Lodi Community Hospital
Lodi Community Hospital in Lodi, OH publishes cash prices for 370 common procedures listed here, from its own machine-readable price file updated Jun 15, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Ohio median for 187 of 366 procedures and below it for 128. By typical cash price it ranks #81 of 139 Ohio hospitals and #11 of 26 hospitals in the Cleveland, OH area, cheapest first. Select a procedure to compare it with other hospitals nearby.
225 Elyria Street, Lodi, OH 44254 Collected Sep 23, 2026 Source price file Check a bill from this hospital (330) 948-1222
Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 361303 · CMS hospital register NPI 1801807870
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Lodi Community Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
State law
This state limits hospital bills for lower-income patients
Ohio's Hospital Care Assurance Program (HCAP): Ohio residents who are not on Medicaid and whose income is at or below 100% of the federal poverty level get basic, medically necessary hospital services free at hospitals in the program; physician bills are not included. Ask the hospital's billing office for an HCAP application. Other states' laws.
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Lodi Community Hospital in Lodi, OH:
- Jul 29, 2025 Met requirements
Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/O & W/CONTRAST MATERIAL | $798.20 | $1,228.00 | $347.28–$1,228.00 | 40% below | 35% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/O & W/CONTRAST MATERIAL | $798.20 | $1,228.00 | $347.28–$1,228.00 | — | 35% |
| Abdominal X-ray, 2 views CPT 74019 RADIOLOGIC EXAM ABDOMEN 2 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | 41% above | 35% |
| Abdominal X-ray, 2 views inpatient CPT 74019 RADIOLOGIC EXAM ABDOMEN 2 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Ankle X-ray, complete, 3 or more views CPT 73610 RADEX ANKLE COMPLETE MINIMUM 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 24% above | 35% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 RADEX ANKLE COMPLETE MINIMUM 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL | $481.65 | $741.00 | $209.55–$741.00 | at median | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL | $481.65 | $741.00 | $209.55–$741.00 | — | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | 49% below | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY | $798.20 | $1,228.00 | $347.28–$1,228.00 | 80% above | 35% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY | $798.20 | $1,228.00 | $347.28–$1,228.00 | — | 35% |
| Breast ultrasound, complete, one breast CPT 76641 US BREAST UNI REAL TIME WITH IMAGE COMPLETE | $477.10 | $734.00 | $207.58–$734.00 | at median | 35% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST UNI REAL TIME WITH IMAGE COMPLETE | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST UNI REAL TIME WITH IMAGE LIMITED | $395.20 | $608.00 | $171.94–$608.00 | 4% below | 35% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST UNI REAL TIME WITH IMAGE LIMITED | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | 25% below | 35% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | — | 35% |
| CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST | $798.20 | $1,228.00 | $347.28–$1,228.00 | 40% below | 35% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST | $798.20 | $1,228.00 | $347.28–$1,228.00 | — | 35% |
| CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST | $798.20 | $1,228.00 | $347.28–$1,228.00 | 39% below | 35% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST | $798.20 | $1,228.00 | $347.28–$1,228.00 | — | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST | $798.20 | $1,228.00 | $347.28–$1,228.00 | 44% below | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST | $798.20 | $1,228.00 | $347.28–$1,228.00 | — | 35% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST | $395.20 | $608.00 | $171.94–$608.00 | 41% above | 35% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM | $395.20 | $608.00 | $171.94–$608.00 | 41% above | 35% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CALCIUM SCORING - SELF PAY | $395.20 | $608.00 | $171.94–$608.00 | 41% above | 35% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O DYE W/CA TEST | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CALCIUM SCORING - SELF PAY | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | 32% below | 35% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | — | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST MATERIAL | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | 19% below | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST MATERIAL | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | — | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN & PELVIS W/WO CONTRST 1/> BODY RE | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | 31% below | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN & PELVIS W/WO CONTRST 1/> BODY RE | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | — | 35% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST MATERIAL | $798.20 | $1,228.00 | $347.28–$1,228.00 | 32% below | 35% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST MATERIAL | $798.20 | $1,228.00 | $347.28–$1,228.00 | — | 35% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | 55% below | 35% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | 46% below | 35% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | 43% below | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/CONTRAST MATERIAL | $798.20 | $1,228.00 | $347.28–$1,228.00 | 21% below | 35% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W/CONTRAST MATERIAL | $798.20 | $1,228.00 | $347.28–$1,228.00 | — | 35% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL | $798.20 | $1,228.00 | $347.28–$1,228.00 | 33% below | 35% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL | $798.20 | $1,228.00 | $347.28–$1,228.00 | — | 35% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | 57% below | 35% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | 56% below | 35% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST MATERIAL | $798.20 | $1,228.00 | $347.28–$1,228.00 | 35% below | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST MATERIAL | $798.20 | $1,228.00 | $347.28–$1,228.00 | — | 35% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY | $903.50 | $1,390.00 | $393.09–$1,390.00 | — | 35% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY | $903.50 | $1,390.00 | $393.09–$1,390.00 | — | 35% |
| Chest CT scan without and with contrast CPT 71270 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+ | $798.20 | $1,228.00 | $347.28–$1,228.00 | 47% below | 35% |
| Chest CT scan without and with contrast inpatient CPT 71270 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+ | $798.20 | $1,228.00 | $347.28–$1,228.00 | — | 35% |
| Chest X-ray, 2 views CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 50% above | 35% |
| Chest X-ray, 2 views inpatient CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Chest X-ray, single view CPT 71045 RADIOLOGIC EXAM CHEST SINGLE VIEW | $395.20 | $608.00 | $171.94–$608.00 | 77% above | 35% |
| Chest X-ray, single view inpatient CPT 71045 RADIOLOGIC EXAM CHEST SINGLE VIEW | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Collarbone (clavicle) X-ray, complete CPT 73000 RADEX CLAVICLE COMPLETE | $395.20 | $608.00 | $171.94–$608.00 | 46% above | 35% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 RADEX CLAVICLE COMPLETE | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE | $477.10 | $734.00 | $207.58–$734.00 | 33% below | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL | $477.10 | $734.00 | $207.58–$734.00 | 5% above | 35% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL | $395.20 | $608.00 | $171.94–$608.00 | 54% above | 35% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST | $477.10 | $734.00 | $207.58–$734.00 | 49% below | 35% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST | $798.20 | $1,228.00 | $347.28–$1,228.00 | 34% below | 35% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST | $798.20 | $1,228.00 | $347.28–$1,228.00 | — | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $458.90 | $706.00 | $199.66–$706.00 | — | 35% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $458.90 | $706.00 | $199.66–$706.00 | — | 35% |
| Diagnostic mammogram, one breast CPT 77065 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $365.95 | $563.00 | $159.22–$563.00 | 2% above | 35% |
| Diagnostic mammogram, one breast inpatient CPT 77065 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $365.95 | $563.00 | $159.22–$563.00 | — | 35% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUP SCAN EXT VEIN BILAT | $903.50 | $1,390.00 | $393.09–$1,390.00 | — | 35% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUP SCAN EXT VEIN BILAT | $903.50 | $1,390.00 | $393.09–$1,390.00 | — | 35% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D | $2,049.45 | $3,153.00 | $891.67–$3,153.00 | 21% above | 35% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TTHRC R-T 2D M-MODE COMPL SPEC&COLR D W/O CONTRAST | $2,049.45 | $3,153.00 | $891.67–$3,153.00 | 21% above | 35% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO TTHRC R-T 2D M-MODE COMPL SPEC&COLR D W/O CONTRAST | $2,049.45 | $3,153.00 | $891.67–$3,153.00 | — | 35% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D | $2,049.45 | $3,153.00 | $891.67–$3,153.00 | — | 35% |
| Elbow X-ray, 2 views CPT 73070 RADEX ELBOW 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 51% above | 35% |
| Elbow X-ray, 2 views inpatient CPT 73070 RADEX ELBOW 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Elbow X-ray, complete, 3 or more views CPT 73080 RADEX ELBOW COMPLETE MINIMUM 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 26% above | 35% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 RADEX ELBOW COMPLETE MINIMUM 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL | $477.10 | $734.00 | $207.58–$734.00 | 45% below | 35% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | 27% above | 35% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 RADEX FOREARM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 45% above | 35% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 RADEX FOREARM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Hand X-ray, 2 views CPT 73120 RADEX HAND 2 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | 79% above | 35% |
| Hand X-ray, 2 views inpatient CPT 73120 RADEX HAND 2 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 RADEX CALCANEUS MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 45% above | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 RADEX CALCANEUS MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND | $4,563.00 | $7,020.00 | $1,985.26–$7,020.00 | 11% above | 35% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND | $4,563.00 | $7,020.00 | $1,985.26–$7,020.00 | — | 35% |
| Knee X-ray, 3 views CPT 73562 RADIOLOGIC EXAMINATION KNEE 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 12% above | 35% |
| Knee X-ray, 3 views inpatient CPT 73562 RADIOLOGIC EXAMINATION KNEE 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Knee X-ray, complete, 4 or more views CPT 73564 RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS | $477.10 | $734.00 | $207.58–$734.00 | 21% above | 35% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | 49% below | 35% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL REAL TIME W/IMAGE LIMITED | $477.10 | $734.00 | $207.58–$734.00 | 14% below | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL REAL TIME W/IMAGE LIMITED | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG | $477.10 | $734.00 | $207.58–$734.00 | at median | 35% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 45% above | 35% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O CONTRST MATERIAL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | 25% below | 35% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O CONTRST MATERIAL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | — | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | 38% below | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | — | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | 33% below | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | — | 35% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST MATERIAL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | 41% below | 35% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST MATERIAL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | — | 35% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/O & W/CONTRAST MATERIAL | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | 30% below | 35% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/O & W/CONTRAST MATERIAL | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | — | 35% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | 33% below | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | — | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | 27% below | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | — | 35% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | 35% below | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | — | 35% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | 31% below | 35% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | — | 35% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | 35% below | 35% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | — | 35% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | 29% below | 35% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | — | 35% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | 34% below | 35% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | — | 35% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/CONTRAST MATERIAL | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | 18% below | 35% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O & W/CONTRAST MATERIAL | $1,601.60 | $2,464.00 | $696.82–$2,464.00 | — | 35% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST MATERIAL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | 29% below | 35% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST MATERIAL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | — | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | 28% below | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL | $1,084.20 | $1,668.00 | $471.71–$1,668.00 | — | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 RADEX SPINE CERVICAL 4 OR 5 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | 6% above | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 RADEX SPINE CERVICAL 4 OR 5 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/CONTRAST MATERIAL | $798.20 | $1,228.00 | $347.28–$1,228.00 | 32% below | 35% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/CONTRAST MATERIAL | $798.20 | $1,228.00 | $347.28–$1,228.00 | — | 35% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | 48% below | 35% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Neck soft tissue X-ray CPT 70360 RADIOLOGIC EXAMINATION NECK SOFT TISSUE | $395.20 | $608.00 | $171.94–$608.00 | 52% above | 35% |
| Neck soft tissue X-ray inpatient CPT 70360 RADIOLOGIC EXAMINATION NECK SOFT TISSUE | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL SPECT MULTIPLE STUDIES | $5,855.20 | $9,008.00 | $2,547.46–$9,008.00 | 46% above | 35% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL SPECT MULTIPLE STUDIES | $5,855.20 | $9,008.00 | $2,547.46–$9,008.00 | — | 35% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH | $6,541.60 | $10,064.00 | $2,846.10–$10,064.00 | 35% above | 35% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH | $6,541.60 | $10,064.00 | $2,846.10–$10,064.00 | — | 35% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | 53% below | 35% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U | $477.10 | $734.00 | $207.58–$734.00 | 10% above | 35% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE | $477.10 | $734.00 | $207.58–$734.00 | 5% below | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $477.10 | $734.00 | $207.58–$734.00 | 20% below | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANT UTERUS LIMITED 1/> FETUSES | $477.10 | $734.00 | $207.58–$734.00 | at median | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANT UTERUS LIMITED 1/> FETUSES | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Rib X-ray, one side, 2 views one side CPT 71100 RADEX RIBS UNILATERAL 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 30% above | 35% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 RADEX RIBS UNILATERAL 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | 25% above | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $395.85 | $609.00 | $172.23–$609.00 | — | 35% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $395.85 | $609.00 | $172.23–$609.00 | — | 35% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 17% above | 35% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Sinus X-ray, complete, 3 or more views CPT 70220 RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 9% above | 35% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Skull X-ray, fewer than 4 views CPT 70250 RADIOLOGIC EXAMINATION SKULL 4< VIEWS | $477.10 | $734.00 | $207.58–$734.00 | 65% above | 35% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 RADIOLOGIC EXAMINATION SKULL 4< VIEWS | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $4,563.00 | $7,020.00 | $1,985.26–$7,020.00 | 27% above | 35% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $4,563.00 | $7,020.00 | $1,985.26–$7,020.00 | — | 35% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY | $798.20 | $1,228.00 | $347.28–$1,228.00 | 58% above | 35% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY | $798.20 | $1,228.00 | $347.28–$1,228.00 | — | 35% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 46% above | 35% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | 47% below | 35% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE W/O CONTRAST MATERIAL | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Toe X-ray, 2 or more views CPT 73660 RADEX TOE MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 58% above | 35% |
| Toe X-ray, 2 or more views inpatient CPT 73660 RADEX TOE MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $477.10 | $734.00 | $207.58–$734.00 | 15% below | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION | $477.10 | $734.00 | $207.58–$734.00 | 24% below | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM & CONTENTS | $477.10 | $734.00 | $207.58–$734.00 | 11% below | 35% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM & CONTENTS | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM | $477.10 | $734.00 | $207.58–$734.00 | 17% below | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY | $798.20 | $1,228.00 | $347.28–$1,228.00 | 35% above | 35% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY | $798.20 | $1,228.00 | $347.28–$1,228.00 | — | 35% |
| Upper arm X-ray (humerus), 2 views CPT 73060 RADEX HUMERUS MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 44% above | 35% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 RADEX HUMERUS MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY | $397.15 | $611.00 | $172.79–$611.00 | 46% below | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY | $397.15 | $611.00 | $172.79–$611.00 | — | 35% |
| Wrist X-ray, 2 views CPT 73100 RADEX WRIST 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 51% above | 35% |
| Wrist X-ray, 2 views inpatient CPT 73100 RADEX WRIST 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Wrist X-ray, complete, 3 or more views CPT 73110 RADEX WRIST COMPLETE MINIMUM 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 18% above | 35% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 RADEX WRIST COMPLETE MINIMUM 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 28% above | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| X-ray of the abdomen, 1 view CPT 74018 RADIOLOGIC EXAM ABDOMEN 1 VIEW | $395.20 | $608.00 | $171.94–$608.00 | 54% above | 35% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 RADIOLOGIC EXAM ABDOMEN 1 VIEW | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| X-ray of the ankle, 2 views CPT 73600 RADIOLOGIC EXAMINATION ANKLE 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 59% above | 35% |
| X-ray of the ankle, 2 views inpatient CPT 73600 RADIOLOGIC EXAMINATION ANKLE 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| X-ray of the finger(s), 2 or more views CPT 73140 RADEX FINGR MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 53% above | 35% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 RADEX FINGR MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| X-ray of the foot, 2 views CPT 73620 RADIOLOGIC EXAMINATION FOOT 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 70% above | 35% |
| X-ray of the foot, 2 views inpatient CPT 73620 RADIOLOGIC EXAMINATION FOOT 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| X-ray of the foot, complete, 3 or more views CPT 73630 RADEX FOOT COMPLETE MINIMUM 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 29% above | 35% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 RADEX FOOT COMPLETE MINIMUM 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| X-ray of the hand, 3 or more views CPT 73130 RADEX HAND MINIMUM 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 21% above | 35% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 RADEX HAND MINIMUM 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| X-ray of the knee, 1 or 2 views CPT 73560 RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 45% above | 35% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RADEX SPINE LUMBOSACRAL 2/3 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | 48% above | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 RADEX SPINE LUMBOSACRAL 2/3 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | 2% above | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 RADEX SPINE THORACIC 2 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | 58% above | 35% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 RADEX SPINE THORACIC 2 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| X-ray of the nasal bones, 3 or more views CPT 70160 RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 35% above | 35% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RADEX SPINE CERVICAL 2 OR 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 18% above | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RADEX SPINE CERVICAL 2 OR 3 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | 90% above | 35% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RADEX SACRUM & COCCYX MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 33% above | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 RADEX SACRUM & COCCYX MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH | $172.90 | $266.00 | $75.22–$266.00 | 31% above | 35% |
| ACTH blood test inpatient CPT 82024 ACTH | $172.90 | $266.00 | $75.22–$266.00 | — | 35% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SGPT | $24.05 | $37.00 | $10.46–$37.00 | 14% below | 35% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 %LIVFIB ALANINE AMINO | $24.05 | $37.00 | $10.46–$37.00 | 14% below | 35% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 %LIVFIB ALANINE AMINO | $24.05 | $37.00 | $10.46–$37.00 | — | 35% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SGPT | $24.05 | $37.00 | $10.46–$37.00 | — | 35% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT | $23.40 | $36.00 | $10.18–$36.00 | 7% below | 35% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANEL | $213.85 | $329.00 | $93.04–$329.00 | 2% below | 35% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PANEL | $213.85 | $329.00 | $93.04–$329.00 | — | 35% |
| Albumin blood test CPT 82040 ALBUMIN SERUM ASSAY | $22.10 | $34.00 | $9.62–$34.00 | at median | 35% |
| Albumin blood test CPT 82040 *ALBUMIN SERUM ASSAY | $22.10 | $34.00 | $9.62–$34.00 | at median | 35% |
| Albumin blood test CPT 82040 LAB-IP ALBUMIN | $22.10 | $34.00 | $9.62–$34.00 | at median | 35% |
| Albumin blood test inpatient CPT 82040 LAB-IP ALBUMIN | $22.10 | $34.00 | $9.62–$34.00 | — | 35% |
| Albumin blood test inpatient CPT 82040 ALBUMIN SERUM ASSAY | $22.10 | $34.00 | $9.62–$34.00 | — | 35% |
| Albumin blood test inpatient CPT 82040 *ALBUMIN SERUM ASSAY | $22.10 | $34.00 | $9.62–$34.00 | — | 35% |
| Aldosterone blood test CPT 82088 ALDOSTERONE, URINE | $182.65 | $281.00 | $79.47–$281.00 | 31% above | 35% |
| Aldosterone blood test CPT 82088 ALDOSTERONE | $182.65 | $281.00 | $79.47–$281.00 | 31% above | 35% |
| Aldosterone blood test CPT 82088 ALDOSTERONE ASSAY | $182.65 | $281.00 | $79.47–$281.00 | 31% above | 35% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE ASSAY | $182.65 | $281.00 | $79.47–$281.00 | — | 35% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE | $182.65 | $281.00 | $79.47–$281.00 | — | 35% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE, URINE | $182.65 | $281.00 | $79.47–$281.00 | — | 35% |
| Alkaline phosphatase (ALP) blood test CPT 84075 *ALKA PHOSPHTAS ASSAY | $23.40 | $36.00 | $10.18–$36.00 | 2% below | 35% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKA PHOSPHTA | $23.40 | $36.00 | $10.18–$36.00 | 2% below | 35% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 *ALKA PHOSPHTAS ASSAY | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKA PHOSPHTA | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 *ALLERG SP IGE;QT OR QUAL | $23.40 | $36.00 | $10.18–$36.00 | at median | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, EGG IGE X2 | $23.40 | $36.00 | $10.18–$36.00 | at median | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MILK IGE X4 | $23.40 | $36.00 | $10.18–$36.00 | at median | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 %PNUTCP ALLG SPEC IGE | $23.40 | $36.00 | $10.18–$36.00 | at median | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE EACH | $23.40 | $36.00 | $10.18–$36.00 | at median | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE QUANT/SEMI EA | $23.40 | $36.00 | $10.18–$36.00 | at median | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 %PNUTCP ALLG SPEC IGE | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE QUANT/SEMI EA | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, EGG IGE X2 | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, MILK IGE X4 | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 *ALLERG SP IGE;QT OR QUAL | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE EACH | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 %2ND TRI AFP | $75.40 | $116.00 | $32.80–$116.00 | 24% above | 35% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETO TUMOR MARKER | $75.40 | $116.00 | $32.80–$116.00 | 24% above | 35% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM | $75.40 | $116.00 | $32.80–$116.00 | 24% above | 35% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SERUM | $75.40 | $116.00 | $32.80–$116.00 | — | 35% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 %2ND TRI AFP | $75.40 | $116.00 | $32.80–$116.00 | — | 35% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETO TUMOR MARKER | $75.40 | $116.00 | $32.80–$116.00 | — | 35% |
| Ammonia blood test CPT 82140 AMMONIA | $65.65 | $101.00 | $28.56–$101.00 | 20% above | 35% |
| Ammonia blood test inpatient CPT 82140 AMMONIA | $65.65 | $101.00 | $28.56–$101.00 | — | 35% |
| Amylase blood test CPT 82150 *AMYLASE ASSAY | $29.25 | $45.00 | $12.73–$45.00 | 39% below | 35% |
| Amylase blood test CPT 82150 AMYLASE | $29.25 | $45.00 | $12.73–$45.00 | 39% below | 35% |
| Amylase blood test inpatient CPT 82150 *AMYLASE ASSAY | $29.25 | $45.00 | $12.73–$45.00 | — | 35% |
| Amylase blood test inpatient CPT 82150 AMYLASE | $29.25 | $45.00 | $12.73–$45.00 | — | 35% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRU PEPT ANTI IG | $57.85 | $89.00 | $25.17–$89.00 | at median | 35% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRU PEPT ANTI IG | $57.85 | $89.00 | $25.17–$89.00 | — | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB(ANA) | $53.95 | $83.00 | $23.47–$83.00 | 2% below | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 %FANA ANA AB | $53.95 | $83.00 | $23.47–$83.00 | 2% below | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR | $53.95 | $83.00 | $23.47–$83.00 | 2% below | 35% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 %FANA ANA AB | $53.95 | $83.00 | $23.47–$83.00 | — | 35% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR | $53.95 | $83.00 | $23.47–$83.00 | — | 35% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR AB(ANA) | $53.95 | $83.00 | $23.47–$83.00 | — | 35% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE ASSAY | $176.15 | $271.00 | $76.64–$271.00 | 18% above | 35% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TUP NATRIURETC PEPTIDE (POINT OF CARE LAB) | $176.15 | $271.00 | $76.64–$271.00 | 18% above | 35% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PRO BNP | $176.15 | $271.00 | $76.64–$271.00 | 18% above | 35% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TUP NATRIURETC PEPTIDE (POINT OF CARE LAB) | $176.15 | $271.00 | $76.64–$271.00 | — | 35% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE ASSAY | $176.15 | $271.00 | $76.64–$271.00 | — | 35% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT PRO BNP | $176.15 | $271.00 | $76.64–$271.00 | — | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 %IOHWC CULTURE | $38.35 | $59.00 | $16.69–$59.00 | 42% below | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL, AEROBIC | $38.35 | $59.00 | $16.69–$59.00 | 42% below | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL CULTURE OTHR SOURCE | $38.35 | $59.00 | $16.69–$59.00 | 42% below | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 %IOHWC CULTURE | $38.35 | $59.00 | $16.69–$59.00 | — | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL, AEROBIC | $38.35 | $59.00 | $16.69–$59.00 | — | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BACTERIAL CULTURE OTHR SOURCE | $38.35 | $59.00 | $16.69–$59.00 | — | 35% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $37.70 | $58.00 | $16.40–$58.00 | 43% below | 35% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $37.70 | $58.00 | $16.40–$58.00 | — | 35% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL | $22.75 | $35.00 | $9.90–$35.00 | 5% below | 35% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL (BACK OFFICE) | $22.75 | $35.00 | $9.90–$35.00 | 5% below | 35% |
| Bilirubin blood test, total CPT 82247 TOTAL BILIRUBIN | $22.75 | $35.00 | $9.90–$35.00 | 5% below | 35% |
| Bilirubin blood test, total CPT 82247 %LIVFIB BILIRUBIN | $22.75 | $35.00 | $9.90–$35.00 | 5% below | 35% |
| Bilirubin blood test, total inpatient CPT 82247 TOTAL BILIRUBIN | $22.75 | $35.00 | $9.90–$35.00 | — | 35% |
| Bilirubin blood test, total inpatient CPT 82247 %LIVFIB BILIRUBIN | $22.75 | $35.00 | $9.90–$35.00 | — | 35% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL (BACK OFFICE) | $22.75 | $35.00 | $9.90–$35.00 | — | 35% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL | $22.75 | $35.00 | $9.90–$35.00 | — | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGERY PATH GROSS MICRO LEVEL 4 | $239.85 | $369.00 | $104.35–$369.00 | 18% above | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH GROSS MICRO LVL IV | $239.85 | $369.00 | $104.35–$369.00 | 18% above | 35% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH GROSS MICRO LVL IV | $239.85 | $369.00 | $104.35–$369.00 | — | 35% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGERY PATH GROSS MICRO LEVEL 4 | $239.85 | $369.00 | $104.35–$369.00 | — | 35% |
| Blood culture for bacteria CPT 87040 CULTURE FOR BLOOD | $46.15 | $71.00 | $20.08–$71.00 | 51% below | 35% |
| Blood culture for bacteria CPT 87040 CULTURE, BACTERIAL, BLOOD, AEROBIC AND ANAEROBIC | $46.15 | $71.00 | $20.08–$71.00 | 51% below | 35% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE, BACTERIAL, BLOOD, AEROBIC AND ANAEROBIC | $46.15 | $71.00 | $20.08–$71.00 | — | 35% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE FOR BLOOD | $46.15 | $71.00 | $20.08–$71.00 | — | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE | $40.95 | $63.00 | $17.82–$63.00 | 157% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $40.95 | $63.00 | $17.82–$63.00 | 157% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE | $40.95 | $63.00 | $17.82–$63.00 | — | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE | $40.95 | $63.00 | $17.82–$63.00 | — | 35% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT (POINT OF CARE LAB) | $17.55 | $27.00 | $7.64–$27.00 | 26% below | 35% |
| Blood glucose (sugar) test CPT 82947 GLUC BLOOD QUANT ASSAY | $17.55 | $27.00 | $7.64–$27.00 | 26% below | 35% |
| Blood glucose (sugar) test CPT 82947 OCC.HEALTH/ BLOOD SUGAR | $17.55 | $27.00 | $7.64–$27.00 | 26% below | 35% |
| Blood glucose (sugar) test CPT 82947 *GLUCOSE QUANT | $17.55 | $27.00 | $7.64–$27.00 | 26% below | 35% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT | $17.55 | $27.00 | $7.64–$27.00 | 26% below | 35% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT | $17.55 | $27.00 | $7.64–$27.00 | — | 35% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUC BLOOD QUANT ASSAY | $17.55 | $27.00 | $7.64–$27.00 | — | 35% |
| Blood glucose (sugar) test inpatient CPT 82947 *GLUCOSE QUANT | $17.55 | $27.00 | $7.64–$27.00 | — | 35% |
| Blood glucose (sugar) test inpatient CPT 82947 OCC.HEALTH/ BLOOD SUGAR | $17.55 | $27.00 | $7.64–$27.00 | — | 35% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT (POINT OF CARE LAB) | $17.55 | $27.00 | $7.64–$27.00 | — | 35% |
| Blood lead test CPT 83655 %UTXM4 LEAD | $54.60 | $84.00 | $23.76–$84.00 | 12% above | 35% |
| Blood lead test CPT 83655 %OSHA LEAD | $54.60 | $84.00 | $23.76–$84.00 | 12% above | 35% |
| Blood lead test CPT 83655 %UTXM3 LEAD | $54.60 | $84.00 | $23.76–$84.00 | 12% above | 35% |
| Blood lead test CPT 83655 LEAD UR 24HR | $54.60 | $84.00 | $23.76–$84.00 | 12% above | 35% |
| Blood lead test CPT 83655 LEAD ASSAY | $54.60 | $84.00 | $23.76–$84.00 | 12% above | 35% |
| Blood lead test inpatient CPT 83655 LEAD ASSAY | $54.60 | $84.00 | $23.76–$84.00 | — | 35% |
| Blood lead test inpatient CPT 83655 LEAD UR 24HR | $54.60 | $84.00 | $23.76–$84.00 | — | 35% |
| Blood lead test inpatient CPT 83655 %UTXM3 LEAD | $54.60 | $84.00 | $23.76–$84.00 | — | 35% |
| Blood lead test inpatient CPT 83655 %UTXM4 LEAD | $54.60 | $84.00 | $23.76–$84.00 | — | 35% |
| Blood lead test inpatient CPT 83655 %OSHA LEAD | $54.60 | $84.00 | $23.76–$84.00 | — | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG TEST QUAL | $33.80 | $52.00 | $14.71–$52.00 | 38% below | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG TEST QUAL (POINT OF CARE LAB) | $33.80 | $52.00 | $14.71–$52.00 | 38% below | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG TEST QUAL (POINT OF CARE LAB) | $33.80 | $52.00 | $14.71–$52.00 | — | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG TEST QUAL | $33.80 | $52.00 | $14.71–$52.00 | — | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO BLOOD TYPING | $13.65 | $21.00 | $5.94–$21.00 | 77% below | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 WHIVF BLD BYPE ABO | $13.65 | $21.00 | $5.94–$21.00 | 77% below | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 WHIVF BLD BYPE ABO | $13.65 | $21.00 | $5.94–$21.00 | — | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO BLOOD TYPING | $13.65 | $21.00 | $5.94–$21.00 | — | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN | $17.55 | $27.00 | $7.64–$27.00 | 25% below | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN; QUAN | $17.55 | $27.00 | $7.64–$27.00 | 25% below | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 I STAT BUN DETERMINATION (POINT OF CARE LAB) | $17.55 | $27.00 | $7.64–$27.00 | 25% below | 35% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 I STAT BUN DETERMINATION (POINT OF CARE LAB) | $17.55 | $27.00 | $7.64–$27.00 | — | 35% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN | $17.55 | $27.00 | $7.64–$27.00 | — | 35% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN; QUAN | $17.55 | $27.00 | $7.64–$27.00 | — | 35% |
| C-peptide blood test CPT 84681 C-PEPTIDE SERUM | $93.60 | $144.00 | $40.72–$144.00 | 18% above | 35% |
| C-peptide blood test inpatient CPT 84681 C-PEPTIDE SERUM | $93.60 | $144.00 | $40.72–$144.00 | — | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $23.40 | $36.00 | $10.18–$36.00 | 53% below | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 %IBDSGI C REAC PROTEIN | $23.40 | $36.00 | $10.18–$36.00 | 53% below | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 %IBDSGI C REAC PROTEIN | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| C. difficile toxin gene test (stool PCR) CPT 87493 AMPLIFICATION, CLOSTRIDIUM DIFFICILE | $167.05 | $257.00 | $72.68–$257.00 | 28% above | 35% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 AMPLIFICATION, CLOSTRIDIUM DIFFICILE | $167.05 | $257.00 | $72.68–$257.00 | — | 35% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSY TUMOR CA 19-9 | $93.60 | $144.00 | $40.72–$144.00 | 28% above | 35% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSY TUMOR CA 19-9 | $93.60 | $144.00 | $40.72–$144.00 | — | 35% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSY TUMOR CA 125 | $93.60 | $144.00 | $40.72–$144.00 | at median | 35% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSY TUMOR CA 125 | $93.60 | $144.00 | $40.72–$144.00 | — | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 MOLECULAR (POINT OF CARE LAB) | $230.10 | $354.00 | $100.11–$354.00 | 63% above | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 SENDOUT | $230.10 | $354.00 | $100.11–$354.00 | 63% above | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 INHOUSE | $230.10 | $354.00 | $100.11–$354.00 | 63% above | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 INHOUSE (POINT OF CARE LAB) | $230.10 | $354.00 | $100.11–$354.00 | 63% above | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 MOLECULAR (POINT OF CARE LAB) | $230.10 | $354.00 | $100.11–$354.00 | — | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 SENDOUT | $230.10 | $354.00 | $100.11–$354.00 | — | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 INHOUSE | $230.10 | $354.00 | $100.11–$354.00 | — | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 INHOUSE (POINT OF CARE LAB) | $230.10 | $354.00 | $100.11–$354.00 | — | 35% |
| Calcium blood test, total CPT 82310 CALCIUM | $23.40 | $36.00 | $10.18–$36.00 | 26% below | 35% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA AG | $85.15 | $131.00 | $37.05–$131.00 | 2% below | 35% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA AG | $85.15 | $131.00 | $37.05–$131.00 | — | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGM | $57.85 | $89.00 | $25.17–$89.00 | at median | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 VZV IGG AB, CSF | $57.85 | $89.00 | $25.17–$89.00 | at median | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG AB | $57.85 | $89.00 | $25.17–$89.00 | at median | 35% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VZV IGG AB, CSF | $57.85 | $89.00 | $25.17–$89.00 | — | 35% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGG AB | $57.85 | $89.00 | $25.17–$89.00 | — | 35% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGM | $57.85 | $89.00 | $25.17–$89.00 | — | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACH AMPLIFY | $157.30 | $242.00 | $68.44–$242.00 | 70% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 %CTNGAO CHLAMYDIA OCULAR | $157.30 | $242.00 | $68.44–$242.00 | 70% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIATRACH AMP OCULAR | $157.30 | $242.00 | $68.44–$242.00 | 70% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIATRACH AMP OCULAR | $157.30 | $242.00 | $68.44–$242.00 | — | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 %CTNGAO CHLAMYDIA OCULAR | $157.30 | $242.00 | $68.44–$242.00 | — | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACH AMPLIFY | $157.30 | $242.00 | $68.44–$242.00 | — | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID | $59.80 | $92.00 | $26.02–$92.00 | 13% above | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID-LIPO PANEL 1 | $59.80 | $92.00 | $26.02–$92.00 | 13% above | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 %NMRLIP CHOLESTEROL | $59.80 | $92.00 | $26.02–$92.00 | 13% above | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 *LIPID PANEL | $59.80 | $92.00 | $26.02–$92.00 | 13% above | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID-LIPO PANEL 1 (POINT OF CARE LAB) | $59.80 | $92.00 | $26.02–$92.00 | 13% above | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID-LIPO PANEL 1 | $59.80 | $92.00 | $26.02–$92.00 | — | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID-LIPO PANEL 1 (POINT OF CARE LAB) | $59.80 | $92.00 | $26.02–$92.00 | — | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID | $59.80 | $92.00 | $26.02–$92.00 | — | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 %NMRLIP CHOLESTEROL | $59.80 | $92.00 | $26.02–$92.00 | — | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 *LIPID PANEL | $59.80 | $92.00 | $26.02–$92.00 | — | 35% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/DIFF | $35.10 | $54.00 | $15.27–$54.00 | 4% below | 35% |
| Complete blood count (CBC) with differential CPT 85025 CBC AUTO W AUTO DIFF | $35.10 | $54.00 | $15.27–$54.00 | 4% below | 35% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO W AUTO DIFF | $35.10 | $54.00 | $15.27–$54.00 | — | 35% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/DIFF | $35.10 | $54.00 | $15.27–$54.00 | — | 35% |
| Complete blood count (CBC), no differential CPT 85027 CBC AUTO WO DIFF | $29.25 | $45.00 | $12.73–$45.00 | 14% below | 35% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTO WO DIFF | $29.25 | $45.00 | $12.73–$45.00 | — | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPRE META PANL | $47.45 | $73.00 | $20.64–$73.00 | 25% below | 35% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPRE META PANL | $47.45 | $73.00 | $20.64–$73.00 | — | 35% |
| Cortisol blood test, total CPT 82533 CORTISOL TOTAL | $72.80 | $112.00 | $31.67–$112.00 | at median | 35% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL | $72.80 | $112.00 | $31.67–$112.00 | — | 35% |
| Creatine kinase (CK) blood test, total CPT 82550 *CREATINE KINASE TOTAL ASSAY | $29.25 | $45.00 | $12.73–$45.00 | 17% below | 35% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 *CREATINE KINASE TOTAL ASSAY | $29.25 | $45.00 | $12.73–$45.00 | — | 35% |
| Creatinine blood test CPT 82565 *CREATININE BLOOD | $22.75 | $35.00 | $9.90–$35.00 | 8% below | 35% |
| Creatinine blood test CPT 82565 CREATININE BLOOD (POINT OF CARE LAB) | $22.75 | $35.00 | $9.90–$35.00 | 8% below | 35% |
| Creatinine blood test CPT 82565 CREATININE BLOOD ASSAY | $22.75 | $35.00 | $9.90–$35.00 | 8% below | 35% |
| Creatinine blood test inpatient CPT 82565 CREATININE BLOOD ASSAY | $22.75 | $35.00 | $9.90–$35.00 | — | 35% |
| Creatinine blood test inpatient CPT 82565 CREATININE BLOOD (POINT OF CARE LAB) | $22.75 | $35.00 | $9.90–$35.00 | — | 35% |
| Creatinine blood test inpatient CPT 82565 *CREATININE BLOOD | $22.75 | $35.00 | $9.90–$35.00 | — | 35% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG AVIDITY | $64.35 | $99.00 | $28.00–$99.00 | 6% below | 35% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB | $64.35 | $99.00 | $28.00–$99.00 | 6% below | 35% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG ANTIBODY | $64.35 | $99.00 | $28.00–$99.00 | 6% below | 35% |
| Cytomegalovirus (CMV) antibody test CPT 86644 %TORCH AB CMV IGG | $64.35 | $99.00 | $28.00–$99.00 | 6% below | 35% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 %TORCH AB CMV IGG | $64.35 | $99.00 | $28.00–$99.00 | — | 35% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB | $64.35 | $99.00 | $28.00–$99.00 | — | 35% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG ANTIBODY | $64.35 | $99.00 | $28.00–$99.00 | — | 35% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG AVIDITY | $64.35 | $99.00 | $28.00–$99.00 | — | 35% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER (POINT OF CARE LAB) | $45.50 | $70.00 | $19.80–$70.00 | 35% below | 35% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT | $45.50 | $70.00 | $19.80–$70.00 | 35% below | 35% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER (POINT OF CARE LAB) | $45.50 | $70.00 | $19.80–$70.00 | — | 35% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANT | $45.50 | $70.00 | $19.80–$70.00 | — | 35% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S | $99.45 | $153.00 | $43.27–$153.00 | at median | 35% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S | $99.45 | $153.00 | $43.27–$153.00 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 OXYCODONE SCRN, UR | $278.85 | $429.00 | $121.32–$429.00 | 192% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 MATERNAL 8PC DRUG SCREEN | $278.85 | $429.00 | $121.32–$429.00 | 192% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR | $278.85 | $429.00 | $121.32–$429.00 | 192% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHYL GLUC UR SCRN | $278.85 | $429.00 | $121.32–$429.00 | 192% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN, BLD | $278.85 | $429.00 | $121.32–$429.00 | 192% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ASSAY OF ACETAMINOPHEN | $278.85 | $429.00 | $121.32–$429.00 | 192% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SALICYLATE, S | $278.85 | $429.00 | $121.32–$429.00 | 192% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL | $278.85 | $429.00 | $121.32–$429.00 | 192% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TESTS PRESUMPTIVE | $278.85 | $429.00 | $121.32–$429.00 | 192% above | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SALICYLATE, S | $278.85 | $429.00 | $121.32–$429.00 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MATERNAL 8PC DRUG SCREEN | $278.85 | $429.00 | $121.32–$429.00 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR | $278.85 | $429.00 | $121.32–$429.00 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHYL GLUC UR SCRN | $278.85 | $429.00 | $121.32–$429.00 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OXYCODONE SCRN, UR | $278.85 | $429.00 | $121.32–$429.00 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCRN, BLD | $278.85 | $429.00 | $121.32–$429.00 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TESTS PRESUMPTIVE | $278.85 | $429.00 | $121.32–$429.00 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ALCOHOL | $278.85 | $429.00 | $121.32–$429.00 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ASSAY OF ACETAMINOPHEN | $278.85 | $429.00 | $121.32–$429.00 | — | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $31.20 | $48.00 | $13.57–$48.00 | 35% below | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL | $31.20 | $48.00 | $13.57–$48.00 | — | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV CAPSID AG IGM | $81.25 | $125.00 | $35.35–$125.00 | 25% above | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV-VCA IFA IGG | $81.25 | $125.00 | $35.35–$125.00 | 25% above | 35% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV-VCA IFA IGG | $81.25 | $125.00 | $35.35–$125.00 | — | 35% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV CAPSID AG IGM | $81.25 | $125.00 | $35.35–$125.00 | — | 35% |
| Estradiol blood test CPT 82670 ESTRADIOL-17B | $125.45 | $193.00 | $54.58–$193.00 | 12% above | 35% |
| Estradiol blood test CPT 82670 ESTRADIOL TANDEM MASS SP | $125.45 | $193.00 | $54.58–$193.00 | 12% above | 35% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL TANDEM MASS SP | $125.45 | $193.00 | $54.58–$193.00 | — | 35% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL-17B | $125.45 | $193.00 | $54.58–$193.00 | — | 35% |
| FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN FSH | $83.20 | $128.00 | $36.20–$128.00 | 3% below | 35% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH SERUM | $83.20 | $128.00 | $36.20–$128.00 | 3% below | 35% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN FSH | $83.20 | $128.00 | $36.20–$128.00 | — | 35% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH SERUM | $83.20 | $128.00 | $36.20–$128.00 | — | 35% |
| Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL | $87.75 | $135.00 | $38.18–$135.00 | 41% below | 35% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL | $87.75 | $135.00 | $38.18–$135.00 | — | 35% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN ASSAY | $61.10 | $94.00 | $26.58–$94.00 | 20% below | 35% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN ASSAY | $61.10 | $94.00 | $26.58–$94.00 | — | 35% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN | $43.55 | $67.00 | $18.95–$67.00 | 3% below | 35% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN | $43.55 | $67.00 | $18.95–$67.00 | — | 35% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM ASSAY | $65.65 | $101.00 | $28.56–$101.00 | 3% below | 35% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM ASSAY | $65.65 | $101.00 | $28.56–$101.00 | — | 35% |
| Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE FREE(FT-3) | $76.05 | $117.00 | $33.09–$117.00 | at median | 35% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE | $76.05 | $117.00 | $33.09–$117.00 | at median | 35% |
| Free T3 thyroid hormone test CPT 84481 T3 DIAL FREE | $76.05 | $117.00 | $33.09–$117.00 | at median | 35% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE | $76.05 | $117.00 | $33.09–$117.00 | — | 35% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 DIAL FREE | $76.05 | $117.00 | $33.09–$117.00 | — | 35% |
| Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE FREE(FT-3) | $76.05 | $117.00 | $33.09–$117.00 | — | 35% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE ASSAY | $40.30 | $62.00 | $17.53–$62.00 | 5% below | 35% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXIN FREE | $40.30 | $62.00 | $17.53–$62.00 | 5% below | 35% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE ASSAY | $40.30 | $62.00 | $17.53–$62.00 | — | 35% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXIN FREE | $40.30 | $62.00 | $17.53–$62.00 | — | 35% |
| Free testosterone test CPT 84402 FTTESM TESTO FR AD MALE | $114.40 | $176.00 | $49.77–$176.00 | 18% above | 35% |
| Free testosterone test CPT 84402 BTSTFC TESTOSTERONE FR | $114.40 | $176.00 | $49.77–$176.00 | 18% above | 35% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $114.40 | $176.00 | $49.77–$176.00 | 18% above | 35% |
| Free testosterone test inpatient CPT 84402 FTTESM TESTO FR AD MALE | $114.40 | $176.00 | $49.77–$176.00 | — | 35% |
| Free testosterone test inpatient CPT 84402 BTSTFC TESTOSTERONE FR | $114.40 | $176.00 | $49.77–$176.00 | — | 35% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE | $114.40 | $176.00 | $49.77–$176.00 | — | 35% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 %LIVFIB GGT | $32.50 | $50.00 | $14.14–$50.00 | 24% below | 35% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT ASSAY | $32.50 | $50.00 | $14.14–$50.00 | 24% below | 35% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 %LIVFIB GGT | $32.50 | $50.00 | $14.14–$50.00 | — | 35% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT ASSAY | $32.50 | $50.00 | $14.14–$50.00 | — | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE SCRN POST DOSE | $21.45 | $33.00 | $9.33–$33.00 | 44% below | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE SCRN POST DOSE | $21.45 | $33.00 | $9.33–$33.00 | — | 35% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 3SPEC | $57.85 | $89.00 | $25.17–$89.00 | 14% below | 35% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3SPEC | $57.85 | $89.00 | $25.17–$89.00 | — | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 *NEISSERIA GONORR DNA AMPL | $157.30 | $242.00 | $68.44–$242.00 | 69% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC AMPLIFICATION | $157.30 | $242.00 | $68.44–$242.00 | 69% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 WHIIVF GC AMP | $157.30 | $242.00 | $68.44–$242.00 | 69% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC AMPLIFICATION | $157.30 | $242.00 | $68.44–$242.00 | — | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 WHIIVF GC AMP | $157.30 | $242.00 | $68.44–$242.00 | — | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 *NEISSERIA GONORR DNA AMPL | $157.30 | $242.00 | $68.44–$242.00 | — | 35% |
| H. pylori antibody blood test CPT 86677 *H PYLORI AB | $75.40 | $116.00 | $32.80–$116.00 | at median | 35% |
| H. pylori antibody blood test CPT 86677 H PYLORI AB | $75.40 | $116.00 | $32.80–$116.00 | at median | 35% |
| H. pylori antibody blood test CPT 86677 H PYLORI AB (BACK OFFICE) | $75.40 | $116.00 | $32.80–$116.00 | at median | 35% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB | $75.40 | $116.00 | $32.80–$116.00 | — | 35% |
| H. pylori antibody blood test inpatient CPT 86677 *H PYLORI AB | $75.40 | $116.00 | $32.80–$116.00 | — | 35% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB (BACK OFFICE) | $75.40 | $116.00 | $32.80–$116.00 | — | 35% |
| H. pylori stool antigen test CPT 87338 IMMUNOASSAY, H. PYLORI | $64.35 | $99.00 | $28.00–$99.00 | 8% below | 35% |
| H. pylori stool antigen test CPT 87338 H. PYLORI QUALITATIVE | $64.35 | $99.00 | $28.00–$99.00 | 8% below | 35% |
| H. pylori stool antigen test inpatient CPT 87338 IMMUNOASSAY, H. PYLORI | $64.35 | $99.00 | $28.00–$99.00 | — | 35% |
| H. pylori stool antigen test inpatient CPT 87338 H. PYLORI QUALITATIVE | $64.35 | $99.00 | $28.00–$99.00 | — | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 QUANTIFICATION, HIV-1 | $381.55 | $587.00 | $166.00–$587.00 | 7% above | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 QUANTIFICATION, HIV-1 | $381.55 | $587.00 | $166.00–$587.00 | — | 35% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV1 HIV2 SNGL ASSAY AB | $61.75 | $95.00 | $26.87–$95.00 | at median | 35% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 HIV 2 SNGL ASSAY AB | $61.75 | $95.00 | $26.87–$95.00 | at median | 35% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV2 SNG ASSY (POINT OF CARE LAB) | $61.75 | $95.00 | $26.87–$95.00 | at median | 35% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/HIV2 SNG ASSY (POINT OF CARE LAB) | $61.75 | $95.00 | $26.87–$95.00 | — | 35% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 HIV 2 SNGL ASSAY AB | $61.75 | $95.00 | $26.87–$95.00 | — | 35% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV1 HIV2 SNGL ASSAY AB | $61.75 | $95.00 | $26.87–$95.00 | — | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 WHIIVF HIV 1&2 AG/AB | $107.90 | $166.00 | $46.94–$166.00 | 46% above | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1&2 ANTIGEN/ANTIBODY | $107.90 | $166.00 | $46.94–$166.00 | 46% above | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 %HEXP HIV 1&2 AG/AB | $107.90 | $166.00 | $46.94–$166.00 | 46% above | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 %HEXP HIV 1&2 AG/AB | $107.90 | $166.00 | $46.94–$166.00 | — | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1&2 ANTIGEN/ANTIBODY | $107.90 | $166.00 | $46.94–$166.00 | — | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 WHIIVF HIV 1&2 AG/AB | $107.90 | $166.00 | $46.94–$166.00 | — | 35% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA HI RISK ANL RECT | $157.30 | $242.00 | $68.44–$242.00 | 32% above | 35% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPVSFX HPV HIGH-RISK TYPE | $157.30 | $242.00 | $68.44–$242.00 | 32% above | 35% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA 16 18 PCR | $157.30 | $242.00 | $68.44–$242.00 | 32% above | 35% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA PROBE REFLEX | $157.30 | $242.00 | $68.44–$242.00 | 32% above | 35% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH-RISK TYPES | $157.30 | $242.00 | $68.44–$242.00 | 32% above | 35% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH-RISK TYPES | $157.30 | $242.00 | $68.44–$242.00 | — | 35% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA PROBE REFLEX | $157.30 | $242.00 | $68.44–$242.00 | — | 35% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA 16 18 PCR | $157.30 | $242.00 | $68.44–$242.00 | — | 35% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA HI RISK ANL RECT | $157.30 | $242.00 | $68.44–$242.00 | — | 35% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPVSFX HPV HIGH-RISK TYPE | $157.30 | $242.00 | $68.44–$242.00 | — | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C GLYCOSYLATED (POINT OF CARE LAB) | $43.55 | $67.00 | $18.95–$67.00 | 4% below | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C GLYCOSYLATED | $43.55 | $67.00 | $18.95–$67.00 | 4% below | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C GLYCOSYLATED | $43.55 | $67.00 | $18.95–$67.00 | — | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C GLYCOSYLATED (POINT OF CARE LAB) | $43.55 | $67.00 | $18.95–$67.00 | — | 35% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN | $10.40 | $16.00 | $4.52–$16.00 | 36% below | 35% |
| Hemoglobin blood test CPT 85018 BLOOD COUNT HGB | $10.40 | $16.00 | $4.52–$16.00 | 36% below | 35% |
| Hemoglobin blood test CPT 85018 *BLOOD COUNT HGB | $10.40 | $16.00 | $4.52–$16.00 | 36% below | 35% |
| Hemoglobin blood test CPT 85018 BLOOD COUNT HGB (POINT OF CARE LAB) | $10.40 | $16.00 | $4.52–$16.00 | 36% below | 35% |
| Hemoglobin blood test inpatient CPT 85018 BLOOD COUNT HGB | $10.40 | $16.00 | $4.52–$16.00 | — | 35% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN | $10.40 | $16.00 | $4.52–$16.00 | — | 35% |
| Hemoglobin blood test inpatient CPT 85018 *BLOOD COUNT HGB | $10.40 | $16.00 | $4.52–$16.00 | — | 35% |
| Hemoglobin blood test inpatient CPT 85018 BLOOD COUNT HGB (POINT OF CARE LAB) | $10.40 | $16.00 | $4.52–$16.00 | — | 35% |
| Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTAL | $53.95 | $83.00 | $23.47–$83.00 | at median | 35% |
| Hepatitis B core antibody test (total) CPT 86704 WHIIVF HEP B CORE AB TOTA | $53.95 | $83.00 | $23.47–$83.00 | at median | 35% |
| Hepatitis B core antibody test (total) CPT 86704 *HEP B CORE AB TOTAL | $53.95 | $83.00 | $23.47–$83.00 | at median | 35% |
| Hepatitis B core antibody test (total) CPT 86704 IDM HEP B CORE AB TOTAL | $53.95 | $83.00 | $23.47–$83.00 | at median | 35% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 *HEP B CORE AB TOTAL | $53.95 | $83.00 | $23.47–$83.00 | — | 35% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB TOTAL | $53.95 | $83.00 | $23.47–$83.00 | — | 35% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 IDM HEP B CORE AB TOTAL | $53.95 | $83.00 | $23.47–$83.00 | — | 35% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 WHIIVF HEP B CORE AB TOTA | $53.95 | $83.00 | $23.47–$83.00 | — | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 *HEP B SURFACE AB | $48.10 | $74.00 | $20.93–$74.00 | 1% below | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 *HEP B SURFACE AB | $48.10 | $74.00 | $20.93–$74.00 | — | 35% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 WHIIVF *%HEP HBSAG | $46.15 | $71.00 | $20.08–$71.00 | 2% below | 35% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 *%HEP HBSAG | $46.15 | $71.00 | $20.08–$71.00 | 2% below | 35% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 *HEP B SURFACE AG EIA | $46.15 | $71.00 | $20.08–$71.00 | 2% below | 35% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG EIA | $46.15 | $71.00 | $20.08–$71.00 | 2% below | 35% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 *HEP B SURFACE AG EIA | $46.15 | $71.00 | $20.08–$71.00 | — | 35% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG EIA | $46.15 | $71.00 | $20.08–$71.00 | — | 35% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 WHIIVF *%HEP HBSAG | $46.15 | $71.00 | $20.08–$71.00 | — | 35% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 *%HEP HBSAG | $46.15 | $71.00 | $20.08–$71.00 | — | 35% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB | $63.70 | $98.00 | $27.71–$98.00 | at median | 35% |
| Hepatitis C antibody blood test (screening) CPT 86803 WHIIVF HEP C AB | $63.70 | $98.00 | $27.71–$98.00 | at median | 35% |
| Hepatitis C antibody blood test (screening) CPT 86803 IDM HEP C AB | $63.70 | $98.00 | $27.71–$98.00 | at median | 35% |
| Hepatitis C antibody blood test (screening) CPT 86803 *HEP C AB | $63.70 | $98.00 | $27.71–$98.00 | at median | 35% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 WHIIVF HEP C AB | $63.70 | $98.00 | $27.71–$98.00 | — | 35% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 *HEP C AB | $63.70 | $98.00 | $27.71–$98.00 | — | 35% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 IDM HEP C AB | $63.70 | $98.00 | $27.71–$98.00 | — | 35% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB | $63.70 | $98.00 | $27.71–$98.00 | — | 35% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 QUANTIFICATION, HEPATITIS C VIRUS | $192.40 | $296.00 | $83.71–$296.00 | at median | 35% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 QUANTIFICATION, HEPATITIS C VIRUS | $192.40 | $296.00 | $83.71–$296.00 | — | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE I | $59.15 | $91.00 | $25.73–$91.00 | at median | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 %HSVG12 IGG 1 | $59.15 | $91.00 | $25.73–$91.00 | at median | 35% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE I | $59.15 | $91.00 | $25.73–$91.00 | — | 35% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 %HSVG12 IGG 1 | $59.15 | $91.00 | $25.73–$91.00 | — | 35% |
| Herpes blood test, HSV-2 antibody CPT 86696 *HERPES SIMPLEX TYPE 2 AB | $87.10 | $134.00 | $37.90–$134.00 | 31% above | 35% |
| Herpes blood test, HSV-2 antibody CPT 86696 *AB; HSV II | $87.10 | $134.00 | $37.90–$134.00 | 31% above | 35% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGM TITER REFLEX | $87.10 | $134.00 | $37.90–$134.00 | 31% above | 35% |
| Herpes blood test, HSV-2 antibody CPT 86696 %HSVG12 IGG 2 | $87.10 | $134.00 | $37.90–$134.00 | 31% above | 35% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 *AB; HSV II | $87.10 | $134.00 | $37.90–$134.00 | — | 35% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 *HERPES SIMPLEX TYPE 2 AB | $87.10 | $134.00 | $37.90–$134.00 | — | 35% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 %HSVG12 IGG 2 | $87.10 | $134.00 | $37.90–$134.00 | — | 35% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGM TITER REFLEX | $87.10 | $134.00 | $37.90–$134.00 | — | 35% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HIGH SENSE | $57.85 | $89.00 | $25.17–$89.00 | 14% below | 35% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HIGH SENSE | $57.85 | $89.00 | $25.17–$89.00 | — | 35% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE ASSAY | $80.60 | $124.00 | $35.07–$124.00 | at median | 35% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE ASSAY | $80.60 | $124.00 | $35.07–$124.00 | — | 35% |
| Insulin blood test CPT 83525 INSULIN ASSAY | $51.35 | $79.00 | $22.34–$79.00 | at median | 35% |
| Insulin blood test inpatient CPT 83525 INSULIN ASSAY | $51.35 | $79.00 | $22.34–$79.00 | — | 35% |
| Iron blood test (serum iron) CPT 83540 FE ASSAY | $29.25 | $45.00 | $12.73–$45.00 | 23% below | 35% |
| Iron blood test (serum iron) CPT 83540 IRON TEST | $29.25 | $45.00 | $12.73–$45.00 | 23% below | 35% |
| Iron blood test (serum iron) CPT 83540 *FE ASSAY | $29.25 | $45.00 | $12.73–$45.00 | 23% below | 35% |
| Iron blood test (serum iron) inpatient CPT 83540 *FE ASSAY | $29.25 | $45.00 | $12.73–$45.00 | — | 35% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON TEST | $29.25 | $45.00 | $12.73–$45.00 | — | 35% |
| Iron blood test (serum iron) inpatient CPT 83540 FE ASSAY | $29.25 | $45.00 | $12.73–$45.00 | — | 35% |
| Iron-binding capacity (TIBC) test CPT 83550 FE BINDING CAPACITY | $39.00 | $60.00 | $16.97–$60.00 | at median | 35% |
| Iron-binding capacity (TIBC) test CPT 83550 *FE BINDING CAPACITY | $39.00 | $60.00 | $16.97–$60.00 | at median | 35% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 FE BINDING CAPACITY | $39.00 | $60.00 | $16.97–$60.00 | — | 35% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 *FE BINDING CAPACITY | $39.00 | $60.00 | $16.97–$60.00 | — | 35% |
| Kidney function blood test panel CPT 80069 RENAL FUNC PANL | $39.00 | $60.00 | $16.97–$60.00 | 46% below | 35% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNC PANL | $39.00 | $60.00 | $16.97–$60.00 | — | 35% |
| LH (luteinizing hormone) test CPT 83002 LUTEINING HORMONE | $83.20 | $128.00 | $36.20–$128.00 | 13% below | 35% |
| LH (luteinizing hormone) test CPT 83002 GONADOTROPIN LH | $83.20 | $128.00 | $36.20–$128.00 | 13% below | 35% |
| LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN LH | $83.20 | $128.00 | $36.20–$128.00 | — | 35% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINING HORMONE | $83.20 | $128.00 | $36.20–$128.00 | — | 35% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID) | $52.00 | $80.00 | $22.62–$80.00 | at median | 35% |
| Lactate (lactic acid) blood test CPT 83605 ASSAY LACTIC ACID (POINT OF CARE LAB) | $52.00 | $80.00 | $22.62–$80.00 | at median | 35% |
| Lactate (lactic acid) blood test CPT 83605 ASSAY LACTIC ACID | $52.00 | $80.00 | $22.62–$80.00 | at median | 35% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE(LACTIC ACID) | $52.00 | $80.00 | $22.62–$80.00 | at median | 35% |
| Lactate (lactic acid) blood test inpatient CPT 83605 ASSAY LACTIC ACID | $52.00 | $80.00 | $22.62–$80.00 | — | 35% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE(LACTIC ACID) | $52.00 | $80.00 | $22.62–$80.00 | — | 35% |
| Lactate (lactic acid) blood test inpatient CPT 83605 ASSAY LACTIC ACID (POINT OF CARE LAB) | $52.00 | $80.00 | $22.62–$80.00 | — | 35% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE (LACTIC ACID) | $52.00 | $80.00 | $22.62–$80.00 | — | 35% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LAC (LD)(LDH) | $27.30 | $42.00 | $11.88–$42.00 | at median | 35% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH | $27.30 | $42.00 | $11.88–$42.00 | at median | 35% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH | $27.30 | $42.00 | $11.88–$42.00 | — | 35% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LAC (LD)(LDH) | $27.30 | $42.00 | $11.88–$42.00 | — | 35% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE ASSAY | $31.20 | $48.00 | $13.57–$48.00 | 46% below | 35% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE ASSAY | $31.20 | $48.00 | $13.57–$48.00 | — | 35% |
| Liver function blood test panel CPT 80076 HEP FUNC PANL | $36.40 | $56.00 | $15.84–$56.00 | 40% below | 35% |
| Liver function blood test panel inpatient CPT 80076 HEP FUNC PANL | $36.40 | $56.00 | $15.84–$56.00 | — | 35% |
| Lyme disease antibody test CPT 86618 LYME REFLEX PNL, CSF | $76.70 | $118.00 | $33.37–$118.00 | at median | 35% |
| Lyme disease antibody test CPT 86618 BORELIA BURGDORFERI LYME | $76.70 | $118.00 | $33.37–$118.00 | at median | 35% |
| Lyme disease antibody test CPT 86618 LYME IGG & IGM SERUM | $76.70 | $118.00 | $33.37–$118.00 | at median | 35% |
| Lyme disease antibody test inpatient CPT 86618 LYME REFLEX PNL, CSF | $76.70 | $118.00 | $33.37–$118.00 | — | 35% |
| Lyme disease antibody test inpatient CPT 86618 LYME IGG & IGM SERUM | $76.70 | $118.00 | $33.37–$118.00 | — | 35% |
| Lyme disease antibody test inpatient CPT 86618 BORELIA BURGDORFERI LYME | $76.70 | $118.00 | $33.37–$118.00 | — | 35% |
| Magnesium blood test CPT 83735 MAG ASSAY | $29.90 | $46.00 | $13.01–$46.00 | 11% below | 35% |
| Magnesium blood test CPT 83735 MAGNESIUM | $29.90 | $46.00 | $13.01–$46.00 | 11% below | 35% |
| Magnesium blood test CPT 83735 MAGNESIUM RBC | $29.90 | $46.00 | $13.01–$46.00 | 11% below | 35% |
| Magnesium blood test CPT 83735 %STCATH MAGNESIUM | $29.90 | $46.00 | $13.01–$46.00 | 11% below | 35% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $29.90 | $46.00 | $13.01–$46.00 | — | 35% |
| Magnesium blood test inpatient CPT 83735 %STCATH MAGNESIUM | $29.90 | $46.00 | $13.01–$46.00 | — | 35% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC | $29.90 | $46.00 | $13.01–$46.00 | — | 35% |
| Magnesium blood test inpatient CPT 83735 MAG ASSAY | $29.90 | $46.00 | $13.01–$46.00 | — | 35% |
| Measles (rubeola) antibody test CPT 86765 MEASLES-RUBEOLA IGM AB | $57.85 | $89.00 | $25.17–$89.00 | 1% above | 35% |
| Measles (rubeola) antibody test CPT 86765 MEASLES-RUBEOLA IGG AB | $57.85 | $89.00 | $25.17–$89.00 | 1% above | 35% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES-RUBEOLA IGG AB | $57.85 | $89.00 | $25.17–$89.00 | — | 35% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES-RUBEOLA IGM AB | $57.85 | $89.00 | $25.17–$89.00 | — | 35% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HTEROPHIL AB SCREEN | $23.40 | $36.00 | $10.18–$36.00 | 56% below | 35% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HTEROPHIL AB SCREEN (POINT OF CARE LAB) | $23.40 | $36.00 | $10.18–$36.00 | 56% below | 35% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETRPHL AB SCRN | $23.40 | $36.00 | $10.18–$36.00 | 56% below | 35% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HTEROPHIL AB SCREEN | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HTEROPHIL AB SCREEN (POINT OF CARE LAB) | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETRPHL AB SCRN | $23.40 | $36.00 | $10.18–$36.00 | — | 35% |
| Mumps immunity blood test CPT 86735 MUMPS IGG ANTIBODY | $58.50 | $90.00 | $25.45–$90.00 | at median | 35% |
| Mumps immunity blood test CPT 86735 MUMPS VIRUS AB IGM | $58.50 | $90.00 | $25.45–$90.00 | at median | 35% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS AB IGM | $58.50 | $90.00 | $25.45–$90.00 | — | 35% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS IGG ANTIBODY | $58.50 | $90.00 | $25.45–$90.00 | — | 35% |
| Obstetric blood test panel CPT 80055 OB PANEL | $214.50 | $330.00 | $93.32–$330.00 | at median | 35% |
| Obstetric blood test panel inpatient CPT 80055 OB PANEL | $214.50 | $330.00 | $93.32–$330.00 | — | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $82.55 | $127.00 | $35.92–$127.00 | at median | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE | $82.55 | $127.00 | $35.92–$127.00 | — | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREEN | $82.55 | $127.00 | $35.92–$127.00 | 4% above | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC | $82.55 | $127.00 | $35.92–$127.00 | 4% above | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (SEND OUT) | $82.55 | $127.00 | $35.92–$127.00 | 4% above | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING | $82.55 | $127.00 | $35.92–$127.00 | 4% above | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 %PHI PROST SPEC AG TOT | $82.55 | $127.00 | $35.92–$127.00 | 4% above | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREEN | $82.55 | $127.00 | $35.92–$127.00 | — | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC | $82.55 | $127.00 | $35.92–$127.00 | — | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREENING | $82.55 | $127.00 | $35.92–$127.00 | — | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 %PHI PROST SPEC AG TOT | $82.55 | $127.00 | $35.92–$127.00 | — | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA (SEND OUT) | $82.55 | $127.00 | $35.92–$127.00 | — | 35% |
| Pap test (liquid-based, automated screening with review) CPT 88175 CYTO IMAGER GYN TP SCREEN | $119.60 | $184.00 | $52.04–$184.00 | 23% above | 35% |
| Pap test (liquid-based, automated screening with review) CPT 88175 CYTO IMAGER GYN TP DIAG | $119.60 | $184.00 | $52.04–$184.00 | 23% above | 35% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTO IMAGER GYN TP SCREEN | $119.60 | $184.00 | $52.04–$184.00 | — | 35% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTO IMAGER GYN TP DIAG | $119.60 | $184.00 | $52.04–$184.00 | — | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOLOGY GYN SC THIN PREP | $91.00 | $140.00 | $39.59–$140.00 | at median | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMR THN PRP | $91.00 | $140.00 | $39.59–$140.00 | at median | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOLOGY GYN SC THIN PREP | $91.00 | $140.00 | $39.59–$140.00 | — | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMR THN PRP | $91.00 | $140.00 | $39.59–$140.00 | — | 35% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE ASSAY | $185.25 | $285.00 | $80.60–$285.00 | 31% above | 35% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE INTACT | $185.25 | $285.00 | $80.60–$285.00 | 31% above | 35% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE INTACT | $185.25 | $285.00 | $80.60–$285.00 | — | 35% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE ASSAY | $185.25 | $285.00 | $80.60–$285.00 | — | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 MANUAL HEME - PTT PLASMA/WHOLE BLOOD | $26.65 | $41.00 | $11.59–$41.00 | 29% below | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 *PTT PLASMA/WHOLE BLOOD | $26.65 | $41.00 | $11.59–$41.00 | 29% below | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 *PTT PLASMA/WHOLE BLOOD | $26.65 | $41.00 | $11.59–$41.00 | — | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 MANUAL HEME - PTT PLASMA/WHOLE BLOOD | $26.65 | $41.00 | $11.59–$41.00 | — | 35% |
| Phosphorus (phosphate) blood test CPT 84100 %STCATH PHOSPOROUS | $21.45 | $33.00 | $9.33–$33.00 | 40% below | 35% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHOROUS ASSAY | $21.45 | $33.00 | $9.33–$33.00 | 40% below | 35% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHOROUS ASSAY | $21.45 | $33.00 | $9.33–$33.00 | — | 35% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 %STCATH PHOSPOROUS | $21.45 | $33.00 | $9.33–$33.00 | — | 35% |
| Potassium blood test CPT 84132 *POTASSIUM SERUM | $21.45 | $33.00 | $9.33–$33.00 | 8% below | 35% |
| Potassium blood test CPT 84132 POTASSIUM | $21.45 | $33.00 | $9.33–$33.00 | 8% below | 35% |
| Potassium blood test CPT 84132 POTASSIUM (POINT OF CARE LAB) | $21.45 | $33.00 | $9.33–$33.00 | 8% below | 35% |
| Potassium blood test inpatient CPT 84132 *POTASSIUM SERUM | $21.45 | $33.00 | $9.33–$33.00 | — | 35% |
| Potassium blood test inpatient CPT 84132 POTASSIUM | $21.45 | $33.00 | $9.33–$33.00 | — | 35% |
| Potassium blood test inpatient CPT 84132 POTASSIUM (POINT OF CARE LAB) | $21.45 | $33.00 | $9.33–$33.00 | — | 35% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 MATERNIT21 PLUS | $3,404.05 | $5,237.00 | $1,481.02–$5,237.00 | 134% above | 35% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 MATERNIT21 PLUS | $3,404.05 | $5,237.00 | $1,481.02–$5,237.00 | — | 35% |
| Progesterone blood test CPT 84144 PROGESTERONE | $93.60 | $144.00 | $40.72–$144.00 | 16% above | 35% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE | $93.60 | $144.00 | $40.72–$144.00 | — | 35% |
| Prolactin blood test CPT 84146 PROLACTIN | $87.10 | $134.00 | $37.90–$134.00 | at median | 35% |
| Prolactin blood test CPT 84146 PROLACTIN MACROADENOMA | $87.10 | $134.00 | $37.90–$134.00 | at median | 35% |
| Prolactin blood test CPT 84146 *PROLACTIN ASSAY | $87.10 | $134.00 | $37.90–$134.00 | at median | 35% |
| Prolactin blood test inpatient CPT 84146 *PROLACTIN ASSAY | $87.10 | $134.00 | $37.90–$134.00 | — | 35% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN MACROADENOMA | $87.10 | $134.00 | $37.90–$134.00 | — | 35% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $87.10 | $134.00 | $37.90–$134.00 | — | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 *PRO TIME | $19.50 | $30.00 | $8.48–$30.00 | 19% below | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PRO TIME (POINT OF CARE LAB) | $19.50 | $30.00 | $8.48–$30.00 | 19% below | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 CLOTTING TEST (POINT OF CARE LAB) | $19.50 | $30.00 | $8.48–$30.00 | 19% below | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 CLOTTING TEST | $19.50 | $30.00 | $8.48–$30.00 | 19% below | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME AND INR (POINT OF CARE LAB) | $19.50 | $30.00 | $8.48–$30.00 | 19% below | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 *PRO TIME | $19.50 | $30.00 | $8.48–$30.00 | — | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CLOTTING TEST | $19.50 | $30.00 | $8.48–$30.00 | — | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME AND INR (POINT OF CARE LAB) | $19.50 | $30.00 | $8.48–$30.00 | — | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CLOTTING TEST (POINT OF CARE LAB) | $19.50 | $30.00 | $8.48–$30.00 | — | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PRO TIME (POINT OF CARE LAB) | $19.50 | $30.00 | $8.48–$30.00 | — | 35% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA OIA (POINT OF CARE LAB) | $74.10 | $114.00 | $32.24–$114.00 | 13% above | 35% |
| Rapid flu test (influenza antigen) CPT 87804 *INFLUENZA A | $74.10 | $114.00 | $32.24–$114.00 | 13% above | 35% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 *INFLUENZA A | $74.10 | $114.00 | $32.24–$114.00 | — | 35% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA OIA (POINT OF CARE LAB) | $74.10 | $114.00 | $32.24–$114.00 | — | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC | $74.10 | $114.00 | $32.24–$114.00 | 30% above | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP ASSAY (POINT OF CARE LAB) | $74.10 | $114.00 | $32.24–$114.00 | 30% above | 35% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC | $74.10 | $114.00 | $32.24–$114.00 | — | 35% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP ASSAY (POINT OF CARE LAB) | $74.10 | $114.00 | $32.24–$114.00 | — | 35% |
| Renin blood test CPT 84244 RENIN PLASMA | $98.80 | $152.00 | $42.99–$152.00 | 16% above | 35% |
| Renin blood test inpatient CPT 84244 RENIN PLASMA | $98.80 | $152.00 | $42.99–$152.00 | — | 35% |
| Rh blood typing CPT 86901 *BLOOD TYPING RH(D) | $13.65 | $21.00 | $5.94–$21.00 | 63% below | 35% |
| Rh blood typing CPT 86901 PAT BLOOD TYPING RH(D) | $13.65 | $21.00 | $5.94–$21.00 | 63% below | 35% |
| Rh blood typing CPT 86901 WHIVF BLD TYPE RHD | $13.65 | $21.00 | $5.94–$21.00 | 63% below | 35% |
| Rh blood typing inpatient CPT 86901 PAT BLOOD TYPING RH(D) | $13.65 | $21.00 | $5.94–$21.00 | — | 35% |
| Rh blood typing inpatient CPT 86901 *BLOOD TYPING RH(D) | $13.65 | $21.00 | $5.94–$21.00 | — | 35% |
| Rh blood typing inpatient CPT 86901 WHIVF BLD TYPE RHD | $13.65 | $21.00 | $5.94–$21.00 | — | 35% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $25.35 | $39.00 | $11.03–$39.00 | 24% below | 35% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR TEST QUANT | $25.35 | $39.00 | $11.03–$39.00 | 24% below | 35% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR TEST QUANT | $25.35 | $39.00 | $11.03–$39.00 | — | 35% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT | $25.35 | $39.00 | $11.03–$39.00 | — | 35% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM IFA | $64.35 | $99.00 | $28.00–$99.00 | 31% above | 35% |
| Rubella antibody test (immunity check) CPT 86762 %TORC AB RUBELLA IGM | $64.35 | $99.00 | $28.00–$99.00 | 31% above | 35% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG SEMI-QUANT | $64.35 | $99.00 | $28.00–$99.00 | 31% above | 35% |
| Rubella antibody test (immunity check) inpatient CPT 86762 %TORC AB RUBELLA IGM | $64.35 | $99.00 | $28.00–$99.00 | — | 35% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG SEMI-QUANT | $64.35 | $99.00 | $28.00–$99.00 | — | 35% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM IFA | $64.35 | $99.00 | $28.00–$99.00 | — | 35% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE AUTO | $12.35 | $19.00 | $5.37–$19.00 | 67% below | 35% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE AUTO | $12.35 | $19.00 | $5.37–$19.00 | — | 35% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 CASA | $133.25 | $205.00 | $57.97–$205.00 | at median | 35% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 CASA | $133.25 | $205.00 | $57.97–$205.00 | — | 35% |
| Sodium blood test CPT 84295 *SODIUM BLOOD | $21.45 | $33.00 | $9.33–$33.00 | 21% below | 35% |
| Sodium blood test CPT 84295 SODIUM | $21.45 | $33.00 | $9.33–$33.00 | 21% below | 35% |
| Sodium blood test CPT 84295 SODIUM BLOOD (POINT OF CARE LAB) | $21.45 | $33.00 | $9.33–$33.00 | 21% below | 35% |
| Sodium blood test inpatient CPT 84295 SODIUM BLOOD (POINT OF CARE LAB) | $21.45 | $33.00 | $9.33–$33.00 | — | 35% |
| Sodium blood test inpatient CPT 84295 SODIUM | $21.45 | $33.00 | $9.33–$33.00 | — | 35% |
| Sodium blood test inpatient CPT 84295 *SODIUM BLOOD | $21.45 | $33.00 | $9.33–$33.00 | — | 35% |
| Stool ova and parasites exam CPT 87177 CONCENTRATION AND ID, OVA AND PARASITE | $39.65 | $61.00 | $17.25–$61.00 | at median | 35% |
| Stool ova and parasites exam inpatient CPT 87177 CONCENTRATION AND ID, OVA AND PARASITE | $39.65 | $61.00 | $17.25–$61.00 | — | 35% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HEMOCULT FECES SCREEN (POINT OF CARE LAB) | $19.50 | $30.00 | $8.48–$30.00 | 32% below | 35% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES COLORECT | $19.50 | $30.00 | $8.48–$30.00 | 32% below | 35% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES COLORECT | $19.50 | $30.00 | $8.48–$30.00 | — | 35% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HEMOCULT FECES SCREEN (POINT OF CARE LAB) | $19.50 | $30.00 | $8.48–$30.00 | — | 35% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLD IA SCRN | $71.50 | $110.00 | $31.11–$110.00 | 34% above | 35% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 IMMUNOASSAY, FECAL OCCULT BLOOD | $71.50 | $110.00 | $31.11–$110.00 | 34% above | 35% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 IMMUNOASSAY, FECAL OCCULT BLOOD | $71.50 | $110.00 | $31.11–$110.00 | — | 35% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLD IA SCRN | $71.50 | $110.00 | $31.11–$110.00 | — | 35% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS T PALLIDUM IGG | $59.15 | $91.00 | $25.73–$91.00 | 2% above | 35% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM | $59.15 | $91.00 | $25.73–$91.00 | 2% above | 35% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM | $59.15 | $91.00 | $25.73–$91.00 | — | 35% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS T PALLIDUM IGG | $59.15 | $91.00 | $25.73–$91.00 | — | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST QUAL | $18.85 | $29.00 | $8.20–$29.00 | 21% below | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL/RPR QUAL | $18.85 | $29.00 | $8.20–$29.00 | 21% below | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL/RPR QUAL | $18.85 | $29.00 | $8.20–$29.00 | — | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST QUAL | $18.85 | $29.00 | $8.20–$29.00 | — | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUNITY MEAS | $278.20 | $428.00 | $121.04–$428.00 | 138% above | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB GOLD PLUS | $278.20 | $428.00 | $121.04–$428.00 | 138% above | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB GOLD PLUS | $278.20 | $428.00 | $121.04–$428.00 | — | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUNITY MEAS | $278.20 | $428.00 | $121.04–$428.00 | — | 35% |
| Testosterone blood test, total (not free testosterone) CPT 84403 FTTESM TESTOSTERONE | $115.70 | $178.00 | $50.34–$178.00 | 26% above | 35% |
| Testosterone blood test, total (not free testosterone) CPT 84403 *TESTOSTERONE TOTAL ASSAY | $115.70 | $178.00 | $50.34–$178.00 | 26% above | 35% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL ASSAY | $115.70 | $178.00 | $50.34–$178.00 | 26% above | 35% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL ASSAY | $115.70 | $178.00 | $50.34–$178.00 | — | 35% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 *TESTOSTERONE TOTAL ASSAY | $115.70 | $178.00 | $50.34–$178.00 | — | 35% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 FTTESM TESTOSTERONE | $115.70 | $178.00 | $50.34–$178.00 | — | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES EA | $65.00 | $100.00 | $28.28–$100.00 | at median | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB | $65.00 | $100.00 | $28.28–$100.00 | at median | 35% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB | $65.00 | $100.00 | $28.28–$100.00 | — | 35% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES EA | $65.00 | $100.00 | $28.28–$100.00 | — | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 %NEO TSH | $75.40 | $116.00 | $32.80–$116.00 | at median | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH) | $75.40 | $116.00 | $32.80–$116.00 | at median | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $75.40 | $116.00 | $32.80–$116.00 | at median | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 %NEO TSH | $75.40 | $116.00 | $32.80–$116.00 | — | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $75.40 | $116.00 | $32.80–$116.00 | — | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (TSH) | $75.40 | $116.00 | $32.80–$116.00 | — | 35% |
| Total IgE blood test CPT 82785 GAMMAGLOBULIN ASSAY IGE | $74.10 | $114.00 | $32.24–$114.00 | 20% above | 35% |
| Total IgE blood test CPT 82785 *GAMMAGLOBULIN ASSAY IGE | $74.10 | $114.00 | $32.24–$114.00 | 20% above | 35% |
| Total IgE blood test inpatient CPT 82785 *GAMMAGLOBULIN ASSAY IGE | $74.10 | $114.00 | $32.24–$114.00 | — | 35% |
| Total IgE blood test inpatient CPT 82785 GAMMAGLOBULIN ASSAY IGE | $74.10 | $114.00 | $32.24–$114.00 | — | 35% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL BLOOD TOTAL | $19.50 | $30.00 | $8.48–$30.00 | 47% below | 35% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL BLOOD TOTAL | $19.50 | $30.00 | $8.48–$30.00 | — | 35% |
| Total thyroxine (T4) blood test CPT 84436 T4 | $30.55 | $47.00 | $13.29–$47.00 | 27% below | 35% |
| Total thyroxine (T4) blood test CPT 84436 *THYROXINE TOTAL ASSAY | $30.55 | $47.00 | $13.29–$47.00 | 27% below | 35% |
| Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL ASSAY | $30.55 | $47.00 | $13.29–$47.00 | 27% below | 35% |
| Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL ASSAY | $30.55 | $47.00 | $13.29–$47.00 | — | 35% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4 | $30.55 | $47.00 | $13.29–$47.00 | — | 35% |
| Total thyroxine (T4) blood test inpatient CPT 84436 *THYROXINE TOTAL ASSAY | $30.55 | $47.00 | $13.29–$47.00 | — | 35% |
| Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE TOTAL(TT-3) | $63.70 | $98.00 | $27.71–$98.00 | 6% above | 35% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIIODOTHYRONINE TOTAL(TT-3) | $63.70 | $98.00 | $27.71–$98.00 | — | 35% |
| Transferrin blood test CPT 84466 TRANSFERRIN | $57.20 | $88.00 | $24.89–$88.00 | 23% below | 35% |
| Transferrin blood test inpatient CPT 84466 TRANSFERRIN | $57.20 | $88.00 | $24.89–$88.00 | — | 35% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF | $157.30 | $242.00 | $68.44–$242.00 | 82% above | 35% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAG AMP | $157.30 | $242.00 | $68.44–$242.00 | 82% above | 35% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF | $157.30 | $242.00 | $68.44–$242.00 | — | 35% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAG AMP | $157.30 | $242.00 | $68.44–$242.00 | — | 35% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES ASSAY | $26.00 | $40.00 | $11.31–$40.00 | 25% below | 35% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES ASSAY | $26.00 | $40.00 | $11.31–$40.00 | — | 35% |
| Troponin test, quantitative CPT 84484 TROPONIN T | $55.90 | $86.00 | $24.32–$86.00 | 33% below | 35% |
| Troponin test, quantitative CPT 84484 TROPONIN I | $55.90 | $86.00 | $24.32–$86.00 | 33% below | 35% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN I | $55.90 | $86.00 | $24.32–$86.00 | — | 35% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN T | $55.90 | $86.00 | $24.32–$86.00 | — | 35% |
| Uric acid blood test CPT 84550 %GMAPS URIC ACID BLD | $20.15 | $31.00 | $8.77–$31.00 | 43% below | 35% |
| Uric acid blood test CPT 84550 URIC ACID BLOOD ASSAY | $20.15 | $31.00 | $8.77–$31.00 | 43% below | 35% |
| Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD ASSAY | $20.15 | $31.00 | $8.77–$31.00 | — | 35% |
| Uric acid blood test inpatient CPT 84550 %GMAPS URIC ACID BLD | $20.15 | $31.00 | $8.77–$31.00 | — | 35% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICRO (POINT OF CARE LAB) | $14.30 | $22.00 | $6.22–$22.00 | 47% below | 35% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W SCPE | $14.30 | $22.00 | $6.22–$22.00 | 47% below | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W SCPE | $14.30 | $22.00 | $6.22–$22.00 | — | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICRO (POINT OF CARE LAB) | $14.30 | $22.00 | $6.22–$22.00 | — | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS ONLY | $10.40 | $16.00 | $4.52–$16.00 | 56% below | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS (POINT OF CARE LAB) | $10.40 | $16.00 | $4.52–$16.00 | 56% below | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO SCPE (POINT OF CARE LAB) | $10.40 | $16.00 | $4.52–$16.00 | 56% below | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO SCPE | $10.40 | $16.00 | $4.52–$16.00 | 56% below | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO SCPE | $10.40 | $16.00 | $4.52–$16.00 | — | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS ONLY | $10.40 | $16.00 | $4.52–$16.00 | — | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO SCPE (POINT OF CARE LAB) | $10.40 | $16.00 | $4.52–$16.00 | — | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS (POINT OF CARE LAB) | $10.40 | $16.00 | $4.52–$16.00 | — | 35% |
| Urinalysis without microscope exam, manual CPT 81002 N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB) | $15.60 | $24.00 | $6.79–$24.00 | 4% below | 35% |
| Urinalysis without microscope exam, manual CPT 81002 UA NON-AUTO W/O MICRO (POINT OF CARE LAB) | $15.60 | $24.00 | $6.79–$24.00 | 4% below | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 UA NON-AUTO W/O MICRO (POINT OF CARE LAB) | $15.60 | $24.00 | $6.79–$24.00 | — | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB) | $15.60 | $24.00 | $6.79–$24.00 | — | 35% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE, BACTERIAL, URINE, QUANTITATIVE | $36.40 | $56.00 | $15.84–$56.00 | 36% below | 35% |
| Urine culture for bacteria, with colony count CPT 87086 CULT/COLONY COUNT QUANT URINE | $36.40 | $56.00 | $15.84–$56.00 | 36% below | 35% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULT/COLONY COUNT QUANT URINE | $36.40 | $56.00 | $15.84–$56.00 | — | 35% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE, BACTERIAL, URINE, QUANTITATIVE | $36.40 | $56.00 | $15.84–$56.00 | — | 35% |
| Urine microalbumin (albumin) test CPT 82043 *MICROALBUMIN URINE QUANT | $26.00 | $40.00 | $11.31–$40.00 | 49% below | 35% |
| Urine microalbumin (albumin) test inpatient CPT 82043 *MICROALBUMIN URINE QUANT | $26.00 | $40.00 | $11.31–$40.00 | — | 35% |
| Urine pregnancy test, read by color change CPT 81025 HCG QUAL FLUID/URINE | $38.35 | $59.00 | $16.69–$59.00 | 21% below | 35% |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE (POINT OF CARE LAB) | $38.35 | $59.00 | $16.69–$59.00 | 21% below | 35% |
| Urine pregnancy test, read by color change CPT 81025 HCG URINE (POINT OF CARE LAB) | $38.35 | $59.00 | $16.69–$59.00 | 21% below | 35% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HCG QUAL FLUID/URINE | $38.35 | $59.00 | $16.69–$59.00 | — | 35% |
| Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST URINE (POINT OF CARE LAB) | $38.35 | $59.00 | $16.69–$59.00 | — | 35% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HCG URINE (POINT OF CARE LAB) | $38.35 | $59.00 | $16.69–$59.00 | — | 35% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 BLOOD | $67.60 | $104.00 | $29.41–$104.00 | 9% below | 35% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VIT B-12 | $67.60 | $104.00 | $29.41–$104.00 | 9% below | 35% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VIT B-12 | $67.60 | $104.00 | $29.41–$104.00 | — | 35% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 BLOOD | $67.60 | $104.00 | $29.41–$104.00 | — | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $132.60 | $204.00 | $57.69–$204.00 | 41% above | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 D2D3 25-OH VITAMIN | $132.60 | $204.00 | $57.69–$204.00 | 41% above | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 D2D3 25-OH VITAMIN | $132.60 | $204.00 | $57.69–$204.00 | — | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY | $132.60 | $204.00 | $57.69–$204.00 | — | 35% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25 DIHYDROXY | $172.90 | $266.00 | $75.22–$266.00 | 12% above | 35% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D 1 25 DIHYDROXY | $172.90 | $266.00 | $75.22–$266.00 | — | 35% |
| Zinc blood test CPT 84630 ZINC BLOOD | $51.35 | $79.00 | $22.34–$79.00 | at median | 35% |
| Zinc blood test inpatient CPT 84630 ZINC BLOOD | $51.35 | $79.00 | $22.34–$79.00 | — | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 %SEQ1 HCG | $67.60 | $104.00 | $29.41–$104.00 | at median | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 %SEQ2 HCG QUANT | $67.60 | $104.00 | $29.41–$104.00 | at median | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANT SERUM | $67.60 | $104.00 | $29.41–$104.00 | at median | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 %1ST TRI HCG QUANT | $67.60 | $104.00 | $29.41–$104.00 | at median | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT SERUM | $67.60 | $104.00 | $29.41–$104.00 | at median | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT SERUM | $67.60 | $104.00 | $29.41–$104.00 | — | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANT SERUM | $67.60 | $104.00 | $29.41–$104.00 | — | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 %SEQ2 HCG QUANT | $67.60 | $104.00 | $29.41–$104.00 | — | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 %1ST TRI HCG QUANT | $67.60 | $104.00 | $29.41–$104.00 | — | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 %SEQ1 HCG | $67.60 | $104.00 | $29.41–$104.00 | — | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ | $716.95 | $1,103.00 | $311.93–$1,103.00 | 90% above | 35% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ | $716.95 | $1,103.00 | $311.93–$1,103.00 | — | 35% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIPULATION | $716.95 | $1,103.00 | $311.93–$1,103.00 | 97% above | 35% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIPULATION | $716.95 | $1,103.00 | $311.93–$1,103.00 | — | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL | $2,445.95 | $3,763.00 | $1,064.18–$3,763.00 | 19% above | 35% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL | $2,445.95 | $3,763.00 | $1,064.18–$3,763.00 | — | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ | $716.95 | $1,103.00 | $311.93–$1,103.00 | 75% above | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ | $716.95 | $1,103.00 | $311.93–$1,103.00 | — | 35% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY | $1,995.50 | $3,070.00 | $868.20–$3,070.00 | at median | 35% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY | $1,995.50 | $3,070.00 | $868.20–$3,070.00 | — | 35% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $154.70 | $238.00 | $67.31–$238.00 | at median | 35% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $154.70 | $238.00 | $67.31–$238.00 | — | 35% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $154.70 | $238.00 | $67.31–$238.00 | at median | 35% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $154.70 | $238.00 | $67.31–$238.00 | — | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX | $601.25 | $925.00 | $261.59–$925.00 | 57% above | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX | $601.25 | $925.00 | $261.59–$925.00 | — | 35% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | $387.40 | $596.00 | $168.55–$596.00 | at median | 35% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | $387.40 | $596.00 | $168.55–$596.00 | — | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $882.70 | $1,358.00 | $384.04–$1,358.00 | 27% above | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $882.70 | $1,358.00 | $384.04–$1,358.00 | — | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US | $882.70 | $1,358.00 | $384.04–$1,358.00 | 43% above | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US | $882.70 | $1,358.00 | $384.04–$1,358.00 | — | 35% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US | $882.70 | $1,358.00 | $384.04–$1,358.00 | 79% above | 35% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US | $882.70 | $1,358.00 | $384.04–$1,358.00 | — | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< | $779.35 | $1,199.00 | $339.08–$1,199.00 | 46% above | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< | $779.35 | $1,199.00 | $339.08–$1,199.00 | — | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $3,105.70 | $4,778.00 | $1,351.22–$4,778.00 | 53% above | 35% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $3,105.70 | $4,778.00 | $1,351.22–$4,778.00 | — | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $3,992.95 | $6,143.00 | $1,737.24–$6,143.00 | 93% above | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $3,992.95 | $6,143.00 | $1,737.24–$6,143.00 | — | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/< | $1,372.15 | $2,111.00 | $596.99–$2,111.00 | 2% above | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/< | $1,372.15 | $2,111.00 | $596.99–$2,111.00 | — | 35% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 | $387.40 | $596.00 | $168.55–$596.00 | 22% above | 35% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 | $387.40 | $596.00 | $168.55–$596.00 | — | 35% |
| Paracentesis with imaging guidance CPT 49083 ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE | $2,803.45 | $4,313.00 | $1,219.72–$4,313.00 | 61% above | 35% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE | $2,803.45 | $4,313.00 | $1,219.72–$4,313.00 | — | 35% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL | $779.35 | $1,199.00 | $339.08–$1,199.00 | at median | 35% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL | $779.35 | $1,199.00 | $339.08–$1,199.00 | — | 35% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE | $779.35 | $1,199.00 | $339.08–$1,199.00 | 16% above | 35% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE | $779.35 | $1,199.00 | $339.08–$1,199.00 | — | 35% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST ELBOW FINGER SHORT ARM | $794.30 | $1,222.00 | $345.58–$1,222.00 | 164% above | 35% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST ELBOW FINGER SHORT ARM | $794.30 | $1,222.00 | $345.58–$1,222.00 | — | 35% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC | $385.45 | $593.00 | $167.70–$593.00 | 33% above | 35% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC | $385.45 | $593.00 | $167.70–$593.00 | — | 35% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT | $471.90 | $726.00 | $205.31–$726.00 | 60% above | 35% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT | $471.90 | $726.00 | $205.31–$726.00 | — | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< | $387.40 | $596.00 | $168.55–$596.00 | 17% above | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< | $387.40 | $596.00 | $168.55–$596.00 | — | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNCTURE | $3,105.70 | $4,778.00 | $1,351.22–$4,778.00 | 190% above | 35% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNCTURE | $3,105.70 | $4,778.00 | $1,351.22–$4,778.00 | — | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM | $387.40 | $596.00 | $168.55–$596.00 | 10% above | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM | $387.40 | $596.00 | $168.55–$596.00 | — | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< | $387.40 | $596.00 | $168.55–$596.00 | 22% above | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< | $387.40 | $596.00 | $168.55–$596.00 | — | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES | $882.70 | $1,358.00 | $384.04–$1,358.00 | 26% above | 35% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES | $882.70 | $1,358.00 | $384.04–$1,358.00 | — | 35% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD/BLOOD COMPONENTS | $1,634.10 | $2,514.00 | $710.96–$2,514.00 | 47% above | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD OR BLOOD COMPONENTS | $1,634.10 | $2,514.00 | $710.96–$2,514.00 | 47% above | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 TXFUS BLOOD/BLOOD COMPONENT | $1,634.10 | $2,514.00 | $710.96–$2,514.00 | 47% above | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD/BLOOD COMPONENTS | $1,634.10 | $2,514.00 | $710.96–$2,514.00 | — | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD OR BLOOD COMPONENTS | $1,634.10 | $2,514.00 | $710.96–$2,514.00 | — | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 TXFUS BLOOD/BLOOD COMPONENT | $1,634.10 | $2,514.00 | $710.96–$2,514.00 | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT | $608.40 | $936.00 | $264.70–$936.00 | 247% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 DAILY PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT | $1,885.65 | $2,901.00 | $820.40–$2,901.00 | 974% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT | $608.40 | $936.00 | $264.70–$936.00 | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 DAILY PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT | $1,885.65 | $2,901.00 | $820.40–$2,901.00 | — | 35% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG | $1,487.85 | $2,289.00 | $647.33–$2,289.00 | 94% above | 35% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG | $1,487.85 | $2,289.00 | $647.33–$2,289.00 | — | 35% |
| Comprehensive eye exam by an eye doctor, new patient CPT 92004 OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST | $385.45 | $593.00 | $167.70–$593.00 | 50% above | 35% |
| Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST | $385.45 | $593.00 | $167.70–$593.00 | — | 35% |
| Comprehensive eye exam, returning patient CPT 92014 OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/> | $385.45 | $593.00 | $167.70–$593.00 | 67% above | 35% |
| Comprehensive eye exam, returning patient inpatient CPT 92014 OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/> | $385.45 | $593.00 | $167.70–$593.00 | — | 35% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 AUDIOMETRY EVAL & SPEECH RECOG | $406.90 | $626.00 | $177.03–$626.00 | 55% above | 35% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 AUDIOMETRY EVAL & SPEECH RECOG | $406.90 | $626.00 | $177.03–$626.00 | — | 35% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN | $3,779.10 | $5,814.00 | $1,644.20–$5,232.60 | 29% above | 35% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN | $3,779.10 | $5,814.00 | $1,644.20–$5,232.60 | — | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R | $222.30 | $342.00 | $96.72–$342.00 | 20% above | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R | $222.30 | $342.00 | $96.72–$342.00 | — | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP | $395.20 | $608.00 | $171.94–$547.20 | 27% above | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP | $395.20 | $608.00 | $171.94–$547.20 | — | 35% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM | $710.45 | $1,093.00 | $309.10–$983.70 | 39% above | 35% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM | $710.45 | $1,093.00 | $309.10–$983.70 | — | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT LOW MDM | $1,242.15 | $1,911.00 | $540.43–$1,719.90 | 47% above | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPARTMENT VISIT LOW MDM | $1,242.15 | $1,911.00 | $540.43–$1,719.90 | — | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT MODERATE MDM | $1,909.70 | $2,938.00 | $830.87–$2,644.20 | 44% above | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPARTMENT VISIT MODERATE MDM | $1,909.70 | $2,938.00 | $830.87–$2,644.20 | — | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT HIGH MDM | $2,749.50 | $4,230.00 | $1,196.24–$3,807.00 | 58% above | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPARTMENT VISIT HIGH MDM | $2,749.50 | $4,230.00 | $1,196.24–$3,807.00 | — | 35% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY | $1,164.15 | $1,791.00 | $506.49–$1,791.00 | 30% above | 35% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY | $1,164.15 | $1,791.00 | $506.49–$1,791.00 | — | 35% |
| Eye exam, returning patient, intermediate CPT 92012 OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT | $385.45 | $593.00 | $167.70–$593.00 | 26% above | 35% |
| Eye exam, returning patient, intermediate inpatient CPT 92012 OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT | $385.45 | $593.00 | $167.70–$593.00 | — | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATE INIT 31-60MIN | $945.10 | $1,454.00 | $411.19–$1,454.00 | 126% above | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATE INIT 31-60MIN | $945.10 | $1,454.00 | $411.19–$1,454.00 | — | 35% |
| IV infusion of a medicine, first hour CPT 96365 IV INF INIT UP TO 1 HR | $945.10 | $1,454.00 | $411.19–$1,454.00 | 118% above | 35% |
| IV infusion of a medicine, first hour CPT 96365 THERAPEUTIC IV INFUSION 1ST HR | $945.10 | $1,454.00 | $411.19–$1,454.00 | 118% above | 35% |
| IV infusion of a medicine, first hour inpatient CPT 96365 THERAPEUTIC IV INFUSION 1ST HR | $945.10 | $1,454.00 | $411.19–$1,454.00 | — | 35% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF INIT UP TO 1 HR | $945.10 | $1,454.00 | $411.19–$1,454.00 | — | 35% |
| IV push of a medicine, first drug CPT 96374 INJECTION IV PUSH INIT | $945.10 | $1,454.00 | $411.19–$1,454.00 | 268% above | 35% |
| IV push of a medicine, first drug CPT 96374 INJ IVPUSH INIT DRUG | $945.10 | $1,454.00 | $411.19–$1,454.00 | 268% above | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 INJ IVPUSH INIT DRUG | $945.10 | $1,454.00 | $411.19–$1,454.00 | — | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 INJECTION IV PUSH INIT | $945.10 | $1,454.00 | $411.19–$1,454.00 | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ SQ/IM | $319.15 | $491.00 | $138.85–$491.00 | 126% above | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM | $319.15 | $491.00 | $138.85–$491.00 | 126% above | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SQ/IM | $319.15 | $491.00 | $138.85–$491.00 | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM | $319.15 | $491.00 | $138.85–$491.00 | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION | $313.30 | $482.00 | $136.31–$482.00 | at median | 35% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION | $313.30 | $482.00 | $136.31–$482.00 | — | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEURMSCL THERAPY 15MIN | $169.65 | $261.00 | $73.81–$261.00 | 55% above | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 VV NEUROMUSCULAR EDUCATION OT (97112) | $169.65 | $261.00 | $73.81–$261.00 | 55% above | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 VV NEUROMUSCULAR EDUCATION PT (97112) | $169.65 | $261.00 | $73.81–$261.00 | 55% above | 35% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURMSCL THERAPY 15MIN | $169.65 | $261.00 | $73.81–$261.00 | — | 35% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 VV NEUROMUSCULAR EDUCATION PT (97112) | $169.65 | $261.00 | $73.81–$261.00 | — | 35% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 VV NEUROMUSCULAR EDUCATION OT (97112) | $169.65 | $261.00 | $73.81–$261.00 | — | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI | $137.80 | $212.00 | $59.95–$212.00 | 113% above | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION THERAPY, INITIAL 15 MIN | $137.80 | $212.00 | $59.95–$212.00 | 113% above | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRITION THERAPY, INITIAL 15 MIN | $137.80 | $212.00 | $59.95–$212.00 | — | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI | $137.80 | $212.00 | $59.95–$212.00 | — | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL - LOW | $438.10 | $674.00 | $190.61–$674.00 | 68% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 VV EVALUATION LOW COMPLEXITY (97165) | $438.10 | $674.00 | $190.61–$674.00 | 68% above | 35% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL - LOW | $438.10 | $674.00 | $190.61–$674.00 | — | 35% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 VV EVALUATION LOW COMPLEXITY (97165) | $438.10 | $674.00 | $190.61–$674.00 | — | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL - HIGH | $393.25 | $605.00 | $171.09–$605.00 | 31% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 VV EVALUATION HIGH COMPLEXITY (97163) | $393.25 | $605.00 | $171.09–$605.00 | 31% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 VV EVALUATION HIGH COMPLEXITY (97163) | $393.25 | $605.00 | $171.09–$605.00 | — | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL - HIGH | $393.25 | $605.00 | $171.09–$605.00 | — | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 VV EVALUATION LOW COMPLEXITY (97161) | $393.25 | $605.00 | $171.09–$605.00 | 51% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL - LOW | $393.25 | $605.00 | $171.09–$605.00 | 51% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL - LOW | $393.25 | $605.00 | $171.09–$605.00 | — | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 VV EVALUATION LOW COMPLEXITY (97161) | $393.25 | $605.00 | $171.09–$605.00 | — | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 VV EVALUATION MODERATE COMPLEXITY (97162) | $393.25 | $605.00 | $171.09–$605.00 | 42% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL - MOD | $393.25 | $605.00 | $171.09–$605.00 | 42% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL - MOD | $393.25 | $605.00 | $171.09–$605.00 | — | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 VV EVALUATION MODERATE COMPLEXITY (97162) | $393.25 | $605.00 | $171.09–$605.00 | — | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES | $156.65 | $241.00 | $68.15–$241.00 | 41% above | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15MIN GP | $156.65 | $241.00 | $68.15–$241.00 | 41% above | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15MIN | $156.65 | $241.00 | $68.15–$241.00 | 41% above | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES | $156.65 | $241.00 | $68.15–$241.00 | — | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15MIN | $156.65 | $241.00 | $68.15–$241.00 | — | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15MIN GP | $156.65 | $241.00 | $68.15–$241.00 | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 VV THERAPEUTIC EXERCISE OT (97110) | $167.70 | $258.00 | $72.96–$258.00 | 42% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 VV THERAPEUTIC EXERCISE PT (97110) | $167.70 | $258.00 | $72.96–$258.00 | 42% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERA EXER 1 | $167.70 | $258.00 | $72.96–$258.00 | 42% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERA EXER 15MIN | $167.70 | $258.00 | $72.96–$258.00 | 42% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUT PROC/EXER, 15 MIN | $167.70 | $258.00 | $72.96–$258.00 | 42% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 VV THERAPEUTIC EXERCISE PT (97110) | $167.70 | $258.00 | $72.96–$258.00 | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUT PROC/EXER, 15 MIN | $167.70 | $258.00 | $72.96–$258.00 | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERA EXER 1 | $167.70 | $258.00 | $72.96–$258.00 | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERA EXER 15MIN | $167.70 | $258.00 | $72.96–$258.00 | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 VV THERAPEUTIC EXERCISE OT (97110) | $167.70 | $258.00 | $72.96–$258.00 | — | 35% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS | $203.45 | $313.00 | $88.52–$313.00 | 62% above | 35% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS | $203.45 | $313.00 | $88.52–$313.00 | — | 35% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS | $149.50 | $230.00 | $65.04–$230.00 | 19% above | 35% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS | $149.50 | $230.00 | $65.04–$230.00 | — | 35% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER | $157.95 | $243.00 | $68.72–$243.00 | 22% above | 35% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER | $157.95 | $243.00 | $68.72–$243.00 | — | 35% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 VIRTUAL PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | at median | 35% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 VIRTUAL PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | — | 35% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | 66% above | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | — | 35% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | 17% above | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | — | 35% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | at median | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | — | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN | $156.00 | $240.00 | $67.87–$240.00 | 7% below | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN | $156.00 | $240.00 | $67.87–$240.00 | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN | $121.55 | $187.00 | $52.88–$187.00 | 11% below | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN | $121.55 | $187.00 | $52.88–$187.00 | — | 35% |
| Speech and language evaluation CPT 92523 EVAL SPEECH SOUND LANG COMPREH | $651.30 | $1,002.00 | $283.37–$1,002.00 | 91% above | 35% |
| Speech and language evaluation CPT 92523 VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVAL (92523) | $651.30 | $1,002.00 | $283.37–$1,002.00 | 91% above | 35% |
| Speech and language evaluation CPT 92523 EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $651.30 | $1,002.00 | $283.37–$1,002.00 | 91% above | 35% |
| Speech and language evaluation inpatient CPT 92523 VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVAL (92523) | $651.30 | $1,002.00 | $283.37–$1,002.00 | — | 35% |
| Speech and language evaluation inpatient CPT 92523 EVAL SPEECH SOUND LANG COMPREH | $651.30 | $1,002.00 | $283.37–$1,002.00 | — | 35% |
| Speech and language evaluation inpatient CPT 92523 EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $651.30 | $1,002.00 | $283.37–$1,002.00 | — | 35% |
| Speech therapy session, individual CPT 92507 TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND | $307.45 | $473.00 | $133.76–$473.00 | 40% above | 35% |
| Speech therapy session, individual CPT 92507 VV SPEECH THERAPY (92507) | $307.45 | $473.00 | $133.76–$473.00 | 40% above | 35% |
| Speech therapy session, individual CPT 92507 SPEECH/HEARING THERAPY INDIV | $307.45 | $473.00 | $133.76–$473.00 | 40% above | 35% |
| Speech therapy session, individual inpatient CPT 92507 TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND | $307.45 | $473.00 | $133.76–$473.00 | — | 35% |
| Speech therapy session, individual inpatient CPT 92507 VV SPEECH THERAPY (92507) | $307.45 | $473.00 | $133.76–$473.00 | — | 35% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH/HEARING THERAPY INDIV | $307.45 | $473.00 | $133.76–$473.00 | — | 35% |
| Spirometry (breathing test) CPT 94010 SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ | $468.00 | $720.00 | $203.62–$720.00 | 51% above | 35% |
| Spirometry (breathing test) inpatient CPT 94010 SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ | $468.00 | $720.00 | $203.62–$720.00 | — | 35% |
| Spirometry before and after a bronchodilator CPT 94060 BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN | $930.80 | $1,432.00 | $404.97–$1,432.00 | 63% above | 35% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN | $930.80 | $1,432.00 | $404.97–$1,432.00 | — | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $178.10 | $274.00 | $77.49–$274.00 | 46% above | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 VV THERAPEUTIC ACTIVITIES (97530) | $178.10 | $274.00 | $77.49–$274.00 | 46% above | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERA FUNC ACTIVITIES 15M | $178.10 | $274.00 | $77.49–$274.00 | 46% above | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERA ACTIVITY DIR 15MIN | $178.10 | $274.00 | $77.49–$274.00 | 46% above | 35% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERA FUNC ACTIVITIES 15M | $178.10 | $274.00 | $77.49–$274.00 | — | 35% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $178.10 | $274.00 | $77.49–$274.00 | — | 35% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERA ACTIVITY DIR 15MIN | $178.10 | $274.00 | $77.49–$274.00 | — | 35% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 VV THERAPEUTIC ACTIVITIES (97530) | $178.10 | $274.00 | $77.49–$274.00 | — | 35% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE | $320.45 | $493.00 | $139.42–$493.00 | 3% below | 35% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE | $320.45 | $493.00 | $139.42–$493.00 | 3% below | 35% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML INTRAMUSCULAR SYRINGE | $1,324.79 | $2,038.14 | $576.39–$2,038.14 | 300% above | 35% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML INTRAMUSCULAR SYRINGE | $1,324.79 | $2,038.14 | $576.39–$2,038.14 | 300% above | 35% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE | $320.45 | $493.00 | $139.42–$493.00 | — | 35% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE | $320.45 | $493.00 | $139.42–$493.00 | — | 35% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML INTRAMUSCULAR SYRINGE | $1,324.79 | $2,038.14 | $576.39–$2,038.14 | — | 35% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML INTRAMUSCULAR SYRINGE | $1,324.79 | $2,038.14 | $576.39–$2,038.14 | — | 35% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE | $427.05 | $657.00 | $185.80–$657.00 | 15% above | 35% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE | $427.05 | $657.00 | $185.80–$657.00 | 15% above | 35% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSPENSION | $447.80 | $688.92 | $194.83–$688.92 | 20% above | 35% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSPENSION | $447.80 | $688.92 | $194.83–$688.92 | 20% above | 35% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE | $427.05 | $657.00 | $185.80–$657.00 | — | 35% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE | $427.05 | $657.00 | $185.80–$657.00 | — | 35% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSPENSION | $447.80 | $688.92 | $194.83–$688.92 | — | 35% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSPENSION | $447.80 | $688.92 | $194.83–$688.92 | — | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VACC 4-6 YR IM | $136.50 | $210.00 | $59.39–$210.00 | 6% above | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VACC 4-6 YR IM | $136.50 | $210.00 | $59.39–$210.00 | 6% above | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 QUADRACEL (PF) 15 LF-48 MCG-5 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $288.17 | $443.34 | $125.38–$443.34 | 123% above | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 QUADRACEL (PF) 15 LF-48 MCG-5 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $288.17 | $443.34 | $125.38–$443.34 | 123% above | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $291.15 | $447.93 | $126.67–$447.93 | 126% above | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $291.15 | $447.93 | $126.67–$447.93 | 126% above | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP-IPV VACC 4-6 YR IM | $136.50 | $210.00 | $59.39–$210.00 | — | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP-IPV VACC 4-6 YR IM | $136.50 | $210.00 | $59.39–$210.00 | — | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 QUADRACEL (PF) 15 LF-48 MCG-5 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $288.17 | $443.34 | $125.38–$443.34 | — | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 QUADRACEL (PF) 15 LF-48 MCG-5 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $288.17 | $443.34 | $125.38–$443.34 | — | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $291.15 | $447.93 | $126.67–$447.93 | — | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $291.15 | $447.93 | $126.67–$447.93 | — | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP IMMUNIZATION | $66.30 | $102.00 | $28.85–$102.00 | 2% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP IMMUNIZATION | $66.30 | $102.00 | $28.85–$102.00 | 2% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE | $66.30 | $102.00 | $28.85–$102.00 | 2% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE | $66.30 | $102.00 | $28.85–$102.00 | 2% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX (DTAP)(PF) 25 LF UNIT-58MCG-10 LF/0.5ML INTRAMUSCULAR SYRINGE | $133.07 | $204.72 | $57.89–$204.72 | 105% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX (DTAP)(PF) 25 LF UNIT-58MCG-10 LF/0.5ML INTRAMUSCULAR SYRINGE | $133.07 | $204.72 | $57.89–$204.72 | 105% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DAPTACEL (DTAP PEDIATRIC) (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP | $136.99 | $210.75 | $59.60–$210.75 | 111% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DAPTACEL (DTAP PEDIATRIC) (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP | $136.99 | $210.75 | $59.60–$210.75 | 111% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE | $66.30 | $102.00 | $28.85–$102.00 | — | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP IMMUNIZATION | $66.30 | $102.00 | $28.85–$102.00 | — | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP IMMUNIZATION | $66.30 | $102.00 | $28.85–$102.00 | — | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE | $66.30 | $102.00 | $28.85–$102.00 | — | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 INFANRIX (DTAP)(PF) 25 LF UNIT-58MCG-10 LF/0.5ML INTRAMUSCULAR SYRINGE | $133.07 | $204.72 | $57.89–$204.72 | — | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 INFANRIX (DTAP)(PF) 25 LF UNIT-58MCG-10 LF/0.5ML INTRAMUSCULAR SYRINGE | $133.07 | $204.72 | $57.89–$204.72 | — | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DAPTACEL (DTAP PEDIATRIC) (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP | $136.99 | $210.75 | $59.60–$210.75 | — | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DAPTACEL (DTAP PEDIATRIC) (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP | $136.99 | $210.75 | $59.60–$210.75 | — | 35% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX (PF) 10 MCG-25 LF-25 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $502.91 | $773.70 | $218.80–$773.70 | 157% above | 35% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX (PF) 10 MCG-25 LF-25 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $502.91 | $773.70 | $218.80–$773.70 | 157% above | 35% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX (PF) 10 MCG-25 LF-25 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $502.91 | $773.70 | $218.80–$773.70 | — | 35% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX (PF) 10 MCG-25 LF-25 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $502.91 | $773.70 | $218.80–$773.70 | — | 35% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PENTACEL (PF) 15 LF-20 MCG-5 LF-62 DU-10 MCG/0.5 ML INTRAMUSCULAR KIT | $303.99 | $467.67 | $132.26–$467.67 | 91% above | 35% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PENTACEL (PF) 15 LF-20 MCG-5 LF-62 DU-10 MCG/0.5 ML INTRAMUSCULAR KIT | $303.99 | $467.67 | $132.26–$467.67 | 91% above | 35% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 PENTACEL (PF) 15 LF-20 MCG-5 LF-62 DU-10 MCG/0.5 ML INTRAMUSCULAR KIT | $303.99 | $467.67 | $132.26–$467.67 | — | 35% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 PENTACEL (PF) 15 LF-20 MCG-5 LF-62 DU-10 MCG/0.5 ML INTRAMUSCULAR KIT | $303.99 | $467.67 | $132.26–$467.67 | — | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DTAP-IPV-HIB-HEPB VACCINE IM | $341.93 | $526.05 | $148.77–$526.05 | at median | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DTAP-IPV-HIB-HEPB VACCINE IM | $341.93 | $526.05 | $148.77–$526.05 | at median | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $762.18 | $1,172.58 | $331.61–$1,172.58 | 123% above | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $762.18 | $1,172.58 | $331.61–$1,172.58 | 123% above | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $762.18 | $1,172.58 | $331.61–$1,172.58 | 123% above | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $762.18 | $1,172.58 | $331.61–$1,172.58 | 123% above | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DTAP-IPV-HIB-HEPB VACCINE IM | $341.93 | $526.05 | $148.77–$526.05 | — | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DTAP-IPV-HIB-HEPB VACCINE IM | $341.93 | $526.05 | $148.77–$526.05 | — | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $762.18 | $1,172.58 | $331.61–$1,172.58 | — | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $762.18 | $1,172.58 | $331.61–$1,172.58 | — | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $762.18 | $1,172.58 | $331.61–$1,172.58 | — | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $762.18 | $1,172.58 | $331.61–$1,172.58 | — | 35% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK TRIVALENT | $184.99 | $284.60 | $80.48–$284.60 | at median | 35% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK TRIVALENT | $184.99 | $284.60 | $80.48–$284.60 | at median | 35% |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLUBLOK TRIVALENT | $184.99 | $284.60 | $80.48–$284.60 | — | 35% |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLUBLOK TRIVALENT | $184.99 | $284.60 | $80.48–$284.60 | — | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE NO PRESERV 0.25 ML | $48.56 | $74.70 | $21.13–$74.70 | 6% above | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE | $48.56 | $74.70 | $21.13–$74.70 | 6% above | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE | $48.56 | $74.70 | $21.13–$74.70 | 6% above | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE NO PRESERV 0.25 ML | $48.56 | $74.70 | $21.13–$74.70 | 6% above | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE | $97.11 | $149.40 | $42.25–$149.40 | 112% above | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE | $97.11 | $149.40 | $42.25–$149.40 | 112% above | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE | $48.56 | $74.70 | $21.13–$74.70 | — | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE NO PRESERV 0.25 ML | $48.56 | $74.70 | $21.13–$74.70 | — | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE | $48.56 | $74.70 | $21.13–$74.70 | — | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE NO PRESERV 0.25 ML | $48.56 | $74.70 | $21.13–$74.70 | — | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE | $97.11 | $149.40 | $42.25–$149.40 | — | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE | $97.11 | $149.40 | $42.25–$149.40 | — | 35% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV VIRUS VACCINE 9 VAL IM | $718.90 | $1,106.00 | $312.78–$1,106.00 | 39% above | 35% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV VIRUS VACCINE 9 VAL IM | $718.90 | $1,106.00 | $312.78–$1,106.00 | 39% above | 35% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | 196% above | 35% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SUSPENSION | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | 196% above | 35% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SUSPENSION | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | 196% above | 35% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | 196% above | 35% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV VIRUS VACCINE 9 VAL IM | $718.90 | $1,106.00 | $312.78–$1,106.00 | — | 35% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV VIRUS VACCINE 9 VAL IM | $718.90 | $1,106.00 | $312.78–$1,106.00 | — | 35% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | — | 35% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SUSPENSION | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | — | 35% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SUSPENSION | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | — | 35% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | — | 35% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 TWINRIX (PF) 720 ELISA UNIT-20 MCG/ML INTRAMUSCULAR SYRINGE | $327.83 | $504.36 | $142.63–$504.36 | 7% above | 35% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 TWINRIX (PF) 720 ELISA UNIT-20 MCG/ML INTRAMUSCULAR SYRINGE | $327.83 | $504.36 | $142.63–$504.36 | 7% above | 35% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 TWINRIX (PF) 720 ELISA UNIT-20 MCG/ML INTRAMUSCULAR SYRINGE | $327.83 | $504.36 | $142.63–$504.36 | — | 35% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 TWINRIX (PF) 720 ELISA UNIT-20 MCG/ML INTRAMUSCULAR SYRINGE | $327.83 | $504.36 | $142.63–$504.36 | — | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE | $194.18 | $298.74 | $84.48–$298.74 | at median | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE | $194.18 | $298.74 | $84.48–$298.74 | at median | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION | $194.18 | $298.74 | $84.48–$298.74 | at median | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION | $194.18 | $298.74 | $84.48–$298.74 | at median | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $207.83 | $319.74 | $90.42–$319.74 | 7% above | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $207.83 | $319.74 | $90.42–$319.74 | 7% above | 35% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION | $194.18 | $298.74 | $84.48–$298.74 | — | 35% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE | $194.18 | $298.74 | $84.48–$298.74 | — | 35% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE | $194.18 | $298.74 | $84.48–$298.74 | — | 35% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION | $194.18 | $298.74 | $84.48–$298.74 | — | 35% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $207.83 | $319.74 | $90.42–$319.74 | — | 35% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $207.83 | $319.74 | $90.42–$319.74 | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEP A/PEDIATRIC ADOLESEN | $89.70 | $138.00 | $39.03–$138.00 | at median | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEP A/PEDIATRIC ADOLESEN | $89.70 | $138.00 | $39.03–$138.00 | at median | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $183.63 | $282.51 | $79.89–$282.51 | 105% above | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $183.63 | $282.51 | $79.89–$282.51 | 105% above | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $183.63 | $282.51 | $79.89–$282.51 | 105% above | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $183.63 | $282.51 | $79.89–$282.51 | 105% above | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $185.00 | $284.61 | $80.49–$284.61 | 106% above | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $185.00 | $284.61 | $80.49–$284.61 | 106% above | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEP A/PEDIATRIC ADOLESEN | $89.70 | $138.00 | $39.03–$138.00 | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEP A/PEDIATRIC ADOLESEN | $89.70 | $138.00 | $39.03–$138.00 | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $183.63 | $282.51 | $79.89–$282.51 | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $183.63 | $282.51 | $79.89–$282.51 | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $183.63 | $282.51 | $79.89–$282.51 | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $183.63 | $282.51 | $79.89–$282.51 | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $185.00 | $284.61 | $80.49–$284.61 | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $185.00 | $284.61 | $80.49–$284.61 | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE | $167.23 | $257.28 | $72.76–$257.28 | 7% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE | $167.23 | $257.28 | $72.76–$257.28 | 7% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SUSPENSION | $167.23 | $257.28 | $72.76–$257.28 | 7% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SUSPENSION | $167.23 | $257.28 | $72.76–$257.28 | 7% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 IMMUNIZATION HEPATITIS | $167.70 | $258.00 | $72.96–$258.00 | 8% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 IMMUNIZATION HEPATITIS | $167.70 | $258.00 | $72.96–$258.00 | 8% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $173.98 | $267.66 | $75.69–$267.66 | 12% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $173.98 | $267.66 | $75.69–$267.66 | 12% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SUSPENSION | $167.23 | $257.28 | $72.76–$257.28 | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE | $167.23 | $257.28 | $72.76–$257.28 | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SUSPENSION | $167.23 | $257.28 | $72.76–$257.28 | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE | $167.23 | $257.28 | $72.76–$257.28 | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 IMMUNIZATION HEPATITIS | $167.70 | $258.00 | $72.96–$258.00 | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 IMMUNIZATION HEPATITIS | $167.70 | $258.00 | $72.96–$258.00 | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $173.98 | $267.66 | $75.69–$267.66 | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $173.98 | $267.66 | $75.69–$267.66 | — | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPB VACC 2 DOSE ADULT IM | $365.30 | $562.00 | $158.93–$562.00 | 67% above | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPB VACC 2 DOSE ADULT IM | $365.30 | $562.00 | $158.93–$562.00 | 67% above | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $728.91 | $1,121.40 | $317.13–$1,121.40 | 233% above | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $728.91 | $1,121.40 | $317.13–$1,121.40 | 233% above | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPB VACC 2 DOSE ADULT IM | $365.30 | $562.00 | $158.93–$562.00 | — | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPB VACC 2 DOSE ADULT IM | $365.30 | $562.00 | $158.93–$562.00 | — | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $728.91 | $1,121.40 | $317.13–$1,121.40 | — | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $728.91 | $1,121.40 | $317.13–$1,121.40 | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $133.46 | $205.32 | $58.06–$205.32 | 122% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $133.46 | $205.32 | $58.06–$205.32 | 122% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $133.46 | $205.32 | $58.06–$205.32 | 122% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $133.46 | $205.32 | $58.06–$205.32 | 122% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $137.40 | $211.38 | $59.78–$211.38 | 129% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $137.40 | $211.38 | $59.78–$211.38 | 129% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $133.46 | $205.32 | $58.06–$205.32 | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $133.46 | $205.32 | $58.06–$205.32 | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $133.46 | $205.32 | $58.06–$205.32 | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $133.46 | $205.32 | $58.06–$205.32 | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $137.40 | $211.38 | $59.78–$211.38 | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $137.40 | $211.38 | $59.78–$211.38 | — | 35% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 PEDVAX HIB (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $143.79 | $221.22 | $62.56–$221.22 | 105% above | 35% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 PEDVAX HIB (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $143.79 | $221.22 | $62.56–$221.22 | 105% above | 35% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 PEDVAX HIB (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $143.79 | $221.22 | $62.56–$221.22 | — | 35% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 PEDVAX HIB (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $143.79 | $221.22 | $62.56–$221.22 | — | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB, PRP-T | $30.55 | $47.00 | $13.29–$47.00 | at median | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB, PRP-T | $30.55 | $47.00 | $13.29–$47.00 | at median | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $30.79 | $47.37 | $13.40–$47.37 | 1% above | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $30.79 | $47.37 | $13.40–$47.37 | 1% above | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HIB, PRP-T | $30.55 | $47.00 | $13.29–$47.00 | — | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HIB, PRP-T | $30.55 | $47.00 | $13.29–$47.00 | — | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $30.79 | $47.37 | $13.40–$47.37 | — | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $30.79 | $47.37 | $13.40–$47.37 | — | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC PRSV FREE INC ANTIG | $132.15 | $203.30 | $57.49–$203.30 | 28% above | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC PRSV FREE INC ANTIG | $132.15 | $203.30 | $57.49–$203.30 | 28% above | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH-DOSE 2025-2026 (PF) 180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $264.24 | $406.53 | $114.97–$406.53 | 156% above | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH-DOSE 2025-2026 (PF) 180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $264.24 | $406.53 | $114.97–$406.53 | 156% above | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC PRSV FREE INC ANTIG | $132.15 | $203.30 | $57.49–$203.30 | — | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC PRSV FREE INC ANTIG | $132.15 | $203.30 | $57.49–$203.30 | — | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH-DOSE 2025-2026 (PF) 180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $264.24 | $406.53 | $114.97–$406.53 | — | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH-DOSE 2025-2026 (PF) 180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $264.24 | $406.53 | $114.97–$406.53 | — | 35% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 IXIARO (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,380.97 | $2,124.57 | $600.83–$2,124.57 | at median | 35% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 IXIARO (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,380.97 | $2,124.57 | $600.83–$2,124.57 | at median | 35% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 IXIARO (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,380.97 | $2,124.57 | $600.83–$2,124.57 | — | 35% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 IXIARO (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,380.97 | $2,124.57 | $600.83–$2,124.57 | — | 35% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MUMPS RUBELLA MEA | $218.40 | $336.00 | $95.02–$336.00 | 5% above | 35% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MUMPS RUBELLA MEA | $218.40 | $336.00 | $95.02–$336.00 | 5% above | 35% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION | $224.04 | $344.67 | $97.47–$344.67 | 7% above | 35% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION | $224.04 | $344.67 | $97.47–$344.67 | 7% above | 35% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MUMPS RUBELLA MEA | $218.40 | $336.00 | $95.02–$336.00 | — | 35% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MUMPS RUBELLA MEA | $218.40 | $336.00 | $95.02–$336.00 | — | 35% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION | $224.04 | $344.67 | $97.47–$344.67 | — | 35% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION | $224.04 | $344.67 | $97.47–$344.67 | — | 35% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 PROQUAD (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUBCUTANEOUS SUSPENSION | $669.63 | $1,030.20 | $291.34–$1,030.20 | 31% above | 35% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 PROQUAD (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUBCUTANEOUS SUSPENSION | $669.63 | $1,030.20 | $291.34–$1,030.20 | 31% above | 35% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 PROQUAD (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUBCUTANEOUS SUSPENSION | $669.63 | $1,030.20 | $291.34–$1,030.20 | — | 35% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 PROQUAD (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUBCUTANEOUS SUSPENSION | $669.63 | $1,030.20 | $291.34–$1,030.20 | — | 35% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) | $411.74 | $633.45 | $179.14–$633.45 | 30% above | 35% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) | $411.74 | $633.45 | $179.14–$633.45 | 30% above | 35% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) | $411.74 | $633.45 | $179.14–$633.45 | — | 35% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) | $411.74 | $633.45 | $179.14–$633.45 | — | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI) | $401.05 | $617.00 | $174.49–$617.00 | at median | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI) | $401.05 | $617.00 | $174.49–$617.00 | at median | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $825.36 | $1,269.78 | $359.09–$1,269.78 | 106% above | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $825.36 | $1,269.78 | $359.09–$1,269.78 | 106% above | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI) | $401.05 | $617.00 | $174.49–$617.00 | — | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI) | $401.05 | $617.00 | $174.49–$617.00 | — | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $825.36 | $1,269.78 | $359.09–$1,269.78 | — | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $825.36 | $1,269.78 | $359.09–$1,269.78 | — | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB RP W/OMV VACCINE IM | $553.80 | $852.00 | $240.95–$852.00 | at median | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB RP W/OMV VACCINE IM | $553.80 | $852.00 | $240.95–$852.00 | at median | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,172.61 | $1,804.02 | $510.18–$1,804.02 | 113% above | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,172.61 | $1,804.02 | $510.18–$1,804.02 | 113% above | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENB RP W/OMV VACCINE IM | $553.80 | $852.00 | $240.95–$852.00 | — | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENB RP W/OMV VACCINE IM | $553.80 | $852.00 | $240.95–$852.00 | — | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,172.61 | $1,804.02 | $510.18–$1,804.02 | — | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,172.61 | $1,804.02 | $510.18–$1,804.02 | — | 35% |
| Meningococcal B vaccine (Trumenba) CPT 90621 TRUMENBA 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,053.74 | $1,621.14 | $458.46–$1,621.14 | 168% above | 35% |
| Meningococcal B vaccine (Trumenba) CPT 90621 TRUMENBA 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,053.74 | $1,621.14 | $458.46–$1,621.14 | 168% above | 35% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 TRUMENBA 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,053.74 | $1,621.14 | $458.46–$1,621.14 | — | 35% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 TRUMENBA 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,053.74 | $1,621.14 | $458.46–$1,621.14 | — | 35% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL SPRAY SYRINGE | $39.69 | $61.06 | $17.27–$61.06 | at median | 35% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL SPRAY SYRINGE | $39.69 | $61.06 | $17.27–$61.06 | at median | 35% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST VACC NSPR 0.2ML | $40.89 | $62.90 | $17.79–$62.90 | 3% above | 35% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST VACC NSPR 0.2ML | $40.89 | $62.90 | $17.79–$62.90 | 3% above | 35% |
| Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL SPRAY SYRINGE | $39.69 | $61.06 | $17.27–$61.06 | — | 35% |
| Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL SPRAY SYRINGE | $39.69 | $61.06 | $17.27–$61.06 | — | 35% |
| Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST VACC NSPR 0.2ML | $40.89 | $62.90 | $17.79–$62.90 | — | 35% |
| Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST VACC NSPR 0.2ML | $40.89 | $62.90 | $17.79–$62.90 | — | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,056.18 | $1,624.89 | $459.52–$1,624.89 | 141% above | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,056.18 | $1,624.89 | $459.52–$1,624.89 | 141% above | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,056.18 | $1,624.89 | $459.52–$1,624.89 | — | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,056.18 | $1,624.89 | $459.52–$1,624.89 | — | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE CODE 90677 | $661.70 | $1,018.00 | $287.89–$1,018.00 | at median | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE CODE 90677 | $661.70 | $1,018.00 | $287.89–$1,018.00 | at median | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,440.87 | $2,216.73 | $626.89–$2,216.73 | 118% above | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,440.87 | $2,216.73 | $626.89–$2,216.73 | 118% above | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE CODE 90677 | $661.70 | $1,018.00 | $287.89–$1,018.00 | — | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE CODE 90677 | $661.70 | $1,018.00 | $287.89–$1,018.00 | — | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,440.87 | $2,216.73 | $626.89–$2,216.73 | — | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,440.87 | $2,216.73 | $626.89–$2,216.73 | — | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE 23V | $274.95 | $423.00 | $119.62–$423.00 | at median | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE 23V | $274.95 | $423.00 | $119.62–$423.00 | at median | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE | $547.93 | $842.97 | $238.39–$842.97 | 99% above | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE | $547.93 | $842.97 | $238.39–$842.97 | 99% above | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE 23V | $274.95 | $423.00 | $119.62–$423.00 | — | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE 23V | $274.95 | $423.00 | $119.62–$423.00 | — | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE | $547.93 | $842.97 | $238.39–$842.97 | — | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE | $547.93 | $842.97 | $238.39–$842.97 | — | 35% |
| Polio vaccine, inactivated (IPV) CPT 90713 INACTIVE POLIO VACCINE | $98.15 | $151.00 | $42.70–$151.00 | 54% above | 35% |
| Polio vaccine, inactivated (IPV) CPT 90713 INACTIVE POLIO VACCINE | $98.15 | $151.00 | $42.70–$151.00 | 54% above | 35% |
| Polio vaccine, inactivated (IPV) CPT 90713 IPOL 40 UNIT-8 UNIT-32 UNIT/0.5 ML SUSPENSION FOR INJECTION | $220.25 | $338.85 | $95.83–$338.85 | 246% above | 35% |
| Polio vaccine, inactivated (IPV) CPT 90713 IPOL 40 UNIT-8 UNIT-32 UNIT/0.5 ML SUSPENSION FOR INJECTION | $220.25 | $338.85 | $95.83–$338.85 | 246% above | 35% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 INACTIVE POLIO VACCINE | $98.15 | $151.00 | $42.70–$151.00 | — | 35% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 INACTIVE POLIO VACCINE | $98.15 | $151.00 | $42.70–$151.00 | — | 35% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPOL 40 UNIT-8 UNIT-32 UNIT/0.5 ML SUSPENSION FOR INJECTION | $220.25 | $338.85 | $95.83–$338.85 | — | 35% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPOL 40 UNIT-8 UNIT-32 UNIT/0.5 ML SUSPENSION FOR INJECTION | $220.25 | $338.85 | $95.83–$338.85 | — | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE | $1,352.00 | $2,080.00 | $588.22–$2,080.00 | 30% above | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE | $1,352.00 | $2,080.00 | $588.22–$2,080.00 | 30% above | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 BEYFORTUS 100 MG/ML INTRAMUSCULAR SYRINGE | $1,392.44 | $2,142.21 | $605.82–$2,142.21 | 34% above | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 BEYFORTUS 100 MG/ML INTRAMUSCULAR SYRINGE | $1,392.44 | $2,142.21 | $605.82–$2,142.21 | 34% above | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE | $1,352.00 | $2,080.00 | $588.22–$2,080.00 | — | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE | $1,352.00 | $2,080.00 | $588.22–$2,080.00 | — | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 BEYFORTUS 100 MG/ML INTRAMUSCULAR SYRINGE | $1,392.44 | $2,142.21 | $605.82–$2,142.21 | — | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 BEYFORTUS 100 MG/ML INTRAMUSCULAR SYRINGE | $1,392.44 | $2,142.21 | $605.82–$2,142.21 | — | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE | $1,352.00 | $2,080.00 | $588.22–$2,080.00 | at median | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE | $1,352.00 | $2,080.00 | $588.22–$2,080.00 | at median | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE | $2,784.87 | $4,284.42 | $1,211.63–$4,284.42 | 106% above | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE | $2,784.87 | $4,284.42 | $1,211.63–$4,284.42 | 106% above | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE | $1,352.00 | $2,080.00 | $588.22–$2,080.00 | — | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE | $1,352.00 | $2,080.00 | $588.22–$2,080.00 | — | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE | $2,784.87 | $4,284.42 | $1,211.63–$4,284.42 | — | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE | $2,784.87 | $4,284.42 | $1,211.63–$4,284.42 | — | 35% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $746.62 | $1,148.64 | $324.84–$1,148.64 | 4% above | 35% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $746.62 | $1,148.64 | $324.84–$1,148.64 | 4% above | 35% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $746.62 | $1,148.64 | $324.84–$1,148.64 | — | 35% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $746.62 | $1,148.64 | $324.84–$1,148.64 | — | 35% |
| Rabies vaccine, one dose CPT 90675 IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION | $1,015.11 | $1,561.71 | $441.65–$1,561.71 | 7% above | 35% |
| Rabies vaccine, one dose CPT 90675 IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION | $1,015.11 | $1,561.71 | $441.65–$1,561.71 | 7% above | 35% |
| Rabies vaccine, one dose CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSPENSION | $1,016.98 | $1,564.59 | $442.47–$1,564.59 | 7% above | 35% |
| Rabies vaccine, one dose CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSPENSION | $1,016.98 | $1,564.59 | $442.47–$1,564.59 | 7% above | 35% |
| Rabies vaccine, one dose inpatient CPT 90675 IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION | $1,015.11 | $1,561.71 | $441.65–$1,561.71 | — | 35% |
| Rabies vaccine, one dose inpatient CPT 90675 IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION | $1,015.11 | $1,561.71 | $441.65–$1,561.71 | — | 35% |
| Rabies vaccine, one dose inpatient CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSPENSION | $1,016.98 | $1,564.59 | $442.47–$1,564.59 | — | 35% |
| Rabies vaccine, one dose inpatient CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSPENSION | $1,016.98 | $1,564.59 | $442.47–$1,564.59 | — | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTATEQ VACCINE 2 ML ORAL SOLUTION | $99.45 | $153.00 | $43.27–$153.00 | 27% below | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTATEQ VACCINE 2 ML ORAL SOLUTION | $99.45 | $153.00 | $43.27–$153.00 | 27% below | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTOVIRUS VAC ORAL USE | $200.85 | $309.00 | $87.39–$309.00 | 48% above | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTOVIRUS VAC ORAL USE | $200.85 | $309.00 | $87.39–$309.00 | 48% above | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTATEQ VACCINE 2 ML ORAL SOLUTION | $99.45 | $153.00 | $43.27–$153.00 | — | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTATEQ VACCINE 2 ML ORAL SOLUTION | $99.45 | $153.00 | $43.27–$153.00 | — | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTOVIRUS VAC ORAL USE | $200.85 | $309.00 | $87.39–$309.00 | — | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTOVIRUS VAC ORAL USE | $200.85 | $309.00 | $87.39–$309.00 | — | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION KIT | $504.29 | $775.83 | $219.40–$775.83 | at median | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION KIT | $504.29 | $775.83 | $219.40–$775.83 | at median | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX GE ANTIGEN COMPONENT 50 MCG IM SUSPENSION | $504.29 | $775.83 | $219.40–$775.83 | at median | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX GE ANTIGEN COMPONENT 50 MCG IM SUSPENSION | $504.29 | $775.83 | $219.40–$775.83 | at median | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VACC RECOMBINANT IM NJX | $505.05 | $777.00 | $219.74–$777.00 | at median | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VACC RECOMBINANT IM NJX | $505.05 | $777.00 | $219.74–$777.00 | at median | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION KIT | $504.29 | $775.83 | $219.40–$775.83 | — | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX GE ANTIGEN COMPONENT 50 MCG IM SUSPENSION | $504.29 | $775.83 | $219.40–$775.83 | — | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX GE ANTIGEN COMPONENT 50 MCG IM SUSPENSION | $504.29 | $775.83 | $219.40–$775.83 | — | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION KIT | $504.29 | $775.83 | $219.40–$775.83 | — | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HZV VACC RECOMBINANT IM NJX | $505.05 | $777.00 | $219.74–$777.00 | — | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HZV VACC RECOMBINANT IM NJX | $505.05 | $777.00 | $219.74–$777.00 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACCINE NO PRSRV >= 7 IM | $91.65 | $141.00 | $39.87–$141.00 | 2% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACCINE NO PRSRV >= 7 IM | $91.65 | $141.00 | $39.87–$141.00 | 2% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DECAVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $91.96 | $141.48 | $40.01–$141.48 | 2% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DECAVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $91.96 | $141.48 | $40.01–$141.48 | 2% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $207.85 | $319.77 | $90.43–$319.77 | 132% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $207.85 | $319.77 | $90.43–$319.77 | 132% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $207.85 | $319.77 | $90.43–$319.77 | 132% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $207.85 | $319.77 | $90.43–$319.77 | 132% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACCINE NO PRSRV >= 7 IM | $91.65 | $141.00 | $39.87–$141.00 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACCINE NO PRSRV >= 7 IM | $91.65 | $141.00 | $39.87–$141.00 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DECAVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $91.96 | $141.48 | $40.01–$141.48 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DECAVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $91.96 | $141.48 | $40.01–$141.48 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $207.85 | $319.77 | $90.43–$319.77 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $207.85 | $319.77 | $90.43–$319.77 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $207.85 | $319.77 | $90.43–$319.77 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $207.85 | $319.77 | $90.43–$319.77 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE >7 IM | $110.50 | $170.00 | $48.08–$170.00 | at median | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE >7 IM | $110.50 | $170.00 | $48.08–$170.00 | at median | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX TDAP 2.5 LF UNIT-8 MCG-5 LF/0.5 ML INTRAMUSCULAR SYRINGE | $224.13 | $344.82 | $97.52–$344.82 | 103% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX TDAP 2.5 LF UNIT-8 MCG-5 LF/0.5 ML INTRAMUSCULAR SYRINGE | $224.13 | $344.82 | $97.52–$344.82 | 103% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP | $228.52 | $351.57 | $99.42–$351.57 | 107% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE | $228.52 | $351.57 | $99.42–$351.57 | 107% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP | $228.52 | $351.57 | $99.42–$351.57 | 107% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE | $228.52 | $351.57 | $99.42–$351.57 | 107% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE >7 IM | $110.50 | $170.00 | $48.08–$170.00 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE >7 IM | $110.50 | $170.00 | $48.08–$170.00 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX TDAP 2.5 LF UNIT-8 MCG-5 LF/0.5 ML INTRAMUSCULAR SYRINGE | $224.13 | $344.82 | $97.52–$344.82 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX TDAP 2.5 LF UNIT-8 MCG-5 LF/0.5 ML INTRAMUSCULAR SYRINGE | $224.13 | $344.82 | $97.52–$344.82 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP | $228.52 | $351.57 | $99.42–$351.57 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE | $228.52 | $351.57 | $99.42–$351.57 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP | $228.52 | $351.57 | $99.42–$351.57 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE | $228.52 | $351.57 | $99.42–$351.57 | — | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $521.57 | $802.41 | $226.92–$802.41 | 82% above | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $521.57 | $802.41 | $226.92–$802.41 | 82% above | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $756.29 | $1,163.52 | $329.04–$1,163.52 | 164% above | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $756.29 | $1,163.52 | $329.04–$1,163.52 | 164% above | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $521.57 | $802.41 | $226.92–$802.41 | — | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $521.57 | $802.41 | $226.92–$802.41 | — | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $756.29 | $1,163.52 | $329.04–$1,163.52 | — | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $756.29 | $1,163.52 | $329.04–$1,163.52 | — | 35% |
| Typhoid vaccine, oral capsules (Vivotif) CPT 90690 VIVOTIF 2 BILLION UNIT CAPSULEDELAYED RELEASE | $45.75 | $70.38 | $19.90–$70.38 | 8% below | 35% |
| Typhoid vaccine, oral capsules (Vivotif) CPT 90690 VIVOTIF 2 BILLION UNIT CAPSULEDELAYED RELEASE | $45.75 | $70.38 | $19.90–$70.38 | 8% below | 35% |
| Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 VIVOTIF 2 BILLION UNIT CAPSULEDELAYED RELEASE | $45.75 | $70.38 | $19.90–$70.38 | — | 35% |
| Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 VIVOTIF 2 BILLION UNIT CAPSULEDELAYED RELEASE | $45.75 | $70.38 | $19.90–$70.38 | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE PNEUMONIA | $139.10 | $214.00 | $60.52–$214.00 | 242% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE SNGL | $139.10 | $214.00 | $60.52–$214.00 | 242% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE FLU | $139.10 | $214.00 | $60.52–$214.00 | 242% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE PNEUMONIA | $139.10 | $214.00 | $60.52–$214.00 | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE FLU | $139.10 | $214.00 | $60.52–$214.00 | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE SNGL | $139.10 | $214.00 | $60.52–$214.00 | — | 35% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN VACCINE EA ADD | $41.60 | $64.00 | $18.10–$64.00 | 20% above | 35% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN VACCINE EA ADD | $41.60 | $64.00 | $18.10–$64.00 | — | 35% |
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://clevelandclinic.pt.panaceainc.com/MRFDownload/clevelandclinic/akron-lodi