Hospital Chicago-Naperville-Elgin, IL-IN

John H. Stroger, Jr. Hospital

John H. Stroger, Jr. Hospital in Chicago, IL publishes cash prices for 520 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Illinois median for 449 of 507 procedures and above it for 54. By typical cash price it ranks #5 of 115 Illinois hospitals and #5 of 63 hospitals in the Chicago, IL area, cheapest first. Click a procedure to compare it with other hospitals nearby.

1901 W. Harrison Street, Chicago, IL 60612 Collected Sep 22, 2026 Source price file (312) 864-6000

Acute care hospital Emergency department CMS star rating 2 of 5 CCN 140124 · CMS hospital register NPI 1588612832

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named John H. Stroger, Jr. Hospital in Chicago, IL:

Mar 25, 2025 Met requirements
Apr 15, 2026 Warning notice
Jun 25, 2026 Case closed

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W&W/O CONTRAST	$313.60	$448.00	$245.44–$500.00	89% below	30%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W&W/O CONTRAST	$313.60	$448.00	$245.44–$500.00	—	30%
Abdominal X-ray, 2 views CPT 74019 X-RAY EXAM ABDOMEN 2 VIEWS	$187.60	$268.00	$24.76–$214.40	47% below	30%
Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY EXAM ABDOMEN 2 VIEWS	$187.60	$268.00	$24.76–$214.40	—	30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3+V RT	$156.10	$223.00	$16.16–$178.40	54% below	30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3+V LT	$156.10	$223.00	$16.16–$178.40	54% below	30%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3+V LT	$156.10	$223.00	$16.16–$178.40	—	30%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3+V RT	$156.10	$223.00	$16.16–$178.40	—	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 DOPPLER ARTERIAL EXT	$238.00	$340.00	$68.07–$495.00	42% below	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 DOPPLER ARTERIAL EXT	$238.00	$340.00	$68.07–$495.00	—	30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPR EXT W/O CONTRAST RT	$187.60	$268.00	$156.06–$500.00	90% below	30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPR EXT W/O CONTRAST LT	$187.60	$268.00	$39.75–$500.00	90% below	30%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPR EXT W/O CONTRAST LT	$187.60	$268.00	$39.75–$500.00	—	30%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPR EXT W/O CONTRAST RT	$187.60	$268.00	$156.06–$500.00	—	30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS	$313.60	$448.00	$22.87–$358.40	52% below	30%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR ESOPHAGUS	$313.60	$448.00	$22.87–$358.40	—	30%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE WHOLE BODY	$715.40	$1,022.00	$197.94–$817.60	55% below	30%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE WHOLE BODY	$715.40	$1,022.00	$197.94–$817.60	—	30%
Breast ultrasound, complete, one breast one side CPT 76641 US LEFT BREAST COMPLETE	$187.60	$268.00	$60.22–$214.40	65% below	30%
Breast ultrasound, complete, one breast one side CPT 76641 US RIGHT BREAST COMPLETE	$187.60	$268.00	$73.33–$214.40	65% below	30%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US RIGHT BREAST COMPLETE	$187.60	$268.00	$73.33–$214.40	—	30%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US LEFT BREAST COMPLETE	$187.60	$268.00	$60.22–$214.40	—	30%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US RIGHT BREAST LIMITED	$156.10	$223.00	$62.12–$178.40	64% below	30%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US LEFT BREAST LIMITED	$156.10	$223.00	$62.12–$178.40	64% below	30%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US RIGHT BREAST LIMITED	$156.10	$223.00	$62.12–$178.40	—	30%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US LEFT BREAST LIMITED	$156.10	$223.00	$62.12–$178.40	—	30%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD&PELV W/O&W/DYE	$624.40	$892.00	$251.16–$713.60	84% below	30%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD&PELV W/O&W/DYE	$624.40	$892.00	$251.16–$713.60	—	30%
CT angiography (CTA) of the head CPT 70496 CTA HEAD& IF DONE POST PROCESS	$313.60	$448.00	$234.01–$500.00	88% below	30%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD& IF DONE POST PROCESS	$313.60	$448.00	$234.01–$500.00	—	30%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W& IF DONE WO & POST	$313.60	$448.00	$268.66–$500.00	88% below	30%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W& IF DONE WO & POST	$313.60	$448.00	$268.66–$500.00	—	30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W & IF DONE W/O CON	$313.60	$448.00	$146.12–$500.00	89% below	30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W & IF DONE W/O CON	$313.60	$448.00	$146.12–$500.00	—	30%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE	$624.40	$892.00	$156.06–$713.60	63% below	30%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO HRT W/3D IMAGE	$624.40	$892.00	$156.06–$713.60	—	30%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 PF-CORON ARTERY W/CALC SCORING	$49.70	$71.00	$30.49–$138.55	78% below	30%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CORONARY ARTERY W/CALC.SCORING	$156.10	$223.00	$30.29–$500.00	29% below	30%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 PF-CORON ARTERY W/CALC SCORING	$49.70	$71.00	$30.49–$138.55	—	30%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CORONARY ARTERY W/CALC.SCORING	$156.10	$223.00	$30.29–$500.00	—	30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$427.00	$610.00	$155.08–$500.00	89% below	30%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CONTRAST	$427.00	$610.00	$155.08–$500.00	—	30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/ CONTRAST	$624.40	$892.00	$194.44–$713.60	86% below	30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/ CONTRAST	$624.40	$892.00	$194.44–$713.60	—	30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PELVIS 1+ SECTION/REGNS	$624.40	$892.00	$267.39–$713.60	88% below	30%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD&PELVIS 1+ SECTION/REGNS	$624.40	$892.00	$267.39–$713.60	—	30%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$313.60	$448.00	$144.71–$500.00	87% below	30%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST	$313.60	$448.00	$144.71–$500.00	—	30%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$187.60	$268.00	$44.45–$500.00	91% below	30%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST	$187.60	$268.00	$44.45–$500.00	—	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAX/FACIAL W/O CONTRAST	$187.60	$268.00	$156.06–$500.00	89% below	30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAX/FACIAL W/O CONTRAST	$187.60	$268.00	$156.06–$500.00	—	30%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONTRAST	$187.60	$268.00	$118.96–$500.00	90% below	30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O CONTRAST	$187.60	$268.00	$118.96–$500.00	—	30%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/CONTRAST	$313.60	$448.00	$112.22–$500.00	85% below	30%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W/CONTRAST	$313.60	$448.00	$112.22–$500.00	—	30%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W&W/O CONTRAST	$313.60	$448.00	$157.00–$500.00	87% below	30%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W&W/O CONTRAST	$313.60	$448.00	$157.00–$500.00	—	30%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$187.60	$268.00	$156.06–$500.00	92% below	30%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$187.60	$268.00	$156.06–$500.00	—	30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O CONTRAS	$187.60	$268.00	$42.09–$500.00	92% below	30%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O CONTRAS	$187.60	$268.00	$42.09–$500.00	—	30%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST	$313.60	$448.00	$141.02–$500.00	86% below	30%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST	$313.60	$448.00	$141.02–$500.00	—	30%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX EXTRACRANIAL BILAT	$427.00	$610.00	$134.51–$495.00	—	30%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUPLEX EXTRACRANIAL BILAT	$427.00	$610.00	$134.51–$495.00	—	30%
Chest CT scan without and with contrast CPT 71270 CT THORAX W&W/O CONTRAST	$313.60	$448.00	$177.06–$500.00	89% below	30%
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX W&W/O CONTRAST	$313.60	$448.00	$177.06–$500.00	—	30%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$156.10	$223.00	$22.35–$178.40	49% below	30%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS W/FLUORO	$156.10	$223.00	$22.35–$178.40	49% below	30%
Chest X-ray, 2 views inpatient CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$156.10	$223.00	$22.35–$178.40	—	30%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS W/FLUORO	$156.10	$223.00	$22.35–$178.40	—	30%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$156.10	$223.00	$12.31–$268.66	37% below	30%
Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW	$156.10	$223.00	$12.31–$268.66	—	30%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE CMPL RT	$156.10	$223.00	$16.16–$178.40	48% below	30%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE CMPL LT	$156.10	$223.00	$16.16–$178.40	48% below	30%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE CMPL LT	$156.10	$223.00	$16.16–$178.40	—	30%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE CMPL RT	$156.10	$223.00	$16.16–$178.40	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITIONEAL COMPLETE	$187.60	$268.00	$77.83–$214.40	78% below	30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITIONEAL COMPLETE	$187.60	$268.00	$77.83–$214.40	—	30%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA BONE DENSITY AXIAL	$187.60	$268.00	$26.10–$214.40	62% below	30%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA BONE DENSITY AXIAL	$187.60	$268.00	$26.10–$214.40	—	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY/PERIPHERAL	$156.10	$223.00	$10.48–$500.00	34% below	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY/PERIPHERAL	$156.10	$223.00	$10.48–$500.00	—	30%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US MATERNAL/DETAILED FETAL SGL	$427.00	$610.00	$61.85–$488.00	56% below	30%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US MATERNAL/DETAILED FETAL SGL	$427.00	$610.00	$61.85–$488.00	—	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX W/O CONTRAST	$187.60	$268.00	$42.77–$500.00	90% below	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX W/O CONTRAST	$187.60	$268.00	$42.77–$500.00	—	30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX W/CONTRAST	$313.60	$448.00	$141.02–$500.00	87% below	30%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX W/CONTRAST	$313.60	$448.00	$141.02–$500.00	—	30%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMOGRAM DIAGNOSTIC BILAT	$195.30	$279.00	$89.78–$223.20	—	30%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMOGRAM DIAGNOSTIC BILAT	$195.30	$279.00	$89.78–$223.20	—	30%
Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAM DIAGNOSTIC UNILAT	$154.00	$220.00	$70.44–$176.00	52% below	30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAM DIAGNOSTIC UNILAT	$154.00	$220.00	$70.44–$176.00	—	30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX ARTERIAL LWR EXT BILAT	$427.00	$610.00	$128.39–$495.00	—	30%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUPLEX ARTERIAL LWR EXT BILAT	$427.00	$610.00	$128.39–$495.00	—	30%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX VENOUS EXT BILAT	$427.00	$610.00	$73.28–$495.00	—	30%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLEX VENOUS EXT BILAT	$427.00	$610.00	$73.28–$495.00	—	30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TTE COMPLETE W/CONTRAST	$977.20	$1,396.00	$242.83–$1,116.80	54% below	30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO TTE COMPLETE W/CONTRAST	$977.20	$1,396.00	$242.83–$1,116.80	—	30%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2V LT	$156.10	$223.00	$16.16–$178.40	45% below	30%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2V RT	$156.10	$223.00	$16.16–$178.40	45% below	30%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2V LT	$156.10	$223.00	$16.16–$178.40	—	30%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2V RT	$156.10	$223.00	$16.16–$178.40	—	30%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW CMPL 3+V RT	$156.10	$223.00	$16.16–$178.40	55% below	30%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW CMPL 3+V LT	$156.10	$223.00	$16.16–$178.40	55% below	30%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW CMPL 3+V RT	$156.10	$223.00	$16.16–$178.40	—	30%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW CMPL 3+V LT	$156.10	$223.00	$16.16–$178.40	—	30%
Eye socket (orbit) CT scan without contrast CPT 70480 CT FOS/SEL/EAR W/O CONTRAST	$187.60	$268.00	$156.06–$500.00	89% below	30%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT FOS/SEL/EAR W/O CONTRAST	$187.60	$268.00	$156.06–$500.00	—	30%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES 3+V	$187.60	$268.00	$16.16–$214.40	57% below	30%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES 3+V	$187.60	$268.00	$16.16–$214.40	—	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2V LT	$156.10	$223.00	$16.16–$178.40	52% below	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2V RT	$156.10	$223.00	$16.16–$178.40	52% below	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR UPPER EXT CHILD 1 VIEW LT	$156.10	$223.00	$16.16–$178.40	52% below	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR UPPER EXT CHILD 1 VIEW RT	$156.10	$223.00	$16.16–$178.40	52% below	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2V RT	$156.10	$223.00	$16.16–$178.40	—	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2V LT	$156.10	$223.00	$16.16–$178.40	—	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR UPPER EXT CHILD 1 VIEW LT	$156.10	$223.00	$16.16–$178.40	—	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR UPPER EXT CHILD 1 VIEW RT	$156.10	$223.00	$16.16–$178.40	—	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBIL SYST IMAGE W/O DRUG	$715.40	$1,022.00	$132.44–$817.60	53% below	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBIL SYST IMAGE W/O DRUG	$715.40	$1,022.00	$132.44–$817.60	—	30%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS RT	$187.60	$268.00	$16.16–$214.40	35% below	30%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS LT	$187.60	$268.00	$16.16–$214.40	35% below	30%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS LT	$187.60	$268.00	$16.16–$214.40	—	30%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS RT	$187.60	$268.00	$16.16–$214.40	—	30%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS 2+V RT	$156.10	$223.00	$16.16–$178.40	41% below	30%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS 2+V LT	$156.10	$223.00	$16.16–$178.40	41% below	30%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEUS 2+V RT	$156.10	$223.00	$16.16–$178.40	—	30%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEUS 2+V LT	$156.10	$223.00	$16.16–$178.40	—	30%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 PF-SLEEP STUDY UNATTENDED	$81.90	$117.00	$76.05–$445.99	86% below	30%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATTENDED W/RESP	$386.40	$552.00	$159.79–$644.09	34% below	30%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 PF-SLEEP STUDY UNATTENDED	$81.90	$117.00	$76.05–$445.99	—	30%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATTENDED W/RESP	$386.40	$552.00	$159.79–$644.09	—	30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG 4 OR > PARAMETERS W/SPLIT	$1,535.80	$2,194.00	$97.53–$1,755.20	68% below	30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG 4 OR > PARAMETERS W/SPLIT	$1,535.80	$2,194.00	$97.53–$1,755.20	—	30%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEWS RT	$156.10	$223.00	$16.16–$178.40	59% below	30%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEWS LT	$156.10	$223.00	$16.16–$178.40	59% below	30%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEWS RT	$156.10	$223.00	$16.16–$178.40	—	30%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEWS LT	$156.10	$223.00	$16.16–$178.40	—	30%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE CMPL 4+V LT	$187.60	$268.00	$16.16–$214.40	59% below	30%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE CMPL 4+V RT	$187.60	$268.00	$16.16–$214.40	59% below	30%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE CMPL 4+V LT	$187.60	$268.00	$16.16–$214.40	—	30%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE CMPL 4+V RT	$187.60	$268.00	$16.16–$214.40	—	30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LWR EXT W/O CONTRAST RT	$187.60	$268.00	$136.99–$500.00	90% below	30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LWR EXT W/O CONTRAST LT	$187.60	$268.00	$30.56–$500.00	90% below	30%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LWR EXT W/O CONTRAST RT	$187.60	$268.00	$136.99–$500.00	—	30%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LWR EXT W/O CONTRAST LT	$187.60	$268.00	$30.56–$500.00	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$187.60	$268.00	$61.27–$214.40	74% below	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$187.60	$268.00	$61.27–$214.40	—	30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREMITY NONVASC LTD	$187.60	$268.00	$12.31–$214.40	54% below	30%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTREMITY NONVASC RT	$187.60	$268.00	$12.31–$214.40	54% below	30%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTREMITY NONVASC LT	$187.60	$268.00	$12.31–$214.40	54% below	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXTREMITY NONVASC LTD	$187.60	$268.00	$12.31–$214.40	—	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTREMITY NONVASC RT	$187.60	$268.00	$12.31–$214.40	—	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTREMITY NONVASC LT	$187.60	$268.00	$12.31–$214.40	—	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 PF-LDCT LUNG CANCER SCREENING	$91.70	$131.00	$59.81–$181.71	84% below	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LDCT LUNG CANCER SCREENING	$187.60	$268.00	$64.72–$500.00	67% below	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 PF-LDCT LUNG CANCER SCREENING	$91.70	$131.00	$59.81–$181.71	—	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LDCT LUNG CANCER SCREENING	$187.60	$268.00	$64.72–$500.00	—	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 2V LT	$156.10	$223.00	$16.16–$178.40	52% below	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR LOWER EXT CHILD 1 VIEW LT	$156.10	$223.00	$16.16–$178.40	52% below	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 2V RT	$156.10	$223.00	$16.16–$178.40	52% below	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR LOWER EXT CHILD 1 VIEW LT	$156.10	$223.00	$16.16–$178.40	—	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 2V RT	$156.10	$223.00	$16.16–$178.40	—	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 2V LT	$156.10	$223.00	$16.16–$178.40	—	30%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O CON	$427.00	$610.00	$241.05–$750.00	85% below	30%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O CON	$427.00	$610.00	$241.05–$750.00	—	30%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST W/WO CONTRAST BI	$624.40	$892.00	$234.40–$750.00	—	30%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST W/WO CONTRAST BI	$624.40	$892.00	$234.40–$750.00	—	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LWR EXT JNT W/O CON RT	$427.00	$610.00	$279.62–$750.00	85% below	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LWR EXT JNT W/O CON LT	$427.00	$610.00	$215.09–$750.00	85% below	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LWR EXT JNT W/O CON LT	$427.00	$610.00	$215.09–$750.00	—	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LWR EXT JNT W/O CON RT	$427.00	$610.00	$279.62–$750.00	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LWR EXTR JOINT W&WO CON LT	$624.40	$892.00	$332.41–$750.00	83% below	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LWR EXTR JOINT W&WO CON RT	$624.40	$892.00	$236.89–$750.00	83% below	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LWR EXTR JOINT W&WO CON RT	$624.40	$892.00	$236.89–$750.00	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LWR EXTR JOINT W&WO CON LT	$624.40	$892.00	$332.41–$750.00	—	30%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$427.00	$610.00	$279.62–$750.00	85% below	30%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST	$427.00	$610.00	$279.62–$750.00	—	30%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W&WO CONTRAST	$624.40	$892.00	$428.34–$750.00	83% below	30%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W&WO CONTRAST	$624.40	$892.00	$428.34–$750.00	—	30%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CON	$427.00	$610.00	$279.62–$750.00	85% below	30%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CON	$427.00	$610.00	$279.62–$750.00	—	30%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W&W/O CON	$624.40	$892.00	$428.34–$750.00	85% below	30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W&W/O CON	$624.40	$892.00	$428.34–$750.00	—	30%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O CONTRAST	$427.00	$610.00	$279.62–$750.00	86% below	30%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O CONTRAST	$427.00	$610.00	$279.62–$750.00	—	30%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SP W&WO CONTRAST	$624.40	$892.00	$292.81–$750.00	85% below	30%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SP W&WO CONTRAST	$624.40	$892.00	$292.81–$750.00	—	30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SP W/O CONTRAST	$427.00	$610.00	$279.62–$750.00	86% below	30%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SP W/O CONTRAST	$427.00	$610.00	$279.62–$750.00	—	30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SP W&WO CONTRAST	$624.40	$892.00	$208.55–$750.00	85% below	30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SP W&WO CONTRAST	$624.40	$892.00	$208.55–$750.00	—	30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SP WO CONTRAST	$427.00	$610.00	$279.62–$750.00	86% below	30%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SP WO CONTRAST	$427.00	$610.00	$279.62–$750.00	—	30%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W&W/O CONTRAST	$624.40	$892.00	$239.95–$750.00	83% below	30%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W&W/O CONTRAST	$624.40	$892.00	$239.95–$750.00	—	30%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST	$427.00	$610.00	$279.62–$750.00	84% below	30%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST	$427.00	$610.00	$279.62–$750.00	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPR EXT JNT W/O CON LT	$427.00	$610.00	$215.43–$750.00	85% below	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPR EXT JNT W/O CON RT	$427.00	$610.00	$215.43–$750.00	85% below	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UPR EXT JNT W/O CON LT	$427.00	$610.00	$215.43–$750.00	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UPR EXT JNT W/O CON RT	$427.00	$610.00	$215.43–$750.00	—	30%
Neck soft tissue CT scan with contrast CPT 70491 CT NECK W/CONTRAST	$313.60	$448.00	$158.95–$500.00	86% below	30%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK W/CONTRAST	$313.60	$448.00	$158.95–$500.00	—	30%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK W/O CONTRAST	$187.60	$268.00	$156.06–$500.00	90% below	30%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK W/O CONTRAST	$187.60	$268.00	$156.06–$500.00	—	30%
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE	$156.10	$223.00	$16.16–$178.40	42% below	30%
Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE	$156.10	$223.00	$16.16–$178.40	—	30%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM HRT MUSCLE IMAGE SPECT MULT	$2,314.90	$3,307.00	$207.26–$2,645.60	39% below	30%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM HRT MUSCLE IMAGE SPECT MULT	$2,314.90	$3,307.00	$207.26–$2,645.60	—	30%
OCT scan of the retina (optical coherence tomography) CPT 92134 PF-SCANNING COMP DX RETINA	$32.20	$46.00	$29.90–$55.50	66% below	30%
OCT scan of the retina (optical coherence tomography) CPT 92134 SCAN COMP DX IMAGE RETINA	$105.70	$151.00	$14.02–$120.80	13% above	30%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET W/CT TUMR SKULL MID-THIGH	$2,557.10	$3,653.00	$103.96–$2,922.40	57% below	30%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET W/CT TUMR SKULL MID-THIGH	$2,557.10	$3,653.00	$103.96–$2,922.40	—	30%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$187.60	$268.00	$156.06–$500.00	90% below	30%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST	$187.60	$268.00	$156.06–$500.00	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS NON-OB LTD	$187.60	$268.00	$49.98–$214.40	66% below	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS NON-OB LTD	$187.60	$268.00	$49.98–$214.40	—	30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS NON OB CMPL	$187.60	$268.00	$65.94–$214.40	77% below	30%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS NON OB CMPL	$187.60	$268.00	$65.94–$214.40	—	30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREGNANCY > OR =14 WKS SGL	$187.60	$268.00	$77.83–$214.40	75% below	30%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREGNANCY > OR =14 WKS SGL	$187.60	$268.00	$77.83–$214.40	—	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREGNANCY < 14 WKS SGL	$187.60	$268.00	$48.39–$214.40	72% below	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREGNANCY < 14 WKS SGL	$187.60	$268.00	$48.39–$214.40	—	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LTD	$187.60	$268.00	$49.98–$214.40	63% below	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANCY LTD	$187.60	$268.00	$49.98–$214.40	—	30%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2V UNI LT	$156.10	$223.00	$16.16–$178.40	56% below	30%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2V UNI RT	$156.10	$223.00	$16.16–$178.40	56% below	30%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2V UNI LT	$156.10	$223.00	$16.16–$178.40	—	30%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2V UNI RT	$156.10	$223.00	$16.16–$178.40	—	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W/CXR 3+V UNI LT	$187.60	$268.00	$16.16–$214.40	61% below	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W/CXR 3+V UNI RT	$187.60	$268.00	$16.16–$214.40	61% below	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W/CXR 3+V UNI RT	$187.60	$268.00	$16.16–$214.40	—	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W/CXR 3+V UNI LT	$187.60	$268.00	$16.16–$214.40	—	30%
Screening mammogram, both breasts both sides CPT 77067 MAMMOGRAM SCREENING BILAT	$161.00	$230.00	$74.19–$184.00	—	30%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREENING UNILAT LT	$161.00	$230.00	$74.19–$184.00	41% below	30%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREENING UNILAT RT	$161.00	$230.00	$74.19–$184.00	41% below	30%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMOGRAM SCREENING BILAT	$161.00	$230.00	$74.19–$184.00	—	30%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREENING UNILAT LT	$161.00	$230.00	$74.19–$184.00	—	30%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREENING UNILAT RT	$161.00	$230.00	$74.19–$184.00	—	30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER CMPL 2+V RT	$156.10	$223.00	$16.16–$178.40	57% below	30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER CMPL 2+V LT	$156.10	$223.00	$16.16–$178.40	57% below	30%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER CMPL 2+V LT	$156.10	$223.00	$16.16–$178.40	—	30%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER CMPL 2+V RT	$156.10	$223.00	$16.16–$178.40	—	30%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL LTD <4V	$187.60	$268.00	$16.16–$214.40	41% below	30%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL LTD <4V	$187.60	$268.00	$16.16–$214.40	—	30%
Sleep study in a lab (polysomnography) CPT 95810 PSG 4 OR MORE PARAMETERS (PSG)	$1,535.80	$2,194.00	$450.00–$1,755.20	62% below	30%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG 4 OR MORE PARAMETERS (PSG)	$1,535.80	$2,194.00	$450.00–$1,755.20	—	30%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWALLOW CINE/VIDEO	$313.60	$448.00	$31.51–$358.40	53% below	30%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR SWALLOW CINE/VIDEO	$313.60	$448.00	$31.51–$358.40	—	30%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR 2V+ LT	$156.10	$223.00	$21.89–$178.40	45% below	30%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR 2+V RT	$156.10	$223.00	$21.89–$178.40	45% below	30%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR 2V+ LT	$156.10	$223.00	$21.89–$178.40	—	30%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR 2+V RT	$156.10	$223.00	$21.89–$178.40	—	30%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO CONTRAST	$187.60	$268.00	$156.06–$500.00	91% below	30%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE WO CONTRAST	$187.60	$268.00	$156.06–$500.00	—	30%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2+V LT	$156.10	$223.00	$16.16–$178.40	35% below	30%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2+V RT	$156.10	$223.00	$16.16–$178.40	35% below	30%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) 2+V RT	$156.10	$223.00	$16.16–$178.40	—	30%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) 2+V LT	$156.10	$223.00	$16.16–$178.40	—	30%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON OB	$187.60	$268.00	$65.94–$214.40	72% below	30%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON OB	$187.60	$268.00	$65.94–$214.40	—	30%
Transvaginal ultrasound during pregnancy CPT 76817 US VAGINAL F/UP - PER FETUS	$187.60	$268.00	$49.98–$214.40	64% below	30%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US VAGINAL F/UP - PER FETUS	$187.60	$268.00	$49.98–$214.40	—	30%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$187.60	$268.00	$77.83–$214.40	82% below	30%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$187.60	$268.00	$77.83–$214.40	—	30%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$187.60	$268.00	$61.97–$214.40	75% below	30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$187.60	$268.00	$61.97–$214.40	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK	$187.60	$268.00	$61.27–$214.40	73% below	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD/NECK	$187.60	$268.00	$61.27–$214.40	—	30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2+V LT	$156.10	$223.00	$16.16–$178.40	50% below	30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2+V RT	$156.10	$223.00	$16.16–$178.40	50% below	30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 2+V RT	$156.10	$223.00	$16.16–$178.40	—	30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 2+V LT	$156.10	$223.00	$16.16–$178.40	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX VENOUS EXT UNILAT/LMTD	$187.60	$268.00	$118.85–$495.00	75% below	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLEX VENOUS EXT UNILAT/LMTD	$187.60	$268.00	$118.85–$495.00	—	30%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2V LT	$156.10	$223.00	$16.16–$178.40	44% below	30%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2V RT	$156.10	$223.00	$16.16–$178.40	44% below	30%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2V RT	$156.10	$223.00	$16.16–$178.40	—	30%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2V LT	$156.10	$223.00	$16.16–$178.40	—	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST CMPL 3+V RT	$156.10	$223.00	$16.16–$178.40	53% below	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST CMPL 3+V LT	$156.10	$223.00	$16.16–$178.40	53% below	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST CMPL 3+V LT	$156.10	$223.00	$16.16–$178.40	—	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST CMPL 3+V RT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR PELVIS & HIPS INF/CHILD 2+V	$156.10	$223.00	$21.89–$178.40	50% below	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP W/WO PELVIS 2-3 V LT	$156.10	$223.00	$21.89–$178.40	50% below	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP W/WO PELVIS 2-3 V RT	$156.10	$223.00	$21.89–$178.40	50% below	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR PELVIS & HIPS INF/CHILD 2+V	$156.10	$223.00	$21.89–$178.40	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP W/WO PELVIS 2-3 V LT	$156.10	$223.00	$21.89–$178.40	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP W/WO PELVIS 2-3 V RT	$156.10	$223.00	$21.89–$178.40	—	30%
X-ray of the abdomen, 1 view CPT 74018 X-RAY EXAM ABDOMEN 1 VIEW	$156.10	$223.00	$20.75–$275.38	42% below	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY EXAM ABDOMEN 1 VIEW	$156.10	$223.00	$20.75–$275.38	—	30%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2V LT	$156.10	$223.00	$16.16–$178.40	45% below	30%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 1V LT	$156.10	$223.00	$16.16–$178.40	45% below	30%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 1V RT	$156.10	$223.00	$16.16–$178.40	45% below	30%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2V RT	$156.10	$223.00	$16.16–$178.40	45% below	30%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2V LT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 1V RT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2V RT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 1V LT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) 2+V LT	$156.10	$223.00	$16.16–$178.40	41% below	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) 2+V RT	$156.10	$223.00	$16.16–$178.40	41% below	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER(S) 2+V LT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER(S) 2+V RT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2V LT	$156.10	$223.00	$16.16–$178.40	44% below	30%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2V RT	$156.10	$223.00	$16.16–$178.40	44% below	30%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2V LT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2V RT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT CMPL 3+V RT	$156.10	$223.00	$16.16–$178.40	55% below	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT CMPL 3+V LT	$156.10	$223.00	$16.16–$178.40	55% below	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT CMPL 3+V LT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT CMPL 3+V RT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND CMPL 3+V LT	$156.10	$223.00	$16.16–$178.40	55% below	30%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND CMPL 3+V RT	$156.10	$223.00	$16.16–$178.40	55% below	30%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND CMPL 3+V LT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND CMPL 3+V RT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2V RT	$156.10	$223.00	$16.16–$178.40	48% below	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2V LT	$156.10	$223.00	$16.16–$178.40	48% below	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2V RT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2V LT	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR SPINE 2 OR 3 VIEWS	$187.60	$268.00	$16.16–$214.40	59% below	30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR SPINE 2 OR 3 VIEWS	$187.60	$268.00	$16.16–$214.40	—	30%
X-ray of the lower back, 4 or more views CPT 72110 XR L-SPINE 4+V	$187.60	$268.00	$27.08–$214.40	68% below	30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR L-SPINE 4+V	$187.60	$268.00	$27.08–$214.40	—	30%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR THORACIC SPINE 2 VIEWS	$187.60	$268.00	$16.16–$214.40	50% below	30%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR THORACIC SPINE 2 VIEWS	$187.60	$268.00	$16.16–$214.40	—	30%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL CMPL 3+V	$156.10	$223.00	$16.16–$178.40	48% below	30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL CMPL 3+V	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE 2-3V	$156.10	$223.00	$16.16–$178.40	58% below	30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR C-SPINE 2-3V	$156.10	$223.00	$16.16–$178.40	—	30%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1-2V	$187.60	$268.00	$16.16–$214.40	46% below	30%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1-2V	$187.60	$268.00	$16.16–$214.40	—	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX 2+ VIEWS	$156.10	$223.00	$16.16–$178.40	57% below	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX 2+ VIEWS	$156.10	$223.00	$16.16–$178.40	—	30%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
ACTH blood test CPT 82024 RL-ADRENOCORTICOTROPIC (ACTH)	$67.90	$97.00	$10.83–$77.60	65% below	30%
ACTH blood test inpatient CPT 82024 RL-ADRENOCORTICOTROPIC (ACTH)	$67.90	$97.00	$10.83–$77.60	—	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SGPT	$9.80	$14.00	$1.49–$11.20	81% below	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SGPT	$9.80	$14.00	$1.49–$11.20	—	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT	$9.10	$13.00	$1.45–$14.18	83% below	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT	$9.10	$13.00	$1.45–$14.18	—	30%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$84.00	$120.00	$8.68–$96.00	68% below	30%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$84.00	$120.00	$8.68–$96.00	—	30%
Albumin blood test CPT 82040 ALBUMIN SERUM	$9.10	$13.00	$1.39–$25.80	78% below	30%
Albumin blood test CPT 82040 RL-ALBUMIN SERUM	$9.10	$13.00	$1.39–$10.40	78% below	30%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$9.10	$13.00	$1.39–$25.80	—	30%
Albumin blood test inpatient CPT 82040 RL-ALBUMIN SERUM	$9.10	$13.00	$1.39–$10.40	—	30%
Aldosterone blood test CPT 82088 ALDOSTERONE	$71.40	$102.00	$9.71–$81.60	55% below	30%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$71.40	$102.00	$9.71–$81.60	—	30%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE ALKALINE	$9.10	$13.00	$1.45–$10.40	82% below	30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE ALKALINE	$9.10	$13.00	$1.45–$10.40	—	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE QN SQ 1ST	$9.80	$14.00	$1.46–$11.20	62% below	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE QN SQ 1ST	$9.80	$14.00	$1.46–$11.20	—	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN SERUM	$29.40	$42.00	$4.71–$33.60	74% below	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN SERUM	$29.40	$42.00	$4.71–$33.60	—	30%
Ammonia blood test CPT 82140 AMMONIA	$25.90	$37.00	$4.09–$29.60	76% below	30%
Ammonia blood test inpatient CPT 82140 AMMONIA	$25.90	$37.00	$4.09–$29.60	—	30%
Amylase blood test CPT 82150 AMYLASE BODY FLUID	$11.90	$17.00	$1.82–$13.60	85% below	30%
Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID	$11.90	$17.00	$1.82–$13.60	—	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$23.10	$33.00	$3.63–$26.40	72% below	30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY	$23.10	$33.00	$3.63–$26.40	—	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY SCREEN	$21.70	$31.00	$3.39–$24.80	76% below	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY SCREEN	$21.70	$31.00	$3.39–$24.80	—	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$69.30	$99.00	$7.95–$79.20	63% below	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$69.30	$99.00	$7.95–$79.20	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHER SOURCE	$15.40	$22.00	$2.42–$17.60	83% below	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE OTHER SOURCE	$15.40	$22.00	$2.42–$17.60	—	30%
Basic metabolic panel (blood test) CPT 80048 BASIC METAB PANEL (CAL-TOTAL)	$15.40	$22.00	$2.37–$17.60	88% below	30%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METAB PANEL (CAL-TOTAL)	$15.40	$22.00	$2.37–$17.60	—	30%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL BODY FLUID	$9.10	$13.00	$1.41–$26.58	85% below	30%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL BODY FLUID	$9.10	$13.00	$1.41–$26.58	—	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PF-GROSS & MICRO LEVEL IV	$63.00	$90.00	$21.67–$111.42	74% below	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 GROSS & MICRO LEVEL IV	$93.80	$134.00	$21.22–$107.20	61% below	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PF-GROSS & MICRO LEVEL IV	$63.00	$90.00	$21.67–$111.42	—	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 GROSS & MICRO LEVEL IV	$93.80	$134.00	$21.22–$107.20	—	30%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$18.20	$26.00	$2.89–$20.80	88% below	30%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$18.20	$26.00	$2.89–$20.80	—	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$16.80	$24.00	$1.08–$19.20	29% below	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$16.80	$24.00	$1.08–$19.20	—	30%
Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD	$7.00	$10.00	$1.20–$17.77	85% below	30%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BLOOD	$7.00	$10.00	$1.20–$17.77	—	30%
Blood lead test CPT 83655 RL-LEAD	$21.70	$31.00	$3.39–$24.80	61% below	30%
Blood lead test CPT 83655 LEAD	$21.70	$31.00	$3.39–$24.80	61% below	30%
Blood lead test inpatient CPT 83655 LEAD	$21.70	$31.00	$3.39–$24.80	—	30%
Blood lead test inpatient CPT 83655 RL-LEAD	$21.70	$31.00	$3.39–$24.80	—	30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QL	$13.30	$19.00	$2.11–$15.20	85% below	30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QL	$13.30	$19.00	$2.11–$15.20	—	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$238.00	$340.00	$0.84–$272.00	182% above	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$238.00	$340.00	$0.84–$272.00	—	30%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN QUANTITATIVE	$7.00	$10.00	$1.11–$10.63	87% below	30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN QUANTITATIVE	$7.00	$10.00	$1.11–$10.63	—	30%
C-peptide blood test CPT 84681 RL-C-PEPTIDE	$37.10	$53.00	$5.84–$42.40	64% below	30%
C-peptide blood test inpatient CPT 84681 RL-C-PEPTIDE	$37.10	$53.00	$5.84–$42.40	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$9.10	$13.00	$1.45–$50.19	88% below	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$9.10	$13.00	$1.45–$50.19	—	30%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNO TUMR AG CA 19-9	$37.10	$53.00	$5.84–$42.40	66% below	30%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNO TUMR AG CA 19-9	$37.10	$53.00	$5.84–$42.40	—	30%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNO TUMR AG CA 125	$37.10	$53.00	$5.84–$42.40	77% below	30%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNO TUMR AG CA 125	$37.10	$53.00	$5.84–$42.40	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID 19 INHOUSE TEST	$90.30	$129.00	$11.08–$142.63	22% below	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID 19 INHOUSE TEST	$90.30	$129.00	$11.08–$142.63	—	30%
Calcium blood test, total CPT 82310 RL-CALCIUM TOTAL	$9.10	$13.00	$1.45–$26.79	80% below	30%
Calcium blood test, total inpatient CPT 82310 RL-CALCIUM TOTAL	$9.10	$13.00	$1.45–$26.79	—	30%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC AG (CEA)	$33.60	$48.00	$5.32–$38.40	76% below	30%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC AG (CEA)	$33.60	$48.00	$5.32–$38.40	—	30%
Chickenpox (varicella) immunity blood test CPT 86787 RL-VARICELLA ZOSTER ANTIBODY	$23.10	$33.00	$3.61–$26.40	69% below	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 RL-VARICELLA ZOSTER ANTIBODY	$23.10	$33.00	$3.61–$26.40	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 NUCLEIC ACID CHLAMYDIA TRACH	$61.60	$88.00	$9.84–$70.40	50% below	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 NUCLEIC ACID CHLAMYDIA TRACH	$61.60	$88.00	$9.84–$70.40	—	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$23.80	$34.00	$3.75–$47.81	82% below	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$23.80	$34.00	$3.75–$47.81	—	30%
Complete blood count (CBC) with differential CPT 85025 CBC AUTO W/AUTO DIF	$14.00	$20.00	$2.18–$16.00	82% below	30%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO W/AUTO DIF	$14.00	$20.00	$2.18–$16.00	—	30%
Complete blood count (CBC), no differential CPT 85027 CBC AUTO W/O DIFF	$11.90	$17.00	$1.81–$13.60	82% below	30%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTO W/O DIFF	$11.90	$17.00	$1.81–$13.60	—	30%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$18.90	$27.00	$2.96–$21.60	88% below	30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$18.90	$27.00	$2.96–$21.60	—	30%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL URINE	$28.70	$41.00	$4.58–$32.80	74% below	30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL URINE	$28.70	$41.00	$4.58–$32.80	—	30%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE (CPK) TOTAL	$11.90	$17.00	$1.83–$24.09	81% below	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE (CPK) TOTAL	$11.90	$17.00	$1.83–$24.09	—	30%
Creatinine blood test CPT 82565 CREATININE BLOOD	$9.10	$13.00	$1.44–$11.55	82% below	30%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$9.10	$13.00	$1.44–$11.55	—	30%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY	$25.20	$36.00	$4.04–$28.80	70% below	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ANTIBODY	$25.20	$36.00	$4.04–$28.80	—	30%
DHEA sulfate (DHEA-S) blood test CPT 82627 RL-DHEA-S	$39.20	$56.00	$6.24–$44.80	64% below	30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 RL-DHEA-S	$39.20	$56.00	$6.24–$44.80	—	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG ANLYS TISSUE PREP	$200.90	$287.00	$15.80–$229.60	106% above	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG ANLYS TISSUE PREP	$200.90	$287.00	$15.80–$229.60	—	30%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$12.60	$18.00	$1.97–$14.40	87% below	30%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$12.60	$18.00	$1.97–$14.40	—	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 RL-EBV VCA ANTIBODY ANTIBODY	$32.20	$46.00	$5.09–$36.80	70% below	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 RL-EBV VCA ANTIBODY ANTIBODY	$32.20	$46.00	$5.09–$36.80	—	30%
Estradiol blood test CPT 82670 ESTRADIOL	$49.00	$70.00	$3.18–$56.00	54% below	30%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$49.00	$70.00	$3.18–$56.00	—	30%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIM HORMONE (FSH)	$32.90	$47.00	$5.21–$37.60	72% below	30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIM HORMONE (FSH)	$32.90	$47.00	$5.21–$37.60	—	30%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, STOOL	$35.00	$50.00	$5.50–$40.00	80% below	30%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, STOOL	$35.00	$50.00	$5.50–$40.00	—	30%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$24.50	$35.00	$3.82–$28.00	81% below	30%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$24.50	$35.00	$3.82–$28.00	—	30%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$17.50	$25.00	$2.38–$20.00	80% below	30%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$17.50	$25.00	$2.38–$20.00	—	30%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$25.90	$37.00	$4.12–$29.60	77% below	30%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$25.90	$37.00	$4.12–$29.60	—	30%
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE (T-3) FREE	$30.10	$43.00	$3.18–$34.40	75% below	30%
Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE (T-3) FREE	$30.10	$43.00	$3.18–$34.40	—	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (T-4) FREE	$16.10	$23.00	$2.53–$18.40	86% below	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE (T-4) FREE	$16.10	$23.00	$2.53–$18.40	—	30%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$44.80	$64.00	$5.49–$51.20	63% below	30%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$44.80	$64.00	$5.49–$51.20	—	30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT/GGTP	$12.60	$18.00	$2.02–$14.40	78% below	30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT/GGTP	$12.60	$18.00	$2.02–$14.40	—	30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST DOSE	$8.40	$12.00	$1.45–$9.60	85% below	30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST DOSE	$8.40	$12.00	$1.45–$9.60	—	30%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLBUTAMIDE TOLERANCE	$23.10	$33.00	$3.94–$26.40	83% below	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLBUTAMIDE TOLERANCE	$23.10	$33.00	$3.94–$26.40	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NUCLEIC ACID AMP NEISSERIA	$61.60	$88.00	$9.84–$70.40	50% below	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NUCLEIC ACID AMP NEISSERIA	$61.60	$88.00	$9.84–$70.40	—	30%
H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODY	$30.10	$43.00	$4.07–$34.40	74% below	30%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI ANTIBODY	$30.10	$43.00	$4.07–$34.40	—	30%
H. pylori stool antigen test CPT 87338 EIA QL H PYLORI ANTIGEN STOOL	$25.20	$36.00	$4.03–$28.80	78% below	30%
H. pylori stool antigen test inpatient CPT 87338 EIA QL H PYLORI ANTIGEN STOOL	$25.20	$36.00	$4.03–$28.80	—	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 NUCLEIC ACID QN HIV-1	$149.10	$213.00	$23.86–$170.40	56% below	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 NUCLEIC ACID QN HIV-1	$149.10	$213.00	$23.86–$170.40	—	30%
HIV-1 and HIV-2 antibody test CPT 86703 HIV1 HIV2 ANTIBODY SGL RES	$24.50	$35.00	$3.85–$28.00	79% below	30%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV1 HIV2 ANTIBODY SGL RES	$24.50	$35.00	$3.85–$28.00	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$42.70	$61.00	$6.76–$48.80	62% below	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$42.70	$61.00	$6.76–$48.80	—	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 NUCLEIC ACID DIRECT HPV	$61.60	$88.00	$9.46–$70.40	58% below	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 RL-NUCLEIC ACID AMP PROBE HPV	$61.60	$88.00	$9.46–$70.40	58% below	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 NUCLEIC ACID DIRECT HPV	$61.60	$88.00	$9.46–$70.40	—	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 RL-NUCLEIC ACID AMP PROBE HPV	$61.60	$88.00	$9.46–$70.40	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED (A1C)	$17.50	$25.00	$2.72–$20.00	80% below	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED (A1C)	$17.50	$25.00	$2.72–$20.00	—	30%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$4.20	$6.00	$0.72–$4.80	87% below	30%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$4.20	$6.00	$0.72–$4.80	—	30%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY	$21.70	$31.00	$3.38–$24.80	72% below	30%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY	$21.70	$31.00	$3.38–$24.80	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY	$18.90	$27.00	$3.01–$21.60	80% below	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY	$18.90	$27.00	$3.01–$21.60	—	30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 EIA QL HEPATITIS B ANTIGEN	$18.20	$26.00	$2.90–$20.80	80% below	30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 EIA QL HEPATITIS B ANTIGEN	$18.20	$26.00	$2.90–$20.80	—	30%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$25.20	$36.00	$4.00–$28.80	78% below	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$25.20	$36.00	$4.00–$28.80	—	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 NUCLEIC ACID QN HEPATITIS C	$75.60	$108.00	$12.01–$86.40	71% below	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 NUCLEIC ACID QN HEPATITIS C	$75.60	$108.00	$12.01–$86.40	—	30%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SMPX I ANTIBODY	$23.10	$33.00	$3.70–$26.40	64% below	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SMPX I ANTIBODY	$23.10	$33.00	$3.70–$26.40	—	30%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SMPX II ANTIBODY IGG	$34.30	$49.00	$5.43–$39.20	57% below	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SMPX II ANTIBODY IGG	$34.30	$49.00	$5.43–$39.20	—	30%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HIGH SENS	$23.10	$33.00	$3.63–$26.40	75% below	30%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HIGH SENS	$23.10	$33.00	$3.63–$26.40	—	30%
Homocysteine blood test CPT 83090 RL-HOMOCYSTINE	$31.50	$45.00	$4.73–$36.00	74% below	30%
Homocysteine blood test inpatient CPT 83090 RL-HOMOCYSTINE	$31.50	$45.00	$4.73–$36.00	—	30%
Insulin blood test CPT 83525 INSULIN TOTAL	$20.30	$29.00	$3.20–$23.20	72% below	30%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$20.30	$29.00	$3.20–$23.20	—	30%
Iron blood test (serum iron) CPT 83540 IRON	$11.90	$17.00	$1.82–$19.82	85% below	30%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$11.90	$17.00	$1.82–$19.82	—	30%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$15.40	$22.00	$2.45–$17.60	79% below	30%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$15.40	$22.00	$2.45–$17.60	—	30%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$15.40	$22.00	$2.44–$17.60	90% below	30%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$15.40	$22.00	$2.44–$17.60	—	30%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE (LH)	$32.90	$47.00	$5.19–$37.60	71% below	30%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE (LH)	$32.90	$47.00	$5.19–$37.60	—	30%
Lactate (lactic acid) blood test CPT 83605 LACTATE/LACTIC ACID BLOOD	$20.30	$29.00	$3.00–$28.50	77% below	30%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE/LACTIC ACID BLOOD	$20.30	$29.00	$3.00–$28.50	—	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDRO (LDH)	$11.20	$16.00	$1.69–$12.80	81% below	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDRO (LDH)	$11.20	$16.00	$1.69–$12.80	—	30%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$12.60	$18.00	$1.93–$14.40	87% below	30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$12.60	$18.00	$1.93–$14.40	—	30%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$14.70	$21.00	$2.29–$47.63	89% below	30%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$14.70	$21.00	$2.29–$47.63	—	30%
Lyme disease antibody test CPT 86618 RL-LYME DISEASE ANTIBODY	$30.10	$43.00	$4.78–$34.40	58% below	30%
Lyme disease antibody test inpatient CPT 86618 RL-LYME DISEASE ANTIBODY	$30.10	$43.00	$4.78–$34.40	—	30%
Magnesium blood test CPT 83735 MAGNESIUM SERUM	$11.90	$17.00	$1.88–$17.19	83% below	30%
Magnesium blood test inpatient CPT 83735 MAGNESIUM SERUM	$11.90	$17.00	$1.88–$17.19	—	30%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$23.10	$33.00	$3.61–$26.40	68% below	30%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY	$23.10	$33.00	$3.61–$26.40	—	30%
Mono test (heterophile antibody, Monospot) CPT 86308 RL-HETEROPHILE ANTIBODY SCREEN	$9.10	$13.00	$1.58–$20.81	89% below	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 RL-HETEROPHILE ANTIBODY SCREEN	$9.10	$13.00	$1.58–$20.81	—	30%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$23.10	$33.00	$3.66–$26.40	68% below	30%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY	$23.10	$33.00	$3.66–$26.40	—	30%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$84.00	$120.00	$10.56–$96.00	60% below	30%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$84.00	$120.00	$10.56–$96.00	—	30%
PSA (prostate-specific antigen) blood test, free CPT 84154 RL-PROSTATE SPECIFIC AG FREE	$32.20	$46.00	$5.16–$36.80	65% below	30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 RL-PROSTATE SPECIFIC AG FREE	$32.20	$46.00	$5.16–$36.80	—	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC AG TOTAL	$32.20	$46.00	$5.16–$36.80	72% below	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC AG TOTAL	$32.20	$46.00	$5.16–$36.80	—	30%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH PAP TLP AUTO/MAN	$46.90	$67.00	$10.75–$53.60	66% below	30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATH PAP TLP AUTO/MAN	$46.90	$67.00	$10.75–$53.60	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH PAP TLP MAN	$35.70	$51.00	$8.27–$40.80	68% below	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH PAP TLP MAN	$35.70	$51.00	$8.27–$40.80	—	30%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PT/H) C TERMINAL	$72.80	$104.00	$11.57–$83.20	67% below	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE (PT/H) C TERMINAL	$72.80	$104.00	$11.57–$83.20	—	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLAS TIME (PTT)	$11.20	$16.00	$1.68–$12.80	84% below	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLAS TIME (PTT)	$11.20	$16.00	$1.68–$12.80	—	30%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS BLOOD	$8.40	$12.00	$1.33–$10.73	87% below	30%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS BLOOD	$8.40	$12.00	$1.33–$10.73	—	30%
Potassium blood test CPT 84132 POTASSIUM SERUM	$8.40	$12.00	$1.29–$39.11	81% below	30%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$8.40	$12.00	$1.29–$39.11	—	30%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 RL-QNATAL ADVANCE	$1,328.60	$1,898.00	$137.00–$1,518.40	51% above	30%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 RL-QNATAL ADVANCE	$1,328.60	$1,898.00	$137.00–$1,518.40	—	30%
Progesterone blood test CPT 84144 PROGESTERONE	$37.10	$53.00	$5.85–$42.40	73% below	30%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$37.10	$53.00	$5.85–$42.40	—	30%
Prolactin blood test CPT 84146 PROLACTIN	$34.30	$49.00	$5.44–$39.20	73% below	30%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$34.30	$49.00	$5.44–$39.20	—	30%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT) - POC	$7.70	$11.00	$1.20–$24.91	80% below	30%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT)	$7.70	$11.00	$1.20–$8.80	80% below	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (PT)	$7.70	$11.00	$1.20–$8.80	—	30%
Rapid flu test (influenza antigen) CPT 87804 IMMUNO OPTICAL INFLUENZA	$29.40	$42.00	$5.04–$33.60	63% below	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 IMMUNO OPTICAL INFLUENZA	$29.40	$42.00	$5.04–$33.60	—	30%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 IMMUNO OPTICAL STREP A	$29.40	$42.00	$3.67–$33.60	52% below	30%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 IMMUNO OPTICAL STREP A	$29.40	$42.00	$3.67–$33.60	—	30%
Renin blood test CPT 84244 RL-RENIN	$38.50	$55.00	$6.17–$44.00	66% below	30%
Renin blood test inpatient CPT 84244 RL-RENIN	$38.50	$55.00	$6.17–$44.00	—	30%
Rh blood typing CPT 86901 BLOOD TYPING RH (D)	$67.20	$96.00	$0.84–$76.80	2% below	30%
Rh blood typing inpatient CPT 86901 BLOOD TYPING RH (D)	$67.20	$96.00	$0.84–$76.80	—	30%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QN	$10.50	$15.00	$1.59–$12.00	83% below	30%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QN	$10.50	$15.00	$1.59–$12.00	—	30%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$25.20	$36.00	$4.04–$28.80	67% below	30%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY	$25.20	$36.00	$4.04–$28.80	—	30%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE, AUTOMATED	$4.90	$7.00	$0.76–$5.60	89% below	30%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE, AUTOMATED	$4.90	$7.00	$0.76–$5.60	—	30%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANLYS CMPL	$21.70	$31.00	$3.07–$24.80	85% below	30%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANLYS CMPL	$21.70	$31.00	$3.07–$24.80	—	30%
Sodium blood test CPT 84295 SODIUM BLOOD	$9.10	$13.00	$1.35–$25.21	81% below	30%
Sodium blood test inpatient CPT 84295 SODIUM BLOOD	$9.10	$13.00	$1.35–$25.21	—	30%
Stool ova and parasites exam CPT 87177 RL-SMEAR OVA PARASITE CNCNT/ID	$16.10	$23.00	$2.44–$18.40	79% below	30%
Stool ova and parasites exam inpatient CPT 87177 RL-SMEAR OVA PARASITE CNCNT/ID	$16.10	$23.00	$2.44–$18.40	—	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES SCREEN	$7.70	$11.00	$1.00–$16.87	73% below	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES SCREEN	$7.70	$11.00	$1.00–$16.87	—	30%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLOOD, OCCULT FECES 1-3 (IFOB)	$32.20	$46.00	$4.87–$36.80	55% below	30%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLOOD, OCCULT FECES 1-3 (IFOB)	$32.20	$46.00	$4.87–$36.80	—	30%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA ANTIBODY CONFIRM	$23.80	$34.00	$3.71–$27.20	65% below	30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA ANTIBODY CONFIRM	$23.80	$34.00	$3.71–$27.20	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RL-SYPHILIS VDRL RPR QL	$7.70	$11.00	$1.20–$12.66	85% below	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RL-SYPHILIS VDRL RPR QL	$7.70	$11.00	$1.20–$12.66	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 RL-TB TEST CELL IMM MEAS IN AG	$108.50	$155.00	$5.67–$124.00	51% below	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 RL-TB TEST CELL IMM MEAS IN AG	$108.50	$155.00	$5.67–$124.00	—	30%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$45.50	$65.00	$7.24–$52.00	64% below	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$45.50	$65.00	$7.24–$52.00	—	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY THYROID	$25.90	$37.00	$4.08–$77.78	68% below	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY THYROID	$25.90	$37.00	$4.08–$77.78	—	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE	$29.40	$42.00	$4.71–$33.60	77% below	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE	$29.40	$42.00	$4.71–$33.60	—	30%
Total IgE blood test CPT 82785 RL-GAMMAGLOBULIN IGE	$29.40	$42.00	$4.62–$33.60	65% below	30%
Total IgE blood test inpatient CPT 82785 RL-GAMMAGLOBULIN IGE	$29.40	$42.00	$4.62–$33.60	—	30%
Total cholesterol blood test CPT 82465 CHOLESTEROL BLOOD TOTAL	$7.70	$11.00	$1.22–$8.80	83% below	30%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL BLOOD TOTAL	$7.70	$11.00	$1.22–$8.80	—	30%
Total thyroxine (T4) blood test CPT 84436 THYROXINE (T-4) TOTAL	$12.60	$18.00	$1.93–$16.06	85% below	30%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE (T-4) TOTAL	$12.60	$18.00	$1.93–$16.06	—	30%
Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE (T-3) TOTAL	$25.20	$36.00	$3.10–$28.80	74% below	30%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIIODOTHYRONINE (T-3) TOTAL	$25.20	$36.00	$3.10–$28.80	—	30%
Transferrin blood test CPT 84466 TRANSFERRIN	$22.40	$32.00	$3.58–$25.60	77% below	30%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$22.40	$32.00	$3.58–$25.60	—	30%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS	$61.60	$88.00	$9.48–$70.40	51% below	30%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS	$61.60	$88.00	$9.48–$70.40	—	30%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$10.50	$15.00	$1.61–$12.76	78% below	30%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$10.50	$15.00	$1.61–$12.76	—	30%
Troponin test, quantitative CPT 84484 TROPONIN QN	$22.40	$32.00	$2.76–$25.60	86% below	30%
Troponin test, quantitative inpatient CPT 84484 TROPONIN QN	$22.40	$32.00	$2.76–$25.60	—	30%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$8.40	$12.00	$1.27–$9.60	88% below	30%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$8.40	$12.00	$1.27–$9.60	—	30%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/MICRO	$5.60	$8.00	$0.97–$67.21	91% below	30%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/MICRO	$5.60	$8.00	$0.97–$67.21	—	30%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O MICRO	$4.20	$6.00	$0.69–$4.80	83% below	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O MICRO	$4.20	$6.00	$0.69–$4.80	—	30%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO ACETONE	$6.30	$9.00	$0.78–$7.20	75% below	30%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO ACETONE	$6.30	$9.00	$0.78–$7.20	—	30%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE W/COLONY COUNT	$14.70	$21.00	$2.26–$27.07	84% below	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE W/COLONY COUNT	$14.70	$21.00	$2.26–$27.07	—	30%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE QN	$10.50	$15.00	$1.62–$12.00	84% below	30%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE QN	$10.50	$15.00	$1.62–$12.00	—	30%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY VISUAL	$15.40	$22.00	$1.94–$17.60	79% below	30%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY VISUAL	$15.40	$22.00	$1.94–$17.60	—	30%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$26.60	$38.00	$4.23–$30.40	79% below	30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$26.60	$38.00	$4.23–$30.40	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 25-OH	$51.80	$74.00	$8.31–$59.20	72% below	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D-3 25-OH	$51.80	$74.00	$8.31–$59.20	—	30%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D (1 25 DIHYDROXY)	$67.90	$97.00	$10.80–$77.60	65% below	30%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D (1 25 DIHYDROXY)	$67.90	$97.00	$10.80–$77.60	—	30%
Zinc blood test CPT 84630 ZINC URINE	$20.30	$29.00	$3.17–$23.20	71% below	30%
Zinc blood test inpatient CPT 84630 ZINC URINE	$20.30	$29.00	$3.17–$23.20	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QN	$26.60	$38.00	$4.61–$30.40	75% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QN	$26.60	$38.00	$4.61–$30.40	—	30%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 PF-REMOVAL OF ADENOIDS	$373.10	$533.00	$224.86–$426.40	92% below	30%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 PF-REMOVAL OF ADENOIDS	$373.10	$533.00	$224.86–$426.40	—	30%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 PF-NECK SPINE FUSE&REMOVE ADDL	$3,446.80	$4,924.00	$2,235.58–$3,939.20	68% below	30%
Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 PF-NECK SPINE FUSE&REMOVE ADDL	$3,446.80	$4,924.00	$2,235.58–$3,939.20	—	30%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 PF-APPENDECTOMY	$1,730.40	$2,472.00	$94.90–$1,977.60	—	30%
Appendectomy, open surgery CPT 44950 PF-APPENDECTOMY	$1,263.50	$1,805.00	$678.80–$1,444.00	68% below	30%
Appendectomy, open surgery inpatient CPT 44950 PF-APPENDECTOMY	$1,263.50	$1,805.00	$678.80–$1,444.00	—	30%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 PF-KNEE ARTHROSCOPY/SURGERY	$1,773.10	$2,533.00	$844.64–$2,026.40	79% below	30%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 PF-KNEE ARTHROSCOPY/SURGERY	$1,773.10	$2,533.00	$844.64–$2,026.40	—	30%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 PF-ARTHROSC ROTATOR CUFF REPR	$1,949.50	$2,785.00	$191.28–$2,228.00	75% below	30%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 PF-ARTHROSC ROTATOR CUFF REPR	$1,949.50	$2,785.00	$191.28–$2,228.00	—	30%
Botox injections for chronic migraine both sides CPT 64615 BOTOX, FACE AND NECK BILATERAL	$548.80	$784.00	$118.26–$627.20	—	30%
Botox injections for chronic migraine CPT 64615 PF-CHEMODENERV MUSC MIGRAINE	$239.40	$342.00	$129.50–$273.60	36% below	30%
Botox injections for chronic migraine one side CPT 64615 BOTOX, FACE AND NECK, LEFT	$548.80	$784.00	$136.76–$627.20	46% above	30%
Botox injections for chronic migraine inpatient both sides CPT 64615 BOTOX, FACE AND NECK BILATERAL	$548.80	$784.00	$118.26–$627.20	—	30%
Botox injections for chronic migraine inpatient CPT 64615 PF-CHEMODENERV MUSC MIGRAINE	$239.40	$342.00	$129.50–$273.60	—	30%
Botox injections for chronic migraine inpatient one side CPT 64615 BOTOX, FACE AND NECK, LEFT	$548.80	$784.00	$136.76–$627.20	—	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LES STEREO	$2,953.30	$4,219.00	$243.40–$3,375.20	2% above	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 PF-BX BREAST 1ST LES STEREO RT	$270.20	$386.00	$172.29–$308.80	91% below	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 PF-BX BREAST 1ST LES STEREO LT	$270.20	$386.00	$8.13–$308.80	91% below	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BX BREAST 1ST LES STEREO LT	$2,953.30	$4,219.00	$243.40–$3,375.20	2% above	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BX BREAST 1ST LES STEREO RT	$2,953.30	$4,219.00	$172.29–$3,375.20	2% above	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 PF-BX BREAST 1ST LES STEREO RT	$270.20	$386.00	$172.29–$308.80	—	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 PF-BX BREAST 1ST LES STEREO LT	$270.20	$386.00	$8.13–$308.80	—	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BX BREAST 1ST LES STEREO RT	$2,953.30	$4,219.00	$172.29–$3,375.20	—	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BX BREAST 1ST LES STEREO LT	$2,953.30	$4,219.00	$243.40–$3,375.20	—	30%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TX FX ANKLE DISTAL FIB W/O	$441.70	$631.00	$277.22–$504.80	at median	30%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 PF-TX FX ANKLE DISTAL FIB	$557.90	$797.00	$291.42–$637.60	26% above	30%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 PF-TX FX METATARSAL W/O MAN	$389.90	$557.00	$233.79–$445.60	40% below	30%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TX FX METATARSAL; W/O MANIP	$441.70	$631.00	$185.78–$504.80	32% below	30%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 PF-CORRECT BUNION-MITCH/CHEVRN	$914.90	$1,307.00	$498.88–$1,045.60	75% below	30%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECT BUN-MITCHELL/CHEVR	$5,850.60	$8,358.00	$521.81–$6,686.40	63% above	30%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 PF-CORRECT BUNION-MITCH/CHEVRN	$914.90	$1,307.00	$498.88–$1,045.60	—	30%
Bunion correction with removal of part of the big toe joint CPT 28292 PF-CORRECT BUN-KELLER/MCB/	$868.70	$1,241.00	$655.99–$1,227.23	75% below	30%
Bunion correction with removal of part of the big toe joint CPT 28292 CORRECT BUN-KELLER/MCB/MAY	$5,850.60	$8,358.00	$498.88–$6,686.40	68% above	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 PF-CARDIOVERSION	$178.50	$255.00	$138.66–$267.48	84% below	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$1,182.30	$1,689.00	$30.63–$1,351.20	3% above	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 PF-CARDIOVERSION	$178.50	$255.00	$138.66–$267.48	—	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$1,182.30	$1,689.00	$30.63–$1,351.20	—	30%
Carpal tunnel release, open surgery CPT 64721 PF-CARPAL TUNNEL SURGERY	$819.70	$1,171.00	$453.46–$936.80	66% below	30%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$3,491.60	$4,988.00	$231.61–$3,990.40	47% above	30%
Carpal tunnel release, open surgery inpatient CPT 64721 PF-CARPAL TUNNEL SURGERY	$819.70	$1,171.00	$453.46–$936.80	—	30%
Cataract surgery with lens implant CPT 66984 PF-CATARACT SURG W/IOL 1 STAGE	$855.40	$1,222.00	$754.79–$977.60	85% below	30%
Cataract surgery with lens implant CPT 66984 CATARACT SUR W/IOL 1 STAGE	$4,126.50	$5,895.00	$679.71–$4,716.00	28% below	30%
Cataract surgery with lens implant inpatient CPT 66984 PF-CATARACT SURG W/IOL 1 STAGE	$855.40	$1,222.00	$754.79–$977.60	—	30%
Cervical biopsy CPT 57500 PF-BIOPSY OF CERVIX	$136.50	$195.00	$62.97–$203.32	85% below	30%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$1,647.10	$2,353.00	$62.97–$1,882.40	80% above	30%
Cervical biopsy inpatient CPT 57500 PF-BIOPSY OF CERVIX	$136.50	$195.00	$62.97–$203.32	—	30%
Cesarean delivery, including prenatal and postpartum care CPT 59510 PF-CESAREAN DELIVERY	$5,335.40	$7,622.00	$211.64–$6,097.60	9% above	30%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 PF-CESAREAN DELIVERY	$5,335.40	$7,622.00	$211.64–$6,097.60	—	30%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 PF-CIRC W/O CLAMP >28 DAYS	$350.70	$501.00	$114.27–$400.80	85% below	30%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRC W/O CLAMP >28 DAYS	$3,738.00	$5,340.00	$129.56–$4,272.00	60% above	30%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 PF-CIRCUMCISION W/REG BLOCK	$166.60	$238.00	$154.70–$1,625.87	90% below	30%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISIONW/REGBLOCK	$3,738.00	$5,340.00	$142.14–$4,272.00	122% above	30%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 PF-CIRCUMCISION W/REG BLOCK	$166.60	$238.00	$154.70–$1,625.87	—	30%
Circumcision, surgical, older than a newborn CPT 54160 PF-CIRCUMCISION NEONATE	$258.30	$369.00	$103.99–$295.20	78% below	30%
Circumcision, surgical, older than a newborn CPT 54160 CIRCW/OCLAMPNEONATE	$1,246.70	$1,781.00	$103.99–$1,424.80	8% above	30%
Circumcision, surgical, older than a newborn inpatient CPT 54160 PF-CIRCUMCISION NEONATE	$258.30	$369.00	$103.99–$295.20	—	30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TRT FX RADIUS/ULNA W/O MANIP	$441.70	$631.00	$107.67–$423.00	16% below	30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 PF-TRT FX RADIUS/ULNA W/O	$644.00	$920.00	$251.80–$736.00	23% above	30%
Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY W/ENDOSCOPE US	$2,139.90	$3,057.00	$226.72–$1,896.00	59% below	30%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLONOSCOPY W/ENDOSCOPE US	$2,139.90	$3,057.00	$226.72–$1,896.00	—	30%
Colonoscopy with polyp removal CPT 45385 PF-LESION REMOVAL COLONOSCOPY	$432.60	$618.00	$247.89–$681.48	83% below	30%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/LESION REM	$2,139.90	$3,057.00	$197.76–$2,445.60	17% below	30%
Colonoscopy with polyp removal inpatient CPT 45385 PF-LESION REMOVAL COLONOSCOPY	$432.60	$618.00	$247.89–$681.48	—	30%
Colonoscopy with tissue sample CPT 45380 PF-COLONOSCOPY AND BIOPSY	$345.10	$493.00	$254.34–$604.15	85% below	30%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY	$2,139.90	$3,057.00	$254.34–$1,896.00	5% below	30%
Colonoscopy with tissue sample inpatient CPT 45380 PF-COLONOSCOPY AND BIOPSY	$345.10	$493.00	$254.34–$604.15	—	30%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY AND BIOPSY	$2,139.90	$3,057.00	$254.34–$1,896.00	—	30%
Colonoscopy, diagnostic CPT 45378 PF-DIAGNOSTIC COLONOSCOPY	$321.30	$459.00	$183.29–$507.35	85% below	30%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$1,663.20	$2,376.00	$61.08–$1,900.80	23% below	30%
Colonoscopy, diagnostic inpatient CPT 45378 PF-DIAGNOSTIC COLONOSCOPY	$321.30	$459.00	$183.29–$507.35	—	30%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 PF-BX OF CERVIX W/SCOPE LEEP	$285.60	$408.00	$112.46–$369.93	91% below	30%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE LEEP	$5,788.30	$8,269.00	$112.46–$6,615.20	85% above	30%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 PF-BX OF CERVIX W/SCOPE LEEP	$285.60	$408.00	$112.46–$369.93	—	30%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 PF-BX/CURETT OF CERVIX W/SCOPE	$240.10	$343.00	$100.12–$274.40	48% below	30%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSC BX&CURETTAGE	$545.30	$779.00	$100.12–$623.20	17% above	30%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 PF-BX/CURETT OF CERVIX W/SCOPE	$240.10	$343.00	$100.12–$274.40	—	30%
Complex cataract surgery with lens implant CPT 66982 PF-CATARACT SURGERY COMPLEX	$1,170.40	$1,672.00	$814.74–$1,355.74	83% below	30%
Complex cataract surgery with lens implant inpatient CPT 66982 PF-CATARACT SURGERY COMPLEX	$1,170.40	$1,672.00	$814.74–$1,355.74	—	30%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY W/STENT INS	$6,302.80	$9,004.00	$161.24–$7,203.20	68% above	30%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 PF-CYSTOSCOPY	$140.70	$201.00	$115.27–$922.95	88% below	30%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$1,246.70	$1,781.00	$115.27–$1,424.80	2% above	30%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 PF-CYSTOSCOPY	$140.70	$201.00	$115.27–$922.95	—	30%
D&C (dilation and curettage), not related to pregnancy CPT 58120 PF-D&C NON-OB	$418.60	$598.00	$70.34–$478.40	86% below	30%
D&C (dilation and curettage), not related to pregnancy CPT 58120 D&C NON-OB	$5,788.30	$8,269.00	$44.76–$6,615.20	97% above	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 PF-DEST LESN PREMALIG 1ST	$88.90	$127.00	$36.58–$101.60	49% below	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DEST LESN PREMALIG 1ST LES	$359.10	$513.00	$36.58–$410.40	106% above	30%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 PF-CREATE EARDRUM OPENING	$275.80	$394.00	$180.20–$460.88	83% below	30%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATEEARDRUMOPENING	$2,774.10	$3,963.00	$136.86–$3,170.40	68% above	30%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 PF-CREATE EARDRUM OPENING	$275.80	$394.00	$180.20–$460.88	—	30%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 PF-CREATE EARDRUM OPENING	$226.80	$324.00	$64.84–$259.20	60% below	30%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 C-CREATE EARDRUM OPENING	$964.60	$1,378.00	$107.80–$1,102.40	68% above	30%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 PF-CREATE EARDRUM OPENING	$226.80	$324.00	$64.84–$259.20	—	30%
Earwax removal by irrigation (rinsing), one ear CPT 69209 PF-REMOVE IMPACTED EAR WAX UNI	$30.80	$44.00	$15.21–$95.64	73% below	30%
Earwax removal by irrigation (rinsing), one ear CPT 69209 FCT-REM IMPACTED EAR WAX UNI	$105.70	$151.00	$10.58–$385.19	8% below	30%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 PF-REMOVE IMPACTED EAR WAX UNI	$30.80	$44.00	$15.21–$95.64	—	30%
Earwax removal with instruments, one ear CPT 69210 PF-REMOVE IMPACTED EAR WAX	$53.20	$76.00	$38.53–$103.06	57% below	30%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX	$105.70	$151.00	$44.82–$120.80	15% below	30%
Earwax removal with instruments, one ear inpatient CPT 69210 PF-REMOVE IMPACTED EAR WAX	$53.20	$76.00	$38.53–$103.06	—	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 PF-BX ENDOMETRIAL SAMPL W/	$113.40	$162.00	$92.61–$327.47	67% below	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BX ENDOMETRIAL SAMPL W/O	$361.90	$517.00	$92.61–$413.60	4% above	30%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 PF-REMOVAL OF ETHMOID SINUS	$543.20	$776.00	$264.81–$620.80	93% below	30%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 PF-REMOVAL OF ETHMOID SINUS	$543.20	$776.00	$264.81–$620.80	—	30%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 PF-SINUS ENDOSCOPY SURGICAL	$632.80	$904.00	$290.06–$723.20	92% below	30%
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 PF-SINUS ENDOSCOPY SURGICAL	$632.80	$904.00	$290.06–$723.20	—	30%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 PF-EXPLORATION MAXILLARY SINUS	$301.70	$431.00	$237.56–$352.36	92% below	30%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 EXPLORE MAXILLARY SINUS	$6,666.10	$9,523.00	$147.69–$7,618.40	68% above	30%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 PF-EXPLORATION MAXILLARY SINUS	$301.70	$431.00	$237.56–$352.36	—	30%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 PF-ENDOSCOPY MAXILLARY SINUS	$444.50	$635.00	$195.78–$508.00	94% below	30%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 PF-ENDOSCOPY MAXILLARY SINUS	$444.50	$635.00	$195.78–$508.00	—	30%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 PF-INJECTION(S) SPINE C/T	$182.00	$260.00	$88.58–$298.48	89% below	30%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION(S) SPINE C/T	$1,262.10	$1,803.00	$108.80–$1,442.40	27% below	30%
Eye injection into the vitreous (intravitreal injection) CPT 67028 PF-INTRAVITREAL	$141.40	$202.00	$131.30–$814.74	76% below	30%
Eye injection into the vitreous (intravitreal injection) CPT 67028 INTRAVITREAL	$590.80	$844.00	$102.07–$675.20	1% above	30%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 PF-INJ ANES/STER L/S SGL RT	$154.70	$221.00	$64.31–$176.80	90% below	30%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 PF-INJ PARAVERT F JNT L/S 1 RT	$154.70	$221.00	$96.10–$176.80	90% below	30%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 PF-INJ ANES/STER L/S SGL LT	$154.70	$221.00	$96.10–$176.80	90% below	30%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 PF-INJ PARAVERT F JNT L/S 1 LT	$154.70	$221.00	$64.31–$176.80	90% below	30%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ ANES/STER LUMB/SACR SGL RT	$1,582.00	$2,260.00	$96.10–$1,808.00	6% above	30%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ ANES/STER LUMB/SACR SGL LT	$1,582.00	$2,260.00	$64.31–$1,808.00	6% above	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 PF-INJ ANES/STER L/S SGL LT	$154.70	$221.00	$96.10–$176.80	—	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 PF-INJ ANES/STER L/S SGL RT	$154.70	$221.00	$64.31–$176.80	—	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 PF-INJ PARAVERT F JNT L/S 1 RT	$154.70	$221.00	$96.10–$176.80	—	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 PF-INJ PARAVERT F JNT L/S 1 LT	$154.70	$221.00	$64.31–$176.80	—	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ ANES/STER LUMB/SACR SGL LT	$1,582.00	$2,260.00	$64.31–$1,808.00	—	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ ANES/STER LUMB/SACR SGL RT	$1,582.00	$2,260.00	$96.10–$1,808.00	—	30%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 PF-RPR AA HRN 1ST 3-10 RDC	$1,122.10	$1,603.00	$550.96–$1,282.40	84% below	30%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 PF-RPR AA HRN 1ST 3-10 RDC	$1,122.10	$1,603.00	$550.96–$1,282.40	—	30%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 PF-RPR AA HRN 1ST > 10 RDC	$1,502.20	$2,146.00	$864.85–$1,716.80	78% below	30%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 PF-RPR AA HRN 1ST > 10 RDC	$1,502.20	$2,146.00	$864.85–$1,716.80	—	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 PF-DIAGNOSTIC SIGMOIDOSCOPY	$104.30	$149.00	$66.55–$177.62	89% below	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$1,663.20	$2,376.00	$66.55–$1,900.80	82% above	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 PF-DIAGNOSTIC SIGMOIDOSCOPY	$104.30	$149.00	$66.55–$177.62	—	30%
Gallbladder removal, laparoscopic CPT 47562 PF-LAPAROSCOPIC CHOLECYSTECTMY	$1,314.60	$1,878.00	$405.47–$1,502.40	80% below	30%
Gallbladder removal, laparoscopic inpatient CPT 47562 PF-LAPAROSCOPIC CHOLECYSTECTMY	$1,314.60	$1,878.00	$405.47–$1,502.40	—	30%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 PF-LAPARO CHOLECYSTECTOMY/GRPH	$1,427.30	$2,039.00	$760.20–$1,631.20	78% below	30%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 PF-LAPARO CHOLECYSTECTOMY/GRPH	$1,427.30	$2,039.00	$760.20–$1,631.20	—	30%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 PF-REMOVAL OF GALLBLADDER	$2,107.00	$3,010.00	$896.11–$2,408.00	—	30%
Hammertoe correction surgery CPT 28285 PF-REPAIR OF HAMMERTOE	$700.00	$1,000.00	$370.89–$800.00	80% below	30%
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE	$5,850.60	$8,358.00	$370.89–$6,686.40	68% above	30%
Hammertoe correction surgery inpatient CPT 28285 PF-REPAIR OF HAMMERTOE	$700.00	$1,000.00	$370.89–$800.00	—	30%
Hemorrhoid banding (rubber band ligation) CPT 46221 PF-HEMORRHOIDECTOMY SMP	$374.50	$535.00	$140.86–$475.18	59% below	30%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY SMP	$1,663.20	$2,376.00	$134.39–$1,900.80	82% above	30%
Hemorrhoidectomy (internal and external), one area CPT 46255 PF-REMOVE INT/EXT HEM 1 GROUP	$686.00	$980.00	$352.83–$784.00	76% below	30%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 PF-REMOVE INT/EXT HEM 1 GROUP	$686.00	$980.00	$352.83–$784.00	—	30%
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 PF-TOTAL HIP ARTHROPLASTY	$3,049.20	$4,356.00	$1,438.51–$3,484.80	—	30%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 PF-TOTAL HYSTERECTOMY	$1,900.50	$2,715.00	$997.03–$2,172.00	—	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 PF-CATHETER FOR HYSTEROGRAPHY	$102.90	$147.00	$13.46–$151.37	73% below	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH/INTRO CONTRAST HYSTEROSAL	$138.60	$198.00	$51.42–$158.40	64% below	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 PF-CATHETER FOR HYSTEROGRAPHY	$102.90	$147.00	$13.46–$151.37	—	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH/INTRO CONTRAST HYSTEROSAL	$138.60	$198.00	$51.42–$158.40	—	30%
Hysteroscopy with endometrial ablation CPT 58563 PF-HYSTEROSCOPY ABLATION	$441.70	$631.00	$246.16–$2,142.62	92% below	30%
Hysteroscopy with endometrial ablation inpatient CPT 58563 PF-HYSTEROSCOPY ABLATION	$441.70	$631.00	$246.16–$2,142.62	—	30%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 PF-HYSTEROSCOPY BIOPSY	$414.40	$592.00	$167.42–$491.88	88% below	30%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTERSC BX ENDOMET	$5,788.30	$8,269.00	$167.42–$6,615.20	72% above	30%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 PF-HYSTEROSCOPY BIOPSY	$414.40	$592.00	$167.42–$491.88	—	30%
IUD insertion (the device itself billed separately) CPT 58300 PF-INSERT INTRAUTERINE DEVICE	$77.00	$110.00	$60.47–$1,355.77	80% below	30%
IUD insertion (the device itself billed separately) inpatient CPT 58300 PF-INSERT INTRAUTERINE DEVICE	$77.00	$110.00	$60.47–$1,355.77	—	30%
Incision and drainage of a simple or single skin abscess CPT 10060 PF-I&D ABSC SMP	$186.90	$267.00	$59.59–$213.60	54% below	30%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PF-PRP I/HERN INIT REDUC >5 YR	$1,049.30	$1,499.00	$540.59–$1,199.20	73% below	30%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PF-PRP I/HERN INIT REDUC >5 YR	$1,049.30	$1,499.00	$540.59–$1,199.20	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 PF-INJ TENDON SHEATH/LIG RT	$65.80	$94.00	$42.41–$75.20	83% below	30%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 PF-INJ SGL TENDON/LIGAMENT RT	$65.80	$94.00	$42.81–$75.20	83% below	30%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 PF-INJ TENDON SHEATH/LIG LT	$65.80	$94.00	$42.81–$241.73	83% below	30%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 PF-INJ SGL TENDON/LIGAMENT LT	$65.80	$94.00	$42.41–$75.20	83% below	30%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJ SINGLE TENDON/LIGAMENT RT	$548.80	$784.00	$42.41–$627.20	44% above	30%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJ SINGLE TENDON/LIGAMENT LT	$548.80	$784.00	$42.81–$627.20	44% above	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 PF-INJ TENDON SHEATH/LIG RT	$65.80	$94.00	$42.41–$75.20	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 PF-INJ SGL TENDON/LIGAMENT LT	$65.80	$94.00	$42.41–$75.20	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 PF-INJ SGL TENDON/LIGAMENT RT	$65.80	$94.00	$42.81–$75.20	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 PF-INJ TENDON SHEATH/LIG LT	$65.80	$94.00	$42.81–$241.73	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 INJ SINGLE TENDON/LIGAMENT RT	$548.80	$784.00	$42.41–$627.20	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 INJ SINGLE TENDON/LIGAMENT LT	$548.80	$784.00	$42.81–$627.20	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PF-ARTHROCENT ASP/INJ JT M	$79.80	$114.00	$53.07–$91.20	82% below	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 PF-ARTHROCENT ASP/INJ JT LG LT	$79.80	$114.00	$50.20–$91.20	82% below	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 PF-ARTHROCNT ASP/INJ JT MAJ LT	$79.80	$114.00	$53.07–$91.20	82% below	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 PF-ARTHROCNT ASP/INJ JT MAJ RT	$79.80	$114.00	$50.20–$91.20	82% below	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 PF-ARTHROCENT ASP/INJ JT LG RT	$79.80	$114.00	$40.08–$91.20	82% below	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHROCENT ASP/INJ JT MAJOR LT	$548.80	$784.00	$53.07–$627.20	22% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHROCENT ASP/INJ JT MAJOR RT	$548.80	$784.00	$50.20–$627.20	22% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 PF-ARTHROCENT ASP/INJ JT LG LT	$79.80	$114.00	$50.20–$91.20	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 PF-ARTHROCNT ASP/INJ JT MAJ LT	$79.80	$114.00	$53.07–$91.20	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 PF-ARTHROCNT ASP/INJ JT MAJ RT	$79.80	$114.00	$50.20–$91.20	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 PF-ARTHROCENT ASP/INJ JT LG RT	$79.80	$114.00	$40.08–$91.20	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 ARTHROCENT ASP/INJ JT MAJOR LT	$548.80	$784.00	$53.07–$627.20	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 ARTHROCENT ASP/INJ JT MAJOR RT	$548.80	$784.00	$50.20–$627.20	—	30%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 PF-INS IMPL DRUG DELIV NON-BIO	$112.70	$161.00	$60.57–$172.16	64% below	30%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INS IMPL DRUG DEL NON-BIO	$238.00	$340.00	$60.57–$272.00	24% below	30%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 PF-INS IMPL DRUG DELIV NON-BIO	$112.70	$161.00	$60.57–$172.16	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PF-ARTHROCENT ASP/INJ JT MD	$63.00	$90.00	$45.43–$72.00	84% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENT ASP/INJ JT INTERMED	$548.80	$784.00	$39.07–$627.20	41% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 PF-ARTHROCENT ASP/INJ JT MD LT	$63.00	$90.00	$40.08–$72.00	84% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 PF-ARTHROENT ASP/INJ JT MED RT	$63.00	$90.00	$40.08–$72.00	84% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 PF-ARTHROCENT ASP/INJ JT MD RT	$63.00	$90.00	$39.07–$72.00	84% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 PF-ARTHROCNT ASP/INJ JT MED LT	$63.00	$90.00	$45.00–$72.00	84% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ARTHROCENT ASP/INJ JT MED LT	$548.80	$784.00	$45.43–$627.20	41% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ARTHROCENT ASP/INJ JT MED RT	$548.80	$784.00	$40.08–$627.20	41% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENT ASP/INJ JT INTERMED	$548.80	$784.00	$39.07–$627.20	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 PF-ARTHROCENT ASP/INJ JT MD LT	$63.00	$90.00	$40.08–$72.00	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 PF-ARTHROCNT ASP/INJ JT MED LT	$63.00	$90.00	$45.00–$72.00	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 PF-ARTHROENT ASP/INJ JT MED RT	$63.00	$90.00	$40.08–$72.00	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 PF-ARTHROCENT ASP/INJ JT MD RT	$63.00	$90.00	$39.07–$72.00	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 ARTHROCENT ASP/INJ JT MED LT	$548.80	$784.00	$45.43–$627.20	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 ARTHROCENT ASP/INJ JT MED RT	$548.80	$784.00	$40.08–$627.20	—	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENT ASP/INJ JT SMALL	$548.80	$784.00	$38.35–$627.20	83% above	30%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 PF-ARTHROCENT ASP/INJ JT SM LT	$61.60	$88.00	$41.74–$70.40	79% below	30%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 PF-ARTHROCENT ASP/INJ JT SM RT	$61.60	$88.00	$39.07–$70.40	79% below	30%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ARTHROCENT ASP/INJ JT SMALL LT	$548.80	$784.00	$44.25–$627.20	83% above	30%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ARTHROCENT ASP/INJ JT SMALL RT	$548.80	$784.00	$39.07–$627.20	83% above	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENT ASP/INJ JT SMALL	$548.80	$784.00	$38.35–$627.20	—	30%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 PF-ARTHROCENT ASP/INJ JT SM LT	$61.60	$88.00	$41.74–$70.40	—	30%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 PF-ARTHROCENT ASP/INJ JT SM RT	$61.60	$88.00	$39.07–$70.40	—	30%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 ARTHROCENT ASP/INJ JT SMALL RT	$548.80	$784.00	$39.07–$627.20	—	30%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 ARTHROCENT ASP/INJ JT SMALL LT	$548.80	$784.00	$44.25–$627.20	—	30%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 PF-KNEE ARTHROSCOPY/SURGERY	$1,270.50	$1,815.00	$604.50–$1,452.00	70% below	30%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 PF-KNEE ARTHROSCOPY/SURGERY	$1,270.50	$1,815.00	$604.50–$1,452.00	—	30%
Knee arthroscopy with meniscus trim CPT 29881 PF-KNEE ARTHROSCOPY/SURGERY	$1,013.60	$1,448.00	$628.07–$1,158.40	75% below	30%
Knee arthroscopy with meniscus trim inpatient CPT 29881 PF-KNEE ARTHROSCOPY/SURGERY	$1,013.60	$1,448.00	$628.07–$1,158.40	—	30%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 PF-KNEE ARTHROSCOPY/SURGERY	$1,049.30	$1,499.00	$713.76–$1,199.20	73% below	30%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 PF-KNEE ARTHROSCOPY/SURGERY	$1,049.30	$1,499.00	$713.76–$1,199.20	—	30%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 PF-KNEE ARTHROSCOPY/SURGERY	$1,158.50	$1,655.00	$631.98–$1,324.00	73% below	30%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 PF-KNEE ARTHROSCOPY/SURGERY	$1,158.50	$1,655.00	$631.98–$1,324.00	—	30%
Laparoscopic Roux-en-Y gastric bypass, standard limb length inpatient CPT 43644 PF-LAP GASTRC BYPASS/ROUX-EN-Y	$3,425.80	$4,894.00	$1,391.77–$3,915.20	—	30%
Laparoscopic adjustable gastric band placement (Lap-Band) CPT 43770 PF-LAP PLACE GASTR ADJ DEVICE	$2,236.50	$3,195.00	$116.08–$2,556.00	97% below	30%
Laparoscopic adjustable gastric band placement (Lap-Band) inpatient CPT 43770 PF-LAP PLACE GASTR ADJ DEVICE	$2,236.50	$3,195.00	$116.08–$2,556.00	—	30%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 PF-LAPAROSCOPY APPENDECTOMY	$1,197.70	$1,711.00	$612.35–$1,368.80	79% below	30%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 PF-LAPAROSCOPY APPENDECTOMY	$1,197.70	$1,711.00	$612.35–$1,368.80	—	30%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 PF-LAPAROSCOPY FUNDOPLASTY	$2,129.40	$3,042.00	$1,196.88–$2,433.60	74% below	30%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 PF-LAPAROSCOPY FUNDOPLASTY	$2,129.40	$3,042.00	$1,196.88–$2,433.60	—	30%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 PF-TLH UTERUS 250 G OR LESS	$1,467.90	$2,097.00	$507.58–$1,677.60	89% below	30%
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 PF-TLH UTERUS 250 G OR LESS	$1,467.90	$2,097.00	$507.58–$1,677.60	—	30%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 PF-TLH W/T/O 250 G OR LESS	$1,683.50	$2,405.00	$896.61–$1,924.00	85% below	30%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 PF-TLH W/T/O 250 G OR LESS	$1,683.50	$2,405.00	$896.61–$1,924.00	—	30%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 PF-LAP ING HERNIA REPAIR INIT	$870.10	$1,243.00	$450.07–$994.40	87% below	30%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 PF-LAP ING HERNIA REPAIR INIT	$870.10	$1,243.00	$450.07–$994.40	—	30%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 PF-LAP ING HERNIA REPAIR RECUR	$1,131.20	$1,616.00	$496.71–$1,292.80	82% below	30%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 PF-LAP ING HERNIA REPAIR RECUR	$1,131.20	$1,616.00	$496.71–$1,292.80	—	30%
Laparoscopic removal of an adjustable gastric band and its port CPT 43774 PF-LAP RMV GASTR ADJ ALL PARTS	$1,905.40	$2,722.00	$1,048.50–$2,177.60	74% below	30%
Laparoscopic removal of an adjustable gastric band and its port inpatient CPT 43774 PF-LAP RMV GASTR ADJ ALL PARTS	$1,905.40	$2,722.00	$1,048.50–$2,177.60	—	30%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 PF-LAPAROSCOPY REMOVE ADNEXA	$1,193.50	$1,705.00	$703.59–$1,364.00	75% below	30%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 PF-LAPAROSCOPY REMOVE ADNEXA	$1,193.50	$1,705.00	$703.59–$1,364.00	—	30%
Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 PF-LAP SLEEVE GASTRECTOMY	$2,158.10	$3,083.00	$1,108.89–$2,466.40	—	30%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 PF-DISCIS CATARACT SEC LAS	$503.30	$719.00	$241.13–$578.35	26% below	30%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 DISCIS CATARACT SEC LASER	$983.50	$1,405.00	$241.13–$1,124.00	44% above	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 PF-RPR LAC INT SC/AXL TO 2.5CM	$252.00	$360.00	$134.36–$295.48	57% below	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 RPR LAC INT SCLP/AXIL TO 2.5CM	$727.30	$1,039.00	$107.88–$675.35	23% above	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 PF-RPR LAC INT SC/AXL TO 2.5CM	$252.00	$360.00	$134.36–$295.48	—	30%
Lower-back epidural injection, with imaging guidance CPT 62323 PF-INJECT SPINE L/S (CD)	$170.10	$243.00	$124.06–$291.65	88% below	30%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION(S) SPINE L/S	$1,262.10	$1,803.00	$85.17–$1,442.40	13% below	30%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PF-INJECT SPINE L/S (CD)	$170.10	$243.00	$124.06–$291.65	—	30%
Lower-back epidural injection, without imaging guidance CPT 62322 PF-NJX INTERLAMINAR LMBR/SAC	$142.10	$203.00	$108.80–$188.20	90% below	30%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR L/S	$1,582.00	$2,260.00	$108.81–$1,808.00	9% above	30%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PF-NJX INTERLAMINAR LMBR/SAC	$142.10	$203.00	$108.80–$188.20	—	30%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ FORAMEN EPIDURAL L/S	$1,582.00	$2,260.00	$64.64–$1,808.00	13% above	30%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 PF-INJ FORAMEN EPIDUR L/S RT	$188.30	$269.00	$113.10–$215.20	87% below	30%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 PF-INJ FORAMEN EPIDUR L/S LT	$188.30	$269.00	$64.64–$215.20	87% below	30%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 PF-INJ FORAMEN EPIDURAL L/S RT	$188.30	$269.00	$64.64–$215.20	87% below	30%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 PF-INJ FORAMEN EPIDURAL L/S LT	$188.30	$269.00	$113.10–$215.20	87% below	30%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJ FORAMEN EPIDURAL L/S RT	$1,582.00	$2,260.00	$113.10–$1,808.00	13% above	30%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJ FORAMEN EPIDURAL L/S LT	$1,582.00	$2,260.00	$64.64–$1,808.00	13% above	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ FORAMEN EPIDURAL L/S	$1,582.00	$2,260.00	$64.64–$1,808.00	—	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 PF-INJ FORAMEN EPIDUR L/S RT	$188.30	$269.00	$113.10–$215.20	—	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 PF-INJ FORAMEN EPIDUR L/S LT	$188.30	$269.00	$64.64–$215.20	—	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 PF-INJ FORAMEN EPIDURAL L/S RT	$188.30	$269.00	$64.64–$215.20	—	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 PF-INJ FORAMEN EPIDURAL L/S LT	$188.30	$269.00	$113.10–$215.20	—	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJ FORAMEN EPIDURAL L/S RT	$1,582.00	$2,260.00	$113.10–$1,808.00	—	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJ FORAMEN EPIDURAL L/S LT	$1,582.00	$2,260.00	$64.64–$1,808.00	—	30%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 PF-LOW BACK DISK SURGERY	$1,871.10	$2,673.00	$1,008.44–$2,138.40	76% below	30%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 PF-LOW BACK DISK SURGERY	$1,871.10	$2,673.00	$1,008.44–$2,138.40	—	30%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 PF-LUMBAR SPINE FUSION COMB	$3,631.60	$5,188.00	$385.75–$4,150.40	57% below	30%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level inpatient CPT 22633 PF-LUMBAR SPINE FUSION COMB	$3,631.60	$5,188.00	$385.75–$4,150.40	—	30%
Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 PF-LUMBAR SPINE FUSION	$3,254.30	$4,649.00	$463.89–$3,719.20	67% below	30%
Lumbar interbody fusion (PLIF or TLIF), one level inpatient CPT 22630 PF-LUMBAR SPINE FUSION	$3,254.30	$4,649.00	$463.89–$3,719.20	—	30%
Lumbar laminectomy (spinal decompression), one level CPT 63047 PF-REMOVAL OF SPINAL LAMINA	$2,244.20	$3,206.00	$1,204.11–$2,564.80	72% below	30%
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 PF-REMOVAL OF SPINAL LAMINA	$2,244.20	$3,206.00	$1,204.11–$2,564.80	—	30%
Lumbar spinal fusion (posterior), one level CPT 22612 PF-LUMBAR SPINE FUSION	$3,083.50	$4,405.00	$1,509.65–$3,524.00	66% below	30%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 PF-LUMBAR SPINE FUSION	$3,083.50	$4,405.00	$1,509.65–$3,524.00	—	30%
Lumpectomy (partial mastectomy) CPT 19301 PF-PARTIAL MASTECTOMY	$1,305.50	$1,865.00	$436.23–$1,492.00	63% below	30%
Lumpectomy (partial mastectomy) inpatient CPT 19301 PF-PARTIAL MASTECTOMY	$1,305.50	$1,865.00	$436.23–$1,492.00	—	30%
Mastectomy (total removal of the breast) CPT 19303 PF-MAST SIMPLE COMPLETE	$1,895.60	$2,708.00	$915.82–$2,166.40	60% below	30%
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY,SIMPLECOMPLETE	$11,872.00	$16,960.00	$99.53–$13,568.00	152% above	30%
Mastectomy (total removal of the breast) inpatient CPT 19303 PF-MAST SIMPLE COMPLETE	$1,895.60	$2,708.00	$915.82–$2,166.40	—	30%
Miscarriage treatment with D&C, first trimester CPT 59820 PF-CARE OF MISCARRIAGE	$732.20	$1,046.00	$306.09–$836.80	79% below	30%
Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT OF MISSED ABORTION	$5,788.30	$8,269.00	$306.09–$6,615.20	68% above	30%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 PF-CARE OF MISCARRIAGE	$732.20	$1,046.00	$306.09–$836.80	—	30%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 PF-MOHS 1 STAGE H/N/HF/G	$550.20	$786.00	$287.31–$832.06	26% below	30%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 MOHS 1 STAGE H/N/HF/G	$1,321.60	$1,888.00	$287.31–$1,510.40	77% above	30%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 PF-MOHS 1 STAGE H/N/HF/G	$550.20	$786.00	$287.31–$832.06	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC LES BGN TRK/ARM TO .5C	$1,266.30	$1,809.00	$76.91–$1,447.20	83% above	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 PF-LES BGN FACE/EAR TO 0.5	$180.60	$258.00	$105.07–$293.16	72% below	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 LES BGN FACE/EAR TO 0.5CM	$1,266.30	$1,809.00	$105.07–$1,447.20	98% above	30%
Nail removal (partial or complete), one nail CPT 11730 PF-REMOVAL OF NAIL PLATE	$92.40	$132.00	$24.87–$118.32	67% below	30%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SINGLE	$359.10	$513.00	$24.87–$410.40	27% above	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 PF-REMOVAL OF NAIL PLATE	$92.40	$132.00	$24.87–$118.32	—	30%
Occipital nerve block (injection for headaches) CPT 64405 N BLOCK INJ OCCIPITAL	$548.80	$784.00	$75.55–$627.20	11% above	30%
Occipital nerve block (injection for headaches) one side CPT 64405 PF-N BLOCK INJ OCCIPITAL RT	$97.30	$139.00	$60.59–$111.20	80% below	30%
Occipital nerve block (injection for headaches) one side CPT 64405 PF-N BLOCK INJ OCCIPITAL LT	$97.30	$139.00	$59.34–$111.20	80% below	30%
Occipital nerve block (injection for headaches) one side CPT 64405 N BLOCK INJ OCCIPITAL RT	$548.80	$784.00	$60.59–$627.20	11% above	30%
Occipital nerve block (injection for headaches) one side CPT 64405 N BLOCK INJ OCCIPITAL LT	$548.80	$784.00	$59.34–$627.20	11% above	30%
Occipital nerve block (injection for headaches) inpatient CPT 64405 N BLOCK INJ OCCIPITAL	$548.80	$784.00	$75.55–$627.20	—	30%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 PF-N BLOCK INJ OCCIPITAL RT	$97.30	$139.00	$60.59–$111.20	—	30%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 PF-N BLOCK INJ OCCIPITAL LT	$97.30	$139.00	$59.34–$111.20	—	30%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 N BLOCK INJ OCCIPITAL LT	$548.80	$784.00	$59.34–$627.20	—	30%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 N BLOCK INJ OCCIPITAL RT	$548.80	$784.00	$60.59–$627.20	—	30%
Open Roux-en-Y gastric bypass through an abdominal incision inpatient CPT 43846 PF-GASTRIC BYPASS FOR OBESITY	$3,264.80	$4,664.00	$1,727.52–$3,731.20	—	30%
Paracentesis with imaging guidance CPT 49083 PF-ABD PARACENTESIS W/IMAGING	$179.90	$257.00	$139.59–$379.55	88% below	30%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,621.90	$2,317.00	$79.87–$1,853.60	12% above	30%
Paracentesis with imaging guidance inpatient CPT 49083 PF-ABD PARACENTESIS W/IMAGING	$179.90	$257.00	$139.59–$379.55	—	30%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$1,621.90	$2,317.00	$79.87–$1,853.60	—	30%
Partial knee replacement (one compartment) CPT 27446 PF-REVISION OF KNEE JOINT	$2,110.50	$3,015.00	$915.93–$2,412.00	76% below	30%
Partial knee replacement (one compartment) inpatient CPT 27446 PF-REVISION OF KNEE JOINT	$2,110.50	$3,015.00	$915.93–$2,412.00	—	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PF-EXC NAIL & MATRIX	$176.40	$252.00	$7.73–$270.08	72% below	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$727.30	$1,039.00	$187.88–$675.35	16% above	30%
Prostate removal (prostatectomy), laparoscopic CPT 55866 PF-LAPARO RADICAL PROSTATECTMY	$2,118.90	$3,027.00	$1,436.16–$2,421.60	97% below	30%
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 PF-LAPARO RADICAL PROSTATECTMY	$2,118.90	$3,027.00	$1,436.16–$2,421.60	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 PF-DESTROY L/S FACET JNT LT	$326.90	$467.00	$71.37–$373.60	86% below	30%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 PF-DESTROY L/S FACET JNT RT	$326.90	$467.00	$204.64–$373.60	86% below	30%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DESTROY LUMB/SAC FACET JNT RT	$3,491.60	$4,988.00	$204.64–$3,990.40	52% above	30%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DESTROY LUMB/SAC FACET JNT LT	$3,491.60	$4,988.00	$71.37–$3,990.40	52% above	30%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 PF-DESTROY L/S FACET JNT LT	$326.90	$467.00	$71.37–$373.60	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 PF-DESTROY L/S FACET JNT RT	$326.90	$467.00	$204.64–$373.60	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 DESTROY LUMB/SAC FACET JNT LT	$3,491.60	$4,988.00	$71.37–$3,990.40	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 DESTROY LUMB/SAC FACET JNT RT	$3,491.60	$4,988.00	$204.64–$3,990.40	—	30%
Removal of a breast lump, open surgery CPT 19120 PF-EXC BREAST CYST/FIBRO/T	$827.40	$1,182.00	$79.74–$945.60	65% below	30%
Removal of a breast lump, open surgery CPT 19120 EXC BREAST CYST/FIBRO/TUM	$7,000.70	$10,001.00	$399.76–$8,000.80	194% above	30%
Removal of a foreign object under the skin, simple CPT 10120 PF-INCISION/REM FB SUBQ SM	$191.10	$273.00	$73.93–$218.40	59% below	30%
Removal of a foreign object under the skin, simple CPT 10120 INCISION/REM FB SUBQ SMP	$727.30	$1,039.00	$55.61–$831.20	56% above	30%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 PF-PARTIAL REMOVAL OF THYROID	$1,288.00	$1,840.00	$874.41–$1,472.00	80% below	30%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 PF-PARTIAL REMOVAL OF THYROID	$1,288.00	$1,840.00	$874.41–$1,472.00	—	30%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 PF-COLON CA SCRN NOT HI RS	$322.70	$461.00	$299.65–$507.35	85% below	30%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 PF-COLON CA SCRN NOT HI RS	$322.70	$461.00	$299.65–$507.35	—	30%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 PF-COLORECTAL SCRN HI RISK IND	$321.30	$459.00	$298.35–$507.35	87% below	30%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 PF-COLORECTAL SCRN HI RISK IND	$321.30	$459.00	$298.35–$507.35	—	30%
Septoplasty to straighten the nasal septum CPT 30520 PF-REPAIR OF NASAL SEPTUM	$1,155.70	$1,651.00	$520.63–$1,320.80	78% below	30%
Septoplasty to straighten the nasal septum inpatient CPT 30520 PF-REPAIR OF NASAL SEPTUM	$1,155.70	$1,651.00	$520.63–$1,320.80	—	30%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 PF-FRAGMENTING OF KIDNEY STONE	$1,010.80	$1,444.00	$577.88–$1,155.20	84% below	30%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 PF-FRAGMENTING OF KIDNEY STONE	$1,010.80	$1,444.00	$577.88–$1,155.20	—	30%
Short arm cast (elbow to hand) CPT 29075 PF-APPLY CAST - SHORT ARM	$114.10	$163.00	$63.34–$130.40	63% below	30%
Short arm cast (elbow to hand) CPT 29075 APPLY CAST - SHORT ARM	$500.50	$715.00	$63.34–$572.00	63% above	30%
Short arm splint (forearm and hand) CPT 29125 PF-APPLY SH ARM SPLINT STATIC	$79.10	$113.00	$43.19–$90.40	68% below	30%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLNT STATIC	$238.00	$340.00	$43.19–$272.00	3% below	30%
Short arm splint (forearm and hand) inpatient CPT 29125 PF-APPLY SH ARM SPLINT STATIC	$79.10	$113.00	$43.19–$90.40	—	30%
Short leg cast (below the knee) CPT 29405 PF-APPLY SHORT LEG CAST	$108.50	$155.00	$68.72–$124.00	67% below	30%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST	$500.50	$715.00	$68.72–$572.00	51% above	30%
Short leg cast (below the knee) inpatient CPT 29405 PF-APPLY SHORT LEG CAST	$108.50	$155.00	$68.72–$124.00	—	30%
Short leg splint (calf to foot) CPT 29515 PF-APPLY LOWER LEG SPLINT	$97.30	$139.00	$52.13–$111.20	61% below	30%
Short leg splint (calf to foot) inpatient CPT 29515 PF-APPLY LOWER LEG SPLINT	$97.30	$139.00	$52.13–$111.20	—	30%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 PF-SHOULDER ARTHROSCOPY/SURG	$1,257.90	$1,797.00	$662.07–$1,437.60	78% below	30%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 PF-SHOULDER ARTHROSCOPY/SURG	$1,257.90	$1,797.00	$662.07–$1,437.60	—	30%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 PF-SHOULDER ARTHROSCOPY/SURG	$303.80	$434.00	$236.80–$744.34	95% below	30%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 PF-SHOULDER ARTHROSCOPY/SURG	$303.80	$434.00	$236.80–$744.34	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR WND SIMPLE S/N/T <2.5CM	$359.10	$513.00	$62.91–$410.40	1% below	30%
Skin biopsy, punch, one lesion CPT 11104 PF-PUNCH SKIN BIOPSY 1ST	$74.20	$106.00	$60.09–$148.55	81% below	30%
Skin biopsy, punch, one lesion CPT 11104 PUNCH SKIN BIOPSY 1ST	$727.30	$1,039.00	$23.26–$831.20	89% above	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 PF-PUNCH SKIN BIOPSY 1ST	$74.20	$106.00	$60.09–$148.55	—	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 PF-EXC TR-EXT MLG+MARG 0.5 <	$207.20	$296.00	$98.11–$389.18	64% below	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 LES MAL TRUNK/ARM TO 0.5CM	$1,266.30	$1,809.00	$98.11–$1,447.20	123% above	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 PF-EXC TR-EXT MLG+MARG 0.5 <	$207.20	$296.00	$98.11–$389.18	—	30%
Skin tag removal, up to 15 tags CPT 11200 PF-REMOVE SKIN TAG UP TO 1	$128.10	$183.00	$40.11–$146.40	49% below	30%
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAG UP TO 15	$359.10	$513.00	$33.02–$410.40	42% above	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PF-SPINAL FLUID TAP DIAGNOSTIC	$126.00	$180.00	$70.79–$197.77	86% below	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC	$1,262.10	$1,803.00	$70.79–$1,442.40	40% above	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PF-SPINAL FLUID TAP DIAGNOSTIC	$126.00	$180.00	$70.79–$197.77	—	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC	$1,262.10	$1,803.00	$70.79–$1,442.40	—	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 PF-RPR LAC SMP SCALP 2.6-7.5CM	$119.70	$171.00	$50.48–$141.63	71% below	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPR WND SIMPL S/N/T 2.6-7.5CM	$359.10	$513.00	$62.91–$410.40	13% below	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 PF-RPR LAC SMP SCALP 2.6-7.5CM	$119.70	$171.00	$50.48–$141.63	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PF-RPR LAC SMP FACE TO 2.5	$113.40	$162.00	$102.83–$164.09	72% below	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR WND SIMPLE FACE <2.5CM	$359.10	$513.00	$50.48–$410.40	11% below	30%
TURP (transurethral resection of the prostate) CPT 52601 PF-PROSTATECTOMY (TURP)	$1,022.00	$1,460.00	$533.78–$1,168.00	82% below	30%
TURP (transurethral resection of the prostate) inpatient CPT 52601 PF-PROSTATECTOMY (TURP)	$1,022.00	$1,460.00	$533.78–$1,168.00	—	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 PF-TANGENTIAL SKIN BIOPSY	$58.10	$83.00	$47.97–$303.56	81% below	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL SKIN BIOPSY 1ST	$727.30	$1,039.00	$30.26–$831.20	142% above	30%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS-PLEURAL W/GUIDE	$1,122.10	$1,603.00	$115.05–$1,282.40	6% below	30%
Thoracentesis with imaging guidance one side CPT 32555 PF-THORACEN-PLEURAL W/GUIDE RT	$182.00	$260.00	$115.05–$208.00	85% below	30%
Thoracentesis with imaging guidance one side CPT 32555 PF-THORACEN-PLEURAL W/GUIDE LT	$182.00	$260.00	$130.00–$208.00	85% below	30%
Thoracentesis with imaging guidance one side CPT 32555 THORACENTESIS-PLEURAL W/G RT	$1,122.10	$1,603.00	$153.16–$1,282.40	6% below	30%
Thoracentesis with imaging guidance one side CPT 32555 THORACENTESIS-PLEURAL W/G LT	$1,122.10	$1,603.00	$115.05–$1,282.40	6% below	30%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS-PLEURAL W/GUIDE	$1,122.10	$1,603.00	$115.05–$1,282.40	—	30%
Thoracentesis with imaging guidance inpatient one side CPT 32555 PF-THORACEN-PLEURAL W/GUIDE LT	$182.00	$260.00	$130.00–$208.00	—	30%
Thoracentesis with imaging guidance inpatient one side CPT 32555 PF-THORACEN-PLEURAL W/GUIDE RT	$182.00	$260.00	$115.05–$208.00	—	30%
Thoracentesis with imaging guidance inpatient one side CPT 32555 THORACENTESIS-PLEURAL W/G LT	$1,122.10	$1,603.00	$115.05–$1,282.40	—	30%
Thoracentesis with imaging guidance inpatient one side CPT 32555 THORACENTESIS-PLEURAL W/G RT	$1,122.10	$1,603.00	$153.16–$1,282.40	—	30%
Tonsil and adenoid removal, age 12 or older CPT 42821 PF-REMOVE TONSILS AND ADENOIDS	$525.70	$751.00	$319.33–$600.80	87% below	30%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 PF-REMOVE TONSILS AND ADENOIDS	$525.70	$751.00	$319.33–$600.80	—	30%
Tonsil and adenoid removal, child under 12 CPT 42820 PF-REMOVE TONSILS AND ADENOIDS	$504.00	$720.00	$328.02–$587.60	92% below	30%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 PF-REMOVE TONSILS AND ADENOIDS	$504.00	$720.00	$328.02–$587.60	—	30%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 PF-REMOVAL TONSILS > 12 YRS	$443.80	$634.00	$292.91–$507.20	87% below	30%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVALOFTONSILS>12YRS	$5,928.30	$8,469.00	$228.39–$6,775.20	68% above	30%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 PF-REMOVAL TONSILS < 12 YRS	$465.50	$665.00	$286.17–$532.00	88% below	30%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVALOFTONSILS<12YRS	$10,584.70	$15,121.00	$220.06–$12,096.80	173% above	30%
Total hip replacement CPT 27130 PF-TOTAL HIP ARTHROPLASTY	$2,352.00	$3,360.00	$1,266.31–$2,688.00	79% below	30%
Total hip replacement inpatient CPT 27130 PF-TOTAL HIP ARTHROPLASTY	$2,352.00	$3,360.00	$1,266.31–$2,688.00	—	30%
Total knee replacement CPT 27447 PF-TOTAL KNEE ARTHROPLASTY	$2,345.00	$3,350.00	$1,285.03–$2,680.00	69% below	30%
Total knee replacement inpatient CPT 27447 PF-TOTAL KNEE ARTHROPLASTY	$2,345.00	$3,350.00	$1,285.03–$2,680.00	—	30%
Total shoulder replacement CPT 23472 PF-RECONSTRUCT SHOULDER JOINT	$2,618.70	$3,741.00	$1,337.37–$2,992.80	71% below	30%
Total shoulder replacement inpatient CPT 23472 PF-RECONSTRUCT SHOULDER JOINT	$2,618.70	$3,741.00	$1,337.37–$2,992.80	—	30%
Total thyroid removal (thyroidectomy) CPT 60240 PF-REMOVAL OF THYROID	$1,689.80	$2,414.00	$1,048.53–$1,931.20	74% below	30%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 PF-REMOVAL OF THYROID	$1,689.80	$2,414.00	$1,048.53–$1,931.20	—	30%
Trigger finger release surgery CPT 26055 PF-INCISE FINGER TENDON SHEATH	$550.20	$786.00	$275.13–$700.80	68% below	30%
Trigger finger release surgery CPT 26055 INCISE FINGER TEND SHEATH	$2,875.60	$4,108.00	$154.52–$3,286.40	68% above	30%
Trigger finger release surgery inpatient CPT 26055 PF-INCISE FINGER TENDON SHEATH	$550.20	$786.00	$275.13–$700.80	—	30%
Trigger point injections, 1 or 2 muscles CPT 20552 PF-INJ TRIGGER POINT 1/2 MUSCL	$68.60	$98.00	$41.79–$78.40	86% below	30%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PT 1-2 MUSCLE(S)	$548.80	$784.00	$41.74–$627.20	11% above	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 PF-INJ TRIGGER POINT 1/2 MUSCL	$68.60	$98.00	$41.79–$78.40	—	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PT 1-2 MUSCLE(S)	$548.80	$784.00	$41.74–$627.20	—	30%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 PF-LAPAROSCOPY TUBAL CAUTERY	$663.60	$948.00	$393.54–$795.23	74% below	30%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 PF-LAPAROSCOPY TUBAL CAUTERY	$663.60	$948.00	$393.54–$795.23	—	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BX BREAST 1ST LES US LT	$2,953.30	$4,219.00	$172.29–$3,375.20	22% above	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BX BREAST 1ST LES US RT	$2,953.30	$4,219.00	$163.54–$3,375.20	22% above	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BX BREAST 1ST LES US RT	$2,953.30	$4,219.00	$163.54–$3,375.20	—	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BX BREAST 1ST LES US LT	$2,953.30	$4,219.00	$172.29–$3,375.20	—	30%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 PF-ESOPH ENDOSCOPY DILATION	$263.20	$376.00	$177.57–$300.80	87% below	30%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH ENDOSCOPY DILATION	$3,431.40	$4,902.00	$158.61–$1,896.00	68% above	30%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 PF-ESOPH ENDOSCOPY DILATION	$263.20	$376.00	$177.57–$300.80	—	30%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ESOPH ENDOSCOPY DILATION	$3,431.40	$4,902.00	$158.61–$1,896.00	—	30%
Upper endoscopy (EGD) with biopsy CPT 43239 PF-UPPER GI ENDOSCOPY BIOPSY	$238.00	$340.00	$183.91–$439.48	89% below	30%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY W/BIOPSY	$1,621.90	$2,317.00	$131.11–$1,853.60	25% below	30%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PF-UPPER GI ENDOSCOPY BIOPSY	$238.00	$340.00	$183.91–$439.48	—	30%
Upper endoscopy (EGD) with injection into the lining CPT 43236 PF-UPPR GI SCOPE W/SUBMUC INJ	$238.00	$340.00	$131.11–$482.63	87% below	30%
Upper endoscopy (EGD) with injection into the lining CPT 43236 UPPER GI SCOPE W/SUBMUC INJ	$1,621.90	$2,317.00	$109.51–$1,896.00	12% below	30%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 PF-UPPR GI SCOPE W/SUBMUC INJ	$238.00	$340.00	$131.11–$482.63	—	30%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 UPPER GI SCOPE W/SUBMUC INJ	$1,621.90	$2,317.00	$109.51–$1,896.00	—	30%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 PF-OPERATIVE UPPER GI ENDOSCPY	$334.60	$478.00	$183.95–$382.40	86% below	30%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 UPPER GI ENDOSCOPY W/SNARE	$3,431.40	$4,902.00	$183.95–$1,896.00	40% above	30%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 PF-OPERATIVE UPPER GI ENDOSCPY	$334.60	$478.00	$183.95–$382.40	—	30%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 UPPER GI ENDOSCOPY W/SNARE	$3,431.40	$4,902.00	$183.95–$1,896.00	—	30%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 PF-UPPR GI ENDOSCPY/GUIDE WIRE	$286.30	$409.00	$189.35–$327.20	89% below	30%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 UPPER GI ENDOSCOPY/GUIDE WIRE	$1,621.90	$2,317.00	$171.90–$1,896.00	38% below	30%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 PF-UPPR GI ENDOSCPY/GUIDE WIRE	$286.30	$409.00	$189.35–$327.20	—	30%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 UPPER GI ENDOSCOPY/GUIDE WIRE	$1,621.90	$2,317.00	$171.90–$1,896.00	—	30%
Upper endoscopy (EGD), diagnostic CPT 43235 PF-UPPR GI ENDOSCOPY DIAGNOSIS	$212.80	$304.00	$155.71–$381.10	86% below	30%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPR GI ENDOSCOPY DIAGNOSIS	$1,621.90	$2,317.00	$76.15–$1,853.60	8% above	30%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PF-UPPR GI ENDOSCOPY DIAGNOSIS	$212.80	$304.00	$155.71–$381.10	—	30%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 PF-ESOPH ENDOSCPE W/DRAIN CYST	$662.20	$946.00	$148.28–$756.80	85% below	30%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 ESOPH ENDOSCOPE W/DRAIN CYST	$10,854.20	$15,506.00	$246.61–$1,896.00	148% above	30%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 PF-ESOPH ENDOSCPE W/DRAIN CYST	$662.20	$946.00	$148.28–$756.80	—	30%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 ESOPH ENDOSCOPE W/DRAIN CYST	$10,854.20	$15,506.00	$246.61–$1,896.00	—	30%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 PF-CYSTOURETERO W/LITHOTRIPSY	$675.50	$965.00	$378.74–$772.00	88% below	30%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 PF-CYSTOURETERO W/LITHOTRIPSY	$675.50	$965.00	$378.74–$772.00	—	30%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 PF-CYSTO/URETERO W/ LITHOTRPSY	$720.30	$1,029.00	$475.57–$823.20	87% below	30%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 PF-CYSTO/URETERO W/ LITHOTRPSY	$720.30	$1,029.00	$475.57–$823.20	—	30%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 PF-VBAC DELIVERY	$5,042.10	$7,203.00	$573.96–$5,762.40	at median	30%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 PF-VBAC DELIVERY	$5,042.10	$7,203.00	$573.96–$5,762.40	—	30%
Vaginal delivery, including prenatal and postpartum care CPT 59400 PF-OBSTETRICAL CARE	$4,694.20	$6,706.00	$332.40–$5,364.80	1% above	30%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 PF-OBSTETRICAL CARE	$4,694.20	$6,706.00	$332.40–$5,364.80	—	30%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 PF-REMOVAL OF SPERM DUCT(S)	$415.80	$594.00	$255.59–$497.98	74% below	30%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECT SEMEN EXAM	$3,738.00	$5,340.00	$232.00–$4,272.00	135% above	30%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 PF-REMOVAL OF SPERM DUCT(S)	$415.80	$594.00	$255.59–$497.98	—	30%
Vein ablation, radiofrequency, first vein one side CPT 36475 PF-ENDOVENOUS RF 1ST VEIN LT	$521.50	$745.00	$64.32–$596.00	89% below	30%
Vein ablation, radiofrequency, first vein one side CPT 36475 PF-ENDOVENOUS RF 1ST VEIN RT	$521.50	$745.00	$312.80–$596.00	89% below	30%
Vein ablation, radiofrequency, first vein one side CPT 36475 ENDOVENOUS RF 1ST VEIN LT	$5,645.50	$8,065.00	$42.71–$6,452.00	15% above	30%
Vein ablation, radiofrequency, first vein one side CPT 36475 ENDOVENOUS RF 1ST VEIN RT	$5,645.50	$8,065.00	$312.80–$6,452.00	15% above	30%
Vein ablation, radiofrequency, first vein inpatient one side CPT 36475 PF-ENDOVENOUS RF 1ST VEIN RT	$521.50	$745.00	$312.80–$596.00	—	30%
Vein ablation, radiofrequency, first vein inpatient one side CPT 36475 PF-ENDOVENOUS RF 1ST VEIN LT	$521.50	$745.00	$64.32–$596.00	—	30%
Vein ablation, radiofrequency, first vein inpatient one side CPT 36475 ENDOVENOUS RF 1ST VEIN RT	$5,645.50	$8,065.00	$312.80–$6,452.00	—	30%
Vein ablation, radiofrequency, first vein inpatient one side CPT 36475 ENDOVENOUS RF 1ST VEIN LT	$5,645.50	$8,065.00	$42.71–$6,452.00	—	30%
Wart removal, up to 14 warts CPT 17110 PF-DESTRUCT B9 LESION 1-14	$115.50	$165.00	$46.66–$383.12	50% below	30%
Wart removal, up to 14 warts CPT 17110 DEST BENIGN LESION <15	$359.10	$513.00	$46.66–$410.40	55% above	30%
Wart removal, up to 14 warts inpatient CPT 17110 PF-DESTRUCT B9 LESION 1-14	$115.50	$165.00	$46.66–$383.12	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$727.30	$1,039.00	$69.20–$831.20	9% above	30%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 PF-TREAT FX RAD EXTRA-ARTICUL	$1,369.90	$1,957.00	$713.55–$1,565.60	81% below	30%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 PF-TREAT FX RAD EXTRA-ARTICUL	$1,369.90	$1,957.00	$713.55–$1,565.60	—	30%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Blood transfusion (giving blood or blood components) CPT 36430 PF-BLOOD TRANSFUSION SERVICE	$86.10	$123.00	$41.95–$98.40	91% below	30%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSE BLOOD/COMP	$788.90	$1,127.00	$29.18–$901.60	16% below	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 PF-BLOOD TRANSFUSION SERVICE	$86.10	$123.00	$41.95–$98.40	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NONPRESSURIZED INHALATION	$392.00	$560.00	$29.44–$448.00	109% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NONPRESSURIZED INHALATION	$392.00	$560.00	$29.44–$448.00	—	30%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION SGL/INIT<1H	$590.80	$844.00	$56.39–$675.20	7% below	30%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION SGL/INIT<1H	$590.80	$844.00	$56.39–$675.20	—	30%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 PF-EYE EXAM NEW COMPREHEN	$140.70	$201.00	$45.82–$178.17	at median	30%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 EYE EXAM NEW COMPREHENSIVE	$238.70	$341.00	$45.82–$272.80	70% above	30%
Comprehensive eye exam, returning patient CPT 92014 PF-EYE EXAM EST COMPREHEN	$112.70	$161.00	$50.90–$147.66	15% below	30%
Comprehensive eye exam, returning patient CPT 92014 EYE EXAM EST COMPREHENSIVE	$238.70	$341.00	$50.90–$272.80	81% above	30%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 AUD COMP EVAL THRESH/RECOG	$230.30	$329.00	$57.25–$263.20	10% below	30%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 AUD COMP EVAL THRESH/RECOG	$230.30	$329.00	$57.25–$263.20	—	30%
Critical care, first 30 to 74 minutes CPT 99291 PF-ER CRITICAL CARE 30-74 MIN	$385.70	$551.00	$188.86–$440.80	80% below	30%
Critical care, first 30 to 74 minutes CPT 99291 ER CRITICAL CARE 30-74 MIN	$1,327.20	$1,896.00	$188.86–$1,232.40	31% below	30%
EEG (brain wave test), awake and drowsy, routine CPT 95816 PF-EEG AWAKE/DROWSY	$103.60	$148.00	$62.36–$409.61	88% below	30%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE/DROWSY	$386.40	$552.00	$133.83–$467.89	54% below	30%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 PF-EEG AWAKE/DROWSY	$103.60	$148.00	$62.36–$409.61	—	30%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE/DROWSY	$386.40	$552.00	$133.83–$467.89	—	30%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PF-ELECTROCARDIOGRAM COMPLETE	$28.70	$41.00	$7.06–$32.80	69% below	30%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 PF-ELECTROCARDIOGRAM COMPLETE	$28.70	$41.00	$7.06–$32.80	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD TRACING	$105.70	$151.00	$21.53–$148.43	55% below	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD TRACING	$105.70	$151.00	$21.53–$148.43	—	30%
Electroconvulsive therapy (ECT), one session CPT 90870 PF-ELECTROCONVULSIVE THER	$180.60	$258.00	$126.75–$206.40	80% below	30%
Electroconvulsive therapy (ECT), one session CPT 90870 ELECTROCONVULSIVE THERAPY	$1,535.80	$2,194.00	$126.75–$1,755.20	68% above	30%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 PF-ELECTROCONVULSIVE THER	$180.60	$258.00	$126.75–$206.40	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL 1	$165.20	$236.00	$152.00–$551.76	20% below	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL 2	$301.00	$430.00	$12.44–$523.00	23% below	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL 3	$528.50	$755.00	$45.04–$523.00	24% below	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL 4	$1,068.20	$1,526.00	$76.63–$991.90	5% below	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL 5	$1,327.20	$1,896.00	$130.40–$1,232.40	21% below	30%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST ONLY (NO IMAGING)	$386.40	$552.00	$81.07–$441.60	60% below	30%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST ONLY (NO IMAGING)	$386.40	$552.00	$81.07–$441.60	—	30%
Eye exam, returning patient, intermediate CPT 92012 PF-EYE EXAM EST INTERMED	$75.60	$108.00	$38.05–$102.03	43% below	30%
Eye exam, returning patient, intermediate CPT 92012 EYE EXAM EST INTERMEDIATE	$238.70	$341.00	$38.05–$272.80	81% above	30%
Family therapy with the patient, 50 minutes CPT 90847 PF-PSYCH THRPY FAMILY W/PT	$183.40	$262.00	$100.42–$209.60	2% above	30%
Family therapy with the patient, 50 minutes CPT 90847 PSYCH THRPY FAMILY W/PT	$317.80	$454.00	$4.03–$363.20	77% above	30%
Family therapy with the patient, 50 minutes inpatient CPT 90847 PF-PSYCH THRPY FAMILY W/PT	$183.40	$262.00	$100.42–$209.60	—	30%
Family therapy without the patient, 50 minutes CPT 90846 PF-PSYCH THRPY FAMILY WO PT	$177.10	$253.00	$89.68–$202.40	6% below	30%
Family therapy without the patient, 50 minutes CPT 90846 PSYCH THRPY FAMILY W/O PT	$317.80	$454.00	$69.88–$363.20	68% above	30%
Family therapy without the patient, 50 minutes inpatient CPT 90846 PF-PSYCH THRPY FAMILY WO PT	$177.10	$253.00	$89.68–$202.40	—	30%
Group psychotherapy session CPT 90853 PF-PSYCH GROUP PSYCHOTHER	$44.10	$63.00	$30.30–$50.40	64% below	30%
Group psychotherapy session CPT 90853 PSYCH THRPY GRP	$182.00	$260.00	$20.15–$208.00	49% above	30%
Group psychotherapy session inpatient CPT 90853 PF-PSYCH GROUP PSYCHOTHER	$44.10	$63.00	$30.30–$50.40	—	30%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 PF-ECG MONIT/REPT UP TO 48 HRS	$126.70	$181.00	$18.51–$198.20	37% below	30%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 PF-ECG MONIT/REPT UP TO 48 HRS	$126.70	$181.00	$18.51–$198.20	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFS THPY FLD INTL 31MN-1HR	$380.80	$544.00	$42.75–$435.20	9% above	30%
IV infusion of a medicine, first hour CPT 96365 IV INFUS THPYPROPH//DX INTL UP	$380.80	$544.00	$12.88–$435.20	9% below	30%
IV push of a medicine, first drug CPT 96374 THERAPYPRO//DX IV PUSH INITIAL	$380.80	$544.00	$14.88–$435.20	77% above	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAP/PRO/DX INJ SQ/IM	$128.80	$184.00	$22.23–$147.20	18% above	30%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PF-PSYCH DX EVAL	$243.60	$348.00	$13.44–$278.40	4% below	30%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DX EVAL	$317.80	$454.00	$99.00–$363.20	26% above	30%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PF-PSYCH DX EVAL	$243.60	$348.00	$13.44–$278.40	—	30%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 PF-NERVE CONDUCT STUDIES 7-8	$192.50	$275.00	$119.37–$238.91	74% below	30%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES; 7-8	$667.80	$954.00	$69.22–$763.20	8% below	30%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 PF-NERVE CONDUCT STUDIES 7-8	$192.50	$275.00	$119.37–$238.91	—	30%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES; 7-8	$667.80	$954.00	$69.22–$763.20	—	30%
Neuromuscular re-education, 15 minutes CPT 97112 PT/OT NEUROMUSCULAR RE-ED 15 MIN	$58.10	$83.00	$27.71–$110.00	53% below	30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT/OT NEUROMUSCULAR RE-ED 15 MIN	$58.10	$83.00	$27.71–$110.00	—	30%
New patient office visit, about 30 minutes CPT 99203 PF-VISIT OP NEW LEVEL 3	$138.60	$198.00	$50.17–$158.40	35% below	30%
New patient office visit, about 30 minutes CPT 99203 VISIT OP NEW LEVEL 3	$238.70	$341.00	$50.17–$272.80	11% above	30%
New patient office visit, about 45 minutes CPT 99204 PF-VISIT OP NEW LEVEL 4	$224.00	$320.00	$87.54–$256.00	24% below	30%
New patient office visit, about 45 minutes CPT 99204 VISIT OP NEW LEVEL 4	$238.70	$341.00	$75.00–$272.80	19% below	30%
New patient office visit, about 60 minutes CPT 99205 VISIT OP NEW LEVEL 5	$238.70	$341.00	$75.00–$272.80	35% below	30%
New patient office visit, about 60 minutes CPT 99205 PF-VISIT OP NEW LEVEL 5	$310.10	$443.00	$141.18–$354.40	15% below	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PF-VISIT OP NEW LEVEL 2	$77.70	$111.00	$47.46–$89.68	50% below	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 VISIT OP NEW LEVEL 2	$238.70	$341.00	$62.38–$282.43	53% above	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 PF-C-NUTRITION THRPY EVAL 15 M	$47.60	$68.00	$18.76–$80.78	12% below	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 PF-NUTRITION THRPY EVAL 15 MIN	$47.60	$68.00	$18.76–$447.49	12% below	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 RD-NUTRITION THRPY EVAL 15 MIN	$56.70	$81.00	$18.76–$64.80	5% above	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION THRPY EVAL 15 MIN	$56.70	$81.00	$18.76–$64.80	5% above	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 PF-NUTRITION THRPY EVAL 15 MIN	$47.60	$68.00	$18.76–$447.49	—	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 PF-C-NUTRITION THRPY EVAL 15 M	$47.60	$68.00	$18.76–$80.78	—	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 RD-NUTRITION THRPY EVAL 15 MIN	$56.70	$81.00	$18.76–$64.80	—	30%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL - LOW COMPLEXITY	$177.80	$254.00	$17.61–$203.20	31% below	30%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL - LOW COMPLEXITY	$177.80	$254.00	$17.61–$203.20	—	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL - HIGH COMPLEXITY	$176.40	$252.00	$82.22–$201.60	49% below	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL - HIGH COMPLEXITY	$176.40	$252.00	$82.22–$201.60	—	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL - LOW COMPLEXITY	$176.40	$252.00	$36.69–$201.60	22% below	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL - LOW COMPLEXITY	$176.40	$252.00	$36.69–$201.60	—	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL - MODERATE COMPLEXITY	$176.40	$252.00	$82.22–$201.60	43% below	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL - MODERATE COMPLEXITY	$176.40	$252.00	$82.22–$201.60	—	30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT/OT MANUAL THRPY 15 MIN	$49.00	$70.00	$6.77–$110.00	65% below	30%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT/OT MANUAL THRPY 15 MIN	$49.00	$70.00	$6.77–$110.00	—	30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT/OT EXERCISE THERAPY 15 MIN	$51.80	$74.00	$12.83–$110.00	57% below	30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT/OT EXERCISE THERAPY 15 MIN	$51.80	$74.00	$12.83–$110.00	—	30%
Preventive checkup, new patient aged 18–39 CPT 99385 PREVENTIVE MED NEW 18-39 YR	$238.70	$341.00	$75.00–$272.80	8% above	30%
Preventive checkup, new patient aged 18–39 CPT 99385 PF-PREVENTIVE NEW 18-39 YR	$319.90	$457.00	$5.00–$365.60	45% above	30%
Preventive checkup, new patient aged 40–64 CPT 99386 PREVENTIVE MED NEW 40-64 YR	$238.70	$341.00	$75.00–$272.80	at median	30%
Preventive checkup, new patient aged 40–64 CPT 99386 PF-PREVENTIVE NEW 40-64 YR	$319.90	$457.00	$5.00–$365.60	34% above	30%
Preventive checkup, new patient aged 65 or older CPT 99387 PREVENTIVE MED NEW > 65 YRS	$238.70	$341.00	$75.00–$272.80	13% above	30%
Preventive checkup, new patient aged 65 or older CPT 99387 PF-PREVENTIVE NEW > 65 YRS	$319.90	$457.00	$5.00–$365.60	52% above	30%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREVENTIVE MED ESTAB 18-39	$238.70	$341.00	$75.00–$272.80	36% above	30%
Preventive checkup, returning patient aged 18–39 CPT 99395 PF-PREVENTIVE ESTAB 18-39	$252.70	$361.00	$5.00–$288.80	44% above	30%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREVENTIVE MED ESTAB 40-64	$238.70	$341.00	$75.00–$272.80	20% above	30%
Preventive checkup, returning patient aged 40–64 CPT 99396 PF-PREVENTIVE ESTAB 40-64	$252.70	$361.00	$5.00–$288.80	27% above	30%
Preventive checkup, returning patient aged 65 or older CPT 99397 PREVENTIVE MED ESTAB > 65 Y	$238.70	$341.00	$75.00–$272.80	12% above	30%
Preventive checkup, returning patient aged 65 or older CPT 99397 PF-PREVENTIVE ESTAB > 65 Y	$252.70	$361.00	$5.00–$288.80	19% above	30%
Psychiatric evaluation with medical services CPT 90792 PF-PSYCH DX EVAL W/MED SRVC	$294.00	$420.00	$152.12–$336.00	5% above	30%
Psychiatric evaluation with medical services CPT 90792 PSYCH DX EVAL W/MED SERV	$317.80	$454.00	$99.00–$363.20	14% above	30%
Psychiatric evaluation with medical services inpatient CPT 90792 PF-PSYCH DX EVAL W/MED SRVC	$294.00	$420.00	$152.12–$336.00	—	30%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PF-PSYCHOLOGC TESTING 1ST H	$182.70	$261.00	$5.10–$208.80	42% below	30%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCHOLOGICAL TESTING 1ST H	$386.40	$552.00	$5.10–$441.60	23% above	30%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PF-PSYCHOLOGC TESTING 1ST H	$182.70	$261.00	$5.10–$208.80	—	30%
Psychotherapy for crisis, first 60 minutes CPT 90839 PF-PSYCHOTH CRISIS; 1ST 60	$231.00	$330.00	$111.90–$264.00	4% below	30%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHRPY CRISIS	$317.80	$454.00	$111.90–$363.20	32% above	30%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PF-PSYCHOTH CRISIS; 1ST 60	$231.00	$330.00	$111.90–$264.00	—	30%
Psychotherapy session, 30 minutes CPT 90832 PF-PSYCHOTH, 30 MINUTES	$123.20	$176.00	$76.68–$176.40	34% below	30%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTH, 30 MINUTES	$317.80	$454.00	$53.34–$363.20	69% above	30%
Psychotherapy session, 30 minutes inpatient CPT 90832 PF-PSYCHOTH, 30 MINUTES	$123.20	$176.00	$76.68–$176.40	—	30%
Psychotherapy session, 45 minutes CPT 90834 PF-PSYCHOTH, 45 MINUTES	$163.80	$234.00	$66.86–$187.20	19% below	30%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTH, 45 MINUTES	$317.80	$454.00	$68.70–$363.20	57% above	30%
Psychotherapy session, 45 minutes inpatient CPT 90834 PF-PSYCHOTH, 45 MINUTES	$163.80	$234.00	$66.86–$187.20	—	30%
Psychotherapy session, 60 minutes CPT 90837 PF-PSYCHOTH, 60 MINUTES	$240.10	$343.00	$84.34–$274.40	20% below	30%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTH, 60 MINUTES	$317.80	$454.00	$93.02–$363.20	5% above	30%
Psychotherapy session, 60 minutes inpatient CPT 90837 PF-PSYCHOTH, 60 MINUTES	$240.10	$343.00	$84.34–$274.40	—	30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 PF-SMOK CESS INTER >3MIN	$21.00	$30.00	$11.34–$99.31	38% below	30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKCESSINTER>3MIN	$67.20	$96.00	$11.34–$76.80	98% above	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF-VISIT OP ESTAB LEVEL 5	$237.30	$339.00	$93.38–$271.20	14% below	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 VISIT OP ESTAB LEVEL 5	$238.70	$341.00	$75.00–$272.80	14% below	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PF-VISIT OP ESTAB LEVEL 3	$108.50	$155.00	$35.48–$124.00	28% below	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 VISIT OP ESTAB LEVEL 3	$238.70	$341.00	$37.37–$272.80	58% above	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PF-VISIT OP ESTAB LEVEL 4	$159.60	$228.00	$57.90–$182.40	10% below	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 VISIT OP ESTAB LEVEL 4	$238.70	$341.00	$69.36–$272.80	34% above	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PF-VISIT OP ESTAB LEVEL 2	$59.50	$85.00	$9.09–$68.00	50% below	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 VISIT OP ESTAB LEVEL 2	$238.70	$341.00	$9.09–$272.80	99% above	30%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PF-CONSULTATION LVL 3	$138.60	$198.00	$5.00–$158.40	40% below	30%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULTATIONLVL3	$238.70	$341.00	$58.27–$272.80	3% above	30%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PF-CONSULTATION LVL 4	$224.00	$320.00	$5.00–$256.00	27% below	30%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULTATIONLVL4	$238.70	$341.00	$75.00–$272.80	22% below	30%
Speech and language evaluation CPT 92523 EVAL SOUND PRODUCTION W/COMPR	$402.50	$575.00	$100.00–$460.00	2% above	30%
Speech and language evaluation inpatient CPT 92523 EVAL SOUND PRODUCTION W/COMPR	$402.50	$575.00	$100.00–$460.00	—	30%
Speech therapy session, individual CPT 92507 ST TREAT SPEECH	$135.10	$193.00	$32.46–$154.40	28% below	30%
Speech therapy session, individual inpatient CPT 92507 ST TREAT SPEECH	$135.10	$193.00	$32.46–$154.40	—	30%
Spirometry (breathing test) CPT 94010 SPIROMETRY/PFT	$386.40	$552.00	$3.06–$441.60	27% above	30%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY/PFT	$386.40	$552.00	$3.06–$441.60	—	30%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY/PFT PRE & POST	$667.80	$954.00	$60.35–$763.20	27% above	30%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY/PFT PRE & POST	$667.80	$954.00	$60.35–$763.20	—	30%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT/OT THERAPEUTIC ACTIVITY 15 MIN	$62.30	$89.00	$27.37–$110.00	51% below	30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT/OT THERAPEUTIC ACTIVITY 15 MIN	$62.30	$89.00	$27.37–$110.00	—	30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PF-PHLEBOTOMY THERAPEUTIC	$177.10	$253.00	$14.13–$202.40	15% below	30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$238.00	$340.00	$18.62–$1,071.83	15% above	30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PF-PHLEBOTOMY THERAPEUTIC	$177.10	$253.00	$14.13–$202.40	—	30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$238.00	$340.00	$18.62–$1,071.83	—	30%
Visual field test, extended CPT 92083 PF-VISUAL FIELD EXAM EXTEND	$47.60	$68.00	$28.81–$109.39	67% below	30%
Visual field test, extended CPT 92083 VISUAL FIELD EXAM EXTEND	$238.00	$340.00	$48.46–$272.00	63% above	30%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 MODERNA COVID-19 VACCINE 50 MCG/0.5ML 12 + YR	$833.78	$1,191.12	$167.32–$952.90	308% above	30%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 MODERNA COVID-19 VACCINE 50 MCG/0.5ML 12 + YR	$833.78	$1,191.12	$167.32–$952.90	—	30%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 PFIZER COVID-19 VACCINE 30 MCG/0.3ML 12+ YR	$1,447.36	$2,067.66	$174.27–$1,654.13	492% above	30%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 PFIZER COVID-19 VACCINE 30 MCG/0.3ML 12+ YR	$1,447.36	$2,067.66	$174.27–$1,654.13	—	30%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE INJ 0.5 ML	$564.45	$806.36	$215.94–$645.09	104% above	30%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE INJ 0.5 ML	$564.45	$806.36	$215.94–$645.09	—	30%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP/IPV (QUADRACEL) INJ 0.5ML	$379.67	$542.39	$75.17–$433.91	269% above	30%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP/IPV (QUADRACEL) INJ 0.5ML	$379.67	$542.39	$75.17–$433.91	—	30%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP-PED (INFANRIX) VACCINE INJ 0.5 ML	$174.00	$248.56	$35.39–$198.85	172% above	30%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP-PED (DAPTACEL) VACCINE INJ 0.5 ML	$178.69	$255.28	$35.39–$204.22	179% above	30%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP-PED (INFANRIX) VACCINE INJ 0.5 ML	$174.00	$248.56	$35.39–$198.85	—	30%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP-PED (DAPTACEL) VACCINE INJ 0.5 ML	$178.69	$255.28	$35.39–$204.22	—	30%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP/HEPB-IPV (PEDIARIX) VACCINE INJ 0.5 ML	$609.29	$870.41	$122.27–$696.33	283% above	30%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTAP/HEPB-IPV (PEDIARIX) VACCINE INJ 0.5 ML	$609.29	$870.41	$122.27–$696.33	—	30%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DTAP-IPV-HIB-HEPB (VAXELIS) VACCINE 0.5 ML	$857.54	$1,225.06	$184.91–$980.04	257% above	30%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DTAP-IPV-HIB-HEPB (VAXELIS) VACCINE 0.5 ML	$857.54	$1,225.06	$184.91–$980.04	—	30%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE (TRI PF) 0.5 ML SYR (FLUZONE) 6 MO - 18 YR	$10.50	$15.00	$6.30–$24.63	69% below	30%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE (TRI PF) 0.5 ML SYR (FLUARIX) 6 MO - 35 MO	$10.50	$15.00	$6.30–$24.63	69% below	30%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE TRI PF INJ (FLULAVAL) 6 MO - 18 YR	$10.50	$15.00	$6.30–$24.63	69% below	30%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE (TRI PF) 0.5 ML SYR (AFLURIA) 3 YR AND UP	$10.50	$15.00	$6.30–$24.63	69% below	30%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE NO PRESERC 3 & >	$10.50	$15.00	$6.30–$24.63	69% below	30%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE TRI PF INJ (FLULAVAL) 6 MO - 18 YR	$10.50	$15.00	$6.30–$24.63	—	30%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE (TRI PF) 0.5 ML SYR (AFLURIA) 3 YR AND UP	$10.50	$15.00	$6.30–$24.63	—	30%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE (TRI PF) 0.5 ML SYR (FLUZONE) 6 MO - 18 YR	$10.50	$15.00	$6.30–$24.63	—	30%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE (TRI PF) 0.5 ML SYR (FLUARIX) 6 MO - 35 MO	$10.50	$15.00	$6.30–$24.63	—	30%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV - HUMAN PAPILLOMAVIRUS (GARDASIL 9-VALENT) VACCINE	$1,934.31	$2,763.31	$362.98–$2,210.64	295% above	30%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV - HUMAN PAPILLOMAVIRUS (GARDASIL 9-VALENT) VACCINE	$1,934.31	$2,763.31	$362.98–$2,210.64	—	30%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A-HEPATITIS B VACCINE 720 UNITS-20 MCG/ML PF INJ 1 ML	$389.35	$556.21	$156.27–$444.97	91% above	30%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS A-HEPATITIS B VACCINE 720 UNITS-20 MCG/ML PF INJ 1 ML	$389.35	$556.21	$156.27–$444.97	—	30%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A 1440 UNITS (ADULT) VAC PF INJ 1 ML	$253.28	$361.83	$98.81–$289.47	110% above	30%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A 1440 UNITS (ADULT) VAC PF INJ 1 ML	$253.28	$361.83	$98.81–$289.47	—	30%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A 720 UNITS (PED) VACCINE PF INJ 0.5 ML	$230.07	$328.67	$46.01–$262.93	180% above	30%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A 720 UNITS (PED) VACCINE PF INJ 0.5 ML	$230.07	$328.67	$46.01–$262.93	—	30%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B ADULT VACCINE (HEPLISAV-B) 20 MCG/0.5 ML	$1,831.62	$2,616.60	$183.79–$2,093.28	717% above	30%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B ADULT VACCINE (HEPLISAV-B) 20 MCG/0.5 ML	$1,831.62	$2,616.60	$183.79–$2,093.28	—	30%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR (MEASLES/MUMPS/RUBELLA) VACCINE INJ 0.5 ML	$286.99	$409.98	$112.34–$327.99	44% above	30%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR (MEASLES/MUMPS/RUBELLA) VACCINE INJ 0.5 ML	$286.99	$409.98	$112.34–$327.99	—	30%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEASLES/MUMPS/RUBELLA/VARICELLA VIRUS VACCINE (PROQUAD) INJ	$848.68	$1,212.41	$328.23–$969.93	104% above	30%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLES/MUMPS/RUBELLA/VARICELLA VIRUS VACCINE (PROQUAD) INJ	$848.68	$1,212.41	$328.23–$969.93	—	30%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJUGATE VACCINE (MENVEO) INJ POWDER	$490.24	$700.34	$196.77–$560.27	98% above	30%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL CONJUGATE VACCINE (MENVEO) INJ POWDER	$490.24	$700.34	$196.77–$560.27	—	30%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL CONJUGATE VACCINE GROUP ACYW SOL	$980.47	$1,400.67	$202.92–$1,120.54	285% above	30%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL CONJUGATE VACCINE (MENQUADFI) POLYSACCHARIDE TETANUS TOXOID GROUP ACYW INJ	$1,010.46	$1,443.51	$202.92–$1,154.81	296% above	30%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL CONJUGATE VACCINE GROUP ACYW SOL	$980.47	$1,400.67	$202.92–$1,120.54	—	30%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL CONJUGATE VACCINE (MENQUADFI) POLYSACCHARIDE TETANUS TOXOID GROUP ACYW INJ	$1,010.46	$1,443.51	$202.92–$1,154.81	—	30%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL GROUP B VACCINE RECOMBINANT (BEXSERO) OMV, ADJUVANTED - NF	$1,394.30	$1,991.86	$279.81–$1,593.49	285% above	30%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL GROUP B VACCINE RECOMBINANT (BEXSERO) OMV, ADJUVANTED - NF	$1,394.30	$1,991.86	$279.81–$1,593.49	—	30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 (PNEUMOCOCCAL 20-VALENT) CONJUGATE VACCINE INJ 0.5 ML	$1,610.24	$2,300.35	$324.03–$1,840.28	262% above	30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PCV20 (PNEUMOCOCCAL 20-VALENT) CONJUGATE VACCINE INJ 0.5 ML	$1,610.24	$2,300.35	$324.03–$1,840.28	—	30%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PNEUMOCOCCAL 21-VALENT CONJUGATE VACCINE (CVX 327) - SUS UD	$1,775.61	$2,536.59	$339.55–$2,029.27	260% above	30%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 PNEUMOCOCCAL 21-VALENT CONJUGATE VACCINE (CVX 327) - SUS UD	$1,775.61	$2,536.59	$339.55–$2,029.27	—	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 (PNEUMOCOCCAL 23-POLYVALENT) VACCINE INJ 0.5 ML	$688.44	$983.48	$138.15–$786.78	275% above	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PPSV23 (PNEUMOCOCCAL 23-POLYVALENT) VACCINE INJ 0.5 ML	$688.44	$983.48	$138.15–$786.78	—	30%
Polio vaccine, inactivated (IPV) CPT 90713 IPV (POLIOVIRUS VACCINE, INACTIVATED) VACCINE INJ (IPOL)	$263.01	$375.73	$52.78–$300.59	60% above	30%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPV (POLIOVIRUS VACCINE, INACTIVATED) VACCINE INJ (IPOL)	$263.01	$375.73	$52.78–$300.59	—	30%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB (CVX 307) ALIP PRESERVATIVE-FREE 100 MG/ML SOL	$1,635.02	$2,335.75	$656.23–$1,868.60	91% above	30%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 NIRSEVIMAB (CVX 307) ALIP PRESERVATIVE-FREE 100 MG/ML SOL	$1,635.02	$2,335.75	$656.23–$1,868.60	—	30%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB (CVX 306) ALIP PRESERVATIVE-FREE 50 MG/0.5 ML SOL	$3,270.05	$4,671.51	$656.23–$3,737.20	169% above	30%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB (CVX 306) ALIP PRESERVATIVE-FREE 50 MG/0.5 ML SOL	$3,270.05	$4,671.51	$656.23–$3,737.20	—	30%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACCINE, PREF A-PREF B, RECOMBINANT PRESERVATIVE-FREE 60 MCG-60 MCG INJ	$901.99	$1,288.56	$362.02–$1,030.85	96% above	30%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACCINE, PREF A-PREF B, RECOMBINANT PRESERVATIVE-FREE 60 MCG-60 MCG INJ	$901.99	$1,288.56	$362.02–$1,030.85	—	30%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, HUMAN DIPLOID CELL INJ 1 ML (NF)	$1,100.05	$1,571.50	$402.25–$1,257.20	46% above	30%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICK EMBRYO CELL INJ 1 ML	$1,277.75	$1,825.36	$402.25–$1,460.28	70% above	30%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, HUMAN DIPLOID CELL INJ 1 ML (NF)	$1,100.05	$1,571.50	$402.25–$1,257.20	—	30%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PURIFIED CHICK EMBRYO CELL INJ 1 ML	$1,277.75	$1,825.36	$402.25–$1,460.28	—	30%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS (ROTATEQ) VACCINE SUSP 2 ML	$150.85	$215.49	$90.51–$172.39	2% above	30%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS (ROTATEQ) VACCINE SUSP 2 ML	$150.85	$215.49	$90.51–$172.39	—	30%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VACCINE INACTIVATED (SHINGRIX) 0.5 ML INJ	$633.59	$905.13	$254.30–$724.11	114% above	30%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VACCINE INACTIVATED (SHINGRIX) 0.5 ML INJ	$633.59	$905.13	$254.30–$724.11	—	30%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD - ADULT/ADOLES (TENIVAC) VACCINE INJ 0.5 ML	$246.94	$352.77	$49.86–$282.21	221% above	30%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD - ADULT/ADOLES (TENIVAC) VACCINE INJ 0.5 ML	$246.94	$352.77	$49.86–$282.21	—	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP - ADULT/ADOLES (BOOSTRIX) VACCINE INJ 0.5 ML	$286.63	$409.47	$57.88–$327.57	185% above	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP - ADULT/ADOLES (BOOSTRIX) VACCINE INJ 0.5 ML	$286.63	$409.47	$57.88–$327.57	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN OTHER VACCINE	$16.71	$23.87	$8.70–$137.05	71% below	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN VAC IM/SQ EA AD	$7.00	$10.00	$6.28–$21.35	82% below	30%

Dental

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Removal of an impacted tooth fully covered by bone, often a wisdom tooth CDT D7240 REMOVAL TOOTH IMPACTED CMPL	$1,156.40	$1,652.00	$172.69–$1,321.60	—	30%
Removal of an impacted tooth fully covered by bone, often a wisdom tooth inpatient CDT D7240 REMOVAL TOOTH IMPACTED CMPL	$1,156.40	$1,652.00	$172.69–$1,321.60	—	30%
Routine teeth cleaning (prophylaxis), adult or teen CDT D1110 PROPHYLAXIS ADULT	$238.70	$341.00	$30.99–$272.80	44% above	30%
Routine teeth cleaning (prophylaxis), adult or teen inpatient CDT D1110 PROPHYLAXIS ADULT	$238.70	$341.00	$30.99–$272.80	—	30%
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACTION ERUPTED TOOTH/EXPOS	$1,156.40	$1,652.00	$49.82–$1,321.60	252% above	30%
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 EXTRACTION ERUPTED TOOTH/EXPOS	$1,156.40	$1,652.00	$49.82–$1,321.60	—	30%

Source file: https://cookcountyhealth.org/wp-content/uploads/366006541_JOHN-H-STROGER-JR-HOSP-OF-COOK-COUNTY-PROVIDENT-HOSPITAL_standardcharges-2.csv