McLaren Port Huron
McLaren Port Huron in Port Huron, MI publishes cash prices for 432 common procedures listed here, from its own machine-readable price file updated Dec 31, 2025. Compared with other hospitals in the state, its outpatient cash prices are below the Michigan median for 293 of 427 procedures and above it for 108. By typical cash price it ranks #30 of 97 Michigan hospitals and #12 of 31 hospitals in the Detroit, MI area, cheapest first. Select a procedure to compare it with other hospitals nearby.
1221 PINE GROVE AVE, PORT HURON MI, 48060 Collected Sep 23, 2026 Source price file Check a bill from this hospital (810) 987-5000
Acute care hospital Nonprofit hospital Emergency department CMS star rating 2 of 5 CCN 230216 · CMS hospital register NPI 1982685384
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
McLaren Port Huron is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Contrast | $1,468.35 | $2,936.70 | $97.38–$1,491.84 | 6% below | 50% |
| Abdominal CT scan without and with contrast CPT 74170 Add On - CT Abdomen w/ + w/o Contrast | $1,468.35 | $2,936.70 | $97.38–$1,491.84 | 6% below | 50% |
| Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/O & W/DYE | $1,516.90 | $3,033.80 | $97.38–$1,541.17 | 3% below | 50% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/ + w/o Contrast | $1,468.35 | $2,936.70 | $97.38–$1,491.84 | — | 50% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 Add On - CT Abdomen w/ + w/o Contrast | $1,468.35 | $2,936.70 | $97.38–$1,491.84 | — | 50% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/O & W/DYE | $1,516.90 | $3,033.80 | $97.38–$1,541.17 | — | 50% |
| Abdominal X-ray, 2 views CPT 74019 X-RAY EXAM ABDOMEN 2 VIEWS | $103.60 | $207.20 | $58.17–$165.94 | 50% below | 50% |
| Abdominal X-ray, 2 views CPT 74019 Add On - 74019 XR Abdomen 2 Views | $107.25 | $214.50 | $58.17–$165.94 | 49% below | 50% |
| Abdominal X-ray, 2 views CPT 74019 XR Abdomen 2 Views | $107.25 | $214.50 | $58.17–$165.94 | 49% below | 50% |
| Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY EXAM ABDOMEN 2 VIEWS | $103.60 | $207.20 | $58.17–$165.94 | — | 50% |
| Abdominal X-ray, 2 views inpatient CPT 74019 Add On - 74019 XR Abdomen 2 Views | $107.25 | $214.50 | $58.17–$165.94 | — | 50% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen 2 Views | $107.25 | $214.50 | $58.17–$165.94 | — | 50% |
| Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE | $107.75 | $215.49 | $48.16–$137.40 | 49% below | 50% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views Left | $110.35 | $220.70 | $48.16–$165.52 | 48% below | 50% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views Right | $110.35 | $220.70 | $48.16–$163.16 | 48% below | 50% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY EXAM OF ANKLE | $107.75 | $215.49 | $48.16–$137.40 | — | 50% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3+ Views Left | $110.35 | $220.70 | $48.16–$165.52 | — | 50% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3+ Views Right | $110.35 | $220.70 | $48.16–$163.16 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Upr/Lwr Extremity Art Study 2 Level | $254.75 | $509.50 | $70.51–$258.83 | 18% below | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS | $260.52 | $521.04 | $70.51–$264.69 | 16% below | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Segmental Pressures U/L 1-2 lvls Bil | $269.45 | $538.90 | $70.51–$404.17 | 13% below | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Segmental Pressures U/L 3 > lvls Uni | $269.45 | $538.90 | $70.51–$273.76 | 13% below | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Upr/Lwr Extremity Art Study 2 Level | $254.75 | $509.50 | $70.51–$258.83 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 UPR/L XTREMITY ART 2 LEVELS | $260.52 | $521.04 | $70.51–$264.69 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Segmental Pressures U/L 3 > lvls Uni | $269.45 | $538.90 | $70.51–$273.76 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Segmental Pressures U/L 1-2 lvls Bil | $269.45 | $538.90 | $70.51–$404.17 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Upper Extremity w/o Contrast Bilat | $896.25 | $1,792.50 | $58.17–$910.59 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O DYE | $865.95 | $1,731.90 | $58.17–$879.81 | 14% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Right | $896.25 | $1,792.50 | $58.17–$910.59 | 11% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Right | $896.25 | $1,792.50 | $58.17–$910.59 | 11% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Right | $896.25 | $1,792.50 | $58.17–$910.59 | 11% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Left | $896.25 | $1,792.50 | $58.17–$910.59 | 11% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity w/o Contrast Right | $896.25 | $1,792.50 | $58.17–$910.59 | 11% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Add On - CT Upper Extrem w/o Cont Right | $896.25 | $1,792.50 | $58.17–$910.59 | 11% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Left | $896.25 | $1,792.50 | $58.17–$910.59 | 11% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Left | $896.25 | $1,792.50 | $58.17–$910.59 | 11% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Right | $896.25 | $1,792.50 | $58.17–$910.59 | 11% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity w/o Contrast Left | $896.25 | $1,792.50 | $58.17–$910.59 | 11% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Left | $896.25 | $1,792.50 | $58.17–$910.59 | 11% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Upper Extremity w/o Contrast Bilat | $896.25 | $1,792.50 | $58.17–$910.59 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY W/O DYE | $865.95 | $1,731.90 | $58.17–$879.81 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder w/o Contrast Right | $896.25 | $1,792.50 | $58.17–$910.59 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity w/o Contrast Left | $896.25 | $1,792.50 | $58.17–$910.59 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder w/o Contrast Left | $896.25 | $1,792.50 | $58.17–$910.59 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity w/o Contrast Right | $896.25 | $1,792.50 | $58.17–$910.59 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist w/o Contrast Left | $896.25 | $1,792.50 | $58.17–$910.59 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist w/o Contrast Right | $896.25 | $1,792.50 | $58.17–$910.59 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow w/o Contrast Left | $896.25 | $1,792.50 | $58.17–$910.59 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow w/o Contrast Right | $896.25 | $1,792.50 | $58.17–$910.59 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Add On - CT Upper Extrem w/o Cont Right | $896.25 | $1,792.50 | $58.17–$910.59 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand w/o Contrast Right | $896.25 | $1,792.50 | $58.17–$910.59 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand w/o Contrast Left | $896.25 | $1,792.50 | $58.17–$910.59 | — | 50% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 CONTRAST X-RAY ESOPHAGUS | $202.41 | $404.81 | $97.38–$277.79 | 28% below | 50% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus | $205.65 | $411.30 | $97.38–$308.48 | 27% below | 50% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 CONTRAST X-RAY ESOPHAGUS | $202.41 | $404.81 | $97.38–$277.79 | — | 50% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophagus | $205.65 | $411.30 | $97.38–$308.48 | — | 50% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone/Joint Img - Whole Body Delay 1 | $806.50 | $1,613.00 | $219.80–$1,161.36 | 14% below | 50% |
| Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY | $833.00 | $1,666.00 | $219.80–$846.33 | 11% below | 50% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone/Joint Img - Whole Body Delay 1 | $806.50 | $1,613.00 | $219.80–$1,161.36 | — | 50% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE IMAGING WHOLE BODY | $833.00 | $1,666.00 | $219.80–$846.33 | — | 50% |
| Breast ultrasound, complete, one breast both sides CPT 76641 US Breast ABUS Complete Bilateral | $148.55 | $297.10 | $58.17–$248.32 | — | 50% |
| Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Complete Bilateral | $148.55 | $297.10 | $58.17–$248.32 | — | 50% |
| Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE | $183.53 | $367.06 | $58.17–$248.32 | 39% below | 50% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast ABUS Complete Left | $148.55 | $297.10 | $58.17–$248.32 | 51% below | 50% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Right | $148.55 | $297.10 | $58.17–$248.32 | 51% below | 50% |
| Breast ultrasound, complete, one breast one side CPT 76641 ADD ON - US Breast ABUS Complete Right | $148.55 | $297.10 | $58.17–$248.32 | 51% below | 50% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Left | $148.55 | $297.10 | $58.17–$248.32 | 51% below | 50% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast ABUS Complete Right | $148.55 | $297.10 | $58.17–$248.32 | 51% below | 50% |
| Breast ultrasound, complete, one breast one side CPT 76641 ADD ON - US Breast Complete Right | $148.55 | $297.10 | $58.17–$248.32 | 51% below | 50% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast Complete Bilateral | $148.55 | $297.10 | $58.17–$248.32 | — | 50% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast ABUS Complete Bilateral | $148.55 | $297.10 | $58.17–$248.32 | — | 50% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 ULTRASOUND BREAST COMPLETE | $183.53 | $367.06 | $58.17–$248.32 | — | 50% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast ABUS Complete Left | $148.55 | $297.10 | $58.17–$248.32 | — | 50% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast ABUS Complete Right | $148.55 | $297.10 | $58.17–$248.32 | — | 50% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Right | $148.55 | $297.10 | $58.17–$248.32 | — | 50% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 ADD ON - US Breast ABUS Complete Right | $148.55 | $297.10 | $58.17–$248.32 | — | 50% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Left | $148.55 | $297.10 | $58.17–$248.32 | — | 50% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 ADD ON - US Breast Complete Right | $148.55 | $297.10 | $58.17–$248.32 | — | 50% |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US Breast Limited Bilateral | $117.95 | $235.90 | $48.16–$192.99 | — | 50% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED | $122.36 | $244.72 | $48.16–$192.99 | 54% below | 50% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left | $117.95 | $235.90 | $48.16–$192.99 | 56% below | 50% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right | $117.95 | $235.90 | $48.16–$192.99 | 56% below | 50% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 Add On - US Breast Limited RT | $117.95 | $235.90 | $48.16–$192.99 | 56% below | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US Breast Limited Bilateral | $117.95 | $235.90 | $48.16–$192.99 | — | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST LIMITED | $122.36 | $244.72 | $48.16–$192.99 | — | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left | $117.95 | $235.90 | $48.16–$192.99 | — | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right | $117.95 | $235.90 | $48.16–$192.99 | — | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 Add On - US Breast Limited RT | $117.95 | $235.90 | $48.16–$192.99 | — | 50% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abdomen and Pelvis | $2,371.05 | $4,742.10 | $195.35–$3,556.58 | 5% below | 50% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Venogram Abdomen and Pelvis | $2,371.05 | $4,742.10 | $195.35–$2,408.99 | 5% below | 50% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 Add On - CT Angio Abdomen and Pelvis | $2,371.05 | $4,742.10 | $195.35–$3,414.31 | 5% below | 50% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Venogram Abdomen and Pelvis | $2,371.05 | $4,742.10 | $195.35–$2,408.99 | — | 50% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 Add On - CT Angio Abdomen and Pelvis | $2,371.05 | $4,742.10 | $195.35–$3,414.31 | — | 50% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abdomen and Pelvis | $2,371.05 | $4,742.10 | $195.35–$3,556.58 | — | 50% |
| CT angiography (CTA) of the head CPT 70496 CT Angio Brain and Neck | $1,191.05 | $2,382.10 | $97.38–$1,715.11 | 23% below | 50% |
| CT angiography (CTA) of the head CPT 70496 CT Angio Brain/Head | $1,191.05 | $2,382.10 | $97.38–$1,715.11 | 23% below | 50% |
| CT angiography (CTA) of the head CPT 70496 CT Venogram Brain/Head | $1,191.05 | $2,382.10 | $97.38–$1,210.11 | 23% below | 50% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT Venogram Brain/Head | $1,191.05 | $2,382.10 | $97.38–$1,210.11 | — | 50% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Brain and Neck | $1,191.05 | $2,382.10 | $97.38–$1,715.11 | — | 50% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Brain/Head | $1,191.05 | $2,382.10 | $97.38–$1,715.11 | — | 50% |
| CT angiography (CTA) of the neck CPT 70498 CT Angio Neck | $1,379.40 | $2,758.80 | $97.38–$2,069.10 | 8% below | 50% |
| CT angiography (CTA) of the neck CPT 70498 CT Venogram Neck | $1,379.40 | $2,758.80 | $97.38–$1,401.47 | 8% below | 50% |
| CT angiography (CTA) of the neck CPT 70498 Add On - CT Angio Neck | $1,379.40 | $2,758.80 | $97.38–$1,986.34 | 8% below | 50% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT Venogram Neck | $1,379.40 | $2,758.80 | $97.38–$1,401.47 | — | 50% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Neck | $1,379.40 | $2,758.80 | $97.38–$2,069.10 | — | 50% |
| CT angiography (CTA) of the neck inpatient CPT 70498 Add On - CT Angio Neck | $1,379.40 | $2,758.80 | $97.38–$1,986.34 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio TAVR Chest, Abdomen, Pelvis | $1,406.35 | $2,812.70 | $97.38–$1,428.85 | 15% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest | $1,406.35 | $2,812.70 | $97.38–$2,109.52 | 15% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest/Abdomen | $1,406.35 | $2,812.70 | $97.38–$1,428.85 | 15% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest Gated | $1,406.35 | $2,812.70 | $97.38–$1,428.85 | 15% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest PE Protocol | $1,406.35 | $2,812.70 | $97.38–$2,109.52 | 15% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest PE Prot w Abd/Pel w/ Cont | $1,406.35 | $2,812.70 | $97.38–$2,109.52 | 15% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest/Abd Aorta + Iliofemoral | $1,406.35 | $2,812.70 | $97.38–$1,428.85 | 15% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest/Abdomen/Pelvis | $1,406.35 | $2,812.70 | $97.38–$2,025.14 | 15% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST | $1,456.75 | $2,913.50 | $97.38–$1,480.06 | 12% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest/Abd Aorta + Iliofemoral | $1,406.35 | $2,812.70 | $97.38–$1,428.85 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest Gated | $1,406.35 | $2,812.70 | $97.38–$1,428.85 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest/Abdomen | $1,406.35 | $2,812.70 | $97.38–$1,428.85 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest/Abdomen/Pelvis | $1,406.35 | $2,812.70 | $97.38–$2,025.14 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio TAVR Chest, Abdomen, Pelvis | $1,406.35 | $2,812.70 | $97.38–$1,428.85 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest PE Protocol | $1,406.35 | $2,812.70 | $97.38–$2,109.52 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest PE Prot w Abd/Pel w/ Cont | $1,406.35 | $2,812.70 | $97.38–$2,109.52 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest | $1,406.35 | $2,812.70 | $97.38–$2,109.52 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST | $1,456.75 | $2,913.50 | $97.38–$1,480.06 | — | 50% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST | $110.12 | $220.23 | $48.16–$275.34 | 27% below | 50% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart Calcium Scoring | $200.00 | $400.00 | $48.16–$288.00 | 33% above | 50% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O DYE W/CA TEST | $110.12 | $220.23 | $48.16–$275.34 | — | 50% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Heart Calcium Scoring | $200.00 | $400.00 | $48.16–$288.00 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST | $1,683.69 | $3,367.37 | $132.22–$1,710.62 | 6% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast | $1,747.45 | $3,494.90 | $132.22–$2,621.18 | 2% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 Add On - CT Abd/Pelvis w/o Contrast | $1,747.45 | $3,494.90 | $132.22–$2,002.93 | 2% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Enterography Abd/Pelvis w/o Cont | $1,747.45 | $3,494.90 | $132.22–$1,775.41 | 2% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd/Pelvis w/o Cont Stone Protocol | $1,747.45 | $3,494.90 | $132.22–$2,516.33 | 2% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CONTRAST | $1,683.69 | $3,367.37 | $132.22–$1,710.62 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Enterography Abd/Pelvis w/o Cont | $1,747.45 | $3,494.90 | $132.22–$1,775.41 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd/Pelvis w/o Cont Stone Protocol | $1,747.45 | $3,494.90 | $132.22–$2,516.33 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Add On - CT Abd/Pelvis w/o Contrast | $1,747.45 | $3,494.90 | $132.22–$2,002.93 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen and Pelvis w/o Contrast | $1,747.45 | $3,494.90 | $132.22–$2,621.18 | — | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography Abd/Pelvis w/Cont | $2,210.25 | $4,420.50 | $195.35–$2,245.61 | 23% below | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 Add On - CT Abd/Pelvis w/ Contrast | $2,210.25 | $4,420.50 | $195.35–$3,315.38 | 23% below | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast | $2,210.25 | $4,420.50 | $195.35–$3,315.38 | 23% below | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELV W/CONTRAST | $2,214.17 | $4,428.33 | $195.35–$2,249.59 | 23% below | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Contrast | $2,210.25 | $4,420.50 | $195.35–$3,315.38 | — | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Add On - CT Abd/Pelvis w/ Contrast | $2,210.25 | $4,420.50 | $195.35–$3,315.38 | — | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography Abd/Pelvis w/Cont | $2,210.25 | $4,420.50 | $195.35–$2,245.61 | — | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELV W/CONTRAST | $2,214.17 | $4,428.33 | $195.35–$2,249.59 | — | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast | $2,637.90 | $5,275.80 | $195.35–$3,338.00 | 1% above | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Add On - CT Abd/Pelvis w/ + w/o Contr | $2,637.90 | $5,275.80 | $195.35–$2,680.11 | 1% above | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen w/ + w/o + Pelvis w/ Contrast | $2,637.90 | $5,275.80 | $195.35–$2,680.11 | 1% above | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd/Pelvis w/ + w/o Contrast Cystogra | $2,637.90 | $5,275.80 | $195.35–$2,680.11 | 1% above | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Enterography Abd/Pelvis w/+ w/o Cont | $2,637.90 | $5,275.80 | $195.35–$2,680.11 | 1% above | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Urogram Abd/Pelvis w/ + w/o Contrast | $2,637.90 | $5,275.80 | $195.35–$3,956.85 | 1% above | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd/Pelvis w/ + w/o Contrast Cystogra | $2,637.90 | $5,275.80 | $195.35–$2,680.11 | — | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Add On - CT Abd/Pelvis w/ + w/o Contr | $2,637.90 | $5,275.80 | $195.35–$2,680.11 | — | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Urogram Abd/Pelvis w/ + w/o Contrast | $2,637.90 | $5,275.80 | $195.35–$3,956.85 | — | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen w/ + w/o + Pelvis w/ Contrast | $2,637.90 | $5,275.80 | $195.35–$2,680.11 | — | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Enterography Abd/Pelvis w/+ w/o Cont | $2,637.90 | $5,275.80 | $195.35–$2,680.11 | — | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast | $2,637.90 | $5,275.80 | $195.35–$3,338.00 | — | 50% |
| CT scan of the abdomen with contrast CPT 74160 Add On - CT Abdomen w/ Contrast | $1,316.55 | $2,633.10 | $97.38–$1,337.61 | 10% below | 50% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast | $1,316.55 | $2,633.10 | $97.38–$1,337.61 | 10% below | 50% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast | $1,316.55 | $2,633.10 | $97.38–$1,337.61 | — | 50% |
| CT scan of the abdomen with contrast inpatient CPT 74160 Add On - CT Abdomen w/ Contrast | $1,316.55 | $2,633.10 | $97.38–$1,337.61 | — | 50% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O DYE | $1,124.26 | $2,248.51 | $58.17–$1,142.24 | 21% above | 50% |
| CT scan of the abdomen without contrast CPT 74150 Add On - CT Abdomen w/o Contrast | $1,212.10 | $2,424.20 | $58.17–$1,231.49 | 30% above | 50% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast | $1,212.10 | $2,424.20 | $58.17–$1,231.49 | 30% above | 50% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O DYE | $1,124.26 | $2,248.51 | $58.17–$1,142.24 | — | 50% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast | $1,212.10 | $2,424.20 | $58.17–$1,231.49 | — | 50% |
| CT scan of the abdomen without contrast inpatient CPT 74150 Add On - CT Abdomen w/o Contrast | $1,212.10 | $2,424.20 | $58.17–$1,231.49 | — | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE | $917.89 | $1,835.77 | $58.17–$932.57 | 12% below | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast | $945.90 | $1,891.80 | $58.17–$1,084.19 | 10% below | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Mandible w/o Contrast | $945.90 | $1,891.80 | $58.17–$961.03 | 10% below | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT TMJ w/o Contrast | $945.90 | $1,891.80 | $58.17–$961.03 | 10% below | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast | $945.90 | $1,891.80 | $58.17–$1,084.19 | 10% below | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O DYE | $917.89 | $1,835.77 | $58.17–$932.57 | — | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Mandible w/o Contrast | $945.90 | $1,891.80 | $58.17–$961.03 | — | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast | $945.90 | $1,891.80 | $58.17–$1,084.19 | — | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT TMJ w/o Contrast | $945.90 | $1,891.80 | $58.17–$961.03 | — | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast | $945.90 | $1,891.80 | $58.17–$1,084.19 | — | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE | $779.94 | $1,559.87 | $58.17–$792.41 | 16% below | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head w/o Contrast | $813.80 | $1,627.60 | $58.17–$1,220.70 | 13% below | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head w/o Cont Stroke Protocol | $813.80 | $1,627.60 | $58.17–$1,171.87 | 13% below | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O DYE | $779.94 | $1,559.87 | $58.17–$792.41 | — | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head w/o Cont Stroke Protocol | $813.80 | $1,627.60 | $58.17–$1,171.87 | — | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head w/o Contrast | $813.80 | $1,627.60 | $58.17–$1,220.70 | — | 50% |
| CT scan of the head with contrast CPT 70460 CT Brain/Head w/ Contrast | $913.20 | $1,826.40 | $97.38–$927.81 | 27% below | 50% |
| CT scan of the head with contrast inpatient CPT 70460 CT Brain/Head w/ Contrast | $913.20 | $1,826.40 | $97.38–$927.81 | — | 50% |
| CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/ + w/o Contrast | $1,162.25 | $2,324.50 | $97.38–$1,470.71 | 26% below | 50% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Brain/Head w/ + w/o Contrast | $1,162.25 | $2,324.50 | $97.38–$1,470.71 | — | 50% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE | $909.55 | $1,819.10 | $58.17–$924.10 | 17% below | 50% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast | $941.40 | $1,882.80 | $58.17–$1,412.10 | 14% below | 50% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O DYE | $909.55 | $1,819.10 | $58.17–$924.10 | — | 50% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast | $941.40 | $1,882.80 | $58.17–$1,412.10 | — | 50% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE | $909.55 | $1,819.10 | $58.17–$924.10 | 18% below | 50% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast | $941.40 | $1,882.80 | $58.17–$1,412.10 | 15% below | 50% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT NECK SPINE W/O DYE | $909.55 | $1,819.10 | $58.17–$924.10 | — | 50% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast | $941.40 | $1,882.80 | $58.17–$1,412.10 | — | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast | $1,230.80 | $2,461.60 | $97.38–$1,410.74 | 8% below | 50% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast | $1,230.80 | $2,461.60 | $97.38–$1,410.74 | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY | $622.87 | $1,245.73 | $132.22–$632.83 | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral | $646.50 | $1,293.00 | $132.22–$969.75 | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 EXTRACRANIAL BILAT STUDY | $622.87 | $1,245.73 | $132.22–$632.83 | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral | $646.50 | $1,293.00 | $132.22–$969.75 | — | 50% |
| Chest CT scan without and with contrast CPT 71270 CT Chest/Abdomen w/ + w/o Contrast | $1,195.75 | $2,391.50 | $97.38–$1,214.88 | 32% below | 50% |
| Chest CT scan without and with contrast CPT 71270 CT Chest/Abd/Pelvis w/ + w/o Contrast | $1,195.75 | $2,391.50 | $97.38–$1,214.88 | 32% below | 50% |
| Chest CT scan without and with contrast CPT 71270 CT Chest High Resolution w/ + w/o Cont | $1,195.75 | $2,391.50 | $97.38–$1,214.88 | 32% below | 50% |
| Chest CT scan without and with contrast CPT 71270 CT Chest w/ + w/o Contrast | $1,195.75 | $2,391.50 | $97.38–$1,214.88 | 32% below | 50% |
| Chest CT scan without and with contrast CPT 71270 CT THORAX W/O & W/DYE | $1,218.50 | $2,437.00 | $97.38–$1,238.00 | 30% below | 50% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Chest/Abd/Pelvis w/ + w/o Contrast | $1,195.75 | $2,391.50 | $97.38–$1,214.88 | — | 50% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Chest w/ + w/o Contrast | $1,195.75 | $2,391.50 | $97.38–$1,214.88 | — | 50% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Chest/Abdomen w/ + w/o Contrast | $1,195.75 | $2,391.50 | $97.38–$1,214.88 | — | 50% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Chest High Resolution w/ + w/o Cont | $1,195.75 | $2,391.50 | $97.38–$1,214.88 | — | 50% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX W/O & W/DYE | $1,218.50 | $2,437.00 | $97.38–$1,238.00 | — | 50% |
| Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS | $104.47 | $208.94 | $48.16–$137.40 | 41% below | 50% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views | $108.05 | $216.10 | $48.16–$163.16 | 39% below | 50% |
| Chest X-ray, 2 views CPT 71046 Add On - 71046 XR Chest 2 Views | $108.05 | $216.10 | $48.16–$137.40 | 39% below | 50% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views B Read | $108.05 | $216.10 | $48.16–$137.40 | 39% below | 50% |
| Chest X-ray, 2 views CPT 71046 XR Chest Inspiration /+ Expiration | $108.05 | $216.10 | $48.16–$137.40 | 39% below | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY EXAM CHEST 2 VIEWS | $104.47 | $208.94 | $48.16–$137.40 | — | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest Inspiration /+ Expiration | $108.05 | $216.10 | $48.16–$137.40 | — | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views B Read | $108.05 | $216.10 | $48.16–$137.40 | — | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views | $108.05 | $216.10 | $48.16–$163.16 | — | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 Add On - 71046 XR Chest 2 Views | $108.05 | $216.10 | $48.16–$137.40 | — | 50% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View Portable | $100.00 | $200.00 | $48.16–$163.16 | 37% below | 50% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View B Read | $100.00 | $200.00 | $48.16–$137.40 | 37% below | 50% |
| Chest X-ray, single view CPT 71045 ADD ON - XR Single View Chest | $100.00 | $200.00 | $48.16–$137.40 | 37% below | 50% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View Frontal | $100.00 | $200.00 | $48.16–$163.16 | 37% below | 50% |
| Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW | $411.63 | $823.26 | $48.16–$418.22 | 161% above | 50% |
| Chest X-ray, single view inpatient CPT 71045 ADD ON - XR Single View Chest | $100.00 | $200.00 | $48.16–$137.40 | — | 50% |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Portable | $100.00 | $200.00 | $48.16–$163.16 | — | 50% |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View B Read | $100.00 | $200.00 | $48.16–$137.40 | — | 50% |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Frontal | $100.00 | $200.00 | $48.16–$163.16 | — | 50% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW | $411.63 | $823.26 | $48.16–$418.22 | — | 50% |
| Collarbone (clavicle) X-ray, complete CPT 73000 X-RAY EXAM OF COLLAR BONE | $113.82 | $227.63 | $48.16–$137.40 | 37% below | 50% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right | $110.35 | $220.70 | $48.16–$163.16 | 39% below | 50% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left | $110.35 | $220.70 | $48.16–$163.16 | 39% below | 50% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 X-RAY EXAM OF COLLAR BONE | $113.82 | $227.63 | $48.16–$137.40 | — | 50% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right | $110.35 | $220.70 | $48.16–$163.16 | — | 50% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left | $110.35 | $220.70 | $48.16–$163.16 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys both sides CPT 76770 US Bilat Renal Urinary Bladder Comp | $389.45 | $778.90 | $58.17–$395.68 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP | $378.25 | $756.49 | $58.17–$384.30 | 39% below | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete | $389.45 | $778.90 | $58.17–$584.18 | 37% below | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal Retroperitoneal Comp | $389.45 | $778.90 | $58.17–$395.68 | 37% below | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient both sides CPT 76770 US Bilat Renal Urinary Bladder Comp | $389.45 | $778.90 | $58.17–$395.68 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US EXAM ABDO BACK WALL COMP | $378.25 | $756.49 | $58.17–$384.30 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal Retroperitoneal Comp | $389.45 | $778.90 | $58.17–$395.68 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete | $389.45 | $778.90 | $58.17–$584.18 | — | 50% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL | $311.48 | $622.96 | $58.17–$316.46 | at median | 50% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton | $320.05 | $640.10 | $58.17–$480.08 | 3% above | 50% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY AXIAL | $311.48 | $622.96 | $58.17–$316.46 | — | 50% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton | $320.05 | $640.10 | $58.17–$480.08 | — | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY/PERIPHERAL | $131.30 | $262.60 | $48.16–$137.40 | at median | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD Bone Density DEXA App Skeleton Periph | $135.90 | $271.80 | $48.16–$138.07 | 4% above | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY/PERIPHERAL | $131.30 | $262.60 | $48.16–$137.40 | — | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BD Bone Density DEXA App Skeleton Periph | $135.90 | $271.80 | $48.16–$138.07 | — | 50% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS | $397.35 | $794.70 | $132.22–$403.71 | 44% below | 50% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Pregnancy Complete w/ Detail | $411.25 | $822.50 | $132.22–$417.83 | 42% below | 50% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 WH OB US Detailed, Single | $411.25 | $822.50 | $132.22–$417.83 | 42% below | 50% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB US DETAILED SNGL FETUS | $397.35 | $794.70 | $132.22–$403.71 | — | 50% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Pregnancy Complete w/ Detail | $411.25 | $822.50 | $132.22–$417.83 | — | 50% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 WH OB US Detailed, Single | $411.25 | $822.50 | $132.22–$417.83 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX W/O DYE | $805.55 | $1,611.10 | $58.17–$818.44 | 19% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest/Abd/Pelvis w/o Contrast | $833.75 | $1,667.50 | $58.17–$955.64 | 16% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest High Resolution w/o Contrast | $833.75 | $1,667.50 | $58.17–$955.64 | 16% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Lung Follow-up LOW Dose | $833.75 | $1,667.50 | $58.17–$847.09 | 16% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast | $833.75 | $1,667.50 | $58.17–$1,250.63 | 16% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest/Abdomen w/o Contrast | $833.75 | $1,667.50 | $58.17–$847.09 | 16% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX W/O DYE | $805.55 | $1,611.10 | $58.17–$818.44 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Contrast | $833.75 | $1,667.50 | $58.17–$1,250.63 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest/Abd/Pelvis w/o Contrast | $833.75 | $1,667.50 | $58.17–$955.64 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest/Abdomen w/o Contrast | $833.75 | $1,667.50 | $58.17–$847.09 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest High Resolution w/o Contrast | $833.75 | $1,667.50 | $58.17–$955.64 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Lung Follow-up LOW Dose | $833.75 | $1,667.50 | $58.17–$847.09 | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest High Resolution w/ Contrast | $994.95 | $1,989.90 | $97.38–$1,010.87 | 24% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast | $994.95 | $1,989.90 | $97.38–$1,432.73 | 24% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest/Abd/Pelvis w/ Contrast | $994.95 | $1,989.90 | $97.38–$1,492.43 | 24% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest/Abdomen w/ Contrast | $994.95 | $1,989.90 | $97.38–$1,010.87 | 24% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ + Abd w/+ w/o + Pelvis w/Con | $994.95 | $1,989.90 | $97.38–$1,010.87 | 24% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ + Abd/Pelvis w/+w/o Contrast | $994.95 | $1,989.90 | $97.38–$1,010.87 | 24% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ + Abd w/ + w/o Contrast | $994.95 | $1,989.90 | $97.38–$1,010.87 | 24% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX W/DYE | $1,043.19 | $2,086.38 | $97.38–$1,059.88 | 20% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ + Abd w/+ w/o + Pelvis w/Con | $994.95 | $1,989.90 | $97.38–$1,010.87 | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest/Abd/Pelvis w/ Contrast | $994.95 | $1,989.90 | $97.38–$1,492.43 | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest/Abdomen w/ Contrast | $994.95 | $1,989.90 | $97.38–$1,010.87 | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Contrast | $994.95 | $1,989.90 | $97.38–$1,432.73 | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest High Resolution w/ Contrast | $994.95 | $1,989.90 | $97.38–$1,010.87 | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ + Abd w/ + w/o Contrast | $994.95 | $1,989.90 | $97.38–$1,010.87 | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ + Abd/Pelvis w/+w/o Contrast | $994.95 | $1,989.90 | $97.38–$1,010.87 | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX W/DYE | $1,043.19 | $2,086.38 | $97.38–$1,059.88 | — | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI | $229.85 | $459.70 | $233.53–$411.79 | — | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Add On - MG Mammo Diagnostic Bilat | $237.90 | $475.80 | $123.04–$411.79 | — | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral | $237.90 | $475.80 | $239.04–$411.79 | — | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Implant Diagnostic Bilateral | $237.90 | $475.80 | $241.71–$411.79 | — | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Post Clip/Wire Placement Bilat | $237.90 | $475.80 | $241.71–$411.79 | — | 50% |
| Diagnostic mammogram, both breasts CPT 77066 MG Breast Tomo Post Clip/Wire Place Bil | $237.90 | $475.80 | $241.71–$411.79 | 24% below | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO INCL CAD BI | $229.85 | $459.70 | $233.53–$411.79 | — | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Add On - MG Mammo Diagnostic Bilat | $237.90 | $475.80 | $123.04–$411.79 | — | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Post Clip/Wire Placement Bilat | $237.90 | $475.80 | $241.71–$411.79 | — | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilateral | $237.90 | $475.80 | $239.04–$411.79 | — | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Implant Diagnostic Bilateral | $237.90 | $475.80 | $241.71–$411.79 | — | 50% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MG Breast Tomo Post Clip/Wire Place Bil | $237.90 | $475.80 | $241.71–$411.79 | — | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Right | $198.05 | $396.10 | $201.22–$323.28 | 36% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Left | $198.05 | $396.10 | $201.22–$323.28 | 36% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Post Clip/Wire Placement Right | $198.05 | $396.10 | $102.43–$323.28 | 36% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Post Clip/Wire Placement Left | $198.05 | $396.10 | $199.00–$323.28 | 36% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 Add On - MG Mammo Diagnostic Left | $198.05 | $396.10 | $102.43–$323.28 | 36% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 Add On - MG Mammo Diagnostic Right | $198.05 | $396.10 | $199.00–$323.28 | 36% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Breast Tomo Post Clip/Wire Place LT | $198.05 | $396.10 | $201.22–$323.28 | 36% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Breast Tomo Post Clip/Wire Place RT | $198.05 | $396.10 | $201.22–$323.28 | 36% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Implant Diagnostic Right | $198.05 | $396.10 | $201.22–$323.28 | 36% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Implant Diagnostic Left | $198.05 | $396.10 | $201.22–$323.28 | 36% below | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Add On - MG Mammo Diagnostic Left | $198.05 | $396.10 | $102.43–$323.28 | — | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Right | $198.05 | $396.10 | $201.22–$323.28 | — | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Left | $198.05 | $396.10 | $201.22–$323.28 | — | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Post Clip/Wire Placement Right | $198.05 | $396.10 | $102.43–$323.28 | — | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Implant Diagnostic Left | $198.05 | $396.10 | $201.22–$323.28 | — | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Breast Tomo Post Clip/Wire Place RT | $198.05 | $396.10 | $201.22–$323.28 | — | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Breast Tomo Post Clip/Wire Place LT | $198.05 | $396.10 | $201.22–$323.28 | — | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Implant Diagnostic Right | $198.05 | $396.10 | $201.22–$323.28 | — | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Add On - MG Mammo Diagnostic Right | $198.05 | $396.10 | $199.00–$323.28 | — | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Post Clip/Wire Placement Left | $198.05 | $396.10 | $199.00–$323.28 | — | 50% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral | $568.95 | $1,137.90 | $132.22–$604.18 | — | 50% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral | $568.95 | $1,137.90 | $132.22–$604.18 | — | 50% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Hospitalist BP 93970 Duplex Extremity Veins Bilat | $281.80 | $563.60 | $132.22–$461.73 | — | 50% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Upper Ext Venous Duplex Bilateral | $281.80 | $563.60 | $132.22–$461.73 | — | 50% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Upper Ext Vein Mapping Bilateral | $281.80 | $563.60 | $132.22–$461.73 | — | 50% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Lower Ext Vein Mapping Bilateral | $281.80 | $563.60 | $132.22–$461.73 | — | 50% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Lower Ext Venous Duplex Bilateral | $281.80 | $563.60 | $132.22–$461.73 | — | 50% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY | $267.29 | $534.57 | $132.22–$461.73 | 55% below | 50% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US Lower Ext Venous Duplex Reflux Bil | $281.80 | $563.60 | $132.22–$461.73 | 53% below | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Upper Ext Venous Duplex Bilateral | $281.80 | $563.60 | $132.22–$461.73 | — | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Hospitalist BP 93970 Duplex Extremity Veins Bilat | $281.80 | $563.60 | $132.22–$461.73 | — | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Lower Ext Vein Mapping Bilateral | $281.80 | $563.60 | $132.22–$461.73 | — | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Upper Ext Vein Mapping Bilateral | $281.80 | $563.60 | $132.22–$461.73 | — | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Lower Ext Venous Duplex Bilateral | $281.80 | $563.60 | $132.22–$461.73 | — | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 EXTREMITY STUDY | $267.29 | $534.57 | $132.22–$461.73 | — | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Lower Ext Venous Duplex Reflux Bil | $281.80 | $563.60 | $132.22–$461.73 | — | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE | $1,180.63 | $2,361.26 | $299.92–$1,199.52 | 17% below | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CEC Echocardiogram Complete W/Contrast | $1,221.45 | $2,442.90 | $299.92–$1,240.99 | 14% below | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CEC Echocardiogram Complete | $1,221.45 | $2,442.90 | $299.92–$1,240.99 | 14% below | 50% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMPLETE | $1,180.63 | $2,361.26 | $299.92–$1,199.52 | — | 50% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CEC Echocardiogram Complete | $1,221.45 | $2,442.90 | $299.92–$1,240.99 | — | 50% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CEC Echocardiogram Complete W/Contrast | $1,221.45 | $2,442.90 | $299.92–$1,240.99 | — | 50% |
| Elbow X-ray, 2 views CPT 73070 X-RAY EXAM OF ELBOW | $106.60 | $213.20 | $48.16–$137.40 | 20% below | 50% |
| Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Left | $110.35 | $220.70 | $48.16–$137.40 | 18% below | 50% |
| Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Right | $110.35 | $220.70 | $48.16–$137.40 | 18% below | 50% |
| Elbow X-ray, 2 views inpatient CPT 73070 X-RAY EXAM OF ELBOW | $106.60 | $213.20 | $48.16–$137.40 | — | 50% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Right | $110.35 | $220.70 | $48.16–$137.40 | — | 50% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Left | $110.35 | $220.70 | $48.16–$137.40 | — | 50% |
| Elbow X-ray, complete, 3 or more views CPT 73080 X-RAY EXAM OF ELBOW | $106.60 | $213.20 | $48.16–$137.40 | 44% below | 50% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete 3+ Views Left | $110.35 | $220.70 | $48.16–$137.40 | 42% below | 50% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete 3+ Views Right | $110.35 | $220.70 | $48.16–$165.52 | 42% below | 50% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 X-RAY EXAM OF ELBOW | $106.60 | $213.20 | $48.16–$137.40 | — | 50% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete 3+ Views Right | $110.35 | $220.70 | $48.16–$165.52 | — | 50% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete 3+ Views Left | $110.35 | $220.70 | $48.16–$137.40 | — | 50% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE | $823.33 | $1,646.66 | $58.17–$836.50 | 18% below | 50% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbits Sella Ear w/o Contrast | $867.65 | $1,735.30 | $58.17–$881.53 | 14% below | 50% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC w/o Contrast | $867.65 | $1,735.30 | $58.17–$881.53 | 14% below | 50% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Temporal Bones w/o Contrast | $867.65 | $1,735.30 | $58.17–$881.53 | 14% below | 50% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE | $823.33 | $1,646.66 | $58.17–$836.50 | — | 50% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbits Sella Ear w/o Contrast | $867.65 | $1,735.30 | $58.17–$881.53 | — | 50% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC w/o Contrast | $867.65 | $1,735.30 | $58.17–$881.53 | — | 50% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Temporal Bones w/o Contrast | $867.65 | $1,735.30 | $58.17–$881.53 | — | 50% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 X-RAY EXAM OF FACIAL BONES | $92.80 | $185.60 | $58.17–$165.94 | 64% below | 50% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones 3+ Views | $96.05 | $192.10 | $58.17–$165.94 | 63% below | 50% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 X-RAY EXAM OF FACIAL BONES | $92.80 | $185.60 | $58.17–$165.94 | — | 50% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones 3+ Views | $96.05 | $192.10 | $58.17–$165.94 | — | 50% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 X-RAY EXAM OF FOREARM | $106.60 | $213.20 | $48.16–$137.40 | 40% below | 50% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Left | $110.35 | $220.70 | $48.16–$163.16 | 38% below | 50% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Right | $110.35 | $220.70 | $48.16–$163.16 | 38% below | 50% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 X-RAY EXAM OF FOREARM | $106.60 | $213.20 | $48.16–$137.40 | — | 50% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Left | $110.35 | $220.70 | $48.16–$163.16 | — | 50% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Right | $110.35 | $220.70 | $48.16–$163.16 | — | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary HIDA Injection/Scan | $872.80 | $1,745.60 | $219.80–$942.82 | 7% below | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary HIDA Injection/Scan | $872.80 | $1,745.60 | $219.80–$942.82 | — | 50% |
| Hand X-ray, 2 views CPT 73120 X-RAY EXAM OF HAND | $106.60 | $213.20 | $58.17–$165.94 | 27% below | 50% |
| Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Right | $110.35 | $220.70 | $58.17–$165.94 | 24% below | 50% |
| Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Left | $110.35 | $220.70 | $58.17–$165.94 | 24% below | 50% |
| Hand X-ray, 2 views inpatient CPT 73120 X-RAY EXAM OF HAND | $106.60 | $213.20 | $58.17–$165.94 | — | 50% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Right | $110.35 | $220.70 | $58.17–$165.94 | — | 50% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Left | $110.35 | $220.70 | $58.17–$165.94 | — | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-RAY EXAM OF HEEL | $106.60 | $213.20 | $48.16–$137.40 | 31% below | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Left | $110.35 | $220.70 | $48.16–$137.40 | 28% below | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Right | $110.35 | $220.70 | $48.16–$137.40 | 28% below | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 X-RAY EXAM OF HEEL | $106.60 | $213.20 | $48.16–$137.40 | — | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus Left | $110.35 | $220.70 | $48.16–$137.40 | — | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus Right | $110.35 | $220.70 | $48.16–$137.40 | — | 50% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study Unatt & Resp Efft | $628.65 | $1,257.30 | $85.58–$942.97 | 14% above | 50% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Sleep Study Unatt & Resp Efft | $628.65 | $1,257.30 | $85.58–$942.97 | — | 50% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM | $2,114.93 | $4,229.86 | $556.51–$2,148.77 | 39% below | 50% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysom 6/> Yrs CPAP 4/> Param | $2,187.20 | $4,374.40 | $556.51–$2,222.20 | 37% below | 50% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM | $2,114.93 | $4,229.86 | $556.51–$2,148.77 | — | 50% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysom 6/> Yrs CPAP 4/> Param | $2,187.20 | $4,374.40 | $556.51–$2,222.20 | — | 50% |
| Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3 | $120.63 | $241.26 | $48.16–$137.40 | 39% below | 50% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left | $113.85 | $227.70 | $48.16–$170.77 | 43% below | 50% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right | $113.85 | $227.70 | $48.16–$163.94 | 43% below | 50% |
| Knee X-ray, 3 views inpatient CPT 73562 X-RAY EXAM OF KNEE 3 | $120.63 | $241.26 | $48.16–$137.40 | — | 50% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Left | $113.85 | $227.70 | $48.16–$170.77 | — | 50% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Right | $113.85 | $227.70 | $48.16–$163.94 | — | 50% |
| Knee X-ray, complete, 4 or more views CPT 73564 X-RAY EXAM KNEE 4 OR MORE | $124.54 | $249.08 | $58.17–$165.94 | 42% below | 50% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4+ Views Right | $120.20 | $240.40 | $58.17–$165.94 | 44% below | 50% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4+ Views Left | $120.20 | $240.40 | $58.17–$180.30 | 44% below | 50% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 X-RAY EXAM KNEE 4 OR MORE | $124.54 | $249.08 | $58.17–$165.94 | — | 50% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4+ Views Left | $120.20 | $240.40 | $58.17–$180.30 | — | 50% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4+ Views Right | $120.20 | $240.40 | $58.17–$165.94 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Foot w/o Contrast Bilateral | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Knee w/o Contrast Bilateral | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Lower Extremity w/o Contrast Bilat | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Hip w/o Contrast Bilateral | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O DYE | $841.74 | $1,683.48 | $58.17–$855.21 | 24% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Add On - CT Lower Extrem w/o Cont Right | $883.95 | $1,767.90 | $58.17–$898.09 | 20% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Left | $883.95 | $1,767.90 | $58.17–$898.09 | 20% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$898.09 | 20% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip w/o Contrast Left | $883.95 | $1,767.90 | $58.17–$898.09 | 20% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$898.09 | 20% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Left | $883.95 | $1,767.90 | $58.17–$898.09 | 20% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$1,325.93 | 20% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Add On - CT Foot w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$898.09 | 20% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Add On - CT Hip w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$898.09 | 20% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Add On - CT Knee w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$898.09 | 20% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity w/o Contrast Left | $883.95 | $1,767.90 | $58.17–$898.09 | 20% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$1,272.89 | 20% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Left | $883.95 | $1,767.90 | $58.17–$898.09 | 20% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$898.09 | 20% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Knee w/o Contrast Bilateral | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Foot w/o Contrast Bilateral | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Lower Extremity w/o Contrast Bilat | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Hip w/o Contrast Bilateral | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY W/O DYE | $841.74 | $1,683.48 | $58.17–$855.21 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity w/o Contrast Left | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$1,325.93 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip w/o Contrast Left | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Add On - CT Foot w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Add On - CT Lower Extrem w/o Cont Right | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Add On - CT Knee w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee w/o Contrast Left | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$1,272.89 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot w/o Contrast Left | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/o Contrast Left | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Add On - CT Hip w/o Contrast Right | $883.95 | $1,767.90 | $58.17–$898.09 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN | $346.22 | $692.43 | $58.17–$351.75 | 27% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited | $357.05 | $714.10 | $58.17–$535.58 | 24% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Limited Abdominal US Exam | $357.05 | $714.10 | $58.17–$362.76 | 24% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Ultrasound Abdomen Limited 76705 | $357.10 | $714.20 | $58.17–$514.22 | 24% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Hospitalist BP 76705 US Abdominal Limited | $357.10 | $714.20 | $58.17–$362.81 | 24% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHO EXAM OF ABDOMEN | $346.22 | $692.43 | $58.17–$351.75 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Limited Abdominal US Exam | $357.05 | $714.10 | $58.17–$362.76 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited | $357.05 | $714.10 | $58.17–$535.58 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Ultrasound Abdomen Limited 76705 | $357.10 | $714.20 | $58.17–$514.22 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Hospitalist BP 76705 US Abdominal Limited | $357.10 | $714.20 | $58.17–$362.81 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 IR Limited ultrasound joint/non vascular extremity | $316.00 | $632.00 | $58.17–$321.06 | 14% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Hospitalist BP 76882 US Limited Jnt/Nonvasc Extrem Structure(s) | $316.00 | $632.00 | $58.17–$321.06 | 14% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/NONVASC XTR STRUX | $325.24 | $650.47 | $58.17–$330.44 | 11% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US MSK Lower Extremity Limited Right | $316.00 | $632.00 | $58.17–$321.06 | 14% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US MSK Shoulder - Humerus Limited Left | $316.00 | $632.00 | $58.17–$321.06 | 14% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US MSK Shoulder - Humerus Limited Right | $316.00 | $632.00 | $58.17–$321.06 | 14% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US MSK Knee - Tib/Fib Limited Right | $316.00 | $632.00 | $58.17–$321.06 | 14% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US MSK Knee - Tib/Fib Limited Left | $316.00 | $632.00 | $58.17–$321.06 | 14% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US MSK Lower Extremity Limited Left | $316.00 | $632.00 | $58.17–$321.06 | 14% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US MSK Upper Extremity Limited Right | $316.00 | $632.00 | $58.17–$321.06 | 14% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Breast Axilla Left | $316.00 | $632.00 | $58.17–$321.06 | 14% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Breast Axilla Right | $316.00 | $632.00 | $58.17–$474.00 | 14% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Nonvascular Limited Left | $316.00 | $632.00 | $58.17–$455.04 | 14% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Nonvascular Limited Right | $316.00 | $632.00 | $58.17–$474.00 | 14% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US MSK Upper Extremity Limited Left | $316.00 | $632.00 | $58.17–$321.06 | 14% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Hospitalist BP 76882 US Limited Jnt/Nonvasc Extrem Structure(s) | $316.00 | $632.00 | $58.17–$321.06 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 IR Limited ultrasound joint/non vascular extremity | $316.00 | $632.00 | $58.17–$321.06 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JT/NONVASC XTR STRUX | $325.24 | $650.47 | $58.17–$330.44 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Breast Axilla Left | $316.00 | $632.00 | $58.17–$321.06 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US MSK Shoulder - Humerus Limited Left | $316.00 | $632.00 | $58.17–$321.06 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Breast Axilla Right | $316.00 | $632.00 | $58.17–$474.00 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US MSK Shoulder - Humerus Limited Right | $316.00 | $632.00 | $58.17–$321.06 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Nonvascular Limited Left | $316.00 | $632.00 | $58.17–$455.04 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Nonvascular Limited Right | $316.00 | $632.00 | $58.17–$474.00 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US MSK Upper Extremity Limited Left | $316.00 | $632.00 | $58.17–$321.06 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US MSK Knee - Tib/Fib Limited Left | $316.00 | $632.00 | $58.17–$321.06 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US MSK Knee - Tib/Fib Limited Right | $316.00 | $632.00 | $58.17–$321.06 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US MSK Upper Extremity Limited Right | $316.00 | $632.00 | $58.17–$321.06 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US MSK Lower Extremity Limited Right | $316.00 | $632.00 | $58.17–$321.06 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US MSK Lower Extremity Limited Left | $316.00 | $632.00 | $58.17–$321.06 | — | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CANCER SCR C- | $271.41 | $542.82 | $58.17–$328.20 | 22% below | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Cancer Screening | $280.25 | $560.50 | $58.17–$420.38 | 20% below | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LUNG CANCER SCR C- | $271.41 | $542.82 | $58.17–$328.20 | — | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Cancer Screening | $280.25 | $560.50 | $58.17–$420.38 | — | 50% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-RAY EXAM OF LOWER LEG | $98.96 | $197.92 | $48.16–$137.40 | 46% below | 50% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Left | $100.45 | $200.90 | $48.16–$163.16 | 46% below | 50% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Right | $100.45 | $200.90 | $48.16–$163.16 | 46% below | 50% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 X-RAY EXAM OF LOWER LEG | $98.96 | $197.92 | $48.16–$137.40 | — | 50% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Left | $100.45 | $200.90 | $48.16–$163.16 | — | 50% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Right | $100.45 | $200.90 | $48.16–$163.16 | — | 50% |
| MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE | $980.25 | $1,960.50 | $132.22–$995.93 | 37% below | 50% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRV Head w/o Contrast | $1,014.55 | $2,029.10 | $132.22–$1,030.78 | 35% below | 50% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Brain/Head w/o Contrast | $1,014.55 | $2,029.10 | $132.22–$1,521.82 | 35% below | 50% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE | $980.25 | $1,960.50 | $132.22–$995.93 | — | 50% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Brain/Head w/o Contrast | $1,014.55 | $2,029.10 | $132.22–$1,521.82 | — | 50% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV Head w/o Contrast | $1,014.55 | $2,029.10 | $132.22–$1,030.78 | — | 50% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast w/ + w/o Contrast Bilateral | $2,454.65 | $4,909.30 | $878.91–$2,493.92 | — | 50% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI Breast w/ + w/o Contrast Bilateral | $2,454.65 | $4,909.30 | $878.91–$2,493.92 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Hips w/o Contrast Bilateral | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT OF LWR EXTRE W/O DYE | $1,043.75 | $2,087.50 | $132.22–$1,060.45 | 35% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 32% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,620.45 | 32% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Add On - MRI Hip w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 32% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Lower Joint w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 32% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,620.45 | 32% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 32% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 32% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Lower Joint w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 32% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,238.24 | 32% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Hips w/o Contrast Bilateral | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JNT OF LWR EXTRE W/O DYE | $1,043.75 | $2,087.50 | $132.22–$1,060.45 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Add On - MRI Hip w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,238.24 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Lower Joint w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Lower Joint w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,620.45 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,620.45 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI Hips w/ + w/o Contrast Bilateral | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Lower Joint w/ + w/o Contrast Right | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 37% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Lower Joint w/ + w/o Contrast Left | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 37% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 37% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 37% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 37% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 37% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 37% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Add On - MRI Hip w/ + w/o Contrast RT | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 37% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 37% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI Hips w/ + w/o Contrast Bilateral | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Lower Joint w/ + w/o Contrast Left | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Lower Joint w/ + w/o Contrast Right | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Add On - MRI Hip w/ + w/o Contrast RT | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O DYE | $907.70 | $1,815.40 | $132.22–$922.22 | 46% below | 50% |
| MRI of the abdomen without contrast CPT 74181 MRI Abd/Pelvis w/o Cnt Urography | $939.45 | $1,878.90 | $132.22–$954.48 | 44% below | 50% |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast | $939.45 | $1,878.90 | $132.22–$954.48 | 44% below | 50% |
| MRI of the abdomen without contrast CPT 74181 MRI Abd/Pelvis w/o Cont Enterography | $939.45 | $1,878.90 | $132.22–$954.48 | 44% below | 50% |
| MRI of the abdomen without contrast CPT 74181 MRI MRCP Abdomen w/o Contrast | $939.45 | $1,878.90 | $132.22–$954.48 | 44% below | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O DYE | $907.70 | $1,815.40 | $132.22–$922.22 | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abd/Pelvis w/o Cnt Urography | $939.45 | $1,878.90 | $132.22–$954.48 | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abd/Pelvis w/o Cont Enterography | $939.45 | $1,878.90 | $132.22–$954.48 | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP Abdomen w/o Contrast | $939.45 | $1,878.90 | $132.22–$954.48 | — | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast | $939.45 | $1,878.90 | $132.22–$954.48 | — | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/O & W/DYE | $1,544.00 | $3,088.00 | $195.35–$1,568.70 | 51% below | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abd/Pelvis w/ + w/o Cnt Urography | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 50% below | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$1,800.16 | 50% below | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abd/Pelvis w/ + w/o Cont Enterography | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 50% below | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI MRCP Abdomen w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 50% below | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/O & W/DYE | $1,544.00 | $3,088.00 | $195.35–$1,568.70 | — | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abd/Pelvis w/ + w/o Cont Enterography | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abd/Pelvis w/ + w/o Cnt Urography | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$1,800.16 | — | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI MRCP Abdomen w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE | $1,039.97 | $2,079.94 | $132.22–$1,056.61 | 38% below | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI IAC w/o Contrast | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 35% below | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast Stroke Protocol | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 35% below | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Cont Hydrocephalus Screen | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 35% below | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI Pituitary w/o Contrast | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 35% below | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast | $1,080.30 | $2,160.60 | $132.22–$1,620.45 | 35% below | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN STEM W/O DYE | $1,039.97 | $2,079.94 | $132.22–$1,056.61 | — | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Pituitary w/o Contrast | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast Stroke Protocol | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast | $1,080.30 | $2,160.60 | $132.22–$1,620.45 | — | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI IAC w/o Contrast | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Cont Hydrocephalus Screen | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE | $1,559.83 | $3,119.66 | $195.35–$1,584.79 | 45% below | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI IAC w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 44% below | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$2,355.83 | 44% below | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Pituitary w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$2,261.59 | 44% below | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN STEM W/O & W/DYE | $1,559.83 | $3,119.66 | $195.35–$1,584.79 | — | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IAC w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Pituitary w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$2,261.59 | — | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$2,355.83 | — | 50% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE | $1,134.29 | $2,268.57 | $132.22–$1,152.43 | 37% below | 50% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast | $1,175.90 | $2,351.80 | $132.22–$1,763.85 | 34% below | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O DYE | $1,134.29 | $2,268.57 | $132.22–$1,152.43 | — | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast | $1,175.90 | $2,351.80 | $132.22–$1,763.85 | — | 50% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE | $1,544.00 | $3,088.00 | $195.35–$1,568.70 | 43% below | 50% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 42% below | 50% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/O & W/DYE | $1,544.00 | $3,088.00 | $195.35–$1,568.70 | — | 50% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI CHEST SPINE W/O DYE | $1,136.15 | $2,272.30 | $132.22–$1,154.33 | 30% below | 50% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast | $1,175.90 | $2,351.80 | $132.22–$1,194.71 | 27% below | 50% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI CHEST SPINE W/O DYE | $1,136.15 | $2,272.30 | $132.22–$1,154.33 | — | 50% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast | $1,175.90 | $2,351.80 | $132.22–$1,194.71 | — | 50% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$1,800.16 | 44% below | 50% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$1,800.16 | — | 50% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE | $1,132.19 | $2,264.38 | $132.22–$1,150.31 | 35% below | 50% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast | $1,175.90 | $2,351.80 | $132.22–$1,763.85 | 33% below | 50% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI NECK SPINE W/O DYE | $1,132.19 | $2,264.38 | $132.22–$1,150.31 | — | 50% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast | $1,175.90 | $2,351.80 | $132.22–$1,763.85 | — | 50% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE | $1,535.15 | $3,070.30 | $195.35–$1,559.71 | 44% below | 50% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$2,261.59 | 43% below | 50% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Prostate w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$2,355.83 | 43% below | 50% |
| MRI of the pelvis without and with contrast CPT 72197 Add On - MRI Pelvis w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | 43% below | 50% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Sacrum/SI Jts w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$2,261.59 | 43% below | 50% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O & W/DYE | $1,535.15 | $3,070.30 | $195.35–$1,559.71 | — | 50% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$2,261.59 | — | 50% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Prostate w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$2,355.83 | — | 50% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Sacrum/SI Jts w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$2,261.59 | — | 50% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 Add On - MRI Pelvis w/ + w/o Contrast | $1,570.55 | $3,141.10 | $195.35–$1,595.68 | — | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE | $987.95 | $1,975.90 | $132.22–$1,003.76 | 42% below | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Prostate w/o Contrast | $1,022.55 | $2,045.10 | $132.22–$1,038.91 | 40% below | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast | $1,022.55 | $2,045.10 | $132.22–$1,038.91 | 40% below | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Sacrum/SI Jts w/o Contrast | $1,022.55 | $2,045.10 | $132.22–$1,038.91 | 40% below | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 Add On - MRI Pelvis w/o Contrast | $1,022.55 | $2,045.10 | $132.22–$1,038.91 | 40% below | 50% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O DYE | $987.95 | $1,975.90 | $132.22–$1,003.76 | — | 50% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Sacrum/SI Jts w/o Contrast | $1,022.55 | $2,045.10 | $132.22–$1,038.91 | — | 50% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast | $1,022.55 | $2,045.10 | $132.22–$1,038.91 | — | 50% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Prostate w/o Contrast | $1,022.55 | $2,045.10 | $132.22–$1,038.91 | — | 50% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 Add On - MRI Pelvis w/o Contrast | $1,022.55 | $2,045.10 | $132.22–$1,038.91 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPR EXTREM W/O DYE | $1,044.14 | $2,088.28 | $132.22–$1,060.85 | 44% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 42% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 42% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 42% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Upper Joint w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 42% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Upper Joint w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 42% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 42% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 42% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | 42% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI JOINT UPR EXTREM W/O DYE | $1,044.14 | $2,088.28 | $132.22–$1,060.85 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Upper Joint w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Upper Joint w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Right | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Left | $1,080.30 | $2,160.60 | $132.22–$1,097.58 | — | 50% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS | $183.10 | $366.20 | $58.17–$186.03 | 38% below | 50% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical 4 or 5 Views | $189.50 | $379.00 | $58.17–$284.25 | 35% below | 50% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS | $183.10 | $366.20 | $58.17–$186.03 | — | 50% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical 4 or 5 Views | $189.50 | $379.00 | $58.17–$284.25 | — | 50% |
| Neck soft tissue CT scan with contrast CPT 70491 CT Neck Soft Tissue w/ Contrast | $1,035.00 | $2,070.00 | $97.38–$1,552.50 | 21% below | 50% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/DYE | $1,078.78 | $2,157.55 | $97.38–$1,096.04 | 18% below | 50% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck Soft Tissue w/ Contrast | $1,035.00 | $2,070.00 | $97.38–$1,552.50 | — | 50% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/DYE | $1,078.78 | $2,157.55 | $97.38–$1,096.04 | — | 50% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O DYE | $790.20 | $1,580.40 | $58.17–$802.84 | 22% below | 50% |
| Neck soft tissue CT scan without contrast CPT 70490 CT Neck Soft Tissue w/o Contrast | $817.85 | $1,635.70 | $58.17–$830.94 | 19% below | 50% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O DYE | $790.20 | $1,580.40 | $58.17–$802.84 | — | 50% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Neck Soft Tissue w/o Contrast | $817.85 | $1,635.70 | $58.17–$830.94 | — | 50% |
| Neck soft tissue X-ray CPT 70360 X-RAY EXAM OF NECK | $96.85 | $193.70 | $48.16–$137.40 | 45% below | 50% |
| Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue | $100.25 | $200.50 | $48.16–$137.40 | 43% below | 50% |
| Neck soft tissue X-ray inpatient CPT 70360 X-RAY EXAM OF NECK | $96.85 | $193.70 | $48.16–$137.40 | — | 50% |
| Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue | $100.25 | $200.50 | $48.16–$137.40 | — | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perf SPECT - Multi Inj | $2,380.75 | $4,761.50 | $714.10–$3,571.13 | 19% below | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perf SPECT - Multi Inj | $2,380.75 | $4,761.50 | $714.10–$3,571.13 | — | 50% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMAGE W/CT SKULL-THIGH | $1,814.98 | $3,629.95 | $797.85–$3,366.43 | 67% below | 50% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMAGE W/CT SKULL-THIGH | $1,814.98 | $3,629.95 | $797.85–$3,366.43 | — | 50% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O DYE | $813.83 | $1,627.66 | $58.17–$826.85 | 18% below | 50% |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast | $841.55 | $1,683.10 | $58.17–$1,262.32 | 16% below | 50% |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Cont Cystogram | $841.55 | $1,683.10 | $58.17–$855.01 | 16% below | 50% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O DYE | $813.83 | $1,627.66 | $58.17–$826.85 | — | 50% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast | $841.55 | $1,683.10 | $58.17–$1,262.32 | — | 50% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Cont Cystogram | $841.55 | $1,683.10 | $58.17–$855.01 | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED | $229.60 | $459.20 | $58.17–$233.27 | 32% below | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 WH US Pelvic, Limited | $237.65 | $475.30 | $58.17–$241.45 | 29% below | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Urinary Bladder | $237.65 | $475.30 | $58.17–$241.45 | 29% below | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Limited w/o Transvag | $237.65 | $475.30 | $58.17–$272.39 | 29% below | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Limited w/ Transvag | $237.65 | $475.30 | $58.17–$241.45 | 29% below | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Hospitalist BP 76857 US Pelvic Non-OB Limited/Follow Up | $237.65 | $475.30 | $58.17–$241.45 | 29% below | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED | $229.60 | $459.20 | $58.17–$233.27 | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Hospitalist BP 76857 US Pelvic Non-OB Limited/Follow Up | $237.65 | $475.30 | $58.17–$241.45 | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 WH US Pelvic, Limited | $237.65 | $475.30 | $58.17–$241.45 | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Urinary Bladder | $237.65 | $475.30 | $58.17–$241.45 | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Limited w/o Transvag | $237.65 | $475.30 | $58.17–$272.39 | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Limited w/ Transvag | $237.65 | $475.30 | $58.17–$241.45 | — | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE | $415.24 | $830.47 | $58.17–$421.88 | 27% below | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 WH US Pelvic, Complete w/ Transvaginal | $425.95 | $851.90 | $58.17–$432.77 | 25% below | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Complete w/ Transvag | $425.95 | $851.90 | $58.17–$638.93 | 25% below | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 WH US Pelvic, Complete | $425.95 | $851.90 | $58.17–$432.77 | 25% below | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Complete w/o Transvag | $425.95 | $851.90 | $58.17–$638.93 | 25% below | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US EXAM PELVIC COMPLETE | $415.24 | $830.47 | $58.17–$421.88 | — | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 WH US Pelvic, Complete w/ Transvaginal | $425.95 | $851.90 | $58.17–$432.77 | — | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 WH US Pelvic, Complete | $425.95 | $851.90 | $58.17–$432.77 | — | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Complete w/o Transvag | $425.95 | $851.90 | $58.17–$638.93 | — | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Complete w/ Transvag | $425.95 | $851.90 | $58.17–$638.93 | — | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Greater Than 14 Weeks | $372.65 | $745.30 | $58.17–$378.61 | 34% below | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 WH OB US Greater Than 14 weeks, Single | $372.65 | $745.30 | $58.17–$378.61 | 34% below | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >/= 14 WKS SNGL FETUS | $452.12 | $904.23 | $58.17–$459.35 | 20% below | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Greater Than 14 Weeks | $372.65 | $745.30 | $58.17–$378.61 | — | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 WH OB US Greater Than 14 weeks, Single | $372.65 | $745.30 | $58.17–$378.61 | — | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >/= 14 WKS SNGL FETUS | $452.12 | $904.23 | $58.17–$459.35 | — | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS | $200.95 | $401.90 | $58.17–$256.90 | 61% below | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 WH OB US, Less Than 14 weeks, Single | $208.00 | $416.00 | $58.17–$256.90 | 60% below | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB Less Than 14 wks w/ Transvag | $208.00 | $416.00 | $58.17–$312.00 | 60% below | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB Less Than 14 wks w/o Transvag | $208.00 | $416.00 | $58.17–$299.52 | 60% below | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US < 14 WKS SINGLE FETUS | $200.95 | $401.90 | $58.17–$256.90 | — | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB Less Than 14 wks w/o Transvag | $208.00 | $416.00 | $58.17–$299.52 | — | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 WH OB US, Less Than 14 weeks, Single | $208.00 | $416.00 | $58.17–$256.90 | — | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB Less Than 14 wks w/ Transvag | $208.00 | $416.00 | $58.17–$312.00 | — | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 WH OB US Limited, 1 or More Fetuses | $209.95 | $419.90 | $58.17–$213.31 | 34% below | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited | $209.95 | $419.90 | $58.17–$213.31 | 34% below | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S) | $264.10 | $528.20 | $58.17–$268.33 | 18% below | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited | $209.95 | $419.90 | $58.17–$213.31 | — | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 WH OB US Limited, 1 or More Fetuses | $209.95 | $419.90 | $58.17–$213.31 | — | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED FETUS(S) | $264.10 | $528.20 | $58.17–$268.33 | — | 50% |
| Rib X-ray, one side, 2 views CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS | $106.60 | $213.20 | $48.16–$137.40 | 46% below | 50% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 Views Right | $110.35 | $220.70 | $48.16–$163.16 | 44% below | 50% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 Views Left | $110.35 | $220.70 | $48.16–$163.16 | 44% below | 50% |
| Rib X-ray, one side, 2 views inpatient CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS | $106.60 | $213.20 | $48.16–$137.40 | — | 50% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 Views Left | $110.35 | $220.70 | $48.16–$163.16 | — | 50% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 Views Right | $110.35 | $220.70 | $48.16–$163.16 | — | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY EXAM UNILAT RIBS/CHEST | $116.80 | $233.60 | $58.17–$165.94 | 50% below | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w/ PA Chest Right | $120.90 | $241.80 | $58.17–$165.94 | 49% below | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w/ PA Chest Left | $120.90 | $241.80 | $58.17–$197.05 | 49% below | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 X-RAY EXAM UNILAT RIBS/CHEST | $116.80 | $233.60 | $58.17–$165.94 | — | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w/ PA Chest Left | $120.90 | $241.80 | $58.17–$197.05 | — | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w/ PA Chest Right | $120.90 | $241.80 | $58.17–$165.94 | — | 50% |
| Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD | $207.35 | $414.70 | $210.67–$340.50 | — | 50% |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Screening Bilateral | $214.60 | $429.20 | $218.03–$340.50 | — | 50% |
| Screening mammogram, both breasts both sides CPT 77067 Add On - MG Mammo Screening Bilateral | $214.60 | $429.20 | $110.99–$340.50 | — | 50% |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Implant Screening Bilateral | $214.60 | $429.20 | $218.03–$340.50 | — | 50% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCR MAMMO BI INCL CAD | $207.35 | $414.70 | $210.67–$340.50 | — | 50% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Implant Screening Bilateral | $214.60 | $429.20 | $218.03–$340.50 | — | 50% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 Add On - MG Mammo Screening Bilateral | $214.60 | $429.20 | $110.99–$340.50 | — | 50% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Screening Bilateral | $214.60 | $429.20 | $218.03–$340.50 | — | 50% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER | $115.14 | $230.28 | $48.16–$137.40 | 46% below | 50% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2+ Views Right | $110.35 | $220.70 | $48.16–$165.52 | 48% below | 50% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2+ Views Left | $110.35 | $220.70 | $48.16–$165.52 | 48% below | 50% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-RAY EXAM OF SHOULDER | $115.14 | $230.28 | $48.16–$137.40 | — | 50% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2+ Views Left | $110.35 | $220.70 | $48.16–$165.52 | — | 50% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2+ Views Right | $110.35 | $220.70 | $48.16–$165.52 | — | 50% |
| Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY EXAM OF SINUSES | $111.75 | $223.50 | $48.16–$137.40 | 52% below | 50% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete | $115.65 | $231.30 | $48.16–$137.40 | 50% below | 50% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 X-RAY EXAM OF SINUSES | $111.75 | $223.50 | $48.16–$137.40 | — | 50% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete | $115.65 | $231.30 | $48.16–$137.40 | — | 50% |
| Skull X-ray, fewer than 4 views CPT 70250 X-RAY EXAM OF SKULL | $106.60 | $213.20 | $58.17–$165.94 | 49% below | 50% |
| Skull X-ray, fewer than 4 views CPT 70250 XR Skull < 4 Views | $110.35 | $220.70 | $58.17–$165.94 | 47% below | 50% |
| Skull X-ray, fewer than 4 views CPT 70250 XR Shunt Eval <4 Vw Skull +Abd/CXR 2 Vw | $110.35 | $220.70 | $58.17–$165.94 | 47% below | 50% |
| Skull X-ray, fewer than 4 views CPT 70250 XR Shunt Eval < 4 Skull Vw +Abd/CXR 1 Vw | $110.35 | $220.70 | $58.17–$165.94 | 47% below | 50% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 X-RAY EXAM OF SKULL | $106.60 | $213.20 | $58.17–$165.94 | — | 50% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull < 4 Views | $110.35 | $220.70 | $58.17–$165.94 | — | 50% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Shunt Eval <4 Vw Skull +Abd/CXR 2 Vw | $110.35 | $220.70 | $58.17–$165.94 | — | 50% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Shunt Eval < 4 Skull Vw +Abd/CXR 1 Vw | $110.35 | $220.70 | $58.17–$165.94 | — | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysom 6/> Yrs 4/> Param | $2,063.00 | $4,126.00 | $556.51–$2,970.72 | 36% below | 50% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysom 6/> Yrs 4/> Param | $2,063.00 | $4,126.00 | $556.51–$2,970.72 | — | 50% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE | $1,052.08 | $2,104.15 | $299.92–$1,068.91 | 11% below | 50% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 CSC Treadmill Stress Echo W/ Contrast | $1,066.60 | $2,133.20 | $299.92–$1,083.67 | 10% below | 50% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 CSC Treadmill Stress Echo W/O Contrast | $1,066.60 | $2,133.20 | $299.92–$1,083.67 | 10% below | 50% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 CSC Dobutamine Stress Echo W/Contrast | $1,066.60 | $2,133.20 | $299.92–$1,083.67 | 10% below | 50% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 CSC Dobutamine Stress Echo W/O Contrast | $1,066.60 | $2,133.20 | $299.92–$1,083.67 | 10% below | 50% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TTE COMPLETE | $1,052.08 | $2,104.15 | $299.92–$1,068.91 | — | 50% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 CSC Treadmill Stress Echo W/ Contrast | $1,066.60 | $2,133.20 | $299.92–$1,083.67 | — | 50% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 CSC Dobutamine Stress Echo W/Contrast | $1,066.60 | $2,133.20 | $299.92–$1,083.67 | — | 50% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 CSC Treadmill Stress Echo W/O Contrast | $1,066.60 | $2,133.20 | $299.92–$1,083.67 | — | 50% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 CSC Dobutamine Stress Echo W/O Contrast | $1,066.60 | $2,133.20 | $299.92–$1,083.67 | — | 50% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function w/ Speech | $212.25 | $424.50 | $97.38–$356.47 | 44% below | 50% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function w/ Speech | $212.25 | $424.50 | $97.38–$356.47 | — | 50% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/> | $120.14 | $240.27 | $48.16–$137.40 | 44% below | 50% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Right | $110.35 | $220.70 | $48.16–$137.40 | 49% below | 50% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Left | $110.35 | $220.70 | $48.16–$165.52 | 49% below | 50% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 X-RAY EXAM OF FEMUR 2/> | $120.14 | $240.27 | $48.16–$137.40 | — | 50% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Right | $110.35 | $220.70 | $48.16–$137.40 | — | 50% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Left | $110.35 | $220.70 | $48.16–$165.52 | — | 50% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT CHEST SPINE W/O DYE | $885.80 | $1,771.60 | $58.17–$899.97 | 16% below | 50% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic w/o Contrast | $916.80 | $1,833.60 | $58.17–$1,050.84 | 13% below | 50% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT CHEST SPINE W/O DYE | $885.80 | $1,771.60 | $58.17–$899.97 | — | 50% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic w/o Contrast | $916.80 | $1,833.60 | $58.17–$1,050.84 | — | 50% |
| Toe X-ray, 2 or more views CPT 73660 X-RAY EXAM OF TOE(S) | $109.93 | $219.86 | $48.16–$137.40 | 13% below | 50% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toe(s) 2+ Views Left | $110.35 | $220.70 | $48.16–$137.40 | 12% below | 50% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toe(s) 2+ Views Right | $110.35 | $220.70 | $48.16–$137.40 | 12% below | 50% |
| Toe X-ray, 2 or more views inpatient CPT 73660 X-RAY EXAM OF TOE(S) | $109.93 | $219.86 | $48.16–$137.40 | — | 50% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toe(s) 2+ Views Right | $110.35 | $220.70 | $48.16–$137.40 | — | 50% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toe(s) 2+ Views Left | $110.35 | $220.70 | $48.16–$137.40 | — | 50% |
| Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB | $326.36 | $652.72 | $58.17–$331.58 | 38% below | 50% |
| Transvaginal pelvic ultrasound CPT 76830 WH US Transvaginal | $334.05 | $668.10 | $58.17–$339.39 | 37% below | 50% |
| Transvaginal pelvic ultrasound CPT 76830 ADD ON - US Transvag AMB | $334.05 | $668.10 | $58.17–$339.39 | 37% below | 50% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB | $334.05 | $668.10 | $58.17–$382.89 | 37% below | 50% |
| Transvaginal pelvic ultrasound CPT 76830 ADD ON - US Transvag | $334.05 | $668.10 | $58.17–$501.08 | 37% below | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL US NON-OB | $326.36 | $652.72 | $58.17–$331.58 | — | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 WH US Transvaginal | $334.05 | $668.10 | $58.17–$339.39 | — | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ADD ON - US Transvag AMB | $334.05 | $668.10 | $58.17–$339.39 | — | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ADD ON - US Transvag | $334.05 | $668.10 | $58.17–$501.08 | — | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB | $334.05 | $668.10 | $58.17–$382.89 | — | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 ADD ON - US OB Transvag | $188.35 | $376.70 | $58.17–$282.53 | 57% below | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal | $188.35 | $376.70 | $58.17–$207.74 | 57% below | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 Hospitalist BP 76817 US Pregnant Uterus Transvaginal | $188.35 | $376.70 | $58.17–$207.74 | 57% below | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 US Transvaginal OB | $188.35 | $376.70 | $58.17–$207.74 | 57% below | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 WH OB US Transvaginal | $188.35 | $376.70 | $58.17–$207.74 | 57% below | 50% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 ADD ON - US OB Transvag | $188.35 | $376.70 | $58.17–$282.53 | — | 50% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal | $188.35 | $376.70 | $58.17–$207.74 | — | 50% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Transvaginal OB | $188.35 | $376.70 | $58.17–$207.74 | — | 50% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 Hospitalist BP 76817 US Pregnant Uterus Transvaginal | $188.35 | $376.70 | $58.17–$207.74 | — | 50% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 WH OB US Transvaginal | $188.35 | $376.70 | $58.17–$207.74 | — | 50% |
| Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE | $501.35 | $1,002.70 | $58.17–$509.37 | 25% below | 50% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $518.90 | $1,037.80 | $58.17–$778.35 | 22% below | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US EXAM ABDOM COMPLETE | $501.35 | $1,002.70 | $58.17–$509.37 | — | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $518.90 | $1,037.80 | $58.17–$778.35 | — | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM | $322.40 | $644.80 | $58.17–$327.56 | 39% below | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents) w/ Doppler | $333.70 | $667.40 | $58.17–$500.55 | 37% below | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 US Testicular w/ Doppler | $333.70 | $667.40 | $58.17–$500.55 | 37% below | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents) w/o Doppler | $333.70 | $667.40 | $58.17–$500.55 | 37% below | 50% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US EXAM SCROTUM | $322.40 | $644.80 | $58.17–$327.56 | — | 50% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents) w/o Doppler | $333.70 | $667.40 | $58.17–$500.55 | — | 50% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents) w/ Doppler | $333.70 | $667.40 | $58.17–$500.55 | — | 50% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Testicular w/ Doppler | $333.70 | $667.40 | $58.17–$500.55 | — | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK | $325.14 | $650.27 | $58.17–$330.34 | 32% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 IR Ultrasound, soft tissue head and neck | $332.20 | $664.40 | $58.17–$337.52 | 30% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue | $332.20 | $664.40 | $58.17–$498.30 | 30% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Hospitalist BP 76536 US Soft Tissues Head & Neck | $332.20 | $664.40 | $58.17–$337.52 | 30% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF HEAD AND NECK | $325.14 | $650.27 | $58.17–$330.34 | — | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue | $332.20 | $664.40 | $58.17–$498.30 | — | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Hospitalist BP 76536 US Soft Tissues Head & Neck | $332.20 | $664.40 | $58.17–$337.52 | — | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 IR Ultrasound, soft tissue head and neck | $332.20 | $664.40 | $58.17–$337.52 | — | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI with Small Bowel | $212.25 | $424.50 | $97.38–$304.84 | 47% below | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI | $212.25 | $424.50 | $97.38–$304.84 | 47% below | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY UPPER GI DELAY W/O KUB | $215.84 | $431.68 | $97.38–$304.84 | 46% below | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI with Small Bowel | $212.25 | $424.50 | $97.38–$304.84 | — | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI | $212.25 | $424.50 | $97.38–$304.84 | — | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 X-RAY UPPER GI DELAY W/O KUB | $215.84 | $431.68 | $97.38–$304.84 | — | 50% |
| Upper arm X-ray (humerus), 2 views CPT 73060 X-RAY EXAM OF HUMERUS | $100.30 | $200.60 | $48.16–$137.40 | 46% below | 50% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Right | $103.80 | $207.60 | $48.16–$137.40 | 44% below | 50% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Left | $103.80 | $207.60 | $48.16–$137.40 | 44% below | 50% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 X-RAY EXAM OF HUMERUS | $100.30 | $200.60 | $48.16–$137.40 | — | 50% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Right | $103.80 | $207.60 | $48.16–$137.40 | — | 50% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Left | $103.80 | $207.60 | $48.16–$137.40 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY | $172.37 | $344.74 | $58.17–$295.02 | 68% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Reflux Right | $177.40 | $354.80 | $58.17–$295.02 | 67% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Reflux Left | $177.40 | $354.80 | $58.17–$295.02 | 67% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Vein Mapping Right | $177.40 | $354.80 | $58.17–$295.02 | 67% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Vein Mapping Left | $177.40 | $354.80 | $58.17–$295.02 | 67% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Vein Mapping Right | $177.40 | $354.80 | $58.17–$295.02 | 67% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Vein Mapping Left | $177.40 | $354.80 | $58.17–$295.02 | 67% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Right | $177.40 | $354.80 | $58.17–$295.02 | 67% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Left | $177.40 | $354.80 | $58.17–$295.02 | 67% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Right | $177.40 | $354.80 | $58.17–$295.02 | 67% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Left | $177.40 | $354.80 | $58.17–$295.02 | 67% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Hospitalist BP 93971 Duplex Extremity Veins Unilat/Limited | $177.40 | $354.80 | $58.17–$295.02 | 67% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 EXTREMITY STUDY | $172.37 | $344.74 | $58.17–$295.02 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Vein Mapping Right | $177.40 | $354.80 | $58.17–$295.02 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Left | $177.40 | $354.80 | $58.17–$295.02 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Right | $177.40 | $354.80 | $58.17–$295.02 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Hospitalist BP 93971 Duplex Extremity Veins Unilat/Limited | $177.40 | $354.80 | $58.17–$295.02 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Right | $177.40 | $354.80 | $58.17–$295.02 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Left | $177.40 | $354.80 | $58.17–$295.02 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Vein Mapping Left | $177.40 | $354.80 | $58.17–$295.02 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Reflux Right | $177.40 | $354.80 | $58.17–$295.02 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Reflux Left | $177.40 | $354.80 | $58.17–$295.02 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Vein Mapping Left | $177.40 | $354.80 | $58.17–$295.02 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Vein Mapping Right | $177.40 | $354.80 | $58.17–$295.02 | — | 50% |
| Wrist X-ray, 2 views CPT 73100 X-RAY EXAM OF WRIST | $112.61 | $225.21 | $48.16–$137.40 | 20% below | 50% |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Right | $110.35 | $220.70 | $48.16–$165.52 | 21% below | 50% |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Left | $110.35 | $220.70 | $48.16–$165.52 | 21% below | 50% |
| Wrist X-ray, 2 views inpatient CPT 73100 X-RAY EXAM OF WRIST | $112.61 | $225.21 | $48.16–$137.40 | — | 50% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Right | $110.35 | $220.70 | $48.16–$165.52 | — | 50% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Left | $110.35 | $220.70 | $48.16–$165.52 | — | 50% |
| Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST | $109.18 | $218.35 | $48.16–$137.40 | 44% below | 50% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views Right | $110.35 | $220.70 | $48.16–$163.16 | 44% below | 50% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views Left | $110.35 | $220.70 | $48.16–$137.40 | 44% below | 50% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-RAY EXAM OF WRIST | $109.18 | $218.35 | $48.16–$137.40 | — | 50% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views Right | $110.35 | $220.70 | $48.16–$163.16 | — | 50% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views Left | $110.35 | $220.70 | $48.16–$137.40 | — | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS | $124.55 | $249.10 | $48.16–$137.40 | 40% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views w/AP Pelvis Left | $128.90 | $257.80 | $48.16–$163.16 | 38% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Left | $128.90 | $257.80 | $48.16–$147.75 | 38% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Right | $128.90 | $257.80 | $48.16–$147.75 | 38% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views w/AP Pelvis Right | $128.90 | $257.80 | $48.16–$137.40 | 38% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS | $124.55 | $249.10 | $48.16–$137.40 | — | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Left | $128.90 | $257.80 | $48.16–$147.75 | — | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views w/AP Pelvis Right | $128.90 | $257.80 | $48.16–$137.40 | — | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views w/AP Pelvis Left | $128.90 | $257.80 | $48.16–$163.16 | — | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Right | $128.90 | $257.80 | $48.16–$147.75 | — | 50% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY EXAM ABDOMEN 1 VIEW | $96.15 | $192.29 | $48.16–$137.40 | 39% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen KUB 1 View Portable | $100.00 | $200.00 | $48.16–$137.40 | 37% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View Sitzmark Scan 1 | $100.00 | $200.00 | $48.16–$137.40 | 37% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 ADD ON - XR Single View Abdomen | $100.00 | $200.00 | $48.16–$137.40 | 37% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View Upright | $100.00 | $200.00 | $48.16–$144.00 | 37% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View Sitzmark Scan 3 | $100.00 | $200.00 | $48.16–$137.40 | 37% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen KUB 1 View | $100.00 | $200.00 | $48.16–$163.16 | 37% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View Sitzmark Scan 2 | $100.00 | $200.00 | $48.16–$137.40 | 37% below | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY EXAM ABDOMEN 1 VIEW | $96.15 | $192.29 | $48.16–$137.40 | — | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View Sitzmark Scan 3 | $100.00 | $200.00 | $48.16–$137.40 | — | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ADD ON - XR Single View Abdomen | $100.00 | $200.00 | $48.16–$137.40 | — | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View Sitzmark Scan 1 | $100.00 | $200.00 | $48.16–$137.40 | — | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen KUB 1 View Portable | $100.00 | $200.00 | $48.16–$137.40 | — | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View Sitzmark Scan 2 | $100.00 | $200.00 | $48.16–$137.40 | — | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen KUB 1 View | $100.00 | $200.00 | $48.16–$163.16 | — | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View Upright | $100.00 | $200.00 | $48.16–$144.00 | — | 50% |
| X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE | $106.60 | $213.20 | $48.16–$137.40 | 39% below | 50% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right | $110.35 | $220.70 | $48.16–$165.52 | 37% below | 50% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left | $110.35 | $220.70 | $48.16–$158.90 | 37% below | 50% |
| X-ray of the ankle, 2 views inpatient CPT 73600 X-RAY EXAM OF ANKLE | $106.60 | $213.20 | $48.16–$137.40 | — | 50% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right | $110.35 | $220.70 | $48.16–$165.52 | — | 50% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left | $110.35 | $220.70 | $48.16–$158.90 | — | 50% |
| X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S) | $106.60 | $213.20 | $48.16–$137.40 | 20% below | 50% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2+ Views Right | $110.35 | $220.70 | $48.16–$165.52 | 17% below | 50% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2+ Views Left | $110.35 | $220.70 | $48.16–$163.16 | 17% below | 50% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-RAY EXAM OF FINGER(S) | $106.60 | $213.20 | $48.16–$137.40 | — | 50% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2+ Views Left | $110.35 | $220.70 | $48.16–$163.16 | — | 50% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2+ Views Right | $110.35 | $220.70 | $48.16–$165.52 | — | 50% |
| X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT | $115.27 | $230.53 | $48.16–$137.40 | 27% below | 50% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right | $110.35 | $220.70 | $48.16–$165.52 | 30% below | 50% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left | $110.35 | $220.70 | $48.16–$158.90 | 30% below | 50% |
| X-ray of the foot, 2 views inpatient CPT 73620 X-RAY EXAM OF FOOT | $115.27 | $230.53 | $48.16–$137.40 | — | 50% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right | $110.35 | $220.70 | $48.16–$165.52 | — | 50% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left | $110.35 | $220.70 | $48.16–$158.90 | — | 50% |
| X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT | $110.23 | $220.45 | $48.16–$137.40 | 39% below | 50% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3+ Views Left | $110.35 | $220.70 | $48.16–$165.52 | 39% below | 50% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3+ Views Right | $110.35 | $220.70 | $48.16–$165.52 | 39% below | 50% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY EXAM OF FOOT | $110.23 | $220.45 | $48.16–$137.40 | — | 50% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3+ Views Right | $110.35 | $220.70 | $48.16–$165.52 | — | 50% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3+ Views Left | $110.35 | $220.70 | $48.16–$165.52 | — | 50% |
| X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND | $111.65 | $223.29 | $48.16–$137.40 | 39% below | 50% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3+ Views Left | $110.35 | $220.70 | $48.16–$163.16 | 40% below | 50% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3+ Views Right | $110.35 | $220.70 | $48.16–$137.40 | 40% below | 50% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 X-RAY EXAM OF HAND | $111.65 | $223.29 | $48.16–$137.40 | — | 50% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3+ Views Right | $110.35 | $220.70 | $48.16–$137.40 | — | 50% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3+ Views Left | $110.35 | $220.70 | $48.16–$163.16 | — | 50% |
| X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2 | $117.22 | $234.44 | $48.16–$137.40 | 25% below | 50% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Left | $110.35 | $220.70 | $48.16–$163.16 | 29% below | 50% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Right | $110.35 | $220.70 | $48.16–$163.16 | 29% below | 50% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY EXAM OF KNEE 1 OR 2 | $117.22 | $234.44 | $48.16–$137.40 | — | 50% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Left | $110.35 | $220.70 | $48.16–$163.16 | — | 50% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Right | $110.35 | $220.70 | $48.16–$163.16 | — | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views | $51.75 | $103.50 | $32.36–$165.94 | 76% below | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS | $106.10 | $212.20 | $58.17–$165.94 | 50% below | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views | $51.75 | $103.50 | $32.36–$165.94 | — | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS | $106.10 | $212.20 | $58.17–$165.94 | — | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS | $171.63 | $343.25 | $58.17–$174.37 | 44% below | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral 4+ Views | $176.40 | $352.80 | $58.17–$264.60 | 43% below | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS | $171.63 | $343.25 | $58.17–$174.37 | — | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral 4+ Views | $176.40 | $352.80 | $58.17–$264.60 | — | 50% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS | $106.60 | $213.20 | $58.17–$165.94 | 42% below | 50% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views | $110.35 | $220.70 | $58.17–$187.60 | 40% below | 50% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY EXAM THORAC SPINE 2VWS | $106.60 | $213.20 | $58.17–$165.94 | — | 50% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views | $110.35 | $220.70 | $58.17–$187.60 | — | 50% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES | $106.60 | $213.20 | $48.16–$137.40 | 39% below | 50% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones 3+ Views | $110.35 | $220.70 | $48.16–$137.40 | 37% below | 50% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-RAY EXAM OF NASAL BONES | $106.60 | $213.20 | $48.16–$137.40 | — | 50% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones 3+ Views | $110.35 | $220.70 | $48.16–$137.40 | — | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW | $108.66 | $217.32 | $48.16–$137.40 | 53% below | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views | $110.35 | $220.70 | $48.16–$165.52 | 52% below | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW | $108.66 | $217.32 | $48.16–$137.40 | — | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views | $110.35 | $220.70 | $48.16–$165.52 | — | 50% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS | $95.50 | $191.00 | $58.17–$165.94 | 42% below | 50% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views | $98.85 | $197.70 | $58.17–$168.05 | 40% below | 50% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-RAY EXAM OF PELVIS | $95.50 | $191.00 | $58.17–$165.94 | — | 50% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views | $98.85 | $197.70 | $58.17–$168.05 | — | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE | $101.85 | $203.70 | $48.16–$137.40 | 42% below | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx 2+ Views | $105.40 | $210.80 | $48.16–$137.40 | 40% below | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY EXAM SACRUM TAILBONE | $101.85 | $203.70 | $48.16–$137.40 | — | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx 2+ Views | $105.40 | $210.80 | $48.16–$137.40 | — | 50% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH (Adrenocorticotropic Hormone) | $117.60 | $235.20 | $21.13–$134.79 | 25% above | 50% |
| ACTH blood test inpatient CPT 82024 ACTH (Adrenocorticotropic Hormone) | $117.60 | $235.20 | $21.13–$134.79 | — | 50% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT | $9.90 | $19.80 | $2.90–$14.85 | 59% below | 50% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT | $9.90 | $19.80 | $2.90–$14.85 | — | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST | $9.90 | $19.80 | $2.83–$14.85 | 55% below | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST Fluid | $9.90 | $19.80 | $2.83–$10.06 | 55% below | 50% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST | $9.90 | $19.80 | $2.83–$14.85 | — | 50% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST Fluid | $9.90 | $19.80 | $2.83–$10.06 | — | 50% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel | $160.75 | $321.50 | $26.05–$163.32 | 5% below | 50% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel | $160.75 | $321.50 | $26.05–$163.32 | — | 50% |
| Albumin blood test CPT 82040 Albumin Level | $31.35 | $62.70 | $2.71–$31.85 | 57% above | 50% |
| Albumin blood test inpatient CPT 82040 Albumin Level | $31.35 | $62.70 | $2.71–$31.85 | — | 50% |
| Aldosterone blood test CPT 82088 Aldosterone Lvl | $88.80 | $177.60 | $22.29–$90.22 | 61% above | 50% |
| Aldosterone blood test CPT 82088 Aldosterone | $88.80 | $177.60 | $22.29–$90.22 | 61% above | 50% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone Lvl | $88.80 | $177.60 | $22.29–$90.22 | — | 50% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone | $88.80 | $177.60 | $22.29–$90.22 | — | 50% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY ALKALINE PHOSPHATASE | $28.45 | $56.90 | $2.83–$28.91 | 35% above | 50% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase | $29.45 | $58.90 | $2.83–$29.92 | 40% above | 50% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ASSAY ALKALINE PHOSPHATASE | $28.45 | $56.90 | $2.83–$28.91 | — | 50% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase | $29.45 | $58.90 | $2.83–$29.92 | — | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Potato IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Oyster IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dust Panel | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grape IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Crab IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Carrot IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cabbage IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, C. frutescens IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Blue Mussel IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Beef IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Barley IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Pork IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Beef IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cabbage IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Corn, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Tuna IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Barley IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rice IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Oat IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Tomato IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rye IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Orange IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 White Bean IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 June Grass, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Elm, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Oyster IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Scallop, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Clam, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Lobster IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Blue Mussel IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Crab IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Sesame Seed IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Almond IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Pecan Nut IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Coconut IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, White Bean IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tomato IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Rice IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tuna IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Potato IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Orange IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Oat IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Hazelnut IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Green Pepper IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cocksfoot (Grass), IgE | $14.25 | $28.50 | $2.86–$16.33 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Birch, IgE | $14.25 | $28.50 | $2.86–$16.33 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus fumigatus, IgE | $14.25 | $28.50 | $2.86–$16.33 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Timothy Grass, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Pigweed, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Penicillium Notatum, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Common Ragweed, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Box Elder/Maple, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Bermuda Grass, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Common Ragweed | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Codfish | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cocksfoot (Orchard Grass) | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cockroach | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Clam | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cladosporium Herbarum | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cat Dander | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Chicken IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Almond IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Add-On - Allergen, Insect Panel, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Add-On - GI Distress Pnl, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Insect Panel IgE - Warde | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GI Distress Panel - Warde | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Plantain (English), Ribwort, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rough Marsh Elder, IgE | $14.25 | $28.50 | $2.86–$16.33 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Redtop (Bentgrass), IgE | $14.25 | $28.50 | $2.86–$16.33 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Oak, IgE | $14.25 | $28.50 | $2.86–$16.33 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Shrimp, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Peanut, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Egg White, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Dog Epithelium, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cow's Milk, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Codfish, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cladosporium herbarum, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cat Epithelium, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Alternaria Alternata, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Birch | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pistachio IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Bermuda Grass | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Aspergillus Fumigatus | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Alternaria Alternata | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 House Dust Greer, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D. Pternyssinus, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D. farinae, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cockroach | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Wheat, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Walnut, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Soybean, IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Wheat | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Walnut | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Timothy Grass | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Soybean | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Shrimp | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Scallop | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Rough Marsh Elder | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Redtop (Bentgrass) | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pigweed | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Penicillium Notatum | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Peanut | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Oak | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Maple (Box Elder) | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen June Grass | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen English Plantain, Ribwort | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Elm | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Egg White | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dog Dander | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dermatophagoides Pteronyssinus | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dermatophagoides Farinae | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cow's Milk | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Corn | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pork IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Sesame Seed IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Candida albicans IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Hormodendrum hordei IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Green Pepper IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Carrot IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Chicken IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Grape IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Lettuce IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Candida albicans IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Hormodendrum hordei IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Coconut IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Lettuce IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Lobster IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pecan Nut IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Rye IgE | $14.25 | $28.50 | $2.86–$14.48 | 124% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA | $268.13 | $536.25 | $2.86–$272.42 | 4109% above | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Bean IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Orange IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rye IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Barley IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Codfish, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Corn | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cladosporium herbarum, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tuna IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cat Epithelium, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Oyster IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alternaria Alternata, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pork IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Birch | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Rye IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Bermuda Grass | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Elm, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg White, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rice IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dog Epithelium, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cow's Milk | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cow's Milk, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oyster IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 June Grass, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pistachio IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Sesame Seed IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Corn, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Aspergillus Fumigatus | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Candida albicans IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Alternaria Alternata | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cabbage IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 House Dust Greer, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Hormodendrum hordei IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D. Pternyssinus, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Beef IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D. farinae, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Green Pepper IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cockroach | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pork IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Wheat, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Carrot IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Walnut, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Barley IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Soybean, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Almond IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chicken IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pecan Nut IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Wheat | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Coconut IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Beef IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, White Bean IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Walnut | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tomato IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Grape IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Rice IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Timothy Grass | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tuna IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Blue Mussel IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Potato IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Soybean | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Orange IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lettuce IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Oat IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Shrimp | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Hazelnut IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, C. frutescens IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Green Pepper IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Scallop | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cocksfoot (Grass), IgE | $14.25 | $28.50 | $2.86–$16.33 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Candida albicans IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Birch, IgE | $14.25 | $28.50 | $2.86–$16.33 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Rough Marsh Elder | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus fumigatus, IgE | $14.25 | $28.50 | $2.86–$16.33 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cabbage IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Timothy Grass, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Redtop (Bentgrass) | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pigweed, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hormodendrum hordei IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicillium Notatum, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pigweed | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Common Ragweed, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Carrot IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Box Elder/Maple, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sesame Seed IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Crab IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Blue Mussel IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Penicillium Notatum | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bermuda Grass, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Coconut IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Common Ragweed | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Peanut | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Codfish | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lobster IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Clam, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Crab IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cocksfoot (Orchard Grass) | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Oak | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cockroach | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Lettuce IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Clam | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Scallop, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Maple (Box Elder) | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cladosporium Herbarum | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grape IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cat Dander | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen June Grass | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Chicken IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Lobster IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Almond IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen English Plantain, Ribwort | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Add-On - Allergen, Insect Panel, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dust Panel | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Add-On - GI Distress Pnl, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Elm | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Insect Panel IgE - Warde | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pecan Nut IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GI Distress Panel - Warde | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Egg White | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Plantain (English), Ribwort, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tomato IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rough Marsh Elder, IgE | $14.25 | $28.50 | $2.86–$16.33 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dog Dander | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Redtop (Bentgrass), IgE | $14.25 | $28.50 | $2.86–$16.33 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oat IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oak, IgE | $14.25 | $28.50 | $2.86–$16.33 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dermatophagoides Pteronyssinus | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Shrimp, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Potato IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peanut, IgE | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dermatophagoides Farinae | $14.25 | $28.50 | $2.86–$14.48 | — | 50% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLG SPEC IGE CRUDE XTRC EA | $268.13 | $536.25 | $2.86–$272.42 | — | 50% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Tumor Marker | $53.10 | $106.20 | $9.17–$79.65 | 4% above | 50% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein Tumor Marker | $53.10 | $106.20 | $9.17–$79.65 | — | 50% |
| Ammonia blood test CPT 82140 ASSAY OF AMMONIA | $64.41 | $128.81 | $7.97–$65.44 | 1% below | 50% |
| Ammonia blood test CPT 82140 Ammonia Arterial | $68.60 | $137.20 | $7.97–$69.70 | 6% above | 50% |
| Ammonia blood test CPT 82140 Ammonia Venous | $68.60 | $137.20 | $7.97–$86.81 | 6% above | 50% |
| Ammonia blood test inpatient CPT 82140 ASSAY OF AMMONIA | $64.41 | $128.81 | $7.97–$65.44 | — | 50% |
| Ammonia blood test inpatient CPT 82140 Ammonia Arterial | $68.60 | $137.20 | $7.97–$69.70 | — | 50% |
| Ammonia blood test inpatient CPT 82140 Ammonia Venous | $68.60 | $137.20 | $7.97–$86.81 | — | 50% |
| Amylase blood test CPT 82150 Amylase Urine | $37.35 | $74.70 | $3.54–$37.95 | 86% above | 50% |
| Amylase blood test CPT 82150 Amylase Level | $37.35 | $74.70 | $3.54–$56.03 | 86% above | 50% |
| Amylase blood test CPT 82150 Amylase 24 Hr Urine | $37.35 | $74.70 | $3.54–$37.95 | 86% above | 50% |
| Amylase blood test CPT 82150 Amylase Fluid | $37.35 | $74.70 | $3.54–$37.95 | 86% above | 50% |
| Amylase blood test inpatient CPT 82150 Amylase Level | $37.35 | $74.70 | $3.54–$56.03 | — | 50% |
| Amylase blood test inpatient CPT 82150 Amylase Urine | $37.35 | $74.70 | $3.54–$37.95 | — | 50% |
| Amylase blood test inpatient CPT 82150 Amylase Fluid | $37.35 | $74.70 | $3.54–$37.95 | — | 50% |
| Amylase blood test inpatient CPT 82150 Amylase 24 Hr Urine | $37.35 | $74.70 | $3.54–$37.95 | — | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Pep IgG | $57.00 | $114.00 | $7.08–$85.50 | 2% above | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Pep IgG | $57.00 | $114.00 | $7.08–$85.50 | — | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES | $55.90 | $111.80 | $6.61–$56.79 | at median | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody | $57.85 | $115.70 | $6.61–$86.78 | 3% above | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Screen w Cascade reflex | $57.85 | $115.70 | $6.61–$73.20 | 3% above | 50% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES | $55.90 | $111.80 | $6.61–$56.79 | — | 50% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibody | $57.85 | $115.70 | $6.61–$86.78 | — | 50% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Screen w Cascade reflex | $57.85 | $115.70 | $6.61–$73.20 | — | 50% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE | $86.15 | $172.30 | $21.48–$87.53 | 11% above | 50% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-proBNP | $89.15 | $178.30 | $21.48–$133.73 | 15% above | 50% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ASSAY OF NATRIURETIC PEPTIDE | $86.15 | $172.30 | $21.48–$87.53 | — | 50% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-proBNP | $89.15 | $178.30 | $21.48–$133.73 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cerebrospinal Fluid Culture with Gram Stain | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Legionella Culture | $44.55 | $89.10 | $4.72–$66.82 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Ear Culture with Gram Stain | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Environmental Culture | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bronchoscopy Culture with Gram Stain | $44.55 | $89.10 | $4.72–$66.82 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture with Gram Stain | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Body Fluid Aerobic with Gram Stain | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Eye Culture with Gram Stain | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Foreign Object Culture | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasal Culture | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Tissue Aerobic with Gram Stain | $44.55 | $89.10 | $4.72–$66.82 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Environmental Water | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Catheter Tip Culture | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Environmental Culture Spore | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Oral Culture | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Aerobic with Gram Stain | $44.55 | $89.10 | $4.72–$66.82 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Aerobic, Anaerobic with Gram Stain | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Body Fluid Aerobic, Anaerobic with Gram Stain | $44.55 | $89.10 | $4.72–$45.26 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Tissue Aerobic, Anaerobic with Gram Stain | $44.55 | $89.10 | $4.72–$66.82 | 16% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHR SPECIMN AEROBIC | $50.18 | $100.35 | $4.72–$50.98 | 5% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Tissue Aerobic with Gram Stain | $44.55 | $89.10 | $4.72–$66.82 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Aerobic, Anaerobic with Gram Stain | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nasal Culture | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Cerebrospinal Fluid Culture with Gram Stain | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Environmental Water | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture with Gram Stain | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Catheter Tip Culture | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bronchoscopy Culture with Gram Stain | $44.55 | $89.10 | $4.72–$66.82 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Environmental Culture | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Foreign Object Culture | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Eye Culture with Gram Stain | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Ear Culture with Gram Stain | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Aerobic with Gram Stain | $44.55 | $89.10 | $4.72–$66.82 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Body Fluid Aerobic, Anaerobic with Gram Stain | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Body Fluid Aerobic with Gram Stain | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Oral Culture | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Tissue Aerobic, Anaerobic with Gram Stain | $44.55 | $89.10 | $4.72–$66.82 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Legionella Culture | $44.55 | $89.10 | $4.72–$66.82 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Environmental Culture Spore | $44.55 | $89.10 | $4.72–$45.26 | — | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE OTHR SPECIMN AEROBIC | $50.18 | $100.35 | $4.72–$50.98 | — | 50% |
| Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL TOTAL CA | $50.34 | $100.68 | $4.63–$51.15 | at median | 50% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $51.75 | $103.50 | $4.63–$77.63 | 3% above | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 METABOLIC PANEL TOTAL CA | $50.34 | $100.68 | $4.63–$51.15 | — | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $51.75 | $103.50 | $4.63–$77.63 | — | 50% |
| Bilirubin blood test, total CPT 82247 Bilirubin Level Fluid | $9.90 | $19.80 | $2.75–$10.06 | 56% below | 50% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total | $9.90 | $19.80 | $2.75–$14.85 | 56% below | 50% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total | $9.90 | $19.80 | $2.75–$14.85 | — | 50% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Level Fluid | $9.90 | $19.80 | $2.75–$10.06 | — | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 Gross Micro Level 4 | $92.30 | $184.60 | $29.23–$138.45 | 15% below | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST | $273.97 | $547.93 | $29.23–$278.35 | 151% above | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 G0416 Prostate Bx Path Any Method | $458.40 | $916.80 | $29.23–$525.42 | 320% above | 50% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 Gross Micro Level 4 | $92.30 | $184.60 | $29.23–$138.45 | — | 50% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM BY PATHOLOGIST | $273.97 | $547.93 | $29.23–$278.35 | — | 50% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 G0416 Prostate Bx Path Any Method | $458.40 | $916.80 | $29.23–$525.42 | — | 50% |
| Blood culture for bacteria CPT 87040 Bone Marrow Culture | $45.25 | $90.50 | $5.65–$45.97 | 28% below | 50% |
| Blood culture for bacteria CPT 87040 Blood Culture | $45.25 | $90.50 | $5.65–$67.88 | 28% below | 50% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA | $61.76 | $123.51 | $5.65–$62.74 | 2% below | 50% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture | $45.25 | $90.50 | $5.65–$67.88 | — | 50% |
| Blood culture for bacteria inpatient CPT 87040 Bone Marrow Culture | $45.25 | $90.50 | $5.65–$45.97 | — | 50% |
| Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE FOR BACTERIA | $61.76 | $123.51 | $5.65–$62.74 | — | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Collection Method -> Venous | $5.93 | $11.86 | $4.97–$14.18 | 54% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 AMB Blood Collection Method -> Venous | $5.93 | $11.86 | $4.97–$14.18 | 54% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection of venous blood by venipuncture 36415 ONC | $5.93 | $11.86 | $4.97–$14.18 | 54% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw | $5.95 | $11.90 | $3.72–$14.18 | 54% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE | $105.90 | $211.80 | $4.97–$107.59 | 722% above | 50% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collection of venous blood by venipuncture 36415 ONC | $5.93 | $11.86 | $4.97–$14.18 | — | 50% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood Collection Method -> Venous | $5.93 | $11.86 | $4.97–$14.18 | — | 50% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 AMB Blood Collection Method -> Venous | $5.93 | $11.86 | $4.97–$14.18 | — | 50% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw | $5.95 | $11.90 | $3.72–$14.18 | — | 50% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE | $105.90 | $211.80 | $4.97–$107.59 | — | 50% |
| Blood glucose (sugar) test CPT 82947 Glucose POC | $9.65 | $19.30 | $2.15–$9.80 | 60% below | 50% |
| Blood glucose (sugar) test CPT 82947 Glucose Fasting | $9.65 | $19.30 | $2.15–$9.80 | 60% below | 50% |
| Blood glucose (sugar) test CPT 82947 Glucose Level | $9.65 | $19.30 | $2.15–$11.06 | 60% below | 50% |
| Blood glucose (sugar) test CPT 82947 .Glucose, POC | $9.65 | $19.30 | $2.15–$14.48 | 60% below | 50% |
| Blood glucose (sugar) test CPT 82947 .Glucose, Arterial POC | $9.65 | $19.30 | $2.15–$9.80 | 60% below | 50% |
| Blood glucose (sugar) test CPT 82947 Whole Blood Glucose POC | $9.65 | $19.30 | $2.15–$9.80 | 60% below | 50% |
| Blood glucose (sugar) test CPT 82947 Glucose Level, 2 Hr PP | $9.65 | $19.30 | $2.15–$9.80 | 60% below | 50% |
| Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT | $26.45 | $52.90 | $2.15–$26.87 | 10% above | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose POC | $9.65 | $19.30 | $2.15–$9.80 | — | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 Whole Blood Glucose POC | $9.65 | $19.30 | $2.15–$9.80 | — | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Level, 2 Hr PP | $9.65 | $19.30 | $2.15–$9.80 | — | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 .Glucose, Arterial POC | $9.65 | $19.30 | $2.15–$9.80 | — | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Fasting | $9.65 | $19.30 | $2.15–$9.80 | — | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Level | $9.65 | $19.30 | $2.15–$11.06 | — | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 .Glucose, POC | $9.65 | $19.30 | $2.15–$14.48 | — | 50% |
| Blood glucose (sugar) test inpatient CPT 82947 ASSAY GLUCOSE BLOOD QUANT | $26.45 | $52.90 | $2.15–$26.87 | — | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG Qualitative Serum | $25.25 | $50.50 | $4.11–$37.88 | 32% below | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY | $55.55 | $111.10 | $4.11–$56.44 | 50% above | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG Qualitative Serum | $25.25 | $50.50 | $4.11–$37.88 | — | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CHORIONIC GONADOTROPIN ASSAY | $55.55 | $111.10 | $4.11–$56.44 | — | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABORh | $16.65 | $33.30 | $1.64–$16.92 | 21% below | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABORh | $16.65 | $33.30 | $1.64–$24.97 | 21% below | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Neonate ABORh | $16.65 | $33.30 | $1.64–$16.92 | 21% below | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABORh | $16.65 | $33.30 | $1.64–$16.92 | — | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Neonate ABORh | $16.65 | $33.30 | $1.64–$16.92 | — | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABORh | $16.65 | $33.30 | $1.64–$24.97 | — | 50% |
| Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen | $9.55 | $19.10 | $2.16–$14.33 | 46% below | 50% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen | $9.55 | $19.10 | $2.16–$14.33 | — | 50% |
| C-peptide blood test CPT 84681 C-Peptide | $73.85 | $147.70 | $11.38–$84.65 | 5% above | 50% |
| C-peptide blood test inpatient CPT 84681 C-Peptide | $73.85 | $147.70 | $11.38–$84.65 | — | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein | $25.25 | $50.50 | $2.83–$37.88 | 26% below | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein | $25.25 | $50.50 | $2.83–$37.88 | — | 50% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE | $91.25 | $182.50 | $20.39–$92.71 | 21% below | 50% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium Difficile PCR | $94.45 | $188.90 | $20.39–$95.96 | 19% below | 50% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE | $91.25 | $182.50 | $20.39–$92.71 | — | 50% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium Difficile PCR | $94.45 | $188.90 | $20.39–$95.96 | — | 50% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19 9 | $57.75 | $115.50 | $11.38–$66.19 | 38% below | 50% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19 9 | $57.75 | $115.50 | $11.38–$66.19 | — | 50% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125 | $53.85 | $107.70 | $11.38–$54.71 | 47% below | 50% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA125 | $55.75 | $111.50 | $11.38–$63.90 | 45% below | 50% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY TUMOR CA 125 | $53.85 | $107.70 | $11.38–$54.71 | — | 50% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA125 | $55.75 | $111.50 | $11.38–$63.90 | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB | $35.91 | $71.82 | $28.07–$161.56 | 66% below | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Rapid Covid POC | $87.90 | $175.80 | $28.07–$161.56 | 17% below | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS CoV-2 (COVID19) by PCR - Cepheid | $87.90 | $175.80 | $28.07–$161.56 | 17% below | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Coronavirus SARS CoV-2 by PCR - Roche | $87.90 | $175.80 | $28.07–$161.56 | 17% below | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB | $35.91 | $71.82 | $28.07–$161.56 | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS CoV-2 (COVID19) by PCR - Cepheid | $87.90 | $175.80 | $28.07–$161.56 | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Coronavirus SARS CoV-2 by PCR - Roche | $87.90 | $175.80 | $28.07–$161.56 | — | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Rapid Covid POC | $87.90 | $175.80 | $28.07–$161.56 | — | 50% |
| Calcium blood test, total CPT 82310 ASSAY OF CALCIUM | $8.90 | $17.80 | $2.82–$9.04 | 56% below | 50% |
| Calcium blood test, total CPT 82310 Calcium Level Total | $9.20 | $18.40 | $2.82–$13.80 | 54% below | 50% |
| Calcium blood test, total inpatient CPT 82310 ASSAY OF CALCIUM | $8.90 | $17.80 | $2.82–$9.04 | — | 50% |
| Calcium blood test, total inpatient CPT 82310 Calcium Level Total | $9.20 | $18.40 | $2.82–$13.80 | — | 50% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA Fluid | $53.10 | $106.20 | $10.37–$53.95 | 36% below | 50% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen | $53.10 | $106.20 | $10.37–$60.86 | 36% below | 50% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA Fluid | $53.10 | $106.20 | $10.37–$53.95 | — | 50% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen | $53.10 | $106.20 | $10.37–$60.86 | — | 50% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY | $34.55 | $69.10 | $7.05–$35.10 | 14% below | 50% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster IgG | $35.75 | $71.50 | $7.05–$40.98 | 11% below | 50% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER ANTIBODY | $34.55 | $69.10 | $7.05–$35.10 | — | 50% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster IgG | $35.75 | $71.50 | $7.05–$40.98 | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH DNA AMP PROBE | $45.47 | $90.94 | $19.19–$60.75 | 39% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia by PCR | $45.80 | $91.60 | $19.19–$60.75 | 38% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia PCR | $45.80 | $91.60 | $19.19–$68.70 | 38% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACH DNA AMP PROBE | $45.47 | $90.94 | $19.19–$60.75 | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia by PCR | $45.80 | $91.60 | $19.19–$60.75 | — | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia PCR | $45.80 | $91.60 | $19.19–$68.70 | — | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $44.42 | $88.83 | $7.32–$45.13 | 13% below | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel Calculated | $45.65 | $91.30 | $7.32–$68.48 | 10% below | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $44.42 | $88.83 | $7.32–$45.13 | — | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel Calculated | $45.65 | $91.30 | $7.32–$68.48 | — | 50% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC | $25.72 | $51.44 | $4.25–$50.00 | 36% below | 50% |
| Complete blood count (CBC) with differential CPT 85025 CBC w/ Diff POC | $26.30 | $52.60 | $4.25–$50.00 | 35% below | 50% |
| Complete blood count (CBC) with differential CPT 85025 CBC w Differential | $26.30 | $52.60 | $4.25–$50.00 | 35% below | 50% |
| Complete blood count (CBC) with differential CPT 85025 CBC W Differential WBC Count POC 85025 Downtime | $26.30 | $52.60 | $4.25–$50.00 | 35% below | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC | $25.72 | $51.44 | $4.25–$50.00 | — | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W Differential WBC Count POC 85025 Downtime | $26.30 | $52.60 | $4.25–$50.00 | — | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC w Differential | $26.30 | $52.60 | $4.25–$50.00 | — | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Diff POC | $26.30 | $52.60 | $4.25–$50.00 | — | 50% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED | $20.70 | $41.40 | $3.54–$45.00 | 29% below | 50% |
| Complete blood count (CBC), no differential CPT 85027 White Blood Cell | $21.40 | $42.80 | $3.54–$45.00 | 26% below | 50% |
| Complete blood count (CBC), no differential CPT 85027 CBC No Diff (Hemogram) | $21.40 | $42.80 | $3.54–$45.00 | 26% below | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE CBC AUTOMATED | $20.70 | $41.40 | $3.54–$45.00 | — | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC No Diff (Hemogram) | $21.40 | $42.80 | $3.54–$45.00 | — | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 White Blood Cell | $21.40 | $42.80 | $3.54–$45.00 | — | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL | $86.26 | $172.51 | $5.78–$87.64 | 15% above | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $87.00 | $174.00 | $5.78–$130.50 | 16% above | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHEN METABOLIC PANEL | $86.26 | $172.51 | $5.78–$87.64 | — | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $87.00 | $174.00 | $5.78–$130.50 | — | 50% |
| Cortisol blood test, total CPT 82533 TOTAL CORTISOL | $50.60 | $101.20 | $8.92–$51.41 | 49% above | 50% |
| Cortisol blood test, total CPT 82533 Cortisol | $52.35 | $104.70 | $8.92–$60.00 | 54% above | 50% |
| Cortisol blood test, total CPT 82533 Cortisol AM | $52.35 | $104.70 | $8.92–$60.00 | 54% above | 50% |
| Cortisol blood test, total CPT 82533 Cortisol Baseline | $52.35 | $104.70 | $8.92–$53.19 | 54% above | 50% |
| Cortisol blood test, total CPT 82533 Cortisol Stim 30 minute | $52.35 | $104.70 | $8.92–$53.19 | 54% above | 50% |
| Cortisol blood test, total CPT 82533 Cortisol Stim 60 minute | $52.35 | $104.70 | $8.92–$53.19 | 54% above | 50% |
| Cortisol blood test, total CPT 82533 Cortisol PM | $52.35 | $104.70 | $8.92–$53.19 | 54% above | 50% |
| Cortisol blood test, total inpatient CPT 82533 TOTAL CORTISOL | $50.60 | $101.20 | $8.92–$51.41 | — | 50% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol Baseline | $52.35 | $104.70 | $8.92–$53.19 | — | 50% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol PM | $52.35 | $104.70 | $8.92–$53.19 | — | 50% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol AM | $52.35 | $104.70 | $8.92–$60.00 | — | 50% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol | $52.35 | $104.70 | $8.92–$60.00 | — | 50% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol Stim 60 minute | $52.35 | $104.70 | $8.92–$53.19 | — | 50% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol Stim 30 minute | $52.35 | $104.70 | $8.92–$53.19 | — | 50% |
| Creatine kinase (CK) blood test, total CPT 82550 ASSAY OF CK (CPK) | $33.20 | $66.40 | $3.56–$33.73 | 11% above | 50% |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase | $34.35 | $68.70 | $3.56–$51.53 | 14% above | 50% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 ASSAY OF CK (CPK) | $33.20 | $66.40 | $3.56–$33.73 | — | 50% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase | $34.35 | $68.70 | $3.56–$51.53 | — | 50% |
| Creatinine blood test CPT 82565 Fractional Excretion of Sodium | $9.90 | $19.80 | $2.80–$10.06 | 58% below | 50% |
| Creatinine blood test CPT 82565 Creatinine Lvl | $9.90 | $19.80 | $2.80–$14.85 | 58% below | 50% |
| Creatinine blood test CPT 82565 Creatinine | $9.90 | $19.80 | $2.80–$14.85 | 58% below | 50% |
| Creatinine blood test CPT 82565 .Creatinine POC | $9.90 | $19.80 | $2.80–$10.06 | 58% below | 50% |
| Creatinine blood test CPT 82565 ASSAY OF CREATININE | $23.92 | $47.83 | $2.80–$24.30 | at median | 50% |
| Creatinine blood test inpatient CPT 82565 Creatinine | $9.90 | $19.80 | $2.80–$14.85 | — | 50% |
| Creatinine blood test inpatient CPT 82565 Fractional Excretion of Sodium | $9.90 | $19.80 | $2.80–$10.06 | — | 50% |
| Creatinine blood test inpatient CPT 82565 .Creatinine POC | $9.90 | $19.80 | $2.80–$10.06 | — | 50% |
| Creatinine blood test inpatient CPT 82565 Creatinine Lvl | $9.90 | $19.80 | $2.80–$14.85 | — | 50% |
| Creatinine blood test inpatient CPT 82565 ASSAY OF CREATININE | $23.92 | $47.83 | $2.80–$24.30 | — | 50% |
| Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus IgG | $38.15 | $76.30 | $7.87–$38.76 | 12% below | 50% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus IgG | $38.15 | $76.30 | $7.87–$38.76 | — | 50% |
| D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT | $36.10 | $72.20 | $5.57–$36.68 | 16% below | 50% |
| D-dimer blood test (blood clot marker) CPT 85379 D Dimer Quantitative | $37.35 | $74.70 | $5.57–$56.03 | 13% below | 50% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION QUANT | $36.10 | $72.20 | $5.57–$36.68 | — | 50% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer Quantitative | $37.35 | $74.70 | $5.57–$56.03 | — | 50% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA Sulfate Serum | $83.25 | $166.50 | $12.16–$95.42 | 29% above | 50% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA Sulfate Serum | $83.25 | $166.50 | $12.16–$95.42 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR | $50.72 | $101.44 | $30.00–$107.58 | 13% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Cocaine Urine | $75.95 | $151.90 | $30.00–$107.58 | 30% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Methadone Urine | $75.95 | $151.90 | $30.00–$107.58 | 30% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Barbiturates Urine | $75.95 | $151.90 | $30.00–$107.58 | 30% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Cannabinoid Urine | $75.95 | $151.90 | $30.00–$107.58 | 30% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Opiates Urine | $75.95 | $151.90 | $30.00–$107.58 | 30% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Amphetamines Urine | $75.95 | $151.90 | $30.00–$107.58 | 30% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Benzodiazepine Urine | $75.95 | $151.90 | $30.00–$107.58 | 30% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Oxycodone/Oxymorphone Scrn w/Rflx, Urine | $75.95 | $151.90 | $30.00–$107.58 | 30% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 PCP Urine | $75.95 | $151.90 | $30.00–$107.58 | 30% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Propoxyphene Urine | $75.95 | $151.90 | $30.00–$107.58 | 30% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 10 Urine | $75.95 | $151.90 | $30.00–$107.58 | 30% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 7 Urine | $75.95 | $151.90 | $30.00–$115.15 | 30% above | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR | $50.72 | $101.44 | $30.00–$107.58 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Benzodiazepine Urine | $75.95 | $151.90 | $30.00–$107.58 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Oxycodone/Oxymorphone Scrn w/Rflx, Urine | $75.95 | $151.90 | $30.00–$107.58 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Methadone Urine | $75.95 | $151.90 | $30.00–$107.58 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cocaine Urine | $75.95 | $151.90 | $30.00–$107.58 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 10 Urine | $75.95 | $151.90 | $30.00–$107.58 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Barbiturates Urine | $75.95 | $151.90 | $30.00–$107.58 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Amphetamines Urine | $75.95 | $151.90 | $30.00–$107.58 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 7 Urine | $75.95 | $151.90 | $30.00–$115.15 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Opiates Urine | $75.95 | $151.90 | $30.00–$107.58 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PCP Urine | $75.95 | $151.90 | $30.00–$107.58 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cannabinoid Urine | $75.95 | $151.90 | $30.00–$107.58 | — | 50% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Propoxyphene Urine | $75.95 | $151.90 | $30.00–$107.58 | — | 50% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel | $25.10 | $50.20 | $3.83–$50.00 | 22% below | 50% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel | $25.10 | $50.20 | $3.83–$50.00 | — | 50% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EB VCA IgG Unit | $42.70 | $85.40 | $9.92–$64.05 | 33% below | 50% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr VCA IgM | $42.70 | $85.40 | $9.92–$43.38 | 33% below | 50% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr VCA IgG | $42.70 | $85.40 | $9.92–$43.38 | 33% below | 50% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr VCA IgG | $42.70 | $85.40 | $9.92–$43.38 | — | 50% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EB VCA IgG Unit | $42.70 | $85.40 | $9.92–$64.05 | — | 50% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr VCA IgM | $42.70 | $85.40 | $9.92–$43.38 | — | 50% |
| Estradiol blood test CPT 82670 ASSAY OF ESTRADIOL | $86.30 | $172.60 | $15.28–$87.68 | 10% above | 50% |
| Estradiol blood test CPT 82670 Estradiol Level | $89.30 | $178.60 | $15.28–$133.95 | 14% above | 50% |
| Estradiol blood test inpatient CPT 82670 ASSAY OF ESTRADIOL | $86.30 | $172.60 | $15.28–$87.68 | — | 50% |
| Estradiol blood test inpatient CPT 82670 Estradiol Level | $89.30 | $178.60 | $15.28–$133.95 | — | 50% |
| FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH) | $79.05 | $158.10 | $10.16–$80.31 | 1% below | 50% |
| FSH (follicle-stimulating hormone) test CPT 83001 Follicular Stimulating Hormone Level | $81.80 | $163.60 | $10.16–$122.70 | 3% above | 50% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 ASSAY OF GONADOTROPIN (FSH) | $79.05 | $158.10 | $10.16–$80.31 | — | 50% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicular Stimulating Hormone Level | $81.80 | $163.60 | $10.16–$122.70 | — | 50% |
| Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL | $51.52 | $103.04 | $10.74–$52.34 | 19% below | 50% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal | $81.55 | $163.10 | $10.74–$122.32 | 29% above | 50% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL | $51.52 | $103.04 | $10.74–$52.34 | — | 50% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal | $81.55 | $163.10 | $10.74–$122.32 | — | 50% |
| Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN | $64.00 | $128.00 | $7.46–$65.02 | 7% above | 50% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $66.25 | $132.50 | $7.46–$99.38 | 10% above | 50% |
| Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN | $64.00 | $128.00 | $7.46–$65.02 | — | 50% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin | $66.25 | $132.50 | $7.46–$99.38 | — | 50% |
| Fibrinogen blood test CPT 85384 Fibrinogen Level | $27.25 | $54.50 | $5.32–$27.69 | 6% below | 50% |
| Fibrinogen blood test CPT 85384 Add-On - Fibrogen (factor 1) activity measurement | $27.25 | $54.50 | $5.32–$27.69 | 6% below | 50% |
| Fibrinogen blood test inpatient CPT 85384 Add-On - Fibrogen (factor 1) activity measurement | $27.25 | $54.50 | $5.32–$27.69 | — | 50% |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen Level | $27.25 | $54.50 | $5.32–$27.69 | — | 50% |
| Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM | $53.90 | $107.80 | $8.04–$54.76 | 27% below | 50% |
| Folate (folic acid) blood test CPT 82746 Folate Level | $55.80 | $111.60 | $8.04–$83.70 | 24% below | 50% |
| Folate (folic acid) blood test inpatient CPT 82746 ASSAY OF FOLIC ACID SERUM | $53.90 | $107.80 | $8.04–$54.76 | — | 50% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Level | $55.80 | $111.60 | $8.04–$83.70 | — | 50% |
| Free T3 thyroid hormone test CPT 84481 T3 Free Level | $64.90 | $129.80 | $9.27–$82.12 | 3% below | 50% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 Free Level | $64.90 | $129.80 | $9.27–$82.12 | — | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE | $51.30 | $102.60 | $4.93–$52.12 | 68% above | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Free Level | $53.10 | $106.20 | $4.93–$79.65 | 74% above | 50% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE | $51.30 | $102.60 | $4.93–$52.12 | — | 50% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 Free Level | $53.10 | $106.20 | $4.93–$79.65 | — | 50% |
| Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE | $61.10 | $122.20 | $13.93–$62.08 | 67% above | 50% |
| Free testosterone test CPT 84402 Testosterone, Free - Warde | $63.25 | $126.50 | $13.93–$64.26 | 72% above | 50% |
| Free testosterone test inpatient CPT 84402 ASSAY OF FREE TESTOSTERONE | $61.10 | $122.20 | $13.93–$62.08 | — | 50% |
| Free testosterone test inpatient CPT 84402 Testosterone, Free - Warde | $63.25 | $126.50 | $13.93–$64.26 | — | 50% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase | $16.75 | $33.50 | $3.94–$19.20 | 45% below | 50% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase | $16.75 | $33.50 | $3.94–$19.20 | — | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST | $21.60 | $43.20 | $2.60–$21.95 | at median | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Gestational Screen (1 Hour) OB | $22.35 | $44.70 | $2.60–$22.71 | 3% above | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TEST | $21.60 | $43.20 | $2.60–$21.95 | — | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Gestational Screen (1 Hour) OB | $22.35 | $44.70 | $2.60–$22.71 | — | 50% |
| Glucose tolerance test, 3 samples CPT 82951 .GTT Glucose Tolerance 2 Hr OB | $45.25 | $90.50 | $7.04–$45.97 | 21% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 GTT Glucose Tolerance 2 Hr | $45.25 | $90.50 | $7.04–$45.97 | 21% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 .GTT Glucose Tolerance 90 Min OB | $45.25 | $90.50 | $7.04–$45.97 | 21% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 .GTT Glucose Tolerance 30 Min OB | $45.25 | $90.50 | $7.04–$45.97 | 21% below | 50% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GTT Glucose Tolerance 2 Hr | $45.25 | $90.50 | $7.04–$45.97 | — | 50% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT Glucose Tolerance 30 Min OB | $45.25 | $90.50 | $7.04–$45.97 | — | 50% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT Glucose Tolerance 90 Min OB | $45.25 | $90.50 | $7.04–$45.97 | — | 50% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT Glucose Tolerance 2 Hr OB | $45.25 | $90.50 | $7.04–$45.97 | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC DNA, PCR | $55.80 | $111.60 | $19.19–$83.70 | 42% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC by PCR | $55.80 | $111.60 | $19.19–$60.75 | 42% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB | $68.65 | $137.30 | $19.19–$69.75 | 29% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC by PCR | $55.80 | $111.60 | $19.19–$60.75 | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC DNA, PCR | $55.80 | $111.60 | $19.19–$83.70 | — | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE DNA AMP PROB | $68.65 | $137.30 | $19.19–$69.75 | — | 50% |
| H. pylori stool antigen test CPT 87338 HPYLORI STOOL IA | $60.80 | $121.60 | $7.87–$61.77 | 4% below | 50% |
| H. pylori stool antigen test inpatient CPT 87338 HPYLORI STOOL IA | $60.80 | $121.60 | $7.87–$61.77 | — | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 EH HIV-1 RNA, Quantitative HCW | $236.15 | $472.30 | $46.55–$239.93 | 29% above | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV1QnRNA | $236.15 | $472.30 | $46.55–$239.93 | 29% above | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA, Quantitative | $236.15 | $472.30 | $46.55–$239.93 | 29% above | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ | $387.45 | $774.90 | $46.55–$393.65 | 112% above | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV1QnRNA | $236.15 | $472.30 | $46.55–$239.93 | — | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA, Quantitative | $236.15 | $472.30 | $46.55–$239.93 | — | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 EH HIV-1 RNA, Quantitative HCW | $236.15 | $472.30 | $46.55–$239.93 | — | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ | $387.45 | $774.90 | $46.55–$393.65 | — | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Rapid Ab I/II - p24 Ag Qual | $49.05 | $98.10 | $13.17–$50.00 | at median | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv I/II Ab. P24 Ag With Reflex | $49.05 | $98.10 | $13.17–$50.00 | at median | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Rapid Ab I/II - p24 Ag Qual | $49.05 | $98.10 | $13.17–$50.00 | — | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv I/II Ab. P24 Ag With Reflex | $49.05 | $98.10 | $13.17–$50.00 | — | 50% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV High Risk | $63.80 | $127.60 | $19.19–$95.70 | 14% below | 50% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV High Risk | $63.80 | $127.60 | $19.19–$95.70 | — | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HEMOGLOBIN TEST | $34.62 | $69.23 | $5.31–$35.17 | 11% below | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c POC Amb | $35.50 | $71.00 | $5.31–$36.07 | 9% below | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c (Glycosylated) | $35.50 | $71.00 | $5.31–$53.25 | 9% below | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HEMOGLOBIN TEST | $34.62 | $69.23 | $5.31–$35.17 | — | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c (Glycosylated) | $35.50 | $71.00 | $5.31–$53.25 | — | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c POC Amb | $35.50 | $71.00 | $5.31–$36.07 | — | 50% |
| Hemoglobin blood test CPT 85018 Hemoglobin POC | $11.90 | $23.80 | $1.30–$12.09 | 26% below | 50% |
| Hemoglobin blood test CPT 85018 Total Hgb | $11.90 | $23.80 | $1.30–$12.09 | 26% below | 50% |
| Hemoglobin blood test CPT 85018 Hemoglobin | $11.90 | $23.80 | $1.30–$13.64 | 26% below | 50% |
| Hemoglobin blood test CPT 85018 .Hemoglobin Total (POC) | $11.90 | $23.80 | $1.30–$12.09 | 26% below | 50% |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin POC | $11.90 | $23.80 | $1.30–$12.09 | — | 50% |
| Hemoglobin blood test inpatient CPT 85018 .Hemoglobin Total (POC) | $11.90 | $23.80 | $1.30–$12.09 | — | 50% |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin | $11.90 | $23.80 | $1.30–$13.64 | — | 50% |
| Hemoglobin blood test inpatient CPT 85018 Total Hgb | $11.90 | $23.80 | $1.30–$12.09 | — | 50% |
| Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Total (IgM and IgG) | $31.50 | $63.00 | $6.59–$47.25 | 29% below | 50% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Total (IgM and IgG) | $31.50 | $63.00 | $6.59–$47.25 | — | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY | $43.70 | $87.40 | $5.87–$44.40 | 4% above | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody | $45.25 | $90.50 | $5.87–$67.88 | 8% above | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 EH Hepatitis B Surface Antibody HCW | $45.25 | $90.50 | $5.87–$45.97 | 8% above | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY | $43.70 | $87.40 | $5.87–$44.40 | — | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 EH Hepatitis B Surface Antibody HCW | $45.25 | $90.50 | $5.87–$45.97 | — | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody | $45.25 | $90.50 | $5.87–$67.88 | — | 50% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen | $45.25 | $90.50 | $5.65–$67.88 | 2% below | 50% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 EH Hepatitis B Surface Antigen HCW | $45.25 | $90.50 | $5.65–$45.97 | 2% below | 50% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen | $45.25 | $90.50 | $5.65–$67.88 | — | 50% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 EH Hepatitis B Surface Antigen HCW | $45.25 | $90.50 | $5.65–$45.97 | — | 50% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody | $55.05 | $110.10 | $7.81–$82.57 | 15% above | 50% |
| Hepatitis C antibody blood test (screening) CPT 86803 EH Hepatitis C Antibody HCW | $55.05 | $110.10 | $7.81–$55.93 | 15% above | 50% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 EH Hepatitis C Antibody HCW | $55.05 | $110.10 | $7.81–$55.93 | — | 50% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody | $55.05 | $110.10 | $7.81–$82.57 | — | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ | $144.74 | $289.47 | $23.43–$147.05 | 10% above | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C RNA Qn Viral Load | $151.05 | $302.10 | $23.43–$226.58 | 15% above | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 EH Hepatitis C RNA Qn Viral Load HCW | $151.05 | $302.10 | $23.43–$153.47 | 15% above | 50% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REVRS TRNSCRPJ | $144.74 | $289.47 | $23.43–$147.05 | — | 50% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C RNA Qn Viral Load | $151.05 | $302.10 | $23.43–$226.58 | — | 50% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 EH Hepatitis C RNA Qn Viral Load HCW | $151.05 | $302.10 | $23.43–$153.47 | — | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex 1 IgG | $37.10 | $74.20 | $7.21–$37.69 | 11% below | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex 1 2 IgG | $37.10 | $74.20 | $7.21–$37.69 | 11% below | 50% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex 1 2 IgG | $37.10 | $74.20 | $7.21–$37.69 | — | 50% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex 1 IgG | $37.10 | $74.20 | $7.21–$37.69 | — | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST | $23.20 | $46.40 | $10.58–$33.49 | 55% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex 2 IgG | $24.00 | $48.00 | $10.58–$33.49 | 53% below | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 TEST | $23.20 | $46.40 | $10.58–$33.49 | — | 50% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex 2 IgG | $24.00 | $48.00 | $10.58–$33.49 | — | 50% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein High Sensitivity (CV Risk) | $53.10 | $106.20 | $7.08–$67.19 | 8% below | 50% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein High Sensitivity (CV Risk) | $53.10 | $106.20 | $7.08–$67.19 | — | 50% |
| Homocysteine blood test CPT 83090 Homocysteine Level | $66.25 | $132.50 | $9.80–$99.38 | 14% below | 50% |
| Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTINE | $157.04 | $314.08 | $9.80–$159.55 | 105% above | 50% |
| Homocysteine blood test inpatient CPT 83090 Homocysteine Level | $66.25 | $132.50 | $9.80–$99.38 | — | 50% |
| Homocysteine blood test inpatient CPT 83090 ASSAY OF HOMOCYSTINE | $157.04 | $314.08 | $9.80–$159.55 | — | 50% |
| Insulin blood test CPT 83525 Insulin Level Total | $57.00 | $114.00 | $6.25–$65.33 | 56% above | 50% |
| Insulin blood test CPT 83525 .INSTT Insulin Tolerance 1 Hr | $57.00 | $114.00 | $6.25–$57.91 | 56% above | 50% |
| Insulin blood test CPT 83525 .INSTT Insulin Tolerance 2 Hr | $57.00 | $114.00 | $6.25–$57.91 | 56% above | 50% |
| Insulin blood test CPT 83525 .INSTT Insulin Tolerance 3 Hr | $57.00 | $114.00 | $6.25–$57.91 | 56% above | 50% |
| Insulin blood test CPT 83525 .INSTT Insulin Tolerance 4 Hr | $57.00 | $114.00 | $6.25–$57.91 | 56% above | 50% |
| Insulin blood test CPT 83525 .INSTT Insulin Tolerance 5 Hr | $57.00 | $114.00 | $6.25–$57.91 | 56% above | 50% |
| Insulin blood test CPT 83525 .INSTT Insulin Tolerance Fasting | $57.00 | $114.00 | $6.25–$57.91 | 56% above | 50% |
| Insulin blood test inpatient CPT 83525 .INSTT Insulin Tolerance 1 Hr | $57.00 | $114.00 | $6.25–$57.91 | — | 50% |
| Insulin blood test inpatient CPT 83525 Insulin Level Total | $57.00 | $114.00 | $6.25–$65.33 | — | 50% |
| Insulin blood test inpatient CPT 83525 .INSTT Insulin Tolerance Fasting | $57.00 | $114.00 | $6.25–$57.91 | — | 50% |
| Insulin blood test inpatient CPT 83525 .INSTT Insulin Tolerance 5 Hr | $57.00 | $114.00 | $6.25–$57.91 | — | 50% |
| Insulin blood test inpatient CPT 83525 .INSTT Insulin Tolerance 4 Hr | $57.00 | $114.00 | $6.25–$57.91 | — | 50% |
| Insulin blood test inpatient CPT 83525 .INSTT Insulin Tolerance 3 Hr | $57.00 | $114.00 | $6.25–$57.91 | — | 50% |
| Insulin blood test inpatient CPT 83525 .INSTT Insulin Tolerance 2 Hr | $57.00 | $114.00 | $6.25–$57.91 | — | 50% |
| Iron blood test (serum iron) CPT 83540 Iron Level | $22.35 | $44.70 | $3.54–$25.62 | 24% below | 50% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Level | $22.35 | $44.70 | $3.54–$25.62 | — | 50% |
| Iron-binding capacity (TIBC) test CPT 83550 TIBC | $33.50 | $67.00 | $4.78–$50.25 | 16% below | 50% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC | $33.50 | $67.00 | $4.78–$50.25 | — | 50% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $64.25 | $128.50 | $4.75–$65.28 | 4% above | 50% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $64.25 | $128.50 | $4.75–$65.28 | — | 50% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone | $73.85 | $147.70 | $10.13–$84.65 | 3% below | 50% |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone | $73.85 | $147.70 | $10.13–$84.65 | — | 50% |
| Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID | $24.85 | $49.70 | $6.33–$25.25 | 45% below | 50% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid Venous | $25.70 | $51.40 | $6.33–$38.55 | 43% below | 50% |
| Lactate (lactic acid) blood test CPT 83605 .Lactate Level, POC | $25.70 | $51.40 | $6.33–$26.11 | 43% below | 50% |
| Lactate (lactic acid) blood test CPT 83605 Lactate Level POC | $25.70 | $51.40 | $6.33–$26.11 | 43% below | 50% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid Arterial | $25.70 | $51.40 | $6.33–$26.11 | 43% below | 50% |
| Lactate (lactic acid) blood test inpatient CPT 83605 ASSAY OF LACTIC ACID | $24.85 | $49.70 | $6.33–$25.25 | — | 50% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid Venous | $25.70 | $51.40 | $6.33–$38.55 | — | 50% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactate Level POC | $25.70 | $51.40 | $6.33–$26.11 | — | 50% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid Arterial | $25.70 | $51.40 | $6.33–$26.11 | — | 50% |
| Lactate (lactic acid) blood test inpatient CPT 83605 .Lactate Level, POC | $25.70 | $51.40 | $6.33–$26.11 | — | 50% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase | $19.30 | $38.60 | $3.30–$22.12 | 20% below | 50% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Fluid | $19.30 | $38.60 | $3.30–$19.61 | 20% below | 50% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Fluid | $19.30 | $38.60 | $3.30–$19.61 | — | 50% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase | $19.30 | $38.60 | $3.30–$22.12 | — | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE | $26.30 | $52.60 | $3.77–$26.72 | 13% below | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $27.20 | $54.40 | $3.77–$40.80 | 10% below | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Fluid | $27.20 | $54.40 | $3.77–$27.64 | 10% below | 50% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 ASSAY OF LIPASE | $26.30 | $52.60 | $3.77–$26.72 | — | 50% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Fluid | $27.20 | $54.40 | $3.77–$27.64 | — | 50% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level | $27.20 | $54.40 | $3.77–$40.80 | — | 50% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $68.60 | $137.20 | $4.47–$102.90 | 46% above | 50% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $68.60 | $137.20 | $4.47–$102.90 | — | 50% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY | $39.60 | $79.20 | $9.32–$40.23 | 52% above | 50% |
| Lyme disease antibody test CPT 86618 Lyme Ab Total | $41.00 | $82.00 | $9.32–$46.99 | 58% above | 50% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY | $39.60 | $79.20 | $9.32–$40.23 | — | 50% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Ab Total | $41.00 | $82.00 | $9.32–$46.99 | — | 50% |
| Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM | $22.70 | $45.40 | $3.66–$23.06 | 14% above | 50% |
| Magnesium blood test CPT 83735 Magnesium Level | $23.50 | $47.00 | $3.66–$35.25 | 18% above | 50% |
| Magnesium blood test CPT 83735 Magnesium 24 Hr Urine | $23.50 | $47.00 | $3.66–$23.88 | 18% above | 50% |
| Magnesium blood test CPT 83735 Magnesium Urine | $23.50 | $47.00 | $3.66–$23.88 | 18% above | 50% |
| Magnesium blood test inpatient CPT 83735 ASSAY OF MAGNESIUM | $22.70 | $45.40 | $3.66–$23.06 | — | 50% |
| Magnesium blood test inpatient CPT 83735 Magnesium Urine | $23.50 | $47.00 | $3.66–$23.88 | — | 50% |
| Magnesium blood test inpatient CPT 83735 Magnesium Level | $23.50 | $47.00 | $3.66–$35.25 | — | 50% |
| Magnesium blood test inpatient CPT 83735 Magnesium 24 Hr Urine | $23.50 | $47.00 | $3.66–$23.88 | — | 50% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY | $36.15 | $72.30 | $7.05–$36.73 | 47% above | 50% |
| Measles (rubeola) antibody test CPT 86765 Rubeola IgG | $37.40 | $74.80 | $7.05–$38.00 | 52% above | 50% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY | $36.15 | $72.30 | $7.05–$36.73 | — | 50% |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola IgG | $37.40 | $74.80 | $7.05–$38.00 | — | 50% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN | $20.85 | $41.70 | $2.83–$21.18 | 50% below | 50% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Monospot: Whole Blood POC | $21.60 | $43.20 | $2.83–$21.95 | 48% below | 50% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen | $21.60 | $43.20 | $2.83–$32.40 | 48% below | 50% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODY SCREEN | $20.85 | $41.70 | $2.83–$21.18 | — | 50% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen | $21.60 | $43.20 | $2.83–$32.40 | — | 50% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Monospot: Whole Blood POC | $21.60 | $43.20 | $2.83–$21.95 | — | 50% |
| Mumps immunity blood test CPT 86735 Mumps Screen IgG | $35.50 | $71.00 | $7.14–$36.07 | 41% above | 50% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Screen IgG | $35.50 | $71.00 | $7.14–$36.07 | — | 50% |
| Obstetric blood test panel CPT 80055 OB Panel | $131.70 | $263.40 | $26.15–$133.81 | 25% below | 50% |
| Obstetric blood test panel inpatient CPT 80055 OB Panel | $131.70 | $263.40 | $26.15–$133.81 | — | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE | $39.00 | $78.00 | $10.06–$39.62 | 32% below | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Free | $40.35 | $80.70 | $10.06–$41.00 | 30% below | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, Free | $40.35 | $80.70 | $10.06–$46.25 | 30% below | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 ASSAY OF PSA FREE | $39.00 | $78.00 | $10.06–$39.62 | — | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Free | $40.35 | $80.70 | $10.06–$41.00 | — | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, Free | $40.35 | $80.70 | $10.06–$46.25 | — | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, Total | $50.55 | $101.10 | $10.06–$57.94 | at median | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Diagnostic | $50.55 | $101.10 | $10.06–$75.82 | at median | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL | $52.73 | $105.46 | $10.06–$53.57 | 4% above | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Diagnostic | $50.55 | $101.10 | $10.06–$75.82 | — | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, Total | $50.55 | $101.10 | $10.06–$57.94 | — | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 ASSAY OF PSA TOTAL | $52.73 | $105.46 | $10.06–$53.57 | — | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE | $94.40 | $188.80 | $22.58–$95.91 | 30% below | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact | $97.70 | $195.40 | $22.58–$146.55 | 27% below | 50% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 ASSAY OF PARATHORMONE | $94.40 | $188.80 | $22.58–$95.91 | — | 50% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact | $97.70 | $195.40 | $22.58–$146.55 | — | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL | $21.60 | $43.20 | $3.29–$21.95 | 30% below | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $22.35 | $44.70 | $3.29–$22.71 | 28% below | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Activated Partial Thromboplastin | $22.35 | $44.70 | $3.29–$33.53 | 28% below | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT With Heparin | $22.35 | $44.70 | $3.29–$22.71 | 28% below | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Activated PTT | $22.35 | $44.70 | $3.29–$33.53 | 28% below | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL | $21.60 | $43.20 | $3.29–$21.95 | — | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Activated Partial Thromboplastin | $22.35 | $44.70 | $3.29–$33.53 | — | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Activated PTT | $22.35 | $44.70 | $3.29–$33.53 | — | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT With Heparin | $22.35 | $44.70 | $3.29–$22.71 | — | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time | $22.35 | $44.70 | $3.29–$22.71 | — | 50% |
| Phosphorus (phosphate) blood test CPT 84100 ASSAY OF PHOSPHORUS | $9.55 | $19.10 | $2.59–$9.70 | 55% below | 50% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level | $9.90 | $19.80 | $2.59–$14.85 | 53% below | 50% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 ASSAY OF PHOSPHORUS | $9.55 | $19.10 | $2.59–$9.70 | — | 50% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level | $9.90 | $19.80 | $2.59–$14.85 | — | 50% |
| Potassium blood test CPT 84132 ASSAY OF SERUM POTASSIUM | $8.30 | $16.60 | $2.60–$8.43 | 64% below | 50% |
| Potassium blood test CPT 84132 Potassium Level | $8.60 | $17.20 | $2.60–$9.86 | 63% below | 50% |
| Potassium blood test CPT 84132 Potassium Level POC | $8.60 | $17.20 | $2.60–$8.74 | 63% below | 50% |
| Potassium blood test inpatient CPT 84132 ASSAY OF SERUM POTASSIUM | $8.30 | $16.60 | $2.60–$8.43 | — | 50% |
| Potassium blood test inpatient CPT 84132 Potassium Level | $8.60 | $17.20 | $2.60–$9.86 | — | 50% |
| Potassium blood test inpatient CPT 84132 Potassium Level POC | $8.60 | $17.20 | $2.60–$8.74 | — | 50% |
| Progesterone blood test CPT 84144 Progesterone Level | $72.05 | $144.10 | $11.41–$108.07 | 13% above | 50% |
| Progesterone blood test inpatient CPT 84144 Progesterone Level | $72.05 | $144.10 | $11.41–$108.07 | — | 50% |
| Prolactin blood test CPT 84146 ASSAY OF PROLACTIN | $71.35 | $142.70 | $10.60–$72.49 | 3% below | 50% |
| Prolactin blood test CPT 84146 Prolactin | $73.85 | $147.70 | $10.60–$84.65 | 1% above | 50% |
| Prolactin blood test inpatient CPT 84146 ASSAY OF PROLACTIN | $71.35 | $142.70 | $10.60–$72.49 | — | 50% |
| Prolactin blood test inpatient CPT 84146 Prolactin | $73.85 | $147.70 | $10.60–$84.65 | — | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 .INR POC | $22.35 | $44.70 | $2.35–$22.71 | 16% above | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT INR (CoaguChek) POC 85610 Downtime | $22.35 | $44.70 | $2.35–$22.71 | 16% above | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 .PT/INR POC | $22.35 | $44.70 | $2.35–$22.71 | 16% above | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 INR POC | $22.35 | $44.70 | $2.35–$22.71 | 16% above | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time and INR | $22.35 | $44.70 | $2.35–$33.53 | 16% above | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $41.87 | $83.74 | $2.35–$42.54 | 118% above | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR POC | $22.35 | $44.70 | $2.35–$22.71 | — | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT INR (CoaguChek) POC 85610 Downtime | $22.35 | $44.70 | $2.35–$22.71 | — | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 .INR POC | $22.35 | $44.70 | $2.35–$22.71 | — | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 .PT/INR POC | $22.35 | $44.70 | $2.35–$22.71 | — | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time and INR | $22.35 | $44.70 | $2.35–$33.53 | — | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $41.87 | $83.74 | $2.35–$42.54 | — | 50% |
| Rapid flu test (influenza antigen) CPT 87804 Influenza POC | $26.40 | $52.80 | $9.05–$28.64 | 45% below | 50% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza POC | $26.40 | $52.80 | $9.05–$28.64 | — | 50% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep | $45.50 | $91.00 | $9.04–$46.23 | 15% below | 50% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep | $45.50 | $91.00 | $9.04–$46.23 | — | 50% |
| Renin blood test CPT 84244 Renin Direct | $55.05 | $110.10 | $12.03–$55.93 | 32% above | 50% |
| Renin blood test CPT 84244 Renin, Direct | $55.05 | $110.10 | $12.03–$55.93 | 32% above | 50% |
| Renin blood test inpatient CPT 84244 Renin Direct | $55.05 | $110.10 | $12.03–$55.93 | — | 50% |
| Renin blood test inpatient CPT 84244 Renin, Direct | $55.05 | $110.10 | $12.03–$55.93 | — | 50% |
| Rh blood typing CPT 86901 Add-On - Rh Type | $16.65 | $33.30 | $1.64–$24.97 | 20% below | 50% |
| Rh blood typing CPT 86901 Rh Type Only | $16.65 | $33.30 | $1.64–$16.92 | 20% below | 50% |
| Rh blood typing inpatient CPT 86901 Add-On - Rh Type | $16.65 | $33.30 | $1.64–$24.97 | — | 50% |
| Rh blood typing inpatient CPT 86901 Rh Type Only | $16.65 | $33.30 | $1.64–$16.92 | — | 50% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $37.90 | $75.80 | $3.10–$38.51 | 10% above | 50% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Arthritis Factor Quant | $39.25 | $78.50 | $3.10–$58.88 | 14% above | 50% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT | $37.90 | $75.80 | $3.10–$38.51 | — | 50% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Arthritis Factor Quant | $39.25 | $78.50 | $3.10–$58.88 | — | 50% |
| Rubella antibody test (immunity check) CPT 86762 Rubella IgG | $39.40 | $78.80 | $7.87–$45.16 | 23% below | 50% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgG | $39.40 | $78.80 | $7.87–$45.16 | — | 50% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED | $30.40 | $60.80 | $1.48–$30.89 | 27% above | 50% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate | $31.45 | $62.90 | $1.48–$47.18 | 31% above | 50% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED RATE AUTOMATED | $30.40 | $60.80 | $1.48–$30.89 | — | 50% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate | $31.45 | $62.90 | $1.48–$47.18 | — | 50% |
| Sodium blood test CPT 84295 ASSAY OF SERUM SODIUM | $8.65 | $17.30 | $2.63–$8.79 | 58% below | 50% |
| Sodium blood test CPT 84295 Sodium Level POC | $8.95 | $17.90 | $2.63–$9.09 | 57% below | 50% |
| Sodium blood test CPT 84295 Sodium Level | $8.95 | $17.90 | $2.63–$9.09 | 57% below | 50% |
| Sodium blood test inpatient CPT 84295 ASSAY OF SERUM SODIUM | $8.65 | $17.30 | $2.63–$8.79 | — | 50% |
| Sodium blood test inpatient CPT 84295 Sodium Level | $8.95 | $17.90 | $2.63–$9.09 | — | 50% |
| Sodium blood test inpatient CPT 84295 Sodium Level POC | $8.95 | $17.90 | $2.63–$9.09 | — | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 .Occult Blood, Stool, Screen POC | $4.70 | $9.40 | $2.40–$7.59 | 73% below | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood, Stool (POC) AMB | $4.70 | $9.40 | $2.40–$7.59 | 73% below | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool Screen | $4.70 | $9.40 | $2.40–$7.59 | 73% below | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Fecal Immunochem Screen | $38.80 | $77.60 | $2.40–$39.42 | 121% above | 50% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool Screen | $4.70 | $9.40 | $2.40–$7.59 | — | 50% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood, Stool (POC) AMB | $4.70 | $9.40 | $2.40–$7.59 | — | 50% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 .Occult Blood, Stool, Screen POC | $4.70 | $9.40 | $2.40–$7.59 | — | 50% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Fecal Immunochem Screen | $38.80 | $77.60 | $2.40–$39.42 | — | 50% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood Fecal Immunochemical Diagnostic | $23.15 | $46.30 | $8.71–$27.56 | 49% below | 50% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood Fecal Immunochemical Diagnostic | $23.15 | $46.30 | $8.71–$27.56 | — | 50% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM | $40.85 | $81.70 | $7.24–$41.50 | 13% below | 50% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Treponemal Antibody | $42.30 | $84.60 | $7.24–$42.98 | 10% below | 50% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM | $40.85 | $81.70 | $7.24–$41.50 | — | 50% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponemal Antibody | $42.30 | $84.60 | $7.24–$42.98 | — | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL | $17.20 | $34.40 | $2.34–$17.48 | at median | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR | $17.80 | $35.60 | $2.34–$26.70 | 4% above | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL | $17.20 | $34.40 | $2.34–$17.48 | — | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR | $17.80 | $35.60 | $2.34–$26.70 | — | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE | $97.41 | $194.81 | $33.90–$107.30 | 23% below | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus | $112.70 | $225.40 | $33.90–$169.05 | 11% below | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE | $97.41 | $194.81 | $33.90–$107.30 | — | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus | $112.70 | $225.40 | $33.90–$169.05 | — | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE | $75.78 | $151.56 | $14.12–$76.99 | 113% above | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total | $76.20 | $152.40 | $14.12–$114.30 | 114% above | 50% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TOTAL TESTOSTERONE | $75.78 | $151.56 | $14.12–$76.99 | — | 50% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total | $76.20 | $152.40 | $14.12–$114.30 | — | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Antibodies | $53.20 | $106.40 | $7.96–$79.80 | 15% above | 50% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Antibodies | $53.20 | $106.40 | $7.96–$79.80 | — | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone Reflex Free T4 | $68.15 | $136.30 | $9.19–$102.23 | 6% above | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $68.15 | $136.30 | $9.19–$102.23 | 6% above | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE | $69.80 | $139.59 | $9.19–$70.91 | 8% above | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone Reflex Free T4 | $68.15 | $136.30 | $9.19–$102.23 | — | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $68.15 | $136.30 | $9.19–$102.23 | — | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE | $69.80 | $139.59 | $9.19–$70.91 | — | 50% |
| Total IgE blood test CPT 82785 Immunoglobulin E | $48.50 | $97.00 | $9.00–$55.59 | 10% above | 50% |
| Total IgE blood test inpatient CPT 82785 Immunoglobulin E | $48.50 | $97.00 | $9.00–$55.59 | — | 50% |
| Total cholesterol blood test CPT 82465 Cholesterol Total | $12.60 | $25.20 | $2.38–$12.80 | 37% below | 50% |
| Total cholesterol blood test CPT 82465 Cholesterol Fluid | $12.60 | $25.20 | $2.38–$12.80 | 37% below | 50% |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol Fluid | $12.60 | $25.20 | $2.38–$12.80 | — | 50% |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol Total | $12.60 | $25.20 | $2.38–$12.80 | — | 50% |
| Total thyroxine (T4) blood test CPT 84436 Thyroxine | $20.40 | $40.80 | $3.76–$20.73 | 39% below | 50% |
| Total thyroxine (T4) blood test CPT 84436 T4 Total Level | $20.40 | $40.80 | $3.76–$23.38 | 39% below | 50% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4 Total Level | $20.40 | $40.80 | $3.76–$23.38 | — | 50% |
| Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine | $20.40 | $40.80 | $3.76–$20.73 | — | 50% |
| Total triiodothyronine (T3) blood test CPT 84480 T3 Total Level | $48.30 | $96.60 | $7.76–$61.12 | 5% above | 50% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 Total Level | $48.30 | $96.60 | $7.76–$61.12 | — | 50% |
| Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN | $34.30 | $68.60 | $6.98–$34.85 | 40% below | 50% |
| Transferrin blood test CPT 84466 Transferrin | $35.50 | $71.00 | $6.98–$36.07 | 38% below | 50% |
| Transferrin blood test inpatient CPT 84466 ASSAY OF TRANSFERRIN | $34.30 | $68.60 | $6.98–$34.85 | — | 50% |
| Transferrin blood test inpatient CPT 84466 Transferrin | $35.50 | $71.00 | $6.98–$36.07 | — | 50% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis by PCR | $72.70 | $145.40 | $19.19–$73.86 | 1% below | 50% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis by PCR | $72.70 | $145.40 | $19.19–$73.86 | — | 50% |
| Triglycerides blood test CPT 84478 Triglycerides | $12.60 | $25.20 | $3.14–$12.80 | 32% below | 50% |
| Triglycerides blood test CPT 84478 Triglycerides, Fluid | $12.60 | $25.20 | $3.14–$12.80 | 32% below | 50% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides | $12.60 | $25.20 | $3.14–$12.80 | — | 50% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides, Fluid | $12.60 | $25.20 | $3.14–$12.80 | — | 50% |
| Troponin test, quantitative CPT 84484 ASSAY OF TROPONIN QUANT | $43.35 | $86.70 | $6.82–$44.04 | 2% above | 50% |
| Troponin test, quantitative CPT 84484 Troponin T High Sensitivity (hs-cTnT) 2 hour | $44.85 | $89.70 | $6.82–$45.57 | 6% above | 50% |
| Troponin test, quantitative CPT 84484 Troponin I | $44.85 | $89.70 | $6.82–$45.57 | 6% above | 50% |
| Troponin test, quantitative CPT 84484 .Troponin, POC | $44.85 | $89.70 | $6.82–$45.57 | 6% above | 50% |
| Troponin test, quantitative CPT 84484 Troponin T High Sensitivity (hs-cTnT) | $44.85 | $89.70 | $6.82–$67.28 | 6% above | 50% |
| Troponin test, quantitative CPT 84484 Troponin T High Sensitivity (hs-cTnT) 4 hour | $44.85 | $89.70 | $6.82–$45.57 | 6% above | 50% |
| Troponin test, quantitative inpatient CPT 84484 ASSAY OF TROPONIN QUANT | $43.35 | $86.70 | $6.82–$44.04 | — | 50% |
| Troponin test, quantitative inpatient CPT 84484 Troponin T High Sensitivity (hs-cTnT) | $44.85 | $89.70 | $6.82–$67.28 | — | 50% |
| Troponin test, quantitative inpatient CPT 84484 Troponin T High Sensitivity (hs-cTnT) 4 hour | $44.85 | $89.70 | $6.82–$45.57 | — | 50% |
| Troponin test, quantitative inpatient CPT 84484 .Troponin, POC | $44.85 | $89.70 | $6.82–$45.57 | — | 50% |
| Troponin test, quantitative inpatient CPT 84484 Troponin I | $44.85 | $89.70 | $6.82–$45.57 | — | 50% |
| Troponin test, quantitative inpatient CPT 84484 Troponin T High Sensitivity (hs-cTnT) 2 hour | $44.85 | $89.70 | $6.82–$45.57 | — | 50% |
| Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID | $9.55 | $19.10 | $2.47–$9.70 | 56% below | 50% |
| Uric acid blood test CPT 84550 Uric Acid Urine | $9.90 | $19.80 | $2.47–$10.06 | 55% below | 50% |
| Uric acid blood test CPT 84550 Uric Acid | $9.90 | $19.80 | $2.47–$14.85 | 55% below | 50% |
| Uric acid blood test inpatient CPT 84550 ASSAY OF BLOOD/URIC ACID | $9.55 | $19.10 | $2.47–$9.70 | — | 50% |
| Uric acid blood test inpatient CPT 84550 Uric Acid | $9.90 | $19.80 | $2.47–$14.85 | — | 50% |
| Uric acid blood test inpatient CPT 84550 Uric Acid Urine | $9.90 | $19.80 | $2.47–$10.06 | — | 50% |
| Urinalysis with microscope exam, automated CPT 81001 Urine Dipstick POC Amb | $11.85 | $23.70 | $1.73–$25.00 | 41% below | 50% |
| Urinalysis with microscope exam, automated CPT 81001 UAWMICR | $11.85 | $23.70 | $1.73–$25.00 | 41% below | 50% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE | $16.09 | $32.18 | $1.73–$25.00 | 20% below | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UAWMICR | $11.85 | $23.70 | $1.73–$25.00 | — | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urine Dipstick POC Amb | $11.85 | $23.70 | $1.73–$25.00 | — | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/SCOPE | $16.09 | $32.18 | $1.73–$25.00 | — | 50% |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis Dip Stick Non-Auto w/Microscopy POC 81000 | $12.40 | $24.80 | $2.20–$25.00 | 17% below | 50% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis Dip Stick Non-Auto w/Microscopy POC 81000 | $12.40 | $24.80 | $2.20–$25.00 | — | 50% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE | $10.60 | $21.20 | $1.23–$25.00 | 18% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 UAPH | $11.00 | $22.00 | $1.23–$25.00 | 15% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 .Urine Dipstick, POC | $11.00 | $22.00 | $1.23–$25.00 | 15% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Ketone Urine | $11.00 | $22.00 | $1.23–$25.00 | 15% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 UA ONLY | $11.00 | $22.00 | $1.23–$25.00 | 15% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 UACulIf | $11.00 | $22.00 | $1.23–$25.00 | 15% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 UAMicIf | $11.00 | $22.00 | $1.23–$25.00 | 15% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Dipstick POC Amb | $11.00 | $22.00 | $1.23–$25.00 | 15% below | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCOPE | $10.60 | $21.20 | $1.23–$25.00 | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA ONLY | $11.00 | $22.00 | $1.23–$25.00 | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 .Urine Dipstick, POC | $11.00 | $22.00 | $1.23–$25.00 | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UACulIf | $11.00 | $22.00 | $1.23–$25.00 | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UAPH | $11.00 | $22.00 | $1.23–$25.00 | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Dipstick POC Amb | $11.00 | $22.00 | $1.23–$25.00 | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UAMicIf | $11.00 | $22.00 | $1.23–$25.00 | — | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Ketone Urine | $11.00 | $22.00 | $1.23–$25.00 | — | 50% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis Dip Stick Non-Auto w/o Micro POC 81002 Downtime | $2.60 | $5.20 | $1.90–$25.00 | 84% below | 50% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick POC Amb | $2.60 | $5.20 | $1.90–$25.00 | 84% below | 50% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Dip Stick Non-Auto w/o Micro POC 81002 Downtime | $2.60 | $5.20 | $1.90–$25.00 | — | 50% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Dipstick POC Amb | $2.60 | $5.20 | $1.90–$25.00 | — | 50% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture | $35.50 | $71.00 | $4.41–$53.25 | 35% below | 50% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT | $72.55 | $145.09 | $4.41–$73.71 | 32% above | 50% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture | $35.50 | $71.00 | $4.41–$53.25 | — | 50% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE/COLONY COUNT | $72.55 | $145.09 | $4.41–$73.71 | — | 50% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin 24 Hr Urine | $35.40 | $70.80 | $3.16–$35.97 | 36% above | 50% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Ur | $35.40 | $70.80 | $3.16–$53.10 | 36% above | 50% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Random Urine | $35.40 | $70.80 | $3.16–$40.58 | 36% above | 50% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin 24 Hr Urine | $35.40 | $70.80 | $3.16–$35.97 | — | 50% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Ur | $35.40 | $70.80 | $3.16–$53.10 | — | 50% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Random Urine | $35.40 | $70.80 | $3.16–$40.58 | — | 50% |
| Urine pregnancy test, read by color change CPT 81025 .HCG Urine (POC) | $21.55 | $43.10 | $4.71–$32.33 | 13% below | 50% |
| Urine pregnancy test, read by color change CPT 81025 HCG Qualitative Urine | $21.55 | $43.10 | $4.71–$32.33 | 13% below | 50% |
| Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy POC | $21.55 | $43.10 | $4.71–$25.00 | 13% below | 50% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST | $266.95 | $533.89 | $4.71–$271.22 | 975% above | 50% |
| Urine pregnancy test, read by color change inpatient CPT 81025 .HCG Urine (POC) | $21.55 | $43.10 | $4.71–$32.33 | — | 50% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HCG Qualitative Urine | $21.55 | $43.10 | $4.71–$32.33 | — | 50% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy POC | $21.55 | $43.10 | $4.71–$25.00 | — | 50% |
| Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST | $266.95 | $533.89 | $4.71–$271.22 | — | 50% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level | $48.30 | $96.60 | $8.25–$72.45 | 20% below | 50% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 | $58.17 | $116.33 | $8.25–$59.10 | 3% below | 50% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level | $48.30 | $96.60 | $8.25–$72.45 | — | 50% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 | $58.17 | $116.33 | $8.25–$59.10 | — | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $37.40 | $74.80 | $16.19–$51.24 | 58% below | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level | $38.70 | $77.40 | $16.19–$58.05 | 56% below | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY | $37.40 | $74.80 | $16.19–$51.24 | — | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy Level | $38.70 | $77.40 | $16.19–$58.05 | — | 50% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D 1 25 Dihydroxy Level | $83.90 | $167.80 | $21.06–$125.85 | 6% above | 50% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D 1 25 Dihydroxy Level | $83.90 | $167.80 | $21.06–$125.85 | — | 50% |
| Zinc blood test CPT 84630 ASSAY OF ZINC | $4.00 | $8.00 | $4.06–$19.71 | 83% below | 50% |
| Zinc blood test inpatient CPT 84630 ASSAY OF ZINC | $4.00 | $8.00 | $4.06–$19.71 | — | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST | $46.30 | $92.60 | $8.23–$47.04 | 4% below | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG Beta Quantitative Serum | $47.90 | $95.80 | $8.23–$71.85 | at median | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPIN TEST | $46.30 | $92.60 | $8.23–$47.04 | — | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG Beta Quantitative Serum | $47.90 | $95.80 | $8.23–$71.85 | — | 50% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL OF ADENOIDS | $3,644.90 | $7,289.80 | $1,773.96–$5,060.64 | 21% above | 50% |
| Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 REMOVAL OF ADENOIDS | $3,644.90 | $7,289.80 | $1,773.96–$5,060.64 | — | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 19081-MG Stereo Breast BX 1st Lesion LT | $2,092.05 | $4,184.10 | $886.27–$3,012.55 | 8% below | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 19081-MG Stereo Breast BX 1st Lesion RT | $2,092.05 | $4,184.10 | $886.27–$2,528.30 | 8% below | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 19081-MG Stereo Breast BX 1st Lesion LT | $2,092.05 | $4,184.10 | $886.27–$3,012.55 | — | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 19081-MG Stereo Breast BX 1st Lesion RT | $2,092.05 | $4,184.10 | $886.27–$2,528.30 | — | 50% |
| Cardiac catheterization with coronary angiogram CPT 93458 L HRT ARTERY/VENTRICLE ANGIO | $8,384.55 | $16,769.09 | $1,759.38–$8,518.70 | 16% below | 50% |
| Cardiac catheterization with coronary angiogram one side CPT 93458 CCL Left Heart Cath (W/Wo Lv Gram ) W/ Coronary Angio | $4,171.10 | $8,342.20 | $1,759.38–$5,019.04 | 58% below | 50% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 L HRT ARTERY/VENTRICLE ANGIO | $8,384.55 | $16,769.09 | $1,759.38–$8,518.70 | — | 50% |
| Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 CCL Left Heart Cath (W/Wo Lv Gram ) W/ Coronary Angio | $4,171.10 | $8,342.20 | $1,759.38–$5,019.04 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CCL Cardioversion - No Chargeable Unless Scheduled | $727.65 | $1,455.30 | $357.95–$1,021.13 | 26% below | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 BP Cardioversion 92960 | $727.65 | $1,455.30 | $357.95–$1,021.13 | 26% below | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Electric Ext | $5,121.23 | $10,242.46 | $357.95–$5,203.17 | 420% above | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 BP Cardioversion 92960 | $727.65 | $1,455.30 | $357.95–$1,021.13 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CCL Cardioversion - No Chargeable Unless Scheduled | $727.65 | $1,455.30 | $357.95–$1,021.13 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Electric Ext | $5,121.23 | $10,242.46 | $357.95–$5,203.17 | — | 50% |
| Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY | $2,856.60 | $5,713.19 | $1,068.17–$3,047.20 | 6% above | 50% |
| Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL SURGERY | $2,856.60 | $5,713.19 | $1,068.17–$3,047.20 | — | 50% |
| Cataract surgery with lens implant CPT 66984 CATARACT SURG W/IOL 1 STAGE | $3,902.67 | $7,805.33 | $1,247.56–$3,965.11 | 40% above | 50% |
| Cataract surgery with lens implant inpatient CPT 66984 CATARACT SURG W/IOL 1 STAGE | $3,902.67 | $7,805.33 | $1,247.56–$3,965.11 | — | 50% |
| Catheter ablation for atrial fibrillation CPT 93656 EP A-FIBRILLATION ABLATION with EP Study | $13,255.50 | $26,511.00 | $698.15–$38,281.38 | 63% below | 50% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 EP A-FIBRILLATION ABLATION with EP Study | $13,255.50 | $26,511.00 | $698.15–$38,281.38 | — | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision, Clamp/Oth Device with Regional/Ring Block 54150 | $323.90 | $647.80 | $329.08–$3,196.59 | 81% below | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision Clamp Type -> Mogen | $323.95 | $647.90 | $329.13–$3,196.59 | 81% below | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision Clamp Type -> Plastibell | $323.95 | $647.90 | $329.13–$3,196.59 | 81% below | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision Clamp Type -> Gomco | $323.95 | $647.90 | $329.13–$3,196.59 | 81% below | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision, Clamp/Oth Device with Regional/Ring Block 54150 | $323.90 | $647.80 | $329.08–$3,196.59 | — | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision Clamp Type -> Gomco | $323.95 | $647.90 | $329.13–$3,196.59 | — | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision Clamp Type -> Mogen | $323.95 | $647.90 | $329.13–$3,196.59 | — | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision Clamp Type -> Plastibell | $323.95 | $647.90 | $329.13–$3,196.59 | — | 50% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed Treatment Distal Radius Fracture/Epiphyseal sep, Inc Ulnar Styloid without manipulation 25600 | $243.30 | $486.60 | $131.21–$374.32 | 36% below | 50% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Closed Treatment Distal Radius Fracture/Epiphyseal sep, Inc Ulnar Styloid without manipulation 25600 | $243.30 | $486.60 | $131.21–$374.32 | — | 50% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/LESION REMOVAL | $2,469.13 | $4,938.25 | $644.96–$2,508.63 | 43% above | 50% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/LESION REMOVAL | $2,469.13 | $4,938.25 | $644.96–$2,508.63 | — | 50% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY | $2,376.49 | $4,752.97 | $644.96–$2,414.51 | 27% above | 50% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY AND BIOPSY | $2,376.49 | $4,752.97 | $644.96–$2,414.51 | — | 50% |
| Colonoscopy, diagnostic CPT 45378 Hospitalist BP 45378 Colonoscopy Flx Dx w/collect Spec when Pfrmd | $967.75 | $1,935.50 | $498.71–$1,422.68 | 17% below | 50% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY | $1,923.54 | $3,847.07 | $498.71–$1,954.31 | 66% above | 50% |
| Colonoscopy, diagnostic inpatient CPT 45378 Hospitalist BP 45378 Colonoscopy Flx Dx w/collect Spec when Pfrmd | $967.75 | $1,935.50 | $498.71–$1,422.68 | — | 50% |
| Colonoscopy, diagnostic inpatient CPT 45378 DIAGNOSTIC COLONOSCOPY | $1,923.54 | $3,847.07 | $498.71–$1,954.31 | — | 50% |
| Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT | $7,844.50 | $15,689.00 | $1,886.59–$7,970.01 | 80% above | 50% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOSCOPY AND TREATMENT | $7,844.50 | $15,689.00 | $1,886.59–$7,970.01 | — | 50% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Premalginant Lesion Destruction;1st Lesion 17000 | $205.65 | $411.30 | $108.69–$310.06 | 5% above | 50% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Premalginant Lesion Destruction;1st Lesion 17000 | $205.65 | $411.30 | $108.69–$310.06 | — | 50% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING | $2,238.94 | $4,477.88 | $810.26–$2,311.46 | 5% above | 50% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 CREATE EARDRUM OPENING | $2,238.94 | $4,477.88 | $810.26–$2,311.46 | — | 50% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Remove Impacted Ear Wax Irr Uni | $101.90 | $203.80 | $32.49–$450.00 | 2% below | 50% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Removal Impacted Cerumen Irrigation/Lvg Unilat | $101.90 | $203.80 | $32.49–$103.53 | 2% below | 50% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Removal Ear Wax with Irrigation Unilateral 69209 | $101.90 | $203.80 | $32.49–$103.53 | 2% below | 50% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Remove Impacted Ear Wax Irr Uni | $101.90 | $203.80 | $32.49–$450.00 | — | 50% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Removal Impacted Cerumen Irrigation/Lvg Unilat | $101.90 | $203.80 | $32.49–$103.53 | — | 50% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Removal Ear Wax with Irrigation Unilateral 69209 | $101.90 | $203.80 | $32.49–$103.53 | — | 50% |
| Earwax removal with instruments, one ear CPT 69210 Remove Impacted Ear Wax Ins Uni | $63.70 | $127.40 | $32.49–$450.00 | 34% below | 50% |
| Earwax removal with instruments, one ear one side CPT 69210 BP Removal Impacted Cerumen Requiring Instrumentation, Unilateral 69210 | $63.70 | $127.40 | $32.49–$122.67 | 34% below | 50% |
| Earwax removal with instruments, one ear one side CPT 69210 Removal Impacted Cerumen Requiring Instrumentation, Unilateral 69210 | $63.70 | $127.40 | $32.49–$122.67 | 34% below | 50% |
| Earwax removal with instruments, one ear one side CPT 69210 Removal Impacted Cerumen Instrumentation Unilat | $63.70 | $127.40 | $32.49–$122.67 | 34% below | 50% |
| Earwax removal with instruments, one ear inpatient CPT 69210 Remove Impacted Ear Wax Ins Uni | $63.70 | $127.40 | $32.49–$450.00 | — | 50% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 Removal Impacted Cerumen Instrumentation Unilat | $63.70 | $127.40 | $32.49–$122.67 | — | 50% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 Removal Impacted Cerumen Requiring Instrumentation, Unilateral 69210 | $63.70 | $127.40 | $32.49–$122.67 | — | 50% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 BP Removal Impacted Cerumen Requiring Instrumentation, Unilateral 69210 | $63.70 | $127.40 | $32.49–$122.67 | — | 50% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 EMB w/wo endocervical biopsy w/o cervical dilation, any method 58100 | $187.10 | $374.20 | $110.04–$313.92 | 21% below | 50% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BP EMB w/wo endocervical biopsy w/o cervical dilation, any method 58100 | $187.10 | $374.20 | $110.04–$313.92 | 21% below | 50% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BP EMB w/wo endocervical biopsy w/o cervical dilation, any method 58100 | $187.10 | $374.20 | $110.04–$313.92 | — | 50% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 EMB w/wo endocervical biopsy w/o cervical dilation, any method 58100 | $187.10 | $374.20 | $110.04–$313.92 | — | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 IR Inj Interlaminar Epidural Cerv/Thorac w/img | $1,341.25 | $2,682.50 | $378.81–$1,362.71 | 38% above | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Injection Interlaminar Cervical/Thoracic w/ Guidance 62321 | $1,341.25 | $2,682.50 | $378.81–$1,362.71 | 38% above | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 62321- CT Injection Cerv/Thor Epidural | $1,341.25 | $2,682.50 | $378.81–$1,362.71 | 38% above | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 62321-XR Injection Cerv/Thor Epidural | $1,341.25 | $2,682.50 | $378.81–$1,362.71 | 38% above | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC | $1,398.90 | $2,797.79 | $378.81–$1,421.28 | 44% above | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 IR Inj Interlaminar Epidural Cerv/Thorac w/img | $1,341.25 | $2,682.50 | $378.81–$1,362.71 | — | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Injection Interlaminar Cervical/Thoracic w/ Guidance 62321 | $1,341.25 | $2,682.50 | $378.81–$1,362.71 | — | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 62321- CT Injection Cerv/Thor Epidural | $1,341.25 | $2,682.50 | $378.81–$1,362.71 | — | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 62321-XR Injection Cerv/Thor Epidural | $1,341.25 | $2,682.50 | $378.81–$1,362.71 | — | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX INTERLAMINAR CRV/THRC | $1,398.90 | $2,797.79 | $378.81–$1,421.28 | — | 50% |
| Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 64493-XR Facet Injection Lumb/Sacr Bilat | $1,083.70 | $2,167.40 | $486.99–$1,389.25 | — | 50% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 IR Pain injection of the paravertbral facet joint Lumbar/sacrum | $1,083.70 | $2,167.40 | $486.99–$1,389.25 | at median | 50% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj Paravert Facet Jnt Lumbar/Sacral W/Guide Single Lvl 64493 | $1,083.70 | $2,167.40 | $486.99–$1,389.25 | at median | 50% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV | $2,473.15 | $4,946.30 | $486.99–$2,512.72 | 128% above | 50% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 64493-XR Facet Injection Lumb/Sacr Left | $1,083.70 | $2,167.40 | $486.99–$1,389.25 | at median | 50% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 64493-XR Facet Injection Lumb/Sacr Right | $1,083.70 | $2,167.40 | $486.99–$1,389.25 | at median | 50% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient both sides CPT 64493 64493-XR Facet Injection Lumb/Sacr Bilat | $1,083.70 | $2,167.40 | $486.99–$1,389.25 | — | 50% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 IR Pain injection of the paravertbral facet joint Lumbar/sacrum | $1,083.70 | $2,167.40 | $486.99–$1,389.25 | — | 50% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Inj Paravert Facet Jnt Lumbar/Sacral W/Guide Single Lvl 64493 | $1,083.70 | $2,167.40 | $486.99–$1,389.25 | — | 50% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT F JNT L/S 1 LEV | $2,473.15 | $4,946.30 | $486.99–$2,512.72 | — | 50% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 64493-XR Facet Injection Lumb/Sacr Right | $1,083.70 | $2,167.40 | $486.99–$1,389.25 | — | 50% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 64493-XR Facet Injection Lumb/Sacr Left | $1,083.70 | $2,167.40 | $486.99–$1,389.25 | — | 50% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 Under Hernia Open Procedures >10 cm, reducible | $18,541.46 | $37,082.91 | $2,976.83–$18,838.12 | 108% above | 50% |
| First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 Under Hernia Open Procedures >10 cm, reducible | $18,541.46 | $37,082.91 | $2,976.83–$18,838.12 | — | 50% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Repair anterior abdominal hernia <3 cm reducible | $8,458.83 | $16,917.65 | $1,930.40–$8,594.17 | 72% above | 50% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 Repair anterior abdominal hernia <3 cm reducible | $8,458.83 | $16,917.65 | $1,930.40–$8,594.17 | — | 50% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY | $1,706.24 | $3,412.48 | $498.71–$1,733.54 | 29% below | 50% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY | $1,706.24 | $3,412.48 | $498.71–$1,733.54 | — | 50% |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $9,391.05 | $18,782.10 | $3,191.39–$9,541.31 | 14% above | 50% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $9,391.05 | $18,782.10 | $3,191.39–$9,541.31 | — | 50% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVE INT/EXT HEM 1 GROUP | $6,466.35 | $12,932.70 | $1,500.09–$6,569.81 | 73% above | 50% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 REMOVE INT/EXT HEM 1 GROUP | $6,466.35 | $12,932.70 | $1,500.09–$6,569.81 | — | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 WH US Hysterosonogram w/Saline/Contrast | $236.65 | $473.30 | $240.44–$352.60 | 52% below | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Add On - 58340-XR Saline Inj for Hystero | $236.65 | $473.30 | $240.44–$352.60 | 52% below | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Add On - 58340-US Saline Inj for Hystero | $236.65 | $473.30 | $240.44–$352.60 | 52% below | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 WH US Hysterosonogram w/Saline/Contrast | $236.65 | $473.30 | $240.44–$352.60 | — | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Add On - 58340-US Saline Inj for Hystero | $236.65 | $473.30 | $240.44–$352.60 | — | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Add On - 58340-XR Saline Inj for Hystero | $236.65 | $473.30 | $240.44–$352.60 | — | 50% |
| Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ABLATION | $5,765.12 | $11,530.24 | $2,700.24–$7,703.07 | 21% above | 50% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY ABLATION | $5,765.12 | $11,530.24 | $2,700.24–$7,703.07 | — | 50% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY | $5,117.92 | $10,235.83 | $1,739.20–$5,199.80 | 15% above | 50% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY BIOPSY | $5,117.92 | $10,235.83 | $1,739.20–$5,199.80 | — | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Hospitalist BP 10060 Incision & Drainage of Abscess, Simple/Single | $235.05 | $470.10 | $108.69–$310.06 | 14% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D Absc; Smpl Or Sgl | $235.05 | $470.10 | $108.69–$450.00 | 14% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Incision & drainage of abscess, simple/single 10060 | $235.05 | $470.10 | $108.69–$310.06 | 14% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 BP Incision and Drainage of Abscess, Simple/Single 10060 | $235.05 | $470.10 | $108.69–$310.06 | 14% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Incision & Drainage Abscess Simple/Single | $235.05 | $470.10 | $108.69–$310.06 | 14% below | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision & Drainage Abscess Simple/Single | $235.05 | $470.10 | $108.69–$310.06 | — | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 BP Incision and Drainage of Abscess, Simple/Single 10060 | $235.05 | $470.10 | $108.69–$310.06 | — | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Absc; Smpl Or Sgl | $235.05 | $470.10 | $108.69–$450.00 | — | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Hospitalist BP 10060 Incision & Drainage of Abscess, Simple/Single | $235.05 | $470.10 | $108.69–$310.06 | — | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision & drainage of abscess, simple/single 10060 | $235.05 | $470.10 | $108.69–$310.06 | — | 50% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 PRP I/HERN INIT REDUC >5 YR | $8,251.87 | $16,503.74 | $1,930.40–$8,383.90 | 44% above | 50% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PRP I/HERN INIT REDUC >5 YR | $8,251.87 | $16,503.74 | $1,930.40–$8,383.90 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550- US Injection Sgl Tend Shth or Lig | $311.10 | $622.20 | $161.47–$460.63 | 22% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Hospitalist BP 20550 Injection(s); single tendon sheath, or ligament, aponeurosis | $311.10 | $622.20 | $161.47–$460.63 | 22% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Sgl Tendon Shth Or Ligament | $311.10 | $622.20 | $161.47–$460.63 | 22% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550- CT Inj Sgl Tend Shth or Ligament | $311.10 | $622.20 | $161.47–$460.63 | 22% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection(s); single tendon sheath, or ligament, aponeurosis 20550 | $311.10 | $622.20 | $160.90–$528.87 | 22% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection(s); single tendon sheath, or ligament, aponeurosis w/Guidance 20550 | $311.10 | $622.20 | $161.47–$460.63 | 22% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 BP Injection(s); single tendon sheath, or ligament, aponeurosis 20550 | $311.10 | $622.20 | $161.47–$460.63 | 22% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT | $1,382.60 | $2,765.19 | $161.47–$1,404.72 | 245% above | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 IR Injection Sgl Tendon Shth or Ligament RT | $311.10 | $622.20 | $161.47–$460.63 | 22% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 IR Injection Sgl Tendon Shth or Ligament LT | $311.10 | $622.20 | $161.47–$460.63 | 22% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550- CT Inj Sgl Tend Shth or Ligament | $311.10 | $622.20 | $161.47–$460.63 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj Sgl Tendon Shth Or Ligament | $311.10 | $622.20 | $161.47–$460.63 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Injection(s); single tendon sheath, or ligament, aponeurosis 20550 | $311.10 | $622.20 | $160.90–$528.87 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550- US Injection Sgl Tend Shth or Lig | $311.10 | $622.20 | $161.47–$460.63 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Injection(s); single tendon sheath, or ligament, aponeurosis w/Guidance 20550 | $311.10 | $622.20 | $161.47–$460.63 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Hospitalist BP 20550 Injection(s); single tendon sheath, or ligament, aponeurosis | $311.10 | $622.20 | $161.47–$460.63 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 BP Injection(s); single tendon sheath, or ligament, aponeurosis 20550 | $311.10 | $622.20 | $161.47–$460.63 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT | $1,382.60 | $2,765.19 | $161.47–$1,404.72 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 IR Injection Sgl Tendon Shth or Ligament LT | $311.10 | $622.20 | $161.47–$460.63 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 IR Injection Sgl Tendon Shth or Ligament RT | $311.10 | $622.20 | $161.47–$460.63 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 BP Arthrocentesis, aspiration and/or injection major joint or bursa without U/S Guidance 20610 | $349.30 | $698.60 | $161.47–$460.63 | 18% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drain/Inj Major Joint/Bursa W/O Us | $349.30 | $698.60 | $161.47–$460.63 | 18% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis/aspiration/inject, major joint/bursa; w/o US guid 20610 | $349.30 | $698.60 | $161.47–$523.95 | 18% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Hospitalist BP 20610 Arthrocentesis/aspiration/inject, major joint/bursa; w/o US guid | $349.30 | $698.60 | $161.47–$460.63 | 18% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US | $2,073.10 | $4,146.19 | $161.47–$2,106.26 | 385% above | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 IR Arthcntsis, Asp/Inj Maj Brsa w/o U/S - RT | $349.30 | $698.60 | $161.47–$460.63 | 18% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 20610-CT Jnt/Bursa Mjr Arthr/Asp/Inj LT | $349.30 | $698.60 | $161.47–$460.63 | 18% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 20610-XR Jnt/Bursa Major Arth/Asp/Inj LT | $349.30 | $698.60 | $161.47–$460.63 | 18% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 20610-XR Jnt/Bursa Major Arth/Asp/Inj RT | $349.30 | $698.60 | $161.47–$460.63 | 18% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 20610-CT Jnt/Bursa Mjr Arthr/Asp/Inj RT | $349.30 | $698.60 | $161.47–$460.63 | 18% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 IR Arthcntsis, Asp/Inj Maj Brsa w/o U/S - LT | $349.30 | $698.60 | $161.47–$460.63 | 18% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Hospitalist BP 20610 Arthrocentesis/aspiration/inject, major joint/bursa; w/o US guid | $349.30 | $698.60 | $161.47–$460.63 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis/aspiration/inject, major joint/bursa; w/o US guid 20610 | $349.30 | $698.60 | $161.47–$523.95 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 BP Arthrocentesis, aspiration and/or injection major joint or bursa without U/S Guidance 20610 | $349.30 | $698.60 | $161.47–$460.63 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Drain/Inj Major Joint/Bursa W/O Us | $349.30 | $698.60 | $161.47–$460.63 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ JOINT/BURSA W/O US | $2,073.10 | $4,146.19 | $161.47–$2,106.26 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 20610-CT Jnt/Bursa Mjr Arthr/Asp/Inj LT | $349.30 | $698.60 | $161.47–$460.63 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 20610-XR Jnt/Bursa Major Arth/Asp/Inj LT | $349.30 | $698.60 | $161.47–$460.63 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 20610-CT Jnt/Bursa Mjr Arthr/Asp/Inj RT | $349.30 | $698.60 | $161.47–$460.63 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 20610-XR Jnt/Bursa Major Arth/Asp/Inj RT | $349.30 | $698.60 | $161.47–$460.63 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 IR Arthcntsis, Asp/Inj Maj Brsa w/o U/S - RT | $349.30 | $698.60 | $161.47–$460.63 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 IR Arthcntsis, Asp/Inj Maj Brsa w/o U/S - LT | $349.30 | $698.60 | $161.47–$460.63 | — | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drain/Inj Inter Joint/Bursa W/O Us | $274.50 | $549.00 | $161.47–$460.63 | 16% below | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis/aspiration/inject, intermed joint/bursa; w/o US guid 20605 | $274.50 | $549.00 | $161.47–$460.63 | 16% below | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Drain/Inj Inter Joint/Bursa W/O Us | $274.50 | $549.00 | $161.47–$460.63 | — | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis/aspiration/inject, intermed joint/bursa; w/o US guid 20605 | $274.50 | $549.00 | $161.47–$460.63 | — | 50% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis/aspiration/inject, small joint/bursa; w/o US guid 20600 | $289.20 | $578.40 | $161.47–$460.63 | 14% below | 50% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis/aspiration/inject, small joint/bursa; w/o US guid 20600 | $289.20 | $578.40 | $161.47–$460.63 | — | 50% |
| Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY/SURGERY | $6,101.26 | $12,202.52 | $1,774.80–$6,198.88 | 29% above | 50% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 KNEE ARTHROSCOPY/SURGERY | $6,101.26 | $12,202.52 | $1,774.80–$6,198.88 | — | 50% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY/SURGERY | $5,664.32 | $11,328.64 | $1,774.80–$5,754.95 | 26% above | 50% |
| Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 KNEE ARTHROSCOPY/SURGERY | $5,664.32 | $11,328.64 | $1,774.80–$5,754.95 | — | 50% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY | $13,542.14 | $27,084.27 | $3,191.39–$13,758.81 | 60% above | 50% |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY APPENDECTOMY | $13,542.14 | $27,084.27 | $3,191.39–$13,758.81 | — | 50% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAPAROSCOPY FUNDOPLASTY | $13,442.35 | $26,884.69 | $5,694.94–$16,246.17 | 390% above | 50% |
| Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 LAPAROSCOPY FUNDOPLASTY | $13,442.35 | $26,884.69 | $5,694.94–$16,246.17 | — | 50% |
| Laparoscopic removal of an adjustable gastric band and its port CPT 43774 LAP RMVL GASTR ADJ ALL PARTS | $8,039.96 | $16,079.91 | $2,081.08–$8,168.59 | 52% above | 50% |
| Laparoscopic removal of an adjustable gastric band and its port inpatient CPT 43774 LAP RMVL GASTR ADJ ALL PARTS | $8,039.96 | $16,079.91 | $2,081.08–$8,168.59 | — | 50% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY REMOVE ADNEXA | $7,042.75 | $14,085.50 | $3,191.39–$9,104.22 | 2% below | 50% |
| Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAPAROSCOPY REMOVE ADNEXA | $7,042.75 | $14,085.50 | $3,191.39–$9,104.22 | — | 50% |
| Laparoscopic sleeve gastrectomy for weight loss CPT 43775 LAP SLEEVE GASTRECTOMY | $17,985.08 | $35,970.15 | $10,314.02–$18,272.84 | 959% above | 50% |
| Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 LAP SLEEVE GASTRECTOMY | $17,985.08 | $35,970.15 | $10,314.02–$18,272.84 | — | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intmd Rpr S/A/T/Ext 2.5 Cm/< | $410.55 | $821.10 | $180.00–$623.45 | 10% above | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Hospitalist BP 12031 Intermediate repair, scalp/axillae/trunk/extem, 2.5cm or less | $410.55 | $821.10 | $218.54–$623.45 | 10% above | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 BP Intermediate repair, scalp/axillae/trunk/extem, 2.5cm or less 12031 | $410.55 | $821.10 | $218.54–$623.45 | 10% above | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intermediate repair, scalp/axillae/trunk/extem, 2.5cm or less 12031 | $410.55 | $821.10 | $218.54–$623.45 | 10% above | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Intmd Rpr S/A/T/Ext 2.5 Cm/< | $410.55 | $821.10 | $180.00–$623.45 | — | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Intermediate repair, scalp/axillae/trunk/extem, 2.5cm or less 12031 | $410.55 | $821.10 | $218.54–$623.45 | — | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Hospitalist BP 12031 Intermediate repair, scalp/axillae/trunk/extem, 2.5cm or less | $410.55 | $821.10 | $218.54–$623.45 | — | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 BP Intermediate repair, scalp/axillae/trunk/extem, 2.5cm or less 12031 | $410.55 | $821.10 | $218.54–$623.45 | — | 50% |
| Left heart catheterization, diagnostic CPT 93452 CCL Lv Gram Only | $4,039.55 | $8,079.10 | $1,759.38–$5,019.04 | 42% below | 50% |
| Left heart catheterization, diagnostic inpatient CPT 93452 CCL Lv Gram Only | $4,039.55 | $8,079.10 | $1,759.38–$5,019.04 | — | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 62323-XR Injection Lmbr/Scrl Epidural | $1,254.25 | $2,508.50 | $378.81–$1,274.32 | 22% above | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 62323- CT Injection Lmbr/Scrl Epidural | $1,254.25 | $2,508.50 | $378.81–$1,274.32 | 22% above | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Injection Interlaminar Lumbar/Sacral w/ Guidance 62323 | $1,254.25 | $2,508.50 | $378.81–$1,274.32 | 22% above | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR Inject non-neurolytic intrlaminar L/S | $1,254.25 | $2,508.50 | $378.81–$1,274.32 | 22% above | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC | $1,627.90 | $3,255.80 | $378.81–$1,653.95 | 58% above | 50% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 62323- CT Injection Lmbr/Scrl Epidural | $1,254.25 | $2,508.50 | $378.81–$1,274.32 | — | 50% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR Inject non-neurolytic intrlaminar L/S | $1,254.25 | $2,508.50 | $378.81–$1,274.32 | — | 50% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Injection Interlaminar Lumbar/Sacral w/ Guidance 62323 | $1,254.25 | $2,508.50 | $378.81–$1,274.32 | — | 50% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 62323-XR Injection Lmbr/Scrl Epidural | $1,254.25 | $2,508.50 | $378.81–$1,274.32 | — | 50% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTERLAMINAR LMBR/SAC | $1,627.90 | $3,255.80 | $378.81–$1,653.95 | — | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 IR Inj Foramen Epidural Lum/Sacr | $1,020.80 | $2,041.60 | $486.99–$1,389.25 | 5% below | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 64483-CT Inject Lmbr/Scrl Foramina Epid | $1,020.80 | $2,041.60 | $486.99–$1,389.25 | 5% below | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection Anesthetic/Steroid Transforaminal w/Guide Lumbar/Sacral Single Lvl 64483 | $1,020.80 | $2,041.60 | $486.99–$1,389.25 | 5% below | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 64483-XR Inject Lmbr/Scrl Foramina Epid | $1,020.80 | $2,041.60 | $486.99–$1,389.25 | 5% below | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ FORAMEN EPIDURAL L/S | $1,595.45 | $3,190.90 | $486.99–$1,620.98 | 49% above | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 IR Inj Foramen Epidural Lum/Sacr | $1,020.80 | $2,041.60 | $486.99–$1,389.25 | — | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 64483-XR Inject Lmbr/Scrl Foramina Epid | $1,020.80 | $2,041.60 | $486.99–$1,389.25 | — | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Injection Anesthetic/Steroid Transforaminal w/Guide Lumbar/Sacral Single Lvl 64483 | $1,020.80 | $2,041.60 | $486.99–$1,389.25 | — | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 64483-CT Inject Lmbr/Scrl Foramina Epid | $1,020.80 | $2,041.60 | $486.99–$1,389.25 | — | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ FORAMEN EPIDURAL L/S | $1,595.45 | $3,190.90 | $486.99–$1,620.98 | — | 50% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LOW BACK DISK SURGERY | $11,962.78 | $23,925.55 | $3,907.62–$12,154.18 | 16% above | 50% |
| Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 LOW BACK DISK SURGERY | $11,962.78 | $23,925.55 | $3,907.62–$12,154.18 | — | 50% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 REMOVE SPINE LAMINA 1 LMBR | $12,331.46 | $24,662.92 | $3,907.62–$12,528.76 | 17% above | 50% |
| Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 REMOVE SPINE LAMINA 1 LMBR | $12,331.46 | $24,662.92 | $3,907.62–$12,528.76 | — | 50% |
| Lumpectomy (partial mastectomy) CPT 19301 PARTIAL MASTECTOMY | $9,620.72 | $19,241.43 | $2,094.62–$9,774.65 | 79% above | 50% |
| Lumpectomy (partial mastectomy) inpatient CPT 19301 PARTIAL MASTECTOMY | $9,620.72 | $19,241.43 | $2,094.62–$9,774.65 | — | 50% |
| Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE | $4,149.45 | $8,298.90 | $1,739.20–$4,961.49 | 23% above | 50% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 CARE OF MISCARRIAGE | $4,149.45 | $8,298.90 | $1,739.20–$4,961.49 | — | 50% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Partial/Complete Simple 1 | $160.90 | $321.80 | $108.69–$310.06 | 22% below | 50% |
| Nail removal (partial or complete), one nail CPT 11730 Spl Avulse Np; Sgl | $160.90 | $321.80 | $108.69–$450.00 | 22% below | 50% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Spl Avulse Np; Sgl | $160.90 | $321.80 | $108.69–$450.00 | — | 50% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Partial/Complete Simple 1 | $160.90 | $321.80 | $108.69–$310.06 | — | 50% |
| Occipital nerve block (injection for headaches) CPT 64405 Nerve Block Inj; Occipital 64405 | $491.45 | $982.90 | $161.47–$499.31 | 5% below | 50% |
| Occipital nerve block (injection for headaches) CPT 64405 IR Occipital Nerve Block | $491.45 | $982.90 | $161.47–$499.31 | 5% below | 50% |
| Occipital nerve block (injection for headaches) CPT 64405 BP Nerve Block Inj; Occipital 64405 | $491.45 | $982.90 | $161.47–$499.31 | 5% below | 50% |
| Occipital nerve block (injection for headaches) CPT 64405 Inj Anesth ; Greater Occipital Nerve | $491.45 | $982.90 | $161.47–$499.31 | 5% below | 50% |
| Occipital nerve block (injection for headaches) CPT 64405 N BLOCK INJ OCCIPITAL | $1,125.82 | $2,251.64 | $161.47–$1,143.83 | 118% above | 50% |
| Occipital nerve block (injection for headaches) one side CPT 64405 Occipital Nerve Block, Right | $491.45 | $982.90 | $161.47–$499.31 | 5% below | 50% |
| Occipital nerve block (injection for headaches) one side CPT 64405 Occipital Nerve Block, Left | $491.45 | $982.90 | $161.47–$499.31 | 5% below | 50% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 Nerve Block Inj; Occipital 64405 | $491.45 | $982.90 | $161.47–$499.31 | — | 50% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 BP Nerve Block Inj; Occipital 64405 | $491.45 | $982.90 | $161.47–$499.31 | — | 50% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 Inj Anesth ; Greater Occipital Nerve | $491.45 | $982.90 | $161.47–$499.31 | — | 50% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 IR Occipital Nerve Block | $491.45 | $982.90 | $161.47–$499.31 | — | 50% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 N BLOCK INJ OCCIPITAL | $1,125.82 | $2,251.64 | $161.47–$1,143.83 | — | 50% |
| Occipital nerve block (injection for headaches) inpatient one side CPT 64405 Occipital Nerve Block, Right | $491.45 | $982.90 | $161.47–$499.31 | — | 50% |
| Occipital nerve block (injection for headaches) inpatient one side CPT 64405 Occipital Nerve Block, Left | $491.45 | $982.90 | $161.47–$499.31 | — | 50% |
| Pacemaker implant (dual chamber) both sides CPT 33208 CI Insert or Replace Dual/BI-V Pacer w/Leads | $15,112.65 | $30,225.30 | $5,724.54–$16,330.60 | — | 50% |
| Pacemaker implant (dual chamber) inpatient both sides CPT 33208 CI Insert or Replace Dual/BI-V Pacer w/Leads | $15,112.65 | $30,225.30 | $5,724.54–$16,330.60 | — | 50% |
| Paracentesis with imaging guidance CPT 49083 49083-CT Paracentesis Abdom w/ CT Guide | $713.05 | $1,426.10 | $512.85–$1,463.01 | 42% below | 50% |
| Paracentesis with imaging guidance CPT 49083 IR Abd paracentesis | $713.05 | $1,426.10 | $512.85–$1,463.01 | 42% below | 50% |
| Paracentesis with imaging guidance CPT 49083 49083-US Paracentesis | $713.05 | $1,426.10 | $512.85–$1,463.01 | 42% below | 50% |
| Paracentesis with imaging guidance CPT 49083 Hospitalist BP 49083 Abdominal Paracentesis w/Image Guide | $713.05 | $1,426.10 | $512.85–$1,463.01 | 42% below | 50% |
| Paracentesis with imaging guidance CPT 49083 BP Abdominal paracentesis (dx/ther); w imaging guidance 49083 | $713.05 | $1,426.10 | $512.85–$1,463.01 | 42% below | 50% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $1,333.84 | $2,667.67 | $512.85–$1,463.01 | 9% above | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 49083-CT Paracentesis Abdom w/ CT Guide | $713.05 | $1,426.10 | $512.85–$1,463.01 | — | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 Hospitalist BP 49083 Abdominal Paracentesis w/Image Guide | $713.05 | $1,426.10 | $512.85–$1,463.01 | — | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 IR Abd paracentesis | $713.05 | $1,426.10 | $512.85–$1,463.01 | — | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 49083-US Paracentesis | $713.05 | $1,426.10 | $512.85–$1,463.01 | — | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 BP Abdominal paracentesis (dx/ther); w imaging guidance 49083 | $713.05 | $1,426.10 | $512.85–$1,463.01 | — | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING | $1,333.84 | $2,667.67 | $512.85–$1,463.01 | — | 50% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal Of Nail Bed | $563.00 | $1,126.00 | $180.00–$623.45 | 7% above | 50% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Nail Matrix Permanent Removal | $563.00 | $1,126.00 | $218.54–$623.45 | 7% above | 50% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal Of Nail Bed | $563.00 | $1,126.00 | $180.00–$623.45 | — | 50% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Nail Matrix Permanent Removal | $563.00 | $1,126.00 | $218.54–$623.45 | — | 50% |
| Prostate biopsy CPT 55700 BP Prostate Biopsy, Needle/Punch-1 or more 55700 | $930.15 | $1,860.30 | $945.03–$3,196.59 | 39% below | 50% |
| Prostate biopsy CPT 55700 55700-US Biopsy Prostate | $930.15 | $1,860.30 | $945.03–$3,196.59 | 39% below | 50% |
| Prostate biopsy CPT 55700 BIOPSY OF PROSTATE | $9,487.47 | $18,974.93 | $1,120.53–$9,639.26 | 521% above | 50% |
| Prostate biopsy inpatient CPT 55700 55700-US Biopsy Prostate | $930.15 | $1,860.30 | $945.03–$3,196.59 | — | 50% |
| Prostate biopsy inpatient CPT 55700 BP Prostate Biopsy, Needle/Punch-1 or more 55700 | $930.15 | $1,860.30 | $945.03–$3,196.59 | — | 50% |
| Prostate biopsy inpatient CPT 55700 BIOPSY OF PROSTATE | $9,487.47 | $18,974.93 | $1,120.53–$9,639.26 | — | 50% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPARO RADICAL PROSTATECTOMY | $17,429.99 | $34,859.97 | $5,694.94–$17,708.86 | 13% above | 50% |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 LAPARO RADICAL PROSTATECTOMY | $17,429.99 | $34,859.97 | $5,694.94–$17,708.86 | — | 50% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 IR Rhizotomy of the Lumbar Spine/Sacral | $1,594.60 | $3,189.20 | $1,068.17–$3,047.20 | 34% below | 50% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destruct Lumb/Sac Facet Jnt Sgl 64635 | $1,594.60 | $3,189.20 | $1,068.17–$3,047.20 | 34% below | 50% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Destruct Lumb/Sac Facet Jnt Sgl 64635 | $1,594.60 | $3,189.20 | $1,068.17–$3,047.20 | — | 50% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 IR Rhizotomy of the Lumbar Spine/Sacral | $1,594.60 | $3,189.20 | $1,068.17–$3,047.20 | — | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 Incision & removal foreign body; simple 10120 | $360.90 | $721.80 | $218.54–$623.45 | 3% below | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 Inc & Rem Fb Sq; Smpl | $360.90 | $721.80 | $180.00–$623.45 | 3% below | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 Incision & Removal Foreign Body Subq Tiss Simple | $360.90 | $721.80 | $218.54–$623.45 | 3% below | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 BP Incision & removal foreign body; simple 10120 | $360.90 | $721.80 | $218.54–$623.45 | 3% below | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY | $6,163.38 | $12,326.75 | $218.54–$6,261.99 | 1551% above | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision & removal foreign body; simple 10120 | $360.90 | $721.80 | $218.54–$623.45 | — | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Inc & Rem Fb Sq; Smpl | $360.90 | $721.80 | $180.00–$623.45 | — | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision & Removal Foreign Body Subq Tiss Simple | $360.90 | $721.80 | $218.54–$623.45 | — | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 BP Incision & removal foreign body; simple 10120 | $360.90 | $721.80 | $218.54–$623.45 | — | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY | $6,163.38 | $12,326.75 | $218.54–$6,261.99 | — | 50% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 BP Colorectal Cancer Screening; Colonoscopy, individual not meeting criteria for high risk G0121 | $823.05 | $1,646.10 | $498.71–$1,422.68 | 20% below | 50% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND | $2,099.55 | $4,199.10 | $498.71–$2,133.14 | 104% above | 50% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 BP Colorectal Cancer Screening; Colonoscopy, individual not meeting criteria for high risk G0121 | $823.05 | $1,646.10 | $498.71–$1,422.68 | — | 50% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLON CA SCRN NOT HI RSK IND | $2,099.55 | $4,199.10 | $498.71–$2,133.14 | — | 50% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 BP Colorectal cancer screening; colonoscopy on individual at high risk G0105 | $814.00 | $1,628.00 | $498.71–$1,422.68 | 21% below | 50% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN; HI RISK IND | $2,087.13 | $4,174.25 | $498.71–$2,120.52 | 103% above | 50% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 BP Colorectal cancer screening; colonoscopy on individual at high risk G0105 | $814.00 | $1,628.00 | $498.71–$1,422.68 | — | 50% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL SCRN; HI RISK IND | $2,087.13 | $4,174.25 | $498.71–$2,120.52 | — | 50% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENTING OF KIDNEY STONE | $9,245.23 | $18,490.45 | $1,886.59–$9,393.15 | 43% above | 50% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 FRAGMENTING OF KIDNEY STONE | $9,245.23 | $18,490.45 | $1,886.59–$9,393.15 | — | 50% |
| Short arm cast (elbow to hand) CPT 29075 Application, cast; elbow to finger (short arm) 29075 | $312.80 | $625.60 | $145.27–$414.42 | 26% above | 50% |
| Short arm cast (elbow to hand) inpatient CPT 29075 Application, cast; elbow to finger (short arm) 29075 | $312.80 | $625.60 | $145.27–$414.42 | — | 50% |
| Short arm splint (forearm and hand) CPT 29125 Application of short arm splint static 29125 | $125.05 | $250.10 | $70.51–$201.14 | 35% below | 50% |
| Short arm splint (forearm and hand) CPT 29125 Hospitalist BP 29125 Application Short Arm Splint, Static | $125.05 | $250.10 | $70.51–$201.14 | 35% below | 50% |
| Short arm splint (forearm and hand) CPT 29125 BP Application Short Arm Splint,Static 29125 | $125.05 | $250.10 | $70.51–$201.14 | 35% below | 50% |
| Short arm splint (forearm and hand) CPT 29125 Apply Short Arm Splint; Static | $125.05 | $250.10 | $64.68–$450.00 | 35% below | 50% |
| Short arm splint (forearm and hand) inpatient CPT 29125 Hospitalist BP 29125 Application Short Arm Splint, Static | $125.05 | $250.10 | $70.51–$201.14 | — | 50% |
| Short arm splint (forearm and hand) inpatient CPT 29125 Apply Short Arm Splint; Static | $125.05 | $250.10 | $64.68–$450.00 | — | 50% |
| Short arm splint (forearm and hand) inpatient CPT 29125 Application of short arm splint static 29125 | $125.05 | $250.10 | $70.51–$201.14 | — | 50% |
| Short arm splint (forearm and hand) inpatient CPT 29125 BP Application Short Arm Splint,Static 29125 | $125.05 | $250.10 | $70.51–$201.14 | — | 50% |
| Short leg cast (below the knee) CPT 29405 Application Short Leg Cast 29405 | $137.90 | $275.80 | $140.11–$414.42 | 49% below | 50% |
| Short leg cast (below the knee) inpatient CPT 29405 Application Short Leg Cast 29405 | $137.90 | $275.80 | $140.11–$414.42 | — | 50% |
| Short leg splint (calf to foot) CPT 29515 Application of short leg splint (calf to foot) 29515 | $126.10 | $252.20 | $86.31–$246.22 | 23% below | 50% |
| Short leg splint (calf to foot) CPT 29515 Apply Short Leg Splint | $126.10 | $252.20 | $65.22–$450.00 | 23% below | 50% |
| Short leg splint (calf to foot) CPT 29515 BP Application of short leg splint (calf to foot) 29515 | $126.10 | $252.20 | $86.31–$246.22 | 23% below | 50% |
| Short leg splint (calf to foot) CPT 29515 Hospitalist BP 29515 Application of Short Leg Splint (calf to foot) | $126.10 | $252.20 | $86.31–$246.22 | 23% below | 50% |
| Short leg splint (calf to foot) inpatient CPT 29515 Apply Short Leg Splint | $126.10 | $252.20 | $65.22–$450.00 | — | 50% |
| Short leg splint (calf to foot) inpatient CPT 29515 Hospitalist BP 29515 Application of Short Leg Splint (calf to foot) | $126.10 | $252.20 | $86.31–$246.22 | — | 50% |
| Short leg splint (calf to foot) inpatient CPT 29515 Application of short leg splint (calf to foot) 29515 | $126.10 | $252.20 | $86.31–$246.22 | — | 50% |
| Short leg splint (calf to foot) inpatient CPT 29515 BP Application of short leg splint (calf to foot) 29515 | $126.10 | $252.20 | $86.31–$246.22 | — | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple Repair Wound Neck Trunk Ext <=2.5cm | $142.90 | $285.80 | $108.69–$310.06 | 32% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Hospitalist BP 12001 Simple Lac Repair Ext/Scalp 2.5 cm Less | $142.95 | $285.90 | $108.69–$310.06 | 32% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 BP Simple Lac Repair Ext/Scalp 2.5CM LESS 12001 | $142.95 | $285.90 | $108.69–$310.06 | 32% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Srep S/N/A/G/Tr/E; 2.5Cm/< | $142.95 | $285.90 | $73.93–$450.00 | 32% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple Lac Repair Ext/Scalp 2.5CM LESS 12001 | $142.95 | $285.90 | $108.69–$310.06 | 32% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple Repair Wound Neck Trunk Ext <=2.5cm | $142.90 | $285.80 | $108.69–$310.06 | — | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 BP Simple Lac Repair Ext/Scalp 2.5CM LESS 12001 | $142.95 | $285.90 | $108.69–$310.06 | — | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Hospitalist BP 12001 Simple Lac Repair Ext/Scalp 2.5 cm Less | $142.95 | $285.90 | $108.69–$310.06 | — | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Srep S/N/A/G/Tr/E; 2.5Cm/< | $142.95 | $285.90 | $73.93–$450.00 | — | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple Lac Repair Ext/Scalp 2.5CM LESS 12001 | $142.95 | $285.90 | $108.69–$310.06 | — | 50% |
| Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy Skin; Singe Lesion | $201.85 | $403.70 | $186.75–$623.45 | 45% below | 50% |
| Skin biopsy, punch, one lesion CPT 11104 Punch BX single lesion 11104 | $201.85 | $403.70 | $186.75–$623.45 | 45% below | 50% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 Punch BX single lesion 11104 | $201.85 | $403.70 | $186.75–$623.45 | — | 50% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy Skin; Singe Lesion | $201.85 | $403.70 | $186.75–$623.45 | — | 50% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Puncture Lumbar Diagnostic | $899.85 | $1,799.70 | $180.00–$1,082.56 | 5% above | 50% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 BP Lumbar Puncture 62270 | $899.85 | $1,799.70 | $378.81–$1,082.56 | 5% above | 50% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal puncture, lumbar, diagnostic 62270 | $899.85 | $1,799.70 | $378.81–$1,082.56 | 5% above | 50% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP DIAGNOSTIC | $4,760.88 | $9,521.75 | $378.81–$4,837.05 | 456% above | 50% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Puncture Lumbar Diagnostic | $899.85 | $1,799.70 | $180.00–$1,082.56 | — | 50% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal puncture, lumbar, diagnostic 62270 | $899.85 | $1,799.70 | $378.81–$1,082.56 | — | 50% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 BP Lumbar Puncture 62270 | $899.85 | $1,799.70 | $378.81–$1,082.56 | — | 50% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL FLUID TAP DIAGNOSTIC | $4,760.88 | $9,521.75 | $378.81–$4,837.05 | — | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple Repair, scalp/neck/axillae/trunk/genital/extrem, 2.5 - 7.5 cm 12002 | $207.50 | $415.00 | $108.69–$310.06 | 16% below | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Sreps/N/A/G/Tr/E; 2.6-7.5Cm | $207.50 | $415.00 | $108.69–$450.00 | 16% below | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 BP Simple Repair, scalp/neck/axillae/trunk/genital/extrem, 2.5 - 7.5 cm 12002 | $207.50 | $415.00 | $108.69–$310.06 | 16% below | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Simple Repair, scalp/neck/axillae/trunk/genital/extrem, 2.5 - 7.5 cm 12002 | $207.50 | $415.00 | $108.69–$310.06 | — | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Sreps/N/A/G/Tr/E; 2.6-7.5Cm | $207.50 | $415.00 | $108.69–$450.00 | — | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 BP Simple Repair, scalp/neck/axillae/trunk/genital/extrem, 2.5 - 7.5 cm 12002 | $207.50 | $415.00 | $108.69–$310.06 | — | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 BP Simple repair, face/ears/nose/lips/eyelids/muc membr, 2.5cm or less 12011 | $169.55 | $339.10 | $108.69–$310.06 | 28% below | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple repair, face/ears/nose/lips/eyelids/muc membr, 2.5cm or less 12011 | $169.55 | $339.10 | $108.69–$310.06 | 28% below | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Srep F/E/N/L/Mm; 2.5Cm/< | $169.55 | $339.10 | $108.69–$450.00 | 28% below | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Srep F/E/N/L/Mm; 2.5Cm/< | $169.55 | $339.10 | $108.69–$450.00 | — | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 BP Simple repair, face/ears/nose/lips/eyelids/muc membr, 2.5cm or less 12011 | $169.55 | $339.10 | $108.69–$310.06 | — | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple repair, face/ears/nose/lips/eyelids/muc membr, 2.5cm or less 12011 | $169.55 | $339.10 | $108.69–$310.06 | — | 50% |
| TURP (transurethral resection of the prostate) CPT 52601 PROSTATECTOMY (TURP) | $8,696.76 | $17,393.51 | $2,780.74–$8,835.90 | 39% above | 50% |
| TURP (transurethral resection of the prostate) inpatient CPT 52601 PROSTATECTOMY (TURP) | $8,696.76 | $17,393.51 | $2,780.74–$8,835.90 | — | 50% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangential Biopsy Skin; Single Lesion | $121.45 | $242.90 | $96.34–$310.06 | 58% below | 50% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangential Biopsy Skin; Single Lesion | $121.45 | $242.90 | $96.34–$310.06 | — | 50% |
| Thoracentesis with imaging guidance CPT 32555 Hospitalist BP 32555 Thoracentesis Needle/Cath Pleura w/Image | $561.35 | $1,122.70 | $338.19–$964.76 | 50% below | 50% |
| Thoracentesis with imaging guidance CPT 32555 32555-US Thoracentesis | $561.35 | $1,122.70 | $338.19–$964.76 | 50% below | 50% |
| Thoracentesis with imaging guidance CPT 32555 32555-CT Thoracentesis w/ CT Guidance | $561.35 | $1,122.70 | $338.19–$964.76 | 50% below | 50% |
| Thoracentesis with imaging guidance CPT 32555 Thoracentesis, needle or catheter, aspiration of the pleural space; w/imaging guidance 32555 | $561.35 | $1,122.70 | $338.19–$964.76 | 50% below | 50% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING | $1,489.02 | $2,978.03 | $338.19–$1,512.84 | 33% above | 50% |
| Thoracentesis with imaging guidance one side CPT 32555 IR Thoracentesis w/Image guidance - LT | $561.35 | $1,122.70 | $338.19–$964.76 | 50% below | 50% |
| Thoracentesis with imaging guidance one side CPT 32555 IR Thoracentesis w/Image guidance - RT | $561.35 | $1,122.70 | $338.19–$964.76 | 50% below | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 32555-CT Thoracentesis w/ CT Guidance | $561.35 | $1,122.70 | $338.19–$964.76 | — | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis, needle or catheter, aspiration of the pleural space; w/imaging guidance 32555 | $561.35 | $1,122.70 | $338.19–$964.76 | — | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 32555-US Thoracentesis | $561.35 | $1,122.70 | $338.19–$964.76 | — | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 Hospitalist BP 32555 Thoracentesis Needle/Cath Pleura w/Image | $561.35 | $1,122.70 | $338.19–$964.76 | — | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING | $1,489.02 | $2,978.03 | $338.19–$1,512.84 | — | 50% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 IR Thoracentesis w/Image guidance - LT | $561.35 | $1,122.70 | $338.19–$964.76 | — | 50% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 IR Thoracentesis w/Image guidance - RT | $561.35 | $1,122.70 | $338.19–$964.76 | — | 50% |
| Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY | $21,184.13 | $42,368.25 | $7,038.15–$21,523.07 | 1% below | 50% |
| Total hip replacement inpatient CPT 27130 TOTAL HIP ARTHROPLASTY | $21,184.13 | $42,368.25 | $7,038.15–$21,523.07 | — | 50% |
| Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH | $2,597.64 | $5,195.28 | $875.42–$2,639.20 | 38% above | 50% |
| Trigger finger release surgery inpatient CPT 26055 INCISE FINGER TENDON SHEATH | $2,597.64 | $5,195.28 | $875.42–$2,639.20 | — | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 BP Injection Single/Mlt Trigger Point 1/2 Muscles 20552 | $326.25 | $652.50 | $161.47–$460.63 | 10% below | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 20552-XR Inj Trigger Pnt 1 or 2 Muscles | $326.25 | $652.50 | $161.47–$460.63 | 10% below | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 IR Trigger point 1 to 2 muscles | $326.25 | $652.50 | $161.47–$460.63 | 10% below | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 BP Injection Single/Mlt Trigger Point 1/2 Muscles With US Guidance 20552 | $326.25 | $652.50 | $161.47–$460.63 | 10% below | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Injection Single/Mlt Trigger Point 1/2 Muscles w/Guidance 20552 | $326.25 | $652.50 | $161.47–$460.63 | 10% below | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Injection Single/Mlt Trigger Point 1/2 Muscles 20552 | $326.25 | $652.50 | $161.47–$460.63 | 10% below | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Trigger Point 1-2 Muscles 20552 | $326.25 | $652.50 | $161.47–$460.63 | 10% below | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Inj Trigger Point 1/2 Muscl | $1,376.41 | $2,752.82 | $161.47–$1,398.43 | 278% above | 50% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Trigger Point 1-2 Muscles 20552 | $326.25 | $652.50 | $161.47–$460.63 | — | 50% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 IR Trigger point 1 to 2 muscles | $326.25 | $652.50 | $161.47–$460.63 | — | 50% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Injection Single/Mlt Trigger Point 1/2 Muscles 20552 | $326.25 | $652.50 | $161.47–$460.63 | — | 50% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Injection Single/Mlt Trigger Point 1/2 Muscles w/Guidance 20552 | $326.25 | $652.50 | $161.47–$460.63 | — | 50% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 BP Injection Single/Mlt Trigger Point 1/2 Muscles With US Guidance 20552 | $326.25 | $652.50 | $161.47–$460.63 | — | 50% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552-XR Inj Trigger Pnt 1 or 2 Muscles | $326.25 | $652.50 | $161.47–$460.63 | — | 50% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 BP Injection Single/Mlt Trigger Point 1/2 Muscles 20552 | $326.25 | $652.50 | $161.47–$460.63 | — | 50% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj Trigger Point 1/2 Muscl | $1,376.41 | $2,752.82 | $161.47–$1,398.43 | — | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Biopsy Breast PerQ 1st Lesion incl U/S Guide 19083 | $1,794.15 | $3,588.30 | $886.27–$2,528.30 | 3% below | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 19083-US Breast Biopsy 1st Lesion Left | $1,794.15 | $3,588.30 | $886.27–$2,528.30 | 3% below | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 19083-US Breast Biopsy 1st Lesion Right | $1,794.15 | $3,588.30 | $886.27–$2,583.58 | 3% below | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Biopsy Breast PerQ 1st Lesion incl U/S Guide 19083 | $1,794.15 | $3,588.30 | $886.27–$2,528.30 | — | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 19083-US Breast Biopsy 1st Lesion Right | $1,794.15 | $3,588.30 | $886.27–$2,583.58 | — | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 19083-US Breast Biopsy 1st Lesion Left | $1,794.15 | $3,588.30 | $886.27–$2,528.30 | — | 50% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH EGD DILATION <30 MM | $2,399.45 | $4,798.89 | $1,037.65–$2,960.15 | at median | 50% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ESOPH EGD DILATION <30 MM | $2,399.45 | $4,798.89 | $1,037.65–$2,960.15 | — | 50% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Egd Biopsy Single/Multiple | $1,058.10 | $2,116.20 | $180.00–$1,463.01 | 15% below | 50% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Egd Biopsy Single/Multiple | $1,058.10 | $2,116.20 | $180.00–$1,463.01 | — | 50% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD GUIDE WIRE INSERTION | $2,099.94 | $4,199.88 | $512.85–$2,133.54 | 42% above | 50% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD GUIDE WIRE INSERTION | $2,099.94 | $4,199.88 | $512.85–$2,133.54 | — | 50% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Egd Diagnostic Brush Wash | $983.35 | $1,966.70 | $180.00–$1,463.01 | 11% above | 50% |
| Upper endoscopy (EGD), diagnostic CPT 43235 BP EGD flex transoral; diag inc collect specimen brush/wash when performed 43235 | $983.35 | $1,966.70 | $512.85–$1,463.01 | 11% above | 50% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 BP EGD flex transoral; diag inc collect specimen brush/wash when performed 43235 | $983.35 | $1,966.70 | $512.85–$1,463.01 | — | 50% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Egd Diagnostic Brush Wash | $983.35 | $1,966.70 | $180.00–$1,463.01 | — | 50% |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTOURETERO W/LITHOTRIPSY | $9,651.87 | $19,303.74 | $2,780.74–$9,806.30 | 31% above | 50% |
| Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 CYSTOURETERO W/LITHOTRIPSY | $9,651.87 | $19,303.74 | $2,780.74–$9,806.30 | — | 50% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY | $10,585.47 | $21,170.94 | $2,780.74–$10,754.84 | 7% above | 50% |
| Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYSTO/URETERO W/LITHOTRIPSY | $10,585.47 | $21,170.94 | $2,780.74–$10,754.84 | — | 50% |
| Wart removal, up to 14 warts CPT 17110 Benign Lesion Destruction (not skin tag), up to 14 lesions 17110 | $201.50 | $403.00 | $108.69–$310.06 | 1% below | 50% |
| Wart removal, up to 14 warts inpatient CPT 17110 Benign Lesion Destruction (not skin tag), up to 14 lesions 17110 | $201.50 | $403.00 | $108.69–$310.06 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement, subcutaneous tissue, 1st 20 sq cm or less 11042 | $345.85 | $691.70 | $218.54–$623.45 | 38% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement Subcutaneous Tissue 20 Sq Cm/< | $345.85 | $691.70 | $178.87–$623.45 | 38% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 BP Debridement, Subcutaneous Tissue, 1st 20 sq cm or Less 11042 | $345.85 | $691.70 | $218.54–$623.45 | 38% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Hospitalist BP 11042 Debridement, Subcutaneous Tissue, 1st 20 sq cm or Less | $345.85 | $691.70 | $218.54–$623.45 | 38% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Deb Subq Tissue 20 Sq Cm/< | $345.85 | $691.70 | $180.00–$623.45 | 38% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debridement Subcutaneous Tissue 20 Sq Cm/< | $345.85 | $691.70 | $178.87–$623.45 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 BP Debridement, Subcutaneous Tissue, 1st 20 sq cm or Less 11042 | $345.85 | $691.70 | $218.54–$623.45 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Hospitalist BP 11042 Debridement, Subcutaneous Tissue, 1st 20 sq cm or Less | $345.85 | $691.70 | $218.54–$623.45 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Deb Subq Tissue 20 Sq Cm/< | $345.85 | $691.70 | $180.00–$623.45 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debridement, subcutaneous tissue, 1st 20 sq cm or less 11042 | $345.85 | $691.70 | $218.54–$623.45 | — | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Charge Downtime | $563.50 | $1,127.00 | $127.31–$682.20 | 25% below | 50% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Charge | $563.50 | $1,127.00 | $127.31–$845.25 | 25% below | 50% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Charge Transformation - 2 | $1,127.50 | $2,255.00 | $127.31–$1,145.54 | 50% above | 50% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Charge Transformation - 3 | $1,691.00 | $3,382.00 | $127.31–$1,718.06 | 125% above | 50% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Charge Transformation - 4 | $2,255.00 | $4,510.00 | $127.31–$2,291.08 | 200% above | 50% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Charge Transformation - 5 | $2,818.50 | $5,637.00 | $127.31–$2,863.60 | 275% above | 50% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Charge Transformation - 6 | $3,382.50 | $6,765.00 | $127.31–$3,436.62 | 350% above | 50% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Charge Downtime | $563.50 | $1,127.00 | $127.31–$682.20 | — | 50% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Charge | $563.50 | $1,127.00 | $127.31–$845.25 | — | 50% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Charge Transformation - 2 | $1,127.50 | $2,255.00 | $127.31–$1,145.54 | — | 50% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Charge Transformation - 3 | $1,691.00 | $3,382.00 | $127.31–$1,718.06 | — | 50% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Charge Transformation - 4 | $2,255.00 | $4,510.00 | $127.31–$2,291.08 | — | 50% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Charge Transformation - 5 | $2,818.50 | $5,637.00 | $127.31–$2,863.60 | — | 50% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Charge Transformation - 6 | $3,382.50 | $6,765.00 | $127.31–$3,436.62 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE MDI -> Subsequent | $56.95 | $113.90 | $23.24–$317.38 | 67% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PFT CHARGE Aerosol Med Therapy -> Subsequent | $56.95 | $113.90 | $23.24–$317.38 | 67% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE Aerosol Med Therapy -> Subsequent | $56.95 | $113.90 | $23.24–$317.38 | 67% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PFT CHARGE Aerosol Med Therapy -> Initial | $56.95 | $113.90 | $23.24–$317.38 | 67% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Pressure/nonpressurized inhale Tx 94640 | $56.95 | $113.90 | $23.24–$317.38 | 67% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PFT CHARGE MDI -> Subsequent | $56.95 | $113.90 | $23.24–$317.38 | 67% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE MDI -> Initial | $56.95 | $113.90 | $23.24–$317.38 | 67% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PFT CHARGE MDI -> Initial | $56.95 | $113.90 | $23.24–$317.38 | 67% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AMB Med Inhalation Tx -> First Airway Inhal Tx 94640 | $56.95 | $113.90 | $23.24–$317.38 | 67% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE Aerosol Med Therapy -> Initial | $56.95 | $113.90 | $23.24–$317.38 | 67% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AMB Med Inhalation Tx -> Subs Airway Inhal TX 94640 | $56.95 | $113.90 | $23.24–$317.38 | 67% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE MDI -> Subsequent | $56.95 | $113.90 | $23.24–$317.38 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Pressure/nonpressurized inhale Tx 94640 | $56.95 | $113.90 | $23.24–$317.38 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PFT CHARGE MDI -> Initial | $56.95 | $113.90 | $23.24–$317.38 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE MDI -> Initial | $56.95 | $113.90 | $23.24–$317.38 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE Aerosol Med Therapy -> Subsequent | $56.95 | $113.90 | $23.24–$317.38 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE Aerosol Med Therapy -> Initial | $56.95 | $113.90 | $23.24–$317.38 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PFT CHARGE MDI -> Subsequent | $56.95 | $113.90 | $23.24–$317.38 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PFT CHARGE Aerosol Med Therapy -> Initial | $56.95 | $113.90 | $23.24–$317.38 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PFT CHARGE Aerosol Med Therapy -> Subsequent | $56.95 | $113.90 | $23.24–$317.38 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AMB Med Inhalation Tx -> Subs Airway Inhal TX 94640 | $56.95 | $113.90 | $23.24–$317.38 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AMB Med Inhalation Tx -> First Airway Inhal Tx 94640 | $56.95 | $113.90 | $23.24–$317.38 | — | 50% |
| Chemotherapy IV infusion, first hour CPT 96413 INF/C IV Infusion initial/single | $322.05 | $644.10 | $181.43–$517.58 | 39% below | 50% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 INF/C IV Infusion initial/single | $322.05 | $644.10 | $181.43–$517.58 | — | 50% |
| Critical care, first 30 to 74 minutes CPT 99291 Critical Care 1St Hour | $1,087.00 | $2,174.00 | $180.00–$1,630.50 | 46% below | 50% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR | $1,216.75 | $2,433.50 | $460.91–$1,416.01 | 40% below | 50% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care 1St Hour | $1,087.00 | $2,174.00 | $180.00–$1,630.50 | — | 50% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST HOUR | $1,216.75 | $2,433.50 | $460.91–$1,416.01 | — | 50% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY | $327.15 | $654.30 | $170.34–$1,006.30 | 58% below | 50% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 CTP EEG Awake and Drowsy | $487.00 | $974.00 | $170.34–$1,006.30 | 37% below | 50% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG Awake & Drowsy | $487.00 | $974.00 | $170.34–$1,006.30 | 37% below | 50% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY | $327.15 | $654.30 | $170.34–$1,006.30 | — | 50% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG Awake & Drowsy | $487.00 | $974.00 | $170.34–$1,006.30 | — | 50% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 CTP EEG Awake and Drowsy | $487.00 | $974.00 | $170.34–$1,006.30 | — | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING | $55.90 | $111.79 | $14.34–$92.69 | 57% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram, Routine With At Least 12 Leads; Tracing Only, W/O Interpret And Report 93005 | $58.50 | $117.00 | $14.34–$92.69 | 55% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CV ECG Acquisition | $58.50 | $117.00 | $14.34–$92.69 | 55% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM TRACING | $55.90 | $111.79 | $14.34–$92.69 | — | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram, Routine With At Least 12 Leads; Tracing Only, W/O Interpret And Report 93005 | $58.50 | $117.00 | $14.34–$92.69 | — | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CV ECG Acquisition | $58.50 | $117.00 | $14.34–$92.69 | — | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Dept Visit Level I | $122.00 | $244.00 | $48.16–$450.00 | 35% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPT VISIT | $122.55 | $245.10 | $48.16–$175.00 | 35% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency Dept Visit Level I | $122.00 | $244.00 | $48.16–$450.00 | — | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPT VISIT | $122.55 | $245.10 | $48.16–$175.00 | — | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Dept Visit Level II | $227.50 | $455.00 | $86.62–$450.00 | 35% below | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT | $236.41 | $472.82 | $86.62–$247.11 | 32% below | 50% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency Dept Visit Level II | $227.50 | $455.00 | $86.62–$450.00 | — | 50% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT VISIT | $236.41 | $472.82 | $86.62–$247.11 | — | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Dept Visit Level III | $340.00 | $680.00 | $151.46–$513.09 | 47% below | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT | $341.41 | $682.82 | $151.46–$432.07 | 46% below | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency Dept Visit Level III | $340.00 | $680.00 | $151.46–$513.09 | — | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT VISIT | $341.41 | $682.82 | $151.46–$432.07 | — | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT | $640.37 | $1,280.73 | $232.92–$664.47 | 39% below | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Dept Visit Level IV | $645.50 | $1,291.00 | $180.00–$968.25 | 39% below | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT VISIT | $640.37 | $1,280.73 | $232.92–$664.47 | — | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency Dept Visit Level IV | $645.50 | $1,291.00 | $180.00–$968.25 | — | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT | $857.21 | $1,714.42 | $335.37–$956.71 | 49% below | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Dept Visit Level V | $876.50 | $1,753.00 | $180.00–$1,314.75 | 48% below | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT VISIT | $857.21 | $1,714.42 | $335.37–$956.71 | — | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency Dept Visit Level V | $876.50 | $1,753.00 | $180.00–$1,314.75 | — | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST | $302.05 | $604.10 | $114.16–$485.92 | 59% below | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CSC Stress Nuclear Treadmill | $312.60 | $625.20 | $114.16–$485.92 | 57% below | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CSC Stress Nuclear Dobutamine | $312.60 | $625.20 | $114.16–$485.92 | 57% below | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CSC Stress Nuclear Persantine | $312.60 | $625.20 | $114.16–$485.92 | 57% below | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CSC Stress Regular Treadmill | $312.60 | $625.20 | $114.16–$485.92 | 57% below | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CSC Stress Nuclear Lexi-Scan | $312.60 | $625.20 | $114.16–$485.92 | 57% below | 50% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIOVASCULAR STRESS TEST | $302.05 | $604.10 | $114.16–$485.92 | — | 50% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CSC Stress Nuclear Persantine | $312.60 | $625.20 | $114.16–$485.92 | — | 50% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CSC Stress Nuclear Dobutamine | $312.60 | $625.20 | $114.16–$485.92 | — | 50% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CSC Stress Nuclear Treadmill | $312.60 | $625.20 | $114.16–$485.92 | — | 50% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CSC Stress Nuclear Lexi-Scan | $312.60 | $625.20 | $114.16–$485.92 | — | 50% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CSC Stress Regular Treadmill | $312.60 | $625.20 | $114.16–$485.92 | — | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INF/H IV Inf Initial 31 - 60 min | $298.85 | $597.70 | $93.96–$328.77 | 15% above | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration Iv Infusion Init 31-60 Mins | $298.85 | $597.70 | $93.96–$448.28 | 15% above | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT | $328.42 | $656.84 | $93.96–$333.67 | 26% above | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INF/H IV Inf Initial 31 - 60 min | $298.85 | $597.70 | $93.96–$328.77 | — | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration Iv Infusion Init 31-60 Mins | $298.85 | $597.70 | $93.96–$448.28 | — | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT | $328.42 | $656.84 | $93.96–$333.67 | — | 50% |
| IV infusion of a medicine, first hour CPT 96365 Ther/Proph/Diag Iv Inf Init =<1 Hr | $298.85 | $597.70 | $115.25–$448.28 | at median | 50% |
| IV infusion of a medicine, first hour CPT 96365 INF/NC IV Infusion Ther Initial | $298.85 | $597.70 | $115.25–$328.77 | at median | 50% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INF/NC IV Infusion Ther Initial | $298.85 | $597.70 | $115.25–$328.77 | — | 50% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Ther/Proph/Diag Iv Inf Init =<1 Hr | $298.85 | $597.70 | $115.25–$448.28 | — | 50% |
| IV push of a medicine, first drug CPT 96374 Ther/Proph/Diag Inj Iv Push | $113.40 | $226.80 | $58.65–$328.77 | 39% below | 50% |
| IV push of a medicine, first drug CPT 96374 INF/NC IV Push Single/Initial Drug | $113.40 | $226.80 | $106.08–$328.77 | 39% below | 50% |
| IV push of a medicine, first drug inpatient CPT 96374 INF/NC IV Push Single/Initial Drug | $113.40 | $226.80 | $106.08–$328.77 | — | 50% |
| IV push of a medicine, first drug inpatient CPT 96374 Ther/Proph/Diag Inj Iv Push | $113.40 | $226.80 | $58.65–$328.77 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/Proph/Diag Inj Sc/Im | $43.60 | $87.20 | $25.00–$111.06 | 52% below | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Amb Med Admin Multiple-IVP -> IM/SQ Inject 96372 | $43.60 | $87.20 | $25.00–$111.06 | 52% below | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Amb Med Admin Multiple -> IM/SQ Inject 96372 | $45.15 | $90.30 | $23.35–$111.06 | 50% below | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 AMB Med Admin -> IM/SQ Inject 96372 | $45.15 | $90.30 | $25.00–$111.06 | 50% below | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 AMB Med Admin Multiple pom -> IM/SQ Inject 96372 | $45.15 | $90.30 | $25.00–$111.06 | 50% below | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INF/NC SQ/IM injection | $45.15 | $90.30 | $25.00–$111.06 | 50% below | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/Proph/Diag Inj Sc/Im | $43.60 | $87.20 | $25.00–$111.06 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Amb Med Admin Multiple-IVP -> IM/SQ Inject 96372 | $43.60 | $87.20 | $25.00–$111.06 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Amb Med Admin Multiple -> IM/SQ Inject 96372 | $45.15 | $90.30 | $23.35–$111.06 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 AMB Med Admin -> IM/SQ Inject 96372 | $45.15 | $90.30 | $25.00–$111.06 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INF/NC SQ/IM injection | $45.15 | $90.30 | $25.00–$111.06 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 AMB Med Admin Multiple pom -> IM/SQ Inject 96372 | $45.15 | $90.30 | $25.00–$111.06 | — | 50% |
| New patient office visit, about 30 minutes CPT 99203 Office Visit Level 3 New Professional 30-44 Minutes 99203 | $89.00 | $178.00 | $46.03–$225.00 | 20% below | 50% |
| New patient office visit, about 30 minutes CPT 99203 New Patient Visit - Level 3 | $148.50 | $297.00 | $108.76–$225.00 | 33% above | 50% |
| New patient office visit, about 30 minutes CPT 99203 OB Triage Level, New Patient -> Level 3 | $148.50 | $297.00 | $108.76–$225.00 | 33% above | 50% |
| New patient office visit, about 30 minutes CPT 99203 New Patient Visit Level 3 | $148.50 | $297.00 | $108.76–$225.00 | 33% above | 50% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPATIENT VISIT NEW | $24,233.80 | $48,467.60 | $108.76–$24,621.54 | 21586% above | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office Visit Level 3 New Professional 30-44 Minutes 99203 | $89.00 | $178.00 | $46.03–$225.00 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 New Patient Visit Level 3 | $148.50 | $297.00 | $108.76–$225.00 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OB Triage Level, New Patient -> Level 3 | $148.50 | $297.00 | $108.76–$225.00 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 New Patient Visit - Level 3 | $148.50 | $297.00 | $108.76–$225.00 | — | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE/OUTPATIENT VISIT NEW | $24,233.80 | $48,467.60 | $108.76–$24,621.54 | — | 50% |
| New patient office visit, about 45 minutes CPT 99204 Office Visit Level 4 New Professional 45-59 Minutes 99204 | $96.00 | $192.00 | $49.65–$250.00 | 19% below | 50% |
| New patient office visit, about 45 minutes CPT 99204 New Patient Visit - Level 4 | $185.80 | $371.60 | $145.48–$250.00 | 57% above | 50% |
| New patient office visit, about 45 minutes CPT 99204 New Patient Visit Level 4 | $186.00 | $372.00 | $145.48–$250.00 | 57% above | 50% |
| New patient office visit, about 45 minutes CPT 99204 OB Triage Level, New Patient -> Level 4 | $186.00 | $372.00 | $145.48–$250.00 | 57% above | 50% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPATIENT VISIT NEW | $23,081.05 | $46,162.09 | $145.48–$23,450.34 | 19435% above | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office Visit Level 4 New Professional 45-59 Minutes 99204 | $96.00 | $192.00 | $49.65–$250.00 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 New Patient Visit - Level 4 | $185.80 | $371.60 | $145.48–$250.00 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OB Triage Level, New Patient -> Level 4 | $186.00 | $372.00 | $145.48–$250.00 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 New Patient Visit Level 4 | $186.00 | $372.00 | $145.48–$250.00 | — | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE/OUTPATIENT VISIT NEW | $23,081.05 | $46,162.09 | $145.48–$23,450.34 | — | 50% |
| New patient office visit, about 60 minutes CPT 99205 Office Visit Level 5 New Professional 60-74 Minutes 99205 | $103.50 | $207.00 | $64.72–$275.00 | 24% below | 50% |
| New patient office visit, about 60 minutes CPT 99205 New Patient Visit - Level 5 | $236.50 | $473.00 | $176.33–$275.00 | 73% above | 50% |
| New patient office visit, about 60 minutes CPT 99205 OB Triage Level, New Patient -> Level 5 | $236.50 | $473.00 | $176.33–$275.00 | 73% above | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Office Visit Level 5 New Professional 60-74 Minutes 99205 | $103.50 | $207.00 | $64.72–$275.00 | — | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 New Patient Visit - Level 5 | $236.50 | $473.00 | $176.33–$275.00 | — | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OB Triage Level, New Patient -> Level 5 | $236.50 | $473.00 | $176.33–$275.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office Visit Level 2 New Professional 15-29 Minutes 99202 | $82.00 | $164.00 | $82.29–$200.00 | 1% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OB Triage Level, New Patient -> Level 1 | $89.50 | $179.00 | $82.29–$200.00 | 8% above | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Patient Visit Level 2 | $107.50 | $215.00 | $82.29–$200.00 | 30% above | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OB Triage Level, New Patient -> Level 2 | $107.50 | $215.00 | $82.29–$200.00 | 30% above | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office/Outpatient Established Patient Visit - Level 2 | $107.65 | $215.30 | $82.29–$200.00 | 30% above | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Patient Visit - Level 2 | $107.65 | $215.30 | $82.29–$200.00 | 30% above | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE/OUTPATIENT VISIT NEW | $370.92 | $741.83 | $82.29–$376.85 | 349% above | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office Visit Level 2 New Professional 15-29 Minutes 99202 | $82.00 | $164.00 | $82.29–$200.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OB Triage Level, New Patient -> Level 1 | $89.50 | $179.00 | $82.29–$200.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OB Triage Level, New Patient -> Level 2 | $107.50 | $215.00 | $82.29–$200.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 New Patient Visit Level 2 | $107.50 | $215.00 | $82.29–$200.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office/Outpatient Established Patient Visit - Level 2 | $107.65 | $215.30 | $82.29–$200.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 New Patient Visit - Level 2 | $107.65 | $215.30 | $82.29–$200.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE/OUTPATIENT VISIT NEW | $370.92 | $741.83 | $82.29–$376.85 | — | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN | $27.00 | $54.00 | $27.43–$56.59 | 41% below | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT Initial Units | $27.40 | $54.80 | $27.84–$56.59 | 40% below | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION INDIV IN | $27.00 | $54.00 | $27.43–$56.59 | — | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT Initial Units | $27.40 | $54.80 | $27.84–$56.59 | — | 50% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN | $182.15 | $364.30 | $125.14–$185.06 | 22% below | 50% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45 MIN | $182.15 | $364.30 | $125.14–$185.06 | — | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN | $118.14 | $236.27 | $120.03–$125.14 | 40% below | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN | $118.14 | $236.27 | $120.03–$125.14 | — | 50% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN | $149.10 | $298.20 | $125.14–$151.49 | 34% below | 50% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX 30 MIN | $149.10 | $298.20 | $125.14–$151.49 | — | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial Comp Preventive Med 18 to 39 years New 99385 | $106.00 | $212.00 | $106.51–$107.70 | 31% below | 50% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Initial Comp Preventive Med 18 to 39 years New 99385 | $106.00 | $212.00 | $106.51–$107.70 | — | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial Comp Preventive Med 40 to 64 years New 99386 | $131.50 | $263.00 | $132.13–$197.25 | 29% below | 50% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Initial Comp Preventive Med 40 to 64 years New 99386 | $131.50 | $263.00 | $132.13–$197.25 | — | 50% |
| Preventive checkup, new patient aged 65 or older CPT 99387 Initial Preventive Medicine New Patient 65Yrs+Greater than 99387 | $144.50 | $289.00 | $146.81 | 34% below | 50% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Initial Preventive Medicine New Patient 65Yrs+Greater than 99387 | $144.50 | $289.00 | $146.81 | — | 50% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 Periodic Comp Preventive Med 18 to 39 years Est 99395 | $95.50 | $191.00 | $49.39–$143.25 | 36% below | 50% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Periodic Comp Preventive Med 18 to 39 years Est 99395 | $95.50 | $191.00 | $49.39–$143.25 | — | 50% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 Periodic Comp Preventive Med 40 to 64 years Est 99396 | $106.00 | $212.00 | $54.82–$159.00 | 37% below | 50% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Periodic Comp Preventive Med 40 to 64 years Est 99396 | $106.00 | $212.00 | $54.82–$159.00 | — | 50% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 Periodic Comp Preventive Med 65+ years Est 99397 | $120.00 | $240.00 | $121.92 | 37% below | 50% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Periodic Comp Preventive Med 65+ years Est 99397 | $120.00 | $240.00 | $121.92 | — | 50% |
| Psychiatric evaluation with medical services CPT 90792 Psych Diagnostic Eval w/Medical Services 90792 | $198.25 | $396.50 | $87.89–$297.38 | at median | 50% |
| Psychiatric evaluation with medical services inpatient CPT 90792 Psych Diagnostic Eval w/Medical Services 90792 | $198.25 | $396.50 | $87.89–$297.38 | — | 50% |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 Mins 90834 | $100.60 | $201.20 | $87.89–$250.72 | 53% below | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy, 45 Mins 90834 | $100.60 | $201.20 | $87.89–$250.72 | — | 50% |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 Mins 90837 | $408.55 | $817.10 | $87.89–$415.09 | 77% above | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy, 60 Mins 90837 | $408.55 | $817.10 | $87.89–$415.09 | — | 50% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco-Use Counsel 3-10 Min | $41.90 | $83.80 | $12.52–$46.49 | 2% above | 50% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 CM Tobacco Cess Inter 3-10 Min 99406 | $42.00 | $84.00 | $12.52–$46.49 | 2% above | 50% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco Use Cessation Intermediate 3-10 Minutes 99406 | $42.00 | $84.00 | $12.52–$63.00 | 2% above | 50% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco-Use Counsel 3-10 Min | $41.90 | $83.80 | $12.52–$46.49 | — | 50% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 CM Tobacco Cess Inter 3-10 Min 99406 | $42.00 | $84.00 | $12.52–$46.49 | — | 50% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco Use Cessation Intermediate 3-10 Minutes 99406 | $42.00 | $84.00 | $12.52–$63.00 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office Visit Level 5 Est Professional 40-54 Minutes 99215 | $103.50 | $207.00 | $104.00–$155.25 | 37% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office Visit Level 5 Est Professional 40-54 Minutes 99215 | $103.50 | $207.00 | $104.00–$155.25 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office Visit Level 3 Est Professional 20-29 Minutes 99213 | $89.00 | $178.00 | $46.03–$133.50 | 7% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Established Patient Visit - Level 3 | $126.80 | $253.60 | $79.29–$182.59 | 33% above | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Established Patient Visit Level 3 | $127.00 | $254.00 | $129.03–$145.57 | 33% above | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OB Triage Level, Est Patient -> Level 3 | $127.00 | $254.00 | $129.03–$182.88 | 33% above | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPATIENT VISIT EST | $24,424.25 | $48,848.49 | $24,815.03 | 25467% above | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office Visit Level 3 Est Professional 20-29 Minutes 99213 | $89.00 | $178.00 | $46.03–$133.50 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Established Patient Visit - Level 3 | $126.80 | $253.60 | $79.29–$182.59 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OB Triage Level, Est Patient -> Level 3 | $127.00 | $254.00 | $129.03–$182.88 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Established Patient Visit Level 3 | $127.00 | $254.00 | $129.03–$145.57 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OUTPATIENT VISIT EST | $24,424.25 | $48,848.49 | $24,815.03 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office Visit Level 4 Est Professional 30-39 Minutes 99214 | $96.50 | $193.00 | $49.91–$144.75 | 18% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OB Triage Level, Est Patient -> Level 4 | $148.50 | $297.00 | $150.88 | 26% above | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Established Patient Visit - Level 4 | $148.50 | $297.00 | $150.88 | 26% above | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Established Patient Visit Level 4 | $148.50 | $297.00 | $150.88–$187.91 | 26% above | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OUTPATIENT VISIT EST | $18,246.80 | $36,493.60 | $18,538.75 | 15344% above | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office Visit Level 4 Est Professional 30-39 Minutes 99214 | $96.50 | $193.00 | $49.91–$144.75 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Established Patient Visit - Level 4 | $148.50 | $297.00 | $150.88 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Established Patient Visit Level 4 | $148.50 | $297.00 | $150.88–$187.91 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OB Triage Level, Est Patient -> Level 4 | $148.50 | $297.00 | $150.88 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OUTPATIENT VISIT EST | $18,246.80 | $36,493.60 | $18,538.75 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office Visit Level 2 Est Professional 10-19 Minutes, 99212 | $82.00 | $164.00 | $42.41–$83.31 | 11% above | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPATIENT VISIT EST | $104.32 | $208.63 | $60.70–$105.98 | 41% above | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Established Patient Visit Level 2 | $107.50 | $215.00 | $60.70–$109.22 | 46% above | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OB Triage Level, Est Patient -> Level 2 | $107.50 | $215.00 | $60.70–$136.03 | 46% above | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Established Patient Visit - Level 2 | $107.65 | $215.30 | $60.70–$155.02 | 46% above | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office/Outpatient New Patient Visit - Level 2 | $107.65 | $215.30 | $60.70–$109.37 | 46% above | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office Visit Level 2 Est Professional 10-19 Minutes, 99212 | $82.00 | $164.00 | $42.41–$83.31 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPATIENT VISIT EST | $104.32 | $208.63 | $60.70–$105.98 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Established Patient Visit Level 2 | $107.50 | $215.00 | $60.70–$109.22 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OB Triage Level, Est Patient -> Level 2 | $107.50 | $215.00 | $60.70–$136.03 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office/Outpatient New Patient Visit - Level 2 | $107.65 | $215.30 | $60.70–$109.37 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Established Patient Visit - Level 2 | $107.65 | $215.30 | $60.70–$155.02 | — | 50% |
| Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN | $191.80 | $383.60 | $194.87–$490.69 | 49% below | 50% |
| Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMPREHEN | $191.80 | $383.60 | $194.87–$490.69 | — | 50% |
| Spirometry (breathing test) CPT 94010 Spirometry POC Amb | $117.60 | $235.20 | $58.60–$244.15 | 43% below | 50% |
| Spirometry (breathing test) CPT 94010 PFT CHARGE -> Spirometry | $117.60 | $235.20 | $58.60–$244.15 | 43% below | 50% |
| Spirometry (breathing test) inpatient CPT 94010 Spirometry POC Amb | $117.60 | $235.20 | $58.60–$244.15 | — | 50% |
| Spirometry (breathing test) inpatient CPT 94010 PFT CHARGE -> Spirometry | $117.60 | $235.20 | $58.60–$244.15 | — | 50% |
| Spirometry before and after a bronchodilator CPT 94060 RT CHARGE PFT -> Spirometry before & after | $197.15 | $394.30 | $87.91–$485.92 | 52% below | 50% |
| Spirometry before and after a bronchodilator CPT 94060 Bronchodilator Response Spirometry Pre+Post-Bronchodilator Admn 94060 | $197.15 | $394.30 | $87.91–$485.92 | 52% below | 50% |
| Spirometry before and after a bronchodilator CPT 94060 PFT CHARGE -> Spirometry before & after | $197.15 | $394.30 | $87.91–$485.92 | 52% below | 50% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Bronchodilator Response Spirometry Pre+Post-Bronchodilator Admn 94060 | $197.15 | $394.30 | $87.91–$485.92 | — | 50% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 RT CHARGE PFT -> Spirometry before & after | $197.15 | $394.30 | $87.91–$485.92 | — | 50% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PFT CHARGE -> Spirometry before & after | $197.15 | $394.30 | $87.91–$485.92 | — | 50% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 INF Ther Phlebotomy | $100.35 | $200.70 | $70.51–$267.74 | 57% below | 50% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY | $123.19 | $246.37 | $70.51–$267.74 | 47% below | 50% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 INF Ther Phlebotomy | $100.35 | $200.70 | $70.51–$267.74 | — | 50% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY | $123.19 | $246.37 | $70.51–$267.74 | — | 50% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Michigan | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 Virus Vial (Spikevax) -> Spikevax PF SYR 0.5mL 91322 | $289.05 | $578.10 | $274.48–$293.67 | 4% above | 50% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 Virus Vial (Spikevax) -> Spikevax PF SYR 0.5mL 91322 | $289.05 | $578.10 | $274.48–$293.67 | — | 50% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 Virus Vial (Comirnaty) -> Comirnaty PF SYR 0.3mL 91320 | $214.25 | $428.50 | $217.68–$285.88 | at median | 50% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 Virus Vial (Comirnaty) -> Comirnaty PF SYR 0.3mL 91320 | $214.25 | $428.50 | $217.68–$285.88 | — | 50% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella Virus (Varivax) Vial -> Varicella Virus 90716 | $201.95 | $403.90 | $205.18–$371.89 | at median | 50% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varicella Virus (Varivax) Vial -> Varicella Virus 90716 | $201.95 | $403.90 | $205.18–$371.89 | — | 50% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTaP IPV (Age 4-6 Years) Vial -> DTaP IPV 90696 | $41.15 | $82.30 | $41.81–$121.60 | 33% below | 50% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTaP IPV (Age 4-6 Years) Vial -> DTaP IPV 90696 | $41.15 | $82.30 | $41.81–$121.60 | — | 50% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTaP Pediatric Under 7 Yrs Vial -> DTaP 90700 | $36.55 | $73.10 | $37.13–$57.28 | 6% below | 50% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTaP Pediatric Under 7 Yrs Vial -> DTaP 90700 | $36.55 | $73.10 | $37.13–$57.28 | — | 50% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTaP HepB IPV (Pediarix) Vial -> DTaP HepB IPV 90723 | $114.20 | $228.40 | $116.03–$200.58 | 16% below | 50% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTaP HepB IPV (Pediarix) Vial -> DTaP HepB IPV 90723 | $114.20 | $228.40 | $116.03–$200.58 | — | 50% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTaP IPV/HIB (Pentacel) Vial -> DTaP IPV/HIB 90698 | $182.15 | $364.30 | $185.06–$232.40 | 16% above | 50% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTaP IPV/HIB (Pentacel) Vial -> DTaP IPV/HIB 90698 | $182.15 | $364.30 | $185.06–$232.40 | — | 50% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DTaP IPV/HIB/Hep B (Vaxelis) Vial -> DTaP IPV/HIB/Hep B 90697 | $438.85 | $877.70 | $303.17–$445.87 | at median | 50% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DTaP IPV/HIB/Hep B (Vaxelis) Vial -> DTaP IPV/HIB/Hep B 90697 | $438.85 | $877.70 | $303.17–$445.87 | — | 50% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza Virus Vial -> IIV3, 0.5ml Inj 90656 | $31.70 | $63.40 | $32.21–$47.55 | at median | 50% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Influenza Virus Vial -> IIV3, 0.5ml Inj 90656 | $31.70 | $63.40 | $32.21–$47.55 | — | 50% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Human Papillomavirus Vial -> 9 valent HPV 90651 | $403.00 | $806.00 | $409.45–$637.02 | 21% above | 50% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Human Papillomavirus Vial -> 9 valent HPV 90651 | $403.00 | $806.00 | $409.45–$637.02 | — | 50% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Hepatitis A Hepatitis B Adult Vial -> Hepatitis A-Hepatitis B Adult 90636 | $172.95 | $345.90 | $175.72–$256.34 | at median | 50% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 Hepatitis A Hepatitis B Adult Vial -> Hepatitis A-Hepatitis B Adult 90636 | $172.95 | $345.90 | $175.72–$256.34 | — | 50% |
| Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Adult Vial -> Hepatitis A Adult 90632 | $117.80 | $235.60 | $119.68–$162.08 | at median | 50% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis A Adult Vial -> Hepatitis A Adult 90632 | $117.80 | $235.60 | $119.68–$162.08 | — | 50% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepatitis A Pediatric Adol Vial -> Hepatitis A Pediatric Adol. 90633 | $97.60 | $195.20 | $75.74–$99.16 | 27% above | 50% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hepatitis A Pediatric Adol Vial -> Hepatitis A Pediatric Adol. 90633 | $97.60 | $195.20 | $75.74–$99.16 | — | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Adult Vial -> Hep B Adult 20 mcg/mL 90746 | $84.00 | $168.00 | $85.34–$139.78 | at median | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Adult Vial -> Hep B Adult 20 mcg/mL 90746 | $84.00 | $168.00 | $85.34–$139.78 | — | 50% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 Hepatitis B Adult Vial -> Hep B Adult (Heplisav B) 0.5ml 90739 | $223.15 | $446.30 | $226.72–$301.49 | 61% above | 50% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 Hepatitis B Adult Vial -> Hep B Adult (Heplisav B) 0.5ml 90739 | $223.15 | $446.30 | $226.72–$301.49 | — | 50% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B Pediatric Adol. Vial -> Hep B Recombivax 5 mcg/0.5mL Pediatric Adol. 90744 | $26.10 | $52.20 | $26.52–$56.62 | 19% below | 50% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B Pediatric Adol. Vial -> Hep B Engerix 10 mcg/0.5mL Pediatric Adol. 90744 | $45.35 | $90.70 | $46.08–$56.62 | 40% above | 50% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepatitis B Pediatric Adol. Vial -> Hep B Recombivax 5 mcg/0.5mL Pediatric Adol. 90744 | $26.10 | $52.20 | $26.52–$56.62 | — | 50% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepatitis B Pediatric Adol. Vial -> Hep B Engerix 10 mcg/0.5mL Pediatric Adol. 90744 | $45.35 | $90.70 | $46.08–$56.62 | — | 50% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Haemophilus B Conjugate (PRP OMP) Vial -> Hib PRP OMP 90647 | $49.20 | $98.40 | $49.99–$60.92 | at median | 50% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 Haemophilus B Conjugate (PRP OMP) Vial -> Hib PRP OMP 90647 | $49.20 | $98.40 | $49.99–$60.92 | — | 50% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Haemophilus B PRP T Vial -> Hib PRP T 90648 | $59.95 | $119.90 | $25.49–$60.91 | 43% above | 50% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Haemophilus B PRP T Vial -> Hib PRP T 90648 | $59.95 | $119.90 | $25.49–$60.91 | — | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza Virus Vial -> High Dose IIV SYR 0.5mL 90662 | $67.55 | $135.10 | $68.63–$166.92 | 13% below | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza Virus Vial -> High Dose IIV3, 0.5ml 90662 | $67.55 | $135.10 | $68.63–$166.92 | 13% below | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza Virus Vial -> High Dose IIV Syr 0.7 mL 90662 | $119.35 | $238.70 | $121.26–$166.92 | 54% above | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Influenza Virus Vial -> High Dose IIV SYR 0.5mL 90662 | $67.55 | $135.10 | $68.63–$166.92 | — | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Influenza Virus Vial -> High Dose IIV3, 0.5ml 90662 | $67.55 | $135.10 | $68.63–$166.92 | — | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Influenza Virus Vial -> High Dose IIV Syr 0.7 mL 90662 | $119.35 | $238.70 | $121.26–$166.92 | — | 50% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 Japanese Encephalitis Vial -> Japanese Encephalitis 90738 | $441.10 | $882.20 | $448.16–$571.19 | at median | 50% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 Japanese Encephalitis Vial -> Japanese Encephalitis 90738 | $441.10 | $882.20 | $448.16–$571.19 | — | 50% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR II Live Vial -> MMR II Live SQ 90707 | $135.95 | $271.90 | $138.13–$184.28 | at median | 50% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR II Live Vial -> MMR II Live SQ 90707 | $135.95 | $271.90 | $138.13–$184.28 | — | 50% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV Live Vial -> MMRV Live SQ 90710 | $355.40 | $710.80 | $361.09–$559.75 | at median | 50% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MMRV Live Vial -> MMRV Live SQ 90710 | $355.40 | $710.80 | $361.09–$559.75 | — | 50% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococal Conjugate (MCV4 MenACWY) Vial -> MCV4 MenACWY 90734 | $207.60 | $415.20 | $210.92–$322.78 | at median | 50% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococal Conjugate (MCV4 MenACWY) Vial -> MCV4 MenACWY 90734 | $207.60 | $415.20 | $210.92–$322.78 | — | 50% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 Meningoccal Conjugate (MenACWY-TT) Vial -> MenACWY-TT 90619 | $236.25 | $472.50 | $240.03–$332.88 | at median | 50% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 Meningoccal Conjugate (MenACWY-TT) Vial -> MenACWY-TT 90619 | $236.25 | $472.50 | $240.03–$332.88 | — | 50% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcal Group B (MenB 4C) Vial -> MenB 4C 90620 | $531.90 | $1,063.80 | $459.01–$540.41 | 58% above | 50% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Meningococcal Group B (MenB 4C) Vial -> MenB 4C 90620 | $531.90 | $1,063.80 | $459.01–$540.41 | — | 50% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumococcal conjugate (PCV13) Vial -> PCV13 90670 | $296.10 | $592.20 | $300.84–$438.30 | 12% above | 50% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Pneumococcal conjugate (PCV13) Vial -> PCV13 90670 | $296.10 | $592.20 | $300.84–$438.30 | — | 50% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Pneumococcal conjugate (PCV15) Vial -> PCV15 90671 | $699.45 | $1,398.90 | $465.77–$710.64 | at median | 50% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 Pneumococcal conjugate (PCV15) Vial -> PCV15 90671 | $699.45 | $1,398.90 | $465.77–$710.64 | — | 50% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal Conjugate (PCV20) Vial -> PCV20 90677 | $381.40 | $762.80 | $387.50–$531.54 | at median | 50% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Pneumococcal Conjugate (PCV20) Vial -> PCV20 90677 | $381.40 | $762.80 | $387.50–$531.54 | — | 50% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 Pneumococcal conjugate (PCV21) Vial -> PCV21 90684 | $486.20 | $972.40 | $493.98–$584.77 | 8% above | 50% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 Pneumococcal conjugate (PCV21) Vial -> PCV21 90684 | $486.20 | $972.40 | $493.98–$584.77 | — | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal poly (PPSV23) Vial -> PPSV23 90732 | $165.65 | $331.30 | $85.67–$226.63 | 5% above | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal poly (PPSV23) Vial -> PPSV23 90732 | $165.65 | $331.30 | $85.67–$226.63 | — | 50% |
| Polio vaccine, inactivated (IPV) CPT 90713 Poliovirus, Inactivated (IPV) Vial -> Poliovirus, Inactivated (IPV) 90713 | $62.75 | $125.50 | $63.75–$86.58 | at median | 50% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 Poliovirus, Inactivated (IPV) Vial -> Poliovirus, Inactivated (IPV) 90713 | $62.75 | $125.50 | $63.75–$86.58 | — | 50% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Nirsevimab (RSV) 1 mL Vial -> Beyfortus RSV PF 1mL 90381 | $750.90 | $1,501.80 | $762.91–$1,076.50 | 1% above | 50% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 Nirsevimab (RSV) 1 mL Vial -> Beyfortus RSV PF 1mL 90381 | $750.90 | $1,501.80 | $762.91–$1,076.50 | — | 50% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Nirsevimab (RSV) 0.5 mL Vial -> Beyfortus RSV PF 0.5mL 90380 | $750.90 | $1,501.80 | $762.91–$1,076.50 | 1% above | 50% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Nirsevimab (RSV) 0.5 mL Vial -> Beyfortus RSV PF 0.5mL 90380 | $750.90 | $1,501.80 | $762.91–$1,076.50 | — | 50% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV Vial (Abryso) -> Abrysvo RSV preF A-preF B 0.5 mL 90678 | $497.10 | $994.20 | $505.05–$593.87 | 4% above | 50% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV Vial (Abryso) -> Abrysvo RSV preF A-preF B 0.5 mL 90678 | $497.10 | $994.20 | $505.05–$593.87 | — | 50% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV Vial (Arexvy) -> Arexvy RSV preF3 0.5 mL 90679 | $497.10 | $994.20 | $505.05–$593.00 | 18% above | 50% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSV Vial (Arexvy) -> Arexvy RSV preF3 0.5 mL 90679 | $497.10 | $994.20 | $505.05–$593.00 | — | 50% |
| Rabies vaccine, one dose CPT 90675 Rabies Vaccine (Rabavert) -> Rabavert 2.5ml 90675 | $515.60 | $1,031.20 | $171.58–$841.27 | at median | 50% |
| Rabies vaccine, one dose CPT 90675 Rabies Vial -> Rabies 90675 | $528.35 | $1,056.70 | $171.58–$841.27 | 2% above | 50% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM | $1,036.30 | $2,072.60 | $171.58–$1,052.88 | 101% above | 50% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine (Rabavert) -> Rabavert 2.5ml 90675 | $515.60 | $1,031.20 | $171.58–$841.27 | — | 50% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Vial -> Rabies 90675 | $528.35 | $1,056.70 | $171.58–$841.27 | — | 50% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE IM | $1,036.30 | $2,072.60 | $171.58–$1,052.88 | — | 50% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 Rotavirus Vial -> RV1 Oral Rotarix 90681 | $214.50 | $429.00 | $217.93–$284.59 | 7% above | 50% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 Rotavirus Vial -> RV1 Oral Rotarix 90681 | $214.50 | $429.00 | $217.93–$284.59 | — | 50% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 Rotavirus Vial -> RV5 Oral Rotateq 90680 | $81.35 | $162.70 | $82.65–$198.87 | 1% below | 50% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 Rotavirus Vial -> RV5 Oral Rotateq 90680 | $81.35 | $162.70 | $82.65–$198.87 | — | 50% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Zoster Recomb Inactivated (HZV) Vial -> Zoster (HZV) Recomb 90750 | $255.85 | $511.70 | $259.94–$417.16 | 30% above | 50% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Zoster Recomb Inactivated (HZV) Vial -> Zoster (HZV) Recomb 90750 | $255.85 | $511.70 | $259.94–$417.16 | — | 50% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus Diphth 7+ Yrs Vial -> Td PF (2 units/0.5 mL) 90714 | $58.90 | $117.80 | $59.84–$81.78 | 9% above | 50% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus Diphth 7+ Yrs Vial -> Td PF (2 units/0.5 mL) 90714 | $58.90 | $117.80 | $59.84–$81.78 | — | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDaP Age 7 Yrs and Older Vial -> Tdap Vaccine 90715 | $66.55 | $133.10 | $67.61–$94.37 | 8% below | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDaP Age 7 Yrs and Older Vial -> Tdap Vaccine 90715 | $66.55 | $133.10 | $67.61–$94.37 | — | 50% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Typhoid Live Vial -> Typhoid 90691 | $191.20 | $382.40 | $194.26–$297.90 | 26% above | 50% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 Typhoid Live Vial -> Typhoid 90691 | $191.20 | $382.40 | $194.26–$297.90 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Varicella Virus (Varivax) -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin DTaP HepB IPV -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Hepatitis B Pediatric Adol. -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Pneumo PPSV23 -> VFC Inj Vaccine G0009 (90471) Pneumo | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin DTaP IPV/HIB/Hep B -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin MMR II Live -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Hib PRP T -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Pneumo PCV 15 -> VFC Inj Vaccine G0009 (90471) Pneumo | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Pneumo PCV20 -> VFC Inj Vaccine G0009 (90471) Pneumo | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin RSV -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Human Papillomavirus -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Pneumo PCV 13 -> VFC Inj Vaccine G0009 (90471) Pneumo | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Influenza Virus -> VFC First Inj Vaccine G0008 (90471) Flu | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Poliovirus (IPV) -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Hepatitis A Pediatric Adol. -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin DTaP IPV -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin DTaP IPV/HIB -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Meningococal Conjugate -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Meningococcal Group B (MenB 4C) -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin MMRV Live -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Hib PRP OMP -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Tetanus-Diphth -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin DTaP Pediatric Under 7yrs -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin TDaP 7 Yrs and Older -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | 50% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Op Immune Adm 1 Vaccine | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Misc -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Varicella Virus (Varivax) -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Pneumo PPSV23 -> First Inj Vaccine G0009 (90471) Pneumo | $40.35 | $80.70 | $20.87–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin MMR II Live -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Pneumo PCV 13 -> First Inj Vaccine G0009 (90471) Pneumo | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin MMRV Live -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Human Papillomavirus -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Influenza Virus -> First Inj Vaccine G0008 (90471) Flu | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Hepatitis B Pediatric Adol. -> First Inj Vaccine G0010 (90471) Hep B | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Hepatitis B Adult -> First Inj Vaccine G0010 (90471) Hep B | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Hepatitis A Hepatitis B Adult -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Hepatitis A Pediatric Adol. -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Hepatitis A Adult -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin DTaP IPV -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin DTaP IPV/HIB -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin DTaP HepB IPV -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Poliovirus (IPV) -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Meningococal Conjugate -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Meningococcal Group B (MenB 4C) -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 First Inj Vaccine (90471) Ambulatory BCE | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Influenza Admin Prq Id Subq/Im Inj 1 Vaccine Initial G0008 (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pneumonia Admin Prq Id Subq/Im Inj 1 Vaccine Initial G0009 (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Hep B Admin Prq Id Subq/Im Inj 1 Vaccine Initial G0010 (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Misc Vaccine Initial Admin Prq Id Subq/Im Inj 90471 | $40.35 | $80.70 | $25.23–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Tetanus-Diphth -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin DTaP Pediatric Under 7yrs -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin TDaP 7 Yrs and Older -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Hib PRP T -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Hib PRP OMP -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Pneumo PCV20 -> First Inj Vaccine G0009 (90471) Pneumo | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Pneumo PCV 15 -> First Inj Vaccine G0009 (90471) Pneumo | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin DTaP IPV/HIB/Hep B -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin RSV -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Pneumo PCV21 -> First Inj Vaccine G0009 (90471) Pneumo | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Flu Virus Vaccine | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Pneumonia Vaccine | $40.35 | $80.70 | $38.93–$111.06 | 75% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Human Papillomavirus -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin DTaP IPV/HIB -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin DTaP IPV -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Hepatitis A Pediatric Adol. -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Pneumo PCV 13 -> VFC Inj Vaccine G0009 (90471) Pneumo | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Pneumo PPSV23 -> VFC Inj Vaccine G0009 (90471) Pneumo | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Varicella Virus (Varivax) -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin MMR II Live -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Hib PRP T -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Influenza Virus -> VFC First Inj Vaccine G0008 (90471) Flu | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Poliovirus (IPV) -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Meningococal Conjugate -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Meningococcal Group B (MenB 4C) -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin MMRV Live -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Hib PRP OMP -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Tetanus-Diphth -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin DTaP Pediatric Under 7yrs -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin TDaP 7 Yrs and Older -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin DTaP HepB IPV -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Hepatitis B Pediatric Adol. -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin DTaP IPV/HIB/Hep B -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Pneumo PCV 15 -> VFC Inj Vaccine G0009 (90471) Pneumo | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Pneumo PCV20 -> VFC Inj Vaccine G0009 (90471) Pneumo | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin RSV -> VFC First Inj Vaccine (90471) | $11.52 | $23.03 | $11.70–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Hib PRP T -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Human Papillomavirus -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin MMR II Live -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Varicella Virus (Varivax) -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Admin Flu Virus Vaccine | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Misc -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Pneumo PCV21 -> First Inj Vaccine G0009 (90471) Pneumo | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin RSV -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin DTaP IPV/HIB/Hep B -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Pneumo PCV 15 -> First Inj Vaccine G0009 (90471) Pneumo | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Pneumo PCV20 -> First Inj Vaccine G0009 (90471) Pneumo | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Hib PRP OMP -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin TDaP 7 Yrs and Older -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin DTaP Pediatric Under 7yrs -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Tetanus-Diphth -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Misc Vaccine Initial Admin Prq Id Subq/Im Inj 90471 | $40.35 | $80.70 | $25.23–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Hep B Admin Prq Id Subq/Im Inj 1 Vaccine Initial G0010 (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pneumonia Admin Prq Id Subq/Im Inj 1 Vaccine Initial G0009 (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin DTaP HepB IPV -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Influenza Admin Prq Id Subq/Im Inj 1 Vaccine Initial G0008 (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 First Inj Vaccine (90471) Ambulatory BCE | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin DTaP IPV/HIB -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin DTaP IPV -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Hepatitis A Adult -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Hepatitis A Pediatric Adol. -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Hepatitis A Hepatitis B Adult -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Meningococcal Group B (MenB 4C) -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Hepatitis B Adult -> First Inj Vaccine G0010 (90471) Hep B | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Hepatitis B Pediatric Adol. -> First Inj Vaccine G0010 (90471) Hep B | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Meningococal Conjugate -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin MMRV Live -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Poliovirus (IPV) -> First Inj Vaccine (90471) | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Pneumo PCV 13 -> First Inj Vaccine G0009 (90471) Pneumo | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Op Immune Adm 1 Vaccine | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Pneumo PPSV23 -> First Inj Vaccine G0009 (90471) Pneumo | $40.35 | $80.70 | $20.87–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin Influenza Virus -> First Inj Vaccine G0008 (90471) Flu | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Admin Pneumonia Vaccine | $40.35 | $80.70 | $38.93–$111.06 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Human Papillomavirus -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Tetanus-Diphth -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin DTaP Pediatric Under 7yrs -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Meningococcal Group B (MenB 4C) -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Hepatitis B Pediatric Adol. -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Pneumo PCV 13 -> VFC Inj Vaccine G0009 (90472) Pneumo | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Hib PRP T -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Poliovirus (IPV) -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin TDaP 7 Yrs and Older -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin DTaP HepB IPV -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin MMRV Live -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin RSV -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Influenza Virus -> VFC Subs Inj Vaccine G0008 (90472) Flu | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Hib PRP OMP -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin DTaP IPV -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Meningococal Conjugate -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Pneumo PCV20 -> VFC Inj Vaccine G0009 (90472) Pneumo | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Pneumo PCV 15 -> VFC Inj Vaccine G0009 (90472) Pneumo | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin DTaP IPV/HIB -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Pneumo PPSV23 -> VFC Inj Vaccine G0009 (90472) Pneumo | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Varicella Virus (Varivax) -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Hepatitis A Pediatric Adol. -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin DTaP IPV/HIB/Hep B -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin MMR II Live -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | 41% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Pneumo PCV21 -> Subs Inj Vaccine G0009 (90472) Pneumo | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin RSV -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Hepatitis B Adult -> Subs Inj Vaccine G0010 (90472) Hep B | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Varicella Virus (Varivax) -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin DTaP IPV/HIB -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Pneumo PCV 13 -> Subs Inj Vaccine G0009 (90472) Pneumo | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Misc -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Meningococcal Group B (MenB 4C) -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin DTaP HepB IPV -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin MMR II Live -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin MMRV Live -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin TDaP 7 Yrs and Older -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $20.95–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin DTaP IPV -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Tetanus-Diphth -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin DTaP Pediatric Under 7yrs -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Poliovirus (IPV) -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Prq Id Subq/Im Inj 1 Vaccine Subsequent 90472 | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Human Papillomavirus -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$50.25 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Subs Inj Vaccine (90472) Ambulatory BCE | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Meningococal Conjugate -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Hib PRP OMP -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Pneumo PCV20 -> Subs Inj Vaccine G0009 (90472) Pneumo | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Pneumo PCV 15 -> Subs Inj Vaccine G0009 (90472) Pneumo | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin DTaP IPV/HIB/Hep B -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Hib PRP T -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Influenza Virus -> Sub Inj Vaccine G0008 (90472) Flu | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Hepatitis B Pediatric Adol. -> Subs Inj Vaccine G0010 (90472) Hep B | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Pneumo PPSV23 -> Subs Inj Vaccine G0009 (90472) Pneumo | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Hepatitis A Adult -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Hepatitis A Pediatric Adol. -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Hepatitis A Hepatitis B Adult -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | 71% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization Adm; Ea Addtl Vaccine | $40.35 | $80.70 | $35.77–$41.00 | 106% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Poliovirus (IPV) -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Hib PRP OMP -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Human Papillomavirus -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin DTaP IPV/HIB/Hep B -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin TDaP 7 Yrs and Older -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Meningococcal Group B (MenB 4C) -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin DTaP HepB IPV -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Hib PRP T -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin DTaP Pediatric Under 7yrs -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Hepatitis B Pediatric Adol. -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin MMR II Live -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin DTaP IPV -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Influenza Virus -> VFC Subs Inj Vaccine G0008 (90472) Flu | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Pneumo PCV 15 -> VFC Inj Vaccine G0009 (90472) Pneumo | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin RSV -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin MMRV Live -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Pneumo PCV 13 -> VFC Inj Vaccine G0009 (90472) Pneumo | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Tetanus-Diphth -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin DTaP IPV/HIB -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Varicella Virus (Varivax) -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Hepatitis A Pediatric Adol. -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Meningococal Conjugate -> VFC Subs Inj Vaccine (90472) | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Pneumo PCV20 -> VFC Inj Vaccine G0009 (90472) Pneumo | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Pneumo PPSV23 -> VFC Inj Vaccine G0009 (90472) Pneumo | $11.52 | $23.03 | $11.70–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin RSV -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Pneumo PPSV23 -> Subs Inj Vaccine G0009 (90472) Pneumo | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin DTaP IPV/HIB -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin DTaP HepB IPV -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Varicella Virus (Varivax) -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Misc -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin MMR II Live -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin TDaP 7 Yrs and Older -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $20.95–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin DTaP IPV -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Subs Inj Vaccine (90472) Ambulatory BCE | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Prq Id Subq/Im Inj 1 Vaccine Subsequent 90472 | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Meningococcal Group B (MenB 4C) -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Meningococal Conjugate -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Pneumo PCV20 -> Subs Inj Vaccine G0009 (90472) Pneumo | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Poliovirus (IPV) -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin DTaP Pediatric Under 7yrs -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Tetanus-Diphth -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Hepatitis B Adult -> Subs Inj Vaccine G0010 (90472) Hep B | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Hepatitis A Hepatitis B Adult -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Hepatitis A Pediatric Adol. -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Hepatitis A Adult -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Hepatitis B Pediatric Adol. -> Subs Inj Vaccine G0010 (90472) Hep B | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Hib PRP T -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin DTaP IPV/HIB/Hep B -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Pneumo PCV 15 -> Subs Inj Vaccine G0009 (90472) Pneumo | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Pneumo PCV21 -> Subs Inj Vaccine G0009 (90472) Pneumo | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Hib PRP OMP -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Human Papillomavirus -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$50.25 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Influenza Virus -> Sub Inj Vaccine G0008 (90472) Flu | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin MMRV Live -> Subs Inj Vaccine (90472) | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Pneumo PCV 13 -> Subs Inj Vaccine G0009 (90472) Pneumo | $33.50 | $67.00 | $34.04–$35.77 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization Adm; Ea Addtl Vaccine | $40.35 | $80.70 | $35.77–$41.00 | — | 50% |
| Yellow fever vaccine, live CPT 90717 Yellow Fever Vial -> Yellow Fever 90717 | $234.60 | $469.20 | $238.35–$455.20 | at median | 50% |
| Yellow fever vaccine, live inpatient CPT 90717 Yellow Fever Vial -> Yellow Fever 90717 | $234.60 | $469.20 | $238.35–$455.20 | — | 50% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.