Hospital Findlay, OH

Blanchard Valley Regional Health Center

Blanchard Valley Regional Health Center in Findlay, OH publishes cash prices for 256 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 above the Ohio median for 159 of 255 procedures and below it for 96. By typical cash price it ranks #96 of 137 Ohio hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1900 South Main Street, Findlay, OH 45840 Collected Sep 22, 2026 Source price file (419) 423-4500

Acute care hospital No emergency department CMS star rating 3 of 5 CCN 360095 · CMS hospital register NPI 1710920327

The price file shows no self-pay discount

For 1746 of the 1746 prices listed here, the cash price in Blanchard Valley Regional Health Center's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR Ankle 3 Views Bilateral	$675.00	$675.00	$31.75–$504.00	—	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle 3 Views Right	$450.00	$450.00	$31.75–$504.00	39% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle 3 Views Left	$450.00	$450.00	$31.75–$504.00	39% above	—
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR Ankle 3 Views Bilateral	$675.00	$675.00	$31.75–$504.00	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle 3 Views Left	$450.00	$450.00	$31.75–$504.00	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle 3 Views Right	$450.00	$450.00	$31.75–$504.00	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 VL Ankle Brachial Indices	$207.00	$207.00	$101.43–$207.00	57% below	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 VL Ankle Brachial Indices	$207.00	$207.00	$101.43–$207.00	—	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus	$590.00	$590.00	$67.40–$554.01	34% above	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophagus	$590.00	$590.00	$67.40–$554.01	—	—
Bone scan, whole body (nuclear medicine) CPT 78306 78306 BONE &/JOINT IMAGING WHOLE BODY	$994.00	$994.00	$351.95–$933.37	35% below	—
Bone scan, whole body (nuclear medicine) CPT 78306 Scan	$994.00	$994.00	$351.95–$933.37	35% below	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 78306 BONE &/JOINT IMAGING WHOLE BODY	$994.00	$994.00	$351.95–$933.37	—	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Scan	$994.00	$994.00	$351.95–$933.37	—	—
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US Breast Limited Bilat-Left	$923.00	$923.00	$77.23–$583.64	—	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right	$615.00	$615.00	$77.23–$583.64	50% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left	$615.00	$615.00	$77.23–$583.64	50% above	—
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US Breast Limited Bilat-Left	$923.00	$923.00	$77.23–$583.64	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left	$615.00	$615.00	$77.23–$583.64	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right	$615.00	$615.00	$77.23–$583.64	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest w/ Contrast	$1,706.00	$1,706.00	$156.15–$2,046.72	20% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest w/ + w/o Contrast	$1,706.00	$1,706.00	$156.15–$2,046.72	20% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Chest Venogram w/ Contrast	$1,706.00	$1,706.00	$156.15–$2,046.72	20% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST	$1,706.00	$1,706.00	$156.15–$2,046.72	20% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest w/ Contrast & Hi Res	$1,706.00	$1,706.00	$156.15–$2,046.72	20% above	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest w/ + w/o Contrast	$1,706.00	$1,706.00	$156.15–$2,046.72	—	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest w/ Contrast	$1,706.00	$1,706.00	$156.15–$2,046.72	—	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST	$1,706.00	$1,706.00	$156.15–$2,046.72	—	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest w/ Contrast & Hi Res	$1,706.00	$1,706.00	$156.15–$2,046.72	—	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Chest Venogram w/ Contrast	$1,706.00	$1,706.00	$156.15–$2,046.72	—	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Calcium Scoring	$166.00	$166.00	$76.94–$277.00	41% below	—
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Calcium Scoring	$166.00	$166.00	$76.94–$277.00	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd Pel w/o IV Con Valsalva Maneuver	$685.00	$685.00	$208.25–$3,251.46	56% below	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Chest Abd Plevis w/o IV & TS Recon	$3,332.00	$3,332.00	$208.25–$3,251.46	112% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Chest Abd Pelvis w/o IV & TS/LS Recon	$3,332.00	$3,332.00	$208.25–$3,251.46	112% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Chest Abd Pelvis w/o IV & LS Recon	$3,332.00	$3,332.00	$208.25–$3,251.46	112% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis w/o IV Contrast	$3,332.00	$3,332.00	$208.25–$3,251.46	112% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Chest Abdomen Pelvis w/o Contrast	$3,332.00	$3,332.00	$208.25–$3,251.46	112% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Chest w/ Abdomen Pelvis w/ + w/o Cont	$3,332.00	$3,332.00	$208.25–$3,251.46	112% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis w/o IV Cont & LS Recon	$3,332.00	$3,332.00	$208.25–$3,251.46	112% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd Pelvis w/o IV Cont Stone Prot.	$3,332.00	$3,332.00	$208.25–$3,251.46	112% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd Pel w/o IV Stone Prot & LS Recon	$3,332.00	$3,332.00	$208.25–$3,251.46	112% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd Pel w/o IV Con + Rectal Contrast	$3,459.00	$3,459.00	$208.25–$3,251.46	120% above	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd Pel w/o IV Con Valsalva Maneuver	$685.00	$685.00	$208.25–$3,251.46	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Chest Abdomen Pelvis w/o Contrast	$3,332.00	$3,332.00	$208.25–$3,251.46	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Chest Abd Plevis w/o IV & TS Recon	$3,332.00	$3,332.00	$208.25–$3,251.46	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Chest Abd Pelvis w/o IV & TS/LS Recon	$3,332.00	$3,332.00	$208.25–$3,251.46	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Chest Abd Pelvis w/o IV & LS Recon	$3,332.00	$3,332.00	$208.25–$3,251.46	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Chest w/ Abdomen Pelvis w/ + w/o Cont	$3,332.00	$3,332.00	$208.25–$3,251.46	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis w/o IV Cont & LS Recon	$3,332.00	$3,332.00	$208.25–$3,251.46	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd Pelvis w/o IV Cont Stone Prot.	$3,332.00	$3,332.00	$208.25–$3,251.46	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis w/o IV Contrast	$3,332.00	$3,332.00	$208.25–$3,251.46	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd Pel w/o IV Stone Prot & LS Recon	$3,332.00	$3,332.00	$208.25–$3,251.46	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd Pel w/o IV Con + Rectal Contrast	$3,459.00	$3,459.00	$208.25–$3,251.46	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Chest Abd Pelvis w/ IV & TS/LS Recon	$3,506.00	$3,506.00	$219.31–$3,373.45	80% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Chest Abd Pelvis w/ IV & LS Recon	$3,506.00	$3,506.00	$219.31–$3,373.45	80% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Chest Abd Pelvis w/ IV & TS Recon	$3,506.00	$3,506.00	$219.31–$3,373.45	80% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis Enterography w/ IV Con	$3,506.00	$3,506.00	$219.31–$3,373.45	80% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Chest Abdomen Pelvis w/ Contrast	$3,506.00	$3,506.00	$219.31–$3,373.45	80% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis w/ IV Contrast	$3,506.00	$3,506.00	$219.31–$3,373.45	80% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd Pelvis w/ IV Contrast & LS Recon	$3,506.00	$3,506.00	$219.31–$3,373.45	80% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd Pel w/ IV Con + Rectal Contrast	$3,551.00	$3,551.00	$219.31–$3,373.45	83% above	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Chest Abd Pelvis w/ IV & LS Recon	$3,506.00	$3,506.00	$219.31–$3,373.45	—	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis Enterography w/ IV Con	$3,506.00	$3,506.00	$219.31–$3,373.45	—	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis w/ IV Contrast	$3,506.00	$3,506.00	$219.31–$3,373.45	—	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Chest Abd Pelvis w/ IV & TS Recon	$3,506.00	$3,506.00	$219.31–$3,373.45	—	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Chest Abd Pelvis w/ IV & TS/LS Recon	$3,506.00	$3,506.00	$219.31–$3,373.45	—	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Chest Abdomen Pelvis w/ Contrast	$3,506.00	$3,506.00	$219.31–$3,373.45	—	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd Pelvis w/ IV Contrast & LS Recon	$3,506.00	$3,506.00	$219.31–$3,373.45	—	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd Pel w/ IV Con + Rectal Contrast	$3,551.00	$3,551.00	$219.31–$3,373.45	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Chest Abdomen Pelvis w/+w/o Contrast	$4,072.00	$4,072.00	$326.25–$1,115.30	75% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd w/ + w/o Pelvis w/ IV Contrast	$4,072.00	$4,072.00	$326.25–$1,115.30	75% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen Pelvis w/ + w/o IV Contrast	$4,072.00	$4,072.00	$326.25–$1,115.30	75% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Chest w/ Abdomen w/+w/o Pelvis w/Cont	$4,072.00	$4,072.00	$326.25–$1,115.30	75% above	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd w/ + w/o Pelvis w/ IV Contrast	$4,072.00	$4,072.00	$326.25–$1,115.30	—	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Chest w/ Abdomen w/+w/o Pelvis w/Cont	$4,072.00	$4,072.00	$326.25–$1,115.30	—	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Chest Abdomen Pelvis w/+w/o Contrast	$4,072.00	$4,072.00	$326.25–$1,115.30	—	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen Pelvis w/ + w/o IV Contrast	$4,072.00	$4,072.00	$326.25–$1,115.30	—	—
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ IV Contrast	$1,163.00	$1,163.00	$162.63–$562.00	at median	—
CT scan of the abdomen with contrast CPT 74160 CT Chest Abdomen w/ IV Con	$1,163.00	$1,163.00	$162.63–$562.00	at median	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT Chest Abdomen w/ IV Con	$1,163.00	$1,163.00	$162.63–$562.00	—	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ IV Contrast	$1,163.00	$1,163.00	$162.63–$562.00	—	—
CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o IV Contrast	$734.00	$734.00	$93.81–$804.64	30% below	—
CT scan of the abdomen without contrast CPT 74150 CT Chest Abdomen w/o IV Con	$734.00	$734.00	$93.81–$804.64	30% below	—
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o IV Contrast	$734.00	$734.00	$93.81–$804.64	—	—
CT scan of the abdomen without contrast inpatient CPT 74150 CT Chest Abdomen w/o IV Con	$734.00	$734.00	$93.81–$804.64	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o IV Surg Navigate/Plan ONLY	$250.00	$250.00	$93.81–$982.20	71% below	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast + Surg Navigate	$828.00	$828.00	$93.81–$982.20	5% below	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Facial Bones w/o Contrast	$828.00	$828.00	$93.81–$982.20	5% below	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast	$828.00	$828.00	$93.81–$982.20	5% below	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o IV Surg Navigate/Plan ONLY	$250.00	$250.00	$93.81–$982.20	—	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast + Surg Navigate	$828.00	$828.00	$93.81–$982.20	—	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Facial Bones w/o Contrast	$828.00	$828.00	$93.81–$982.20	—	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast	$828.00	$828.00	$93.81–$982.20	—	—
CT scan of the head or brain, no contrast dye CPT 70450 CT Brain w/o IV Surg Navigate/Plan ONLY	$250.00	$250.00	$96.75–$706.06	70% below	—
CT scan of the head or brain, no contrast dye CPT 70450 CT Brain w/o Contrast	$744.00	$744.00	$96.75–$706.06	11% below	—
CT scan of the head or brain, no contrast dye CPT 70450 CT Stroke Protocol Brain w/o Contrast	$744.00	$744.00	$96.75–$706.06	11% below	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain w/o IV Surg Navigate/Plan ONLY	$250.00	$250.00	$96.75–$706.06	—	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Stroke Protocol Brain w/o Contrast	$744.00	$744.00	$96.75–$706.06	—	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain w/o Contrast	$744.00	$744.00	$96.75–$706.06	—	—
CT scan of the head with contrast CPT 70460 CT Brain w/ IV Surg Navigate/Plan ONLY	$250.00	$250.00	$244.30–$526.78	75% below	—
CT scan of the head with contrast CPT 70460 CT Brain w/ Contrast	$1,012.00	$1,012.00	$244.30–$526.78	1% above	—
CT scan of the head with contrast inpatient CPT 70460 CT Brain w/ IV Surg Navigate/Plan ONLY	$250.00	$250.00	$244.30–$526.78	—	—
CT scan of the head with contrast inpatient CPT 70460 CT Brain w/ Contrast	$1,012.00	$1,012.00	$244.30–$526.78	—	—
CT scan of the head without and with contrast CPT 70470 CT Brain w/ + w/o Contrast	$1,281.00	$1,281.00	$161.96–$620.29	11% above	—
CT scan of the head without and with contrast inpatient CPT 70470 CT Brain w/ + w/o Contrast	$1,281.00	$1,281.00	$161.96–$620.29	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast	$836.00	$836.00	$93.44–$836.00	24% below	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LS WO CONTRAST	$836.00	$836.00	$93.44–$836.00	24% below	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast	$836.00	$836.00	$93.44–$836.00	—	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LS WO CONTRAST	$836.00	$836.00	$93.44–$836.00	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast	$836.00	$836.00	$93.81–$882.46	22% below	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERV SPINE WO CONTR	$836.00	$836.00	$93.81–$882.46	22% below	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast	$836.00	$836.00	$93.81–$882.46	—	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERV SPINE WO CONTR	$836.00	$836.00	$93.81–$882.46	—	—
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast	$1,013.00	$1,013.00	$162.10–$1,044.00	17% below	—
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ IV Con + Rectal Contrast	$1,044.00	$1,044.00	$162.10–$1,044.00	15% below	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast	$1,013.00	$1,013.00	$162.10–$1,044.00	—	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ IV Con + Rectal Contrast	$1,044.00	$1,044.00	$162.10–$1,044.00	—	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 VL Carotid Duplex Bilateral	$794.00	$794.00	$184.65–$745.57	—	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 VL Carotid Duplex Bilateral	$794.00	$794.00	$184.65–$745.57	—	—
Chest X-ray, 2 views both sides CPT 71046 XR Chest Obliques Bilateral	$263.00	$263.00	$66.75–$249.59	—	—
Chest X-ray, 2 views both sides CPT 71046 XR Chest Decubitus Bilateral	$263.00	$263.00	$66.75–$249.59	—	—
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views	$263.00	$263.00	$66.75–$249.59	4% below	—
Chest X-ray, 2 views inpatient both sides CPT 71046 XR Chest Decubitus Bilateral	$263.00	$263.00	$66.75–$249.59	—	—
Chest X-ray, 2 views inpatient both sides CPT 71046 XR Chest Obliques Bilateral	$263.00	$263.00	$66.75–$249.59	—	—
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views	$263.00	$263.00	$66.75–$249.59	—	—
Chest X-ray, single view CPT 71045 CHEST FRONTAL SINGLE VIEW	$250.00	$250.00	$69.78–$237.25	7% above	—
Chest X-ray, single view CPT 71045 XR Chest Apical Lordotic View Only	$250.00	$250.00	$69.78–$237.25	7% above	—
Chest X-ray, single view CPT 71045 XR Chest 1 View Expiration	$250.00	$250.00	$69.78–$237.25	7% above	—
Chest X-ray, single view CPT 71045 XR Chest 1 View	$250.00	$250.00	$69.78–$237.25	7% above	—
Chest X-ray, single view one side CPT 71045 XR Chest Decubitus Right	$250.00	$250.00	$69.78–$237.25	7% above	—
Chest X-ray, single view one side CPT 71045 XR Chest Decubitus Left	$250.00	$250.00	$69.78–$237.25	7% above	—
Chest X-ray, single view inpatient CPT 71045 CHEST FRONTAL SINGLE VIEW	$250.00	$250.00	$69.78–$237.25	—	—
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View	$250.00	$250.00	$69.78–$237.25	—	—
Chest X-ray, single view inpatient CPT 71045 XR Chest Apical Lordotic View Only	$250.00	$250.00	$69.78–$237.25	—	—
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Expiration	$250.00	$250.00	$69.78–$237.25	—	—
Chest X-ray, single view inpatient one side CPT 71045 XR Chest Decubitus Left	$250.00	$250.00	$69.78–$237.25	—	—
Chest X-ray, single view inpatient one side CPT 71045 XR Chest Decubitus Right	$250.00	$250.00	$69.78–$237.25	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP	$1,278.00	$1,278.00	$93.81–$1,212.82	80% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal/Bladder w/ Renal Arterial Dup	$1,278.00	$1,278.00	$93.81–$1,212.82	80% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal and Bladder	$1,278.00	$1,278.00	$93.81–$1,212.82	80% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal Bladder and Pelvis	$1,278.00	$1,278.00	$93.81–$1,212.82	80% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP BIL	$1,278.00	$1,278.00	$93.81–$1,212.82	80% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete	$1,278.00	$1,278.00	$93.81–$1,212.82	80% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal/Bladder w/ Renal Arterial Dup	$1,278.00	$1,278.00	$93.81–$1,212.82	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US EXAM ABDO BACK WALL COMP BIL	$1,278.00	$1,278.00	$93.81–$1,212.82	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal Bladder and Pelvis	$1,278.00	$1,278.00	$93.81–$1,212.82	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal and Bladder	$1,278.00	$1,278.00	$93.81–$1,212.82	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete	$1,278.00	$1,278.00	$93.81–$1,212.82	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US EXAM ABDO BACK WALL COMP	$1,278.00	$1,278.00	$93.81–$1,212.82	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density (2 Areas)	$421.00	$421.00	$85.74–$494.44	7% below	—
DEXA bone density scan of the hip, pelvis or spine one side CPT 77080 BD Bone Density (Spine, Hip, Rt Forearm)	$307.00	$307.00	$85.74–$494.44	32% below	—
DEXA bone density scan of the hip, pelvis or spine one side CPT 77080 BD Bone Density (Spine, Hip, Lt Forearm)	$307.00	$307.00	$85.74–$494.44	32% below	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density (2 Areas)	$421.00	$421.00	$85.74–$494.44	—	—
DEXA bone density scan of the hip, pelvis or spine inpatient one side CPT 77080 BD Bone Density (Spine, Hip, Lt Forearm)	$307.00	$307.00	$85.74–$494.44	—	—
DEXA bone density scan of the hip, pelvis or spine inpatient one side CPT 77080 BD Bone Density (Spine, Hip, Rt Forearm)	$307.00	$307.00	$85.74–$494.44	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) one side CPT 77081 BD Bone Density Rt Forearm	$253.00	$253.00	$77.22	1% below	—
DEXA bone density scan of the wrist, heel or finger (peripheral) one side CPT 77081 BD Bone Density Lt Forearm	$253.00	$253.00	$77.22	1% below	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient one side CPT 77081 BD Bone Density Lt Forearm	$253.00	$253.00	$77.22	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient one side CPT 77081 BD Bone Density Rt Forearm	$253.00	$253.00	$77.22	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o IV Surg Navigate/Plan ONLY	$250.00	$250.00	$93.81–$350.51	73% below	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast Super D	$744.00	$744.00	$93.81–$350.51	21% below	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast & TS Recon	$744.00	$744.00	$93.81–$350.51	21% below	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast	$744.00	$744.00	$93.81–$350.51	21% below	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest and Hi Res w/o Contrast	$744.00	$744.00	$93.81–$350.51	21% below	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest High Resolution	$744.00	$744.00	$93.81–$350.51	21% below	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX; WO CONTRAST	$744.00	$744.00	$93.81–$350.51	21% below	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o IV Surg Navigate/Plan ONLY	$250.00	$250.00	$93.81–$350.51	—	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Contrast & TS Recon	$744.00	$744.00	$93.81–$350.51	—	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX; WO CONTRAST	$744.00	$744.00	$93.81–$350.51	—	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Contrast	$744.00	$744.00	$93.81–$350.51	—	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Contrast Super D	$744.00	$744.00	$93.81–$350.51	—	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest and Hi Res w/o Contrast	$744.00	$744.00	$93.81–$350.51	—	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest High Resolution	$744.00	$744.00	$93.81–$350.51	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX; W CONTRAST	$1,013.00	$1,013.00	$94.59–$981.36	11% below	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast	$1,013.00	$1,013.00	$94.59–$981.36	11% below	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast & TS Recon	$1,013.00	$1,013.00	$94.59–$981.36	11% below	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX; W CONTRAST	$1,013.00	$1,013.00	$94.59–$981.36	—	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Contrast	$1,013.00	$1,013.00	$94.59–$981.36	—	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Contrast & TS Recon	$1,013.00	$1,013.00	$94.59–$981.36	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammogram Follow Up Bilateral	$598.00	$598.00	$60.93–$570.89	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammogram Digital Diag Bilat + Tomo	$598.00	$598.00	$60.93–$570.89	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammogram Digital Diagnostic Bilat	$598.00	$598.00	$60.93–$570.89	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammogram Follow Up Bilateral + Tomo	$598.00	$598.00	$60.93–$570.89	—	—
Diagnostic mammogram, both breasts CPT 77066 MG Mammogram Digital Diagnostic Implant	$598.00	$598.00	$60.93–$570.89	53% above	—
Diagnostic mammogram, both breasts CPT 77066 MG Mammogram Digital Diag Male Bil +Tomo	$598.00	$598.00	$60.93–$570.89	53% above	—
Diagnostic mammogram, both breasts CPT 77066 MG Mammogram Digital Diag Implant + Tomo	$598.00	$598.00	$60.93–$570.89	53% above	—
Diagnostic mammogram, both breasts CPT 77066 MG Mammogram Digital Diagnostic Male Bil	$598.00	$598.00	$60.93–$570.89	53% above	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammogram Follow Up Bilateral	$598.00	$598.00	$60.93–$570.89	—	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammogram Follow Up Bilateral + Tomo	$598.00	$598.00	$60.93–$570.89	—	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammogram Digital Diag Bilat + Tomo	$598.00	$598.00	$60.93–$570.89	—	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammogram Digital Diagnostic Bilat	$598.00	$598.00	$60.93–$570.89	—	—
Diagnostic mammogram, both breasts inpatient CPT 77066 MG Mammogram Digital Diag Male Bil +Tomo	$598.00	$598.00	$60.93–$570.89	—	—
Diagnostic mammogram, both breasts inpatient CPT 77066 MG Mammogram Digital Diag Implant + Tomo	$598.00	$598.00	$60.93–$570.89	—	—
Diagnostic mammogram, both breasts inpatient CPT 77066 MG Mammogram Digital Diagnostic Male Bil	$598.00	$598.00	$60.93–$570.89	—	—
Diagnostic mammogram, both breasts inpatient CPT 77066 MG Mammogram Digital Diagnostic Implant	$598.00	$598.00	$60.93–$570.89	—	—
Diagnostic mammogram, one breast one side CPT 77065 MG Mammogram Digital Diag Left + Tomo	$480.00	$480.00	$60.93–$450.72	35% above	—
Diagnostic mammogram, one breast one side CPT 77065 MG Mammogram Follow Up Right	$480.00	$480.00	$60.93–$450.72	35% above	—
Diagnostic mammogram, one breast one side CPT 77065 MG Mammogram Follow Up Left	$480.00	$480.00	$60.93–$450.72	35% above	—
Diagnostic mammogram, one breast one side CPT 77065 MG Mammogram Digital Diagnostic Right	$480.00	$480.00	$60.93–$450.72	35% above	—
Diagnostic mammogram, one breast one side CPT 77065 MG Mammogram Digital Diagnostic Left	$480.00	$480.00	$60.93–$450.72	35% above	—
Diagnostic mammogram, one breast one side CPT 77065 MG Mammogram Digital Diag Right + Tomo	$480.00	$480.00	$60.93–$450.72	35% above	—
Diagnostic mammogram, one breast one side CPT 77065 MG Mammogram Follow Up Right + Tomo	$480.00	$480.00	$60.93–$450.72	35% above	—
Diagnostic mammogram, one breast one side CPT 77065 MG Mammogram Folow Up Left + Tomo	$480.00	$480.00	$60.93–$450.72	35% above	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammogram Digital Diag Right + Tomo	$480.00	$480.00	$60.93–$450.72	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammogram Folow Up Left + Tomo	$480.00	$480.00	$60.93–$450.72	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammogram Follow Up Left	$480.00	$480.00	$60.93–$450.72	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammogram Follow Up Right	$480.00	$480.00	$60.93–$450.72	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammogram Digital Diagnostic Right	$480.00	$480.00	$60.93–$450.72	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammogram Digital Diag Left + Tomo	$480.00	$480.00	$60.93–$450.72	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammogram Digital Diagnostic Left	$480.00	$480.00	$60.93–$450.72	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammogram Follow Up Right + Tomo	$480.00	$480.00	$60.93–$450.72	—	—
Duplex ultrasound of the leg arteries, both legs CPT 93925 VL Extremity Arterial Duplex Lower Bil	$496.00	$496.00	$186.46–$389.36	41% below	—
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 VL Extremity Arterial Duplex Lower Bil	$496.00	$496.00	$186.46–$389.36	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VL Lower Extremity Vein Map Bilateral	$496.00	$496.00	$162.39–$465.74	—	—
Duplex ultrasound of the leg veins, both legs CPT 93970 VL Extremity Venous Duplex Upper Bil	$496.00	$496.00	$162.39–$465.74	43% below	—
Duplex ultrasound of the leg veins, both legs CPT 93970 VL Extremity Venous Duplex Lower Bil	$496.00	$496.00	$162.39–$465.74	43% below	—
Duplex ultrasound of the leg veins, both legs CPT 93970 VL Ext Venous Duplex Lower w/ Reflux Bil	$496.00	$496.00	$162.39–$465.74	43% below	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VL Lower Extremity Vein Map Bilateral	$496.00	$496.00	$162.39–$465.74	—	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VL Ext Venous Duplex Lower w/ Reflux Bil	$496.00	$496.00	$162.39–$465.74	—	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VL Extremity Venous Duplex Upper Bil	$496.00	$496.00	$162.39–$465.74	—	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VL Extremity Venous Duplex Lower Bil	$496.00	$496.00	$162.39–$465.74	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 EC Cardiac Echo Transthoracic	$2,475.00	$2,475.00	$415.34–$2,348.78	46% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 EC Cardiac Echo TTE w/ Agitated Saline	$2,475.00	$2,475.00	$415.34–$2,348.78	46% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 EC Cardiac Echo TTE w/ Agitated Saline	$2,475.00	$2,475.00	$415.34–$2,348.78	—	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 EC Cardiac Echo Transthoracic	$2,475.00	$2,475.00	$415.34–$2,348.78	—	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Scan	$1,634.00	$1,634.00	$578.21–$1,534.33	3% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Scan	$1,634.00	$1,634.00	$578.21–$1,534.33	—	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study Charge -> Yes	$1,208.00	$1,208.00	$106.07–$1,223.47	72% above	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HSAT	$1,208.00	$1,208.00	$106.07–$1,223.47	72% above	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep study Unatt&Resp Effect 95806	$1,208.00	$1,208.00	$106.07–$1,223.47	72% above	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study Unattended	$1,288.00	$1,288.00	$106.07–$1,223.47	83% above	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HSAT	$1,208.00	$1,208.00	$106.07–$1,223.47	—	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Sleep study Unatt&Resp Effect 95806	$1,208.00	$1,208.00	$106.07–$1,223.47	—	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Sleep Study Charge -> Yes	$1,208.00	$1,208.00	$106.07–$1,223.47	—	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Sleep Study Unattended	$1,288.00	$1,288.00	$106.07–$1,223.47	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Spilt Study	$4,761.00	$4,761.00	$836.34–$4,470.58	24% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PAP titration Study	$4,761.00	$4,761.00	$836.34–$4,470.58	24% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Incomplete BPAP 95811-52	$4,960.00	$4,960.00	$836.34–$4,470.58	30% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep Diagnostic/BPAP	$4,960.00	$4,960.00	$836.34–$4,470.58	30% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Incomplete Split 95811-52	$4,960.00	$4,960.00	$836.34–$4,470.58	30% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Incomplete CPAP 95811-52	$4,960.00	$4,960.00	$836.34–$4,470.58	30% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Spilt Study	$4,761.00	$4,761.00	$836.34–$4,470.58	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PAP titration Study	$4,761.00	$4,761.00	$836.34–$4,470.58	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Incomplete Split 95811-52	$4,960.00	$4,960.00	$836.34–$4,470.58	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Sleep Diagnostic/BPAP	$4,960.00	$4,960.00	$836.34–$4,470.58	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Incomplete CPAP 95811-52	$4,960.00	$4,960.00	$836.34–$4,470.58	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Incomplete BPAP 95811-52	$4,960.00	$4,960.00	$836.34–$4,470.58	—	—
Knee X-ray, 3 views both sides CPT 73562 XR Knee 3 Views Bilateral	$630.00	$630.00	$32.18–$473.76	—	—
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left	$420.00	$420.00	$32.18–$473.76	19% above	—
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right	$420.00	$420.00	$32.18–$473.76	19% above	—
Knee X-ray, 3 views inpatient both sides CPT 73562 XR Knee 3 Views Bilateral	$630.00	$630.00	$32.18–$473.76	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Left	$420.00	$420.00	$32.18–$473.76	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Right	$420.00	$420.00	$32.18–$473.76	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GUIDED NEEDLE PLACEMENT	$480.00	$480.00	$57.43–$1,415.35	13% below	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN BIL	$1,242.00	$1,242.00	$57.43–$1,415.35	125% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN 59	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder and Pelvis	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver Renal and Bladder	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Soft Tissue Superficial	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pancreas	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Biliary Tree	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pylorus	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder Renal and Bladder	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver + Elastography	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Right Upper Quadrant + Elastography	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Right Upper Quadrant	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Left Upper Quadrant	$1,278.00	$1,278.00	$57.43–$1,415.35	132% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GUIDED NEEDLE PLACEMENT	$480.00	$480.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHO EXAM OF ABDOMEN BIL	$1,242.00	$1,242.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver + Elastography	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder and Pelvis	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Biliary Tree	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Spleen	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder Renal and Bladder	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pylorus	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Soft Tissue Superficial	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHO EXAM OF ABDOMEN 59	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver Renal and Bladder	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pancreas	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Right Upper Quadrant + Elastography	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Right Upper Quadrant	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Left Upper Quadrant	$1,278.00	$1,278.00	$57.43–$1,415.35	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Screening Low Dose	$335.00	$335.00	$93.43–$317.92	17% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Screening Low Dose	$335.00	$335.00	$93.43–$317.92	—	—
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast w/ + w/o Contrast Bilateral	$2,130.00	$2,130.00	$325.18–$1,430.40	—	—
MRI of both breasts, without and then with contrast dye CPT 77049 MRI Breast Screen Abbrev w/+w/o Con Bil	$802.00	$802.00	$458.26–$1,430.40	79% below	—
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI Breast w/ + w/o Contrast Bilateral	$2,130.00	$2,130.00	$325.18–$1,430.40	—	—
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI Breast Screen Abbrev w/+w/o Con Bil	$802.00	$802.00	$458.26–$1,430.40	—	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right	$897.00	$897.00	$158.51–$608.31	47% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Surg.Navigate or Plan ONLY Left	$897.00	$897.00	$158.51–$608.31	47% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Surg.Navigate or PlanONLY Right	$897.00	$897.00	$158.51–$608.31	47% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left	$897.00	$897.00	$158.51–$608.31	47% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right	$897.00	$897.00	$158.51–$608.31	47% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left	$897.00	$897.00	$158.51–$608.31	47% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right	$897.00	$897.00	$158.51–$608.31	47% below	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left	$897.00	$897.00	$158.51–$608.31	47% below	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Surg.Navigate or Plan ONLY Left	$897.00	$897.00	$158.51–$608.31	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Left	$897.00	$897.00	$158.51–$608.31	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Surg.Navigate or PlanONLY Right	$897.00	$897.00	$158.51–$608.31	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Left	$897.00	$897.00	$158.51–$608.31	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Right	$897.00	$897.00	$158.51–$608.31	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Right	$897.00	$897.00	$158.51–$608.31	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Left	$897.00	$897.00	$158.51–$608.31	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Right	$897.00	$897.00	$158.51–$608.31	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Right	$1,274.00	$1,274.00	$325.18–$935.50	46% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Left	$1,274.00	$1,274.00	$325.18–$935.50	46% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Right	$1,274.00	$1,274.00	$325.18–$935.50	46% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Left	$1,274.00	$1,274.00	$325.18–$935.50	46% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Right	$1,274.00	$1,274.00	$325.18–$935.50	46% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Left	$1,274.00	$1,274.00	$325.18–$935.50	46% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Right	$1,274.00	$1,274.00	$325.18–$935.50	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Right	$1,274.00	$1,274.00	$325.18–$935.50	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Right	$1,274.00	$1,274.00	$325.18–$935.50	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Left	$1,274.00	$1,274.00	$325.18–$935.50	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Left	$1,274.00	$1,274.00	$325.18–$935.50	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Left	$1,274.00	$1,274.00	$325.18–$935.50	—	—
MRI of the abdomen without contrast CPT 74181 MRI Enterography w/o Contrast	$1,519.00	$1,519.00	$217.03–$1,441.53	17% below	—
MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast	$1,519.00	$1,519.00	$217.03–$1,441.53	17% below	—
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast	$1,519.00	$1,519.00	$217.03–$1,441.53	—	—
MRI of the abdomen without contrast inpatient CPT 74181 MRI Enterography w/o Contrast	$1,519.00	$1,519.00	$217.03–$1,441.53	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Enterography w/ + w/o Contrast	$3,162.00	$3,162.00	$323.66–$2,969.12	39% above	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast	$3,162.00	$3,162.00	$323.66–$2,969.12	39% above	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Enterography w/ + w/o Contrast	$3,162.00	$3,162.00	$323.66–$2,969.12	—	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast	$3,162.00	$3,162.00	$323.66–$2,969.12	—	—
MRI of the brain, no contrast dye CPT 70551 MRI Brain & MRA Head w/o Contrast	$1,465.00	$1,465.00	$209.10–$1,360.99	8% below	—
MRI of the brain, no contrast dye CPT 70551 MRI IAC w/o contrast	$1,465.00	$1,465.00	$217.04–$220.81	8% below	—
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast	$1,465.00	$1,465.00	$209.10–$1,360.99	8% below	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain & MRA Head w/o Contrast	$1,465.00	$1,465.00	$209.10–$1,360.99	—	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI IAC w/o contrast	$1,465.00	$1,465.00	$217.04–$220.81	—	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast	$1,465.00	$1,465.00	$209.10–$1,360.99	—	—
MRI of the brain, with and without contrast dye CPT 70553 MRI IAC w/ + w/o Contrast	$2,221.00	$2,221.00	$323.66–$955.64	2% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI Pituitary w/ + w/o Contrast	$2,221.00	$2,221.00	$323.66–$955.64	2% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o MRA Head w/o Contrast	$2,221.00	$2,221.00	$323.66–$955.64	2% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast	$2,221.00	$2,221.00	$323.66–$955.64	2% above	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Pituitary w/ + w/o Contrast	$2,221.00	$2,221.00	$323.66–$955.64	—	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast	$2,221.00	$2,221.00	$323.66–$955.64	—	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o MRA Head w/o Contrast	$2,221.00	$2,221.00	$323.66–$955.64	—	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IAC w/ + w/o Contrast	$2,221.00	$2,221.00	$323.66–$955.64	—	—
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast	$662.00	$662.00	$209.10–$601.90	60% below	—
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast	$662.00	$662.00	$209.10–$601.90	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$1,039.00	$1,039.00	$325.42–$956.16	56% below	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$1,039.00	$1,039.00	$325.42–$956.16	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast	$662.00	$662.00	$209.10–$641.00	59% below	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast	$662.00	$662.00	$209.10–$641.00	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$1,039.00	$1,039.00	$326.25–$936.24	54% below	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$1,039.00	$1,039.00	$326.25–$936.24	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast	$662.00	$662.00	$209.10–$615.36	59% below	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast	$662.00	$662.00	$209.10–$615.36	—	—
MRI of the pelvis without and with contrast CPT 72197 MRI Prostate w/ + w/o Contrast	$1,281.00	$1,281.00	$324.45–$946.10	36% below	—
MRI of the pelvis without and with contrast CPT 72197 MRI Sacrum Coccyx w/ + w/o Contrast	$1,281.00	$1,281.00	$324.45–$946.10	36% below	—
MRI of the pelvis without and with contrast CPT 72197 MRI Rectum w/ + w/o Contrast	$1,281.00	$1,281.00	$324.45–$946.10	36% below	—
MRI of the pelvis without and with contrast CPT 72197 MRI Urogram w/+w/o contrast	$1,281.00	$1,281.00	$324.45–$946.10	36% below	—
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast	$1,281.00	$1,281.00	$324.45–$946.10	36% below	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Urogram w/+w/o contrast	$1,281.00	$1,281.00	$324.45–$946.10	—	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast	$1,281.00	$1,281.00	$324.45–$946.10	—	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Sacrum Coccyx w/ + w/o Contrast	$1,281.00	$1,281.00	$324.45–$946.10	—	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Rectum w/ + w/o Contrast	$1,281.00	$1,281.00	$324.45–$946.10	—	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Prostate w/ + w/o Contrast	$1,281.00	$1,281.00	$324.45–$946.10	—	—
MRI of the pelvis, no contrast dye CPT 72195 MRI Prostate w/o Contrast	$769.00	$769.00	$209.10–$605.76	49% below	—
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast	$769.00	$769.00	$209.10–$605.76	49% below	—
MRI of the pelvis, no contrast dye CPT 72195 MRI Sacrum Coccyx w/o Contrast	$769.00	$769.00	$209.10–$605.76	49% below	—
MRI of the pelvis, no contrast dye CPT 72195 MRI Rectum w/o Contrast	$769.00	$769.00	$209.10–$605.76	49% below	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Sacrum Coccyx w/o Contrast	$769.00	$769.00	$209.10–$605.76	—	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Prostate w/o Contrast	$769.00	$769.00	$209.10–$605.76	—	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast	$769.00	$769.00	$209.10–$605.76	—	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Rectum w/o Contrast	$769.00	$769.00	$209.10–$605.76	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Left	$641.00	$641.00	$219.53–$608.31	56% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Left	$641.00	$641.00	$219.53–$608.31	56% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Right	$641.00	$641.00	$219.53–$608.31	56% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Left	$641.00	$641.00	$219.53–$608.31	56% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Right	$641.00	$641.00	$219.53–$608.31	56% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Right	$641.00	$641.00	$219.53–$608.31	56% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Left	$641.00	$641.00	$219.53–$608.31	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Right	$641.00	$641.00	$219.53–$608.31	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Left	$641.00	$641.00	$219.53–$608.31	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Right	$641.00	$641.00	$219.53–$608.31	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Left	$641.00	$641.00	$219.53–$608.31	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Right	$641.00	$641.00	$219.53–$608.31	—	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Scan	$8,205.00	$8,205.00	$75.00–$8,205.00	105% above	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Scan	$8,205.00	$8,205.00	$75.00–$8,205.00	—	—
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Scan	$3,250.00	$3,250.00	$1,329.58–$3,051.75	33% below	—
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Scan	$3,250.00	$3,250.00	$1,329.58–$3,051.75	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Urinary Bladder	$803.00	$803.00	$93.81–$801.60	83% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Penile Soft Tissue	$803.00	$803.00	$93.81–$801.60	83% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Limited	$803.00	$803.00	$93.81–$801.60	83% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Limited + Transvaginal	$803.00	$803.00	$93.81–$801.60	83% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Limited + Tranvaginal w Duplex	$803.00	$803.00	$93.81–$801.60	83% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Abd Renal Bladder and Transvaginal	$803.00	$803.00	$93.81–$801.60	83% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Soft Tissue Superficial	$803.00	$803.00	$93.81–$801.60	83% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED	$803.00	$803.00	$93.81–$801.60	83% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Abd Renal Bladder and Transvaginal	$803.00	$803.00	$93.81–$801.60	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Urinary Bladder	$803.00	$803.00	$93.81–$801.60	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Penile Soft Tissue	$803.00	$803.00	$93.81–$801.60	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Soft Tissue Superficial	$803.00	$803.00	$93.81–$801.60	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Limited + Tranvaginal w Duplex	$803.00	$803.00	$93.81–$801.60	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Limited + Transvaginal	$803.00	$803.00	$93.81–$801.60	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Limited	$803.00	$803.00	$93.81–$801.60	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED	$803.00	$803.00	$93.81–$801.60	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Complete	$1,036.00	$1,036.00	$95.34–$983.16	103% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE	$1,036.00	$1,036.00	$95.34–$983.16	103% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Abd Renal Bladder and Pelvis	$1,036.00	$1,036.00	$95.34–$983.16	103% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Abdomen and Pelvis	$1,036.00	$1,036.00	$95.34–$983.16	103% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Abdomen and Pelvis	$1,036.00	$1,036.00	$95.34–$983.16	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Abd Renal Bladder and Pelvis	$1,036.00	$1,036.00	$95.34–$983.16	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Complete	$1,036.00	$1,036.00	$95.34–$983.16	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US EXAM PELVIC COMPLETE	$1,036.00	$1,036.00	$95.34–$983.16	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB > 14 Weeks Twins	$837.00	$837.00	$73.93–$785.94	41% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB > 14 Weeks	$837.00	$837.00	$73.93–$785.94	41% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB > 14 and Biophysical Profile	$837.00	$837.00	$73.93–$785.94	41% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >= 14 WKS SNGL FETUS	$837.00	$837.00	$73.93–$785.94	41% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB > 14 Twins and Biophysical Profile	$837.00	$837.00	$73.93–$785.94	41% above	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB > 14 Weeks Twins	$837.00	$837.00	$73.93–$785.94	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >= 14 WKS SNGL FETUS	$837.00	$837.00	$73.93–$785.94	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB > 14 and Biophysical Profile	$837.00	$837.00	$73.93–$785.94	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB > 14 Twins and Biophysical Profile	$837.00	$837.00	$73.93–$785.94	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB > 14 Weeks	$837.00	$837.00	$73.93–$785.94	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB < 14 Weeks Twins	$837.00	$837.00	$138.75–$837.00	53% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB < 14 Weeks	$837.00	$837.00	$138.75–$837.00	53% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS	$837.00	$837.00	$138.75–$837.00	53% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB < 14 Weeks Twins	$837.00	$837.00	$138.75–$837.00	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US < 14 WKS SINGLE FETUS	$837.00	$837.00	$138.75–$837.00	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB < 14 Weeks	$837.00	$837.00	$138.75–$837.00	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited and Biophysical Profile	$678.00	$678.00	$72.52–$723.83	42% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED 1+ FETUS(S)	$678.00	$678.00	$72.52–$723.83	42% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited and Cord Duplex	$678.00	$678.00	$72.52–$723.83	42% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited	$678.00	$678.00	$72.52–$723.83	42% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited	$678.00	$678.00	$72.52–$723.83	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited and Biophysical Profile	$678.00	$678.00	$72.52–$723.83	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited and Cord Duplex	$678.00	$678.00	$72.52–$723.83	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED 1+ FETUS(S)	$678.00	$678.00	$72.52–$723.83	—	—
Screening mammogram, both breasts both sides CPT 77067 MG Mammogram Digital Screen Bilat +Tomo	$236.00	$236.00	$60.93–$223.96	—	—
Screening mammogram, both breasts both sides CPT 77067 MG Mammogram Digital Screening Bilateral	$236.00	$236.00	$60.93–$223.96	—	—
Screening mammogram, both breasts CPT 77067 MG Mammogram Digital Scrn Implant + Tomo	$236.00	$236.00	$60.93–$223.96	23% above	—
Screening mammogram, both breasts CPT 77067 MG Mammogram Digital Screening Implant	$236.00	$236.00	$60.93–$223.96	23% above	—
Screening mammogram, both breasts one side CPT 77067 MG Mammogram Digital Screen Left + Tomo	$236.00	$236.00	$60.93–$223.96	23% above	—
Screening mammogram, both breasts one side CPT 77067 MG Mammogram Digital Left	$236.00	$236.00	$60.93–$223.96	23% above	—
Screening mammogram, both breasts one side CPT 77067 MG Mammogram Digital Screen Right + Tomo	$236.00	$236.00	$60.93–$223.96	23% above	—
Screening mammogram, both breasts one side CPT 77067 MG Mammogram Digital Right	$236.00	$236.00	$60.93–$223.96	23% above	—
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammogram Digital Screen Bilat +Tomo	$236.00	$236.00	$60.93–$223.96	—	—
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammogram Digital Screening Bilateral	$236.00	$236.00	$60.93–$223.96	—	—
Screening mammogram, both breasts inpatient CPT 77067 MG Mammogram Digital Screening Implant	$236.00	$236.00	$60.93–$223.96	—	—
Screening mammogram, both breasts inpatient CPT 77067 MG Mammogram Digital Scrn Implant + Tomo	$236.00	$236.00	$60.93–$223.96	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammogram Digital Screen Right + Tomo	$236.00	$236.00	$60.93–$223.96	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammogram Digital Left	$236.00	$236.00	$60.93–$223.96	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammogram Digital Right	$236.00	$236.00	$60.93–$223.96	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammogram Digital Screen Left + Tomo	$236.00	$236.00	$60.93–$223.96	—	—
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder Complete Bilateral	$688.00	$688.00	$32.18–$459.00	—	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Right	$459.00	$459.00	$32.18–$459.00	36% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Left	$459.00	$459.00	$32.18–$459.00	36% above	—
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder Complete Bilateral	$688.00	$688.00	$32.18–$459.00	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Left	$459.00	$459.00	$32.18–$459.00	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Right	$459.00	$459.00	$32.18–$459.00	—	—
Sleep study in a lab (polysomnography) CPT 95810 Polysomnography	$4,761.00	$4,761.00	$828.22–$4,470.58	33% above	—
Sleep study in a lab (polysomnography) CPT 95810 Incomplete PSG 95810-52	$4,960.00	$4,960.00	$828.22–$4,470.58	38% above	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysomnography	$4,761.00	$4,761.00	$828.22–$4,470.58	—	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 Incomplete PSG 95810-52	$4,960.00	$4,960.00	$828.22–$4,470.58	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function + Esophogram	$411.00	$411.00	$156.16–$385.93	19% below	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function w/ Video	$411.00	$411.00	$156.16–$385.93	19% below	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR DYSPHASIA STUDY	$428.00	$428.00	$156.16–$385.93	15% below	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function w/ Video	$411.00	$411.00	$156.16–$385.93	—	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function + Esophogram	$411.00	$411.00	$156.16–$385.93	—	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR DYSPHASIA STUDY	$428.00	$428.00	$156.16–$385.93	—	—
Transvaginal pelvic ultrasound CPT 76830 US Abd Pelvis and Transvaginal	$891.00	$891.00	$93.43–$845.56	60% above	—
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal	$891.00	$891.00	$93.43–$845.56	60% above	—
Transvaginal pelvic ultrasound CPT 76830 US Renal Bladder Pelvis and Transvaginal	$891.00	$891.00	$93.43–$845.56	60% above	—
Transvaginal pelvic ultrasound CPT 76830 US Pelvis and Transvaginal	$891.00	$891.00	$93.43–$845.56	60% above	—
Transvaginal pelvic ultrasound CPT 76830 US Abdomen and Transvaginal	$891.00	$891.00	$93.43–$845.56	60% above	—
Transvaginal pelvic ultrasound CPT 76830 NON-OB TRANSVAG US	$891.00	$891.00	$93.43–$845.56	60% above	—
Transvaginal pelvic ultrasound CPT 76830 US Abd Renal Bladder Pel and Transvag	$891.00	$891.00	$93.43–$845.56	60% above	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US Abd Renal Bladder Pel and Transvag	$891.00	$891.00	$93.43–$845.56	—	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal	$891.00	$891.00	$93.43–$845.56	—	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US Renal Bladder Pelvis and Transvaginal	$891.00	$891.00	$93.43–$845.56	—	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US Pelvis and Transvaginal	$891.00	$891.00	$93.43–$845.56	—	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US Abdomen and Transvaginal	$891.00	$891.00	$93.43–$845.56	—	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US Abd Pelvis and Transvaginal	$891.00	$891.00	$93.43–$845.56	—	—
Transvaginal pelvic ultrasound inpatient CPT 76830 NON-OB TRANSVAG US	$891.00	$891.00	$93.43–$845.56	—	—
Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal	$720.00	$720.00	$145.04–$703.00	44% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US OB < 14 and OB Transvaginal	$720.00	$720.00	$145.04–$703.00	44% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US OB < 14 Twins and OB Transvaginal	$720.00	$720.00	$145.04–$703.00	44% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US OB > 14 OB TV w/ Cord Duplex	$720.00	$720.00	$145.04–$703.00	44% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US OB > 14 and OB Transvaginal	$720.00	$720.00	$145.04–$703.00	44% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US BPP w/ Cord Duplex and OB TV	$720.00	$720.00	$145.04–$703.00	44% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US Biophysical Profile and OB Transvag	$720.00	$720.00	$145.04–$703.00	44% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US OB Limited and OB Transvaginal	$720.00	$720.00	$145.04–$703.00	44% above	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Limited and OB Transvaginal	$720.00	$720.00	$145.04–$703.00	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US BPP w/ Cord Duplex and OB TV	$720.00	$720.00	$145.04–$703.00	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Biophysical Profile and OB Transvag	$720.00	$720.00	$145.04–$703.00	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB < 14 Twins and OB Transvaginal	$720.00	$720.00	$145.04–$703.00	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB < 14 and OB Transvaginal	$720.00	$720.00	$145.04–$703.00	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB > 14 OB TV w/ Cord Duplex	$720.00	$720.00	$145.04–$703.00	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB > 14 and OB Transvaginal	$720.00	$720.00	$145.04–$703.00	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal	$720.00	$720.00	$145.04–$703.00	—	—
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Comp w/ Duplex + Elastography	$1,060.00	$1,060.00	$93.44–$1,673.00	69% above	—
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE	$1,673.00	$1,673.00	$93.44–$1,673.00	167% above	—
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$1,673.00	$1,673.00	$93.44–$1,673.00	167% above	—
Ultrasound of the abdomen, complete CPT 76700 US Abdomen and Renal Bladder	$1,673.00	$1,673.00	$93.44–$1,673.00	167% above	—
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE 59	$1,673.00	$1,673.00	$93.44–$1,673.00	167% above	—
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete + Elastography	$1,673.00	$1,673.00	$93.44–$1,673.00	167% above	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Comp w/ Duplex + Elastography	$1,060.00	$1,060.00	$93.44–$1,673.00	—	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US EXAM ABDOM COMPLETE	$1,673.00	$1,673.00	$93.44–$1,673.00	—	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$1,673.00	$1,673.00	$93.44–$1,673.00	—	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen and Renal Bladder	$1,673.00	$1,673.00	$93.44–$1,673.00	—	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US EXAM ABDOM COMPLETE 59	$1,673.00	$1,673.00	$93.44–$1,673.00	—	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete + Elastography	$1,673.00	$1,673.00	$93.44–$1,673.00	—	—
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum and Contents	$974.00	$974.00	$93.81–$1,109.48	82% above	—
Ultrasound of the scrotum and testicles CPT 76870 US Testicular	$1,111.00	$1,111.00	$93.81–$1,109.48	108% above	—
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum and Contents 59	$1,111.00	$1,111.00	$93.81–$1,109.48	108% above	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum and Contents	$974.00	$974.00	$93.81–$1,109.48	—	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Testicular	$1,111.00	$1,111.00	$93.81–$1,109.48	—	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum and Contents 59	$1,111.00	$1,111.00	$93.81–$1,109.48	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue	$1,244.00	$1,244.00	$93.81–$1,244.00	119% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$1,244.00	$1,244.00	$93.81–$1,244.00	119% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue	$1,244.00	$1,244.00	$93.81–$1,244.00	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$1,244.00	$1,244.00	$93.81–$1,244.00	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI	$877.00	$877.00	$162.63–$832.27	48% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI w/ Esophogram	$877.00	$877.00	$162.63–$832.27	48% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI w/ Omni	$877.00	$877.00	$162.63–$832.27	48% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI w/ Small Bowel	$877.00	$877.00	$162.63–$832.27	48% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI w/ Esophogram	$877.00	$877.00	$162.63–$832.27	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI w/ Omni	$877.00	$877.00	$162.63–$832.27	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI	$877.00	$877.00	$162.63–$832.27	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI w/ Small Bowel	$877.00	$877.00	$162.63–$832.27	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VL Venous Evaluation Limited	$259.00	$259.00	$87.18–$259.00	64% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VL Lower Extremity Vein Map Left	$259.00	$259.00	$87.18–$259.00	64% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 IV Extremity Venous Duplex Upper Left	$259.00	$259.00	$87.18–$259.00	64% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VL Lower Extremity Vein Map Right	$259.00	$259.00	$87.18–$259.00	64% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 IV Extremity Venous Duplex Lower Right	$259.00	$259.00	$87.18–$259.00	64% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VL Ext Venous Duplex Lower w/ Reflux Lt	$259.00	$259.00	$87.18–$259.00	64% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VL Ext Venous Duplex Lower w/ Reflux Rt	$259.00	$259.00	$87.18–$259.00	64% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VL Extremity Venous Duplex Lower Left	$259.00	$259.00	$87.18–$259.00	64% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VL Extremity Venous Duplex Upper Right	$259.00	$259.00	$87.18–$259.00	64% below	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VL Venous Evaluation Limited	$259.00	$259.00	$87.18–$259.00	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 IV Extremity Venous Duplex Upper Left	$259.00	$259.00	$87.18–$259.00	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 IV Extremity Venous Duplex Lower Right	$259.00	$259.00	$87.18–$259.00	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VL Ext Venous Duplex Lower w/ Reflux Lt	$259.00	$259.00	$87.18–$259.00	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VL Ext Venous Duplex Lower w/ Reflux Rt	$259.00	$259.00	$87.18–$259.00	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VL Lower Extremity Vein Map Right	$259.00	$259.00	$87.18–$259.00	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VL Extremity Venous Duplex Lower Left	$259.00	$259.00	$87.18–$259.00	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VL Lower Extremity Vein Map Left	$259.00	$259.00	$87.18–$259.00	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VL Extremity Venous Duplex Upper Right	$259.00	$259.00	$87.18–$259.00	—	—
Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Navicular Bilateral	$696.00	$696.00	$32.18–$522.50	—	—
Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist 3 or More Views Bilateral	$696.00	$696.00	$32.18–$522.50	—	—
Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist 3 Views w/ Navicular Bilateral	$696.00	$696.00	$32.18–$522.50	—	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist 3 or More Views Left	$464.00	$464.00	$32.18–$522.50	35% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist 3 or More Views Right	$464.00	$464.00	$32.18–$522.50	35% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist 3 Views w/ Navicular Right	$464.00	$464.00	$32.18–$522.50	35% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Navicular Right	$464.00	$464.00	$32.18–$522.50	35% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist 3 Views w/ Navicular Left	$464.00	$464.00	$32.18–$522.50	35% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Navicular Left	$464.00	$464.00	$32.18–$522.50	35% above	—
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist 3 Views w/ Navicular Bilateral	$696.00	$696.00	$32.18–$522.50	—	—
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Navicular Bilateral	$696.00	$696.00	$32.18–$522.50	—	—
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist 3 or More Views Bilateral	$696.00	$696.00	$32.18–$522.50	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Navicular Right	$464.00	$464.00	$32.18–$522.50	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Navicular Left	$464.00	$464.00	$32.18–$522.50	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist 3 Views w/ Navicular Right	$464.00	$464.00	$32.18–$522.50	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist 3 or More Views Right	$464.00	$464.00	$32.18–$522.50	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist 3 or More Views Left	$464.00	$464.00	$32.18–$522.50	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist 3 Views w/ Navicular Left	$464.00	$464.00	$32.18–$522.50	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Right	$280.00	$280.00	$32.18–$266.00	9% below	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2 Views Left	$280.00	$280.00	$32.18–$266.00	9% below	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2 Views Right	$280.00	$280.00	$32.18–$266.00	9% below	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Left	$280.00	$280.00	$32.18–$266.00	9% below	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Operative 2-3 Views Left	$280.00	$280.00	$32.18–$266.00	9% below	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Operative 2-3 Views Right	$280.00	$280.00	$32.18–$266.00	9% below	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Pelvis/Hip Infant/Child 2or3 Views Lt	$280.00	$280.00	$32.18–$266.00	9% below	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Pelvis/Hip Infant/Child 2or3 Views Rt	$280.00	$280.00	$32.18–$266.00	9% below	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Right	$280.00	$280.00	$32.18–$266.00	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Operative 2-3 Views Right	$280.00	$280.00	$32.18–$266.00	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Left	$280.00	$280.00	$32.18–$266.00	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Pelvis/Hip Infant/Child 2or3 Views Lt	$280.00	$280.00	$32.18–$266.00	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2 Views Right	$280.00	$280.00	$32.18–$266.00	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Pelvis/Hip Infant/Child 2or3 Views Rt	$280.00	$280.00	$32.18–$266.00	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2 Views Left	$280.00	$280.00	$32.18–$266.00	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Operative 2-3 Views Left	$280.00	$280.00	$32.18–$266.00	—	—
X-ray of the abdomen, 1 view CPT 74018 ABD SGL AP VW	$406.00	$406.00	$66.75–$385.70	57% above	—
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen AP	$406.00	$406.00	$66.75–$385.70	57% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen AP	$406.00	$406.00	$66.75–$385.70	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 ABD SGL AP VW	$406.00	$406.00	$66.75–$385.70	—	—
X-ray of the ankle, 2 views both sides CPT 73600 XR Ankle 2 Views Bilateral	$551.00	$551.00	$32.18–$443.00	—	—
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left	$368.00	$368.00	$32.18–$443.00	40% above	—
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right	$368.00	$368.00	$32.18–$443.00	40% above	—
X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR Ankle 2 Views Bilateral	$551.00	$551.00	$32.18–$443.00	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left	$368.00	$368.00	$32.18–$443.00	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right	$368.00	$368.00	$32.18–$443.00	—	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Thumb Right	$404.00	$404.00	$16.09–$483.84	56% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 4th Digit Left	$404.00	$404.00	$16.09–$483.84	56% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 3rd Digit Right	$404.00	$404.00	$16.09–$483.84	56% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 3rd Digit Left	$404.00	$404.00	$16.09–$483.84	56% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 2nd Digit Right	$404.00	$404.00	$16.09–$483.84	56% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 4th Digit Right	$404.00	$404.00	$16.09–$483.84	56% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 5th Digit Left	$404.00	$404.00	$16.09–$483.84	56% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 5th Digit Right	$404.00	$404.00	$16.09–$483.84	56% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Thumb Left	$404.00	$404.00	$16.09–$483.84	56% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 2nd Digit Left	$404.00	$404.00	$16.09–$483.84	56% above	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Thumb Right	$404.00	$404.00	$16.09–$483.84	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 5th Digit Right	$404.00	$404.00	$16.09–$483.84	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Thumb Left	$404.00	$404.00	$16.09–$483.84	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 2nd Digit Left	$404.00	$404.00	$16.09–$483.84	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 4th Digit Left	$404.00	$404.00	$16.09–$483.84	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 2nd Digit Right	$404.00	$404.00	$16.09–$483.84	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 4th Digit Right	$404.00	$404.00	$16.09–$483.84	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 3rd Digit Right	$404.00	$404.00	$16.09–$483.84	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 5th Digit Left	$404.00	$404.00	$16.09–$483.84	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 3rd Digit Left	$404.00	$404.00	$16.09–$483.84	—	—
X-ray of the foot, 2 views both sides CPT 73620 XR Foot 2 Views Bilateral	$551.00	$551.00	$32.18–$389.16	—	—
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right	$368.00	$368.00	$32.18–$389.16	56% above	—
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left	$368.00	$368.00	$32.18–$389.16	56% above	—
X-ray of the foot, 2 views inpatient both sides CPT 73620 XR Foot 2 Views Bilateral	$551.00	$551.00	$32.18–$389.16	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right	$368.00	$368.00	$32.18–$389.16	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left	$368.00	$368.00	$32.18–$389.16	—	—
X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR Foot 3 Views Bilateral	$675.00	$675.00	$32.18–$478.75	—	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot 3 Views Left	$450.00	$450.00	$32.18–$478.75	47% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot 3 Views Right	$450.00	$450.00	$32.18–$478.75	47% above	—
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR Foot 3 Views Bilateral	$675.00	$675.00	$32.18–$478.75	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot 3 Views Right	$450.00	$450.00	$32.18–$478.75	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot 3 Views Left	$450.00	$450.00	$32.18–$478.75	—	—
X-ray of the hand, 3 or more views both sides CPT 73130 XR Hand 3 Views Bilateral	$696.00	$696.00	$16.09–$504.00	—	—
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand 3 Views Right	$464.00	$464.00	$16.09–$504.00	40% above	—
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand 3 Views Left	$464.00	$464.00	$16.09–$504.00	40% above	—
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR Hand 3 Views Bilateral	$696.00	$696.00	$16.09–$504.00	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand 3 Views Left	$464.00	$464.00	$16.09–$504.00	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand 3 Views Right	$464.00	$464.00	$16.09–$504.00	—	—
X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 Views Bilateral	$530.00	$530.00	$16.09–$423.36	—	—
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Right	$353.00	$353.00	$16.09–$423.36	27% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Left	$353.00	$353.00	$16.09–$423.36	27% above	—
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR Knee 1 or 2 Views Bilateral	$530.00	$530.00	$16.09–$423.36	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Right	$353.00	$353.00	$16.09–$423.36	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Left	$353.00	$353.00	$16.09–$423.36	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral Obliques Only	$604.00	$604.00	$66.75–$604.00	84% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$604.00	$604.00	$66.75–$604.00	84% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2/3 Views in OR	$604.00	$604.00	$66.75–$604.00	84% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral Obliques Only	$604.00	$604.00	$66.75–$604.00	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$604.00	$604.00	$66.75–$604.00	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2/3 Views in OR	$604.00	$604.00	$66.75–$604.00	—	—
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Complete	$813.00	$813.00	$35.24–$771.54	73% above	—
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral 4 Views + in OR	$813.00	$813.00	$35.24–$771.54	73% above	—
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral 2/3 Views w/Bending	$813.00	$813.00	$35.24–$771.54	73% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral 2/3 Views w/Bending	$813.00	$813.00	$35.24–$771.54	—	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral 4 Views + in OR	$813.00	$813.00	$35.24–$771.54	—	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Complete	$813.00	$813.00	$35.24–$771.54	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views	$424.00	$424.00	$35.24–$398.14	39% above	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views	$424.00	$424.00	$35.24–$398.14	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Minimum 3 Views	$416.00	$416.00	$67.40–$493.95	42% above	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Minimum 3 Views	$416.00	$416.00	$67.40–$493.95	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical < 4 Views	$604.00	$604.00	$35.92–$573.20	78% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical < 4 Views	$604.00	$604.00	$35.92–$573.20	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views	$268.00	$268.00	$35.24–$254.33	7% above	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views	$268.00	$268.00	$35.24–$254.33	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx Minimum 2 Views	$424.00	$424.00	$35.92–$407.04	43% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx Minimum 2 Views	$424.00	$424.00	$35.92–$407.04	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 AST	$19.00	$19.00	$3.23–$11.00	34% below	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$26.00	$26.00	$3.23–$11.00	10% below	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 AST	$19.00	$19.00	$3.23–$11.00	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$26.00	$26.00	$3.23–$11.00	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase	$39.00	$39.00	$5.08–$36.62	55% above	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase	$39.00	$39.00	$5.08–$36.62	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Profile, Acute	$108.00	$108.00	$17.68–$102.49	49% below	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Profile, Acute	$108.00	$108.00	$17.68–$102.49	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific IgE 2	$13.00	$13.00	$1.10–$322.53	44% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific IgE 3	$13.00	$13.00	$1.10–$322.53	44% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Box Elder-Maple IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Dog Dander IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Cottonwood IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Cockroach IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Cladosporium IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Cat Epithelium IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Bermuda Grass IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Eastern Sycamore IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Elm IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Walnut-Food IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Soybean IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pistachio IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pecan-Food IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Milk IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Hazelnut-Food IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Egg White IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cashew IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Almond IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 White Ash IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Walnut Tree IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Timothy Grass IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Silver Birch IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 House Dust Mites DF IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Aspergillus Fumigatus IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Alternaria Tenuis IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Short Ragweed IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Russion Thistle IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Rough Pigweed IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Red Sorrel IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Penicillium IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 House Dust Mites DP IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Mountain Cedar IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Pecan Hickory IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Oak IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 RPR5 Mulberry IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	23% below	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Specific IgE 3	$13.00	$13.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Specific IgE 2	$13.00	$13.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pistachio IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Cottonwood IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Soybean IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Cockroach IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Walnut-Food IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Elm IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Cladosporium IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Eastern Sycamore IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pecan-Food IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peanut IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Cat Epithelium IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Milk IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Bermuda Grass IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hazelnut-Food IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Box Elder-Maple IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg White IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Red Sorrel IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cashew IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Almond IgE, Serum-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Rough Pigweed IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 White Ash IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Mountain Cedar IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Walnut Tree IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 House Dust Mites DP IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Timothy Grass IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Mulberry IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Silver Birch IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Pecan Hickory IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 House Dust Mites DF IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Aspergillus Fumigatus IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Russion Thistle IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Alternaria Tenuis IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Oak IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Short Ragweed IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Dog Dander IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR5 Penicillium IgE,S-Mayo	$18.00	$18.00	$1.10–$322.53	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Antibody-Mayo	$142.00	$142.00	$12.69–$134.90	145% above	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Antibody-Mayo	$142.00	$142.00	$12.69–$134.90	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody HEp-2 Substrate-Mayo	$133.00	$133.00	$11.85–$127.29	141% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody, S-Mayo	$133.00	$133.00	$11.85–$127.29	141% above	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibody, S-Mayo	$133.00	$133.00	$11.85–$127.29	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibody HEp-2 Substrate-Mayo	$133.00	$133.00	$11.85–$127.29	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Type Natriuretic Peptide	$62.00	$62.00	$16.82–$62.00	59% below	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-Pro B-Type Natriuretic Peptide	$62.00	$62.00	$16.82–$62.00	59% below	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-Pro B-Type Natriuretic Peptide	$62.00	$62.00	$16.82–$62.00	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-Type Natriuretic Peptide	$62.00	$62.00	$16.82–$62.00	—	—
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Profile	$94.00	$94.00	$5.50–$94.04	43% above	—
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Profile	$94.00	$94.00	$5.50–$94.04	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Bone Marrow Biopsy	$531.00	$531.00	$4.07–$986.60	161% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexity	$531.00	$531.00	$4.07–$986.60	161% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Cytology Cell Block	$531.00	$531.00	$4.07–$986.60	161% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 59 AP Bill Surg Path Level IV Complexity	$531.00	$531.00	$4.07–$986.60	161% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 8830559 AP Bill BM Clot Intrp (Tiss Exam Lvl IV)	$531.00	$531.00	$4.07–$986.60	161% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP KBx Bill Surg Level IV - Send Out	$531.00	$531.00	$4.07–$986.60	161% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Cytology Cell Block	$531.00	$531.00	$4.07–$986.60	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 8830559 AP Bill BM Clot Intrp (Tiss Exam Lvl IV)	$531.00	$531.00	$4.07–$986.60	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP KBx Bill Surg Level IV - Send Out	$531.00	$531.00	$4.07–$986.60	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexity	$531.00	$531.00	$4.07–$986.60	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 59 AP Bill Surg Path Level IV Complexity	$531.00	$531.00	$4.07–$986.60	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Bone Marrow Biopsy	$531.00	$531.00	$4.07–$986.60	—	—
Blood culture for bacteria CPT 87040 Culture Blood	$58.00	$58.00	$5.21–$94.42	38% below	—
Blood culture for bacteria inpatient CPT 87040 Culture Blood	$58.00	$58.00	$5.21–$94.42	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 CDM Collections: Venous Draw	$20.00	$20.00	$2.97–$19.00	26% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw	$20.00	$20.00	$2.97–$19.00	26% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE WND	$20.00	$20.00	$2.97–$19.00	26% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture Type -> Venous	$20.00	$20.00	$2.97–$19.00	26% above	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 CDM Collections: Venous Draw	$20.00	$20.00	$2.97–$19.00	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw	$20.00	$20.00	$2.97–$19.00	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE WND	$20.00	$20.00	$2.97–$19.00	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture Type -> Venous	$20.00	$20.00	$2.97–$19.00	—	—
Blood glucose (sugar) test CPT 82947 POC Glucose iStat Capillary	$24.00	$24.00	$2.64–$15.20	2% above	—
Blood glucose (sugar) test CPT 82947 POC Glucose iStat Arterial	$28.00	$28.00	$2.64–$15.20	19% above	—
Blood glucose (sugar) test CPT 82947 Glucose Fasting	$28.00	$28.00	$2.64–$15.20	19% above	—
Blood glucose (sugar) test CPT 82947 Glucose 1 Hour Post Prandial	$28.00	$28.00	$2.64–$15.20	19% above	—
Blood glucose (sugar) test CPT 82947 Gestational Diabetes Screen (ACOG Recommendations)	$28.00	$28.00	$2.64–$15.20	19% above	—
Blood glucose (sugar) test CPT 82947 .Glucose 3 Hour Gest	$28.00	$28.00	$2.64–$15.20	19% above	—
Blood glucose (sugar) test CPT 82947 POC Glucose iStat Venous	$28.00	$28.00	$2.64–$15.20	19% above	—
Blood glucose (sugar) test CPT 82947 Glucose Random	$28.00	$28.00	$2.64–$15.20	19% above	—
Blood glucose (sugar) test CPT 82947 Out of Range Blood Glucose Capillary	$28.00	$28.00	$2.64–$15.20	19% above	—
Blood glucose (sugar) test inpatient CPT 82947 POC Glucose iStat Capillary	$24.00	$24.00	$2.64–$15.20	—	—
Blood glucose (sugar) test inpatient CPT 82947 Glucose Random	$28.00	$28.00	$2.64–$15.20	—	—
Blood glucose (sugar) test inpatient CPT 82947 Out of Range Blood Glucose Capillary	$28.00	$28.00	$2.64–$15.20	—	—
Blood glucose (sugar) test inpatient CPT 82947 Glucose 1 Hour Post Prandial	$28.00	$28.00	$2.64–$15.20	—	—
Blood glucose (sugar) test inpatient CPT 82947 Glucose Fasting	$28.00	$28.00	$2.64–$15.20	—	—
Blood glucose (sugar) test inpatient CPT 82947 POC Glucose iStat Arterial	$28.00	$28.00	$2.64–$15.20	—	—
Blood glucose (sugar) test inpatient CPT 82947 POC Glucose iStat Venous	$28.00	$28.00	$2.64–$15.20	—	—
Blood glucose (sugar) test inpatient CPT 82947 .Glucose 3 Hour Gest	$28.00	$28.00	$2.64–$15.20	—	—
Blood glucose (sugar) test inpatient CPT 82947 Gestational Diabetes Screen (ACOG Recommendations)	$28.00	$28.00	$2.64–$15.20	—	—
Blood lead test CPT 83655 Ur Lead	$76.00	$76.00	$11.87–$76.00	56% above	—
Blood lead test CPT 83655 Lead Capillary Bld with Demographics-Mayo	$76.00	$76.00	$11.87–$76.00	56% above	—
Blood lead test CPT 83655 Lead	$76.00	$76.00	$11.87–$76.00	56% above	—
Blood lead test CPT 83655 Lead Venous Bld with Demographics-Mayo	$76.00	$76.00	$11.87–$76.00	56% above	—
Blood lead test inpatient CPT 83655 Lead	$76.00	$76.00	$11.87–$76.00	—	—
Blood lead test inpatient CPT 83655 Ur Lead	$76.00	$76.00	$11.87–$76.00	—	—
Blood lead test inpatient CPT 83655 Lead Venous Bld with Demographics-Mayo	$76.00	$76.00	$11.87–$76.00	—	—
Blood lead test inpatient CPT 83655 Lead Capillary Bld with Demographics-Mayo	$76.00	$76.00	$11.87–$76.00	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test, Serum, Qual w/Reflex BhCG Quant	$83.00	$83.00	$13.96–$93.09	46% above	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test, Serum, Qualitative	$83.00	$83.00	$13.96–$93.09	46% above	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Test, Serum, Qualitative	$83.00	$83.00	$13.96–$93.09	—	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Test, Serum, Qual w/Reflex BhCG Quant	$83.00	$83.00	$13.96–$93.09	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Baby ABO/Rh	$184.00	$184.00	$16.53–$184.00	222% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO/Rh	$184.00	$184.00	$16.53–$184.00	222% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Type ABO/Rh Typing	$184.00	$184.00	$16.53–$184.00	222% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bill 86900	$184.00	$184.00	$16.53–$184.00	222% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABO/Rh	$184.00	$184.00	$16.53–$184.00	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Baby ABO/Rh	$184.00	$184.00	$16.53–$184.00	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Bill 86900	$184.00	$184.00	$16.53–$184.00	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood Type ABO/Rh Typing	$184.00	$184.00	$16.53–$184.00	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein	$135.00	$135.00	$5.08–$128.25	162% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein	$135.00	$135.00	$5.08–$128.25	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 C. difficile Toxogenic DNA, PCR	$134.00	$134.00	$36.52–$127.30	1% above	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. difficile Toxogenic DNA, PCR	$134.00	$134.00	$36.52–$127.30	—	—
CA 19-9 blood test (tumor marker) CPT 86301 Carbohydrate Ag 19-9 (CA 19-9), S	$82.00	$82.00	$14.32–$77.82	14% above	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Carbohydrate Ag 19-9 (CA 19-9), S	$82.00	$82.00	$14.32–$77.82	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$146.00	$146.00	$20.39–$138.55	56% above	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$146.00	$146.00	$20.39–$138.55	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COV19 Rapid	$142.00	$142.00	$21.24–$133.34	1% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CoV-2 PCR	$142.00	$142.00	$21.24–$133.34	1% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COVID19 RNA Detection-Mayo	$144.00	$144.00	$39.91–$133.34	2% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COV19 Rapid	$142.00	$142.00	$21.24–$133.34	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CoV-2 PCR	$142.00	$142.00	$21.24–$133.34	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COVID19 RNA Detection-Mayo	$144.00	$144.00	$39.91–$133.34	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis DNA	$155.00	$155.00	$19.77–$147.10	66% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis RNA-Mayo	$155.00	$155.00	$19.77–$147.10	66% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis DNA	$155.00	$155.00	$19.77–$147.10	66% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis DNA	$155.00	$155.00	$19.77–$147.10	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis DNA	$155.00	$155.00	$19.77–$147.10	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis RNA-Mayo	$155.00	$155.00	$19.77–$147.10	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$141.00	$141.00	$13.12–$57.82	164% above	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$141.00	$141.00	$13.12–$57.82	—	—
Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/ Differential	$61.00	$61.00	$4.85–$57.28	64% above	—
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/ Differential	$61.00	$61.00	$4.85–$57.28	—	—
Complete blood count (CBC), no differential CPT 85027 Complete Blood Count without Diff	$72.00	$72.00	$6.34–$83.59	118% above	—
Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count without Diff	$72.00	$72.00	$6.34–$83.59	—	—
Comprehensive metabolic panel (blood test) CPT 80053 CMP	$117.00	$117.00	$6.79–$109.86	84% above	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP	$117.00	$117.00	$6.79–$109.86	—	—
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer Reflex ONLY, Plasma-Mayo	$20.36	$20.36	$9.98–$158.40	72% below	—
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer	$132.00	$132.00	$9.98–$158.40	83% above	—
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer-Mayo	$132.00	$132.00	$9.98–$158.40	83% above	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer Reflex ONLY, Plasma-Mayo	$20.36	$20.36	$9.98–$158.40	—	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer	$132.00	$132.00	$9.98–$158.40	—	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer-Mayo	$132.00	$132.00	$9.98–$158.40	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate-Mayo	$153.00	$153.00	$13.06–$145.20	54% above	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone Sulfate-Mayo	$153.00	$153.00	$13.06–$145.20	—	—
Estradiol blood test CPT 82670 Estradiol Level	$290.00	$290.00	$12.93–$275.50	159% above	—
Estradiol blood test inpatient CPT 82670 Estradiol Level	$290.00	$290.00	$12.93–$275.50	—	—
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone Level	$159.00	$159.00	$12.93–$152.64	85% above	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone Level	$159.00	$159.00	$12.93–$152.64	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Stool	$380.00	$380.00	$11.48–$451.20	154% above	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Stool	$380.00	$380.00	$11.48–$451.20	—	—
Ferritin blood test (iron stores) CPT 82728 Ferritin	$96.00	$96.00	$10.67–$108.48	26% above	—
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$96.00	$96.00	$10.67–$108.48	—	—
Folate (folic acid) blood test CPT 82746 Folate Level	$110.00	$110.00	$10.77–$104.39	64% above	—
Folate (folic acid) blood test CPT 82746 Vitamin B12 and Folate	$110.00	$110.00	$10.77–$104.39	64% above	—
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$110.00	$110.00	$10.77–$104.39	—	—
Folate (folic acid) blood test inpatient CPT 82746 Vitamin B12 and Folate	$110.00	$110.00	$10.77–$104.39	—	—
Free T3 thyroid hormone test CPT 84481 Free T3.	$144.00	$144.00	$16.60–$136.66	97% above	—
Free T3 thyroid hormone test inpatient CPT 84481 Free T3.	$144.00	$144.00	$16.60–$136.66	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4	$87.00	$87.00	$5.82–$48.96	109% above	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4	$87.00	$87.00	$5.82–$48.96	—	—
Free testosterone test CPT 84402 Testosterone, Free, Direct-LabCorp	$110.00	$110.00	$13.06–$104.50	16% above	—
Free testosterone test CPT 84402 Testosterone, Total and Free - Mayo	$110.00	$110.00	$13.06–$104.50	16% above	—
Free testosterone test CPT 84402 Testosterone Free-Mayo	$110.00	$110.00	$13.06–$104.50	16% above	—
Free testosterone test inpatient CPT 84402 Testosterone, Free, Direct-LabCorp	$110.00	$110.00	$13.06–$104.50	—	—
Free testosterone test inpatient CPT 84402 Testosterone Free-Mayo	$110.00	$110.00	$13.06–$104.50	—	—
Free testosterone test inpatient CPT 84402 Testosterone, Total and Free - Mayo	$110.00	$110.00	$13.06–$104.50	—	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 .General Health Panel 80050 Charge ONLY	$71.00	$71.00	$23.90–$66.67	67% below	—
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 .General Health Panel 80050 Charge ONLY	$71.00	$71.00	$23.90–$66.67	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hour Postprandial	$39.00	$39.00	$6.91–$9.39	11% above	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 Hour Postprandial	$39.00	$39.00	$6.91–$9.39	—	—
Glucose tolerance test, 3 samples CPT 82951 .Glucose Baseline Gest ADA	$142.00	$142.00	$6.26–$24.70	111% above	—
Glucose tolerance test, 3 samples CPT 82951 .Glucose Baseline	$142.00	$142.00	$6.26–$24.70	111% above	—
Glucose tolerance test, 3 samples CPT 82951 .Glucose Baseline Gest	$142.00	$142.00	$6.26–$24.70	111% above	—
Glucose tolerance test, 3 samples inpatient CPT 82951 .Glucose Baseline Gest	$142.00	$142.00	$6.26–$24.70	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 .Glucose Baseline	$142.00	$142.00	$6.26–$24.70	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 .Glucose Baseline Gest ADA	$142.00	$142.00	$6.26–$24.70	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae RNA-Mayo	$129.00	$129.00	$20.35–$122.42	39% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonorrhea, DNA	$129.00	$129.00	$20.35–$122.42	39% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria gonorrhoeae RNA-Mayo	$129.00	$129.00	$20.35–$122.42	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonorrhea, DNA	$129.00	$129.00	$20.35–$122.42	—	—
H. pylori stool antigen test CPT 87338 Helicobacter pylori Antigen	$159.00	$159.00	$14.09–$181.42	128% above	—
H. pylori stool antigen test inpatient CPT 87338 Helicobacter pylori Antigen	$159.00	$159.00	$14.09–$181.42	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA Detection and Quantification-Mayo	$340.00	$340.00	$39.53–$322.66	5% below	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA Detection and Quantification-Mayo	$340.00	$340.00	$39.53–$322.66	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Rapid HIV 1/2 Ab-Agn Screen	$130.00	$130.00	$19.76–$122.07	76% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 and HIV-2 Ab, p24 Ag Screen	$130.00	$130.00	$9.43–$46.06	76% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 and HIV-2 Ab, p24 Ag Screen	$130.00	$130.00	$9.43–$46.06	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Rapid HIV 1/2 Ab-Agn Screen	$130.00	$130.00	$19.76–$122.07	—	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA Scrn and Genotype-LabCorp	$127.00	$127.00	$34.39–$148.99	7% above	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA Screen-LabCorp	$157.00	$157.00	$34.39–$148.99	33% above	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA Amplification Screen	$157.00	$157.00	$34.39–$148.99	33% above	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA Scrn and Genotype-LabCorp	$127.00	$127.00	$34.39–$148.99	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA Amplification Screen	$157.00	$157.00	$34.39–$148.99	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA Screen-LabCorp	$157.00	$157.00	$34.39–$148.99	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c	$39.00	$39.00	$6.14–$18.03	15% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c with Reflex Fructosamine	$39.00	$39.00	$6.14–$18.03	15% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c	$39.00	$39.00	$6.14–$18.03	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c with Reflex Fructosamine	$39.00	$39.00	$6.14–$18.03	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody	$138.00	$138.00	$10.53–$163.38	187% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody Quantitative	$138.00	$138.00	$10.53–$163.38	187% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Profile	$138.00	$138.00	$10.53–$163.38	187% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody Quantitative	$138.00	$138.00	$10.53–$163.38	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody	$138.00	$138.00	$10.53–$163.38	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Profile	$138.00	$138.00	$10.53–$163.38	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen, Serum REFLEX ONLY-Mayo	$114.00	$114.00	$10.07–$18.98	146% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$114.00	$114.00	$4.13–$21.00	146% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis Profile, Chronic	$114.00	$114.00	$4.13–$21.00	146% above	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$114.00	$114.00	$4.13–$21.00	—	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis Profile, Chronic	$114.00	$114.00	$4.13–$21.00	—	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen, Serum REFLEX ONLY-Mayo	$114.00	$114.00	$10.07–$18.98	—	—
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody	$157.00	$157.00	$5.70–$28.64	145% above	—
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Ab w/reflex HCV RNA Qnt, PCR	$157.00	$157.00	$5.70–$28.64	145% above	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Ab w/reflex HCV RNA Qnt, PCR	$157.00	$157.00	$5.70–$28.64	—	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody	$157.00	$157.00	$5.70–$28.64	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA Quant, Blood	$187.00	$187.00	$41.73–$187.00	3% below	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA Quant, Blood	$187.00	$187.00	$41.73–$187.00	—	—
Herpes blood test, HSV-1 antibody CPT 86695 HSV Type 1 IgG	$63.00	$63.00	$12.93–$90.00	7% above	—
Herpes blood test, HSV-1 antibody CPT 86695 Herpes simplex Type 1 IgG-Mayo	$90.00	$90.00	$12.93–$90.00	52% above	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV Type 1 IgG	$63.00	$63.00	$12.93–$90.00	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes simplex Type 1 IgG-Mayo	$90.00	$90.00	$12.93–$90.00	—	—
Herpes blood test, HSV-2 antibody CPT 86696 HSV Type 2 IgG	$91.00	$91.00	$14.32–$101.54	37% above	—
Herpes blood test, HSV-2 antibody CPT 86696 Herpes simplex Type 2 IgG-Mayo	$107.00	$107.00	$14.32–$101.54	61% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV Type 2 IgG	$91.00	$91.00	$14.32–$101.54	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes simplex Type 2 IgG-Mayo	$107.00	$107.00	$14.32–$101.54	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 High Sensitivity C-Reactive Protein	$117.00	$117.00	$12.69–$111.15	73% above	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 High Sensitivity C-Reactive Protein	$117.00	$117.00	$12.69–$111.15	—	—
Homocysteine blood test CPT 83090 Homocysteine,Total,S-Mayo	$121.00	$121.00	$13.92–$121.00	50% above	—
Homocysteine blood test inpatient CPT 83090 Homocysteine,Total,S-Mayo	$121.00	$121.00	$13.92–$121.00	—	—
Insulin blood test CPT 83525 Insulin Level	$120.00	$120.00	$11.20–$113.88	134% above	—
Insulin blood test CPT 83525 .Insulin 1 Hour	$120.00	$120.00	$11.20–$113.88	134% above	—
Insulin blood test CPT 83525 Insulin Fasting	$120.00	$120.00	$11.20–$113.88	134% above	—
Insulin blood test CPT 83525 .Insulin Fasting	$120.00	$120.00	$11.20–$113.88	134% above	—
Insulin blood test CPT 83525 .Insulin 2 Hour	$120.00	$120.00	$11.20–$113.88	134% above	—
Insulin blood test CPT 83525 .Insulin 3 Hour	$120.00	$120.00	$11.20–$113.88	134% above	—
Insulin blood test inpatient CPT 83525 .Insulin 2 Hour	$120.00	$120.00	$11.20–$113.88	—	—
Insulin blood test inpatient CPT 83525 .Insulin 1 Hour	$120.00	$120.00	$11.20–$113.88	—	—
Insulin blood test inpatient CPT 83525 .Insulin 3 Hour	$120.00	$120.00	$11.20–$113.88	—	—
Insulin blood test inpatient CPT 83525 .Insulin Fasting	$120.00	$120.00	$11.20–$113.88	—	—
Insulin blood test inpatient CPT 83525 Insulin Fasting	$120.00	$120.00	$11.20–$113.88	—	—
Insulin blood test inpatient CPT 83525 Insulin Level	$120.00	$120.00	$11.20–$113.88	—	—
Iron blood test (serum iron) CPT 83540 Iron Level	$44.00	$44.00	$6.34–$41.80	16% above	—
Iron blood test (serum iron) CPT 83540 TIBC	$44.00	$44.00	$6.34–$41.80	16% above	—
Iron blood test (serum iron) inpatient CPT 83540 TIBC	$44.00	$44.00	$6.34–$41.80	—	—
Iron blood test (serum iron) inpatient CPT 83540 Iron Level	$44.00	$44.00	$6.34–$41.80	—	—
Kidney function blood test panel CPT 80069 Renal Panel	$95.00	$95.00	$8.51–$89.21	30% above	—
Kidney function blood test panel inpatient CPT 80069 Renal Panel	$95.00	$95.00	$8.51–$89.21	—	—
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$154.00	$154.00	$13.06–$147.84	61% above	—
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone	$154.00	$154.00	$13.06–$147.84	—	—
Lipase blood test (pancreas enzyme) CPT 83690 Lipase, Body Fluid	$75.00	$75.00	$7.22–$73.50	29% above	—
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$75.00	$75.00	$7.22–$73.50	29% above	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase, Body Fluid	$75.00	$75.00	$7.22–$73.50	—	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level	$75.00	$75.00	$7.22–$73.50	—	—
Liver function blood test panel CPT 80076 Hep Func Panel	$115.00	$115.00	$8.01–$134.42	84% above	—
Liver function blood test panel inpatient CPT 80076 Hep Func Panel	$115.00	$115.00	$8.01–$134.42	—	—
Lyme disease antibody test CPT 86618 Lyme Disease Serology-Mayo	$130.00	$130.00	$14.60–$123.37	69% above	—
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Serology-Mayo	$130.00	$130.00	$14.60–$123.37	—	—
Magnesium blood test CPT 83735 Magnesium, 24 Hour, Urine	$25.00	$25.00	$6.57–$23.73	26% below	—
Magnesium blood test CPT 83735 Magnesium Level	$25.00	$25.00	$6.57–$23.73	26% below	—
Magnesium blood test CPT 83735 Magnesium, Random, Urine	$25.00	$25.00	$6.57–$23.73	26% below	—
Magnesium blood test CPT 83735 Magnesium,Fecal-Mayo	$25.00	$25.00	$6.57–$23.73	26% below	—
Magnesium blood test inpatient CPT 83735 Magnesium Level	$25.00	$25.00	$6.57–$23.73	—	—
Magnesium blood test inpatient CPT 83735 Magnesium, 24 Hour, Urine	$25.00	$25.00	$6.57–$23.73	—	—
Magnesium blood test inpatient CPT 83735 Magnesium, Random, Urine	$25.00	$25.00	$6.57–$23.73	—	—
Magnesium blood test inpatient CPT 83735 Magnesium,Fecal-Mayo	$25.00	$25.00	$6.57–$23.73	—	—
Measles (rubeola) antibody test CPT 86765 Measles IgG Antibody	$81.00	$81.00	$12.62–$95.00	42% above	—
Measles (rubeola) antibody test inpatient CPT 86765 Measles IgG Antibody	$81.00	$81.00	$12.62–$95.00	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Test w Reflex EBV Ab Profile	$93.00	$93.00	$13.97–$109.04	79% above	—
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Test	$93.00	$93.00	$13.97–$109.04	79% above	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Test	$93.00	$93.00	$13.97–$109.04	—	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Test w Reflex EBV Ab Profile	$93.00	$93.00	$13.97–$109.04	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Free PSA	$42.00	$42.00	$18.02–$35.15	49% below	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Free PSA	$42.00	$42.00	$18.02–$35.15	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate-Specific Antigen (PSA), Total, Screen	$117.00	$117.00	$11.97–$35.15	48% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate-Specific Antigen (PSA), Total and Free	$117.00	$117.00	$18.02–$35.15	48% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate-Specific Antigen (PSA), Total, Diagnostic	$117.00	$117.00	$18.02–$35.15	48% above	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate-Specific Antigen (PSA), Total and Free	$117.00	$117.00	$18.02–$35.15	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate-Specific Antigen (PSA), Total, Screen	$117.00	$117.00	$11.97–$35.15	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate-Specific Antigen (PSA), Total, Diagnostic	$117.00	$117.00	$18.02–$35.15	—	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 88142 AP Bill Gyn Cytology Liquid Prep	$142.00	$142.00	$17.96–$142.00	56% above	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 88142 AP Bill Gyn Cytology Liquid Prep	$142.00	$142.00	$17.96–$142.00	—	—
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact	$110.00	$110.00	$29.75–$103.29	22% below	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact with Minerals	$110.00	$110.00	$29.75–$103.29	22% below	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact	$110.00	$110.00	$29.75–$103.29	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact with Minerals	$110.00	$110.00	$29.75–$103.29	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Lupus Anticoag APTT	$12.02	$12.02	$5.91–$37.96	68% below	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$40.00	$40.00	$5.91–$37.96	8% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT Mixing Studies	$40.00	$40.00	$5.91–$37.96	8% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$40.00	$40.00	$5.91–$37.96	8% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT-Mayo	$40.00	$40.00	$5.91–$37.96	8% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Lupus Anticoag APTT	$12.02	$12.02	$5.91–$37.96	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT-Mayo	$40.00	$40.00	$5.91–$37.96	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$40.00	$40.00	$5.91–$37.96	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$40.00	$40.00	$5.91–$37.96	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT Mixing Studies	$40.00	$40.00	$5.91–$37.96	—	—
Progesterone blood test CPT 84144 Progesterone Level	$108.00	$108.00	$13.06–$126.90	34% above	—
Progesterone blood test inpatient CPT 84144 Progesterone Level	$108.00	$108.00	$13.06–$126.90	—	—
Prolactin blood test CPT 84146 Prolactin Level	$214.00	$214.00	$12.93–$240.64	146% above	—
Prolactin blood test inpatient CPT 84146 Prolactin Level	$214.00	$214.00	$12.93–$240.64	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 Lupus Anticoag PT	$8.58	$8.58	$4.20–$28.00	64% below	—
Prothrombin time (PT/INR) clotting test CPT 85610 PT-Mayo	$27.00	$27.00	$4.20–$28.00	12% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 Coagucheck Serial Number	$27.00	$27.00	$4.20–$28.00	12% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 Protime Mixing Studies	$27.00	$27.00	$4.20–$28.00	12% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time	$27.00	$27.00	$4.20–$28.00	12% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PT	$27.00	$27.00	$4.20–$28.00	12% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 85610 AMB PTINR (Coumadin Clinic) Prothrombin time;	$27.00	$27.00	$4.20–$28.00	12% above	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Lupus Anticoag PT	$8.58	$8.58	$4.20–$28.00	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT-Mayo	$27.00	$27.00	$4.20–$28.00	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time	$27.00	$27.00	$4.20–$28.00	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT	$27.00	$27.00	$4.20–$28.00	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 AMB PTINR (Coumadin Clinic) Prothrombin time;	$27.00	$27.00	$4.20–$28.00	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Coagucheck Serial Number	$27.00	$27.00	$4.20–$28.00	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Protime Mixing Studies	$27.00	$27.00	$4.20–$28.00	—	—
Rapid flu test (influenza antigen) CPT 87804 Influenza A Antigen	$46.00	$46.00	$12.78–$38.40	30% below	—
Rapid flu test (influenza antigen) CPT 87804 Influenza B Antigen	$46.00	$46.00	$12.78–$38.40	30% below	—
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza B Antigen	$46.00	$46.00	$12.78–$38.40	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A Antigen	$46.00	$46.00	$12.78–$38.40	—	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor, Serum	$48.00	$48.00	$5.56–$45.60	45% above	—
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor, Serum	$48.00	$48.00	$5.56–$45.60	—	—
Rubella antibody test (immunity check) CPT 86762 Rubella IgG Antibody	$134.00	$134.00	$14.10–$134.00	176% above	—
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgG Antibody	$134.00	$134.00	$14.10–$134.00	—	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Analysis	$136.00	$136.00	$19.70–$143.04	2% above	—
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Semen Analysis	$136.00	$136.00	$19.70–$143.04	—	—
Stool ova and parasites exam CPT 87177 Ova and Parasite, Travel History or Immunocompromised, Feces-Mayo	$91.00	$91.00	$8.72–$85.45	130% above	—
Stool ova and parasites exam inpatient CPT 87177 Ova and Parasite, Travel History or Immunocompromised, Feces-Mayo	$91.00	$91.00	$8.72–$85.45	—	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood, Immunochemical, Stool	$69.00	$69.00	$10.98–$64.79	29% above	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 .Occult Blood 2	$69.00	$69.00	$10.98–$64.79	29% above	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 .Occult blood 3	$69.00	$69.00	$10.98–$64.79	29% above	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 .Occult Blood 2	$69.00	$69.00	$10.98–$64.79	—	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood, Immunochemical, Stool	$69.00	$69.00	$10.98–$64.79	—	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 .Occult blood 3	$69.00	$69.00	$10.98–$64.79	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL Screen CSF-Mayo	$47.00	$47.00	$4.18–$51.70	95% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Screen	$47.00	$47.00	$4.18–$51.70	95% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL Screen CSF-Mayo	$47.00	$47.00	$4.18–$51.70	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Screen	$47.00	$47.00	$4.18–$51.70	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus,Blood	$249.00	$249.00	$33.69–$236.30	99% above	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus,Blood	$249.00	$249.00	$33.69–$236.30	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total	$123.00	$123.00	$13.06–$130.15	33% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total	$137.00	$137.00	$13.06–$130.15	49% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Level Total	$137.00	$137.00	$13.06–$130.15	49% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Total	$123.00	$123.00	$13.06–$130.15	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Level Total	$137.00	$137.00	$13.06–$130.15	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total	$137.00	$137.00	$13.06–$130.15	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Anti-Thyroid Peroxidase IgG-Mayo	$90.00	$90.00	$14.18–$103.68	38% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 TAP Thyroperoxidase Ab-Mayo	$108.00	$108.00	$14.18–$103.68	66% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroperoxidase Antibody-Mayo	$108.00	$108.00	$14.18–$103.68	66% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver/Kidney Microsome 1 Ab,S-Mayo	$108.00	$108.00	$14.18–$103.68	66% above	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Anti-Thyroid Peroxidase IgG-Mayo	$90.00	$90.00	$14.18–$103.68	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 TAP Thyroperoxidase Ab-Mayo	$108.00	$108.00	$14.18–$103.68	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver/Kidney Microsome 1 Ab,S-Mayo	$108.00	$108.00	$14.18–$103.68	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroperoxidase Antibody-Mayo	$108.00	$108.00	$14.18–$103.68	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (Thyrotropin)-Mayo	$131.00	$131.00	$11.00–$124.44	74% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$135.00	$135.00	$11.00–$124.44	80% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH with Reflex Free T4	$135.00	$135.00	$11.00–$124.44	80% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH with Reflex Total T4	$135.00	$135.00	$11.00–$124.44	80% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (Thyrotropin)-Mayo	$131.00	$131.00	$11.00–$124.44	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH with Reflex Free T4	$135.00	$135.00	$11.00–$124.44	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$135.00	$135.00	$11.00–$124.44	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH with Reflex Total T4	$135.00	$135.00	$11.00–$124.44	—	—
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis, Amplified RNA-Mayo	$114.00	$114.00	$40.69–$108.19	32% above	—
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis, Amplified RNA-Mayo	$114.00	$114.00	$40.69–$108.19	—	—
Uric acid blood test CPT 84550 Uric Acid	$24.00	$24.00	$4.43–$22.80	32% below	—
Uric acid blood test CPT 84550 Uric Acid Level (Rasburicase - Elitek)	$24.00	$24.00	$4.43–$22.80	32% below	—
Uric acid blood test inpatient CPT 84550 Uric Acid	$24.00	$24.00	$4.43–$22.80	—	—
Uric acid blood test inpatient CPT 84550 Uric Acid Level (Rasburicase - Elitek)	$24.00	$24.00	$4.43–$22.80	—	—
Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Culture, if indicated	$25.00	$25.00	$2.94–$23.48	7% below	—
Urinalysis with microscope exam, automated CPT 81001 Routine Urinalysis without Culture, Manual	$25.00	$25.00	$2.94–$23.48	7% below	—
Urinalysis with microscope exam, automated CPT 81001 Routine Urinalysis without Culture	$25.00	$25.00	$2.94–$23.48	7% below	—
Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Culture if Ind Manual	$25.00	$25.00	$2.94–$23.48	7% below	—
Urinalysis with microscope exam, automated inpatient CPT 81001 Routine Urinalysis without Culture	$25.00	$25.00	$2.94–$23.48	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Culture, if indicated	$25.00	$25.00	$2.94–$23.48	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Culture if Ind Manual	$25.00	$25.00	$2.94–$23.48	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 Routine Urinalysis without Culture, Manual	$25.00	$25.00	$2.94–$23.48	—	—
Urinalysis without microscope exam, automated CPT 81003 Specific Gravity, Urine	$9.00	$9.00	$1.96–$3.80	62% below	—
Urinalysis without microscope exam, automated CPT 81003 pH, 24 Hour, Urine	$9.00	$9.00	$1.96–$3.80	62% below	—
Urinalysis without microscope exam, automated CPT 81003 Urine Dipstick	$9.00	$9.00	$1.96–$3.80	62% below	—
Urinalysis without microscope exam, automated inpatient CPT 81003 pH, 24 Hour, Urine	$9.00	$9.00	$1.96–$3.80	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity, Urine	$9.00	$9.00	$1.96–$3.80	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Dipstick	$9.00	$9.00	$1.96–$3.80	—	—
Urine culture for bacteria, with colony count CPT 87086 Urine Colony Count	$56.00	$56.00	$7.91–$53.14	2% below	—
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Colony Count	$56.00	$56.00	$7.91–$53.14	—	—
Urine pregnancy test, read by color change CPT 81025 Pregnancy Test, Urine, Qualitative	$95.00	$95.00	$7.57–$102.60	95% above	—
Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy Test, Urine, Qualitative	$95.00	$95.00	$7.57–$102.60	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level	$122.00	$122.00	$13.31–$115.78	65% above	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level	$122.00	$122.00	$13.31–$115.78	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy Total	$168.00	$168.00	$19.08–$56.99	83% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25-Hydroxy Total	$168.00	$168.00	$19.08–$56.99	—	—
Zinc blood test CPT 84630 Zinc Level-Mayo	$63.00	$63.00	$11.16–$59.79	23% above	—
Zinc blood test inpatient CPT 84630 Zinc Level-Mayo	$63.00	$63.00	$11.16–$59.79	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Human Chorionic Gonadotropin Quantitative (Fertility)	$153.00	$153.00	$23.33–$156.04	126% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta HCG Quantitative (Tumor Marker)-Mayo	$153.00	$153.00	$23.33–$156.04	126% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG Total	$153.00	$153.00	$23.33–$156.04	126% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta hCG Quantitative (Fertility) w/Rflx Progesterone	$153.00	$153.00	$23.33–$156.04	126% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG Total	$153.00	$153.00	$23.33–$156.04	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta hCG Quantitative (Fertility) w/Rflx Progesterone	$153.00	$153.00	$23.33–$156.04	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta Human Chorionic Gonadotropin Quantitative (Fertility)	$153.00	$153.00	$23.33–$156.04	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta HCG Quantitative (Tumor Marker)-Mayo	$153.00	$153.00	$23.33–$156.04	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Botox injections for chronic migraine CPT 64615 PM Neurolysis with Botox (muscle/migraine)	$542.00	$542.00	$178.86–$518.40	4% below	—
Botox injections for chronic migraine CPT 64615 64615 AMB Chemodenervation muscle innervated facial trigeminal cervical spinal accessory nerves BIL	$813.00	$813.00	$178.86–$518.40	44% above	—
Botox injections for chronic migraine inpatient CPT 64615 PM Neurolysis with Botox (muscle/migraine)	$542.00	$542.00	$178.86–$518.40	—	—
Botox injections for chronic migraine inpatient CPT 64615 64615 AMB Chemodenervation muscle innervated facial trigeminal cervical spinal accessory nerves BIL	$813.00	$813.00	$178.86–$518.40	—	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Affirm Biopsy Left	$6,009.00	$6,009.00	$1,280.31–$6,009.00	50% above	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Stereotactic Biopsy Left	$6,009.00	$6,009.00	$1,280.31–$6,009.00	50% above	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Stereotactic Biopsy Right	$6,009.00	$6,009.00	$1,280.31–$6,009.00	50% above	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Affirm Biopsy Right	$6,009.00	$6,009.00	$1,280.31–$6,009.00	50% above	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Affirm Biopsy Left	$6,009.00	$6,009.00	$1,280.31–$6,009.00	—	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Stereotactic Biopsy Right	$6,009.00	$6,009.00	$1,280.31–$6,009.00	—	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Stereotactic Biopsy Left	$6,009.00	$6,009.00	$1,280.31–$6,009.00	—	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Affirm Biopsy Right	$6,009.00	$6,009.00	$1,280.31–$6,009.00	—	—
Cardiac catheterization with coronary angiogram one side CPT 93458 Left Heart Cath W/ LV	$17,625.00	$17,625.00	$2,356.85–$16,920.00	47% above	—
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 Left Heart Cath W/ LV	$17,625.00	$17,625.00	$2,356.85–$16,920.00	—	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 ED Procedure Performed -> Cardioversion	$2,366.00	$2,366.00	$502.89–$2,221.67	15% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Charge -> Yes	$2,366.00	$2,366.00	$1,012.83–$2,221.67	15% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Cath Lab	$2,366.00	$2,366.00	$471.87–$2,221.67	15% above	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ED Procedure Performed -> Cardioversion	$2,366.00	$2,366.00	$502.89–$2,221.67	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Cath Lab	$2,366.00	$2,366.00	$471.87–$2,221.67	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Charge -> Yes	$2,366.00	$2,366.00	$1,012.83–$2,221.67	—	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision Charge -> Yes	$1,466.00	$1,466.00	$1,150.81–$1,376.57	23% below	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision Charge -> Yes	$1,466.00	$1,466.00	$1,150.81–$1,376.57	—	—
Coronary stent placement, one artery CPT 92928 PTCA & Stent Initial Vessel BM Stent	$27,110.00	$27,110.00	$18,635.01–$26,025.60	110% above	—
Coronary stent placement, one artery CPT 92928 PTCA and Stent Initial Vessel De Stent	$27,110.00	$27,110.00	$10,351.09–$26,025.60	110% above	—
Coronary stent placement, one artery inpatient CPT 92928 PTCA & Stent Initial Vessel BM Stent	$27,110.00	$27,110.00	$18,635.01–$26,025.60	—	—
Coronary stent placement, one artery inpatient CPT 92928 PTCA and Stent Initial Vessel De Stent	$27,110.00	$27,110.00	$10,351.09–$26,025.60	—	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$984.00	$984.00	$582.92	51% below	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$984.00	$984.00	$582.92	—	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 Foreign Body Removal Site -> Cerumen, Impaction Irrigation	$232.00	$232.00	$62.74–$217.85	50% above	—
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE, UNILATERAL	$232.00	$232.00	$62.74–$217.85	50% above	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Foreign Body Removal Site -> Cerumen, Impaction Irrigation	$232.00	$232.00	$62.74–$217.85	—	—
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE, UNILATERAL	$232.00	$232.00	$62.74–$217.85	—	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 62321 PM Cervical/Thoracic epidural steroid injection	$1,598.00	$1,598.00	$522.69–$1,598.00	28% below	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 62321 PM Cervical/Thoracic epidural steroid injection	$1,598.00	$1,598.00	$522.69–$1,598.00	—	—
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 64493-50 PM Lumbar/Sacral Facet Injection 1st Level Bilateral	$3,321.00	$3,321.00	$247.95–$2,670.09	—	—
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 64493-50 PM Lumbar/Sacral Dorsal Medial Branch Block 1st Level Bilateral	$3,321.00	$3,321.00	$247.95–$2,670.09	—	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 64493 PM Lumbar/Sacral Facet Injection 1st Level	$2,214.00	$2,214.00	$247.95–$2,670.09	1% above	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 64493 PM Lumbar/Sacral Dorsal Medial Branch Block 1st Level	$2,214.00	$2,214.00	$247.95–$2,670.09	1% above	—
Facet joint injection, lower back, one level, with imaging guidance inpatient both sides CPT 64493 64493-50 PM Lumbar/Sacral Facet Injection 1st Level Bilateral	$3,321.00	$3,321.00	$247.95–$2,670.09	—	—
Facet joint injection, lower back, one level, with imaging guidance inpatient both sides CPT 64493 64493-50 PM Lumbar/Sacral Dorsal Medial Branch Block 1st Level Bilateral	$3,321.00	$3,321.00	$247.95–$2,670.09	—	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 64493 PM Lumbar/Sacral Facet Injection 1st Level	$2,214.00	$2,214.00	$247.95–$2,670.09	—	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 64493 PM Lumbar/Sacral Dorsal Medial Branch Block 1st Level	$2,214.00	$2,214.00	$247.95–$2,670.09	—	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HYSTEROGR/SIS CONTR/SALINE INJ	$878.00	$878.00	$79.30–$789.59	130% above	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HYSTEROGR/SIS CONTR/SALINE INJ	$878.00	$878.00	$79.30–$789.59	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Abscess Simple or Single -> Yes	$380.00	$380.00	$181.52–$198.40	1% below	—
Incision and drainage of a simple or single skin abscess CPT 10060 ID Body Site -> I&D Abscess/Cyst/Hematoma Single	$380.00	$380.00	$178.40–$380.00	1% below	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSC; SMPL OR SGL WND	$380.00	$380.00	$181.52–$198.40	1% below	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ID Body Site -> I&D Abscess/Cyst/Hematoma Single	$380.00	$380.00	$178.40–$380.00	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSC; SMPL OR SGL WND	$380.00	$380.00	$181.52–$198.40	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Abscess Simple or Single -> Yes	$380.00	$380.00	$181.52–$198.40	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 Sacroiliac joint injection Bilateral POC	$602.00	$602.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 PM Sacroiliac Joint Injection; bilat	$722.00	$722.00	$162.65–$722.00	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 20610-50 PM Hip Injection Bilateral	$865.00	$865.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 20610-50 PM Bursa Injection Large Bilateral	$865.00	$865.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 20610-50 PM Shoulder Injection Bilateral	$865.00	$865.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 2061050 AMB Large joint injection bilateral	$865.00	$865.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 20610-50 PM Knee Injection Bilateral	$865.00	$865.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 PM Large Joint Injectiong; bilat	$865.00	$865.00	$162.65–$722.00	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ MAJOR JNT/BURSA	$481.00	$481.00	$118.19–$548.15	31% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PM sacroiliac joint injection	$481.00	$481.00	$162.65–$722.00	31% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 AMB Sacroiliac joint injection POC	$481.00	$481.00	$118.19–$548.15	31% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PM large joint injection	$577.00	$577.00	$162.65–$722.00	17% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 PM Knee Injection	$577.00	$577.00	$118.19–$548.15	17% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 PM Shoulder Injection	$577.00	$577.00	$118.19–$548.15	17% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 PM Bursa injection large	$577.00	$577.00	$118.19–$548.15	17% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 PM Hip Injection	$577.00	$577.00	$118.19–$548.15	17% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspiration Body Site -> Knee	$577.00	$577.00	$268.56–$541.80	17% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 AMB Large joint injection	$577.00	$577.00	$118.19–$548.15	17% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ MAJOR JNT/BURSA 50	$865.00	$865.00	$118.19–$548.15	24% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 DRAIN/INJ MAJOR JNT/BURSA RT	$577.00	$577.00	$118.19–$548.15	17% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 DRAIN/INJ MAJOR JNT/BURSA LT	$577.00	$577.00	$118.19–$548.15	17% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 Sacroiliac joint injection Bilateral POC	$602.00	$602.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 PM Sacroiliac Joint Injection; bilat	$722.00	$722.00	$162.65–$722.00	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 20610-50 PM Knee Injection Bilateral	$865.00	$865.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 2061050 AMB Large joint injection bilateral	$865.00	$865.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 20610-50 PM Shoulder Injection Bilateral	$865.00	$865.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 20610-50 PM Bursa Injection Large Bilateral	$865.00	$865.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 PM Large Joint Injectiong; bilat	$865.00	$865.00	$162.65–$722.00	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 20610-50 PM Hip Injection Bilateral	$865.00	$865.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ MAJOR JNT/BURSA	$481.00	$481.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 AMB Sacroiliac joint injection POC	$481.00	$481.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PM sacroiliac joint injection	$481.00	$481.00	$162.65–$722.00	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PM large joint injection	$577.00	$577.00	$162.65–$722.00	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 AMB Large joint injection	$577.00	$577.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 PM Shoulder Injection	$577.00	$577.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Aspiration Body Site -> Knee	$577.00	$577.00	$268.56–$541.80	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 PM Knee Injection	$577.00	$577.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 PM Hip Injection	$577.00	$577.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 PM Bursa injection large	$577.00	$577.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ MAJOR JNT/BURSA 50	$865.00	$865.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 DRAIN/INJ MAJOR JNT/BURSA LT	$577.00	$577.00	$118.19–$548.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 DRAIN/INJ MAJOR JNT/BURSA RT	$577.00	$577.00	$118.19–$548.15	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 2060550 AMB Medium joint injection bilateral	$662.00	$662.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 20605-50 PM Wrist Injection Bilateral	$795.00	$795.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 20605-50 PM Ankle Injection Bilateral	$795.00	$795.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 20605-50 PM Bursa Injection Medium Bilateral	$795.00	$795.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 20605-50 PM Elbow Injection Bilateral	$795.00	$795.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 PM Medium Joint Injection; bilat	$795.00	$795.00	$410.96–$492.37	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 AMB Medium joint injection	$442.00	$442.00	$130.14–$497.67	29% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/JNT INTERM JNT/BURSA WND	$530.00	$530.00	$130.14–$497.67	15% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 PM Wrist Injection	$530.00	$530.00	$130.14–$497.67	15% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 PM Ankle Injection	$530.00	$530.00	$130.14–$497.67	15% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 PM Bursa Injection Medium	$530.00	$530.00	$130.14–$497.67	15% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PM medium joint injection	$530.00	$530.00	$410.96–$492.37	15% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 PM Elbow Injection	$530.00	$530.00	$130.14–$497.67	15% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ INTERM JNT/BURSA 50	$602.00	$602.00	$130.14–$497.67	4% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 DRAIN/INJ INTERM JNT/BURSA LT	$530.00	$530.00	$130.14–$497.67	15% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 DRAIN/INJ INTERM JNT/BURSA RT	$530.00	$530.00	$130.14–$497.67	15% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient both sides CPT 20605 2060550 AMB Medium joint injection bilateral	$662.00	$662.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient both sides CPT 20605 20605-50 PM Elbow Injection Bilateral	$795.00	$795.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient both sides CPT 20605 20605-50 PM Bursa Injection Medium Bilateral	$795.00	$795.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient both sides CPT 20605 20605-50 PM Ankle Injection Bilateral	$795.00	$795.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient both sides CPT 20605 PM Medium Joint Injection; bilat	$795.00	$795.00	$410.96–$492.37	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient both sides CPT 20605 20605-50 PM Wrist Injection Bilateral	$795.00	$795.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 AMB Medium joint injection	$442.00	$442.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 PM Wrist Injection	$530.00	$530.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 PM Ankle Injection	$530.00	$530.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 PM Bursa Injection Medium	$530.00	$530.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 PM Elbow Injection	$530.00	$530.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/JNT INTERM JNT/BURSA WND	$530.00	$530.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 PM medium joint injection	$530.00	$530.00	$410.96–$492.37	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ INTERM JNT/BURSA 50	$602.00	$602.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 DRAIN/INJ INTERM JNT/BURSA LT	$530.00	$530.00	$130.14–$497.67	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 DRAIN/INJ INTERM JNT/BURSA RT	$530.00	$530.00	$130.14–$497.67	—	—
Joint injection or drainage, small joint (fingers, toes) both sides CPT 20600 2060050 AMB Small joint injection bilateral	$406.00	$406.00	$119.01–$435.26	—	—
Joint injection or drainage, small joint (fingers, toes) both sides CPT 20600 20600-50 PM Bursa Injection Small Bilateral	$727.00	$727.00	$119.01–$435.26	—	—
Joint injection or drainage, small joint (fingers, toes) both sides CPT 20600 20600-50 PM Toe Injection Bilateral	$727.00	$727.00	$119.01–$435.26	—	—
Joint injection or drainage, small joint (fingers, toes) both sides CPT 20600 20600-50 PM Finger Injection Bilateral	$727.00	$727.00	$119.01–$435.26	—	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 AMB Small joint injection	$404.00	$404.00	$119.01–$435.26	18% below	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 PM Toe Injection	$484.00	$484.00	$119.01–$435.26	2% below	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 PM Finger Injection	$484.00	$484.00	$119.01–$435.26	2% below	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 PM Bursa Injection Small	$484.00	$484.00	$119.01–$435.26	2% below	—
Joint injection or drainage, small joint (fingers, toes) inpatient both sides CPT 20600 2060050 AMB Small joint injection bilateral	$406.00	$406.00	$119.01–$435.26	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient both sides CPT 20600 20600-50 PM Finger Injection Bilateral	$727.00	$727.00	$119.01–$435.26	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient both sides CPT 20600 20600-50 PM Toe Injection Bilateral	$727.00	$727.00	$119.01–$435.26	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient both sides CPT 20600 20600-50 PM Bursa Injection Small Bilateral	$727.00	$727.00	$119.01–$435.26	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 AMB Small joint injection	$404.00	$404.00	$119.01–$435.26	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 PM Bursa Injection Small	$484.00	$484.00	$119.01–$435.26	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 PM Finger Injection	$484.00	$484.00	$119.01–$435.26	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 PM Toe Injection	$484.00	$484.00	$119.01–$435.26	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Laceration Wound/2 Layer -> Scalp/Trunk/Extremity <2.5cm	$615.00	$615.00	$363.49–$382.17	10% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Laceration Wound/2 Layer -> Scalp/Trunk/Extremity <2.5cm	$615.00	$615.00	$363.49–$382.17	—	—
Lower-back epidural injection, with imaging guidance CPT 62323 62323 PM Caudal Epidural	$1,598.00	$1,598.00	$436.10–$1,518.10	20% below	—
Lower-back epidural injection, with imaging guidance CPT 62323 62323 PM Lumbar/Sacral Epidural Injection	$1,598.00	$1,598.00	$436.10–$1,518.10	20% below	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 62323 PM Caudal Epidural	$1,598.00	$1,598.00	$436.10–$1,518.10	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 62323 PM Lumbar/Sacral Epidural Injection	$1,598.00	$1,598.00	$436.10–$1,518.10	—	—
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 64483-50 PM Lumbar/Sacral Transforaminal Epidural Steroid Injection Bilateral	$3,322.00	$3,322.00	$520.16–$2,240.60	—	—
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 64483-50 PM Lumbar/Sacral Nerve Root Injection Bilateral	$3,322.00	$3,322.00	$520.16–$2,240.60	—	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 64483 PM Lumbar/Sacral Nerve Root Injection	$2,215.00	$2,215.00	$520.16–$2,240.60	7% above	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 64483 PM Lumbar/Sacral Transforaminal Epidural Steroid Injection	$2,215.00	$2,215.00	$520.16–$2,240.60	7% above	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 CT Injection Epidural Lumbar	$2,613.00	$2,613.00	$520.16–$2,240.60	27% above	—
Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 64483-50 PM Lumbar/Sacral Transforaminal Epidural Steroid Injection Bilateral	$3,322.00	$3,322.00	$520.16–$2,240.60	—	—
Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 64483-50 PM Lumbar/Sacral Nerve Root Injection Bilateral	$3,322.00	$3,322.00	$520.16–$2,240.60	—	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 64483 PM Lumbar/Sacral Transforaminal Epidural Steroid Injection	$2,215.00	$2,215.00	$520.16–$2,240.60	—	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 64483 PM Lumbar/Sacral Nerve Root Injection	$2,215.00	$2,215.00	$520.16–$2,240.60	—	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 CT Injection Epidural Lumbar	$2,613.00	$2,613.00	$520.16–$2,240.60	—	—
Nail removal (partial or complete), one nail CPT 11730 ED Procedure Performed -> Nail plate avulsion, single	$540.00	$540.00	$486.54–$507.06	69% above	—
Nail removal (partial or complete), one nail inpatient CPT 11730 ED Procedure Performed -> Nail plate avulsion, single	$540.00	$540.00	$486.54–$507.06	—	—
Occipital nerve block (injection for headaches) both sides CPT 64405 64405-50 PM Occipital Nerve Block Bilateral	$831.00	$831.00	$189.56–$274.49	—	—
Occipital nerve block (injection for headaches) both sides CPT 64405 PM Occipital Nerve Block; bilat	$831.00	$831.00	$390.16–$523.45	—	—
Occipital nerve block (injection for headaches) both sides CPT 64405 6440550 AMB Occipital nerve block bilat POC	$1,032.00	$1,032.00	$189.56–$274.49	—	—
Occipital nerve block (injection for headaches) CPT 64405 INJECTION AA&/STRD GREATER OCCIPITAL NERVE	$554.00	$554.00	$439.70–$520.21	41% below	—
Occipital nerve block (injection for headaches) CPT 64405 PM occipital nerve block	$554.00	$554.00	$390.16–$523.45	41% below	—
Occipital nerve block (injection for headaches) CPT 64405 64405 PM Occipital Nerve Block	$554.00	$554.00	$189.56–$274.49	41% below	—
Occipital nerve block (injection for headaches) CPT 64405 64405 AMB Occipital nerve block POC	$688.00	$688.00	$189.56–$274.49	27% below	—
Occipital nerve block (injection for headaches) inpatient both sides CPT 64405 64405-50 PM Occipital Nerve Block Bilateral	$831.00	$831.00	$189.56–$274.49	—	—
Occipital nerve block (injection for headaches) inpatient both sides CPT 64405 PM Occipital Nerve Block; bilat	$831.00	$831.00	$390.16–$523.45	—	—
Occipital nerve block (injection for headaches) inpatient both sides CPT 64405 6440550 AMB Occipital nerve block bilat POC	$1,032.00	$1,032.00	$189.56–$274.49	—	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 64405 PM Occipital Nerve Block	$554.00	$554.00	$189.56–$274.49	—	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 PM occipital nerve block	$554.00	$554.00	$390.16–$523.45	—	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION AA&/STRD GREATER OCCIPITAL NERVE	$554.00	$554.00	$439.70–$520.21	—	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 64405 AMB Occipital nerve block POC	$688.00	$688.00	$189.56–$274.49	—	—
Pacemaker implant (dual chamber) CPT 33208 INSERT HEART PM ATRIAL AND VEN	$17,332.00	$17,332.00	$8,500.58–$16,587.15	15% above	—
Pacemaker implant (dual chamber) CPT 33208 INSERTION OF A DUAL CHAMBER PACEMAKER	$17,332.00	$17,332.00	$8,500.58–$16,587.15	15% above	—
Pacemaker implant (dual chamber) inpatient CPT 33208 INSERT HEART PM ATRIAL AND VEN	$17,332.00	$17,332.00	$8,500.58–$16,587.15	—	—
Pacemaker implant (dual chamber) inpatient CPT 33208 INSERTION OF A DUAL CHAMBER PACEMAKER	$17,332.00	$17,332.00	$8,500.58–$16,587.15	—	—
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/ IMAGING	$1,864.00	$1,864.00	$573.12–$1,768.94	7% above	—
Paracentesis with imaging guidance CPT 49083 Assist Paracentesis with Imaging Charge -> Yes	$1,864.00	$1,864.00	$573.12–$1,768.94	7% above	—
Paracentesis with imaging guidance CPT 49083 CT Paracentesis	$1,864.00	$1,864.00	$573.12–$1,768.94	7% above	—
Paracentesis with imaging guidance CPT 49083 US Paracentesis	$1,864.00	$1,864.00	$573.12–$1,768.94	7% above	—
Paracentesis with imaging guidance inpatient CPT 49083 Assist Paracentesis with Imaging Charge -> Yes	$1,864.00	$1,864.00	$573.12–$1,768.94	—	—
Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis	$1,864.00	$1,864.00	$573.12–$1,768.94	—	—
Paracentesis with imaging guidance inpatient CPT 49083 CT Paracentesis	$1,864.00	$1,864.00	$573.12–$1,768.94	—	—
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/ IMAGING	$1,864.00	$1,864.00	$573.12–$1,768.94	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 ED Procedure Performed -> Nail and Nail Matrix, Excision	$575.00	$575.00	$534.18	26% below	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 ED Procedure Performed -> Nail and Nail Matrix, Excision	$575.00	$575.00	$534.18	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level both sides CPT 64635 64635-50 PM Lumbar Radiofrequency Ablation Bilateral	$5,003.00	$5,003.00	$503.45–$4,147.52	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 64635 PM Lumbar Radiofrequency Ablation Unilateral	$3,335.00	$3,335.00	$503.45–$4,147.52	3% above	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient both sides CPT 64635 64635-50 PM Lumbar Radiofrequency Ablation Bilateral	$5,003.00	$5,003.00	$503.45–$4,147.52	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 64635 PM Lumbar Radiofrequency Ablation Unilateral	$3,335.00	$3,335.00	$503.45–$4,147.52	—	—
Removal of a foreign object under the skin, simple CPT 10120 Foreign Body Removal Site -> Skin, Subcutaneous Simple FB	$885.00	$885.00	$193.04–$839.87	32% above	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 Foreign Body Removal Site -> Skin, Subcutaneous Simple FB	$885.00	$885.00	$193.04–$839.87	—	—
Short arm splint (forearm and hand) CPT 29125 Treatments Done -> Thumb spica splint applied	$468.00	$468.00	$67.03–$561.60	61% above	—
Short arm splint (forearm and hand) CPT 29125 Treatments Done -> Volar splint applied	$468.00	$468.00	$67.03–$561.60	61% above	—
Short arm splint (forearm and hand) CPT 29125 Orthopedic Splinting Site -> Short Arm Splinting	$468.00	$468.00	$67.03–$561.60	61% above	—
Short arm splint (forearm and hand) CPT 29125 Treatments Done -> Ulnar gutter splint applied	$468.00	$468.00	$67.03–$561.60	61% above	—
Short arm splint (forearm and hand) inpatient CPT 29125 Treatments Done -> Volar splint applied	$468.00	$468.00	$67.03–$561.60	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 Orthopedic Splinting Site -> Short Arm Splinting	$468.00	$468.00	$67.03–$561.60	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 Treatments Done -> Thumb spica splint applied	$468.00	$468.00	$67.03–$561.60	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 Treatments Done -> Ulnar gutter splint applied	$468.00	$468.00	$67.03–$561.60	—	—
Short leg cast (below the knee) CPT 29405 APPLY SH LEG CAST	$428.00	$428.00	$129.40	8% above	—
Short leg cast (below the knee) inpatient CPT 29405 APPLY SH LEG CAST	$428.00	$428.00	$129.40	—	—
Short leg splint (calf to foot) CPT 29515 Treatments Done -> Posterior short leg splint w/ stirrup applied	$387.00	$387.00	$64.13–$367.65	27% above	—
Short leg splint (calf to foot) CPT 29515 Treatments Done -> Posterior short leg splint applied	$387.00	$387.00	$64.13–$367.65	27% above	—
Short leg splint (calf to foot) CPT 29515 Orthopedic Splinting Site -> Short Leg Splinting	$387.00	$387.00	$64.13–$367.65	27% above	—
Short leg splint (calf to foot) inpatient CPT 29515 Treatments Done -> Posterior short leg splint applied	$387.00	$387.00	$64.13–$367.65	—	—
Short leg splint (calf to foot) inpatient CPT 29515 Treatments Done -> Posterior short leg splint w/ stirrup applied	$387.00	$387.00	$64.13–$367.65	—	—
Short leg splint (calf to foot) inpatient CPT 29515 Orthopedic Splinting Site -> Short Leg Splinting	$387.00	$387.00	$64.13–$367.65	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Laceration Wound/Simple -> Scalp/Neck/Trunk/Genital/Extrem, <2.5cm	$400.00	$400.00	$128.33–$400.00	21% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Laceration Wound/Simple -> Scalp/Neck/Trunk/Genital/Extrem, <2.5cm	$400.00	$400.00	$128.33–$400.00	—	—
Skin biopsy, punch, one lesion CPT 11104 11104 Punch bx of skin single lesion WND	$665.00	$665.00	$364.98–$624.44	48% above	—
Skin biopsy, punch, one lesion inpatient CPT 11104 11104 Punch bx of skin single lesion WND	$665.00	$665.00	$364.98–$624.44	—	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 ED Procedure Performed -> Lumbar Puncture	$1,193.00	$1,193.00	$671.26–$1,108.30	10% above	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 ED Procedure Performed -> Lumbar Puncture	$1,193.00	$1,193.00	$671.26–$1,108.30	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Laceration Wound/Simple -> Scalp/Neck/Trunk/Gen/Extr, 2.6-7.5cm	$450.00	$450.00	$144.38–$427.05	28% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Laceration Wound/Simple -> Scalp/Neck/Trunk/Gen/Extr, 2.6-7.5cm	$450.00	$450.00	$144.38–$427.05	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Laceration Wound/Simple -> Face/Ears/Eyelids/Nose/Lips, <2.5cm	$385.00	$385.00	$126.05–$365.37	21% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Laceration Wound/Simple -> Face/Ears/Eyelids/Nose/Lips, <2.5cm	$385.00	$385.00	$126.05–$365.37	—	—
Thoracentesis with imaging guidance both sides CPT 32555 Thoracentesis With Imaging Charge -> Yes, bilateral	$1,702.00	$1,702.00	$463.54–$1,065.77	—	—
Thoracentesis with imaging guidance CPT 32555 US Thoracentesis w/ Tube Placement	$1,135.00	$1,135.00	$463.54–$1,065.77	37% below	—
Thoracentesis with imaging guidance CPT 32555 US Thoracentesis	$1,135.00	$1,135.00	$463.54–$1,065.77	37% below	—
Thoracentesis with imaging guidance CPT 32555 CT Thoracentesis	$1,135.00	$1,135.00	$463.54–$1,065.77	37% below	—
Thoracentesis with imaging guidance one side CPT 32555 Thoracentesis With Imaging Charge -> Yes, unilateral (single)	$1,135.00	$1,135.00	$463.54–$1,065.77	37% below	—
Thoracentesis with imaging guidance inpatient both sides CPT 32555 Thoracentesis With Imaging Charge -> Yes, bilateral	$1,702.00	$1,702.00	$463.54–$1,065.77	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 CT Thoracentesis	$1,135.00	$1,135.00	$463.54–$1,065.77	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis	$1,135.00	$1,135.00	$463.54–$1,065.77	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis w/ Tube Placement	$1,135.00	$1,135.00	$463.54–$1,065.77	—	—
Thoracentesis with imaging guidance inpatient one side CPT 32555 Thoracentesis With Imaging Charge -> Yes, unilateral (single)	$1,135.00	$1,135.00	$463.54–$1,065.77	—	—
Trigger point injections, 1 or 2 muscles CPT 20552 PM trigger point injection (1-2 muscle groups)	$662.00	$662.00	$251.71–$268.56	5% below	—
Trigger point injections, 1 or 2 muscles CPT 20552 20552 PM Trigger Point Injection (1-2 Muscle Groups)	$662.00	$662.00	$268.56	5% below	—
Trigger point injections, 1 or 2 muscles CPT 20552 20552 PM Piriformis Injection	$662.00	$662.00	$268.56	5% below	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 PM Piriformis Injection	$662.00	$662.00	$268.56	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 PM trigger point injection (1-2 muscle groups)	$662.00	$662.00	$251.71–$268.56	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 PM Trigger Point Injection (1-2 Muscle Groups)	$662.00	$662.00	$268.56	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Biopsy Breast Right	$6,009.00	$6,009.00	$1,267.88–$11,133.78	80% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Biopsy Breast Lymph Node Right	$6,009.00	$6,009.00	$1,267.88–$11,133.78	80% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Biopsy Breast Left	$6,009.00	$6,009.00	$1,267.88–$11,133.78	80% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Biopsy Breast Lymph Node Left	$6,009.00	$6,009.00	$1,267.88–$11,133.78	80% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Biopsy Breast Lymph Node Right	$6,009.00	$6,009.00	$1,267.88–$11,133.78	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Biopsy Breast Left	$6,009.00	$6,009.00	$1,267.88–$11,133.78	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Biopsy Breast Right	$6,009.00	$6,009.00	$1,267.88–$11,133.78	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Biopsy Breast Lymph Node Left	$6,009.00	$6,009.00	$1,267.88–$11,133.78	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ED Debridement -> To subcutaneous tissue, < 20 sq cm	$672.00	$672.00	$148.36	14% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 DEB SUBQ TISSUE 20 SQ CM/< WND	$672.00	$672.00	$182.48–$631.01	14% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBQ TISSUE 20 SQ CM <	$672.00	$672.00	$146.92–$4,859.00	14% below	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 DEB SUBQ TISSUE 20 SQ CM/< WND	$672.00	$672.00	$182.48–$631.01	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 ED Debridement -> To subcutaneous tissue, < 20 sq cm	$672.00	$672.00	$148.36	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBQ TISSUE 20 SQ CM <	$672.00	$672.00	$146.92–$4,859.00	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration Charge	$727.00	$727.00	$235.27–$718.45	35% below	—
Blood transfusion (giving blood or blood components) CPT 36430 36430 Blood administration	$727.00	$727.00	$235.27–$718.45	35% below	—
Blood transfusion (giving blood or blood components) CPT 36430 Dialysis Charge -> DU BLOOD ADMIN	$727.00	$727.00	$235.27–$718.45	35% below	—
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration Charge -> Yes	$727.00	$727.00	$235.27–$718.45	35% below	—
Blood transfusion (giving blood or blood components) CPT 36430 INF 36430	$727.00	$727.00	$235.27–$718.45	35% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN CHARGE	$727.00	$727.00	$235.27–$718.45	35% below	—
Blood transfusion (giving blood or blood components) CPT 36430 ONC 36430	$727.00	$727.00	$235.27–$718.45	35% below	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 36430 Blood administration	$727.00	$727.00	$235.27–$718.45	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ONC 36430	$727.00	$727.00	$235.27–$718.45	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 INF 36430	$727.00	$727.00	$235.27–$718.45	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Charge -> Yes	$727.00	$727.00	$235.27–$718.45	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Charge	$727.00	$727.00	$235.27–$718.45	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Dialysis Charge -> DU BLOOD ADMIN	$727.00	$727.00	$235.27–$718.45	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN CHARGE	$727.00	$727.00	$235.27–$718.45	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Sputum Induction	$156.00	$156.00	$38.56–$295.68	12% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhaler Charge -> Initial	$308.00	$308.00	$38.56–$295.68	74% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$308.00	$308.00	$38.56–$295.68	74% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Charge -> In-line with Metaneb	$308.00	$308.00	$38.56–$295.68	74% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Charge -> Initial	$308.00	$308.00	$38.56–$295.68	74% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Charge -> Initial with Metaneb	$308.00	$308.00	$38.56–$295.68	74% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Metered Dose Inhaler Charge -> Inhaler Tx-initial	$308.00	$308.00	$38.56–$295.68	74% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Sputum Induction	$156.00	$156.00	$38.56–$295.68	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Metered Dose Inhaler Charge -> Inhaler Tx-initial	$308.00	$308.00	$38.56–$295.68	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Charge -> In-line with Metaneb	$308.00	$308.00	$38.56–$295.68	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Charge -> Initial with Metaneb	$308.00	$308.00	$38.56–$295.68	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Charge -> Initial	$308.00	$308.00	$38.56–$295.68	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Inhaler Charge -> Initial	$308.00	$308.00	$38.56–$295.68	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$308.00	$308.00	$38.56–$295.68	—	—
Chemotherapy IV infusion, first hour CPT 96413 INF 96413	$858.00	$858.00	$163.14–$880.56	13% above	—
Chemotherapy IV infusion, first hour CPT 96413 ONC 96413	$858.00	$858.00	$163.14–$880.56	13% above	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1ST DRUG UP TO 1 HR (16-90 MINUTES)	$858.00	$858.00	$163.14–$880.56	13% above	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 INF 96413	$858.00	$858.00	$163.14–$880.56	—	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 ONC 96413	$858.00	$858.00	$163.14–$880.56	—	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION 1ST DRUG UP TO 1 HR (16-90 MINUTES)	$858.00	$858.00	$163.14–$880.56	—	—
Critical care, first 30 to 74 minutes CPT 99291 99291 - Critical Care	$2,100.00	$2,100.00	$113.79–$2,060.20	29% below	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - Critical Care	$2,100.00	$2,100.00	$113.79–$2,060.20	—	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG	$500.00	$500.00	$245.00–$500.00	48% below	—
EEG (brain wave test), awake and drowsy, routine one side CPT 95816 EEG RT Charge -> Yes	$500.00	$500.00	$245.00–$500.00	48% below	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG	$500.00	$500.00	$245.00–$500.00	—	—
EEG (brain wave test), awake and drowsy, routine inpatient one side CPT 95816 EEG RT Charge -> Yes	$500.00	$500.00	$245.00–$500.00	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Time ECG Read Date and Time	$133.00	$133.00	$27.63–$180.31	28% below	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG 15-Lead Acquisition	$190.00	$190.00	$27.63–$180.31	3% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG 12-Lead Acquisition	$190.00	$190.00	$27.63–$180.31	3% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Time ECG Read Date and Time	$133.00	$133.00	$27.63–$180.31	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG 15-Lead Acquisition	$190.00	$190.00	$27.63–$180.31	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG 12-Lead Acquisition	$190.00	$190.00	$27.63–$180.31	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1	$150.00	$150.00	$47.19–$142.50	52% below	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1	$150.00	$150.00	$47.19–$142.50	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2	$350.00	$350.00	$94.52–$332.15	31% below	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2	$350.00	$350.00	$94.52–$332.15	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3	$750.00	$750.00	$110.54–$711.75	11% below	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3	$750.00	$750.00	$110.54–$711.75	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4	$1,200.00	$1,200.00	$108.84–$1,138.80	10% below	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4	$1,200.00	$1,200.00	$108.84–$1,138.80	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5	$1,800.00	$1,800.00	$175.03–$1,708.20	4% above	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5	$1,800.00	$1,800.00	$175.03–$1,708.20	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017 Add on Charge	$1,413.00	$1,413.00	$128.84–$1,427.30	57% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 CVSLR STRESS TEST; TRACING	$1,504.00	$1,504.00	$128.84–$1,427.30	68% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 Electrocardiogram Stress Exercise	$1,504.00	$1,504.00	$128.84–$1,427.30	68% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIO STRESS TEST	$1,504.00	$1,504.00	$128.84–$1,427.30	68% above	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Add on Charge	$1,413.00	$1,413.00	$128.84–$1,427.30	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CVSLR STRESS TEST; TRACING	$1,504.00	$1,504.00	$128.84–$1,427.30	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIO STRESS TEST	$1,504.00	$1,504.00	$128.84–$1,427.30	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Electrocardiogram Stress Exercise	$1,504.00	$1,504.00	$128.84–$1,427.30	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360- Hydration, first hour	$513.00	$513.00	$168.29–$487.35	23% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATN IV INF INIT 31-60 MINS WND	$513.00	$513.00	$41.36–$481.71	23% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Inf.Hydration Initial <1hr -> Yes	$513.00	$513.00	$41.36–$481.71	23% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ONC 96360	$513.00	$513.00	$41.36–$481.71	23% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INF 96360	$513.00	$513.00	$41.36–$481.71	23% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration IV Infusion Initial 31 minutes to 1 hour	$513.00	$513.00	$41.36–$481.71	23% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration IV Infusion Initial 31 minutes to 1 hour	$513.00	$513.00	$41.36–$481.71	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360- Hydration, first hour	$513.00	$513.00	$168.29–$487.35	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ONC 96360	$513.00	$513.00	$41.36–$481.71	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Inf.Hydration Initial <1hr -> Yes	$513.00	$513.00	$41.36–$481.71	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INF 96360	$513.00	$513.00	$41.36–$481.71	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATN IV INF INIT 31-60 MINS WND	$513.00	$513.00	$41.36–$481.71	—	—
IV infusion of a medicine, first hour CPT 96365 INF 96365	$681.00	$681.00	$182.16–$646.27	57% above	—
IV infusion of a medicine, first hour CPT 96365 IV INFUSION DRUG 1ST HOUR 16-90 MINUTES	$681.00	$681.00	$182.16–$646.27	57% above	—
IV infusion of a medicine, first hour CPT 96365 ONC 96365	$681.00	$681.00	$182.16–$646.27	57% above	—
IV infusion of a medicine, first hour CPT 96365 IV Thpy, Prophylaxis Initial <1hr -> Yes	$681.00	$681.00	$182.16–$646.27	57% above	—
IV infusion of a medicine, first hour CPT 96365 THR/POPH/DX IV INF INIT =<1 HR WND	$681.00	$681.00	$182.16–$646.27	57% above	—
IV infusion of a medicine, first hour CPT 96365 96365- IV tx, first hour	$681.00	$681.00	$182.16–$646.27	57% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 THR/POPH/DX IV INF INIT =<1 HR WND	$681.00	$681.00	$182.16–$646.27	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 INF 96365	$681.00	$681.00	$182.16–$646.27	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV Thpy, Prophylaxis Initial <1hr -> Yes	$681.00	$681.00	$182.16–$646.27	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION DRUG 1ST HOUR 16-90 MINUTES	$681.00	$681.00	$182.16–$646.27	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 96365- IV tx, first hour	$681.00	$681.00	$182.16–$646.27	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 ONC 96365	$681.00	$681.00	$182.16–$646.27	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372- Subq/IM Injection	$174.00	$174.00	$18.84–$174.00	23% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INF 96372 - Epogen	$174.00	$174.00	$22.66–$163.39	23% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PM SQ/IM injection by nurse	$174.00	$174.00	$22.66–$163.39	23% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM WND	$174.00	$174.00	$22.66–$163.39	23% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INF 96372	$174.00	$174.00	$22.66–$163.39	23% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SC Injection, Shots Only -> Yes	$174.00	$174.00	$22.66–$163.39	23% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ONC 96372 - Epogen	$174.00	$174.00	$22.66–$163.39	23% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ONC 96372	$174.00	$174.00	$22.66–$163.39	23% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 SQ/OR IM INJECTION THERAPEUTIC (EACH INJECTION)	$174.00	$174.00	$22.66–$163.39	23% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 THER/PROPH/DIAG INJECTION SM/SQ	$176.00	$176.00	$22.66–$163.39	24% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ONC 96372 - Epogen	$174.00	$174.00	$22.66–$163.39	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INF 96372 - Epogen	$174.00	$174.00	$22.66–$163.39	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ONC 96372	$174.00	$174.00	$22.66–$163.39	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 SQ/OR IM INJECTION THERAPEUTIC (EACH INJECTION)	$174.00	$174.00	$22.66–$163.39	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372- Subq/IM Injection	$174.00	$174.00	$18.84–$174.00	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INF 96372	$174.00	$174.00	$22.66–$163.39	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SC Injection, Shots Only -> Yes	$174.00	$174.00	$22.66–$163.39	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM WND	$174.00	$174.00	$22.66–$163.39	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PM SQ/IM injection by nurse	$174.00	$174.00	$22.66–$163.39	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 THER/PROPH/DIAG INJECTION SM/SQ	$176.00	$176.00	$22.66–$163.39	—	—
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED EA 15 MINS	$92.00	$92.00	$22.47–$217.14	14% below	—
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Units	$92.00	$92.00	$19.89–$92.00	14% below	—
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Units PTA	$92.00	$92.00	$19.89–$92.00	14% below	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Reeducation Units PTA	$92.00	$92.00	$19.89–$92.00	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED EA 15 MINS	$92.00	$92.00	$22.47–$217.14	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Reeducation Units	$92.00	$92.00	$19.89–$92.00	—	—
New patient office visit, about 30 minutes CPT 99203 Labor Check Charge -> New Pt Level 3	$120.00	$120.00	$16.05–$120.00	9% above	—
New patient office visit, about 30 minutes CPT 99203 OFFICE OP VISIT NEW LVL 3	$120.00	$120.00	$23.57–$120.00	9% above	—
New patient office visit, about 30 minutes CPT 99203 99203 New patient visit mod COVID Tent	$120.00	$120.00	$16.05–$120.00	9% above	—
New patient office visit, about 30 minutes CPT 99203 99203 AMB Office OP Visit New Lvl 3 Clinic 30 met or exceeded	$120.00	$120.00	$16.05–$120.00	9% above	—
New patient office visit, about 30 minutes CPT 99203 TC HOA Facility Charge NEW LVL 3	$120.00	$120.00	$16.05–$120.00	9% above	—
New patient office visit, about 30 minutes CPT 99203 99203- Clinic New Level 3	$120.00	$120.00	$16.05–$120.00	9% above	—
New patient office visit, about 30 minutes CPT 99203 TC SWC FACILITY CHARGE NEW LVL 3	$120.00	$120.00	$16.05–$120.00	9% above	—
New patient office visit, about 30 minutes CPT 99203 TC FACILITY CHARGE NEW LVL 3	$120.00	$120.00	$16.05–$120.00	9% above	—
New patient office visit, about 30 minutes CPT 99203 OFFICE OP VISIT NEW LVL 3 WND	$120.00	$120.00	$16.05–$120.00	9% above	—
New patient office visit, about 30 minutes CPT 99203 Swab Obtained -> Yes - New Patient	$120.00	$120.00	$16.05–$120.00	9% above	—
New patient office visit, about 30 minutes inpatient CPT 99203 TC FACILITY CHARGE NEW LVL 3	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 TC HOA Facility Charge NEW LVL 3	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 TC SWC FACILITY CHARGE NEW LVL 3	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE OP VISIT NEW LVL 3	$120.00	$120.00	$23.57–$120.00	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 99203 AMB Office OP Visit New Lvl 3 Clinic 30 met or exceeded	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 99203- Clinic New Level 3	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 99203 New patient visit mod COVID Tent	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 Labor Check Charge -> New Pt Level 3	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 Swab Obtained -> Yes - New Patient	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE OP VISIT NEW LVL 3 WND	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 45 minutes CPT 99204 OFFICE OP VISIT NEW LVL 4 WND	$120.00	$120.00	$16.05–$120.00	1% below	—
New patient office visit, about 45 minutes CPT 99204 OFFICE OP VISIT NEW LVL 4	$120.00	$120.00	$78.02–$120.00	1% below	—
New patient office visit, about 45 minutes CPT 99204 TC HOA Facility Charge NEW LVL 4	$120.00	$120.00	$16.05–$120.00	1% below	—
New patient office visit, about 45 minutes CPT 99204 Labor Check Charge -> New Pt Level 4	$120.00	$120.00	$16.05–$120.00	1% below	—
New patient office visit, about 45 minutes CPT 99204 99204- Clinic New Level 4	$120.00	$120.00	$78.02–$120.00	1% below	—
New patient office visit, about 45 minutes CPT 99204 TC FACILITY CHARGE NEW LVL 4	$120.00	$120.00	$16.05–$120.00	1% below	—
New patient office visit, about 45 minutes CPT 99204 99204 AMB New patient visit 45 min met or exceeded	$120.00	$120.00	$16.05–$120.00	1% below	—
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE OP VISIT NEW LVL 4 WND	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 Labor Check Charge -> New Pt Level 4	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 99204- Clinic New Level 4	$120.00	$120.00	$78.02–$120.00	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE OP VISIT NEW LVL 4	$120.00	$120.00	$78.02–$120.00	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 99204 AMB New patient visit 45 min met or exceeded	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 TC FACILITY CHARGE NEW LVL 4	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 TC HOA Facility Charge NEW LVL 4	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 60 minutes CPT 99205 OFFICE OP VISIT NEW LVL 5	$120.00	$120.00	$81.46–$120.00	31% below	—
New patient office visit, about 60 minutes CPT 99205 OFFICE OP VISIT NEW LVL 5 WND	$120.00	$120.00	$16.05–$120.00	31% below	—
New patient office visit, about 60 minutes CPT 99205 Labor Check Charge -> New Pt Level 5	$120.00	$120.00	$16.05–$120.00	31% below	—
New patient office visit, about 60 minutes CPT 99205 99205 AMB New patient visit 60 min met or exceeded	$120.00	$120.00	$16.05–$120.00	31% below	—
New patient office visit, about 60 minutes CPT 99205 99205- Clinic New Level 5	$120.00	$120.00	$16.05–$120.00	31% below	—
New patient office visit, about 60 minutes CPT 99205 TC HOA Facility Charge NEW LVL 5	$120.00	$120.00	$16.05–$120.00	31% below	—
New patient office visit, about 60 minutes CPT 99205 TC FACILITY CHARGE NEW LVL 5	$120.00	$120.00	$16.05–$120.00	31% below	—
New patient office visit, about 60 minutes inpatient CPT 99205 Labor Check Charge -> New Pt Level 5	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE OP VISIT NEW LVL 5 WND	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 99205- Clinic New Level 5	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 TC FACILITY CHARGE NEW LVL 5	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE OP VISIT NEW LVL 5	$120.00	$120.00	$81.46–$120.00	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 99205 AMB New patient visit 60 min met or exceeded	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 TC HOA Facility Charge NEW LVL 5	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE OP VISIT NEW LVL 2 CLINIC	$115.00	$115.00	$16.05–$120.00	18% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 TC FACILITY CHARGE NEW LVL 2	$115.00	$115.00	$16.05–$120.00	18% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Swab Obtained -> No - New patient	$120.00	$120.00	$16.05–$120.00	23% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Labor Check Charge -> New Pt Level 2	$120.00	$120.00	$16.05–$120.00	23% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 New patient visit min to mod COVID Tent	$120.00	$120.00	$16.05–$120.00	23% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Coumadin Clinic Initial Visit	$120.00	$120.00	$16.05–$120.00	23% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE OP VISIT NEW LVL 2	$120.00	$120.00	$81.42–$111.48	23% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202- Clinic New Level 2	$120.00	$120.00	$16.05–$120.00	23% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 TC HOA Facility Charge NEW LVL 2	$120.00	$120.00	$16.05–$120.00	23% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE OP VISIT NEW LVL 2 WND	$120.00	$120.00	$16.05–$120.00	23% above	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE OP VISIT NEW LVL 2 CLINIC	$115.00	$115.00	$16.05–$120.00	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 TC FACILITY CHARGE NEW LVL 2	$115.00	$115.00	$16.05–$120.00	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202- Clinic New Level 2	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Swab Obtained -> No - New patient	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 TC HOA Facility Charge NEW LVL 2	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 New patient visit min to mod COVID Tent	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Labor Check Charge -> New Pt Level 2	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Coumadin Clinic Initial Visit	$120.00	$120.00	$16.05–$120.00	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE OP VISIT NEW LVL 2	$120.00	$120.00	$81.42–$111.48	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE OP VISIT NEW LVL 2 WND	$120.00	$120.00	$16.05–$120.00	—	—
Occupational therapy evaluation, low complexity CPT 97165 OT Inpatient Evaluation Charge -> Yes	$169.00	$169.00	$94.08–$192.00	35% below	—
Occupational therapy evaluation, low complexity CPT 97165 OT Low Complexity Evaluation	$192.00	$192.00	$94.08–$192.00	26% below	—
Occupational therapy evaluation, low complexity CPT 97165 97165 Occupational therapy evaluation; low complexity	$192.00	$192.00	$62.86–$180.29	26% below	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Inpatient Evaluation Charge -> Yes	$169.00	$169.00	$94.08–$192.00	—	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Low Complexity Evaluation	$192.00	$192.00	$94.08–$192.00	—	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 97165 Occupational therapy evaluation; low complexity	$192.00	$192.00	$62.86–$180.29	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT High Complexity Evaluation	$192.00	$192.00	$72.83–$172.67	36% below	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 97163 Physical therapy evaluation; high complexity	$192.00	$192.00	$63.36–$180.29	36% below	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT High Complexity Evaluation	$192.00	$192.00	$72.83–$172.67	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 97163 Physical therapy evaluation; high complexity	$192.00	$192.00	$63.36–$180.29	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Low Complexity Evaluation -> Yes	$140.00	$140.00	$57.25–$140.00	46% below	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 97161 Physical therapy evaluation; low complexity	$168.00	$168.00	$55.00–$159.43	36% below	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Low Complexity Evaluation -> Yes	$140.00	$140.00	$57.25–$140.00	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 97161 Physical therapy evaluation; low complexity	$168.00	$168.00	$55.00–$159.43	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Mod Complexity Evaluation	$180.00	$180.00	$55.30–$169.20	35% below	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 97162 Physical therapy evaluation; moderate complexity	$180.00	$180.00	$49.11–$180.00	35% below	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 97162 Physical therapy evaluation; moderate complexity	$180.00	$180.00	$49.11–$180.00	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Mod Complexity Evaluation	$180.00	$180.00	$55.30–$169.20	—	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINS	$81.00	$81.00	$17.56–$76.06	25% below	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Charge Units	$81.00	$81.00	$17.56–$76.06	25% below	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY EA 15 MIN	$81.00	$81.00	$19.82–$81.00	25% below	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY EA 15 MIN	$81.00	$81.00	$19.82–$81.00	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINS	$81.00	$81.00	$17.56–$76.06	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy Charge Units	$81.00	$81.00	$17.56–$76.06	—	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN	$91.00	$91.00	$20.89–$253.62	21% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE EA 15 MIN	$91.00	$91.00	$20.22–$169.08	21% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise Charges	$91.00	$91.00	$19.58–$91.00	21% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise Charges PTA	$91.00	$91.00	$19.58–$91.00	21% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Charges	$91.00	$91.00	$20.89–$253.62	21% below	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercise Charges PTA	$91.00	$91.00	$19.58–$91.00	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Charges	$91.00	$91.00	$20.89–$253.62	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN	$91.00	$91.00	$20.89–$253.62	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercise Charges	$91.00	$91.00	$19.58–$91.00	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE EA 15 MIN	$91.00	$91.00	$20.22–$169.08	—	—
Psychotherapy for crisis, first 60 minutes CPT 90839 Behavioral Health Crisis Charges -> 90839: 0-74 minutes	$262.00	$262.00	$122.62–$248.90	16% below	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Behavioral Health Crisis Charges -> 90839: 0-74 minutes	$262.00	$262.00	$122.62–$248.90	—	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE OP VISIT EST LVL 5	$120.00	$120.00	$16.05–$120.00	29% below	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE OP VISIT EST LVL 5 WND	$120.00	$120.00	$16.05–$120.00	29% below	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 TC FACIILTY CHARGE EST LVL 5	$120.00	$120.00	$16.05–$120.00	29% below	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 TC HOA Facility Charge EST LVL 5	$120.00	$120.00	$16.05–$120.00	29% below	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215- Clinic Est Level 5	$120.00	$120.00	$16.05–$120.00	29% below	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE OP VISIT EST LVL 5 ED	$120.00	$120.00	$55.90–$120.00	29% below	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 AMB Established patient 40 min met or exceeded	$120.00	$120.00	$16.05–$120.00	29% below	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Labor Check Charge -> Est. Pt Level 5	$120.00	$120.00	$16.05–$120.00	29% below	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE OP VISIT EST LVL 5	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE OP VISIT EST LVL 5 WND	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE OP VISIT EST LVL 5 ED	$120.00	$120.00	$55.90–$120.00	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 TC FACIILTY CHARGE EST LVL 5	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Labor Check Charge -> Est. Pt Level 5	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 TC HOA Facility Charge EST LVL 5	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 AMB Established patient 40 min met or exceeded	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215- Clinic Est Level 5	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Labor Check Charge -> Est. Pt Level 3	$120.00	$120.00	$16.05–$120.00	4% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TC SWC FACILITY CHARGE EST LVL 3	$120.00	$120.00	$16.05–$120.00	4% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TC FACIILTY CHARGE EST LVL 3	$120.00	$120.00	$16.05–$120.00	4% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 AMB Established patient 20 min met or exceeded	$120.00	$120.00	$16.05–$120.00	4% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Established patient mod COVID Tent	$120.00	$120.00	$16.05–$120.00	4% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TC HOA Facility Charge EST LVL 3	$120.00	$120.00	$16.05–$120.00	4% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE OP VISIT EST LVL 3 WND	$120.00	$120.00	$16.05–$120.00	4% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Swab Obtained -> Yes - Established Patient	$120.00	$120.00	$16.05–$120.00	4% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213- Clinic Est Level 3	$120.00	$120.00	$16.05–$120.00	4% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE OP VISIT EST LVL 3	$120.00	$120.00	$16.05–$120.00	4% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE OP VISIT EST LVL 3 ED	$120.00	$120.00	$59.59–$120.00	4% above	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213- Clinic Est Level 3	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 Established patient mod COVID Tent	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Labor Check Charge -> Est. Pt Level 3	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Swab Obtained -> Yes - Established Patient	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE OP VISIT EST LVL 3	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE OP VISIT EST LVL 3 WND	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE OP VISIT EST LVL 3 ED	$120.00	$120.00	$59.59–$120.00	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 AMB Established patient 20 min met or exceeded	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TC SWC FACILITY CHARGE EST LVL 3	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TC HOA Facility Charge EST LVL 3	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TC FACIILTY CHARGE EST LVL 3	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE OP VISIT EST LVL 4 WND	$120.00	$120.00	$16.05–$120.00	12% below	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE OP VISIT EST LVL 4	$120.00	$120.00	$16.05–$120.00	12% below	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Labor Check Charge -> Est. Pt Level 4	$120.00	$120.00	$16.05–$120.00	12% below	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 AMB Established patient 30 min met or exceeded	$120.00	$120.00	$16.05–$120.00	12% below	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE OP VISIT EST LVL 4 ED	$120.00	$120.00	$38.74–$120.00	12% below	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214- Clinic Est Level 4	$120.00	$120.00	$38.74–$120.00	12% below	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TC HOA Facility Charge EST LVL 4	$120.00	$120.00	$16.05–$120.00	12% below	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TC FACIILTY CHARGE EST LVL 4	$120.00	$120.00	$16.05–$120.00	12% below	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE OP VISIT EST LVL 4 ED	$120.00	$120.00	$38.74–$120.00	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 TC FACIILTY CHARGE EST LVL 4	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 TC HOA Facility Charge EST LVL 4	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214- Clinic Est Level 4	$120.00	$120.00	$38.74–$120.00	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 AMB Established patient 30 min met or exceeded	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Labor Check Charge -> Est. Pt Level 4	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE OP VISIT EST LVL 4	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE OP VISIT EST LVL 4 WND	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Swab Obtained -> No - Estabilished Patient	$120.00	$120.00	$16.05–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Labor Check Charge -> Est. Pt Level 2	$120.00	$120.00	$16.05–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Established patient min to mod COVID Tent	$120.00	$120.00	$16.05–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Coumadin Clinic Follow-up visit	$120.00	$120.00	$16.05–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 AMB Established patient 10 min met or exceeded	$120.00	$120.00	$16.05–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TC HOA Facility Charge EST LVL 2	$120.00	$120.00	$16.05–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 XR Rad Visit Level 2	$120.00	$120.00	$16.05–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212- Clinic Est Level 2	$120.00	$120.00	$16.05–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE OP VISIT EST LVL 2 WND	$120.00	$120.00	$16.05–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TC FACIILTY CHARGE EST LVL 2	$120.00	$120.00	$16.05–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE OP VISIT EST LVL 2	$120.00	$120.00	$16.05–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE OP VISIT EST LVL 2 ED	$120.00	$120.00	$35.95–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99214 HOS E & M Medical Clearance	$120.00	$120.00	$35.95–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99213 HOS E & M Medical Clearance	$120.00	$120.00	$35.95–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 HOS E & M Medical Clearance	$120.00	$120.00	$16.05–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TC SWC FACILITY CHARGE EST LVL 2	$120.00	$120.00	$16.05–$120.00	23% above	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 TC SWC FACILITY CHARGE EST LVL 2	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 XR Rad Visit Level 2	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE OP VISIT EST LVL 2 WND	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 TC HOA Facility Charge EST LVL 2	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212- Clinic Est Level 2	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 TC FACIILTY CHARGE EST LVL 2	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE OP VISIT EST LVL 2 ED	$120.00	$120.00	$35.95–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 AMB Established patient 10 min met or exceeded	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Coumadin Clinic Follow-up visit	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Established patient min to mod COVID Tent	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Labor Check Charge -> Est. Pt Level 2	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Swab Obtained -> No - Estabilished Patient	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 HOS E & M Medical Clearance	$120.00	$120.00	$16.05–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99213 HOS E & M Medical Clearance	$120.00	$120.00	$35.95–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99214 HOS E & M Medical Clearance	$120.00	$120.00	$35.95–$120.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE OP VISIT EST LVL 2	$120.00	$120.00	$16.05–$120.00	—	—
Speech and language evaluation CPT 92523 ST acute speech sound lang comprehen -> Yes	$225.00	$225.00	$197.63–$213.73	32% below	—
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN	$270.00	$270.00	$83.15–$270.00	18% below	—
Speech and language evaluation inpatient CPT 92523 ST acute speech sound lang comprehen -> Yes	$225.00	$225.00	$197.63–$213.73	—	—
Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMPREHEN	$270.00	$270.00	$83.15–$270.00	—	—
Speech therapy session, individual CPT 92507 ST acute speech/hearing therapy indiv -> Yes	$153.00	$153.00	$70.79–$183.00	30% below	—
Speech therapy session, individual CPT 92507 SPEECH/HEARING THERAPY INDIV	$183.00	$183.00	$70.79–$183.00	16% below	—
Speech therapy session, individual inpatient CPT 92507 ST acute speech/hearing therapy indiv -> Yes	$153.00	$153.00	$70.79–$183.00	—	—
Speech therapy session, individual inpatient CPT 92507 SPEECH/HEARING THERAPY INDIV	$183.00	$183.00	$70.79–$183.00	—	—
Spirometry (breathing test) CPT 94010 Pulmonary Function Spirometry	$362.00	$362.00	$38.56–$520.00	17% above	—
Spirometry (breathing test) CPT 94010 PULMONARY SPIROMETRY	$520.00	$520.00	$38.56–$520.00	68% above	—
Spirometry (breathing test) CPT 94010 PULMONARY SPIROMETRY BEDSIDE	$520.00	$520.00	$38.56–$520.00	68% above	—
Spirometry (breathing test) one side CPT 94010 Pulmonary Spirometry RT Charge -> Yes	$520.00	$520.00	$38.56–$520.00	68% above	—
Spirometry (breathing test) one side CPT 94010 Pulmonary Spirometry Bedside RT Charge -> Yes	$520.00	$520.00	$38.56–$520.00	68% above	—
Spirometry (breathing test) inpatient CPT 94010 Pulmonary Function Spirometry	$362.00	$362.00	$38.56–$520.00	—	—
Spirometry (breathing test) inpatient CPT 94010 PULMONARY SPIROMETRY BEDSIDE	$520.00	$520.00	$38.56–$520.00	—	—
Spirometry (breathing test) inpatient CPT 94010 PULMONARY SPIROMETRY	$520.00	$520.00	$38.56–$520.00	—	—
Spirometry (breathing test) inpatient one side CPT 94010 Pulmonary Spirometry Bedside RT Charge -> Yes	$520.00	$520.00	$38.56–$520.00	—	—
Spirometry (breathing test) inpatient one side CPT 94010 Pulmonary Spirometry RT Charge -> Yes	$520.00	$520.00	$38.56–$520.00	—	—
Spirometry before and after a bronchodilator CPT 94060 PULMONARY FUNCTION COMPLETE	$813.00	$813.00	$75.20–$772.35	42% above	—
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM PRE & POST	$813.00	$813.00	$75.20–$772.35	42% above	—
Spirometry before and after a bronchodilator one side CPT 94060 Bronchospasm Pre and Post RT Charge -> Yes	$813.00	$813.00	$75.20–$772.35	42% above	—
Spirometry before and after a bronchodilator one side CPT 94060 Pulmonary Function Complete RT Charge -> Yes	$813.00	$813.00	$75.20–$772.35	42% above	—
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM PRE & POST	$813.00	$813.00	$75.20–$772.35	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 PULMONARY FUNCTION COMPLETE	$813.00	$813.00	$75.20–$772.35	—	—
Spirometry before and after a bronchodilator inpatient one side CPT 94060 Pulmonary Function Complete RT Charge -> Yes	$813.00	$813.00	$75.20–$772.35	—	—
Spirometry before and after a bronchodilator inpatient one side CPT 94060 Bronchospasm Pre and Post RT Charge -> Yes	$813.00	$813.00	$75.20–$772.35	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Charges	$81.00	$81.00	$27.68–$191.76	32% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACITIVYT DIR EA 15M	$81.00	$81.00	$27.68–$191.76	32% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charge PTA	$81.00	$81.00	$24.36–$76.87	32% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charge	$81.00	$81.00	$24.36–$76.87	32% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUT ACTIVITY DIR EA 15M	$81.00	$81.00	$24.36–$76.87	32% below	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUT ACTIVITY DIR EA 15M	$81.00	$81.00	$24.36–$76.87	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities Charge	$81.00	$81.00	$24.36–$76.87	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities Charge PTA	$81.00	$81.00	$24.36–$76.87	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACITIVYT DIR EA 15M	$81.00	$81.00	$27.68–$191.76	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Charges	$81.00	$81.00	$27.68–$191.76	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 ONC 99195	$243.00	$243.00	$44.33–$288.00	3% above	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic -> Yes	$243.00	$243.00	$44.33–$288.00	3% above	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 INF 99195	$243.00	$243.00	$44.33–$288.00	3% above	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy	$243.00	$243.00	$44.33–$288.00	3% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy	$243.00	$243.00	$44.33–$288.00	—	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic -> Yes	$243.00	$243.00	$44.33–$288.00	—	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 INF 99195	$243.00	$243.00	$44.33–$288.00	—	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 ONC 99195	$243.00	$243.00	$44.33–$288.00	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Rabies vaccine, one dose CPT 90675 rabies vaccine, purified chick embryo cell 2.5 intl units IM Inj	$732.16	$732.16	$236.78–$702.87	23% below	—
Rabies vaccine, one dose CPT 90675 rabies vaccine, human diploid cell 2.5 intl units IM Inj	$1,095.03	$1,095.03	$236.78–$702.87	15% above	—
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine, purified chick embryo cell 2.5 intl units IM Inj	$732.16	$732.16	$236.78–$702.87	—	—
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine, human diploid cell 2.5 intl units IM Inj	$1,095.03	$1,095.03	$236.78–$702.87	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2.5 units-18.5 mcg/0.5 mL - Boostrix	$332.80	$332.80	$11.87–$332.80	201% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL Sus	$332.80	$332.80	$11.87–$332.80	201% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL Sus	$332.80	$332.80	$11.87–$332.80	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2.5 units-18.5 mcg/0.5 mL - Boostrix	$332.80	$332.80	$11.87–$332.80	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ONC G0008	$102.00	$102.00	$20.28–$102.00	167% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INF G0009	$102.00	$102.00	$20.28–$102.00	167% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ONC G0009	$102.00	$102.00	$20.28–$102.00	167% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ONC G0010	$102.00	$102.00	$20.28–$102.00	167% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$102.00	$102.00	$20.28–$102.00	167% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Influenza admin	$102.00	$102.00	$20.28–$102.00	167% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ONC 90471	$102.00	$102.00	$20.28–$102.00	167% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 G0008 Medicare Flu admin	$102.00	$102.00	$20.28–$102.00	167% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INF G0010	$102.00	$102.00	$20.28–$102.00	167% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INF 90471	$102.00	$102.00	$20.28–$102.00	167% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Admin 1 Vaccine -> Yes	$102.00	$102.00	$20.28–$102.00	167% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1 VACCINE WND	$102.00	$102.00	$20.28–$102.00	167% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 TD INJECTION	$102.00	$102.00	$20.28–$102.00	167% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INF G0008	$102.00	$102.00	$20.28–$102.00	167% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ONC G0008	$102.00	$102.00	$20.28–$102.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INF G0008	$102.00	$102.00	$20.28–$102.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INF 90471	$102.00	$102.00	$20.28–$102.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 G0008 Medicare Flu admin	$102.00	$102.00	$20.28–$102.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 TD INJECTION	$102.00	$102.00	$20.28–$102.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$102.00	$102.00	$20.28–$102.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INF G0009	$102.00	$102.00	$20.28–$102.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INF G0010	$102.00	$102.00	$20.28–$102.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN 1 VACCINE WND	$102.00	$102.00	$20.28–$102.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ONC G0010	$102.00	$102.00	$20.28–$102.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization Admin 1 Vaccine -> Yes	$102.00	$102.00	$20.28–$102.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Influenza admin	$102.00	$102.00	$20.28–$102.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ONC 90471	$102.00	$102.00	$20.28–$102.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ONC G0009	$102.00	$102.00	$20.28–$102.00	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ONC 90472	$61.00	$61.00	$64.60	75% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Immunization admin each additional vaccine	$61.00	$61.00	$64.60	75% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization Admin 1 Each Additional Vaccine -> Yes	$61.00	$61.00	$64.60	75% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ONC 90772	$61.00	$61.00	$64.60	75% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Immunization admin each additional vaccine	$61.00	$61.00	$64.60	75% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INF 90472	$61.00	$61.00	$64.60	75% above	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ONC 90472	$61.00	$61.00	$64.60	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 Immunization admin each additional vaccine	$61.00	$61.00	$64.60	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 Immunization admin each additional vaccine	$61.00	$61.00	$64.60	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INF 90472	$61.00	$61.00	$64.60	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization Admin 1 Each Additional Vaccine -> Yes	$61.00	$61.00	$64.60	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ONC 90772	$61.00	$61.00	$64.60	—	—

Source file: https://hospitalpricetransparencyfiles.com/blanchard-valley-regional-health-center/341369963_Blanchard-Valley-Regional-Health-Center_standardcharges.csv