Hospital Wilmington, OH

Clinton Memorial Hospital

Clinton Memorial Hospital in Wilmington, OH publishes cash prices for 314 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 276 of 313 procedures and above it for 34. By typical cash price it ranks #14 of 139 Ohio hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

610 West Main Street, Wilmington, OH 45177 Collected Sep 22, 2026 Source price file Check a bill from this hospital (937) 382-9335

Acute care hospital Government-owned hospital No emergency department CMS star rating 2 of 5 CCN 360175 · CMS hospital register

Financial assistance

Public hospital: ask for its charity care or sliding-scale discount

Clinton Memorial Hospital is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.

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.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WO/W	$1,235.53	$2,471.06	—	7% below	50%
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WW/O	$1,235.53	$2,471.06	—	7% below	50%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WW/O	$1,235.53	$2,471.06	—	—	50%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WO/W	$1,235.53	$2,471.06	—	—	50%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN FLAT&UPRIGHT	$132.97	$265.95	—	61% below	50%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN FLAT&UPRIGHT	$132.97	$265.95	—	—	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE COMP >3V LT	$180.47	$360.94	—	44% below	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE COMP >3V RT	$180.47	$360.94	—	44% below	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE COMPLT 3 VW LT	$180.47	$360.94	—	44% below	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE COMPLT 3 VW RT	$180.47	$360.94	—	44% below	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE COMPLT 3 VW LT	$180.47	$360.94	—	—	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE COMP >3V LT	$180.47	$360.94	—	—	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE COMPLT 3 VW RT	$180.47	$360.94	—	—	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE COMP >3V RT	$180.47	$360.94	—	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 EXT ART STDY 1-2 LVL	$334.56	$669.11	—	31% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 EXT ART STDY 1-2 LVL	$334.56	$669.11	—	—	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXT W/O LT	$801.73	$1,603.45	—	15% below	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXT WO RT	$801.73	$1,603.45	—	15% below	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXT W/O RT	$801.73	$1,603.45	—	15% below	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXT WO LT	$801.73	$1,603.45	—	15% below	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UP EXT W/O RT	$801.73	$1,603.45	—	—	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UP EXT WO LT	$801.73	$1,603.45	—	—	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UP EXT WO RT	$801.73	$1,603.45	—	—	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UP EXT W/O LT	$801.73	$1,603.45	—	—	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAG/BAR SWALLOW	$322.99	$645.97	—	27% below	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAG/BAR SWALLOW	$322.99	$645.97	—	—	50%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE/JOINT WHOLE BDY	$894.31	$1,788.62	—	42% below	50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE/JOINT WHOLE BDY	$894.31	$1,788.62	—	—	50%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST LT COMPL	$179.22	$358.44	—	62% below	50%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST RT COMPL	$179.22	$358.44	—	62% below	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST LT COMPL	$179.22	$358.44	—	—	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST RT COMPL	$179.22	$358.44	—	—	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LT LTD	$179.22	$358.44	—	56% below	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST RT LTD	$179.22	$358.44	—	56% below	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LT LTD	$179.22	$358.44	—	—	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST RT LTD	$179.22	$358.44	—	—	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD/PELVIS W/WO	$1,928.37	$3,856.73	—	10% below	50%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD/PELVIS W/WO	$1,928.37	$3,856.73	—	—	50%
CT angiography (CTA) of the head CPT 70496 CTA HEAD WO/W	$763.74	$1,527.48	—	43% below	50%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD WO/W	$763.74	$1,527.48	—	—	50%
CT angiography (CTA) of the neck CPT 70498 CTA NECK WO/W	$1,514.18	$3,028.36	—	16% above	50%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK WO/W	$1,514.18	$3,028.36	—	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST WO/W	$1,469.85	$2,939.69	—	4% above	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST WO/W	$1,469.85	$2,939.69	—	—	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D	$2,116.49	$4,232.98	—	32% above	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO HRT W/3D	$2,116.49	$4,232.98	—	—	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART CA SCORE	$51.73	$103.46	—	82% below	50%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART CA SCORE	$51.73	$103.46	—	—	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS WO	$1,175.37	$2,350.73	—	26% below	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS W/O C	$1,175.37	$2,350.73	—	26% below	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS W/O C	$1,175.37	$2,350.73	—	—	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS WO	$1,175.37	$2,350.73	—	—	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W	$1,376.76	$2,753.52	—	31% below	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W/CONT	$1,376.76	$2,753.52	—	31% below	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W	$1,376.76	$2,753.52	—	—	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W/CONT	$1,376.76	$2,753.52	—	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS WO/W	$1,636.42	$3,272.84	—	30% below	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS W/WO/C	$1,636.42	$3,272.84	—	30% below	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELVIS WO/W	$1,636.42	$3,272.84	—	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELVIS W/WO/C	$1,636.42	$3,272.84	—	—	50%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W	$1,075.96	$2,151.92	—	8% below	50%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W	$1,075.96	$2,151.92	—	—	50%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO	$915.11	$1,830.21	—	13% below	50%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O	$915.11	$1,830.21	—	13% below	50%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO	$915.11	$1,830.21	—	—	50%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O	$915.11	$1,830.21	—	—	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXLLFCIAL W/O	$809.96	$1,619.91	—	7% below	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO	$809.96	$1,619.91	—	7% below	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO	$809.96	$1,619.91	—	—	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXLLFCIAL W/O	$809.96	$1,619.91	—	—	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO	$800.47	$1,600.94	—	4% below	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O	$800.47	$1,600.94	—	4% below	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O	$800.47	$1,600.94	—	—	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN WO	$800.47	$1,600.94	—	—	50%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W	$778.32	$1,556.63	—	23% below	50%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W	$778.32	$1,556.63	—	—	50%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN WW/O	$1,188.69	$2,377.38	—	at median	50%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN WO/W	$1,188.69	$2,377.38	—	at median	50%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN WO/W	$1,188.69	$2,377.38	—	—	50%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN WW/O	$1,188.69	$2,377.38	—	—	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE WO	$1,108.25	$2,216.50	—	1% above	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L-SPINE WO	$1,108.25	$2,216.50	—	—	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE WO/	$1,035.41	$2,070.82	—	4% below	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE WO/	$1,035.41	$2,070.82	—	—	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W	$998.05	$1,996.11	—	18% below	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W	$998.05	$1,996.11	—	—	50%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 DPLX SC XCRN ART CMP	$367.65	$735.31	—	49% below	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 DPLX SC XCRN ART CMP	$367.65	$735.31	—	—	50%
Chest CT scan without and with contrast CPT 71270 CT THORAX WO/W	$1,141.82	$2,283.64	—	24% below	50%
Chest CT scan without and with contrast CPT 71270 CT THORAX WW/O	$1,141.82	$2,283.64	—	24% below	50%
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX WO/W	$1,141.82	$2,283.64	—	—	50%
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX WW/O	$1,141.82	$2,283.64	—	—	50%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS	$189.98	$379.96	—	28% below	50%
Chest X-ray, 2 views CPT 71046 CHEST 2 VWSW/FLUORO	$218.49	$436.97	—	17% below	50%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS	$189.98	$379.96	—	—	50%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VWSW/FLUORO	$218.49	$436.97	—	—	50%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW	$104.47	$208.95	—	53% below	50%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW	$104.47	$208.95	—	—	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE COMP LT	$189.98	$379.96	—	30% below	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE COMPLETE LT	$189.98	$379.96	—	30% below	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE COMPLETE RT	$189.98	$379.96	—	30% below	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE COMP RT	$189.98	$379.96	—	30% below	50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE COMPLETE RT	$189.98	$379.96	—	—	50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE COMPLETE LT	$189.98	$379.96	—	—	50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE COMP LT	$189.98	$379.96	—	—	50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE COMP RT	$189.98	$379.96	—	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERIT COMP	$315.38	$630.76	—	56% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERIT COMP	$315.38	$630.76	—	—	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BN DENSITY WO VF	$174.15	$348.30	—	62% below	50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BN DENSITY WO VF	$174.15	$348.30	—	—	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX W/O	$939.17	$1,878.34	—	at median	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX WO	$939.17	$1,878.34	—	at median	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX WO	$939.17	$1,878.34	—	—	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX W/O	$939.17	$1,878.34	—	—	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX W	$1,138.63	$2,277.26	—	6% below	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX W	$1,138.63	$2,277.26	—	—	50%
Diagnostic mammogram, both breasts CPT 77066 MAMMO DIAG BIL	$203.38	$406.77	—	43% below	50%
Diagnostic mammogram, both breasts inpatient CPT 77066 MAMMO DIAG BIL	$203.38	$406.77	—	—	50%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG UNI RT	$155.00	$310.00	—	57% below	50%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG UNI LT	$155.00	$310.00	—	57% below	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG UNI LT	$155.00	$310.00	—	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG UNI RT	$155.00	$310.00	—	—	50%
Duplex ultrasound of the leg arteries, both legs CPT 93925 DPLX SC LW EXT ART C	$367.65	$735.31	—	59% below	50%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 DPLX SC LW EXT ART C	$367.65	$735.31	—	—	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 DUPLX SCAN VEINS COM	$448.96	$897.92	—	50% below	50%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 DUPLX SCAN VEINS COM	$448.96	$897.92	—	—	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMP	$1,291.15	$2,582.30	—	24% below	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMP	$1,291.15	$2,582.30	—	—	50%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VIEW RT	$174.15	$348.30	—	33% below	50%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VIEW LT	$174.15	$348.30	—	33% below	50%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2VW RT	$174.15	$348.30	—	33% below	50%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2VW LT	$174.15	$348.30	—	33% below	50%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2VW RT	$174.15	$348.30	—	—	50%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2VW LT	$174.15	$348.30	—	—	50%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2 VIEW RT	$174.15	$348.30	—	—	50%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2 VIEW LT	$174.15	$348.30	—	—	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW COMP 3VW LT	$189.98	$379.96	—	40% below	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW COMP 3VW RT	$189.98	$379.96	—	40% below	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW 3 VIEW LT	$189.98	$379.96	—	40% below	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW 3 VIEW RT	$189.98	$379.96	—	40% below	50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW 3 VIEW LT	$189.98	$379.96	—	—	50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW COMP 3VW RT	$189.98	$379.96	—	—	50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW COMP 3VW LT	$189.98	$379.96	—	—	50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW 3 VIEW RT	$189.98	$379.96	—	—	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT SELL/ORB/IAC W/O	$800.47	$1,600.94	—	7% below	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT SELL/ORB/IAC WO	$842.27	$1,684.54	—	2% below	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC BIL W/O	$842.32	$1,684.64	—	2% below	50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT SELL/ORB/IAC W/O	$800.47	$1,600.94	—	—	50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT SELL/ORB/IAC WO	$842.27	$1,684.54	—	—	50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC BIL W/O	$842.32	$1,684.64	—	—	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES COMPLET	$152.00	$303.99	—	60% below	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES COMP	$152.00	$303.99	—	60% below	50%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES COMPLET	$152.00	$303.99	—	—	50%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES COMP	$152.00	$303.99	—	—	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM 2VW RT	$164.01	$328.03	—	40% below	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM 2 VIEW RT	$164.01	$328.03	—	40% below	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM 2 VIEW LT	$164.01	$328.03	—	40% below	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM 2VW LT	$164.01	$328.03	—	40% below	50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM 2 VIEW LT	$164.01	$328.03	—	—	50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM 2VW LT	$164.01	$328.03	—	—	50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM 2 VIEW RT	$164.01	$328.03	—	—	50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM 2VW RT	$164.01	$328.03	—	—	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HIDA SCAN INCL GB	$548.52	$1,097.04	—	65% below	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HIDA SCAN INCL GB	$548.52	$1,097.04	—	—	50%
Hand X-ray, 2 views CPT 73120 HAND 2 VW BL	$181.13	$362.25	—	32% below	50%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VIEW RT	$181.13	$362.25	—	32% below	50%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VW LT	$181.13	$362.25	—	32% below	50%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VIEW LT	$181.13	$362.25	—	32% below	50%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VW RT	$181.13	$362.25	—	32% below	50%
Hand X-ray, 2 views inpatient CPT 73120 HAND 2 VW BL	$181.13	$362.25	—	—	50%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VIEW RT	$181.13	$362.25	—	—	50%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VW RT	$181.13	$362.25	—	—	50%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VW LT	$181.13	$362.25	—	—	50%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VIEW LT	$181.13	$362.25	—	—	50%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HEEL/CALCNEOS 2 VW L	$183.66	$367.32	—	32% below	50%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HEEL/CALCANOS 2 VW R	$183.66	$367.32	—	32% below	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEUS 2VW RT	$202.63	$405.25	—	25% below	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEUS 2VW LT	$202.63	$405.25	—	25% below	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HEEL/CALCNEOS 2 VW L	$183.66	$367.32	—	—	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HEEL/CALCANOS 2 VW R	$183.66	$367.32	—	—	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCANEUS 2VW LT	$202.63	$405.25	—	—	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCANEUS 2VW RT	$202.63	$405.25	—	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGR 4+/CPAP	$2,859.93	$5,719.86	—	30% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGR 4+/CPAP	$2,859.93	$5,719.86	—	—	50%
Knee X-ray, 3 views one side CPT 73562 KNEE 3V RT	$358.44	$716.87	—	2% above	50%
Knee X-ray, 3 views one side CPT 73562 KNEE 3V LT	$358.44	$716.87	—	2% above	50%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEW LT	$358.44	$716.87	—	2% above	50%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEW RT	$358.44	$716.87	—	2% above	50%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEW RT	$358.44	$716.87	—	—	50%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3V LT	$358.44	$716.87	—	—	50%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3V RT	$358.44	$716.87	—	—	50%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEW LT	$358.44	$716.87	—	—	50%
Knee X-ray, complete, 4 or more views CPT 73564 KNEE COMPLT >4 VEW R	$214.15	$428.29	—	45% below	50%
Knee X-ray, complete, 4 or more views CPT 73564 KNEE COMPLT >4 VIW L	$214.15	$428.29	—	45% below	50%
Knee X-ray, complete, 4 or more views CPT 73564 KNEE 4 >VWS BOTH L R	$475.61	$951.21	—	21% above	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE COMP > 4 RT	$308.40	$616.81	—	21% below	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE COMP > 4 LT	$308.40	$616.81	—	21% below	50%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 KNEE COMPLT >4 VEW R	$214.15	$428.29	—	—	50%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 KNEE COMPLT >4 VIW L	$214.15	$428.29	—	—	50%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 KNEE 4 >VWS BOTH L R	$475.61	$951.21	—	—	50%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE COMP > 4 LT	$308.40	$616.81	—	—	50%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE COMP > 4 RT	$308.40	$616.81	—	—	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT W/O RT	$960.07	$1,920.14	—	2% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT W/O LT	$960.07	$1,920.14	—	2% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT WO RT	$960.07	$1,920.14	—	2% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT WO LT	$960.07	$1,920.14	—	2% above	50%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXT WO LT	$960.07	$1,920.14	—	—	50%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXT WO RT	$960.07	$1,920.14	—	—	50%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXT W/O LT	$960.07	$1,920.14	—	—	50%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXT W/O RT	$960.07	$1,920.14	—	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN	$443.29	$886.58	—	20% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$443.29	$886.58	—	20% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$443.29	$886.58	—	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHO EXAM OF ABDOMEN	$443.29	$886.58	—	—	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT NONVAS LTD RT	$207.93	$415.86	—	56% below	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT NONVAS LTD LT	$207.93	$415.86	—	56% below	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT NONVAS LTD RT	$207.93	$415.86	—	—	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT NONVAS LTD LT	$207.93	$415.86	—	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE LUNG SCR	$224.18	$448.36	—	24% below	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LOW DOSE LUNG SCR	$224.18	$448.36	—	—	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA FIBLA 2 VEW LT	$178.56	$357.13	—	35% below	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA FIBLA 2 VEW RT	$178.56	$357.13	—	35% below	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA FIBULA 2V LT	$178.56	$357.13	—	35% below	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA FIBULA 2V RT	$178.56	$357.13	—	35% below	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA FIBULA 2V RT	$178.56	$357.13	—	—	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA FIBULA 2V LT	$178.56	$357.13	—	—	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA FIBLA 2 VEW LT	$178.56	$357.13	—	—	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA FIBLA 2 VEW RT	$178.56	$357.13	—	—	50%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO	$1,202.61	$2,405.22	—	17% below	50%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O	$1,202.61	$2,405.22	—	17% below	50%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O	$1,202.61	$2,405.22	—	—	50%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO	$1,202.61	$2,405.22	—	—	50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LOW EXT JT WO BLT	$1,904.62	$3,809.23	—	9% above	50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JT L-EXT W/O BL	$1,904.93	$3,809.86	—	9% above	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LE JNT WO RT	$1,707.35	$3,414.69	—	3% below	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JT L-EXT W/O RT	$1,707.35	$3,414.69	—	3% below	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JT L-EXT W/O LT	$1,707.35	$3,414.69	—	3% below	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LE JNT WO LT	$1,707.35	$3,414.69	—	3% below	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LOW EXT JT WO BLT	$1,904.62	$3,809.23	—	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JT L-EXT W/O BL	$1,904.93	$3,809.86	—	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LE JNT WO LT	$1,707.35	$3,414.69	—	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI JT L-EXT W/O RT	$1,707.35	$3,414.69	—	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LE JNT WO RT	$1,707.35	$3,414.69	—	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI JT L-EXT W/O LT	$1,707.35	$3,414.69	—	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LE JNT W/WO RT	$1,729.50	$3,459.00	—	28% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI JT L-EXT WO/W RT	$1,729.50	$3,459.00	—	28% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI JT L-EXT WO/W LT	$1,729.50	$3,459.00	—	28% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LE JNT W/WO LT	$1,729.50	$3,459.00	—	28% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LE JNT W/WO LT	$1,729.50	$3,459.00	—	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LE JNT W/WO RT	$1,729.50	$3,459.00	—	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI JT L-EXT WO/W RT	$1,729.50	$3,459.00	—	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI JT L-EXT WO/W LT	$1,729.50	$3,459.00	—	—	50%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO	$1,604.13	$3,208.25	—	13% below	50%
MRI of the abdomen without contrast CPT 74181 MRI ABD W/O	$1,604.13	$3,208.25	—	13% below	50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABD W/O	$1,604.13	$3,208.25	—	—	50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO	$1,604.13	$3,208.25	—	—	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD WO/W	$1,861.88	$3,723.75	—	19% below	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO/W	$1,862.09	$3,724.17	—	19% below	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD WO/W	$1,861.88	$3,723.75	—	—	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO/W	$1,862.09	$3,724.17	—	—	50%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO	$1,554.72	$3,109.45	—	3% below	50%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O	$1,554.72	$3,109.45	—	3% below	50%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO	$1,554.72	$3,109.45	—	—	50%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O	$1,554.72	$3,109.45	—	—	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/W	$2,240.56	$4,481.12	—	3% above	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/W/O	$2,240.56	$4,481.12	—	3% above	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/W/O	$2,240.56	$4,481.12	—	—	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO/W	$2,240.56	$4,481.12	—	—	50%
MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O	$1,666.80	$3,333.60	—	at median	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-SPINE W/O	$1,666.80	$3,333.60	—	—	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE W/W/O	$2,212.71	$4,425.42	—	5% below	50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L-SPINE W/W/O	$2,212.71	$4,425.42	—	—	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE W/O	$1,706.10	$3,412.19	—	2% above	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T-SPINE W/O	$1,706.10	$3,412.19	—	—	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE W/W/O	$2,232.95	$4,465.91	—	1% below	50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C-SPINE W/W/O	$2,232.95	$4,465.91	—	—	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O	$1,650.34	$3,300.68	—	at median	50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-SPINE W/O	$1,650.34	$3,300.68	—	—	50%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/W	$1,477.44	$2,954.89	—	24% below	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO/W	$1,477.44	$2,954.89	—	—	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO	$1,432.48	$2,864.97	—	6% below	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O	$1,432.48	$2,864.97	—	6% below	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO	$1,432.48	$2,864.97	—	—	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O	$1,432.48	$2,864.97	—	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI JT UP EXT W/O LT	$1,718.11	$3,436.22	—	14% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPPER EXT JNT RT	$1,718.11	$3,436.22	—	14% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI JT UP EXT W/O RT	$1,718.11	$3,436.22	—	14% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPR EXT JNT LT W	$1,718.11	$3,436.22	—	14% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UPPER EXT JNT RT	$1,718.11	$3,436.22	—	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UPR EXT JNT LT W	$1,718.11	$3,436.22	—	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI JT UP EXT W/O RT	$1,718.11	$3,436.22	—	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI JT UP EXT W/O LT	$1,718.11	$3,436.22	—	—	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C SPINE 4 OR 5 VIEWS	$237.47	$474.95	—	47% below	50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 C SPINE 4 OR 5 VIEWS	$237.47	$474.95	—	—	50%
Neck soft tissue CT scan with contrast CPT 70491 CT SFT TISS/NCK W	$973.37	$1,946.73	—	18% below	50%
Neck soft tissue CT scan with contrast CPT 70491 CT SFT TISS/NECK W	$973.37	$1,946.73	—	18% below	50%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SFT TISS/NECK W	$973.37	$1,946.73	—	—	50%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SFT TISS/NCK W	$973.37	$1,946.73	—	—	50%
Neck soft tissue CT scan without contrast CPT 70490 CT SFT TISS/NECK WO	$786.54	$1,573.09	—	15% below	50%
Neck soft tissue CT scan without contrast CPT 70490 CT SFT TISS/NCK W/O	$786.54	$1,573.09	—	15% below	50%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SFT TISS/NCK W/O	$786.54	$1,573.09	—	—	50%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SFT TISS/NECK WO	$786.54	$1,573.09	—	—	50%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE	$155.16	$310.31	—	40% below	50%
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE	$155.16	$310.31	—	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM CARDIOLITE TREAD	$1,697.73	$3,395.47	—	58% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM CARDIOLITE TREAD	$1,697.73	$3,395.47	—	—	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PT W/CT SKL-THI PI	$3,842.28	$7,684.56	—	21% below	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PT W/CT SKL-THI PS	$3,842.28	$7,684.56	—	21% below	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PT W/CT SKL-THI PS	$3,842.28	$7,684.56	—	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PT W/CT SKL-THI PI	$3,842.28	$7,684.56	—	—	50%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO	$1,001.84	$2,003.68	—	at median	50%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O	$1,001.84	$2,003.68	—	at median	50%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O	$1,001.84	$2,003.68	—	—	50%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO	$1,001.84	$2,003.68	—	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS NON OB LTD	$303.33	$606.67	—	30% below	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS NON OB LTD	$303.33	$606.67	—	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS NON OB	$675.07	$1,350.14	—	34% above	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS NON OB	$675.07	$1,350.14	—	—	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 PREG UTERUS COMPLETE	$476.24	$952.47	—	21% below	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 PREG UTERUS COMPLETE	$476.24	$952.47	—	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB 1ST TRMSTR SGL	$395.50	$791.01	—	28% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB 1ST TRMSTR SGL	$395.50	$791.01	—	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LTD FETUS(S)	$142.44	$284.87	—	70% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 PREG UTERUS LIMITED	$214.15	$428.29	—	55% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LTD FETUS(S)	$142.44	$284.87	—	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 PREG UTERUS LIMITED	$214.15	$428.29	—	—	50%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNIL 2VWS LT	$147.56	$295.11	—	51% below	50%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNIL 2 VWS RT	$147.56	$295.11	—	51% below	50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNIL 2VWS LT	$147.56	$295.11	—	—	50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNIL 2 VWS RT	$147.56	$295.11	—	—	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIB W/CHST 3V UNI LT	$167.82	$335.65	—	56% below	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIB W/CHST 3V UNI RT	$167.82	$335.65	—	56% below	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIB W/CHST 3V UNI LT	$167.82	$335.65	—	—	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIB W/CHST 3V UNI RT	$167.82	$335.65	—	—	50%
Screening mammogram, both breasts both sides CPT 77067 MAMM SCRN BILAT CAD	$196.07	$392.14	—	—	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMM SCRN BILAT CAD	$196.07	$392.14	—	—	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER COMP RT	$237.47	$474.95	—	30% below	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER COMPLETE RT	$237.47	$474.95	—	30% below	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER COMPLETE LT	$237.47	$474.95	—	30% below	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER COMP LT	$237.47	$474.95	—	30% below	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER COMP LT	$237.47	$474.95	—	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER COMPLETE RT	$237.47	$474.95	—	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER COMP RT	$237.47	$474.95	—	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER COMPLETE LT	$237.47	$474.95	—	—	50%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUS PARA COMPLETE	$216.57	$433.15	—	40% below	50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUS PARA COMPLETE	$216.57	$433.15	—	—	50%
Skull X-ray, fewer than 4 views CPT 70250 SKULL < 4VWS	$214.15	$428.29	—	26% below	50%
Skull X-ray, fewer than 4 views CPT 70250 SKULL <4	$214.15	$428.29	—	26% below	50%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL <4	$214.15	$428.29	—	—	50%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL < 4VWS	$214.15	$428.29	—	—	50%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY 4 +	$2,557.84	$5,115.69	—	29% below	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY 4 +	$2,557.84	$5,115.69	—	—	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOW FUNC W/VIDEO	$214.15	$428.29	—	58% below	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOW FUNC W/VIDEO	$214.15	$428.29	—	—	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR LT 2+ VIEWS	$79.16	$158.32	—	71% below	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR RT 2+ VIEWS	$79.16	$158.32	—	71% below	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR 2+ VIEW LT	$113.72	$227.44	—	58% below	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR 2+ VIEW RT	$113.72	$227.44	—	58% below	50%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR RT 2+ VIEWS	$79.16	$158.32	—	—	50%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR LT 2+ VIEWS	$79.16	$158.32	—	—	50%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR 2+ VIEW LT	$113.72	$227.44	—	—	50%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR 2+ VIEW RT	$113.72	$227.44	—	—	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T-SPINE W/O	$853.03	$1,706.07	—	6% below	50%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT T-SPINE W/O	$853.03	$1,706.07	—	—	50%
Toe X-ray, 2 or more views one side CPT 73660 TOE 2 VIEW LT	$174.15	$348.30	—	30% below	50%
Toe X-ray, 2 or more views one side CPT 73660 TOE (S) >2 LT	$174.15	$348.30	—	30% below	50%
Toe X-ray, 2 or more views one side CPT 73660 TOE 2 VIEW RT	$174.15	$348.30	—	30% below	50%
Toe X-ray, 2 or more views one side CPT 73660 TOE (S) >2 RT	$174.15	$348.30	—	30% below	50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE 2 VIEW RT	$174.15	$348.30	—	—	50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE 2 VIEW LT	$174.15	$348.30	—	—	50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE (S) >2 RT	$174.15	$348.30	—	—	50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE (S) >2 LT	$174.15	$348.30	—	—	50%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$577.57	$1,155.14	—	2% above	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$577.57	$1,155.14	—	—	50%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL	$241.78	$483.57	—	52% below	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL	$241.78	$483.57	—	—	50%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$538.28	$1,076.56	—	14% below	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$538.28	$1,076.56	—	—	50%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM & CONT	$523.73	$1,047.46	—	2% below	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM & CONT	$523.73	$1,047.46	—	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$570.60	$1,141.19	—	at median	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID	$570.60	$1,141.19	—	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W/WO DLAY WO KUB	$545.25	$1,090.51	—	8% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W/WO DELAY KUB	$692.81	$1,385.62	—	17% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W/SMALL BOWEL	$835.29	$1,670.59	—	41% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W/WO DLAY WO KUB	$545.25	$1,090.51	—	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W/WO DELAY KUB	$692.81	$1,385.62	—	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W/SMALL BOWEL	$835.29	$1,670.59	—	—	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS 2VW RT	$136.79	$273.58	—	50% below	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS 2 VIEW RT	$136.79	$273.58	—	50% below	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS 2 VIEW LT	$136.79	$273.58	—	50% below	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS 2VW LT	$136.79	$273.58	—	50% below	50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS 2 VIEW LT	$136.79	$273.58	—	—	50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS 2 VIEW RT	$136.79	$273.58	—	—	50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS 2VW LT	$136.79	$273.58	—	—	50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS 2VW RT	$136.79	$273.58	—	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLX SCAN VEINS UNI	$284.19	$568.38	—	61% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLX SCAN VEINS UNI	$284.19	$568.38	—	—	50%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VIEW RT	$139.95	$279.90	—	46% below	50%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VIEW LT	$139.95	$279.90	—	46% below	50%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2VW LT	$139.95	$279.90	—	46% below	50%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2VW RT	$139.95	$279.90	—	46% below	50%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2VW LT	$139.95	$279.90	—	—	50%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2 VIEW LT	$139.95	$279.90	—	—	50%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2 VIEW RT	$139.95	$279.90	—	—	50%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2VW RT	$139.95	$279.90	—	—	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST COMP >3VW RT	$169.08	$338.16	—	49% below	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST COMP >3VW LT	$169.08	$338.16	—	49% below	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST COMP >3VW RT	$169.08	$338.16	—	—	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST COMP >3VW LT	$169.08	$338.16	—	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP PINNING 2-3 LT	$113.72	$227.44	—	63% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP LT 2-3	$113.72	$227.44	—	63% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP RT 2-3	$113.72	$227.44	—	63% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP PINNING 2-3 RT	$113.72	$227.44	—	63% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2-3 RT	$113.72	$227.44	—	63% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2-3 LT	$113.72	$227.44	—	63% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP RT 2-3	$113.72	$227.44	—	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2-3 RT	$113.72	$227.44	—	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2-3 LT	$113.72	$227.44	—	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP PINNING 2-3 LT	$113.72	$227.44	—	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP LT 2-3	$113.72	$227.44	—	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP PINNING 2-3 RT	$113.72	$227.44	—	—	50%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN KUB 1 VW	$146.93	$293.85	—	43% below	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN KUB 1 VW	$146.93	$293.85	—	—	50%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEW RT	$142.49	$284.97	—	43% below	50%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEW LT	$142.49	$284.97	—	43% below	50%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2V LT	$142.49	$284.97	—	43% below	50%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2V RT	$142.49	$284.97	—	43% below	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2V LT	$142.49	$284.97	—	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEW RT	$142.49	$284.97	—	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEW LT	$142.49	$284.97	—	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2V RT	$142.49	$284.97	—	—	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER 2 VIEW RT	$174.15	$348.30	—	32% below	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER 2 VIEW LT	$174.15	$348.30	—	32% below	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER 2VW RT	$174.15	$348.30	—	32% below	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER 2VW LT	$174.15	$348.30	—	32% below	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER 2 VIEW LT	$174.15	$348.30	—	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER 2VW LT	$174.15	$348.30	—	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER 2VW RT	$174.15	$348.30	—	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER 2 VIEW RT	$174.15	$348.30	—	—	50%
X-ray of the foot, 2 views CPT 73620 FOOT 2V BL	$152.62	$305.24	—	34% below	50%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2V RT	$152.62	$305.24	—	34% below	50%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2V LT	$152.62	$305.24	—	34% below	50%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEW RT	$152.62	$305.24	—	34% below	50%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEW LT	$152.62	$305.24	—	34% below	50%
X-ray of the foot, 2 views inpatient CPT 73620 FOOT 2V BL	$152.62	$305.24	—	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VIEW LT	$152.62	$305.24	—	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VIEW RT	$152.62	$305.24	—	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2V LT	$152.62	$305.24	—	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2V RT	$152.62	$305.24	—	—	50%
X-ray of the foot, complete, 3 or more views CPT 73630 FOOT COMP 3V BL	$177.94	$355.87	—	42% below	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT COMPLETE >3 RT	$177.94	$355.87	—	42% below	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT COMP >3 LT	$177.94	$355.87	—	42% below	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT COMP >3 RT	$177.94	$355.87	—	42% below	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT COMPLETE >3 LT	$177.94	$355.87	—	42% below	50%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT COMP 3V BL	$177.94	$355.87	—	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT COMPLETE >3 RT	$177.94	$355.87	—	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT COMPLETE >3 LT	$177.94	$355.87	—	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT COMP >3 RT	$177.94	$355.87	—	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT COMP >3 LT	$177.94	$355.87	—	—	50%
X-ray of the hand, 3 or more views one side CPT 73130 HAND 3 VW RT	$169.08	$338.16	—	48% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 HAND 3 VIEW LT	$169.08	$338.16	—	48% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 HAND 3 VW LT	$169.08	$338.16	—	48% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 HAND 3 VIEW RT	$169.08	$338.16	—	48% below	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND 3 VIEW LT	$169.08	$338.16	—	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND 3 VIEW RT	$169.08	$338.16	—	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND 3 VW LT	$169.08	$338.16	—	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND 3 VW RT	$169.08	$338.16	—	—	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1-2 VIEW LT	$234.94	$469.88	—	14% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1-2 VIEW RT	$234.94	$469.88	—	14% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1-2VW LT	$234.94	$469.88	—	14% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1-2VW RT	$234.94	$469.88	—	14% below	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1-2 VIEW RT	$234.94	$469.88	—	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1-2VW LT	$234.94	$469.88	—	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1-2VW RT	$234.94	$469.88	—	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1-2 VIEW LT	$234.94	$469.88	—	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LS SPINE 2 OR 3 V	$214.15	$428.29	—	34% below	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LS SPINE 2 OR 3 V	$214.15	$428.29	—	—	50%
X-ray of the lower back, 4 or more views CPT 72110 LS SPINE 4VW >	$227.34	$454.68	—	52% below	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LS SPINE 4VW >	$227.34	$454.68	—	—	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2 VW	$174.15	$348.30	—	42% below	50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2 VW	$174.15	$348.30	—	—	50%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES COMP	$174.15	$348.30	—	40% below	50%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES COMPLETE	$174.15	$348.30	—	40% below	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES COMPLETE	$174.15	$348.30	—	—	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES COMP	$174.15	$348.30	—	—	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERV SPINE 3VW >LESS	$205.81	$411.63	—	38% below	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 2-3 V	$267.24	$534.47	—	20% below	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERV SPINE 3VW >LESS	$205.81	$411.63	—	—	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 2-3 V	$267.24	$534.47	—	—	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS AP ONLY	$143.12	$286.23	—	43% below	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS AP ONLY	$143.12	$286.23	—	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM & COCCYX	$120.31	$240.61	—	59% below	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM/COCCYX	$120.31	$240.61	—	59% below	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM/COCCYX	$120.31	$240.61	—	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM & COCCYX	$120.31	$240.61	—	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
ACTH blood test CPT 82024 ACTH, PLASMA (RIA)	$106.65	$213.30	—	19% below	50%
ACTH blood test inpatient CPT 82024 ACTH, PLASMA (RIA)	$106.65	$213.30	—	—	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SGPT	$14.55	$29.10	—	48% below	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SGPT	$14.55	$29.10	—	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT	$13.93	$27.85	—	45% below	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT	$13.93	$27.85	—	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEP PANEL	$184.22	$368.45	—	15% below	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEP PANEL	$184.22	$368.45	—	—	50%
Albumin blood test CPT 82040 ALBUMIN, SERUM	$13.32	$26.65	—	40% below	50%
Albumin blood test CPT 82040 ISRP ALBUMIN SERUM	$16.35	$32.70	—	26% below	50%
Albumin blood test inpatient CPT 82040 ALBUMIN, SERUM	$13.32	$26.65	—	—	50%
Albumin blood test inpatient CPT 82040 ISRP ALBUMIN SERUM	$16.35	$32.70	—	—	50%
Aldosterone blood test CPT 82088 ALDOSTERONE	$121.38	$242.75	—	13% below	50%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$121.38	$242.75	—	—	50%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$17.55	$35.10	—	27% below	50%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$17.55	$35.10	—	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE	$15.75	$31.50	—	33% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE EACH	$15.75	$31.50	—	33% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE EA	$18.18	$36.35	—	22% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ICU R&B	$2,000.00	$4,000.00	—	8447% above	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE EACH	$15.75	$31.50	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLG SPEC IGE CRUDE	$15.75	$31.50	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE EA	$18.18	$36.35	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ICU R&B	$2,000.00	$4,000.00	—	—	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROT SER	$55.15	$110.30	—	9% below	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROT SER	$55.15	$110.30	—	—	50%
Ammonia blood test CPT 82140 AMMONIA	$41.20	$82.40	—	25% below	50%
Ammonia blood test inpatient CPT 82140 AMMONIA	$41.20	$82.40	—	—	50%
Amylase blood test CPT 82150 AMYLASE BODY FLUID	$12.13	$24.25	—	75% below	50%
Amylase blood test CPT 82150 AMYLASE	$35.15	$70.30	—	27% below	50%
Amylase blood test CPT 82150 URINE AMYLASE	$39.40	$78.80	—	18% below	50%
Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID	$12.13	$24.25	—	—	50%
Amylase blood test inpatient CPT 82150 AMYLASE	$35.15	$70.30	—	—	50%
Amylase blood test inpatient CPT 82150 URINE AMYLASE	$39.40	$78.80	—	—	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP AB	$40.65	$81.30	—	30% below	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP AB	$40.65	$81.30	—	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI CENTROMERE ANA	$33.15	$66.30	—	40% below	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$84.65	$169.30	—	53% above	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI CENTROMERE ANA	$33.15	$66.30	—	—	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$84.65	$169.30	—	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B NATRIURETIC PEPTID	$66.65	$133.30	—	55% below	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B NATRIURETIC PEPTID	$66.65	$133.30	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT-ROUTINE	$22.05	$44.10	—	67% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 PRESUMPTIVE ID AEROB	$32.65	$65.30	—	51% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT-EAR	$53.30	$106.60	—	19% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT-CERVIX/UTERUS	$53.30	$106.60	—	19% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT-STERILE BDY FLU	$53.30	$106.60	—	19% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT-WOUND/ABSCESS	$53.30	$106.60	—	19% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT-OTH SOURCE	$53.30	$106.60	—	19% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT-TISSUE	$53.30	$106.60	—	19% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT-RESPIRATORY	$53.30	$106.60	—	19% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT-NASAL	$53.30	$106.60	—	19% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT-CATHETER TIP	$53.30	$106.60	—	19% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT-EYE	$53.30	$106.60	—	19% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT THROAT OR NOSE	$53.30	$106.60	—	19% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT-CSF	$62.65	$125.30	—	5% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT-ENVIRONMENTAL	$71.35	$142.70	—	8% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT-ROUTINE	$22.05	$44.10	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 PRESUMPTIVE ID AEROB	$32.65	$65.30	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT-CATHETER TIP	$53.30	$106.60	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT-WOUND/ABSCESS	$53.30	$106.60	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT THROAT OR NOSE	$53.30	$106.60	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT-EAR	$53.30	$106.60	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT-EYE	$53.30	$106.60	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT-NASAL	$53.30	$106.60	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT-RESPIRATORY	$53.30	$106.60	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT-TISSUE	$53.30	$106.60	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT-CERVIX/UTERUS	$53.30	$106.60	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT-OTH SOURCE	$53.30	$106.60	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT-STERILE BDY FLU	$53.30	$106.60	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT-CSF	$62.65	$125.30	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT-ENVIRONMENTAL	$71.35	$142.70	—	—	50%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANE	$56.35	$112.70	—	14% below	50%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANE	$56.35	$112.70	—	—	50%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$12.13	$24.25	—	49% below	50%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$12.13	$24.25	—	—	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEV IV	$152.60	$305.20	—	25% below	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH LEV IV	$152.60	$305.20	—	—	50%
Blood culture for bacteria CPT 87040 CULT-BLOOD	$64.00	$128.00	—	32% below	50%
Blood culture for bacteria inpatient CPT 87040 CULT-BLOOD	$64.00	$128.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$14.65	$29.30	—	8% below	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$14.65	$29.30	—	—	50%
Blood glucose (sugar) test CPT 82947 GLUCOSE 2HR PP	$9.97	$19.95	—	58% below	50%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT	$16.35	$32.70	—	31% below	50%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE 2HR PP	$9.97	$19.95	—	—	50%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT	$16.35	$32.70	—	—	50%
Blood lead test CPT 83655 LEAD	$33.95	$67.90	—	30% below	50%
Blood lead test inpatient CPT 83655 LEAD	$33.95	$67.90	—	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SERUM QUAL	$38.17	$76.35	—	30% below	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG SERUM QUAL	$38.17	$76.35	—	—	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO BLOOD TYPE	$72.70	$145.40	—	22% above	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO BLOOD TYPE	$72.70	$145.40	—	—	50%
Blood urea nitrogen (BUN) test CPT 84520 BUN	$13.32	$26.65	—	43% below	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$13.32	$26.65	—	—	50%
C-peptide blood test CPT 84681 C-PEPTIDE	$51.92	$103.85	—	34% below	50%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$51.92	$103.85	—	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$29.98	$59.95	—	40% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP	$29.98	$59.95	—	—	50%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PRB	$90.97	$181.95	—	30% below	50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PRB	$90.97	$181.95	—	—	50%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$39.23	$78.45	—	46% below	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$39.23	$78.45	—	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$54.00	$108.00	—	42% below	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$54.00	$108.00	—	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19	$196.95	$393.90	—	40% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19	$196.95	$393.90	—	—	50%
Calcium blood test, total CPT 82310 CALCIUM	$16.95	$33.90	—	46% below	50%
Calcium blood test, total CPT 82310 CALCIUM RANDOM URINE	$16.95	$33.90	—	46% below	50%
Calcium blood test, total inpatient CPT 82310 CALCIUM	$16.95	$33.90	—	—	50%
Calcium blood test, total inpatient CPT 82310 CALCIUM RANDOM URINE	$16.95	$33.90	—	—	50%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$64.83	$129.65	—	25% below	50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$64.83	$129.65	—	—	50%
Chickenpox (varicella) immunity blood test CPT 86787 AB VARICELLA ZOSTER	$49.33	$98.65	—	15% below	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 AB VARICELLA ZOSTER	$49.33	$98.65	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AMP PROBE	$96.25	$192.50	—	4% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAM/GC/TRICHOMONAS	$210.65	$421.30	—	128% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA AMP PROBE	$96.25	$192.50	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAM/GC/TRICHOMONAS	$210.65	$421.30	—	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$38.77	$77.55	—	27% below	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIO IQ ADV. LIPID	$76.97	$153.95	—	45% above	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$38.77	$77.55	—	—	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARDIO IQ ADV. LIPID	$76.97	$153.95	—	—	50%
Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO DIFF	$37.27	$74.55	—	2% above	50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO DIFF	$37.27	$74.55	—	—	50%
Complete blood count (CBC), no differential CPT 85027 CBC AUTO W/PLT WO/DF	$22.73	$45.45	—	33% below	50%
Complete blood count (CBC), no differential CPT 85027 CWMDP CBC W/O DIFF	$23.35	$46.70	—	31% below	50%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTO W/PLT WO/DF	$22.73	$45.45	—	—	50%
Complete blood count (CBC), no differential inpatient CPT 85027 CWMDP CBC W/O DIFF	$23.35	$46.70	—	—	50%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$111.50	$223.00	—	75% above	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$111.50	$223.00	—	—	50%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$49.08	$98.15	—	32% below	50%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$49.08	$98.15	—	—	50%
Creatine kinase (CK) blood test, total CPT 82550 CPK	$19.40	$38.80	—	45% below	50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK	$19.40	$38.80	—	—	50%
Creatinine blood test CPT 82565 CREATININE POC	$14.55	$29.10	—	41% below	50%
Creatinine blood test CPT 82565 CREATININE BLOOD	$14.55	$29.10	—	41% below	50%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$14.55	$29.10	—	—	50%
Creatinine blood test inpatient CPT 82565 CREATININE POC	$14.55	$29.10	—	—	50%
Cytomegalovirus (CMV) antibody test CPT 86644 AB CMV	$39.48	$78.95	—	43% below	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 AB CMV	$39.48	$78.95	—	—	50%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT	$54.35	$108.70	—	22% below	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANT	$54.35	$108.70	—	—	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$55.45	$110.90	—	44% below	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$55.45	$110.90	—	—	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 FENTANYL URINE QUAL	$36.35	$72.70	—	62% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COCAINE QUANT	$45.42	$90.85	—	52% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE DRUG S OR M	$57.58	$115.15	—	40% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BENZODIAZEPINES	$57.58	$115.15	—	40% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OXYCODONE CONFIRM	$76.35	$152.70	—	20% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN BLOOD	$128.75	$257.50	—	35% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG PANEL 10 URINE	$128.75	$257.50	—	35% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BUPREN & METAB SCRN	$189.68	$379.35	—	99% above	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FENTANYL URINE QUAL	$36.35	$72.70	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 COCAINE QUANT	$45.42	$90.85	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BENZODIAZEPINES	$57.58	$115.15	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE DRUG S OR M	$57.58	$115.15	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OXYCODONE CONFIRM	$76.35	$152.70	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN BLOOD	$128.75	$257.50	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG PANEL 10 URINE	$128.75	$257.50	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BUPREN & METAB SCRN	$189.68	$379.35	—	—	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$39.40	$78.80	—	17% below	50%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$39.40	$78.80	—	—	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV IGG/IGM	$41.98	$83.95	—	35% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID IGM	$46.67	$93.35	—	28% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID	$46.67	$93.35	—	28% below	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV IGG/IGM	$41.98	$83.95	—	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID IGM	$46.67	$93.35	—	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID	$46.67	$93.35	—	—	50%
Estradiol blood test CPT 82670 ESTRADIOL	$79.38	$158.75	—	29% below	50%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$79.38	$158.75	—	—	50%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$46.33	$92.65	—	46% below	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$46.33	$92.65	—	—	50%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN	$110.90	$221.80	—	26% below	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN	$110.90	$221.80	—	—	50%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$38.77	$77.55	—	49% below	50%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$38.77	$77.55	—	—	50%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$37.90	$75.80	—	16% below	50%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$37.90	$75.80	—	—	50%
Folate (folic acid) blood test CPT 82746 FOLIC ACID, SERUM	$52.70	$105.40	—	22% below	50%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID, SERUM	$52.70	$105.40	—	—	50%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$81.83	$163.65	—	8% above	50%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$81.83	$163.65	—	—	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$32.70	$65.40	—	23% below	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$32.70	$65.40	—	—	50%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$76.97	$153.95	—	21% below	50%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$76.97	$153.95	—	—	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$16.35	$32.70	—	62% below	50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$16.35	$32.70	—	—	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$207.88	$415.75	—	6% below	50%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$207.88	$415.75	—	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST DOSE	$16.35	$32.70	—	57% below	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST DOSE	$16.35	$32.70	—	—	50%
Glucose tolerance test, 3 samples CPT 82951 GTT UP TO 3 SPEC	$60.60	$121.20	—	10% below	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT UP TO 3 SPEC	$60.60	$121.20	—	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC AMP PROBE	$75.30	$150.60	—	19% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC AMP PROBE	$75.30	$150.60	—	—	50%
H. pylori antibody blood test CPT 86677 AB HELICOBACTER PYLO	$44.67	$89.35	—	41% below	50%
H. pylori antibody blood test inpatient CPT 86677 AB HELICOBACTER PYLO	$44.67	$89.35	—	—	50%
H. pylori stool antigen test CPT 87338 H PYLORI AG	$61.98	$123.95	—	11% below	50%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI AG	$61.98	$123.95	—	—	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 VIRAL LOAD	$289.30	$578.60	—	19% below	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 VIRAL LOAD	$289.30	$578.60	—	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG HIV1&2 AB A	$55.52	$111.05	—	25% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG HIV1&2 AB A	$55.52	$111.05	—	—	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 PAPILLOMA HUMAN PCR	$63.33	$126.65	—	47% below	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 PAPILLOMA HUMAN PCR	$63.33	$126.65	—	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCAT	$43.02	$86.05	—	6% below	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCAT	$43.02	$86.05	—	—	50%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$15.80	$31.60	—	2% below	50%
Hemoglobin blood test CPT 85018 BLD COUNT HEMOGLOBIN	$16.52	$33.05	—	2% above	50%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$15.80	$31.60	—	—	50%
Hemoglobin blood test inpatient CPT 85018 BLD COUNT HEMOGLOBIN	$16.52	$33.05	—	—	50%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTAL	$23.30	$46.60	—	57% below	50%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS PANEL 8	$41.98	$83.95	—	22% below	50%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB TOTAL	$23.30	$46.60	—	—	50%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS PANEL 8	$41.98	$83.95	—	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB	$29.45	$58.90	—	39% below	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB	$29.45	$58.90	—	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG	$47.33	$94.65	—	at median	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG	$47.33	$94.65	—	—	50%
Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB	$54.00	$108.00	—	16% below	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB	$54.00	$108.00	—	—	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C VIRAL RNA GTYP	$101.33	$202.65	—	47% below	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA PRB PCR QT	$436.63	$873.25	—	127% above	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C VIRAL RNA GTYP	$101.33	$202.65	—	—	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C RNA PRB PCR QT	$436.63	$873.25	—	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 AB HERPES TYPE I	$45.15	$90.30	—	24% below	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 AB HERPES TYPE I	$45.15	$90.30	—	—	50%
Herpes blood test, HSV-2 antibody CPT 86696 AB HERPES TYPE II	$36.65	$73.30	—	45% below	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 AB HERPES TYPE II	$36.65	$73.30	—	—	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENS	$54.65	$109.30	—	19% below	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENS	$54.65	$109.30	—	—	50%
Homocysteine blood test CPT 83090 HOMOCYSTINE QUANT	$93.33	$186.65	—	16% above	50%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE QUANT	$93.33	$186.65	—	—	50%
Insulin blood test CPT 83525 INSULIN TOTAL	$36.35	$72.70	—	29% below	50%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$36.35	$72.70	—	—	50%
Iron blood test (serum iron) CPT 83540 IRON	$26.07	$52.15	—	31% below	50%
Iron blood test (serum iron) CPT 83540 IRON LIVER TISSUE	$231.50	$463.00	—	509% above	50%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$26.07	$52.15	—	—	50%
Iron blood test (serum iron) inpatient CPT 83540 IRON LIVER TISSUE	$231.50	$463.00	—	—	50%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDNG CAPACITY	$27.88	$55.75	—	29% below	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDNG CAPACITY	$27.88	$55.75	—	—	50%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$90.30	$180.60	—	26% above	50%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$90.30	$180.60	—	—	50%
LH (luteinizing hormone) test CPT 83002 LH	$46.17	$92.35	—	52% below	50%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$46.17	$92.35	—	—	50%
Lactate (lactic acid) blood test CPT 83605 LACTATE BODY FLD	$26.65	$53.30	—	49% below	50%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$26.65	$53.30	—	49% below	50%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$26.65	$53.30	—	—	50%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE BODY FLD	$26.65	$53.30	—	—	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH SERUM	$23.02	$46.05	—	16% below	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH BODY FLUID	$23.02	$46.05	—	16% below	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH SERUM	$23.02	$46.05	—	—	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH BODY FLUID	$23.02	$46.05	—	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE-BODY FLUID	$17.18	$34.35	—	70% below	50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$33.95	$67.90	—	42% below	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE-BODY FLUID	$17.18	$34.35	—	—	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$33.95	$67.90	—	—	50%
Liver function blood test panel CPT 80076 HEPATIC FUNCT PANEL	$72.10	$144.20	—	19% above	50%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCT PANEL	$72.10	$144.20	—	—	50%
Lyme disease antibody test CPT 86618 AB LYME DISEASE	$54.65	$109.30	—	29% below	50%
Lyme disease antibody test inpatient CPT 86618 AB LYME DISEASE	$54.65	$109.30	—	—	50%
Magnesium blood test CPT 83735 MAGNESIUM SERUM	$26.07	$52.15	—	23% below	50%
Magnesium blood test CPT 83735 MAGNESIUM OTH SRC	$29.07	$58.15	—	14% below	50%
Magnesium blood test inpatient CPT 83735 MAGNESIUM SERUM	$26.07	$52.15	—	—	50%
Magnesium blood test inpatient CPT 83735 MAGNESIUM OTH SRC	$29.07	$58.15	—	—	50%
Measles (rubeola) antibody test CPT 86765 RUBEOLA SCREEN	$35.33	$70.65	—	38% below	50%
Measles (rubeola) antibody test CPT 86765 RUBEOLA TITER	$44.67	$89.35	—	22% below	50%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA SCREEN	$35.33	$70.65	—	—	50%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA TITER	$44.67	$89.35	—	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREEN	$47.33	$94.65	—	11% below	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SCREEN	$47.33	$94.65	—	—	50%
Mumps immunity blood test CPT 86735 AB MUMPS IGG	$35.77	$71.55	—	39% below	50%
Mumps immunity blood test CPT 86735 AB MUMPS IGM	$35.77	$71.55	—	39% below	50%
Mumps immunity blood test inpatient CPT 86735 AB MUMPS IGG	$35.77	$71.55	—	—	50%
Mumps immunity blood test inpatient CPT 86735 AB MUMPS IGM	$35.77	$71.55	—	—	50%
Obstetric blood test panel CPT 80055 OB PANEL W/BB ID	$75.75	$151.50	—	65% below	50%
Obstetric blood test panel inpatient CPT 80055 OB PANEL W/BB ID	$75.75	$151.50	—	—	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$45.85	$91.70	—	44% below	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$45.85	$91.70	—	—	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$54.08	$108.15	—	32% below	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$54.08	$108.15	—	—	50%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP THN PRP W/MN SCR	$75.67	$151.35	—	22% below	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP THN PRP W/MN SCR	$75.67	$151.35	—	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP-THIN PREP DIAG	$60.27	$120.55	—	34% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP-THIN PREP DIAG	$60.27	$120.55	—	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$83.63	$167.25	—	41% below	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$83.63	$167.25	—	—	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$30.95	$61.90	—	18% below	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$30.95	$61.90	—	—	50%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS INORG	$20.60	$41.20	—	42% below	50%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS INORG	$20.60	$41.20	—	—	50%
Potassium blood test CPT 84132 POTASSIUM SERUM	$12.72	$25.45	—	46% below	50%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$12.72	$25.45	—	—	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHRMOML ANEUPL	$1,150.08	$2,300.15	—	21% below	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 FETAL CHRMOML ANEUPL	$1,150.08	$2,300.15	—	—	50%
Progesterone blood test CPT 84144 PROGESTERONE FREE	$46.60	$93.20	—	42% below	50%
Progesterone blood test CPT 84144 PROGESTERONE	$47.77	$95.55	—	41% below	50%
Progesterone blood test inpatient CPT 84144 PROGESTERONE FREE	$46.60	$93.20	—	—	50%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$47.77	$95.55	—	—	50%
Prolactin blood test CPT 84146 PROLACTIN	$33.95	$67.90	—	61% below	50%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$33.95	$67.90	—	—	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME INR	$18.32	$36.65	—	24% below	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PT	$18.32	$36.65	—	24% below	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT	$18.32	$36.65	—	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME INR	$18.32	$36.65	—	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE DRUG SCRN W CO	$73.92	$147.85	—	28% above	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE DRUG SCRN W CO	$73.92	$147.85	—	—	50%
Rapid flu test (influenza antigen) CPT 87804 INFLU DIRCT OPTCL OB	$41.15	$82.30	—	37% below	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLU DIRCT OPTCL OB	$41.15	$82.30	—	—	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP DIR OPT OBS	$38.00	$76.00	—	34% below	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP DIR OPT OBS	$38.00	$76.00	—	—	50%
Renin blood test CPT 84244 RENIN	$51.50	$103.00	—	40% below	50%
Renin blood test inpatient CPT 84244 RENIN	$51.50	$103.00	—	—	50%
Rh blood typing CPT 86901 RH TYPE	$42.42	$84.85	—	14% above	50%
Rh blood typing inpatient CPT 86901 RH TYPE	$42.42	$84.85	—	—	50%
Rheumatoid factor (RF) test CPT 86431 RA FACTOR QUANT	$46.67	$93.35	—	41% above	50%
Rheumatoid factor (RF) test inpatient CPT 86431 RA FACTOR QUANT	$46.67	$93.35	—	—	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA TITER	$39.48	$78.95	—	20% below	50%
Rubella antibody test (immunity check) CPT 86762 AB RUBELLA IGM	$49.98	$99.95	—	2% above	50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA TITER	$39.48	$78.95	—	—	50%
Rubella antibody test (immunity check) inpatient CPT 86762 AB RUBELLA IGM	$49.98	$99.95	—	—	50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR AUTOMATED	$6.95	$13.90	—	82% below	50%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR AUTOMATED	$6.95	$13.90	—	—	50%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANAL COMPLETE	$68.47	$136.95	—	49% below	50%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANAL COMPLETE	$68.47	$136.95	—	—	50%
Sodium blood test CPT 84295 SODIUM SERUM	$15.15	$30.30	—	44% below	50%
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$15.15	$30.30	—	—	50%
Stool ova and parasites exam CPT 87177 O&P EXAM	$69.97	$139.95	—	76% above	50%
Stool ova and parasites exam inpatient CPT 87177 O&P EXAM	$69.97	$139.95	—	—	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCC BLOOD FECES	$18.80	$37.60	—	35% below	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCC BLOOD FECES	$18.80	$37.60	—	—	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSY TEST BLOODFECAL	$38.05	$76.10	—	29% below	50%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 ASSY TEST BLOODFECAL	$38.05	$76.10	—	—	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 AB FTA	$36.30	$72.60	—	37% below	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 AB FTA	$36.30	$72.60	—	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUAL	$30.68	$61.35	—	29% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-CSF	$30.68	$61.35	—	29% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL-CSF	$30.68	$61.35	—	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR QUAL	$30.68	$61.35	—	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON	$170.03	$340.05	—	45% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON	$170.03	$340.05	—	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$59.38	$118.75	—	36% below	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$59.38	$118.75	—	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 AB THYROID PEROXIDAS	$34.67	$69.35	—	47% below	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 AB MICROSOMAL EA	$39.90	$79.80	—	39% below	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICR AB	$42.65	$85.30	—	34% below	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 AB LIVER/KIDNEY EACH	$72.00	$144.00	—	11% above	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 AB THYROID PEROXIDAS	$34.67	$69.35	—	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 AB MICROSOMAL EA	$39.90	$79.80	—	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICR AB	$42.65	$85.30	—	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 AB LIVER/KIDNEY EACH	$72.00	$144.00	—	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$60.60	$121.20	—	19% below	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$60.60	$121.20	—	—	50%
Total IgE blood test CPT 82785 IGE	$60.00	$120.00	—	3% below	50%
Total IgE blood test inpatient CPT 82785 IGE	$60.00	$120.00	—	—	50%
Total cholesterol blood test CPT 82465 CHOLESTEROL, SERUM	$12.72	$25.45	—	65% below	50%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL, SERUM	$12.72	$25.45	—	—	50%
Total thyroxine (T4) blood test CPT 84436 T4 TOTAL	$32.13	$64.25	—	23% below	50%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 TOTAL	$32.13	$64.25	—	—	50%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$52.10	$104.20	—	13% below	50%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$52.10	$104.20	—	—	50%
Transferrin blood test CPT 84466 TRANSFERRIN	$36.35	$72.70	—	51% below	50%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$36.35	$72.70	—	—	50%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS TMA	$148.65	$297.30	—	72% above	50%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS TMA	$148.65	$297.30	—	—	50%
Triglycerides blood test CPT 84478 TRIGLYCERIDE	$20.60	$41.20	—	40% below	50%
Triglycerides blood test CPT 84478 VCP TRIGLYCERIDES	$32.13	$64.25	—	7% below	50%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE	$20.60	$41.20	—	—	50%
Triglycerides blood test inpatient CPT 84478 VCP TRIGLYCERIDES	$32.13	$64.25	—	—	50%
Troponin test, quantitative CPT 84484 HIGH SENS TROPONIN	$46.30	$92.60	—	45% below	50%
Troponin test, quantitative CPT 84484 TROPONIN QUANT	$48.48	$96.95	—	42% below	50%
Troponin test, quantitative inpatient CPT 84484 HIGH SENS TROPONIN	$46.30	$92.60	—	—	50%
Troponin test, quantitative inpatient CPT 84484 TROPONIN QUANT	$48.48	$96.95	—	—	50%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$22.43	$44.85	—	36% below	50%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$22.43	$44.85	—	—	50%
Urinalysis with microscope exam, automated CPT 81001 UA AUTO W MICRO	$20.65	$41.30	—	24% below	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA AUTO W MICRO	$20.65	$41.30	—	—	50%
Urinalysis without microscope exam, automated CPT 81003 UA DIPSTICK	$4.03	$8.05	—	83% below	50%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO M	$18.00	$36.00	—	23% below	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA DIPSTICK	$4.03	$8.05	—	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO M	$18.00	$36.00	—	—	50%
Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTICK	$24.02	$48.05	—	48% above	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTICK	$24.02	$48.05	—	—	50%
Urine culture for bacteria, with colony count CPT 87086 CULT-URINE CC	$44.67	$89.35	—	21% below	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT-URINE CC	$44.67	$89.35	—	—	50%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMN QUANT UA	$23.02	$46.05	—	55% below	50%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMN QUANT UA	$23.02	$46.05	—	—	50%
Urine pregnancy test, read by color change CPT 81025 URINE HCG	$48.65	$97.30	—	at median	50%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TST	$48.65	$97.30	—	at median	50%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE HCG	$48.65	$97.30	—	—	50%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TST	$48.65	$97.30	—	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMN B-12	$55.15	$110.30	—	26% below	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMN B-12	$55.15	$110.30	—	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMN D-3 (25 -OH)	$66.03	$132.05	—	30% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D; 25 HYDROXY	$84.85	$169.70	—	10% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMN D-3 (25 -OH)	$66.03	$132.05	—	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VIT D; 25 HYDROXY	$84.85	$169.70	—	—	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVIT D 1,25	$88.47	$176.95	—	43% below	50%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 DIHYDROXYVIT D 1,25	$88.47	$176.95	—	—	50%
Zinc blood test CPT 84630 ZINC	$29.68	$59.35	—	42% below	50%
Zinc blood test inpatient CPT 84630 ZINC	$29.68	$59.35	—	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG SERUM QUANT	$61.23	$122.45	—	9% below	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG SERUM QUANT	$61.23	$122.45	—	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTRNL	$803.50	$1,607.00	—	61% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERN	$839.66	$1,679.32	—	59% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION/DEFIB	$895.90	$1,791.81	—	57% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 MS TELEMETRY OVRFLW	$1,274.25	$2,548.50	—	38% below	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTRNL	$803.50	$1,607.00	—	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERN	$839.66	$1,679.32	—	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION/DEFIB	$895.90	$1,791.81	—	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 MS TELEMETRY OVRFLW	$1,274.25	$2,548.50	—	—	50%
Circumcision, surgical, older than a newborn CPT 54160 NURSERY BOARDER BABY	$925.00	$1,850.00	—	54% below	50%
Circumcision, surgical, older than a newborn inpatient CPT 54160 NURSERY BOARDER BABY	$925.00	$1,850.00	—	—	50%

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 ADMIN	$447.11	$894.21	—	60% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION ADMIN	$467.69	$935.38	—	58% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/COMP	$467.69	$935.38	—	58% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION	$467.69	$935.38	—	58% below	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN	$447.11	$894.21	—	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION	$467.69	$935.38	—	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/COMP	$467.69	$935.38	—	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION ADMIN	$467.69	$935.38	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL CONTINUOUS	$180.24	$360.47	—	3% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TX SUBS	$180.24	$360.47	—	3% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HHN INITIAL	$180.34	$360.68	—	3% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HHN TX SUBS	$180.87	$361.73	—	3% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TX INITIAL	$180.87	$361.73	—	3% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TX SUBS	$180.24	$360.47	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL CONTINUOUS	$180.24	$360.47	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HHN INITIAL	$180.34	$360.68	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TX INITIAL	$180.87	$361.73	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HHN TX SUBS	$180.87	$361.73	—	—	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INF 1ST HR	$611.14	$1,222.28	—	20% below	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INF INIT HR	$864.50	$1,729.00	—	13% above	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INF 1ST HR	$611.14	$1,222.28	—	—	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INF INIT HR	$864.50	$1,729.00	—	—	50%
Critical care, first 30 to 74 minutes CPT 99291 ER CRIT CARE	$2,905.89	$5,811.77	—	1% below	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ER CRIT CARE	$2,905.89	$5,811.77	—	—	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE DRWSY 20-4	$484.15	$968.30	—	49% below	50%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE DRWSY 20-4	$484.15	$968.30	—	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING CARD RHB	$107.15	$214.30	—	42% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING	$134.64	$269.28	—	27% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING CARD RHB	$107.15	$214.30	—	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING	$134.64	$269.28	—	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT LEV1	$178.12	$356.24	—	43% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER VISIT LEV1	$178.12	$356.24	—	—	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT LEV2	$306.13	$612.25	—	40% below	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER VISIT LEV2	$306.13	$612.25	—	—	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT LEV3	$613.05	$1,226.11	—	27% below	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER VISIT LEV3	$613.05	$1,226.11	—	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT LEV4	$917.29	$1,834.59	—	31% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER VISIT LEV4	$917.29	$1,834.59	—	—	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT LEV5	$1,215.74	$2,431.48	—	30% below	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER VISIT LEV5	$1,215.74	$2,431.48	—	—	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST TRACING	$639.93	$1,279.86	—	29% below	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST TRACING	$639.93	$1,279.86	—	—	50%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 EKG 48HR W/VIS SCAN	$722.75	$1,445.50	—	29% above	50%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 EKG 48HR W/VIS SCAN	$722.75	$1,445.50	—	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDR INTL HR	$147.05	$294.10	—	65% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDR 1ST HR	$147.05	$294.10	—	65% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INF 1ST	$192.07	$384.15	—	54% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDR 1ST HR	$147.05	$294.10	—	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDR INTL HR	$147.05	$294.10	—	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INF 1ST	$192.07	$384.15	—	—	50%
IV infusion of a medicine, first hour CPT 96365 IV INF TX/DX 1 HR	$147.05	$294.10	—	66% below	50%
IV infusion of a medicine, first hour CPT 96365 IV INF TX/DX 1HR	$147.05	$294.10	—	66% below	50%
IV infusion of a medicine, first hour CPT 96365 IV INF TX/DX1HR	$147.05	$294.10	—	66% below	50%
IV infusion of a medicine, first hour CPT 96365 IV INF TX/DX 1ST HR	$147.05	$294.10	—	66% below	50%
IV infusion of a medicine, first hour CPT 96365 TX/PRO/DX IV INF 1ST	$359.45	$718.90	—	17% below	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF TX/DX 1 HR	$147.05	$294.10	—	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF TX/DX 1ST HR	$147.05	$294.10	—	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF TX/DX1HR	$147.05	$294.10	—	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF TX/DX 1HR	$147.05	$294.10	—	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 TX/PRO/DX IV INF 1ST	$359.45	$718.90	—	—	50%
IV push of a medicine, first drug CPT 96374 INJ IV BUBBLE STUDY	$59.60	$119.20	—	77% below	50%
IV push of a medicine, first drug CPT 96374 INJ/IV INT/SGL SUBS	$62.75	$125.50	—	76% below	50%
IV push of a medicine, first drug CPT 96374 INJ IVP SGL/INT SUB	$62.75	$125.50	—	76% below	50%
IV push of a medicine, first drug CPT 96374 INJ IVP SGL/INT SUBS	$139.47	$278.95	—	46% below	50%
IV push of a medicine, first drug CPT 96374 INJ IV SGL/INT SUB	$180.68	$361.35	—	30% below	50%
IV push of a medicine, first drug CPT 96374 THER/PRPH/DX INJ IV	$192.07	$384.15	—	25% below	50%
IV push of a medicine, first drug inpatient CPT 96374 INJ IV BUBBLE STUDY	$59.60	$119.20	—	—	50%
IV push of a medicine, first drug inpatient CPT 96374 INJ IVP SGL/INT SUB	$62.75	$125.50	—	—	50%
IV push of a medicine, first drug inpatient CPT 96374 INJ/IV INT/SGL SUBS	$62.75	$125.50	—	—	50%
IV push of a medicine, first drug inpatient CPT 96374 INJ IVP SGL/INT SUBS	$139.47	$278.95	—	—	50%
IV push of a medicine, first drug inpatient CPT 96374 INJ IV SGL/INT SUB	$180.68	$361.35	—	—	50%
IV push of a medicine, first drug inpatient CPT 96374 THER/PRPH/DX INJ IV	$192.07	$384.15	—	—	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM/SQ	$53.88	$107.75	—	62% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM/SQ	$79.25	$158.50	—	44% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PRPH/DIG INJ SC	$88.13	$176.25	—	38% below	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ IM/SQ	$53.88	$107.75	—	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM/SQ	$79.25	$158.50	—	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PRPH/DIG INJ SC	$88.13	$176.25	—	—	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED/15 MIN	$52.56	$105.13	—	52% below	50%
Neuromuscular re-education, 15 minutes CPT 97112 PTA NEURO RE-ED 15 M	$52.56	$105.13	—	52% below	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC RE-ED/15"	$62.70	$125.40	—	43% below	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED/15 MIN	$52.56	$105.13	—	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PTA NEURO RE-ED 15 M	$52.56	$105.13	—	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC RE-ED/15"	$62.70	$125.40	—	—	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT IND ASSESS/15MN	$22.52	$45.04	—	65% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT IND ASSESS/15MN	$22.52	$45.04	—	—	50%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LTD	$150.38	$300.75	—	42% below	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LTD	$150.38	$300.75	—	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL EXT	$242.54	$485.09	—	19% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL EXT	$242.54	$485.09	—	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LTD	$204.56	$409.12	—	22% below	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LTD	$204.56	$409.12	—	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL INT	$242.54	$485.09	—	13% below	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL INT	$242.54	$485.09	—	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PTA MANUAL THER 15 M	$92.72	$185.44	—	16% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THER/15 MIN	$92.72	$185.44	—	16% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THER/15 MIN	$92.72	$185.44	—	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PTA MANUAL THER 15 M	$92.72	$185.44	—	—	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 ST EXERCISE TX 15"	$89.92	$179.84	—	24% below	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXER/15 MIN	$107.66	$215.32	—	9% below	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PTA THER EXER/15 MIN	$107.66	$215.32	—	9% below	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 ST EXERCISE TX 15"	$89.92	$179.84	—	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXER/15 MIN	$107.66	$215.32	—	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PTA THER EXER/15 MIN	$107.66	$215.32	—	—	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV SMOKING 3-10 M	$46.09	$92.17	—	5% above	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV SMOKING 3-10 M	$46.09	$92.17	—	—	50%
Speech and language evaluation CPT 92523 ST EV SOUND LANG CMP	$189.98	$379.96	—	44% below	50%
Speech and language evaluation inpatient CPT 92523 ST EV SOUND LANG CMP	$189.98	$379.96	—	—	50%
Speech therapy session, individual CPT 92507 ST IND TX LTD	$107.66	$215.32	—	51% below	50%
Speech therapy session, individual CPT 92507 ST IND TX EXT	$128.53	$257.07	—	41% below	50%
Speech therapy session, individual CPT 92507 ST IND TX INT	$128.53	$257.07	—	41% below	50%
Speech therapy session, individual inpatient CPT 92507 ST IND TX LTD	$107.66	$215.32	—	—	50%
Speech therapy session, individual inpatient CPT 92507 ST IND TX EXT	$128.53	$257.07	—	—	50%
Speech therapy session, individual inpatient CPT 92507 ST IND TX INT	$128.53	$257.07	—	—	50%
Spirometry (breathing test) CPT 94010 PFT SPIROMETRY	$202.63	$405.25	—	35% below	50%
Spirometry (breathing test) inpatient CPT 94010 PFT SPIROMETRY	$202.63	$405.25	—	—	50%
Spirometry before and after a bronchodilator CPT 94060 PFT SPIROMETRY B&A	$348.30	$696.60	—	39% below	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT SPIROMETRY B&A	$348.30	$696.60	—	—	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 PTA THERPACT/15 MIN	$39.90	$79.79	—	67% below	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPACT/15 MIN	$39.90	$79.79	—	67% below	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PTA THERPACT/15 MIN	$39.90	$79.79	—	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPACT/15 MIN	$39.90	$79.79	—	—	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THER SPX	$82.42	$164.85	—	65% below	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPECT PHLEBOTOMY	$103.75	$207.50	—	56% below	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THER SPX	$82.42	$164.85	—	—	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPECT PHLEBOTOMY	$103.75	$207.50	—	—	50%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 CARDIO STRESS TEST	$633.38	$1,266.75	—	19% below	50%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 CARDIO STRESS TEST	$633.38	$1,266.75	—	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLUAD 0.5 ML FLU 65+	$77.95	$155.90	—	3% above	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLUAD 0.5 ML FLU 65+	$77.95	$155.90	—	—	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VV SPLT PF 3YRS>	$30.91	$61.83	—	32% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VV SPLT PF 3YRS>	$30.91	$61.83	—	—	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VAC ADULT 1ML	$90.45	$180.91	—	42% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VAC ADULT 1ML	$90.45	$180.91	—	—	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEP B VACC 5MCG	$37.36	$74.72	—	38% below	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEP B VACC 5MCG	$37.36	$74.72	—	—	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB VACC	$31.41	$62.83	—	3% above	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HIB VACC	$31.41	$62.83	—	—	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC HD 65+0.7ML	$83.75	$167.49	—	19% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC HD 65+0.7ML	$83.75	$167.49	—	—	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 POLYMIX B 500000U V	$20.65	$41.30	—	90% below	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR INJ	$109.72	$219.45	—	47% below	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 POLYMIX B 500000U V	$20.65	$41.30	—	—	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR INJ	$109.72	$219.45	—	—	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 FOSPHEN 500MG PE J	$26.90	$53.80	—	92% below	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 ROCURON 10MG/ML 5ML	$30.65	$61.30	—	90% below	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 INDOCYAN GREEN 25MG	$128.30	$256.60	—	60% below	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOC VAC ACYW135	$141.15	$282.29	—	55% below	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING POLY/GO A VAC	$142.12	$284.23	—	55% below	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 FOSPHEN 500MG PE J	$26.90	$53.80	—	—	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 ROCURON 10MG/ML 5ML	$30.65	$61.30	—	—	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 INDOCYAN GREEN 25MG	$128.30	$256.60	—	—	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOC VAC ACYW135	$141.15	$282.29	—	—	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENING POLY/GO A VAC	$142.12	$284.23	—	—	50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR 13 VAC .5 ML	$223.88	$447.77	—	49% below	50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR 13 VAC .5 ML	$223.88	$447.77	—	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMO 23 VAC ADLT	$113.57	$227.14	—	59% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMO 23 VAC ADLT	$113.57	$227.14	—	—	50%
Rabies vaccine, one dose CPT 90675 RABIES VAC 2.5 U J	$398.47	$796.94	—	58% below	50%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC 2.5 U J	$398.47	$796.94	—	—	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD TOXOID 0.5ML PF J	$51.20	$102.40	—	43% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD TOXOID 0.5ML PF J	$51.20	$102.40	—	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACC 7YRS> IM	$67.01	$134.02	—	39% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACC 7YRS> IM	$67.01	$134.02	—	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 SUTURES G11	$40.13	$80.25	—	1% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUN ADMIN 1ST VACC	$47.47	$94.94	—	17% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUN ADMIN 1 VACC	$49.72	$99.43	—	22% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMIN INIT	$78.14	$156.28	—	92% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 SUTURES G11	$40.13	$80.25	—	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUN ADMIN 1ST VACC	$47.47	$94.94	—	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUN ADMIN 1 VACC	$49.72	$99.43	—	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMIN INIT	$78.14	$156.28	—	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN ADD VACC	$22.16	$44.31	—	36% below	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN ADDL VAC	$23.18	$46.35	—	33% below	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINE ADMIN EA ADD	$39.90	$79.79	—	15% above	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 OXYGEN PER DAY	$404.40	$808.80	—	1062% above	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADMIN ADD VACC	$22.16	$44.31	—	—	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADMIN ADDL VAC	$23.18	$46.35	—	—	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINE ADMIN EA ADD	$39.90	$79.79	—	—	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 OXYGEN PER DAY	$404.40	$808.80	—	—	50%

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://apps.trihealth.com/static/pricing/273633811_clinton-memorial-hospital_standardcharges.json