Hospital McAllen-Edinburg-Mission, TX

Driscoll Children's Hospital Rio Grande Valley

Listed in its price file as “Driscoll Children’s Hospital”.

Driscoll Children's Hospital Rio Grande Valley in Edinburg, TX publishes cash prices for 356 common procedures listed here, from its own machine-readable price file updated Oct 6, 2025. Compared with other hospitals in the state, its outpatient cash prices are below the Texas median for 246 of 356 procedures and above it for 109. By typical cash price it ranks #91 of 299 Texas hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

2820 Michaelangelo Drive, Edinburg, TX 78539-1402 Collected Sep 22, 2026 Source price file Check a bill from this hospital (361) 694-5041

Children's hospital Nonprofit hospital Emergency department CCN 453321 · CMS hospital register

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Driscoll Children's Hospital Rio Grande Valley is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Abdominal CT scan without and with contrast CPT 74170 CT Abd W/WO Contrast	$3,076.19	$15,380.96	$165.82–$178.55	7% above	80%
Abdominal X-ray, 2 views CPT 74019 Abdomen 2 View	$190.62	$953.12	$36.09–$165.82	50% below	80%
Ankle X-ray, complete, 3 or more views CPT 73610 Ankle 3 or >Views	$180.10	$900.48	$35.75–$165.82	49% below	80%
Ankle X-ray, complete, 3 or more views CPT 73610 Ankle 3 or 4v	$209.44	$1,047.20	$35.75–$165.82	41% below	80%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT Limited,Extrem WO Cont	$470.62	$2,353.12	$108.97–$165.82	72% below	80%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT Upper Extremity WO/Con	$1,365.06	$6,825.28	$108.97–$165.82	17% below	80%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Barium Swallow	$390.66	$1,953.28	$98.90–$165.82	22% below	80%
Bone scan, whole body (nuclear medicine) CPT 78306 Bone Imaging Whole Body	$1,450.40	$7,252.00	$165.82	8% below	80%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Cta Abd Pelvis W WO Contrast	$5,155.14	$25,775.68	$165.82–$368.12	28% above	80%
CT angiography (CTA) of the head CPT 70496 Cta Head WO/W Ce & Ipp	$2,291.74	$11,458.72	$165.82–$178.55	4% below	80%
CT angiography (CTA) of the neck CPT 70498 Cta Neck WO/W Ce & Ipp	$2,291.74	$11,458.72	$165.82–$178.55	4% below	80%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Cta Chest WO/W Ce W Ipp	$2,886.46	$14,432.32	$165.82–$178.55	12% above	80%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Hchg Cta Coronary W/Ce W/Ipp	$2,446.53	$12,232.64	$165.82–$178.55	47% above	80%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Hchg Cta Coronary WO/W Ce W/Pp	$2,972.48	$14,862.40	$165.82–$178.55	79% above	80%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Cct Ipp Qan Calclum WO	$2,105.15	$10,525.76	$80.90–$165.82	1011% above	80%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Hchg CT Pelvis & Abd WO Cont	$4,107.26	$20,536.32	$165.82–$192.13	45% above	80%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Hchg CT Pelvis & Abd W Cont	$3,942.40	$19,712.00	$165.82–$324.78	4% above	80%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Hchg CT Pelvis & Abd W/WO Cont	$6,054.50	$30,272.48	$165.82–$364.20	60% above	80%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W/Contrast	$2,340.13	$11,700.64	$165.82–$178.55	7% below	80%
CT scan of the abdomen without contrast CPT 74150 CT Abd WO Contrast	$2,075.36	$10,376.80	$108.97–$165.82	3% above	80%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial WO Contr	$2,043.78	$10,218.88	$108.97–$165.82	25% above	80%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hchg CT Sinus Fusion Scan WO	$2,043.78	$10,218.88	$108.97–$165.82	25% above	80%
CT scan of the head or brain, no contrast dye CPT 70450 CT Limited,Brain WO Cont	$306.21	$1,531.04	$108.97–$165.82	82% below	80%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head WO Contrast	$1,842.18	$9,210.88	$108.97–$165.82	10% above	80%
CT scan of the head with contrast CPT 70460 CT Head With Contrast	$1,732.64	$8,663.20	$156.38–$165.82	3% above	80%
CT scan of the head without and with contrast CPT 70470 CT Head W/WO Contrast	$2,710.18	$13,550.88	$165.82–$178.55	33% above	80%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar Spine WO Contra	$2,042.43	$10,212.16	$108.97–$165.82	18% above	80%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C Spine WO Contrast	$2,042.43	$10,212.16	$108.97–$165.82	at median	80%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W Contrast	$2,471.39	$12,356.96	$165.82–$178.55	14% above	80%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Duplx,Carotid Doppler	$790.68	$3,953.40	$165.82	26% below	80%
Chest CT scan without and with contrast CPT 71270 CT Chest W/WO Contrast	$2,738.18	$13,690.88	$165.82–$178.55	7% above	80%
Chest X-ray, 2 views CPT 71046 Chest Spec Vw Decub Bu	$178.30	$891.52	$32.75–$165.82	54% below	80%
Chest X-ray, 2 views CPT 71046 Chest; 2v W/Fluoro	$206.53	$1,032.64	$32.75–$165.82	47% below	80%
Chest X-ray, 2 views CPT 71046 Chest 2v W/Fluoro	$206.53	$1,032.64	$32.75–$165.82	47% below	80%
Chest X-ray, 2 views CPT 71046 Chest 2 Views	$219.07	$1,095.36	$32.75–$165.82	44% below	80%
Chest X-ray, single view CPT 71045 Chest 1 View	$154.56	$772.80	$25.06–$165.82	52% below	80%
Chest X-ray, single view CPT 71045 Tube Insrt, Brovi	$159.71	$798.56	$25.06–$165.82	51% below	80%
Chest X-ray, single view CPT 71045 Tube Ins, Mediport	$161.28	$806.40	$25.06–$165.82	50% below	80%
Collarbone (clavicle) X-ray, complete both sides CPT 73000 Clavicles, Ap Bilateral	$126.34	$631.68	$31.41–$165.82	—	80%
Collarbone (clavicle) X-ray, complete CPT 73000 Clavicle, Ap	$81.98	$409.92	$31.41–$165.82	73% below	80%
Collarbone (clavicle) X-ray, complete CPT 73000 Clavicle 1v	$126.11	$630.56	$31.41–$165.82	58% below	80%
Collarbone (clavicle) X-ray, complete CPT 73000 Clavicle 2v	$193.98	$969.92	$31.41–$165.82	35% below	80%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Echo Retroperitoneal	$346.30	$1,731.52	$108.97–$165.82	50% below	80%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Echo, Renal	$553.28	$2,766.40	$108.97–$165.82	20% below	80%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Limited,Chest WO Cont	$306.21	$1,531.04	$108.97–$165.82	80% below	80%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest WO Contrast	$2,023.84	$10,119.20	$108.97–$165.82	33% above	80%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest W Contrast	$2,203.49	$11,017.44	$165.82–$178.55	10% above	80%
Duplex ultrasound of the leg arteries, both legs CPT 93925 Dpx Doplr,Lowr Ext/Art,Bi	$638.66	$3,193.30	$165.82	54% below	80%
Duplex ultrasound of the leg veins, both legs CPT 93970 Duplx Doppler Ext,Venous	$715.44	$3,577.20	$165.82	54% below	80%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Hchg 2d Echo With Spectral and Color Flow Doppler; Complete	$1,061.94	$5,309.70	$165.82	44% below	80%
Elbow X-ray, 2 views CPT 73070 Elbow 1v	$126.11	$630.56	$28.40–$165.82	60% below	80%
Elbow X-ray, 2 views CPT 73070 Elbow 2 Views	$174.05	$870.24	$28.40–$165.82	45% below	80%
Elbow X-ray, complete, 3 or more views CPT 73080 Elbow Comp.3 or More View	$208.77	$1,043.84	$31.41–$165.82	46% below	80%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit WO Contrast	$1,198.18	$5,990.88	$108.97–$165.82	19% below	80%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Mid Ear WO Contrast	$1,841.73	$9,208.64	$108.97–$165.82	24% above	80%
Facial bones X-ray, complete, 3 or more views CPT 70150 Zygoma 3v	$205.63	$1,028.16	$46.11–$165.82	47% below	80%
Facial bones X-ray, complete, 3 or more views CPT 70150 Maxilla Series 3v	$236.99	$1,184.96	$46.11–$165.82	39% below	80%
Facial bones X-ray, complete, 3 or more views CPT 70150 Facial Bones,Comp 3 V	$315.17	$1,575.84	$46.11–$165.82	19% below	80%
Forearm X-ray (radius and ulna), 2 views CPT 73090 Forearm 1 View	$126.11	$630.56	$28.40–$165.82	66% below	80%
Forearm X-ray (radius and ulna), 2 views CPT 73090 Forearm, 2 Views	$184.80	$924.00	$28.40–$165.82	50% below	80%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobilliary Scan	$1,194.59	$5,972.96	$165.82	25% below	80%
Hand X-ray, 2 views CPT 73120 Hand 1v	$126.11	$630.56	$30.40–$165.82	60% below	80%
Hand X-ray, 2 views CPT 73120 Hand 2v	$172.03	$860.16	$30.40–$165.82	46% below	80%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Calcaneous 1 View	$81.98	$409.92	$28.06–$165.82	71% below	80%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Heel 1v (Calcaneous	$96.77	$483.84	$28.06–$165.82	66% below	80%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Heel 2v (Calcaneous	$141.12	$705.60	$28.06–$165.82	51% below	80%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Calcaneous 2 View	$184.80	$924.00	$28.06–$165.82	36% below	80%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Psg Age 6-20 4+ Param W/Cpap	$2,240.26	$11,201.30	$165.82	47% below	80%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Npsb Continous Positive	$3,509.44	$17,547.20	$165.82	17% below	80%
Knee X-ray, 3 views CPT 73562 Knee 3 View	$208.77	$1,043.84	$39.43–$165.82	44% below	80%
Knee X-ray, complete, 4 or more views CPT 73564 Knee Comp. 4 or >Views	$216.61	$1,083.04	$44.78–$165.82	49% below	80%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT Lower Extremity WO Con	$1,365.06	$6,825.28	$108.97–$165.82	17% below	80%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Echo, Urinary Bladder	$217.06	$1,085.28	$89.21–$165.82	64% below	80%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Echo Pyloric/Abd Limited	$222.88	$1,114.40	$89.21–$165.82	63% below	80%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Ge Reflux Evaluation Sono	$225.57	$1,127.84	$89.21–$165.82	63% below	80%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Echo Urinary Bladder	$283.14	$1,415.68	$89.21–$165.82	53% below	80%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Echo Spleen	$342.94	$1,714.72	$89.21–$165.82	43% below	80%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Echo Limitd Abd.Sing Org	$359.74	$1,798.72	$89.21–$165.82	40% below	80%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Echo Hepartic Abd 1 Organ	$365.57	$1,827.84	$89.21–$165.82	40% below	80%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Echo Hepatic Abd 1 Organ	$525.06	$2,625.28	$89.21–$165.82	13% below	80%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Echo Gallbladder Sngl Org	$541.63	$2,708.16	$89.21–$165.82	10% below	80%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Echo Pancreas Abd 1 Organ	$603.46	$3,017.28	$89.21–$165.82	at median	80%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Echo Extremity Non Vasc	$365.57	$1,827.84	$165.82	6% below	80%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Hchg Echo Extrem Non Vas Lim	$365.57	$1,827.84	$165.82	6% below	80%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Leg 1 View	$81.98	$409.92	$30.74–$165.82	76% below	80%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Leg(Tib/Fib),1v	$119.17	$595.84	$30.74–$165.82	66% below	80%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Leg,(Tib/Fib)Ap/Lat	$172.70	$863.52	$30.74–$165.82	50% below	80%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Leg 2 Views	$202.94	$1,014.72	$30.74–$165.82	41% below	80%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Hchg Leg Bilt 3 View 1-3y	$263.87	$1,319.36	$30.74–$165.82	24% below	80%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Hchg Leg Rt 3view 1-3y	$202.94	$1,014.72	$30.74–$165.82	41% below	80%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Hchg Leg Lt 3view 1-3y	$202.94	$1,014.72	$30.74–$165.82	41% below	80%
MR angiography (MRA) of the head without contrast CPT 70544 Mra Head W/O Contrast	$1,412.32	$7,061.60	$165.82–$230.13	21% below	80%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Joint Low Ext W/O Con	$1,620.19	$8,100.96	$165.82–$218.53	26% below	80%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Mrijoint Lowext W/O W Con	$3,156.38	$15,781.92	$165.82–$368.12	5% above	80%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen W/O Contrast	$1,458.24	$7,291.20	$165.82–$213.51	29% below	80%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen W/O W Con	$3,340.74	$16,703.68	$165.82–$368.12	9% above	80%
MRI of the brain, no contrast dye CPT 70551 MRI Brain W/O Contrast	$1,388.58	$6,942.88	$165.82–$211.18	25% below	80%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain W/O W Contrast	$3,256.29	$16,281.44	$165.82–$347.16	15% above	80%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar W/O Cont	$1,824.93	$9,124.64	$165.82–$206.83	17% below	80%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumb W/O W Cont	$3,237.47	$16,187.36	$165.82–$349.84	1% above	80%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spinethoracic W/O Con	$1,824.93	$9,124.64	$165.82–$206.49	10% below	80%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cerv WO/W Cont	$3,237.47	$16,187.36	$165.82–$350.50	1% below	80%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cerv W/O Cont	$1,644.61	$8,223.04	$165.82–$206.49	27% below	80%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis W/O W Contrast	$3,163.10	$15,815.52	$165.82–$368.12	1% above	80%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis W/O Contrast	$1,613.25	$8,066.24	$165.82–$230.13	32% below	80%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR Upp Ext Jt W/O Cont	$1,620.19	$8,100.96	$165.82–$219.19	9% below	80%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Spine C Ap/Lat/Flex & Ext	$221.54	$1,107.68	$51.45–$165.82	59% below	80%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Spine C Ap/Lat/Oblq	$221.54	$1,107.68	$51.45–$165.82	59% below	80%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Spine Cerv W Oblqs 4v	$221.54	$1,107.68	$51.45–$165.82	59% below	80%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Spine Cervical,Min 4 View	$291.65	$1,458.24	$51.45–$165.82	47% below	80%
Neck soft tissue CT scan with contrast CPT 70491 CT Neck W Contrast	$1,935.36	$9,676.80	$165.82–$178.55	2% below	80%
Neck soft tissue CT scan without contrast CPT 70490 CT Neck WO Contrast	$1,673.95	$8,369.76	$108.97–$165.82	9% above	80%
Neck soft tissue X-ray CPT 70360 Neck Soft Tissue	$196.90	$984.48	$30.74–$165.82	17% below	80%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocard Spct Mult St Res	$4,222.18	$21,110.88	$165.82	2% above	80%
OCT scan of the retina (optical coherence tomography) CPT 92134 Diagnostic Scan of Optic Nerve and Retina	$72.60	$363.00	$165.82	56% below	80%
OCT scan of the retina (optical coherence tomography) CPT 92134 Hchg Computerized Opthalmic Dx Imaging; Retina	$86.90	$434.50	$165.82	48% below	80%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet CT Skull-Thigh	$1,912.73	$9,563.66	$165.82	56% below	80%
Pelvic CT scan without contrast CPT 72192 CT Limited, Hips W/O Cont	$306.21	$1,531.04	$108.97–$165.82	81% below	80%
Pelvic CT scan without contrast CPT 72192 CT Hip/Fem Antivers Measr	$607.71	$3,038.56	$108.97–$165.82	63% below	80%
Pelvic CT scan without contrast CPT 72192 CT Pelvis WO Contrast	$1,965.38	$9,826.88	$108.97–$165.82	21% above	80%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Hchg US Ab/Pel Vas Ltd	$527.97	$2,639.84	$165.82	9% above	80%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Echo Pelvic Comp Non OB	$684.99	$3,424.96	$165.82	10% below	80%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Echo Preg Uterus Limited	$426.27	$2,131.36	$82.53–$165.82	7% below	80%
Rib X-ray, one side, 2 views one side CPT 71100 Ribs Unilateral 2 Views	$211.46	$1,057.28	$35.75–$165.82	29% below	80%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs Unilat Inc Ap Cxr 3v	$128.80	$644.00	$41.10–$165.82	67% below	80%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs Unilat 3v W/Ap Cxr	$273.06	$1,365.28	$41.10–$165.82	31% below	80%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 Shoulder Bilat Axillary/Y Min 2v	$119.84	$599.20	$33.41–$165.82	—	80%
Shoulder X-ray, complete, 2 or more views CPT 73030 Shoulder 2views	$138.88	$694.40	$33.41–$165.82	56% below	80%
Shoulder X-ray, complete, 2 or more views CPT 73030 Shoulder Comp Min 2 View	$184.35	$921.76	$33.41–$165.82	42% below	80%
Shoulder X-ray, complete, 2 or more views CPT 73030 Shoulder 2v	$213.47	$1,067.36	$33.41–$165.82	33% below	80%
Shoulder X-ray, complete, 2 or more views CPT 73030 Shoulder & Clav 3v	$223.78	$1,118.88	$33.41–$165.82	30% below	80%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Hchg Shoulder Rt Axillary/Y Min 2v	$119.84	$599.20	$33.41–$165.82	62% below	80%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Hchg Shoulder Lt Axillary/Y Min 2v	$119.84	$599.20	$33.41–$165.82	62% below	80%
Sinus X-ray, complete, 3 or more views CPT 70220 Sinuses Complete Min 3 V	$213.25	$1,066.24	$36.75–$165.82	47% below	80%
Sinus X-ray, complete, 3 or more views CPT 70220 Sinuses Complete 3v	$327.71	$1,638.56	$36.75–$165.82	19% below	80%
Skull X-ray, fewer than 4 views CPT 70250 Skull 3v or Less	$172.93	$864.64	$34.75–$165.82	46% below	80%
Skull X-ray, fewer than 4 views CPT 70250 Skull, 3v	$179.20	$896.00	$34.75–$165.82	44% below	80%
Skull X-ray, fewer than 4 views CPT 70250 Skull 2v	$185.70	$928.48	$34.75–$165.82	42% below	80%
Skull X-ray, fewer than 4 views CPT 70250 Skull 1 or 2 Views	$213.47	$1,067.36	$34.75–$165.82	33% below	80%
Skull X-ray, fewer than 4 views CPT 70250 Skull Less Than 4v	$275.30	$1,376.48	$34.75–$165.82	14% below	80%
Sleep study in a lab (polysomnography) CPT 95810 Psc Age 6-20 4+ Param	$1,918.18	$9,590.90	$165.82	54% below	80%
Sleep study in a lab (polysomnography) CPT 95810 Npsg 4 or > Parameters, 6yr or >	$2,654.52	$13,272.60	$165.82	36% below	80%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Dysphagia Evaluation Vtr	$316.29	$1,581.44	$130.65–$165.82	47% below	80%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Swallow Study	$435.46	$2,177.28	$130.65–$165.82	28% below	80%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Femur, 2 Views	$208.77	$1,043.84	$34.41–$165.82	36% below	80%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Thoracic Spine WO Cont	$2,042.43	$10,212.16	$108.97–$165.82	8% above	80%
Toe X-ray, 2 or more views CPT 73660 Toe(S) 2v or >	$121.18	$605.92	$28.40–$165.82	55% below	80%
Ultrasound of the abdomen, complete CPT 76700 Echo Abdomen Complete	$537.60	$2,688.00	$108.97–$165.82	32% below	80%
Ultrasound of the scrotum and testicles CPT 76870 Echo Testicular	$525.06	$2,625.28	$102.91–$165.82	14% below	80%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Echo Thyroid Soft Tissue	$419.78	$2,098.88	$108.97–$165.82	33% below	80%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Echo Soft Tissue Hd Neck	$419.78	$2,098.88	$108.97–$165.82	33% below	80%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Upper GI Series	$590.24	$2,951.20	$122.63–$165.82	18% below	80%
Upper arm X-ray (humerus), 2 views CPT 73060 Humerus 1v	$114.46	$572.32	$31.41–$165.82	67% below	80%
Upper arm X-ray (humerus), 2 views CPT 73060 Humerus 2 Views	$177.18	$885.92	$31.41–$165.82	50% below	80%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Hchg US Dpx Up Ext Ven Uniltd	$553.52	$2,767.60	$165.82	29% below	80%
Wrist X-ray, 2 views CPT 73100 Wrist, Ap/Lat	$114.02	$570.08	$33.08–$165.82	62% below	80%
Wrist X-ray, 2 views CPT 73100 Wrist 2 Views	$114.02	$570.08	$33.08–$165.82	62% below	80%
Wrist X-ray, 2 views CPT 73100 Wrist 1 View	$126.11	$630.56	$33.08–$165.82	57% below	80%
Wrist X-ray, 2 views CPT 73100 Wrist Ap/Lat	$175.39	$876.96	$33.08–$165.82	41% below	80%
Wrist X-ray, complete, 3 or more views CPT 73110 Wrist 3 or >Views	$112.90	$564.48	$39.43–$165.82	69% below	80%
Wrist X-ray, complete, 3 or more views CPT 73110 Wrist(Schapoid Series	$113.34	$566.72	$39.43–$165.82	69% below	80%
Wrist X-ray, complete, 3 or more views CPT 73110 Wrist,3views	$133.28	$666.40	$39.43–$165.82	64% below	80%
Wrist X-ray, complete, 3 or more views CPT 73110 Wrist 3v	$204.74	$1,023.68	$39.43–$165.82	44% below	80%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Pelvis Ap W Hips 2v	$155.90	$779.52	$45.44–$165.82	58% below	80%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Jnt 2v Unilat	$208.54	$1,042.72	$45.44–$165.82	43% below	80%
X-ray of the abdomen, 1 view CPT 74018 Abdomen 1 View	$164.19	$820.96	$29.08–$165.82	52% below	80%
X-ray of the ankle, 2 views CPT 73600 Ankle 1v	$126.11	$630.56	$31.74–$165.82	58% below	80%
X-ray of the ankle, 2 views CPT 73600 Ankle 2v	$174.05	$870.24	$31.74–$165.82	42% below	80%
X-ray of the finger(s), 2 or more views CPT 73140 Thumb Min 2 Vw	$110.21	$551.04	$36.43–$165.82	54% below	80%
X-ray of the finger(s), 2 or more views CPT 73140 Finger(S) 2 or > Views	$147.39	$736.96	$36.43–$165.82	39% below	80%
X-ray of the finger(s), 2 or more views CPT 73140 Thumb, Ap/Lat	$147.39	$736.96	$36.43–$165.82	39% below	80%
X-ray of the foot, 2 views CPT 73620 Foot 1 View	$126.11	$630.56	$27.74–$165.82	62% below	80%
X-ray of the foot, 2 views CPT 73620 Foot 2view	$187.71	$938.56	$27.74–$165.82	44% below	80%
X-ray of the foot, complete, 3 or more views CPT 73630 Foot 3 or 4 V	$204.74	$1,023.68	$33.41–$165.82	45% below	80%
X-ray of the hand, 3 or more views CPT 73130 Hand 3 or > Views	$202.94	$1,014.72	$35.41–$165.82	47% below	80%
X-ray of the knee, 1 or 2 views CPT 73560 Knee 1v	$126.11	$630.56	$33.41–$165.82	57% below	80%
X-ray of the knee, 1 or 2 views CPT 73560 Knee 2v	$184.35	$921.76	$33.41–$165.82	37% below	80%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Spine Ls Lat Flx&Ext Vws	$128.58	$642.88	$38.76–$165.82	71% below	80%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Spine, Lumbar, 2 Views	$158.59	$792.96	$38.76–$165.82	64% below	80%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Spine Lumbar 3 Views	$181.44	$907.20	$38.76–$165.82	59% below	80%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Spine Ls 3v	$211.68	$1,058.40	$38.76–$165.82	52% below	80%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Spine Lumbar 2 or 3 Vws	$243.71	$1,218.56	$38.76–$165.82	45% below	80%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Hchg L-Spine Ap/Lat<10yrs	$243.71	$1,218.56	$38.76–$165.82	45% below	80%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Hchg L-Spine Ap/Lat/Spot>10yrs	$278.66	$1,393.28	$38.76–$165.82	37% below	80%
X-ray of the lower back, 4 or more views CPT 72110 Spine Ls Ap/Lat/Oblqs 4v	$215.71	$1,078.56	$49.45–$165.82	62% below	80%
X-ray of the lower back, 4 or more views CPT 72110 Spne Lumbar Comp	$250.43	$1,252.16	$49.45–$165.82	56% below	80%
X-ray of the lower back, 4 or more views CPT 72110 Spine Lumbar Comp	$384.83	$1,924.16	$49.45–$165.82	32% below	80%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Spine Dorsal 2view	$151.42	$757.12	$31.74–$165.82	62% below	80%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Spine Thoracic 2v	$232.96	$1,164.80	$31.74–$165.82	42% below	80%
X-ray of the nasal bones, 3 or more views CPT 70160 Nasal Bones, 3v	$135.97	$679.84	$37.09–$165.82	50% below	80%
X-ray of the nasal bones, 3 or more views CPT 70160 Nasal Bones 3 Views	$179.65	$898.24	$37.09–$165.82	35% below	80%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Spine Cervical Ap/Lat	$158.59	$792.96	$38.43–$165.82	57% below	80%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Spine Cervicle, Ap/Lat	$158.59	$792.96	$38.43–$165.82	57% below	80%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Spine Cerv 2v	$158.59	$792.96	$38.43–$165.82	57% below	80%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Spine Cerv 2 or 3 V	$243.71	$1,218.56	$38.43–$165.82	33% below	80%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis 1 or 2 Views	$122.98	$614.88	$27.06–$165.82	61% below	80%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis Ap Standing W Hip	$140.90	$704.48	$27.06–$165.82	55% below	80%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis,Ap Standing W Hips	$140.90	$704.48	$27.06–$165.82	55% below	80%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis 1 View	$177.18	$885.92	$27.06–$165.82	43% below	80%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis Ap W Hips	$216.61	$1,083.04	$27.06–$165.82	31% below	80%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis 2 Views	$220.19	$1,100.96	$27.06–$165.82	30% below	80%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Sacrum & Coccyx Min. 2 Vw	$157.47	$787.36	$31.41–$165.82	49% below	80%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Sacrum & Coccyx 2 or > V	$188.38	$941.92	$31.41–$165.82	39% below	80%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
ACTH blood test CPT 82024 Assay of Acth	$269.56	$1,347.80	$32.44–$165.82	26% above	80%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alt, Sgpt	$123.74	$618.70	$4.45–$165.82	147% above	80%
AST (aspartate aminotransferase) enzyme test CPT 84450 Ast, Sgot	$123.74	$618.70	$4.35–$165.82	140% above	80%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel	$320.16	$1,600.80	$40.01–$165.82	16% below	80%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Evi Acute Hepatitis Pnl	$337.87	$1,689.35	$40.01–$165.82	12% below	80%
Albumin blood test CPT 82040 Albumin	$109.94	$549.70	$4.16–$165.82	196% above	80%
Aldosterone blood test CPT 82088 Assay of Aldosterone	$312.11	$1,560.55	$34.23–$165.82	134% above	80%
Alkaline phosphatase (ALP) blood test CPT 84075 Assay Alkaline Phosphatase	$36.11	$180.55	$4.35–$165.82	24% below	80%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige	$10.81	$54.05	$4.38–$165.82	55% below	80%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha-Fetoprotein, Serum	$88.32	$441.60	$14.09–$165.82	17% below	80%
Ammonia blood test CPT 82140 Assay of Ammonia	$102.12	$510.60	$12.24–$165.82	28% below	80%
Amylase blood test CPT 82150 Assay of Amylase	$112.01	$560.05	$5.44–$165.82	44% above	80%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibody	$125.35	$626.75	$10.88–$165.82	126% above	80%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen	$52.21	$261.05	$10.16–$165.82	32% below	80%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies	$117.76	$588.80	$10.16–$165.82	53% above	80%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Natriuretic Peptide	$65.78	$328.90	$32.98–$165.82	58% below	80%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Hchg Bnp	$73.83	$369.15	$32.98–$165.82	53% below	80%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Bacteria, Other	$69.00	$345.00	$7.24–$165.82	3% above	80%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel	$235.06	$1,175.30	$7.11–$165.82	12% above	80%
Bilirubin blood test, total CPT 82247 Total Bilirubin	$105.11	$525.55	$4.22–$165.82	84% above	80%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Tissue Exam by Pathologist Lev IV	$553.61	$2,768.05	$165.82	86% above	80%
Blood culture for bacteria CPT 87040 Culture-Blood	$151.11	$755.55	$8.67–$165.82	26% below	80%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Labcorp Venipuncture Chg	$5.29	$26.45	$165.82	71% below	80%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Quest Venipuncture	$11.04	$55.20	$165.82	39% below	80%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Hchg Venipuncture	$14.03	$70.15	$165.82	22% below	80%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Hchg Evi Venipunture	$14.03	$70.15	$165.82	22% below	80%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture, Routine	$15.41	$77.05	$165.82	15% below	80%
Blood glucose (sugar) test CPT 82947 POCT Glucose	$49.45	$247.25	$3.30–$165.82	19% above	80%
Blood glucose (sugar) test CPT 82947 Glucose Quantitative	$49.68	$248.40	$3.30–$165.82	19% above	80%
Blood glucose (sugar) test CPT 82947 Glucose	$123.74	$618.70	$3.30–$165.82	197% above	80%
Blood lead test CPT 83655 Assay Lead	$88.32	$441.60	$10.17–$165.82	90% above	80%
Blood lead test CPT 83655 Assay of Lead	$117.76	$588.80	$10.17–$165.82	153% above	80%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Serum Pregnancy Test	$80.96	$404.80	$6.32–$165.82	41% below	80%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bld Grp-Abo	$43.93	$219.65	$2.51–$165.82	50% below	80%
Blood urea nitrogen (BUN) test CPT 84520 Bun Urea Nitrogren	$50.60	$253.00	$3.32–$165.82	4% below	80%
C-peptide blood test CPT 84681 Assay of C-Peptide	$71.99	$359.95	$17.48–$165.82	1% below	80%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein	$47.61	$238.05	$4.35–$165.82	8% below	80%
C. difficile toxin gene test (stool PCR) CPT 87493 Toxicgenic C Diff Pcr	$105.34	$526.70	$31.31–$165.82	40% below	80%
CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay, Tumor, Ca 19-9	$155.02	$775.10	$17.48–$165.82	17% above	80%
CA-125 blood test (ovarian cancer marker) CPT 86304 Immunoassay, Tumor, Ca 125	$144.90	$724.50	$17.48–$165.82	4% below	80%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Hchg Sars-Cov-2 Covid-19 Amp Prb	$416.30	$2,081.50	$51.31–$165.82	351% above	80%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Hchg Sars-Cov-D Covid-19 Amp Prb	$416.30	$2,081.50	$51.31–$165.82	351% above	80%
Calcium blood test, total CPT 82310 Calcium	$123.74	$618.70	$4.33–$165.82	115% above	80%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen	$133.17	$665.85	$15.93–$165.82	at median	80%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Antibody	$80.04	$400.20	$10.82–$165.82	30% above	80%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Hchg Chylmd Trach Dna Amp Probe Institutional	$21.16	$105.80	$29.48–$165.82	83% below	80%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Hchg Evi Chlamydia Trac. Rna	$148.81	$744.05	$29.48–$165.82	20% above	80%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chylmd Trach, Dna, Amp Probe	$207.23	$1,036.15	$29.48–$165.82	67% above	80%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Evi Chlamydia Trac. Rna	$207.23	$1,036.15	$29.48–$165.82	67% above	80%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Profile	$239.89	$1,199.45	$11.25–$165.82	62% above	80%
Complete blood count (CBC) with differential CPT 85025 Automated Bld CT & Diff	$45.31	$226.55	$6.53–$165.82	50% below	80%
Complete blood count (CBC) with differential CPT 85025 Auto Bld Cnt & Auto Diff	$57.27	$286.35	$6.53–$165.82	37% below	80%
Complete blood count (CBC), no differential CPT 85027 Abcsl	$61.41	$307.05	$5.43–$165.82	34% below	80%
Comprehensive metabolic panel (blood test) CPT 80053 Comp Metabolic Panel	$321.31	$1,606.55	$8.87–$165.82	30% above	80%
Cortisol blood test, total CPT 82533 Total Cortisol	$129.26	$646.30	$13.69–$165.82	58% above	80%
Creatine kinase (CK) blood test, total CPT 82550 Assay of CK (Cpk	$117.30	$586.50	$5.47–$165.82	83% above	80%
Creatinine blood test CPT 82565 Assay of Creatinine	$108.79	$543.95	$4.30–$165.82	103% above	80%
Cytomegalovirus (CMV) antibody test CPT 86644 Cmv Antibody	$59.11	$295.55	$12.09–$165.82	17% below	80%
D-dimer blood test (blood clot marker) CPT 85379 Fibrin Degradation, Quant	$66.01	$330.05	$8.55–$165.82	61% below	80%
DHEA sulfate (DHEA-S) blood test CPT 82627 Hchg Dhea-Sulfate	$32.43	$162.15	$18.67–$165.82	78% below	80%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Drug Screen	$395.60	$1,978.00	$52.20–$165.82	537% above	80%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Evi Drug Screen	$445.97	$2,229.85	$52.20–$165.82	618% above	80%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Prof	$226.32	$1,131.60	$5.89–$165.82	42% above	80%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein-Barr Antibody Vca	$94.76	$473.80	$15.24–$165.82	10% above	80%
Estradiol blood test CPT 82670 Assay of Estradiol	$166.75	$833.75	$23.47–$165.82	34% above	80%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$99.36	$496.80	$15.61–$165.82	36% below	80%
Fecal calprotectin (stool inflammation test) CPT 83993 Assay for Calprotectin Fecal	$127.42	$637.10	$16.49–$165.82	40% below	80%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$147.89	$739.45	$11.45–$165.82	77% above	80%
Fibrinogen blood test CPT 85384 Fibrinogen Activity	$60.26	$301.30	$8.16–$165.82	30% below	80%
Folate (folic acid) blood test CPT 82746 Folates (Folic Acid)Serum	$22.77	$113.85	$12.35–$165.82	72% below	80%
Free T3 thyroid hormone test CPT 84481 Free Assay (Ft-3	$148.58	$742.90	$14.23–$165.82	7% above	80%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Assay of Free Thyroxine	$88.32	$441.60	$7.58–$165.82	18% above	80%
Free testosterone test CPT 84402 Assay of Testosterone	$196.88	$984.40	$21.39–$165.82	86% above	80%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Ggt, Gma Glt Tran	$117.30	$586.50	$6.05–$165.82	99% above	80%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Post Prandial Battery	$107.64	$538.20	$3.99–$165.82	39% above	80%
Glucose tolerance test, 3 samples CPT 82951 Gtt, Each Additional Spec	$8.51	$42.55	$10.81–$165.82	94% below	80%
Glucose tolerance test, 3 samples CPT 82951 Ogtt C Hep Lock 4hrs	$90.16	$450.80	$10.81–$165.82	41% below	80%
Glucose tolerance test, 3 samples CPT 82951 OB-Gtt 3hr	$127.42	$637.10	$10.81–$165.82	16% below	80%
Glucose tolerance test, 3 samples CPT 82951 Ogtt W/Hep Lock-6hrs.	$131.56	$657.80	$10.81–$165.82	13% below	80%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Hchg N.Gonorrhoeae Dna Amp Prob Institutional	$21.16	$105.80	$29.48–$165.82	84% below	80%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Hchg Evi Neisseria Gonor Rna	$148.81	$744.05	$29.48–$165.82	14% above	80%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Evi Neisseria Gonor Rna	$338.79	$1,693.95	$29.48–$165.82	159% above	80%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.Gonorrhoeae, Dna, Amp Prob	$338.79	$1,693.95	$29.48–$165.82	159% above	80%
H. pylori antibody blood test CPT 86677 Helicobacter Pylori	$80.04	$400.20	$14.15–$165.82	37% below	80%
H. pylori stool antigen test CPT 87338 Hpylori, Stool, Eia	$91.08	$455.40	$12.08–$165.82	12% above	80%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1, Dna, Quant	$271.63	$1,358.15	$71.48–$165.82	10% below	80%
HIV-1 and HIV-2 antibody test CPT 86703 Evi Hiv 1/2 Ab	$81.19	$405.95	$11.52–$165.82	6% below	80%
HIV-1 and HIV-2 antibody test CPT 86703 Hiv 1/2 Screen	$86.94	$434.70	$11.52–$165.82	at median	80%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hchg Hiv Ag/Ab Combo	$68.77	$343.85	$20.23–$165.82	49% below	80%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hchg an.Hbaic	$49.45	$247.25	$8.16–$165.82	41% below	80%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 An.Hba1c	$73.37	$366.85	$8.16–$165.82	12% below	80%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Glycosylated Hemoglobin Test	$78.43	$392.15	$8.16–$165.82	6% below	80%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Enzymatic Hemoglobin A1c (A1c_E)	$84.87	$424.35	$8.16–$165.82	1% above	80%
Hemoglobin blood test CPT 85018 Ciba Hemoglobin	$11.27	$56.35	$1.99–$165.82	74% below	80%
Hemoglobin blood test CPT 85018 Hemoglobin	$14.49	$72.45	$1.99–$165.82	67% below	80%
Hepatitis B core antibody test (total) CPT 86704 Hep B Core Antibody, Total	$66.70	$333.50	$10.12–$165.82	8% below	80%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Antibody	$62.33	$311.65	$9.02–$165.82	2% below	80%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag, Eia	$57.73	$288.65	$8.68–$165.82	18% below	80%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Ab Test	$78.43	$392.15	$11.99–$165.82	8% below	80%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C, Rna, Quant	$232.53	$1,162.65	$35.99–$165.82	1% below	80%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Test	$60.26	$301.30	$11.08–$165.82	16% below	80%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2	$72.45	$362.25	$16.25–$165.82	14% below	80%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein, Hs	$113.85	$569.25	$10.88–$165.82	51% above	80%
Homocysteine blood test CPT 83090 Assay of Homocysteine	$118.45	$592.25	$15.05–$165.82	21% below	80%
Insulin blood test CPT 83525 Insulin	$102.35	$511.75	$9.60–$165.82	49% above	80%
Iron blood test (serum iron) CPT 83540 IRON	$123.74	$618.70	$5.43–$165.82	75% above	80%
Iron-binding capacity (TIBC) test CPT 83550 Iron Bnd Cap(Tibc)	$123.74	$618.70	$7.34–$165.82	38% above	80%
Kidney function blood test panel CPT 80069 Hchg Renal Function Panel	$70.84	$354.20	$7.29–$165.82	60% below	80%
LH (luteinizing hormone) test CPT 83002 Gonadotropin (Lh	$105.80	$529.00	$15.56–$165.82	24% below	80%
Lactate (lactic acid) blood test CPT 83605 Ciba Lactate Art	$19.09	$95.45	$9.72–$165.82	80% below	80%
Lactate (lactic acid) blood test CPT 83605 Assay of Lactic Acid POC	$53.36	$266.80	$9.72–$165.82	44% below	80%
Lactate (lactic acid) blood test CPT 83605 Assay of Lactic Acid	$70.61	$353.05	$9.72–$165.82	26% below	80%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate (Ld) (Ldh) Enzyme	$106.49	$532.45	$5.07–$165.82	160% above	80%
Lipase blood test (pancreas enzyme) CPT 83690 Assay Lipase	$66.70	$333.50	$5.79–$165.82	1% below	80%
Liver function blood test panel CPT 80076 Liver Profile	$285.66	$1,428.30	$6.86–$165.82	48% above	80%
Lyme disease antibody test CPT 86618 Lyme Disease Antibody	$135.47	$677.35	$14.31–$165.82	64% above	80%
Magnesium blood test CPT 83735 Assay of Magnesium	$54.74	$273.70	$5.63–$165.82	19% above	80%
Measles (rubeola) antibody test CPT 86765 Rubeola Antibody	$87.17	$435.85	$10.82–$165.82	138% above	80%
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Spot	$48.07	$240.35	$4.35–$165.82	43% below	80%
Mumps immunity blood test CPT 86735 Mumps Antibody	$63.94	$319.70	$10.96–$165.82	8% above	80%
PSA (prostate-specific antigen) blood test, free CPT 84154 Assay of Psa, Free	$140.76	$703.80	$15.45–$165.82	25% above	80%
PSA (prostate-specific antigen) blood test, total CPT 84153 Assay of Psa, Total	$102.35	$511.75	$15.45–$165.82	20% above	80%
PSA (prostate-specific antigen) blood test, total CPT 84153 Evi Psa Screen	$177.10	$885.50	$15.45–$165.82	107% above	80%
Pap test (liquid-based, automated screening with review) CPT 88175 Cytopath C/V Auto Fluid Redo	$160.54	$802.70	$22.35–$165.82	112% above	80%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytopath, C/V, Thin Layer	$123.28	$616.40	$17.02–$165.82	36% above	80%
Parathyroid hormone (PTH) blood test CPT 83970 Intact Pth	$149.96	$749.80	$34.68–$165.82	26% below	80%
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin Time, Partial	$42.78	$213.90	$5.05–$165.82	14% below	80%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Inorganic Phos	$102.12	$510.60	$3.98–$165.82	64% above	80%
Potassium blood test CPT 84132 Hchg Potassium Statlab	$21.16	$105.80	$4.00–$165.82	65% below	80%
Potassium blood test CPT 84132 Potassium POC	$21.16	$105.80	$4.00–$165.82	65% below	80%
Potassium blood test CPT 84132 Potassium Wb Assay	$37.03	$185.15	$4.00–$165.82	38% below	80%
Potassium blood test CPT 84132 Potassium	$102.12	$510.60	$4.00–$165.82	71% above	80%
Progesterone blood test CPT 84144 Progesterone	$123.74	$618.70	$17.52–$165.82	23% above	80%
Prolactin blood test CPT 84146 Assay of Prolactin	$115.69	$578.45	$16.28–$165.82	5% above	80%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time	$77.28	$386.40	$3.60–$165.82	70% above	80%
Rapid flu test (influenza antigen) CPT 87804 Hchg POCT Flu B Test	$80.50	$402.50	$13.90–$165.82	14% below	80%
Rapid flu test (influenza antigen) CPT 87804 Influenza a Antigen Detec	$80.50	$402.50	$13.90–$165.82	14% below	80%
Rapid flu test (influenza antigen) CPT 87804 Hchg POCT Flu a Test	$80.50	$402.50	$13.90–$165.82	14% below	80%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Hchg POCT Rapid Strep Test	$72.68	$363.40	$13.89–$165.82	26% below	80%
Renin blood test CPT 84244 Assay of Renin	$153.64	$768.20	$18.47–$165.82	51% above	80%
Rh blood typing CPT 86901 Blood Group Rh	$23.23	$116.15	$2.51–$165.82	64% below	80%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor, Quant	$147.89	$739.45	$4.76–$165.82	224% above	80%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody	$87.17	$435.85	$12.09–$165.82	72% above	80%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sed Rate-Erythrocyte,Auto	$64.86	$324.30	$2.27–$165.82	6% above	80%
Sodium blood test CPT 84295 Hchg Sodium Serum Statlab	$24.84	$124.20	$4.04–$165.82	60% below	80%
Sodium blood test CPT 84295 Sodium Serum POC	$24.84	$124.20	$4.04–$165.82	60% below	80%
Sodium blood test CPT 84295 Sodium Wb Assay	$74.75	$373.75	$4.04–$165.82	20% above	80%
Sodium blood test CPT 84295 Hchg Sodium Serum	$102.12	$510.60	$4.04–$165.82	64% above	80%
Stool ova and parasites exam CPT 87177 O/P Direct Smear/Concentration	$69.92	$349.60	$7.48–$165.82	4% above	80%
Stool test for hidden blood (guaiac FOBT) CPT 82270 An.Hemocult	$15.18	$75.90	$3.68–$165.82	60% below	80%
Syphilis antibody test (Treponema pallidum) CPT 86780 T Pallidum Ab Fta-Ab	$12.19	$60.95	$11.12–$165.82	72% below	80%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Test Non-Trep Qual	$42.32	$211.60	$3.59–$165.82	1% below	80%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Evi Rpr	$48.07	$240.35	$3.59–$165.82	13% above	80%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB Test Cell Immun Measure	$103.04	$515.20	$52.06–$165.82	50% below	80%
Testosterone blood test, total (not free testosterone) CPT 84403 Hchg Assay of Total Testosterone-Inhouse	$89.24	$446.20	$21.68–$165.82	11% below	80%
Testosterone blood test, total (not free testosterone) CPT 84403 Assay of Total Testosterone	$249.32	$1,246.60	$21.68–$165.82	149% above	80%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Antibody	$83.26	$416.30	$12.22–$165.82	at median	80%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh, Third Generation Srm	$8.05	$40.25	$14.11–$165.82	92% below	80%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Trf/Tsh	$115.23	$576.15	$14.11–$165.82	10% above	80%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Assay Thyroid Stim Hormone	$162.61	$813.05	$14.11–$165.82	55% above	80%
Total IgE blood test CPT 82785 Assay of Ige	$48.07	$240.35	$13.83–$165.82	39% below	80%
Total cholesterol blood test CPT 82465 Cholesterol	$123.74	$618.70	$3.65–$165.82	123% above	80%
Total thyroxine (T4) blood test CPT 84436 Assay of Total Thyroxine	$136.85	$684.25	$5.77–$165.82	71% above	80%
Total triiodothyronine (T3) blood test CPT 84480 Assay, Triiodothyronine (T3	$45.77	$228.85	$11.91–$165.82	63% below	80%
Transferrin blood test CPT 84466 Trf Transferrin	$138.46	$692.30	$10.72–$165.82	16% above	80%
Trichomonas test (NAAT) CPT 87661 Hchg Evi Trichomonas Vaginalsis Amplif	$128.11	$640.55	$29.48–$165.82	46% above	80%
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis Amplif	$178.02	$890.10	$29.48–$165.82	104% above	80%
Triglycerides blood test CPT 84478 Assay of Triglycerides	$102.12	$510.60	$4.82–$165.82	50% above	80%
Troponin test, quantitative CPT 84484 Troponin	$121.67	$608.35	$10.47–$165.82	7% above	80%
Uric acid blood test CPT 84550 Uric Acid , Blood	$106.95	$534.75	$3.80–$165.82	36% above	80%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Routine	$64.86	$324.30	$2.66–$165.82	31% below	80%
Urinalysis without microscope exam, automated CPT 81003 Hchg POCT Ua Clinitek Status	$31.51	$157.55	$1.89–$165.82	35% below	80%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis, Auto, W/O Scope	$39.56	$197.80	$1.89–$165.82	18% below	80%
Urinalysis without microscope exam, automated CPT 81003 Hchg Urinalysis Auto W/O Scope	$39.68	$198.38	$1.89–$165.82	18% below	80%
Urinalysis without microscope exam, manual CPT 81002 Hchg POCT Urinalysis Visual	$31.51	$157.55	$2.92–$165.82	7% above	80%
Urinalysis without microscope exam, manual CPT 81002 Urine Sg/Ph/Ketones	$31.51	$157.55	$2.92–$165.82	7% above	80%
Urinalysis without microscope exam, manual CPT 81002 Hchg an Urine Dipstick	$33.58	$167.90	$2.92–$165.82	14% above	80%
Urinalysis without microscope exam, manual CPT 81002 An. Urine Dipstick	$40.71	$203.55	$2.92–$165.82	38% above	80%
Urine culture for bacteria, with colony count CPT 87086 Culture, Urine	$141.45	$707.25	$6.78–$165.82	9% above	80%
Urine microalbumin (albumin) test CPT 82043 Micro Albumin Urine	$147.89	$739.45	$4.86–$165.82	190% above	80%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test	$80.96	$404.80	$7.23–$165.82	5% below	80%
Urine pregnancy test, read by color change CPT 81025 Hchg an.Urine Pregnancy	$83.95	$419.75	$7.23–$165.82	1% below	80%
Urine pregnancy test, read by color change CPT 81025 Hchg Urine Pregnancy Test	$84.11	$420.56	$7.23–$165.82	1% below	80%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B-12	$113.85	$569.25	$12.67–$165.82	25% above	80%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Hchg Vitamin D, Tosoh	$95.68	$478.40	$24.86–$165.82	20% below	80%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25 Hydroxy	$238.74	$1,193.70	$24.86–$165.82	100% above	80%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vit D 1, 25-Dihydroxy	$277.15	$1,385.75	$32.34–$165.82	76% above	80%
Zinc blood test CPT 84630 Zinc,Urine	$14.26	$71.30	$9.57–$165.82	79% below	80%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hchg Evi Gonadotropin Chorionic Hcg (Beta)	$89.24	$446.20	$12.64–$165.82	21% below	80%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Chorionic Gonadotropin Test	$108.10	$540.50	$12.64–$165.82	4% below	80%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 Hchg Tx Closed Distal Fibular Fx W/O Manipulation Lt	$257.62	$1,288.10	$165.82	45% below	80%
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 Hchg Tx Closed Distal Fibular Fx W/O Manipulation Rt	$257.62	$1,288.10	$165.82	45% below	80%
Broken foot (metatarsal) treatment without surgery or setting one side CPT 28470 Hchg Tx Closed Metatarsal Fx W/O Manipulation Lt	$257.62	$1,288.10	$165.82	8% below	80%
Broken foot (metatarsal) treatment without surgery or setting one side CPT 28470 Hchg Tx Closed Metatarsal Fx W/O Manipulation Rt	$257.62	$1,288.10	$165.82	8% below	80%
Cardiac catheterization with coronary angiogram one side CPT 93458 Hchg Lt Hrt Cor/Lv Angio	$2,943.16	$14,715.80	$165.82–$7,166.00	72% below	80%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion	$415.14	$2,075.70	$165.82–$7,166.00	69% below	80%
Catheter ablation for atrial fibrillation CPT 93656 Hchg Ep W Afib Abl Vt P.V.I.	$4,677.42	$23,387.10	$165.82–$7,166.00	85% below	80%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision W/Regionl Block	$555.45	$2,777.25	$93.35	55% below	80%
Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 Hchg Tx Closed Distal Radial/Ulnar Fx W/O Manipulation Rt	$257.62	$1,288.10	$165.82	43% below	80%
Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 Hchg Tx Closed Distal Radial/Ulnar Fx W/O Manipulation Lt	$257.62	$1,288.10	$165.82	43% below	80%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colposcopy W/Biopsy	$124.30	$621.50	$165.82	50% below	80%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Ear Lavage	$33.66	$168.30	$165.82	70% below	80%
Earwax removal with instruments, one ear CPT 69210 Hchg Ear Lavage	$45.98	$229.90	$31.74	63% below	80%
Eye injection into the vitreous (intravitreal injection) CPT 67028 Hchg Inject Intravitreal Pharmcologic	$674.96	$3,374.80	$165.82	28% above	80%
Incision and drainage of a simple or single skin abscess CPT 10060 Hchg I & D Abscess Single W Scalpel -Simple	$66.13	$330.65	$165.82	85% below	80%
Incision and drainage of a simple or single skin abscess CPT 10060 Hchg I & D Abscess Single Simple/W Scalpel	$112.64	$563.20	$165.82	74% below	80%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Hchg Injection(S); Single Tendon/Sheet/Ligament, Aponeurosis/Plantar Fascia	$373.34	$1,866.70	$165.82	7% below	80%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis, Aspiration and or Injection Major Joint	$260.96	$1,304.80	$165.82	56% below	80%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Hchg Arthrocentesis, Aspiration &/or Injection, Maj Joint/Bursa - W/O Ultrasound - Shoulder/Hip/Knee/Subacromial Bursa	$373.34	$1,866.70	$165.82	37% below	80%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Hchg Arthorcentesis, Aspiration &/or Inj, Intermediate Joint/Bursa W/O Ultrsound - Wrist/Ankle/Olecranon Bursa	$373.34	$1,866.70	$165.82	37% below	80%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Hchg Arthrocentesis, Aspiration &/or Injection, Small Joint/Bursa W/O Ultrasound - Fingers/Toes	$373.34	$1,866.70	$165.82	13% below	80%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Hchg Repair, Intermediate, Wounds of Scalp, Axillae, Trunk and/or Extremities (Excluding Hands and Feet); 2.5 Cm or Less	$579.48	$2,897.40	$165.82	9% above	80%
Left heart catheterization, diagnostic one side CPT 93452 Hchg Lt Hrt Cath W/Ventric	$2,857.14	$14,285.70	$165.82–$7,166.00	69% below	80%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Hchg Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed Elsewhere), Trunk, Arms or Legs; Excised Diameter 0.5 Cm or Less	$1,258.40	$6,292.00	$165.82	56% above	80%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Hchg Excision, Other Benign Lesion Including Margins, Except Skin Tag, Excised Diameter 0.5 Cm or Less	$1,001.88	$5,009.40	$165.82	16% above	80%
Pacemaker implant (dual chamber) CPT 33208 Hchg Insrt/Rpl Pm Atrial&Vent	$6,689.76	$33,448.80	$165.82–$7,166.00	65% below	80%
Paracentesis with imaging guidance CPT 49083 Pertioneocen Abd Paracen	$241.47	$1,207.36	$165.82	83% below	80%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Hchg Excision of Nail and Nail Matrix, Partial or Complete (Eg, Ingrown or Deformed Nail), for Permanent Removal	$795.96	$3,979.80	$165.82	56% above	80%
Removal of a breast lump, open surgery CPT 19120 Hchg Excision of Cyst, Fibroadenoma, or Other Benign or Malignant Tumor, Aberrant Breast Tissue, Duct Lesion, Nipple or Areolar Lesion (Except 19300), Open, Male or Female, 1 or More Lesion	$2,501.84	$12,509.20	$165.82	49% below	80%
Removal of a foreign object under the skin, simple CPT 10120 Hchg Incision and Removal of Foreign Body, Subcutaneous Tissues; Simple	$629.64	$3,148.20	$165.82	20% above	80%
Septoplasty to straighten the nasal septum CPT 30520 Hchg Septoplasty or Submucous Resection, With or Without Cartilage Scoring, Contouring or Replacement With Graft	$1,769.24	$8,846.20	$165.82	52% below	80%
Short arm cast (elbow to hand) CPT 29075 Elbow to Finger Cast	$343.42	$1,717.10	$165.82	23% above	80%
Short arm cast (elbow to hand) one side CPT 29075 Hchg Appl Cast Elbow to Finger Lt	$113.52	$567.60	$165.82	59% below	80%
Short arm cast (elbow to hand) one side CPT 29075 Hchg Appl Cast Elbow to Finger Rt	$124.96	$624.80	$165.82	55% below	80%
Short arm splint (forearm and hand) CPT 29125 Hchg Application Short Arm Splint Forearm to Hand	$66.13	$330.65	$165.82	71% below	80%
Short arm splint (forearm and hand) one side CPT 29125 Hchg Appl Short Arm Splint Forearm -Hand Static Rt	$113.52	$567.60	$165.82	50% below	80%
Short arm splint (forearm and hand) one side CPT 29125 Hchg Appl Short Arm Splint Forearm -Hand Static Lt	$124.96	$624.80	$165.82	45% below	80%
Short leg cast (below the knee) CPT 29405 Appl Cast Short Leg 60	$122.10	$610.50	$165.82	64% below	80%
Short leg cast (below the knee) CPT 29405 At Appl Cast Short Leg 60	$122.10	$610.50	$165.82	64% below	80%
Short leg cast (below the knee) CPT 29405 At Appl Cast Short Leg 30	$122.10	$610.50	$165.82	64% below	80%
Short leg cast (below the knee) CPT 29405 Appl Cast Short Leg 30	$122.10	$610.50	$165.82	64% below	80%
Short leg cast (below the knee) one side CPT 29405 Hchg Appl Cast Short Leg Knee-Toes Rt	$113.52	$567.60	$165.82	67% below	80%
Short leg cast (below the knee) one side CPT 29405 Hchg Appl Cast Short Leg Knee-Toes Lt	$113.52	$567.60	$165.82	67% below	80%
Short leg splint (calf to foot) CPT 29515 Hchg Application Short Leg Splint Calf to Foot	$66.13	$330.65	$165.82	75% below	80%
Short leg splint (calf to foot) one side CPT 29515 Hchg Appl Short Leg Splint Calf -Foot Lt	$103.18	$515.90	$165.82	60% below	80%
Short leg splint (calf to foot) one side CPT 29515 Hchg Appl Short Leg Splint Calf -Foot Rt	$113.52	$567.60	$165.82	57% below	80%
Skin biopsy, punch, one lesion CPT 11104 Hchg Punch Biopsy of Skin (Including Simple Closure, When Performed); Single Lesion	$320.98	$1,604.90	$165.82	24% below	80%
Skin tag removal, up to 15 tags CPT 11200 Hchg Removal of Skin Tags, Multiple Fibrocutaneous Tags, Any Area; Up to and Including 15 Lesions	$696.30	$3,481.50	$74.14	129% above	80%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Punct Diagnostic Lumbar	$425.60	$2,128.00	$165.82	59% below	80%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Punct/Lumbar	$503.36	$2,516.80	$165.82	52% below	80%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Hchg Simple Repair of Superficial Wounds of Face, Ears, Eyelids, Nose, Lips 2.5 Cm or Less	$207.02	$1,035.10	$165.82	47% below	80%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Hchg Tangential Biopsy of Skin (Eg, Shave, Scoop, Saucerize, Curette); Single Lesion	$269.28	$1,346.40	$165.82	25% below	80%
Wart removal, up to 14 warts CPT 17110 Hchg Destruction (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettement), of Benign Lesions Other Than Skin Tags or Cutaneous Vascular Proliferative Lesions; Up	$187.00	$935.00	$165.82	6% below	80%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Hchg Debridement, Subcutaneous Tissue (Includes Epidermis and Dermis, if Performed); First 20 Sq Cm or Less	$879.34	$4,396.70	$165.82	13% below	80%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration	$349.58	$1,747.90	$165.82	54% below	80%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfus One Time	$463.54	$2,317.70	$165.82	39% below	80%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Treatment,Init	$50.40	$252.00	$165.82	75% below	80%
Chemotherapy IV infusion, first hour CPT 96413 Chemo Infus Up to 1hr	$794.08	$3,970.40	$165.82	47% above	80%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 Opthalmological Visit, New Pt, Comprehensive	$163.02	$815.10	$165.82	32% below	80%
Comprehensive eye exam, returning patient CPT 92014 Ophthalmological Visit, Established, Comprehensive	$130.46	$652.30	$165.82	43% below	80%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Comp Audio (Incl Sat/Srt	$142.56	$712.80	$165.82	52% below	80%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care First 30-74 Min	$286.45	$1,432.25	$165.82–$7,800.00	89% below	80%
Critical care, first 30 to 74 minutes CPT 99291 ER Level 6-Critical Care	$1,221.28	$6,106.40	$165.82–$7,800.00	52% below	80%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg 20-40 Min	$515.02	$2,575.10	$165.82	44% below	80%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$187.66	$938.30	$165.82	31% below	80%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED Level 1	$79.90	$399.50	$51.36–$500.00	66% below	80%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER Level 1	$95.88	$479.40	$51.36–$500.00	59% below	80%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED Level 2	$178.84	$894.20	$51.36–$1,500.00	59% below	80%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER Level 2	$214.03	$1,070.15	$51.36–$1,500.00	51% below	80%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED Level 3	$332.35	$1,661.75	$51.36–$2,499.00	57% below	80%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER Level 3	$410.55	$2,052.75	$51.36–$2,499.00	47% below	80%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER Level 4	$497.42	$2,487.10	$165.82–$3,900.00	61% below	80%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Sexual Assault Exam Fee	$359.70	$1,798.50	$165.82	80% below	80%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER Level 5	$674.22	$3,371.10	$165.82–$7,800.00	62% below	80%
Exercise stress test, tracing only, the hospital charge CPT 93017 Hchg Stress Tst Pharm	$837.54	$4,187.70	$165.82	33% below	80%
Exercise stress test, tracing only, the hospital charge CPT 93017 Hchg Stress Test V02	$1,087.68	$5,438.40	$165.82	13% below	80%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test	$1,087.68	$5,438.40	$165.82	13% below	80%
Eye exam, returning patient, intermediate CPT 92012 Opthalmological Visit, Established, Intermediate	$97.90	$489.50	$165.82	50% below	80%
Family therapy with the patient, 50 minutes CPT 90847 Fam Psych W/Pt Present	$107.64	$538.21	$98.11–$165.82	62% below	80%
Family therapy without the patient, 50 minutes CPT 90846 Fam Psych W/O Pt Present	$107.64	$538.21	$94.07–$165.82	58% below	80%
Group psychotherapy session CPT 90853 Group Psychotherapy (Other Than of a Multiple-Family Group)	$156.64	$783.20	$165.82	4% below	80%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration 31min-1hr	$253.22	$1,266.10	$165.82	42% below	80%
IV infusion of a medicine, first hour CPT 96365 IV Proph/Dx Up to 1hr	$333.74	$1,668.70	$165.82	26% below	80%
IV push of a medicine, first drug CPT 96374 IV Push Initial	$30.58	$152.90	$165.82	87% below	80%
IV push of a medicine, first drug CPT 96374 IV Push Single /Initial	$39.60	$198.00	$165.82	83% below	80%
IV push of a medicine, first drug CPT 96374 Hchg IV Push Sngl Initial	$66.22	$331.10	$165.82	71% below	80%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im/Sub Q	$25.96	$129.80	$165.82	82% below	80%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject Im/Subq Single Rx	$28.38	$141.90	$165.82	81% below	80%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Diagnostic Evaluation	$110.66	$553.30	$149.12–$165.82	71% below	80%
Neuromuscular re-education, 15 minutes CPT 97112 Hchg Neuromuscular Cotx 15	$49.94	$249.70	$33.30–$165.82	56% below	80%
Neuromuscular re-education, 15 minutes CPT 97112 Hchg at Neuromuscular Cotx 15	$49.94	$249.70	$33.30–$165.82	56% below	80%
Neuromuscular re-education, 15 minutes CPT 97112 Hchg at Neuromuscular Re-ED 15	$61.38	$306.90	$33.30–$165.82	46% below	80%
Neuromuscular re-education, 15 minutes CPT 97112 At Neuromuscular Re-ED, 15	$61.38	$306.90	$33.30–$165.82	46% below	80%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Re-ED, 15	$74.58	$372.90	$33.30–$165.82	34% below	80%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Re-ED,Si 15	$74.58	$372.90	$33.30–$165.82	34% below	80%
New patient office visit, about 30 minutes CPT 99203 Hchg Evi New Patient Level 3	$177.76	$888.80	$165.82	21% below	80%
New patient office visit, about 30 minutes CPT 99203 C-New Patient Level3	$177.76	$888.80	$165.82	21% below	80%
New patient office visit, about 30 minutes CPT 99203 Hchg Quick Care New III	$222.64	$1,113.20	$165.82	2% below	80%
New patient office visit, about 30 minutes CPT 99203 Level III New Patient	$222.64	$1,113.20	$165.82	2% below	80%
New patient office visit, about 30 minutes CPT 99203 Hchg Office O/P New Low 30 Min	$222.64	$1,113.20	$165.82	2% below	80%
New patient office visit, about 45 minutes CPT 99204 Hchg Office O/P New Mod 45 Min	$265.14	$1,325.72	$165.82	9% below	80%
New patient office visit, about 45 minutes CPT 99204 Hchg Level IV New Patient (55-75 Pts)	$265.32	$1,326.60	$165.82	9% below	80%
New patient office visit, about 45 minutes CPT 99204 Hchg Quick Care New IV	$265.32	$1,326.60	$165.82	9% below	80%
New patient office visit, about 45 minutes CPT 99204 Hchg Evi New Patient Level 4	$283.14	$1,415.70	$165.82	3% below	80%
New patient office visit, about 45 minutes CPT 99204 C- New Patient Level 4	$283.14	$1,415.70	$165.82	3% below	80%
New patient office visit, about 60 minutes CPT 99205 C-New Patient Level 5	$301.62	$1,508.10	$165.82	3% above	80%
New patient office visit, about 60 minutes CPT 99205 Hchg Quick Care New Level V	$310.43	$1,552.16	$165.82	6% above	80%
New patient office visit, about 60 minutes CPT 99205 Level V New Patient	$310.64	$1,553.20	$165.82	6% above	80%
New patient office visit, about 60 minutes CPT 99205 Hchg Evi New Patient Level 5	$331.76	$1,658.80	$165.82	13% above	80%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 C-New Patient Level2	$142.34	$711.70	$165.82	4% below	80%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Hchg Evi New Patient Level 2	$142.34	$711.70	$165.82	4% below	80%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Hchg Office O/P New Sf 15 Min	$178.37	$891.83	$165.82	20% above	80%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Hchg Quick Care New II	$178.42	$892.10	$165.82	20% above	80%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Level II New Patient	$178.42	$892.10	$165.82	20% above	80%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Nutr Therapy 15min	$18.26	$91.30	$31.74–$165.82	64% below	80%
Occupational therapy evaluation, low complexity CPT 97165 Hchg at Ot Eval Low Comp	$91.74	$458.70	$98.93–$165.82	62% below	80%
Occupational therapy evaluation, low complexity CPT 97165 Hchg Ot Eval Low Comp	$111.54	$557.70	$98.93–$165.82	54% below	80%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Hchg at Pt Eval High Comp	$326.48	$1,632.40	$98.93–$165.82	13% above	80%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Hchg Pt Eval High Comp	$396.44	$1,982.20	$98.93–$165.82	37% above	80%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Hchg at Pt Eval Low Comp	$91.74	$458.70	$98.93–$165.82	55% below	80%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Hchg Pt Eval Low Comp	$111.54	$557.70	$98.93–$165.82	45% below	80%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Hchg Pt Eval Standard Workers Comp	$137.06	$685.30	$98.93–$165.82	45% below	80%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Hchg at Pt Eval Moderate Comp	$183.70	$918.50	$98.93–$165.82	26% below	80%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Hchg Pt Eval Moderate Comp	$223.30	$1,116.50	$98.93–$165.82	10% below	80%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 At-Manual Therapy 15	$67.76	$338.80	$26.74–$165.82	39% below	80%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy 15	$74.58	$372.90	$26.74–$165.82	33% below	80%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 At Manual Therapy 15	$119.02	$595.10	$26.74–$165.82	8% above	80%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy 15m	$149.60	$748.00	$26.74–$165.82	35% above	80%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hchg at Ther Ex Cotx 15	$49.94	$249.70	$29.03–$165.82	55% below	80%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 At Ther Proc (15	$61.38	$306.90	$29.03–$165.82	45% below	80%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 At-Ther Ex,Ndt or St (15	$61.38	$306.90	$29.03–$165.82	45% below	80%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Proc (15	$74.58	$372.90	$29.03–$165.82	33% below	80%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Ex, Ndt or Si (15	$74.58	$372.90	$29.03–$165.82	33% below	80%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hchg Ther Ex Cotx 15	$100.54	$502.70	$29.03–$165.82	10% below	80%
Psychiatric evaluation with medical services CPT 90792 Hchg Psychiatric Diagnostic Evaluation With Medical Services	$122.98	$614.90	$169.43	63% below	80%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Hchg Psychologiccal Test 1st Hr	$247.40	$1,237.00	$165.82	19% below	80%
Psychotherapy for crisis, first 60 minutes CPT 90839 Psychotherapy for Crisis; First 60 Minutes	$198.88	$994.40	$165.82	39% below	80%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 Minutes With Patient	$106.92	$534.60	$65.72–$165.82	43% below	80%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 Minutes With Patient	$133.10	$665.50	$87.11–$165.82	52% below	80%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 Minutes With Patient	$152.02	$760.10	$128.07–$165.82	45% below	80%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Quick Care Established Level V	$265.10	$1,325.50	$165.82	7% below	80%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Hchg Office O/P Est Hi 40 Min (80+ Points)	$265.14	$1,325.72	$165.82	7% below	80%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Level V Establised	$265.32	$1,326.60	$165.82	7% below	80%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 C-Estabalished Level 5	$283.58	$1,417.90	$165.82	at median	80%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Hchg Evi Estb Patient Level 5	$283.58	$1,417.90	$165.82	at median	80%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Hchg Evi Estb Patient Level 3	$142.34	$711.70	$165.82	19% below	80%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 C-Estb Patient Level 3	$142.34	$711.70	$165.82	19% below	80%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Hchg Office O/P Est Low 20 Min	$178.37	$891.83	$165.82	2% above	80%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Hchg Quick Care Estab III	$178.42	$892.10	$165.82	2% above	80%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Level III Established	$178.42	$892.10	$165.82	2% above	80%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Level IV Established	$222.64	$1,113.20	$165.82	16% above	80%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Hchg Quick Care Estab IV	$222.64	$1,113.20	$165.82	16% above	80%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Hchg Office O/P Est Mod 30 Min	$222.64	$1,113.20	$165.82	16% above	80%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Hchg Evi Estb Patient Level 4	$237.60	$1,188.00	$165.82	23% above	80%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 C- Established Level 4	$237.60	$1,188.00	$165.82	23% above	80%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 C-Estb Patient Level2	$106.48	$532.40	$165.82	15% below	80%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Level II Established	$133.76	$668.80	$165.82	7% above	80%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Hchg Quick Care Estab II	$133.76	$668.80	$165.82	7% above	80%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Hchg Office O/P Est Sf 10 Min	$133.84	$669.19	$165.82	7% above	80%
Specialist consultation, low complexity or 30+ minutes CPT 99243 Hchg Office Consultation for a New or Established Patient, Which Requires These 3 Key Components: a Detailed History; a Detailed Examination; and Medical Decision Making of Low Complexity.	$85.80	$429.00	$165.82	4% below	80%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Dietary Consult IV	$121.88	$609.40	$132.23–$165.82	25% below	80%
Speech and language evaluation CPT 92523 Hchg at St Evl Speechlang Brief	$185.24	$926.20	$165.82–$224.44	52% below	80%
Speech and language evaluation CPT 92523 Hchg St Eval Speechlang Brief	$203.94	$1,019.70	$165.82–$224.44	48% below	80%
Speech and language evaluation CPT 92523 Hchg at St Evl Speechlang Stnd	$410.96	$2,054.80	$165.82–$224.44	6% above	80%
Speech and language evaluation CPT 92523 Hchg St Eval Speechlang Stand	$477.18	$2,385.90	$165.82–$224.44	23% above	80%
Speech and language evaluation CPT 92523 Hchg at St Evl Speechlang Comp	$523.38	$2,616.90	$165.82–$224.44	35% above	80%
Speech and language evaluation CPT 92523 Hchg St Eval Speechlang Complx	$665.06	$3,325.30	$165.82–$224.44	71% above	80%
Speech therapy session, individual CPT 92507 Hchg at Speech Therapy Tx	$113.30	$566.50	$75.34–$165.82	48% below	80%
Speech therapy session, individual CPT 92507 Hchg at Speech Therapy Tx 60	$131.78	$658.90	$75.34–$165.82	39% below	80%
Speech therapy session, individual CPT 92507 Hchg at Speech Therapy Tx 45	$131.78	$658.90	$75.34–$165.82	39% below	80%
Speech therapy session, individual CPT 92507 Hchg Speech Therapy Tx 45	$131.78	$658.90	$75.34–$165.82	39% below	80%
Speech therapy session, individual CPT 92507 Hchg Speech Therapy Tx 60	$131.78	$658.90	$75.34–$165.82	39% below	80%
Speech therapy session, individual CPT 92507 Hchg Speech Therapy Tx	$131.78	$658.90	$75.34–$165.82	39% below	80%
Speech therapy session, individual CPT 92507 Hchg Speech Therapy Co Tx	$131.78	$658.90	$75.34–$165.82	39% below	80%
Speech therapy session, individual CPT 92507 Hchg at Speech Therapy Co Tx	$132.00	$659.99	$75.34–$165.82	39% below	80%
Spirometry (breathing test) CPT 94010 Pulmonary Func A	$193.80	$969.00	$165.82	46% below	80%
Spirometry before and after a bronchodilator CPT 94060 P/P B-Dilat. Spirometry	$333.00	$1,665.00	$165.82	44% below	80%
Therapeutic activities (functional training), 15 minutes CPT 97530 Hchg at Ther Activity Cotx(15	$49.94	$249.70	$36.41–$165.82	56% below	80%
Therapeutic activities (functional training), 15 minutes CPT 97530 Hchg Ther Activity Cotx 15	$49.94	$249.70	$36.41–$165.82	56% below	80%
Therapeutic activities (functional training), 15 minutes CPT 97530 Hchg at Ther Activity Cotx 15	$52.14	$260.70	$36.41–$165.82	54% below	80%
Therapeutic activities (functional training), 15 minutes CPT 97530 Atther Actvty-Funct,Ndt15	$61.38	$306.90	$36.41–$165.82	46% below	80%
Therapeutic activities (functional training), 15 minutes CPT 97530 At Ther Activity 15	$61.38	$306.90	$36.41–$165.82	46% below	80%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities, Each 15 Minutes	$66.44	$332.20	$36.41–$165.82	41% below	80%
Therapeutic activities (functional training), 15 minutes CPT 97530 Ther Activity 15	$74.58	$372.90	$36.41–$165.82	34% below	80%
Therapeutic activities (functional training), 15 minutes CPT 97530 Ther Actvty-Funct, Ndt 15	$74.58	$372.90	$36.41–$165.82	34% below	80%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy	$468.38	$2,341.90	$165.82–$7,166.00	105% above	80%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Hchg Phlebotomy	$583.88	$2,919.40	$165.82	155% above	80%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$267.95	$1,339.75	$165.82–$169.59	33% below	80%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE	$143.75	$718.75	$95.45–$165.82	32% below	80%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION	$356.90	$1,784.50	$165.82–$284.90	35% below	80%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE	$103.90	$519.50	$71.85–$165.82	43% below	80%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE	$56.95	$284.75	$39.00–$165.82	39% below	80%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$136.25	$681.25	$95.26–$165.82	32% below	80%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$328.55	$1,642.75	$165.82–$283.72	42% below	80%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE	$163.40	$817.00	$133.47–$165.82	35% below	80%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION	$622.55	$3,112.75	$165.82–$410.70	87% above	80%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML INTRAMUSCULAR SYRINGE	$617.05	$3,085.25	$165.82	37% below	80%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE	$740.45	$3,702.25	$165.82	24% below	80%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$285.75	$1,428.75	$165.82–$329.99	72% below	80%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$606.55	$3,032.75	$165.82–$329.99	41% below	80%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION	$143.25	$716.25	$98.78–$165.82	39% above	80%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP	$49.60	$248.00	$31.05–$165.82	51% below	80%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$49.60	$248.00	$31.05–$165.82	51% below	80%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE	$51.55	$257.75	$38.75–$165.82	56% below	80%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$53.45	$267.25	$38.75–$165.82	54% below	80%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE	$68.15	$340.75	$38.75–$165.82	42% below	80%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE	$459.15	$2,295.75	$165.82	5% above	80%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Hchg Adm Immun Ini WO Counsel	$7.20	$36.00	$165.82	90% below	80%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Hchg Adm Immun>19yrs Int	$7.20	$36.00	$165.82	90% below	80%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Admin Immunization Ec Add	$5.04	$25.20	$165.82	89% below	80%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Hchg Adm Immun>19yrs Ec Add	$5.04	$25.20	$165.82	89% below	80%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Hchg Adm Immun Ech WO Counsel	$7.20	$36.00	$165.82	85% below	80%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://driscollchildrens.org/wp-content/uploads/742577746-1124796081_Driscoll-Childrens-Hospital_standardcharges.csv