Hospital Oklahoma City, OK

OU Health - University of Oklahoma Medical Center

Listed in its price file as “OU Health - University of Oklahoma Medical Center|Oklahoma Childrens Hospital| OU Health Edmond Medical Center”.

OU Health - University of Oklahoma Medical Center in Oklahoma City, OK publishes cash prices for 464 common procedures listed here, from its own machine-readable price file updated Mar 25, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Oklahoma median for 433 of 451 procedures and above it for 15. By typical cash price it ranks #1 of 64 Oklahoma hospitals and #1 of 8 hospitals in the Oklahoma City, OK area, cheapest first. Select a procedure to compare it with other hospitals nearby.

700 NE 13th St,Oklahoma City,OK,73104 Collected Sep 22, 2026 Source price file Check a bill from this hospital

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Abdominal CT scan without and with contrast CPT 74170 CT SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST	$880.90	$8,809.00	$167.87–$1,522.00	34% below	90%
Abdominal X-ray, 2 views CPT 74019 X-RAY OF ABDOMEN; 2 VIEWS	$99.30	$993.00	$100.06–$448.00	53% below	90%
Abdominal X-ray, 2 views one side CPT 74019 X-RAY OF ABDOMEN; 2 VIEWS	$99.30	$993.00	$100.06–$448.00	53% below	90%
Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY OF ANKLE; MINIMUM OF 3 VIEWS	$84.90	$849.00	$83.29–$448.00	52% below	90%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY OF ANKLE; MINIMUM OF 3 VIEWS	$84.90	$849.00	$83.29–$448.00	52% below	90%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY OF ANKLE; MINIMUM OF 3 VIEWS	$84.90	$849.00	$83.29–$448.00	52% below	90%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT SCAN OF ARM WITHOUT CONTRAST	$311.00	$3,110.00	$100.06–$1,522.00	66% below	90%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SCAN OF ARM WITHOUT CONTRAST	$311.00	$3,110.00	$100.06–$1,522.00	66% below	90%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SCAN OF ARM WITHOUT CONTRAST	$311.00	$3,110.00	$100.06–$1,522.00	66% below	90%
Barium swallow (esophagus X-ray with contrast) CPT 74220 SINGLE CONTRAST X-RAY OF ESOPHAGUS	$137.70	$1,377.00	$167.87–$448.00	53% below	90%
Bone scan, whole body (nuclear medicine) CPT 78306 NUCLEAR MEDICINE STUDY OF BONE AND/OR JOINT WHOLE BODY	$349.70	$3,497.00	$382.61–$1,945.00	63% below	90%
Breast ultrasound, complete, one breast CPT 76641 COMPLETE ULTRASOUND SCAN OF 1 BREAST	$77.60	$776.00	$100.06–$465.00	78% below	90%
Breast ultrasound, complete, one breast one side CPT 76641 COMPLETE ULTRASOUND SCAN OF 1 BREAST	$51.70	$517.00	$100.06–$465.00	85% below	90%
Breast ultrasound, complete, one breast one side CPT 76641 COMPLETE ULTRASOUND SCAN OF 1 BREAST	$51.70	$517.00	$100.06–$465.00	85% below	90%
Breast ultrasound, limited (one breast or one area) CPT 76642 LIMITED ULTRASOUND SCAN OF 1 BREAST	$37.50	$375.00	$83.29–$465.00	89% below	90%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 LIMITED ULTRASOUND SCAN OF 1 BREAST	$37.50	$375.00	$83.29–$465.00	89% below	90%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 LIMITED ULTRASOUND SCAN OF 1 BREAST	$37.50	$375.00	$83.29–$465.00	89% below	90%
CT angiography (CTA) of the head CPT 70496 CT SCAN OF BLOOD VESSELS OF HEAD WITH CONTRAST	$525.40	$5,254.00	$167.87–$1,522.00	60% below	90%
CT angiography (CTA) of the neck CPT 70498 CT SCAN OF BLOOD VESSELS OF NECK WITH CONTRAST	$499.30	$4,993.00	$167.87–$1,522.00	62% below	90%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT SCAN OF BLOOD VESSELS OF CHEST WITH CONTRAST	$591.60	$5,916.00	$167.87–$1,522.00	61% below	90%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST	$21.80	$218.00	$83.29–$1,522.00	79% below	90%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT SCAN OF HEART WITH EVALUATION OF BLOOD VESSEL CALCIUM	$75.30	$753.00	$83.29–$1,522.00	26% below	90%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT SCAN OF ABDOMEN AND PELVIS WITHOUT CONTRAST	$1,018.40	$10,184.00	$228.36–$1,522.00	24% below	90%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$872.70	$8,727.00	$333.90–$1,522.00	52% below	90%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT SCAN OF ABDOMEN AND PELVIS BEFORE AND AFTER CONTRAST	$1,290.10	$12,901.00	$333.90–$1,522.00	39% below	90%
CT scan of the abdomen with contrast CPT 74160 CT SCAN OF ABDOMEN WITH CONTRAST	$551.70	$5,517.00	$167.87–$1,522.00	50% below	90%
CT scan of the abdomen without contrast CPT 74150 CT SCAN OF ABDOMEN WITHOUT CONTRAST	$505.20	$5,052.00	$100.06–$1,522.00	49% below	90%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN OF FACE WITHOUT CONTRAST	$515.40	$5,154.00	$100.06–$1,522.00	46% below	90%
CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$512.40	$5,124.00	$100.06–$1,522.00	48% below	90%
CT scan of the head with contrast CPT 70460 CT SCAN HEAD OR BRAIN WITH CONTRAST	$515.90	$5,159.00	$167.87–$1,522.00	57% below	90%
CT scan of the head without and with contrast CPT 70470 CT SCAN OF HEAD OR BRAIN BEFORE AND AFTER CONTRAST	$731.40	$7,314.00	$167.87–$1,522.00	43% below	90%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN OF LOWER SPINE WITHOUT CONTRAST	$677.30	$6,773.00	$100.06–$1,522.00	34% below	90%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN OF UPPER SPINE WITHOUT CONTRAST	$524.60	$5,246.00	$100.06–$1,522.00	51% below	90%
CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN OF PELVIS WITH CONTRAST	$585.90	$5,859.00	$167.87–$1,522.00	46% below	90%
Chest CT scan without and with contrast CPT 71270 CT SCAN OF CHEST BEFORE AND AFTER CONTRAST	$791.50	$7,915.00	$167.87–$1,522.00	36% below	90%
Chest X-ray, 2 views CPT 71046 X-RAY OF CHEST; 2 VIEWS	$68.30	$683.00	$83.29–$448.00	62% below	90%
Chest X-ray, single view CPT 71045 X-RAY OF CHEST; 1 VIEW	$60.20	$602.00	$83.29–$448.00	64% below	90%
Collarbone (clavicle) X-ray, complete CPT 73000 X-RAY OF COLLAR BONE	$89.10	$891.00	$83.29–$448.00	50% below	90%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X-RAY OF COLLAR BONE	$89.10	$891.00	$83.29–$448.00	50% below	90%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X-RAY OF COLLAR BONE	$89.10	$891.00	$83.29–$448.00	50% below	90%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 COMPLETE ULTRASOUND SCAN BEHIND ABDOMINAL CAVITY	$201.20	$2,012.00	$100.06–$465.00	57% below	90%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY MEASUREMENT OF FOREARM; FINGER; HAND; OR FOOT	$26.90	$269.00	$83.29–$448.00	75% below	90%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 ULTRASOUND SCAN OF PREGNANT UTERUS WITH DETAILED FETAL ANATOMIC EXAMINATION; SINGLE OR FIRST FETUS	$213.20	$2,132.00	$228.36–$465.00	61% below	90%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN OF CHEST WITHOUT CONTRAST	$505.70	$5,057.00	$100.06–$1,522.00	47% below	90%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN OF CHEST WITH CONTRAST	$570.30	$5,703.00	$167.87–$1,522.00	50% below	90%
Diagnostic mammogram, both breasts CPT 77066 DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$48.90	$489.00	$44.73–$448.00	83% below	90%
Diagnostic mammogram, one breast CPT 77065 DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$38.50	$385.00	$36.33–$448.00	81% below	90%
Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$38.50	$385.00	$36.33–$448.00	81% below	90%
Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$38.50	$385.00	$36.33–$448.00	81% below	90%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ULTRASOUND OF HEART WITH COLOR-DEPICTED BLOOD FLOW; RATE; DIRECTION AND VALVE FUNCTION	$658.60	$6,586.00	$448.00–$889.02	40% below	90%
Elbow X-ray, 2 views CPT 73070 X-RAY OF ELBOW; 2 VIEWS	$81.90	$819.00	$83.29–$448.00	53% below	90%
Elbow X-ray, 2 views one side CPT 73070 X-RAY OF ELBOW; 2 VIEWS	$81.90	$819.00	$83.29–$448.00	53% below	90%
Elbow X-ray, 2 views one side CPT 73070 X-RAY OF ELBOW; 2 VIEWS	$81.90	$819.00	$83.29–$448.00	53% below	90%
Elbow X-ray, complete, 3 or more views CPT 73080 X-RAY OF ELBOW; MINIMUM OF 3 VIEWS	$102.30	$1,023.00	$83.29–$448.00	43% below	90%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY OF ELBOW; MINIMUM OF 3 VIEWS	$102.30	$1,023.00	$83.29–$448.00	43% below	90%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY OF ELBOW; MINIMUM OF 3 VIEWS	$102.30	$1,023.00	$83.29–$448.00	43% below	90%
Eye socket (orbit) CT scan without contrast CPT 70480 CT SCAN OF CRANIAL CAVITY WITHOUT CONTRAST	$614.40	$6,144.00	$100.06–$1,522.00	33% below	90%
Facial bones X-ray, complete, 3 or more views CPT 70150 X-RAY OF FACE BONES; MINIMUM OF 3 VIEWS	$168.00	$1,680.00	$100.06–$448.00	24% below	90%
Forearm X-ray (radius and ulna), 2 views CPT 73090 X-RAY OF FOREARM; 2 VIEWS	$73.20	$732.00	$83.29–$448.00	59% below	90%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY OF FOREARM; 2 VIEWS	$73.20	$732.00	$83.29–$448.00	59% below	90%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY OF FOREARM; 2 VIEWS	$73.20	$732.00	$83.29–$448.00	59% below	90%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NUCLEAR MEDICINE STUDY OF LIVER AND BILE DUCT SYSTEM	$382.40	$3,824.00	$382.61–$1,945.00	67% below	90%
Hand X-ray, 2 views CPT 73120 X-RAY OF HAND; 2 VIEWS	$49.00	$490.00	$100.06–$448.00	74% below	90%
Hand X-ray, 2 views one side CPT 73120 X-RAY OF HAND; 2 VIEWS	$49.00	$490.00	$100.06–$448.00	74% below	90%
Hand X-ray, 2 views one side CPT 73120 X-RAY OF HAND; 2 VIEWS	$49.00	$490.00	$100.06–$448.00	74% below	90%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-RAY OF HEEL; MINIMUM OF 2 VIEWS	$90.10	$901.00	$83.29–$448.00	44% below	90%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 X-RAY OF HEEL; MINIMUM OF 2 VIEWS	$90.10	$901.00	$83.29–$448.00	44% below	90%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 X-RAY OF HEEL; MINIMUM OF 2 VIEWS	$90.10	$901.00	$83.29–$448.00	44% below	90%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY INCLUDING HEART RATE; BREATHING; AIRFLOW; AND EFFORT	$105.00	$1,050.00	$206.65–$448.00	75% below	90%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY IN SLEEP LAB WITH CONTINUOUS AIRWAY PRESSURE (6 YEARS OR OLDER)	$1,130.00	$11,300.00	$448.00–$1,397.16	63% below	90%
Knee X-ray, 3 views CPT 73562 X-RAY OF KNEE; 3 VIEWS	$111.30	$1,113.00	$83.29–$448.00	43% below	90%
Knee X-ray, 3 views one side CPT 73562 X-RAY OF KNEE; 3 VIEWS	$111.30	$1,113.00	$83.29–$448.00	43% below	90%
Knee X-ray, 3 views one side CPT 73562 X-RAY OF KNEE; 3 VIEWS	$111.30	$1,113.00	$83.29–$448.00	43% below	90%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY OF KNEE; 4 OR MORE VIEWS	$118.70	$1,187.00	$100.06–$448.00	58% below	90%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY OF KNEE; 4 OR MORE VIEWS	$118.70	$1,187.00	$100.06–$448.00	58% below	90%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST	$460.30	$4,603.00	$100.06–$1,522.00	49% below	90%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST	$460.30	$4,603.00	$100.06–$1,522.00	49% below	90%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST	$460.30	$4,603.00	$100.06–$1,522.00	49% below	90%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIMITED ULTRASOUND SCAN OF ABDOMEN	$178.40	$1,784.00	$100.06–$465.00	54% below	90%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS	$96.40	$964.00	$100.06–$465.00	63% below	90%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS	$96.40	$964.00	$100.06–$465.00	63% below	90%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS	$96.40	$964.00	$100.06–$465.00	63% below	90%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-RAY OF LOWER LEG; 2 VIEWS	$82.30	$823.00	$83.29–$448.00	51% below	90%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY OF LOWER LEG; 2 VIEWS	$82.30	$823.00	$83.29–$448.00	51% below	90%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY OF LOWER LEG; 2 VIEWS	$82.30	$823.00	$83.29–$448.00	51% below	90%
MR angiography (MRA) of the head without contrast CPT 70544 MRI SCAN OF BLOOD VESSELS OF HEAD WITHOUT CONTRAST	$508.70	$5,087.00	$228.36–$2,407.00	53% below	90%
MRI of both breasts, without and then with contrast dye CPT 77049 MRI SCAN OF BOTH BREASTS	$492.10	$4,921.00	$102.05–$2,407.00	73% below	90%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$561.60	$5,616.00	$228.36–$2,407.00	58% below	90%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$561.60	$5,616.00	$228.36–$2,407.00	58% below	90%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$561.60	$5,616.00	$228.36–$2,407.00	58% below	90%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$842.90	$8,429.00	$333.90–$2,407.00	53% below	90%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$842.90	$8,429.00	$333.90–$2,407.00	53% below	90%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$842.90	$8,429.00	$333.90–$2,407.00	53% below	90%
MRI of the abdomen without contrast CPT 74181 MRI SCAN OF ABDOMEN WITHOUT CONTRAST	$643.10	$6,431.00	$228.36–$2,407.00	45% below	90%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST	$1,153.50	$11,535.00	$333.90–$2,407.00	40% below	90%
MRI of the brain, no contrast dye CPT 70551 MRI SCAN OF BRAIN WITHOUT CONTRAST	$696.70	$6,967.00	$228.36–$2,407.00	44% below	90%
MRI of the brain, with and without contrast dye CPT 70553 MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$944.70	$9,447.00	$333.90–$2,407.00	37% below	90%
MRI of the lower back, no contrast dye CPT 72148 MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$865.30	$8,653.00	$228.36–$2,407.00	32% below	90%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SCAN OF LOWER SPINAL CANAL BEFORE AND AFTER CONTRAST	$908.30	$9,083.00	$333.90–$2,407.00	44% below	90%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SCAN OF MIDDLE SPINAL CANAL WITHOUT CONTRAST	$879.40	$8,794.00	$228.36–$2,407.00	22% below	90%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SCAN OF UPPER SPINAL CANAL BEFORE AND AFTER CONTRAST	$841.60	$8,416.00	$333.90–$2,407.00	49% below	90%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SCAN OF UPPER SPINAL CANAL WITHOUT CONTRAST	$800.40	$8,004.00	$228.36–$2,407.00	33% below	90%
MRI of the pelvis without and with contrast CPT 72197 MRI SCAN OF PELVIS BEFORE AND AFTER CONTRAST	$921.90	$9,219.00	$333.90–$2,407.00	43% below	90%
MRI of the pelvis, no contrast dye CPT 72195 MRI SCAN OF PELVIS WITHOUT CONTRAST	$557.60	$5,576.00	$228.36–$2,407.00	46% below	90%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST	$602.40	$6,024.00	$228.36–$2,407.00	57% below	90%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST	$602.40	$6,024.00	$228.36–$2,407.00	57% below	90%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY OF UPPER SPINE; 4-5 VIEWS	$161.90	$1,619.00	$100.06–$448.00	41% below	90%
Neck soft tissue CT scan with contrast CPT 70491 CT SCAN OF SOFT TISSUE OF NECK WITH CONTRAST	$483.10	$4,831.00	$167.87–$1,522.00	56% below	90%
Neck soft tissue CT scan without contrast CPT 70490 CT SCAN OF SOFT TISSUE OF NECK WITHOUT CONTRAST	$527.90	$5,279.00	$100.06–$1,522.00	38% below	90%
Neck soft tissue X-ray CPT 70360 X-RAY OF SOFT TISSUE OF NECK	$95.10	$951.00	$83.29–$448.00	41% below	90%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 NUCLEAR MEDICINE STUDY FROM SKULL BASE TO MID-THIGH WITH CT SCAN	$1,158.30	$11,583.00	$1,368.54–$5,390.00	71% below	90%
Pelvic CT scan without contrast CPT 72192 CT SCAN OF PELVIS WITHOUT CONTRAST	$513.50	$5,135.00	$100.06–$1,522.00	47% below	90%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 LIMITED ULTRASOUND SCAN OF PELVIS	$68.10	$681.00	$100.06–$465.00	77% below	90%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 COMPLETE ULTRASOUND SCAN OF PELVIS	$175.90	$1,759.00	$100.06–$465.00	64% below	90%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND SCAN OF PREGNANT UTERUS (LESS THAN 14 WEEKS); SINGLE OR FIRST FETUS	$115.10	$1,151.00	$100.06–$465.00	70% below	90%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 LIMITED ULTRASOUND OF PREGNANT UTERUS	$116.90	$1,169.00	$100.06–$465.00	65% below	90%
Rib X-ray, one side, 2 views CPT 71100 X-RAY OF RIBS ON SIDE OF BODY; 2 VIEWS	$120.70	$1,207.00	$83.29–$448.00	40% below	90%
Rib X-ray, one side, 2 views one side CPT 71100 X-RAY OF RIBS ON SIDE OF BODY; 2 VIEWS	$120.70	$1,207.00	$83.29–$448.00	40% below	90%
Rib X-ray, one side, 2 views one side CPT 71100 X-RAY OF RIBS ON SIDE OF BODY; 2 VIEWS	$120.70	$1,207.00	$83.29–$448.00	40% below	90%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 X-RAY OF RIBS ON SIDE OF BODY; MINIMUM OF 3 VIEWS	$129.20	$1,292.00	$100.06–$448.00	47% below	90%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY OF RIBS ON SIDE OF BODY; MINIMUM OF 3 VIEWS	$129.20	$1,292.00	$100.06–$448.00	47% below	90%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY OF RIBS ON SIDE OF BODY; MINIMUM OF 3 VIEWS	$129.20	$1,292.00	$100.06–$448.00	47% below	90%
Screening mammogram, both breasts CPT 77067 SCREENING MAMMOGRAPHY	$45.80	$458.00	$33.81–$448.00	75% below	90%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS	$119.40	$1,194.00	$83.29–$448.00	38% below	90%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS	$119.40	$1,194.00	$83.29–$448.00	38% below	90%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS	$119.40	$1,194.00	$83.29–$448.00	38% below	90%
Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY OF PARANASAL SINUS; MINIMUM OF 3 VIEWS	$146.80	$1,468.00	$83.29–$448.00	29% below	90%
Skull X-ray, fewer than 4 views CPT 70250 X-RAY OF SKULL; 1-3 VIEWS	$106.10	$1,061.00	$100.06–$448.00	48% below	90%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER)	$1,075.80	$10,758.00	$448.00–$1,397.16	61% below	90%
Swallow study (modified barium swallow, video X-ray) CPT 74230 IMAGING FOR EVALUATION OF SWALLOWING FUNCTION	$201.30	$2,013.00	$167.87–$448.00	38% below	90%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY OF THIGH BONE; MINIMUM 2 VIEWS	$113.30	$1,133.00	$83.29–$448.00	41% below	90%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY OF THIGH BONE; MINIMUM 2 VIEWS	$113.30	$1,133.00	$83.29–$448.00	41% below	90%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY OF THIGH BONE; MINIMUM 2 VIEWS	$113.30	$1,133.00	$83.29–$448.00	41% below	90%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SCAN OF MIDDLE SPINE WITHOUT CONTRAST	$512.00	$5,120.00	$100.06–$1,522.00	49% below	90%
Toe X-ray, 2 or more views CPT 73660 X-RAY OF TOE; MINIMUM OF 2 VIEWS	$87.90	$879.00	$83.29–$448.00	46% below	90%
Toe X-ray, 2 or more views one side CPT 73660 X-RAY OF TOE; MINIMUM OF 2 VIEWS	$87.90	$879.00	$83.29–$448.00	46% below	90%
Toe X-ray, 2 or more views one side CPT 73660 X-RAY OF TOE; MINIMUM OF 2 VIEWS	$87.90	$879.00	$83.29–$448.00	46% below	90%
Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$185.30	$1,853.00	$100.06–$465.00	56% below	90%
Transvaginal ultrasound during pregnancy CPT 76817 VAGINAL ULTRASOUND OF PREGNANT UTERUS	$182.10	$1,821.00	$100.06–$465.00	43% below	90%
Ultrasound of the abdomen, complete CPT 76700 COMPLETE ULTRASOUND SCAN OF ABDOMEN	$253.20	$2,532.00	$100.06–$465.00	52% below	90%
Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND SCAN OF SCROTUM	$172.00	$1,720.00	$100.06–$465.00	52% below	90%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SCAN OF HEAD AND NECK SOFT TISSUE	$150.30	$1,503.00	$100.06–$465.00	63% below	90%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 SINGLE CONTRAST X-RAY OF UPPER DIGESTIVE TRACT	$163.30	$1,633.00	$167.87–$448.00	57% below	90%
Upper arm X-ray (humerus), 2 views CPT 73060 X-RAY OF UPPER ARM; MINIMUM OF 2 VIEWS	$77.40	$774.00	$83.29–$448.00	56% below	90%
Upper arm X-ray (humerus), 2 views one side CPT 73060 X-RAY OF UPPER ARM; MINIMUM OF 2 VIEWS	$77.40	$774.00	$83.29–$448.00	56% below	90%
Upper arm X-ray (humerus), 2 views one side CPT 73060 X-RAY OF UPPER ARM; MINIMUM OF 2 VIEWS	$77.40	$774.00	$83.29–$448.00	56% below	90%
Wrist X-ray, 2 views CPT 73100 X-RAY OF WRIST; 2 VIEWS	$75.70	$757.00	$83.29–$448.00	54% below	90%
Wrist X-ray, 2 views one side CPT 73100 X-RAY OF WRIST; 2 VIEWS	$75.70	$757.00	$83.29–$448.00	54% below	90%
Wrist X-ray, 2 views one side CPT 73100 X-RAY OF WRIST; 2 VIEWS	$75.70	$757.00	$83.29–$448.00	54% below	90%
Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS	$80.10	$801.00	$83.29–$448.00	55% below	90%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS	$80.10	$801.00	$83.29–$448.00	55% below	90%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS	$80.10	$801.00	$83.29–$448.00	55% below	90%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$92.90	$929.00	$83.29–$448.00	51% below	90%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$92.90	$929.00	$83.29–$448.00	51% below	90%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$92.90	$929.00	$83.29–$448.00	51% below	90%
X-ray of the abdomen, 1 view CPT 74018 X-RAY OF ABDOMEN; 1 VIEW	$71.60	$716.00	$83.29–$448.00	59% below	90%
X-ray of the ankle, 2 views CPT 73600 X-RAY OF ANKLE; 2 VIEWS	$70.80	$708.00	$83.29–$448.00	60% below	90%
X-ray of the ankle, 2 views one side CPT 73600 X-RAY OF ANKLE; 2 VIEWS	$70.80	$708.00	$83.29–$448.00	60% below	90%
X-ray of the ankle, 2 views one side CPT 73600 X-RAY OF ANKLE; 2 VIEWS	$70.80	$708.00	$83.29–$448.00	60% below	90%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS	$66.70	$667.00	$83.29–$448.00	59% below	90%
X-ray of the finger(s), 2 or more views one side CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS	$66.70	$667.00	$83.29–$448.00	59% below	90%
X-ray of the finger(s), 2 or more views one side CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS	$66.70	$667.00	$83.29–$448.00	59% below	90%
X-ray of the foot, 2 views CPT 73620 X-RAY OF FOOT; 2 VIEWS	$70.10	$701.00	$83.29–$448.00	60% below	90%
X-ray of the foot, 2 views one side CPT 73620 X-RAY OF FOOT; 2 VIEWS	$70.10	$701.00	$83.29–$448.00	60% below	90%
X-ray of the foot, 2 views one side CPT 73620 X-RAY OF FOOT; 2 VIEWS	$70.10	$701.00	$83.29–$448.00	60% below	90%
X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS	$108.90	$1,089.00	$83.29–$448.00	45% below	90%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS	$108.90	$1,089.00	$83.29–$448.00	45% below	90%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS	$108.90	$1,089.00	$83.29–$448.00	45% below	90%
X-ray of the hand, 3 or more views CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS	$59.00	$590.00	$83.29–$448.00	70% below	90%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS	$59.00	$590.00	$83.29–$448.00	70% below	90%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS	$59.00	$590.00	$83.29–$448.00	70% below	90%
X-ray of the knee, 1 or 2 views CPT 73560 X-RAY OF KNEE; 1-2 VIEWS	$96.90	$969.00	$83.29–$448.00	44% below	90%
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY OF KNEE; 1-2 VIEWS	$96.90	$969.00	$83.29–$448.00	44% below	90%
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY OF KNEE; 1-2 VIEWS	$96.90	$969.00	$83.29–$448.00	44% below	90%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY OF LOWER AND SACRAL SPINE; 2-3 VIEWS	$68.10	$681.00	$100.06–$448.00	68% below	90%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$137.90	$1,379.00	$100.06–$448.00	56% below	90%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY OF MIDDLE SPINE; 2 VIEWS	$105.50	$1,055.00	$100.06–$448.00	50% below	90%
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY OF NOSE BONES; MINIMUM OF 3 VIEWS	$86.50	$865.00	$83.29–$448.00	47% below	90%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY OF UPPER SPINE; 2-3 VIEWS	$94.40	$944.00	$83.29–$448.00	54% below	90%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY OF PELVIS; 1-2 VIEWS	$84.50	$845.00	$100.06–$448.00	56% below	90%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY OF SACRUM AND TAILBONE; MINIMUM OF 2 VIEWS	$82.90	$829.00	$83.29–$448.00	53% below	90%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH) LEVEL	$15.03	$150.25	$38.62–$448.00	88% below	90%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER ENZYME (SGPT); LEVEL	$39.10	$391.00	$5.30–$448.00	20% above	90%
AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER ENZYME (SGOT); LEVEL	$40.60	$406.00	$5.18–$448.00	8% above	90%
Albumin blood test CPT 82040 ALBUMIN (PROTEIN) LEVEL	$8.50	$85.00	$4.95–$448.00	73% below	90%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE (ENZYME) LEVEL; ALKALINE	$8.10	$81.00	$5.18–$448.00	73% below	90%
Allergy blood test, specific IgE, per allergen CPT 86003 MEASUREMENT OF ANTIBODY (IGE) TO ALLERGIC SUBSTANCE; CRUDE ALLERGEN EXTRACT; EACH	$33.00	$330.00	$5.22–$448.00	53% above	90%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (AFP) LEVEL; SERUM	$36.50	$365.00	$16.77–$448.00	34% below	90%
Ammonia blood test CPT 82140 AMMONIA LEVEL	$19.40	$194.00	$14.57–$448.00	72% below	90%
Amylase blood test CPT 82150 AMYLASE (ENZYME) LEVEL	$8.00	$80.00	$6.48–$448.00	83% below	90%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$9.00	$90.00	$12.95–$448.00	86% below	90%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 MEASUREMENT OF ANTIBODY FOR RHEUMATOID ARTHRITIS ASSESSMENT	$12.00	$120.00	$12.95–$448.00	82% below	90%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$7.00	$70.00	$12.09–$448.00	89% below	90%
Antinuclear antibody (ANA) blood test, screen CPT 86038 SCREENING TEST FOR AUTOIMMUNE DISORDER	$25.10	$251.00	$12.09–$448.00	59% below	90%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$17.25	$172.50	$39.26–$448.00	85% below	90%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (HEART AND BLOOD VESSEL PROTEIN) LEVEL	$77.90	$779.00	$39.26–$448.00	34% below	90%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL CULTURE; ANY OTHER SOURCE EXCEPT URINE; BLOOD OR STOOL; AEROBIC	$57.80	$578.00	$8.62–$448.00	31% above	90%
Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$75.20	$752.00	$8.46–$448.00	37% above	90%
Bilirubin blood test, total CPT 82247 BILIRUBIN LEVEL; TOTAL	$37.60	$376.00	$5.02–$448.00	4% below	90%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY EXAMINATION OF TISSUE USING A MICROSCOPE; INTERMEDIATE COMPLEXITY	$30.00	$300.00	$49.87–$448.00	79% below	90%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST	$132.80	$1,328.00	$49.87–$448.00	5% below	90%
Blood culture for bacteria CPT 87040 BACTERIAL BLOOD CULTURE	$53.30	$533.00	$10.32–$448.00	28% below	90%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$2.70	$27.00	$5.25–$448.00	73% below	90%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE	$18.00	$180.00	$5.25–$448.00	80% above	90%
Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE (SUGAR) LEVEL	$7.80	$78.00	$3.93–$448.00	72% below	90%
Blood lead test CPT 83655 LEAD LEVEL	$8.05	$80.50	$12.11–$448.00	83% below	90%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (REPRODUCTIVE HORMONE) ANALYSIS	$12.30	$123.00	$7.52–$448.00	73% below	90%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD GROUP TYPING (ABO)	$35.20	$352.00	$6.46–$448.00	42% below	90%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN LEVEL TO ASSESS KIDNEY FUNCTION; QUANTITATIVE	$5.80	$58.00	$3.95–$448.00	77% below	90%
C-peptide blood test CPT 84681 C-PEPTIDE (PROTEIN) LEVEL	$53.70	$537.00	$20.81–$448.00	41% below	90%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION	$10.40	$104.00	$5.18–$448.00	73% below	90%
C. difficile toxin gene test (stool PCR) CPT 87493 DETECTION TEST BY NUCLEIC ACID FOR CLOSTRIDIUM DIFFICILE; AMPLIFIED PROBE TECHNIQUE	$19.05	$190.50	$37.27–$448.00	80% below	90%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 125	$37.00	$370.00	$20.81–$448.00	60% below	90%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 AMPLIFED DNA OR RNA PROBE DETECTION OF SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (COVID-19) ANTIGEN	$23.00	$230.00	$51.31–$448.00	72% below	90%
Calcium blood test, total CPT 82310 CALCIUM LEVEL; TOTAL	$34.00	$340.00	$5.16–$448.00	6% below	90%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA) PROTEIN LEVEL	$8.60	$86.00	$18.96–$448.00	92% below	90%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY	$5.03	$50.25	$12.88–$448.00	91% below	90%
Chickenpox (varicella) immunity blood test CPT 86787 ANALYSIS FOR ANTIBODY TO VARICELLA-ZOSTER VIRUS (CHICKEN POX)	$50.50	$505.00	$12.88–$448.00	13% below	90%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$24.70	$247.00	$13.39–$448.00	65% below	90%
Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$5.65	$56.50	$7.77–$448.00	88% below	90%
Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$25.70	$257.00	$6.47–$448.00	42% below	90%
Cortisol blood test, total CPT 82533 CORTISOL (HORMONE) MEASUREMENT; TOTAL	$38.50	$385.00	$16.30–$448.00	50% below	90%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE (CARDIAC ENZYME) LEVEL; TOTAL	$10.30	$103.00	$6.51–$448.00	75% below	90%
Creatinine blood test CPT 82565 BLOOD CREATININE LEVEL	$5.80	$58.00	$5.12–$448.00	80% below	90%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY	$10.20	$102.00	$14.39–$448.00	87% below	90%
Cytomegalovirus (CMV) antibody test CPT 86644 ANALYSIS FOR ANTIBODY TO CYTOMEGALOVIRUS (CMV)	$13.30	$133.00	$14.39–$448.00	82% below	90%
D-dimer blood test (blood clot marker) CPT 85379 COAGULATION FUNCTION MEASUREMENT; D-DIMER; QUANTITATIVE	$12.80	$128.00	$10.18–$448.00	87% below	90%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TESTING FOR PRESENCE OF DRUG; BY CHEMISTRY ANALYZERS	$30.10	$301.00	$62.14–$448.00	69% below	90%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 BLOOD TEST PANEL FOR ELECTROLYTES (SODIUM POTASSIUM; CHLORIDE; CARBON DIOXIDE)	$34.40	$344.00	$7.01–$448.00	43% below	90%
Epstein-Barr virus (EBV) antibody test CPT 86665 ANALYSIS FOR ANTIBODY TO EPSTEIN-BARR VIRUS (MONONUCLEOSIS VIRUS); VIRAL CAPSID	$8.28	$82.75	$18.14–$448.00	88% below	90%
Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL	$13.80	$138.00	$27.94–$448.00	85% below	90%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$24.40	$244.00	$19.63–$448.00	83% below	90%
Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN (PROTEIN) LEVEL	$31.90	$319.00	$19.63–$448.00	78% below	90%
Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL	$31.40	$314.00	$13.63–$448.00	51% below	90%
Fibrinogen blood test CPT 85384 FIBRINOGEN (FACTOR 1) ACTIVITY MEASUREMENT	$6.68	$66.75	$9.72–$448.00	91% below	90%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$18.20	$182.00	$9.72–$448.00	74% below	90%
Folate (folic acid) blood test CPT 82746 FOLIC ACID LEVEL; SERUM	$11.38	$113.75	$14.70–$448.00	83% below	90%
Free T3 thyroid hormone test CPT 84481 THYROID HORMONE; T3 MEASUREMENT; FREE	$15.93	$159.25	$16.94–$448.00	82% below	90%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (THYROID CHEMICAL); FREE	$52.40	$524.00	$9.02–$448.00	15% below	90%
Free testosterone test CPT 84402 TESTOSTERONE (HORMONE) LEVEL; FREE	$36.80	$368.00	$25.47–$448.00	58% below	90%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE (LIVER ENZYME) LEVEL	$39.20	$392.00	$7.20–$448.00	20% below	90%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$187.00	$1,870.00	$83.16–$448.00	4% below	90%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 BLOOD GLUCOSE (SUGAR) LEVEL AFTER RECEIVING DOSE OF GLUCOSE	$5.93	$59.25	$4.75–$448.00	81% below	90%
Glucose tolerance test, 3 samples CPT 82951 BLOOD GLUCOSE (SUGAR) TOLERANCE TEST; 3 SPECIMENS	$31.60	$316.00	$12.87–$448.00	53% below	90%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB	$19.70	$197.00	$35.09–$448.00	76% below	90%
HIV-1 and HIV-2 antibody test CPT 86703 ANALYSIS FOR ANTIBODY TO HIV-1 AND HIV-2 VIRUS	$12.60	$126.00	$13.71–$448.00	76% below	90%
HPV test for high-risk types, one combined (pooled) result CPT 87624 DETECTION TEST BY NUCLEIC ACID FOR HUMAN PAPILLOMAVIRUS (HPV); HIGH-RISK TYPES	$9.70	$97.00	$35.09–$448.00	89% below	90%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOLED RSLT	$17.80	$178.00	$35.09–$448.00	81% below	90%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL	$21.80	$218.00	$9.71–$448.00	49% below	90%
Hemoglobin blood test CPT 85018 BLOOD COUNT; HEMOGLOBIN	$2.83	$28.25	$2.37–$448.00	86% below	90%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$3.30	$33.00	$2.37–$448.00	84% below	90%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY MEASUREMENT	$11.20	$112.00	$12.05–$448.00	77% below	90%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY MEASUREMENT	$44.40	$444.00	$10.74–$448.00	6% below	90%
Hepatitis B surface antigen (HBsAg) test CPT 87340 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HEPATITIS B SURFACE ANTIGEN	$8.83	$88.25	$10.33–$448.00	81% below	90%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY MEASUREMENT	$15.48	$154.75	$14.27–$448.00	72% below	90%
Hepatitis C viral load (HCV RNA) test CPT 87522 DETECTION TEST BY NUCLEIC ACID FOR HEPATITIS C VIRUS; QUANTIFICATION	$30.05	$300.50	$42.84–$448.00	86% below	90%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$11.50	$115.00	$13.19–$448.00	82% below	90%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$15.70	$157.00	$19.35–$448.00	74% below	90%
High-sensitivity CRP (hs-CRP) test CPT 86141 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION; HIGH SENSITIVITY	$6.65	$66.50	$12.95–$448.00	88% below	90%
Homocysteine blood test CPT 83090 HOMOCYSTEINE (AMINO ACID) LEVEL	$19.60	$196.00	$17.92–$448.00	83% below	90%
Insulin blood test CPT 83525 INSULIN MEASUREMENT; TOTAL	$6.20	$62.00	$11.43–$448.00	88% below	90%
Iron blood test (serum iron) CPT 83540 IRON LEVEL	$10.30	$103.00	$6.47–$448.00	72% below	90%
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON	$45.30	$453.00	$6.47–$448.00	25% above	90%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$39.20	$392.00	$8.74–$448.00	17% below	90%
Kidney function blood test panel CPT 80069 KIDNEY FUNCTION BLOOD TEST PANEL	$75.20	$752.00	$8.68–$448.00	at median	90%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING (REPRODUCTIVE HORMONE) LEVEL	$8.58	$85.75	$18.52–$448.00	88% below	90%
Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID	$22.70	$227.00	$11.57–$448.00	62% below	90%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID LEVEL	$111.70	$1,117.00	$11.57–$448.00	89% above	90%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (ENZYME) LEVEL	$5.50	$55.00	$6.04–$448.00	84% below	90%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (FAT ENZYME) LEVEL	$11.00	$110.00	$6.89–$448.00	79% below	90%
Magnesium blood test CPT 83735 MAGNESIUM LEVEL	$37.40	$374.00	$6.70–$448.00	1% above	90%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$14.70	$147.00	$12.88–$448.00	66% below	90%
PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE	$7.70	$77.00	$18.39–$448.00	92% below	90%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL	$7.70	$77.00	$18.39–$448.00	90% below	90%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$29.80	$298.00	$18.39–$448.00	61% below	90%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP TEST; MANUAL SCREENING	$12.65	$126.50	$20.26–$448.00	82% below	90%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) LEVEL	$39.70	$397.00	$41.28–$448.00	72% below	90%
Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$35.40	$354.00	$6.01–$448.00	9% above	90%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHATE LEVEL	$4.90	$49.00	$4.74–$448.00	85% below	90%
Potassium blood test CPT 84132 BLOOD POTASSIUM LEVEL	$5.80	$58.00	$4.76–$448.00	83% below	90%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 TEST FOR DETECTING GENES ASSOCIATED WITH FETAL DISEASE; ANEUPLOIDY GENOMIC SEQUENCE ANALYSIS PANEL	$201.30	$2,013.00	$448.00–$1,328.34	83% below	90%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$4.80	$48.00	$4.29–$448.00	85% below	90%
Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME	$28.20	$282.00	$4.29–$448.00	14% below	90%
Rh blood typing CPT 86901 BLOOD TYPING SEROLOGIC RH(D)	$4.78	$47.76	$6.46–$448.00	89% below	90%
Rh blood typing CPT 86901 BLOOD TYPING FOR RH (D) ANTIGEN	$26.40	$264.00	$6.46–$448.00	42% below	90%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR LEVEL	$5.68	$56.75	$5.67–$448.00	81% below	90%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RED BLOOD CELL SEDIMENTATION RATE; TO DETECT INFLAMMATION; AUTOMATED	$25.80	$258.00	$2.70–$448.00	5% above	90%
Sodium blood test CPT 84295 BLOOD SODIUM LEVEL	$4.90	$49.00	$4.81–$448.00	85% below	90%
Stool ova and parasites exam CPT 87177 SMEAR FOR PARASITES	$9.50	$95.00	$8.90–$448.00	85% below	90%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL	$6.00	$60.00	$15.92–$448.00	90% below	90%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM	$5.50	$55.00	$13.24–$448.00	87% below	90%
Syphilis antibody test (Treponema pallidum) CPT 86780 ANALYSIS FOR ANTIBODY; TREPONEMA PALLIDUM	$8.50	$85.00	$13.24–$448.00	80% below	90%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS DETECTION TEST	$13.50	$135.00	$4.27–$448.00	57% below	90%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (HORMONE) LEVEL; TOTAL	$49.90	$499.00	$25.81–$448.00	46% below	90%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT	$6.73	$67.25	$14.55–$448.00	89% below	90%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$47.40	$474.00	$16.80–$448.00	12% below	90%
Total IgE blood test CPT 82785 IGE (IMMUNE SYSTEM PROTEIN) LEVEL	$8.48	$84.75	$16.46–$448.00	84% below	90%
Total cholesterol blood test CPT 82465 CHOLESTEROL LEVEL	$4.78	$47.75	$4.35–$448.00	86% below	90%
Total thyroxine (T4) blood test CPT 84436 THYROXINE (THYROID CHEMICAL); TOTAL	$44.30	$443.00	$6.87–$448.00	3% above	90%
Transferrin blood test CPT 84466 TRANSFERRIN (IRON BINDING PROTEIN) LEVEL	$10.78	$107.75	$12.76–$448.00	81% below	90%
Trichomonas test (NAAT) CPT 87661 DETECTION TEST BY NUCLEIC ACID FOR TRICHOMONAS VAGINALIS (GENITAL PARASITE); AMPLIFIED PROBE TECHNIQUE	$8.64	$86.35	$35.09–$448.00	90% below	90%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$14.90	$149.00	$35.09–$448.00	83% below	90%
Triglycerides blood test CPT 84478 TRIGLYCERIDES LEVEL	$24.40	$244.00	$5.74–$448.00	29% below	90%
Troponin test, quantitative CPT 84484 TROPONIN (PROTEIN) ANALYSIS; QUANTITATIVE	$31.20	$312.00	$12.47–$448.00	56% below	90%
Uric acid blood test CPT 84550 URIC ACID LEVEL; BLOOD	$22.40	$224.00	$4.52–$448.00	17% below	90%
Urinalysis with microscope exam, automated CPT 81001 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$40.00	$400.00	$3.17–$448.00	25% above	90%
Urinalysis with microscope exam, manual CPT 81000 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; NON-AUTOMATED	$7.60	$76.00	$4.02–$448.00	57% below	90%
Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST	$25.10	$251.00	$2.25–$448.00	75% above	90%
Urine culture for bacteria, with colony count CPT 87086 BACTERIAL COLONY COUNT; URINE	$7.90	$79.00	$8.07–$448.00	84% below	90%
Urine microalbumin (albumin) test CPT 82043 UR ALBUMIN QUANTITATIVE	$3.73	$37.26	$5.78–$448.00	90% below	90%
Urine microalbumin (albumin) test CPT 82043 URINE MICROALBUMIN (PROTEIN) LEVEL	$8.83	$88.25	$5.78–$448.00	77% below	90%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) LEVEL	$32.80	$328.00	$15.08–$448.00	50% below	90%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$12.30	$123.00	$29.60–$448.00	91% below	90%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 LEVEL	$67.70	$677.00	$29.60–$448.00	48% below	90%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY	$16.00	$160.00	$38.50–$448.00	90% below	90%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D; 1; 25 LEVEL	$29.50	$295.00	$38.50–$448.00	81% below	90%
Zinc blood test CPT 84630 ASSAY OF ZINC	$4.00	$40.00	$11.39–$448.00	93% below	90%
Zinc blood test CPT 84630 ZINC LEVEL	$22.10	$221.00	$11.39–$448.00	62% below	90%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN; CHORIONIC (REPRODUCTIVE HORMONE) LEVEL	$19.10	$191.00	$15.05–$448.00	69% below	90%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 PRIMARY REMOVAL OF ADENOIDS (YOUNGER THAN 12 YEARS)	$1,067.93	$10,679.34	$448.00–$9,389.00	66% below	90%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 FUSION OF UPPER SPINE BONE WITH REMOVAL OF DISC AND RELEASE OF SPINAL CORD OR NERVE; 1 DISC	$962.63	$9,626.25	$448.00–$20,888.51	94% below	90%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 REPAIR OF ANTERIOR CRUCIATE LIGAMENT OF KNEE USING AN ENDOSCOPE	$4,612.30	$46,123.00	$448.00–$11,805.84	72% below	90%
Arthroscopic ACL reconstruction or repair of the knee one side CPT 29888 REPAIR OF ANTERIOR CRUCIATE LIGAMENT OF KNEE USING AN ENDOSCOPE	$1,803.90	$18,039.00	$448.00–$11,805.84	89% below	90%
Arthroscopic ACL reconstruction or repair of the knee one side CPT 29888 REPAIR OF ANTERIOR CRUCIATE LIGAMENT OF KNEE USING AN ENDOSCOPE	$2,336.83	$23,368.33	$448.00–$11,805.84	86% below	90%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE	$768.72	$7,687.16	$448.00–$11,805.84	94% below	90%
Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE	$953.23	$9,532.25	$448.00–$11,805.84	93% below	90%
Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE	$3,812.90	$38,129.00	$448.00–$11,805.84	72% below	90%
Botox injections for chronic migraine CPT 64615 INJECTION OF CHEMICAL FOR PARALYSIS OF FACIAL AND NECK NERVE MUSCLES ON BOTH SIDES OF FACE	$82.30	$823.00	$293.77–$1,173.00	67% below	90%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING X-RAY WITH NEEDLE; FIRST GROWTH	$305.30	$3,053.00	$448.00–$3,821.00	85% below	90%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING X-RAY WITH NEEDLE; FIRST GROWTH	$305.30	$3,053.00	$448.00–$3,821.00	85% below	90%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING X-RAY WITH NEEDLE; FIRST GROWTH	$305.30	$3,053.00	$448.00–$3,821.00	85% below	90%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TREATMENT OF BROKEN OUTSIDE LOWER LEG BONE AT ANKLE	$291.00	$2,910.00	$236.08–$1,173.00	14% above	90%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TREATMENT OF BROKEN BONE IN FOREFOOT OR MIDFOOT	$57.60	$576.00	$236.08–$1,173.00	71% below	90%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECTION OF BUNION WITH ALIGNMENT CORRECTION OF MIDFOOT BONE TOWARD TOE AREA	$2,219.87	$22,198.67	$448.00–$10,137.00	59% below	90%
Cardiac catheterization with coronary angiogram one side CPT 93458 INSERTION OF TUBE IN LEFT LOWER HEART CHAMBER AND CORONARY ARTERY FOR DIAGNOSIS WITH REVIEW BY RADIOLOGIST	$2,369.80	$23,698.00	$1,463.00–$5,274.61	64% below	90%
Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL SHOCK TO HEART TO REGULATE HEART BEAT	$276.00	$2,760.00	$448.00–$2,712.00	72% below	90%
Carpal tunnel release, open surgery CPT 64721 RELEASE AND/OR RELOCATION OF HAND NERVE	$943.13	$9,431.34	$448.00–$9,389.00	62% below	90%
Carpal tunnel release, open surgery one side CPT 64721 RELEASE AND/OR RELOCATION OF HAND NERVE	$533.97	$5,339.66	$448.00–$9,389.00	78% below	90%
Carpal tunnel release, open surgery one side CPT 64721 RELEASE AND/OR RELOCATION OF HAND NERVE	$753.38	$7,533.75	$448.00–$9,389.00	69% below	90%
Cataract surgery with lens implant CPT 66984 REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$1,270.97	$12,709.66	$448.00–$9,389.00	63% below	90%
Cataract surgery with lens implant one side CPT 66984 REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$1,047.90	$10,479.00	$448.00–$9,389.00	69% below	90%
Cataract surgery with lens implant one side CPT 66984 REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$1,047.90	$10,479.00	$448.00–$9,389.00	69% below	90%
Catheter ablation for atrial fibrillation CPT 93656 COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH CATHETER DESTRUCTION OF ABNORMALITY CAUSING ATRIAL FIBRILLATION (UNCOORDINATED CONTRACTION OF UPPER CHAMBERS OF HEART) BY PULMONARY VEIN ISOLATION	$8,031.90	$80,319.00	$448.00–$46,346.00	48% below	90%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$95.75	$957.45	$448.00–$1,498.55	86% below	90%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUM 28 DAYS OR OLDER	$242.58	$2,425.83	$448.00–$9,389.00	93% below	90%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 REMOVAL OF FORESKIN (OLDER THAN 28 DAYS)	$1,067.93	$10,679.34	$448.00–$9,389.00	69% below	90%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE	$81.36	$813.58	$448.00–$9,389.00	85% below	90%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TREATMENT OF BROKEN FOREARM (RADIUS) BONE AT THE WRIST AREA ON THE THUMB SIDE OF THE WRIST WITHOUT MANIPULATION	$62.60	$626.00	$236.08–$1,173.00	76% below	90%
Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 CLOSED TREATMENT OF BROKEN FOREARM (RADIUS) BONE AT THE WRIST AREA ON THE THUMB SIDE OF THE WRIST WITHOUT MANIPULATION	$62.60	$626.00	$236.08–$1,173.00	76% below	90%
Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY W/ENDOSCOPE US	$140.55	$1,405.45	$448.00–$3,821.00	90% below	90%
Colonoscopy with endoscopic ultrasound CPT 45391 ULTRASOUND EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$560.40	$5,604.00	$448.00–$3,821.00	61% below	90%
Colonoscopy with polyp removal CPT 45385 REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$487.30	$4,873.00	$448.00–$3,821.00	70% below	90%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY	$140.55	$1,405.45	$448.00–$3,821.00	91% below	90%
Colonoscopy with tissue sample CPT 45380 BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$487.30	$4,873.00	$448.00–$3,821.00	69% below	90%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$374.40	$3,744.00	$448.00–$3,821.00	75% below	90%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE LEEP	$372.35	$3,723.46	$448.00–$5,266.79	91% below	90%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$38.21	$382.08	$291.64–$1,311.00	85% below	90%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BIOPSY AND SCRAPING OF CERVIX USING AN ENDOSCOPE	$79.80	$798.00	$291.64–$1,311.00	68% below	90%
Complex cataract surgery with lens implant CPT 66982 COMPLEX REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$2,541.93	$25,419.34	$448.00–$9,389.00	45% below	90%
Complex cataract surgery with lens implant one side CPT 66982 COMPLEX REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$1,004.50	$10,045.00	$448.00–$9,389.00	78% below	90%
Complex cataract surgery with lens implant one side CPT 66982 COMPLEX REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS	$1,047.90	$10,479.00	$448.00–$9,389.00	77% below	90%
Coronary stent placement, one artery CPT 92928 PRQ TCAT PLMT NTRAC ST 1 LES	$1,310.23	$13,102.26	$448.00–$18,782.37	87% below	90%
Cystoscopy with ureteral stent placement CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE	$349.30	$3,493.00	$448.00–$9,389.00	95% below	90%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT	$415.20	$4,151.98	$448.00–$5,735.14	94% below	90%
Cystoscopy with ureteral stent placement one side CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE	$1,047.90	$10,479.00	$448.00–$9,389.00	84% below	90%
Cystoscopy with ureteral stent placement one side CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE	$1,047.90	$10,479.00	$448.00–$9,389.00	84% below	90%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$81.36	$813.58	$448.00–$1,173.00	88% below	90%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 DIAGNOSTIC EXAM OF BLADDER AND URETHRA USING AN ENDOSCOPE	$189.50	$1,895.00	$448.00–$1,173.00	72% below	90%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE	$372.35	$3,723.46	$448.00–$5,266.79	90% below	90%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND SCRAPING OF UTERUS	$1,047.90	$10,479.00	$448.00–$9,389.00	72% below	90%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION	$23.84	$238.44	$192.01–$1,173.00	76% below	90%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION OF PRECANCER SKIN GROWTH; 1 GROWTH	$54.70	$547.00	$192.01–$1,173.00	45% below	90%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA	$1,803.90	$18,039.00	$448.00–$3,821.00	42% below	90%
Ear tube placement (tympanostomy) under general anesthesia, one ear one side CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA	$471.57	$4,715.66	$448.00–$3,821.00	85% below	90%
Ear tube placement (tympanostomy) under general anesthesia, one ear one side CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA	$738.03	$7,380.33	$448.00–$3,821.00	76% below	90%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING	$65.53	$655.29	$448.00–$1,519.00	77% below	90%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 INCISION OF EARDRUM WITH INSERTION OF EARDRUM TUBE UNDER LOCAL OR TOPICAL ANESTHESIA	$174.20	$1,742.00	$448.00–$1,519.00	39% below	90%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING	$17.10	$171.00	$56.46–$1,173.00	72% below	90%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING	$17.10	$171.00	$56.46–$1,173.00	72% below	90%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING	$17.10	$171.00	$56.46–$1,173.00	72% below	90%
Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED EAR WAX	$78.30	$783.00	$56.46–$1,173.00	4% above	90%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL OF IMPACTED EAR WAX	$78.30	$783.00	$56.46–$1,173.00	4% above	90%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL OF IMPACTED EAR WAX	$78.30	$783.00	$56.46–$1,173.00	4% above	90%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF LINING OF UTERUS	$53.90	$539.00	$193.49–$1,173.00	80% below	90%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 REMOVAL OF NASAL SINUS USING AN ENDOSCOPE	$553.53	$5,535.25	$448.00–$11,482.46	95% below	90%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 EXPLORATION OF NASAL SINUS USING AN ENDOSCOPE	$476.61	$4,766.12	$448.00–$11,482.46	94% below	90%
Endoscopic sinus surgery: opening the frontal sinus one side CPT 31276 EXPLORATION OF NASAL SINUS USING AN ENDOSCOPE	$476.61	$4,766.12	$448.00–$11,482.46	94% below	90%
Endoscopic sinus surgery: opening the frontal sinus one side CPT 31276 EXPLORATION OF NASAL SINUS USING AN ENDOSCOPE	$635.48	$6,354.83	$448.00–$11,482.46	92% below	90%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 INCISION OF NASAL SINUS USING AN ENDOSCOPE	$3,105.55	$31,055.51	$448.00–$9,389.00	21% below	90%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus one side CPT 31256 INCISION OF NASAL SINUS USING AN ENDOSCOPE	$384.36	$3,843.58	$448.00–$9,389.00	90% below	90%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus one side CPT 31256 INCISION OF NASAL SINUS USING AN ENDOSCOPE	$2,306.15	$23,061.52	$448.00–$9,389.00	42% below	90%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 REMOVAL OF NASAL SINUS TISSUE USING AN ENDOSCOPE	$553.53	$5,535.25	$448.00–$11,482.46	91% below	90%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue one side CPT 31267 REMOVAL OF NASAL SINUS TISSUE USING AN ENDOSCOPE	$635.48	$6,354.83	$448.00–$11,482.46	90% below	90%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue one side CPT 31267 REMOVAL OF NASAL SINUS TISSUE USING AN ENDOSCOPE	$943.13	$9,431.34	$448.00–$11,482.46	85% below	90%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE	$303.53	$3,035.34	$448.00–$2,712.00	54% below	90%
Eye injection into the vitreous (intravitreal injection) CPT 67028 INJECTION OF DRUG INTO EYE	$99.10	$991.00	$316.12–$1,173.00	83% below	90%
Eye injection into the vitreous (intravitreal injection) one side CPT 67028 INJECTION OF DRUG INTO EYE	$1,107.05	$11,070.52	$316.12–$2,440.00	91% above	90%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL	$329.47	$3,294.67	$448.00–$2,712.00	71% below	90%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL	$258.53	$2,585.34	$448.00–$2,712.00	77% below	90%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); 3 CM TO 10 CM; REDUCIBLE	$2,155.90	$21,559.00	$448.00–$10,532.88	54% below	90%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); GREATER THAN 10 CM; REDUCIBLE	$3,812.90	$38,129.00	$448.00–$10,532.88	54% below	90%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); LESS THAN 3 CM; REDUCIBLE	$1,414.70	$14,147.00	$448.00–$10,137.00	70% below	90%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$108.85	$1,088.51	$448.00–$2,712.00	89% below	90%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC EXAM OF LOWER PORTION OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$374.00	$3,740.00	$448.00–$2,712.00	63% below	90%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$687.20	$6,871.99	$448.00–$11,062.00	85% below	90%
Gallbladder removal, laparoscopic CPT 47562 REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$2,214.10	$22,141.00	$448.00–$11,062.00	52% below	90%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 REMOVAL OF GALLBLADDER WITH X-RAY STUDY OF BILE DUCTS USING AN ENDOSCOPE	$1,476.07	$14,760.67	$448.00–$11,062.00	77% below	90%
Gallbladder removal, open surgery through a larger incision CPT 47600 REMOVAL OF GALLBLADDER	$1,803.90	$18,039.00	$448.00–$9,526.00	4% above	90%
Hammertoe correction surgery one side CPT 28285 CORRECTION OF TOE JOINT DEFORMITY	$702.18	$7,021.83	$448.00–$9,389.00	82% below	90%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INSERTION OF TUBE AND INTRODUCTION OF CONTRAST FOR X-RAY OF UTERUS AND FALLOPIAN TUBES	$67.50	$675.00	$49.06–$1,173.00	65% below	90%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY	$78.80	$788.00	$49.06–$2,440.00	59% below	90%
Hysteroscopy with endometrial ablation CPT 58563 EXAM OF UTERUS WITH DESTRUCTION OF LINING OF UTERUS USING AN ENDOSCOPE	$1,047.90	$10,479.00	$448.00–$10,137.00	87% below	90%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$1,601.90	$16,019.00	$448.00–$9,389.00	71% below	90%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF IUD FOR PREGNANCY PREVENTION	$108.40	$1,084.00	$448.00–$1,173.00	76% below	90%
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE	$140.90	$1,409.00	$448.00–$1,173.00	69% below	90%
Incision and drainage of a simple or single skin abscess CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS	$58.50	$585.00	$192.01–$1,173.00	78% below	90%
Incision and drainage of a simple or single skin abscess one side CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS	$58.50	$585.00	$192.01–$1,173.00	78% below	90%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$3,817.90	$38,179.00	$448.00–$10,137.00	19% below	90%
Inguinal (groin) hernia repair, age 5 or older one side CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$359.32	$3,593.16	$448.00–$10,137.00	92% below	90%
Inguinal (groin) hernia repair, age 5 or older one side CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$2,709.90	$27,099.00	$448.00–$10,137.00	43% below	90%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT	$107.70	$1,077.00	$293.77–$1,173.00	71% below	90%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT	$113.70	$1,137.00	$293.77–$2,440.00	69% below	90%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT	$1,047.90	$10,479.00	$293.77–$2,440.00	186% above	90%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION OF DRUG DELIVERY IMPLANT INTO TISSUE	$78.30	$783.00	$127.33–$1,173.00	65% below	90%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT	$141.90	$1,419.00	$293.77–$1,173.00	47% below	90%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT	$141.90	$1,419.00	$293.77–$1,173.00	47% below	90%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT	$141.90	$1,419.00	$293.77–$1,173.00	47% below	90%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$35.28	$352.75	$293.77–$2,440.00	86% below	90%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT	$108.10	$1,081.00	$293.77–$1,173.00	56% below	90%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT	$110.60	$1,106.00	$293.77–$1,173.00	55% below	90%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 REPAIR OF INSIDE OR OUTSIDE KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$4,673.67	$46,736.67	$448.00–$10,137.00	40% below	90%
Knee arthroscopy with meniscus repair (one side of the knee) one side CPT 29882 REPAIR OF INSIDE OR OUTSIDE KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$3,607.80	$36,078.00	$448.00–$10,137.00	54% below	90%
Knee arthroscopy with meniscus repair (one side of the knee) one side CPT 29882 REPAIR OF INSIDE OR OUTSIDE KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$3,812.90	$38,129.00	$448.00–$10,137.00	51% below	90%
Knee arthroscopy with meniscus trim CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$2,214.10	$22,141.00	$448.00–$10,137.00	71% below	90%
Knee arthroscopy with meniscus trim one side CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$3,013.50	$30,135.00	$448.00–$10,137.00	60% below	90%
Knee arthroscopy with meniscus trim one side CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$4,673.67	$46,736.67	$448.00–$10,137.00	38% below	90%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 REMOVAL OF BOTH KNEE CARTILAGES USING AN ENDOSCOPE	$3,812.90	$38,129.00	$448.00–$10,137.00	44% below	90%
Knee arthroscopy with removal of both torn meniscus parts one side CPT 29880 REMOVAL OF BOTH KNEE CARTILAGES USING AN ENDOSCOPE	$2,214.10	$22,141.00	$448.00–$10,137.00	68% below	90%
Knee arthroscopy with removal of both torn meniscus parts one side CPT 29880 REMOVAL OF BOTH KNEE CARTILAGES USING AN ENDOSCOPE	$2,219.87	$22,198.67	$448.00–$10,137.00	68% below	90%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 REMOVAL OR SHAVING OF KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$4,213.10	$42,131.00	$448.00–$10,137.00	38% below	90%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) one side CPT 29877 REMOVAL OR SHAVING OF KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$1,270.97	$12,709.66	$448.00–$10,137.00	81% below	90%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) one side CPT 29877 REMOVAL OR SHAVING OF KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$1,537.43	$15,374.33	$448.00–$10,137.00	78% below	90%
Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 BYPASS OF STOMACH USING AN ENDOSCOPE	$1,153.08	$11,530.75	$448.00–$11,062.00	—	90%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 REMOVAL OF APPENDIX USING AN ENDOSCOPE	$2,214.10	$22,141.00	$448.00–$11,062.00	at median	90%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 STRENGTHENING OF MUSCLE BETWEEN ESOPHAGUS AND STOMACH BY WRAPPING PART OF STOMACH AROUND ESOPHAGUS USING AN ENDOSCOPE	$3,812.90	$38,129.00	$448.00–$17,294.71	at median	90%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 REMOVAL OF UTERUS THROUGH ABDOMEN USING AN ENDOSCOPE; 250.0 G OR LESS	$1,301.65	$13,016.50	$448.00–$17,294.71	90% below	90%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 REMOVAL OF UTERUS; TUBES; AND/OR OVARIES THROUGH ABDOMEN USING AN ENDOSCOPE; 250.0 G OR LESS	$953.23	$9,532.25	$448.00–$17,294.71	94% below	90%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE	$3,812.90	$38,129.00	$448.00–$11,062.00	39% below	90%
Laparoscopic inguinal (groin) hernia repair, first repair on that side one side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE	$1,660.58	$16,605.75	$448.00–$11,062.00	74% below	90%
Laparoscopic inguinal (groin) hernia repair, first repair on that side one side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE	$2,214.10	$22,141.00	$448.00–$11,062.00	65% below	90%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 REPAIR OF RECURRENT GROIN HERNIA USING AN ENDOSCOPE	$2,214.10	$22,141.00	$448.00–$11,062.00	80% below	90%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia one side CPT 49651 REPAIR OF RECURRENT GROIN HERNIA USING AN ENDOSCOPE	$2,214.10	$22,141.00	$448.00–$11,062.00	80% below	90%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia one side CPT 49651 REPAIR OF RECURRENT GROIN HERNIA USING AN ENDOSCOPE	$3,013.50	$30,135.00	$448.00–$11,062.00	72% below	90%
Laparoscopic removal of an adjustable gastric band and its port CPT 43774 REMOVAL OF STOMACH REDUCTION DEVICE AND PORT USING AN ENDOSCOPE	$2,214.10	$22,141.00	$448.00–$33,508.00	76% below	90%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY REMOVE ADNEXA	$687.20	$6,871.99	$448.00–$11,062.00	94% below	90%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE	$1,414.70	$14,147.00	$448.00–$11,062.00	88% below	90%
Laparoscopic removal of fallopian tubes and/or ovaries one side CPT 58661 REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE	$1,352.93	$13,529.25	$448.00–$11,062.00	88% below	90%
Laparoscopic removal of fallopian tubes and/or ovaries one side CPT 58661 REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE	$3,812.90	$38,129.00	$448.00–$11,062.00	67% below	90%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 PARTIAL REMOVAL OF STOMACH FOR WEIGHT LOSS USING AN ENDOSCOPE	$3,013.50	$30,135.00	$448.00–$11,062.00	—	90%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$47.49	$474.90	$389.05–$1,173.00	86% below	90%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$110.80	$1,108.00	$389.05–$1,173.00	67% below	90%
Left heart catheterization, diagnostic one side CPT 93452 INSERTION OF TUBE IN LEFT HEART CHAMBERS FOR DIAGNOSIS WITH REVIEW BY RADIOLOGIST	$2,389.50	$23,895.00	$1,463.00–$5,274.61	49% below	90%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE	$360.20	$3,602.00	$448.00–$2,712.00	51% below	90%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC	$108.56	$1,085.56	$448.00–$1,439.03	83% below	90%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$666.10	$6,661.00	$448.00–$2,712.00	31% below	90%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$434.00	$4,340.00	$448.00–$2,712.00	55% below	90%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$479.60	$4,796.00	$448.00–$2,712.00	50% below	90%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC	$6,593.50	$65,935.00	$448.00–$11,805.84	32% below	90%
Lumbar discectomy or laminotomy to free a nerve root, one level one side CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC	$3,271.00	$32,710.00	$448.00–$11,805.84	66% below	90%
Lumbar discectomy or laminotomy to free a nerve root, one level one side CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC	$3,271.00	$32,710.00	$448.00–$11,805.84	66% below	90%
Lumbar laminectomy (spinal decompression), one level CPT 63047 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD AND/OR NERVES; 1 SEGMENT	$5,872.33	$58,723.34	$448.00–$11,805.84	53% below	90%
Lumbar spinal fusion (posterior), one level CPT 22612 FUSION OF SPINE IN LOWER BACK	$1,090.33	$10,903.33	$448.00–$28,527.48	96% below	90%
Lumpectomy (partial mastectomy) CPT 19301 PARTIAL REMOVAL OF BREAST	$1,601.90	$16,019.00	$448.00–$9,389.00	57% below	90%
Lumpectomy (partial mastectomy) one side CPT 19301 PARTIAL REMOVAL OF BREAST	$1,047.90	$10,479.00	$448.00–$9,389.00	72% below	90%
Lumpectomy (partial mastectomy) one side CPT 19301 PARTIAL REMOVAL OF BREAST	$1,506.75	$15,067.50	$448.00–$9,389.00	60% below	90%
Mastectomy (total removal of the breast) CPT 19303 SIMPLE COMPLETE REMOVAL OF BREAST	$3,074.87	$30,748.67	$448.00–$10,803.53	60% below	90%
Mastectomy (total removal of the breast) one side CPT 19303 SIMPLE COMPLETE REMOVAL OF BREAST	$1,906.45	$19,064.51	$448.00–$10,803.53	75% below	90%
Mastectomy (total removal of the breast) one side CPT 19303 SIMPLE COMPLETE REMOVAL OF BREAST	$2,306.15	$23,061.50	$448.00–$10,803.53	70% below	90%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 REMOVAL AND MICROSCOPIC EXAM OF GROWTH OF HEAD; NECK; HANDS; FEET; OR GENITALS; 1-5 TISSUE BLOCKS	$815.98	$8,159.75	$448.00–$2,440.00	35% below	90%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$83.80	$837.95	$448.00–$1,173.00	71% below	90%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 REMOVAL OF NONCANCER SKIN GROWTH OF BODY; ARMS; OR LEGS; 0.5 CM OR LESS	$314.30	$3,143.00	$448.00–$1,173.00	9% above	90%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/<	$83.80	$837.95	$448.00–$1,311.00	78% below	90%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REMOVAL OF NONCANCER SKIN GROWTH OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 0.5 CM OR LESS	$698.60	$6,986.00	$448.00–$2,712.00	81% above	90%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$23.84	$238.44	$192.01–$1,173.00	89% below	90%
Nail removal (partial or complete), one nail CPT 11730 SIMPLE SEPARATION OF FINGERNAIL OR TOENAIL FROM NAIL BED; FIRST NAIL	$158.40	$1,584.00	$192.01–$1,173.00	28% below	90%
Nail removal (partial or complete), one nail one side CPT 11730 SIMPLE SEPARATION OF FINGERNAIL OR TOENAIL FROM NAIL BED; FIRST NAIL	$158.40	$1,584.00	$192.01–$1,173.00	28% below	90%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION OF ANESTHETIC AGENT AND/OR STEROID INTO UPPER NECK AND BACK OF HEAD NERVE	$101.80	$1,018.00	$293.77–$1,173.00	73% below	90%
Pacemaker implant (dual chamber) CPT 33208 INSRT HEART PM ATRIAL & VENT	$1,271.77	$12,717.70	$448.00–$46,346.00	86% below	90%
Pacemaker implant (dual chamber) CPT 33208 INSERTION OF PACEMAKER AND UPPER AND LOWER HEART CHAMBER ELECTRODE	$2,382.00	$23,820.00	$448.00–$46,346.00	74% below	90%
Paracentesis with imaging guidance CPT 49083 DRAINAGE OF FLUID FROM ABDOMINAL CAVITY USING IMAGING GUIDANCE	$159.80	$1,598.00	$448.00–$3,821.00	83% below	90%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PERMANENT REMOVAL FINGERNAIL OR TOENAIL	$110.80	$1,108.00	$389.05–$1,173.00	74% below	90%
Prostate biopsy CPT 55700 BIOPSY OF PROSTATE GLAND	$551.30	$5,513.00	$448.00–$1,311.00	83% below	90%
Prostate removal (prostatectomy), laparoscopic CPT 55866 SURGICAL REMOVAL OF PROSTATE AND SURROUNDING LYMPH NODES USING AN ENDOSCOPE	$2,070.37	$20,703.66	$448.00–$33,508.00	90% below	90%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$453.97	$4,539.74	$448.00–$6,370.41	72% below	90%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$1,601.90	$16,019.00	$448.00–$9,389.00	1% below	90%
Removal of a breast lump, open surgery one side CPT 19120 REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$533.97	$5,339.66	$448.00–$9,389.00	67% below	90%
Removal of a breast lump, open surgery one side CPT 19120 REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$1,906.45	$19,064.51	$448.00–$9,389.00	18% above	90%
Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL	$47.49	$474.90	$389.05–$1,173.00	87% below	90%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE	$123.20	$1,232.00	$389.05–$1,173.00	66% below	90%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 REMOVAL OF THYROID LOBE ON SIDE OF NECK	$3,013.50	$30,135.00	$448.00–$11,062.00	73% below	90%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 REMOVAL OF THYROID LOBE ON SIDE OF NECK	$2,603.30	$26,033.00	$448.00–$11,062.00	77% below	90%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 REMOVAL OF THYROID LOBE ON SIDE OF NECK	$3,812.90	$38,129.00	$448.00–$11,062.00	66% below	90%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$108.85	$1,088.51	$448.00–$2,712.00	92% below	90%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$374.00	$3,740.00	$448.00–$2,712.00	72% below	90%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN; HI RISK IND	$108.85	$1,088.51	$448.00–$2,712.00	92% below	90%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK	$374.00	$3,740.00	$448.00–$2,712.00	73% below	90%
Septoplasty to straighten the nasal septum CPT 30520 RESHAPING OF NASAL CARTILAGE	$517.59	$5,175.91	$448.00–$9,389.00	86% below	90%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 SHOCK WAVE CRUSHING OF KIDNEY STONES	$4,419.90	$44,199.00	$448.00–$11,062.00	54% below	90%
Shock-wave lithotripsy to break up kidney stones (from outside the body) one side CPT 50590 SHOCK WAVE CRUSHING OF KIDNEY STONES	$4,419.90	$44,199.00	$448.00–$11,062.00	54% below	90%
Shock-wave lithotripsy to break up kidney stones (from outside the body) one side CPT 50590 SHOCK WAVE CRUSHING OF KIDNEY STONES	$4,419.90	$44,199.00	$448.00–$11,062.00	54% below	90%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST	$31.99	$319.85	$267.68–$455.06	87% below	90%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF ELBOW TO FINGER CAST	$83.50	$835.00	$267.68–$455.06	66% below	90%
Short arm cast (elbow to hand) one side CPT 29075 APPLICATION OF ELBOW TO FINGER CAST	$83.50	$835.00	$267.68–$455.06	66% below	90%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT	$22.40	$224.00	$127.33–$448.00	84% below	90%
Short arm splint (forearm and hand) one side CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT	$22.40	$224.00	$127.33–$448.00	84% below	90%
Short arm splint (forearm and hand) one side CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT	$22.40	$224.00	$127.33–$448.00	84% below	90%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST	$31.99	$319.85	$80.00–$455.06	82% below	90%
Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST	$100.10	$1,001.00	$267.68–$455.06	43% below	90%
Short leg cast (below the knee) one side CPT 29405 APPLICATION OF SHORT LEG CAST	$100.10	$1,001.00	$267.68–$455.06	43% below	90%
Short leg cast (below the knee) one side CPT 29405 APPLICATION OF SHORT LEG CAST	$115.10	$1,151.00	$267.68–$455.06	34% below	90%
Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT	$45.30	$453.00	$155.52–$448.00	77% below	90%
Short leg splint (calf to foot) one side CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT	$45.30	$453.00	$155.52–$448.00	77% below	90%
Short leg splint (calf to foot) one side CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT	$45.30	$453.00	$155.52–$448.00	77% below	90%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 PARTIAL REMOVAL OF COLLAR BONE AT SHOULDER USING AN ENDOSCOPE	$2,306.15	$23,061.52	$448.00–$11,062.00	68% below	90%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) one side CPT 29824 PARTIAL REMOVAL OF COLLAR BONE AT SHOULDER USING AN ENDOSCOPE	$953.23	$9,532.25	$448.00–$11,062.00	87% below	90%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) one side CPT 29824 PARTIAL REMOVAL OF COLLAR BONE AT SHOULDER USING AN ENDOSCOPE	$1,506.75	$15,067.50	$448.00–$11,062.00	79% below	90%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$768.72	$7,687.16	$140.06–$2,440.00	92% below	90%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$476.61	$4,766.12	$140.06–$2,440.00	95% below	90%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$1,506.75	$15,067.50	$140.06–$2,440.00	85% below	90%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$158.40	$1,584.00	$192.01–$1,173.00	20% below	90%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$47.49	$474.90	$389.05–$2,440.00	86% below	90%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH	$61.90	$619.00	$389.05–$2,440.00	82% below	90%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM/<	$83.80	$837.95	$448.00–$1,173.00	74% below	90%
Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15	$23.84	$238.44	$192.01–$1,173.00	85% below	90%
Spinal tap (lumbar puncture), diagnostic CPT 62270 REMOVAL OF CEREBROSPINAL FLUID WITH LOWER BACK SPINAL TAP FOR DIAGNOSTIC TEST	$229.60	$2,296.00	$448.00–$1,173.00	63% below	90%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM	$158.40	$1,584.00	$192.01–$448.00	26% below	90%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs one side CPT 12002 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM	$158.40	$1,584.00	$192.01–$448.00	26% below	90%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SURFACE WOUND OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 2.5 CM OR LESS	$158.40	$1,584.00	$192.01–$448.00	14% below	90%
TURP (transurethral resection of the prostate) CPT 52601 REMOVAL OF PROSTATE GLAND USING AN ELECTROCAUTERY KNIFE THROUGH URETHRA WITH CONTROL OF BLEEDING USING AN ENDOSCOPE	$1,601.90	$16,019.00	$448.00–$10,550.00	66% below	90%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY OF RELATED SKIN GROWTH; FIRST GROWTH	$58.20	$582.00	$389.05–$1,173.00	79% below	90%
Thoracentesis with imaging guidance CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE	$291.40	$2,914.00	$448.00–$2,712.00	57% below	90%
Thoracentesis with imaging guidance one side CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE	$255.60	$2,556.00	$448.00–$1,173.00	63% below	90%
Thoracentesis with imaging guidance one side CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE	$291.40	$2,914.00	$448.00–$2,712.00	57% below	90%
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS)	$698.60	$6,986.00	$448.00–$9,631.54	85% below	90%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS (12 YEARS OR OLDER)	$1,601.90	$16,019.00	$448.00–$9,389.00	51% below	90%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS (YOUNGER THAN 12 YEARS)	$533.97	$5,339.66	$448.00–$9,631.54	83% below	90%
Total hip replacement one side CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$5,486.00	$54,860.00	$448.00–$33,508.00	63% below	90%
Total hip replacement one side CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$8,808.50	$88,085.00	$448.00–$33,508.00	41% below	90%
Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY	$2,663.80	$26,638.00	$448.00–$20,888.51	90% below	90%
Total knee replacement CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$6,593.50	$65,935.00	$448.00–$33,508.00	74% below	90%
Total knee replacement one side CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$4,378.50	$43,785.00	$448.00–$33,508.00	83% below	90%
Total knee replacement one side CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$5,486.00	$54,860.00	$448.00–$33,508.00	79% below	90%
Total shoulder replacement CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER	$5,486.00	$54,860.00	$448.00–$33,508.00	76% below	90%
Total shoulder replacement one side CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER	$4,378.50	$43,785.00	$448.00–$33,508.00	81% below	90%
Total shoulder replacement one side CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER	$5,486.00	$54,860.00	$448.00–$33,508.00	76% below	90%
Total thyroid removal (thyroidectomy) CPT 60240 REMOVAL OF THYROID	$6,211.10	$62,111.00	$448.00–$11,062.00	31% below	90%
Trigger finger release surgery CPT 26055 INCISION OF TENDON COVERING OF FINGER	$1,047.90	$10,479.00	$448.00–$3,821.00	24% below	90%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES	$128.50	$1,285.00	$293.77–$2,440.00	51% below	90%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES	$1,506.75	$15,067.50	$293.77–$2,440.00	471% above	90%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING ULTRASOUND; FIRST GROWTH	$305.30	$3,053.00	$448.00–$3,821.00	83% below	90%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING ULTRASOUND; FIRST GROWTH	$305.30	$3,053.00	$448.00–$3,821.00	83% below	90%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING ULTRASOUND; FIRST GROWTH	$473.33	$4,733.34	$448.00–$3,821.00	74% below	90%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH EGD DILATION <30 MM	$226.62	$2,266.24	$448.00–$3,821.00	87% below	90%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 BALLOON DILATION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE; LESS THAN 3.0 CM	$783.70	$7,837.00	$448.00–$3,821.00	56% below	90%
Upper endoscopy (EGD) with biopsy CPT 43239 BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$398.30	$3,983.00	$448.00–$3,821.00	63% below	90%
Upper endoscopy (EGD) with injection into the lining CPT 43236 INJECTION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$401.20	$4,012.00	$448.00–$3,821.00	74% below	90%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE	$226.62	$2,266.24	$448.00–$3,821.00	90% below	90%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 REMOVAL OF POLYPS OR GROWTHS OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$783.70	$7,837.00	$448.00–$3,821.00	64% below	90%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 INSERTION OF GUIDE WIRE WITH DILATION OF ESOPHAGUS USING A FLEXIBLE ENDOSCOPE	$371.50	$3,715.00	$448.00–$3,821.00	73% below	90%
Upper endoscopy (EGD), diagnostic CPT 43235 DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$401.20	$4,012.00	$448.00–$3,821.00	65% below	90%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 EGD W/TRANSMURAL DRAIN CYST	$678.77	$6,787.74	$448.00–$9,877.34	88% below	90%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 DRAINAGE OF FLUID COLLECTION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,594.10	$25,941.00	$448.00–$9,877.34	53% below	90%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CRUSHING OF STONE OF URETER USING AN ENDOSCOPE	$2,446.50	$24,465.00	$448.00–$10,550.00	59% below	90%
Ureteroscopy with laser stone breaking (lithotripsy) one side CPT 52353 CRUSHING OF STONE OF URETER USING AN ENDOSCOPE	$1,563.20	$15,632.00	$448.00–$10,550.00	74% below	90%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN ENDOSCOPE	$3,013.50	$30,135.00	$448.00–$10,550.00	74% below	90%
Ureteroscopy with laser stone breaking and stent placement one side CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN ENDOSCOPE	$2,214.10	$22,141.00	$448.00–$10,550.00	81% below	90%
Ureteroscopy with laser stone breaking and stent placement one side CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN ENDOSCOPE	$2,214.10	$22,141.00	$448.00–$10,550.00	81% below	90%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S)	$242.58	$2,425.83	$448.00–$3,401.05	62% below	90%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT	$1,047.90	$10,479.00	$448.00–$9,389.00	64% above	90%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14	$23.84	$238.44	$192.01–$1,173.00	85% below	90%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF SKIN GROWTH; 1-14 GROWTHS	$54.70	$547.00	$192.01–$1,173.00	66% below	90%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS	$147.00	$1,470.00	$389.05–$1,311.00	69% below	90%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 TREATMENT OF BROKEN FOREARM BONE ON THUMB SIDE OF WRIST; ABOVE WRIST; WITH PLACEMENT OF STABILIZING DEVICE	$2,214.10	$22,141.00	$448.00–$11,805.84	84% below	90%
Wrist fracture surgery (plate and screws), distal radius one side CPT 25607 TREATMENT OF BROKEN FOREARM BONE ON THUMB SIDE OF WRIST; ABOVE WRIST; WITH PLACEMENT OF STABILIZING DEVICE	$1,004.50	$10,045.00	$448.00–$11,805.84	93% below	90%
Wrist fracture surgery (plate and screws), distal radius one side CPT 25607 TREATMENT OF BROKEN FOREARM BONE ON THUMB SIDE OF WRIST; ABOVE WRIST; WITH PLACEMENT OF STABILIZING DEVICE	$3,013.50	$30,135.00	$448.00–$11,805.84	78% below	90%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD PRODUCTS	$194.90	$1,949.00	$107.00–$1,173.00	73% below	90%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION	$2,214.10	$22,141.00	$209.58–$448.00	1577% above	90%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$25.40	$254.03	—	—	90%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION	$44.90	$449.00	—	—	90%
Chemotherapy IV infusion, first hour CPT 96413 ADMINISTRATION OF CHEMOTHERAPY INTO VEIN; 1 HOUR OR LESS	$101.00	$1,010.00	$316.12–$1,603.00	73% below	90%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE; FIRST 30-74 MINUTES	$925.80	$9,258.00	$448.00–$1,500.00	24% below	90%
EEG (brain wave test), awake and drowsy, routine CPT 95816 MEASUREMENT OF BRAIN WAVE ACTIVITY (EEG); AWAKE AND DROWSY	$205.00	$2,050.00	$206.65–$1,175.00	62% below	90%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING	$53.20	$532.00	$56.46–$448.00	59% below	90%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD SEVERITY	$61.50	$615.00	$80.70–$1,500.00	62% below	90%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY	$94.60	$946.00	$146.95–$1,500.00	70% below	90%
Emergency room visit, level 2 of 5, straightforward problem one side CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY	$99.30	$993.00	$146.95–$1,500.00	68% below	90%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$189.80	$1,898.00	$261.25–$1,382.00	64% below	90%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$346.00	$3,460.00	$399.34–$3,451.00	54% below	90%
Emergency room visit, level 4 of 5, moderate-complexity problem one side CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$363.30	$3,633.00	$399.34–$3,451.00	52% below	90%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$679.50	$6,795.00	$448.00–$4,139.00	41% below	90%
Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE OR DRUG-INDUCED HEART STRESS TEST WITH ELECTROCARDIOGRAM (ECG)	$217.30	$2,173.00	$206.65–$933.00	44% below	90%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 XTRNL ECG REC UP TO 48 HRS	$53.70	$537.00	$448.00–$725.00	30% below	90%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION INTO A VEIN FOR HYDRATION; 31-60 MINUTES	$56.90	$569.00	$203.57–$448.00	69% below	90%
IV infusion of a medicine, first hour CPT 96365 INFUSION INTO A VEIN FOR THERAPY; PREVENTION; OR DIAGNOSIS; 1 HOUR OR LESS	$47.80	$478.00	$203.57–$448.00	80% below	90%
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$25.53	$255.28	$203.57–$448.00	83% below	90%
IV push of a medicine, first drug CPT 96374 INJECTION OF DRUG OR SUBSTANCE INTO VEIN	$44.50	$445.00	$203.57–$448.00	70% below	90%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE	$11.90	$119.00	$68.91–$448.00	82% below	90%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION; 7-8 STUDIES	$101.80	$1,018.00	$357.13–$607.12	79% below	90%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION	$18.50	$185.00	$30.98–$448.00	74% below	90%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$26.50	$265.00	$68.93–$448.00	84% below	90%
New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30 MIN	$35.00	$350.00	$68.93–$448.00	79% below	90%
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$40.90	$409.00	$112.76–$448.00	82% below	90%
New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45 MIN	$44.00	$440.00	$112.76–$448.00	81% below	90%
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$43.30	$433.00	$154.28–$448.00	84% below	90%
New patient office visit, about 60 minutes CPT 99205 OFFICE O/P NEW HI 60 MIN	$52.00	$520.00	$154.28–$448.00	81% below	90%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 15-29 MINUTES	$23.40	$234.00	$39.74–$448.00	82% below	90%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN	$27.50	$275.00	$39.74–$448.00	79% below	90%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN	$12.50	$125.00	$25.42–$448.00	74% below	90%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 THERAPY PROCEDURE FOR NUTRITION MANAGEMENT; EACH 15 MINUTES	$49.00	$490.00	$25.42–$448.00	1% above	90%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$63.70	$637.00	$51.96–$448.00	43% below	90%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES	$65.40	$654.00	$51.96–$448.00	60% below	90%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$64.00	$640.00	$51.96–$448.00	43% below	90%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$63.60	$636.00	$51.96–$448.00	53% below	90%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS	$27.50	$275.00	$26.26–$448.00	60% below	90%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES	$21.80	$218.00	$27.52–$448.00	68% below	90%
Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW AGE 18-39	$45.10	$451.00	$448.00	55% below	90%
Preventive checkup, new patient aged 18–39 CPT 99385 INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (18-39 YEARS)	$59.40	$594.00	$448.00	41% below	90%
Preventive checkup, new patient aged 40–64 CPT 99386 PREV VISIT NEW AGE 40-64	$52.30	$523.00	$448.00	55% below	90%
Preventive checkup, new patient aged 40–64 CPT 99386 INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (40-64 YEARS)	$54.00	$540.00	$448.00	53% below	90%
Preventive checkup, new patient aged 65 or older CPT 99387 INIT PM E/M NEW PAT 65+ YRS	$56.90	$569.00	$448.00	50% below	90%
Preventive checkup, new patient aged 65 or older CPT 99387 INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (65 YEARS OR OLDER)	$58.30	$583.00	$448.00	49% below	90%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREV VISIT EST AGE 18-39	$40.80	$408.00	$448.00	51% below	90%
Preventive checkup, returning patient aged 18–39 CPT 99395 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (18-39 YEARS)	$46.20	$462.00	$448.00	44% below	90%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREV VISIT EST AGE 40-64	$43.30	$433.00	$448.00	55% below	90%
Preventive checkup, returning patient aged 40–64 CPT 99396 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (40-64 YEARS)	$46.20	$462.00	$448.00	52% below	90%
Preventive checkup, returning patient aged 65 or older CPT 99397 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (65 YEAR OLD OR OLDER)	$46.20	$462.00	$448.00	55% below	90%
Preventive checkup, returning patient aged 65 or older CPT 99397 PER PM REEVAL EST PAT 65+ YR	$46.60	$466.00	$448.00	55% below	90%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING AND TOBACCO USE INTENSIVE COUNSELING; 4-10 MINUTES	$16.60	$166.00	$35.86–$448.00	56% below	90%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 40-54 MINUTES	$43.50	$435.00	$121.35–$448.00	81% below	90%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE O/P EST HI 40 MIN	$46.00	$460.00	$121.35–$448.00	80% below	90%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$26.60	$266.00	$55.60–$448.00	80% below	90%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20 MIN	$31.00	$310.00	$55.60–$448.00	77% below	90%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30 MIN	$38.50	$385.00	$81.78–$448.00	78% below	90%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$41.10	$411.00	$81.78–$448.00	76% below	90%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 10-19 MINUTES	$25.10	$251.00	$30.01–$448.00	80% below	90%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN	$26.00	$260.00	$30.01–$448.00	79% below	90%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFF/OP CNSLTJ NEW/EST LOW 30	$26.30	$263.00	$448.00	72% below	90%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFF/OP CNSLTJ NEW/EST MOD 40	$29.10	$291.00	$448.00	70% below	90%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN	$90.50	$905.00	$51.96–$449.00	51% below	90%
Speech therapy session, individual CPT 92507 TX SP LANG VOICE COMM INDIV	$35.90	$359.00	$51.96–$449.00	71% below	90%
Spirometry (breathing test) CPT 94010 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME	$59.80	$598.00	$206.65–$611.00	72% below	90%
Spirometry before and after a bronchodilator CPT 94060 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME CHANGES BEFORE AND AFTER MEDICATION ADMINISTRATION	$110.70	$1,107.00	$357.13–$611.00	72% below	90%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPY PROCEDURE USING FUNCTIONAL ACTIVITIES	$12.50	$125.00	$32.85–$448.00	80% below	90%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES	$16.30	$163.00	$32.85–$448.00	73% below	90%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 DRAWING OF BLOOD FOR A MEDICAL PROBLEM	$119.70	$1,197.00	$127.33–$448.00	3% below	90%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM	$20.00	$200.00	$347.55–$448.00	83% below	90%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 Spikevax 2023-2024 Formula	$108.78	$1,087.80	—	—	90%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 Spikevax 2024-2025 Formula Ages 12 and up	$119.11	$1,191.12	—	—	90%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 Spikevax 2025-2026 Formula Ages 12 and up	$119.11	$1,191.12	—	—	90%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCV2 VAC 30MCG TRS-SUC IM	$39.60	$396.00	$335.19–$448.00	63% below	90%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Valu-Dryl Allergy	$39.60	$396.00	$335.19–$448.00	63% below	90%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Comirnaty 2025-2026 Age Over 65 / High Risk 12-64	$39.60	$396.00	$335.19–$448.00	63% below	90%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Comirnaty 2023-2024 Age 12 and older	$39.60	$396.00	$335.19–$448.00	63% below	90%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Comirnaty 2023-2024 Age 12 and older	$168.00	$1,680.00	—	—	90%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Comirnaty PFS 2024-2025 Age 12 and older	$191.45	$1,914.50	—	—	90%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Comirnaty 2025-2026 Age Over 65 / High Risk 12-64	$237.78	$2,377.82	—	—	90%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE	$52.30	$523.00	$448.00	81% below	90%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varivax	$52.30	$523.00	$448.00	81% below	90%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varivax	$80.64	$806.36	—	—	90%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VACCINE 4-6 YRS IM	$37.30	$373.00	$448.00	48% below	90%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 Kinrix	$47.64	$476.43	—	—	90%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 Quadracel	$55.89	$558.91	—	—	90%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VACCINE < 7 YRS IM	$8.60	$86.00	$448.00	87% below	90%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Infanrix	$11.20	$111.96	$448.00	83% below	90%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Daptacel	$12.18	$121.75	$448.00	82% below	90%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Infanrix	$23.32	$233.24	—	—	90%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Daptacel	$26.16	$261.61	—	—	90%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEP B-IPV VACCINE IM	$32.40	$324.00	$448.00	75% below	90%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Pediarix	$43.26	$432.58	$448.00	66% below	90%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 Pediarix	$86.52	$865.16	—	—	90%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IPV/HIB VACCINE IM	$23.00	$230.00	$448.00	70% below	90%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 Pentacel	$50.18	$501.75	$448.00	34% below	90%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 Pentacel-ActHIB Component	$44.33	$443.32	—	—	90%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 Pentacel	$44.33	$443.32	—	—	90%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 Pentacel-DTaP/IPV Component	$109.12	$1,091.20	—	—	90%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DTAP-IPV-HIB-HEPB VACCINE IM	$39.10	$391.00	$448.00	54% below	90%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 RIV3 VACCINE NO PRESERV IM	$17.30	$173.00	$179.50–$448.00	—	90%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE; TRIVALENT; SPLIT VIRUS; PRESERVATIVE-FREE; 0.5 ML DOSAGE	$7.70	$77.00	$48.05–$448.00	85% below	90%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone High-Dose 2025-2026 Formula	$7.70	$77.00	$48.05–$448.00	85% below	90%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone 2024-2025 Formula PFS	$7.70	$77.00	$48.05–$448.00	85% below	90%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Afluria 2025-2026 Formula PFS	$7.70	$77.00	$48.05–$448.00	85% below	90%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Afluria 2024-2025 Formula PFS	$7.70	$77.00	$48.05–$448.00	85% below	90%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone 2025-2026 Formula PFS	$7.70	$77.00	$48.05–$448.00	85% below	90%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Afluria 2016-2017 Formula	$10.97	$109.66	—	—	90%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Afluria 2018-2019 Formula	$14.57	$145.70	—	—	90%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FluLaval 2024-2025 Formula	$16.47	$164.68	—	—	90%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Fluarix 2024-2025 Formula	$16.47	$164.68	—	—	90%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Fluarix 2025-2026 Formula	$17.11	$171.06	—	—	90%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FluLaval 2025-2026 Formula	$17.11	$171.06	—	—	90%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Fluzone 2024-2025 Formula PFS	$17.27	$172.66	—	—	90%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Fluzone 2025-2026 Formula PFS	$17.43	$174.33	—	—	90%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Afluria 2024-2025 Formula PFS	$18.04	$180.35	—	—	90%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Afluria 2025-2026 Formula PFS	$18.74	$187.35	—	—	90%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Gardasil 9	$82.40	$824.00	$448.00	66% below	90%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9VHPV VACCINE 2/3 DOSE IM	$82.40	$824.00	$448.00	66% below	90%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Gardasil 9	$276.33	$2,763.31	—	—	90%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Twinrix	$38.80	$388.00	$448.00	77% below	90%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/HEP B VACC ADULT IM	$38.80	$388.00	$448.00	77% below	90%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 Twinrix	$47.08	$470.84	—	—	90%
Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM	$24.50	$245.00	$448.00	86% below	90%
Hepatitis A vaccine, adult dose CPT 90632 Havrix	$24.50	$245.00	$448.00	86% below	90%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Havrix	$30.92	$309.23	—	—	90%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Vaqta	$35.68	$356.83	—	—	90%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACCINE PEDIATRIC OR ADOLESCENT DOSAGE	$9.00	$90.00	$448.00	89% below	90%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Havrix Pediatric	$9.00	$90.00	$448.00	89% below	90%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPA VACC PED/ADOL 2 DOSE IM	$29.17	$291.66	—	—	90%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Havrix Pediatric	$31.82	$318.23	—	—	90%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Vaqta Pediatric	$33.49	$334.85	—	—	90%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE; ADULT DOSAGE (3 DOSE SCHEDULE)	$21.20	$212.00	$151.32–$448.00	78% below	90%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$21.20	$212.00	$151.32–$448.00	78% below	90%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Engerix-B	$21.20	$212.00	$151.32–$448.00	78% below	90%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Recombivax HB	$30.28	$302.77	$151.32–$448.00	68% below	90%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 Heplisav-B	$130.83	$1,308.30	—	—	90%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPB VACC 3 DOSE PED/ADOL IM	$9.50	$95.00	$66.16–$448.00	84% below	90%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Engerix-B	$12.23	$122.33	$66.16–$448.00	80% below	90%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPB VACC 3 DOSE PED/ADOL IM	$16.94	$169.40	—	—	90%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Engerix-B Pediatric	$16.94	$169.40	—	—	90%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Engerix-B	$25.19	$251.85	—	—	90%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIB PRP-OMP VACC 3 DOSE IM	$9.00	$90.00	$448.00	90% below	90%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ActHIB	$5.37	$53.74	$448.00	88% below	90%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Hiberix	$5.48	$54.77	$448.00	88% below	90%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB PRP-T VACCINE 4 DOSE IM	$53.20	$532.00	$448.00	15% above	90%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Hiberix	$5.33	$53.25	—	—	90%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HIB PRP-T VACCINE 4 DOSE IM	$5.33	$53.25	—	—	90%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 ActHIB	$5.79	$57.90	—	—	90%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone 2024-2025 Formula PFS	$32.40	$324.00	$179.50–$448.00	81% below	90%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM	$32.40	$324.00	$179.50–$448.00	81% below	90%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose 2024-2025 Formula	$32.40	$324.00	$179.50–$448.00	81% below	90%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Tenivac	$32.40	$324.00	$179.50–$448.00	81% below	90%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Valu-Dryl Allergy	$32.40	$324.00	$179.50–$448.00	81% below	90%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Ammonium Phosphate Dibasic	$32.40	$324.00	$179.50–$448.00	81% below	90%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose 2025-2026 Formula	$36.16	$361.64	$179.50–$448.00	79% below	90%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone High-Dose 2016-2017 Formula	$26.32	$263.21	—	—	90%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone High-Dose Quadrivalent 2020-2021 Formula	$32.10	$320.95	—	—	90%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone High-Dose Quadrivalent 2021-2022 Formula	$34.35	$343.48	—	—	90%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone High-Dose Quadrivalent 2022-2023 Formula	$36.81	$368.11	—	—	90%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone High-Dose Quadrivalent 2023-2024 Formula	$38.63	$386.33	—	—	90%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone High-Dose 2018-2019 Formula	$39.33	$393.27	—	—	90%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone High-Dose 2019-2020 Formula	$41.27	$412.68	—	—	90%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone High-Dose 2024-2025 Formula	$61.52	$615.20	—	—	90%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone High-Dose 2025-2026 Formula	$72.33	$723.28	—	—	90%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II	$30.70	$307.00	$448.00	81% below	90%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES; MUMPS; AND RUBELLA VACCINE	$30.70	$307.00	$448.00	81% below	90%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II	$41.00	$409.98	—	—	90%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Priorix	$41.00	$409.98	—	—	90%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV VACCINE SC	$86.60	$866.00	$448.00	53% below	90%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 ProQuad	$121.24	$1,212.41	—	—	90%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menactra	$36.70	$367.00	$448.00	77% below	90%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWYCRM VACC IM	$36.70	$367.00	$448.00	77% below	90%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MenQuadfi	$36.70	$367.00	$448.00	77% below	90%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menveo	$69.98	$699.81	$448.00	56% below	90%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Menveo	$74.17	$741.65	—	—	90%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Menactra	$124.84	$1,248.44	—	—	90%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENACWY-TT VACCINE IM	$70.10	$0.01	$448.00	67% below	-700900%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MenQuadfi	$72.18	$721.76	$448.00	66% below	90%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MenQuadfi	$148.67	$1,486.67	—	—	90%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Bexsero	$210.99	$2,109.94	—	—	90%
Meningococcal B vaccine (Trumenba) CPT 90621 MENB-FHBP VACC 2/3 DOSE IM	$47.00	$470.00	$448.00	—	90%
Meningococcal B vaccine (Trumenba) CPT 90621 Trumenba	$79.88	$798.75	$448.00	—	90%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 Trumenba	$189.66	$1,896.59	—	—	90%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule inpatient CPT 90611 Jynneos	$235.87	$2,358.72	—	—	90%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PCV13 VACCINE IM	$95.00	$0.01	$448.00–$554.68	65% below	-949900%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Prevnar 13	$196.04	$1,960.42	—	—	90%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL CONJUGATE VACCINE; 20 VALENT (PCV20); FOR INTRAMUSCULAR USE	$158.90	$1,589.00	$448.00–$640.79	79% below	90%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Valu-Dryl Allergy	$158.90	$1,589.00	$448.00–$640.79	79% below	90%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE IM	$158.90	$1,589.00	$448.00–$640.79	79% below	90%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20	$158.90	$1,589.00	$448.00–$640.79	79% below	90%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumovax 23	$158.90	$1,589.00	$448.00–$640.79	79% below	90%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Pneumovax 23	$98.35	$983.48	—	—	90%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Prevnar 20	$113.25	$1,132.46	—	—	90%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 Gardasil 9	$98.40	$984.00	$448.00–$704.96	76% below	90%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PCV21 VACCINE IM	$98.40	$984.00	$448.00–$704.96	76% below	90%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 Capvaxive	$98.40	$984.00	$448.00–$704.96	76% below	90%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 PCV21 VACCINE IM	$253.66	$2,536.59	—	—	90%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 Capvaxive	$253.66	$2,536.59	—	—	90%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Prevnar 20	$35.50	$355.00	$286.96–$448.00	79% below	90%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$35.50	$355.00	$286.96–$448.00	79% below	90%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23	$49.17	$491.74	$286.96–$448.00	70% below	90%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumovax 23	$98.35	$983.48	—	—	90%
Polio vaccine, inactivated (IPV) CPT 90713 Ipol	$18.74	$187.35	$448.00	71% below	90%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS IPV SC/IM	$26.75	$267.46	—	—	90%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 Ipol	$30.88	$308.79	—	—	90%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 Beyfortus	$249.93	$2,499.25	—	—	90%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Beyfortus	$499.85	$4,998.52	—	—	90%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACC PREF BIVALENT IM	$106.20	$1,062.00	$448.00	76% below	90%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 Abrysvo	$106.20	$1,062.00	$448.00	76% below	90%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 Abrysvo	$134.01	$1,340.09	—	—	90%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 Arexvy	$1,176.00	$11,760.00	—	—	90%
Rabies vaccine, one dose CPT 90675 RabAvert	$173.84	$1,738.42	$319.75–$704.73	72% below	90%
Rabies vaccine, one dose CPT 90675 Imovax Rabies	$189.49	$1,894.87	$319.75–$704.73	69% below	90%
Rabies vaccine, one dose inpatient CPT 90675 RabAvert	$159.20	$1,591.98	—	—	90%
Rabies vaccine, one dose inpatient CPT 90675 Imovax Rabies	$170.17	$1,701.70	—	—	90%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE IM	$182.54	$1,825.36	—	—	90%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 RV1 VACC 2 DOSE LIVE ORAL	$43.50	$435.00	$448.00	53% below	90%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 Rotarix	$43.50	$435.00	$448.00	53% below	90%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 RV5 VACC 3 DOSE LIVE ORAL	$13.70	$137.00	$448.00	87% below	90%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 RotaTeq	$21.55	$215.50	—	—	90%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Shingrix	$98.57	$985.69	—	—	90%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tenivac	$16.83	$168.25	$448.00	80% below	90%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus and Diphtheria Toxoids Adsorbed	$15.64	$156.37	—	—	90%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TDVAX	$23.51	$235.07	—	—	90%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tenivac	$38.36	$383.57	—	—	90%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Infanrix	$12.27	$122.71	$448.00	86% below	90%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Daptacel	$12.63	$126.25	$448.00	85% below	90%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM	$13.30	$133.00	$448.00	84% below	90%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tenivac	$13.30	$133.00	$448.00	84% below	90%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix	$13.30	$133.00	$448.00	84% below	90%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Adacel	$20.53	$205.25	$448.00	76% below	90%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Boostrix	$33.33	$333.27	—	—	90%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE 7 YRS/> IM	$37.32	$373.17	—	—	90%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Adacel	$42.59	$425.91	—	—	90%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 Typhim Vi	$70.82	$708.19	—	—	90%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$8.39	$83.90	$68.91–$448.00	85% below	90%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE	$27.00	$270.00	$68.91–$448.00	52% below	90%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMINISTRATION OF VACCINE; EACH ADDITIONAL VACCINE	$13.50	$135.00	$232.00–$448.00	55% below	90%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD	$14.20	$142.00	$232.00–$448.00	52% below	90%

Dental

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACTION; ERUPTED TOOTH OR EXPOSED ROOT (ELEVATION AND/OR FORCEPS REMOVAL)	$1,157.90	$11,579.00	$448.00–$1,051.82	—	90%

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://apim.services.craneware.com/api-pricing-transparency/api/public/ebdcd27316bbcd47fb02c60d601d05cc/charges/mrf