Deaconess Hospital
Deaconess Hospital in Newburgh, IN publishes cash prices for 267 common procedures listed here, from its own machine-readable price file updated Feb 11, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Indiana median for 234 of 260 procedures and above it for 24. By typical cash price it ranks #10 of 84 Indiana hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
4011 Gateway Blvd, Newburgh, IN 47630 Collected Sep 23, 2026 Source price file Check a bill from this hospital (812) 450-5000
Acute care hospital Nonprofit hospital Emergency department CMS star rating 2 of 5 CCN 150082 · CMS hospital register NPI 1053361642
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Deaconess Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W&W/O CONTRAST | $876.81 | $2,657.00 | $163.91–$2,338.16 | 35% below | 67% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W&W/O CONTRAST | $876.81 | $2,657.00 | $876.81–$2,338.16 | — | 67% |
| Abdominal X-ray, 2 views CPT 74019 HC XR ABDOMEN 2 VIEWS | $153.78 | $466.00 | $102.57–$410.08 | 43% below | 67% |
| Abdominal X-ray, 2 views inpatient CPT 74019 HC XR ABDOMEN 2 VIEWS | $153.78 | $466.00 | $153.78–$410.08 | — | 67% |
| Ankle X-ray, complete, 3 or more views CPT 73610 HC XR ANKLE COMPLETE 3+ VIEWS | $165.66 | $502.00 | $84.78–$441.76 | 16% below | 67% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC XR ANKLE COMPLETE 3+ VIEWS | $165.66 | $502.00 | $165.66–$441.76 | — | 67% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC DOPPLER ARTERIAL EXTREMITY LIMITED BILAT | $211.86 | $642.00 | $119.18–$564.96 | — | 67% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC DOPPLER ARTERIAL EXTREMITY LIMITED BILAT | $211.86 | $642.00 | $211.86–$564.96 | — | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY W/O CONTRAST | $587.07 | $1,779.00 | $98.07–$1,565.52 | 27% below | 67% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTREMITY W/O CONTRAST | $587.07 | $1,779.00 | $587.07–$1,565.52 | — | 67% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XR EXAM ESOPHAGUS 1CNTRST | $323.07 | $979.00 | $171.41–$861.52 | 31% below | 67% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC XR EXAM ESOPHAGUS 1CNTRST | $323.07 | $979.00 | $323.07–$861.52 | — | 67% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE WHOLE BODY | $1,099.56 | $3,332.00 | $384.78–$2,932.16 | 30% below | 67% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE WHOLE BODY | $1,099.56 | $3,332.00 | $1,099.56–$2,932.16 | — | 67% |
| Breast ultrasound, complete, one breast both sides CPT 76641 HC US BREAST COMPLETE BILATERAL | $381.81 | $1,157.00 | $102.57–$1,018.16 | — | 67% |
| Breast ultrasound, complete, one breast one side CPT 76641 HC US BREAST COMPLETE UNILATERAL | $315.48 | $956.00 | $102.57–$841.28 | 27% below | 67% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 HC US BREAST COMPLETE BILATERAL | $381.81 | $1,157.00 | $381.81–$1,018.16 | — | 67% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US BREAST COMPLETE UNILATERAL | $315.48 | $956.00 | $315.48–$841.28 | — | 67% |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC US BREAST LIMITED BILATERAL | $231.33 | $701.00 | $84.78–$616.88 | — | 67% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US BREAST LIMITED UNILATERAL | $231.33 | $701.00 | $84.78–$616.88 | 29% below | 67% |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 HC US BREAST LIMITED BILATERAL | $231.33 | $701.00 | $231.33–$616.88 | — | 67% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC US BREAST LIMITED UNILATERAL | $231.33 | $701.00 | $231.33–$616.88 | — | 67% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABD/PELVIS W/WO CONTRAST POST | $1,271.82 | $3,854.00 | $358.79–$3,391.52 | 33% below | 67% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CTA ABD/PELVIS W/WO CONTRAST POST | $1,271.82 | $3,854.00 | $1,271.82–$3,391.52 | — | 67% |
| CT angiography (CTA) of the head CPT 70496 HC CTA HEAD W&W/O CONTRAST | $945.45 | $2,865.00 | $163.76–$2,521.20 | 26% below | 67% |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CTA HEAD W&W/O CONTRAST | $945.45 | $2,865.00 | $945.45–$2,521.20 | — | 67% |
| CT angiography (CTA) of the neck CPT 70498 HC CTA NECK W&W/O CONTRAST | $939.18 | $2,846.00 | $163.76–$2,504.48 | 23% below | 67% |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC CTA NECK W&W/O CONTRAST | $939.18 | $2,846.00 | $939.18–$2,504.48 | — | 67% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA CHEST (NONCORONARY) W AND/OR W/O CONTRAST | $950.40 | $2,880.00 | $163.76–$2,534.40 | 25% below | 67% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CTA CHEST (NONCORONARY) W AND/OR W/O CONTRAST | $950.40 | $2,880.00 | $950.40–$2,534.40 | — | 67% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CORONARY ARTERIES W CALCIUM SCORING | $1,370.49 | $4,153.00 | $163.45–$3,654.64 | 63% above | 67% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CORONARY ARTERIES W CALCIUM SCORING | $1,370.49 | $4,153.00 | $1,370.49–$3,654.64 | — | 67% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CARDIAC SCORING | $18.81 | $57.00 | $14.25–$818.00 | 90% below | 67% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CALCIUM SCORING | $18.81 | $57.00 | $14.25–$818.00 | 90% below | 67% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC VASCULAR SCREENING CARDIAC SCORING | $20.13 | $61.00 | $15.25–$818.00 | 89% below | 67% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT AORTIC ROOT CALCIUM SCORE | $40.26 | $122.00 | $30.50–$818.00 | 78% below | 67% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CALCIUM SCORING | $18.81 | $57.00 | $18.81–$50.16 | — | 67% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CARDIAC SCORING | $18.81 | $57.00 | $18.81–$50.16 | — | 67% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC VASCULAR SCREENING CARDIAC SCORING | $20.13 | $61.00 | $20.13–$53.68 | — | 67% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT AORTIC ROOT CALCIUM SCORE | $40.26 | $122.00 | $40.26–$107.36 | — | 67% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABDOMEN & PELVIS W/O CONTRAST | $512.49 | $1,553.00 | $228.61–$1,366.64 | 57% below | 67% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABDOMEN & PELVIS W/O CONTRAST | $512.49 | $1,553.00 | $512.49–$1,366.64 | — | 67% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN AND PELVIS WITH CONTRAST | $1,002.21 | $3,037.00 | $358.79–$2,672.56 | 42% below | 67% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN AND PELVIS WITH CONTRAST | $1,002.21 | $3,037.00 | $1,002.21–$2,672.56 | — | 67% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN & PELVIS W&W/O CONTRAST 1+ REGIONS | $1,148.73 | $3,481.00 | $358.79–$3,063.28 | 33% below | 67% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABDOMEN & PELVIS W&W/O CONTRAST 1+ REGIONS | $1,148.73 | $3,481.00 | $1,148.73–$3,063.28 | — | 67% |
| CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W/CONTRAST | $760.65 | $2,305.00 | $163.91–$2,028.40 | 29% below | 67% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W/CONTRAST | $760.65 | $2,305.00 | $760.65–$2,028.40 | — | 67% |
| CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O CONTRAST | $465.96 | $1,412.00 | $102.57–$1,242.56 | 45% below | 67% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN W/O CONTRAST | $465.96 | $1,412.00 | $465.96–$1,242.56 | — | 67% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL W/O CONTRAST | $464.31 | $1,407.00 | $102.57–$1,238.16 | 44% below | 67% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL W/O CONTRAST | $464.31 | $1,407.00 | $464.31–$1,238.16 | — | 67% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST | $465.63 | $1,411.00 | $102.57–$1,241.68 | 39% below | 67% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST | $465.63 | $1,411.00 | $465.63–$1,241.68 | — | 67% |
| CT scan of the head with contrast CPT 70460 HC CT HEAD/BRAIN W/CONTRAST | $478.83 | $1,451.00 | $171.41–$1,276.88 | 44% below | 67% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD/BRAIN W/CONTRAST | $478.83 | $1,451.00 | $478.83–$1,276.88 | — | 67% |
| CT scan of the head without and with contrast CPT 70470 HC CT HEAD/BRAIN W&W/O CONTRAST | $582.45 | $1,765.00 | $171.41–$1,553.20 | 44% below | 67% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD/BRAIN W&W/O CONTRAST | $582.45 | $1,765.00 | $582.45–$1,553.20 | — | 67% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE W/O CONTRAST | $587.07 | $1,779.00 | $102.57–$1,565.52 | 34% below | 67% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE W/O CONTRAST | $587.07 | $1,779.00 | $587.07–$1,565.52 | — | 67% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE W/O CONTRAST | $594.99 | $1,803.00 | $102.57–$1,586.64 | 29% below | 67% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL SPINE W/O CONTRAST | $594.99 | $1,803.00 | $594.99–$1,586.64 | — | 67% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/CONTRAST | $763.95 | $2,315.00 | $163.91–$2,037.20 | 17% below | 67% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/CONTRAST | $763.95 | $2,315.00 | $763.95–$2,037.20 | — | 67% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX EXTRACRANIAL/CAROTID BILAT | $495.66 | $1,502.00 | $228.61–$1,321.76 | — | 67% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX EXTRACRANIAL/CAROTID BILAT | $495.66 | $1,502.00 | $495.66–$1,321.76 | — | 67% |
| Chest CT scan without and with contrast CPT 71270 HC CT THORAX DIAG W&W/O CONTRAST | $939.18 | $2,846.00 | $171.41–$2,504.48 | 14% below | 67% |
| Chest CT scan without and with contrast inpatient CPT 71270 HC CT THORAX DIAG W&W/O CONTRAST | $939.18 | $2,846.00 | $939.18–$2,504.48 | — | 67% |
| Chest X-ray, 2 views CPT 71046 HC XR CHEST 2 VIEWS | $125.40 | $380.00 | $67.00–$334.40 | 39% below | 67% |
| Chest X-ray, 2 views inpatient CPT 71046 HC XR CHEST 2 VIEWS | $125.40 | $380.00 | $125.40–$334.40 | — | 67% |
| Chest X-ray, single view CPT 71045 HC XR CHEST 1 VIEW | $98.67 | $299.00 | $67.00–$286.62 | 39% below | 67% |
| Chest X-ray, single view inpatient CPT 71045 HC XR CHEST 1 VIEW | $98.67 | $299.00 | $98.67–$263.12 | — | 67% |
| Collarbone (clavicle) X-ray, complete CPT 73000 HC XR CLAVICLE COMPLETE | $141.90 | $430.00 | $84.78–$378.40 | 26% below | 67% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC XR CLAVICLE COMPLETE | $141.90 | $430.00 | $141.90–$378.40 | — | 67% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITIONEAL COMPLETE | $450.45 | $1,365.00 | $102.57–$1,201.20 | 10% below | 67% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITIONEAL COMPLETE | $450.45 | $1,365.00 | $450.45–$1,201.20 | — | 67% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC XR BONE DENSITY DUAL ENERGY (DXA) AXIAL | $232.32 | $704.00 | $104.34–$619.52 | 20% below | 67% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC XR BONE DENSITY DUAL ENERGY (DXA) AXIAL | $232.32 | $704.00 | $232.32–$619.52 | — | 67% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC XR BONE DENSITY DUAL ENERGY (DEXA) APPENDICULAR | $128.04 | $388.00 | $86.24–$341.44 | 12% below | 67% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC XR BONE DENSITY DUAL ENERGY (DEXA) APPENDICULAR | $128.04 | $388.00 | $128.04–$341.44 | — | 67% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US PREGNANCY DETAILED SINGLE/FIRST GEST | $491.70 | $1,490.00 | $228.61–$1,311.20 | 13% below | 67% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US PREGNANCY DETAILED SINGLE/FIRST GEST | $491.70 | $1,490.00 | $491.70–$1,311.20 | — | 67% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX DIAG W/O CONTRAST | $587.07 | $1,779.00 | $102.57–$1,565.52 | 30% below | 67% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT LOW DOSE LUNG DIAGNOSTIC - FOLLOW UP | $587.07 | $1,779.00 | $102.57–$1,565.52 | 30% below | 67% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT LOW DOSE LUNG DIAGNOSTIC - FOLLOW UP | $587.07 | $1,779.00 | $587.07–$1,565.52 | — | 67% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX DIAG W/O CONTRAST | $587.07 | $1,779.00 | $587.07–$1,565.52 | — | 67% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX DIAG W/CONTRAST | $760.65 | $2,305.00 | $171.41–$2,028.40 | 19% below | 67% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT THORAX DIAG W/CONTRAST | $760.65 | $2,305.00 | $760.65–$2,028.40 | — | 67% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC MAMMOGRAM DIAGNOSTIC BILATERAL W/DIGITAL IMAGES W CAD | $251.46 | $762.00 | $190.50–$670.56 | — | 67% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC MAMMOGRAM DIAGNOSTIC BILATERAL W/DIGITAL IMAGES W CAD | $251.46 | $762.00 | $251.46–$670.56 | — | 67% |
| Diagnostic mammogram, one breast one side CPT 77065 HC MAMMOGRAM DIAGNOSTIC UNILATERAL W/DIGITAL IMAGES W CAD | $198.33 | $601.00 | $150.25–$528.88 | 11% below | 67% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC MAMMOGRAM DIAGNOSTIC UNILATERAL W/DIGITAL IMAGES W CAD | $198.33 | $601.00 | $198.33–$528.88 | — | 67% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX ARTERIAL LOWER EXTREMITY BILAT | $495.66 | $1,502.00 | $228.61–$1,321.76 | — | 67% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX ARTERIAL LOWER EXTREMITY BILAT | $495.66 | $1,502.00 | $495.66–$1,321.76 | — | 67% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX VENOUS EXTREMITY BILAT | $495.66 | $1,502.00 | $228.61–$1,321.76 | — | 67% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX VENOUS EXTREMITY BILAT | $495.66 | $1,502.00 | $495.66–$1,321.76 | — | 67% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO COMPLETE PORTABLE | $542.52 | $1,644.00 | $411.00–$1,740.11 | 67% below | 67% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO COMPLETE PEDIATRIC | $542.52 | $1,644.00 | $411.00–$1,740.11 | 67% below | 67% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO 2D WITH SPEC/COLOR FLOW M-MODE COMPLETE | $542.52 | $1,644.00 | $411.00–$1,740.11 | 67% below | 67% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO COMPLETE | $727.65 | $2,205.00 | $514.68–$1,940.40 | 56% below | 67% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO COMPLETE PORTABLE | $542.52 | $1,644.00 | $542.52–$1,446.72 | — | 67% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO COMPLETE PEDIATRIC | $542.52 | $1,644.00 | $542.52–$1,446.72 | — | 67% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO 2D WITH SPEC/COLOR FLOW M-MODE COMPLETE | $542.52 | $1,644.00 | $542.52–$1,446.72 | — | 67% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO COMPLETE | $727.65 | $2,205.00 | $727.65–$1,940.40 | — | 67% |
| Elbow X-ray, 2 views CPT 73070 HC XR ELBOW 2 VIEWS | $141.90 | $430.00 | $84.78–$378.40 | 14% below | 67% |
| Elbow X-ray, 2 views inpatient CPT 73070 HC XR ELBOW 2 VIEWS | $141.90 | $430.00 | $141.90–$378.40 | — | 67% |
| Elbow X-ray, complete, 3 or more views CPT 73080 HC XR ELBOW COMPLETE 3+ VIEWS | $165.66 | $502.00 | $84.78–$441.76 | 35% below | 67% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC XR ELBOW COMPLETE 3+ VIEWS | $165.66 | $502.00 | $165.66–$441.76 | — | 67% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT/SELLA/FOSSA/EAR W/O CONTRAST | $770.22 | $2,334.00 | $102.57–$2,053.92 | 10% below | 67% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT/SELLA/FOSSA/EAR W/O CONTRAST | $770.22 | $2,334.00 | $770.22–$2,053.92 | — | 67% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC XR FACIAL BONES COMPLETE 3+ VIEWS | $208.56 | $632.00 | $102.57–$556.16 | 24% below | 67% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC XR FACIAL BONES COMPLETE 3+ VIEWS | $208.56 | $632.00 | $208.56–$556.16 | — | 67% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC XR FOREARM 2 VIEWS | $128.04 | $388.00 | $84.78–$341.44 | 31% below | 67% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC XR FOREARM 2 VIEWS | $128.04 | $388.00 | $128.04–$341.44 | — | 67% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM HEPATOBILIARY SYSTEM IMAGING INC GALLBLADDER | $676.50 | $2,050.00 | $384.78–$1,804.00 | 49% below | 67% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NM HEPATOBILIARY SYSTEM IMAGING INC GALLBLADDER | $676.50 | $2,050.00 | $676.50–$1,804.00 | — | 67% |
| Hand X-ray, 2 views CPT 73120 HC XR HAND 2 VIEWS | $130.35 | $395.00 | $98.75–$347.60 | 24% below | 67% |
| Hand X-ray, 2 views inpatient CPT 73120 HC XR HAND 2 VIEWS | $130.35 | $395.00 | $130.35–$347.60 | — | 67% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC XR CALCANEUS 2+ VIEWS | $138.93 | $421.00 | $84.78–$370.48 | 35% below | 67% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC XR CALCANEUS 2+ VIEWS | $138.93 | $421.00 | $138.93–$370.48 | — | 67% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND CPAP | $1,602.81 | $4,857.00 | $975.42–$4,274.16 | 51% below | 67% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND SPLY | $1,602.81 | $4,857.00 | $975.42–$4,274.16 | 51% below | 67% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND SPLY | $1,602.81 | $4,857.00 | $1,602.81–$4,274.16 | — | 67% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND CPAP | $1,602.81 | $4,857.00 | $1,602.81–$4,274.16 | — | 67% |
| Knee X-ray, 3 views CPT 73562 HC XR KNEE 3 VIEWS | $181.83 | $551.00 | $84.78–$484.88 | 21% below | 67% |
| Knee X-ray, 3 views inpatient CPT 73562 HC XR KNEE 3 VIEWS | $181.83 | $551.00 | $181.83–$484.88 | — | 67% |
| Knee X-ray, complete, 4 or more views CPT 73564 HC XR KNEE COMPLETE 4+ VIEWS | $208.56 | $632.00 | $102.57–$556.16 | 20% below | 67% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC XR KNEE COMPLETE 4+ VIEWS | $208.56 | $632.00 | $208.56–$556.16 | — | 67% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY W/O CONTRAST | $587.07 | $1,779.00 | $102.57–$1,565.52 | 25% below | 67% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXTREMITY W/O CONTRAST | $587.07 | $1,779.00 | $587.07–$1,565.52 | — | 67% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED ED | $366.63 | $1,111.00 | $102.57–$977.68 | 20% below | 67% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED | $366.63 | $1,111.00 | $102.57–$977.68 | 20% below | 67% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED | $366.63 | $1,111.00 | $366.63–$977.68 | — | 67% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED ED | $366.63 | $1,111.00 | $366.63–$977.68 | — | 67% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US EXTREMITY NON VASCULAR LIMITED ANATOMIC SPEC | $66.99 | $203.00 | $50.75–$455.00 | 78% below | 67% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US EXTREMITY NON VASCULAR LIMITED ANATOMIC SPEC | $66.99 | $203.00 | $66.99–$178.64 | — | 67% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC LOW DOSE LUNG CT SCREENING | $204.93 | $621.00 | $104.34–$818.00 | 8% above | 67% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC LOW DOSE LUNG CT SCREENING | $204.93 | $621.00 | $204.93–$546.48 | — | 67% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR TIBIA/FIBULA 2 VIEWS | $130.35 | $395.00 | $84.78–$347.60 | 34% below | 67% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC XR TIBIA/FIBULA 2 VIEWS | $130.35 | $395.00 | $130.35–$347.60 | — | 67% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD W/O CONTRAST | $1,119.36 | $3,392.00 | $228.61–$2,984.96 | at median | 67% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA HEAD W/O CONTRAST | $1,119.36 | $3,392.00 | $1,119.36–$2,984.96 | — | 67% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY JOINT W/O CONTRAST | $673.53 | $2,041.00 | $228.61–$1,796.08 | 35% below | 67% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY JOINT W/O CONTRAST | $673.53 | $2,041.00 | $673.53–$1,796.08 | — | 67% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXTREMITY JOINT W&W/O CONTRAST | $1,494.57 | $4,529.00 | $358.79–$3,985.52 | 3% above | 67% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXTREMITY JOINT W&W/O CONTRAST | $1,494.57 | $4,529.00 | $1,494.57–$3,985.52 | — | 67% |
| MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN W/O CONTRAST | $1,068.21 | $3,237.00 | $228.61–$2,848.56 | at median | 67% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN W/O CONTRAST | $1,068.21 | $3,237.00 | $1,068.21–$2,848.56 | — | 67% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W&W/O CONTRAST | $1,618.98 | $4,906.00 | $358.79–$4,317.28 | 3% above | 67% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN W&W/O CONTRAST | $1,618.98 | $4,906.00 | $1,618.98–$4,317.28 | — | 67% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O CONTRAST | $676.50 | $2,050.00 | $228.61–$1,804.00 | 33% below | 67% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O CONTRAST | $676.50 | $2,050.00 | $676.50–$1,804.00 | — | 67% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W&W/O CONTRAST | $1,079.10 | $3,270.00 | $358.79–$2,877.60 | 17% below | 67% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W&W/O CONTRAST | $1,079.10 | $3,270.00 | $1,079.10–$2,877.60 | — | 67% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST | $675.51 | $2,047.00 | $228.61–$1,801.36 | 34% below | 67% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST | $675.51 | $2,047.00 | $675.51–$1,801.36 | — | 67% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W&W/O CONTRAST | $1,080.42 | $3,274.00 | $358.79–$2,881.12 | 26% below | 67% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE W&W/O CONTRAST | $1,080.42 | $3,274.00 | $1,080.42–$2,881.12 | — | 67% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O CONTRAST | $675.84 | $2,048.00 | $228.61–$1,802.24 | 33% below | 67% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE W/O CONTRAST | $675.84 | $2,048.00 | $675.84–$1,802.24 | — | 67% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE W&W/O CONTRAST | $1,088.34 | $3,298.00 | $358.79–$2,902.24 | 26% below | 67% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI CERVICAL SPINE W&W/O CONTRAST | $1,088.34 | $3,298.00 | $1,088.34–$2,902.24 | — | 67% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O CONTRAST | $675.84 | $2,048.00 | $228.61–$1,802.24 | 35% below | 67% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O CONTRAST | $675.84 | $2,048.00 | $675.84–$1,802.24 | — | 67% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W&W/O CONTRAST | $1,613.70 | $4,890.00 | $358.79–$4,303.20 | 11% above | 67% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS W&W/O CONTRAST | $1,613.70 | $4,890.00 | $1,613.70–$4,303.20 | — | 67% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS W/O CONTRAST | $1,245.42 | $3,774.00 | $228.61–$3,321.12 | 18% above | 67% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS W/O CONTRAST | $1,245.42 | $3,774.00 | $1,245.42–$3,321.12 | — | 67% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXTREMITY JOINT W/O CONTRAST | $673.53 | $2,041.00 | $228.61–$1,796.08 | 37% below | 67% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXTREMITY JOINT W/O CONTRAST | $673.53 | $2,041.00 | $673.53–$1,796.08 | — | 67% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC XR CERVICAL SPINE 4 OR 5 VIEWS | $213.18 | $646.00 | $102.57–$568.48 | 39% below | 67% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC XR CERVICAL SPINE 4 OR 5 VIEWS | $213.18 | $646.00 | $213.18–$568.48 | — | 67% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT NECK W/CONTRAST | $757.35 | $2,295.00 | $171.41–$2,019.60 | 23% below | 67% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT NECK W/CONTRAST | $757.35 | $2,295.00 | $757.35–$2,019.60 | — | 67% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT NECK W/O CONTRAST | $585.75 | $1,775.00 | $102.57–$1,562.00 | 30% below | 67% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT NECK W/O CONTRAST | $585.75 | $1,775.00 | $585.75–$1,562.00 | — | 67% |
| Neck soft tissue X-ray CPT 70360 HC XR NECK SOFT TISSUE | $144.21 | $437.00 | $84.78–$384.56 | 17% below | 67% |
| Neck soft tissue X-ray inpatient CPT 70360 HC XR NECK SOFT TISSUE | $144.21 | $437.00 | $144.21–$384.56 | — | 67% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM MYOCARDIAL PERFUSION MULTIPLE SPECT | $2,254.56 | $6,832.00 | $1,324.75–$6,012.16 | 41% below | 67% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM MYOCARDIAL PERFUSION MULTIPLE SPECT | $2,254.56 | $6,832.00 | $2,254.56–$6,012.16 | — | 67% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET W/CT TUMOR IMAGING SKULL TO MID-THIGH | $2,899.05 | $8,785.00 | $1,459.54–$7,730.80 | 29% below | 67% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET W/CT TUMOR IMAGING SKULL TO MID-THIGH | $2,899.05 | $8,785.00 | $2,899.05–$7,730.80 | — | 67% |
| Pelvic CT scan without contrast CPT 72192 HC CT PELVIS W/O CONTRAST | $465.63 | $1,411.00 | $102.57–$1,241.68 | 44% below | 67% |
| Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS W/O CONTRAST | $465.63 | $1,411.00 | $465.63–$1,241.68 | — | 67% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIS NON OB LIMITED | $133.98 | $406.00 | $101.50–$455.00 | 62% below | 67% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIS NON OB LIMITED ED | $133.98 | $406.00 | $101.50–$455.00 | 62% below | 67% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIS NON OB LIMITED | $133.98 | $406.00 | $133.98–$357.28 | — | 67% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIS NON OB LIMITED ED | $133.98 | $406.00 | $133.98–$357.28 | — | 67% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIS NON OB | $445.83 | $1,351.00 | $102.57–$1,188.88 | 4% below | 67% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIS NON OB | $445.83 | $1,351.00 | $445.83–$1,188.88 | — | 67% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREGNANCY > 14 WEEKS SINGLE/FIRST GEST | $539.88 | $1,636.00 | $102.57–$1,439.68 | 3% below | 67% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREGNANCY > 14 WEEKS SINGLE/FIRST GEST | $539.88 | $1,636.00 | $539.88–$1,439.68 | — | 67% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US PREGNANCY < 14 WEEKS SINGLE/FIRST GEST | $431.31 | $1,307.00 | $102.57–$1,150.16 | 16% below | 67% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US PREGNANCY < 14 WEEKS SINGLE/FIRST GEST | $431.31 | $1,307.00 | $431.31–$1,150.16 | — | 67% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US PREGNANCY 1 OR MORE FETUSES LIMITED | $303.60 | $920.00 | $102.57–$809.60 | 20% below | 67% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US PREGNANCY 1 OR MORE FETUSES LIMITED | $303.60 | $920.00 | $303.60–$809.60 | — | 67% |
| Rib X-ray, one side, 2 views one side CPT 71100 HC XR RIBS UNILATERAL 2 VIEWS | $141.90 | $430.00 | $84.78–$378.40 | 31% below | 67% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC XR RIBS UNILATERAL 2 VIEWS | $141.90 | $430.00 | $141.90–$378.40 | — | 67% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC XR RIBS UNILATERAL W/CHEST 3+ VIEWS | $168.63 | $511.00 | $102.57–$449.68 | 31% below | 67% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC XR RIBS UNILATERAL W/CHEST 3+ VIEWS | $168.63 | $511.00 | $168.63–$449.68 | — | 67% |
| Screening mammogram, both breasts both sides CPT 77067 HC MAMMOGRAM SCREENING BILATERAL W/DIGITAL IMAGES W CAD | $180.18 | $546.00 | $136.50–$480.48 | — | 67% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC MAMMOGRAM SCREENING BILATERAL W/DIGITAL IMAGES W CAD | $180.18 | $546.00 | $180.18–$480.48 | — | 67% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC XR SHOULDER COMPLETE 2+ VIEWS | $141.90 | $430.00 | $84.78–$378.40 | 32% below | 67% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC XR SHOULDER COMPLETE 2+ VIEWS | $141.90 | $430.00 | $141.90–$378.40 | — | 67% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC XR SINUSES COMPLETE 3+ VIEWS | $181.83 | $551.00 | $84.78–$484.88 | 36% below | 67% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC XR SINUSES COMPLETE 3+ VIEWS | $181.83 | $551.00 | $181.83–$484.88 | — | 67% |
| Skull X-ray, fewer than 4 views CPT 70250 HC XR SKULL < 4 VIEWS | $171.27 | $519.00 | $102.57–$456.72 | 26% below | 67% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 HC XR SKULL < 4 VIEWS | $171.27 | $519.00 | $171.27–$456.72 | — | 67% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $1,522.29 | $4,613.00 | $975.42–$4,059.44 | 42% below | 67% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $1,522.29 | $4,613.00 | $1,522.29–$4,059.44 | — | 67% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC ECHO TTHRC R T 2D WWO M MODE REST AND STRS CONT ECG | $879.12 | $2,664.00 | $514.68–$2,344.32 | 51% below | 67% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC ECHO TTHRC R T 2D WWO M MODE REST AND STRS CONT ECG | $879.12 | $2,664.00 | $879.12–$2,344.32 | — | 67% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC XR EXAM SWLNG FUNCJ CNTRST STUDY | $459.69 | $1,393.00 | $171.41–$1,225.84 | 27% above | 67% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC XR EXAM SWLNG FUNCJ CNTRST STUDY | $459.69 | $1,393.00 | $459.69–$1,225.84 | — | 67% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC XR FEMUR MIN 2 VIEWS | $138.27 | $419.00 | $84.78–$368.72 | 31% below | 67% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC XR FEMUR MIN 2 VIEWS | $138.27 | $419.00 | $138.27–$368.72 | — | 67% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC SPINE W/O CONTRAST | $592.68 | $1,796.00 | $102.57–$1,580.48 | 30% below | 67% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT THORACIC SPINE W/O CONTRAST | $592.68 | $1,796.00 | $592.68–$1,580.48 | — | 67% |
| Toe X-ray, 2 or more views CPT 73660 HC XR TOE(S) 2+ VIEWS | $157.74 | $478.00 | $84.78–$420.64 | 3% above | 67% |
| Toe X-ray, 2 or more views inpatient CPT 73660 HC XR TOE(S) 2+ VIEWS | $157.74 | $478.00 | $157.74–$420.64 | — | 67% |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL | $514.80 | $1,560.00 | $102.57–$1,372.80 | 27% above | 67% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL | $514.80 | $1,560.00 | $514.80–$1,372.80 | — | 67% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC US PREGNANCY TRANSVAGINAL | $347.49 | $1,053.00 | $102.57–$926.64 | 6% below | 67% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US PREGNANCY TRANSVAGINAL | $347.49 | $1,053.00 | $347.49–$926.64 | — | 67% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN COMPLETE | $485.43 | $1,471.00 | $102.57–$1,294.48 | 7% below | 67% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN COMPLETE | $485.43 | $1,471.00 | $485.43–$1,294.48 | — | 67% |
| Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM | $207.57 | $629.00 | $102.57–$553.52 | 51% below | 67% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM | $207.57 | $629.00 | $207.57–$553.52 | — | 67% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US SOFT TISSUE HEAD/NECK | $521.40 | $1,580.00 | $102.57–$1,390.40 | 22% above | 67% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US SOFT TISSUE HEAD/NECK ED | $521.40 | $1,580.00 | $102.57–$1,390.40 | 22% above | 67% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US SOFT TISSUE HEAD/NECK | $521.40 | $1,580.00 | $521.40–$1,390.40 | — | 67% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US SOFT TISSUE HEAD/NECK ED | $521.40 | $1,580.00 | $521.40–$1,390.40 | — | 67% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC XR EXAM UPR GI TRC 1CNTRST | $372.24 | $1,128.00 | $171.41–$992.64 | 29% below | 67% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC XR EXAM UPR GI TRC 1CNTRST | $372.24 | $1,128.00 | $372.24–$992.64 | — | 67% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS 2+ VIEWS | $130.35 | $395.00 | $84.78–$347.60 | 32% below | 67% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC XR HUMERUS 2+ VIEWS | $130.35 | $395.00 | $130.35–$347.60 | — | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUPLEX VENOUS EXTREMITY UNILATERAL/LIMITED ED | $247.50 | $750.00 | $102.57–$660.00 | 61% below | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUPLEX VENOUS EXTREMITY UNILATERAL/LIMITED | $247.50 | $750.00 | $102.57–$660.00 | 61% below | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUPLEX VENOUS EXTREMITY UNILATERAL/LIMITED | $247.50 | $750.00 | $247.50–$660.00 | — | 67% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUPLEX VENOUS EXTREMITY UNILATERAL/LIMITED ED | $247.50 | $750.00 | $247.50–$660.00 | — | 67% |
| Wrist X-ray, 2 views CPT 73100 HC XR WRIST 2 VIEWS | $152.46 | $462.00 | $84.78–$406.56 | 2% below | 67% |
| Wrist X-ray, 2 views inpatient CPT 73100 HC XR WRIST 2 VIEWS | $152.46 | $462.00 | $152.46–$406.56 | — | 67% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC XR WRIST COMPLETE 3+ VIEWS | $195.36 | $592.00 | $84.78–$520.96 | 23% below | 67% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC XR WRIST COMPLETE 3+ VIEWS | $195.36 | $592.00 | $195.36–$520.96 | — | 67% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC XR HIP UNILATERAL W/PELVIS 2-3 VIEWS | $131.34 | $398.00 | $84.78–$350.24 | 50% below | 67% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC XR HIP UNILATERAL W/PELVIS 2-3 VIEWS | $131.34 | $398.00 | $131.34–$350.24 | — | 67% |
| X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN 1 VIEW | $149.49 | $453.00 | $84.78–$398.64 | 31% below | 67% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN 1 VIEW | $149.49 | $453.00 | $149.49–$398.64 | — | 67% |
| X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 2 VIEWS | $138.93 | $421.00 | $84.78–$370.48 | 13% below | 67% |
| X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 2 VIEWS | $138.93 | $421.00 | $138.93–$370.48 | — | 67% |
| X-ray of the finger(s), 2 or more views CPT 73140 HC XR FINGER(S) 2+ VIEWS | $178.86 | $542.00 | $84.78–$476.96 | 12% above | 67% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC XR FINGER(S) 2+ VIEWS | $178.86 | $542.00 | $178.86–$476.96 | — | 67% |
| X-ray of the foot, 2 views CPT 73620 HC XR FOOT 2 VIEWS | $133.98 | $406.00 | $84.78–$357.28 | 18% below | 67% |
| X-ray of the foot, 2 views inpatient CPT 73620 HC XR FOOT 2 VIEWS | $133.98 | $406.00 | $133.98–$357.28 | — | 67% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC XR FOOT COMPLETE 3+ VIEWS | $152.46 | $462.00 | $84.78–$406.56 | 24% below | 67% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC XR FOOT COMPLETE 3+ VIEWS | $152.46 | $462.00 | $152.46–$406.56 | — | 67% |
| X-ray of the hand, 3 or more views CPT 73130 HC XR HAND COMPLETE 3+ VIEWS | $160.05 | $485.00 | $84.78–$426.80 | 21% below | 67% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HC XR HAND COMPLETE 3+ VIEWS | $160.05 | $485.00 | $160.05–$426.80 | — | 67% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC XR KNEE 1 OR 2 VIEWS | $147.18 | $446.00 | $84.78–$392.48 | 30% below | 67% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC XR KNEE 1 OR 2 VIEWS | $147.18 | $446.00 | $147.18–$392.48 | — | 67% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC XR LUMBAR SPINE 2 OR 3 VIEWS | $173.91 | $527.00 | $102.57–$463.76 | 31% below | 67% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC XR LUMBAR SPINE 2 OR 3 VIEWS | $173.91 | $527.00 | $173.91–$463.76 | — | 67% |
| X-ray of the lower back, 4 or more views CPT 72110 HC XR LUMBAR SPINE 4+ VIEWS | $242.88 | $736.00 | $102.57–$647.68 | 30% below | 67% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC XR LUMBAR SPINE 4+ VIEWS | $242.88 | $736.00 | $242.88–$647.68 | — | 67% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC XR THORACIC SPINE 2 VIEWS | $147.18 | $446.00 | $102.57–$392.48 | 37% below | 67% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC XR THORACIC SPINE 2 VIEWS | $147.18 | $446.00 | $147.18–$392.48 | — | 67% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC XR NASAL BONES COMPLETE 3+ VIEWS | $176.22 | $534.00 | $84.78–$469.92 | 13% below | 67% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC XR NASAL BONES COMPLETE 3+ VIEWS | $176.22 | $534.00 | $176.22–$469.92 | — | 67% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR CERVICAL SPINE 2 OR 3 VIEWS | $160.05 | $485.00 | $84.78–$426.80 | 36% below | 67% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC XR CERVICAL SPINE 2 OR 3 VIEWS | $160.05 | $485.00 | $160.05–$426.80 | — | 67% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC XR PELVIS 1 OR 2 VIEWS | $136.62 | $414.00 | $102.57–$364.32 | 30% below | 67% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC XR PELVIS 1 OR 2 VIEWS | $136.62 | $414.00 | $136.62–$364.32 | — | 67% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC XR SACRUM/COCCYX 2+ VIEWS | $141.90 | $430.00 | $84.78–$378.40 | 35% below | 67% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC XR SACRUM/COCCYX 2+ VIEWS | $141.90 | $430.00 | $141.90–$378.40 | — | 67% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRUL PEPTIDE AB IGG | $28.71 | $87.00 | $7.12–$76.56 | 46% below | 67% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRUL PEPTIDE AB IGG | $28.71 | $87.00 | $28.71–$76.56 | — | 67% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC SARS-COV-2 COVID-19 AMP PRB POC | $48.51 | $147.00 | $28.22–$129.36 | 54% below | 67% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC SARS-COV-2 COVID-19 AMP PRB POC | $48.51 | $147.00 | $48.51–$129.36 | — | 67% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER IGG | $21.78 | $66.00 | $7.08–$58.08 | 78% below | 67% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER IGG | $21.78 | $66.00 | $21.78–$58.08 | — | 67% |
| Measles (rubeola) antibody test CPT 86765 HC RUBEOLA ANTIBODY MEASLES | $28.05 | $85.00 | $7.08–$74.80 | 64% below | 67% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA ANTIBODY MEASLES | $28.05 | $85.00 | $28.05–$74.80 | — | 67% |
| Mumps immunity blood test CPT 86735 HC MUMPS ANTIBODY IGG | $21.78 | $66.00 | $7.18–$58.08 | 71% below | 67% |
| Mumps immunity blood test inpatient CPT 86735 HC MUMPS ANTIBODY IGG | $21.78 | $66.00 | $21.78–$58.08 | — | 67% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRSMV DIR OPTIC READ OBS PR DATE DCP | $18.48 | $56.00 | $6.93–$49.28 | 81% below | 67% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRSMV DIRECT OPT OBS PR DATE T-CUP | $19.14 | $58.00 | $6.93–$51.04 | 81% below | 67% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRSMV DIRECT OPT OBS PR DATE I-CUP | $19.14 | $58.00 | $6.93–$51.04 | 81% below | 67% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TEST PRSMV DIR OPTIC READ OBS PR DATE DCP | $18.48 | $56.00 | $18.48–$49.28 | — | 67% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TEST PRSMV DIRECT OPT OBS PR DATE T-CUP | $19.14 | $58.00 | $19.14–$51.04 | — | 67% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TEST PRSMV DIRECT OPT OBS PR DATE I-CUP | $19.14 | $58.00 | $19.14–$51.04 | — | 67% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine CPT 64615 HC CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE | $513.15 | $1,555.00 | $276.32–$3,517.00 | 20% below | 67% |
| Botox injections for chronic migraine inpatient CPT 64615 HC CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE | $513.15 | $1,555.00 | $513.15–$1,368.40 | — | 67% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST 1ST LESION STEREOTACTIC | $1,754.94 | $5,318.00 | $1,329.50–$5,627.00 | 30% below | 67% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST 1ST LESION STEREOTACTIC | $1,754.94 | $5,318.00 | $1,754.94–$4,679.84 | — | 67% |
| Cardiac catheterization with coronary angiogram CPT 93458 HC LHC W/WO LV ANGIO/CORONARY ANGIO | $3,780.15 | $11,455.00 | $2,863.75–$10,278.26 | 62% below | 67% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 HC LHC W/WO LV ANGIO/CORONARY ANGIO | $3,780.15 | $11,455.00 | $3,780.15–$10,080.40 | — | 67% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTIVE EXTERNAL | $581.46 | $1,762.00 | $440.50–$3,949.00 | 59% below | 67% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTIVE EXTERNAL | $581.46 | $1,762.00 | $581.46–$1,550.56 | — | 67% |
| Catheter ablation for atrial fibrillation CPT 93656 HC EP COMP STUDY W/ABLATION AFIB W/TRANSSEPTAL | $15,203.76 | $46,072.00 | $11,518.00–$74,914.44 | 45% below | 67% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 HC EP COMP STUDY W/ABLATION AFIB W/TRANSSEPTAL | $15,203.76 | $46,072.00 | $15,203.76–$40,543.36 | — | 67% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION W/REGIONL BLOCK | $207.90 | $630.00 | $157.50–$6,967.00 | 71% below | 67% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION W/REGIONL BLOCK | $207.90 | $630.00 | $207.90–$554.40 | — | 67% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC COLPOSC CERVIX W/ADJ VAG W/BX & CURRETAG | $581.46 | $1,762.00 | $299.29–$3,517.00 | 75% below | 67% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HC COLPOSC CERVIX W/ADJ VAG W/BX & CURRETAG | $581.46 | $1,762.00 | $581.46–$1,550.56 | — | 67% |
| Coronary stent placement, one artery CPT 92928 HC STENT CORONARY BM INITIAL VESSEL LC | $9,111.96 | $27,612.00 | $6,903.00–$34,700.26 | 42% below | 67% |
| Coronary stent placement, one artery CPT 92928 HC STENT CORONARY BM INITIAL VESSEL LM | $9,111.96 | $27,612.00 | $6,903.00–$34,700.26 | 42% below | 67% |
| Coronary stent placement, one artery CPT 92928 HC STENT CORONARY BM INITIAL VESSEL RI | $9,111.96 | $27,612.00 | $6,903.00–$34,700.26 | 42% below | 67% |
| Coronary stent placement, one artery CPT 92928 HC STENT CORONARY BM INITIAL VESSEL RC | $9,111.96 | $27,612.00 | $6,903.00–$34,700.26 | 42% below | 67% |
| Coronary stent placement, one artery CPT 92928 HC STENT CORONARY BM INITIAL VESSEL LD | $9,111.96 | $27,612.00 | $6,903.00–$34,700.26 | 42% below | 67% |
| Coronary stent placement, one artery inpatient CPT 92928 HC STENT CORONARY BM INITIAL VESSEL LD | $9,111.96 | $27,612.00 | $9,111.96–$24,298.56 | — | 67% |
| Coronary stent placement, one artery inpatient CPT 92928 HC STENT CORONARY BM INITIAL VESSEL RI | $9,111.96 | $27,612.00 | $9,111.96–$24,298.56 | — | 67% |
| Coronary stent placement, one artery inpatient CPT 92928 HC STENT CORONARY BM INITIAL VESSEL LM | $9,111.96 | $27,612.00 | $9,111.96–$24,298.56 | — | 67% |
| Coronary stent placement, one artery inpatient CPT 92928 HC STENT CORONARY BM INITIAL VESSEL RC | $9,111.96 | $27,612.00 | $9,111.96–$24,298.56 | — | 67% |
| Coronary stent placement, one artery inpatient CPT 92928 HC STENT CORONARY BM INITIAL VESSEL LC | $9,111.96 | $27,612.00 | $9,111.96–$24,298.56 | — | 67% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUCT PREMALG LESION 1 | $160.38 | $486.00 | $121.50–$3,517.00 | 14% below | 67% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUCT PREMALG LESION 1 | $160.38 | $486.00 | $160.38–$427.68 | — | 67% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $114.84 | $348.00 | $57.07–$3,517.00 | 35% below | 67% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $114.84 | $348.00 | $114.84–$306.24 | — | 67% |
| Earwax removal with instruments, one ear one side CPT 69210 HC REMOVE CERUMEN IMPACTED REQUIRING INSTR UNILAT | $114.84 | $348.00 | $57.07–$3,517.00 | 28% below | 67% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMOVE CERUMEN IMPACTED REQUIRING INSTR UNILAT | $114.84 | $348.00 | $114.84–$306.24 | — | 67% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC BIOPSY OF UTERUS LINING | $321.09 | $973.00 | $185.91–$3,517.00 | 12% above | 67% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC BIOPSY OF UTERUS LINING | $321.09 | $973.00 | $321.09–$856.24 | — | 67% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC INJX INTERLAMINAR CRV/THRC | $1,127.28 | $3,416.00 | $645.17–$3,949.00 | 6% above | 67% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC EPIDURAL NECK CHEST W/IMAGING | $1,127.28 | $3,416.00 | $645.17–$3,949.00 | 6% above | 67% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC INJX INTERLAMINAR CRV/THRC | $1,127.28 | $3,416.00 | $1,127.28–$3,006.08 | — | 67% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC EPIDURAL NECK CHEST W/IMAGING | $1,127.28 | $3,416.00 | $1,127.28–$3,006.08 | — | 67% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ PV FACET JNT L/S W/ IMAGE GUIDANCE 1 LEV | $630.63 | $1,911.00 | $477.75–$3,949.00 | 45% below | 67% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ PV FACET JNT L/S 1 LEV | $630.63 | $1,911.00 | $477.75–$3,949.00 | 45% below | 67% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ FACET JOINT LUMBAR OR SACRAL SINGLE LEVEL | $760.32 | $2,304.00 | $576.00–$3,949.00 | 34% below | 67% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ PV FACET JNT L/S W/ IMAGE GUIDANCE 1 LEV | $630.63 | $1,911.00 | $630.63–$1,681.68 | — | 67% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ PV FACET JNT L/S 1 LEV | $630.63 | $1,911.00 | $630.63–$1,681.68 | — | 67% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ FACET JOINT LUMBAR OR SACRAL SINGLE LEVEL | $760.32 | $2,304.00 | $760.32–$2,027.52 | — | 67% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS | $1,276.11 | $3,867.00 | $852.66–$3,949.00 | 42% below | 67% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS | $1,276.11 | $3,867.00 | $1,276.11–$3,402.96 | — | 67% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC HYSTEROSALPINGOGRAM | $250.47 | $759.00 | $106.68–$3,517.00 | 13% below | 67% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC HYSTEROSALPINGOGRAM | $250.47 | $759.00 | $250.47–$667.92 | — | 67% |
| IUD insertion (the device itself billed separately) CPT 58300 HC INSERT IUD | $161.70 | $490.00 | $122.50–$3,517.00 | 97% below | 67% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 HC INSERT IUD | $161.70 | $490.00 | $161.70–$431.20 | — | 67% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D ABSCESS SIMPLE | $302.61 | $917.00 | $186.78–$3,517.00 | 34% below | 67% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC INCISION/DRAIN ABSCESS SIMP/SING | $302.61 | $917.00 | $186.78–$3,517.00 | 34% below | 67% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC INCISION/DRAIN ABSCESS SIMP/SING | $302.61 | $917.00 | $302.61–$806.96 | — | 67% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D ABSCESS SIMPLE | $302.61 | $917.00 | $302.61–$806.96 | — | 67% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ TENDON SHEATH/LIGAMENT | $201.63 | $611.00 | $152.75–$3,517.00 | 62% below | 67% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJECTION TENDON SHEATH | $245.19 | $743.00 | $185.75–$3,517.00 | 54% below | 67% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJECTION TENDON SHEATH W/FLUORO | $245.19 | $743.00 | $185.75–$3,517.00 | 54% below | 67% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJ TENDON SHEATH/LIGAMENT | $201.63 | $611.00 | $201.63–$537.68 | — | 67% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJECTION TENDON SHEATH | $245.19 | $743.00 | $245.19–$653.84 | — | 67% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJECTION TENDON SHEATH W/FLUORO | $245.19 | $743.00 | $245.19–$653.84 | — | 67% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASP OR INJ MAJ JNT/BURSA | $194.70 | $590.00 | $147.50–$3,517.00 | 53% below | 67% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHRO/ASP/INJ MAJOR JOINT/BURSA | $513.48 | $1,556.00 | $276.32–$3,517.00 | 24% above | 67% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASP/INJ JOINT/BURSA MAJOR | $513.48 | $1,556.00 | $276.32–$3,517.00 | 24% above | 67% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCEN ASP/INJ JOINT/BURSA MAJOR W/O US | $513.48 | $1,556.00 | $276.32–$3,517.00 | 24% above | 67% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASP OR INJ MAJ JNT/BURSA | $194.70 | $590.00 | $194.70–$519.20 | — | 67% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASP/INJ JOINT/BURSA MAJOR | $513.48 | $1,556.00 | $513.48–$1,369.28 | — | 67% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHRO/ASP/INJ MAJOR JOINT/BURSA | $513.48 | $1,556.00 | $513.48–$1,369.28 | — | 67% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCEN ASP/INJ JOINT/BURSA MAJOR W/O US | $513.48 | $1,556.00 | $513.48–$1,369.28 | — | 67% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERTION DRUG IMPLANT DEVICE | $109.23 | $331.00 | $82.75–$3,517.00 | 94% below | 67% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERTION DRUG IMPLANT DEVICE | $109.23 | $331.00 | $109.23–$291.28 | — | 67% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS ASP/INJ JOINT/BURSA INTERMEDIATE | $473.55 | $1,435.00 | $276.32–$3,517.00 | 11% above | 67% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCEN ASP/INJ JOINT/BURSA INTERMEDIATE W/O US | $473.55 | $1,435.00 | $276.32–$3,139.00 | 11% above | 67% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS ASPI JOINT - INTERMEDIATE | $473.55 | $1,435.00 | $276.32–$3,517.00 | 11% above | 67% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCEN ASP/INJ JOINT/BURSA INTERMEDIATE W/O US | $473.55 | $1,435.00 | $473.55–$1,262.80 | — | 67% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS ASPI JOINT - INTERMEDIATE | $473.55 | $1,435.00 | $473.55–$1,262.80 | — | 67% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS ASP/INJ JOINT/BURSA INTERMEDIATE | $473.55 | $1,435.00 | $473.55–$1,262.80 | — | 67% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHROCENTESIS ASP/INJ JOINT/BURSA SMALL | $456.39 | $1,383.00 | $276.32–$3,517.00 | 55% above | 67% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHROCENTESIS ASP INJ SMALL JOINT FINGERS/TOES | $456.39 | $1,383.00 | $276.32–$3,517.00 | 55% above | 67% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHROCEN ASP/INJ JOINT/BURSA SMALL W/O US | $456.39 | $1,383.00 | $276.32–$3,139.00 | 55% above | 67% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ARTHROCEN ASP/INJ JOINT/BURSA SMALL W/O US | $456.39 | $1,383.00 | $456.39–$1,217.04 | — | 67% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ARTHROCENTESIS ASP INJ SMALL JOINT FINGERS/TOES | $456.39 | $1,383.00 | $456.39–$1,217.04 | — | 67% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ARTHROCENTESIS ASP/INJ JOINT/BURSA SMALL | $456.39 | $1,383.00 | $456.39–$1,217.04 | — | 67% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC REPAIR LAC INTERMED SCALP/AXIL/TRUNK <2.5CM | $616.11 | $1,867.00 | $372.00–$3,517.00 | 14% below | 67% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC REPAIR LAC INTERMED SCALP/AXIL/TRUNK <2.5CM | $616.11 | $1,867.00 | $616.11–$1,642.96 | — | 67% |
| Left heart catheterization, diagnostic CPT 93452 HC LHC W/WO LV ANGIO | $3,780.15 | $11,455.00 | $2,863.75–$10,278.26 | 51% below | 67% |
| Left heart catheterization, diagnostic inpatient CPT 93452 HC LHC W/WO LV ANGIO | $3,780.15 | $11,455.00 | $3,780.15–$10,080.40 | — | 67% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC EPIDURAL LUMBAR SACRAL W IMAGING | $1,127.28 | $3,416.00 | $645.17–$3,949.00 | 12% below | 67% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,127.28 | $3,416.00 | $645.17–$3,949.00 | 12% below | 67% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,127.28 | $3,416.00 | $1,127.28–$3,006.08 | — | 67% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC EPIDURAL LUMBAR SACRAL W IMAGING | $1,127.28 | $3,416.00 | $1,127.28–$3,006.08 | — | 67% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC EPIDURAL LUMBAR SACRAL WO IMAGING | $1,001.22 | $3,034.00 | $758.50–$3,949.00 | 29% below | 67% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC EPIDURAL LUMBAR SACRAL WO IMAGING | $1,001.22 | $3,034.00 | $1,001.22–$2,669.92 | — | 67% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJECT FORAMEN EPIDURAL L/S SINGLE | $660.99 | $2,003.00 | $500.75–$3,949.00 | 59% below | 67% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $660.99 | $2,003.00 | $500.75–$3,949.00 | 59% below | 67% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJECT FORAMEN EPIDURAL L/S SINGLE | $660.99 | $2,003.00 | $660.99–$1,762.64 | — | 67% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $660.99 | $2,003.00 | $660.99–$1,762.64 | — | 67% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC SKIN BENIG <0.5 CM TRUNK ARM LEG | $337.26 | $1,022.00 | $255.50–$3,949.00 | 85% below | 67% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC SKIN BENIG <0.5 CM TRUNK ARM LEG | $337.26 | $1,022.00 | $337.26–$899.36 | — | 67% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXC SKIN BENIGN <0.5 CM FACE FACIAL | $337.26 | $1,022.00 | $255.50–$3,949.00 | 54% below | 67% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC EXC SKIN BENIGN <0.5 CM FACE FACIAL | $337.26 | $1,022.00 | $337.26–$899.36 | — | 67% |
| Nail removal (partial or complete), one nail CPT 11730 HC AVULSION NAIL PLATE 1 NAIL | $362.34 | $1,098.00 | $186.78–$3,517.00 | 8% below | 67% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION NAIL PLATE 1 NAIL | $362.34 | $1,098.00 | $362.34–$966.24 | — | 67% |
| Occipital nerve block (injection for headaches) CPT 64405 HC INJECTION AA & STRD GREATER OCCIPITAL NERVE | $194.70 | $590.00 | $147.50–$3,517.00 | 68% below | 67% |
| Occipital nerve block (injection for headaches) CPT 64405 HC NJX AA /STRD GR OPTICAL NERVE | $244.20 | $740.00 | $185.00–$3,517.00 | 60% below | 67% |
| Occipital nerve block (injection for headaches) CPT 64405 HC INJX AA&/STRD GREATER OCCIPITAL NERVE | $252.78 | $766.00 | $191.50–$3,517.00 | 58% below | 67% |
| Occipital nerve block (injection for headaches) CPT 64405 HC NERVE BLOCK INJ OCCIPITAL | $252.78 | $766.00 | $191.50–$3,517.00 | 58% below | 67% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJECTION AA & STRD GREATER OCCIPITAL NERVE | $194.70 | $590.00 | $194.70–$519.20 | — | 67% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC NJX AA /STRD GR OPTICAL NERVE | $244.20 | $740.00 | $244.20–$651.20 | — | 67% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC NERVE BLOCK INJ OCCIPITAL | $252.78 | $766.00 | $252.78–$674.08 | — | 67% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJX AA&/STRD GREATER OCCIPITAL NERVE | $252.78 | $766.00 | $252.78–$674.08 | — | 67% |
| Pacemaker implant (dual chamber) CPT 33208 HC PPM INSERT DUAL W/FLUORO | $8,209.41 | $24,877.00 | $6,219.25–$33,681.77 | 32% below | 67% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 HC PPM INSERT DUAL W/FLUORO | $8,209.41 | $24,877.00 | $8,209.41–$21,891.76 | — | 67% |
| Paracentesis with imaging guidance CPT 49083 HC ABDOMINAL PARACENTESIS W IMAGING | $1,381.71 | $4,187.00 | $845.70–$5,627.00 | at median | 67% |
| Paracentesis with imaging guidance CPT 49083 HC ABDOMINAL PARACENTESIS W IMAGING ED | $1,381.71 | $4,187.00 | $845.70–$5,627.00 | at median | 67% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOMINAL PARACENTESIS W IMAGING ED | $1,381.71 | $4,187.00 | $1,381.71–$3,684.56 | — | 67% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOMINAL PARACENTESIS W IMAGING | $1,381.71 | $4,187.00 | $1,381.71–$3,684.56 | — | 67% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC EXCISION NAIL & MATRIX | $616.11 | $1,867.00 | $372.00–$3,517.00 | 11% below | 67% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC EXCISION NAIL & MATRIX | $616.11 | $1,867.00 | $616.11–$1,642.96 | — | 67% |
| Prostate biopsy CPT 55700 HC BIOPSY PROSTATE NEEDLE SINGLE OR MULTI | $1,369.17 | $4,149.00 | $1,037.25–$6,424.59 | 62% below | 67% |
| Prostate biopsy inpatient CPT 55700 HC BIOPSY PROSTATE NEEDLE SINGLE OR MULTI | $1,369.17 | $4,149.00 | $1,369.17–$3,651.12 | — | 67% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DEST NRV LUMB/SACR SGL | $1,572.12 | $4,764.00 | $1,191.00–$6,967.00 | 53% below | 67% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC DEST NRV LUMB/SACR SGL | $1,572.12 | $4,764.00 | $1,572.12–$4,192.32 | — | 67% |
| Removal of a foreign object under the skin, simple CPT 10120 HC INCISION/REMOVAL FOREIGN BODY SUBQ SIMPLE | $616.11 | $1,867.00 | $372.00–$3,517.00 | at median | 67% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC INCISION/REMOVAL FOREIGN BODY SUBQ SIMPLE | $616.11 | $1,867.00 | $616.11–$1,642.96 | — | 67% |
| Short arm splint (forearm and hand) CPT 29125 HC APPLY SPLINT SHORT ARM | $98.67 | $299.00 | $74.75–$3,517.00 | 46% below | 67% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY SPLINT SHORT ARM | $98.67 | $299.00 | $98.67–$263.12 | — | 67% |
| Short leg splint (calf to foot) CPT 29515 HC APPLY SPLINT SHORT LEG | $241.89 | $733.00 | $147.00–$3,517.00 | at median | 67% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC APPLY SPLINT SHORT LEG | $241.89 | $733.00 | $241.89–$645.04 | — | 67% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC REPAIR LAC SIMPLE SCALP/HAND/FT/GEN <2.5CM | $339.57 | $1,029.00 | $186.78–$3,517.00 | 22% below | 67% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC REPAIR LAC SIMPLE SCALP/HAND/FT/GEN <2.5CM | $339.57 | $1,029.00 | $339.57–$905.52 | — | 67% |
| Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BX SKIN SINGLE LESION | $577.83 | $1,751.00 | $372.00–$3,517.00 | 28% above | 67% |
| Skin biopsy, punch, one lesion CPT 11104 HC FAT PAD BX | $577.83 | $1,751.00 | $372.00–$3,517.00 | 28% above | 67% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC FAT PAD BX | $577.83 | $1,751.00 | $577.83–$1,540.88 | — | 67% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BX SKIN SINGLE LESION | $577.83 | $1,751.00 | $577.83–$1,540.88 | — | 67% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC EXC SKIN MALIG <0.5 CM TRUNK ARM LEG | $333.63 | $1,011.00 | $252.75–$3,949.00 | 31% below | 67% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 HC EXC SKIN MALIG <0.5 CM TRUNK ARM LEG | $333.63 | $1,011.00 | $333.63–$889.68 | — | 67% |
| Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL OF SKIN TAGS UP TO 15 | $162.36 | $492.00 | $123.00–$3,517.00 | 43% below | 67% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVAL OF SKIN TAGS UP TO 15 | $162.36 | $492.00 | $162.36–$432.96 | — | 67% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC | $1,127.28 | $3,416.00 | $645.17–$3,949.00 | 10% above | 67% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC | $1,127.28 | $3,416.00 | $1,127.28–$3,006.08 | — | 67% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC REPAIR LAC SIMPLE SCALP/HAND/FT/GEN 2.6-7.5CM | $339.57 | $1,029.00 | $186.78–$3,517.00 | 15% below | 67% |
| 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 REPAIR LAC SIMPLE SCALP/HAND/FT/GEN 2.6-7.5CM | $339.57 | $1,029.00 | $339.57–$905.52 | — | 67% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC REPAIR LAC SIMPLE FACE/EAR/LIPS <2.5CM | $339.57 | $1,029.00 | $186.78–$3,517.00 | 21% below | 67% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC REPAIR LAC SIMPLE FACE/EAR/LIPS <2.5CM | $339.57 | $1,029.00 | $339.57–$905.52 | — | 67% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGNTL BX SKIN SINGLE LESION | $421.74 | $1,278.00 | $186.78–$3,517.00 | 4% above | 67% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGNTL BX SKIN SINGLE LESION | $421.74 | $1,278.00 | $421.74–$1,124.64 | — | 67% |
| Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS WITH IMAGE GUIDE | $1,441.11 | $4,367.00 | $586.08–$3,842.96 | 32% above | 67% |
| Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS W IMAGE GUIDANCE | $1,441.11 | $4,367.00 | $586.08–$3,949.00 | 32% above | 67% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS WITH IMAGE GUIDE | $1,441.11 | $4,367.00 | $1,441.11–$3,842.96 | — | 67% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS W IMAGE GUIDANCE | $1,441.11 | $4,367.00 | $1,441.11–$3,842.96 | — | 67% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC INJX TRIGGER POINT 1/2 MUSCL | $513.15 | $1,555.00 | $276.32–$3,517.00 | 10% below | 67% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC TRIGGER PT 1-2 MUSCLE | $513.15 | $1,555.00 | $276.32–$3,517.00 | 10% below | 67% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC TRIGGER PT 1-2 MUSCLE | $513.15 | $1,555.00 | $513.15–$1,368.40 | — | 67% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJX TRIGGER POINT 1/2 MUSCL | $513.15 | $1,555.00 | $513.15–$1,368.40 | — | 67% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST 1ST LESION US IMAG | $1,369.17 | $4,149.00 | $455.00–$5,113.92 | 41% below | 67% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST 1ST LESION US IMAG | $1,369.17 | $4,149.00 | $1,369.17–$3,651.12 | — | 67% |
| Wart removal, up to 14 warts CPT 17110 HC LESION DESTRUCTION UP TO 14 | $128.37 | $389.00 | $97.25–$3,517.00 | 57% below | 67% |
| Wart removal, up to 14 warts inpatient CPT 17110 HC LESION DESTRUCTION UP TO 14 | $128.37 | $389.00 | $128.37–$342.32 | — | 67% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE SKIN/SUBQ TISSUE 1ST 20 SQ CM | $476.85 | $1,445.00 | $361.25–$3,517.00 | 39% below | 67% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDE SKIN/SUBQ TISSUE 1ST 20 SQ CM | $476.85 | $1,445.00 | $476.85–$1,271.60 | — | 67% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC TRANSFUSION BLOOD/BLOOD COMPONENTS | $623.04 | $1,888.00 | $404.99–$3,517.00 | 31% below | 67% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC TRANSFUSION BLOOD/BLOOD COMPONENTS | $623.04 | $1,888.00 | $623.04–$1,661.44 | — | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHAL RX AIRWAY OBST/DX SPUTUM INDUCT EZ PAP | $21.12 | $64.00 | $16.00–$672.78 | 81% below | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHAL RX AIRWAY OBST/DX SPUTUM INDUCT NEB | $142.23 | $431.00 | $107.75–$672.78 | 26% above | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHAL RX AIRWAY OBST/DX SPUTUM INDUCT INTRAPULM PERCUSS | $142.23 | $431.00 | $107.75–$672.78 | 26% above | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHAL RX AIRWAY OBST/DX SPUTUM INDUCT NMDI | $142.23 | $431.00 | $107.75–$672.78 | 26% above | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHAL RX AIRWAY OBST/DX SPUTUM INDUCT EZ PAP | $21.12 | $64.00 | $21.12–$56.32 | — | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHAL RX AIRWAY OBST/DX SPUTUM INDUCT INTRAPULM PERCUSS | $142.23 | $431.00 | $142.23–$379.28 | — | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHAL RX AIRWAY OBST/DX SPUTUM INDUCT NEB | $142.23 | $431.00 | $142.23–$379.28 | — | 67% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHAL RX AIRWAY OBST/DX SPUTUM INDUCT NMDI | $142.23 | $431.00 | $142.23–$379.28 | — | 67% |
| Chemotherapy IV infusion, first hour CPT 96413 HC IV CHEMOTHERAPY INFUSION - INITIAL UP TO 1 HOUR | $540.54 | $1,638.00 | $315.96–$1,441.44 | 20% below | 67% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC IV CHEMOTHERAPY INFUSION - INITIAL UP TO 1 HOUR | $540.54 | $1,638.00 | $540.54–$1,441.44 | — | 67% |
| Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE 30 - 74 MIN | $1,559.91 | $4,727.00 | $199.24–$4,159.76 | 27% below | 67% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE 30 - 74 MIN | $1,559.91 | $4,727.00 | $1,559.91–$4,159.76 | — | 67% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE AND DROWSY | $417.78 | $1,266.00 | $292.83–$1,114.08 | 39% below | 67% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG AWAKE AND DROWSY | $417.78 | $1,266.00 | $417.78–$1,114.08 | — | 67% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG PILOT FFA | $28.71 | $87.00 | $21.75–$192.92 | 86% below | 67% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG FPC/SC | $126.72 | $384.00 | $57.07–$337.92 | 37% below | 67% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG | $126.72 | $384.00 | $57.07–$337.92 | 37% below | 67% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC EKG PILOT FFA | $28.71 | $87.00 | $28.71–$76.56 | — | 67% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC EKG FPC/SC | $126.72 | $384.00 | $126.72–$337.92 | — | 67% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC EKG | $126.72 | $384.00 | $126.72–$337.92 | — | 67% |
| Electroconvulsive therapy (ECT), one session CPT 90870 HC ECT SEIZURE SINGLE | $882.42 | $2,674.00 | $500.04–$2,353.12 | 31% below | 67% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 HC ECT SEIZURE SINGLE | $882.42 | $2,674.00 | $616.00–$2,353.12 | — | 67% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED LEVEL 1 VISIT 99281 | $68.31 | $207.00 | $33.30–$2,716.00 | 69% below | 67% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED LEVEL 1 VISIT 99281 | $68.31 | $207.00 | $68.31–$182.16 | — | 67% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED LEVEL 2 VISIT 99282 | $279.51 | $847.00 | $56.00–$2,716.00 | 33% below | 67% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED LEVEL 2 VISIT 99282 | $279.51 | $847.00 | $279.51–$745.36 | — | 67% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED LEVEL 3 VISIT 99283 | $456.72 | $1,384.00 | $94.45–$2,716.00 | 41% below | 67% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED LEVEL 3 VISIT 99283 | $456.72 | $1,384.00 | $456.72–$1,217.92 | — | 67% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED LEVEL 4 VISIT 99284 | $721.71 | $2,187.00 | $159.95–$2,716.00 | 39% below | 67% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED LEVEL 4 VISIT 99284 | $721.71 | $2,187.00 | $721.71–$1,924.56 | — | 67% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED LEVEL 5 VISIT 99285 | $1,079.76 | $3,272.00 | $237.74–$2,879.36 | 38% below | 67% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED LEVEL 5 VISIT 99285 | $1,079.76 | $3,272.00 | $1,079.76–$2,879.36 | — | 67% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC STRESS TEST TREADML OR BIKE/PHARM | $315.15 | $955.00 | $238.75–$990.06 | 59% below | 67% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC STRESS TEST TREADML OR BIKE/PHARM | $315.15 | $955.00 | $315.15–$840.40 | — | 67% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY SESSION - MH | $86.79 | $263.00 | $65.75–$370.00 | 57% below | 67% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY SESSION - MH | $86.79 | $263.00 | $86.79–$231.44 | — | 67% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV HYDRATION INFUSION - INITIAL 31 MINUTES TO 1 HOUR | $201.30 | $610.00 | $152.50–$676.08 | 45% below | 67% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV HYDRATION INFUSION - INITIAL 31 MINUTES TO 1 HOUR | $201.30 | $610.00 | $201.30–$536.80 | — | 67% |
| IV infusion of a medicine, first hour CPT 96365 HC IV THERAPEUTIC INFUSION - INITIAL UP TO 1 HOUR | $291.39 | $883.00 | $199.97–$777.04 | 28% below | 67% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV THERAPEUTIC INFUSION - INITIAL UP TO 1 HOUR | $291.39 | $883.00 | $291.39–$777.04 | — | 67% |
| IV push of a medicine, first drug CPT 96374 HC IV PUSH INITIAL RADIOLOGY | $190.08 | $576.00 | $144.00–$676.08 | 10% below | 67% |
| IV push of a medicine, first drug CPT 96374 HC IV THERAPEUTIC PUSH - INITIAL | $190.08 | $576.00 | $144.00–$676.08 | 10% below | 67% |
| IV push of a medicine, first drug inpatient CPT 96374 HC IV PUSH INITIAL RADIOLOGY | $190.08 | $576.00 | $190.08–$506.88 | — | 67% |
| IV push of a medicine, first drug inpatient CPT 96374 HC IV THERAPEUTIC PUSH - INITIAL | $190.08 | $576.00 | $190.08–$506.88 | — | 67% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC IM/SC THERAPEUTIC ADMINISTRATION | $56.10 | $170.00 | $42.50–$222.20 | 47% below | 67% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION SQ/IM | $56.10 | $170.00 | $42.50–$222.20 | 47% below | 67% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC IM/SC THERAPEUTIC ADMINISTRATION | $56.10 | $170.00 | $56.10–$149.60 | — | 67% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJECTION SQ/IM | $56.10 | $170.00 | $56.10–$149.60 | — | 67% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCH DIAGNOSTIC EVALUATION | $50.82 | $154.00 | $38.50–$502.91 | 80% below | 67% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCH DIAGNOSTIC EVALUATION | $50.82 | $154.00 | $50.82–$135.52 | — | 67% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC NCS 7 OR 8 STUDIES | $387.09 | $1,173.00 | $292.83–$1,032.24 | 55% below | 67% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HC NCS 7 OR 8 STUDIES | $387.09 | $1,173.00 | $387.09–$1,032.24 | — | 67% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC OT NEUROMUSCULAR RE ED 15 MIN | $59.07 | $179.00 | $44.75–$251.00 | 22% below | 67% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC PT NEUROMUSCULAR RE ED 15 MIN | $59.07 | $179.00 | $44.75–$251.00 | 22% below | 67% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PT NEUROMUSCULAR RE ED 15 MIN | $59.07 | $179.00 | $59.07–$157.52 | — | 67% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC OT NEUROMUSCULAR RE ED 15 MIN | $59.07 | $179.00 | $59.07–$157.52 | — | 67% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MED NUTR THER 1ST INDIV EA 15 MIN | $23.10 | $70.00 | $17.50–$61.60 | 32% below | 67% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MED NUTR THER 1ST INDIV EA 15 MIN | $23.10 | $70.00 | $23.10–$61.60 | — | 67% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION 45 MIN LOW COMPLEX | $115.83 | $351.00 | $87.75–$308.88 | 27% below | 67% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION 120 MIN LOW COMPLEX | $115.83 | $351.00 | $87.75–$308.88 | 27% below | 67% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION 105 MIN LOW COMPLEX | $115.83 | $351.00 | $87.75–$308.88 | 27% below | 67% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION 90 MIN LOW COMPLEX | $115.83 | $351.00 | $87.75–$308.88 | 27% below | 67% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION 75 MIN LOW COMPLEX | $115.83 | $351.00 | $87.75–$308.88 | 27% below | 67% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION 60 MIN LOW COMPLEX | $115.83 | $351.00 | $87.75–$308.88 | 27% below | 67% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION 30 MIN LOW COMPLEX | $115.83 | $351.00 | $87.75–$308.88 | 27% below | 67% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION 15 MIN LOW COMPLEX | $115.83 | $351.00 | $87.75–$308.88 | 27% below | 67% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION 60 MIN LOW COMPLEX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION 45 MIN LOW COMPLEX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION 15 MIN LOW COMPLEX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION 30 MIN LOW COMPLEX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION 120 MIN LOW COMPLEX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION 105 MIN LOW COMPLEX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION 90 MIN LOW COMPLEX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION 75 MIN LOW COMPLEX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION 75 MIN HIGH COMPLEX | $208.56 | $632.00 | $115.00–$556.16 | 11% below | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION 105 MIN HIGH COMPLX | $208.56 | $632.00 | $115.00–$556.16 | 11% below | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION 120 MIN HIGH COMPLX | $208.56 | $632.00 | $115.00–$556.16 | 11% below | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION 90 MIN HIGH COMPLEX | $208.56 | $632.00 | $115.00–$556.16 | 11% below | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION 15 MIN HIGH COMPLEX | $208.56 | $632.00 | $115.00–$556.16 | 11% below | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION 30 MIN HIGH COMPLEX | $208.56 | $632.00 | $115.00–$556.16 | 11% below | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION 45 MIN HIGH COMPLEX | $208.56 | $632.00 | $115.00–$556.16 | 11% below | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION 60 MIN HIGH COMPLEX | $208.56 | $632.00 | $115.00–$556.16 | 11% below | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION 15 MIN II HIGH COMPLEX | $208.56 | $632.00 | $115.00–$556.16 | 11% below | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION 90 MIN HIGH COMPLEX | $208.56 | $632.00 | $208.56–$556.16 | — | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION 75 MIN HIGH COMPLEX | $208.56 | $632.00 | $208.56–$556.16 | — | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION 120 MIN HIGH COMPLX | $208.56 | $632.00 | $208.56–$556.16 | — | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION 105 MIN HIGH COMPLX | $208.56 | $632.00 | $208.56–$556.16 | — | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION 60 MIN HIGH COMPLEX | $208.56 | $632.00 | $208.56–$556.16 | — | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION 45 MIN HIGH COMPLEX | $208.56 | $632.00 | $208.56–$556.16 | — | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION 30 MIN HIGH COMPLEX | $208.56 | $632.00 | $208.56–$556.16 | — | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION 15 MIN II HIGH COMPLEX | $208.56 | $632.00 | $208.56–$556.16 | — | 67% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION 15 MIN HIGH COMPLEX | $208.56 | $632.00 | $208.56–$556.16 | — | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION 90 MIN LOW COMPLX | $115.83 | $351.00 | $87.75–$308.88 | 19% below | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION 15 MIN LOW COMPLX | $115.83 | $351.00 | $87.75–$308.88 | 19% below | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION 15 MIN II LOW COMPLX | $115.83 | $351.00 | $87.75–$308.88 | 19% below | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION 45 MIN LOW COMPLX | $115.83 | $351.00 | $87.75–$308.88 | 19% below | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION 30 MIN LOW COMPLX | $115.83 | $351.00 | $87.75–$308.88 | 19% below | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION 75 MIN LOW COMPLX | $115.83 | $351.00 | $87.75–$308.88 | 19% below | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION 120 MIN LOW COMPLX | $115.83 | $351.00 | $87.75–$308.88 | 19% below | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION 105 MIN LOW COMPLX | $115.83 | $351.00 | $87.75–$308.88 | 19% below | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION 60 MIN LOW COMPLX | $115.83 | $351.00 | $87.75–$308.88 | 19% below | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION 75 MIN LOW COMPLX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION 15 MIN LOW COMPLX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION 15 MIN II LOW COMPLX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION 30 MIN LOW COMPLX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION 45 MIN LOW COMPLX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION 60 MIN LOW COMPLX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION 105 MIN LOW COMPLX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION 120 MIN LOW COMPLX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION 90 MIN LOW COMPLX | $115.83 | $351.00 | $115.83–$308.88 | — | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION 60 MIN MOD COMPLEX | $173.91 | $527.00 | $115.00–$463.76 | 7% below | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION 105 MIN MOD COMPLX | $173.91 | $527.00 | $115.00–$463.76 | 7% below | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION 120 MIN MOD COMPLX | $173.91 | $527.00 | $115.00–$463.76 | 7% below | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION 75 MIN MOD COMPLEX | $173.91 | $527.00 | $115.00–$463.76 | 7% below | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION 90 MIN MOD COMPLEX | $173.91 | $527.00 | $115.00–$463.76 | 7% below | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION 15 MIN MOD COMPLEX | $173.91 | $527.00 | $115.00–$463.76 | 7% below | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION 15 MIN II MOD COMPLEX | $173.91 | $527.00 | $115.00–$463.76 | 7% below | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION 30 MIN MOD COMPLEX | $173.91 | $527.00 | $115.00–$463.76 | 7% below | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION 45 MIN MOD COMPLEX | $173.91 | $527.00 | $115.00–$463.76 | 7% below | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION 90 MIN MOD COMPLEX | $173.91 | $527.00 | $173.91–$463.76 | — | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION 60 MIN MOD COMPLEX | $173.91 | $527.00 | $173.91–$463.76 | — | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION 105 MIN MOD COMPLX | $173.91 | $527.00 | $173.91–$463.76 | — | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION 120 MIN MOD COMPLX | $173.91 | $527.00 | $173.91–$463.76 | — | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION 75 MIN MOD COMPLEX | $173.91 | $527.00 | $173.91–$463.76 | — | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION 15 MIN MOD COMPLEX | $173.91 | $527.00 | $173.91–$463.76 | — | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION 15 MIN II MOD COMPLEX | $173.91 | $527.00 | $173.91–$463.76 | — | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION 30 MIN MOD COMPLEX | $173.91 | $527.00 | $173.91–$463.76 | — | 67% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION 45 MIN MOD COMPLEX | $173.91 | $527.00 | $173.91–$463.76 | — | 67% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MYOFAS REL SFT TISSUE | $69.30 | $210.00 | $39.39–$251.00 | 19% below | 67% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC OT MANUIAL THERAPY 15 MIN | $69.30 | $210.00 | $39.39–$251.00 | 19% below | 67% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT TRACTION MANUAL | $69.30 | $210.00 | $39.39–$251.00 | 19% below | 67% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MANUAL THERAPY 15 MIN | $69.30 | $210.00 | $39.39–$251.00 | 19% below | 67% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PT TRACTION MANUAL | $69.30 | $210.00 | $69.30–$184.80 | — | 67% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PT MYOFAS REL SFT TISSUE | $69.30 | $210.00 | $69.30–$184.80 | — | 67% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC OT MANUIAL THERAPY 15 MIN | $69.30 | $210.00 | $69.30–$184.80 | — | 67% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PT MANUAL THERAPY 15 MIN | $69.30 | $210.00 | $69.30–$184.80 | — | 67% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISE 15 MIN | $66.00 | $200.00 | $42.73–$251.00 | 13% below | 67% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EX W HC PACK | $66.00 | $200.00 | $42.73–$251.00 | 13% below | 67% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISE 15 MIN II | $66.00 | $200.00 | $42.73–$251.00 | 13% below | 67% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISE 15 MIN | $66.00 | $200.00 | $42.73–$251.00 | 13% below | 67% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT CPM TREATMENT | $67.32 | $204.00 | $42.73–$251.00 | 11% below | 67% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISE 15 MIN | $66.00 | $200.00 | $66.00–$176.00 | — | 67% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISE 15 MIN | $66.00 | $200.00 | $66.00–$176.00 | — | 67% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISE 15 MIN II | $66.00 | $200.00 | $66.00–$176.00 | — | 67% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EX W HC PACK | $66.00 | $200.00 | $66.00–$176.00 | — | 67% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT CPM TREATMENT | $67.32 | $204.00 | $67.32–$179.52 | — | 67% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 HC WELL EXAM EST AGE 18-39 | $53.46 | $162.00 | $40.50–$142.56 | 51% below | 67% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 HC WELL EXAM EST AGE 18-39 | $53.46 | $162.00 | $53.46–$142.56 | — | 67% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 HC WELL EXAM EST AGE 40-64 | $53.46 | $162.00 | $40.50–$142.56 | 54% below | 67% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 HC WELL EXAM EST AGE 40-64 | $53.46 | $162.00 | $53.46–$142.56 | — | 67% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 HC WELL EXAM EST AGE > 65 | $53.46 | $162.00 | $40.50–$146.65 | 62% below | 67% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 HC WELL EXAM EST AGE > 65 | $53.46 | $162.00 | $53.46–$142.56 | — | 67% |
| Psychiatric evaluation with medical services CPT 90792 HC PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES | $105.27 | $319.00 | $79.75–$502.91 | 46% below | 67% |
| Psychiatric evaluation with medical services inpatient CPT 90792 HC PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES | $105.27 | $319.00 | $105.27–$280.72 | — | 67% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCH W/PATIENT 30 MINUTES | $77.22 | $234.00 | $58.50–$502.91 | 21% below | 67% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCH W/PATIENT 30 MINUTES | $77.22 | $234.00 | $77.22–$205.92 | — | 67% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCH W/PATIENT 45 MINUTES | $138.27 | $419.00 | $104.75–$502.91 | 2% below | 67% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCH W/PATIENT 45 MINUTES | $138.27 | $419.00 | $138.27–$368.72 | — | 67% |
| Psychotherapy session, 60 minutes CPT 90837 HC PSYCH W/PATIENT 60 MINUTES | $155.10 | $470.00 | $117.50–$502.91 | 27% below | 67% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCH W/PATIENT 60 MINUTES | $155.10 | $470.00 | $155.10–$413.60 | — | 67% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC SMOKING CESSATION 3-10 MIN | $28.05 | $85.00 | $11.07–$90.52 | 6% below | 67% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC SMOKING CESSATION 3-10 MIN | $28.05 | $85.00 | $28.05–$74.80 | — | 67% |
| Speech and language evaluation CPT 92523 HC ST SPEECH SOUND LANG COMPREHEN 45 MIN | $303.93 | $921.00 | $230.25–$810.48 | 49% above | 67% |
| Speech and language evaluation CPT 92523 HC ST SPEECH SOUND LANG COMPREHEN 30 MIN | $303.93 | $921.00 | $230.25–$810.48 | 49% above | 67% |
| Speech and language evaluation CPT 92523 HC ST SPEECH SOUND LANG COMPREHEN 75 MIN | $303.93 | $921.00 | $230.25–$810.48 | 49% above | 67% |
| Speech and language evaluation CPT 92523 HC ST SPEECH SOUND LANG COMPREHEN 15 MIN | $303.93 | $921.00 | $230.25–$810.48 | 49% above | 67% |
| Speech and language evaluation CPT 92523 HC ST SPEECH SOUND LANG COMPREHEN 60 MIN | $303.93 | $921.00 | $230.25–$810.48 | 49% above | 67% |
| Speech and language evaluation inpatient CPT 92523 HC ST SPEECH SOUND LANG COMPREHEN 30 MIN | $303.93 | $921.00 | $303.93–$810.48 | — | 67% |
| Speech and language evaluation inpatient CPT 92523 HC ST SPEECH SOUND LANG COMPREHEN 75 MIN | $303.93 | $921.00 | $303.93–$810.48 | — | 67% |
| Speech and language evaluation inpatient CPT 92523 HC ST SPEECH SOUND LANG COMPREHEN 60 MIN | $303.93 | $921.00 | $303.93–$810.48 | — | 67% |
| Speech and language evaluation inpatient CPT 92523 HC ST SPEECH SOUND LANG COMPREHEN 45 MIN | $303.93 | $921.00 | $303.93–$810.48 | — | 67% |
| Speech and language evaluation inpatient CPT 92523 HC ST SPEECH SOUND LANG COMPREHEN 15 MIN | $303.93 | $921.00 | $303.93–$810.48 | — | 67% |
| Speech therapy session, individual CPT 92507 HC ST SPEECH/HEARING THERAPY 45 MIN | $174.57 | $529.00 | $111.65–$465.52 | 20% above | 67% |
| Speech therapy session, individual CPT 92507 HC ST SPEECH/HEARING THERAPY 60 MIN | $174.57 | $529.00 | $111.65–$465.52 | 20% above | 67% |
| Speech therapy session, individual CPT 92507 HC ST SPEECH/HEARING THERAPY 15 MIN | $174.57 | $529.00 | $111.65–$465.52 | 20% above | 67% |
| Speech therapy session, individual CPT 92507 HC ST SPEECH TREATMENT | $174.57 | $529.00 | $111.65–$465.52 | 20% above | 67% |
| Speech therapy session, individual CPT 92507 HC ST SPEECH/HEARING THERAPY 30 MIN | $174.57 | $529.00 | $111.65–$465.52 | 20% above | 67% |
| Speech therapy session, individual inpatient CPT 92507 HC ST SPEECH/HEARING THERAPY 45 MIN | $174.57 | $529.00 | $174.57–$465.52 | — | 67% |
| Speech therapy session, individual inpatient CPT 92507 HC ST SPEECH/HEARING THERAPY 15 MIN | $174.57 | $529.00 | $174.57–$465.52 | — | 67% |
| Speech therapy session, individual inpatient CPT 92507 HC ST SPEECH TREATMENT | $174.57 | $529.00 | $174.57–$465.52 | — | 67% |
| Speech therapy session, individual inpatient CPT 92507 HC ST SPEECH/HEARING THERAPY 30 MIN | $174.57 | $529.00 | $174.57–$465.52 | — | 67% |
| Speech therapy session, individual inpatient CPT 92507 HC ST SPEECH/HEARING THERAPY 60 MIN | $174.57 | $529.00 | $174.57–$465.52 | — | 67% |
| Spirometry (breathing test) CPT 94010 HC PFT SPIROMETRY WO BRONCHODILATOR | $120.45 | $365.00 | $91.25–$492.70 | 51% below | 67% |
| Spirometry (breathing test) CPT 94010 HC PFT SPIROMETRY WO BRONCHODILATOR BEDSIDE | $120.45 | $365.00 | $91.25–$492.70 | 51% below | 67% |
| Spirometry (breathing test) CPT 94010 HC SPIROMETRY OUTPATIENT CLINIC | $120.45 | $365.00 | $91.25–$492.70 | 51% below | 67% |
| Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY OUTPATIENT CLINIC | $120.45 | $365.00 | $120.45–$321.20 | — | 67% |
| Spirometry (breathing test) inpatient CPT 94010 HC PFT SPIROMETRY WO BRONCHODILATOR BEDSIDE | $120.45 | $365.00 | $120.45–$321.20 | — | 67% |
| Spirometry (breathing test) inpatient CPT 94010 HC PFT SPIROMETRY WO BRONCHODILATOR | $120.45 | $365.00 | $120.45–$321.20 | — | 67% |
| Spirometry before and after a bronchodilator CPT 94060 HC PFT SPIROMETRY W BRONCHODILATOR | $211.53 | $641.00 | $160.25–$990.06 | 61% below | 67% |
| Spirometry before and after a bronchodilator CPT 94060 HC PFT SPIROMETRY W BRONCHODILATOR BEDSIDE | $211.53 | $641.00 | $160.25–$990.06 | 61% below | 67% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC PFT SPIROMETRY W BRONCHODILATOR BEDSIDE | $211.53 | $641.00 | $211.53–$564.08 | — | 67% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC PFT SPIROMETRY W BRONCHODILATOR | $211.53 | $641.00 | $211.53–$564.08 | — | 67% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT THERAPEUTIC ACTIVITY 15 MIN | $67.32 | $204.00 | $27.00–$251.00 | 11% below | 67% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT THERAPEUTIC ACTIVITY 15 MIN | $67.32 | $204.00 | $27.00–$251.00 | 11% below | 67% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT THERAPEUTIC ACTIVITY 15 MIN II | $67.32 | $204.00 | $27.00–$251.00 | 11% below | 67% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT THERAPEUTIC ACTIVITY 15 MIN II | $67.32 | $204.00 | $67.32–$179.52 | — | 67% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC OT THERAPEUTIC ACTIVITY 15 MIN | $67.32 | $204.00 | $67.32–$179.52 | — | 67% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT THERAPEUTIC ACTIVITY 15 MIN | $67.32 | $204.00 | $67.32–$179.52 | — | 67% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THERAPEUTIC | $131.34 | $398.00 | $99.50–$402.91 | 38% below | 67% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY THERAPEUTIC | $131.34 | $398.00 | $131.34–$350.24 | — | 67% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 HC IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE | $36.30 | $110.00 | $27.50–$196.32 | 38% below | 67% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY | $36.30 | $110.00 | $27.50–$196.32 | 38% below | 67% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 HC IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE | $36.30 | $110.00 | $36.30–$96.80 | — | 67% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY | $36.30 | $110.00 | $36.30–$96.80 | — | 67% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 HC SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE | $68.97 | $209.00 | $52.25–$336.74 | 79% below | 67% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 HC SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE | $68.97 | $209.00 | $68.97–$183.92 | — | 67% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC CHICKEN PX VACC SC | $135.96 | $412.00 | $103.00–$362.56 | 67% below | 67% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR | $217.47 | $659.00 | $164.75–$579.92 | 47% below | 67% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC CHICKEN PX VACC SC | $135.96 | $412.00 | $135.96–$362.56 | — | 67% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR | $217.47 | $659.00 | $217.47–$579.92 | — | 67% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 HC DTAP-IPV IM AGE 4-6 YEAR | $93.72 | $284.00 | $71.00–$249.92 | 36% below | 67% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 HC DTAP-IPV IM AGE 4-6 YEAR | $93.72 | $284.00 | $93.72–$249.92 | — | 67% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHTH-ACELL PERTUSSIS-TETANUS 15-23-5 LF-MCG/0.5 IM SUSP | $64.35 | $195.00 | $48.75–$171.60 | 22% below | 67% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC DTAP VACC < 7 YRS IM | $74.58 | $226.00 | $56.50–$198.88 | 9% below | 67% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHTH-ACELL PERTUSSIS-TETANUS 15-23-5 LF-MCG/0.5 IM SUSP | $64.35 | $195.00 | $64.35–$171.60 | — | 67% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC DTAP VACC < 7 YRS IM | $74.58 | $226.00 | $74.58–$198.88 | — | 67% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEPATITIS B RECOMB-IPV IM SUSY | $127.71 | $387.00 | $96.75–$340.56 | 33% below | 67% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTAP-HEPATITIS B RECOMB-IPV IM SUSY | $127.71 | $387.00 | $127.71–$340.56 | — | 67% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 HC DTAP HIB IP VACC IM | $123.42 | $374.00 | $93.50–$329.12 | 50% below | 67% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IPV-HIB VACCINE IM SUSR | $144.21 | $437.00 | $109.25–$384.56 | 42% below | 67% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 HC DTAP HIB IP VACC IM | $123.42 | $374.00 | $123.42–$329.12 | — | 67% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTAP-IPV-HIB VACCINE IM SUSR | $144.21 | $437.00 | $144.21–$384.56 | — | 67% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 HC DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR | $95.70 | $290.00 | $72.50–$594.40 | 75% below | 67% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 HC DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR | $95.70 | $290.00 | $95.70–$255.20 | — | 67% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACC SPLIT PF 0.5 ML IM SUSY | $14.19 | $43.00 | $10.75–$46.44 | 64% below | 67% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC FLU VACCINE NO PRES | $14.19 | $43.00 | $10.75–$46.44 | 64% below | 67% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HC FLU VACCINE NO PRES | $14.19 | $43.00 | $14.19–$37.84 | — | 67% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VIRUS VACC SPLIT PF 0.5 ML IM SUSY | $14.19 | $43.00 | $14.19–$37.84 | — | 67% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC HUMAN PAPILLOMA VIRUS NONAVALENT HPV 3 DOSE IM | $245.19 | $743.00 | $185.75–$653.84 | 61% below | 67% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSY | $329.84 | $999.50 | $249.88–$879.56 | 48% below | 67% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC HUMAN PAPILLOMA VIRUS NONAVALENT HPV 3 DOSE IM | $245.19 | $743.00 | $245.19–$653.84 | — | 67% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSY | $329.84 | $999.50 | $329.84–$879.56 | — | 67% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HC HEP A HEP B VACC ADULT IM | $108.57 | $329.00 | $82.25–$289.52 | 54% below | 67% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HC HEP A HEP B VACC ADULT IM | $108.57 | $329.00 | $108.57–$289.52 | — | 67% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE 50 UNIT/ML IM SUSP (WRAPPER) | $109.40 | $331.50 | $82.88–$291.72 | 36% below | 67% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE 1440 EL U/ML IM SUSY | $110.55 | $335.00 | $83.75–$294.80 | 35% below | 67% |
| Hepatitis A vaccine, adult dose CPT 90632 HC HEPATITIS A VIRUS VACCINE | $118.47 | $359.00 | $89.75–$315.92 | 30% below | 67% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE 50 UNIT/ML IM SUSP (WRAPPER) | $109.40 | $331.50 | $109.40–$291.72 | — | 67% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE 1440 EL U/ML IM SUSY | $110.55 | $335.00 | $110.55–$294.80 | — | 67% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HC HEPATITIS A VIRUS VACCINE | $118.47 | $359.00 | $118.47–$315.92 | — | 67% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACCINE 25 UNIT/0.5ML IM SUSP (WRAPPER) | $75.74 | $229.50 | $57.38–$201.96 | 11% below | 67% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC HEP A VACC PED ADOL 2 DOSE | $83.82 | $254.00 | $63.50–$223.52 | 2% below | 67% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VACCINE 25 UNIT/0.5ML IM SUSP (WRAPPER) | $75.74 | $229.50 | $75.74–$201.96 | — | 67% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HC HEP A VACC PED ADOL 2 DOSE | $83.82 | $254.00 | $83.82–$223.52 | — | 67% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC HEP B VACCINE ADULT 3 DOSE SCHEDULE | $13.86 | $42.00 | $10.50–$140.76 | 92% below | 67% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC RECOMBINANT 10 MCG/ML IJ SUSP (WRAPPER) | $90.26 | $273.50 | $68.38–$240.68 | 49% below | 67% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC HEP B VACCINE ADULT 3 DOSE SCHEDULE | $13.86 | $42.00 | $13.86–$36.96 | — | 67% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC RECOMBINANT 10 MCG/ML IJ SUSP (WRAPPER) | $90.26 | $273.50 | $90.26–$240.68 | — | 67% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HC HEPB VACCINE HEPLISAV ADULT 2 DOSE SCHEDULE FOR IM | $163.35 | $495.00 | $123.75–$435.60 | 45% below | 67% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VAC RECOMB ADJ 20 MCG/0.5ML IM SOSY | $180.84 | $548.00 | $137.00–$482.24 | 40% below | 67% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VAC RECOMBINANT 40 MCG/ML IJ SUSP | $221.60 | $671.50 | $167.88–$590.92 | 26% below | 67% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HC HEPB VACCINE HEPLISAV ADULT 2 DOSE SCHEDULE FOR IM | $163.35 | $495.00 | $163.35–$435.60 | — | 67% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VAC RECOMB ADJ 20 MCG/0.5ML IM SOSY | $180.84 | $548.00 | $180.84–$482.24 | — | 67% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VAC RECOMBINANT 40 MCG/ML IJ SUSP | $221.60 | $671.50 | $221.60–$590.92 | — | 67% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VAC RECOMBINANT 5 MCG/0.5ML IJ SUSP (WRAPPER) | $61.71 | $187.00 | $46.75–$164.56 | 16% below | 67% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC HEPB VACC PED/ADOL 3 DOSE IM | $70.95 | $215.00 | $50.77–$189.20 | 3% below | 67% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VAC RECOMBINANT 5 MCG/0.5ML IJ SUSP (WRAPPER) | $61.71 | $187.00 | $61.71–$164.56 | — | 67% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HC HEPB VACC PED/ADOL 3 DOSE IM | $70.95 | $215.00 | $70.95–$189.20 | — | 67% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPHILUS B POLYSAC CONJ VAC 7.5 MCG/0.5 ML IM SUSP | $64.68 | $196.00 | $49.00–$172.48 | 1% below | 67% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPHILUS B POLYSAC CONJ VAC 7.5 MCG/0.5 ML IM SUSP | $64.68 | $196.00 | $64.68–$172.48 | — | 67% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSAC CONJ VAC IM SOLR | $41.58 | $126.00 | $25.21–$110.88 | 15% below | 67% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC HIB VACC PRP-T IM | $75.57 | $229.00 | $25.21–$201.52 | 55% above | 67% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSAC CONJ VAC IM SOLR | $41.58 | $126.00 | $41.58–$110.88 | — | 67% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HC HIB VACC PRP-T IM | $75.57 | $229.00 | $75.57–$201.52 | — | 67% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC VACCINE INFLUENZA HIGH DOSE 65+ | $12.87 | $39.00 | $9.75–$196.32 | 93% below | 67% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HC VACCINE INFLUENZA HIGH DOSE 65+ | $12.87 | $39.00 | $12.87–$34.32 | — | 67% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 HC MMR VACC SC | $92.40 | $280.00 | $70.00–$246.40 | 64% below | 67% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR | $122.27 | $370.50 | $92.63–$326.04 | 52% below | 67% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC MMR VACC SC | $92.40 | $280.00 | $92.40–$246.40 | — | 67% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR | $122.27 | $370.50 | $122.27–$326.04 | — | 67% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC MMRV VACCINE | $178.20 | $540.00 | $124.04–$475.20 | 58% below | 67% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEASLES-MUMPS-RUBELLA-VARICELL SC SUSR | $292.22 | $885.50 | $124.04–$779.24 | 31% below | 67% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 HC MMRV VACCINE | $178.20 | $540.00 | $178.20–$475.20 | — | 67% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLES-MUMPS-RUBELLA-VARICELL SC SUSR | $292.22 | $885.50 | $292.22–$779.24 | — | 67% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC MENINGOCOCCAL VACC IM | $160.38 | $486.00 | $121.50–$427.68 | 54% below | 67% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING ACY&W-135 DIPHTH CONJ IM SOLN | $173.75 | $526.50 | $131.63–$463.32 | 50% below | 67% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC MENINGOCOCCAL VACC IM | $160.38 | $486.00 | $160.38–$427.68 | — | 67% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENING ACY&W-135 DIPHTH CONJ IM SOLN | $173.75 | $526.50 | $173.75–$463.32 | — | 67% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 HC MENACWY-TT CONJ VACC SEROGROUPS ACWY FOR IM USE | $102.63 | $311.00 | $77.75–$330.38 | 67% below | 67% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENING ACY&W-135 TETANUS CONJ IM SOLN | $202.29 | $613.00 | $153.25–$539.44 | 35% below | 67% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 HC MENACWY-TT CONJ VACC SEROGROUPS ACWY FOR IM USE | $102.63 | $311.00 | $102.63–$273.68 | — | 67% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENING ACY&W-135 TETANUS CONJ IM SOLN | $202.29 | $613.00 | $202.29–$539.44 | — | 67% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY | $244.20 | $740.00 | $185.00–$651.20 | 37% below | 67% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY | $244.20 | $740.00 | $244.20–$651.20 | — | 67% |
| Meningococcal B vaccine (Trumenba) CPT 90621 HC MENB RECOMB LIPOPROT SEROGRP B 3 DOSE IM | $178.20 | $540.00 | $135.00–$475.20 | 58% below | 67% |
| Meningococcal B vaccine (Trumenba) CPT 90621 MENINGOCOCCAL B VAC (RECOMB) IM SUSY | $232.82 | $705.50 | $176.38–$620.84 | 45% below | 67% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 HC MENB RECOMB LIPOPROT SEROGRP B 3 DOSE IM | $178.20 | $540.00 | $178.20–$475.20 | — | 67% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 MENINGOCOCCAL B VAC (RECOMB) IM SUSY | $232.82 | $705.50 | $232.82–$620.84 | — | 67% |
| Mpox and smallpox vaccine (Jynneos), 2-dose schedule CPT 90611 SMALLPOX & MONKEYPOX VAC, LIVE 0.1 ML ID SUSP | $274.89 | $833.00 | $0.01–$733.04 | — | 67% |
| Mpox and smallpox vaccine (Jynneos), 2-dose schedule inpatient CPT 90611 SMALLPOX & MONKEYPOX VAC, LIVE 0.1 ML ID SUSP | $274.89 | $833.00 | $274.89–$733.04 | — | 67% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 HC INFLUENZA VIRUS VACCINE LIVE NA LIQD | $22.44 | $68.00 | $17.00–$59.84 | 42% below | 67% |
| Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 HC INFLUENZA VIRUS VACCINE LIVE NA LIQD | $22.44 | $68.00 | $22.44–$59.84 | — | 67% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC PNEUMOCOCCAL VACC 13 VAL IM | $179.19 | $543.00 | $135.75–$515.98 | 62% below | 67% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP | $234.30 | $710.00 | $177.50–$624.80 | 50% below | 67% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 HC PNEUMOCOCCAL VACC 13 VAL IM | $179.19 | $543.00 | $179.19–$477.84 | — | 67% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP | $234.30 | $710.00 | $234.30–$624.80 | — | 67% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 HC PCV15 VACCINE FOR INTRAMUSCULAR USE | $204.93 | $621.00 | $155.25–$546.48 | 63% below | 67% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PNEUMOCOCCAL 15-VAL CONJ VACC 0.5 ML IM SUSY | $230.84 | $699.50 | $174.88–$615.56 | 59% below | 67% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 HC PCV15 VACCINE FOR INTRAMUSCULAR USE | $204.93 | $621.00 | $204.93–$546.48 | — | 67% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 PNEUMOCOCCAL 15-VAL CONJ VACC 0.5 ML IM SUSY | $230.84 | $699.50 | $230.84–$615.56 | — | 67% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HC PCV20 VACCINE FOR INTRAMUSCULAR USE | $218.46 | $662.00 | $165.50–$625.80 | 65% below | 67% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY | $247.17 | $749.00 | $187.25–$659.12 | 60% below | 67% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 HC PCV20 VACCINE FOR INTRAMUSCULAR USE | $218.46 | $662.00 | $218.46–$582.56 | — | 67% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY | $247.17 | $749.00 | $247.17–$659.12 | — | 67% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML IJ SOSY | $26.40 | $80.00 | $20.00–$266.94 | 87% below | 67% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC PNEUMOCOCCAL VACCINE | $30.69 | $93.00 | $23.25–$266.94 | 85% below | 67% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML IJ SOSY | $26.40 | $80.00 | $26.40–$70.40 | — | 67% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC PNEUMOCOCCAL VACCINE | $30.69 | $93.00 | $30.69–$81.84 | — | 67% |
| Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE INACTIVATED IJ SUSP | $448.47 | $1,359.00 | $84.18–$1,195.92 | 262% above | 67% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE INACTIVATED IJ SUSP | $448.47 | $1,359.00 | $448.47–$1,195.92 | — | 67% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 HC RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE | $496.65 | $1,505.00 | $376.25–$1,324.40 | 56% below | 67% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML IM SOSY | $519.09 | $1,573.00 | $393.25–$1,384.24 | 54% below | 67% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 HC RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE | $496.65 | $1,505.00 | $496.65–$1,324.40 | — | 67% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML IM SOSY | $519.09 | $1,573.00 | $519.09–$1,384.24 | — | 67% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 HC RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE | $420.09 | $1,273.00 | $318.25–$2,058.21 | 63% below | 67% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5ML IM SOSY | $519.09 | $1,573.00 | $393.25–$2,058.21 | 54% below | 67% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 HC RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE | $420.09 | $1,273.00 | $420.09–$1,120.24 | — | 67% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5ML IM SOSY | $519.09 | $1,573.00 | $519.09–$1,384.24 | — | 67% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV PRE-FUSION F A&B VAC RCMB 120 MCG/0.5ML IM SOLR | $309.21 | $937.00 | $234.25–$824.56 | 49% below | 67% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 HC RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE | $318.45 | $965.00 | $241.25–$849.20 | 48% below | 67% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV PRE-FUSION F A&B VAC RCMB 120 MCG/0.5ML IM SOLR | $309.21 | $937.00 | $309.21–$824.56 | — | 67% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 HC RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE | $318.45 | $965.00 | $318.45–$849.20 | — | 67% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 HC RSV VACC PREF RECOMBINANT ADJT FOR IM USE | $303.27 | $919.00 | $229.75–$808.72 | 60% below | 67% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSVPREF3 VAC RECOMB ADJUVANTED 120 MCG/0.5ML IM SUSR | $308.72 | $935.50 | $233.88–$823.24 | 59% below | 67% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 HC RSV VACC PREF RECOMBINANT ADJT FOR IM USE | $303.27 | $919.00 | $303.27–$808.72 | — | 67% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSVPREF3 VAC RECOMB ADJUVANTED 120 MCG/0.5ML IM SUSR | $308.72 | $935.50 | $308.72–$823.24 | — | 67% |
| Rabies vaccine, one dose CPT 90675 RABIES VIRUS VACCINE, HDC IM SUSR | $410.19 | $1,243.00 | $310.75–$1,093.84 | 49% below | 67% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC IM SUSR | $410.85 | $1,245.00 | $311.25–$1,095.60 | 49% below | 67% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VIRUS VACCINE, HDC IM SUSR | $410.19 | $1,243.00 | $410.19–$1,093.84 | — | 67% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC IM SUSR | $410.85 | $1,245.00 | $410.85–$1,095.60 | — | 67% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VAC LIVE PENTAVALENT PO SOLN | $85.47 | $259.00 | $64.75–$227.92 | 55% below | 67% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC ROTAVIRUS VACC 3 DOSE ORAL | $117.81 | $357.00 | $89.25–$314.16 | 39% below | 67% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VAC LIVE PENTAVALENT PO SOLN | $85.47 | $259.00 | $85.47–$227.92 | — | 67% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 HC ROTAVIRUS VACC 3 DOSE ORAL | $117.81 | $357.00 | $117.81–$314.16 | — | 67% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR | $224.24 | $679.50 | $169.88–$597.96 | 43% below | 67% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR | $224.24 | $679.50 | $224.24–$597.96 | — | 67% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC TD VACC NO PRSRV >/= 7 IM | $66.99 | $203.00 | $45.90–$178.64 | 41% below | 67% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LF/0.5ML IM SUSP | $69.80 | $211.50 | $45.90–$186.12 | 39% below | 67% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC TD VACC NO PRSRV >/= 7 IM | $66.99 | $203.00 | $66.99–$178.64 | — | 67% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LF/0.5ML IM SUSP | $69.80 | $211.50 | $69.80–$186.12 | — | 67% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSY | $72.44 | $219.50 | $54.88–$193.16 | 41% below | 67% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2-15.5 LF-MCG/0.5 IM SUSP (WRAPPER) | $74.91 | $227.00 | $56.75–$199.76 | 39% below | 67% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC TDAP VACCINE = > 7 IM | $100.65 | $305.00 | $63.18–$268.40 | 18% below | 67% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSY | $72.44 | $219.50 | $72.44–$193.16 | — | 67% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2-15.5 LF-MCG/0.5 IM SUSP (WRAPPER) | $74.91 | $227.00 | $74.91–$199.76 | — | 67% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC TDAP VACCINE = > 7 IM | $100.65 | $305.00 | $100.65–$268.40 | — | 67% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC VACCINE ADMIN SINGLE | $11.88 | $36.00 | $9.00–$222.20 | 81% below | 67% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC VACCINE ADMIN SINGLE | $11.88 | $36.00 | $11.88–$31.68 | — | 67% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC VACCINE ADMIN EA ADDL | $11.88 | $36.00 | $9.00–$31.68 | 70% below | 67% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC VACCINE ADMIN EA ADDL | $11.88 | $36.00 | $11.88–$31.68 | — | 67% |
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.