Munson Healthcare Cadillac
Munson Healthcare Cadillac in Cadillac, MI publishes cash prices for 53 common procedures listed here, from its own machine-readable price file updated Apr 17, 2026. Click a procedure to compare it with other hospitals nearby.
400 Hobart St, Cadillac, MI 49601 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT CHEST ABDOMEN PELVIS W/CONT (ORAL+IV) | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ENTEROGRAPHY | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Exams | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD + PELVIS W/IV CONT (NO ORAL) | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 93079 CT ABD PELV W/ IV+ORAL CONT | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 93077 CT ABD PELV W/ IV CONT | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN + PELVIS W/CONTRAST (ORAL+IV) | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT VENOGRAM ABD + PEL W/ CONTRAST | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT CHEST ABD PELVIS W/IV CONT (NO ORAL) | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 93077 CT ABD PELV W/ IV CONT | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 93079 CT ABD PELV W/ IV+ORAL CONT | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD + PELVIS W/IV CONT (NO ORAL) | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN + PELVIS W/CONTRAST (ORAL+IV) | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT CHEST ABD PELVIS W/IV CONT (NO ORAL) | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT CHEST ABDOMEN PELVIS W/CONT (ORAL+IV) | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ENTEROGRAPHY | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Exams | $3,390.65 | $3,989.00 | 15% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT VENOGRAM ABD + PEL W/ CONTRAST | $3,390.65 | $3,989.00 | 15% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONTRAST | $1,334.50 | $1,570.00 | 15% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT STEALTH HEAD W/O CONTRAST | $1,334.50 | $1,570.00 | 15% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Exams | $1,334.50 | $1,570.00 | 15% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Exams | $1,334.50 | $1,570.00 | 15% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONTRAST | $1,334.50 | $1,570.00 | 15% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT STEALTH HEAD W/O CONTRAST | $1,334.50 | $1,570.00 | 15% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/ CONTRAST (ORAL + IV) | $2,017.05 | $2,373.00 | 15% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Exams | $2,017.05 | $2,373.00 | 15% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/ IV CONTRAST (NO ORAL CONT) | $2,017.05 | $2,373.00 | 15% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/ IV CONTRAST (NO ORAL CONT) | $2,017.05 | $2,373.00 | 15% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/ CONTRAST (ORAL + IV) | $2,017.05 | $2,373.00 | 15% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Exams | $2,017.05 | $2,373.00 | 15% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MA FFD MAMM DIAGNOSTIC BILAT | $414.80 | $488.00 | 15% |
| Diagnostic mammogram, both breasts CPT 77066 MA FFD MAMM DIAGNOSTIC W/ CONT BIL | $395.25 | $465.00 | 15% |
| Diagnostic mammogram, both breasts CPT 77066 MA MAMM 3D DIAGNOSTIC W/ CONT BIL | $395.25 | $465.00 | 15% |
| Diagnostic mammogram, both breasts CPT 77066 MA Exams | $414.80 | $488.00 | 15% |
| Diagnostic mammogram, both breasts CPT 77066 MA FFD DX FOLLOW PROCEDURE BIL | $414.80 | $488.00 | 15% |
| Diagnostic mammogram, both breasts CPT 77066 MA MAMM 3D DIAGNOSTIC BIL | $414.80 | $488.00 | 15% |
| Diagnostic mammogram, both breasts CPT 77066 MA MAMM 3D DX FOLL PROCEDURE BIL | $414.80 | $488.00 | 15% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA FFD MAMM DIAGNOSTIC BILAT | $414.80 | $488.00 | 15% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MA MAMM 3D DIAGNOSTIC W/ CONT BIL | $395.25 | $465.00 | 15% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MA FFD MAMM DIAGNOSTIC W/ CONT BIL | $395.25 | $465.00 | 15% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MA Exams | $414.80 | $488.00 | 15% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MA MAMM 3D DX FOLL PROCEDURE BIL | $414.80 | $488.00 | 15% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MA FFD DX FOLLOW PROCEDURE BIL | $414.80 | $488.00 | 15% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MA MAMM 3D DIAGNOSTIC BIL | $414.80 | $488.00 | 15% |
| Diagnostic mammogram, one breast CPT 77065 MA Exams | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MA MAMM 3D DIAGNOSTIC W/ CONT LT | $306.85 | $361.00 | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MA FFD MAMM DIAGNOSTIC W/ CONT RT | $306.85 | $361.00 | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MA FFD MAMM DIAGNOSTIC W/ CONT LT | $306.85 | $361.00 | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MA MAMM 3D DIAGNOSTIC W/ CONT RT | $306.85 | $361.00 | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MA MAMM 3D DX FOLL PROCEDURE RT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MA FFD DX FOLLOW PROCEDURE RT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MA MAMM 3D DIAGNOSTIC RT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MA MAMM 3D DIAGNOSTIC LT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MA FFD MAMM DIAGNOSTIC UNI RT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MA FFD MAMM DIAGNOSTIC UNI LT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MA FFD MAMM DIAGNOSTIC FOLLOW SCRN RT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MA FFD MAMM DIAGNOSTIC FOLLOW SCRN LT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MA FFD DX FOLLOW PROCEDURE LT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast one side CPT 77065 MA MAMM 3D DX FOLL PROCEDURE LT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MA Exams | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA FFD MAMM DIAGNOSTIC W/ CONT LT | $306.85 | $361.00 | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA MAMM 3D DIAGNOSTIC W/ CONT RT | $306.85 | $361.00 | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA MAMM 3D DIAGNOSTIC W/ CONT LT | $306.85 | $361.00 | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA FFD MAMM DIAGNOSTIC W/ CONT RT | $306.85 | $361.00 | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA MAMM 3D DX FOLL PROCEDURE RT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA FFD DX FOLLOW PROCEDURE RT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA FFD DX FOLLOW PROCEDURE LT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA FFD MAMM DIAGNOSTIC FOLLOW SCRN RT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA FFD MAMM DIAGNOSTIC UNI LT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA FFD MAMM DIAGNOSTIC UNI RT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA MAMM 3D DIAGNOSTIC LT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA MAMM 3D DIAGNOSTIC RT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA MAMM 3D DX FOLL PROCEDURE LT | $322.15 | $379.00 | 15% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA FFD MAMM DIAGNOSTIC FOLLOW SCRN LT | $322.15 | $379.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI HIPS BILATERAL W/O CONTRAST | $2,590.80 | $3,048.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR Exams | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI INCOMPLETE JOINT LOWER EXTREM | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP LIMITED W/O CONTRAST RT | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE W/O CONTRAST RT | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP W/O CONTRAST LT | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP W/O CONTRAST RT | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE W/O CONTRAST LT | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE W/O CONTRAST RT | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE W/O CONTRAST LT | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI HIPS BILATERAL W/O CONTRAST | $2,590.80 | $3,048.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR Exams | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI INCOMPLETE JOINT LOWER EXTREM | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP W/O CONTRAST LT | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE W/O CONTRAST LT | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP LIMITED W/O CONTRAST RT | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP W/O CONTRAST RT | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE W/O CONTRAST RT | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE W/O CONTRAST LT | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE W/O CONTRAST RT | $2,593.35 | $3,051.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI HIPS BIL W/ + W/O CONTRAST | $3,740.00 | $4,400.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR Exams | $3,744.25 | $4,405.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE W/ + W/O CONTRAST LT | $3,744.25 | $4,405.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE W/ + W/O CONTRAST LT | $3,744.25 | $4,405.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP W/ + W/O CONTRAST RT | $3,744.25 | $4,405.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP W/ + W/O CONTRAST LT | $3,744.25 | $4,405.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE W/ + W/O CONTRAST RT | $3,744.25 | $4,405.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE W/ + W/O CONTRAST RT | $3,744.25 | $4,405.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI HIPS BIL W/ + W/O CONTRAST | $3,740.00 | $4,400.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR Exams | $3,744.25 | $4,405.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE W/ + W/O CONTRAST RT | $3,744.25 | $4,405.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE W/ + W/O CONTRAST RT | $3,744.25 | $4,405.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE W/ + W/O CONTRAST LT | $3,744.25 | $4,405.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE W/ + W/O CONTRAST LT | $3,744.25 | $4,405.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP W/ + W/O CONTRAST LT | $3,744.25 | $4,405.00 | 15% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP W/ + W/O CONTRAST RT | $3,744.25 | $4,405.00 | 15% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST | $2,494.75 | $2,935.00 | 15% |
| MRI of the brain, no contrast dye CPT 70551 MR Exams | $2,494.75 | $2,935.00 | 15% |
| MRI of the brain, no contrast dye CPT 70551 MRI INCOMPLETE BRAIN | $2,494.75 | $2,935.00 | 15% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR Exams | $2,494.75 | $2,935.00 | 15% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST | $2,494.75 | $2,935.00 | 15% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI INCOMPLETE BRAIN | $2,494.75 | $2,935.00 | 15% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/ + W/O CONTRAST | $3,730.65 | $4,389.00 | 15% |
| MRI of the brain, with and without contrast dye CPT 70553 MR Exams | $3,730.65 | $4,389.00 | 15% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/ + W/O CONTRAST | $3,730.65 | $4,389.00 | 15% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Exams | $3,730.65 | $4,389.00 | 15% |
| MRI of the lower back, no contrast dye CPT 72148 MR Exams | $2,462.45 | $2,897.00 | 15% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O CONTRAST | $2,462.45 | $2,897.00 | 15% |
| MRI of the lower back, no contrast dye CPT 72148 MRI INCOMPLETE LUMBAR SPINE | $2,462.45 | $2,897.00 | 15% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MR Exams | $2,462.45 | $2,897.00 | 15% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI INCOMPLETE LUMBAR SPINE | $2,462.45 | $2,897.00 | 15% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O CONTRAST | $2,462.45 | $2,897.00 | 15% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB >=14 weeks Single Fetus 76805 | $304.30 | $358.00 | 15% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB COMPLETE- | $717.40 | $844.00 | 15% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Exams | $717.40 | $844.00 | 15% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB COMPLETE | $717.40 | $844.00 | 15% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB >=14 weeks Single Fetus 76805 | $304.30 | $358.00 | 15% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Exams | $717.40 | $844.00 | 15% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB COMPLETE | $717.40 | $844.00 | 15% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB COMPLETE- | $717.40 | $844.00 | 15% |
| Screening mammogram, both breasts both sides CPT 77067 MA FFD MAMM SCREEN BILATERAL | $320.45 | $377.00 | 15% |
| Screening mammogram, both breasts CPT 77067 MA Exams | $320.45 | $377.00 | 15% |
| Screening mammogram, both breasts CPT 77067 MA MAMM 3D SCREENING BIL | $320.45 | $377.00 | 15% |
| Screening mammogram, both breasts one side CPT 77067 MA FFD MAMM SCREEN LT UNI | $320.45 | $377.00 | 15% |
| Screening mammogram, both breasts one side CPT 77067 MA MAMM 3D SCREENING LT | $320.45 | $377.00 | 15% |
| Screening mammogram, both breasts one side CPT 77067 MA MAMM 3D SCREENING RT | $320.45 | $377.00 | 15% |
| Screening mammogram, both breasts one side CPT 77067 MA FFD MAMM SCREEN RT UNI | $320.45 | $377.00 | 15% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MA FFD MAMM SCREEN BILATERAL | $320.45 | $377.00 | 15% |
| Screening mammogram, both breasts inpatient CPT 77067 MA Exams | $320.45 | $377.00 | 15% |
| Screening mammogram, both breasts inpatient CPT 77067 MA MAMM 3D SCREENING BIL | $320.45 | $377.00 | 15% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MA FFD MAMM SCREEN RT UNI | $320.45 | $377.00 | 15% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MA MAMM 3D SCREENING LT | $320.45 | $377.00 | 15% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MA FFD MAMM SCREEN LT UNI | $320.45 | $377.00 | 15% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MA MAMM 3D SCREENING RT | $320.45 | $377.00 | 15% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysom 6/> Yrs 4/> par RDC 95810 | $3,589.55 | $4,223.00 | 15% |
| Sleep study in a lab (polysomnography) CPT 95810 PSG Study Reduced Serv (C) | $3,589.55 | $4,223.00 | 15% |
| Sleep study in a lab (polysomnography) CPT 95810 PSG Study (C) | $3,589.55 | $4,223.00 | 15% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/> YRS 4/> PARAM 95810 | $3,589.55 | $4,223.00 | 15% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG Study (C) | $3,589.55 | $4,223.00 | 15% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG Study Reduced Serv (C) | $3,589.55 | $4,223.00 | 15% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM 6/> YRS 4/> PARAM 95810 | $3,589.55 | $4,223.00 | 15% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysom 6/> Yrs 4/> par RDC 95810 | $3,589.55 | $4,223.00 | 15% |
| Transvaginal pelvic ultrasound CPT 76830 US Pelvis Non-OB 76830 | $269.45 | $317.00 | 15% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON OB W/ DOPPLER | $691.90 | $814.00 | 15% |
| Transvaginal pelvic ultrasound CPT 76830 US Exams | $691.90 | $814.00 | 15% |
| Transvaginal pelvic ultrasound CPT 76830 4611 US TRANSVAGINAL NON OB | $703.80 | $828.00 | 15% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON OB | $893.35 | $1,051.00 | 15% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Pelvis Non-OB 76830 | $269.45 | $317.00 | 15% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Exams | $691.90 | $814.00 | 15% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON OB W/ DOPPLER | $691.90 | $814.00 | 15% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 4611 US TRANSVAGINAL NON OB | $703.80 | $828.00 | 15% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON OB | $893.35 | $1,051.00 | 15% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE | $903.55 | $1,063.00 | 15% |
| Ultrasound of the abdomen, complete CPT 76700 US Exams | $903.55 | $1,063.00 | 15% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Exams | $903.55 | $1,063.00 | 15% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE | $903.55 | $1,063.00 | 15% |
| X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBAR MIN 4 V 72110 | $102.85 | $121.00 | 15% |
| X-ray of the lower back, 4 or more views CPT 72110 GD Exams | $516.80 | $608.00 | 15% |
| X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBAR MIN 4 V | $516.80 | $608.00 | 15% |
| X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBAR AP + LAT W/ FLEX + EXT | $516.80 | $608.00 | 15% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBAR MIN 4 V 72110 | $102.85 | $121.00 | 15% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 GD Exams | $516.80 | $608.00 | 15% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBAR AP + LAT W/ FLEX + EXT | $516.80 | $608.00 | 15% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBAR MIN 4 V | $516.80 | $608.00 | 15% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $82.45 | $97.00 | 15% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $82.45 | $97.00 | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $90.95 | $107.00 | 15% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $90.95 | $107.00 | 15% |
| Complete blood count (CBC) with differential CPT 85025 CBC w/ Differential | $70.55 | $83.00 | 15% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Differential | $70.55 | $83.00 | 15% |
| Complete blood count (CBC), no differential CPT 85027 CBC without Differential | $33.15 | $39.00 | 15% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC without Differential | $33.15 | $39.00 | 15% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $145.35 | $171.00 | 15% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $145.35 | $171.00 | 15% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $120.70 | $142.00 | 15% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $120.70 | $142.00 | 15% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $104.55 | $123.00 | 15% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $104.55 | $123.00 | 15% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate Health Index Rflx, Serum | $57.35 | $67.47 | 15% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Free and Total | $70.55 | $83.00 | 15% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Free | $70.55 | $83.00 | 15% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Prostate Health Index Rflx, Serum | $57.35 | $67.47 | 15% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Free | $70.55 | $83.00 | 15% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Free and Total | $70.55 | $83.00 | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Health Index Reflex, Serum | $10.66 | $12.53 | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate-Specific Antigen (PSA) Ultrasensitive, Serum | $34.81 | $40.95 | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 84153 4727 | $56.10 | $66.00 | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 84153 4140 | $56.10 | $66.00 | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Diagnostic | $56.10 | $66.00 | 15% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Health Index Reflex, Serum | $10.66 | $12.53 | 15% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate-Specific Antigen (PSA) Ultrasensitive, Serum | $34.81 | $40.95 | 15% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 4140 | $56.10 | $66.00 | 15% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Diagnostic | $56.10 | $66.00 | 15% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 4727 | $56.10 | $66.00 | 15% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $36.55 | $43.00 | 15% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time Heparin Protocol | $36.55 | $43.00 | 15% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 6787 | $39.24 | $46.16 | 15% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time | $36.55 | $43.00 | 15% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time Heparin Protocol | $36.55 | $43.00 | 15% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 6787 | $39.24 | $46.16 | 15% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 4832 | $8.27 | $9.72 | 15% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time and INR | $24.65 | $29.00 | 15% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $24.65 | $29.00 | 15% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME BCE | $24.65 | $29.00 | 15% |
| Prothrombin time (PT/INR) clotting test CPT 85610 INR POC | $24.65 | $29.00 | 15% |
| Prothrombin time (PT/INR) clotting test CPT 85610 INR (POCT) | $24.65 | $29.00 | 15% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 4832 | $8.27 | $9.72 | 15% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR (POCT) | $24.65 | $29.00 | 15% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $24.65 | $29.00 | 15% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME BCE | $24.65 | $29.00 | 15% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR POC | $24.65 | $29.00 | 15% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time and INR | $24.65 | $29.00 | 15% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid-Stimulating Hormone-Sensitive (s-TSH), Serum | $28.25 | $33.23 | 15% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Function Cascade | $119.85 | $141.00 | 15% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $119.85 | $141.00 | 15% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH with Reflex to FT4 | $119.85 | $141.00 | 15% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid-Stimulating Hormone-Sensitive (s-TSH), Serum | $28.25 | $33.23 | 15% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH with Reflex to FT4 | $119.85 | $141.00 | 15% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Function Cascade | $119.85 | $141.00 | 15% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $119.85 | $141.00 | 15% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Culture if Indicated | $31.45 | $37.00 | 15% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Dipstick auto w/ Micro POC | $31.45 | $37.00 | 15% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Microscopic | $31.45 | $37.00 | 15% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Culture if Indicated | $31.45 | $37.00 | 15% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Dipstick auto w/ Micro POC | $31.45 | $37.00 | 15% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Microscopic | $31.45 | $37.00 | 15% |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis Dipstick non-auto with Micro POC | $36.55 | $43.00 | 15% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis Dipstick non-auto with Micro POC | $36.55 | $43.00 | 15% |
| Urinalysis without microscope exam, automated CPT 81003 pH Urine | $17.00 | $20.00 | 15% |
| Urinalysis without microscope exam, automated CPT 81003 Ketones Urine | $17.00 | $20.00 | 15% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick auto POC - UC | $19.55 | $23.00 | 15% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick (POCT) | $19.55 | $23.00 | 15% |
| Urinalysis without microscope exam, automated CPT 81003 POC Urine Dip (nsg) Automated Task - UC Only | $19.55 | $23.00 | 15% |
| Urinalysis without microscope exam, automated CPT 81003 POC Urinalysis Dipstick auto - UC | $19.55 | $23.00 | 15% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick auto POC | $19.55 | $23.00 | 15% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 pH Urine | $17.00 | $20.00 | 15% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Ketones Urine | $17.00 | $20.00 | 15% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 POC Urinalysis Dipstick auto - UC | $19.55 | $23.00 | 15% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Dipstick auto POC - UC | $19.55 | $23.00 | 15% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Dipstick auto POC | $19.55 | $23.00 | 15% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Dipstick (POCT) | $19.55 | $23.00 | 15% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 POC Urine Dip (nsg) Automated Task - UC Only | $19.55 | $23.00 | 15% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis Dipstick non-auto POC - UC | $21.25 | $25.00 | 15% |
| Urinalysis without microscope exam, manual CPT 81002 81002 URINALYSIS NONAUTO W/O SCOP BCE | $21.25 | $25.00 | 15% |
| Urinalysis without microscope exam, manual CPT 81002 DIPSTICK URINE BCE | $21.25 | $25.00 | 15% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis Dipstick non-auto POC | $21.25 | $25.00 | 15% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Dipstick non-auto POC - UC | $21.25 | $25.00 | 15% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 81002 URINALYSIS NONAUTO W/O SCOP BCE | $21.25 | $25.00 | 15% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 DIPSTICK URINE BCE | $21.25 | $25.00 | 15% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Dipstick non-auto POC | $21.25 | $25.00 | 15% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy, diagnostic CPT 45378 Colonoscopy Low G0121 45378 | $757.35 | $891.00 | 15% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy High G0105 45378 | $757.35 | $891.00 | 15% |
| Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy High G0105 45378 | $757.35 | $891.00 | 15% |
| Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy Low G0121 45378 | $757.35 | $891.00 | 15% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Injection with imaging guidance 62323 | $575.45 | $677.00 | 15% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Injection with imaging guidance 62323 | $575.45 | $677.00 | 15% |
| Lower-back epidural injection, without imaging guidance CPT 62322 62322 NJX INTERLAMINAR LMBR/SAC | $1,261.40 | $1,484.00 | 15% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTER LMBR/SAC MAT BCE | $1,261.40 | $1,484.00 | 15% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJECT LUMBAR DIAGNOSTIC/1 | $1,805.40 | $2,124.00 | 15% |
| Lower-back epidural injection, without imaging guidance CPT 62322 1808 INJECT LUMBAR DIAGNOSTIC/1 | $1,805.40 | $2,124.00 | 15% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX INTER LMBR/SAC MAT BCE | $1,261.40 | $1,484.00 | 15% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 62322 NJX INTERLAMINAR LMBR/SAC | $1,261.40 | $1,484.00 | 15% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECT LUMBAR DIAGNOSTIC/1 | $1,805.40 | $2,124.00 | 15% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 1808 INJECT LUMBAR DIAGNOSTIC/1 | $1,805.40 | $2,124.00 | 15% |
| Prostate biopsy CPT 55700 Prostate Biopsy Needle/Punch-1 or more 55700 | $536.35 | $631.00 | 15% |
| Prostate biopsy inpatient CPT 55700 Prostate Biopsy Needle/Punch-1 or more 55700 | $536.35 | $631.00 | 15% |
| Removal of a breast lump, open surgery CPT 19120 Biopsy 19120 | $1,160.25 | $1,365.00 | 15% |
| Removal of a breast lump, open surgery inpatient CPT 19120 Biopsy 19120 | $1,160.25 | $1,365.00 | 15% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 Vbac Delivery 59610 | $5,109.35 | $6,011.00 | 15% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 Vbac Delivery 59610 | $5,109.35 | $6,011.00 | 15% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM COMPLETE | $131.75 | $155.00 | 15% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Electrocardiogram (ECG) Routine 12-Lead Tracing and I&R (Global) 93000 | $190.40 | $224.00 | 15% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG - UC 93000 | $190.40 | $224.00 | 15% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ELECTROCARDIOGRAM COMPLETE | $131.75 | $155.00 | 15% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG - UC 93000 | $190.40 | $224.00 | 15% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Electrocardiogram (ECG) Routine 12-Lead Tracing and I&R (Global) 93000 | $190.40 | $224.00 | 15% |
| Family therapy with the patient, 50 minutes CPT 90847 Family Couples Psychotherapy w/ Patient 90847 | $176.80 | $208.00 | 15% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Couples Psychotherapy w/ Patient 90847 | $176.80 | $208.00 | 15% |
| Family therapy without the patient, 50 minutes CPT 90846 Family Couples Psychotherapy W/O Patient 90846 | $210.80 | $248.00 | 15% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Couples Psychotherapy W/O Patient 90846 | $210.80 | $248.00 | 15% |
| Group psychotherapy session CPT 90853 Group Therapy 90853 | $48.45 | $57.00 | 15% |
| Group psychotherapy session inpatient CPT 90853 Group Therapy 90853 | $48.45 | $57.00 | 15% |
| New patient office visit, about 30 minutes CPT 99203 Office Outpatient Visit New L3 | $118.15 | $139.00 | 15% |
| New patient office visit, about 30 minutes CPT 99203 Office Visit Level 3 New 99203 | $118.15 | $139.00 | 15% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office Outpatient Visit New L3 | $118.15 | $139.00 | 15% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office Visit Level 3 New 99203 | $118.15 | $139.00 | 15% |
| New patient office visit, about 45 minutes CPT 99204 Office Visit Level 4 New 99204 | $118.15 | $139.00 | 15% |
| New patient office visit, about 45 minutes CPT 99204 Office Outpatient Visit New L4 | $118.15 | $139.00 | 15% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office Outpatient Visit New L4 | $118.15 | $139.00 | 15% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office Visit Level 4 New 99204 | $118.15 | $139.00 | 15% |
| New patient office visit, about 60 minutes CPT 99205 Office Outpatient Visit New L5 | $118.15 | $139.00 | 15% |
| New patient office visit, about 60 minutes CPT 99205 Office Visit Level 5 New 99205 | $118.15 | $139.00 | 15% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Office Outpatient Visit New L5 | $118.15 | $139.00 | 15% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Office Visit Level 5 New 99205 | $118.15 | $139.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 COTA Therapeutic Exercise 15min | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise 15min | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise 15min | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PTA Therapeutic Exercise 15min | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise 15 min - PT MMC | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 PT THERAPEUTIC EX 15 MIN CQ | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT 97110 PTM THERAPEUTIC EX 15 MIN | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 ST THERAPEUTIC EXERCISE | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise 15 min - OT | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 THERAPEUTIC EXERCISES EA 15 OT IP | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 ST 97110 ST THER EX FACE 15 MIN | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 OT THERAPEUTIC EX 15 MIN CO | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 THERAPEUTIC EXERCISES EA 15 PT IP | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 ST THERAPEUTIC EXERCISE | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 COTA Therapeutic Exercise 15min | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 THERAPEUTIC EXERCISES EA 15 OT IP | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercise 15 min - OT | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 OT THERAPEUTIC EX 15 MIN CO | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 THERAPEUTIC EXERCISES EA 15 PT IP | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise 15min | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PTA Therapeutic Exercise 15min | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercise 15 min - PT MMC | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 PT THERAPEUTIC EX 15 MIN CQ | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT 97110 PTM THERAPEUTIC EX 15 MIN | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise 15min | $106.25 | $125.00 | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 ST 97110 ST THER EX FACE 15 MIN | $106.25 | $125.00 | 15% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial Comp Preventive Med 18 to 39 years New 99385 | $209.95 | $247.00 | 15% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Initial Comp Preventive Med 18 to 39 years New 99385 | $209.95 | $247.00 | 15% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial Comp Preventive Med 40 to 64 years New 99386 | $241.40 | $284.00 | 15% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Initial Comp Preventive Med 40 to 64 years New 99386 | $241.40 | $284.00 | 15% |
| Psychotherapy session, 30 minutes CPT 90832 Psychotherapy 30 Mins 90832 | $134.30 | $158.00 | 15% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy 30 Mins 90832 | $134.30 | $158.00 | 15% |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy 45 Mins 90834 | $213.35 | $251.00 | 15% |
| Psychotherapy session, 45 minutes CPT 90834 Psych THPY 45 Min PO 90834 | $242.25 | $285.00 | 15% |
| Psychotherapy session, 45 minutes CPT 90834 VIDEO Psychotherapy 45 Mins 90834 | $242.25 | $285.00 | 15% |
| Psychotherapy session, 45 minutes CPT 90834 Psych Thpy 45 Min 90834 | $242.25 | $285.00 | 15% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy 45 Mins 90834 | $213.35 | $251.00 | 15% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Psych Thpy 45 Min 90834 | $242.25 | $285.00 | 15% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Psych THPY 45 Min PO 90834 | $242.25 | $285.00 | 15% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 VIDEO Psychotherapy 45 Mins 90834 | $242.25 | $285.00 | 15% |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy 60 Mins 90837 | $260.10 | $306.00 | 15% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy 60 Mins 90837 | $260.10 | $306.00 | 15% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Office Consult Level 3 99243 | $251.60 | $296.00 | 15% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office Consult Level 3 99243 | $251.60 | $296.00 | 15% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office Consult Level 4 99244 | $358.70 | $422.00 | 15% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office Consult Level 4 99244 | $358.70 | $422.00 | 15% |