Hospital Madison, WI

UnityPoint Health - Meriter

Listed in its price file as “Meriter Hospital, Inc”.

UnityPoint Health - Meriter in Madison, WI publishes cash prices for 376 common procedures listed here, from its own machine-readable price file updated Jan 28, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Wisconsin median for 338 of 373 procedures and below it for 35. By typical cash price it ranks #102 of 103 Wisconsin hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

202 South Park Street, Madison, WI 53715-1596 Collected Sep 23, 2026 Source price file Check a bill from this hospital (608) 417-6210

Acute care hospital Nonprofit hospital Emergency department CMS star rating 5 of 5 CCN 520089 · CMS hospital register NPI 1114920048

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

UnityPoint Health - Meriter is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W WO CONTRAST	$5,468.16	$6,835.19	$171.95–$6,493.43	129% above	20%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W WO CONTRAST	$5,468.16	$6,835.19	$1,572.09–$6,493.43	—	20%
Abdominal X-ray, 2 views CPT 74019 HC X-RAY EXAM ABDOMEN 2 VIEWS	$545.16	$681.44	$102.72–$647.37	127% above	20%
Abdominal X-ray, 2 views inpatient CPT 74019 HC X-RAY EXAM ABDOMEN 2 VIEWS	$545.16	$681.44	$156.73–$647.37	—	20%
Ankle X-ray, complete, 3 or more views CPT 73610 HC ANKLE MIN 3 VIEWS	$601.04	$751.29	$85.05–$713.73	155% above	20%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC ANKLE MIN 3 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS	$1,121.16	$1,401.45	$124.51–$1,331.38	191% above	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS UNILAT	$1,121.16	$1,401.45	$124.51–$1,331.38	191% above	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS	$1,121.16	$1,401.45	$322.33–$1,331.38	—	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS UNILAT	$1,121.16	$1,401.45	$322.33–$1,331.38	—	20%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTR WO CONTRAST	$3,187.15	$3,983.93	$102.72–$3,784.73	122% above	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTR WO CONTRAST	$3,187.15	$3,983.93	$916.30–$3,784.73	—	20%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC ESOPHAGRAM SGL CONTRAST STUDY	$1,079.10	$1,348.87	$171.95–$1,281.43	104% above	20%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC ESOPHAGRAM SGL CONTRAST STUDY	$1,079.10	$1,348.87	$310.24–$1,281.43	—	20%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE IMAGING WHOLE BODY	$2,435.61	$3,044.51	$388.14–$2,892.28	63% above	20%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE IMAGING WHOLE BODY	$2,435.61	$3,044.51	$700.24–$2,892.28	—	20%
Breast ultrasound, complete, one breast both sides CPT 76641 HC US BREAST COMPLETE (BILAT)	$2,434.60	$3,043.24	$102.72–$2,891.08	—	20%
Breast ultrasound, complete, one breast CPT 76641 HC US BREAST COMPLETE	$1,217.30	$1,521.62	$102.72–$1,445.54	130% above	20%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 HC US BREAST COMPLETE (BILAT)	$2,434.60	$3,043.24	$699.95–$2,891.08	—	20%
Breast ultrasound, complete, one breast inpatient CPT 76641 HC US BREAST COMPLETE	$1,217.30	$1,521.62	$349.97–$1,445.54	—	20%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC US BREAST LIMITED (BILAT)	$2,012.34	$2,515.42	$85.05–$2,389.65	—	20%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US BREAST LIMITED	$1,006.17	$1,257.71	$85.05–$1,194.82	156% above	20%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 HC US BREAST LIMITED (BILAT)	$2,012.34	$2,515.42	$578.55–$2,389.65	—	20%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US BREAST LIMITED	$1,006.17	$1,257.71	$289.27–$1,194.82	—	20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT ANGIO ABD AND PELV WO W CONTRAST	$5,890.88	$7,363.60	$344.96–$6,995.42	93% above	20%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CT ANGIO ABD AND PELV WO W CONTRAST	$5,890.88	$7,363.60	$1,693.63–$6,995.42	—	20%
CT angiography (CTA) of the head CPT 70496 HC CT ANGIOGRAPHY HEAD W WO CONTRAST	$3,368.37	$4,210.46	$171.95–$3,999.94	62% above	20%
CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIOGRAPHY HEAD W WO CONTRAST	$3,368.37	$4,210.46	$968.41–$3,999.94	—	20%
CT angiography (CTA) of the neck CPT 70498 HC CT ANGIOGRAPHY NECK W WO CONTRAST	$3,368.37	$4,210.46	$171.95–$3,999.94	66% above	20%
CT angiography (CTA) of the neck inpatient CPT 70498 HC CT ANGIOGRAPHY NECK W WO CONTRAST	$3,368.37	$4,210.46	$968.41–$3,999.94	—	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST W WO CONTRAST	$5,539.32	$6,924.14	$171.95–$6,577.93	173% above	20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIOGRAPHY CHEST W WO CONTRAST	$5,539.32	$6,924.14	$1,592.55–$6,577.93	—	20%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CT ANGIOGRAPHY HEART	$4,396.71	$5,495.88	$344.96–$5,221.09	151% above	20%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CT ANGIOGRAPHY HEART	$4,396.71	$5,495.88	$1,264.05–$5,221.09	—	20%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HEART WO CONTRAST W CALCIUM SCORE	$171.60	$214.50	$49.34–$1,098.00	167% above	20%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HEART WO CONTRAST W CALCIUM SCORE	$171.60	$214.50	$49.34–$203.78	—	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$3,174.60	$3,968.25	$233.48–$3,769.84	26% above	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$3,174.60	$3,968.25	$912.70–$3,769.84	—	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$4,905.25	$6,131.56	$344.96–$5,824.98	53% above	20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$4,905.25	$6,131.56	$1,410.26–$5,824.98	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD & PELVIS W WO CONTR 1+ REG/SEC	$5,468.16	$6,835.19	$344.96–$6,493.43	48% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD & PELVIS W WO CONTR 1+ REG/SEC	$5,468.16	$6,835.19	$1,572.09–$6,493.43	—	20%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST	$4,905.25	$6,131.56	$171.95–$5,824.98	199% above	20%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W CONTRAST	$4,905.25	$6,131.56	$1,410.26–$5,824.98	—	20%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST	$3,174.60	$3,968.25	$102.72–$3,769.84	151% above	20%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN WO CONTRAST	$3,174.60	$3,968.25	$912.70–$3,769.84	—	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$1,930.44	$2,413.04	$102.72–$2,292.39	39% above	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$1,930.44	$2,413.04	$555.00–$2,292.39	—	20%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD OR BRAIN WO CONTRAST	$1,930.44	$2,413.04	$102.72–$2,292.39	50% above	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD OR BRAIN WO CONTRAST	$1,930.44	$2,413.04	$555.00–$2,292.39	—	20%
CT scan of the head with contrast CPT 70460 HC CT HEAD OR BRAIN W CONTRAST	$2,982.82	$3,728.52	$171.95–$3,542.09	93% above	20%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD OR BRAIN W CONTRAST	$2,982.82	$3,728.52	$857.56–$3,542.09	—	20%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD OR BRAIN W WO CONTRAST	$3,325.12	$4,156.39	$171.95–$3,948.57	81% above	20%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD OR BRAIN W WO CONTRAST	$3,325.12	$4,156.39	$955.97–$3,948.57	—	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$3,187.15	$3,983.93	$102.72–$3,784.73	107% above	20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$3,187.15	$3,983.93	$916.30–$3,784.73	—	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE WO CONTRAST	$3,186.26	$3,982.82	$102.72–$3,783.68	107% above	20%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL SPINE WO CONTRAST	$3,186.26	$3,982.82	$916.05–$3,783.68	—	20%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST	$4,905.25	$6,131.56	$171.95–$5,824.98	199% above	20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST	$4,905.25	$6,131.56	$1,410.26–$5,824.98	—	20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC CAROTID DUPLEX SCAN; BILAT	$1,674.08	$2,092.60	$233.48–$1,987.97	—	20%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC CAROTID DUPLEX SCAN; BILAT	$1,674.08	$2,092.60	$481.30–$1,987.97	—	20%
Chest CT scan without and with contrast CPT 71270 HC CT CHEST W WO CONTRAST DIAG	$5,468.16	$6,835.19	$171.95–$6,493.43	137% above	20%
Chest CT scan without and with contrast inpatient CPT 71270 HC CT CHEST W WO CONTRAST DIAG	$5,468.16	$6,835.19	$1,572.09–$6,493.43	—	20%
Chest X-ray, 2 views CPT 71046 HC X-RAY EXAM CHEST 2 VIEWS	$527.92	$659.90	$85.05–$626.91	146% above	20%
Chest X-ray, 2 views inpatient CPT 71046 HC X-RAY EXAM CHEST 2 VIEWS	$527.92	$659.90	$151.78–$626.91	—	20%
Chest X-ray, single view CPT 71045 HC X-RAY EXAM CHEST 1 VIEW	$516.45	$645.56	$85.05–$613.28	219% above	20%
Chest X-ray, single view inpatient CPT 71045 HC X-RAY EXAM CHEST 1 VIEW	$516.45	$645.56	$148.48–$613.28	—	20%
Collarbone (clavicle) X-ray, complete CPT 73000 HC CLAVICLE COMPLETE	$601.04	$751.29	$85.05–$713.73	190% above	20%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC CLAVICLE COMPLETE	$601.04	$751.29	$172.80–$713.73	—	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US EXAM RETROPERITONEAL COMPL	$1,415.87	$1,769.83	$102.72–$1,681.34	158% above	20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US EXAM RETROPERITONEAL COMPL	$1,415.87	$1,769.83	$407.06–$1,681.34	—	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY AXIAL	$859.38	$1,074.22	$102.72–$1,020.51	116% above	20%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DXA BONE DENSITY AXIAL	$859.38	$1,074.22	$247.07–$1,020.51	—	20%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC MM DXA BONE DENSITY/PERIPHERAL 1+ SITES	$536.92	$671.14	$85.05–$637.58	90% above	20%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC MM DXA BONE DENSITY/PERIPHERAL 1+ SITES	$536.92	$671.14	$154.36–$637.58	—	20%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US OB DETAILED SNGL FETUS	$2,205.77	$2,757.21	$233.48–$2,619.35	222% above	20%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US OB DETAILED SNGL FETUS	$2,205.77	$2,757.21	$634.16–$2,619.35	—	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST WO CONTRAST DIAG	$3,174.60	$3,968.25	$102.72–$3,769.84	121% above	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT CHEST WO CONTRAST DIAG	$3,174.60	$3,968.25	$912.70–$3,769.84	—	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT CHEST W CONTRAST DIAG	$4,905.25	$6,131.56	$171.95–$5,824.98	199% above	20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT CHEST W CONTRAST DIAG	$4,905.25	$6,131.56	$1,410.26–$5,824.98	—	20%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LE ART/BPG; BILAT	$2,435.26	$3,044.07	$233.48–$2,891.87	—	20%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LE ART/BPG; BILAT	$2,435.26	$3,044.07	$700.14–$2,891.87	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXT VEINS; BILAT	$2,571.04	$3,213.79	$233.48–$3,053.10	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXT VEINS; BILAT	$2,571.04	$3,213.79	$739.17–$3,053.10	—	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE W/ DOPPLER COMPLETE	$2,942.49	$3,678.11	$529.61–$3,494.20	68% above	20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE W/ DOPPLER COMPLETE	$2,942.49	$3,678.11	$845.97–$3,494.20	—	20%
Elbow X-ray, 2 views CPT 73070 HC ELBOW 2 VIEWS	$601.04	$751.29	$85.05–$713.73	214% above	20%
Elbow X-ray, 2 views inpatient CPT 73070 HC ELBOW 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
Elbow X-ray, complete, 3 or more views CPT 73080 HC ELBOW MIN 3 VIEWS	$601.04	$751.29	$85.05–$713.73	155% above	20%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC ELBOW MIN 3 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT SELLA MID INNER EAR WO CONTR	$1,930.44	$2,413.04	$102.72–$2,292.39	34% above	20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT SELLA MID INNER EAR WO CONTR	$1,930.44	$2,413.04	$555.00–$2,292.39	—	20%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC FACIAL BONES MIN 3 VIEWS	$675.44	$844.30	$102.72–$802.09	125% above	20%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC FACIAL BONES MIN 3 VIEWS	$675.44	$844.30	$194.19–$802.09	—	20%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC FOREARM 2 VIEWS	$601.04	$751.29	$85.05–$713.73	205% above	20%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC FOREARM 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM HEPATOBILIARY SYSTEM IMAGING	$2,024.44	$2,530.55	$388.14–$2,404.02	37% above	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NM HEPATOBILIARY SYSTEM IMAGING	$2,024.44	$2,530.55	$582.03–$2,404.02	—	20%
Hand X-ray, 2 views CPT 73120 HC HAND 2 VIEWS	$601.04	$751.29	$102.72–$713.73	219% above	20%
Hand X-ray, 2 views inpatient CPT 73120 HC HAND 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC CALCANEUS MIN 2 VIEWS	$601.04	$751.29	$85.05–$713.73	203% above	20%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC CALCANEUS MIN 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
Knee X-ray, 3 views CPT 73562 HC KNEE 3 VIEWS	$601.04	$751.29	$85.05–$713.73	136% above	20%
Knee X-ray, 3 views inpatient CPT 73562 HC KNEE 3 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
Knee X-ray, complete, 4 or more views CPT 73564 HC KNEE MIN 4 VIEWS	$675.44	$844.30	$102.72–$802.09	144% above	20%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC KNEE MIN 4 VIEWS	$675.44	$844.30	$194.19–$802.09	—	20%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTR WO CONTRAST	$3,077.92	$3,847.40	$102.72–$3,655.03	111% above	20%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXTR WO CONTRAST	$3,077.92	$3,847.40	$884.90–$3,655.03	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US EXAM ABDOMEN LIMITED	$1,414.32	$1,767.90	$102.72–$1,679.51	218% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US EXAM ABDOMEN LIMITED	$1,414.32	$1,767.90	$406.62–$1,679.51	—	20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US XTR NON-VASC LTD	$919.47	$1,149.33	$102.72–$1,091.86	221% above	20%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US XTR NON-VASC LTD	$919.47	$1,149.33	$264.35–$1,091.86	—	20%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC TIBIA FIBULA 2 VIEWS	$601.04	$751.29	$85.05–$713.73	182% above	20%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC TIBIA FIBULA 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD WO CONTRAST	$2,169.75	$2,712.18	$233.48–$2,576.57	2% below	20%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA HEAD WO CONTRAST	$2,169.75	$2,712.18	$623.80–$2,576.57	—	20%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOW EXTR ANY JOINT WO CONTRAST	$2,066.76	$2,583.45	$233.48–$2,454.28	6% below	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOW EXTR ANY JOINT WO CONTRAST	$2,066.76	$2,583.45	$594.19–$2,454.28	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOW EXTR ANY JOINT W WO CONTR	$3,306.07	$4,132.58	$344.96–$3,925.95	3% below	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOW EXTR ANY JOINT W WO CONTR	$3,306.07	$4,132.58	$950.49–$3,925.95	—	20%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST	$2,313.01	$2,891.26	$233.48–$2,746.70	5% above	20%
MRI of the abdomen without contrast CPT 74181 HC MR CHOLANGIOPANCREATOGRAPHY (MRCP)	$3,082.92	$3,853.65	$233.48–$3,660.97	39% above	20%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN WO CONTRAST	$2,313.01	$2,891.26	$664.99–$2,746.70	—	20%
MRI of the abdomen without contrast inpatient CPT 74181 HC MR CHOLANGIOPANCREATOGRAPHY (MRCP)	$3,082.92	$3,853.65	$886.34–$3,660.97	—	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W WO CONTRAST	$3,552.32	$4,440.40	$344.96–$4,218.38	4% above	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRCP W WO CONTRAST	$5,167.22	$6,459.02	$344.96–$6,136.07	51% above	20%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN W WO CONTRAST	$3,552.32	$4,440.40	$1,021.29–$4,218.38	—	20%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRCP W WO CONTRAST	$5,167.22	$6,459.02	$1,485.57–$6,136.07	—	20%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN WO CONTRAST	$2,124.55	$2,655.68	$233.48–$2,522.90	4% below	20%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN WO CONTRAST	$2,124.55	$2,655.68	$610.81–$2,522.90	—	20%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W WO CONTRAST	$3,169.68	$3,962.09	$344.96–$3,763.99	7% below	20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W WO CONTRAST	$3,169.68	$3,962.09	$911.28–$3,763.99	—	20%
MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINE LUMBAR WO CONTRAST	$2,118.84	$2,648.54	$233.48–$2,516.11	4% below	20%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINE LUMBAR WO CONTRAST	$2,118.84	$2,648.54	$609.16–$2,516.11	—	20%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI SPINE LUMBAR W WO CONTRAST	$3,141.13	$3,926.41	$344.96–$3,730.09	8% below	20%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI SPINE LUMBAR W WO CONTRAST	$3,141.13	$3,926.41	$903.07–$3,730.09	—	20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI SPINE THORACIC WO CONTRAST	$2,025.63	$2,532.03	$233.48–$2,405.43	8% below	20%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI SPINE THORACIC WO CONTRAST	$2,025.63	$2,532.03	$582.37–$2,405.43	—	20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI SPINE CERVICAL W WO CONTRAST	$3,141.13	$3,926.41	$344.96–$3,730.09	8% below	20%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI SPINE CERVICAL W WO CONTRAST	$3,141.13	$3,926.41	$903.07–$3,730.09	—	20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI SPINE CERVICAL WO CONTRAST	$2,118.84	$2,648.54	$233.48–$2,516.11	4% below	20%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI SPINE CERVICAL WO CONTRAST	$2,118.84	$2,648.54	$609.16–$2,516.11	—	20%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W WO CONTRAST	$3,392.42	$4,240.52	$344.96–$4,028.49	1% below	20%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS W WO CONTRAST	$3,392.42	$4,240.52	$975.32–$4,028.49	—	20%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO CONTRAST	$2,273.04	$2,841.30	$233.48–$2,699.24	3% above	20%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS WO CONTRAST	$2,273.04	$2,841.30	$653.50–$2,699.24	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UP EXTR ANY JOINT WO CONTRAST	$2,064.30	$2,580.37	$233.48–$2,451.35	7% below	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UP EXTR ANY JOINT WO CONTRAST	$2,064.30	$2,580.37	$593.49–$2,451.35	—	20%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC CERVICAL SPINE MIN 4 VIEWS	$925.86	$1,157.32	$102.72–$1,099.45	188% above	20%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC CERVICAL SPINE MIN 4 VIEWS	$925.86	$1,157.32	$266.18–$1,099.45	—	20%
Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$2,982.82	$3,728.52	$171.95–$3,542.09	82% above	20%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$2,982.82	$3,728.52	$857.56–$3,542.09	—	20%
Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$1,930.44	$2,413.04	$102.72–$2,292.39	36% above	20%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$1,930.44	$2,413.04	$555.00–$2,292.39	—	20%
Neck soft tissue X-ray CPT 70360 HC SOFT TISSUE NECK	$534.47	$668.08	$85.05–$634.68	155% above	20%
Neck soft tissue X-ray inpatient CPT 70360 HC SOFT TISSUE NECK	$534.47	$668.08	$153.66–$634.68	—	20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM HEART MUSCLE SPECT MULT	$5,040.51	$6,300.63	$1,260.99–$5,985.60	63% above	20%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM HEART MUSCLE SPECT MULT	$5,040.51	$6,300.63	$1,449.14–$5,985.60	—	20%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC NM PET IMAGE W CT SKULL THIGH	$3,775.21	$4,719.01	$1,085.37–$8,740.00	11% below	20%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC NM PET IMAGE W CT SKULL THIGH	$3,775.21	$4,719.01	$1,085.37–$4,483.06	—	20%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST	$3,174.60	$3,968.25	$102.72–$3,769.84	149% above	20%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS WO CONTRAST	$3,174.60	$3,968.25	$912.70–$3,769.84	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC LTD TRANSABDOMINAL	$919.47	$1,149.33	$102.72–$1,091.86	130% above	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM PELVIC LTD TRANSABDOMINAL	$919.47	$1,149.33	$264.35–$1,091.86	—	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US EXAM PELVIC COMP TRANSABDOMINAL	$1,415.87	$1,769.83	$102.72–$1,681.34	170% above	20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US EXAM PELVIC COMP TRANSABDOMINAL	$1,415.87	$1,769.83	$407.06–$1,681.34	—	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB COMPLETE SNGL FETUS	$1,415.87	$1,769.83	$102.72–$1,681.34	147% above	20%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB COMPLETE SNGL FETUS	$1,415.87	$1,769.83	$407.06–$1,681.34	—	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US OB LESS THAN 14 WKS SNGL FETUS	$1,047.83	$1,309.78	$102.72–$1,244.29	104% above	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US OB LESS THAN 14 WKS SNGL FETUS	$1,047.83	$1,309.78	$301.25–$1,244.29	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED FETUS(S)	$919.47	$1,149.33	$102.72–$1,091.86	150% above	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED FETUS(S)	$919.47	$1,149.33	$264.35–$1,091.86	—	20%
Rib X-ray, one side, 2 views one side CPT 71100 HC RIBS UNILATERAL 2 VIEWS	$601.04	$751.29	$85.05–$713.73	168% above	20%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC RIBS UNILATERAL 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC RIBS CHEST UNIL MIN 3 VIEWS	$675.44	$844.30	$102.72–$802.09	143% above	20%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC RIBS CHEST UNIL MIN 3 VIEWS	$675.44	$844.30	$194.19–$802.09	—	20%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC SHOULDER MIN 2 VIEWS	$601.04	$751.29	$85.05–$713.73	156% above	20%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC SHOULDER MIN 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
Sinus X-ray, complete, 3 or more views CPT 70220 HC SINUSES MIN 3 VIEWS	$675.44	$844.30	$85.05–$802.09	155% above	20%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC SINUSES MIN 3 VIEWS	$675.44	$844.30	$194.19–$802.09	—	20%
Skull X-ray, fewer than 4 views CPT 70250 HC SKULL LESS THAN 4 VIEWS	$601.04	$751.29	$102.72–$713.73	146% above	20%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC SKULL LESS THAN 4 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC STRESS TTE COMPLETE	$1,425.69	$1,782.11	$409.89–$1,693.00	30% below	20%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC STRESS TTE COMPLETE	$1,425.69	$1,782.11	$409.89–$1,693.00	—	20%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC SWALLOWING FUNCTION W CINE VIDEO	$1,079.10	$1,348.87	$171.95–$1,281.43	136% above	20%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC SWALLOWING FUNCTION W CINE VIDEO	$1,079.10	$1,348.87	$310.24–$1,281.43	—	20%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC X-RAY EXAM OF FEMUR 2/> VW	$542.11	$677.63	$85.05–$643.75	120% above	20%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC X-RAY EXAM OF FEMUR 2/> VW	$542.11	$677.63	$155.85–$643.75	—	20%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC SPINE WO CONTRAST	$3,104.12	$3,880.15	$102.72–$3,686.14	102% above	20%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT THORACIC SPINE WO CONTRAST	$3,104.12	$3,880.15	$892.43–$3,686.14	—	20%
Toe X-ray, 2 or more views CPT 73660 HC TOE OR TOES MIN 2 VIEWS	$601.04	$751.29	$85.05–$713.73	198% above	20%
Toe X-ray, 2 or more views inpatient CPT 73660 HC TOE OR TOES MIN 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
Transvaginal pelvic ultrasound CPT 76830 HC US NON OB TRANSVAG	$1,415.87	$1,769.83	$102.72–$1,681.34	202% above	20%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US NON OB TRANSVAG	$1,415.87	$1,769.83	$407.06–$1,681.34	—	20%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL	$919.47	$1,149.33	$102.72–$1,091.86	135% above	20%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US OB TRANSVAGINAL	$919.47	$1,149.33	$264.35–$1,091.86	—	20%
Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE	$1,660.97	$2,076.21	$102.72–$1,972.40	145% above	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US EXAM ABDOMEN COMPLETE	$1,660.97	$2,076.21	$477.53–$1,972.40	—	20%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM AND CONTENTS	$1,415.87	$1,769.83	$102.72–$1,681.34	187% above	20%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM AND CONTENTS	$1,415.87	$1,769.83	$407.06–$1,681.34	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM OF HEAD AND NECK	$1,415.87	$1,769.83	$102.72–$1,681.34	177% above	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US EXAM OF HEAD AND NECK	$1,415.87	$1,769.83	$407.06–$1,681.34	—	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC UGI W OR WO KUB	$1,079.10	$1,348.87	$171.95–$1,281.43	58% above	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC UGI W OR WO KUB	$1,079.10	$1,348.87	$310.24–$1,281.43	—	20%
Upper arm X-ray (humerus), 2 views CPT 73060 HC HUMERUS MIN 2 VIEWS	$601.04	$751.29	$85.05–$713.73	186% above	20%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC HUMERUS MIN 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXT VEINS UNIL/LIMIT	$1,512.67	$1,890.83	$102.72–$1,796.29	112% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC DUPLEX EXT VEINS UNIL/LIMIT	$1,512.67	$1,890.83	$434.89–$1,796.29	—	20%
Wrist X-ray, 2 views CPT 73100 HC WRIST 2 VIEWS	$601.04	$751.29	$85.05–$713.73	179% above	20%
Wrist X-ray, 2 views inpatient CPT 73100 HC WRIST 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
Wrist X-ray, complete, 3 or more views CPT 73110 HC WRIST COMPL MIN 3 VIEWS	$601.04	$751.29	$85.05–$713.73	136% above	20%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC WRIST COMPL MIN 3 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS	$542.11	$677.63	$85.05–$643.75	86% above	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS	$542.11	$677.63	$155.85–$643.75	—	20%
X-ray of the abdomen, 1 view CPT 74018 HC X-RAY EXAM ABDOMEN 1 VIEW	$533.66	$667.07	$85.05–$633.72	153% above	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC X-RAY EXAM ABDOMEN 1 VIEW	$533.66	$667.07	$153.43–$633.72	—	20%
X-ray of the ankle, 2 views CPT 73600 HC ANKLE 2 VIEWS	$601.04	$751.29	$85.05–$713.73	202% above	20%
X-ray of the ankle, 2 views inpatient CPT 73600 HC ANKLE 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
X-ray of the finger(s), 2 or more views CPT 73140 HC FINGER OR FINGERS MIN 2 VIEWS	$601.04	$751.29	$85.05–$713.73	146% above	20%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC FINGER OR FINGERS MIN 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
X-ray of the foot, 2 views CPT 73620 HC FOOT 2 VIEWS	$601.04	$751.29	$85.05–$713.73	216% above	20%
X-ray of the foot, 2 views inpatient CPT 73620 HC FOOT 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
X-ray of the foot, complete, 3 or more views CPT 73630 HC FOOT MIN 3 VIEWS	$601.04	$751.29	$85.05–$713.73	149% above	20%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC FOOT MIN 3 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
X-ray of the hand, 3 or more views CPT 73130 HC HAND MIN 3 VIEWS	$601.04	$751.29	$85.05–$713.73	156% above	20%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC HAND MIN 3 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
X-ray of the knee, 1 or 2 views CPT 73560 HC KNEE 1 OR 2 VIEWS	$601.04	$751.29	$85.05–$713.73	184% above	20%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC KNEE 1 OR 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC LUMBOSACR SPINE 2 OR 3 VIEWS	$601.04	$751.29	$102.72–$713.73	106% above	20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC LUMBOSACR SPINE 2 OR 3 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
X-ray of the lower back, 4 or more views CPT 72110 HC LUMBOSACR SPINE MIN 4 VIEWS	$925.86	$1,157.32	$102.72–$1,099.45	148% above	20%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC LUMBOSACR SPINE MIN 4 VIEWS	$925.86	$1,157.32	$266.18–$1,099.45	—	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC THORACIC SPINE 2 VIEWS	$601.04	$751.29	$102.72–$713.73	153% above	20%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC THORACIC SPINE 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
X-ray of the nasal bones, 3 or more views CPT 70160 HC NASAL BONES MIN 3 VIEWS	$601.04	$751.29	$85.05–$713.73	148% above	20%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC NASAL BONES MIN 3 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC CERVICAL SPINE 2 OR 3 VIEWS	$601.04	$751.29	$85.05–$713.73	150% above	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC CERVICAL SPINE 2 OR 3 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC PELVIS 1 OR 2 VIEWS	$601.04	$751.29	$102.72–$713.73	171% above	20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC PELVIS 1 OR 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC SACRUM COCCYX MIN 2 VIEWS	$601.04	$751.29	$85.05–$713.73	178% above	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC SACRUM COCCYX MIN 2 VIEWS	$601.04	$751.29	$172.80–$713.73	—	20%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
ACTH blood test CPT 82024 HC ACTH	$343.54	$429.42	$38.62–$407.95	56% above	20%
ACTH blood test inpatient CPT 82024 HC ACTH	$343.54	$429.42	$98.77–$407.95	—	20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE; ALANINE AMINO	$70.60	$88.25	$5.30–$83.84	102% above	20%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE; ALANINE AMINO	$70.60	$88.25	$20.30–$83.84	—	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC AST OR SGOT	$69.12	$86.40	$5.18–$82.08	46% above	20%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC AST OR SGOT	$69.12	$86.40	$19.87–$82.08	—	20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC ACUTE HEPATITIS PANEL	$443.48	$554.34	$47.63–$526.62	46% above	20%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC ACUTE HEPATITIS PANEL	$443.48	$554.34	$127.50–$526.62	—	20%
Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN	$67.02	$83.77	$4.95–$79.58	79% above	20%
Albumin blood test inpatient CPT 82040 HC ASSAY OF SERUM ALBUMIN	$67.02	$83.77	$19.27–$79.58	—	20%
Aldosterone blood test CPT 82088 HC ALDOSTERONE	$424.45	$530.56	$40.75–$504.03	118% above	20%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE	$424.45	$530.56	$122.03–$504.03	—	20%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOSPHATASE	$69.76	$87.19	$5.18–$82.83	43% above	20%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOSPHATASE	$69.76	$87.19	$20.05–$82.83	—	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERG SP IGE; QUAN OR SEMIQUAN	$23.12	$28.89	$5.22–$27.45	8% below	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERG SP IGE; QUAN OR SEMIQUAN	$23.12	$28.89	$6.64–$27.45	—	20%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN, SERUM	$198.01	$247.51	$16.77–$235.13	137% above	20%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN, SERUM	$198.01	$247.51	$56.93–$235.13	—	20%
Ammonia blood test CPT 82140 HC AMMONIA	$343.51	$429.38	$14.57–$407.91	283% above	20%
Ammonia blood test inpatient CPT 82140 HC AMMONIA	$343.51	$429.38	$98.76–$407.91	—	20%
Amylase blood test CPT 82150 HC AMYLASE	$344.32	$430.40	$6.48–$408.88	458% above	20%
Amylase blood test inpatient CPT 82150 HC AMYLASE	$344.32	$430.40	$98.99–$408.88	—	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP ANTIBODY	$160.18	$200.22	$12.95–$190.21	94% above	20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCP ANTIBODY	$160.18	$200.22	$46.05–$190.21	—	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR AB (ANA);	$126.48	$158.10	$12.09–$150.20	84% above	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR AB (ANA);	$126.48	$158.10	$36.36–$150.20	—	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE	$398.36	$497.95	$39.26–$473.05	179% above	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE	$398.36	$497.95	$114.53–$473.05	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC BACTERIAL CULTURE - OTHR SOURCE	$114.76	$143.45	$8.62–$136.28	119% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC BACTERIAL CULTURE - OTHR SOURCE	$114.76	$143.45	$32.99–$136.28	—	20%
Basic metabolic panel (blood test) CPT 80048 HC METABOLIC PANEL TOTAL CA	$146.82	$183.52	$8.46–$174.34	66% above	20%
Basic metabolic panel (blood test) inpatient CPT 80048 HC METABOLIC PANEL TOTAL CA	$146.82	$183.52	$42.21–$174.34	—	20%
Bilirubin blood test, total CPT 82247 HC TOTAL BILIRUBIN	$67.93	$84.91	$5.02–$80.66	45% above	20%
Bilirubin blood test, total inpatient CPT 82247 HC TOTAL BILIRUBIN	$67.93	$84.91	$19.53–$80.66	—	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURG PATH, LEVEL-IV	$712.40	$890.49	$51.61–$845.97	230% above	20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SURG PATH, LEVEL-IV	$712.40	$890.49	$204.81–$845.97	—	20%
Blood culture for bacteria CPT 87040 HC AEROB BACTERIAL BLOOD CULTURE	$136.80	$171.00	$10.32–$162.45	59% above	20%
Blood culture for bacteria inpatient CPT 87040 HC AEROB BACTERIAL BLOOD CULTURE	$136.80	$171.00	$39.33–$162.45	—	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE	$28.53	$35.66	$5.00–$33.88	94% above	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE	$28.53	$35.66	$8.20–$33.88	—	20%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUAN BLOOD	$47.58	$59.47	$3.93–$56.50	95% above	20%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUAN BLOOD	$47.58	$59.47	$13.68–$56.50	—	20%
Blood lead test CPT 83655 HC LEAD	$118.95	$148.68	$12.11–$141.25	116% above	20%
Blood lead test inpatient CPT 83655 HC LEAD	$118.95	$148.68	$34.20–$141.25	—	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC HCG QUAL	$101.00	$126.25	$7.52–$119.94	63% above	20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC HCG QUAL	$101.00	$126.25	$29.04–$119.94	—	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING; ABO	$78.90	$98.62	$22.68–$124.51	86% above	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING; ABO	$78.90	$98.62	$22.68–$93.69	—	20%
Blood urea nitrogen (BUN) test CPT 84520 HC UREA NITROGEN; QUAN	$58.71	$73.38	$3.95–$69.71	128% above	20%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC UREA NITROGEN; QUAN	$58.71	$73.38	$16.88–$69.71	—	20%
C-peptide blood test CPT 84681 HC C-PEPTIDE	$64.73	$80.91	$18.61–$76.86	25% below	20%
C-peptide blood test inpatient CPT 84681 HC C-PEPTIDE	$64.73	$80.91	$18.61–$76.86	—	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN	$32.42	$40.52	$5.18–$38.49	41% below	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN	$32.42	$40.52	$9.32–$38.49	—	20%
C. difficile toxin gene test (stool PCR) CPT 87493 HC C DIFF AMPLIFIED PROBE	$467.68	$584.59	$37.27–$555.36	210% above	20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C DIFF AMPLIFIED PROBE	$467.68	$584.59	$134.46–$555.36	—	20%
CA 19-9 blood test (tumor marker) CPT 86301 HC IA, QUANT; CA 19-9	$257.44	$321.80	$20.81–$305.71	129% above	20%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IA, QUANT; CA 19-9	$257.44	$321.80	$74.01–$305.71	—	20%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC IA, QUANT; CA 125	$257.44	$321.80	$20.81–$305.71	115% above	20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IA, QUANT; CA 125	$257.44	$321.80	$74.01–$305.71	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID-19 LAB TEST NON-CDC AMP PRB	$132.21	$165.26	$38.01–$157.00	2% below	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC COVID-19 LAB TEST NON-CDC AMP PRB	$132.21	$165.26	$38.01–$157.00	—	20%
Calcium blood test, total CPT 82310 HC CALCIUM; TOTAL	$68.80	$85.99	$5.16–$81.69	31% above	20%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM; TOTAL	$68.80	$85.99	$19.78–$81.69	—	20%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CEA	$234.72	$293.39	$18.96–$278.72	73% above	20%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CEA	$234.72	$293.39	$67.48–$278.72	—	20%
Chickenpox (varicella) immunity blood test CPT 86787 HC AB; VARICELLA-ZOSTER	$72.00	$89.99	$12.88–$85.49	2% below	20%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC AB; VARICELLA-ZOSTER	$72.00	$89.99	$20.70–$85.49	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA T, AMPLIF NA PROBE	$314.92	$393.65	$35.09–$373.97	120% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA T, AMPLIF NA PROBE	$314.92	$393.65	$90.54–$373.97	—	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL	$231.55	$289.43	$13.39–$274.96	160% above	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL	$231.55	$289.43	$66.57–$274.96	—	20%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF	$119.31	$149.13	$7.77–$141.67	65% above	20%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF	$119.31	$149.13	$34.30–$141.67	—	20%
Complete blood count (CBC), no differential CPT 85027 HC COMPL AUTOM CBC W PLT	$99.26	$124.07	$6.47–$117.87	89% above	20%
Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPL AUTOM CBC W PLT	$99.26	$124.07	$28.54–$117.87	—	20%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHEN METABOLIC PANEL	$182.63	$228.28	$10.56–$216.87	61% above	20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHEN METABOLIC PANEL	$182.63	$228.28	$52.50–$216.87	—	20%
Cortisol blood test, total CPT 82533 HC CORTISOL; TOTAL	$192.33	$240.41	$16.30–$228.39	60% above	20%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL; TOTAL	$192.33	$240.41	$55.29–$228.39	—	20%
Creatine kinase (CK) blood test, total CPT 82550 HC CPK; TOTAL	$87.23	$109.03	$6.51–$103.58	37% above	20%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CPK; TOTAL	$87.23	$109.03	$25.08–$103.58	—	20%
Creatinine blood test CPT 82565 HC CREATININE; BLOOD	$68.10	$85.12	$5.12–$80.86	115% above	20%
Creatinine blood test inpatient CPT 82565 HC CREATININE; BLOOD	$68.10	$85.12	$19.58–$80.86	—	20%
Cytomegalovirus (CMV) antibody test CPT 86644 HC AB; CMV	$144.60	$180.74	$14.39–$171.70	105% above	20%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC AB; CMV	$144.60	$180.74	$41.57–$171.70	—	20%
D-dimer blood test (blood clot marker) CPT 85379 HC D-DIMER - QUAN	$124.60	$155.74	$10.18–$147.95	57% above	20%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D-DIMER - QUAN	$124.60	$155.74	$35.82–$147.95	—	20%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DHEA-S	$274.72	$343.40	$22.23–$326.23	93% above	20%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DHEA-S	$274.72	$343.40	$78.98–$326.23	—	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST(S) PRSMV CHEM ANLYZR	$249.50	$311.87	$62.14–$296.28	115% above	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST(S) PRSMV CHEM ANLYZR	$249.50	$311.87	$71.73–$296.28	—	20%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL	$121.76	$152.19	$7.01–$144.58	149% above	20%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL	$121.76	$152.19	$35.00–$144.58	—	20%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC AB; EB VCA	$174.12	$217.64	$18.14–$206.76	111% above	20%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC AB; EB VCA	$174.12	$217.64	$50.06–$206.76	—	20%
Estradiol blood test CPT 82670 HC ESTRADIOL	$327.80	$409.74	$27.94–$389.25	155% above	20%
Estradiol blood test inpatient CPT 82670 HC ESTRADIOL	$327.80	$409.74	$94.24–$389.25	—	20%
FSH (follicle-stimulating hormone) test CPT 83001 HC FSH	$218.52	$273.15	$18.58–$259.49	89% above	20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC FSH	$218.52	$273.15	$62.82–$259.49	—	20%
Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY FOR CALPROTECTIN FECAL	$212.45	$265.56	$19.63–$252.28	13% above	20%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC ASSAY FOR CALPROTECTIN FECAL	$212.45	$265.56	$61.08–$252.28	—	20%
Ferritin blood test (iron stores) CPT 82728 HC FERRITIN	$180.87	$226.08	$13.63–$214.78	100% above	20%
Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN	$180.87	$226.08	$52.00–$214.78	—	20%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN; ACTIVITY	$129.88	$162.34	$9.72–$154.22	92% above	20%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN; ACTIVITY	$129.88	$162.34	$37.34–$154.22	—	20%
Folate (folic acid) blood test CPT 82746 HC FOLIC ACID; SERUM	$173.52	$216.90	$14.70–$206.06	76% above	20%
Folate (folic acid) blood test inpatient CPT 82746 HC FOLIC ACID; SERUM	$173.52	$216.90	$49.89–$206.06	—	20%
Free T3 thyroid hormone test CPT 84481 HC T3; FREE	$112.91	$141.13	$16.94–$134.07	16% above	20%
Free T3 thyroid hormone test inpatient CPT 84481 HC T3; FREE	$112.91	$141.13	$32.46–$134.07	—	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC FREE THYROXINE	$121.18	$151.47	$9.02–$143.90	50% above	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC FREE THYROXINE	$121.18	$151.47	$34.84–$143.90	—	20%
Free testosterone test CPT 84402 HC TESTOSTERONE; FREE	$115.35	$144.18	$25.47–$136.97	2% below	20%
Free testosterone test inpatient CPT 84402 HC TESTOSTERONE; FREE	$115.35	$144.18	$33.16–$136.97	—	20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GLUTAMYLTRANSFERASE, GAMMA	$96.40	$120.49	$7.20–$114.47	81% above	20%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GLUTAMYLTRANSFERASE, GAMMA	$96.40	$120.49	$27.71–$114.47	—	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE; POST GLUCOSE DOSE	$64.29	$80.36	$4.75–$76.34	30% above	20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE; POST GLUCOSE DOSE	$64.29	$80.36	$18.48–$76.34	—	20%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT)	$171.64	$214.54	$12.87–$203.81	91% above	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT)	$171.64	$214.54	$49.34–$203.81	—	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC NEISSERIA, AMPLIF NA PROBE	$314.92	$393.65	$35.09–$373.97	120% above	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC NEISSERIA, AMPLIF NA PROBE	$314.92	$393.65	$90.54–$373.97	—	20%
H. pylori stool antigen test CPT 87338 HC H PYLORI STOOL IMMUNOASSAY	$169.87	$212.33	$14.38–$201.71	31% above	20%
H. pylori stool antigen test inpatient CPT 87338 HC H PYLORI STOOL IMMUNOASSAY	$169.87	$212.33	$48.84–$201.71	—	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1, NA QUAN	$627.45	$784.31	$85.10–$745.09	62% above	20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1, NA QUAN	$627.45	$784.31	$180.39–$745.09	—	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV-1 AG W/ HIV-1 & HIV-2 AB	$179.64	$224.55	$24.08–$213.32	75% above	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV-1 AG W/ HIV-1 & HIV-2 AB	$179.64	$224.55	$51.65–$213.32	—	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC HPV HIGH-RISK TYPES	$311.82	$389.77	$35.09–$370.28	118% above	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC HPV HIGH-RISK TYPES	$311.82	$389.77	$89.65–$370.28	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN GLYCOSYLATED TEST (A1C)	$129.30	$161.62	$9.71–$153.54	88% above	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN GLYCOSYLATED TEST (A1C)	$129.30	$161.62	$37.17–$153.54	—	20%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN	$36.96	$46.19	$2.37–$43.88	111% above	20%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN	$36.96	$46.19	$10.62–$43.88	—	20%
Hepatitis B core antibody test (total) CPT 86704 HC AB; HBCAB - TOTAL	$160.29	$200.36	$12.05–$190.34	100% above	20%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC AB; HBCAB - TOTAL	$160.29	$200.36	$46.08–$190.34	—	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC AB: HBSAB	$142.96	$178.70	$10.74–$169.77	93% above	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC AB: HBSAB	$142.96	$178.70	$41.10–$169.77	—	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEP B SURFACE AG IMMUNOASSAY	$136.80	$171.00	$10.33–$162.45	110% above	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEP B SURFACE AG IMMUNOASSAY	$136.80	$171.00	$39.33–$162.45	—	20%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C AB	$168.02	$210.02	$14.27–$199.52	109% above	20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C AB	$168.02	$210.02	$48.30–$199.52	—	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEP-C, NA QUAN	$455.09	$568.86	$42.84–$540.42	92% above	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEP-C, NA QUAN	$455.09	$568.86	$130.84–$540.42	—	20%
Herpes blood test, HSV-1 antibody CPT 86695 HC AB; HSV I	$162.92	$203.64	$13.19–$193.46	140% above	20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC AB; HSV I	$162.92	$203.64	$46.84–$193.46	—	20%
Herpes blood test, HSV-2 antibody CPT 86696 HC AB; HSV II	$208.81	$261.01	$19.35–$247.96	157% above	20%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC AB; HSV II	$208.81	$261.01	$60.03–$247.96	—	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN, HS	$171.69	$214.61	$12.95–$203.88	115% above	20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN, HS	$171.69	$214.61	$49.36–$203.88	—	20%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTINE	$208.36	$260.44	$17.92–$247.42	76% above	20%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTINE	$208.36	$260.44	$59.90–$247.42	—	20%
Insulin blood test CPT 83525 HC INSULIN; TOTAL	$136.24	$170.30	$11.43–$161.79	102% above	20%
Insulin blood test inpatient CPT 83525 HC INSULIN; TOTAL	$136.24	$170.30	$39.17–$161.79	—	20%
Iron blood test (serum iron) CPT 83540 HC IRON	$87.24	$109.04	$6.47–$103.59	64% above	20%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON	$87.24	$109.04	$25.08–$103.59	—	20%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY	$117.52	$146.89	$8.74–$139.55	89% above	20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY	$117.52	$146.89	$33.78–$139.55	—	20%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL	$150.38	$187.97	$8.68–$178.57	46% above	20%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL	$150.38	$187.97	$43.23–$178.57	—	20%
LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN; LUTEINIZING HORMONE	$217.61	$272.01	$18.52–$258.41	123% above	20%
LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN; LUTEINIZING HORMONE	$217.61	$272.01	$62.56–$258.41	—	20%
Lactate (lactic acid) blood test CPT 83605 HC LACTATE	$142.32	$177.90	$11.57–$169.01	104% above	20%
Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTATE	$142.32	$177.90	$40.92–$169.01	—	20%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE	$80.80	$101.00	$6.04–$95.95	62% above	20%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE	$80.80	$101.00	$23.23–$95.95	—	20%
Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE	$91.80	$114.74	$6.89–$109.00	35% above	20%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE	$91.80	$114.74	$26.39–$109.00	—	20%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL	$142.04	$177.55	$8.17–$168.67	39% above	20%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL	$142.04	$177.55	$40.84–$168.67	—	20%
Lyme disease antibody test CPT 86618 HC AB; LYME'S DISEASE	$211.09	$263.86	$17.03–$250.67	153% above	20%
Lyme disease antibody test inpatient CPT 86618 HC AB; LYME'S DISEASE	$211.09	$263.86	$60.69–$250.67	—	20%
Magnesium blood test CPT 83735 HC MAGNESIUM	$89.97	$112.46	$6.70–$106.84	71% above	20%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM	$89.97	$112.46	$25.87–$106.84	—	20%
Measles (rubeola) antibody test CPT 86765 HC AB; RUBEOLA	$176.54	$220.67	$12.88–$209.64	114% above	20%
Measles (rubeola) antibody test inpatient CPT 86765 HC AB; RUBEOLA	$176.54	$220.67	$50.75–$209.64	—	20%
Mono test (heterophile antibody, Monospot) CPT 86308 HC QUAL HETEROPHILE AB	$69.79	$87.23	$5.18–$82.87	26% above	20%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC QUAL HETEROPHILE AB	$69.79	$87.23	$20.06–$82.87	—	20%
Mumps immunity blood test CPT 86735 HC AB; MUMPS	$175.33	$219.16	$13.05–$208.20	104% above	20%
Mumps immunity blood test inpatient CPT 86735 HC AB; MUMPS	$175.33	$219.16	$50.41–$208.20	—	20%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA; FREE	$165.64	$207.04	$18.39–$196.69	79% above	20%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA; FREE	$165.64	$207.04	$47.62–$196.69	—	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA; TOTAL	$206.07	$257.58	$18.39–$244.70	117% above	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA; TOTAL	$206.07	$257.58	$59.24–$244.70	—	20%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTOPATH C/V AUTO FLUID REDO	$92.75	$115.93	$26.61–$110.13	12% below	20%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTOPATH C/V AUTO FLUID REDO	$92.75	$115.93	$26.66–$110.13	—	20%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHORMONE	$362.36	$452.95	$41.28–$430.30	70% above	20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHORMONE	$362.36	$452.95	$104.18–$430.30	—	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT; PLASMA OR WHOLE BLOOD	$92.89	$116.11	$6.01–$110.30	77% above	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT; PLASMA OR WHOLE BLOOD	$92.89	$116.11	$26.71–$110.30	—	20%
Phosphorus (phosphate) blood test CPT 84100 HC PHOSPHATE	$64.28	$80.35	$4.74–$76.33	55% above	20%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC PHOSPHATE	$64.28	$80.35	$18.48–$76.33	—	20%
Potassium blood test CPT 84132 HC ASSAY OF SERUM POTASSIUM	$62.44	$78.05	$4.76–$74.15	128% above	20%
Potassium blood test inpatient CPT 84132 HC ASSAY OF SERUM POTASSIUM	$62.44	$78.05	$17.95–$74.15	—	20%
Progesterone blood test CPT 84144 HC PROGESTERONE ASSAY	$218.52	$273.15	$20.86–$259.49	81% above	20%
Progesterone blood test inpatient CPT 84144 HC PROGESTERONE ASSAY	$218.52	$273.15	$62.82–$259.49	—	20%
Prolactin blood test CPT 84146 HC PROLACTIN ASSAY	$226.80	$283.49	$19.38–$269.32	88% above	20%
Prolactin blood test inpatient CPT 84146 HC PROLACTIN ASSAY	$226.80	$283.49	$65.20–$269.32	—	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME	$61.24	$76.54	$4.29–$72.71	82% above	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME	$61.24	$76.54	$17.60–$72.71	—	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST(S) PRSMV DIR OPT OBS	$41.00	$51.24	$11.79–$48.68	28% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TEST(S) PRSMV DIR OPT OBS	$41.00	$51.24	$11.79–$48.68	—	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP A ASSAY W/OPTIC	$159.76	$199.70	$16.53–$189.72	251% above	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP A ASSAY W/OPTIC	$159.76	$199.70	$45.93–$189.72	—	20%
Renin blood test CPT 84244 HC RENIN	$272.00	$339.99	$21.99–$322.99	84% above	20%
Renin blood test inpatient CPT 84244 HC RENIN	$272.00	$339.99	$78.20–$322.99	—	20%
Rh blood typing CPT 86901 HC BLOOD TYPING; RH D	$78.91	$98.63	$22.68–$93.70	99% above	20%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING; RH D	$78.91	$98.63	$22.68–$93.70	—	20%
Rheumatoid factor (RF) test CPT 86431 HC QUAN RHEUM FACTOR	$82.60	$103.24	$5.67–$98.08	41% above	20%
Rheumatoid factor (RF) test inpatient CPT 86431 HC QUAN RHEUM FACTOR	$82.60	$103.24	$23.75–$98.08	—	20%
Rubella antibody test (immunity check) CPT 86762 HC AB; RUBELLA	$163.02	$203.77	$14.39–$193.58	98% above	20%
Rubella antibody test (immunity check) inpatient CPT 86762 HC AB; RUBELLA	$163.02	$203.77	$46.87–$193.58	—	20%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC AUTOM ERYTHROCYTE SED RATE	$55.97	$69.96	$2.70–$66.46	35% above	20%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC AUTOM ERYTHROCYTE SED RATE	$55.97	$69.96	$16.09–$66.46	—	20%
Sodium blood test CPT 84295 HC ASSAY OF SERUM SODIUM	$65.20	$81.49	$4.81–$77.42	163% above	20%
Sodium blood test inpatient CPT 84295 HC ASSAY OF SERUM SODIUM	$65.20	$81.49	$18.74–$77.42	—	20%
Stool ova and parasites exam CPT 87177 HC OVA & PARASITES, DIR SMR W ID	$118.36	$147.95	$8.90–$140.55	82% above	20%
Stool ova and parasites exam inpatient CPT 87177 HC OVA & PARASITES, DIR SMR W ID	$118.36	$147.95	$34.03–$140.55	—	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD FECES	$44.08	$55.09	$4.38–$52.34	109% above	20%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC OCCULT BLOOD FECES	$44.08	$55.09	$12.67–$52.34	—	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC TREPONEMA PALLIDUM	$110.16	$137.70	$13.24–$130.82	100% above	20%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC TREPONEMA PALLIDUM	$110.16	$137.70	$31.67–$130.82	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREP QUAL	$52.71	$65.88	$4.27–$62.59	33% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREP QUAL	$52.71	$65.88	$15.15–$62.59	—	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB TEST CELL IMMUN MEASURE	$195.26	$244.07	$56.14–$231.87	23% below	20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB TEST CELL IMMUN MEASURE	$195.26	$244.07	$56.14–$231.87	—	20%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE; TOTAL	$257.46	$321.82	$25.81–$305.73	124% above	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE; TOTAL	$257.46	$321.82	$74.02–$305.73	—	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL AB, EACH	$180.18	$225.22	$14.55–$213.96	157% above	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL AB, EACH	$180.18	$225.22	$51.80–$213.96	—	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE	$181.64	$227.05	$16.80–$215.70	102% above	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE	$181.64	$227.05	$52.22–$215.70	—	20%
Total IgE blood test CPT 82785 HC ASSAY OF IGE	$189.70	$237.12	$16.46–$225.26	86% above	20%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF IGE	$189.70	$237.12	$54.54–$225.26	—	20%
Total cholesterol blood test CPT 82465 HC SERUM/WB TOT CHOLEST	$58.77	$73.46	$4.35–$69.79	27% above	20%
Total cholesterol blood test inpatient CPT 82465 HC SERUM/WB TOT CHOLEST	$58.77	$73.46	$16.90–$69.79	—	20%
Total thyroxine (T4) blood test CPT 84436 HC THYROXINE; TOTAL	$85.37	$106.71	$6.87–$101.37	64% above	20%
Total thyroxine (T4) blood test inpatient CPT 84436 HC THYROXINE; TOTAL	$85.37	$106.71	$24.54–$101.37	—	20%
Total triiodothyronine (T3) blood test CPT 84480 HC T3; TOTAL	$175.62	$219.52	$14.18–$208.54	64% above	20%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC T3; TOTAL	$175.62	$219.52	$50.49–$208.54	—	20%
Transferrin blood test CPT 84466 HC TRANSFERRIN	$158.36	$197.95	$12.76–$188.05	67% above	20%
Transferrin blood test inpatient CPT 84466 HC TRANSFERRIN	$158.36	$197.95	$45.53–$188.05	—	20%
Trichomonas test (NAAT) CPT 87661 HC TRICHOMONAS VAGINALIS AMPLIF	$123.38	$154.22	$35.09–$146.51	10% below	20%
Trichomonas test (NAAT) inpatient CPT 87661 HC TRICHOMONAS VAGINALIS AMPLIF	$123.38	$154.22	$35.47–$146.51	—	20%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES	$75.62	$94.52	$5.74–$89.79	40% above	20%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES	$75.62	$94.52	$21.74–$89.79	—	20%
Troponin test, quantitative CPT 84484 HC TROPONIN, QUAN	$131.29	$164.11	$12.47–$155.90	55% above	20%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN, QUAN	$131.29	$164.11	$37.75–$155.90	—	20%
Uric acid blood test CPT 84550 HC URIC ACID; BLOOD	$63.40	$79.25	$4.52–$75.29	26% above	20%
Uric acid blood test inpatient CPT 84550 HC URIC ACID; BLOOD	$63.40	$79.25	$18.23–$75.29	—	20%
Urinalysis with microscope exam, automated CPT 81001 HC AUTOM URINE DIP W MICRO	$45.30	$56.62	$3.17–$53.79	26% above	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC AUTOM URINE DIP W MICRO	$45.30	$56.62	$13.02–$53.79	—	20%
Urinalysis without microscope exam, automated CPT 81003 HC AUTOM URINALYSIS WO MICRO	$31.84	$39.80	$2.25–$37.81	27% above	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC AUTOM URINALYSIS WO MICRO	$31.84	$39.80	$9.15–$37.81	—	20%
Urinalysis without microscope exam, manual CPT 81002 HC N-AUTOM URINALYS WO MICRO	$36.64	$45.80	$3.48–$43.51	166% above	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC N-AUTOM URINALYS WO MICRO	$36.64	$45.80	$10.53–$43.51	—	20%
Urine culture for bacteria, with colony count CPT 87086 HC BACT CULTURE - URINE; QUAN COUNT	$108.35	$135.43	$8.07–$128.66	44% above	20%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC BACT CULTURE - URINE; QUAN COUNT	$108.35	$135.43	$31.15–$128.66	—	20%
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN; URINE, QUAN	$75.64	$94.54	$5.78–$89.81	16% above	20%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN; URINE, QUAN	$75.64	$94.54	$21.74–$89.81	—	20%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY, VISUAL COLOR	$88.78	$110.97	$8.61–$105.42	79% above	20%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY, VISUAL COLOR	$88.78	$110.97	$25.52–$105.42	—	20%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12 LEVEL	$177.20	$221.49	$15.08–$210.42	73% above	20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B-12 LEVEL	$177.20	$221.49	$50.94–$210.42	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D, 25 HYDROXY	$88.88	$111.10	$25.55–$105.55	43% below	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC VITAMIN D, 25 HYDROXY	$88.88	$111.10	$25.55–$105.55	—	20%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VIT D 1, 25-DIHYDROXY	$410.17	$512.71	$38.50–$487.07	156% above	20%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC VIT D 1, 25-DIHYDROXY	$410.17	$512.71	$117.92–$487.07	—	20%
Zinc blood test CPT 84630 HC ZINC	$128.36	$160.45	$11.39–$152.43	60% above	20%
Zinc blood test inpatient CPT 84630 HC ZINC	$128.36	$160.45	$36.90–$152.43	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HCG; QUAN	$181.37	$226.71	$15.05–$215.37	54% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HCG; QUAN	$181.37	$226.71	$52.14–$215.37	—	20%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CL TX DSTL FIB FX WO MANIP	$918.13	$1,147.66	$231.70–$1,090.28	67% above	20%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC CL TX DSTL FIB FX WO MANIP	$918.13	$1,147.66	$263.96–$1,090.28	—	20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC CL TX METATARSAL FX WO MANIP	$550.22	$687.77	$158.19–$653.38	8% below	20%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC CL TX METATARSAL FX WO MANIP	$550.22	$687.77	$158.19–$653.38	—	20%
Cardiac catheterization with coronary angiogram CPT 93458 HC L HRT ARTERY/VENTRICLE ANGIO	$15,285.64	$19,107.04	$3,106.79–$21,851.00	56% above	20%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 HC L HRT ARTERY/VENTRICLE ANGIO	$15,285.64	$19,107.04	$4,394.62–$18,151.69	—	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION	$815.12	$1,018.89	$234.34–$967.95	17% below	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION	$815.12	$1,018.89	$234.34–$967.95	—	20%
Catheter ablation for atrial fibrillation CPT 93656 HC TX ATRIAL FIB PULM VEIN ISOL	$44,770.17	$55,962.71	$12,871.42–$53,164.57	153% above	20%
Catheter ablation for atrial fibrillation inpatient CPT 93656 HC TX ATRIAL FIB PULM VEIN ISOL	$44,770.17	$55,962.71	$12,871.42–$53,164.57	—	20%
Cervical biopsy CPT 57500 HC BIOPSY OF CERVIX	$426.49	$533.11	$122.62–$841.07	28% below	20%
Cervical biopsy inpatient CPT 57500 HC BIOPSY OF CERVIX	$426.49	$533.11	$122.62–$506.45	—	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION W/REGIONL BLOCK	$475.63	$594.53	$136.74–$1,978.70	133% above	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION W/REGIONL BLOCK	$475.63	$594.53	$136.74–$564.80	—	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC TX FRACTURE D RADIUS/ULNA WO MANIP	$1,311.61	$1,639.51	$231.70–$1,557.53	113% above	20%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC TX FRACTURE D RADIUS/ULNA WO MANIP	$1,311.61	$1,639.51	$377.09–$1,557.53	—	20%
Colonoscopy with polyp removal CPT 45385 HC COLONOSCOPY W/LESION REMOVAL BY SNARE	$3,477.30	$4,346.62	$999.72–$5,169.00	42% above	20%
Colonoscopy with polyp removal inpatient CPT 45385 HC COLONOSCOPY W/LESION REMOVAL BY SNARE	$3,477.30	$4,346.62	$999.72–$4,129.29	—	20%
Coronary stent placement, one artery CPT 92928 HC PRQ CARD STENT W/ANGIO 1 VSL	$19,537.84	$24,422.30	$5,617.13–$37,154.00	149% above	20%
Coronary stent placement, one artery inpatient CPT 92928 HC PRQ CARD STENT W/ANGIO 1 VSL	$19,537.84	$24,422.30	$5,617.13–$23,201.19	—	20%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY	$2,607.43	$3,259.28	$644.72–$3,937.00	163% above	20%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY	$2,607.43	$3,259.28	$749.63–$3,096.32	—	20%
Ear tube placement (tympanostomy) with local anesthesia, one ear one side CPT 69433 HC TYMPANOSTOMY LOCAL; UNILATERAL	$2,177.57	$2,721.96	$491.89–$3,937.00	317% above	20%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient one side CPT 69433 HC TYMPANOSTOMY LOCAL; UNILATERAL	$2,177.57	$2,721.96	$626.05–$2,585.86	—	20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC REMOVE IMPACTED EAR WAX UNI	$286.83	$358.53	$57.38–$3,937.00	210% above	20%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC REMOVE IMPACTED EAR WAX UNI	$286.83	$358.53	$82.46–$340.60	—	20%
Earwax removal with instruments, one ear CPT 69210 HC REMOVAL IMPACTED CERUMEN (EARWAX)	$286.83	$358.53	$57.38–$3,937.00	242% above	20%
Earwax removal with instruments, one ear inpatient CPT 69210 HC REMOVAL IMPACTED CERUMEN (EARWAX)	$286.83	$358.53	$82.46–$340.60	—	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ENDOMETRIAL BX WO CERVICAL DILATION	$1,176.30	$1,470.37	$194.31–$1,396.85	333% above	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC ENDOMETRIAL BX WO CERVICAL DILATION	$1,176.30	$1,470.37	$338.19–$1,396.85	—	20%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC INJ INTERLAM C/T W IMG	$2,258.07	$2,822.58	$649.19–$2,681.45	71% above	20%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC INJ INTERLAM C/T W IMG	$2,258.07	$2,822.58	$649.19–$2,681.45	—	20%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV	$5,979.52	$7,474.39	$859.95–$7,100.67	270% above	20%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV	$5,979.52	$7,474.39	$1,719.11–$7,100.67	—	20%
Gallbladder removal, laparoscopic CPT 47562 HC LAPAROSCOPY CHOLECYSTECOMY	$19,655.76	$24,569.70	$5,635.53–$23,341.22	112% above	20%
Gallbladder removal, laparoscopic inpatient CPT 47562 HC LAPAROSCOPY CHOLECYSTECOMY	$19,655.76	$24,569.70	$5,651.03–$23,341.22	—	20%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC INJ SALINE HYSTEROGRAM	$613.35	$766.68	$176.34–$1,756.00	82% above	20%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC INJ SALINE HYSTEROGRAM	$613.35	$766.68	$176.34–$728.35	—	20%
IUD insertion (the device itself billed separately) CPT 58300 HC INSERT IUD	$654.44	$818.05	$188.15–$3,937.00	115% above	20%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC INSERT IUD	$654.44	$818.05	$188.15–$777.15	—	20%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D ABSC SMPL OR SGL	$885.37	$1,106.71	$191.93–$1,051.37	203% above	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D ABSC SMPL OR SGL	$885.37	$1,106.71	$254.54–$1,051.37	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ SGL TENDON SHTH OR LIGAMENT	$1,003.19	$1,253.98	$285.13–$1,191.28	194% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJ SGL TENDON SHTH OR LIGAMENT	$1,003.19	$1,253.98	$288.42–$1,191.28	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC DRAIN/INJ MAJOR JNT/BURSA	$2,295.63	$2,869.53	$285.13–$2,726.05	429% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC DRAIN/INJ MAJOR JNT/BURSA	$2,295.63	$2,869.53	$659.99–$2,726.05	—	20%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERT DRUG IMPLANT	$685.71	$857.13	$124.51–$3,937.00	160% above	20%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERT DRUG IMPLANT	$685.71	$857.13	$197.14–$814.27	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJ INTERM JNT/BURSA	$2,295.63	$2,869.53	$285.13–$2,726.05	617% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC DRAIN/INJ INTERM JNT/BURSA	$2,295.63	$2,869.53	$659.99–$2,726.05	—	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJ JOINT/BURSA W/O US	$2,295.63	$2,869.53	$285.13–$3,937.00	518% above	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN/INJ JOINT/BURSA W/O US	$2,295.63	$2,869.53	$659.99–$2,726.05	—	20%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 HC LAP ING HERNIA REPAIR INIT	$19,655.76	$24,569.70	$5,635.53–$23,341.22	622% above	20%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 HC LAP ING HERNIA REPAIR INIT	$19,655.76	$24,569.70	$5,651.03–$23,341.22	—	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC INT REP S/A/T/EX 2.5 CM/<	$1,201.47	$1,501.83	$345.42–$3,937.00	128% above	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC INT REP S/A/T/EX 2.5 CM/<	$1,201.47	$1,501.83	$345.42–$1,426.74	—	20%
Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY	$14,557.76	$18,197.19	$3,106.79–$21,851.00	113% above	20%
Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY	$14,557.76	$18,197.19	$4,185.35–$17,287.33	—	20%
Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ INTERLAM L/S W IMG	$2,258.07	$2,822.58	$649.19–$2,681.45	97% above	20%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ INTERLAM L/S W IMG	$2,258.07	$2,822.58	$649.19–$2,681.45	—	20%
Lower-back epidural injection, without imaging guidance CPT 62322 HC INJ INTERLAM L/S WO IMG	$2,258.07	$2,822.58	$649.19–$2,681.45	174% above	20%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC INJ INTERLAM L/S WO IMG	$2,258.07	$2,822.58	$649.19–$2,681.45	—	20%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 HC INJ(S) FORAMEN EPID L/S SGL LEV BILAT	$4,671.49	$5,839.36	$859.95–$5,547.39	—	20%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ(S) FORAMEN EPIDURAL L/S SGL LEV	$2,335.75	$2,919.68	$671.53–$3,937.00	118% above	20%
Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 HC INJ(S) FORAMEN EPID L/S SGL LEV BILAT	$4,671.49	$5,839.36	$1,343.05–$5,547.39	—	20%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ(S) FORAMEN EPIDURAL L/S SGL LEV	$2,335.75	$2,919.68	$671.53–$2,773.70	—	20%
Miscarriage treatment with D&C, first trimester CPT 59820 HC SURG TX MISSED ABORT 1ST TRIMESTER	$8,797.97	$10,997.46	$2,529.42–$10,447.59	656% above	20%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HC SURG TX MISSED ABORT 1ST TRIMESTER	$8,797.97	$10,997.46	$2,529.42–$10,447.59	—	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC TR-EXT B9+MARG 0.5 CM/<	$1,969.34	$2,461.67	$566.18–$3,937.00	465% above	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC TR-EXT B9+MARG 0.5 CM/<	$1,969.34	$2,461.67	$566.18–$2,338.59	—	20%
Nail removal (partial or complete), one nail CPT 11730 HC SPL AVULSE NP SGL	$799.04	$998.79	$191.93–$3,937.00	240% above	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC SPL AVULSE NP SGL	$799.04	$998.79	$229.72–$948.85	—	20%
Occipital nerve block (injection for headaches) CPT 64405 HC INJ ANESTH/STER GREATER OCCIPITAL NERVE	$2,035.60	$2,544.50	$285.13–$2,417.28	340% above	20%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJ ANESTH/STER GREATER OCCIPITAL NERVE	$2,035.60	$2,544.50	$585.24–$2,417.28	—	20%
Pacemaker implant (dual chamber) CPT 33208 HC INSERT HEART PM ATRIAL & VENT	$32,928.01	$41,160.01	$9,147.00–$39,102.01	419% above	20%
Pacemaker implant (dual chamber) inpatient CPT 33208 HC INSERT HEART PM ATRIAL & VENT	$32,928.01	$41,160.01	$9,466.80–$39,102.01	—	20%
Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W/IMAGING	$1,996.07	$2,495.08	$573.87–$5,169.00	55% above	20%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABD PARACENTESIS W/IMAGING	$1,996.07	$2,495.08	$573.87–$2,370.33	—	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL OF NAIL BED	$2,067.82	$2,584.77	$385.91–$3,937.00	534% above	20%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC REMOVAL OF NAIL BED	$2,067.82	$2,584.77	$594.50–$2,455.53	—	20%
Prostate biopsy CPT 55700 HC BX PROSTATE NDLE PUNCH	$4,723.50	$5,904.37	$1,358.01–$5,609.15	209% above	20%
Prostate biopsy inpatient CPT 55700 HC BX PROSTATE NDLE PUNCH	$4,723.50	$5,904.37	$1,358.01–$5,609.15	—	20%
Radiofrequency ablation of facet joint nerves, lower back, one level both sides CPT 64635 HC DESTROY LUMB/SAC FACET JNT BILAT	$8,968.95	$11,211.18	$1,886.22–$10,650.62	—	20%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DESTROY LUMB/SAC FACET JNT UNIL	$4,484.48	$5,605.59	$1,289.29–$5,325.31	81% above	20%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient both sides CPT 64635 HC DESTROY LUMB/SAC FACET JNT BILAT	$8,968.95	$11,211.18	$2,578.57–$10,650.62	—	20%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC DESTROY LUMB/SAC FACET JNT UNIL	$4,484.48	$5,605.59	$1,289.29–$5,325.31	—	20%
Removal of a foreign object under the skin, simple CPT 10120 HC INC & REM FB SQ SMPL	$1,546.83	$1,933.53	$385.91–$3,937.00	360% above	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC INC & REM FB SQ SMPL	$1,546.83	$1,933.53	$444.71–$1,836.85	—	20%
Short arm cast (elbow to hand) CPT 29075 HC APPLY SHORT ARM CAST	$229.77	$287.21	$66.06–$3,937.00	9% below	20%
Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLY SHORT ARM CAST	$229.77	$287.21	$66.06–$272.85	—	20%
Short arm splint (forearm and hand) CPT 29125 HC APPLY SHORT ARM SPLINT STATIC	$136.10	$170.12	$39.13–$3,937.00	23% below	20%
Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY SHORT ARM SPLINT STATIC	$136.10	$170.12	$39.13–$161.61	—	20%
Short leg cast (below the knee) CPT 29405 HC APPLY SH LEG CAST	$557.20	$696.50	$160.20–$3,937.00	137% above	20%
Short leg cast (below the knee) inpatient CPT 29405 HC APPLY SH LEG CAST	$557.20	$696.50	$160.20–$661.68	—	20%
Short leg splint (calf to foot) CPT 29515 HC APPLY SHORT LEG SPLINT	$477.58	$596.97	$137.30–$3,937.00	130% above	20%
Short leg splint (calf to foot) inpatient CPT 29515 HC APPLY SHORT LEG SPLINT	$477.58	$596.97	$137.30–$567.12	—	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC SREP S/N/A/G/TR/E 2.5 CM/<	$535.16	$668.94	$153.86–$3,937.00	64% above	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC SREP S/N/A/G/TR/E 2.5 CM/<	$535.16	$668.94	$153.86–$635.49	—	20%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BX SKIN SINGLE LESION	$1,705.18	$2,131.47	$385.91–$2,024.90	610% above	20%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BX SKIN SINGLE LESION	$1,705.18	$2,131.47	$490.24–$2,024.90	—	20%
Skin tag removal, up to 15 tags CPT 11200 HC REM SKIN TAGS TO 15	$538.53	$673.16	$154.83–$3,937.00	280% above	20%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC REM SKIN TAGS TO 15	$538.53	$673.16	$154.83–$639.50	—	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE LUMBAR DIAG	$2,034.14	$2,542.67	$584.81–$2,415.54	236% above	20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE LUMBAR DIAG	$2,034.14	$2,542.67	$584.81–$2,415.54	—	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC SREP S/N/A/G/TR/E 2.6-7.5 CM	$535.16	$668.94	$153.86–$3,937.00	165% above	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC SREP S/N/A/G/TR/E 2.6-7.5 CM	$535.16	$668.94	$153.86–$635.49	—	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC SREP F/E/N/L/MM 2.5 CM/<	$538.53	$673.16	$154.83–$3,937.00	74% above	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC SREP F/E/N/L/MM 2.5 CM/<	$538.53	$673.16	$154.83–$639.50	—	20%
Thoracentesis with imaging guidance CPT 32555 HC ASPIRATE PLEURA W/ IMAGING	$4,391.72	$5,489.64	$597.19–$5,215.16	266% above	20%
Thoracentesis with imaging guidance inpatient CPT 32555 HC ASPIRATE PLEURA W/ IMAGING	$4,391.72	$5,489.64	$1,262.62–$5,215.16	—	20%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ TRIGGER POINT 1/2 MUSCL	$1,003.19	$1,253.98	$285.13–$1,191.28	183% above	20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJ TRIGGER POINT 1/2 MUSCL	$1,003.19	$1,253.98	$288.42–$1,191.28	—	20%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC UGI BALLOON DIL ESOPH < 30 MM DIA	$5,446.49	$6,808.11	$1,565.87–$6,467.70	105% above	20%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC UGI BALLOON DIL ESOPH < 30 MM DIA	$5,446.49	$6,808.11	$1,565.87–$6,467.70	—	20%
Upper endoscopy (EGD) with biopsy CPT 43239 HC UGI W BX SGL/MULTIPLE	$3,541.46	$4,426.82	$905.61–$4,205.48	124% above	20%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC UGI W BX SGL/MULTIPLE	$3,541.46	$4,426.82	$1,018.17–$4,205.48	—	20%
Upper endoscopy (EGD), diagnostic CPT 43235 HC UGI DIAGNOSTIC	$3,541.46	$4,426.82	$905.61–$4,205.48	141% above	20%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC UGI DIAGNOSTIC	$3,541.46	$4,426.82	$1,018.17–$4,205.48	—	20%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 HC CYSTO/URETERO W LITHOTRIPSY	$14,081.45	$17,601.81	$4,048.42–$16,721.72	575% above	20%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 HC CYSTO/URETERO W LITHOTRIPSY	$14,081.45	$17,601.81	$4,048.42–$16,721.72	—	20%
Vein ablation, radiofrequency, first vein CPT 36475 HC ENDOVENOUS RF 1ST VEIN	$10,017.85	$12,522.31	$2,880.13–$11,896.19	157% above	20%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 HC ENDOVENOUS RF 1ST VEIN	$10,017.85	$12,522.31	$2,880.13–$11,896.19	—	20%
Wart removal, up to 14 warts CPT 17110 HC DESTRUCT B9 LESION 1-14	$512.91	$641.13	$147.46–$3,937.00	161% above	20%
Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCT B9 LESION 1-14	$512.91	$641.13	$147.46–$609.07	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE SKIN TO SQ TISSUE	$872.47	$1,090.58	$250.83–$1,036.05	64% above	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDE SKIN TO SQ TISSUE	$872.47	$1,090.58	$250.83–$1,036.05	—	20%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC TRANSFUSION BLOOD OR COMPONENT PER UNIT	$733.40	$916.75	$210.85–$870.91	26% above	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC TRANSFUSION BLOOD OR COMPONENT PER UNIT	$733.40	$916.75	$210.85–$870.91	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI AIRWAY INHALATION TX INITIAL	$618.50	$773.12	$177.82–$734.46	615% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI AIRWAY INHALATION TX SUBQ	$618.50	$773.12	$177.82–$734.46	615% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TREATMENT INITIAL	$721.57	$901.96	$196.46–$856.86	735% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TREATMENT SUBQ	$721.57	$901.96	$196.46–$856.86	735% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC MDI AIRWAY INHALATION TX SUBQ	$618.50	$773.12	$177.82–$734.46	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC MDI AIRWAY INHALATION TX INITIAL	$618.50	$773.12	$177.82–$734.46	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AIRWAY INHALATION TREATMENT SUBQ	$721.57	$901.96	$207.45–$856.86	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AIRWAY INHALATION TREATMENT INITIAL	$721.57	$901.96	$207.45–$856.86	—	20%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO, IV INFUSION, 1 HR	$980.96	$1,226.19	$282.02–$1,164.88	75% above	20%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO, IV INFUSION, 1 HR	$980.96	$1,226.19	$282.02–$1,164.88	—	20%
Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE 30-74 MIN	$4,344.86	$5,431.07	$813.89–$5,159.52	143% above	20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE 30-74 MIN	$4,344.86	$5,431.07	$1,249.15–$5,159.52	—	20%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE & DROWSY	$1,016.50	$1,270.62	$292.24–$1,207.09	52% above	20%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG AWAKE & DROWSY	$1,016.50	$1,270.62	$292.24–$1,207.09	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC 12 LEAD EKG; TRACING ONLY	$244.38	$305.47	$57.38–$290.20	66% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC 12 LEAD EKG; TRACING ONLY	$244.38	$305.47	$70.26–$290.20	—	20%
Electroconvulsive therapy (ECT), one session CPT 90870 HC ELECTROCONVULSIVE THERAPY	$539.81	$674.76	$155.19–$641.02	26% below	20%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 HC ELECTROCONVULSIVE THERAPY	$539.81	$674.76	$155.19–$641.02	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED LEVEL 1 VISIT	$375.42	$469.27	$85.05–$1,619.00	100% above	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED LEVEL 1 VISIT	$375.42	$469.27	$107.93–$445.81	—	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED LEVEL 2 VISIT	$719.99	$899.98	$152.96–$1,619.00	123% above	20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED LEVEL 2 VISIT	$719.99	$899.98	$207.00–$854.98	—	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED LEVEL 3 VISIT	$1,304.15	$1,630.18	$267.45–$2,158.00	120% above	20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED LEVEL 3 VISIT	$1,304.15	$1,630.18	$374.94–$1,548.67	—	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED LEVEL 4 VISIT	$2,075.99	$2,594.98	$411.31–$3,880.00	126% above	20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED LEVEL 4 VISIT	$2,075.99	$2,594.98	$596.85–$2,465.23	—	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED LEVEL 5 VISIT	$3,001.09	$3,751.36	$592.21–$3,880.00	105% above	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED LEVEL 5 VISIT	$3,001.09	$3,751.36	$862.81–$3,563.79	—	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CVSLR STRESS TEST; TRACING	$1,033.17	$1,291.46	$297.04–$1,226.89	30% above	20%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CVSLR STRESS TEST; TRACING	$1,033.17	$1,291.46	$297.04–$1,226.89	—	20%
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY THERAPY W PT 50 MIN	$322.06	$402.57	$92.59–$382.44	70% above	20%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY THERAPY W PT 50 MIN	$322.06	$402.57	$92.59–$382.44	—	20%
Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY THERAPY WO PT 50 MIN	$322.06	$402.57	$92.59–$382.44	76% above	20%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY THERAPY WO PT 50 MIN	$322.06	$402.57	$92.59–$382.44	—	20%
Group psychotherapy session CPT 90853 HC GROUP THERAPY NOT MULTI-FAMILY	$317.18	$396.47	$89.35–$376.65	320% above	20%
Group psychotherapy session CPT 90853 HC IOP PSYCH ADOL/YA	$660.17	$825.21	$89.35–$783.95	775% above	20%
Group psychotherapy session CPT 90853 HC CHEM DEPENDENCY GROUP IOP	$813.24	$1,016.54	$89.35–$965.71	977% above	20%
Group psychotherapy session CPT 90853 HC A/D TX PROG PER DIEM MODERATE ADOL/YA	$1,344.88	$1,681.10	$89.35–$1,597.05	1682% above	20%
Group psychotherapy session inpatient CPT 90853 HC GROUP THERAPY NOT MULTI-FAMILY	$317.18	$396.47	$91.19–$376.65	—	20%
Group psychotherapy session inpatient CPT 90853 HC IOP PSYCH ADOL/YA	$660.17	$825.21	$189.80–$783.95	—	20%
Group psychotherapy session inpatient CPT 90853 HC CHEM DEPENDENCY GROUP IOP	$813.24	$1,016.54	$233.80–$965.71	—	20%
Group psychotherapy session inpatient CPT 90853 HC A/D TX PROG PER DIEM MODERATE ADOL/YA	$1,344.88	$1,681.10	$386.65–$1,597.05	—	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC HYDRATION IV INFUSION INIT 31-60 MIN	$614.52	$768.14	$176.67–$729.73	115% above	20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC HYDRATION IV INFUSION INIT 31-60 MIN	$614.52	$768.14	$176.67–$729.73	—	20%
IV infusion of a medicine, first hour CPT 96365 HC THER/PROPH/DX IV INF INIT UP TO 1HR	$614.52	$768.14	$176.67–$729.73	94% above	20%
IV infusion of a medicine, first hour inpatient CPT 96365 HC THER/PROPH/DX IV INF INIT UP TO 1HR	$614.52	$768.14	$176.67–$729.73	—	20%
IV push of a medicine, first drug CPT 96374 HC THER/PRO/DX INJ IV PUSH	$614.52	$768.14	$176.67–$729.73	272% above	20%
IV push of a medicine, first drug inpatient CPT 96374 HC THER/PRO/DX INJ IV PUSH	$614.52	$768.14	$176.67–$729.73	—	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THER/PROPH/DIAG INJ SC/IM	$201.96	$252.45	$58.06–$239.83	151% above	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THER/PROPH/DIAG INJ SC/IM	$201.96	$252.45	$58.06–$239.83	—	20%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCH DIAGNOSTIC EVALUATION	$585.44	$731.79	$155.19–$695.20	167% above	20%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCH DIAGNOSTIC EVALUATION	$585.44	$731.79	$168.31–$695.20	—	20%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSCLE RE-EDUC EA 15M	$176.43	$220.53	$31.14–$381.00	85% above	20%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSCLE RE-EDUC EA 15M	$176.43	$220.53	$50.72–$209.50	—	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC INIT NUTRITION THERAPY; EACH 15M	$99.52	$124.40	$28.61–$118.18	66% above	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC INIT NUTRITION THERAPY; EACH 15M	$99.52	$124.40	$28.61–$118.18	—	20%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEX	$478.39	$597.98	$97.60–$568.08	159% above	20%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVAL LOW COMPLEX	$478.39	$597.98	$137.54–$568.08	—	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEX	$531.94	$664.92	$95.13–$631.67	69% above	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVAL HIGH COMPLEX	$531.94	$664.92	$152.93–$631.67	—	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEX	$456.05	$570.06	$95.13–$541.56	147% above	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVAL LOW COMPLEX	$456.05	$570.06	$131.11–$541.56	—	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL MOD COMPLEX	$492.53	$615.66	$95.13–$584.88	97% above	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVAL MOD COMPLEX	$492.53	$615.66	$141.60–$584.88	—	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY EA 15M	$176.80	$221.00	$26.40–$381.00	83% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY EA 15M	$176.80	$221.00	$50.83–$209.95	—	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAP EXERCISE ROM EA 15M	$171.85	$214.81	$27.97–$381.00	77% above	20%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAP EXERCISE ROM EA 15M	$171.85	$214.81	$49.41–$204.07	—	20%
Preventive checkup, returning patient aged 40–64 CPT 99396 HC PREV REEVAL EST AGE 40-64 YRS	$279.96	$349.95	$80.49–$332.45	66% above	20%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 HC PREV REEVAL EST AGE 40-64 YRS	$279.96	$349.95	$80.49–$332.45	—	20%
Psychiatric evaluation with medical services CPT 90792 HC PSYCH DIAG EVAL W/MED SRVC	$593.79	$742.23	$155.19–$705.12	115% above	20%
Psychiatric evaluation with medical services inpatient CPT 90792 HC PSYCH DIAG EVAL W/MED SRVC	$593.79	$742.23	$170.71–$705.12	—	20%
Psychotherapy for crisis, first 60 minutes CPT 90839 HC PSYTX CRISIS INITIAL 60 MIN	$630.91	$788.63	$155.19–$749.20	114% above	20%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PSYTX CRISIS INITIAL 60 MIN	$630.91	$788.63	$181.38–$749.20	—	20%
Psychotherapy session, 30 minutes CPT 90832 HC PSYTX W PT 30 MIN (16-37 MIN)	$224.45	$280.56	$64.53–$266.53	111% above	20%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYTX W PT 30 MIN (16-37 MIN)	$224.45	$280.56	$64.53–$266.53	—	20%
Psychotherapy session, 45 minutes CPT 90834 HC PSYTX W PT 45 MIN (38-52 MIN)	$297.02	$371.27	$85.39–$352.71	110% above	20%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYTX W PT 45 MIN (38-52 MIN)	$297.02	$371.27	$85.39–$352.71	—	20%
Psychotherapy session, 60 minutes CPT 90837 HC PSYTX W PT 60 MIN (>53 MIN)	$439.89	$549.86	$126.47–$522.37	107% above	20%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYTX W PT 60 MIN (>53 MIN)	$439.89	$549.86	$126.47–$522.37	—	20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC SMOKE/TOBACCO COUNSELING 3-10 MIN	$129.34	$161.67	$28.77–$153.59	348% above	20%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC SMOKE/TOBACCO COUNSELING 3-10 MIN	$129.34	$161.67	$37.18–$153.59	—	20%
Speech and language evaluation CPT 92523 HC EVAL SPEECH SOUND LANG COMPREHEN	$562.52	$703.15	$161.72–$667.99	58% above	20%
Speech and language evaluation inpatient CPT 92523 HC EVAL SPEECH SOUND LANG COMPREHEN	$562.52	$703.15	$161.72–$667.99	—	20%
Speech therapy session, individual CPT 92507 HC SPEECH/HEARING THERAPY	$516.03	$645.03	$73.02–$612.78	104% above	20%
Speech therapy session, individual inpatient CPT 92507 HC SPEECH/HEARING THERAPY	$516.03	$645.03	$148.36–$612.78	—	20%
Spirometry (breathing test) CPT 94010 HC SPIROMETRY	$302.93	$378.66	$87.09–$359.73	8% above	20%
Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY	$302.93	$378.66	$87.09–$359.73	—	20%
Spirometry before and after a bronchodilator CPT 94060 HC BRONCHOSPASM PRE & POST BD	$708.50	$885.62	$203.69–$841.34	46% above	20%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC BRONCHOSPASM PRE & POST BD	$708.50	$885.62	$203.69–$841.34	—	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUTIC ACTIVITY DIR EA 15M	$185.60	$231.99	$33.53–$381.00	106% above	20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUTIC ACTIVITY DIR EA 15M	$185.60	$231.99	$53.36–$220.39	—	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY, THERAPEUTIC	$342.31	$427.88	$98.41–$406.49	71% above	20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY, THERAPEUTIC	$342.31	$427.88	$98.41–$406.49	—	20%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VAC AB SURF ANT ADJ 0.5 ML IM SUSY	$58.72	$73.40	$16.88–$98.16	13% below	20%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA VAC AB SURF ANT ADJ 0.5 ML IM SUSY	$58.72	$73.40	$16.88–$69.73	—	20%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 MRNA VACC (MODERNA) 50 MCG/0.5ML IM SUSY	$296.88	$371.10	$85.35–$352.55	78% above	20%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 MRNA VACC (MODERNA) 50 MCG/0.5ML IM SUSY	$296.88	$371.10	$85.35–$352.55	—	20%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUS	$362.84	$453.55	$104.32–$430.87	122% above	20%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUS	$362.84	$453.55	$104.32–$430.87	—	20%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEPATITIS B RECOMB-IPV IM SUSY	$226.76	$283.45	$65.19–$269.28	64% above	20%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTAP-HEPATITIS B RECOMB-IPV IM SUSY	$226.76	$283.45	$65.19–$269.28	—	20%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE 1440 EL U/ML IM SUSP	$202.60	$253.25	$58.25–$240.59	54% above	20%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE 1440 EL U/ML IM SUSP	$202.60	$253.25	$58.25–$240.59	—	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SUSP	$181.20	$226.50	$52.10–$215.18	57% above	20%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SUSP	$181.20	$226.50	$52.10–$215.18	—	20%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VAC RECOMB ADJ 20 MCG/0.5ML IM SOSY	$306.24	$382.80	$88.04–$363.66	43% above	20%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VAC RECOMB ADJ 20 MCG/0.5ML IM SOSY	$306.24	$382.80	$88.04–$363.66	—	20%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML IJ SUSY	$115.52	$144.40	$31.67–$137.18	105% above	20%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML IJ SUSY	$115.52	$144.40	$33.21–$137.18	—	20%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPHILUS B POLYSAC CONJ VAC 7.5 MCG/0.5 ML IM S	$118.96	$148.70	$34.20–$141.27	137% above	20%
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 S	$118.96	$148.70	$34.20–$141.27	—	20%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES, MUMPS RUBELLA VAC IJ SOLR	$222.36	$277.95	$63.93–$264.05	45% above	20%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES, MUMPS RUBELLA VAC IJ SOLR	$222.36	$277.95	$63.93–$264.05	—	20%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL A C YW-135 OLIG IM SOLN	$321.80	$402.25	$92.52–$382.14	40% above	20%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL A C YW-135 OLIG IM SOLN	$321.80	$402.25	$92.52–$382.14	—	20%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY	$428.00	$535.00	$123.05–$508.25	85% above	20%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY	$428.00	$535.00	$123.05–$508.25	—	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY	$488.52	$610.65	$140.45–$580.12	67% above	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY	$488.52	$610.65	$140.45–$580.12	—	20%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5ML IM SOSY	$901.60	$1,127.00	$259.21–$1,070.65	12% below	20%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5ML IM SOSY	$901.60	$1,127.00	$259.21–$1,070.65	—	20%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV PRE-FUSION F AB VAC RCMB 120 MCG/0.5ML IM SOL	$542.00	$677.50	$155.83–$643.63	2% below	20%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV PRE-FUSION F AB VAC RCMB 120 MCG/0.5ML IM SOL	$542.00	$677.50	$155.83–$643.63	—	20%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC IM SUSR	$748.84	$936.05	$215.29–$889.25	29% above	20%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC IM SUSR	$748.84	$936.05	$215.29–$889.25	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ	$134.52	$168.15	$38.67–$159.74	225% above	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ	$134.52	$168.15	$38.67–$159.74	—	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC TDAP VACCINE >7 IM	$67.80	$84.75	$19.49–$80.51	17% below	20%
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	$145.84	$182.30	$41.93–$173.19	79% above	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC TDAP VACCINE >7 IM	$67.80	$84.75	$19.49–$80.51	—	20%
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	$146.07	$182.58	$41.99–$173.45	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADM 1 VACCINE	$68.48	$85.60	$19.69–$81.32	77% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADM 1 VACCINE	$68.48	$85.60	$19.69–$81.32	—	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADM EA ADDTL VACCINE	$53.27	$66.58	$15.31–$63.25	64% above	20%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZATION ADM EA ADDTL VACCINE	$53.27	$66.58	$15.31–$63.25	—	20%

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

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

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

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

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

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

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

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

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

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/7949/390806367_meriter-hospital,-inc_standardcharges.csv