	$442.40	$632.00	—	19% above	30%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS	$693.00	$990.00	—	87% above	30%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS	$693.00	$990.00	—	—	30%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC XR FOREARM 2 VIEWS	$294.70	$421.00	—	8% above	30%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC XR FOREARM 2 VIEWS	$463.40	$662.00	—	69% above	30%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC XR FOREARM 1 VIEW	$463.40	$662.00	—	69% above	30%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC XR FOREARM 1 VIEW	$463.40	$662.00	—	—	30%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC XR FOREARM 2 VIEWS	$463.40	$662.00	—	—	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM HEPATOBILIARY SYSTEM	$751.10	$1,073.00	—	36% below	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NM HEPATOBILIARY SYSTEM	$751.10	$1,073.00	—	—	30%
Hand X-ray, 2 views CPT 73120 HC XR HAND 2 VIEWS	$277.90	$397.00	—	2% below	30%
Hand X-ray, 2 views CPT 73120 HC XR HAND 1 VIEW	$277.90	$397.00	—	2% below	30%
Hand X-ray, 2 views CPT 73120 HC XR HAND 1 VIEW	$436.80	$624.00	—	54% above	30%
Hand X-ray, 2 views CPT 73120 HC XR HAND 2 VIEWS	$436.80	$624.00	—	54% above	30%
Hand X-ray, 2 views inpatient CPT 73120 HC XR HAND 1 VIEW	$436.80	$624.00	—	—	30%
Hand X-ray, 2 views inpatient CPT 73120 HC XR HAND 2 VIEWS	$436.80	$624.00	—	—	30%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC XR HEEL MIN 2 VIEWS	$267.40	$382.00	—	3% above	30%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC XR HEEL MIN 2 VIEWS	$417.90	$597.00	—	60% above	30%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC XR HEEL MIN 2 VIEWS	$417.90	$597.00	—	—	30%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC AUTOSET TITRATION	$616.00	$880.00	—	36% above	30%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC PORTABLE SLEEP SCREENING IP	$616.00	$880.00	—	36% above	30%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP SCORING	$616.00	$880.00	—	36% above	30%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP STUDY UNATT&RESP EFFT	$616.00	$880.00	—	36% above	30%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP STUDY UNATT&RESP EFFT	$616.00	$880.00	—	—	30%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP SCORING	$616.00	$880.00	—	—	30%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC PORTABLE SLEEP SCREENING IP	$616.00	$880.00	—	—	30%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC AUTOSET TITRATION	$616.00	$880.00	—	—	30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAPHY W/CPAP REDUCED	$2,758.00	$3,940.00	—	20% below	30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAPHY W/CPAP	$3,722.60	$5,318.00	—	8% above	30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNO-CPAP/BIPAP-1 ON 1 PT	$3,810.10	$5,443.00	—	10% above	30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNOGRAPHY W/CPAP REDUCED	$2,758.00	$3,940.00	—	—	30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNOGRAPHY W/CPAP	$3,722.60	$5,318.00	—	—	30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNO-CPAP/BIPAP-1 ON 1 PT	$3,810.10	$5,443.00	—	—	30%
Knee X-ray, 3 views CPT 73562 HC XR KNEE 3 VIEWS	$372.40	$532.00	—	20% above	30%
Knee X-ray, 3 views CPT 73562 HC XR KNEE 3 VIEWS	$582.40	$832.00	—	88% above	30%
Knee X-ray, 3 views inpatient CPT 73562 HC XR KNEE 3 VIEWS	$582.40	$832.00	—	—	30%
Knee X-ray, complete, 4 or more views CPT 73564 HC XR KNEE 4/PLUS VIEWS	$473.20	$676.00	—	13% above	30%
Knee X-ray, complete, 4 or more views CPT 73564 HC XR KNEE 4/PLUS VIEWS	$741.30	$1,059.00	—	76% above	30%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC XR KNEE 4/PLUS VIEWS	$741.30	$1,059.00	—	—	30%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$959.70	$1,371.00	—	29% below	30%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$1,199.80	$1,714.00	—	11% below	30%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$1,199.80	$1,714.00	—	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED	$451.50	$645.00	—	11% below	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ED ABDOMEN LIMITED CDM	$648.90	$927.00	—	28% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED	$707.00	$1,010.00	—	40% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ED ABDOMEN LIMITED CDM	$648.90	$927.00	—	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED	$707.00	$1,010.00	—	—	30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC PR ED 76882 US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$98.70	$141.00	—	69% below	30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$293.30	$419.00	—	8% below	30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US ED LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$422.80	$604.00	—	33% above	30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$460.60	$658.00	—	45% above	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC PR ED 76882 US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$98.70	$141.00	—	—	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US ED LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$422.80	$604.00	—	—	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$460.60	$658.00	—	—	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX LW DOSE LNG CA SCR WO CONTRAST CDM	$323.40	$462.00	—	37% above	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT THORAX LW DOSE LNG CA SCR WO CONTRAST CDM	$323.40	$462.00	—	—	30%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR LOWER LEG 2 VIEWS	$294.70	$421.00	—	7% above	30%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR LOWER LEG LIMITED	$463.40	$662.00	—	68% above	30%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR LOWER LEG 2 VIEWS	$463.40	$662.00	—	68% above	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC XR LOWER LEG 2 VIEWS	$463.40	$662.00	—	—	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC XR LOWER LEG LIMITED	$463.40	$662.00	—	—	30%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD WO CONTRAST	$2,004.10	$2,863.00	—	1% above	30%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA HEAD WO CONTRAST	$2,004.10	$2,863.00	—	—	30%
MRI of both breasts, without and then with contrast dye CPT 77049 HC MRI BREAST W/O & W/ CONTRAST W/ CAD BIL	$4,228.70	$6,041.00	—	76% above	30%
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 HC MRI BREAST W/O & W/ CONTRAST W/ CAD BIL	$4,228.70	$6,041.00	—	—	30%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE LIMITED	$1,233.40	$1,762.00	—	35% below	30%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST	$2,258.90	$3,227.00	—	19% above	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE LIMITED	$1,233.40	$1,762.00	—	—	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST	$2,258.90	$3,227.00	—	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST	$4,088.70	$5,841.00	—	40% above	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST	$4,088.70	$5,841.00	—	—	30%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN W/O DYE LIMITED	$2,437.40	$3,482.00	—	17% above	30%
MRI of the abdomen without contrast CPT 74181 HC MRI MRCP ABDOMEN WO CONTRAST	$2,501.80	$3,574.00	—	20% above	30%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST	$2,501.80	$3,574.00	—	20% above	30%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN W/O DYE LIMITED	$2,437.40	$3,482.00	—	—	30%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN WO CONTRAST	$2,501.80	$3,574.00	—	—	30%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI MRCP ABDOMEN WO CONTRAST	$2,501.80	$3,574.00	—	—	30%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN WO & W CONTRAST	$3,213.70	$4,591.00	—	3% above	30%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN WO & W CONTRAST	$3,213.70	$4,591.00	—	—	30%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O DYE LIMITED	$1,418.20	$2,026.00	—	26% below	30%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN STEM W/O DYE	$1,418.20	$2,026.00	—	26% below	30%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O DYE LIMITED	$1,418.20	$2,026.00	—	—	30%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN STEM W/O DYE	$1,418.20	$2,026.00	—	—	30%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/O & W/DYE	$2,258.20	$3,226.00	—	22% below	30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W/O & W/DYE	$2,258.20	$3,226.00	—	—	30%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O DYE LIMITED	$2,705.50	$3,865.00	—	29% above	30%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O DYE	$2,940.70	$4,201.00	—	40% above	30%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O DYE LIMITED	$2,705.50	$3,865.00	—	—	30%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O DYE	$2,940.70	$4,201.00	—	—	30%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE	$4,686.50	$6,695.00	—	54% above	30%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE	$4,686.50	$6,695.00	—	—	30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O DYE LIMITED	$2,501.80	$3,574.00	—	18% above	30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O DYE	$2,951.20	$4,216.00	—	39% above	30%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE W/O DYE LIMITED	$2,501.80	$3,574.00	—	—	30%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE W/O DYE	$2,951.20	$4,216.00	—	—	30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE LIMITED	$2,170.00	$3,100.00	—	26% below	30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE	$3,332.70	$4,761.00	—	13% above	30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE LIMITED	$2,170.00	$3,100.00	—	—	30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE	$3,332.70	$4,761.00	—	—	30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O DYE	$1,733.20	$2,476.00	—	14% below	30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O DYE LIMITED	$1,733.20	$2,476.00	—	14% below	30%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O DYE LIMITED	$1,733.20	$2,476.00	—	—	30%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O DYE	$1,733.20	$2,476.00	—	—	30%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS WO & W CONTRAST	$3,213.70	$4,591.00	—	6% above	30%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS WO & W CONTRAST	$3,213.70	$4,591.00	—	—	30%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS W/O DYE LIMITED	$2,437.40	$3,482.00	—	27% above	30%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO CONTRAST	$2,437.40	$3,482.00	—	27% above	30%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS W/O DYE LIMITED	$2,437.40	$3,482.00	—	—	30%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS WO CONTRAST	$2,437.40	$3,482.00	—	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI JOINT UPR EXTREM W/O DYE LIMITED	$1,233.40	$1,762.00	—	35% below	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST	$2,032.10	$2,903.00	—	7% above	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI JOINT UPR EXTREM W/O DYE LIMITED	$1,233.40	$1,762.00	—	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST	$2,032.10	$2,903.00	—	—	30%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC XR SPINE CERVICAL 4 OR 5 VIEWS	$501.20	$716.00	—	12% above	30%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC XR SPINE CERVICAL 4 OR 5 VIEWS	$786.80	$1,124.00	—	76% above	30%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC XR SPINE CERVICAL 4 OR 5 VIEWS	$786.80	$1,124.00	—	—	30%
Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$1,145.20	$1,636.00	—	32% below	30%
Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$1,430.80	$2,044.00	—	15% below	30%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$1,430.80	$2,044.00	—	—	30%
Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$885.50	$1,265.00	—	34% below	30%
Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$1,107.40	$1,582.00	—	17% below	30%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$1,107.40	$1,582.00	—	—	30%
Neck soft tissue X-ray CPT 70360 HC XR NECK SOFT TISSUE	$202.30	$289.00	—	15% below	30%
Neck soft tissue X-ray CPT 70360 HC XR NECK SOFT TISSUE	$317.80	$454.00	—	34% above	30%
Neck soft tissue X-ray inpatient CPT 70360 HC XR NECK SOFT TISSUE	$317.80	$454.00	—	—	30%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM MYCARD PERFUS SPECT MULTIPLE	$3,550.40	$5,072.00	—	at median	30%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM MYCARD PERFUS SPECT MULTIPLE	$3,550.40	$5,072.00	—	—	30%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGE W CT SKULL MID THIGH	$5,890.50	$8,415.00	—	34% above	30%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGE W CT SKULL MID THIGH	$5,890.50	$8,415.00	—	—	30%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST	$1,141.00	$1,630.00	—	21% below	30%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST	$1,426.60	$2,038.00	—	1% below	30%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS WO CONTRAST	$1,426.60	$2,038.00	—	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC LIMITED	$496.30	$709.00	—	9% above	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US ED EXAM PELVIC LIMITED CDM	$714.70	$1,021.00	—	57% above	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC FOLLICLE LIMITED	$778.40	$1,112.00	—	71% above	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC LIMITED	$778.40	$1,112.00	—	71% above	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US ED EXAM PELVIC LIMITED CDM	$714.70	$1,021.00	—	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM PELVIC LIMITED	$778.40	$1,112.00	—	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM PELVIC FOLLICLE LIMITED	$778.40	$1,112.00	—	—	30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC NON-OB COMPLETE	$653.80	$934.00	—	9% above	30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC NON-OB COMPLETE	$1,023.40	$1,462.00	—	71% above	30%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIC NON-OB COMPLETE	$1,023.40	$1,462.00	—	—	30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS	$672.00	$960.00	—	4% above	30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS	$1,053.50	$1,505.00	—	63% above	30%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS	$1,053.50	$1,505.00	—	—	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby one side CPT 76801 HC US OB LT 14 WKS SINGLE FETUS CDM	$525.00	$750.00	—	5% above	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby one side CPT 76801 HC US OB LT 14 WKS SINGLE FETUS CDM	$820.40	$1,172.00	—	64% above	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient one side CPT 76801 HC US OB LT 14 WKS SINGLE FETUS CDM	$820.40	$1,172.00	—	—	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED FETUS(S) CDM	$393.40	$562.00	—	10% below	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US ED OB LIMITED FETUS(S) CDM	$564.20	$806.00	—	29% above	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED FETUS(S) CDM	$614.60	$878.00	—	41% above	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US ED OB LIMITED FETUS(S) CDM	$564.20	$806.00	—	—	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED FETUS(S) CDM	$614.60	$878.00	—	—	30%
Rib X-ray, one side, 2 views CPT 71100 HC XR RIBS UNI 2 VIEWS	$321.30	$459.00	—	9% above	30%
Rib X-ray, one side, 2 views CPT 71100 HC XR RIBS UNI 2 VIEWS	$504.70	$721.00	—	72% above	30%
Rib X-ray, one side, 2 views inpatient CPT 71100 HC XR RIBS UNI 2 VIEWS	$504.70	$721.00	—	—	30%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC XR RIBS/CHEST UNI MIN 3 VIEWS	$498.40	$712.00	—	36% above	30%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC XR RIBS/CHEST UNI MIN 3 VIEWS	$781.20	$1,116.00	—	113% above	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC XR RIBS/CHEST UNI MIN 3 VIEWS	$781.20	$1,116.00	—	—	30%
Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD	$336.70	$481.00	—	1% below	30%
Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN BIL W CAD	$428.40	$612.00	—	27% above	30%
Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD	$336.70	$481.00	—	—	30%
Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREEN BIL W CAD	$428.40	$612.00	—	—	30%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS	$362.60	$518.00	—	11% above	30%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS	$569.10	$813.00	—	74% above	30%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS	$569.10	$813.00	—	—	30%
Sinus X-ray, complete, 3 or more views CPT 70220 HC XR SINUSES PARANASAL MIN 3 VIEWS	$442.40	$632.00	—	37% above	30%
Sinus X-ray, complete, 3 or more views CPT 70220 HC XR SINUSES PARANASAL MIN 3 VIEWS	$693.00	$990.00	—	114% above	30%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC XR SINUSES PARANASAL MIN 3 VIEWS	$693.00	$990.00	—	—	30%
Skull X-ray, fewer than 4 views CPT 70250 HC XR SKULL 1-3 VIEWS	$351.40	$502.00	—	21% above	30%
Skull X-ray, fewer than 4 views CPT 70250 HC XR SKULL 1-3 VIEWS	$548.80	$784.00	—	90% above	30%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC XR SKULL 1-3 VIEWS	$548.80	$784.00	—	—	30%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAM REDUCED SERVICE	$1,705.20	$2,436.00	—	43% below	30%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAM 1 ON 1 PT	$3,409.70	$4,871.00	—	13% above	30%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY 4 OR MORE	$3,409.70	$4,871.00	—	13% above	30%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAM REDUCED SERVICE	$1,705.20	$2,436.00	—	—	30%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY 4 OR MORE	$3,409.70	$4,871.00	—	—	30%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAM 1 ON 1 PT	$3,409.70	$4,871.00	—	—	30%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC ECHO STRESS W/INTERP REPT & MONITOR	$2,506.00	$3,580.00	—	121% above	30%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC ECHO STRESS W/INTERP REPT & MONITOR	$2,506.00	$3,580.00	—	—	30%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$613.20	$876.00	—	14% above	30%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$961.80	$1,374.00	—	78% above	30%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$961.80	$1,374.00	—	—	30%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC XR FEMUR MIN 2 VIEWS	$183.40	$262.00	—	30% below	30%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC XR FEMUR MIN 2 VIEWS	$287.70	$411.00	—	10% above	30%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC XR FEMUR MIN 2 VIEWS	$287.70	$411.00	—	—	30%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT CHEST SPINE WO CONTRAST	$1,141.00	$1,630.00	—	21% below	30%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT CHEST SPINE WO CONTRAST	$1,426.60	$2,038.00	—	1% below	30%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT CHEST SPINE WO CONTRAST	$1,426.60	$2,038.00	—	—	30%
Toe X-ray, 2 or more views CPT 73660 HC XR TOE(S) MIN 2 VIEWS	$237.30	$339.00	—	3% below	30%
Toe X-ray, 2 or more views CPT 73660 HC XR TOE(S) MIN 2 VIEWS	$373.10	$533.00	—	52% above	30%
Toe X-ray, 2 or more views inpatient CPT 73660 HC XR TOE(S) MIN 2 VIEWS	$373.10	$533.00	—	—	30%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON-OB	$422.80	$604.00	—	15% below	30%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON-OB	$662.20	$946.00	—	33% above	30%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON-OB	$662.20	$946.00	—	—	30%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL CDM	$449.40	$642.00	—	6% above	30%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL CDM	$704.20	$1,006.00	—	66% above	30%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US OB TRANSVAGINAL CDM	$704.20	$1,006.00	—	—	30%
Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE	$653.80	$934.00	—	6% below	30%
Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE	$1,023.40	$1,462.00	—	47% above	30%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US EXAM ABDOMEN COMPLETE	$1,023.40	$1,462.00	—	—	30%
Ultrasound of the scrotum and testicles CPT 76870 HC US EXAM SCROTUM & CONTENTS	$467.60	$668.00	—	19% below	30%
Ultrasound of the scrotum and testicles CPT 76870 HC US EXAM SCROTUM & CONTENTS	$733.60	$1,048.00	—	27% above	30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US EXAM SCROTUM & CONTENTS	$733.60	$1,048.00	—	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM OF HEAD AND NECK	$393.40	$562.00	—	30% below	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US ED EXAM OF HEAD AND NECK CDM	$564.20	$806.00	—	1% above	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM OF HEAD AND NECK	$614.60	$878.00	—	10% above	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US ED EXAM OF HEAD AND NECK CDM	$564.20	$806.00	—	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US EXAM OF HEAD AND NECK	$614.60	$878.00	—	—	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC XR RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY CDM	$1,031.80	$1,474.00	—	51% above	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC XR RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY CDM	$1,618.40	$2,312.00	—	137% above	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC XR RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY CDM	$1,618.40	$2,312.00	—	—	30%
Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS MIN 2 VIEWS	$321.30	$459.00	—	16% above	30%
Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS MIN 2 VIEWS	$504.70	$721.00	—	82% above	30%
Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS 1 VIEW	$504.70	$721.00	—	82% above	30%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC XR HUMERUS 1 VIEW	$504.70	$721.00	—	—	30%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC XR HUMERUS MIN 2 VIEWS	$504.70	$721.00	—	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$794.50	$1,135.00	—	18% above	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$1,246.70	$1,781.00	—	85% above	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$1,246.70	$1,781.00	—	—	30%
Wrist X-ray, 2 views CPT 73100 HC XR WRIST 2 VIEWS	$277.90	$397.00	—	11% above	30%
Wrist X-ray, 2 views CPT 73100 HC XR WRIST 1 VIEW	$277.90	$397.00	—	11% above	30%
Wrist X-ray, 2 views CPT 73100 HC XR WRIST 1 VIEW	$436.80	$624.00	—	75% above	30%
Wrist X-ray, 2 views CPT 73100 HC XR WRIST 2 VIEWS	$436.80	$624.00	—	75% above	30%
Wrist X-ray, 2 views inpatient CPT 73100 HC XR WRIST 1 VIEW	$436.80	$624.00	—	—	30%
Wrist X-ray, 2 views inpatient CPT 73100 HC XR WRIST 2 VIEWS	$436.80	$624.00	—	—	30%
Wrist X-ray, complete, 3 or more views CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS	$298.90	$427.00	—	5% below	30%
Wrist X-ray, complete, 3 or more views CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS	$468.30	$669.00	—	49% above	30%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS	$468.30	$669.00	—	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC XR HIPS UNI W PELVIS WHEN PERFORMED 2-3 VIEWS	$183.40	$262.00	—	43% below	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC XR HIPS UNI W PELVIS WHEN PERFORMED 2-3 VIEWS	$287.70	$411.00	—	11% below	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC XR HIPS UNI W PELVIS WHEN PERFORMED 2-3 VIEWS	$287.70	$411.00	—	—	30%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN 1 VIEW	$249.20	$356.00	—	4% below	30%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN PORTABLE 1 VIEW	$390.60	$558.00	—	51% above	30%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN 1 VIEW	$390.60	$558.00	—	51% above	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN PORTABLE 1 VIEW	$390.60	$558.00	—	—	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN 1 VIEW	$390.60	$558.00	—	—	30%
X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 2 VIEWS	$277.90	$397.00	—	10% above	30%
X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 1 VIEW	$277.90	$397.00	—	10% above	30%
X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 1 VIEW	$436.80	$624.00	—	72% above	30%
X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 2 VIEWS	$436.80	$624.00	—	72% above	30%
X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 2 VIEWS	$436.80	$624.00	—	—	30%
X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 1 VIEW	$436.80	$624.00	—	—	30%
X-ray of the finger(s), 2 or more views CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS	$237.30	$339.00	—	11% below	30%
X-ray of the finger(s), 2 or more views CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS	$373.10	$533.00	—	40% above	30%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS	$373.10	$533.00	—	—	30%
X-ray of the foot, 2 views CPT 73620 HC XR FOOT 2 VIEWS	$277.90	$397.00	—	at median	30%
X-ray of the foot, 2 views CPT 73620 HC XR FOOT 1 VIEW	$277.90	$397.00	—	at median	30%
X-ray of the foot, 2 views CPT 73620 HC XR FOOT 1 VIEW	$436.80	$624.00	—	57% above	30%
X-ray of the foot, 2 views CPT 73620 HC XR FOOT 2 VIEWS	$436.80	$624.00	—	57% above	30%
X-ray of the foot, 2 views inpatient CPT 73620 HC XR FOOT 2 VIEWS	$436.80	$624.00	—	—	30%
X-ray of the foot, 2 views inpatient CPT 73620 HC XR FOOT 1 VIEW	$436.80	$624.00	—	—	30%
X-ray of the foot, complete, 3 or more views CPT 73630 HC XR FOOT MIN 3 VIEWS	$298.90	$427.00	—	1% below	30%
X-ray of the foot, complete, 3 or more views CPT 73630 HC XR FOOT MIN 3 VIEWS	$468.30	$669.00	—	55% above	30%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC XR FOOT MIN 3 VIEWS	$468.30	$669.00	—	—	30%
X-ray of the hand, 3 or more views CPT 73130 HC XR HAND MIN 3 VIEWS	$298.90	$427.00	—	3% below	30%
X-ray of the hand, 3 or more views CPT 73130 HC XR HAND MIN 3 VIEWS	$468.30	$669.00	—	52% above	30%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC XR HAND MIN 3 VIEWS	$468.30	$669.00	—	—	30%
X-ray of the knee, 1 or 2 views CPT 73560 HC XR KNEE 1-2 VIEWS	$320.60	$458.00	—	12% above	30%
X-ray of the knee, 1 or 2 views CPT 73560 HC XR KNEE 1-2 VIEWS	$504.70	$721.00	—	76% above	30%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC XR KNEE 1-2 VIEWS	$504.70	$721.00	—	—	30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS	$375.20	$536.00	—	1% above	30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS	$590.10	$843.00	—	59% above	30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS	$590.10	$843.00	—	—	30%
X-ray of the lower back, 4 or more views CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS	$512.40	$732.00	—	14% above	30%
X-ray of the lower back, 4 or more views CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS	$802.20	$1,146.00	—	78% above	30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS	$802.20	$1,146.00	—	—	30%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC XR SPINE THORACIC 2 VIEWS	$331.10	$473.00	—	4% above	30%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC XR SPINE THORACIC 2 VIEWS	$520.10	$743.00	—	64% above	30%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC XR SPINE THORACIC 2 VIEWS	$520.10	$743.00	—	—	30%
X-ray of the nasal bones, 3 or more views CPT 70160 HC XR NASAL BONES MIN 3 VIEWS	$294.70	$421.00	—	15% above	30%
X-ray of the nasal bones, 3 or more views CPT 70160 HC XR NASAL BONES MIN 3 VIEWS	$463.40	$662.00	—	81% above	30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC XR NASAL BONES MIN 3 VIEWS	$463.40	$662.00	—	—	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS	$336.00	$480.00	—	5% above	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS	$527.10	$753.00	—	65% above	30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS	$527.10	$753.00	—	—	30%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS	$294.70	$421.00	—	3% above	30%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS	$463.40	$662.00	—	62% above	30%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS	$463.40	$662.00	—	—	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC XR TAILBONE MIN 2 VIEWS	$321.30	$459.00	—	14% above	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC XR TAILBONE MIN 2 VIEWS	$504.70	$721.00	—	78% above	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC XR TAILBONE MIN 2 VIEWS	$504.70	$721.00	—	—	30%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
ACTH blood test CPT 82024 HC ADRENOCORTICOTROPIC HORMONE ACTH CDM	$23.10	$33.00	—	90% below	30%
ACTH blood test inpatient CPT 82024 HC ADRENOCORTICOTROPIC HORMONE ACTH CDM	$23.10	$33.00	—	—	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALANINE AMINO (ALT) (SGPT)	$17.50	$25.00	—	63% below	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE ALANINE AMINO ALT SGPT LAB	$23.80	$34.00	—	50% below	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC V FIBROSURE SGPT	$56.00	$80.00	—	19% above	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC SGPT (ALT)	$95.20	$136.00	—	102% above	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC ALANINE AMINO (ALT) (SGPT)	$17.50	$25.00	—	—	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE ALANINE AMINO ALT SGPT LAB	$23.80	$34.00	—	—	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC V FIBROSURE SGPT	$56.00	$80.00	—	—	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC SGPT (ALT)	$95.20	$136.00	—	—	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT LAB	$6.30	$9.00	—	85% below	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT	$17.50	$25.00	—	59% below	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC SGOT (AST)	$91.70	$131.00	—	116% above	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT LAB	$6.30	$9.00	—	—	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT	$17.50	$25.00	—	—	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC SGOT (AST)	$91.70	$131.00	—	—	30%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS ACUTE PANEL	$58.10	$83.00	—	76% below	30%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS ACUTE PANEL	$58.10	$83.00	—	—	30%
Albumin blood test CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD LAB	$5.60	$8.00	—	84% below	30%
Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN (RL)	$16.80	$24.00	—	53% below	30%
Albumin blood test CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD CDM	$87.50	$125.00	—	146% above	30%
Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN	$87.50	$125.00	—	146% above	30%
Albumin blood test inpatient CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD LAB	$5.60	$8.00	—	—	30%
Albumin blood test inpatient CPT 82040 HC ASSAY OF SERUM ALBUMIN (RL)	$16.80	$24.00	—	—	30%
Albumin blood test inpatient CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD CDM	$87.50	$125.00	—	—	30%
Albumin blood test inpatient CPT 82040 HC ASSAY OF SERUM ALBUMIN	$87.50	$125.00	—	—	30%
Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE CDM	$36.40	$52.00	—	78% below	30%
Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE LAB	$41.30	$59.00	—	75% below	30%
Aldosterone blood test CPT 82088 HC ALDOSTERONE BLD	$58.80	$84.00	—	65% below	30%
Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE PLASMA LAB	$58.80	$84.00	—	65% below	30%
Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE CDM	$36.40	$52.00	—	—	30%
Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE LAB	$41.30	$59.00	—	—	30%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE BLD	$58.80	$84.00	—	—	30%
Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE PLASMA LAB	$58.80	$84.00	—	—	30%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOS	$25.20	$36.00	—	34% below	30%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ASSAY OF PHOSPHATASE ALKALINE LAB	$25.20	$36.00	—	34% below	30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ASSAY OF PHOSPHATASE ALKALINE LAB	$25.20	$36.00	—	—	30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOS	$25.20	$36.00	—	—	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH LAB	$11.20	$16.00	—	58% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT X 1LAB	$14.70	$21.00	—	45% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE - ALLERGEN SPEC	$14.70	$21.00	—	45% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT X 33LAB	$14.70	$21.00	—	45% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE - IGE ALLERGEN	$14.70	$21.00	—	45% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN PANEL RESPIRATORY RGN 17 CASCADE AND PACIFIC NW	$16.80	$24.00	—	37% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE	$19.60	$28.00	—	27% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE PANEL EACH ALLERGEN	$19.60	$28.00	—	27% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE - IGE QUANT	$19.60	$28.00	—	27% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$19.60	$28.00	—	27% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLG SPEC IGE CRUDE XTRC EA (RL)	$35.70	$51.00	—	34% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE - QUANT	$37.80	$54.00	—	41% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE - EA	$78.40	$112.00	—	193% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH CDM	$85.40	$122.00	—	219% above	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH LAB	$11.20	$16.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE - IGE ALLERGEN	$14.70	$21.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT X 1LAB	$14.70	$21.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE - ALLERGEN SPEC	$14.70	$21.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT X 33LAB	$14.70	$21.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN PANEL RESPIRATORY RGN 17 CASCADE AND PACIFIC NW	$16.80	$24.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE - IGE QUANT	$19.60	$28.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE	$19.60	$28.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$19.60	$28.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE PANEL EACH ALLERGEN	$19.60	$28.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLG SPEC IGE CRUDE XTRC EA (RL)	$35.70	$51.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE - QUANT	$37.80	$54.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE - EA	$78.40	$112.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH CDM	$85.40	$122.00	—	—	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM	$19.60	$28.00	—	77% below	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA FETOPROTEIN TUMOR MARKER	$19.60	$28.00	—	77% below	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM CDM	$30.10	$43.00	—	64% below	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM LAB	$42.00	$60.00	—	50% below	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM	$19.60	$28.00	—	—	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA FETOPROTEIN TUMOR MARKER	$19.60	$28.00	—	—	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM CDM	$30.10	$43.00	—	—	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM LAB	$42.00	$60.00	—	—	30%
Ammonia blood test CPT 82140 HC ASSAY OF AMMONIA LAB	$14.70	$21.00	—	87% below	30%
Ammonia blood test CPT 82140 HC AMMONIA (RL)	$20.30	$29.00	—	82% below	30%
Ammonia blood test inpatient CPT 82140 HC ASSAY OF AMMONIA LAB	$14.70	$21.00	—	—	30%
Ammonia blood test inpatient CPT 82140 HC AMMONIA (RL)	$20.30	$29.00	—	—	30%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE ISOENZYME PANCREATIC	$49.70	$71.00	—	20% below	30%
Amylase blood test CPT 82150 HC AMYLASE	$114.10	$163.00	—	83% above	30%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE LAB	$114.10	$163.00	—	83% above	30%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE	$114.10	$163.00	—	83% above	30%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE CDM	$128.80	$184.00	—	107% above	30%
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE ISOENZYME PANCREATIC	$49.70	$71.00	—	—	30%
Amylase blood test inpatient CPT 82150 HC AMYLASE	$114.10	$163.00	—	—	30%
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE LAB	$114.10	$163.00	—	—	30%
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE	$114.10	$163.00	—	—	30%
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE CDM	$128.80	$184.00	—	—	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP ANTIBODY	$28.70	$41.00	—	63% below	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY LAB	$30.10	$43.00	—	61% below	30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCP ANTIBODY	$28.70	$41.00	—	—	30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY LAB	$30.10	$43.00	—	—	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES	$17.50	$25.00	—	75% below	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA	$17.50	$25.00	—	75% below	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA	$19.60	$28.00	—	72% below	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA LAB	$47.60	$68.00	—	32% below	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES	$17.50	$25.00	—	—	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA	$17.50	$25.00	—	—	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA	$19.60	$28.00	—	—	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA LAB	$47.60	$68.00	—	—	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE LAB	$72.80	$104.00	—	62% below	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE	$72.80	$104.00	—	62% below	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE	$72.80	$104.00	—	—	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE LAB	$72.80	$104.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BACTERIA OTHER - LOWER RESPIR	$17.50	$25.00	—	80% below	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BACTERIA OTHER - MISC/OTHER/ROUTINE	$46.90	$67.00	—	46% below	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL LAB	$60.90	$87.00	—	30% below	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BACTERIA OTHER - WOUND	$107.10	$153.00	—	23% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL CDM	$113.40	$162.00	—	30% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BACTERIA OTHER	$113.40	$162.00	—	30% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE BACTERIA OTHER - LOWER RESPIR	$17.50	$25.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE BACTERIA OTHER - MISC/OTHER/ROUTINE	$46.90	$67.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL LAB	$60.90	$87.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE BACTERIA OTHER - WOUND	$107.10	$153.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL CDM	$113.40	$162.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE BACTERIA OTHER	$113.40	$162.00	—	—	30%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL	$82.60	$118.00	—	10% above	30%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL	$82.60	$118.00	—	—	30%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL LAB	$6.30	$9.00	—	86% below	30%
Bilirubin blood test, total CPT 82247 HC V FIBROSURE BILIRUBIN TOTAL	$56.00	$80.00	—	27% above	30%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL	$80.50	$115.00	—	82% above	30%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL LAB	$6.30	$9.00	—	—	30%
Bilirubin blood test, total inpatient CPT 82247 HC V FIBROSURE BILIRUBIN TOTAL	$56.00	$80.00	—	—	30%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL	$80.50	$115.00	—	—	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM	$175.00	$250.00	—	at median	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC BILL SURG SLIDE PREP	$175.00	$250.00	—	at median	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB	$175.00	$250.00	—	at median	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB	$175.00	$250.00	—	—	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC BILL SURG SLIDE PREP	$175.00	$250.00	—	—	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM	$175.00	$250.00	—	—	30%
Blood culture for bacteria CPT 87040 HC BLOOD CULTURE FOR BACTERIA	$231.70	$331.00	—	55% above	30%
Blood culture for bacteria inpatient CPT 87040 HC BLOOD CULTURE FOR BACTERIA	$231.70	$331.00	—	—	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC BLOOD DRAW VENIPUNCTURE CDM	$35.70	$51.00	—	43% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM	$35.70	$51.00	—	43% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL DRAW FEE	$35.70	$51.00	—	43% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ED ROUTINE VENIPUNCTURE OR LEGAL DRAW CDM	$43.40	$62.00	—	74% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL SHIPPING	$46.90	$67.00	—	88% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL PROCESSING	$60.20	$86.00	—	141% above	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL DRAW FEE	$35.70	$51.00	—	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM	$35.70	$51.00	—	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC BLOOD DRAW VENIPUNCTURE CDM	$35.70	$51.00	—	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ED ROUTINE VENIPUNCTURE OR LEGAL DRAW CDM	$43.40	$62.00	—	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL SHIPPING	$46.90	$67.00	—	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL PROCESSING	$60.20	$86.00	—	—	30%
Blood glucose (sugar) test CPT 82947 HC ASSAY GLUCOSE BLOOD QUANT	$17.50	$25.00	—	53% below	30%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP LAB	$23.80	$34.00	—	36% below	30%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD (EXCEPT REAGENT STRIP)	$70.70	$101.00	—	89% above	30%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP	$79.10	$113.00	—	111% above	30%
Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY GLUCOSE BLOOD QUANT	$17.50	$25.00	—	—	30%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP LAB	$23.80	$34.00	—	—	30%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD (EXCEPT REAGENT STRIP)	$70.70	$101.00	—	—	30%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP	$79.10	$113.00	—	—	30%
Blood lead test CPT 83655 HC HVY MET BLD - LEAD	$17.50	$25.00	—	72% below	30%
Blood lead test CPT 83655 HC HVY MET UR - LEAD	$17.50	$25.00	—	72% below	30%
Blood lead test CPT 83655 HC ASSAY OF LEAD LAB	$21.00	$30.00	—	67% below	30%
Blood lead test CPT 83655 HC LEAD BLOOD	$21.00	$30.00	—	67% below	30%
Blood lead test CPT 83655 HC ASSAY OF LEAD CDM	$40.60	$58.00	—	36% below	30%
Blood lead test CPT 83655 HC LEAD - URINE	$97.30	$139.00	—	53% above	30%
Blood lead test inpatient CPT 83655 HC HVY MET UR - LEAD	$17.50	$25.00	—	—	30%
Blood lead test inpatient CPT 83655 HC HVY MET BLD - LEAD	$17.50	$25.00	—	—	30%
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD LAB	$21.00	$30.00	—	—	30%
Blood lead test inpatient CPT 83655 HC LEAD BLOOD	$21.00	$30.00	—	—	30%
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD CDM	$40.60	$58.00	—	—	30%
Blood lead test inpatient CPT 83655 HC LEAD - URINE	$97.30	$139.00	—	—	30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE CDM	$96.60	$138.00	—	30% above	30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE CDM	$96.60	$138.00	—	—	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO LAB	$54.60	$78.00	—	16% below	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC ARC ABO TYPE	$65.10	$93.00	—	at median	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO CDM	$68.60	$98.00	—	6% above	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO LAB	$54.60	$78.00	—	—	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC ARC ABO TYPE	$65.10	$93.00	—	—	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO CDM	$68.60	$98.00	—	—	30%
Blood urea nitrogen (BUN) test CPT 84520 HC BUN	$70.70	$101.00	—	94% above	30%
Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY OF UREA NITROGEN QUANTITATIVE LAB	$70.70	$101.00	—	94% above	30%
Blood urea nitrogen (BUN) test CPT 84520 HC UREA NITROGEN BODY FLUID	$70.70	$101.00	—	94% above	30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC BUN	$70.70	$101.00	—	—	30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY OF UREA NITROGEN QUANTITATIVE LAB	$70.70	$101.00	—	—	30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC UREA NITROGEN BODY FLUID	$70.70	$101.00	—	—	30%
C-peptide blood test CPT 84681 HC ASSAY OF C-PEPTIDE CDM	$97.30	$139.00	—	12% below	30%
C-peptide blood test inpatient CPT 84681 HC ASSAY OF C-PEPTIDE CDM	$97.30	$139.00	—	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN	$8.40	$12.00	—	86% below	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN LAB	$18.20	$26.00	—	69% below	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC CRP	$98.00	$140.00	—	67% above	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN	$8.40	$12.00	—	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN LAB	$18.20	$26.00	—	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC CRP	$98.00	$140.00	—	—	30%
C. difficile toxin gene test (stool PCR) CPT 87493 HC CLOSTRIDIUM DIFFICILE TOXINS AMPLIFIED PROBE	$134.40	$192.00	—	23% below	30%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC CLOSTRIDIUM DIFFICILE TOXINS AMPLIFIED PROBE	$134.40	$192.00	—	—	30%
CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9	$32.90	$47.00	—	70% below	30%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9	$32.90	$47.00	—	—	30%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 CDM	$52.50	$75.00	—	56% below	30%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 LAB	$52.50	$75.00	—	56% below	30%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 CDM	$52.50	$75.00	—	—	30%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 LAB	$52.50	$75.00	—	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ LAB	$123.20	$176.00	—	17% above	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ CDM	$123.20	$176.00	—	17% above	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ CDM	$123.20	$176.00	—	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ LAB	$123.20	$176.00	—	—	30%
Calcium blood test, total CPT 82310 HC CALCIUM TOTAL CDM	$20.30	$29.00	—	52% below	30%
Calcium blood test, total CPT 82310 HC CALCIUM SERUM	$20.30	$29.00	—	52% below	30%
Calcium blood test, total CPT 82310 HC CALCIUM TOTAL LAB	$91.70	$131.00	—	116% above	30%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM TOTAL CDM	$20.30	$29.00	—	—	30%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM SERUM	$20.30	$29.00	—	—	30%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM TOTAL LAB	$91.70	$131.00	—	—	30%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CARCINOEMBRYONIC ANTIGEN CEA CDM	$37.80	$54.00	—	71% below	30%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CARCINOEMBRYONIC ANTIGEN CEA CDM	$37.80	$54.00	—	—	30%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER ANTIBODY - IGG	$17.50	$25.00	—	78% below	30%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER AB IGG(PNL)	$28.70	$41.00	—	64% below	30%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER AB IGM(PNL)	$28.70	$41.00	—	64% below	30%
Chickenpox (varicella) immunity blood test CPT 86787 HC ANTIBODY VARICELLA-ZOSTER CDM	$32.20	$46.00	—	59% below	30%
Chickenpox (varicella) immunity blood test CPT 86787 HC ANTIBODY VARICELLA-ZOSTER	$40.60	$58.00	—	49% below	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA-ZOSTER ANTIBODY - IGG	$17.50	$25.00	—	—	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER AB IGM(PNL)	$28.70	$41.00	—	—	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER AB IGG(PNL)	$28.70	$41.00	—	—	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC ANTIBODY VARICELLA-ZOSTER CDM	$32.20	$46.00	—	—	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC ANTIBODY VARICELLA-ZOSTER	$40.60	$58.00	—	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ	$33.60	$48.00	—	75% below	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE	$47.60	$68.00	—	65% below	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ LAB	$47.60	$68.00	—	65% below	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIFIED DNA	$47.60	$68.00	—	65% below	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS PCR	$135.80	$194.00	—	1% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ	$33.60	$48.00	—	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ LAB	$47.60	$68.00	—	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIFIED DNA	$47.60	$68.00	—	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE	$47.60	$68.00	—	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS PCR	$135.80	$194.00	—	—	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL LAB	$14.70	$21.00	—	83% below	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC NMR-CHOLESTEROL TOTAL	$25.20	$36.00	—	72% below	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL CDM	$71.40	$102.00	—	20% below	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL - PAML	$90.30	$129.00	—	2% above	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL OF NMR	$95.20	$136.00	—	7% above	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PROFILE	$96.60	$138.00	—	9% above	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL	$116.90	$167.00	—	31% above	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL LAB	$14.70	$21.00	—	—	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC NMR-CHOLESTEROL TOTAL	$25.20	$36.00	—	—	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL CDM	$71.40	$102.00	—	—	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL - PAML	$90.30	$129.00	—	—	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL OF NMR	$95.20	$136.00	—	—	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PROFILE	$96.60	$138.00	—	—	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL	$116.90	$167.00	—	—	30%
Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC LAB	$18.20	$26.00	—	73% below	30%
Complete blood count (CBC) with differential CPT 85025 HC CBC	$18.20	$26.00	—	73% below	30%
Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC CDM	$63.70	$91.00	—	5% below	30%
Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC W/AUTO DIF WBC	$91.00	$130.00	—	35% above	30%
Complete blood count (CBC) with differential CPT 85025 HC CBC WITH DIFF AUTO	$121.10	$173.00	—	80% above	30%
Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$121.10	$173.00	—	80% above	30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC LAB	$18.20	$26.00	—	—	30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC	$18.20	$26.00	—	—	30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC CDM	$63.70	$91.00	—	—	30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE CBC W/AUTO DIF WBC	$91.00	$130.00	—	—	30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$121.10	$173.00	—	—	30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC WITH DIFF AUTO	$121.10	$173.00	—	—	30%
Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED LAB	$93.80	$134.00	—	83% above	30%
Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED	$93.80	$134.00	—	83% above	30%
Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED	$93.80	$134.00	—	—	30%
Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED LAB	$93.80	$134.00	—	—	30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHEN METABOLIC PANEL	$126.70	$181.00	—	39% above	30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHEN METABOLIC PANEL	$126.70	$181.00	—	—	30%
Cortisol blood test, total CPT 82533 HC CORTISOL POST DEX 2	$22.40	$32.00	—	79% below	30%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL LAB	$22.40	$32.00	—	79% below	30%
Cortisol blood test, total CPT 82533 HC CORTISOL	$44.10	$63.00	—	58% below	30%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL	$44.10	$63.00	—	58% below	30%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL SUPPRESSION	$58.80	$84.00	—	44% below	30%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL SALIVA	$70.00	$100.00	—	34% below	30%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL CDM	$119.00	$170.00	—	13% above	30%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL POST DEX 2	$22.40	$32.00	—	—	30%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL LAB	$22.40	$32.00	—	—	30%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL	$44.10	$63.00	—	—	30%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL	$44.10	$63.00	—	—	30%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL SUPPRESSION	$58.80	$84.00	—	—	30%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL SALIVA	$70.00	$100.00	—	—	30%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL CDM	$119.00	$170.00	—	—	30%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE TOTAL CDM	$19.60	$28.00	—	71% below	30%
Creatine kinase (CK) blood test, total CPT 82550 HC CK TOTAL	$114.10	$163.00	—	72% above	30%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE TOTAL LAB	$114.10	$163.00	—	72% above	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE TOTAL CDM	$19.60	$28.00	—	—	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CK TOTAL	$114.10	$163.00	—	—	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE TOTAL LAB	$114.10	$163.00	—	—	30%
Creatinine blood test CPT 82565 HC CREATININE BLOOD LAB	$5.60	$8.00	—	87% below	30%
Creatinine blood test CPT 82565 HC ASSAY CREATININE	$91.70	$131.00	—	112% above	30%
Creatinine blood test inpatient CPT 82565 HC CREATININE BLOOD LAB	$5.60	$8.00	—	—	30%
Creatinine blood test inpatient CPT 82565 HC ASSAY CREATININE	$91.70	$131.00	—	—	30%
Cytomegalovirus (CMV) antibody test CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV LAB	$19.60	$28.00	—	74% below	30%
Cytomegalovirus (CMV) antibody test CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV CDM	$22.40	$32.00	—	71% below	30%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV ANTIBODY	$97.30	$139.00	—	28% above	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV LAB	$19.60	$28.00	—	—	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV CDM	$22.40	$32.00	—	—	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV ANTIBODY	$97.30	$139.00	—	—	30%
D-dimer blood test (blood clot marker) CPT 85379 HC D-DIMER QUANTITATIVE	$18.20	$26.00	—	85% below	30%
D-dimer blood test (blood clot marker) CPT 85379 HC FIBRIN DEGRADATION QUANT	$72.80	$104.00	—	39% below	30%
D-dimer blood test (blood clot marker) CPT 85379 HC DDIMER QUANT	$109.90	$157.00	—	8% below	30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D-DIMER QUANTITATIVE	$18.20	$26.00	—	—	30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC FIBRIN DEGRADATION QUANT	$72.80	$104.00	—	—	30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC DDIMER QUANT	$109.90	$157.00	—	—	30%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE CDM	$28.70	$41.00	—	78% below	30%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE LAB	$156.10	$223.00	—	21% above	30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE CDM	$28.70	$41.00	—	—	30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE LAB	$156.10	$223.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$28.70	$41.00	—	82% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR METH PER DOS LAB	$38.50	$55.00	—	76% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR THC URINE PER DOS LAB	$38.50	$55.00	—	76% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUGS OF ABUSE URINE	$38.50	$55.00	—	76% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR PROPOXY PER DOS LAB	$42.00	$60.00	—	74% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE CDM	$51.80	$74.00	—	68% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR SALICYLATE PER DOS LAB	$51.80	$74.00	—	68% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ALCOHOL PER DOS	$63.70	$91.00	—	60% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR NICOTINE PER DOS LAB	$78.40	$112.00	—	51% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR BENZODIAZEPINE PER DOS LAB	$79.10	$113.00	—	51% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR COCAINE PER DOS LAB	$79.10	$113.00	—	51% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR BARBITURATES PER DOS	$79.10	$113.00	—	51% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR TRICYCLICS PER DOS LAB	$84.00	$120.00	—	48% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR OPIATES URINE PER DOS LAB	$87.50	$125.00	—	46% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR OPIATES PER DOS	$87.50	$125.00	—	46% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ALCOHOL URINE PER DOS	$98.00	$140.00	—	39% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR PER DOS	$102.90	$147.00	—	36% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR MECONIUM PER DOS	$114.80	$164.00	—	29% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ETHYLGLCURONIDE PER DOS	$135.80	$194.00	—	16% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR PER DOS PANEL 10-50 LAB	$205.10	$293.00	—	27% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR CORDSTAT PER DOS	$225.40	$322.00	—	40% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE LAB	$262.50	$375.00	—	63% above	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$28.70	$41.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR METH PER DOS LAB	$38.50	$55.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR THC URINE PER DOS LAB	$38.50	$55.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUGS OF ABUSE URINE	$38.50	$55.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR PROPOXY PER DOS LAB	$42.00	$60.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE CDM	$51.80	$74.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR SALICYLATE PER DOS LAB	$51.80	$74.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ALCOHOL PER DOS	$63.70	$91.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR NICOTINE PER DOS LAB	$78.40	$112.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR COCAINE PER DOS LAB	$79.10	$113.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR BARBITURATES PER DOS	$79.10	$113.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR BENZODIAZEPINE PER DOS LAB	$79.10	$113.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR TRICYCLICS PER DOS LAB	$84.00	$120.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR OPIATES PER DOS	$87.50	$125.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR OPIATES URINE PER DOS LAB	$87.50	$125.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ALCOHOL URINE PER DOS	$98.00	$140.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR PER DOS	$102.90	$147.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR MECONIUM PER DOS	$114.80	$164.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ETHYLGLCURONIDE PER DOS	$135.80	$194.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR PER DOS PANEL 10-50 LAB	$205.10	$293.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR CORDSTAT PER DOS	$225.40	$322.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE LAB	$262.50	$375.00	—	—	30%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL	$54.60	$78.00	—	at median	30%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL	$54.60	$78.00	—	—	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR ANTIBODY - VIRAL CAPSID	$27.30	$39.00	—	71% below	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA LAB	$27.30	$39.00	—	71% below	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA CDM	$48.30	$69.00	—	49% below	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR ANTIBODY - VIRAL CAPSID IGM	$89.60	$128.00	—	6% below	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR ANTIBODY - VIRAL CAPSID IGG	$89.60	$128.00	—	6% below	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR ANTIBODY - VIRAL CAPSID	$27.30	$39.00	—	—	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA LAB	$27.30	$39.00	—	—	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA CDM	$48.30	$69.00	—	—	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR ANTIBODY - VIRAL CAPSID IGM	$89.60	$128.00	—	—	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR ANTIBODY - VIRAL CAPSID IGG	$89.60	$128.00	—	—	30%
Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL LAB	$33.60	$48.00	—	76% below	30%
Estradiol blood test CPT 82670 HC ESTRADIOL	$44.80	$64.00	—	68% below	30%
Estradiol blood test CPT 82670 HC ASSAY OF TOTAL ESTRADIOL LAB	$78.40	$112.00	—	44% below	30%
Estradiol blood test CPT 82670 HC ASSAY OF TOTAL ESTRADIOL CDM	$156.10	$223.00	—	12% above	30%
Estradiol blood test inpatient CPT 82670 HC ASSAY OF ESTRADIOL LAB	$33.60	$48.00	—	—	30%
Estradiol blood test inpatient CPT 82670 HC ESTRADIOL	$44.80	$64.00	—	—	30%
Estradiol blood test inpatient CPT 82670 HC ASSAY OF TOTAL ESTRADIOL LAB	$78.40	$112.00	—	—	30%
Estradiol blood test inpatient CPT 82670 HC ASSAY OF TOTAL ESTRADIOL CDM	$156.10	$223.00	—	—	30%
FSH (follicle-stimulating hormone) test CPT 83001 HC FSH(FOLLICLE STIMULATE HORMONE)	$20.30	$29.00	—	78% below	30%
FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE LAB	$25.20	$36.00	—	73% below	30%
FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE CDM	$26.60	$38.00	—	72% below	30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC FSH(FOLLICLE STIMULATE HORMONE)	$20.30	$29.00	—	—	30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE LAB	$25.20	$36.00	—	—	30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE CDM	$26.60	$38.00	—	—	30%
Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY OF CALPROTECTIN FECAL CDM	$63.70	$91.00	—	68% below	30%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC ASSAY OF CALPROTECTIN FECAL CDM	$63.70	$91.00	—	—	30%
Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN	$25.90	$37.00	—	74% below	30%
Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN CDM	$139.30	$199.00	—	42% above	30%
Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN	$25.90	$37.00	—	—	30%
Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN CDM	$139.30	$199.00	—	—	30%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN	$224.70	$321.00	—	179% above	30%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN	$224.70	$321.00	—	—	30%
Folate (folic acid) blood test CPT 82746 HC ASSAY OF FOLIC ACID SERUM CDM	$152.60	$218.00	—	45% above	30%
Folate (folic acid) blood test inpatient CPT 82746 HC ASSAY OF FOLIC ACID SERUM CDM	$152.60	$218.00	—	—	30%
Free T3 thyroid hormone test CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE LAB	$19.60	$28.00	—	78% below	30%
Free T3 thyroid hormone test CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE CDM	$25.20	$36.00	—	72% below	30%
Free T3 thyroid hormone test inpatient CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE LAB	$19.60	$28.00	—	—	30%
Free T3 thyroid hormone test inpatient CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE CDM	$25.20	$36.00	—	—	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE LAB	$16.10	$23.00	—	77% below	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE CDM	$86.10	$123.00	—	24% above	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE LAB	$16.10	$23.00	—	—	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE CDM	$86.10	$123.00	—	—	30%
Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE LAB	$19.60	$28.00	—	85% below	30%
Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE	$35.70	$51.00	—	72% below	30%
Free testosterone test CPT 84402 HC TESTOSTERONE FREE	$36.40	$52.00	—	71% below	30%
Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE CDM	$54.60	$78.00	—	57% below	30%
Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE LAB	$19.60	$28.00	—	—	30%
Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE	$35.70	$51.00	—	—	30%
Free testosterone test inpatient CPT 84402 HC TESTOSTERONE FREE	$36.40	$52.00	—	—	30%
Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE CDM	$54.60	$78.00	—	—	30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GGT	$17.50	$25.00	—	68% below	30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GLUTAMYLTRASE GAMMA LAB	$23.80	$34.00	—	56% below	30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC V FIBROSURE GGT	$56.00	$80.00	—	3% above	30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GAMMA GT TOTAL	$106.40	$152.00	—	96% above	30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC ASSAY OF GGT	$17.50	$25.00	—	—	30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC ASSAY OF GLUTAMYLTRASE GAMMA LAB	$23.80	$34.00	—	—	30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC V FIBROSURE GGT	$56.00	$80.00	—	—	30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GAMMA GT TOTAL	$106.40	$152.00	—	—	30%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC GENERAL HEALTH PANEL	$356.30	$509.00	—	54% above	30%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC GENERAL HEALTH PANEL	$356.30	$509.00	—	—	30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GESTATIONAL GLUCOSE 1 HOUR	$70.70	$101.00	—	72% above	30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE	$70.70	$101.00	—	72% above	30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE LAB	$70.70	$101.00	—	72% above	30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE TOLERANCE 1 HR	$79.10	$113.00	—	92% above	30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE	$70.70	$101.00	—	—	30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GESTATIONAL GLUCOSE 1 HOUR	$70.70	$101.00	—	—	30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE LAB	$70.70	$101.00	—	—	30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE TOLERANCE 1 HR	$79.10	$113.00	—	—	30%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) 3 SPECIMENS	$14.70	$21.00	—	80% below	30%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE(3 SPEC)	$169.40	$242.00	—	133% above	30%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS CDM	$195.30	$279.00	—	168% above	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) 3 SPECIMENS	$14.70	$21.00	—	—	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE(3 SPEC)	$169.40	$242.00	—	—	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS CDM	$195.30	$279.00	—	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.GONORRHOEAE DNA AMPLIFIED PROBE	$28.70	$41.00	—	77% below	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ CDM	$47.60	$68.00	—	62% below	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ LAB	$47.60	$68.00	—	62% below	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ	$135.80	$194.00	—	8% above	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N.GONORRHOEAE DNA AMPLIFIED PROBE	$28.70	$41.00	—	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ CDM	$47.60	$68.00	—	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ LAB	$47.60	$68.00	—	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ	$135.80	$194.00	—	—	30%
H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI ANTIBODY - IGA	$16.10	$23.00	—	81% below	30%
H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI - IGG	$16.10	$23.00	—	81% below	30%
H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI	$17.50	$25.00	—	80% below	30%
H. pylori antibody blood test CPT 86677 HC ANTIBODY HELICOBACTER PYLORI LAB	$19.60	$28.00	—	77% below	30%
H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI ANTIBODY - IGA	$21.00	$30.00	—	76% below	30%
H. pylori antibody blood test CPT 86677 HC ANTIBODY HELICOBACTER PYLORI CDM	$117.60	$168.00	—	36% above	30%
H. pylori antibody blood test inpatient CPT 86677 HC HELICOBACTER PYLORI - IGG	$16.10	$23.00	—	—	30%
H. pylori antibody blood test inpatient CPT 86677 HC HELICOBACTER PYLORI ANTIBODY - IGA	$16.10	$23.00	—	—	30%
H. pylori antibody blood test inpatient CPT 86677 HC HELICOBACTER PYLORI	$17.50	$25.00	—	—	30%
H. pylori antibody blood test inpatient CPT 86677 HC ANTIBODY HELICOBACTER PYLORI LAB	$19.60	$28.00	—	—	30%
H. pylori antibody blood test inpatient CPT 86677 HC ANTIBODY HELICOBACTER PYLORI CDM	$117.60	$168.00	—	—	30%
H. pylori stool antigen test CPT 87338 HC IAAD IA HPYLORI STOOL CDM	$62.30	$89.00	—	56% below	30%
H. pylori stool antigen test inpatient CPT 87338 HC IAAD IA HPYLORI STOOL CDM	$62.30	$89.00	—	—	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION LAB	$146.30	$209.00	—	62% below	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV ULTRA SENSITIVE PCR	$154.00	$220.00	—	60% below	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 DNA QUANTIFICATION	$490.00	$700.00	—	27% above	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION LAB	$146.30	$209.00	—	—	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV ULTRA SENSITIVE PCR	$154.00	$220.00	—	—	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 DNA QUANTIFICATION	$490.00	$700.00	—	—	30%
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV-1/HIV-2 SINGLE ASSAY	$94.50	$135.00	—	10% above	30%
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV-1/HIV-2 SINGLE ASSAY - REFLEXIVE	$96.60	$138.00	—	12% above	30%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV-1/HIV-2 SINGLE ASSAY	$94.50	$135.00	—	—	30%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV-1/HIV-2 SINGLE ASSAY - REFLEXIVE	$96.60	$138.00	—	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC ANTI-HIV 1/2 AB & P24 AG	$32.90	$47.00	—	66% below	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE	$50.40	$72.00	—	49% below	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE CDM	$68.60	$98.00	—	30% below	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC ANTI-HIV 1/2 AB & P24 AG	$32.90	$47.00	—	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE	$50.40	$72.00	—	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE CDM	$68.60	$98.00	—	—	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES	$37.80	$54.00	—	73% below	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES LAB	$129.50	$185.00	—	9% below	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES	$37.80	$54.00	—	—	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES LAB	$129.50	$185.00	—	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC SENDOUT GLYCOSYLATED HEMOGLOBIN	$11.90	$17.00	—	83% below	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C CDM	$108.50	$155.00	—	54% above	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC SENDOUT GLYCOSYLATED HEMOGLOBIN	$11.90	$17.00	—	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C CDM	$108.50	$155.00	—	—	30%
Hemoglobin blood test CPT 85018 HC BLOOD COUNT HEMOGLOBIN LAB	$18.20	$26.00	—	38% below	30%
Hemoglobin blood test CPT 85018 HC BLOOD COUNT HEMOGLOBIN	$47.60	$68.00	—	62% above	30%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN (HGB)	$47.60	$68.00	—	62% above	30%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN	$47.60	$68.00	—	62% above	30%
Hemoglobin blood test CPT 85018 HC BLOOD COUNT HEMOGLOBIN CDM	$47.60	$68.00	—	62% above	30%
Hemoglobin blood test inpatient CPT 85018 HC BLOOD COUNT HEMOGLOBIN LAB	$18.20	$26.00	—	—	30%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN (HGB)	$47.60	$68.00	—	—	30%
Hemoglobin blood test inpatient CPT 85018 HC BLOOD COUNT HEMOGLOBIN CDM	$47.60	$68.00	—	—	30%
Hemoglobin blood test inpatient CPT 85018 HC BLOOD COUNT HEMOGLOBIN	$47.60	$68.00	—	—	30%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN	$47.60	$68.00	—	—	30%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL CDM	$21.00	$30.00	—	69% below	30%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL LAB	$32.20	$46.00	—	53% below	30%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL CDM	$21.00	$30.00	—	—	30%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL LAB	$32.20	$46.00	—	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB CDM	$32.20	$46.00	—	57% below	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB LAB	$38.50	$55.00	—	48% below	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB CDM	$32.20	$46.00	—	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB LAB	$38.50	$55.00	—	—	30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN CDM	$20.30	$29.00	—	73% below	30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN LAB	$32.20	$46.00	—	57% below	30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN CDM	$20.30	$29.00	—	—	30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN LAB	$32.20	$46.00	—	—	30%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY LAB	$25.20	$36.00	—	71% below	30%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEP C AB REFLEXIVE	$25.20	$36.00	—	71% below	30%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY	$26.60	$38.00	—	69% below	30%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY CDM	$90.30	$129.00	—	5% above	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY LAB	$25.20	$36.00	—	—	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEP C AB REFLEXIVE	$25.20	$36.00	—	—	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY	$26.60	$38.00	—	—	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY CDM	$90.30	$129.00	—	—	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION CDM	$68.60	$98.00	—	80% below	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION (RL)	$105.70	$151.00	—	68% below	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C RNA QUANTIFICATION	$105.70	$151.00	—	68% below	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION LAB	$249.20	$356.00	—	26% below	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C QUANTITATIVE PCR	$321.30	$459.00	—	4% below	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION CDM	$68.60	$98.00	—	—	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEPATITIS C RNA QUANTIFICATION	$105.70	$151.00	—	—	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION (RL)	$105.70	$151.00	—	—	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION LAB	$249.20	$356.00	—	—	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEPATITIS C QUANTITATIVE PCR	$321.30	$459.00	—	—	30%
Herpes blood test, HSV-1 antibody CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 CDM	$22.40	$32.00	—	68% below	30%
Herpes blood test, HSV-1 antibody CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 LAB	$22.40	$32.00	—	68% below	30%
Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TEST - TYPE 1 IGG	$27.30	$39.00	—	61% below	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 LAB	$22.40	$32.00	—	—	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 CDM	$22.40	$32.00	—	—	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TEST - TYPE 1 IGG	$27.30	$39.00	—	—	30%
Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TYPE 2	$25.20	$36.00	—	71% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HC HSV 2 ANTIBODY IGG	$30.10	$43.00	—	66% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 CDM	$30.10	$43.00	—	66% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 LAB	$75.60	$108.00	—	14% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TYPE 2 - TYPE 2 IGG	$75.60	$108.00	—	14% below	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TYPE 2	$25.20	$36.00	—	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 CDM	$30.10	$43.00	—	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HSV 2 ANTIBODY IGG	$30.10	$43.00	—	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TYPE 2 - TYPE 2 IGG	$75.60	$108.00	—	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 LAB	$75.60	$108.00	—	—	30%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY CDM	$98.00	$140.00	—	32% above	30%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY CDM	$98.00	$140.00	—	—	30%
Homocysteine blood test CPT 83090 HC HOMOCYSTINE PLASMA (HYPERC)	$25.20	$36.00	—	79% below	30%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTEINE (RL)	$25.20	$36.00	—	79% below	30%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTEINE LAB	$25.20	$36.00	—	79% below	30%
Homocysteine blood test CPT 83090 HC HOMOCYSTINE PLASMA QUANT	$38.50	$55.00	—	68% below	30%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTEINE CDM	$233.80	$334.00	—	92% above	30%
Homocysteine blood test inpatient CPT 83090 HC HOMOCYSTINE PLASMA (HYPERC)	$25.20	$36.00	—	—	30%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTEINE LAB	$25.20	$36.00	—	—	30%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTEINE (RL)	$25.20	$36.00	—	—	30%
Homocysteine blood test inpatient CPT 83090 HC HOMOCYSTINE PLASMA QUANT	$38.50	$55.00	—	—	30%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTEINE CDM	$233.80	$334.00	—	—	30%
Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL CDM	$16.10	$23.00	—	80% below	30%
Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL LAB	$47.60	$68.00	—	42% below	30%
Insulin blood test CPT 83525 HC INSULIN LEVEL ASSAY	$58.80	$84.00	—	29% below	30%
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN TOTAL CDM	$16.10	$23.00	—	—	30%
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN TOTAL LAB	$47.60	$68.00	—	—	30%
Insulin blood test inpatient CPT 83525 HC INSULIN LEVEL ASSAY	$58.80	$84.00	—	—	30%
Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON CDM	$8.40	$12.00	—	82% below	30%
Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON	$87.50	$125.00	—	86% above	30%
Iron blood test (serum iron) CPT 83540 HC IRON	$114.10	$163.00	—	143% above	30%
Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON CDM	$8.40	$12.00	—	—	30%
Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON	$87.50	$125.00	—	—	30%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON	$114.10	$163.00	—	—	30%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY CDM	$8.40	$12.00	—	86% below	30%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY CDM	$8.40	$12.00	—	—	30%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL CDM	$95.20	$136.00	—	25% above	30%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL CDM	$95.20	$136.00	—	—	30%
LH (luteinizing hormone) test CPT 83002 HC LUTENIZING HORMONE	$20.30	$29.00	—	79% below	30%
LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE LAB	$25.20	$36.00	—	74% below	30%
LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE CDM	$26.60	$38.00	—	72% below	30%
LH (luteinizing hormone) test inpatient CPT 83002 HC LUTENIZING HORMONE	$20.30	$29.00	—	—	30%
LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE LAB	$25.20	$36.00	—	—	30%
LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE CDM	$26.60	$38.00	—	—	30%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTATE LAB	$97.30	$139.00	—	3% below	30%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTATE	$107.10	$153.00	—	7% above	30%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTATE LAB	$97.30	$139.00	—	—	30%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTATE	$107.10	$153.00	—	—	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE LDH LAB	$11.90	$17.00	—	72% below	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE LDH CDM	$22.40	$32.00	—	48% below	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH SERUM	$106.40	$152.00	—	146% above	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH BODY FLUID	$106.40	$152.00	—	146% above	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE LDH LAB	$11.90	$17.00	—	—	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE LDH CDM	$22.40	$32.00	—	—	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LDH SERUM	$106.40	$152.00	—	—	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LDH BODY FLUID	$106.40	$152.00	—	—	30%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE LAB	$32.20	$46.00	—	62% below	30%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE CDM	$114.10	$163.00	—	36% above	30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE LAB	$32.20	$46.00	—	—	30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE CDM	$114.10	$163.00	—	—	30%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL LAB	$19.60	$28.00	—	70% below	30%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL CDM	$98.00	$140.00	—	49% above	30%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL LAB	$19.60	$28.00	—	—	30%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL CDM	$98.00	$140.00	—	—	30%
Lyme disease antibody test CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE LAB	$18.20	$26.00	—	81% below	30%
Lyme disease antibody test CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE LAB	$18.20	$26.00	—	81% below	30%
Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY	$30.10	$43.00	—	69% below	30%
Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY - CSF	$79.80	$114.00	—	17% below	30%
Lyme disease antibody test inpatient CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE LAB	$18.20	$26.00	—	—	30%
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY	$30.10	$43.00	—	—	30%
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY - CSF	$79.80	$114.00	—	—	30%
Magnesium blood test CPT 83735 HC MAGNESIUM (RL)	$9.10	$13.00	—	83% below	30%
Magnesium blood test CPT 83735 HC MAGNESIUM-URINE	$26.60	$38.00	—	51% below	30%
Magnesium blood test CPT 83735 HC MAGNESIUM QUANT URINE	$48.30	$69.00	—	10% below	30%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM LAB	$58.80	$84.00	—	9% above	30%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM CDM	$117.60	$168.00	—	118% above	30%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM (RL)	$9.10	$13.00	—	—	30%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM-URINE	$26.60	$38.00	—	—	30%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM QUANT URINE	$48.30	$69.00	—	—	30%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM LAB	$58.80	$84.00	—	—	30%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM CDM	$117.60	$168.00	—	—	30%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA ANTIBODY - IGG	$20.30	$29.00	—	71% below	30%
Measles (rubeola) antibody test CPT 86765 HC MEASLES AB IGG (PANL)	$28.70	$41.00	—	60% below	30%
Measles (rubeola) antibody test CPT 86765 HC MEASLES AB IGM (PANL)	$28.70	$41.00	—	60% below	30%
Measles (rubeola) antibody test CPT 86765 HC ANTIBODY RUBEOLA CDM	$30.80	$44.00	—	57% below	30%
Measles (rubeola) antibody test CPT 86765 HC ANTIBODY RUBEOLA LAB	$40.60	$58.00	—	43% below	30%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA ANTIBODY - IGG	$20.30	$29.00	—	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 HC MEASLES AB IGM (PANL)	$28.70	$41.00	—	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 HC MEASLES AB IGG (PANL)	$28.70	$41.00	—	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 HC ANTIBODY RUBEOLA CDM	$30.80	$44.00	—	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 HC ANTIBODY RUBEOLA LAB	$40.60	$58.00	—	—	30%
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES SCREEN LAB	$19.60	$28.00	—	66% below	30%
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES	$171.50	$245.00	—	200% above	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES SCREEN LAB	$19.60	$28.00	—	—	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES	$171.50	$245.00	—	—	30%
Mumps immunity blood test CPT 86735 HC ANTIBODY MUMPS LAB	$12.60	$18.00	—	82% below	30%
Mumps immunity blood test CPT 86735 HC ANTIBODY MUMPS CDM	$20.30	$29.00	—	72% below	30%
Mumps immunity blood test CPT 86735 HC ANTIBODY MUMPS	$22.40	$32.00	—	69% below	30%
Mumps immunity blood test CPT 86735 HC MUMPS ANTIBODY IGG	$28.70	$41.00	—	60% below	30%
Mumps immunity blood test CPT 86735 HC MUMPS VIRUS AB IGM (ARUP)	$28.70	$41.00	—	60% below	30%
Mumps immunity blood test inpatient CPT 86735 HC ANTIBODY MUMPS LAB	$12.60	$18.00	—	—	30%
Mumps immunity blood test inpatient CPT 86735 HC ANTIBODY MUMPS CDM	$20.30	$29.00	—	—	30%
Mumps immunity blood test inpatient CPT 86735 HC ANTIBODY MUMPS	$22.40	$32.00	—	—	30%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS VIRUS AB IGM (ARUP)	$28.70	$41.00	—	—	30%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS ANTIBODY IGG	$28.70	$41.00	—	—	30%
Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL	$50.40	$72.00	—	57% below	30%
Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL LAB	$148.40	$212.00	—	26% above	30%
Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL	$50.40	$72.00	—	—	30%
Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL LAB	$148.40	$212.00	—	—	30%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE	$25.20	$36.00	—	74% below	30%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE LAB	$25.20	$36.00	—	74% below	30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE	$25.20	$36.00	—	—	30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE LAB	$25.20	$36.00	—	—	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC AG TOT(PAML)	$27.30	$39.00	—	75% below	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATIC SPECIFIC AG	$48.30	$69.00	—	56% below	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL LAB	$142.80	$204.00	—	29% above	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM	$156.80	$224.00	—	42% above	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC AG TOT(PAML)	$27.30	$39.00	—	—	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATIC SPECIFIC AG	$48.30	$69.00	—	—	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL LAB	$142.80	$204.00	—	—	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM	$156.80	$224.00	—	—	30%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS	$20.30	$29.00	—	78% below	30%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS LAB	$58.10	$83.00	—	36% below	30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS	$20.30	$29.00	—	—	30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS LAB	$58.10	$83.00	—	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN LAB	$35.70	$51.00	—	57% below	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC PAP-THIN PREP SCREENING	$60.90	$87.00	—	27% below	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN LAB	$35.70	$51.00	—	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC PAP-THIN PREP SCREENING	$60.90	$87.00	—	—	30%
Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE LAB	$124.60	$178.00	—	41% below	30%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHORMONE (PARATHYROID HORMONE)	$124.60	$178.00	—	41% below	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC ASSAY OF PARATHORMONE LAB	$124.60	$178.00	—	—	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHORMONE (PARATHYROID HORMONE)	$124.60	$178.00	—	—	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA LAB	$11.20	$16.00	—	73% below	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB	$11.20	$16.00	—	73% below	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT (LUPUS ANTICOAG) PLASMA	$11.90	$17.00	—	71% below	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD (RL)	$17.50	$25.00	—	58% below	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL	$21.00	$30.00	—	49% below	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD	$46.90	$67.00	—	14% above	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA LAB	$11.20	$16.00	—	—	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB	$11.20	$16.00	—	—	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT (LUPUS ANTICOAG) PLASMA	$11.90	$17.00	—	—	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD (RL)	$17.50	$25.00	—	—	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL	$21.00	$30.00	—	—	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD	$46.90	$67.00	—	—	30%
Phosphorus (phosphate) blood test CPT 84100 HC ASSAY PHOSPHORUS	$86.10	$123.00	—	115% above	30%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC ASSAY PHOSPHORUS	$86.10	$123.00	—	—	30%
Potassium blood test CPT 84132 HC POTASSIUM	$81.20	$116.00	—	97% above	30%
Potassium blood test inpatient CPT 84132 HC POTASSIUM	$81.20	$116.00	—	—	30%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS LAB	$407.40	$582.00	—	47% below	30%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS	$407.40	$582.00	—	47% below	30%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS	$407.40	$582.00	—	—	30%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS LAB	$407.40	$582.00	—	—	30%
Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE CDM	$30.10	$43.00	—	69% below	30%
Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE CDM	$30.10	$43.00	—	—	30%
Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN CDM	$28.70	$41.00	—	74% below	30%
Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN LAB	$135.80	$194.00	—	25% above	30%
Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN CDM	$28.70	$41.00	—	—	30%
Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN LAB	$135.80	$194.00	—	—	30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME LAB	$11.20	$16.00	—	72% below	30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME (RT)	$14.00	$20.00	—	65% below	30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTIME (LUPUS ANTICOAG)	$22.40	$32.00	—	44% below	30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME	$46.90	$67.00	—	17% above	30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME 85610	$65.10	$93.00	—	63% above	30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC AC PROTIME	$65.10	$93.00	—	63% above	30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC COAGUCHECK WAIVED TESTING	$70.70	$101.00	—	77% above	30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN	$72.80	$104.00	—	82% above	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME LAB	$11.20	$16.00	—	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME (RT)	$14.00	$20.00	—	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTIME (LUPUS ANTICOAG)	$22.40	$32.00	—	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME	$46.90	$67.00	—	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC AC PROTIME	$65.10	$93.00	—	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME 85610	$65.10	$93.00	—	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC COAGUCHECK WAIVED TESTING	$70.70	$101.00	—	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN	$72.80	$104.00	—	—	30%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA A-B-DIRECT AG	$22.40	$32.00	—	67% below	30%
Rapid flu test (influenza antigen) CPT 87804 HC IAADIADOO INFLUENZA CDM	$72.80	$104.00	—	7% above	30%
Rapid flu test (influenza antigen) CPT 87804 HC IAADIADOO INFLUENZA LAB	$107.10	$153.00	—	58% above	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA A-B-DIRECT AG	$22.40	$32.00	—	—	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC IAADIADOO INFLUENZA CDM	$72.80	$104.00	—	—	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC IAADIADOO INFLUENZA LAB	$107.10	$153.00	—	—	30%
Renin blood test CPT 84244 HC RENIN	$32.20	$46.00	—	75% below	30%
Renin blood test CPT 84244 HC ASSAY OF RENIN LAB	$32.20	$46.00	—	75% below	30%
Renin blood test CPT 84244 HC ASSAY OF RENIN CDM	$51.80	$74.00	—	60% below	30%
Renin blood test inpatient CPT 84244 HC RENIN	$32.20	$46.00	—	—	30%
Renin blood test inpatient CPT 84244 HC ASSAY OF RENIN LAB	$32.20	$46.00	—	—	30%
Renin blood test inpatient CPT 84244 HC ASSAY OF RENIN CDM	$51.80	$74.00	—	—	30%
Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D)	$41.30	$59.00	—	14% below	30%
Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) LAB	$54.60	$78.00	—	14% above	30%
Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) CDM	$68.60	$98.00	—	43% above	30%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D)	$41.30	$59.00	—	—	30%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) LAB	$54.60	$78.00	—	—	30%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) CDM	$68.60	$98.00	—	—	30%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE LAB	$16.10	$23.00	—	60% below	30%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANTITATIV	$40.60	$58.00	—	2% above	30%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANT	$53.20	$76.00	—	33% above	30%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR	$107.10	$153.00	—	168% above	30%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE LAB	$16.10	$23.00	—	—	30%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANTITATIV	$40.60	$58.00	—	—	30%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANT	$53.20	$76.00	—	—	30%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR	$107.10	$153.00	—	—	30%
Rubella antibody test (immunity check) CPT 86762 HC ANTIBODY RUBELLA LAB	$19.60	$28.00	—	72% below	30%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY	$19.60	$28.00	—	72% below	30%
Rubella antibody test (immunity check) CPT 86762 HC ANTIBODY RUBELLA CDM	$30.10	$43.00	—	56% below	30%
Rubella antibody test (immunity check) CPT 86762 HC ANTIBODY RUBELLA	$75.60	$108.00	—	10% above	30%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY	$19.60	$28.00	—	—	30%
Rubella antibody test (immunity check) inpatient CPT 86762 HC ANTIBODY RUBELLA LAB	$19.60	$28.00	—	—	30%
Rubella antibody test (immunity check) inpatient CPT 86762 HC ANTIBODY RUBELLA CDM	$30.10	$43.00	—	—	30%
Rubella antibody test (immunity check) inpatient CPT 86762 HC ANTIBODY RUBELLA	$75.60	$108.00	—	—	30%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC RBC SED RATE AUTOMATED	$55.30	$79.00	—	55% above	30%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC RBC SED RATE AUTOMATED	$55.30	$79.00	—	—	30%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC SEMEN ANALYSIS VOLUME COUNT MOTILITY DIFFERENT LAB	$143.50	$205.00	—	128% above	30%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC SEMEN ANALYSIS VOLUME COUNT MOTILITY DIFFERENT LAB	$143.50	$205.00	—	—	30%
Sodium blood test CPT 84295 HC SODIUM	$86.80	$124.00	—	106% above	30%
Sodium blood test inpatient CPT 84295 HC SODIUM	$86.80	$124.00	—	—	30%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS	$11.90	$17.00	—	82% below	30%
Stool ova and parasites exam CPT 87177 HC OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID LAB	$48.30	$69.00	—	28% below	30%
Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES SMEARS	$11.90	$17.00	—	—	30%
Stool ova and parasites exam inpatient CPT 87177 HC OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID LAB	$48.30	$69.00	—	—	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD FECES	$50.40	$72.00	—	66% above	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM	$50.40	$72.00	—	66% above	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM	$50.40	$72.00	—	—	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC OCCULT BLOOD FECES	$50.40	$72.00	—	—	30%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 CDM	$25.20	$36.00	—	66% below	30%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 CDM	$25.20	$36.00	—	—	30%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM LAB	$9.80	$14.00	—	86% below	30%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM CDM	$20.30	$29.00	—	70% below	30%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC TREPONEMA PALLIDUM - AB	$20.30	$29.00	—	70% below	30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM LAB	$9.80	$14.00	—	—	30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM CDM	$20.30	$29.00	—	—	30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC TREPONEMA PALLIDUM - AB	$20.30	$29.00	—	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREP QUAL - CSF	$16.10	$23.00	—	50% below	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREP QUAL RPR	$98.70	$141.00	—	206% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL CDM	$100.80	$144.00	—	213% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREP QUAL	$171.50	$245.00	—	432% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL LAB	$171.50	$245.00	—	432% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREP QUAL - CSF	$16.10	$23.00	—	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREP QUAL RPR	$98.70	$141.00	—	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL CDM	$100.80	$144.00	—	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREP QUAL	$171.50	$245.00	—	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL LAB	$171.50	$245.00	—	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON CDM	$48.30	$69.00	—	77% below	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON	$254.10	$363.00	—	22% above	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON LAB	$254.10	$363.00	—	22% above	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC QUANTIFERON TB GOLD	$254.10	$363.00	—	22% above	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON CDM	$48.30	$69.00	—	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON	$254.10	$363.00	—	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC QUANTIFERON TB GOLD	$254.10	$363.00	—	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON LAB	$254.10	$363.00	—	—	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSERONE	$28.00	$40.00	—	78% below	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL	$28.70	$41.00	—	78% below	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE -TOTAL	$32.90	$47.00	—	74% below	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE TOTAL (RL)	$35.70	$51.00	—	72% below	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC BIO-T-TESTOSTERONE TOTAL	$35.70	$51.00	—	72% below	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE	$37.80	$54.00	—	70% below	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL LAB	$53.20	$76.00	—	58% below	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE TOTAL	$54.60	$78.00	—	57% below	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL CDM	$58.80	$84.00	—	54% below	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSERONE	$28.00	$40.00	—	—	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL	$28.70	$41.00	—	—	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE -TOTAL	$32.90	$47.00	—	—	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE TOTAL (RL)	$35.70	$51.00	—	—	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC BIO-T-TESTOSTERONE TOTAL	$35.70	$51.00	—	—	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE	$37.80	$54.00	—	—	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL LAB	$53.20	$76.00	—	—	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE TOTAL	$54.60	$78.00	—	—	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL CDM	$58.80	$84.00	—	—	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODIES EACH CDM	$23.10	$33.00	—	71% below	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODIES EACH LAB	$30.10	$43.00	—	63% below	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY - MISC	$44.10	$63.00	—	46% below	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY	$82.60	$118.00	—	2% above	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODIES EACH CDM	$23.10	$33.00	—	—	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODIES EACH LAB	$30.10	$43.00	—	—	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY - MISC	$44.10	$63.00	—	—	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY	$82.60	$118.00	—	—	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB	$16.80	$24.00	—	84% below	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH CDM	$23.10	$33.00	—	78% below	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY THYROID STIM HORMON	$28.70	$41.00	—	73% below	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH REFLEX TO FT4	$48.30	$69.00	—	54% below	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH	$180.60	$258.00	—	71% above	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB	$16.80	$24.00	—	—	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH CDM	$23.10	$33.00	—	—	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY THYROID STIM HORMON	$28.70	$41.00	—	—	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH REFLEX TO FT4	$48.30	$69.00	—	—	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH	$180.60	$258.00	—	—	30%
Total IgE blood test CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE LAB	$19.60	$28.00	—	80% below	30%
Total IgE blood test CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE CDM	$19.60	$28.00	—	80% below	30%
Total IgE blood test CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE	$23.10	$33.00	—	76% below	30%
Total IgE blood test CPT 82785 HC IGE SERUM TOTAL	$23.10	$33.00	—	76% below	30%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE CDM	$19.60	$28.00	—	—	30%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE LAB	$19.60	$28.00	—	—	30%
Total IgE blood test inpatient CPT 82785 HC IGE SERUM TOTAL	$23.10	$33.00	—	—	30%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE	$23.10	$33.00	—	—	30%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL TOTAL	$17.50	$25.00	—	52% below	30%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL SERUM/WHOLE BLOOD TOTAL LAB	$23.80	$34.00	—	35% below	30%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL	$78.40	$112.00	—	115% above	30%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL TOTAL	$17.50	$25.00	—	—	30%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL SERUM/WHOLE BLOOD TOTAL LAB	$23.80	$34.00	—	—	30%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL	$78.40	$112.00	—	—	30%
Total thyroxine (T4) blood test CPT 84436 HC ASSAY OF THYROXINE TOTAL LAB	$12.60	$18.00	—	78% below	30%
Total thyroxine (T4) blood test CPT 84436 HC THYROXINE TOTAL	$28.70	$41.00	—	49% below	30%
Total thyroxine (T4) blood test CPT 84436 HC THYROXINE T4	$94.50	$135.00	—	67% above	30%
Total thyroxine (T4) blood test inpatient CPT 84436 HC ASSAY OF THYROXINE TOTAL LAB	$12.60	$18.00	—	—	30%
Total thyroxine (T4) blood test inpatient CPT 84436 HC THYROXINE TOTAL	$28.70	$41.00	—	—	30%
Total thyroxine (T4) blood test inpatient CPT 84436 HC THYROXINE T4	$94.50	$135.00	—	—	30%
Total triiodothyronine (T3) blood test CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3 LAB	$17.50	$25.00	—	81% below	30%
Total triiodothyronine (T3) blood test CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3	$21.00	$30.00	—	77% below	30%
Total triiodothyronine (T3) blood test CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3 CDM	$26.60	$38.00	—	71% below	30%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3 LAB	$17.50	$25.00	—	—	30%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3	$21.00	$30.00	—	—	30%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3 CDM	$26.60	$38.00	—	—	30%
Transferrin blood test CPT 84466 HC ASSAY TRANSFERRIN	$67.90	$97.00	—	23% below	30%
Transferrin blood test inpatient CPT 84466 HC ASSAY TRANSFERRIN	$67.90	$97.00	—	—	30%
Trichomonas test (NAAT) CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH CDM	$47.60	$68.00	—	57% below	30%
Trichomonas test (NAAT) CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH LAB	$82.60	$118.00	—	25% below	30%
Trichomonas test (NAAT) inpatient CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH CDM	$47.60	$68.00	—	—	30%
Trichomonas test (NAAT) inpatient CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH LAB	$82.60	$118.00	—	—	30%
Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES LAB	$103.60	$148.00	—	134% above	30%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES	$103.60	$148.00	—	134% above	30%
Triglycerides blood test inpatient CPT 84478 HC ASSAY OF TRIGLYCERIDES LAB	$103.60	$148.00	—	—	30%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES	$103.60	$148.00	—	—	30%
Troponin test, quantitative CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE LAB	$191.80	$274.00	—	41% above	30%
Troponin test, quantitative CPT 84484 HC TROPONIN QUANTITATIVE	$191.80	$274.00	—	41% above	30%
Troponin test, quantitative inpatient CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE LAB	$191.80	$274.00	—	—	30%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN QUANTITATIVE	$191.80	$274.00	—	—	30%
Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID LAB	$18.20	$26.00	—	60% below	30%
Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID CDM	$80.50	$115.00	—	79% above	30%
Uric acid blood test inpatient CPT 84550 HC ASSAY OF BLOOD/URIC ACID LAB	$18.20	$26.00	—	—	30%
Uric acid blood test inpatient CPT 84550 HC ASSAY OF BLOOD/URIC ACID CDM	$80.50	$115.00	—	—	30%
Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY	$46.20	$66.00	—	17% above	30%
Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM	$98.70	$141.00	—	150% above	30%
Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB	$98.70	$141.00	—	150% above	30%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY	$46.20	$66.00	—	—	30%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB	$98.70	$141.00	—	—	30%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM	$98.70	$141.00	—	—	30%
Urinalysis with microscope exam, manual CPT 81000 HC URINALYSIS BY DIPSTICK	$26.60	$38.00	—	56% above	30%
Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINALYSIS BY DIPSTICK	$26.60	$38.00	—	—	30%
Urinalysis without microscope exam, automated CPT 81003 HC AUTOM URINALYSIS WO MICRO (RL)	$7.00	$10.00	—	76% below	30%
Urinalysis without microscope exam, automated CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB	$9.10	$13.00	—	68% below	30%
Urinalysis without microscope exam, automated CPT 81003 HC PH URINE DIPSTICK AUTO W/O MICROSCOPY LAB	$26.60	$38.00	—	7% below	30%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE	$78.40	$112.00	—	173% above	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC AUTOM URINALYSIS WO MICRO (RL)	$7.00	$10.00	—	—	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB	$9.10	$13.00	—	—	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC PH URINE DIPSTICK AUTO W/O MICROSCOPY LAB	$26.60	$38.00	—	—	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE	$78.40	$112.00	—	—	30%
Urinalysis without microscope exam, manual CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$17.50	$25.00	—	14% below	30%
Urinalysis without microscope exam, manual CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP CDM	$42.70	$61.00	—	109% above	30%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$17.50	$25.00	—	—	30%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP CDM	$42.70	$61.00	—	—	30%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE LAB	$30.10	$43.00	—	64% below	30%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE	$50.40	$72.00	—	40% below	30%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE CDM	$58.80	$84.00	—	30% below	30%
Urine culture for bacteria, with colony count CPT 87086 HC URINE CULTURE/COLONY COUNT	$86.80	$124.00	—	3% above	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE LAB	$30.10	$43.00	—	—	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE	$50.40	$72.00	—	—	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE CDM	$58.80	$84.00	—	—	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC URINE CULTURE/COLONY COUNT	$86.80	$124.00	—	—	30%
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN QUANTITATIVE	$95.90	$137.00	—	83% above	30%
Urine microalbumin (albumin) test CPT 82043 HC URINE ALBUMIN QUANTITATIVE LAB	$95.90	$137.00	—	83% above	30%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN QUANTITATIVE	$95.90	$137.00	—	—	30%
Urine microalbumin (albumin) test inpatient CPT 82043 HC URINE ALBUMIN QUANTITATIVE LAB	$95.90	$137.00	—	—	30%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST	$25.20	$36.00	—	50% below	30%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST	$25.20	$36.00	—	—	30%
Vitamin B12 (cobalamin) blood test CPT 82607 HC CYANOCOBALAMIN VITAMIN B-12 LAB	$15.40	$22.00	—	85% below	30%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN-B12	$221.90	$317.00	—	123% above	30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC CYANOCOBALAMIN VITAMIN B-12 LAB	$15.40	$22.00	—	—	30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN-B12	$221.90	$317.00	—	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED LAB	$25.20	$36.00	—	81% below	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$47.60	$68.00	—	65% below	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D 25 HYDROXY PEDIATRIC	$50.40	$72.00	—	63% below	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED LAB	$25.20	$36.00	—	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$47.60	$68.00	—	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC VITAMIN D 25 HYDROXY PEDIATRIC	$50.40	$72.00	—	—	30%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$46.90	$67.00	—	73% below	30%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$46.90	$67.00	—	—	30%
Zinc blood test CPT 84630 HC ASSAY OF ZINC CDM	$17.50	$25.00	—	77% below	30%
Zinc blood test CPT 84630 HC ASSAY OF ZINC LAB	$44.10	$63.00	—	42% below	30%
Zinc blood test CPT 84630 HC ASSAY OF ZINC	$112.00	$160.00	—	48% above	30%
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC CDM	$17.50	$25.00	—	—	30%
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC LAB	$44.10	$63.00	—	—	30%
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC	$112.00	$160.00	—	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE	$19.60	$28.00	—	82% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE LAB	$19.60	$28.00	—	82% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HCG QUANTITATIVE	$22.40	$32.00	—	79% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE CDM	$53.20	$76.00	—	51% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC (HCG) QUANTITATIVE	$105.70	$151.00	—	3% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE LAB	$19.60	$28.00	—	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE	$19.60	$28.00	—	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HCG QUANTITATIVE	$22.40	$32.00	—	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE CDM	$53.20	$76.00	—	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC (HCG) QUANTITATIVE	$105.70	$151.00	—	—	30%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC ED SINUS ENDO W/BALLOON DILATION CDM	$3,437.00	$4,910.00	—	28% below	30%
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 HC ED SINUS ENDO W/BALLOON DILATION CDM	$3,437.00	$4,910.00	—	—	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST 1ST LESION STEREO	$3,305.40	$4,722.00	—	49% above	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST 1ST LESION STEREO	$3,305.40	$4,722.00	—	—	30%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC PR ED 27786 CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM	$585.90	$837.00	—	10% below	30%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC ED CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM	$595.70	$851.00	—	8% below	30%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC PR ED 27786 CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM	$585.90	$837.00	—	—	30%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC ED CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM	$595.70	$851.00	—	—	30%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC ED TREAT METATARSAL FRACTURE W/O MANIPULATION CDM	$249.20	$356.00	—	57% below	30%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC PR ED 28470 TREAT METATARSAL FRACTURE W/O MANIPULATION CDM	$410.20	$586.00	—	29% below	30%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC ED TREAT METATARSAL FRACTURE W/O MANIPULATION CDM	$249.20	$356.00	—	—	30%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC PR ED 28470 TREAT METATARSAL FRACTURE W/O MANIPULATION CDM	$410.20	$586.00	—	—	30%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HC ED CORRECTION OF BUNION CDM	$6,039.60	$8,628.00	—	2% below	30%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 HC ED CORRECTION OF BUNION CDM	$6,039.60	$8,628.00	—	—	30%
Cardiac catheterization with coronary angiogram CPT 93458 HC CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I	$12,903.10	$18,433.00	—	22% above	30%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 HC CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I	$12,903.10	$18,433.00	—	—	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC PR ED 92960 CARDIOVERSION ELECTIVE EXTERNAL CDM	$369.60	$528.00	—	66% below	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$2,179.80	$3,114.00	—	99% above	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC PR ED 92960 CARDIOVERSION ELECTIVE EXTERNAL CDM	$369.60	$528.00	—	—	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$2,179.80	$3,114.00	—	—	30%
Carpal tunnel release, open surgery CPT 64721 HC ED NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL CDM	$3,867.50	$5,525.00	—	16% above	30%
Carpal tunnel release, open surgery inpatient CPT 64721 HC ED NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL CDM	$3,867.50	$5,525.00	—	—	30%
Cervical biopsy CPT 57500 HC ED BIOPSY OF CERVIX CDM	$1,085.00	$1,550.00	—	39% above	30%
Cervical biopsy inpatient CPT 57500 HC ED BIOPSY OF CERVIX CDM	$1,085.00	$1,550.00	—	—	30%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION W/REGIONL BLOCK CDM	$149.10	$213.00	—	65% below	30%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION W/REGIONL BLOCK CDM	$149.10	$213.00	—	—	30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC ED TREAT DISTAL RADIAL FRACTURE RADIUS/ULNA W/O MANIP CDM	$475.30	$679.00	—	23% below	30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC PR ED 25600 TREAT DISTAL RADIAL FRACTURE RADIUS/UNA W/O MANIP CDM	$606.20	$866.00	—	2% below	30%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC ED TREAT DISTAL RADIAL FRACTURE RADIUS/ULNA W/O MANIP CDM	$475.30	$679.00	—	—	30%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC PR ED 25600 TREAT DISTAL RADIAL FRACTURE RADIUS/UNA W/O MANIP CDM	$606.20	$866.00	—	—	30%
Colonoscopy, diagnostic CPT 45378 HC ED COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD CDM	$2,172.80	$3,104.00	—	12% above	30%
Colonoscopy, diagnostic inpatient CPT 45378 HC ED COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD CDM	$2,172.80	$3,104.00	—	—	30%
Coronary stent placement, one artery CPT 92928 HC INSERT COR STENT PERC TRLUML W/ANGIO ONE ART/BRNCH	$13,565.30	$19,379.00	—	36% below	30%
Coronary stent placement, one artery inpatient CPT 92928 HC INSERT COR STENT PERC TRLUML W/ANGIO ONE ART/BRNCH	$13,565.30	$19,379.00	—	—	30%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOSCOPY	$1,522.50	$2,175.00	—	65% above	30%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC ED CYSTOURETHROSCOPY CDM	$1,522.50	$2,175.00	—	65% above	30%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC ED CYSTOURETHROSCOPY CDM	$1,522.50	$2,175.00	—	—	30%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOSCOPY	$1,522.50	$2,175.00	—	—	30%
D&C (dilation and curettage), not related to pregnancy CPT 58120 HC ED DILATION AND CURETTAGE CDM	$4,818.80	$6,884.00	—	63% above	30%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC ED DILATION AND CURETTAGE CDM	$4,818.80	$6,884.00	—	—	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC ED DESTRUCT PREMALG LESION FIRST LESION CDM	$175.00	$250.00	—	6% below	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC ED DESTRUCT PREMALG LESION FIRST LESION CDM	$175.00	$250.00	—	—	30%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC ED REMOVE IMPACTED EAR WAX UNI CDM	$208.60	$298.00	—	87% above	30%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC PR ED 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT CDM	$21.70	$31.00	—	81% below	30%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC ED REMOVE IMPACTED EAR WAX UNI CDM	$208.60	$298.00	—	—	30%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC PR ED 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT CDM	$21.70	$31.00	—	—	30%
Earwax removal with instruments, one ear one side CPT 69210 HC PR ED 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$95.20	$136.00	—	44% below	30%
Earwax removal with instruments, one ear one side CPT 69210 HC ED REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$583.10	$833.00	—	242% above	30%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC PR ED 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$95.20	$136.00	—	—	30%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC ED REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$583.10	$833.00	—	—	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ED ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX CDM	$293.30	$419.00	—	at median	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC ED ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX CDM	$293.30	$419.00	—	—	30%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC ED INJ INTERLAMINR CRV-THOR W IMG CDM	$1,779.40	$2,542.00	—	17% above	30%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC INJ W/NDL OR CATH PLCMNT EPIDRL C/T W/IMG	$1,779.40	$2,542.00	—	17% above	30%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC INJ W/NDL OR CATH PLCMNT EPIDRL C/T W/IMG	$1,779.40	$2,542.00	—	—	30%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC ED INJ INTERLAMINR CRV-THOR W IMG CDM	$1,779.40	$2,542.00	—	—	30%
Eye injection into the vitreous (intravitreal injection) CPT 67028 HC ED INTRAVITREAL NJX PHARMACOLOGIC AGT SPX CDM	$590.10	$843.00	—	26% below	30%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HC ED INTRAVITREAL NJX PHARMACOLOGIC AGT SPX CDM	$590.10	$843.00	—	—	30%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV	$3,021.20	$4,316.00	—	31% above	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV	$3,021.20	$4,316.00	—	—	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC ED SIGMOID DX FLX W WO SPEC COLL CDM	$1,773.10	$2,533.00	—	13% above	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC ED SIGMOID DX FLX W WO SPEC COLL CDM	$1,773.10	$2,533.00	—	—	30%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC ED LAPARO CHOLECYSTECTOMY/GRAPH CDM	$10,153.50	$14,505.00	—	9% below	30%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 HC ED LAPARO CHOLECYSTECTOMY/GRAPH CDM	$10,153.50	$14,505.00	—	—	30%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC ED HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS CDM	$1,013.60	$1,448.00	—	20% below	30%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC ED HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS CDM	$1,013.60	$1,448.00	—	—	30%
Hemorrhoidectomy (internal and external), one area CPT 46255 HC ED HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP CDM	$5,018.30	$7,169.00	—	25% above	30%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HC ED HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP CDM	$5,018.30	$7,169.00	—	—	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC CATHETER FOR HYSTEROGRAPHY	$283.50	$405.00	—	12% above	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC CATHETER FOR HYSTEROGRAPHY	$283.50	$405.00	—	—	30%
IUD insertion (the device itself billed separately) CPT 58300 HC ED INSERTION INTRAUTERINE DEVICE IUD CDM	$943.60	$1,348.00	—	229% above	30%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC ED INSERTION INTRAUTERINE DEVICE IUD CDM	$943.60	$1,348.00	—	—	30%
Incision and drainage of a simple or single skin abscess CPT 10060 HC PR ED 10060 DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM	$212.10	$303.00	—	43% below	30%
Incision and drainage of a simple or single skin abscess CPT 10060 HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$583.10	$833.00	—	56% above	30%
Incision and drainage of a simple or single skin abscess CPT 10060 HC ED DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM	$583.10	$833.00	—	56% above	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC PR ED 10060 DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM	$212.10	$303.00	—	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC ED DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM	$583.10	$833.00	—	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$583.10	$833.00	—	—	30%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC ED RPR 1ST INGUN HRNA AGE 5 YRS OR MORE REDUCIBLE CDM	$7,964.60	$11,378.00	—	at median	30%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC ED RPR 1ST INGUN HRNA AGE 5 YRS OR MORE REDUCIBLE CDM	$7,964.60	$11,378.00	—	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC PR ED 20550 INJ TENDON SHEATH/LIGAMENT CDM	$105.00	$150.00	—	65% below	30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC ED INJ TENDON SHEATH/LIGAMENT CDM	$602.00	$860.00	—	99% above	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC PR ED 20550 INJ TENDON SHEATH/LIGAMENT CDM	$105.00	$150.00	—	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC ED INJ TENDON SHEATH/LIGAMENT CDM	$602.00	$860.00	—	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PR ED 20610 DRAIN/INJECT JOINT/BURSA MAJOR JOINT W/O US GUIDANCE CDM	$80.50	$115.00	—	83% below	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PR ED 20610 DRAIN/INJECT JOINT/BURSA MAJOR CDM	$107.80	$154.00	—	78% below	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$1,225.70	$1,751.00	—	153% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ED ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US CDM	$1,225.70	$1,751.00	—	153% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC PR ED 20610 DRAIN/INJECT JOINT/BURSA MAJOR JOINT W/O US GUIDANCE CDM	$80.50	$115.00	—	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC PR ED 20610 DRAIN/INJECT JOINT/BURSA MAJOR CDM	$107.80	$154.00	—	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$1,225.70	$1,751.00	—	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ED ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US CDM	$1,225.70	$1,751.00	—	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC PR ED 20605 DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE CDM	$118.30	$169.00	—	74% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ED ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US CDM	$801.50	$1,145.00	—	75% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE	$801.50	$1,145.00	—	75% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC PR ED 20605 DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE CDM	$118.30	$169.00	—	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE	$801.50	$1,145.00	—	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ED ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US CDM	$801.50	$1,145.00	—	—	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC PR ED 20600 DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE CDM	$85.40	$122.00	—	77% below	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE	$662.20	$946.00	—	75% above	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ED ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US CDM	$662.20	$946.00	—	75% above	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC PR ED 20600 DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE CDM	$85.40	$122.00	—	—	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE	$662.20	$946.00	—	—	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ED ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US CDM	$662.20	$946.00	—	—	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC PR ED 12031 INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM	$438.90	$627.00	—	33% below	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC ED INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM	$583.10	$833.00	—	12% below	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC PR ED 12031 INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM	$438.90	$627.00	—	—	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC ED INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM	$583.10	$833.00	—	—	30%
Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY	$9,835.00	$14,050.00	—	21% above	30%
Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY	$9,835.00	$14,050.00	—	—	30%
Lower-back epidural injection, with imaging guidance CPT 62323 HC ED INJ EPI LUMB/SACRAL W IMAGING CDM	$1,779.40	$2,542.00	—	16% above	30%
Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ W/NDL OR CATH PLCMNT EPIDRL L/S W/IMG	$1,779.40	$2,542.00	—	16% above	30%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ W/NDL OR CATH PLCMNT EPIDRL L/S W/IMG	$1,779.40	$2,542.00	—	—	30%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC ED INJ EPI LUMB/SACRAL W IMAGING CDM	$1,779.40	$2,542.00	—	—	30%
Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$2,071.30	$2,959.00	—	81% above	30%
Lower-back epidural injection, without imaging guidance CPT 62322 HC ED INJ EPI LUMB/SACRAL WO IMAGING CDM	$2,071.30	$2,959.00	—	81% above	30%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC ED INJ EPI LUMB/SACRAL WO IMAGING CDM	$2,071.30	$2,959.00	—	—	30%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$2,071.30	$2,959.00	—	—	30%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ FORAMEN EPIDURAL L/S	$3,542.00	$5,060.00	—	106% above	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ FORAMEN EPIDURAL L/S	$3,542.00	$5,060.00	—	—	30%
Miscarriage treatment with D&C, first trimester CPT 59820 HC ED SPONTANEOUS ABORTION FAC CDM	$5,950.70	$8,501.00	—	24% above	30%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HC ED SPONTANEOUS ABORTION FAC CDM	$5,950.70	$8,501.00	—	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC PR11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS	$140.70	$201.00	—	81% below	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM OR LESS CDM	$1,937.60	$2,768.00	—	163% above	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS CDM	$1,937.60	$2,768.00	—	163% above	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC PR11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS	$140.70	$201.00	—	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM OR LESS CDM	$1,937.60	$2,768.00	—	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS CDM	$1,937.60	$2,768.00	—	—	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC ED EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM OR LESS CDM	$817.60	$1,168.00	—	9% above	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC ED EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM OR LESS CDM	$817.60	$1,168.00	—	—	30%
Nail removal (partial or complete), one nail CPT 11730 HC PR ED 11730 REMOVAL OF NAIL PLATE CDM	$178.50	$255.00	—	36% below	30%
Nail removal (partial or complete), one nail CPT 11730 HC ED REMOVAL OF NAIL PLATE CDM	$583.10	$833.00	—	108% above	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC PR ED 11730 REMOVAL OF NAIL PLATE CDM	$178.50	$255.00	—	—	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC ED REMOVAL OF NAIL PLATE CDM	$583.10	$833.00	—	—	30%
Occipital nerve block (injection for headaches) CPT 64405 HC PR ED 64405 NERVE BLOCK INJ OCCIPITAL CDM	$95.90	$137.00	—	86% below	30%
Occipital nerve block (injection for headaches) CPT 64405 HC ED NERVE BLOCK INJ OCCIPITAL CDM	$615.30	$879.00	—	7% below	30%
Occipital nerve block (injection for headaches) CPT 64405 HC INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV	$615.30	$879.00	—	7% below	30%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC PR ED 64405 NERVE BLOCK INJ OCCIPITAL CDM	$95.90	$137.00	—	—	30%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV	$615.30	$879.00	—	—	30%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC ED NERVE BLOCK INJ OCCIPITAL CDM	$615.30	$879.00	—	—	30%
Pacemaker implant (dual chamber) CPT 33208 HC INSERTION PERM AV PACER	$10,298.40	$14,712.00	—	2% below	30%
Pacemaker implant (dual chamber) inpatient CPT 33208 HC INSERTION PERM AV PACER	$10,298.40	$14,712.00	—	—	30%
Paracentesis with imaging guidance CPT 49083 HC PR ED 49083 ABD PARACENT W/IMAG GUIDANCE CDM	$201.60	$288.00	—	85% below	30%
Paracentesis with imaging guidance CPT 49083 HC ED ABD PARACENTESIS W/IMAG GUIDANCE CDM	$1,720.60	$2,458.00	—	30% above	30%
Paracentesis with imaging guidance CPT 49083 HC ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE CDM	$1,879.50	$2,685.00	—	42% above	30%
Paracentesis with imaging guidance inpatient CPT 49083 HC PR ED 49083 ABD PARACENT W/IMAG GUIDANCE CDM	$201.60	$288.00	—	—	30%
Paracentesis with imaging guidance inpatient CPT 49083 HC ED ABD PARACENTESIS W/IMAG GUIDANCE CDM	$1,720.60	$2,458.00	—	—	30%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE CDM	$1,879.50	$2,685.00	—	—	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC PR ED 11750 REMOVAL OF NAIL BED CDM	$540.40	$772.00	—	20% below	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC ED REMOVAL OF NAIL BED CDM	$583.10	$833.00	—	14% below	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC PR ED 11750 REMOVAL OF NAIL BED CDM	$540.40	$772.00	—	—	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC ED REMOVAL OF NAIL BED CDM	$583.10	$833.00	—	—	30%
Prostate biopsy CPT 55700 HC BIOPSY OF PROSTATE	$3,922.10	$5,603.00	—	114% above	30%
Prostate biopsy inpatient CPT 55700 HC BIOPSY OF PROSTATE	$3,922.10	$5,603.00	—	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$2,454.20	$3,506.00	—	22% below	30%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$2,454.20	$3,506.00	—	—	30%
Removal of a foreign object under the skin, simple CPT 10120 HC PR ED 10120 REMOVE FOREIGN BODY SIMPLE CDM	$280.70	$401.00	—	46% below	30%
Removal of a foreign object under the skin, simple CPT 10120 HC INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$583.10	$833.00	—	12% above	30%
Removal of a foreign object under the skin, simple CPT 10120 HC ED REMOVE FOREIGN BODY SIMPLE CDM	$583.10	$833.00	—	12% above	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC PR ED 10120 REMOVE FOREIGN BODY SIMPLE CDM	$280.70	$401.00	—	—	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC ED REMOVE FOREIGN BODY SIMPLE CDM	$583.10	$833.00	—	—	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$583.10	$833.00	—	—	30%
Septoplasty to straighten the nasal septum CPT 30520 HC ED REPAIR OF NASAL SEPTUM CDM	$3,787.00	$5,410.00	—	24% below	30%
Septoplasty to straighten the nasal septum inpatient CPT 30520 HC ED REPAIR OF NASAL SEPTUM CDM	$3,787.00	$5,410.00	—	—	30%
Short arm cast (elbow to hand) CPT 29075 HC ED SHORT ARM CAST APPLICATION CDM	$298.20	$426.00	—	32% below	30%
Short arm cast (elbow to hand) inpatient CPT 29075 HC ED SHORT ARM CAST APPLICATION CDM	$298.20	$426.00	—	—	30%
Short arm splint (forearm and hand) CPT 29125 HC PR ED 29125 SHORT ARM SPLINT APPLICATION CDM	$121.10	$173.00	—	56% below	30%
Short arm splint (forearm and hand) CPT 29125 HC ED SHORT ARM SPLINT APPLICATION CDM	$315.70	$451.00	—	14% above	30%
Short arm splint (forearm and hand) inpatient CPT 29125 HC PR ED 29125 SHORT ARM SPLINT APPLICATION CDM	$121.10	$173.00	—	—	30%
Short arm splint (forearm and hand) inpatient CPT 29125 HC ED SHORT ARM SPLINT APPLICATION CDM	$315.70	$451.00	—	—	30%
Short leg cast (below the knee) CPT 29405 HC ED SHORT LEG CAST APPLICATION CDM	$338.80	$484.00	—	2% below	30%
Short leg cast (below the knee) inpatient CPT 29405 HC ED SHORT LEG CAST APPLICATION CDM	$338.80	$484.00	—	—	30%
Short leg splint (calf to foot) CPT 29515 HC PR ED 29515 SHORT LEG SPLINT APPLICATION CDM	$133.00	$190.00	—	62% below	30%
Short leg splint (calf to foot) CPT 29515 HC ED SHORT LEG SPLINT APPLICATION CDM	$395.50	$565.00	—	12% above	30%
Short leg splint (calf to foot) inpatient CPT 29515 HC PR ED 29515 SHORT LEG SPLINT APPLICATION CDM	$133.00	$190.00	—	—	30%
Short leg splint (calf to foot) inpatient CPT 29515 HC ED SHORT LEG SPLINT APPLICATION CDM	$395.50	$565.00	—	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC PR ED 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/OR LESS CDM	$165.90	$237.00	—	51% below	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM	$523.60	$748.00	—	55% above	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC PR ED 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/OR LESS CDM	$165.90	$237.00	—	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM	$523.60	$748.00	—	—	30%
Skin biopsy, punch, one lesion CPT 11104 HC PR 11104 PUNCH BIOPSY SKIN SINGLE LESION	$86.80	$124.00	—	74% below	30%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$457.80	$654.00	—	36% above	30%
Skin biopsy, punch, one lesion CPT 11104 HC ED PUNCH BIOPSY SKIN SINGLE LESION CDM	$457.80	$654.00	—	36% above	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PR 11104 PUNCH BIOPSY SKIN SINGLE LESION	$86.80	$124.00	—	—	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC ED PUNCH BIOPSY SKIN SINGLE LESION CDM	$457.80	$654.00	—	—	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$457.80	$654.00	—	—	30%
Skin tag removal, up to 15 tags CPT 11200 HC PR 11200 REMOVAL OF SKIN TAGS	$161.00	$230.00	—	26% below	30%
Skin tag removal, up to 15 tags CPT 11200 HC ED REMOVAL OF SKIN TAGS CDM	$179.90	$257.00	—	17% below	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC PR 11200 REMOVAL OF SKIN TAGS	$161.00	$230.00	—	—	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC ED REMOVAL OF SKIN TAGS CDM	$179.90	$257.00	—	—	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$252.70	$361.00	—	75% below	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC ED SPINAL PUNCTURE LUMBAR DIAGNOSTIC CDM	$252.70	$361.00	—	75% below	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC PR ED 62270 SPINAL FLUID TAP DIAGNOSTIC CDM	$294.70	$421.00	—	70% below	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$252.70	$361.00	—	—	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC ED SPINAL PUNCTURE LUMBAR DIAGNOSTIC CDM	$252.70	$361.00	—	—	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC PR ED 62270 SPINAL FLUID TAP DIAGNOSTIC CDM	$294.70	$421.00	—	—	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC PR ED 12002 REPAIR SUPERFIC WOUND(S) 2.6 TO 7.5CM SLP NK AX EXGEN T CDM	$201.60	$288.00	—	51% below	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC ED REPAIR SUPERFICIAL WND(S) 2.6-7.5CM SLP NK AX EXGEN TRNK E CDM	$583.10	$833.00	—	41% above	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC PR ED 12002 REPAIR SUPERFIC WOUND(S) 2.6 TO 7.5CM SLP NK AX EXGEN T CDM	$201.60	$288.00	—	—	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC ED REPAIR SUPERFICIAL WND(S) 2.6-7.5CM SLP NK AX EXGEN TRNK E CDM	$583.10	$833.00	—	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC PR ED 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/OR LESS CDM	$203.00	$290.00	—	50% below	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair one side CPT 12011 HC ED REPAIR SUPERFICIAL WOUND(S) LT/2.5 FACE ERS EYLD NSE LPS MUC CDM	$310.80	$444.00	—	23% below	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC PR ED 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/OR LESS CDM	$203.00	$290.00	—	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient one side CPT 12011 HC ED REPAIR SUPERFICIAL WOUND(S) LT/2.5 FACE ERS EYLD NSE LPS MUC CDM	$310.80	$444.00	—	—	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC PR 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$69.30	$99.00	—	74% below	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION	$457.80	$654.00	—	73% above	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC ED TANGENTIAL BIOPSY SKIN SINGLE LESION CDM	$457.80	$654.00	—	73% above	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC PR 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$69.30	$99.00	—	—	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION	$457.80	$654.00	—	—	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC ED TANGENTIAL BIOPSY SKIN SINGLE LESION CDM	$457.80	$654.00	—	—	30%
Thoracentesis with imaging guidance CPT 32555 HC PR 32555 THORANCENTESIS NEEDLE/CATH PLEURA W IMAGING	$189.00	$270.00	—	86% below	30%
Thoracentesis with imaging guidance CPT 32555 HC PR ED 32555 THORACENTESIS/ASPIR W IMG GD CDM	$202.30	$289.00	—	85% below	30%
Thoracentesis with imaging guidance CPT 32555 HC ED THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING CDM	$2,680.30	$3,829.00	—	103% above	30%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$2,680.30	$3,829.00	—	103% above	30%
Thoracentesis with imaging guidance inpatient CPT 32555 HC PR 32555 THORANCENTESIS NEEDLE/CATH PLEURA W IMAGING	$189.00	$270.00	—	—	30%
Thoracentesis with imaging guidance inpatient CPT 32555 HC PR ED 32555 THORACENTESIS/ASPIR W IMG GD CDM	$202.30	$289.00	—	—	30%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$2,680.30	$3,829.00	—	—	30%
Thoracentesis with imaging guidance inpatient CPT 32555 HC ED THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING CDM	$2,680.30	$3,829.00	—	—	30%
Trigger point injections, 1 or 2 muscles CPT 20552 HC PR ED 20552 INJ TRIGGER POINT 1/2 MUSCL CDM	$100.10	$143.00	—	72% below	30%
Trigger point injections, 1 or 2 muscles CPT 20552 HC IR INJ TRIGGER POINT(S)1TO2 MUSC	$457.10	$653.00	—	27% above	30%
Trigger point injections, 1 or 2 muscles CPT 20552 HC ED INJ TRIGGER POINT 1/2 MUSCL CDM	$457.10	$653.00	—	27% above	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC PR ED 20552 INJ TRIGGER POINT 1/2 MUSCL CDM	$100.10	$143.00	—	—	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC ED INJ TRIGGER POINT 1/2 MUSCL CDM	$457.10	$653.00	—	—	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC IR INJ TRIGGER POINT(S)1TO2 MUSC	$457.10	$653.00	—	—	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST 1ST LESION US IMAG	$1,740.20	$2,486.00	—	31% below	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST 1ST LESION US IMAG	$1,740.20	$2,486.00	—	—	30%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC ED UGI W DILATION ESOPHAGUS BAL CDM	$2,091.60	$2,988.00	—	9% below	30%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC ED UGI W DILATION ESOPHAGUS BAL CDM	$2,091.60	$2,988.00	—	—	30%
Upper endoscopy (EGD) with biopsy CPT 43239 HC ED EGD TRANSORAL BIOPSY SINGLE/MULTIPLE CDM	$2,046.10	$2,923.00	—	6% above	30%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC ED EGD TRANSORAL BIOPSY SINGLE/MULTIPLE CDM	$2,046.10	$2,923.00	—	—	30%
Upper endoscopy (EGD), diagnostic CPT 43235 HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM	$1,983.80	$2,834.00	—	22% above	30%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM	$1,983.80	$2,834.00	—	—	30%
Wart removal, up to 14 warts CPT 17110 HC ED DESTRUCTION BENIGN LESIONS UP TO 14 CDM	$185.50	$265.00	—	22% below	30%
Wart removal, up to 14 warts CPT 17110 HC PR 17110 DESTRUCT B9 LESION 1-14	$205.80	$294.00	—	13% below	30%
Wart removal, up to 14 warts inpatient CPT 17110 HC ED DESTRUCTION BENIGN LESIONS UP TO 14 CDM	$185.50	$265.00	—	—	30%
Wart removal, up to 14 warts inpatient CPT 17110 HC PR 17110 DESTRUCT B9 LESION 1-14	$205.80	$294.00	—	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC PR ED 11042 DEB SUBQ TISSUE FIRST 20 SQ CM OR LESS CDM	$216.30	$309.00	—	66% below	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC ED DEB SUBQ TISSUE 20 SQ CM OR LESS - DEBRIDE SKIN CDM	$583.10	$833.00	—	9% below	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC PR ED 11042 DEB SUBQ TISSUE FIRST 20 SQ CM OR LESS CDM	$216.30	$309.00	—	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC ED DEB SUBQ TISSUE 20 SQ CM OR LESS - DEBRIDE SKIN CDM	$583.10	$833.00	—	—	30%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC ED TREAT FX RAD EXTRA-ARTICUL CDM	$8,722.00	$12,460.00	—	18% below	30%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 HC ED TREAT FX RAD EXTRA-ARTICUL CDM	$8,722.00	$12,460.00	—	—	30%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION EA UNIT CDM	$782.60	$1,118.00	—	20% below	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION EA UNIT CDM	$782.60	$1,118.00	—	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT DAILY	$140.70	$201.00	—	30% below	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC ED INHALATION TREATMENT CDM	$140.70	$201.00	—	30% below	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT DAILY	$140.70	$201.00	—	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC ED INHALATION TREATMENT CDM	$140.70	$201.00	—	—	30%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO IV INFUSION INITIAL HR CDM	$647.50	$925.00	—	17% below	30%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO IV INFUSION INITIAL HR CDM	$647.50	$925.00	—	—	30%
Critical care, first 30 to 74 minutes CPT 99291 HC PR ED 99291 CRITICAL CARE FIRST HOUR CDM	$488.60	$698.00	—	85% below	30%
Critical care, first 30 to 74 minutes CPT 99291 HC ED CRITICAL CARE FIRST HOUR CDM	$2,810.50	$4,015.00	—	13% below	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC PR ED 99291 CRITICAL CARE FIRST HOUR CDM	$488.60	$698.00	—	—	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ED CRITICAL CARE FIRST HOUR CDM	$2,810.50	$4,015.00	—	—	30%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE AND DROWSY PORTABLE	$1,061.90	$1,517.00	—	37% above	30%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY	$1,061.90	$1,517.00	—	37% above	30%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY	$1,061.90	$1,517.00	—	—	30%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG AWAKE AND DROWSY PORTABLE	$1,061.90	$1,517.00	—	—	30%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC ECG 12 LEAD W/INTERP & REPORT	$84.00	$120.00	—	18% below	30%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 HC ECG 12 LEAD W/INTERP & REPORT	$84.00	$120.00	—	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ECG 12 LEAD TRACING ONLY	$184.10	$263.00	—	1% below	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ECG 12 LEAD TRACING ONLY	$184.10	$263.00	—	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED FAC E&M VISIT LEVEL 1 CDM	$350.00	$500.00	—	40% above	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED FAC E&M VISIT LEVEL 1 CDM	$350.00	$500.00	—	—	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED FAC E&M VISIT LEVEL 2 CDM	$584.50	$835.00	—	29% above	30%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED FAC E&M VISIT LEVEL 2 CDM	$584.50	$835.00	—	—	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED FAC E&M VISIT LEVEL 3 CDM	$1,015.00	$1,450.00	—	26% above	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED FAC E&M VISIT LEVEL 3 CDM	$1,015.00	$1,450.00	—	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED SEXUAL ASSAULT EXAM CDM	$1,612.10	$2,303.00	—	19% above	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED FAC E&M VISIT LEVEL 4 CDM	$1,612.10	$2,303.00	—	19% above	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED SEXUAL ASSAULT EXAM CDM	$1,612.10	$2,303.00	—	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED FAC E&M VISIT LEVEL 4 CDM	$1,612.10	$2,303.00	—	—	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED FAC E&M VISIT LEVEL 5 CDM	$2,258.20	$3,226.00	—	1% above	30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED FAC E&M VISIT LEVEL 5 CDM	$2,258.20	$3,226.00	—	—	30%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY	$964.60	$1,378.00	—	62% above	30%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIO STRESS TEST MEDICINE	$964.60	$1,378.00	—	62% above	30%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY	$964.60	$1,378.00	—	—	30%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIO STRESS TEST MEDICINE	$964.60	$1,378.00	—	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC ED IV HYDRATION INITIAL HR CDM	$372.40	$532.00	—	10% above	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV HYDRATION INITIAL HR CDM	$372.40	$532.00	—	10% above	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV HYDRATION INITIAL HR CDM	$372.40	$532.00	—	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC ED IV HYDRATION INITIAL HR CDM	$372.40	$532.00	—	—	30%
IV infusion of a medicine, first hour CPT 96365 HC ED IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR CDM	$553.70	$791.00	—	37% above	30%
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION INITIAL HR CDM	$553.70	$791.00	—	37% above	30%
IV infusion of a medicine, first hour inpatient CPT 96365 HC ED IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR CDM	$553.70	$791.00	—	—	30%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION INITIAL HR CDM	$553.70	$791.00	—	—	30%
IV push of a medicine, first drug CPT 96374 HC ED IV INJECTION THERAPEUTIC PROPH/DX PUSH SINGLE/1ST SBST/DRUG CDM	$297.50	$425.00	—	27% above	30%
IV push of a medicine, first drug CPT 96374 HC INJ IV PUSH INITIAL DRUG CDM	$297.50	$425.00	—	27% above	30%
IV push of a medicine, first drug inpatient CPT 96374 HC INJ IV PUSH INITIAL DRUG CDM	$297.50	$425.00	—	—	30%
IV push of a medicine, first drug inpatient CPT 96374 HC ED IV INJECTION THERAPEUTIC PROPH/DX PUSH SINGLE/1ST SBST/DRUG CDM	$297.50	$425.00	—	—	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC ED THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM CDM	$145.60	$208.00	—	49% above	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ SQ OR IM CDM	$145.60	$208.00	—	49% above	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJ SQ OR IM CDM	$145.60	$208.00	—	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC ED THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM CDM	$145.60	$208.00	—	—	30%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSC REEDUCA THER PX 1 OR MORE AREAS EACH 15 MIN	$56.00	$80.00	—	43% below	30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSC REEDUCA THER PX 1 OR MORE AREAS EACH 15 MIN	$56.00	$80.00	—	—	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EA 15 MIN CDM	$154.00	$220.00	—	142% above	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MEDICAL NUTRITION INITIAL ASSMT&IVNTJ BARIATRIC THERAPY INDIV EACH 15MIN	$154.00	$220.00	—	142% above	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MEDICAL NUTRITION INITIAL ASSMT&IVNTJ BARIATRIC THERAPY INDIV EACH 15MIN	$154.00	$220.00	—	—	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EA 15 MIN CDM	$154.00	$220.00	—	—	30%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION LOW COMPLEX	$118.30	$169.00	—	45% below	30%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION LOW COMPLEX	$118.30	$169.00	—	—	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION HIGH COMPLEX	$130.90	$187.00	—	53% below	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION HIGH COMPLEX	$130.90	$187.00	—	—	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION LOW COMPLEX CDM	$130.90	$187.00	—	41% below	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION LOW COMPLEX CDM	$130.90	$187.00	—	—	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION MOD COMPLEX CDM	$130.90	$187.00	—	47% below	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION MOD COMPLEX CDM	$130.90	$187.00	—	—	30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY TQS 1 OR MORE REGIONS EACH 15 MINUTES	$59.50	$85.00	—	30% below	30%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY TQS 1 OR MORE REGIONS EACH 15 MINUTES	$59.50	$85.00	—	—	30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN	$53.20	$76.00	—	45% below	30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN	$53.20	$76.00	—	—	30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC BEHAV CHNG SMOKING 3-10 MIN	$40.60	$58.00	—	20% above	30%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC BEHAV CHNG SMOKING 3-10 MIN	$40.60	$58.00	—	—	30%
Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE CONSULTATION LEVEL 3	$105.70	$151.00	—	35% below	30%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 HC OFFICE CONSULTATION LEVEL 3	$105.70	$151.00	—	—	30%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OFFICE CONSULTATION LEVEL 4	$105.70	$151.00	—	58% below	30%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 HC OFFICE CONSULTATION LEVEL 4	$105.70	$151.00	—	—	30%
Speech and language evaluation CPT 92523 HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION CDM	$387.80	$554.00	—	1% above	30%
Speech and language evaluation inpatient CPT 92523 HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION CDM	$387.80	$554.00	—	—	30%
Speech therapy session, individual CPT 92507 HC TX SPEECH/LANG/VOICE COMMJ/AUDITORY PROCESS - INDIVIDUAL	$322.70	$461.00	—	48% above	30%
Speech therapy session, individual inpatient CPT 92507 HC TX SPEECH/LANG/VOICE COMMJ/AUDITORY PROCESS - INDIVIDUAL	$322.70	$461.00	—	—	30%
Spirometry (breathing test) CPT 94010 HC BEDSIDE SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ CDM	$195.30	$279.00	—	21% below	30%
Spirometry (breathing test) CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$195.30	$279.00	—	21% below	30%
Spirometry (breathing test) inpatient CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$195.30	$279.00	—	—	30%
Spirometry (breathing test) inpatient CPT 94010 HC BEDSIDE SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ CDM	$195.30	$279.00	—	—	30%
Spirometry before and after a bronchodilator CPT 94060 HC SPIROMETRY PRE POST BRONCHODILATOR CDM	$246.40	$352.00	—	41% below	30%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC SPIROMETRY PRE POST BRONCHODILATOR CDM	$246.40	$352.00	—	—	30%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$56.70	$81.00	—	46% below	30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$56.70	$81.00	—	—	30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC ED PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE CDM	$269.50	$385.00	—	33% above	30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC THERAPUTIC PHLEBOTOMY	$269.50	$385.00	—	33% above	30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC THERAPUTIC PHLEBOTOMY	$269.50	$385.00	—	—	30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC ED PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE CDM	$269.50	$385.00	—	—	30%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 HC CARDIO STRESS TEST SUPV INTERP & REPT	$238.00	$340.00	—	at median	30%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 HC CARDIO STRESS TEST SUPV INTERP & REPT	$238.00	$340.00	—	—	30%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 HC PR RX COVID-19 VACCINE SINGLE DOSE (MODERNA) PF IM 50 MCG/0.5 ML	$204.40	$292.00	—	40% above	30%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 HC PR RX COVID-19 VACCINE SINGLE DOSE (MODERNA) PF IM 50 MCG/0.5 ML	$204.40	$292.00	—	—	30%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 HC PR RX COVID-19 VACCINE SINGLE DOSE (PFIZER) PF TRIS-SUC IM 30 MCG/0.3 ML	$183.40	$262.00	—	14% above	30%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 HC PR RX COVID-19 VACCINE SINGLE DOSE (PFIZER) PF TRIS-SUC IM 30 MCG/0.3 ML	$183.40	$262.00	—	—	30%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VAC LIVE FOR INJ 1350 PFU/0.5ML	$827.35	$1,181.93	—	309% above	30%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VAC LIVE FOR INJ 1350 PFU/0.5ML	$827.35	$1,181.93	—	—	30%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE (RECOMBINANT) SUSP 20 MCG/ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 20 MCG/ML	$414.79	$592.55	—	434% above	30%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE (RECOMBINANT) SUSP 20 MCG/ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 20 MCG/ML	$414.79	$592.55	—	—	30%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES-MUMPS-RUBELLA VIRUS VACCINES FOR INJ SOLN	$618.70	$883.85	—	258% above	30%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES-MUMPS-RUBELLA VIRUS VACCINES FOR INJ SOLN	$618.70	$883.85	—	—	30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE SUS PREF SYR 0.5 ML	$1,301.15	$1,858.79	—	175% above	30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE SUS PREF SYR 0.5 ML	$1,301.15	$1,858.79	—	—	30%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC FOR INJ	$1,618.69	$2,312.41	—	161% above	30%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC FOR INJ	$1,618.69	$2,312.41	—	—	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TET-DIPH-ACELL PERTUSS AD PREF SYR 5-2.5-18.5 LF-MCG/0.5ML	$299.09	$427.27	—	262% above	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TET TOX-DIPH-ACELL PERTUSS AD INJ 5-2.5-18.5 LF-LF-MCG/0.5ML	$321.92	$459.89	—	289% above	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TET-DIPH-ACELL PERTUSS AD PREF SYR 5-2.5-18.5 LF-MCG/0.5ML	$299.09	$427.27	—	—	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TET TOX-DIPH-ACELL PERTUSS AD INJ 5-2.5-18.5 LF-LF-MCG/0.5ML	$321.92	$459.89	—	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM	$16.10	$23.00	—	62% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN INFLUENZA VIRUS VAC CDM	$70.00	$100.00	—	66% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE CDM	$70.00	$100.00	—	66% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM	$70.00	$100.00	—	66% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMIN CDM	$70.00	$100.00	—	66% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM	$16.10	$23.00	—	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE CDM	$70.00	$100.00	—	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMIN CDM	$70.00	$100.00	—	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN INFLUENZA VIRUS VAC CDM	$70.00	$100.00	—	—	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADMIN EACH ADD CDM	$68.60	$98.00	—	90% above	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZATION ADMIN EACH ADD CDM	$68.60	$98.00	—	—	30%

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://pricetransparency.providence.org/wamt/live/300502262_providence-st-mary-medical-center_standardcharges.json