Hospital Kennewick-Richland, WA

Kadlec Regional Medical Center

Kadlec Regional Medical Center in Richland, WA publishes cash prices for 383 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Washington median for 281 of 380 procedures and below it for 98. By typical cash price it ranks #46 of 60 Washington hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

888 Swift Blvd, Richland, WA 99352,3290 W 19th Ave, Kennewick, WA 99337 Collected Sep 23, 2026 Source price file Check a bill from this hospital (509) 946-4611

Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 500058 · CMS hospital register NPI 1972507580

Financial assistance

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

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

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

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

State law

This state limits hospital bills for lower-income patients

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W & W/O CONTRAST	$1,909.60	$2,728.00	—	8% below	30%
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W & W/O CONTRAST	$2,121.00	$3,030.00	—	2% above	30%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W & W/O CONTRAST	$2,121.00	$3,030.00	—	—	30%
Abdominal X-ray, 2 views CPT 74019 HC XR ABDOMEN 2 VIEWS	$375.20	$536.00	—	16% above	30%
Abdominal X-ray, 2 views CPT 74019 HC XR ABDOMEN 2 VIEWS	$377.30	$539.00	—	16% above	30%
Abdominal X-ray, 2 views inpatient CPT 74019 HC XR ABDOMEN 2 VIEWS	$377.30	$539.00	—	—	30%
Ankle X-ray, complete, 3 or more views CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS	$438.90	$627.00	—	41% above	30%
Ankle X-ray, complete, 3 or more views CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS	$487.90	$697.00	—	57% above	30%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS	$487.90	$697.00	—	—	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$1,621.20	$2,316.00	—	330% above	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$1,621.20	$2,316.00	—	—	30%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$1,287.30	$1,839.00	—	9% below	30%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$1,430.80	$2,044.00	—	1% above	30%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$1,430.80	$2,044.00	—	—	30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XR ESOPHAGUS W CONTRAST	$676.90	$967.00	—	11% above	30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XR ESOPHAGUS W CONTRAST	$752.50	$1,075.00	—	24% above	30%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC XR ESOPHAGUS W CONTRAST	$752.50	$1,075.00	—	—	30%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE AND OR JOINT IMAGING WHOLE BODY CDM	$1,094.10	$1,563.00	—	27% below	30%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE AND OR JOINT IMAGING WHOLE BODY CDM	$1,216.60	$1,738.00	—	18% below	30%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE AND OR JOINT IMAGING WHOLE BODY CDM	$1,216.60	$1,738.00	—	—	30%
Breast ultrasound, complete, one breast CPT 76641 HC US BREAST UNI COMPLETE	$669.90	$957.00	—	55% above	30%
Breast ultrasound, complete, one breast CPT 76641 HC US BREAST UNI COMPLETE	$744.10	$1,063.00	—	72% above	30%
Breast ultrasound, complete, one breast inpatient CPT 76641 HC US BREAST UNI COMPLETE	$744.10	$1,063.00	—	—	30%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US BREAST UNI LIMITED	$362.60	$518.00	—	7% above	30%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US ED BREAST UNI LIMITED CDM	$373.10	$533.00	—	10% above	30%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US BREAST UNI LIMITED	$403.20	$576.00	—	19% above	30%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US ED BREAST UNI LIMITED CDM	$373.10	$533.00	—	—	30%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US BREAST UNI LIMITED	$403.20	$576.00	—	—	30%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN PELVIS	$4,560.50	$6,515.00	—	27% above	30%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN PELVIS	$5,067.30	$7,239.00	—	41% above	30%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CTA ABDOMEN PELVIS	$5,067.30	$7,239.00	—	—	30%
CT angiography (CTA) of the head CPT 70496 HC CT ANGIOGRAPHY HEAD W CONTRAST	$2,510.20	$3,586.00	—	19% above	30%
CT angiography (CTA) of the head CPT 70496 HC CT ANGIOGRAPHY HEAD W CONTRAST	$2,788.80	$3,984.00	—	32% above	30%
CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIOGRAPHY HEAD W CONTRAST	$2,788.80	$3,984.00	—	—	30%
CT angiography (CTA) of the neck CPT 70498 HC CT ANGIOGRAPHY NECK W CONTRAST	$2,510.20	$3,586.00	—	11% above	30%
CT angiography (CTA) of the neck CPT 70498 HC CT ANGIOGRAPHY NECK W CONTRAST	$2,788.80	$3,984.00	—	24% above	30%
CT angiography (CTA) of the neck inpatient CPT 70498 HC CT ANGIOGRAPHY NECK W CONTRAST	$2,788.80	$3,984.00	—	—	30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST	$2,339.40	$3,342.00	—	3% below	30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST	$2,599.80	$3,714.00	—	8% above	30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIOGRAPHY CHEST	$2,599.80	$3,714.00	—	—	30%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CCTA HEART ARTERIES/GRAFTS W/3D IMAGE W/ CONTRAST	$1,656.20	$2,366.00	—	42% above	30%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CCTA HEART ARTERIES/GRAFTS W/3D IMAGE W/ CONTRAST	$1,839.60	$2,628.00	—	58% above	30%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CCTA HEART ARTERIES/GRAFTS W/3D IMAGE W/ CONTRAST	$1,839.60	$2,628.00	—	—	30%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CCTA HEART W/ CALCIUM SCORING W/O CONTRAST	$76.30	$109.00	—	43% below	30%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CCTA HEART W/ CALCIUM SCORING W/O CONTRAST	$76.30	$109.00	—	43% below	30%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CCTA HEART W/ CALCIUM SCORING W/O CONTRAST	$76.30	$109.00	—	—	30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$2,693.60	$3,848.00	—	7% above	30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$2,993.20	$4,276.00	—	19% above	30%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$2,993.20	$4,276.00	—	—	30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$3,344.60	$4,778.00	—	8% above	30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$3,716.30	$5,309.00	—	20% above	30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$3,716.30	$5,309.00	—	—	30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST	$3,818.50	$5,455.00	—	3% above	30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST	$4,242.70	$6,061.00	—	14% above	30%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST	$4,242.70	$6,061.00	—	—	30%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST	$1,672.30	$2,389.00	—	11% below	30%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST	$1,857.80	$2,654.00	—	1% below	30%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W CONTRAST	$1,857.80	$2,654.00	—	—	30%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST	$1,346.80	$1,924.00	—	6% below	30%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST	$1,497.30	$2,139.00	—	4% above	30%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN WO CONTRAST	$1,497.30	$2,139.00	—	—	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL W/O DYE LIMITED	$1,355.20	$1,936.00	—	23% above	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$1,365.00	$1,950.00	—	24% above	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL W/O DYE LIMITED	$1,365.00	$1,950.00	—	24% above	30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL W/O DYE LIMITED	$1,365.00	$1,950.00	—	—	30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$1,365.00	$1,950.00	—	—	30%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN WO CONTRAST	$1,335.60	$1,908.00	—	at median	30%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN WO CONTRAST	$1,484.00	$2,120.00	—	11% above	30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN WO CONTRAST	$1,484.00	$2,120.00	—	—	30%
CT scan of the head with contrast CPT 70460 HC CT HEAD/BRAIN W CONTRAST	$1,390.90	$1,987.00	—	5% below	30%
CT scan of the head with contrast CPT 70460 HC CT HEAD/BRAIN W CONTRAST	$1,545.60	$2,208.00	—	6% above	30%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD/BRAIN W CONTRAST	$1,545.60	$2,208.00	—	—	30%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST	$1,971.90	$2,817.00	—	14% above	30%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST	$2,191.70	$3,131.00	—	27% above	30%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST	$2,191.70	$3,131.00	—	—	30%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$1,534.40	$2,192.00	—	7% above	30%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$1,704.50	$2,435.00	—	19% above	30%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$1,704.50	$2,435.00	—	—	30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT NECK SPINE WO CONTRAST	$1,644.30	$2,349.00	—	10% above	30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT NECK SPINE WO CONTRAST	$1,826.30	$2,609.00	—	22% above	30%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT NECK SPINE WO CONTRAST	$1,826.30	$2,609.00	—	—	30%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST	$1,672.30	$2,389.00	—	7% below	30%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST	$1,857.80	$2,654.00	—	3% above	30%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST	$1,857.80	$2,654.00	—	—	30%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$868.70	$1,241.00	—	—	30%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$966.00	$1,380.00	—	—	30%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$966.00	$1,380.00	—	—	30%
Chest CT scan without and with contrast CPT 71270 HC CT THORAX W & W/O CONTRAST	$1,909.60	$2,728.00	—	8% below	30%
Chest CT scan without and with contrast CPT 71270 HC CT THORAX W & W/O CONTRAST	$2,121.00	$3,030.00	—	2% above	30%
Chest CT scan without and with contrast inpatient CPT 71270 HC CT THORAX W & W/O CONTRAST	$2,121.00	$3,030.00	—	—	30%
Chest X-ray, 2 views CPT 71046 HC XR CHEST 2 VIEWS	$567.00	$810.00	—	96% above	30%
Chest X-ray, 2 views CPT 71046 HC XR CHEST 2 VIEWS	$628.60	$898.00	—	117% above	30%
Chest X-ray, 2 views inpatient CPT 71046 HC XR CHEST 2 VIEWS	$628.60	$898.00	—	—	30%
Chest X-ray, single view CPT 71045 HC XR CHEST 1 VIEW	$386.40	$552.00	—	61% above	30%
Chest X-ray, single view CPT 71045 HC XR CHEST PORTABLE 1 VIEW	$429.80	$614.00	—	79% above	30%
Chest X-ray, single view CPT 71045 HC XR CHEST 1 VIEW	$429.80	$614.00	—	79% above	30%
Chest X-ray, single view inpatient CPT 71045 HC XR CHEST 1 VIEW	$429.80	$614.00	—	—	30%
Chest X-ray, single view inpatient CPT 71045 HC XR CHEST PORTABLE 1 VIEW	$429.80	$614.00	—	—	30%
Collarbone (clavicle) X-ray, complete CPT 73000 HC XR CLAVICLE COMPLETE	$363.30	$519.00	—	32% above	30%
Collarbone (clavicle) X-ray, complete CPT 73000 HC XR CLAVICLE COMPLETE	$403.20	$576.00	—	47% above	30%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC XR CLAVICLE COMPLETE	$403.20	$576.00	—	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$808.50	$1,155.00	—	30% above	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$897.40	$1,282.00	—	45% above	30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE	$897.40	$1,282.00	—	—	30%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC XR DXA BONE DENSITY STUDY AXIAL	$605.50	$865.00	—	44% above	30%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC XR DXA BONE DENSITY STUDY AXIAL	$672.70	$961.00	—	60% above	30%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC XR DXA BONE DENSITY STUDY AXIAL	$672.70	$961.00	—	—	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC PR 77081 DXA BONE DENSITY STUDY 1/GT SITES APPENDICLR SKEL	$137.20	$196.00	—	21% below	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC PR 77081 DXA BONE DENSITY STUDY 1/GT SITES APPENDICLR SKEL	$219.80	$314.00	—	27% above	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC BONE DENSITY PERIPHERAL SKELETON	$241.50	$345.00	—	39% above	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC BONE DENSITY PERIPHERAL SKELETON	$268.80	$384.00	—	55% above	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC PR 77081 DXA BONE DENSITY STUDY 1/GT SITES APPENDICLR SKEL	$219.80	$314.00	—	—	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC BONE DENSITY PERIPHERAL SKELETON	$268.80	$384.00	—	—	30%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US OB DETAILED SINGLE FETUS CDM	$833.00	$1,190.00	—	17% above	30%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US OB DETAILED SINGLE FETUS CDM	$833.00	$1,190.00	—	—	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX WO CONTRAST	$1,357.30	$1,939.00	—	9% below	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX WO CONTRAST	$1,509.20	$2,156.00	—	1% above	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX W/O DYE F/U LUNG SCREENING	$1,509.20	$2,156.00	—	1% above	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX WO CONTRAST	$1,509.20	$2,156.00	—	—	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX W/O DYE F/U LUNG SCREENING	$1,509.20	$2,156.00	—	—	30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W CONTRAST	$1,684.20	$2,406.00	—	11% below	30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W CONTRAST	$1,871.10	$2,673.00	—	1% below	30%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT THORAX W CONTRAST	$1,871.10	$2,673.00	—	—	30%
Diagnostic mammogram, both breasts CPT 77066 HC MAMMO DIAG BIL W CAD	$635.60	$908.00	—	41% above	30%
Diagnostic mammogram, both breasts CPT 77066 HC MAMMO DIAG BIL W CAD	$705.60	$1,008.00	—	56% above	30%
Diagnostic mammogram, both breasts inpatient CPT 77066 HC MAMMO DIAG BIL W CAD	$705.60	$1,008.00	—	—	30%
Diagnostic mammogram, one breast CPT 77065 HC MAMMO DIAG UNI W CAD	$413.70	$591.00	—	8% above	30%
Diagnostic mammogram, one breast CPT 77065 HC MAMMO DIAG UNI W CAD	$459.20	$656.00	—	19% above	30%
Diagnostic mammogram, one breast inpatient CPT 77065 HC MAMMO DIAG UNI W CAD	$459.20	$656.00	—	—	30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$1,131.90	$1,617.00	—	—	30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$1,257.90	$1,797.00	—	—	30%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$1,257.90	$1,797.00	—	—	30%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY	$1,535.10	$2,193.00	—	—	30%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY	$1,535.10	$2,193.00	—	—	30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO TTE 2D W DOPPLER COMPLETE	$1,823.50	$2,605.00	—	9% above	30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO TTE 2D W DOPPLER COMPLETE	$2,026.50	$2,895.00	—	21% above	30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO TTE 2D W DOPPLER COMPLETE	$2,026.50	$2,895.00	—	—	30%
Elbow X-ray, 2 views CPT 73070 HC XR ELBOW LIMITED	$359.10	$513.00	—	34% above	30%
Elbow X-ray, 2 views CPT 73070 HC XR ELBOW 2 VIEWS	$366.10	$523.00	—	36% above	30%
Elbow X-ray, 2 views CPT 73070 HC XR ELBOW 2 VIEWS	$406.70	$581.00	—	51% above	30%
Elbow X-ray, 2 views CPT 73070 HC XR ELBOW LIMITED	$406.70	$581.00	—	51% above	30%
Elbow X-ray, 2 views inpatient CPT 73070 HC XR ELBOW 2 VIEWS	$406.70	$581.00	—	—	30%
Elbow X-ray, 2 views inpatient CPT 73070 HC XR ELBOW LIMITED	$406.70	$581.00	—	—	30%
Elbow X-ray, complete, 3 or more views CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS	$450.80	$644.00	—	42% above	30%
Elbow X-ray, complete, 3 or more views CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS	$500.50	$715.00	—	58% above	30%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS	$500.50	$715.00	—	—	30%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT/EAR/FOSSA WO CONTRAST	$1,180.20	$1,686.00	—	4% below	30%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT/EAR/FOSSA WO CONTRAST	$1,310.40	$1,872.00	—	7% above	30%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT/EAR/FOSSA WO CONTRAST	$1,310.40	$1,872.00	—	—	30%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS	$665.00	$950.00	—	80% above	30%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS	$739.20	$1,056.00	—	100% above	30%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS	$739.20	$1,056.00	—	—	30%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC XR FOREARM 1 VIEW	$296.10	$423.00	—	8% above	30%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC XR FOREARM 2 VIEWS	$363.30	$519.00	—	33% above	30%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC XR FOREARM 2 VIEWS	$403.20	$576.00	—	47% above	30%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC XR FOREARM 1 VIEW	$296.10	$423.00	—	—	30%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC XR FOREARM 2 VIEWS	$403.20	$576.00	—	—	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM HEPATOBILIARY SYSTEM	$997.50	$1,425.00	—	15% below	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM HEPATOBILIARY SYSTEM	$1,108.10	$1,583.00	—	6% below	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NM HEPATOBILIARY SYSTEM	$1,108.10	$1,583.00	—	—	30%
Hand X-ray, 2 views CPT 73120 HC XR HAND 1 VIEW	$364.70	$521.00	—	28% above	30%
Hand X-ray, 2 views CPT 73120 HC XR HAND 1 VIEW	$401.10	$573.00	—	41% above	30%
Hand X-ray, 2 views CPT 73120 HC XR HAND 2 VIEWS	$405.30	$579.00	—	42% above	30%
Hand X-ray, 2 views inpatient CPT 73120 HC XR HAND 1 VIEW	$401.10	$573.00	—	—	30%
Hand X-ray, 2 views inpatient CPT 73120 HC XR HAND 2 VIEWS	$405.30	$579.00	—	—	30%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC XR HEEL MIN 2 VIEWS	$348.60	$498.00	—	34% above	30%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC XR HEEL MIN 2 VIEWS	$387.10	$553.00	—	49% above	30%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC XR HEEL MIN 2 VIEWS	$387.10	$553.00	—	—	30%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC PR 95806 SLEEP STUDY UNATT&RESP EFFT	$79.80	$114.00	—	82% below	30%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC PR 95806 SLEEP STUDY UNATT&RESP EFFT	$79.80	$114.00	—	—	30%
Knee X-ray, 3 views CPT 73562 HC XR KNEE 3 VIEWS	$434.70	$621.00	—	40% above	30%
Knee X-ray, 3 views CPT 73562 HC XR KNEE 3 VIEWS	$483.70	$691.00	—	56% above	30%
Knee X-ray, 3 views inpatient CPT 73562 HC XR KNEE 3 VIEWS	$483.70	$691.00	—	—	30%
Knee X-ray, complete, 4 or more views CPT 73564 HC XR KNEE 4/PLUS VIEWS	$463.40	$662.00	—	10% above	30%
Knee X-ray, complete, 4 or more views CPT 73564 HC XR KNEE 4/PLUS VIEWS	$514.50	$735.00	—	22% above	30%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC XR KNEE 4/PLUS VIEWS	$514.50	$735.00	—	—	30%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$1,371.30	$1,959.00	—	2% above	30%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$1,523.20	$2,176.00	—	13% above	30%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$1,523.20	$2,176.00	—	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED	$672.00	$960.00	—	33% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ED ABDOMEN LIMITED CDM	$692.30	$989.00	—	37% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED	$747.60	$1,068.00	—	48% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ED ABDOMEN LIMITED CDM	$692.30	$989.00	—	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED	$747.60	$1,068.00	—	—	30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$583.10	$833.00	—	83% above	30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US ED LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$672.70	$961.00	—	112% above	30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$726.60	$1,038.00	—	129% above	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US ED LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$672.70	$961.00	—	—	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$726.60	$1,038.00	—	—	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX LW DOSE LNG CA SCR WO CONTRAST CDM	$228.90	$327.00	—	3% below	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX LW DOSE LNG CA SCR WO CONTRAST CDM	$228.90	$327.00	—	3% below	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT THORAX LW DOSE LNG CA SCR WO CONTRAST CDM	$228.90	$327.00	—	—	30%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR LOWER LEG 2 VIEWS	$397.60	$568.00	—	44% above	30%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR LOWER LEG LIMITED	$441.00	$630.00	—	59% above	30%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR LOWER LEG 2 VIEWS	$441.00	$630.00	—	59% above	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC XR LOWER LEG 2 VIEWS	$441.00	$630.00	—	—	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC XR LOWER LEG LIMITED	$441.00	$630.00	—	—	30%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD WO CONTRAST	$2,251.90	$3,217.00	—	14% above	30%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD WO CONTRAST	$2,502.50	$3,575.00	—	26% above	30%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA HEAD WO CONTRAST	$2,502.50	$3,575.00	—	—	30%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MRI BREAST W/CONTRAST BILATERAL	$1,230.60	$1,758.00	—	—	30%
MRI of both breasts, without and then with contrast dye CPT 77049 HC MRI BREAST W/O & W/ CONTRAST W/ CAD BIL	$2,272.90	$3,247.00	—	5% below	30%
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 HC MRI BREAST W/O & W/ CONTRAST W/ CAD BIL	$2,272.90	$3,247.00	—	—	30%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST	$2,615.20	$3,736.00	—	38% above	30%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST	$2,905.70	$4,151.00	—	53% above	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST	$2,905.70	$4,151.00	—	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST	$3,140.90	$4,487.00	—	7% above	30%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST	$3,490.90	$4,987.00	—	19% above	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST	$3,490.90	$4,987.00	—	—	30%
MRI of the abdomen without contrast CPT 74181 HC MRI MRCP ABDOMEN WO CONTRAST	$2,396.10	$3,423.00	—	15% above	30%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST	$2,396.10	$3,423.00	—	15% above	30%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN W/O DYE LIMITED	$2,396.10	$3,423.00	—	15% above	30%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST	$2,487.80	$3,554.00	—	19% above	30%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI MRCP ABDOMEN WO CONTRAST	$2,396.10	$3,423.00	—	—	30%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN W/O DYE LIMITED	$2,396.10	$3,423.00	—	—	30%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN WO CONTRAST	$2,396.10	$3,423.00	—	—	30%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN WO & W CONTRAST	$3,895.50	$5,565.00	—	25% above	30%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN WO & W CONTRAST	$4,328.10	$6,183.00	—	39% above	30%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN WO & W CONTRAST	$4,328.10	$6,183.00	—	—	30%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN STEM W/O DYE	$2,929.50	$4,185.00	—	52% above	30%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN STEM W/O DYE	$3,254.30	$4,649.00	—	69% above	30%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O DYE LIMITED	$3,254.30	$4,649.00	—	69% above	30%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O DYE LIMITED	$3,254.30	$4,649.00	—	—	30%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN STEM W/O DYE	$3,254.30	$4,649.00	—	—	30%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/O & W/DYE	$3,362.10	$4,803.00	—	15% above	30%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/O & W/DYE	$3,735.90	$5,337.00	—	28% above	30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W/O & W/DYE	$3,735.90	$5,337.00	—	—	30%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O DYE	$2,494.80	$3,564.00	—	19% above	30%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O DYE LIMITED	$2,772.00	$3,960.00	—	32% above	30%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O DYE	$2,772.00	$3,960.00	—	32% above	30%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O DYE	$2,772.00	$3,960.00	—	—	30%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O DYE LIMITED	$2,772.00	$3,960.00	—	—	30%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE LIMITED	$3,922.10	$5,603.00	—	29% above	30%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE	$3,922.10	$5,603.00	—	29% above	30%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE LIMITED	$4,358.90	$6,227.00	—	44% above	30%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE	$4,358.90	$6,227.00	—	44% above	30%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE	$4,358.90	$6,227.00	—	—	30%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE LIMITED	$4,358.90	$6,227.00	—	—	30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O DYE	$2,942.80	$4,204.00	—	39% above	30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O DYE	$3,245.20	$4,636.00	—	53% above	30%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE W/O DYE	$3,245.20	$4,636.00	—	—	30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE	$3,721.20	$5,316.00	—	26% above	30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE	$4,134.90	$5,907.00	—	40% above	30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE	$4,134.90	$5,907.00	—	—	30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O DYE	$2,790.90	$3,987.00	—	38% above	30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O DYE	$3,101.70	$4,431.00	—	54% above	30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O DYE LIMITED	$3,101.70	$4,431.00	—	54% above	30%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O DYE	$3,101.70	$4,431.00	—	—	30%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O DYE LIMITED	$3,101.70	$4,431.00	—	—	30%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS WO & W CONTRAST	$3,301.90	$4,717.00	—	9% above	30%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS WO & W CONTRAST	$3,668.70	$5,241.00	—	21% above	30%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS WO & W CONTRAST	$3,668.70	$5,241.00	—	—	30%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO CONTRAST	$2,397.50	$3,425.00	—	25% above	30%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO CONTRAST	$2,663.50	$3,805.00	—	39% above	30%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS W/O DYE LIMITED	$2,663.50	$3,805.00	—	39% above	30%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS W/O DYE LIMITED	$2,663.50	$3,805.00	—	—	30%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS WO CONTRAST	$2,663.50	$3,805.00	—	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST	$2,615.20	$3,736.00	—	37% above	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI JOINT UPR EXTREM W/O DYE LIMITED	$2,905.70	$4,151.00	—	52% above	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST	$2,905.70	$4,151.00	—	52% above	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI JOINT UPR EXTREM W/O DYE LIMITED	$2,905.70	$4,151.00	—	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST	$2,905.70	$4,151.00	—	—	30%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC XR SPINE CERVICAL 4 OR 5 VIEWS	$687.40	$982.00	—	54% above	30%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC XR SPINE CERVICAL 4 OR 5 VIEWS	$763.00	$1,090.00	—	71% above	30%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC XR SPINE CERVICAL 4 OR 5 VIEWS	$763.00	$1,090.00	—	—	30%
Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$1,487.50	$2,125.00	—	11% below	30%
Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$1,652.00	$2,360.00	—	1% below	30%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$1,652.00	$2,360.00	—	—	30%
Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$1,357.30	$1,939.00	—	2% above	30%
Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$1,507.10	$2,153.00	—	13% above	30%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$1,507.10	$2,153.00	—	—	30%
Neck soft tissue X-ray CPT 70360 HC XR NECK SOFT TISSUE	$345.80	$494.00	—	46% above	30%
Neck soft tissue X-ray CPT 70360 HC XR NECK SOFT TISSUE	$383.60	$548.00	—	62% above	30%
Neck soft tissue X-ray inpatient CPT 70360 HC XR NECK SOFT TISSUE	$383.60	$548.00	—	—	30%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM MYCARD PERFUS SPECT MULTIPLE	$3,630.20	$5,186.00	—	2% above	30%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM MYCARD PERFUS SPECT MULTIPLE	$4,033.40	$5,762.00	—	14% above	30%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM MYCARD PERFUS SPECT MULTIPLE	$4,033.40	$5,762.00	—	—	30%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGE W CT SKULL MID THIGH	$3,926.30	$5,609.00	—	11% below	30%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGE W CT SKULL MID THIGH	$4,362.40	$6,232.00	—	1% below	30%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGE W CT SKULL MID THIGH	$4,362.40	$6,232.00	—	—	30%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST	$1,346.80	$1,924.00	—	7% below	30%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST	$1,497.30	$2,139.00	—	4% above	30%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS WO CONTRAST	$1,497.30	$2,139.00	—	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC LIMITED	$521.50	$745.00	—	14% above	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US ED EXAM PELVIC LIMITED CDM	$536.20	$766.00	—	18% above	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC LIMITED	$578.90	$827.00	—	27% above	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC FOLLICLE LIMITED	$578.90	$827.00	—	27% above	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US ED EXAM PELVIC LIMITED CDM	$536.20	$766.00	—	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM PELVIC FOLLICLE LIMITED	$578.90	$827.00	—	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM PELVIC LIMITED	$578.90	$827.00	—	—	30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC NON-OB COMPLETE	$808.50	$1,155.00	—	35% above	30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC NON-OB COMPLETE	$897.40	$1,282.00	—	50% above	30%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIC NON-OB COMPLETE	$897.40	$1,282.00	—	—	30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS	$968.10	$1,383.00	—	50% above	30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS	$1,076.60	$1,538.00	—	67% above	30%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS	$1,076.60	$1,538.00	—	—	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby one side CPT 76801 HC US OB LT 14 WKS SINGLE FETUS CDM	$722.40	$1,032.00	—	44% above	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby one side CPT 76801 HC US OB LT 14 WKS SINGLE FETUS CDM	$802.90	$1,147.00	—	60% above	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient one side CPT 76801 HC US OB LT 14 WKS SINGLE FETUS CDM	$802.90	$1,147.00	—	—	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED FETUS(S) CDM	$514.50	$735.00	—	18% above	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US ED OB LIMITED FETUS(S) CDM	$530.60	$758.00	—	22% above	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED FETUS(S) CDM	$573.30	$819.00	—	31% above	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US ED OB LIMITED FETUS(S) CDM	$530.60	$758.00	—	—	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED FETUS(S) CDM	$573.30	$819.00	—	—	30%
Rib X-ray, one side, 2 views CPT 71100 HC XR RIBS UNI 2 VIEWS	$545.30	$779.00	—	86% above	30%
Rib X-ray, one side, 2 views CPT 71100 HC XR RIBS UNI 2 VIEWS	$606.20	$866.00	—	106% above	30%
Rib X-ray, one side, 2 views inpatient CPT 71100 HC XR RIBS UNI 2 VIEWS	$606.20	$866.00	—	—	30%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC XR RIBS/CHEST UNI MIN 3 VIEWS	$574.70	$821.00	—	57% above	30%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC XR RIBS/CHEST UNI MIN 3 VIEWS	$638.40	$912.00	—	74% above	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC XR RIBS/CHEST UNI MIN 3 VIEWS	$638.40	$912.00	—	—	30%
Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN BIL W CAD	$317.10	$453.00	—	6% below	30%
Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD	$317.10	$453.00	—	6% below	30%
Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD	$350.00	$500.00	—	3% above	30%
Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN BIL W CAD	$350.00	$500.00	—	3% above	30%
Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD	$350.00	$500.00	—	—	30%
Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREEN BIL W CAD	$350.00	$500.00	—	—	30%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS	$467.60	$668.00	—	43% above	30%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS	$518.70	$741.00	—	58% above	30%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS	$518.70	$741.00	—	—	30%
Sinus X-ray, complete, 3 or more views CPT 70220 HC XR SINUSES PARANASAL MIN 3 VIEWS	$514.50	$735.00	—	59% above	30%
Sinus X-ray, complete, 3 or more views CPT 70220 HC XR SINUSES PARANASAL MIN 3 VIEWS	$572.60	$818.00	—	77% above	30%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC XR SINUSES PARANASAL MIN 3 VIEWS	$572.60	$818.00	—	—	30%
Skull X-ray, fewer than 4 views CPT 70250 HC XR SKULL 1-3 VIEWS	$347.90	$497.00	—	20% above	30%
Skull X-ray, fewer than 4 views CPT 70250 HC XR SKULL 1-3 VIEWS	$386.40	$552.00	—	34% above	30%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC XR SKULL 1-3 VIEWS	$386.40	$552.00	—	—	30%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC ECHO STRESS W/INTERP REPT & MONITOR	$1,593.20	$2,276.00	—	41% above	30%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC ECHO STRESS W/INTERP REPT & MONITOR	$1,593.20	$2,276.00	—	—	30%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$776.30	$1,109.00	—	44% above	30%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$863.10	$1,233.00	—	60% above	30%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$863.10	$1,233.00	—	—	30%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC XR FEMUR MIN 2 VIEWS	$518.70	$741.00	—	99% above	30%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC XR FEMUR MIN 2 VIEWS	$518.70	$741.00	—	—	30%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT CHEST SPINE WO CONTRAST	$1,545.60	$2,208.00	—	7% above	30%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT CHEST SPINE WO CONTRAST	$1,717.10	$2,453.00	—	19% above	30%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT CHEST SPINE WO CONTRAST	$1,717.10	$2,453.00	—	—	30%
Toe X-ray, 2 or more views CPT 73660 HC XR TOE(S) MIN 2 VIEWS	$361.90	$517.00	—	47% above	30%
Toe X-ray, 2 or more views CPT 73660 HC XR TOE(S) MIN 2 VIEWS	$401.10	$573.00	—	63% above	30%
Toe X-ray, 2 or more views inpatient CPT 73660 HC XR TOE(S) MIN 2 VIEWS	$401.10	$573.00	—	—	30%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON-OB	$746.20	$1,066.00	—	49% above	30%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON-OB	$830.20	$1,186.00	—	66% above	30%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON-OB	$830.20	$1,186.00	—	—	30%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL CDM	$746.20	$1,066.00	—	76% above	30%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL CDM	$830.20	$1,186.00	—	95% above	30%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US OB TRANSVAGINAL CDM	$830.20	$1,186.00	—	—	30%
Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE	$938.70	$1,341.00	—	35% above	30%
Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE	$1,042.30	$1,489.00	—	50% above	30%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US EXAM ABDOMEN COMPLETE	$1,042.30	$1,489.00	—	—	30%
Ultrasound of the scrotum and testicles CPT 76870 HC US EXAM SCROTUM & CONTENTS	$753.90	$1,077.00	—	31% above	30%
Ultrasound of the scrotum and testicles CPT 76870 HC US EXAM SCROTUM & CONTENTS	$837.20	$1,196.00	—	45% above	30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US EXAM SCROTUM & CONTENTS	$837.20	$1,196.00	—	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM OF HEAD AND NECK	$709.10	$1,013.00	—	27% above	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US ED EXAM OF HEAD AND NECK CDM	$729.40	$1,042.00	—	30% above	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM OF HEAD AND NECK	$787.50	$1,125.00	—	41% above	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US ED EXAM OF HEAD AND NECK CDM	$729.40	$1,042.00	—	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US EXAM OF HEAD AND NECK	$787.50	$1,125.00	—	—	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC XR RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY CDM	$678.30	$969.00	—	1% below	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC XR RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY CDM	$754.60	$1,078.00	—	11% above	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC XR RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY CDM	$754.60	$1,078.00	—	—	30%
Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS 1 VIEW	$402.50	$575.00	—	45% above	30%
Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS MIN 2 VIEWS	$406.70	$581.00	—	47% above	30%
Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS MIN 2 VIEWS	$406.70	$581.00	—	47% above	30%
Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS 1 VIEW	$406.70	$581.00	—	47% above	30%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC XR HUMERUS 1 VIEW	$406.70	$581.00	—	—	30%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC XR HUMERUS MIN 2 VIEWS	$406.70	$581.00	—	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$994.70	$1,421.00	—	48% above	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$1,106.00	$1,580.00	—	64% above	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$1,106.00	$1,580.00	—	—	30%
Wrist X-ray, 2 views CPT 73100 HC XR WRIST 1 VIEW	$348.60	$498.00	—	39% above	30%
Wrist X-ray, 2 views CPT 73100 HC XR WRIST 2 VIEWS	$351.40	$502.00	—	40% above	30%
Wrist X-ray, 2 views CPT 73100 HC XR WRIST 1 VIEW	$387.10	$553.00	—	55% above	30%
Wrist X-ray, 2 views CPT 73100 HC XR WRIST 2 VIEWS	$390.60	$558.00	—	56% above	30%
Wrist X-ray, 2 views inpatient CPT 73100 HC XR WRIST 1 VIEW	$387.10	$553.00	—	—	30%
Wrist X-ray, 2 views inpatient CPT 73100 HC XR WRIST 2 VIEWS	$390.60	$558.00	—	—	30%
Wrist X-ray, complete, 3 or more views CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS	$438.90	$627.00	—	40% above	30%
Wrist X-ray, complete, 3 or more views CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS	$487.90	$697.00	—	55% above	30%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS	$487.90	$697.00	—	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC XR HIPS UNI W PELVIS WHEN PERFORMED 2-3 VIEWS	$295.40	$422.00	—	9% below	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC XR HIPS UNI W PELVIS WHEN PERFORMED 2-3 VIEWS	$302.40	$432.00	—	7% below	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC XR HIPS UNI W PELVIS WHEN PERFORMED 2-3 VIEWS	$302.40	$432.00	—	—	30%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN 1 VIEW	$341.60	$488.00	—	32% above	30%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN PORTABLE 1 VIEW	$376.60	$538.00	—	45% above	30%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN 1 VIEW	$376.60	$538.00	—	45% above	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN PORTABLE 1 VIEW	$376.60	$538.00	—	—	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN 1 VIEW	$376.60	$538.00	—	—	30%
X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 2 VIEWS	$347.90	$497.00	—	37% above	30%
X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 1 VIEW	$382.90	$547.00	—	51% above	30%
X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 2 VIEWS	$386.40	$552.00	—	53% above	30%
X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 1 VIEW	$382.90	$547.00	—	—	30%
X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 2 VIEWS	$386.40	$552.00	—	—	30%
X-ray of the finger(s), 2 or more views CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS	$297.50	$425.00	—	12% above	30%
X-ray of the finger(s), 2 or more views CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS	$330.40	$472.00	—	24% above	30%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS	$330.40	$472.00	—	—	30%
X-ray of the foot, 2 views CPT 73620 HC XR FOOT 1 VIEW	$273.70	$391.00	—	2% below	30%
X-ray of the foot, 2 views CPT 73620 HC XR FOOT 2 VIEWS	$347.90	$497.00	—	25% above	30%
X-ray of the foot, 2 views CPT 73620 HC XR FOOT 2 VIEWS	$386.40	$552.00	—	39% above	30%
X-ray of the foot, 2 views inpatient CPT 73620 HC XR FOOT 1 VIEW	$273.70	$391.00	—	—	30%
X-ray of the foot, 2 views inpatient CPT 73620 HC XR FOOT 2 VIEWS	$386.40	$552.00	—	—	30%
X-ray of the foot, complete, 3 or more views CPT 73630 HC XR FOOT MIN 3 VIEWS	$438.90	$627.00	—	46% above	30%
X-ray of the foot, complete, 3 or more views CPT 73630 HC XR FOOT MIN 3 VIEWS	$487.90	$697.00	—	62% above	30%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC XR FOOT MIN 3 VIEWS	$487.90	$697.00	—	—	30%
X-ray of the hand, 3 or more views CPT 73130 HC XR HAND MIN 3 VIEWS	$438.90	$627.00	—	42% above	30%
X-ray of the hand, 3 or more views CPT 73130 HC XR HAND MIN 3 VIEWS	$487.90	$697.00	—	58% above	30%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC XR HAND MIN 3 VIEWS	$487.90	$697.00	—	—	30%
X-ray of the knee, 1 or 2 views CPT 73560 HC XR KNEE 1-2 VIEWS	$370.30	$529.00	—	29% above	30%
X-ray of the knee, 1 or 2 views CPT 73560 HC XR KNEE 1-2 VIEWS	$412.30	$589.00	—	44% above	30%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC XR KNEE 1-2 VIEWS	$412.30	$589.00	—	—	30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS	$445.90	$637.00	—	20% above	30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS	$496.30	$709.00	—	34% above	30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS	$496.30	$709.00	—	—	30%
X-ray of the lower back, 4 or more views CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS	$693.70	$991.00	—	54% above	30%
X-ray of the lower back, 4 or more views CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS	$770.70	$1,101.00	—	71% above	30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS	$770.70	$1,101.00	—	—	30%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC XR SPINE THORACIC 2 VIEWS	$445.90	$637.00	—	41% above	30%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC XR SPINE THORACIC 2 VIEWS	$453.60	$648.00	—	43% above	30%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC XR SPINE THORACIC 2 VIEWS	$453.60	$648.00	—	—	30%
X-ray of the nasal bones, 3 or more views CPT 70160 HC XR NASAL BONES MIN 3 VIEWS	$423.50	$605.00	—	65% above	30%
X-ray of the nasal bones, 3 or more views CPT 70160 HC XR NASAL BONES MIN 3 VIEWS	$471.10	$673.00	—	84% above	30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC XR NASAL BONES MIN 3 VIEWS	$471.10	$673.00	—	—	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS	$445.90	$637.00	—	39% above	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS	$496.30	$709.00	—	55% above	30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS	$496.30	$709.00	—	—	30%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS	$366.10	$523.00	—	28% above	30%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS	$406.70	$581.00	—	42% above	30%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS	$406.70	$581.00	—	—	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC XR TAILBONE MIN 2 VIEWS	$464.10	$663.00	—	64% above	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC XR TAILBONE MIN 2 VIEWS	$515.20	$736.00	—	82% above	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC XR TAILBONE MIN 2 VIEWS	$515.20	$736.00	—	—	30%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
ACTH blood test CPT 82024 HC ADRENOCORTICOTROPIC HORMONE ACTH CDM	$208.60	$298.00	—	6% below	30%
ACTH blood test inpatient CPT 82024 HC ADRENOCORTICOTROPIC HORMONE ACTH CDM	$208.60	$298.00	—	—	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALT (SGPT) 84460	$52.50	$75.00	—	11% above	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALANINE AMINO (ALT) (SGPT)	$52.50	$75.00	—	11% above	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC SGPT (ALT)	$52.50	$75.00	—	11% above	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC ALT (SGPT) 84460	$52.50	$75.00	—	—	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC SGPT (ALT)	$52.50	$75.00	—	—	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC ALANINE AMINO (ALT) (SGPT)	$52.50	$75.00	—	—	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT	$52.50	$75.00	—	24% above	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC SGOT (AST)	$52.50	$75.00	—	24% above	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC SGOT / AST	$52.50	$75.00	—	24% above	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC SGOT (AST)	$52.50	$75.00	—	—	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC SGOT / AST	$52.50	$75.00	—	—	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT	$52.50	$75.00	—	—	30%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS ACUTE PANEL	$339.50	$485.00	—	37% above	30%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS ACUTE PANEL	$339.50	$485.00	—	—	30%
Albumin blood test CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD CDM	$17.50	$25.00	—	51% below	30%
Albumin blood test CPT 82040 HC ZALBUMIN SERUM (PANL)	$39.90	$57.00	—	12% above	30%
Albumin blood test CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD LAB	$39.90	$57.00	—	12% above	30%
Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN	$39.90	$57.00	—	12% above	30%
Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN (RL)	$39.90	$57.00	—	12% above	30%
Albumin blood test inpatient CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD CDM	$17.50	$25.00	—	—	30%
Albumin blood test inpatient CPT 82040 HC ASSAY OF SERUM ALBUMIN	$39.90	$57.00	—	—	30%
Albumin blood test inpatient CPT 82040 HC ZALBUMIN SERUM (PANL)	$39.90	$57.00	—	—	30%
Albumin blood test inpatient CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD LAB	$39.90	$57.00	—	—	30%
Albumin blood test inpatient CPT 82040 HC ASSAY OF SERUM ALBUMIN (RL)	$39.90	$57.00	—	—	30%
Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE CDM	$159.60	$228.00	—	5% below	30%
Aldosterone blood test CPT 82088 HC ALDOSTERONE BLD	$159.60	$228.00	—	5% below	30%
Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE PLASMA LAB	$159.60	$228.00	—	5% below	30%
Aldosterone blood test CPT 82088 HC ALDOSTERONE (SERUM)	$159.60	$228.00	—	5% below	30%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE (SERUM)	$159.60	$228.00	—	—	30%
Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE CDM	$159.60	$228.00	—	—	30%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE BLD	$159.60	$228.00	—	—	30%
Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE PLASMA LAB	$159.60	$228.00	—	—	30%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOS	$65.80	$94.00	—	73% above	30%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ASSAY OF PHOSPHATASE ALKALINE LAB	$65.80	$94.00	—	73% above	30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ASSAY OF PHOSPHATASE ALKALINE LAB	$65.80	$94.00	—	—	30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOS	$65.80	$94.00	—	—	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH LAB	$15.40	$22.00	—	42% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC SINGLE ALLERGEN(PANL)	$32.90	$47.00	—	23% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH CDM	$32.90	$47.00	—	23% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE	$32.90	$47.00	—	23% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE - IGE QUANT	$32.90	$47.00	—	23% above	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH LAB	$15.40	$22.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE - IGE QUANT	$32.90	$47.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC SINGLE ALLERGEN(PANL)	$32.90	$47.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE	$32.90	$47.00	—	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH CDM	$32.90	$47.00	—	—	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM LAB	$111.30	$159.00	—	33% above	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM CDM	$111.30	$159.00	—	33% above	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM CDM	$111.30	$159.00	—	—	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM LAB	$111.30	$159.00	—	—	30%
Ammonia blood test CPT 82140 HC ASSAY OF AMMONIA LAB	$114.10	$163.00	—	at median	30%
Ammonia blood test inpatient CPT 82140 HC ASSAY OF AMMONIA LAB	$114.10	$163.00	—	—	30%
Amylase blood test CPT 82150 HC AMYLASE	$95.20	$136.00	—	53% above	30%
Amylase blood test CPT 82150 HC AMYLASE (BODY FLUID)	$95.20	$136.00	—	53% above	30%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE	$95.20	$136.00	—	53% above	30%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE LAB	$95.20	$136.00	—	53% above	30%
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE	$95.20	$136.00	—	—	30%
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE LAB	$95.20	$136.00	—	—	30%
Amylase blood test inpatient CPT 82150 HC AMYLASE	$95.20	$136.00	—	—	30%
Amylase blood test inpatient CPT 82150 HC AMYLASE (BODY FLUID)	$95.20	$136.00	—	—	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP AB IGG	$108.50	$155.00	—	40% above	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY LAB	$108.50	$155.00	—	40% above	30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY LAB	$108.50	$155.00	—	—	30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCP AB IGG	$108.50	$155.00	—	—	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES	$79.10	$113.00	—	13% above	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA	$79.10	$113.00	—	13% above	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA LAB	$79.10	$113.00	—	13% above	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA IGG REFLEX (ARUP)	$79.10	$113.00	—	13% above	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA IGG REFLEX (ARUP)	$79.10	$113.00	—	—	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA LAB	$79.10	$113.00	—	—	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA	$79.10	$113.00	—	—	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES	$79.10	$113.00	—	—	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE	$181.30	$259.00	—	6% below	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE LAB	$181.30	$259.00	—	6% below	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE	$181.30	$259.00	—	—	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE LAB	$181.30	$259.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BACTERIA OTHER - MISC/OTHER/ROUTINE	$97.30	$139.00	—	12% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL CDM	$155.40	$222.00	—	79% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-RESPIR UPPER	$171.50	$245.00	—	97% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BACTERIA OTHER	$171.50	$245.00	—	97% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BACTERIA OTHER- BODY FLUID	$171.50	$245.00	—	97% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BACTERIA OTHER - EAR	$171.50	$245.00	—	97% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BACTERIA OTHER - RESPIRATORY	$171.50	$245.00	—	97% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-SURGICAL TISSUE	$171.50	$245.00	—	97% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC BACTERIAL CULTURE - OTHR SOURCE	$171.50	$245.00	—	97% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL LAB	$171.50	$245.00	—	97% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE BACTERIA OTHER - MISC/OTHER/ROUTINE	$97.30	$139.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL CDM	$155.40	$222.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-RESPIR UPPER	$171.50	$245.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE BACTERIA OTHER - EAR	$171.50	$245.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE BACTERIA OTHER - RESPIRATORY	$171.50	$245.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-SURGICAL TISSUE	$171.50	$245.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC BACTERIAL CULTURE - OTHR SOURCE	$171.50	$245.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL LAB	$171.50	$245.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE BACTERIA OTHER	$171.50	$245.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE BACTERIA OTHER- BODY FLUID	$171.50	$245.00	—	—	30%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL	$119.70	$171.00	—	60% above	30%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL	$119.70	$171.00	—	—	30%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL	$74.20	$106.00	—	68% above	30%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL CDM	$74.20	$106.00	—	68% above	30%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL LAB	$74.20	$106.00	—	68% above	30%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL	$74.20	$106.00	—	—	30%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL LAB	$74.20	$106.00	—	—	30%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL CDM	$74.20	$106.00	—	—	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM	$375.20	$536.00	—	114% above	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB	$375.20	$536.00	—	114% above	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB	$375.20	$536.00	—	—	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM	$375.20	$536.00	—	—	30%
Blood culture for bacteria CPT 87040 HC CULTURE-BLOOD	$306.60	$438.00	—	106% above	30%
Blood culture for bacteria CPT 87040 HC BLOOD CULTURE FOR BACTERIA	$306.60	$438.00	—	106% above	30%
Blood culture for bacteria inpatient CPT 87040 HC CULTURE-BLOOD	$306.60	$438.00	—	—	30%
Blood culture for bacteria inpatient CPT 87040 HC BLOOD CULTURE FOR BACTERIA	$306.60	$438.00	—	—	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ED ROUTINE VENIPUNCTURE OR LEGAL DRAW CDM	$36.40	$52.00	—	46% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC BLOOD DRAW VENIPUNCTURE CDM	$36.40	$52.00	—	46% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL SHIPPING	$36.40	$52.00	—	46% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM	$36.40	$52.00	—	46% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - IVT VENIP LAB DRAW	$36.40	$52.00	—	46% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL PROCESSING	$36.40	$52.00	—	46% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL DRAW FEE	$36.40	$52.00	—	46% above	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM	$36.40	$52.00	—	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ED ROUTINE VENIPUNCTURE OR LEGAL DRAW CDM	$36.40	$52.00	—	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - IVT VENIP LAB DRAW	$36.40	$52.00	—	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL SHIPPING	$36.40	$52.00	—	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL PROCESSING	$36.40	$52.00	—	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL DRAW FEE	$36.40	$52.00	—	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC BLOOD DRAW VENIPUNCTURE CDM	$36.40	$52.00	—	—	30%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE WHOLE BLOOD	$63.00	$90.00	—	68% above	30%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE	$63.00	$90.00	—	68% above	30%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD (EXCEPT REAGENT STRIP)	$63.00	$90.00	—	68% above	30%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE FASTING	$63.00	$90.00	—	68% above	30%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE FASTING	$63.00	$90.00	—	—	30%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE	$63.00	$90.00	—	—	30%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD (EXCEPT REAGENT STRIP)	$63.00	$90.00	—	—	30%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE WHOLE BLOOD	$63.00	$90.00	—	—	30%
Blood lead test CPT 83655 HC ASSAY OF LEAD LAB	$11.90	$17.00	—	81% below	30%
Blood lead test CPT 83655 HC LEAD BLOOD	$11.90	$17.00	—	81% below	30%
Blood lead test CPT 83655 HC HVY MET BLD - LEAD	$77.70	$111.00	—	22% above	30%
Blood lead test CPT 83655 HC LEAD WHOLE BLOOD	$77.70	$111.00	—	22% above	30%
Blood lead test CPT 83655 HC ASSAY OF LEAD	$77.70	$111.00	—	22% above	30%
Blood lead test inpatient CPT 83655 HC LEAD BLOOD	$11.90	$17.00	—	—	30%
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD LAB	$11.90	$17.00	—	—	30%
Blood lead test inpatient CPT 83655 HC HVY MET BLD - LEAD	$77.70	$111.00	—	—	30%
Blood lead test inpatient CPT 83655 HC LEAD WHOLE BLOOD	$77.70	$111.00	—	—	30%
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD	$77.70	$111.00	—	—	30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC CHORIONIC GONADOTROPIN QUAL	$76.30	$109.00	—	2% above	30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE LAB	$76.30	$109.00	—	2% above	30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE CDM	$76.30	$109.00	—	2% above	30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE CDM	$76.30	$109.00	—	—	30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE LAB	$76.30	$109.00	—	—	30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC CHORIONIC GONADOTROPIN QUAL	$76.30	$109.00	—	—	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC ARC ABO TYPE	$53.90	$77.00	—	17% below	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO LAB	$131.60	$188.00	—	103% above	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC ABO GROUP	$131.60	$188.00	—	103% above	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC ARC ABO TYPE	$53.90	$77.00	—	—	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC ABO GROUP	$131.60	$188.00	—	—	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO LAB	$131.60	$188.00	—	—	30%
Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY OF UREA NITROGEN QUANTITATIVE LAB	$54.60	$78.00	—	50% above	30%
Blood urea nitrogen (BUN) test CPT 84520 HC BUN (BLOOD UREA NITROGEN)	$54.60	$78.00	—	50% above	30%
Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY OF UREA NITROGEN	$54.60	$78.00	—	50% above	30%
Blood urea nitrogen (BUN) test CPT 84520 HC BUN	$54.60	$78.00	—	50% above	30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC BUN (BLOOD UREA NITROGEN)	$54.60	$78.00	—	—	30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC BUN	$54.60	$78.00	—	—	30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY OF UREA NITROGEN QUANTITATIVE LAB	$54.60	$78.00	—	—	30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY OF UREA NITROGEN	$54.60	$78.00	—	—	30%
C-peptide blood test CPT 84681 HC ASSAY OF C-PEPTIDE	$101.50	$145.00	—	8% below	30%
C-peptide blood test CPT 84681 HC ASSAY OF C-PEPTIDE CDM	$101.50	$145.00	—	8% below	30%
C-peptide blood test inpatient CPT 84681 HC ASSAY OF C-PEPTIDE CDM	$101.50	$145.00	—	—	30%
C-peptide blood test inpatient CPT 84681 HC ASSAY OF C-PEPTIDE	$101.50	$145.00	—	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN	$65.10	$93.00	—	11% above	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN LAB	$65.10	$93.00	—	11% above	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN	$65.10	$93.00	—	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN LAB	$65.10	$93.00	—	—	30%
C. difficile toxin gene test (stool PCR) CPT 87493 HC INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE LAB	$147.70	$211.00	—	16% below	30%
C. difficile toxin gene test (stool PCR) CPT 87493 HC CLOSTRIDIUM DIFFICILE TOXINS AMPLIFIED PROBE	$147.70	$211.00	—	16% below	30%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE LAB	$147.70	$211.00	—	—	30%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC CLOSTRIDIUM DIFFICILE TOXINS AMPLIFIED PROBE	$147.70	$211.00	—	—	30%
CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9	$144.90	$207.00	—	31% above	30%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9	$144.90	$207.00	—	—	30%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 CDM	$144.90	$207.00	—	21% above	30%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 CDM	$144.90	$207.00	—	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ LAB	$74.90	$107.00	—	29% below	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ CDM	$81.90	$117.00	—	22% below	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ LAB	$74.90	$107.00	—	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ CDM	$81.90	$117.00	—	—	30%
Calcium blood test, total CPT 82310 HC CALCIUM SERUM	$51.10	$73.00	—	21% above	30%
Calcium blood test, total CPT 82310 HC CALCIUM-UR RANDOM	$51.10	$73.00	—	21% above	30%
Calcium blood test, total CPT 82310 HC CALCIUM (CA)	$51.10	$73.00	—	21% above	30%
Calcium blood test, total CPT 82310 HC CALCIUM TOTAL LAB	$51.10	$73.00	—	21% above	30%
Calcium blood test, total CPT 82310 HC ZCALCIUM(PNL)	$51.10	$73.00	—	21% above	30%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM-UR RANDOM	$51.10	$73.00	—	—	30%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM (CA)	$51.10	$73.00	—	—	30%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM SERUM	$51.10	$73.00	—	—	30%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM TOTAL LAB	$51.10	$73.00	—	—	30%
Calcium blood test, total inpatient CPT 82310 HC ZCALCIUM(PNL)	$51.10	$73.00	—	—	30%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CARCINOEMBRYONIC ANTIGEN CEA CDM	$136.50	$195.00	—	5% above	30%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CEA	$136.50	$195.00	—	5% above	30%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CEA	$136.50	$195.00	—	—	30%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CARCINOEMBRYONIC ANTIGEN CEA CDM	$136.50	$195.00	—	—	30%
Chickenpox (varicella) immunity blood test CPT 86787 HC ANTIBODY VARICELLA-ZOSTER CDM	$91.00	$130.00	—	15% above	30%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER ANTIBODY - IGG	$91.00	$130.00	—	15% above	30%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER AB IGM(PNL)	$91.00	$130.00	—	15% above	30%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER ANTIBODY - AB	$91.00	$130.00	—	15% above	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC ANTIBODY VARICELLA-ZOSTER CDM	$91.00	$130.00	—	—	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA-ZOSTER ANTIBODY - IGG	$91.00	$130.00	—	—	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER AB IGM(PNL)	$91.00	$130.00	—	—	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA-ZOSTER ANTIBODY - AB	$91.00	$130.00	—	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ LAB	$171.50	$245.00	—	28% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ	$171.50	$245.00	—	28% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC C TRACHOMATIS APTIMA (ARUP)	$189.00	$270.00	—	41% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIFIED DNA	$189.00	$270.00	—	41% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE	$189.00	$270.00	—	41% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ	$171.50	$245.00	—	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ LAB	$171.50	$245.00	—	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC C TRACHOMATIS APTIMA (ARUP)	$189.00	$270.00	—	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIFIED DNA	$189.00	$270.00	—	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE	$189.00	$270.00	—	—	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PROFILE	$88.90	$127.00	—	at median	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL	$127.40	$182.00	—	43% above	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL LAB	$127.40	$182.00	—	43% above	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PROFILE	$88.90	$127.00	—	—	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL LAB	$127.40	$182.00	—	—	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL	$127.40	$182.00	—	—	30%
Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC LAB	$115.50	$165.00	—	71% above	30%
Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$115.50	$165.00	—	71% above	30%
Complete blood count (CBC) with differential CPT 85025 HC CBC WITH DIFF AUTO	$115.50	$165.00	—	71% above	30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$115.50	$165.00	—	—	30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC LAB	$115.50	$165.00	—	—	30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC WITH DIFF AUTO	$115.50	$165.00	—	—	30%
Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED	$98.00	$140.00	—	91% above	30%
Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED LAB	$98.00	$140.00	—	91% above	30%
Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC AUTOMATED	$98.00	$140.00	—	91% above	30%
Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC AUTOMATED	$98.00	$140.00	—	—	30%
Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED LAB	$98.00	$140.00	—	—	30%
Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED	$98.00	$140.00	—	—	30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHEN METABOLIC PANEL	$131.60	$188.00	—	44% above	30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHEN METABOLIC PANEL	$131.60	$188.00	—	—	30%
Cortisol blood test, total CPT 82533 HC CORTISOL (PM)	$157.50	$225.00	—	49% above	30%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL LAB	$157.50	$225.00	—	49% above	30%
Cortisol blood test, total CPT 82533 HC CORTISOL (AM)	$157.50	$225.00	—	49% above	30%
Cortisol blood test, total CPT 82533 HC CORTISOL	$157.50	$225.00	—	49% above	30%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL	$157.50	$225.00	—	49% above	30%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL	$157.50	$225.00	—	—	30%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL LAB	$157.50	$225.00	—	—	30%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL (PM)	$157.50	$225.00	—	—	30%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL	$157.50	$225.00	—	—	30%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL (AM)	$157.50	$225.00	—	—	30%
Creatine kinase (CK) blood test, total CPT 82550 HC CK TOTAL	$98.00	$140.00	—	47% above	30%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE TOTAL CDM	$98.00	$140.00	—	47% above	30%
Creatine kinase (CK) blood test, total CPT 82550 HC CPK	$98.00	$140.00	—	47% above	30%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE TOTAL LAB	$98.00	$140.00	—	47% above	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CPK	$98.00	$140.00	—	—	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CK TOTAL	$98.00	$140.00	—	—	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE TOTAL CDM	$98.00	$140.00	—	—	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE TOTAL LAB	$98.00	$140.00	—	—	30%
Creatinine blood test CPT 82565 HC CREATININE BLOOD	$76.30	$109.00	—	77% above	30%
Creatinine blood test CPT 82565 HC CREATININE BLOOD LAB	$76.30	$109.00	—	77% above	30%
Creatinine blood test CPT 82565 HC ASSAY OF CREATININE	$76.30	$109.00	—	77% above	30%
Creatinine blood test CPT 82565 HC ASSAY CREATININE	$76.30	$109.00	—	77% above	30%
Creatinine blood test inpatient CPT 82565 HC ASSAY CREATININE	$76.30	$109.00	—	—	30%
Creatinine blood test inpatient CPT 82565 HC ASSAY OF CREATININE	$76.30	$109.00	—	—	30%
Creatinine blood test inpatient CPT 82565 HC CREATININE BLOOD	$76.30	$109.00	—	—	30%
Creatinine blood test inpatient CPT 82565 HC CREATININE BLOOD LAB	$76.30	$109.00	—	—	30%
Cytomegalovirus (CMV) antibody test CPT 86644 HC ARC CMV SCREEN	$81.90	$117.00	—	7% above	30%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV ANTIBODY-MISC	$81.90	$117.00	—	7% above	30%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV ANTIBODY	$81.90	$117.00	—	7% above	30%
Cytomegalovirus (CMV) antibody test CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV CDM	$81.90	$117.00	—	7% above	30%
Cytomegalovirus (CMV) antibody test CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV LAB	$81.90	$117.00	—	7% above	30%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV AB IGG (PANL)	$81.90	$117.00	—	7% above	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV ANTIBODY	$81.90	$117.00	—	—	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV LAB	$81.90	$117.00	—	—	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV ANTIBODY-MISC	$81.90	$117.00	—	—	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC ARC CMV SCREEN	$81.90	$117.00	—	—	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV CDM	$81.90	$117.00	—	—	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV AB IGG (PANL)	$81.90	$117.00	—	—	30%
D-dimer blood test (blood clot marker) CPT 85379 HC FIBRIN DEGRADATION QUANT	$151.20	$216.00	—	27% above	30%
D-dimer blood test (blood clot marker) CPT 85379 HC DDIMER QUANT	$151.20	$216.00	—	27% above	30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC FIBRIN DEGRADATION QUANT	$151.20	$216.00	—	—	30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC DDIMER QUANT	$151.20	$216.00	—	—	30%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE	$151.20	$216.00	—	17% above	30%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE CDM	$151.20	$216.00	—	17% above	30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE CDM	$151.20	$216.00	—	—	30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE	$151.20	$216.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR THC URINE PER DOS LAB	$374.50	$535.00	—	133% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR TRICYCLICS PER DOS LAB	$374.50	$535.00	—	133% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR SALICYLATE PER DOS LAB	$374.50	$535.00	—	133% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE CDM	$374.50	$535.00	—	133% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR MECONIUM PER DOS	$374.50	$535.00	—	133% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ALCOHOL PER DOS	$374.50	$535.00	—	133% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR CORDSTAT PER DOS	$374.50	$535.00	—	133% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR PER DOS	$374.50	$535.00	—	133% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$374.50	$535.00	—	133% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE LAB	$374.50	$535.00	—	133% above	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR PER DOS	$374.50	$535.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ALCOHOL PER DOS	$374.50	$535.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE CDM	$374.50	$535.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR CORDSTAT PER DOS	$374.50	$535.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$374.50	$535.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR MECONIUM PER DOS	$374.50	$535.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR TRICYCLICS PER DOS LAB	$374.50	$535.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR SALICYLATE PER DOS LAB	$374.50	$535.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR THC URINE PER DOS LAB	$374.50	$535.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE LAB	$374.50	$535.00	—	—	30%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL	$119.70	$171.00	—	119% above	30%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL	$119.70	$171.00	—	—	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR ANTIBODY - VIRAL CAPSID	$86.10	$123.00	—	9% below	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR ANTIBODY - VIRAL CAPSID IGM	$86.10	$123.00	—	9% below	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA LAB	$86.10	$123.00	—	9% below	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA LAB	$86.10	$123.00	—	—	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR ANTIBODY - VIRAL CAPSID IGM	$86.10	$123.00	—	—	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR ANTIBODY - VIRAL CAPSID	$86.10	$123.00	—	—	30%
Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL	$123.90	$177.00	—	11% below	30%
Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL LAB	$123.90	$177.00	—	11% below	30%
Estradiol blood test CPT 82670 HC ESTRADIOL	$123.90	$177.00	—	11% below	30%
Estradiol blood test inpatient CPT 82670 HC ESTRADIOL	$123.90	$177.00	—	—	30%
Estradiol blood test inpatient CPT 82670 HC ASSAY OF ESTRADIOL	$123.90	$177.00	—	—	30%
Estradiol blood test inpatient CPT 82670 HC ASSAY OF ESTRADIOL LAB	$123.90	$177.00	—	—	30%
FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE CDM	$102.90	$147.00	—	9% above	30%
FSH (follicle-stimulating hormone) test CPT 83001 HC FSH(FOLLICLE STIMULATE HORMONE)	$102.90	$147.00	—	9% above	30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC FSH(FOLLICLE STIMULATE HORMONE)	$102.90	$147.00	—	—	30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE CDM	$102.90	$147.00	—	—	30%
Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY OF CALPROTECTIN FECAL CDM	$98.00	$140.00	—	51% below	30%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC ASSAY OF CALPROTECTIN FECAL CDM	$98.00	$140.00	—	—	30%
Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN	$103.60	$148.00	—	5% above	30%
Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN CDM	$103.60	$148.00	—	5% above	30%
Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN CDM	$103.60	$148.00	—	—	30%
Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN	$103.60	$148.00	—	—	30%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN ACTIVITY	$106.40	$152.00	—	32% above	30%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN	$114.80	$164.00	—	42% above	30%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN ACTIVITY	$106.40	$152.00	—	—	30%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN	$114.80	$164.00	—	—	30%
Folate (folic acid) blood test CPT 82746 HC ASSAY OF FOLIC ACID SERUM	$95.20	$136.00	—	10% below	30%
Folate (folic acid) blood test CPT 82746 HC BLOOD FOLIC ACID SERUM	$102.90	$147.00	—	2% below	30%
Folate (folic acid) blood test CPT 82746 HC ASSAY OF FOLIC ACID SERUM CDM	$102.90	$147.00	—	2% below	30%
Folate (folic acid) blood test inpatient CPT 82746 HC ASSAY OF FOLIC ACID SERUM	$95.20	$136.00	—	—	30%
Folate (folic acid) blood test inpatient CPT 82746 HC ASSAY OF FOLIC ACID SERUM CDM	$102.90	$147.00	—	—	30%
Folate (folic acid) blood test inpatient CPT 82746 HC BLOOD FOLIC ACID SERUM	$102.90	$147.00	—	—	30%
Free T3 thyroid hormone test CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE LAB	$95.90	$137.00	—	7% above	30%
Free T3 thyroid hormone test CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE CDM	$103.60	$148.00	—	16% above	30%
Free T3 thyroid hormone test CPT 84481 HC FREE ASSAY (FT-3)	$103.60	$148.00	—	16% above	30%
Free T3 thyroid hormone test inpatient CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE LAB	$95.90	$137.00	—	—	30%
Free T3 thyroid hormone test inpatient CPT 84481 HC FREE ASSAY (FT-3)	$103.60	$148.00	—	—	30%
Free T3 thyroid hormone test inpatient CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE CDM	$103.60	$148.00	—	—	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC THYROXINE FREE	$78.40	$112.00	—	13% above	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE LAB	$78.40	$112.00	—	13% above	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ZT4 FREE BY EQUIL DIALYSIS(ARUP)	$78.40	$112.00	—	13% above	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE CDM	$78.40	$112.00	—	13% above	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC THYROXINE FREE	$78.40	$112.00	—	—	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ZT4 FREE BY EQUIL DIALYSIS(ARUP)	$78.40	$112.00	—	—	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE CDM	$78.40	$112.00	—	—	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE LAB	$78.40	$112.00	—	—	30%
Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE	$131.60	$188.00	—	3% above	30%
Free testosterone test CPT 84402 HC TESTO FREE FEM-CHILD	$131.60	$188.00	—	3% above	30%
Free testosterone test CPT 84402 HC TESTOSTERONE FREE	$131.60	$188.00	—	3% above	30%
Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE LAB	$131.60	$188.00	—	3% above	30%
Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE LAB	$131.60	$188.00	—	—	30%
Free testosterone test inpatient CPT 84402 HC TESTO FREE FEM-CHILD	$131.60	$188.00	—	—	30%
Free testosterone test inpatient CPT 84402 HC TESTOSTERONE FREE	$131.60	$188.00	—	—	30%
Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE	$131.60	$188.00	—	—	30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GAMMA GT TOTAL	$74.20	$106.00	—	37% above	30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GGT	$74.20	$106.00	—	37% above	30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC ASSAY OF GGT	$74.20	$106.00	—	—	30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GAMMA GT TOTAL	$74.20	$106.00	—	—	30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE	$63.00	$90.00	—	53% above	30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE LAB	$63.00	$90.00	—	53% above	30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE GESTATIONAL SCREEN	$63.00	$90.00	—	53% above	30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE LAB	$63.00	$90.00	—	—	30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE	$63.00	$90.00	—	—	30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE GESTATIONAL SCREEN	$63.00	$90.00	—	—	30%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) 3 SPECIMENS	$93.80	$134.00	—	29% above	30%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOL GESTATIONAL	$93.80	$134.00	—	29% above	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOL GESTATIONAL	$93.80	$134.00	—	—	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) 3 SPECIMENS	$93.80	$134.00	—	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ LAB	$165.90	$237.00	—	31% above	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ	$165.90	$237.00	—	31% above	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ CDM	$183.40	$262.00	—	45% above	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N GONORRHOEAE APTIMA (ARUP)	$183.40	$262.00	—	45% above	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.GONORRHOEAE DNA AMPLIFIED PROBE	$183.40	$262.00	—	45% above	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ	$165.90	$237.00	—	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ LAB	$165.90	$237.00	—	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ CDM	$183.40	$262.00	—	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N GONORRHOEAE APTIMA (ARUP)	$183.40	$262.00	—	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N.GONORRHOEAE DNA AMPLIFIED PROBE	$183.40	$262.00	—	—	30%
H. pylori antibody blood test CPT 86677 HC H PYLORI AB IGA(PNL)	$95.90	$137.00	—	11% above	30%
H. pylori antibody blood test CPT 86677 HC ANTIBODY HELICOBACTER PYLORI LAB	$95.90	$137.00	—	11% above	30%
H. pylori antibody blood test inpatient CPT 86677 HC H PYLORI AB IGA(PNL)	$95.90	$137.00	—	—	30%
H. pylori antibody blood test inpatient CPT 86677 HC ANTIBODY HELICOBACTER PYLORI LAB	$95.90	$137.00	—	—	30%
H. pylori stool antigen test CPT 87338 HC IAAD IA HPYLORI STOOL CDM	$205.10	$293.00	—	44% above	30%
H. pylori stool antigen test inpatient CPT 87338 HC IAAD IA HPYLORI STOOL CDM	$205.10	$293.00	—	—	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV STANDARD PCR	$508.20	$726.00	—	32% above	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION LAB	$508.20	$726.00	—	32% above	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV ULTRA SENSITIVE PCR	$508.20	$726.00	—	32% above	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV STANDARD PCR	$508.20	$726.00	—	—	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV ULTRA SENSITIVE PCR	$508.20	$726.00	—	—	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION LAB	$508.20	$726.00	—	—	30%
HIV-1 and HIV-2 antibody test CPT 86703 HC RAPID HIV 1-2	$91.00	$130.00	—	6% above	30%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC RAPID HIV 1-2	$91.00	$130.00	—	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB	$97.30	$139.00	—	1% below	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC ANTI-HIV 1/2 AB & P24 AG	$192.50	$275.00	—	96% above	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB	$97.30	$139.00	—	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC ANTI-HIV 1/2 AB & P24 AG	$192.50	$275.00	—	—	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES LAB	$192.50	$275.00	—	35% above	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES	$192.50	$275.00	—	35% above	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES	$192.50	$275.00	—	—	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES LAB	$192.50	$275.00	—	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C CDM	$72.80	$104.00	—	3% above	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C LAB	$72.80	$104.00	—	3% above	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C LAB	$72.80	$104.00	—	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C CDM	$72.80	$104.00	—	—	30%
Hemoglobin blood test CPT 85018 HC BLOOD COUNT HEMOGLOBIN LAB	$53.20	$76.00	—	81% above	30%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN (HGB)	$58.10	$83.00	—	98% above	30%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN	$58.10	$83.00	—	98% above	30%
Hemoglobin blood test CPT 85018 HC BLOOD COUNT HEMOGLOBIN	$58.10	$83.00	—	98% above	30%
Hemoglobin blood test inpatient CPT 85018 HC BLOOD COUNT HEMOGLOBIN LAB	$53.20	$76.00	—	—	30%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN (HGB)	$58.10	$83.00	—	—	30%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN	$58.10	$83.00	—	—	30%
Hemoglobin blood test inpatient CPT 85018 HC BLOOD COUNT HEMOGLOBIN	$58.10	$83.00	—	—	30%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL LAB	$86.80	$124.00	—	26% above	30%
Hepatitis B core antibody test (total) CPT 86704 HC HEP B CORE (IGG-IGM) ANTIBODY	$86.80	$124.00	—	26% above	30%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL CDM	$86.80	$124.00	—	26% above	30%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEP B CORE (IGG-IGM) ANTIBODY	$86.80	$124.00	—	—	30%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL CDM	$86.80	$124.00	—	—	30%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL LAB	$86.80	$124.00	—	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB CDM	$86.80	$124.00	—	17% above	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB LAB	$86.80	$124.00	—	17% above	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB CDM	$86.80	$124.00	—	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB LAB	$86.80	$124.00	—	—	30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN LAB	$116.20	$166.00	—	53% above	30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEP B SRF AG RFLX CNFRM(OF PANL)	$116.20	$166.00	—	53% above	30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN CDM	$116.20	$166.00	—	53% above	30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN CDM	$116.20	$166.00	—	—	30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEP B SRF AG RFLX CNFRM(OF PANL)	$116.20	$166.00	—	—	30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN LAB	$116.20	$166.00	—	—	30%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY LAB	$107.10	$153.00	—	24% above	30%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY	$107.10	$153.00	—	24% above	30%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY CDM	$107.10	$153.00	—	24% above	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY	$107.10	$153.00	—	—	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY CDM	$107.10	$153.00	—	—	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY LAB	$107.10	$153.00	—	—	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION CDM	$487.20	$696.00	—	45% above	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C RNA QUANTIFICATION	$487.20	$696.00	—	45% above	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION LAB	$487.20	$696.00	—	45% above	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEP C PCR (QUANT)	$487.20	$696.00	—	45% above	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION CDM	$487.20	$696.00	—	—	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEPATITIS C RNA QUANTIFICATION	$487.20	$696.00	—	—	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEP C PCR (QUANT)	$487.20	$696.00	—	—	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION LAB	$487.20	$696.00	—	—	30%
Herpes blood test, HSV-1 antibody CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 LAB	$58.80	$84.00	—	15% below	30%
Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TEST - TYPE 1 IGG	$58.80	$84.00	—	15% below	30%
Herpes blood test, HSV-1 antibody CPT 86695 HC HSV 1 AND 2 (PANL)	$58.80	$84.00	—	15% below	30%
Herpes blood test, HSV-1 antibody CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 CDM	$58.80	$84.00	—	15% below	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 LAB	$58.80	$84.00	—	—	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HSV 1 AND 2 (PANL)	$58.80	$84.00	—	—	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 CDM	$58.80	$84.00	—	—	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TEST - TYPE 1 IGG	$58.80	$84.00	—	—	30%
Herpes blood test, HSV-2 antibody CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 LAB	$84.00	$120.00	—	5% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HC GLYCOPROT G-SPEC AB IGG (PANL)	$84.00	$120.00	—	5% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TYPE 2	$84.00	$120.00	—	5% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 CDM	$84.00	$120.00	—	5% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TYPE 2 - TYPE 2 IGG	$84.00	$120.00	—	5% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HC HSV 2 ANTIBODY IGG	$84.00	$120.00	—	5% below	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 CDM	$84.00	$120.00	—	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TYPE 2 - TYPE 2 IGG	$84.00	$120.00	—	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TYPE 2	$84.00	$120.00	—	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC GLYCOPROT G-SPEC AB IGG (PANL)	$84.00	$120.00	—	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HSV 2 ANTIBODY IGG	$84.00	$120.00	—	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 LAB	$84.00	$120.00	—	—	30%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY CDM	$74.20	$106.00	—	at median	30%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY CDM	$74.20	$106.00	—	—	30%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTEINE LAB	$151.90	$217.00	—	25% above	30%
Homocysteine blood test CPT 83090 HC HOMOCYSTINE PLASMA (HYPERC)	$151.90	$217.00	—	25% above	30%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTEINE LAB	$151.90	$217.00	—	—	30%
Homocysteine blood test inpatient CPT 83090 HC HOMOCYSTINE PLASMA (HYPERC)	$151.90	$217.00	—	—	30%
Insulin blood test CPT 83525 HC INSULIN LEVEL ASSAY	$85.40	$122.00	—	3% above	30%
Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL LAB	$85.40	$122.00	—	3% above	30%
Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL CDM	$85.40	$122.00	—	3% above	30%
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN TOTAL LAB	$85.40	$122.00	—	—	30%
Insulin blood test inpatient CPT 83525 HC INSULIN LEVEL ASSAY	$85.40	$122.00	—	—	30%
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN TOTAL CDM	$85.40	$122.00	—	—	30%
Iron blood test (serum iron) CPT 83540 HC IRON	$62.30	$89.00	—	32% above	30%
Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON CDM	$65.80	$94.00	—	40% above	30%
Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON	$65.80	$94.00	—	40% above	30%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON	$62.30	$89.00	—	—	30%
Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON CDM	$65.80	$94.00	—	—	30%
Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON	$65.80	$94.00	—	—	30%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY CDM	$72.80	$104.00	—	21% above	30%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY LAB	$72.80	$104.00	—	21% above	30%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY CDM	$72.80	$104.00	—	—	30%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY LAB	$72.80	$104.00	—	—	30%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL CDM	$137.20	$196.00	—	81% above	30%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL CDM	$137.20	$196.00	—	—	30%
LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE CDM	$88.90	$127.00	—	8% below	30%
LH (luteinizing hormone) test CPT 83002 HC LUTEINIZING HORMORE (LH)	$88.90	$127.00	—	8% below	30%
LH (luteinizing hormone) test inpatient CPT 83002 HC LUTEINIZING HORMORE (LH)	$88.90	$127.00	—	—	30%
LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE CDM	$88.90	$127.00	—	—	30%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTATE LAB	$84.70	$121.00	—	15% below	30%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID	$90.30	$129.00	—	10% below	30%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTATE	$90.30	$129.00	—	10% below	30%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTATE LAB	$84.70	$121.00	—	—	30%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTATE	$90.30	$129.00	—	—	30%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID	$90.30	$129.00	—	—	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE LDH LAB	$9.80	$14.00	—	77% below	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH BODY FLUID	$55.30	$79.00	—	28% above	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE LDH CDM	$60.20	$86.00	—	39% above	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH SERUM	$60.20	$86.00	—	39% above	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE (LD) (LDH) ENZYME	$60.20	$86.00	—	39% above	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE LDH LAB	$9.80	$14.00	—	—	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LDH BODY FLUID	$55.30	$79.00	—	—	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE (LD) (LDH) ENZYME	$60.20	$86.00	—	—	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LDH SERUM	$60.20	$86.00	—	—	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE LDH CDM	$60.20	$86.00	—	—	30%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE	$88.90	$127.00	—	6% above	30%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE CDM	$88.90	$127.00	—	6% above	30%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE LAB	$88.90	$127.00	—	6% above	30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE LAB	$88.90	$127.00	—	—	30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE	$88.90	$127.00	—	—	30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE CDM	$88.90	$127.00	—	—	30%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL CDM	$137.20	$196.00	—	109% above	30%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL CDM	$137.20	$196.00	—	—	30%
Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY - IGG-IGM	$98.70	$141.00	—	3% above	30%
Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY - CSF	$98.70	$141.00	—	3% above	30%
Lyme disease antibody test CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE LAB	$98.70	$141.00	—	3% above	30%
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY - IGG-IGM	$98.70	$141.00	—	—	30%
Lyme disease antibody test inpatient CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE LAB	$98.70	$141.00	—	—	30%
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY - CSF	$98.70	$141.00	—	—	30%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM	$73.50	$105.00	—	36% above	30%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM LAB	$73.50	$105.00	—	36% above	30%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM CDM	$73.50	$105.00	—	36% above	30%
Magnesium blood test CPT 83735 HC MAGNESIUM URINE (ARUP)	$73.50	$105.00	—	36% above	30%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM LAB	$73.50	$105.00	—	—	30%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM	$73.50	$105.00	—	—	30%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM CDM	$73.50	$105.00	—	—	30%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM URINE (ARUP)	$73.50	$105.00	—	—	30%
Measles (rubeola) antibody test CPT 86765 HC MEASLES AB IGG (PANL)	$40.60	$58.00	—	43% below	30%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA ANTIBODY - IGG	$40.60	$58.00	—	43% below	30%
Measles (rubeola) antibody test CPT 86765 HC ANTIBODY RUBEOLA CDM	$40.60	$58.00	—	43% below	30%
Measles (rubeola) antibody test inpatient CPT 86765 HC MEASLES AB IGG (PANL)	$40.60	$58.00	—	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 HC ANTIBODY RUBEOLA CDM	$40.60	$58.00	—	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA ANTIBODY - IGG	$40.60	$58.00	—	—	30%
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES	$65.80	$94.00	—	15% above	30%
Mono test (heterophile antibody, Monospot) CPT 86308 HC MONO TEST	$65.80	$94.00	—	15% above	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES	$65.80	$94.00	—	—	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC MONO TEST	$65.80	$94.00	—	—	30%
Mumps immunity blood test CPT 86735 HC MUMPS ANTIBODY IGG	$63.00	$90.00	—	12% below	30%
Mumps immunity blood test CPT 86735 HC ANTIBODY MUMPS CDM	$63.00	$90.00	—	12% below	30%
Mumps immunity blood test CPT 86735 HC ANTIBODY MUMPS LAB	$63.00	$90.00	—	12% below	30%
Mumps immunity blood test inpatient CPT 86735 HC ANTIBODY MUMPS LAB	$63.00	$90.00	—	—	30%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS ANTIBODY IGG	$63.00	$90.00	—	—	30%
Mumps immunity blood test inpatient CPT 86735 HC ANTIBODY MUMPS CDM	$63.00	$90.00	—	—	30%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC ANTIGEN FREE	$106.40	$152.00	—	8% above	30%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE	$106.40	$152.00	—	8% above	30%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE LAB	$106.40	$152.00	—	8% above	30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC ANTIGEN FREE	$106.40	$152.00	—	—	30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE	$106.40	$152.00	—	—	30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE LAB	$106.40	$152.00	—	—	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL LAB	$22.40	$32.00	—	80% below	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL	$147.70	$211.00	—	33% above	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM	$147.70	$211.00	—	33% above	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATIC SPECIFIC AG	$147.70	$211.00	—	33% above	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL LAB	$22.40	$32.00	—	—	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATIC SPECIFIC AG	$147.70	$211.00	—	—	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL	$147.70	$211.00	—	—	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM	$147.70	$211.00	—	—	30%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS LAB	$192.50	$275.00	—	111% above	30%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS	$192.50	$275.00	—	111% above	30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS	$192.50	$275.00	—	—	30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS LAB	$192.50	$275.00	—	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC PAP-THIN PREP SCREENING	$147.00	$210.00	—	77% above	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC PAP-THIN PREP SCREENING	$147.00	$210.00	—	—	30%
Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE LAB	$227.50	$325.00	—	8% above	30%
Parathyroid hormone (PTH) blood test CPT 83970 HC PTH INTACT	$227.50	$325.00	—	8% above	30%
Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE	$227.50	$325.00	—	8% above	30%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHORMONE (PARATHYROID HORMONE)	$227.50	$325.00	—	8% above	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC ASSAY OF PARATHORMONE LAB	$227.50	$325.00	—	—	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PTH INTACT	$227.50	$325.00	—	—	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC ASSAY OF PARATHORMONE	$227.50	$325.00	—	—	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHORMONE (PARATHYROID HORMONE)	$227.50	$325.00	—	—	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL	$114.10	$163.00	—	177% above	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC ZPTT-D (PANL)	$114.10	$163.00	—	177% above	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB	$114.10	$163.00	—	177% above	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC ZPTT-D (PANL)	$114.10	$163.00	—	—	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB	$114.10	$163.00	—	—	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL	$114.10	$163.00	—	—	30%
Phosphorus (phosphate) blood test CPT 84100 HC ASSAY PHOSPHORUS	$53.20	$76.00	—	33% above	30%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC ASSAY PHOSPHORUS	$53.20	$76.00	—	—	30%
Potassium blood test CPT 84132 HC POTASSIUM(K)	$59.50	$85.00	—	44% above	30%
Potassium blood test CPT 84132 HC POTASSIUM	$59.50	$85.00	—	44% above	30%
Potassium blood test inpatient CPT 84132 HC POTASSIUM	$59.50	$85.00	—	—	30%
Potassium blood test inpatient CPT 84132 HC POTASSIUM(K)	$59.50	$85.00	—	—	30%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS LAB	$222.60	$318.00	—	71% below	30%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS LAB	$222.60	$318.00	—	—	30%
Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE CDM	$106.40	$152.00	—	9% above	30%
Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE CDM	$106.40	$152.00	—	—	30%
Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN CDM	$120.40	$172.00	—	11% above	30%
Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN CDM	$120.40	$172.00	—	—	30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN	$58.80	$84.00	—	47% above	30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME	$58.80	$84.00	—	47% above	30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME LAB	$58.80	$84.00	—	47% above	30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC ZPT-D (PANL)	$58.80	$84.00	—	47% above	30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME 85610	$58.80	$84.00	—	47% above	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN	$58.80	$84.00	—	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME LAB	$58.80	$84.00	—	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME	$58.80	$84.00	—	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC ZPT-D (PANL)	$58.80	$84.00	—	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME 85610	$58.80	$84.00	—	—	30%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRSMV DIRECT OPT OBS PER DOS	$374.50	$535.00	—	654% above	30%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TEST PRSMV DIRECT OPT OBS PER DOS	$374.50	$535.00	—	—	30%
Rapid flu test (influenza antigen) CPT 87804 HC IAADIADOO INFLUENZA CDM	$168.00	$240.00	—	148% above	30%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA A SCREEN	$168.00	$240.00	—	148% above	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA A SCREEN	$168.00	$240.00	—	—	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC IAADIADOO INFLUENZA CDM	$168.00	$240.00	—	—	30%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC IAADIADOO STREPTOCOCCUS GROUP A LAB	$81.90	$117.00	—	14% above	30%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC IAADIADOO STREPTOCOCCUS GROUP A LAB	$81.90	$117.00	—	—	30%
Renin blood test CPT 84244 HC ASSAY OF RENIN CDM	$112.70	$161.00	—	14% below	30%
Renin blood test CPT 84244 HC RENIN	$112.70	$161.00	—	14% below	30%
Renin blood test inpatient CPT 84244 HC ASSAY OF RENIN CDM	$112.70	$161.00	—	—	30%
Renin blood test inpatient CPT 84244 HC RENIN	$112.70	$161.00	—	—	30%
Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D)	$32.90	$47.00	—	31% below	30%
Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) LAB	$121.80	$174.00	—	155% above	30%
Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH(D)	$131.60	$188.00	—	175% above	30%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D)	$32.90	$47.00	—	—	30%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) LAB	$121.80	$174.00	—	—	30%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH(D)	$131.60	$188.00	—	—	30%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANT	$79.10	$113.00	—	98% above	30%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE LAB	$79.10	$113.00	—	98% above	30%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE LAB	$79.10	$113.00	—	—	30%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANT	$79.10	$113.00	—	—	30%
Rubella antibody test (immunity check) CPT 86762 HC ANTIBODY RUBELLA LAB	$66.50	$95.00	—	4% below	30%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY	$66.50	$95.00	—	4% below	30%
Rubella antibody test (immunity check) CPT 86762 HC ANTIBODY RUBELLA CDM	$66.50	$95.00	—	4% below	30%
Rubella antibody test (immunity check) inpatient CPT 86762 HC ANTIBODY RUBELLA LAB	$66.50	$95.00	—	—	30%
Rubella antibody test (immunity check) inpatient CPT 86762 HC ANTIBODY RUBELLA CDM	$66.50	$95.00	—	—	30%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY	$66.50	$95.00	—	—	30%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC RBC SED RATE AUTOMATED	$78.40	$112.00	—	119% above	30%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC RBC SED RATE AUTOMATED	$78.40	$112.00	—	—	30%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC SEMEN ANALYSIS	$133.00	$190.00	—	111% above	30%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC SEMEN ANALYSIS	$133.00	$190.00	—	—	30%
Sodium blood test CPT 84295 HC SODIUM BLOOD	$49.70	$71.00	—	18% above	30%
Sodium blood test CPT 84295 HC SODIUM	$49.70	$71.00	—	18% above	30%
Sodium blood test inpatient CPT 84295 HC SODIUM	$49.70	$71.00	—	—	30%
Sodium blood test inpatient CPT 84295 HC SODIUM BLOOD	$49.70	$71.00	—	—	30%
Stool ova and parasites exam CPT 87177 HC OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID	$78.40	$112.00	—	16% above	30%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS	$78.40	$112.00	—	16% above	30%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS - CONC & ID	$78.40	$112.00	—	16% above	30%
Stool ova and parasites exam inpatient CPT 87177 HC OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID	$78.40	$112.00	—	—	30%
Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES SMEARS	$78.40	$112.00	—	—	30%
Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES SMEARS - CONC & ID	$78.40	$112.00	—	—	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM	$36.40	$52.00	—	20% above	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC STOOL OCCULT BLOOD - SINGLE	$38.50	$55.00	—	27% above	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD FECES	$38.50	$55.00	—	27% above	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM	$36.40	$52.00	—	—	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC STOOL OCCULT BLOOD - SINGLE	$38.50	$55.00	—	—	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC OCCULT BLOOD FECES	$38.50	$55.00	—	—	30%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 CDM	$72.10	$103.00	—	3% below	30%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 CDM	$72.10	$103.00	—	—	30%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC TREPONEMA PALLIDUM - AB	$6.30	$9.00	—	91% below	30%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM LAB	$8.40	$12.00	—	88% below	30%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM CDM	$57.40	$82.00	—	16% below	30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC TREPONEMA PALLIDUM - AB	$6.30	$9.00	—	—	30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM LAB	$8.40	$12.00	—	—	30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM CDM	$57.40	$82.00	—	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREP QUAL - VDRL	$96.60	$138.00	—	200% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL LAB	$96.60	$138.00	—	200% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREP QUAL	$96.60	$138.00	—	200% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREP QUAL - CSF	$96.60	$138.00	—	200% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREP QUAL RPR	$96.60	$138.00	—	200% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREP QUAL	$96.60	$138.00	—	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREP QUAL - CSF	$96.60	$138.00	—	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREP QUAL RPR	$96.60	$138.00	—	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL LAB	$96.60	$138.00	—	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREP QUAL - VDRL	$96.60	$138.00	—	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON CDM	$74.20	$106.00	—	64% below	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON	$182.70	$261.00	—	12% below	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON LAB	$182.70	$261.00	—	12% below	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC QUANTIFERON TB GOLD	$182.70	$261.00	—	12% below	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON CDM	$74.20	$106.00	—	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON	$182.70	$261.00	—	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC QUANTIFERON TB GOLD	$182.70	$261.00	—	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON LAB	$182.70	$261.00	—	—	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL LAB	$144.20	$206.00	—	13% above	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE TOTAL	$144.20	$206.00	—	13% above	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE -TOTAL	$144.20	$206.00	—	13% above	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE	$144.20	$206.00	—	13% above	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL	$144.20	$206.00	—	13% above	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE TOTAL	$144.20	$206.00	—	—	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL LAB	$144.20	$206.00	—	—	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL	$144.20	$206.00	—	—	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE	$144.20	$206.00	—	—	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE -TOTAL	$144.20	$206.00	—	—	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODIES EACH CDM	$93.10	$133.00	—	15% above	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY	$93.10	$133.00	—	15% above	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODIES EACH LAB	$93.10	$133.00	—	15% above	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC THYROID PEROXIDASE AB (ANTI-TPO)	$93.10	$133.00	—	15% above	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODIES EACH CDM	$93.10	$133.00	—	—	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY	$93.10	$133.00	—	—	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODIES EACH LAB	$93.10	$133.00	—	—	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC THYROID PEROXIDASE AB (ANTI-TPO)	$93.10	$133.00	—	—	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB	$105.70	$151.00	—	at median	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH REFLEX TO FT4	$114.10	$163.00	—	8% above	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH(THYROID STIMULATING HORMONE)	$114.10	$163.00	—	8% above	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH	$114.10	$163.00	—	8% above	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE TSH	$114.10	$163.00	—	8% above	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB	$105.70	$151.00	—	—	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH	$114.10	$163.00	—	—	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE TSH	$114.10	$163.00	—	—	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH(THYROID STIMULATING HORMONE)	$114.10	$163.00	—	—	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH REFLEX TO FT4	$114.10	$163.00	—	—	30%
Total IgE blood test CPT 82785 HC IMMUNOGLOBULIN E (IGE)	$93.80	$134.00	—	2% below	30%
Total IgE blood test CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE	$93.80	$134.00	—	2% below	30%
Total IgE blood test CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE LAB	$93.80	$134.00	—	2% below	30%
Total IgE blood test CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE CDM	$93.80	$134.00	—	2% below	30%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE CDM	$93.80	$134.00	—	—	30%
Total IgE blood test inpatient CPT 82785 HC IMMUNOGLOBULIN E (IGE)	$93.80	$134.00	—	—	30%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE	$93.80	$134.00	—	—	30%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE LAB	$93.80	$134.00	—	—	30%
Total cholesterol blood test CPT 82465 HC ASSAY BLD/SERUM CHOLESTEROL	$37.10	$53.00	—	2% above	30%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL	$37.10	$53.00	—	2% above	30%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL	$37.10	$53.00	—	—	30%
Total cholesterol blood test inpatient CPT 82465 HC ASSAY BLD/SERUM CHOLESTEROL	$37.10	$53.00	—	—	30%
Total thyroxine (T4) blood test CPT 84436 HC ASSAY OF THYROXINE TOTAL LAB	$60.90	$87.00	—	8% above	30%
Total thyroxine (T4) blood test CPT 84436 HC THYROXINE TOTAL	$65.10	$93.00	—	15% above	30%
Total thyroxine (T4) blood test CPT 84436 HC ZT4 (PANL)	$65.10	$93.00	—	15% above	30%
Total thyroxine (T4) blood test CPT 84436 HC THYROXINE T4	$65.10	$93.00	—	15% above	30%
Total thyroxine (T4) blood test inpatient CPT 84436 HC ASSAY OF THYROXINE TOTAL LAB	$60.90	$87.00	—	—	30%
Total thyroxine (T4) blood test inpatient CPT 84436 HC ZT4 (PANL)	$65.10	$93.00	—	—	30%
Total thyroxine (T4) blood test inpatient CPT 84436 HC THYROXINE TOTAL	$65.10	$93.00	—	—	30%
Total thyroxine (T4) blood test inpatient CPT 84436 HC THYROXINE T4	$65.10	$93.00	—	—	30%
Total triiodothyronine (T3) blood test CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3 LAB	$82.60	$118.00	—	9% below	30%
Total triiodothyronine (T3) blood test CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3 CDM	$88.90	$127.00	—	2% below	30%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3 LAB	$82.60	$118.00	—	—	30%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3 CDM	$88.90	$127.00	—	—	30%
Transferrin blood test CPT 84466 HC ASSAY OF TRANSFERRIN	$109.20	$156.00	—	23% above	30%
Transferrin blood test CPT 84466 HC ASSAY TRANSFERRIN	$109.20	$156.00	—	23% above	30%
Transferrin blood test inpatient CPT 84466 HC ASSAY OF TRANSFERRIN	$109.20	$156.00	—	—	30%
Transferrin blood test inpatient CPT 84466 HC ASSAY TRANSFERRIN	$109.20	$156.00	—	—	30%
Trichomonas test (NAAT) CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH LAB	$145.60	$208.00	—	33% above	30%
Trichomonas test (NAAT) CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH CDM	$145.60	$208.00	—	33% above	30%
Trichomonas test (NAAT) inpatient CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH CDM	$145.60	$208.00	—	—	30%
Trichomonas test (NAAT) inpatient CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH LAB	$145.60	$208.00	—	—	30%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES (BODY FLUID)	$47.60	$68.00	—	8% above	30%
Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES LAB	$47.60	$68.00	—	8% above	30%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES	$47.60	$68.00	—	8% above	30%
Triglycerides blood test CPT 84478 HC ZTRIGLYCERIDES (PANL)	$47.60	$68.00	—	8% above	30%
Triglycerides blood test inpatient CPT 84478 HC ASSAY OF TRIGLYCERIDES LAB	$47.60	$68.00	—	—	30%
Triglycerides blood test inpatient CPT 84478 HC ZTRIGLYCERIDES (PANL)	$47.60	$68.00	—	—	30%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES (BODY FLUID)	$47.60	$68.00	—	—	30%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES	$47.60	$68.00	—	—	30%
Troponin test, quantitative CPT 84484 HC TROPONIN I	$165.90	$237.00	—	22% above	30%
Troponin test, quantitative CPT 84484 HC TROPONIN QUANTITATIVE	$165.90	$237.00	—	22% above	30%
Troponin test, quantitative CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE LAB	$165.90	$237.00	—	22% above	30%
Troponin test, quantitative CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE	$165.90	$237.00	—	22% above	30%
Troponin test, quantitative inpatient CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE LAB	$165.90	$237.00	—	—	30%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN I	$165.90	$237.00	—	—	30%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN QUANTITATIVE	$165.90	$237.00	—	—	30%
Troponin test, quantitative inpatient CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE	$165.90	$237.00	—	—	30%
Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID LAB	$48.30	$69.00	—	7% above	30%
Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID CDM	$48.30	$69.00	—	7% above	30%
Uric acid blood test inpatient CPT 84550 HC ASSAY OF BLOOD/URIC ACID CDM	$48.30	$69.00	—	—	30%
Uric acid blood test inpatient CPT 84550 HC ASSAY OF BLOOD/URIC ACID LAB	$48.30	$69.00	—	—	30%
Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM	$82.60	$118.00	—	109% above	30%
Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB	$82.60	$118.00	—	109% above	30%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM	$82.60	$118.00	—	—	30%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB	$82.60	$118.00	—	—	30%
Urinalysis without microscope exam, automated CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB	$14.00	$20.00	—	51% below	30%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE	$44.80	$64.00	—	56% above	30%
Urinalysis without microscope exam, automated CPT 81003 HC PH URINE DIPSTICK AUTO W/O MICROSCOPY LAB	$44.80	$64.00	—	56% above	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB	$14.00	$20.00	—	—	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC PH URINE DIPSTICK AUTO W/O MICROSCOPY LAB	$44.80	$64.00	—	—	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE	$44.80	$64.00	—	—	30%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE LAB	$142.80	$204.00	—	69% above	30%
Urine culture for bacteria, with colony count CPT 87086 HC URINE CULTURE/COLONY COUNT	$142.80	$204.00	—	69% above	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE LAB	$142.80	$204.00	—	—	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC URINE CULTURE/COLONY COUNT	$142.80	$204.00	—	—	30%
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN (24HR UR)	$65.80	$94.00	—	25% above	30%
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN QUANTITATIVE	$65.80	$94.00	—	25% above	30%
Urine microalbumin (albumin) test CPT 82043 HC URINE ALBUMIN QUANTITATIVE LAB	$65.80	$94.00	—	25% above	30%
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN QUANTITATIVE RANDOM	$65.80	$94.00	—	25% above	30%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN QUANTITATIVE	$65.80	$94.00	—	—	30%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN (24HR UR)	$65.80	$94.00	—	—	30%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN QUANTITATIVE RANDOM	$65.80	$94.00	—	—	30%
Urine microalbumin (albumin) test inpatient CPT 82043 HC URINE ALBUMIN QUANTITATIVE LAB	$65.80	$94.00	—	—	30%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST	$62.30	$89.00	—	24% above	30%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST	$62.30	$89.00	—	—	30%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12	$104.30	$149.00	—	5% above	30%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN-B12	$104.30	$149.00	—	5% above	30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B-12	$104.30	$149.00	—	—	30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN-B12	$104.30	$149.00	—	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED LAB	$177.80	$254.00	—	31% above	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$177.80	$254.00	—	31% above	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$177.80	$254.00	—	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED LAB	$177.80	$254.00	—	—	30%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VITAMIN D 1 25-DIHYDROXY	$128.80	$184.00	—	26% below	30%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$128.80	$184.00	—	26% below	30%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$128.80	$184.00	—	—	30%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC VITAMIN D 1 25-DIHYDROXY	$128.80	$184.00	—	—	30%
Zinc blood test CPT 84630 HC ASSAY OF ZINC LAB	$75.60	$108.00	—	at median	30%
Zinc blood test CPT 84630 HC ZINC	$75.60	$108.00	—	at median	30%
Zinc blood test CPT 84630 HC ASSAY OF ZINC CDM	$75.60	$108.00	—	at median	30%
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC CDM	$75.60	$108.00	—	—	30%
Zinc blood test inpatient CPT 84630 HC ZINC	$75.60	$108.00	—	—	30%
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC LAB	$75.60	$108.00	—	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE LAB	$150.50	$215.00	—	39% above	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE CDM	$160.30	$229.00	—	48% above	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC HCG QUANT	$160.30	$229.00	—	48% above	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC (HCG) QUANTITATIVE	$160.30	$229.00	—	48% above	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HCG (QUANTITATIVE)	$160.30	$229.00	—	48% above	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE LAB	$150.50	$215.00	—	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC HCG QUANT	$160.30	$229.00	—	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE CDM	$160.30	$229.00	—	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HCG (QUANTITATIVE)	$160.30	$229.00	—	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC (HCG) QUANTITATIVE	$160.30	$229.00	—	—	30%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC ED SINUS ENDO W/BALLOON DILATION CDM	$3,027.50	$4,325.00	—	36% below	30%
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 HC ED SINUS ENDO W/BALLOON DILATION CDM	$3,027.50	$4,325.00	—	—	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST 1ST LESION STEREO	$5,586.00	$7,980.00	—	152% above	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST 1ST LESION STEREO	$5,586.00	$7,980.00	—	—	30%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC ED CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM	$459.20	$656.00	—	29% below	30%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC ED CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM	$459.20	$656.00	—	—	30%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC ED TREAT METATARSAL FRACTURE W/O MANIPULATION CDM	$420.70	$601.00	—	27% below	30%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC ED TREAT METATARSAL FRACTURE W/O MANIPULATION CDM	$420.70	$601.00	—	—	30%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HC ED CORRECTION OF BUNION CDM	$5,941.60	$8,488.00	—	3% below	30%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 HC ED CORRECTION OF BUNION CDM	$5,941.60	$8,488.00	—	—	30%
Cardiac catheterization with coronary angiogram CPT 93458 HC CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I	$18,242.70	$26,061.00	—	73% above	30%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 HC CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I	$18,242.70	$26,061.00	—	—	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$1,976.80	$2,824.00	—	81% above	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$1,976.80	$2,824.00	—	—	30%
Carpal tunnel release, open surgery CPT 64721 HC ED NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL CDM	$3,804.50	$5,435.00	—	14% above	30%
Carpal tunnel release, open surgery inpatient CPT 64721 HC ED NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL CDM	$3,804.50	$5,435.00	—	—	30%
Catheter ablation for atrial fibrillation CPT 93656 HC COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$25,757.20	$36,796.00	—	at median	30%
Catheter ablation for atrial fibrillation inpatient CPT 93656 HC COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$25,757.20	$36,796.00	—	—	30%
Cervical biopsy CPT 57500 HC BIOPSY OF CERVIX	$1,066.10	$1,523.00	—	37% above	30%
Cervical biopsy CPT 57500 HC ED BIOPSY OF CERVIX CDM	$1,066.10	$1,523.00	—	37% above	30%
Cervical biopsy inpatient CPT 57500 HC ED BIOPSY OF CERVIX CDM	$1,066.10	$1,523.00	—	—	30%
Cervical biopsy inpatient CPT 57500 HC BIOPSY OF CERVIX	$1,066.10	$1,523.00	—	—	30%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC PR 54150 CIRCUMCISION W/REGIONAL BLOCK	$87.50	$125.00	—	80% below	30%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION W/REGIONL BLOCK CDM	$345.80	$494.00	—	19% below	30%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC PR 54150 CIRCUMCISION W/REGIONAL BLOCK	$87.50	$125.00	—	—	30%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION W/REGIONL BLOCK CDM	$345.80	$494.00	—	—	30%
Circumcision, surgical, older than a newborn CPT 54160 HC PR 54160 CIRCUMCISION NEONATE	$87.50	$125.00	—	76% below	30%
Circumcision, surgical, older than a newborn inpatient CPT 54160 HC PR 54160 CIRCUMCISION NEONATE	$87.50	$125.00	—	—	30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC ED TREAT DISTAL RADIAL FRACTURE RADIUS/ULNA W/O MANIP CDM	$467.60	$668.00	—	24% below	30%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC ED TREAT DISTAL RADIAL FRACTURE RADIUS/ULNA W/O MANIP CDM	$467.60	$668.00	—	—	30%
Colonoscopy, diagnostic CPT 45378 HC ED COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD CDM	$2,125.20	$3,036.00	—	10% above	30%
Colonoscopy, diagnostic inpatient CPT 45378 HC ED COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD CDM	$2,125.20	$3,036.00	—	—	30%
Coronary stent placement, one artery CPT 92928 HC INSERT COR STENT PERC TRLUML W/ANGIO ONE ART/BRNCH	$19,600.00	$28,000.00	—	8% below	30%
Coronary stent placement, one artery inpatient CPT 92928 HC INSERT COR STENT PERC TRLUML W/ANGIO ONE ART/BRNCH	$19,600.00	$28,000.00	—	—	30%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC ED CYSTOURETHROSCOPY CDM	$844.90	$1,207.00	—	9% below	30%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOSCOPY	$844.90	$1,207.00	—	9% below	30%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY CDM	$844.90	$1,207.00	—	9% below	30%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOSCOPY	$844.90	$1,207.00	—	—	30%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC ED CYSTOURETHROSCOPY CDM	$844.90	$1,207.00	—	—	30%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY CDM	$844.90	$1,207.00	—	—	30%
D&C (dilation and curettage), not related to pregnancy CPT 58120 HC ED DILATION AND CURETTAGE CDM	$4,740.40	$6,772.00	—	60% above	30%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC ED DILATION AND CURETTAGE CDM	$4,740.40	$6,772.00	—	—	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC ED DESTRUCT PREMALG LESION FIRST LESION CDM	$172.20	$246.00	—	7% below	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC ED DESTRUCT PREMALG LESION FIRST LESION CDM	$172.20	$246.00	—	—	30%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC ED REMOVE IMPACTED EAR WAX UNI CDM	$224.00	$320.00	—	101% above	30%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC ED REMOVE IMPACTED EAR WAX UNI CDM	$224.00	$320.00	—	—	30%
Earwax removal with instruments, one ear one side CPT 69210 HC ED REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$350.00	$500.00	—	105% above	30%
Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$350.00	$500.00	—	105% above	30%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC ED REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$350.00	$500.00	—	—	30%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$350.00	$500.00	—	—	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ED ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX CDM	$288.40	$412.00	—	2% below	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC BIOPSY OF UTERUS LINING	$288.40	$412.00	—	2% below	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC ED ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX CDM	$288.40	$412.00	—	—	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC BIOPSY OF UTERUS LINING	$288.40	$412.00	—	—	30%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC ED INJ INTERLAMINR CRV-THOR W IMG CDM	$3,332.70	$4,761.00	—	119% above	30%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC INJ W/NDL OR CATH PLCMNT EPIDRL C/T W/IMG	$3,332.70	$4,761.00	—	119% above	30%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC INJ W/NDL OR CATH PLCMNT EPIDRL C/T W/IMG	$3,332.70	$4,761.00	—	—	30%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC ED INJ INTERLAMINR CRV-THOR W IMG CDM	$3,332.70	$4,761.00	—	—	30%
Eye injection into the vitreous (intravitreal injection) CPT 67028 HC ED INTRAVITREAL NJX PHARMACOLOGIC AGT SPX CDM	$648.90	$927.00	—	18% below	30%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HC ED INTRAVITREAL NJX PHARMACOLOGIC AGT SPX CDM	$648.90	$927.00	—	—	30%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV	$2,702.70	$3,861.00	—	18% above	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV	$2,702.70	$3,861.00	—	—	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC ED SIGMOID DX FLX W WO SPEC COLL CDM	$1,773.10	$2,533.00	—	13% above	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC ED SIGMOID DX FLX W WO SPEC COLL CDM	$1,773.10	$2,533.00	—	—	30%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC ED LAPARO CHOLECYSTECTOMY/GRAPH CDM	$12,202.40	$17,432.00	—	10% above	30%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 HC ED LAPARO CHOLECYSTECTOMY/GRAPH CDM	$12,202.40	$17,432.00	—	—	30%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC ED HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS CDM	$996.80	$1,424.00	—	21% below	30%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC ED HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS CDM	$996.80	$1,424.00	—	—	30%
Hemorrhoidectomy (internal and external), one area CPT 46255 HC ED HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP CDM	$4,936.40	$7,052.00	—	23% above	30%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HC ED HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP CDM	$4,936.40	$7,052.00	—	—	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC CATHETER FOR HYSTEROGRAPHY	$434.70	$621.00	—	72% above	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC CATHETER FOR HYSTEROGRAPHY	$483.00	$690.00	—	91% above	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC CATHETER FOR HYSTEROGRAPHY	$483.00	$690.00	—	—	30%
IUD insertion (the device itself billed separately) CPT 58300 HC ED INSERTION INTRAUTERINE DEVICE IUD CDM	$928.20	$1,326.00	—	224% above	30%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC ED INSERTION INTRAUTERINE DEVICE IUD CDM	$928.20	$1,326.00	—	—	30%
Incision and drainage of a simple or single skin abscess CPT 10060 HC ED DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM	$636.30	$909.00	—	70% above	30%
Incision and drainage of a simple or single skin abscess CPT 10060 HC DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE	$636.30	$909.00	—	70% above	30%
Incision and drainage of a simple or single skin abscess CPT 10060 HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE CDM	$636.30	$909.00	—	70% above	30%
Incision and drainage of a simple or single skin abscess CPT 10060 HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$636.30	$909.00	—	70% above	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC ED DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM	$636.30	$909.00	—	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$636.30	$909.00	—	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE CDM	$636.30	$909.00	—	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE	$636.30	$909.00	—	—	30%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC ED RPR 1ST INGUN HRNA AGE 5 YRS OR MORE REDUCIBLE CDM	$7,835.10	$11,193.00	—	2% below	30%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC ED RPR 1ST INGUN HRNA AGE 5 YRS OR MORE REDUCIBLE CDM	$7,835.10	$11,193.00	—	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC ED INJ TENDON SHEATH/LIGAMENT CDM	$373.80	$534.00	—	24% above	30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$373.80	$534.00	—	24% above	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$373.80	$534.00	—	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC ED INJ TENDON SHEATH/LIGAMENT CDM	$373.80	$534.00	—	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$784.70	$1,121.00	—	62% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ED ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US CDM	$784.70	$1,121.00	—	62% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$784.70	$1,121.00	—	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ED ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US CDM	$784.70	$1,121.00	—	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERMED	$682.50	$975.00	—	49% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE	$682.50	$975.00	—	49% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ED ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US CDM	$682.50	$975.00	—	49% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE	$682.50	$975.00	—	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ED ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US CDM	$682.50	$975.00	—	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERMED	$682.50	$975.00	—	—	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE	$592.90	$847.00	—	56% above	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ED ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US CDM	$592.90	$847.00	—	56% above	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE	$592.90	$847.00	—	56% above	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ED ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US CDM	$592.90	$847.00	—	—	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE	$592.90	$847.00	—	—	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC ED INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM	$744.80	$1,064.00	—	13% above	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC ED INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM	$744.80	$1,064.00	—	—	30%
Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY	$7,180.60	$10,258.00	—	12% below	30%
Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY	$7,180.60	$10,258.00	—	—	30%
Lower-back epidural injection, with imaging guidance CPT 62323 HC ED INJ EPI LUMB/SACRAL W IMAGING CDM	$3,299.10	$4,713.00	—	115% above	30%
Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ W/NDL OR CATH PLCMNT EPIDRL L/S W/IMG	$3,299.10	$4,713.00	—	115% above	30%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ W/NDL OR CATH PLCMNT EPIDRL L/S W/IMG	$3,299.10	$4,713.00	—	—	30%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC ED INJ EPI LUMB/SACRAL W IMAGING CDM	$3,299.10	$4,713.00	—	—	30%
Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$1,918.70	$2,741.00	—	68% above	30%
Lower-back epidural injection, without imaging guidance CPT 62322 HC ED INJ EPI LUMB/SACRAL WO IMAGING CDM	$1,918.70	$2,741.00	—	68% above	30%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$1,918.70	$2,741.00	—	—	30%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC ED INJ EPI LUMB/SACRAL WO IMAGING CDM	$1,918.70	$2,741.00	—	—	30%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ FORAMEN EPIDURAL L/S	$2,252.60	$3,218.00	—	31% above	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ FORAMEN EPIDURAL L/S	$2,252.60	$3,218.00	—	—	30%
Miscarriage treatment with D&C, first trimester CPT 59820 HC ED SPONTANEOUS ABORTION FAC CDM	$5,853.40	$8,362.00	—	22% above	30%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HC ED SPONTANEOUS ABORTION FAC CDM	$5,853.40	$8,362.00	—	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM OR LESS CDM	$756.00	$1,080.00	—	3% above	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM OR LESS CDM	$756.00	$1,080.00	—	—	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC ED EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM OR LESS CDM	$804.30	$1,149.00	—	7% above	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC ED EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM OR LESS CDM	$804.30	$1,149.00	—	—	30%
Nail removal (partial or complete), one nail CPT 11730 HC AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 CDM	$448.00	$640.00	—	60% above	30%
Nail removal (partial or complete), one nail CPT 11730 HC ED REMOVAL OF NAIL PLATE CDM	$448.00	$640.00	—	60% above	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 CDM	$448.00	$640.00	—	—	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC ED REMOVAL OF NAIL PLATE CDM	$448.00	$640.00	—	—	30%
Occipital nerve block (injection for headaches) CPT 64405 HC ED NERVE BLOCK INJ OCCIPITAL CDM	$950.60	$1,358.00	—	43% above	30%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC ED NERVE BLOCK INJ OCCIPITAL CDM	$950.60	$1,358.00	—	—	30%
Pacemaker implant (dual chamber) CPT 33208 HC INSERTION PERM AV PACER	$23,840.60	$34,058.00	—	128% above	30%
Pacemaker implant (dual chamber) inpatient CPT 33208 HC INSERTION PERM AV PACER	$23,840.60	$34,058.00	—	—	30%
Paracentesis with imaging guidance CPT 49083 HC PR ED 49083 ABD PARACENT W/IMAG GUIDANCE CDM	$146.30	$209.00	—	89% below	30%
Paracentesis with imaging guidance CPT 49083 HC PR 49083 ABD PARACENT W/IMAG GUIDANCE	$146.30	$209.00	—	89% below	30%
Paracentesis with imaging guidance CPT 49083 HC PR 49083 ABD PARACENT W/IMAG GUIDANCE	$146.30	$209.00	—	89% below	30%
Paracentesis with imaging guidance CPT 49083 HC ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE CDM	$2,338.70	$3,341.00	—	76% above	30%
Paracentesis with imaging guidance CPT 49083 HC ED ABD PARACENTESIS W/IMAG GUIDANCE CDM	$2,338.70	$3,341.00	—	76% above	30%
Paracentesis with imaging guidance inpatient CPT 49083 HC PR 49083 ABD PARACENT W/IMAG GUIDANCE	$146.30	$209.00	—	—	30%
Paracentesis with imaging guidance inpatient CPT 49083 HC PR ED 49083 ABD PARACENT W/IMAG GUIDANCE CDM	$146.30	$209.00	—	—	30%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE CDM	$2,338.70	$3,341.00	—	—	30%
Paracentesis with imaging guidance inpatient CPT 49083 HC ED ABD PARACENTESIS W/IMAG GUIDANCE CDM	$2,338.70	$3,341.00	—	—	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC ED REMOVAL OF NAIL BED CDM	$1,192.80	$1,704.00	—	76% above	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC ED REMOVAL OF NAIL BED CDM	$1,192.80	$1,704.00	—	—	30%
Prostate biopsy CPT 55700 HC BIOPSY OF PROSTATE	$2,400.30	$3,429.00	—	31% above	30%
Prostate biopsy CPT 55700 HC BIOPSY OF PROSTATE	$2,400.30	$3,429.00	—	31% above	30%
Prostate biopsy inpatient CPT 55700 HC BIOPSY OF PROSTATE	$2,400.30	$3,429.00	—	—	30%
Removal of a foreign object under the skin, simple CPT 10120 HC ED REMOVE FOREIGN BODY SIMPLE CDM	$1,033.20	$1,476.00	—	99% above	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC ED REMOVE FOREIGN BODY SIMPLE CDM	$1,033.20	$1,476.00	—	—	30%
Septoplasty to straighten the nasal septum CPT 30520 HC ED REPAIR OF NASAL SEPTUM CDM	$3,725.40	$5,322.00	—	25% below	30%
Septoplasty to straighten the nasal septum inpatient CPT 30520 HC ED REPAIR OF NASAL SEPTUM CDM	$3,725.40	$5,322.00	—	—	30%
Short arm cast (elbow to hand) CPT 29075 HC ED SHORT ARM CAST APPLICATION CDM	$293.30	$419.00	—	33% below	30%
Short arm cast (elbow to hand) inpatient CPT 29075 HC ED SHORT ARM CAST APPLICATION CDM	$293.30	$419.00	—	—	30%
Short arm splint (forearm and hand) CPT 29125 HC ED SHORT ARM SPLINT APPLICATION CDM	$592.90	$847.00	—	114% above	30%
Short arm splint (forearm and hand) inpatient CPT 29125 HC ED SHORT ARM SPLINT APPLICATION CDM	$592.90	$847.00	—	—	30%
Short leg cast (below the knee) CPT 29405 HC ED SHORT LEG CAST APPLICATION CDM	$333.20	$476.00	—	4% below	30%
Short leg cast (below the knee) inpatient CPT 29405 HC ED SHORT LEG CAST APPLICATION CDM	$333.20	$476.00	—	—	30%
Short leg splint (calf to foot) CPT 29515 HC ED SHORT LEG SPLINT APPLICATION CDM	$674.10	$963.00	—	90% above	30%
Short leg splint (calf to foot) inpatient CPT 29515 HC ED SHORT LEG SPLINT APPLICATION CDM	$674.10	$963.00	—	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/OR LESS	$667.10	$953.00	—	97% above	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM	$667.10	$953.00	—	97% above	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/OR LESS	$667.10	$953.00	—	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM	$667.10	$953.00	—	—	30%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$384.30	$549.00	—	14% above	30%
Skin biopsy, punch, one lesion CPT 11104 HC ED PUNCH BIOPSY SKIN SINGLE LESION CDM	$384.30	$549.00	—	14% above	30%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$384.30	$549.00	—	14% above	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC ED PUNCH BIOPSY SKIN SINGLE LESION CDM	$384.30	$549.00	—	—	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$384.30	$549.00	—	—	30%
Skin tag removal, up to 15 tags CPT 11200 HC ED REMOVAL OF SKIN TAGS CDM	$181.30	$259.00	—	17% below	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC ED REMOVAL OF SKIN TAGS CDM	$181.30	$259.00	—	—	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$1,851.50	$2,645.00	—	87% above	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC ED SPINAL PUNCTURE LUMBAR DIAGNOSTIC CDM	$1,851.50	$2,645.00	—	87% above	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$1,851.50	$2,645.00	—	—	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC ED SPINAL PUNCTURE LUMBAR DIAGNOSTIC CDM	$1,851.50	$2,645.00	—	—	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC REPAIR SUPERFICIAL WOUND(S) 2.5 TO 7.5 CM	$767.20	$1,096.00	—	85% above	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC ED REPAIR SUPERFICIAL WND(S) 2.6-7.5CM SLP NK AX EXGEN TRNK E CDM	$767.20	$1,096.00	—	85% above	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC REPAIR SUPERFICIAL WOUND(S) 2.5 TO 7.5 CM	$767.20	$1,096.00	—	—	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC ED REPAIR SUPERFICIAL WND(S) 2.6-7.5CM SLP NK AX EXGEN TRNK E CDM	$767.20	$1,096.00	—	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC SIMPLE REPAIR F/E/E/N/L/M 2.5CM/OR LESS CDM	$691.60	$988.00	—	71% above	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair one side CPT 12011 HC ED REPAIR SUPERFICIAL WOUND(S) LT/2.5 FACE ERS EYLD NSE LPS MUC CDM	$691.60	$988.00	—	71% above	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC SIMPLE REPAIR F/E/E/N/L/M 2.5CM/OR LESS CDM	$691.60	$988.00	—	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient one side CPT 12011 HC ED REPAIR SUPERFICIAL WOUND(S) LT/2.5 FACE ERS EYLD NSE LPS MUC CDM	$691.60	$988.00	—	—	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC ED TANGENTIAL BIOPSY SKIN SINGLE LESION CDM	$235.90	$337.00	—	11% below	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC ED TANGENTIAL BIOPSY SKIN SINGLE LESION CDM	$235.90	$337.00	—	—	30%
Thoracentesis with imaging guidance CPT 32555 HC PR ED 32555 THORACENTESIS/ASPIR W IMG GD CDM	$151.90	$217.00	—	89% below	30%
Thoracentesis with imaging guidance CPT 32555 HC PR 32555 THORANCENTESIS NEEDLE/CATH PLEURA W IMAGING	$151.90	$217.00	—	89% below	30%
Thoracentesis with imaging guidance CPT 32555 HC PR 32555 THORANCENTESIS NEEDLE/CATH PLEURA W IMAGING	$151.90	$217.00	—	89% below	30%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$2,872.10	$4,103.00	—	117% above	30%
Thoracentesis with imaging guidance CPT 32555 HC ED THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING CDM	$2,872.10	$4,103.00	—	117% above	30%
Thoracentesis with imaging guidance inpatient CPT 32555 HC PR 32555 THORANCENTESIS NEEDLE/CATH PLEURA W IMAGING	$151.90	$217.00	—	—	30%
Thoracentesis with imaging guidance inpatient CPT 32555 HC PR ED 32555 THORACENTESIS/ASPIR W IMG GD CDM	$151.90	$217.00	—	—	30%
Thoracentesis with imaging guidance inpatient CPT 32555 HC ED THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING CDM	$2,872.10	$4,103.00	—	—	30%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$2,872.10	$4,103.00	—	—	30%
Trigger point injections, 1 or 2 muscles CPT 20552 HC IR INJ TRIGGER POINT(S)1TO2 MUSC	$520.10	$743.00	—	44% above	30%
Trigger point injections, 1 or 2 muscles CPT 20552 HC ED INJ TRIGGER POINT 1/2 MUSCL CDM	$548.80	$784.00	—	52% above	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC IR INJ TRIGGER POINT(S)1TO2 MUSC	$520.10	$743.00	—	—	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC ED INJ TRIGGER POINT 1/2 MUSCL CDM	$548.80	$784.00	—	—	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST 1ST LESION US IMAG	$4,179.00	$5,970.00	—	67% above	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST 1ST LESION US IMAG	$4,179.00	$5,970.00	—	—	30%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC ED UGI W DILATION ESOPHAGUS BAL CDM	$2,091.60	$2,988.00	—	9% below	30%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC ED UGI W DILATION ESOPHAGUS BAL CDM	$2,091.60	$2,988.00	—	—	30%
Upper endoscopy (EGD) with biopsy CPT 43239 HC ED EGD TRANSORAL BIOPSY SINGLE/MULTIPLE CDM	$2,046.10	$2,923.00	—	6% above	30%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC ED EGD TRANSORAL BIOPSY SINGLE/MULTIPLE CDM	$2,046.10	$2,923.00	—	—	30%
Upper endoscopy (EGD), diagnostic CPT 43235 HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM	$1,983.80	$2,834.00	—	22% above	30%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM	$1,983.80	$2,834.00	—	—	30%
Vein ablation, radiofrequency, first vein CPT 36475 HC VEIN ABLATION RF INITIAL VEIN	$9,012.50	$12,875.00	—	89% above	30%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 HC VEIN ABLATION RF INITIAL VEIN	$9,012.50	$12,875.00	—	—	30%
Wart removal, up to 14 warts CPT 17110 HC ED DESTRUCTION BENIGN LESIONS UP TO 14 CDM	$182.00	$260.00	—	23% below	30%
Wart removal, up to 14 warts inpatient CPT 17110 HC ED DESTRUCTION BENIGN LESIONS UP TO 14 CDM	$182.00	$260.00	—	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEB SUBQ TISSUE FIRST 20 SQ CM OR LESS	$906.50	$1,295.00	—	41% above	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC ED DEB SUBQ TISSUE 20 SQ CM OR LESS - DEBRIDE SKIN CDM	$906.50	$1,295.00	—	41% above	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE SUBQ TISSUE LTE 20 SQ CM	$906.50	$1,295.00	—	41% above	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDE SUBQ TISSUE LTE 20 SQ CM	$906.50	$1,295.00	—	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEB SUBQ TISSUE FIRST 20 SQ CM OR LESS	$906.50	$1,295.00	—	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC ED DEB SUBQ TISSUE 20 SQ CM OR LESS - DEBRIDE SKIN CDM	$906.50	$1,295.00	—	—	30%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC ED TREAT FX RAD EXTRA-ARTICUL CDM	$8,579.90	$12,257.00	—	19% below	30%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 HC ED TREAT FX RAD EXTRA-ARTICUL CDM	$8,579.90	$12,257.00	—	—	30%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION EA UNIT CDM	$1,657.60	$2,368.00	—	69% above	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION EA UNIT CDM	$1,657.60	$2,368.00	—	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-SPUTUM INDUCTION	$197.40	$282.00	—	2% below	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT DAILY	$210.70	$301.00	—	5% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC ED INHALATION TREATMENT CDM	$210.70	$301.00	—	5% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-SPUTUM INDUCTION	$197.40	$282.00	—	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT DAILY	$210.70	$301.00	—	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC ED INHALATION TREATMENT CDM	$210.70	$301.00	—	—	30%
Chemotherapy IV infusion, first hour CPT 96413 HC TYSABRI INFUSION FIRST HR	$595.00	$850.00	—	24% below	30%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO IV INFUSION INITIAL HR CDM	$595.00	$850.00	—	24% below	30%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC TYSABRI INFUSION FIRST HR	$595.00	$850.00	—	—	30%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO IV INFUSION INITIAL HR CDM	$595.00	$850.00	—	—	30%
Critical care, first 30 to 74 minutes CPT 99291 HC ED CRITICAL CARE FIRST HOUR CDM	$4,292.40	$6,132.00	—	33% above	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ED CRITICAL CARE FIRST HOUR CDM	$4,292.40	$6,132.00	—	—	30%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY	$1,421.00	$2,030.00	—	84% above	30%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY	$1,421.00	$2,030.00	—	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ECG 12 LEAD TRACING ONLY	$217.70	$311.00	—	17% above	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ECG 12 LEAD TRACING ONLY	$217.70	$311.00	—	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED FAC E&M VISIT LEVEL 1 CDM	$273.00	$390.00	—	9% above	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED FAC E&M VISIT LEVEL 1 CDM	$273.00	$390.00	—	—	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED FAC E&M VISIT LEVEL 2 CDM	$497.00	$710.00	—	9% above	30%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED FAC E&M VISIT LEVEL 2 CDM	$497.00	$710.00	—	—	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED FAC E&M VISIT LEVEL 3 CDM	$954.10	$1,363.00	—	19% above	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED FAC E&M VISIT LEVEL 3 CDM	$954.10	$1,363.00	—	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED SEXUAL ASSAULT EXAM CDM	$1,662.50	$2,375.00	—	23% above	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED FAC E&M VISIT LEVEL 4 CDM	$1,662.50	$2,375.00	—	23% above	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED FAC E&M VISIT LEVEL 4 CDM	$1,662.50	$2,375.00	—	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED SEXUAL ASSAULT EXAM CDM	$1,662.50	$2,375.00	—	—	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED FAC E&M VISIT LEVEL 5 CDM	$2,582.30	$3,689.00	—	15% above	30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED FAC E&M VISIT LEVEL 5 CDM	$2,582.30	$3,689.00	—	—	30%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY	$585.90	$837.00	—	1% below	30%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY	$585.90	$837.00	—	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV HYDRATION INITIAL HR CDM	$378.70	$541.00	—	12% above	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC ED IV HYDRATION INITIAL HR CDM	$378.70	$541.00	—	12% above	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV HYDRATION INITIAL HR CDM	$378.70	$541.00	—	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC ED IV HYDRATION INITIAL HR CDM	$378.70	$541.00	—	—	30%
IV infusion of a medicine, first hour CPT 96365 HC ED IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR CDM	$441.70	$631.00	—	9% above	30%
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION INITIAL HR CDM	$441.70	$631.00	—	9% above	30%
IV infusion of a medicine, first hour inpatient CPT 96365 HC ED IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR CDM	$441.70	$631.00	—	—	30%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION INITIAL HR CDM	$441.70	$631.00	—	—	30%
IV push of a medicine, first drug CPT 96374 HC INJ IV PUSH INITIAL DRUG CDM	$221.20	$316.00	—	6% below	30%
IV push of a medicine, first drug CPT 96374 HC ED IV INJECTION THERAPEUTIC PROPH/DX PUSH SINGLE/1ST SBST/DRUG CDM	$221.20	$316.00	—	6% below	30%
IV push of a medicine, first drug inpatient CPT 96374 HC INJ IV PUSH INITIAL DRUG CDM	$221.20	$316.00	—	—	30%
IV push of a medicine, first drug inpatient CPT 96374 HC ED IV INJECTION THERAPEUTIC PROPH/DX PUSH SINGLE/1ST SBST/DRUG CDM	$221.20	$316.00	—	—	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC ED THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM CDM	$179.90	$257.00	—	85% above	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ SQ OR IM CDM	$179.90	$257.00	—	85% above	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJ SQ OR IM CDM	$179.90	$257.00	—	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC ED THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM CDM	$179.90	$257.00	—	—	30%
Neuromuscular re-education, 15 minutes CPT 97112 HC CRISIS TELEH 97112 NEUROMUSCUL REEDUCAT EA 15 MIN CDM	$102.20	$146.00	—	3% above	30%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSC REEDUCA THER PX 1 OR MORE AREAS EACH 15 MIN	$102.20	$146.00	—	3% above	30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSC REEDUCA THER PX 1 OR MORE AREAS EACH 15 MIN	$102.20	$146.00	—	—	30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC CRISIS TELEH 97112 NEUROMUSCUL REEDUCAT EA 15 MIN CDM	$102.20	$146.00	—	—	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EA 15 MIN CDM	$80.50	$115.00	—	26% above	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC CRISIS PHONE 97802 MED NUTRITION INDIV INIT EA 15 MIN CDM	$80.50	$115.00	—	26% above	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC CRISIS TELEH 97802 MEDICAL NUTRITION INDIV INIT THERAPY EA 15 MIN CDM	$80.50	$115.00	—	26% above	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EA 15 MIN CDM	$80.50	$115.00	—	—	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC CRISIS TELEH 97802 MEDICAL NUTRITION INDIV INIT THERAPY EA 15 MIN CDM	$80.50	$115.00	—	—	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC CRISIS PHONE 97802 MED NUTRITION INDIV INIT EA 15 MIN CDM	$80.50	$115.00	—	—	30%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION LOW COMPLEX	$168.70	$241.00	—	22% below	30%
Occupational therapy evaluation, low complexity CPT 97165 HC CRISIS TELEH 97165 OT EVALUATION LOW COMPLEX CDM	$168.70	$241.00	—	22% below	30%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION LOW COMPLEX	$168.70	$241.00	—	—	30%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC CRISIS TELEH 97165 OT EVALUATION LOW COMPLEX CDM	$168.70	$241.00	—	—	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION HIGH COMPLEX	$247.80	$354.00	—	10% below	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC CRISIS TELEH 97163 PT EVALUATION HIGH COMPLEX CDM	$247.80	$354.00	—	10% below	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC CRISIS TELEH 97163 PT EVALUATION HIGH COMPLEX CDM	$247.80	$354.00	—	—	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION HIGH COMPLEX	$247.80	$354.00	—	—	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC CRISIS TELEH 97161 PT EVALUATION LOW COMPLEX CDM	$210.70	$301.00	—	5% below	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION LOW COMPLEX CDM	$210.70	$301.00	—	5% below	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC CRISIS TELEH 97161 PT EVALUATION LOW COMPLEX CDM	$210.70	$301.00	—	—	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION LOW COMPLEX CDM	$210.70	$301.00	—	—	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION MOD COMPLEX CDM	$227.50	$325.00	—	8% below	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC CRISIS TELEH 97162 PT EVALUATION MOD COMPLEX CDM	$227.50	$325.00	—	8% below	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC CRISIS TELEH 97162 PT EVALUATION MOD COMPLEX CDM	$227.50	$325.00	—	—	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION MOD COMPLEX CDM	$227.50	$325.00	—	—	30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY TQS 1 OR MORE REGIONS EACH 15 MINUTES	$94.50	$135.00	—	12% above	30%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY TQS 1 OR MORE REGIONS EACH 15 MINUTES	$94.50	$135.00	—	—	30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC CRISIS TELEH 97110 THERAPEUTIC EXERCISES EA 15 MIN CDM	$98.70	$141.00	—	3% above	30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN	$98.70	$141.00	—	3% above	30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN	$98.70	$141.00	—	—	30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC CRISIS TELEH 97110 THERAPEUTIC EXERCISES EA 15 MIN CDM	$98.70	$141.00	—	—	30%
Speech and language evaluation CPT 92523 HC CRISIS TELEH 92523 SPEECH SOUND LANG COMPREHEN CDM	$409.50	$585.00	—	7% above	30%
Speech and language evaluation CPT 92523 HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION CDM	$409.50	$585.00	—	7% above	30%
Speech and language evaluation inpatient CPT 92523 HC CRISIS TELEH 92523 SPEECH SOUND LANG COMPREHEN CDM	$409.50	$585.00	—	—	30%
Speech and language evaluation inpatient CPT 92523 HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION CDM	$409.50	$585.00	—	—	30%
Speech therapy session, individual CPT 92507 HC TX SPEECH/LANG/VOICE COMMJ/AUDITORY PROCESS - INDIVIDUAL	$158.90	$227.00	—	27% below	30%
Speech therapy session, individual CPT 92507 HC CRISIS TELEH 92507 SPEECH/HEARING THERAPY - INDIV CDM	$158.90	$227.00	—	27% below	30%
Speech therapy session, individual inpatient CPT 92507 HC TX SPEECH/LANG/VOICE COMMJ/AUDITORY PROCESS - INDIVIDUAL	$158.90	$227.00	—	—	30%
Speech therapy session, individual inpatient CPT 92507 HC CRISIS TELEH 92507 SPEECH/HEARING THERAPY - INDIV CDM	$158.90	$227.00	—	—	30%
Spirometry (breathing test) CPT 94010 HC PR 94010 SPIROMETRY	$34.30	$49.00	—	86% below	30%
Spirometry (breathing test) CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$350.00	$500.00	—	41% above	30%
Spirometry (breathing test) inpatient CPT 94010 HC PR 94010 SPIROMETRY	$34.30	$49.00	—	—	30%
Spirometry (breathing test) inpatient CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$350.00	$500.00	—	—	30%
Spirometry before and after a bronchodilator CPT 94060 HC PR 94060 SPIROMETRY PRE POST BRONCHODILATOR	$292.60	$418.00	—	30% below	30%
Spirometry before and after a bronchodilator CPT 94060 HC SPIROMETRY PRE POST BRONCHODILATOR CDM	$387.10	$553.00	—	8% below	30%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC PR 94060 SPIROMETRY PRE POST BRONCHODILATOR	$292.60	$418.00	—	—	30%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC SPIROMETRY PRE POST BRONCHODILATOR CDM	$387.10	$553.00	—	—	30%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$107.10	$153.00	—	2% above	30%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC CRISIS TELEH 97530 THERAPEUTIC ACTIVITIES EA 15 MIN	$107.10	$153.00	—	2% above	30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$107.10	$153.00	—	—	30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC CRISIS TELEH 97530 THERAPEUTIC ACTIVITIES EA 15 MIN	$107.10	$153.00	—	—	30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC ED PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE CDM	$604.80	$864.00	—	199% above	30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC THERAPUTIC PHLEBOTOMY	$604.80	$864.00	—	199% above	30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC THERAPUTIC PHLEBOTOMY	$604.80	$864.00	—	—	30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC ED PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE CDM	$604.80	$864.00	—	—	30%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 HC PR RX COVID-19 VACCINE SINGLE DOSE (MODERNA) PF IM 50 MCG/0.5 ML	$204.40	$292.00	—	40% above	30%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 HC PR RX COVID-19 VACCINE SINGLE DOSE (MODERNA) PF IM 50 MCG/0.5 ML	$204.40	$292.00	—	—	30%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 HC PR RX COVID-19 VACCINE SINGLE DOSE (PFIZER) PF TRIS-SUC IM 30 MCG/0.3 ML	$183.40	$262.00	—	14% above	30%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 HC PR RX COVID-19 VACCINE SINGLE DOSE (PFIZER) PF TRIS-SUC IM 30 MCG/0.3 ML	$183.40	$262.00	—	—	30%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH, ACELLULAR PERT & TET TOX INJ 25 LF-58 MCG-10 LF/0.5ML	$97.96	$139.94	—	111% above	30%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH, ACELLULAR PERT & TET TOX INJ 25 LF-58 MCG-10 LF/0.5ML	$97.96	$139.94	—	—	30%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DIPH-TET TOX-AC PERT AD-POLIO IPV-HIB-HEP B REC SUSP PRE SYR	$388.95	$555.64	—	134% above	30%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DIPH-TET TOX-AC PERT AD-POLIO IPV-HIB-HEP B REC SUSP PRE SYR	$388.95	$555.64	—	—	30%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACCINE SPLIT PF SUSP PREF SYRINGE 0.5 ML	$59.68	$85.26	—	107% above	30%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VIRUS VACCINE SPLIT PF SUSP PREF SYRINGE 0.5 ML	$59.68	$85.26	—	—	30%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP 10 MCG/0.5ML	$57.02	$81.46	—	1% above	30%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP 10 MCG/0.5ML	$57.02	$81.46	—	—	30%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPHILUS B POLYSACCHARIDE CONJ VAC IM SUSP 7.5 MCG/0.5 ML	$109.58	$156.54	—	573% above	30%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPHILUS B POLYSACCHARIDE CONJ VAC IM SUSP 7.5 MCG/0.5 ML	$109.58	$156.54	—	—	30%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACCHARIDE CONJUGATE VACCINE FOR INJ	$48.32	$69.03	—	53% above	30%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSACCHARIDE CONJUGATE VACCINE FOR INJ	$48.32	$69.03	—	—	30%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES-MUMPS-RUBELLA VIRUS VACCINES FOR INJ SOLN	$329.13	$470.19	—	91% above	30%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES-MUMPS-RUBELLA VIRUS VACCINES FOR INJ SOLN	$329.13	$470.19	—	—	30%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL (A, C, Y, AND W-135) TETANUS CONJUGATE VACCINE	$403.61	$576.59	—	155% above	30%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL (A, C, Y, AND W-135) TETANUS CONJUGATE VACCINE	$403.61	$576.59	—	—	30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE SUS PREF SYR 0.5 ML	$694.55	$992.21	—	47% above	30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE SUS PREF SYR 0.5 ML	$694.55	$992.21	—	—	30%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC FOR INJ	$864.70	$1,235.28	—	39% above	30%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC FOR INJ	$864.70	$1,235.28	—	—	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TET-DIPH-ACELL PERTUSS AD PREF SYR 5-2.5-18.5 LF-MCG/0.5ML	$164.72	$235.32	—	99% above	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TET-DIPH-ACELL PERTUSS AD PREF SYR 5-2.5-18.5 LF-MCG/0.5ML	$164.72	$235.32	—	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMIN CDM	$63.70	$91.00	—	51% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE CDM	$63.70	$91.00	—	51% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM	$63.70	$91.00	—	51% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN INFLUENZA VIRUS VAC CDM	$63.70	$91.00	—	51% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE CDM	$63.70	$91.00	—	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN INFLUENZA VIRUS VAC CDM	$63.70	$91.00	—	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMIN CDM	$63.70	$91.00	—	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM	$63.70	$91.00	—	—	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADMIN EACH ADD CDM	$56.70	$81.00	—	57% above	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZATION ADMIN EACH ADD CDM	$56.70	$81.00	—	—	30%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://pricetransparency.providence.org/wamt/live/910655392_kadlec-regional-medical-center_standardcharges.json