UConn Health, Waterbury Hospital
UConn Health, Waterbury Hospital in Waterbury, CT publishes cash prices for 51 common procedures listed here, from its own machine-readable price file updated May 13, 2026. Click a procedure to compare it with other hospitals nearby.
64 Robbins St, Waterbury, CT 06708 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis w IV Contrast | $2,345.89 | $4,691.77 | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography | $2,345.89 | $4,691.77 | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis w IV Contrast | $2,345.89 | $4,691.77 | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography | $2,345.89 | $4,691.77 | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain wo Contrast | $958.85 | $1,917.69 | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head Stroke Alert | $958.85 | $1,917.69 | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain wo Contrast | $958.85 | $1,917.69 | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Stroke Alert | $958.85 | $1,917.69 | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w IV Contrast | $608.12 | $1,216.24 | 50% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w IV Contrast | $608.12 | $1,216.24 | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MA Mammogram Digital Bilat Diagnostic | $735.42 | $1,470.83 | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MA Digital Mammo Diag Bilat Augmented | $735.42 | $1,470.83 | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA Digital Mammo Diag Bilat Augmented | $735.42 | $1,470.83 | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA Mammogram Digital Bilat Diagnostic | $735.42 | $1,470.83 | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Mammogram Digital Diagnostic Right | $454.95 | $909.89 | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Digital Mammo Diagnostic Augmented LT | $454.95 | $909.89 | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Mammogram Digital Diagnostic Left | $454.95 | $909.89 | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Digital Mammo Diagnostic Augmented RT | $454.95 | $909.89 | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Mammogram Digital Diagnostic Left | $454.95 | $909.89 | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Digital Mammo Diagnostic Augmented LT | $454.95 | $909.89 | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Mammogram Digital Diagnostic Right | $454.95 | $909.89 | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Digital Mammo Diagnostic Augmented RT | $454.95 | $909.89 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Hip wo Contrast Bilateral | $834.24 | $1,668.48 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Knee wo Contrast Bilateral | $834.24 | $1,668.48 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Ankle wo Contrast Bilateral | $834.24 | $1,668.48 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Lower Ext Jnt wo Contrast Bilat | $834.24 | $1,668.48 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Lower Ext Jnt wo Contrast Left | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle wo Contrast Left | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee wo Contrast Right | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee wo Contrast Right Visionaire | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hips wo Contrast Left | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Lower Ext Jnt wo Contrast Right | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee wo Contrast Left Visionaire | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee wo Contrast Left | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hips wo Contrast Right | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle wo Contrast Right | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Ankle wo Contrast Bilateral | $834.24 | $1,668.48 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Lower Ext Jnt wo Contrast Bilat | $834.24 | $1,668.48 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Knee wo Contrast Bilateral | $834.24 | $1,668.48 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Hip wo Contrast Bilateral | $834.24 | $1,668.48 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Lower Ext Jnt wo Contrast Left | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee wo Contrast Left | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle wo Contrast Right | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle wo Contrast Left | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hips wo Contrast Left | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee wo Contrast Left Visionaire | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee wo Contrast Right | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Lower Ext Jnt wo Contrast Right | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hips wo Contrast Right | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee wo Contrast Right Visionaire | $2,179.08 | $4,358.15 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI Ankle w wo Contrast Bilateral | $1,309.29 | $2,618.58 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI Knee w wo Contrast Bilateral | $1,309.29 | $2,618.58 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI Lower Ext Jnt w wo Contrast Bilat | $1,309.29 | $2,618.58 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI Hip w wo Contrast Bilateral | $1,309.29 | $2,618.58 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w wo Contrast Left | $1,780.57 | $3,561.13 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hips w wo Contrast Right | $1,780.57 | $3,561.13 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w wo Contrast Left | $1,780.57 | $3,561.13 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hips w wo Contrast Left | $1,780.57 | $3,561.13 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w wo Contrast Right | $1,780.57 | $3,561.13 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w wo Contrast Right | $1,780.57 | $3,561.13 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI Knee w wo Contrast Bilateral | $1,309.29 | $2,618.58 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI Hip w wo Contrast Bilateral | $1,309.29 | $2,618.58 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI Lower Ext Jnt w wo Contrast Bilat | $1,309.29 | $2,618.58 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI Ankle w wo Contrast Bilateral | $1,309.29 | $2,618.58 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w wo Contrast Right | $1,780.57 | $3,561.13 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w wo Contrast Left | $1,780.57 | $3,561.13 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hips w wo Contrast Right | $1,780.57 | $3,561.13 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hips w wo Contrast Left | $1,780.57 | $3,561.13 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w wo Contrast Left | $1,780.57 | $3,561.13 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w wo Contrast Right | $1,780.57 | $3,561.13 | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain wo Contrast | $2,118.31 | $4,236.62 | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain wo Contrast | $2,118.31 | $4,236.62 | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w wo Contrast | $2,798.48 | $5,596.95 | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w wo Contrast | $2,798.48 | $5,596.95 | 50% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar wo Contrast | $2,180.42 | $4,360.84 | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar wo Contrast | $2,180.42 | $4,360.84 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound Fetal First Trimester Charge | $503.18 | $1,006.36 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Complete 2nd/3rd Trimester | $553.65 | $1,107.29 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ultrasound Fetal First Trimester Charge | $503.18 | $1,006.36 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Complete 2nd/3rd Trimester | $553.65 | $1,107.29 | 50% |
| Screening mammogram, both breasts both sides CPT 77067 MA Mammogram Self Referred Bilat Screen | $502.20 | $1,004.40 | 50% |
| Screening mammogram, both breasts CPT 77067 MA Mammogram Digital Screen | $502.20 | $1,004.40 | 50% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MA Mammogram Self Referred Bilat Screen | $502.20 | $1,004.40 | 50% |
| Screening mammogram, both breasts inpatient CPT 77067 MA Mammogram Digital Screen | $502.20 | $1,004.40 | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysomnography 6+ hours; age 6 years or older | $3,798.26 | $7,596.51 | 50% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysomnography 6+ hours; age 6 years or older | $3,798.26 | $7,596.51 | 50% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB | $1,001.23 | $2,002.45 | 50% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON-OB | $1,001.23 | $2,002.45 | 50% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal w Doppler | $1,001.23 | $2,002.45 | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON-OB | $1,001.23 | $2,002.45 | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal w Doppler | $1,001.23 | $2,002.45 | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB | $1,001.23 | $2,002.45 | 50% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $1,028.91 | $2,057.81 | 50% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete w Doppler | $1,028.91 | $2,057.81 | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $1,028.91 | $2,057.81 | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete w Doppler | $1,028.91 | $2,057.81 | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 Views | $552.70 | $1,105.40 | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 Views | $552.70 | $1,105.40 | 50% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 BMP SO | $18.14 | $36.27 | 50% |
| Basic metabolic panel (blood test) CPT 80048 BMP | $94.79 | $189.58 | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BMP SO | $18.14 | $36.27 | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BMP | $94.79 | $189.58 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $78.39 | $156.78 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Cardio IQ-Advanced Lipid Panel w/ Inflammation (SO) | $78.39 | $156.78 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $78.39 | $156.78 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Cardio IQ-Advanced Lipid Panel w/ Inflammation (SO) | $78.39 | $156.78 | 50% |
| Complete blood count (CBC) with differential CPT 85025 CBC with Automated Differential | $34.76 | $69.52 | 50% |
| Complete blood count (CBC) with differential CPT 85025 M CBCA | $34.76 | $69.52 | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 M CBCA | $34.76 | $69.52 | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC with Automated Differential | $34.76 | $69.52 | 50% |
| Complete blood count (CBC), no differential CPT 85027 Complete Blood Count & Platelet | $33.63 | $67.26 | 50% |
| Complete blood count (CBC), no differential CPT 85027 Lab CBC for Platelet Agglutinins | $33.63 | $67.26 | 50% |
| Complete blood count (CBC), no differential CPT 85027 Manual CBC | $33.63 | $67.26 | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count & Platelet | $33.63 | $67.26 | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Manual CBC | $33.63 | $67.26 | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Lab CBC for Platelet Agglutinins | $33.63 | $67.26 | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 CMP SO | $22.68 | $45.36 | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 CMP | $179.67 | $359.34 | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 Neonate Comprehensive Metabolic Panel | $179.67 | $359.34 | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP SO | $22.68 | $45.36 | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Neonate Comprehensive Metabolic Panel | $179.67 | $359.34 | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP | $179.67 | $359.34 | 50% |
| Kidney function blood test panel CPT 80069 zzRenal Function Panel 08-29-06 | $94.57 | $189.13 | 50% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $113.59 | $227.18 | 50% |
| Kidney function blood test panel inpatient CPT 80069 zzRenal Function Panel 08-29-06 | $94.57 | $189.13 | 50% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $113.59 | $227.18 | 50% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel (SO) | $17.37 | $34.74 | 50% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $90.63 | $181.25 | 50% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel Neonate | $90.63 | $181.25 | 50% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel (SO) | $17.37 | $34.74 | 50% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $90.63 | $181.25 | 50% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel Neonate | $90.63 | $181.25 | 50% |
| Obstetric blood test panel CPT 80055 LabChg OB Panel | $260.15 | $520.29 | 50% |
| Obstetric blood test panel inpatient CPT 80055 LabChg OB Panel | $260.15 | $520.29 | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate Specific Antigen Free & Total 84100405 | $78.75 | $157.50 | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Prostate Specific Antigen Free & Total 84100405 | $78.75 | $157.50 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total (SO) | $10.50 | $21.00 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Post-Prostatectomy (SO) | $78.50 | $157.00 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSAD (Prostatic Specific Antigen Diagnostic) | $78.50 | $157.00 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen Screen | $78.50 | $157.00 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen Free & Total (SO) | $78.50 | $157.00 | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total (SO) | $10.50 | $21.00 | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen Free & Total (SO) | $78.50 | $157.00 | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Post-Prostatectomy (SO) | $78.50 | $157.00 | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSAD (Prostatic Specific Antigen Diagnostic) | $78.50 | $157.00 | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen Screen | $78.50 | $157.00 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Lupus Anticoagulant Eval w/reflex 85730 | $31.91 | $63.81 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $34.97 | $69.94 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-Heparin Protocol | $34.97 | $69.94 | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Lupus Anticoagulant Eval w/reflex 85730 | $31.91 | $63.81 | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-Heparin Protocol | $34.97 | $69.94 | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time | $34.97 | $69.94 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $34.97 | $69.94 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 ACC INR POC | $35.54 | $71.08 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 INR POC | $35.54 | $71.08 | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $34.97 | $69.94 | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR POC | $35.54 | $71.08 | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 ACC INR POC | $35.54 | $71.08 | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $71.19 | $142.38 | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/Reflex FT4 | $71.19 | $142.38 | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $71.19 | $142.38 | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/Reflex FT4 | $71.19 | $142.38 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 $Urinalysis Microscopic | $50.00 | $100.00 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 Myoglobin Urine Screening | $50.00 | $100.00 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Microscopic | $50.00 | $100.00 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 AWH-URMI | $50.00 | $100.00 | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Myoglobin Urine Screening | $50.00 | $100.00 | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 $Urinalysis Microscopic | $50.00 | $100.00 | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 AWH-URMI | $50.00 | $100.00 | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Microscopic | $50.00 | $100.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 pH Urine | $19.57 | $39.13 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Foley | $22.68 | $45.36 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Reflex Microscopic | $22.68 | $45.36 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 pH Urine | $19.57 | $39.13 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Reflex Microscopic | $22.68 | $45.36 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Foley | $22.68 | $45.36 | 50% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy with polyp removal CPT 45385 Colonoscopy flexible; with removal of tumor polyp or lesion by snare technique | $2,923.89 | $5,847.77 | 50% |
| Colonoscopy with polyp removal inpatient CPT 45385 Colonoscopy flexible; with removal of tumor polyp or lesion by snare technique | $2,923.89 | $5,847.77 | 50% |
| Colonoscopy with tissue sample CPT 45380 Colonoscopy flexible; with biopsy single or multiple | $2,808.77 | $5,617.53 | 50% |
| Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy flexible; with biopsy single or multiple | $2,808.77 | $5,617.53 | 50% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy flexible; DX including collection of specimen when performed | $3,099.74 | $6,199.47 | 50% |
| Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy flexible; DX including collection of specimen when performed | $3,099.74 | $6,199.47 | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 CT Epidural Steroid Inj Lumbar/Sacral | $3,416.39 | $6,832.77 | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR Epidural Steroid Inj Lumbar/Sacral | $3,416.83 | $6,833.66 | 50% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CT Epidural Steroid Inj Lumbar/Sacral | $3,416.39 | $6,832.77 | 50% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR Epidural Steroid Inj Lumbar/Sacral | $3,416.83 | $6,833.66 | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 CT Nerve Root Block Lumbar/Sacral | $3,590.82 | $7,181.63 | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 IR Nerve Root Block Lumbar/Sacral | $3,590.82 | $7,181.63 | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 CT Nerve Root Block Lumbar/Sacral | $3,590.82 | $7,181.63 | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 IR Nerve Root Block Lumbar/Sacral | $3,590.82 | $7,181.63 | 50% |
| Prostate biopsy CPT 55700 CT Biospsy Core Prostate | $2,726.28 | $5,452.56 | 50% |
| Prostate biopsy CPT 55700 IR Biopsy Core Prostate | $2,726.28 | $5,452.56 | 50% |
| Prostate biopsy CPT 55700 US Biopsy Core Prostate | $2,726.28 | $5,452.56 | 50% |
| Prostate biopsy inpatient CPT 55700 IR Biopsy Core Prostate | $2,726.28 | $5,452.56 | 50% |
| Prostate biopsy inpatient CPT 55700 CT Biospsy Core Prostate | $2,726.28 | $5,452.56 | 50% |
| Prostate biopsy inpatient CPT 55700 US Biopsy Core Prostate | $2,726.28 | $5,452.56 | 50% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy of esoph/stomach/small bowel w/endoscope 43239 | $1,440.65 | $2,881.29 | 50% |
| Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPYBIOPSY | $2,585.95 | $5,171.89 | 50% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Biopsy of esoph/stomach/small bowel w/endoscope 43239 | $1,440.65 | $2,881.29 | 50% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI ENDOSCOPYBIOPSY | $2,585.95 | $5,171.89 | 50% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esoph/stomach/sm bowel w/endoscope 43235 | $1,440.65 | $2,881.29 | 50% |
| Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GI ENDOSCOPY DIAGNOSIS | $2,917.57 | $5,835.14 | 50% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Diagnostic exam of esoph/stomach/sm bowel w/endoscope 43235 | $1,440.65 | $2,881.29 | 50% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPER GI ENDOSCOPY DIAGNOSIS | $2,917.57 | $5,835.14 | 50% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 1 | $1,367.19 | $2,734.37 | 50% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 1 | $1,367.19 | $2,734.37 | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 BCE ONLY-CHRG - Cardiology EKG/Holter Charges-STAT/Routine EKG 12 lead or 15 lead | $145.80 | $291.59 | 50% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 BCE ONLY-CHRG - Cardiology EKG/Holter Charges-STAT/Routine EKG 12 lead or 15 lead | $145.80 | $291.59 | 50% |
| Family therapy with the patient, 50 minutes CPT 90847 PHP/IOP Family Couples Psych w/Patient 90847 | $186.13 | $372.25 | 50% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 PHP/IOP Family Couples Psych w/Patient 90847 | $186.13 | $372.25 | 50% |
| Family therapy without the patient, 50 minutes CPT 90846 PHP/IOP Family Therapy w/o Patient 90846 | $121.98 | $243.96 | 50% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 PHP/IOP Family Therapy w/o Patient 90846 | $121.98 | $243.96 | 50% |
| Group psychotherapy session CPT 90853 PHP/IOP Group Therapy 90853 û 95 | $109.88 | $219.75 | 50% |
| Group psychotherapy session CPT 90853 PHP/IOP Group Therapy 90853 - GT | $109.88 | $219.75 | 50% |
| Group psychotherapy session CPT 90853 PHP/IOP Group Therapy 90853 | $109.88 | $219.75 | 50% |
| Group psychotherapy session CPT 90853 Group Therapy 90853 | $109.88 | $219.75 | 50% |
| Group psychotherapy session CPT 90853 Partial PHP/IOP Medicaid 90853- 52 | $109.88 | $219.75 | 50% |
| Group psychotherapy session inpatient CPT 90853 Partial PHP/IOP Medicaid 90853- 52 | $109.88 | $219.75 | 50% |
| Group psychotherapy session inpatient CPT 90853 Group Therapy 90853 | $109.88 | $219.75 | 50% |
| Group psychotherapy session inpatient CPT 90853 PHP/IOP Group Therapy 90853 | $109.88 | $219.75 | 50% |
| Group psychotherapy session inpatient CPT 90853 PHP/IOP Group Therapy 90853 û 95 | $109.88 | $219.75 | 50% |
| Group psychotherapy session inpatient CPT 90853 PHP/IOP Group Therapy 90853 - GT | $109.88 | $219.75 | 50% |
| New patient office visit, about 30 minutes CPT 99203 ACC E&M New Patient Level 3 | $116.85 | $233.69 | 50% |
| New patient office visit, about 30 minutes CPT 99203 ACC E&M New Pt. Level 3 | $116.85 | $233.69 | 50% |
| New patient office visit, about 30 minutes CPT 99203 Visit Level III | $116.85 | $233.69 | 50% |
| New patient office visit, about 30 minutes CPT 99203 BCE ONLY-CHRG - CHF New Patient-Level 3 | $249.68 | $499.35 | 50% |
| New patient office visit, about 30 minutes CPT 99203 Level 3 | $249.68 | $499.35 | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Visit Level III | $116.85 | $233.69 | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 ACC E&M New Patient Level 3 | $116.85 | $233.69 | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 ACC E&M New Pt. Level 3 | $116.85 | $233.69 | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Level 3 | $185.94 | $371.88 | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 BCE ONLY-CHRG - CHF New Patient-Level 3 | $249.68 | $499.35 | 50% |
| New patient office visit, about 45 minutes CPT 99204 ACC E&M New Pt. Level 4 | $133.54 | $267.07 | 50% |
| New patient office visit, about 45 minutes CPT 99204 Visit Level IV | $133.54 | $267.07 | 50% |
| New patient office visit, about 45 minutes CPT 99204 ACC E&M New Patient Level 4 | $133.54 | $267.07 | 50% |
| New patient office visit, about 45 minutes CPT 99204 Level 4 | $357.82 | $715.64 | 50% |
| New patient office visit, about 45 minutes CPT 99204 BCE ONLY-CHRG - CHF New Patient-Level 4 | $357.82 | $715.64 | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 ACC E&M New Patient Level 4 | $133.54 | $267.07 | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 ACC E&M New Pt. Level 4 | $133.54 | $267.07 | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Visit Level IV | $133.54 | $267.07 | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 BCE ONLY-CHRG - CHF New Patient-Level 4 | $357.82 | $715.64 | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Level 4 | $357.82 | $715.64 | 50% |
| New patient office visit, about 60 minutes CPT 99205 ACC E&M New Patient Level 5 | $161.36 | $322.71 | 50% |
| New patient office visit, about 60 minutes CPT 99205 ACC E&M New Pt. Level 5 | $161.36 | $322.71 | 50% |
| New patient office visit, about 60 minutes CPT 99205 Visit Level V | $161.36 | $322.71 | 50% |
| New patient office visit, about 60 minutes CPT 99205 Level 5 | $185.94 | $371.88 | 50% |
| New patient office visit, about 60 minutes CPT 99205 BCE ONLY-CHRG - CHF New Patient-Level 5 | $452.81 | $905.62 | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 ACC E&M New Pt. Level 5 | $161.36 | $322.71 | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Visit Level V | $161.36 | $322.71 | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 ACC E&M New Patient Level 5 | $161.36 | $322.71 | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Level 5 | $452.81 | $905.62 | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 BCE ONLY-CHRG - CHF New Patient-Level 5 | $452.81 | $905.62 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Units | $72.98 | $145.96 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Assistant Units | $95.79 | $191.57 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units | $145.17 | $290.33 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units | $145.17 | $290.33 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Assistant Units | $72.98 | $145.96 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Assistant Units | $95.79 | $191.57 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units | $145.17 | $290.33 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units | $145.17 | $290.33 | 50% |
| Psychotherapy session, 30 minutes CPT 90832 PHP/IOP Psychotherapy 30 Mins 90832 | $112.09 | $224.18 | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PHP/IOP Psychotherapy 30 Mins 90832 | $112.09 | $224.18 | 50% |
| Psychotherapy session, 45 minutes CPT 90834 PHP/IOP Psychotherapy 45 Mins 90834 | $160.50 | $321.00 | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PHP/IOP Psychotherapy 45 Mins 90834 | $160.50 | $321.00 | 50% |
| Psychotherapy session, 60 minutes CPT 90837 PHP/IOP Psychotherapy 60 Mins 90837 | $214.00 | $428.00 | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PHP/IOP Psychotherapy 60 Mins 90837 | $214.00 | $428.00 | 50% |