Carolinas Medical Center
Carolinas Medical Center in Charlotte, NC publishes cash prices for 47 common procedures listed here, from its own machine-readable price file updated Dec 4, 2025. Click a procedure to compare it with other hospitals nearby.
1000 Blythe Blvd, Charlotte, NC 28203 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT SCAN ABDOMEN AND PELVIS W CONTRAST | $3,217.18 | $6,434.35 | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT SCAN ABDOMEN AND PELVIS W CONTRAST | $3,217.18 | $6,434.35 | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT SCAN ABDOMEN AND PELVIS W CONTRAST | $3,217.18 | $6,434.35 | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT SCAN ABDOMEN AND PELVIS W CONTRAST | $3,217.18 | $6,434.35 | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT SCAN ABDOMEN AND PELVIS W CONTRAST | $3,217.18 | $6,434.35 | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT SCAN ABDOMEN AND PELVIS W CONTRAST | $3,217.18 | $6,434.35 | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST | $1,268.90 | $2,537.80 | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST | $1,268.90 | $2,537.80 | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST | $1,268.90 | $2,537.80 | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST | $1,268.90 | $2,537.80 | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST | $1,268.90 | $2,537.80 | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST | $1,268.90 | $2,537.80 | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT SCAN OF PELVIS CONTRAST | $1,608.98 | $3,217.95 | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT SCAN OF PELVIS CONTRAST | $1,608.98 | $3,217.95 | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT SCAN OF PELVIS CONTRAST | $1,608.98 | $3,217.95 | 50% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT SCAN OF PELVIS CONTRAST | $1,608.98 | $3,217.95 | 50% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT SCAN OF PELVIS CONTRAST | $1,608.98 | $3,217.95 | 50% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT SCAN OF PELVIS CONTRAST | $1,608.98 | $3,217.95 | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $442.60 | $885.20 | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $442.60 | $885.20 | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $442.60 | $885.20 | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $442.60 | $885.20 | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $442.60 | $885.20 | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $442.60 | $885.20 | 50% |
| Diagnostic mammogram, one breast CPT 77065 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $221.33 | $442.65 | 50% |
| Diagnostic mammogram, one breast CPT 77065 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $221.33 | $442.65 | 50% |
| Diagnostic mammogram, one breast CPT 77065 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $221.33 | $442.65 | 50% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $221.33 | $442.65 | 50% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $221.33 | $442.65 | 50% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $221.33 | $442.65 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREM JT W/O CONTRAST | $1,922.30 | $3,844.60 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREM JT W/O CONTRAST | $1,922.30 | $3,844.60 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREM JT W/O CONTRAST | $1,922.30 | $3,844.60 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREM JT W/O CONTRAST | $1,922.30 | $3,844.60 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREM JT W/O CONTRAST | $1,922.30 | $3,844.60 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREM JT W/O CONTRAST | $1,922.30 | $3,844.60 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI JOINT OF LEG COMBO | $2,495.38 | $4,990.75 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI JOINT OF LEG COMBO | $2,495.38 | $4,990.75 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI JOINT OF LEG COMBO | $2,495.38 | $4,990.75 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI JOINT OF LEG COMBO | $2,495.38 | $4,990.75 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI JOINT OF LEG COMBO | $2,495.38 | $4,990.75 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI JOINT OF LEG COMBO | $2,495.38 | $4,990.75 | 50% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O CONTRAST | $1,765.28 | $3,530.55 | 50% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O CONTRAST | $1,765.28 | $3,530.55 | 50% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O CONTRAST | $1,765.28 | $3,530.55 | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O CONTRAST | $1,765.28 | $3,530.55 | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O CONTRAST | $1,765.28 | $3,530.55 | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O CONTRAST | $1,765.28 | $3,530.55 | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W & W/O CONTRAST | $2,659.03 | $5,318.05 | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W & W/O CONTRAST | $2,659.03 | $5,318.05 | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W & W/O CONTRAST | $2,659.03 | $5,318.05 | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W & W/O CONTRAST | $2,659.03 | $5,318.05 | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W & W/O CONTRAST | $2,659.03 | $5,318.05 | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W & W/O CONTRAST | $2,659.03 | $5,318.05 | 50% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $2,013.08 | $4,026.15 | 50% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $2,013.08 | $4,026.15 | 50% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $2,013.08 | $4,026.15 | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $2,013.08 | $4,026.15 | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $2,013.08 | $4,026.15 | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $2,013.08 | $4,026.15 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB >/= 14 WKS SNGL FETUS | $479.30 | $958.60 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB >/= 14 WKS SNGL FETUS | $479.30 | $958.60 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB >/= 14 WKS SNGL FETUS | $479.30 | $958.60 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB >/= 14 WKS SNGL FETUS | $479.30 | $958.60 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB >/= 14 WKS SNGL FETUS | $479.30 | $958.60 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB >/= 14 WKS SNGL FETUS | $479.30 | $958.60 | 50% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $319.93 | $639.85 | 50% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $319.93 | $639.85 | 50% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $319.93 | $639.85 | 50% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $319.93 | $639.85 | 50% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $319.93 | $639.85 | 50% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $319.93 | $639.85 | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $3,182.88 | $6,365.75 | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $3,182.88 | $6,365.75 | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $3,182.88 | $6,365.75 | 50% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $3,182.88 | $6,365.75 | 50% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $3,182.88 | $6,365.75 | 50% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $3,182.88 | $6,365.75 | 50% |
| Transvaginal pelvic ultrasound CPT 76830 HC TRANSVAGINAL ULTRASOUND | $491.58 | $983.15 | 50% |
| Transvaginal pelvic ultrasound CPT 76830 HC TRANSVAGINAL ULTRASOUND | $491.58 | $983.15 | 50% |
| Transvaginal pelvic ultrasound CPT 76830 HC TRANSVAGINAL ULTRASOUND | $491.58 | $983.15 | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC TRANSVAGINAL ULTRASOUND | $491.58 | $983.15 | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC TRANSVAGINAL ULTRASOUND | $491.58 | $983.15 | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC TRANSVAGINAL ULTRASOUND | $491.58 | $983.15 | 50% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOM B-SCAN &/OR REAL TIME COMPLETE | $665.35 | $1,330.70 | 50% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOM B-SCAN &/OR REAL TIME COMPLETE | $665.35 | $1,330.70 | 50% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOM B-SCAN &/OR REAL TIME COMPLETE | $665.35 | $1,330.70 | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOM B-SCAN &/OR REAL TIME COMPLETE | $665.35 | $1,330.70 | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOM B-SCAN &/OR REAL TIME COMPLETE | $665.35 | $1,330.70 | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOM B-SCAN &/OR REAL TIME COMPLETE | $665.35 | $1,330.70 | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 HC DX SPINE LUMBAR MIN 4 VIEWS | $430.23 | $860.45 | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 HC DX SPINE LUMBAR MIN 4 VIEWS | $430.23 | $860.45 | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 HC DX SPINE LUMBAR MIN 4 VIEWS | $430.23 | $860.45 | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC DX SPINE LUMBAR MIN 4 VIEWS | $430.23 | $860.45 | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC DX SPINE LUMBAR MIN 4 VIEWS | $430.23 | $860.45 | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC DX SPINE LUMBAR MIN 4 VIEWS | $430.23 | $860.45 | 50% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL BUNDLED CHARGE | $177.03 | $354.05 | 50% |
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL BUNDLED CHARGE | $177.03 | $354.05 | 50% |
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL BUNDLED CHARGE | $177.03 | $354.05 | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL BUNDLED CHARGE | $177.03 | $354.05 | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL BUNDLED CHARGE | $177.03 | $354.05 | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL BUNDLED CHARGE | $177.03 | $354.05 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL BUNDLED CHARGE | $187.73 | $375.45 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL BUNDLED CHARGE | $187.73 | $375.45 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL BUNDLED CHARGE | $187.73 | $375.45 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL BUNDLED CHARGE | $187.73 | $375.45 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL BUNDLED CHARGE | $187.73 | $375.45 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL BUNDLED CHARGE | $187.73 | $375.45 | 50% |
| Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC AUTO DIFF WBC | $135.48 | $270.95 | 50% |
| Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC AUTO DIFF WBC | $135.48 | $270.95 | 50% |
| Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC AUTO DIFF WBC | $135.48 | $270.95 | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE CBC AUTO DIFF WBC | $135.48 | $270.95 | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE CBC AUTO DIFF WBC | $135.48 | $270.95 | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE CBC AUTO DIFF WBC | $135.48 | $270.95 | 50% |
| Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC | $66.43 | $132.85 | 50% |
| Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC | $66.43 | $132.85 | 50% |
| Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC | $66.43 | $132.85 | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC | $66.43 | $132.85 | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC | $66.43 | $132.85 | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC | $66.43 | $132.85 | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE | $244.73 | $489.45 | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE | $244.73 | $489.45 | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE | $244.73 | $489.45 | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE | $244.73 | $489.45 | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE | $244.73 | $489.45 | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE | $244.73 | $489.45 | 50% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL BUNDLED CHARGE | $113.35 | $226.70 | 50% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL BUNDLED CHARGE | $113.35 | $226.70 | 50% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL BUNDLED CHARGE | $113.35 | $226.70 | 50% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL BUNDLED CHARGE | $113.35 | $226.70 | 50% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL BUNDLED CHARGE | $113.35 | $226.70 | 50% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL BUNDLED CHARGE | $113.35 | $226.70 | 50% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL BUNDLED CHARGE | $198.50 | $397.00 | 50% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL BUNDLED CHARGE | $198.50 | $397.00 | 50% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL BUNDLED CHARGE | $198.50 | $397.00 | 50% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL BUNDLED CHARGE | $198.50 | $397.00 | 50% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL BUNDLED CHARGE | $198.50 | $397.00 | 50% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL BUNDLED CHARGE | $198.50 | $397.00 | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC AG PSA FREE | $99.20 | $198.40 | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC AG PSA FREE | $99.20 | $198.40 | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC AG PSA FREE | $99.20 | $198.40 | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC AG PSA FREE | $99.20 | $198.40 | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC AG PSA FREE | $99.20 | $198.40 | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC AG PSA FREE | $99.20 | $198.40 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN TOTAL | $103.85 | $207.70 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN TOTAL | $103.85 | $207.70 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN TOTAL | $103.85 | $207.70 | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN TOTAL | $103.85 | $207.70 | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN TOTAL | $103.85 | $207.70 | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN TOTAL | $103.85 | $207.70 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLAS TIME PARTIAL | $69.85 | $139.70 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLAS TIME PARTIAL | $69.85 | $139.70 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLAS TIME PARTIAL | $69.85 | $139.70 | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLAS TIME PARTIAL | $69.85 | $139.70 | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLAS TIME PARTIAL | $69.85 | $139.70 | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLAS TIME PARTIAL | $69.85 | $139.70 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $67.70 | $135.40 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $67.70 | $135.40 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $67.70 | $135.40 | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $67.70 | $135.40 | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $67.70 | $135.40 | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $67.70 | $135.40 | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY THYROID STIMULATING HORMONE | $186.98 | $373.95 | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY THYROID STIMULATING HORMONE | $186.98 | $373.95 | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY THYROID STIMULATING HORMONE | $186.98 | $373.95 | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY THYROID STIMULATING HORMONE | $186.98 | $373.95 | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY THYROID STIMULATING HORMONE | $186.98 | $373.95 | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY THYROID STIMULATING HORMONE | $186.98 | $373.95 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS AUTO W/SCOPE MICRO | $40.35 | $80.70 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS AUTO W/SCOPE MICRO | $40.35 | $80.70 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS AUTO W/SCOPE MICRO | $40.35 | $80.70 | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS AUTO W/SCOPE MICRO | $40.35 | $80.70 | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS AUTO W/SCOPE MICRO | $40.35 | $80.70 | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS AUTO W/SCOPE MICRO | $40.35 | $80.70 | 50% |
| Urinalysis with microscope exam, manual CPT 81000 HC URINE SINGLE XZ | $40.35 | $80.70 | 50% |
| Urinalysis with microscope exam, manual CPT 81000 HC URINE SINGLE XZ | $40.35 | $80.70 | 50% |
| Urinalysis with microscope exam, manual CPT 81000 HC URINE SINGLE XZ | $40.35 | $80.70 | 50% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINE SINGLE XZ | $40.35 | $80.70 | 50% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINE SINGLE XZ | $40.35 | $80.70 | 50% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINE SINGLE XZ | $40.35 | $80.70 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE | $52.38 | $104.75 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE | $52.38 | $104.75 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE | $52.38 | $104.75 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE | $52.38 | $104.75 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE | $52.38 | $104.75 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE | $52.38 | $104.75 | 50% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS NONAUTO W/O MICRO | $37.18 | $74.35 | 50% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS NONAUTO W/O MICRO | $37.18 | $74.35 | 50% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS NONAUTO W/O MICRO | $37.18 | $74.35 | 50% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS NONAUTO W/O MICRO | $37.18 | $74.35 | 50% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS NONAUTO W/O MICRO | $37.18 | $74.35 | 50% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS NONAUTO W/O MICRO | $37.18 | $74.35 | 50% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY | $11,777.43 | $23,554.85 | 50% |
| Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY | $11,777.43 | $23,554.85 | 50% |
| Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY | $11,777.43 | $23,554.85 | 50% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY | $11,777.43 | $23,554.85 | 50% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY | $11,777.43 | $23,554.85 | 50% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY | $11,777.43 | $23,554.85 | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ EPI SUBAR LUM/SAC W/IMAGE | $2,207.98 | $4,415.95 | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ EPI SUBAR LUM/SAC W/IMAGE | $2,207.98 | $4,415.95 | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ EPI SUBAR LUM/SAC W/IMAGE | $2,207.98 | $4,415.95 | 50% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ EPI SUBAR LUM/SAC W/IMAGE | $2,207.98 | $4,415.95 | 50% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ EPI SUBAR LUM/SAC W/IMAGE | $2,207.98 | $4,415.95 | 50% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ EPI SUBAR LUM/SAC W/IMAGE | $2,207.98 | $4,415.95 | 50% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,177.23 | $2,354.45 | 50% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,177.23 | $2,354.45 | 50% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,177.23 | $2,354.45 | 50% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,177.23 | $2,354.45 | 50% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,177.23 | $2,354.45 | 50% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,177.23 | $2,354.45 | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W GUIDE 1 LVL | $2,207.48 | $4,414.95 | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W GUIDE 1 LVL | $2,207.48 | $4,414.95 | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W GUIDE 1 LVL | $2,207.48 | $4,414.95 | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W GUIDE 1 LVL | $2,207.48 | $4,414.95 | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W GUIDE 1 LVL | $2,207.48 | $4,414.95 | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W GUIDE 1 LVL | $2,207.48 | $4,414.95 | 50% |
| Prostate biopsy CPT 55700 HC BIOPSY PROSTATE NEEDLE OR PUNCH | $897.95 | $1,795.90 | 50% |
| Prostate biopsy CPT 55700 HC BIOPSY PROSTATE NEEDLE OR PUNCH | $897.95 | $1,795.90 | 50% |
| Prostate biopsy CPT 55700 HC BIOPSY PROSTATE NEEDLE OR PUNCH | $897.95 | $1,795.90 | 50% |
| Prostate biopsy inpatient CPT 55700 HC BIOPSY PROSTATE NEEDLE OR PUNCH | $897.95 | $1,795.90 | 50% |
| Prostate biopsy inpatient CPT 55700 HC BIOPSY PROSTATE NEEDLE OR PUNCH | $897.95 | $1,795.90 | 50% |
| Prostate biopsy inpatient CPT 55700 HC BIOPSY PROSTATE NEEDLE OR PUNCH | $897.95 | $1,795.90 | 50% |
| Removal of a breast lump, open surgery CPT 19120 HC EXCISION CYST OR OTHER TUMOR BREAST TISSUE | $4,631.50 | $9,263.00 | 50% |
| Removal of a breast lump, open surgery CPT 19120 HC EXCISION CYST OR OTHER TUMOR BREAST TISSUE | $4,631.50 | $9,263.00 | 50% |
| Removal of a breast lump, open surgery CPT 19120 HC EXCISION CYST OR OTHER TUMOR BREAST TISSUE | $4,631.50 | $9,263.00 | 50% |
| Removal of a breast lump, open surgery inpatient CPT 19120 HC EXCISION CYST OR OTHER TUMOR BREAST TISSUE | $4,631.50 | $9,263.00 | 50% |
| Removal of a breast lump, open surgery inpatient CPT 19120 HC EXCISION CYST OR OTHER TUMOR BREAST TISSUE | $4,631.50 | $9,263.00 | 50% |
| Removal of a breast lump, open surgery inpatient CPT 19120 HC EXCISION CYST OR OTHER TUMOR BREAST TISSUE | $4,631.50 | $9,263.00 | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 HC LIC PSYTX FAMILY W/PT FAC | $27.68 | $55.35 | 50% |
| Family therapy with the patient, 50 minutes CPT 90847 HC PSYCHOTHERAPY FAMILY W/PT 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy with the patient, 50 minutes CPT 90847 HC LIC PSYTX FAMILY W/PT FAC | $27.68 | $55.35 | 50% |
| Family therapy with the patient, 50 minutes CPT 90847 HC PSYCHOTHERAPY FAMILY W/PT 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy with the patient, 50 minutes CPT 90847 HC LIC PSYTX FAMILY W/PT FAC | $27.68 | $55.35 | 50% |
| Family therapy with the patient, 50 minutes CPT 90847 HC PSYCHOTHERAPY FAMILY W/PT 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PSYCHOTHERAPY FAMILY W/PT 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PSYCHOTHERAPY FAMILY W/PT 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PSYCHOTHERAPY FAMILY W/PT 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC LIC PSYTX FAMILY W/PT FAC | $27.68 | $55.35 | 50% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC LIC PSYTX FAMILY W/PT FAC | $27.68 | $55.35 | 50% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC LIC PSYTX FAMILY W/PT FAC | $27.68 | $55.35 | 50% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PT 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy without the patient, 50 minutes CPT 90846 HC LIC PSYTX FAMILY W/O PT FAC 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy without the patient, 50 minutes CPT 90846 HC LIC PSYTX FAMILY W/O PT FAC 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy without the patient, 50 minutes CPT 90846 HC LIC PSYTX FAMILY W/O PT FAC 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PT 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PT 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAC PSYTX CRISIS EA ADD 16-45 MIN | $56.90 | $113.80 | 50% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAC PSYTX CRISIS EA ADD 16-45 MIN | $56.90 | $113.80 | 50% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAC PSYTX CRISIS EA ADD 16-45 MIN | $56.90 | $113.80 | 50% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PT 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PT 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC LIC PSYTX FAMILY W/O PT FAC 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PT 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC LIC PSYTX FAMILY W/O PT FAC 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC LIC PSYTX FAMILY W/O PT FAC 50 MIN | $27.68 | $55.35 | 50% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAC PSYTX CRISIS EA ADD 16-45 MIN | $56.90 | $113.80 | 50% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAC PSYTX CRISIS EA ADD 16-45 MIN | $56.90 | $113.80 | 50% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAC PSYTX CRISIS EA ADD 16-45 MIN | $56.90 | $113.80 | 50% |
| Group psychotherapy session CPT 90853 HC IOP PSYCH PER DIEM | $100.78 | $201.55 | 50% |
| Group psychotherapy session CPT 90853 HC IOP TX ISSUEGROUP45-50 | $100.78 | $201.55 | 50% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY | $100.78 | $201.55 | 50% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY | $100.78 | $201.55 | 50% |
| Group psychotherapy session CPT 90853 HC IOP PSYCH PER DIEM | $100.78 | $201.55 | 50% |
| Group psychotherapy session CPT 90853 HC LIC GRP PSYTX FAC-INT | $100.78 | $201.55 | 50% |
| Group psychotherapy session CPT 90853 HC IOP PSYCH PER DIEM | $100.78 | $201.55 | 50% |
| Group psychotherapy session CPT 90853 HC LIC GRP PSYTX FAC-INT | $100.78 | $201.55 | 50% |
| Group psychotherapy session CPT 90853 HC IOP TX ISSUEGROUP45-50 | $100.78 | $201.55 | 50% |
| Group psychotherapy session CPT 90853 HC LIC GRP PSYTX FAC-INT | $100.78 | $201.55 | 50% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY | $100.78 | $201.55 | 50% |
| Group psychotherapy session CPT 90853 HC IOP TX ISSUEGROUP45-50 | $100.78 | $201.55 | 50% |
| Group psychotherapy session inpatient CPT 90853 HC LIC GRP PSYTX FAC-INT | $100.78 | $201.55 | 50% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY | $100.78 | $201.55 | 50% |
| Group psychotherapy session inpatient CPT 90853 HC IOP PSYCH PER DIEM | $100.78 | $201.55 | 50% |
| Group psychotherapy session inpatient CPT 90853 HC IOP TX ISSUEGROUP45-50 | $100.78 | $201.55 | 50% |
| Group psychotherapy session inpatient CPT 90853 HC LIC GRP PSYTX FAC-INT | $100.78 | $201.55 | 50% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY | $100.78 | $201.55 | 50% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY | $100.78 | $201.55 | 50% |
| Group psychotherapy session inpatient CPT 90853 HC IOP TX ISSUEGROUP45-50 | $100.78 | $201.55 | 50% |
| Group psychotherapy session inpatient CPT 90853 HC IOP PSYCH PER DIEM | $100.78 | $201.55 | 50% |
| Group psychotherapy session inpatient CPT 90853 HC LIC GRP PSYTX FAC-INT | $100.78 | $201.55 | 50% |
| Group psychotherapy session inpatient CPT 90853 HC IOP TX ISSUEGROUP45-50 | $100.78 | $201.55 | 50% |
| Group psychotherapy session inpatient CPT 90853 HC IOP PSYCH PER DIEM | $100.78 | $201.55 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISES | $93.88 | $187.75 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISES | $93.88 | $187.75 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISES | $93.88 | $187.75 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISES | $93.88 | $187.75 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISES | $93.88 | $187.75 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISES | $93.88 | $187.75 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC RECREATION IND TIMED | $95.65 | $191.30 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC RECREATION IND TIMED | $95.65 | $191.30 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC RECREATION IND TIMED | $95.65 | $191.30 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISES | $93.88 | $187.75 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISES | $93.88 | $187.75 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISES | $93.88 | $187.75 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISES | $93.88 | $187.75 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISES | $93.88 | $187.75 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISES | $93.88 | $187.75 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC RECREATION IND TIMED | $95.65 | $191.30 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC RECREATION IND TIMED | $95.65 | $191.30 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC RECREATION IND TIMED | $95.65 | $191.30 | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC VISIT NEW PREVT 18-39 YRS | $105.78 | $211.55 | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC VISIT NEW PREVT 18-39 YRS | $105.78 | $211.55 | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC VISIT NEW PREVT 18-39 YRS | $105.78 | $211.55 | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC CLINIC VISIT NEW HEALTHCHECK EXAM 18-39 YRS | $129.70 | $259.40 | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC CLINIC VISIT NEW HEALTHCHECK EXAM 18-39 YRS | $129.70 | $259.40 | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC CLINIC VISIT NEW HEALTHCHECK EXAM 18-39 YRS | $129.70 | $259.40 | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC PSYCH CLINIC NEW HEALTHCHECK EXAM 18-39 YRS | $143.25 | $286.50 | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC PSYCH CLINIC NEW HEALTHCHECK EXAM 18-39 YRS | $143.25 | $286.50 | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC PSYCH CLINIC NEW HEALTHCHECK EXAM 18-39 YRS | $143.25 | $286.50 | 50% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC VISIT NEW PREVT 18-39 YRS | $105.78 | $211.55 | 50% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC VISIT NEW PREVT 18-39 YRS | $105.78 | $211.55 | 50% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC VISIT NEW PREVT 18-39 YRS | $105.78 | $211.55 | 50% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC CLINIC VISIT NEW HEALTHCHECK EXAM 18-39 YRS | $129.70 | $259.40 | 50% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC CLINIC VISIT NEW HEALTHCHECK EXAM 18-39 YRS | $129.70 | $259.40 | 50% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC CLINIC VISIT NEW HEALTHCHECK EXAM 18-39 YRS | $129.70 | $259.40 | 50% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC PSYCH CLINIC NEW HEALTHCHECK EXAM 18-39 YRS | $143.25 | $286.50 | 50% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC PSYCH CLINIC NEW HEALTHCHECK EXAM 18-39 YRS | $143.25 | $286.50 | 50% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC PSYCH CLINIC NEW HEALTHCHECK EXAM 18-39 YRS | $143.25 | $286.50 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC CLINIC VISIT NEW PREVT 40-64 YRS | $147.50 | $295.00 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC CLINIC VISIT NEW PREVT 40-64 YRS | $147.50 | $295.00 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC CLINIC VISIT NEW PREVT 40-64 YRS | $147.50 | $295.00 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC PSYCH CLINIC VISIT NEW PREVT 40-64 YRS | $175.43 | $350.85 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC PSYCH CLINIC VISIT NEW PREVT 40-64 YRS | $175.43 | $350.85 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC PSYCH CLINIC VISIT NEW PREVT 40-64 YRS | $175.43 | $350.85 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC VISIT NEW PREVT 40-64 YRS PRO FEE | $188.15 | $376.30 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC VISIT NEW PREVT 40-64 YRS PRO FEE | $188.15 | $376.30 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC VISIT NEW PREVT 40-64 YRS PRO FEE | $188.15 | $376.30 | 50% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC CLINIC VISIT NEW PREVT 40-64 YRS | $147.50 | $295.00 | 50% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC CLINIC VISIT NEW PREVT 40-64 YRS | $147.50 | $295.00 | 50% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC CLINIC VISIT NEW PREVT 40-64 YRS | $147.50 | $295.00 | 50% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC PSYCH CLINIC VISIT NEW PREVT 40-64 YRS | $175.43 | $350.85 | 50% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC PSYCH CLINIC VISIT NEW PREVT 40-64 YRS | $175.43 | $350.85 | 50% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC PSYCH CLINIC VISIT NEW PREVT 40-64 YRS | $175.43 | $350.85 | 50% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC VISIT NEW PREVT 40-64 YRS PRO FEE | $188.15 | $376.30 | 50% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC VISIT NEW PREVT 40-64 YRS PRO FEE | $188.15 | $376.30 | 50% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC VISIT NEW PREVT 40-64 YRS PRO FEE | $188.15 | $376.30 | 50% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES | $81.48 | $162.95 | 50% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY W/PATIENT 30 MINUTES | $81.48 | $162.95 | 50% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY W/PATIENT 30 MINUTES | $81.48 | $162.95 | 50% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES | $81.48 | $162.95 | 50% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES | $81.48 | $162.95 | 50% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY W/PATIENT 30 MINUTES | $81.48 | $162.95 | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES | $81.48 | $162.95 | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES | $81.48 | $162.95 | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY W/PATIENT 30 MINUTES | $81.48 | $162.95 | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY W/PATIENT 30 MINUTES | $81.48 | $162.95 | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES | $81.48 | $162.95 | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY W/PATIENT 30 MINUTES | $81.48 | $162.95 | 50% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES | $94.00 | $188.00 | 50% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES | $94.00 | $188.00 | 50% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES | $94.00 | $188.00 | 50% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES PRO FEE | $113.13 | $226.25 | 50% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES PRO FEE | $113.13 | $226.25 | 50% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES PRO FEE | $113.13 | $226.25 | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES | $94.00 | $188.00 | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES | $94.00 | $188.00 | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES | $94.00 | $188.00 | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES PRO FEE | $113.13 | $226.25 | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES PRO FEE | $113.13 | $226.25 | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES PRO FEE | $113.13 | $226.25 | 50% |
| Psychotherapy session, 60 minutes CPT 90837 HC FAC PSYCHOTHERAPY PT &/ FAMILY 60 MIN | $109.70 | $219.40 | 50% |
| Psychotherapy session, 60 minutes CPT 90837 HC FAC PSYCHOTHERAPY PT &/ FAMILY 60 MIN | $109.70 | $219.40 | 50% |
| Psychotherapy session, 60 minutes CPT 90837 HC FAC PSYCHOTHERAPY PT &/ FAMILY 60 MIN | $109.70 | $219.40 | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC FAC PSYCHOTHERAPY PT &/ FAMILY 60 MIN | $109.70 | $219.40 | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC FAC PSYCHOTHERAPY PT &/ FAMILY 60 MIN | $109.70 | $219.40 | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC FAC PSYCHOTHERAPY PT &/ FAMILY 60 MIN | $109.70 | $219.40 | 50% |