University Health System
Listed in its price file as “Bexar County Hospital District”.
University Health System in San Antonio, TX publishes cash prices for 432 common procedures listed here, from its own machine-readable price file updated Oct 7, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Texas median for 421 of 427 procedures and above it for 5. By typical cash price it ranks #29 of 299 Texas hospitals and #1 of 13 hospitals in the San Antonio, TX area, cheapest first. Select a procedure to compare it with other hospitals nearby.
4502 Medical Dr, San Antonio, TX 78229 Collected Oct 13, 2026 Source price file Check a bill from this hospital (210) 358-2000
Acute care hospital Government-owned hospital Emergency department CMS star rating 3 of 5 CCN 450213 · CMS hospital register NPI 1821011248
Financial assistance
Public hospital: ask for its charity care or sliding-scale discount
University Health System is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W/O & W/DYE - CT ABDOMEN W WO CONTRAST | $1,503.75 | $6,015.00 | $176.20–$15,037.50 | 48% below | 75% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W/O & W/DYE - CT ABDOMEN W WO CONTRAST | $1,503.75 | $6,015.00 | $2,033.07–$5,112.75 | — | 75% |
| Abdominal X-ray, 2 views CPT 74019 HC RADIOLOGIC EXAM ABDOMEN 2 VIEWS | $262.25 | $1,049.00 | $37.09–$2,622.50 | 31% below | 75% |
| Abdominal X-ray, 2 views inpatient CPT 74019 HC RADIOLOGIC EXAM ABDOMEN 2 VIEWS | $262.25 | $1,049.00 | $354.56–$891.65 | — | 75% |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS BILATERAL | $192.00 | $768.00 | $37.09–$1,920.00 | — | 75% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS RIGHT | $128.25 | $513.00 | $37.09–$1,282.50 | 64% below | 75% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS LEFT | $128.25 | $513.00 | $37.09–$1,282.50 | 64% below | 75% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS BILATERAL | $192.00 | $768.00 | $259.58–$652.80 | — | 75% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS RIGHT | $128.25 | $513.00 | $173.39–$436.05 | — | 75% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS LEFT | $128.25 | $513.00 | $173.39–$436.05 | — | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC VASC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL LIMITED BILATERAL | $136.00 | $544.00 | $133.65–$1,360.00 | — | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS - CV US ANKLE BRACHIAL INDICES EXTRM CMP | $136.00 | $544.00 | $133.65–$1,360.00 | 78% below | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS - TRANSCUTANEOUS O2 MEASUREMENT | $136.00 | $544.00 | $133.65–$1,360.00 | 78% below | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC PBB UPR/L XTREMITY ART 2 LEVELS - CV US ANKLE BRACHIAL INDICES EXTRM CMP | $136.00 | $544.00 | $133.65–$1,360.00 | 78% below | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC VASC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL | $136.00 | $544.00 | $133.65–$1,360.00 | 78% below | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 HC NON-INVAS PHYSIOLOGIC STUDY UNILAT EXTREMITY ART 3/>LEVEL | $136.00 | $544.00 | $133.65–$1,360.00 | 78% below | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC VASC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL LIMITED BILATERAL | $136.00 | $544.00 | $183.87–$462.40 | — | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC PBB UPR/L XTREMITY ART 2 LEVELS - CV US ANKLE BRACHIAL INDICES EXTRM CMP | $136.00 | $544.00 | $183.87–$462.40 | — | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS - CV US ANKLE BRACHIAL INDICES EXTRM CMP | $136.00 | $544.00 | $183.87–$462.40 | — | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS - TRANSCUTANEOUS O2 MEASUREMENT | $136.00 | $544.00 | $183.87–$462.40 | — | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC VASC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL | $136.00 | $544.00 | $183.87–$462.40 | — | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 HC NON-INVAS PHYSIOLOGIC STUDY UNILAT EXTREMITY ART 3/>LEVEL | $136.00 | $544.00 | $183.87–$462.40 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT UPPER EXT BILATERAL WO IV CONTRAST | $1,219.25 | $4,877.00 | $105.02–$12,192.50 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT SHOULDER BILATERAL WO IV CONTRAST | $1,219.25 | $4,877.00 | $105.02–$12,192.50 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT ELBOW BILATERAL WO IV CONTRAST | $1,219.25 | $4,877.00 | $105.02–$12,192.50 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT HAND BILATERAL WO IV CONTRAST | $1,219.25 | $4,877.00 | $105.02–$12,192.50 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT JOINT SC WO IV CONT | $884.00 | $3,536.00 | $105.02–$8,840.00 | 46% below | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT HAND RIGHT WO IV CONTRAST | $884.00 | $3,536.00 | $105.02–$8,840.00 | 46% below | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT UPPER EXT RIGHT WO IV CONTRAST | $884.00 | $3,536.00 | $105.02–$8,840.00 | 46% below | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT ELBOW LEFT WO IV CONTRAST | $884.00 | $3,536.00 | $105.02–$8,840.00 | 46% below | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT RADIUS ULNA LEFT WO IV CONT | $884.00 | $3,536.00 | $105.02–$8,840.00 | 46% below | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT RADIUS ULNA RIGHT WO IV CONT | $884.00 | $3,536.00 | $105.02–$8,840.00 | 46% below | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT HAND LEFT WO IV CONTRAST | $884.00 | $3,536.00 | $105.02–$8,840.00 | 46% below | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT ELBOW RIGHT WO IV CONTRAST | $884.00 | $3,536.00 | $105.02–$8,840.00 | 46% below | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT SHOULDER LEFT WO IV CONTRAST | $884.00 | $3,536.00 | $105.02–$8,840.00 | 46% below | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT SHOULDER RIGHT WO IV CONTRAST | $884.00 | $3,536.00 | $105.02–$8,840.00 | 46% below | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT WRIST LEFT WO IV CONTRAST | $884.00 | $3,536.00 | $105.02–$8,840.00 | 46% below | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT WRIST RIGHT WO IV CONTRAST | $884.00 | $3,536.00 | $105.02–$8,840.00 | 46% below | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT UPPER EXT LEFT WO IV CONTRAST | $884.00 | $3,536.00 | $105.02–$8,840.00 | 46% below | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT HAND BILATERAL WO IV CONTRAST | $1,219.25 | $4,877.00 | $1,648.43–$4,145.45 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT ELBOW BILATERAL WO IV CONTRAST | $1,219.25 | $4,877.00 | $1,648.43–$4,145.45 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT UPPER EXT BILATERAL WO IV CONTRAST | $1,219.25 | $4,877.00 | $1,648.43–$4,145.45 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT SHOULDER BILATERAL WO IV CONTRAST | $1,219.25 | $4,877.00 | $1,648.43–$4,145.45 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT JOINT SC WO IV CONT | $884.00 | $3,536.00 | $1,195.17–$3,005.60 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT ELBOW RIGHT WO IV CONTRAST | $884.00 | $3,536.00 | $1,195.17–$3,005.60 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT UPPER EXT LEFT WO IV CONTRAST | $884.00 | $3,536.00 | $1,195.17–$3,005.60 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT WRIST LEFT WO IV CONTRAST | $884.00 | $3,536.00 | $1,195.17–$3,005.60 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT SHOULDER RIGHT WO IV CONTRAST | $884.00 | $3,536.00 | $1,195.17–$3,005.60 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT SHOULDER LEFT WO IV CONTRAST | $884.00 | $3,536.00 | $1,195.17–$3,005.60 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT ELBOW LEFT WO IV CONTRAST | $884.00 | $3,536.00 | $1,195.17–$3,005.60 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT UPPER EXT RIGHT WO IV CONTRAST | $884.00 | $3,536.00 | $1,195.17–$3,005.60 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT WRIST RIGHT WO IV CONTRAST | $884.00 | $3,536.00 | $1,195.17–$3,005.60 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT RADIUS ULNA LEFT WO IV CONT | $884.00 | $3,536.00 | $1,195.17–$3,005.60 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT RADIUS ULNA RIGHT WO IV CONT | $884.00 | $3,536.00 | $1,195.17–$3,005.60 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT HAND LEFT WO IV CONTRAST | $884.00 | $3,536.00 | $1,195.17–$3,005.60 | — | 75% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT SCAN UPPER EXTREMITY W/O DYE - CT HAND RIGHT WO IV CONTRAST | $884.00 | $3,536.00 | $1,195.17–$3,005.60 | — | 75% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC ESOPHAGRAM - FL ESOPHAGUS BARIUM SWALLOW | $184.25 | $737.00 | $99.90–$1,842.50 | 63% below | 75% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC ESOPHAGRAM - FL ESOPHAGUS BARIUM SWALLOW | $184.25 | $737.00 | $249.11–$626.45 | — | 75% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC BONE IMAGING, WHOLE BODY - HC BONE &/OR JOINT IMAGING WHOLE BODY | $637.25 | $2,549.00 | $275.66–$6,372.50 | 59% below | 75% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC BONE IMAGING, WHOLE BODY - HC BONE &/OR JOINT IMAGING WHOLE BODY | $637.25 | $2,549.00 | $861.56–$2,166.65 | — | 75% |
| Breast ultrasound, complete, one breast both sides CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST BILATERAL COMPLETE | $257.00 | $1,028.00 | $103.91–$2,570.00 | — | 75% |
| Breast ultrasound, complete, one breast one side CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST LEFT COMPLETE | $216.25 | $865.00 | $103.91–$2,162.50 | 51% below | 75% |
| Breast ultrasound, complete, one breast one side CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST RIGHT COMPLETE | $216.25 | $865.00 | $103.91–$2,162.50 | 51% below | 75% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST BILATERAL COMPLETE | $257.00 | $1,028.00 | $347.46–$873.80 | — | 75% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST LEFT COMPLETE | $216.25 | $865.00 | $292.37–$735.25 | — | 75% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST RIGHT COMPLETE | $216.25 | $865.00 | $292.37–$735.25 | — | 75% |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST BILATERAL LIMITED | $157.25 | $629.00 | $85.54–$1,572.50 | — | 75% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST RIGHT LIMITED | $146.00 | $584.00 | $85.54–$1,460.00 | 58% below | 75% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST LEFT LIMITED | $146.00 | $584.00 | $85.54–$1,460.00 | 58% below | 75% |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST BILATERAL LIMITED | $157.25 | $629.00 | $212.60–$534.65 | — | 75% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST RIGHT LIMITED | $146.00 | $584.00 | $197.39–$496.40 | — | 75% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST LEFT LIMITED | $146.00 | $584.00 | $197.39–$496.40 | — | 75% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT ANGIO ABD&PELV W/O&W/DYE - CT ANGIOGRAM ABDOMEN PELVIS W CONTRAST | $2,494.75 | $9,979.00 | $350.46–$24,947.50 | 38% below | 75% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CT ANGIO ABD&PELV W/O&W/DYE - CT ANGIOGRAM ABDOMEN PELVIS W CONTRAST | $2,494.75 | $9,979.00 | $3,372.90–$8,482.15 | — | 75% |
| CT angiography (CTA) of the head CPT 70496 HC CT ANGIO,HEAD COMBO - CT HEAD ANGIO W AND WO IV CONTRAST | $702.00 | $2,808.00 | $176.20–$7,020.00 | 71% below | 75% |
| CT angiography (CTA) of the head CPT 70496 HC CT ANGIO,HEAD COMBO - CT HEAD NECK ANGIO W AND WO IV CONTRAST | $702.00 | $2,808.00 | $176.20–$7,020.00 | 71% below | 75% |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIO,HEAD COMBO - CT HEAD ANGIO W AND WO IV CONTRAST | $702.00 | $2,808.00 | $949.10–$2,386.80 | — | 75% |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIO,HEAD COMBO - CT HEAD NECK ANGIO W AND WO IV CONTRAST | $702.00 | $2,808.00 | $949.10–$2,386.80 | — | 75% |
| CT angiography (CTA) of the neck CPT 70498 HC CT ANGIO,NECK COMBO - CT NECK ANGIO W AND WO IV CONTRAST | $673.50 | $2,694.00 | $176.20–$6,735.00 | 72% below | 75% |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC CT ANGIO,NECK COMBO - CT NECK ANGIO W AND WO IV CONTRAST | $673.50 | $2,694.00 | $910.57–$2,289.90 | — | 75% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIO, CHEST, COMBO, INCL IMAGE - CT CHEST ANGIO W AND WO IV CONT | $1,393.50 | $5,574.00 | $176.20–$13,935.00 | 46% below | 75% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIO, CHEST, COMBO, INCL IMAGE - CT CHEST ANGIO W AND WO IV CONT | $1,393.50 | $5,574.00 | $1,884.01–$4,737.90 | — | 75% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CT ANGIO HRT W/3D IMAGE - CT HEART CORONARY ANGIOGRAM | $1,383.75 | $5,535.00 | $180.34–$13,837.50 | 17% below | 75% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CT ANGIO HRT W/3D IMAGE - CT HEART CORONARY ANGIOGRAM | $1,383.75 | $5,535.00 | $1,870.83–$4,704.75 | — | 75% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HRT W/O DYE W/CA TEST - CT HEART CALCIUM SCORING WO CONTRAST | $854.50 | $3,418.00 | $86.88–$8,545.00 | 351% above | 75% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HRT W/O DYE W/CA TEST - CT HEART CALCIUM SCORING WO CONTRAST | $854.50 | $3,418.00 | $1,155.28–$2,905.30 | — | 75% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS W/O CONTRAST - CT ABDOMEN PELVIS WO CONTRAST | $1,857.25 | $7,429.00 | $189.79–$18,572.50 | 35% below | 75% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS W/O CONTRAST - CT ABDOMEN PELVIS WO CONTRAST | $1,857.25 | $7,429.00 | $2,511.00–$6,314.65 | — | 75% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST | $2,370.25 | $9,481.00 | $318.09–$23,702.50 | 38% below | 75% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST | $2,370.25 | $9,481.00 | $3,204.58–$8,058.85 | — | 75% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD & PELV 1/> REGNS - CT ABDOMEN PELVIS W WO CONTRAST | $2,548.75 | $10,195.00 | $350.46–$25,487.50 | 33% below | 75% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD & PELV 1/> REGNS - CT ABDOMEN PELVIS W WO CONTRAST | $2,548.75 | $10,195.00 | $3,445.91–$8,665.75 | — | 75% |
| CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W/DYE - CT ABDOMEN W CONTRAST | $1,269.00 | $5,076.00 | $176.20–$12,690.00 | 49% below | 75% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W/DYE - CT ABDOMEN W CONTRAST | $1,269.00 | $5,076.00 | $1,715.69–$4,314.60 | — | 75% |
| CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O DYE - CT ABDOMEN WO CONTRAST | $1,113.50 | $4,454.00 | $105.02–$11,135.00 | 45% below | 75% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN W/O DYE - CT ABDOMEN WO CONTRAST | $1,113.50 | $4,454.00 | $1,505.45–$3,785.90 | — | 75% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS WO CONTRAST | $746.50 | $2,986.00 | $105.02–$7,465.00 | 54% below | 75% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS FACIAL BONES WO CONT | $746.50 | $2,986.00 | $105.02–$7,465.00 | 54% below | 75% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS WO CONTRAST | $746.50 | $2,986.00 | $1,009.27–$2,538.10 | — | 75% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS FACIAL BONES WO CONT | $746.50 | $2,986.00 | $1,009.27–$2,538.10 | — | 75% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT BODY TOM HEAD WO CONTRAST | $1,084.25 | $4,337.00 | $105.02–$10,842.50 | 35% below | 75% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST | $1,084.25 | $4,337.00 | $105.02–$10,842.50 | 35% below | 75% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD EPILEPSY INTRACR ELECT WO CONTRAST | $1,084.25 | $4,337.00 | $105.02–$10,842.50 | 35% below | 75% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD LEKSELL LOCALIZER WO CONTRAST | $1,084.25 | $4,337.00 | $105.02–$10,842.50 | 35% below | 75% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT BODY TOM HEAD WO CONTRAST | $1,084.25 | $4,337.00 | $1,465.91–$3,686.45 | — | 75% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD LEKSELL LOCALIZER WO CONTRAST | $1,084.25 | $4,337.00 | $1,465.91–$3,686.45 | — | 75% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD EPILEPSY INTRACR ELECT WO CONTRAST | $1,084.25 | $4,337.00 | $1,465.91–$3,686.45 | — | 75% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST | $1,084.25 | $4,337.00 | $1,465.91–$3,686.45 | — | 75% |
| CT scan of the head with contrast CPT 70460 HC CT SCAN HEAD CONTRAST - CT HEAD W CONTRAST | $1,077.25 | $4,309.00 | $153.36–$10,772.50 | 36% below | 75% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT SCAN HEAD CONTRAST - CT HEAD W CONTRAST | $1,077.25 | $4,309.00 | $1,456.44–$3,662.65 | — | 75% |
| CT scan of the head without and with contrast CPT 70470 HC CT SCAN HEAD COMBO - CT HEAD W WO CONTRAST | $1,276.00 | $5,104.00 | $176.20–$12,760.00 | 38% below | 75% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT SCAN HEAD COMBO - CT HEAD W WO CONTRAST | $1,276.00 | $5,104.00 | $1,725.15–$4,338.40 | — | 75% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT SCAN,LUMBAR SPINE,W/O CONTRAST - CT LUMBAR SPINE WO CONTRAST | $572.75 | $2,291.00 | $105.02–$5,727.50 | 67% below | 75% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT SCAN,LUMBAR SPINE,W/O CONTRAST - CT LUMBAR SPINE WO CONTRAST | $572.75 | $2,291.00 | $774.36–$1,947.35 | — | 75% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT SCAN,CERVICAL SPINE,W/O CONTRAST - CT CERVICAL SPINE WO CONTRAST | $1,261.25 | $5,045.00 | $105.02–$12,612.50 | 38% below | 75% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT SCAN,CERVICAL SPINE,W/O CONTRAST - CT CERVICAL SPINE WO CONTRAST | $1,261.25 | $5,045.00 | $1,705.21–$4,288.25 | — | 75% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST | $592.00 | $2,368.00 | $176.20–$5,920.00 | 73% below | 75% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST | $592.00 | $2,368.00 | $800.38–$2,012.80 | — | 75% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL,BILAT - CV US DOPPLER CAROTID | $392.75 | $1,571.00 | $191.46–$3,927.50 | — | 75% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL,BILAT - CAROTID ULTRASOUND NEUROLOGY | $392.75 | $1,571.00 | $191.46–$3,927.50 | — | 75% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC VASC DUPLEX SCAN EXTRACRANIAL ARTERIES,BILATERAL | $392.75 | $1,571.00 | $191.46–$3,927.50 | — | 75% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL,BILAT - CAROTID ULTRASOUND NEUROLOGY | $392.75 | $1,571.00 | $531.00–$1,335.35 | — | 75% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC VASC DUPLEX SCAN EXTRACRANIAL ARTERIES,BILATERAL | $392.75 | $1,571.00 | $531.00–$1,335.35 | — | 75% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL,BILAT - CV US DOPPLER CAROTID | $392.75 | $1,571.00 | $531.00–$1,335.35 | — | 75% |
| Chest CT scan without and with contrast CPT 71270 HC CAT SCAN OF CHEST COMBO - CT CHEST W WO CONTRAST DX | $1,650.75 | $6,603.00 | $176.20–$16,507.50 | 35% below | 75% |
| Chest CT scan without and with contrast inpatient CPT 71270 HC CAT SCAN OF CHEST COMBO - CT CHEST W WO CONTRAST DX | $1,650.75 | $6,603.00 | $2,231.81–$5,612.55 | — | 75% |
| Chest X-ray, 2 views both sides CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS BILATERAL | $238.00 | $952.00 | $33.75–$2,380.00 | — | 75% |
| Chest X-ray, 2 views CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS W/ OBLIQUES | $238.00 | $952.00 | $33.75–$2,380.00 | 39% below | 75% |
| Chest X-ray, 2 views CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - FL/XR CHEST 2 VIEWS W/ FLUORO | $238.00 | $952.00 | $33.75–$2,380.00 | 39% below | 75% |
| Chest X-ray, 2 views CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS | $238.00 | $952.00 | $33.75–$2,380.00 | 39% below | 75% |
| Chest X-ray, 2 views CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS W/ APICAL LORDOTIC | $238.00 | $952.00 | $33.75–$2,380.00 | 39% below | 75% |
| Chest X-ray, 2 views one side CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR RIBS 2 VWS LT W/ CHEST ANTEROPOST | $238.00 | $952.00 | $33.75–$2,380.00 | 39% below | 75% |
| Chest X-ray, 2 views one side CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR RIBS 2 VWS RT W/ CHEST ANTEROPOST | $238.00 | $952.00 | $33.75–$2,380.00 | 39% below | 75% |
| Chest X-ray, 2 views inpatient both sides CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS BILATERAL | $238.00 | $952.00 | $321.78–$809.20 | — | 75% |
| Chest X-ray, 2 views inpatient CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS W/ OBLIQUES | $238.00 | $952.00 | $321.78–$809.20 | — | 75% |
| Chest X-ray, 2 views inpatient CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS W/ APICAL LORDOTIC | $238.00 | $952.00 | $321.78–$809.20 | — | 75% |
| Chest X-ray, 2 views inpatient CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS | $238.00 | $952.00 | $321.78–$809.20 | — | 75% |
| Chest X-ray, 2 views inpatient CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - FL/XR CHEST 2 VIEWS W/ FLUORO | $238.00 | $952.00 | $321.78–$809.20 | — | 75% |
| Chest X-ray, 2 views inpatient one side CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR RIBS 2 VWS RT W/ CHEST ANTEROPOST | $238.00 | $952.00 | $321.78–$809.20 | — | 75% |
| Chest X-ray, 2 views inpatient one side CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR RIBS 2 VWS LT W/ CHEST ANTEROPOST | $238.00 | $952.00 | $321.78–$809.20 | — | 75% |
| Chest X-ray, single view CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST EXPIRATION ONLY | $168.00 | $672.00 | $26.06–$1,680.00 | 48% below | 75% |
| Chest X-ray, single view CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST 1 VIEW | $168.00 | $672.00 | $26.06–$1,680.00 | 48% below | 75% |
| Chest X-ray, single view CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST LATERAL DECUBITUS | $168.00 | $672.00 | $26.06–$1,680.00 | 48% below | 75% |
| Chest X-ray, single view CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST INSPIRATION EXPIRATION | $168.00 | $672.00 | $26.06–$1,680.00 | 48% below | 75% |
| Chest X-ray, single view inpatient CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST INSPIRATION EXPIRATION | $168.00 | $672.00 | $227.14–$571.20 | — | 75% |
| Chest X-ray, single view inpatient CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST EXPIRATION ONLY | $168.00 | $672.00 | $227.14–$571.20 | — | 75% |
| Chest X-ray, single view inpatient CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST LATERAL DECUBITUS | $168.00 | $672.00 | $227.14–$571.20 | — | 75% |
| Chest X-ray, single view inpatient CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST 1 VIEW | $168.00 | $672.00 | $227.14–$571.20 | — | 75% |
| Collarbone (clavicle) X-ray, complete both sides CPT 73000 HC X-RAY CLAVICLE - XR CLAVICLE BILATERAL | $220.50 | $882.00 | $32.41–$2,205.00 | — | 75% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 HC X-RAY CLAVICLE - XR CLAVICLE LEFT | $166.75 | $667.00 | $32.41–$1,667.50 | 44% below | 75% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 HC X-RAY CLAVICLE - XR CLAVICLE RIGHT | $166.75 | $667.00 | $32.41–$1,667.50 | 44% below | 75% |
| Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 HC X-RAY CLAVICLE - XR CLAVICLE BILATERAL | $220.50 | $882.00 | $298.12–$749.70 | — | 75% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC X-RAY CLAVICLE - XR CLAVICLE RIGHT | $166.75 | $667.00 | $225.45–$566.95 | — | 75% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC X-RAY CLAVICLE - XR CLAVICLE LEFT | $166.75 | $667.00 | $225.45–$566.95 | — | 75% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - US RENAL COMPLETE | $212.50 | $850.00 | $105.02–$2,125.00 | 69% below | 75% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - US RETROPERITONEUM | $212.50 | $850.00 | $105.02–$2,125.00 | 69% below | 75% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - US ABDOMINAL AORTA COMPLETE | $212.50 | $850.00 | $105.02–$2,125.00 | 69% below | 75% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - US RENAL COMPLETE | $212.50 | $850.00 | $287.30–$722.50 | — | 75% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - US RETROPERITONEUM | $212.50 | $850.00 | $287.30–$722.50 | — | 75% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - US ABDOMINAL AORTA COMPLETE | $212.50 | $850.00 | $287.30–$722.50 | — | 75% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY AXIAL - DEXA BONE DENSITY | $90.00 | $360.00 | $38.09–$900.00 | 77% below | 75% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY AXIAL - XR BONE DENSITY WITH SPECT LUMBAR | $90.00 | $360.00 | $38.09–$900.00 | 77% below | 75% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DXA BONE DENSITY AXIAL - XR BONE DENSITY WITH SPECT LUMBAR | $90.00 | $360.00 | $121.68–$306.00 | — | 75% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DXA BONE DENSITY AXIAL - DEXA BONE DENSITY | $90.00 | $360.00 | $121.68–$306.00 | — | 75% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DXA BONE DENSITY/PERIPHERAL - DEXA BONE DENSITY EXTREMITY | $53.50 | $214.00 | $31.41–$535.00 | 76% below | 75% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC DXA BONE DENSITY/PERIPHERAL - DEXA BONE DENSITY EXTREMITY | $53.50 | $214.00 | $72.33–$181.90 | — | 75% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC PBB OB US DETAILED SNGL FETUS - US OB DETAIL FETAL ANAT SING OR 1ST GEST | $185.50 | $742.00 | $176.09–$1,855.00 | 73% below | 75% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC OB US DETAILED SNGL FETUS - US OB DETAIL FETAL ANAT SING OR 1ST GEST | $185.50 | $742.00 | $176.09–$1,855.00 | 73% below | 75% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC OB US DETAILED SNGL FETUS - US OB DETAIL FETAL ANAT SING OR 1ST GEST | $185.50 | $742.00 | $250.80–$630.70 | — | 75% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC PBB OB US DETAILED SNGL FETUS - US OB DETAIL FETAL ANAT SING OR 1ST GEST | $185.50 | $742.00 | $250.80–$630.70 | — | 75% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT SCAN,THORAX,W/O CONTRAST - CT CHEST WO CONTRAST DX | $940.50 | $3,762.00 | $105.02–$9,405.00 | 38% below | 75% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT SCAN,THORAX,W/O CONTRAST - CT CHEST WO CONTRAST DX | $940.50 | $3,762.00 | $1,271.56–$3,197.70 | — | 75% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CAT SCAN OF CHEST CONTRAST - CT CHEST PULMONARY EMBOLISM W IV CONT DX | $1,393.50 | $5,574.00 | $173.08–$13,935.00 | 30% below | 75% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CAT SCAN OF CHEST CONTRAST - CT CHEST W CONTRAST DX | $1,463.00 | $5,852.00 | $173.08–$14,630.00 | 27% below | 75% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CAT SCAN OF CHEST CONTRAST - CT CHEST PULMONARY EMBOLISM W IV CONT DX | $1,393.50 | $5,574.00 | $1,884.01–$4,737.90 | — | 75% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CAT SCAN OF CHEST CONTRAST - CT CHEST W CONTRAST DX | $1,463.00 | $5,852.00 | $1,977.98–$4,974.20 | — | 75% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI - MAMMO BREAST DIAGNOSTIC BILATERAL | $121.75 | $487.00 | $150.52–$1,217.50 | — | 75% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI - MG BREAST BILATERAL POST BIOPSY CLIP | $121.75 | $487.00 | $150.52–$1,217.50 | — | 75% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI - MAMMO BREAST DIAGNOSTIC BILATERAL | $121.75 | $487.00 | $164.61–$413.95 | — | 75% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI - MG BREAST BILATERAL POST BIOPSY CLIP | $121.75 | $487.00 | $164.61–$413.95 | — | 75% |
| Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS RIGHT | $95.00 | $380.00 | $118.85–$950.00 | 65% below | 75% |
| Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS LEFT | $95.00 | $380.00 | $118.85–$950.00 | 65% below | 75% |
| Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC RIGHT | $95.00 | $380.00 | $118.85–$950.00 | 65% below | 75% |
| Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC LEFT | $95.00 | $380.00 | $118.85–$950.00 | 65% below | 75% |
| Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MG BREAST LEFT POST BIOPSY CLIP | $95.00 | $380.00 | $118.85–$950.00 | 65% below | 75% |
| Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MG BREAST RIGHT POST BIOPSY CLIP | $95.00 | $380.00 | $118.85–$950.00 | 65% below | 75% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS LEFT | $95.00 | $380.00 | $128.44–$323.00 | — | 75% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC RIGHT | $95.00 | $380.00 | $128.44–$323.00 | — | 75% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MG BREAST LEFT POST BIOPSY CLIP | $95.00 | $380.00 | $128.44–$323.00 | — | 75% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MG BREAST RIGHT POST BIOPSY CLIP | $95.00 | $380.00 | $128.44–$323.00 | — | 75% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS RIGHT | $95.00 | $380.00 | $128.44–$323.00 | — | 75% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC LEFT | $95.00 | $380.00 | $128.44–$323.00 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - LOWER EXTREMITY ARTERIAL BYPASS GFT DUP | $459.75 | $1,839.00 | $233.52–$4,597.50 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - LOWER EXTREMITY PSEUDOANEURYSM DUPLEX | $459.75 | $1,839.00 | $233.52–$4,597.50 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC VASC DUPLEX LO EXTREM ART BILAT | $459.75 | $1,839.00 | $233.52–$4,597.50 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - US LOWER EXTREMITY ARTERIES BILATERAL | $459.75 | $1,839.00 | $233.52–$4,597.50 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - CV US DOPPLER ARTERIAL LEGS BILATERAL | $459.75 | $1,839.00 | $233.52–$4,597.50 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - LOWER EXTREMITY ARTERIAL DUPLEX | $459.75 | $1,839.00 | $233.52–$4,597.50 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - FEMORAL POPLITEAL ANEURYSM DUPLEX | $459.75 | $1,839.00 | $233.52–$4,597.50 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC VASC DUPLEX LO EXTREM ART BILAT | $459.75 | $1,839.00 | $621.58–$1,563.15 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - US LOWER EXTREMITY ARTERIES BILATERAL | $459.75 | $1,839.00 | $621.58–$1,563.15 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - CV US DOPPLER ARTERIAL LEGS BILATERAL | $459.75 | $1,839.00 | $621.58–$1,563.15 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - LOWER EXTREMITY ARTERIAL DUPLEX | $459.75 | $1,839.00 | $621.58–$1,563.15 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - LOWER EXTREMITY ARTERIAL BYPASS GFT DUP | $459.75 | $1,839.00 | $621.58–$1,563.15 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - FEMORAL POPLITEAL ANEURYSM DUPLEX | $459.75 | $1,839.00 | $621.58–$1,563.15 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - LOWER EXTREMITY PSEUDOANEURYSM DUPLEX | $459.75 | $1,839.00 | $621.58–$1,563.15 | — | 75% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - UPPER EXTREMITY DVT | $481.75 | $1,927.00 | $188.79–$4,817.50 | — | 75% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC VASC DUPLEX EXTREM VENOUS,BILAT | $481.75 | $1,927.00 | $188.79–$4,817.50 | — | 75% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - LOWER EXTREMITY DVT | $481.75 | $1,927.00 | $188.79–$4,817.50 | — | 75% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - VENOUS REFLUX DUPLEX | $481.75 | $1,927.00 | $188.79–$4,817.50 | — | 75% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - US DOPPLER VENOUS ARMS BILATERAL | $481.75 | $1,927.00 | $188.79–$4,817.50 | — | 75% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - CV US DOPPLER VENOUS LEGS BILATERAL | $481.75 | $1,927.00 | $188.79–$4,817.50 | — | 75% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC VASC DUPLEX EXTREM VENOUS,BILAT | $481.75 | $1,927.00 | $651.33–$1,637.95 | — | 75% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - CV US DOPPLER VENOUS LEGS BILATERAL | $481.75 | $1,927.00 | $651.33–$1,637.95 | — | 75% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - US DOPPLER VENOUS ARMS BILATERAL | $481.75 | $1,927.00 | $651.33–$1,637.95 | — | 75% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - VENOUS REFLUX DUPLEX | $481.75 | $1,927.00 | $651.33–$1,637.95 | — | 75% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - LOWER EXTREMITY DVT | $481.75 | $1,927.00 | $651.33–$1,637.95 | — | 75% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - UPPER EXTREMITY DVT | $481.75 | $1,927.00 | $651.33–$1,637.95 | — | 75% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE W/DOPPLER/COLORFLOW COMPLETE | $852.50 | $3,410.00 | $548.90–$8,525.00 | 55% below | 75% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE W/DOPPLER/COLORFLOW COMPLETE | $852.50 | $3,410.00 | $1,152.58–$2,898.50 | — | 75% |
| Elbow X-ray, 2 views both sides CPT 73070 HC X-RAY ELBOW 2 VW - XR ELBOW 1-2 VIEWS BILATERAL | $154.25 | $617.00 | $29.40–$1,542.50 | — | 75% |
| Elbow X-ray, 2 views one side CPT 73070 HC X-RAY ELBOW 2 VW - XR ELBOW 1-2 VIEWS LEFT | $131.75 | $527.00 | $29.40–$1,317.50 | 58% below | 75% |
| Elbow X-ray, 2 views one side CPT 73070 HC X-RAY ELBOW 2 VW - XR ELBOW 1-2 VIEWS RIGHT | $131.75 | $527.00 | $29.40–$1,317.50 | 58% below | 75% |
| Elbow X-ray, 2 views inpatient both sides CPT 73070 HC X-RAY ELBOW 2 VW - XR ELBOW 1-2 VIEWS BILATERAL | $154.25 | $617.00 | $208.55–$524.45 | — | 75% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 HC X-RAY ELBOW 2 VW - XR ELBOW 1-2 VIEWS RIGHT | $131.75 | $527.00 | $178.13–$447.95 | — | 75% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 HC X-RAY ELBOW 2 VW - XR ELBOW 1-2 VIEWS LEFT | $131.75 | $527.00 | $178.13–$447.95 | — | 75% |
| Elbow X-ray, complete, 3 or more views both sides CPT 73080 HC X-RAY ELBOW 3+ VW - XR ELBOW 3+ VIEWS BILATERAL | $180.00 | $720.00 | $32.75–$1,800.00 | — | 75% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 HC X-RAY ELBOW 3+ VW - XR ELBOW 3+ VIEWS RIGHT | $160.50 | $642.00 | $32.75–$1,605.00 | 58% below | 75% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 HC X-RAY ELBOW 3+ VW - XR ELBOW 3+ VIEWS LEFT | $160.50 | $642.00 | $32.75–$1,605.00 | 58% below | 75% |
| Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 HC X-RAY ELBOW 3+ VW - XR ELBOW 3+ VIEWS BILATERAL | $180.00 | $720.00 | $243.36–$612.00 | — | 75% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC X-RAY ELBOW 3+ VW - XR ELBOW 3+ VIEWS LEFT | $160.50 | $642.00 | $217.00–$545.70 | — | 75% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC X-RAY ELBOW 3+ VW - XR ELBOW 3+ VIEWS RIGHT | $160.50 | $642.00 | $217.00–$545.70 | — | 75% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT SCAN,ORBIT/SELLA/POST FOSSA/EAR,W/O - CT ORBITS/SELLA WO IV CONT | $746.50 | $2,986.00 | $105.02–$7,465.00 | 50% below | 75% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT SCAN,ORBIT/SELLA/POST FOSSA/EAR,W/O - CT AUDITORY CANALS WO CONT | $746.50 | $2,986.00 | $105.02–$7,465.00 | 50% below | 75% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT SCAN,ORBIT/SELLA/POST FOSSA/EAR,W/O - CT ORBITS/SELLA WO IV CONT | $746.50 | $2,986.00 | $1,009.27–$2,538.10 | — | 75% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT SCAN,ORBIT/SELLA/POST FOSSA/EAR,W/O - CT AUDITORY CANALS WO CONT | $746.50 | $2,986.00 | $1,009.27–$2,538.10 | — | 75% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC X-RAY FACIAL BONES 3+ VW - XR FACIAL BONES 3+ VIEWS | $113.25 | $453.00 | $47.11–$1,132.50 | 71% below | 75% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC X-RAY FACIAL BONES 3+ VW - XR FACIAL BONES 3+ VIEWS | $113.25 | $453.00 | $153.11–$385.05 | — | 75% |
| Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 HC X-RAY FOREARM 2 VW - XR FOREARM 2 VIEWS BILATERAL | $188.75 | $755.00 | $29.40–$1,887.50 | — | 75% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC X-RAY FOREARM 2 VW - XR FOREARM 2 VIEWS LEFT | $127.25 | $509.00 | $29.40–$1,272.50 | 66% below | 75% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC X-RAY FOREARM 2 VW - XR FOREARM 2 VIEWS RIGHT | $127.25 | $509.00 | $29.40–$1,272.50 | 66% below | 75% |
| Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 HC X-RAY FOREARM 2 VW - XR FOREARM 2 VIEWS BILATERAL | $188.75 | $755.00 | $255.19–$641.75 | — | 75% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC X-RAY FOREARM 2 VW - XR FOREARM 2 VIEWS RIGHT | $127.25 | $509.00 | $172.04–$432.65 | — | 75% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC X-RAY FOREARM 2 VW - XR FOREARM 2 VIEWS LEFT | $127.25 | $509.00 | $172.04–$432.65 | — | 75% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER - NM LIVER FUNCTION | $602.25 | $2,409.00 | $303.06–$6,022.50 | 62% below | 75% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER - NM LIVER FUNCTION | $602.25 | $2,409.00 | $814.24–$2,047.65 | — | 75% |
| Hand X-ray, 2 views both sides CPT 73120 HC X-RAY HAND 2 VW - XR HAND 1-2 VIEWS BILATERAL | $113.25 | $453.00 | $31.41–$1,132.50 | — | 75% |
| Hand X-ray, 2 views one side CPT 73120 HC X-RAY HAND 2 VW - XR HAND 1-2 VIEWS RIGHT | $113.25 | $453.00 | $31.41–$1,132.50 | 64% below | 75% |
| Hand X-ray, 2 views one side CPT 73120 HC X-RAY HAND 2 VW - XR HAND 1-2 VIEWS LEFT | $113.25 | $453.00 | $31.41–$1,132.50 | 64% below | 75% |
| Hand X-ray, 2 views inpatient both sides CPT 73120 HC X-RAY HAND 2 VW - XR HAND 1-2 VIEWS BILATERAL | $113.25 | $453.00 | $153.11–$385.05 | — | 75% |
| Hand X-ray, 2 views inpatient one side CPT 73120 HC X-RAY HAND 2 VW - XR HAND 1-2 VIEWS RIGHT | $113.25 | $453.00 | $153.11–$385.05 | — | 75% |
| Hand X-ray, 2 views inpatient one side CPT 73120 HC X-RAY HAND 2 VW - XR HAND 1-2 VIEWS LEFT | $113.25 | $453.00 | $153.11–$385.05 | — | 75% |
| Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 HC X-RAY HEEL - XR CALCANEUS 2 VIEWS BILATERAL | $255.50 | $1,022.00 | $28.74–$2,555.00 | — | 75% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC X-RAY HEEL - XR CALCANEUS 2 VIEWS RIGHT | $171.25 | $685.00 | $28.74–$1,712.50 | 40% below | 75% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC X-RAY HEEL - XR CALCANEUS 2 VIEWS LEFT | $171.25 | $685.00 | $28.74–$1,712.50 | 40% below | 75% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 HC X-RAY HEEL - XR CALCANEUS 2 VIEWS BILATERAL | $255.50 | $1,022.00 | $345.44–$868.70 | — | 75% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC X-RAY HEEL - XR CALCANEUS 2 VIEWS RIGHT | $171.25 | $685.00 | $231.53–$582.25 | — | 75% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC X-RAY HEEL - XR CALCANEUS 2 VIEWS LEFT | $171.25 | $685.00 | $231.53–$582.25 | — | 75% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAPHY W/CPAP | $793.00 | $3,172.00 | $862.65–$7,930.00 | 81% below | 75% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNOGRAPHY W/CPAP | $793.00 | $3,172.00 | $1,072.14–$2,696.20 | — | 75% |
| Knee X-ray, 3 views both sides CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS BILATERAL | $348.25 | $1,393.00 | $40.76–$3,482.50 | — | 75% |
| Knee X-ray, 3 views one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS RIGHT | $232.75 | $931.00 | $40.76–$2,327.50 | 37% below | 75% |
| Knee X-ray, 3 views one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS LEFT | $232.75 | $931.00 | $40.76–$2,327.50 | 37% below | 75% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS BILATERAL | $348.25 | $1,393.00 | $470.83–$1,184.05 | — | 75% |
| Knee X-ray, 3 views inpatient one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS RIGHT | $232.75 | $931.00 | $314.68–$791.35 | — | 75% |
| Knee X-ray, 3 views inpatient one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS LEFT | $232.75 | $931.00 | $314.68–$791.35 | — | 75% |
| Knee X-ray, complete, 4 or more views both sides CPT 73564 HC X-RAY KNEE 4+ VIEW - XR KNEE 4+ VIEWS BILATERAL | $412.50 | $1,650.00 | $46.78–$4,125.00 | — | 75% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 HC X-RAY KNEE 4+ VIEW - XR KNEE 4+ VIEWS LEFT | $287.50 | $1,150.00 | $46.78–$2,875.00 | 32% below | 75% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 HC X-RAY KNEE 4+ VIEW - XR KNEE 4+ VIEWS RIGHT | $287.50 | $1,150.00 | $46.78–$2,875.00 | 32% below | 75% |
| Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 HC X-RAY KNEE 4+ VIEW - XR KNEE 4+ VIEWS BILATERAL | $412.50 | $1,650.00 | $557.70–$1,402.50 | — | 75% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC X-RAY KNEE 4+ VIEW - XR KNEE 4+ VIEWS LEFT | $287.50 | $1,150.00 | $388.70–$977.50 | — | 75% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC X-RAY KNEE 4+ VIEW - XR KNEE 4+ VIEWS RIGHT | $287.50 | $1,150.00 | $388.70–$977.50 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FEMUR BILATERAL WO IV CONTRAST | $944.25 | $3,777.00 | $105.02–$9,442.50 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT ANKLE BILATERAL WO IV CONTRAST | $944.25 | $3,777.00 | $105.02–$9,442.50 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FOOT BILATERAL WO IV CONTRAST | $944.25 | $3,777.00 | $105.02–$9,442.50 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT KNEE BILATERAL WO IV CONTRAST | $944.25 | $3,777.00 | $105.02–$9,442.50 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT HIP BILATERAL WO IV CONTRAST | $944.25 | $3,777.00 | $105.02–$9,442.50 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT LOWER EXTREMITY BILATERAL WO IV CONTRAST | $944.25 | $3,777.00 | $105.02–$9,442.50 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT LOWER EXTREMITY WO IV CONTRAST | $643.75 | $2,575.00 | $105.02–$6,437.50 | 61% below | 75% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT TIBIA FIBULA BIL WO IV CONT | $944.25 | $3,777.00 | $105.02–$9,442.50 | 43% below | 75% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT HIP RIGHT WO IV CONTRAST | $643.75 | $2,575.00 | $105.02–$6,437.50 | 61% below | 75% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT HIP LEFT WO IV CONTRAST | $643.75 | $2,575.00 | $105.02–$6,437.50 | 61% below | 75% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT KNEE LEFT WO IV CONTRAST | $643.75 | $2,575.00 | $105.02–$6,437.50 | 61% below | 75% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FEMUR LEFT WO IV CONTRAST | $643.75 | $2,575.00 | $105.02–$6,437.50 | 61% below | 75% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT TIBIA FIBULA RT WO IV CONT | $643.75 | $2,575.00 | $105.02–$6,437.50 | 61% below | 75% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FOOT LEFT WO IV CONTRAST | $643.75 | $2,575.00 | $105.02–$6,437.50 | 61% below | 75% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FOOT RIGHT WO IV CONTRAST | $643.75 | $2,575.00 | $105.02–$6,437.50 | 61% below | 75% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT ANKLE LEFT WO IV CONTRAST | $643.75 | $2,575.00 | $105.02–$6,437.50 | 61% below | 75% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT KNEE RIGHT WO IV CONTRAST | $643.75 | $2,575.00 | $105.02–$6,437.50 | 61% below | 75% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FEMUR RIGHT WO IV CONTRAST | $643.75 | $2,575.00 | $105.02–$6,437.50 | 61% below | 75% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT TIBIA FIBULA LT WO IV CONT | $643.75 | $2,575.00 | $105.02–$6,437.50 | 61% below | 75% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT ANKLE RIGHT WO IV CONTRAST | $643.75 | $2,575.00 | $105.02–$6,437.50 | 61% below | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT HIP BILATERAL WO IV CONTRAST | $944.25 | $3,777.00 | $1,276.63–$3,210.45 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT KNEE BILATERAL WO IV CONTRAST | $944.25 | $3,777.00 | $1,276.63–$3,210.45 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FOOT BILATERAL WO IV CONTRAST | $944.25 | $3,777.00 | $1,276.63–$3,210.45 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT ANKLE BILATERAL WO IV CONTRAST | $944.25 | $3,777.00 | $1,276.63–$3,210.45 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT LOWER EXTREMITY BILATERAL WO IV CONTRAST | $944.25 | $3,777.00 | $1,276.63–$3,210.45 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FEMUR BILATERAL WO IV CONTRAST | $944.25 | $3,777.00 | $1,276.63–$3,210.45 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT LOWER EXTREMITY WO IV CONTRAST | $643.75 | $2,575.00 | $870.35–$2,188.75 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT TIBIA FIBULA BIL WO IV CONT | $944.25 | $3,777.00 | $1,276.63–$3,210.45 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FOOT LEFT WO IV CONTRAST | $643.75 | $2,575.00 | $870.35–$2,188.75 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT TIBIA FIBULA LT WO IV CONT | $643.75 | $2,575.00 | $870.35–$2,188.75 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT TIBIA FIBULA RT WO IV CONT | $643.75 | $2,575.00 | $870.35–$2,188.75 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT KNEE LEFT WO IV CONTRAST | $643.75 | $2,575.00 | $870.35–$2,188.75 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT KNEE RIGHT WO IV CONTRAST | $643.75 | $2,575.00 | $870.35–$2,188.75 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT HIP RIGHT WO IV CONTRAST | $643.75 | $2,575.00 | $870.35–$2,188.75 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FEMUR LEFT WO IV CONTRAST | $643.75 | $2,575.00 | $870.35–$2,188.75 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT ANKLE RIGHT WO IV CONTRAST | $643.75 | $2,575.00 | $870.35–$2,188.75 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT HIP LEFT WO IV CONTRAST | $643.75 | $2,575.00 | $870.35–$2,188.75 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT ANKLE LEFT WO IV CONTRAST | $643.75 | $2,575.00 | $870.35–$2,188.75 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FOOT RIGHT WO IV CONTRAST | $643.75 | $2,575.00 | $870.35–$2,188.75 | — | 75% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT SCAN,LOWER EXTREMITY,W/O CONTRAST - CT FEMUR RIGHT WO IV CONTRAST | $643.75 | $2,575.00 | $870.35–$2,188.75 | — | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US ENDOANAL | $237.00 | $948.00 | $88.55–$2,370.00 | 61% below | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC PBB US, ABDOMEN LIMITED - US ABDOMEN LIMITED | $237.00 | $948.00 | $88.55–$2,370.00 | 61% below | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US LOWER BACK SOFT TISSUE | $237.00 | $948.00 | $88.55–$2,370.00 | 61% below | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US RECTUM | $237.00 | $948.00 | $88.55–$2,370.00 | 61% below | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED | $237.00 | $948.00 | $88.55–$2,370.00 | 61% below | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED SPLEEN | $237.00 | $948.00 | $88.55–$2,370.00 | 61% below | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US PELVIS APPENDIX | $237.00 | $948.00 | $88.55–$2,370.00 | 61% below | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED LIVER | $237.00 | $948.00 | $88.55–$2,370.00 | 61% below | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US GALLBLADDER | $332.75 | $1,331.00 | $88.55–$3,327.50 | 45% below | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US PELVIS APPENDIX | $237.00 | $948.00 | $320.42–$805.80 | — | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US ENDOANAL | $237.00 | $948.00 | $320.42–$805.80 | — | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED SPLEEN | $237.00 | $948.00 | $320.42–$805.80 | — | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC PBB US, ABDOMEN LIMITED - US ABDOMEN LIMITED | $237.00 | $948.00 | $320.42–$805.80 | — | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US LOWER BACK SOFT TISSUE | $237.00 | $948.00 | $320.42–$805.80 | — | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US RECTUM | $237.00 | $948.00 | $320.42–$805.80 | — | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED | $237.00 | $948.00 | $320.42–$805.80 | — | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED LIVER | $237.00 | $948.00 | $320.42–$805.80 | — | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US GALLBLADDER | $332.75 | $1,331.00 | $449.88–$1,131.35 | — | 75% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC PBB LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG | $157.50 | $630.00 | $30.35–$1,575.00 | 60% below | 75% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG | $157.50 | $630.00 | $30.35–$1,575.00 | 60% below | 75% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US LMTD JT/NONVASC XTR STRUX - US WRIST RIGHT LIMITED | $157.50 | $630.00 | $30.35–$1,575.00 | 60% below | 75% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US LMTD JT/NONVASC XTR STRUX - US KNEE LEFT LIMITED | $157.50 | $630.00 | $30.35–$1,575.00 | 60% below | 75% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US LMTD JT/NONVASC XTR STRUX - US KNEE RIGHT LIMITED | $157.50 | $630.00 | $30.35–$1,575.00 | 60% below | 75% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US LMTD JT/NONVASC XTR STRUX - US WRIST LEFT LIMITED | $157.50 | $630.00 | $30.35–$1,575.00 | 60% below | 75% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG | $157.50 | $630.00 | $212.94–$535.50 | — | 75% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC PBB LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG | $157.50 | $630.00 | $212.94–$535.50 | — | 75% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC US LMTD JT/NONVASC XTR STRUX - US WRIST LEFT LIMITED | $157.50 | $630.00 | $212.94–$535.50 | — | 75% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC US LMTD JT/NONVASC XTR STRUX - US KNEE LEFT LIMITED | $157.50 | $630.00 | $212.94–$535.50 | — | 75% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC US LMTD JT/NONVASC XTR STRUX - US KNEE RIGHT LIMITED | $157.50 | $630.00 | $212.94–$535.50 | — | 75% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC US LMTD JT/NONVASC XTR STRUX - US WRIST RIGHT LIMITED | $157.50 | $630.00 | $212.94–$535.50 | — | 75% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX LOW DOSE LUNG CA SCREENING W/O CONTRAST | $104.50 | $418.00 | $105.02–$1,045.00 | 57% below | 75% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT THORAX LOW DOSE LUNG CA SCREENING W/O CONTRAST | $104.50 | $418.00 | $141.28–$355.30 | — | 75% |
| Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 HC X-RAY TIB + FIB, 2VW - XR TIBIA FIBULA 2 VIEWS BILATERAL | $264.50 | $1,058.00 | $31.74–$2,645.00 | — | 75% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC X-RAY TIB + FIB, 2VW - XR TIBIA FIBULA 2 VIEWS RIGHT | $190.50 | $762.00 | $31.74–$1,905.00 | 45% below | 75% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC X-RAY TIB + FIB, 2VW - XR TIBIA FIBULA 2 VIEWS LEFT | $190.50 | $762.00 | $31.74–$1,905.00 | 45% below | 75% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 HC X-RAY TIB + FIB, 2VW - XR TIBIA FIBULA 2 VIEWS BILATERAL | $264.50 | $1,058.00 | $357.60–$899.30 | — | 75% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC X-RAY TIB + FIB, 2VW - XR TIBIA FIBULA 2 VIEWS RIGHT | $190.50 | $762.00 | $257.56–$647.70 | — | 75% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC X-RAY TIB + FIB, 2VW - XR TIBIA FIBULA 2 VIEWS LEFT | $190.50 | $762.00 | $257.56–$647.70 | — | 75% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC MR ANGIO, HEAD - MR HEAD ANGIO WO IV CONTRAST | $1,225.25 | $4,901.00 | $224.54–$12,252.50 | 32% below | 75% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MR ANGIO, HEAD - MR HEAD ANGIO WO IV CONTRAST | $1,225.25 | $4,901.00 | $1,656.54–$4,165.85 | — | 75% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE BILATERAL WO CONT | $525.75 | $2,103.00 | $210.84–$5,257.50 | — | 75% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI KNEE BILATERAL WO CONT | $525.75 | $2,103.00 | $210.84–$5,257.50 | — | 75% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIPS BILATERAL WO CONT | $525.75 | $2,103.00 | $210.84–$5,257.50 | — | 75% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE LT WO CONT | $412.50 | $1,650.00 | $210.84–$4,125.00 | 81% below | 75% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP LT WO CONT | $412.50 | $1,650.00 | $210.84–$4,125.00 | 81% below | 75% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP RT WO CONT | $412.50 | $1,650.00 | $210.84–$4,125.00 | 81% below | 75% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI KNEE LT WO CONT | $412.50 | $1,650.00 | $210.84–$4,125.00 | 81% below | 75% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI KNEE RT WO CONT | $412.50 | $1,650.00 | $210.84–$4,125.00 | 81% below | 75% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE RT WO CONT | $412.50 | $1,650.00 | $210.84–$4,125.00 | 81% below | 75% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIPS BILATERAL WO CONT | $525.75 | $2,103.00 | $710.81–$1,787.55 | — | 75% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE BILATERAL WO CONT | $525.75 | $2,103.00 | $710.81–$1,787.55 | — | 75% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI KNEE BILATERAL WO CONT | $525.75 | $2,103.00 | $710.81–$1,787.55 | — | 75% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI KNEE LT WO CONT | $412.50 | $1,650.00 | $557.70–$1,402.50 | — | 75% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE LT WO CONT | $412.50 | $1,650.00 | $557.70–$1,402.50 | — | 75% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP LT WO CONT | $412.50 | $1,650.00 | $557.70–$1,402.50 | — | 75% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE RT WO CONT | $412.50 | $1,650.00 | $557.70–$1,402.50 | — | 75% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP RT WO CONT | $412.50 | $1,650.00 | $557.70–$1,402.50 | — | 75% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI KNEE RT WO CONT | $412.50 | $1,650.00 | $557.70–$1,402.50 | — | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR KNEE BILATERAL W AND WO IV CONTRAST | $661.75 | $2,647.00 | $350.46–$6,617.50 | — | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR HIP BILATERAL W AND WO IV CONTRAST | $661.75 | $2,647.00 | $350.46–$6,617.50 | — | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR ANKLE BILATERAL W AND WO IV CONTRAST | $661.75 | $2,647.00 | $350.46–$6,617.50 | — | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR ANKLE RIGHT W AND WO IV CONTRAST | $543.75 | $2,175.00 | $350.46–$5,437.50 | 82% below | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR KNEE RIGHT W AND WO IV CONTRAST | $543.75 | $2,175.00 | $350.46–$5,437.50 | 82% below | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR HIP RIGHT W AND WO IV CONTRAST | $543.75 | $2,175.00 | $350.46–$5,437.50 | 82% below | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR ANKLE LEFT W AND WO IV CONTRAST | $543.75 | $2,175.00 | $350.46–$5,437.50 | 82% below | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR HIP LEFT W AND WO IV CONTRAST | $543.75 | $2,175.00 | $350.46–$5,437.50 | 82% below | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR KNEE LEFT W AND WO IV CONTRAST | $543.75 | $2,175.00 | $350.46–$5,437.50 | 82% below | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR ANKLE BILATERAL W AND WO IV CONTRAST | $661.75 | $2,647.00 | $894.69–$2,249.95 | — | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR KNEE BILATERAL W AND WO IV CONTRAST | $661.75 | $2,647.00 | $894.69–$2,249.95 | — | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR HIP BILATERAL W AND WO IV CONTRAST | $661.75 | $2,647.00 | $894.69–$2,249.95 | — | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR HIP RIGHT W AND WO IV CONTRAST | $543.75 | $2,175.00 | $735.15–$1,848.75 | — | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR KNEE RIGHT W AND WO IV CONTRAST | $543.75 | $2,175.00 | $735.15–$1,848.75 | — | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR KNEE LEFT W AND WO IV CONTRAST | $543.75 | $2,175.00 | $735.15–$1,848.75 | — | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR ANKLE LEFT W AND WO IV CONTRAST | $543.75 | $2,175.00 | $735.15–$1,848.75 | — | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR ANKLE RIGHT W AND WO IV CONTRAST | $543.75 | $2,175.00 | $735.15–$1,848.75 | — | 75% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR HIP LEFT W AND WO IV CONTRAST | $543.75 | $2,175.00 | $735.15–$1,848.75 | — | 75% |
| MRI of the abdomen without contrast CPT 74181 HC MRI, ABDOMEN (MRI) - MRI ABDOMEN WO CONTRAST MRCP | $1,297.50 | $5,190.00 | $204.83–$12,975.00 | 37% below | 75% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI, ABDOMEN (MRI) - MRI ABDOMEN WO CONTRAST MRCP | $1,297.50 | $5,190.00 | $1,754.22–$4,411.50 | — | 75% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN W WO CONTRAST MRCP | $1,583.50 | $6,334.00 | $350.46–$15,835.00 | 48% below | 75% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN W WO CONTRAST | $1,583.50 | $6,334.00 | $350.46–$15,835.00 | 48% below | 75% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN W WO CONTRAST MRCP | $1,583.50 | $6,334.00 | $2,140.89–$5,383.90 | — | 75% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN W WO CONTRAST | $1,583.50 | $6,334.00 | $2,140.89–$5,383.90 | — | 75% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN - MR PITUITARY WO IV CONTRAST | $1,739.00 | $6,956.00 | $204.15–$17,390.00 | 6% below | 75% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN - MRI BRAIN WO CONTRAST | $1,739.00 | $6,956.00 | $204.15–$17,390.00 | 6% below | 75% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN - MR PITUITARY WO IV CONTRAST | $1,739.00 | $6,956.00 | $2,351.13–$5,912.60 | — | 75% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN - MRI BRAIN WO CONTRAST | $1,739.00 | $6,956.00 | $2,351.13–$5,912.60 | — | 75% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN COMBO - MR PITUITARY W/WO IV CONTRAST | $1,965.50 | $7,862.00 | $332.80–$19,655.00 | 31% below | 75% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST | $1,965.50 | $7,862.00 | $332.80–$19,655.00 | 31% below | 75% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN COMBO - MR PITUITARY W/WO IV CONTRAST | $1,965.50 | $7,862.00 | $2,657.36–$6,682.70 | — | 75% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST | $1,965.50 | $7,862.00 | $2,657.36–$6,682.70 | — | 75% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI, LUMBAR SPINE - MRI COMPLETE SPINE WO CONTRAST | $789.50 | $3,158.00 | $199.14–$7,895.00 | 64% below | 75% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI, LUMBAR SPINE - MRI LUMBAR SPINE WO CONTRAST | $789.50 | $3,158.00 | $199.14–$7,895.00 | 64% below | 75% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI, LUMBAR SPINE - MRI COMPLETE SPINE WO CONTRAST | $789.50 | $3,158.00 | $1,067.40–$2,684.30 | — | 75% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI, LUMBAR SPINE - MRI LUMBAR SPINE WO CONTRAST | $789.50 | $3,158.00 | $1,067.40–$2,684.30 | — | 75% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI, LUMBAR SPINE COMBO - MRI LUMBAR SPINE W WO CONTRAST | $1,041.00 | $4,164.00 | $333.80–$10,410.00 | 67% below | 75% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI, LUMBAR SPINE COMBO - MRI LUMBAR SPINE W WO CONTRAST | $1,041.00 | $4,164.00 | $1,407.43–$3,539.40 | — | 75% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI, DORSAL SPINE - MRI COMPLETE SPINE WO CONTRAST | $1,540.00 | $6,160.00 | $198.48–$15,400.00 | 24% below | 75% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI, DORSAL SPINE - MRI THORACIC SPINE WO CONTRAST | $1,540.00 | $6,160.00 | $198.48–$15,400.00 | 24% below | 75% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI, DORSAL SPINE - MRI THORACIC SPINE WO CONTRAST | $1,540.00 | $6,160.00 | $2,082.08–$5,236.00 | — | 75% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI, DORSAL SPINE - MRI COMPLETE SPINE WO CONTRAST | $1,540.00 | $6,160.00 | $2,082.08–$5,236.00 | — | 75% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI, CERV SPINE COMBO - MRI CERVICAL SPINE W WO CONTRAST | $1,714.00 | $6,856.00 | $334.46–$17,140.00 | 48% below | 75% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI, CERV SPINE COMBO - MRI CERVICAL SPINE W WO CONTRAST | $1,714.00 | $6,856.00 | $2,317.33–$5,827.60 | — | 75% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI, CERV SPINE - MRI CERVICAL SPINE WO CONTRAST | $1,404.00 | $5,616.00 | $198.48–$14,040.00 | 38% below | 75% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI, CERV SPINE - MRI COMPLETE SPINE WO CONTRAST | $1,404.00 | $5,616.00 | $198.48–$14,040.00 | 38% below | 75% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI, CERV SPINE - MRI CERVICAL SPINE WO CONTRAST | $1,404.00 | $5,616.00 | $1,898.21–$4,773.60 | — | 75% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI, CERV SPINE - MRI COMPLETE SPINE WO CONTRAST | $1,404.00 | $5,616.00 | $1,898.21–$4,773.60 | — | 75% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI, PELVIS, COMBO - MRI PELVIS W WO CONTRAST | $1,480.75 | $5,923.00 | $350.46–$14,807.50 | 52% below | 75% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI, PELVIS, COMBO - MRI PELVIS W WO CONTRAST | $1,480.75 | $5,923.00 | $2,001.97–$5,034.55 | — | 75% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI, PELVIS, W/O CONTRAST - MRI PELVIS WO CONTRAST | $1,039.00 | $4,156.00 | $233.52–$10,390.00 | 56% below | 75% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI, PELVIS, W/O CONTRAST - MRI PELVIS WO CONTRAST | $1,039.00 | $4,156.00 | $1,404.73–$3,532.60 | — | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 HC MRI, JOINT UPPER EXTREM - MR SHOULDER BILATERAL WO IV CONTRAST | $727.75 | $2,911.00 | $211.18–$7,277.50 | — | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 HC MRI, JOINT UPPER EXTREM - MR ELBOW BILATERAL WO IV CONTRAST | $727.75 | $2,911.00 | $211.18–$7,277.50 | — | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 HC MRI, JOINT UPPER EXTREM - MR WRIST BILATERAL WO IV CONTRAST | $727.75 | $2,911.00 | $211.18–$7,277.50 | — | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI, JOINT UPPER EXTREM - MR BRACHIAL PLEXUS WO IV CONTRAST | $570.75 | $2,283.00 | $211.18–$5,707.50 | 68% below | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR SHOULDER LEFT WO IV CONTRAST | $570.75 | $2,283.00 | $211.18–$5,707.50 | 68% below | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR WRIST LEFT WO IV CONTRAST | $570.75 | $2,283.00 | $211.18–$5,707.50 | 68% below | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR ELBOW RIGHT WO IV CONTRAST | $570.75 | $2,283.00 | $211.18–$5,707.50 | 68% below | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR WRIST RIGHT WO IV CONTRAST | $570.75 | $2,283.00 | $211.18–$5,707.50 | 68% below | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR SHOULDER RIGHT WO IV CONTRAST | $570.75 | $2,283.00 | $211.18–$5,707.50 | 68% below | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR ELBOW LEFT WO IV CONTRAST | $570.75 | $2,283.00 | $211.18–$5,707.50 | 68% below | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 HC MRI, JOINT UPPER EXTREM - MR SHOULDER BILATERAL WO IV CONTRAST | $727.75 | $2,911.00 | $983.92–$2,474.35 | — | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 HC MRI, JOINT UPPER EXTREM - MR WRIST BILATERAL WO IV CONTRAST | $727.75 | $2,911.00 | $983.92–$2,474.35 | — | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 HC MRI, JOINT UPPER EXTREM - MR ELBOW BILATERAL WO IV CONTRAST | $727.75 | $2,911.00 | $983.92–$2,474.35 | — | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI, JOINT UPPER EXTREM - MR BRACHIAL PLEXUS WO IV CONTRAST | $570.75 | $2,283.00 | $771.65–$1,940.55 | — | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR ELBOW LEFT WO IV CONTRAST | $570.75 | $2,283.00 | $771.65–$1,940.55 | — | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR SHOULDER RIGHT WO IV CONTRAST | $570.75 | $2,283.00 | $771.65–$1,940.55 | — | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR SHOULDER LEFT WO IV CONTRAST | $570.75 | $2,283.00 | $771.65–$1,940.55 | — | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR ELBOW RIGHT WO IV CONTRAST | $570.75 | $2,283.00 | $771.65–$1,940.55 | — | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR WRIST LEFT WO IV CONTRAST | $570.75 | $2,283.00 | $771.65–$1,940.55 | — | 75% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR WRIST RIGHT WO IV CONTRAST | $570.75 | $2,283.00 | $771.65–$1,940.55 | — | 75% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC RADEX SPINE CERVICAL 4 OR 5 VIEWS - XR CERVICAL SPINE COMP 4-5 VIEWS | $287.50 | $1,150.00 | $53.46–$2,875.00 | 47% below | 75% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC RADEX SPINE CERVICAL 4 OR 5 VIEWS - XR CERVICAL SPINE COMP 4-5 VIEWS | $287.50 | $1,150.00 | $388.70–$977.50 | — | 75% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT NECK TISSUE CONTRAST - CT 4D PARATHYROID W CONTRAST | $675.75 | $2,703.00 | $176.20–$6,757.50 | 66% below | 75% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT NECK TISSUE CONTRAST - CT SOFT TISSUE NECK W CONTRAST | $675.75 | $2,703.00 | $176.20–$6,757.50 | 66% below | 75% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT NECK TISSUE CONTRAST - CT 4D PARATHYROID W CONTRAST | $675.75 | $2,703.00 | $913.61–$2,297.55 | — | 75% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT NECK TISSUE CONTRAST - CT SOFT TISSUE NECK W CONTRAST | $675.75 | $2,703.00 | $913.61–$2,297.55 | — | 75% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT SCAN,SOFT TISSUE NECK,W/O CONTRAST - CT SOFT TISSUE NECK WO CONT | $523.25 | $2,093.00 | $105.02–$5,232.50 | 66% below | 75% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT SCAN,SOFT TISSUE NECK,W/O CONTRAST - CT SOFT TISSUE NECK WO CONT | $523.25 | $2,093.00 | $707.43–$1,779.05 | — | 75% |
| Neck soft tissue X-ray CPT 70360 HC X-RAY NECK SOFT TISSUE - XR NECK SOFT TISSUE | $148.00 | $592.00 | $31.74–$1,480.00 | 38% below | 75% |
| Neck soft tissue X-ray inpatient CPT 70360 HC X-RAY NECK SOFT TISSUE - XR NECK SOFT TISSUE | $148.00 | $592.00 | $200.10–$503.20 | — | 75% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST EXERCISE W MYOCARD PERF | $1,455.50 | $5,822.00 | $438.05–$14,555.00 | 65% below | 75% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST ADENOSINE W MYOCARD PERF | $1,455.50 | $5,822.00 | $438.05–$14,555.00 | 65% below | 75% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST REGADENOSON W MYOCARD PERF | $1,455.50 | $5,822.00 | $438.05–$14,555.00 | 65% below | 75% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST DOBUTAMINE W MYOCARD PERF | $1,455.50 | $5,822.00 | $438.05–$14,555.00 | 65% below | 75% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - NM HEART PERFUSION SPECT STRESS & REST | $1,455.50 | $5,822.00 | $438.05–$14,555.00 | 65% below | 75% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST EXERCISE W MYOCARD PERF | $1,455.50 | $5,822.00 | $1,967.84–$4,948.70 | — | 75% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - NM HEART PERFUSION SPECT STRESS & REST | $1,455.50 | $5,822.00 | $1,967.84–$4,948.70 | — | 75% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST DOBUTAMINE W MYOCARD PERF | $1,455.50 | $5,822.00 | $1,967.84–$4,948.70 | — | 75% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST REGADENOSON W MYOCARD PERF | $1,455.50 | $5,822.00 | $1,967.84–$4,948.70 | — | 75% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST ADENOSINE W MYOCARD PERF | $1,455.50 | $5,822.00 | $1,967.84–$4,948.70 | — | 75% |
| OCT scan of the retina (optical coherence tomography) CPT 92134 HC PBB OCT-RETINA MACULA | $41.75 | $167.00 | $56.45–$417.50 | 75% below | 75% |
| OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 HC PBB OCT-RETINA MACULA | $41.75 | $167.00 | $56.45–$141.95 | — | 75% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGE W/CT SKULL-THIGH - PT/CT BONE SKULL BASE TO MID THIGH | $1,623.00 | $6,492.00 | $1,436.46–$16,230.00 | 62% below | 75% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGE W/CT SKULL-THIGH - PT/CT BONE SKULL BASE TO MID THIGH | $1,623.00 | $6,492.00 | $2,194.30–$5,518.20 | — | 75% |
| Pelvic CT scan without contrast CPT 72192 HC CT SCAN,PELVIS,W/O CONTRAST - CT PELVIS WO CONTRAST | $561.00 | $2,244.00 | $105.02–$5,610.00 | 65% below | 75% |
| Pelvic CT scan without contrast inpatient CPT 72192 HC CT SCAN,PELVIS,W/O CONTRAST - CT PELVIS WO CONTRAST | $561.00 | $2,244.00 | $758.47–$1,907.40 | — | 75% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC PBB SONO PELVIS LIMITED | $113.25 | $453.00 | $50.79–$1,132.50 | 77% below | 75% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED FOLLICLES | $113.25 | $453.00 | $50.79–$1,132.50 | 77% below | 75% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC SONO PELVIS LIMITED | $113.25 | $453.00 | $50.79–$1,132.50 | 77% below | 75% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED | $113.25 | $453.00 | $50.79–$1,132.50 | 77% below | 75% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC PBB SONO PELVIS LIMITED | $113.25 | $453.00 | $153.11–$385.05 | — | 75% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED FOLLICLES | $113.25 | $453.00 | $153.11–$385.05 | — | 75% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC SONO PELVIS LIMITED | $113.25 | $453.00 | $153.11–$385.05 | — | 75% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED | $113.25 | $453.00 | $153.11–$385.05 | — | 75% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC PBB ECHO,PELVIC (NONOBSTETRIC) - US PELVIS | $182.25 | $729.00 | $96.28–$1,822.50 | 76% below | 75% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC ECHO,PELVIC (NONOBSTETRIC) - US PELVIS | $182.25 | $729.00 | $96.28–$1,822.50 | 76% below | 75% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC PBB ECHO,PELVIC (NONOBSTETRIC) - US PELVIS | $182.25 | $729.00 | $246.40–$619.65 | — | 75% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC ECHO,PELVIC (NONOBSTETRIC) - US PELVIS | $182.25 | $729.00 | $246.40–$619.65 | — | 75% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST | $149.50 | $598.00 | $105.02–$1,495.00 | 75% below | 75% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC PBB OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST | $149.50 | $598.00 | $105.02–$1,495.00 | 75% below | 75% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST | $149.50 | $598.00 | $202.12–$508.30 | — | 75% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC PBB OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST | $149.50 | $598.00 | $202.12–$508.30 | — | 75% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC OB US < 14 WKS SINGLE FETUS - US OB < 14 WEEKS SINGLE OR FIRST GEST | $138.75 | $555.00 | $105.02–$1,387.50 | 76% below | 75% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC PBB OB US < 14 WKS SINGLE FETUS - US OB < 14 WEEKS SINGLE OR FIRST GEST | $138.75 | $555.00 | $105.02–$1,387.50 | 76% below | 75% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC PBB OB US < 14 WKS SINGLE FETUS - US OB < 14 WEEKS SINGLE OR FIRST GEST | $138.75 | $555.00 | $187.59–$471.75 | — | 75% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC OB US < 14 WKS SINGLE FETUS - US OB < 14 WEEKS SINGLE OR FIRST GEST | $138.75 | $555.00 | $187.59–$471.75 | — | 75% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC OB US LIMITED FETUS(S) - US OB LIMITED 1+ FETUSES | $113.25 | $453.00 | $81.86–$1,132.50 | 75% below | 75% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC PBB OB US LIMITED FETUS(S) - US OB LIMITED 1+ FETUSES | $113.25 | $453.00 | $81.86–$1,132.50 | 75% below | 75% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC PBB OB US LIMITED FETUS(S) - US OB LIMITED 1+ FETUSES | $113.25 | $453.00 | $153.11–$385.05 | — | 75% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC OB US LIMITED FETUS(S) - US OB LIMITED 1+ FETUSES | $113.25 | $453.00 | $153.11–$385.05 | — | 75% |
| Rib X-ray, one side, 2 views one side CPT 71100 HC X-RAY RIBS 2 VW UNILAT - XR RIBS 2 VIEWS RIGHT | $116.50 | $466.00 | $37.09–$1,165.00 | 61% below | 75% |
| Rib X-ray, one side, 2 views one side CPT 71100 HC X-RAY RIBS 2 VW UNILAT - XR RIBS 2 VIEWS LEFT | $116.50 | $466.00 | $37.09–$1,165.00 | 61% below | 75% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC X-RAY RIBS 2 VW UNILAT - XR RIBS 2 VIEWS LEFT | $116.50 | $466.00 | $157.51–$396.10 | — | 75% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC X-RAY RIBS 2 VW UNILAT - XR RIBS 2 VIEWS RIGHT | $116.50 | $466.00 | $157.51–$396.10 | — | 75% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC X-RAY RIBS 2 VWS RT W/CHEST POSTEROANTERIOR MIN 3 VWS | $127.50 | $510.00 | $42.44–$1,275.00 | 68% below | 75% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC X-RAY RIBS 2 VWS LT W/CHEST POSTEROANTERIOR MIN 3 VWS | $127.50 | $510.00 | $42.44–$1,275.00 | 68% below | 75% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC X-RAY RIBS 2 VWS RT W/CHEST POSTEROANTERIOR MIN 3 VWS | $127.50 | $510.00 | $172.38–$433.50 | — | 75% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC X-RAY RIBS 2 VWS LT W/CHEST POSTEROANTERIOR MIN 3 VWS | $127.50 | $510.00 | $172.38–$433.50 | — | 75% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING BILATERAL | $100.50 | $402.00 | $121.00–$1,005.00 | — | 75% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING LEFT | $100.50 | $402.00 | $121.00–$1,005.00 | — | 75% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING RIGHT | $100.50 | $402.00 | $121.00–$1,005.00 | — | 75% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING RIGHT | $100.50 | $402.00 | $135.88–$341.70 | — | 75% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING BILATERAL | $100.50 | $402.00 | $135.88–$341.70 | — | 75% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING LEFT | $100.50 | $402.00 | $135.88–$341.70 | — | 75% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS BILATERAL | $288.00 | $1,152.00 | $34.75–$2,880.00 | — | 75% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS RIGHT | $208.75 | $835.00 | $34.75–$2,087.50 | 35% below | 75% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS LEFT | $208.75 | $835.00 | $34.75–$2,087.50 | 35% below | 75% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS BILATERAL | $288.00 | $1,152.00 | $389.38–$979.20 | — | 75% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS LEFT | $208.75 | $835.00 | $282.23–$709.75 | — | 75% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS RIGHT | $208.75 | $835.00 | $282.23–$709.75 | — | 75% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC X-RAY SINUSES 3+ VW - XR PARANASAL SINUSES 3+ VIEWS | $274.25 | $1,097.00 | $37.76–$2,742.50 | 32% below | 75% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC X-RAY SINUSES 3+ VW - XR PARANASAL SINUSES 3+ VIEWS | $274.25 | $1,097.00 | $370.79–$932.45 | — | 75% |
| Skull X-ray, fewer than 4 views CPT 70250 HC X-RAY SKULL <4 VW - XR SKULL 1-3 VIEWS | $157.25 | $629.00 | $36.09–$1,572.50 | 51% below | 75% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 HC X-RAY SKULL <4 VW - XR SKULL 1-3 VIEWS | $157.25 | $629.00 | $212.60–$534.65 | — | 75% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY 6/> YRS REDUCED SERVICE < 6HRS | $606.50 | $2,426.00 | $819.99–$6,065.00 | 85% below | 75% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY 6/> YRS 4/> ADD PARAM OVERNIGHT | $606.50 | $2,426.00 | $819.99–$6,065.00 | 85% below | 75% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY 6/> YRS REDUCED SERVICE < 6HRS | $606.50 | $2,426.00 | $819.99–$2,062.10 | — | 75% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY 6/> YRS 4/> ADD PARAM OVERNIGHT | $606.50 | $2,426.00 | $819.99–$2,062.10 | — | 75% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC ECHOCARDIOGRAM EXERCISE STRESS TEST COMPLETE | $268.25 | $1,073.00 | $362.67–$2,682.50 | 90% below | 75% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC ECHOCARDIOGRAM PHARM STRESS TEST COMPLETE | $669.00 | $2,676.00 | $548.90–$6,690.00 | 75% below | 75% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC ECHOCARDIOGRAM EXERCISE STRESS TEST COMPLETE | $268.25 | $1,073.00 | $362.67–$912.05 | — | 75% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC ECHOCARDIOGRAM PHARM STRESS TEST COMPLETE | $669.00 | $2,676.00 | $904.49–$2,274.60 | — | 75% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC CINE/VID X-RAY THROAT/ESOPH - FL ESOPH BARIUM SWLW W/ VIDEO & SPEECH | $276.50 | $1,106.00 | $127.64–$2,765.00 | 54% below | 75% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC CINE/VID X-RAY THROAT/ESOPH - FL ESOPH BARIUM SWLW W/ VIDEO & SPEECH | $276.50 | $1,106.00 | $373.83–$940.10 | — | 75% |
| Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 HC RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS - XR FEMUR 2+ VW BILAT | $213.25 | $853.00 | $35.75–$2,132.50 | — | 75% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS - XR FEMUR 2+ VW RT | $176.75 | $707.00 | $35.75–$1,767.50 | 46% below | 75% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS - XR FEMUR 2+ VW LT | $176.75 | $707.00 | $35.75–$1,767.50 | 46% below | 75% |
| Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 HC RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS - XR FEMUR 2+ VW BILAT | $213.25 | $853.00 | $288.31–$725.05 | — | 75% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS - XR FEMUR 2+ VW LT | $176.75 | $707.00 | $238.97–$600.95 | — | 75% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS - XR FEMUR 2+ VW RT | $176.75 | $707.00 | $238.97–$600.95 | — | 75% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT SCAN,THORACIC SPINE,W/O CONTRAST - CT THORACIC SPINE WO CONTRAST | $881.25 | $3,525.00 | $105.02–$8,812.50 | 53% below | 75% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT SCAN,THORACIC SPINE,W/O CONTRAST - CT THORACIC SPINE WO CONTRAST | $881.25 | $3,525.00 | $1,191.45–$2,996.25 | — | 75% |
| Toe X-ray, 2 or more views both sides CPT 73660 HC X-RAY TOE(S) - XR TOES 2+ VIEWS BILATERAL | $127.00 | $508.00 | $29.40–$1,270.00 | — | 75% |
| Toe X-ray, 2 or more views one side CPT 73660 HC X-RAY TOE(S) - XR TOES 2+ VIEWS RIGHT | $84.25 | $337.00 | $29.40–$842.50 | 69% below | 75% |
| Toe X-ray, 2 or more views one side CPT 73660 HC X-RAY TOE(S) - XR TOES 2+ VIEWS LEFT | $84.25 | $337.00 | $29.40–$842.50 | 69% below | 75% |
| Toe X-ray, 2 or more views inpatient both sides CPT 73660 HC X-RAY TOE(S) - XR TOES 2+ VIEWS BILATERAL | $127.00 | $508.00 | $171.70–$431.80 | — | 75% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 HC X-RAY TOE(S) - XR TOES 2+ VIEWS LEFT | $84.25 | $337.00 | $113.91–$286.45 | — | 75% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 HC X-RAY TOE(S) - XR TOES 2+ VIEWS RIGHT | $84.25 | $337.00 | $113.91–$286.45 | — | 75% |
| Transvaginal pelvic ultrasound CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL - US PELVIS TRANSVAGINAL | $158.75 | $635.00 | $105.02–$1,587.50 | 74% below | 75% |
| Transvaginal pelvic ultrasound CPT 76830 HC PBB ECHOGRAPHY,TRANSVAGINAL - US PELVIS TRANSVAGINAL | $158.75 | $635.00 | $105.02–$1,587.50 | 74% below | 75% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL - US PELVIS TRANSVAGINAL | $158.75 | $635.00 | $214.63–$539.75 | — | 75% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC PBB ECHOGRAPHY,TRANSVAGINAL - US PELVIS TRANSVAGINAL | $158.75 | $635.00 | $214.63–$539.75 | — | 75% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC PBB TRANSVAGINAL US OBSTETRIC - US OB TRANSVAGINAL | $125.50 | $502.00 | $93.23–$1,255.00 | 75% below | 75% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC TRANSVAGINAL US OBSTETRIC - US OB TRANSVAGINAL | $125.50 | $502.00 | $93.23–$1,255.00 | 75% below | 75% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC PBB TRANSVAGINAL US OBSTETRIC - US OB TRANSVAGINAL | $125.50 | $502.00 | $169.68–$426.70 | — | 75% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC TRANSVAGINAL US OBSTETRIC - US OB TRANSVAGINAL | $125.50 | $502.00 | $169.68–$426.70 | — | 75% |
| Ultrasound of the abdomen, complete CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN COMPLETE | $308.00 | $1,232.00 | $105.02–$3,080.00 | 61% below | 75% |
| Ultrasound of the abdomen, complete CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN | $308.00 | $1,232.00 | $105.02–$3,080.00 | 61% below | 75% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN | $308.00 | $1,232.00 | $416.42–$1,047.20 | — | 75% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN COMPLETE | $308.00 | $1,232.00 | $416.42–$1,047.20 | — | 75% |
| Ultrasound of the scrotum and testicles CPT 76870 HC CHG ECHO,SCROTUM & CONTENTS | $375.25 | $1,501.00 | $101.58–$3,752.50 | 39% below | 75% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC CHG ECHO,SCROTUM & CONTENTS | $375.25 | $1,501.00 | $507.34–$1,275.85 | — | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC CHG US, HEAD/NECK TISSUES,REAL TIME | $188.25 | $753.00 | $105.02–$1,882.50 | 70% below | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US NECK | $188.25 | $753.00 | $105.02–$1,882.50 | 70% below | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US NECK PARATHYROID | $188.25 | $753.00 | $105.02–$1,882.50 | 70% below | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US NECK PAROTID | $188.25 | $753.00 | $105.02–$1,882.50 | 70% below | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC PBB US, HEAD/NECK TISSUES,REAL TIME - US HEAD NECK SOFT TISSUE | $188.25 | $753.00 | $105.02–$1,882.50 | 70% below | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US HEAD NECK SOFT TISSUE | $188.25 | $753.00 | $105.02–$1,882.50 | 70% below | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC PBB US, HEAD/NECK TISSUES,REAL TIME - US HEAD NECK SOFT TISSUE | $188.25 | $753.00 | $254.51–$640.05 | — | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US NECK PARATHYROID | $188.25 | $753.00 | $254.51–$640.05 | — | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US NECK | $188.25 | $753.00 | $254.51–$640.05 | — | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC CHG US, HEAD/NECK TISSUES,REAL TIME | $188.25 | $753.00 | $254.51–$640.05 | — | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US HEAD NECK SOFT TISSUE | $188.25 | $753.00 | $254.51–$640.05 | — | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US NECK PAROTID | $188.25 | $753.00 | $254.51–$640.05 | — | 75% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC X-RAY UPPER GI DELAY W/O KUB - FL UPPER GI WITHOUT KUB | $364.25 | $1,457.00 | $124.96–$3,642.50 | 49% below | 75% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC X-RAY UPPER GI DELAY W/O KUB - FL UPPER GI WITHOUT KUB | $364.25 | $1,457.00 | $492.47–$1,238.45 | — | 75% |
| Upper arm X-ray (humerus), 2 views both sides CPT 73060 HC X-RAY HUMERUS - XR HUMERUS BILATERAL | $178.00 | $712.00 | $32.41–$1,780.00 | — | 75% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HC X-RAY HUMERUS - XR HUMERUS LEFT | $161.75 | $647.00 | $32.41–$1,617.50 | 54% below | 75% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HC X-RAY HUMERUS - XR HUMERUS RIGHT | $161.75 | $647.00 | $32.41–$1,617.50 | 54% below | 75% |
| Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 HC X-RAY HUMERUS - XR HUMERUS BILATERAL | $178.00 | $712.00 | $240.66–$605.20 | — | 75% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC X-RAY HUMERUS - XR HUMERUS LEFT | $161.75 | $647.00 | $218.69–$549.95 | — | 75% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC X-RAY HUMERUS - XR HUMERUS RIGHT | $161.75 | $647.00 | $218.69–$549.95 | — | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - LOWER EXTREM SUPERFICIAL VEIN MAP | $386.25 | $1,545.00 | $105.02–$3,862.50 | 51% below | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - ABLATION SUPERFICIAL VEIN MAP | $386.25 | $1,545.00 | $105.02–$3,862.50 | 51% below | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC VASC DUPLEX EXTREM VENOUS,UNI OR LTD | $386.25 | $1,545.00 | $105.02–$3,862.50 | 51% below | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - UPPER EXTREM SUPERFICIAL VEIN MAP | $386.25 | $1,545.00 | $105.02–$3,862.50 | 51% below | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - US DOPPLER VENOUS ARM RIGHT | $386.25 | $1,545.00 | $105.02–$3,862.50 | 51% below | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - CV US DOPPLER VENOUS LEG RIGHT | $386.25 | $1,545.00 | $105.02–$3,862.50 | 51% below | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - CV US DOPPLER VENOUS LEG LEFT | $386.25 | $1,545.00 | $105.02–$3,862.50 | 51% below | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - US DOPPLER VENOUS ARM LEFT | $386.25 | $1,545.00 | $105.02–$3,862.50 | 51% below | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - ABLATION SUPERFICIAL VEIN MAP | $386.25 | $1,545.00 | $522.21–$1,313.25 | — | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC VASC DUPLEX EXTREM VENOUS,UNI OR LTD | $386.25 | $1,545.00 | $522.21–$1,313.25 | — | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - UPPER EXTREM SUPERFICIAL VEIN MAP | $386.25 | $1,545.00 | $522.21–$1,313.25 | — | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - LOWER EXTREM SUPERFICIAL VEIN MAP | $386.25 | $1,545.00 | $522.21–$1,313.25 | — | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - CV US DOPPLER VENOUS LEG RIGHT | $386.25 | $1,545.00 | $522.21–$1,313.25 | — | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - CV US DOPPLER VENOUS LEG LEFT | $386.25 | $1,545.00 | $522.21–$1,313.25 | — | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - US DOPPLER VENOUS ARM RIGHT | $386.25 | $1,545.00 | $522.21–$1,313.25 | — | 75% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - US DOPPLER VENOUS ARM LEFT | $386.25 | $1,545.00 | $522.21–$1,313.25 | — | 75% |
| Wrist X-ray, 2 views both sides CPT 73100 HC X-RAY WRIST 2 VW - XR WRIST 1-2 VIEWS BILATERAL | $218.75 | $875.00 | $34.09–$2,187.50 | — | 75% |
| Wrist X-ray, 2 views one side CPT 73100 HC X-RAY WRIST 2 VW - XR WRIST 1-2 VIEWS LEFT | $156.00 | $624.00 | $34.09–$1,560.00 | 47% below | 75% |
| Wrist X-ray, 2 views one side CPT 73100 HC X-RAY WRIST 2 VW - XR WRIST 1-2 VIEWS RIGHT | $156.00 | $624.00 | $34.09–$1,560.00 | 47% below | 75% |
| Wrist X-ray, 2 views inpatient both sides CPT 73100 HC X-RAY WRIST 2 VW - XR WRIST 1-2 VIEWS BILATERAL | $218.75 | $875.00 | $295.75–$743.75 | — | 75% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 HC X-RAY WRIST 2 VW - XR WRIST 1-2 VIEWS LEFT | $156.00 | $624.00 | $210.91–$530.40 | — | 75% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 HC X-RAY WRIST 2 VW - XR WRIST 1-2 VIEWS RIGHT | $156.00 | $624.00 | $210.91–$530.40 | — | 75% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS BILATERAL | $260.25 | $1,041.00 | $41.10–$2,602.50 | — | 75% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS LEFT | $178.00 | $712.00 | $41.10–$1,780.00 | 52% below | 75% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS RIGHT | $178.00 | $712.00 | $41.10–$1,780.00 | 52% below | 75% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS BILATERAL | $260.25 | $1,041.00 | $351.86–$884.85 | — | 75% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS RIGHT | $178.00 | $712.00 | $240.66–$605.20 | — | 75% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS LEFT | $178.00 | $712.00 | $240.66–$605.20 | — | 75% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW RIGHT | $126.75 | $507.00 | $47.11–$1,267.50 | 66% below | 75% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW LEFT | $126.75 | $507.00 | $47.11–$1,267.50 | 66% below | 75% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW LEFT | $126.75 | $507.00 | $171.37–$430.95 | — | 75% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW RIGHT | $126.75 | $507.00 | $171.37–$430.95 | — | 75% |
| X-ray of the abdomen, 1 view CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR ABDOMEN 1 VIEW | $207.00 | $828.00 | $30.08–$2,070.00 | 39% below | 75% |
| X-ray of the abdomen, 1 view CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR COLON MOTILITY | $207.00 | $828.00 | $30.08–$2,070.00 | 39% below | 75% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR COLON MOTILITY | $207.00 | $828.00 | $279.86–$703.80 | — | 75% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR ABDOMEN 1 VIEW | $207.00 | $828.00 | $279.86–$703.80 | — | 75% |
| X-ray of the ankle, 2 views both sides CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS BILATERAL | $166.50 | $666.00 | $32.75–$1,665.00 | — | 75% |
| X-ray of the ankle, 2 views one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS LEFT | $120.00 | $480.00 | $32.75–$1,200.00 | 60% below | 75% |
| X-ray of the ankle, 2 views one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS RIGHT | $120.00 | $480.00 | $32.75–$1,200.00 | 60% below | 75% |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS BILATERAL | $166.50 | $666.00 | $225.11–$566.10 | — | 75% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS LEFT | $120.00 | $480.00 | $162.24–$408.00 | — | 75% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS RIGHT | $120.00 | $480.00 | $162.24–$408.00 | — | 75% |
| X-ray of the finger(s), 2 or more views both sides CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS BILATERAL | $200.00 | $800.00 | $38.09–$2,000.00 | — | 75% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS RIGHT | $149.00 | $596.00 | $38.09–$1,490.00 | 38% below | 75% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS LEFT | $149.00 | $596.00 | $38.09–$1,490.00 | 38% below | 75% |
| X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS BILATERAL | $200.00 | $800.00 | $270.40–$680.00 | — | 75% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS RIGHT | $149.00 | $596.00 | $201.45–$506.60 | — | 75% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS LEFT | $149.00 | $596.00 | $201.45–$506.60 | — | 75% |
| X-ray of the foot, 2 views both sides CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS BILATERAL | $113.25 | $453.00 | $28.40–$1,132.50 | — | 75% |
| X-ray of the foot, 2 views one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS LEFT | $80.75 | $323.00 | $28.40–$807.50 | 76% below | 75% |
| X-ray of the foot, 2 views one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS RIGHT | $80.75 | $323.00 | $28.40–$807.50 | 76% below | 75% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS BILATERAL | $113.25 | $453.00 | $153.11–$385.05 | — | 75% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS RIGHT | $80.75 | $323.00 | $109.17–$274.55 | — | 75% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS LEFT | $80.75 | $323.00 | $109.17–$274.55 | — | 75% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS BILATERAL | $115.25 | $461.00 | $34.41–$1,152.50 | — | 75% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS LEFT | $80.75 | $323.00 | $34.41–$807.50 | 78% below | 75% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS RIGHT | $80.75 | $323.00 | $34.41–$807.50 | 78% below | 75% |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS BILATERAL | $115.25 | $461.00 | $155.82–$391.85 | — | 75% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS LEFT | $80.75 | $323.00 | $109.17–$274.55 | — | 75% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS RIGHT | $80.75 | $323.00 | $109.17–$274.55 | — | 75% |
| X-ray of the hand, 3 or more views both sides CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS BILATERAL | $98.00 | $392.00 | $37.09–$980.00 | — | 75% |
| X-ray of the hand, 3 or more views one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS LEFT | $80.75 | $323.00 | $37.09–$807.50 | 79% below | 75% |
| X-ray of the hand, 3 or more views one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS RIGHT | $80.75 | $323.00 | $37.09–$807.50 | 79% below | 75% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS BILATERAL | $98.00 | $392.00 | $132.50–$333.20 | — | 75% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS RIGHT | $80.75 | $323.00 | $109.17–$274.55 | — | 75% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS LEFT | $80.75 | $323.00 | $109.17–$274.55 | — | 75% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS BILAT | $282.50 | $1,130.00 | $34.41–$2,825.00 | — | 75% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS LEFT | $217.00 | $868.00 | $34.41–$2,170.00 | 26% below | 75% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS RIGHT | $217.00 | $868.00 | $34.41–$2,170.00 | 26% below | 75% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS BILAT | $282.50 | $1,130.00 | $381.94–$960.50 | — | 75% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS LEFT | $217.00 | $868.00 | $293.38–$737.80 | — | 75% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS RIGHT | $217.00 | $868.00 | $293.38–$737.80 | — | 75% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC X-RAY LUMBAR SPINE 2/3 VW - XR LUMBAR SPINE 2-3 VIEWS | $122.75 | $491.00 | $40.10–$1,227.50 | 72% below | 75% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC X-RAY LUMBAR SPINE 2/3 VW - XR LUMBAR SPINE 2-3 VIEWS | $122.75 | $491.00 | $165.96–$417.35 | — | 75% |
| X-ray of the lower back, 4 or more views CPT 72110 HC X-RAY LUMBAR SPINE 4 VW - XR LUMBAR SPINE COMPLETE 4+ VIEWS | $165.50 | $662.00 | $51.45–$1,655.00 | 71% below | 75% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC X-RAY LUMBAR SPINE 4 VW - XR LUMBAR SPINE COMPLETE 4+ VIEWS | $165.50 | $662.00 | $223.76–$562.70 | — | 75% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC X-RAY THORACIC SPINE 2 VW - XR THORACIC SPINE 2 VIEWS | $140.25 | $561.00 | $33.08–$1,402.50 | 65% below | 75% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC X-RAY THORACIC SPINE 2 VW - XR THORACIC SPINE 2 VIEWS | $140.25 | $561.00 | $189.62–$476.85 | — | 75% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC X-RAY NASAL BONES - XR NASAL BONES | $80.75 | $323.00 | $38.43–$807.50 | 71% below | 75% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC X-RAY NASAL BONES - XR NASAL BONES | $80.75 | $323.00 | $109.17–$274.55 | — | 75% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 2-3 VIEWS | $250.25 | $1,001.00 | $39.76–$2,502.50 | 31% below | 75% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 2-3 VIEWS | $250.25 | $1,001.00 | $338.34–$850.85 | — | 75% |
| X-ray of the pelvis, 1 or 2 views both sides CPT 72170 HC X-RAY PELVIS 1/2 VW - XR PELVIS BILATERAL 1-2 VIEWS | $222.00 | $888.00 | $28.06–$2,220.00 | — | 75% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC X-RAY PELVIS 1/2 VW - XR PELVIS 1-2 VIEWS | $192.25 | $769.00 | $28.06–$1,922.50 | 39% below | 75% |
| X-ray of the pelvis, 1 or 2 views inpatient both sides CPT 72170 HC X-RAY PELVIS 1/2 VW - XR PELVIS BILATERAL 1-2 VIEWS | $222.00 | $888.00 | $300.14–$754.80 | — | 75% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC X-RAY PELVIS 1/2 VW - XR PELVIS 1-2 VIEWS | $192.25 | $769.00 | $259.92–$653.65 | — | 75% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC X-RAY SACRUM/COCCYX 2+ VW - XR SACRUM COCCYX 2+ VIEWS | $80.75 | $323.00 | $32.75–$807.50 | 74% below | 75% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC X-RAY SACRUM/COCCYX 2+ VW - XR SACRUM COCCYX 2+ VIEWS | $80.75 | $323.00 | $109.17–$274.55 | — | 75% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 HC ASSAY OF ACTH - ACTH | $58.25 | $233.00 | $32.44–$582.50 | 73% below | 75% |
| ACTH blood test inpatient CPT 82024 HC ASSAY OF ACTH - ACTH | $58.25 | $233.00 | $78.75–$198.05 | — | 75% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE ALANINE AMINO (ALT) (SGPT) - ALT (SGPT) | $19.00 | $76.00 | $4.45–$190.00 | 62% below | 75% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE ALANINE AMINO (ALT) (SGPT) - ALT (SGPT) | $19.00 | $76.00 | $25.69–$64.60 | — | 75% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO (AST) (SGOT) - AST (SGOT) | $19.00 | $76.00 | $4.35–$190.00 | 63% below | 75% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO (AST) (SGOT) - AST (SGOT) | $19.00 | $76.00 | $25.69–$64.60 | — | 75% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS PANEL,ACUTE | $82.00 | $328.00 | $33.00–$820.00 | 79% below | 75% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS PANEL,ACUTE | $82.00 | $328.00 | $110.86–$278.80 | — | 75% |
| Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN - ALBUMIN | $13.00 | $52.00 | $4.16–$130.00 | 65% below | 75% |
| Albumin blood test inpatient CPT 82040 HC ASSAY OF SERUM ALBUMIN - ALBUMIN | $13.00 | $52.00 | $17.58–$44.20 | — | 75% |
| Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE - ALDOSTERONE,24HR URINE | $56.00 | $224.00 | $33.00–$560.00 | 58% below | 75% |
| Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE - ALDOSTERONE | $58.50 | $234.00 | $33.00–$585.00 | 56% below | 75% |
| Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE - ALDOSTERONE,24HR URINE | $56.00 | $224.00 | $75.71–$190.40 | — | 75% |
| Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE - ALDOSTERONE | $58.50 | $234.00 | $79.09–$198.90 | — | 75% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC ASSAY ALKAL PHOSPHATASE - ALKALINE PHOSPHATASE | $19.50 | $78.00 | $4.35–$195.00 | 59% below | 75% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ASSAY ALKAL PHOSPHATASE - ALKALINE PHOSPHATASE | $19.50 | $78.00 | $26.36–$66.30 | — | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SUMMER SQUASH IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SUGAR, CANE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN STEMPHYLIUM BOTRYOSUM IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN STACHYBOTRYS CHARTARUM IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN: MOSQUITO IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: STRAWBERRY IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RASPBERRY IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEACH IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: GIANT RAGWEED IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN POTATO IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PERCH IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PENICILLIUM IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: PECAN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PARSLEY IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OAK,RED IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OAK DUST IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MILK IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WHITEFISH IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAGWEED, WESTERN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN JOHNSON GRASS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORMODENDRUM HORDEI | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HELMINTHOSPORIUM SAT | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG WHITE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GARLIC IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FLOUNDER IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FIRE ANT (INVICTA) IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DOG DANDER | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN D PTERONYSSINUS | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN D FARINAE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHOCOLATE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CEDAR, MOUNTAIN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CAT HAIR/DANDER,STAN | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BLACK WALNUT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BLACK BASS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEAN, PINTO IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BAHIA GRASS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EUCALYPTUS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EPICOCCUM PURPURASCEN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: ENGLISH PLANTAIN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: ELM IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGGPLANT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG, WHOLE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG YOLK IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DILL IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - AUREOBASIDIUM PULLULANS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPEN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN AMPICILLIN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALDER, SMOOTH IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PEA (PISUM SATIVUM) IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: SWORDFISH | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: DANDELION IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CURVULARIA LUNATA IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CUCUMBER IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CRAYFISH (FRESHWATER) IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CRANBERRY IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CRAB IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COW EPITHELIA/DANDER IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: MULBERRY (MORUS ALBA) IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: BASIL (OCIMUM BASILCUM) IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: SQUID (LOLIGO SPP.) IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: SWEET CHESTNUT | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CLAMS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: COCHINEAL EXTRACT | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCKLEBUR IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCKROACH, AMERICAN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCONUT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CODFISH IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN ANIMAL FEATHER MIX IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN ANIMAL HORSE HAIR DANDER IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FUNGI MOLD A FUMIGATUS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FUNGI MOLD P NOTATUM IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FOOD CHESTNUT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN TREE POPLAR WHITE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FOOD BEET ROOT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN APRICOT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASH, WHITE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPARAGUS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MITE: BLOMIA TROPICALIS | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPERGILLUS FUMAGATUS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPERGILLUS NIGER IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN AVOCADO IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BANANA IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BARLEY IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BAYLEAF (LAUREL) IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEAN, GREEN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEAN, LIMA IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN INSECT: COCKROACH, GERMAN | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN VENOM: EUROPEAN PAPER WASP | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: FLAXSEED/LINSEED | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FOOD QUINOA IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEEF IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BERMUDA GRASS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BIRCH IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BLACKBERRY IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BLUEGRASS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BLUEBERRY IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BOTRYTIS CINEREA IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BRAZIL NUT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BROCCOLI IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BROME, SMOOTH IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BUMBLEBEE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CABBAGE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CANDIDA ALBICANS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CANTALOUPE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: CILANTRO (CORIANDER) | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: MINT | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CARROT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CASEIN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CASHEW IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CAT EPITHELLIUM IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CAULIFLOWER IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CEDAR, RED IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CELERY IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CEPHALOSPORIUM ACRE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: CATFISH | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: OCTOPUS | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: TILAPIA | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHEESE, CHEDDAR IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: DATE (PHOENIX DACTYLIFERA) IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHICKEN, SERUM PROTEINS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CINNAMON IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CLADOSPORIUM HERBARUM IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: CHICKPEA | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PEAR | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OCCUPATIONAL: COTTON SEED IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: GRAPEFRUIT | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PINE NUT, PIGNOLES | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PISTACHIO | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: COTTONWOOD IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CORN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COFFEE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAGWEED, FALSE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MILK, GOAT'S IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORNET, WHITE FACE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN APPLE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ANCHOVY IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RYE, PERENNIAL IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TRICHOPHYTON MENTAGROPHYTE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HACKBERRY IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LEPIDOGLYPHUS DESTRUCTOR IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OAK, LIVE/VIRGINIA IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SAGE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TROUT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HADDOCK IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LETTUCE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OAT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SALMON IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TUNA IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HALIBUT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LIME IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PIGWEED, ROUGH IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TURKEY IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HAZELNUT/FILBERT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: LOBSTER IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: OLIVE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SARDINE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN VANILLA IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HERRING IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MACADAMIA NUT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FOOD BLACK OLIVE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PINEAPPLE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SCALLOP IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MACKEREL IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PLUM IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SESAME SEED IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: WALNUT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MALT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ONION IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN POPPY SEED IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PENICILLIN G IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HOUSE DUST: HOLLISTER IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MANGO IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ORANGE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PORK IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHEEP SORREL (DOCK) IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OCCUPATIONAL: LATEX | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUCOR IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HONEY IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MAPLE, BOX ELDER IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OREGANO IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN POTATO, SWEET IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHRIMP IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WATERMELON IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: ALTERNARIA ALTERNATA | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN KIWI FRUIT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HONEYBEE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MARSHELDER, ROUGH IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PRIVET, COMMON IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WHEAT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OYSTER IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SNAPPER, RED IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: FUSARIUM PROLIFERATUM | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MESQUITE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SOLE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WHEY IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SOYBEAN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: MUCOR RACEMOSUS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ANIMAL: MOUSE EPITHELIUM | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORNET, YELLOW FACE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MIMOSA/ACACIA IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PAPAYA FOOD IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAGWEED, SHORT/COMMON IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SPINACH IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PUMPKIN | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHERRY, BING IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FOOD ANNATTO SEED IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FOOD GELATIN BOVINE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FOOD GELATIN PORCINE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN GRASS ORCHARD COCKSFOOT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN GRASS MEADOW FESCUE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FUNGI MOLD ALTERNARIA ALTERNATA IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN JUNE GRASS KENTUCKY BLUEGRASS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FOOD COW MILK IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PHOMA BETAE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN NUTMEG IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LENTIL IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TOMATO IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RYE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, GREEN BELL IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN NETTLE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN THYME IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, CHILI IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUSTARD IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LEMON IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HOUSE DUST: GREER IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN THISTLE, RUSSIAN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RICE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, BLACK IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUSSEL IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LAMB'S QUARTER IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GRAPE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TEA IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RHIZOPUS NIGRICANS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUSHROOM IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LAMB IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: STEMPHYLIUM HERBARUM | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: GOLDENROD IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN YELLOW JACKET IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN REDTOP, BENTGRASS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PENICILLIN V IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN KOCHIA IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUGWORT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN INSECT PAPER WASP IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE-ALLERGEN FOOD, VENISON (DEER MEAT) | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: OAK | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALMONDS IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN VENOM | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WORMWOOD IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SUNFLOWER SEED IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PECAN NUT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MOUSE URINE IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GLUTEN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: WILLOW | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ZUCCHINI IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WILLOW, BLACK IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TIMOTHY IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DRUG: AMOXICILLOYL IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEANUT IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GINGER IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SYCAMORE, AMERICAN IGE | $9.25 | $37.00 | $4.38–$92.50 | 61% below | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PUMPKIN | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FOOD BEET ROOT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN TREE POPLAR WHITE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CRAYFISH (FRESHWATER) IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CRANBERRY IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CRAB IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COW EPITHELIA/DANDER IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: MULBERRY (MORUS ALBA) IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: BASIL (OCIMUM BASILCUM) IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: SQUID (LOLIGO SPP.) IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: SWEET CHESTNUT | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: CHICKPEA | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PEAR | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OCCUPATIONAL: COTTON SEED IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: GRAPEFRUIT | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PINE NUT, PIGNOLES | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PISTACHIO | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: COTTONWOOD IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CORN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COFFEE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN YELLOW JACKET IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN REDTOP, BENTGRASS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PENICILLIN V IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUGWORT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN KOCHIA IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN INSECT PAPER WASP IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE-ALLERGEN FOOD, VENISON (DEER MEAT) | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: OAK | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN VENOM | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WORMWOOD IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SUNFLOWER SEED IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PECAN NUT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MOUSE URINE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GLUTEN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: WILLOW | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ZUCCHINI IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WILLOW, BLACK IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TIMOTHY IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DRUG: AMOXICILLOYL IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEANUT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GINGER IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SYCAMORE, AMERICAN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SUMMER SQUASH IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SUGAR, CANE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN STEMPHYLIUM BOTRYOSUM IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN STACHYBOTRYS CHARTARUM IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN: MOSQUITO IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: STRAWBERRY IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RASPBERRY IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEACH IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: GIANT RAGWEED IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN POTATO IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PERCH IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PENICILLIUM IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: PECAN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PARSLEY IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OAK,RED IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OAK DUST IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MILK IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WHITEFISH IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAGWEED, WESTERN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN JOHNSON GRASS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORMODENDRUM HORDEI | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HELMINTHOSPORIUM SAT | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG WHITE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GARLIC IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FLOUNDER IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FIRE ANT (INVICTA) IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DOG DANDER | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN D PTERONYSSINUS | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN D FARINAE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHOCOLATE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CEDAR, MOUNTAIN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CAT HAIR/DANDER,STAN | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BLACK WALNUT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BLACK BASS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEAN, PINTO IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BAHIA GRASS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EUCALYPTUS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EPICOCCUM PURPURASCEN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: ENGLISH PLANTAIN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: ELM IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGGPLANT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG, WHOLE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG YOLK IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DILL IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - AUREOBASIDIUM PULLULANS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPEN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN AMPICILLIN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALDER, SMOOTH IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PEA (PISUM SATIVUM) IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: SWORDFISH | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: DANDELION IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CURVULARIA LUNATA IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CUCUMBER IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CODFISH IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCONUT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCKROACH, AMERICAN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCKLEBUR IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: COCHINEAL EXTRACT | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CLAMS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CLADOSPORIUM HERBARUM IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CINNAMON IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHICKEN, SERUM PROTEINS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: DATE (PHOENIX DACTYLIFERA) IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHEESE, CHEDDAR IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: TILAPIA | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: OCTOPUS | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: CATFISH | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CEPHALOSPORIUM ACRE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CELERY IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CEDAR, RED IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CAULIFLOWER IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CAT EPITHELLIUM IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CASHEW IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CASEIN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CARROT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: MINT | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: CILANTRO (CORIANDER) | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CANTALOUPE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CANDIDA ALBICANS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CABBAGE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BUMBLEBEE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BROME, SMOOTH IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BROCCOLI IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BRAZIL NUT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BOTRYTIS CINEREA IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BLUEBERRY IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BLUEGRASS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BLACKBERRY IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BIRCH IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BERMUDA GRASS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEEF IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FOOD QUINOA IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: FLAXSEED/LINSEED | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN VENOM: EUROPEAN PAPER WASP | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN INSECT: COCKROACH, GERMAN | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEAN, LIMA IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEAN, GREEN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BAYLEAF (LAUREL) IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BARLEY IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BANANA IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN AVOCADO IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPERGILLUS NIGER IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPERGILLUS FUMAGATUS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MITE: BLOMIA TROPICALIS | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPARAGUS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASH, WHITE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN APRICOT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN APPLE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ANCHOVY IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALMONDS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FOOD CHESTNUT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FUNGI MOLD P NOTATUM IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FUNGI MOLD A FUMIGATUS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN ANIMAL HORSE HAIR DANDER IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN ANIMAL FEATHER MIX IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FOOD COW MILK IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN JUNE GRASS KENTUCKY BLUEGRASS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FUNGI MOLD ALTERNARIA ALTERNATA IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN GRASS MEADOW FESCUE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN GRASS ORCHARD COCKSFOOT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FOOD GELATIN PORCINE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FOOD GELATIN BOVINE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FOOD ANNATTO SEED IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHERRY, BING IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SPINACH IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAGWEED, SHORT/COMMON IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PAPAYA FOOD IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MIMOSA/ACACIA IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORNET, YELLOW FACE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ANIMAL: MOUSE EPITHELIUM | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: MUCOR RACEMOSUS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SOYBEAN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAGWEED, FALSE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MILK, GOAT'S IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORNET, WHITE FACE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WHEY IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SOLE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MESQUITE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: FUSARIUM PROLIFERATUM | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SNAPPER, RED IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OYSTER IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WHEAT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PRIVET, COMMON IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MARSHELDER, ROUGH IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HONEYBEE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN KIWI FRUIT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: ALTERNARIA ALTERNATA | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WATERMELON IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHRIMP IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN POTATO, SWEET IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OREGANO IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MAPLE, BOX ELDER IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HONEY IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUCOR IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OCCUPATIONAL: LATEX | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHEEP SORREL (DOCK) IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PORK IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ORANGE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MANGO IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HOUSE DUST: HOLLISTER IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PENICILLIN G IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN POPPY SEED IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ONION IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MALT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: WALNUT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SESAME SEED IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PLUM IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MACKEREL IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SCALLOP IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PINEAPPLE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FOOD BLACK OLIVE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MACADAMIA NUT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HERRING IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN VANILLA IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SARDINE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: OLIVE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: LOBSTER IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HAZELNUT/FILBERT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TURKEY IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PIGWEED, ROUGH IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LIME IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HALIBUT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TUNA IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SALMON IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OAT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LETTUCE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HADDOCK IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TROUT IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SAGE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OAK, LIVE/VIRGINIA IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LEPIDOGLYPHUS DESTRUCTOR IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HACKBERRY IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TRICHOPHYTON MENTAGROPHYTE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RYE, PERENNIAL IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PHOMA BETAE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN NUTMEG IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LENTIL IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TOMATO IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RYE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, GREEN BELL IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN NETTLE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN THYME IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, CHILI IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUSTARD IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LEMON IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HOUSE DUST: GREER IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN THISTLE, RUSSIAN IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RICE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, BLACK IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUSSEL IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LAMB'S QUARTER IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GRAPE IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TEA IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RHIZOPUS NIGRICANS IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUSHROOM IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LAMB IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: STEMPHYLIUM HERBARUM | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: GOLDENROD IGE | $9.25 | $37.00 | $12.51–$31.45 | — | 75% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN, SERUM - ALPHA-FETOPROTEIN MARKER | $38.50 | $154.00 | $14.09–$385.00 | 64% below | 75% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN, SERUM - ALPHA FETOPROTEIN, MATERNAL | $38.50 | $154.00 | $14.09–$385.00 | 64% below | 75% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN, SERUM - ALPHA FETOPROTEIN, MATERNAL | $38.50 | $154.00 | $52.05–$130.90 | — | 75% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN, SERUM - ALPHA-FETOPROTEIN MARKER | $38.50 | $154.00 | $52.05–$130.90 | — | 75% |
| Ammonia blood test CPT 82140 HC ASSAY OF AMMONIA - AMMONIA | $33.00 | $132.00 | $12.24–$330.00 | 77% below | 75% |
| Ammonia blood test inpatient CPT 82140 HC ASSAY OF AMMONIA - AMMONIA | $33.00 | $132.00 | $44.62–$112.20 | — | 75% |
| Amylase blood test CPT 82150 HC ASSAY OF AMYLASE - AMYLASE ISOENZYMES | $16.75 | $67.00 | $5.44–$167.50 | 78% below | 75% |
| Amylase blood test CPT 82150 HC ASSAY OF AMYLASE - AMYLASE BODY FLUID | $16.75 | $67.00 | $5.44–$167.50 | 78% below | 75% |
| Amylase blood test CPT 82150 HC ASSAY OF AMYLASE - AMYLASE,RANDOM | $16.75 | $67.00 | $5.44–$167.50 | 78% below | 75% |
| Amylase blood test CPT 82150 HC ASSAY OF AMYLASE - AMYLASE | $16.75 | $67.00 | $5.44–$167.50 | 78% below | 75% |
| Amylase blood test CPT 82150 HC ASSAY OF AMYLASE - AMYLASE,24 HOUR URINE | $43.25 | $173.00 | $5.44–$432.50 | 44% below | 75% |
| Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE - AMYLASE,RANDOM | $16.75 | $67.00 | $22.65–$56.95 | — | 75% |
| Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE - AMYLASE BODY FLUID | $16.75 | $67.00 | $22.65–$56.95 | — | 75% |
| Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE - AMYLASE ISOENZYMES | $16.75 | $67.00 | $22.65–$56.95 | — | 75% |
| Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE - AMYLASE | $16.75 | $67.00 | $22.65–$56.95 | — | 75% |
| Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE - AMYLASE,24 HOUR URINE | $43.25 | $173.00 | $58.47–$147.05 | — | 75% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CIRULLINATED PEPTIDE ANTIBODY - CYCLIC CITRUL PEPTIDE ANTIBDY | $21.50 | $86.00 | $10.88–$215.00 | 61% below | 75% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CIRULLINATED PEPTIDE ANTIBODY - CYCLIC CITRUL PEPTIDE ANTIBDY | $21.50 | $86.00 | $29.07–$73.10 | — | 75% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA (ANTINUCLEAR ANTIBODIES) | $29.50 | $118.00 | $10.16–$295.00 | 62% below | 75% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA (ANTINUCLEAR ANTIBODIES) | $29.50 | $118.00 | $39.88–$100.30 | — | 75% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE - B-TYPE NATRIURETIC PEPTIDE (BNP) | $42.75 | $171.00 | $32.98–$427.50 | 73% below | 75% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE - B-TYPE NATRIURETIC PEPTIDE (BNP) | $42.75 | $171.00 | $57.80–$145.35 | — | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE OTHER SPECIMEN AEROBIC - THROAT STREP SCN-MICRO | $84.25 | $337.00 | $7.24–$842.50 | 26% above | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE OTHER SPECIMEN AEROBIC | $84.25 | $337.00 | $7.24–$842.50 | 26% above | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE OTHER SPECIMEN AEROBIC | $84.25 | $337.00 | $113.91–$286.45 | — | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE OTHER SPECIMEN AEROBIC - THROAT STREP SCN-MICRO | $84.25 | $337.00 | $113.91–$286.45 | — | 75% |
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL | $41.50 | $166.00 | $7.11–$415.00 | 80% below | 75% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL | $41.50 | $166.00 | $56.11–$141.10 | — | 75% |
| Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL - BILIRUBIN BODY FLUID | $9.00 | $36.00 | $4.22–$90.00 | 84% below | 75% |
| Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL - BILIRUBIN TOTAL | $9.00 | $36.00 | $4.22–$90.00 | 84% below | 75% |
| Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL - BILIRUBIN NEONATAL | $9.00 | $36.00 | $4.22–$90.00 | 84% below | 75% |
| Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL - BILIRUBIN NEONATAL | $9.00 | $36.00 | $12.17–$30.60 | — | 75% |
| Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL - BILIRUBIN BODY FLUID | $9.00 | $36.00 | $12.17–$30.60 | — | 75% |
| Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL - BILIRUBIN TOTAL | $9.00 | $36.00 | $12.17–$30.60 | — | 75% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURG PATH,LEVEL IV - LAB SURG PATH,LEVEL IV | $212.75 | $851.00 | $33.00–$2,127.50 | 28% below | 75% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SURG PATH,LEVEL IV - LAB SURG PATH,LEVEL IV | $212.75 | $851.00 | $287.64–$723.35 | — | 75% |
| Blood culture for bacteria CPT 87040 HC CULTURES, BLOOD | $25.75 | $103.00 | $8.67–$257.50 | 87% below | 75% |
| Blood culture for bacteria inpatient CPT 87040 HC CULTURES, BLOOD | $25.75 | $103.00 | $34.81–$87.55 | — | 75% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC PBB COLLECTION VENOUS BLOOD,VENIPUNCTURE - DRAW CHARGE | $5.75 | $23.00 | $7.77–$57.50 | 68% below | 75% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC COLLECTION VENOUS BLOOD,VENIPUNCTURE - BUNDLED CHARGE | $5.75 | $23.00 | $7.77–$57.50 | 68% below | 75% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC COLLECTION VENOUS BLOOD,VENIPUNCTURE - DRAW CHARGE | $5.75 | $23.00 | $7.77–$57.50 | 68% below | 75% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC PBB COLLECTION VENOUS BLOOD,VENIPUNCTURE - DRAW CHARGE | $5.75 | $23.00 | $7.77–$19.55 | — | 75% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC COLLECTION VENOUS BLOOD,VENIPUNCTURE - BUNDLED CHARGE | $5.75 | $23.00 | $7.77–$19.55 | — | 75% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC COLLECTION VENOUS BLOOD,VENIPUNCTURE - DRAW CHARGE | $5.75 | $23.00 | $7.77–$19.55 | — | 75% |
| Blood glucose (sugar) test CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GTT FASTING | $11.00 | $44.00 | $3.30–$110.00 | 74% below | 75% |
| Blood glucose (sugar) test CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - POCT GLUCOMETER | $24.50 | $98.00 | $3.30–$245.00 | 41% below | 75% |
| Blood glucose (sugar) test CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GLUCOSE RANDOM | $26.50 | $106.00 | $3.30–$265.00 | 36% below | 75% |
| Blood glucose (sugar) test CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GLUCOSE FASTING | $26.50 | $106.00 | $3.30–$265.00 | 36% below | 75% |
| Blood glucose (sugar) test CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - 2 HR PP | $31.50 | $126.00 | $3.30–$315.00 | 24% below | 75% |
| Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GTT FASTING | $11.00 | $44.00 | $14.87–$37.40 | — | 75% |
| Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - POCT GLUCOMETER | $24.50 | $98.00 | $33.12–$83.30 | — | 75% |
| Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GLUCOSE RANDOM | $26.50 | $106.00 | $35.83–$90.10 | — | 75% |
| Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GLUCOSE FASTING | $26.50 | $106.00 | $35.83–$90.10 | — | 75% |
| Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - 2 HR PP | $31.50 | $126.00 | $42.59–$107.10 | — | 75% |
| Blood lead test CPT 83655 HC ASSAY OF LEAD - LEAD URINE | $23.25 | $93.00 | $10.17–$232.50 | 50% below | 75% |
| Blood lead test CPT 83655 HC ASSAY OF LEAD - LEAD BLOOD | $23.25 | $93.00 | $10.17–$232.50 | 50% below | 75% |
| Blood lead test CPT 83655 HC ASSAY OF LEAD - LEAD, CAPILLARY BLOOD | $23.25 | $93.00 | $10.17–$232.50 | 50% below | 75% |
| Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD - LEAD, CAPILLARY BLOOD | $23.25 | $93.00 | $31.43–$79.05 | — | 75% |
| Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD - LEAD URINE | $23.25 | $93.00 | $31.43–$79.05 | — | 75% |
| Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD - LEAD BLOOD | $23.25 | $93.00 | $31.43–$79.05 | — | 75% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC CHORIONIC GONADOTROPIN, QUAL - POC HCG QUALITATIVE CLINITEK | $14.00 | $56.00 | $6.32–$140.00 | 90% below | 75% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC CHORIONIC GONADOTROPIN, QUAL - HCG QUALITATIVE URINE | $14.00 | $56.00 | $6.32–$140.00 | 90% below | 75% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC CHORIONIC GONADOTROPIN, QUAL - HCG QUALITATIVE SERUM | $14.00 | $56.00 | $6.32–$140.00 | 90% below | 75% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC CHORIONIC GONADOTROPIN, QUAL - HCG QUALITATIVE URINE | $14.00 | $56.00 | $18.93–$47.60 | — | 75% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC CHORIONIC GONADOTROPIN, QUAL - POC HCG QUALITATIVE CLINITEK | $14.00 | $56.00 | $18.93–$47.60 | — | 75% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC CHORIONIC GONADOTROPIN, QUAL - HCG QUALITATIVE SERUM | $14.00 | $56.00 | $18.93–$47.60 | — | 75% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO - ABO/RH TYPE | $79.00 | $316.00 | $2.51–$790.00 | 11% below | 75% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO - BLOOD TYPE | $79.00 | $316.00 | $2.51–$790.00 | 11% below | 75% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO - BLOOD TYPE | $79.00 | $316.00 | $106.81–$268.60 | — | 75% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO - ABO/RH TYPE | $79.00 | $316.00 | $106.81–$268.60 | — | 75% |
| Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY UREA NITROGEN, QUAN - POST-DIALYSIS BUN (BLOOD UREA NITROGEN) | $9.00 | $36.00 | $3.32–$90.00 | 83% below | 75% |
| Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY UREA NITROGEN, QUAN - PRE-DIALYSIS BUN (BLOOD UREA NITROGEN) | $9.00 | $36.00 | $3.32–$90.00 | 83% below | 75% |
| Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY UREA NITROGEN, QUAN - UREA NITROGEN, BODY FLUID | $9.00 | $36.00 | $3.32–$90.00 | 83% below | 75% |
| Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY UREA NITROGEN, QUAN - BLOOD UREA NITROGEN | $9.00 | $36.00 | $3.32–$90.00 | 83% below | 75% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY UREA NITROGEN, QUAN - UREA NITROGEN, BODY FLUID | $9.00 | $36.00 | $12.17–$30.60 | — | 75% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY UREA NITROGEN, QUAN - PRE-DIALYSIS BUN (BLOOD UREA NITROGEN) | $9.00 | $36.00 | $12.17–$30.60 | — | 75% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY UREA NITROGEN, QUAN - POST-DIALYSIS BUN (BLOOD UREA NITROGEN) | $9.00 | $36.00 | $12.17–$30.60 | — | 75% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY UREA NITROGEN, QUAN - BLOOD UREA NITROGEN | $9.00 | $36.00 | $12.17–$30.60 | — | 75% |
| C-peptide blood test CPT 84681 HC ASSAY OF C-PEPTIDE - C-PEPTIDE | $48.00 | $192.00 | $17.48–$480.00 | 34% below | 75% |
| C-peptide blood test inpatient CPT 84681 HC ASSAY OF C-PEPTIDE - C-PEPTIDE | $48.00 | $192.00 | $64.90–$163.20 | — | 75% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC IMMUNOASSAY QUANT NOS NONAB - TRYPTASE | $10.75 | $43.00 | $4.35–$107.50 | 79% below | 75% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN - C-REACTIVE PROTEIN | $10.75 | $43.00 | $4.35–$107.50 | 79% below | 75% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC IMMUNOASSAY QUANT NOS NONAB - TRYPTASE | $10.75 | $43.00 | $14.53–$36.55 | — | 75% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN - C-REACTIVE PROTEIN | $10.75 | $43.00 | $14.53–$36.55 | — | 75% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC C DIFFICILE PCR | $73.25 | $293.00 | $31.31–$732.50 | 58% below | 75% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C DIFFICILE PCR | $73.25 | $293.00 | $99.03–$249.05 | — | 75% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 19-9 - CANCER ANTIGEN 19-9 | $39.25 | $157.00 | $17.48–$392.50 | 70% below | 75% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 19-9 - CANCER ANTIGEN 19-9 | $39.25 | $157.00 | $53.07–$133.45 | — | 75% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 125 - CA 125 | $54.00 | $216.00 | $17.48–$540.00 | 64% below | 75% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 125 - CA 125 | $54.00 | $216.00 | $73.01–$183.60 | — | 75% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC SARS-COV2 COVID 19 AMPLIFIED PROBE | $41.25 | $165.00 | $33.00–$412.50 | 55% below | 75% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC SARS-COV2 COVID 19 AMPLIFIED PROBE | $41.25 | $165.00 | $55.77–$140.25 | — | 75% |
| Calcium blood test, total CPT 82310 HC ASSAY OF CALCIUM, TOTAL - CALCIUM | $11.00 | $44.00 | $4.33–$110.00 | 81% below | 75% |
| Calcium blood test, total inpatient CPT 82310 HC ASSAY OF CALCIUM, TOTAL - CALCIUM | $11.00 | $44.00 | $14.87–$37.40 | — | 75% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC CARCINOEMBRYONIC ANTIGEN - CEA (CARCINOEMBRYONIC ANTIGEN) | $37.25 | $149.00 | $15.93–$372.50 | 72% below | 75% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CARCINOEMBRYONIC ANTIGEN - CEA (CARCINOEMBRYONIC ANTIGEN) | $37.25 | $149.00 | $50.36–$126.65 | — | 75% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER - VARICELLA ZOSTER IGG | $25.75 | $103.00 | $10.82–$257.50 | 58% below | 75% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER - VARICELLA ZOSTER IGM | $25.75 | $103.00 | $10.82–$257.50 | 58% below | 75% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA-ZOSTER - VARICELLA ZOSTER IGG | $25.75 | $103.00 | $34.81–$87.55 | — | 75% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA-ZOSTER - VARICELLA ZOSTER IGM | $25.75 | $103.00 | $34.81–$87.55 | — | 75% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHYLMD TRACH, DNA, AMP PROBE - CHLAMYDIA DNA PCR | $37.25 | $149.00 | $29.48–$372.50 | 70% below | 75% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHYLMD TRACH, DNA, AMP PROBE - CHLAMYDIA DNA PCR | $37.25 | $149.00 | $50.36–$126.65 | — | 75% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL | $36.25 | $145.00 | $11.25–$362.50 | 76% below | 75% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL | $36.25 | $145.00 | $49.01–$123.25 | — | 75% |
| Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC & AUTO DIFF WBC - ADDITIONAL CHARGE | $23.75 | $95.00 | $6.53–$237.50 | 74% below | 75% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE CBC & AUTO DIFF WBC - ADDITIONAL CHARGE | $23.75 | $95.00 | $32.11–$80.75 | — | 75% |
| Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC - CBC | $14.00 | $56.00 | $5.43–$140.00 | 85% below | 75% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC - CBC | $14.00 | $56.00 | $18.93–$47.60 | — | 75% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC METABOLIC PANEL,COMPREHENSIVE | $82.25 | $329.00 | $8.87–$822.50 | 67% below | 75% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC METABOLIC PANEL,COMPREHENSIVE | $82.25 | $329.00 | $111.20–$279.65 | — | 75% |
| Cortisol blood test, total CPT 82533 HC TOTAL CORTISOL - CORTISOL | $33.00 | $132.00 | $13.69–$330.00 | 60% below | 75% |
| Cortisol blood test, total inpatient CPT 82533 HC TOTAL CORTISOL - CORTISOL | $33.00 | $132.00 | $44.62–$112.20 | — | 75% |
| Creatine kinase (CK) blood test, total CPT 82550 HC ASSAY OF CK (CPK) - CK | $31.75 | $127.00 | $5.47–$317.50 | 50% below | 75% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC ASSAY OF CK (CPK) - CK | $31.75 | $127.00 | $42.93–$107.95 | — | 75% |
| Creatinine blood test CPT 82565 HC ASSAY OF CREATININE - POCT CREATININE SERUM | $13.50 | $54.00 | $4.30–$135.00 | 75% below | 75% |
| Creatinine blood test CPT 82565 HC ASSAY OF CREATININE - CREATININE SERUM | $13.50 | $54.00 | $4.30–$135.00 | 75% below | 75% |
| Creatinine blood test inpatient CPT 82565 HC ASSAY OF CREATININE - POCT CREATININE SERUM | $13.50 | $54.00 | $18.25–$45.90 | — | 75% |
| Creatinine blood test inpatient CPT 82565 HC ASSAY OF CREATININE - CREATININE SERUM | $13.50 | $54.00 | $18.25–$45.90 | — | 75% |
| Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV ANTIBODY - CMV IGG | $20.00 | $80.00 | $12.09–$200.00 | 72% below | 75% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV ANTIBODY - CMV IGG | $20.00 | $80.00 | $27.04–$68.00 | — | 75% |
| D-dimer blood test (blood clot marker) CPT 85379 HC FIBRIN DEGRADPRODUCTS,D-DIMER, QUANT - D-DIMER,QUANTITATIVE | $51.50 | $206.00 | $8.55–$515.00 | 70% below | 75% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC FIBRIN DEGRADPRODUCTS,D-DIMER, QUANT - D-DIMER,QUANTITATIVE | $51.50 | $206.00 | $69.63–$175.10 | — | 75% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE - DHEA-SULFATE | $29.00 | $116.00 | $18.67–$290.00 | 81% below | 75% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE - DHEA-SULFATE | $29.00 | $116.00 | $39.21–$98.60 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - HEROIN, SER OR PLASMA - SCR W RFLX /QN | $50.75 | $203.00 | $33.00–$507.50 | 18% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - BUNDLE | $50.75 | $203.00 | $33.00–$507.50 | 18% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - COCAINE URINE QUAL | $50.75 | $203.00 | $33.00–$507.50 | 18% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - OPIATE QUALITATIVE URINE | $50.75 | $203.00 | $33.00–$507.50 | 18% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - PHENCYCLIDINE (PCP) SCREEN UR | $50.75 | $203.00 | $33.00–$507.50 | 18% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - AMPHETAMINE SCRN | $50.75 | $203.00 | $33.00–$507.50 | 18% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - BARBITURATE SCRN, URINE | $50.75 | $203.00 | $33.00–$507.50 | 18% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANALYZERS | $50.75 | $203.00 | $33.00–$507.50 | 18% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST OF PRSMV CHEM ANLYZR, BENZODIAZEPINE SERUM | $50.75 | $203.00 | $33.00–$507.50 | 18% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST OF PRSMV CHEM ANLYZR, CANNABINOID SCREEN, URINE | $50.75 | $203.00 | $33.00–$507.50 | 18% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - DRUGS OF ABUSE, MECON W REF TO CONFIRM | $50.75 | $203.00 | $33.00–$507.50 | 18% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST DEF 1-9 CLASSES, MECONIUM | $59.25 | $237.00 | $33.00–$592.50 | 5% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG PANEL 9A, UR-SCN W/ REFLX TO CONF/QT | $65.50 | $262.00 | $33.00–$655.00 | 5% above | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC FLUNITRAZEPAM & METABOLITE - SCREEN - SERUM | $65.50 | $262.00 | $33.00–$655.00 | 5% above | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST DEF 1-7 CLASSES, URINE | $67.50 | $270.00 | $33.00–$675.00 | 9% above | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC GAMMA-HYDROXYBUTYRIC ACID (GHB) - SERUM/PLASMA | $71.75 | $287.00 | $33.00–$717.50 | 15% above | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC GAMMA-HYDROXYBUTYRIC ACID (GHB) - URINE | $71.75 | $287.00 | $33.00–$717.50 | 15% above | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - DIURETIC SCR, UR | $73.25 | $293.00 | $33.00–$732.50 | 18% above | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC TRICYCLIC ANTIDEPRESSANT SCRN, URINE | $74.50 | $298.00 | $33.00–$745.00 | 20% above | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN PANEL, SER/PLAS, W/ RFLX TO CONF/QT | $122.75 | $491.00 | $33.00–$1,227.50 | 98% above | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANALYZERS | $50.75 | $203.00 | $68.61–$172.55 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - BUNDLE | $50.75 | $203.00 | $68.61–$172.55 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - COCAINE URINE QUAL | $50.75 | $203.00 | $68.61–$172.55 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - OPIATE QUALITATIVE URINE | $50.75 | $203.00 | $68.61–$172.55 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST OF PRSMV CHEM ANLYZR, BENZODIAZEPINE SERUM | $50.75 | $203.00 | $68.61–$172.55 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST OF PRSMV CHEM ANLYZR, CANNABINOID SCREEN, URINE | $50.75 | $203.00 | $68.61–$172.55 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - PHENCYCLIDINE (PCP) SCREEN UR | $50.75 | $203.00 | $68.61–$172.55 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - AMPHETAMINE SCRN | $50.75 | $203.00 | $68.61–$172.55 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - BARBITURATE SCRN, URINE | $50.75 | $203.00 | $68.61–$172.55 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - DRUGS OF ABUSE, MECON W REF TO CONFIRM | $50.75 | $203.00 | $68.61–$172.55 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - HEROIN, SER OR PLASMA - SCR W RFLX /QN | $50.75 | $203.00 | $68.61–$172.55 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST DEF 1-9 CLASSES, MECONIUM | $59.25 | $237.00 | $80.11–$201.45 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG PANEL 9A, UR-SCN W/ REFLX TO CONF/QT | $65.50 | $262.00 | $88.56–$222.70 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC FLUNITRAZEPAM & METABOLITE - SCREEN - SERUM | $65.50 | $262.00 | $88.56–$222.70 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST DEF 1-7 CLASSES, URINE | $67.50 | $270.00 | $91.26–$229.50 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC GAMMA-HYDROXYBUTYRIC ACID (GHB) - URINE | $71.75 | $287.00 | $97.01–$243.95 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC GAMMA-HYDROXYBUTYRIC ACID (GHB) - SERUM/PLASMA | $71.75 | $287.00 | $97.01–$243.95 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR - DIURETIC SCR, UR | $73.25 | $293.00 | $99.03–$249.05 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC TRICYCLIC ANTIDEPRESSANT SCRN, URINE | $74.50 | $298.00 | $100.72–$253.30 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN PANEL, SER/PLAS, W/ RFLX TO CONF/QT | $122.75 | $491.00 | $165.96–$417.35 | — | 75% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL | $17.25 | $69.00 | $5.89–$172.50 | 89% below | 75% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL | $17.25 | $69.00 | $23.32–$58.65 | — | 75% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR CAPSID VCA - EPSTEIN-BARR VIRUS VCA ANTIBODY PANEL | $36.75 | $147.00 | $15.24–$367.50 | 57% below | 75% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR CAPSID VCA - EPSTEIN-BARR VIRUS VCA, IGG | $36.75 | $147.00 | $15.24–$367.50 | 57% below | 75% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR CAPSID VCA - EPSTEIN-BARR VIRUS VCA, IGM | $36.75 | $147.00 | $15.24–$367.50 | 57% below | 75% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR CAPSID VCA - EPSTEIN-BARR VIRUS VCA, IGG | $36.75 | $147.00 | $49.69–$124.95 | — | 75% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR CAPSID VCA - EPSTEIN-BARR VIRUS VCA ANTIBODY PANEL | $36.75 | $147.00 | $49.69–$124.95 | — | 75% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR CAPSID VCA - EPSTEIN-BARR VIRUS VCA, IGM | $36.75 | $147.00 | $49.69–$124.95 | — | 75% |
| Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL - ESTRADIOL | $55.00 | $220.00 | $23.47–$550.00 | 56% below | 75% |
| Estradiol blood test inpatient CPT 82670 HC ASSAY OF ESTRADIOL - ESTRADIOL | $55.00 | $220.00 | $74.36–$187.00 | — | 75% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN (FSH) - FSH | $94.25 | $377.00 | $15.61–$942.50 | 40% below | 75% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN (FSH) - FSH | $94.25 | $377.00 | $127.43–$320.45 | — | 75% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC CALPROTECTIN, FECAL | $67.50 | $270.00 | $16.49–$675.00 | 68% below | 75% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC CALPROTECTIN, FECAL | $67.50 | $270.00 | $91.26–$229.50 | — | 75% |
| Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN - FERRITIN | $27.75 | $111.00 | $11.45–$277.50 | 67% below | 75% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN - FERRITIN | $27.75 | $111.00 | $37.52–$94.35 | — | 75% |
| Fibrinogen blood test CPT 85384 HC FIBRINOGEN, ACTIVITY - FIBRINOGEN | $17.75 | $71.00 | $8.16–$177.50 | 79% below | 75% |
| Fibrinogen blood test CPT 85384 HC FIBRINOGEN, ACTIVITY - FIBRINOGEN,QUANTITATIVE | $17.75 | $71.00 | $8.16–$177.50 | 79% below | 75% |
| Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN, ACTIVITY - FIBRINOGEN | $17.75 | $71.00 | $24.00–$60.35 | — | 75% |
| Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN, ACTIVITY - FIBRINOGEN,QUANTITATIVE | $17.75 | $71.00 | $24.00–$60.35 | — | 75% |
| Folate (folic acid) blood test CPT 82746 HC BLOOD FOLIC ACID SERUM - FOLATE | $48.50 | $194.00 | $12.35–$485.00 | 39% below | 75% |
| Folate (folic acid) blood test inpatient CPT 82746 HC BLOOD FOLIC ACID SERUM - FOLATE | $48.50 | $194.00 | $65.57–$164.90 | — | 75% |
| Free T3 thyroid hormone test CPT 84481 HC TRIIODOTHYRONINE FREE ASSAY (FT-3) - T3 FREE | $23.00 | $92.00 | $14.23–$230.00 | 84% below | 75% |
| Free T3 thyroid hormone test inpatient CPT 84481 HC TRIIODOTHYRONINE FREE ASSAY (FT-3) - T3 FREE | $23.00 | $92.00 | $31.10–$78.20 | — | 75% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE - T4 FREE BY EQUILIBRIUM DIALYSIS | $30.75 | $123.00 | $7.58–$307.50 | 59% below | 75% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE - T4 FREE | $30.75 | $123.00 | $7.58–$307.50 | 59% below | 75% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE - T4 FREE | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE - T4 FREE BY EQUILIBRIUM DIALYSIS | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
| Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE | $52.00 | $208.00 | $21.39–$520.00 | 51% below | 75% |
| Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE, ADULT MALE ED/LC-MS/MS | $52.00 | $208.00 | $21.39–$520.00 | 51% below | 75% |
| Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE, ADULT MALE | $52.00 | $208.00 | $21.39–$520.00 | 51% below | 75% |
| Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE, FEMALES OR CHILDREN | $52.00 | $208.00 | $21.39–$520.00 | 51% below | 75% |
| Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE, ADULT MALE | $52.00 | $208.00 | $70.30–$176.80 | — | 75% |
| Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE, FEMALES OR CHILDREN | $52.00 | $208.00 | $70.30–$176.80 | — | 75% |
| Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE | $52.00 | $208.00 | $70.30–$176.80 | — | 75% |
| Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE, ADULT MALE ED/LC-MS/MS | $52.00 | $208.00 | $70.30–$176.80 | — | 75% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GGT - GAMMA GT | $21.00 | $84.00 | $6.05–$210.00 | 64% below | 75% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GGT - POCT GAMMA GLUTAMYL TRANSFERASE (GGT) | $21.00 | $84.00 | $6.05–$210.00 | 64% below | 75% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC ASSAY OF GGT - GAMMA GT | $21.00 | $84.00 | $28.39–$71.40 | — | 75% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC ASSAY OF GGT - POCT GAMMA GLUTAMYL TRANSFERASE (GGT) | $21.00 | $84.00 | $28.39–$71.40 | — | 75% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC GENERAL HEALTH PANEL - BUNDLED CHARGE | $101.75 | $407.00 | $33.00–$1,017.50 | 76% below | 75% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC GENERAL HEALTH PANEL - BUNDLED CHARGE | $101.75 | $407.00 | $137.57–$345.95 | — | 75% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE TEST - GTT 1 HOUR | $26.50 | $106.00 | $3.99–$265.00 | 66% below | 75% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE TEST - GTT 1 HOUR | $26.50 | $106.00 | $35.83–$90.10 | — | 75% |
| Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - BUNDLED CHARGE | $26.25 | $105.00 | $10.81–$262.50 | 83% below | 75% |
| Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - GTT 2 HOUR | $26.25 | $105.00 | $10.81–$262.50 | 83% below | 75% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - BUNDLED CHARGE | $26.25 | $105.00 | $35.49–$89.25 | — | 75% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - GTT 2 HOUR | $26.25 | $105.00 | $35.49–$89.25 | — | 75% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.GONORRHOEAE, DNA, AMP PROB - GC DNA PCR | $39.50 | $158.00 | $29.48–$395.00 | 70% below | 75% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N.GONORRHOEAE, DNA, AMP PROB - GC DNA PCR | $39.50 | $158.00 | $53.40–$134.30 | — | 75% |
| H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI - HELICOBACTER PYLORI IGG | $15.00 | $60.00 | $14.15–$150.00 | 88% below | 75% |
| H. pylori antibody blood test inpatient CPT 86677 HC HELICOBACTER PYLORI - HELICOBACTER PYLORI IGG | $15.00 | $60.00 | $20.28–$51.00 | — | 75% |
| H. pylori stool antigen test CPT 87338 HC IAAD IA HPYLORI STOOL - H PYLORI ANTIGEN STOOL | $21.00 | $84.00 | $12.08–$210.00 | 74% below | 75% |
| H. pylori stool antigen test inpatient CPT 87338 HC IAAD IA HPYLORI STOOL - H PYLORI ANTIGEN STOOL | $21.00 | $84.00 | $28.39–$71.40 | — | 75% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRPJ - HIV RNA, QUANTITATIVE, PCR | $97.75 | $391.00 | $33.00–$977.50 | 68% below | 75% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRPJ - HIV RNA, QUANTITATIVE, PCR | $97.75 | $391.00 | $132.16–$332.35 | — | 75% |
| HIV-1 and HIV-2 antibody test CPT 86703 HC HIV-1/HIV-2, SINGLE ASSAY - RAPID HIV 1 AND 2 SCREEN | $35.00 | $140.00 | $11.52–$350.00 | 60% below | 75% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV-1/HIV-2, SINGLE ASSAY - RAPID HIV 1 AND 2 SCREEN | $35.00 | $140.00 | $47.32–$119.00 | — | 75% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV AG/AB COMBO SCRN | $34.25 | $137.00 | $20.23–$342.50 | 75% below | 75% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV AG/AB COMBO SCRN | $34.25 | $137.00 | $46.31–$116.45 | — | 75% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV DNA PROBE, AMP | $28.50 | $114.00 | $29.48–$285.00 | 60% below | 75% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HC HPV DNA TISSUE | $110.75 | $443.00 | $29.48–$1,107.50 | 56% above | 75% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV DNA PROBE, AMP | $28.50 | $114.00 | $38.53–$96.90 | — | 75% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC HPV DNA TISSUE | $110.75 | $443.00 | $149.73–$376.55 | — | 75% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - HEMOGLOBIN A1C | $27.00 | $108.00 | $8.16–$270.00 | 68% below | 75% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - POCT GLYCATED HEMOGLOBIN, TOTAL | $27.00 | $108.00 | $8.16–$270.00 | 68% below | 75% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - HEMOGLOBIN A1C | $27.00 | $108.00 | $36.50–$91.80 | — | 75% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - POCT GLYCATED HEMOGLOBIN, TOTAL | $27.00 | $108.00 | $36.50–$91.80 | — | 75% |
| Hemoglobin blood test CPT 85018 HC HEMOGLOBIN - HEMOGLOBIN | $9.50 | $38.00 | $1.99–$95.00 | 78% below | 75% |
| Hemoglobin blood test CPT 85018 HC HEMOGLOBIN - FREE HEMOGLOBIN PLASMA | $9.50 | $38.00 | $1.99–$95.00 | 78% below | 75% |
| Hemoglobin blood test CPT 85018 HC HEMOGLOBIN - POCT HEMOGLOBIN | $9.50 | $38.00 | $1.99–$95.00 | 78% below | 75% |
| Hemoglobin blood test CPT 85018 HC HEMOGLOBIN - TOTAL HEMOGLOBIN | $9.50 | $38.00 | $1.99–$95.00 | 78% below | 75% |
| Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN - HEMOGLOBIN | $9.50 | $38.00 | $12.84–$32.30 | — | 75% |
| Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN - POCT HEMOGLOBIN | $9.50 | $38.00 | $12.84–$32.30 | — | 75% |
| Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN - FREE HEMOGLOBIN PLASMA | $9.50 | $38.00 | $12.84–$32.30 | — | 75% |
| Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN - TOTAL HEMOGLOBIN | $9.50 | $38.00 | $12.84–$32.30 | — | 75% |
| Hepatitis B core antibody test (total) CPT 86704 HC HEP B CORE AB TEST, TOTAL - HEPATITIS B CORE ANTIBODY, TOTAL | $33.50 | $134.00 | $10.12–$335.00 | 54% below | 75% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEP B CORE AB TEST, TOTAL - HEPATITIS B CORE ANTIBODY, TOTAL | $33.50 | $134.00 | $45.29–$113.90 | — | 75% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY | $24.50 | $98.00 | $9.02–$245.00 | 62% below | 75% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY | $24.50 | $98.00 | $33.12–$83.30 | — | 75% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN - HEPATITIS B SURFACE ANTIGEN | $24.25 | $97.00 | $8.68–$242.50 | 65% below | 75% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN - HEPATITIS B SURFACE ANTIGEN | $24.25 | $97.00 | $32.79–$82.45 | — | 75% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C AB TEST - HEPATITIS C ANTIBODY | $33.25 | $133.00 | $11.99–$332.50 | 61% below | 75% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C AB TEST - HEPATITIS C ANTIBODY | $33.25 | $133.00 | $44.95–$113.05 | — | 75% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION - HCV QUANT PCR | $198.50 | $794.00 | $33.00–$1,985.00 | 16% below | 75% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION - HCV QUANT PCR | $198.50 | $794.00 | $268.37–$674.90 | — | 75% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TEST, TYPE 1 - HSV 1 IGG ANTIBODY | $17.50 | $70.00 | $11.08–$175.00 | 76% below | 75% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TEST, TYPE 1 - HSV 1 IGG ANTIBODY | $17.50 | $70.00 | $23.66–$59.50 | — | 75% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TEST, TYPE 2 - HSV 2 IGG ANTIBODY | $17.50 | $70.00 | $16.25–$175.00 | 79% below | 75% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TEST, TYPE 2 - HSV 2 IGG ANTIBODY | $17.50 | $70.00 | $23.66–$59.50 | — | 75% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN,HIGH SENSITIVITY - HIGH SENSITIVITY CRP | $19.50 | $78.00 | $10.88–$195.00 | 74% below | 75% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN,HIGH SENSITIVITY - HIGH SENSITIVITY CRP | $19.50 | $78.00 | $26.36–$66.30 | — | 75% |
| Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE TOTAL | $33.50 | $134.00 | $15.05–$335.00 | 78% below | 75% |
| Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE TOTAL | $33.50 | $134.00 | $45.29–$113.90 | — | 75% |
| Insulin blood test CPT 83525 HC ASSAY OF INSULIN,TOTAL | $23.25 | $93.00 | $9.60–$232.50 | 66% below | 75% |
| Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN,TOTAL | $23.25 | $93.00 | $31.43–$79.05 | — | 75% |
| Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON - IRON,LIVER TISSUE | $13.00 | $52.00 | $5.43–$130.00 | 82% below | 75% |
| Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON - IRON | $13.00 | $52.00 | $5.43–$130.00 | 82% below | 75% |
| Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON - IRON | $13.00 | $52.00 | $17.58–$44.20 | — | 75% |
| Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON - IRON,LIVER TISSUE | $13.00 | $52.00 | $17.58–$44.20 | — | 75% |
| Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING TEST - IRON AND IRON BINDING CAPACITY PANEL - SR OR PL | $20.75 | $83.00 | $7.34–$207.50 | 77% below | 75% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING TEST - IRON AND IRON BINDING CAPACITY PANEL - SR OR PL | $20.75 | $83.00 | $28.05–$70.55 | — | 75% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL | $32.00 | $128.00 | $7.29–$320.00 | 82% below | 75% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL | $32.00 | $128.00 | $43.26–$108.80 | — | 75% |
| LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN (LH) - LUTEINIZING HORMONE | $92.00 | $368.00 | $15.56–$920.00 | 34% below | 75% |
| LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN (LH) - LUTEINIZING HORMONE | $92.00 | $368.00 | $124.38–$312.80 | — | 75% |
| Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID - LACTATE CSF | $29.25 | $117.00 | $9.72–$292.50 | 69% below | 75% |
| Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID - POCT LACTIC ACID (LACTATE) | $29.25 | $117.00 | $9.72–$292.50 | 69% below | 75% |
| Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID - LACTIC ACID, ARTERIAL, WHOLE BLOOD | $29.25 | $117.00 | $9.72–$292.50 | 69% below | 75% |
| Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID - LACTATE | $29.25 | $117.00 | $9.72–$292.50 | 69% below | 75% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID - POCT LACTIC ACID (LACTATE) | $29.25 | $117.00 | $39.55–$99.45 | — | 75% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID - LACTIC ACID, ARTERIAL, WHOLE BLOOD | $29.25 | $117.00 | $39.55–$99.45 | — | 75% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID - LACTATE CSF | $29.25 | $117.00 | $39.55–$99.45 | — | 75% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID - LACTATE | $29.25 | $117.00 | $39.55–$99.45 | — | 75% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE (LD) (LDH) ENZYME - LACTATE DEHYDROGENASE FL | $15.50 | $62.00 | $5.07–$155.00 | 62% below | 75% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE (LD) (LDH) ENZYME - LACTATE DEHYDROGENASE, CSF | $17.25 | $69.00 | $5.07–$172.50 | 58% below | 75% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE (LD) (LDH) ENZYME - LACTATE DEHYDROGENASE | $17.25 | $69.00 | $5.07–$172.50 | 58% below | 75% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE (LD) (LDH) ENZYME - LACTATE DEHYDROGENASE FL | $15.50 | $62.00 | $20.96–$52.70 | — | 75% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE (LD) (LDH) ENZYME - LACTATE DEHYDROGENASE | $17.25 | $69.00 | $23.32–$58.65 | — | 75% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE (LD) (LDH) ENZYME - LACTATE DEHYDROGENASE, CSF | $17.25 | $69.00 | $23.32–$58.65 | — | 75% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE - LIPASE BODY FLUID | $24.50 | $98.00 | $5.79–$245.00 | 64% below | 75% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE - LIPASE | $35.00 | $140.00 | $5.79–$350.00 | 48% below | 75% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE - LIPASE BODY FLUID | $24.50 | $98.00 | $33.12–$83.30 | — | 75% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE - LIPASE | $35.00 | $140.00 | $47.32–$119.00 | — | 75% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL | $36.25 | $145.00 | $6.86–$362.50 | 81% below | 75% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL | $36.25 | $145.00 | $49.01–$123.25 | — | 75% |
| Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES, REFLEXIVE PANEL (CSF) | $19.75 | $79.00 | $14.31–$197.50 | 76% below | 75% |
| Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES, TOTAL, CSF | $19.75 | $79.00 | $14.31–$197.50 | 76% below | 75% |
| Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES | $23.00 | $92.00 | $14.31–$230.00 | 72% below | 75% |
| Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES W/RFLX TO IGG/IGM BY WESTERN BLOT | $37.75 | $151.00 | $14.31–$377.50 | 54% below | 75% |
| Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES, TOTAL, CSF | $19.75 | $79.00 | $26.70–$67.15 | — | 75% |
| Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES, REFLEXIVE PANEL (CSF) | $19.75 | $79.00 | $26.70–$67.15 | — | 75% |
| Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES | $23.00 | $92.00 | $31.10–$78.20 | — | 75% |
| Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES W/RFLX TO IGG/IGM BY WESTERN BLOT | $37.75 | $151.00 | $51.04–$128.35 | — | 75% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM FECAL | $46.00 | $184.00 | $5.63–$460.00 | at median | 75% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM | $53.00 | $212.00 | $5.63–$530.00 | 15% above | 75% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM URINE | $53.00 | $212.00 | $5.63–$530.00 | 15% above | 75% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM 24HR URINE | $53.00 | $212.00 | $5.63–$530.00 | 15% above | 75% |
| Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM FECAL | $46.00 | $184.00 | $62.19–$156.40 | — | 75% |
| Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM 24HR URINE | $53.00 | $212.00 | $71.66–$180.20 | — | 75% |
| Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM URINE | $53.00 | $212.00 | $71.66–$180.20 | — | 75% |
| Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM | $53.00 | $212.00 | $71.66–$180.20 | — | 75% |
| Measles (rubeola) antibody test CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY, IGM | $26.25 | $105.00 | $10.82–$262.50 | 28% below | 75% |
| Measles (rubeola) antibody test CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY IGG | $26.25 | $105.00 | $10.82–$262.50 | 28% below | 75% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY IGG | $26.25 | $105.00 | $35.49–$89.25 | — | 75% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY, IGM | $26.25 | $105.00 | $35.49–$89.25 | — | 75% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES,SCREEN - MONONUCLEOSIS SCREEN | $41.75 | $167.00 | $4.35–$417.50 | 51% below | 75% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES,SCREEN - MONONUCLEOSIS SCREEN | $41.75 | $167.00 | $56.45–$141.95 | — | 75% |
| Mumps immunity blood test CPT 86735 HC MUMPS - MUMPS IGG ANTIBODY | $18.00 | $72.00 | $10.96–$180.00 | 69% below | 75% |
| Mumps immunity blood test CPT 86735 HC MUMPS - MUMPS IGM ANTIBODY | $18.00 | $72.00 | $10.96–$180.00 | 69% below | 75% |
| Mumps immunity blood test inpatient CPT 86735 HC MUMPS - MUMPS IGM ANTIBODY | $18.00 | $72.00 | $24.34–$61.20 | — | 75% |
| Mumps immunity blood test inpatient CPT 86735 HC MUMPS - MUMPS IGG ANTIBODY | $18.00 | $72.00 | $24.34–$61.20 | — | 75% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC ANTIGEN, FREE | $15.00 | $60.00 | $15.45–$150.00 | 87% below | 75% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC ANTIGEN, FREE | $15.00 | $60.00 | $20.28–$51.00 | — | 75% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - DIAGNOSTIC | $64.25 | $257.00 | $15.45–$642.50 | 25% below | 75% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA, ULTRASENSITIVE | $64.25 | $257.00 | $15.45–$642.50 | 25% below | 75% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - TOTAL | $64.25 | $257.00 | $15.45–$642.50 | 25% below | 75% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA SCREENING | $70.50 | $282.00 | $15.45–$705.00 | 18% below | 75% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - TOTAL | $64.25 | $257.00 | $86.87–$218.45 | — | 75% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA, ULTRASENSITIVE | $64.25 | $257.00 | $86.87–$218.45 | — | 75% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - DIAGNOSTIC | $64.25 | $257.00 | $86.87–$218.45 | — | 75% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA SCREENING | $70.50 | $282.00 | $95.32–$239.70 | — | 75% |
| Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTOPATH C/V AUTO FLUID REDO - LAB CYTOPAT,CER/VAG,THIN LAYER,INTER | $21.75 | $87.00 | $22.35–$217.50 | 71% below | 75% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTOPATH C/V AUTO FLUID REDO - LAB CYTOPAT,CER/VAG,THIN LAYER,INTER | $21.75 | $87.00 | $29.41–$73.95 | — | 75% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CYTOPATH C/V THIN LAYER - LAB CYTOPATH CERV/VAG THIN LAYER | $19.00 | $76.00 | $17.02–$190.00 | 79% below | 75% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC CYTOPATH C/V THIN LAYER - LAB CYTOPATH CERV/VAG THIN LAYER | $19.00 | $76.00 | $25.69–$64.60 | — | 75% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE - PTH INTACT | $48.25 | $193.00 | $33.00–$482.50 | 76% below | 75% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC ASSAY OF PARATHORMONE - PTH INTACT | $48.25 | $193.00 | $65.23–$164.05 | — | 75% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLAS TIME PARTIAL - TIME MIXING STUDY DIRECT | $40.00 | $160.00 | $5.05–$400.00 | 20% below | 75% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLAS TIME PARTIAL - APTT | $50.50 | $202.00 | $5.05–$505.00 | 1% above | 75% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLAS TIME PARTIAL - HEPZYME | $50.50 | $202.00 | $5.05–$505.00 | 1% above | 75% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLAS TIME PARTIAL - TIME MIXING STUDY DIRECT | $40.00 | $160.00 | $54.08–$136.00 | — | 75% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLAS TIME PARTIAL - APTT | $50.50 | $202.00 | $68.28–$171.70 | — | 75% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLAS TIME PARTIAL - HEPZYME | $50.50 | $202.00 | $68.28–$171.70 | — | 75% |
| Phosphorus (phosphate) blood test CPT 84100 HC ASSAY OF INORGANIC PHOSPHORUS - PHOSPHORUS | $20.00 | $80.00 | $3.98–$200.00 | 68% below | 75% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HC ASSAY OF INORGANIC PHOSPHORUS - PHOSPHORUS | $20.00 | $80.00 | $27.04–$68.00 | — | 75% |
| Potassium blood test CPT 84132 HC ASSAY OF SERUM POTASSIUM - POTASSIUM BODY FLUID | $32.25 | $129.00 | $4.00–$322.50 | 46% below | 75% |
| Potassium blood test CPT 84132 HC ASSAY OF SERUM POTASSIUM - POTASSIUM | $32.25 | $129.00 | $4.00–$322.50 | 46% below | 75% |
| Potassium blood test inpatient CPT 84132 HC ASSAY OF SERUM POTASSIUM - POTASSIUM BODY FLUID | $32.25 | $129.00 | $43.60–$109.65 | — | 75% |
| Potassium blood test inpatient CPT 84132 HC ASSAY OF SERUM POTASSIUM - POTASSIUM | $32.25 | $129.00 | $43.60–$109.65 | — | 75% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHRMOML ANEUPLOIDY, NIPT FETAL ANEUPLOIDY W/22Q MICRODEL | $620.50 | $2,482.00 | $33.00–$6,205.00 | 29% below | 75% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHRMOML ANEUPLOIDY, NIPT FETAL ANEUPLOIDY W/ MICRODELETIONS | $620.50 | $2,482.00 | $33.00–$6,205.00 | 29% below | 75% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC FETAL CHRMOML ANEUPLOIDY, NIPT FETAL ANEUPLOIDY W/22Q MICRODEL | $620.50 | $2,482.00 | $838.92–$2,109.70 | — | 75% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC FETAL CHRMOML ANEUPLOIDY, NIPT FETAL ANEUPLOIDY W/ MICRODELETIONS | $620.50 | $2,482.00 | $838.92–$2,109.70 | — | 75% |
| Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE - PROGESTERONE | $35.00 | $140.00 | $17.52–$350.00 | 65% below | 75% |
| Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE - PROGESTERONE | $35.00 | $140.00 | $47.32–$119.00 | — | 75% |
| Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN - PROLACTIN | $30.75 | $123.00 | $16.28–$307.50 | 72% below | 75% |
| Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN - MONOMERIC PROLACTIN | $30.75 | $123.00 | $16.28–$307.50 | 72% below | 75% |
| Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN - PROLACTIN MACROADENOMA | $30.75 | $123.00 | $16.28–$307.50 | 72% below | 75% |
| Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN - PROLACTIN MACROADENOMA | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
| Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN - PROLACTIN | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
| Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN - MONOMERIC PROLACTIN | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - PROTIME-INR | $29.25 | $117.00 | $3.60–$292.50 | 36% below | 75% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - PROTIME-POC INR | $29.25 | $117.00 | $3.60–$292.50 | 36% below | 75% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - PROTIME-INR | $29.25 | $117.00 | $39.55–$99.45 | — | 75% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - PROTIME-POC INR | $29.25 | $117.00 | $39.55–$99.45 | — | 75% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP A ASSAY W/OPTIC - RAPID STREP A SCREEN | $42.75 | $171.00 | $13.89–$427.50 | 56% below | 75% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC PBB STREP A ASSAY W/OPTIC - RAPID STREP A SCREEN | $42.75 | $171.00 | $13.89–$427.50 | 56% below | 75% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC PBB STREP A ASSAY W/OPTIC - RAPID STREP A SCREEN | $42.75 | $171.00 | $57.80–$145.35 | — | 75% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP A ASSAY W/OPTIC - RAPID STREP A SCREEN | $42.75 | $171.00 | $57.80–$145.35 | — | 75% |
| Renin blood test CPT 84244 HC ASSAY OF RENIN - RENIN DIRECT ASSAY | $51.50 | $206.00 | $18.47–$515.00 | 49% below | 75% |
| Renin blood test inpatient CPT 84244 HC ASSAY OF RENIN - RENIN DIRECT ASSAY | $51.50 | $206.00 | $69.63–$175.10 | — | 75% |
| Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) | $28.50 | $114.00 | $2.51–$285.00 | 56% below | 75% |
| Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) | $28.50 | $114.00 | $38.53–$96.90 | — | 75% |
| Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR, QUANT - RHEUMATOID FACTOR | $21.50 | $86.00 | $4.76–$215.00 | 53% below | 75% |
| Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR, QUANT - RHEUMATOID FACTOR | $21.50 | $86.00 | $29.07–$73.10 | — | 75% |
| Rubella antibody test (immunity check) CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGM | $19.75 | $79.00 | $12.09–$197.50 | 61% below | 75% |
| Rubella antibody test (immunity check) CPT 86762 HC RUBELLA - RUBELLA ANTIBODY IGG | $19.75 | $79.00 | $12.09–$197.50 | 61% below | 75% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGM | $19.75 | $79.00 | $26.70–$67.15 | — | 75% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA - RUBELLA ANTIBODY IGG | $19.75 | $79.00 | $26.70–$67.15 | — | 75% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC RBC SED RATE, AUTO - SEDIMENTATION RATE, AUTOMATED | $14.25 | $57.00 | $2.27–$142.50 | 77% below | 75% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC RBC SED RATE, AUTO - SEDIMENTATION RATE, AUTOMATED | $14.25 | $57.00 | $19.27–$48.45 | — | 75% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC SEMEN ANALYSIS,VOLUME, COUNT, MOTILITY, DIFF - SEMEN ANALYSIS | $27.75 | $111.00 | $12.31–$277.50 | 78% below | 75% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC SEMEN ANALYSIS,VOLUME, COUNT, MOTILITY, DIFF - SEMEN ANALYSIS | $27.75 | $111.00 | $37.52–$94.35 | — | 75% |
| Sodium blood test CPT 84295 HC ASSAY OF SERUM SODIUM - SODIUM | $33.50 | $134.00 | $4.04–$335.00 | 46% below | 75% |
| Sodium blood test inpatient CPT 84295 HC ASSAY OF SERUM SODIUM - SODIUM | $33.50 | $134.00 | $45.29–$113.90 | — | 75% |
| Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS - OVA AND PARASITE EXAMINATION | $35.00 | $140.00 | $7.48–$350.00 | 48% below | 75% |
| Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES SMEARS - OVA AND PARASITE EXAMINATION | $35.00 | $140.00 | $47.32–$119.00 | — | 75% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC FECAL IMMUNOCHEMICAL TEST | $22.75 | $91.00 | $13.37–$227.50 | 66% below | 75% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC FECAL IMMUNOCHEMICAL TEST | $22.75 | $91.00 | $30.76–$77.35 | — | 75% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM - T. PALLIDUM CONFIRMATORY | $17.75 | $71.00 | $11.12–$177.50 | 60% below | 75% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM - FTA ANTIBODIES, IGG AND IGM | $17.75 | $71.00 | $11.12–$177.50 | 60% below | 75% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM - FTA ANTIBODIES, IGG AND IGM | $17.75 | $71.00 | $24.00–$60.35 | — | 75% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM - T. PALLIDUM CONFIRMATORY | $17.75 | $71.00 | $24.00–$60.35 | — | 75% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - RAPID PLASMA REAGIN-SYP | $20.50 | $82.00 | $3.59–$205.00 | 52% below | 75% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - VDRL CSF | $20.50 | $82.00 | $3.59–$205.00 | 52% below | 75% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - VDRL CSF | $20.50 | $82.00 | $27.72–$69.70 | — | 75% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - RAPID PLASMA REAGIN-SYP | $20.50 | $82.00 | $27.72–$69.70 | — | 75% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB TEST, CELL MEDIATED ANTIGEN RESPONSE,GAMMA INTERFRON - TB TEST | $50.50 | $202.00 | $33.00–$505.00 | 75% below | 75% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB TEST, CELL MEDIATED ANTIGEN RESPONSE,GAMMA INTERFRON - TB TEST | $50.50 | $202.00 | $68.28–$171.70 | — | 75% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE, FEMALES OR CHILDREN | $30.75 | $123.00 | $21.68–$307.50 | 69% below | 75% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE, LC-MS/MS, MALES | $30.75 | $123.00 | $21.68–$307.50 | 69% below | 75% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE, ADULT MALE | $30.75 | $123.00 | $21.68–$307.50 | 69% below | 75% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE | $30.75 | $123.00 | $21.68–$307.50 | 69% below | 75% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE, FEMALES OR CHILDREN | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE, LC-MS/MS, MALES | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE, ADULT MALE | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY - ANTI-MICROSOMAL AB | $22.50 | $90.00 | $12.22–$225.00 | 73% below | 75% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY - THYROID PEROXIDASE ANTIBODY | $26.75 | $107.00 | $12.22–$267.50 | 68% below | 75% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY - ANTI-MICROSOMAL AB | $22.50 | $90.00 | $30.42–$76.50 | — | 75% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY - THYROID PEROXIDASE ANTIBODY | $26.75 | $107.00 | $36.17–$90.95 | — | 75% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE | $28.00 | $112.00 | $14.11–$280.00 | 73% below | 75% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE | $28.00 | $112.00 | $37.86–$95.20 | — | 75% |
| Total IgE blood test CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE - IMMUNOGLOBULIN IGE | $27.75 | $111.00 | $13.83–$277.50 | 65% below | 75% |
| Total IgE blood test inpatient CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE - IMMUNOGLOBULIN IGE | $27.75 | $111.00 | $37.52–$94.35 | — | 75% |
| Total cholesterol blood test CPT 82465 HC ASSAY, BLD/SERUM CHOLESTEROL - CHOLESTEROL TOTAL | $8.25 | $33.00 | $3.65–$82.50 | 85% below | 75% |
| Total cholesterol blood test CPT 82465 HC ASSAY, BLD/SERUM CHOLESTEROL - CHOLESTEROL FLUID | $8.25 | $33.00 | $3.65–$82.50 | 85% below | 75% |
| Total cholesterol blood test inpatient CPT 82465 HC ASSAY, BLD/SERUM CHOLESTEROL - CHOLESTEROL TOTAL | $8.25 | $33.00 | $11.15–$28.05 | — | 75% |
| Total cholesterol blood test inpatient CPT 82465 HC ASSAY, BLD/SERUM CHOLESTEROL - CHOLESTEROL FLUID | $8.25 | $33.00 | $11.15–$28.05 | — | 75% |
| Total thyroxine (T4) blood test CPT 84436 HC ASSAY OF TOTAL THYROXINE - T4 (THYROID HORMONE) | $18.25 | $73.00 | $5.77–$182.50 | 77% below | 75% |
| Total thyroxine (T4) blood test inpatient CPT 84436 HC ASSAY OF TOTAL THYROXINE - T4 (THYROID HORMONE) | $18.25 | $73.00 | $24.67–$62.05 | — | 75% |
| Total triiodothyronine (T3) blood test CPT 84480 HC TRIIODOTHYRONINE TOTAL ASSAY, TT-3 - T3 (THYROID HORMONE) | $64.00 | $256.00 | $11.91–$640.00 | 49% below | 75% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 HC TRIIODOTHYRONINE TOTAL ASSAY, TT-3 - T3 (THYROID HORMONE) | $64.00 | $256.00 | $86.53–$217.60 | — | 75% |
| Transferrin blood test CPT 84466 HC ASSAY OF TRANSFERRIN - TRANSFERRIN | $45.00 | $180.00 | $10.72–$450.00 | 62% below | 75% |
| Transferrin blood test inpatient CPT 84466 HC ASSAY OF TRANSFERRIN - TRANSFERRIN | $45.00 | $180.00 | $60.84–$153.00 | — | 75% |
| Trichomonas test (NAAT) CPT 87661 HC TRICHOMONAS VAGINALIS AMPLIFIED PROBE | $24.25 | $97.00 | $29.48–$242.50 | 72% below | 75% |
| Trichomonas test (NAAT) inpatient CPT 87661 HC TRICHOMONAS VAGINALIS AMPLIFIED PROBE | $24.25 | $97.00 | $32.79–$82.45 | — | 75% |
| Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES - TRIGLYCERIDES BODY FLUID | $35.75 | $143.00 | $4.82–$357.50 | 47% below | 75% |
| Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES - TRIGLYCERIDES | $39.00 | $156.00 | $4.82–$390.00 | 43% below | 75% |
| Triglycerides blood test inpatient CPT 84478 HC ASSAY OF TRIGLYCERIDES - TRIGLYCERIDES BODY FLUID | $35.75 | $143.00 | $48.33–$121.55 | — | 75% |
| Triglycerides blood test inpatient CPT 84478 HC ASSAY OF TRIGLYCERIDES - TRIGLYCERIDES | $39.00 | $156.00 | $52.73–$132.60 | — | 75% |
| Troponin test, quantitative CPT 84484 HC ASSAY OF TROPONIN, QUANT - TROPONIN I | $46.75 | $187.00 | $10.47–$467.50 | 59% below | 75% |
| Troponin test, quantitative CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE | $46.75 | $187.00 | $10.47–$467.50 | 59% below | 75% |
| Troponin test, quantitative inpatient CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE | $46.75 | $187.00 | $63.21–$158.95 | — | 75% |
| Troponin test, quantitative inpatient CPT 84484 HC ASSAY OF TROPONIN, QUANT - TROPONIN I | $46.75 | $187.00 | $63.21–$158.95 | — | 75% |
| Uric acid blood test CPT 84550 HC ASSAY OF URIC ACID, BLOOD - URIC ACID | $13.75 | $55.00 | $3.80–$137.50 | 82% below | 75% |
| Uric acid blood test inpatient CPT 84550 HC ASSAY OF URIC ACID, BLOOD - URIC ACID | $13.75 | $55.00 | $18.59–$46.75 | — | 75% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS, AUTO, W/SCOPE - URINALYSIS MICROSCOPIC | $13.25 | $53.00 | $2.66–$132.50 | 86% below | 75% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS, AUTO, W/SCOPE - BUNDLED CHARGE | $13.25 | $53.00 | $2.66–$132.50 | 86% below | 75% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS, AUTO, W/SCOPE - BUNDLED CHARGE | $13.25 | $53.00 | $17.91–$45.05 | — | 75% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS, AUTO, W/SCOPE - URINALYSIS MICROSCOPIC | $13.25 | $53.00 | $17.91–$45.05 | — | 75% |
| Urinalysis without microscope exam, automated CPT 81003 HC PBB URINALYSIS, AUTO, W/O SCOPE | $8.75 | $35.00 | $1.89–$87.50 | 82% below | 75% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY | $8.75 | $35.00 | $1.89–$87.50 | 82% below | 75% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - POCT URINALYSIS CHEM ONLY | $8.75 | $35.00 | $1.89–$87.50 | 82% below | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - POCT URINALYSIS CHEM ONLY | $8.75 | $35.00 | $11.83–$29.75 | — | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY | $8.75 | $35.00 | $11.83–$29.75 | — | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC PBB URINALYSIS, AUTO, W/O SCOPE | $8.75 | $35.00 | $11.83–$29.75 | — | 75% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS NONAUTO W/O SCOPE - URINALYSIS DIPSTICK | $9.50 | $38.00 | $2.92–$95.00 | 68% below | 75% |
| Urinalysis without microscope exam, manual CPT 81002 HC PBB URINALYSIS NONAUTO W/O SCOPE | $9.50 | $38.00 | $2.92–$95.00 | 68% below | 75% |
| Urinalysis without microscope exam, manual CPT 81002 HC SPECIFIC GRAVITY, URINALYSIS | $9.50 | $38.00 | $2.92–$95.00 | 68% below | 75% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC PBB URINALYSIS NONAUTO W/O SCOPE | $9.50 | $38.00 | $12.84–$32.30 | — | 75% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS NONAUTO W/O SCOPE - URINALYSIS DIPSTICK | $9.50 | $38.00 | $12.84–$32.30 | — | 75% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC SPECIFIC GRAVITY, URINALYSIS | $9.50 | $38.00 | $12.84–$32.30 | — | 75% |
| Urine culture for bacteria, with colony count CPT 87086 HC CULTURE/URINE/MICRO | $27.75 | $111.00 | $6.78–$277.50 | 79% below | 75% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE/URINE/MICRO | $27.75 | $111.00 | $37.52–$94.35 | — | 75% |
| Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN, QUANTITATIVE - MICROALBUMIN RANDOM URINE | $19.00 | $76.00 | $4.86–$190.00 | 63% below | 75% |
| Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN, QUANTITATIVE - MICROALBUMIN 24HR URINE | $21.00 | $84.00 | $4.86–$210.00 | 59% below | 75% |
| Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN, QUANTITATIVE - MICROALBUMIN RANDOM URINE | $19.00 | $76.00 | $25.69–$64.60 | — | 75% |
| Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN, QUANTITATIVE - MICROALBUMIN 24HR URINE | $21.00 | $84.00 | $28.39–$71.40 | — | 75% |
| Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST - POCT PREGNANCY, URINE | $8.00 | $32.00 | $7.23–$80.00 | 91% below | 75% |
| Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST - PREGNANCY URINE | $8.00 | $32.00 | $7.23–$80.00 | 91% below | 75% |
| Urine pregnancy test, read by color change CPT 81025 HC PBB URINE PREGNANCY TEST | $8.00 | $32.00 | $7.23–$80.00 | 91% below | 75% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST - PREGNANCY URINE | $8.00 | $32.00 | $10.82–$27.20 | — | 75% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC PBB URINE PREGNANCY TEST | $8.00 | $32.00 | $10.82–$27.20 | — | 75% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST - POCT PREGNANCY, URINE | $8.00 | $32.00 | $10.82–$27.20 | — | 75% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12 - VITAMIN B12 | $33.00 | $132.00 | $12.67–$330.00 | 64% below | 75% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B-12 - VITAMIN B12 | $33.00 | $132.00 | $44.62–$112.20 | — | 75% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC ASSAY OF VIT D,CALCIFEDIOL W FRACTIONS, IF PERFORMED - VITAMIN D 25 | $41.00 | $164.00 | $24.86–$410.00 | 66% below | 75% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC ASSAY OF VIT D,CALCIFEDIOL W FRACTIONS, IF PERFORMED - VITAMIN D 25 | $41.00 | $164.00 | $55.43–$139.40 | — | 75% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC ASSAY, DIHYDROXYVITAMIN D W/FRACTIONS, IF PERFORMED - VITAMIN D 1 | $31.25 | $125.00 | $32.34–$312.50 | 80% below | 75% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC ASSAY, DIHYDROXYVITAMIN D W/FRACTIONS, IF PERFORMED - VITAMIN D 1 | $31.25 | $125.00 | $42.25–$106.25 | — | 75% |
| Zinc blood test CPT 84630 HC ASSAY OF ZINC - ZINC, SERUM OR PLASMA | $30.75 | $123.00 | $9.57–$307.50 | 55% below | 75% |
| Zinc blood test CPT 84630 HC ASSAY OF ZINC - ZINC | $30.75 | $123.00 | $9.57–$307.50 | 55% below | 75% |
| Zinc blood test CPT 84630 HC ASSAY OF ZINC - ZINC, WHOLE BLOOD | $30.75 | $123.00 | $9.57–$307.50 | 55% below | 75% |
| Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC - ZINC | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
| Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC - ZINC, SERUM OR PLASMA | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
| Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC - ZINC, WHOLE BLOOD | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC CHORIONIC GONADOTROPIN, QUANT - HCG MATERNAL | $30.75 | $123.00 | $12.64–$307.50 | 73% below | 75% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC CHORIONIC GONADOTROPIN, QUANT - HCG QUANTITATIVE BLOOD | $30.75 | $123.00 | $12.64–$307.50 | 73% below | 75% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC CHORIONIC GONADOTROPIN, QUANT - HCG (TUMOR MARKER) CSF | $30.75 | $123.00 | $12.64–$307.50 | 73% below | 75% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC CHORIONIC GONADOTROPIN, QUANT - HCG QUANTITATIVE BLOOD | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC CHORIONIC GONADOTROPIN, QUANT - HCG (TUMOR MARKER) CSF | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC CHORIONIC GONADOTROPIN, QUANT - HCG MATERNAL | $30.75 | $123.00 | $41.57–$104.55 | — | 75% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine CPT 64615 HC PBB CHEMODENERV MUSCLE MIGRAINE | $141.25 | $565.00 | $59.25–$1,530.00 | 75% below | 75% |
| Botox injections for chronic migraine CPT 64615 HC CHEMODENERV MUSCLE MIGRAINE | $141.25 | $565.00 | $59.25–$1,530.00 | 75% below | 75% |
| Botox injections for chronic migraine inpatient CPT 64615 HC CHEMODENERV MUSCLE MIGRAINE | $141.25 | $565.00 | $190.97–$480.25 | — | 75% |
| Botox injections for chronic migraine inpatient CPT 64615 HC PBB CHEMODENERV MUSCLE MIGRAINE | $141.25 | $565.00 | $190.97–$480.25 | — | 75% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE | $549.00 | $2,196.00 | $486.45–$5,490.00 | 84% below | 75% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE | $549.00 | $2,196.00 | $742.25–$1,866.60 | — | 75% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC PBB CLOSED RX DIST FIBULA FX | $85.25 | $341.00 | $85.32–$1,530.00 | 82% below | 75% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CLOSED RX DIST FIBULA FX | $85.25 | $341.00 | $85.32–$1,530.00 | 82% below | 75% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC CLOSED RX DIST FIBULA FX | $85.25 | $341.00 | $115.26–$289.85 | — | 75% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC PBB CLOSED RX DIST FIBULA FX | $85.25 | $341.00 | $115.26–$289.85 | — | 75% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC PBB CLOSED TX METATARSAL FX W/O MANIP EA | $106.50 | $426.00 | $85.32–$1,530.00 | 62% below | 75% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC CLOSED TX METATARSAL FX W/O MANIP EA | $106.50 | $426.00 | $85.32–$1,530.00 | 62% below | 75% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC PBB CLOSED TX METATARSAL FX W/O MANIP EA | $106.50 | $426.00 | $143.99–$362.10 | — | 75% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC CLOSED TX METATARSAL FX W/O MANIP EA | $106.50 | $426.00 | $143.99–$362.10 | — | 75% |
| Cardiac catheterization with coronary angiogram CPT 93458 HC CATH PLACE/COR ANGIO W/LHC INCL IMG S&I | $4,216.75 | $16,867.00 | $2,400.00–$42,167.50 | 60% below | 75% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 HC CATH PLACE/COR ANGIO W/LHC INCL IMG S&I | $4,216.75 | $16,867.00 | $5,701.05–$14,336.95 | — | 75% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXT - TEE COMPLETE W/ COLOR AND CARDIOVERSION | $342.25 | $1,369.00 | $462.72–$3,422.50 | 74% below | 75% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL | $342.25 | $1,369.00 | $462.72–$3,422.50 | 74% below | 75% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC PBB CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL | $342.25 | $1,369.00 | $462.72–$3,422.50 | 74% below | 75% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXT - TEE COMPLETE W/ CARDIOVERSION | $342.25 | $1,369.00 | $462.72–$3,422.50 | 74% below | 75% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXT - TEE W/ DOPPLER, COLOR AND CARDIOVERSION | $342.25 | $1,369.00 | $462.72–$3,422.50 | 74% below | 75% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC PBB CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL | $342.25 | $1,369.00 | $462.72–$1,163.65 | — | 75% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRIC EXT - TEE W/ DOPPLER, COLOR AND CARDIOVERSION | $342.25 | $1,369.00 | $462.72–$1,163.65 | — | 75% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRIC EXT - TEE COMPLETE W/ COLOR AND CARDIOVERSION | $342.25 | $1,369.00 | $462.72–$1,163.65 | — | 75% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRIC EXT - TEE COMPLETE W/ CARDIOVERSION | $342.25 | $1,369.00 | $462.72–$1,163.65 | — | 75% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL | $342.25 | $1,369.00 | $462.72–$1,163.65 | — | 75% |
| Catheter ablation for atrial fibrillation CPT 93656 HC EP COMP EVAL W/ABLATION PULM VEIN ISOLATION | $15,581.75 | $62,327.00 | $827.00–$155,817.50 | 49% below | 75% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 HC EP COMP EVAL W/ABLATION PULM VEIN ISOLATION | $15,581.75 | $62,327.00 | $21,066.53–$52,977.95 | — | 75% |
| Cervical biopsy CPT 57500 HC BIOPSY CERVIX, 1 OR MORE, OR EXCISION OF LESION | $468.25 | $1,873.00 | $91.36–$4,682.50 | 59% below | 75% |
| Cervical biopsy CPT 57500 HC PBB BIOPSY CERVIX, 1 OR MORE, OR EXCISION OF LESION | $468.25 | $1,873.00 | $91.36–$4,682.50 | 59% below | 75% |
| Cervical biopsy inpatient CPT 57500 HC BIOPSY CERVIX, 1 OR MORE, OR EXCISION OF LESION | $468.25 | $1,873.00 | $633.07–$1,592.05 | — | 75% |
| Cervical biopsy inpatient CPT 57500 HC PBB BIOPSY CERVIX, 1 OR MORE, OR EXCISION OF LESION | $468.25 | $1,873.00 | $633.07–$1,592.05 | — | 75% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC PBB CIRCUMCISION,OTHR | $995.50 | $3,982.00 | $565.00–$9,955.00 | 74% below | 75% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 HC PBB CIRCUMCISION,OTHR | $995.50 | $3,982.00 | $1,345.92–$3,384.70 | — | 75% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION W/CLAMP,OTHER DEVICE W/REG BLOCK | $944.00 | $3,776.00 | $565.00–$9,440.00 | 23% below | 75% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC PBB CIRCUMCISION W/CLAMP,OTHER DEVICE W/REG BLOCK | $944.00 | $3,776.00 | $565.00–$9,440.00 | 23% below | 75% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION W/CLAMP,OTHER DEVICE W/REG BLOCK | $944.00 | $3,776.00 | $1,276.29–$3,209.60 | — | 75% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC PBB CIRCUMCISION W/CLAMP,OTHER DEVICE W/REG BLOCK | $944.00 | $3,776.00 | $1,276.29–$3,209.60 | — | 75% |
| Circumcision, surgical, older than a newborn CPT 54160 HC CIRCUMCISION NEONATE OTHER THAN CLAMP =/< 28DAYS | $349.50 | $1,398.00 | $238.15–$3,495.00 | 85% below | 75% |
| Circumcision, surgical, older than a newborn CPT 54160 HC PBB CIRCUMCISION NEONATE OTHER THAN CLAMP =/< 28DAYS | $349.50 | $1,398.00 | $238.15–$3,495.00 | 85% below | 75% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 HC PBB CIRCUMCISION NEONATE OTHER THAN CLAMP =/< 28DAYS | $349.50 | $1,398.00 | $472.52–$1,188.30 | — | 75% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 HC CIRCUMCISION NEONATE OTHER THAN CLAMP =/< 28DAYS | $349.50 | $1,398.00 | $472.52–$1,188.30 | — | 75% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC PBB CLOSED RX DIST RAD/ULNA FX | $127.25 | $509.00 | $85.32–$1,530.00 | 72% below | 75% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLOSED RX DIST RAD/ULNA FX | $127.25 | $509.00 | $85.32–$1,530.00 | 72% below | 75% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC CLOSED RX DIST RAD/ULNA FX | $127.25 | $509.00 | $172.04–$432.65 | — | 75% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC PBB CLOSED RX DIST RAD/ULNA FX | $127.25 | $509.00 | $172.04–$432.65 | — | 75% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC COLPOSCOPY W/ELECTRODE BIOPSY CERVIX | $784.00 | $3,136.00 | $174.42–$7,840.00 | 78% below | 75% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC PBB COLPOSCOPY W/ELECTRODE BIOPSY CERVIX | $784.00 | $3,136.00 | $174.42–$7,840.00 | 78% below | 75% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 HC COLPOSCOPY W/ELECTRODE BIOPSY CERVIX | $784.00 | $3,136.00 | $1,059.97–$2,665.60 | — | 75% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 HC PBB COLPOSCOPY W/ELECTRODE BIOPSY CERVIX | $784.00 | $3,136.00 | $1,059.97–$2,665.60 | — | 75% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC PBB COLPOSC,CERVIX W/ADJ VAG,W/BX & CURRETAGE | $157.50 | $630.00 | $65.06–$3,000.00 | 36% below | 75% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC COLPOSC,CERVIX W/ADJ VAG,W/BX & CURRETAGE | $157.50 | $630.00 | $65.06–$3,000.00 | 36% below | 75% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HC PBB COLPOSC,CERVIX W/ADJ VAG,W/BX & CURRETAGE | $157.50 | $630.00 | $212.94–$535.50 | — | 75% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HC COLPOSC,CERVIX W/ADJ VAG,W/BX & CURRETAGE | $157.50 | $630.00 | $212.94–$535.50 | — | 75% |
| Coronary stent placement, one artery CPT 92928 HC PRQ TRLUML COR STENT W/ANGIO 1 ART/BRANCH(ES) | $3,824.50 | $15,298.00 | $2,400.00–$38,245.00 | 67% below | 75% |
| Coronary stent placement, one artery inpatient CPT 92928 HC PRQ TRLUML COR STENT W/ANGIO 1 ART/BRANCH(ES) | $3,824.50 | $15,298.00 | $5,170.72–$13,003.30 | — | 75% |
| Cystoscopy with ureteral stent placement CPT 52332 HC CYSTO WITH URETERAL STENT INSERT | $1,238.75 | $4,955.00 | $565.00–$12,387.50 | 71% below | 75% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 HC CYSTO WITH URETERAL STENT INSERT | $1,238.75 | $4,955.00 | $1,674.79–$4,211.75 | — | 75% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOSCOPY | $255.50 | $1,022.00 | $238.15–$2,555.00 | 78% below | 75% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC PBB CYSTOSCOPY | $255.50 | $1,022.00 | $238.15–$2,555.00 | 78% below | 75% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOSCOPY | $255.50 | $1,022.00 | $345.44–$868.70 | — | 75% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC PBB CYSTOSCOPY | $255.50 | $1,022.00 | $345.44–$868.70 | — | 75% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 HC D & C W/O SUCTION | $1,089.50 | $4,358.00 | $565.00–$10,895.00 | 73% below | 75% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC D & C W/O SUCTION | $1,089.50 | $4,358.00 | $1,473.00–$3,704.30 | — | 75% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC PBB DESTRUC BENIGN/PREMAL,FIRST LESION | $67.50 | $270.00 | $91.26–$1,530.00 | 66% below | 75% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUC BENIGN/PREMAL,FIRST LESION | $67.50 | $270.00 | $91.26–$675.00 | 66% below | 75% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC PBB DESTRUC BENIGN/PREMAL,FIRST LESION | $67.50 | $270.00 | $91.26–$229.50 | — | 75% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUC BENIGN/PREMAL,FIRST LESION | $67.50 | $270.00 | $91.26–$229.50 | — | 75% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC CREATE EARDRUM OPENING | $189.00 | $756.00 | $117.66–$3,340.00 | 76% below | 75% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC PBB CREATE EARDRUM OPENING | $189.00 | $756.00 | $117.66–$3,340.00 | 76% below | 75% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 HC CREATE EARDRUM OPENING | $189.00 | $756.00 | $255.53–$642.60 | — | 75% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 HC PBB CREATE EARDRUM OPENING | $189.00 | $756.00 | $255.53–$642.60 | — | 75% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $112.50 | $450.00 | $59.26–$1,125.00 | 1% above | 75% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC PBB REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $112.50 | $450.00 | $59.26–$1,125.00 | 1% above | 75% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC PBB REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $112.50 | $450.00 | $152.10–$382.50 | — | 75% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $112.50 | $450.00 | $152.10–$382.50 | — | 75% |
| Earwax removal with instruments, one ear both sides CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION BILATERAL | $112.50 | $450.00 | $59.26–$1,125.00 | — | 75% |
| Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $112.50 | $450.00 | $59.26–$1,125.00 | 9% below | 75% |
| Earwax removal with instruments, one ear one side CPT 69210 HC PBB REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $112.50 | $450.00 | $59.26–$1,125.00 | 9% below | 75% |
| Earwax removal with instruments, one ear inpatient both sides CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION BILATERAL | $112.50 | $450.00 | $152.10–$382.50 | — | 75% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 HC PBB REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $112.50 | $450.00 | $152.10–$382.50 | — | 75% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $112.50 | $450.00 | $152.10–$382.50 | — | 75% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC PBB BIOPSY OF UTERUS LINING | $101.25 | $405.00 | $45.96–$1,530.00 | 73% below | 75% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC BIOPSY OF UTERUS LINING | $101.25 | $405.00 | $45.96–$1,530.00 | 73% below | 75% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC PBB BIOPSY OF UTERUS LINING | $101.25 | $405.00 | $136.89–$344.25 | — | 75% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC BIOPSY OF UTERUS LINING | $101.25 | $405.00 | $136.89–$344.25 | — | 75% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN | $311.00 | $1,244.00 | $262.86–$3,110.00 | 78% below | 75% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC PBB NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN | $311.00 | $1,244.00 | $262.86–$3,110.00 | 78% below | 75% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN | $311.00 | $1,244.00 | $420.47–$1,057.40 | — | 75% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC PBB NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN | $311.00 | $1,244.00 | $420.47–$1,057.40 | — | 75% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 HC INJECT INTRAVITREAL PHARMCOLOGIC | $143.00 | $572.00 | $48.45–$1,530.00 | 73% below | 75% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 HC PBB INJECT INTRAVITREAL PHARMCOLOGIC | $143.00 | $572.00 | $48.45–$1,530.00 | 73% below | 75% |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HC PBB INJECT INTRAVITREAL PHARMCOLOGIC | $143.00 | $572.00 | $193.34–$486.20 | — | 75% |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HC INJECT INTRAVITREAL PHARMCOLOGIC | $143.00 | $572.00 | $193.34–$486.20 | — | 75% |
| Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 HC INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1ST LEVEL BILATERAL | $465.00 | $1,860.00 | $340.77–$4,650.00 | — | 75% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1ST LEVEL | $465.00 | $1,860.00 | $340.77–$4,650.00 | 73% below | 75% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC PBB INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1ST LEVEL | $465.00 | $1,860.00 | $340.77–$4,650.00 | 73% below | 75% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient both sides CPT 64493 HC INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1ST LEVEL BILATERAL | $465.00 | $1,860.00 | $628.68–$1,581.00 | — | 75% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1ST LEVEL | $465.00 | $1,860.00 | $628.68–$1,581.00 | — | 75% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC PBB INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1ST LEVEL | $465.00 | $1,860.00 | $628.68–$1,581.00 | — | 75% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 HC REPAIR AA HERNIA INITIAL <3CM REDUCIBLE | $2,287.50 | $9,150.00 | $1,151.54–$22,875.00 | 64% below | 75% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 HC REPAIR AA HERNIA INITIAL <3CM REDUCIBLE | $2,287.50 | $9,150.00 | $3,092.70–$7,777.50 | — | 75% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC PBB LIGATION HEMORRHOID(S) | $490.00 | $1,960.00 | $163.62–$4,900.00 | 45% below | 75% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC LIGATION HEMORRHOID(S) | $490.00 | $1,960.00 | $163.62–$4,900.00 | 45% below | 75% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC PBB LIGATION HEMORRHOID(S) | $490.00 | $1,960.00 | $662.48–$1,666.00 | — | 75% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC LIGATION HEMORRHOID(S) | $490.00 | $1,960.00 | $662.48–$1,666.00 | — | 75% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HC PBB HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP | $1,772.25 | $7,089.00 | $565.00–$17,722.50 | 51% below | 75% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HC HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP | $1,772.25 | $7,089.00 | $565.00–$17,722.50 | 51% below | 75% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HC PBB HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP | $1,772.25 | $7,089.00 | $2,396.08–$6,025.65 | — | 75% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HC HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP | $1,772.25 | $7,089.00 | $2,396.08–$6,025.65 | — | 75% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC INJECT HYSTEROSALPINGOGRAM | $77.25 | $309.00 | $104.44–$1,530.00 | 79% below | 75% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC PBB CATH/INJECT HYSTEROSALPINGOGRAM | $77.25 | $309.00 | $104.44–$1,530.00 | 79% below | 75% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC INJECT HYSTEROSALPINGOGRAM | $77.25 | $309.00 | $104.44–$262.65 | — | 75% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC PBB CATH/INJECT HYSTEROSALPINGOGRAM | $77.25 | $309.00 | $104.44–$262.65 | — | 75% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC PBB HYSTEROSCOPY W/REMOVE ADHESIONS/POLYPS | $999.50 | $3,998.00 | $565.00–$9,995.00 | 79% below | 75% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC HYSTEROSCOPY W/REMOVE ADHESIONS/POLYPS | $999.50 | $3,998.00 | $565.00–$9,995.00 | 79% below | 75% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HC HYSTEROSCOPY W/REMOVE ADHESIONS/POLYPS | $999.50 | $3,998.00 | $1,351.32–$3,398.30 | — | 75% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HC PBB HYSTEROSCOPY W/REMOVE ADHESIONS/POLYPS | $999.50 | $3,998.00 | $1,351.32–$3,398.30 | — | 75% |
| IUD insertion (the device itself billed separately) CPT 58300 HC INSERT INTRAUTERINE DEVICE | $282.25 | $1,129.00 | $68.82–$2,822.50 | 25% below | 75% |
| IUD insertion (the device itself billed separately) CPT 58300 HC PBB INSERT INTRAUTERINE DEVICE | $282.25 | $1,129.00 | $68.82–$2,822.50 | 25% below | 75% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 HC PBB INSERT INTRAUTERINE DEVICE | $282.25 | $1,129.00 | $381.60–$959.65 | — | 75% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 HC INSERT INTRAUTERINE DEVICE | $282.25 | $1,129.00 | $381.60–$959.65 | — | 75% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC PBB DRAIN SKIN ABSCESS SIMPLE | $134.00 | $536.00 | $65.06–$1,530.00 | 69% below | 75% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC DRAIN SKIN ABSCESS SIMPLE | $134.00 | $536.00 | $65.06–$1,530.00 | 69% below | 75% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC DRAIN SKIN ABSCESS SIMPLE | $134.00 | $536.00 | $181.17–$455.60 | — | 75% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC PBB DRAIN SKIN ABSCESS SIMPLE | $134.00 | $536.00 | $181.17–$455.60 | — | 75% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC PBB INJECT TENDON SHEATH/LIGAMENT | $104.75 | $419.00 | $23.54–$1,530.00 | 74% below | 75% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJECT TENDON SHEATH/LIGAMENT | $104.75 | $419.00 | $23.54–$1,530.00 | 74% below | 75% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJECT TENDON SHEATH/LIGAMENT | $104.75 | $419.00 | $141.62–$356.15 | — | 75% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC PBB INJECT TENDON SHEATH/LIGAMENT | $104.75 | $419.00 | $141.62–$356.15 | — | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $128.75 | $515.00 | $27.96–$1,530.00 | 78% below | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PBB ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $128.75 | $515.00 | $27.96–$1,530.00 | 78% below | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC PBB ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $128.75 | $515.00 | $174.07–$437.75 | — | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $128.75 | $515.00 | $174.07–$437.75 | — | 75% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC PBB INSERT DRUG DELIVERY IMPLANT | $203.50 | $814.00 | $46.38–$2,035.00 | 15% below | 75% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERT DRUG DELIVERY IMPLANT | $203.50 | $814.00 | $46.38–$2,035.00 | 15% below | 75% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC PBB INSERT DRUG DELIVERY IMPLANT | $203.50 | $814.00 | $275.13–$691.90 | — | 75% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERT DRUG DELIVERY IMPLANT | $203.50 | $814.00 | $275.13–$691.90 | — | 75% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC PBB ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US | $128.75 | $515.00 | $23.54–$1,530.00 | 78% below | 75% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US | $128.75 | $515.00 | $23.54–$1,530.00 | 78% below | 75% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC PBB ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US | $128.75 | $515.00 | $174.07–$437.75 | — | 75% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US | $128.75 | $515.00 | $174.07–$437.75 | — | 75% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US | $128.75 | $515.00 | $22.70–$1,530.00 | 70% below | 75% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC PBB ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US | $128.75 | $515.00 | $22.70–$1,530.00 | 70% below | 75% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US | $128.75 | $515.00 | $174.07–$437.75 | — | 75% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC PBB ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US | $128.75 | $515.00 | $174.07–$437.75 | — | 75% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC PBB REPAIR WND INTERM <2.5CM SCALP,AX,TRUNK,EXTREM | $301.00 | $1,204.00 | $143.08–$3,010.00 | 43% below | 75% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC REPAIR WND INTERM <2.5CM SCALP,AX,TRUNK,EXTREM | $301.00 | $1,204.00 | $143.08–$3,010.00 | 43% below | 75% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC PBB REPAIR WND INTERM <2.5CM SCALP,AX,TRUNK,EXTREM | $301.00 | $1,204.00 | $406.95–$1,023.40 | — | 75% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC REPAIR WND INTERM <2.5CM SCALP,AX,TRUNK,EXTREM | $301.00 | $1,204.00 | $406.95–$1,023.40 | — | 75% |
| Left heart catheterization, diagnostic one side CPT 93452 HC CATH LEFT HEART CATH INJECT VETRICULOGRAPHY, IMAGE SUPERVISE/INTERP | $2,389.25 | $9,557.00 | $2,400.00–$23,892.50 | 74% below | 75% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HC CATH LEFT HEART CATH INJECT VETRICULOGRAPHY, IMAGE SUPERVISE/INTERP | $2,389.25 | $9,557.00 | $3,230.27–$8,123.45 | — | 75% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC PBB NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $288.00 | $1,152.00 | $262.86–$2,880.00 | 83% below | 75% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $288.00 | $1,152.00 | $262.86–$2,880.00 | 83% below | 75% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $288.00 | $1,152.00 | $389.38–$979.20 | — | 75% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC PBB NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $288.00 | $1,152.00 | $389.38–$979.20 | — | 75% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $383.25 | $1,533.00 | $262.86–$3,832.50 | 69% below | 75% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC PBB NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $383.25 | $1,533.00 | $262.86–$3,832.50 | 69% below | 75% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC PBB NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $383.25 | $1,533.00 | $518.15–$1,303.05 | — | 75% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $383.25 | $1,533.00 | $518.15–$1,303.05 | — | 75% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE BILATERAL,1 LEVEL | $417.00 | $1,668.00 | $340.77–$4,170.00 | — | 75% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC PBB INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL | $417.00 | $1,668.00 | $340.77–$4,170.00 | 72% below | 75% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL | $417.00 | $1,668.00 | $340.77–$4,170.00 | 72% below | 75% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE BILATERAL,1 LEVEL | $417.00 | $1,668.00 | $563.78–$1,417.80 | — | 75% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC PBB INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL | $417.00 | $1,668.00 | $563.78–$1,417.80 | — | 75% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL | $417.00 | $1,668.00 | $563.78–$1,417.80 | — | 75% |
| Miscarriage treatment with D&C, first trimester CPT 59820 HC CARE OF MISCARRIAGE | $1,348.75 | $5,395.00 | $565.00–$13,487.50 | 63% below | 75% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HC CARE OF MISCARRIAGE | $1,348.75 | $5,395.00 | $1,823.51–$4,585.75 | — | 75% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC BENIGN LESION +MARGIN <0.5CM TRNK/EXTR | $420.50 | $1,682.00 | $77.79–$4,205.00 | 48% below | 75% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC PBB EXC BENIGN LESION +MARGIN <0.5CM TRNK/EXTR | $420.50 | $1,682.00 | $77.79–$4,205.00 | 48% below | 75% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC PBB EXC BENIGN LESION +MARGIN <0.5CM TRNK/EXTR | $420.50 | $1,682.00 | $568.52–$1,429.70 | — | 75% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC BENIGN LESION +MARGIN <0.5CM TRNK/EXTR | $420.50 | $1,682.00 | $568.52–$1,429.70 | — | 75% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXC SKIN BENIG <0.5CM FACE/EAR/EYELID/NOSE/LIP/MUCOUS MEMBRANE | $274.75 | $1,099.00 | $86.38–$3,000.00 | 68% below | 75% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC PBB EXC SKIN BENIG <0.5CM FACE/EAR/EYELID/NOSE/LIP/MUCOUS MEMBRANE | $274.75 | $1,099.00 | $86.38–$3,000.00 | 68% below | 75% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC PBB EXC SKIN BENIG <0.5CM FACE/EAR/EYELID/NOSE/LIP/MUCOUS MEMBRANE | $274.75 | $1,099.00 | $371.46–$934.15 | — | 75% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC EXC SKIN BENIG <0.5CM FACE/EAR/EYELID/NOSE/LIP/MUCOUS MEMBRANE | $274.75 | $1,099.00 | $371.46–$934.15 | — | 75% |
| Nail removal (partial or complete), one nail CPT 11730 HC PBB REMOVAL OF NAIL PLATE | $118.25 | $473.00 | $159.87–$1,530.00 | 58% below | 75% |
| Nail removal (partial or complete), one nail CPT 11730 HC REMOVAL OF NAIL PLATE | $118.25 | $473.00 | $159.87–$1,530.00 | 58% below | 75% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC PBB REMOVAL OF NAIL PLATE | $118.25 | $473.00 | $159.87–$402.05 | — | 75% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC REMOVAL OF NAIL PLATE | $118.25 | $473.00 | $159.87–$402.05 | — | 75% |
| Occipital nerve block (injection for headaches) both sides CPT 64405 HC INJECT NERV BLCK,BILAT GREAT OCCIPTL | $320.00 | $1,280.00 | $30.18–$3,200.00 | — | 75% |
| Occipital nerve block (injection for headaches) CPT 64405 HC PBB INJECT NERV BLCK,GREAT OCCIPTL | $226.75 | $907.00 | $30.18–$2,267.50 | 47% below | 75% |
| Occipital nerve block (injection for headaches) CPT 64405 HC INJECT NERV BLCK,GREAT OCCIPTL | $226.75 | $907.00 | $30.18–$2,267.50 | 47% below | 75% |
| Occipital nerve block (injection for headaches) inpatient both sides CPT 64405 HC INJECT NERV BLCK,BILAT GREAT OCCIPTL | $320.00 | $1,280.00 | $432.64–$1,088.00 | — | 75% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJECT NERV BLCK,GREAT OCCIPTL | $226.75 | $907.00 | $306.57–$770.95 | — | 75% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC PBB INJECT NERV BLCK,GREAT OCCIPTL | $226.75 | $907.00 | $306.57–$770.95 | — | 75% |
| Pacemaker implant (dual chamber) CPT 33208 HC INSERT/REPLACE PGEN W/LEADS;A/V | $4,633.25 | $18,533.00 | $1,062.00–$46,332.50 | 76% below | 75% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 HC INSERT/REPLACE PGEN W/LEADS;A/V | $4,633.25 | $18,533.00 | $6,264.15–$15,753.05 | — | 75% |
| Paracentesis with imaging guidance CPT 49083 HC PBB ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE | $800.00 | $3,200.00 | $334.95–$8,000.00 | 45% below | 75% |
| Paracentesis with imaging guidance CPT 49083 HC ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE | $800.00 | $3,200.00 | $334.95–$8,000.00 | 45% below | 75% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC PBB ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE | $800.00 | $3,200.00 | $1,081.60–$2,720.00 | — | 75% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE | $800.00 | $3,200.00 | $1,081.60–$2,720.00 | — | 75% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC PBB REMOVAL OF NAIL BED | $226.00 | $904.00 | $84.71–$2,260.00 | 56% below | 75% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL OF NAIL BED | $226.00 | $904.00 | $84.71–$2,260.00 | 56% below | 75% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC REMOVAL OF NAIL BED | $226.00 | $904.00 | $305.55–$768.40 | — | 75% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC PBB REMOVAL OF NAIL BED | $226.00 | $904.00 | $305.55–$768.40 | — | 75% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DESTROY L/S FACET JNT W/IMAG | $900.75 | $3,603.00 | $565.00–$9,007.50 | 68% below | 75% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC PBB DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL | $900.75 | $3,603.00 | $565.00–$9,007.50 | 68% below | 75% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC DESTROY L/S FACET JNT W/IMAG | $900.75 | $3,603.00 | $1,217.81–$3,062.55 | — | 75% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC PBB DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL | $900.75 | $3,603.00 | $1,217.81–$3,062.55 | — | 75% |
| Removal of a foreign object under the skin, simple CPT 10120 HC REMOVE FOREIGN BODY SIMPLE | $276.50 | $1,106.00 | $86.38–$2,765.00 | 47% below | 75% |
| Removal of a foreign object under the skin, simple CPT 10120 HC PBB REMOVE FOREIGN BODY SIMPLE | $276.50 | $1,106.00 | $86.38–$2,765.00 | 47% below | 75% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC PBB REMOVE FOREIGN BODY SIMPLE | $276.50 | $1,106.00 | $373.83–$940.10 | — | 75% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMOVE FOREIGN BODY SIMPLE | $276.50 | $1,106.00 | $373.83–$940.10 | — | 75% |
| Short arm cast (elbow to hand) CPT 29075 HC APPLY FOREARM CAST | $108.00 | $432.00 | $45.13–$1,080.00 | 61% below | 75% |
| Short arm cast (elbow to hand) CPT 29075 HC APPLY SHORT ARM CAST | $108.00 | $432.00 | $45.13–$1,080.00 | 61% below | 75% |
| Short arm cast (elbow to hand) CPT 29075 HC OT APPLY FOREARM CAST | $108.00 | $432.00 | $45.13–$1,080.00 | 61% below | 75% |
| Short arm cast (elbow to hand) CPT 29075 HC PBB APPLY SHORT ARM CAST | $108.00 | $432.00 | $45.13–$1,080.00 | 61% below | 75% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLY FOREARM CAST | $108.00 | $432.00 | $146.02–$367.20 | — | 75% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC PBB APPLY SHORT ARM CAST | $108.00 | $432.00 | $146.02–$367.20 | — | 75% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLY SHORT ARM CAST | $108.00 | $432.00 | $146.02–$367.20 | — | 75% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC OT APPLY FOREARM CAST | $108.00 | $432.00 | $146.02–$367.20 | — | 75% |
| Short arm splint (forearm and hand) CPT 29125 HC PBB APPLY SHORT ARM SPLINT, STATIC | $57.00 | $228.00 | $77.06–$570.00 | 75% below | 75% |
| Short arm splint (forearm and hand) CPT 29125 HC OT APPLY FOREARM SPLINT,STATIC | $57.00 | $228.00 | $64.00–$570.00 | 75% below | 75% |
| Short arm splint (forearm and hand) CPT 29125 HC APPLY SHORT ARM SPLINT, STATIC | $57.00 | $228.00 | $77.06–$570.00 | 75% below | 75% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC PBB APPLY SHORT ARM SPLINT, STATIC | $57.00 | $228.00 | $77.06–$193.80 | — | 75% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY SHORT ARM SPLINT, STATIC | $57.00 | $228.00 | $77.06–$193.80 | — | 75% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC OT APPLY FOREARM SPLINT,STATIC | $57.00 | $228.00 | $77.06–$193.80 | — | 75% |
| Short leg cast (below the knee) CPT 29405 HC PT APPLY SHORT LEG CAST | $118.75 | $475.00 | $39.03–$1,187.50 | 65% below | 75% |
| Short leg cast (below the knee) CPT 29405 HC PBB PT APPLY SHORT LEG CAST | $118.75 | $475.00 | $39.03–$1,187.50 | 65% below | 75% |
| Short leg cast (below the knee) CPT 29405 HC OT APPLY SHORT LEG CAST | $118.75 | $475.00 | $39.03–$1,187.50 | 65% below | 75% |
| Short leg cast (below the knee) CPT 29405 HC APPLY SHORT LEG CAST | $118.75 | $475.00 | $39.03–$1,187.50 | 65% below | 75% |
| Short leg cast (below the knee) CPT 29405 HC PBB APPLY SHORT LEG CAST | $118.75 | $475.00 | $39.03–$1,187.50 | 65% below | 75% |
| Short leg cast (below the knee) inpatient CPT 29405 HC PBB PT APPLY SHORT LEG CAST | $118.75 | $475.00 | $160.55–$403.75 | — | 75% |
| Short leg cast (below the knee) inpatient CPT 29405 HC APPLY SHORT LEG CAST | $118.75 | $475.00 | $160.55–$403.75 | — | 75% |
| Short leg cast (below the knee) inpatient CPT 29405 HC PT APPLY SHORT LEG CAST | $118.75 | $475.00 | $160.55–$403.75 | — | 75% |
| Short leg cast (below the knee) inpatient CPT 29405 HC OT APPLY SHORT LEG CAST | $118.75 | $475.00 | $160.55–$403.75 | — | 75% |
| Short leg cast (below the knee) inpatient CPT 29405 HC PBB APPLY SHORT LEG CAST | $118.75 | $475.00 | $160.55–$403.75 | — | 75% |
| Short leg splint (calf to foot) CPT 29515 HC PBB APPLY SHORT LEG SPLINT | $71.75 | $287.00 | $34.33–$717.50 | 73% below | 75% |
| Short leg splint (calf to foot) CPT 29515 HC OT APPLY LOWER LEG SPLINT | $71.75 | $287.00 | $34.33–$717.50 | 73% below | 75% |
| Short leg splint (calf to foot) CPT 29515 HC APPLY SHORT LEG SPLINT | $71.75 | $287.00 | $34.33–$717.50 | 73% below | 75% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC OT APPLY LOWER LEG SPLINT | $71.75 | $287.00 | $97.01–$243.95 | — | 75% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC APPLY SHORT LEG SPLINT | $71.75 | $287.00 | $97.01–$243.95 | — | 75% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC PBB APPLY SHORT LEG SPLINT | $71.75 | $287.00 | $97.01–$243.95 | — | 75% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC PBB REPAIR SUPERFICIAL WND SIMPLE =/< 2.5CM SCALP,N,AX,GEN,TRUNK,EXTREM | $123.25 | $493.00 | $166.63–$1,530.00 | 63% below | 75% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC REPAIR SUPERFICIAL WND SIMPLE =/< 2.5CM SCALP,N,AX,GEN,TRUNK,EXTREM | $123.25 | $493.00 | $166.63–$1,530.00 | 63% below | 75% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC REPAIR SUPERFICIAL WND SIMPLE =/< 2.5CM SCALP,N,AX,GEN,TRUNK,EXTREM | $123.25 | $493.00 | $166.63–$419.05 | — | 75% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC PBB REPAIR SUPERFICIAL WND SIMPLE =/< 2.5CM SCALP,N,AX,GEN,TRUNK,EXTREM | $123.25 | $493.00 | $166.63–$419.05 | — | 75% |
| Skin biopsy, punch, one lesion CPT 11104 HC PBB PUNCH SKIN BX SNGL LESION | $174.50 | $698.00 | $79.46–$1,745.00 | 59% below | 75% |
| Skin biopsy, punch, one lesion CPT 11104 HC PUNCH SKIN BX SNGL LESION | $174.50 | $698.00 | $79.46–$1,745.00 | 59% below | 75% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH SKIN BX SNGL LESION | $174.50 | $698.00 | $235.92–$593.30 | — | 75% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC PBB PUNCH SKIN BX SNGL LESION | $174.50 | $698.00 | $235.92–$593.30 | — | 75% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC EXC MALIG LESION =< 0.5CM TRNK/ARMS/LEGS | $254.50 | $1,018.00 | $112.68–$2,545.00 | 78% below | 75% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC PBB EXC MALIG LESION =< 0.5CM TRNK/ARMS/LEGS | $254.50 | $1,018.00 | $112.68–$2,545.00 | 78% below | 75% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 HC PBB EXC MALIG LESION =< 0.5CM TRNK/ARMS/LEGS | $254.50 | $1,018.00 | $344.08–$865.30 | — | 75% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 HC EXC MALIG LESION =< 0.5CM TRNK/ARMS/LEGS | $254.50 | $1,018.00 | $344.08–$865.30 | — | 75% |
| Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL OF SKIN TAGS, UP TO 15 | $84.75 | $339.00 | $114.58–$1,530.00 | 72% below | 75% |
| Skin tag removal, up to 15 tags CPT 11200 HC PBB REMOVAL OF SKIN TAGS, UP TO 15 | $84.75 | $339.00 | $114.58–$1,530.00 | 72% below | 75% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVAL OF SKIN TAGS, UP TO 15 | $84.75 | $339.00 | $114.58–$288.15 | — | 75% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC PBB REMOVAL OF SKIN TAGS, UP TO 15 | $84.75 | $339.00 | $114.58–$288.15 | — | 75% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC PBB SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC | $454.25 | $1,817.00 | $262.86–$4,542.50 | 57% below | 75% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC | $454.25 | $1,817.00 | $262.86–$4,542.50 | 57% below | 75% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC | $454.25 | $1,817.00 | $614.15–$1,544.45 | — | 75% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC PBB SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC | $454.25 | $1,817.00 | $614.15–$1,544.45 | — | 75% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC PBB REPAIR SUPERFICIAL WND SIMPLE 2.6-7.5CM SCALP,N,AX,GEN,TRUNK,EXTREM | $133.00 | $532.00 | $179.82–$4,400.00 | 66% below | 75% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC REPAIR SUPERFICIAL WND SIMPLE 2.6-7.5CM SCALP,N,AX,GEN,TRUNK,EXTREM | $133.00 | $532.00 | $179.82–$4,400.00 | 66% below | 75% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC REPAIR SUPERFICIAL WND SIMPLE 2.6-7.5CM SCALP,N,AX,GEN,TRUNK,EXTREM | $133.00 | $532.00 | $179.82–$452.20 | — | 75% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC PBB REPAIR SUPERFICIAL WND SIMPLE 2.6-7.5CM SCALP,N,AX,GEN,TRUNK,EXTREM | $133.00 | $532.00 | $179.82–$452.20 | — | 75% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC REPAIR SUPERFICIAL WND SIMPLE =/< 2.5CM FACE,EAR,EYELID,NOSE,LIP,MM | $133.00 | $532.00 | $179.82–$4,400.00 | 66% below | 75% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC PBB REPAIR SUPERFICIAL WND SIMPLE =/< 2.5CM FACE,EAR,EYELID,NOSE,LIP,MM | $133.00 | $532.00 | $179.82–$4,400.00 | 66% below | 75% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC PBB REPAIR SUPERFICIAL WND SIMPLE =/< 2.5CM FACE,EAR,EYELID,NOSE,LIP,MM | $133.00 | $532.00 | $179.82–$452.20 | — | 75% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC REPAIR SUPERFICIAL WND SIMPLE =/< 2.5CM FACE,EAR,EYELID,NOSE,LIP,MM | $133.00 | $532.00 | $179.82–$452.20 | — | 75% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL SKIN BX SNGL SHAVE/SCOOP/CURETTE LESION | $174.50 | $698.00 | $64.23–$1,745.00 | 52% below | 75% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC PBB TANGENTIAL SKIN BX SNGL SHAVE/SCOOP/CURETTE LESION | $174.50 | $698.00 | $64.23–$1,745.00 | 52% below | 75% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC PBB TANGENTIAL SKIN BX SNGL SHAVE/SCOOP/CURETTE LESION | $174.50 | $698.00 | $235.92–$593.30 | — | 75% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGENTIAL SKIN BX SNGL SHAVE/SCOOP/CURETTE LESION | $174.50 | $698.00 | $235.92–$593.30 | — | 75% |
| Thoracentesis with imaging guidance CPT 32555 HC PBB THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING | $412.50 | $1,650.00 | $223.75–$4,125.00 | 71% below | 75% |
| Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING | $412.50 | $1,650.00 | $223.75–$4,125.00 | 71% below | 75% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING | $412.50 | $1,650.00 | $557.70–$1,402.50 | — | 75% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC PBB THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING | $412.50 | $1,650.00 | $557.70–$1,402.50 | — | 75% |
| Trigger finger release surgery CPT 26055 HC PBB INCISE FINGER TENDON SHEATH | $728.25 | $2,913.00 | $494.00–$7,282.50 | 70% below | 75% |
| Trigger finger release surgery CPT 26055 HC INCISE FINGER TENDON SHEATH | $728.25 | $2,913.00 | $494.00–$7,282.50 | 70% below | 75% |
| Trigger finger release surgery inpatient CPT 26055 HC PBB INCISE FINGER TENDON SHEATH | $728.25 | $2,913.00 | $984.59–$2,476.05 | — | 75% |
| Trigger finger release surgery inpatient CPT 26055 HC INCISE FINGER TENDON SHEATH | $728.25 | $2,913.00 | $984.59–$2,476.05 | — | 75% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC PBB INJECT TRIGGER POINT, 1 OR 2 | $104.75 | $419.00 | $23.26–$1,530.00 | 76% below | 75% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC INJECT TRIGGER POINT, 1 OR 2 | $104.75 | $419.00 | $23.26–$1,530.00 | 76% below | 75% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJECT TRIGGER POINT, 1 OR 2 | $104.75 | $419.00 | $141.62–$356.15 | — | 75% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC PBB INJECT TRIGGER POINT, 1 OR 2 | $104.75 | $419.00 | $141.62–$356.15 | — | 75% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion both sides CPT 19083 HC BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE BILATERAL | $689.25 | $2,757.00 | $486.45–$6,892.50 | — | 75% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE | $689.25 | $2,757.00 | $486.45–$6,892.50 | 75% below | 75% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient both sides CPT 19083 HC BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE BILATERAL | $689.25 | $2,757.00 | $931.87–$2,343.45 | — | 75% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE | $689.25 | $2,757.00 | $931.87–$2,343.45 | — | 75% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 HC VASECTOMY | $736.25 | $2,945.00 | $565.00–$7,362.50 | 84% below | 75% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 HC PBB VASECTOMY | $736.25 | $2,945.00 | $565.00–$7,362.50 | 84% below | 75% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 HC VASECTOMY | $736.25 | $2,945.00 | $995.41–$2,503.25 | — | 75% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 HC PBB VASECTOMY | $736.25 | $2,945.00 | $995.41–$2,503.25 | — | 75% |
| Wart removal, up to 14 warts CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14 | $241.00 | $964.00 | $201.55–$2,410.00 | 20% above | 75% |
| Wart removal, up to 14 warts CPT 17110 HC PBB DESTRUCTION BENIGN LESIONS UP TO 14 | $241.00 | $964.00 | $201.55–$2,410.00 | 20% above | 75% |
| Wart removal, up to 14 warts inpatient CPT 17110 HC PBB DESTRUCTION BENIGN LESIONS UP TO 14 | $241.00 | $964.00 | $325.83–$819.40 | — | 75% |
| Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14 | $241.00 | $964.00 | $325.83–$819.40 | — | 75% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM | $254.25 | $1,017.00 | $143.08–$3,000.00 | 75% below | 75% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC PBB DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM | $254.25 | $1,017.00 | $143.08–$3,000.00 | 75% below | 75% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM | $254.25 | $1,017.00 | $343.75–$864.45 | — | 75% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC PBB DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM | $254.25 | $1,017.00 | $343.75–$864.45 | — | 75% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION SERVICE | $213.25 | $853.00 | $30.73–$2,132.50 | 72% below | 75% |
| Blood transfusion (giving blood or blood components) CPT 36430 HC PBB BLOOD TRANSFUSION SERVICE | $213.25 | $853.00 | $30.73–$2,132.50 | 72% below | 75% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION SERVICE | $213.25 | $853.00 | $288.31–$725.05 | — | 75% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC PBB BLOOD TRANSFUSION SERVICE | $213.25 | $853.00 | $288.31–$725.05 | — | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC PBB INHALATION TREATMENT | $140.25 | $561.00 | $33.00–$1,402.50 | 31% below | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT INDUCED SPUTUM | $140.25 | $561.00 | $33.00–$1,402.50 | 31% below | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT INHALATION TREATMENT SUBSEQUENT | $140.25 | $561.00 | $33.00–$1,402.50 | 31% below | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT INDUCED SPUTUM SUBSEQUENT | $140.25 | $561.00 | $33.00–$1,402.50 | 31% below | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT EZPAP TREATMENT | $140.25 | $561.00 | $33.00–$1,402.50 | 31% below | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT MDI/DPI | $140.25 | $561.00 | $33.00–$1,402.50 | 31% below | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT INHALATION TREATMENT | $140.25 | $561.00 | $33.00–$1,402.50 | 31% below | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC PBB INHALATION TREATMENT | $140.25 | $561.00 | $189.62–$476.85 | — | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT INHALATION TREATMENT SUBSEQUENT | $140.25 | $561.00 | $189.62–$476.85 | — | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT INDUCED SPUTUM | $140.25 | $561.00 | $189.62–$476.85 | — | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT MDI/DPI | $140.25 | $561.00 | $189.62–$476.85 | — | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT INHALATION TREATMENT | $140.25 | $561.00 | $189.62–$476.85 | — | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT INDUCED SPUTUM SUBSEQUENT | $140.25 | $561.00 | $189.62–$476.85 | — | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT EZPAP TREATMENT | $140.25 | $561.00 | $189.62–$476.85 | — | 75% |
| Chemotherapy IV infusion, first hour CPT 96413 HC CHEMOTHER, IV INFUSION, 1 HR | $236.50 | $946.00 | $319.75–$2,365.00 | 56% below | 75% |
| Chemotherapy IV infusion, first hour CPT 96413 HC PBB CHEMOTHER, IV INFUSION, 1 HR | $236.50 | $946.00 | $319.75–$2,365.00 | 56% below | 75% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMOTHER, IV INFUSION, 1 HR | $236.50 | $946.00 | $319.75–$804.10 | — | 75% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC PBB CHEMOTHER, IV INFUSION, 1 HR | $236.50 | $946.00 | $319.75–$804.10 | — | 75% |
| Comprehensive eye exam by an eye doctor, new patient CPT 92004 HC EYE EXAM NEW PATIENT | $50.19 | $200.75 | $67.85–$4,400.00 | 79% below | 75% |
| Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 HC EYE EXAM NEW PATIENT | $50.19 | $200.75 | $67.85–$170.64 | — | 75% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC PBB COMPREHENSIVE HEARING TEST | $167.50 | $670.00 | $62.00–$1,675.00 | 44% below | 75% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HC PBB COMPREHENSIVE HEARING TEST | $167.50 | $670.00 | $226.46–$569.50 | — | 75% |
| Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE, E/M 30-74 MINUTES | $2,320.75 | $9,283.00 | $750.00–$23,207.50 | 9% below | 75% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE, E/M 30-74 MINUTES | $2,320.75 | $9,283.00 | $3,137.65–$7,890.55 | — | 75% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE AND DROWSY RECORD | $437.50 | $1,750.00 | $216.91–$4,375.00 | 52% below | 75% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG AWAKE AND DROWSY RECORD | $437.50 | $1,750.00 | $591.50–$1,487.50 | — | 75% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC PBB EKG MPC | $82.25 | $329.00 | $14.84–$822.50 | 41% below | 75% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 HC PBB EKG MPC | $82.25 | $329.00 | $111.20–$279.65 | — | 75% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ELECTROCARDIOGRAM, TRACING - ECG 12-LEAD | $111.75 | $447.00 | $59.26–$1,117.50 | 59% below | 75% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC PBB ELECTROCARDIOGRAM, TRACING - ECG 12-LEAD | $111.75 | $447.00 | $59.26–$1,117.50 | 59% below | 75% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ELECTROCARDIOGRAM, TRACING - ECG 12-LEAD | $111.75 | $447.00 | $151.09–$379.95 | — | 75% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC PBB ELECTROCARDIOGRAM, TRACING - ECG 12-LEAD | $111.75 | $447.00 | $151.09–$379.95 | — | 75% |
| Electroconvulsive therapy (ECT), one session CPT 90870 HC ELECTROCONVULSIVE THERAPY | $333.50 | $1,334.00 | $450.89–$3,335.00 | 68% below | 75% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 HC ELECTROCONVULSIVE THERAPY | $333.50 | $1,334.00 | $450.89–$1,133.90 | — | 75% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMERGENCY DEPARTMENT LEVEL 1 VISIT LIMITED/MINOR PROB | $125.00 | $500.00 | $84.71–$1,250.00 | 47% below | 75% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC EMERGENCY DEPARTMENT LEVEL 1 VISIT LIMITED/MINOR PROB | $125.00 | $500.00 | $169.00–$425.00 | — | 75% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY DEPARTMENT LEVEL 2 VISIT LOW/MODER SEVERITY | $216.75 | $867.00 | $154.24–$2,167.50 | 50% below | 75% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC EMERGENCY DEPARTMENT LEVEL 2 VISIT LOW/MODER SEVERITY | $216.75 | $867.00 | $293.05–$736.95 | — | 75% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY | $486.00 | $1,944.00 | $274.22–$4,860.00 | 37% below | 75% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY | $486.00 | $1,944.00 | $657.07–$1,652.40 | — | 75% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY | $1,025.25 | $4,101.00 | $419.16–$10,252.50 | 21% below | 75% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY | $1,025.25 | $4,101.00 | $1,386.14–$3,485.85 | — | 75% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC | $1,612.00 | $6,448.00 | $598.24–$16,120.00 | 9% below | 75% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC | $1,612.00 | $6,448.00 | $2,179.42–$5,480.80 | — | 75% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY | $588.75 | $2,355.00 | $216.91–$5,887.50 | 53% below | 75% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY | $588.75 | $2,355.00 | $795.99–$2,001.75 | — | 75% |
| Family therapy with the patient, 50 minutes CPT 90847 HC PBB FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MIN | $90.50 | $362.00 | $122.36–$905.00 | 68% below | 75% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MIN | $90.50 | $362.00 | $122.36–$905.00 | 68% below | 75% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PBB FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MIN | $90.50 | $362.00 | $122.36–$307.70 | — | 75% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MIN | $90.50 | $362.00 | $122.36–$307.70 | — | 75% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY-30 MIN | $37.00 | $148.00 | $50.02–$370.00 | 77% below | 75% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY 45 MIN | $46.50 | $186.00 | $62.87–$465.00 | 71% below | 75% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY-60 MIN | $56.25 | $225.00 | $76.05–$562.50 | 65% below | 75% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY-30 MIN | $37.00 | $148.00 | $50.02–$125.80 | — | 75% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY 45 MIN | $46.50 | $186.00 | $62.87–$158.10 | — | 75% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY-60 MIN | $56.25 | $225.00 | $76.05–$191.25 | — | 75% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV INFUSION, HYDRATION, 31-60 MIN | $156.25 | $625.00 | $82.00–$1,562.50 | 64% below | 75% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC PBB IV INFUSION, HYDRATION, 31-60 MIN | $156.25 | $625.00 | $82.00–$1,562.50 | 64% below | 75% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC PBB IV INFUSION, HYDRATION, 31-60 MIN | $156.25 | $625.00 | $211.25–$531.25 | — | 75% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV INFUSION, HYDRATION, 31-60 MIN | $156.25 | $625.00 | $211.25–$531.25 | — | 75% |
| IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR | $179.25 | $717.00 | $82.00–$1,792.50 | 60% below | 75% |
| IV infusion of a medicine, first hour CPT 96365 HC PBB IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR | $179.25 | $717.00 | $82.00–$1,792.50 | 60% below | 75% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR | $179.25 | $717.00 | $242.35–$609.45 | — | 75% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC PBB IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR | $179.25 | $717.00 | $242.35–$609.45 | — | 75% |
| IV push of a medicine, first drug CPT 96374 HC PBB INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, INITIAL DRUG | $140.75 | $563.00 | $82.00–$1,407.50 | 38% below | 75% |
| IV push of a medicine, first drug CPT 96374 HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, INITIAL DRUG | $140.75 | $563.00 | $82.00–$1,407.50 | 38% below | 75% |
| IV push of a medicine, first drug inpatient CPT 96374 HC PBB INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, INITIAL DRUG | $140.75 | $563.00 | $190.29–$478.55 | — | 75% |
| IV push of a medicine, first drug inpatient CPT 96374 HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, INITIAL DRUG | $140.75 | $563.00 | $190.29–$478.55 | — | 75% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC PBB INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT | $90.00 | $360.00 | $72.33–$900.00 | 39% below | 75% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT | $90.00 | $360.00 | $72.33–$900.00 | 39% below | 75% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC PBB INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT | $90.00 | $360.00 | $121.68–$306.00 | — | 75% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT | $90.00 | $360.00 | $121.68–$306.00 | — | 75% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PBB PSYCHIATRIC DIAGNOSTIC EVALUATION | $117.00 | $468.00 | $158.18–$1,170.00 | 70% below | 75% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCHIATRIC DIAGNOSTIC EVALUATION | $117.00 | $468.00 | $158.18–$1,170.00 | 70% below | 75% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCHIATRIC DIAGNOSTIC EVALUATION | $117.00 | $468.00 | $158.18–$397.80 | — | 75% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PBB PSYCHIATRIC DIAGNOSTIC EVALUATION | $117.00 | $468.00 | $158.18–$397.80 | — | 75% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC NERVE CONDUC 7-8 STUDIES | $152.25 | $609.00 | $205.84–$1,522.50 | 78% below | 75% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC PBB NERVE CONDUC 7-8 STUDIES | $152.25 | $609.00 | $205.84–$1,522.50 | 78% below | 75% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HC NERVE CONDUC 7-8 STUDIES | $152.25 | $609.00 | $205.84–$517.65 | — | 75% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HC PBB NERVE CONDUC 7-8 STUDIES | $152.25 | $609.00 | $205.84–$517.65 | — | 75% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC PBB PT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $52.75 | $211.00 | $31.90–$527.50 | 53% below | 75% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC PT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $52.75 | $211.00 | $31.90–$527.50 | 53% below | 75% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC OT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $52.75 | $211.00 | $31.90–$527.50 | 53% below | 75% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC PBB OT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $52.75 | $211.00 | $31.90–$527.50 | 53% below | 75% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PBB OT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $52.75 | $211.00 | $71.32–$179.35 | — | 75% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC OT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $52.75 | $211.00 | $71.32–$179.35 | — | 75% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PBB PT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $52.75 | $211.00 | $71.32–$179.35 | — | 75% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $52.75 | $211.00 | $71.32–$179.35 | — | 75% |
| New patient office visit, about 30 minutes CPT 99203 HC NEW PT FACILITY LEVEL III | $59.00 | $236.00 | $79.77–$590.00 | 74% below | 75% |
| New patient office visit, about 30 minutes CPT 99203 HC FP OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES | $59.00 | $236.00 | $79.77–$590.00 | 74% below | 75% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC FP OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES | $59.00 | $236.00 | $79.77–$200.60 | — | 75% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC NEW PT FACILITY LEVEL III | $59.00 | $236.00 | $79.77–$200.60 | — | 75% |
| New patient office visit, about 45 minutes CPT 99204 HC FP OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES | $100.00 | $400.00 | $135.20–$1,000.00 | 66% below | 75% |
| New patient office visit, about 45 minutes CPT 99204 HC NEW PT FACILITY LEVEL IV | $100.00 | $400.00 | $135.20–$1,000.00 | 66% below | 75% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC NEW PT FACILITY LEVEL IV | $100.00 | $400.00 | $135.20–$340.00 | — | 75% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC FP OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES | $100.00 | $400.00 | $135.20–$340.00 | — | 75% |
| New patient office visit, about 60 minutes CPT 99205 HC FP OFFICE/OUTPATIENT NEW HIGH MDM 60-74 MINUTES | $130.50 | $522.00 | $176.44–$1,305.00 | 55% below | 75% |
| New patient office visit, about 60 minutes CPT 99205 HC NEW PT FACILITY LEVEL V | $130.50 | $522.00 | $176.44–$1,305.00 | 55% below | 75% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC NEW PT FACILITY LEVEL V | $130.50 | $522.00 | $176.44–$443.70 | — | 75% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC FP OFFICE/OUTPATIENT NEW HIGH MDM 60-74 MINUTES | $130.50 | $522.00 | $176.44–$443.70 | — | 75% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC NEW PT FACILITY LEVEL II | $39.25 | $157.00 | $53.07–$392.50 | 74% below | 75% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC FP OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES | $39.25 | $157.00 | $53.07–$392.50 | 74% below | 75% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC NEW PT FACILITY LEVEL II | $39.25 | $157.00 | $53.07–$133.45 | — | 75% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC FP OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES | $39.25 | $157.00 | $53.07–$133.45 | — | 75% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC PBB MED NUTR THER, 1ST, INDIV, EA 15 MIN | $31.75 | $127.00 | $35.75–$317.50 | 37% below | 75% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MED NUTR THER, 1ST, INDIV, EA 15 MIN | $31.75 | $127.00 | $35.75–$317.50 | 37% below | 75% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC PBB MED NUTR THER, 1ST, INDIV, EA 15 MIN | $31.75 | $127.00 | $42.93–$107.95 | — | 75% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MED NUTR THER, 1ST, INDIV, EA 15 MIN | $31.75 | $127.00 | $42.93–$107.95 | — | 75% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS | $124.00 | $496.00 | $64.00–$1,240.00 | 49% below | 75% |
| Occupational therapy evaluation, low complexity CPT 97165 HC PBB OT OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS | $124.00 | $496.00 | $64.00–$1,240.00 | 49% below | 75% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS | $124.00 | $496.00 | $167.65–$421.60 | — | 75% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC PBB OT OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS | $124.00 | $496.00 | $167.65–$421.60 | — | 75% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS | $145.00 | $580.00 | $64.00–$1,450.00 | 50% below | 75% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PBB PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS | $145.00 | $580.00 | $64.00–$1,450.00 | 50% below | 75% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PBB PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS | $145.00 | $580.00 | $196.04–$493.00 | — | 75% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS | $145.00 | $580.00 | $196.04–$493.00 | — | 75% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS | $129.50 | $518.00 | $64.00–$1,295.00 | 36% below | 75% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PBB PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS | $129.50 | $518.00 | $64.00–$1,295.00 | 36% below | 75% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PBB PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS | $129.50 | $518.00 | $175.08–$440.30 | — | 75% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS | $129.50 | $518.00 | $175.08–$440.30 | — | 75% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PBB PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS | $139.50 | $558.00 | $64.00–$1,395.00 | 44% below | 75% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS | $139.50 | $558.00 | $64.00–$1,395.00 | 44% below | 75% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PBB PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS | $139.50 | $558.00 | $188.60–$474.30 | — | 75% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS | $139.50 | $558.00 | $188.60–$474.30 | — | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $46.75 | $187.00 | $27.03–$467.50 | 58% below | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PBB PT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $46.75 | $187.00 | $27.03–$467.50 | 58% below | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC OT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $46.75 | $187.00 | $27.03–$467.50 | 58% below | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PBB OT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $46.75 | $187.00 | $27.03–$467.50 | 58% below | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $46.75 | $187.00 | $63.21–$158.95 | — | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PBB PT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $46.75 | $187.00 | $63.21–$158.95 | — | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC OT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $46.75 | $187.00 | $63.21–$158.95 | — | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PBB OT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $46.75 | $187.00 | $63.21–$158.95 | — | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISES | $63.50 | $254.00 | $28.33–$635.00 | 43% below | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PBB OT THERAPEUTIC EXERCISES | $63.50 | $254.00 | $28.33–$635.00 | 43% below | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PBB PT THERAPEUTIC EXERCISES | $63.50 | $254.00 | $28.33–$635.00 | 43% below | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISES | $63.50 | $254.00 | $28.33–$635.00 | 43% below | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PBB PT THERAPEUTIC EXERCISES | $63.50 | $254.00 | $85.85–$215.90 | — | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISES | $63.50 | $254.00 | $85.85–$215.90 | — | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PBB OT THERAPEUTIC EXERCISES | $63.50 | $254.00 | $85.85–$215.90 | — | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISES | $63.50 | $254.00 | $85.85–$215.90 | — | 75% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC FP PREVENTIVE VISIT NEW INDIVIDUAL AGE 18 - 39 | $75.75 | $303.00 | $102.41–$757.50 | 46% below | 75% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC FP PREVENTIVE VISIT NEW INDIVIDUAL AGE 18 - 39 | $75.75 | $303.00 | $102.41–$257.55 | — | 75% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC FP PREVENTIVE VISIT NEW INDIVIDUAL AGE 40 - 64 | $92.25 | $369.00 | $124.72–$922.50 | 36% below | 75% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC FP PREVENTIVE VISIT NEW INDIVIDUAL AGE 40 - 64 | $92.25 | $369.00 | $124.72–$313.65 | — | 75% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 HC FP PREVENTIVE VISIT ESTABLISHED INDIVIDUAL AGE 18 - 39 | $69.50 | $278.00 | $93.96–$695.00 | 35% below | 75% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 HC FP PREVENTIVE VISIT ESTABLISHED INDIVIDUAL AGE 18 - 39 | $69.50 | $278.00 | $93.96–$236.30 | — | 75% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 HC FP PREVENTIVE VISIT ESTABLISHED INDIVIDUAL AGE 40 - 64 | $75.25 | $301.00 | $101.74–$752.50 | 51% below | 75% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 HC FP PREVENTIVE VISIT ESTABLISHED INDIVIDUAL AGE 40 - 64 | $75.25 | $301.00 | $101.74–$255.85 | — | 75% |
| Psychiatric evaluation with medical services CPT 90792 HC PBB PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES | $161.00 | $644.00 | $178.30–$1,610.00 | 51% below | 75% |
| Psychiatric evaluation with medical services inpatient CPT 90792 HC PBB PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES | $161.00 | $644.00 | $217.67–$547.40 | — | 75% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 HC PBB PSYCHOTHERAPY FOR CRISIS 30-74 MINS | $102.50 | $410.00 | $138.58–$1,025.00 | 69% below | 75% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 HC PSYCHOTHERAPY FOR CRISIS 30-74 MINS | $102.50 | $410.00 | $138.58–$1,025.00 | 69% below | 75% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PSYCHOTHERAPY FOR CRISIS 30-74 MINS | $102.50 | $410.00 | $138.58–$348.50 | — | 75% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PBB PSYCHOTHERAPY FOR CRISIS 30-74 MINS | $102.50 | $410.00 | $138.58–$348.50 | — | 75% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES | $76.25 | $305.00 | $103.09–$762.50 | 60% below | 75% |
| Psychotherapy session, 30 minutes CPT 90832 HC PBB PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES | $76.25 | $305.00 | $103.09–$762.50 | 60% below | 75% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES | $76.25 | $305.00 | $103.09–$259.25 | — | 75% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PBB PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES | $76.25 | $305.00 | $103.09–$259.25 | — | 75% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY W/PATIENT 45 MINUTES | $95.50 | $382.00 | $129.12–$955.00 | 65% below | 75% |
| Psychotherapy session, 45 minutes CPT 90834 HC PBB PSYCHOTHERAPY W/PATIENT 45 MINUTES | $95.50 | $382.00 | $129.12–$955.00 | 65% below | 75% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PBB PSYCHOTHERAPY W/PATIENT 45 MINUTES | $95.50 | $382.00 | $129.12–$324.70 | — | 75% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY W/PATIENT 45 MINUTES | $95.50 | $382.00 | $129.12–$324.70 | — | 75% |
| Psychotherapy session, 60 minutes CPT 90837 HC PBB PSYCHOTHERAPY 60 MINUTES | $112.50 | $450.00 | $152.10–$1,125.00 | 59% below | 75% |
| Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY 60 MINUTES | $112.50 | $450.00 | $152.10–$1,125.00 | 59% below | 75% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PBB PSYCHOTHERAPY 60 MINUTES | $112.50 | $450.00 | $152.10–$382.50 | — | 75% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY 60 MINUTES | $112.50 | $450.00 | $152.10–$382.50 | — | 75% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC FP OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN | $86.00 | $344.00 | $116.27–$860.00 | 70% below | 75% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC EST PT FACILITY LEVEL V | $86.00 | $344.00 | $116.27–$860.00 | 70% below | 75% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC EST PT FACILITY LEVEL V | $86.00 | $344.00 | $116.27–$292.40 | — | 75% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC FP OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN | $86.00 | $344.00 | $116.27–$292.40 | — | 75% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC FP OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN | $39.50 | $158.00 | $53.40–$395.00 | 78% below | 75% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC EST PT FACILITY LEVEL III | $39.50 | $158.00 | $53.40–$395.00 | 78% below | 75% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC FP OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN | $39.50 | $158.00 | $53.40–$134.30 | — | 75% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC EST PT FACILITY LEVEL III | $39.50 | $158.00 | $53.40–$134.30 | — | 75% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC EST PT FACILITY LEVEL IV | $61.00 | $244.00 | $82.47–$610.00 | 68% below | 75% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC FP OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN | $61.00 | $244.00 | $82.47–$610.00 | 68% below | 75% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC EST PT FACILITY LEVEL IV | $61.00 | $244.00 | $82.47–$207.40 | — | 75% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC FP OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN | $61.00 | $244.00 | $82.47–$207.40 | — | 75% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC FP OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN | $31.25 | $125.00 | $42.25–$312.50 | 75% below | 75% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC EST PT FACILITY LEVEL II | $39.50 | $158.00 | $53.40–$395.00 | 68% below | 75% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC FP OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN | $31.25 | $125.00 | $42.25–$106.25 | — | 75% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC EST PT FACILITY LEVEL II | $39.50 | $158.00 | $53.40–$134.30 | — | 75% |
| Speech and language evaluation CPT 92523 HC SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $152.00 | $608.00 | $64.00–$1,520.00 | 61% below | 75% |
| Speech and language evaluation CPT 92523 HC PBB SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $152.00 | $608.00 | $64.00–$1,520.00 | 61% below | 75% |
| Speech and language evaluation inpatient CPT 92523 HC PBB SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $152.00 | $608.00 | $205.50–$516.80 | — | 75% |
| Speech and language evaluation inpatient CPT 92523 HC SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $152.00 | $608.00 | $205.50–$516.80 | — | 75% |
| Speech therapy session, individual CPT 92507 HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL 30 MIN | $61.25 | $245.00 | $64.00–$612.50 | 72% below | 75% |
| Speech therapy session, individual CPT 92507 HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL 45 MIIN | $61.25 | $245.00 | $64.00–$612.50 | 72% below | 75% |
| Speech therapy session, individual CPT 92507 HC PBB SLP SPEECH/HEARING THERAPY, INDIVIDUAL | $67.00 | $268.00 | $64.00–$670.00 | 69% below | 75% |
| Speech therapy session, individual CPT 92507 HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL | $67.00 | $268.00 | $64.00–$670.00 | 69% below | 75% |
| Speech therapy session, individual inpatient CPT 92507 HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL 30 MIN | $61.25 | $245.00 | $82.81–$208.25 | — | 75% |
| Speech therapy session, individual inpatient CPT 92507 HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL 45 MIIN | $61.25 | $245.00 | $82.81–$208.25 | — | 75% |
| Speech therapy session, individual inpatient CPT 92507 HC PBB SLP SPEECH/HEARING THERAPY, INDIVIDUAL | $67.00 | $268.00 | $90.58–$227.80 | — | 75% |
| Speech therapy session, individual inpatient CPT 92507 HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL | $67.00 | $268.00 | $90.58–$227.80 | — | 75% |
| Spirometry (breathing test) CPT 94010 HC BREATHING CAPACITY TEST - SPIROMETRY WITHOUT BRONCHODILATOR | $111.75 | $447.00 | $104.00–$1,117.50 | 69% below | 75% |
| Spirometry (breathing test) CPT 94010 HC PBB BREATHING CAPACITY TEST - BREATHING CAPACITY TEST | $111.75 | $447.00 | $104.00–$1,117.50 | 69% below | 75% |
| Spirometry (breathing test) CPT 94010 HC BREATHING CAPACITY TEST - SPIROMETRY | $111.75 | $447.00 | $104.00–$1,117.50 | 69% below | 75% |
| Spirometry (breathing test) CPT 94010 HC BREATHING CAPACITY TEST - OFFICE SPIROMETRY | $111.75 | $447.00 | $104.00–$1,117.50 | 69% below | 75% |
| Spirometry (breathing test) inpatient CPT 94010 HC PBB BREATHING CAPACITY TEST - BREATHING CAPACITY TEST | $111.75 | $447.00 | $151.09–$379.95 | — | 75% |
| Spirometry (breathing test) inpatient CPT 94010 HC BREATHING CAPACITY TEST - OFFICE SPIROMETRY | $111.75 | $447.00 | $151.09–$379.95 | — | 75% |
| Spirometry (breathing test) inpatient CPT 94010 HC BREATHING CAPACITY TEST - SPIROMETRY WITHOUT BRONCHODILATOR | $111.75 | $447.00 | $151.09–$379.95 | — | 75% |
| Spirometry (breathing test) inpatient CPT 94010 HC BREATHING CAPACITY TEST - SPIROMETRY | $111.75 | $447.00 | $151.09–$379.95 | — | 75% |
| Spirometry before and after a bronchodilator CPT 94060 HC PBB EVAL OF BRONCHOSPASM - SPIROMETRY WITH BRONCHODILATOR | $299.75 | $1,199.00 | $104.00–$2,997.50 | 50% below | 75% |
| Spirometry before and after a bronchodilator CPT 94060 HC EVAL OF BRONCHOSPASM - SPIROMETRY WITH BRONCHODILATOR | $299.75 | $1,199.00 | $104.00–$2,997.50 | 50% below | 75% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC PBB EVAL OF BRONCHOSPASM - SPIROMETRY WITH BRONCHODILATOR | $299.75 | $1,199.00 | $405.26–$1,019.15 | — | 75% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC EVAL OF BRONCHOSPASM - SPIROMETRY WITH BRONCHODILATOR | $299.75 | $1,199.00 | $405.26–$1,019.15 | — | 75% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $68.50 | $274.00 | $34.02–$685.00 | 39% below | 75% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC PBB PT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $68.50 | $274.00 | $34.02–$685.00 | 39% below | 75% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $68.50 | $274.00 | $34.02–$685.00 | 39% below | 75% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC PBB OT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $68.50 | $274.00 | $34.02–$685.00 | 39% below | 75% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC OT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $68.50 | $274.00 | $92.61–$232.90 | — | 75% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PBB OT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $68.50 | $274.00 | $92.61–$232.90 | — | 75% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $68.50 | $274.00 | $92.61–$232.90 | — | 75% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PBB PT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $68.50 | $274.00 | $92.61–$232.90 | — | 75% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY | $105.75 | $423.00 | $82.00–$1,057.50 | 54% below | 75% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PBB PHLEBOTOMY | $105.75 | $423.00 | $82.00–$1,057.50 | 54% below | 75% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PBB PHLEBOTOMY | $105.75 | $423.00 | $142.97–$359.55 | — | 75% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY | $105.75 | $423.00 | $142.97–$359.55 | — | 75% |
| Visual field test, extended CPT 92083 HC PBB VISUAL FIELD EXAMINATION EXTENDED | $120.25 | $481.00 | $107.00–$1,202.50 | 51% below | 75% |
| Visual field test, extended CPT 92083 HC VISUAL FIELD EXAM,EXTENDED - HUMPHREY VISUAL FIELD - OU - BOTH EYES | $120.25 | $481.00 | $107.00–$1,202.50 | 51% below | 75% |
| Visual field test, extended CPT 92083 HC VISUAL FIELD EXAM,EXTENDED - GOLDMANN PERIMETRY - OU - BOTH EYES | $120.25 | $481.00 | $107.00–$1,202.50 | 51% below | 75% |
| Visual field test, extended one side CPT 92083 HC VISUAL FIELD EXAM,EXTENDED - HUMPHREY VISUAL FIELD - OS - LEFT EYE | $92.50 | $370.00 | $107.00–$925.00 | 62% below | 75% |
| Visual field test, extended one side CPT 92083 HC VISUAL FIELD EXAM,EXTENDED - HUMPHREY VISUAL FIELD - OD - RIGHT EYE | $92.50 | $370.00 | $107.00–$925.00 | 62% below | 75% |
| Visual field test, extended inpatient CPT 92083 HC VISUAL FIELD EXAM,EXTENDED - GOLDMANN PERIMETRY - OU - BOTH EYES | $120.25 | $481.00 | $162.58–$408.85 | — | 75% |
| Visual field test, extended inpatient CPT 92083 HC PBB VISUAL FIELD EXAMINATION EXTENDED | $120.25 | $481.00 | $162.58–$408.85 | — | 75% |
| Visual field test, extended inpatient CPT 92083 HC VISUAL FIELD EXAM,EXTENDED - HUMPHREY VISUAL FIELD - OU - BOTH EYES | $120.25 | $481.00 | $162.58–$408.85 | — | 75% |
| Visual field test, extended inpatient one side CPT 92083 HC VISUAL FIELD EXAM,EXTENDED - HUMPHREY VISUAL FIELD - OS - LEFT EYE | $92.50 | $370.00 | $125.06–$314.50 | — | 75% |
| Visual field test, extended inpatient one side CPT 92083 HC VISUAL FIELD EXAM,EXTENDED - HUMPHREY VISUAL FIELD - OD - RIGHT EYE | $92.50 | $370.00 | $125.06–$314.50 | — | 75% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 HC PBB COVID VACC SARSCOV2 VACCINE 30MCG/0.3ML TRS-SUC 12/>YRS PFIZER | $31.25 | $125.00 | $42.25–$312.50 | 81% below | 75% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARS-CoV-2 COVID XBB.1.5 monovalent vaccine Pfizer, 12yrs and older | $235.14 | $940.54 | $168.37–$2,351.35 | 41% above | 75% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 HC PBB COVID VACC SARSCOV2 VACCINE 30MCG/0.3ML TRS-SUC 12/>YRS PFIZER | $31.25 | $125.00 | $42.25–$106.25 | — | 75% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARS-CoV-2 COVID XBB.1.5 monovalent vaccine Pfizer, 12yrs and older | $235.14 | $940.54 | $317.90–$799.46 | — | 75% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC PBB VAR VACCINE LIVE FOR SUBCUTANEOUS USE | $38.46 | $153.81 | $51.99–$384.53 | 90% below | 75% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella virus vaccine (VAR), live, SQ | $265.70 | $1,062.78 | $359.22–$2,656.95 | 33% below | 75% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC PBB VAR VACCINE LIVE FOR SUBCUTANEOUS USE | $38.46 | $153.81 | $51.99–$130.74 | — | 75% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varicella virus vaccine (VAR), live, SQ | $265.70 | $1,062.78 | $359.22–$903.36 | — | 75% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 HC PBB DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE | $46.13 | $184.52 | $62.37–$461.30 | 38% below | 75% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV vaccine 4-6 yrs IM | $97.83 | $391.29 | $132.26–$978.23 | 32% above | 75% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 HC PBB DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE | $46.13 | $184.52 | $62.37–$156.84 | — | 75% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP-IPV vaccine 4-6 yrs IM | $97.83 | $391.29 | $132.26–$332.60 | — | 75% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC PBB DTAP IMMUNIZATION, IM, <7 YO | $19.30 | $77.19 | $26.09–$192.98 | 79% below | 75% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Diphtheria, tetanus toxoids, acellular pertussis (DTaP) < 7 years IM | $46.22 | $184.86 | $62.48–$462.15 | 49% below | 75% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC PBB DTAP IMMUNIZATION, IM, <7 YO | $19.30 | $77.19 | $26.09–$65.61 | — | 75% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Diphtheria, tetanus toxoids, acellular pertussis (DTaP) < 7 years IM | $46.22 | $184.86 | $62.48–$157.13 | — | 75% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HC PBB DTAP-HEPB-IPV VACCINE INTRAMUSCULAR | $26.00 | $104.00 | $35.15–$260.00 | 88% below | 75% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HC PBB DTAP-HEPB-IPV VACCINE INTRAMUSCULAR | $26.00 | $104.00 | $35.15–$88.40 | — | 75% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 HC PBB DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE | $56.45 | $225.80 | $76.32–$564.50 | 80% below | 75% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IPV/HIB vaccnie IM | $187.82 | $751.25 | $253.92–$1,878.13 | 33% below | 75% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 HC PBB DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE | $56.45 | $225.80 | $76.32–$191.93 | — | 75% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTAP-IPV/HIB vaccnie IM | $187.82 | $751.25 | $253.92–$638.56 | — | 75% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 HC PBB DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR | $225.34 | $901.35 | $304.66–$2,253.38 | at median | 75% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DTaP-IPV-HIB-HepB vaccine IM | $240.67 | $962.67 | $325.38–$2,406.68 | 6% above | 75% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 HC PBB DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR | $225.34 | $901.35 | $304.66–$766.15 | — | 75% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DTaP-IPV-HIB-HepB vaccine IM | $240.67 | $962.67 | $325.38–$818.27 | — | 75% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 HC PBB FLU VACC RIV3 PRSV FREE IM | $18.34 | $73.33 | $24.79–$214.41 | 95% below | 75% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 Influenza virus vaccine, trivalent 0.5 mL IM | $124.74 | $498.96 | $122.52–$1,247.40 | 65% below | 75% |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 HC PBB FLU VACC RIV3 PRSV FREE IM | $18.34 | $73.33 | $24.79–$62.33 | — | 75% |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 Influenza virus vaccine, trivalent 0.5 mL IM | $124.74 | $498.96 | $168.65–$424.12 | — | 75% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC PBB FLU VACC IIV3 VACC PRSV FREE 0.5ML IM | $18.34 | $73.33 | $23.89–$183.33 | 51% below | 75% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza virus vaccine, trivalent 0.5 mL IM | $31.30 | $125.19 | $23.89–$312.98 | 17% below | 75% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HC PBB FLU VACC IIV3 VACC PRSV FREE 0.5ML IM | $18.34 | $73.33 | $24.79–$62.33 | — | 75% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Influenza virus vaccine, trivalent 0.5 mL IM | $31.30 | $125.19 | $42.31–$106.41 | — | 75% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC PBB 9VHPV VACC 2/3 DOSE SCHED IM USE | $135.15 | $540.60 | $182.72–$1,351.50 | 75% below | 75% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Human Papillomavirus vaccine ,nonavalent (9vHPV), 2 or 3 dose schedule IM | $434.99 | $1,739.94 | $588.10–$4,349.85 | 20% below | 75% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC PBB 9VHPV VACC 2/3 DOSE SCHED IM USE | $135.15 | $540.60 | $182.72–$459.51 | — | 75% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Human Papillomavirus vaccine ,nonavalent (9vHPV), 2 or 3 dose schedule IM | $434.99 | $1,739.94 | $588.10–$1,478.95 | — | 75% |
| Hepatitis A vaccine, adult dose CPT 90632 HC PBB HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE | $52.43 | $209.72 | $70.89–$524.30 | 71% below | 75% |
| Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A vaccine (HepA), adult dose IM | $129.55 | $518.18 | $175.14–$1,295.45 | 29% below | 75% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HC PBB HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE | $52.43 | $209.72 | $70.89–$178.26 | — | 75% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis A vaccine (HepA), adult dose IM | $129.55 | $518.18 | $175.14–$440.45 | — | 75% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC PBB HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE | $18.89 | $75.53 | $25.53–$188.83 | 80% below | 75% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepatitis A vaccine (HepA), pedi dose-2 dose schedule IM | $60.98 | $243.92 | $82.44–$609.80 | 35% below | 75% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HC PBB HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE | $18.89 | $75.53 | $25.53–$64.20 | — | 75% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hepatitis A vaccine (HepA), pedi dose-2 dose schedule IM | $60.98 | $243.92 | $82.44–$207.33 | — | 75% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC PBB HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE | $45.50 | $182.00 | $61.52–$455.00 | 72% below | 75% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B vaccine (HepB), adult dose, 3 dose schedule IM | $113.22 | $452.85 | $75.15–$1,132.13 | 31% below | 75% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC PBB HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE | $45.50 | $182.00 | $61.52–$154.70 | — | 75% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B vaccine (HepB), adult dose, 3 dose schedule IM | $113.22 | $452.85 | $153.06–$384.92 | — | 75% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HC PBB HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE | $78.00 | $312.00 | $105.46–$780.00 | 81% below | 75% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HC PBB HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE | $78.00 | $312.00 | $105.46–$265.20 | — | 75% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC PBB HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM | $24.00 | $96.00 | $32.45–$240.00 | 71% below | 75% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B vaccine (HepB), pedi dose, 3 dose schedule IM | $45.73 | $182.89 | $33.22–$457.23 | 44% below | 75% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HC PBB HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM | $24.00 | $96.00 | $32.45–$81.60 | — | 75% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepatitis B vaccine (HepB), pedi dose, 3 dose schedule IM | $45.73 | $182.89 | $61.82–$155.46 | — | 75% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Haemophilus influenzae type b vaccine (Hib) 4 dose schedule IM | $20.31 | $81.24 | $27.46–$203.10 | 57% below | 75% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC PBB HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE | $23.17 | $92.65 | $31.32–$231.63 | 51% below | 75% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Haemophilus influenzae type b vaccine (Hib) 4 dose schedule IM | $21.43 | $85.72 | $28.97–$72.86 | — | 75% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HC PBB HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE | $23.17 | $92.65 | $31.32–$78.75 | — | 75% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC PBB IIV VACCINE PRESERV FREE INCREASED AG COUNT IM | $18.34 | $73.33 | $24.79–$214.41 | 88% below | 75% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HC PBB IIV VACCINE PRESERV FREE INCREASED AG COUNT IM | $18.34 | $73.33 | $24.79–$62.33 | — | 75% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 HC PBB MMR VIRUS IMMUNIZATION, SUBCUT | $102.50 | $410.00 | $138.58–$1,025.00 | 49% below | 75% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles, mumps and rubella virus vaccine (MMR II), live SQ | $141.32 | $565.26 | $191.06–$1,413.15 | 30% below | 75% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 measles, mumps, and rubella virus vaccine (PRIORIX), live SQ | $141.32 | $565.26 | $191.06–$1,413.15 | 30% below | 75% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC PBB MMR VIRUS IMMUNIZATION, SUBCUT | $102.50 | $410.00 | $138.58–$348.50 | — | 75% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles, mumps, and rubella virus vaccine (PRIORIX), live SQ | $141.32 | $565.26 | $191.06–$480.47 | — | 75% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Measles, mumps and rubella virus vaccine (MMR II), live SQ | $141.32 | $565.26 | $191.06–$480.47 | — | 75% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC PBB COMBINED VACCINE,MMR+VARICELLA,SUB-Q | $89.25 | $357.00 | $120.67–$892.50 | 68% below | 75% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 Measles, mumps, rubella, and varicella vaccine (MMRV), live SQ | $381.80 | $1,527.17 | $516.18–$3,817.93 | 39% above | 75% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 HC PBB COMBINED VACCINE,MMR+VARICELLA,SUB-Q | $89.25 | $357.00 | $120.67–$303.45 | — | 75% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 Measles, mumps, rubella, and varicella vaccine (MMRV), live SQ | $381.80 | $1,527.17 | $516.18–$1,298.09 | — | 75% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC PBB MENINGOCOCCAL VACCINE FOR IM | $39.25 | $157.00 | $53.07–$392.50 | 89% below | 75% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MenACWY-D/-CRM conj vaccine, quad, diphtheria toxoid/CRM197 carrier IM | $244.44 | $977.73 | $330.47–$2,444.33 | 31% below | 75% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC PBB MENINGOCOCCAL VACCINE FOR IM | $39.25 | $157.00 | $53.07–$133.45 | — | 75% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MenACWY-D/-CRM conj vaccine, quad, diphtheria toxoid/CRM197 carrier IM | $244.44 | $977.73 | $330.47–$831.07 | — | 75% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 HC PBB MENACWY-TT CONJ VACC SEROGROUPS ACWY 0.5ML FOR IM USE | $177.83 | $711.30 | $240.42–$1,778.25 | 73% below | 75% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MenACWY-TT conjugated vaccine, quad, tetanus toxoid carrier IM | $244.99 | $979.95 | $331.22–$2,449.88 | 63% below | 75% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 HC PBB MENACWY-TT CONJ VACC SEROGROUPS ACWY 0.5ML FOR IM USE | $177.83 | $711.30 | $240.42–$604.61 | — | 75% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MenACWY-TT conjugated vaccine, quad, tetanus toxoid carrier IM | $244.99 | $979.95 | $331.22–$832.96 | — | 75% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HC PBB MENB-4C VACC 2 DOSE IM | $111.06 | $444.21 | $150.14–$1,110.53 | 82% below | 75% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MenB-4C recomb protein & outer membrane vesicle vaccine IM | $332.32 | $1,329.25 | $449.29–$3,323.13 | 45% below | 75% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 HC PBB MENB-4C VACC 2 DOSE IM | $111.06 | $444.21 | $150.14–$377.58 | — | 75% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MenB-4C recomb protein & outer membrane vesicle vaccine IM | $332.32 | $1,329.25 | $449.29–$1,129.86 | — | 75% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC PBB PCV13 VACCINE FOR INTRAMUSCULAR USE | $135.80 | $543.20 | $183.60–$1,358.00 | 72% below | 75% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 HC PBB PCV13 VACCINE FOR INTRAMUSCULAR USE | $135.80 | $543.20 | $183.60–$461.72 | — | 75% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 HC PBB PCV15 VACCINE FOR INTRAMUSCULAR USE | $298.79 | $1,195.15 | $269.31–$2,987.88 | 71% below | 75% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 pneumococcal conjugate vaccine, 15 valent (PCV15) IM | $332.64 | $1,330.55 | $269.31–$3,326.38 | 68% below | 75% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 HC PBB PCV15 VACCINE FOR INTRAMUSCULAR USE | $298.79 | $1,195.15 | $403.96–$1,015.88 | — | 75% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 pneumococcal conjugate vaccine, 15 valent (PCV15) IM | $332.64 | $1,330.55 | $449.73–$1,130.97 | — | 75% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HC PBB PCV20 VACCINE FOR INTRAMUSCULAR USE | $344.20 | $1,376.80 | $341.00–$3,442.00 | 39% below | 75% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal conjugate vaccine, 20 valent (PCV20) IM | $419.24 | $1,676.94 | $341.00–$4,192.35 | 26% below | 75% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 HC PBB PCV20 VACCINE FOR INTRAMUSCULAR USE | $344.20 | $1,376.80 | $465.36–$1,170.28 | — | 75% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal conjugate vaccine, 20 valent (PCV20) IM | $419.24 | $1,676.94 | $566.81–$1,425.40 | — | 75% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 HC PBB PCV21 VACCINE FOR INTRAMUSCULAR USE | $129.50 | $518.00 | $175.08–$1,295.00 | 65% below | 75% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 pneumococcal conjugate vaccine, 21 valent (PCV21) IM | $399.36 | $1,597.43 | $344.25–$3,993.58 | 9% above | 75% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 HC PBB PCV21 VACCINE FOR INTRAMUSCULAR USE | $129.50 | $518.00 | $175.08–$440.30 | — | 75% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 pneumococcal conjugate vaccine, 21 valent (PCV21) IM | $399.36 | $1,597.43 | $539.93–$1,357.82 | — | 75% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC PBB PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE | $29.50 | $118.00 | $39.88–$295.00 | 88% below | 75% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 pneumococcal polysaccharide vaccine, 23-valent (PPSV23) IM | $169.35 | $677.40 | $133.47–$1,693.50 | 33% below | 75% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC PBB PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE | $29.50 | $118.00 | $39.88–$100.30 | — | 75% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 pneumococcal polysaccharide vaccine, 23-valent (PPSV23) IM | $169.35 | $677.40 | $228.96–$575.79 | — | 75% |
| Polio vaccine, inactivated (IPV) CPT 90713 HC PBB POLIOVIRUS VACCINE INACTIVATED, SUB-Q/IM | $10.50 | $42.00 | $14.20–$105.00 | 97% below | 75% |
| Polio vaccine, inactivated (IPV) CPT 90713 Poliovirus vaccine, inactivated (IPV), SQ or IM | $72.28 | $289.12 | $97.72–$722.80 | 78% below | 75% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 HC PBB POLIOVIRUS VACCINE INACTIVATED, SUB-Q/IM | $10.50 | $42.00 | $14.20–$35.70 | — | 75% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 Poliovirus vaccine, inactivated (IPV), SQ or IM | $72.28 | $289.12 | $97.72–$245.75 | — | 75% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 HC PBB RSV MONOCLONAL ANTIBODY BEYFORTUS 1ML | $891.00 | $3,564.00 | $1,204.63–$8,910.00 | 9% below | 75% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 HC PBB RSV MONOCLONAL ANTIBODY BEYFORTUS 1ML | $891.00 | $3,564.00 | $1,204.63–$3,029.40 | — | 75% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 HC PBB RSV MONOCLONAL ANTIBODY BEYFORTUS 0.5ML | $891.00 | $3,564.00 | $1,204.63–$8,910.00 | 9% below | 75% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 HC PBB RSV MONOCLONAL ANTIBODY BEYFORTUS 0.5ML | $891.00 | $3,564.00 | $1,204.63–$3,029.40 | — | 75% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV vaccine (ABRYSVO), adult dose 0.5 mL | $421.93 | $1,687.69 | $570.44–$4,219.23 | 34% below | 75% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 HC PBB RSV ABRYSVO 0.5ML | $531.00 | $2,124.00 | $717.91–$5,310.00 | 17% below | 75% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV vaccine (ABRYSVO), adult dose 0.5 mL | $421.93 | $1,687.69 | $570.44–$1,434.54 | — | 75% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 HC PBB RSV ABRYSVO 0.5ML | $531.00 | $2,124.00 | $717.91–$1,805.40 | — | 75% |
| Rabies vaccine, one dose CPT 90675 HC PBB RABIES VACCINE, IM | $319.08 | $1,276.30 | $331.98–$3,190.75 | 69% below | 75% |
| Rabies vaccine, one dose CPT 90675 Rabies vaccine, for IM use | $521.32 | $2,085.28 | $331.98–$5,213.20 | 49% below | 75% |
| Rabies vaccine, one dose inpatient CPT 90675 HC PBB RABIES VACCINE, IM | $319.08 | $1,276.30 | $431.39–$1,084.86 | — | 75% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies vaccine, for IM use | $543.14 | $2,172.56 | $734.33–$1,846.68 | — | 75% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 HC PBB RV1 VACCINE 2 DOSE SCHEDULE LIVE FOR ORAL USE | $200.37 | $801.45 | $270.89–$2,003.63 | 52% above | 75% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 HC PBB RV1 VACCINE 2 DOSE SCHEDULE LIVE FOR ORAL USE | $200.37 | $801.45 | $270.89–$681.23 | — | 75% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC PBB RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE | $68.38 | $273.50 | $92.44–$683.75 | 34% below | 75% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 HC PBB RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE | $68.38 | $273.50 | $92.44–$232.48 | — | 75% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HC PBB HZV ZOSTER VACCINE RECOMBINANT IM | $126.00 | $504.00 | $170.35–$1,260.00 | 38% below | 75% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Zoster (shingles) vaccine (HZV), recombinant, subunit, adjuvanted IM | $335.63 | $1,342.52 | $453.77–$3,356.30 | 64% above | 75% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HC PBB HZV ZOSTER VACCINE RECOMBINANT IM | $126.00 | $504.00 | $170.35–$428.40 | — | 75% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Zoster (shingles) vaccine (HZV), recombinant, subunit, adjuvanted IM | $335.63 | $1,342.52 | $453.77–$1,141.14 | — | 75% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC PBB TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE | $15.00 | $60.00 | $20.28–$150.00 | 85% below | 75% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus and diptheria toxoids absorbed (Td), PF, 7 years or older | $69.25 | $276.98 | $93.62–$692.45 | 31% below | 75% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC PBB TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE | $15.00 | $60.00 | $20.28–$51.00 | — | 75% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus and diptheria toxoids absorbed (Td), PF, 7 years or older | $69.25 | $276.98 | $93.62–$235.43 | — | 75% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC PBB TDAP VACCINE 7 YRS OR OLDER, IM | $37.60 | $150.39 | $50.83–$375.98 | 68% below | 75% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), 7 years or older | $75.40 | $301.60 | $101.94–$754.00 | 36% below | 75% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC PBB TDAP VACCINE 7 YRS OR OLDER, IM | $37.60 | $150.39 | $50.83–$127.83 | — | 75% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), 7 years or older | $75.40 | $301.60 | $101.94–$256.36 | — | 75% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC PBB IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID | $11.67 | $46.67 | $15.77–$126.58 | 84% below | 75% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID | $11.67 | $46.67 | $15.77–$126.58 | 84% below | 75% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID | $11.67 | $46.67 | $15.77–$39.67 | — | 75% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC PBB IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID | $11.67 | $46.67 | $15.77–$39.67 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC PBB IMMUNIZ,ADMIN,EACH ADDL | $11.67 | $46.67 | $15.45–$116.68 | 75% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZ,ADMIN,EACH ADDL | $11.67 | $46.67 | $15.45–$116.68 | 75% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZ,ADMIN,EACH ADDL | $11.67 | $46.67 | $15.77–$39.67 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC PBB IMMUNIZ,ADMIN,EACH ADDL | $11.67 | $46.67 | $15.77–$39.67 | — | 75% |
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.