Hospital

Norton Scott Hospital

Listed in its price file as “Norton HealthcareIndiana, Inc”.

Norton Scott Hospital in Scottsburg, IN publishes cash prices for 325 common procedures listed here, from its own machine-readable price file updated Jun 3, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Indiana median for 313 of 322 procedures and above it for 8. By typical cash price it ranks #4 of 84 Indiana hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

1451 N Gardner St, Scottsburg, IN 47170 Collected Sep 23, 2026 Source price file Check a bill from this hospital (812) 752-3456

Critical access hospital (rural, 25 beds or fewer) For-profit hospital Emergency department CMS star rating 2 of 5 CCN 151334 · CMS hospital register NPI 1013251594

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Abdominal CT scan without and with contrast CPT 74170 HB CT ABD W & W/O CONT	$721.80	$3,609.00	$144.34–$3,248.10	47% below	80%
Abdominal CT scan without and with contrast inpatient CPT 74170 HB CT ABD W & W/O CONT	$721.80	$3,609.00	$2,029.70–$3,248.10	—	80%
Abdominal X-ray, 2 views CPT 74019 HB ABDOMEN XR 2 VIEWS	$100.80	$504.00	$106.34–$453.60	63% below	80%
Abdominal X-ray, 2 views inpatient CPT 74019 HB ABDOMEN XR 2 VIEWS	$100.80	$504.00	$283.45–$453.60	—	80%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HB ANKLE MIN 3 VWS RT	$88.20	$441.00	$17.51–$396.90	55% below	80%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HB ANKLE MIN 3 VWS LT	$88.20	$441.00	$17.51–$396.90	55% below	80%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HB ANKLE MIN 3 VWS LT	$88.20	$441.00	$248.02–$396.90	—	80%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HB ANKLE MIN 3 VWS RT	$88.20	$441.00	$248.02–$396.90	—	80%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HB ANKLE BRACHIAL INDEX	$83.60	$418.00	$33.66–$376.20	77% below	80%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HB ANKLE BRACHIAL INDEX	$83.60	$418.00	$235.08–$376.20	—	80%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HB CT UPPER EXT W/O CONT RT	$430.80	$2,154.00	$97.76–$1,938.60	46% below	80%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HB CT UPPER EXT W/O CONT LT	$430.80	$2,154.00	$97.76–$1,938.60	46% below	80%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HB CT UPPER EXT W/O CONT RT	$430.80	$2,154.00	$1,211.41–$1,938.60	—	80%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HB CT UPPER EXT W/O CONT LT	$430.80	$2,154.00	$1,211.41–$1,938.60	—	80%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HB ESOPHAGUS	$97.80	$489.00	$48.47–$440.10	79% below	80%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HB ESOPHAGUS	$97.80	$489.00	$275.01–$440.10	—	80%
Bone scan, whole body (nuclear medicine) CPT 78306 HB NM BONE SCAN WHOLE BODY	$318.80	$1,594.00	$147.39–$1,434.60	80% below	80%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HB NM BONE SCAN WHOLE BODY	$318.80	$1,594.00	$896.47–$1,434.60	—	80%
Breast ultrasound, complete, one breast one side CPT 76641 HB ULTRASOUND BREASTCOMPLETE LT	$163.00	$815.00	$51.67–$733.50	62% below	80%
Breast ultrasound, complete, one breast one side CPT 76641 HB ULTRASOUND BREASTCOMPLETE RT	$163.00	$815.00	$51.67–$733.50	62% below	80%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HB ULTRASOUND BREASTCOMPLETE RT	$163.00	$815.00	$458.36–$733.50	—	80%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HB ULTRASOUND BREASTCOMPLETE LT	$163.00	$815.00	$458.36–$733.50	—	80%
Breast ultrasound, limited (one breast or one area) CPT 76642 HB ULTRASOUND BREAST LIMITED BIL	$220.00	$1,100.00	$39.50–$990.00	32% below	80%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HB ULTRASOUND BREAST LIMITED LT	$146.80	$734.00	$39.50–$660.60	55% below	80%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HB ULTRASOUND BREAST LIMITED RT	$146.80	$734.00	$39.50–$660.60	55% below	80%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HB ULTRASOUND BREAST LIMITED BIL	$220.00	$1,100.00	$618.64–$990.00	—	80%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HB ULTRASOUND BREAST LIMITED LT	$146.80	$734.00	$412.80–$660.60	—	80%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HB ULTRASOUND BREAST LIMITED RT	$146.80	$734.00	$412.80–$660.60	—	80%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HB CT ANGIO ABD&PELV W/O&W/DYE	$1,063.00	$5,315.00	$300.00–$4,783.50	44% below	80%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HB CT ANGIO ABD&PELV W/O&W/DYE	$1,063.00	$5,315.00	$2,989.16–$4,783.50	—	80%
CT angiography (CTA) of the head CPT 70496 HB CT ANGIO HEAD W & W/O CONTR	$762.20	$3,811.00	$178.02–$3,429.90	40% below	80%
CT angiography (CTA) of the head inpatient CPT 70496 HB CT ANGIO HEAD W & W/O CONTR	$762.20	$3,811.00	$2,143.31–$3,429.90	—	80%
CT angiography (CTA) of the neck CPT 70498 HB CT ANGIO NECK W & W/O CONT	$643.40	$3,217.00	$178.02–$2,895.30	47% below	80%
CT angiography (CTA) of the neck inpatient CPT 70498 HB CT ANGIO NECK W & W/O CONT	$643.40	$3,217.00	$1,809.24–$2,895.30	—	80%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HB CT ANGIO CHEST W& W/O CONTR	$630.20	$3,151.00	$178.02–$2,835.90	50% below	80%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HB CT ANGIO CHEST W& W/O CONTR	$630.20	$3,151.00	$1,772.12–$2,835.90	—	80%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HB CT ABD & PELVIS W/O CONTRAST	$479.20	$2,396.00	$89.84–$2,156.40	60% below	80%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HB CT ABD & PELVIS W/O CONTRAST	$479.20	$2,396.00	$1,347.51–$2,156.40	—	80%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HB CT ABDOMEN & PELVIS W/CONTRAST	$718.40	$3,592.00	$162.17–$3,232.80	58% below	80%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HB CT ABDOMEN & PELVIS W/CONTRAST	$718.40	$3,592.00	$2,020.14–$3,232.80	—	80%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HB CT ABD & PELV 1+ SECTION/REGNS	$718.40	$3,592.00	$192.64–$3,232.80	58% below	80%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HB CT ABD & PELV 1+ SECTION/REGNS	$718.40	$3,592.00	$2,020.14–$3,232.80	—	80%
CT scan of the abdomen with contrast CPT 74160 HB CT ABD W CONT	$630.20	$3,151.00	$122.78–$2,835.90	41% below	80%
CT scan of the abdomen with contrast inpatient CPT 74160 HB CT ABD W CONT	$630.20	$3,151.00	$1,772.12–$2,835.90	—	80%
CT scan of the abdomen without contrast CPT 74150 HB CT ABD W/O CONT	$499.00	$2,495.00	$65.81–$2,245.50	41% below	80%
CT scan of the abdomen without contrast inpatient CPT 74150 HB CT ABD W/O CONT	$499.00	$2,495.00	$1,403.19–$2,245.50	—	80%
CT scan of the face and sinuses, no contrast dye CPT 70486 HB CT MAXILLOFACIAL AREA W/O CONT	$499.00	$2,495.00	$104.21–$2,245.50	40% below	80%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HB CT MAXILLOFACIAL AREA W/O CONT	$499.00	$2,495.00	$1,403.19–$2,245.50	—	80%
CT scan of the head or brain, no contrast dye CPT 70450 HB CT HEAD W/O CONTRAST	$401.80	$2,009.00	$56.64–$1,808.10	47% below	80%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HB CT HEAD W/O CONTRAST	$401.80	$2,009.00	$1,129.86–$1,808.10	—	80%
CT scan of the head with contrast CPT 70460 HB CT HEAD WITH CONTRAST	$538.20	$2,691.00	$78.44–$2,421.90	37% below	80%
CT scan of the head with contrast inpatient CPT 70460 HB CT HEAD WITH CONTRAST	$538.20	$2,691.00	$1,513.42–$2,421.90	—	80%
CT scan of the head without and with contrast CPT 70470 HB BRAIN LAB CT HEAD W/WO CONTRAS	$610.40	$3,052.00	$97.02–$2,746.80	41% below	80%
CT scan of the head without and with contrast inpatient CPT 70470 HB BRAIN LAB CT HEAD W/WO CONTRAS	$610.40	$3,052.00	$1,716.44–$2,746.80	—	80%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HB CT LUMB SPINE W/O CONTR	$499.00	$2,495.00	$98.01–$2,245.50	44% below	80%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HB CT LUMB SPINE W/O CONTR	$499.00	$2,495.00	$1,403.19–$2,245.50	—	80%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HB CT CERV SPINE W/O CONTR	$512.00	$2,560.00	$99.00–$2,304.00	39% below	80%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HB CT C SPINE W/O CONT POST MYELO	$512.00	$2,560.00	$99.00–$2,304.00	39% below	80%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HB CT CERV SPINE W/O CONTR	$512.00	$2,560.00	$1,439.74–$2,304.00	—	80%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HB CT C SPINE W/O CONT POST MYELO	$512.00	$2,560.00	$1,439.74–$2,304.00	—	80%
CT scan of the pelvis, with contrast dye CPT 72193 HB CT PELVIS W CONTR	$630.20	$3,151.00	$123.28–$2,835.90	32% below	80%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HB CT PELVIS W CONTR	$630.20	$3,151.00	$1,772.12–$2,835.90	—	80%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HB DUPLEX EXTRACRANIAL BILATERAL	$208.60	$1,043.00	$97.43–$938.70	—	80%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HB DUPLEX EXTRACRANIAL BILATERAL	$208.60	$1,043.00	$586.58–$938.70	—	80%
Chest CT scan without and with contrast CPT 71270 HB CT CHEST W&W/O CONTR	$668.20	$3,341.00	$153.25–$3,006.90	38% below	80%
Chest CT scan without and with contrast inpatient CPT 71270 HB CT CHEST W&W/O CONTR	$668.20	$3,341.00	$1,878.98–$3,006.90	—	80%
Chest X-ray, 2 views CPT 71046 HB CHEST XR 2 VIEWS	$99.20	$496.00	$62.12–$446.40	52% below	80%
Chest X-ray, 2 views inpatient CPT 71046 HB CHEST XR 2 VIEWS	$99.20	$496.00	$278.95–$446.40	—	80%
Chest X-ray, single view CPT 71045 HB CHEST XR SINGLE VIEW	$45.20	$226.00	$49.72–$203.40	72% below	80%
Chest X-ray, single view inpatient CPT 71045 HB CHEST XR SINGLE VIEW	$45.20	$226.00	$127.10–$203.40	—	80%
Collarbone (clavicle) X-ray, complete one side CPT 73000 HB CLAVICLE COMPLETE LT	$73.60	$368.00	$14.53–$331.20	62% below	80%
Collarbone (clavicle) X-ray, complete one side CPT 73000 HB CLAVICLE COMPLETE RT	$73.60	$368.00	$14.53–$331.20	62% below	80%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HB CLAVICLE COMPLETE LT	$73.60	$368.00	$206.96–$331.20	—	80%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HB CLAVICLE COMPLETE RT	$73.60	$368.00	$206.96–$331.20	—	80%
Complete ultrasound of the back of the abdomen, such as both kidneys both sides CPT 76770 HB US RENAL BILATERAL	$245.40	$1,227.00	$67.05–$1,104.30	—	80%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient both sides CPT 76770 HB US RENAL BILATERAL	$245.40	$1,227.00	$690.06–$1,104.30	—	80%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HB BC BONE DENS MLT SITES AX SKEL	$170.20	$851.00	$26.92–$765.90	41% below	80%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HB BC BONE DENS MLT SITES AX SKEL	$170.20	$851.00	$478.60–$765.90	—	80%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HB BC BONE DENS PERIPHERAL	$105.20	$526.00	$11.56–$473.40	28% below	80%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HB BC BONE DENS PERIPHERAL	$105.20	$526.00	$295.82–$473.40	—	80%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HB US PREG UTRS REAL TIME 1ST GES	$237.00	$1,185.00	$62.59–$1,066.50	58% below	80%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HB US PREG UTRS REAL TIME 1ST GES	$237.00	$1,185.00	$666.44–$1,066.50	—	80%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HB CT CHEST W/O CONTR	$499.00	$2,495.00	$97.76–$2,245.50	40% below	80%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HB CT CHEST W/O CONTR	$499.00	$2,495.00	$1,403.19–$2,245.50	—	80%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HB CT CHEST W CONTR	$630.20	$3,151.00	$123.28–$2,835.90	33% below	80%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HB CT CHEST W CONTR	$630.20	$3,151.00	$1,772.12–$2,835.90	—	80%
Diagnostic mammogram, both breasts CPT 77066 HB MAMMO DIAG BIL	$132.00	$660.00	$83.89–$594.00	70% below	80%
Diagnostic mammogram, both breasts inpatient CPT 77066 HB MAMMO DIAG BIL	$132.00	$660.00	$371.18–$594.00	—	80%
Diagnostic mammogram, one breast one side CPT 77065 HB MAMMO DIAG LT	$106.40	$532.00	$65.56–$478.80	52% below	80%
Diagnostic mammogram, one breast one side CPT 77065 HB MAMMO DIAG RT	$106.40	$532.00	$65.56–$478.80	52% below	80%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HB MAMMO DIAG RT	$106.40	$532.00	$299.20–$478.80	—	80%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HB MAMMO DIAG LT	$106.40	$532.00	$299.20–$478.80	—	80%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HB DUPLEX LOW EXT ART BILAT	$170.60	$853.00	$97.43–$767.70	—	80%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HB DUPLEX LOW EXT ART BILAT	$170.60	$853.00	$479.73–$767.70	—	80%
Duplex ultrasound of the leg veins, both legs CPT 93970 HB DUPLEX EXTREMITIES COMPLETE	$552.60	$2,763.00	$189.62–$2,486.70	58% below	80%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HB DUPLEX EXTREMITIES COMPLETE	$552.60	$2,763.00	$1,553.91–$2,486.70	—	80%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HB ECHO MMODE 2D SPECTCOLOR 93306	$476.80	$2,384.00	$524.48–$2,145.60	71% below	80%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HB ECHO MMODE 2D SPECTCOLOR 93306	$476.80	$2,384.00	$1,340.76–$2,145.60	—	80%
Elbow X-ray, 2 views one side CPT 73070 HB ELBOW 1 VW LEFT	$25.80	$129.00	$14.28–$116.10	84% below	80%
Elbow X-ray, 2 views one side CPT 73070 HB ELBOW AP & LAT LT	$69.20	$346.00	$14.28–$311.40	58% below	80%
Elbow X-ray, 2 views one side CPT 73070 HB ELBOW AP & LAT RT	$69.20	$346.00	$14.28–$311.40	58% below	80%
Elbow X-ray, 2 views inpatient one side CPT 73070 HB ELBOW 1 VW LEFT	$25.80	$129.00	$72.55–$116.10	—	80%
Elbow X-ray, 2 views inpatient one side CPT 73070 HB ELBOW AP & LAT LT	$69.20	$346.00	$194.59–$311.40	—	80%
Elbow X-ray, 2 views inpatient one side CPT 73070 HB ELBOW AP & LAT RT	$69.20	$346.00	$194.59–$311.40	—	80%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HB ELBOW COMP MIN 3 VWS LT	$102.80	$514.00	$17.51–$462.60	60% below	80%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HB ELBOW COMP MIN 3 VWS RT	$102.80	$514.00	$17.51–$462.60	60% below	80%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HB ELBOW COMP MIN 3 VWS RT	$102.80	$514.00	$289.07–$462.60	—	80%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HB ELBOW COMP MIN 3 VWS LT	$102.80	$514.00	$289.07–$462.60	—	80%
Eye socket (orbit) CT scan without contrast CPT 70480 HB CT ORBITS W/O CONT	$409.60	$2,048.00	$106.34–$1,843.20	52% below	80%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HB CT ORBITS W/O CONT	$409.60	$2,048.00	$1,151.80–$1,843.20	—	80%
Facial bones X-ray, complete, 3 or more views CPT 70150 HB FACIAL BONES MIN 3 VWS	$99.20	$496.00	$20.97–$446.40	64% below	80%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HB FACIAL BONES MIN 3 VWS	$99.20	$496.00	$278.95–$446.40	—	80%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HB FOREARM 2 VIEWS LT	$69.20	$346.00	$13.79–$311.40	62% below	80%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HB FOREARM 2 VIEWS RT	$69.20	$346.00	$13.79–$311.40	62% below	80%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HB FOREARM 2 VIEWS LT	$69.20	$346.00	$194.59–$311.40	—	80%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HB FOREARM 2 VIEWS RT	$69.20	$346.00	$194.59–$311.40	—	80%
Hand X-ray, 2 views one side CPT 73120 HB HAND 1 V RT	$32.20	$161.00	$13.54–$144.90	81% below	80%
Hand X-ray, 2 views one side CPT 73120 HB HAND 1 V LT	$32.20	$161.00	$13.54–$144.90	81% below	80%
Hand X-ray, 2 views one side CPT 73120 HB HAND 2 VWS LT	$64.20	$321.00	$13.54–$288.90	63% below	80%
Hand X-ray, 2 views one side CPT 73120 HB HAND 2 VWS RT	$64.20	$321.00	$13.54–$288.90	63% below	80%
Hand X-ray, 2 views inpatient one side CPT 73120 HB HAND 1 V LT	$32.20	$161.00	$90.55–$144.90	—	80%
Hand X-ray, 2 views inpatient one side CPT 73120 HB HAND 1 V RT	$32.20	$161.00	$90.55–$144.90	—	80%
Hand X-ray, 2 views inpatient one side CPT 73120 HB HAND 2 VWS LT	$64.20	$321.00	$180.53–$288.90	—	80%
Hand X-ray, 2 views inpatient one side CPT 73120 HB HAND 2 VWS RT	$64.20	$321.00	$180.53–$288.90	—	80%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HB CALCANEUS MIN 2 VWS LT	$67.80	$339.00	$14.28–$305.10	68% below	80%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HB CALCANEUS MIN 2 VWS RT	$67.80	$339.00	$14.28–$305.10	68% below	80%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HB CALCANEUS MIN 2 VWS LT	$67.80	$339.00	$190.65–$305.10	—	80%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HB CALCANEUS MIN 2 VWS RT	$67.80	$339.00	$190.65–$305.10	—	80%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HB SLEEP STUDY UNATTENDED	$179.60	$898.00	$127.78–$808.20	56% below	80%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HB SLEEP STUDY UNATTENDED	$179.60	$898.00	$505.04–$808.20	—	80%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HB POLYSOM 4/OVER W/CPAP	$961.20	$4,806.00	$912.79–$4,325.40	70% below	80%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HB POLYSOM 4/OVER W/CPAP	$961.20	$4,806.00	$2,702.89–$4,325.40	—	80%
Knee X-ray, 3 views one side CPT 73562 HB KNEE 3 VWS LT	$114.20	$571.00	$19.24–$513.90	50% below	80%
Knee X-ray, 3 views one side CPT 73562 HB KNEE 3 VWS RT	$114.20	$571.00	$19.24–$513.90	50% below	80%
Knee X-ray, 3 views inpatient one side CPT 73562 HB KNEE 3 VWS RT	$114.20	$571.00	$321.13–$513.90	—	80%
Knee X-ray, 3 views inpatient one side CPT 73562 HB KNEE 3 VWS LT	$114.20	$571.00	$321.13–$513.90	—	80%
Knee X-ray, complete, 4 or more views one side CPT 73564 HB KNEE 4 OR MORE VWS RT	$131.80	$659.00	$22.21–$593.10	50% below	80%
Knee X-ray, complete, 4 or more views one side CPT 73564 HB KNEE 4 OR MORE VWS LT	$131.80	$659.00	$22.21–$593.10	50% below	80%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HB KNEE 4 OR MORE VWS LT	$131.80	$659.00	$370.62–$593.10	—	80%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HB KNEE 4 OR MORE VWS RT	$131.80	$659.00	$370.62–$593.10	—	80%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HB CT LOWER EXT W/O CONTR RT	$359.20	$1,796.00	$97.76–$1,616.40	54% below	80%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HB CT LOWER EXT W/O CONTR LT	$359.20	$1,796.00	$97.76–$1,616.40	54% below	80%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HB CT LOWER EXT W/O CONTR RT	$359.20	$1,796.00	$1,010.07–$1,616.40	—	80%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HB CT LOWER EXT W/O CONTR LT	$359.20	$1,796.00	$1,010.07–$1,616.40	—	80%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HB US ABDOMINAL LIMITED	$222.20	$1,111.00	$55.41–$999.90	51% below	80%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HB US ABDOMINAL LIMITED	$222.20	$1,111.00	$624.83–$999.90	—	80%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HB US XTR NON-VASC LMTD	$72.20	$361.00	$7.60–$324.90	76% below	80%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HB US XTR NON-VASC LMTD	$72.20	$361.00	$203.03–$324.90	—	80%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HB TIBIA/FIB 1V RT	$34.20	$171.00	$13.29–$153.90	83% below	80%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HB TIBIA/FIB 1V LT	$34.20	$171.00	$13.29–$153.90	83% below	80%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HB TIBIA/FIBULA AP/LAT RT	$67.80	$339.00	$13.29–$305.10	66% below	80%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HB TIBIA/FIBULA AP/LAT LT	$67.80	$339.00	$13.29–$305.10	66% below	80%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HB TIBIA/FIB 1V LT	$34.20	$171.00	$96.17–$153.90	—	80%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HB TIBIA/FIB 1V RT	$34.20	$171.00	$96.17–$153.90	—	80%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HB TIBIA/FIBULA AP/LAT RT	$67.80	$339.00	$190.65–$305.10	—	80%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HB TIBIA/FIBULA AP/LAT LT	$67.80	$339.00	$190.65–$305.10	—	80%
MR angiography (MRA) of the head without contrast CPT 70544 HB MRA HEAD W/O CONTRAST	$893.40	$4,467.00	$240.45–$4,020.30	20% below	80%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HB MRA HEAD W/O CONTRAST	$893.40	$4,467.00	$2,512.24–$4,020.30	—	80%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HB MRI LOWER EXT JOINT W/O CONTRAST RT	$893.40	$4,467.00	$129.47–$4,020.30	13% below	80%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HB MRI LOWER EXT JOINT W/O CONTRAST LT	$893.40	$4,467.00	$129.47–$4,020.30	13% below	80%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HB MRI LOWER EXT JOINT W/O CONTRAST LT	$893.40	$4,467.00	$2,512.24–$4,020.30	—	80%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HB MRI LOWER EXT JOINT W/O CONTRAST RT	$893.40	$4,467.00	$2,512.24–$4,020.30	—	80%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HB MRI LOWER EXT JOINT WO & W CONT RT	$1,030.80	$5,154.00	$262.99–$4,638.60	29% below	80%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HB MRI LOWER EXT JOINT WO & W CONT LT	$1,030.80	$5,154.00	$262.99–$4,638.60	29% below	80%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HB MRI LOWER EXT JOINT WO & W CONT RT	$1,030.80	$5,154.00	$2,898.61–$4,638.60	—	80%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HB MRI LOWER EXT JOINT WO & W CONT LT	$1,030.80	$5,154.00	$2,898.61–$4,638.60	—	80%
MRI of the abdomen without contrast CPT 74181 HB MRI ABDOMEN W/O CONTRAST	$758.00	$3,790.00	$183.97–$3,411.00	29% below	80%
MRI of the abdomen without contrast inpatient CPT 74181 HB MRI ABDOMEN W/O CONTRAST	$758.00	$3,790.00	$2,131.50–$3,411.00	—	80%
MRI of the abdomen, without and then with contrast dye CPT 74183 HB MRI ABDOMEN WO & W CONT	$1,030.80	$5,154.00	$283.55–$4,638.60	35% below	80%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HB MRI ABDOMEN WO & W CONT	$1,030.80	$5,154.00	$2,898.61–$4,638.60	—	80%
MRI of the brain, no contrast dye CPT 70551 HB MRI BRAIN W/O CONTRAST	$882.40	$4,412.00	$119.07–$3,970.80	13% below	80%
MRI of the brain, no contrast dye inpatient CPT 70551 HB MRI BRAIN W/O CONTRAST	$882.40	$4,412.00	$2,481.31–$3,970.80	—	80%
MRI of the brain, with and without contrast dye CPT 70553 HB MRI BRAIN WO & W CONT	$1,274.80	$6,374.00	$193.88–$5,736.60	2% below	80%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HB MRI BRAIN WO & W CONT	$1,274.80	$6,374.00	$3,584.74–$5,736.60	—	80%
MRI of the lower back, no contrast dye CPT 72148 HB MRI LUMBAR SPINE W/O CONTR	$893.40	$4,467.00	$117.33–$4,020.30	12% below	80%
MRI of the lower back, no contrast dye inpatient CPT 72148 HB MRI LUMBAR SPINE W/O CONTR	$893.40	$4,467.00	$2,512.24–$4,020.30	—	80%
MRI of the lower back, without and then with contrast dye CPT 72158 HB MRI LUMBAR SPINE W&W/O CONT	$1,030.80	$5,154.00	$192.89–$4,638.60	30% below	80%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HB MRI LUMBAR SPINE W&W/O CONT	$1,030.80	$5,154.00	$2,898.61–$4,638.60	—	80%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HB MRI THORACIC SPINE W/O CONT	$1,024.80	$5,124.00	$117.33–$4,611.60	2% above	80%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HB MRI THORACIC SPINE W/O CONT	$1,024.80	$5,124.00	$2,881.74–$4,611.60	—	80%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HB MRI CERV SPINE WO & W CONT	$1,030.80	$5,154.00	$194.13–$4,638.60	30% below	80%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HB MRI CERV SPINE WO & W CONT	$1,030.80	$5,154.00	$2,898.61–$4,638.60	—	80%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HB MRI CERV SPINE W/O CONTR	$1,024.80	$5,124.00	$117.33–$4,611.60	2% below	80%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HB MRI CERV SPINE W/O CONTR	$1,024.80	$5,124.00	$2,881.74–$4,611.60	—	80%
MRI of the pelvis without and with contrast CPT 72197 HB MRI PELVIS WO & W CONT	$1,030.80	$5,154.00	$282.31–$4,638.60	29% below	80%
MRI of the pelvis without and with contrast inpatient CPT 72197 HB MRI PELVIS WO & W CONT	$1,030.80	$5,154.00	$2,898.61–$4,638.60	—	80%
MRI of the pelvis, no contrast dye CPT 72195 HB MRI PELVIS W/O CONTRAST	$1,024.80	$5,124.00	$211.96–$4,611.60	3% below	80%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HB MRI PELVIS W/O CONTRAST	$1,024.80	$5,124.00	$2,881.74–$4,611.60	—	80%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HB MRI JOINT UPPER EXT W/O CONT LT	$1,024.80	$5,124.00	$129.22–$4,611.60	4% below	80%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HB MRI JOINT UPPER EXT W/O CONT RT	$1,024.80	$5,124.00	$129.22–$4,611.60	4% below	80%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HB MRI JOINT UPPER EXT W/O CONT LT	$1,024.80	$5,124.00	$2,881.74–$4,611.60	—	80%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HB MRI JOINT UPPER EXT W/O CONT RT	$1,024.80	$5,124.00	$2,881.74–$4,611.60	—	80%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HB C SPINE MIN 4 VIEWS	$127.20	$636.00	$22.95–$572.40	63% below	80%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HB C SPINE MIN 4 VIEWS	$127.20	$636.00	$357.69–$572.40	—	80%
Neck soft tissue CT scan with contrast CPT 70491 HB CT NECK W CONTRAST	$407.80	$2,039.00	$122.78–$1,835.10	58% below	80%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HB CT NECK W CONTRAST	$407.80	$2,039.00	$1,146.73–$1,835.10	—	80%
Neck soft tissue CT scan without contrast CPT 70490 HB CT NECK W/O CONTR	$401.80	$2,009.00	$97.76–$1,808.10	52% below	80%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HB CT NECK W/O CONTR	$401.80	$2,009.00	$1,129.86–$1,808.10	—	80%
Neck soft tissue X-ray CPT 70360 HB SOFT TISSUE NECK	$60.80	$304.00	$14.53–$273.60	65% below	80%
Neck soft tissue X-ray inpatient CPT 70360 HB SOFT TISSUE NECK	$60.80	$304.00	$170.97–$273.60	—	80%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HB HT MUSCLE IMAGE SPEC MULT	$872.00	$4,360.00	$280.83–$3,924.00	77% below	80%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HB HT MUSCLE IMAGE SPEC MULT	$872.00	$4,360.00	$2,452.06–$3,924.00	—	80%
Pelvic CT scan without contrast CPT 72192 HB CT PELVIS W/O CONTRAST	$499.00	$2,495.00	$67.30–$2,245.50	40% below	80%
Pelvic CT scan without contrast inpatient CPT 72192 HB CT PELVIS W/O CONTRAST	$499.00	$2,495.00	$1,403.19–$2,245.50	—	80%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HB US PELVIC NON OB LTD	$175.80	$879.00	$24.19–$791.10	51% below	80%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HB US PELVIC NON OB LTD	$175.80	$879.00	$494.35–$791.10	—	80%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HB US PELVIC NON OB COMP	$229.40	$1,147.00	$62.84–$1,032.30	51% below	80%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HB US PELVIC NON OB COMP	$229.40	$1,147.00	$645.07–$1,032.30	—	80%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HB US PELVIC OB >14WK 1ST	$237.00	$1,185.00	$67.54–$1,066.50	57% below	80%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HB US PELVIC OB >14WK 1ST	$237.00	$1,185.00	$666.44–$1,066.50	—	80%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HB US PELVIC OB	$208.60	$1,043.00	$53.92–$938.70	59% below	80%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HB US PELVIC OB	$208.60	$1,043.00	$586.58–$938.70	—	80%
Rib X-ray, one side, 2 views one side CPT 71100 HB RIBS UNILAT LT 2 VWS	$84.00	$420.00	$15.28–$378.00	59% below	80%
Rib X-ray, one side, 2 views one side CPT 71100 HB RIBS UNILAT RT 2 VWS	$84.00	$420.00	$15.28–$378.00	59% below	80%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HB RIBS UNILAT LT 2 VWS	$84.00	$420.00	$236.21–$378.00	—	80%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HB RIBS UNILAT RT 2 VWS	$84.00	$420.00	$236.21–$378.00	—	80%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HB RIBS UNILAT RT W PA CHEST MIN3	$128.40	$642.00	$18.74–$577.80	47% below	80%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HB RIBS UNILAT LT W PA CHEST MIN3	$128.40	$642.00	$18.74–$577.80	47% below	80%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HB RIBS UNILAT RT W PA CHEST MIN3	$128.40	$642.00	$361.06–$577.80	—	80%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HB RIBS UNILAT LT W PA CHEST MIN3	$128.40	$642.00	$361.06–$577.80	—	80%
Screening mammogram, both breasts CPT 77067 HB MAMMO SCREEN BIL	$109.40	$547.00	$69.28–$492.30	56% below	80%
Screening mammogram, both breasts one side CPT 77067 HB MAMMO SCREEN RT	$92.40	$462.00	$69.28–$415.80	63% below	80%
Screening mammogram, both breasts one side CPT 77067 HB MAMMO SCREEN LT	$92.40	$462.00	$69.28–$415.80	63% below	80%
Screening mammogram, both breasts inpatient CPT 77067 HB MAMMO SCREEN BIL	$109.40	$547.00	$307.63–$492.30	—	80%
Screening mammogram, both breasts inpatient one side CPT 77067 HB MAMMO SCREEN RT	$92.40	$462.00	$259.83–$415.80	—	80%
Screening mammogram, both breasts inpatient one side CPT 77067 HB MAMMO SCREEN LT	$92.40	$462.00	$259.83–$415.80	—	80%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HB SHOULDER COMP MIN 2 VW LT	$115.60	$578.00	$14.78–$520.20	45% below	80%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HB SHOULDER COMP MIN 2 VW RT	$115.60	$578.00	$14.78–$520.20	45% below	80%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HB SHOULDER COMP MIN 2 VW RT	$115.60	$578.00	$325.07–$520.20	—	80%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HB SHOULDER COMP MIN 2 VW LT	$115.60	$578.00	$325.07–$520.20	—	80%
Sinus X-ray, complete, 3 or more views CPT 70220 HB SINUS PARANASAL MIN 3 VWS	$93.20	$466.00	$18.50–$419.40	67% below	80%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HB SINUS PARANASAL MIN 3 VWS	$93.20	$466.00	$262.08–$419.40	—	80%
Skull X-ray, fewer than 4 views CPT 70250 HB SKULL UNDER 4 VIEWS	$37.40	$187.00	$17.51–$168.30	84% below	80%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HB SKULL UNDER 4 VIEWS	$37.40	$187.00	$105.17–$168.30	—	80%
Sleep study in a lab (polysomnography) CPT 95810 HB POLYSOMNOGR 4/OVR PMTR	$900.80	$4,504.00	$912.79–$4,053.60	66% below	80%
Sleep study in a lab (polysomnography) CPT 95810 HB POLYSOMNOGR 4/OVER PMTR ABORT	$900.80	$4,504.00	$912.79–$4,053.60	66% below	80%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HB POLYSOMNOGR 4/OVR PMTR	$900.80	$4,504.00	$2,533.05–$4,053.60	—	80%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HB POLYSOMNOGR 4/OVER PMTR ABORT	$900.80	$4,504.00	$2,533.05–$4,053.60	—	80%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HB EXER STRESS ECHO W CONT EKG	$595.80	$2,979.00	$548.30–$2,681.10	67% below	80%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HB STRESS ECHO COMP W CONT EKG	$595.80	$2,979.00	$548.30–$2,681.10	67% below	80%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HB EXER STRESS ECHO W CONT EKG	$595.80	$2,979.00	$1,675.39–$2,681.10	—	80%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HB STRESS ECHO COMP W CONT EKG	$595.80	$2,979.00	$1,675.39–$2,681.10	—	80%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HB MODIFIED BARIUM SWALLOW	$93.80	$469.00	$45.99–$422.10	74% below	80%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HB MODIFIED BARIUM SWALLOW	$93.80	$469.00	$263.77–$422.10	—	80%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HB X-RAY EXAM RIGHT FEMUR	$87.60	$438.00	$15.77–$394.20	56% below	80%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HB X-RAY EXAM LEFT FEMUR	$87.60	$438.00	$15.77–$394.20	56% below	80%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HB X-RAY EXAM RIGHT FEMUR	$87.60	$438.00	$246.33–$394.20	—	80%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HB X-RAY EXAM LEFT FEMUR	$87.60	$438.00	$246.33–$394.20	—	80%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HB CT T SPINE W/O CONTRAST	$403.00	$2,015.00	$98.51–$1,813.50	53% below	80%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HB CT T SPINE W/O CONTRAST	$403.00	$2,015.00	$1,133.24–$1,813.50	—	80%
Toe X-ray, 2 or more views one side CPT 73660 HB TOES MIN 2 VWS LT	$67.80	$339.00	$16.76–$305.10	56% below	80%
Toe X-ray, 2 or more views one side CPT 73660 HB TOES MIN 2 VWS RT	$67.80	$339.00	$16.76–$305.10	56% below	80%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HB TOES MIN 2 VWS RT	$67.80	$339.00	$190.65–$305.10	—	80%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HB TOES MIN 2 VWS LT	$67.80	$339.00	$190.65–$305.10	—	80%
Transvaginal pelvic ultrasound CPT 76830 HB US TRANSVAGINAL	$243.60	$1,218.00	$64.08–$1,096.20	40% below	80%
Transvaginal pelvic ultrasound inpatient CPT 76830 HB US TRANSVAGINAL	$243.60	$1,218.00	$685.00–$1,096.20	—	80%
Transvaginal ultrasound during pregnancy CPT 76817 HB US TRANSVAG PREG LTD	$255.00	$1,275.00	$44.51–$1,147.50	31% below	80%
Transvaginal ultrasound during pregnancy CPT 76817 HB US TRANSVAG PREG COMPL	$255.00	$1,275.00	$44.51–$1,147.50	31% below	80%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HB US TRANSVAG PREG COMPL	$255.00	$1,275.00	$717.06–$1,147.50	—	80%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HB US TRANSVAG PREG LTD	$255.00	$1,275.00	$717.06–$1,147.50	—	80%
Ultrasound of the abdomen, complete CPT 76700 HB US ABDOMEN COMP	$260.80	$1,304.00	$70.27–$1,173.60	50% below	80%
Ultrasound of the abdomen, complete inpatient CPT 76700 HB US ABDOMEN COMP	$260.80	$1,304.00	$733.37–$1,173.60	—	80%
Ultrasound of the scrotum and testicles CPT 76870 HB US SCROTUM/TESTICULAR	$230.60	$1,153.00	$29.15–$1,037.70	46% below	80%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HB US SCROTUM/TESTICULAR	$230.60	$1,153.00	$648.45–$1,037.70	—	80%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HB US SOFT TISSUE HEAD AND NECK	$182.20	$911.00	$65.56–$819.90	57% below	80%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HB US SOFT TISSUE HEAD AND NECK	$182.20	$911.00	$512.35–$819.90	—	80%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HB UPPER GI W/O KUB	$104.40	$522.00	$56.64–$469.80	80% below	80%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HB UPPER GI W/O KUB	$104.40	$522.00	$293.57–$469.80	—	80%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HB HUMERUS MIN 2 VWS RT	$101.20	$506.00	$14.28–$455.40	47% below	80%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HB HUMERUS 1 VIEW LT	$101.20	$506.00	$14.28–$455.40	47% below	80%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HB HUMERUS MIN 2 VWS LT	$101.20	$506.00	$14.28–$455.40	47% below	80%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HB HUMERUS 1 VIEW LT	$101.20	$506.00	$284.57–$455.40	—	80%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HB HUMERUS MIN 2 VWS RT	$101.20	$506.00	$284.57–$455.40	—	80%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HB HUMERUS MIN 2 VWS LT	$101.20	$506.00	$284.57–$455.40	—	80%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HB US DUP VENOUS EXT UP RT	$276.40	$1,382.00	$106.34–$1,243.80	56% below	80%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HB US DUP VENOUS EXT LOW RT	$276.40	$1,382.00	$106.34–$1,243.80	56% below	80%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HB US DUP VENOUS EXT UP LT	$276.40	$1,382.00	$106.34–$1,243.80	56% below	80%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HB US DUP VENOUS EXT LOW LT	$276.40	$1,382.00	$106.34–$1,243.80	56% below	80%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HB US DUP VENOUS EXT LOW LT	$276.40	$1,382.00	$777.24–$1,243.80	—	80%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HB US DUP VENOUS EXT UP RT	$276.40	$1,382.00	$777.24–$1,243.80	—	80%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HB US DUP VENOUS EXT UP LT	$276.40	$1,382.00	$777.24–$1,243.80	—	80%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HB US DUP VENOUS EXT LOW RT	$276.40	$1,382.00	$777.24–$1,243.80	—	80%
Wrist X-ray, 2 views one side CPT 73100 HB WRIST 1 V LT	$32.20	$161.00	$15.77–$144.90	79% below	80%
Wrist X-ray, 2 views one side CPT 73100 HB WRIST AP & LAT LT	$64.20	$321.00	$15.77–$288.90	59% below	80%
Wrist X-ray, 2 views one side CPT 73100 HB WRIST AP & LAT RT	$64.20	$321.00	$15.77–$288.90	59% below	80%
Wrist X-ray, 2 views inpatient one side CPT 73100 HB WRIST 1 V LT	$32.20	$161.00	$90.55–$144.90	—	80%
Wrist X-ray, 2 views inpatient one side CPT 73100 HB WRIST AP & LAT RT	$64.20	$321.00	$180.53–$288.90	—	80%
Wrist X-ray, 2 views inpatient one side CPT 73100 HB WRIST AP & LAT LT	$64.20	$321.00	$180.53–$288.90	—	80%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HB WRIST COMP MIN 3 VW RT	$109.40	$547.00	$20.48–$492.30	57% below	80%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HB WRIST COMP MIN 3 VW LT	$109.40	$547.00	$20.48–$492.30	57% below	80%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HB WRIST COMP MIN 3 VW LT	$109.40	$547.00	$307.63–$492.30	—	80%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HB WRIST COMP MIN 3 VW RT	$109.40	$547.00	$307.63–$492.30	—	80%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HB X-RAY EXAM HIP UNI 2-3 VIEWS	$119.00	$595.00	$20.73–$535.50	55% below	80%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HB X-RAY EXAM HIP UNI 2-3 VIEWS	$119.00	$595.00	$334.63–$535.50	—	80%
X-ray of the abdomen, 1 view CPT 74018 HB ABDOMEN XR SINGLE VIEW	$61.60	$308.00	$62.12–$277.20	72% below	80%
X-ray of the abdomen, 1 view inpatient CPT 74018 HB ABDOMEN XR SINGLE VIEW	$61.60	$308.00	$173.22–$277.20	—	80%
X-ray of the ankle, 2 views one side CPT 73600 HB ANKLE AP & LAT RT	$66.40	$332.00	$14.28–$298.80	58% below	80%
X-ray of the ankle, 2 views one side CPT 73600 HB ANKLE 1 VW LT	$66.40	$332.00	$14.28–$298.80	58% below	80%
X-ray of the ankle, 2 views one side CPT 73600 HB ANKLE AP & LAT LT	$66.40	$332.00	$14.28–$298.80	58% below	80%
X-ray of the ankle, 2 views one side CPT 73600 HB ANKLE 1 VW RT	$108.00	$540.00	$14.28–$486.00	32% below	80%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HB ANKLE AP & LAT LT	$66.40	$332.00	$186.72–$298.80	—	80%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HB ANKLE 1 VW LT	$66.40	$332.00	$186.72–$298.80	—	80%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HB ANKLE AP & LAT RT	$66.40	$332.00	$186.72–$298.80	—	80%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HB ANKLE 1 VW RT	$108.00	$540.00	$303.70–$486.00	—	80%
X-ray of the finger(s), 2 or more views one side CPT 73140 HB FINGERS MIN 2 VWS RT	$64.20	$321.00	$18.50–$288.90	60% below	80%
X-ray of the finger(s), 2 or more views one side CPT 73140 HB FINGERS MIN 2 VWS LT	$64.20	$321.00	$18.50–$288.90	60% below	80%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HB FINGERS MIN 2 VWS LT	$64.20	$321.00	$180.53–$288.90	—	80%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HB FINGERS MIN 2 VWS RT	$64.20	$321.00	$180.53–$288.90	—	80%
X-ray of the foot, 2 views one side CPT 73620 HB FOOT 2 VW LT	$35.40	$177.00	$13.79–$159.30	78% below	80%
X-ray of the foot, 2 views one side CPT 73620 HB FOOT 1V RT	$35.40	$177.00	$13.79–$159.30	78% below	80%
X-ray of the foot, 2 views one side CPT 73620 HB FOOT AP & LAT LT	$66.40	$332.00	$13.79–$298.80	59% below	80%
X-ray of the foot, 2 views one side CPT 73620 HB FOOT AP & LAT RT	$66.40	$332.00	$13.79–$298.80	59% below	80%
X-ray of the foot, 2 views inpatient one side CPT 73620 HB FOOT 1V RT	$35.40	$177.00	$99.54–$159.30	—	80%
X-ray of the foot, 2 views inpatient one side CPT 73620 HB FOOT 2 VW LT	$35.40	$177.00	$99.54–$159.30	—	80%
X-ray of the foot, 2 views inpatient one side CPT 73620 HB FOOT AP & LAT RT	$66.40	$332.00	$186.72–$298.80	—	80%
X-ray of the foot, 2 views inpatient one side CPT 73620 HB FOOT AP & LAT LT	$66.40	$332.00	$186.72–$298.80	—	80%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HB FOOT COMP MIN 3 VWS RT	$70.20	$351.00	$16.27–$315.90	65% below	80%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HB FOOT COMP MIN 3 VWS LT	$70.20	$351.00	$16.27–$315.90	65% below	80%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HB FOOT COMP MIN 3 VWS LT	$70.20	$351.00	$197.40–$315.90	—	80%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HB FOOT COMP MIN 3 VWS RT	$70.20	$351.00	$197.40–$315.90	—	80%
X-ray of the hand, 3 or more views one side CPT 73130 HB HAND MIN 3 VWS RT	$66.40	$332.00	$17.01–$298.80	67% below	80%
X-ray of the hand, 3 or more views one side CPT 73130 HB HAND MIN 3 VWS LT	$66.40	$332.00	$17.01–$298.80	67% below	80%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HB HAND MIN 3 VWS RT	$66.40	$332.00	$186.72–$298.80	—	80%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HB HAND MIN 3 VWS LT	$66.40	$332.00	$186.72–$298.80	—	80%
X-ray of the knee, 1 or 2 views one side CPT 73560 HB KNEE 1-2 VIEWS RT	$99.80	$499.00	$15.03–$449.10	52% below	80%
X-ray of the knee, 1 or 2 views one side CPT 73560 HB KNEE 1-2 VIEWS LT	$99.80	$499.00	$15.03–$449.10	52% below	80%
X-ray of the knee, 1 or 2 views one side CPT 73560 HB KNEE 2 VWS LT	$100.00	$500.00	$15.03–$450.00	52% below	80%
X-ray of the knee, 1 or 2 views one side CPT 73560 HB KNEE 2 VWS RT	$100.00	$500.00	$15.03–$450.00	52% below	80%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HB KNEE 1-2 VIEWS LT	$99.80	$499.00	$280.64–$449.10	—	80%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HB KNEE 1-2 VIEWS RT	$99.80	$499.00	$280.64–$449.10	—	80%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HB KNEE 2 VWS LT	$100.00	$500.00	$281.20–$450.00	—	80%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HB KNEE 2 VWS RT	$100.00	$500.00	$281.20–$450.00	—	80%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HB L SPINE AP & LATERAL	$81.60	$408.00	$17.01–$367.20	68% below	80%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HB L SPINE AP & LATERAL	$81.60	$408.00	$229.46–$367.20	—	80%
X-ray of the lower back, 4 or more views CPT 72110 HB L SPINE COMP W OBLIQUES	$105.00	$525.00	$23.45–$472.50	70% below	80%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HB L SPINE COMP W OBLIQUES	$105.00	$525.00	$295.26–$472.50	—	80%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HB T SPINE AP & LATERAL	$136.20	$681.00	$15.77–$612.90	42% below	80%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HB T SPINE AP & LATERAL	$136.20	$681.00	$382.99–$612.90	—	80%
X-ray of the nasal bones, 3 or more views CPT 70160 HB NASAL BONES MIN 3 VWS	$65.20	$326.00	$17.75–$293.40	68% below	80%
X-ray of the nasal bones, 3 or more views CPT 70160 HB NASAL BONES AP & LAT ONLY	$65.20	$326.00	$17.75–$293.40	68% below	80%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HB NASAL BONES AP & LAT ONLY	$65.20	$326.00	$183.34–$293.40	—	80%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HB NASAL BONES MIN 3 VWS	$65.20	$326.00	$183.34–$293.40	—	80%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HB C SPINE AP & LAT 2/3 VIEWS	$69.20	$346.00	$17.01–$311.40	72% below	80%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HB C SPINE AP & LAT 2/3 VIEWS	$69.20	$346.00	$194.59–$311.40	—	80%
X-ray of the pelvis, 1 or 2 views CPT 72170 HB PELVIS 1 OR 2 VIEWS	$97.00	$485.00	$13.79–$436.50	51% below	80%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HB PELVIS 1 OR 2 VIEWS	$97.00	$485.00	$272.76–$436.50	—	80%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HB SACRUM & COCCYX MIN 2 VWS	$103.60	$518.00	$14.28–$466.20	53% below	80%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HB SACRUM & COCCYX MIN 2 VWS	$103.60	$518.00	$291.32–$466.20	—	80%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
ACTH blood test CPT 82024 HB ACTH	$39.60	$198.00	$28.03–$178.20	84% below	80%
ACTH blood test inpatient CPT 82024 HB ACTH	$39.60	$198.00	$111.36–$178.20	—	80%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HB SGPT/ALT	$18.20	$91.00	$4.50–$81.90	34% below	80%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HB FIBROSURE-SGPT (S/O)	$18.40	$92.00	$4.50–$82.80	33% below	80%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HB SGPT/ALT	$18.20	$91.00	$51.18–$81.90	—	80%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HB FIBROSURE-SGPT (S/O)	$18.40	$92.00	$51.74–$82.80	—	80%
AST (aspartate aminotransferase) enzyme test CPT 84450 HB FIBROSURE-SGOT (S/O)	$15.40	$77.00	$4.40–$69.30	47% below	80%
AST (aspartate aminotransferase) enzyme test CPT 84450 HB SGOT/AST	$17.80	$89.00	$4.40–$80.10	39% below	80%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HB FIBROSURE-SGOT (S/O)	$15.40	$77.00	$43.30–$69.30	—	80%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HB SGOT/AST	$17.80	$89.00	$50.05–$80.10	—	80%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HB ACUTE HEPATITIS PANEL	$176.80	$884.00	$40.48–$795.60	44% below	80%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HB ACUTE HEPATITIS PANEL	$176.80	$884.00	$497.16–$795.60	—	80%
Albumin blood test CPT 82040 HB ALBUMIN SERUM	$16.00	$80.00	$4.20–$72.00	30% below	80%
Albumin blood test inpatient CPT 82040 HB ALBUMIN SERUM	$16.00	$80.00	$44.99–$72.00	—	80%
Aldosterone blood test CPT 82088 HB ALDOSTERONE	$74.40	$372.00	$34.63–$334.80	64% below	80%
Aldosterone blood test inpatient CPT 82088 HB ALDOSTERONE	$74.40	$372.00	$209.21–$334.80	—	80%
Alkaline phosphatase (ALP) blood test CPT 84075 HB ALKALINE PHOSPHATASE (INH)	$17.60	$88.00	$4.40–$79.20	45% below	80%
Alkaline phosphatase (ALP) blood test CPT 84075 HB ALK PHOS (SO)	$17.60	$88.00	$4.40–$79.20	45% below	80%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HB ALKALINE PHOSPHATASE (INH)	$17.60	$88.00	$49.49–$79.20	—	80%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HB ALK PHOS (SO)	$17.60	$88.00	$49.49–$79.20	—	80%
Allergy blood test, specific IgE, per allergen CPT 86003 HB ALLERGEN IGE (INHSE)	$14.00	$70.00	$4.43–$63.00	27% below	80%
Allergy blood test, specific IgE, per allergen CPT 86003 HB ALLERGEN IGE (S/O)	$14.00	$70.00	$4.43–$63.00	27% below	80%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HB ALLERGEN IGE (INHSE)	$14.00	$70.00	$39.37–$63.00	—	80%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HB ALLERGEN IGE (S/O)	$14.00	$70.00	$39.37–$63.00	—	80%
Alpha-fetoprotein (AFP) blood test CPT 82105 HB ALPHA FETOPROTEIN	$42.40	$212.00	$14.26–$190.80	58% below	80%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HB ALPHA FETOPROTEIN	$42.40	$212.00	$119.23–$190.80	—	80%
Ammonia blood test CPT 82140 HB AMMONIA	$43.00	$215.00	$12.38–$193.50	64% below	80%
Ammonia blood test inpatient CPT 82140 HB AMMONIA	$43.00	$215.00	$120.92–$193.50	—	80%
Amylase blood test CPT 82150 HB AMYLASE	$39.60	$198.00	$5.51–$178.20	24% below	80%
Amylase blood test inpatient CPT 82150 HB AMYLASE	$39.60	$198.00	$111.36–$178.20	—	80%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HB CYCLIC CITRULLINATED AB	$35.60	$178.00	$11.00–$160.20	32% below	80%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HB CYCLIC CITRULLINATED AB	$35.60	$178.00	$100.11–$160.20	—	80%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HB ANA SCREEN	$34.00	$170.00	$10.27–$153.00	43% below	80%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HB ANA SCREEN	$34.00	$170.00	$95.61–$153.00	—	80%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HB BNP	$65.00	$325.00	$28.85–$292.50	62% below	80%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HB BNP	$65.00	$325.00	$182.78–$292.50	—	80%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB CULTURE CSF	$38.80	$194.00	$7.32–$174.60	58% below	80%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB CULTURE AEROBIC - ALLOGENEIC BONE BANK	$39.00	$195.00	$7.32–$175.50	58% below	80%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB CULTURE SPUTUM - W/GS	$103.20	$516.00	$7.32–$464.40	10% above	80%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB CULTURE THROAT	$103.20	$516.00	$7.32–$464.40	10% above	80%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB CULTURE WOUND	$103.20	$516.00	$7.32–$464.40	10% above	80%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB CULTURE CSF	$38.80	$194.00	$109.11–$174.60	—	80%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB CULTURE AEROBIC - ALLOGENEIC BONE BANK	$39.00	$195.00	$109.67–$175.50	—	80%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB CULTURE WOUND	$103.20	$516.00	$290.20–$464.40	—	80%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB CULTURE SPUTUM - W/GS	$103.20	$516.00	$290.20–$464.40	—	80%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB CULTURE THROAT	$103.20	$516.00	$290.20–$464.40	—	80%
Basic metabolic panel (blood test) CPT 80048 HB BMP W TOTAL CALCIUM	$40.20	$201.00	$5.69–$180.90	49% below	80%
Basic metabolic panel (blood test) inpatient CPT 80048 HB BMP W TOTAL CALCIUM	$40.20	$201.00	$113.04–$180.90	—	80%
Bilirubin blood test, total CPT 82247 HB BILIRUBIN TOTAL	$17.60	$88.00	$4.26–$79.20	49% below	80%
Bilirubin blood test, total CPT 82247 HB FIBROSURE-BILIRUBIN (S/O)	$17.60	$88.00	$4.26–$79.20	49% below	80%
Bilirubin blood test, total inpatient CPT 82247 HB FIBROSURE-BILIRUBIN (S/O)	$17.60	$88.00	$49.49–$79.20	—	80%
Bilirubin blood test, total inpatient CPT 82247 HB BILIRUBIN TOTAL	$17.60	$88.00	$49.49–$79.20	—	80%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HB PATH LVL IV/88305	$79.80	$399.00	$53.43–$359.10	69% below	80%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HB MSO-LEVEL IV GROSS/MICRO	$79.80	$399.00	$53.43–$359.10	69% below	80%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HB MSO-LEVEL IV GROSS/MICRO	$79.80	$399.00	$224.40–$359.10	—	80%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HB PATH LVL IV/88305	$79.80	$399.00	$224.40–$359.10	—	80%
Blood culture for bacteria CPT 87040 HB CULTURE BLOOD	$52.40	$262.00	$8.77–$235.80	60% below	80%
Blood culture for bacteria CPT 87040 HB CULTURE BLD AEROB ONLY	$52.40	$262.00	$8.77–$235.80	60% below	80%
Blood culture for bacteria inpatient CPT 87040 HB CULTURE BLOOD	$52.40	$262.00	$147.35–$235.80	—	80%
Blood culture for bacteria inpatient CPT 87040 HB CULTURE BLD AEROB ONLY	$52.40	$262.00	$147.35–$235.80	—	80%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HB SPECIMEN COLLECTION VENIPUNCT	$8.00	$40.00	$5.00–$36.00	52% below	80%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HB VENIPUNCTURE	$10.00	$50.00	$5.00–$45.00	40% below	80%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HB SPECIMEN COLLECTION VENIPUNCT	$8.00	$40.00	$22.50–$36.00	—	80%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HB VENIPUNCTURE	$10.00	$50.00	$28.12–$45.00	—	80%
Blood glucose (sugar) test CPT 82947 HB GLUCOSE BLD QUANT	$15.20	$76.00	$3.34–$68.40	43% below	80%
Blood glucose (sugar) test CPT 82947 HB FIBROSURE-GLUCOSE (S/O)	$15.40	$77.00	$3.34–$69.30	42% below	80%
Blood glucose (sugar) test inpatient CPT 82947 HB GLUCOSE BLD QUANT	$15.20	$76.00	$42.74–$68.40	—	80%
Blood glucose (sugar) test inpatient CPT 82947 HB FIBROSURE-GLUCOSE (S/O)	$15.40	$77.00	$43.30–$69.30	—	80%
Blood lead test CPT 83655 HB LEAD	$25.60	$128.00	$10.29–$115.20	64% below	80%
Blood lead test inpatient CPT 83655 HB LEAD	$25.60	$128.00	$71.99–$115.20	—	80%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HB HCG SERUM QUAL	$34.20	$171.00	$6.38–$153.90	53% below	80%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HB HCG SERUM QUAL	$34.20	$171.00	$96.17–$153.90	—	80%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HB BLOOD TYPING ABO	$18.00	$90.00	$2.54–$136.63	63% below	80%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HB REF ABO TYPE	$41.20	$206.00	$2.54–$185.40	16% below	80%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HB BLOOD TYPING ABO	$18.00	$90.00	$50.62–$81.00	—	80%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HB REF ABO TYPE	$41.20	$206.00	$115.85–$185.40	—	80%
Blood urea nitrogen (BUN) test CPT 84520 HB BUN	$15.20	$76.00	$3.35–$68.40	36% below	80%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HB BUN	$15.20	$76.00	$42.74–$68.40	—	80%
C-peptide blood test CPT 84681 HB C-PEPTIDE	$41.80	$209.00	$16.31–$188.10	70% below	80%
C-peptide blood test CPT 84681 HB C PEPTIDE	$41.80	$209.00	$16.31–$188.10	70% below	80%
C-peptide blood test inpatient CPT 84681 HB C-PEPTIDE	$41.80	$209.00	$117.54–$188.10	—	80%
C-peptide blood test inpatient CPT 84681 HB C PEPTIDE	$41.80	$209.00	$117.54–$188.10	—	80%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HB C-REACTIVE PROTEIN	$24.80	$124.00	$3.25–$111.60	64% below	80%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HB C-REACTIVE PROTEIN	$24.80	$124.00	$69.74–$111.60	—	80%
C. difficile toxin gene test (stool PCR) CPT 87493 HB CLO DIFFICILE AMP PROBE	$67.60	$338.00	$29.83–$304.20	49% below	80%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HB CLO DIFFICILE AMP PROBE	$67.60	$338.00	$190.09–$304.20	—	80%
CA 19-9 blood test (tumor marker) CPT 86301 HB CA 19 9	$43.00	$215.00	$17.69–$193.50	70% below	80%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HB CA 19 9	$43.00	$215.00	$120.92–$193.50	—	80%
CA-125 blood test (ovarian cancer marker) CPT 86304 HB CA 125	$49.00	$245.00	$17.69–$220.50	70% below	80%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HB CA 125	$49.00	$245.00	$137.79–$220.50	—	80%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HB COVID-19 NON CDC	$64.20	$321.00	$20.52–$288.90	39% below	80%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HB COVID-19 NON CDC	$64.20	$321.00	$51.31–$288.90	—	80%
Calcium blood test, total CPT 82310 HB CALCIUM TOTAL	$17.00	$85.00	$4.38–$76.50	36% below	80%
Calcium blood test, total inpatient CPT 82310 HB CALCIUM TOTAL	$17.00	$85.00	$47.80–$76.50	—	80%
Carcinoembryonic antigen (CEA) test CPT 82378 HB CEA	$49.40	$247.00	$16.12–$222.30	59% below	80%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HB CEA	$49.40	$247.00	$138.91–$222.30	—	80%
Chickenpox (varicella) immunity blood test CPT 86787 HB VARICELLA ZOSTER AB EA (INH	$32.00	$160.00	$10.95–$144.00	67% below	80%
Chickenpox (varicella) immunity blood test CPT 86787 HB MEM-VZ AB	$32.00	$160.00	$10.95–$144.00	67% below	80%
Chickenpox (varicella) immunity blood test CPT 86787 HB VARICELLA ZOSTER AB EA(SO)	$32.20	$161.00	$10.95–$144.90	67% below	80%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HB MEM-VZ AB	$32.00	$160.00	$89.98–$144.00	—	80%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HB VARICELLA ZOSTER AB EA (INH	$32.00	$160.00	$89.98–$144.00	—	80%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HB VARICELLA ZOSTER AB EA(SO)	$32.20	$161.00	$90.55–$144.90	—	80%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HB CHLAMYD TRACH AMP PROBE	$44.60	$223.00	$29.83–$200.70	54% below	80%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HB CHLAMYD TRACH AMP PROBE	$44.60	$223.00	$125.42–$200.70	—	80%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HB LIPID PANEL-INHSE	$43.80	$219.00	$9.68–$197.10	58% below	80%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HB LIPID PANEL (SO)	$43.80	$219.00	$9.68–$197.10	58% below	80%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HB LIPID PANEL-INHSE	$43.80	$219.00	$123.17–$197.10	—	80%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HB LIPID PANEL (SO)	$43.80	$219.00	$123.17–$197.10	—	80%
Complete blood count (CBC) with differential CPT 85025 HB CBC/PLT/AUTO DIFF	$30.20	$151.00	$6.61–$135.90	27% below	80%
Complete blood count (CBC) with differential inpatient CPT 85025 HB CBC/PLT/AUTO DIFF	$30.20	$151.00	$84.92–$135.90	—	80%
Complete blood count (CBC), no differential CPT 85027 HB CBC/PLT/NO DIFF	$23.40	$117.00	$5.50–$105.30	21% below	80%
Complete blood count (CBC), no differential CPT 85027 HB CBC W/O DIFF	$23.40	$117.00	$5.50–$105.30	21% below	80%
Complete blood count (CBC), no differential CPT 85027 HB H&H PLATELET CT	$34.00	$170.00	$5.50–$153.00	15% above	80%
Complete blood count (CBC), no differential inpatient CPT 85027 HB CBC/PLT/NO DIFF	$23.40	$117.00	$65.80–$105.30	—	80%
Complete blood count (CBC), no differential inpatient CPT 85027 HB CBC W/O DIFF	$23.40	$117.00	$65.80–$105.30	—	80%
Complete blood count (CBC), no differential inpatient CPT 85027 HB H&H PLATELET CT	$34.00	$170.00	$95.61–$153.00	—	80%
Cortisol blood test, total CPT 82533 HB CORTISOL TOTAL	$44.40	$222.00	$13.86–$199.80	53% below	80%
Cortisol blood test, total CPT 82533 HB CORTISOL TOTAL (SO)	$77.20	$386.00	$13.86–$347.40	18% below	80%
Cortisol blood test, total inpatient CPT 82533 HB CORTISOL TOTAL	$44.40	$222.00	$124.85–$199.80	—	80%
Cortisol blood test, total inpatient CPT 82533 HB CORTISOL TOTAL (SO)	$77.20	$386.00	$217.09–$347.40	—	80%
Creatine kinase (CK) blood test, total CPT 82550 HB CK/CPK TOTAL	$31.60	$158.00	$5.30–$142.20	19% below	80%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HB CK/CPK TOTAL	$31.60	$158.00	$88.86–$142.20	—	80%
Creatinine blood test CPT 82565 HB CREATININE BLOOD	$17.00	$85.00	$4.36–$76.50	41% below	80%
Creatinine blood test inpatient CPT 82565 HB CREATININE BLOOD	$17.00	$85.00	$47.80–$76.50	—	80%
Cytomegalovirus (CMV) antibody test CPT 86644 HB CMV AB EA (INHSE)	$34.20	$171.00	$12.23–$153.90	57% below	80%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HB CMV AB EA (INHSE)	$34.20	$171.00	$96.17–$153.90	—	80%
D-dimer blood test (blood clot marker) CPT 85379 HB D DIMER QUANT	$73.60	$368.00	$8.65–$331.20	40% below	80%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HB D DIMER QUANT	$73.60	$368.00	$206.96–$331.20	—	80%
DHEA sulfate (DHEA-S) blood test CPT 82627 HB DHEA SULFATE	$48.80	$244.00	$18.89–$219.60	67% below	80%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HB DHEA SULFATE	$48.80	$244.00	$137.23–$219.60	—	80%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HB DRUG SCREEN-ANALYZER (IH)	$24.80	$124.00	$27.28–$111.60	78% below	80%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HB DRUG SCREEN-ANALYZER (SO)	$54.20	$271.00	$34.27–$243.90	53% below	80%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HB HAIR TOXICOLOGY - 5 DRUG (S/O)	$54.20	$271.00	$34.27–$243.90	53% below	80%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB DRUG SCREEN-ANALYZER (IH)	$24.80	$124.00	$69.74–$111.60	—	80%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB HAIR TOXICOLOGY - 5 DRUG (S/O)	$54.20	$271.00	$152.41–$243.90	—	80%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB DRUG SCREEN-ANALYZER (SO)	$54.20	$271.00	$152.41–$243.90	—	80%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HB ELECTROLYTE PANEL	$32.00	$160.00	$4.75–$144.00	50% below	80%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HB ELECTROLYTE PANEL	$32.00	$160.00	$89.98–$144.00	—	80%
Epstein-Barr virus (EBV) antibody test CPT 86665 HB EBV VCA EA	$34.20	$171.00	$15.41–$153.90	58% below	80%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HB EBV VCA EA	$34.20	$171.00	$96.17–$153.90	—	80%
Estradiol blood test CPT 82670 HB ESTRADIOL	$56.40	$282.00	$23.75–$253.80	56% below	80%
Estradiol blood test inpatient CPT 82670 HB ESTRADIOL	$56.40	$282.00	$158.60–$253.80	—	80%
FSH (follicle-stimulating hormone) test CPT 83001 HB FSH (INH)	$42.40	$212.00	$15.79–$190.80	67% below	80%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HB FSH (INH)	$42.40	$212.00	$119.23–$190.80	—	80%
Fecal calprotectin (stool inflammation test) CPT 83993 HB CALPROTECTIN	$83.40	$417.00	$16.68–$375.30	54% below	80%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HB CALPROTECTIN	$83.40	$417.00	$234.52–$375.30	—	80%
Ferritin blood test (iron stores) CPT 82728 HB FERRITIN	$38.20	$191.00	$11.58–$171.90	52% below	80%
Ferritin blood test (iron stores) inpatient CPT 82728 HB FERRITIN	$38.20	$191.00	$107.42–$171.90	—	80%
Fibrinogen blood test CPT 85384 HB FIBRINOGEN	$53.00	$265.00	$7.22–$238.50	11% below	80%
Fibrinogen blood test inpatient CPT 85384 HB FIBRINOGEN	$53.00	$265.00	$149.04–$238.50	—	80%
Folate (folic acid) blood test CPT 82746 HB FOLIC ACID SERUM	$36.80	$184.00	$12.49–$165.60	52% below	80%
Folate (folic acid) blood test inpatient CPT 82746 HB FOLIC ACID SERUM	$36.80	$184.00	$103.48–$165.60	—	80%
Free T3 thyroid hormone test CPT 84481 HB T3 FREE	$36.60	$183.00	$14.40–$164.70	72% below	80%
Free T3 thyroid hormone test inpatient CPT 84481 HB T3 FREE	$36.60	$183.00	$102.92–$164.70	—	80%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HB T4 FREE	$34.20	$171.00	$7.66–$153.90	58% below	80%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HB T4 FREE	$34.20	$171.00	$96.17–$153.90	—	80%
Free testosterone test CPT 84402 HB TESTOSTERONE FREE	$49.60	$248.00	$21.64–$223.20	41% below	80%
Free testosterone test inpatient CPT 84402 HB TESTOSTERONE FREE	$49.60	$248.00	$139.48–$223.20	—	80%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HB GGT	$22.60	$113.00	$6.12–$101.70	31% below	80%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HB FIBROSURE-GGT (S/O)	$22.60	$113.00	$6.12–$101.70	31% below	80%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HB GGT	$22.60	$113.00	$63.55–$101.70	—	80%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HB FIBROSURE-GGT (S/O)	$22.60	$113.00	$63.55–$101.70	—	80%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HB GENERAL HEALTH PANEL	$81.20	$406.00	$10.26–$365.40	74% below	80%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HB GENERAL HEALTH PANEL	$81.20	$406.00	$228.33–$365.40	—	80%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HB GLUCOSE POST DOSE	$19.00	$95.00	$4.04–$85.50	54% below	80%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HB GLUCOSE POST DOSE	$19.00	$95.00	$53.43–$85.50	—	80%
Glucose tolerance test, 3 samples CPT 82951 HB GLUC TOL UP TO 3 SPEC	$41.00	$205.00	$10.94–$184.50	45% below	80%
Glucose tolerance test, 3 samples inpatient CPT 82951 HB GLUC TOL UP TO 3 SPEC	$41.00	$205.00	$115.29–$184.50	—	80%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HB GC AMP PROBE	$43.60	$218.00	$29.83–$196.20	55% below	80%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HB GC AMP PROBE	$43.60	$218.00	$122.60–$196.20	—	80%
H. pylori antibody blood test CPT 86677 HB H. PYLORI AB EA (S/O)	$41.20	$206.00	$12.34–$185.40	57% below	80%
H. pylori antibody blood test inpatient CPT 86677 HB H. PYLORI AB EA (S/O)	$41.20	$206.00	$115.85–$185.40	—	80%
H. pylori stool antigen test CPT 87338 HB H.PYLORI AG-STOOL	$50.00	$250.00	$12.22–$225.00	62% below	80%
H. pylori stool antigen test inpatient CPT 87338 HB H.PYLORI AG-STOOL	$50.00	$250.00	$140.60–$225.00	—	80%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HB H-1 REVERSE TRANSCRIPT & QUANT	$124.80	$624.00	$72.31–$561.60	65% below	80%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HB H 1 RNA PCR QUANTITATIVE	$124.80	$624.00	$72.31–$561.60	65% below	80%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HB H-1 REVERSE TRANSCRIPT & QUANT	$124.80	$624.00	$350.94–$561.60	—	80%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HB H 1 RNA PCR QUANTITATIVE	$124.80	$624.00	$350.94–$561.60	—	80%
HIV-1 and HIV-2 antibody test CPT 86703 HB H1/2 ABS	$36.60	$183.00	$11.66–$164.70	39% below	80%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HB H1/2 ABS	$36.60	$183.00	$102.92–$164.70	—	80%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HB H1AG+H1/H2ABS	$45.20	$226.00	$20.47–$203.40	24% below	80%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HB HIV-1 AG W/HIV-1 & HIV-2 AB	$45.20	$226.00	$20.47–$203.40	24% below	80%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HB H1AG+H1/H2ABS	$45.20	$226.00	$127.10–$203.40	—	80%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HB HIV-1 AG W/HIV-1 & HIV-2 AB	$45.20	$226.00	$127.10–$203.40	—	80%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HB HPV HIGH-RISK TYPES	$48.80	$244.00	$16.76–$219.60	53% below	80%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HB HPV HIGH-RISK TYPES	$48.80	$244.00	$137.23–$219.60	—	80%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HB HGB/A1C/GLYCOSYLATED	$45.20	$226.00	$8.25–$203.40	31% below	80%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HB HGB A1C	$45.20	$226.00	$8.25–$203.40	31% below	80%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HB HGB/A1C/GLYCOSYLATED	$45.20	$226.00	$127.10–$203.40	—	80%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HB HGB A1C	$45.20	$226.00	$127.10–$203.40	—	80%
Hemoglobin blood test CPT 85018 HB HEMOGLOBIN	$11.60	$58.00	$1.81–$52.20	37% below	80%
Hemoglobin blood test inpatient CPT 85018 HB HEMOGLOBIN	$11.60	$58.00	$32.62–$52.20	—	80%
Hepatitis B core antibody test (total) CPT 86704 HB HEP B CORE AB	$31.20	$156.00	$10.24–$140.40	53% below	80%
Hepatitis B core antibody test (total) CPT 86704 HB HBC TOTAL ANTIBODY	$31.20	$156.00	$10.24–$140.40	53% below	80%
Hepatitis B core antibody test (total) inpatient CPT 86704 HB HEP B CORE AB	$31.20	$156.00	$87.73–$140.40	—	80%
Hepatitis B core antibody test (total) inpatient CPT 86704 HB HBC TOTAL ANTIBODY	$31.20	$156.00	$87.73–$140.40	—	80%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HB HEP B SURFACE AB	$31.20	$156.00	$9.13–$140.40	52% below	80%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HB HEP B SURFACE AB	$31.20	$156.00	$87.73–$140.40	—	80%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HB HEP B SURF AG	$30.20	$151.00	$8.78–$135.90	50% below	80%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HB HBSAG	$30.20	$151.00	$8.78–$135.90	50% below	80%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HB HBSAG	$30.20	$151.00	$84.92–$135.90	—	80%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HB HEP B SURF AG	$30.20	$151.00	$84.92–$135.90	—	80%
Hepatitis C antibody blood test (screening) CPT 86803 HB HEPATITIS C AB	$67.00	$335.00	$12.13–$301.50	33% below	80%
Hepatitis C antibody blood test (screening) CPT 86803 HB HEP C AB	$67.00	$335.00	$12.13–$301.50	33% below	80%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HB HEPATITIS C AB	$67.00	$335.00	$188.40–$301.50	—	80%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HB HEP C AB	$67.00	$335.00	$188.40–$301.50	—	80%
Hepatitis C viral load (HCV RNA) test CPT 87522 HB HEPATITIS C QUANT	$121.60	$608.00	$36.40–$547.20	46% below	80%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HB HEPATITIS C QUANT	$121.60	$608.00	$341.94–$547.20	—	80%
Herpes blood test, HSV-1 antibody CPT 86695 HB HSV AB TYPE 1 EA	$26.80	$134.00	$11.21–$120.60	47% below	80%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HB HSV AB TYPE 1 EA	$26.80	$134.00	$75.36–$120.60	—	80%
Herpes blood test, HSV-2 antibody CPT 86696 HB HSV AB TYPE 2 EA	$28.60	$143.00	$16.45–$128.70	61% below	80%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HB HSV AB TYPE 2 EA	$28.60	$143.00	$80.42–$128.70	—	80%
High-sensitivity CRP (hs-CRP) test CPT 86141 HB CRP-HIGH SENSITIVITY	$32.00	$160.00	$11.00–$144.00	57% below	80%
High-sensitivity CRP (hs-CRP) test CPT 86141 HB HSCRP	$32.00	$160.00	$11.00–$144.00	57% below	80%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HB HSCRP	$32.00	$160.00	$89.98–$144.00	—	80%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HB CRP-HIGH SENSITIVITY	$32.00	$160.00	$89.98–$144.00	—	80%
Homocysteine blood test CPT 83090 HB HOMOCYSTEINE	$55.40	$277.00	$14.33–$249.30	57% below	80%
Homocysteine blood test inpatient CPT 83090 HB HOMOCYSTEINE	$55.40	$277.00	$155.78–$249.30	—	80%
Insulin blood test CPT 83525 HB INSULIN TOTAL	$30.20	$151.00	$9.71–$135.90	58% below	80%
Insulin blood test inpatient CPT 83525 HB INSULIN TOTAL	$30.20	$151.00	$84.92–$135.90	—	80%
Iron blood test (serum iron) CPT 83540 HB IRON (INH)	$21.40	$107.00	$5.51–$96.30	55% below	80%
Iron blood test (serum iron) inpatient CPT 83540 HB IRON (INH)	$21.40	$107.00	$60.18–$96.30	—	80%
Iron-binding capacity (TIBC) test CPT 83550 HB UIBC	$25.00	$125.00	$7.43–$112.50	44% below	80%
Iron-binding capacity (TIBC) test CPT 83550 HB TIBC	$25.00	$125.00	$7.43–$112.50	44% below	80%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HB TIBC	$25.00	$125.00	$70.30–$112.50	—	80%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HB UIBC	$25.00	$125.00	$70.30–$112.50	—	80%
Kidney function blood test panel CPT 80069 HB RENAL FUNCTION PANEL	$47.40	$237.00	$5.69–$213.30	53% below	80%
Kidney function blood test panel inpatient CPT 80069 HB RENAL FUNCTION PANEL	$47.40	$237.00	$133.29–$213.30	—	80%
LH (luteinizing hormone) test CPT 83002 HB LH (INH)	$46.20	$231.00	$15.74–$207.90	67% below	80%
LH (luteinizing hormone) test inpatient CPT 83002 HB LH (INH)	$46.20	$231.00	$129.91–$207.90	—	80%
Lactate (lactic acid) blood test CPT 83605 HB LACTIC ACID	$51.80	$259.00	$9.08–$233.10	42% below	80%
Lactate (lactic acid) blood test inpatient CPT 83605 HB LACTIC ACID	$51.80	$259.00	$145.66–$233.10	—	80%
Lactate dehydrogenase (LDH) blood test CPT 83615 HB LDH	$21.20	$106.00	$5.13–$95.40	50% below	80%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HB LDH	$21.20	$106.00	$59.61–$95.40	—	80%
Lipase blood test (pancreas enzyme) CPT 83690 HB LIPASE	$41.20	$206.00	$5.86–$185.40	54% below	80%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HB LIPASE	$41.20	$206.00	$115.85–$185.40	—	80%
Liver function blood test panel CPT 80076 HB HEPATIC FUNCTION PANEL	$69.40	$347.00	$5.69–$312.30	27% below	80%
Liver function blood test panel inpatient CPT 80076 HB HEPATIC FUNCTION PANEL	$69.40	$347.00	$195.15–$312.30	—	80%
Lyme disease antibody test CPT 86618 HB LYME TOTAL ANTIBODY MTTT	$41.80	$209.00	$14.47–$188.10	66% below	80%
Lyme disease antibody test CPT 86618 HB LYME DISEASE AB	$43.80	$219.00	$14.47–$197.10	64% below	80%
Lyme disease antibody test inpatient CPT 86618 HB LYME TOTAL ANTIBODY MTTT	$41.80	$209.00	$117.54–$188.10	—	80%
Lyme disease antibody test inpatient CPT 86618 HB LYME DISEASE AB	$43.80	$219.00	$123.17–$197.10	—	80%
Magnesium blood test CPT 83735 HB MAGNESIUM	$24.80	$124.00	$5.69–$111.60	48% below	80%
Magnesium blood test inpatient CPT 83735 HB MAGNESIUM	$24.80	$124.00	$69.74–$111.60	—	80%
Measles (rubeola) antibody test CPT 86765 HB RUBEOLA AB EA (INHSE)	$29.20	$146.00	$10.95–$131.40	63% below	80%
Measles (rubeola) antibody test CPT 86765 HB MEM-MEASLES AB	$29.20	$146.00	$10.95–$131.40	63% below	80%
Measles (rubeola) antibody test inpatient CPT 86765 HB MEM-MEASLES AB	$29.20	$146.00	$82.11–$131.40	—	80%
Measles (rubeola) antibody test inpatient CPT 86765 HB RUBEOLA AB EA (INHSE)	$29.20	$146.00	$82.11–$131.40	—	80%
Mono test (heterophile antibody, Monospot) CPT 86308 HB HETEROPHILE AB OR MONO TEST	$25.20	$126.00	$4.40–$113.40	68% below	80%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HB HETEROPHILE AB OR MONO TEST	$25.20	$126.00	$70.86–$113.40	—	80%
Mumps immunity blood test CPT 86735 HB MEM-MUMPS AB	$29.00	$145.00	$11.09–$130.50	62% below	80%
Mumps immunity blood test CPT 86735 HB MUMPS AB EA (INHSE)	$104.40	$522.00	$11.09–$469.80	37% above	80%
Mumps immunity blood test inpatient CPT 86735 HB MEM-MUMPS AB	$29.00	$145.00	$81.55–$130.50	—	80%
Mumps immunity blood test inpatient CPT 86735 HB MUMPS AB EA (INHSE)	$104.40	$522.00	$293.57–$469.80	—	80%
PSA (prostate-specific antigen) blood test, free CPT 84154 HB PSA FREE	$50.00	$250.00	$15.64–$225.00	28% below	80%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HB PSA FREE	$50.00	$250.00	$140.60–$225.00	—	80%
PSA (prostate-specific antigen) blood test, total CPT 84153 HB PSA (SO)	$42.40	$212.00	$15.64–$190.80	47% below	80%
PSA (prostate-specific antigen) blood test, total CPT 84153 HB PSA TOTAL	$42.40	$212.00	$15.64–$190.80	47% below	80%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HB PSA (SO)	$42.40	$212.00	$119.23–$190.80	—	80%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HB PSA TOTAL	$42.40	$212.00	$119.23–$190.80	—	80%
Pap test (liquid-based, automated screening with review) CPT 88175 HB CYTOPATH CER/VAG W/RESCR MAN	$40.20	$201.00	$21.82–$180.90	52% below	80%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HB CYTOPATH CER/VAG W/RESCR MAN	$40.20	$201.00	$113.04–$180.90	—	80%
Parathyroid hormone (PTH) blood test CPT 83970 HB PARATHORMONE	$73.80	$369.00	$35.08–$332.10	62% below	80%
Parathyroid hormone (PTH) blood test CPT 83970 HB PTH RAPID	$73.80	$369.00	$35.08–$332.10	62% below	80%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HB PTH RAPID	$73.80	$369.00	$207.53–$332.10	—	80%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HB PARATHORMONE	$73.80	$369.00	$207.53–$332.10	—	80%
Partial thromboplastin time (PTT) clotting test CPT 85730 HB PTT ACTIVATED	$43.20	$216.00	$5.10–$194.40	14% below	80%
Partial thromboplastin time (PTT) clotting test CPT 85730 HB POCT APTT	$43.20	$216.00	$5.10–$194.40	14% below	80%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HB PTT ACTIVATED	$43.20	$216.00	$121.48–$194.40	—	80%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HB POCT APTT	$43.20	$216.00	$121.48–$194.40	—	80%
Phosphorus (phosphate) blood test CPT 84100 HB PHOSPHORUS BLOOD	$18.00	$90.00	$4.03–$81.00	37% below	80%
Phosphorus (phosphate) blood test inpatient CPT 84100 HB PHOSPHORUS BLOOD	$18.00	$90.00	$50.62–$81.00	—	80%
Potassium blood test CPT 84132 HB POTASSIUM BLOOD	$16.20	$81.00	$3.91–$72.90	43% below	80%
Potassium blood test inpatient CPT 84132 HB POTASSIUM BLOOD	$16.20	$81.00	$45.55–$72.90	—	80%
Progesterone blood test CPT 84144 HB PROGESTERONE	$44.40	$222.00	$17.73–$199.80	68% below	80%
Progesterone blood test inpatient CPT 84144 HB PROGESTERONE	$44.40	$222.00	$124.85–$199.80	—	80%
Prolactin blood test CPT 84146 HB PROLACTIN	$53.00	$265.00	$16.47–$238.50	47% below	80%
Prolactin blood test inpatient CPT 84146 HB PROLACTIN	$53.00	$265.00	$149.04–$238.50	—	80%
Prothrombin time (PT/INR) clotting test CPT 85610 HB PROTHROMBIN TIME	$22.00	$110.00	$3.34–$99.00	17% below	80%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HB PROTHROMBIN TIME	$22.00	$110.00	$61.86–$99.00	—	80%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HB DRUG SCREEN-VISUAL READ (IH)	$48.00	$240.00	$6.43–$216.00	52% below	80%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HB DRUG SCREEN-VISUAL READ (IH)	$48.00	$240.00	$134.98–$216.00	—	80%
Rapid flu test (influenza antigen) CPT 87804 HB POCT RAPID FLU A/B	$30.40	$152.00	$9.73–$136.80	42% below	80%
Rapid flu test (influenza antigen) inpatient CPT 87804 HB POCT RAPID FLU A/B	$30.40	$152.00	$85.48–$136.80	—	80%
Renin blood test CPT 84244 HB RENIN	$69.80	$349.00	$18.69–$314.10	37% below	80%
Renin blood test inpatient CPT 84244 HB RENIN	$69.80	$349.00	$196.28–$314.10	—	80%
Rh blood typing CPT 86901 HB BLOOD TYPING RH(D)	$17.80	$89.00	$2.54–$80.10	54% below	80%
Rh blood typing CPT 86901 HB REF RH TYPE	$34.60	$173.00	$2.54–$155.70	10% below	80%
Rh blood typing inpatient CPT 86901 HB BLOOD TYPING RH(D)	$17.80	$89.00	$50.05–$80.10	—	80%
Rh blood typing inpatient CPT 86901 HB REF RH TYPE	$34.60	$173.00	$97.30–$155.70	—	80%
Rheumatoid factor (RF) test CPT 86431 HB ANA-RF	$22.80	$114.00	$4.82–$102.60	53% below	80%
Rheumatoid factor (RF) test CPT 86431 HB RHEUMATOID FACT QUANT	$22.80	$114.00	$4.82–$102.60	53% below	80%
Rheumatoid factor (RF) test inpatient CPT 86431 HB ANA-RF	$22.80	$114.00	$64.11–$102.60	—	80%
Rheumatoid factor (RF) test inpatient CPT 86431 HB RHEUMATOID FACT QUANT	$22.80	$114.00	$64.11–$102.60	—	80%
Rubella antibody test (immunity check) CPT 86762 HB RUBELLA AB EA (INHSE)	$27.60	$138.00	$12.23–$124.20	59% below	80%
Rubella antibody test (immunity check) inpatient CPT 86762 HB RUBELLA AB EA (INHSE)	$27.60	$138.00	$77.61–$124.20	—	80%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HB SED RATE AUTOMATED	$17.80	$89.00	$2.30–$80.10	54% below	80%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HB SED RATE AUTOMATED	$17.80	$89.00	$50.05–$80.10	—	80%
Sodium blood test CPT 84295 HB SODIUM BLOOD	$15.00	$75.00	$4.09–$67.50	59% below	80%
Sodium blood test inpatient CPT 84295 HB SODIUM BLOOD	$15.00	$75.00	$42.18–$67.50	—	80%
Stool ova and parasites exam CPT 87177 HB OVA & PARASITE	$56.40	$282.00	$7.42–$253.80	16% above	80%
Stool ova and parasites exam inpatient CPT 87177 HB OVA & PARASITE	$56.40	$282.00	$158.60–$253.80	—	80%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HB OCCULT BLOOD FECES	$18.00	$90.00	$2.77–$81.00	50% below	80%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HB OCCULT BLOOD FECES	$18.00	$90.00	$50.62–$81.00	—	80%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HB OCCULT BLOOD IMMUNOASSAY	$6.80	$34.00	$7.48–$30.60	87% below	80%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HB OCCULT BLOOD IMMUNOCHEMICAL	$50.40	$252.00	$13.52–$226.80	3% below	80%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HB OCCULT BLOOD IMMUNOASSAY	$6.80	$34.00	$19.12–$30.60	—	80%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HB OCCULT BLOOD IMMUNOCHEMICAL	$50.40	$252.00	$141.72–$226.80	—	80%
Syphilis antibody test (Treponema pallidum) CPT 86780 HB TREPONEMA PALLIDUM AB (SO)	$30.80	$154.00	$5.42–$138.60	54% below	80%
Syphilis antibody test (Treponema pallidum) CPT 86780 HB T. PALLIDUM AB-TOTAL (INHSE)	$30.80	$154.00	$5.42–$138.60	54% below	80%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HB TREPONEMA PALLIDUM AB (SO)	$30.80	$154.00	$86.61–$138.60	—	80%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HB T. PALLIDUM AB-TOTAL (INHSE)	$30.80	$154.00	$86.61–$138.60	—	80%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HB RPR QUAL	$18.00	$90.00	$3.63–$81.00	56% below	80%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HB RPR QUAL	$18.00	$90.00	$50.62–$81.00	—	80%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HB TB-CMIOF G-INTERFERON AG RESP	$67.20	$336.00	$52.67–$302.40	55% below	80%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HB TB-CMIOF G-INTERFERON AG RESP	$67.20	$336.00	$188.97–$302.40	—	80%
Testosterone blood test, total (not free testosterone) CPT 84403 HB TESTOSTERONE TOTAL	$53.00	$265.00	$21.94–$238.50	55% below	80%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HB TESTOSTERONE TOTAL	$53.00	$265.00	$149.04–$238.50	—	80%
Thyroid peroxidase (TPO) antibody test CPT 86376 HB TPO ANTIBODY	$32.00	$160.00	$12.37–$144.00	65% below	80%
Thyroid peroxidase (TPO) antibody test CPT 86376 HB ANA-TPO	$32.00	$160.00	$12.37–$144.00	65% below	80%
Thyroid peroxidase (TPO) antibody test CPT 86376 HB MICROSOME AB EA	$109.20	$546.00	$12.37–$491.40	18% above	80%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HB ANA-TPO	$32.00	$160.00	$89.98–$144.00	—	80%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HB TPO ANTIBODY	$32.00	$160.00	$89.98–$144.00	—	80%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HB MICROSOME AB EA	$109.20	$546.00	$307.07–$491.40	—	80%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HB TSH	$44.60	$223.00	$14.28–$200.70	45% below	80%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HB TSH	$44.60	$223.00	$125.42–$200.70	—	80%
Total IgE blood test CPT 82785 HB IGE GAMMAGLOBULIN	$36.60	$183.00	$13.99–$164.70	51% below	80%
Total IgE blood test inpatient CPT 82785 HB IGE GAMMAGLOBULIN	$36.60	$183.00	$102.92–$164.70	—	80%
Total cholesterol blood test CPT 82465 HB FIBROSURE-CHOLESTEROL (S/O)	$15.40	$77.00	$3.70–$69.30	50% below	80%
Total cholesterol blood test CPT 82465 HB CHOLESTEROL TOTAL	$17.20	$86.00	$3.70–$77.40	44% below	80%
Total cholesterol blood test inpatient CPT 82465 HB FIBROSURE-CHOLESTEROL (S/O)	$15.40	$77.00	$43.30–$69.30	—	80%
Total cholesterol blood test inpatient CPT 82465 HB CHOLESTEROL TOTAL	$17.20	$86.00	$48.37–$77.40	—	80%
Total thyroxine (T4) blood test CPT 84436 HB T4 TOTAL	$26.20	$131.00	$5.84–$117.90	45% below	80%
Total thyroxine (T4) blood test inpatient CPT 84436 HB T4 TOTAL	$26.20	$131.00	$73.67–$117.90	—	80%
Total triiodothyronine (T3) blood test CPT 84480 HB T3 TOTAL	$38.60	$193.00	$12.05–$173.70	68% below	80%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HB T3 TOTAL	$38.60	$193.00	$108.54–$173.70	—	80%
Transferrin blood test CPT 84466 HB TRANSFERRIN	$32.00	$160.00	$10.85–$144.00	62% below	80%
Transferrin blood test inpatient CPT 84466 HB TRANSFERRIN	$32.00	$160.00	$89.98–$144.00	—	80%
Trichomonas test (NAAT) CPT 87661 HB TRICHOMONAS DNA AMP PROBE	$53.00	$265.00	$35.09–$238.50	44% below	80%
Trichomonas test (NAAT) CPT 87661 HB TRICHOMONAS VAGINALIS DIRECT P	$53.00	$265.00	$35.09–$238.50	44% below	80%
Trichomonas test (NAAT) CPT 87661 HB TVGPCR - TRICHOMONAS PCR	$53.20	$266.00	$35.09–$239.40	44% below	80%
Trichomonas test (NAAT) inpatient CPT 87661 HB TRICHOMONAS DNA AMP PROBE	$53.00	$265.00	$149.04–$238.50	—	80%
Trichomonas test (NAAT) inpatient CPT 87661 HB TRICHOMONAS VAGINALIS DIRECT P	$53.00	$265.00	$149.04–$238.50	—	80%
Trichomonas test (NAAT) inpatient CPT 87661 HB TVGPCR - TRICHOMONAS PCR	$53.20	$266.00	$149.60–$239.40	—	80%
Triglycerides blood test CPT 84478 HB FIBROSURE-TRIGLYCERIDES (S/O)	$15.40	$77.00	$4.89–$69.30	57% below	80%
Triglycerides blood test CPT 84478 HB TRIGLYCERIDES	$20.20	$101.00	$4.89–$90.90	43% below	80%
Triglycerides blood test inpatient CPT 84478 HB FIBROSURE-TRIGLYCERIDES (S/O)	$15.40	$77.00	$43.30–$69.30	—	80%
Triglycerides blood test inpatient CPT 84478 HB TRIGLYCERIDES	$20.20	$101.00	$56.80–$90.90	—	80%
Troponin test, quantitative CPT 84484 HB TROPONIN I HIGH SENSITIVE	$105.00	$525.00	$8.36–$472.50	13% below	80%
Troponin test, quantitative CPT 84484 HB TROPONIN I HIGH SENSITIVE ASSAY	$114.20	$571.00	$8.36–$513.90	6% below	80%
Troponin test, quantitative CPT 84484 HB TROPONIN I	$114.20	$571.00	$8.36–$513.90	6% below	80%
Troponin test, quantitative inpatient CPT 84484 HB TROPONIN I HIGH SENSITIVE	$105.00	$525.00	$295.26–$472.50	—	80%
Troponin test, quantitative inpatient CPT 84484 HB TROPONIN I	$114.20	$571.00	$321.13–$513.90	—	80%
Troponin test, quantitative inpatient CPT 84484 HB TROPONIN I HIGH SENSITIVE ASSAY	$114.20	$571.00	$321.13–$513.90	—	80%
Uric acid blood test CPT 84550 HB URIC ACID BLOOD	$18.00	$90.00	$3.84–$81.00	62% below	80%
Uric acid blood test inpatient CPT 84550 HB URIC ACID BLOOD	$18.00	$90.00	$50.62–$81.00	—	80%
Urinalysis with microscope exam, automated CPT 81001 HB UA AUTO W/MICRO	$20.80	$104.00	$2.69–$93.60	50% below	80%
Urinalysis with microscope exam, automated inpatient CPT 81001 HB UA AUTO W/MICRO	$20.80	$104.00	$58.49–$93.60	—	80%
Urinalysis without microscope exam, automated CPT 81003 HB UR KETONE DIPSTICK	$14.20	$71.00	$1.91–$63.90	42% below	80%
Urinalysis without microscope exam, automated CPT 81003 HB US AUTO W/O MICRO	$14.20	$71.00	$1.91–$63.90	42% below	80%
Urinalysis without microscope exam, automated inpatient CPT 81003 HB UR KETONE DIPSTICK	$14.20	$71.00	$39.93–$63.90	—	80%
Urinalysis without microscope exam, automated inpatient CPT 81003 HB US AUTO W/O MICRO	$14.20	$71.00	$39.93–$63.90	—	80%
Urine culture for bacteria, with colony count CPT 87086 HB CULTURE URINE COLONY COUNT	$31.20	$156.00	$6.86–$140.40	29% below	80%
Urine culture for bacteria, with colony count inpatient CPT 87086 HB CULTURE URINE COLONY COUNT	$31.20	$156.00	$87.73–$140.40	—	80%
Urine microalbumin (albumin) test CPT 82043 HB MICROALBUMIN QUANT-UR	$24.20	$121.00	$4.91–$108.90	30% below	80%
Urine microalbumin (albumin) test inpatient CPT 82043 HB MICROALBUMIN QUANT-UR	$24.20	$121.00	$68.05–$108.90	—	80%
Urine pregnancy test, read by color change CPT 81025 HB HCG URINE QUAL	$27.00	$135.00	$1.02–$121.50	50% below	80%
Urine pregnancy test, read by color change inpatient CPT 81025 HB HCG URINE QUAL	$27.00	$135.00	$75.92–$121.50	—	80%
Vitamin B12 (cobalamin) blood test CPT 82607 HB VITAMIN B 12	$37.60	$188.00	$12.81–$169.20	49% below	80%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HB VITAMIN B 12	$37.60	$188.00	$105.73–$169.20	—	80%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HB 25-OH VITAMIN D-3	$60.80	$304.00	$23.22–$273.60	55% below	80%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HB 25-OH VITAMIN D	$60.80	$304.00	$23.22–$273.60	55% below	80%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HB 25-OH VITAMIN D-3	$60.80	$304.00	$170.97–$273.60	—	80%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HB 25-OH VITAMIN D	$60.80	$304.00	$170.97–$273.60	—	80%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HB VIT D 1/25 DIHYDROXY	$74.80	$374.00	$32.72–$336.60	58% below	80%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HB VIT D 1/25 DIHYDROXY	$74.80	$374.00	$210.34–$336.60	—	80%
Zinc blood test CPT 84630 HB ZINC	$27.60	$138.00	$9.67–$124.20	67% below	80%
Zinc blood test inpatient CPT 84630 HB ZINC	$27.60	$138.00	$77.61–$124.20	—	80%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HB HCG QUANT (SO)	$51.40	$257.00	$12.80–$231.30	36% below	80%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HB HCG SERUM QUANT	$51.40	$257.00	$12.80–$231.30	36% below	80%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HB HCG QUANT (SO)	$51.40	$257.00	$144.54–$231.30	—	80%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HB HCG SERUM QUANT	$51.40	$257.00	$144.54–$231.30	—	80%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Cardioversion, elective (restoring heart rhythm) CPT 92960 HB PFS CARDIOVERSION	$187.00	$935.00	$205.70–$841.50	87% below	80%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HB CARDIOVERSION	$187.00	$935.00	$205.70–$841.50	87% below	80%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HB PFS CARDIOVERSION	$187.00	$935.00	$525.84–$841.50	—	80%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HB CARDIOVERSION	$187.00	$935.00	$525.84–$841.50	—	80%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HB CLOSED TX DISTAL RADIAL FX W/O MANIP	$266.20	$1,331.00	$239.88–$1,197.90	39% below	80%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HB CLOSED TX DISTAL RADIAL FX W/O MANIP	$266.20	$1,331.00	$748.55–$1,197.90	—	80%
Colonoscopy with endoscopic ultrasound CPT 45391 HB COLONOSCOPY W/ EUS	$179.00	$895.00	$196.90–$1,249.82	90% below	80%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 HB COLONOSCOPY W/ EUS	$179.00	$895.00	$503.35–$805.50	—	80%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HB IRRIGATE IMPACT CERUMEN	$81.60	$408.00	$59.40–$696.00	54% below	80%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HB IRRIGATE IMPACT CERUMEN	$81.60	$408.00	$229.46–$367.20	—	80%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HB LAC REPAIR INTERMEDIATE S/A/T/E SM	$109.20	$546.00	$120.12–$696.00	85% below	80%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HB LAC REPAIR INTERMEDIATE S/A/T/E SM	$109.20	$546.00	$307.07–$491.40	—	80%
Nail removal (partial or complete), one nail CPT 11730 HB AVULSION NAIL PLATE SIMPLE SINGLE	$55.20	$276.00	$60.72–$696.00	86% below	80%
Nail removal (partial or complete), one nail inpatient CPT 11730 HB AVULSION NAIL PLATE SIMPLE SINGLE	$55.20	$276.00	$155.22–$248.40	—	80%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HB EXCISION NAIL AND MATRIX PERM REMOVAL	$167.00	$835.00	$183.70–$751.50	76% below	80%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HB EXCISION NAIL AND MATRIX PERM REMOVAL	$167.00	$835.00	$469.60–$751.50	—	80%
Removal of a foreign object under the skin, simple CPT 10120 HB INCISION REMOVAL FOREIGN BODY SUBQ TISSUE SIMPLE	$66.80	$334.00	$73.48–$696.00	89% below	80%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HB INCISION REMOVAL FOREIGN BODY SUBQ TISSUE SIMPLE	$66.80	$334.00	$187.84–$300.60	—	80%
Short arm cast (elbow to hand) CPT 29075 HB CAST SHORT ARM	$91.40	$457.00	$100.54–$696.00	75% below	80%
Short arm cast (elbow to hand) inpatient CPT 29075 HB CAST SHORT ARM	$91.40	$457.00	$257.02–$411.30	—	80%
Short arm splint (forearm and hand) CPT 29125 HB SPLINT SHORT ARM STATIC	$45.20	$226.00	$49.72–$696.00	75% below	80%
Short arm splint (forearm and hand) inpatient CPT 29125 HB SPLINT SHORT ARM STATIC	$45.20	$226.00	$127.10–$203.40	—	80%
Short leg splint (calf to foot) CPT 29515 HB SPLINT SHORT LEG	$50.80	$254.00	$55.88–$696.00	79% below	80%
Short leg splint (calf to foot) inpatient CPT 29515 HB SPLINT SHORT LEG	$50.80	$254.00	$142.85–$228.60	—	80%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HB LAC REPAIR SIMPLE SUPERFICIAL SM	$86.20	$431.00	$94.82–$696.00	80% below	80%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HB SMPL RPR S/N/A/GN/TRNK <=2.5CM	$86.20	$431.00	$94.82–$387.90	80% below	80%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HB SMPL RPR S/N/A/GN/TRNK <=2.5CM	$86.20	$431.00	$242.39–$387.90	—	80%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HB LAC REPAIR SIMPLE SUPERFICIAL SM	$86.20	$431.00	$242.39–$387.90	—	80%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HB LUMBAR PUNCTURE, DIAGNOSTIC	$272.40	$1,362.00	$299.64–$1,225.80	73% below	80%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HB LUMBAR PUNCTURE, DIAGNOSTIC	$272.40	$1,362.00	$765.99–$1,225.80	—	80%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HB LAC REPAIR SIMPLE SUPERFICIAL MED	$104.40	$522.00	$114.84–$696.00	74% below	80%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HB LAC REPAIR SIMPLE SUPERFICIAL MED	$104.40	$522.00	$293.57–$469.80	—	80%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HB LAC REPAIR SIMPLE FACE SM	$137.80	$689.00	$151.58–$696.00	68% below	80%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HB LAC REPAIR SIMPLE FACE SM	$137.80	$689.00	$387.49–$620.10	—	80%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HB BLOOD TRANSFUSION ADMIN	$324.60	$1,623.00	$357.06–$1,460.70	64% below	80%
Blood transfusion (giving blood or blood components) CPT 36430 HB BLD COMP TRANS 0.5-1.0 HR	$324.60	$1,623.00	$357.06–$1,460.70	64% below	80%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HB BLOOD TRANSFUSION ADMIN	$324.60	$1,623.00	$912.78–$1,460.70	—	80%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HB BLD COMP TRANS 0.5-1.0 HR	$324.60	$1,623.00	$912.78–$1,460.70	—	80%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB MINI NEB SUBSEQ	$18.40	$92.00	$20.24–$215.59	84% below	80%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB MDI/MININEB INITIAL	$73.60	$368.00	$80.96–$331.20	35% below	80%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HB MINI NEB SUBSEQ	$18.40	$92.00	$51.74–$82.80	—	80%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HB MDI/MININEB INITIAL	$73.60	$368.00	$206.96–$331.20	—	80%
Critical care, first 30 to 74 minutes CPT 99291 HB ER LEVEL CRITICAL CARE	$258.20	$1,291.00	$284.02–$1,161.90	88% below	80%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HB ER LEVEL CRITICAL CARE	$258.20	$1,291.00	$726.06–$1,161.90	—	80%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HB ROUTINE EEG AWAKE AND DROWSY	$257.00	$1,285.00	$282.70–$1,156.50	62% below	80%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HB ROUTINE EEG AWAKE AND DROWSY	$257.00	$1,285.00	$722.68–$1,156.50	—	80%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HB EKG	$74.00	$370.00	$59.40–$333.00	63% below	80%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HB EKG	$98.80	$494.00	$277.83–$444.60	—	80%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HB ER LEVEL 1	$275.60	$1,378.00	$75.80–$1,240.20	27% above	80%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HB ER LEVEL 1	$275.60	$1,378.00	$774.99–$1,240.20	—	80%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HB ER LEVEL 2	$70.60	$353.00	$75.80–$696.00	83% below	80%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HB ER LEVEL 2	$70.60	$353.00	$198.53–$317.70	—	80%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HB ER LEVEL 3	$117.00	$585.00	$75.80–$696.00	85% below	80%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HB ER LEVEL 3	$117.00	$585.00	$329.00–$526.50	—	80%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HB ER LEVEL 4	$150.80	$754.00	$75.80–$1,419.00	87% below	80%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HB ER LEVEL 4	$151.20	$756.00	$425.17–$680.40	—	80%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HB ER LEVEL 5	$205.00	$1,025.00	$75.80–$1,764.00	88% below	80%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HB ER LEVEL 5	$205.00	$1,025.00	$576.46–$922.50	—	80%
Exercise stress test, tracing only, the hospital charge CPT 93017 HB EXERCISE STRESS TEST	$236.40	$1,182.00	$260.04–$1,063.80	69% below	80%
Exercise stress test, tracing only, the hospital charge CPT 93017 HB PHARMACEUTICAL STRESS TEST	$236.40	$1,182.00	$260.04–$1,063.80	69% below	80%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HB EXERCISE STRESS TEST	$236.40	$1,182.00	$664.76–$1,063.80	—	80%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HB PHARMACEUTICAL STRESS TEST	$236.40	$1,182.00	$664.76–$1,063.80	—	80%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HB IV INFUSION HYDRATION INIT HR	$83.40	$417.00	$91.74–$375.30	77% below	80%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HB IV INFUSION INITIAL	$83.40	$417.00	$91.74–$375.30	77% below	80%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HB IV INFUSION INITIAL	$83.40	$417.00	$234.52–$375.30	—	80%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HB IV INFUSION HYDRATION INIT HR	$83.40	$417.00	$234.52–$375.30	—	80%
IV infusion of a medicine, first hour CPT 96365 HB OP IV INFUSION TX,DX INITL HR	$179.60	$898.00	$197.56–$808.20	56% below	80%
IV infusion of a medicine, first hour CPT 96365 HB IV INFUSION TX, DX INITIAL HR	$179.60	$898.00	$197.56–$808.20	56% below	80%
IV infusion of a medicine, first hour inpatient CPT 96365 HB OP IV INFUSION TX,DX INITL HR	$179.60	$898.00	$505.04–$808.20	—	80%
IV infusion of a medicine, first hour inpatient CPT 96365 HB IV INFUSION TX, DX INITIAL HR	$179.60	$898.00	$505.04–$808.20	—	80%
IV push of a medicine, first drug CPT 96374 HB IV MEDICATION INITIAL	$70.00	$350.00	$77.00–$315.00	67% below	80%
IV push of a medicine, first drug CPT 96374 HB OP IV MEDICATION INITIAL	$70.00	$350.00	$77.00–$315.00	67% below	80%
IV push of a medicine, first drug inpatient CPT 96374 HB OP IV MEDICATION INITIAL	$70.00	$350.00	$196.84–$315.00	—	80%
IV push of a medicine, first drug inpatient CPT 96374 HB IV MEDICATION INITIAL	$70.00	$350.00	$196.84–$315.00	—	80%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HB IM/SQ MEDICATION INITIAL	$38.60	$193.00	$42.46–$173.70	63% below	80%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HB IM INITIAL	$38.60	$193.00	$42.46–$173.70	63% below	80%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HB IM/SQ INJECTON INITIAL	$38.60	$193.00	$42.46–$173.70	63% below	80%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HB IM/SQ MEDICATION INTIAL	$88.60	$443.00	$71.17–$398.70	16% below	80%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HB IM/SQ INJ SUBSEQUENT	$88.60	$443.00	$71.17–$398.70	16% below	80%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HB IM/SQ MEDICATION SUBSEQ	$88.60	$443.00	$71.17–$398.70	16% below	80%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HB IM/SQ MEDICATION INITIAL	$38.60	$193.00	$108.54–$173.70	—	80%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HB IM/SQ INJECTON INITIAL	$38.60	$193.00	$108.54–$173.70	—	80%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HB IM INITIAL	$38.60	$193.00	$108.54–$173.70	—	80%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HB IM/SQ INJ SUBSEQUENT	$88.60	$443.00	$249.14–$398.70	—	80%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HB IM/SQ MEDICATION SUBSEQ	$88.60	$443.00	$249.14–$398.70	—	80%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HB IM/SQ MEDICATION INTIAL	$88.60	$443.00	$249.14–$398.70	—	80%
Neuromuscular re-education, 15 minutes CPT 97112 HB NEURO RE-ED EACH 15 MIN PT	$46.80	$234.00	$30.65–$210.60	38% below	80%
Neuromuscular re-education, 15 minutes CPT 97112 HB NEURO RE-ED EACH 15 MIN OT	$46.80	$234.00	$30.65–$210.60	38% below	80%
Neuromuscular re-education, 15 minutes CPT 97112 HB NEUROMUSC RE ED PT 15 MIN PT	$46.80	$234.00	$30.65–$210.60	38% below	80%
Neuromuscular re-education, 15 minutes CPT 97112 HB NEUROMUSC RE ED OT 15 MIN	$46.80	$234.00	$30.65–$210.60	38% below	80%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HB NEURO RE-ED EACH 15 MIN PT	$46.80	$234.00	$131.60–$210.60	—	80%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HB NEUROMUSC RE ED PT 15 MIN PT	$46.80	$234.00	$131.60–$210.60	—	80%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HB NEUROMUSC RE ED OT 15 MIN	$46.80	$234.00	$131.60–$210.60	—	80%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HB NEURO RE-ED EACH 15 MIN OT	$46.80	$234.00	$131.60–$210.60	—	80%
Occupational therapy evaluation, low complexity CPT 97165 HB WHEELCHAIR/SEAT EVAL LOW OT	$92.40	$462.00	$96.07–$415.80	42% below	80%
Occupational therapy evaluation, low complexity CPT 97165 HB OP OT EVAL LOW	$92.40	$462.00	$96.07–$415.80	42% below	80%
Occupational therapy evaluation, low complexity CPT 97165 HB OT EVAL LOW	$92.40	$462.00	$96.07–$415.80	42% below	80%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HB OT EVAL LOW	$92.40	$462.00	$259.83–$415.80	—	80%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HB OP OT EVAL LOW	$92.40	$462.00	$259.83–$415.80	—	80%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HB WHEELCHAIR/SEAT EVAL LOW OT	$92.40	$462.00	$259.83–$415.80	—	80%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HB NEURO PT EVAL HIGH	$124.80	$624.00	$93.69–$561.60	47% below	80%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HB WHEELCHAIR/SEAT EVAL HIGH PT	$147.80	$739.00	$93.69–$665.10	37% below	80%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HB PT EVAL HIGH	$147.80	$739.00	$93.69–$665.10	37% below	80%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HB NEURO PT EVAL HIGH	$124.80	$624.00	$350.94–$561.60	—	80%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HB PT EVAL HIGH	$147.80	$739.00	$415.61–$665.10	—	80%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HB WHEELCHAIR/SEAT EVAL HIGH PT	$147.80	$739.00	$415.61–$665.10	—	80%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HB PEDS PT EVAL LOW - OP	$87.00	$435.00	$93.69–$391.50	39% below	80%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HB NEURO PT EVAL LOW	$116.80	$584.00	$93.69–$525.60	19% below	80%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HB WHEELCHAIR/SEAT EVAL LOW PT	$116.80	$584.00	$93.69–$525.60	19% below	80%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HB PT EVAL LOW	$116.80	$584.00	$93.69–$525.60	19% below	80%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HB PEDS PT EVAL LOW - OP	$87.00	$435.00	$244.64–$391.50	—	80%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HB PT EVAL LOW	$116.80	$584.00	$328.44–$525.60	—	80%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HB WHEELCHAIR/SEAT EVAL LOW PT	$116.80	$584.00	$328.44–$525.60	—	80%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HB NEURO PT EVAL LOW	$116.80	$584.00	$328.44–$525.60	—	80%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HB PT EVAL MOD	$125.60	$628.00	$93.69–$565.20	33% below	80%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HB WHEELCHAIR/SEAT EVAL MOD PT	$125.60	$628.00	$93.69–$565.20	33% below	80%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HB NEURO PT EVAL MOD	$125.80	$629.00	$93.69–$566.10	33% below	80%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HB WHEELCHAIR/SEAT EVAL MOD PT	$125.60	$628.00	$353.19–$565.20	—	80%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HB PT EVAL MOD	$125.60	$628.00	$353.19–$565.20	—	80%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HB NEURO PT EVAL MOD	$125.80	$629.00	$353.75–$566.10	—	80%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HB MANUAL TX TECH EA 15 MIN PT	$52.40	$262.00	$26.00–$235.80	39% below	80%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HB MANUAL THERAPY 15 MIN PT	$52.40	$262.00	$26.00–$235.80	39% below	80%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HB MANUAL TX TECH EA 15 MIN OT	$52.40	$262.00	$26.00–$235.80	39% below	80%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HB MANUAL THERAPY 15 MIN	$52.40	$262.00	$26.00–$235.80	39% below	80%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HB MANUAL TX TECH EA 15 MIN PT	$52.40	$262.00	$147.35–$235.80	—	80%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HB MANUAL TX TECH EA 15 MIN OT	$52.40	$262.00	$147.35–$235.80	—	80%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HB MANUAL THERAPY 15 MIN PT	$52.40	$262.00	$147.35–$235.80	—	80%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HB MANUAL THERAPY 15 MIN	$52.40	$262.00	$147.35–$235.80	—	80%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB THERAPEUTIC EXERCISE 15 MIN	$37.40	$187.00	$27.54–$168.30	51% below	80%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB THER EX EACH 15 MIN OT	$37.40	$187.00	$27.54–$168.30	51% below	80%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB THERAPEUTIC EXERCISE 15 MIN PT	$52.40	$262.00	$27.54–$235.80	31% below	80%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB THERAPEUTIC EXERCISE @ 15 MIN PT	$52.40	$262.00	$27.54–$235.80	31% below	80%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HB THERAPEUTIC EXERCISE 15 MIN	$37.40	$187.00	$105.17–$168.30	—	80%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HB THER EX EACH 15 MIN OT	$37.40	$187.00	$105.17–$168.30	—	80%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HB THERAPEUTIC EXERCISE @ 15 MIN PT	$52.40	$262.00	$147.35–$235.80	—	80%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HB THERAPEUTIC EXERCISE 15 MIN PT	$52.40	$262.00	$147.35–$235.80	—	80%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HB SMOK CESS COUN INTER > 3 MIN	$20.80	$104.00	$22.88–$93.60	31% below	80%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HB SMOK CESS COUN INTER > 3 MIN	$20.80	$104.00	$58.49–$93.60	—	80%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HB CLINIC VISIT V	$36.00	$180.00	$39.60–$162.00	76% below	80%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HB CLINIC VISIT V	$36.00	$180.00	$101.23–$162.00	—	80%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HB CLINIC VISIT III	$31.80	$159.00	$34.98–$143.10	64% below	80%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HB F/U OP VISIT W/RD 31-45 MIN	$79.20	$396.00	$87.12–$356.40	10% below	80%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HB CLINIC VISIT III	$31.80	$159.00	$89.42–$143.10	—	80%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HB F/U OP VISIT W/RD 31-45 MIN	$79.20	$396.00	$222.71–$356.40	—	80%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HB CLINIC VISIT IV	$34.00	$170.00	$37.40–$153.00	69% below	80%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HB CLINIC VISIT IV	$34.00	$170.00	$95.61–$153.00	—	80%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HB CLINIC VISIT II	$29.60	$148.00	$32.56–$133.20	43% below	80%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HB OP VISIT ESTB PT LEVEL II	$29.60	$148.00	$32.56–$133.20	43% below	80%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HB OP VISIT ESTB PT LEVEL II	$29.60	$148.00	$83.24–$133.20	—	80%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HB CLINIC VISIT II	$29.60	$148.00	$83.24–$133.20	—	80%
Speech and language evaluation CPT 92523 HB SPEECH SOUND LANG COMPREHEN	$129.20	$646.00	$142.12–$581.40	37% below	80%
Speech and language evaluation inpatient CPT 92523 HB SPEECH SOUND LANG COMPREHEN	$129.20	$646.00	$363.31–$581.40	—	80%
Speech therapy session, individual CPT 92507 HB TX SPEECH/LANG SLP	$95.40	$477.00	$72.05–$429.30	34% below	80%
Speech therapy session, individual inpatient CPT 92507 HB TX SPEECH/LANG SLP	$95.40	$477.00	$268.26–$429.30	—	80%
Spirometry (breathing test) CPT 94010 HB SPIROMETRY	$89.20	$446.00	$98.12–$401.40	64% below	80%
Spirometry (breathing test) CPT 94010 HB INCENTIVE SPIROMETRY INIT PFT	$89.20	$446.00	$98.12–$401.40	64% below	80%
Spirometry (breathing test) inpatient CPT 94010 HB SPIROMETRY	$89.20	$446.00	$250.83–$401.40	—	80%
Spirometry (breathing test) inpatient CPT 94010 HB INCENTIVE SPIROMETRY INIT PFT	$89.20	$446.00	$250.83–$401.40	—	80%
Spirometry before and after a bronchodilator CPT 94060 HB PRE/POST FLOW VOL LOOP	$165.40	$827.00	$181.94–$744.30	70% below	80%
Spirometry before and after a bronchodilator inpatient CPT 94060 HB PRE/POST FLOW VOL LOOP	$165.40	$827.00	$465.10–$744.30	—	80%
Therapeutic activities (functional training), 15 minutes CPT 97530 HB FUNC THERA ACT OT 15 MIN OT	$36.40	$182.00	$32.88–$163.80	52% below	80%
Therapeutic activities (functional training), 15 minutes CPT 97530 HB FUNC THERA ACT OT 15 MIN	$36.40	$182.00	$32.88–$163.80	52% below	80%
Therapeutic activities (functional training), 15 minutes CPT 97530 HB FUNC THERA ACT PT 15 MIN PT	$46.80	$234.00	$32.88–$210.60	38% below	80%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HB FUNC THERA ACT OT 15 MIN OT	$36.40	$182.00	$102.36–$163.80	—	80%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HB FUNC THERA ACT OT 15 MIN	$36.40	$182.00	$102.36–$163.80	—	80%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HB FUNC THERA ACT PT 15 MIN PT	$46.80	$234.00	$131.60–$210.60	—	80%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HB THERAPEUTIC PHLEBOTOMY	$66.20	$331.00	$72.82–$297.90	69% below	80%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HB THERAPEUTIC PHLEBOTOMY	$66.20	$331.00	$186.15–$297.90	—	80%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEPATITIS B RECOMB-IPV IM SUSP PRESYRG	$212.33	$1,061.62	$98.93–$955.45	12% above	80%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTAP-HEPATITIS B RECOMB-IPV IM SUSP PRESYRG	$212.33	$1,061.62	$623.06–$955.45	—	80%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IPV-HIB VACCINE IM SUSR	$249.42	$1,247.09	$107.55–$1,122.38	1% above	80%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTAP-IPV-HIB VACCINE IM SUSR	$249.42	$1,247.09	$731.92–$1,122.38	—	80%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSP PRESYRG	$631.62	$3,158.06	$322.20–$2,842.26	at median	80%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSP PRESYRG	$631.62	$3,158.06	$1,853.47–$2,842.26	—	80%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A-HEP B RECOMB VAC 720-20 ELU-MCG/ML IM SUSP PRESYRG	$271.39	$1,356.92	$130.93–$1,221.23	14% above	80%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS A-HEP B RECOMB VAC 720-20 ELU-MCG/ML IM SUSP PRESYRG	$271.39	$1,356.92	$796.38–$1,221.23	—	80%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE 50 UNIT/ML IM SUSP	$160.53	$802.65	$106.39–$722.38	6% below	80%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE 50 UNIT/ML IM SUSP	$160.53	$802.65	$471.07–$722.38	—	80%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SUSP	$143.96	$719.76	$70.38–$647.78	18% below	80%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SUSP	$143.96	$719.76	$422.43–$647.78	—	80%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VAC RECOMB ADJ 20 MCG/0.5ML IM SOL PRESYRG	$299.04	$1,495.20	$168.30–$1,345.68	at median	80%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VAC RECOMB ADJ 20 MCG/0.5ML IM SOL PRESYRG	$299.04	$1,495.20	$877.53–$1,345.68	—	80%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VAC RECOMBINANT 5 MCG/0.5ML IJ SUSP	$55.95	$279.74	$30.77–$251.77	24% below	80%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VAC RECOMBINANT 5 MCG/0.5ML IJ SUSP PRESYRG	$55.95	$279.74	$30.77–$251.77	24% below	80%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VAC RECOMBINANT 10 MCG/ML IJ SUSP PRESYRG	$138.41	$692.05	$30.77–$622.84	89% above	80%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VAC RECOMBINANT 5 MCG/0.5ML IJ SUSP	$55.95	$279.74	$164.18–$251.77	—	80%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VAC RECOMBINANT 5 MCG/0.5ML IJ SUSP PRESYRG	$55.95	$279.74	$164.18–$251.77	—	80%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VAC RECOMBINANT 10 MCG/ML IJ SUSP PRESYRG	$138.41	$692.05	$406.16–$622.84	—	80%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPHILUS B POLYSAC CONJ VAC 7.5 MCG/0.5 ML IM SUSP	$60.19	$300.94	$40.01–$270.85	8% below	80%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPHILUS B POLYSAC CONJ VAC 7.5 MCG/0.5 ML IM SUSP	$60.19	$300.94	$176.62–$270.85	—	80%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSAC CONJ VAC 10 MCG IJ SOLR	$24.35	$121.71	$16.23–$109.54	50% below	80%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSAC CONJ VAC IM SOLR	$34.78	$173.89	$16.23–$156.50	29% below	80%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSAC CONJ VAC 10 MCG IJ SOLR	$24.35	$121.71	$71.43–$109.54	—	80%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSAC CONJ VAC IM SOLR	$34.78	$173.89	$102.05–$156.50	—	80%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR	$187.43	$937.10	$124.60–$843.39	27% below	80%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR	$187.43	$937.10	$549.99–$843.39	—	80%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING ACY&W-135 DIPHTH CONJ IM SOLN	$285.36	$1,426.78	$102.50–$1,284.11	18% below	80%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENING ACY&W-135 DIPHTH CONJ IM SOLN	$285.36	$1,426.78	$837.38–$1,284.11	—	80%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP	$434.51	$2,172.54	$236.97–$1,955.28	7% below	80%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP	$434.51	$2,172.54	$1,275.06–$1,955.28	—	80%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSP PRESYRG	$592.34	$2,961.68	$273.85–$2,665.51	5% below	80%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSP PRESYRG	$592.34	$2,961.68	$1,738.21–$2,665.51	—	80%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE INACTIVATED IJ SUSP	$915.57	$4,577.84	$57.44–$4,120.06	639% above	80%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE INACTIVATED IJ SUSP	$915.57	$4,577.84	$2,686.73–$4,120.06	—	80%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC IM SUSR	$727.76	$3,638.80	$327.78–$3,274.92	9% below	80%
Rabies vaccine, one dose CPT 90675 RABIES VIRUS VACCINE, HDC IM SUSR	$900.88	$4,504.40	$327.78–$4,053.96	13% above	80%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC IM SUSR	$727.76	$3,638.80	$2,135.61–$3,274.92	—	80%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VIRUS VACCINE, HDC IM SUSR	$900.88	$4,504.40	$2,643.63–$4,053.96	—	80%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR	$368.63	$1,843.10	$207.79–$1,658.79	6% below	80%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR	$379.97	$1,899.84	$207.79–$1,709.86	3% below	80%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR	$368.63	$1,843.10	$1,081.72–$1,658.79	—	80%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR	$379.97	$1,899.84	$1,115.02–$1,709.86	—	80%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LF/0.5ML IM SUSP	$87.68	$438.37	$39.97–$394.53	23% below	80%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPHTHERIA-TETANUS TOXOIDS DT 25-5 LFU/0.5ML IM SUSP	$126.42	$632.06	$39.97–$568.86	10% above	80%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LF/0.5ML IM SUSP	$87.68	$438.37	$257.28–$394.53	—	80%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIPHTHERIA-TETANUS TOXOIDS DT 25-5 LFU/0.5ML IM SUSP	$126.42	$632.06	$370.96–$568.86	—	80%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH-ACELL PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 IM SUSP	$58.20	$290.98	$63.84–$261.88	53% below	80%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP	$90.28	$451.36	$63.84–$406.22	26% below	80%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP PRESYRG	$95.56	$477.75	$63.84–$429.98	22% below	80%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2-15.5 LF-MCG/0.5 IM SUSP	$97.36	$486.75	$63.84–$438.08	21% below	80%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2-15.5 LF-MCG/0.5 IM SUSP PRESYRG	$97.36	$486.75	$63.84–$438.08	21% below	80%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH-ACELL PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 IM SUSP	$58.20	$290.98	$170.77–$261.88	—	80%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP PRESYRG	$95.56	$477.75	$280.39–$429.98	—	80%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP	$95.56	$477.75	$280.39–$429.98	—	80%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2-15.5 LF-MCG/0.5 IM SUSP	$97.36	$486.75	$285.67–$438.08	—	80%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2-15.5 LF-MCG/0.5 IM SUSP PRESYRG	$97.36	$486.75	$285.67–$438.08	—	80%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB INFLUENZA IMMUNIZATION ADM >18	$31.20	$156.00	$34.32–$140.40	49% below	80%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB IMMUNIZATION ADMIN >19 YRS	$31.20	$156.00	$34.32–$140.40	49% below	80%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB PNEUMOVAC IMMUNIZATION ADM >18	$31.20	$156.00	$34.32–$140.40	49% below	80%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HB INFLUENZA IMMUNIZATION ADM >18	$31.20	$156.00	$87.73–$140.40	—	80%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HB PNEUMOVAC IMMUNIZATION ADM >18	$31.20	$156.00	$87.73–$140.40	—	80%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HB IMMUNIZATION ADMIN >19 YRS	$31.20	$156.00	$87.73–$140.40	—	80%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HB IMMUNIZATION ADMIN ADD >19 YRS	$7.20	$36.00	$7.92–$32.40	82% below	80%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HB IMMUNIZATION ADMIN ADD >19 YRS	$7.20	$36.00	$20.25–$32.40	—	80%

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

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

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

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

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

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

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

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

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

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/12590/461113518-1013251594_norton-healthcareindiana%2C-inc_standardcharges.csv