Mercy Hospital Waldron
Mercy Hospital Waldron in Mansfield, AR publishes cash prices for 61 common procedures listed here, from its own machine-readable price file updated Jun 12, 2026. Click a procedure to compare it with other hospitals nearby.
100 N Walnut Street Mansfield Arkansas Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen & Pelvis W/Contrast Material | $577.50 | $770.00 | 25% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen & Pelvis W/Contrast Material | $577.50 | $770.00 | 25% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head/Brain W/O Contrast Material | $238.50 | $318.00 | 25% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head/Brain W/O Contrast Material | $238.50 | $318.00 | 25% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W/Contrast Material | $381.75 | $509.00 | 25% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W/Contrast Material | $381.75 | $509.00 | 25% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Diagnostic Mammography Computer-Aided Detcj Bi | $268.50 | $358.00 | 25% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Diagnostic Mammography Computer-Aided Detcj Bi | $268.50 | $358.00 | 25% |
| Diagnostic mammogram, one breast CPT 77065 Diagnostic Mammography Computer-Aided Detcj Uni | $202.50 | $270.00 | 25% |
| Diagnostic mammogram, one breast inpatient CPT 77065 Diagnostic Mammography Computer-Aided Detcj Uni | $202.50 | $270.00 | 25% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Any Jt Lower Extrem W/O Contrast Matrl | $483.75 | $645.00 | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Any Jt Lower Extrem W/O Contrast Matrl | $483.75 | $645.00 | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Any Jt Lower Extrem W/O & W/Contrast Matrl | $823.50 | $1,098.00 | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Any Jt Lower Extrem W/O & W/Contrast Matrl | $823.50 | $1,098.00 | 25% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain Brain Stem W/O Contrast Material | $552.00 | $736.00 | 25% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain Brain Stem W/O Contrast Material | $552.00 | $736.00 | 25% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain Brain Stem W/O W/Contrast Material | $876.00 | $1,168.00 | 25% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain Brain Stem W/O W/Contrast Material | $876.00 | $1,168.00 | 25% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spinal Canal Lumbar W/O Contrast Material | $390.75 | $521.00 | 25% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spinal Canal Lumbar W/O Contrast Material | $390.75 | $521.00 | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Uterus After 1st Trimest 1/1st Gestation | $234.00 | $312.00 | 25% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Uterus After 1st Trimest 1/1st Gestation | $234.00 | $312.00 | 25% |
| Screening mammogram, both breasts both sides CPT 77067 Screening Mammography Bi 2-View Breast Inc Cad | $204.75 | $273.00 | 25% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 Screening Mammography Bi 2-View Breast Inc Cad | $204.75 | $273.00 | 25% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysom 6/>Yrs Sleep 4/> Addl Param Attnd | $1,273.50 | $1,698.00 | 25% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysom 6/>Yrs Sleep 4/> Addl Param Attnd | $1,273.50 | $1,698.00 | 25% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal | $192.00 | $256.00 | 25% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal | $192.00 | $256.00 | 25% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdominal Real Time W/Image Documentation | $208.50 | $278.00 | 25% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdominal Real Time W/Image Documentation | $208.50 | $278.00 | 25% |
| X-ray of the lower back, 4 or more views CPT 72110 Radex Spine Lumbosacral Minimum 4 Views | $87.75 | $117.00 | 25% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Radex Spine Lumbosacral Minimum 4 Views | $87.75 | $117.00 | 25% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel Calcium Total | $25.50 | $34.00 | 25% |
| Basic metabolic panel (blood test) CPT 80048 POC Bmp W Calcium Total | $25.50 | $34.00 | 25% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Pnl Calcium Total | $25.50 | $34.00 | 25% |
| Basic metabolic panel (blood test) inpatient CPT 80048 POC Bmp W Calcium Total | $25.50 | $34.00 | 25% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel Calcium Total | $25.50 | $34.00 | 25% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Pnl Calcium Total | $25.50 | $34.00 | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $40.50 | $54.00 | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 POC Lipid Panel | $40.50 | $54.00 | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Tfh So Lipid Panel | $40.50 | $54.00 | 25% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 POC Lipid Panel | $40.50 | $54.00 | 25% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $40.50 | $54.00 | 25% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Tfh So Lipid Panel | $40.50 | $54.00 | 25% |
| Complete blood count (CBC) with differential CPT 85025 Blood Count Complete Auto&Auto Difrntl Wbc | $23.25 | $31.00 | 25% |
| Complete blood count (CBC) with differential CPT 85025 POC Cbc W Auto Diff | $23.25 | $31.00 | 25% |
| Complete blood count (CBC) with differential CPT 85025 Cbc W Auto Diff | $23.25 | $31.00 | 25% |
| Complete blood count (CBC) with differential inpatient CPT 85025 POC Cbc W Auto Diff | $23.25 | $31.00 | 25% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Blood Count Complete Auto&Auto Difrntl Wbc | $23.25 | $31.00 | 25% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Cbc W Auto Diff | $23.25 | $31.00 | 25% |
| Complete blood count (CBC), no differential CPT 85027 Cbc Automated WO Diff | $19.50 | $26.00 | 25% |
| Complete blood count (CBC), no differential CPT 85027 Blood Count Complete Automated | $19.50 | $26.00 | 25% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Blood Count Complete Automated | $19.50 | $26.00 | 25% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Cbc Automated WO Diff | $19.50 | $26.00 | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 POC Comprehensive Metabolic Panel | $57.75 | $77.00 | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $57.75 | $77.00 | 25% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 POC Comprehensive Metabolic Panel | $57.75 | $77.00 | 25% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $57.75 | $77.00 | 25% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $26.25 | $35.00 | 25% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $26.25 | $35.00 | 25% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $24.75 | $33.00 | 25% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $24.75 | $33.00 | 25% |
| Obstetric blood test panel CPT 80055 Obstetric Panel | $85.50 | $114.00 | 25% |
| Obstetric blood test panel inpatient CPT 80055 Obstetric Panel | $85.50 | $114.00 | 25% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Psa Free | $51.75 | $69.00 | 25% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Assay of Prostate Specific Antigen Free | $51.75 | $69.00 | 25% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Psa Free | $51.75 | $69.00 | 25% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Assay of Prostate Specific Antigen Free | $51.75 | $69.00 | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Assay of Prostate Specific Antigen Total | $55.50 | $74.00 | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 POC Psa Total Diagnostic | $55.50 | $74.00 | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Total Diagnostic | $55.50 | $74.00 | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Ultrasensitive | $55.50 | $74.00 | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Assay of Prostate Specific Antigen Total | $55.50 | $74.00 | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 POC Psa Total Diagnostic | $55.50 | $74.00 | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Ultrasensitive | $55.50 | $74.00 | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Total Diagnostic | $55.50 | $74.00 | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Mixing | $18.75 | $25.00 | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin Time Partial Plasma/Whole Blood | $18.75 | $25.00 | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Tfh So Ptt Partial Thromboplastin Time | $18.75 | $25.00 | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Partial Thromboplastin Time | $18.75 | $25.00 | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Tfh So Ptt Partial Thromboplastin Time | $18.75 | $25.00 | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin Time Partial Plasma/Whole Blood | $18.75 | $25.00 | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt Mixing | $18.75 | $25.00 | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt Partial Thromboplastin Time | $18.75 | $25.00 | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time Mixing Test | $13.50 | $18.00 | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $13.50 | $18.00 | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 POC Prothrombin Time | $13.50 | $18.00 | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POC Prothrombin Time | $13.50 | $18.00 | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time Mixing Test | $13.50 | $18.00 | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $13.50 | $18.00 | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Ultrasensitive Tsh | $51.00 | $68.00 | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Assay of Thyroid Stimulating Hormone Tsh | $51.00 | $68.00 | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh Newborn | $51.00 | $68.00 | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh Thyroid Stimulating Hormone | $51.00 | $68.00 | 25% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Tsh Thyroid Stimulating Hormone | $51.00 | $68.00 | 25% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Ultrasensitive Tsh | $51.00 | $68.00 | 25% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Assay of Thyroid Stimulating Hormone Tsh | $51.00 | $68.00 | 25% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Tsh Newborn | $51.00 | $68.00 | 25% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Automated W Micro | $9.75 | $13.00 | 25% |
| Urinalysis with microscope exam, automated CPT 81001 POC Urinalysis Automated W Micro | $9.75 | $13.00 | 25% |
| Urinalysis with microscope exam, automated CPT 81001 Urnls Dip Stick/Tablet Reagent Auto Microscopy | $9.75 | $13.00 | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urnls Dip Stick/Tablet Reagent Auto Microscopy | $9.75 | $13.00 | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Automated W Micro | $9.75 | $13.00 | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 POC Urinalysis Automated W Micro | $9.75 | $13.00 | 25% |
| Urinalysis with microscope exam, manual CPT 81000 Urinls Dip Stick/Tablet Reagnt Non-Auto Micrscpy | $12.75 | $17.00 | 25% |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis Non Automated W Micro | $12.75 | $17.00 | 25% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Urinls Dip Stick/Tablet Reagnt Non-Auto Micrscpy | $12.75 | $17.00 | 25% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis Non Automated W Micro | $12.75 | $17.00 | 25% |
| Urinalysis without microscope exam, automated CPT 81003 Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy | $9.75 | $13.00 | 25% |
| Urinalysis without microscope exam, automated CPT 81003 POC Urinalysis Automated W/O Micro | $9.75 | $13.00 | 25% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Ph Automated | $9.75 | $13.00 | 25% |
| Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine Automated | $9.75 | $13.00 | 25% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Ketones Automated | $9.75 | $13.00 | 25% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Automated W/O Micro | $9.75 | $13.00 | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 POC Urinalysis Automated W/O Micro | $9.75 | $13.00 | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Ph Automated | $9.75 | $13.00 | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy | $9.75 | $13.00 | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Ketones Automated | $9.75 | $13.00 | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine Automated | $9.75 | $13.00 | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Automated W/O Micro | $9.75 | $13.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis Non Automated WO Micro | $10.50 | $14.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Ph Nonautomated | $10.50 | $14.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp | $10.50 | $14.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 POC Urinalysis Non-Auto | $10.50 | $14.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Ketones Nonautomated | $10.50 | $14.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Ketones Nonautomated | $10.50 | $14.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Ph Nonautomated | $10.50 | $14.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp | $10.50 | $14.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Non Automated WO Micro | $10.50 | $14.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 POC Urinalysis Non-Auto | $10.50 | $14.00 | 25% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp | $1,123.50 | $1,498.00 | 25% |
| Cataract surgery with lens implant inpatient CPT 66984 Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp | $1,123.50 | $1,498.00 | 25% |
| Colonoscopy with polyp removal CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq | $774.75 | $1,033.00 | 25% |
| Colonoscopy with polyp removal inpatient CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq | $774.75 | $1,033.00 | 25% |
| Colonoscopy with tissue sample CPT 45380 Colonoscopy W/Biopsy Single/Multiple | $733.50 | $978.00 | 25% |
| Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy W/Biopsy Single/Multiple | $733.50 | $978.00 | 25% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd | $649.50 | $866.00 | 25% |
| Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd | $649.50 | $866.00 | 25% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Post-Cataract Laser Surgery | $570.75 | $761.00 | 25% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Post-Cataract Laser Surgery | $570.75 | $761.00 | 25% |
| Left heart catheterization, diagnostic CPT 93452 L Hrt Cath W/Njx L Ventriculography Img S&I | $1,377.75 | $1,837.00 | 25% |
| Left heart catheterization, diagnostic inpatient CPT 93452 L Hrt Cath W/Njx L Ventriculography Img S&I | $1,377.75 | $1,837.00 | 25% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $411.00 | $548.00 | 25% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $411.00 | $548.00 | 25% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $272.25 | $363.00 | 25% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $272.25 | $363.00 | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level | $383.25 | $511.00 | 25% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level | $383.25 | $511.00 | 25% |
| Prostate biopsy CPT 55700 Prostate Needle Biopsy Any Approach | $351.75 | $469.00 | 25% |
| Prostate biopsy inpatient CPT 55700 Prostate Needle Biopsy Any Approach | $351.75 | $469.00 | 25% |
| Removal of a breast lump, open surgery CPT 19120 Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion | $816.75 | $1,089.00 | 25% |
| Removal of a breast lump, open surgery inpatient CPT 19120 Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion | $816.75 | $1,089.00 | 25% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Egd Transoral Biopsy Single/Multiple | $590.25 | $787.00 | 25% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Egd Transoral Biopsy Single/Multiple | $590.25 | $787.00 | 25% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic | $477.75 | $637.00 | 25% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic | $477.75 | $637.00 | 25% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Ecg Routine Ecg W/Least 12 Lds W/I&R | $33.00 | $44.00 | 25% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Ecg Routine Ecg W/Least 12 Lds W/I&R | $33.00 | $44.00 | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 Family Psychotherapy W/Patient Present 50 Mins | $184.50 | $246.00 | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Psychotherapy W/Patient Present 50 Mins | $184.50 | $246.00 | 25% |
| Family therapy without the patient, 50 minutes CPT 90846 Family Psychotherapy W/O Patient Present 50 Mins | $177.00 | $236.00 | 25% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psychotherapy W/O Patient Present 50 Mins | $177.00 | $236.00 | 25% |
| Group psychotherapy session CPT 90853 Group Psychotherapy | $47.25 | $63.00 | 25% |
| Group psychotherapy session inpatient CPT 90853 Group Psychotherapy | $47.25 | $63.00 | 25% |
| New patient office visit, about 30 minutes CPT 99203 Office/Outpatient New Low Mdm 30 Minutes | $132.00 | $176.00 | 25% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office/Outpatient New Low Mdm 30 Minutes | $132.00 | $176.00 | 25% |
| New patient office visit, about 45 minutes CPT 99204 Office/Outpatient New Moderate Mdm 45 Minutes | $204.75 | $273.00 | 25% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office/Outpatient New Moderate Mdm 45 Minutes | $204.75 | $273.00 | 25% |
| New patient office visit, about 60 minutes CPT 99205 Office/Outpatient New High Mdm 60 Minutes | $258.00 | $344.00 | 25% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Office/Outpatient New High Mdm 60 Minutes | $258.00 | $344.00 | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Px 1/> Areas Each 15 Min Exercises | $50.25 | $67.00 | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Px 1/> Areas Each 15 Min Exercises | $50.25 | $67.00 | 25% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial Preventive Medicine New Pt Age 18-39yrs | $174.75 | $233.00 | 25% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Initial Preventive Medicine New Pt Age 18-39yrs | $174.75 | $233.00 | 25% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial Preventive Medicine New Patient 40-64yrs | $205.50 | $274.00 | 25% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Initial Preventive Medicine New Patient 40-64yrs | $205.50 | $274.00 | 25% |
| Psychotherapy session, 30 minutes CPT 90832 Psychotherapy W/Patient 30 Minutes | $122.25 | $163.00 | 25% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy W/Patient 30 Minutes | $122.25 | $163.00 | 25% |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy W/Patient 45 Minutes | $160.50 | $214.00 | 25% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy W/Patient 45 Minutes | $160.50 | $214.00 | 25% |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy W/Patient 60 Minutes | $239.25 | $319.00 | 25% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy W/Patient 60 Minutes | $239.25 | $319.00 | 25% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Office/OP Consltj New/Est Pt Low Mdm 30 Minutes | $171.00 | $228.00 | 25% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office/OP Consltj New/Est Pt Low Mdm 30 Minutes | $171.00 | $228.00 | 25% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes | $255.75 | $341.00 | 25% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes | $255.75 | $341.00 | 25% |