Holy Cross Hospital a Div of Taos Health Systems
Holy Cross Hospital a Div of Taos Health Systems in Taos, NM publishes cash prices for 326 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the New Mexico median for 206 of 324 procedures and above it for 102. By typical cash price it ranks #6 of 20 New Mexico hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
1397 Weimer Road, Taos, NM 87571 Collected Sep 23, 2026 Source price file Check a bill from this hospital (575) 758-8883
Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CMS star rating 1 of 5 CCN 321310 · CMS hospital register NPI 1902338049
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Holy Cross Hospital a Div of Taos Health Systems is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs New Mexico | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/WO CONTRAST | $2,280.00 | $2,850.00 | — | 6% below | 20% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/WO CONTRAST | $2,280.00 | $2,850.00 | — | — | 20% |
| Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN 2 VIEWS | $331.60 | $414.50 | — | 75% above | 20% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR ABDOMEN 2 VIEWS | $331.60 | $414.50 | — | — | 20% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE LT 3 VIEWS MIN | $288.00 | $360.00 | — | 9% above | 20% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE RT 3 VIEWS MIN | $288.00 | $360.00 | — | 9% above | 20% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE RT 3 VIEWS MIN | $288.00 | $360.00 | — | — | 20% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE LT 3 VIEWS MIN | $288.00 | $360.00 | — | — | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 ABI/TBI BILAT PHYS STUDY EXTREM ARTERIES | $230.40 | $288.00 | — | — | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ANKLE BRACHIAL INDEX | $301.60 | $377.00 | — | 26% below | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 ABI/TBI BILAT PHYS STUDY EXTREM ARTERIES | $230.40 | $288.00 | — | — | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ANKLE BRACHIAL INDEX | $301.60 | $377.00 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT EXT UPPER RT W/O CONTRAST | $1,507.60 | $1,884.50 | — | 7% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT EXT UPPER LT W/O CONTRAST | $1,507.60 | $1,884.50 | — | 7% above | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT EXT UPPER LT W/O CONTRAST | $1,507.60 | $1,884.50 | — | — | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT EXT UPPER RT W/O CONTRAST | $1,507.60 | $1,884.50 | — | — | 20% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS SINGLE CONTRAST | $451.60 | $564.50 | — | 8% below | 20% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR ESOPHAGUS SINGLE CONTRAST | $451.60 | $564.50 | — | — | 20% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN WHOLE BODY | $1,392.40 | $1,740.50 | — | 36% above | 20% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN WHOLE BODY | $1,392.40 | $1,740.50 | — | — | 20% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL LIMITED RIGHT | $356.80 | $446.00 | — | 34% above | 20% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL LIMITED LEFT | $356.80 | $446.00 | — | 34% above | 20% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL, LIMITED | $356.80 | $446.00 | — | 34% above | 20% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILATERAL LIMITED RIGHT | $356.80 | $446.00 | — | — | 20% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILATERAL, LIMITED | $356.80 | $446.00 | — | — | 20% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILATERAL LIMITED LEFT | $356.80 | $446.00 | — | — | 20% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABDOMEN/PELVIS | $1,989.60 | $2,487.00 | — | 19% below | 20% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN/PELVIS | $1,989.60 | $2,487.00 | — | — | 20% |
| CT angiography (CTA) of the head CPT 70496 CTA HEAD/BRAIN W/WO CONTRAST | $2,131.20 | $2,664.00 | — | 23% above | 20% |
| CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD/BRAIN W/WO CONTRAST | $2,131.20 | $2,664.00 | — | — | 20% |
| CT angiography (CTA) of the neck CPT 70498 CTA NECK | $2,106.40 | $2,633.00 | — | 32% above | 20% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK | $2,106.40 | $2,633.00 | — | — | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST | $2,278.00 | $2,847.50 | — | 1% above | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST | $2,278.00 | $2,847.50 | — | — | 20% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT HEART 3D ANGIOGRAPHY | $584.00 | $730.00 | — | 68% below | 20% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT HEART 3D ANGIOGRAPHY | $584.00 | $730.00 | — | — | 20% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART CALCIUM SCORING | $164.80 | $206.00 | — | 19% below | 20% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART CALCIUM SCORING | $164.80 | $206.00 | — | — | 20% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PEL W/O CONTRAST | $1,918.80 | $2,398.50 | — | 29% below | 20% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PEL W/O CONTRAST | $1,918.80 | $2,398.50 | — | — | 20% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PEL W/CONTRAST | $2,236.80 | $2,796.00 | — | 33% below | 20% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PEL W/CONTRAST | $2,236.80 | $2,796.00 | — | — | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PEL W/WO CONTRAST | $2,537.60 | $3,172.00 | — | 37% below | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PEL W/WO CONTRAST | $2,537.60 | $3,172.00 | — | — | 20% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST | $1,962.40 | $2,453.00 | — | 5% below | 20% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST | $1,962.40 | $2,453.00 | — | — | 20% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST | $1,669.60 | $2,087.00 | — | 6% below | 20% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST | $1,669.60 | $2,087.00 | — | — | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS W/O CONTRAST | $1,473.20 | $1,841.50 | — | 13% above | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CONTRAST | $1,473.20 | $1,841.50 | — | 13% above | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CONTRAST | $1,473.20 | $1,841.50 | — | — | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS W/O CONTRAST | $1,473.20 | $1,841.50 | — | — | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONTRAST | $1,504.80 | $1,881.00 | — | at median | 20% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O CONTRAST | $1,504.80 | $1,881.00 | — | — | 20% |
| CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/CONTRAST | $1,755.20 | $2,194.00 | — | 2% below | 20% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W/CONTRAST | $1,755.20 | $2,194.00 | — | — | 20% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/WO CONTRAST | $2,046.80 | $2,558.50 | — | 2% above | 20% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/WO CONTRAST | $2,046.80 | $2,558.50 | — | — | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR W/O CONTRAST | $1,793.20 | $2,241.50 | — | at median | 20% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR W/O CONTRAST | $1,793.20 | $2,241.50 | — | — | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL W/O CONTRAST | $1,784.80 | $2,231.00 | — | 14% below | 20% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL W/O CONTRAST | $1,784.80 | $2,231.00 | — | — | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST | $1,872.00 | $2,340.00 | — | 5% below | 20% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST | $1,872.00 | $2,340.00 | — | — | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DUPLEX COMPLETE | $783.60 | $979.50 | — | 54% above | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID DUPLEX COMPLETE | $783.60 | $979.50 | — | — | 20% |
| Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO CONTRAST | $2,215.60 | $2,769.50 | — | 5% above | 20% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO CONTRAST | $2,215.60 | $2,769.50 | — | — | 20% |
| Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS | $275.20 | $344.00 | — | 14% above | 20% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS | $275.20 | $344.00 | — | — | 20% |
| Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW | $230.40 | $288.00 | — | 8% above | 20% |
| Chest X-ray, single view CPT 71045 XR CHEST SPECIAL VIEW | $243.20 | $304.00 | — | 14% above | 20% |
| Chest X-ray, single view inpatient CPT 71045 XR CHEST 1 VIEW | $230.40 | $288.00 | — | — | 20% |
| Chest X-ray, single view inpatient CPT 71045 XR CHEST SPECIAL VIEW | $243.20 | $304.00 | — | — | 20% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE LT | $258.40 | $323.00 | — | 4% above | 20% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE RT | $258.40 | $323.00 | — | 4% above | 20% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE RT | $258.40 | $323.00 | — | — | 20% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE LT | $258.40 | $323.00 | — | — | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL/RENAL COMPLETE | $533.60 | $667.00 | — | 1% above | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL/RENAL COMPLETE | $533.60 | $667.00 | — | — | 20% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR BONE DEXA-AXIAL SKELETON | $404.00 | $505.00 | — | 60% above | 20% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR BONE DEXA-AXIAL SKELETON | $404.00 | $505.00 | — | — | 20% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 XR BONE DEXA-APPENDICULAR SKELETON | $236.40 | $295.50 | — | 7% above | 20% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 XR BONE DEXA-APPENDICULAR SKELETON | $236.40 | $295.50 | — | — | 20% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST | $1,622.40 | $2,028.00 | — | at median | 20% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST | $1,622.40 | $2,028.00 | — | — | 20% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST | $1,890.40 | $2,363.00 | — | at median | 20% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/CONTRAST | $1,890.40 | $2,363.00 | — | — | 20% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO 2D DIAGNOSTIC BILATERAL | $415.60 | $519.50 | — | — | 20% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO 2D DIAGNOSTIC BILATERAL | $415.60 | $519.50 | — | — | 20% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO 2D DIAGNOSTIC UNILATERAL RIGHT | $227.60 | $284.50 | — | 23% above | 20% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO 2D DIAGNOSTIC UNILATERAL LEFT | $227.60 | $284.50 | — | 23% above | 20% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO 2D DIAGNOSTIC UNILATERAL | $227.60 | $284.50 | — | 23% above | 20% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO 2D DIAGNOSTIC UNILATERAL LEFT | $227.60 | $284.50 | — | — | 20% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO 2D DIAGNOSTIC UNILATERAL | $227.60 | $284.50 | — | — | 20% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO 2D DIAGNOSTIC UNILATERAL RIGHT | $227.60 | $284.50 | — | — | 20% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US EXT DUPLEX VENOUS BILATERAL | $799.60 | $999.50 | — | — | 20% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US EXT DUPLEX VENOUS BILATERAL | $799.60 | $999.50 | — | — | 20% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO US ADULT COMPLETE REST | $822.00 | $1,027.50 | — | 38% below | 20% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO US ADULT COMPLETE REST | $822.00 | $1,027.50 | — | — | 20% |
| Elbow X-ray, 2 views one side CPT 73070 XR ELBOW RT 2 VIEWS | $237.20 | $296.50 | — | 5% above | 20% |
| Elbow X-ray, 2 views one side CPT 73070 XR ELBOW LT 2 VIEWS | $327.20 | $409.00 | — | 45% above | 20% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW RT 2 VIEWS | $237.20 | $296.50 | — | — | 20% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW LT 2 VIEWS | $327.20 | $409.00 | — | — | 20% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW LT 3 VIEWS MIN | $290.00 | $362.50 | — | 19% above | 20% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW RT 3 VIEWS MIN | $290.00 | $362.50 | — | 19% above | 20% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW LT 3 VIEWS MIN | $290.00 | $362.50 | — | — | 20% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW RT 3 VIEWS MIN | $290.00 | $362.50 | — | — | 20% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT,SELLA,FOSSA,EAR W/O CONTRAST | $1,564.00 | $1,955.00 | — | 16% above | 20% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT,SELLA,FOSSA,EAR W/O CONTRAST | $1,564.00 | $1,955.00 | — | — | 20% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES 3V MIN | $383.60 | $479.50 | — | 26% above | 20% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES 3V MIN | $383.60 | $479.50 | — | — | 20% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM LT | $258.40 | $323.00 | — | 5% above | 20% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM RT | $258.40 | $323.00 | — | 5% above | 20% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM RT | $258.40 | $323.00 | — | — | 20% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM LT | $258.40 | $323.00 | — | — | 20% |
| Hand X-ray, 2 views one side CPT 73120 XR HAND RT 2 VIEWS | $247.60 | $309.50 | — | 5% above | 20% |
| Hand X-ray, 2 views one side CPT 73120 XR HAND LT 2 VIEWS | $247.60 | $309.50 | — | 5% above | 20% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND LT 2 VIEWS | $247.60 | $309.50 | — | — | 20% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND RT 2 VIEWS | $247.60 | $309.50 | — | — | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEOUS RT 2V MIN | $239.60 | $299.50 | — | 2% above | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEOUS LT 2V MIN | $239.60 | $299.50 | — | 2% above | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEOUS LT 2V MIN | $239.60 | $299.50 | — | — | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEOUS RT 2V MIN | $239.60 | $299.50 | — | — | 20% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE LT 4 VIEWS MIN | $366.80 | $458.50 | — | 4% above | 20% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE RT 4 VIEWS MIN | $366.80 | $458.50 | — | 4% above | 20% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE RT 4 VIEWS MIN | $366.80 | $458.50 | — | — | 20% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE LT 4 VIEWS MIN | $366.80 | $458.50 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT EXT LOWER RT W/O CONTRST | $1,517.60 | $1,897.00 | — | 8% below | 20% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT EXT LOWER LT W/O CONT | $1,517.60 | $1,897.00 | — | 8% below | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT EXT LOWER RT W/O CONTRST | $1,517.60 | $1,897.00 | — | — | 20% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT EXT LOWER LT W/O CONT | $1,517.60 | $1,897.00 | — | — | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL LMTD/FU | $480.00 | $600.00 | — | at median | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL LMTD/FU | $480.00 | $600.00 | — | — | 20% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT NONVASCULAR LIMITED RT | $210.00 | $262.50 | — | 35% below | 20% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT NONVASCULAR LIMITED LT | $210.00 | $262.50 | — | 35% below | 20% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT NONVASCULAR LIMITED LT | $210.00 | $262.50 | — | — | 20% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT NONVASCULAR LIMITED RT | $210.00 | $262.50 | — | — | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST CANCER SCREEN | $293.20 | $366.50 | — | 31% below | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST CANCER SCREEN | $293.20 | $366.50 | — | — | 20% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIB/FIB RT 2 VIEWS | $274.40 | $343.00 | — | at median | 20% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIB/FIB LT 2 VIEWS | $274.40 | $343.00 | — | at median | 20% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIB/FIB RT 2 VIEWS | $274.40 | $343.00 | — | — | 20% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIB/FIB LT 2 VIEWS | $274.40 | $343.00 | — | — | 20% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD/BRAIN W/O CONTRAST | $1,629.20 | $2,036.50 | — | 11% below | 20% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD/BRAIN W/O CONTRAST | $1,629.20 | $2,036.50 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI EXT LOWER HIP RT W/O CONTRAST | $1,254.00 | $1,567.50 | — | 15% below | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI EXT LOWER HIP LT W/O CONTRAST | $1,254.00 | $1,567.50 | — | 15% below | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI EXT LOWER KNEE LT W/O CONTRAST | $1,254.00 | $1,567.50 | — | 15% below | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI EXT LOWER ANKLE RT W/O CONTRAST | $1,254.00 | $1,567.50 | — | 15% below | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI EXT LOWER ANKLE LT W/O CONTRAST | $1,254.00 | $1,567.50 | — | 15% below | 20% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI EXT LOWER KNEE RT W/O CONTRAST | $1,254.00 | $1,567.50 | — | 15% below | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI EXT LOWER KNEE LT W/O CONTRAST | $1,254.00 | $1,567.50 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI EXT LOWER HIP LT W/O CONTRAST | $1,254.00 | $1,567.50 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI EXT LOWER ANKLE RT W/O CONTRAST | $1,254.00 | $1,567.50 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI EXT LOWER KNEE RT W/O CONTRAST | $1,254.00 | $1,567.50 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI EXT LOWER ANKLE LT W/O CONTRAST | $1,254.00 | $1,567.50 | — | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI EXT LOWER HIP RT W/O CONTRAST | $1,254.00 | $1,567.50 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI EXT LOWER ANKLE LT W/WO CONTRAST | $2,711.20 | $3,389.00 | — | 9% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI EXT LOWER HIP LT W/WO CONTRAST | $2,711.20 | $3,389.00 | — | 9% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI EXT LOWER ANKLE RT W/WO CONTRAST | $2,711.20 | $3,389.00 | — | 9% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI EXT LOWER KNEE RT W/WO CONTRAST | $2,711.20 | $3,389.00 | — | 9% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI EXT LOWER HIP RT W/WO CONTRAST | $2,711.20 | $3,389.00 | — | 9% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI EXT LOWER KNEE LT W/WO CONTRAST | $2,711.20 | $3,389.00 | — | 9% above | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI EXT LOWER ANKLE LT W/WO CONTRAST | $2,711.20 | $3,389.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI EXT LOWER HIP LT W/WO CONTRAST | $2,711.20 | $3,389.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI EXT LOWER HIP RT W/WO CONTRAST | $2,711.20 | $3,389.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI EXT LOWER KNEE LT W/WO CONTRAST | $2,711.20 | $3,389.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI EXT LOWER KNEE RT W/WO CONTRAST | $2,711.20 | $3,389.00 | — | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI EXT LOWER ANKLE RT W/WO CONTRAST | $2,711.20 | $3,389.00 | — | — | 20% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST | $1,812.40 | $2,265.50 | — | 16% below | 20% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST | $1,812.40 | $2,265.50 | — | — | 20% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO CONTRAST | $2,499.20 | $3,124.00 | — | 9% below | 20% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO CONTRAST | $2,499.20 | $3,124.00 | — | — | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI HEAD/BRAIN & STEM W/O CONTRAST | $1,832.40 | $2,290.50 | — | at median | 20% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI HEAD/BRAIN & STEM W/O CONTRAST | $1,832.40 | $2,290.50 | — | — | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI HEAD/BRAIN & STEM W/WO CONT | $2,610.00 | $3,262.50 | — | 6% below | 20% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI HEAD/BRAIN & STEM W/WO CONT | $2,610.00 | $3,262.50 | — | — | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR W/O CONTRAST | $1,900.40 | $2,375.50 | — | 7% below | 20% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR W/O CONTRAST | $1,900.40 | $2,375.50 | — | — | 20% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR W/WO CONTRAST | $2,661.20 | $3,326.50 | — | 7% below | 20% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINE LUMBAR W/WO CONTRAST | $2,661.20 | $3,326.50 | — | — | 20% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORACIC W/O CONTRAST | $1,878.00 | $2,347.50 | — | 15% below | 20% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE THORACIC W/O CONTRAST | $1,878.00 | $2,347.50 | — | — | 20% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVICAL W/WO CONTRAST | $2,659.20 | $3,324.00 | — | 5% below | 20% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CERVICAL W/WO CONTRAST | $2,659.20 | $3,324.00 | — | — | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL W/O CONTRAST | $1,885.20 | $2,356.50 | — | 10% below | 20% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CERVICAL W/O CONTRAST | $1,885.20 | $2,356.50 | — | — | 20% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO CONTRAST | $2,477.20 | $3,096.50 | — | 20% below | 20% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO CONTRAST | $2,477.20 | $3,096.50 | — | — | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST | $1,755.20 | $2,194.00 | — | 12% below | 20% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST | $1,755.20 | $2,194.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI EXT UPPER WRIST LT W/O CONTRAST | $1,251.20 | $1,564.00 | — | 19% below | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI EXT UPPER SHOULDER RT W/O CONTRAST | $1,251.20 | $1,564.00 | — | 19% below | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI EXT UPPER ELBOW LT W/O CONTRAST | $1,251.20 | $1,564.00 | — | 19% below | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI EXT UPPER SHOULDER LT W/O CONTRAST | $1,251.20 | $1,564.00 | — | 19% below | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI EXT UPPER WRIST RT W/O CONTRAST | $1,251.20 | $1,564.00 | — | 19% below | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI EXT UPPER ELBOW RT W/O CONTRAST | $1,251.20 | $1,564.00 | — | 19% below | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI EXT UPPER ELBOW LT W/O CONTRAST | $1,251.20 | $1,564.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI EXT UPPER ELBOW RT W/O CONTRAST | $1,251.20 | $1,564.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI EXT UPPER SHOULDER LT W/O CONTRAST | $1,251.20 | $1,564.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI EXT UPPER WRIST LT W/O CONTRAST | $1,251.20 | $1,564.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI EXT UPPER WRIST RT W/O CONTRAST | $1,251.20 | $1,564.00 | — | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI EXT UPPER SHOULDER RT W/O CONTRAST | $1,251.20 | $1,564.00 | — | — | 20% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE-C 4 VIEWS MIN | $450.40 | $563.00 | — | 15% above | 20% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE-C 4 VIEWS MIN | $450.40 | $563.00 | — | — | 20% |
| Neck soft tissue CT scan with contrast CPT 70491 CT NECK W/CONTRAST | $1,790.00 | $2,237.50 | — | 8% above | 20% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK W/CONTRAST | $1,790.00 | $2,237.50 | — | — | 20% |
| Neck soft tissue CT scan without contrast CPT 70490 CT NECK W/O CONTRAST | $1,543.20 | $1,929.00 | — | 5% above | 20% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK W/O CONTRAST | $1,543.20 | $1,929.00 | — | — | 20% |
| Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE 1 VIEW | $250.00 | $312.50 | — | 6% above | 20% |
| Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE 1 VIEW | $250.00 | $312.50 | — | — | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARDIAL REST/STRESS | $2,116.00 | $2,645.00 | — | 8% below | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARDIAL REST/STRESS | $2,116.00 | $2,645.00 | — | — | 20% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST | $1,609.20 | $2,011.50 | — | 4% below | 20% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST | $1,609.20 | $2,011.50 | — | — | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED | $359.20 | $449.00 | — | 13% below | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED | $359.20 | $449.00 | — | — | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE | $536.80 | $671.00 | — | 3% above | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMPLETE | $536.80 | $671.00 | — | — | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB OVER 14 WEEKS +TV IF NEEDED | $513.60 | $642.00 | — | 1% above | 20% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB OVER 14 WEEKS +TV IF NEEDED | $513.60 | $642.00 | — | — | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB UNDER 14 WEEKS | $529.60 | $662.00 | — | 7% above | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB UNDER 14 WEEKS | $529.60 | $662.00 | — | — | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB WELLBEING LIMITED | $344.00 | $430.00 | — | 22% below | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB WELLBEING LIMITED | $344.00 | $430.00 | — | — | 20% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS LT 2 VIEWS | $300.80 | $376.00 | — | 12% above | 20% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS RT 2 VIEWS | $300.80 | $376.00 | — | 12% above | 20% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS RT 2 VIEWS | $300.80 | $376.00 | — | — | 20% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS LT 2 VIEWS | $300.80 | $376.00 | — | — | 20% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNI LT W/PA CHEST 3V | $372.00 | $465.00 | — | 23% above | 20% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNI RT W/PA CHEST 3V | $372.00 | $465.00 | — | 23% above | 20% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS UNI LT W/PA CHEST 3V | $372.00 | $465.00 | — | — | 20% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS UNI RT W/PA CHEST 3V | $372.00 | $465.00 | — | — | 20% |
| Screening mammogram, both breasts CPT 77067 MAMMO 2D SCREENING | $272.00 | $340.00 | — | 5% below | 20% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO 2D SCREENING | $272.00 | $340.00 | — | — | 20% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER RT 2 VIEWS MIN | $300.80 | $376.00 | — | 27% above | 20% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER LT 2 VIEWS MIN | $300.80 | $376.00 | — | 27% above | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER LT 2 VIEWS MIN | $300.80 | $376.00 | — | — | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER RT 2 VIEWS MIN | $300.80 | $376.00 | — | — | 20% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUS SERIES 3 OR MORE VIEWS | $379.60 | $474.50 | — | 23% above | 20% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUS SERIES 3 OR MORE VIEWS | $379.60 | $474.50 | — | — | 20% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL <4 VIEWS | $291.20 | $364.00 | — | 8% below | 20% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL <4 VIEWS | $291.20 | $364.00 | — | — | 20% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 CARDIAC STRESS ECHO W/O CONTRAST | $1,113.60 | $1,392.00 | — | 4% above | 20% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 CARDIAC STRESS ECHO W/O CONTRAST | $1,113.60 | $1,392.00 | — | — | 20% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR MODIFIED SWALLOWING STUDY | $502.80 | $628.50 | — | 5% below | 20% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR MODIFIED SWALLOWING STUDY | $502.80 | $628.50 | — | — | 20% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR RT 2 VIEWS MIN | $293.20 | $366.50 | — | 25% above | 20% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR LT 2 VIEWS MIN | $293.20 | $366.50 | — | 25% above | 20% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR RT 2 VIEWS MIN | $293.20 | $366.50 | — | — | 20% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR LT 2 VIEWS MIN | $293.20 | $366.50 | — | — | 20% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPINE THORACIC W/O CONTRAST | $1,710.80 | $2,138.50 | — | at median | 20% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SPINE THORACIC W/O CONTRAST | $1,710.80 | $2,138.50 | — | — | 20% |
| Toe X-ray, 2 or more views one side CPT 73660 XR FOOT LT GREAT TOE | $243.20 | $304.00 | — | 28% above | 20% |
| Toe X-ray, 2 or more views one side CPT 73660 XR FOOT LT 2ND DIGIT | $243.20 | $304.00 | — | 28% above | 20% |
| Toe X-ray, 2 or more views one side CPT 73660 XR FOOT RT GREAT TOE | $243.20 | $304.00 | — | 28% above | 20% |
| Toe X-ray, 2 or more views one side CPT 73660 XR FOOT RT 4TH DIGIT | $243.20 | $304.00 | — | 28% above | 20% |
| Toe X-ray, 2 or more views one side CPT 73660 XR FOOT RT 3RD DIGIT | $243.20 | $304.00 | — | 28% above | 20% |
| Toe X-ray, 2 or more views one side CPT 73660 XR FOOT RT 2ND DIGIT | $243.20 | $304.00 | — | 28% above | 20% |
| Toe X-ray, 2 or more views one side CPT 73660 XR FOOT RT 5TH DIGIT | $243.20 | $304.00 | — | 28% above | 20% |
| Toe X-ray, 2 or more views one side CPT 73660 XR FOOT LT 5TH DIGIT | $243.20 | $304.00 | — | 28% above | 20% |
| Toe X-ray, 2 or more views one side CPT 73660 XR FOOT LT 4TH DIGIT | $243.20 | $304.00 | — | 28% above | 20% |
| Toe X-ray, 2 or more views one side CPT 73660 XR FOOT LT 3RD DIGIT | $243.20 | $304.00 | — | 28% above | 20% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT LT GREAT TOE | $243.20 | $304.00 | — | — | 20% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT RT 2ND DIGIT | $243.20 | $304.00 | — | — | 20% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT RT 4TH DIGIT | $243.20 | $304.00 | — | — | 20% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT RT 5TH DIGIT | $243.20 | $304.00 | — | — | 20% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT RT GREAT TOE | $243.20 | $304.00 | — | — | 20% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT RT 3RD DIGIT | $243.20 | $304.00 | — | — | 20% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT LT 3RD DIGIT | $243.20 | $304.00 | — | — | 20% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT LT 4TH DIGIT | $243.20 | $304.00 | — | — | 20% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT LT 2ND DIGIT | $243.20 | $304.00 | — | — | 20% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT LT 5TH DIGIT | $243.20 | $304.00 | — | — | 20% |
| Transvaginal pelvic ultrasound CPT 76830 US PELVIC TRANVAGINAL (NONPREG) | $462.80 | $578.50 | — | 5% below | 20% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US PELVIC TRANVAGINAL (NONPREG) | $462.80 | $578.50 | — | — | 20% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL | $396.40 | $495.50 | — | 15% above | 20% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL | $396.40 | $495.50 | — | — | 20% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL COMPLETE | $654.00 | $817.50 | — | 9% above | 20% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL COMPLETE | $654.00 | $817.50 | — | — | 20% |
| Ultrasound of the scrotum and testicles CPT 76870 US TESTICLE/SCROTUM | $488.40 | $610.50 | — | 7% below | 20% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICLE/SCROTUM | $488.40 | $610.50 | — | — | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NECK SOFT TISSUE | $453.60 | $567.00 | — | 1% below | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NECK SOFT TISSUE | $453.60 | $567.00 | — | — | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI SERIES SINGLE CONTRAST STUDY | $665.60 | $832.00 | — | 27% above | 20% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UGI SERIES SINGLE CONTRAST STUDY | $665.60 | $832.00 | — | — | 20% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS RT 2 VIEWS MIN | $268.40 | $335.50 | — | 8% above | 20% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS LT 2 VIEWS MIN | $268.40 | $335.50 | — | 8% above | 20% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS RT 2 VIEWS MIN | $268.40 | $335.50 | — | — | 20% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS LT 2 VIEWS MIN | $268.40 | $335.50 | — | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 LIMITED DOPPLER STUDY | $55.60 | $69.50 | — | 91% below | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US EXT DUPLEX VENOUS RT | $540.40 | $675.50 | — | 8% below | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US EXT DUPLEX VENOUS LT | $540.40 | $675.50 | — | 8% below | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 LIMITED DOPPLER STUDY | $55.60 | $69.50 | — | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US EXT DUPLEX VENOUS LT | $540.40 | $675.50 | — | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US EXT DUPLEX VENOUS RT | $540.40 | $675.50 | — | — | 20% |
| Wrist X-ray, 2 views one side CPT 73100 XR WRIST LT 2 VIEWS | $234.00 | $292.50 | — | 4% above | 20% |
| Wrist X-ray, 2 views one side CPT 73100 XR WRIST RT 2 VIEWS | $234.00 | $292.50 | — | 4% above | 20% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST LT 2 VIEWS | $234.00 | $292.50 | — | — | 20% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST RT 2 VIEWS | $234.00 | $292.50 | — | — | 20% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST LT 3 VIEWS MIN | $282.80 | $353.50 | — | 7% above | 20% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST RT 3 VIEWS MIN | $282.80 | $353.50 | — | 7% above | 20% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST RT 3 VIEWS MIN | $282.80 | $353.50 | — | — | 20% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST LT 3 VIEWS MIN | $282.80 | $353.50 | — | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR INFANT PELVIS/HIP 2V | $272.80 | $341.00 | — | 17% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LT W/ PELVIS 2-3 VIEWS | $291.20 | $364.00 | — | 25% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP RT W/ PELVIS 2-3 VIEWS | $291.20 | $364.00 | — | 25% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR INFANT PELVIS/HIP 2V | $272.80 | $341.00 | — | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LT W/ PELVIS 2-3 VIEWS | $291.20 | $364.00 | — | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP RT W/ PELVIS 2-3 VIEWS | $291.20 | $364.00 | — | — | 20% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW | $245.60 | $307.00 | — | 5% above | 20% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW | $245.60 | $307.00 | — | — | 20% |
| X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE LT 2 VIEWS | $243.20 | $304.00 | — | 22% above | 20% |
| X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE RT 2 VIEWS | $243.20 | $304.00 | — | 22% above | 20% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE RT 2 VIEWS | $243.20 | $304.00 | — | — | 20% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE LT 2 VIEWS | $243.20 | $304.00 | — | — | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR HAND RT 3RD DIGIT | $214.80 | $268.50 | — | 19% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR HAND RT 5TH DIGIT | $214.80 | $268.50 | — | 19% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR HAND RT THUMB | $214.80 | $268.50 | — | 19% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR HAND RT 4TH DIGIT | $214.80 | $268.50 | — | 19% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR HAND RT 2ND DIGIT | $214.80 | $268.50 | — | 19% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR HAND LT THUMB | $214.80 | $268.50 | — | 19% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR HAND LT 5TH DIGIT | $214.80 | $268.50 | — | 19% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR HAND LT 4TH DIGIT | $214.80 | $268.50 | — | 19% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR HAND LT 3RD DIGIT | $214.80 | $268.50 | — | 19% above | 20% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR HAND LT 2ND DIGIT | $214.80 | $268.50 | — | 19% above | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR HAND RT 3RD DIGIT | $214.80 | $268.50 | — | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR HAND RT 2ND DIGIT | $214.80 | $268.50 | — | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR HAND LT THUMB | $214.80 | $268.50 | — | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR HAND LT 3RD DIGIT | $214.80 | $268.50 | — | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR HAND RT THUMB | $214.80 | $268.50 | — | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR HAND RT 5TH DIGIT | $214.80 | $268.50 | — | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR HAND RT 4TH DIGIT | $214.80 | $268.50 | — | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR HAND LT 5TH DIGIT | $214.80 | $268.50 | — | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR HAND LT 2ND DIGIT | $214.80 | $268.50 | — | — | 20% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR HAND LT 4TH DIGIT | $214.80 | $268.50 | — | — | 20% |
| X-ray of the foot, 2 views one side CPT 73620 XR FOOT RT 2 VIEWS | $245.60 | $307.00 | — | 13% above | 20% |
| X-ray of the foot, 2 views one side CPT 73620 XR FOOT LT 2 VIEWS | $245.60 | $307.00 | — | 13% above | 20% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT RT 2 VIEWS | $245.60 | $307.00 | — | — | 20% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT LT 2 VIEWS | $245.60 | $307.00 | — | — | 20% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT LT 3 VIEWS MIN | $285.20 | $356.50 | — | 7% above | 20% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT RT 3 VIEWS MIN | $285.20 | $356.50 | — | 7% above | 20% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT RT 3 VIEWS MIN | $285.20 | $356.50 | — | — | 20% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT LT 3 VIEWS MIN | $285.20 | $356.50 | — | — | 20% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR HAND LT 3 VIEWS MIN | $286.40 | $358.00 | — | 17% above | 20% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR HAND RT 3 VIEWS MIN | $286.40 | $358.00 | — | 17% above | 20% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND RT 3 VIEWS MIN | $286.40 | $358.00 | — | — | 20% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND LT 3 VIEWS MIN | $286.40 | $358.00 | — | — | 20% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE LT 1-2 VIEWS | $262.00 | $327.50 | — | 12% above | 20% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE RT 1-2 VIEWS | $262.00 | $327.50 | — | 12% above | 20% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE RT 1-2 VIEWS | $262.00 | $327.50 | — | — | 20% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE LT 1-2 VIEWS | $262.00 | $327.50 | — | — | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE-L 2 VIEWS | $342.40 | $428.00 | — | 10% above | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE-L 2 VIEWS | $342.40 | $428.00 | — | — | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE-L W/OBLIQUES 5 VIEWS | $491.60 | $614.50 | — | 25% above | 20% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE-L W/OBLIQUES 5 VIEWS | $491.60 | $614.50 | — | — | 20% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES 3 VIEWS MIN | $286.40 | $358.00 | — | 22% above | 20% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES 3 VIEWS MIN | $286.40 | $358.00 | — | — | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE-C 2 VIEWS | $316.40 | $395.50 | — | 17% above | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE-C 2 VIEWS | $316.40 | $395.50 | — | — | 20% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIC AP | $252.40 | $315.50 | — | at median | 20% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIC AP | $252.40 | $315.50 | — | — | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX 2 VIEWS MIN | $292.40 | $365.50 | — | 15% above | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX 2 VIEWS MIN | $292.40 | $365.50 | — | — | 20% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs New Mexico | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH 004440 | $102.40 | $128.00 | — | 43% below | 20% |
| ACTH blood test inpatient CPT 82024 ACTH 004440 | $102.40 | $128.00 | — | — | 20% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT/ALT | $27.20 | $34.00 | — | 63% below | 20% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT LABCORP 001545 | $27.20 | $34.00 | — | 63% below | 20% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 FIB-4 RFX TO ELF 402175 | $27.20 | $34.00 | — | 63% below | 20% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT/ALT | $27.20 | $34.00 | — | — | 20% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 FIB-4 RFX TO ELF 402175 | $27.20 | $34.00 | — | — | 20% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT LABCORP 001545 | $27.20 | $34.00 | — | — | 20% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT/AST | $26.40 | $33.00 | — | 57% below | 20% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT/AST | $26.40 | $33.00 | — | — | 20% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS SCREEN PANEL | $242.40 | $303.00 | — | 11% below | 20% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEP ACUTE PANEL, A+B+C 144000 | $242.40 | $303.00 | — | 11% below | 20% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEP ACUTE PANEL, A+B+C 144000 | $242.40 | $303.00 | — | — | 20% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS SCREEN PANEL | $242.40 | $303.00 | — | — | 20% |
| Albumin blood test CPT 82040 ALBUMIN | $10.80 | $13.50 | — | 75% below | 20% |
| Albumin blood test CPT 82040 MS PANEL SERUM ALBUMIN | $38.40 | $48.00 | — | 12% below | 20% |
| Albumin blood test inpatient CPT 82040 ALBUMIN | $10.80 | $13.50 | — | — | 20% |
| Albumin blood test inpatient CPT 82040 MS PANEL SERUM ALBUMIN | $38.40 | $48.00 | — | — | 20% |
| Aldosterone blood test CPT 82088 ALDOSTERONE URINE 24HR 004291 | $73.60 | $92.00 | — | 62% below | 20% |
| Aldosterone blood test CPT 82088 ALDOSTERONE 004374 | $140.80 | $176.00 | — | 26% below | 20% |
| Aldosterone blood test CPT 82088 ALDOSTERONE 3 SPECIMENS 053272 | $140.80 | $176.00 | — | 26% below | 20% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE URINE 24HR 004291 | $73.60 | $92.00 | — | — | 20% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE 004374 | $140.80 | $176.00 | — | — | 20% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE 3 SPECIMENS 053272 | $140.80 | $176.00 | — | — | 20% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE | $26.40 | $33.00 | — | 62% below | 20% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE | $26.40 | $33.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ENGLISH PLANTAIN IGE 602536 | $29.60 | $37.00 | — | at median | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SWEET CHESTNUT IGE 602538 | $36.40 | $45.50 | — | 23% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AVOCADO IGE 602745 | $36.40 | $45.50 | — | 23% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LATEX IGE 602669 | $37.60 | $47.00 | — | 27% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BANANA IGE 602742 | $37.60 | $47.00 | — | 27% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASH WHITE IGE 602927 | $37.60 | $47.00 | — | 27% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 KIWI IGE 602734 | $37.60 | $47.00 | — | 27% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CYPRESS,ITALIAN IGE 602934 | $37.60 | $47.00 | — | 27% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MANGO IGE 602741 | $37.60 | $47.00 | — | 27% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FESCUE MEADOW IGE 602549 | $37.60 | $47.00 | — | 27% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RABBITBUSH ALLERGEN | $47.60 | $59.50 | — | 61% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUNTAIN CEDAR ALLERGEN | $47.60 | $59.50 | — | 61% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SALMON ALLERGEN | $47.60 | $59.50 | — | 61% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AMERICAN ELM IGE 602476 | $48.40 | $60.50 | — | 64% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EUCALYPTUS TREE ALLERGEN | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OREGANO ALLERGEN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ONION ALLERGEN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LETTUCE ALLERGEN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SYCAMORE TREE ALLERGEN | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STEMPHYLLIUM BOTRYOSUM ALL | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST:WEED ALLERGEN | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST:TOMAT ORNGE GRPFRT | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST ALLERGENS | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPINACH ALLERGEN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MIMOSA/ACACIA TREE ALLERGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IODINE BUSH ALLERGEN | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PAPRIKA ALLERGEN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GRAPE ALLERGEN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CUMIN ALLERGEN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BROCCOLI ALLERGEN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PUMPKIN IGE 602786 | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CABBAGE ALLERGEN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BARLEY ALLERGEN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LENTIL ALLERGEN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BETA LACTOGLOBULIN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHEESE CHEDDAR IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHEESE MOLD TYPE IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALPHA LACTALBUMIN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASEIN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CARROT ALLERGEN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAYENNE ALLERGEN IGE | $49.20 | $61.50 | — | 66% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ELM ALLERGEN 602476 | $50.00 | $62.50 | — | 69% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COTTONWOOD ALLERGEN 602518 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER ALLERGEN 602495 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HORNET, YELLOW IGE 602891 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HORNET, WHITE FACE 602887 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COW DANDER ALLERGEN 602685 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOPS ALLERGEN 602478 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP ALLERGEN 602473 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GUINEA PIG EPITHELIUM IGE 602686 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DUCK FEATHERS 602704 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GOOSE FEATHERS 602688 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HONEYBEE ALLERGEN 602886 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HORSE DANDER ALLERGEN 602684 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PANEL 18 TRICORE | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WINGSCALE ALLERGEN 823792 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW JACKET IGE 602889 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PAPER WASP IGE 602890 | $50.80 | $63.50 | — | 72% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SYCAMORE, MAPLE LEAF 602948 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HACKBERRY IGE 602943 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RUSSIAN OLIVE IGE 602935 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLACK WILLOW IGE 602937 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINE ALLERGEN 602928 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BIRCH TREE IGE 602936 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKLEBUR IGE 602970 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FIREBUSH KOCHIA IGE 602972 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LAMBS QUARTER IGE 602537 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MARSH ELDER IGE 602570 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RUSSIAN THISTLE IGE 602515 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WESTERN RAGWEED IGE 602544 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOCK SORREL IGE 602974 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FUSARIUM IGE 602560 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH ALLERGEN 602465 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GREEN PEA ALLERGEN 602517 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RYE GRASS ALLERGEN 602872 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER ALLERGEN 602454 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JUNIPER IGE 602491 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RABBIT EPITHELIUM 602700 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MAPLE-BOX ELDER IGE 602489 | $51.60 | $64.50 | — | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CRAB ALLERGEN 602493 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CUCUMBER IGE 602798 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 APPLE IGE 602724 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CARROT IGE 602521 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLACK MOLD IGE 602918 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MILK IGE W/ COMPONENT RFX 603927 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BUMBLEBEE IGE 602897 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUGWORT IGE 602531 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN FEATHERS 602703 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PHOMA BETAE 602552 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PALM TREE IGE 602949 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TUNA IGE 602510 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINEAPPLE IGE 602770 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE-EGG WHITE W/ RFX 603940 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LIME IGE | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LEMON IGE | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORANGE IGE | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GRAPEFRUIT IGE | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TANGERINE IGE | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 NUTMEG IGE 602820 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT IGE 602470 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MACADAMIA NUT IGE 602568 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TOMATO IGE 602468 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEACH 602744 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GREEN BEAN 602838 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHILI PEPPER 602817 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHERRY,BING 602796 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 APRICOT IGE 602795 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OYSTER IGE 602514 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLAM ALLERGEN, IGE 602529 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALDER GREY, IGE 602545 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE URINE IGE 602689 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FLAVUS IGE 800463 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS NIGER IGE 602916 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MELON IGE 602737 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ONION IG-E 602723 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WATERMELON IG-E 602718 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STRAWBERRY IG-E 602513 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SETOMELANOMA ROSTRAT IGE 602561 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAT IGE 602553 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT IGE W/COMPONENT REFLEX 603916 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP SORREL IGE 602542 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT ALLERGEN 602477 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MESQUITE IGE 602932 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT IGE 602483 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUSTARD IGE 602739 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED IGE 602485 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCONUT IGE 602512 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RICE IGE 602511 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN IGE 602497 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN ALLERGEN 602500 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SALMON ALLERGEN 602507 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SWEET VERNAL GRASS IGE 602866 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORCHARD GRASS ALLERGEN 602867 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 REDTOP GRASS ALLERGEN 602869 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE IGE 602452 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORANGE ALLERGEN 602472 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT ALLERGEN IGE 602459 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT ALLERGEN 602530 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SUNFLOWER SEED IGE 602766 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN IGE 602457 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PORK ALLERGEN IGE 602498 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO ALLERGEN 602486 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINON ALLERGEN 602550 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN ALLERGEN 602470 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT ALLERGEN 602451 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MILK (COW) ALLERGEN 602453 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE OAK IGE 602480 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE MULBERRY IGE 602569 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SAGEBRUSH ALLERGEN 602966 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS ALLERGEN 602506 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAGWEED ALLERGEN 602463 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PIGWEED IGE 602484 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIUM CHRYS IGE 602502 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OLIVE TREE ALLERGEN 602527 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 NETTLE WEED IGE 602973 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUCOR RACEMOSUS ALLERGEN 602562 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 KENTUCKY BLUEGRASS IGE 602496 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JOHNSON GRASS IGE 602503 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EUROPEAN DUSTMITE IGE 602467 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GARLIC ALLERGEN IGE 602519 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG YOLK ALLERGEN 602487 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG ALLERGEN 602528 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER ALLERGEN 602456 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHEESE,AMERICAN IGE 903700 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND ALLERGEN 602479 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA ALTERNATA IGE 602455 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AMERICAN COCKROACH IGE 602481 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AMERICAN ELM ALLERGEN 602476 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AMERICAN DUSTMITE ALLERGEN 602475 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS IGE 602471 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BAHIA GRASS ALLERGEN 602534 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BEEF ALLERGEN 602509 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS ALLERGEN 602464 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW ALLERGEN 602461 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBARUM 602462 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CORN ALLERGEN IGE 602460 | $52.40 | $65.50 | — | 77% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE FOOD 608005 | $175.20 | $219.00 | — | 492% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, FOOD 602989 | $175.20 | $219.00 | — | 492% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPRING-TREE, SEASONAL ALLERGENS | $175.39 | $219.24 | — | 493% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FALL-WEED, SEASONAL ALLERGENS 062463 | $191.10 | $238.87 | — | 546% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, MOLD 062448 | $628.80 | $786.00 | — | 2024% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE AREA 11 602641 | $1,230.00 | $1,537.50 | — | 4055% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROF RESPIRATORY AREA 1 602627 | $1,279.20 | $1,599.00 | — | 4222% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS, ZONE 15 676650 | $1,328.40 | $1,660.50 | — | 4388% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE ZONE 10 676601 | $1,328.40 | $1,660.50 | — | 4388% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS, ZONE 12 676627 | $1,328.40 | $1,660.50 | — | 4388% above | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ENGLISH PLANTAIN IGE 602536 | $29.60 | $37.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET CHESTNUT IGE 602538 | $36.40 | $45.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AVOCADO IGE 602745 | $36.40 | $45.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASH WHITE IGE 602927 | $37.60 | $47.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KIWI IGE 602734 | $37.60 | $47.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FESCUE MEADOW IGE 602549 | $37.60 | $47.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CYPRESS,ITALIAN IGE 602934 | $37.60 | $47.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MANGO IGE 602741 | $37.60 | $47.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BANANA IGE 602742 | $37.60 | $47.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX IGE 602669 | $37.60 | $47.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON ALLERGEN | $47.60 | $59.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RABBITBUSH ALLERGEN | $47.60 | $59.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUNTAIN CEDAR ALLERGEN | $47.60 | $59.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AMERICAN ELM IGE 602476 | $48.40 | $60.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPRIKA ALLERGEN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BROCCOLI ALLERGEN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PUMPKIN IGE 602786 | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CUMIN ALLERGEN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BARLEY ALLERGEN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPE ALLERGEN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARROT ALLERGEN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LETTUCE ALLERGEN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STEMPHYLLIUM BOTRYOSUM ALL | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EUCALYPTUS TREE ALLERGEN | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CABBAGE ALLERGEN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ONION ALLERGEN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASEIN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALPHA LACTALBUMIN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAYENNE ALLERGEN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OREGANO ALLERGEN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ALLERGENS | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MIMOSA/ACACIA TREE ALLERGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPINACH ALLERGEN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SYCAMORE TREE ALLERGEN | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LENTIL ALLERGEN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IODINE BUSH ALLERGEN | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST:TOMAT ORNGE GRPFRT | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST:WEED ALLERGEN | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BETA LACTOGLOBULIN IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHEESE CHEDDAR IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHEESE MOLD TYPE IGE | $49.20 | $61.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ELM ALLERGEN 602476 | $50.00 | $62.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOOSE FEATHERS 602688 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP ALLERGEN 602473 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER ALLERGEN 602495 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GUINEA PIG EPITHELIUM IGE 602686 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW JACKET IGE 602889 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PANEL 18 TRICORE | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORNET, WHITE FACE 602887 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WINGSCALE ALLERGEN 823792 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COTTONWOOD ALLERGEN 602518 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPER WASP IGE 602890 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DUCK FEATHERS 602704 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORNET, YELLOW IGE 602891 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HONEYBEE ALLERGEN 602886 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COW DANDER ALLERGEN 602685 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORSE DANDER ALLERGEN 602684 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SCALLOPS ALLERGEN 602478 | $50.80 | $63.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINE ALLERGEN 602928 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FUSARIUM IGE 602560 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GREEN PEA ALLERGEN 602517 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JUNIPER IGE 602491 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH ALLERGEN 602465 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BIRCH TREE IGE 602936 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKLEBUR IGE 602970 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FIREBUSH KOCHIA IGE 602972 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RUSSIAN OLIVE IGE 602935 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER ALLERGEN 602454 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RYE GRASS ALLERGEN 602872 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HACKBERRY IGE 602943 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMBS QUARTER IGE 602537 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MARSH ELDER IGE 602570 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RABBIT EPITHELIUM 602700 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SYCAMORE, MAPLE LEAF 602948 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAPLE-BOX ELDER IGE 602489 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RUSSIAN THISTLE IGE 602515 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLACK WILLOW IGE 602937 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WESTERN RAGWEED IGE 602544 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOCK SORREL IGE 602974 | $51.60 | $64.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AMERICAN ELM ALLERGEN 602476 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE-EGG WHITE W/ RFX 603940 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEEF ALLERGEN 602509 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LIME IGE | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUCOR RACEMOSUS ALLERGEN 602562 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LEMON IGE | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM HERBARUM 602462 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORANGE IGE | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPEFRUIT IGE | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TANGERINE IGE | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KENTUCKY BLUEGRASS IGE 602496 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NUTMEG IGE 602820 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA GRASS ALLERGEN 602464 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN NUT IGE 602470 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MACADAMIA NUT IGE 602568 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA IGE 602510 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TOMATO IGE 602468 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JOHNSON GRASS IGE 602503 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEACH 602744 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GREEN BEAN 602838 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHILI PEPPER 602817 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHERRY,BING 602796 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EUROPEAN DUSTMITE IGE 602467 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APRICOT IGE 602795 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OYSTER IGE 602514 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLAM ALLERGEN, IGE 602529 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALDER GREY, IGE 602545 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE URINE IGE 602689 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FLAVUS IGE 800463 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS NIGER IGE 602916 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MELON IGE 602737 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ONION IG-E 602723 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WATERMELON IG-E 602718 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STRAWBERRY IG-E 602513 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SETOMELANOMA ROSTRAT IGE 602561 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAT IGE 602553 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT IGE W/COMPONENT REFLEX 603916 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP SORREL IGE 602542 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT ALLERGEN 602477 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MESQUITE IGE 602932 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT IGE 602483 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUSTARD IGE 602739 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SEED IGE 602485 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GARLIC ALLERGEN IGE 602519 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCONUT IGE 602512 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RICE IGE 602511 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG YOLK ALLERGEN 602487 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN IGE 602497 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN ALLERGEN 602500 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG ALLERGEN 602528 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON ALLERGEN 602507 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OLIVE TREE ALLERGEN 602527 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PALM TREE IGE 602949 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET VERNAL GRASS IGE 602866 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER ALLERGEN 602456 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORCHARD GRASS ALLERGEN 602867 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REDTOP GRASS ALLERGEN 602869 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE IGE 602452 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PHOMA BETAE 602552 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORANGE ALLERGEN 602472 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAB ALLERGEN 602493 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN ALLERGEN IGE 602460 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINEAPPLE IGE 602770 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NETTLE WEED IGE 602973 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT ALLERGEN IGE 602459 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHEESE,AMERICAN IGE 903700 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT ALLERGEN 602530 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SUNFLOWER SEED IGE 602766 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN FEATHERS 602703 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN IGE 602457 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW ALLERGEN 602461 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PORK ALLERGEN IGE 602498 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND ALLERGEN 602479 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BAHIA GRASS ALLERGEN 602534 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUGWORT IGE 602531 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO ALLERGEN 602486 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINON ALLERGEN 602550 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA ALTERNATA IGE 602455 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN ALLERGEN 602470 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT ALLERGEN 602451 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AMERICAN COCKROACH IGE 602481 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIUM CHRYS IGE 602502 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BUMBLEBEE IGE 602897 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK (COW) ALLERGEN 602453 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK IGE W/ COMPONENT RFX 603927 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE OAK IGE 602480 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE MULBERRY IGE 602569 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SAGEBRUSH ALLERGEN 602966 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AMERICAN DUSTMITE ALLERGEN 602475 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS ALLERGEN 602506 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLACK MOLD IGE 602918 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAGWEED ALLERGEN 602463 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS IGE 602471 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PIGWEED IGE 602484 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARROT IGE 602521 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APPLE IGE 602724 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CUCUMBER IGE 602798 | $52.40 | $65.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, FOOD 602989 | $175.20 | $219.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE FOOD 608005 | $175.20 | $219.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPRING-TREE, SEASONAL ALLERGENS | $175.39 | $219.24 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FALL-WEED, SEASONAL ALLERGENS 062463 | $191.10 | $238.87 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE, MOLD 062448 | $628.80 | $786.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE AREA 11 602641 | $1,230.00 | $1,537.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROF RESPIRATORY AREA 1 602627 | $1,279.20 | $1,599.00 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE ZONE 10 676601 | $1,328.40 | $1,660.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS, ZONE 15 676650 | $1,328.40 | $1,660.50 | — | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS, ZONE 12 676627 | $1,328.40 | $1,660.50 | — | — | 20% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 .AFP | $35.20 | $44.00 | — | 70% below | 20% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP, OPEN SPINA BIFIDA 010801 | $70.40 | $88.00 | — | 39% below | 20% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN BODY FLUID 823936 | $99.60 | $124.50 | — | 14% below | 20% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN TUMOR 002253 | $99.60 | $124.50 | — | 14% below | 20% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 .AFP | $35.20 | $44.00 | — | — | 20% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP, OPEN SPINA BIFIDA 010801 | $70.40 | $88.00 | — | — | 20% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN TUMOR 002253 | $99.60 | $124.50 | — | — | 20% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN BODY FLUID 823936 | $99.60 | $124.50 | — | — | 20% |
| Ammonia blood test CPT 82140 AMMONIA | $74.00 | $92.50 | — | 36% below | 20% |
| Ammonia blood test inpatient CPT 82140 AMMONIA | $74.00 | $92.50 | — | — | 20% |
| Amylase blood test CPT 82150 ASCITES FLUID AMYLASE | $33.20 | $41.50 | — | 67% below | 20% |
| Amylase blood test CPT 82150 AMYLASE | $33.20 | $41.50 | — | 67% below | 20% |
| Amylase blood test CPT 82150 BODY FLUID AMYLASE | $33.20 | $41.50 | — | 67% below | 20% |
| Amylase blood test CPT 82150 AMYLASE URINE | $55.20 | $69.00 | — | 44% below | 20% |
| Amylase blood test CPT 82150 AMYLASE ISOENZYMES 123110 | $119.60 | $149.50 | — | 20% above | 20% |
| Amylase blood test inpatient CPT 82150 AMYLASE | $33.20 | $41.50 | — | — | 20% |
| Amylase blood test inpatient CPT 82150 BODY FLUID AMYLASE | $33.20 | $41.50 | — | — | 20% |
| Amylase blood test inpatient CPT 82150 ASCITES FLUID AMYLASE | $33.20 | $41.50 | — | — | 20% |
| Amylase blood test inpatient CPT 82150 AMYLASE URINE | $55.20 | $69.00 | — | — | 20% |
| Amylase blood test inpatient CPT 82150 AMYLASE ISOENZYMES 123110 | $119.60 | $149.50 | — | — | 20% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCL CIT PEP(CCP) IGG/A 164914 | $55.60 | $69.50 | — | 33% below | 20% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCL CIT PEP(CCP) IGG/A 164914 | $55.60 | $69.50 | — | — | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 CONNECTIVE TISSUE (CTD) CASCADE 520340 | $23.20 | $29.00 | — | 76% below | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA REFLEX TITER/PATTERN 520075 | $23.20 | $29.00 | — | 76% below | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY IFA REFLEX TITER/PATTERN 164947 | $23.20 | $29.00 | — | 76% below | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA 12 PLUS PROFILE(RDL) 520180 | $63.60 | $79.50 | — | 36% below | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA RFLX FOR SLE IF POS 164863 | $63.60 | $79.50 | — | 36% below | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA DIRECT | $81.60 | $102.00 | — | 17% below | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA BY IFA REFLEX TITER/PATTERN 164947 | $23.20 | $29.00 | — | — | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA REFLEX TITER/PATTERN 520075 | $23.20 | $29.00 | — | — | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CONNECTIVE TISSUE (CTD) CASCADE 520340 | $23.20 | $29.00 | — | — | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA 12 PLUS PROFILE(RDL) 520180 | $63.60 | $79.50 | — | — | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA RFLX FOR SLE IF POS 164863 | $63.60 | $79.50 | — | — | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA DIRECT | $81.60 | $102.00 | — | — | 20% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-PRO-BNP | $109.60 | $137.00 | — | 36% below | 20% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-PRO-BNP | $109.60 | $137.00 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 THROAT CULTURE | $40.00 | $50.00 | — | 53% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE NOSE | $40.00 | $50.00 | — | 53% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE UPPER RESPIRATORY | $40.00 | $50.00 | — | 53% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CATHETER CULTURE | $45.20 | $56.50 | — | 47% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 AEROBIC CULTURE | $45.20 | $56.50 | — | 47% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 EYE CULTURE | $45.20 | $56.50 | — | 47% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 EAR CULTURE | $45.20 | $56.50 | — | 47% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE DAYMED : O2, ANO2 | $45.20 | $56.50 | — | 47% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CSF CULTURE + GRAM STAIN | $45.20 | $56.50 | — | 47% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BRONCHOALVEOLAR LAVAGE CULTURE | $45.20 | $56.50 | — | 47% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BRONCHIAL ASPI CULT + GRAM STAIN | $45.20 | $56.50 | — | 47% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GENITAL CULTURE | $45.20 | $56.50 | — | 47% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 INFECTION PREVENTION CULTURE | $45.20 | $56.50 | — | 47% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 WOUND CULTURE | $46.80 | $58.50 | — | 45% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BODY FLUID CULTURE | $46.80 | $58.50 | — | 45% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SINUS | $46.80 | $58.50 | — | 45% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 ASCITES FLUID CULTURE | $46.80 | $58.50 | — | 45% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SPUTUM CULTURE + GRAM STAIN | $46.80 | $58.50 | — | 45% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 PLEURAL FLUID CULTURE | $46.80 | $58.50 | — | 45% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 ABSCESS CULTURE | $46.80 | $58.50 | — | 45% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SURGICAL CULTURE - GS, O2, ANO2 | $46.80 | $58.50 | — | 45% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 TISSUE CULTURE - GS, O2, ANO2 | $46.80 | $58.50 | — | 45% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LEGIONELLA CULTURE 086868 | $48.80 | $61.00 | — | 42% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE UPPER RESPIRATORY | $40.00 | $50.00 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE NOSE | $40.00 | $50.00 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 THROAT CULTURE | $40.00 | $50.00 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 EYE CULTURE | $45.20 | $56.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 EAR CULTURE | $45.20 | $56.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GENITAL CULTURE | $45.20 | $56.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CSF CULTURE + GRAM STAIN | $45.20 | $56.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BRONCHOALVEOLAR LAVAGE CULTURE | $45.20 | $56.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BRONCHIAL ASPI CULT + GRAM STAIN | $45.20 | $56.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 AEROBIC CULTURE | $45.20 | $56.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 INFECTION PREVENTION CULTURE | $45.20 | $56.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE DAYMED : O2, ANO2 | $45.20 | $56.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CATHETER CULTURE | $45.20 | $56.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SPUTUM CULTURE + GRAM STAIN | $46.80 | $58.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 PLEURAL FLUID CULTURE | $46.80 | $58.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 ASCITES FLUID CULTURE | $46.80 | $58.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BODY FLUID CULTURE | $46.80 | $58.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 ABSCESS CULTURE | $46.80 | $58.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SURGICAL CULTURE - GS, O2, ANO2 | $46.80 | $58.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 TISSUE CULTURE - GS, O2, ANO2 | $46.80 | $58.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 WOUND CULTURE | $46.80 | $58.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE SINUS | $46.80 | $58.50 | — | — | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LEGIONELLA CULTURE 086868 | $48.80 | $61.00 | — | — | 20% |
| Basic metabolic panel (blood test) CPT 80048 RENAL BASIC METABOLIC PANEL | $42.80 | $53.50 | — | 72% below | 20% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $42.80 | $53.50 | — | 72% below | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $42.80 | $53.50 | — | — | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 RENAL BASIC METABOLIC PANEL | $42.80 | $53.50 | — | — | 20% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL LABCORP 001099 | $26.00 | $32.50 | — | 60% below | 20% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL | $26.00 | $32.50 | — | 60% below | 20% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL NEONATAL | $26.00 | $32.50 | — | 60% below | 20% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL NEONATAL | $26.00 | $32.50 | — | — | 20% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL LABCORP 001099 | $26.00 | $32.50 | — | — | 20% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL | $26.00 | $32.50 | — | — | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV PATHOLOGY | $230.80 | $288.50 | — | 12% above | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 BONE MARROW ASPIRATION | $246.80 | $308.50 | — | 20% above | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 BONE MARROW BIOPSY | $246.80 | $308.50 | — | 20% above | 20% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV PATHOLOGY | $230.80 | $288.50 | — | — | 20% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 BONE MARROW BIOPSY | $246.80 | $308.50 | — | — | 20% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 BONE MARROW ASPIRATION | $246.80 | $308.50 | — | — | 20% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE | $52.80 | $66.00 | — | 60% below | 20% |
| Blood culture for bacteria CPT 87040 TRXN BLOOD CULTURE-BAG | $52.80 | $66.00 | — | 60% below | 20% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE LABCORP 008300 | $52.80 | $66.00 | — | 60% below | 20% |
| Blood culture for bacteria CPT 87040 TRXN BLOOD CULTURE-PATIENT | $52.80 | $66.00 | — | 60% below | 20% |
| Blood culture for bacteria inpatient CPT 87040 TRXN BLOOD CULTURE-PATIENT | $52.80 | $66.00 | — | — | 20% |
| Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE | $52.80 | $66.00 | — | — | 20% |
| Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE LABCORP 008300 | $52.80 | $66.00 | — | — | 20% |
| Blood culture for bacteria inpatient CPT 87040 TRXN BLOOD CULTURE-BAG | $52.80 | $66.00 | — | — | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 SPECIMEN COLLECTION | $17.60 | $22.00 | — | 24% below | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE BLOOD COLLECTION | $19.20 | $24.00 | — | 17% below | 20% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 SPECIMEN COLLECTION | $17.60 | $22.00 | — | — | 20% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE BLOOD COLLECTION | $19.20 | $24.00 | — | — | 20% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE | $19.20 | $24.00 | — | 51% below | 20% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE - CRITICAL PATIENT | $19.20 | $24.00 | — | 51% below | 20% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE 2HR POST-PRANDIAL | $19.20 | $24.00 | — | 51% below | 20% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE (GEM) | $19.20 | $24.00 | — | 51% below | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE 2HR POST-PRANDIAL | $19.20 | $24.00 | — | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE (GEM) | $19.20 | $24.00 | — | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE | $19.20 | $24.00 | — | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE - CRITICAL PATIENT | $19.20 | $24.00 | — | — | 20% |
| Blood lead test CPT 83655 LEAD URINE 007633 | $62.80 | $78.50 | — | 9% below | 20% |
| Blood lead test CPT 83655 LEAD | $78.40 | $98.00 | — | 14% above | 20% |
| Blood lead test CPT 83655 SO LAB LEAD 24 UR | $81.60 | $102.00 | — | 19% above | 20% |
| Blood lead test CPT 83655 LEAD BLOOD PEDIATRIC 717009 | $84.00 | $105.00 | — | 22% above | 20% |
| Blood lead test CPT 83655 LEAD BLOOD ADULT 007625 | $84.00 | $105.00 | — | 22% above | 20% |
| Blood lead test inpatient CPT 83655 LEAD URINE 007633 | $62.80 | $78.50 | — | — | 20% |
| Blood lead test inpatient CPT 83655 LEAD | $78.40 | $98.00 | — | — | 20% |
| Blood lead test inpatient CPT 83655 SO LAB LEAD 24 UR | $81.60 | $102.00 | — | — | 20% |
| Blood lead test inpatient CPT 83655 LEAD BLOOD ADULT 007625 | $84.00 | $105.00 | — | — | 20% |
| Blood lead test inpatient CPT 83655 LEAD BLOOD PEDIATRIC 717009 | $84.00 | $105.00 | — | — | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY SERUM | $67.20 | $84.00 | — | 38% below | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY SERUM | $67.20 | $84.00 | — | — | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 UBS ABO GROUPING | $95.60 | $119.50 | — | 8% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 NEWBORN ABORH | $95.60 | $119.50 | — | 8% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO BLOOD TYPING | $95.60 | $119.50 | — | 8% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 UBS ABO GROUPING | $95.60 | $119.50 | — | — | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO BLOOD TYPING | $95.60 | $119.50 | — | — | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 NEWBORN ABORH | $95.60 | $119.50 | — | — | 20% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN/CREATININE RATIO | $20.80 | $26.00 | — | 71% below | 20% |
| Blood urea nitrogen (BUN) test CPT 84520 BLOOD UREA NITROGEN | $20.80 | $26.00 | — | 71% below | 20% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BLOOD UREA NITROGEN | $20.80 | $26.00 | — | — | 20% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN/CREATININE RATIO | $20.80 | $26.00 | — | — | 20% |
| C-peptide blood test CPT 84681 C-PEPTIDE 010108 | $92.80 | $116.00 | — | 16% below | 20% |
| C-peptide blood test inpatient CPT 84681 C-PEPTIDE 010108 | $92.80 | $116.00 | — | — | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP LABCORP 006627 | $55.60 | $69.50 | — | 8% below | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN (NON-CARDIAC) | $55.60 | $69.50 | — | 8% below | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP HIGH SENSITIVITY (CARDIAC) | $55.60 | $69.50 | — | 8% below | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP-SYNOVIAL FLUID | $55.60 | $69.50 | — | 8% below | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP-SYNOVIAL FLUID | $55.60 | $69.50 | — | — | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP LABCORP 006627 | $55.60 | $69.50 | — | — | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP HIGH SENSITIVITY (CARDIAC) | $55.60 | $69.50 | — | — | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN (NON-CARDIAC) | $55.60 | $69.50 | — | — | 20% |
| C. difficile toxin gene test (stool PCR) CPT 87493 CDIFF A+B DNA (NAAT) ASSAY | $149.60 | $187.00 | — | at median | 20% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C. DIFFICILE/EPI CEPHEID | $149.60 | $187.00 | — | at median | 20% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. DIFFICILE/EPI CEPHEID | $149.60 | $187.00 | — | — | 20% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CDIFF A+B DNA (NAAT) ASSAY | $149.60 | $187.00 | — | — | 20% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 002261 | $117.60 | $147.00 | — | 17% below | 20% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 002261 | $117.60 | $147.00 | — | — | 20% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 002303 | $98.80 | $123.50 | — | 23% below | 20% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 002303 | $98.80 | $123.50 | — | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-Cov-2,NAA 139900 LABCORP | $120.00 | $150.00 | — | 7% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SNF SARS-Cov-2,NAA | $120.00 | $150.00 | — | 7% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19, RAPID | $120.00 | $150.00 | — | 7% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS COVID-19 CSV PCR(PANTHER) | $120.00 | $150.00 | — | 7% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-Cov-2,NAA NON-PATIENTS | $120.00 | $150.00 | — | 7% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 CEPHEID | $120.00 | $150.00 | — | 7% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 TRICORE | $240.00 | $300.00 | — | 114% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 COVID19 RT-PCR (SCHOOL) | $120.00 | $150.00 | — | 7% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 COVID19, SILARIS, RT-PCR | $120.00 | $150.00 | — | 7% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 SARS-COV-2, RT-PCR | $120.00 | $150.00 | — | 7% above | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 CEPHEID | $120.00 | $150.00 | — | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-Cov-2,NAA 139900 LABCORP | $120.00 | $150.00 | — | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS COVID-19 CSV PCR(PANTHER) | $120.00 | $150.00 | — | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-Cov-2,NAA NON-PATIENTS | $120.00 | $150.00 | — | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SNF SARS-Cov-2,NAA | $120.00 | $150.00 | — | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19, RAPID | $120.00 | $150.00 | — | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 TRICORE | $240.00 | $300.00 | — | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 SARS-COV-2, RT-PCR | $120.00 | $150.00 | — | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 COVID19, SILARIS, RT-PCR | $120.00 | $150.00 | — | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 COVID19 RT-PCR (SCHOOL) | $120.00 | $150.00 | — | — | 20% |
| Calcium blood test, total CPT 82310 CALCIUM | $26.40 | $33.00 | — | 47% below | 20% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM | $26.40 | $33.00 | — | — | 20% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA CARCINOEMBRYONIC AG 002139 | $92.80 | $116.00 | — | 34% below | 20% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA CARCINOEMBRYONIC AG 002139 | $92.80 | $116.00 | — | — | 20% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG 096206 | $150.40 | $188.00 | — | 124% above | 20% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGM 834640 | $150.40 | $188.00 | — | 124% above | 20% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGM 096776 | $150.40 | $188.00 | — | 124% above | 20% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGM 834640 | $150.40 | $188.00 | — | — | 20% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGG 096206 | $150.40 | $188.00 | — | — | 20% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGM 096776 | $150.40 | $188.00 | — | — | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA UR-AMPLIFICATION | $62.40 | $78.00 | — | 47% below | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS, NAA | $62.40 | $78.00 | — | 47% below | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DIR AG URINE | $105.60 | $132.00 | — | 10% below | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA PATH | $126.80 | $158.50 | — | 8% above | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA APTIMA PCR 188078 | $126.80 | $158.50 | — | 8% above | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA UR-AMPLIFICATION | $62.40 | $78.00 | — | — | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS, NAA | $62.40 | $78.00 | — | — | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA DIR AG URINE | $105.60 | $132.00 | — | — | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA APTIMA PCR 188078 | $126.80 | $158.50 | — | — | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA PATH | $126.80 | $158.50 | — | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE LABCORP 303756 | $66.40 | $83.00 | — | 50% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE | $66.40 | $83.00 | — | 50% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE | $66.40 | $83.00 | — | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE LABCORP 303756 | $66.40 | $83.00 | — | — | 20% |
| Complete blood count (CBC) with differential CPT 85025 .CBC W/AUTO DIFF | $40.00 | $50.00 | — | 56% below | 20% |
| Complete blood count (CBC) with differential CPT 85025 CBC | $80.80 | $101.00 | — | 11% below | 20% |
| Complete blood count (CBC) with differential inpatient CPT 85025 .CBC W/AUTO DIFF | $40.00 | $50.00 | — | — | 20% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC | $80.80 | $101.00 | — | — | 20% |
| Complete blood count (CBC), no differential CPT 85027 .CHARGE HEMOGRAM | $33.20 | $41.50 | — | 30% below | 20% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM | $33.20 | $41.50 | — | 30% below | 20% |
| Complete blood count (CBC), no differential inpatient CPT 85027 .CHARGE HEMOGRAM | $33.20 | $41.50 | — | — | 20% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM | $33.20 | $41.50 | — | — | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL-LC | $54.00 | $67.50 | — | 72% below | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 CMP LABCORP 322000 | $54.00 | $67.50 | — | 72% below | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 CMP COMPREHENSIVE METABOLIC PANEL | $54.00 | $67.50 | — | 72% below | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL-LC | $54.00 | $67.50 | — | — | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP COMPREHENSIVE METABOLIC PANEL | $54.00 | $67.50 | — | — | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP LABCORP 322000 | $54.00 | $67.50 | — | — | 20% |
| Cortisol blood test, total CPT 82533 CORTISOL TOTAL | $94.00 | $117.50 | — | 8% below | 20% |
| Cortisol blood test, total CPT 82533 CORTISOL 4 SPECIMENS 026948 | $121.20 | $151.50 | — | 19% above | 20% |
| Cortisol blood test, total CPT 82533 CORTISOL 2 SPECIMENS 024265 | $121.20 | $151.50 | — | 19% above | 20% |
| Cortisol blood test, total CPT 82533 CORTISOL PM 104026 | $121.20 | $151.50 | — | 19% above | 20% |
| Cortisol blood test, total CPT 82533 CORTISOL RANDOM 004051 | $121.20 | $151.50 | — | 19% above | 20% |
| Cortisol blood test, total CPT 82533 CORTISOL AM 104018 | $121.20 | $151.50 | — | 19% above | 20% |
| Cortisol blood test, total CPT 82533 CORTISOL SALIVARY 500179 | $121.20 | $151.50 | — | 19% above | 20% |
| Cortisol blood test, total CPT 82533 CORTISOL 3 SPECIMENS 028498 | $121.20 | $151.50 | — | 19% above | 20% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL | $94.00 | $117.50 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL SALIVARY 500179 | $121.20 | $151.50 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL RANDOM 004051 | $121.20 | $151.50 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL AM 104018 | $121.20 | $151.50 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL 3 SPECIMENS 028498 | $121.20 | $151.50 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL PM 104026 | $121.20 | $151.50 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL 2 SPECIMENS 024265 | $121.20 | $151.50 | — | — | 20% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL 4 SPECIMENS 026948 | $121.20 | $151.50 | — | — | 20% |
| Creatine kinase (CK) blood test, total CPT 82550 .CREATINE KINASE REF | $31.60 | $39.50 | — | 58% below | 20% |
| Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE | $33.20 | $41.50 | — | 56% below | 20% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 .CREATINE KINASE REF | $31.60 | $39.50 | — | — | 20% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE | $33.20 | $41.50 | — | — | 20% |
| Creatinine blood test CPT 82565 CREATININE W/GFR | $26.40 | $33.00 | — | 64% below | 20% |
| Creatinine blood test CPT 82565 eGFR 100768 | $26.40 | $33.00 | — | 64% below | 20% |
| Creatinine blood test inpatient CPT 82565 eGFR 100768 | $26.40 | $33.00 | — | — | 20% |
| Creatinine blood test inpatient CPT 82565 CREATININE W/GFR | $26.40 | $33.00 | — | — | 20% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG SERUM 006494 | $82.00 | $102.50 | — | 8% above | 20% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG CSF 828825 | $105.20 | $131.50 | — | 39% above | 20% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG SERUM 006494 | $82.00 | $102.50 | — | — | 20% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG CSF 828825 | $105.20 | $131.50 | — | — | 20% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER TEST QUANTITATIVE | $52.40 | $65.50 | — | 58% below | 20% |
| D-dimer blood test (blood clot marker) CPT 85379 DDIMER QUANT | $135.60 | $169.50 | — | 8% above | 20% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER TEST QUANTITATIVE | $52.40 | $65.50 | — | — | 20% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 DDIMER QUANT | $135.60 | $169.50 | — | — | 20% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE 004020 | $124.40 | $155.50 | — | 2% below | 20% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE 004020 | $124.40 | $155.50 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SALICYLATE | $37.20 | $46.50 | — | 78% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN URINE COC 788793 | $52.00 | $65.00 | — | 69% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG+ALC SCREEN URINE COC 788793 | $52.00 | $65.00 | — | 69% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 EMPLOYEE DRUG SCREEN URINE COC | $52.00 | $65.00 | — | 69% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL URINE | $58.40 | $73.00 | — | 66% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 METHAQUALONE SCREEN 798272 | $67.60 | $84.50 | — | 60% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 FENTANYL SCREEN W/ RFX TO CONF 721574 | $67.60 | $84.50 | — | 60% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHANOL, URINE 735316 | $69.60 | $87.00 | — | 59% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 NICOTINE SCREEN URINE 716555 | $69.60 | $87.00 | — | 59% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 NICOTINE METABOLITE SERUM 070322 | $69.60 | $87.00 | — | 59% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 AMPHETAMINE SCREEN URINE NMS LAB | $69.60 | $87.00 | — | 59% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 BLOOD ALCOHOL | $70.40 | $88.00 | — | 59% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 MECONIUM DRUG SCREEN | $74.40 | $93.00 | — | 56% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 THC, SCREEN WITH CONF 700834 | $122.00 | $152.50 | — | 28% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN 007740 | $122.00 | $152.50 | — | 28% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN | $122.00 | $152.50 | — | 28% below | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 MECONIUM DRUG SCREEN USDTL | $180.00 | $225.00 | — | 6% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ANABOLIC STEROID SCREEN 790348 | $213.60 | $267.00 | — | 25% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 FENTANYL SCREEN URINE 761200 | $213.60 | $267.00 | — | 25% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 OXYCODONE/OXYMORPHONE URINE 737660 | $213.60 | $267.00 | — | 25% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG ABUSE PROF, UR (7DRUGS+ALC) 726778 | $213.60 | $267.00 | — | 25% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG PROFILE, URINE 9 DRUGS 794370 | $213.60 | $267.00 | — | 25% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 TRAMADOL URINE 764365 | $213.60 | $267.00 | — | 25% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 FENTANYL SCREEN URINE | $213.60 | $267.00 | — | 25% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 PROPOXYPHENE SCREEN RFX CONF 737477 | $213.60 | $267.00 | — | 25% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN 13 SERUM W/CONF 700845 | $241.60 | $302.00 | — | 42% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 19 DRUG + ETG SCREEN PANEL URINE 764390 | $241.60 | $302.00 | — | 42% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN 10 SERUM 700841 | $241.60 | $302.00 | — | 42% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 PED DRUG SCREEN RFX CONF 713323 | $241.60 | $302.00 | — | 42% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN W/GHB BLOOD 738806 | $241.60 | $302.00 | — | 42% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN+SALICYLATE | $242.80 | $303.50 | — | 42% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 CORD DRUG SCREEN USDTL | $306.00 | $382.50 | — | 80% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 TOXU14+ALCOHOL | $354.80 | $443.50 | — | 108% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 KETAMINE UR 764258 | $358.40 | $448.00 | — | 110% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 GAM HYDROXYBUTYRIC ACID UR 738792 | $358.40 | $448.00 | — | 110% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 FLUNITRAZEPAM SCREEN URINE 808417 | $358.40 | $448.00 | — | 110% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 MDMA URINE 722117 | $358.40 | $448.00 | — | 110% above | 20% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 MULTI-DRUG SCREEN | $392.00 | $490.00 | — | 130% above | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SALICYLATE | $37.20 | $46.50 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG+ALC SCREEN URINE COC 788793 | $52.00 | $65.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 EMPLOYEE DRUG SCREEN URINE COC | $52.00 | $65.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN URINE COC 788793 | $52.00 | $65.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ALCOHOL URINE | $58.40 | $73.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FENTANYL SCREEN W/ RFX TO CONF 721574 | $67.60 | $84.50 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 METHAQUALONE SCREEN 798272 | $67.60 | $84.50 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 AMPHETAMINE SCREEN URINE NMS LAB | $69.60 | $87.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NICOTINE SCREEN URINE 716555 | $69.60 | $87.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NICOTINE METABOLITE SERUM 070322 | $69.60 | $87.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHANOL, URINE 735316 | $69.60 | $87.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BLOOD ALCOHOL | $70.40 | $88.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MECONIUM DRUG SCREEN | $74.40 | $93.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ACETAMINOPHEN | $122.00 | $152.50 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 THC, SCREEN WITH CONF 700834 | $122.00 | $152.50 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ACETAMINOPHEN 007740 | $122.00 | $152.50 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MECONIUM DRUG SCREEN USDTL | $180.00 | $225.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG PROFILE, URINE 9 DRUGS 794370 | $213.60 | $267.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OXYCODONE/OXYMORPHONE URINE 737660 | $213.60 | $267.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FENTANYL SCREEN URINE 761200 | $213.60 | $267.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PROPOXYPHENE SCREEN RFX CONF 737477 | $213.60 | $267.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG ABUSE PROF, UR (7DRUGS+ALC) 726778 | $213.60 | $267.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ANABOLIC STEROID SCREEN 790348 | $213.60 | $267.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FENTANYL SCREEN URINE | $213.60 | $267.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TRAMADOL URINE 764365 | $213.60 | $267.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN W/GHB BLOOD 738806 | $241.60 | $302.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 19 DRUG + ETG SCREEN PANEL URINE 764390 | $241.60 | $302.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN 13 SERUM W/CONF 700845 | $241.60 | $302.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN 10 SERUM 700841 | $241.60 | $302.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PED DRUG SCREEN RFX CONF 713323 | $241.60 | $302.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ACETAMINOPHEN+SALICYLATE | $242.80 | $303.50 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CORD DRUG SCREEN USDTL | $306.00 | $382.50 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TOXU14+ALCOHOL | $354.80 | $443.50 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MDMA URINE 722117 | $358.40 | $448.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 KETAMINE UR 764258 | $358.40 | $448.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FLUNITRAZEPAM SCREEN URINE 808417 | $358.40 | $448.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 GAM HYDROXYBUTYRIC ACID UR 738792 | $358.40 | $448.00 | — | — | 20% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MULTI-DRUG SCREEN | $392.00 | $490.00 | — | — | 20% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES (GEM) | $36.40 | $45.50 | — | 66% below | 20% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES | $36.40 | $45.50 | — | 66% below | 20% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES | $36.40 | $45.50 | — | — | 20% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES (GEM) | $36.40 | $45.50 | — | — | 20% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID AB | $32.40 | $40.50 | — | 71% below | 20% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR IGA VCA 829532 | $59.60 | $74.50 | — | 47% below | 20% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR IGM VCA 096735 | $59.60 | $74.50 | — | 47% below | 20% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR IGG VCA 096230 | $111.20 | $139.00 | — | 1% below | 20% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID AB | $32.40 | $40.50 | — | — | 20% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR IGA VCA 829532 | $59.60 | $74.50 | — | — | 20% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR IGM VCA 096735 | $59.60 | $74.50 | — | — | 20% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR IGG VCA 096230 | $111.20 | $139.00 | — | — | 20% |
| Estradiol blood test CPT 82670 ESTRADIOL SERUM | $64.80 | $81.00 | — | 63% below | 20% |
| Estradiol blood test CPT 82670 ESTRADIOL 004515 | $83.20 | $104.00 | — | 53% below | 20% |
| Estradiol blood test CPT 82670 ESTRADIOL SENSITIVE 140244 | $151.60 | $189.50 | — | 14% below | 20% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL SERUM | $64.80 | $81.00 | — | — | 20% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL 004515 | $83.20 | $104.00 | — | — | 20% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL SENSITIVE 140244 | $151.60 | $189.50 | — | — | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIM HORMONE 004309 | $85.60 | $107.00 | — | 37% below | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH PEDIATRIC 502280 | $85.60 | $107.00 | — | 37% below | 20% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIM HORMONE 004309 | $85.60 | $107.00 | — | — | 20% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH PEDIATRIC 502280 | $85.60 | $107.00 | — | — | 20% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL 123255 | $394.40 | $493.00 | — | 114% above | 20% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL 123255 | $394.40 | $493.00 | — | — | 20% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $84.80 | $106.00 | — | 24% below | 20% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN 004598 | $84.80 | $106.00 | — | 24% below | 20% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN 004598 | $84.80 | $106.00 | — | — | 20% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $84.80 | $106.00 | — | — | 20% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN | $43.20 | $54.00 | — | 59% below | 20% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN | $43.20 | $54.00 | — | — | 20% |
| Folate (folic acid) blood test CPT 82746 FOLATE SERUM 002014 | $72.40 | $90.50 | — | 20% below | 20% |
| Folate (folic acid) blood test CPT 82746 FOLATE, SERUM | $72.40 | $90.50 | — | 20% below | 20% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE, SERUM | $72.40 | $90.50 | — | — | 20% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE SERUM 002014 | $72.40 | $90.50 | — | — | 20% |
| Free T3 thyroid hormone test CPT 84481 FREE T3 | $111.20 | $139.00 | — | 8% below | 20% |
| Free T3 thyroid hormone test CPT 84481 FREE T3 010389 | $111.20 | $139.00 | — | 8% below | 20% |
| Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 | $111.20 | $139.00 | — | — | 20% |
| Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 010389 | $111.20 | $139.00 | — | — | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (T4) 001974 | $116.00 | $145.00 | — | 6% below | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 001974 | $116.00 | $145.00 | — | 6% below | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 | $116.00 | $145.00 | — | 6% below | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 DIALYSIS/MASS SPEC 501902 | $159.60 | $199.50 | — | 30% above | 20% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 | $116.00 | $145.00 | — | — | 20% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE (T4) 001974 | $116.00 | $145.00 | — | — | 20% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 001974 | $116.00 | $145.00 | — | — | 20% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 DIALYSIS/MASS SPEC 501902 | $159.60 | $199.50 | — | — | 20% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE 144980 | $128.40 | $160.50 | — | 2% below | 20% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE 144980 | $128.40 | $160.50 | — | — | 20% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GLUTAMYL TRANSFERASE | $37.20 | $46.50 | — | 34% below | 20% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT | $46.80 | $58.50 | — | 17% below | 20% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GLUTAMYL TRANSFERASE | $37.20 | $46.50 | — | — | 20% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT | $46.80 | $58.50 | — | — | 20% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE SCREEN 1 HR OB (ACOG) | $19.20 | $24.00 | — | 46% below | 20% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE SCREEN 1 HR OB (ACOG) | $19.20 | $24.00 | — | — | 20% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 HR OB | $63.20 | $79.00 | — | 43% below | 20% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL TEST GTT 3 SPECIME | $65.20 | $81.50 | — | 42% below | 20% |
| Glucose tolerance test, 3 samples CPT 82951 .GLUCOSE 2 HOUR OB (ACOG) | $65.20 | $81.50 | — | 42% below | 20% |
| Glucose tolerance test, 3 samples CPT 82951 .GLUC TOLERANCE TEST 2 HR | $65.20 | $81.50 | — | 42% below | 20% |
| Glucose tolerance test, 3 samples CPT 82951 .GLUCOSE 2 HOUR OB (ADA) | $65.20 | $81.50 | — | 42% below | 20% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 3 HR | $66.40 | $83.00 | — | 41% below | 20% |
| Glucose tolerance test, 3 samples CPT 82951 LACTOSE TOLERANCE TEST 046300 | $67.20 | $84.00 | — | 40% below | 20% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 HR OB | $63.20 | $79.00 | — | — | 20% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .GLUC TOLERANCE TEST 2 HR | $65.20 | $81.50 | — | — | 20% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .GLUCOSE 2 HOUR OB (ACOG) | $65.20 | $81.50 | — | — | 20% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL TEST GTT 3 SPECIME | $65.20 | $81.50 | — | — | 20% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .GLUCOSE 2 HOUR OB (ADA) | $65.20 | $81.50 | — | — | 20% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 3 HR | $66.40 | $83.00 | — | — | 20% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 LACTOSE TOLERANCE TEST 046300 | $67.20 | $84.00 | — | — | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC UR-AMPLIFCATION | $62.40 | $78.00 | — | 50% below | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, NAA | $62.40 | $78.00 | — | 50% below | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC PCR APTIMA 188086 | $123.60 | $154.50 | — | 2% below | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHEA PATH | $123.60 | $154.50 | — | 2% below | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE, NAA | $62.40 | $78.00 | — | — | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC UR-AMPLIFCATION | $62.40 | $78.00 | — | — | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC PCR APTIMA 188086 | $123.60 | $154.50 | — | — | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHEA PATH | $123.60 | $154.50 | — | — | 20% |
| H. pylori antibody blood test CPT 86677 H PYLORI IGA 163170 | $74.00 | $92.50 | — | 29% below | 20% |
| H. pylori antibody blood test CPT 86677 H PYLORI IGM 163204 | $74.00 | $92.50 | — | 29% below | 20% |
| H. pylori antibody blood test CPT 86677 H PYLORI IGG 162289 | $90.40 | $113.00 | — | 13% below | 20% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGM 163204 | $74.00 | $92.50 | — | — | 20% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGA 163170 | $74.00 | $92.50 | — | — | 20% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGG 162289 | $90.40 | $113.00 | — | — | 20% |
| H. pylori stool antigen test CPT 87338 H PYLORI STOOL ANTIGEN 180764 | $49.20 | $61.50 | — | 38% below | 20% |
| H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL ANTIGEN 180764 | $49.20 | $61.50 | — | — | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 INFECT AGENT DET BY NUC AC | $54.80 | $68.50 | — | 84% below | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA PCR CHARGE | $151.60 | $189.50 | — | 54% below | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV QUANT PCR 550430 | $400.40 | $500.50 | — | 20% above | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 INFECT AGENT DET BY NUC AC | $54.80 | $68.50 | — | — | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA PCR CHARGE | $151.60 | $189.50 | — | — | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV QUANT PCR 550430 | $400.40 | $500.50 | — | — | 20% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV SCREEN | $49.20 | $61.50 | — | 51% below | 20% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV SCREEN | $49.20 | $61.50 | — | — | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1+2 AB/AG RFLX 083935 | $122.80 | $153.50 | — | 20% above | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1+2 AB/AG RFLX 083935 | $122.80 | $153.50 | — | — | 20% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV APTIMA 507800 | $135.60 | $169.50 | — | 9% above | 20% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK TYPES | $135.60 | $169.50 | — | 9% above | 20% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH RISK TYPES | $135.60 | $169.50 | — | — | 20% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV APTIMA 507800 | $135.60 | $169.50 | — | — | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HA1C DUPLICATE TEST | $46.80 | $58.50 | — | 37% below | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 H A1C WITH EAG HCH | $50.00 | $62.50 | — | 33% below | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C LABCORP | $50.00 | $62.50 | — | 33% below | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HA1C DUPLICATE TEST | $46.80 | $58.50 | — | — | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 H A1C WITH EAG HCH | $50.00 | $62.50 | — | — | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C LABCORP | $50.00 | $62.50 | — | — | 20% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN | $12.40 | $15.50 | — | 69% below | 20% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN | $12.40 | $15.50 | — | — | 20% |
| Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB, TOTAL 006718 | $23.20 | $29.00 | — | 65% below | 20% |
| Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB, TOTAL RFX TO IGM 160101 | $23.20 | $29.00 | — | 65% below | 20% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE IGGIGM | $72.40 | $90.50 | — | 8% above | 20% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB, TOTAL RFX TO IGM 160101 | $23.20 | $29.00 | — | — | 20% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB, TOTAL 006718 | $23.20 | $29.00 | — | — | 20% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE IGGIGM | $72.40 | $90.50 | — | — | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB,IMM.QUAL 006395 | $21.60 | $27.00 | — | 79% below | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURF AB,IMM.QUAL 006395 | $21.60 | $27.00 | — | — | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN OB | $46.00 | $57.50 | — | 25% below | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG | $50.80 | $63.50 | — | 17% below | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG 006510 | $50.80 | $63.50 | — | 17% below | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN OB | $46.00 | $57.50 | — | — | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG | $50.80 | $63.50 | — | — | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG 006510 | $50.80 | $63.50 | — | — | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV ANTIBODY REFLEX TO NAA 144045 | $52.40 | $65.50 | — | 38% below | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB SCRN RFLX PCR 144050 | $52.40 | $65.50 | — | 38% below | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB SCRN RFLX PCR/GENO 144127 | $52.40 | $65.50 | — | 38% below | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB SCREEN | $52.40 | $65.50 | — | 38% below | 20% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB SCRN RFLX PCR/GENO 144127 | $52.40 | $65.50 | — | — | 20% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV ANTIBODY REFLEX TO NAA 144045 | $52.40 | $65.50 | — | — | 20% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB SCRN RFLX PCR 144050 | $52.40 | $65.50 | — | — | 20% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB SCREEN | $52.40 | $65.50 | — | — | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HYBRIDIZATION | $79.20 | $99.00 | — | 75% below | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C PCR CHARGE | $137.20 | $171.50 | — | 57% below | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C PCR QUANT 550080 | $188.80 | $236.00 | — | 41% below | 20% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HYBRIDIZATION | $79.20 | $99.00 | — | — | 20% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C PCR CHARGE | $137.20 | $171.50 | — | — | 20% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C PCR QUANT 550080 | $188.80 | $236.00 | — | — | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV I-IGG CSF | $88.00 | $110.00 | — | 28% above | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV I-IGM CSF | $88.00 | $110.00 | — | 28% above | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 IGG 164897 | $93.60 | $117.00 | — | 37% above | 20% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV I-IGG CSF | $88.00 | $110.00 | — | — | 20% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV I-IGM CSF | $88.00 | $110.00 | — | — | 20% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE 1 IGG 164897 | $93.60 | $117.00 | — | — | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV II-IGM CSF | $88.00 | $110.00 | — | 3% above | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV II-IGG CSF | $88.00 | $110.00 | — | 3% above | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV2 IGG | $88.00 | $110.00 | — | 3% above | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 SPECIFIC AB IGG 164098 | $93.60 | $117.00 | — | 9% above | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 IGG 163033 | $93.60 | $117.00 | — | 9% above | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV II-IGM CSF | $88.00 | $110.00 | — | — | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV II-IGG CSF | $88.00 | $110.00 | — | — | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV2 IGG | $88.00 | $110.00 | — | — | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 IGG 163033 | $93.60 | $117.00 | — | — | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 SPECIFIC AB IGG 164098 | $93.60 | $117.00 | — | — | 20% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HS/ CARDIAC LABCORP 120766 | $55.60 | $69.50 | — | 17% below | 20% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HS/ CARDIAC LABCORP 120766 | $55.60 | $69.50 | — | — | 20% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE PLASMA 706994 | $97.20 | $121.50 | — | 32% below | 20% |
| Homocysteine blood test CPT 83090 HOMOCYATEINE | $178.00 | $222.50 | — | 25% above | 20% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE PLASMA 706994 | $97.20 | $121.50 | — | — | 20% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYATEINE | $178.00 | $222.50 | — | — | 20% |
| Insulin blood test CPT 83525 INSULIN POST-PRANDIAL 004333 | $22.40 | $28.00 | — | 71% below | 20% |
| Insulin blood test CPT 83525 INSULIN 004333 | $22.40 | $28.00 | — | 71% below | 20% |
| Insulin blood test CPT 83525 INSULIN TOTAL | $132.00 | $165.00 | — | 73% above | 20% |
| Insulin blood test inpatient CPT 83525 INSULIN 004333 | $22.40 | $28.00 | — | — | 20% |
| Insulin blood test inpatient CPT 83525 INSULIN POST-PRANDIAL 004333 | $22.40 | $28.00 | — | — | 20% |
| Insulin blood test inpatient CPT 83525 INSULIN TOTAL | $132.00 | $165.00 | — | — | 20% |
| Iron blood test (serum iron) CPT 83540 IRON | $33.20 | $41.50 | — | 58% below | 20% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON | $33.20 | $41.50 | — | — | 20% |
| Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON BINDING CAPACITY | $48.80 | $61.00 | — | 38% below | 20% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BINDING CAPACITY | $48.80 | $61.00 | — | — | 20% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $164.40 | $205.50 | — | 7% above | 20% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $164.40 | $205.50 | — | — | 20% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE 004283 | $98.80 | $123.50 | — | 27% below | 20% |
| LH (luteinizing hormone) test CPT 83002 LH PEDIATRIC 502286 | $98.80 | $123.50 | — | 27% below | 20% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE 004283 | $98.80 | $123.50 | — | — | 20% |
| LH (luteinizing hormone) test inpatient CPT 83002 LH PEDIATRIC 502286 | $98.80 | $123.50 | — | — | 20% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE BLOOD | $101.20 | $126.50 | — | 17% below | 20% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID BLOOD | $101.20 | $126.50 | — | 17% below | 20% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID (GEM) | $101.20 | $126.50 | — | 17% below | 20% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE BLOOD | $101.20 | $126.50 | — | — | 20% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID (GEM) | $101.20 | $126.50 | — | — | 20% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID BLOOD | $101.20 | $126.50 | — | — | 20% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 ASCITES FLUID LDH | $30.00 | $37.50 | — | 60% below | 20% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 BODY FLUID LDH | $30.00 | $37.50 | — | 60% below | 20% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 PLEURAL FLUID LDH | $30.00 | $37.50 | — | 60% below | 20% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE | $31.20 | $39.00 | — | 59% below | 20% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 PLEURAL FLUID LDH | $30.00 | $37.50 | — | — | 20% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 ASCITES FLUID LDH | $30.00 | $37.50 | — | — | 20% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 BODY FLUID LDH | $30.00 | $37.50 | — | — | 20% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE | $31.20 | $39.00 | — | — | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $53.20 | $66.50 | — | 47% below | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE, BODY FLUID 829034 | $53.20 | $66.50 | — | 47% below | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE-LABCORP 001404 | $53.20 | $66.50 | — | 47% below | 20% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE, BODY FLUID 829034 | $53.20 | $66.50 | — | — | 20% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $53.20 | $66.50 | — | — | 20% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE-LABCORP 001404 | $53.20 | $66.50 | — | — | 20% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANL LABCORP | $45.20 | $56.50 | — | 70% below | 20% |
| Liver function blood test panel CPT 80076 LIVER FUNCTION PANEL-LC | $45.20 | $56.50 | — | 70% below | 20% |
| Liver function blood test panel CPT 80076 LIVER FUNCTION PANEL | $45.20 | $56.50 | — | 70% below | 20% |
| Liver function blood test panel inpatient CPT 80076 LIVER FUNCTION PANEL | $45.20 | $56.50 | — | — | 20% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANL LABCORP | $45.20 | $56.50 | — | — | 20% |
| Liver function blood test panel inpatient CPT 80076 LIVER FUNCTION PANEL-LC | $45.20 | $56.50 | — | — | 20% |
| Lyme disease antibody test CPT 86618 LYME DISEASES TOTAL AB RFX TO IA 164226 | $86.40 | $108.00 | — | 25% below | 20% |
| Lyme disease antibody test CPT 86618 LYME DISEASE TOTAL AB RFX IA 164226 | $86.40 | $108.00 | — | 25% below | 20% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY IGM | $201.20 | $251.50 | — | 75% above | 20% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASES TOTAL AB RFX TO IA 164226 | $86.40 | $108.00 | — | — | 20% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE TOTAL AB RFX IA 164226 | $86.40 | $108.00 | — | — | 20% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY IGM | $201.20 | $251.50 | — | — | 20% |
| Magnesium blood test CPT 83735 MAGNESIUM | $34.80 | $43.50 | — | 54% below | 20% |
| Magnesium blood test CPT 83735 MAGNESIUM LABCORP 001537 | $34.80 | $43.50 | — | 54% below | 20% |
| Magnesium blood test CPT 83735 MAGNESIUM RBC 080283 | $84.00 | $105.00 | — | 10% above | 20% |
| Magnesium blood test CPT 83735 MAGNESIUM URINE | $86.40 | $108.00 | — | 14% above | 20% |
| Magnesium blood test CPT 83735 MAGNESIUM 24HR URINE 003400 | $86.40 | $108.00 | — | 14% above | 20% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM LABCORP 001537 | $34.80 | $43.50 | — | — | 20% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $34.80 | $43.50 | — | — | 20% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC 080283 | $84.00 | $105.00 | — | — | 20% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM 24HR URINE 003400 | $86.40 | $108.00 | — | — | 20% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE | $86.40 | $108.00 | — | — | 20% |
| Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) IGG ANTIBODY 096560 | $84.00 | $105.00 | — | 13% above | 20% |
| Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) IGM ANTIBODY 832493 | $84.00 | $105.00 | — | 13% above | 20% |
| Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) IGM ANTIBODY 160178 | $84.00 | $105.00 | — | 13% above | 20% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM ANTIBODY 160218 | $84.00 | $105.00 | — | 13% above | 20% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA) IGG ANTIBODY 096560 | $84.00 | $105.00 | — | — | 20% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA) IGM ANTIBODY 160178 | $84.00 | $105.00 | — | — | 20% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA) IGM ANTIBODY 832493 | $84.00 | $105.00 | — | — | 20% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGM ANTIBODY 160218 | $84.00 | $105.00 | — | — | 20% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONOTEST | $26.40 | $33.00 | — | 67% below | 20% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOTEST | $26.40 | $33.00 | — | — | 20% |
| Mumps immunity blood test CPT 86735 MUMPS VIRUS ANTIBOD IGG | $42.80 | $53.50 | — | 41% below | 20% |
| Mumps immunity blood test CPT 86735 MUMPS IGM 160499 | $66.80 | $83.50 | — | 8% below | 20% |
| Mumps immunity blood test CPT 86735 MUMPS IGG 096552 | $66.80 | $83.50 | — | 8% below | 20% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS ANTIBOD IGG | $42.80 | $53.50 | — | — | 20% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS IGM 160499 | $66.80 | $83.50 | — | — | 20% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS IGG 096552 | $66.80 | $83.50 | — | — | 20% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $504.80 | $631.00 | — | 56% above | 20% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL | $504.80 | $631.00 | — | — | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 .PSA FREE | $33.20 | $41.50 | — | 62% below | 20% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 .PSA FREE | $33.20 | $41.50 | — | — | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 .PSA TOTAL REF | $74.80 | $93.50 | — | 24% below | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL LABCORP 010322 | $79.60 | $99.50 | — | 19% below | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL RFLX TO FREE 480661 | $79.60 | $99.50 | — | 19% below | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ULTRASENSITIVE 140731 | $79.60 | $99.50 | — | 19% below | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 .PSA TOTAL REF | $74.80 | $93.50 | — | — | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL LABCORP 010322 | $79.60 | $99.50 | — | — | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA ULTRASENSITIVE 140731 | $79.60 | $99.50 | — | — | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL RFLX TO FREE 480661 | $79.60 | $99.50 | — | — | 20% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP RFX TO HR HPV ASC-U 199300 | $84.80 | $106.00 | — | 9% below | 20% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP RFX HPV ALL PATH 199345 | $84.80 | $106.00 | — | 9% below | 20% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP IG (IMAGE GUIDED) 193000 | $84.80 | $106.00 | — | 9% below | 20% |
| Pap test (liquid-based, automated screening with review) CPT 88175 .CHARGE PAP IG | $84.80 | $106.00 | — | 9% below | 20% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP RFX HPV ALL PATH 199345 | $84.80 | $106.00 | — | — | 20% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP RFX TO HR HPV ASC-U 199300 | $84.80 | $106.00 | — | — | 20% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 .CHARGE PAP IG | $84.80 | $106.00 | — | — | 20% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP IG (IMAGE GUIDED) 193000 | $84.80 | $106.00 | — | — | 20% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN PREP PAP | $83.20 | $104.00 | — | 12% above | 20% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN PREP PAP | $83.20 | $104.00 | — | — | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 C TERMINAL PTH INTACT | $87.20 | $109.00 | — | 55% below | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID MID MOLECULE | $143.60 | $179.50 | — | 26% below | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT | $210.00 | $262.50 | — | 8% above | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT 015610 | $210.00 | $262.50 | — | 8% above | 20% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 C TERMINAL PTH INTACT | $87.20 | $109.00 | — | — | 20% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID MID MOLECULE | $143.60 | $179.50 | — | — | 20% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT | $210.00 | $262.50 | — | — | 20% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT 015610 | $210.00 | $262.50 | — | — | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT, ACTIVATED 005207 | $16.00 | $20.00 | — | 78% below | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT (LAC) | $16.00 | $20.00 | — | 78% below | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME | $34.40 | $43.00 | — | 53% below | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT | $76.40 | $95.50 | — | 4% above | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT (LAC) | $16.00 | $20.00 | — | — | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT, ACTIVATED 005207 | $16.00 | $20.00 | — | — | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME | $34.40 | $43.00 | — | — | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT | $76.40 | $95.50 | — | — | 20% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS | $24.40 | $30.50 | — | 68% below | 20% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS | $24.40 | $30.50 | — | — | 20% |
| Potassium blood test CPT 84132 POTASSIUM | $24.00 | $30.00 | — | 58% below | 20% |
| Potassium blood test CPT 84132 RBC POTASSIUM | $49.20 | $61.50 | — | 15% below | 20% |
| Potassium blood test inpatient CPT 84132 POTASSIUM | $24.00 | $30.00 | — | — | 20% |
| Potassium blood test inpatient CPT 84132 RBC POTASSIUM | $49.20 | $61.50 | — | — | 20% |
| Progesterone blood test CPT 84144 PROGRESTERONE RAPID | $62.40 | $78.00 | — | 49% below | 20% |
| Progesterone blood test CPT 84144 PROGESTERONE 004317 | $101.20 | $126.50 | — | 18% below | 20% |
| Progesterone blood test CPT 84144 PROGESTERONE | $101.20 | $126.50 | — | 18% below | 20% |
| Progesterone blood test CPT 84144 PROGESTERONE FREE & TOTAL 503658 | $101.20 | $126.50 | — | 18% below | 20% |
| Progesterone blood test inpatient CPT 84144 PROGRESTERONE RAPID | $62.40 | $78.00 | — | — | 20% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE FREE & TOTAL 503658 | $101.20 | $126.50 | — | — | 20% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE 004317 | $101.20 | $126.50 | — | — | 20% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE | $101.20 | $126.50 | — | — | 20% |
| Prolactin blood test CPT 84146 MACROPROLACTIN 500324 | $105.20 | $131.50 | — | 30% below | 20% |
| Prolactin blood test CPT 84146 PROLACTIN SERUM 004465 | $105.20 | $131.50 | — | 30% below | 20% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN SERUM 004465 | $105.20 | $131.50 | — | — | 20% |
| Prolactin blood test inpatient CPT 84146 MACROPROLACTIN 500324 | $105.20 | $131.50 | — | — | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME+INR LABCORP 005199 | $34.40 | $43.00 | — | 34% below | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME+INR | $34.40 | $43.00 | — | 34% below | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME+INR LABCORP 005199 | $34.40 | $43.00 | — | — | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME+INR | $34.40 | $43.00 | — | — | 20% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 GROUP A STREPT SCREEN - RAPID | $59.60 | $74.50 | — | 10% below | 20% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 GROUP A STREPT SCREEN - RAPID | $59.60 | $74.50 | — | — | 20% |
| Renin blood test CPT 84244 RENIN ACTIVITY 002006 | $101.20 | $126.50 | — | 4% below | 20% |
| Renin blood test CPT 84244 PLASMA RENIN | $136.40 | $170.50 | — | 29% above | 20% |
| Renin blood test inpatient CPT 84244 RENIN ACTIVITY 002006 | $101.20 | $126.50 | — | — | 20% |
| Renin blood test inpatient CPT 84244 PLASMA RENIN | $136.40 | $170.50 | — | — | 20% |
| Rh blood typing CPT 86901 RH TYPING ONLY | $43.20 | $54.00 | — | 30% below | 20% |
| Rh blood typing CPT 86901 UBS RH TYPING | $43.20 | $54.00 | — | 30% below | 20% |
| Rh blood typing CPT 86901 RH RETYPE | $43.20 | $54.00 | — | 30% below | 20% |
| Rh blood typing inpatient CPT 86901 RH RETYPE | $43.20 | $54.00 | — | — | 20% |
| Rh blood typing inpatient CPT 86901 RH TYPING ONLY | $43.20 | $54.00 | — | — | 20% |
| Rh blood typing inpatient CPT 86901 UBS RH TYPING | $43.20 | $54.00 | — | — | 20% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID ARTHRITIS | $29.20 | $36.50 | — | 53% below | 20% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR 006502 | $54.00 | $67.50 | — | 13% below | 20% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QNT | $61.60 | $77.00 | — | at median | 20% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID ARTHRITIS | $29.20 | $36.50 | — | — | 20% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR 006502 | $54.00 | $67.50 | — | — | 20% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QNT | $61.60 | $77.00 | — | — | 20% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG ANTIBODY 006197 | $73.20 | $91.50 | — | at median | 20% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM 096537 | $78.00 | $97.50 | — | 7% above | 20% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG ANTIBODY 006197 | $73.20 | $91.50 | — | — | 20% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM 096537 | $78.00 | $97.50 | — | — | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR | $19.20 | $24.00 | — | 56% below | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR | $19.20 | $24.00 | — | — | 20% |
| Sodium blood test CPT 84295 SODIUM | $24.80 | $31.00 | — | 43% below | 20% |
| Sodium blood test inpatient CPT 84295 SODIUM | $24.80 | $31.00 | — | — | 20% |
| Stool ova and parasites exam CPT 87177 OVA + PARASITE, URINE 008629 | $51.20 | $64.00 | — | 60% below | 20% |
| Stool ova and parasites exam CPT 87177 OVA + PARASITE EXAM 008623 | $51.20 | $64.00 | — | 60% below | 20% |
| Stool ova and parasites exam inpatient CPT 87177 OVA + PARASITE EXAM 008623 | $51.20 | $64.00 | — | — | 20% |
| Stool ova and parasites exam inpatient CPT 87177 OVA + PARASITE, URINE 008629 | $51.20 | $64.00 | — | — | 20% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL 3 SAMPLES | $19.60 | $24.50 | — | 20% below | 20% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD STOOL 3 SAMPLES | $19.60 | $24.50 | — | — | 20% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL BLOOD IMMUNOASSAY 182949 | $64.80 | $81.00 | — | 4% below | 20% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL BLOOD IMMUNOASSAY 182949 | $64.80 | $81.00 | — | — | 20% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB CHARGE | $67.60 | $84.50 | — | 9% below | 20% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM ABS 082370 | $67.60 | $84.50 | — | 9% below | 20% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS AB SCREEN | $67.60 | $84.50 | — | 9% below | 20% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TPPA TREPONEMAL ABS 082339 | $73.20 | $91.50 | — | 1% below | 20% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 FTA ANTIBODIES 082370 | $73.20 | $91.50 | — | 1% below | 20% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 FTA ABS CSF 828472 | $78.00 | $97.50 | — | 5% above | 20% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS AB SCREEN | $67.60 | $84.50 | — | — | 20% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM AB CHARGE | $67.60 | $84.50 | — | — | 20% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM ABS 082370 | $67.60 | $84.50 | — | — | 20% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA ANTIBODIES 082370 | $73.20 | $91.50 | — | — | 20% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TPPA TREPONEMAL ABS 082339 | $73.20 | $91.50 | — | — | 20% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA ABS CSF 828472 | $78.00 | $97.50 | — | — | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-CSF | $40.80 | $51.00 | — | 15% below | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF 006445 | $42.40 | $53.00 | — | 11% below | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR REFLEX TPA/RPR QNT 012005 | $57.20 | $71.50 | — | 19% above | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL-CSF | $40.80 | $51.00 | — | — | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF 006445 | $42.40 | $53.00 | — | — | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR REFLEX TPA/RPR QNT 012005 | $57.20 | $71.50 | — | — | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD 182893 | $191.20 | $239.00 | — | 11% below | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD 182893 | $191.20 | $239.00 | — | — | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL 004226 | $132.00 | $165.00 | — | at median | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL LCMS 070001 | $132.00 | $165.00 | — | at median | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $132.00 | $165.00 | — | at median | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL 004226 | $132.00 | $165.00 | — | — | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL | $132.00 | $165.00 | — | — | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL LCMS 070001 | $132.00 | $165.00 | — | — | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB | $61.60 | $77.00 | — | 28% below | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI MICROSOMAL ANTIBODIES | $81.60 | $102.00 | — | 4% below | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOMAL AB 163980 | $86.80 | $108.50 | — | 2% above | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROX.(TPO) ABS 006676 | $123.20 | $154.00 | — | 45% above | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB | $61.60 | $77.00 | — | — | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI MICROSOMAL ANTIBODIES | $81.60 | $102.00 | — | — | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOMAL AB 163980 | $86.80 | $108.50 | — | — | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROX.(TPO) ABS 006676 | $123.20 | $154.00 | — | — | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE | $85.60 | $107.00 | — | 29% below | 20% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE | $85.60 | $107.00 | — | — | 20% |
| Total IgE blood test CPT 82785 IGE SERUM 002170 | $108.80 | $136.00 | — | 3% above | 20% |
| Total IgE blood test inpatient CPT 82785 IGE SERUM 002170 | $108.80 | $136.00 | — | — | 20% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL | $22.80 | $28.50 | — | 59% below | 20% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL | $22.80 | $28.50 | — | — | 20% |
| Total thyroxine (T4) blood test CPT 84436 THYROXINE T4 | $35.60 | $44.50 | — | 46% below | 20% |
| Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE T4 | $35.60 | $44.50 | — | — | 20% |
| Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3 002188 | $95.60 | $119.50 | — | 2% below | 20% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3 002188 | $95.60 | $119.50 | — | — | 20% |
| Transferrin blood test CPT 84466 TRANSFERRIN 004937 | $73.60 | $92.00 | — | 18% below | 20% |
| Transferrin blood test inpatient CPT 84466 TRANSFERRIN 004937 | $73.60 | $92.00 | — | — | 20% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS PCR | $61.20 | $76.50 | — | 5% below | 20% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS PATH | $126.80 | $158.50 | — | 96% above | 20% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAG PCR 188052 | $178.40 | $223.00 | — | 176% above | 20% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS PCR | $61.20 | $76.50 | — | — | 20% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS PATH | $126.80 | $158.50 | — | — | 20% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAG PCR 188052 | $178.40 | $223.00 | — | — | 20% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES | $74.00 | $92.50 | — | 13% above | 20% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES ASCITES FLUID 101170 | $74.00 | $92.50 | — | 13% above | 20% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES BODY FLUID 101170 | $74.00 | $92.50 | — | 13% above | 20% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES | $74.00 | $92.50 | — | — | 20% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES BODY FLUID 101170 | $74.00 | $92.50 | — | — | 20% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES ASCITES FLUID 101170 | $74.00 | $92.50 | — | — | 20% |
| Troponin test, quantitative CPT 84484 ACCESS TROPONIN I HIGH- SENSITIVITY | $161.60 | $202.00 | — | 21% above | 20% |
| Troponin test, quantitative CPT 84484 TROPONIN I HIGH- SENSITIVITY | $161.60 | $202.00 | — | 21% above | 20% |
| Troponin test, quantitative inpatient CPT 84484 ACCESS TROPONIN I HIGH- SENSITIVITY | $161.60 | $202.00 | — | — | 20% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN I HIGH- SENSITIVITY | $161.60 | $202.00 | — | — | 20% |
| Uric acid blood test CPT 84550 URIC ACID | $23.60 | $29.50 | — | 61% below | 20% |
| Uric acid blood test inpatient CPT 84550 URIC ACID | $23.60 | $29.50 | — | — | 20% |
| Urinalysis with microscope exam, automated CPT 81001 .CHARGE UA W/MICRO | $59.60 | $74.50 | — | 1% above | 20% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICROSCOPIC | $59.60 | $74.50 | — | 1% above | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICROSCOPIC | $59.60 | $74.50 | — | — | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 .CHARGE UA W/MICRO | $59.60 | $74.50 | — | — | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE BLOOD | $12.40 | $15.50 | — | 48% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE KETONE DIP | $12.40 | $15.50 | — | 48% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE PROTEIN DIP | $12.40 | $15.50 | — | 48% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE PH | $12.40 | $15.50 | — | 48% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE SPECIFIC GRAVITY | $12.40 | $15.50 | — | 48% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE GLUCOSE DIP | $12.40 | $15.50 | — | 48% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE BILIRUBIN DIP | $12.40 | $15.50 | — | 48% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 .CHARGE UA DIPSTICK ONLY | $32.80 | $41.00 | — | 38% above | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE GLUCOSE DIP | $12.40 | $15.50 | — | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE KETONE DIP | $12.40 | $15.50 | — | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE BLOOD | $12.40 | $15.50 | — | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE PROTEIN DIP | $12.40 | $15.50 | — | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE PH | $12.40 | $15.50 | — | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE SPECIFIC GRAVITY | $12.40 | $15.50 | — | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE BILIRUBIN DIP | $12.40 | $15.50 | — | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 .CHARGE UA DIPSTICK ONLY | $32.80 | $41.00 | — | — | 20% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE | $40.80 | $51.00 | — | 55% below | 20% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE | $40.80 | $51.00 | — | — | 20% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN 24HR URINE | $16.80 | $21.00 | — | 81% below | 20% |
| Urine microalbumin (albumin) test CPT 82043 MALB/CREA URINE RATIO 140285 | $80.40 | $100.50 | — | 8% below | 20% |
| Urine microalbumin (albumin) test CPT 82043 MICROALB/CREAT URINE RATIO | $80.40 | $100.50 | — | 8% below | 20% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN 24HR URINE | $16.80 | $21.00 | — | — | 20% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALB/CREAT URINE RATIO | $80.40 | $100.50 | — | — | 20% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MALB/CREA URINE RATIO 140285 | $80.40 | $100.50 | — | — | 20% |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY UR QUAL | $67.60 | $84.50 | — | 91% above | 20% |
| Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY UR QUAL | $67.60 | $84.50 | — | — | 20% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $81.20 | $101.50 | — | 28% below | 20% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 001503 | $81.20 | $101.50 | — | 28% below | 20% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 001503 | $81.20 | $101.50 | — | — | 20% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 | $81.20 | $101.50 | — | — | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-OH LOCI | $115.20 | $144.00 | — | 32% below | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-25 HYDROXY (D2+D3) FRAC 504115 | $115.20 | $144.00 | — | 32% below | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25 HYDROXY 081950 | $115.20 | $144.00 | — | 32% below | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D-25 HYDROXY (D2+D3) FRAC 504115 | $115.20 | $144.00 | — | — | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-OH LOCI | $115.20 | $144.00 | — | — | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25 HYDROXY 081950 | $115.20 | $144.00 | — | — | 20% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1 25-DIHYDROXY | $93.20 | $116.50 | — | 47% below | 20% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 CALCITRIOL VIT D 1,25 081091 | $217.60 | $272.00 | — | 24% above | 20% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 1 25-DIHYDROXY | $93.20 | $116.50 | — | — | 20% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 CALCITRIOL VIT D 1,25 081091 | $217.60 | $272.00 | — | — | 20% |
| Zinc blood test CPT 84630 ZINC PLASMA OR SERUM 001800 | $73.60 | $92.00 | — | 5% below | 20% |
| Zinc blood test CPT 84630 ZINC WB 070032 | $73.60 | $92.00 | — | 5% below | 20% |
| Zinc blood test CPT 84630 RBC ZINC 070029 | $125.60 | $157.00 | — | 62% above | 20% |
| Zinc blood test inpatient CPT 84630 ZINC WB 070032 | $73.60 | $92.00 | — | — | 20% |
| Zinc blood test inpatient CPT 84630 ZINC PLASMA OR SERUM 001800 | $73.60 | $92.00 | — | — | 20% |
| Zinc blood test inpatient CPT 84630 RBC ZINC 070029 | $125.60 | $157.00 | — | — | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 AFP HCG-QUANT | $35.20 | $44.00 | — | 76% below | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT | $66.40 | $83.00 | — | 54% below | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG INTACT QUANTITATIVE | $83.20 | $104.00 | — | 42% below | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 AFP HCG-QUANT | $35.20 | $44.00 | — | — | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT | $66.40 | $83.00 | — | — | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG INTACT QUANTITATIVE | $83.20 | $104.00 | — | — | 20% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs New Mexico | Off list |
|---|---|---|---|---|---|
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TX FIBULAR FX DISTAL LAT MAL | $490.00 | $612.50 | — | 42% below | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TX FIBULAR FX DISTAL LAT MAL | $490.00 | $612.50 | — | — | 20% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 FRACTURE METATARSAL | $292.40 | $365.50 | — | 4% below | 20% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 FRACTURE METATARSAL | $292.40 | $365.50 | — | — | 20% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL | $1,180.00 | $1,475.00 | — | at median | 20% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL | $1,180.00 | $1,475.00 | — | — | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TX RADIUS FX/EPIPHY SEP/ULNA | $630.80 | $788.50 | — | 48% above | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TX RADIUS FX/EPIPHY SEP/ULNA | $630.80 | $788.50 | — | — | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALIG LESION 1ST | $128.80 | $161.00 | — | at median | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION OF FACE LESION | $146.80 | $183.50 | — | 14% above | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT PREMALIG LESION 1ST | $128.80 | $161.00 | — | — | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION OF FACE LESION | $146.80 | $183.50 | — | — | 20% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN IRRIG | $141.20 | $176.50 | — | 6% above | 20% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVAL IMPACTED CERUMEN IRRIG | $141.20 | $176.50 | — | — | 20% |
| Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN | $116.00 | $145.00 | — | 22% below | 20% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN | $116.00 | $145.00 | — | — | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 IR SPINE C-T EPID/LAMINAL INJ INCL GUIDE | $1,243.60 | $1,554.50 | — | 49% above | 20% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 IR SPINE C-T EPID/LAMINAL INJ INCL GUIDE | $1,243.60 | $1,554.50 | — | — | 20% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 IR SPINE L-S FACET INJ PARAVER 1ST LVL I | $1,137.20 | $1,421.50 | — | at median | 20% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 IR SPINE L-S FACET INJ PARAVER 1ST LVL I | $1,137.20 | $1,421.50 | — | — | 20% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY | $319.20 | $399.00 | — | 67% below | 20% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY | $319.20 | $399.00 | — | — | 20% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOIDS | $291.20 | $364.00 | — | 65% below | 20% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 LIGATION OF HEMORRHOIDS | $291.20 | $364.00 | — | — | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS, SINGLE/SIMPLE | $209.20 | $261.50 | — | 44% below | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE | $368.40 | $460.50 | — | 2% below | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION SOFT TISS ABSCESS | $368.40 | $460.50 | — | 2% below | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS, SINGLE/SIMPLE | $209.20 | $261.50 | — | — | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION SOFT TISS ABSCESS | $368.40 | $460.50 | — | — | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE/SINGLE | $368.40 | $460.50 | — | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION TEND SHEATH | $211.20 | $264.00 | — | 54% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION TEND SHEATH | $211.20 | $264.00 | — | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JNT/BURSA | $581.20 | $726.50 | — | 36% above | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJ MAJOR JOINT | $581.20 | $726.50 | — | 36% above | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 IR ASP/INJ MJR JNT/BURSA LT W/O US GUIDE | $599.60 | $749.50 | — | 40% above | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 IR ASP/INJ MJR JNT/BURSA RT W/O US GUIDE | $599.60 | $749.50 | — | 40% above | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR JNT/BURSA | $581.20 | $726.50 | — | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/INJ MAJOR JOINT | $581.20 | $726.50 | — | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 IR ASP/INJ MJR JNT/BURSA LT W/O US GUIDE | $599.60 | $749.50 | — | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 IR ASP/INJ MJR JNT/BURSA RT W/O US GUIDE | $599.60 | $749.50 | — | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ JOINT/BURSA W/O US | $544.80 | $681.00 | — | 50% above | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 IR ASP/INJ INT JNT/BURSA RT W/O US GUIDA | $599.60 | $749.50 | — | 65% above | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 IR ASP/INJ INT JNT/BURSA LT W/O US GUI | $599.60 | $749.50 | — | 65% above | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ JOINT/BURSA W/O US | $544.80 | $681.00 | — | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 IR ASP/INJ INT JNT/BURSA RT W/O US GUIDA | $599.60 | $749.50 | — | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 IR ASP/INJ INT JNT/BURSA LT W/O US GUI | $599.60 | $749.50 | — | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 IR ASP/INJ SM JNT/BURSA RT W/O US GUIDE | $566.00 | $707.50 | — | 50% above | 20% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 IR ASP/INJ SM JNT/BURSA LT W/O US GUIDE | $566.00 | $707.50 | — | 50% above | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 IR ASP/INJ SM JNT/BURSA RT W/O US GUIDE | $566.00 | $707.50 | — | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 IR ASP/INJ SM JNT/BURSA LT W/O US GUIDE | $566.00 | $707.50 | — | — | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INT REP 2 LAYER 2.5CM OR LESS | $384.40 | $480.50 | — | 38% below | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INT REP 2 LAYER 2.5CM OR LESS | $384.40 | $480.50 | — | — | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR SPINE L-S EPID/LAMINAL INJ INCL GUIDE | $1,243.60 | $1,554.50 | — | 22% below | 20% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR SPINE L-S EPID/LAMINAL INJ INCL GUIDE | $1,243.60 | $1,554.50 | — | — | 20% |
| Lower-back epidural injection, without imaging guidance CPT 62322 EPIDURAL OR SUBARACHNOID INJ | $521.60 | $652.00 | — | 53% below | 20% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 EPIDURAL OR SUBARACHNOID INJ | $521.60 | $652.00 | — | — | 20% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 IR SPINE L-S EPID INJ TRANSFOR 1ST LVL I | $1,566.00 | $1,957.50 | — | at median | 20% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 IR SPINE L-S EPID INJ TRANSFOR 1ST LVL I | $1,566.00 | $1,957.50 | — | — | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 REMOVAL SKIN LESION 0.5CM OR< | $194.80 | $243.50 | — | 72% below | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BENIGN LESION (T,A&1) | $647.20 | $809.00 | — | 7% below | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 REMOVAL SKIN LESION 0.5CM OR< | $194.80 | $243.50 | — | — | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BENIGN LESION (T,A&1) | $647.20 | $809.00 | — | — | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REMOVAL SKIN LESION 0.5CM OR< | $245.60 | $307.00 | — | 66% below | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BEN LES (F,E,E,N&L)<.5CM | $647.20 | $809.00 | — | 11% below | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 REMOVAL SKIN LESION 0.5CM OR< | $245.60 | $307.00 | — | — | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BEN LES (F,E,E,N&L)<.5CM | $647.20 | $809.00 | — | — | 20% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SINGLE | $216.40 | $270.50 | — | 41% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE | $409.60 | $512.00 | — | 12% above | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SINGLE | $216.40 | $270.50 | — | — | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE | $409.60 | $512.00 | — | — | 20% |
| Occipital nerve block (injection for headaches) CPT 64405 NERVE BLOCK OCCIPITAL | $996.00 | $1,245.00 | — | 149% above | 20% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 NERVE BLOCK OCCIPITAL | $996.00 | $1,245.00 | — | — | 20% |
| Paracentesis with imaging guidance CPT 49083 PARACENTESIS ABD W/ IMAGING | $1,249.60 | $1,562.00 | — | at median | 20% |
| Paracentesis with imaging guidance CPT 49083 IR PARACENTESIS INCL GUIDANCE | $1,249.60 | $1,562.00 | — | at median | 20% |
| Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS ABD W/ IMAGING | $1,249.60 | $1,562.00 | — | — | 20% |
| Paracentesis with imaging guidance inpatient CPT 49083 IR PARACENTESIS INCL GUIDANCE | $1,249.60 | $1,562.00 | — | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVE INGROWN TOENAIL PERM | $316.40 | $395.50 | — | 31% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED PART | $525.20 | $656.50 | — | 15% above | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVE INGROWN TOENAIL PERM | $316.40 | $395.50 | — | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED PART | $525.20 | $656.50 | — | — | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISE RMVL FB SQ TISS SIMPLE | $228.40 | $285.50 | — | 61% below | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 I&D FOREIGN BODY SQ SIMPLE | $404.00 | $505.00 | — | 32% below | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISE RMVL FB SQ TISS SIMPLE | $228.40 | $285.50 | — | — | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 I&D FOREIGN BODY SQ SIMPLE | $404.00 | $505.00 | — | — | 20% |
| Short arm splint (forearm and hand) CPT 29125 SPLINT SHORT ARM | $202.40 | $253.00 | — | 23% below | 20% |
| Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT SHORT ARM | $202.40 | $253.00 | — | — | 20% |
| Short leg splint (calf to foot) CPT 29515 SPLINT SHORT LEG | $209.20 | $261.50 | — | 26% below | 20% |
| Short leg splint (calf to foot) inpatient CPT 29515 SPLINT SHORT LEG | $209.20 | $261.50 | — | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR 2.5 CM OR LESS | $303.60 | $379.50 | — | 16% below | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR 2.5 CM OR LESS | $303.60 | $379.50 | — | — | 20% |
| Skin biopsy, punch, one lesion CPT 11104 BIOPSY SKIN PUNCH 1ST SINGLE LESION | $352.80 | $441.00 | — | 27% below | 20% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SIGLE LESION | $847.20 | $1,059.00 | — | 76% above | 20% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 BIOPSY SKIN PUNCH 1ST SINGLE LESION | $352.80 | $441.00 | — | — | 20% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SIGLE LESION | $847.20 | $1,059.00 | — | — | 20% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC MAL LES TRUNK/ARM/LEG =<.5CM DIAM | $1,016.80 | $1,271.00 | — | 34% above | 20% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC MAL LESION (T,A&L)<.5CM | $1,210.00 | $1,512.50 | — | 60% above | 20% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC MAL LES TRUNK/ARM/LEG =<.5CM DIAM | $1,016.80 | $1,271.00 | — | — | 20% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC MAL LESION (T,A&L)<.5CM | $1,210.00 | $1,512.50 | — | — | 20% |
| Skin tag removal, up to 15 tags CPT 11200 SKIN TAG REMOVAL <=15 LESIONS | $128.80 | $161.00 | — | 66% below | 20% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS UP | $250.00 | $312.50 | — | 34% below | 20% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 SKIN TAG REMOVAL <=15 LESIONS | $128.80 | $161.00 | — | — | 20% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS UP | $250.00 | $312.50 | — | — | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR TAP | $754.00 | $942.50 | — | 12% below | 20% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR TAP | $754.00 | $942.50 | — | — | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR 2.6-7.C CM | $354.00 | $442.50 | — | 11% below | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR 2.6-7.C CM | $354.00 | $442.50 | — | — | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR FACE 0-2.5 CM | $334.40 | $418.00 | — | 2% below | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR FACE 0-2.5 CM | $334.40 | $418.00 | — | — | 20% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY SKIN TANGENTIAL 1ST SINGLE LESION | $82.80 | $103.50 | — | 88% below | 20% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY SKIN LESION | $478.40 | $598.00 | — | 31% below | 20% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 BIOPSY SKIN TANGENTIAL 1ST SINGLE LESION | $82.80 | $103.50 | — | — | 20% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 BIOPSY SKIN LESION | $478.40 | $598.00 | — | — | 20% |
| Thoracentesis with imaging guidance CPT 32555 IR US THORACENTESIS INCL GUIDANCE | $1,117.60 | $1,397.00 | — | 9% below | 20% |
| Thoracentesis with imaging guidance CPT 32555 IR CT THORACENTESIS INCL GUIDANCE | $1,117.60 | $1,397.00 | — | 9% below | 20% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS | $1,346.40 | $1,683.00 | — | 10% above | 20% |
| Thoracentesis with imaging guidance inpatient CPT 32555 IR CT THORACENTESIS INCL GUIDANCE | $1,117.60 | $1,397.00 | — | — | 20% |
| Thoracentesis with imaging guidance inpatient CPT 32555 IR US THORACENTESIS INCL GUIDANCE | $1,117.60 | $1,397.00 | — | — | 20% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS | $1,346.40 | $1,683.00 | — | — | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ 1-2 MUSCLES | $355.60 | $444.50 | — | 39% below | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 IR INJ TRIGGER POINT 1-2 MUSCLES | $628.40 | $785.50 | — | 8% above | 20% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ 1-2 MUSCLES | $355.60 | $444.50 | — | — | 20% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 IR INJ TRIGGER POINT 1-2 MUSCLES | $628.40 | $785.50 | — | — | 20% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 IR US BREAST BIOPSY/NDL LOC CLIP 1ST INC | $2,020.80 | $2,526.00 | — | 14% below | 20% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 IR US BREAST BIOPSY/NDL LOC CLIP 1ST INC | $2,020.80 | $2,526.00 | — | — | 20% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF WARTS UP | $132.80 | $166.00 | — | 38% below | 20% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT LESIONS <= 14 LESIONS | $179.60 | $224.50 | — | 16% below | 20% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION OF WARTS UP | $132.80 | $166.00 | — | — | 20% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT LESIONS <= 14 LESIONS | $179.60 | $224.50 | — | — | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SUBCUTANEOUS TISSUE 1ST 20 SQ CM | $628.00 | $785.00 | — | 46% below | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT AUBQ TIS 1ST 20SQCM< | $959.20 | $1,199.00 | — | 17% below | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SUBCUTANEOUS TISSUE 1ST 20 SQ CM | $628.00 | $785.00 | — | — | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DBRDMT AUBQ TIS 1ST 20SQCM< | $959.20 | $1,199.00 | — | — | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs New Mexico | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION | $637.20 | $796.50 | — | 7% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION OR COMPONENTS - IFC | $673.20 | $841.50 | — | 2% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION - OBS | $673.20 | $841.50 | — | 2% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION - LD | $772.00 | $965.00 | — | 12% above | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION - MS | $772.00 | $965.00 | — | 12% above | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION - ICU | $772.00 | $965.00 | — | 12% above | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION - OR | $834.40 | $1,043.00 | — | 21% above | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION OR COMPONENTS X2 | $1,009.80 | $1,262.25 | — | 47% above | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION OR COMPONENTS X3 | $1,178.00 | $1,472.50 | — | 71% above | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION OR COMPONENTS X4 | $1,346.40 | $1,683.00 | — | 96% above | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION | $637.20 | $796.50 | — | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION - OBS | $673.20 | $841.50 | — | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION OR COMPONENTS - IFC | $673.20 | $841.50 | — | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION - LD | $772.00 | $965.00 | — | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION - ICU | $772.00 | $965.00 | — | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION - MS | $772.00 | $965.00 | — | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION - OR | $834.40 | $1,043.00 | — | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION OR COMPONENTS X2 | $1,009.80 | $1,262.25 | — | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION OR COMPONENTS X3 | $1,178.00 | $1,472.50 | — | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION OR COMPONENTS X4 | $1,346.40 | $1,683.00 | — | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 CP EZ PAP (IPPB) INITIAL TX | $86.40 | $108.00 | — | 28% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ER NEB TX (INITIAL) | $89.60 | $112.00 | — | 26% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 CP SPUTUM INDUCTION | $90.40 | $113.00 | — | 25% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 CP MED NEB TX (INITIAL) | $229.60 | $287.00 | — | 90% above | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 CP EZ PAP (IPPB) INITIAL TX | $86.40 | $108.00 | — | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ER NEB TX (INITIAL) | $89.60 | $112.00 | — | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 CP SPUTUM INDUCTION | $90.40 | $113.00 | — | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 CP MED NEB TX (INITIAL) | $229.60 | $287.00 | — | — | 20% |
| Chemotherapy IV infusion, first hour CPT 96413 INITIAL CHEMO INFUSION 1ST HR | $534.80 | $668.50 | — | 3% above | 20% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 INITIAL CHEMO INFUSION 1ST HR | $534.80 | $668.50 | — | — | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 1ST 30-74 MIN | $2,341.60 | $2,927.00 | — | 11% above | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 1ST 30-74 MIN | $2,341.60 | $2,927.00 | — | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ER EKG 12 LEAD | $133.60 | $167.00 | — | 26% below | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG | $184.80 | $231.00 | — | 2% above | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ER EKG 12 LEAD | $133.60 | $167.00 | — | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG | $184.80 | $231.00 | — | — | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL I | $180.40 | $225.50 | — | 10% below | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER LEVEL I | $180.40 | $225.50 | — | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL II | $293.20 | $366.50 | — | at median | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL II | $293.20 | $366.50 | — | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL III | $518.40 | $648.00 | — | 3% below | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER LEVEL III | $518.40 | $648.00 | — | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL IV | $923.20 | $1,154.00 | — | 8% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER LEVEL IV | $923.20 | $1,154.00 | — | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL V | $1,598.40 | $1,998.00 | — | 12% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER LEVEL V | $1,598.40 | $1,998.00 | — | — | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC NM STRESS PHARM | $879.20 | $1,099.00 | — | 62% above | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC NM STRESS TREADMILL | $879.20 | $1,099.00 | — | 62% above | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TREADMILL | $879.20 | $1,099.00 | — | 62% above | 20% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC NM STRESS PHARM | $879.20 | $1,099.00 | — | — | 20% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TREADMILL | $879.20 | $1,099.00 | — | — | 20% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC NM STRESS TREADMILL | $879.20 | $1,099.00 | — | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL 1ST HR | $193.60 | $242.00 | — | 43% below | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL 31 MIN TO 1 HR | $193.60 | $242.00 | — | 43% below | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL (1ST HR) | $193.60 | $242.00 | — | 43% below | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL (1ST HR) | $193.60 | $242.00 | — | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL 1ST HR | $193.60 | $242.00 | — | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL 31 MIN TO 1 HR | $193.60 | $242.00 | — | — | 20% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION INITIAL (UPTO1HR) | $232.00 | $290.00 | — | 46% below | 20% |
| IV infusion of a medicine, first hour CPT 96365 INITIAL INFUSION UP TO 1 HR | $330.80 | $413.50 | — | 23% below | 20% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION INITIAL 1ST HR | $379.60 | $474.50 | — | 11% below | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION INITIAL (UPTO1HR) | $232.00 | $290.00 | — | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INITIAL INFUSION UP TO 1 HR | $330.80 | $413.50 | — | — | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION INITIAL 1ST HR | $379.60 | $474.50 | — | — | 20% |
| IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL OR INFUSION<16 | $74.00 | $92.50 | — | 60% below | 20% |
| IV push of a medicine, first drug CPT 96374 IV PUSH THER/PROPH/DX INJ | $84.40 | $105.50 | — | 54% below | 20% |
| IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL | $101.60 | $127.00 | — | 45% below | 20% |
| IV push of a medicine, first drug inpatient CPT 96374 IV PUSH INITIAL OR INFUSION<16 | $74.00 | $92.50 | — | — | 20% |
| IV push of a medicine, first drug inpatient CPT 96374 IV PUSH THER/PROPH/DX INJ | $84.40 | $105.50 | — | — | 20% |
| IV push of a medicine, first drug inpatient CPT 96374 IV PUSH INITIAL | $101.60 | $127.00 | — | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJ THERAPUTIC MED | $58.40 | $73.00 | — | 49% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM/SQ THERAPEUTIC | $68.00 | $85.00 | — | 40% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM OR SQ EACH | $74.00 | $92.50 | — | 35% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM/SQ | $101.60 | $127.00 | — | 11% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJ THERAPUTIC MED | $58.40 | $73.00 | — | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM/SQ THERAPEUTIC | $68.00 | $85.00 | — | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM OR SQ EACH | $74.00 | $92.50 | — | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM/SQ | $101.60 | $127.00 | — | — | 20% |
| Occupational therapy evaluation, low complexity CPT 97165 z PT EVAL LOW COMPLEX EVAL | $193.20 | $241.50 | — | 17% below | 20% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 z PT EVAL LOW COMPLEX EVAL | $193.20 | $241.50 | — | — | 20% |
| Spirometry (breathing test) CPT 94010 CP PFT PULMONARY FUNCTION TEST | $156.00 | $195.00 | — | 12% below | 20% |
| Spirometry (breathing test) CPT 94010 PEAK FLOW | $191.20 | $239.00 | — | 7% above | 20% |
| Spirometry (breathing test) inpatient CPT 94010 CP PFT PULMONARY FUNCTION TEST | $156.00 | $195.00 | — | — | 20% |
| Spirometry (breathing test) inpatient CPT 94010 PEAK FLOW | $191.20 | $239.00 | — | — | 20% |
| Spirometry before and after a bronchodilator CPT 94060 CP PFT PRE/POST BRONCHODILATOR | $306.80 | $383.50 | — | 19% below | 20% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 CP PFT PRE/POST BRONCHODILATOR | $306.80 | $383.50 | — | — | 20% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY | $100.80 | $126.00 | — | 44% below | 20% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC | $230.40 | $288.00 | — | 27% above | 20% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY | $100.80 | $126.00 | — | — | 20% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC | $230.40 | $288.00 | — | — | 20% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs New Mexico | Off list |
|---|---|---|---|---|---|
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Flu Vaccine 0.5 ML 2017-18: PREFIL.SYR | $52.80 | $66.00 | — | 15% above | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Flu Vaccine 0.5 ML 2017-18: PREFIL.SYR | $52.80 | $66.00 | — | — | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vacc Adult 20 MCG/ML INJ | $140.23 | $175.29 | — | 50% above | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vacc Adult 20 MCG/ML INJ | $140.23 | $175.29 | — | — | 20% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B Vacc Ped 5 MCG/0.5 ML INJ | $35.26 | $44.08 | — | 44% below | 20% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B Vacc Ped 10MCG/0.5ML:Engerx | $148.26 | $185.32 | — | 135% above | 20% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepatitis B Vacc Ped 5 MCG/0.5 ML INJ | $35.26 | $44.08 | — | — | 20% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepatitis B Vacc Ped 10MCG/0.5ML:Engerx | $148.26 | $185.32 | — | — | 20% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles,Mumps&Rubella Vaccine 0.5 ML | $169.73 | $212.16 | — | 41% above | 20% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Measles,Mumps&Rubella Vaccine 0.5 ML | $169.73 | $212.16 | — | — | 20% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumococcal Vac 13 (Prevnar) 0.5 ML Syr | $346.90 | $433.62 | — | 10% above | 20% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Pneumococcal Vac 13 (Prevnar) 0.5 ML Syr | $346.90 | $433.62 | — | — | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PneumoConjugateVac 20VAL 0.5 ML INJ | $364.24 | $455.30 | — | 13% below | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PneumoConjugateVac 20VAL 0.5 ML INJ | $364.24 | $455.30 | — | — | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23 0.5 ML SDV.INJ | $177.61 | $222.01 | — | 5% above | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumovax 23 0.5 ML SDV.INJ | $177.61 | $222.01 | — | — | 20% |
| Rabies vaccine, one dose CPT 90675 Rabies Vaccine PF 2.5 UNIT SDV.INJ | $342.58 | $428.22 | — | 17% below | 20% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine PF 2.5 UNIT SDV.INJ | $342.58 | $428.22 | — | — | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus & Dipth (Td) 0.5 ML PREFIL.SYR | $59.47 | $74.34 | — | at median | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus & Dipth (Td) 0.5 ML PREFIL.SYR | $59.47 | $74.34 | — | — | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Diph,Pertuss(Acell),Tet(Tdap) 0.5 ML | $103.14 | $128.92 | — | 26% above | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Diph,Pertuss(Acell),Tet(Tdap) 0.5 ML | $103.14 | $128.92 | — | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE | $54.00 | $67.50 | — | 16% above | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJECTION 1 VACCINE | $54.00 | $67.50 | — | 16% above | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMINISTRATION | $54.80 | $68.50 | — | 18% above | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJECTION 1 VACCINE | $54.00 | $67.50 | — | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE | $54.00 | $67.50 | — | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMINISTRATION | $54.80 | $68.50 | — | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINE IM/SQ (EA ADDL) | $27.60 | $34.50 | — | 11% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJ ADDL VACCINE | $51.60 | $64.50 | — | 107% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINE IM/SQ (EA ADDL) | $27.60 | $34.50 | — | — | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJ ADDL VACCINE | $51.60 | $64.50 | — | — | 20% |
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://hospitalpricedisclosure.com/Download.aspx?pxi=azz4F7h*__*O0Qk*_**_*hg3MJzKw*-*