Ascension Calumet Hospital
Ascension Calumet Hospital in Chilton, WI publishes cash prices for 449 common procedures listed here, from its own machine-readable price file updated Jan 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Wisconsin median for 379 of 444 procedures and above it for 65. By typical cash price it ranks #10 of 103 Wisconsin hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
614 Memorial Dr Chilton WI 53014 Collected Sep 23, 2026 Source price file Check a bill from this hospital (920) 849-2386
Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 521317 · CMS hospital register NPI 1376541748
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Ascension Calumet Hospital 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 Wisconsin | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W/WO CONTRAST | $1,006.05 | $1,765.00 | $70.54–$667.54 | 58% below | 43% |
| Abdominal X-ray, 2 views CPT 74019 HC X-RAY EXAM ABDOMEN 2 VIEWS | $229.71 | $403.00 | $11.55–$85.71 | 4% below | 43% |
| Ankle X-ray, complete, 3 or more views CPT 73610 HC X-RAY EXAM OF ANKLE 3/> VIEWS | $165.30 | $290.00 | $8.96–$82.88 | 30% below | 43% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC UPR/L XTR NON-INVAS ART STUDY 2 LEVELS LIMITED | $420.09 | $737.00 | $12.19–$678.04 | 9% above | 43% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST | $518.70 | $910.00 | $50.39–$428.44 | 64% below | 43% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC BONE IMAGING WHOLE BODY | $820.23 | $1,439.00 | $42.55–$730.48 | 45% below | 43% |
| Breast ultrasound, complete, one breast CPT 76641 HC ULTRASOUND BREAST COMPLETE | $494.19 | $867.00 | $36.99–$257.60 | 7% below | 43% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HC ULTRASOUND BREAST LIMITED | $371.07 | $651.00 | $34.41–$210.65 | 6% below | 43% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN PELVIS W/WO CONTRAST | $1,820.01 | $3,193.00 | $110.26–$970.47 | 40% below | 43% |
| CT angiography (CTA) of the head CPT 70496 HC STROKE CT ANGIOGRAPHY HEAD AI | $1,374.84 | $2,412.00 | $88.12–$988.60 | 34% below | 43% |
| CT angiography (CTA) of the head CPT 70496 HC CTA HEAD W/WO CONTRAST | $1,374.84 | $2,412.00 | $88.12–$988.60 | 34% below | 43% |
| CT angiography (CTA) of the neck CPT 70498 HC CTA NECK W/WO CONTRAST | $1,309.29 | $2,297.00 | $88.12–$1,029.08 | 36% below | 43% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA CHEST W/WO CONTRAST | $1,371.99 | $2,407.00 | $91.56–$739.38 | 32% below | 43% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABDOMEN PELVIS WO CONTRAST | $1,371.99 | $2,407.00 | $87.75–$480.52 | 45% below | 43% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN PELVIS W CONTRAST | $1,553.25 | $2,725.00 | $91.80–$784.40 | 52% below | 43% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN PELVIS CONTRAST 1/> REGIONS | $1,644.45 | $2,885.00 | $101.15–$882.11 | 55% below | 43% |
| CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST | $845.88 | $1,484.00 | $64.27–$593.04 | 48% below | 43% |
| CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST | $595.65 | $1,045.00 | $60.09–$358.24 | 53% below | 43% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST | $548.91 | $963.00 | $43.24–$410.79 | 61% below | 43% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD WO CONTRAST | $640.68 | $1,124.00 | $42.89–$294.90 | 50% below | 43% |
| CT scan of the head with contrast CPT 70460 HC CT HEAD W CONTRAST | $685.14 | $1,202.00 | $57.14–$391.67 | 56% below | 43% |
| CT scan of the head without and with contrast CPT 70470 HC CT HEAD W/WO CONTRAST | $845.88 | $1,484.00 | $64.27–$458.82 | 54% below | 43% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST | $709.08 | $1,244.00 | $50.39–$383.79 | 54% below | 43% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE WO CONTRAST | $731.88 | $1,284.00 | $50.39–$387.78 | 52% below | 43% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST | $823.08 | $1,444.00 | $58.62–$580.34 | 50% below | 43% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC CAROTID DUPLEX BILATERAL STUDY | $954.75 | $1,675.00 | $39.61–$1,541.00 | — | 43% |
| Chest CT scan without and with contrast CPT 71270 HC CT THORAX W/WO CONTRAST | $1,097.25 | $1,925.00 | $63.04–$598.10 | 52% below | 43% |
| Chest X-ray, 2 views CPT 71046 HC X-RAY EXAM CHEST 2 VIEWS | $156.18 | $274.00 | $11.18–$78.02 | 27% below | 43% |
| Chest X-ray, single view CPT 71045 HC X-RAY EXAM CHEST 1 VIEW | $120.27 | $211.00 | $8.97–$60.86 | 26% below | 43% |
| Collarbone (clavicle) X-ray, complete CPT 73000 HC X-RAY EXAM OF CLAVICLE COMPLETE | $63.84 | $112.00 | $8.59–$74.35 | 69% below | 43% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE | $593.94 | $1,042.00 | $37.36–$272.08 | 8% above | 43% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY AXIAL | $255.36 | $448.00 | $10.35–$94.11 | 36% below | 43% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DXA BONE DENSITY/PERIPHERAL | $126.54 | $222.00 | $10.35–$77.08 | 55% below | 43% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX WO CONTRAST | $722.19 | $1,267.00 | $54.56–$382.21 | 50% below | 43% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W CONTRAST | $914.28 | $1,604.00 | $58.97–$480.63 | 44% below | 43% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI | $725.61 | $1,273.00 | $50.39–$405.50 | — | 43% |
| Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI | $581.40 | $1,020.00 | $41.04–$321.38 | 89% above | 43% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLX ART LOWER EXTREM BILAT | $1,584.60 | $2,780.00 | $39.25–$2,557.60 | — | 43% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC VEN DUPL SCAN BILAT UP/LW | $992.37 | $1,741.00 | $34.33–$1,601.72 | — | 43% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC PRO-S TTE W/DOPPLER COMPLETE | $501.60 | $880.00 | $73.25–$682.35 | 71% below | 43% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE W/DOPPLER COMPLETE W/O CONTRAST | $1,679.22 | $2,946.00 | $73.25–$682.35 | 4% below | 43% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE W/DOPPLER COMPLETE W CONTRAST | $1,877.01 | $3,293.00 | $73.25–$682.35 | 7% above | 43% |
| Elbow X-ray, 2 views CPT 73070 HC PRO-S XRAY EXAM OF ELBOW 2 VWS | $21.66 | $38.00 | $8.59–$27.75 | 89% below | 43% |
| Elbow X-ray, 2 views CPT 73070 HC X-RAY EXAM OF ELBOW 2 VIEWS | $63.84 | $112.00 | $8.59–$67.56 | 67% below | 43% |
| Elbow X-ray, complete, 3 or more views CPT 73080 HC X-RAY EXAM OF ELBOW 3/> VIEWS | $179.55 | $315.00 | $8.96–$73.56 | 24% below | 43% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT SELLA WO CONTRAST | $669.18 | $1,174.00 | $65.00–$511.59 | 54% below | 43% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC X-RAY EXAM OF FACIAL BONES 3/>VIEWS | $106.02 | $186.00 | $13.38–$109.64 | 65% below | 43% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC X-RAY EXAM OF FOREARM | $153.90 | $270.00 | $8.23–$68.40 | 22% below | 43% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC HEPATOBILIARY IMAGING W OR WO GB | $1,027.14 | $1,802.00 | $37.00–$822.02 | 31% below | 43% |
| Hand X-ray, 2 views CPT 73120 HC X-RAY EXAM OF HAND 2 VIEWS | $106.02 | $186.00 | $8.59–$71.80 | 44% below | 43% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC PRO-S X-RAY EXAM OF HEEL | $29.07 | $51.00 | $8.23–$50.45 | 85% below | 43% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC X-RAY EXAM OF HEEL 2 VIEWS | $62.70 | $110.00 | $8.23–$66.71 | 68% below | 43% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC HOME SLEEP TEST TYPE III | $726.18 | $1,274.00 | $46.82–$714.00 | 18% above | 43% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAPHY WITH CPAP | $4,268.16 | $7,488.00 | $130.63–$3,687.00 | 16% above | 43% |
| Knee X-ray, 3 views CPT 73562 HC X-RAY EXAM OF KNEE 3 VIEWS | $159.03 | $279.00 | $9.69–$93.12 | 37% below | 43% |
| Knee X-ray, complete, 4 or more views CPT 73564 HC X-RAY EXAM KNEE 4 OR MORE VIEWS | $224.58 | $394.00 | $11.89–$104.36 | 19% below | 43% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST | $519.84 | $912.00 | $50.39–$382.21 | 64% below | 43% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMINAL LTD | $593.94 | $1,042.00 | $29.50–$218.74 | 33% above | 43% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG | $202.35 | $355.00 | $26.63–$137.29 | 29% below | 43% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC LOW DOSE CT THORAX LUNG SCREENING | $72.96 | $128.00 | $54.56–$71.43 | 84% below | 43% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC X-RAY EXAM TIBIA/FIBULA 2 VIEWS | $167.01 | $293.00 | $8.23–$72.66 | 22% below | 43% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD WO CONTRAST | $1,897.53 | $3,329.00 | $60.46–$952.88 | 14% below | 43% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI JOINT LOWER EXTREMITY WO CONTRAST | $2,001.27 | $3,511.00 | $68.68–$548.68 | 9% below | 43% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI JOINT LOWER EXTREMITY W/WO CONTRAST | $2,253.21 | $3,953.00 | $108.63–$1,082.35 | 34% below | 43% |
| MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST | $1,721.40 | $3,020.00 | $73.62–$728.27 | 22% below | 43% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W/WO CONTRAST | $2,357.52 | $4,136.00 | $110.85–$1,117.97 | 31% below | 43% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN WO CONTRAST | $1,943.70 | $3,410.00 | $74.72–$852.88 | 12% below | 43% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/WO CONTRAST | $2,608.32 | $4,576.00 | $115.40–$1,067.96 | 24% below | 43% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE WO CONTRAST | $1,945.98 | $3,414.00 | $75.07–$722.71 | 12% below | 43% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/WO CONTRAST | $2,448.72 | $4,296.00 | $115.76–$1,037.80 | 28% below | 43% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE WO CONTRAST | $1,866.75 | $3,275.00 | $74.72–$723.51 | 16% below | 43% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE W/WO CONTRAST | $2,382.60 | $4,180.00 | $115.76–$1,044.15 | 30% below | 43% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE WO CONTRAST | $2,005.26 | $3,518.00 | $74.72–$721.90 | 9% below | 43% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W/WO CONTRAST | $2,014.38 | $3,534.00 | $110.85–$1,113.21 | 41% below | 43% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO CONTRAST | $1,411.32 | $2,476.00 | $73.97–$841.75 | 36% below | 43% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI JOINT UPPER EXTREMITY WO CONTRAST | $2,348.40 | $4,120.00 | $68.68–$550.09 | 6% above | 43% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC PRO-S X-RAY EXAM NECK SPINE 4/5 VWS | $49.02 | $86.00 | $13.76–$79.02 | 85% below | 43% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC X-RAY EXAM NECK SPINE 4/5VWS | $204.06 | $358.00 | $13.76–$120.73 | 36% below | 43% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST | $731.88 | $1,284.00 | $69.80–$486.53 | 55% below | 43% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST | $516.42 | $906.00 | $64.64–$395.16 | 64% below | 43% |
| Neck soft tissue X-ray CPT 70360 HC X-RAY EXAM OF NECK | $61.56 | $108.00 | $9.33–$72.74 | 71% below | 43% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC MYOCARDIAL SPECT MULTIPLE STUDIES | $2,649.36 | $4,648.00 | $80.76–$1,140.25 | 14% below | 43% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET/CT IMAGE SKULL BASE-THIGH | $3,064.32 | $5,376.00 | $120.16–$3,687.56 | 28% below | 43% |
| Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST | $609.90 | $1,070.00 | $54.94–$349.01 | 52% below | 43% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US NON-OB PELVIC LTD /FOLLOW UP | $470.25 | $825.00 | $24.95–$183.00 | 17% above | 43% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US NON-OB PELVIC COMPLETE | $607.05 | $1,065.00 | $34.66–$263.35 | 16% above | 43% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB 14 WKS / > SINGLE FETUS | $431.49 | $757.00 | $50.60–$336.66 | 25% below | 43% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US OB < 14WKS SINGLE FETUS | $352.26 | $618.00 | $50.25–$294.18 | 31% below | 43% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LTD 1 / > FETUS | $343.71 | $603.00 | $32.81–$202.02 | 6% below | 43% |
| Rib X-ray, one side, 2 views CPT 71100 HC X-RAY EXAM RIBS UNI 2 VIEWS | $211.47 | $371.00 | $11.18–$84.82 | 6% below | 43% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC X-RAY EXAM UNILAT RIBS/CHEST | $243.39 | $427.00 | $13.76–$97.79 | 12% below | 43% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCREEN MAMMO BI INCL CAD | $309.51 | $543.00 | $38.46–$327.96 | — | 43% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC X-RAY EXAM OF SHOULDER 2/> VIEWS | $153.90 | $270.00 | $9.69–$78.69 | 34% below | 43% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC X-RAY EXAM OF SINUSES 3/> VIEWS | $84.36 | $148.00 | $11.18–$87.37 | 68% below | 43% |
| Skull X-ray, fewer than 4 views CPT 70250 HC X-RAY EXAM OF SKULL < 4 VIEWS | $149.34 | $262.00 | $9.33–$84.64 | 39% below | 43% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAM STUDY | $4,056.12 | $7,116.00 | $125.71–$3,687.00 | 19% above | 43% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC SWALLOWING FUNCTION CINE/VIDEO CONTRAST STUDY | $170.43 | $299.00 | $26.91–$244.90 | 63% below | 43% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC X-RAY EXAM OF FEMUR 2/> VIEWS | $222.87 | $391.00 | $9.33–$82.09 | 9% below | 43% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC SPINE WO CONTRAST | $548.91 | $963.00 | $50.39–$385.40 | 64% below | 43% |
| Toe X-ray, 2 or more views CPT 73660 HC X-RAY EXAM OF TOE(S) 2 VIEWS | $72.39 | $127.00 | $6.75–$66.56 | 64% below | 43% |
| Transvaginal pelvic ultrasound CPT 76830 HC US NON-OB TRANSVAGINAL | $522.69 | $917.00 | $35.01–$295.64 | 11% above | 43% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL EXAM | $285.57 | $501.00 | $38.32–$230.52 | 27% below | 43% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMINAL COMPLETE | $791.16 | $1,388.00 | $40.68–$295.07 | 16% above | 43% |
| Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM & TESTICLES | $558.03 | $979.00 | $32.08–$252.09 | 13% above | 43% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM OF SOFT TISSUES HEAD AND NECK | $518.13 | $909.00 | $28.38–$278.06 | 2% above | 43% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HC X-RAY EXAM OF HUMERUS | $152.19 | $267.00 | $8.23–$74.35 | 28% below | 43% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC PRO-S VENOUS DUPLEX LOWER EXTREMITY | $74.10 | $130.00 | $22.14–$119.60 | 90% below | 43% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUP VENOUS EXTREMITY UNILATERAL/LIMITED | $661.77 | $1,161.00 | $22.14–$1,068.12 | 7% below | 43% |
| Wrist X-ray, 2 views CPT 73100 HC X-RAY EXAM OF WRIST 2 VIEWS | $116.85 | $205.00 | $8.59–$77.75 | 46% below | 43% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC X-RAY EXAM OF WRIST 3/> VIEWS | $153.33 | $269.00 | $8.96–$92.23 | 40% below | 43% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC X-RAY HIP WITH PELVIS 2/3 VIEW | $193.80 | $340.00 | $11.54–$107.76 | 33% below | 43% |
| X-ray of the abdomen, 1 view CPT 74018 HC X-RAY EXAM ABDOMEN 1 VIEW | $143.64 | $252.00 | $9.33–$69.34 | 32% below | 43% |
| X-ray of the ankle, 2 views CPT 73600 HC X-RAY EXAM OF ANKLE 2 VIEWS | $63.27 | $111.00 | $8.23–$75.19 | 68% below | 43% |
| X-ray of the finger(s), 2 or more views CPT 73140 HC X-RAY EXAM OF FINGER(S) | $106.02 | $186.00 | $7.11–$84.42 | 57% below | 43% |
| X-ray of the foot, 2 views CPT 73620 HC X-RAY EXAM OF FOOT 2 VIEWS | $136.80 | $240.00 | $7.87–$65.87 | 28% below | 43% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC X-RAY EXAM OF FOOT 3/> VIEWS | $164.16 | $288.00 | $8.60–$77.80 | 32% below | 43% |
| X-ray of the hand, 3 or more views CPT 73130 HC X-RAY EXAM OF HAND 3/> VIEWS | $176.70 | $310.00 | $8.96–$82.88 | 25% below | 43% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC X-RAY EXAM OF KNEE 1 OR 2 VIEWS | $145.35 | $255.00 | $8.59–$79.46 | 31% below | 43% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC X-RAY EXAM L-S SPINE 2/3 VWS | $210.90 | $370.00 | $11.54–$90.77 | 28% below | 43% |
| X-ray of the lower back, 4 or more views CPT 72110 HC X-RAY EXAM L-2 SPINE 4/>VWS | $239.40 | $420.00 | $13.38–$115.57 | 36% below | 43% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC X-RAY EXAM THORAC SPINE 2VWS | $204.06 | $358.00 | $10.43–$75.39 | 14% below | 43% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC X-RAY EXAM OF NASAL BONES | $75.81 | $133.00 | $8.60–$86.28 | 69% below | 43% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC X-RAY EXAM NECK SPINE 2-3 VW | $195.51 | $343.00 | $11.54–$90.77 | 19% below | 43% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC X-RAY EXAM OF PELVIS 1 OR 2 VIEWS | $134.52 | $236.00 | $8.96–$67.60 | 39% below | 43% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC X-RAY EXAM SACRUM & COCCYX 2/> | $164.73 | $289.00 | $8.96–$74.40 | 24% below | 43% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 HC ASSAY OF ACTH | $135.66 | $238.00 | $40.55–$86.81 | 38% below | 43% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALANINE AMINO (ALT) (SGPT) | $20.52 | $36.00 | $5.57–$17.67 | 41% below | 43% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE (AST) (SGOT) | $19.95 | $35.00 | $5.44–$17.28 | 58% below | 43% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC ACUTE HEPATITIS PANEL | $192.66 | $338.00 | $50.01–$107.07 | 37% below | 43% |
| Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN | $19.38 | $34.00 | $5.20–$16.52 | 48% below | 43% |
| Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE | $143.07 | $251.00 | $42.79–$91.59 | 27% below | 43% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC ASSAY ALKALINE PHOSPHATASE | $19.95 | $35.00 | $5.44–$17.28 | 59% below | 43% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE | $18.24 | $32.00 | $4.64–$10.02 | 27% below | 43% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM | $59.28 | $104.00 | $17.61–$37.70 | 29% below | 43% |
| Ammonia blood test CPT 82140 HC ASSAY OF AMMONIA | $57.00 | $100.00 | $15.30–$32.75 | 36% below | 43% |
| Amylase blood test CPT 82150 HC ASSAY OF AMYLASE | $48.45 | $85.00 | $6.80–$45.94 | 22% below | 43% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP ANTIBODY | $47.88 | $84.00 | $13.60–$29.09 | 42% below | 43% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES | $66.69 | $117.00 | $12.69–$23.41 | 3% below | 43% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC ASSAY OF NATRIURETIC PEPTIDE - POC | $118.56 | $208.00 | $41.22–$113.38 | 17% below | 43% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC ASSAY OF NATRIURETIC PEPTIDE | $118.56 | $208.00 | $41.22–$113.38 | 17% below | 43% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, THROAT | $32.49 | $57.00 | $9.05–$19.37 | 38% below | 43% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, NASAL | $32.49 | $57.00 | $9.05–$19.37 | 38% below | 43% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, CSF W/ GRAM STAIN | $32.49 | $57.00 | $9.05–$19.37 | 38% below | 43% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, EAR | $32.49 | $57.00 | $9.05–$19.37 | 38% below | 43% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, EYE | $32.49 | $57.00 | $9.05–$19.37 | 38% below | 43% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE OTHER SPECIMEN AEROBIC RECTAL SCRN | $64.41 | $113.00 | $9.05–$19.37 | 23% above | 43% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE OTHER SPECIMEN AEROBIC | $64.41 | $113.00 | $9.05–$19.37 | 23% above | 43% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, GENITAL | $65.55 | $115.00 | $9.05–$19.37 | 25% above | 43% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, SPUTUM | $70.68 | $124.00 | $9.05–$19.37 | 35% above | 43% |
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL-CALCIUM, TOTAL | $98.04 | $172.00 | $8.88–$59.96 | 11% above | 43% |
| Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL | $19.38 | $34.00 | $5.27–$16.77 | 59% below | 43% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURGICAL PATHOLOGY GROSS EXAM LVL IV | $124.83 | $219.00 | $39.50–$94.86 | 42% below | 43% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURGICAL PATHOLOGY GROSS EXAM LEVEL IV | $385.32 | $676.00 | $39.50–$94.86 | 79% above | 43% |
| Blood culture for bacteria CPT 87040 HC BLOOD CULTURE FOR BACTERIA | $112.29 | $197.00 | $10.84–$23.22 | 31% above | 43% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - LEGAL | $19.38 | $34.00 | $3.00–$9.00 | 32% above | 43% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE | $19.38 | $34.00 | $3.00–$9.00 | 32% above | 43% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC PRO ROUTINE VENIPUNCTURE | $21.66 | $38.00 | $3.00–$34.08 | 48% above | 43% |
| Blood glucose (sugar) test CPT 82947 HC ASSAY GLUCOSE BLOOD QUANTITATIVE - POC | $14.25 | $25.00 | $4.13–$13.10 | 42% below | 43% |
| Blood glucose (sugar) test CPT 82947 HC ASSAY GLUCOSE BLOOD QUANTITATIVE | $14.25 | $25.00 | $4.13–$13.10 | 42% below | 43% |
| Blood lead test CPT 83655 HC ASSAY OF LEAD | $37.05 | $65.00 | $12.72–$40.44 | 33% below | 43% |
| Blood lead test CPT 83655 HC ASSAY OF LEAD - POC | $37.05 | $65.00 | $12.72–$40.44 | 33% below | 43% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC CHORIONIC GONADOTROPIN ASSAY | $57.57 | $101.00 | $7.90–$53.34 | 7% below | 43% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING ABO | $74.10 | $130.00 | $3.14–$6.15 | 74% above | 43% |
| Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY OF UREA NITROGEN | $15.96 | $28.00 | $4.15–$13.19 | 38% below | 43% |
| Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY OF UREA NITROGEN - POC | $15.96 | $28.00 | $4.15–$13.19 | 38% below | 43% |
| C-peptide blood test CPT 84681 HC ASSAY OF C-PEPTIDE | $27.93 | $49.00 | $7.47–$39.96 | 68% below | 43% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN | $19.38 | $34.00 | $5.44–$11.63 | 65% below | 43% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC CLOSTRIDIUM DIFFICILE AMPLIFIED PROBE | $118.56 | $208.00 | $39.13–$78.87 | 21% below | 43% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9 | $73.53 | $129.00 | $21.85–$46.78 | 35% below | 43% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY TUMOR CA 125 | $73.53 | $129.00 | $21.85–$46.78 | 39% below | 43% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID-19 TEST AMPLIFIED PROBE TECHNIQUE | $110.01 | $193.00 | $51.31–$70.81 | 19% below | 43% |
| Calcium blood test, total CPT 82310 HC ASSAY OF CALCIUM TOTAL | $25.08 | $44.00 | $5.42–$36.60 | 52% below | 43% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC CARCINOEMBRYONIC ANTIGEN | $116.28 | $204.00 | $19.91–$42.64 | 14% below | 43% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER ANTIBODY | $33.63 | $59.00 | $8.32–$24.75 | 54% below | 43% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHYLAMYDIA TRACHOMATIS DNA AMP PROBE | $156.75 | $275.00 | $36.84–$78.87 | 10% above | 43% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL | $75.24 | $132.00 | $14.06–$94.94 | 16% below | 43% |
| Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC W/AUTO DIFFERENTIAL WBC | $41.61 | $73.00 | $8.16–$49.56 | 43% below | 43% |
| Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC AUTOMATED | $34.20 | $60.00 | $6.79–$14.54 | 35% below | 43% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL | $115.71 | $203.00 | $11.09–$74.89 | 2% above | 43% |
| Cortisol blood test, total CPT 82533 HC TOTAL CORTISOL | $86.07 | $151.00 | $17.12–$36.65 | 28% below | 43% |
| Creatine kinase (CK) blood test, total CPT 82550 HC ASSAY OF CK (CPK) | $25.08 | $44.00 | $6.84–$21.75 | 61% below | 43% |
| Creatinine blood test CPT 82565 HC ASSAY OF CREATININE - POC | $20.52 | $36.00 | $5.38–$17.11 | 35% below | 43% |
| Creatinine blood test CPT 82565 HC ASSAY OF CREATININE | $20.52 | $36.00 | $5.38–$17.11 | 35% below | 43% |
| Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV ANTIBODY | $42.75 | $75.00 | $15.11–$32.36 | 39% below | 43% |
| D-dimer blood test (blood clot marker) CPT 85379 HC FIBRIN DEGRADATION QUANTITATIVE | $41.61 | $73.00 | $10.69–$19.54 | 48% below | 43% |
| D-dimer blood test (blood clot marker) CPT 85379 HC FIBRIN DEGRADATION QUANTITATIVE - POC | $41.61 | $73.00 | $10.69–$19.54 | 48% below | 43% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE | $79.23 | $139.00 | $23.34–$49.98 | 44% below | 43% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRESUMPTIVE CHEM ANALYZER | $106.59 | $187.00 | $65.25–$108.91 | 8% below | 43% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC LSD URINE SCREEN | $123.12 | $216.00 | $65.25–$108.91 | 6% above | 43% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC COTININE SCREEN URINE | $153.33 | $269.00 | $65.25–$108.91 | 32% above | 43% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC URINE FENTANYL SCREEN | $153.33 | $269.00 | $65.25–$108.91 | 32% above | 43% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC ETHYL GLUCURONIDE | $171.00 | $300.00 | $65.25–$108.91 | 48% above | 43% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC UMBILICAL CORD DRUG SCREEN | $262.20 | $460.00 | $65.25–$108.91 | 126% above | 43% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL | $53.01 | $93.00 | $7.36–$49.74 | 9% above | 43% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL - POC | $53.01 | $93.00 | $7.36–$49.74 | 9% above | 43% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR CAPSID VCA | $64.41 | $113.00 | $19.05–$40.79 | 22% below | 43% |
| Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL | $99.18 | $174.00 | $29.34–$62.80 | 23% below | 43% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC ASSAY OF GONADOTROPIN (FSH) | $113.43 | $199.00 | $19.51–$131.75 | 2% below | 43% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY FOR CALPROTECTIN FECAL | $125.97 | $221.00 | $20.61–$44.12 | 33% below | 43% |
| Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN | $57.00 | $100.00 | $14.31–$30.64 | 37% below | 43% |
| Fibrinogen blood test CPT 85384 HC FIBRINOGEN ACTIVITY | $42.18 | $74.00 | $10.21–$19.09 | 38% below | 43% |
| Folate (folic acid) blood test CPT 82746 HC ASSAY OF FOLIC ACID SERUM | $61.56 | $108.00 | $15.44–$33.05 | 38% below | 43% |
| Free T3 thyroid hormone test CPT 84481 HC FREE ASSAY (FT-3) | $50.16 | $88.00 | $16.91–$32.54 | 49% below | 43% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE | $50.16 | $88.00 | $9.47–$20.26 | 38% below | 43% |
| Free testosterone test CPT 84402 HC ASSAY OF FREE TESTOSTERONE | $75.24 | $132.00 | $26.74–$57.24 | 36% below | 43% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GGT | $35.34 | $62.00 | $7.56–$51.06 | 34% below | 43% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC 80050 GENERAL HEALTH PANEL | $135.66 | $238.00 | $55.18–$61.92 | 51% below | 43% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE TEST | $27.93 | $49.00 | $4.99–$33.65 | 43% below | 43% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE TEST - POC | $27.93 | $49.00 | $4.99–$33.65 | 43% below | 43% |
| Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) | $46.74 | $82.00 | $13.51–$42.99 | 48% below | 43% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC NESSERIA GONORRHOEAE DNA AMPLIFIED PROBE | $156.75 | $275.00 | $36.84–$78.87 | 10% above | 43% |
| H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI ANTIBODY | $33.63 | $59.00 | $8.32–$27.86 | 64% below | 43% |
| H. pylori stool antigen test CPT 87338 HC HPYLORI STOOL EIA | $42.18 | $74.00 | $15.10–$32.32 | 67% below | 43% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 QUANTIFICATION&REVERSE TRANSCRIPT | $295.83 | $519.00 | $89.36–$191.27 | 24% below | 43% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB | $79.80 | $140.00 | $25.28–$54.12 | 22% below | 43% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HC HPV HIGH-RISK TYPES | $83.79 | $147.00 | $36.84–$78.87 | 41% below | 43% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST | $50.16 | $88.00 | $10.20–$68.86 | 27% below | 43% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - POC | $50.16 | $88.00 | $10.20–$68.86 | 27% below | 43% |
| Hemoglobin blood test CPT 85018 HC HEMOGLOBIN - POC | $14.25 | $25.00 | $2.49–$16.83 | 19% below | 43% |
| Hemoglobin blood test CPT 85018 HC HEMOGLOBIN | $14.25 | $25.00 | $2.49–$16.83 | 19% below | 43% |
| Hepatitis B core antibody test (total) CPT 86704 HC HEP B CORE ANTIBODY TOTAL | $43.32 | $76.00 | $12.65–$27.08 | 46% below | 43% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEP B SURFACE ANTIBODY | $66.69 | $117.00 | $11.28–$24.14 | 10% below | 43% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEPATITIS B SURFACE AG EIA | $38.19 | $67.00 | $10.85–$23.22 | 41% below | 43% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY TEST | $24.51 | $43.00 | $14.98–$32.08 | 69% below | 43% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C REVERSE TRANSCRIPTION | $150.48 | $264.00 | $44.98–$96.28 | 36% below | 43% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TYPE 1 TEST | $86.64 | $152.00 | $13.85–$29.65 | 28% above | 43% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TYPE 2 TEST | $86.64 | $152.00 | $20.32–$43.51 | 7% above | 43% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY | $27.93 | $49.00 | $13.60–$29.09 | 65% below | 43% |
| Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTINE | $38.76 | $68.00 | $18.82–$37.92 | 67% below | 43% |
| Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL | $41.04 | $72.00 | $12.00–$25.69 | 39% below | 43% |
| Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON | $41.61 | $73.00 | $6.79–$14.55 | 22% below | 43% |
| Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING TEST | $47.88 | $84.00 | $9.18–$19.65 | 23% below | 43% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL | $95.76 | $168.00 | $9.11–$61.56 | 7% below | 43% |
| LH (luteinizing hormone) test CPT 83002 HC ASSAY OF GONADOTROPIN (LH) | $66.12 | $116.00 | $19.45–$61.87 | 32% below | 43% |
| Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID - POC | $53.58 | $94.00 | $12.15–$75.74 | 23% below | 43% |
| Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID | $53.58 | $94.00 | $12.15–$75.74 | 23% below | 43% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE (LD) (LDH) ENZYME | $22.80 | $40.00 | $6.34–$13.56 | 54% below | 43% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE | $58.14 | $102.00 | $7.23–$15.48 | 14% below | 43% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL | $95.76 | $168.00 | $8.58–$18.36 | 6% below | 43% |
| Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY | $54.15 | $95.00 | $17.88–$56.89 | 35% below | 43% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM | $41.04 | $72.00 | $7.04–$15.05 | 22% below | 43% |
| Measles (rubeola) antibody test CPT 86765 HC RUBEOLA ANTIBODY | $63.84 | $112.00 | $13.52–$28.96 | 23% below | 43% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODY SCREEN - POC | $32.49 | $57.00 | $5.44–$36.70 | 41% below | 43% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODY SCREEN | $32.49 | $57.00 | $5.44–$36.70 | 41% below | 43% |
| Mumps immunity blood test CPT 86735 HC MUMPS ANTIBODY | $60.99 | $107.00 | $13.70–$29.32 | 29% below | 43% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE | $65.55 | $115.00 | $19.31–$41.35 | 29% below | 43% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $31.35 | $55.00 | $19.31–$41.35 | 67% below | 43% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA SCREENING | $96.33 | $169.00 | $19.31–$41.35 | 1% above | 43% |
| Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTOPATHOLOGY C/V AUTOMATED FLUID REDO | $138.51 | $243.00 | $27.94–$59.25 | 32% above | 43% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CYTOPATHOLOGY C/V THIN LAYER | $72.39 | $127.00 | $21.27–$45.54 | 20% below | 43% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE | $144.21 | $253.00 | $43.34–$92.78 | 32% below | 43% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA OR WB | $33.63 | $59.00 | $6.31–$13.50 | 36% below | 43% |
| Phosphorus (phosphate) blood test CPT 84100 HC ASSAY OF PHOSPHORUS | $22.80 | $40.00 | $4.98–$10.66 | 45% below | 43% |
| Potassium blood test CPT 84132 HC ASSAY OF SERUM POTASSIUM | $17.67 | $31.00 | $5.00–$15.36 | 36% below | 43% |
| Potassium blood test CPT 84132 HC ASSAY OF SERUM POTASSIUM - POC | $17.67 | $31.00 | $5.00–$15.36 | 36% below | 43% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHRMOML ANEUPLOIDY | $1,297.89 | $2,277.00 | $797.00–$1,047.49 | 8% above | 43% |
| Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE | $66.12 | $116.00 | $21.90–$41.83 | 45% below | 43% |
| Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN | $113.43 | $199.00 | $20.35–$43.56 | 6% below | 43% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $19.95 | $35.00 | $4.50–$27.85 | 41% below | 43% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - POC | $19.95 | $35.00 | $4.50–$27.85 | 41% below | 43% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRESUMPTIVE DIRECT OPT OBS - POC | $78.66 | $138.00 | $13.23–$72.36 | 38% above | 43% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP A ASSAY W/OPTIC - POC | $37.62 | $66.00 | $17.15–$40.07 | 17% below | 43% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP A ASSAY W/OPTIC | $43.32 | $76.00 | $17.15–$40.07 | 5% below | 43% |
| Renin blood test CPT 84244 HC ASSAY OF RENIN | $78.66 | $138.00 | $23.09–$49.43 | 47% below | 43% |
| Rh blood typing CPT 86901 HC BLOOD TYPING RH (D) | $22.80 | $40.00 | $3.14–$6.15 | 42% below | 43% |
| Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE | $34.20 | $60.00 | $5.95–$12.75 | 42% below | 43% |
| Rubella antibody test (immunity check) CPT 86762 HC RUBELLA AB IGG | $52.44 | $92.00 | $15.11–$32.36 | 36% below | 43% |
| Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY | $52.44 | $92.00 | $15.11–$32.36 | 36% below | 43% |
| Rubella antibody test (immunity check) CPT 86762 HC RUBELLA AB IGM | $52.44 | $92.00 | $15.11–$32.36 | 36% below | 43% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC RBC SEDIMENTATION RATE AUTOMATED | $11.40 | $20.00 | $2.84–$6.07 | 73% below | 43% |
| Sodium blood test CPT 84295 HC ASSAY OF SERUM SODIUM - POC | $19.38 | $34.00 | $5.05–$16.09 | 22% below | 43% |
| Sodium blood test CPT 84295 HC ASSAY OF SERUM SODIUM | $19.38 | $34.00 | $5.05–$16.09 | 22% below | 43% |
| Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS | $33.06 | $58.00 | $9.35–$20.00 | 49% below | 43% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD FECES - POC | $17.10 | $30.00 | $4.60–$7.31 | 19% below | 43% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD FECES | $17.10 | $30.00 | $4.60–$7.31 | 19% below | 43% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC ASSAY SCREEN BLOOD FECAL 1-3 | $49.02 | $86.00 | $16.72–$53.12 | 19% below | 43% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 | $49.02 | $86.00 | $16.72–$53.12 | 19% below | 43% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC TREPONEMA PALLIDUM TPPA | $22.80 | $40.00 | $11.32–$25.43 | 59% below | 43% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC TREPONEMA PALLIDUM | $26.22 | $46.00 | $11.32–$25.43 | 52% below | 43% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL QUALITATIVE | $26.22 | $46.00 | $4.48–$9.60 | 34% below | 43% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB TEST CELL IMMUNITY MEASURE | $106.02 | $186.00 | $65.08–$139.31 | 58% below | 43% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE | $124.83 | $219.00 | $27.10–$56.64 | 9% above | 43% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY EACH | $56.43 | $99.00 | $15.28–$32.70 | 19% below | 43% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY THYROID STIM HORMONE | $87.21 | $153.00 | $17.64–$119.17 | 3% below | 43% |
| Total IgE blood test CPT 82785 HC ASSAY OF IGE | $57.00 | $100.00 | $17.28–$37.01 | 44% below | 43% |
| Total cholesterol blood test CPT 82465 HC ASSAY BLOOD/SERUM CHOLESTEROL | $17.10 | $30.00 | $4.57–$14.53 | 63% below | 43% |
| Total thyroxine (T4) blood test CPT 84436 HC ASSAY OF TOTAL THYROXINE | $38.19 | $67.00 | $7.21–$15.43 | 27% below | 43% |
| Total triiodothyronine (T3) blood test CPT 84480 HC ASSAY TRIIODOTHYRONINE (T3) | $51.87 | $91.00 | $14.89–$31.86 | 52% below | 43% |
| Transferrin blood test CPT 84466 HC ASSAY OF TRANSFERRIN | $46.74 | $82.00 | $13.40–$28.69 | 51% below | 43% |
| Trichomonas test (NAAT) CPT 87661 HC TRICHOMONAS VAGINALIS AMPLIFIED | $59.85 | $105.00 | $36.84–$78.87 | 56% below | 43% |
| Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES | $21.66 | $38.00 | $6.03–$19.20 | 60% below | 43% |
| Troponin test, quantitative CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE | $87.78 | $154.00 | $13.09–$22.11 | 4% above | 43% |
| Troponin test, quantitative CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE - POC | $87.78 | $154.00 | $13.09–$22.11 | 4% above | 43% |
| Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID | $25.08 | $44.00 | $4.75–$32.04 | 50% below | 43% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS AUTOMATED W/SCOPE | $26.79 | $47.00 | $3.33–$7.13 | 26% below | 43% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTOMATED W/O SCOPE - POC | $19.95 | $35.00 | $2.36–$15.91 | 20% below | 43% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTOMATED W/O SCOPE | $19.95 | $35.00 | $2.36–$15.91 | 20% below | 43% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS NONAUTOMATED W/O SCOPE-POC | $5.70 | $10.00 | $3.65–$5.74 | 59% below | 43% |
| Urine culture for bacteria, with colony count CPT 87086 HC URINE CULTURE/COLONY COUNT | $63.84 | $112.00 | $8.47–$18.15 | 15% below | 43% |
| Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN QUANTITATIVE | $31.35 | $55.00 | $6.07–$41.01 | 52% below | 43% |
| Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST - POC | $24.51 | $43.00 | $9.04–$14.21 | 51% below | 43% |
| Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST | $24.51 | $43.00 | $9.04–$14.21 | 51% below | 43% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12 | $61.56 | $108.00 | $15.83–$33.89 | 40% below | 43% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D 25 HYDROXY | $127.11 | $223.00 | $31.08–$66.54 | 18% below | 43% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VIT D 1 25-DIHYDROXY | $135.09 | $237.00 | $40.43–$86.53 | 16% below | 43% |
| Zinc blood test CPT 84630 HC ASSAY OF ZINC | $38.19 | $67.00 | $11.96–$23.28 | 52% below | 43% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC CHORIONIC GONADOTROPIN TEST | $91.20 | $160.00 | $15.80–$33.84 | 22% below | 43% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 HC PRO-S SURGERY; KNEE LIGAMENT REPAIR | $1,671.24 | $2,932.00 | $1,007.95–$1,282.44 | 86% below | 43% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 HC PRO-S SHOULDER ROTATOR CUFF SURGERY | $1,818.30 | $3,190.00 | $1,104.34–$1,401.51 | 65% below | 43% |
| Botox injections for chronic migraine CPT 64615 HC PRO CHEMODENERV MUSC MIGRAIN | $449.73 | $789.00 | $120.27–$518.40 | 39% below | 43% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC PRO-S TREAT ANKLE FRACTURE | $320.91 | $563.00 | $312.28–$422.09 | 42% below | 43% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC FAC TREAT ANKLE FRACTURE | $603.63 | $1,059.00 | $312.28–$422.09 | 10% above | 43% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC FAC TREAT METATARSAL FRACTURE | $433.20 | $760.00 | $224.12–$293.72 | 28% below | 43% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC PRO-ER TREAT METATARSAL FRACTURE | $487.92 | $856.00 | $224.12–$792.56 | 18% below | 43% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC PRO-S TREAT METATARSAL FRACTURE | $650.94 | $1,142.00 | $224.12–$792.56 | 9% above | 43% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HC PRO-S CORRECTION HALLUX VALGUS | $742.71 | $1,303.00 | $549.35–$1,235.58 | 83% below | 43% |
| Bunion correction with removal of part of the big toe joint CPT 28292 HC PRO-S CORRECTION HALLUX VALGUS | $942.78 | $1,654.00 | $519.85–$965.50 | 83% below | 43% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC PRO-ER CARDIOVERSION | $1,047.66 | $1,838.00 | $113.16–$524.58 | 6% above | 43% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC ELECTIVE CARDIOVERSION | $1,272.24 | $2,232.00 | $113.16–$524.58 | 29% above | 43% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION EXTERNAL | $1,272.24 | $2,232.00 | $113.16–$524.58 | 29% above | 43% |
| Carpal tunnel release, open surgery CPT 64721 HC PRO-S CARPAL TUNNEL SURGERY | $540.93 | $949.00 | $461.42–$584.30 | 76% below | 43% |
| Carpal tunnel release, open surgery CPT 64721 HC FAC CARPAL TUNNEL SURGERY | $746.70 | $1,310.00 | $461.42–$584.30 | 66% below | 43% |
| Carpal tunnel release, open surgery CPT 64721 HC PRO CARPAL TUNNEL SURGERY | $1,287.63 | $2,259.00 | $461.42–$1,563.41 | 42% below | 43% |
| Cervical biopsy CPT 57500 HC PRO-S BIOPSY OF CERVIX | $115.71 | $203.00 | $77.89 | 80% below | 43% |
| Cervical biopsy CPT 57500 HC FAC BX SINGLE/MX/LOC EXC LES W/WO | $303.81 | $533.00 | $77.89–$520.01 | 49% below | 43% |
| Cervical biopsy CPT 57500 HC PRO BIOPSY OF CERVIX | $418.38 | $734.00 | $77.89–$520.01 | 29% below | 43% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC PRO-S CIRC NO CLAMP/DORSL SLIT;NOT N | $403.56 | $708.00 | $207.21–$261.70 | 57% below | 43% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC PRO-S TREAT FRACTURE RADIUS/ULNA | $260.49 | $457.00 | $355.06–$452.10 | 58% below | 43% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC FAC CLOSED TRTMT RADIAL/ULNAR FX | $620.16 | $1,088.00 | $355.06–$452.10 | 1% above | 43% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC PRO-ER TREAT FRACTURE RADIUS/ULNA | $672.60 | $1,180.00 | $355.06–$452.10 | 9% above | 43% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC PRO TREAT FRACTURE RADIUS/ULNA | $880.08 | $1,544.00 | $355.06–$1,196.48 | 43% above | 43% |
| Colonoscopy with polyp removal CPT 45385 HC PRO-S COLONOSCOPY W/LESION REMOVAL | $599.64 | $1,052.00 | $261.49–$627.28 | 76% below | 43% |
| Colonoscopy with tissue sample CPT 45380 HC PRO-S COLONOSCOPY AND BIOPSY | $430.35 | $755.00 | $206.66–$605.64 | 79% below | 43% |
| Colonoscopy, diagnostic CPT 45378 HC PRO-S DIAGNOSTIC COLONOSCOPY | $372.78 | $654.00 | $189.87–$467.05 | 79% below | 43% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC PRO-S BX/CURETT OF CERVIX W/SCOPE | $243.96 | $428.00 | $137.71–$222.71 | 46% below | 43% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC PRO BX/CURETT OF CERVIX W/SCOPE | $488.49 | $857.00 | $137.71–$589.61 | 8% above | 43% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC PRO-S CYSTOSCOPY | $141.36 | $248.00 | $82.93 | 86% below | 43% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC FAC CYSTURTHRSCP IRRG&EVE MX OBST | $490.20 | $860.00 | $82.93–$764.59 | 51% below | 43% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC PRO CYSTOSCOPY | $631.56 | $1,108.00 | $82.93–$764.59 | 36% below | 43% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC PRO-S DESTRUCT PREMALG LESION | $63.27 | $111.00 | $58.80–$88.97 | 65% below | 43% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC FAC DESTRUC BEN/PREMALIG LES; 1 LE | $129.96 | $228.00 | $58.80–$88.97 | 28% below | 43% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC PRO DESTRUCT PREMALG LESION | $193.23 | $339.00 | $58.80–$236.74 | 7% above | 43% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC FAC CREATE EARDRUM OPENING | $462.84 | $812.00 | $140.58–$713.96 | 11% below | 43% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC PRO REMOVE IMPACTED EAR WAX UNI | $40.47 | $71.00 | $16.89–$50.51 | 56% below | 43% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC FAC REMOVE IMPACTED EAR WAX UNI | $41.04 | $72.00 | $16.89–$50.51 | 56% below | 43% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC PRO-WI REMOVE IMPACTED EAR WAX UNI | $124.26 | $218.00 | $16.89–$50.51 | 34% above | 43% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC PRO-ER REMOVE IMPACTED EAR WAX UNI | $124.26 | $218.00 | $16.89–$50.51 | 34% above | 43% |
| Earwax removal with instruments, one ear CPT 69210 HC PRO-S REMOVE IMPACTED EAR WAX UNI | $63.27 | $111.00 | $33.72–$62.85 | 25% below | 43% |
| Earwax removal with instruments, one ear CPT 69210 HC FAC REMOVAL IMPACT CERUMEN 1 EAR | $71.82 | $126.00 | $33.72–$62.85 | 14% below | 43% |
| Earwax removal with instruments, one ear CPT 69210 HC PRO-ER REMOVE IMPACTED EAR WAX UNI | $124.26 | $218.00 | $33.72–$171.23 | 48% above | 43% |
| Earwax removal with instruments, one ear CPT 69210 HC PRO-WI REMOVE IMPACTED EAR WAX UNI | $124.26 | $218.00 | $33.72–$171.23 | 48% above | 43% |
| Earwax removal with instruments, one ear CPT 69210 HC PRO REMOVE IMPACTED EAR WAX UNI | $135.09 | $237.00 | $33.72–$171.23 | 61% above | 43% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC PRO-S BIOPSY OF UTERUS LINING | $150.48 | $264.00 | $64.71–$135.63 | 45% below | 43% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC FAC BIOPSY ENDOMETRIAL W/WO ENDOCE | $200.07 | $351.00 | $64.71–$322.96 | 26% below | 43% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC PRO BIOPSY OF UTERUS LINING | $350.55 | $615.00 | $64.71–$351.86 | 29% above | 43% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC PRO INJ EPI CER/THOR W/IMG | $863.55 | $1,515.00 | $112.86–$944.74 | 35% below | 43% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX INTERLAMINAR CRV/THRC W IMG | $1,946.55 | $3,415.00 | $112.86–$944.74 | 47% above | 43% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC PRO INJ LUMB/SAC SGL W/FLUO | $1,344.06 | $2,358.00 | $95.27–$632.63 | 17% below | 43% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 HC PRO-S RPR AA HRN 1ST 3-10 RDC | $887.49 | $1,557.00 | $568.59 | 86% below | 43% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 HC PRO-S RPR AA HRN 1ST > 10 RDC | $1,205.55 | $2,115.00 | $764.94 | 81% below | 43% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 HC PRO-S RPR AA HRN 1ST < 3 CM RDC | $515.85 | $905.00 | $340.49 | 76% below | 43% |
| Gallbladder removal, laparoscopic CPT 47562 HC PRO-S LAPAROSCOPIC CHOLECYSTECTOMY | $1,353.75 | $2,375.00 | $665.89–$2,324.78 | 85% below | 43% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC PRO-S LAPARO CHOLECYSTECTOMY/GRAPH | $1,379.97 | $2,421.00 | $723.39–$924.04 | 85% below | 43% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 HC PRO-S REMOVAL OF GALLBLADDER | $2,017.80 | $3,540.00 | $1,074.52–$1,374.86 | 28% below | 43% |
| Hammertoe correction surgery CPT 28285 HC PRO-S REPAIR OF HAMMERTOE | $548.34 | $962.00 | $413.75–$730.38 | 80% below | 43% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC PRO-S LIGATION OF HEMORRHOID(S) | $193.80 | $340.00 | $202.55 | 85% below | 43% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HC PRO-S REMOVE INT/EXT HEM 1 GROUP | $513.00 | $900.00 | $368.72–$710.11 | 85% below | 43% |
| IUD insertion (the device itself billed separately) CPT 58300 HC PRO-S INSERT INTRAUTERINE DEVICE | $75.24 | $132.00 | $52.80 | 75% below | 43% |
| IUD insertion (the device itself billed separately) CPT 58300 HC FAC INSERTION OF IUD | $160.74 | $282.00 | $52.80–$245.43 | 47% below | 43% |
| IUD insertion (the device itself billed separately) CPT 58300 HC PRO INSERT INTRAUTERINE DEVICE | $235.41 | $413.00 | $52.80–$333.26 | 23% below | 43% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC PRO-S DRAINAGE OF SKIN ABSCESS | $110.58 | $194.00 | $113.81–$165.94 | 62% below | 43% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC FAC DRAINAGE OF SKIN ABSCESS SIMPLE/SINGLE | $182.97 | $321.00 | $113.81–$165.94 | 37% below | 43% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC WI DRAINAGE OF SKIN ABSCESS | $253.08 | $444.00 | $113.81–$439.20 | 13% below | 43% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC PRO DRAINAGE OF SKIN ABSCESS | $293.55 | $515.00 | $113.81–$439.20 | at median | 43% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC PRO-WI DRAINAGE OF SKIN ABSCESS | $314.64 | $552.00 | $113.81–$439.20 | 8% above | 43% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC PRO-ER DRAINAGE OF SKIN ABSCESS | $314.64 | $552.00 | $113.81–$439.20 | 8% above | 43% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC PRO-S PRP I/HERN INIT REDUC >5 YR | $900.60 | $1,580.00 | $530.29–$674.31 | 86% below | 43% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC PRO-S INJ TENDON SHEATH/LIGAMENT | $75.24 | $132.00 | $40.26–$74.75 | 78% below | 43% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC FAC INJECTION 1 TENDON SHEATH/LIGAMENT APONEURO | $83.79 | $147.00 | $40.26–$74.75 | 75% below | 43% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC PRO INJ TENDON SHEATH/LIGAMENT | $166.44 | $292.00 | $40.26–$197.89 | 51% below | 43% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS | $542.64 | $952.00 | $40.26–$197.89 | 59% above | 43% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PRO-S DRAIN/INJ MAJ JOINT/BURSA W/O US | $110.01 | $193.00 | $46.76–$84.64 | 75% below | 43% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC FAC INJECT/ASP MAJOR JOINT | $136.80 | $240.00 | $46.76–$222.60 | 68% below | 43% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PRO DRAIN/INJ MAJ JOINT/BURSA W/O US | $258.21 | $453.00 | $46.76–$222.60 | 40% below | 43% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PRO-ER DRAIN/INJ MAJ JOINT/BURSA W/O US | $473.67 | $831.00 | $46.76–$222.60 | 9% above | 43% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC INJECT/ASP MAJOR JOINT | $939.93 | $1,649.00 | $46.76–$222.60 | 117% above | 43% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC PRO-S INSERTION DRUG DLVR IMPLANT | $140.22 | $246.00 | $63.65–$136.95 | 47% below | 43% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC PRO-S DRAIN/INJ INTERM JOINT/BURSA W/O US | $85.50 | $150.00 | $38.24–$71.79 | 73% below | 43% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC FAC INJECT/ASP MEDIUM JOINT | $102.60 | $180.00 | $38.24–$172.19 | 68% below | 43% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC PRO DRAIN/INJ INTERM JOINT/BURSA W/O US | $193.80 | $340.00 | $38.24–$188.44 | 39% below | 43% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC PRO-ER DRAIN/INJ INTERM JOINT/BURSA W/O US | $473.67 | $831.00 | $38.24–$188.44 | 48% above | 43% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC INJECT/ASP MEDIUM JOINT | $843.60 | $1,480.00 | $38.24–$188.44 | 164% above | 43% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC PRO-S DRAIN/INJ SM JOINT/BURSA W/O US | $78.09 | $137.00 | $37.13–$68.98 | 79% below | 43% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC FAC INJECT/ASP SMALL JOINT | $94.62 | $166.00 | $37.13–$165.48 | 75% below | 43% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC PRO DRAIN/INJ SM JOINT/BURSA W/O US | $179.55 | $315.00 | $37.13–$181.88 | 52% below | 43% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC INJECT/ASP SMALL JOINT | $650.37 | $1,141.00 | $37.13–$181.88 | 75% above | 43% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 HC PRO-S KNEE ARTHROSCOPY/SURGERY | $1,254.00 | $2,200.00 | $717.67–$908.35 | 82% below | 43% |
| Knee arthroscopy with meniscus trim CPT 29881 HC PRO-S KNEE SURGERY; MENISCECTOMY | $1,079.58 | $1,894.00 | $567.30–$714.17 | 78% below | 43% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 HC PRO-S KNEE SURGERY; MENISCECTOMY | $1,039.11 | $1,823.00 | $588.13–$740.45 | 81% below | 43% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 HC PRO-S KNEE SURGERY; CHONDROPLASTY | $951.90 | $1,670.00 | $648.54–$817.73 | 69% below | 43% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 HC PRO-S LAPAROSCOPY APPENDECTOMY | $1,072.74 | $1,882.00 | $609.18–$776.10 | 76% below | 43% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 HC PRO-S LAPAROSCOPY FUNDOPLASTY | $2,101.02 | $3,686.00 | $1,075.97–$1,382.12 | 23% below | 43% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 HC PRO-S LAP ING HERNIA REPAIR INIT | $713.07 | $1,251.00 | $440.73–$558.61 | 74% below | 43% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 HC PRO-S LAP ING HERNIA REPAIR RECUR | $935.37 | $1,641.00 | $574.55–$727.13 | 87% below | 43% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC PRO-S INTMD RPR S/A/T/EXT 2.5 CM/< | $144.78 | $254.00 | $159.35 | 73% below | 43% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC FAC INTMD RPR S/A/T/EXT 2.5 CM/< | $388.17 | $681.00 | $159.35–$356.24 | 26% below | 43% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC PRO-ER INTMD RPR S/A/T/EXT 2.5 CM/< | $473.67 | $831.00 | $159.35–$704.14 | 10% below | 43% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC PRO INTMD RPR S/A/T/EXT 2.5 CM/< | $532.38 | $934.00 | $159.35–$912.60 | 1% above | 43% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC PRO INJ EPI LUM/SAC W/IMG | $668.61 | $1,173.00 | $104.29–$933.45 | 42% below | 43% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC NJX INTERLAMINAR LMBR/SAC W IMG | $1,946.55 | $3,415.00 | $104.29–$933.45 | 70% above | 43% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC PRO INJ EPI LUM/SAC W/O IMG | $668.61 | $1,173.00 | $82.72–$546.38 | 19% below | 43% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX INTERLAMINAR LMBR/SAC W/O IMG | $1,268.82 | $2,226.00 | $82.72–$546.38 | 54% above | 43% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC PRO INJ TRANSEPI LUM/SAC SGL | $836.76 | $1,468.00 | $117.30–$862.20 | 22% below | 43% |
| Lumpectomy (partial mastectomy) CPT 19301 HC PRO-S PARTIAL MASTECTOMY | $983.25 | $1,725.00 | $667.57–$849.20 | 69% below | 43% |
| Mastectomy (total removal of the breast) CPT 19303 HC PRO-S MASTECTOMY SIMPLE COMPLETE | $1,557.24 | $2,732.00 | $966.47–$1,232.56 | 78% below | 43% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC PRO-S EXC TR-EXT B9+MARG 0.5 CM< | $72.96 | $128.00 | $89.62 | 79% below | 43% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC FAC EXC TR-EXT B9+MARG 0.5 CM< | $205.77 | $361.00 | $89.62–$173.49 | 41% below | 43% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC PRO EXC TR-EXT B9+MARG 0.5 CM< | $278.73 | $489.00 | $89.62–$455.40 | 20% below | 43% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC PRO-S EXC FACE-MM B9+MARG 0.5 CM/< | $90.06 | $158.00 | $114.72 | 83% below | 43% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC PRO EXC FACE-MM B9+MARG 0.5 CM/< | $341.43 | $599.00 | $114.72–$507.79 | 34% below | 43% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC PRO-ER EXC FACE-MM B9+MARG 0.5 CM/< | $1,200.42 | $2,106.00 | $114.72–$507.79 | 133% above | 43% |
| Nail removal (partial or complete), one nail CPT 11730 HC PRO-S REMOVAL OF NAIL PLATE | $84.36 | $148.00 | $56.67 | 64% below | 43% |
| Nail removal (partial or complete), one nail CPT 11730 HC FAC AVUL NAIL PLAT PART/CMPL SMPL; | $174.42 | $306.00 | $56.67–$258.55 | 26% below | 43% |
| Nail removal (partial or complete), one nail CPT 11730 HC PRO REMOVAL OF NAIL PLATE | $258.78 | $454.00 | $56.67–$402.90 | 10% above | 43% |
| Nail removal (partial or complete), one nail CPT 11730 HC PRO-ER REMOVAL OF NAIL PLATE | $305.52 | $536.00 | $56.67–$402.90 | 30% above | 43% |
| Occipital nerve block (injection for headaches) CPT 64405 HC PRO INJ GREATER OCC NERVE | $372.21 | $653.00 | $52.75–$254.51 | 19% below | 43% |
| Occipital nerve block (injection for headaches) CPT 64405 HC INJECT GREATER OCCIPITAL | $420.66 | $738.00 | $52.75–$254.51 | 9% below | 43% |
| Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W/IMAGING | $1,455.78 | $2,554.00 | $109.86–$1,097.93 | 13% above | 43% |
| Partial knee replacement (one compartment) CPT 27446 HC PRO-S REVISION OF KNEE JOINT | $1,950.54 | $3,422.00 | $1,179.68–$1,506.93 | 65% below | 43% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC PRO-S REMOVAL OF NAIL BED | $188.67 | $331.00 | $108.68–$219.87 | 42% below | 43% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC FAC EXC NAIL&MATRIX PART/CMPL PERM | $347.13 | $609.00 | $108.68–$572.25 | 6% above | 43% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC PRO REMOVAL OF NAIL BED | $535.80 | $940.00 | $108.68–$572.25 | 64% above | 43% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC PRO DEST FAC NRV LUM/SAC SGL | $3,439.95 | $6,035.00 | $203.01–$1,513.20 | 39% above | 43% |
| Removal of a breast lump, open surgery CPT 19120 HC PRO-S EXC BRST CYST TUMR/LES OPN M/F | $540.93 | $949.00 | $426.88–$677.26 | 73% below | 43% |
| Removal of a foreign object under the skin, simple CPT 10120 HC PRO-S REMOVE FOREIGN BODY | $110.01 | $193.00 | $112.27 | 67% below | 43% |
| Removal of a foreign object under the skin, simple CPT 10120 HC FAC REMOVE FOREIGN BODY SIMPLE | $268.47 | $471.00 | $112.27–$206.12 | 20% below | 43% |
| Removal of a foreign object under the skin, simple CPT 10120 HC PRO REMOVE FOREIGN BODY | $377.91 | $663.00 | $112.27–$550.95 | 12% above | 43% |
| Removal of a foreign object under the skin, simple CPT 10120 HC PRO-ER REMOVE FOREIGN BODY | $630.99 | $1,107.00 | $112.27–$550.95 | 88% above | 43% |
| Removal of a foreign object under the skin, simple CPT 10120 HC PRO-WI REMOVE FOREIGN BODY | $630.99 | $1,107.00 | $112.27–$550.95 | 88% above | 43% |
| Removal of one lobe of the thyroid (lobectomy) CPT 60220 HC PRO-S PARTIAL REMOVAL OF THYROID | $1,412.46 | $2,478.00 | $728.31–$920.02 | 46% below | 43% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC PRO-S COLON CA SCRN NOT HI RISK IND | $372.21 | $653.00 | $164.42–$467.19 | 81% below | 43% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC PRO-S COLORECTAL SCRN; HI RISK IND | $372.78 | $654.00 | $164.42–$467.05 | 80% below | 43% |
| Septoplasty to straighten the nasal septum CPT 30520 HC FAC REPAIR OF NASAL SEPTUM | $1,235.76 | $2,168.00 | $715.89–$899.47 | 66% below | 43% |
| Short arm cast (elbow to hand) CPT 29075 HC PRO-S APPLY FOREARM CAST | $90.06 | $158.00 | $65.17–$114.34 | 64% below | 43% |
| Short arm cast (elbow to hand) CPT 29075 HC FAC APPLY CAST; ELBOW TO FINGER | $182.97 | $321.00 | $65.17–$306.38 | 27% below | 43% |
| Short arm cast (elbow to hand) CPT 29075 HC PRO APPLY FOREARM CAST | $273.03 | $479.00 | $65.17–$306.38 | 8% above | 43% |
| Short arm splint (forearm and hand) CPT 29125 HC APPLY FOREARM SPLINT | $156.18 | $274.00 | $42.23–$229.58 | 11% below | 43% |
| Short arm splint (forearm and hand) CPT 29125 HC PRO-WI APPLY FOREARM SPLINT | $305.52 | $536.00 | $42.23–$229.58 | 74% above | 43% |
| Short arm splint (forearm and hand) CPT 29125 HC PRO-ER APPLY FOREARM SPLINT | $305.52 | $536.00 | $42.23–$229.58 | 74% above | 43% |
| Short leg cast (below the knee) CPT 29405 HC PRO-S APPLY SHORT LEG CAST | $102.03 | $179.00 | $61.40–$105.38 | 57% below | 43% |
| Short leg cast (below the knee) CPT 29405 HC FAC APPLY SHORT LEG CAST | $172.14 | $302.00 | $61.40–$285.60 | 27% below | 43% |
| Short leg cast (below the knee) CPT 29405 HC PRO APPLY SHORT LEG CAST | $274.17 | $481.00 | $61.40–$285.60 | 17% above | 43% |
| Short leg splint (calf to foot) CPT 29515 HC PRO-S APPLY LOWER LEG SPLINT | $84.36 | $148.00 | $52.12–$93.39 | 59% below | 43% |
| Short leg splint (calf to foot) CPT 29515 HC FAC APPLICATION OF LOWER LEG SPLINT | $137.37 | $241.00 | $52.12–$228.93 | 34% below | 43% |
| Short leg splint (calf to foot) CPT 29515 HC PRO APPLY LOWER LEG SPLINT | $221.73 | $389.00 | $52.12–$253.88 | 7% above | 43% |
| Short leg splint (calf to foot) CPT 29515 HC PRO-ER APPLY LOWER LEG SPLINT | $305.52 | $536.00 | $52.12–$253.88 | 47% above | 43% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 HC PRO-S SHOULDER ARTHROSCOPY SURGERY | $1,022.58 | $1,794.00 | $707.71–$891.18 | 70% below | 43% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HC PRO-S SHO ARTHRS SRG DECOMPRESSION | $1,353.18 | $2,374.00 | $173.24–$620.93 | 38% below | 43% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC PRO-S RPR S/N/AX/GEN/TRNK 2.5CM/< | $88.35 | $155.00 | $45.42–$124.66 | 73% below | 43% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC FAC RPR S/N/AX/GEN/TRNK 2.5CM/< | $182.40 | $320.00 | $45.42–$203.05 | 44% below | 43% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC PRO-ER RPR S/N/AX/GEN/TRNK 2.5CM/< | $207.48 | $364.00 | $45.42–$324.41 | 36% below | 43% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC PRO RPR S/N/AX/GEN/TRNK 2.5CM/< | $270.75 | $475.00 | $45.42–$324.41 | 17% below | 43% |
| Skin biopsy, punch, one lesion CPT 11104 HC PRO-S PUNCH BX SKIN SINGLE LESION | $72.96 | $128.00 | $48.59 | 70% below | 43% |
| Skin biopsy, punch, one lesion CPT 11104 HC FAC PUNCH BX SKIN SINGLE LESION | $238.26 | $418.00 | $48.59–$229.22 | 1% below | 43% |
| Skin biopsy, punch, one lesion CPT 11104 HC PRO PUNCH BX SKIN SINGLE LESION | $310.65 | $545.00 | $48.59–$456.60 | 29% above | 43% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC PRO-S EXCSN MAL LESION TRK/ARM/LEG 0.5 CM/< | $238.83 | $419.00 | $128.78–$270.41 | 35% below | 43% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC PRO EXCSN MAL LESION TRK/ARM/LEG 0.5 CM/< | $510.15 | $895.00 | $128.78–$713.96 | 39% above | 43% |
| Skin tag removal, up to 15 tags CPT 11200 HC PRO-S REMOVAL OF SKIN TAGS <W/15 | $66.69 | $117.00 | $81.63 | 53% below | 43% |
| Skin tag removal, up to 15 tags CPT 11200 HC FAC REMV SKIN TAGS; TO & INCL 15 L | $135.66 | $238.00 | $81.63–$120.51 | 4% below | 43% |
| Skin tag removal, up to 15 tags CPT 11200 HC PRO REMOVAL OF SKIN TAGS <W/15 | $202.35 | $355.00 | $81.63–$321.68 | 43% above | 43% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC PRO SPINAL LUMBAR PUNCTURE | $514.71 | $903.00 | $63.44–$504.71 | 15% below | 43% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC LUMBAR PUNCTURE | $975.27 | $1,711.00 | $63.44–$504.71 | 61% above | 43% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC PRO-ER SPINAL LUMBAR PUNCTURE | $1,016.31 | $1,783.00 | $63.44–$504.71 | 68% above | 43% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC PRO-S RPR S/N/AX/GEN/TRNK2.6-7.5CM | $120.27 | $211.00 | $59.49–$150.30 | 40% below | 43% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC PRO-ER RPR S/N/AX/GEN/TRNK2.6-7.5CM | $250.23 | $439.00 | $59.49–$395.06 | 24% above | 43% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC PRO RPR S/N/AX/GEN/TRNK2.6-7.5CM | $325.47 | $571.00 | $59.49–$395.06 | 61% above | 43% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC PRO-S RPR F/E/E/N/L/M 2.5 CM/< | $112.86 | $198.00 | $56.04–$150.11 | 64% below | 43% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC FAC RPR F/E/E/N/L/M 2.5 CM/< | $212.04 | $372.00 | $56.04–$250.80 | 31% below | 43% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC FAC SIMP REP FACE < 2.5 CM | $304.38 | $534.00 | $56.04–$394.13 | 2% below | 43% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC PRO-ER RPR F/E/E/N/L/M 2.5 CM/< | $318.06 | $558.00 | $56.04–$394.13 | 3% above | 43% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC PRO RPR F/E/E/N/L/M 2.5 CM/< | $325.47 | $571.00 | $56.04–$394.13 | 5% above | 43% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC PRO-S TANGENTIAL BX SKIN SINGLE LES | $58.14 | $102.00 | $39.38 | 76% below | 43% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC FAC TANGENTIAL BX SKIN SINGLE LES | $190.38 | $334.00 | $39.38–$182.45 | 21% below | 43% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC PRO TANGENTIAL BX SKIN SINGLE LES | $247.95 | $435.00 | $39.38–$362.51 | 3% above | 43% |
| Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS W IMAGING | $1,658.70 | $2,910.00 | $112.68–$1,136.18 | 38% above | 43% |
| Total hip replacement CPT 27130 HC PRO-S TOTAL HIP ARTHROPLASTY | $2,561.01 | $4,493.00 | $1,315.64–$1,676.50 | 29% below | 43% |
| Total knee replacement CPT 27447 HC PRO-S TOTAL KNEE ARTHROPLASTY | $2,739.99 | $4,807.00 | $1,313.97–$1,674.83 | 56% below | 43% |
| Total knee replacement CPT 27447 HC PRO TOTAL KNEE ARTHROPLASTY | $4,798.83 | $8,419.00 | $1,313.97–$4,825.43 | 24% below | 43% |
| Total shoulder replacement CPT 23472 HC PRO-S RECONSTRUCT SHOULDER JOINT | $2,660.19 | $4,667.00 | $1,482.79–$1,892.13 | 56% below | 43% |
| Total thyroid removal (thyroidectomy) CPT 60240 HC PRO-S REMOVAL OF THYROID | $1,849.65 | $3,245.00 | $937.31–$1,189.41 | 45% below | 43% |
| Trigger finger release surgery CPT 26055 HC PRO-S INCISE FINGER TENDON SHEATH | $325.47 | $571.00 | $311.61 | 78% below | 43% |
| Trigger finger release surgery CPT 26055 HC FAC INCISE FINGER TENDON SHEATH | $1,419.87 | $2,491.00 | $311.61–$1,980.08 | 6% below | 43% |
| Trigger finger release surgery CPT 26055 HC PRO INCISE FINGER TENDON SHEATH | $1,745.34 | $3,062.00 | $311.61–$1,980.08 | 16% above | 43% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC PRO-S INJ TRIGGER POINT 1/2 MUSCL | $67.26 | $118.00 | $38.44–$72.20 | 81% below | 43% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC FAC INJ TRIGGER POINT 1/2 MUSCL | $83.22 | $146.00 | $38.44–$72.20 | 77% below | 43% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC PRO INJ TRIGGER POINT 1/2 MUSCL | $155.04 | $272.00 | $38.44–$201.11 | 56% below | 43% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ TRIGGER POINT 1/2 MUSCL | $457.71 | $803.00 | $38.44–$201.11 | 29% above | 43% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC PRO-ER INJ TRIGGER POINT 1/2 MUSCL | $473.67 | $831.00 | $38.44–$201.11 | 33% above | 43% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST 1ST LESION US IMAG | $5,641.86 | $9,898.00 | $158.89–$2,198.18 | 179% above | 43% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC PRO-S EGD BIOPSY SINGLE/MULTIPLE | $241.68 | $424.00 | $143.11 | 85% below | 43% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 HC PRO-S UPPER GI SCOPE W/SUBMUC INJ | $242.25 | $425.00 | $143.11 | 84% below | 43% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC PRO-S EGD GUIDE WIRE INSERTION | $149.91 | $263.00 | $171.45 | 92% below | 43% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC PRO-S EGD DIAGNOSTIC BRUSH WASH | $234.27 | $411.00 | $126.80–$408.97 | 84% below | 43% |
| Wart removal, up to 14 warts CPT 17110 HC PRO-S DESTRUCT BENIGN LESION 1-14 | $47.31 | $83.00 | $73.34 | 76% below | 43% |
| Wart removal, up to 14 warts CPT 17110 HC FAC DESTRUC WART MOLLUSC/MILIA; UP | $165.30 | $290.00 | $73.34–$153.33 | 16% below | 43% |
| Wart removal, up to 14 warts CPT 17110 HC PRO DESTRUCT BENIGN LESION 1-14 | $212.61 | $373.00 | $73.34–$317.31 | 8% above | 43% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC PRO-S DEB SUBQ TISSUE 20 SQ CM/< | $69.54 | $122.00 | $63.16 | 87% below | 43% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC FAC DEB SUBQ TISSUE >20 SQ CM | $176.13 | $309.00 | $63.16–$283.62 | 67% below | 43% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC PRO DEB SUBQ TISSUE 20 SQ CM/< | $245.67 | $431.00 | $63.16–$283.62 | 54% below | 43% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE SKIN/TISSUE 20 SQ CM/< | $601.92 | $1,056.00 | $63.16–$455.29 | 13% above | 43% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC PRO-ER DEB SUBQ TISSUE >20 SQ CM | $630.99 | $1,107.00 | $63.16–$455.29 | 18% above | 43% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC PRO-S TREAT FX RAD EXTRA-ARTICUL | $1,072.17 | $1,881.00 | $778.03–$973.28 | 88% below | 43% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION SERVICE | $378.48 | $664.00 | $44.61–$125.44 | 35% below | 43% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC FAC PRESS/NONPRESS INHAL AC OBST T | $53.01 | $93.00 | $8.33–$57.12 | 39% below | 43% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC PRO AIRWAY INHALATION TREATMENT | $54.15 | $95.00 | $8.33–$57.12 | 37% below | 43% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TREATMENT | $144.21 | $253.00 | $8.33–$57.12 | 67% above | 43% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TREATMENT-RESP | $144.21 | $253.00 | $8.33–$57.12 | 67% above | 43% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC WI AIRWAY INHALATION TREATMENT | $144.21 | $253.00 | $8.33–$57.12 | 67% above | 43% |
| Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO INFUSION INITIAL UP TO 1 HR | $558.03 | $979.00 | $137.25–$468.16 | at median | 43% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC FAC COMPREHENSIVE HEARING TEST | $37.05 | $65.00 | $34.03–$51.98 | 76% below | 43% |
| Critical care, first 30 to 74 minutes CPT 99291 HC PRO CRITICAL CARE FIRST HOUR | $493.05 | $865.00 | $222.55–$608.98 | 72% below | 43% |
| Critical care, first 30 to 74 minutes CPT 99291 HC PRO-ER CRITICAL CARE FIRST HOUR | $1,156.53 | $2,029.00 | $222.55–$1,957.00 | 35% below | 43% |
| Critical care, first 30 to 74 minutes CPT 99291 HC ER CRITICAL CARE 1ST HOUR | $2,368.35 | $4,155.00 | $222.55–$3,992.00 | 33% above | 43% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE/DROWSY | $375.63 | $659.00 | $60.15–$432.22 | 44% below | 43% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC PRO EEG AWAKE & DROWSY | $872.10 | $1,530.00 | $60.15–$1,192.94 | 30% above | 43% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG | $177.27 | $311.00 | $6.55–$27.01 | 20% above | 43% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC PRO-ER EMERGENCY DEPT VISIT LEVEL 1 | $111.15 | $195.00 | $11.83–$180.00 | 41% below | 43% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER CARE LEVEL I | $117.42 | $206.00 | $11.83–$180.00 | 37% below | 43% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC PRO-ER EMERGENCY DEPT VISIT LEVEL 2 | $233.70 | $410.00 | $43.40–$320.00 | 28% below | 43% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER CARE LEVEL II | $262.77 | $461.00 | $43.40–$431.00 | 19% below | 43% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC PRO-ER EMERGENCY DEPT VISIT LEVEL 3 | $349.98 | $614.00 | $73.88–$141.68 | 41% below | 43% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER CARE LEVEL III | $411.54 | $722.00 | $73.88–$141.68 | 31% below | 43% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC PRO-ER EMERGENCY DEPT VISIT LEVEL 4 | $656.07 | $1,151.00 | $125.71–$258.63 | 29% below | 43% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER CARE LEVEL IV | $675.45 | $1,185.00 | $125.71–$258.63 | 27% below | 43% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC PRO-ER EMERGENCY DEPT VISIT LEVEL 5 | $963.87 | $1,691.00 | $182.14–$375.41 | 34% below | 43% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER CARE LEVEL V | $1,304.73 | $2,289.00 | $182.14–$1,957.00 | 11% below | 43% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC SEXUAL ASSAULT FACILITY | $1,957.38 | $3,434.00 | $182.14–$3,383.00 | 33% above | 43% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIOVASCULAR STRESS TEST | $437.76 | $768.00 | $39.85–$109.21 | 45% below | 43% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV INITIAL HYDRATION 31 MIN-1 HR | $439.47 | $771.00 | $34.65–$110.66 | 54% above | 43% |
| IV infusion of a medicine, first hour CPT 96365 HC IV INITIAL INFUS 1ST HR THER/PROPH/DIAG | $433.77 | $761.00 | $66.48–$229.00 | 37% above | 43% |
| IV push of a medicine, first drug CPT 96374 HC INJ INITIAL IV PUSH THER/PROPH/DIAG | $189.24 | $332.00 | $39.07–$128.10 | 15% above | 43% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC FAC SC/IM THER/PROPJ/DIAG | $64.41 | $113.00 | $15.38–$46.61 | 20% below | 43% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ SC/IM THER/PROPH/DIAG | $129.39 | $227.00 | $15.38–$46.61 | 61% above | 43% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PRO-S PSYCH DIAGNOSTIC EVALUATION | $277.02 | $486.00 | $161.88–$476.78 | 26% above | 43% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PRO PSYCH DIAGNOSTIC EVALUATION | $371.64 | $652.00 | $161.88–$476.78 | 69% above | 43% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC PRO NERVE CONDUCTION STUDIES 7-8 | $477.09 | $837.00 | $111.59–$632.23 | 50% below | 43% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC NERVE CONDUCTION STUDIES 7-8 STUDIES | $1,189.59 | $2,087.00 | $111.59–$632.23 | 24% above | 43% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC PT NEUROMUSCULAR REEDUCATION / 15 MIN | $113.43 | $199.00 | $43.05–$67.56 | 19% above | 43% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC OT NEUROMUSCULAR REEDUCATION / 15 MIN | $113.43 | $199.00 | $43.05–$67.56 | 19% above | 43% |
| New patient office visit, about 30 minutes CPT 99203 HC PRO-S OFFICE O/P NEW LOW 30 MIN OR > | $100.32 | $176.00 | $85.89–$155.18 | 49% below | 43% |
| New patient office visit, about 30 minutes CPT 99203 HC PRO OFFICE O/P NEW LOW 30 MIN OR > | $200.07 | $351.00 | $85.89–$233.80 | 1% above | 43% |
| New patient office visit, about 45 minutes CPT 99204 HC PRO-S OFFICE O/P NEW MOD 45 MIN OR > | $166.44 | $292.00 | $140.21–$264.06 | 26% below | 43% |
| New patient office visit, about 45 minutes CPT 99204 HC PRO OFFICE O/P NEW MOD 45 MIN OR > | $294.69 | $517.00 | $140.21–$357.24 | 31% above | 43% |
| New patient office visit, about 60 minutes CPT 99205 HC PRO-S OFFICE O/P NEW HI 60 MIN OR > | $210.90 | $370.00 | $190.58–$344.75 | 31% below | 43% |
| New patient office visit, about 60 minutes CPT 99205 HC PRO OFFICE O/P NEW HI 60 MIN OR > | $380.76 | $668.00 | $190.58–$451.68 | 25% above | 43% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC PRO-S OFFICE O/P NEW SF 15 MIN OR > | $62.70 | $110.00 | $49.93–$103.77 | 52% below | 43% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC PRO OFFICE O/P NEW SF 15 MIN OR > | $135.66 | $238.00 | $49.93–$164.91 | 4% above | 43% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MNT INITL INDIV 15MIN | $63.84 | $112.00 | $35.44–$95.79 | 6% above | 43% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEX | $222.30 | $390.00 | $110.00–$110.91 | 20% above | 43% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEX | $323.19 | $567.00 | $104.53–$108.93 | 2% above | 43% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEX | $223.44 | $392.00 | $104.53–$108.93 | 21% above | 43% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL MOD COMPLEX | $269.04 | $472.00 | $104.53–$108.93 | 8% above | 43% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MANUAL THERAPY 1 OR MORE REGIONS/15 MIN | $86.64 | $152.00 | $34.40–$60.72 | 11% below | 43% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC OT MANUAL THERAPY 1 OR MORE REGIONS/15 MIN | $86.64 | $152.00 | $34.40–$60.72 | 11% below | 43% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISES / 15 MIN | $98.61 | $173.00 | $37.41–$64.83 | 2% above | 43% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISES / 15 MIN | $98.61 | $173.00 | $37.41–$64.83 | 2% above | 43% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC FAC INIT PREV MED E&M NEW PT; 18-3 | $100.32 | $176.00 | $99.46 | 28% below | 43% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC PRO-S PREV VISIT NEW AGE 18-39 | $112.29 | $197.00 | $99.46–$176.03 | 20% below | 43% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC PRO PREV VISIT NEW AGE 18-39 | $212.61 | $373.00 | $99.46–$290.57 | 52% above | 43% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC FAC INIT PREV MED E&M NEW PT; 40-6 | $106.59 | $187.00 | $120.71 | 29% below | 43% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC PRO-S PREV VISIT NEW AGE 40-64 | $133.95 | $235.00 | $120.71–$203.54 | 11% below | 43% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC PRO PREV VISIT NEW AGE 40-64 | $240.54 | $422.00 | $120.71–$336.42 | 59% above | 43% |
| Preventive checkup, new patient aged 65 or older CPT 99387 HC FAC INIT PREV MED E&M NEW PT; 65 Y | $122.55 | $215.00 | $129.66 | 31% below | 43% |
| Preventive checkup, new patient aged 65 or older CPT 99387 HC PRO-S PREV VISIT NEW AGE 65+ | $151.62 | $266.00 | $129.66–$264.87 | 15% below | 43% |
| Preventive checkup, new patient aged 65 or older CPT 99387 HC PRO PREV VISIT NEW AGE 65+ | $274.17 | $481.00 | $129.66–$364.99 | 54% above | 43% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 HC FAC PRD PREV MED E&M EST PT; 18-39 | $87.21 | $153.00 | $90.86 | 44% below | 43% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 HC PRO-S PREV VISIT EST AGE 18-39 | $102.60 | $180.00 | $90.86–$158.84 | 34% below | 43% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 HC PRO PREV VISIT EST AGE 18-39 | $189.81 | $333.00 | $90.86–$262.25 | 22% above | 43% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 HC FAC PRD PREV MED E&M EST PT; 40-64 | $90.06 | $158.00 | $98.72 | 47% below | 43% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 HC PRO-S PREV VISIT EST AGE 40-64 | $107.73 | $189.00 | $98.72–$169.07 | 36% below | 43% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 HC PRO PREV VISIT EST AGE 40-64 | $197.22 | $346.00 | $98.72–$278.88 | 17% above | 43% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 HC FAC PRD PREV MED E&M EST PT; 65 YR | $102.60 | $180.00 | $103.87 | 31% below | 43% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 HC PRO-S PREV VISIT EST AGE 65+ | $117.99 | $207.00 | $103.87–$181.46 | 21% below | 43% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 HC PRO PREV VISIT EST AGE 65+ | $220.59 | $387.00 | $103.87–$299.68 | 48% above | 43% |
| Psychiatric evaluation with medical services CPT 90792 HC PRO PSYCH DX EVAL W/MED SERV | $377.34 | $662.00 | $183.95–$528.09 | 37% above | 43% |
| Psychotherapy session, 30 minutes CPT 90832 HC PRO-S PSYCHOTHERAPY 30 MIN | $123.69 | $217.00 | $74.83–$177.15 | 16% above | 43% |
| Psychotherapy session, 30 minutes CPT 90832 HC PRO PSYCHOTHERAPY 30 MIN | $158.46 | $278.00 | $74.83–$232.78 | 49% above | 43% |
| Psychotherapy session, 45 minutes CPT 90834 HC PRO-S PSYCHOTHERAPY 45 MIN | $165.87 | $291.00 | $99.06–$236.30 | 17% above | 43% |
| Psychotherapy session, 45 minutes CPT 90834 HC PRO PSYCHOTHERAPY 45 MIN | $212.04 | $372.00 | $99.06–$309.61 | 50% above | 43% |
| Psychotherapy session, 60 minutes CPT 90837 HC PRO-S PSYCHOTHERAPY 60 MIN | $234.27 | $411.00 | $146.18–$354.65 | 10% above | 43% |
| Psychotherapy session, 60 minutes CPT 90837 HC PRO PSYCHOTHERAPY 60 MIN | $298.68 | $524.00 | $146.18–$464.04 | 40% above | 43% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC FAC TOBACCO CESSATION 3-10 MIN | $13.11 | $23.00 | $12.74–$20.76 | 55% below | 43% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC PRO-S BEHAV CHNG SMOKING 3-10 MIN | $15.96 | $28.00 | $12.74–$25.41 | 45% below | 43% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC PRO BEHAV CHNG SMOKING 3-10 MIN | $29.07 | $51.00 | $12.74–$33.27 | 1% above | 43% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC BEHAV CHNG SMOKING 3-10 MIN | $58.14 | $102.00 | $12.74–$33.27 | 101% above | 43% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC FAC CLINIC OFFICE/OUTPATIENT VISIT EST | $108.87 | $191.00 | $152.42 | 63% below | 43% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC PRO-WI OFFICE O/P EST HI 40 MIN OR > | $141.93 | $249.00 | $152.42–$228.54 | 52% below | 43% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC PRO-S OFFICE O/P EST HI 40 MIN OR > | $151.62 | $266.00 | $152.42–$228.54 | 49% below | 43% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC WI WALK IN LEVEL 5 | $152.19 | $267.00 | $152.42–$228.54 | 48% below | 43% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OFFICE/OUTPATIENT VISIT EST LEV 5 | $210.90 | $370.00 | $152.42–$319.23 | 29% below | 43% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC PRO OFFICE O/P EST HI 40 MIN OR > | $267.33 | $469.00 | $152.42–$319.23 | 9% below | 43% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC FAC CLINIC OFFICE/OUTPATIENT VISIT EST | $62.70 | $110.00 | $69.68–$105.09 | 62% below | 43% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PRO-WI OFFICE O/P EST LOW 20 MIN OR > | $67.26 | $118.00 | $69.68–$105.09 | 59% below | 43% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PRO-S OFFICE O/P EST LOW 20 MIN OR > | $68.40 | $120.00 | $69.68–$105.09 | 58% below | 43% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC WI WALK IN LEVEL 3 | $86.64 | $152.00 | $69.68–$105.09 | 47% below | 43% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PRO OFFICE O/P EST LOW 20 MIN OR > | $135.09 | $237.00 | $69.68–$163.26 | 18% below | 43% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OFFICE/OUTPATIENT VISIT EST LEV 3 | $149.34 | $262.00 | $69.68–$163.26 | 9% below | 43% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC FAC CLINIC OFFICE/OUTPATIENT VISIT EST | $89.49 | $157.00 | $102.92 | 52% below | 43% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC PRO-WI OFFICE O/P MOD LOW 30 MIN OR > | $102.60 | $180.00 | $102.92–$162.41 | 45% below | 43% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC PRO-S OFFICE O/P MOD LOW 30 MIN OR > | $105.45 | $185.00 | $102.92–$162.41 | 43% below | 43% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC WI WALK IN LEVEL 4 | $119.70 | $210.00 | $102.92–$162.41 | 36% below | 43% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE/OUTPATIENT VISIT EST LEV 4 | $168.15 | $295.00 | $102.92–$237.46 | 10% below | 43% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC PRO OFFICE O/P EST MOD 30 MIN OR > | $194.94 | $342.00 | $102.92–$237.46 | 5% above | 43% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC PRO-WI OFFICE O/P EST SF 10 MIN OR > | $34.20 | $60.00 | $37.18–$52.31 | 65% below | 43% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC PRO-S OFFICE O/P EST SF 10 MIN OR > | $41.04 | $72.00 | $37.18–$52.31 | 58% below | 43% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC FAC CLINIC OFFICE/OUTPATIENT VISIT EST | $48.45 | $85.00 | $37.18–$52.31 | 50% below | 43% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC WI WALK IN LEVEL 2 | $58.71 | $103.00 | $37.18–$98.51 | 39% below | 43% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC PRO OFFICE O/P EST SF 10 MIN OR > | $89.49 | $157.00 | $37.18–$98.51 | 7% below | 43% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OFFICE/OUTPATIENT VISIT EST LEV 2 | $133.38 | $234.00 | $37.18–$98.51 | 38% above | 43% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 HC FAC OFFICE CNSLT NEW/ESTAB PT | $104.88 | $184.00 | $93.80–$161.19 | 48% below | 43% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 HC PRO-S OFFICE CONSULT NEW/EST LOW | $138.51 | $243.00 | $93.80–$198.25 | 31% below | 43% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 HC PRO OFFICE CONSULT NEW/EST LOW | $243.39 | $427.00 | $93.80–$270.30 | 22% above | 43% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC FAC OFC CNSLT NEW/ESTAB PT | $140.22 | $246.00 | $142.94–$241.34 | 56% below | 43% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC PRO-S OFFICE CONSULT NEW/EST MOD | $220.02 | $386.00 | $142.94–$318.51 | 31% below | 43% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC PRO OFFICE CONSULT NEW/EST MOD | $360.24 | $632.00 | $142.94–$404.59 | 12% above | 43% |
| Speech and language evaluation CPT 92523 HC SPEECH SOUND LANGUAGE COMPREHENSION | $310.08 | $544.00 | $247.87–$316.30 | 13% below | 43% |
| Speech therapy session, individual CPT 92507 HC SPEECH/HEARING THERAPY INDIVIDUAL | $165.87 | $291.00 | $83.09–$264.72 | 35% below | 43% |
| Spirometry (breathing test) CPT 94010 HC PRO-S BREATHING CAPACITY TEST | $30.21 | $53.00 | $8.60–$39.42 | 89% below | 43% |
| Spirometry (breathing test) CPT 94010 HC FAC SPIROMTRY W/RECRD-VC-EXPIR FLO | $91.20 | $160.00 | $8.60–$115.29 | 67% below | 43% |
| Spirometry (breathing test) CPT 94010 HC PRO BREATHING CAPACITY TEST | $119.70 | $210.00 | $8.60–$115.29 | 57% below | 43% |
| Spirometry before and after a bronchodilator CPT 94060 HC BRONCHOSPASM EVAL | $396.72 | $696.00 | $10.82–$192.69 | 18% below | 43% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT THERAPEUTIC ACTIVITIES / 15 MIN | $102.60 | $180.00 | $48.01–$70.93 | 14% above | 43% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT THERAPEUTIC ACTIVITIES / 15 MIN | $102.60 | $180.00 | $48.01–$70.93 | 14% above | 43% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY | $345.99 | $607.00 | $101.00–$325.33 | 73% above | 43% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 HC FAC IIV ADJUVANT VACCINE IM | $88.35 | $155.00 | $75.20 | 31% above | 43% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC FAC VAR VACCINE LIVE SUBQ | $200.64 | $352.00 | $316.54 | 22% above | 43% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 HC FAC DTAP-IPV VACCINE 4-6 YRS IM | $57.57 | $101.00 | $72.66 | 32% below | 43% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC FAC DTAP VACCINE < 7 YRS IM | $28.50 | $50.00 | $38.27 | 31% below | 43% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HC FAC DTAP-HEP B-IPV VACCINE IM | $80.94 | $142.00 | $111.16 | 42% below | 43% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEP B VACCINE/DP(A)T-POLIO/PF SYRINGE 1 | $170.19 | $298.58 | $182.18 | 23% above | 43% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 HC FAC DTAP-IPV/HIB VACCINE IM | $125.97 | $221.00 | $214.07 | 8% above | 43% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 HC FAC RIV3 VACCINE NO PRESERV IM | $79.80 | $140.00 | $51.30 | 7% above | 43% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC FAC IIV3 VACC NO PRSV 0.5 ML IM | $23.37 | $41.00 | $21.25 | 27% below | 43% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC FAC 9VHPV VACCINE 2/3 DOSE IM | $312.93 | $549.00 | $531.93 | 2% below | 43% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HC FAC HEP A/HEP B VACC ADULT IM | $119.70 | $210.00 | $208.64 | 38% below | 43% |
| Hepatitis A vaccine, adult dose CPT 90632 HC FAC HEPA VACCINE ADULT IM | $166.44 | $292.00 | $98.11–$292.00 | 26% above | 43% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC FAC HEPA VACC PED/ADOL 2 DOSE IM | $34.20 | $60.00 | $44.10 | 34% below | 43% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC FAC HEPB VACCINE 3 DOSE ADULT IM | $59.28 | $104.00 | $79.44–$104.00 | 49% below | 43% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HC FAC HEPB VACC 2/4 DOSE ADULT IM | $196.65 | $345.00 | $224.39–$345.00 | 8% below | 43% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC FAC HEPB VACC 3 DOSE PED/ADOL IM | $30.78 | $54.00 | $41.86–$54.00 | 45% below | 43% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HC FAC IMM HIB PRP-OMP VACC 3 DOSE IM | $37.05 | $65.00 | $56.91 | 26% below | 43% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMPH B POLYSAC CONJ-MENIN/PF 7.5MCG/0.5 ML SOLUT | $70.51 | $123.71 | $56.91 | 40% above | 43% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC FAC HIB PRP-T VACCINE 4 DOSE IM | $41.04 | $72.00 | $30.82 | 2% below | 43% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC FAC IIV NO PRSV INCREASED AG IM | $79.80 | $140.00 | $102.76–$140.00 | 1% above | 43% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC QS2021-22(65YR UP)/PF 240MCG/0.7 ML SYRIN | $111.67 | $195.91 | $102.76–$195.91 | 41% above | 43% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 HC FAC INACTIVATED JE VACC IM | $422.94 | $742.00 | $504.42 | 52% above | 43% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 HC FAC MEASLES MUMPS RUBELLA | $108.87 | $191.00 | $177.19 | 29% below | 43% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC FAC MMRV LIVE | $331.74 | $582.00 | $264.00 | 31% above | 43% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC FAC MENACWYD/MENACWYCRM VACC IM | $133.38 | $234.00 | $178.19 | 42% below | 43% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HC FAC MENB-4C VACC 2 DOSE IM | $196.65 | $345.00 | $253.58 | 15% below | 43% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 HC FAC LAIV3 VACCINE INTRANASAL | $30.78 | $54.00 | $28.51 | 21% below | 43% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC FAC PNEUMOCOCCAL 13 VALENT | $258.21 | $453.00 | $361.19–$453.00 | 12% below | 43% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HC FAC PCV20 VACCINE IM | $370.50 | $650.00 | $404.12–$650.00 | 27% above | 43% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC FAC PPSV23 VACC 2 YRS+ SUBQ/IM | $137.94 | $242.00 | $186.86–$242.00 | 2% below | 43% |
| Polio vaccine, inactivated (IPV) CPT 90713 HC FAC POLIOVIRUS IPV SC/IM | $45.60 | $80.00 | $48.78 | 24% below | 43% |
| Rabies vaccine, one dose CPT 90675 HC FAC RABIES VACCINE IM | $434.91 | $763.00 | $459.97–$763.00 | 25% below | 43% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE (PCEC)/PF 2.5UNIT SUSPENSION FOR RE | $795.23 | $1,395.15 | $459.97–$1,395.15 | 37% above | 43% |
| Rabies vaccine, one dose CPT 90675 RABIES VACC, HUMAN DIPLOID/PF 2.5UNIT RECON SOLN 1 | $799.08 | $1,401.89 | $459.97–$1,401.89 | 38% above | 43% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 HC FAC RV1 VACC 2 DOSE LIVE ORAL | $170.43 | $299.00 | $222.09 | 12% above | 43% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC FAC ROTAVIRUS LIVE ORAL | $117.42 | $206.00 | $184.27 | 1% above | 43% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HC FAC HZV VACC RECOMBINANT IM | $197.79 | $347.00 | $220.09 | at median | 43% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC FAC TD VACC NO PRESV 7 YRS+ IM | $41.04 | $72.00 | $35.97–$72.00 | 1% below | 43% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS/PF SYRINGE 1 | $91.34 | $160.25 | $35.97–$160.25 | 120% above | 43% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC FAC TDAP VACCINE 7 YRS/> IM | $46.74 | $82.00 | $54.14–$82.00 | 43% below | 43% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSS(ACELL),TET VAC SUSPENSION 1 | $106.75 | $187.28 | $54.14–$187.28 | 31% above | 43% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 HC FAC TYPHOID VACCINE IM | $137.94 | $242.00 | $168.56 | 11% above | 43% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC PRO IMMUNIZATION ADMIN | $30.78 | $54.00 | $22.16–$48.27 | 20% below | 43% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMIN | $66.12 | $116.00 | $22.16–$48.27 | 71% above | 43% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC TC IMMUNIZATION ADMIN EA ADD | $15.39 | $27.00 | $15.71–$17.14 | 53% below | 43% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC PRO IMMUNIZATION ADMIN EACH ADD | $18.24 | $32.00 | $15.71–$17.14 | 44% below | 43% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADMIN EACH ADD | $40.47 | $71.00 | $15.71–$43.33 | 25% above | 43% |
| Yellow fever vaccine, live CPT 90717 HC FAC YELLOW FEVER VACCINE SUBQ | $478.80 | $840.00 | $247.47 | 178% above | 43% |
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.