Hospital Wooster, OH

Aultman Orrville Hospital

Aultman Orrville Hospital in Orrville, OH publishes cash prices for 330 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Ohio median for 251 of 327 procedures and above it for 76. By typical cash price it ranks #30 of 139 Ohio hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

832 South Main Street, Orrville, OH 44667 Collected Oct 15, 2026 Source price file Check a bill from this hospital (330) 682-3010

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 361323 · CMS hospital register NPI 1891718375

Financial assistance

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

Aultman Orrville 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.

State law

This state limits hospital bills for lower-income patients

Ohio's Hospital Care Assurance Program (HCAP): Ohio residents who are not on Medicaid and whose income is at or below 100% of the federal poverty level get basic, medically necessary hospital services free at hospitals in the program; physician bills are not included. Ask the hospital's billing office for an HCAP application. Other states' laws.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 4 actions for a hospital named Aultman Orrville Hospital in Orrville, OH:

Sep 19, 2024 Warning notice
Oct 2, 2024 Case closed
Jul 15, 2025 Warning notice
Jul 22, 2025 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Abdominal CT scan without and with contrast CPT 74170 Ct, Abd W And Wo Contrast	$675.45	$1,501.00	—	49% below	55%
Abdominal CT scan without and with contrast inpatient CPT 74170 Ct, Abd W And Wo Contrast	$675.45	$1,501.00	—	—	55%
Abdominal X-ray, 2 views CPT 74019 Xray Exam Abdomen 2 Views	$263.25	$585.00	—	22% below	55%
Abdominal X-ray, 2 views inpatient CPT 74019 Xray Exam Abdomen 2 Views	$263.25	$585.00	—	—	55%
Ankle X-ray, complete, 3 or more views CPT 73610 Xray Of Ankle 3 Views	$222.75	$495.00	—	30% below	55%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Xray Of Ankle 3 Views	$222.75	$495.00	—	—	55%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Extrem Arterial Single Level	$555.75	$1,235.00	—	15% above	55%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Extrem Arterial Single Level	$555.75	$1,235.00	—	—	55%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 Ct Upper Extrem W/O Contrast	$585.45	$1,301.00	—	38% below	55%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 Ct Upper Extrem W/O Contrast	$585.45	$1,301.00	—	—	55%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Esophogram	$404.10	$898.00	—	9% below	55%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Esophogram	$404.10	$898.00	—	—	55%
Bone scan, whole body (nuclear medicine) CPT 78306 Bone/Joint Wb	$1,095.30	$2,434.00	—	29% below	55%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone/Joint Wb	$1,095.30	$2,434.00	—	—	55%
Breast ultrasound, complete, one breast CPT 76641 Us Breast Complete	$337.50	$750.00	—	29% below	55%
Breast ultrasound, complete, one breast inpatient CPT 76641 Us Breast Complete	$337.50	$750.00	—	—	55%
Breast ultrasound, limited (one breast or one area) CPT 76642 Us Breast Limited	$337.50	$750.00	—	18% below	55%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 Us Breast Limited	$337.50	$750.00	—	—	55%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Cta Abd/Pelvis +/- Contrast	$1,170.00	$2,600.00	—	45% below	55%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 Cta Abd/Pelvis +/- Contrast	$1,170.00	$2,600.00	—	—	55%
CT angiography (CTA) of the head CPT 70496 Ct Angiography Head	$1,010.70	$2,246.00	—	24% below	55%
CT angiography (CTA) of the head inpatient CPT 70496 Ct Angiography Head	$1,010.70	$2,246.00	—	—	55%
CT angiography (CTA) of the neck CPT 70498 Ct Angiography Neck	$1,010.70	$2,246.00	—	23% below	55%
CT angiography (CTA) of the neck inpatient CPT 70498 Ct Angiography Neck	$1,010.70	$2,246.00	—	—	55%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Ct Angiography Chest	$957.60	$2,128.00	—	32% below	55%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 Ct Angiography Chest	$957.60	$2,128.00	—	—	55%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Abdomen/Pelvis W/O Contrast	$955.80	$2,124.00	—	40% below	55%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Ct Abdomen/Pelvis W/O Contrast	$955.80	$2,124.00	—	—	55%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Ct Abdomen/Pelvis W/Contrast	$1,413.90	$3,142.00	—	29% below	55%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Ct Abdomen/Pelvis W/Contrast	$1,413.90	$3,142.00	—	—	55%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abd/Pelvis W & W/O Contrast	$1,541.70	$3,426.00	—	34% below	55%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Ct Abd/Pelvis W & W/O Contrast	$1,541.70	$3,426.00	—	—	55%
CT scan of the abdomen with contrast CPT 74160 Ct Abdomen W/Dye	$593.55	$1,319.00	—	49% below	55%
CT scan of the abdomen with contrast inpatient CPT 74160 Ct Abdomen W/Dye	$593.55	$1,319.00	—	—	55%
CT scan of the abdomen without contrast CPT 74150 Ct Abdomen W/O Dye	$550.35	$1,223.00	—	48% below	55%
CT scan of the abdomen without contrast inpatient CPT 74150 Ct Abdomen W/O Dye	$550.35	$1,223.00	—	—	55%
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Maxillofacial W/O Dye	$837.45	$1,861.00	—	4% below	55%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Ct Maxillofacial W/O Dye	$837.45	$1,861.00	—	—	55%
CT scan of the head or brain, no contrast dye CPT 70450 Ct - Head/Brain Wo Contrast	$623.70	$1,386.00	—	25% below	55%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 Ct - Head/Brain Wo Contrast	$623.70	$1,386.00	—	—	55%
CT scan of the head with contrast CPT 70460 Ct Head/Brain W/Contrast	$787.05	$1,749.00	—	22% below	55%
CT scan of the head with contrast inpatient CPT 70460 Ct Head/Brain W/Contrast	$787.05	$1,749.00	—	—	55%
CT scan of the head without and with contrast CPT 70470 Ct Head/Brain W & W/O Contrast	$1,224.45	$2,721.00	—	3% above	55%
CT scan of the head without and with contrast inpatient CPT 70470 Ct Head/Brain W & W/O Contrast	$1,224.45	$2,721.00	—	—	55%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct Lumbar Spine W/O Dye	$657.00	$1,460.00	—	40% below	55%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 Ct Lumbar Spine W/O Dye	$657.00	$1,460.00	—	—	55%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct Cervical Spine W/O Contrast	$842.85	$1,873.00	—	21% below	55%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 Ct Cervical Spine W/O Contrast	$842.85	$1,873.00	—	—	55%
CT scan of the pelvis, with contrast dye CPT 72193 Ct Pelvis W/Dye	$821.70	$1,826.00	—	33% below	55%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 Ct Pelvis W/Dye	$821.70	$1,826.00	—	—	55%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Us Carotid Bilateral	$590.40	$1,312.00	—	—	55%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Us Carotid Bilateral	$590.40	$1,312.00	—	—	55%
Chest CT scan without and with contrast CPT 71270 Ct Chest W/O & W/Dye	$983.70	$2,186.00	—	35% below	55%
Chest CT scan without and with contrast inpatient CPT 71270 Ct Chest W/O & W/Dye	$983.70	$2,186.00	—	—	55%
Chest X-ray, 2 views CPT 71046 Xray Exam Chest 2 Views	$159.30	$354.00	—	40% below	55%
Chest X-ray, 2 views inpatient CPT 71046 Xray Exam Chest 2 Views	$159.30	$354.00	—	—	55%
Chest X-ray, single view CPT 71045 Xray Exam Chest 1 View	$149.85	$333.00	—	33% below	55%
Chest X-ray, single view inpatient CPT 71045 Xray Exam Chest 1 View	$149.85	$333.00	—	—	55%
Collarbone (clavicle) X-ray, complete CPT 73000 Xray Of Collar Bone	$218.25	$485.00	—	20% below	55%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 Xray Of Collar Bone	$218.25	$485.00	—	—	55%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Retroperitoneal Us Complete	$406.35	$903.00	—	43% below	55%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Retroperitoneal Us Complete	$406.35	$903.00	—	—	55%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dxa Bone Density Axial	$190.80	$424.00	—	58% below	55%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Dxa Bone Density Axial	$190.80	$424.00	—	—	55%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Bone Densitometry Peripheral	$79.65	$177.00	—	69% below	55%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Bone Densitometry Peripheral	$79.65	$177.00	—	—	55%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Ob Us Detailed Single Fetus	$467.10	$1,038.00	—	45% below	55%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 Ob Us Detailed Single Fetus	$467.10	$1,038.00	—	—	55%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Thorax W/O Dye	$678.60	$1,508.00	—	28% below	55%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Ct Thorax W/O Dye	$678.60	$1,508.00	—	—	55%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Thorax W/Dye	$698.85	$1,553.00	—	42% below	55%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Ct Thorax W/Dye	$698.85	$1,553.00	—	—	55%
Diagnostic mammogram, both breasts both sides CPT 77066 Mammogram Dx W/Cad Bilateral	$145.80	$324.00	—	—	55%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Mammogram Dx W/Cad Bilateral	$145.80	$324.00	—	—	55%
Diagnostic mammogram, one breast one side CPT 77065 Mammogram Dx W/Cad Unilateral	$129.60	$288.00	—	64% below	55%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Mammogram Dx W/Cad Unilateral	$129.60	$288.00	—	—	55%
Duplex ultrasound of the leg arteries, both legs CPT 93925 Noncdm Charge Record	$494.55	$1,099.00	—	45% below	55%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 Noncdm Charge Record	$494.55	$1,099.00	—	—	55%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Extremity Study-Bilateral	$470.70	$1,046.00	—	—	55%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Extremity Study-Bilateral	$470.70	$1,046.00	—	—	55%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echocardiogram Complete	$1,082.25	$2,405.00	—	36% below	55%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echocardiogram Complete	$1,082.25	$2,405.00	—	—	55%
Elbow X-ray, 2 views CPT 73070 Xray Of Elbow 2 Views	$139.95	$311.00	—	46% below	55%
Elbow X-ray, 2 views inpatient CPT 73070 Xray Of Elbow 2 Views	$139.95	$311.00	—	—	55%
Elbow X-ray, complete, 3 or more views CPT 73080 Xray Of Elbow 3 Views	$230.40	$512.00	—	27% below	55%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 Xray Of Elbow 3 Views	$230.40	$512.00	—	—	55%
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Orbit/Ear/Fossa W/O Dye	$698.85	$1,553.00	—	19% below	55%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Ct Orbit/Ear/Fossa W/O Dye	$698.85	$1,553.00	—	—	55%
Facial bones X-ray, complete, 3 or more views CPT 70150 X-Ray Exam Of Facial Bones	$272.25	$605.00	—	28% below	55%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 X-Ray Exam Of Facial Bones	$272.25	$605.00	—	—	55%
Forearm X-ray (radius and ulna), 2 views CPT 73090 Xray Of Forearm 2 Views	$236.25	$525.00	—	13% below	55%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 Xray Of Forearm 2 Views	$236.25	$525.00	—	—	55%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary System Imaging	$995.40	$2,212.00	—	37% below	55%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hepatobiliary System Imaging	$995.40	$2,212.00	—	—	55%
Hand X-ray, 2 views CPT 73120 Xray Of Hand 2 Views	$139.50	$310.00	—	48% below	55%
Hand X-ray, 2 views inpatient CPT 73120 Xray Of Hand 2 Views	$139.50	$310.00	—	—	55%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Xray Of Heel 2 Views	$236.25	$525.00	—	13% below	55%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 Xray Of Heel 2 Views	$236.25	$525.00	—	—	55%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysominography 4+ Att W/Cpap	$4,396.50	$9,770.00	—	7% above	55%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysominography 4+ Att W/Cpap	$4,396.50	$9,770.00	—	—	55%
Knee X-ray, 3 views CPT 73562 Xray Of Knee 3 Views	$194.85	$433.00	—	45% below	55%
Knee X-ray, 3 views inpatient CPT 73562 Xray Of Knee 3 Views	$194.85	$433.00	—	—	55%
Knee X-ray, complete, 4 or more views CPT 73564 Xray Of Knee 4+ Views	$294.75	$655.00	—	25% below	55%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 Xray Of Knee 4+ Views	$294.75	$655.00	—	—	55%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 Ct Lower Extrem W/O Dye	$590.40	$1,312.00	—	37% below	55%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 Ct Lower Extrem W/O Dye	$590.40	$1,312.00	—	—	55%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdomen	$364.05	$809.00	—	34% below	55%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Echo Abdomen Limited	$364.05	$809.00	—	34% below	55%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Echo Abdomen Limited	$364.05	$809.00	—	—	55%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Us Abdomen	$364.05	$809.00	—	—	55%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Limited Nonvascular Extremity	$167.40	$372.00	—	65% below	55%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Er-Us Limited Joint Nonvasclt	$167.40	$372.00	—	65% below	55%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Er-Us Limited Joint Nonvasclt	$167.40	$372.00	—	—	55%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Limited Nonvascular Extremity	$167.40	$372.00	—	—	55%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Thorax Lung Cancer Scr C-	$96.75	$215.00	—	67% below	55%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Ct Thorax Lung Cancer Scr C-	$96.75	$215.00	—	—	55%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Xray Of Lower Leg 2 Views	$207.00	$460.00	—	24% below	55%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 Xray Of Lower Leg 2 Views	$207.00	$460.00	—	—	55%
MR angiography (MRA) of the head without contrast CPT 70544 Mra Head W/O Contrast	$1,258.65	$2,797.00	—	13% below	55%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Mra Head W/O Contrast	$1,258.65	$2,797.00	—	—	55%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Mri Lower Extrem/Joint	$1,850.40	$4,112.00	—	6% above	55%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Mri Lower Extremity/Joint	$1,850.40	$4,112.00	—	6% above	55%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Mri Lower Extremity/Joint	$1,850.40	$4,112.00	—	—	55%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Mri Lower Extrem/Joint	$1,850.40	$4,112.00	—	—	55%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Mri Lwr Extrem/Joint W&Wo Dye	$2,125.80	$4,724.00	—	11% below	55%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Mri Lwr Extrem/Joint W&Wo Dye	$2,125.80	$4,724.00	—	—	55%
MRI of the abdomen without contrast CPT 74181 Mri Abdomen W/O Dye	$1,837.35	$4,083.00	—	at median	55%
MRI of the abdomen without contrast inpatient CPT 74181 Mri Abdomen W/O Dye	$1,837.35	$4,083.00	—	—	55%
MRI of the abdomen, without and then with contrast dye CPT 74183 Mri Abdomen W/O & W/Dye	$3,308.40	$7,352.00	—	44% above	55%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 Mri Abdomen W/O & W/Dye	$3,308.40	$7,352.00	—	—	55%
MRI of the brain, no contrast dye CPT 70551 Mri Brain W/O Contrast	$1,405.80	$3,124.00	—	13% below	55%
MRI of the brain, no contrast dye inpatient CPT 70551 Mri Brain W/O Contrast	$1,405.80	$3,124.00	—	—	55%
MRI of the brain, with and without contrast dye CPT 70553 Mri Brain W & W/O Contrast	$2,757.15	$6,127.00	—	26% above	55%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Mri Brain W & W/O Contrast	$2,757.15	$6,127.00	—	—	55%
MRI of the lower back, no contrast dye CPT 72148 Mri Lumbar Spine W/O Contrast	$1,682.55	$3,739.00	—	1% above	55%
MRI of the lower back, no contrast dye inpatient CPT 72148 Mri Lumbar Spine W/O Contrast	$1,682.55	$3,739.00	—	—	55%
MRI of the lower back, without and then with contrast dye CPT 72158 Mri Lumbar Spine W/O & W/Dye	$1,826.55	$4,059.00	—	22% below	55%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 Mri Lumbar Spine W/O & W/Dye	$1,826.55	$4,059.00	—	—	55%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mri Chest Spine W/O Dye	$1,771.65	$3,937.00	—	6% above	55%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 Mri Chest Spine W/O Dye	$1,771.65	$3,937.00	—	—	55%
MRI of the neck (cervical spine) without and with contrast CPT 72156 Mri Neck Spine W/O & W/Dye	$2,506.50	$5,570.00	—	11% above	55%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 Mri Neck Spine W/O & W/Dye	$2,506.50	$5,570.00	—	—	55%
MRI of the neck (cervical spine), no contrast dye CPT 72141 Mri Neck Spine W/O Dye	$2,078.55	$4,619.00	—	26% above	55%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 Mri Neck Spine W/O Dye	$2,078.55	$4,619.00	—	—	55%
MRI of the pelvis without and with contrast CPT 72197 Mri Pelvis W/O & W/Dye	$2,529.90	$5,622.00	—	29% above	55%
MRI of the pelvis without and with contrast inpatient CPT 72197 Mri Pelvis W/O & W/Dye	$2,529.90	$5,622.00	—	—	55%
MRI of the pelvis, no contrast dye CPT 72195 Mri Pelvis W/O Dye	$1,514.25	$3,365.00	—	at median	55%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Mri Pelvis W/O Dye	$1,514.25	$3,365.00	—	—	55%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 Mri Upper Extremity/Joint	$1,850.40	$4,112.00	—	22% above	55%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 Mri Upper Extremity/Joint	$1,850.40	$4,112.00	—	—	55%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-Ray Cervical Spine 4-5 Views	$353.25	$785.00	—	21% below	55%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 X-Ray Cervical Spine 4-5 Views	$353.25	$785.00	—	—	55%
Neck soft tissue CT scan with contrast CPT 70491 Ct Soft Tissue Neck W/Dye	$922.95	$2,051.00	—	22% below	55%
Neck soft tissue CT scan with contrast inpatient CPT 70491 Ct Soft Tissue Neck W/Dye	$922.95	$2,051.00	—	—	55%
Neck soft tissue CT scan without contrast CPT 70490 Ct Soft Tissue Neck W/O Dye	$648.45	$1,441.00	—	30% below	55%
Neck soft tissue CT scan without contrast inpatient CPT 70490 Ct Soft Tissue Neck W/O Dye	$648.45	$1,441.00	—	—	55%
Neck soft tissue X-ray CPT 70360 Xray Of Neck	$203.40	$452.00	—	22% below	55%
Neck soft tissue X-ray inpatient CPT 70360 Xray Of Neck	$203.40	$452.00	—	—	55%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial Perfusion	$2,324.70	$5,166.00	—	42% below	55%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Myocardial Perfusion	$2,324.70	$5,166.00	—	—	55%
Pelvic CT scan without contrast CPT 72192 Ct Pelvis W/O Dye	$582.30	$1,294.00	—	42% below	55%
Pelvic CT scan without contrast inpatient CPT 72192 Ct Pelvis W/O Dye	$582.30	$1,294.00	—	—	55%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Pelvic Limited/Follow Up	$275.40	$612.00	—	37% below	55%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Pelvic Limited/Follow Up	$275.40	$612.00	—	—	55%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvic Complete	$450.00	$1,000.00	—	11% below	55%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Us Pelvic Complete	$450.00	$1,000.00	—	—	55%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ob Us >= 14 Wks Single Fetus	$216.45	$481.00	—	64% below	55%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ob Us >= 14 Wks Single Fetus	$216.45	$481.00	—	—	55%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ob Us < 14 Wks, Single Fetus	$306.90	$682.00	—	44% below	55%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Ob Us < 14 Wks, Single Fetus	$306.90	$682.00	—	—	55%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Ob Us Limited 1 Or More Fetus	$193.05	$429.00	—	60% below	55%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Ob Us Limited 1 Or More Fetus	$193.05	$429.00	—	—	55%
Rib X-ray, one side, 2 views one side CPT 71100 Xray Unilateral Ribs 2 Views	$221.40	$492.00	—	27% below	55%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Xray Unilateral Ribs 2 Views	$221.40	$492.00	—	—	55%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Xray Of Unilat Ribs/Chest	$276.30	$614.00	—	28% below	55%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Xray Of Unilat Ribs/Chest	$276.30	$614.00	—	—	55%
Screening mammogram, both breasts CPT 77067 Mammogram Screening W/Cad	$155.70	$346.00	—	19% below	55%
Screening mammogram, both breasts inpatient CPT 77067 Mammogram Screening W/Cad	$155.70	$346.00	—	—	55%
Shoulder X-ray, complete, 2 or more views CPT 73030 Xray Of Shoulder 2-3 Views	$227.70	$506.00	—	32% below	55%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Xray Of Shoulder 2-3 Views	$227.70	$506.00	—	—	55%
Sinus X-ray, complete, 3 or more views CPT 70220 Xray Of Sinuses	$285.30	$634.00	—	21% below	55%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Xray Of Sinuses	$285.30	$634.00	—	—	55%
Skull X-ray, fewer than 4 views CPT 70250 Xray Of Skull	$189.00	$420.00	—	35% below	55%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Xray Of Skull	$189.00	$420.00	—	—	55%
Sleep study in a lab (polysomnography) CPT 95810 Polysominography 4+ Attended	$3,456.90	$7,682.00	—	4% below	55%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysominography 4+ Attended	$3,456.90	$7,682.00	—	—	55%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Xray Of Femur 2+ Views	$214.20	$476.00	—	21% below	55%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 Xray Of Femur 2+ Views	$214.20	$476.00	—	—	55%
Thoracic spine (mid back) CT scan without contrast CPT 72128 Ct Chest Spine W/O Dye	$613.80	$1,364.00	—	32% below	55%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 Ct Chest Spine W/O Dye	$613.80	$1,364.00	—	—	55%
Toe X-ray, 2 or more views CPT 73660 Xray Of Toe(S) 2+ Views	$194.85	$433.00	—	22% below	55%
Toe X-ray, 2 or more views inpatient CPT 73660 Xray Of Toe(S) 2+ Views	$194.85	$433.00	—	—	55%
Transvaginal pelvic ultrasound CPT 76830 Non-Ob Transvag Us	$364.50	$810.00	—	35% below	55%
Transvaginal pelvic ultrasound inpatient CPT 76830 Non-Ob Transvag Us	$364.50	$810.00	—	—	55%
Transvaginal ultrasound during pregnancy CPT 76817 Transvaginal Ob Us	$252.45	$561.00	—	50% below	55%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Transvaginal Ob Us	$252.45	$561.00	—	—	55%
Ultrasound of the abdomen, complete CPT 76700 Us Abdomen Complete	$505.35	$1,123.00	—	19% below	55%
Ultrasound of the abdomen, complete inpatient CPT 76700 Us Abdomen Complete	$505.35	$1,123.00	—	—	55%
Ultrasound of the scrotum and testicles CPT 76870 Us, Scrotum And Contents	$450.00	$1,000.00	—	16% below	55%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Us, Scrotum And Contents	$450.00	$1,000.00	—	—	55%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Thyroid	$471.15	$1,047.00	—	18% below	55%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Us Thyroid	$471.15	$1,047.00	—	—	55%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Xray Of Upper Digestive Tract	$240.75	$535.00	—	59% below	55%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Xray Of Upper Digestive Tract	$240.75	$535.00	—	—	55%
Upper arm X-ray (humerus), 2 views CPT 73060 Xray Of Humerus 2+ Views	$202.05	$449.00	—	27% below	55%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 Xray Of Humerus 2+ Views	$202.05	$449.00	—	—	55%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Extremity Study-Unilateral	$342.90	$762.00	—	53% below	55%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Extremity Study-Unilateral	$342.90	$762.00	—	—	55%
Wrist X-ray, 2 views CPT 73100 Xray Of Wrist 2 Views	$139.50	$310.00	—	47% below	55%
Wrist X-ray, 2 views inpatient CPT 73100 Xray Of Wrist 2 Views	$139.50	$310.00	—	—	55%
Wrist X-ray, complete, 3 or more views CPT 73110 Xray Of Wrist 3 Views	$229.50	$510.00	—	31% below	55%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Xray Of Wrist 3 Views	$229.50	$510.00	—	—	55%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Xray Of Hip 2-3 Views	$211.95	$471.00	—	31% below	55%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 Xray Of Hip 2-3 Views	$211.95	$471.00	—	—	55%
X-ray of the abdomen, 1 view CPT 74018 Xray Exam Abdomen 1 View	$225.45	$501.00	—	12% below	55%
X-ray of the abdomen, 1 view inpatient CPT 74018 Xray Exam Abdomen 1 View	$225.45	$501.00	—	—	55%
X-ray of the ankle, 2 views CPT 73600 Xray Of Ankle 2 Views	$139.05	$309.00	—	44% below	55%
X-ray of the ankle, 2 views inpatient CPT 73600 Xray Of Ankle 2 Views	$139.05	$309.00	—	—	55%
X-ray of the finger(s), 2 or more views CPT 73140 Xray Of Finger(S) 2+ Views	$177.30	$394.00	—	31% below	55%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 Xray Of Finger(S) 2+ Views	$177.30	$394.00	—	—	55%
X-ray of the foot, 2 views CPT 73620 Xray Of Foot 2 Views	$135.45	$301.00	—	42% below	55%
X-ray of the foot, 2 views inpatient CPT 73620 Xray Of Foot 2 Views	$135.45	$301.00	—	—	55%
X-ray of the foot, complete, 3 or more views CPT 73630 Xray Of Foot 3 Views	$236.25	$525.00	—	23% below	55%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Xray Of Foot 3 Views	$236.25	$525.00	—	—	55%
X-ray of the hand, 3 or more views CPT 73130 Xray Of Hand 3 Views	$236.25	$525.00	—	28% below	55%
X-ray of the hand, 3 or more views inpatient CPT 73130 Xray Of Hand 3 Views	$236.25	$525.00	—	—	55%
X-ray of the knee, 1 or 2 views CPT 73560 Xray Of Knee 1-2 Views	$183.15	$407.00	—	33% below	55%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 Xray Of Knee 1-2 Views	$183.15	$407.00	—	—	55%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-Ray Exam Of Lower Spine	$284.40	$632.00	—	12% below	55%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-Ray Exam Of Lower Spine	$284.40	$632.00	—	—	55%
X-ray of the lower back, 4 or more views CPT 72110 Xray Of Lower Spine 4+ Views	$378.45	$841.00	—	19% below	55%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Xray Of Lower Spine 4+ Views	$378.45	$841.00	—	—	55%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xray Thoracic Spine 2 Views	$171.90	$382.00	—	43% below	55%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Xray Thoracic Spine 2 Views	$171.90	$382.00	—	—	55%
X-ray of the nasal bones, 3 or more views CPT 70160 Xray Nasal Bones Min 3 Views	$204.30	$454.00	—	30% below	55%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Xray Nasal Bones Min 3 Views	$204.30	$454.00	—	—	55%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-Ray Cervical Spine 2-3 Views	$274.50	$610.00	—	18% below	55%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-Ray Cervical Spine 2-3 Views	$274.50	$610.00	—	—	55%
X-ray of the pelvis, 1 or 2 views CPT 72170 Xray Of Pelvis 1-2 Views	$183.15	$407.00	—	27% below	55%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Xray Of Pelvis 1-2 Views	$183.15	$407.00	—	—	55%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-Ray Of Tailbone	$229.95	$511.00	—	23% below	55%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-Ray Of Tailbone	$229.95	$511.00	—	—	55%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
ACTH blood test CPT 82024 Lab-Acth	$53.10	$118.00	—	60% below	55%
ACTH blood test inpatient CPT 82024 Lab-Acth	$53.10	$118.00	—	—	55%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Lab-Alt-Transfer;Alanine Amino	$32.40	$72.00	—	16% above	55%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Lab-Alt-Transfer;Alanine Amino	$32.40	$72.00	—	—	55%
AST (aspartate aminotransferase) enzyme test CPT 84450 Lab-Ast Or Sgot	$34.20	$76.00	—	36% above	55%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Lab-Ast Or Sgot	$34.20	$76.00	—	—	55%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Lab-Acute Hepatitis Panel	$172.80	$384.00	—	21% below	55%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Lab-Acute Hepatitis Panel	$172.80	$384.00	—	—	55%
Albumin blood test CPT 82040 Lab-Albumin;Serum/Plasma/Bld	$20.70	$46.00	—	6% below	55%
Albumin blood test inpatient CPT 82040 Lab-Albumin;Serum/Plasma/Bld	$20.70	$46.00	—	—	55%
Aldosterone blood test CPT 82088 Lab-Aldosterone	$133.20	$296.00	—	5% below	55%
Aldosterone blood test inpatient CPT 82088 Lab-Aldosterone	$133.20	$296.00	—	—	55%
Alkaline phosphatase (ALP) blood test CPT 84075 Lab-Alkaline Phosphatase	$33.75	$75.00	—	41% above	55%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Lab-Alkaline Phosphatase	$33.75	$75.00	—	—	55%
Allergy blood test, specific IgE, per allergen CPT 86003 Lab-Allergen Specific Ige	$23.85	$53.00	—	2% above	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lab-Allergen Specific Ige	$23.85	$53.00	—	—	55%
Alpha-fetoprotein (AFP) blood test CPT 82105 Lab-Alpha-Feta Protein Serum	$54.90	$122.00	—	9% below	55%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Lab-Alpha-Feta Protein Serum	$54.90	$122.00	—	—	55%
Ammonia blood test CPT 82140 Lab-Ammonia	$45.00	$100.00	—	18% below	55%
Ammonia blood test inpatient CPT 82140 Lab-Ammonia	$45.00	$100.00	—	—	55%
Amylase blood test CPT 82150 Lab-Amylase, Urine	$24.30	$54.00	—	49% below	55%
Amylase blood test inpatient CPT 82150 Lab-Amylase, Urine	$24.30	$54.00	—	—	55%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Lab-Ia, Nonab(Cy Cit Peptide)	$72.90	$162.00	—	26% above	55%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Lab-Ia, Nonab(Cy Cit Peptide)	$72.90	$162.00	—	—	55%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Lab-Ana	$61.65	$137.00	—	12% above	55%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Lab-Ana	$61.65	$137.00	—	—	55%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Lab-Natriuretic Peptide	$113.40	$252.00	—	24% below	55%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Lab-Natriuretic Peptide	$113.40	$252.00	—	—	55%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Lab-Culture Aerobic	$55.80	$124.00	—	15% below	55%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Lab-Culture Csf	$55.80	$124.00	—	15% below	55%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Lab-Culture Aerobic	$55.80	$124.00	—	—	55%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Lab-Culture Csf	$55.80	$124.00	—	—	55%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel	$56.25	$125.00	—	14% below	55%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel	$56.25	$125.00	—	—	55%
Bilirubin blood test, total CPT 82247 Lab-Bilirubin Total	$18.45	$41.00	—	23% below	55%
Bilirubin blood test, total inpatient CPT 82247 Lab-Bilirubin Total	$18.45	$41.00	—	—	55%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Lab-Sl4 Tissue Exm By Path	$149.85	$333.00	—	26% below	55%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Lab-Sl4 Tissue Exm By Path	$149.85	$333.00	—	—	55%
Blood culture for bacteria CPT 87040 Lab-Aerob Bacterial Blood Cult	$72.90	$162.00	—	22% below	55%
Blood culture for bacteria inpatient CPT 87040 Lab-Aerob Bacterial Blood Cult	$72.90	$162.00	—	—	55%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture	$11.25	$25.00	—	29% below	55%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Routine Venipuncture	$11.25	$25.00	—	29% below	55%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture	$11.25	$25.00	—	—	55%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Routine Venipuncture	$11.25	$25.00	—	—	55%
Blood glucose (sugar) test CPT 82947 Lab-Glucose; Quan, Blood	$17.55	$39.00	—	26% below	55%
Blood glucose (sugar) test inpatient CPT 82947 Lab-Glucose; Quan, Blood	$17.55	$39.00	—	—	55%
Blood lead test CPT 83655 Lab-Lead	$40.05	$89.00	—	18% below	55%
Blood lead test CPT 83655 Lab-Lead Hmsc I	$40.05	$89.00	—	18% below	55%
Blood lead test CPT 83655 Lab-Lead Hms	$40.05	$89.00	—	18% below	55%
Blood lead test CPT 83655 Lab-Lead R	$40.05	$89.00	—	18% below	55%
Blood lead test inpatient CPT 83655 Lab-Lead Hms	$40.05	$89.00	—	—	55%
Blood lead test inpatient CPT 83655 Lab-Lead R	$40.05	$89.00	—	—	55%
Blood lead test inpatient CPT 83655 Lab-Lead	$40.05	$89.00	—	—	55%
Blood lead test inpatient CPT 83655 Lab-Lead Hmsc I	$40.05	$89.00	—	—	55%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Lab-Pregnancy Test-Serum	$27.00	$60.00	—	50% below	55%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Lab-Pregnancy Test-Serum	$27.00	$60.00	—	—	55%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Lab-Bld Typing; Serologic; Abo	$27.45	$61.00	—	54% below	55%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Lab-Bld Typing; Serologic; Abo	$27.45	$61.00	—	—	55%
Blood urea nitrogen (BUN) test CPT 84520 Lab-Urea Nitrogen; Quan	$18.45	$41.00	—	21% below	55%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Lab-Urea Nitrogen; Quan	$18.45	$41.00	—	—	55%
C-peptide blood test CPT 84681 Lab-C-Peptide	$117.90	$262.00	—	49% above	55%
C-peptide blood test inpatient CPT 84681 Lab-C-Peptide	$117.90	$262.00	—	—	55%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Lab-C Reactive Protein	$6.75	$15.00	—	87% below	55%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 Lab-C Reactive Protein	$6.75	$15.00	—	—	55%
C. difficile toxin gene test (stool PCR) CPT 87493 Lab-Clostridium Difficile	$31.05	$69.00	—	76% below	55%
C. difficile toxin gene test (stool PCR) CPT 87493 Lab-C. Difficile By Pcr	$87.75	$195.00	—	33% below	55%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Lab-Clostridium Difficile	$31.05	$69.00	—	—	55%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Lab-C. Difficile By Pcr	$87.75	$195.00	—	—	55%
CA 19-9 blood test (tumor marker) CPT 86301 Lab-Ia, Quant; Ca 19-9	$59.40	$132.00	—	19% below	55%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Lab-Ia, Quant; Ca 19-9	$59.40	$132.00	—	—	55%
CA-125 blood test (ovarian cancer marker) CPT 86304 Lab-Immunoassay Non Antibody	$59.40	$132.00	—	37% below	55%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Lab-Immunoassay Non Antibody	$59.40	$132.00	—	—	55%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Lab-Sars Cov-2 Covid 19	$95.85	$213.00	—	32% below	55%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Lab-Sars Cov-2 Covid 19	$95.85	$213.00	—	—	55%
Calcium blood test, total CPT 82310 Lab-Calcium; Total	$20.70	$46.00	—	34% below	55%
Calcium blood test, total inpatient CPT 82310 Lab-Calcium; Total	$20.70	$46.00	—	—	55%
Carcinoembryonic antigen (CEA) test CPT 82378 Lab-Cea	$63.45	$141.00	—	27% below	55%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Lab-Cea	$63.45	$141.00	—	—	55%
Chickenpox (varicella) immunity blood test CPT 86787 Lab-Ab; Varicella-Zoster	$54.00	$120.00	—	7% below	55%
Chickenpox (varicella) immunity blood test CPT 86787 Lab-Varicella Igg	$54.00	$120.00	—	7% below	55%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Lab-Varicella Igg	$54.00	$120.00	—	—	55%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Lab-Ab; Varicella-Zoster	$54.00	$120.00	—	—	55%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Lab-Chlmyd Trach Dna Amp Probe	$29.70	$66.00	—	68% below	55%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Lab-Chlamydia - Amp Pr Urine	$153.90	$342.00	—	67% above	55%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Lab-Chlmyd Trach Dna Amp Probe	$29.70	$66.00	—	—	55%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Lab-Chlamydia - Amp Pr Urine	$153.90	$342.00	—	—	55%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lab-Lipid Panel	$90.45	$201.00	—	71% above	55%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lab-Lipid Panel	$90.45	$201.00	—	—	55%
Complete blood count (CBC) with differential CPT 85025 Lab-Cbc W Plt W Autom Diff	$27.90	$62.00	—	23% below	55%
Complete blood count (CBC) with differential inpatient CPT 85025 Lab-Cbc W Plt W Autom Diff	$27.90	$62.00	—	—	55%
Complete blood count (CBC), no differential CPT 85027 Lab-Complete Cbc Automated	$40.05	$89.00	—	18% above	55%
Complete blood count (CBC), no differential inpatient CPT 85027 Lab-Complete Cbc Automated	$40.05	$89.00	—	—	55%
Comprehensive metabolic panel (blood test) CPT 80053 Lab-Comp Metabolic Panel	$77.40	$172.00	—	22% above	55%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Lab-Comp Metabolic Panel	$77.40	$172.00	—	—	55%
Cortisol blood test, total CPT 82533 Lab-Cortisol Total	$65.25	$145.00	—	10% below	55%
Cortisol blood test, total inpatient CPT 82533 Lab-Cortisol Total	$65.25	$145.00	—	—	55%
Creatine kinase (CK) blood test, total CPT 82550 Lab-Cpk; Total	$24.75	$55.00	—	30% below	55%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Lab-Cpk; Total	$24.75	$55.00	—	—	55%
Creatinine blood test CPT 82565 Lab-Creatinine; Blood	$21.60	$48.00	—	13% below	55%
Creatinine blood test inpatient CPT 82565 Lab-Creatinine; Blood	$21.60	$48.00	—	—	55%
Cytomegalovirus (CMV) antibody test CPT 86644 Lab-Ab; Cmv	$59.40	$132.00	—	14% below	55%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Lab-Ab; Cmv	$59.40	$132.00	—	—	55%
D-dimer blood test (blood clot marker) CPT 85379 Lab-D-Dimer Quantitative	$40.05	$89.00	—	42% below	55%
D-dimer blood test (blood clot marker) CPT 85379 Lab-D Dimer High Sensitivity	$45.00	$100.00	—	35% below	55%
D-dimer blood test (blood clot marker) inpatient CPT 85379 Lab-D-Dimer Quantitative	$40.05	$89.00	—	—	55%
D-dimer blood test (blood clot marker) inpatient CPT 85379 Lab-D Dimer High Sensitivity	$45.00	$100.00	—	—	55%
DHEA sulfate (DHEA-S) blood test CPT 82627 Lab-Dhea-S	$72.90	$162.00	—	27% below	55%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Lab-Dhea-S	$72.90	$162.00	—	—	55%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Lab-Urine Drug Screen	$56.25	$125.00	—	41% below	55%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Lab-Test For Presence Of Drug	$223.65	$497.00	—	134% above	55%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Lab-Urine Drug Screen	$56.25	$125.00	—	—	55%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Lab-Test For Presence Of Drug	$223.65	$497.00	—	—	55%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Lab-Electrolyte Panel	$40.05	$89.00	—	16% below	55%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Lab-Electrolyte Panel	$40.05	$89.00	—	—	55%
Epstein-Barr virus (EBV) antibody test CPT 86665 Lab-Ebv-Vca Igg	$56.70	$126.00	—	13% below	55%
Epstein-Barr virus (EBV) antibody test CPT 86665 Lab-Epstein-Barr Capsid Vca	$56.70	$126.00	—	13% below	55%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Lab-Epstein-Barr Capsid Vca	$56.70	$126.00	—	—	55%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Lab-Ebv-Vca Igg	$56.70	$126.00	—	—	55%
Estradiol blood test CPT 82670 Lab-Estradiol,Serum	$103.95	$231.00	—	7% below	55%
Estradiol blood test inpatient CPT 82670 Lab-Estradiol,Serum	$103.95	$231.00	—	—	55%
FSH (follicle-stimulating hormone) test CPT 83001 Lab-Gonadotropin; Fsh	$60.75	$135.00	—	29% below	55%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Lab-Gonadotropin; Fsh	$60.75	$135.00	—	—	55%
Fecal calprotectin (stool inflammation test) CPT 83993 Lab-Assay Calprotectin Fecal	$64.80	$144.00	—	57% below	55%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Lab-Assay Calprotectin Fecal	$64.80	$144.00	—	—	55%
Ferritin blood test (iron stores) CPT 82728 Lab-Ferritin	$10.80	$24.00	—	86% below	55%
Ferritin blood test (iron stores) inpatient CPT 82728 Lab-Ferritin	$10.80	$24.00	—	—	55%
Fibrinogen blood test CPT 85384 Lab-Fibrinogen; Activity	$29.70	$66.00	—	34% below	55%
Fibrinogen blood test inpatient CPT 85384 Lab-Fibrinogen; Activity	$29.70	$66.00	—	—	55%
Folate (folic acid) blood test CPT 82746 Lab-Folic Acid,Serum	$48.15	$107.00	—	29% below	55%
Folate (folic acid) blood test inpatient CPT 82746 Lab-Folic Acid,Serum	$48.15	$107.00	—	—	55%
Free T3 thyroid hormone test CPT 84481 Lab-T3 Free	$58.50	$130.00	—	23% below	55%
Free T3 thyroid hormone test inpatient CPT 84481 Lab-T3 Free	$58.50	$130.00	—	—	55%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Lab-Free Thyroxine	$36.90	$82.00	—	13% below	55%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Lab-Free Thyroxine	$36.90	$82.00	—	—	55%
Free testosterone test CPT 84402 Lab-Testosterone Free	$85.50	$190.00	—	12% below	55%
Free testosterone test inpatient CPT 84402 Lab-Testosterone Free	$85.50	$190.00	—	—	55%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Lab-Glutamyltransferase, Gamma	$23.85	$53.00	—	44% below	55%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Lab-Glutamyltransferase, Gamma	$23.85	$53.00	—	—	55%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 Lab-General Health Panel	$119.70	$266.00	—	46% below	55%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 Lab-General Health Panel	$119.70	$266.00	—	—	55%
Glucose tolerance test, 3 samples CPT 82951 Lab-3Hr Gtt (3 Specimens)	$42.75	$95.00	—	36% below	55%
Glucose tolerance test, 3 samples inpatient CPT 82951 Lab-3Hr Gtt (3 Specimens)	$42.75	$95.00	—	—	55%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Lab-Neisseria Gonorrhoeae Pcr	$29.70	$66.00	—	68% below	55%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Lab-Neisseria- Amp Pr Urine	$161.10	$358.00	—	73% above	55%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Lab-Neisseria Gonorrhoeae Pcr	$29.70	$66.00	—	—	55%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Lab-Neisseria- Amp Pr Urine	$161.10	$358.00	—	—	55%
H. pylori antibody blood test CPT 86677 Lab-H.Pylori Antibody Total	$62.10	$138.00	—	18% below	55%
H. pylori antibody blood test inpatient CPT 86677 Lab-H.Pylori Antibody Total	$62.10	$138.00	—	—	55%
H. pylori stool antigen test CPT 87338 Lab-Hpylori Stool Ia	$69.75	$155.00	—	at median	55%
H. pylori stool antigen test inpatient CPT 87338 Lab-Hpylori Stool Ia	$69.75	$155.00	—	—	55%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Lab-Hiv Ultrasens Quant By Rna	$408.60	$908.00	—	14% above	55%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Lab-Hiv Ultrasens Quant By Rna	$408.60	$908.00	—	—	55%
HIV-1 and HIV-2 antibody test CPT 86703 Noncdm Charge Record	$55.80	$124.00	—	10% below	55%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Noncdm Charge Record	$55.80	$124.00	—	—	55%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv-1 Ag W/Hiv-1 & Hiv-2 Ab	$127.35	$283.00	—	72% above	55%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv-1 Ag W/Hiv-1 & Hiv-2 Ab	$127.35	$283.00	—	—	55%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Lab-Hpv High-Risk Types	$162.90	$362.00	—	37% above	55%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Lab-Hpv High-Risk Types	$162.90	$362.00	—	—	55%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Lab-Hgb A1C	$32.40	$72.00	—	29% below	55%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hgb A1C Poc	$32.40	$72.00	—	29% below	55%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Lab-Hgb A1C	$32.40	$72.00	—	—	55%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hgb A1C Poc	$32.40	$72.00	—	—	55%
Hemoglobin blood test CPT 85018 Hemoglobin Poc	$16.65	$37.00	—	3% above	55%
Hemoglobin blood test CPT 85018 Lab-Hemoglobin	$16.65	$37.00	—	3% above	55%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin Poc	$16.65	$37.00	—	—	55%
Hemoglobin blood test inpatient CPT 85018 Lab-Hemoglobin	$16.65	$37.00	—	—	55%
Hepatitis B core antibody test (total) CPT 86704 Lab-Ab; Hbcab - Total	$47.70	$106.00	—	12% below	55%
Hepatitis B core antibody test (total) inpatient CPT 86704 Lab-Ab; Hbcab - Total	$47.70	$106.00	—	—	55%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Lab-Hep B Surface Antibody	$44.55	$99.00	—	8% below	55%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Lab-Hep B Surface Antibody	$44.55	$99.00	—	—	55%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Lab-Hepatitis B Surface Ag Ia	$42.75	$95.00	—	10% below	55%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Lab-Hepatitis B Surface Ag Ia	$42.75	$95.00	—	—	55%
Hepatitis C antibody blood test (screening) CPT 86803 Lab-Hepatitis C Antibody	$55.35	$123.00	—	14% below	55%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Lab-Hepatitis C Antibody	$55.35	$123.00	—	—	55%
Hepatitis C viral load (HCV RNA) test CPT 87522 Lab-Hep-C Na Quan	$343.80	$764.00	—	79% above	55%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Lab-Hep-C Na Quan	$343.80	$764.00	—	—	55%
Herpes blood test, HSV-1 antibody CPT 86695 Lab-Hsv Ab 1 Igg	$50.85	$113.00	—	14% below	55%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Lab-Hsv Ab 1 Igg	$50.85	$113.00	—	—	55%
Herpes blood test, HSV-2 antibody CPT 86696 Lab-Hsv Ab 2 Igg	$37.35	$83.00	—	44% below	55%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Lab-Hsv Ab 2 Igg	$37.35	$83.00	—	—	55%
High-sensitivity CRP (hs-CRP) test CPT 86141 Lab-C-Reactive Protein, Hs	$54.90	$122.00	—	19% below	55%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Lab-C-Reactive Protein, Hs	$54.90	$122.00	—	—	55%
Homocysteine blood test CPT 83090 Lab-Homocysteine - Blood	$63.00	$140.00	—	22% below	55%
Homocysteine blood test inpatient CPT 83090 Lab-Homocysteine - Blood	$63.00	$140.00	—	—	55%
Insulin blood test CPT 83525 Lab-Insulin Assay Total	$47.25	$105.00	—	8% below	55%
Insulin blood test CPT 83525 Lab-Insulin Antibody Total	$47.25	$105.00	—	8% below	55%
Insulin blood test inpatient CPT 83525 Lab-Insulin Assay Total	$47.25	$105.00	—	—	55%
Insulin blood test inpatient CPT 83525 Lab-Insulin Antibody Total	$47.25	$105.00	—	—	55%
Iron blood test (serum iron) CPT 83540 Lab-Iron	$22.05	$49.00	—	42% below	55%
Iron blood test (serum iron) inpatient CPT 83540 Lab-Iron	$22.05	$49.00	—	—	55%
Iron-binding capacity (TIBC) test CPT 83550 Lab-Iron Binding Capacity	$31.05	$69.00	—	20% below	55%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Lab-Iron Binding Capacity	$31.05	$69.00	—	—	55%
Kidney function blood test panel CPT 80069 Lab-Renal Function Panel	$68.40	$152.00	—	5% below	55%
Kidney function blood test panel inpatient CPT 80069 Lab-Renal Function Panel	$68.40	$152.00	—	—	55%
LH (luteinizing hormone) test CPT 83002 Lab-Lh Luteinizing Hormone	$61.65	$137.00	—	35% below	55%
LH (luteinizing hormone) test inpatient CPT 83002 Lab-Lh Luteinizing Hormone	$61.65	$137.00	—	—	55%
Lactate (lactic acid) blood test CPT 83605 Lab-Lactic Acid (Lactate)	$38.25	$85.00	—	26% below	55%
Lactate (lactic acid) blood test inpatient CPT 83605 Lab-Lactic Acid (Lactate)	$38.25	$85.00	—	—	55%
Lipase blood test (pancreas enzyme) CPT 83690 Lab-Lipase	$34.65	$77.00	—	40% below	55%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lab-Lipase	$34.65	$77.00	—	—	55%
Liver function blood test panel CPT 80076 Lab-Hepatic Function Panel	$58.95	$131.00	—	3% below	55%
Liver function blood test panel inpatient CPT 80076 Lab-Hepatic Function Panel	$58.95	$131.00	—	—	55%
Lyme disease antibody test CPT 86618 Lab-Ab; Lyme's Disease	$66.60	$148.00	—	13% below	55%
Lyme disease antibody test inpatient CPT 86618 Lab-Ab; Lyme's Disease	$66.60	$148.00	—	—	55%
Magnesium blood test CPT 83735 Lab-Rbc Magnesium	$28.80	$64.00	—	15% below	55%
Magnesium blood test CPT 83735 Lab-Magnesium	$28.80	$64.00	—	15% below	55%
Magnesium blood test CPT 83735 Lab-Magnesium - Urine	$28.80	$64.00	—	15% below	55%
Magnesium blood test inpatient CPT 83735 Lab-Magnesium - Urine	$28.80	$64.00	—	—	55%
Magnesium blood test inpatient CPT 83735 Lab-Magnesium	$28.80	$64.00	—	—	55%
Magnesium blood test inpatient CPT 83735 Lab-Rbc Magnesium	$28.80	$64.00	—	—	55%
Measles (rubeola) antibody test CPT 86765 Lab-Rubeola Antibody (Measles)	$54.00	$120.00	—	5% below	55%
Measles (rubeola) antibody test inpatient CPT 86765 Lab-Rubeola Antibody (Measles)	$54.00	$120.00	—	—	55%
Mono test (heterophile antibody, Monospot) CPT 86308 Lab-Qual Heterophile Ab	$32.85	$73.00	—	38% below	55%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Lab-Qual Heterophile Ab	$32.85	$73.00	—	—	55%
Mumps immunity blood test CPT 86735 Lab Ab; Mumps Igm	$54.90	$122.00	—	6% below	55%
Mumps immunity blood test CPT 86735 Lab-Ab; Mumps Igg	$54.90	$122.00	—	6% below	55%
Mumps immunity blood test inpatient CPT 86735 Lab-Ab; Mumps Igg	$54.90	$122.00	—	—	55%
Mumps immunity blood test inpatient CPT 86735 Lab Ab; Mumps Igm	$54.90	$122.00	—	—	55%
PSA (prostate-specific antigen) blood test, free CPT 84154 Lab-Psa Free	$61.65	$137.00	—	25% below	55%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Lab-Psa Free	$61.65	$137.00	—	—	55%
Pap test (liquid-based, automated screening with review) CPT 88175 Lab-Gyn Cytopathology	$67.50	$150.00	—	31% below	55%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Lab-Gyn Cytopathology	$67.50	$150.00	—	—	55%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Lab-Tpp-Cp Cerv/Vag; Atl	$67.95	$151.00	—	25% below	55%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Lab-Tpp-Cp Cerv/Vag; Atl	$67.95	$151.00	—	—	55%
Parathyroid hormone (PTH) blood test CPT 83970 Lab-Parathyroid Hormone	$135.00	$300.00	—	5% below	55%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Lab-Parathyroid Hormone	$135.00	$300.00	—	—	55%
Partial thromboplastin time (PTT) clotting test CPT 85730 Lab-Ptt	$39.60	$88.00	—	5% above	55%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Lab-Ptt	$39.60	$88.00	—	—	55%
Phosphorus (phosphate) blood test CPT 84100 Lab-Phosphate	$26.55	$59.00	—	26% below	55%
Phosphorus (phosphate) blood test inpatient CPT 84100 Lab-Phosphate	$26.55	$59.00	—	—	55%
Potassium blood test CPT 84132 Lab-Potassium; Serum/Plas/ Bld	$19.80	$44.00	—	15% below	55%
Potassium blood test inpatient CPT 84132 Lab-Potassium; Serum/Plas/ Bld	$19.80	$44.00	—	—	55%
Progesterone blood test CPT 84144 Lab-Progesterone	$63.00	$140.00	—	22% below	55%
Progesterone blood test inpatient CPT 84144 Lab-Progesterone	$63.00	$140.00	—	—	55%
Prolactin blood test CPT 84146 Lab-Prolactin Assay	$63.45	$141.00	—	27% below	55%
Prolactin blood test inpatient CPT 84146 Lab-Prolactin Assay	$63.45	$141.00	—	—	55%
Prothrombin time (PT/INR) clotting test CPT 85610 Lab-Prothrombin Time	$27.45	$61.00	—	14% above	55%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time	$27.45	$61.00	—	14% above	55%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time	$27.45	$61.00	—	—	55%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Lab-Prothrombin Time	$27.45	$61.00	—	—	55%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Lab-Drug Screen Non Tlc Device	$100.35	$223.00	—	73% above	55%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Lab-Drug Screen Non Tlc Device	$100.35	$223.00	—	—	55%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Lab-Strep A Assay W/Optic	$67.95	$151.00	—	19% above	55%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Lab-Strep A Assay W/Optic	$67.95	$151.00	—	—	55%
Renin blood test CPT 84244 Lab-Renin	$116.55	$259.00	—	36% above	55%
Renin blood test inpatient CPT 84244 Lab-Renin	$116.55	$259.00	—	—	55%
Rh blood typing CPT 86901 Lab-Bld Typing; Serologic;Rh D	$30.60	$68.00	—	18% below	55%
Rh blood typing inpatient CPT 86901 Lab-Bld Typing; Serologic;Rh D	$30.60	$68.00	—	—	55%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Igm, Igg & I	$12.60	$28.00	—	62% below	55%
Rheumatoid factor (RF) test CPT 86431 Lab-Quan Rheum Factor	$27.00	$60.00	—	19% below	55%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Igm, Igg & I	$12.60	$28.00	—	—	55%
Rheumatoid factor (RF) test inpatient CPT 86431 Lab-Quan Rheum Factor	$27.00	$60.00	—	—	55%
Rubella antibody test (immunity check) CPT 86762 Lab-Ab; Rubella	$59.40	$132.00	—	21% above	55%
Rubella antibody test (immunity check) inpatient CPT 86762 Lab-Ab; Rubella	$59.40	$132.00	—	—	55%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Lab-Sedimentation Rate	$20.25	$45.00	—	47% below	55%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Lab-Sedimentation Rate	$20.25	$45.00	—	—	55%
Sodium blood test CPT 84295 Lab-Blood Sodium Level	$26.55	$59.00	—	2% below	55%
Sodium blood test inpatient CPT 84295 Lab-Blood Sodium Level	$26.55	$59.00	—	—	55%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Lab-Occult Blood Feces 3 Cards	$17.10	$38.00	—	41% below	55%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Lab-Occult Blood Feces 3 Cards	$17.10	$38.00	—	—	55%
Syphilis antibody test (Treponema pallidum) CPT 86780 Lab-Ab;Treponema Confirm	$77.40	$172.00	—	34% above	55%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Lab-Ab;Treponema Confirm	$77.40	$172.00	—	—	55%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Lab-Vdrl, Rpr, Sts; Qual	$22.95	$51.00	—	4% below	55%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Lab-Vdrl, Rpr, Sts; Qual	$22.95	$51.00	—	—	55%
Testosterone blood test, total (not free testosterone) CPT 84403 Lab-Testosterone; Total	$68.40	$152.00	—	26% below	55%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Lab-Testosterone; Total	$68.40	$152.00	—	—	55%
Thyroid peroxidase (TPO) antibody test CPT 86376 Lab-Microsomal Ab, Each	$59.85	$133.00	—	8% below	55%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Lab-Microsomal Ab, Each	$59.85	$133.00	—	—	55%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Lab-Thyroid Stim Hormoneone	$80.55	$179.00	—	7% above	55%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Lab-Thyroid Stim Hormoneone	$80.55	$179.00	—	—	55%
Total IgE blood test CPT 82785 Lab-Assay Of Ige	$52.20	$116.00	—	16% below	55%
Total IgE blood test inpatient CPT 82785 Lab-Assay Of Ige	$52.20	$116.00	—	—	55%
Total cholesterol blood test CPT 82465 Lab-Serum/Wb Tot Cholest	$20.70	$46.00	—	43% below	55%
Total cholesterol blood test inpatient CPT 82465 Lab-Serum/Wb Tot Cholest	$20.70	$46.00	—	—	55%
Total thyroxine (T4) blood test CPT 84436 Lab-Thyroxine; Total T4	$27.90	$62.00	—	33% below	55%
Total thyroxine (T4) blood test inpatient CPT 84436 Lab-Thyroxine; Total T4	$27.90	$62.00	—	—	55%
Total triiodothyronine (T3) blood test CPT 84480 Lab-T3; Total	$56.70	$126.00	—	6% below	55%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Lab-T3; Total	$56.70	$126.00	—	—	55%
Transferrin blood test CPT 84466 Lab-Transferrin	$76.95	$171.00	—	4% above	55%
Transferrin blood test inpatient CPT 84466 Lab-Transferrin	$76.95	$171.00	—	—	55%
Trichomonas test (NAAT) CPT 87661 Lab-Candida Vag/Trich Vag Pcr	$29.70	$66.00	—	66% below	55%
Trichomonas test (NAAT) CPT 87661 Lab-Trichomonas Vaginalis Amp	$238.95	$531.00	—	177% above	55%
Trichomonas test (NAAT) inpatient CPT 87661 Lab-Candida Vag/Trich Vag Pcr	$29.70	$66.00	—	—	55%
Trichomonas test (NAAT) inpatient CPT 87661 Lab-Trichomonas Vaginalis Amp	$238.95	$531.00	—	—	55%
Triglycerides blood test CPT 84478 Lab-Triglycerides	$28.80	$64.00	—	16% below	55%
Triglycerides blood test inpatient CPT 84478 Lab-Triglycerides	$28.80	$64.00	—	—	55%
Troponin test, quantitative CPT 84484 Lab-Troponin, Quan I	$86.40	$192.00	—	3% above	55%
Troponin test, quantitative inpatient CPT 84484 Lab-Troponin, Quan I	$86.40	$192.00	—	—	55%
Uric acid blood test CPT 84550 Lab-Uric Acid; Blood	$34.20	$76.00	—	3% below	55%
Uric acid blood test inpatient CPT 84550 Lab-Uric Acid; Blood	$34.20	$76.00	—	—	55%
Urinalysis with microscope exam, automated CPT 81001 Autom Urine Dip W/Micro	$31.05	$69.00	—	15% above	55%
Urinalysis with microscope exam, automated inpatient CPT 81001 Autom Urine Dip W/Micro	$31.05	$69.00	—	—	55%
Urinalysis without microscope exam, automated CPT 81003 Lab-Urine Scrn Auto W/O Micro	$14.85	$33.00	—	37% below	55%
Urinalysis without microscope exam, automated CPT 81003 Lab-Bilirubin Urine	$27.90	$62.00	—	19% above	55%
Urinalysis without microscope exam, automated inpatient CPT 81003 Lab-Urine Scrn Auto W/O Micro	$14.85	$33.00	—	—	55%
Urinalysis without microscope exam, automated inpatient CPT 81003 Lab-Bilirubin Urine	$27.90	$62.00	—	—	55%
Urine culture for bacteria, with colony count CPT 87086 Lab-Bact Cult-Urine; Count	$39.15	$87.00	—	31% below	55%
Urine culture for bacteria, with colony count inpatient CPT 87086 Lab-Bact Cult-Urine; Count	$39.15	$87.00	—	—	55%
Urine microalbumin (albumin) test CPT 82043 Lab-Microalbumin, U. Quant	$18.45	$41.00	—	64% below	55%
Urine microalbumin (albumin) test inpatient CPT 82043 Lab-Microalbumin, U. Quant	$18.45	$41.00	—	—	55%
Urine pregnancy test, read by color change CPT 81025 Lab-Urine Pregnancy Test	$37.80	$84.00	—	22% below	55%
Urine pregnancy test, read by color change inpatient CPT 81025 Lab-Urine Pregnancy Test	$37.80	$84.00	—	—	55%
Vitamin B12 (cobalamin) blood test CPT 82607 Lab-Vitamin B-12 Level	$52.20	$116.00	—	30% below	55%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Lab-Vitamin B-12 Level	$52.20	$116.00	—	—	55%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Lab-Vitamin D, 25 Hydroxy	$96.75	$215.00	—	3% above	55%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Lab-Vitamin D, 25 Hydroxy	$96.75	$215.00	—	—	55%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Lab-Vit D 1 25-Dihydroxy	$130.95	$291.00	—	15% below	55%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Lab-Vit D 1 25-Dihydroxy	$130.95	$291.00	—	—	55%
Zinc blood test CPT 84630 Lab-Zinc Serum/Urine	$101.25	$225.00	—	97% above	55%
Zinc blood test inpatient CPT 84630 Lab-Zinc Serum/Urine	$101.25	$225.00	—	—	55%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Lab-Hcg Quant	$93.60	$208.00	—	38% above	55%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Lab-Hcg Quant	$93.60	$208.00	—	—	55%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Tx Distal Fib Fx W/O Manip-Clo	$774.45	$1,721.00	—	105% above	55%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Tx Distal Fib Fx W/O Manip-Clo	$774.45	$1,721.00	—	—	55%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Tx Broken Foot W/O Manip-Clsd	$433.35	$963.00	—	19% above	55%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Tx Broken Foot W/O Manip-Clsd	$433.35	$963.00	—	—	55%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion	$1,393.20	$3,096.00	—	32% below	55%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion	$1,393.20	$3,096.00	—	—	55%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision <= 28 Days	$853.20	$1,896.00	—	52% below	55%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision <= 28 Days	$853.20	$1,896.00	—	—	55%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Tx Bkn Forearm W/O Manip-Clsd	$499.05	$1,109.00	—	22% above	55%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Tx Bkn Forearm W/O Manip-Clsd	$499.05	$1,109.00	—	—	55%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Rem Ear Wax - Irrigat - Unilat	$108.45	$241.00	—	30% below	55%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Rem Ear Wax - Irrigat - Unilat	$108.45	$241.00	—	—	55%
Earwax removal with instruments, one ear CPT 69210 Remove Impacted Ear Wax	$318.60	$708.00	—	106% above	55%
Earwax removal with instruments, one ear inpatient CPT 69210 Remove Impacted Ear Wax	$318.60	$708.00	—	—	55%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endometrial Biopsy	$734.40	$1,632.00	—	91% above	55%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Endometrial Biopsy	$734.40	$1,632.00	—	—	55%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Inj Spine C/T With Imaging	$2,161.80	$4,804.00	—	3% below	55%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Inj Spine C/T With Imaging	$2,161.80	$4,804.00	—	—	55%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj Paravert F Jnt L/S 1 Level	$2,211.75	$4,915.00	—	1% above	55%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj Paravert F Jnt L/S 1 Lev	$2,211.75	$4,915.00	—	1% above	55%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Inj Paravert F Jnt L/S 1 Lev	$2,211.75	$4,915.00	—	—	55%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Inj Paravert F Jnt L/S 1 Level	$2,211.75	$4,915.00	—	—	55%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Intro Saline Contr Hysterosalp	$76.50	$170.00	—	80% below	55%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Intro Saline Contr Hysterosalp	$76.50	$170.00	—	—	55%
Incision and drainage of a simple or single skin abscess CPT 10060 Drainage Of Abscess	$657.00	$1,460.00	—	70% above	55%
Incision and drainage of a simple or single skin abscess CPT 10060 Er-Drainage Of Abscess	$657.00	$1,460.00	—	70% above	55%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Er-Drainage Of Abscess	$657.00	$1,460.00	—	—	55%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drainage Of Abscess	$657.00	$1,460.00	—	—	55%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Tendon Sheath/Ligament	$625.05	$1,389.00	—	84% above	55%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj Tendon Sheath/Ligament	$625.05	$1,389.00	—	—	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drain/Inj Lg Joint/Bursa	$664.20	$1,476.00	—	5% below	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Drain/Inj Lg Joint/Bursa	$664.20	$1,476.00	—	—	55%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drain/Inj Med Joint/Bursa	$644.40	$1,432.00	—	4% above	55%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Drain/Inj Med Joint/Bursa	$644.40	$1,432.00	—	—	55%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Drain/Inj Small Joint/Bursa	$625.05	$1,389.00	—	27% above	55%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Drain/Inj Small Joint/Bursa	$625.05	$1,389.00	—	—	55%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intmd Wnd Repair S/Tr/Ext	$391.05	$869.00	—	27% below	55%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Intmd Wnd Repair S/Tr/Ext	$391.05	$869.00	—	—	55%
Lower-back epidural injection, with imaging guidance CPT 62323 Inj Spine L/S With Imaging	$2,125.80	$4,724.00	—	4% above	55%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Inj Spine L/S With Imaging	$2,125.80	$4,724.00	—	—	55%
Lower-back epidural injection, without imaging guidance CPT 62322 Inj Spine L/S W/O Imaging	$1,619.10	$3,598.00	—	at median	55%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Inj Spine L/S W/O Imaging	$1,619.10	$3,598.00	—	—	55%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Foramen Epidural L/S	$1,395.90	$3,102.00	—	33% below	55%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inj Foramen Epidural L/S	$1,395.90	$3,102.00	—	—	55%
Miscarriage treatment with D&C, first trimester CPT 59820 Ld D&C Less Than 12 Weeks	$6,227.55	$13,839.00	—	12% below	55%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 Ld D&C Less Than 12 Weeks	$6,227.55	$13,839.00	—	—	55%
Nail removal (partial or complete), one nail CPT 11730 Avulsion Of Nail Plate	$486.00	$1,080.00	—	52% above	55%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Of Nail Plate	$486.00	$1,080.00	—	—	55%
Occipital nerve block (injection for headaches) CPT 64405 Nerve Block Inj Occipital	$734.40	$1,632.00	—	7% below	55%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Nerve Block Inj Occipital	$734.40	$1,632.00	—	—	55%
Paracentesis with imaging guidance CPT 49083 Abd Paracentesis W/ Imaging	$1,302.75	$2,895.00	—	25% below	55%
Paracentesis with imaging guidance CPT 49083 Ir Abd Paracentesis W/ Imaging	$1,302.75	$2,895.00	—	25% below	55%
Paracentesis with imaging guidance inpatient CPT 49083 Abd Paracentesis W/ Imaging	$1,302.75	$2,895.00	—	—	55%
Paracentesis with imaging guidance inpatient CPT 49083 Ir Abd Paracentesis W/ Imaging	$1,302.75	$2,895.00	—	—	55%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Of Nail Bed	$974.25	$2,165.00	—	25% above	55%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Of Nail Bed	$974.25	$2,165.00	—	—	55%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destroy Lumb/Sac Facet Jnt	$3,238.65	$7,197.00	—	3% below	55%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Destroy Lumb/Sac Facet Jnt	$3,238.65	$7,197.00	—	—	55%
Removal of a foreign object under the skin, simple CPT 10120 Removal Of Foreign Body-Simple	$689.40	$1,532.00	—	3% above	55%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Removal Of Foreign Body-Simple	$689.40	$1,532.00	—	—	55%
Short arm cast (elbow to hand) CPT 29075 Short Arm Cast (Elbow)	$435.60	$968.00	—	45% above	55%
Short arm cast (elbow to hand) inpatient CPT 29075 Short Arm Cast (Elbow)	$435.60	$968.00	—	—	55%
Short arm splint (forearm and hand) CPT 29125 Apply Short Arm Splint; Static	$556.65	$1,237.00	—	92% above	55%
Short arm splint (forearm and hand) inpatient CPT 29125 Apply Short Arm Splint; Static	$556.65	$1,237.00	—	—	55%
Short leg cast (below the knee) CPT 29405 Short Leg Cast (Below Knee)	$593.10	$1,318.00	—	56% above	55%
Short leg cast (below the knee) inpatient CPT 29405 Short Leg Cast (Below Knee)	$593.10	$1,318.00	—	—	55%
Short leg splint (calf to foot) CPT 29515 Apply Short Leg Splint	$332.10	$738.00	—	13% above	55%
Short leg splint (calf to foot) inpatient CPT 29515 Apply Short Leg Splint	$332.10	$738.00	—	—	55%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simp Rep S/N/A/G/Tr/E; 2.5Cm/<	$452.70	$1,006.00	—	37% above	55%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simp Rep S/N/A/G/Tr/E; 2.5Cm/<	$452.70	$1,006.00	—	—	55%
Skin tag removal, up to 15 tags CPT 11200 Rem Skin Tags <= 15 Lesions	$347.40	$772.00	—	19% above	55%
Skin tag removal, up to 15 tags inpatient CPT 11200 Rem Skin Tags <= 15 Lesions	$347.40	$772.00	—	—	55%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Ir Lumbar Puncture Diagnostic	$993.60	$2,208.00	—	7% below	55%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Diagnostic	$993.60	$2,208.00	—	7% below	55%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture Diagnostic	$993.60	$2,208.00	—	—	55%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Ir Lumbar Puncture Diagnostic	$993.60	$2,208.00	—	—	55%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple Body 2.6-7.5Cm	$459.00	$1,020.00	—	30% above	55%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Simple Body 2.6-7.5Cm	$459.00	$1,020.00	—	—	55%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple Face 0-2.5Cm	$466.20	$1,036.00	—	47% above	55%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple Face 0-2.5Cm	$466.20	$1,036.00	—	—	55%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis W/Guide No Tube	$1,309.50	$2,910.00	—	25% below	55%
Thoracentesis with imaging guidance CPT 32555 Ir Thoracentesis W/Guide	$1,309.50	$2,910.00	—	25% below	55%
Thoracentesis with imaging guidance inpatient CPT 32555 Ir Thoracentesis W/Guide	$1,309.50	$2,910.00	—	—	55%
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis W/Guide No Tube	$1,309.50	$2,910.00	—	—	55%
Trigger point injections, 1 or 2 muscles CPT 20552 Inj Trigger Point 1-2 Muscles	$527.85	$1,173.00	—	24% below	55%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj Trigger Point 1-2 Muscles	$527.85	$1,173.00	—	—	55%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Bx Brst Us W/Dev 1St Lesion	$1,783.35	$3,963.00	—	46% below	55%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Bx Brst Us W/Dev 1St Lesion	$1,783.35	$3,963.00	—	—	55%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Tissue <= 20 Sq Cm	$820.80	$1,824.00	—	5% above	55%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Tissue <= 20 Sq Cm	$820.80	$1,824.00	—	—	55%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion	$1,179.00	$2,620.00	—	6% above	55%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion	$1,179.00	$2,620.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment	$113.40	$252.00	—	35% below	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment	$113.40	$252.00	—	—	55%
Critical care, first 30 to 74 minutes CPT 99291 E&M Crit Care 1St 30-74 Minute	$1,016.55	$2,259.00	—	65% below	55%
Critical care, first 30 to 74 minutes inpatient CPT 99291 E&M Crit Care 1St 30-74 Minute	$1,016.55	$2,259.00	—	—	55%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg	$88.20	$196.00	—	52% below	55%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg-Tracing 12 Lead	$88.20	$196.00	—	52% below	55%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg-Tracing 12 Lead	$88.20	$196.00	—	—	55%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg	$88.20	$196.00	—	—	55%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Visit Level 1	$203.85	$453.00	—	35% below	55%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency Visit Level 1	$203.85	$453.00	—	—	55%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Visit Level 2	$265.95	$591.00	—	48% below	55%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency Visit Level 2	$265.95	$591.00	—	—	55%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Visit Level 3	$405.00	$900.00	—	52% below	55%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency Visit Level 3	$405.00	$900.00	—	—	55%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Visit Level 4	$512.55	$1,139.00	—	61% below	55%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency Visit Level 4	$512.55	$1,139.00	—	—	55%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Visit Level 5	$634.05	$1,409.00	—	64% below	55%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency Visit Level 5	$634.05	$1,409.00	—	—	55%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test Procedure	$508.50	$1,130.00	—	43% below	55%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test Procedure	$508.50	$1,130.00	—	—	55%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Hydration, 31 Min To 1 Hour	$210.15	$467.00	—	50% below	55%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Iv Hydration, 31 Min To 1 Hour	$210.15	$467.00	—	—	55%
IV infusion of a medicine, first hour CPT 96365 Ther/Proph/Diag Iv Inf Init Hr	$206.55	$459.00	—	52% below	55%
IV infusion of a medicine, first hour inpatient CPT 96365 Ther/Proph/Diag Iv Inf Init Hr	$206.55	$459.00	—	—	55%
IV push of a medicine, first drug CPT 96374 Ther/Proph/Diag Inj, Iv Push	$128.25	$285.00	—	50% below	55%
IV push of a medicine, first drug inpatient CPT 96374 Ther/Proph/Diag Inj, Iv Push	$128.25	$285.00	—	—	55%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/Proph/Diag Inj, Sc/Im	$75.15	$167.00	—	47% below	55%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/Proph/Diag Inj, Sc/Im	$75.15	$167.00	—	—	55%
Neuromuscular re-education, 15 minutes CPT 97112 Pt Neuro Muscular Re-Education	$58.05	$129.00	—	47% below	55%
Neuromuscular re-education, 15 minutes CPT 97112 Ot Neuro Muscular Re-Education	$58.05	$129.00	—	47% below	55%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Ot Neuro Muscular Re-Education	$58.05	$129.00	—	—	55%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Pt Neuro Muscular Re-Education	$58.05	$129.00	—	—	55%
New patient office visit, about 30 minutes CPT 99203 Off/Oupt Visit New Pt Lev 3	$239.40	$532.00	—	118% above	55%
New patient office visit, about 30 minutes inpatient CPT 99203 Off/Oupt Visit New Pt Lev 3	$239.40	$532.00	—	—	55%
New patient office visit, about 45 minutes CPT 99204 Off/Oupt Visit New Pt Lev 4	$289.80	$644.00	—	139% above	55%
New patient office visit, about 45 minutes inpatient CPT 99204 Off/Oupt Visit New Pt Lev 4	$289.80	$644.00	—	—	55%
New patient office visit, about 60 minutes CPT 99205 Off/Oupt Visit New Pt Lev 5	$318.60	$708.00	—	84% above	55%
New patient office visit, about 60 minutes inpatient CPT 99205 Off/Oupt Visit New Pt Lev 5	$318.60	$708.00	—	—	55%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Off/Oupt Visit New Pt Lev 2	$202.50	$450.00	—	100% above	55%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Off/Outpt Visit New Pt Lvl 2	$202.50	$450.00	—	100% above	55%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Off/Outpt Visit New Pt Lvl 2	$202.50	$450.00	—	—	55%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Off/Oupt Visit New Pt Lev 2	$202.50	$450.00	—	—	55%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Nutrit Ind 15 Min Telehealth	$66.15	$147.00	—	2% above	55%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Init Nutrition Therapy; Each 1	$66.15	$147.00	—	2% above	55%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Init Nutrition Therapy; Each 1	$66.15	$147.00	—	—	55%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Nutrit Ind 15 Min Telehealth	$66.15	$147.00	—	—	55%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Low Complex 30 Min	$139.95	$311.00	—	46% below	55%
Occupational therapy evaluation, low complexity inpatient CPT 97165 Ot Eval Low Complex 30 Min	$139.95	$311.00	—	—	55%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval High Complex 45 Min	$164.25	$365.00	—	45% below	55%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pt Eval High Complex 45 Min	$164.25	$365.00	—	—	55%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Low Complex 20 Min	$135.00	$300.00	—	48% below	55%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Pt Eval Low Complex 20 Min	$135.00	$300.00	—	—	55%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Mod Complex 30 Min	$149.85	$333.00	—	46% below	55%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pt Eval Mod Complex 30 Min	$149.85	$333.00	—	—	55%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Pt Manual Therapy Per 15 Min	$67.95	$151.00	—	39% below	55%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Ot Manual Therapy Per 15 Min	$67.95	$151.00	—	39% below	55%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Pt Manual Therapy Per 15 Min	$67.95	$151.00	—	—	55%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Ot Manual Therapy Per 15 Min	$67.95	$151.00	—	—	55%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Pt Therapeutic Exer Per 15 Min	$72.90	$162.00	—	38% below	55%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ot Therapeutic Exer Per 15 Min	$72.90	$162.00	—	38% below	55%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ot Therapeutic Exer Per 15 Min	$72.90	$162.00	—	—	55%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Pt Therapeutic Exer Per 15 Min	$72.90	$162.00	—	—	55%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Behav Chng Smoking 3-10 Min	$36.45	$81.00	—	17% below	55%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Behav Chng Smoking 3-10 Min	$36.45	$81.00	—	—	55%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Off/Outpt Visit Estab Pt Lev 5	$385.20	$856.00	—	129% above	55%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Off/Oupt Visit Estab Pt Lev 5	$385.20	$856.00	—	129% above	55%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Off/Outpt Visit Estab Pt Lev 5	$385.20	$856.00	—	—	55%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Off/Oupt Visit Estab Pt Lev 5	$385.20	$856.00	—	—	55%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Off/Oupt Visit Estab Pt Lev 3	$211.05	$469.00	—	82% above	55%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Off/Outpt Visit Estab Pt Lev 3	$211.05	$469.00	—	82% above	55%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Off/Outpt Visit Estab Pt Lev 3	$211.05	$469.00	—	—	55%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Off/Oupt Visit Estab Pt Lev 3	$211.05	$469.00	—	—	55%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Off/Oupt Visit Estab Pt Lev 4	$274.05	$609.00	—	100% above	55%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Off/Outpt Visit Estab Pt Lev 4	$274.05	$609.00	—	100% above	55%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Off/Oupt Visit Estab Pt Lev 4	$274.05	$609.00	—	—	55%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Off/Outpt Visit Estab Pt Lev 4	$274.05	$609.00	—	—	55%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Off/Outpt Visit Estab Pt Lev 2	$146.70	$326.00	—	45% above	55%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Off/Oupt Visit Estab Pt Lev 2	$146.70	$326.00	—	45% above	55%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Off/Outpt Visit Estab Pt Lev 2	$146.70	$326.00	—	—	55%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Off/Oupt Visit Estab Pt Lev 2	$146.70	$326.00	—	—	55%
Speech and language evaluation CPT 92523 Speech Sound Lang Comprehen	$159.75	$355.00	—	53% below	55%
Speech and language evaluation inpatient CPT 92523 Speech Sound Lang Comprehen	$159.75	$355.00	—	—	55%
Speech therapy session, individual CPT 92507 Speech/Hearing Therapy	$169.65	$377.00	—	22% below	55%
Speech therapy session, individual inpatient CPT 92507 Speech/Hearing Therapy	$169.65	$377.00	—	—	55%
Spirometry (breathing test) CPT 94010 Noncdm Charge Record	$201.15	$447.00	—	35% below	55%
Spirometry (breathing test) CPT 94010 Breathing Capacity Test	$201.15	$447.00	—	35% below	55%
Spirometry (breathing test) inpatient CPT 94010 Noncdm Charge Record	$201.15	$447.00	—	—	55%
Spirometry (breathing test) inpatient CPT 94010 Breathing Capacity Test	$201.15	$447.00	—	—	55%
Spirometry before and after a bronchodilator CPT 94060 Bronchospasm - Pre & Post Bd	$348.30	$774.00	—	39% below	55%
Spirometry before and after a bronchodilator inpatient CPT 94060 Bronchospasm - Pre & Post Bd	$348.30	$774.00	—	—	55%
Therapeutic activities (functional training), 15 minutes CPT 97530 Ot Therepeutic Activities	$59.85	$133.00	—	51% below	55%
Therapeutic activities (functional training), 15 minutes CPT 97530 Pt Therepeutic Activities	$59.85	$133.00	—	51% below	55%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Ot Therepeutic Activities	$59.85	$133.00	—	—	55%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Pt Therepeutic Activities	$59.85	$133.00	—	—	55%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Admin 1St Vaccine	$47.25	$105.00	—	16% above	55%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization Admin 1St Vaccine	$47.25	$105.00	—	—	55%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization Adm Ea Addtl Vac	$43.65	$97.00	—	25% above	55%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization Adm Ea Addtl Vac	$43.65	$97.00	—	—	55%

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

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

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

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

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

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

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

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

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

Source file: https://aultman.org/pricing-transparency/2026/1891718375_aultman-orrville-hospital_standardcharges.json