Hospital Chicago-Naperville-Elgin, IL-IN

MacNeal Hospital

MacNeal Hospital in Berwyn, IL publishes cash prices for 459 common procedures listed here, from its own machine-readable price file updated Mar 31, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Illinois median for 454 of 455 procedures. By typical cash price it ranks #6 of 115 Illinois hospitals and #6 of 63 hospitals in the Chicago, IL area, cheapest first. Click a procedure to compare it with other hospitals nearby.

3249 S. Oak Park Ave, Berwyn, IL 60402 Collected Sep 23, 2026 Source price file (708) 783-9100

Acute care hospital Emergency department CMS star rating 3 of 5 CCN 140054 · CMS hospital register NPI 1295710580

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 3 actions for a hospital named MacNeal Hospital in Berwyn, IL:

Jun 15, 2023 Met requirements
Apr 16, 2025 Warning notice
Jul 18, 2025 Case closed

Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken. Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen W&W/O Contrast	$699.20	$3,680.00	$31.92–$1,484.49	76% below	81%
Abdominal X-ray, 2 views CPT 74019 Abdomen Complete 2 Vw	$127.87	$673.00	$127.87–$932.11	64% below	81%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 Ankle Cmplt Min 3 Vw Bilat Mortise	$165.68	$872.00	$15.79–$205.10	—	81%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 Ankle Cmplt Min 3 Vw Bilat Standing	$165.68	$872.00	$15.79–$205.10	—	81%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 Ankle Cmplt Min 3 Vw Bilat Mortise, Harris	$165.68	$872.00	$15.79–$205.10	—	81%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 Ankle Cmplt Min 3 Vw Bilat Talar	$165.68	$872.00	$15.79–$205.10	—	81%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 Ankle Complt Min 3 Vw Bilat	$165.87	$873.00	$15.79–$205.10	—	81%
Ankle X-ray, complete, 3 or more views CPT 73610 Ankle 3+ Views	$110.58	$582.00	$110.58–$806.07	68% below	81%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Cmplt Min 3 Vw Rt Mortise	$110.58	$582.00	$15.79–$205.10	68% below	81%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Complt Min 3 Vw Lt	$110.58	$582.00	$110.58–$806.07	68% below	81%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Complt Min 3 Vw Rt	$110.58	$582.00	$110.58–$806.07	68% below	81%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Cmplt Min 3 Vw Lt Mortise, Harris	$110.58	$582.00	$15.79–$205.10	68% below	81%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Cmplt Min 3 Vw Lt Mortise	$110.58	$582.00	$110.58–$806.07	68% below	81%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Cmplt Min 3 Vw Lt Talar	$110.58	$582.00	$110.58–$806.07	68% below	81%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Cmplt Min 3 Vw Lt Standing	$110.58	$582.00	$15.79–$205.10	68% below	81%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Cmplt Min 3 Vw Rt Mortise, Harris	$110.58	$582.00	$110.58–$806.07	68% below	81%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Cmplt Min 3 Vw Rt Standing	$110.58	$582.00	$110.58–$806.07	68% below	81%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Cmplt Min 3 Vw Rt Talar	$110.58	$582.00	$15.79–$205.10	68% below	81%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Monitor Transcut P02-Pc02	$171.95	$905.00	$23.11–$466.46	58% below	81%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Abi Ankle Brachial Index	$171.95	$905.00	$23.11–$466.46	58% below	81%
Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 Abi Ankle Brachial Index Unilat 1-2 Levels	$163.40	$860.00	$163.40–$1,191.10	60% below	81%
Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 HC CT Upper Ext W/O Contrast Bilat	$699.77	$3,683.00	$19.07–$912.70	—	81%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Upper Ext W/O Contrast Lt	$466.45	$2,455.00	$19.07–$912.70	75% below	81%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Ext W/O Contrast Rt	$466.45	$2,455.00	$19.07–$912.70	75% below	81%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Esophagram	$158.46	$834.00	$31.92–$536.47	76% below	81%
Bone scan, whole body (nuclear medicine) CPT 78306 Bone &/Joint Imaging Whole Body	$521.36	$2,744.00	$72.05–$1,515.31	67% below	81%
Bone scan, whole body (nuclear medicine) CPT 78306 Scan Bone Whole Body	$521.36	$2,744.00	$72.05–$1,515.31	67% below	81%
Breast ultrasound, complete, one breast both sides CPT 76641 U/S Breast Bilat Incl Axilla Complete	$194.37	$1,023.00	$19.07–$564.81	—	81%
Breast ultrasound, complete, one breast CPT 76641 HC US Breast Uni Real Time With Image Complete	$129.58	$682.00	$19.07–$564.81	76% below	81%
Breast ultrasound, complete, one breast CPT 76641 U/S Breast Uni Incl Axilla Complete (Fc)	$129.58	$682.00	$129.58–$944.57	76% below	81%
Breast ultrasound, complete, one breast one side CPT 76641 U/S Breast Uni Lt Incl Axilla Complete	$129.58	$682.00	$19.07–$564.81	76% below	81%
Breast ultrasound, complete, one breast one side CPT 76641 U/S Breast Uni Rt Incl Axilla Complete	$129.58	$682.00	$19.07–$564.81	76% below	81%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC US Breast Bilat Real Time With Image Limited (IR)	$181.83	$957.00	$181.83–$1,325.45	—	81%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC US Breast Bilateral Real Time With Image Limited	$182.21	$959.00	$15.79–$464.41	—	81%
Breast ultrasound, limited (one breast or one area) CPT 76642 U/S Breast Uni Incl Axilla Limited (Fc)	$121.41	$639.00	$121.41–$885.02	72% below	81%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US Breast Uni Real Time With Image Limited	$121.41	$639.00	$121.41–$885.02	72% below	81%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 U/S Breast Uni Lt Incl Axilla Limited	$121.41	$639.00	$15.79–$464.41	72% below	81%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US Breast Uni Rt Real Time With Image Limited (IR)	$121.41	$639.00	$121.41–$885.02	72% below	81%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US Breast Uni Lt Real Time With Image Limited (IR)	$121.41	$639.00	$121.41–$885.02	72% below	81%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 U/S Breast Uni Rt Incl Axilla Limited	$121.41	$639.00	$15.79–$464.41	72% below	81%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angiogrm Abd & Pelv W/WO Cont W/ Imag Post Proc	$769.31	$4,049.00	$64.03–$2,163.75	80% below	81%
CT angiography (CTA) of the head CPT 70496 CT Angio Head W W/O Cont	$579.88	$3,052.00	$579.88–$4,227.02	78% below	81%
CT angiography (CTA) of the neck CPT 70498 CT Angio Neck W W/O Cont	$575.32	$3,028.00	$575.32–$4,193.78	79% below	81%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Angio Chest W&W/O Cont	$610.85	$3,215.00	$610.85–$4,452.78	79% below	81%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Card Struct / Morph + Cor Art	$964.25	$5,075.00	$64.03–$1,813.95	43% below	81%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Card Cor Art W W/O Cont	$964.25	$5,075.00	$64.03–$1,813.95	43% below	81%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT Heart No Contrast Quant Eval Coronry Calcium (S/P Only)	$48.94	$257.58	$15.79–$571.75	78% below	81%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Card Cor Cal W/O Cont	$99.18	$522.00	$15.79–$571.75	55% below	81%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd & Pelvis W/O Contrast	$879.51	$4,629.00	$43.34–$1,012.03	76% below	81%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd & Pelvis W/ Contrast	$1,101.05	$5,795.00	$64.03–$1,717.13	76% below	81%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd & Pelvis W/ & W/O Cont 1 or Both Bdy Regions	$1,274.33	$6,707.00	$64.03–$1,924.44	75% below	81%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W/Contrast	$593.18	$3,122.00	$31.92–$1,318.59	76% below	81%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen W/O Contrast	$483.17	$2,543.00	$19.07–$757.74	76% below	81%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Denta Scan Complete	$417.24	$2,196.00	$417.24–$3,041.46	76% below	81%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Facial Bones O-H W/ 3d Proto	$439.28	$2,312.00	$439.28–$3,202.12	75% below	81%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Temporomandibular Joint	$439.28	$2,312.00	$439.28–$3,202.12	75% below	81%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus Screen	$439.28	$2,312.00	$439.28–$3,202.12	75% below	81%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial W/O Contrast	$439.28	$2,312.00	$439.28–$3,202.12	75% below	81%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Denta Simplant Reformat	$439.28	$2,312.00	$439.28–$3,202.12	75% below	81%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Denta Scan Plan	$439.28	$2,312.00	$439.28–$3,202.12	75% below	81%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head W/O Contrast	$475.19	$2,501.00	$19.07–$596.82	75% below	81%
CT scan of the head with contrast CPT 70460 CT Head W/Contrast	$509.77	$2,683.00	$509.77–$3,715.96	75% below	81%
CT scan of the head without and with contrast CPT 70470 CT Head W&W/O Contrast	$671.08	$3,532.00	$671.08–$4,891.82	73% below	81%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar Spine W/O Con	$529.15	$2,785.00	$529.15–$3,857.23	76% below	81%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Cervical Spine W/O Con	$507.49	$2,671.00	$507.49–$3,699.34	79% below	81%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W/Contrast	$566.01	$2,979.00	$566.01–$4,125.92	74% below	81%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Carotid Duplex Bilat Complt	$457.90	$2,410.00	$43.34–$1,062.51	—	81%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Xray US Carotid Doppl Bil	$457.90	$2,410.00	$43.34–$1,062.51	47% below	81%
Chest CT scan without and with contrast CPT 71270 CT Thorax W&W/O Contrast	$643.34	$3,386.00	$31.92–$1,112.09	78% below	81%
Chest X-ray, 2 views CPT 71046 Chest 2 Vw	$106.97	$563.00	$106.97–$779.76	65% below	81%
Chest X-ray, single view CPT 71045 Chest 1 Vw - Lord	$97.09	$511.00	$15.79–$143.38	61% below	81%
Chest X-ray, single view CPT 71045 Chest 1 Vw	$97.09	$511.00	$97.09–$707.74	61% below	81%
Chest X-ray, single view CPT 71045 Chest 1 Vw Portable	$97.09	$511.00	$15.79–$143.38	61% below	81%
Chest X-ray, single view CPT 71045 Chest 1 Vw - Decub	$97.09	$511.00	$15.79–$143.38	61% below	81%
Collarbone (clavicle) X-ray, complete both sides CPT 73000 Clavicle Complt Bilat	$168.72	$888.00	$15.79–$183.82	—	81%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Complt Rt	$112.48	$592.00	$112.48–$819.92	63% below	81%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Complt Lt	$112.48	$592.00	$112.48–$819.92	63% below	81%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 U/S Retroperitoneal, Complete	$237.88	$1,252.00	$237.88–$1,734.02	72% below	81%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dexa Scan Occh	$150.86	$794.00	$150.86–$1,099.69	70% below	81%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Scan Dexa, Axial Skeleton	$150.86	$794.00	$150.86–$1,099.69	70% below	81%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dexa With Bone Age	$150.86	$794.00	$150.86–$1,099.69	70% below	81%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dexa With Morphology Analysis	$150.86	$794.00	$150.86–$1,099.69	70% below	81%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 NM Dexa Bone Density	$150.86	$794.00	$150.86–$1,099.69	70% below	81%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Dexa Appendicular Skel	$69.35	$365.00	$69.35–$505.53	70% below	81%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 U/S Preg Detailed Single	$239.59	$1,261.00	$43.34–$954.92	75% below	81%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 U/S Preg Detailed 1st Gest	$239.59	$1,261.00	$239.59–$1,746.49	75% below	81%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax W/O Contrast	$462.65	$2,435.00	$19.07–$743.06	76% below	81%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax W/Contrast	$582.92	$3,068.00	$582.92–$4,249.18	76% below	81%
Diagnostic mammogram, both breasts both sides CPT 77066 Mammogram Digtl Diag Same Day as Scrn W/ or W/O Cad Bilat	$166.63	$877.00	$166.63–$1,214.65	—	81%
Diagnostic mammogram, both breasts both sides CPT 77066 Mammogram Digtl Diag W/ or W/O Cad Bilat	$166.63	$877.00	$35.77–$885.04	—	81%
Diagnostic mammogram, both breasts both sides CPT 77066 Mammogram Digtl Diag W/ or W/O Cad Bilat Recall	$166.63	$877.00	$166.63–$1,214.65	—	81%
Diagnostic mammogram, one breast one side CPT 77065 Mammogram Digtl Diag W/ or W/O Cad Unilat Lt Recall	$142.31	$749.00	$142.31–$1,037.37	55% below	81%
Diagnostic mammogram, one breast one side CPT 77065 Mammogram Digtl Diag W/ or W/O Cad Unilat Rt	$142.31	$749.00	$142.31–$1,037.37	55% below	81%
Diagnostic mammogram, one breast one side CPT 77065 Mammogram Digtl Diag W/ or W/O Cad Unilat Lt	$142.31	$749.00	$142.31–$1,037.37	55% below	81%
Diagnostic mammogram, one breast one side CPT 77065 Mammogram Digtl Diag Same Day as Scrn W/ or W/O Cad Unil Rt	$142.31	$749.00	$28.30–$700.20	55% below	81%
Diagnostic mammogram, one breast one side CPT 77065 Mammogram Digtl Diag Same Day as Scrn W/ or W/O Cad Unil Lt	$142.31	$749.00	$28.30–$700.20	55% below	81%
Diagnostic mammogram, one breast one side CPT 77065 Mammogram Digtl Diag W/ or W/O Cad Unilat Rt Recall	$142.31	$749.00	$28.30–$700.20	55% below	81%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 U/S Lower Extremity Art. Bilat	$277.97	$1,463.00	$277.97–$2,026.26	—	81%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Arterial Duplex Leg Bilat	$277.97	$1,463.00	$43.34–$1,349.71	—	81%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Duplex Mapping Leg Bilat	$391.40	$2,060.00	$391.40–$2,853.10	—	81%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex Extremity Veins Bilat	$391.40	$2,060.00	$391.40–$2,853.10	—	81%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Extremity Venous Dop, Bilat	$391.40	$2,060.00	$391.40–$2,853.10	—	81%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Duplex Mapping Arm Bilat	$391.40	$2,060.00	$391.40–$2,853.10	—	81%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Duplex Dvt Arm Bilat	$391.40	$2,060.00	$391.40–$2,853.10	—	81%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Duplex Dvt Leg Bilat	$391.40	$2,060.00	$391.40–$2,853.10	—	81%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Duplex Reflux Leg Bilat	$391.40	$2,060.00	$391.40–$2,853.10	—	81%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Pvi Protocol 2d M-Mode W/ Dopp & Colr Flow	$618.26	$3,254.00	$98.31–$1,072.00	71% below	81%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Saline Cont 2d M-Mode W/ Dopp & Colr Flow	$618.26	$3,254.00	$98.31–$1,072.00	71% below	81%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo 2d M-Mode No Cont W/ Dopp & Colr Flow	$618.26	$3,254.00	$98.31–$1,072.00	71% below	81%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo W/ Imag Cont 2d M-Mode W/ Dopp & Colr Flow Complt	$618.26	$3,254.00	$98.31–$1,072.00	71% below	81%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Vv Opt 2d M-Mode W/ Dopp & Colr Flow	$618.26	$3,254.00	$618.26–$4,506.79	71% below	81%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Aortic Protocol 2d M-Mode W/ Dopp & Colr Flow	$618.26	$3,254.00	$98.31–$1,072.00	71% below	81%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Dyssynch 2d M-Mode W/ Dopp & Colr Flow	$618.26	$3,254.00	$618.26–$4,506.79	71% below	81%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo for Pulm Htn Rv Assess W/ Saline Cont & Dopp	$618.26	$3,254.00	$618.26–$4,506.79	71% below	81%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Tte Cmpl W Doppler & Color Flow	$618.26	$3,254.00	$618.26–$4,506.79	71% below	81%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Peds Echo 2d M-Mode No Contr W/ Dopp & Colr Flow	$618.26	$3,254.00	$98.31–$1,072.00	71% below	81%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Av/Vv Opt 2d M-Mode W/ Dopp & Colr Flow	$618.26	$3,254.00	$618.26–$4,506.79	71% below	81%
Elbow X-ray, 2 views both sides CPT 73070 Elbow 2 Vw Bilat	$117.42	$618.00	$117.42–$855.93	—	81%
Elbow X-ray, 2 views one side CPT 73070 Elbow 2 Vw Rt	$78.28	$412.00	$78.28–$570.62	73% below	81%
Elbow X-ray, 2 views one side CPT 73070 Elbow 2 Vw Lt	$78.28	$412.00	$78.28–$570.62	73% below	81%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 Elbow 3 Vw Bilat Radial Head Capitullum	$177.08	$932.00	$15.79–$183.35	—	81%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 Elbow 3 Vw Bilat Olecranon	$177.08	$932.00	$15.79–$183.35	—	81%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 Elbow 3 Vw Bilat	$177.08	$932.00	$177.08–$1,290.82	—	81%
Elbow X-ray, complete, 3 or more views CPT 73080 Elbow 3+ Views	$118.18	$622.00	$118.18–$861.47	66% below	81%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow 3 Vw Lt	$118.18	$622.00	$118.18–$861.47	66% below	81%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow 3 Vw Rt Radial Head Capitullum	$118.18	$622.00	$15.79–$183.35	66% below	81%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow 3 Vw Rt Olecranon	$118.18	$622.00	$15.79–$183.35	66% below	81%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow 3 Vw Lt Radial Head Capitullum	$118.18	$622.00	$15.79–$183.35	66% below	81%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow 3 Vw Lt Olecranon	$118.18	$622.00	$15.79–$183.35	66% below	81%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow 3 Vw Rt	$118.18	$622.00	$118.18–$861.47	66% below	81%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orb Se P/Fos Ear W/O Cont	$409.45	$2,155.00	$409.45–$2,984.68	76% below	81%
Facial bones X-ray, complete, 3 or more views CPT 70150 Facial Bone Complt Min 3 Vw	$127.49	$671.00	$127.49–$929.34	71% below	81%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 Forearm 2 Vw Bilat	$177.08	$932.00	$177.08–$1,290.82	—	81%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm 2 Vw Lt	$118.18	$622.00	$118.18–$861.47	63% below	81%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm 2 Vw Rt	$118.18	$622.00	$118.18–$861.47	63% below	81%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobil Sys Imag W/WO Gallbladder	$402.99	$2,121.00	$402.99–$2,937.59	73% below	81%
Hand X-ray, 2 views both sides CPT 73120 Hand 2 Vw Bilat	$140.60	$740.00	$140.60–$1,024.90	—	81%
Hand X-ray, 2 views one side CPT 73120 Hand 2 Vw Rt	$93.67	$493.00	$93.67–$682.81	68% below	81%
Hand X-ray, 2 views one side CPT 73120 Hand 2 Vw Lt	$93.67	$493.00	$93.67–$682.81	68% below	81%
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 Calcaneus Min 2 Vw Bilat	$163.59	$861.00	$15.79–$158.11	—	81%
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 Calcaneus Min 2 Vw Bilat Standing	$163.78	$862.00	$163.78–$1,193.87	—	81%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Calcaneus 2 Views	$109.06	$574.00	$109.06–$794.99	59% below	81%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Calcaneus Min 2 Vw Lt Standing	$109.06	$574.00	$15.79–$158.11	59% below	81%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Calcaneus Min 2 Vw Rt Standing	$109.06	$574.00	$109.06–$794.99	59% below	81%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Calcaneus Min 2 Vw Lt	$109.06	$574.00	$109.06–$794.99	59% below	81%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Calcaneus Min 2 Vw Rt	$109.06	$574.00	$109.06–$794.99	59% below	81%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study Unatt W/ Eeg, Ekg, Resp & O2 Mon	$141.36	$744.00	$28.05–$520.04	76% below	81%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study Unatt W/ Ekg, Resp & O2 Mon	$141.36	$744.00	$141.36–$1,030.44	76% below	81%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnogram Age 6 & Abv 4 or > Param W/ Cpap Att Tech	$1,333.80	$7,020.00	$1,333.80–$9,722.70	72% below	81%
Knee X-ray, 3 views both sides CPT 73562 Knee 3 Vw Bilat Sunrise	$154.28	$812.00	$15.79–$230.29	—	81%
Knee X-ray, 3 views both sides CPT 73562 Knee 3 Vw Bilat Sunrise Standing	$154.28	$812.00	$15.79–$230.29	—	81%
Knee X-ray, 3 views both sides CPT 73562 Knee 3 Vw Bilat	$154.47	$813.00	$15.79–$230.29	—	81%
Knee X-ray, 3 views CPT 73562 Knee 3 Views	$102.98	$542.00	$102.98–$750.67	73% below	81%
Knee X-ray, 3 views one side CPT 73562 Knee 3 Vw Lt	$102.98	$542.00	$102.98–$750.67	73% below	81%
Knee X-ray, 3 views one side CPT 73562 Knee 3 Vw Rt	$102.98	$542.00	$102.98–$750.67	73% below	81%
Knee X-ray, 3 views one side CPT 73562 Knee 3 Vw Rt Sunrise	$102.98	$542.00	$102.98–$750.67	73% below	81%
Knee X-ray, 3 views one side CPT 73562 Knee 3 Vw Lt Sunrise Standing	$102.98	$542.00	$102.98–$750.67	73% below	81%
Knee X-ray, 3 views one side CPT 73562 Knee 3 Vw Lt Sunrise	$102.98	$542.00	$102.98–$750.67	73% below	81%
Knee X-ray, 3 views one side CPT 73562 Knee 3 Vw Rt Sunrise Standing	$102.98	$542.00	$102.98–$750.67	73% below	81%
Knee X-ray, complete, 4 or more views both sides CPT 73564 Knee Cmplt 4 or More Vw Bilat Standing	$227.43	$1,197.00	$19.07–$267.96	—	81%
Knee X-ray, complete, 4 or more views both sides CPT 73564 Knee Cmplt 4 or More Vw Bilat Incl Obliq	$227.43	$1,197.00	$19.07–$267.96	—	81%
Knee X-ray, complete, 4 or more views both sides CPT 73564 Knee Complt 4 or More Vw Bilat	$227.81	$1,199.00	$19.07–$267.96	—	81%
Knee X-ray, complete, 4 or more views CPT 73564 Knee 4+ Views	$151.81	$799.00	$151.81–$1,106.62	67% below	81%
Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Cmplt 4 or More Vw Rt Standing	$151.81	$799.00	$19.07–$267.96	67% below	81%
Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Cmplt 4 or More Vw Lt Incl Obliq	$151.81	$799.00	$19.07–$267.96	67% below	81%
Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Cmplt 4 or More Vw Lt Standing	$151.81	$799.00	$19.07–$267.96	67% below	81%
Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Complt 4 or More Vw Lt	$151.81	$799.00	$151.81–$1,106.62	67% below	81%
Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Complt 4 or More Vw Rt	$151.81	$799.00	$151.81–$1,106.62	67% below	81%
Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Cmplt 4 or More Vw Rt Incl Obliq	$151.81	$799.00	$151.81–$1,106.62	67% below	81%
Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 HC CT Lower Ext W/O Contrast Bilat	$629.66	$3,314.00	$19.07–$728.20	—	81%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Ext W/O Contrast Rt	$419.71	$2,209.00	$19.07–$728.20	77% below	81%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Lower Ext W/O Contrast Lt	$419.71	$2,209.00	$19.07–$728.20	77% below	81%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Lower Ext W/O Contrast Unilat	$419.71	$2,209.00	$419.71–$3,059.47	77% below	81%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S Abdominal Ltd (Fc)	$239.21	$1,259.00	$19.07–$481.61	66% below	81%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S Abdominal Limited	$239.21	$1,259.00	$19.07–$481.61	66% below	81%
Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 HC U/S Extrem Non-Vasc Joint or Other Non-Vasc Struct Ltd Bilat	$198.17	$1,043.00	$198.17–$1,444.56	—	81%
Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 HC U/S Extrem Non-Vasc Joint/Othr Non-Vasc Struct Ltd Bilat	$198.17	$1,043.00	$198.17–$1,444.56	—	81%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC U/S Extrem Non-Vasc Joint or Other Non-Vasc Struct Ltd (Fc) L	$132.24	$696.00	$132.24–$963.96	67% below	81%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US Joint/Oth Nonvasc Xtr Strux R-T W/Img Limited	$132.24	$696.00	$132.24–$963.96	67% below	81%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC U/S Extrem Non-Vasc Joint or Other Non-Vasc Struct Ltd (Fc) B	$198.17	$1,043.00	$198.17–$1,444.56	51% below	81%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC U/S Extrem Non-Vasc Joint/Othr Non-Vasc Struct Ltd Lt	$132.24	$696.00	$132.24–$963.96	67% below	81%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 U/S Extrem Non-Vasc Joint or Other Non-Vasc Struct Ltd Rt	$132.24	$696.00	$19.07–$343.42	67% below	81%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC U/S Extrem Non-Vasc Joint or Other Non-Vasc Struct Ltd Lt	$132.24	$696.00	$132.24–$963.96	67% below	81%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 U/S Extrem Non-Vasc Joint or Other Non-Vasc Struct Ltd (Fc) Rt	$132.24	$696.00	$132.24–$963.96	67% below	81%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Cancer Screen Low Dose	$73.34	$386.00	$19.07–$769.48	87% below	81%
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 Tib / Fib 2 Vw Bilat	$183.92	$968.00	$15.79–$177.90	—	81%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tib / Fib 2 Vw Rt	$122.55	$645.00	$15.79–$177.90	62% below	81%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tib / Fib 2 Vw Lt	$122.55	$645.00	$122.55–$893.33	62% below	81%
MR angiography (MRA) of the head without contrast CPT 70544 MR Head Vasc Mra W/O Con	$655.50	$3,450.00	$43.34–$1,230.96	76% below	81%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MR Breast Bilat W or WO Cad W/Con	$904.78	$4,762.00	$396.64–$1,931.16	—	81%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MR Breast Bilat W or WO Cad W & WO Con (C8908)	$1,094.21	$5,759.00	$396.64–$1,931.16	—	81%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 HC MR Low Ext Joint W/O Con Bilat	$1,233.48	$6,492.00	$43.34–$1,149.76	—	81%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MR Low Ext Joint W/O Con Lt	$822.32	$4,328.00	$43.34–$1,149.76	71% below	81%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR Low Ext Joint W/O Con Rt	$822.32	$4,328.00	$822.32–$5,994.28	71% below	81%
MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 HC MR Low Ext Joint W&W/O Con Bilat	$1,433.93	$7,547.00	$1,433.93–$10,452.60	—	81%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR Low Ext Joint W&W/O Con Rt	$955.89	$5,031.00	$64.03–$2,188.22	74% below	81%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MR Low Ext Joint W&W/O Con Lt	$955.89	$5,031.00	$64.03–$2,188.22	74% below	81%
MRI of the abdomen without contrast CPT 74181 MR Scan Abdomen W/O Con	$739.67	$3,893.00	$739.67–$5,391.81	73% below	81%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR Scan Abdomen W&W/O Con	$1,048.23	$5,517.00	$64.03–$1,911.28	72% below	81%
MRI of the brain, no contrast dye CPT 70551 MR Scan Brain/Head WO/Cont	$752.78	$3,962.00	$43.34–$1,102.26	74% below	81%
MRI of the brain, with and without contrast dye CPT 70553 MR Scan Cpa/Iac-W/WO Cont	$994.84	$5,236.00	$994.84–$7,251.86	76% below	81%
MRI of the brain, with and without contrast dye CPT 70553 Stereo Brain Radio-Surg Protocol	$994.84	$5,236.00	$64.03–$1,793.35	76% below	81%
MRI of the brain, with and without contrast dye CPT 70553 MR Scan Sella/Pit-W/WO Co	$994.84	$5,236.00	$994.84–$7,251.86	76% below	81%
MRI of the brain, with and without contrast dye CPT 70553 MR Scan Brain-W/WO Cont	$994.84	$5,236.00	$994.84–$7,251.86	76% below	81%
MRI of the lower back, no contrast dye CPT 72148 MR Scan Spine Lumb-WO/Con	$783.37	$4,123.00	$783.37–$5,710.36	74% below	81%
MRI of the lower back, without and then with contrast dye CPT 72158 MR Scan Spine Lumb-W/WO C	$1,002.06	$5,274.00	$1,002.06–$7,304.49	76% below	81%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR Scan Spine Thor-WO/Con	$744.04	$3,916.00	$744.04–$5,423.66	75% below	81%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR Scan Spine Cerv-W/WO C	$993.89	$5,231.00	$993.89–$7,244.94	76% below	81%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR Scan Spine Cerv-WO/Con	$754.49	$3,971.00	$754.49–$5,499.84	75% below	81%
MRI of the pelvis without and with contrast CPT 72197 MR Prostate W W/O Cont	$1,032.46	$5,434.00	$1,032.46–$7,526.09	72% below	81%
MRI of the pelvis without and with contrast CPT 72197 MR Scan Pelvis/Hip W&W/O Con	$1,032.46	$5,434.00	$64.03–$1,903.41	72% below	81%
MRI of the pelvis, no contrast dye CPT 72195 MR Prostate W/O Cont	$707.18	$3,722.00	$707.18–$5,154.97	74% below	81%
MRI of the pelvis, no contrast dye CPT 72195 MR Scan Pelvis/Hip W/O Con	$707.18	$3,722.00	$43.34–$1,292.85	74% below	81%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 HC MR Up Ext Joint W/O Con Bilat	$1,172.30	$6,170.00	$43.34–$1,151.72	—	81%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MR Up Ext Joint W/O Con Lt	$781.47	$4,113.00	$781.47–$5,696.51	73% below	81%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR Up Ext Joint W/O Con Rt	$781.47	$4,113.00	$781.47–$5,696.51	73% below	81%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Spine Cervical Min 4 Vw	$186.01	$979.00	$186.01–$1,355.92	66% below	81%
Neck soft tissue CT scan with contrast CPT 70491 CT Neck Sft Tiss W/Contrast	$572.09	$3,011.00	$572.09–$4,170.24	74% below	81%
Neck soft tissue CT scan with contrast CPT 70491 CT Larynx W/ Contrast	$572.09	$3,011.00	$572.09–$4,170.24	74% below	81%
Neck soft tissue CT scan without contrast CPT 70490 CT Neck S Tiss/Partid W/O Contrast	$485.64	$2,556.00	$485.64–$3,540.06	74% below	81%
Neck soft tissue X-ray CPT 70360 Neck Soft Tiss 2 Vw	$111.91	$589.00	$111.91–$815.77	58% below	81%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocard Perf Spect Mult Study	$1,263.31	$6,649.00	$234.07–$2,407.87	66% below	81%
OCT scan of the retina (optical coherence tomography) CPT 92134 Scan Computr Opht Dx Imag Post Seg Unil/Bil Retina	$93.86	$494.00	$93.86–$684.19	at median	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Colorectal Ca Init W/ CT Ac	$2,205.90	$11,610.00	$261.52–$2,066.31	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Esophageal Ca Init W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Esophageal Ca Restage W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Lung Nodule Init W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Lung Nodule Restage W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Cervical Init W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Neuroendocrine Tumor (Nets) Restage W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Neuroendocrine Tumor (Nets) Init W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Colorectal Ca Restage W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Lymphoma Init W/ CT Ac	$2,205.90	$11,610.00	$261.52–$2,066.31	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Cervical Restage W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Lymphoma Restage W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Breast Init W/ CT Ac	$2,205.90	$11,610.00	$261.52–$2,066.31	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Ovarian Init W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Ovarian Restage W/ CT Ac	$2,205.90	$11,610.00	$261.52–$2,066.31	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Body Skull Base to Mid Thigh Init W/ CT Ac	$2,205.90	$11,610.00	$261.52–$2,066.31	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Prostate Ca Init W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Body Skull Base to Mid Thigh Restage W/ CT Ac	$2,205.90	$11,610.00	$261.52–$2,066.31	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Thyroid Ca Initi W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Thyroid Ca Restage W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pet/CT Psma	$2,205.90	$11,610.00	$261.52–$2,066.31	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet/CT Bone Skull Base to Mid Thigh	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Prostate Ca Restage W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Breast Restage W/ CT Ac	$2,205.90	$11,610.00	$2,205.90–$16,079.85	63% below	81%
Pelvic CT scan without contrast CPT 72192 CT Pelvis W/O Contrast	$455.05	$2,395.00	$19.07–$742.59	76% below	81%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 U/S Follicular Dev	$156.37	$823.00	$19.07–$269.66	72% below	81%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 U/S Pelvic Gyn Ltd or F/U (Fc)	$156.37	$823.00	$156.37–$1,139.86	72% below	81%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Ultrasound Follic Dvlpt Limit (Fc)	$156.37	$823.00	$156.37–$1,139.86	72% below	81%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Ultrasound Follic Dvlpt Complt (Fc)	$314.45	$1,655.00	$19.07–$582.48	62% below	81%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 U/S Pelvic Mass Diag	$314.45	$1,655.00	$314.45–$2,292.18	62% below	81%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 U/S Pelvic Gyn Complete (Fc)	$314.45	$1,655.00	$314.45–$2,292.18	62% below	81%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 U/S Pregnancy > 14 Wks	$223.63	$1,177.00	$19.07–$741.27	70% below	81%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 U/S Preg > 14 Wks Sing Gest	$223.63	$1,177.00	$223.63–$1,630.15	70% below	81%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 U/S Preg < 14 Wks Sing Gest (Fc)	$127.30	$670.00	$127.30–$927.95	81% below	81%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 U/S Pregnancy < 14 Wks	$127.30	$670.00	$19.07–$637.76	81% below	81%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 U/S Preg < 14 Wks Singl Gest	$127.30	$670.00	$127.30–$927.95	81% below	81%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 U/S Preg Ltd One or More Fetuses	$117.61	$619.00	$19.07–$443.26	77% below	81%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 U/S Pregnancy Ltd	$117.61	$619.00	$19.07–$443.26	77% below	81%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 U/S Preg Ltd, One or More Fetus	$117.61	$619.00	$117.61–$857.32	77% below	81%
Rib X-ray, one side, 2 views one side CPT 71100 Ribs 2 Vw Unilat Rt	$116.28	$612.00	$15.79–$204.76	67% below	81%
Rib X-ray, one side, 2 views one side CPT 71100 Ribs 2 Vw Unilat Lt	$116.28	$612.00	$15.79–$204.76	67% below	81%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs Min 3 Vw Unilat Lt	$148.77	$783.00	$19.07–$234.04	69% below	81%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs Min 3 Vw Unilat Rt	$148.77	$783.00	$19.07–$234.04	69% below	81%
Screening mammogram, both breasts both sides CPT 77067 Mammogram Digtl Scrn W/ or W/O Cad 2vw Ea Bilat	$139.27	$733.00	$29.08–$719.52	—	81%
Screening mammogram, both breasts one side CPT 77067 HC Mammo Breast Screening Unilateral (Mod-52)	$132.24	$696.00	$29.08–$719.52	51% below	81%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 Shoulder Complt Min 2 Vw Bilat	$209.00	$1,100.00	$209.00–$1,523.50	—	81%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 Shoulder Cmplt Min 2 Vw Bilat Evans Series	$209.19	$1,101.00	$209.19–$1,524.89	—	81%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 Shoulder Cmplt Min 2 Vw Bilat Ap, Scap	$209.19	$1,101.00	$209.19–$1,524.89	—	81%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 Shoulder Cmplt Min 2 Vw Bilat Ap, Outlet	$209.19	$1,101.00	$209.19–$1,524.89	—	81%
Shoulder X-ray, complete, 2 or more views CPT 73030 Shoulder 2+ Views	$139.27	$733.00	$139.27–$1,015.21	62% below	81%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Cmplt Min 2 Vw Rt Ap, Outlet	$139.27	$733.00	$15.79–$194.75	62% below	81%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Cmplt Min 2 Vw Rt Ap, Scap	$139.27	$733.00	$15.79–$194.75	62% below	81%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Complt Min 2 Vw Lt	$139.27	$733.00	$15.79–$194.75	62% below	81%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Complt Min 2 Vw Rt	$139.27	$733.00	$15.79–$194.75	62% below	81%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Cmplt Min 2 Vw Lt Ap, Outlet	$139.27	$733.00	$139.27–$1,015.21	62% below	81%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Cmplt Min 2 Vw Lt Ap, Scap	$139.27	$733.00	$139.27–$1,015.21	62% below	81%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Cmplt Min 2 Vw Rt Evans Series	$139.27	$733.00	$15.79–$194.75	62% below	81%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Cmplt Min 2 Vw Lt Evans Series	$139.27	$733.00	$15.79–$194.75	62% below	81%
Sinus X-ray, complete, 3 or more views CPT 70220 Sinus / Paranasal Complt Min 3 Vw	$142.31	$749.00	$142.31–$1,037.37	67% below	81%
Skull X-ray, fewer than 4 views CPT 70250 Skull < 4 Vw	$104.12	$548.00	$104.12–$758.98	67% below	81%
Sleep study in a lab (polysomnography) CPT 95810 Polysomnogram Age 6 & Abv 4 or > Param Att Tech	$1,058.68	$5,572.00	$1,058.68–$7,717.22	74% below	81%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Bicycle Stress Echo No Cont W/ Ekg	$720.10	$3,790.00	$98.31–$1,267.61	54% below	81%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Treadmill Stress Echo No Cont W/ Ekg	$720.10	$3,790.00	$98.31–$1,267.61	54% below	81%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Peds Treadmill Stress Echo No Contr	$720.10	$3,790.00	$98.31–$1,267.61	54% below	81%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Dobutamine Stress Echo No Cont	$720.10	$3,790.00	$98.31–$1,267.61	54% below	81%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Treadmill Stress Echo W/ Cont W/ Ekg	$901.17	$4,743.00	$98.31–$1,267.61	42% below	81%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Bicycle Stress Echo W/ Cont W/ Ekg	$901.17	$4,743.00	$98.31–$1,267.61	42% below	81%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Swallowing Func W/ Cinerad / Videorad	$165.68	$872.00	$31.92–$691.81	75% below	81%
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 Femur Min 2 Vw Bilat Standing Scoli Cassette	$109.06	$574.00	$109.06–$794.99	—	81%
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 Femur Min 2 Vw Bilat Standing	$109.06	$574.00	$109.06–$794.99	—	81%
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 Femur Min 2 Vw Bilat	$109.44	$576.00	$109.44–$797.76	—	81%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Femur 2+ Views	$72.96	$384.00	$72.96–$531.84	74% below	81%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Min 2 Vw Rt	$72.96	$384.00	$72.96–$531.84	74% below	81%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Min 2 Vw Lt	$72.96	$384.00	$72.96–$531.84	74% below	81%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Min 2 Vw Lt Standing Scoli Cassette	$72.96	$384.00	$72.96–$531.84	74% below	81%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Min 2 Vw Lt Standing	$72.96	$384.00	$72.96–$531.84	74% below	81%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Min 2 Vw Rt Standing	$72.96	$384.00	$72.96–$531.84	74% below	81%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Min 2 Vw Rt Standing Scoli Cassette	$72.96	$384.00	$72.96–$531.84	74% below	81%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Thoracic Spine W/O Con	$493.81	$2,599.00	$493.81–$3,599.62	77% below	81%
Toe X-ray, 2 or more views both sides CPT 73660 Toe(S) Min 2 Vw Bilat	$106.40	$560.00	$15.79–$163.47	—	81%
Toe X-ray, 2 or more views CPT 73660 Toe(S) 2+ Views	$70.87	$373.00	$70.87–$516.61	71% below	81%
Toe X-ray, 2 or more views one side CPT 73660 Toe Min 2 Vw Rt 5th	$70.87	$373.00	$15.79–$163.47	71% below	81%
Toe X-ray, 2 or more views one side CPT 73660 Toe(S) Min 2 Vw Rt	$70.87	$373.00	$70.87–$516.61	71% below	81%
Toe X-ray, 2 or more views one side CPT 73660 Toe(S) Min 2 Vw Lt	$70.87	$373.00	$15.79–$163.47	71% below	81%
Toe X-ray, 2 or more views one side CPT 73660 Toe Min 2 Vw Lt Halix	$70.87	$373.00	$15.79–$163.47	71% below	81%
Toe X-ray, 2 or more views one side CPT 73660 Toe Min 2 Vw Lt 2nd	$70.87	$373.00	$15.79–$163.47	71% below	81%
Toe X-ray, 2 or more views one side CPT 73660 Toe Min 2 Vw Lt 3rd	$70.87	$373.00	$15.79–$163.47	71% below	81%
Toe X-ray, 2 or more views one side CPT 73660 Toe Min 2 Vw Lt 4th	$70.87	$373.00	$15.79–$163.47	71% below	81%
Toe X-ray, 2 or more views one side CPT 73660 Toe Min 2 Vw Lt 5th	$70.87	$373.00	$15.79–$163.47	71% below	81%
Toe X-ray, 2 or more views one side CPT 73660 Toe Min 2 Vw Rt Halix	$70.87	$373.00	$15.79–$163.47	71% below	81%
Toe X-ray, 2 or more views one side CPT 73660 Toe Min 2 Vw Rt 2nd	$70.87	$373.00	$15.79–$163.47	71% below	81%
Toe X-ray, 2 or more views one side CPT 73660 Toe Min 2 Vw Rt 3rd	$70.87	$373.00	$15.79–$163.47	71% below	81%
Toe X-ray, 2 or more views one side CPT 73660 Toe Min 2 Vw Rt 4th	$70.87	$373.00	$15.79–$163.47	71% below	81%
Transvaginal pelvic ultrasound CPT 76830 U/S Endovaginal	$218.69	$1,151.00	$218.69–$1,594.14	67% below	81%
Transvaginal pelvic ultrasound CPT 76830 U/S Transvaginal (Fc)	$218.69	$1,151.00	$19.07–$659.51	67% below	81%
Transvaginal ultrasound during pregnancy CPT 76817 U/S Preg Transvaginal	$122.17	$643.00	$19.07–$503.87	77% below	81%
Transvaginal ultrasound during pregnancy CPT 76817 U/S Preg Transvaginal (Fc)	$122.17	$643.00	$122.17–$890.56	77% below	81%
Ultrasound of the abdomen, complete CPT 76700 U/S Abdominal, Complete	$344.09	$1,811.00	$344.09–$2,508.24	68% below	81%
Ultrasound of the abdomen, complete CPT 76700 U/S Abdominal Complete (Fc)	$344.09	$1,811.00	$19.07–$638.95	68% below	81%
Ultrasound of the abdomen, complete CPT 76700 HC US Exam Abdom Complete W/Mod-59	$344.09	$1,811.00	$344.09–$2,508.24	68% below	81%
Ultrasound of the scrotum and testicles CPT 76870 U/S Testicular	$233.32	$1,228.00	$233.32–$1,700.78	69% below	81%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 U/S Thyroid/Soft Tissue Neck	$279.49	$1,471.00	$279.49–$2,037.34	59% below	81%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GI Upper Stomach W/O Kub	$221.92	$1,168.00	$31.92–$672.24	72% below	81%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC Xray of Upper GI Tract Sngl Contrast	$221.92	$1,168.00	$31.92–$672.24	72% below	81%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Radiologic Exam Upr GI Trc Single Contrast Study	$221.92	$1,168.00	$31.92–$672.24	72% below	81%
Upper arm X-ray (humerus), 2 views both sides CPT 73060 Humerus 2 Vw Bilat	$176.89	$931.00	$176.89–$1,289.44	—	81%
Upper arm X-ray (humerus), 2 views both sides CPT 73060 Humerus 2 Vw Bilat Translat	$176.89	$931.00	$176.89–$1,289.44	—	81%
Upper arm X-ray (humerus), 2 views CPT 73060 Humerus 2+ Views	$117.99	$621.00	$117.99–$860.09	62% below	81%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus 2 Vw Lt Translat	$117.99	$621.00	$117.99–$860.09	62% below	81%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus 2 Vw Rt	$117.99	$621.00	$117.99–$860.09	62% below	81%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus 2 Vw Lt	$117.99	$621.00	$117.99–$860.09	62% below	81%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus 2 Vw Rt Translat	$117.99	$621.00	$117.99–$860.09	62% below	81%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 U/S Extremity Venous Dop Uni/Limited	$259.92	$1,368.00	$259.92–$1,894.68	66% below	81%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Duplex Extremity Veins Uni/Ltd	$259.92	$1,368.00	$259.92–$1,894.68	66% below	81%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Dvt Arm Unilat	$259.92	$1,368.00	$259.92–$1,894.68	66% below	81%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 U/S Ext Venous P/P Ablation Unilat Rt	$259.92	$1,368.00	$259.92–$1,894.68	66% below	81%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 U/S Ext Venous P/P Ablation Unilat Lt	$259.92	$1,368.00	$259.92–$1,894.68	66% below	81%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Mapping Arm Unilat	$259.92	$1,368.00	$259.92–$1,894.68	66% below	81%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Dvt Leg Unilat	$259.92	$1,368.00	$259.92–$1,894.68	66% below	81%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Reflux Leg Unilat	$259.92	$1,368.00	$259.92–$1,894.68	66% below	81%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Mapping Leg Unilat	$259.92	$1,368.00	$259.92–$1,894.68	66% below	81%
Wrist X-ray, 2 views both sides CPT 73100 Wrist 2 Vw Bilat Neutral Ortho	$136.61	$719.00	$15.79–$189.73	—	81%
Wrist X-ray, 2 views both sides CPT 73100 Wrist 2 Vw Bilat	$136.61	$719.00	$136.61–$995.82	—	81%
Wrist X-ray, 2 views CPT 73100 Wrist 1-2 Views	$91.01	$479.00	$91.01–$663.42	67% below	81%
Wrist X-ray, 2 views one side CPT 73100 Wrist 2 Vw Rt Neutral Ortho	$91.01	$479.00	$15.79–$189.73	67% below	81%
Wrist X-ray, 2 views one side CPT 73100 Wrist 2 Vw Lt Neutral Ortho	$91.01	$479.00	$15.79–$189.73	67% below	81%
Wrist X-ray, 2 views one side CPT 73100 Wrist 2 Vw Lt	$91.01	$479.00	$91.01–$663.42	67% below	81%
Wrist X-ray, 2 views one side CPT 73100 Wrist 2 Vw Rt	$91.01	$479.00	$91.01–$663.42	67% below	81%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 Wrist Complt Min 3 Vw Bilat	$181.07	$953.00	$181.07–$1,319.91	—	81%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 Wrist Cmplt Min 3 Vw Bilat Grip Ortho	$181.07	$953.00	$15.79–$234.72	—	81%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 Wrist Cmplt Min 3 Vw Bilat Scaphoid Ortho	$181.07	$953.00	$15.79–$234.72	—	81%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 Wrist Complt Min 3 Vw Bilat Fossa	$181.07	$953.00	$15.79–$234.72	—	81%
Wrist X-ray, complete, 3 or more views CPT 73110 Wrist 3+ Views	$120.65	$635.00	$120.65–$879.48	64% below	81%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Complt Min 3 Vw Rt Fossa	$120.65	$635.00	$15.79–$234.72	64% below	81%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Complt Min 3 Vw Lt	$120.65	$635.00	$120.65–$879.48	64% below	81%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Complt Min 3 Vw Rt	$120.65	$635.00	$120.65–$879.48	64% below	81%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Cmplt Min 3 Vw Lt Grip Ortho	$120.65	$635.00	$15.79–$234.72	64% below	81%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Cmplt Min 3 Vw Lt Scaphoid Ortho	$120.65	$635.00	$15.79–$234.72	64% below	81%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Cmplt Min 3 Vw Rt Grip Ortho	$120.65	$635.00	$15.79–$234.72	64% below	81%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Cmplt Min 3 Vw Rt Scaphoid Ortho	$120.65	$635.00	$15.79–$234.72	64% below	81%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Complt Min 3 Vw Lt Fossa	$120.65	$635.00	$15.79–$234.72	64% below	81%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Hip W or WO Pelvis 2-3 Vws	$73.15	$385.00	$73.15–$533.23	76% below	81%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Fluoro Hip Pinning 2-3 Vw	$73.15	$385.00	$73.15–$533.23	76% below	81%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Hip W/WO Pelvis 2-3 Vw Inf/Child	$73.15	$385.00	$73.15–$533.23	76% below	81%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip W/WO Pelvis Complete 2-3 Vw Lt	$73.15	$385.00	$15.79–$269.96	76% below	81%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip W/WO Pelvis Complete 2-3 Vw Rt Crosstable	$73.15	$385.00	$73.15–$533.23	76% below	81%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip W/WO Pelvis Complete 2-3 Vw Lt Crosstable	$73.15	$385.00	$73.15–$533.23	76% below	81%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip W/WO Pelvis Complete 2-3 Vw Rt	$73.15	$385.00	$15.79–$269.96	76% below	81%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip W/WO Pelvis Complete 2-3 Vw Lt Lowenstein	$73.15	$385.00	$73.15–$533.23	76% below	81%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip W/WO Pelvis Complete 2-3 Vw Rt Lowenstein	$73.15	$385.00	$73.15–$533.23	76% below	81%
X-ray of the abdomen, 1 view CPT 74018 Abdomen 1 Vw	$106.97	$563.00	$106.97–$779.76	60% below	81%
X-ray of the ankle, 2 views both sides CPT 73600 Ankle 2 Vw Bilat Standing	$148.01	$779.00	$15.79–$179.86	—	81%
X-ray of the ankle, 2 views both sides CPT 73600 Ankle 2 Vw Bilat	$148.20	$780.00	$15.79–$179.86	—	81%
X-ray of the ankle, 2 views CPT 73600 Ankle 2 Views	$98.80	$520.00	$98.80–$720.20	65% below	81%
X-ray of the ankle, 2 views one side CPT 73600 Ankle 2 Vw Rt Standing	$98.80	$520.00	$15.79–$179.86	65% below	81%
X-ray of the ankle, 2 views one side CPT 73600 Ankle 2 Vw Rt	$98.80	$520.00	$98.80–$720.20	65% below	81%
X-ray of the ankle, 2 views one side CPT 73600 Ankle 2 Vw Lt	$98.80	$520.00	$98.80–$720.20	65% below	81%
X-ray of the ankle, 2 views one side CPT 73600 Ankle 2 Vw Lt Standing	$98.80	$520.00	$15.79–$179.86	65% below	81%
X-ray of the finger(s), 2 or more views both sides CPT 73140 Finger(S) Minimum 2 Vw Bilat	$102.03	$537.00	$102.03–$743.75	—	81%
X-ray of the finger(s), 2 or more views both sides CPT 73140 Finger Minimum 2 Vw Bilat Thumb	$102.03	$537.00	$15.79–$218.80	—	81%
X-ray of the finger(s), 2 or more views both sides CPT 73140 Finger Minimum 2 Vw Bilat Small	$102.03	$537.00	$15.79–$218.80	—	81%
X-ray of the finger(s), 2 or more views both sides CPT 73140 Finger Minimum 2 Vw Bilat Ring	$102.03	$537.00	$15.79–$218.80	—	81%
X-ray of the finger(s), 2 or more views both sides CPT 73140 Finger Minimum 2 Vw Bilat Middle	$102.03	$537.00	$15.79–$218.80	—	81%
X-ray of the finger(s), 2 or more views both sides CPT 73140 Finger Minimum 2 Vw Bilat Index	$102.03	$537.00	$15.79–$218.80	—	81%
X-ray of the finger(s), 2 or more views CPT 73140 Finger(S) 2+ Views	$68.02	$358.00	$68.02–$495.83	74% below	81%
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger Minimum 2 Vw Lt Index	$68.02	$358.00	$15.79–$218.80	74% below	81%
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger Minimum 2 Vw Lt Small	$68.02	$358.00	$15.79–$218.80	74% below	81%
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger Minimum 2 Vw Lt Ring	$68.02	$358.00	$15.79–$218.80	74% below	81%
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger Minimum 2 Vw Lt Middle	$68.02	$358.00	$15.79–$218.80	74% below	81%
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger Minimum 2 Vw Rt Small	$68.02	$358.00	$68.02–$495.83	74% below	81%
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger Minimum 2 Vw Rt Ring	$68.02	$358.00	$68.02–$495.83	74% below	81%
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger(S) Minimum 2 Vw Rt	$68.02	$358.00	$68.02–$495.83	74% below	81%
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger(S) Minimum 2 Vw Lt	$68.02	$358.00	$68.02–$495.83	74% below	81%
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger Minimum 2 Vw Lt Thumb	$68.02	$358.00	$15.79–$218.80	74% below	81%
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger Minimum 2 Vw Rt Middle	$68.02	$358.00	$68.02–$495.83	74% below	81%
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger Minimum 2 Vw Rt Index	$68.02	$358.00	$68.02–$495.83	74% below	81%
X-ray of the finger(s), 2 or more views one side CPT 73140 Finger Minimum 2 Vw Rt Thumb	$68.02	$358.00	$68.02–$495.83	74% below	81%
X-ray of the foot, 2 views both sides CPT 73620 Foot 2 Vw Bilat Standing	$124.64	$656.00	$15.79–$158.11	—	81%
X-ray of the foot, 2 views both sides CPT 73620 Foot 2 Vw Bilat Ap, Ext Obliq	$124.64	$656.00	$124.64–$908.56	—	81%
X-ray of the foot, 2 views both sides CPT 73620 Foot 2 Vw Bilat Ap, Int Obliq	$124.64	$656.00	$15.79–$158.11	—	81%
X-ray of the foot, 2 views both sides CPT 73620 Foot 2 Vw Bilat	$124.83	$657.00	$15.79–$158.11	—	81%
X-ray of the foot, 2 views CPT 73620 Foot 1-2 Views	$83.22	$438.00	$83.22–$606.63	70% below	81%
X-ray of the foot, 2 views one side CPT 73620 Foot 2 Vw Rt Ap, Int Obliq	$83.22	$438.00	$15.79–$158.11	70% below	81%
X-ray of the foot, 2 views one side CPT 73620 Foot 2 Vw Lt	$83.22	$438.00	$83.22–$606.63	70% below	81%
X-ray of the foot, 2 views one side CPT 73620 Foot 2 Vw Rt Ap, Ext Obliq	$83.22	$438.00	$83.22–$606.63	70% below	81%
X-ray of the foot, 2 views one side CPT 73620 Foot 2 Vw Lt Ap, Int Obliq	$83.22	$438.00	$83.22–$606.63	70% below	81%
X-ray of the foot, 2 views one side CPT 73620 Foot 2 Vw Rt Standing	$83.22	$438.00	$83.22–$606.63	70% below	81%
X-ray of the foot, 2 views one side CPT 73620 Foot 2 Vw Lt Ap, Ext Obliq	$83.22	$438.00	$83.22–$606.63	70% below	81%
X-ray of the foot, 2 views one side CPT 73620 Foot 2 Vw Rt	$83.22	$438.00	$83.22–$606.63	70% below	81%
X-ray of the foot, 2 views one side CPT 73620 Foot 2 Vw Lt Standing	$83.22	$438.00	$83.22–$606.63	70% below	81%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 Foot Cmplt Min 3 Vw Bilat Standing Harris	$184.30	$970.00	$184.30–$1,343.45	—	81%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 Foot Cmplt Min 3 Vw Bilat Standing	$184.30	$970.00	$15.79–$191.26	—	81%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 Foot Cmplt Min 3 Vw Bilat Axial Sesamoid	$184.30	$970.00	$184.30–$1,343.45	—	81%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 Foot Complt Min 3 Vw Bilat	$184.49	$971.00	$15.79–$191.26	—	81%
X-ray of the foot, complete, 3 or more views CPT 73630 Foot 3+ Views	$122.93	$647.00	$122.93–$896.10	64% below	81%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Cmplt Min 3 Vw Rt Standing Harris	$122.93	$647.00	$122.93–$896.10	64% below	81%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Complt Min 3 Vw Rt	$122.93	$647.00	$122.93–$896.10	64% below	81%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Complt Min 3 Vw Lt	$122.93	$647.00	$122.93–$896.10	64% below	81%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Cmplt Min 3 Vw Lt Axial Sesamoid	$122.93	$647.00	$122.93–$896.10	64% below	81%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Cmplt Min 3 Vw Rt Axial Sesamoid	$122.93	$647.00	$15.79–$191.26	64% below	81%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Cmplt Min 3 Vw Lt Standing	$122.93	$647.00	$15.79–$191.26	64% below	81%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Cmplt Min 3 Vw Lt Standing Harris	$122.93	$647.00	$122.93–$896.10	64% below	81%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Cmplt Min 3 Vw Rt Standing	$122.93	$647.00	$15.79–$191.26	64% below	81%
X-ray of the hand, 3 or more views both sides CPT 73130 Hand 3 Vw Bilat	$163.59	$861.00	$163.59–$1,192.49	—	81%
X-ray of the hand, 3 or more views one side CPT 73130 Hand 3 Vw Lt	$109.06	$574.00	$109.06–$794.99	69% below	81%
X-ray of the hand, 3 or more views one side CPT 73130 Hand 3 Vw Rt	$109.06	$574.00	$109.06–$794.99	69% below	81%
X-ray of the knee, 1 or 2 views both sides CPT 73560 Knee 1 or 2 Vw Bilat Proximal	$125.78	$662.00	$125.78–$916.87	—	81%
X-ray of the knee, 1 or 2 views both sides CPT 73560 Patella 1 or 2 Vw Bilat	$125.78	$662.00	$15.79–$191.73	—	81%
X-ray of the knee, 1 or 2 views both sides CPT 73560 Knee 1 or 2 Vw Bilat Standing	$125.78	$662.00	$125.78–$916.87	—	81%
X-ray of the knee, 1 or 2 views both sides CPT 73560 Knee 1 or 2 Vw Bilat	$125.97	$663.00	$15.79–$191.73	—	81%
X-ray of the knee, 1 or 2 views CPT 73560 Knee 1-2 Views	$83.98	$442.00	$83.98–$612.17	72% below	81%
X-ray of the knee, 1 or 2 views one side CPT 73560 Patella 1 or 2 Vw Lt	$83.98	$442.00	$83.98–$612.17	72% below	81%
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 1 or 2 Vw Rt	$83.98	$442.00	$83.98–$612.17	72% below	81%
X-ray of the knee, 1 or 2 views one side CPT 73560 Patella 1 or 2 Vw Rt	$83.98	$442.00	$83.98–$612.17	72% below	81%
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 1 or 2 Vw Lt	$83.98	$442.00	$83.98–$612.17	72% below	81%
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 1 or 2 Vw Rt Standing	$83.98	$442.00	$83.98–$612.17	72% below	81%
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 1 or 2 Vw Lt Proximal	$83.98	$442.00	$83.98–$612.17	72% below	81%
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 1 or 2 Vw Lt Standing	$83.98	$442.00	$83.98–$612.17	72% below	81%
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 1 or 2 Vw Rt Proximal	$83.98	$442.00	$83.98–$612.17	72% below	81%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Spine Lumbar 2-3 Views	$133.00	$700.00	$133.00–$969.50	71% below	81%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Spine Lumbosac 2 or 3 Vw Ferguson	$133.00	$700.00	$133.00–$969.50	71% below	81%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Spine Lumbosac 2 or 3 Vw Standing	$133.00	$700.00	$133.00–$969.50	71% below	81%
X-ray of the lower back, 4 or more views CPT 72110 Spine Lumbosac Min 4 Vw Flex/Ext Ortho	$190.76	$1,004.00	$190.76–$1,390.54	67% below	81%
X-ray of the lower back, 4 or more views CPT 72110 Spine Lumbosac Min 4 Vw Flex/Ext Stand Ortho	$190.76	$1,004.00	$190.76–$1,390.54	67% below	81%
X-ray of the lower back, 4 or more views CPT 72110 Spine Lumbosac Min 4 Vw	$190.76	$1,004.00	$19.07–$293.79	67% below	81%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Spine Thoracic 2 Vw	$124.45	$655.00	$124.45–$907.18	67% below	81%
X-ray of the nasal bones, 3 or more views CPT 70160 Nasal Bone Complt Min 3 Vw	$121.60	$640.00	$121.60–$886.40	60% below	81%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Spine Cervical 2 or 3 Vw	$117.99	$621.00	$117.99–$860.09	68% below	81%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Spine Cervical 2 or 3 Vw Ap, Lat Ortho	$117.99	$621.00	$15.79–$222.55	68% below	81%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Spine Cervical 2 or 3 Vw Ap,Lat,OP Mouth Orth	$117.99	$621.00	$15.79–$222.55	68% below	81%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis 1 or 2 Vw Ap, False Profile	$114.57	$603.00	$114.57–$835.16	67% below	81%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis 1-2 Views	$114.57	$603.00	$114.57–$835.16	67% below	81%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis 1 or 2 Vw Low Ap Pelvis	$114.57	$603.00	$114.57–$835.16	67% below	81%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis 1 or 2 Vw Ap	$114.57	$603.00	$19.07–$155.68	67% below	81%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis 1 or 2 Vw Frog	$114.57	$603.00	$114.57–$835.16	67% below	81%
X-ray of the pelvis, 1 or 2 views one side CPT 72170 Pelvis 1 or 2 Vw Rt Crosstable	$114.57	$603.00	$114.57–$835.16	67% below	81%
X-ray of the pelvis, 1 or 2 views one side CPT 72170 Pelvis 1 or 2 Vw Lt Low Ap Pelvis, Lowenst	$114.57	$603.00	$114.57–$835.16	67% below	81%
X-ray of the pelvis, 1 or 2 views one side CPT 72170 Pelvis 1 or 2 Vw Rt Frog	$114.57	$603.00	$114.57–$835.16	67% below	81%
X-ray of the pelvis, 1 or 2 views one side CPT 72170 Pelvis 1 or 2 Vw Rt Low Ap Pelvis, Lowenst	$114.57	$603.00	$114.57–$835.16	67% below	81%
X-ray of the pelvis, 1 or 2 views one side CPT 72170 Pelvis 1 or 2 Vw Lt Frog	$114.57	$603.00	$114.57–$835.16	67% below	81%
X-ray of the pelvis, 1 or 2 views one side CPT 72170 Pelvis 1 or 2 Vw Lt Crosstable	$114.57	$603.00	$114.57–$835.16	67% below	81%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Sacrum / Coccyx Min 2 Vw	$132.05	$695.00	$15.79–$183.35	63% below	81%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
ACTH blood test CPT 82024 Adrenocorticotropic Hormone (Wacth)	$41.61	$219.00	$41.61–$303.32	79% below	81%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alt / Sgpt (Sgpt)	$21.09	$111.00	$21.09–$153.74	60% below	81%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alt (Nash)	$21.09	$111.00	$21.09–$153.74	60% below	81%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Amino (Hcvfs)	$21.09	$111.00	$0.91–$7.20	60% below	81%
AST (aspartate aminotransferase) enzyme test CPT 84450 Ast / Sgot (Sgot)	$17.67	$93.00	$0.89–$7.04	66% below	81%
AST (aspartate aminotransferase) enzyme test CPT 84450 Ast (Nash)	$22.23	$117.00	$22.23–$162.05	58% below	81%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel (Acuteh)	$144.97	$763.00	$144.97–$1,056.76	44% below	81%
Albumin blood test CPT 82040 Alb Serum Qt (Qiggsy)	$10.07	$53.00	$10.07–$73.41	76% below	81%
Albumin blood test CPT 82040 Albumin Serum (Alb)	$16.53	$87.00	$16.53–$120.50	60% below	81%
Aldosterone blood test CPT 82088 Aldosterone (Waldos)	$25.27	$133.00	$25.27–$184.21	84% below	81%
Aldosterone blood test CPT 82088 Aldosterone Urine (Qualds)	$43.32	$228.00	$43.32–$315.78	73% below	81%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphata (Qapiso)	$11.21	$59.00	$11.21–$81.72	78% below	81%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$14.82	$78.00	$0.89–$7.04	70% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige (Wrap22)	$6.65	$35.00	$6.65–$48.48	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige (Wapr5)	$6.84	$36.00	$6.84–$49.86	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige (Wapr8)	$6.84	$36.00	$6.84–$49.86	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige (Wrap10)	$7.03	$37.00	$7.03–$51.25	73% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige (Wnfp)	$7.22	$38.00	$7.22–$52.63	72% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige (Wshelf)	$7.22	$38.00	$7.22–$52.63	72% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige (Wcap)	$7.22	$38.00	$7.22–$52.63	72% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige Ea (Qovo)	$8.36	$44.00	$8.36–$60.94	68% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qcatfe)	$8.93	$47.00	$0.90–$9.15	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qcarwe)	$8.93	$47.00	$0.90–$9.15	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qtrote)	$8.93	$47.00	$8.93–$65.10	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qcraye)	$8.93	$47.00	$0.90–$9.15	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qhalbe)	$8.93	$47.00	$0.90–$9.15	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qdille)	$8.93	$47.00	$0.90–$9.15	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qoctpe)	$8.93	$47.00	$8.93–$65.10	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qchkpe)	$8.93	$47.00	$8.93–$65.10	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qsunfe)	$8.93	$47.00	$8.93–$65.10	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qbmuse)	$8.93	$47.00	$0.90–$9.15	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qlente)	$8.93	$47.00	$0.90–$9.15	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qtomae)	$8.93	$47.00	$8.93–$65.10	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qcephe)	$8.93	$47.00	$0.90–$9.15	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qpopye)	$8.93	$47.00	$8.93–$65.10	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qoyste)	$8.93	$47.00	$8.93–$65.10	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qcocne)	$8.93	$47.00	$0.90–$9.15	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige	$8.93	$47.00	$8.93–$65.10	66% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Lab Allergen, Ige (Alrgn)	$13.87	$73.00	$13.87–$101.11	47% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qprche)	$14.63	$77.00	$14.63–$106.65	44% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige (Qtilae)	$19.19	$101.00	$19.19–$139.89	26% below	81%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Feto Protein (Qpenta)	$23.37	$123.00	$23.37–$170.36	79% below	81%
Alpha-fetoprotein (AFP) blood test CPT 82105 Afp Maternal (Qafpms)	$26.79	$141.00	$26.79–$195.29	76% below	81%
Alpha-fetoprotein (AFP) blood test CPT 82105 Afp Maternal (Wafpms)	$27.74	$146.00	$27.74–$202.21	75% below	81%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Serum (Wquad4)	$27.74	$146.00	$2.88–$22.79	75% below	81%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha-Fetoprotein Serum	$49.02	$258.00	$49.02–$357.33	57% below	81%
Ammonia blood test CPT 82140 Ammonia (Qstone)	$31.54	$166.00	$31.54–$229.91	70% below	81%
Ammonia blood test CPT 82140 Ammonia (Amon)	$43.13	$227.00	$2.51–$19.80	60% below	81%
Amylase blood test CPT 82150 Amylase Isoenzymes (Qamyfr)	$10.83	$57.00	$10.83–$78.95	87% below	81%
Amylase blood test CPT 82150 Amylase (Amy)	$29.07	$153.00	$1.11–$8.81	65% below	81%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrul Pep Ab (Ccpg)	$29.26	$154.00	$29.26–$213.29	65% below	81%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab (Qana)	$8.36	$44.00	$2.08–$12.32	91% below	81%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab (Qahp)	$21.28	$112.00	$2.08–$16.43	76% below	81%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Abs	$38.38	$202.00	$38.38–$279.77	57% below	81%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Natriuretic Peptid (Bnp)	$53.77	$283.00	$53.77–$391.96	72% below	81%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Istat B-Natriuretic Peptide (Ibnp)	$53.77	$283.00	$6.75–$53.35	72% below	81%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Other Specimen Aerobic (Qcsfcu)	$15.39	$81.00	$15.39–$112.19	83% below	81%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Othr Specimn Aerobic (Pngbs)	$26.98	$142.00	$1.48–$11.71	70% below	81%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat or Nose Culture (Resp)	$47.12	$248.00	$1.48–$11.71	48% below	81%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic Culture (Aer)	$47.12	$248.00	$47.12–$343.48	48% below	81%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Lab Envr Cult	$47.12	$248.00	$47.12–$343.48	48% below	81%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture (Gencul)	$47.12	$248.00	$47.12–$343.48	48% below	81%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cath Tip Culture (Cathc)	$47.12	$248.00	$47.12–$343.48	48% below	81%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CSF Culture (Csfc)	$47.12	$248.00	$1.48–$11.71	48% below	81%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel (Bmpp)	$49.97	$263.00	$49.97–$364.26	61% below	81%
Bilirubin blood test, total CPT 82247 Bilirubin, Total (Tbil)	$14.63	$77.00	$14.63–$106.65	76% below	81%
Bilirubin blood test, total CPT 82247 Bilirubin Total (Hcvfs)	$15.77	$83.00	$15.77–$114.96	74% below	81%
Bilirubin blood test, total CPT 82247 Bilirubin Tot (Nash)	$18.81	$99.00	$0.86–$6.82	69% below	81%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surg Path Level 4 (Level4)	$121.60	$640.00	$121.60–$886.40	49% below	81%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surg Path Level 4 (Oslbx)	$121.60	$640.00	$121.60–$886.40	49% below	81%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level IV - Renal Bx	$121.60	$640.00	$121.60–$886.40	49% below	81%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surg Path Lev 4 Cell Block(Ybk	$121.60	$640.00	$121.60–$886.40	49% below	81%
Blood culture for bacteria CPT 87040 Blood Culture (Bld)	$48.64	$256.00	$1.78–$14.02	68% below	81%
Blood culture for bacteria CPT 87040 Cult Bact; Bld Aer, Isol/Pre ID (Bchpc)	$48.64	$256.00	$48.64–$354.56	68% below	81%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Draw Vital Tears	$11.59	$61.00	$11.59–$84.49	51% below	81%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 IP Peripheral Phlebotomy	$11.59	$61.00	$11.59–$84.49	51% below	81%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Draw Venipuncture L & D	$11.59	$61.00	$11.59–$84.49	51% below	81%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Draw Venous Puncture (Fc)	$11.59	$61.00	$1.56–$12.35	51% below	81%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Draw Routn Venipunc	$11.59	$61.00	$11.59–$84.49	51% below	81%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture Routn Bld Draw	$11.59	$61.00	$1.56–$12.35	51% below	81%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Draw Venipuncture	$11.59	$61.00	$1.56–$12.35	51% below	81%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Lab Tech Draw - Blood Draw Venipuncture	$11.59	$61.00	$11.59–$84.49	51% below	81%
Blood glucose (sugar) test CPT 82947 HC Glucose Arterial (Glart)	$12.16	$64.00	$12.16–$88.64	73% below	81%
Blood glucose (sugar) test CPT 82947 HC Glucose Venous Mixed Ven (Glven)	$12.16	$64.00	$12.16–$88.64	73% below	81%
Blood glucose (sugar) test CPT 82947 Glucose - Ccl	$19.76	$104.00	$19.76–$144.04	56% below	81%
Blood glucose (sugar) test CPT 82947 Anes Analys Fasting Blood Sugar	$19.76	$104.00	$0.68–$5.34	56% below	81%
Blood glucose (sugar) test CPT 82947 Glucose, Quantitative (Glu)	$19.76	$104.00	$19.76–$144.04	56% below	81%
Blood glucose (sugar) test CPT 82947 Glucose Qt Bld (Nash)	$21.66	$114.00	$0.68–$5.34	52% below	81%
Blood lead test CPT 83655 Lead (Mleadb)	$13.30	$70.00	$13.30–$96.95	76% below	81%
Blood lead test CPT 83655 Lead (Qblead)	$15.20	$80.00	$15.20–$110.80	73% below	81%
Blood lead test CPT 83655 Lead UR Hvy Met Pnl (Qhmplu)	$16.72	$88.00	$16.72–$121.88	70% below	81%
Blood lead test CPT 83655 Lead Level Blood - Peds Mobile Van	$24.89	$131.00	$24.89–$181.44	56% below	81%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hcg, Qualitative (Preg)	$26.98	$142.00	$1.29–$10.22	70% below	81%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Typing Abo (A1type)	$47.12	$248.00	$47.12–$343.48	44% below	81%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Lab Blood Typing Abo	$47.12	$248.00	$47.12–$343.48	44% below	81%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Group (Bscidm)	$47.12	$248.00	$3.53–$167.96	44% below	81%
Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen, Qt (Bun)	$12.54	$66.00	$12.54–$91.41	76% below	81%
C-peptide blood test CPT 84681 C-Peptide (Wcpe)	$24.32	$128.00	$24.32–$177.28	77% below	81%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein (Crpro)	$29.26	$154.00	$29.26–$213.29	60% below	81%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium Diff by Pcr (Cdtpcr)	$37.24	$196.00	$6.41–$50.65	80% below	81%
CA 19-9 blood test (tumor marker) CPT 86301 Cancer Ag 19-9 (Ca199)	$30.21	$159.00	$3.58–$28.28	73% below	81%
CA-125 blood test (ovarian cancer marker) CPT 86304 Ca125	$64.98	$342.00	$64.98–$473.67	60% below	81%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Sars-Cov-2 Covid-19 Amp Prb (Acov19) POC	$40.66	$214.00	$8.83–$61.57	65% below	81%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars-Cov-2 Covid-19 Amp Prb (Cvid19)	$76.00	$400.00	$8.83–$69.73	34% below	81%
Calcium blood test, total CPT 82310 Calcium Random UR (Rucacr)	$11.97	$63.00	$11.97–$87.26	74% below	81%
Calcium blood test, total CPT 82310 Calcium Total (Ca, Ruca)	$18.05	$95.00	$0.89–$7.01	60% below	81%
Carcinoembryonic antigen (CEA) test CPT 82378 Lab Cea	$64.22	$338.00	$64.22–$468.13	55% below	81%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Igm (Qigmvz)	$17.10	$90.00	$17.10–$124.65	77% below	81%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Ab	$49.59	$261.00	$49.59–$361.49	33% below	81%
Chickenpox (varicella) immunity blood test CPT 86787 HC Vzv Igg (Vzvht)	$394.63	$2,077.00	$394.63–$2,876.65	430% above	81%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamyd Ampl Prb (Ctng)	$42.94	$226.00	$42.94–$313.01	65% below	81%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel (Lpr)	$48.64	$256.00	$2.30–$18.20	62% below	81%
Complete blood count (CBC) with differential CPT 85025 Cbc W Automated Diff (Cbcdf)	$28.69	$151.00	$28.69–$209.14	63% below	81%
Complete blood count (CBC), no differential CPT 85027 Cbc Automated W Platelet (Cbc)	$22.23	$117.00	$22.23–$162.05	66% below	81%
Comprehensive metabolic panel (blood test) CPT 80053 Onc Comprehensive Metabol Panel (Onccmp)	$15.01	$79.00	$15.01–$109.42	91% below	81%
Comprehensive metabolic panel (blood test) CPT 80053 Comp Metabolic Panel (Cmpp)	$60.80	$320.00	$60.80–$443.20	62% below	81%
Cortisol blood test, total CPT 82533 Cortisol Total (Qcah9)	$31.54	$166.00	$31.54–$229.91	71% below	81%
Cortisol blood test, total CPT 82533 Cortisol Total	$48.64	$256.00	$48.64–$354.56	56% below	81%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase Ttl (Qciso)	$8.93	$47.00	$8.93–$65.10	85% below	81%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase, Total (CK)	$21.85	$115.00	$21.85–$159.28	64% below	81%
Creatinine blood test CPT 82565 Creatinine, Blood (Cr)	$24.51	$129.00	$24.51–$178.67	51% below	81%
Creatinine blood test CPT 82565 Creatinine I-Stat (Icr) - OP (Fc)	$24.51	$129.00	$24.51–$178.67	51% below	81%
Creatinine blood test CPT 82565 Istat Creatinine (Icrr)	$24.51	$129.00	$0.88–$6.96	51% below	81%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Ab (Bscidm)	$17.86	$94.00	$17.86–$130.19	79% below	81%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus	$29.45	$155.00	$29.45–$214.68	65% below	81%
Cytomegalovirus (CMV) antibody test CPT 86644 Cmv Abs Igg (Qcmvav)	$29.45	$155.00	$29.45–$214.68	65% below	81%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer Quant (Ddim)	$35.15	$185.00	$35.15–$256.23	71% below	81%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea-S	$69.92	$368.00	$69.92–$509.68	35% below	81%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Test,Any No.,Instrum (Maceta)	$15.28	$80.44	$15.28–$111.41	84% below	81%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drg Scr Mult Cls Mult Analy (Wueglc)	$38.95	$205.00	$38.95–$283.93	60% below	81%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Sing Drg Class Method per Dos (Drugm)	$56.81	$299.00	$10.69–$83.72	42% below	81%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Salicylate (Msalic)	$59.95	$315.52	$59.95–$437.00	39% below	81%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Single Drug Class (Qdau10)	$77.90	$410.00	$10.69–$84.45	20% below	81%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Sing Drg Class Method per Dos (Cord5)	$112.48	$592.00	$10.69–$84.45	15% above	81%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Scr Mult Drg Class per Pt Encount (Drugpm)	$118.94	$626.00	$118.94–$867.01	22% above	81%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drg Scr Clas a Sing Drg Meth Ins Test Sys (Drugu)	$118.94	$626.00	$118.94–$867.01	22% above	81%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel (Lyt)	$30.21	$159.00	$30.21–$220.22	69% below	81%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC Epstein-Barr Virus, Vca (Qebvcm)	$9.88	$52.00	$3.12–$14.56	91% below	81%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Vca (Webvpl)	$13.30	$70.00	$3.12–$19.60	88% below	81%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Capsid Vca (Ebv)	$22.80	$120.00	$22.80–$166.20	79% below	81%
Epstein-Barr virus (EBV) antibody test CPT 86665 Ab Epstein-Barr Virus Igm	$35.34	$186.00	$35.34–$257.61	67% below	81%
Estradiol blood test CPT 82670 Estradiol;Total (E2)	$68.40	$360.00	$68.40–$498.60	36% below	81%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stim Hormone	$58.14	$306.00	$58.14–$423.81	51% below	81%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Fecal (Qcalpr)	$92.34	$486.00	$92.34–$673.11	47% below	81%
Ferritin blood test (iron stores) CPT 82728 Lab Ferritin (Fer)	$44.08	$232.00	$2.34–$18.52	67% below	81%
Fibrinogen blood test CPT 85384 Fibrinogen Activity	$28.69	$151.00	$28.69–$209.14	67% below	81%
Folate (folic acid) blood test CPT 82746 Folic Acid	$37.05	$195.00	$37.05–$270.08	67% below	81%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3 Free	$51.87	$273.00	$51.87–$378.11	57% below	81%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 (Qfrt4d)	$19.00	$100.00	$1.55–$12.26	84% below	81%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxin Free	$36.67	$193.00	$36.67–$267.31	68% below	81%
Free testosterone test CPT 84402 Testosterone Free (Wtstn)	$15.77	$83.00	$4.38–$23.24	87% below	81%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Ggt (Gt)	$16.91	$89.00	$16.91–$123.27	71% below	81%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Ggt (Nash)	$19.95	$105.00	$1.24–$9.78	66% below	81%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Glutamyltransferase Gamma (Hcvfs)	$19.95	$105.00	$1.24–$9.78	66% below	81%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose, Post Glucose Dose(2pp	$19.38	$102.00	$19.38–$141.27	66% below	81%
Glucose tolerance test, 3 samples CPT 82951 Gtt,3 Specimens (Gt3)	$41.80	$220.00	$41.80–$304.70	69% below	81%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N Gonrh Ampl Prb (Ctng)	$46.17	$243.00	$46.17–$336.56	63% below	81%
H. pylori stool antigen test CPT 87338 Helicobacter Pylori Stl (Whpag)	$15.20	$80.00	$2.47–$19.54	87% below	81%
H. pylori stool antigen test CPT 87338 H Pylori Ag Stool Eia (Gmhhpag)	$48.26	$254.00	$48.26–$351.79	58% below	81%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv 1 Quantification (Hivrt)	$127.68	$672.00	$127.68–$930.72	62% below	81%
HIV-1 and HIV-2 antibody test CPT 86703 Hiv-1 & Hiv-2 Ab (Bscidm)	$17.86	$94.00	$2.36–$18.63	85% below	81%
HIV-1 and HIV-2 antibody test CPT 86703 Hiv1 & Hib2 Abs Sing Rslt (Hiv1ab)	$21.28	$112.00	$21.28–$155.12	82% below	81%
HIV-1 and HIV-2 antibody test CPT 86703 Hiv 1/2 Ab (Scidm)	$23.94	$126.00	$2.36–$18.63	80% below	81%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv1 Ag With Hiv1 & Hiv2 Abs Sing Rslt (Hivabg)	$37.43	$197.00	$37.43–$272.85	67% below	81%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv High/Low Risk (Qhpvm)	$25.27	$133.00	$6.04–$47.23	83% below	81%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv High/Low W/Rfx (Qhpvmr)	$27.74	$146.00	$6.04–$47.23	81% below	81%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Human Papillomavirus, Hi Risk (Mahpv)	$55.67	$293.00	$55.67–$405.81	62% below	81%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Glyco Hgb (Qglyhb)	$16.53	$87.00	$16.53–$120.50	81% below	81%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Lab Glyc Hgb	$38.57	$203.00	$38.57–$281.16	57% below	81%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c Test - OP	$38.57	$203.00	$1.67–$13.20	57% below	81%
Hemoglobin blood test CPT 85018 Hemoglobin - Ccl	$15.20	$80.00	$15.20–$110.80	52% below	81%
Hemoglobin blood test CPT 85018 Anes Analys Hemoglobin	$15.20	$80.00	$0.41–$4.84	52% below	81%
Hemoglobin blood test CPT 85018 Hemoglobin (HH)	$15.20	$80.00	$15.20–$110.80	52% below	81%
Hemoglobin blood test CPT 85018 Hemocue - OP (Fc)	$15.20	$80.00	$15.20–$110.80	52% below	81%
Hemoglobin blood test CPT 85018 Hemocue	$15.20	$80.00	$15.20–$110.80	52% below	81%
Hepatitis B core antibody test (total) CPT 86704 Hep B Core Ab (Bscidm)	$15.77	$83.00	$15.77–$114.96	80% below	81%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Ab (Scidm)	$22.04	$116.00	$2.07–$16.38	72% below	81%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Ab	$35.34	$186.00	$35.34–$257.61	55% below	81%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab	$44.84	$236.00	$44.84–$326.86	52% below	81%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Surf Ag (Bscidm)	$14.63	$77.00	$14.63–$106.65	84% below	81%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surf Ag (Scidm)	$22.04	$116.00	$1.78–$14.04	75% below	81%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surf Ag	$40.85	$215.00	$40.85–$297.78	54% below	81%
Hepatitis C antibody blood test (screening) CPT 86803 Hep C Ab (Bscidm)	$17.10	$90.00	$17.10–$124.65	85% below	81%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus Ab (Scidm)	$27.36	$144.00	$2.45–$19.39	76% below	81%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Ab	$71.82	$378.00	$71.82–$523.53	36% below	81%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC Hepatitis C Quant (Qhcvrt)	$54.53	$287.00	$7.37–$58.22	79% below	81%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Quant (Hcvrt)	$143.07	$753.00	$143.07–$1,042.91	46% below	81%
Herpes blood test, HSV-1 antibody CPT 86695 Hsv 1 Igg Antibody (Hsvg1)	$16.91	$89.00	$16.91–$123.27	74% below	81%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type 1 (Qhsvm)	$17.86	$94.00	$17.86–$130.19	73% below	81%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type 1 (Qhscsf)	$19.19	$101.00	$19.19–$139.89	70% below	81%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type 1 (Qhs1mt)	$22.23	$117.00	$22.23–$162.05	66% below	81%
Herpes blood test, HSV-2 antibody CPT 86696 Hsv 2 Igg Antibody (Hsvg2)	$20.90	$110.00	$20.90–$152.35	74% below	81%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2 (Qhsvm)	$20.90	$110.00	$20.90–$152.35	74% below	81%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2 (Qhscsf)	$22.80	$120.00	$22.80–$166.20	72% below	81%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2 (Qhs2mt)	$22.80	$120.00	$22.80–$166.20	72% below	81%
High-sensitivity CRP (hs-CRP) test CPT 86141 High Sens C Reactive Protein (Crphs)	$28.69	$151.00	$28.69–$209.14	69% below	81%
Homocysteine blood test CPT 83090 Homocystein (Hcy)	$55.48	$292.00	$55.48–$404.42	54% below	81%
Insulin blood test CPT 83525 Insulin	$39.52	$208.00	$39.52–$288.08	46% below	81%
Iron blood test (serum iron) CPT 83540 Iron (Fe)	$26.22	$138.00	$26.22–$191.13	67% below	81%
Kidney function blood test panel CPT 80069 Renal Function Panel (Rfpp)	$58.14	$306.00	$58.14–$423.81	61% below	81%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone (Qlh)	$55.86	$294.00	$55.86–$407.19	51% below	81%
LH (luteinizing hormone) test CPT 83002 Leutenizing Hormone	$59.09	$311.00	$59.09–$430.74	49% below	81%
Lactate (lactic acid) blood test CPT 83605 HC Lactate Arterial (Laart)	$23.94	$126.00	$23.94–$174.51	73% below	81%
Lactate (lactic acid) blood test CPT 83605 HC Lactate Venous (Laven)	$23.94	$126.00	$23.94–$174.51	73% below	81%
Lactate (lactic acid) blood test CPT 83605 Anes Analys Lactate (Ola)	$30.78	$162.00	$30.78–$224.37	66% below	81%
Lactate (lactic acid) blood test CPT 83605 Art Lactate Wb (Arla)	$30.78	$162.00	$30.78–$224.37	66% below	81%
Lactate (lactic acid) blood test CPT 83605 Istat Lactate (Ilacv)	$30.78	$162.00	$1.99–$15.72	66% below	81%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid (Wbla)	$30.78	$162.00	$30.78–$224.37	66% below	81%
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh Sendout (Qliso)	$7.79	$41.00	$1.04–$8.21	86% below	81%
Lactate dehydrogenase (LDH) blood test CPT 83615 Onc Lac Dehydro (Oncbmp)	$12.16	$64.00	$12.16–$88.64	79% below	81%
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh Oncology (Oncldb)	$12.73	$67.00	$12.73–$92.80	78% below	81%
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh (Ldh)	$24.89	$131.00	$1.04–$8.21	57% below	81%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase (Lipas)	$35.15	$185.00	$1.19–$9.36	62% below	81%
Liver function blood test panel CPT 80076 Liver Function Panel (Lfpp)	$50.16	$264.00	$50.16–$365.64	64% below	81%
Lyme disease antibody test CPT 86618 Lyme Disease Ab (Qlymab)	$24.32	$128.00	$24.32–$177.28	66% below	81%
Magnesium blood test CPT 83735 Magnesium (Qurrsk)	$11.02	$58.00	$11.02–$80.33	84% below	81%
Magnesium blood test CPT 83735 Magnesium Oncology (Oncmgb)	$14.63	$77.00	$14.63–$106.65	79% below	81%
Magnesium blood test CPT 83735 Onc Magnesium (Oncbmp)	$14.63	$77.00	$1.15–$9.11	79% below	81%
Magnesium blood test CPT 83735 Magnesium (Qstone)	$17.10	$90.00	$1.15–$9.11	76% below	81%
Magnesium blood test CPT 83735 Magnesium (Mg/Umg/Rumg)	$25.08	$132.00	$1.15–$9.11	64% below	81%
Measles (rubeola) antibody test CPT 86765 Rubeola Igm (Qmeasm)	$23.75	$125.00	$23.75–$173.13	67% below	81%
Measles (rubeola) antibody test CPT 86765 Rubeola, Igg Ab (Measle)	$34.96	$184.00	$34.96–$254.84	52% below	81%
Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile Ab Scr	$22.23	$117.00	$22.23–$162.05	73% below	81%
Mumps immunity blood test CPT 86735 Mumps Igm Ab (Qmumpm)	$37.05	$195.00	$2.24–$17.73	49% below	81%
Mumps immunity blood test CPT 86735 Mumps Igg (Mumpsg, Mumpgm)	$38.76	$204.00	$38.76–$282.54	47% below	81%
PSA (prostate-specific antigen) blood test, free CPT 84154 Free Psa (Tfpsa)	$36.29	$191.00	$36.29–$264.54	61% below	81%
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Diagnostic (Psad)	$40.28	$212.00	$3.16–$24.99	64% below	81%
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa-Prostate Specif Antifen-Screen (Psa)	$44.08	$232.00	$44.08–$321.32	61% below	81%
Pap test (liquid-based, automated screening with review) CPT 88175 Cyto Cerv/Vag Auto Thin Prep Man Rescr (Tpim)	$11.97	$63.00	$4.58–$17.64	91% below	81%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap Thin Prep (Paptp)	$30.97	$163.00	$30.97–$225.76	72% below	81%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap Thin Prep Diag (Paptpd)	$30.97	$163.00	$30.97–$225.76	72% below	81%
Parathyroid hormone (PTH) blood test CPT 83970 Parathormone	$78.47	$413.00	$78.47–$572.01	64% below	81%
Parathyroid hormone (PTH) blood test CPT 83970 Intraoperative Pth (Iopth)	$78.47	$413.00	$78.47–$572.01	64% below	81%
Partial thromboplastin time (PTT) clotting test CPT 85730 Silica Screen Ratio (Scts)	$24.32	$128.00	$24.32–$177.28	65% below	81%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Ti (Ptt	$24.32	$128.00	$24.32–$177.28	65% below	81%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Inorganic (Phos)	$17.29	$91.00	$17.29–$126.04	72% below	81%
Potassium blood test CPT 84132 Potassium, Serum (K)	$19.57	$103.00	$19.57–$142.66	56% below	81%
Potassium blood test CPT 84132 Anes Analys Potassium Serum	$19.57	$103.00	$19.57–$142.66	56% below	81%
Potassium blood test CPT 84132 K Potassium - Ccl	$19.57	$103.00	$19.57–$142.66	56% below	81%
Potassium blood test CPT 84132 Istat Potassium (Iabg)	$19.57	$103.00	$0.82–$6.47	56% below	81%
Progesterone blood test CPT 84144 Progesterone	$50.92	$268.00	$50.92–$371.18	62% below	81%
Prolactin blood test CPT 84146 Prolactin (Hpr)	$59.47	$313.00	$59.47–$433.51	53% below	81%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time (Pt)	$23.75	$125.00	$23.75–$173.13	38% below	81%
Prothrombin time (PT/INR) clotting test CPT 85610 Coagucheck for Pt / Inr - OP (Fc)	$23.75	$125.00	$0.74–$5.83	38% below	81%
Rapid flu test (influenza antigen) CPT 87804 Influenza Assay W Optical Observton (Mrflu)	$23.75	$125.00	$23.75–$173.13	70% below	81%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep Test - OP	$33.25	$175.00	$2.84–$22.46	45% below	81%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infect Agnt Detect Streptococcus a (Mrapia)	$33.25	$175.00	$33.25–$242.38	45% below	81%
Renin blood test CPT 84244 Plasma Renin (Qrenac)	$28.31	$149.00	$28.31–$206.37	75% below	81%
Rh blood typing CPT 86901 Rh Group (Bscidm)	$8.93	$47.00	$8.93–$65.10	87% below	81%
Rh blood typing CPT 86901 Lab Blood Typing Rh	$20.52	$108.00	$20.52–$149.58	70% below	81%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Qt	$26.22	$138.00	$26.22–$191.13	59% below	81%
Rubella antibody test (immunity check) CPT 86762 Rubella Igm (Qrubem)	$17.67	$93.00	$17.67–$128.81	77% below	81%
Rubella antibody test (immunity check) CPT 86762 Rubella Ab	$39.90	$210.00	$39.90–$290.85	48% below	81%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate (Esr)	$17.67	$93.00	$0.46–$4.84	62% below	81%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Anal,Vol,Cnt,Motil,Diff (Msemen)	$11.16	$58.72	$11.16–$81.33	92% below	81%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Analysis	$87.21	$459.00	$2.12–$16.73	40% below	81%
Sodium blood test CPT 84295 Istat Sodium (Iabg)	$20.52	$108.00	$0.83–$6.54	58% below	81%
Sodium blood test CPT 84295 Anes Analys Sodium	$20.52	$108.00	$20.52–$149.58	58% below	81%
Sodium blood test CPT 84295 Na Sodium - Ccl	$20.52	$108.00	$20.52–$149.58	58% below	81%
Sodium blood test CPT 84295 Sodium, Serum (Na)	$20.52	$108.00	$20.52–$149.58	58% below	81%
Stool ova and parasites exam CPT 87177 Ova & Parasites Conc ID (Wovap)	$6.84	$36.00	$6.84–$49.86	91% below	81%
Stool ova and parasites exam CPT 87177 Ova & Parasites Conc & ID (Ovap)	$6.84	$36.00	$1.53–$10.08	91% below	81%
Stool ova and parasites exam CPT 87177 Ovap Direct Smear (Movap)	$29.60	$155.80	$29.60–$215.78	60% below	81%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood;Feces 1-3(Obst)	$15.77	$83.00	$0.75–$5.95	45% below	81%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Fecal Occ Blood - Cancer Screen - OP	$15.77	$83.00	$0.75–$5.95	45% below	81%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Hemocult	$15.77	$83.00	$15.77–$114.96	45% below	81%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Occult Blood,Fecal Immuno (Wfitob)	$14.25	$75.00	$14.25–$103.88	80% below	81%
Syphilis antibody test (Treponema pallidum) CPT 86780 T Pallidum Ab Igg (Qftaab)	$11.59	$61.00	$11.59–$84.49	83% below	81%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidium (Bscidm)	$13.68	$72.00	$13.68–$99.72	80% below	81%
Syphilis antibody test (Treponema pallidum) CPT 86780 T Pallidum Confirm (Qftatp)	$13.68	$72.00	$13.68–$99.72	80% below	81%
Syphilis antibody test (Treponema pallidum) CPT 86780 Antibody T Pallidum (Tpab)	$22.99	$121.00	$22.99–$167.59	66% below	81%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Qual (Scidm)	$11.59	$61.00	$0.73–$9.15	77% below	81%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Test Ql (Wvdrsf)	$11.59	$61.00	$0.73–$9.15	77% below	81%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Test Qual (Srpr)	$18.81	$99.00	$18.81–$137.12	63% below	81%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB Test Cell Med Immun Ag Response (Mqftg)	$36.10	$190.00	$10.66–$53.20	84% below	81%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB Test Cell Mediated Immun Ag Rsp (Qqftgp)	$39.14	$206.00	$39.14–$285.31	82% below	81%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Tot (Wtstn)	$15.77	$83.00	$4.44–$23.24	87% below	81%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total	$63.08	$332.00	$63.08–$459.82	50% below	81%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC Microsomal Abs Ea (Lkmabg)	$18.24	$96.00	$2.50–$19.77	77% below	81%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Ab Ea (Qahp)	$26.60	$140.00	$26.60–$193.90	67% below	81%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Ab, Ea (Tpoab)	$31.92	$168.00	$31.92–$232.68	60% below	81%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver Kidney Microsom Ab	$31.92	$168.00	$31.92–$232.68	60% below	81%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Ab Ea (Qlc1)	$37.24	$196.00	$37.24–$271.46	53% below	81%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh - Pku	$56.05	$295.00	$56.05–$408.58	56% below	81%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stim Hormone (Tsh)	$56.05	$295.00	$56.05–$408.58	56% below	81%
Total IgE blood test CPT 82785 Total Qt Ige (Wapr8)	$10.45	$55.00	$10.45–$76.18	88% below	81%
Total IgE blood test CPT 82785 Total Qt Ige (Wnfp)	$10.45	$55.00	$10.45–$76.18	88% below	81%
Total IgE blood test CPT 82785 Total Qt Ige (Wapr5)	$10.45	$55.00	$10.45–$76.18	88% below	81%
Total IgE blood test CPT 82785 Total Qt Ige (Wcap)	$10.45	$55.00	$10.45–$76.18	88% below	81%
Total IgE blood test CPT 82785 Gammaglobulin Ige (Qige)	$16.15	$85.00	$16.15–$117.73	81% below	81%
Total cholesterol blood test CPT 82465 Cholesterol, Serum, Total(Chol	$15.77	$83.00	$15.77–$114.96	65% below	81%
Total cholesterol blood test CPT 82465 Cholesterol Tot (Nash)	$19.95	$105.00	$0.75–$5.91	55% below	81%
Total thyroxine (T4) blood test CPT 84436 Thyroxine (T4)	$26.22	$138.00	$26.22–$191.13	68% below	81%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (T3)	$42.56	$224.00	$42.56–$310.24	57% below	81%
Transferrin blood test CPT 84466 Transferrin (Tran)	$29.83	$157.00	$29.83–$217.45	69% below	81%
Trichomonas test (NAAT) CPT 87661 Trichom Vag Amp Prb (Mtvpcr)	$16.91	$89.00	$16.91–$123.27	86% below	81%
Trichomonas test (NAAT) CPT 87661 Trich Vag Amp Prb (Tvpcr)	$21.85	$115.00	$6.04–$47.23	82% below	81%
Triglycerides blood test CPT 84478 Triglycerides	$16.15	$85.00	$0.99–$7.80	65% below	81%
Triglycerides blood test CPT 84478 Triglycerides (Nash)	$19.95	$105.00	$19.95–$145.43	57% below	81%
Troponin test, quantitative CPT 84484 HC Troponin Quant (Hstrop)	$13.30	$70.00	$13.30–$96.95	92% below	81%
Troponin test, quantitative CPT 84484 Istat Troponin Quant (Ictni)	$48.45	$255.00	$2.14–$16.95	69% below	81%
Troponin test, quantitative CPT 84484 Troponin, Quantitative (Tropi)	$48.45	$255.00	$48.45–$353.18	69% below	81%
Uric acid blood test CPT 84550 Uric Acid (Uric)	$15.96	$84.00	$15.96–$116.34	78% below	81%
Urinalysis with microscope exam, automated CPT 81001 Ua Auto,W/Micro (Muamic)	$53.39	$281.00	$53.39–$389.19	17% below	81%
Urinalysis without microscope exam, automated CPT 81003 U/a by Clinitek (Status) - OP (Fc)	$13.49	$71.00	$13.49–$98.34	46% below	81%
Urinalysis without microscope exam, automated CPT 81003 U/a by Clinitek (Cdpstk)	$13.49	$71.00	$0.39–$3.06	46% below	81%
Urinalysis without microscope exam, automated CPT 81003 Lab Performed - U/a Clinitek Status	$13.49	$71.00	$0.39–$3.06	46% below	81%
Urinalysis without microscope exam, automated CPT 81003 U/a by Clinitek (Status)	$13.49	$71.00	$13.49–$98.34	46% below	81%
Urinalysis without microscope exam, automated CPT 81003 U/a Auto W/O Micro (Dipstk)	$13.49	$71.00	$13.49–$98.34	46% below	81%
Urinalysis without microscope exam, automated CPT 81003 Urine Dipstick	$13.49	$71.00	$13.49–$98.34	46% below	81%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis Dip	$7.22	$38.00	$0.60–$4.73	71% below	81%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis, Dipstick - OP	$7.22	$38.00	$7.22–$52.63	71% below	81%
Urine culture for bacteria, with colony count CPT 87086 Urine Reflex Culture (Urinrc)	$31.54	$166.00	$31.54–$229.91	66% below	81%
Urine culture for bacteria, with colony count CPT 87086 Cult, Urine W Cc (Urin)	$31.54	$166.00	$31.54–$229.91	66% below	81%
Urine microalbumin (albumin) test CPT 82043 Microalbumin (Malb, Malbcr)	$25.84	$136.00	$25.84–$188.36	60% below	81%
Urine pregnancy test, read by color change CPT 81025 Pregnancy Test-Cardinal Health-Rapid Cassette Hcg-Urine Only	$33.06	$174.00	$1.48–$11.70	55% below	81%
Urine pregnancy test, read by color change CPT 81025 Pregnancy Test Urine Quickvue	$33.06	$174.00	$33.06–$240.99	55% below	81%
Urine pregnancy test, read by color change CPT 81025 Pregnancy Test Urine Quickvue (Gmh) (Pocupt)	$33.06	$174.00	$1.48–$11.70	55% below	81%
Urine pregnancy test, read by color change CPT 81025 Pregnancy Test Urine Quickvue - OP	$37.24	$196.00	$37.24–$271.46	50% below	81%
Urine pregnancy test, read by color change CPT 81025 Pregnancy Test Urine Quickvue (Fc)	$37.24	$196.00	$37.24–$271.46	50% below	81%
Urine pregnancy test, read by color change CPT 81025 POC Pregnancy Test	$37.24	$196.00	$37.24–$271.46	50% below	81%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12	$40.85	$215.00	$40.85–$297.78	68% below	81%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy (Vitd)	$24.32	$128.00	$24.32–$177.28	87% below	81%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vit D 25hydroxy,Includes Fract (Zvitd)	$56.43	$297.00	$56.43–$411.35	69% below	81%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Dihydroxyvitamin D, 1,25 (Qdihyd)	$37.62	$198.00	$6.62–$52.32	81% below	81%
Zinc blood test CPT 84630 Zinc (Wzn)	$12.35	$65.00	$12.35–$90.03	82% below	81%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Quant (Qpenta)	$22.61	$119.00	$22.61–$164.82	78% below	81%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin Quant (Qquad4)	$29.64	$156.00	$29.64–$216.06	72% below	81%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin Quant (Wquad4)	$29.64	$156.00	$2.59–$20.45	72% below	81%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg, Quant (Bhcg)	$51.30	$270.00	$51.30–$373.95	51% below	81%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Balloon dilation of the maxillary sinus opening, one side both sides CPT 31295 Sinus Endoscopy W/ Baln Dil Max Sinus Bilat	$2,311.92	$12,168.00	$834.90–$9,020.15	—	81%
Balloon dilation of the maxillary sinus opening, one side one side CPT 31295 Sinus Endoscopy W/ Baln Dil Max Sinus Unilat	$1,541.28	$8,112.00	$834.90–$9,020.15	65% below	81%
Botox injections for chronic migraine both sides CPT 64615 Chemodenerv Musc Fac, Trigem, Cerv, Acc Nrv Bilat	$156.37	$823.00	$156.37–$1,139.86	—	81%
Botox injections for chronic migraine CPT 64615 Chemodenerv Musc Facial/Trigem/Cerv Migraine	$156.37	$823.00	$156.37–$1,139.86	58% below	81%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion both sides CPT 19081 HC Breast Bx Bilat, Plc Loc Dev, Imag Perc Stereo 1st Les	$972.04	$5,116.00	$972.04–$7,085.66	—	81%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 Breast Bx Rt, Plc Loc Dev, Imag Perc Stereo 1st Les	$647.90	$3,410.00	$647.90–$4,722.85	78% below	81%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 Breast Bx Lt, Plc Loc Dev, Imag Perc Stereo 1st Les	$647.90	$3,410.00	$647.90–$4,722.85	78% below	81%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Closed Tx Dist Fib Fx W/O Manip	$89.30	$470.00	$89.30–$650.95	80% below	81%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed Tx Metatarsl Fx W/O Manip	$145.54	$766.00	$145.54–$1,060.91	77% below	81%
Cardiac catheterization with coronary angiogram one side CPT 93458 Cath Plc Cor Art Anggrm & Lt Hrt Cath W/ Inj & Rad	$2,633.59	$13,861.00	$2,633.59–$19,197.49	74% below	81%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Extern Terminated	$353.59	$1,861.00	$117.33–$852.67	69% below	81%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Elective External	$372.21	$1,959.00	$372.21–$2,713.22	67% below	81%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion, External	$372.21	$1,959.00	$372.21–$2,713.22	67% below	81%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion External Elective	$372.21	$1,959.00	$372.21–$2,713.22	67% below	81%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion External	$372.21	$1,959.00	$372.21–$2,713.22	67% below	81%
Carpal tunnel release, open surgery CPT 64721 Neuroplsty/Trnsp Med Nrv Carp Tun	$654.93	$3,447.00	$654.93–$4,774.10	73% below	81%
Catheter ablation for atrial fibrillation CPT 93656 Comp Ep Study & Ablat of Af by Pvi Incl Ts&La Pac/Rec	$6,846.84	$36,036.00	$6,846.84–$49,909.86	75% below	81%
Cervical biopsy CPT 57500 Cervix Bx or Excis Lesion	$430.16	$2,264.00	$156.12–$1,134.60	53% below	81%
Cervical biopsy CPT 57500 Cervix Bx Sing/Mult or Exc Lesion (Fc)	$430.16	$2,264.00	$156.12–$1,134.60	53% below	81%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Circumcision No Clmp Excpt Nbn	$723.33	$3,807.00	$367.29–$2,669.26	69% below	81%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision Newborn (Fc)	$801.80	$4,220.00	$367.29–$4,931.00	52% below	81%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC Circumcision Newborn	$801.80	$4,220.00	$801.80–$5,844.70	52% below	81%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcis Nwbrn W/Clamp,Othr	$801.80	$4,220.00	$367.29–$2,669.26	52% below	81%
Circumcision, surgical, older than a newborn CPT 54160 Circumcision No Clmp Nbn	$712.69	$3,751.00	$119.67–$1,942.43	38% below	81%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC Cltx Dstl Radial Fx/Epiphysl Sep W/O Manj	$81.51	$429.00	$81.51–$594.17	84% below	81%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed Tx Dist Radial Fx W/O Manip	$81.51	$429.00	$43.01–$1,847.44	84% below	81%
Colonoscopy with endoscopic ultrasound CPT 45391 Colonoscopy Flex W/ Endosc U/S	$367.65	$1,935.00	$367.65–$2,679.98	93% below	81%
Colonoscopy with polyp removal CPT 45385 Colonoscopy W/Snare Polypect Comb	$811.49	$4,271.00	$811.49–$5,915.34	68% below	81%
Colonoscopy with polyp removal CPT 45385 Colonoscopy W/Snare Polypect	$811.49	$4,271.00	$811.49–$5,915.34	68% below	81%
Colonoscopy with tissue sample CPT 45380 Colonoscopy W/Biopsy	$1,018.78	$5,362.00	$1,018.78–$7,426.37	55% below	81%
Colonoscopy, diagnostic CPT 45378 Colonoscopy Terminated	$629.66	$3,314.00	$629.66–$4,589.89	71% below	81%
Colonoscopy, diagnostic CPT 45378 Colonoscopy	$692.74	$3,646.00	$163.47–$1,942.00	68% below	81%
Colonoscopy, diagnostic CPT 45378 Ca Screen Colonoscopy	$878.18	$4,622.00	$878.18–$6,401.47	59% below	81%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 Colposcopy W/Leep	$679.82	$3,578.00	$570.08–$4,143.01	78% below	81%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colposcopy Cerv / Up Vag W/ Bx Cerv / Curretage	$269.23	$1,417.00	$54.54–$706.41	42% below	81%
Coronary stent placement, one artery CPT 92928 Stent Plc Cor W/ or W/O Angpls Singl Vesl	$3,882.84	$20,436.00	$2,033.32–$14,777.05	72% below	81%
Cystoscopy with ureteral stent placement CPT 52332 Cystoscpy W/ Ins Ureteral Stent	$1,140.95	$6,005.00	$618.39–$4,494.09	70% below	81%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystoscopy (Fc)	$749.74	$3,946.00	$749.74–$5,465.21	38% below	81%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystoscopy W/ Bladder Irrig	$749.74	$3,946.00	$749.74–$5,465.21	38% below	81%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystoscopy	$749.74	$3,946.00	$749.74–$5,465.21	38% below	81%
D&C (dilation and curettage), not related to pregnancy CPT 58120 Dilation & Currettage Diag/Ther Non-OB	$871.53	$4,587.00	$871.53–$6,353.00	70% below	81%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Dstr Premalig Les 1st Les	$47.31	$249.00	$35.63–$293.79	73% below	81%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Tympanostomy W/Tube	$288.80	$1,520.00	$91.31–$697.22	50% below	81%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Removal Impact Cerumen W/ Irrig / Lavage Unilat	$31.73	$167.00	$31.73–$231.30	72% below	81%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Rem Impacted Cerumen W/ Irrig / Lavage Unilat	$31.73	$167.00	$31.73–$231.30	72% below	81%
Earwax removal with instruments, one ear both sides CPT 69210 Rem Impacted Cerumen W Instrument, Bilat	$83.79	$441.00	$10.65–$441.00	—	81%
Earwax removal with instruments, one ear CPT 69210 Removal Impact Cerumen Same Day as Aduiol Test	$19.38	$102.00	$10.65–$173.35	84% below	81%
Earwax removal with instruments, one ear CPT 69210 Rem Impacted Cerumen W Instrument, Uni	$55.86	$294.00	$10.65–$294.00	55% below	81%
Earwax removal with instruments, one ear one side CPT 69210 Rem Impacted Cerumen W Instrument, Right	$55.86	$294.00	$10.65–$294.00	55% below	81%
Earwax removal with instruments, one ear one side CPT 69210 Rem Impacted Cerumen W Instrument Left (Fc)	$55.86	$294.00	$10.65–$294.00	55% below	81%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endomet Bx W/O Cerv Dilatn	$207.29	$1,091.00	$207.29–$1,511.04	40% below	81%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Inj Epid Diag/Ther Cerv/Thor W/ Img	$300.01	$1,579.00	$124.17–$1,248.00	83% below	81%
Eye injection into the vitreous (intravitreal injection) CPT 67028 Intravitreal Inj of Pharm Agt	$266.38	$1,402.00	$266.38–$1,941.77	54% below	81%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj Paraverteb Facet Lumb/Sac Singl Lev	$300.20	$1,580.00	$300.20–$2,188.30	80% below	81%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj Paraverteb Facet Lumb/Sac Sing Lev	$300.20	$1,580.00	$300.20–$2,188.30	80% below	81%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj Paraverteb Facet Lumb/Sac Sing Level	$300.20	$1,580.00	$300.20–$2,188.30	80% below	81%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Ca Screen Flex Sig	$317.49	$1,671.00	$163.47–$1,248.00	65% below	81%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Flex Sig Diag W/WO Spec	$317.49	$1,671.00	$163.47–$1,248.00	65% below	81%
Hemorrhoid banding (rubber band ligation) CPT 46221 Hemorrhoidectomy Int by Rubber Band Ligation	$336.30	$1,770.00	$163.47–$1,447.67	63% below	81%
Hemorrhoid banding (rubber band ligation) CPT 46221 Hemorrhoid Banding	$336.30	$1,770.00	$336.30–$2,451.45	63% below	81%
Hemorrhoidectomy (internal and external), one area CPT 46255 Hemorrhoidect Int/Ext Simp	$784.32	$4,128.00	$491.70–$3,573.40	72% below	81%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Intro Saline / Cont for Sis or Hsg	$155.99	$821.00	$155.99–$1,137.09	60% below	81%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 U/S Hystero Saline/Contr Inj	$155.99	$821.00	$155.99–$1,137.09	60% below	81%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Contrast Introduct Hysterosalpingography	$175.75	$925.00	$175.75–$1,281.13	55% below	81%
Hysteroscopy with endometrial ablation CPT 58563 Hysteroscopy W/ Endometrial Ablation	$1,040.44	$5,476.00	$885.09–$6,432.32	81% below	81%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hysteroscpy W/ Bx Endomet &/or Polypec	$974.32	$5,128.00	$570.08–$4,143.01	71% below	81%
IUD insertion (the device itself billed separately) CPT 58300 Insertion Intrauterine Device - Iud	$66.12	$348.00	$66.12–$481.98	83% below	81%
Incision and drainage of a simple or single skin abscess CPT 10060 Incision and Drainage, Simple	$137.94	$726.00	$137.94–$1,005.51	66% below	81%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D Abscess Simple	$137.94	$726.00	$137.94–$1,005.51	66% below	81%
Incision and drainage of a simple or single skin abscess CPT 10060 Ewc - I & D Abscess / Paronychia / Cyst	$137.94	$726.00	$137.94–$1,005.51	66% below	81%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D Abscess Simple / Sing	$137.94	$726.00	$137.94–$1,005.51	66% below	81%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC ED Repair Initial Inguinal Hernia 5yrs/> Reducible	$2,065.87	$10,873.00	$632.75–$4,598.45	46% below	81%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Tendon Sheath / Ligament	$188.10	$990.00	$188.10–$1,371.15	51% below	81%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Sing Tendon Sheath or Lig	$188.10	$990.00	$188.10–$1,371.15	51% below	81%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Singl Tend Sheath / Ligament	$188.10	$990.00	$52.93–$384.64	51% below	81%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 HC Arthrocent Asp/Inj Major Jt/Bursa WO US Guid Bilat	$348.27	$1,833.00	$348.27–$2,538.71	—	81%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocent Asp/Inj Major Jt/Bursa WO US Guid (Lt) (Fc)	$232.18	$1,222.00	$52.93–$831.00	48% below	81%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ED Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US (Lt)	$232.18	$1,222.00	$232.18–$1,692.47	48% below	81%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthrocent Asp/Inj Major Jt/Bursa WO US Guid (Rt)	$232.18	$1,222.00	$232.18–$1,692.47	48% below	81%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insertion Drug Delivery Implant	$37.43	$197.00	$37.43–$272.85	88% below	81%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthrocentesis Intermed Joint	$153.14	$806.00	$153.14–$1,116.31	61% below	81%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocent Asp/Inj Intrmd Jt/Bursa WO US Guid	$153.14	$806.00	$153.14–$1,116.31	61% below	81%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ED Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US	$153.14	$806.00	$153.14–$1,116.31	61% below	81%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Asp/Inj Intermediate Jt/Bursa WO U/S Guid	$153.14	$806.00	$52.93–$831.00	61% below	81%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocent Asp/Inj Sm Jnt/Bursa WO U/S Guid	$109.25	$575.00	$109.25–$796.38	64% below	81%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ED Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US	$109.25	$575.00	$109.25–$796.38	64% below	81%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Yag Capsulotomy	$316.92	$1,668.00	$98.36–$1,637.54	54% below	81%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Lyr Cls Wnd Sc/Tk/Ex < 2.6 Cm	$124.07	$653.00	$124.07–$904.41	79% below	81%
Left heart catheterization, diagnostic CPT 93452 Lt Hrt Cath W/ Inj & Rad S&I	$1,774.22	$9,338.00	$1,774.22–$12,933.13	76% below	81%
Lower-back epidural injection, with imaging guidance CPT 62323 Inj Epid Diag/Ther Lumb/Sac W/ Img	$375.63	$1,977.00	$124.17–$1,248.00	74% below	81%
Lower-back epidural injection, without imaging guidance CPT 62322 Inj Epid Diag/Ther Lumb/Sac W/O Img	$320.34	$1,686.00	$159.63–$1,248.00	78% below	81%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Anes Agt/Ster Trnsfor Epid W/ Fluor Lum/Sac Sing	$458.47	$2,413.00	$458.47–$3,342.01	67% below	81%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Anes/Ster Trnsfor Epid W/ Fluor Lum/Sac Sing	$458.47	$2,413.00	$458.47–$3,342.01	67% below	81%
Miscarriage treatment with D&C, first trimester CPT 59820 Treatment Missed Ab Surg 1st Trimester	$708.32	$3,728.00	$708.32–$5,163.28	79% below	81%
Miscarriage treatment with D&C, first trimester CPT 59820 Manual Asp Uterus 1st Trimester Missed Ab (Fc)	$708.32	$3,728.00	$570.08–$4,931.00	79% below	81%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 Mohs Surg H/N/Hf/G 1st Stag 5 Blocks	$249.85	$1,315.00	$249.85–$1,821.28	67% below	81%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc Ben Les Tk/AR/Lg < 0.6 Cm	$262.01	$1,379.00	$126.15–$916.80	62% below	81%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Exc Ben Les Fc/ER/Ey/N/L < 0.6cm	$218.31	$1,149.00	$218.31–$1,591.37	66% below	81%
Nail removal (partial or complete), one nail CPT 11730 Removal Nail Plate Single	$101.46	$534.00	$101.46–$739.59	64% below	81%
Occipital nerve block (injection for headaches) CPT 64405 HC Injection Aa&/Strd Greater Occipital Nerve	$142.69	$751.00	$52.93–$831.00	71% below	81%
Occipital nerve block (injection for headaches) CPT 64405 Greatr Occip Nrv Inj Anest Agt	$142.69	$751.00	$52.93–$394.49	71% below	81%
Occipital nerve block (injection for headaches) CPT 64405 Inj Anes Agnt Greater Occipital Nrv	$142.69	$751.00	$142.69–$1,040.14	71% below	81%
Pacemaker implant (dual chamber) CPT 33208 Ins New/Rplcmt Prm Pm W/Transv Eltrd Atrial&Vent	$5,005.17	$26,343.00	$1,876.39–$14,283.00	57% below	81%
Paracentesis with imaging guidance CPT 49083 Paracentesis Abd Diag/Ther W/ Imag Guid	$375.44	$1,976.00	$375.44–$2,736.76	74% below	81%
Paracentesis with imaging guidance CPT 49083 Paracentesis Abd Diag/Ther W/ Img Guid	$375.44	$1,976.00	$375.44–$2,736.76	74% below	81%
Paracentesis with imaging guidance CPT 49083 HC Paracentesis Abd Diag/Ther W/ Imag Guid	$375.44	$1,976.00	$375.44–$2,736.76	74% below	81%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Nail Excis Partial/Complt	$255.74	$1,346.00	$71.63–$539.28	59% below	81%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Nail Excis Partial / Complete	$255.74	$1,346.00	$71.63–$539.28	59% below	81%
Prostate biopsy CPT 55700 Biopsy Prostate, Sing/Mult	$823.46	$4,334.00	$823.46–$6,002.59	67% below	81%
Prostate biopsy CPT 55700 Prostate Biopsy Needle/Punch	$823.46	$4,334.00	$367.29–$2,669.26	67% below	81%
Prostate biopsy CPT 55700 Prostate Biopsy Needle / Punch	$823.46	$4,334.00	$823.46–$6,002.59	67% below	81%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Lumb/Sac Dstr Neur Agt Singl W/ Imag Guid	$404.70	$2,130.00	$404.70–$2,950.05	82% below	81%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Rfa Lumb / Sac Singl Facet Jnt	$437.76	$2,304.00	$350.12–$2,544.51	81% below	81%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Rfa Water Cooled Lumb / Sac Singl Facet Jnt	$437.76	$2,304.00	$437.76–$3,191.04	81% below	81%
Removal of a breast lump, open surgery CPT 19120 Exc Aberr Breast Tiss Open 1 or More Les	$716.49	$3,771.00	$686.58–$4,989.65	70% below	81%
Removal of a foreign object under the skin, simple CPT 10120 Incis/Rem Forgn Bdy Sq Tiss	$215.08	$1,132.00	$215.08–$1,567.82	54% below	81%
Removal of a foreign object under the skin, simple CPT 10120 Incis/Rem Foreign Body Sq Tiss	$215.08	$1,132.00	$71.63–$557.83	54% below	81%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Ca Screen Colonoscopy High-Risk Pt	$704.33	$3,707.00	$704.33–$5,134.20	70% below	81%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Lithotripsy	$1,215.62	$6,398.00	$1,215.62–$8,861.23	81% below	81%
Short arm cast (elbow to hand) both sides CPT 29075 HC Cast Application Short Arm Bilat (Fc)	$202.16	$1,064.00	$47.62–$346.06	—	81%
Short arm cast (elbow to hand) both sides CPT 29075 HC ED Cast Application Short Arm Bilat	$269.42	$1,418.00	$269.42–$1,963.93	—	81%
Short arm cast (elbow to hand) both sides CPT 29075 HC Cast Application Short Arm Pt Bilat	$269.42	$1,418.00	$269.42–$1,963.93	—	81%
Short arm cast (elbow to hand) both sides CPT 29075 HC Cast Application Short Arm Ot Bilat	$269.42	$1,418.00	$269.42–$1,963.93	—	81%
Short arm cast (elbow to hand) one side CPT 29075 HC ED Cast Application Short Arm Rt	$134.71	$709.00	$134.71–$981.97	56% below	81%
Short arm cast (elbow to hand) one side CPT 29075 Cast Application Short Arm Lt	$134.71	$709.00	$47.62–$346.06	56% below	81%
Short arm cast (elbow to hand) one side CPT 29075 Cast Application Short Arm Pt Lt	$134.71	$709.00	$134.71–$981.97	56% below	81%
Short arm cast (elbow to hand) one side CPT 29075 HC Cast Application Short Arm Rt (Fc)	$134.71	$709.00	$47.62–$346.06	56% below	81%
Short arm cast (elbow to hand) one side CPT 29075 Cast Application Short Arm (Fc) Lt	$134.71	$709.00	$134.71–$981.97	56% below	81%
Short arm cast (elbow to hand) one side CPT 29075 HC Cast Application Short Arm Ot Rt	$134.71	$709.00	$134.71–$981.97	56% below	81%
Short arm cast (elbow to hand) one side CPT 29075 Cast Application Short Arm Ot Lt	$134.71	$709.00	$134.71–$981.97	56% below	81%
Short arm cast (elbow to hand) one side CPT 29075 HC Cast Application Short Arm Pt Rt	$134.71	$709.00	$134.71–$981.97	56% below	81%
Short arm splint (forearm and hand) CPT 29125 Splint Applicatn Short Arm	$116.66	$614.00	$23.11–$210.29	52% below	81%
Short arm splint (forearm and hand) CPT 29125 Splint Application Short Arm	$116.66	$614.00	$116.66–$850.39	52% below	81%
Short arm splint (forearm and hand) CPT 29125 Ewc - Ortho Glass Short Arm Mold	$116.66	$614.00	$116.66–$850.39	52% below	81%
Short leg cast (below the knee) both sides CPT 29405 HC Cast Application Short Leg Pt Bilat	$387.22	$2,038.00	$387.22–$2,822.63	—	81%
Short leg cast (below the knee) both sides CPT 29405 HC ED Cast Application Short Leg Bilat	$387.22	$2,038.00	$387.22–$2,822.63	—	81%
Short leg cast (below the knee) both sides CPT 29405 HC Cast Application Short Leg Bilat (Fc)	$387.22	$2,038.00	$387.22–$2,822.63	—	81%
Short leg cast (below the knee) both sides CPT 29405 HC Cast Application Short Leg Ot Bilat	$387.22	$2,038.00	$47.62–$376.23	—	81%
Short leg cast (below the knee) one side CPT 29405 HC Cast Application Short Leg Pt Rt	$193.61	$1,019.00	$193.61–$1,411.32	41% below	81%
Short leg cast (below the knee) one side CPT 29405 Cast Application Short Leg Pt Lt	$193.61	$1,019.00	$193.61–$1,411.32	41% below	81%
Short leg cast (below the knee) one side CPT 29405 Cast Application Short Leg Ot Lt	$193.61	$1,019.00	$193.61–$1,411.32	41% below	81%
Short leg cast (below the knee) one side CPT 29405 HC Cast Application Short Leg Ot Rt	$193.61	$1,019.00	$47.62–$346.06	41% below	81%
Short leg cast (below the knee) one side CPT 29405 Cast Application Short Leg Lt	$193.61	$1,019.00	$47.62–$346.06	41% below	81%
Short leg cast (below the knee) one side CPT 29405 HC ED Cast Application Short Leg Rt	$193.61	$1,019.00	$193.61–$1,411.32	41% below	81%
Short leg cast (below the knee) one side CPT 29405 Cast Application Short Leg (Fc) Lt	$193.61	$1,019.00	$193.61–$1,411.32	41% below	81%
Short leg cast (below the knee) one side CPT 29405 HC Cast Application Short Leg Rt (Fc)	$193.61	$1,019.00	$193.61–$1,411.32	41% below	81%
Short leg splint (calf to foot) CPT 29515 Splint Application Short Leg	$102.41	$539.00	$102.41–$746.52	59% below	81%
Short leg splint (calf to foot) CPT 29515 Splint Applicatn Short Leg	$102.41	$539.00	$102.41–$746.52	59% below	81%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Wnd Rep Simp Sc/Nk/Ax/Tk < 2.6 Cm	$95.57	$503.00	$95.57–$696.66	74% below	81%
Skin biopsy, punch, one lesion CPT 11104 Bx Skin Punch Sgl Lesn	$129.39	$681.00	$71.63–$831.00	66% below	81%
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy Skin Single Lesion	$129.39	$681.00	$71.63–$520.60	66% below	81%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Exc Mal Les T/AR/Lg < 0.6 Cm	$223.82	$1,178.00	$223.82–$1,631.53	61% below	81%
Skin tag removal, up to 15 tags CPT 11200 Skin Tag Removal 1-15	$76.38	$402.00	$76.38–$556.77	70% below	81%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Puncture, Lumbar	$356.06	$1,874.00	$356.06–$2,595.49	60% below	81%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Punc Lumbar Diag	$356.06	$1,874.00	$124.17–$1,248.00	60% below	81%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Diag	$356.06	$1,874.00	$356.06–$2,595.49	60% below	81%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Diagnostic	$356.06	$1,874.00	$356.06–$2,595.49	60% below	81%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Wnd Rep Simp Sc/Nk/Ax/Tk 2.6-7.5 Cm	$98.80	$520.00	$98.80–$720.20	76% below	81%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Wound Repair Simple Fc/ER/Ey/N/L 2.5 Cm/<	$119.13	$627.00	$119.13–$868.40	70% below	81%
TURP (transurethral resection of the prostate) CPT 52601 HC Trurl Electrosurg Rescj Prostate Bleed Complete	$2,036.04	$10,716.00	$911.47–$6,624.08	64% below	81%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Bx Skin Tangent Sgl Lesn	$129.39	$681.00	$35.63–$831.00	57% below	81%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangential Biopsy Skin Single Lesion	$129.39	$681.00	$35.63–$424.56	57% below	81%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis Asp Pleural Space W/ Imag Guid	$366.13	$1,927.00	$366.13–$2,668.90	69% below	81%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis W/ Imag Guid	$366.13	$1,927.00	$110.85–$1,248.00	69% below	81%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Tonsilectmy Prim/Secnd > Age 11	$667.85	$3,515.00	$581.47–$4,225.80	81% below	81%
Trigger finger release surgery CPT 26055 Tendon Sheath Incision	$629.66	$3,314.00	$286.95–$2,085.37	63% below	81%
Trigger point injections, 1 or 2 muscles CPT 20552 Trigr Pnt Inj 1-2 Musc Sing / Mult	$133.76	$704.00	$52.93–$384.64	73% below	81%
Trigger point injections, 1 or 2 muscles CPT 20552 Trigger Point Inj 1-2 Musc Sing/Mult	$133.76	$704.00	$52.93–$384.64	73% below	81%
Trigger point injections, 1 or 2 muscles CPT 20552 Trigger Point Inj 1-2 Musc Sing / Mult	$133.76	$704.00	$52.93–$831.00	73% below	81%
Trigger point injections, 1 or 2 muscles CPT 20552 Trigger Pnt Inj 1-2 Musc Sing/Mult	$133.76	$704.00	$52.93–$831.00	73% below	81%
Ultrasound-guided breast needle biopsy with marker clip, first lesion both sides CPT 19083 HC Breast Bx Bilat, Plc Loc Dev, Imag Perc US 1st Les	$971.85	$5,115.00	$290.50–$2,111.21	—	81%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC Bx Breast W/Device 1st Lesion Ultrasound Guide	$647.90	$3,410.00	$647.90–$4,722.85	73% below	81%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 Breast Bx Rt, Plc Loc Dev, Imag Perc US 1st Les	$647.90	$3,410.00	$290.50–$2,111.21	73% below	81%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 Breast Bx Lt, Plc Loc Dev, Imag Perc US 1st Les	$647.90	$3,410.00	$290.50–$2,111.21	73% below	81%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Egd Flex Trnsoral W/ Baln Dil Esoph <30mm	$736.82	$3,878.00	$340.12–$2,471.83	64% below	81%
Upper endoscopy (EGD) with biopsy CPT 43239 Egd Flex Trnsoral W/ Bx Sing/Mult	$652.46	$3,434.00	$168.10–$1,942.00	70% below	81%
Upper endoscopy (EGD) with biopsy CPT 43239 Egd Flx Trnsoral W/ Bx Sing/Mult	$652.46	$3,434.00	$652.46–$4,756.09	70% below	81%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Egd Flex Trnsoral W/ Submucos Inj	$628.33	$3,307.00	$168.10–$1,942.00	66% below	81%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Egd Flex Trnsoral W/ Rem Les Snare	$728.84	$3,836.00	$728.84–$5,312.86	70% below	81%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Egd Flex Trnsoral W/ Ins Gw / Dil	$663.48	$3,492.00	$168.10–$1,942.00	75% below	81%
Upper endoscopy (EGD), diagnostic CPT 43235 Egd Flex Trnsoral Diag W/WO Spec Term	$583.30	$3,070.00	$168.10–$1,942.00	61% below	81%
Upper endoscopy (EGD), diagnostic CPT 43235 Egd Flex Trnsoral Diag W/WO Spec	$632.32	$3,328.00	$168.10–$1,221.66	58% below	81%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 Egd Flex Trnsoral W/ Trnsmural Drain Cyst	$2,154.22	$11,338.00	$1,067.32–$7,756.66	51% below	81%
Vein ablation, radiofrequency, first vein CPT 36475 HC Rfa 1st Vein/Perforator	$555.56	$2,924.00	$555.56–$4,049.74	89% below	81%
Vein ablation, radiofrequency, first vein CPT 36475 Rfa Ther Incomp 1st Vein Incl Guid, Ea Ext	$1,322.40	$6,960.00	$564.33–$4,101.27	73% below	81%
Vein ablation, radiofrequency, first vein CPT 36475 Rfa Therapy Incom V 1st Vein	$1,487.51	$7,829.00	$564.33–$5,408.00	70% below	81%
Wart removal, up to 14 warts CPT 17110 Dstr Ben Les / Wart Not Sktg/Cut Vasc < 15	$47.69	$251.00	$47.69–$347.64	79% below	81%
Wart removal, up to 14 warts CPT 17110 Dstr Ben Les / Wart Not Sk Tg / Cut Vasc Up to 14 Les	$47.69	$251.00	$35.63–$373.38	79% below	81%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debrdmnt Sq Tiss 1st 20 Sq Cm or Less	$291.65	$1,535.00	$71.63–$520.60	56% below	81%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood or Blood Components (per Encounter)	$330.22	$1,738.00	$330.22–$2,407.13	65% below	81%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Bld Product (per Encounter)	$330.22	$1,738.00	$78.38–$569.66	65% below	81%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood/Blood Prod per Visit	$330.22	$1,738.00	$78.38–$569.66	65% below	81%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion per Visit	$330.22	$1,738.00	$330.22–$2,407.13	65% below	81%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Treatment	$52.44	$276.00	$52.44–$382.26	72% below	81%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Metered Dose Inhaler Tx	$52.44	$276.00	$52.44–$382.26	72% below	81%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Ippb Tx	$52.44	$276.00	$52.44–$382.26	72% below	81%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hyperinflation Tx	$52.44	$276.00	$52.44–$382.26	72% below	81%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Tx Intermittent	$52.44	$276.00	$52.44–$382.26	72% below	81%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation Tx by ER - Neb, Mdi, Ippb	$52.44	$276.00	$36.47–$265.02	72% below	81%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Med Nebulizer Treatment	$52.44	$276.00	$36.47–$265.02	72% below	81%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Sputum Induction	$52.44	$276.00	$36.47–$265.02	72% below	81%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mdi Treatment	$52.44	$276.00	$52.44–$382.26	72% below	81%
Chemotherapy IV infusion, first hour CPT 96413 Infusion Chemo 1st Hr Init	$208.81	$1,099.00	$208.81–$1,522.12	67% below	81%
Chemotherapy IV infusion, first hour CPT 96413 Infusion Chemo 1st Hr Initial	$208.81	$1,099.00	$59.47–$708.84	67% below	81%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 Ophthal Exam Comp New Pt W Gross Vis Fld	$46.74	$246.00	$46.74–$340.71	67% below	81%
Comprehensive eye exam, returning patient CPT 92014 Ophthal Exam Comp Est Pt W Gross Vis Fld	$46.17	$243.00	$46.17–$336.56	65% below	81%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Veterans Evaluation Service	$58.71	$309.00	$58.71–$427.97	77% below	81%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Comprehensive Audio Eval One Ear (Fc)	$90.25	$475.00	$28.05–$203.87	65% below	81%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Comprehensive Audio Eval	$95.76	$504.00	$28.05–$203.87	62% below	81%
Critical care, first 30 to 74 minutes CPT 99291 HC Critical Care 1st 30-74 Min W/Procedure (Mod 25)	$804.27	$4,233.00	$804.27–$5,862.71	58% below	81%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care 1st 30-74 Min	$804.27	$4,233.00	$151.08–$4,233.00	58% below	81%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Eeg Awake & Drowsy	$244.53	$1,287.00	$244.53–$1,782.50	71% below	81%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg Awake and Drowsy	$244.53	$1,287.00	$244.53–$1,782.50	71% below	81%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocard,Tracing Only	$82.08	$432.00	$82.08–$598.32	65% below	81%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED Only - Ekg 12-Lead	$82.08	$432.00	$10.65–$84.15	65% below	81%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg 12-Lead - to Be Done in OP Clinic or Loc Lab	$82.08	$432.00	$10.65–$84.15	65% below	81%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Vectorcardiogram / Ekg	$82.08	$432.00	$10.65–$84.15	65% below	81%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg 12-Lead - Gmh IP / ED	$82.08	$432.00	$82.08–$598.32	65% below	81%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg 12-Lead - Done in Outpatient Gmh	$82.08	$432.00	$82.08–$598.32	65% below	81%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg 12-Lead - Loyola/Macneal Locations	$82.08	$432.00	$82.08–$598.32	65% below	81%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg 12-Lead - to Be Done by Cancer Ctr Lab	$82.08	$432.00	$82.08–$598.32	65% below	81%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg 12-Lead	$82.08	$432.00	$10.65–$84.15	65% below	81%
Electroconvulsive therapy (ECT), one session CPT 90870 Ect Procedure	$150.86	$794.00	$150.86–$1,099.69	84% below	81%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED Visit Level I	$104.50	$550.00	$15.79–$628.00	49% below	81%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED Visit Level I W/Procedure (Mod 25)	$104.50	$550.00	$104.50–$761.75	49% below	81%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED Visit Level II	$158.46	$834.00	$28.39–$834.00	59% below	81%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED Visit Level II W/Procedure (Mod 25)	$158.46	$834.00	$158.46–$1,155.09	59% below	81%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED Visit Level III W/Procedure (Mod 25)	$342.00	$1,800.00	$342.00–$2,493.00	51% below	81%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED Visit Level III	$342.00	$1,800.00	$49.65–$2,118.00	51% below	81%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED Visit Level IV W/Procedure (Mod 25)	$646.00	$3,400.00	$646.00–$4,709.00	43% below	81%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED Visit Level IV	$646.00	$3,400.00	$76.35–$3,400.00	43% below	81%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED Visit Level V	$722.00	$3,800.00	$109.93–$3,800.00	57% below	81%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED Visit Level V W/Procedure (Mod 25)	$722.00	$3,800.00	$722.00–$5,263.00	57% below	81%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test,Tracing Only	$298.49	$1,571.00	$298.49–$2,175.84	69% below	81%
Exercise stress test, tracing only, the hospital charge CPT 93017 Peds Treadmill Exercise Test (Non Imaging)	$298.49	$1,571.00	$55.83–$439.88	69% below	81%
Exercise stress test, tracing only, the hospital charge CPT 93017 Treadmill Exercise Test (No Imaging)	$298.49	$1,571.00	$298.49–$2,175.84	69% below	81%
Eye exam, returning patient, intermediate CPT 92012 Ophth Exam W/ Initiation Tx Progrm Est Pt	$25.08	$132.00	$25.08–$182.82	81% below	81%
Eye exam, returning patient, intermediate CPT 92012 Ophthal Exam Interm Est Pt WO Gross Vis Fld	$46.17	$243.00	$46.17–$336.56	65% below	81%
Group psychotherapy session CPT 90853 Group Psychotherapy Other Than Multi-Family	$52.63	$277.00	$52.63–$383.65	57% below	81%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infusion Hydration 1st Hr Init	$107.92	$568.00	$37.78–$279.04	69% below	81%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infusion Hydration 1st Hr Initial	$107.92	$568.00	$107.92–$786.68	69% below	81%
IV infusion of a medicine, first hour CPT 96365 Infusion Non-Chemo 1st Hr Initial	$129.58	$682.00	$37.78–$339.12	69% below	81%
IV infusion of a medicine, first hour CPT 96365 Infusion Non-Chemo 1st Hr Init	$129.58	$682.00	$129.58–$944.57	69% below	81%
IV push of a medicine, first drug CPT 96374 Inj Fee Non-Chemo Ivp Initial	$72.96	$384.00	$72.96–$531.84	66% below	81%
IV push of a medicine, first drug CPT 96374 Inj Fee Non-Chemo Ivp Init	$72.96	$384.00	$37.78–$274.53	66% below	81%
IV push of a medicine, first drug CPT 96374 Inj Fee Non Chemo Ivp Initial	$72.96	$384.00	$37.78–$274.53	66% below	81%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj Fee Filgrastim	$45.41	$239.00	$12.76–$92.74	58% below	81%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj Fee Non-Chemo Sq, Im (Pt Purch Own Med)	$45.41	$239.00	$12.76–$92.74	58% below	81%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj Fee Epogen / Aranesp	$45.41	$239.00	$12.76–$92.74	58% below	81%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj Fee Non-Chemo Sq, Im	$45.41	$239.00	$45.41–$331.02	58% below	81%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC Psychiatric Diagnosis Evaluation	$119.89	$631.00	$119.89–$873.94	53% below	81%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nerve Conduction Studies 7-8 Studies	$112.10	$590.00	$112.10–$817.15	85% below	81%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromusc Re-ED 15 Min Pt	$35.15	$185.00	$35.15–$256.23	71% below	81%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromusc Re-ED 15 Min Ot	$35.15	$185.00	$7.09–$175.52	71% below	81%
New patient office visit, about 30 minutes CPT 99203 New Level III 30-45 Min	$25.08	$132.00	$25.08–$182.82	88% below	81%
New patient office visit, about 30 minutes CPT 99203 New Level III	$25.08	$132.00	$25.08–$182.82	88% below	81%
New patient office visit, about 45 minutes CPT 99204 New Level IV 45-60 Min	$31.54	$166.00	$31.54–$229.91	89% below	81%
New patient office visit, about 45 minutes CPT 99204 New Level IV	$31.54	$166.00	$31.54–$229.91	89% below	81%
New patient office visit, about 60 minutes CPT 99205 Tis-I Nurse Visit New	$46.74	$246.00	$246.00–$987.09	87% below	81%
New patient office visit, about 60 minutes CPT 99205 New Level V	$46.74	$246.00	$46.74–$340.71	87% below	81%
New patient office visit, about 60 minutes CPT 99205 New Level V > 1 Hr	$46.74	$246.00	$46.74–$340.71	87% below	81%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Level II	$24.13	$127.00	$24.13–$175.90	85% below	81%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Level II 15-30 Min	$24.13	$127.00	$24.13–$175.90	85% below	81%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Peds Dietitian Init Visit	$6.65	$35.00	$6.65–$48.48	88% below	81%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Bariatric Adult Dietitian Assmt	$6.65	$35.00	$7.04–$203.04	88% below	81%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 OP Nutr Assmt / ED Init Ind 15 Min	$17.86	$94.00	$17.86–$130.19	67% below	81%
Occupational therapy evaluation, low complexity CPT 97165 New Eval Ot Low Complexity	$76.38	$402.00	$76.38–$556.77	70% below	81%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 New Eval Pt High Complexity	$112.48	$592.00	$21.70–$537.06	67% below	81%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 New Eval Pt Low Complexity	$76.38	$402.00	$76.38–$556.77	66% below	81%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 New Eval Pt Moderate Complexity	$105.83	$557.00	$21.70–$537.06	66% below	81%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy 15 Min Ot	$42.94	$226.00	$42.94–$313.01	70% below	81%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy 15 Min Pt	$42.94	$226.00	$42.94–$313.01	70% below	81%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Isokinetic Exercise 15 Min Pt	$40.66	$214.00	$40.66–$296.39	66% below	81%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Exercise 15 Min Ot	$40.66	$214.00	$40.66–$296.39	66% below	81%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Exercise 15 Min Pt	$40.66	$214.00	$40.66–$296.39	66% below	81%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Psych Test Eval MD/Qhp 1st Hr	$75.62	$398.00	$75.62–$551.23	76% below	81%
Psychotherapy for crisis, first 60 minutes CPT 90839 HC Psychotherapy for Crisis 60 Min	$119.89	$631.00	$119.89–$873.94	50% below	81%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking / Tobacco Cessation Counsel Intermed 3-10 Min	$9.69	$51.00	$5.34–$64.56	72% below	81%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Est Level V	$46.74	$246.00	$246.00–$785.79	83% below	81%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Est Level V > 1 Hr	$46.74	$246.00	$46.74–$340.71	83% below	81%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Tis-I Nurse Visit Family	$46.74	$246.00	$46.74–$340.71	83% below	81%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OB Triage Est Level V	$51.49	$271.00	$51.49–$375.34	81% below	81%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Tis Nurse Visit Family	$57.00	$300.00	$57.00–$415.50	79% below	81%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Est Level III 30-45 Min	$25.08	$132.00	$25.08–$182.82	83% below	81%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Tis-I Nurse Visit Return	$25.08	$132.00	$25.08–$182.82	83% below	81%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Est Level III	$25.08	$132.00	$132.00–$361.42	83% below	81%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OB Triage Est Level III	$27.55	$145.00	$27.55–$200.83	82% below	81%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Est Level IV 45-60 Min	$31.54	$166.00	$31.54–$229.91	82% below	81%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Est Level IV	$31.54	$166.00	$166.00–$532.21	82% below	81%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OB Triage Est Level IV	$34.77	$183.00	$34.77–$253.46	80% below	81%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Est Level II 15-30 Min	$24.13	$127.00	$24.13–$175.90	80% below	81%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Rn Visit Cath Maintenance	$24.13	$127.00	$24.13–$175.90	80% below	81%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Est Level II	$24.13	$127.00	$127.00–$193.26	80% below	81%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OB Triage Est Level II	$25.27	$133.00	$25.27–$184.21	79% below	81%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OP Lactation Serv Fee Comp (60-Min)	$100.13	$527.00	$527.00	67% below	81%
Speech and language evaluation CPT 92523 Eval Speech Sound Product W/ Eval Lang Comp & Exp 90 Min	$113.81	$599.00	$113.81–$829.62	71% below	81%
Speech and language evaluation CPT 92523 Eval Speech Sound Product W/ Eval Lang Comp & Exp 60 Min	$113.81	$599.00	$113.81–$829.62	71% below	81%
Speech and language evaluation CPT 92523 Eval Speech Sound Product W/ Eval Lang Comp & Exp 45 Min	$113.81	$599.00	$113.81–$829.62	71% below	81%
Speech and language evaluation CPT 92523 Eval Speech Sound Product W/ Eval Lang Comp & Exp 75 Min	$113.81	$599.00	$113.81–$829.62	71% below	81%
Speech and language evaluation CPT 92523 Eval Speech Sound Product W/ Eval Lang Comp & Exp 15 Min	$113.81	$599.00	$113.81–$829.62	71% below	81%
Speech and language evaluation CPT 92523 Eval Speech Sound Product W/ Eval Lang Comp & Exp 30 Min	$113.81	$599.00	$113.81–$829.62	71% below	81%
Speech therapy session, individual CPT 92507 Spch/Lang/Voice Ther 30min Slp	$86.83	$457.00	$86.83–$632.95	53% below	81%
Speech therapy session, individual CPT 92507 Spch/Lang/Voice Ther 75min Slp	$86.83	$457.00	$86.83–$632.95	53% below	81%
Speech therapy session, individual CPT 92507 Spch/Lang/Voice/Ther 45min Slp	$86.83	$457.00	$86.83–$632.95	53% below	81%
Speech therapy session, individual CPT 92507 Spch/Lang/Voice/Ther 60min Slp	$86.83	$457.00	$86.83–$632.95	53% below	81%
Speech therapy session, individual CPT 92507 Voice Prosthetic Modif Slp	$86.83	$457.00	$86.83–$632.95	53% below	81%
Speech therapy session, individual CPT 92507 Spch/Lang/Voice Ther 15min Slp	$86.83	$457.00	$86.83–$632.95	53% below	81%
Spirometry (breathing test) CPT 94010 Spirometry	$132.43	$697.00	$28.05–$203.87	57% below	81%
Spirometry (breathing test) CPT 94010 Spirometry W/ Graphic Record	$132.43	$697.00	$132.43–$965.35	57% below	81%
Spirometry before and after a bronchodilator CPT 94060 Spiro Pre/Post Bronchodilator	$173.85	$915.00	$55.83–$405.76	67% below	81%
Spirometry before and after a bronchodilator CPT 94060 Spiro-Pre & Post Bronchodilatr	$173.85	$915.00	$55.83–$405.76	67% below	81%
TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 Tms Tx Init Deliv & Mgmt	$106.59	$561.00	$106.59–$776.99	66% below	81%
Therapeutic activities (functional training), 15 minutes CPT 97530 Funct Ther Activ 15 Min Ot	$35.34	$186.00	$35.34–$257.61	72% below	81%
Therapeutic activities (functional training), 15 minutes CPT 97530 Funct Ther Activ 15 Min Pt	$35.34	$186.00	$7.67–$189.90	72% below	81%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy 5 West	$70.68	$372.00	$23.11–$526.59	66% below	81%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Lab Thera	$70.68	$372.00	$70.68–$515.22	66% below	81%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy	$70.68	$372.00	$70.68–$515.22	66% below	81%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy 3rd Floor	$70.68	$372.00	$23.11–$526.59	66% below	81%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy 5 South	$70.68	$372.00	$23.11–$526.59	66% below	81%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy 6th Floor	$70.68	$372.00	$23.11–$526.59	66% below	81%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy Tcu	$70.68	$372.00	$23.11–$526.59	66% below	81%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy OB/Gyn	$70.68	$372.00	$23.11–$526.59	66% below	81%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy Icu	$70.68	$372.00	$23.11–$526.59	66% below	81%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy - Apheresis	$70.68	$372.00	$23.11–$526.59	66% below	81%
Visual field test, extended CPT 92083 Visual Field Hvf or 3 Isop	$44.27	$233.00	$44.27–$322.71	70% below	81%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Influenza (Fluad) Trivalent 0.5ml >65+ Im (Fc)	$33.44	$176.00	$33.44–$243.76	72% below	81%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 Influenza (Fluad) Trivalent 0.5ml >65+ Im (Fc)	$33.44	$176.00	$33.44–$243.76	—	81%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 HC Covid-19 (Pfizer 12+) 30mcg/0.3ml (Comirnaty) Mrna 2024-2025	$61.37	$323.00	$61.37–$447.36	75% below	81%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 HC Covid-19/Sarscov2 Vac Pfizer Mrna-Lnp Spike Protein 30mcg Trs	$63.65	$335.00	$63.65–$463.98	74% below	81%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 HC Covid-19 (Pfizer 12+) 30mcg/0.3ml (Comirnaty) Mrna 2024-2025	$61.37	$323.00	$61.37–$447.36	—	81%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 HC Covid-19/Sarscov2 Vac Pfizer Mrna-Lnp Spike Protein 30mcg Trs	$63.65	$335.00	$63.65–$463.98	—	81%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella Virus Vacc Live Sq Inj (Fc)	$95.19	$501.00	$95.19–$693.89	66% below	81%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varicella Virus Vacc Live Sq Inj (Fc)	$95.19	$501.00	$95.19–$693.89	—	81%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Dtap-Ipv (Kinrix) Vacc Age 4-6 Im Inj	$33.06	$174.00	$33.06–$240.99	68% below	81%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Dtap-Ipv (Quadracel) Vacc Age 4-6 Im Inj	$37.05	$195.00	$37.05–$270.08	64% below	81%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 Dtap-Ipv (Kinrix) Vacc Age 4-6 Im Inj	$33.06	$174.00	$33.06–$240.99	—	81%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 Dtap-Ipv (Quadracel) Vacc Age 4-6 Im Inj	$37.05	$195.00	$37.05–$270.08	—	81%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC Diphth/Tetanus/Acel Pertuss Dtap (Infanrix) < 7 Y/O Im Inj (F	$18.43	$97.00	$18.43–$134.35	71% below	81%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Diphth/Tetanus/Acel Pertuss Dtap (Daptacel) < 7 Y/O Im Inj	$50.16	$264.00	$50.16–$365.64	22% below	81%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC Diphth/Tetanus/Acel Pertuss Dtap (Infanrix) < 7 Y/O Im Inj (F	$18.43	$97.00	$18.43–$134.35	—	81%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Diphth/Tetanus/Acel Pertuss Dtap (Daptacel) < 7 Y/O Im Inj	$50.16	$264.00	$50.16–$365.64	—	81%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Pediarix Inj Vacc (Dtap, Hep B, Polio) (Fc)	$38.95	$205.00	$38.95–$283.93	76% below	81%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 Pediarix Inj Vacc (Dtap, Hep B, Polio) (Fc)	$38.95	$205.00	$38.95–$283.93	—	81%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 Pentacel Vacc Inj Im (Dtap, Hib, Polio) (Fc)	$61.18	$322.00	$61.18–$445.97	67% below	81%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 Pentacel Vacc Inj Im (Dtap, Hib, Polio) (Fc)	$61.18	$322.00	$61.18–$445.97	—	81%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 Vaxelis Inj	$82.65	$435.00	$82.65–$602.48	66% below	81%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 Vaxelis Inj	$82.65	$435.00	$82.65–$602.48	—	81%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza (Flulaval) Trivalent 0.5ml >6 Mon (Fc)	$9.69	$51.00	$9.69–$70.64	72% below	81%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza (Fluarix) Trivalent 0.5ml >6 Mon (Fc)	$11.40	$60.00	$11.40–$83.10	67% below	81%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Influenza (Flulaval) Trivalent 0.5ml >6 Mon (Fc)	$9.69	$51.00	$9.69–$70.64	—	81%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Influenza (Fluarix) Trivalent 0.5ml >6 Mon (Fc)	$11.40	$60.00	$11.40–$83.10	—	81%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Hpv 9-Valent Recomb (Gardasil-9) Vacc Im Inj	$147.44	$776.00	$147.44–$1,074.76	70% below	81%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Hpv 9-Valent Recomb (Gardasil-9) Vacc Im Inj	$147.44	$776.00	$147.44–$1,074.76	—	81%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Twinrix Hep a & B	$60.99	$321.00	$60.99–$444.59	70% below	81%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 Twinrix Hep a & B	$60.99	$321.00	$60.99–$444.59	—	81%
Hepatitis A vaccine, adult dose CPT 90632 Tis Hepatitis a Vacc Adult Im Inj (Fc)	$26.98	$142.00	$26.98–$196.67	78% below	81%
Hepatitis A vaccine, adult dose CPT 90632 Tis-I Hepatitis a Vacc Adult Im Inj (Fc)	$26.98	$142.00	$26.98–$196.67	78% below	81%
Hepatitis A vaccine, adult dose CPT 90632 Hepatitis a (Adult) Im Inj (Fc)	$41.80	$220.00	$41.80–$304.70	65% below	81%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Tis-I Hepatitis a Vacc Adult Im Inj (Fc)	$26.98	$142.00	$26.98–$196.67	—	81%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Tis Hepatitis a Vacc Adult Im Inj (Fc)	$26.98	$142.00	$26.98–$196.67	—	81%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis a (Adult) Im Inj (Fc)	$41.80	$220.00	$41.80–$304.70	—	81%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Tis Hepatitis a Vacc Peds Im Inj (Fc)	$13.68	$72.00	$13.68–$99.72	83% below	81%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Tis-I Hepatitis a Vacc Peds Im Inj (Fc)	$13.68	$72.00	$13.68–$99.72	83% below	81%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepatitis a Peds/Adol (Havrix) Im Inj (Fc)	$19.95	$105.00	$19.95–$145.43	76% below	81%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Tis Hepatitis a Vacc Peds Im Inj (Fc)	$13.68	$72.00	$13.68–$99.72	—	81%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Tis-I Hepatitis a Vacc Peds Im Inj (Fc)	$13.68	$72.00	$13.68–$99.72	—	81%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hepatitis a Peds/Adol (Havrix) Im Inj (Fc)	$19.95	$105.00	$19.95–$145.43	—	81%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Tis Loymis Hepatitis B Adult Engerix-B 3-Dose Sch Im Inj	$14.82	$78.00	$14.82–$108.03	86% below	81%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Adult Engerix-B 3-Dose Sch Im Inj	$16.15	$85.00	$16.15–$117.73	85% below	81%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Tis Hepatitis B Adult Engerix-B 3-Dose Sch Im Inj	$22.42	$118.00	$22.42–$163.43	79% below	81%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Tis-I Hepatitis B Adult Engerix-B 3-Dose Sch Im Inj	$22.42	$118.00	$22.42–$163.43	79% below	81%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Tis Loymis Hepatitis B Adult Engerix-B 3-Dose Sch Im Inj	$14.82	$78.00	$14.82–$108.03	—	81%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Adult Engerix-B 3-Dose Sch Im Inj	$16.15	$85.00	$16.15–$117.73	—	81%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Tis Hepatitis B Adult Engerix-B 3-Dose Sch Im Inj	$22.42	$118.00	$22.42–$163.43	—	81%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Tis-I Hepatitis B Adult Engerix-B 3-Dose Sch Im Inj	$22.42	$118.00	$22.42–$163.43	—	81%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 Hepatitis B Adult Heplisav-B 2-Dose Sch Im Inj (Fc)	$68.21	$359.00	$68.21–$497.22	70% below	81%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 Hepatitis B Adult Heplisav-B 2-Dose Sch Im Inj (Fc)	$68.21	$359.00	$68.21–$497.22	—	81%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B Peds/Adol Engerix-B 3-Dose Sch Im Inj	$13.49	$71.00	$13.49–$98.34	85% below	81%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepatitis B Peds/Adol Engerix-B 3-Dose Sch Im Inj	$13.49	$71.00	$13.49–$98.34	—	81%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Haemophilus B (Ped Vax Hib) Vacc Im Inj (Fc)	$21.85	$115.00	$21.85–$159.28	65% below	81%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 Haemophilus B (Ped Vax Hib) Vacc Im Inj (Fc)	$21.85	$115.00	$21.85–$159.28	—	81%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Haemophilus B (Act Hib) Im Inj (Fc)	$8.17	$43.00	$8.17–$59.56	85% below	81%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Haemophilus B (Hiberix) Im Inj (Fc)	$8.17	$43.00	$8.17–$59.56	85% below	81%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Haemophilus B (Hiberix) Im Inj (Fc)	$8.17	$43.00	$8.17–$59.56	—	81%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Haemophilus B (Act Hib) Im Inj (Fc)	$8.17	$43.00	$8.17–$59.56	—	81%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Tis-I Influenza Fluzone Vacc Pf Hi Dose Age 65&Abv Im Inj	$17.10	$90.00	$17.10–$124.65	78% below	81%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza Fluzone Vacc Pf High Dose Age 65 & Abv Im Inj	$34.39	$181.00	$34.39–$250.69	55% below	81%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza Fluzone High Dose 65 & Abv Im Inj	$38.00	$200.00	$38.00–$277.00	51% below	81%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Tis-I Influenza Fluzone Vacc Pf Hi Dose Age 65&Abv Im Inj	$17.10	$90.00	$17.10–$124.65	—	81%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Influenza Fluzone Vacc Pf High Dose Age 65 & Abv Im Inj	$34.39	$181.00	$34.39–$250.69	—	81%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Influenza Fluzone High Dose 65 & Abv Im Inj	$38.00	$200.00	$38.00–$277.00	—	81%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 Tis Loymis Jap Enceph Virus Ixiaro Vac Im Inj (Fc)	$61.75	$325.00	$61.75–$450.13	85% below	81%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 Tis Japanese Enceph Virus Ixiaro Vacc Im Inj (Fc)	$66.50	$350.00	$66.50–$484.75	84% below	81%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 Tis-I Japanese Enceph Virus Ixiaro Vacc Im Inj (Fc)	$66.50	$350.00	$66.50–$484.75	84% below	81%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 Tis Loymis Jap Enceph Virus Ixiaro Vac Im Inj (Fc)	$61.75	$325.00	$61.75–$450.13	—	81%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 Tis Japanese Enceph Virus Ixiaro Vacc Im Inj (Fc)	$66.50	$350.00	$66.50–$484.75	—	81%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 Tis-I Japanese Enceph Virus Ixiaro Vacc Im Inj (Fc)	$66.50	$350.00	$66.50–$484.75	—	81%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Tis-I Mmr Live Vacc Sq Inj (Fc)	$24.32	$128.00	$24.32–$177.28	88% below	81%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Tis Mmr Live Vacc Sq Inj (Fc)	$24.32	$128.00	$24.32–$177.28	88% below	81%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Mmr Live Sq Inj (Fc)	$56.05	$295.00	$56.05–$408.58	72% below	81%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Tis Mmr Live Vacc Sq Inj (Fc)	$24.32	$128.00	$24.32–$177.28	—	81%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Tis-I Mmr Live Vacc Sq Inj (Fc)	$24.32	$128.00	$24.32–$177.28	—	81%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Mmr Live Sq Inj (Fc)	$56.05	$295.00	$56.05–$408.58	—	81%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 Mmr With Varicella Vacc Inj (Fc)	$156.18	$822.00	$156.18–$1,138.47	62% below	81%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 Mmr With Varicella Vacc Inj (Fc)	$156.18	$822.00	$156.18–$1,138.47	—	81%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Tis-I Meningococcal Menactra Vacc Im Inj (Fc)	$46.93	$247.00	$46.93–$342.10	81% below	81%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Tis Meningococcal Menactra Vacc Im Inj (Fc)	$46.93	$247.00	$46.93–$342.10	81% below	81%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal Vacc (Menactra) Im Inj (Fc)	$59.09	$311.00	$59.09–$430.74	76% below	81%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal Menveo Mcv40 Vacc 2 Vial 2mo-55yr Im Inj (Fc)	$59.66	$314.00	$59.66–$434.89	76% below	81%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal Menveo Mcv40 Vacc 1 Vial 2mo-55yr Im Inj (Fc)	$61.56	$324.00	$61.56–$448.74	75% below	81%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Tis-I Meningococcal Menactra Vacc Im Inj (Fc)	$46.93	$247.00	$46.93–$342.10	—	81%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Tis Meningococcal Menactra Vacc Im Inj (Fc)	$46.93	$247.00	$46.93–$342.10	—	81%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal Vacc (Menactra) Im Inj (Fc)	$59.09	$311.00	$59.09–$430.74	—	81%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal Menveo Mcv40 Vacc 2 Vial 2mo-55yr Im Inj (Fc)	$59.66	$314.00	$59.66–$434.89	—	81%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal Menveo Mcv40 Vacc 1 Vial 2mo-55yr Im Inj (Fc)	$61.56	$324.00	$61.56–$448.74	—	81%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 Meningococcal Vacc (Menquadfi) Im Inj	$85.50	$450.00	$85.50–$623.25	66% below	81%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 Meningococcal Vacc (Menquadfi) Im Inj	$85.50	$450.00	$85.50–$623.25	—	81%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcal Grp B (Bexsero) Vacc Im Inj	$95.00	$500.00	$95.00–$692.50	74% below	81%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Meningococcal Grp B (Bexsero) Vacc Im Inj	$95.00	$500.00	$95.00–$692.50	—	81%
Meningococcal B vaccine (Trumenba) CPT 90621 Meningococcal Trumenba Vacc Rlp Grp B Im Inj	$90.44	$476.00	$90.44–$659.26	72% below	81%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 Meningococcal Trumenba Vacc Rlp Grp B Im Inj	$90.44	$476.00	$90.44–$659.26	—	81%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule CPT 90611 HC Smallpox/Monkeypox Vaccine Preservative Free 0.5 Ml Dose Susp	$157.51	$829.00	$157.51–$1,148.17	59% below	81%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule inpatient CPT 90611 HC Smallpox/Monkeypox Vaccine Preservative Free 0.5 Ml Dose Susp	$157.51	$829.00	$157.51–$1,148.17	—	81%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Prevnar-13 Val Im Inj (Fc)	$116.47	$613.00	$116.47–$849.01	68% below	81%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Prevnar-13 Val Im Inj (Fc)	$116.47	$613.00	$116.47–$849.01	—	81%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Prevnar-15 Val Im Inj (Fc)	$105.45	$555.00	$105.45–$768.68	70% below	81%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 Prevnar-15 Val Im Inj (Fc)	$105.45	$555.00	$105.45–$768.68	—	81%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar-20 Val Im Inj (Fc)	$132.05	$695.00	$132.05–$962.58	70% below	81%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Prevnar-20 Val Im Inj (Fc)	$132.05	$695.00	$132.05–$962.58	—	81%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal 23-Val (Pneumovax) Adult Inj (Fc)	$64.22	$338.00	$64.22–$468.13	65% below	81%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal 23-Val (Pneumovax) Adult Inj (Fc)	$64.22	$338.00	$64.22–$468.13	—	81%
Polio vaccine, inactivated (IPV) CPT 90713 Tis Loymis Polio Inact Vacc Sq/Im Inj (Fc)	$11.40	$60.00	$11.40–$83.10	93% below	81%
Polio vaccine, inactivated (IPV) CPT 90713 Tis Polio Inact Vacc Sq/Im Inj (Fc)	$14.44	$76.00	$14.44–$105.26	91% below	81%
Polio vaccine, inactivated (IPV) CPT 90713 Tis-I Polio Inact Vacc Sq/Im Inj (Fc)	$14.44	$76.00	$14.44–$105.26	91% below	81%
Polio vaccine, inactivated (IPV) CPT 90713 Polio Virus 0.5ml Inj (Fc)	$22.23	$117.00	$22.23–$162.05	86% below	81%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 Tis Loymis Polio Inact Vacc Sq/Im Inj (Fc)	$11.40	$60.00	$11.40–$83.10	—	81%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 Tis Polio Inact Vacc Sq/Im Inj (Fc)	$14.44	$76.00	$14.44–$105.26	—	81%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 Tis-I Polio Inact Vacc Sq/Im Inj (Fc)	$14.44	$76.00	$14.44–$105.26	—	81%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 Polio Virus 0.5ml Inj (Fc)	$22.23	$117.00	$22.23–$162.05	—	81%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Rsv (Nirsevimab / Beyfortus) 100mg/1.0ml Im (Fc)	$270.94	$1,426.00	$270.94–$1,975.01	68% below	81%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 Rsv (Nirsevimab / Beyfortus) 100mg/1.0ml Im (Fc)	$270.94	$1,426.00	$270.94–$1,975.01	—	81%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Rsv (Nirsevimab / Beyfortus) 50mg/0.5ml Im (Fc)	$270.94	$1,426.00	$270.94–$1,975.01	78% below	81%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Rsv (Nirsevimab / Beyfortus) 50mg/0.5ml Im (Fc)	$270.94	$1,426.00	$270.94–$1,975.01	—	81%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 Rsv Pref (Abrysvo 0.5ml) Age > 60yrs or Gestational Age 32-36 Wk	$161.50	$850.00	$161.50–$1,177.25	65% below	81%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 Rsv Pref (Abrysvo 0.5ml) Age > 60yrs or Gestational Age 32-36 Wk	$161.50	$850.00	$161.50–$1,177.25	—	81%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 Rsv Pref3 (Arexvy 0.5ml) Adjuvant Reconstituted 60+ Yrs	$140.98	$742.00	$140.98–$1,027.67	71% below	81%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 Rsv Pref3 (Arexvy 0.5ml) Adjuvant Reconstituted 60+ Yrs	$140.98	$742.00	$140.98–$1,027.67	—	81%
Rabies vaccine, one dose CPT 90675 Tis Loymis Rabies Vacc Im Inj (Fc)	$130.15	$685.00	$130.15–$948.73	83% below	81%
Rabies vaccine, one dose CPT 90675 Rabies Vacc(Fibroblast Im)1.0 Ml Im/Inj (Fc)	$184.49	$971.00	$184.49–$1,344.84	75% below	81%
Rabies vaccine, one dose inpatient CPT 90675 Tis Loymis Rabies Vacc Im Inj (Fc)	$130.15	$685.00	$130.15–$948.73	—	81%
Rabies vaccine, one dose inpatient CPT 90675 Rabies Vacc(Fibroblast Im)1.0 Ml Im/Inj (Fc)	$184.49	$971.00	$184.49–$1,344.84	—	81%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 Rotavirus (Rotarix) Monovalent 2 Dose Po (Fc)	$20.33	$107.00	$20.33–$148.20	91% below	81%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 Rotavirus (Rotarix) Monovalent 2 Dose Po (Fc)	$20.33	$107.00	$20.33–$148.20	—	81%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 Rotavirus (3 Dose) Rotateq Live Penta 2ml Oral Vacc	$18.43	$97.00	$18.43–$134.35	88% below	81%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 CHIP Rotavirus (Rotateq) Pentavalent 3 Dose Po (Fc)	$36.10	$190.00	$36.10–$263.15	76% below	81%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 Rotavirus (3 Dose) Rotateq Live Penta 2ml Oral Vacc	$18.43	$97.00	$18.43–$134.35	—	81%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 CHIP Rotavirus (Rotateq) Pentavalent 3 Dose Po (Fc)	$36.10	$190.00	$36.10–$263.15	—	81%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Zoster (Shingles) Shingrix Recomb Vacc Im Inj	$95.38	$502.00	$95.38–$695.27	68% below	81%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Zoster (Shingles) Shingrix Recomb Vacc Im Inj	$95.38	$502.00	$95.38–$695.27	—	81%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC Tetanus/Diph (Tdvax)Adult Im Inj	$17.10	$90.00	$17.10–$124.65	78% below	81%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC Tetanus/Diph (Tdvax)Adult Im Inj	$17.10	$90.00	$17.10–$124.65	—	81%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tis-I Tdap (Adacel) Age 10-64 Im Inj (Fc)	$23.18	$122.00	$23.18–$168.97	77% below	81%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tis Tdap (Adacel) Age 10-64 Im Inj (Fc)	$23.18	$122.00	$23.18–$168.97	77% below	81%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tis-I Tdap (Boostrix) Age 10 & Abv Im Inj (Fc)	$23.18	$122.00	$23.18–$168.97	77% below	81%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tis Tdap (Boostrix) Age 10 & Abv Im Inj (Fc)	$23.18	$122.00	$23.18–$168.97	77% below	81%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap (Boostrix) 10 Yrs and Older (Fc)	$26.60	$140.00	$26.60–$193.90	74% below	81%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap (Adacel) Age 10-64 Im Inj (Fc)	$31.73	$167.00	$31.73–$231.30	68% below	81%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tis Tdap (Adacel) Age 10-64 Im Inj (Fc)	$23.18	$122.00	$23.18–$168.97	—	81%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tis Tdap (Boostrix) Age 10 & Abv Im Inj (Fc)	$23.18	$122.00	$23.18–$168.97	—	81%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tis-I Tdap (Adacel) Age 10-64 Im Inj (Fc)	$23.18	$122.00	$23.18–$168.97	—	81%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tis-I Tdap (Boostrix) Age 10 & Abv Im Inj (Fc)	$23.18	$122.00	$23.18–$168.97	—	81%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap (Boostrix) 10 Yrs and Older (Fc)	$26.60	$140.00	$26.60–$193.90	—	81%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap (Adacel) Age 10-64 Im Inj (Fc)	$31.73	$167.00	$31.73–$231.30	—	81%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Tis-I Typhoid Vacc (Vicp) Im Inj (Fc)	$27.55	$145.00	$27.55–$200.83	86% below	81%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Tis Typhoid Vacc (Vicp) Im Inj (Fc)	$27.55	$145.00	$27.55–$200.83	86% below	81%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Typhoid Vacc (Vicp) Im Inj (Fc)	$66.88	$352.00	$66.88–$487.52	66% below	81%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 Tis-I Typhoid Vacc (Vicp) Im Inj (Fc)	$27.55	$145.00	$27.55–$200.83	—	81%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 Tis Typhoid Vacc (Vicp) Im Inj (Fc)	$27.55	$145.00	$27.55–$200.83	—	81%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 Typhoid Vacc (Vicp) Im Inj (Fc)	$66.88	$352.00	$66.88–$487.52	—	81%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 Tis Loymis Typhoid Live Vacc Oral (Fc)	$12.35	$65.00	$12.35–$90.03	65% below	81%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 Tis Typhoid Live Vacc Oral (Fc)	$14.25	$75.00	$14.25–$103.88	60% below	81%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 Tis-I Typhoid Live Vacc Oral (Fc)	$19.00	$100.00	$19.00–$138.50	46% below	81%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 Tis Loymis Typhoid Live Vacc Oral (Fc)	$12.35	$65.00	$12.35–$90.03	—	81%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 Tis Typhoid Live Vacc Oral (Fc)	$14.25	$75.00	$14.25–$103.88	—	81%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 Tis-I Typhoid Live Vacc Oral (Fc)	$19.00	$100.00	$19.00–$138.50	—	81%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Fee Flu Inj	$22.99	$121.00	$22.99–$167.59	60% below	81%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Inj Fee Pneumococcal	$22.99	$121.00	$12.76–$113.42	60% below	81%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Inj Fee Influenza	$22.99	$121.00	$12.76–$113.42	60% below	81%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Inj Fee Vaccine (1) Single	$22.99	$121.00	$12.76–$113.42	60% below	81%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Fee Pneumococcal Inj	$22.99	$121.00	$22.99–$167.59	60% below	81%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vfc Inj Fee Vacc Single	$22.99	$121.00	$12.76–$113.42	60% below	81%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Inj Fee Hepatitis B	$22.99	$121.00	$12.76–$113.42	60% below	81%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vfc Inj Fee Vacc Ea Add'l Vacc	$4.56	$24.00	$4.56–$33.24	88% below	81%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Inj Fee Vaccine Ea Addl	$7.60	$40.00	$39.22–$78.82	81% below	81%
Yellow fever vaccine, live CPT 90717 Tis Loymis Yellow Fever Live Vacc Sq Inj (Fc)	$24.70	$130.00	$24.70–$180.05	91% below	81%
Yellow fever vaccine, live CPT 90717 Tis-I Yellow Fever Live Vacc Sq Inj (Fc)	$28.50	$150.00	$28.50–$207.75	90% below	81%
Yellow fever vaccine, live CPT 90717 Tis Yellow Fever Live Vacc Sq Inj (Fc)	$28.50	$150.00	$28.50–$207.75	90% below	81%
Yellow fever vaccine, live inpatient CPT 90717 Tis Loymis Yellow Fever Live Vacc Sq Inj (Fc)	$24.70	$130.00	$24.70–$180.05	—	81%
Yellow fever vaccine, live inpatient CPT 90717 Tis-I Yellow Fever Live Vacc Sq Inj (Fc)	$28.50	$150.00	$28.50–$207.75	—	81%
Yellow fever vaccine, live inpatient CPT 90717 Tis Yellow Fever Live Vacc Sq Inj (Fc)	$28.50	$150.00	$28.50–$207.75	—	81%

Source file: https://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/macnealhospital